bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of an Impaired Maternal–Fetal Environment on Death in Children With Congenital Heart Defects Undergoing Surgery in Denmark From 1994 to 2018
Authors: Kristensen Rasmus , Omann Camilla , Ekelund Charlotte K. , Gaynor J. William , Hjortdal Vibeke E.
Published: March 2024

Background

Studies show that an impaired maternal–fetal environment (iMFE) increases the mortality risk in children with single‐ventricle congenital heart defects (CHDs). We investigated the impact of an iMFE on death in children with various surgically corrected CHDs.

Methods and Results

In this nationwide register‐based study, we examined the association between an iMFE (including preeclampsia, gestational hypertension, gestational diabetes, maternal smoking during pregnancy) and death in a large cohort of children with surgically corrected CHDs in Denmark (1994–2018). Survival analysis was done using Cox regression, adjusted for confounding and mediating covariates. The cohort included 3304 children: 1662 (50.3%) with minor CHD and 1642 (49.7%) with major CHD. Among them, 792 (24%) children were exposed to an iMFE. During the study, there were 290 deaths: 71 (9.3%) in children exposed to an iMFE and 219 (8.7%) in those unexposed.

There were no differences in mortality risk between children with CHD exposed to an iMFE and those unexposed (hazard ratio [HR], 1.12 [95% CI, 0.86–1.47];
P
=0.4). This was consistent across subgroups, including minor CHD (HR, 0.76 [95% CI, 0.39–1.47];
P
=0.4), major CHD (HR, 1.23 [95% CI, 0.92–1.64];
P
=0.2), and hypoplastic left heart syndrome/univentricular heart (HR, 1.08 [95% CI, 0.64–1.85];
P
=0.8).

Conclusions

Impairment of the maternal–fetal environment did not impact the mortality rate in children with CHD undergoing operation in Denmark from 1994 to 2018. We believe the cause of these discrepant findings to previous studies may be due to differences in the composition of CHD and prenatal maternal health care and health status of the population.
Representation of Real‐World Adults With Chronic Kidney Disease in Clinical Trials Supporting Blood Pressure Treatment Targets
Authors: Li June , An Jaejin , Huang Mengjiao , Zhou Mengnan , Montez‐Rath Maria E. , Niu Fang , Sim John J. , Pao Alan C. , Charu Vivek , Odden Michelle C. , Kurella Tamura Manjula
Published: March 2024

Background

Little is known about how well trial participants with chronic kidney disease (CKD) represent real‐world adults with CKD. We assessed the population representativeness of clinical trials supporting the 2021 Kidney Disease: Improving Global Outcomes blood pressure (BP) guidelines in real‐world adults with CKD.

Methods and Results

Using a cross‐sectional analysis, we identified patients with CKD who met the guideline definition of hypertension based on use of antihypertensive medications or sustained systolic BP ≥120 mm Hg in 2019 in the Veterans Affairs and Kaiser Permanente of Southern California. We applied the eligibility criteria from 3 BP target trials, SPRINT (Systolic Pressure Intervention Trial), ACCORD (Action to Control Cardiovascular Risk in Diabetes), and AASK (African American Study of Kidney Disease), to estimate the proportion of adults with a systolic BP above the guideline‐recommended target and the proportion who met eligibility criteria for ≥1 trial. We identified 503 480 adults in the Veterans Affairs and 73 412 adults in Kaiser Permanente of Southern California with CKD and hypertension in 2019. We estimated 79.7% in the Veterans Affairs and 87.3% in the Kaiser Permanente of Southern California populations had a systolic BP ≥120 mm Hg; only 23.8% [23.7%–24.0%] in the Veterans Affairs and 20.8% [20.5%–21.1%] in Kaiser Permanente of Southern California were trial‐eligible. Among trial‐ineligible patients, >50% met >1 exclusion criteria.

Conclusions

Major BP target trials were representative of fewer than 1 in 4 real‐world adults with CKD and hypertension. A large proportion of adults who are at risk for cardiovascular morbidity from hypertension and susceptible to adverse treatment effects lack relevant treatment information.
Statin Twitter: Human and Automated Bot Contributions, 2010 to 2022
Authors: Slavin Samuel D. , Berman Adam N. , Beam Andrew L. , Navar Ann Marie , Mittleman Murray A.
Published: March 2024

Background

Many individuals eligible for statin therapy decline treatment, often due to fear of adverse effects. Misinformation about statins is common and drives statin reluctance, but its prevalence on social media platforms, such as Twitter (now X) remains unclear. Social media bots are known to proliferate medical misinformation, but their involvement in statin‐related discourse is unknown. This study examined temporal trends in volume, author type (bot or human), and sentiment of statin‐related Twitter posts (tweets).

Methods and Results

We analyzed original tweets with statin‐related terms from 2010 to 2022 using a machine learning–derived classifier to determine the author's bot probability, natural language processing to assign each tweet a negative or positive sentiment, and manual qualitative analysis to identify statin skepticism in a random sample of all tweets and in highly influential tweets. We identified 1 155 735 original statin‐related tweets. Bots produced 333 689 (28.9%), humans produced 699 876 (60.6%), and intermediate probability accounts produced 104 966 (9.1%). Over time, the proportion of bot tweets decreased from 47.8% to 11.3%, and human tweets increased from 43.6% to 79.8%. The proportion of negative‐sentiment tweets increased from 27.8% to 43.4% for bots and 30.9% to 38.4% for humans. Manually coded statin skepticism increased from 8.0% to 19.0% for bots and from 26.0% to 40.0% for humans.

Conclusions

Over the past decade, humans have overtaken bots as generators of statin‐related content on Twitter. Negative sentiment and statin skepticism have increased across all user types. Twitter may be an important forum to combat statin‐related misinformation.
Risk Score for Prediction of Dialysis After Transcatheter Aortic Valve Replacement
Authors: Pasceri Vincenzo , Pelliccia Francesco , Mehran Roxana , Dangas George , Porto Italo , Radico Francesco , Biancari Fausto , D'Ascenzo Fabrizio , Saia Francesco , Luzi Giampaolo , Bedogni Francesco , Amat Santos Ignacio J. , De Marzo Vincenzo , Dimagli Arnaldo , Mäkikallio Timo , Stabile Eugenio , Blasco‐Turrión Sara , Testa Luca , Barbanti Marco , Tamburino Corrado , Fabiocchi Franco , Chilmeran Ahmed , Conrotto Federico , Costa Giuliano , Stefanini Giulio , Spaccarotella Carmen , Macchione Andrea , La Torre Michele , Bendandi Francesco , Juvonen Tatu , Wańha Wojciech , Wojakowski Wojtek , Benedetto Umberto , Indolfi Ciro , Hildick‐Smith David , Zimarino Marco
Published: March 2024

Background

Dialysis is a rare but serious complication after transcatheter aortic valve replacement. We analyzed the large multicenter TRITAVI (transfusion requirements in transcatheter aortic valve implantation) registry in order to develop and validate a clinical score assessing this risk.

Methods and Results

A total of 10 071 consecutive patients were enrolled in 19 European centers. Patients were randomly assigned (2:1) to a derivation and validation cohort. Two scores were developed, 1 including only preprocedural variables (TRITAVIpre) and 1 also including procedural variables (TRITAVIpost). In the 6714 patients of the derivation cohort (age 82±6 years, 48% men), preprocedural factors independently associated with dialysis and included in the TRITAVIpre score were male sex, diabetes, prior coronary artery bypass graft, anemia, nonfemoral access, and creatinine clearance <30 mL/min per m
2
. Additional independent predictors among procedural features were volume of contrast, need for transfusion, and major vascular complications. Both scores showed a good discrimination power for identifying risk for dialysis with C‐statistic 0.78 for TRITAVIpre and C‐statistic 0.88 for TRITAVIpost score. Need for dialysis increased from the lowest to the highest of 3 risk score groups (from 0.3% to 3.9% for TRITAVIpre score and from 0.1% to 6.2% for TRITAVIpost score). Analysis of the 3357 patients of the validation cohort (age 82±7 years, 48% men) confirmed the good discrimination power of both scores (C‐statistic 0.80 for TRITAVIpre and 0.81 for TRITAVIpost score). Need for dialysis was associated with a significant increase in 1‐year mortality (from 6.9% to 54.4%;
P
=0.0001).

Conclusions

A simple preprocedural clinical score can help predict the risk of dialysis after transcatheter aortic valve replacement.
Baseline Uric Acid Levels and Intravenous Thrombolysis Outcomes in Patients With Acute Ischemic Stroke: A Prospective Cohort Study
Authors: Zhang Peng , Wang Rui , Guo Zhen‐Ni , Jin Hang , Qu Yang , Zhen Qing , Yang Yi
Published: March 2024

Background

The study aimed to investigate the relationship between uric acid (UA) levels and functional outcomes at 3 months in patients with acute ischemic stroke (AIS) who underwent intravenous thrombolysis (IVT).

Methods and Results

This prospective cohort study included 1001 consecutive patients with AIS who underwent IVT. The correlation between UA levels and post‐IVT AIS outcomes was examined. Any nonlinear relationship was assessed using a restricted cubic spline function. The nonlinear
P
value for the association of UA levels with favorable (modified Rankin Scale [mRS] score ≤2) and excellent (mRS score ≤1) outcomes at 3 months post‐IVT were <0.001 and 0.001, respectively. However, for patients with and without hyperuricemia, no evident nonlinear relationship was observed between UA levels and favorable 3‐month post‐IVT outcomes, with nonlinear
P
values of 0.299 and 0.207, respectively. The corresponding interaction analysis yielded a
P
value of 0.001, indicating significant heterogeneity. Similar results were obtained for excellent outcomes at 3 months post‐IVT. In the hyperuricemia group, increased UA levels by 50 μmol/L reduced the odds of a favorable 3‐month post‐AIS outcome (odds ratio [OR], 0.75 [95% CI, 0.57–0.97]). Conversely, in the nonhyperuricemia group, a similar UA increase was linked to higher favorable outcome odds (OR, 1.31 [95% CI, 1.15–1.50]).

Conclusions

An inverted U‐shaped nonlinear relationship was observed between UA levels and favorable and excellent outcomes at 3 months in patients with AIS who underwent IVT. Higher UA levels predict favorable outcomes in patients without hyperuricemia but unfavorable outcomes in those with hyperuricemia.
RV1+RV3 Index to Differentiate Idiopathic Ventricular Arrhythmias Arising From Right Ventricular Outflow Tract and Aortic Sinus of Valsalva: A Multicenter Study
Authors: Chen Ning , Wang Lei , Jiao Jincheng , Ju Weizhu , Wang Zhe , Zou Cao , Yi Fu , Xiao Fangyi , Shen Wenzhi , Li Chengzong , Shi Linsheng , Chen Long , Ji Yuan , Wei Youquan , Gu Kai , Yang Gang , Chen Hongwu , Li Mingfang , Liu Hailei , Chen Minglong
Published: March 2024

Background

This study aimed to investigate the predictive value of parameters of every precordial lead and their combinations in differentiating between idiopathic ventricular arrhythmias (IVAs) from the right ventricular outflow tract and aortic sinus of Valsalva (ASV).

Methods and Results

Between March 1, 2018, and December 1, 2021, consecutive patients receiving successful ablation of right ventricular outflow tract or ASV IVAs were enrolled. The amplitude and duration of the R wave and S wave were measured in every precordial lead during IVAs. These parameters were either summed, subtracted, multiplied, or divided to create different indexes. The index with the highest area under the curve to predict ASV IVAs was developed, compared with established indexes, and validated in an independent prospective multicenter cohort. A total of 150 patients (60 men; mean age, 45.3±16.4 years) were included in the derivation cohort. The RV1+RV3 index (summed R‐wave amplitude in leads V1 and V3) had the highest area under the curve (0.942) among the established indexes. An RV1+RV3 index >1.3 mV could predict ASV IVAs with a sensitivity of 95% and a specificity of 83%. Its predictive performance was maintained in the validation cohort (N=109). In patients with V3 R/S transition, an RV1+RV3 index >1.3 mV could predict ASV IVAs, with an area under the curve of 0.892, 93% sensitivity, and 75% specificity.

Conclusions

The RV1+RV3 index is a simple and novel criterion that accurately differentiates between right ventricular outflow tract and ASV IVAs. Its performance outperformed established indexes, making it a valuable tool in clinical practice.
Shared Genetic Features of Psoriasis and Myocardial Infarction: Insights From a Weighted Gene Coexpression Network Analysis
Authors: Zhou Qiaoyu , Shi Ruizheng
Published: March 2024

Background

Increasing evidence suggests a higher propensity for acute myocardial infarction (MI) in patients with psoriasis. However, the shared mechanisms underlying this comorbidity in these patients remain unclear. This study aimed to explore the shared genetic features of psoriasis and MI and to identify potential biomarkers indicating their coexistence.

Methods and Results

Data sets obtained from the gene expression omnibus were examined using a weighted gene coexpression network analysis approach. Hub genes were identified using coexpression modules and validated in other data sets and through in vitro cellular experiments. Bioinformatics tools, including the Human microRNA Disease Database, StarBase, and miRNet databases, were used to construct a ceRNA network and predict potential regulatory mechanisms. By applying weighted gene coexpression network analysis, we identified 2 distinct modules that were significant for both MI and psoriasis. Inflammatory and immune pathways were highlighted by gene ontology enrichment analysis of the overlapping genes. Three pivotal genes—Src homology and collagen 1, disruptor of telomeric silencing 1‐like, and feline leukemia virus subgroup C cellular receptor family member 2—were identified as potential biomarkers. We constructed a ceRNA network that suggested the upstream regulatory roles of these genes in the coexistence of psoriasis and MI.

Conclusions

As potential therapeutic targets, Src homology and collagen 1, feline leukemia virus subgroup C cellular receptor family member 2, and disruptor of telomeric silencing 1‐like provide novel insights into the shared genetic features between psoriasis and MI. This study paves the way for future studies focusing on the prevention of MI in patients with psoriasis.
Return to Work After Refractory Out‐of‐Hospital Cardiac Arrest in Patients Managed With or Without Extracorporeal Cardiopulmonary Resuscitation: A Nationwide Register‐Based Study
Authors: Gregers Emilie , Kragholm Kristian , Linde Louise , Mørk Sivagowry Rasalingam , Andreasen Jo Bønding , Terkelsen Christian Juhl , Lassen Jens Flensted , Møller Jacob Eifer , Laugesen Helle , Smerup Morten , Kjærgaard Jesper , Møller‐Sørensen Peter Hasse , Holmvang Lene , Torp‐Pedersen Christian , Hassager Christian , Søholm Helle
Published: March 2024

Background

Extracorporeal cardiopulmonary resuscitation (ECPR) is increasingly used for refractory out‐of‐hospital cardiac arrest (OHCA). However, survivors managed with ECPR are at risk of poor functional status. The purpose of this study was to investigate return to work (RTW) after refractory OHCA.

Methods and Results

Of 44 360 patients with OHCA in the period of 2011 to 2020, this nationwide registry‐based study included 805 patients with refractory OHCA in the working age (18–65 years) who were employed before OHCA (2% of the total OHCA cohort). Demographics, prehospital characteristics, status at hospital arrival, employment status, and survival were retrieved through the Danish national registries. Sustainable RTW was defined as RTW for ≥6 months without any long sick leave relapses. Median follow‐up time was 4.1 years. ECPR and standard advanced cardiovascular life support were applied in 136 and 669 patients, respectively. RTW 1 year after OHCA was similar (39% versus 54%;
P
=0.2) and sustainable RTW was high in both survivors managed with ECPR and survivors managed with standard advanced cardiovascular life support (83% versus 85%;
P
>0.9). Younger age and shorter length of hospitalization were associated with RTW in multivariable Cox analysis, whereas ECPR was not.

Conclusions

In refractory OHCA‐patients employed prior to OHCA, approximately 1 out of 2 patients were employed after 1 year with no difference between patients treated with ECPR or standard advanced cardiovascular life support. Younger age and shorter length of hospitalization were associated with RTW while ECPR was not.
All That Heaven Allows
Authors: Noble Christopher Isaac
Published: March 2024

In the last book of The Consolation of Philosophy, Boethius develops his solution to the problem of divine foreknowledge and free choice. Interpreters standardly hold that this problem and his solution to it presuppose causal indeterminism. In this paper, I argue that Boethius, following a Neoplatonist view found in Proclus, is a causal determinist and compatibilist and maintains that God’s providential knowledge ensures the occurrence of all the events he knows. This alternative interpretation offers a better fit with Boethius’s text and its historical antecedents and provides resources to address the main criticisms of his solution.
‘Something Completely New in Art’
Authors: Whitehouse Deja
Published: March 2024

According to writer and poet Charles Cammell (1890–1968), Aleister Crowley (1875–1947) believed that through his influence and guidance, he could significantly improve an artist’s nascent abilities. Crowley claimed success for the musical achievements of Leila Waddell (1880–1932), the poetry of Victor Neuburg (1883–1940) and the artistic talents of Frieda, Lady Harris, née Bloxam (1877–1962). In 1938, Crowley invited Harris to illustrate The Book of Thoth, his last major magical work, designating her “artist executant.” Their partnership extended far beyond the requirements of the Thoth Tarot paintings: not only did Harris become Crowley’s magical pupil; they formed a strong and enduring friendship that lasted to the end of Crowley’s life. Harris had already achieved moderate success as an artist, but Crowley showed her how she could express esoteric concepts in her paintings, thereby creating “something completely new in art” (Harris to Crowley, Letter, 10 December 1940). Harris’s correspondence with Crowley shows that she eagerly embraced his guidance, determined to manifest the Tarot images in accordance with his vision. At the same time, she applied the same techniques to her own works and came to the realisation that art was the true basis of her spiritual path. Using extracts from Crowley’s and Harris’s correspondence, Crowley’s diary entries, and examples of Harris’s artwork, this article will argue that in the case of Frieda Harris, Crowley did indeed draw out her nascent artistic skills, and in doing so, enabled her to manifest Tarot designs, which on his own admission, “any given card is something beyond anything I had ever contemplated” (Crowley to Harris, Letter, 25 January 1939).
Creating Imaginative Pauses with Sin
Authors: Fleeson Nathan E.
Published: March 2024

Oscar Wilde and Paul Cadmus both utilize their art to renegotiate how we imagine our relationship to sin within Catholicism. This article draws attention to resonances between their approaches by presenting a Wildean queer theological aesthetic as a framework to interpret Cadmus’s art. A Wildean framework utilizes the excesses of both Catholicism and queerness as a foil for each other to create pauses for the imagination in a culture and religious tradition that risks falling into mechanization. In the space of that excess, we are allowed to escape the trap of existence to live as Individuals, claiming sin as an excess that offers an imaginative pause out of mere existence. Applied to Cadmus, a Wildean framework focuses on how Cadmus’s works also engages queer and Catholic excess to renegotiate Catholic guilt around the body and instead see the body and its sin as a site to know the Self.
“Vastness and Profundity”
Authors: Garton-Gundling Kyle
Published: March 2024

Scholars have often struggled to define the boundaries between sublime and religious experiences, but research tends to agree that sublimity is rational while religious experience is non-rational. However, this view receives a challenge from key texts in science fiction. In the texts I examine, contrary to prevailing views, sublimity turns mystical, while new religions become rational. Furthermore, religion and sublimity relate uneasily, as opposite poles that are distinct from but necessary to one another, with different texts emphasizing one while marginalizing, but not erasing, the other. I explore four authors, two of whom—Arthur C. Clarke and Liu Cixin—emphasize sublimity while relegating religion, while the other two—Robert A. Heinlein and Octavia E. Butler—focus on a fictional religion while subordinating the sublime. Taken together, these texts reveal the ambivalent interdependence of rational and non-rational states of mind in ways that could promote better understanding between religious and non-religious perspectives.
The Most Perfect Book in the World
Authors: Peters William
Published: March 2024

As initially published by Aleister Crowley (1875–1947) in 1909, his book 777 contained tables of correspondences between the Tarot, qabalistic Tree of Life, divine pantheons and other aspects of Western esotericism. Unsatisfied with the original edition, in 1925 he commissioned artist Oskar Hopfer (1892–1966) to produce diagrams to illustrate the correspondences contained in the tables. Unfortunately, no publisher was found to issue the revised work, and the project went unfulfilled. Hopfer’s original work for Crowley is no longer extant. His designs were considered lost until the recent discovery of set of the diagrams in a German museum. This discovery has shed light on Crowley’s plans for the revised edition of 777, his attempts to publish the work, and his belief in the power of the visual arts to communicate complex esoteric principles.
Astragaloside for Improving Diabetic Vasculopathy Based on Microalbuminuria and C-Reactive Protein
Authors: Ding Mei , Fang Shuping
Published: March 2024

Astragaloside has an ameliorative effect on diabetic vasculopathy. In this experiment, we investigated the role of astragaloside in improving diabetic vasculopathy. Eighty cases of type 2 diabetes mellitus (T2DM) patients with microalbuminuria (MAU) symptoms were selected and divided
into T2DM group, astragaloside group, astragaloside+SRI-011381 group and astragaloside+ LDN193189 group. Another 20 healthy check-ups were selected as control group. We detected the content of C-reactive protein (CRP), ankle-brachial index (ABI) for both lower limbs, ultrasound examination
of both lower limbs, and determined the vascular internal diameter (D), peak flow rate (Vmax), blood flow (Vol) of these three arteries, as well as grading the degree of lesion and scoring. T2DM group showed an increase in CRP level and UAlb content, decreased vessel internal
diameter, an increased peak flow rate, decreased blood flow and ABI index, and a higher incidence of arteriopathy, which were all reversed in the Astragaloside group. The incidence of arterial lesions was lower. Compared with astragaloside group, serum CRP level and urine albumin content were
increased in the astragaloside+SRI-011381 group, and serum CRP level and urine albumin content were decreased in the astragaloside+LDN193189 group. Moreover, inhibition of TGF-β/Smad pathway improved diabetic vasculopathy. Astragaloside therefore improves diabetic vasculopathy
and slows diseased progression by inhibiting TGF-β/Smad signaling, lowering CRP levels as well as urinary albumin levels, hindering vasoconstriction and increasing blood flow.
Possible Mechanism of Astragalus notoginseng Compound Glycosides Reversing Chemoresistance of Breast Cancer
Authors: Chen Xuedong , Zhang Ruixuan , Wang Yu , Wang Jiangbo , Huang Jun
Published: March 2024

Preoperative chemotherapy can help to downstage cancer, while postoperative chemotherapy can potentially reduce the risk of cancer recurrence or metastasis. However, as the number of chemotherapy sessions or drug dose increases, patients may develop different degrees of drug resistance.
Traditional Chinese Medicine (TCM) holds that the main cause of breast cancer formation and development is “qi stagnation and blood stasis”. Treatment can be initiated by invigorating qi and activating blood flow. Astragalus membranaceus and Panax notoginseng belong
to the traditional Chinese herbs used to promote qi and blood circulation. Astragaloside IV (AST IV) and Panax notoginseng saponins (PNS) are important active ingredients of TCM with cardiovascular and cerebrovascular effects, respectively. These compounds have various functions, including
tonifying qi and rising Yang, consolidating surface, reducing perspiration, benefiting water retention, reducing swelling, promoting body fluid, and nourishing blood. Through animal experiments, we found that the total compound of Astragalus notoginseng can effectively improve the inflammatory
state and hypoxia state of breast cancer xenografts in nude mice, as well as reduce tumor volume. These results suggest that astragalus and Panax notoginseng compound glycosides can reverse the chemoresistance to a certain extent. The effectiveness of astragaloside and Panax notoginseng
compound glycosides in reversing chemoresistance may be attributed to their active components, such as AST IV and PNS, which can regulate HIF-1α/MDR1, and improve the hypoxia of tumor cells. Therefore, this study suggests that Astragalus and Panax notoginseng compound glycosides
have potential value in the treatment of chemoresistance of breast cancer.
Design and Optimizing of Precision Seeder of Pinus sylvestris var. mongolica L. Bud-Seeds for Containerized Nursery Production
Authors: Miao Zhen-Kun , Li Zhi-Ru
Published: March 2024

Mongolian pine holds immense ecological and economic values as a vital biobased material. Its wood fiber, rosin and turpentine are important raw materials suitable for multiple industrial applications, it also exhibited soil and water conservation capabilities. To improve its
seeding efficiency, this study designed a precision seeding machine for Mongolian pine (Pinus sylvestris var. mongolica L.) bud-seeds, and optimized the technical seeding parameters, which utilized a combined vibration-air blowing fluidization device to overcome seed flowability
limitations and facilitate accurate seed selection. A particle model was established based on the seeds’ physical characteristics, and EDEM software was utilized to simulate the spatial distribution of seed particles under various seeding parameters through seeding experiments. The optimal
air pressure for the combined seed supply was approximately 0.24 kPa, with a frequency of 20 Hz and an amplitude of 5 mm, to obtain an optimal spatial distribution of the seed particles. The most effective seeding area for seed adhesion was determined to be 5–15 mm from the bottom of
the seeding plate. When the seed suction negative pressure is set to 6.7 kPa, with an upper hole diameter of 0.9 mm, a lower hole diameter of 3 mm, and a hole depth of 1.5 mm, the seedling emergence rate reached 89.06%, and the fastest emergence time was 2 days. One month after sowing, the
seedlings exhibited a height growth rate of 16.1%, and a ground diameter growth rate of 20.9%. This study demonstrates the effectiveness of the precision seeding machine and optimized parameters in achieving efficient and accurate sowing of Mongolian pine bud-seeds. This work provides
basic technical and data support for advancing the development and sustainable utilization of Mongolian pine as a vital biobased material resource.
Inhibition of Acute Myeloid Leukaemia Development by Bittersweet Based on miR-let-7a Regulating Vascular Endothelial Growth Factor A Resistance Mechanism
Authors: Guo Liying , Lu Ting , Wang Yulei , Zhou Chang
Published: March 2024

Acute myeloid leukaemia (AML) is closely related to regulation of miR-let-7a and vascular endothelial growth factor A (VEGFA). Picrasidine is a traditional Chinese medicine extract with antitumour effects, but its mechanism of action in AML is unclear. This study investigated picloram’s
effect on AML and its relationship with miR-let-7a regulation of VEGFA resistance mechanism. Bone marrow samples from leukaemia patients in the Department of Haematology of our hospital were collected, and RT-PCR detected miR-let-7a and VEGFA expression in the bone marrow of healthy individuals
and leukaemia patients. At the same time, cell culture of AML-resistant cell line K562/ADM was performed, which was divided into NC group, Picrasidine L group, Picrasidine M group, Picrasidine H group, si-NC group, Picrasidine H+miR-let-7a inhibitor group, Picrasidine H+miR-let-7a mimic group,
miR-let-7a mimic+hVEGF-IN-1 group, miR-let-7a inhibitor+hVEGF-IN-1 group, and Picrasidine H+miR-let-7a mimic+hVEGF-IN-1 group. Cell proliferation and apoptosis was detected and correlation between miR-let-7a and VEGFA was analyzed by clinical samples. Picrasidine had a significant ameliorative
effect on acute myeloid leukaemia in a dose-dependent manner. miR-let-7a was lowly expressed and VEGFA was highly expressed in AML patients. miR-let-7a and VEGFA showed significant correlation in human AML disease staging, and there was a statistically significant difference (p <0.05).
That is to say, picloram promotes miR-let-7a expression, thus achieving inhibition of VEGFA, which in turn promotes apoptosis of AML drug-resistant cell line K562/ADM and inhibits its proliferation. The ameliorative effect of Picrasidine on acute myeloid leukaemia was achieved by upregulating
miR-let-7a and downregulating VEGFA.
Effects of Trauma Center Consolidation on Adult Trauma at a Rural Level 1 Trauma Center
Authors: Heard Matthew A. , Bray Sheree , Archer Allen , O'Quinn Payton C. , Wheeler Hannah , Leonard Matthew , Burns J. Bracken
Published: March 2024

Objective

The aim was to determine the impact of consolidation of two rural level 1 trauma centers on adult trauma patients presenting to the remaining level 1 trauma center. To our knowledge, a study assessing the impact of trauma center consolidation on adult trauma patients had yet to be performed.

Methods

A single institution, retrospective study was conducted at a rural level 1 trauma center. Adult trauma patients who presented to our center from January 2017 to January 2022 were included. The cohorts spanned 33 months pre- and post-consolidation. Multiple demographic and outcome measures were gathered. Data were analyzed using the student’s t-test and Chi-squared testing.

Results

There was a 33% increase in overall trauma activations and 9% increase in transfers from outside facilities post-consolidation. The post-consolidation group was significantly older, had higher mean injury severity score, and decreased hospital-free days. The post-consolidation group also saw an increase in ICU admission and surgical intervention. While there were no significant differences in ICU-free days or ventilator days, patients in the post-consolidation group with the highest level of activation who required both surgical intervention and ICU admission experienced decreased mortality.

Conclusion

The consolidation of trauma services to a single level 1 trauma center in a rural Appalachian health system led to higher trauma volume and acuity, but most importantly decreased mortality for the most severely injured trauma patients.
Prevalence, Predictors, and Cross-Resistance of Community-Acquired Extended-Spectrum Beta-Lactamase–Producing Enterobacterales in Pediatric Urinary Tract Infections in Israel
Authors: Rizik Suha , Kassis Imad , Nasrallah Elias , Makhoul Nadeen , Dabaja-Younis Halima
Published: March 2024

This retrospective study evaluates the incidence and risk factors of community-acquired urinary tract infections (CA-UTIs) linked to extended-spectrum beta-lactamase–producing Enterobacterales (ESBLPE). The study was conducted in a tertiary hospital in northern Israel and included children younger than 18 years with CA-UTIs due to Enterobacterales who were admitted to the emergency department, during the years 2017 to 2019. Among the 570 children, 9.8% had ESBLPE-associated CA-UTIs. This prevalence remained steady over the study period. ESBLPE exhibited substantial resistance to amoxicillin/clavulanic acid (62.5% vs 20.4%, P < .001, odds ratio [OR] = 6.5), trimethoprim/sulfamethoxazole (58.9% vs 18%, P < .001, OR = 6.6), ciprofloxacin (33.9% vs 3.1%, P < .001, OR = 15.9), piperacillin/tazobactam (26.8% vs 7%, P < .001, OR = 4.9), and gentamicin (21.4% vs 4.3%, P < .001, OR = 6.1), compared with non-ESBLPE. Risk factors for ESBLPE-associated UTIs included recent antibiotic treatment within the past 3 months ( P = .003, OR = 3.5) and colonization with ESBLPE ( P < .001, OR = 12.8). Given the variable incidence of ESBLPE, relying on local epidemiology for antibiotic selection pending culture results is crucial. The study finding of a low ESBLPE incidence, coupled with global concerns regarding carbapenem resistance, supports cautious use of broad-spectrum antibiotics in nonsevere cases.
Book review: Uddipana Goswami, Conflict and Reconciliation: Politics of Ethnicity in Assam
Authors: Bharadwaj Kasturi
Published: March 2024

Uddipana Goswami, Conflict and Reconciliation: Politics of Ethnicity in Assam. India: Routledge, 2014, 223 pp., ₹695, ISBN 978-0-415-71113-5.
The Association of Levels of Mindfulness on the Cognitive Performance of Community-Dwelling, Low-Educated Older Adults From a Middle-Income Country
Authors: Pelegrini Lucas Nogueira de Carvalho , Monteiro Diana Quirino , Rodrigues Rosalina Aparecida Partezani
Published: March 2024

Limited information exists on the potential link between levels of mindfulness and cognitive performance in seniors with low education. This cross-sectional study aims to explore the association between mindfulness levels and cognitive performance in older adults with different years of education. Participants were grouped by education levels and assessed for cognitive performance (ACE-R; Digit Span test), levels of mindfulness (Langer Mindfulness Scale-21), and depressive symptoms (Geriatric Depression Scale-15). Group comparisons, correlations, and linear and logistic regression analyses were conducted ( p < .05). Cognitive performance, mindfulness levels, and depressive symptoms differed between groups, and correlations were found between mindfulness levels, ACE-R, and Digit Span scores. After controlling for education, the association between mindfulness levels and ACE-R performance remained significant. Logistic regression revealed that higher education and mindfulness levels increased the likelihood of scoring above the ACE-R cut-off. This study underscores the association between levels of mindfulness and cognitive performance in older adults.
Comprehensive investigation of recycled PVC powder
Authors: Chaouch Walid , Msahli Slah , Jeguirim Mejdi , Papamichael Iliana , Zorpas Antonis A
Published: March 2024

This study constitutes a comprehensive investigation centred on comprehending the behaviour and characteristics of recycled polyvinyl chloride (PVC) powders. The overarching objective is to successfully conclude the initial research phase, during which PVC-coated fabric offcuts undergo a transformation into PVC powder while achieving complete separation from polyethylene terephthalate fibres. The study entails a qualitative description of the morphology of PVC powder particles, employing an optical microscope to distinguish the diverse shapes exhibited by these particles. The optical microscope observations of PVC powder reveal a distinct array of non-spherical particles characterized by flat, elongated shapes. These high-magnification images unveil the intricate morphological features of the particles, highlighting their irregular shapes. Subsequently, a quantitative analysis of PVC particle size distribution is performed, comparing results from optical microscopy with those obtained through mechanical sieving. The qualitative and quantitative findings obtained provide robust evidence supporting the correlation and confirm that most particles are smaller than 600 µm (93.6%) using an optical microscope and the sieving process (96.39%). The greatest fraction (83.44%) is in the size range between 200 and 600 µm. Assessing flowability, another significant aspect in the evaluation of powders, provides insights into its behaviour and interparticle interactions. The flowability results indicate a Compressibility Index of approximately 26.84%, which suggests poor flowability. This means that the powder is likely to encounter difficulties in flowing freely. This finding is in line with the Hausner ratio, which measures 1.37. This investigation of recycled PVC powder will offer insights into the potential applications and processing considerations of this powder. More concretely, the use of recycled PVC powder shows promise as a viable alternative to conventional PVC resin in plastisol formulations, offering the potential to maintain the properties of the final PVC product without adverse effects.
Numerical simulation of temperature profile during laser cladding of nickel powder for in situ repairing
Authors: Raj Dhiraj , Das Bipul , Maity Saikat Ranjan
Published: March 2024

A 3-D Finite Element (FE) model was established to simulate the laser cladding of nickel powder for in situ repairing AISI 410 stainless steel. The temperature distribution field was estimated at six different points using low laser power of 450 W and a scanning speed of 2 mm/s. This study used a moving laser heat source in COMSOL to simulate the laser cladding process. The proposed FE model investigated the temperature field in two cases: (1) in situ repairing the defect by laser cladding without preheating and (2) in situ repairing the defect by laser cladding technique after preheating the cavity made on the substrate. A time-temperature profile was obtained after the simulation in both cases. The results of both cases were compared and analyzed. When the cladding material is poured into the preheated cavity, its temperature rises due to the heating effect obtained from the cavity, resulting in a higher maximum temperature after the cladding process. It was observed that after the cladding process, the maximum temperature was higher in the case of laser cladding after preheating the substrate (2400.49 K) compared to the maximum temperature in cladding without preheating the substrate (1770 K). Therefore, a molten pool is formed, solidifying rapidly to form a clad coating with better metallurgical bonding and enhanced surface properties.
Food Security in Rural Bangladesh: A Comparative Study of Scientific and Grassroots Perceptions
Authors: Shatil Tanvir , Islam M. Rezaul
Published: March 2024

The literature provides a comprehensive understanding of the scientific definition of food security in terms of its conceptual meaning, measurement and analysis. However, this definition contrasts significantly with the non-scientific or local understanding of food security. This article illustrates this disparity by examining the scientific definition and perception of food security in rural Bangladesh. Data was collected through qualitative research using focus group discussions and in-depth case interviews with smallholder farmers. The results reveal a significant difference between the scientific and local definitions of food security, with the latter being defined as having a sufficient supply of rice to last the entire year. Their food security is largely influenced by their socio-economic realities, coping strategies, and social networks, and the disparity in understanding of food security differs across the categories. This study highlights the importance of understanding the local perspective of food security for development practitioners, experts and policymakers, which has serious implications from a policy perspective.
The Price of Losing Autonomy: Assessing the Economic Impact of County-to-District Mergers in China
Authors: He Jianzi
Published: March 2024

Amalgamations in democratic settings often result in disadvantages for small and peripheral units, as their political power diminishes in the merged jurisdictions. This article extends the discussion to China by assessing the economic outcomes of county-level units after their conversion into districts directly controlled by city authorities. Leveraging a large county-year panel dataset and employing an advanced causal effect estimator, my analysis reveals a generally less optimistic outlook for these county-turned districts following the mergers. The negative impacts are initially evident in microeconomic indicators, especially in resident deposits, and later materialize in the long-term trajectories of macroeconomic indicators. Furthermore, heterogeneous analysis and a comparative case study in Hangzhou city link the problem to the loss of administrative autonomy. Notably, the negative impacts are less likely to manifest in county-turned districts that are under provincial protection and therefore maintain a certain degree of administrative autonomy after the mergers.
The effect of internal blinds on thermal comfort: An experimental analysis in an office room with radiant panels
Authors: Dogan Ahmet , Kayaci Nurullah , Demir Hakan
Published: March 2024

This study investigated the impact of two types of internal blinds on the indoor thermal environment of a highly glazed office room in Istanbul during summer. The research examined four configurations: (i) no blinds, (ii) roller blinds, (iii) layered roller blinds in night mode and (iv) layered roller blinds in day mode. Measurements of air velocity, average radiation temperature, air temperature and relative humidity were conducted to assess thermal comfort. The findings revealed that internal blinds significantly influence thermal comfort in radiantly cooled office spaces during summer. Without blinds, the indoor environment only met ISO 7730 comfort category C, with average predicted mean vote (PMV) and predicted percentage of dissatisfied (PPD) values of 0.6 and 12.5%, respectively. However, with internal blinds, comfort categories A and B were achieved, resulting in improved thermal comfort levels, with average PMV and PPD values ranging from 0.2 to 0.3 and 6% to 7.5%, respectively. Roller blinds, in particular, proved highly effective in enhancing thermal comfort and reducing mean radiant and indoor air temperatures in highly glazed radiant cooling offices. This demonstrated their energy-efficient potential for improving indoor thermal comfort.
Framing Automation and Human Error in the Context of the Skill, Rule and Knowledge Taxonomy
Authors: van Paassen Marinus M. (René) , Landman Annemarie , Borst Clark , Mulder Max
Published: March 2024

Automation errors may result in human performance issues that are often difficult to grasp. Skraaning and Jamieson (2023) proposed a taxonomy for classifying automation errors into categories based on the visible symptoms of design problems, so as to benefit the design of training scenarios. In this paper, we propose a complementary classification that is based on the mechanisms of human-automation interaction guided by Rasmussen’s Skill, Rule and Knowledge (SRK) taxonomy. We identified four main failure classes and expect that this classification can support automation designers.
A multi-criteria decision-making method for thermal insulation material selection in nZEB level questioned affordable multifamily housings
Authors: Yilmaz Burcu Çiğdem , Acun Özgünler Seden , Yilmaz Yiğit
Published: March 2024

An affordable multifamily housing building archetype project was researched to improve the building envelope’s thermo-physical performance based on thermal insulation configurations to optimize the energy use, life-cycle cost, environmental impact, and thermal comfort with questioning nZEB concept. Five thermal insulation materials as extruded polystyrene (XPS), expanded polystyrene (EPS), rockwool (RW), glass wool (GW), and cellular glass (CG), were studied with four> attribute variations (thermal comfort, density, embodied carbon, and embodied energy) and five thickness variations (0.04, 0.08, 0.12, 0.16, 0.20 m). A total of 100 alternative scenarios> were obtained for the decision-making process, with four performance criteria to be evaluated in terms of energy, cost, thermal comfort, and environmental impact. Equal weights method (EWM), weighted sum method (WSM), and analytical hierarchy process (AHP) were examined for the multi-criteria decision-making among 46 scenariosvel. The analysis beyond the cost-optimal energy efficiency level, which varies between 64.89 and 72.62 kWh/m2a for primary energy use with a potential 10% further reduction, ensures the European Commission’s recommendations that target 50–70 kWh/m2a of primary energy use for housings in the continental climate to achieve nZEB. The best scenarios cover significantly the XPS at the head due to lover investment costs, where RW, GW, and EPS are followed among the best 10 scenarios, respectively. Besides, AHP provides a more effective distribution of weighting factors than the WSM where the best scenarios of the AHP covers 12 cm thermal insulation alternatives by balancing the investment costs and energy efficiency levels. The paper provides insight into thermal insulation material selection while searching for the advantages and priorities of thermal insulation materials’ attributes beyond the cost-optimal energy efficiency level to reach the nZEB range.
Modified elastic intramedullary nail internal fixation for distal tibial metaphyseal junction fracture
Authors: Liu Wanlin , Zhao Zhenqun , Bai Rui , Meng Chenyang
Published: March 2024

Objective:

To investigate the application of modified elastic intramedullary nail and the outcomes between modified elastic stable intramedullary nailing and traditional elastic stable intramedullary nailing in children with distal tibial metaphyseal junction fracture.

Methods:

A retrospective study was conducted. From January 2018 to January 2021, a total of 36 children with distal tibial metaphyseal junction fracture were treated in our hospital. All of them were treated with closed reduction and elastic stable intramedullary nailing internal fixation. A total of 18 children were treated by modified elastic stable intramedullary nailing and 18 children were treated by traditional elastic stable intramedullary nailing. Postoperative imaging, clinical efficacy, and complications were analyzed.

Results:

The mean follow-up time was 20 (15–36) months in modified group and 22 (16–33) months in traditional group. There were no complications such as infection, loss of reduction, and unequal length of lower limbs in modified group while loss of reduction occurred in two cases in traditional group. In these two cases of loss of reduction, we preformed manual reduction and replacement of long leg casts, and there was no loss of reduction, and the patient achieved a good prognosis. In the last follow-up, American Orthopaedic Foot & Ankle Society score was used. In modified group, excellent outcome achieved in 17 cases, good outcome achieved in 1 case, and satisfactory therapeutic effect was achieved. In traditional elastic stable intramedullary nailing group, excellent outcome achieved in 14 cases, and good outcome achieved in 4 cases. There was no statistical difference in the scores between the two groups.

Conclusion:

It was concluded that modified elastic stable intramedullary nailing fixation is a safe and effective treatment.