bluuebunny/crossref_metadata_2025 huggingface dataset:
A rolling bearing fault signal denoising algorithm that combines a new adaptive information entropy with a new wavelet threshold function
Authors: Li Min , Li Xuemei , Liu Bin , Lv Shangsong , Liu Chengjie
Published: October 2024

Mechanical fault diagnosis is of great significance to industrial automation, and extracting vibration fault signals is one of the important tasks in mechanical health monitoring and fault diagnosis. However, due to the complex working environment of rolling bearings, a large amount of noise makes it difficult to extract vibration fault signals. Denoising the vibration signal of bearings can remove interference noise, simplify the early identification of signal features, and thus improve diagnostic accuracy and mechanical maintenance efficiency. This paper proposes a rolling bearing fault signal denoising algorithm, which constructs a new feature extraction and denoising function. This method first decomposes the noisy signal into Intrinsic Mode Functions (IMFs) by Intrinsic Computing Expressive Empirical Mode Decomposition with Adaptive Noise (ICEEMDAN). Secondly, a new adaptive information entropy threshold function is constructed to extract the noisy IMFs from it. Then, the noisy IMF signal is denoised by a new wavelet threshold function. Finally, the noise-free IMFs are reconstructed to reconstruct the denoised signal. To verify the actual performance of the algorithm, comparative experiments were conducted on a self-collected dataset and a public dataset, the results show that this method improves the continuity of signal reconstruction and can remove various types of vibration fault noise signals more effectively and accurately, thereby improving the fault detection accuracy by 2%–9%.
A generalized framework for identification and geometrical feature extraction of circular and polygonal shaped prisms
Authors: Vala Rushiraj , Chauhan Mihir , Sanghvi Harshal A , Hashemi Javad , Pandya Abhijit
Published: October 2024

This paper introduces a versatile framework crucial for robotic applications such as object manipulation, mobile robot navigation, and pole climbing. It addresses the identification of geometric shapes and dimensions of diverse objects found in varied environments. The proposed method utilizes LiDAR scanning to capture objects from different angles, generating point clouds merged through transformations and superimpositions. After filtering and slicing, intersections are isolated and projected onto a chosen datum plane. The framework employs Non-Linear Least Square fitting via Gauss Newton iterative approach, utilizing pseudo-inverse Jacobian of a hypotrochoid to approximate polygons. The algorithm consecutively fits polygon prisms, determining the best fit with the least norm of error. Results indicate an average least square error of less than 9% for radius fitting and a high f-score for shape identification.
Automated design of digital filters using convolutional neural networks for extracting ringdown gravitational waves
Authors: Sakai Kazuki , Odonchimed Sodtavilan , Takano Mitsuki , Takahashi Hirotaka
Published: October 2024

The observation of gravitational waves is expected to allow new tests of general relativity to be performed. As the gravitational wave signal is hidden by detector noise in observed data, a method to reduce noise is required to analyze the ringdown phase of gravitational wave signals. Recently, some noise reduction methods based on a neural network have been proposed; however, the results of these methods must be considered with caution because the output can contain spurious components. To overcome this limitation, in this study, we developed a neural network–based method to design optimal digital filters for extracting ringdown gravitational wave signals. In this method, no spurious components appear in the output because the digital filters reduce the noise. We conducted simulations with waveforms of gravitational waves from binary black hole coalescence and confirmed that the proposed method designs appropriate filters that reduce detector noise.
Green Foreign Energy Policy
Authors: Prontera Andrea
Published: October 2024

This chapter presents the analytical framework adopted in this book to analyse, compare, and explain the green foreign energy policies of the major international actors. It highlights the building blocks of green foreign energy policy and its differences from fossil fuel foreign energy policy before illustrating the main drivers of green foreign energy policy, the issue areas in which it can be analytically organized and empirically mapped, and the tools of statecraft that governments can deploy to achieve their objectives in this field. A four-dimensional matrix comprising an issue areas dimension, a tools dimension, a mode of engagement dimension, and a geographical dimension is developed for the study of green foreign energy policies. The chapter also discusses the internal–external nexus and the role of state–market relations in this field. Finally, it illustrates the green power strategies that major international actors can pursue in the context of the global energy transition.
The European Union
Authors: Prontera Andrea
Published: October 2024

This chapter analyses the green foreign energy policy and green power strategy of the EU. First, it explains how climate and technological sovereignty priorities have emerged in Europe, prompting a greening of the EU regulatory state and a shift towards a catalytic state. These processes intensified under the Juncker Commission and subsequent von der Leyen Commission; the latter, with the European Green Deal, has placed the energy transition at the centre of EU internal and external action. Moreover, the chapter illustrates the further innovations introduced after the Covid-19 crisis and the Russian invasion of Ukraine amid a deterioration of the international landscape and growing competition with China. These developments have produced an overall greening of the EU external action, although its green power strategy must still face important constraints that limit its ability to act as a leader in the emerging low-carbon world.
The United States
Authors: Prontera Andrea
Published: October 2024

This chapter analyses the US green foreign energy policy and green power strategy. First, it illustrates the evolution of the US renewable energy and green industrial policies, highlighting the challenges that they encounter amid the growing politicization of climate issues. The chapter then illustrates the development of the US green internal and external approaches under Obama and Trump. Trump sought to dismantle many of the innovations introduced by Obama; however, the US renewable energy complex resisted those changes. Moreover, because of the growing rivalry with China, important innovations continued to materialize, even during the Trump administration. Finally, the chapter illustrates the recent major shift under Biden—the US has increased its domestic and international efforts to regain a leadership position in the global energy transition. This is being accomplished through an economic green power strategy that is coordinated with the US global military posture and involves US allies and partners.
Pharmacotherapy of acute ST-elevation myocardial infarction and the pharmacist’s role, part 1: Patient presentation through revascularization
Authors: Hyland Sara J , Eaton Rachael E , Max Marion E , Egbert Susan B , Wong Stephanie A , Blais Danielle M
Published: October 2024

Purpose

Key pharmacotherapeutic modalities and considerations for the patient with ST-elevation myocardial infarction (STEMI) across the critical initial phases of care are reviewed.

Despite established value in the emergency department (ED), cardiac care, and intensive care settings, there is currently little published literature describing or supporting clinical pharmacist roles in the acute management of STEMI. The high-risk period from hospital presentation through revascularization and stabilization involves complex pharmacotherapeutic decision points, many operational medication needs, and multiple layers of quality oversight. While rife with opportunities for pharmacists to optimize care, this timeframe appears inconsistently targeted by clinical pharmacy services, which may halt after ED evaluation and then resume upon postcatheterization cardiac unit admission. Herein we review the key pharmacotherapeutic modalities and considerations for the patient with STEMI across the critical initial phases of care. These include supportive therapies prior to revascularization, the host of antithrombotics involved in revascularization by percutaneous coronary intervention and/or fibrinolysis, and other periprocedural medications. Important practice guidelines and clinical resources are summarized from the clinical pharmacist perspective, and roles and responsibilities of the responding pharmacist are suggested. A companion article will extend the review to periprocedural adverse event management, key early decision-making regarding long-term risk reduction, and pharmacist involvement in institutional quality improvement efforts. We aim to support inpatient pharmacy departments in advancing clinical services for this critical patient population, and we call for further research delineating pharmacist impact on patient and institutional STEMI outcomes.

Conclusion

Patients presenting with STEMI rapidly traverse multiple phases of care and receive a host of antithrombotic and supportive medications during acute management, presenting many important pharmacotherapeutic decision points and roles for pharmacists.
Large-volume intravenous fluid use before and after implementation of a fluid conservation strategy
Authors: Carr John , Orvin Dustin
Published: October 2024

Purpose

We describe the implementation of a fluid conservation strategy in a 2-hospital community health system and its effects on utilization of 1,000-mL bags of 0.9% sodium chloride and lactated Ringer’s solution.

Disruptions to medical supply chains are unpredictable and can cause significant impacts on patient care. A fluid conservation strategy including guidance statements and mandatory order modifications in a 2-hospital community health system was associated with decreases in the use of 1,000-mL bags of 0.9% sodium chloride and lactated Ringer’s solutions of 52% and 39%, respectively, compared with the utilization rates over the prior year.

Conclusion

Institutions facing shortages should consider multidisciplinary strategies with trackable metrics when faced with supply chain disruptions.
Expanding phenotypic insights of palmoplantar keratodermas based on novel FAM83G variants
Authors: van Gisbergen Marike W , Rossel S Vanya J , Theunissen Tom E J , Janssen Renske , Kaseke Tariraishe , van der Smagt Jasper J , Steijlen Peter M , Vreeburg Maaike , Gostynski Antoni H , van Geel Michel
Published: October 2024

We report two unrelated patients with new pathogenic variants in the FAM83G gene, supporting the causal link to previously identified families with recessive hereditary palmoplantar keratoderma. Although structural changes of the hairs are a key feature of FAM83G-associated disease, a complete loss of the gene, seen in one of the patients, shows normal hair and does not support this part of the clinical phenotype.
Polylactic acid-based dressing with oxygen generation and enzyme-like activity for accelerating both light-driven biofilm elimination and wound healing
Authors: Wen Tianci , Xiong Shilang , Zhao Huihui , Wang Junzhe , Wang Chunming , Long Zhisheng , Xiong Long , Qian Guowen
Published: October 2024

Background

Photodynamic therapy (PDT) is a widely used therapeutic approach for eradicating bacterial biofilms in infected wound, but its effectiveness is limited by the hypoxic environment within the biofilm. This study aimed to investigate whether the efficiency of photodynamic removing biofilm is improving by providing oxygen (O2), as well as the expression of cytokines involved in infected wound healing.

Methods

Manganese dioxide (MnO2) nanoparticles with catalase-like activity were grown in situ on graphitic phase carbon nitride (g-C3N4, CN) nanosheets to construct an all-in-one CN-MnO2 nanozyme, which was then incorporated into poly-L-lactic acid (PLLA) to prepare CN-MnO2/PLLA wound dressing by electrospinning. Subsequently, the in vitro antibacterial biofilm ratio and antibacterial ratio of CN-MnO2/PLLA wound dressing were examined by spread plate and crystal violet staining under irradiation with 808 nm near-infrared light and 660 nm visible light. Meanwhile, the rat skin injury model was established, and hematoxylin and eosin (H&E), Masson’s, tumor necrosis factor-α (TNF-α), Arginase 1 (Arg-1), vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (BFGF) were evaluated in vivo to assess the effect of CN-MnO2/PLLA wound dressing on wound healing.

Results

Biofilm density caused by Staphylococcus aureus and Pseudomonas aeruginosa had elimination rates of 83 and 62%, respectively, when treated with CN-MnO2/PLLA dressing. Additionally, the dressing exhibited high antibacterial efficacy against both bacteria, achieving 99 and 98.7% elimination of Staphylococcus aureus and Pseudomonas aeruginosa, respectively. Furthermore, in vivo experiments showed that the CN-MnO2/PLLA wound dressing achieved complete healing of infected wounds on Day 14, with a wound healing rate of >99% by increasing collagen deposition, expression of anti-inflammatory cytokine Arg-1, vascularization cytokine VEGF, and epithelial cell BFGF, and inhibiting the expression of inflammatory cytokine TNF-α.

Conclusions

The CN-MnO2/PLLA wound dressing exhibited excellent antibacterial properties in vitro and in vivo. In addition, CN-MnO2/PLLA wound dressing accelerated rapid wound healing through an anti-inflammatory, pro-vascular regeneration and skin tissue remodeling mechanism.
Cutaneous melanoma in situ: a review
Authors: Karponis Dimitrios , Joshy Jilse , Stratigos Ioannis A , Craig Paul J , Mistry Khaylen , van Bodegraven Birgitta , Venables Zoe C , Levell Nick J
Published: October 2024

Cutaneous melanoma in situ (MIS), also known as ‘stage 0 melanoma’, is a collection of malignant melanocytes in the epidermis and epithelial adnexa, without evidence of microinvasion to the papillary dermis. Distinct histological subtypes include lentigo maligna (LM), superficial spreading (SS) MIS and acral lentiginous (AL) MIS. LM is the most common subtype, usually diagnosed later in life (median age at diagnosis of 66–72 years) and associated with cumulative ultraviolet radiation exposure. SS MIS is associated with intense episodes of sun exposure and is more common on the trunk and extremities. AL MIS is seen in nonhair-bearing skin. AL MIS, although rare (0.6% of MIS in England), is found in a higher proportion in more pigmented skin types compared with other MIS subtypes. Most international studies between 1990 and 2019 report rising incidence for MIS. US data show a decline in the incidence of LM between 2015 and 2019. For 2013–2019 in England, the recorded incidence of LM is plateauing, whereas that of other MIS is rising. Definitive diagnosis of MIS is by histological examination of biopsied skin with immunohistochemistry but can be supported with dermoscopy and reflectance confocal microscopy. Surgical treatment (excision or Mohs micrographic surgery) is the gold standard. Depending on MIS subtype, other options such as cryotherapy, topical imiquimod, radiotherapy or watchful waiting may be appropriate. The latest 5-year net-survival rates in England between 2013 and 2015 are 98.6% for AL MIS and exceed 100% for all other MIS. This review summarizes the aetiology, pathogenesis, epidemiology, diagnosis and management of MIS.
Inorganic–organic hybrid nonwoven fabrics with colorimetric detection capability for borate ions in aqueous solutions
Authors: Sasai Ryo , Kaneda Kazuma , Fujimura Takuya
Published: October 2024

A nonwoven fabric sheet with an immobilized colorimetric reagent was prepared to detect borate anions in aqueous media. The fabric comprised immobilized chromotropate and 1-butanesulfonate anions and chromotropate, as the colorimetric reagent, per anion exchange capacity of the layered double hydroxide. The resulting sheet quantitatively detected borate anions through photoluminescence measurements. Thus, it can be used for onsite quantitative analysis of dissolved boron in water, with promising potential for water quality monitoring and, consequently, sustainable and safe water resources globally.
Variability in spruce beetle (Coleoptera: Curculionidae, Scolytinae) adult diapause and evidence for oocyte development prior to winter in a Colorado population
Authors: Davenport Marianne E , Bentz Barbara J , Hansen E Matthew , Ragland Gregory J
Published: October 2024

Diapause regulates seasonal insect life cycles and may be highly variable within and among populations due to genetic and environmental variability. Both types of variation may influence how populations respond plastically or evolutionarily to changing climates. We assessed diapause variability in spruce beetle Dendroctonus rufipennis Kirby (Coleoptera: Curculionidae, Scolytinae), a major forest pest whose life cycle timing is regulated by both prepupal and adult diapauses. Using mating studies and ovary dissections, we tested for variability in adult diapause within and between collection sites in Colorado and Wyoming, USA. Ovary morphology suggested that most females from both sites enter diapause prior to egg formation (oogenesis) when reared at warm temperatures. Though previous studies suggested that adult diapause is obligate, we found that a small proportion of females from both populations terminated diapause without winter chilling in the lab. Moreover, we found that most female beetles sampled at the Colorado field site had mature ovaries relatively early in the fall, suggesting that transient exposure to low temperatures may potentiate pre-winter reproductive development. Adult diapause may act primarily as a block to prevent offspring production late in the season but not necessarily as an overwintering phenotype. Overall, our data do not suggest imminent life cycle shifts mediated by adult diapause, but if the observed variability is heritable, diapause regulation may evolve in response to changing environmental conditions.
Comparison of sublethal effects of 3 acaricides on life table parameters of Tetranychus urticae Koch (Acari: Tetranychidae) and Polyphagotarsonemus latus Banks (Acari: Tarsonemidae)
Authors: Bi Sijin , Huang Huiling , Huang Chuqin , Jishi Merezha , Zhang Jing , Xiong Ting , Zhang Yannan
Published: October 2024

To assess the effects of sublethal concentrations of 3 acaricides—Bifenazate, Etoxazole, and Azocyclotin—on the development and reproduction of Tetranychus urticae Koch (Acari: Tetranychidae) and Polyphagotarsonemus latus Banks. Our results indicated that the LC20 values of Bifenazate, Etoxazole, and Azocyclotin against T. urticae are 3.196, 25.249, and 32.387 mg/L, and against P. latus to be 18.058, 4.641, and 13.755 mg/L, respectively. Sublethal concentrations of these acaricides significantly impacted the development time, lifespan, and fecundity of both mite species. Among the acaricides, Azocyclotin significantly extended the immature developmental period of T. urticae and P. latus. All acaricides reduced the lifespan and fecundity of both species, with Etoxazole having the most substantial impact on the daily fecundity and reproductive of T. urticae. The intrinsic rates of natural increase (rm) for T. urticae exposed to Bifenazate, Etoxazole, and Azocyclotin were 0.17, −0.04, and 0.20, respectively. For P. latus, the rm values were 0.27, 0.23, and 0.25, respectively. These results suggest that under the exposure of sublethal acaricides, P. latus gained a competitive advantage in population competition. These findings underscore the importance of understanding the differential impacts of acaricides on various mite species to develop effective pest management strategies.
Novel risk score for predicting acute cardiovascular and cerebrovascular events after chest radiotherapy in patients with breast or lung cancer
Authors: Abu Rmilah Anan , Adham Alkurashi , Ikram-Ul Haq , Alzu’bi Hossam , Nandan Anevakar , Jouni Hayan , Hirashi Satomi , Owen Dawn , Deswal Anita , Lin Steven H , Abe Jun-Ichi , Chao Tzu Cheng , Browne Jacinta , Leiner Tim , Laack Nadia , Herrmann Joerg
Published: October 2024

Aims

Radiation therapy (RT) is an integral component of cancer therapy but associated with adverse events. Our goal was to establish risk prediction models for major adverse cardiovascular and cerebrovascular events (MACCE) after chest RT.

Methods and results

A retrospective study of lung/breast cancer patients who had chest RT with planning CT at Mayo Clinic between 01/2010 and 01/2014. Predictive models were developed based on weighted independent predictors using a derivation (406 lung and 711 breast cancer) and validation cohort (179 lung and 234 breast cancer). Patient characteristics, pre-RT CT for coronary artery calcification (CAC), and post-RT MACCE data were reviewed. Post-RT MACCE occurred in 6.1 and 5.6% in the derivation and validation cohort over a mean follow-up of 42 ± 13 months. Post-therapy model (C2AD2) included CAC (two points), MACCE history (two points), age ≥74 (three points), DM (two points), and mean heart radiation dose ≥ 850 mGy (two points), and pre-therapy model (C2AD) included post-therapy model parameters minus mean heart radiation dose. Both models stratified patients into three risk groups: low (0–2), intermediate (3–5), and high (≥6). Post-RT MACCE across these groups were 2.7, 8.9, and 19.8% in the derivation, and 3.9, 6.6, and 16.4% in the validation cohort for post-therapy model (C2AD2) and 2.8, 9.2, and 20.4% in the derivation and 3.7, 9.2, and 13.2% in the validation cohort for pre-therapy model. Both models showed statistically significant graded survival outcome.

Conclusion

Post-therapy (C2AD2) and pre-therapy (C2AD) models are simple, easy to use and effective tools to stratify breast and lung cancer patients undergoing chest radiation for post-RT MACCE.
Subjective Memory Complaints and the Effect of a Multidomain Lifestyle Intervention on Cognition: The FINGER Trial
Authors: Vaskivuo Laura , Hokkanen Laura , Levälahti Esko , Hänninen Tuomo , Antikainen Riitta , Bäckman Lars , Laatikainen Tiina , Paajanen Teemu , Stigsdotter Neely Anna , Strandberg Timo , Tuomilehto Jaakko , Soininen Hilkka , Kivipelto Miia , Ngandu Tiia
Published: October 2024

Objectives

Older people reporting subjective memory complaints (SMCs) may have a greater risk of cognitive decline. Multidomain lifestyle interventions are a promising strategy for the prevention of cognitive decline. The aim of this study was to investigate whether the presence of SMCs affects the efficacy of a 2-year multidomain lifestyle intervention on cognition.

Methods

This study is part of the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) project. Participants (a subsample of 568 individuals, baseline age 60-77 years) were randomized (1:1) to receive a 2-year multidomain lifestyle intervention group including dietary advice, exercise, cognitive training, and vascular risk management, or regular health advice control group. Cognitive performance was assessed at baseline and at 1- and 2-year visits, using a neuropsychological test battery, including tests assessing memory, executive functions, and processing speed. Participants rated the frequency of SMCs using the Prospective and Retrospective Memory Questionnaire.

Results

Having more retrospective SMCs was linked to a less favorable cognitive trajectory over 2 years. The difference between the intervention and control groups in annual change in tested memory performance was 0.077 (95% CI, 0.008–0.146) among those reporting more retrospective SMCs and −0.011 (−0.074 to 0.053) among those with less SMCs; interaction effect p = .019. No other interactions between SMCs and intervention allocation were observed.

Discussion

A lifestyle intervention may be beneficial for older adults with and without SMCs. Persons having more retrospective SMCs may benefit more from the intervention regarding memory functioning.

Clinical Trials Registration Number: NCT01041989
“It Made Me Change the Way I Do Business”: Outcomes From Age-Friendly Community Initiatives as Systems Change
Authors: Greenfield Emily A , Pope Natalie E
Published: October 2024

Background and Objectives

Since the early 2000s, a global age-friendly communities (AFC) movement has called for improving the built, social, and service environments of localities for aging. Yet research on the outcomes of AFC initiatives, as programmatic efforts toward AFC progress, remains in its nascence. Drawing on “The Water of Systems Change” framework, our study aimed to address this gap by exploring the extent to which accomplishments of AFC initiatives are indicative of altering six conditions for systems change: policies, organizational practices, resource allocations, power dynamics, relationships, and mental models.

Research Design and Methods

We analyzed qualitative data from 26 key informant interviews across eight mature AFC initiatives in the northeastern United States (U.S.). We engaged in iterative phases of thematic analysis to explore how the initiatives’ accomplishments, as described by the participants, align with each of six focal conditions for systems change.

Results

We found especially robust and consistent evidence for outcomes in terms of enhanced organizational practices on aging; resource flows; connections within and across communities; and mental models about older adults. Evidence for outcomes concerning changes in power dynamics and policy was more limited.

Discussion and Implications

Conceptualizing AFC initiatives as systems-change interventions can bolster research, evaluation, and program development as the movement proliferates and diversifies into the 21st century. Insights can help to advance praxis that empowers AFC leaders as changemakers for “successful aging” at the level of society.
Time-dependent electromagnetic scattering from dispersive materials
Authors: Nick Jörg , Burkhard Selina , Lubich Christian
Published: October 2024

This paper studies time-dependent electromagnetic scattering from obstacles that are described by dispersive material laws. We consider the numerical treatment of a scattering problem in which a dispersive material law, for a causal and passive homogeneous material, determines the wave–material interaction in the scatterer. The resulting problem is nonlocal in time inside the scatterer and is posed on an unbounded domain. Well-posedness of the scattering problem is shown using a formulation that is fully given on the surface of the scatterer via a time-dependent boundary integral equation. Discretizing this equation by convolution quadrature in time and boundary elements in space yields a provably stable and convergent method that is fully parallel in time and space. Under regularity assumptions on the exact solution we derive error bounds with explicit convergence rates in time and space. Numerical experiments illustrate the theoretical results and show the effectiveness of the method.
Phylogeography and species distribution modeling unveil unnoticed Pliocene diversity: the case of a montane Iberian bush-cricket, Antaxius spinibrachius (Orthoptera: Tettigoniidae)
Authors: Gutiérrez-Rodríguez Jorge , Domenech-Fernández Miguel , Barranco Pablo , García-París Mario
Published: October 2024

The geographic distribution and systematics of many groups of insects are still understudied across large geographic areas of the Iberian Peninsula. This lack of knowledge and the fact that many species have a complex evolutionary history due to the existence of “refugia within refugia” have hindered the taxonomic description of the true biodiversity in the Iberian Peninsula. Here, we discuss the evolutionary history of a flightless Iberian bush-cricket Antaxius spinibrachius (Fischer, 1853) using 1 nuclear and 2 mitochondrial markers. We applied species distribution modeling to design sampling strategies in climatically favorable areas and to detect missing isolated populations or unknown lineages. Following the species distribution modeled using all of the presence records available, we discovered 4 new isolated populations in Sierra Madrona, Serra de São Mamede, Sierra de Montánchez, and Sierra de la Demanda. Phylogenetic analyses recovered 2 major Pliocene lineages with a north–south geographic speciation pattern in the Iberian Peninsula. This north–south vicariant event split the common ancestor of these species on either side of the Tagus Valley, probably associated with the Pliocene climate change and the reorganization of paleobasins of the western Iberian Peninsula during the Miocene–Pliocene. We described the southern Iberian Plateau lineage of Antaxius as a new species of bush-cricket based on phylogenetic and morphological evidence, Antaxius oretanus sp. nov. We assessed the conservation status of the new species as “VU B2ab(iii,v)” under the IUCN criteria.
Influences on use of antibiotics without prescription by the public in low- and middle-income countries: a systematic review and synthesis of qualitative evidence
Authors: Cabral Christie , Zhang Tingting , Oliver Isabel , Little Paul , Yardley Lucy , Lambert Helen
Published: October 2024

Objectives

Self-medication with antibiotics is common practice in many low- and middle-income countries (LMIC). This review synthesizes the qualitative evidence on influences on perceptions and practices in relation to self-medication by the public with antibiotics in LMIC.

Methods

A systematic search was conducted of relevant medical, international and social science databases. Searching, screening, data extraction and quality appraisal followed standard methods. A meta-ethnographic approach was used for synthesis, starting with translation of studies and using a line-of-argument approach to develop the final themes.

Results

The search identified 78 eligible studies. Antibiotics were understood as a powerful, potentially dangerous but effective medicine for treating infections. This perception was strongly influenced by the common experience of being prescribed antibiotics for infections, both individually and collectively. This contributed to an understanding of antibiotics as a rational treatment for infection symptoms that was sanctioned by medical authorities. Accessing antibiotics from medical professionals was often difficult logistically and financially. In contrast, antibiotics were readily available over the counter from local outlets. People viewed treating infection symptoms with antibiotics as rational practice, although they were concerned about the risks to the individual and only took them when they believed they were needed.

Conclusions

A new model to explain self-medication with antibiotics is presented. This uses the socio-ecological model to integrate influences that operate at individual, community and wider socioeconomic levels, drawing on theories of medical authority and the medicalization and commercialization of health. Interventions to reduce overuse of antibiotics in LMIC need to address both clinical practice and community self-medication practices together.
Outpatient parenteral antimicrobial therapy for patients with Enterococcus faecalis endocarditis using continuous infusion IV benzylpenicillin plus IV ceftriaxone
Authors: Briggs Simon , Duffy Eamon , Bhally Hasan , Broom Matthew , Campbell Patrick , Lane Rebekah , McBride Stephen , Walls Genevieve , Dalton Simon
Published: October 2024

Background

Many patients with Enterococcus faecalis endocarditis are clinically stable and able to leave hospital before completing antibiotic treatment, but data are lacking regarding some outpatient treatment options.

Objectives

To assess the outcomes for adults with E. faecalis endocarditis receiving outpatient parenteral antimicrobial therapy (OPAT) with continuous infusion IV benzylpenicillin plus bolus/continuous infusion IV ceftriaxone.

Patients and methods

We retrospectively reviewed adults who received at least 2 weeks duration of OPAT for E. faecalis endocarditis with the above treatment regimen in the Auckland and Christchurch regions between July 2019 and September 2022.

Results

Forty-four patients met inclusion criteria. Fifteen were female (34%). The median age was 80 (IQR 71.5 to 84) years. Twenty-two (50%) had prosthetic valve (PV), 15 (34%) native valve (NV), 3 (7%) NV and/or cardiac implantable electronic device (CIED) infection, 3 (7%) PV and/or CIED infection, and 1 (2%) repaired valve endocarditis. Patients received a median of 16.5 days inpatient and 28 days OPAT antibiotic treatment. The 12 month outcome was cure (n = 25; 57%), antibiotic suppression (n = 9; 20%), relapse (n = 2; 5%; both possible) or death (n = 8; 18%). Compared with a historical cohort treated with OPAT continuous infusion IV benzylpenicillin plus bolus IV gentamicin, there was no difference in the relapse rate.

Conclusions

This study adds to the accumulating evidence supporting the treatment of E. faecalis endocarditis with OPAT continuous infusion IV benzylpenicillin plus bolus/continuous infusion IV ceftriaxone. This is an option for patients requiring further antibiotic treatment at the time of hospital discharge.
Financing Devices Involving the Transfer or Retention of Title
Authors: Bridge Michael , Gullifer Louise , Lomnicka Eva
Published: October 2024

This chapter considers various financing devices that, although performing an equivalent function to security interests, are not generally considered ‘security’ under English law; they are called ‘quasi-security’ interests, to acknowledge that their economic function, in ‘securing’ the performance of obligations, is the same as that of true ‘security’. They fall into two main

categories: those involving the retention and those involving the transfer of title. The discussion is organized according to the nature of the collateral involved: goods, investment products, and receivables. Reference is made to the consumer credit regulatory regime in so far as these devices fall within its scope.
Priority Between Consensual and Non-Consensual Security Interests
Authors: Bridge Michael , Gullifer Louise , Lomnicka Eva
Published: October 2024

This chapter deals with priority issues arising between ownership and consensual security interests (ortgage and charge), on the one hand, and a range of interests arising by operation of law. These latter interests consist primarily of possessory and equitable liens; maritime liens; statutory rights of detention; the rights of execution creditors; the rights of creditors availing themselves of third-party debt (formerly garnishee) proceedings; and the rights of creditors availing themselves of rent and rates arrears (formerly distress) proceedings. The list of possessory liens is a disparate one, marked by history and unlikely to increase in number. The most significant legislation considered is the Tribunals, Courts and Enforcement Act 2007.
Enforcement of Rights not Including the Transfer of Title
Authors: Bridge Michael , Gullifer Louise , Lomnicka Eva
Published: October 2024

This short chapter is concerned with the enforcement of certain quasi-security rights when faced with competing entitlements.The substantive law relating to these entitlement is dealt with elsewhere, notably in chapter 8. The entitlements consist primarily of contractual set-off, flawed asset clauses, negative pledge clauses, inter-creditor and subordination agreements, the Quistclose trust and liens over sub-freights.
What Military Applicants Value When Choosing a Residency in Gynecologic Surgery and Obstetrics
Authors: Mathess Judith Makenzie , Karlson Kristina , Chatfield Lindsay , Shvartsman Katerina
Published: October 2024

Introduction

Military medical students participate in a separate residency match program, distinct from their civilian counterparts. There is limited information regarding factors that applicants find important when selecting a residency program in Gynecologic Surgery and Obstetrics (GSO). We aimed to identify factors that influence applicant program selection.

Materials and Methods

A voluntary, anonymous, 45-question survey was distributed to military candidates pursuing GSO residency training in the fall of 2023. Participants were asked to rate the factors they considered most important when ranking residency programs.

Results

Thirty-seven of the sixty (61.7%) applicants completed the survey. The culture of the residency program was deemed “important” by most participants (94.6%), followed by surgical volume (70.3%) and obstetric volume (70.3%). When asked to rank selection factors, the culture of the residency program, geographic location, and surgical volume were among the top 5 influential factors for the majority of applicants. Participants considered the following factors “not important”: Salary (military pay versus civilian salary) (43.2%), research opportunities (32.4%), and availability of abortion training (21.6%). Most military applicants (62.2%) stated that abortion restrictions would not affect program selection, while 37.8% reported that this would affect their rankings.

Conclusions

Gynecologic Surgery and Obstetrics military applicants deemed the residency program’s culture, surgical volume, and obstetrical volume to be the most important factors impacting residency program selection. Residency programs can use these findings to promote program strengths, improve program shortfalls, and guide applicant recruitment.
Correlated mid-infrared and X-ray outbursts in black hole X-ray binaries: a new route to discovery in infrared surveys
Authors: John Chris , De Kishalay , Lucchini Matteo , Behar Ehud , Kara Erin , MacLeod Morgan , Panagiotou Christos , Wang Jingyi
Published: October 2024

The mid-infrared (MIR; $\lambda \simeq 3\!\!-\!\!10\ \mu \mathrm{ m}$) bands offer a unique window into understanding accretion and jet formation in Galactic black hole X-ray binaries (BHXRBs). Although difficult to observe from the ground, the Near-Earth Object Wide-field Infrared Survey Explorer (NEOWISE) survey offers an excellent data set to study MIR variability when combined with contemporaneous X-ray data from Monitor of All-sky X-ray Image (MAXI) mission over an $\approx\!\! 15$ yr baseline. Using a new difference imaging pipeline for NEOWISE data, we present the first systematic MIR study of BHXRB outbursts. Analysing a sample of 16 sources, we show variability trends wherein (i) the MIR bands are dominated by jet emission during the hard states, constraining the electron power spectrum index ($p\approx 1\!\!-\!\!4$) in the optically thin regime and indicating emitting regions of few $10\times$ gravitational radii when evolving towards a flat spectrum, (ii) the MIR luminosity ($L_{\mathrm{ IR}}$) scales as $L_{\mathrm{ IR}} \propto L_\mathrm{ X}^{0.82\pm 0.12}$ with the $2\!\!-\!\!10$ keV X-ray luminosity ($L_\mathrm{ X}$) in the hard state, consistent with a jet, and (iii) thermal disc emission dominates the soft states as the jet switches off and suppresses ($\gtrsim\!\! 10\times$) the MIR emission into an inverted spectrum (spectral index $\alpha \approx -1$). We highlight ‘mini’ outbursts detected in NEOWISE (including two previously unreported episodes of MAXI J1828−249 from September 2015 and September 2016) but missed in MAXI due to their faint fluxes’ confusion, exhibiting MIR colours suggestive of thermal disc emission. We highlight that upcoming infrared surveys and the Rubin observatory will be powerful discovery engines for the distinctively large-amplitude and long-lived outbursts of BHXRBs, as an independent discovery route to X-ray monitors.
Diagnosis and Management of Thoracolumbar Spinal Disorders Presenting as Cardiac, Gastrointestinal, and Other False Pain Syndromes
Authors: Brown Nolan J. , Kuo Cathleen , Pennington Zach , Zhang Angie , Choi Ashley E. , Chan Andrew K. , Shahrestani Shane , Bui Nicholas E. , Hatter Matthew J. , Camino-Willhuber Gaston , Pham Martin H. , Oh Michael Y.
Published: October 2024

Summary of Background Data:

Although pseudoangina is most commonly caused by cervical disc herniation, several cases have been described where thoracic herniation produced symptoms of pseudoangina. If thoracic herniation can produce angina-like pain, then it is important to consider whether pathology of the thoracolumbar spine, in general, can trigger false pain syndromes distinct from pseudoangina.

Objective:

We seek to provide the most comprehensive study regarding the diagnosis and treatment of spinal conditions causing false pain syndromes.

Study Design:

Systematic review of the current literature using PRISMA 2020 recommendations.

Methods:

We queried the literature and systematically selected relevant studies according to PRISMA guidelines.

Results:

Across 22 selected studies, the sample size was 30 patients, and a total of 26 met the criteria for statistical analysis. Seven (26.9%) of these patients presented with a chief complaint of pseudoangina resulting from thoracic disc herniation. 73.1% (19/26) of patients exhibited pain mimicking visceral origin. Overall, 13/19 (68.4%) patients exhibited thoracic spine disease only and 4/19 (21.1%) patients were affected at lumbar levels only, while 2 (10.5%) patients exhibited thoracolumbar herniation. Presentations included abdominal pain (11/19) mimicking appendicitis or pancreatitis, flank pain mimicking renal colic (8/19), and 2 cases of scrotal pain/orchalgia. Symptom durations ranged from acute (<24 h) to 7 years. Treatments were reported for 18/19 patients and all treated patients reported alleviated pain. Seven out of 18 patients were managed conservatively while 11/18 were treated surgically. Misdiagnosis resulted in unnecessary surgery (pancreaticojejunostomy) or other invasive procedures.

Conclusions:

In spinal disorders manifesting with atypical pain syndromes, delay in proper diagnosis and unnecessary treatments can, unfortunately, cause prolonged patient suffering and increased cost of health care. As a result, some have proposed that spinal screening should be incorporated into clinical examinations involving false pain syndromes.
Risk Factors for Increased Opioid Use During Postoperative Intensive Care
Authors: Guichard Lauriane , Engoren Milo C. , Li Yi-Ju , Sigakis Matthew J. , An Xinming , Brummett Chad M. , Mauck Matthew C. , Raghunathan Karthik , Clauw Daniel J. , Krishnamoorthy Vijay
Published: October 2024

IMPORTANCE:

In the ICU, opioids treat pain and improve ventilator tolerance as part of an analgosedation approach. Identifying predictors of opioid consumption during the ICU course might highlight actionable items to reduce opioid consumption.

OBJECTIVES:

To identify risk factors for opioid use during a postoperative ICU course.

DESIGN, SETTING, AND PARTICIPANTS:

Patients enrolled in the Michigan Genomics Initiative single-center prospective observational cohort study completed baseline preoperative sociodemographic and mental/physical health questionnaires and provided blood samples for genetic analysis. Included patients were 18 years old and older, admitted to ICU postoperatively, and received opioids postoperatively.

MAIN OUTCOMES AND MEASURES:

The primary outcome was ICU mean daily oral morphine equivalent (OME) use. The association between OME and phenotypic risk factors and genetic variants previously associated with pain were analyzed through univariable and multivariable linear regression models.

RESULTS:

The cohort consisted of 1865 mixed-surgical patients with mean age of 56 years (sd, 15 yr). Preoperative opioid users were more likely to continue to receive opioids throughout their ICU stay than opioid-naive patients. OME (log10 scale) was most strongly associated with ICU mechanical ventilation (β = 0.27; 95% CI, 0.15–0.38; p < 0.0001; effect size 1.85 for receiving > 24 hours of mechanical ventilation), preoperative opioid use (β = 0.22; 95% CI, 0.16–0.29; p < 0.0001; effect size 1.67 for receiving preoperative opioids), major surgery (β = 0.21; 95% CI, 0.12–0.30; p < 0.0001; effect size 1.62 compared with minor surgery), and current/former illicit drug use (β = 0.12; 95% CI, 0.01–0.23; p = 0.04; effect size 1.30 for drug use). Younger age, centralized pain, and longer anesthetic duration were also significantly associated with OME but with smaller effect sizes. Selected genetic variants (FKBP5, COMT, and OPRM1) were not associated with OME use.

CONCLUSIONS AND RELEVANCE:

Mechanical ventilation and preoperative opioids were the strongest risk factors for postoperative ICU opioid consumption, whereas psychologic factors and genetic variants were not associated.
Travel Distances for Interhospital Transfers of Critically Ill Children: A Geospatial Analysis
Authors: Joseph Allan M. , Horvat Christopher M. , Davis Billie S. , Kahn Jeremy M.
Published: October 2024

IMPORTANCE:

The U.S. pediatric acute care system has become more centralized, placing increasing importance on interhospital transfers.

OBJECTIVES:

We conducted a geospatial analysis of critically ill children undergoing interfacility transfer with a specific focus on understanding travel distances between the patient’s residence and the hospitals in which they receive care.

DESIGN, SETTING, AND PARTICIPANTS:

Retrospective geospatial analysis using five U.S. state-level administrative databases; four states observed from 2016 to 2019 and one state from 2018 to 2019. Participants included 10,665 children who experienced 11,713 episodes of critical illness involving transfer between two hospitals.

MAIN OUTCOMES AND MEASURES:

Travel distances and the incidence of “potentially suboptimal triage,” in which patients were transferred to a second hospital less than five miles further from their residence than the first hospital.

RESULTS:

Patients typically present to hospitals near their residence (median distance from residence to first hospital, 4.2 miles; interquartile range [IQR], 1.8–9.6 miles). Transfer distances are relatively large (median distance between hospitals, 28.9 miles; IQR, 11.2–53.2 miles), taking patients relatively far away from their residences (median distance from residence to second hospital, 30.1 miles; IQR, 12.2–54.9 miles). Potentially suboptimal triage was frequent: 24.2 percent of patients were transferred to a hospital less than five miles further away from their residence than the first hospital. Potentially suboptimal triage was most common in children living in urban counties, and became less common with increasing medical complexity.

CONCLUSIONS AND RELEVANCE:

The current pediatric critical care system is organized in a hub-and-spoke model, which requires large travel distances for some patients. Some transfers might be prevented by more efficient prehospital triage. Current transfer patterns suggest the choice of initial hospital is influenced by geography as well as by attempts to match hospital resources with perceived patient needs.