bluuebunny/crossref_metadata_2025 huggingface dataset:
Design and performance analysis of 4H-SiC LDMOS
Authors: Yang Shuaiqiang , Liu Yingkun , Tan Yongliang , Liu Jiajia
Published: August 2024

Integration and miniaturization are the development directions of power electronics in the future. In this paper, SiC-LDMOS is successfully fabricated on a p-type epitaxial layer for high-power integrated circuits. By extracting the transfer characteristics, output characteristics and breakdown characteristics of SiC-LDMOS, the impact of varying drift region parameters and channel length on device performance is investigated. The experimental results show that when the drift region length is 10 μm, the doping concentration is 7×1016 cm-3 and the channel length is 1 μm, SiC-LDMOS exhibits the best comprehensive performance with a breakdown voltage of 1130 V, a specific on-resistance of 14.6 mΩ·cm2 and a figure of merit of 87.4 MW/cm2. Compared with previously reported SiC lateral MOSFETs and SiC-LDMOS, our device exhibits superior performance.
Theoretical and experimental study on a novel gear drive with high transmission efficiency
Authors: Tian Chao , Zhang Luhe , Wang Dongyu , Cheng Liang , Ni Yangyong , Chen Bingkui
Published: August 2024

This paper introduces a novel gear drive characterized by high transmission efficiency. The gear incorporates cubic curves with corresponding tangents defining the normal section tooth profile. The generation principle of this new gear drive is thoroughly established. Utilizing gear meshing theory, key parameters such as the relative motion velocity, normal vector, and meshing equation are derived. Subsequently, the fundamental principle of the conjugate curve is formulated. The methodology for generating the tooth profile is also explored. An efficiency test was conducted on the gear, and the results demonstrate a superior transmission efficiency relative to that of traditional involute gears.
Construction of maritime traffic network based on DBSCAN
Authors: Wu Hanyue
Published: August 2024

Trajectory data is essentially a sequence of spatial points ordered by timestamps, usually with some descriptive information in addition to basic spatiotemporal information. This paper investigates how publicly available Automatic Identification System (AIS) data can be used to analyze maritime traffic and transform it into directed graphs for estimating potential destination points of trajectories. In the maritime field, analyzing and modeling maritime traffic is crucial for vessel safety and efficiency, creating pathways with waypoints and segments, and further forming traffic networks. Our approach incorporates a detailed analysis of the distribution characteristics of different types of navigational points, leading to the adoption of tailored clustering parameters and methods. This differentiation allows for a nuanced understanding of stationary points at docks and anchorages, as well as navigational changes along shipping routes. Using the DBSCAN algorithm, we successfully cluster similar waypoints, considering cluster density and shape without needing to predefine the cluster count.
Research on the impact of train speed on the uplink performance of balise transmission system
Authors: Mu Haoyan , Xu Qing
Published: August 2024

In the CTCS system, the balise plays an important role in supporting the normal operation of trains. Based on this, this article studies the performance of the uplink of the balise transmission system under different speed conditions from three perspectives: theory, simulation, and measurement. Based on an in-depth analysis of the energy and data transmission process between the vehicle antenna and the ground balise, relevant electromagnetic theoretical models such as the input and output characteristics of the balise and the antenna magnetic field distribution are established. An electromagnetic field model of the balise transmission system is established using Maxwell software, and the simulation results are obtained. An experimental environment is built using responder products and the simulation results are analyzed. Methods are explored to improve the adaptability of responder transmission systems under high-speed operating conditions.
Efficiency evaluation and influencing factors of Industrial Internet enabling manufacturing industry
Authors: Liu Xia
Published: August 2024

The industrial Internet is an important support for the transformation and upgrading of the manufacturing industry. In the present work, a non-oriented SBM-DEA super-efficiency model is constructed. It takes Jiangsu Province in China as an example to estimate the efficiency of industrial Internet enabling manufacturing transformation and upgrading and further analyzes the influencing factors of enabling efficiency by using the Tobit model. It shows that the efficiency level of the transformation of the industrial Internet-enabling manufacturing industry varies greatly from place to place, the distribution is unstable, and there is a big contrast with the level of economic development in different places. The number of supporting service institutions, policy support, and the proportion of secondary industry have a significant positive influence on the enabling efficiency of the industrial Internet, while the degree of opening to the outside world has a significant inhibitory effect on the comprehensive efficiency of the industrial Internet.
3D mode shapes characterization under hammer impact using 3D-DIC and phase-based motion magnification
Authors: Yan Song , Zhang Zhiwei
Published: August 2024

Modal analysis constitutes a fundamental aspect of structural investigation within diverse engineering domains, encompassing sectors such as automotive, wind energy, and aerospace. The prominence of high-frequency excitation loads, exemplified by the combustion phenomena in liquid rocket engines, necessitates an in-depth examination of the high-frequency vibrational response within structural components. However, the complexity of evaluating high-frequency vibrations arises from the negligible displacement associated with these responses. When using an optical full-field measurement system based on a high-speed camera for vibration measurement, it is usually severely affected by noise. Direct analysis of raw data using an optical measurement system (3D-DIC) is not feasible. In this paper, we combine phase-based motion magnification and digital image correlation methods to obtain the high-frequency vibration modes of the structure. 3D-DIC(3D Digital Image Correlation)analysis is performed on the magnified images to quantify the out-of-plane vibration modes of the structure. Using the cantilever beam as an example, the first five out-of-plane vibration mode shapes were separated from the response video under a single hammer excitation. Especially the 5th order natural frequency is as high as 3503 Hz, and the corresponding structural response was below the noise floor of the camera system. The vibration mode results obtained by this method are highly consistent with the vibration modes obtained by the 3D-SLDV(3D Scanning Laser Doppler Vibrometer) method. Finally, this method was applied to identify the out-of-plane vibration modes of real engine pipe. The combination of motion magnification techniques and DIC can enhance the capability of traditional 3D-DIC, which is beneficial for high-frequency structural identification. Future research could concentrate on optimizing motion amplification factors for different structures and loads, and creating automated algorithms for analyzing and visualizing amplified motion data in real time.
Optimized the locations and sizes of FACTS devices on electrical network involving wind power using a new hybrid stochastic algorithm
Authors: Djeblahi Zahia , Mahdad Belkacem , Srairi Kamel
Published: August 2024

This article focuses on utilizing a new hybrid optimization algorithm called the Fitness-Distance Balance-based Archimedes Optimization Algorithm (FDB-AOA) to solve the Optimal Power Flow (OPF) problems within a recently adopted electrical transmission grid, specifically the modified IEEE-30 bus system. This system integrates thermal and wind -based generating units, including various types of Flexible AC Transmission System (FACTS) devices. Several tests are performed where the stochastic wind energy is modeled using probability density functions. The optimization goal takes into account the cost of thermal generation, the direct cost of scheduled wind power, and the penalty cost for underestimating wind power. The locations and sizing of FACTS devices are optimized with aim of reducing several fitness functions. The optimization results achieved by the proposed method in solving single objective functions were more effective in finding the optimal solution compared to several well-known algorithms. The results show the superiority of the proposed method in the majority of case studies, as it achieved a better optimum solution with a total generation cost (

C

gen

) value of 806.9817 $/h, and a real power loss (

P

loss

) value 1.7619 MW, also yields a competitive gross cost (

C

gross

) value of 1104.6652 $/h compared to those obtained by the other algorithms. In contrast, the statistical analysis proven the superiority of this algorithm where the standard deviations (SD) required in solving the single objective problem (

C

gen

) is 0.0996, which are better compared to other techniques. the simulation results demonstrate that the FDB-AOA optimizer is robust than other approaches, like the Success history based-adaptive differential evolution (SHADE) algorithm, MSA (Moth Swarm Algorithm), and ABC (artificial bee colony) integrated with the SF (superiority of feasible solutions) approach, in solving OPF problems involving the integration of both thermal and wind power plants along with FACTS devices.
High-performance binary to gray code converter: balancing energy use and thermal stability
Authors: Aruna Patthi , Gurumurthy Komanapalli
Published: August 2024

Quantum Dot Cellular Automata (QCA) is an advanced technology in quantum electronics, leveraging quantum cells as its fundamental unit. This article introduces a design for a Binary to Gray (BG) code converter using the QCA technology. The proposed design uses fewer cells than previous models and extends the bit size capability to five bits in a single layer to minimize complexity and improve efficiency. The primary goal is to develop energy and thermal efficient BG code converters. These designs achieve a cell count reduction of 45.16% for two-bit, 29.54% for three-bit, and 25.45% for four-bit converters while improving the overall area by 41.17%, 29.54%, and 40% for two-bit,three-bit, and four-bit converters, respectively, with a latency of 0.5. The 55-cell, five-bit BG converter takes up 0.07μ
m
2 and has a latency of 0.5. Comprehensive simulations were conducted using the QCADesigner, QCADesignerE 2.0.3, and QCA Pro tools to validate the proposed design’s functionality.
Performance of composite steel-concrete beam with stiffener next to web opening
Authors: Mastan Sheik , S Anandh , S Sindhu Nachiar
Published: August 2024

Openings are provided in Composite steel-concrete beams (CB) for the allowance of ducts and pipes, which generally reduces the beam’s flexural performance. So, to retain the strength of these beams, stiffeners are introduced adjacent to the web openings. Hence, a numerical study is performed to evaluate the influence of the stiffeners next to web openings through finite element analysis (FEA) software ABAQUS v6.14. Three different shapes of openings with three different placements of stiffeners are considered for the study, namely circular, rectangular, and triangular openings with stiffeners along longitudinal, transverse, and diagonal directions. As revealed from the findings of FEA, comparisons are made based on the ultimate load, stiffness, and stress distribution. From comparisons, it is found that double-sided longitudinal and transverse stiffeners next to the circle opening are comparable to conventional CB. Similarly, Diagonal stiffeners increase strength in rectangular and triangle openings. Transverse stiffeners failed to increase load capacity and decrease stress concentration compared to other longitudinal and diagonal stiffeners. Further validation for the finite element results is done using the Levenberg–Marquardt (LM) algorithm, using the backpropagation variant technique of Artificial Neural Network (ANN). The results of ANN, i.e., Mean Square Error (MSE) and Multiple Determination Coefficient (R2), are above 0.9 and below 1, respectively. Thus, the results of ANN indicate that the provided results are perfectly fit for predicting with the ANN technique.
Measuring the Dunkelflaute: how (not) to analyze variable renewable energy shortage
Authors: Kittel Martin , Schill Wolf-Peter
Published: August 2024

As variable renewable energy (VRE) sources increasingly gain importance in global energy systems, there is a growing interest in understanding periods of VRE shortage (‘Dunkelflauten’). Defining, quantifying, and comparing such shortage events across different renewable generation technologies and locations presents a surprisingly intricate challenge. Various methodological approaches exist in different bodies of literature, which have been applied to single technologies in specific locations or technology portfolios across multiple regions. We provide an overview of various methods for quantifying VRE shortage, focusing either on supply from variable renewables or its mismatch with electricity demand. We explain and critically discuss the merits and challenges of different approaches for defining and identifying shortage events and propose further methodological improvements for more accurate shortage determination. Additionally, we elaborate on comparability requirements for multi-technological and multi-regional energy shortage analysis. In doing so, we aim to contribute to unifying disparate methodologies, harmonizing terminologies, and providing guidance for future research.
Introduction
Authors: Fossati Marta
Published: August 2024

This Introduction uses Nadine Gordimer’s definition of the short story as a ‘flash of fireflies’ as the starting point for a discussion of the monograph’s core thematic concerns and key theoretical engagements. After assessing the importance of the short story in South Africa and other postcolonial contexts—notwithstanding the form’s status as ‘minor genre’—this Introduction outlines the debate in South African letters around the aesthetics of Black protest writing in the wake of Njabulo Ndebele’s critical interventions. It also addresses the generic hybridity of some of the short stories considered, arguing that their proximity to literary journalism and their realist style should be considered as integrated aesthetic dimensions of the South African short story in English by Black writers.
Experimentalism in Herbert Dhlomo’s Ten ‘Unpublished’ Short Stories
Authors: Fossati Marta
Published: August 2024

This chapter offers, for the first time, a close reading of all the short stories written by Herbert Dhlomo between the early 1930s and the late 1940s. By considering these fictions in conjunction with Dhlomo’s journalistic pieces, this chapter argues that Dhlomo’s stories tackle important coeval themes, thus testifying to a fascinating take on South Africa just before the onset of apartheid. The chapter dissects the complex aesthetic structure of Dhlomo’s stories, with a particular focus on the use of intertextuality and on instances of generic hybridity. It also interrogates Dhlomo’s position—as a New African writer—in relation to modernity and global modernism(s), calling for a re-evaluation of his experimental prose fiction. This chapter ultimately suggests that Dhlomo’s short stories prefigure, in some respects, later prose fiction by the Drum writers and Mtutuzeli Matshoba.
Foreign Entanglement, Foreign Officials, and the ‘War on Drugs’
Authors: Nili Shmuel
Published: August 2024

This chapter explores the tension between the American (and global) interest in deterring drug-related crimes, and the moral duty of the United States to defer to the wishes of foreign societies that have been suffering from staggering drug-related violence triggered (to a significant extent) by the United States’ own ‘War on Drugs’. More specifically, the chapter explores this tension by inquiring into the ways in which the United States might use its own jurisdiction to either protect (via asylum) or attack (via criminal prosecution) foreign officials who have collaborated with drug cartels—some, culpably, others, under duress. The relational priority principle helps us to see which of these jurisdictional decisions are justified, which are not, and why.
Conclusion
Authors: Nili Shmuel
Published: August 2024

This conclusion recapitulates the book’s main themes, while reflecting on the implications of its arguments for the way in which contemporary political philosophy theorizes the relationship among different legal systems.
Allura Red AC is a xenobiotic. Is it also a carcinogen?
Authors: Hofseth Lorne J , Hebert James R , Murphy Elizabeth Angela , Trauner Erica , Vikas Athul , Harris Quinn , Chumanevich Alexander A
Published: August 2024

Merriam-Webster and Oxford define a xenobiotic as any substance foreign to living systems. Allura Red AC (a.k.a., E129; FD&C Red No. 40), a synthetic food dye extensively used in manufacturing ultra-processed foods and therefore highly prevalent in our food supply, falls under this category. The surge in synthetic food dye consumption during the 70s and 80s was followed by an epidemic of metabolic diseases and the emergence of early-onset colorectal cancer in the 1990s. This temporal association raises significant concerns, particularly given the widespread inclusion of synthetic food dyes in ultra-processed products, notably those marketed toward children. Given its interactions with key contributors to colorectal carcinogenesis such as inflammatory mediators, the microbiome, and DNA damage, there is growing interest in understanding Allura Red AC’s potential impact on colon health as a putative carcinogen. This review discusses the history of Allura Red AC, current research on its effects on the colon and rectum, potential mechanisms underlying its impact on colon health, and provides future considerations. Indeed, although no governing agencies classify Allura Red AC as a carcinogen, its interaction with key guardians of carcinogenesis makes it suspect and worthy of further molecular investigation. The goal of this review is to inspire research into the impact of synthetic food dyes on colon health.
Impact of epicardial fat on coronary vascular function, cardiac morphology, and cardiac function in women with suspected INOCA
Authors: Zamani Sauyeh K , Wei Janet , Hathorn Brandon , Robuck Erica , Kwan Alan C , Pepine Carl J , Handberg Eileen , Cipher Daisha J , Dey Damini , Bairey Merz C Noel , Nelson Michael D
Published: August 2024

Aims

Epicardial fat is a metabolically active adipose tissue depot situated between the myocardium and visceral pericardium that covers ∼80% of the heart surface. While epicardial fat has been associated with the development of atherosclerotic coronary artery disease, less is known about the relationship between epicardial fat and coronary vascular function. Moreover, the relations between excess epicardial fat and cardiac morphology and function remain incompletely understood.

Methods and results

To address these knowledge gaps, we retrospectively analysed data from 294 individuals from our database of women with suspected ischaemia with no obstructive coronary disease (INOCA) who underwent both invasive coronary function testing and cardiac magnetic resonance imaging. Epicardial fat area, biventricular morphology, and function, as well as left atrial function, were assessed from cine images, per established protocols. The major novel findings were two-fold: first, epicardial fat area was not associated with coronary vascular dysfunction. Secondly, epicardial fat was associated with increased left ventricular concentricity (β = 0.15, P = 0.01), increased septal thickness (β = 0.17, P = 0.002), and reduced left atrial conduit fraction (β = −0.15, P = 0.02), even after accounting for age, BMI, and history of hypertension.

Conclusion

Taken together, these data do not support a measurable relationship between epicardial fat and coronary vascular dysfunction but do suggest that epicardial fat may be related to concentric remodelling and diastolic dysfunction in women with suspected INOCA. Prospective studies are needed to elucidate the long-term impact of epicardial fat in this patient population.
Fine mapping and identification of candidate genes associated with powdery mildew resistance in melon (Cucumis melo L.)
Authors: Duan Xiaoyu , Yuan Yue , Real Núria , Tang Mi , Ren Jian , Wei Jiaqi , Liu Bin , Zhang Xuejun
Published: August 2024

Powdery mildew (PM), a common disease of many major crop species, including melon (Cucumis melo L.), affects plant growth and fruit quality and seriously reduces production. Using a combined morphological and molecular approach, we attribute the PM pathogen that naturally occurs in melon to Podosphaera xanthii, and specifically to physiological race 1. An investigation into the genetic basis of PM resistance in melon using the resistant accession ‘PI 164637’ and susceptible counterpart ‘HDZ’ reveals dominant inheritance of PM resistance at the seedling stage, supported by F2 and backcross population segregation ratios. Adult plant assessments indicate a major gene with an additive effect for PM resistance. Bulk segregant analysis coupled with high-throughput sequencing identified a significant quantitative trait locus on chromosome 6 that is associated with PM resistance. Genetic mapping narrowed down the candidate region to 63.5 kb using InDel molecular markers, harboring 12 candidate genes. The marker chr06_indel_5 047 127 demonstrated high accuracy in screening PM resistance in an F2 segregating population and 30 inbred lines as natural populations. Functional annotation and expression analysis of candidate genes revealed that MYB transcription factor MELO3C006700, GATA transcription factor MELO3C028829 and heparanase-like protein MELO3C006697 are promising candidate genes for PM resistance in melon. The genetic architecture underlying this resistance in melon offers valuable insights for breeding programs, and the identified markers, especially chr06_indel_5 047 127, may enable practical applications for marker-assisted selection in developing PM-resistant melon varieties.
The Ambiguities and Vagaries of Popular Control: Trust and Parochial Corruption in Early Modern England
Authors: Knights Mark
Published: August 2024

Over the seventeenth and eighteenth centuries, and across Britain’s empire, the idea took hold that a public office was a fiduciary trust, with legally and rhetorically enforceable duties of accountability, selflessness, and duty of care. Coupled with a remarkably free press which enabled the exposure and pursuit of corrupt activity, and petitioning activity that put pressure on Parliament, this development fostered important ideas and practices of public accountability. Yet, as the second half of the article shows, these were often difficult to effect and sustain at the local level, especially in large urban parishes, where campaigners were sometimes able to mobilize popular support for anti-corruption investigations but also faced a degree of indifference that meant change and reform were protracted, patchy, and by no means certain. Thus, on the one hand, popular control—or perhaps better, popular accountability—advanced in conceptual, legal, and some practical ways; but on the other, in some circumstances it was difficult to implement and was blunted by a range of factors that limited popular pressure and worked against reform. This article thus problematizes a linear narrative of unfailing progress toward greater accountability, highlighting instead the variety of local experiences and the nature of anti-corruption as an ongoing process. Both the central state and the parish state faced similar challenges, albeit in different contexts.
Improving Coccidioidomycosis Testing for Emergency Department Patients With Suspect Community-Acquired Pneumonia: Analysis of Provider Attitudes and the Effect of a Targeted Intervention
Authors: Cunningham Cody A , Brown Ashlyn T , Ravi Srekar N , Bearss Jeremiah J , O’Shea Michael P , Elshaer Amani K , Biondi Matt V , Seddighzadeh Bobak , Elmasry Sandra N , Havanur Amogh , Mahajan Avanika , Savic Juliana , Alozie Nneoma U , Rappaport Douglas , Urumov Andrej , Blair Janis E
Published: August 2024

Coccidioidomycosis is a common cause of community-acquired pneumonia in endemic regions. Approximately 20 000 cases of coccidioidomycosis occur annually; however, this statistic is limited by a widespread lack of testing. Here, we analyze emergency medicine provider attitudes toward coccidioidal testing and assess the effect of an intervention to improve testing rates.
Innate lymphoid cells in immunoglobulin E-mediated food allergy
Authors: Ilangovan Janarthanan , Neves Joana F. , Santos Alexandra F.
Published: August 2024

Purpose of review

Recognition of the importance of innate lymphoid cells (ILCs) in the immune mechanisms of food allergy has grown in recent years. This review summarizes recent findings of ILCs in immunoglobulin E (IgE)-mediated food allergy. New research on ILCs in the context of the microbiome and other atopic diseases are also considered with respect to how they can inform understanding of the role of ILCs in food allergy.

Recent findings

ILCs can mediate allergic and tolerogenic responses through multiple pathways. A novel subset of interleukin (IL)-10 producing ILC2s are associated with tolerance following immunotherapy to grass pollen, house dust mite allergy and lipid transfer protein allergy. ILC2s can drive food allergen-specific T cell responses in an antigen-specific manner. A memory subset of ILC2s has been identified through studies of other atopic diseases and is associated with effectiveness of response to therapy.

The role of ILCs in food allergy and oral tolerance is relatively understudied compared to other diseases. ILCs can modulate immune responses through several mechanisms, and it is likely that these are of importance in the context of food allergy. Better understanding of theses pathways may help to answer fundamental questions regarding the development of food allergy and lead to novel therapeutic targets and treatment.
Improving Time to Antibiotics in Patients With Long Bone Open Fractures Presenting to the Pediatric Emergency Department
Authors: Keenan Kaitlin , Patel Deepa , Patel Ronak , Gorgens Sophia , James Douglas , Zapke Jennifer , Hardardt Ryan , LaMaina Laura , Sommer Patricia , Dimauro Kevin , Cerise Jane , Bullaro Francesca
Published: August 2024

OBJECTIVES:

To evaluate a new triage workflow aimed at improving time to intravenous antibiotics in open fractures to under less than 60 minutes of arrival to the Pediatric Emergency Department.

METHODS:

Design:

A prospective, multidisciplinary, quality improvement project.

Setting:

A tertiary care, Level 1 pediatric trauma hospital in New York.

Patient Selection Criteria:

Patients ages 17 years and younger with long bone open fractures between June 1, 2020, and May 31, 2021, excluding those transferred from an outside hospital, with nonlong bone fractures and nonfractured, injured extremities.

Outcome Measures and Comparisons:

The new workflow involved splint removal and skin assessment during triage to identify open fractures. The aim of serial Plan-Do-Study-Act cycles was to refine this workflow and reduce antibiotic administration time. Primary outcome: percentage of patients with open fracture receiving intravenous antibiotics within 60 minutes. Secondary outcome: assessment of triage documentation regarding splint presence and removal. An exact Wilcoxon two-sample test compared time from patient arrival (quick registration) with antibiotic administration before, during, and after workflow implementation on June 1, 2020.

RESULTS:

A total of 51 patients (33 male) ages 17 years and younger, with open fractures, were reviewed: 25 during the preintervention phase January 1, 2018 to May 31, 2020; 14 during the intervention phase June 1, 2020 to May 31, 2021; and 12 during the postintervention phase June 1, 2021 to November 30, 2021. Continuous improvement efforts through Plan-Do-Study-Act cycles focusing on education, reinforcement, recognition, and barrier identification increased the percentage of patients receiving antibiotics within 60 minutes from 36% to 87.5%. The median time and interquartile range (interquartile range: 25th percentile–75th percentile) from quick registration to administration was 86 minutes (interquartile range: 51–147) before June 1, 2020, and 34 minutes (interquartile range: 16–42) thereafter.

CONCLUSION:

The implemented triage workflow led to improved time to antibiotics to within 60 minutes for patients with long bone open fractures in the pediatric emergency department.

LEVEL OF EVIDENCE:

Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
No Increased Risk of All-cause Revision up to 10 Years in Patients Who Underwent Bariatric Surgery Before Single-level Lumbar Fusion
Authors: Kuyl Emile-Victor , Gupta Arnav , Parel Philip M. , Quan Theodore , Patel Tushar Ch. , Mesfin Addisu
Published: August 2024

Study Design:

Retrospective cohort study.

Objective:

This study aimed to assess whether prior bariatric surgery (BS) is associated with higher 10-year surgical complication and revision rates in lumbar spine fusion compared with the general population and morbidly obese patients.

Background:

Obesity accelerates degenerative spine processes, often necessitating lumbar fusion for functional improvement. BS is explored for weight loss in lumbar spine cases, but its impact on fusion outcomes remains unclear. Existing literature on BS before lumbar fusion yields conflicting results, with a limited investigation into long-term spine complications.

Methods:

Utilizing the PearlDiver database, we examined patients undergoing elective primary single-level lumbar fusion, categorizing them by prior BS. Propensity score matching created cohorts from (1) the general population without BS history and (2) morbidly obese patients without BS history. Using Kaplan-Meier and Cox proportional hazard modeling, we compared 10-year cumulative incidence rates and hazard ratios (HRs) for all-cause revision and specific revision indications.

Results:

Patients who underwent BS exhibited a higher cumulative incidence and risk of decompressive laminectomy and irrigation & debridement (I&D) within 10 years postlumbar fusion compared with matched controls from the general population [decompressive laminectomy: HR = 1.32; I&D: HR = 1.35]. Compared with matched controls from a morbidly obese population, patients who underwent BS were associated with lower rates of adjacent segment disease (HR = 0.31) and I&D (HR = 0.64). However, the risk of all-cause revision within 10 years did not increase for patients who underwent BS compared with matched or unmatched controls from the general population or morbidly obese patients (P > 0.05).

Conclusions:

Prior BS did not elevate the 10-year all-cause revision risk in lumbar fusion compared with the general population or morbidly obese patients. However, patients who underwent BS were associated with a lower 10-year risk of I&D when compared with morbidly obese patients without BS. Our study indicates comparable long-term surgical complication rates between patients who underwent BS and these control groups, with an associated reduction in risk of infectious complications when compared with morbidly obese patients. Although BS may address medical comorbidities, its impact on long-term lumbar fusion revision outcomes is limited.
Laser-assisted Abdominoplasty Marking to Achieve a Better Design of Abdominal Scar
Authors: Wongkietkachorn Apinut , Wongkietkachorn Nuttapone , Jomkoh Pojanan , Wongkietkachorn Supawich
Published: August 2024

Ensuring bilateral symmetry when marking for abdominoplasty incision is critical and can be challenging when using traditional landmarks. This study aims to compare the outcomes of laser-assisted abdominoplasty marking to the traditional method. In this prospective study, patients undergoing standard abdominoplasty were included. Abdomens were randomized to determine which half would serve as the dominant side for clinical marking. Marking was first performed using a traditional method and then using a laser level, and any differences were recorded. A total of 50 patients participated in the study. The distance between markings at the most lateral point was as high as 10.0 [7.0–10.0] mm (P < 0.001), as was that at 12 cm (7.0 [5.0–8.0] mm, P = 0.03). However, the difference at 6 cm was 1.0 [0.0–4.0] mm (P < 0.001). Using a laser level during abdominoplasty marking can increase symmetry of the marking.
Arterial blood pressure monitoring in stroke cohorts: the impact of reduced sampling rates to optimise remote patient monitoring
Authors: Ball James D. , Panerai Ronney B. , Henstock Tim , Minhas Jatinder S.
Published: August 2024

Objective

Remote patient monitoring (RPM) beat-to-beat blood pressure (BP) provides an opportunity to measure poststroke BP variability (BPV), which is associated with clinical stroke outcomes. BP sampling interval (SI) influences ambulatory BPV, but RPM BP SI optimisation research is limited. SI and RPM device capabilities require compromises, meaning SI impact requires investigation. Therefore, this study assessed healthy and stroke subtype BPV via optimised BP sampling, aiding sudden BP change identification and potentially assisting cardiovascular event (recurrent stroke) prediction.

Methods

Leicester Cerebral Haemodynamic Database ischaemic [acute ischaemic stroke (AIS), n = 68] and haemorrhagic stroke (intracerebral haemorrhage, n = 12) patient and healthy control (HC, n = 40) baseline BP data were analysed. Intrasubject and interpatient SD (SDi/SDp) represented individual/population variability with synthetically altered SIs. Matched-filter approaches using cross-correlation function detected sudden BP changes.

Results

At SIs between 1 and 180 s, SBP and DBP SDi staticised while SDp increased at SI < 30 s. Mean BP and HR SDi and SDp increased at SI < 60s. AIS BPV, normalised to SI1s, increased at SI30s (26%–131%) and SI120s (1%–274%). BPV increased concomitantly with SI. Cross-correlation analysis showed HC and AIS BP sudden change detection accuracy reductions with increasing SI. Positive BP deviation detection fell 48.48% (SI10s) to 78.79% (SI75s) in HC and 67.5% (SI10s) to 100% (SI75s) in AIS. Negative BP deviation detection fell 50% (SI10s) to 82.35% (SI75s) in HC and 52.27% (SI10s) to 95.45% (SI75s) in AIS.

Conclusion

Sudden BP change detection and BPV are relatively robust to SI increases within certain limits, but accuracy reductions generate unacceptable estimates, considerable within RPM device design. This research warrants further SI optimisation.
Etiologies and clinical characteristics of macular hole: An 8-year, single-center, retrospective study
Authors: Yue Huifang , Liu Chenyu , Zhang Yunda , Zhang Lijuan , Gao Zhao , Ma Tao , Zhang Ximei
Published: August 2024

To investigate the etiologies and clinical characteristics of full-thickness macular hole (FTMH) cases at Shanxi Eye Hospital in North China. Patients diagnosed with FTMH who underwent surgery from 2012 to 2020 were included, and the etiologies and clinical features of MH types were analyzed in an 8-year, cross-sectional, retrospective study. A total of 752 cases (776 eyes) were analyzed. The top 3 subtypes of MH were idiopathic (IMH, 64.4%), myopic (MMH, 21.1%) and traumatic (TMH, 3.7%) MH. Among these, there were significant differences in sex, age, and baseline best-corrected visual acuity (BCVA) distributions. Females predominated in the IMH and MMH groups, while males predominated in the TMH group. The IMH onset age was older than the MMH and TMH onset ages. Baseline BCVA in the IMH (Z = 8.9, P < .001) and the other group (Z = 4.0, P < .001) was significantly better than that in the MMH group. In the IMH group, females were younger, had a shorter axial length (AL), and had a worse baseline BCVA than males, while in the MMH group, there were no significant sex differences. Multivariate correlation analysis showed that a smaller hole diameter in IMH, no retinal detachment in MMH, and a younger age in TMH may result in better baseline BCVA. The most common MH etiologies were IMH, MMH and TMH, which contributed to differences in clinical features. Females predominated in the IMH and MMH groups, and the onset of MMH occurred 6.5 years earlier than the onset of IMH. Therefore, early fundus monitoring in females and high myopia patients is helpful for the early detection and treatment of MH.
Evaluating accuracy and reproducibility of ChatGPT responses to patient-based questions in Ophthalmology: An observational study
Authors: Alqudah Asem A. , Aleshawi Abdelwahab J. , Baker Mohammed , Alnajjar Zaina , Ayasrah Ibrahim , Ta’ani Yaqoot , Al Salkhadi Mohammad , Aljawarneh Shaima’a
Published: August 2024

Chat Generative Pre-Trained Transformer (ChatGPT) is an online large language model that appears to be a popular source of health information, as it can provide patients with answers in the form of human-like text, although the accuracy and safety of its responses are not evident. This study aims to evaluate the accuracy and reproducibility of ChatGPT responses to patients-based questions in ophthalmology. We collected 150 questions from the “Ask an ophthalmologist” page of the American Academy of Ophthalmology, which were reviewed and refined by two ophthalmologists for their eligibility. Each question was inputted into ChatGPT twice using the “new chat” option. The grading scale included the following: (1) comprehensive, (2) correct but inadequate, (3) some correct and some incorrect, and (4) completely incorrect. Totally, 117 questions were inputted into ChatGPT, which provided “comprehensive” responses to 70/117 (59.8%) of questions. Concerning reproducibility, it was defined as no difference in grading categories (1 and 2 vs 3 and 4) between the 2 responses for each question. ChatGPT provided reproducible responses to 91.5% of questions. This study shows moderate accuracy and reproducibility of ChatGPT responses to patients’ questions in ophthalmology. ChatGPT may be—after more modifications—a supplementary health information source, which should be used as an adjunct, but not a substitute, to medical advice. The reliability of ChatGPT should undergo more investigations.
Percutaneous nucleoplasty and intradiscal electrothermal therapy in the management of lumbar discogenic pain: A retrospective comparative study
Authors: Yoo Yongjae , Bae Jungil , Kim Hangaram , Lee Hongna , Moon Jee Youn , Kim Yong-Chul
Published: August 2024

Percutaneous lumbar nucleoplasty (PLN) and intradiscal electrothermal therapy (IDET) are effective treatment options for discogenic low back pain (D-LBP). We evaluated the effectiveness of PLN and IDET and the positive predictive factors associated with intradiscal procedures. We reviewed the medical records of 205 patients who underwent IDET or PLN in patients with D-LBP followed by positive provocation discography. A successful outcome was defined as ≥ 50% pain relief on the numerical rating scale (NRS) pain score at the 6-month follow-up visit. The relationship between the outcome of the intradiscal procedure and clinical variables was investigated using multivariate analyses. Of the 142 patients (89 with PLN and 53 with IDET), 86 (60.5%) experienced a successful outcome, which was more substantial in PLN (n = 61, 68.5%) than in IDET (n = 25, 47.2%; P = .010). The high-grade Modified Dallas Discogram Scale in provocation discography and a procedure at the L3/L4 spinal level were independent positive predictors of successful outcomes (P = .023 and .010, respectively). Coexisting psychiatric disorders, such as depression and anxiety, were negative predictors of successful treatment (P = .007). No serious complications related to the intradiscal procedures were reported during the 6-month follow-up period. PLN and IDET might be effective for managing low back pain (LBP) from internal disc disruption (IDD). The high-grade Modified Dallas Discogram, a procedure at the L3/4 spinal level, and the absence of neuropsychiatric disorders could be positive factors for the successful outcome of the intradiscal procedure.
A randomized, double-blind, placebo-controlled study to evaluate the benefits of a standardized Nigella sativa oil containing 5% thymoquinone in reducing the symptoms of seasonal allergy
Authors: Majeed Anju , Majeed Shaheen , Parameswarappa Avinash Kadasiddappa , Murali Avinash , Gudimallam Satish , Siddegowda Chikkalingaiah , Chandrashekar Harshith , Mundkur Lakshmi
Published: August 2024

Background:

Allergic rhinitis (AR) or seasonal allergy characterized by sneezing, nasal congestion, nasal itching, and nasal discharge, triggered by immune reactions to environmental allergens. Present day customers also monitor the personal improvements in the area of Evidence-Based natural medicines/supplements

Methods:

A randomized, double-blind, placebo-controlled study was conducted on 65 participants aged 18 to 60 years having 2 or more allergic symptoms like sneezing, rhinorrhoea, nasal obstruction, and nasal itching for a cumulative period greater than 1 hour per day. The study participants received a capsule of NSO (250 mg) with 2.5 mg piperine (BioPerine) as a bioavailability enhancer or a placebo, twice a day, after food for 15 days. The primary objectives were evaluated by mean change in Total Nasal Symptom Score and the duration of AR symptoms per day from baseline to Day 15. Secondary endpoints were changes in Total Ocular Symptoms Score, AR symptom frequency and severity, serum Immunoglobulin E levels, and Patient Global Impression of Change scale. Adverse events were monitored throughout the study.

Results:

Sixty-five patients were enrolled and all of them completed the study, N = 33 in NSO and N = 32 in placebo. A significant reduction in Total Nasal Symptom Score and Total Ocular Symptoms Score was observed in the NSO group compared to the placebo, highlighting the potential of NSO in alleviating AR symptoms. The episodes of AR symptoms per day and the frequency of symptoms in 24 hours reduced significantly in 15 days in both groups, but the extent of improvement was significantly higher in NSO compared to placebo. Improvement in Patient Global Impression of Change was also significantly better in NSO compared to the placebo. Serum Immunoglobulin E levels decreased in NSO but were not significantly different from placebo. No clinically significant changes were observed in vital signs, liver and renal function, lipid profile, hematology, fasting blood sugar, or urine analysis at the end of the study.

Conclusion:

The result of the study demonstrates that NSO 250 mg with 2.5 mg piperine is an effective and well-tolerated supplement for the management of AR symptoms.
ChatGPT in medicine: A cross-disciplinary systematic review of ChatGPT’s (artificial intelligence) role in research, clinical practice, education, and patient interaction
Authors: Fatima Afia , Shafique Muhammad Ashir , Alam Khadija , Fadlalla Ahmed Tagwa Kalool , Mustafa Muhammad Saqlain
Published: August 2024

Background:

ChatGPT, a powerful AI language model, has gained increasing prominence in medicine, offering potential applications in healthcare, clinical decision support, patient communication, and medical research. This systematic review aims to comprehensively assess the applications of ChatGPT in healthcare education, research, writing, patient communication, and practice while also delineating potential limitations and areas for improvement.

Method:

Our comprehensive database search retrieved relevant papers from PubMed, Medline and Scopus. After the screening process, 83 studies met the inclusion criteria. This review includes original studies comprising case reports, analytical studies, and editorials with original findings.

Result:

ChatGPT is useful for scientific research and academic writing, and assists with grammar, clarity, and coherence. This helps non-English speakers and improves accessibility by breaking down linguistic barriers. However, its limitations include probable inaccuracy and ethical issues, such as bias and plagiarism. ChatGPT streamlines workflows and offers diagnostic and educational potential in healthcare but exhibits biases and lacks emotional sensitivity. It is useful in inpatient communication, but requires up-to-date data and faces concerns about the accuracy of information and hallucinatory responses.

Conclusion:

Given the potential for ChatGPT to transform healthcare education, research, and practice, it is essential to approach its adoption in these areas with caution due to its inherent limitations.
The Nurse-Implemented Chronotherapeutic Bundle in Critically Ill Children, RESTORE Resilience (R2): Pilot Testing in a Two-Phase Cohort Study, 2017–2021
Authors: Curley Martha A. Q. , Dawkins-Henry Onella S. , Kalvas Laura Beth , Perry-Eaddy Mallory A. , Georgostathi Georgia , Yuan Ian , Wypij David , Asaro Lisa A. , Zuppa Athena F. , Kudchadkar Sapna R.
Published: August 2024

OBJECTIVES:

Pilot test the nurse-led chronotherapeutic bundle in critically ill children, RESTORE Resilience (R2).

DESIGN:

A two-phase cohort study was carried out from 2017 to 2021.

SETTING:

Two similarly sized and organized PICUs in the United States.

PATIENTS:

Children 6 months to 17 years old who were mechanically ventilated for acute respiratory failure.

INTERVENTIONS:

R2 seven-item chronotherapeutic bundle, including: 1) replication of child’s pre-hospital daily routine (i.e., sleep/wake, feeding, activity patterns); 2) cycled day-night light/sound modulation; 3) minimal effective sedation; 4) night fasting with bolus enteral daytime feedings; 5) early progressive mobility; 6) nursing care continuity; and 7) parent diaries.

MEASUREMENTS AND MAIN RESULTS:

Children underwent environmental (light, sound) and patient (actigraphy, activity log, salivary melatonin, electroencephalogram) monitoring. Parents completed the Child’s Daily Routine and Sleep Survey (CDRSS) and Family-Centered Care Scale. The primary outcome was post-extubation daytime activity consolidation (Daytime Activity Ratio Estimate [DARE]). Twenty baseline-phase (2017–2019) and 36 intervention-phase (2019–2021) participants were enrolled. During the intervention phase, nurses used the CDRSS to construct children’s PICU schedules. Overall compliance with nurse-implemented R2 elements 1–5 increased from 18% (interquartile range, 13–30%) at baseline to 63% (53–68%) during the intervention phase (p < 0.001). Intervention participants were exposed to their pre-hospitalization daily routine (p = 0.002), cycled day-night light/sound modulation (p < 0.001), and early progressive mobility on more PICU days (p = 0.02). Sedation target identification, enteral feeding schedules, and nursing care continuity did not differ between phases. Parent diaries were seldom used. DARE improved during the intervention phase and was higher pre-extubation (median 62% vs. 53%; p = 0.04) but not post-extubation (62% vs. 57%; p = 0.56).

CONCLUSIONS:

In the PICU, implementation of an individualized nurse-implemented chronotherapeutic bundle is feasible. Children who received the R2 bundle had increased pre-extubation daytime activity consolidation compared to children receiving usual care. Given variation in protocol adherence, further R2 testing should include interprofessional collaboration, pragmatic trial design, and implementation science strategies.