bluuebunny/crossref_metadata_2025 huggingface dataset:
Graphene Mitigates Nanoscale Tribochemical Wear of Silica Glass in Water
Authors: Sahoo Sourav , Khan Zuhaa , Mannan Sajid , Krishnan N. M. Anoop , Gosvami Nitya Nand
Published: December 2024

Despite the ubiquitous use of glasses, their simultaneous susceptibility toward scratch‐induced defects and atmospheric hydration deteriorates their mechanical and chemical durability. Here, it is demonstrated that the deposition of a few‐layer graphene provides unprecedented wear resistance to silica glass in aqueous conditions. To this extent, nanoscale scratch tests are carried out on graphene‐glass surfaces via contact‐mode atomic force microscopy with chemically inert and reactive tips. It is observed that the graphene‐glass exhibits up to ≈98% friction reduction and no discernable damage or material loss. This observation is in stark contrast to the behavior of bare silica glass which suffers severe tribochemical wear at equivalent contact conditions with even milder stresses. Further, through reactive molecular simulations, it is demonstrated that parallel mechanisms of lubrication and chemical passivity contribute to the enhanced damage resistance of graphene‐glass surfaces against any countersurface chemistry. Altogether, the present study provides an impetus toward physically and chemically durable glass coatings exploiting the functionalities of two‐dimensional materials.
Dual-layer dual-energy CT characterization of thrombus composition in acute pulmonary embolism and chronic thromboembolic pulmonary hypertension
Authors: Gertz Roman Johannes , Lennartz Simon , Kaya Kenan , Wawer Matos Reimer Robert Peter , Pennig Lenhard , Kottlors Jonathan , Kröger Jan Robert , Gietzen Carsten Herbert , Große Hokamp Nils , Rosenkranz Stephan , Fintelmann Florian Johannes , Pienn Michael , Bunck Alexander Christian
Published: December 2024

To evaluate dual-layer dual-energy computed tomography (dlDECT)-based characterization of thrombus composition for differentiation of acute pulmonary embolism (PE) and chronic thromboembolic pulmonary hypertension (CTEPH). This retrospective single center cohort study included 49 patients with acute PE and 33 patients with CTEPH who underwent CT pulmonary angiography on a dlDECT from 06/2016 to 06/2022. Conventional images), material specific images (virtual non-contrast [VNC], iodine density overlay [IDO], electron density [ED]), and virtual monoenergetic images (VMI50KeV) were analyzed. Regions-of-interest (ROIs) were manually placed in pulmonary artery thrombi, and morphological imaging characteristics for acute and chronic PE were assessed. Area under the receiver operating characteristics curve (AUC) of ROI measurements, morphological imaging features, and their combination in distinguishing between acute PE and CTEPH were evaluated. Compared to PE, thrombi in patients with CTEPH had lower attenuation on conventional images (Median [inter-quartile range]: 40 [35–47] HU vs 64 [52–83] HU) and VMI50keV reconstructions (59 [46–72] HU vs 101 [80–123] HU) as well as decreased iodine uptake (IDO: 0.5 [0.2–1.0] vs 1.2 [0.5–1.8]; p for all < 0.001). Conventional images and VMI50keV reconstructions were the most accurate for differentiating between acute and chronic thrombi (conventional: AUC 0.92, 95% CI 0.86–0.98; VMI50keV: AUC 0.91, 95% CI 0.85–0.97). Main pulmonary artery (MPA) diameter combined with thrombus attenuation significantly increased the AUC compared to MPA diameter alone (p = 0.002 respectively). Thrombi in patients with CTEPH exhibit lower attenuation and reduced contrast enhancement. Analyzing attenuation in pulmonary thrombi may add diagnostic information to established morphological parameters in differentiating acute PE from CTEPH.
Supporting the Development of Executive Function Skills Through Structured Play: A Qualitative Study of South African Preschool Teachers
Authors: Etokabeka Elsa
Published: December 2024

Executive function encompasses various cognitive skills that govern our thoughts and actions when completing a task. The skills include self-regulation, memorisation, and cognitive flexibility to ultimately foster autonomy, planning, and problem solving skills. Various interventions have been used to develop executive function skills; however, the use of structured play has not been adequately assessed. Therefore, this qualitative study explored how the development of executive function skills can be supported in preschool settings using structured play. Since acquiring new knowledge and skills is particularly effective during social interaction, Vygotsky’s sociocultural theory was the conceptual framework. A qualitative approach was deemed the most suitable choice as it relied on direct observation of the phenomenon. Eight South African preschool teachers were selected from four preschools with different curricula (National Curriculum Framework, Independent School Association of South Africa curriculum, Montessori, and Reggio Emilia). Research data was obtained using semi-structured interviews and lesson observations. The data was then analysed and coded to arrive at six themes. The themes include: (1) guiding, (2) modelling, (3) instructing, (4) repeating, (5) incorporating child-led activities, and (6) considering children’s interests. Overall, the data supported active engagement through social experiences as a route to develop executive function skills. Given the psychosocial benefits of acquiring executive function skills at an early age, the contribution of this study suggests that play-based strategies are effective in enhancing executive function skills. These strategies are applicable in different learning environments.
Magnetoresistive and magnetocaloric properties of polycrystalline Sm0.50Sr0.50MnO3 compound with short range magnetic ordering
Authors: Karikar Amanulla , Das Kalipada , Das I.
Published: December 2024

In this study, the magnetic and magneto-transport properties of polycrystalline

$$\hbox {Sm}_{0.50}\hbox {Sr}_{0.50}\hbox {MnO}_3$$

Sm

0.50

Sr

0.50

MnO
3

have been investigated. The presence of short-range magnetic order plays a crucial role in influencing electron transport, making it a promising pathway for tuning magnetoresistive properties for specific applications. This research focuses on the effects of magnetic nanoclusters on spin-dependent scattering and their impact on magneto-transport and magnetocaloric properties in polycrystalline

$$\hbox {Sm}_{0.50}\hbox {Sr}_{0.50}\hbox {MnO}_3$$

Sm

0.50

Sr

0.50

MnO
3

. Experimental results reveal a significant magnetocaloric effect and notable magnetoresistance within the liquid nitrogen temperature range. At 100 K, the magnetoresistance reaches approximately 70% under an external magnetic field of 20 kOe. The magnetocaloric entropy change is calculated to be 3.5 J/kg-K for a 70 kOe magnetic field, with the entropy change curve exhibiting a broadened peak, leading to a substantial Relative Cooling Power (RCP). These findings enhance our understanding of the material’s behavior and highlight its potential for various technological applications.
Optical logic array: a photonic solution towards universal computing
Authors: Fang Lu
Published: December 2024

Graphical abstract
Influence of in situ heating and laser remelting on martensitic precipitation-hardening stainless steel fabricated by laser powder bed fusion
Authors: Ali Majed , Almotari Abdalmageed , Qattawi Ala
Published: December 2024

The introduction of in situ heat-assisted fabrication and laser remelting as novel techniques within laser-based additive manufacturing aims to mitigate porosity and reduce surface roughness. However, a comprehensive understanding of the impact of in situ heating and laser remelting on mechanical properties and microstructure is still lacking, particularly for precipitate-hardenable metals like 15-5PH and 17-4 PH stainless steel, which can yield mechanical properties comparable to conventionally fabricated materials. This study presents experimental findings that demonstrate the efficacy of in situ heating during laser powder bed fusion (LPBF) in significantly reducing porosity and enhancing the material’s ductility. The performed XRD analyses indicate that the retained austenite phase increased in samples fabricated with heat-assisted LPBF. There is a reduction in the experimentally measured ultimate tensile strength, yield strength, and hardness in the precipitate-hardenable stainless steel samples that were fabricated by the introduced method using a heated plate. The experimental results reveal a 25% increase in ductility for heat-assisted LPBF fabrication compared to without heated substrate. In addition, SEM fractography analysis indicates a significant reduction in crack size and porosity in samples produced by heat-assisted LPBF.
Problems related to the operation of machines and devices for the production of ceramic roof tiles with a special consideration of the durability of tools for band extrusion
Authors: Hawryluk Marek , Marzec Jan
Published: December 2024

This article performs a complex analysis of the production of ceramic roof tiles from a plastic mass based mainly on clay with additions, subjected to the successive stages of the process, in order to ultimately obtain a roof tile to be used in roofings. It discusses the most important aspects and parameters of production which affect the abrasive and tribological wear of the machine elements. Particularly the key elements of those devices on the roof tile production lines which are in direct contact with the extruded material have to be especially resistant to abrasive wear, which occurs as a result of contact with the extruded clay band. The wear of tools of this type is affected by many, often opposing, factors and physic and chemical phenomena. This makes the analysis of their wear difficult and complex, at the same time demonstrating the difficulties in a detailed analysis of such processes as well as the key technological parameters, especially in terms of the possibilities of applying numerical modeling. This article also performs a review of the materials used for the production of machine elements for roof tiles and their optimization in the aspect of a continuous development of the production technology. A special attention is mostly paid to the wear of machines and devices used for band extrusion as well as the possible directions of further development of the ceramic industry.
Regeneration of virus-free plants from undeveloped ovules of seedless citrus cultivars: a practical approach for combating citrus viral diseases
Authors: Zhang Zhehui , Hu Yongjun , Wang Ming , Nie Ruihan , Sun Manli , Xie Zongzhou , Chai Lijun , Ye Junli , Deng Xiuxin
Published: December 2024

The citrus industry is confronted with significant challenges posed by viral diseases. However, commercially favored seedless cultivars cannot be propagated through seeds to generate virus-free plants. Obtaining virus-free plants from seedless cultivars has been an important goal for research and practical purposes. In this study, virus-free plants were successfully regenerated from undeveloped ovules of seedless citrus cultivars through somatic embryogenesis. Following rigorous sterilization, the undeveloped ovules, collected from fruits harvested at 210 DAF (days after flowering), were cultured in darkness on MGS medium (MS medium containing 0.5 g L−1 malt extract, 1 mg L−1 GA3, 40 mg L−1 SAD [adenine hemisulfate]) to induce embryoid formation. The embryoids were then transferred to a 16-h photoperiod to promote bud regeneration. Thereafter, the regenerated buds were grafted onto in vitro rootstocks to recover entire plants. Four viruses, including Citrus exocortis viroid (CEVd), Citrus yellow vein clearing virus (CYVCV), Citrus tristeza virus (CTV), and Citrus tatter leaf virus (CTLV), were confirmed to be successfully eradicated in the regenerated plants. Both whole-genome resequencing and single-gene sequence alignment analyses confirmed that the regenerated plants retained genetic fidelity to the maternal plants. Furthermore, we established that the regeneration protocol from undeveloped ovules is an effective and practical method for virus elimination across diverse citrus varieties. These findings provide an alternative strategy for combating citrus viral diseases and achieving germplasm conservation.
The Timing of Sea-Level Rise Impacts to Cultural Heritage Sites along the Georgia Coast, USA, through Fine-Grain Ecological Modeling
Authors: Cochran Lindsey E. , Thompson Victor D. , Anderson David G. , Hladik Christine M. , Herbert Ellen
Published: December 2024

Large datasets, combined with modeling techniques, provide a quantitative way to estimate when known archaeological sites will be impacted by climatological changes. With over 4,000 archaeological sites recorded on the coast of Georgia, USA, the state provides an ideal opportunity to compare methods. Here, we compare the popular passive “bathtub” modeling with the dynamic Sea Level Affecting Marshes Model (SLAMM) combined with the Marshes Equilibrium Model (MEM). The goal of this effort is to evaluate prior modeling and test the benefits of more detailed ecological modeling in assessing site loss. Our findings indicate that although rough counts of archaeological sites destroyed by sea-level rise (SLR) are similar in all approaches, using the latter two methods provides critical information needed in prioritizing site studies and documentation before irrevocable damages occur. Our results indicate that within the next 80 years, approximately 40% of Georgia's coastal sites will undergo a loss of archaeological context due to wetlands shifting from dry ecological zones to transitional marshlands or submerged estuaries and swamps.
Designing efficient ligand exchange strategies for the synthesis of stable perovskite nanocrystals
Authors: Zhang Xuanyu , Yao Zhiwei , Deng Ming , Wu Ruifa , Wang Jing , Ren Yong , Wang Chengbo , Jia Guohua , Qian Lei , Xiang Chaoyu
Published: December 2024

Stable PeNCs are synthesized by promoting ligand exchange. High-performance devices are then fabricated based on these PeNCs.
Augmented reality navigation in orthognathic surgery: Comparative analysis and a paradigm shift
Authors: Żelechowski Marek , Zubizarreta‐Oteiza Jokin , Karnam Murali , Faludi Balázs , Zentai Norbert , Gerig Nicolas , Rauter Georg , Thieringer Florian M. , Cattin Philippe C.
Published: December 2024

The emergence of augmented reality (AR) in surgical procedures could significantly enhance accuracy and outcomes, particularly in the complex field of orthognathic surgery. This study compares the effectiveness and accuracy of traditional drilling guides with two AR‐based navigation techniques: one utilizing ArUco markers and the other employing small‐workspace infrared tracking cameras for a drilling task. Additionally, an alternative AR visualization paradigm for surgical navigation is proposed that eliminates the potential inaccuracies of image detection using headset cameras. Through a series of controlled experiments designed to assess the accuracy of hole placements in surgical scenarios, the performance of each method was evaluated both quantitatively and qualitatively. The findings reveal that the small‐workspace infrared tracking camera system is on par with the accuracy of conventional drilling guides, hinting at a promising future where such guides could become obsolete. This technology demonstrates a substantial advantage by circumventing the common issues encountered with traditional tracking systems and surpassing the accuracy of ArUco marker‐based navigation. These results underline the potential of this system for enabling more minimally invasive interventions, a crucial step towards enhancing surgical accuracy and, ultimately, patient outcomes. The study resulted in three relevant contributions: first, a new paradigm for AR visualization in the operating room, relying only on exact tracking information to navigate the surgeon is proposed. Second, the comparative analysis marks a critical step forward in the evolution of surgical navigation, paving the way for integrating more sophisticated AR solutions in orthognathic surgery and beyond. Finally, the system with a robotic arm is integrated and the inaccuracies present in a typical human‐controlled system are evaluated.
Template‐based universal adversarial attack for synthetic aperture radar automatic target recognition network
Authors: Liu Wei , Wan Xuanshen , Niu Chaoyang , Lu Wanjie , Li Yuanli
Published: December 2024

Existing synthetic aperture radar (SAR) adversarial attack algorithms primarily focus on the digital image domain, and constructing adversarial examples in real‐world scenarios presents significant and challenging hurdles. This study proposes the template‐based universal adversarial attack (TUAA) algorithm. Initially, a SAR interference template generator module is constructed to derive a universal adversarial perturbation in the image domain. The designed loss function guides the parameter updating of the generator, thereby improving the attack effectiveness and perturbation concealment. Subsequently, a SAR jamming signal generator module is developed, which swiftly generates the interference signal using the range convolutional and azimuth multiplication modulation jamming method. Consequently, the victim model can be effectively targeted by merely transmitting the jamming signal to the SAR receiver. Experimental results show that TUAA reduces the recognition rate of four typical DNN models to less than 15% under acceptable time costs and image deformation.
A Firing Cannon: Bilateral Lower Limb Ischemia as a Manifestation of Cardiac Myxoma
Authors: Elbayomi Mohamed , Groß Raphael , Presheet Pathare , Agaimy Abbas , May Mattias , Wayend Micheal , Heim Christian
Published: December 2024

Background Cardiac myxomas are the most common primary cardiac neoplasms.

Case Description We present a case of a middle-aged lady with cardiac myxoma in her left atrium awaiting semi-elective surgery. During the preoperative period, the patient presented emergently with acute bilateral lower limb ischemia. This lady was fortunate to have these emboli fired towards a tissue with ischemia tolerance capacity. If these emboli had been directed toward the central nervous system, this patient would have experienced devastating complications and even death.

Conclusion This presentation opens the debate on the timing of surgical intervention in myxoma patients.
Beyond the Chest Wall: Examining the Relationship between Morphological Features and Psychosocial Distress in Pectus Excavatum Patients
Authors: Janssen Nicky , Daemen Jean H.T. , van Hulst Luca DRTG , Franssen Aimée J.P.M. , Coorens Nadine A. , Hulsewé Karel W.E. , Vissers Yvonne L.J. , de Loos Erik R.
Published: December 2024

Introduction Pectus excavatum patients frequently experience psychosocial distress, yet the relationship with morphological features of the deformity remains unexplored. We hypothesize that certain morphological features analyzed by 3D optical surface imaging contribute more prominently to the distress experienced by pectus excavatum patients as they impact the visible severity of the deformity.

Materials and Methods Consecutive pectus excavatum patients who received three-dimensional optical surface imaging between August 2019 and November 2022 were included. Logistic regression analysis assessed the association between morphological features and psychosocial distress in which the distress was scored as a binary variable, based on a self-reported assessment.

Results Among 215 patients, 55% reported psychosocial distress with multivariable analyses revealing greater depth and length of the deformity being significantly correlated with psychosocial distress. However, this prediction model demonstrated a moderate discriminative ability with an area under the receiver operating characteristic curve of 0.66 (95% confidence interval [CI], 0.59–0.73) for pectus depth and 0.58 (95% CI, 0.51–0.66) for pectus length.

Conclusions The morphological features of length and depth of the deformity are correlated with psychosocial distress. Nonetheless, these individual features are weak predictors due to their moderate discriminative ability. This underscores that other patient-related factors, such as personality traits, neuropsychological conditions, and other psychosocial influences, are likely to play a role in the occurrence of psychosocial distress. Future studies should investigate these variables alongside the incorporation of standardized instruments for measuring psychosocial distress to better understand and address the distress in this population.
Optimizing Post-Kasai Management in Biliary Atresia: Balancing Native Liver Survival and Transplant Timing
Authors: Madadi-Sanjani Omid , Uecker Marie , Thomas Gordon , Fischer Lutz , Hegen Bianca , Herrmann Jochen , Reinshagen Konrad , Tomuschat Christian
Published: December 2024

Background Kasai procedure (KPE) is a palliative intervention in infants with biliary atresia (BA) aiming to restore biliary drainage. While the measure of success in BA is the post-Kasai native liver survival (NLS), BA remains the most frequent indication for liver transplantation in children. While a considerable amount of children fail to clear their jaundice following KPE, resulting in early liver failure and transplantation, some children become jaundice-free after “successful” KPE. However, sequelae of chronic liver disease might affect those children, becoming a later risk for NLS. While liver transplantation is inevitable in the majority of children, various salvage procedures have been recently described to maintain NLS. This article provides a comprehensive overview of procedures performed after KPE to prolong NLS in BA patients from early childhood to late adulthood and discusses their indications and limitations.

Methods A literature-based search for surgical and radiological interventions performed in BA patients after KPE to prolong NLS (salvage procedures) was performed using PubMed. Data from case reports, retrospective studies, and registries were included.

Results Fifteen studies included 794 patients who underwent post-KPE salvage procedures. The Oxford Centre for Evidence-Based Medicine levels were IIc to IV.

Interventions included redo-Kasai's (n = 710) for cessation of bile flow post-KPE, surgical and radiological procedures (n = 14) for bile lakes, and recurrent cholangitis, shunt surgery (n = 49), and transjugular intrahepatic portosystemic shunt (n = 21) for portal hypertension in BA patients. Age at the time of salvage interventions varied considerably, including redo-Kasai's at 27 days of life and percutaneous biliary interventions in a 35-year-old.

Conclusion Salvage procedures can maintain NLS after KPE in BA patients with disease sequelae. However, indications remain scarce and liver transplantation is ultimately unavoidable in the majority of patients. While redo-Kasai numbers are globally decreasing with the advances in liver transplantation, procedures for bile lakes and portal hypertension can be viable options for patients with complications but otherwise stable liver function. Discussion on those procedures should be held by multidisciplinary expert teams, involving pediatric hepatologists, pediatric surgeons, and transplant surgeons to elaborate on the potential of maintaining NLS or proceeding with transplantation.
Prone Positioning for Acute Respiratory Failure after PEA: An Initial Experience
Authors: Ak Koray , Tarazi Majd , Öztürk Fatih , Yıldızeli Şehnaz Olgun , Kararmaz Alper , Mutlu Bulent , Yildizeli Bedrettin
Published: December 2024

Background We retrospectively analyzed patients who underwent prone positioning (PP) for acute respiratory failure after pulmonary endarterectomy (PEA).

Methods A total of 125 patients underwent PEA and the outcome related to patients who underwent PP for acute respiratory failure after surgery was analyzed.

Results In all 13 patients (10%) underwent PP at the mean duration of 28.2 ± 10.6 hours after surgery and the mean prone time was 29.4 ± 9.8 hours. Compared with the pre-prone values, there was a significant improvement in the mean arterial oxygen to fraction of inspired oxygen ratio at the end of PP (119.4 ± 12.4 versus 202 ± 58.3) (p = 0.0002). Eight patients (61%) revealed a significant improvement in oxygenation with PP. Five patients who remained unresponsive underwent extracorporeal membrane oxygenation and four of them were weaned off successfully. In multivariate logistic stepwise analysis, the need for a moderate inotropy (odds ratio [OR]: 3.1) and low preoperative cardiac index (OR: 0.2) were independent predictors of PP. Under PP, the most common complication was ventilator-associated pneumonia (n = 9, 70%) and PP was found to be an independent predictor of ventilator-associated pneumonia (OR: 10.3). Early mortality was seen in three patients (23%, sepsis in two and adult respiratory distress syndrome in one).

Conclusion In the early care of acute respiratory failure following PTE, PP may be a feasible option, despite an increased risk of ventilator-associated pneumonia. More research involving a larger sample size is necessary.
Primary versus Secondary Immune Thrombocytopenia (ITP): A Meeting Report from the 2023 McMaster ITP Summit
Authors: Modi Dimpy , Chowdhury Saifur R. , Mahamad Syed , Modi Hayley , Cines Douglas B. , Neunert Cindy E. , Al-Samkari Hanny , Cooper Nichola , Moulis Guillaume , Cunningham-Rundles Charlotte , Liebman Howard A. , Bussel James B. , Breakey Vicky R. , Nazy Ishac , Arnold Donald M.
Published: December 2024

The McMaster Immune Thrombocytopenia (ITP) Summit, held on October 27, 2023, was an educational seminar from leading experts in immune thrombocytopenia and related disorders geared toward hematologists, internists, immunologists, and clinical and translational scientists. The focus of the Summit was to review the mechanisms, diagnosis, and treatment of primary versus secondary ITP. Specific objectives were to describe the unique features of secondary ITP, and to review its mechanisms in the context of autoimmune disease and infection. The key messages in this Summit were: (1) ITP is a heterogeneous disease, and genetic and immunologic insights may help classify patient subtypes; (2) exploring the autoimmune mechanisms and their association with hypogammaglobulinemia in patients with secondary ITP could improve our understanding of ITP and its subtypes; (3) investigating the mechanisms of ITP in the context of infections caused by viruses such as CMV, HIV, dengue, and hepatitis C, or bacteria such as H. pylori, or vaccinations could provide insight into the causes of ITP. A better understanding of secondary ITP could help elucidate the pathogenesis of ITP.
Recent Applications of Triphenylmethyl (Trityl) Cations in Synthesis
Authors: Mulks Florian F. , Gong Yiwei
Published: December 2024

Carbocations, often deemed transient and unstable intermediates in organic chemistry, gained significant recognition with the awarding of the Nobel Prize in Chemistry to George A. Olah in 1995 for his work on carbocation chemistry. The triphenylmethyl (trityl) cation, a stable and versatile carbocation, has emerged as a significant player in organic reactions. This short review provides an update on the use of trityl cations as organic Lewis acids, highlighting their role in various catalytic processes. We aim to offer a comprehensive overview of the latest developments and prospects of these ions. The continued exploration of trityl cations promises to enhance their role as a valuable tool in synthetic chemistry, offering efficient alternatives to traditional inorganic or metal-based catalysts.

1 Introduction

2 Synthesis of Fluorinated Triphenylmethylium Acids

3 Redox Behavior of Tritylium Salts

4 Lewis Acids for Organocatalysis

5 Catalysis of Multicomponent Syntheses

6 Initiation of Carbenium- and Silylium-Centered Reactivity

7 Polymer Synthesis

8 Further Applications of Tritylium Salts

9 Conclusion and Outlook
Beyond Hydrolysis: Scalable, On-Demand Dihydrogen Release from NaBH4 Enables Circular and Sustainable Process Design
Authors: Wessels Pier W. , Verhoef Caroline J. , Buß Florenz , Geiger Valentin , de Jong G. Bas , Wesselingh Tim , Germanacos Philip , Slootweg J. Chris
Published: December 2024

Hydrogen storage in its elemental form poses significant safety and economic challenges. Metal hydrides, particularly sodium borohydride, offer a promising alternative because of their superior safety profiles and enhanced transportability. This study presents a scalable hydrogen release system based on sodium borohydride and commercially available alcohols and acids. The system enables rapid, controlled hydrogen generation, achieving quantitative yields. Quantum chemical calculations were performed to propose a mechanism for the alcoholysis of NaBH4 with isopropyl alcohol (IPA) and acid present. It was demonstrated that the reaction proceeds via isopropoxy-substituted borane derivatives BH(3−n)(O
i
Pr)
n
(for n = 0, 1, 2, 3), which can form Lewis acid–base adducts with IPA. These Lewis acid–base adducts serve as reaction complexes for σ-bond metathesis, upon which an equivalent of hydrogen gas is released. Notably, the spent fuel can be regenerated to sodium borohydride using established chemical reactions, ensuring the system's sustainability and applicability for larger-scale hydrogen production.
Medical School Curricular Changes and Their Impact on Mental Health during the Onset of the COVID-19 Pandemic
Authors: Al Kassab Leen , Fozouni Laila , Reynolds Christopher , Pham Phuong , Dobiesz Valerie
Published: December 2024

Objectives The main objectives were to identify and categorize the curricular changes that occurred in U.S. medical schools during the onset of the coronavirus disease 2019 (COVID-19) pandemic, and to identify the relationship between curricular changes and COVID-19 surges and student mental health.

Methods This Institutional Review Board-approved study consisted of a voluntary online survey of U.S. medical students. A convenience sample of students was reached through Facebook groups, medical student organizations, and administrators. The survey consisted of questions about demographics, curricular changes, and mental health. Univariate and backward stepwise multivariate linear regression were used to assess associations between mental health outcomes and demographic characteristics, curricular changes, and stressors.

Results Four-hundred and nine medical students completed the survey from 21 states between May 29, 2020, and August 29, 2020. Seventy-nine percent of respondents reported continuing their basic science curricula virtually. Forty-five percent reported that rotations continued virtually; those reported being offered virtually included internal medicine (77%), family medicine (78%), surgery (70%), obstetrics/gynecology (73%), pediatrics (74%), and psychiatry (76%). The majority of students reported that core clerkships (78%) and subinternships (86%) were not allowed, and away rotations were universally canceled. In univariate linear regression, having in-person subinternships and core clerkships allowed, as well as not relocating for coursework or residence (experienced by 35% of students), was associated with improved mental health outcomes, while experiencing graduation changes (15%) or being from the Southern region was associated with worse outcomes (p < 0.001).

Conclusion During the early COVID-19 pandemic, students reported that their medical schools adapted by converting to virtual platforms for basic science and core clerkships. Allowing in-person rotations and limiting relocation were associated with improved mental health outcomes among students. Limitations included sample size, selection bias, and student perceptions.
Assessing the Impact of USMLE Step 1 Going Pass-Fail: A Brief Review of the Performance Data
Authors: English Kevan
Published: December 2024

On January 26, 2022, the United States Medical Licensing Examination (USMLE) Step 1 exam transitioned to a pass-fail grading system instead of the conventional three-digit score. This move was intended to decrease the emphasis on Step 1 scores and facilitate a more holistic approach by programs in the residency selection process. However, since the implementation of the new grading system, we have seen a lower passing percentage among all medical students, including U.S. MDs, DOs, and international medical graduates. In this article, we assess the USMLE Step 1 performance data since the change in scoring and some factors that may have contributed to the lower passing rates among all medical students.
Urothelial carcinoma in situ with “early papillary formation” vs “lateral spread/shoulder lesion” of prior high-grade noninvasive papillary urothelial carcinoma: A survey of pathologist and urologist interpretations
Authors: Sangoi Ankur R , Shahabi Ali , Hirsch Michelle S , Kao Chia-Sui (Sunny) , Deebajah Mustafa , Barletta Justine A , Paner Gladell P , Smith Steven C , Grignon David J , Compérat Eva , Amin Mahul B , Maclean Fiona , Shah Rajal B , Iczkowski Kenneth A , Delprado Warick , Cheng Liang , Pan Chin-Chen , McKenney Jesse K , Ro Jae Y , Khani Francesca , Montironi Rodolfo , Robinson Brian D , Al-Ahmadie Hikmat , Epstein Jonathan I , Trpkov Kiril , Tretiakova Maria , Shen Steven S , Alanee Shaheen , Weight Christopher J , Akgul Mahmut , Williamson Sean R
Published: December 2024

Objectives

Urothelial carcinoma in situ (CIS) with early papillary formation is terminology sometimes used to suggest incipient high-grade papillary urothelial carcinoma (PUC) but may lead to confusion between true CIS and lateral flat spread of PUC.

Methods

It remains unclear how pathologists and urologists interpret this scenario, so a survey was circulated to 68 pathologists (group 1 = 28 academic genitourinary pathologists; group 2 = 17 pathologists with a self-reported genitourinary focus; group 3 = 23 pathologists self-reported as not genitourinary specialists) and 32 urologists.

Results

Regarding atypical urothelial lesions that appear mainly flat but contain possible papillae, group 3 was more likely to label this as CIS compared with groups 1 and 2 (35% for group 3 vs 13% for groups 1 and 2), while groups 1 and 2 more often adopted another descriptive diagnosis, such as “CIS with early papillary features” (38% for groups 1 and 2 vs 13% for group 3). Among all 3 groups, group 1 was most likely to diagnose concomitant CIS and PUC in the same specimen but in different tissue fragments (58%). Pagetoid spread was reported to favor CIS predominantly by group 1 (61%). Urologists felt that the term lateral spread/shoulder was unclear (75%) and preferred early PUC (44%) or PUC with early growth (44%). Half (53%) of urologists felt that reporting CIS instead of lateral spread of PUC would change management.

Conclusions

Documentation of flat lesions lacks consensus among pathologists and may benefit from standardized terminology. Moreover, the distinction between CIS and early or lateral spread of PUC is not always clear to urologists and can influence disease management.
Development of a nano-specific safe-by-design module to identify risk management strategies
Authors: Ben Jeddi Hasnae , Goede Henk , Franken Remy , van Someren Eugene , Shandilya Neeraj , Vermoolen Ruby , Steck Josephine , Artous Sebastien , Hermosilla Jorge Salvador , Fransman Wouter
Published: December 2024

This article describes the development of a Safe-by-Design (SbD) module and its integration into an easy-to-use tool, named the Nano Exposure Quantifier—Safe-by-Design (NEQ-SbD) tool. The NEQ-SbD tool guides its user to lower the exposure to nanomaterials at the worksite where nanomaterials are manipulated or handled during a wide range of activities. This allows the tool user with an informed decision to assess airborne exposure and to select, compare, and identify appropriate risk management measures (RMM). The SbD module was developed using various information sources that can support and guide the SbD process, including the (i) RMM effectiveness based on analyses of an Exposure Control Efficacy Library (ECEL), (ii) RMM performance using a Computational Fluid Dynamics (CFD) model, (iii) e-cards based on a qualitative analysis of RMM information sources, and (iv) guidance for SbD strategy using an exposure directionality assessment. This information has been integrated in the user interface of the SbD module and NEQ-SbD tool to facilitate the SbD decision-making process. The SbD concept applied in the integrated NEQ-SbD tool introduces a comparison between a baseline exposure assessment and an (improved) SbD exposure assessment. The integrated NEQ-SbD tool consists of 4 modules including (i) a baseline exposure assessment, (ii) baseline results, (iii) SbD assessment, and (iv) SbD comparative results. The main purpose of the SbD module lies in guiding the user to the most sensitive (exposure) parameters and allowing a side-by-side comparison of potentially suitable RMMs. The integrated NEQ-SbD tool also offers a tiered approach and seamlessly shifts from a tier-1 to tier-2 uncertainty of an exposure assessment. The SbD module is illustrated using a worked example for the transfer of nano powders, showing the possibility of identifying SbD solutions for both safe-by-process and safe-by-material design purposes. The NEQ-SbD tool is a valuable tool for the SbD of nanomaterials and as a decision-making tool to support SbD risk management strategies that lead to minimizing health risks associated with occupational exposures.
Inhibition of shoot branching in Arabidopsis by the artificially biosynthesized canonical strigolactone
Authors: Mizutori Yuki , Nishiyama Kotaro , Seto Yoshiya
Published: December 2024

Strigolactones (SLs) are apocarotenoid plant hormones that regulate shoot branching. The natural SLs can be divided into 2 groups, canonical and noncanonical SLs, according to those chemical structures. In a model plant, Arabidopsis thaliana, it has been thought to produce only noncanonical SLs. Moreover, in rice, it was suggested that canonical-SL such as 4-deoxyorobanchol (4DO) does not have a critical role in shoot branching inhibition. In this report, to understand the potential of canonical-SL in the shoot branching inhibition pathway in Arabidopsis, SL biosynthetic genes involved in canonical-SL production in other plant species were individually expressed in Arabidopsis. Our data clearly demonstrate that 5-deoxystrigol, but not 4DO, can inhibit shoot branching in Arabidopsis. Moreover, the results confirmed the important role of CLA methyltransferase in the shoot branching inhibition pathway in Arabidopsis.
Type I interferon and mitochondrial dysfunction are associated with dysregulated cytotoxic CD8+ T cell responses in juvenile systemic lupus erythematosus
Authors: Radziszewska Anna , Peckham Hannah , Restuadi Restuadi , Kartawinata Melissa , Moulding Dale , de Gruijter Nina M , Robinson George A , Butt Maryam , Deakin Claire T , Wilkinson Meredyth G Ll , Wedderburn Lucy R , Jury Elizabeth C , Rosser Elizabeth C , Ciurtin Coziana
Published: December 2024

Juvenile systemic lupus erythematosus (JSLE) is an autoimmune condition which causes significant morbidity in children and young adults and is more severe in its presentation than adult-onset SLE. While many aspects of immune dysfunction have been studied extensively in adult-onset SLE, there is limited and contradictory evidence of how cytotoxic CD8+ T cells contribute to disease pathogenesis and studies exploring cytotoxicity in JSLE are virtually non-existent. Here, we report that CD8+ T cell cytotoxic capacity is reduced in JSLE versus healthy controls, irrespective of treatment or disease activity. Transcriptomic and serum metabolomic analysis identified that this reduction in cytotoxic CD8+ T cells in JSLE was associated with upregulated type I interferon (IFN) signalling, mitochondrial dysfunction, and metabolic disturbances when compared to controls. Greater interrogation of the influence of these pathways on altered cytotoxic CD8+ T cell function demonstrated that JSLE CD8+ T cells had enlarged mitochondria and enhanced sensitivity to IFN-α leading to selective apoptosis of effector memory (EM) CD8+ T cells, which are enriched for cytotoxic mediator-expressing cells. This process ultimately contributes to the observed reduction in CD8+ T cell cytotoxicity in JSLE, reinforcing the growing evidence that mitochondrial dysfunction is a key pathogenic factor affecting multiple immune cell populations in type I IFN-driven rheumatic diseases.
Intravenous amino acid for kidney protection: current understanding and future perspectives
Authors: Kotani Yuki , Baiardo Redaelli Martina , Pruna Alessandro , Losiggio Rosario , Cocozza Susanna , Ti Lian Kah , Bradic Nikola , Comis Marco , Landoni Giovanni , Bellomo Rinaldo
Published: December 2024

Acute kidney injury (AKI) is a common complication in critically ill and perioperative patients and is associated with mortality, morbidity, medical costs, and progression to chronic kidney function. Unfortunately, despite numerous research efforts, until recently, there was no AKI preventive therapy supported by level 1 evidence. Among the several factors that contribute to renal damage, two of the major triggers of AKI development are renal hypoperfusion and renal medullary hypoxia. The intravenous administration of a mixture of amino acids promotes the prevention of AKI through multiple mechanisms: the recruitment of renal functional reserve, increased renal blood flow, and improvements in renal oxygenation. Such mechanisms of action led to increased glomerular filtration rate and urine output in preclinical and pilot clinical studies. To test if these benefits on physiological parameters could be translated into clinically meaningful outcomes, a multicenter, randomized, placebo-controlled, trial was conducted in the cardiac surgery setting. Among 3511 adult patients undergoing elective cardiac surgery with cardiopulmonary bypass, intravenous amino acid administration, compared to placebo, significantly reduced the occurrence of AKI, providing the first level 1 evidence of an effective treatment for AKI prevention. In this review, we provide the epidemiology and pathophysiology of cardiac surgery-associated AKI and the concept of renal functional reserve. Then, we summarize the underlying mechanisms of intravenous amino acid infusion as a renoprotective strategy and its preclinical and clinical evidence. Finally, we discuss the existing evidence gaps and future directions of this promising intervention.
AneRBC dataset: a benchmark dataset for computer-aided anemia diagnosis using RBC images
Authors: Shahzad Muhammad , Shirazi Syed Hamad , Yaqoob Muhammad , Khan Zakir , Rasheed Assad , Ahmed Sheikh Israr , Hayat Asad , Zhou Huiyu
Published: December 2024

Visual analysis of peripheral blood smear slides using medical image analysis is required to diagnose red blood cell (RBC) morphological deformities caused by anemia. The absence of a complete anaemic RBC dataset has hindered the training and testing of deep convolutional neural networks (CNNs) for computer-aided analysis of RBC morphology. We introduce a benchmark RBC image dataset named Anemic RBC (AneRBC) to overcome this problem. This dataset is divided into two versions: AneRBC-I and AneRBC-II. AneRBC-I contains 1000 microscopic images, including 500 healthy and 500 anaemic images with 1224 × 960 pixel resolution, along with manually generated ground truth of each image. Each image contains approximately 1550 RBC elements, including normocytes, microcytes, macrocytes, elliptocytes, and target cells, resulting in a total of approximately 1 550 000 RBC elements. The dataset also includes each image’s complete blood count and morphology reports to validate the CNN model results with clinical data. Under the supervision of a team of expert pathologists, the annotation, labeling, and ground truth for each image were generated. Due to the high resolution, each image was divided into 12 subimages with ground truth and incorporated into AneRBC-II. AneRBC-II comprises a total of 12 000 images, comprising 6000 original and 6000 anaemic RBC images. Four state-of-the-art CNN models were applied for segmentation and classification to validate the proposed dataset.

Database URL:  https://data.mendeley.com/datasets/hms3sjzt7f/1
Granulomatous inflammatory responses are elicited in the liver of PD-1 knockout mice by de novo genome mutagenesis
Authors: Nagaretnam Ilamangai , Kakimoto Yoshiya , Yoneshige Azusa , Takeuchi Fuka , Sakimura Takayuki , Sato Kanato , Osaki Yoshiro , Ishii Yuta , Ozaki Ai , Tamura Masaru , Hamada Michito , Shigeoka Toshiaki , Ito Akihiko , Ishida Yasumasa
Published: December 2024

Introduction

Programmed death-1 (PD-1) is a negative regulator of immune responses. Upon deletion of PD-1 in mice, symptoms of autoimmunity developed only after they got old. In a model experiment in cancer immunotherapy, PD-1 was shown to prevent cytotoxic T lymphocytes from attacking cancer cells that expressed neoantigens derived from genome mutations. Furthermore, the larger number of genome mutations in cancer cells led to more robust anti-tumor immune responses after the PD-1 blockade. To understand the common molecular mechanisms underlying these findings, we hypothesize that we might have acquired PD-1 during evolution to avoid/suppress autoimmune reactions against neoantigens derived from mutations in the genome of aged individuals.

Methods

To test the hypothesis, we introduced random mutations into the genome of young PD-1–/– and PD-1+/+ mice. We employed two different procedures of random mutagenesis: administration of a potent chemical mutagen N-ethyl-N-nitrosourea (ENU) into the peritoneal cavity of mice and deletion of MSH2, which is essential for the mismatch-repair activity in the nucleus and therefore for the suppression of accumulation of random mutations in the genome.

Results

We observed granulomatous inflammatory changes in the liver of the ENU-treated PD-1 knockout (KO) mice but not in the wild-type (WT) counterparts. Such lesions also developed in the PD-1/MSH2 double KO mice but not in the MSH2 single KO mice.

Conclusion

These results support our hypothesis about the physiological function of PD-1 and address the mechanistic reasons for immune-related adverse events observed in cancer patients having PD-1-blockade immunotherapies.
Management of dyslipidaemia in patients with comorbidities—facing the challenge
Authors: Frühwald Lisa , Fasching Peter , Dobrev Dobromir , Kaski Juan Carlos , Borghi Claudio , Wassmann Sven , Huber Kurt , Semb Anne Grete , Agewall Stefan , Drexel Heinz
Published: December 2024

This review aims to examine the evidence on the benefits and risks of lipid-lowering drugs in patients with liver disease. Elevated liver enzyme levels often lead to cautious discontinuation of these drugs, potentially withholding from patients their benefit in reducing cardiovascular disease morbidity and mortality. Using a literature search of PubMed, we examine the efficacy and safety profiles of various lipid-lowering agents, including statins, ezetimibe, bempedoic acid, PCSK9 inhibitors, fibrates, and icosapent ethyl, focusing particularly on their potential side effects related to liver health. A major challenge in the assessment of drug-induced hepatotoxicity is the fact that it relies heavily on case reports rather than real-world evidence. There is currently a lack of robust evidence on lipid-lowering therapy in people with pre-existing liver disease. Nevertheless, we have attempted to summarize the available data for all the drugs mentioned in order to provide guidance for the treatment of patients with liver dysfunction. This review highlights the need for further research to optimize treatment strategies for patients with coexisting liver and cardiovascular disease.