bluuebunny/crossref_metadata_2025 huggingface dataset:
Transjugular intrahepatic portosystemic shunt creation (TIPS) in the angio-CT—a hybrid intervention with image fusion
Authors: Nadjiri Jonathan , Waggershauser Tobias , Mühlmann Marc , Ehmer Ursula , Geisler Fabian , Mayr Ulrich , Geith Tobias , Paprottka Philipp M.
Published: June 2023

Objective

For transjugular intrahepatic portosystemic shunt (TIPS) creation, ultrasound guidance for portal vein puncture is strongly recommended. However, outside regular hours of service, a skilled sonographer might be lacking. Hybrid intervention suites combine CT imaging with conventional angiography allowing to project 3D information into the conventional 2D imaging and further CT-fluoroscopic puncture of the portal vein. The purpose of this study was to assess whether TIPS using angio-CT facilitates the procedure for a single interventional radiologist.

Methods

All TIPS procedures from 2021 and 2022 which took place outside regular working hours were included (n = 20). Ten TIPS procedures were performed with just fluoroscopy guidance and ten procedures using angio-CT. For the angio-CT TIPS, a contrast-enhanced CT was performed on the angiography table. From the CT, a 3D volume was created using virtual rendering technique (VRT). The VRT was blended with the conventional angiography image onto the live monitor and used as guidance for the TIPS needle. Fluoroscopy time, area dose product, and interventional time were assessed.

Results

Hybrid intervention with angio-CT did lead to a significantly shorter fluoroscopy time and interventional time (p = 0.034 for both). Mean radiation exposure was significantly reduced, too (p = 0.04). Furthermore, the mortality rate was lower in patients who underwent the hybrid TIPS (0% vs 33%).

Conclusion

TIPS procedure in angio-CT performed by only one interventional radiologist is quicker and reduces radiation exposure for the interventionalist compared to mere fluoroscopy guidance. The results further indicate increased safety using angio-CT.

Clinical relevance statement

This study aimed to evaluate the feasibility of using angio-CT in TIPS procedures during non-standard working hours. Results indicated that the use of angio-CT significantly reduced fluoroscopy time, interventional time, and radiation exposure, while also leading to improved patient outcomes.

Key Points

• Image guiding such as ultrasound is recommended for transjugular intrahepatic portosystemic shunt creation but might be not available for emergency cases outside of regular working hours.

• Transjugular intrahepatic portosystemic shunt creation using an angio-CT with image fusion is feasible for only one physician under emergency settings and results in lower radiation exposure and faster procedures.

• Transjugular intrahepatic portosystemic shunt creation using an angio-CT with image fusion seems to be safer than using mere fluoroscopy guidance.
From Second-Order Differential Geometry to Stochastic Geometric Mechanics
Authors: Huang Qiao , Zambrini Jean-Claude
Published: June 2023

Classical geometric mechanics, including the study of symmetries, Lagrangian and Hamiltonian mechanics, and the Hamilton–Jacobi theory, are founded on geometric structures such as jets, symplectic and contact ones. In this paper, we shall use a partly forgotten framework of second-order (or stochastic) differential geometry, developed originally by L. Schwartz and P.-A. Meyer, to construct second-order counterparts of those classical structures. These will allow us to study symmetries of stochastic differential equations (SDEs), to establish stochastic Lagrangian and Hamiltonian mechanics and their key relations with second-order Hamilton–Jacobi–Bellman (HJB) equations. Indeed, stochastic prolongation formulae will be derived to study symmetries of SDEs and mixed-order Cartan symmetries. Stochastic Hamilton’s equations will follow from a second-order symplectic structure and canonical transformations will lead to the HJB equation. A stochastic variational problem on Riemannian manifolds will provide a stochastic Euler–Lagrange equation compatible with HJB one and equivalent to the Riemannian version of stochastic Hamilton’s equations. A stochastic Noether’s theorem will also follow. The inspirational example, along the paper, will be the rich dynamical structure of Schrödinger’s problem in optimal transport, where the latter is also regarded as a Euclidean version of hydrodynamical interpretation of quantum mechanics.
High-frequency shock wave lithotripsy: stone comminution and evaluation of renal parenchyma injury in a porcine ex-vivo model
Authors: Rassweiler-Seyfried Marie-Claire , Mayer Jürgen , Goldenstedt Cedric , Storz Rafael , Marlinghaus Ernst , Heine Gerold , Alken Peter , Rassweiler Jens Jochen
Published: June 2023

Background

The electrohydraulic high-frequency shock wave (Storz Medical, Taegerwilen, Switzerland) is a new way to create small fragments with frequencies up to 100 Hertz (Hz). This study evaluated the efficacy and safety of this method in a stone and porcine model.

Materials and methods

BEGO stones were put in a condom in a specifically designed fixture treated with different modulations to see stone comminution. Standardized ex vivo porcine model with perfused kidneys with 26 upper and lower poles of 15 kidneys was treated with the following modulations: voltage 16–24 kV, capacitor 12 nF and frequency up to 100 Hz. 2000–20,000 shock waves were applied to each pole. The kidneys were perfused with barium sulfate solution (BaSO4) and x-ray was performed to quantify the lesions using pixel volumetry.

Results

There was no correlation between the number of shock waves and the powdering degree or the applied Energy and the grade of pulverization in the stone model. Regarding the perfused kidney model, the number of shock waves, applied voltage and frequency had no direct correlation with the occurrence of parenchymal lesions The detected lesions of the renal parenchyma were minimal, technical parameters had no significant impact and the lesions did not differ from the results of former experiments using 1–1.5 Hz in the same model.

Conclusions

High-frequency shock wave lithotripsy can produce small stone fragments to pass in a very short time. The injury to the renal parenchyma is comparable to the results of the conventional SWL using 1–1.5 Hz.
Association of preoperative clinical frailty and clinical outcomes in elderly patients with stable coronary artery disease after percutaneous coronary intervention
Authors: Shimono Hirokazu , Tokushige Akihiro , Kanda Daisuke , Ohno Ayaka , Hayashi Masao , Fukuyado Mana , Akao Mitsumasa , Kawasoe Mariko , Arikawa Ryo , Otsuji Hideaki , Chaen Hideto , Okui Hideki , Oketani Naoya , Ohishi Mitsuru
Published: June 2023

There are few reports on the long-term clinical outcome after percutaneous coronary intervention (PCI) in patients with stable coronary artery disease (CAD) complicated with frailty. This novel study investigated the association between pre-PCI frailty and long-term clinical outcomes in elderly patients aged 65 years or older with stable CAD who underwent elective PCI. We assessed 239 consecutive patients aged 65 years or older with stable CAD who underwent successful elective PCI at Kagoshima City Hospital between January 1st, 2017 and December 31st, 2020. Frailty was retrospectively assessed using the Canadian Study and Aging Clinical Frailty Scale (CFS). Based on the pre-PCI CFS, patients were divided into two groups: the non-frail (CFS < 5) and the frail (CFS ≥ 5) group. We investigated the association between pre-PCI CFS and major adverse cardiovascular events (MACEs) defined as the composite of all-cause death, non-fatal myocardial infarction, non-fatal stroke, and heart failure requiring hospitalization. Additionally, we assessed the association between pre-PCI CFS and major bleeding events defined as Bleeding Academic Research Consortium (BARC) type 3 or 5 bleeding. The mean age was 74.8 ± 7.0 years, and 73.6% were men. According to the pre-PCI frailty assessment, 38 (15.9%) and 201 (84.1%) were classified as frail and non-frail groups, respectively. During a median follow-up of 962 (607–1284) days, 46 patients developed MACEs and 10 patients developed major bleeding events. Kaplan–Meier curves showed a significantly higher incidence of MACE in the frail group compared to those in the non-frail group (Log-rank p < 0.001). Even in multivariate analysis, pre-PCI frailty (CFS ≥ 5) was independently associated with MACE (HR 4.27, 95% CI 1.86–9.80, p-value: < 0.001). Additionally, the cumulative incidence of major bleeding events was significantly higher in the frail group than in the non-frail group (Log-rank p = 0.001). Pre-PCI frailty was an independent risk factor for MACE and bleeding events in elderly patients with stable CAD who underwent elective PCI.
The positive effect of spermidine in older adults suffering from dementia after 1 year
Authors: Pekar Thomas , Wendzel Aribert , Jarisch Reinhart
Published: June 2023

Background

A positive effect of the effect of a 3-month oral spermidine intake on memory performance has already been demonstrated. The continuation of this study aimed to examine whether there could be observed an improvement in memory performance after one year.

Method

45 residents of the nursing home “Gepflegt Wohnen” in Hart bei Graz, Styria, Austria, were given a daily dose of 3.3 mg spermidine in their diet for one year.

Results

The comparison of the MMSE test results at baseline and after one year demonstrated a significant (p < 0.001) difference. The mean improvement is 5 points.

Conclusion

The new results confirm the already proven positive effect of oral spermidine intake on memory performance.
An improved Henry gas optimization algorithm for joint mining decision and resource allocation in a MEC-enabled blockchain networks
Authors: Hussien Reda M. , Abohany Amr A. , Moustafa Nour , Sallam Karam M.
Published: June 2023

This paper investigates a wireless blockchain network with mobile edge computing in which Internet of Things (IoT) devices can behave as blockchain users (BUs). This blockchain network’s ultimate goal is to increase the overall profits of all BUs. Because not all BUs join in the mining process, using traditional swarm and evolution algorithms to solve this problem results in a high level of redundancy in the search space. To solve this problem, a modified chaotic Henry single gas solubility optimization algorithm, called CHSGSO, has been proposed. In CHSGSO, the allocation of resources to BUs who decide to engage in mining as an individual is encoded. This results in a different size for each individual in the entire population, which leads to the elimination of unnecessary search space regions. Because the individual size equals the number of participating BUs, we devise an adaptive strategy to fine-tune each individual size. In addition, a chaotic map was incorporated into the original Henry gas solubility optimization to improve resource allocation and accelerate the convergence rate. Extensive experiments on a set of instances were carried out to validate the superiority of the proposed CHSGSO. Its efficiency is demonstrated by comparing it to four well-known meta-heuristic algorithms.
Requirements engineering for sustainable software systems: a systematic mapping study
Authors: Bambazek Peter , Groher Iris , Seyff Norbert
Published: June 2023

Various approaches toward the development of sustainable software systems have been proposed by the requirements engineering community over the last decade. We conducted a systematic mapping study, analyzed 55 publications, and identified 29 approaches that have been published since the year 2000. We analyzed how the approaches evolved over time and how the publications and authors are influenced by each other. Furthermore, the approaches are analyzed in terms of their supported requirements engineering activities, along with the evidence provided in the publications. Additionally, we also analyzed which sustainability definitions have been used, if an iterative application of the approaches is discussed, and if the approaches also provide a tool-support for practitioners. We noticed an increase of publications on requirements engineering approaches toward sustainability in the last years, whereas a majority discuss sustainability based on the same multi-dimensional concept. Although different case studies have been already conducted, we noticed a lack of an industrial application. Our main findings concern the need of an evaluation on how the proposed requirements engineering approaches can also be applied in agile software development processes. Additionally, we also promote the development of supporting software tools to support practitioners in adapting the proposed approaches.
BatchHL$$^{+}$$: batch dynamic labelling for distance queries on large-scale networks
Authors: Farhan Muhammad , Koehler Henning , Wang Qing
Published: June 2023

Many real-world applications operate on dynamic graphs to perform important tasks. In this article, we study batch-dynamic algorithms that are capable of updating distance labelling efficiently in order to reflect the effects of rapid changes on such graphs. To explore the full pruning potentials, we first characterize the minimal set of vertices being affected by batch updates. Then, we reveal patterns of interactions among different updates (edge insertions and edge deletions) and leverage them to design pruning rules for reducing update search space. These interesting findings lead us to developing a new batch-dynamic method, called BatchHL$$^+$$

+

, which can dynamize labelling for distance queries much more efficiently than existing work. We provide formal proofs for the correctness and minimality of BatchHL$$^+$$

+

which are non-trivial and require a delicate analysis of patterns of interactions. Empirically, we have evaluated the performance of BatchHL$$^+$$

+

on 15 real-world networks. The results show that BatchHL$$^+$$

+

significantly outperforms the state-of-the-art methods with up to 3 orders of magnitude faster in reflecting updates of rapidly changing graphs for distance queries.
Eigenständige Analgesie mit Piritramid durch Notfallsanitäter – retrospektive Auswertung der elektronischen Einsatzdokumentation
Authors: Dittmar Michael S. , Kneißl Katharina , Schlickeisen Julia , Lamprecht Christoph , Kraus Martin , Glaser Christian , Kanz Karl-Georg , Nickl Stephan , Parsch Axel , Schiele Albert , Prückner Stephan , Bayeff-Filloff Michael , Trentzsch Heiko
Published: June 2023

Hintergrund

Schmerzen sind ein häufiger Behandlungsgrund in der prähospitalen Notfallmedizin. In Bayern delegieren die Ärztlichen Leiter Rettungsdienst (ÄLRD) bei subjektiv nichttolerablen Schmerzen nach isoliertem Extremitätentrauma an Notfallsanitäter (NotSan) landesweit einheitlich die Kurzinfusion von 7,5 mg des Opioidanalgetikums Piritramid.

Methode

Die Routineeinsatzdokumentation aller Einsätze im bayerischen Rettungsdienst mit Heranziehungen des Delegationsalgorithmus „Isolierte Extremitätenverletzung“ der ÄLRD nach § 4 Abs. 2 Nr. 2c Notfallsanitätergesetz wurde über einen 2‑Jahres-Zeitraum ausgewertet. Evaluiert wurden der Effekt auf die Schmerzintensität nach der numerischen Rating-Skala (NRS) und dem Vorliegen nichttolerabler Schmerzen, Auswirkungen auf die Vitalfunktionen sowie die Notwendigkeit von bestimmten weitergehenden Interventionen.

Ergebnisse

Bei 7151 identifizierten Einsätzen erfolgte in 6097 Fällen eine eigenständige Analgesie durch NotSan entlang der Delegation der ÄLRD. Die Schmerzintensität nach der NRS konnte von im Median 7 (Interquartilsabstand [IQR] 2) auf 3 (IQR 2, p < 0,001) gesenkt und in 96,9 % ein aus Patientensicht tolerables Niveau erreicht werden. In 9,4 % der Fälle wurde ein Notarzt nachgefordert und in 5,0 % eine ergänzende Analgesie verabreicht. Etwa jeder zehnte Patient erhielt Sauerstoff. Atemwegsinterventionen waren in wenigen Einzelfällen notwendig, eine Antagonisierung nur nach höheren als den delegierten Opiatdosen.

Schlussfolgerung

Eine vom ÄLRD delegierte und von NotSan eigenständig durchgeführte Opiatgabe senkt das Schmerzniveau relevant. Wesentliche Hinweise auf eine Patientengefährdung fanden sich nicht. Durch dieses Verfahren konnten in Bayern jährlich geschätzt ca. 2500 Notarzteinsätze vermieden werden.
A preliminary investigation into the efficacy of training soccer heading in immersive virtual reality
Authors: Marshall B. , Uiga L. , Parr J. V. V. , Wood G.
Published: June 2023

Recent research has suggested a link between repetitive soccer heading and the increased incidence of neurodegenerative disease in retired players. In response, restrictions have been introduced to limit the amount of soccer heading in training and competitive matches. Therefore, while heading remains an integral part of the game, players are restricted in the amount of training that they can gain on this important skill without potentially harming their long-term wellbeing. The aim of this study was to provide a preliminary investigation into the efficacy of training soccer heading in immersive virtual reality (VR) which allows the practice of the skill without the risk of repetitive head impacts. Thirty-six recreational soccer players were divided into a VR group (n = 18) who trained soccer heading on three occasions over a 7–10-day period in VR and a control group (n = 18) who received no training in soccer heading. Measures of real-world heading performance (i.e. the number of goals scored and shot accuracy), perceived confidence and perceived self-efficacy were assessed pre- and post-training. The results showed that the VR group experienced significant improvements in the number of goals scored and increased their perceptions of confidence and self-efficacy. These results show preliminary support for the inclusion of VR-based training in soccer heading where players can hone their heading skills without exposure to repeated head impacts. Implications and practical applications are discussed.
Analyzing nurses’ decisions to leave their profession—a duration analysis
Authors: Kroczek Martin
Published: June 2023

Many countries suffer from skilled labor shortages in nursing. One way to increase the nurse labor supply is to raise their retention rates. Yet, though several studies exist on factors associated with the nurse labor supply at different levels, literature on factors associated with nurses’ decisions to leave their occupation is relatively scarce. Based on German administrative data, I analyze the determinants of nurses’ decisions to leave their profession. My results suggest that younger nurses, nurses in the social sector, and nurses working with smaller employers leave their occupation more often than their counterparts, irrespective of their specific nursing occupations and care settings. Nurses leave more often where more alternative occupational options are available. Nurses who have been unemployed and nurses who have been employed in a different field have a higher probability of leaving the occupation, whereas nurses who just finished vocational training only have a moderate propensity to leave. Female nurses leave less often if employed part time. Female nurses in part time leave even more seldom if they have children. A change in the hospital reimbursement system and introducing a nursing minimum wage during the first decade of the century did not change nurses’ occupation durations.
A case of recurring perioperative circulatory arrest: mind the autonomic nervous system
Authors: Limper Ulrich , Keipke Dorothee , Lindenbeck Lars , Lanz Friederike , Kramer Claudia , Meissner Axel , Wappler Frank , Annecke Thorsten
Published: June 2023

We report the case of an elderly woman who developed recurring episodes of unexplained cardiocirculatory arrest. The index event appeared during surgery to fix a fracture of the ankle and consisted of bradypnea, hypotension and asystole, coherent with a Bezold–Jarisch-like cardioprotective reflex. Classical signs of acute myocardial infarction were absent. Yet, occlusion of the right coronary artery (RCA) was observed and successfully revascularized, whereupon circulatory arrests vanished. We discuss several differential diagnoses. Unexplainable circulatory failure, with sinus bradycardia and arterial hypotension, despite lack of ECG signs of ischemia or significant troponin levels, suggest the action of cardioprotective reflexes of the autonomic nervous system. Coronary artery disease is a common source. Attention to cardioprotective reflexes should be taken in the case of unexplained cardiac arrest without overt reasons. We recommend performing coronary angiography to exclude significant coronary stenosis.
Towards a Transferable Modeling Method of the Knee to Distinguish Between Future Healthy Joints from Osteoarthritic Joints: Data from the Osteoarthritis Initiative
Authors: Paz Alexander , García José J. , Korhonen Rami K. , Mononen Mika E.
Published: June 2023

Computational models can be used to predict the onset and progression of knee osteoarthritis. Ensuring the transferability of these approaches among computational frameworks is urgent for their reliability. In this work, we assessed the transferability of a template-based modeling strategy, based on the finite element (FE) method, by implementing it on two different FE softwares and comparing their results and conclusions. For that, we simulated the knee joint cartilage biomechanics of 154 knees using healthy baseline conditions and predicted the degeneration that occurred after 8 years of follow-up. For comparisons, we grouped the knees using their Kellgren–Lawrence grade at the 8-year follow-up time and the simulated volume of cartilage tissue that exceeded age-dependent thresholds of maximum principal stress. We considered the medial compartment of the knee in the FE models and used ABAQUS and FEBio FE softwares for simulations. The two FE softwares detected different volumes of overstressed tissue in corresponding knee samples (p < 0.01). However, both programs correctly distinguished between the joints that remained healthy and those that developed severe osteoarthritis after the follow-up (AUC = 0.73). These results indicate that different software implementations of a template-based modeling method similarly classify future knee osteoarthritis grades, motivating further evaluations using simpler cartilage constitutive models and additional studies on the reproducibility of these modeling strategies.
Removing of cationic dyes using self-cleaning membranes-based PVC/nano-cellulose combined with titanium aluminate
Authors: Elfiky Aya Abd El Aziz , Mubarak Mahmoud F. , Keshawy Mohamed , Sayed Ibrahim El Tantawy El , Moghny Thanaa Abdel
Published: June 2023

This research used the phase inversion approach to construct polyvinyl chloride nanocellulose@titanium aluminate nanocomposite membranes (PVC/NC@TALCM) to adsorb and filter dye from wastewater. FTIR, XRD, and SEM were used to determine the adsorptive nanocomposite membrane that had been synthesized. The thermal and electrical properties measurements were carried out using a static system. The influence of several adsorbent dosages, pH, and dye concentrations on the nanocomposite membrane’s adsorption ability was investigated. Using a dead-end filtration system, the PVC-NC@TALCM was evaluated as a pressure filtration membrane system. It was found that 98.6% of MB dye was removed by PVC-NC@TALCM membrane, which was loaded with 5% titanium aluminate at pH 10. The kinetic adsorption studies indicated that the adsorption of MB onto the PVC-NC@TALCM nanocomposite membrane obeys pseudo-second-order that indicates the chemosorption process. The isotherm data were described using Freundlich and Langmuir models, and the Freundlich isotherms were shown to be more closely match the experimental data than the Langmuir model. Finally, the PVC-NC@TALCM nanocomposite membrane was economical, environmentally friendly, and self-cleaning.
Investigation of coagulation and microfiltration for Danube water as the first step of make-up water production
Authors: Shaheen Reem , Cséfalvay Edit
Published: June 2023

A comparison of coagulation with two coagulants, poly-aluminum chloride (PACl) and ferric chloride (FeCl3), followed by microfiltration, was evaluated to obtain a better coagulant for an efficient pretreatment method for make-up water preparation from Danube water for thermal power plants. Efficiency was determined by chloride concentration and retention based on the total suspended solid content of the treated water samples. Results were compared to microfiltration working alone as a chemical-free pretreatment. Addition of PACl resulted in the lowest total suspended solid content (18.0 ± 1.3 mg/L), slightly lower than obtained for microfiltration alone (19.6 ± 2.5 mg/L) and significantly lower than for FeCl3 (25.0 ± 3.3 mg/L). Regarding the retention values, coagulation with PACl followed by microfiltration, microfiltration working alone and coagulation with FeCl3 followed by microfiltration represented retention values of 68%, 66.21%, and 56.89%, respectively. Considering the chloride concentration, it remained constant after microfiltration alone; meanwhile, adding coagulants showed a significant rise, ~ 6.4- and 5.7-times higher than the raw water's value after adding FeCl3 and PACl, respectively. From environmental viewpoint, microfiltration alone is recommended because it can provide a steady flux and low total suspended solid content without additional load of chloride ion which shall be eliminated in the further desalination step.
Factors influencing accidental food allergic reactions in schools and preschools
Authors: Crealey Miranda , Byrne Aideen
Published: June 2023

Background

Children spend a large proportion of their childhood in schools. In Ireland, there is no government policy on the management of food allergy (FA) in schools or preschool childcare settings (CCS). There is limited data worldwide on rate of accidental allergic reactions (AARs) within these settings.

Aim

The aim of this paper is to report the management of FA and the incidence of AARs in Irish school or preschool CCS.

Methods

A prospective observational study was established, enrolling children aged 2 to 16 years with confirmed FA. Participants were contacted at three monthly intervals for 1 year to report AARs to food. Data pertaining to schools and preschool CCS is reported here.

Results

A total of 521 children (402 attending school and 119 attending preschool CCS) were enrolled. The annualised incidence of AARs in school was 4.5% (95% CI 2.6–7.0) and in preschool CCS 5% (95% CI 1.8–11.1); 6 of 7 of the nut reactions occurred in schools banning nuts. Half (3/6) of the preschool reactions were to cow’s milk; 174/521 (33%) children did not provide their individualised allergy action plan (AAP). Four out of 18 (22%) AARs in school were anaphylaxis and none were administered adrenaline by school staff.

Conclusion

The incidence of AARs in this Irish cohort was found to be equivalent to the international experience. However, many of the recorded reactions identified in this study were likely avoidable. Preparation for AARs needs optimising. The ineffectiveness of “nut bans” remains unrecognised. Promoting milk and egg allergy resolution in infancy would likely reduce preschool- and school-based reaction numbers.
Meditation as an Adjunct to the Management of Acute Pain
Authors: Wipplinger Flavia , Holthof Niels , Andereggen Lukas , Urman Richard D. , Luedi Markus M. , Bello Corina
Published: June 2023

Purpose of Review

We aim to present current understanding and evidence for meditation, mostly referring to mindfulness meditation, for the management of acute pain and potential opportunities of incorporating it into the acute pain service practice.

Recent Findings

There is conflicting evidence concerning meditation as a remedy in acute pain. While some studies have found a bigger impact of meditation on the emotional response to a painful stimulus than on the reduction in actual pain intensities, functional Magnet Resonance Imaging has enabled the identification of various brain areas involved in meditation-induced pain relief.

Potential benefits of meditation in acute pain treatment include changes in neurocognitive processes. Practice and Experience are necessary to induce pain modulation. In the treatment of acute pain, evidence is emerging only recently. Meditative techniques represent a promising approach for acute pain in various settings.
Primary tumour iodine avidity in relation to uptake in persistent metastatic disease in papillary and poorly differentiated thyroid cancer
Authors: Nilsson Joachim N. , Grybäck Per , Juhlin C. Christofer , Hedman Christel , Lundgren Catharina Ihre
Published: June 2023

Purpose

Patients with persistent or recurrent papillary and poorly differentiated thyroid cancer can be effectively treated with radioiodine, if the tumour tissue is iodine-avid. However, iodine-avidity status is often unknown at the time of initial radioiodine treatment, limiting any adaptive approach. This study aimed to clarify the relationship between pre-therapeutic iodine avidity in primary tumour tissue, initial lymph node metastases and iodine uptake in subsequent metastases.

Methods

Iodine avidity was prospectively assessed pre-therapeutically in 35 patients by injection of tracer amounts of iodine-131 two days prior to surgery. Iodine concentrations in resected tissue samples were measured, enabling accurate and histologically verifiable iodine avidity data for both primary tumour and initial lymph node metastases. Iodine uptake in persistent metastatic disease was assessed by review of radiology, and treatment response was examined through journal studies.

Results

Out of data from 35 patients, 10 had persistent disease at presentation or during follow-up (range 19–46 months). Four patients had non-avid persistent metastatic disease, all with low iodine avidity in their primary tumours and initial lymph node metastases. Patients with low pre-therapeutic iodine avidity did not appear to have greater risk of persistent disease.

Conclusion

The results indicate a close link between pre-therapeutically measured iodine concentrations in primary tumours with iodine avidity of any subsequent metastases.
Locally led adaptation: Promise, pitfalls, and possibilities
Authors: Rahman M. Feisal , Falzon Danielle , Robinson Stacy-ann , Kuhl Laura , Westoby Ross , Omukuti Jessica , Schipper E. Lisa F. , McNamara Karen E. , Resurrección Bernadette P. , Mfitumukiza David , Nadiruzzaman Md.
Published: June 2023

Locally led adaptation (LLA) has recently gained importance against top-down planning practices that often exclude the lived realities and priorities of local communities and create injustices at the local level. The promise of LLA is that adaptation would be defined, prioritised, designed, monitored, and evaluated by local communities themselves, enabling a shift in power to local stakeholders, resulting in more effective adaptation interventions. Critical reflections on the intersections of power and justice in LLA are, however, lacking. This article offers a nuanced understanding of the power and justice considerations required to make LLA useful for local communities and institutions, and to resolve the tensions between LLA and other development priorities. It also contributes to a further refinement of LLA methodologies and practices to better realise its promises. Ultimately, we argue that the utility of the LLA framing in promoting climate justice and empowering local actors needs to be tested empirically.
Sex and strain-specific spectral attraction of Tribolium castaneum (Coleoptera: Tenebrionidae): behavioral studies
Authors: Sone Sota , Miyatake Takahisa
Published: June 2023

We examined the attraction of adults to six LEDs in the red flour beetles, Tribolium castaneum (Herbst) (Coleoptera: Tenebrionidae), which is widespread as a stored grain insect. In the experiment, bluish green and green were more attractive than the two UVs, blue, and red LEDs only in females. On the other hand, no difference was found in attraction among the six LEDs in males. Next, we investigated the relationship between light intensity and attractiveness. No sexual difference in attractiveness in different light intensities was found, but the strongest light intensity was more attractive than other light intensities. Finally, we investigated the relationship between light attraction and strains artificially selected for the duration of death feigning. Short-strain beetles were more attracted to UV lights than long-strain beetles.
Influence of Austenite Stability on the Machinability of Different Grades of Austempered Ductile Iron (ADI) During Dry Turning Machining
Authors: Hussein Mona , Ahmed Mostafa , Soliman Mohamed , Mohamed Lamiaa Z. , Palkowski Heinz , Rashad Ragaie M. , Nofal A.
Published: June 2023

This work evaluated the machinability characteristics of three different austempered ductile irons using three machinability indicators: cutting force, tool wear, and surface roughness. Additionally, this paper addresses the interplay among the production conditions of ADIs, microstructural development, the TRIP effect arising from transformations of the retained austenite into martensite, and the machinability behavior of ADIs. Various characterization studies including hardness measurement, X-ray diffraction analysis, light and electron microscope were used. Machinability results indicated that the increase in cutting force is always associated with a corresponding increase in the martensite content when the cutting depth was increased from 0.5 to 2.0 mm. Such correlation is more evident with ADI grade austempered at high austempering temperature, 375 °C (ADI-375). It was noticed that although ADI-375 has only 0.46% martensite in the structure before machining, this ratio increases with the highest depth of cut of 2.0 mm to reach about ~ 23% martensite with a corresponding increase in the cutting force. Ferrite content and morphology have a great impact on the overall surface finish of each grade as it leads to deteriorating the surface characteristics of the investigated alloys. This could explain the highest roughness values across all processing experiments obtained in the ADI grade austenitized in the intercritical region (IADI), which mainly contains the highest ferrite content. Tool wear and chip characteristics were also studied in this work.
Information cascade final size distributions derived from urn models
Authors: Oida Kazumasa
Published: June 2023

Bipolarization is a phenomenon in which either a large or very small information cascade appears randomly when the retweet rate is high. This phenomenon, which has been observed only in simulations, has the potential to significantly advance the prediction of final cascade sizes because forecasters need only focus on the two peaks in the final cascade size distribution rather than considering the effects of various details, such as network structure and user behavioral patterns. The phenomenon also suggests the difficulty of identifying factors that lead to the emergence of large-scale cascades. To verify the existence of bipolarization, this paper theoretically derives mathematical expressions of the cascade final size distribution using urn models, which simplify the diffusion behavior of actual online social networks. Under the assumption of infinite network size, the distribution exhibits power-law behavior, consistent with the results of existing diffusion models and previous Twitter analytical outcomes. Under the assumption of finite network size, bipolarization is observed.
Retrospective Proposals for the Orbital Correction of GSAT0201 & GSAT0202
Authors: Buson Sebastiano , Bettanini Carlo
Published: June 2023

On August 22, 2014, the first two Full Operational Capacity satellites of the Galileo constellation were launched from Kourou on a Soyuz ST-B rocket. Shortly after the insertion into the final orbit, the on-board telemetry showed the achieved orbit was different from the target highly inclined circular orbit, due to a failure in the Fregat upper stage attitude control system. This anomaly precluded nominal operations in the Galileo constellation, as well as introducing limitations in the use of several of on-board subsystems. A recovery campaign took place in the winter of 2014 to change the two satellites’ trajectories, so to reduce the entity of operative constraints and provide better communication with the ground segment. With no dedicated orbital thruster available, attitude thrusters were used effectively to modify and enhance the orbit and recover from a multi-system failure, making reinsertion in a GNSS constellation possible. This work investigates, by means of a numerical model, the best combination and sequence of maneuvers that could have been implemented in the recovery campaign to satisfy most proposed drivers with the given $$\Delta v$$

Δ
v

budget. The results show that different final orbits with the same resonance but lower eccentricity could have been achieved.
Residual Seizure Rate of Intermittent Inpatient EEG Compared to a Continuous EEG Model
Authors: Xie Dave , Toutant Darion , Ng Marcus C.
Published: June 2023

Background:

Subclinical seizures are common in hospitalized patients and require electroencephalography (EEG) for detection and intervention. At our institution, continuous EEG (cEEG) is not available, but intermittent EEGs are subject to constant live interpretation. As part of quality improvement (QI), we sought to estimate the residual missed seizure rate at a typical quaternary Canadian health care center without cEEG.

Methods:

We calculated residual risk percentages using the clinically validated 2HELPS2B score to risk-stratify EEGs before deriving a risk percentage using a MATLAB calculator which modeled the risk decay curve for each recording. We generated a range of estimated residual seizure rates depending on whether a pre-cEEG screening EEG was simulated, EEGs showing seizures were included, or repeat EEGs on the same patient were excluded.

Results:

Over a 4-month QI period, 499 inpatient EEGs were scored as low (n = 125), medium (n = 123), and high (n = 251) seizure risk according to 2HELPS2B criteria. Median recording duration was 1:00:06 (interquartile range, IQR 30:40–2:21:10). The model with highest residual seizure rate included recordings with confirmed electrographic seizures (median 20.83%, IQR 20.6–26.6%), while the model with lowest residual seizure rate was in seizure-free recordings (median 10.59%, IQR 4%–20.6%). These rates were significantly higher than the benchmark 5% miss-rate threshold set by 2HELPS2B (p<0.0001).

Conclusions:

We estimate that intermittent inpatient EEG misses 2–4 times more subclinical seizures than the 2HELPS2B-determined acceptable 5% seizure miss-rate threshold for cEEG. Future research is needed to determine the impact of potentially missed seizures on clinical care.
Remote and semi-automated methods to conduct a decentralized randomized clinical trial
Authors: Cafaro Teresa , LaRiccia Patrick J. , Bandomer Brigid , Goldstein Helen , Brobyn Tracy L. , Hunter Krystal , Roy Satyajeet , Ng Kevin Q. , Mitrev Ludmil V. , Tsai Alan , Thwing Denise , Maag Mary Ann , Chung Myung K. , van Helmond Noud
Published: June 2023

Introduction:

Designing and conducting clinical trials is challenging for some institutions and researchers due to associated time and personnel requirements. We conducted recruitment, screening, informed consent, study product distribution, and data collection remotely. Our objective is to describe how to conduct a randomized clinical trial using remote and automated methods.

Methods:

A randomized clinical trial in healthcare workers is used as a model. A random group of workers were invited to participate in the study through email. Following an automated process, interested individuals scheduled consent/screening interviews. Enrollees received study product by mail and surveys via email. Adherence to study product and safety were monitored with survey data review and via real-time safety alerts to study staff.

Results:

A staff of 10 remotely screened 406 subjects and enrolled 299 over a 3-month period. Adherence to study product was 87%, and survey data completeness was 98.5% over 9 months. Participants and study staff scored the System Usability Scale 93.8% and 90%, respectively. The automated and remote methods allowed the study maintenance period to be managed by a small study team of two members, while safety monitoring was conducted by three to four team members. Conception of the trial to study completion was 21 months.

Conclusions:

The remote and automated methods produced efficient subject recruitment with excellent study product adherence and data completeness. These methods can improve efficiency without sacrificing safety or quality. We share our XML file for researchers to use as a template for learning purposes or designing their own clinical trials.
Opening industry data: The private sector’s role in addressing societal challenges
Authors: Hansen Jennifer , Pang Yiu-Shing
Published: June 2023

This commentary explores the potential of private companies to advance scientific progress and solve social challenges through opening and sharing their data. Open data can accelerate scientific discoveries, foster collaboration, and promote long-term business success. However, concerns regarding data privacy and security can hinder data sharing. Companies have options to mitigate the challenges through developing data governance mechanisms, collaborating with stakeholders, communicating the benefits, and creating incentives for data sharing, among others. Ultimately, open data has immense potential to drive positive social impact and business value, and companies can explore solutions for their specific circumstances and tailor them to their specific needs.
Bottom-up forecasting: Applications and limitations in load forecasting using smart-meter data
Authors: Anand Harsh , Nateghi Roshanak , Alemazkoor Negin
Published: June 2023

Reliable short-term load forecasting is vital for the planning and operation of electric power systems. Short-term load forecasting is a critical component used in purchasing and generating electric power, dispatching, and load switching, which is essential for balancing supply and demand and mitigating the risk of power shortages. This is becoming even more critical given the transition to carbon-neutral technologies in the energy sector. Specifically, since renewable sources are inherently uncertain, a distributed energy system with renewable generation units is more heavily dependent on accurate load forecasts for demand-response management than traditional energy sectors. Despite extensive literature on forecasting electricity demand, most studies focus on predicting the total demand solely based on the previous-step observations of aggregate demand. With advances in smart-metering technology and the availability of high-resolution consumption data, harnessing fine-resolution smart-meter data in load forecasting has attracted increasing attention. Studies using smart-meter data mainly involve a “bottom-up” approach that develops separate forecast models at sub-aggregate levels and aggregates the forecasts to estimate the total demand. While this approach is conducive to incorporating fine-resolution data for load forecasting, it has several shortcomings that can result in sub-optimal forecasts. However, these shortcomings are hardly acknowledged in the load forecasting literature. This work demonstrates how limitations imposed by such a bottom-up load forecasting approach can lead to misleading results, which could hamper efficient load management within a carbon-neutral grid.
STATE IMMUNITY AND THIRD-PARTY LIMITS ON THE JURISDICTION OF DOMESTIC COURTS
Authors: Franchini Daniel
Published: June 2023

Recent case law has evidenced doctrinal ambiguity concerning whether State immunity precludes domestic courts’ jurisdiction when rights and interests of third-party States may be affected. This article posits that such confusion arises from a failure to recognize State immunity as a rule predicated on the sovereign status of the defendant. Through an analysis of State practice, the article contends that the concept of indirect impleading incorporated in the United Nations Convention on State Immunity does not challenge the status-based nature of this rule. Construing State immunity as a subject-matter rule erroneously conflates it with distinct doctrines, such as Monetary Gold and the act of State doctrine.
Scholars, Secrets, and Sultans: Clerical Authority in West Africa, 1450–1650
Authors: Wright Zachary
Published: June 2023

Available historical sources for West Africa's Middle Niger c. 1450–1650 reveal that the ‘indigenous’ (non-Arab) Islamic scholarly class was already a self-conscious, independent social entity long before the clerical revolutions of later centuries. The influence of Muslim scholars was not limited to urban environments like Timbuktu, and clerical elites claimed a number of mostly independent communities throughout West Africa by the end of the sixteenth century. Mostly based on a reading of Arabic texts such as Muḥammad al-Kābarī's Bustān al-fawāʾid (‘Garden of Beneficial Prayers’) in dialogue with the Tārīkh Ibn al-Mukhtār and Tārīkh al-Sūdān (‘Timbuktu Chronicles’), this article argues that Muslim scholars were engaged in a spiritual war for independence clearly on display since the beginning of the Songhay empire. Scholarly texts display deep concern for tempering unjust political power and the protection and attraction of women, discourses that reveal a perilous clerical struggle to assert community independence. Later armed jihads were thus not so much a break from earlier traditions of clerical pacificism, they were the natural evolution from this earlier spiritual jihad.
Litigation in thyroid surgery: a pan-specialty review of National Health Service (UK) data
Authors: Arwyn-Jones James , Ross Talisa , Navaratnam Annakan , George Manish , Machin John T , Briggs Tim W R , Tolley Neil
Published: June 2023

Objective

Thyroid surgery carries risks that significantly impact patients. This paper describes the landscape of thyroid surgery related litigation claims in the National Health Service from April 2015 to April 2020, to establish learning points in order to improve patient care and minimise litigation risk.

Methods

Data were requested from National Health Service Resolution and Hospital Episode Statistics. Claims were classified into operative and non-operative causes. Subspecialty information, incident details and claim costings were analysed.

Results

Sixty claims were identified. Thirty-eight claims (63.3 per cent) were closed, with an average total claim cost of £68 816 and average damages paid of £36 349. Claims related to diagnostic issues were most common (n = 19); of claims associated with operative causes (n = 30), those relating to nerve injury were most common (n = 8), with issues of nerve monitoring and consent being cited.

Conclusion

Utilisation of well-established protocols will likely reduce litigation in thyroid surgery, as we move towards a landscape in which the patient journey is thoroughly scrutinised for targeted improvements.
FIRST-ORDER FRIENDLINESS
Authors: BADIA GUILLERMO , MAKINSON DAVID
Published: June 2023

In this note we study a counterpart in predicate logic of the notion of logical friendliness, introduced into propositional logic in [15]. The result is a new consequence relation for predicate languages with equality using first-order models. While compactness, interpolation and axiomatizability fail dramatically, several other properties are preserved from the propositional case. Divergence is diminished when the language does not contain equality with its standard interpretation.