bluuebunny/crossref_metadata_2025 huggingface dataset:
Mathematics Metacognitive Skills of Papua’s Students in Solving Mathematics Problems
Authors: Tjalla Awaluddin , Putriyani Maria Fransiska
Published: June 2018

This research focuses on the analysis of mathematics metacognitive skills of Papua’s students in School of Indonesian Children in solving mathematics learning problems. The research was conducted to provide a good quality education for Papuan students, so the research start the research from the metacognitive skills especially in mathematics. The respondents of the research are 6 students from grade VII in School of Indonesian Children. Those respondents are represent of higher mathematical ability, medium mathematical ability, and lower mathematical ability. The research used descriptive qualitative research method. Data collection procedures used in this research was in-depth interview and participant observation as well as documents related to metacognitive process in solving the problems in learning mathematics. The in-depth interview was with the respondents, the Principal, the mathematical teacher and the Character Building teacher. For documents related to metacognitive process in solving the problems in learning mathematics such as the result national exam in elementary, the result daily test of math, the result of quiz or homework. In general, the students in Papua were lack of mathematics metacognitive ability such as, lack of cognitive knowledge and cognitive regulation, sometimes they cannot perform the activities that reflects conscious metacognitive such as mathematics problem solving. The research result indicates that the structure metacognitive ability of students in Papua influences their problem solving ability in learning mathematics. This metacognitive ability is also influenced by the fact that it becomes their characteristics background as respondents from Papua.
Inquiry-Based Learning Model to Improve Higher Order Thinking Skills
Authors: Tindangen Makrina
Published: June 2018

This study aims to present ways of implementing inquiry- learning model with the use of scientific reports to improve teachers’ understanding and ability on teaching biology at secondary level. The quantitative research method is quasi-experiment design with pre-test and post-test control group. The research instrument for collecting data of students’ higher order thinking skills is scoring rubrics for assessing abilities on developing and presenting a scientific report. The instruments for assessing teachers’ skills are teacher observation sheets over inquiry-based learning scientific report using an induction method. The research subjects consist of 4 biology teachers and 80 of grade 10 students from Public Secondary School 3 Samarinda.The teachers are all female; while from 80 students, 53 of them are female and the rest 27 are male. The students’ age ranges from 16 to 18 years old. The research lasted for 1 month.Analysis of data uses t test, that if toutcome is higher than ttable, the inquiry-based learning model using scientific reports does affect students’ higher order thinking skills. Data analysis is composed in tabulation format with several graded categories: inadequate, sufficient, good and excellent. The result of the study is that higher order thinking skills of students are increasing in numbers and more equal compared with classes taught by teachers who did not follow the inquiry-based learning model workshop and presentation. The inquiry-based learning model was applied via preparation and presentations of scientific reports after the students carry out practical activities through the guidance of student activity worksheets.
Radicalization of Faith Concept in the School of Islam: Study of Khawarij and Muktazilah
Authors: Nur Ramli
Published: June 2018

The Radicalism is an idea or school that pursues revolution or social and political reforms in a tough or drastic way. The school of khawarij and muktazilah (two groups) have marked the history of Islamic thought about the concept of faith. The coloration shown tends to represent extremes in understanding the concept of faith. In general, it makes charitable deeds or branch teachings (furu') as part of the nature of faith. That leads to them getting caught in judging faith based on it being black or white between mukmin and kafir. Therefore the perpetrators of the great sins are punished out of Islam. Not merely categorization, but they also fighting and justifying of Muslims whom they consider to have abandoned the teachings of birth or violated something prohibited on the teaching of birth.Such as of these understandings have mutated in the long history of the Muslims into the various nisbat mentions and often manipulate the religious as legitimacy for destructive radical actions. That is why this idea is quite dangerous not only at the beginning of its appearance but also in the current era to watch out for. This article has researched and analyzed the understandings of the two groups (Khawarij and Muktazilah).
Sentiment Analysis Algorithms through Azure Machine Learning: Analysis and Comparison
Authors: Harfoushi Osama , Hasan Dana , Obiedat Ruba
Published: June 2018

The Sentimental Analysis (SA) is a widely known and used technique in the natural language processing realm. It is often used in determining the sentiment of a text. It can be used to perform social media analytics. This study sought to compare two algorithms; Logistic Regression, and Support Vector Machine (SVM) using Microsoft Azure Machine Learning. This was demonstrated by performing a series of experiments on three Twitter datasets (TD). Accordingly, data was sourced from Twitter a microblogging platform. Data were obtained in the form of individuals’ opinions, image, views, and twits from Twitter. Azure cloud-based sentiment analytics models were created based on the two algorithms. This work was extended with more in-depth analysis from another Master research conducted lately. Results confirmed that Microsoft Azure ML platform can be used to build effective SA models that can be used to perform data analytics.
Amerikanisering van corruptiebestrijding
Authors: Haijer F. , Sikkema E.
Published: June 2018

Amerikanisering van corruptiebestrijding – Buitengerechtelijke afdoening en andere tendensen in de handhaving van anticorruptiewetgeving

In de jaren 2014-2017 heeft in Nederland een grote omschakeling plaatsgevonden op het terrein van de handhaving in buitenlandse corruptiezaken. Van een niet-handhaver lijkt Nederland veranderd te zijn in een corruptiebestrijder om rekening mee te houden. Wij verklaren deze ontwikkeling allereerst vanuit het perspectief van Amerikaans buitenlands beleid. Vervolgens beschouwen wij de stand van zaken met betrekking tot buitengerechtelijke afdoening in Nederland, in het bijzonder de hoge of bijzondere transactie en de strafbeschikking. We werpen ten slotte een blik op de toekomst, waarbij wij vooral kijken naar de mogelijkheden van rechterlijke toetsing en het compenseren van buitenlandse slachtoffers.
Ne bis in idem revisited. Over de lotgevallen van een beginsel
Authors: Crijns J.H. , van Emmerik M.L.
Published: June 2018

Ne bis in idem revisited. Over de lotgevallen van een beginsel

Gegeven de toenemende mogelijkheden tot samenloop van punitieve procedures rijst de vraag of en in hoeverre een dergelijke samenloop opportuun of doelmatig kan worden geacht. Of anders en huiselijker geformuleerd: is dergelijke cumulatie van sancties niet wat te veel van het goede? In deze bijdrage wordt ingegaan op de recente ontwikkelingen in de nationale en de Europese jurisprudentie ten aanzien van het ne bis in idem-beginsel. Als startpunt van de beschrijving wordt gekozen voor het Alcoholslotprogramma-arrest waarin het verbod van dubbele bestraffing door de Hoge Raad tot een van de beginselen van een goede procesorde wordt gerekend.
De hoogtepunten uit vijf jaren milieustrafrechtjurisprudentie (2013-2018)
Authors: Velthuis M.
Published: June 2018

De hoogtepunten uit vijf jaren milieustrafrechtjurisprudentie (2013-2018)

In dit artikel wordt een overzicht gegeven van de jurisprudentie op het gebied van het milieustrafrecht over de afgelopen vijf jaren (2013-2018). De zaken tegen Odfjell, Trafigura, Dow Benelux en Chemiepack komen aan de orde. Daarnaast wordt jurisprudentie behandeld waaruit volgt dat rechters kritisch beoordelen of het OM ontvankelijk is, of de relevante delictsbestanddelen bewezen kunnen worden, of voldaan is aan de vereisten voor daderschap en/of deelneming en of de overtreding opzettelijk is begaan. Ook worden relevante ontnemingsuitspraken gesignaleerd. De auteur sluit af met een blik op de toekomst.
Over schurftige schapen, natte geiten, dorstige honden en dikke eekhoorns
Authors: Baar J.L.
Published: June 2018

Over schurftige schapen, natte geiten, dorstige honden en dikke eekhoorns

Dit artikel geeft een update van twee eerdere artikelen die in dit tijdschrift verschenen. In de eerste plaats wordt jurisprudentie ten aanzien van de geldigheid van de dagvaarding besproken in Wet dieren-zaken. Daarnaast wordt de ondergrens van het onthouden van de nodige zorg, artikel 2.2 lid 8 Wet dieren, besproken.
Jurisprudentiële ontwikkelingen over het samenhangcriterium van de ‘b-grond’ in de Wet Bibob
Authors: van der Vorm B.
Published: June 2018

Jurisprudentiële ontwikkelingen over het samenhangcriterium van de ‘b-grond’ in de Wet Bibob

Uit de recente jurisprudentie over de Wet Bibob blijkt dat soms onduidelijkheid bestaat over de vraag wanneer strafbare feiten voldoende samenhang vertonen met activiteiten waarvoor de vergunning is aangevraagd of verleend. Uit jurisprudentie blijkt enerzijds dat sprake is van voldoende samenhang, indien de vergunning het plegen van strafbare feiten kan faciliteren. Anderzijds is het uitgangspunt van de Afdeling dat de horecabranche zeer kwetsbaar is voor (bepaalde) overtredingen, zodat zonder al te veel problemen – in de horecabranche – een samenhang wordt aangenomen tussen de strafbare feiten en de activiteiten waarvoor de vergunning is aangevraagd of is verleend.
Zorgen over de zorgplicht
Authors: Mein A.G.
Published: June 2018

Zorgen over de zorgplicht – Bespreking proefschrift ’t Hart over zorgplicht bij financiële dienstverlening

Het proefschrift van ’t Hart omvat een beschrijving en analyse van de zorgplicht voor financiële dienstverleners. Inachtname van die zorgplicht is van groot belang voor de bedrijfsvoering van financiële ondernemingen. Op basis van zijn analyse van de werking van de zorgplicht in de praktijk, doet ’t Hart een aantal voorstellen voor een effectievere en evenwichtiger werking van die zorgplicht. Kritisch is ’t Hart over het toezicht van de AFM op de naleving van de zorgplicht. Dat zou buitenwettelijk zijn en heeft in de praktijk een te grote impact op de invulling van de zorgplicht. In het verlengde daarvan doet hij dan ook voorstellen voor zorgvuldigheid waaraan het toezicht van de AFM in dit verband zou moeten voldoen.
Belastingfraude kan niet altijd worden witgewassen
Authors: Feenstra A.A.
Published: June 2018

Belastingfraude kan niet altijd worden witgewassen – Annotatie bij HR 7 oktober 2008, ECLI:NL:HR:2008:BD2774

In deze lustrumeditie van dit tijdschrift past een annotatie bij een arrest dat ook een, zij het tweede, lustrum viert. Dit betreft het arrest van de Hoge Raad van 7 oktober 2008, waarin de Hoge Raad oordeelde dat ook een fiscaal delict als gronddelict voor witwassen kan gelden. Dit oordeel van de Hoge Raad roept in de jaren nadien nog steeds vragen op over de samenloop tussen de fiscaliteit en het strafrecht, vooral ten aanzien van de specifieke witwashandelingen, de inkeerregeling en ontneming.
De erkenning in België van Nederlandse levenstestamenten en de gevolgen van een Vlaamse wetswijziging voor (Nederlandse) huwelijkse voorwaarden
Authors: van de Ven K.M.L.L.
Published: June 2018

De erkenning in België van Nederlandse levenstestamenten en de gevolgen van een Vlaamse wetswijziging voor (Nederlandse) huwelijkse voorwaarden

In deze bijdrage wordt aandacht besteed aan een standpunt van het federale consultatiecentrum voor het Belgische notariaat over de erkenning van Nederlandse levenstestamenten en aan de gevolgen van een Vlaamse wetswijziging voor (Nederlandse) huwelijkse voorwaarden.
Pilot study: Assessment of the presence of mold in indoor swimming pools
Authors: Agababova Milena , Hon Chun-Yip
Published: June 2018

Indoor swimming pools are the ideal environment for mold growth as they are intentionally humid and warm. Although there are no established safe exposure levels for airborne mold spores, their presence has been associated with adverse health effects that may put individuals at risk. The objective of this pilot study was to observe the occurrence of airborne mold within indoor swimming pools (n = 6) in the Greater Toronto Area. Viable air samples were taken using a Surface Air System air sampler and cultured to quantify and identify airborne mold using microscopy. In addition, relative humidity and temperature were measured and facility characteristics were recorded. Overall, the mold counts were relatively low and were consistent with the literature. However, a biodiverse fungal profile was found at most sites—some of which included fungal groups linked to harmful health effects in humans. Since this was a pilot study, further research is suggested to determine whether the concentration of mold is a cause for concern.
Prioritizing professional competencies in environmental public health: A best–worst scaling experiment
Authors: Wallar Lauren E. , McEwen Scott A. , Sargeant Jan M. , Mercer Nicola J. , Papadopoulos Andrew
Published: June 2018

The professional development of environmental public health professionals in Canada is guided by a set of 133 discipline-specific competencies. Given the diversity of practice in environmental public health, certain competencies may be more important to job effectiveness depending on a practitioner’s context. However, the most important competencies to job effectiveness by context are unknown. Thus, the objectives of this study were to prioritize the discipline-specific competencies according to their importance to job effectiveness, and determine if importance varied by demographic variables. A quantitative discrete-choice method termed best–worst scaling was used to determine the relative importance of competencies. Discrete choice information was electronically collected and analyzed using Hierarchical Bayesian analysis. Our analysis indicates that communication was most important to job effectiveness relative to the other categories. Competency statements within each category differed in their importance to job effectiveness. Further, management and front-line practitioners differed in the importance placed on five of the eight categories. This information can be used to guide new training opportunities, thereby investing in the capacity of environmental health professionals to better protect population health.
Vertical stratification of plant–pollinator interactions in a temperate grassland
Authors: Klecka Jan , Hadrava Jiří , Koloušková Pavla
Published: June 2018

Visitation of plants by different pollinators depends on individual plant traits, spatial context, and other factors. A neglected aspect of small-scale variation of plant–pollinator interactions is the role of vertical position of flowers. We conducted a series of experiments to study vertical stratification of plant–pollinator interactions in a dry grassland. We observed flower visitors on cut inflorescences ofCentaurea scabiosaandInula salicinaplaced at different heights above ground in two types of surrounding vegetation: short and tall. Even at such a small-scale, we detected significant shift in total visitation rate of inflorescences in response to their vertical position. In short vegetation, inflorescences close to the ground were visited more frequently, while in tall vegetation, inflorescences placed higher received more visits. Moreover, we found major differences in the composition of the pollinator community on flowers at different heights. In a second experiment, we measured flower visitation rate in inflorescences ofSalvia verticillataof variable height. Total flower visitation rate increased markedly with inflorescence height in this case. Data on seed set of individual plants provide evidence for a corresponding positive pollinator-mediated selection on increased inflorescence height. Overall, our results demonstrate strong vertical stratification of plant–pollinator interactions at the scale of mere decimetres. This may have important ecological as well as evolutionary implications.
Effects of equal-volume resistance training with different training frequencies in muscle size and strength in trained men
Authors: Gentil Paulo , Fisher James , Steele James , Campos Mario H. , Silva Marcelo H. , Paoli Antonio , Giessing Jurgen , Bottaro Martim
Published: June 2018

Background

The objective of the present study was to compare the effects of equal-volume resistance training (RT) performed with different training frequencies on muscle size and strength in trained young men.

Methods

Sixteen men with at least one year of RT experience were divided into two groups, G1 and G2, that trained each muscle group once and twice a week, respectively, for 10 weeks. Elbow flexor muscle thickness (MT) was measured using a B-Mode ultrasound and concentric peak torque of elbow extensors and flexors were assessed by an isokinetic dynamometer.

Results

ANOVA did not reveal group by time interactions for any variable, indicating no difference between groups for the changes in MT or PT of elbow flexors and extensors. Notwithstanding, MT of elbow flexors increased significantly (3.1%, P < 0.05) only in G1. PT of elbow flexors and extensors did not increase significantly for any group.

Discussion

The present study suggest that there were no differences in the results promoted by equal-volume resistance training performed once or twice a week on upper body muscle strength in trained men. Only the group performing one session per week significantly increased the MT of their elbow flexors. However, with either once or twice a week training, adaptations appear largely minimal in previously trained males.
A Miocene pygmy right whale fossil from Australia
Authors: Marx Felix G. , Park Travis , Fitzgerald Erich M.G. , Evans Alistair R.
Published: June 2018

Neobalaenines are an enigmatic group of baleen whales represented today by a single living species: the pygmy right whale, Caperea marginata, found only in the Southern Hemisphere. Molecular divergence estimates date the origin of pygmy right whales to 22–26 Ma, yet so far there are only three confirmed fossil occurrences. Here, we describe an isolated periotic from the latest Miocene of Victoria (Australia). The new fossil shows all the hallmarks of Caperea, making it the second-oldest described neobalaenine, and the oldest record of the genus. Overall, the new specimen resembles C. marginata in its external morphology and details of the cochlea, but is more archaic in it having a hypertrophied suprameatal area and a greater number of cochlear turns. The presence of Caperea in Australian waters during the Late Miocene matches the distribution of the living species, and supports a southern origin for pygmy right whales.
Prevalence of extended spectrum beta lactamase and plasmid mediated quinolone resistant genes in strains of Klebsiella pneumonia, Morganella morganii, Leclercia adecarboxylata and Citrobacter freundii isolated from poultry in South Western Nigeria
Authors: Akinbami Olajumoke R. , Olofinsae Samson , Ayeni Funmilola A.
Published: June 2018

A serious concern is arising on the coexistence of extended-spectrum beta-lactamase (ESBL) and plasmid mediated quinolone resistance (PMQR) producing bacteria in animal husbandry, which could be transferred to humans, especially in strains that may not be routinely screened for resistance. This study therefore tested the prevalence of ESBL and PMQR genes in selected bacteria isolated from poultry faeces. Faecal droppings of birds were collected from 11 farms in five states in South Western Nigeria. Bacteria were isolated from the samples on cefotaxime supplemented plates and identified with MALDI-TOF. The MIC was determined using VITEK system and resistance genes were detected with PCR. A total of 350 strains were isolated from different samples and selected strains were identified as 23 Klebsiella pneumonia, 12 Morganella morganii, seven Leclercia adecarboxylata and one Citrobacter freundii. All the species were resistant to gentamycin, trimethoprim/sulphamethaxole, tobramycin, piperacillin, cefotaxime and aztreonam (except Morganella morganii strains which were mostly susceptible to aztreonam). All the tested strains were susceptible to imipenem, meropenem and amikacin. All Leclercia adecarboxylata strains were resistant to ceftazidime, cefepime and fosfomycin while all Morganella morganii strains were resistant to fosfomycin, moxifloxacin and ciprofloxacin. All tested species were generally sensitive to ciprofloxacin except Morganella morganii strains which were resistant to ciprofloxacin. The resistance to ciprofloxacin, ceftazidime, cefepime, tigercylin, colistin and fosfomycin were 65%, 40%, 23%,, 7%, 33%, 48% respectively while the prevalence of SHV, TEM and CTX genes were 42%, 63%, 35% respectively. 9.3% of the isolates had the three ESBL genes, 2.33% had qnrA gene, 4.65% had qnr B gene while none had qnrS gene. The most prevalent PMQR gene is Oqxb (25.58%) while 6.98% had the qep gene. Klebsiella pneumoniae generally had both ESBL and PMQR genes. The high prevalence of extended spectrum beta-lactamase genes in the studied strains calls for caution in the use of beta lactam antibiotics in poultry feeds. This is the first report of the occurrence of extended spectrum beta-lactamase and plasmid mediated quinolone resistance genes in Morganella morganii and Leclercia adecarboxylata strains isolated from poultry faeces.
A Young Woman With Headaches and Peripheral Vision Loss
Authors: Peer Austin D. , Nagy M. Aurel , Levin Marc H.
Published: November 2024

A 30-year-old nulliparous woman with obesity and history of migraines and depression had 1 month of daily headaches, transient bilateral visual blurring, persistent vision loss in the temporal region of one eye, pulsatile tinnitus, and mild bilateral papilledema. What is the diagnosis and what would you do next?
Postmarketing Surveillance of Inferior Vena Cava Filters Among US Medicare Beneficiaries
Authors: Ferro Enrico G. , Mackel Julie B. , Kramer Renee D. , Torguson Rebecca , Whatley Eleni M. , O’Connell Gregory , Pullin Brian , Watson Nathan W. , Li Siling , Song Yang , Krawisz Anna K. , Carroll Brett J. , Schermerhorn Marc L. , Weinstein Jeffrey L. , Farb Andrew , Zuckerman Bram , Yeh Robert W. , Secemsky Eric A.
Published: November 2024

Importance

Inferior vena cava filters (IVCFs) are commonly used to prevent pulmonary embolism in selected clinical scenarios, despite limited evidence to support their use. Current recommendations from professional societies and the US Food and Drug Administration endorse timely IVCF retrieval when clinically feasible. Current IVCF treatment patterns and outcomes remain poorly described.

Objectives

To evaluate temporal trends and practice patterns in IVCF insertion and retrieval among older US patients and report the incidence of periprocedural and long-term safety events of indwelling and retrieved IVCFs.

Design, Setting, and Participants

Prespecified, retrospective, observational cohort of Medicare Fee-for-Service (FFS) beneficiaries, leveraging 100% of samples of inpatient and outpatient claims data from January 1, 2013, to December 31, 2021.

Exposure

First-time IVCF insertion while insured by Medicare FFS.

Main Outcomes and Measures

The primary safety outcome was the composite of all-cause death, filter-related complications (eg, fracture, embolization), operating room visits following filter-related procedures, or new diagnosis of deep vein thrombosis (DVT). Events were considered periprocedural if they occurred within 30 days of IVCF insertion or retrieval and long-term if they occurred more than 30 days after.

Results

Among 270 866 patients with IVCFs placed during the study period (mean age, 75.1 years; 52.8% female), 64.9% were inserted for first-time venous thromboembolism (VTE), 26.3% for recurrent VTE, and 8.8% for VTE prophylaxis. Of these patients, 63.3% had major bleeds or trauma within 30 days of IVCF insertion. The volume of insertions decreased from 44 680 per year in 2013 to 19 501 per year in 2021. The cumulative incidence of retrieval was 15.3% at a median of 1.2 years and 16.8% at maximum follow-up of 9.0 years. Older age, more comorbidities, and Black race were associated with a decreased likelihood of retrieval, whereas placement at a large teaching hospital was associated with an increased likelihood of retrieval. The incidence of caval thrombosis and DVT among patients with nonretrieved IVCFs was 2.2% (95% CI, 2.1%-2.3%) and 9.2% (95% CI, 9.0%-9.3%), respectively. The majority (93.5%) of retrieval attempts were successful, with low incidence of 30-day complications (mortality, 0.7% [95% CI, 0.6%-0.8%]; filter-related complications, 1.4% [95% CI, 1.2%-1.5%]).

Conclusions and Relevance

In this large, US real-world analysis, IVCF insertion declined, yet retrievals remained low. Strategies to increase timely retrieval are needed, as nonretrieved IVCFs may have long-term complications.
Psoriasis Risk With Immune Checkpoint Inhibitors
Authors: To Sheng-Yin , Lee Cho-Hao , Chen Yi-Hsien , Hsu Chia-Lu , Yang Hui-Wen , Jiang Ying-Shan , Wen Yuan-Liang , Chen I-Wen , Kao Li-Ting
Published: November 2024

Importance

Immune checkpoint inhibitors (ICIs) are recognized as revolutionary cancer therapies but have raised concerns about immune-related adverse events, including the development of autoimmune diseases.

Objective

To evaluate the psoriasis risk associated with the use of ICIs in patients with cancer.

Design, Setting, and Participants

This nationwide cohort study with a target trial emulation design used data from the Taiwan National Health Insurance database and the Taiwan Cancer Registry. The participants included were patients who received antineoplastic medications for cancer at stages III and IV between January 1, 2019, and June 30, 2021. Data were analyzed from May 2023 to July 2024.

Exposures

Patients treated with ICIs were classified as ICI users, while those who received chemotherapy or targeted therapies were categorized as non-ICI users.

Main Outcome and Measures

The primary outcome was the incidence of psoriasis during the follow-up period. Stabilized inverse probability of treatment weighting (IPTW) was used to mitigate potential confounders. Cox and Fine-Gray hazard models were used to calculate hazard ratios (HRs) for psoriasis risk between groups.

Results

Of 135 230 patients who received antineoplastic medications (mean [SD] age, 62.94 [13.01] years; 45.1% female), 3188 patients were eligible for the ICI user group, while 132 042 patients were eligible for the non-ICI user group. ICI users experienced a higher incidence of psoriasis at 5.76 cases per 1000 person-years, compared to 1.44 cases in the non-ICI group. After adjusting for demographics and comorbidities, ICI users were found to have a 2-fold increase in the risk of developing psoriasis (IPTW-adjusted HR, 3.31; IPTW-adjusted subdistribution HR, 2.43). Both as-started design and on-treatment design showed consistent findings, and the results were consistent and robust across all follow-up intervals and all sensitivity analyses.

Conclusions and Relevance

In this cohort study, patients with cancer treated with ICIs faced an increased risk of psoriasis. Medical professionals should be aware of the potential adverse effects of immunotherapy to ensure optimal cancer care.
Long-Term Risk of Autoimmune and Autoinflammatory Connective Tissue Disorders Following COVID-19
Authors: Heo Yeon-Woo , Jeon Jae Joon , Ha Min Chul , Kim You Hyun , Lee Solam
Published: November 2024

Importance

Few studies have investigated the association between COVID-19 and autoimmune and autoinflammatory connective tissue disorders; however, research with long-term observation remains insufficient.

Objective

To investigate the long-term risk of autoimmune and autoinflammatory diseases after COVID-19 over an extended observation period.

Design, Setting, and Participants

This retrospective nationwide population-based study investigated the Korea Disease Control and Prevention Agency–COVID-19–National Health Insurance Service (K-COV-N) cohort. Individuals with confirmed COVID-19 from October 8, 2020, to December 31, 2022, and controls identified among individuals who participated in the general health examination in 2018 were included in the analysis.

Exposures

Confirmed COVID-19.

Main Outcomes and Measures

Incidence and risk of autoimmune and autoinflammatory connective tissue disorders in patients after COVID-19. Various covariates, such as demographic characteristics, general health data, socioeconomic status, and comorbidity profiles, were balanced using inverse probability weighting.

Results

A total of 6 912 427 participants (53.6% male; mean [SD] age, 53.39 [20.13] years) consisting of 3 145 388 with COVID-19 and 3 767 039 controls with an observational period of more than 180 days were included. Alopecia areata (adjusted hazard ratio [AHR], 1.11 [95% CI, 1.07-1.15]), alopecia totalis (AHR, 1.24 [95% CI, 1.09-1.42]), vitiligo (AHR, 1.11 [95% CI, 1.04-1.19]), Behçet disease (AHR, 1.45 [95% CI, 1.20-1.74]), Crohn disease (AHR, 1.35 [95% CI, 1.14-1.60]), ulcerative colitis (AHR, 1.15 [95% CI, 1.04-1.28]), rheumatoid arthritis (AHR, 1.09 [95% CI, 1.06-1.12]), systemic lupus erythematosus (AHR, 1.14 [95% CI, 1.01-1.28]), Sjögren syndrome (AHR, 1.13 [95% CI, 1.03-1.25]), ankylosing spondylitis (AHR, 1.11 [95% CI, 1.02-1.20]), and bullous pemphigoid (AHR, 1.62 [95% CI, 1.07-2.45]) were associated with higher risk in the COVID-19 group. Subgroup analyses revealed that demographic factors, including male and female sex, age younger than 40 years, and age 40 years and older, exhibited diverse associations with the risk of autoimmune and autoinflammatory outcomes. In addition, severe COVID-19 infection requiring intensive care unit admission, the Delta period, and not being vaccinated were associated with higher risk.

Conclusions and Relevance

This retrospective cohort study with an extended follow-up period found associations between COVID-19 and the long-term risk of various autoimmune and autoinflammatory connective tissue disorders. Long-term monitoring and care of patients is crucial after COVID-19, considering demographic factors, disease severity, and vaccination status, to mitigate these risks.
TikTok Challenges—Unintentional Injuries vs Suicide Attempts
Authors: Ataga Onomeasike , Arnold Valerie K.
Published: November 2024

This Viewpoint discusses injuries among US children that are attributable to TikTok challenges, addresses the challenge of distinguishing between unintentional injuries and suicide attempts, and explores potential methods of prevention, treatment, and clinical disposition for such injuries.
Finding Time and Energy to Exercise—5 Tips for Surgeons
Authors: McDermott James , Lum Sharon S. , de Virgilio Christian
Published: November 2024

This Viewpoint provides recommendations for surgeons to stay active amidst demanding professional and personal commitments to help manage stress, avoid burnout, and improve overall quality of life.
Cyberfeminism
Authors: Hagerty Darbee
Published: November 2024

“Cyberfeminism,” a term coined in the early 1990s, refers to a broad set of perspectives involving new online technologies and gender equality. Arising in the context of the Internet, which was surfacing during this period as a mass communication medium, cyberfeminism was on the cutting edge of creativity and advocacy. Although it is now somewhat dated, the combination of “cyber” and “feminism” represented an exciting new development in the history of women's liberation and digital media.
Subclinical imaging activity in multiple sclerosis patients during war‐related psychological stress
Authors: Zveik Omri , Friedman‐Korn Tal , Rechtman Ariel , Ganz Tal , Hoichman Garrick , Shweiki Lyne , Ekstein Dana , Vaknin‐Dembinsky Adi
Published: November 2024

Objectives

Psychological stress has been suggested as a contributory factor in the onset and progression of multiple sclerosis (MS). The 7 October 2023 terrorist attacks in Israel caused significant psychological stress, providing a unique context to study its impact on MS activity. This study aims to assess the impact of war‐related psychological stress on MS activity using magnetic resonance imaging (MRI) scans and clinical follow‐up.

Methods

This observational retrospective case–control study includes 93 patients with MS (pwMS) who had routine annual MRI scans from three periods (7 October 2021 to 7 January 2022; 7 October 2022 to 7 January 2023; and 7 October 2023 to 7 January 2024). Data were collected from medical records and MRI scans at Hadassah Medical Center. MRI scans were classified as active if new or enlarging T2 lesions and/or enhancing T1 lesions were present.

Results

MRI activity significantly increased among pwMS during the first 3 months of the war compared to the corresponding period in the preceding year (11/93 vs. 23/93, P = 0.0139), with an OR of 4.0 (95% confidence interval: 1.29–16.442). pwMS with an EDSS score ≥4 showed a significant increase in MRI activity (P = 0.045), whereas no significant increase was observed in patients with an EDSS score ≤3.5 (P = 0.23). Additionally, MRI activity increased later during the war compared to the previous year (P < 0.0001).

Interpretation

This study provides evidence of increased MRI‐detected disease activity in pwMS during periods of war‐related psychological stress. Our findings highlight the importance of considering psychological stress in MS management. Healthcare providers should be aware of the potential for increased disease activity in pwMS during extreme stress and may consider more frequent monitoring, including MRI scans, or treatment adjustments during such periods.
Gout Flare Burden in the United States: A Multiyear Cross‐Sectional Survey Study
Authors: Singh Jasvinder A. , Morlock Amy , Morlock Robert
Published: November 2024

Objective

The objective of this study was to assess the burden of gout flares and examine associated patient characteristics and outcomes in a sample of US adults.

Methods

Data were collected via an online survey of US adults ≥18 years using a random stratified sampling framework. Participants with gout completed questions about treatments, serum urate (SU) levels, severity, satisfaction with control, and gout flares. All participants completed the Veterans RAND 12‐Item Health Survey, the Generalized Anxiety Disorder 7‐Item Scale, and the Patient Health Questionnaire 9‐Item Scale. Data were summarized using descriptive statistics. Multivariable‐adjusted logistic regression analyses examined factors predictive of reporting gout flares to a physician.

Results

A total of 933 participants met the study criteria for having gout. Those with gout tended to be older (58.3 [SD 13.3] years vs 45.4 [SD 16.1] years; P < 0.001), male (76.3% vs 46.9%; P < 0.001), White (80.5% vs 76.8%; P = 0.01), and married or living with their partner (58.9% vs 52.8%; P < 0.001) compared with those without gout (n = 30,146). The total gout flare burden for those with gout was 6.6 gout flares per year. Nearly 72% of gout flares were either not reported to physicians or pretreated or prevented. Characteristics of those who were less likely to report gout flares included being younger, being less educated, having a lower Charlson Comorbidity Index score, not being diagnosed with gout by their doctor, and not taking a urate‐lowering therapy.

Conclusion

This study confirmed that gout flares are common in US adults with gout and found that gout flares are underreported. Reliance on clinical documentation of physician‐reported gout flares is insufficient to assess the true patient burden of gout.
Fault in Converter Interfaced Micro Grid Using Detection and Identification of Hybrid Technique
Authors: Mani Saravana Kumar , Vengadakrishnan Krishnakumar , Moorthy Vijayaragavan
Published: November 2024

This paper introduces a novel hybrid approach, termed ZOA‐SNN, for fault detection and identification in converter‐interfaced microgrids. By integrating the Zebra Optimization Algorithm (ZOA) with Spiking Neural Network (SNN) technology, the proposed method provides a comprehensive solution suitable for both grid‐connected and autonomous microgrid operation scenarios. The technique effectively isolates faults in the microgrid while maintaining operation continuity, particularly in islanded conditions. When operating in grid‐connected mode, distributed generators (DGs) provide electricity as needed. When the grid is not available, power sharing amongst DGs is controlled by voltage angle droop control. By isolating malfunctioning portions, the proposed protection system reduces load shedding, while DG control guarantees smooth islanding and resynchronization. Evaluation on the MATLAB platform demonstrates the superior performance of the proposed technique compared to existing algorithms such as Augmented Lagrangian Particle Swarm Optimization (ALPSO), Graph Convolutional Network (GCN), and Buffalo Optimization (BO). With an accuracy, recall, precision, and F1‐score reaching 98.5%, 99.2%, 99.1%, and 99.1%, respectively, the ZOA‐SNN approach excels in fault detection and classification. Additionally, it significantly reduces computation times for parameter calculation, enhancing efficiency in microgrid control systems. These results highlight the innovation and advantages of the ZOA‐SNN approach in enhancing the reliability and efficiency of fault detection systems in microgrid environments.
Xiao‐Ban‐Xia Decoction Alleviates Chemotherapy‐Induced Nausea and Vomiting by Inhibiting Ferroptosis via Activation of The Nrf2/SLC7A11/GPX4 Pathway
Authors: Liang Wan , Ren Yuke , Wang Yusu , Chen Weijian , Mo Ziyao , Yang Chenglu , Nie Ke
Published: November 2024

Chemotherapy‐induced nausea and vomiting (CINV) represents the common gastrointestinal side effect for cancer patients. Xiao‐Ban‐Xia decoction (XBXD), a classical anti‐emetic traditional Chinese medicine formula, is frequently used for the clinical treatment of CINV. This study used a cisplatin‐induced rat pica model to explore whether the anti‐emetic mechanism of XBXD in treating CINV is related to ferroptosis. The inflammatory damage of the gastrointestinal tract is evaluated by HE staining and ELISA. The degree of ferroptosis are validated by the iron deposition, the levels of ROS, MDA, and GSH, and the ultrastructure of mitochondria in the gastric antrum and ileum. The potential ferroptosis‐related targets of XBXD against CINV are screened by network pharmacology and further assessed by Western blot. XBXD significantly decreased the kaolin consumption in rats, and improved the inflammatory pathological damage, with decreased levels of HMGB1, IL‐1β, and TNF‐α. Furthermore, XBXD significantly suppressed ferroptosis, as indicated by the improvement of iron deposition, mitochondrial abnormalities, and oxidative stress. The network pharmacology and Western blot results indicated that XBXD activated the Nrf2/SLC7A11/GPX4 signaling pathway. This study proved that XBXD activates the Nrf2/SLC7A11/GPX4 signaling pathway, thereby inhibiting ferroptosis, which represents a critical anti‐emetic mechanism of XBXD in combatting CINV.
Recent Advances in Near‐β Titanium Alloys: Microstructure Control, Deformation Mechanisms, and Oxidation Behavior
Authors: Zhuo Longchao , Zhan Mingrui , Xie Yixing , Chen Bingqing , Ji Kaile , Wang Hao
Published: November 2024

Near‐β titanium alloys are used as promising structural materials for aerospace, biomedical, and other advanced applications due to their excellent combination of high specific strength and superior corrosion resistance. Precise control of the microstructure and mechanical properties through thermomechanical processing and heat treatment is paramount for exploiting the full potential of these alloys. This review article provides a comprehensive and critical assessment of the state‐of‐the‐art research on the microstructure evolution, deformation mechanisms, and oxidation behavior of near‐β titanium alloys. Furthermore, the challenges and emerging opportunities in the development of near‐β titanium alloys have also been identified, ranging from alloy design and processing optimization to multiscale characterization and integrated computational materials engineering. This review article provides a timely and comprehensive roadmap for the research and development of near‐β titanium alloys, paving the way for unlocking their full potential in critical industries.
Poly(bis(1‐methylpiperazin‐1‐ium‐amide) Nanofilm Composite Membrane with Nanochannel‑Enabled Microporous Structure and Enhanced Steric Hindrance for Magnesium/Lithium Separation
Authors: Soyekwo Faizal , Liu Changkun , Mao Xin , Shi Xinyu
Published: November 2024

Efficient lithium/magnesium (Li+/Mg2+) separation attainment is fundamental to the extraction of lithium from brine by nanofiltration membrane separation process, which is essential for resource recovery and a circular water economy. However, for poly(piperazine‐amide) nanofilm composite membranes, the higher electronegativity affects the Mg2+ rejection and consequently Li+/Mg2+ separation performance. Manipulating the positive charge density and pore size regulation of the nanofiltration membranes are determinative of the Li+/Mg2+ separation performance improvement. Here, a new monomer 1,1′‐(hexane‐1,6‐diyl)bis(1‐methylpiperazin‐1‐ium) bromide containing bis‐quaternary ammonium cations is employed as a molecular building block to fabricate polyamide nanofilms via interfacial polymerization. The dual quaternary ammoniums and the rod‐shaped conformation of the monomer confer enhanced electropositivity, steric hindrance, loosely packed microporous network structure (pore diameter∼0.8–1.35 nm), and high free volume. The resultant membrane exhibits high water permeance of 28.34 L m−2 h−1 bar−1 with good Li+/Mg2+ selectivity of up to 76.9. In addition, the membrane also exhibits chlorine stability performance owing to the lack of the chlorine sensitive −NH groups in the formed tertiary amide structures. Computational insights on the structural properties, nanofilm formation, and transmembrane water and ion transport behaviors are provided. This study offers insightful theoretical and technological concepts to design and construct membrane materials for energy‐efficient separations.
Novel Graphene‐Epoxy Composite with Aligned Architecture and Ultrahigh Thermal Conductivity
Authors: Ma Zhenqian , Wang Jinyue , Hao Zhenliang , Dai Jingjie , Zhu Xiangyu , Zheng He , Liu Xiongjun , Zhang Hailong , Lu Zhaoping
Published: November 2024

Because of the surge in the power density of electronic devices, there is an urgent need for improvements in the thermal conductivity of packaging materials. Nowadays, epoxy composites supplemented with thermally conductive fillers are widely used for this purpose, but unfortunately, none of them can satisfactorily meet industrial requirements. Herein, this article reports on a novel method to prepare well‐shaped and highly ordered graphene‐epoxy composite architecture; that is, the epoxy infiltrates into tubular graphene columns that have been restored to the high thermally conductive structure of graphene. As a result, the newly developed graphene‐epoxy composite exhibits record‐high thermal conductivity of 69.74 W m−1 K−1 with filler content of only 11.22 wt.%. The unprecedentedly high thermal conductivity stems from the construction of thermally conductive channels and restoration of the inherent π–π conjugate structure of graphene. These findings not only offer a breakthrough in packaging materials with significantly enhanced thermal conductivity but also provide a promising avenue for the development of other advanced graphene‐added composites.
Immuno‐Isolation Strategy with Tacrolimus‐Loaded Nanofilm Promotes Stable Stem Cell‐Based Cartilage Regeneration
Authors: Guo Zhiyi , Zhu Xinsheng , Xu Liang , Zhu Jianxiang , Zhang Xue , Yang Yang , Song Nan
Published: November 2024

Bone marrow stem cells (BMSCs)‐engineered cartilage (BEC) shows promise for clinically repairing cartilage defects. However, when implanted in immunocompetent large animals, BEC becomes susceptible to ossification due to inflammatory infiltration. To address this, a nanofilm isolation approach is developed to enhance BEC's chondrogenic stability. Tacrolimus (FK506), known for its immunosuppressive effect, is integrated into adipic dihydrazide (ADH)‐modified hyaluronic acid (HA), creating an acid‐responsive macromolecular prodrug called FK506@HA‐ADH. This prodrug is then blended with poly(lactic‐co‐glycolic acid) (PLGA) to form electrospun FK506@HA/PLGA nanofilm. Goat‐derived BMSCs are induced in vitro to form BEC, which is enclosed within the FK506@HA/PLGA nanofilm and subcutaneously implanted in autologous goats. The nanofilm acted as a physical barrier, preventing immunocyte infiltration. Additionally, in response to the acidic environment triggered by inflammation and the gradual degradation of PLGA, the FK506@HA‐ADH prodrug is cleaved, releasing FK506 as needed. The released FK506 effectively countered inflammatory cytokines and promoted cartilaginous maturity. These combined mechanisms significantly inhibited BEC hypertrophy and improved its chondrogenic stability within an immunocompetent goat model. This nanofilm‐based isolation strategy established an immunosuppressive niche, successfully preventing endochondral ossification and promoting stable cartilage formation in BEC. These advancements are crucial for translating stem cell‐based therapies into clinical use for cartilage repair.
Immunometabolic Effect of Nitric Oxide on Human Macrophages Challenged With the SARS‐CoV2‐Induced Cytokine Storm. A Fluxomic Approach
Authors: Sánchez‐García Sergio , Povo‐Retana Adrián , Marin Silvia , Madurga Sergio , Fariñas Marco , Aleixandre Nuria , Castrillo Antonio , de la Rosa Juan V. , Alvarez‐Lucena Carlota , Landauro‐Vera Rodrigo , Prieto Patricia , Cascante Marta , Boscá Lisardo
Published: November 2024

The cytokine storm associated with SARS‐CoV‐2 infection is one of the most distinctive pathological signatures in COVID‐19 patients. Macrophages respond to this pro‐inflammatory challenge by reprogramming their functional and metabolic phenotypes. Interestingly, human macrophages fail to express the inducible form of the NO synthase (NOS2) in response to pro‐inflammatory activation and, therefore, NO is not synthesized by these cells. The contribution of exogenously added NO, via a chemical NO‐donor, on the immunometabolic changes associated with the cytokine storm is investigated. By using metabolic, transcriptomic, and functional assays the effect of NO in human macrophages is evaluated and found specific responses. Moreover, through integrative fluxomic analysis, pathways modified by NO that contribute to the expression of a particular phenotype in human macrophages are identified, which includes a decrease in mitochondrial respiration and TCA with a slight increase in the glycolytic flux. A significant ROS increase and preserved cell viability are observed in the presence of NO, which may ease the inflammatory response and host defense. Also, NO reverses the cytokine storm‐induced itaconate accumulation. These changes offer additional clues to understanding the potential crosstalk between NO and the COVID‐19 cytokine storm‐dependent signaling pathways.