bluuebunny/crossref_metadata_2025 huggingface dataset:
The Argument from Moral Responsibility
Authors: Joyce Richard
Published: July 2024

Of the philosophers who are skeptical of the existence of moral responsibility, many remain optimistic that morality could carry on healthily with all reference to responsibility abolished. This chapter casts doubt on this optimism. Various arguments against moral responsibility are briefly outlined and accepted for the sake of argument to succeed. The chapter examines the effect that skepticism about moral responsibility should have on other kinds of moral judgment, such as axiological judgments (good and bad), deontological judgments (obligatory and permissible), and aretaic judgments (virtue and vice). Consideration is also given to what the abolition of responsibility would mean for the practices of apologizing and forgiving and for the emotion of guilt. It is concluded that the abolition of moral responsibility would have a far-reaching impact throughout the rest of moral discourse, such that being an error theorist about responsibility commits one to a more general moral error theory.
Defenses of Moral Fictionalism
Authors: Joyce Richard
Published: July 2024

This chapter defends moral fictionalism from several objections, with discussion structured around the critical appraisal of three alternative views: metaphorist fictionalism, abolitionism, and conservationism. Metaphorist fictionalism recommends eliminating erroneous ontological commitment by modeling moral discourse on metaphorical language, by which we say false things in order to convey truths. Metaphorist fictionalism is ultimately rejected as the best form of moral fictionalism, but its discussion helps to show that certain common objections to moral fictionalism are misguided. The moral abolitionist maintains that morality does more harm than good, generally speaking, and that it should therefore be eliminated. The moral conservationist maintains that morality does more good than harm, generally speaking, and that it should therefore be retained; but the conservationist thinks that these benefits are available only if moral judgments remain items of belief. Arguments are offered against both abolitionism and conservationism, in favor of moral fictionalism.
A Religious History of Ancient Egypt
Authors: Baum Robert M
Published: July 2024

This chapter begins with a discussion of the debates about the place of Egypt in African and Western civilizations, emphasizing the position of Egypt at the crossroads between Africa and the Eastern Mediterranean worlds. The chapter traces the changes in Egyptian cosmologies, deities, ethics, and ritual practices from the unification of Egypt to the New Kingdom. The religious reforms of Akhenaten and the resistance to them are particularly important to this chapter. The growing interaction with Nubia is examined, both as a source of religious innovation and as a place of Egyptian influence. The changing roles of women in religious ritual are also examined.
A deep learning architecture for metabolic pathway prediction
Authors: Baranwal Mayank , Magner Abram , Elvati Paolo , Saldinger Jacob , Violi Angela , Hero Alfred O
Published: July 2024

Motivation

Understanding the mechanisms and structural mappings between molecules and pathway classes are critical for design of reaction predictors for synthesizing new molecules. This article studies the problem of prediction of classes of metabolic pathways (series of chemical reactions occurring within a cell) in which a given biochemical compound participates. We apply a hybrid machine learning approach consisting of graph convolutional networks used to extract molecular shape features as input to a random forest classifier. In contrast to previously applied machine learning methods for this problem, our framework automatically extracts relevant shape features directly from input SMILES representations, which are atom-bond specifications of chemical structures composing the molecules.

Results

Our method is capable of correctly predicting the respective metabolic pathway class of 95.16% of tested compounds, whereas competing methods only achieve an accuracy of 84.92% or less. Furthermore, our framework extends to the task of classification of compounds having mixed membership in multiple pathway classes. Our prediction accuracy for this multi-label task is 95.62%. We analyze the relative importance of various global physicochemical features to the pathway class prediction problem and show that simple linear/logistic regression models can predict the values of these global features from the shape features extracted using our framework.

Availability and implementation

https://github.com/baranwa2/MetabolicPathwayPrediction.
Biopsychosocial phenotypes in people with HIV in the CHARTER cohort
Authors: Tang Bin , Ellis Ronald J , Vaida Florin , Umlauf Anya , Franklin Donald R , Dastgheyb Raha , Rubin Leah H , Riggs Patricia K , Iudicello Jennifer E , Clifford David B , Moore David J , Heaton Robert K , Letendre Scott L
Published: July 2024

Neuropsychiatric complications such as neurocognitive impairment and depression are common in people with HIV despite viral suppression on antiretroviral therapy, but these conditions are heterogeneous in their clinical presentations and associated disability. Identifying novel biopsychosocial phenotypes that account for neurocognitive performance and depressive and functional symptoms will better reflect the complexities encountered in clinical practice and may have pathological and therapeutic implications. We classified 1580 people with HIV based on 17 features, including 7 cognitive domains, 4 subscales of the Beck depression inventory-II, 5 components of the patient’s assessment of own functioning inventory, and dependence in instrumental and basic activities of daily living. A two-stage clustering procedure consisting of dimension reduction with self-organizing maps and Mahalanobis distance-based k-means clustering algorithms was applied to cross-sectional data. Baseline demographic and clinical characteristics were compared between the phenotypes, and their prediction on the biopsychosocial phenotypes was evaluated using multinomial logistic regression. Four distinct phenotypes were identified. Participants in Phenotype 1 overall did well in all domains. Phenotype 2 had mild-to-moderate depressive symptoms and the most substance use disorders. Phenotype 3 had mild-to-moderate cognitive impairment, moderate depressive symptoms, and the worst daily functioning; they also had the highest proportion of females and non-HIV conditions that could affect cognition. Phenotype 4 had mild-to-moderate cognitive impairment but with relatively good mood, and daily functioning. Multivariable analysis showed that demographic characteristics, medical conditions, lifetime cocaine use disorder, triglycerides, and non-antiretroviral therapy medications were important variables associated with biopsychosocial phenotype. We found complex, multidimensional biopsychosocial profiles in people with HIV that were associated with different risk patterns. Future longitudinal work should determine the stability of these phenotypes, assess factors that influence transitions from one phenotype to another, and characterize their biological associations.
Determination of Volatile Halogenated Hydrocarbons in Drinking and Environmental Waters by Headspace Gas Chromatography
Authors: Mo Weifei , Hu Hongmei , Yu Jiangmei , Zhang Tongtong , Liu Qin , Li Mengyan , Zhang Xiaoning , Li Tiejun , Guo Yuanming
Published: July 2024

Volatile halogenated hydrocarbons (VHHs) are annually produced and released into the environment, posing a threat to public health. In this study, a simple, rapid, sensitive and automated method based on headspace and gas chromatography (GC) with electron-capture detection was described for the determination of VHHs in different concentration levels in water samples. The proposed headspace GC method was initially optimized, and the optimum experimental conditions found were 10-mL water sample containing 20% w/v sodium chloride placed in a 20-mL vial and stirred at 60°C for 35 min, and then 14 VHHs were well separated on DB-35 MS capillary column with a split ratio of 12.5: 1. The limits of detection were in the low μg/L level, ranging between 0.01 and 0.6 μg/L. Finally optimized method was applied for determination 14 VHHs in drinking and environmental waters. The total mean concentrations of VHHs were 34.962, 26.183, 3.228 and 647.344 μg/L in tap water, purified water with 1-year-old filter element, seawater and effluents, respectively. However, no VHHs was detected in purified water with a new filter element. The main composition is different among different water matrix, which may be attributed to their different sources.
DGA domain embedding with deep metric learning
Authors: Yang Yifan , Li Xionglve , Yang Tao , Hou Bingnan , Zeng Lingbin , Cai Zhiping , Kuang Wenyuan
Published: July 2024

Botnets currently use domain-generation algorithms to produce fast-flux domains that enable them to evade detection. Accurately categorizing these botnet domains is crucial to develop cybersecurity solutions against botnet threats. However, existing methods, requiring labeled data, are ineffective against new botnets. To address this issue, we propose Domain2Vec, a metric learning-based approach that can explore new botnets. Domain2Vec integrates a framework of metric learning, which uses individual domains from known botnets for categorization of unknown botnet domains. The training involves an attention-based encoder, and it includes a constraint to ensure that samples with the same labels are closer in the embedding space. The categorization uses the encoder to project domain names into appropriate representations (numerical vectors), even for domains from new botnets. Finally, Domain2Vec uses numerical vectors to explore botnets. Experiments showed that Domain2Vec performs well on domain retrieval and clustering tasks without labeled data, outperforming the state of the art by 13% and 100%, respectively. Real-world tests demonstrate that Domain2Vec can effectively identify unreported malicious domains and monitor botnet activities.
Coronavirus disease 2019–related myocardial injury is associated with immune dysregulation in symptomatic patients with cardiac magnetic resonance imaging abnormalities
Authors: Ćorović Andrej , Zhao Xiaohui , Huang Yuan , Newland Stephen R , Gopalan Deepa , Harrison James , Giakomidi Despina , Chen Shanna , Yarkoni Natalia S , Wall Christopher , Peverelli Marta , Sriranjan Rouchelle , Gallo Arianna , Graves Martin J , Sage Andrew , Lyons Paul A , Sithole Nyarie , Bennett Martin R , Rudd James H F , Mallat Ziad , Zhao Tian X , Nus Meritxell , Tarkin Jason M
Published: July 2024

Aims

While acute cardiovascular complications of coronavirus disease 2019 (COVID-19) are well described, less is known about longer-term cardiac sequelae. For many individuals with cardiac signs or symptoms arising after COVID-19 infection, the aetiology remains unclear. We examined immune profiles associated with magnetic resonance imaging (MRI) abnormalities in patients with unexplained cardiac injury after COVID-19.

Methods and results

Twenty-one participants {mean age 47 [standard deviation (SD) 13] years, 71% female} with long COVID-19 (n = 17), raised troponin (n = 2), or unexplained new-onset heart failure (n = 2), who did not have pre-existing heart conditions or recent steroid/immunosuppression treatment, were enrolled a mean 346 (SD 191) days after COVID-19 infection in a prospective observational study. Cardiac MRI and blood sampling for deep immunophenotyping using mass cytometry by time of flight and measurement of proteomic inflammatory markers were performed. Nine of the 21 (43%) participants had MRI abnormalities (MRI(+)), including non-ischaemic patterns of late gadolinium enhancement and/or visually overt myocardial oedema in 8 people. One patient had mildly impaired biventricular function without fibrosis or oedema, and two had severe left ventricular (LV) impairment. MRI(+) individuals had higher blood CCL3, CCL7, FGF-23, and CD4 Th2 cells, and lower CD8 T effector memory (TEM) cells, than MRI(−). Cluster analysis revealed lower expression of inhibitory receptors PD1 and TIM3 in CD8 TEM cells from MRI(+) patients than MRI(−) patients, and functional studies of CD8 T αβ cells showed higher proportions of cytotoxic granzyme B+(GZB+)-secreting cells upon stimulation. CD8 TEM cells and CCL7 were the strongest predictors of MRI abnormalities in a least absolute shrinkage and selection operator regression model (composite area under the curve 0.96, 95% confidence interval 0.88–1.0). CCL7 was correlated with diffuse myocardial fibrosis/oedema detected by quantitative T1 mapping (r = 0.47, P = 0.04).

Conclusion

COVID-19-related cardiac injury in symptomatic patients with non-ischaemic myocarditis-like MRI abnormalities is associated with immune dysregulation, including decreased peripheral CD8 TEM cells and increased CCL7, persisting long after the initial infection.
Effect of patent complete revascularization on the akinetic myocardial segments
Authors: Kim Min-Seok , Kim Min-Jeong , Jeong Hyeon Ju , Hwang Seong Wook , Kim Ki-Bong
Published: July 2024

OBJECTIVES

The aims of the study were (i) to examine the changes in echocardiographic parameters and (ii) to compare the fate of myocardial segments with akinesia and without akinesia on preoperative echocardiography after coronary artery bypass grafting.

METHODS

One hundred one patients who underwent complete revascularization, who were assessed by preoperative, before discharge, postoperative 3- and 12-month echocardiographic examinations, and who showed all patent grafts at postoperative 1-year angiograms were included. Echocardiographic left ventricular ejection fraction was assessed, and a 16-segment model was adopted for regional analysis of the left ventricle. A total of 1616 segments were analysed based on a 6-point scale: 1 = normal (N = 1083), 2 = mild hypokinesia (N = 2), 3 = moderate hypokinesia (N = 74), 4 = severe hypokinesia (N = 150), 5 = akinesia without thinning (N = 259) and 6 = akinesia with thinning (N = 48).

RESULTS

The serial left ventricular ejection fraction measured preoperatively, before discharge, at postoperative 3- and 12-months were 0.48 ± 0.14, 0.49 ± 0.12, 0.49 ± 0.10 and 0.54 ± 0.10, respectively. The left ventricular ejection fraction significantly increased over time during the postoperative 12 months (P < 0.001). Wall motion scores tended to decrease over time in both segment groups with akinesia and without akinesia (P < 0.001), and improvement of the wall motion was significantly higher in the segment group with akinesia than in the segment group without akinesia (P < 0.001).

CONCLUSIONS

The left ventricular ejection fraction and regional wall motion improved over time during the postoperative 12 months, regardless of the presence of an akinetic segment. Complete revascularization including akinetic myocardium should be considered when performing coronary artery bypass grafting.
Economics and antitrust enforcement at the EU: an update
Authors: Katsoulacos Y , Makri G
Published: July 2024

We extend the dataset, revise, and improve the methodology applied in empirically measuring the role of economics in antitrust enforcement by European Commission’s DG for Competition (EC’s DGCOMP), first examined in Katsoulacos and Makri (2021, this journal). Infringement decisions from 1992 to 2021 are now examined, including a number of important digital and hi-tech market decisions from 2018 to 2021. The revised methodology significantly clarifies the role of potential assessment screens in identifying eight (rather than five) potential Legal Standards, also taking into account the Quick Look standards. Additionally, we now distinguish evidence presented depending on the burden of proof. Thus, we capture the role of economic analysis and evidence applied by DGCOMP, in proving that conduct is anti-competitive, through the new Cumulative Economic Analysis Indicator, as distinguished from the role of efficiency analysis presented by defendants and then assessed by DGCOMP, which is now independently measured; combined, these define a new indicator of the Total Economic Evidence presented during assessment. The quality of enforcement by DGCOMP, measured by the closeness of the weighted average Cumulative Economic Analysis Indicator empirically identified for different conduct types to its theoretically optimal (decision error minimizing) level, is captured and its evolution is considered and compared to other Competition Authorities.
Managing Long-term Orofacial Contractures and Microstomia Through Intraoral Stretching
Authors: Arguello Lori Ann , Kerr Kathleen Mary
Published: July 2024

Microstomia and orofacial contractures continue to garner interest regarding the effectiveness of treatment methodologies utilized to impact functional change. Oral splints are an accepted tool in the management of microstomia. However, the concepts of which oral splints to use, timing of initiation, and duration of treatment have not gained a consensus. This article reviews approaches to oral splinting and an alternative intraoral approach using splints designed to provide a graded, low load, multidirectional, and prolonged stretch specifically in facial burn survivors including those with mature scars. Two participants participated in a trial using oral splints placed inside the mouth at established contracture points. Participants were requested to use the splints for 1 h twice daily. Participants were photographed weekly producing 9 facial expressions, and distance between 13 facial landmarks was measured to evaluate change in tissue length. Numerical changes observed from beginning to end of the trial indicate positive and negative alterations, signifying lengthening or shortening of tissue. Negative changes denote reduction in distance between endpoints, while positive changes signify an increase. Participants verbalized functional improvements in oral motor and psychosocial function posttreatment. To date, oral splints can be custom fabricated for each individual patient. However, few oral splints are created to provide multidirectional stretch focusing on problem areas across the mid and lower face. The intraoral splints and regimen described here have the capability of providing a stretching intervention that could be applicable in various stages of burn recovery.
Biased Retention of Environment-Responsive Genes Following Genome Fractionation
Authors: Beringer Marc , Choudhury Rimjhim Roy , Mandáková Terezie , Grünig Sandra , Poretti Manuel , Leitch Ilia J , Lysak Martin A , Parisod Christian
Published: July 2024

The molecular underpinnings and consequences of cycles of whole-genome duplication (WGD) and subsequent gene loss through subgenome fractionation remain largely elusive. Endogenous drivers, such as transposable elements (TEs), have been postulated to shape genome-wide dominance and biased fractionation, leading to a conserved least-fractionated (LF) subgenome and a degenerated most-fractionated (MF) subgenome. In contrast, the role of exogenous factors, such as those induced by environmental stresses, has been overlooked. In this study, a chromosome-scale assembly of the alpine buckler mustard (Biscutella laevigata; Brassicaceae) that underwent a WGD event about 11 million years ago is coupled with transcriptional responses to heat, cold, drought, and herbivory to assess how gene expression is associated with differential gene retention across the MF and LF subgenomes. Counteracting the impact of TEs in reducing the expression and retention of nearby genes across the MF subgenome, dosage balance is highlighted as a main endogenous promoter of the retention of duplicated gene products under purifying selection. Consistent with the “turn a hobby into a job” model, about one-third of environment-responsive duplicates exhibit novel expression patterns, with one copy typically remaining conditionally expressed, whereas the other copy has evolved constitutive expression, highlighting exogenous factors as a major driver of gene retention. Showing uneven patterns of fractionation, with regions remaining unbiased, but with others showing high bias and significant enrichment in environment-responsive genes, this mesopolyploid genome presents evolutionary signatures consistent with an interplay of endogenous and exogenous factors having driven gene content following WGD-fractionation cycles.
Operation warp speed: Harbinger of American industrial innovation policies
Authors: Bonvillian William B
Published: July 2024

Operation warp speed (OWS) was a crash effort from 2020 to 2021 to undertake the late-stage development, production, and distribution of vaccines for the coronavirus pandemic. The vaccines were developed, approved, and available in a record time of 8 months using an industrial policy approach. Mainstream economists have long opposed industrial policy approaches as market interference, unless they can be justified by clear market failures. The nation has long had industrial economic policies in such areas as defense, health, transport, and agriculture. However, interventionist policies on the non-defense innovation side of the economy after the research stage have generally been avoided. OWS was a departure, an industrial innovation policy. OWS built a new organization with officials from major health science, regulatory, public health, and research agencies as well as the Defense Department. Elements of its program included: supporting a portfolio of different technology platforms, guaranteed contracts that enable production to evolve alongside development, flexible contracting mechanisms that enabled rapid procurement and intervention into supply chains, rapid technology certification that assured the new vaccines of rapid market entry, mapping supply chains and filling gaps to assure rapid production and distribution, and major product distribution. The elements applied in OWS amount to a new tool kit potentially relevant to other areas, and the USA is now pursuing a series of these in other technology fields.
Policy responses to the rise of global OTT platforms in Korea
Authors: Kim Min Sung , Kim Seongcheol
Published: July 2024

The outbreak of COVID-19 and subsequent social distancing measures sparked a surge in demand and unprecedented growth opportunities for OTT (over-the-top) services. Despite the need to foster Korea’s domestic media and cultural industry, the Korean government has almost failed to properly operate OTT policies and the opportunity went to global operators. Although Korea’s content competitiveness has advanced to a global level, local OTTs continue to lag Netflix. This is not a concern confined to Korea. This paper identifies the focal actors of Korea’s local OTT platforms, analyzes the developmental phases of the Korean OTT market, and draws policy-related and industrial implications by ascertaining, which factors hinder local OTT services from achieving their desired development, within the context of the actor-network theory. This paper offers a fresh perspective on the policy responses to the rise of global OTT platforms and the downturn of local OTT platforms in Korea.
SME digital transformation and the COVID-19 pandemic: a case study of a hard-hit metropolitan area
Authors: Holl Adelheid , Rama Ruth
Published: July 2024

Cities and regions are facing diverse challenges, and the transformation to a digital economy is a core issue. The coronavirus disease-2019 (COVID-19) pandemic has had widespread impacts on business, and it has heightened the need for digitalization. We analyse if and to what degree the COVID-19 pandemic has accelerated the digital transformation of small and medium-sized enterprises (SMEs) in the metropolitan region of Madrid. Our research strategy is based on a quantitative analysis of survey data at the company level. Our results show that a large share of SMEs invested in digital technologies as a response to the pandemic, but there are also important differences between basic and more advanced digital technologies and between manufacturing and service sector firms. SMEs’ previous knowledge and technological resources and capabilities, as well as their collaboration networks with providers are found to trigger adoption of digital technology. Implications for postpandemic policies are highlighted.
Investigating the emergence of a zoonotic virus: phylogenetic analysis of European bat lyssavirus 1 in the UK
Authors: Golding Megan E , Wu Guanghui , Wilkie Rebekah , Picard-Meyer Evelyne , Servat Alexandre , Marston Denise A , Aegerter James N , Horton Daniel L , McElhinney Lorraine M
Published: July 2024

European bat lyssavirus 1 (EBLV-1, Lyssavirus hamburg) is predominantly detected in serotine bats (Eptesicus serotinus) and is responsible for the majority of bat rabies cases in mainland Europe. A passive bat rabies surveillance scheme detected the virus in a serotine bat in the UK for the first time in October 2018. As of May 2024, 34 cases have been reported, 20 of which involved contact with an animal and 5 reported human contact. We investigated the emergence of EBLV-1 by undertaking comprehensive sequence analysis and Bayesian phylogenetics, based on complete virus genomes of 33 UK sequences and 108 sequences covering six countries in mainland Europe (1968–2023), including 21 French EBLV-1-positive RNA samples sequenced for this study. Sequence analysis revealed extreme similarity among UK EBLV-1 sequences (99.9%–100%), implying a single source of introduction rather than multiple independent introductions. Bayesian analysis revealed that the UK EBLV-1 sequences shared their most recent common ancestor with an EBLV-1 sequence from a serotine bat detected in Brittany, France, in 2001, with an estimated date of divergence of 1997. Within the UK sequences, the earliest divergence was estimated to occur in 2007. This study provides valuable insights into the molecular epidemiology of an emerging zoonotic pathogen and improved understanding of the risks posed to public and animal health.
Examining the Relationship Between Hearing Health Beliefs and Social Determinants of Health in Black Adults
Authors: Lewis Charity T. , Toman Julia , Sanchez Victoria A. , Corvin Jaime , Arnold Michelle L.
Published: July 2024

Objectives:

Hearing loss is a highly prevalent condition; however, it is widely under-treated, and Black Americans have been found to have significantly lower rates of hearing aid utilization than other ethnic/racial groups. In this exploratory study, we aimed to identify hearing health beliefs among Black adults, guided by the Health Belief Model, with social determinants of health, and examine individual differences in these perspectives.

Design:

The Hearing Beliefs Questionnaire (HBQ) was administered online to measure constructs of the Health Belief Model among 200 Black adults aged 18 to 75 (M = 39.14, SD = 14.24). Approximately 13% reported hearing difficulty. In addition, 11 social determinants of health questions were included. Participants were recruited from a university otolaryngology clinic and local Black congregations, meeting inclusion criteria of being 18 or older and Black/African American. Mean scores and SDs for HBQ subscales were calculated. Analysis included analysis of variance and t tests to explore relationships with demographic variables and social determinants of health. Multiple regression analyses predicted HBQ subscale scores from sociodemographic variables.

Results:

Mean HBQ subscale scores ranged from 3.88 (SD = 2.28) for Perceived Barriers to 6.76 (SD = 1.93) for Perceived Benefits. Positive correlations were observed between Perceived Severity, Perceived Benefits, and Perceived Self-Efficacy scores and participant educational attainment. Lower economic stability was correlated with poorer scores in Perceived Self-Efficacy, Perceived Severity, and Perceived Benefits. Black adults’ willingness to purchase a hearing aid was heavily influenced by their Perceived Benefit, Perceived Severity, and Perceived Self-Efficacy scores, with lower scores correlating with unwillingness to purchase devices. Higher frequency of racism/discrimination and financial hardship correlated with increased Perceived Barriers scores for accessing hearing healthcare. In addition, hearing health beliefs between participants with self-reported hearing difficulty and those without trouble only exhibited differences in the Perceived Susceptibility subscale, with those experiencing hearing difficulty having higher scores in this subscale; no other distinctions were identified.

Conclusions:

The Health Belief Model, used with social determinants of health, revealed associations, and variations, in the hearing health beliefs held by Black adults. The present investigation reveals heterogeneity within this group and pinpoints individuals at higher risk for untreated hearing loss, stemming from their negative perceptions about hearing healthcare. These beliefs are influenced by demographics and social determinants of health, underscoring areas ripe for intervention.
Osseointegration: A new approach to improve functional performance of prostheses – a systematic review of the literature
Authors: Karimi Mohammad Taghi , Kavyani Mahsa , Mehrvar Amir
Published: July 2024

Background:

Individuals with amputations experience functional limitations in their daily activities, depending on the level of their injuries. They often encounter problems with socket-based prostheses. Osseointegration is a new method in prosthetic rehabilitation that aims to enhance the performance of amputees and reduce the issues associated with current prostheses. The objective of this review was to assess the advantages and disadvantages of this novel approach in the rehabilitation of amputees.

Method:

A search was conducted in various databases, including Google Scholar, PubMed, ISI Web of Knowledge, Embase, and Scopus. The search terms used were “osseointegration,” “prosthesis,” and “amputation.” The quality of the studies was evaluated using the Down and Black tool.

Results:

The search using the aforementioned keywords yielded 18 papers. Out of these, 10 papers focused on the use of osseointegration for lower limb amputations, while 5 papers focused on upper limb amputations. Additionally, 3 papers examined the occurrence of stump infections associated with this method. The quality of the studies ranged from 15 to 20.

Conclusion:

Based on the available literature, osseointegration addresses some of the challenges associated with socket-based prostheses. Furthermore, it improves the performance of prostheses. However, there are several issues with this method, including high costs, stump infections, and the need for extensive expertise to insert the implant. Further large-scale studies are necessary to determine the various limitations and advantages of this approach for different levels of amputations.
The Effect of Thrombin-gelatin Matrix Compared With Absorbable Gelatin Sponge on Intraoperative Hemostasis in Unilateral Open-door Laminoplasty
Authors: Huang Chengyi , Chen Zhu , Liu Hao , He Junbo , Shen Yiwei , Wu Tingkui , Wang Beiyu
Published: July 2024

Study Design.

Prospective, randomized, parallel-controlled trial.

Objective.

The primary aim of this study was to determine whether thrombin-gelatin matrix (TGM) combined with an absorbable gelatin sponge (AGS) could more greatly reduce intraoperative blood loss (IBL) in unilateral open-door laminoplasty than the sole use of an AGS could. The secondary aims were to evaluate the hemostatic efficiency, amount of postoperative bleeding, and safety of the application of TGM combined with an AGS.

Summary of Background Data.

IBL during cervical laminoplasty is substantial and is a proper indication for the application of hemostatic agents. However, we are unaware of any clinical trials on the application of TGM and an AGS in posterior cervical spine surgery.

Methods.

A total of 80 consecutive patients who underwent unilateral open-door laminoplasty were enrolled from September 2020 to March 2022. Patients were randomized into 2 groups, the TGM-AGS group and the AGS group, with 40 patients in each group. The primary outcome was IBL. Other outcomes included the duration of operation, duration of hemostasis, duration of drainage, maximum decrease in hemoglobin (Hb), length of hospital stay, volume of drainage, number of drainage days, occurrence of adverse events, coagulation indicators, and patient-reported outcome measures (PROMs).

Results.

The mean IBL for patients in the TGM-AGS group (75.22 ± 21.83 mL) was significantly lower than that in the AGS group (252.43 ± 57.39 mL) (mean difference = 177.21 mL, 95% confidence interval [CI], 157.88-196.53 mL, t=18.25, P<0.001); the duration of hemostasis, volume of drainage, days of drainage in the TGM group, and maximum decrease in Hb were also significantly less than those in the AGS group (P<0.01).

Conclusion.

The hemostatic efficacy of TGM-AGS is better than that of an AGS alone in IBL. TGM-AGS is also superior to an AGS alone in the evaluation of hemostatic efficiency and postoperative bleeding.
Educational Interventions for Rapid Response Team Members
Authors: Birch Alexander , Varty Maureen
Published: July 2024

Background

Research continues to be conducted on rapid response systems as patient outcomes associated with rapid response team activations are still not consistently showing benefit. One particular area of focus that is a growing area is the literature regarding training and education for individual team members of the rapid response team.

Objective

The purpose of this narrative review was to describe the current literature regarding educational interventions for rapid response team members.

Methods

This review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. To be included in the narrative review, studies needed to be reporting on educational interventional research for rapid response team members of the efferent limb. No studies were excluded based upon study design or publication years.

Results

This narrative review included 6 studies. Four studies assessed outcomes associated with rapid response team members, and 2 of the studies assessed patient outcomes associated with implementing education routinely for rapid response teams. All studies found a positive impact of implementing educational interventions.

Discussion

Our narrative review found that limited research has been conducted in the area of educational interventions for rapid response team members, and of the articles identified, most did not assess patient-associated outcomes. The findings demonstrate that this area of research is in its early stages, and further work is needed to identify what content should be provided in the education and what educational methodologies should be employed, and to continue to assess patient health outcomes associated with educational interventions for rapid response team members.
Efficacy Evaluation of a Hyaluronic Acid Dermal Filler Containing Mannitol: Clinical and Aesthetic Assessment Using High-Frequency Ultrasound
Authors: Samadi Aniseh , Ahmadian Yazdi Hasti , Kafi Hamidreza , Yazdanparast Taraneh , Ahmad Nasrollahi Saman , Zartab Hamed , Firooz Alireza
Published: July 2024

BACKGROUND

Mannitol may be a good excipient for hyaluronic acid (HA) filler.

OBJECTIVE

This study aimed to assess the tolerability and effectiveness of a mannitol-containing HA filler for the improvement of nasolabial folds (NLFs).

PATIENTS AND METHODS

Thirty Middle Eastern participants aged 18 to 65 years with moderate-to-severe NLFs on the Wrinkle Severity Rating Scale (WSRS) received 1 to 2 mL of a HA filler containing mannitol in both NLFs. Wrinkle Severity Rating Scale; volume, depth, and area of NLFs; and ultrasound parameters were measured at baseline, Weeks 2, 12, and 24 after the injection. Adverse events and participants' satisfaction were recorded in all follow-up visits.

RESULTS

Eighty-nine percent, 86%, and 61% of participants showed at least one grade improvement in WSRS, at Weeks 2, 12, and 24, respectively. The area and volume of NLFs significantly decreased compared with baseline (p-value < .01). In severe NLFs, echo density of the dermis significantly increased at Week 2. Participants reported great satisfaction with the treatment, and adverse events were mainly mild and transient. One patient had significant pain during injection, but this resolved without sequelae.

CONCLUSION

The tested mannitol-containing HA filler showed to be effective in Middle Eastern participants. The safety will require a follow-up larger study.
Impact of acute kidney injury response on survival and liver transplant rates in hospitalized patients with cirrhosis awaiting liver transplantation: Results from the HRS-HARMONY consortium
Authors: Li Xing , Ouyang Tianqi , Belcher Justin M. , Patidar Kavish R. , Cullaro Giuseppe , Asrani Sumeet K. , Wadei Hani M. , Simonetto Douglas A. , Regner Kevin R. , Dageforde Leigh A. , Przybyszewski Eric M. , Wilechansky Robert M. , Sharma Pratima , Ufere Nneka N. , Duarte-Rojo Andres , Wahid Nabeel A. , Orman Eric S. , St. Hillien Shelsea A. , Robinson Jevon E. , Chung Raymond T. , Allegretti Andrew S. ,   I on behalf of the HRS-HARMONY research collaborative
Published: July 2024

Acute kidney injury (AKI) frequently complicates the course of hospitalized patients with cirrhosis and negatively affects their prognosis. How AKI response influences the timing of liver transplantation (LT) remains unclear. We sought to assess the impact of AKI response to treatment on survival and LT rates in patients with cirrhosis awaiting LT. This was a retrospective multicenter study of cirrhosis patients waitlisted for LT and hospitalized with AKI in 2019. The exposure was AKI response versus no response during hospitalization. Outcomes were 90-day overall and transplant-free survival, and rates of LT with time to transplant. We adjusted for age, sex, race, cirrhosis etiology, site, and Model for End-Stage Liver Disease-Sodium (MELD-Na) score. Among the 317 patients in this study, 170 had an AKI response (53.6%), and 147 had no response (46.4%). Compared to nonresponders, responders had better 90-day overall survival (89.4% vs. 76.2%, adjusted subhazard ratio for mortality 0.34, p=0.001), and transplant-free survival (63.5% vs. 25.2%, aHR for probability of death or transplant 0.35, p<0.001). The LT rate was lower in responders (45.9% vs. 61.2%, adjusted subhazard ratio 0.55, p=0.005); 79% of transplants in responders occurred after discharge, at a median of 103 days, while 62% of transplants in nonresponders occurred during hospitalization, with the remainder occurring postdischarge at a median of 58 days. In patients with cirrhosis waitlisted for LT who are hospitalized with AKI, AKI response to therapy is associated with improved 90-day survival, despite a reduced LT rate and longer time to LT.
Clinical Factors Related to Abnormal General Movements Trajectories: Development of a Multicriteria Index
Authors: Mendonça Karoline Tury de , Pascoal Ana Flávia de Souza , Lanza Fernanda de Cordoba , Viñolas Prat Bernat , Morais Rosane Luzia de Souza , Camargos Ana Cristina Resende
Published: July 2024

Purpose:

To create a multicriteria index with clinical factors associated with abnormal general movements (GMs) trajectories during a stay in the neonatal intensive care unit.

Methods:

A longitudinal study assessed abnormal GMs trajectories in preterm infants in the neonatal intensive care unit. The multicriteria index included clinical factors such as intraventricular hemorrhage, respiratory support, gestational age, patent ductus arteriosus, and infection based on multi-attribute utility theory.

Results:

A total of 52 preterm newborns, 57.7% male, were evaluated. The multicriteria index correlated with abnormal GMs trajectories and explained 26.5% of the variance in these trajectories.

Conclusion:

The developed multicriteria index, with the inclusion of combined clinical factors, allowed the identification of part of the abnormal trajectories of GMs in preterm infants. The multicriteria analysis can help clinicians to identify infants who have a greater chance of poor developmental trajectories before hospital discharge.
A Quality Improvement Project to Decrease Fractures Secondary to Metabolic Bone Disease of Prematurity
Authors: Rau Nicole M. , Monagle Lisa J. , Fischer Ashley M.
Published: July 2024

Introduction:

Osteopenia of prematurity is common in the neonatal intensive care unit, with an incidence of up to 54% in extremely low birthweight infants. The baseline fracture rate in our level IV midwestern neonatal intensive care unit was 13%, with poor compliance with recommended intakes of calcium, calcium:phosphorus ratio, and Vitamin D.

Methods:

A multidisciplinary team implemented a screening guideline through four Plan-Do-Study-Act cycles, which addressed staff education, vitamin D screening, and incorporation of calcitriol. In total, 150 patients born between October 1, 2019 and April 30, 2023 were screened for mineral intakes, laboratory abnormalities, and the development of fractures or osteopenia.

Results:

The incidence of fractures decreased from 13% to 5.3%. Compliance with mineral intakes improved for calcium, calcium: phosphorus ratio, and Vitamin D. Infants born after the guideline were 4.8 times less likely to develop fractures.

Conclusion:

Quality improvement methodology successfully decreased the rate of fractures due to osteopenia of prematurity and increased compliance with recommended mineral intakes.
Perception of Simulation Culture Readiness Among Healthcare Personnel at a Medical City in Saudi Arabia
Authors: Almotairy Monir M. , Alharbi Saad S. , Nahari Ahmed M. , Alabdle Dalia M. , Alraddade Haifaa N. , Hakamy Essa Y.
Published: July 2024

Introduction

Research in Saudi Arabia concerning health organizations' readiness to use simulation in healthcare personnel training is insufficient. Therefore, this study explored simulation readiness culture and identified associations between simulation readiness culture and healthcare personnel characteristics at a medical city in the western region of Saudi Arabia.

Methods

This cross-sectional study used convenience sampling and the Simulation Culture Organizational Readiness Survey (SCORS), a 36-item questionnaire, to collect data from healthcare personnel working at 3 hospitals and 5 primary care centers at a medical city in the western region of Saudi Arabia. A total of 209 healthcare personnel participated in the study.

Results

The mean total SCORS score was 120.53 (standard deviation ±28.32). Men had significantly higher Readiness for Culture Change and Time, Personnel, and Resource Readiness subscale scores, as well as SCORS total score. Participants with undergraduate degrees had significantly higher Defined Need and Support for Change subscale scores. In the multiple regression analysis, sex and being certified in simulation statistically significantly predicted the SCORS total score and Readiness for Culture Change subscale score, whereas being certified in simulation alone only statistically significantly predicted the Defined Need and Support for Change subscale score.

Conclusions

Simulation culture readiness showed great potential to integrate simulation in healthcare personnel training. The variation in simulation culture readiness based on demographic characteristics warrants further evaluation and consideration by clinical leaders to better optimize the outcomes of healthcare personnel training.
Novel 4D-printed multi-stable metamaterials: programmability of force-displacement behaviour and deformation sequence
Authors: Wan Mengqi , Yu Keqin , Zeng Hao , Khatibi Akbar A. , Yin Meigui , Sun Huiyu
Published: July 2024

The unique properties of metamaterials are determined by the configuration and spatial arrangement of artificially designed unit structures. However, the configuration and mechanical properties of conventional metamaterials are challenging to reverse and adjust. Based on curved beams, two types of novel three-dimensional (3D) multi-stable metamaterials with reconfigurable deformation and tunable mechanical properties are designed and fabricated using a four-dimensional (4D) printing method. The effects of temperature and curved-beam thickness on the force-displacement curves and multi-stable snapping sequence of the 3D multi-stable metamaterials are investigated by finite-element analysis (FEA) and experiments. In addition, based on the designed four-branch multi-stable metamaterials, three- and six-branched multi-stable structures are designed by changing the number of curved-beam branches. It is shown that, owing to shape memory effects, the 3D multi-stable metamaterials can realize mechanical programmability, and the multi-stable deformation sequence can be precisely regulated by varying the temperature and curved-beam thickness. These 4D-printed multi-stable metamaterials provide valuable contributions to the design of programmable multi-stable metamaterials and their applications in soft robots and intelligent structures.

This article is part of the theme issue ‘Current developments in elastic and acoustic metamaterials science (Part 1)’.
Design and experimental validation of a finite-size labyrinthine metamaterial for vibro-acoustics: enabling upscaling towards large-scale structures
Authors: Hermann S. , Billon K. , Parlak A. M. , Orlowsky J. , Collet M. , Madeo A.
Published: July 2024

In this article, we present the design and experimental validation of a labyrinthine metamaterial for vibro-acoustic applications. Based on a two-dimensional unit cell, different designs of finite-size metamaterial specimens in a sandwich configuration including two plates are proposed. The design phase includes an optimization based on Bloch-Floquet analysis with the aims of maximizing the band gap and extruding the specimens in the third dimension while keeping the absorption properties almost unaffected. By manufacturing and experimentally testing finite-sized specimens, we assess their capacity to mitigate vibrations in vibro-impact tests. The experiments confirm a band gap in the low- to mid-frequency range. Numerical models are employed to validate the experiments and to examine additional vibro-acoustic load cases. The metamaterial’s performances are compared with benchmark solutions, usually employed for noise and vibration mitigation, showing a comparable efficacy in the band gap region. To eventually improve the metamaterial’s performance, we optimize its interaction with the air and test different types of connections between the metamaterial and the homogeneous plates. This finally leads to metamaterial samples largely exceeding the benchmark performances in the band gap region and reveals the potential of interfaces for performance optimization of composed structures.

This article is part of the theme issue ‘Current developments in elastic and acoustic metamaterials science (Part 1)’.
Current developments in elastic and acoustic metamaterials science
Authors: Failla Giuseppe , Marzani Alessandro , Palermo Antonio , Russillo Andrea Francesco , Colquitt Daniel
Published: July 2024

The concept of metamaterial recently emerged as a new frontier of scientific research, encompassing physics, materials science and engineering. In a broad sense, a metamaterial indicates an engineered material with exotic properties not found in nature, obtained by appropriate architecture either at macro-scale or at micro-/nano-scales. The architecture of metamaterials can be tailored to open unforeseen opportunities for mechanical and acoustic applications, as demonstrated by an impressive and increasing number of studies. Building on this knowledge, this theme issue aims to gather cutting-edge theoretical, computational and experimental studies on elastic and acoustic metamaterials, with the purpose of offering a wide perspective on recent achievements and future challenges.

This article is part of the theme issue ‘Current developments in elastic and acoustic metamaterials science (Part 1)’.