bluuebunny/crossref_metadata_2025 huggingface dataset:
Investigating the influence of topology on elastic properties in spinodal microstructures
Authors: Golnary Farshid , Asghari Mohsen
Published: September 2023

Spinodal topologies formed through self-assembly processes exhibit unique mechanical properties, such as smoothness and non-periodicity, making them resistant to buckling and manufacturing defects. While extensive research has focused on their mechanical behavior, limited attention has been given to understanding the impact of their complex topology. This study aims to investigate the relationship between the topological features of two-dimensional spinodal topologies, characterized using computational homology, and their elastic response by analyzing scaling laws. Sensitivity analysis was conducted to determine the influence of various topological characteristics on Young’s modulus and Poisson’s ratio. Computational homology techniques were used to measure Betti numbers, which represent the number of loops and disjoint regions in the spinodal topologies. Additionally, these techniques were also employed to determine the size of these loops and regions. Among all the topological characteristics studied, the number and size of loops were found to have the highest influence on the elastic properties, specifically Young’s modulus and Poisson’s ratio. Understanding the rules that govern the way two-dimensional spinodal topologies respond elastically is crucial for comprehending how they behave mechanically and for optimizing their performance. The research findings highlight the significant impact of certain topological features, specifically the number and size of loops, on the material properties. This knowledge provides valuable insights for designing and engineering spinodal structures.
Global dynamics of a reaction-diffusion brucellosis model with spatiotemporal heterogeneity and nonlocal delay
Authors: Liu Shu-Min , Bai Zhenguo , Sun Gui-Quan
Published: September 2023

The increase of animal transportation and livestock lead to repeated outbreaks of brucellosis, and its transmission process is extremely complex. According to the clinical symptoms and infectious differences of the diseased sheep, it is further divided into acute infection and chronic infection, and a reaction-diffusion SLICB (susceptible-latent-acute infected-chronic infected-brucella) model with seasonality, spatial heterogeneity and nonlocal delay is proposed to understand the transmission law of brucellosis and analyze its transmission risk. Based on the basic reproduction number

0

of the model, the final development trend of brucellosis transmission among sheep is analyzed by persistence theory. The

0

of the model is numerically calculated by the generalized power method, and simulation analysis shows that: (i) extending the latent period and increasing the random walk rate of infected sheep can effectively prevent brucellosis from developing into an endemic disease; (ii) the greater the density of acute infections, the higher the risk of brucellosis transmission, and the density of infected sheep and the time to reach the stable state will have a large deviation if only consider acute or chronic sheep; (iii) reaching the peak time will be delayed if the peak time of sheep birth is delayed. These results can provide some suggestions for the control of brucellosis.
Aubry–Mather theory on graphs
Authors: Siconolfi Antonio , Sorrentino Alfonso
Published: September 2023

We formulate Aubry–Mather theory for Hamiltonians/Lagrangians defined on graphs, study the structure of minimizing measures, and discuss the relationship with weak KAM theory developed in Siconolfi and Sorrentino (2018 Anal. PDE
1 171–211). Moreover, we describe how to transport and interpret these results on networks.
The potential of wildlife diversity and possible roles in oil palm agrosystem management: case study in Riau province
Authors: Santosa Y , Putri M M , Kwatrina R T
Published: September 2023

The use of chemical fertilizers and control of pests/diseases and weeds in the management of oil palm plantations, besides causing very high production costs, is also feared to have a negative impact on the environment. Therefore and in the context of fulfilling the world community’s demands, “management of oil palm plantations that optimize the use of biodiversity” is a non-negotiable decision choice. This paper is a synthesis of research that has been carried out in 8 oil palm plantations spread across the provinces of Riau. The results showed that in the oil palm agrosystem found between 3 - 9 species of mammals (Macaca fascicularis; Macaca nemestrina, Presbytis cristata, Prionailurus bengalensis, etc.). The potential roles of several types of mammals are as pollinators (Callosciurus notatus); as seed dispersers (Paradoxurus hemaphroditus), and as pest control (Prionailurus bengalensis). Further research is needed to examine the role of each mammal species in oil palm agrosystems.
Potential and role of bird diversity in various oil palm land cover of PT Selatan Agro Makmur Lestari, South Sumatra
Authors: Affandi R
Published: September 2023

The change in the development paradigm to a “green economy” requires the management of oil palm plantations (as one of the national strategic industries) to make more use of biodiversity in increasing its productivity. In addition to reducing production costs (the use of chemical fertilizers, chemical pest and weed control), optimizing the use of biodiversity in oil palm agrosystems will be able to realize the management of oil palm plantations in a sustainable and environmentally sound manner. This study aims to identify the potential for species diversity and the role of birds in oil palm plantation agrosystems. Data collection on the potential for species diversity was carried out on six types of oil palm plantation land cover at PT Selatan Agro Makmur Lestari, South Sumatra with the transect line method along 1 km with a width of 50 meters. As for the role of various types of birds in the ecosystem, a literature review is carried out. The highest number of species and individuals was found in shrubs as many as 19 species and 69 individuals. On the other hand, the lowest number of species and individuals was found in smallholder oil palm plantations-II with 6 species and 16 individuals. In terms of the number of individuals, cave swiftlet (Collocalia linchi) was the largest species with 58 individuals, while cerulean kingfisher (Alcedo coerulescens), pink-necked green pigeon (Treron vernans), and white-headed munia (Lonchura maja) were the species with the fewest individual encounters. (only 1 individual). Based on the literature review, the types of birds found at the research site have four ecological roles. There are insect pest controller, seed dispersers, predator, and weed controller. Further research is needed to examine more deeply the role (quantitative ecology) of each bird species in oil palm agrosystems.
Variations in species diversity and the role of butterflies in oil palm agroecosystems at PT BSM South Sumatra
Authors: Parida I
Published: September 2023

Reducing the use of chemical fertilizers and controlling pests/chemical diseases is one of the prerequisites for the realization of sustainable oil palm plantation management. In line with that, the paradigm of green economic development requires optimizing the utilization of biodiversity in various aspects of managing oil palm plantations in Indonesia. Therefore, research is needed that can describe the variation and role of biodiversity (one of which is butterfly taxa) in the agro-ecosystem of oil palm plantations. This study aims to identify variations in species diversity and the role of butterflies in the agro-ecosystem of oil palm plantations. Observation of butterfly species diversity was carried out on seven types of oil palm plantation land cover at PT BSM. The method used is pollard transect (2 km with a width of 10 m) and trapping. The role of various types of butterflies is carried out through a literature search. The results showed that there were 163 individuals from 30 species and consisted of 4 families namely Papilionidae, Pieridae and Lycaenidae. The highest diversity and richness index values were found in smallholder plantations 1 (H′=2.42) and (Dmg=4.01), while the lowest were found in young oil palm areas (H′=0.87) and (Dmg=0. 99). The highest evenness index value was found in shrubs (E=1) while the lowest was in young oil palm land cover (E=0.54). Butterfly species that have potential as environmental bioindicators are Tanaecia pelea, Neptis hylas, Cupha erymantis, Neptis ida, Danaus affinis, Junonia atlites, Leptosia nina, Catopsilia pyranthe, Rapala iarbus, Papilio memnon, Losaria coon, Papilio polytes, Spindiasis lohita and Eurema hecabe. While the pollinators are Ypthima baldus, Catopsilia pyranthe, Hypolimnas bolina, Papilio polytes, and Neptis hylas.
Possible relation of cathepsin C activity and seasonal fluctuation of skin lesions in Papillon–Lefèvre syndrome
Authors: Sakai Akari , Shinkuma Satoru , Miura Nobuaki , Deguchi Tokiko , Oginezawa Mahoko , Nakajima Mami , Katsumi Tatsuya , Hayashi Ryota , Abe Riichiro
Published: September 2023

Our patient with Papillon–Lefèvre syndrome with a novel p.G430V and recurrent p.G301S missense mutation showing aggravation of skin lesions in wintertime. A temperature-dependent cathepsin C enzymatic activity study indicates a possible association between seasonal fluctuations, minimal dental involvement and temperature.
The effects of pre-cue alpha and cueing strategy on age-related deficits in post-cue alpha activity and target processing during visual spatial attention
Authors: Wang Jiaqi , Sun Junfeng , Li Chunbo , Tong Shanbao , Hong Xiangfei
Published: September 2023

Electroencephalography alpha-band (8–13 Hz) activity during visual spatial attention declines in normal aging. We recently reported the impacts of pre-cue baseline alpha and cueing strategy on post-cue anticipatory alpha activity and target processing in visual spatial attention (Wang et al., Cerebral Cortex, 2023). However, whether these factors affected aging effects remains unaddressed. We investigated this issue in two independent experiments (n = 114) with different cueing strategies (instructional vs. probabilistic). When median-splitting young adults (YA) by their pre-cue alpha power, we found that older adults exhibited similar pre-cue and post-cue alpha activity as YA with lower pre-cue alpha, and only YA with higher pre-cue alpha showed significant post-cue alpha activity, suggesting that diminished anticipatory alpha activity was not specific to aging but likely due to a general decrease with baseline alpha. Moreover, we found that the aging effects on cue-related event-related potentials were dependent on cueing strategy but were relatively independent of pre-cue alpha. However, age-related deficits in target-related N1 attentional modulation might depend on both pre-cue alpha and cueing strategy. By considering the impacts of pre-cue alpha and cueing strategy, our findings offer new insights into age-related deficits in anticipatory alpha activity and target processing during visual spatial attention.
Self-modulation of the sense of agency via neurofeedback enhances sensory-guided behavioral control
Authors: Zito Giuseppe A , de Sousa Ribeiro Ricardo , Kamal Eshita , Ledergerber Debora , Imbach Lukas , Polania Rafael
Published: September 2023

The sense of agency is a fundamental aspect of human self-consciousness, whose neural correlates encompass widespread brain networks. Research has explored the neuromodulatory properties of the sense of agency with noninvasive brain stimulation, which induces exogenous manipulations of brain activity; however, it is unknown whether endogenous modulation of the sense of agency is also achievable. We investigated whether the sense of agency can be self-regulated with electroencephalography-based neurofeedback. We conducted 2 experiments in which healthy humans performed a motor task while their motor control was artificially disrupted, and gave agency statements on their perceived control. We first identified the electrophysiological response to agency processing, and then applied neurofeedback in a parallel, sham-controlled design, where participants learnt to self-modulate their sense of agency. We found that behavioral measures of agency and performance on the task decreased with the increasing disruption of control. This was negatively correlated with power spectral density in the theta band, and positively correlated in the alpha and beta bands, at central and parietal electrodes. After neurofeedback training of central theta rhythms, participants improved their actual control over the task, and this was associated with a significant decrease in the frequency band trained via neurofeedback. Thus, self-regulation of theta rhythms can improve sensory-guided behavior.
6. Turning over a new leaf: desistance research for a new generation
Authors: Weaver Beth , Graham Hannah , Maruna Shadd
Published: September 2023

This chapter introduces the notion of desistance, which refers to the sustained abstinence from offending among those who previously had engaged in patterns of criminality. Early desistance research implies how people can change and criminality is not a permanent trait. Desistance was also a product of its time, catching fire at a particular moment in British criminology that involved Tony Blair’s ‘New Labour’ Government’s criminal justice policies. The chapter explains how the potential of intersectionality to generate new, critical insights into desistance research and theory. It references several case studies and literature on justice practices being influenced by desistance theory.
7. Urban criminal collaborations
Authors: Fraser Alistair , Hobbs Dick
Published: September 2023

This chapter examines a range of criminological classifications for urban criminal groups, covering both youthful and adult-oriented collaborations. The chapter provides a critical overview of the following categorizations: gangs; subcultures; professional crime; the underworld; and organized crime. Debates relating to each are introduced. While criminological approaches to youthful groups have a clear history, from the ‘Chicago School’ to the ‘Birmingham School’, perspectives on adult groups are less solid and more interdisciplinary. In both cases, the chapter argues that criminological classifications have struggled to capture the complexities brought on by the changing nature of the urban political economy. The chapter concludes by introducing a critical perspective that problematizes criminological categorizations of urban criminal collaborations.
9. Mental health, mental disabilities, and crime
Authors: O’Loughlin Ailbhe , Peay Jill
Published: September 2023

What is the nature of the relationship between mental disability and crime? This chapter examines its nature, scope, direction, and implications for the study of criminology. Its early sections critically assess issues of definition, causation, and of the success of treatment interventions. Its latter part reviews developments in policy and the emerging blurring of risk-oriented and therapeutic objectives. It concludes by urging a more sophisticated and less discriminatory approach to the field, which does not focus on diagnoses but rather on a holistic understanding of the relationship between people and crime.
19. Prostitution and sex work
Authors: Phoenix Jo
Published: September 2023

This chapter explores current characteristics and contexts of women’s involvement in prostitution and sex work, particularly as they have evolved during the twentieth and twenty-first centuries, before describing criminological knowledge about prostitution and sex workers. The final sections of the chapter review current regulatory frameworks governing women’s involvement in prostitution. Running throughout the chapter is the question: what is the relationship between how prostitution is theorized and the politics of prostitution policy and its reform?
20. Understanding and rehabilitating men with sexual convictions: Theory, intervention, and compassion
Authors: Blagden Nicholas , Winder Belinda
Published: September 2023

This chapter explores the theory, intervention, and compassion to understand and rehabilitate men under sexual convictions. It examines some of the statistics and trends around sexual offending before considering the heterogeneity and severity of sexual offences. People with sexual convictions are a heterogeneous group often with complex needs and trauma histories. Thus, compassionate criminology recognizes the trauma frequently experienced by those with sexual convictions while advocating the intervention to focus on values, strengths, compassion, and other factors significant for human flourishing. Moreover, compassionate criminology aims to reduce harm and sexual victimization by allowing an opportunity for repair. The chapter considers the experience of imprisonment and the efficacy of intervention.
23. Social harm and zemiology
Authors: Canning Victoria , Hillyard Paddy , Tombs Steve
Published: September 2023

Over the past two decades, Zemiology—the study of social harm—has proliferated internationally. Many scholars and activists alike have come to recognize the limitations of state-centric definitions of crime and shed light instead on many forms of harm which often go unseen and undocumented, and yet can be more far reaching and devastating in impact. This chapter therefore introduces the foundations of the epistemological shift to social harm studies, and the development of Zemiology. It goes on to outline typologies and dimensions of harm and highlights the avoidable and preventable nature of many such harms. Finally, the chapter concludes by considering the centrality of action-oriented research and activism in addressing, mitigating and ultimately preventing the endemic nature of such harms going forward.
30. Making and managing terrorism and counter-terrorism: The view from criminology
Authors: Innes Martin , Levi Michael
Published: September 2023

This chapter examines how ideas and concepts derived from criminology can inform our understandings of terrorism and counter-terrorism in insightful and innovative ways. Terrorism is designed as communicative violence that seeks to work by sending messages intended to influence the views of a wider public. The analysis attends to how terrorism has been constructed as a social and political problem in the contemporary era; the role attributed to extremism and processes of radicalization; and the extent to which these influence the framing and conduct of counter-terrorism responses, including financing terrorism. The particular perspective accents how terrorist campaigns and counter-terrorist responses routinely develop in interaction with each other.
37. Border criminology and the changing nature of penal power
Authors: Bosworth Mary
Published: September 2023

This chapter describes the field of ‘border criminology’, which examines the growing convergence between criminal justice and immigration control. It starts with an overview of the global immigration and asylum context before outlining key ideas and areas of scholarship within border criminology. It then turns to look more closely at penal power, drawing on fieldwork and policy analysis to explore the methodological and epistemological implications for criminology of examining citizenship and migration. It ends by arguing for greater engagement with the challenges and effects of mass mobility. As the impact of a decision to arrest in any street in Britain may be felt in countries far away, it is time for criminologists to take into account more explicitly the global nature of criminal justice and reflect on its implications for how and what we study.
The impact of hospital command centre on patient flow and data quality: findings from the UK National Health Service
Authors: Mebrahtu Teumzghi F , McInerney Ciaran D , Benn Jonathan , McCrorie Carolyn , Granger Josh , Lawton Tom , Sheikh Naeem , Habli Ibrahim , Randell Rebecca , Johnson Owen
Published: September 2023

In the last 6 years, hospitals in developed countries have been trialling the use of command centres for improving organizational efficiency and patient care. However, the impact of these command centres has not been systematically studied in the past. It is a retrospective population-based study. Participants were patients who visited the Bradford Royal Infirmary hospital, Accident and Emergency (A&E) Department, between 1 January 2018 and 31 August 2021. Outcomes were patient flow (measured as A&E waiting time, length of stay, and clinician seen time) and data quality (measured by the proportion of missing treatment and assessment dates and valid transition between A&E care stages). Interrupted time-series segmented regression and process mining were used for analysis. A&E transition time from patient arrival to assessment by a clinician marginally improved during the intervention period; there was a decrease of 0.9 min [95% confidence interval (CI): 0.35–1.4], 3 min (95% CI: 2.4–3.5), 9.7 min (95% CI: 8.4–11.0), and 3.1 min (95% CI: 2.7–3.5) during ‘patient flow program’, ‘command centre display roll-in’, ‘command centre activation’, and ‘hospital wide training program’, respectively. However, the transition time from patient treatment until the conclusion of consultation showed an increase of 11.5 min (95% CI: 9.2–13.9), 12.3 min (95% CI: 8.7–15.9), 53.4 min (95% CI: 48.1–58.7), and 50.2 min (95% CI: 47.5–52.9) for the respective four post-intervention periods. Furthermore, the length of stay was not significantly impacted; the change was −8.8 h (95% CI: −17.6 to 0.08), −8.9 h (95% CI: −18.6 to 0.65), −1.67 h (95% CI: −10.3 to 6.9), and −0.54 h (95% CI: −13.9 to 12.8) during the four respective post-intervention periods. It was a similar pattern for the waiting and clinician seen times. Data quality as measured by the proportion of missing dates of records was generally poor (treatment date = 42.7% and clinician seen date = 23.4%) and did not significantly improve during the intervention periods. The findings of the study suggest that a command centre package that includes process change and software technology does not appear to have a consistent positive impact on patient safety and data quality based on the indicators and data we used. Therefore, hospitals considering introducing a command centre should not assume there will be benefits in patient flow and data quality.
Magnetic fields of low-mass main sequences stars: non-linear dynamo theory and mean-field numerical simulations
Authors: Kleeorin N , Rogachevskii I , Safiullin N , Gershberg R , Porshnev S
Published: September 2023

Our theoretical and numerical analysis have suggested that for low-mass main sequences stars (of the spectral classes from M5 to G0) rotating much faster than the Sun, the generated large-scale magnetic field is caused by the mean-field α2Ω dynamo, whereby the α2 dynamo is modified by a weak differential rotation. Even for a weak differential rotation, the behaviour of the magnetic activity is changed drastically from aperiodic regime to non-linear oscillations and appearance of a chaotic behaviour with increase of the differential rotation. Periods of the magnetic cycles decrease with increase of the differential rotation, and they vary from tens to thousand years. This long-term behaviour of the magnetic cycles may be related to the characteristic time of the evolution of the magnetic helicity density of the small-scale field. The performed analysis is based on the mean-field simulations (MFS) of the α2Ω and α2 dynamos and a developed non-linear theory of α2 dynamo. The applied MFS model was calibrated using turbulent parameters typical for the solar convective zone.
A grid of 200 000 models of young δ Scuti stars using mesa and GYRE
Authors: Murphy Simon J , Bedding Timothy R , Gautam Anuj , Joyce Meridith
Published: September 2023

The rapidly increasing number of delta Scuti stars with regular patterns among their pulsation frequencies necessitates modelling tools to better understand the observations. Further, with a dozen identified modes per star, there is potential to make meaningful inferences on stellar structure using these young δ Sct stars. We compute and describe a grid of >200 000 stellar models from the early pre-main sequence (pre-MS) to roughly one-third of the MS lifetime, and calculate their pulsation frequencies. From these, we also calculate asteroseismic parameters and explore how those parameters change with mass, age, and metal mass fraction. We show that the large frequency separation, Δν, is insensitive to mass at the zero-age main sequence. In the frequency regime observed, the Δν we measure (from modes with n ∼ 5–9) differs from the solar scaling relation by ∼13 per cent. We find that the lowest radial order is often poorly modelled, perhaps indicating that the lower order pressure modes contain further untapped potential for revealing the physics of the stellar interior. We also show that different nuclear reaction networks available in mesa can affect the pulsation frequencies of young δ Sct stars by as much as 5 per cent. We apply the grid to five newly modelled stars, including two pre-MS stars each with 15+ modes identified, and we make the grid available as a community resource.
Evaluation of the ACR/EULAR 2022 criteria for classification of ANCA-associated vasculitis in a population-based cohort from Sweden
Authors: Rathmann Jens , Segelmark Mårten , Mohammad Aladdin J
Published: September 2023

Objective

To evaluate the ACR/EULAR 2022 criteria for ANCA-associated vasculitides (AAV) classification and compare them with the European Medicines Agency (EMA) algorithm and with classification based only on ANCA serology.

Methods

In the analysis, 374 cases (47% female) were classified according to the EMA algorithm, ANCA serology and ACR/EULAR criteria. The agreement rate was calculated using the kappa (κ) statistic.

Results

Under EMA, 192 patients were classified as granulomatosis with polyangiitis (GPA), 159 as microscopic polyangiitis (MPA) and 23 as eosinophilic granulomatosis with polyangiitis (EGPA). The ACR/EULAR criteria classified 199 patients as GPA, 136 as MPA and 22 as EGPA. Four patients (1.1%) met criteria of two disease categories, and 13 (3.5%) were unclassifiable. The observed agreement between EMA and ACR/EULAR was 85% for GPA, 75% for MPA and 96% for EGPA. The unweighted κ statistic was 0.66 (95% CI: 0.60, 0.74). Of the 188 PR3-ANCA positive patients, 186 (98.9%) were classified as GPA using ACR/EULAR criteria, and 135 of 161 (83.9%) MPO-ANCA positive patients were classified as MPA. With a classification solely based on ANCA specificity, agreement with ACR/EULAR was 99% for GPA and 88% for MPA.

Conclusions

EMA and ACR/EULAR classification give similar results. A small proportion of patients cannot be classified or fall into two categories. Some patients exhibiting granuloma, a key feature of GPA, are nevertheless classified as MPA, conflicting with the current view of histopathology of AAV. There is high agreement of ANCA-based classification with that of ACR/EULAR, reflected in the considerable weight granted to ANCA in the new criteria. These crucial elements within the new criteria necessitate a consensus discussion among field experts.
CircMTA1 promotes glioblastoma angiogenesis by encoding MTA1‐134aa
Authors: Niu Ben , Wei Deng , Liu Xiao‐yu , Zhai Bei , Liu Xiao‐bai , Yao Yi‐long , Xue Yi‐xue , Wang Ping
Published: September 2023

Glioblastoma multiforme (GBM) is the most malignant brain tumor with rapid angiogenesis. How to inhibit GBM angiogenesis is a key problem to be solved. To explore the targets of inhibiting GBM angiogenesis, this study confirmed that the expression of circMTA1 (hsa_circ_0033614) was significantly upregulated in human brain microvascular endothelial cells exposed to glioma cell‐conditioned medium (GECs). The expression of circMTA1 in the cytoplasm was significantly higher than that in the nucleus. Upregulated circMTA1 in GECs can promote cell proliferation, migration, and tube formation. Further exploration of the circularization mechanism of circMTA1 confirmed that KHDRBS1 protein can bind to the upstream and downstream flanking sequences of circMTA1 and promote circMTA1 biogenesis by coordinating Alu element pairing. KHDRBS1 upregulated the proliferation, migration, and tube formation of GECs by promoting the biogenesis of circMTA1. CircMTA1 can encode the protein MTA1‐134aa by internal ribosome entry site sequence‐mediated translation mechanism, and promote the proliferation, migration, and tube formation of GECs through the encoded MTA1‐134aa. This study provides a new target for inhibiting angiogenesis in brain GBM and a new strategy for improving the therapeutic efficacy of GBM.
Myocutaneous flap reconstruction after radiation therapy for breast cancer
Authors: Andaloro Alicia M.
Published: September 2023

Breast cancer poses a significant physical change to the patient's body, and treatment can last months to years. This article describes the latissimus dorsi myocutaneous flap, a surgical alternative when first-line reconstructive surgical options have failed because of concurrent treatments, specifically, radiation therapy.
Understanding academic rank among PAs practicing in academic medical centers
Authors: Louwagie Victoria , Halasy Michael
Published: September 2023

Objective:

To evaluate the attitudes and prevalence of academic/clinical rank among practicing physician associates/assistants (PAs) in different specialties and geographic locations.

Methods:

We surveyed PAs in clinical practice with a bias toward hospital/academic-based clinicians. The survey was a modified instrument to evaluate perceptions, attitudes, barriers, and prevalence of academic rank.

Results:

Overall, 65% of respondents indicated academic/clinical rank opportunities were of interest, but 60.8% noted that they were not eligible to hold rank in their institutions. Nearly 55% indicated a desire to hold rank, but 81.9% of respondents did not hold rank. The survey response rate was 22.9%. A lack of departmental emphasis was a common barrier to rank.

Conclusions:

Clinically practicing PAs clearly have a desire or interest in academic/clinical rank, but barriers persist. Further development of opportunities to hold academic/clinical rank with mentorship may improve PA careers and propel professional advancement and parity.
Carbon monoxide poisoning
Authors: Overfelt Conner
Published: September 2023

Diagnosis of carbon monoxide (CO) poisoning is challenging, as it is generally based on a history of present illness leading to clinical suspicion. CO is a tasteless, odorless, and colorless gas that has become known as the “silent killer.” CO poisoning affects approximately 50,000 people in the United States each year and presents with wide range of nonspecific symptoms. Patients often do not know that they are being exposed to CO gas; it is therefore important to ask pertinent questions when taking a patient's history. Treatment consists of oxygen therapy. If a diagnosis is not made and treatment is not administered promptly, complications may occur.
APRNs' perception of telehealth use
Authors: Adelman Deborah S. , Fant Catherine , Koklys Julia C.
Published: September 2023

Background:

The COVID-19 pandemic resulted in a significant increase in the use of telehealth. Although advanced practice registered nurses (APRNs) play an essential role in improving healthcare accessibility, including the provision of telehealth, for many individuals, few studies examining provider perceptions of telehealth have included APRN participants.

Methods:

This article describes a quantitative, descriptive study involving a survey administered electronically to a convenience sample of APRNs from one state.

Results:

Seventy-five APRN participants completed the survey, with NPs comprising nearly 90% of the sample. On average, surveyed APRNs had been conducting telehealth visits for 2.57 years. Most participants were able to develop or maintain rapport with new or established patients using telehealth and felt that their patients were satisfied by these visits. More than one-third of participants reported that new patients seen via telehealth received somewhat worse care than patients seen face to face, and one-quarter reported that established patients seen via telehealth received somewhat worse care.

Conclusion:

Although some concerns exist, overall, APRNs' perceptions of the use of telehealth were positive, with most wishing to continue providing care via telehealth in the future. This study adds to the literature on providers' perceptions of telehealth by describing the APRN viewpoint.
Assessing the Safety and Efficacy of Tranexamic Acid Usage in Osteogenesis Imperfecta Patients
Authors: Eaton Vincent , Braaten Marco , Schissel Makayla , Wallace Maegen
Published: September 2023

Background:

Osteogenesis Imperfecta (OI) usually causes an increased fracture burden and bone deformity, with subsequent operations common. In addition to skeletal manifestations, there is a potential increase in bleeding susceptibility due to the increased frequency of orthopedic procedures, warranting investigation into methods to mitigate this risk. This study aims to evaluate the safety and efficacy of tranexamic acid (TXA) usage to reduce intraoperative blood loss in children with OI. We want to assess the potential benefits, risks, and complications involved with TXA use in this patient population.

Methods:

TXA-receiving patients (cases) were matched 1:1 with non-TXA-receiving controls on the following criteria: age within 2 years, bone category, and OI Type. Descriptive statistics were used to summarize the data. Fisher Exact Test was performed to compare transfusion status between groups. A Wilcoxon Rank Sum test was performed to assess differences between the groups in days of stay, length of surgery, and estimated blood loss (EBL). All analyses were conducted using SAS version 9.4. P<0.05 was considered statistically significant.

Results:

Our TXA-receiving population of 30 patients consisted of 11 females and 19 males. One patient was OI type I, 13 were OI type III, 14 were OI type IV, and 2 were categorized as Other (not Type I through Type IV). We found a significant difference in transfusion status (P=0.02), with zero TXA patients requiring a transfusion compared with 20% of the control cases. There is also a significant difference in median EBL (P=0.0004) between groups, with TXA patients having decreased intraoperative EBL (20 vs. 62.5 mL). There was also a difference in median days of postoperative stay between TXA-receiving and non–TXA-receiving patients (P=0.001; 2.6 vs. 4 d).

Conclusions:

Our study concluded that TXA use in OI patients is associated with lower perioperative transfusions and intraoperative blood loss rates. These results support the standard usage of TXA in these patients to reduce intraoperative blood loss.

Level of Evidence:

Level III
Genetic insights into thymic carcinomas and thymic neuroendocrine neoplasms denote prognosis signatures and pathways
Authors: Wang Shuyuan , Gu Zhitao , Zhu Lei , Han Yuchen , Yu Hong , Fang Wentao , Han Baohui
Published: September 2023

Background:

Thymic carcinomas (TCs) and thymic neuroendocrine neoplasms (TNENs) are two aggressive subtypes of thymic malignancy. Traditional therapy for advanced TCs and TNENs has limited outcome. New genomic profiling of TCs and TNENs might provide insights that contribute to the development of new treatment approaches.

Methods:

We used gene panel sequencing technologies to investigate the genetic aberrations of 32 TC patients and 15 TNEN patients who underwent surgery at Shanghai Chest Hospital between 2015 and 2017. Patient samples were sequenced using a 324-gene platform with licensed technologies. In this study, we focused on clinically relevant genomic alterations (CRGAs), which are previously proven to be pathogenic alterations, to identify the pathology-specific mutational patterns, prognostic signatures of TCs and TNENs.

Results:

The mutational profiles between TCs and TNENs were diverse. The genetic alterations that ranked highest in TCs were in CDKN2A, TP53, ASXL1, CDKN2B, PIK3C2G, PTCH1, and ROS1, while those in TNENs were in MEN1, MLL2, APC, RB1, and TSC2. Prognostic analysis showed that mutations of ROS1, CDKN2A, CDKN2B, BRAF, and BAP1 were significantly associated with worse outcomes in TC patients, and that mutation of ERBB2 indicated shortened disease-free survival (DFS) and overall survival (OS) in TNEN patients. Further investigation found that the prognosis-related genes were focused on signal pathways of cell cycle control, chromatin remodeling/DNA methylation, phosphoinositide 3-kinases (PI3K)/protein kinase B (AKT)/mammalian target of rapamycin (mTOR), and receptor tyrosine kinase (RTK)/RAS/mitogen-activated protein kinase (MAPK) signaling.

Conclusion:

We profiled the mutational features of 47 Chinese patients with thymic malignancy of diverse pathologic phenotypes to uncover the integrated genomic landscape of these rare tumors, and identified the pathology-specific mutational patterns, prognostic signatures, and potential therapeutic targets for TCs and TNENs.
Wilms Tumor in Child With Trisomy 18 and Horseshoe Kidney
Authors: Chen Elizabeth , Hackney Lisa , VanHeyst Kristen , Miyasaka Eiichi A.
Published: September 2023

Trisomy 18 is associated with several congenital malformations, including horseshoe kidney. It can be full, partial, or mosaic, and mosaicism is often associated with lesser severity and longer life expectancy, placing patients at greater risk of developing neoplasms or malignancies. One common tumor among children with Trisomy 18 is Wilms tumor, which is also associated with renal congenital abnormalities such as horseshoe kidney. We present a case describing the occurrence of these three characteristics: development of Wilms tumor in a patient with Trisomy 18 and a horseshoe kidney and discuss treatment with regards to these conditions.
First-Pass Success of Intubations Using Video Versus Direct Laryngoscopy in Children With Limited Neck Mobility
Authors: Khanam Dilruba , Schoenfeld Elizabeth , Ginsberg-Peltz Julien , Lutfy-Clayton Lucienne , Schoenfeld David A. , Spirko Blake , Brown Calvin A. , Nishisaki Akira ,   for the National Emergency Airway Registry (NEAR) and National Emergency Airway Registry for Children (NEAR4KIDS) and Pediatric Acute Lung Injury and Sepsis Investigators (PALISI)
Published: September 2023

Objective

It is not clear whether video laryngoscopy (VL) is associated with a higher first-pass success rate in pediatric patients with limited neck mobility when compared with direct laryngoscopy (DL). We sought to determine the association between the laryngoscopy method and first-pass success.

Methods

In this retrospective cohort study, we examined intubation data extracted from 2 prospectively collected, multicenter, airway management safety databases (National Emergency Airway Registry and the National Emergency Airway Registry for children), obtained during the years 2013–2018 in the emergency department. Intubations were included if patients were aged younger than 18 and had limited neck mobility. We compared first-pass success rates for ED intubations that were performed using VL versus DL. We built a structural causal model to account for potential confounders such as age, disease category (medical or trauma condition), other difficult airway characteristics, use of sedatives/paralytics, and laryngoscopist training level. We also analyzed adverse events as a secondary outcome.

Results

Of 34,239 intubations (19,071 in the National Emergency Airway Registry and 15,168 in the National Emergency Airway Registry for children), a total of 341 intubations (1.0%) met inclusion criteria; 168 were performed via VL and 173 were performed via DL. The median age of patients was 124 months (interquartile range, 48–204). There was no difference in first-pass success between VL and DL (79.8% vs 75.7%, P = 0.44). Video laryngoscopy was not associated with higher first-pass success (odds ratio, 1.11; 95% confidence interval 0.84–1.47, with DL as a comparator) when a structural causal model was used to account for confounders. There was no difference in the adverse events between VL and DL groups (13.7% vs 8.7%, P = 0.19).

Conclusion

In children with limited neck mobility receiving tracheal intubation in the ED, neither VL nor DL was associated with a higher first-pass success rate.
Post Living Donor Liver Transplantation Small-for-size Syndrome: Definitions, Timelines, Biochemical, and Clinical Factors for Diagnosis: Guidelines From the ILTS-iLDLT-LTSI Consensus Conference
Authors: Kow Alfred Wei Chieh , Liu Jiang , Patel Madhukar S. , De Martin Eleonora , Reddy Mettu Srinivas , Soejima Yuji , Syn Nicholas , Watt Kymberly , Xia Qiang , Saraf Neeraj , Kamel Refaat , Nasralla David , McKenna Greg , Srinvasan Parthi , Elsabbagh Ahmed M. , Pamecha Vinayendra , Palaniappan Kumar , Mas Valeria , Tokat Yaman , Asthana Sonal , Cherukuru Ramkiran , Egawa Hiroto , Lerut Jan , Broering Dieter , Berenguer Marina , Cattral Mark , Clavien Pierre-Alain , Chen Chao-Long , Shah Samir , Zhu Zhi-Jun , Emond Jean , Ascher Nancy , Rammohan Ashwin , Bhangui Prashant , Rela Mohamed , Kim Dong-sik , Ikegami Toru ,   On behalf of the ILTS-iLDLT-LTSI SFSS Working Group
Published: September 2023

Background.

When a partial liver graft is unable to meet the demands of the recipient, a clinical phenomenon, small-for-size syndrome (SFSS), may ensue. Clear definition, diagnosis, and management are needed to optimize transplant outcomes.

Methods.

A Consensus Scientific committee (106 members from 21 countries) performed an extensive literature review on specific aspects of SFSS, recommendations underwent blinded review by an independent panel, and discussion/voting on the recommendations occurred at the Consensus Conference.

Results.

The ideal graft-to-recipient weight ratio of ≥0.8% (or graft volume standard liver volume ratio of ≥40%) is recommended. It is also recommended to measure portal pressure or portal blood flow during living donor liver transplantation and maintain a postreperfusion portal pressure of <15 mm Hg and/or portal blood flow of <250 mL/min/100 g graft weight to optimize outcomes. The typical time point to diagnose SFSS is the postoperative day 7 to facilitate treatment and intervention. An objective 3-grade stratification of severity for protocolized management of SFSS is proposed.

Conclusions.

The proposed grading system based on clinical and biochemical factors will help clinicians in the early identification of patients at risk of developing SFSS and institute timely therapeutic measures. The validity of this newly created grading system should be evaluated in future prospective studies.
Legal and Regulatory Challenges for Emerging Regenerative Medicine Solutions for Diabetes
Authors: Thom Rebecca L. , Cronin Antonia J. ,   the VANGUARD Consortium
Published: September 2023

Regenerative medicine solutions for type 1 diabetes are a rapidly developing field of medical technology. To date, these solutions have been principally cell-based treatments and at present, in Europe, these therapies are regulated under European Union regulations for advanced therapy medicinal products. But now, new emerging technology combining cellular therapy with medical devices is under development. The potential of this novel hybrid model to create a bioartificial pancreas to treat type 1 diabetes is tantalizing. However, incorporating medical devices creates a further layer of regulatory complexity. This article seeks to expose the complexity of this legal and regulatory landscape and demonstrate how evolving technology could challenge the entire existing legal paradigm. We start by summarizing the status of the only established cell-based therapy—transplantation. We set out the regulation of cellular therapies, their classification, and the role of statutory bodies. We examine the bottleneck of therapies moving from bench to bedside, and we consider the additional challenges of products, which use a combination of cells and medical devices. Finally, we argue that for the potential of this rapidly growing area of technology to be realized a seismic shift in how we regulate frontier cellular therapies will be required.
Cavernous Sinus MRI Findings in Inflammatory and Ischemic Oculomotor Cranial Nerve Palsies
Authors: Yunqing Wu , Shilei Cui , Yong Li , Qing Li , Xiaohong Shi , Jiawei Wang
Published: September 2023

Background:

The significance of asymmetric enhancement on cavernous sinus MRIs in the differential diagnosis of ischemic and inflammatory oculomotor cranial nerve (OCN) palsies remains controversial. This study explored the cavernous sinus MRI findings for cavernous sinus idiopathic inflammation (inflammation group), microvascular ischemic OCN palsy (ischemic group), and ocular myasthenia gravis (OMG group) patients.

Methods:

A total of 66, 117, and 60 patients were included in the inflammation, ischemic, and OMG groups, respectively. Cavernous sinus MRIs were retrospectively analyzed.

Results:

The abnormality rates of cavernous sinus MRIs for OMG and ischemic groups were 41.7% (25/60) and 61.5% (72/117), respectively. Inconsistency rates between clinical topical diagnosis and imaging findings for inflammation and ischemic groups were 3.0% (2/66) and 13.7% (16/117), respectively (P = 0.020). In the inflammation group, cavernous sinus thickness, thickening enhancement, and enhancing adjacent lesions were noted in 90.9% (60/66), 71.2% (47/66), and 25.8% (17/66) of the patients, whereas in the ischemic group, they were noted in 51.3% (60/117), 38.5% (45/117), and 0.9% (3/117) of the patients, respectively (P < 0.001). Among ischemic CN III palsy patients, 55.5% (15/27) and 16.7% (2/12) of the cases had CN III enlargement and enhancement in the diabetic and nondiabetic groups, respectively (P = 0.037).

Conclusions:

Cavernous sinus MRI abnormalities can be explained by specific pathologic mechanisms of the primary disease based on the complex neuroanatomy. However, suspicious inflammatory changes cannot exclude the possibility of ischemia and over reliance on these findings should be avoided.
Primary Subacute Osteomyelitis of the Talus in a Child by an Unusual Organism: A Case Report and Literature Review
Authors: Shah Sohaib , Donnachie Douglas , Niazi Noman , Conyers Russell , Dartnell Jo , Katchburian Marcos , Ayodele Oluwarantimi
Published: September 2023

Case

We would like to present the case of a 6-year-old girl who presented with progressive ankle pain and eventual inability to weight bear. She was shown to have primary acute osteomyelitis of the talus caused by Pasteurella canis, a commensal organism usually found in the oropharynx of dogs, despite the absence of any history of a dog bite or other zoonotic risk factors.  
 
We describe the symptoms, signs, radiographic appearances and outcome of the surgical and medical management, along with a review of the literature. This case report aims to increase awareness of this rare pathology and help guide other clinicians in accurately diagnosing and managing the condition.