bluuebunny/crossref_metadata_2025 huggingface dataset:
Negotiating the authenticity of AI: how the discourse on AI rejects human indeterminacy
Authors: Beerends Siri , Aydin Ciano
Published: February 2024

In this paper, we demonstrate how the language and reasonings that academics, developers, consumers, marketers, and journalists deploy to accept or reject AI as authentic intelligence has far-reaching bearing on how we understand our human intelligence and condition. The discourse on AI is part of what we call the “authenticity negotiation process” through which AI’s “intelligence” is given a particular meaning and value. This has implications for scientific theory, research directions, ethical guidelines, design principles, funding, media attention, and the way people relate to and act upon AI. It also has great impact on humanity’s self-image and the way we negotiate what it means to be human, existentially, culturally, politically, and legally. We use a discourse analysis of academic papers, AI education programs, and online discussions to demonstrate how AI itself, as well as the products, services, and decisions delivered by AI systems are negotiated as authentic or inauthentic intelligence. In this negotiation process, AI stakeholders indirectly define and essentialize what being human(like) means. The main argument we will develop is that this process of indirectly defining and essentializing humans results in an elimination of the space for humans to be indeterminate. By eliminating this space and, hence, denying indeterminacy, the existential condition of the human being is jeopardized. Rather than re-creating humanity in AI, the AI discourse is re-defining what it means to be human and how humanity is valued and should be treated.
Exactly Solvable Anharmonic Oscillator, Degenerate Orthogonal Polynomials and Painlevé II
Authors: Bertola M. , Chavez-Heredia E. , Grava T.
Published: February 2024

Using WKB analysis, the paper addresses a conjecture of Shapiro and Tater on the similarity between two sets of points in the complex plane; on one side is the set the values of $$t\in \mathbb {C}$$

t
∈
C

for which the spectrum of the quartic anharmonic oscillator in the complex plane $$\begin{aligned} \frac{\textrm{d}^{2} y}{\textrm{d} x^{2}} - \left( x^4 + tx^2 + 2Jx \right) y = \Lambda y, \end{aligned}$$

d
2

y

d

x
2

-

x
4

+
t

x
2

+
2
J
x

y
=
Λ
y
,

with certain boundary conditions, has repeated eigenvalues. On the other side is the set of zeroes of the Vorob’ev–Yablonskii polynomials, i.e. the poles of rational solutions of the second Painlevé equation. Along the way, we indicate a surprising and deep connection between the anharmonic oscillator problem and certain degenerate orthogonal (monic) polynomials.
A Green’s Function Proof of the Positive Mass Theorem
Authors: Agostiniani Virginia , Mazzieri Lorenzo , Oronzio Francesca
Published: February 2024

In this paper, a new proof of the Positive Mass Theorem is established through a newly discovered monotonicity formula, holding along the level sets of the Green’s function of an asymptotically flat 3-manifolds. In the same context and for $$1<p<3$$

1
<
p
<
3

, a Geroch-type calculation is performed along the level sets of p-harmonic functions, leading to a new proof of the Riemannian Penrose Inequality under favourable assumptions. A new characterisation of scalar curvature lower bounds in terms of the monotonicity formulas is also given.
Bone Density and Trabecular Bone Score Decline Rapidly in the First Year After Bone Marrow Transplantation with a Marked Increase in 10-Year Fracture Risk
Authors: Gong Joanna Y. , Chiang Cherie , Wark John D. , Ritchie David , Panek-Hudson Yvonne , Le Minh V. , Limbri Lydia , Fabila Nicolo , Fourlanos Spiros , Yates Christopher J.
Published: February 2024

As outcomes from allogeneic bone marrow transplantation (BMT) have improved, prevention of long-term complications, such as fragility fractures, has gained importance. We aimed to assess areal bone mineral density (aBMD) and trabecular bone score (TBS) changes post BMT, and determine their relationship with fracture prevalence. Patients who attended the Royal Melbourne Hospital (RMH) BMT clinic between 2005–2021 were included. Patient characteristics and dual-energy X-ray absorptiometry (DXA) values were collected from the electronic medical record and a survey. TBS iNsight™ was used to calculate TBS for DXA scans performed from 2019 onwards. 337 patients with sequential DXAs were eligible for inclusion. Patients were primarily male (60%) and mean age ± SD was 45.7 ± 13.4 years. The annualised decline in aBMD was greater at the femoral neck (0.066g/cm2 (0.0038–0.17)) and total hip (0.094g/cm2 (0.013–0.19)), compared to the lumbar spine (0.049g/cm2 (− 0.0032–0.16)), p < 0.0001. TBS declined independently of aBMD T-scores at all sites. Eighteen patients (5.3%) sustained 19 fractures over 3884 person-years of follow-up post-transplant (median follow-up 11 years (8.2–15)). This 5.3% fracture prevalence over the median 11-year follow-up period is higher than what would be predicted with FRAX® estimates. Twenty-two patients (6.5%) received antiresorptive therapy, and 9 of 18 (50%) who fractured received or were on antiresorptive therapy. In BMT patients, aBMD and TBS decline rapidly and independently in the first year post BMT. However, FRAX® fracture probability estimates incorporating these values significantly underestimate fracture rates, and antiresorptive treatment rates remain relatively low.
Cesium adsorption ability of charcoal made from Japanese cedar and Japanese oak wood: effect of Fe3+-addition to starting materials
Authors: Yamagishi Takayuki , Shibutani Sakae , Suzuki Hikaru , Yamauchi Shigeru
Published: February 2024

To investigate the effect of Fe-addition on the Cs+-adsorption ability (Cs+-AA) of woody charcoal, charcoal samples were prepared from Japanese cedar (JC) and Japanese oak (JO) wood impregnated with Fe3+ at 600 and 800 °C. The residual functional groups of the charcoal samples were examined using infrared-photoacoustic spectroscopy. OH groups were observed in the charcoal made at 600 °C, and no vibrational bands were detectable in the charcoal synthesized at 800 °C. The observation of Raman D-, G-, and G´-bands revealed that all charcoal samples contained sp2-carbon atoms but graphitization occurred only in the iron-loaded charcoal made at 800 °C. The Cs+-AA of the JC and JO charcoal samples were evaluated based on the adsorption isotherms of an aqueous CsCl (Cs+: 33 mg/L) solution. The addition of Fe3+ to wood had a negative effect on the Cs+-AA of the JO charcoal made at 600 °C, but a positive effect on the Cs+-AA of the JC charcoal prepared at 800 °C.
Evaluation of the long-term patient-reported outcomes after hip arthroplasty or joint preserving with Sugioka femoral osteotomy in patients with femoral head osteonecrosis
Authors: Shoji Takeshi , Shozen Hideki , Ueki Shinichi , Kaneta Hiroki , Yaunaga Yuji , Adachi Nobuo
Published: February 2024

Purpose

This study retrospectively evaluated long-term clinical outcomes and patient-reported outcome measures (PROMs) in patients with osteonecrosis of the femoral head (ONFH) who underwent transtrochanteric rotational osteotomy (TRO), curved varus osteotomy (CVO), and total hip arthroplasty (THA).

Methods

We retrospectively reviewed the 109 hips in 96 patients (46 men, 50 women) who underwent CVO, TRO, or THA for ONFH treatment. The mean follow-up period for the TRO, CVO, and THA groups was 14.8, 11.5, and 13.3 years, respectively.

Results

The THA conversion rate of the TRO patients was significantly higher than that of the patients with CVO, and the final clinical scores in the patients with TRO did not improve compared with preoperative scores. Postoperative PROMs showed that the total and pain scores of the patients with THA were significantly higher than those of patients with TRO and CVO, while the PROM score did not change between patients with TRO and CVO. The analysis further showed that the preoperative type C2, stage 3A, or postoperative type C1 and C2 were significant predictors of decreased final PROM scores.

Conclusion

This study found that CVO and THA are clinically effective treatments for ONFH, with significant improvements compared with preoperative scores. However, THA was associated with significantly higher PROMs and pain scores than those of CVO and TRO in long-term follow-up. Furthermore, our results suggest that postoperative PROMs depend mainly on the preoperative level of collapse and postoperative transposed intact ratio of the articular surface of the femoral head.
Influence of chromium oxide nanoparticles and fiber fillers on silicone rubber nanocomposite
Authors: Naguib Hamdy M. , Taha Eman O. , El-Deeb Asmaa S. , Kader Marwa M. Abdel , Ahmed Mona A.
Published: February 2024

The development of polymer composites, considering the environmental issues, is aimed for minimizing the industrial content. New environmental-friendly nanocomposites, based on silicone rubber matrix and different concentrations of natural fiber/chromium oxide fillers, are prepared for the first time. The microstructural analysis confirms the successful obtaining of microfibers after treatment and chromium oxide nanoparticles and the formation of the final composite. The nanocomposites achieved improved physical and mechanical properties due to the dual effect of both fillers and attachment to the matrix. The 1% optimized nanocomposite achieved the highest modulus, dielectric properties, hydrophobicity, and surface stability. The effect of exposure to weathering conditions was studied. The characterization sentence asserts the preparation of a novel silicone rubber nanocomposite with improved properties, along with the environmental impact, regarding the dual effect of natural fiber waste and chromium oxide nanoparticles.
Investigating the effects of tilting the postural drainage lithotripsy system on cerebral blood flow, intracranial pressure, heart rate, and blood pressure
Authors: Dai Liangliang , Li Shihui , Yang Tao , Wei Hanping , Song Rijin , Meng Xianghu , Yuan Xiaoliang , Jiao Zhimin , Wu Tingchun , Shi Honglei
Published: February 2024

Purpose

To investigate the effect of the postural drainage lithotripsy system developed by our experimental team on the vital signs of patient with urinary stones during the stone removal process.

Methods

Four groups of 15 subjects (0°, 10°, 40°, and 70°) were subjected to different angles of head-down tilt to measure middle cerebral artery blood flow velocity (MCAv), cerebrovascular conductance coefficient (CVCi), intracranial pressure (nICP), heart rate (HR), and mean arterial blood pressure (MAP).

Results

As the angle of HDT changed, MCAv values, nICP values, CVCi values, HR values, and MAP values changed significantly (all P ≤ 0.001), and the difference was statistically significant. During 10°HDT, despite a slight increase in nICP, the other measurements remained stable. During 40°HDT, only the MCAv values did not change significantly, whereas the rest of the measures were significantly altered. During 70°HDT, all indicators changed significantly.

Conclusions

The significant alterations in cerebral blood flow, intracranial pressure, and hemodynamics induced during the treatment of renal residual fragments with postural drainage should be used with caution in individuals with cerebrovascular accidents.

China Clinical Trials Registry

ChiCTR2300070671; Registration date: 2023-04-18.
Hirnstimulation: NIBS, THS und Optogenetik
Authors: Freise Johannes
Published: February 2024

Unterschiedliche Formen von Hirnstimulation werden sowohl zur Therapie verschiedener neurologischer und psychiatrischer Krankheiten als auch zu Forschungszwecken verwendet. Im rechtswissenschaftlichen Diskurs fand bisher überwiegend die Tiefe-Hirnstimulation Beachtung. Dagegen mangelt es an Ausführungen zu Methoden der nicht-invasiven Hirnstimulation. Der Beitrag nimmt, vor dem Hintergrund des durch die Verordnung (EU) 2017/745 veränderten Rechtsrahmens, zunächst eine medizinprodukterechtliche Einordnung vor. Anschließend werden Fragen von Aufklärung und Einwilligung erläutert. Darüber hinaus werden rechtliche Aspekte der Verwendung von KI im Kontext von nicht-invasiver Hirnstimulation und Tiefer-Hirnstimulation dargestellt. Zum Abschluss erfolgt ein Ausblick auf die noch in der Entwicklung befindlichen Methoden der neuronalen Optogenetik.
Brain stem tumors in children less than 3 months: Clinical and radiologic findings of a rare disease
Authors: Papangelopoulou Danai , Bison Brigitte , Behrens Lars , Bailey Simon , Ansari Marc , Ehlert Karoline , Martinez Ofelia Cruz , Kramm Christof M. , Morales La Madrid Andres , von Bueren Andre O.
Published: February 2024

Purpose

Brain stem tumors in children < 3 months at diagnosis are extremely rare. Our aim is to study a retrospective cohort to improve the understanding of the disease course and guide patient management.

Methods

This is a multicenter retrospective analysis across the European Society for Pediatric Oncology SIOP-E HGG/DIPG Working Group linked centers, including patients with a brainstem tumor diagnosed between 2009 and 2020 and aged < 3 months at diagnosis. Clinical data were collected, and imaging characteristics were analyzed blindly and independently by two neuroradiologists.

Results

Five cases were identified. No patient received any therapy. The epicenter of two tumors was in the medulla oblongata alone and in the medulla oblongata and the pons in three. For patients with tumor in equal parts in the medulla oblongata and the pons (n = 3), the extension at diagnosis involved the spinal cord; for the two patients with the tumor epicenter in the medulla oblongata alone (n = 2), the extension at diagnosis included the pons (n = 2) and the spinal cord (n = 1). Biopsy was performed in one patient identifying a pilocytic astrocytoma. Two patients died. In one patient, autopsy revealed a high-grade glioma (case 3). Three survivors showed either spontaneous tumor regression (n = 2) or stable disease (n = 1). Survivors were followed up for 10, 7, and 0.6 years, respectively. One case had the typical imaging characteristics of a dorsal exophytic low-grade glioma.

Conclusions

No patient fulfilled the radiologic criteria defining a high-grade glioma. Central neuroradiological review and biopsy may provide useful information regarding the patient management.
Is survival after transanal total mesorectal excision (taTME) worse than that after traditional total mesorectal excision? A retrospective propensity score-adjusted cohort study
Authors: Ammann Yanic , Warschkow Rene , Schmied Bruno , De Lorenzi Diego , Reißfelder Christoph , Bischofberger Stephan , Marti Lukas , Brunner Walter
Published: February 2024

Purpose

Transanal total mesorectal excision (taTME) was developed to provide better vision during resection of the mesorectum. Conflicting results have shown an increase in local recurrence and shorter survival after taTME. This study compared the outcomes of taTME and abdominal (open, laparoscopic, robotic) total mesorectal excision (abTME).

Methods

Patients who underwent taTME or abTME for stages I–III rectal cancer and who received an anastomosis were included. A retrospective analysis of a prospectively conducted database was performed. The primary endpoints were overall survival (OS), cancer-specific survival (CSS), and disease-free survival (DFS). Risk factors were adjusted by propensity score matching (PSM). The secondary endpoints were local recurrence rates and combined poor pathological outcomes.

Results

From 2012 to 2020, a total of 189 patients underwent taTME, and 119 underwent abTME; patients were followed up for a mean of 54.7 (SD 24.2) and 78.4 (SD 34.8) months, respectively (p < 0.001). The 5-year survival rates after taTME and abTME were not significantly different after PSM: OS: 78.2% vs. 88.6% (p = 0.073), CSS: 87.4% vs. 92.1% (p = 0.359), and DFS: 69.3% vs. 80.9% (p = 0.104), respectively. No difference in the local recurrence rate was observed (taTME, n = 10 (5.3%); abTME, n = 10 (8.4%); p = 0.280). Combined poor pathological outcomes were more frequent after abTME (n = 36, 34.3%) than after taTME (n = 35, 19.6%) (p = 0.006); this difference was nonsignificant according to multivariate analysis (p = 0.404).

Conclusion

taTME seems to be a good treatment option for patients with rectal cancer and is unlikely to significantly affect local recurrence or survival. However, further investigations concerning the latter are warranted.

Trial registration

ClinicalTrials.gov (NCT0496910).
Dietary protein and blood pressure: an umbrella review of systematic reviews and evaluation of the evidence
Authors: Boeing Heiner , Amini Anna M. , Haardt Julia , Schmidt Annemarie , Bischoff-Ferrari Heike A. , Buyken Anette E. , Egert Sarah , Ellinger Sabine , Kroke Anja , Lorkowski Stefan , Louis Sandrine , Nimptsch Katharina , Schulze Matthias B. , Schutkowski Alexandra , Schwingshackl Lukas , Siener Roswitha , Zittermann Armin , Watzl Bernhard , Stangl Gabriele I. ,   the German Nutrition Society
Published: February 2024

Introduction

This umbrella review aimed to investigate the evidence of an effect of dietary intake of total protein, animal and plant protein on blood pressure (BP), and hypertension (PROSPERO: CRD42018082395).

Methods

PubMed, Embase and Cochrane Database were systematically searched for systematic reviews (SRs) of prospective studies with or without meta-analysis published between 05/2007 and 10/2022. The methodological quality and outcome-specific certainty of evidence were assessed by the AMSTAR 2 and NutriGrade tools, followed by an assessment of the overall certainty of evidence. SRs investigating specific protein sources are described in this review, but not included in the assessment of the overall certainty of evidence.

Results

Sixteen SRs were considered eligible for the umbrella review. Ten of the SRs investigated total protein intake, six animal protein, six plant protein and four animal vs. plant protein. The majority of the SRs reported no associations or effects of total, animal and plant protein on BP (all “possible” evidence), whereby the uncertainty regarding the effects on BP was particularly high for plant protein. Two SRs addressing milk-derived protein showed a reduction in BP; in contrast, SRs investigating soy protein found no effect on BP. The outcome-specific certainty of evidence of the SRs was mostly rated as low.

Discussion/conclusion

This umbrella review showed uncertainties whether there are any effects on BP from the intake of total protein, or animal or plant proteins, specifically. Based on data from two SRs with milk protein, it cannot be excluded that certain types of protein could favourably influence BP.
Seawater nasal wash to reduce symptom duration and viral load in COVID-19 and upper respiratory tract infections: a randomized controlled multicenter trial
Authors: de Gabory Ludovic , Vallet Sophie , Naelten Gaëlle , Raherison-Semjen Chantal
Published: February 2024

Purpose

The objective was to assess the efficacy of seawater nasal wash on symptom duration, intranasal viral load, household transmission in COVID-19 and URTIs.

Methods

This prospective, randomized, controlled, multicentric, parallel study included 355 mild/moderate COVID-19 and URTI adults with rhinologic symptoms ≤ 48h. Active group performed 4-daily nasal washes with undiluted isotonic seawater versus control group (without nasal wash). Symptoms were self-assessed daily using the WURSS-21 questionnaire for 3 weeks. Viral load was measured by RT-PCR on nasopharyngeal swabs collected on Day 0, Day 5, Day 14 and Day 21. Digital droplet PCR was additionally performed for SARS-CoV-2.

Results

Overall COVID-19 subjects recovered earlier the ability to accomplish daily activities in the active group (– 1.6 day, p = 0.0487) with earlier improvement of taste (– 2 days, p = 0.0404). COVID-19 subjects with severe nasal symptoms at D0 showed the earliest resolution of anosmia (– 5.2 days, p = 0.0281), post-nasal drip (– 4.1 days, p = 0.0102), face pain/heaviness (– 4.5 days, p = 0.0078), headache (– 3.1 days, p = 0.0195), sore throat (– 3.3 days, p = 0.0319), dyspnea (– 3.1 days, p = 0.0195), chest congestion (– 2.8 days, p = 0.0386) and loss of appetite (– 4.5 days, p = 0.0186) with nasal wash. In URTIs subjects, an earlier resolution of rhinorrhea (– 3.5 days, p = 0.0370), post-nasal drip (– 3.7 days, p = 0.0378), and overall sickness (– 4.3 days, p = 0.0248) was reported with nasal wash.

Evolution towards more severe COVID-19 was lower in active vs control, with earlier viral load reduction in youngest subjects (≥ 1.5log10 copies/10000 cells at Day 5: 88.9% vs 62.5%, p = 0.0456). In the active group, a lower percentage of SARS-CoV-2 positive household contacts (0–10.7%) was reported vs controls (3.2–16.1%) among subjects with Delta variant (p = 0.0413).

Conclusion

This trial showed the efficacy and safety of seawater nasal wash in COVID-19 and URTIs.

Trial registration

Trial registry ClinicalTrials.gov: NCT04916639. Registration date: 04.06.2021.
Hypothermic sepsis in time since death estimation – a case report
Authors: Potente Stefan , Hanser Victoria , Heinbuch Sara , Wrede Arne , Schäfer Nadine , Schmidt Peter
Published: February 2024

Both hyper- and hypothermia are problematic in temperature based forensic time since death estimation. Hyperthermia may occur in infection, traumatic brain injury, and intoxication. Hypothermia is encountered predominantly in exposure. Sepsis may present itself clinically as hypothermic. Sepsis is not uncommon in the forensic setting and mostly occurs in the context of malpractice accusations. There is usually little overlap between sepsis and typical forensic time since death estimation scenarios of violent or otherwise suspicious deaths. In the presented case, hypothermia and time since death estimations did collide. An inmate was found dead in his jail cell. Wardens claimed they had visually approached him alive relatively shortly prior. Rectal temperature measurements, using two separate crime scene thermometers as well as temperature loggers, revealed low rectal temperature at relatively high ambient temperature. These findings suggested a much longer postmortem interval and consequently raised doubts about the stated timeline. The wardens’ claims were however confirmed by camera recordings, which also allowed a reasonable estimate of the true time of death. The cause of death was confirmed as septic organ failure at autopsy, which explained low rectal temperature. The presence of Wischnewski-spots was noted. When the Prism-method was applied to the temperature recordings, low rectal temperature at the time of death was detected successfully. However, adaptation of the underlying equation for lower “starting temperature” did not produce satisfactory results. It is concluded that even though hypothermia at the time of death may possibly be detected from temperature data, attempts at time since death estimation for cases of hypothermia by adaptation of the equation should be avoided.
A Delphi consensus to identify the key screening tests/questions for a digital neurological examination for epidemiological research
Authors: Ferreira Vasco Ribeiro , Brayne Carol , Ragonese Paolo , Ketzoian Carlos , Piccioli Marta , Tinti Lorenzo , Casali Carlo , di Lorenzo Cherubino , Ramos Claudia , Azevedo João , Gomes Adriana , Stewart Roderick , Haas Hein , Hoppenbrouwer Stan , Metting Esther , Gallo Valentina
Published: February 2024

Background

Most neurological diseases have no curative treatment; therefore, focusing on prevention is key. Continuous research to uncover the protective and risk factors associated with different neurological diseases is crucial to successfully inform prevention strategies. eHealth has been showing promising advantages in healthcare and public health and may therefore be relevant to facilitate epidemiological studies.

Objective

In this study, we performed a Delphi consensus exercise to identify the key screening tests to inform the development of a digital neurological examination tool for epidemiological research.

Methods

Twelve panellists (six experts in neurological examination, five experts in data collection—two were also experts in the neurological examination, and three experts in participant experience) of different nationalities joined the Delphi exercise. Experts in the neurological examination provided a selection of items that allow ruling out neurological impairment and can be performed by trained health workers. The items were then rated by them and other experts in terms of their feasibility and acceptability.

Results

Ten tests and seven anamnestic questions were included in the final set of screening items for the digital neurological examination. Three tests and five anamnestic questions were excluded from the final selection due to their low ratings on feasibility.

Conclusion

This work identifies the key feasible and acceptable screening tests and anamnestic questions to build an electronic tool for performing the neurological examination, in the absence of a neurologist.
A spectral finite element Reissner–Mindlin shell formulation with NURBS-based geometry definition
Authors: Azizi Nima , Dornisch Wolfgang
Published: February 2024

A curved non-isoparametric Reissner–Mindlin shell element is developed for analyzing thin-walled structures. The standard kinematic description of the element requires the calculation of the director vector. To address this demand accurately, similar to isogeometric analysis (IGA), the geometry is defined by utilization of the non-uniform rational B-splines (NURBS) imported directly from computer-aided design (CAD) files. Then, shape functions of the Legendre spectral element method (SEM) are used to interpolate the displacements. Consequently, the shell director vector and Jacobian of the transformation are calculated properly according to the presented formulation. On the other hand, in Legendre SEM combined with Gauss–Lobatto–Legendre quadrature, the integration points and the element nodes coincide. Thus, the easily computable local coordinate systems at the integration points can be used directly as nodal basis systems. A separate calculation of nodal basis systems at control points, which is the source of either complexity or error in IGA shells, is not required. Given the condition number of the stiffness matrix in the developed method, super high-order elements can also be used. Very high order p-refined elements are used in addition to h-refinement of the mesh to show the capability of higher order elements to analyze problems without mesh refinement. The validity and convergence rate of the method are investigated and verified through various cases of h- and p-refinement in challenging obstacle course problems.
Thermal stress and comfort assessment in urban areas using Copernicus Climate Change Service Era 5 reanalysis and collected microclimatic data
Authors: Silva Tiago , Lopes António , Vasconcelos João , Chokhachian Ata , Wagenfeld Malte , Santucci Daniele
Published: February 2024

In this initial study of a research project, this paper seeks to understand the thermal conditions in the cities of Lisbon and Munich, specifically focusing on Urban Heat Island intensity and on thermal comfort using the Universal Thermal Climate Index modeling data at the Local Climate Zone scale. Based on these datasets, Munich has exhibited more unfavourable thermal conditions than Lisbon. In terms of UHII, both cities have shown that low, medium, and high rise compact urban areas and bare rock or paved areas have the highest values, while sparsely built areas have the lowest. These results differ from the UTCI, which indicates that in Lisbon and Munich, these sparsely built areas as well as areas with low plants and vegetation are the most uncomfortable. In Munich, the population was exposed to very strong heat stress, while Lisbon experienced strong heat stress conditions. Conversely, low, medium, and high rise compact urban areas and densely wooded areas in Munich, and scattered trees areas and large low-rise urban areas in Lisbon, have demonstrated the lowest monthly mean and average maximum values. These results will be further explored in future studies in the city of Lisbon and cross-checked with data obtained from roving missions. This will enable a more detailed temporal and local analysis.
Equity of travel to access surgery and radiation therapy for lung cancer in New Zealand
Authors: Gurney Jason , Davies Anna , Stanley James , Whitehead Jesse , Costello Shaun , Dawkins Paul , Henare Kimiora , Jackson Christopher G. C. A. , Lawrenson Ross , Scott Nina , Koea Jonathan
Published: February 2024

Purpose

Centralisation of lung cancer treatment can improve outcomes, but may result in differential access to care for those who do not reside within treatment centres.

Methods

We used national-level cancer registration and health care access data and used Geographic Information Systems (GIS) methods to determine the distance and time to access first relevant surgery and first radiation therapy among all New Zealanders diagnosed with lung cancer (2007–2019; N = 27,869), and compared these outcomes between ethnic groups. We also explored the likelihood of being treated at a high-, medium-, or low-volume hospital. Analysis involved both descriptive and adjusted logistic regression modelling.

Results

We found that Māori tend to need to travel further (with longer travel times) to access both surgery (median travel distance: Māori 57 km, European 34 km) and radiation therapy (Māori 75 km, European 35 km) than Europeans. Māori have greater odds of living more than 200 km away from both surgery (adjusted odds ratio [aOR] 1.83, 95% CI 1.49–2.25) and radiation therapy (aOR 1.41, 95% CI 1.25–1.60).

Conclusions

Centralisation of care may often improve treatment outcomes, but it also makes accessing treatment even more difficult for populations who are more likely to live rurally and in deprivation, such as Māori.
NnU-Net versus mesh growing algorithm as a tool for the robust and timely segmentation of neurosurgical 3D images in contrast-enhanced T1 MRI scans
Authors: de Boer Mathijs , Kos Tessa M. , Fick Tim , van Doormaal Jesse A. M. , Colombo Elisa , Kuijf Hugo J. , Robe Pierre A. J. T. , Regli Luca P. , Bartels Lambertus W. , van Doormaal Tristan P. C.
Published: February 2024

Purpose

This study evaluates the nnU-Net for segmenting brain, skin, tumors, and ventricles in contrast-enhanced T1 (T1CE) images, benchmarking it against an established mesh growing algorithm (MGA).

Methods

We used 67 retrospectively collected annotated single-center T1CE brain scans for training models for brain, skin, tumor, and ventricle segmentation. An additional 32 scans from two centers were used test performance compared to that of the MGA. The performance was measured using the Dice-Sørensen coefficient (DSC), intersection over union (IoU), 95th percentile Hausdorff distance (HD95), and average symmetric surface distance (ASSD) metrics, with time to segment also compared.

Results

The nnU-Net models significantly outperformed the MGA (p < 0.0125) with a median brain segmentation DSC of 0.971 [95CI: 0.945–0.979], skin: 0.997 [95CI: 0.984–0.999], tumor: 0.926 [95CI: 0.508–0.968], and ventricles: 0.910 [95CI: 0.812–0.968]. Compared to the MGA’s median DSC for brain: 0.936 [95CI: 0.890, 0.958], skin: 0.991 [95CI: 0.964, 0.996], tumor: 0.723 [95CI: 0.000–0.926], and ventricles: 0.856 [95CI: 0.216–0.916]. NnU-Net performance between centers did not significantly differ except for the skin segmentations Additionally, the nnU-Net models were faster (mean: 1139 s [95CI: 685.0–1616]) than the MGA (mean: 2851 s [95CI: 1482–6246]).

Conclusions

The nnU-Net is a fast, reliable tool for creating automatic deep learning-based segmentation pipelines, reducing the need for extensive manual tuning and iteration. The models are able to achieve this performance despite a modestly sized training set. The ability to create high-quality segmentations in a short timespan can prove invaluable in neurosurgical settings.
Unleashing the potential of metaphors: a categorization system for exploring return to work after maternity
Authors: Rapisarda Sebastiano , Santoro Valentina , Dal Corso Laura
Published: February 2024

Purpose

Return to work after maternity leave represents a radical change in women’s lives. This paper aims to present a new metaphor categorization system based on two studies, which could assist working mothers in expressing the nuances of their experience when returning to work after maternity leave.

Methods

We carried out the analysis of the metaphors according to the method for thematic analysis, through a multistep, iterative coding process. To ensure the researchers encode the data similarly, inter-coder reliability was achieved through the judges’ agreement method. The level of agreement between the two judges was measured by Cohen’s kappa.

Results

In Study 1, we established a system comprising ten metaphor categories (namely, Natural event and/or element, Challenge and destination, Movement and/or action, Fresh start, Fight, Game and hobby, Animal, Alternate reality, Means of transport, Hostile place). In Study 2, we recognized the same metaphor categories observed in Study 1, except “Means of transport”, even with data sourced from a distinct participant group, an indicator of credibility in terms of inter-coder reliability.

Conclusion

Findings highlight the usefulness of this new metaphor categorization system (named Meta4Moms@Work—Metaphors system for Moms back to Work) to facilitate a more straightforward elicitation of the meanings employed by working mothers to depict their return to work after maternity leave. Leveraging these insights, researchers/practitioners can develop and execute primary and secondary interventions aimed to enhance working mothers’ work-life balance, well-being, and mental health.
Feasibility study of wearable capillary refill time measurement device
Authors: Shinozaki Masayoshi , Saito Daiki , Nakada Taka-aki , Nomura Yukihiro , Nakaguchi Toshiya
Published: February 2024

Capillary refill time (CRT) is an internationally accepted indicator of peripheral circulation. The CRT is measured by applying compression to the fingernail for a few seconds, releasing it, and observing the process of refilling of blood at the fingertip. The international guidelines for the management of sepsis and septic shock 2021 contains an additional new recommendation for CRT measurement to determine the peripheral circulation statuses of adult patients with septic shock. However, the current CRT measurement method lacks objectivity. Previous studies have reported the development of measurement devices and video analysis systems, which involve complex measurement environment construction and assume only in-hospital measurements. In addition, since medical workers are limited in the number of carrying medical devices, devices that can be used to obtain multiple biometric indicators in a single measurement are needed. Hence, a prototype wearable CRT measurement device was developed in this study, and its feasibility was evaluated by comparing the agreement, intra-class correlation coefficient, and coefficient of variation with those of a CRT measurement device developed in the past. The results indicated that mean CRTs between measurement methods were agreement, with moderate or better intra-rater reliability and no difference in coefficient of variation. Therefore, the results indicate the feasibility of the proposed wearable CRT device.
Bioturbation by Benthic Stingrays Alters the Biogeomorphology of Tidal Flats
Authors: Nauta Janne , Leurs Guido , Nieuwenhuis Brian O. , Mathijssen Donné R. A. H. , Olff Han , Bouma Tjeerd J. , van der Wal Daphne , Hijner Nadia , Regalla Aissa , Pontes Samuel Ledo , Govers Laura L.
Published: February 2024

Fishing-down-marine-food-webs has resulted in alarming declines of various species worldwide. Benthic rays are one examples of such overexploited species. On tidal flats, these rays are highly abundant and play an ecologically important role. They use tidal flats as refuge, feeding and resting grounds, during which they bury into the sediment, which results in sediment bioturbation. Changes in bioturbation intensity, following ray removal, may affect the biogeomorphology of tidal flats with possible cascading effects on the macrozoobenthic community. However, it is poorly understood how these indirect effects could influence ecosystem function. We therefore studied the geomorphic impact of benthic rays (specifically the pearl whipray/stingray Fontitrygon margaritella) on the tropical tidal flats of the Bijagós Archipelago, Guinea-Bissau, on a landscape scale. We investigated 1) bioturbation rates by rays using drone and ground surveys, 2) the spatial distribution of ray pits on multiple tidal flats, 3) the impact of rays on sediment properties and macrozoobenthos by experimental exclusion (15 months). Benthic rays bioturbated 3.7 ± 0.35% of the tidal flat’s sediment surface per day over one single 24-h period, which equals a complete top-sediment-surface turnover every 27 days. The spatial distribution of ray pits was affected by tidal flat geomorphology since pits decayed faster at areas exposed to strong hydrodynamic forces. Predator exclusion altered sediment properties, leading to changes in sedimentation (− 17%) and erosion (− 43%) rates. In addition, macrozoobenthic species composition changed, marked by an increase in Capitellidae worms and a greater biomass of Malacostraca over time. These changes indicated substantial effects of ray bioturbation on the biotic and geomorphic landscape of tidal flats. Overall, we conclude that changing abundances of benthic rays can have clear landscape-wide geomorphological effects on intertidal ecosystems. These indirect consequences of fisheries should be incorporated in integrative management plans to preserve tidal flats and connected ecosystems.
miR-34c-5p inhibited fibroblast proliferation, differentiation and epithelial-mesenchymal transition in benign airway stenosis via MDMX/p53 pathway
Authors: Wei Jinmei , Chen Yan , Feng Tingmei , Wei Yuihui , Yang Caizhen , Zhang Changwen , Li Wentao , Liu Guangnan
Published: February 2024

Benign airway stenosis (BAS) means airway stenosis or obstruction that results from a variety of non-malignant factors, including tuberculosis, trauma, benign tumors, etc. In consideration of the currently limited research on microRNAs in BAS, this study aimed to explore the role and mechanism of miR-34c-5p in BAS. The expression of miR-34c-5p in BAS granulation tissues showed a significant down-regulation compared with the normal control group. Moreover, miR-34c-5p mimics suppressed the proliferation and differentiation of human bronchial fibroblasts (HBFs) and the epithelial-mesenchymal transition (EMT) of human bronchial epithelial cells (HBE). Conversely, miR-34c-5p inhibitors aggravated those effects. A dual-luciferase reporter assay confirmed that miR-34c-5p can target MDMX rather than Notch1. The over-expression of MDMX can reverse the inhibiting effect of miR-34c-5p on HBFs proliferation, differentiation and EMT. Furthermore, the expressions of tumor protein (p53) and PTEN were down-regulated following the over-expression of MDMX. In addition, the expressions of PI3K and AKT showed an up-regulation. In conclusion, miR-34c-5p was down-regulated in BAS and may inhibit fibroblast proliferation differentiation and EMT in BAS via the MDMX/p53 signaling axis. These findings expand the understanding of the role of miR-34c-5p and will help develop new treatment strategies for BAS.
Understanding the Mechanisms and Implications of the First Flush in Mine Pools: Insights from Field Studies in Europe’s Deepest Metal Mine and Analogue Modelling
Authors: Mugova Elke , Molaba Leshego , Wolkersdorfer Christian
Published: February 2024

The chemical composition of mine water discharged from flooded underground mines typically improves over time. This phenomenon is called first flush and can be described by a characteristic curve. Shortly after the mine water begins to discharge, water constituent concentrations rise and then fall in an almost exponential curve, improving water quality over time. In this study, the change in mine water quality was investigated throughout the mine water body. This mine water body commonly consists of different water bodies with individual densities, resulting in mine water stratification. Anthropogenic disturbance of the mine water body can disrupt this stratification and also the positive effect of the first flush. To better understand and predict the first flush, the first flush was simulated experimentally using an analogue model of a flooded underground mine, the Agricola Model Mine. The results were compared with field studies to help understanding and predicting the change in mine water quality. Overall, the results suggest that the first flush occurs throughout the mine water body, making it similar to a chemical reactor. This better understanding of the process can lead to more effective mine water management and design of mine water treatment facilities.

Graphical Abstract
Effect of direct oral anticoagulants on bleeding during and after cataract surgery
Authors: Maytal Anat , Naidorf Rosenblatt Hadar , Rotem Reut , Segev Fani
Published: February 2024

Purpose

To assess the risk for intraoperative and postoperative ocular bleeding associated with direct oral anticoagulant treatment in patients undergoing phacoemulsification surgery.

Methods

Consecutive patients had phacoemulsification and intraocular lens implantation while taking uninterrupted direct oral anticoagulants (dabigatran, rivaroxaban, or apixaban). Gender and age-matched patients without antithrombotic therapy were used as the control group. Patients were examined one week postoperatively. Intraoperative and postoperative hemorrhagic and non-hemorrhagic complications were assessed.

Results

Forty patients (56 eyes) on direct oral anticoagulants and 120 patients (172 eyes) without anticoagulation, at a mean age of 77 years, had phacoemulsification. There was no significant difference between the groups in the rate of intraoperative and postoperative bleeding. One eye (1.8%) in the treatment group and 3 eyes (1.7%) in the control group had hyphema (p = 0.72). No patient had thromboembolic event during or after surgery.

Conclusions

Cataract surgery was safely performed while continuing direct oral anticoagulation.
Validation of a methylation-based signature for subventricular zone involvement in glioblastoma
Authors: Ehret Felix , Zühlke Oliver , Schweizer Leonille , Kahn Johannes , Csapo-Schmidt Christoph , Roohani Siyer , Zips Daniel , Capper David , Adeberg Sebastian , Abdollahi Amir , Knoll Maximilian , Kaul David
Published: February 2024

Purpose

Glioblastomas (GBM) with subventricular zone (SVZ) contact have previously been associated with a specific epigenetic fingerprint. We aim to validate a reported bulk methylation signature to determine SVZ contact.

Methods

Methylation array analysis was performed on IDHwt GBM patients treated at our institution. The v11b4 classifier was used to ensure the inclusion of only receptor tyrosine kinase (RTK) I, II, and mesenchymal (MES) subtypes. Methylation-based assignment (SVZM ±) was performed using hierarchical cluster analysis. Magnetic resonance imaging (MRI) (T1ce) was independently reviewed for SVZ contact by three experienced readers.

Results

Sixty-five of 70 samples were classified as RTK I, II, and MES. Full T1ce MRI-based rater consensus was observed in 54 cases, which were retained for further analysis. Epigenetic SVZM classification and SVZ were strongly associated (OR: 15.0, p = 0.003). Thirteen of fourteen differential CpGs were located in the previously described differentially methylated LRBA/MAB21L2 locus. SVZ + tumors were linked to shorter OS (hazard ratio (HR): 3.80, p = 0.02) than SVZM + at earlier time points (time-dependency of SVZM, p < 0.05). Considering the SVZ consensus as the ground truth, SVZM classification yields a sensitivity of 96.6%, specificity of 36.0%, positive predictive value (PPV) of 63.6%, and negative predictive value (NPV) of 90.0%.

Conclusion

Herein, we validated the specific epigenetic signature in GBM in the vicinity of the SVZ and highlighted the importance of methylation of a part of the LRBA/MAB21L2 gene locus. Whether SVZM can replace MRI-based SVZ assignment as a prognostic and diagnostic tool will require prospective studies of large, homogeneous cohorts.
Spectra and Anisotropy of Solar Energetic Protons During GLE #65 on 28 October, 2003 and GLE #66 on 29 October, 2003
Authors: Mishev Alexander L. , Koldobskiy Sergey A. , Larsen Nicholas , Usoskin Ilya G.
Published: February 2024

Solar Cycle 23 was the most active in ground-level enhancements (GLEs) with 16 events registered by the global neutron monitor network. In this paper, we study a very active period in October–November, 2003, which revealed an intense solar activity burst that led to several eruptive processes and produced a sequence of three GLEs. By applying state-of-the-art modelling to records from the global neutron monitor network as well as space-borne data, we derived the spectral and anisotropy characteristics of accelerated solar protons during the GLE #65 event on 28 October, 2003 and GLE #66 on 29 October, 2003. The spectra and the pitch angle distributions are obtained with a 5-min time resolution, providing their dynamical evolution throughout the event. The spectra are parameterised with a modified power-law rigidity spectrum, whilst the angular distribution with a Gaussian. The constraints and uncertainties of the derived characteristics are evaluated by corresponding modelling.
Regulation of nerve-evoked contractions of the murine vas deferens
Authors: Wong Pei Yee , Fong Zhihui , Hollywood Mark A. , Thornbury Keith D. , Sergeant Gerard P.
Published: February 2024

Stimulation of sympathetic nerves in the vas deferens yields biphasic contractions consisting of a rapid transient component resulting from activation of P2X1 receptors by ATP and a secondary sustained component mediated by activation of α1-adrenoceptors by noradrenaline. Noradrenaline can also potentiate the ATP-dependent contractions of the vas deferens, but the mechanisms underlying this effect are unclear. The purpose of the present study was to investigate the mechanisms underlying potentiation of transient contractions of the vas deferens induced by activation of α1-adrenoceptors. Contractions of the mouse vas deferens were induced by electric field stimulation (EFS). Delivery of brief (1s duration) pulses (4 Hz) yielded transient contractions that were inhibited tetrodotoxin (100 nM) and guanethidine (10 µM). α,β-meATP (10 µM), a P2X1R desensitising agent, reduced the amplitude of these responses by 65% and prazosin (100 nM), an α1-adrenoceptor antagonist, decreased mean contraction amplitude by 69%. Stimulation of α1-adrenoceptors with phenylephrine (3 µM) enhanced EFS and ATP-induced contractions and these effects were mimicked by the phorbol ester PDBu (1 µM), which activates PKC. The PKC inhibitor GF109203X (1 µM) prevented the stimulatory effects of PDBu on ATP-induced contractions of the vas deferens but only reduced the stimulatory effects of phenylephrine by 40%. PDBu increased the amplitude of ATP-induced currents recorded from freshly isolated vas deferens myocytes and HEK-293 cells expressing human P2X1Rs by 93%. This study indicates that: (1) potentiation of ATP-evoked contractions of the mouse vas deferens by α1-adrenoceptor activation were not fully blocked by the PKC inhibitor GF109203X and (2) that the stimulatory effect of PKC on ATP-induced contractions of the vas deferens is associated with enhanced P2X1R currents in vas deferens myocytes.