bluuebunny/crossref_metadata_2025 huggingface dataset:
Extended Reconstructed Sea Surface Temperature, Version 6 (ERSSTv6). Part II: Upgrades on Quality Control and Large-Scale Filter
Authors: Huang Boyin , Yin Xungang , Boyer Tim , Liu Chunying , Menne Matthew , Rao Yuhan Douglas , Smith Thomas , Vose Russell , Zhang Huai-Min
Published: January 2025

NOAA’s Extended Reconstructed Sea Surface Temperature (ERSST) is a monthly 2°SST product starting from 1850. Our Part I study indicated that the performance scores of spatial correlation coefficient (SCC) and root-mean-square difference (RMSD) dropped clearly after the mid-1970s in the analysis of ERSST with an artificial neural network (ANN) method. In this Part II study, we demonstrate that ERSST with the ANN method can further be improved progressively in the final ERSSTv6 by the following steps: 1) applying a nearest neighbor check (NNC) quality-control algorithm on ship observations, 2) applying a large-scale (>200 km) filter (LS200) on SST superobservations, and 3) upgrading algorithms in proxy SST from ice concentration. These progressive improvements were assessed against validation and observation datasets. In comparison with ERSST with the ANN method alone, the quality of ERSSTv6 improves in the statistical metrics of SCC and RMSD by 2%–11% and 0.01°–0.24°C, respectively, in the global oceans. In the ice-covered regions, SST bias and RMSD decrease by 0.67° and 0.29°C, respectively.

Significance Statement

The ERSSTv6 using an artificial neural network (ANN) is further improved by progressively implementing the nearest neighbor check (NNC) in quality control (QC) on ship observations, large-scale filter (LS200) on SST superobservations, and ice-SST proxy algorithm in the ice-covered regions.
Post-COVID-19 Pandemic Restrictions: Follow-Up on Changes Within Canadian Academic and Fieldwork Curricula
Authors: MacKenzie Diane , Roberts Mary Roduta , Martini Rose , Ausman Christine , Schmitz Cori
Published: January 2025

Background. COVID-19 pandemic restrictions necessitated curricular modifications in Canadian occupational therapy education. Documentation and reflection on temporary or permanent curriculum modifications and their perceived impact on student learning and outcomes is critical. Purpose. To explore and compare reported curricula changes (academic and fieldwork) during restricted and post-restricted delivery periods together with the perceived impact on learners. Method. A cross-sectional online descriptive survey was sent to key representatives from administration, curriculum, and fieldwork at all 14 accredited occupational therapy university programs in Canada. Findings. Overall, many pandemic-restricted curricula delivery and assessment changes shifted back toward pre-pandemic methods. Changes that were maintained were congruent with universal design or perceived limited adverse impact on learning. Both in-person and virtual learning were perceived as important for changing practice needs. Fieldwork placement recruitment remained a challenge, with some programs increasing the use of simulation. Interpersonal competency development and assessment method integrity were more visible and of concern. Conclusion. Interpersonal competency development and assessment method integrity were more visible and of concern. Programs demonstrated remarkable flexibility to shift, adapt, and deliver curricula, but the human cost for this accomplishment is still palpable.
The effect of blade turning angle on rotation improvement of a small horizontal axis wind turbine
Authors: Tanovic Dragoljub , Simonovic Aleksandar , Kostic Olivera , Svorcan Jelena
Published: January 2025

Optimization of wind turbine aerodynamic performances implies solving the problem in the domains such as airfoil selection, blade rotation angle, chord optimization, number of blades, appropriate tip speed ratio, etc. The current paper studies the effect of blade rotation angle [Formula: see text] on power coefficient [Formula: see text], torque [Formula: see text] and mechanical power [Formula: see text] in a small horizontal axis wind turbine ( HAWT). The analysis involves two models of blades ( V and) of the airfoil class SD 7003. The first part of the paper employs numerical analysis, that is, Ansys CFX and Ansys Fluent software packages, to define wind turbine characteristics. The obtained results indicate that as the rotation angle [Formula: see text] increases the [Formula: see text] increases within an appropriate range of tip speed ratio [Formula: see text] change. The second part describes experimental investigation conducted on considered HAWT to define the values of [Formula: see text] and [Formula: see text] for studied blade rotation angles and comparison with the values obtained from Ansys. Existing differences in values are a consequence of the design of the HAWT, that is, the influence of the mass moment of inertia of the rotor and generator as well as the placement of the generator. Experimental setup and methodology allow for investigating the effect of different blade models, rotor and generator structure on wind turbine torque and mechanical power output characteristic.
EXPRESS: Smart Contracts in Supply Chains
Authors: Guo Liang
Published: January 2025

The blockchain technology can generate decentralized consensus, hence enhancing the verifiability and contractability of payoff-relevant states in a distribution channel or supply chain (e.g., seller cost and/or buyer value). Therefore, smart contracts can be written between supply chain partners such that transactions are automatically executed at state-dependent prices. We examine the economic impacts of blockchain-enabled smart contracts on the equilibrium generation and allocation of surplus in a three-level supply chain. Our model highlights the role of smart contract in removing ex post asymmetric decision right, which is otherwise inherently present under regular contracts where trade decisions are made based on constant transfer prices. As a result, the seller (under cost uncertainty) or the buyer (under value uncertainty) may hurt itself by signing a smart with the middleman, despite the improvement in the supply chain's total efficiency and surplus. Therefore, the equilibrium choice of smart contract can be socially insufficient. Moreover, interestingly, a prisoner's dilemma may arise: the seller's and the buyer's dominant choice is the regular contract, whereas everyone would be better off if the smart contract is jointly adopted by all parties.
EXPRESS: From Streetwear to High Fashion: How Nonelite Producers Use Hybridization to Enter an Elite Category
Authors: Dolbec Pierre-Yann
Published: January 2025

Gaining access to elite categories is challenging for nonelite producers. My longitudinal analysis of the evolution of the fashion market explains how some nonelite streetwear producers gained access to the elite high fashion category by creating an interstitial hybrid category—luxury streetwear—that bridged the two. Nonelite producers create a hybrid category by establishing commensurability with the elite category and generating appeal through cultural consonance. The hybrid category challenges the elite boundary while potentializing value creation for elites. In response, elite producers subsume the hybrid category, which resolves the challenge posed by nonelite producers and allows elites to capture the value introduced by nonelites by absorbing and exerting control over them. By doing so, elite producers rejuvenate their category’s cultural relevance and strengthen its elite status, while some nonelite producers gain access to the elite category. I contribute to research by theorizing nonelites’ status gains through categorical hybridization, an empirically prevalent but undertheorized phenomenon. I then leverage my theoretical insights to explain why subsumption solves cooptation issues, distinguish between collective and collaborative market driving, suggest that market actors can concomitantly participate in market maintenance and change, and offer managerial recommendations for nonelites to solidify status gains.
EXPRESS: Accounting for Formative and Reflective Topics in Product Review Data for Better Consumer Insights
Authors: Büschken Joachim , Otter Thomas , Allenby Greg M.
Published: January 2025

Observations of product and service reviews suggest that textual product reviews may contain statements that talk about the overall experience (“We had a great time”) or, similarly, whether to recommend a particular product. We argue that such statements encapsulate an overall assessment and hence are not independently informative about, but rather reflect overall ratings. We propose a model that allows for the distinction between topics that contribute to and topics that merely reflect an overall evaluation and apply it to a data set consisting of luxury hotel reviews. Compared to a standard supervised LDA, we find our model to better fit the data and to improve customer insights by resulting in more semantically coherent topics which point at specific aspects with positive and negative relationships to customers' evaluation of their experience.
4-Week intervention combining kiwifruit consumption and small-sided soccer games improves sleep quality in children with overweight/obesity and pre-existing sleep problems
Authors: Kerkeni Manel , Kerkeni Mohamed , Ammar Achraf , Aziz Abdul Rashid , Jallouli Anwar , AlSaleh Aseel , Husain Waqar , Ghazzawi Hadeel A , Moalla Wassim , Chtourou Hamdi , Jahrami Haitham , Trabelsi Khaled
Published: January 2025

Background: Childhood obesity is a global public health concern associated with various health risks, including disrupted sleep patterns. Aim: This study investigated the effects of kiwifruit consumption and small-sided soccer games (SSSG) over 4 weeks on sleep patterns in overweight/obese children with sleep problems. Methods: Thirty-six participants, aged 8 to 12 years with a body mass index above the 85th percentile, were randomly assigned to one of three groups: SSSG only ( n = 12), SSSG-kiwifruit (SSSG-K, n = 12), or control (CG, n = 12). Sleep patterns were monitor 1 week before, and during the first and last 2 weeks of the intervention. The CG group maintained their usual routines without structured physical activity. The SSSG and SSSG-K groups, both engaged in SSSG type of training two to three times per week, with the SSSG-K group also consuming on a daily basis two kiwifruits 1 hour before bedtime. Results: In the final 2 weeks, the SSSG group demonstrated significant improvements in sleep efficiency ( p = 0.03), sleep latency ( p < 0.001), and bedtime timing ( p < 0.001) compared to baseline. The SSSG-K group also showed significant improvements in sleep efficiency, sleep latency, and total sleep time compared to baseline, and relative to CG, and SSSG groups during the 4 weeks (all p < 0.05). Additionally, SSSG-K participants had earlier bedtimes and increased time in bed compared to their baseline ( p < 0.05). Conclusion: Combining kiwifruit consumption with SSSG exercise effectively enhances sleep patterns in overweight/obese children.
User requirements for research data management services in Myanmar university libraries: A case study of the University of Yangon Library
Authors: Zar Kyaw Aint Thin , Zhou Lihong , Wang Zengmin
Published: January 2025

University libraries in Myanmar are developing research data management services (RDMS) to support and boost the country's research and development. This paper reports on a research study that aims to identify and understand user requirements for RDMS. The University of Yangon Library (UYL) was selected as the research case, and 40 faculty members, research students, and library workers were approached and interviewed. The analysis of interview data adopted a thematic approach and used two analytic tools: coding for tagging and interpreting data; and concept map for visualising and demonstrating the progress of analysis. The analysis discerned 12 RDMS requirements in four theoretical themes: research data management planning, research data collection, research data processing and analysis, and research data preservation and sharing. Moreover, the analysis indicated that, to support the development of RDMS, libraries should enact three different roles, namely, participative role, educational and consultative role, and facilitative role. Also, practical implications were drawn from the analysis and suggested a three-stage action plan for RDMS development at the case library. Although this study focuses on libraries in Myanmar universities, the findings provide useful insights and implications for university libraries in other countries.
Cold-spray repair of CuCrZr crystallizers: Effect of substrate pretreatment
Authors: Wang Bo , Yu Min , Chen Qin , Chen Hui
Published: January 2025

Cold spraying is a promising technique for repairing damaged CuCrZr crystallizers, and the interface between the repair coating and the substrate plays a critical role in determining the heat transfer efficiency of the repaired crystallizers. In this study, two coating/substrate interfaces were prepared through polishing and grit-blasting the CuCrZr substrate surface. Effect of substrate pretreatment on microstructure and performance of the CuCrZr coating was studied using electron backscatter diffraction, adhesive shear strength and thermal conduction tests. Results show that the surface preparation method does not affect the microstructure and hardness of the CuCrZr coating, but the coating sprayed on the grit-blasted substrate has a lower shear adhesive strength and heat conductivity than the coating sprayed on the polished substrate. This difference is attributed to the formation of a work hardening zone during the grit-blasting process. After releasing this work hardening by annealing at 500°C, the difference in heat conductivity then disappears, but the average shear adhesive strength of the annealed coating on the polished substrate is still higher than that on the grit-blasted substrate. Therefore, polishing the substrate could serve as a more viable option for the cold spray repair of CuCrZr crystallizers.
Evaluating the Temporal Effect of Image Features on Dynamic Aesthetic Experience of Generative art
Authors: Meng Pu , Diao Zhuoyue , Meng Xin , Zhang Liqun
Published: January 2025

The emergence of dynamic digital arts, such as dynamic generative art, has reshaped how aesthetic experiences can be studied, emphasizing their inherently dynamic and evolving nature. Within the framework of computational aesthetics, which seeks to model and quantify human perceptions of beauty, this study extends the focus from static to dynamic stimuli. We investigate the temporal relationship between evolving image features and aesthetic judgments, exploring how dynamic visual properties influence the progression of aesthetic judgments over time. By introducing temporal offsets in the analysis and employing linear and nonlinear statistical models, we examine continuous aesthetic ratings alongside an extensive set of image features. Our findings offer a novel perspective on the enduring impact of image features on aesthetic experience.
Steatotic liver disease diagnosed in a 24-year-old woman with Rett syndrome: a case report
Authors: Albino Larissa , Adatia Adil , Thiesen Aducio , Halloran Brendan , Dong Victor , Moctezuma-Velázquez Carlos
Published: January 2025

Rett syndrome (RTT) is a neurodevelopmental disorder caused by mutations in the MECP2 gene, potentially disrupting lipid metabolism and leading to dyslipidemia (DLD) and steatotic liver disease (SLD). Although SLD has been described in RTT mouse models, it remains undocumented in humans. We herein describe a 24-year-old woman with RTT who was evaluated for abnormal liver enzymes. Imaging revealed hepatic steatosis, and transient elastography showed a controlled attenuation parameter of 342 dB/m and stiffness of 7.1 kPa. Laboratory investigations excluded secondary causes, including insulin resistance, metabolic syndrome, alcohol use, and new medications. Her Homeostatic Model Assessment for Insulin Resistance score was 1.8, her hemoglobin A1c concentration was 4.8%, and her lipid profile showed elevated triglycerides and low-density lipoprotein, consistent with DLD. Liver biopsy confirmed SLD. This case supports the hypothesis that MECP2 mutations in RTT disrupt lipid metabolism through a unique pathophysiologic mechanism, increasing the risk of DLD and SLD independently of traditional metabolic syndrome factors. It highlights the importance of early screening for liver disease in patients with RTT, despite their young age, to prevent complications. Additionally, it validates MECP2-null mouse models as reliable tools for investigating future therapeutic strategies in RTT.
Internal control, financing constraints, and R&D investment: Evidence from Chinese pharmaceutical manufacturing industry
Authors: Li Mohan , Low Mei Peng , Tee Peck Ling
Published: January 2025

The pharmaceutical industry contributes significantly to global healthcare by researching, developing, and producing medicines, therapies, and treatments that enhance and prolong human life. This research utilizes the annual data of 327 listed pharmaceutical manufacturing companies in China from 2015 to 2022 and conducted an empirical analysis on the impact of internal control on R&D investment and considered the mediating effect of financing constraints. The research results of listed pharmaceutical companies in China are as follows: (1) High-quality internal control can effectively promote R&D investments. (2) A more significant boost in R&D investment can be achieved by implementing internal controls that meet strategic and asset safety objectives. (3) Effective internal controls can alleviate financing constraints and promote research and development investment. (4) Large companies can significantly reduce financing constraints and promote R&D investment through high-quality internal control compared to small- and medium-sized companies. (5) With further research, high-quality internal controls can drive R&D investment by promoting profitability and maintaining good leverage levels. According to the empirical results, this research gives the relevant discussion and suggestions from the aspect of internal control key objectives.
Third Time's a Charm
Authors: Schwirck Samantha
Published: January 2025

The New York Public Library broke off a century-long relationship with incandescent for a nearly 10-year affair with CFL. Enter LED
Peritoneopleuropericardial leakage confirmed with peritoneal scintigraphy in a teenage girl
Authors: Gülaldi Nedim Cüneyt Murat , Ozlu Sare Gülfem , Bozkurt İrem , Bayrakci Umut Selda
Published: January 2025

Peritoneopericardial leakage is a rare but important complication of peritoneal dialysis. Peritoneal scintigraphy is reported to be effective in diagnosing the peritoneopericardial communication. Although switching to hemodialysis is commonly recommended, reducing exchange volumes and performing peritoneal dialysis in an upright sitting position may also be considered particularly in pediatric patients. Here we presented a 10-year-old girl in whom peritoneopericardial leakage was demonstrated with peritoneal scintigraphy and was successfully managed by conservative approach.
Analysis and optimization for buckling behavior of functionally graded face layers and porous core sandwich plates resting on pasternak elastic foundation
Authors: Thanh Huan Duong , Tien Thinh Le
Published: January 2025

In this paper, the first-order shear deformation theory (FSDT) is employed to derive analytical solutions for the buckling analysis of functionally graded material—porous—functionally graded material (FGM-porous-FGM) sandwich plate resting on Pasternak elastic foundation. The top and bottom layers of the plate consist of functionally graded materials that vary according to the exponential law along the thickness direction, while the core layer is composed of a porous material. The governing equations are derived by using the principle of minimum total potential energy. Based on the Navier’s solution, the displacements are obtained to satisfy the boundary conditions. The results are then compared with existing published literature showing the accuracy of the proposed solutions. Moreover, parametric studies investigate the effects of material parameters, geometric dimensions, foundation coefficients and face-core-face thickness ratios on the critical buckling load of the rectangular FGM-porous-FGM sandwich plate. In the case of uniaxial loading, the critical bucking load is almost twice for the case of biaxial loading, no matter the value of volume fraction index. For all the cases of face-core-face thickness ratio, the biaxial critical buckling load linearly depends on the porosity coefficient. The porosity coefficient is crucial when and only when the volume of the core is almost eight times bigger than the volume of the face layer. Optimization studies are then presented in order to: (i) maximize the critical buckling load and (ii) optimize the input variables corresponding to a given value of the critical buckling load. The proposed study aims to provide valuable insights into the design and application of FGM-porous-FGM sandwich plates in various engineering fields, contributing to the development of more resilient and efficient structural components.
Inhibitory Effects of Different Doses of Matrine on Breast Cancer and Its Relationship with miR-188
Authors: Liu Zhao , Xu Jian , Xia Heng , Wang Miaofeng , Xu Qianlan
Published: January 2025

Background

Malignant tumors represented by breast cancer still have limitations in clinical treatment methods. Matrine is a compound with anticancer activity, but its inhibitory effect on breast cancer and its mechanism for regulating miR-188 are still unclear.

Purpose

Therefore, it is necessary to explore more effective breast cancer treatment methods and understand the intervention mechanism of matrine and its effect on miR-188.

Methods

A nude mouse model of breast cancer was in this study constructed and divided into a model group, 4 mg/kg group, 8 mg/kg group, drug group, and miR-188 mimic group. Different concentrations of matrine were administered intragastrically, and cell proliferation and apoptosis were observed. At the same time, a specific mechanism for miR-188 in the anti-breast cancer effect of matrine was explored by overexpressing miR-188.

Results

It was found that matrine inhibited the proliferation of breast cancer cells and caused cancer cell apoptosis. In addition, it inhibited cell migration in a dose-dependent manner. At the same time, miR-188 was lowly expressed in breast cancer and significantly increased after matrine treatment. Overexpression of miR-188 enhanced the antitumor effect of matrine. Phosphatase and tensin homolog (PTEN) was also activated in the surface by matrine, and expressions of matrix metalloproteinase-9 (MMP-9) and matrix metalloproteinase-2 (MMP-2) were inhibited. This study shows that matrine has a significant inhibitory effect on breast cancer, and its mechanism is related to upregulation of miR-188, activation of PTEN, and inhibition of MMP-9 and MMP-2 expressions.

Conclusion

miR-188 is involved in the anti-breast cancer process, which can be used as the theoretical basis of matrine potential drugs for breast cancer treatment. Meanwhile, miR-188 and matrine will also have great potential in developing new breast cancer treatment methods, which can provide ideas and a basis for further development of related studies.
Statism and state activism in response to China’s belt and Road Initiative: Indonesia and Malaysia’s approaches to developing the EV sector
Authors: Tritto Angela
Published: January 2025

How have the Belt and Road Initiative (BRI)’s host countries employed state capitalism to pursue global value chain (GVC) integration? This article answers this question by analyzing cases of electric vehicle GVCs in Indonesia and Malaysia. Employing qualitative and quantitative data, the discussion unpacks how the BRI generates opportunities for activist states to channel new capital and technologies toward national strategic economic outcomes. In Indonesia, President Widodo’s state capitalism efforts employed Chinese investments to bring new smelting and refining technologies to restructure and industrialize the country’s mineral sector. As a result, Indonesia has become a leading nickel-processing destination for stainless steel production and, more recently, for electric vehicle batteries. Meanwhile, the Malaysian government has directed investments toward green energy and smart manufacturing, which resulted in the brokerage of a pivotal car manufacturing joint venture. Both countries employed a mix of statism and state activism to partake in the emerging GVCs connected to the electric vehicle sector, with Indonesia preferring the former by primarily employing industrial policy interventions to prioritize private sector investments, while Malaysia predilected hybrid forms of state and private sector coordination. Overall, the results show that industrial policies and Chinese investments have brought opportunities but also unintended development outcomes.
Community Gardening as an Organizing Strategy
Authors: Murphy John W , Callaghan Karen A
Published: January 2025

Community gardening is a novel application to community organizing. The point of this article is to place this mode of organizing in a community-based perspective. By becoming community-based, this organizing strategy will become organic and help to strengthen community bonds and promote collective action. In a community-based project, local knowledge and control are paramount. But for this change to occur a proper, underlying philosophy must be developed. Without this philosophical change, many projects that strive to be community-based are merely community-situated. This philosophical change is also discussed, so that community gardening can become a bona fide community-based initiative.
Teaching While Streaming: Adult Adoptee Themes in The Real Housewives Reality Series
Authors: Branco Susan F.
Published: January 2025

Bravo network's The Real Housewives, a long running reality tv series, spans multiple cities in the United States and across the globe. Counselor educators may utilize adult adoptee related issues present in the series for couples and family counseling students. This teaching brief describes the Real Housewives of Orange County's Katie Ginella, a transracial, international adoptee, whose storyline includes identity challenges, intergenerational trauma, and birth family reunion. Implications for couple and family counselor educators are described.
Incidental Finding of a Persistent Right Vitelline Artery in a 13-Year-Old Boy with Acute Appendicitis: A Case Report with Clinico-Pathological Correlation and a Comprehensive Literature Review
Authors: Arredondo Montero Javier , Sáez Álvarez Samuel , Rodríguez Ruiz María , Hernando Martín Mercedes
Published: January 2025

The persistence of fetal vitelline structures may occur. The primary intestinal arterial supply development happens normally in this scenario, but a vitelline vascular remnant (VVR) persists. A 13-year-old boy with a history of severe and intermittent abdominal pain since early infancy presented to the Emergency Department with clinical, analytical, and ultrasonographic findings suggestive of acute appendicitis. There was no evidence of intestinal obstruction. Surgical treatment was indicated. A thick fibrovascular band from the umbilicus to the terminal ileum's mesentery was identified during laparoscopy. A gangrenous cecal appendix was also identified. A regular appendectomy and surgical excision of the band was performed. The histopathological study confirmed that it was a persistent right vitelline artery (VVR) and that the patient had acute gangrenous appendicitis. The patient evolved favorably and is currently asymptomatic and under follow-up. The literature on VVR is scarce. The present manuscript reviews the main characteristics of this embryological insult based on the preceding literature. Standardization of terminology regarding VVR will help better understand this pathology in the future.
Scorpionism in the State of Bahia, Brazil: A More Neglected Problem During the Pandemic?
Authors: Braga Jacqueline Ramos Machado , dos Santos Luís Vinícius Sena , Mata Amanda Cristina de Souza , Moraes Isabel Cristina
Published: January 2025

Introduction

During the confinement in the COVID-19 pandemic, there was an increase in the production of urban waste, increasing the risk of accidents caused by scorpions. We sought to determine the clinical and epidemiologic aspects of scorpionism records in the 7 mesoregions of the State of Bahia, Brazil, examining differences in periods before and during the pandemic.

Methods

Data were obtained from SINAN, Brazil's Notifiable Diseases Information System (January 2010–December 2021). Measures of morbidity (incidence and lethality) and mortality were evaluated, comparing the averages before (2018 and 2019) and during the pandemic (2020 and 2021). Sociodemographic data (ie, gender, age group, and race) and conditions of care (ie, time, classification, and evolution) were compared by mesoregion.

Results

A total of 159,982 cases of scorpionism were registered, with a higher proportion in the prepandemic period ( P<0.05) and a higher average incidence in the Center South of Bahia (267.32; n=82,059; 51.29%). Most cases occurred in mixed-race individuals (61.73%), females (n=81,292; 51.22%), and individuals between 20 and 39 y of age (n=48,876; 30.55%) and most cases were classified as mild (n=136,816; 85.52%), were attended in <1 h (n=81,941; 51.22%), and progresses to cure (n=142,082; 88.81%). There were 263 deaths (0.16%), with a mortality rate of 1.77/100,000 inhabitants and a lethality of 0.16%.

Conclusion

It is suggested that during the COVID-19 pandemic, despite the upward curve of accidents, social isolation measures and collective fear may have decreased the search for medical care after a scorpion sting, reducing notifications of the condition in the State of Bahia.
Clinical validation of artificial intelligence-based single-subject morphometry without normative reference database
Authors: Hedderich Dennis M , Opfer Roland , Krüger Julia , Spies Lothar , Yakushev Igor , Buchert Ralph
Published: January 2025

Background

Single-subject voxel-based morphometry (VBM) is a powerful technique for reader-independent detection of brain atrophy in structural magnetic resonance imaging (MRI) to support the (differential) diagnosis and staging of neurodegenerative diseases in individual patients. However, VBM is sensitive to the MRI scanner platform and details of the acquisition sequence. To mitigate this limitation, we recently proposed and technically validated a convolutional neural network (CNN)-based VBM which does not rely on a normative reference database.

Objective

Clinical validation of CNN-based VBM.

Methods

CNN-based VBM was compared with conventional VBM based on a mixed-scanner normative database in 227 consecutive patients (66.0 ± 9.6 years, 53.3% female) with suspected dementing neurodegenerative disease. VBM maps were interpreted visually by two experienced readers, first with respect to the presence of any neurodegenerative disease, then for the differentiation between Alzheimer's disease (AD)-typical and non-AD atrophy patterns. A Likert 6-score was used for both tasks. Simultaneously acquired positron emission tomography (PET) with 18F-fluorodeoxyglucose (FDG) served as reference standard.

Results

Repeated-measures ANOVA revealed a significant impact of the VBM method on the visual detection of any neurodegenerative disease (p < 0.001). Balanced accuracy/sensitivity/specificity were 80.4/86.3/74.5% for CNN-based VBM versus 75.7/79.5/71.8% for conventional VBM. Differentiation between AD and non-AD typical atrophy patterns did not differ between both VBM methods (p = 0.871).

Conclusions

CNN-based VBM provides clinically useful accuracy for the detection of neurodegeneration-suspect atrophy with higher sensitivity than conventional VBM with a mixed-scanner normative reference database and without compromising specificity.
A Bleed From the Distal Anastomosis Site of a Bypass Graft From the Left Common Iliac Artery to the Celiac Trunk Treated With a Surgeon-Modified Fenestrated Endograft
Authors: Grima Matthew Joe , Zammit Michaela , Cassar Kevin
Published: January 2025

Purpose:

The use of surgeon-modified fenestrated endograft to treat a bleeding complication in the common iliac artery.

Technique:

An Endurant limb graft was modified on back table in theater after planning the fenestration using a semi-automated centerline. The Endurant stent was planned to land flush at the aortic bifurcation. The Endurant limb was partially deployed until the fenestration opened facing the anastomosis to enable rotation and axial movement of the stent graft, if needed. By obtaining access from the contralateral common femoral artery, the fenestration was cannulated using up-and-over technique and bypass graft cannulated. The Endurant stent graft was then fully deployed. Through a separate puncture in the ipsilateral sheath, the fenestration was re-cannulated using a hydrophilic wire, and a balloon-expandable covered stent was introduced through a 7F sheath and then flared in a kissing fashion along with the Endurant stent. The distal part of the Endurant limb was extended with a bare metal stent into the external iliac artery. Control angiography was satisfactory, and bleeding was controlled.

Conclusion:

Surgeon-modified stent graft in the iliac arteries can be used even in the context of non-aneurysmal disease to treat patients in high-risk emergency situations and could be part of the armamentarium of the vascular surgeon.

Clinical Impact

Physician-modified endografts are increasingly being used by vascular surgeons and interventional radiologists to treat patients with complex aorto-iliac aneurysms in whom custom-made endograft provided by the manufacturer is too expensive to produce and/or patient requires urgent surgery. Data on the use of physician-modified endografts to treat non-aneurysmal disease is lacking. This technical note highlights the use of physician-modified endograft to treat a patient with bleeding complication from the distal anastomosis of an iliac artery to coeliac trunk bypass graft in whom open surgery posed unacceptable high morbidity and mortality risks. This technical note continues to add more information and knowledge to the vascular surgery / interventional radiology communities on the use of physician-modified endografts and also adds another tool in the armamentarium of teams involved.
Optimizing haemodialysis outcomes: A pilot study on the effectiveness of multidisciplinary clinics in enhancing vascular access and improving patient outcomes
Authors: Lai Boon Cheok , Tay Hui Boon , Lee Pei Shan
Published: January 2025

Background

Patients with kidney failure face increased health risks during early haemodialysis due to physical and emotional challenges. Most patients begin haemodialysis using catheters, which increases mortality and complication risks. This study evaluates the impact of multidisciplinary clinics on vascular access and patient outcomes on haemodialysis.

Objectives

To compare the influence of multidisciplinary clinics with conventional clinics on the utilisation of definitive vascular access for haemodialysis.

Methods

This is a single-centre, retrospective cohort study included 145 patients newly started on haemodialysis. Patients were evaluated over a 12-month follow-up period (July 2018 to December 2020). The primary outcome was definitive vascular access for haemodialysis. Secondary outcomes included the frequencies of catheter-related bloodstream infections, intensive care unit admissions, and recurrent hospitalizations.

Results

The study analysed 53 and 92 participants in the multidisciplinary clinics and conventional groups, respectively. Although only 10% of patients started haemodialysis with definitive access, the multidisciplinary clinics group exhibited significantly higher utilisation of definitive vascular access after 6 months (OR = 2.44, 95% CI 1.16-5.26, p = .039). The multidisciplinary clinics group had lower risks of intensive care unit admission (OR 0.92, 95% CI 1.03-1.15, p = .026) and recurrent hospitalization (OR 0.13, 95% CI 2.06-26.68, p = .001). Although not statistically significant (OR 0.34, 95% CI 0.47-18.46, p = .709), the multidisciplinary clinics group had a lower incidence of catheter-related infections.

Conclusions

Multidisciplinary care significantly increases the use of definitive vascular access, reduces intensive care unit admissions, and hospitalization rates, demonstrating the effectiveness of comprehensive, coordinated care in managing patients on haemodialysis.
A Critical Appraisal of the Application of Frailty and Sarcopenia in the Spinal Oncology Population
Authors: MacLean Mark A. , Charles Antoinette J. , Georgiopoulos Miltiadis , Phinney Jackie , Charest-Morin Raphaële , Goodwin Rory , Laufer Ilya , Fehlings Michael G. , Shin John , Dea Nicholas , Rhines Laurence D. , Sahgal Arjun , Gokaslan Ziya , Stephens Byron , Disch Alexander C. , Kumar Naresh , O’Toole John , Sciubba Daniel M. , Netzer Cordula , Goldschlager Tony , Gibbs Wende , Weber Michael H. ,   on behalf of the AO Spine Knowledge Forum Tumor
Published: January 2025

Study Design

Systematic review and clinimetric analysis.

Objectives

Frailty and sarcopenia predict worse surgical outcomes among spinal degenerative and deformity-related populations; this association is less clear in the context of spinal oncology. Here, we sought to identify frailty and sarcopenia tools applied in spinal oncology and appraise their clinimetric properties.

Methods

A systematic review was conducted from January 1st, 2000, until June 2022. Study characteristics, frailty tools, and measures of sarcopenia were recorded. Component domains, individual items, cut-off values, and measurement techniques were collected. Clinimetric assessment was performed according to Consensus-based Standards for Health Measurement Instruments.

Results

Twenty-two studies were included (42 514 patients). Seventeen studies utilized 6 frailty tools; the three most employed were the Metastatic Spine tumor Frailty Index (MSTFI), Modified Frailty Index-11 (mFI-11), and the mFI-5. Eight studies utilized measures of sarcopenia; the three most common were the L3-Total Psoas Area (TPA)/Vertebral Body Area (VBA), L3-TPA/Height2, and L3-Spinal Muscle Index (L3-Cross-Sectional Muscle Area/Height2). Frailty and sarcopenia measures lacked or had uncertain content and construct validity. Frailty measures were objective except the Johns-Hopkins Adjusted Clinical Groups. All tools were feasible except the Hospital Frailty Risk Score (HFRS). Positive predictive validity was observed for the HFRS and in select studies employing the mFI-5, MSTFI, and L3-TPA/VBA. All frailty tools had floor or ceiling effects.

Conclusions

Existing tools for evaluating frailty and sarcopenia among patients undergoing surgery for spinal tumors have poor clinimetric properties. Here, we provide a pragmatic approach to utilizing existing frailty and sarcopenia tools, until more clinimetrically robust instruments are developed.
What is the Optimal Management of Metastatic Spine Patients With Intermediate Spinal Instability Neoplastic Scores: To Operate or Not to Operate?
Authors: Kwan William Chu , Zuckerman Scott L. , Fisher Charles G. , Laufer Ilya , Chou Dean , O'Toole John E. , Schultheiss Markus , Weber Michael H. , Sciubba Daniel M. , Pahuta Markian , Shin John H. , Fehlings Michael G. , Versteeg Anne , Goodwin Matthew L. , Boriani Stefano , Bettegowda Chetan , Lazary Aron , Gasbarrini Alessandro , Reynolds Jeremy J. , Verlaan Jorrit-Jan , Sahgal Arjun , Gokaslan Ziya L. , Rhines Laurence D. , Dea Nicolas
Published: January 2025

Study Design

Systematic review.

Objective

In patients with extradural metastatic spine disease, we sought to systematically review the outcomes and complications of patients with intermediate Spinal Instability Neoplastic Score (SINS) lesions undergoing radiation therapy, percutaneous interventions, minimally invasive surgeries, or open spinal surgeries.

Methods

Following PRISMA guidelines for systematic reviews, MEDLINE, EMBASE, Web of Science, the Cochrane Database of Systematic Reviews and the Cochrane Center Register of Controlled Trials were queried for studies that reported on SINS intermediate patients who underwent: 1) radiotherapy, 2) percutaneous intervention, 3) minimally invasive, or 4) open surgery. Dates of publication were between 2013-22. Patients with low- or high-grade SINS were excluded. Outcome measures were pain score, functional status, neurological outcome, ambulation, survival, and perioperative complications.

Results

Thirty-nine studies (n = 4554) were included that analyzed outcomes in the SINS intermediate cohort. Radiotherapy appeared to provide temporary improvement in pain score; however, recurrent pain led to surgery in 15%–20% of patients. Percutaneous vertebral augmentation provided improvement in pain. Minimally invasive surgery and open surgery offered improvement in pain, quality of life, neurological, and ambulatory outcomes. Open surgery may be associated with more complications. There was limited evidence for radiofrequency ablation.

Conclusion

In the SINS intermediate group, radiotherapy was associated with temporary improvement of pain but may require subsequent surgery. Both minimally invasive surgery and open spinal surgery achieved improvements in pain, quality of life, and neurological outcomes for patients with spine metastases. Open surgery may be associated with more complications.
Risk Factors for the Development of Neurological Deficits in Metastatic Spinal Disease: An International, Multicenter Delphi Study
Authors: Huele Eline H. , Gal Roxanne , Eppinga Wietse S.C. , Verkooijen Helena M. , O’Toole John E. , Laufer Ilya , Sciubba Daniel M. , Netzer Cordula , Foppen Wouter , Sahgal Arjun , Fehlings Michael G. , Lo Sheng-fu L. , Fisher Charles G. , Rhines Laurence D. , Reynolds Jeremy J. , Lazary Aron , Gasbarrini Alessandro , Dea Nicolas , Weber Michael H. , Verlaan Jorrit Jan
Published: January 2025

Study Design

Delphi study

Objective

The objective of this study was to identify risk factors associated with the development and/or progression of neurological deficits in patients with metastatic spinal disease.

Methods

A three-round Delphi study was conducted between January-May 2023 including AO Spine members, comprising mainly neurosurgeons and orthopedic surgeons. In round 1, participants listed radiological factors, patient characteristics, tumor characteristics, previous cancer-related treatment factors and additional factors. In round 2, participants ranked the factors on importance per category and selected a top 9 from all factors. Kendall’s W coefficient of concordance was calculated as a measure of consensus. In the final round, participants provided feedback on the rankings resulting from round 2. Lastly, the highest-ranking factors were more clearly defined and operationalized by an expert panel.

Results

Over two hundred physicians and researchers participated in each round. The factors listed in the first round were collapsed into 12 radiological factors, 14 patient characteristics, 6 tumor characteristics and 12 previous cancer-related treatment factors. High agreement was found in round 3 on the top-half lists in each category and the overall top 9, originating from round 2. Kendall’s W indicated strong agreement between the participants. ‘Epidural spinal cord compression’, ‘aggressive tumor behavior’ and ‘mechanical instability’ were deemed most influential for the development of neurological deficits.

Conclusion

This study provides factors that may be related to the development and/or progression of neurological deficits in patients with metastatic spinal disease. This list can serve as a basis for future directions in prognostication research.
A Student-Informed Guide for Success on the OB/GYN Clerkship
Authors: Hopkins-Kotb Naeema , Sylla Hannan , Krotinger Anna , Pelletier Andrea , Bartz Deborah A. , Johnson Natasha R.
Published: January 2025

The obstetrics and gynecology (OB/GYN) clerkship is a uniquely enriching and challenging rotation for medical students. Available literature prepares students for medicine and surgery clerkships, but few guides identify and discuss the unique characteristics of OB/GYN that impact student learning and performance during the clerkship. Here, we aim to highlight the specific clinical learning environments, emotionally sensitive experiences, and technical performance expectations that students should anticipate and be prepared for in the OB/GYN clerkship. We believe all students benefit from learning these skills to care for their future patients no matter their chosen specialty.
Using a machine learning framework for natural language processing to create a high-resolution carbon emission map for urban manufacturing
Authors: Wang Tinyu , Yan Fengying , Ma Jian , Zhang Xiaoping , Dong Liang
Published: January 2025

Managing carbon emissions from the manufacturing sector is crucial for sustainable development, and effective identification of manufacturing land is key to achieving this goal. However, current methods for identifying urban manufacturing land remain inadequate. In this study, we employ a fine-tuned, pre-trained natural language processing model based on Bidirectional Encoder Representations from Transformers to classify points of interest data into manufacturing industry categories. This approach enables us to identify manufacturing land and allocate corresponding carbon emissions data to specific parcels. The global Moran’s Index and local Moran’s Index are applied to analyze the relationship between manufacturing concentration and carbon emission intensity. The results demonstrate that the fine-tuned model achieved an accuracy rate of 91.6% on the test set, successfully identifying 98.72% of the manufacturing land in the study area. The intensity of carbon emissions from manufacturing exhibits a significant positive spatial correlation, with urban areas characterized by high-high and low-low clustering of emissions. In rural areas, high-emission manufacturers tend to be co-located with low-emission enterprises. Within individual manufacturing sectors, most exhibit low-low clustering, suggesting a potential relationship between such clustering and lower carbon emissions. This study provides detailed spatial data for the management of carbon emissions in the manufacturing sector and addresses the gap in micro-scale research on the correlation between manufacturing concentration and carbon emissions.
Experimental investigation and optimization of process parameter of abrasive water jet machining (AWJM) on D2 steel
Authors: Phani K. V. S. , Nanda Basanta Kumar , Mishra Swayam Bikash , Nayak Santosh Kumar , Mishra Ruby
Published: January 2025

Abrasive water jet machining (AWJM) is the most significant hybrid unconventional machining technique for its exceptional material removal rate (MRR) and surface quality for any type of brittle, ductile, and composite materials with a higher level of precision and accuracy. It has great flexibility in machining for producing complex-shaped parts that can be used in automobile, marine, aerospace, and chemical industries. This study focuses on the application of AWJM for cutting of D2 steel components using silicon carbide (SiC) abrasives. The experiments are conducted following the Box-Behnken Design (BBD) of response surface methodology (RSM) as the design of experiment (DOE) by considering pressure (P), traverse speed (TS), and abrasive flow rate (AFR) as the input factors each with three different levels in obtaining the corresponding outputs, namely MRR and surface roughness (Ra). Finally, the multicriteria decision-making (MCDM), Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) method, is applied to optimize the output values as MRR of 2.757 mm3/sec, and Ra of 1.014 µm.