bluuebunny/crossref_metadata_2025 huggingface dataset:
Co‐Producing Peritoneal Dialysis Nursing Sensitive Indicators for Quality Care: A Multinational Consensus Building Design
Authors: Baillie Jessica , Bonner Ann , Guillouet Sonia , Mikut Cornelia , Punzalan Sally , Kaczmarek Anna , Wenzyl Lawrence Climaco , Finderup Jeanette
Published: January 2025

Background

Nursing sensitive indicators are a way of measuring aspects of patient care that are most affected by the actions of the nurse. Despite the existence of nursing sensitive indicators, these are largely not suitable to measure peritoneal dialysis nursing practice.

Objective

This project aimed to co‐develop a set of peritoneal dialysis nursing‐sensitive indicators.

Design

Informed by the Donabedian quality framework (structure, process, outcome), a multinational co‐production consensus design was used.

Participants and Measurements

First, an expert panel of seven professionals proposed potential indicators from clinical expertise and examining peer‐reviewed articles and clinical guidelines. Next, the expert panel undertook a consensus building process involving face‐to‐face meetings and online discussion to refine the indicators. Lastly indicator confirmation was undertaken using a 5‐point rating scale involving delegates at a major conference.

Results

The initial indicator proposal, based on evidence and clinical experience, identified 65 potential indicators (20 structural, 22 process and 23 outcome). The consensus process involved discussion and negotiation to reduce the potential indicators to 28 (eight structural, 12 process and eight outcome). Confirmation involved 25 nurses with all 28 indicators supported (all > 3.5/5). Indicators highly supported were patient satisfaction, fluid balance assessment, peritoneal dialysis catheter exit‐site, clinical signs measurement, peritonitis investigation, peritoneal dialysis catheter complications referral and infection rates.

Conclusion

Following further validity, reliability and feasibility testing, these nursing sensitive indicators can be used to measure the quality of peritoneal dialysis nursing care provided for patients and families.
Self‐Normalized KPSS Tests With Power Enhancement
Authors: Peng‐Zhou JunYi , Song Xiaojun
Published: January 2025

Much research has focused on testing the null hypothesis of stationarity against the unit root alternative. In this paper, we propose a novel class of self‐normalized KPSS tests without needing a consistent estimation of the long‐run variance. Under persistent autocorrelation, the widely used heteroskedasticity and autocorrelation consistent long‐run variance estimator proposed by Newey and West [Econometrica (1987) Vol. 55, pp. 703–708], Newey and West [The Review of Economic Studies (1994) Vol. 61, pp. 631–653], and Andrews [Econometrica (1991) Vol. 59, pp. 817–858] may not be reliable and often lead to tests with size distortions and power losses in finite samples. In addition, the practitioner has to choose the truncation lag that is ultimately arbitrary. To improve the finite sample performance of the stationarity tests and make them robust to realistic amounts of dependence, we propose the use of self‐normalizing methods, for example, the range‐based self‐normalization by Hong et al. [Journal of Econometrics (2024) Vol. 238, 105603] and the fixed‐ asymptotics by Kiefer and Vogelsang [Econometric Theory (2005) Vol. 21, pp. 1130–1164] and Amsler, Schmidt, and Vogelsang [Journal of Time Series Econometrics (2009) Vol. 1, pp. 1–44], to control the effect of the long‐run variance. The self‐normalized tests are inconsistent in that, under the unit root alternative, they do not diverge as the sample size approaches infinity. To recover the consistency of the tests, we devise a mechanism similar to the power enhancement mechanism proposed by Fan, Liao, and Yao [Econometrica (2015) Vol. 83, pp. 1497–1541]. Under the null hypothesis, this mechanism is asymptotically negligible. However, under the alternative hypothesis, the mechanism diverges as the sample size increases. We show that this mechanism also enhances the power of the self‐normalized stationarity tests. A simulation study and an empirical application demonstrate the merits of the approach advocated.
Reinforcement learning‐based trajectory planning for continuous digging of excavator working devices in trenching tasks
Authors: Tan X. , Wei W. , Liu C. , Cheng K. , Wang Y. , Yao Z. , Huang Q.
Published: January 2025

This paper addresses the challenge of real‐time, continuous trajectory planning for autonomous excavation. A hybrid method combining particle swarm optimization (PSO) and reinforcement learning (RL) is proposed. First, three types of excavation trajectories are defined for different geometric shapes of the digging area. Then, an excavation trajectory optimization method based on the PSO algorithm is established, resulting in optimal trajectories, the sensitive parameters, and the corresponding variation ranges. Second, an RL model is built, and the optimization results obtained offline are used as training samples. The RL‐based method can be applied for continuous digging tasks, which is beneficial for improving the overall efficiency of the autonomous operation of the excavator. Finally, simulation experiments were conducted in four distinct conditions. The results demonstrate that the proposed method effectively accomplishes excavation tasks, with trajectory generation completed within 0.5 s. Comprehensive performance metrics remained below 0.14, and the excavation rate exceeded 92%, surpassing or matching the performance of the optimization‐based method and PINN‐based method. Moreover, the proposed method produced consistently balanced trajectory performance across all sub‐tasks. These results underline the method's effectiveness in achieving real‐time, multi‐objective, and continuous trajectory planning for autonomous excavators.
The Effects of Pranayama and Deep Breathing Exercises on Pain and Sleep Quality After Laparoscopic Cholecystectomy
Authors: Kurt Elif , Yayla Ayşegül
Published: January 2025

The purpose of the present research is to determine the effects of pranayama and deep breathing exercises applied to patients after laparoscopic cholecystectomy on shoulder pain and sleep quality. The research was conducted at the General Surgery Clinics of the University of Health Sciences, Van Training and Research Hospital between March 2023 and June 2024. The study was carried out using a pretest‐posttest control group randomized controlled experimental trial design. A total of 66 patients (22 in the pranayama group, 22 in the deep breathing group, and 22 in the control group) were included in the study. The research data were collected using the “Patient Descriptive Form,” “Visual Analog Scale,” and “Richard‐Campbell Sleep Scale.” The three groups had similar mean preoperative pain and sleep scores (p > 0.05). Mean pain scores were lower in the pranayama and deep breathing groups than in the control group after the exercise at the 6th, 12th, and 24th postoperative hours and discharge (p < 0.05). Deep breathing exercises were revealed to decrease postoperative pain more effectively than pranayama breathing exercises. Considering sleep scores, the pranayama and deep breathing groups had higher mean sleep scores in comparison with the control group (p < 0.05).

Trail Registration: This study was registered in the ClinicalTrials.gov database as (NCT06495411) Protocol Registration and Result System. This study was conducted as a master thesis.
The diagnostic accuracy and feasibility of paediatric visual field tests: A systematic review
Authors: Riaz Maria , Ross Nicole C. , Mayer D. Luisa
Published: January 2025

Purpose

Alternative non‐standard paediatric visual field (VF) tests have been developed to address the challenges associated with standard approaches. However, diagnostic accuracy of these new VF tests has not yet been rigorously evaluated. This systematic review aims to explore diagnostic accuracy and feasibility of non‐standard VF tests in paediatric patients.

Methods

The following databases were searched for English language studies comparing a non‐standard paediatric VF test to standard methods, such as standard automated perimetry (SAP), manual kinetic perimetry (MKP) and confrontation testing (CT): EMBASE, PubMed, Ovid MEDLINE, Web of Science, Scopus, VisionCite, Cochrane Library, ClinicalTrials.gov, African Index Medicus, LILACS, Trip and grey literature databases. Studies included were of children ≤18 years old with suspected or known VF defects (n > 3). Case reports, case series, editorials and letters were excluded. This review follows the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines. Risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS‐2) tool.

Results

Thirty studies (n = 2074 children, age range: 2 months to 18 years) published between 1990 and 2023 met the inclusion/exclusion criteria. Twenty index tests were reported, sorted into four categories of methods: behavioural/observational (5), electrophysiological (2), modifications of standard perimetry (11) and eye tracking (2). Risk of bias, based on the QUADAS‐2 results, was unclear or high for most studies. Sensitivities of 10 studies (behavioural/observational [2]; electrophysiological [2]; modifications of standard perimetry [2] and eye tracking [4]) were 60%–100%, 75%, 80%–94% and 70%–100%, and specificities were 98%–100%, 86%–88%, 68%–100% and 50%–100%, respectively.

Conclusions

Alternative non‐standard paediatric VF tests, and behavioural/observational methods in particular, show potential for adequate diagnostic accuracy and feasibility, although limited to certain conditions and ages. Studies with complete reporting and low risk of bias are needed to determine the diagnostic accuracy and feasibility of non‐standard paediatric VF tests.
Impact of Dexamethasone on Blood Glucose After Total Knee Arthroplasty in Patients With Type 2 Diabetes
Authors: Chen Jiazheng , Wang Cheng , Li Feng , Wang Xinguang , Li Yang , Feng Hui , Zhao Minwei , Tian Hua
Published: January 2025

Objective

With the global aging population, the incidence of OA is rising annually, and the number of TKA surgeries is rapidly increasing, placing a heavy economic and healthcare burden on society. As one of the key medications in the ERAS protocol, DXM can significantly reduce postoperative pain, suppress nausea and vomiting, and accelerate patient recovery. However, the safety of perioperative DXM use in patients with diabetes remains unclear. This study aims to clarify the safety of perioperative DXM application in diabetic patients.

Methods

This retrospective analysis involved 285 patients with type 2 diabetes and late‐stage knee osteoarthritis who underwent unilateral TKA at the Joint Surgery Center of Peking University Third Hospital from January 2019 to November 2022. After application of the inclusion and exclusion criteria, 161 patients were included in the study. The patients were divided into two groups according to whether they had received continuous intravenous administration of DXM for 3 days postoperatively: the DXM group (n = 66) and the non‐DXM group (n = 95). All other treatments and medications were the same in both groups. The patients' PBG, incidence of PONV, length of hospital stay, pain scores, and clinical data were collected and compared between the two groups.

Results

There were no significant differences in the general preoperative data between the DXM and non‐DXM groups. The average PBG and the proportion of patients with levels exceeding 200 mg/dL were not significantly different between the two groups (10.84 mg/dL vs. 11.05 mg/dL and 43.2% vs. 43.9%). The postoperative visual analog scale scores (3.67 vs. 2.48) and the incidence of PONV were significantly lower in the DXM than non‐DXM group (40% vs. 16%). The preoperative level of glycated hemoglobin accurately predicted PBG. Furthermore, there were no statistically significant differences in the incidence of early postoperative complications between the groups.

Conclusions

The administration of DXM after unilateral TKA can effectively reduce postoperative pain and suppress the occurrence of PONV without affecting PBG in patients with type 2 diabetes. In addition, the preoperative level of glycated hemoglobin can accurately predict PBG.
Inappropriate Shocks in Brugada Syndrome Patients With a Subcutaneous Implantable Cardioverter Defibrillator
Authors: Watanabe Masaya , Nanbu Tadafumi , Ishidoya Yuki , Suzuki George , Yotsukura Akihiko , Yoshida Izumi , Tanaka Yoshitaka , Inoue Kazushige , Mitsuishi Junko , Kanno Tomomi , Sakurai Masayuki , Anzai Toshihisa
Published: January 2025

Background

This study aimed to compare inappropriate shock (IAS) rates between subcutaneous implantable cardioverter‐defibrillator (S‐ICD) and transvenous ICD (TV‐ICD) in Brugada syndrome (BrS) patients and identify risk factors for IAS in S‐ICD use.

Methods

We enrolled consecutive patients with BrS who underwent ICD implantation between 2013 and 2023. Data on clinical characteristics, S‐ICD screening test data, and IAS occurrence were retrospectively analyzed.

Results

In total, 74 patients (40 with S‐ICDs and 34 with TV‐ICD) were enrolled in the study. During a median follow‐up of 4.6 years, IAS occurred in nine S‐ICD and three TV‐ICD patients, exhibiting a non‐statistically significant trend (log‐rank p = 0.103) toward a higher incidence in the S‐ICD group. The incidence of IAS related to non‐atrial tachyarrhythmia (non‐AT) causes was significantly higher in the S‐ICD group than in the TV‐ICD group (log‐rank p = 0.014). Fewer electrocardiography (ECG) sensing vectors passing the screening test at both the baseline and exercise test (hazard ratio [HR] 0.31, 95% confidence interval [CI] 0.09–0.85; p = 0.21) and detection of ATs (HR 5.25, 95% CI 1.15–24.05; p = −0.048) were associated with IAS in patients with S‐ICD.

Conclusion

No significant difference was observed in the overall incidence of IAS between the S‐ICD and TV‐ICD groups; however, IAS due to non‐AT causes occurred more frequently in the S‐ICD group. Fewer ECG sensing vectors passing screening were significantly correlated with the IAS when exercise test results were considered. Therefore, ECG screening, including exercise testing, is preferable for S‐ICD candidates.
Soil Microbial Mechanisms to Improve Pear Seedling Growth by Applying Bacillus and Trichoderma‐Amended Biofertilizers
Authors: Ma Yanwei , Zuohereguli Kuerban , Zhang Lisheng , Kang Yalong , Shi Liwen , Xu Hao , Ruan Yang , Wen Tao , Mei Xinlan , Dong Caixia , Xu Yangchun , Shen Qirong
Published: January 2025

Bacillus velezensis SQR9 or Trichoderma harzianum NJAU4742‐amended bioorganic fertilizers might significantly improve the soil microbial community and crop yields. However, the mechanisms these microorganisms act are far away from distinctness. We combined amplicon sequencing with culturable approaches to investigate the effects of these microorganisms on pear tree growth, rhizosphere nutrients and microbial mechanisms. The SQR9 and T4742 treatments increased the total biomass of pear trees by 68% and 84%, respectively, compared to the conventional organic fertilizer treatment (CK). SQR9 tends to increase soil organic matter and available phosphorus, while T4742 more effectively enhances nitrogen, potassium, iron and zinc levels. These effects were primarily linked to changes in the microbial community. T4742 treatment enriched twice as many differential microbes as SQR9. SQR9 significantly enriched Urebacillus, Streptomyces and Mycobacterium, while T4742 increased the abundance of Pseudomonas, Aspergillus and Penicillium. In vitro experiments revealed that secondary metabolites secreted by B. velezensis SQR9 and T. harzianum NJAU4742 stimulate the growth of key probiotics associated with their respective treatments, enhancing soil fertility and plant biomass. The study revealed the specific roles of these bioorganic fertilizers in agricultural applications, providing new insights for developing effective and targeted bioorganic fertilizer products and promoting sustainable agriculture.
PagSND1‐B1 Regulates Wood Formation by Influencing Phosphorus Absorption and Distribution in Poplar
Authors: Cheng Peisheng , Gong Liling , Bai Qiuxian , Dong Ning , An Yi , Jiang Chen , Huang Lichao , Lu Mengzhu , Zhang Jin , Chen Ningning
Published: January 2025

In natural environments, the growth and development of trees are continuously affected by phosphorus (P) starvation stress. However, the mechanisms through which trees balance stem growth and P distribution remain unknown. This study found that in the woody model species poplar, the P loss in stems is more severe than that in roots and leaves under P starvation conditions, thereby inhibiting stem development and reducing the expression of numerous genes related to wood formation, including PagSND1‐B1. Intriguingly, overexpression of PagSND1‐B1 in poplar enhances resistance to P starvation and promotes xylem development. Further analysis demonstrated that PagSND1‐B1 can directly and positively regulate the phosphorus transporter PagPHT1;5a. Analysis of P content changes in leaves, stems and roots of transgenic poplar before and after treatment indicated that overexpression of PagSND1‐B1 disrupts the normal P redistribution procedure, leading to increased P accumulation in stems, which is beneficial for xylem development. Therefore, PagSND1‐B1 participates in the phosphorus absorption and homoeostasis of poplar by modulating PagPHT1;5a. This study provides valuable insights into the regulatory function of PagSND1‐B1 in wood formation and the process by which trees balance phosphorus distribution and xylem development.
“It is Strange to Call an Uzbek, a Jew, or a Latvian, Russian”: Stalin’s Nationalities Policy and the Question of Jewish Assimilation Revisited
Authors: Shumsky Dmitry
Published: January 2025

The traditional Sovietological paradigm of Stalin’s nationalities policy—presented as an anti‐national policy geared toward the assimilation of non‐Russian ethnic groups in the supernational entity of the “Soviet people” and its Russian culture—has, in recent decades, given way to a more complex approach that has identified strong tendencies in the ideology and practice of Stalinist Bolshevism to foster “primordial” ethnic identities. Most of the historiography on Soviet Jews, however, has found it hard to break free of Cold‐War Sovietological assumptions and continues to view the policies of the Stalinist regime toward the Jews as seeking their assimilation and eventual disappearance. The present article attempts to re‐examine this view and point to the ambivalent and even negative attitude of Stalin and his acolytes to the issue of Jewish assimilation—this based on a closer reading of Stalin’s relevant writings and archival sources pertaining to the Birobidzhan project and the period of anti‐Jewish persecution, some of which have never been studied before, and on the critical insights of recent studies on the subject of Stalin’s nationalities policy.
Gingival Debulking Surgery for a Child With Severe Aplastic Anemia: A Case Report
Authors: Hurley Caitlin R. , Winters John , McAlpine Melanie , Ng Michelle , Anthonappa Robert P.
Published: January 2025

Introduction

Aplastic anemia (AA) is a rare condition that frequently manifests with pancytopenia. Management of severe disease is through either allogenic stem cell transplantation or immunosuppressive therapy with supportive care. Drug‐induced gingival overgrowth (DIGO) is a potential complication of a number of medications, including cyclosporine and amlodipine.

Case Report

The following report presents the case of a male child who was diagnosed with severe AA at 7 years of age. He was managed with immunosuppressive therapy and developed DIGO as a side effect of treatment, exacerbated by poor oral hygiene. Nonsurgical and surgical management strategies were utilized. Gingival debulking surgery was completed at 9 years of age, once the patient's condition had stabilized. Postoperative care included regular dental prophylaxis and oral hygiene instruction. The patient's medical condition remained stable, and his oral health was maintained without relapse of DIGO.

Conclusion

This case emphasizes the importance of coordinated care for managing DIGO in immunocompromised pediatric patients and describes the successful management of DIGO using both nonsurgical and surgical methods.
Breaking the glass ceiling: Statistical evidence of the gender effect in higher education leadership
Authors: Wu Allison
Published: January 2025

This study aims to explore the influence of female presidential leadership (gender effect) on the overall performance of universities in the United States. To achieve this research objective, data on the gender of university presidents from 1983 to 2022 were manually collected from 129 top universities in the USA. Using this dataset, a sample comprising two groups was constructed: a treatment group consisting of male‐to‐female presidential transitions and a control group comprising male‐to‐male presidential transitions. The hypothesis was tested through a difference‐in‐differences approach. The results of the study were also validated using parallel trend analysis. The results suggest that female presidents have a significant positive impact on university rankings. This means that female leadership is associated with improvements in university rankings, highlighting their potential contribution to the advancement of educational institutions and pursuit of excellence through policy decisions and leadership. Moreover, the difference‐in‐differences analysis results reveal that universities under the leadership of female presidents achieve higher rankings than those with male presidents, especially after presidential transitions. Thus, this study provides the first statistical evidence that female educators are more effective leaders in terms of university performance than their male counterparts.
Financial literacy for individuals with intellectual and developmental disabilities: Border crossing required
Authors: Kang Sungwoo , Kastberg Signe , Mason Benjamin
Published: January 2025

In the evolving landscape of financial literacy in education, this study aims to describe methodologies used in mathematics and special education research, specifically targeting individuals with intellectual and developmental disabilities (IDD). Based on a systematic review of research studies that addressed financial literacy for students with IDD, we analyzed definitions of financial literacy, educational objectives, and the differing strategies employed to meet those objectives and aligned target domains in financial literacy using Bloom's taxonomy. Our investigation reveals disciplinary differences in definitions, objectives, and strategies in studies from mathematics and special education. Mathematics education research encourages contextual problem‐solving, urging students to apply learned knowledge to practical situations, thereby facilitating advanced financial decision‐making skills. In a complementary view, special education research tends to focus on skill acquisition and maintenance that support student performance of essential financial tasks (identifying coins and their value). Both disciplines aim to enhance students' financial literacy, catering to the complex needs of individuals with IDD. This analysis underscores the need for an integrated approach to reinforce financial literacy and to promote more independent and community‐involved experiences for individuals with IDD.
Playing With Perceptions: Investigating Bias in Soccer Through Skin Tone Manipulation
Authors: Nesseler Cornel , Gasparetto Thadeu , Naidenova Iuliia , Parshakov Petr
Published: January 2025

Objective

This study aims to investigate implicit discrimination in soccer by examining whether participants’ evaluations of fouls are influenced by players’ skin color.

Methods

An optimal experimental design was developed where players’ skin color in soccer videos was artificially altered. Participants were asked to choose the most appropriate penalty for a player committing a foul. The data were analyzed using ordered logit regressions to assess whether skin color influenced the penalties assigned.

Results

Contrary to previous research and popular belief, the results show that participants’ penalty decisions were not significantly influenced by the players’ skin color.

Conclusions

The findings suggest that implicit discrimination may not be present in this context, challenging previous studies that found racial biases in sports. The experimental design and results lay the groundwork for further research into implicit bias in sports contexts.
Retrobulbar Infiltrative Lipoma in a Dog
Authors: Presley Trace , Sasaki Emi , de Cecco Bianca S. , Carter Renee T. , St. Blanc Alissa , Rademacher Nathalie , Camacho‐Luna Pilar
Published: January 2025

A 6‐year‐old castrated male mixed breed dog presented to the “Louisiana State University Veterinary Teaching Hospital &‐anonymized for review” ophthalmology service with marked exophthalmos and lagophthalmos of the left eye and soft tissue swelling medial to the zygomatic arch. A computed tomography (CT) scan was performed, and it revealed a well‐marginated, lobulated, homogenously fat density involving the retrobulbar space. Preliminary results of a fine‐needle aspirate (FNA) and biopsy were not conclusive, and a modified transfrontal orbitotomy was performed to remove the mass. Histopathological evaluation was diagnostic for retrobulbar infiltrative lipoma. Nine months after the surgery, the eye appears within normal limits with no evidence of recurrence.
Physiology of bridging stent grafts after fenestrated/branched endovascular aortic repair: Where translational science meets the clinical profile
Authors: Moothathamby Thurkga , Jubouri Matti , Rajasekar Tharun , Roy Subham , Alfwaress Maya , Rezk Samuel S. S. , Ghattas Samuel N. S. , D'Oria Mario , Bailey Damian M. , Williams Ian M. , Bashir Mohamad
Published: January 2025

Fenestrated/branched endovascular aortic repair emerges as the primary therapeutic modality for intricate aortic pathologies encompassing the paravisceral and thoracoabdominal segments, where bridging stent grafts (BSGs) play a vital role in linking the primary aortic endograft with target vessels. Bridging stent grafts can be categorized mainly into self‐expanding stent grafts (SESGs) and balloon‐expandable stent grafts (BESGs). Physiological factors significantly influence post‐complex endovascular aortic repair BSG behaviour, impacting clinical outcomes of SESGs and BESGs in different but overlapping ways. Crucial prerequisites for BSGs encompass not only flexibility but also resilience against mechanical stress and compliance mismatch, especially when bridging the rigid aortic main body with dynamic target vessels. The significance of considering these physiological factors in clinical decision‐making is underscored by recognizing the interplay between SESG and BESG characteristics, vessel physiology and patient haemorheology. Such factors include the anatomy and tortuosity of the vessel, diameter of the vessel and BSG, deployment and durability, extrinsic stenosis and respiratory motion. Haemorheological factors, such as anti‐thrombotic therapy and hydration status, need to be considered. This narrative review examines both in vitro and in vivo evidence regarding the impact of physiological factors on the behaviour of BSGs and assesses the consequences for clinical outcomes following complex endovascular aortic repair.
A Brayton Pumped Thermal Energy Storage System Based on Supercritical Carbon Dioxide Recompression Reheating Discharge Cycle
Authors: You Dongchuan , Tatli Akif Eren , Metghalchi Hameed
Published: January 2025

In recent years, renewable energy such as solar energy and large-scale energy storage, which is a very important technology to compensate for solar energy's fluctuation due to weather issues, have been extensively investigated. In this paper, a Pumped Thermal Energy Storage (PTES) cycle based on a supercritical carbon dioxide (sCO2) Recompression Reheating cycle and energy pump with a recuperator has been proposed and analyzed. Molten salt with varying temperatures of 565 °C to 730 °C has been used for energy storage. The pressure ratios have been fixed in the discharge cycle as 2.5, and in the charging cycle, it varies in order to find the optimum operation condition. Parametric studies have been made to determine the best performance of the new system. Molten salt temperature, split ratio, pressure ratio, and intermediate pressure have been varied in the calculation. Exergy analysis has been developed in order to determine exergy destruction in all components. Roundtrip efficiencies have been calculated over a wide range of operating conditions. Different working fluids such as argon, carbon dioxide, and nitrogen were used in both cycles. Performance was determined for different combinations of working fluids. It is concluded that for best performance working fluid for energy pump (charging) should be argon and carbon dioxide should be the working fluid for discharging cycle. For this combination operating at optimum molten salt temperature, intermediate pressure and split ratio in the discharging cycle, the roundtrip efficiency is 66%, which is the maximum.
A Design for Remanufacturing Framework Incorporating Identification, Evaluation, and Validation: A Case Study of Hydraulic Manifold
Authors: Liu Xinyang , Chung In-Bum , Behtash Mohammad , Davied Matthew , Thompson Todd , Lopez Richard , Lee Michael , Bishop William , Wang Pingfeng , Hu Chao
Published: January 2025

In recent years, academic researchers and engineers in the industry have widely recognized the necessity of integrating remanufacturing considerations into product design iterations to advance sustainability objectives. Acknowledging the importance of design for remanufacturing (DfRem), efforts were made to develop tools and guidelines that could be implemented in practice. However, such methods largely rely upon experiential insights and qualitative assessments, leaving a gap in the ability to quantitatively assess the economic and environmental impacts of design choices. To bridge this gap, we investigate existing efforts and present a framework for DfRem that integrates established design and remanufacturing practices into a cohesive workflow with quantitative assessments. To demonstrate its efficacy for making practical design changes for remanufacturing, we apply the framework to a hydraulic manifold in a transmission system for heavy-duty tractors. Through this industry-relevant case study, we focus on showcasing the practical utility of our framework. Based on the identified design modifications from remanufacturability analysis, we estimate the reductions in life cycle costs, energy consumption, and emissions. Afterward, the modifications are tested using physical experiments with plans for integration into future iterations of the hydraulic manifold design and production. We anticipate this framework can illustrate the process of remanufacturing that ensures improvements in sustainability while maintaining performance and reliability standards.
Integrity Evaluation of Boundary Function of Main Components in Nuclear Plants during Severe Accidents
Authors: Tsukimori Kazuyuki , Yada Hiroki
Published: January 2025

After the accident at the Fukushima Daiichi nuclear power plant, very strict safety measures were implemented for nuclear power plants in Japan. It thus becomes a crucial issue if the safety of a plant is maintained or not at beyond design basis events, that is, whether it is possible or not to keep radioactive materials inside the facility during severe accidents. In other words, it is crucial to determine whether the integrity of the boundary of the components that contain radioactive materials can be maintained under beyond design basis loading, such as during mega-earthquake and excessive temperature and/or pressure increase.

In this study, head plates and bellows were examined as components that compose the parts of the boundary of vessels that contain the primary coolant of a prototype fast breeder reactor. The behaviors of buckling, post-buckling deformation, and penetration failure, that is, loss of boundary function of these components with increasing pressure were investigated. The series of this research program started in FY2013 and the research proceeded step by step. The new result in this paper is the application of the proposed criteria to head plates and bellows, and a conservative estimation of penetration failure of these components is obtained.
Restoring cefepime activity against multidrug-resistant KPC-producing
Klebsiella pneumoniae
by combination with boronic acid inhibitors, MB076 and S02030
Authors: Rojas Laura J. , Nielsen Travis B. , Pantapalangkoor Paul , Taracila Magdalena A. , Introvigne Maria L. , Sharma Rajnikant , Yeshwante Shekhar , Mojica Maria F. , Papp-Wallace Krisztina M. , Hujer Andrea M. , Prati Fabio , Caselli Emilia , Spellberg Brad , Rather Philip N. , Rao Gauri G. , Bonomo Robert A.
Published: January 2025

Foremost in the design of new β-lactamase inhibitors (BLIs) are the boronic acid transition state inhibitors (BATSIs). Two highly potent BATSIs being developed are S02030 and MB076 strategically designed to be active against cephalosporinases and carbapenemases, especially KPC. When combined with cefepime, S02030 and MB076 demonstrated potent antimicrobial activity against laboratory and clinical strains of
Enterobacterales
expressing a variety of class A and class C β-lactamases, including
bla
KPC-2
and
bla
KPC-3
. Static time-kill assays revealed the bactericidal activity of cefepime in combination with S02030 and MB076 against a multidrug-resistant KPC-producing
K. pneumoniae
(KPC-
Kpn
-1), in which a ≥ 3-log
10
decrease in the bacterial density was observed by 6 h.
In vivo
efficacy of MB076 in combination with cefepime was evaluated in a lung infection model where male C57BL/6 mice were infected intranasally with KPC-
Kpn
-1. Cefepime alone administered at 2 h post infection resulted in a 1.07 log
10
CFU reduction at 24 h, while cefepime in combination with MB076 resulted in an enhanced reduction of 2.70 log
10
CFU (
P
< 0.0001) compared to the no treatment control group. In a survival analysis where mice were infected via the tail vein with KPC-
Kpn
-1
,
all mice treated with placebo or cefepime alone (100 mg/kg) died, whereas those treated with a 1:4 molar ratio of cefepime-MB076 survived. Our data demonstrate bactericidal activity and
in vivo
efficacy of cefepime-MB076 comparable to ceftazidime-avibactam and support the continued development of this combination as a new treatment option for infections caused by class A carbapenemase producing
Enterobacterales,
particularly KPC-
Kpn
.
Positive feedback regulation between RpoS and BosR in the Lyme disease pathogen
Authors: Raghunandanan Sajith , Priya Raj , Lin Gaofeng , Alanazi Fuad , Zoss Andrew , Warren Elise , Stewart Philip , Yang X. Frank
Published: January 2025

In
Borrelia burgdorferi
, the causative agent of Lyme disease, differential gene expression is primarily governed by the alternative sigma factor RpoS (σ
S
). Understanding the regulation of RpoS is crucial for elucidating how
B. burgdorferi
is maintained throughout its enzootic cycle. Our recent studies have shown that the homolog of Fur/PerR repressor/activator BosR functions as an RNA-binding protein that controls the
rpoS
mRNA stability. However, the mechanisms regulating BosR, particularly in response to host signals and environmental cues, remain largely unclear. In this study, we uncovered a positive feedback loop between RpoS and BosR, wherein RpoS post-transcriptionally regulates BosR levels. Specifically, mutation or deletion of
rpoS
significantly reduced BosR levels, whereas artificial induction of
rpoS
resulted in a dose-dependent increase in BosR levels. Notably, RpoS does not affect
bosR
mRNA levels but instead modulates the turnover rate of the BosR protein. Moreover, we demonstrated that environmental cues do not directly influence
bosR
expression but instead induce
rpoS
transcription and RpoS production, thereby enhancing BosR protein levels. These findings reveal a new layer of complexity in the RpoN-RpoS regulatory pathway, challenging the existing paradigm and suggesting a need to re-evaluate the factors and signals previously implicated in regulating RpoS via BosR. This study provides new insights into the intricate regulatory networks underpinning
B. burgdorferi
’s adaptation and survival in its enzootic cycle.

IMPORTANCE

Lyme disease is the most prevalent arthropod-borne infection in the United States. The etiological agent,
Borreliella
(or
Borrelia
)
burgdorferi
, is maintained in nature through an enzootic cycle involving a tick vector and a mammalian host. RpoS, the master regulator of differential gene expression, plays a crucial role in tick transmission and mammalian infection of
B. burgdorferi
. This study reveals a positive feedback loop between RpoS and a Fur/PerR homolog. Elucidating this regulatory network is essential for identifying potential therapeutic targets to disrupt
B. burgdorferi
’s enzootic cycle. The findings also have broader implications for understanding the regulation of RpoS and Fur/PerR family in other bacteria.
Evaluation of tumor-colonizing
Salmonella
strains using the chick chorioallantoic membrane model
Authors: Mon Khin K. Z. , Kenney Linda J.
Published: January 2025

The chick embryo chorioallantoic membrane (CAM) tumor model is a valuable preclinical model for studying the tumor-colonizing process of
Salmonella enterica
serovar Typhimurium. It offers advantages such as cost-effectiveness, rapid turnaround, reduced engraftment issues, and ease of observation. In this study, we explored and validated the applicability of the partially immune-deficient CAM tumor model. Herein, we demonstrate that
Salmonella
preferentially colonizes tumors and directly causes tumor cell death. Bacterial migration, tumor colonization, and intra-tumor distribution did not require flagellar-mediated motility. The vast majority of
Salmonella
that colonized the CAM tumor were extracellular. Thus, tumor invasion was independent of both
Salmonella
pathogenicity island-1-encoded and
Salmonella
pathogenicity island-2-encoded type III secretion systems. Surprisingly, the extracellular residence of
Salmonella
on CAM tumors did not require biofilm formation. We evaluated our wild-type parental strain compared to the attenuated clinical strain VNP20009 and discovered a reduced tumor colonization capability of VNP20009. The inability to effectively colonize CAM tumors potentially explains the reduced anti-tumor efficacy of VNP20009. Our work establishes the xenograft CAM model as an informative and predictive screening platform for studying tumor-colonizing
Salmonella
.

IMPORTANCE

Cancer has a major impact on society, as it poses a significant health burden to human populations worldwide.
Salmonella
Typhimurium has demonstrated promise in cancer treatment by exerting direct tumoricidal effects and enhancing host-mediated anti-tumor immunity in xenograft mouse studies. A general understanding of its pathogenesis and the relative ease of genetic manipulation support the development of attenuated strains for therapeutic use. Alternative
in ovo
models, such as the chorioallantoic membrane tumor model, present a suitable screening platform to accelerate the development of therapeutic strains. It allows for rapid evaluation of
Salmonella
strains to assess their efficacy and potential as oncolytic agents. The present study establishes that the
in ovo
tumor model can be utilized as a preclinical tool for evaluating oncolytic
Salmonella
, bridging the gap between
in vitro
and
in vivo
screening.
In vitro
dynamics of rumen microbiota and fermentation profiles with Antler growth of Sika deer
Authors: Li Songze , Wang Shaoying , Zhu Yuhang , Mu Ruina , Wang Tao , Zhen Yuguo , Si Huazhe , Du Rui , Li Zhipeng
Published: January 2025

The rumen microbiota plays a vital role in the nutrient metabolism affecting the growth of velvet antler. However, the fermentation patterns and dynamics of the rumen microbiota across growth stages of velvet antler remain largely unexplored. Here, we employed an
in vitro
fermentation approach to assess fermentation parameters and microbial composition in the rumen liquid of sika deer during the early growth (EG), metaphase growth (MG), and fast growth (FG) phases . Our findings indicated that the levels of short-chain fatty acids (SCFAs), ammonia nitrogen, and gas production increased over fermentation time in all three groups. The concentrations of total SCFAs, ammonia nitrogen, and gas production, along with the proportions of butyrate, isobutyrate, and isovalerate, were markedly higher in the MG and FG groups compared with the EG group. Principal coordinate analysis highlighted significant variations in microbial communities among the EG, MG, and FG groups during the fermentation process. The abundances of
Stomatobaculum
and
Blautia
across the three groups increased over fermentation time, whereas
Bacteroides
,
Lawsonibacter
,
Sporobacter
,
Papillibacter
,
Butyricicoccus
, and
Succiniclasticum
exhibited higher abundances in MG or FG groups than in the EG group after 24 hours of fermentation. Co-occurrence network analysis uncovered positive correlations between butyrate levels and butyrate-producing bacteria (
Stomatobaculum
,
Butyrivibrio
) in the MG and FG groups. Additionally, there were positive correlations between proteolytic bacteria (
Clostridium
and
Roseburia
) and branched-chain volatile fatty acids in the FG group. These findings shed light on the fermentation patterns and microbial dynamics within the rumen of sika deer during different growth periods of velvet antler.

IMPORTANCE

Velvet antlers are distinctive and rapidly growing organs that hold significant value in traditional medicine. Through
in vitro
analysis, our study characterized the dynamics of microbiota and metabolites within the rumen liquid fermentation of sika deer throughout the different antler growth phase. We identified distinct microbial communities at various fermentation time points and observed shifts in fermentation patterns that paralleled antler development. These findings suggest a potentially pivotal role for these microbial dynamics in facilitating the growth process of velvet antlers.
Comprehensive management and oral rehabilitation of amelogenesis imperfecta: a multidisciplinary treatment approach
Authors: Dixit Disha , Kaushal Shalini , Pathak Anjani Kumar , Lal Nand
Published: January 2025

Amelogenesis imperfecta (AI) is a genetic disorder that affects both primary and permanent teeth. It primarily manifests as developmental disorders of enamel. The condition occurs independently of other systemic disorders and is caused by mutations in genes responsible for enamel formation, inherited in autosomal dominant, autosomal recessive or X-linked patterns. Diagnosis of AI involves a combination of clinical examination, medical history review and imaging studies. Clinicians typically look for characteristic signs such as abnormal enamel colour, texture and thickness, with family history also playing an important role. AI can present as hypoplastic, hypocalcified or hypomaturation defects, leading to issues like tooth sensitivity, poor aesthetics and reduced vertical dimension. Genetic counselling is advised for families to understand the hereditary nature of AI. Effective management of AI requires comprehensive care, regular monitoring and personalised treatment plans with a multidisciplinary approach to improve both the functionality and aesthetics of the patient.
Endovascular management of an aortic injury in thoracic kyphosis surgery: a minimally invasive rescue for a life-threatening injury
Authors: Mehra Rohit , Swain Pranati , Sharma Vyom , Puri Sanjay
Published: January 2025

A patient in his early adolescence, who was treated for T5-T6 tubercular spondylodiscitis with an un-instrumented decompression, presented at 36 months post-index surgery, for post-laminectomy instability and kyphosis, after completing his requisite antitubercular treatment. He underwent thoracic posterior instrumented kyphosis correction and anterior reconstruction, with a T5-T6 partial corpectomy and corpectomy spacer placement, through a posterior midline incision. On the second postoperative day, he started complaining of pain on the left side of his chest, abdomen and left shoulder. On contrast-enhanced CT evaluation, one of the pedicle screws was found to be impinging on the aortic wall, with contrast opacification in the left hemithorax. After resuscitation, he underwent a minimally invasive endovascular procedure (thoracic endovascular aortic repair, TEVAR), circumventing the need for a complex and morbid open thoracic repair in an adolescent. Post-TEVAR, the pedicle screw realignment was done. The patient has now returned to full daily activities and a normal schooling.
Enhancing patient safety and risk management through clinical pathways in oncology
Authors: Milanesi Marco , Fiorito Rita , Caloccia Lara , Guglielmetti Chiara , Giganti Giulia , Andreasi Sara Elisa , Triarico Antonio
Published: January 2025

The increasing emphasis on risk management and quality assessment in hospital management necessitates strict adherence to government and international standards. Those standards are particularly important, and certification requirements further underscore this need. The objective of this paper is to outline the application of the INTegrated Audit Model in a Comprehensive Cancer Center. This model represents a revised version of Tracer Methodology, for audit surveys, aimed at aligning audit activities with UNI EN ISO 9001:2015 and Joint Commission Standards for quality, patient safety and clinical risk management.

Using the INTegrated Audit Model, a total of 7 tracers were conducted, and 31 units underwent auditing during the period spanning from 2022 to 2023. Each audit inquiry was documented, categorised and cross-referenced with International Organization for Standardization (ISO) and Joint Commission International (JCI) standards. Areas exhibiting the highest incidence of non-conformities and observations were systematically linked to relevant standards. Subsequently, a comprehensive analysis was conducted on the ensuing findings.

The INTegrated Audit Model allowed for systematic data collection across clinical pathways, revealing prevalent issues and areas for improvement in patient care. By aligning identified topics with ISO and JCI standards, compliance with international guidelines was assessed, offering units insight into their current status and areas for enhancement.

Overall, both auditees and auditors expressed satisfaction with the methodology and continuous training, highlighting its effectiveness in fostering collaboration, improving time management and promoting adherence to accreditation standards.

The study highlights the effectiveness of the methodology in monitoring unit activities and adherence to clinical pathways and international standards applied to an oncological setting. Audits conducted with this approach provided a thorough assessment of critical areas impacting patient care and clinical governance, contributing to a comprehensive understanding of service delivery.