bluuebunny/crossref_metadata_2025 huggingface dataset:
Research on Wellbore Blockage Mechanism and Blockage Removal Technology of Shale Gas Wells
Authors: Yuan Yaoshun , Du Juan , Liu Pingli , Zou Qi , Chen Xiang , Liu Jinming
Published: November 2024

With the continuous extension of development time, the production decline of single well is accelerated, and the problem of wellbore blockage in shale gas wells is prominent. The problem of wellbore blockage seriously restricts the stable production and efficient development of gas fields. In this paper, the ‘micro + macro’ analysis method is used to study the blockage. It is found that the wellbore blockage mainly includes corrosion, scaling products and a small amount of clay minerals brought by the reservoir during gas production. In the process of production, corrosion and scaling mechanism work together. Acidic gas such as CO2 in shale gas are dissolved in high-salinity formation water, causing electrochemical corrosion of the string. The formation of corrosion products will promote the deposition and adsorption of inorganic scales. The uneven accumulation of corrosion product films will enhance the surface roughness of the substrate and accelerate the deposition of scale samples around the crystal nucleus. At the same time, scaling will cause corrosion under the scale of the pipe string. Cl− can penetrate into the film through the micropores covering the product film on the metal surface, and pitting corrosion occurs to corrode the pipe string. Finally, the corrosion and scaling products together cause the pipe string to be blocked. Based on the analysis results of blockages and water samples, a blockage removal liquid system was developed according to the blockage mechanism. It has a high dissolution ability and the corrosion of 125SG, 155V and N80 steel sheets at 60°C for 4h is less than 1 g/(m2·h), which meets the requirements of industry standards. This system can inhibit the secondary precipitation of metal ions, has low corrosion damage to oil and casing, can remove wellbore blockage, does not need to flow back, will not cause secondary damage to the reservoir. It can provide guiding significance for similar shale gas well wellbore blockage removal.
Medieval physics at Oxford: who, what and why?
Authors: Hannam James
Published: November 2024

The University of Oxford was an important centre for natural philosophy including physics in particular during the Middle Ages. Among several important figures, the so-called Merton Calculators hold pride of place for their work integrating mathematics into physics. Their advances were influential across western Europe and formed part of Galileo Galilei’s new science of kinematics in the seventeenth century. The surviving syllabi show that Oxford students were expected to cover Aristotle’s natural philosophy in some detail, as well as the four branches of mathematics: arithmetic, music, geometry and astronomy.
Dynamic optimization design of thin plate structure based on surrogate model
Authors: Ma Weijie , Nie Kun , Wang Shaowei
Published: November 2024

To enhance dynamic optimization efficiency in traditional thin plate structures, surrogate models are integrated for structural dynamic size optimization, reducing dependence on high-precision finite element simulations. This paper focuses on optimizing the aluminum alloy sheet as the subject of research. The parameters of the specimen are optimized through sensitivity analysis, based on the comparison between the free mode Finite Element Analysis (FEA) and Experimental Modal Analysis (EMA) results. The modified specimen undergoes validation under a four-edge clamped boundary condition. Subsequently, random vibration analysis is conducted to determine the root mean square (RMS) value of the acceleration response. Employing surrogate model technology, four models are constructed using parametric modeling and experimental design methods. These models are then compared for their fitting effectiveness. The results indicate that the RBF model exhibits the highest accuracy in fitting each response, effectively replacing dynamic simulation. Finally, the RBF combined with the NSGA-II method, optimizes the specimen’s structural size, resulting in a 21.6% reduction in mass and an 18.60% decrease in acceleration response. These outcomes demonstrate satisfactory optimization results, ensuring accuracy while enhancing the dynamic characteristics of the specimen structure. This research offers valuable insights for related engineering applications.
Research on the trajectory tracking method of aircraft towing systems based on nonlinear control
Authors: Cui Yuxin , Yao Zhining , Zhang Hongyan , Ni Tao , Wang Chaofei
Published: November 2024

In this paper, for the towing problem of wheeled aircraft, an automatic control method is proposed based on the nonlinear control theory, which realizes the trajectory tracking of the aircraft by controlling the velocity of the towing point of the aircraft, so as to realize the aircraft’s outbound and inbound operations. Firstly, based on the nonholonomic constraint theory, the mathematical model of the aircraft towing system is established, and the kinematic relationship between the aircraft towing point and the aircraft is obtained. Then, a controller is designed based on the nonlinear control theory, and the stability analysis is carried out using the Lyapunov method to realize the trajectory tracking of the aircraft traction system. Finally, the effectiveness and accuracy of the control method are verified by the combination of MATLAB simulation analysis and scaled-down model experiment. The results show that the proposed control method can realize the trajectory control of the aircraft towing system.
The Fate of Creative Ideas
Authors: Honneth Axel
Published: November 2024

This paper explores Max Weber’s reasons for claiming that morally exemplary ideas with some regularity produce the unwanted result of highly dubious ethical consequences. The diagnosis of such “normative paradoxes” is Weber’s attempt to refute the optimistic philosophies of history with their own tools. If the philosophy of the Enlightenment assumed that bold, progressive ideas could steer the world toward improvement, Weber sought to demonstrate that the opposite was true: once such ideas became historically effective, there was a certain inevitability with which they produced evil and social harm. It will be shown that Weber thought he could justify this thesis by demonstrating that it is ultimately the givens of human nature that stand in the way of any linear and faithful realization of morally well-intentioned ideas, and even cause them to be transformed into their opposites.
Objectify Yourself!
Authors: Helbig Daniela K
Published: November 2024

This chapter examines Marianne Weber’s reflections on the separability between thought and personality. While this question has become an important aspect of Max Weber’s reception history, Marianne Weber did not pose it as a historiographical or biographical problem but rather in the context of her work as a leader of the bourgeois German women’s movement. Retracing her response to Georg Simmel’s views on women’s contribution to what he called objective culture, the chapter shows how Marianne Weber turned a striving for objectified detachment from the personal into a practical life task for the women of her generation. In its normative function for individual lives, it was a task comparable to the duties that Max Weber posited for the life of the scholar, grounded in his methodological notion of objectivity.
Caesarism and Democratic Agency in Max Weber
Authors: Whimster Sam
Published: November 2024

Weber’s types of legitimate domination are used to conduct both a critique and defense of democracy. The rise of figures such as Presidents Donald Trump, Jair Bolsonaro, Narendra Modi, and Viktor Orbán is presented in terms of a caesarist rather than a charismatic model. Caesarism attacks the legal-rational legitimacy of politics and the normalization of politics by democratic parliamentary parties and officials. Legitimacy for Weber is the believability of rule by the ruled, but democracy demands co-rule and involves a commitment to ideas in their own right such as natural law. The caesarist leader generates validity of rule through demagoguery and the emotionalization of politics. Caesarism is illustrated by nineteenth-century American politics—city bosses and the spoils system—and by the rise of Donald Trump. Every democracy, says Weber, has the tendency to select its leader in the direction of caesarism. Trump’s self-acclamation as the winner of the 2019 presidential election, using Weber’s theory, should be countered by Congress as the parliamentary guarantee against the caesarist dictator. Weber assumes that the rule of law is upheld, but parliamentarians must speak up for democracy. UK Prime Ministers Blair and Johnson are analyzed as caesarist leaders.
Art Museums as Catalysts for Human Flourishing
Authors: Bostwick Davis Elliot
Published: November 2024

This chapter examines art museums as catalysts for human flourishing. It develops the argument that art museums offer numerous opportunities to promote and sustain human flourishing. Quantitative metrics of art museums’ success and social media engagement do not adequately measure how art museums support and expand the ability of visits to experience greater well-being. Inspired by audience responses to the opening of the Art of the Americas Wing at the Museum of Fine Arts, Boston (MFA), the chapter describes the development of new metrics for measuring flourishing in conjunction with a 2018 MFA pilot exhibition about Native American art. The chapter concludes that art, whether accessed in a museum or via a range of digital formats, will continue to serve as an essential, public resource for cultivating a greater sense of well-being and flourishing.
Root system architecture reorganization under decreasing soil phosphorus lowers root system conductance of Zea mays
Authors: Bauer Felix Maximilian , Baker Dirk Norbert , Giraud Mona , Baca Cabrera Juan Carlos , Vanderborght Jan , Lobet Guillaume , Schnepf Andrea
Published: November 2024

Background and Aims

The global supply of phosphorus (P) is decreasing. At the same time, climate change is reducing the availability of water in most regions of the world. Insights into how decreasing P availability influences plant architecture are crucial to understanding its influence on plant functional properties, such as the root system’s water uptake capacity.

Methods

In this study, we investigated the structural and functional responses of Zea mays to varying P fertilization levels focusing especially on the root system’s conductance. A rhizotron experiment with soils ranging from severe P deficiency to sufficiency was conducted. We measured the architectural parameters of the whole plant and combined them with root hydraulic properties to simulate time-dependent root system conductance of growing plants under different P levels.

Key Results

We observed changes in the root system architecture, characterized by decreasing crown root elongation and reduced axial root radii with declining P availability. Modelling revealed that only plants with optimal P availability sustained a high root system conductance, while all other P levels led to a significantly lower root system conductance, under both light and severe P deficiency.

Conclusion

We postulate that P deficiency decreases root system conductance, which could mitigate drought conditions through a more conservative water use strategy, but ultimately reduces biomass and impairs root development and overall water uptake capacity. Our results also highlight that the organization of the root system, rather than its overall size, is critical for estimating important root functions.
A Prospective, Randomized, Controlled Trial of Methylene Blue Injection for Costal Cartilage Harvest Postoperative Analgesia
Authors: Zhang Ziang , Zhu Ziyu , Liu Hengxin , Chen Jie , Jin Changxin , Zhang Xi
Published: November 2024

Background

In plastic surgery, costal cartilage is an excellent support material. However, postoperative pain from costal cartilage harvesting can impact patient recovery and satisfaction with the surgery. Recent reports have shown that methylene blue (MB) is an effective local analgesic in postoperative management.

Objectives

We aimed to evaluate the safety and effectiveness of MB for pain relief in patients undergoing costal cartilage harvesting.

Methods

A total of 106 patients undergoing costal cartilage harvesting surgery were selected from the plastic surgery department between December 2022 and March 2024. They were randomly divided into 2 groups: the MB group and the ropivacaine group, with 53 patients in each group. Pain levels were assessed with a numerical rating scale, the Insomnia Severity Index (ISI), arm elevation angle, and postoperative satisfaction scales at 1 day, 3 days, 5 days, 1 week, 1 month, and 3 months postoperatively.

Results

Patients receiving MB exhibited a significant decrease in pain scores from 5 days to 1 month of treatment compared to the ropivacaine group. Additionally, in the MB group there was an improvement in ISI scores from 5 days to 1 month compared to the ropivacaine group. Furthermore, during the 3-month follow-up, the MB group had significant increases in satisfaction scores compared to the control group. Arm elevation angle in the MB group was significantly higher compared to the ropivacaine group at 5 days, 1week, and 1month. No serious adverse events were reported, with only 2 patients experiencing an allergic rash.

Conclusions

Methylene blue demonstrated significant pain reduction with minimal adverse effects.

Level of Evidence: 3 (Therapeutic)
Inflammageing, a targetable pathway for preventing cardiovascular diseases
Authors: Aranda Juan Francisco , Ramírez Cristina M , Mittelbrunn María
Published: November 2024

Inflammageing, characterized by persistent chronic inflammation in older adults, has emerged as a critical factor linked to age-related diseases, such as cardiovascular diseases (CVDs), metabolic disorders, and cognitive decline, which collectively contribute to the leading causes of death globally. Elevated levels of cytokines, chemokines, and other inflammatory mediators characterize inflammageing and serve as indicators of biological age. Among the causes of inflammageing, deterioration of the immune system, mitochondrial dysfunction, dysbiosis, accumulation of DAMPs, together with genetic or epigenetic factors, contribute to inflammageing not only in CVD but also in other age-related conditions. This review examines the causes and consequences of inflammageing, particularly its implications for atherosclerosis and heart failure with preserved ejection fraction and explores potential strategies to mitigate it in the onset of CVD.
Use of Modified Multiplier of the Simple Endoscopic Score for Crohn’s Disease Endoscopic Improvement Thresholds Enhances Effect Size Differentiation Between Adalimumab Versus Placebo: A Post Hoc Analysis of the EXTEND Trial
Authors: Wong Emily C L , Dulai Parambir S , Marshall John K , Laroux Stephen , Jairath Vipul , Reinisch Walter , Narula Neeraj
Published: November 2024

Introduction

The Modified Multiplier of the Simple Endoscopic Score for Crohn’s Disease (MM-SES-CD) refines the assessment of endoscopic CD severity by differentially weighting parameters in the original SES-CD. A threshold of <22.5 for MM-SES-CD suggests endoscopic remission (ER) and correlates with a low risk of long-term disease progression. This study examines whether MM-SES-CD-defined ER and response criteria are more sensitive to treatment effects compared to conventional SES-CD definitions.

Methods

This post hoc analysis of the EXTEND (extend the safety and efficacy of adalimumab through endoscopic healing) trial compared various SES-CD and MM-SES-CD definitions of ER and endoscopic response in CD patients treated with adalimumab or placebo. The study included participants with moderate–severe CD and a baseline MM-SES-CD score ≥ 22.5. The primary outcome of ER, defined as MM-SES-CD < 22.5, was evaluated at Weeks 12 and 52. Area under the curve (AUC) analyses compared thresholds for predicting Week 52 ER.

Results

Of the 100 participants (77.5% of the EXTEND population), 51 received adalimumab and 49 received placebo. At Week 12, 62% achieved MM-SES-CD ≥ 20% reduction from baseline, compared to 39% with SES-CD ≥ 50% reduction. At Week 52, 56.9% of adalimumab-treated participants achieved MM-SES-CD < 22.5, compared to 10.2% in the placebo group. Modified Multiplier of the Simple Endoscopic Score for Crohn’s Disease ≥ 20% reduction at Week 12 better predicted Week 52 ER than SES-CD ≥ 50% reduction (AUC: 0.73 vs 0.62, p = 0.002).

Conclusion

MM-SES-CD definitions improved discrimination between treatment and placebo and offered superior predictive accuracy for Week 52 ER. Its use may enhance trial efficiency and better predict long-term disease outcomes.
Residual pulmonary stenosis and right ventricular contractility in repaired tetralogy of Fallot
Authors: Tominaga Yuji , Iwai Shigemitsu , Taira Masaki , Tsumura Sanae , Kurosaki Kenichi , Sakaniwa Ryoto , Ueno Takayoshi , Miyagawa Shigeru ,   Congenital Osaka Cardiovascular Surgery Research (COSCAR) Group
Published: November 2024

OBJECTIVES

The impact of residual pulmonary stenosis (rPS) or right ventricular (RV) outflow tract obstruction on prognosis after surgical pulmonary valve insertion) in repaired tetralogy of Fallot patients with pulmonary regurgitation (PR) remains controversial. rPS assessment is partially dependent on RV contractility. We investigated the impact of rPS according to RV ejection fraction (RVEF).

METHODS

In this multicentre, retrospective study, 117 repaired tetralogy of Fallot patients who underwent surgical pulmonary valve insertion for more than moderate PR between 2003 and 2021 were examined. Regarding rPS, the threshold for PR with rPS (PSR) and PR was 25 mmHg. For RVEF, the threshold for preserved RVEF (pEF) and reduced RVEF (rEF) was 40%. The patients were divided into 4 groups: patients with PR and pEF (PR-pEF) (n = 48), those with PR and rEF (PR-rEF) (n = 44), those with PSR and pEF (PSR-pEF) (n = 16), and those with PSR and rEF (PSR-rEF) (n = 9). Clinical parameters, postoperative adverse event rates and their associations were studied.

RESULTS

The 5-year freedom from adverse cardiovascular events was the highest in the PSR-pEF and the lowest in the PSR-rEF groups. The PSR-rEF group had the highest RV end-diastolic pressure (RVEDP) (12 ± 2.2 mmHg) (P = 0.006). From multivariable analysis, RVEDP was associated with postoperative adverse events (P = 0.016). RVEDP > 8 mmHg was associated with a lower freedom from adverse events.

CONCLUSIONS

The freedom from adverse events was the lowest in the PSR-rEF group, with the highest RVEDP, suggesting RV systolic and diastolic dysfunction. Reduced RVEF may mask the intrinsic degree of residual stenosis, delay surgical pulmonary valve insertion timing and increase adverse events.
Predictive and prognostic factors in patients with anaplastic lymphoma kinase rearranged early-stage lung adenocarcinoma
Authors: Gallina Filippo Tommaso , Cecere Fabiana Letizia , Tajè Riccardo , Bertolaccini Luca , Casiraghi Monica , Spaggiari Lorenzo , Cannone Giorgio , Busetto Alberto , Rea Federico , Martucci Nicola , De Luca Giuseppe , Mercadante Edoardo , Mazzoni Francesca , Bongiolatti Stefano , Voltolini Luca , Melis Enrico , Sperduti Isabella , Cappuzzo Federico , Rayes Roni , Ferri Lorenzo , Facciolo Francesco , Spicer Jonathan
Published: November 2024

OBJECTIVES

This study aimed to evaluate the predictive and prognostic factors in clinical stage I, anaplastic lymphoma kinase (ALK)-rearranged lung adenocarcinoma following radical surgery. Additionally, it sought to compare these factors with an external cohort of ALK wild-type patients.

METHODS

A multicentric, retrospective, case–control analysis was conducted on patients with clinical T1-2 N0 ALK-rearranged lung adenocarcinoma who underwent anatomical resection and radical lymphadenectomy. Data were collected from 5 high-volume oncological centres. An external cohort of ALK wild-type patients was also analysed for comparison. Survival analyses were performed using the Kaplan–Meier method, and multivariable Cox regression analysis was used to identify prognostic factors.

RESULTS

From January 2016 to December 2022, 63 patients with ALK-rearranged lung adenocarcinoma were included. High-grade tumours (G3) significantly associated with upstaging (odds ratio = 3.904, P = 0.04). Disease-free survival (DFS) and overall survival were significantly improved in upstaged patients receiving adjuvant treatment [hazard ratio (HR) = 0.18, P = 0.0042; HR = 0.24, P = 0.0004, respectively]. The solid or micropapillary histological subtypes were independently associated with worse DFS (HR = 3.41, P = 0.022). Comparison with 435 ALK wild-type patients showed worse DFS in the ALK-rearranged group (HR = 2.09, P = 0.0003). ALK-rearranged patients had higher rates of nodal upstaging, systemic and brain recurrences.

CONCLUSIONS

Clinical T1-2 N0 ALK-rearranged lung adenocarcinoma is an aggressive disease with a specific tropism for lymph nodes and the brain. High-grade tumours are predictive of nodal upstaging. Adjuvant treatment significantly improves DFS and overall survival in upstaged patients, highlighting the need for personalized preoperative staging and post-surgical management in this cohort.
Saccharomyces Genome Database: advances in genome annotation, expanded biochemical pathways, and other key enhancements
Authors: Engel Stacia R , Aleksander Suzi , Nash Robert S , Wong Edith D , Weng Shuai , Miyasato Stuart R , Sherlock Gavin , Cherry J Michael
Published: November 2024

Budding yeast (Saccharomyces cerevisiae) is the most extensively characterized eukaryotic model organism and has long been used to gain insight into the fundamentals of genetics, cellular biology, and the functions of specific genes and proteins. The Saccharomyces Genome Database (SGD) is a scientific resource that provides information about the genome and biology of S. cerevisiae. For more than 30 years, SGD has maintained the genetic nomenclature, chromosome maps, and functional annotation for budding yeast along with search and analysis tools to explore these data. Here, we describe recent updates at SGD, including the 2 most recent reference genome annotation updates, expanded biochemical pathway representation, changes to SGD search and data files, and other enhancements to the SGD website and user interface. These activities are part of our continuing effort to promote insights gained from yeast to enable the discovery of functional relationships between sequence and gene products in fungi and higher eukaryotes.
A pre- and postnatal immune challenge influences muscle growth and metabolism in weaned pigs
Authors: Dobbins Thomas W , Fuerniss Luke K , Hernandez Manuel S , Johnson Bradley J , Petry Amy L , Broadway Paul R , Burdick Sanchez Nicole C , Legako Jerrad F
Published: November 2024

The in utero environment is key to both fetal and postnatal growth and development. The objective of this study was to determine if administration of an acute low-dose lipopolysaccharide (LPS) to gestating sows during mid to late gestation and postweaning would alter the offsprings metabolomic profile of the longissimus dorsi (LD) and muscle ultrastructure. Pregnant Camborough sows were randomly assigned to receive LPS (LPS; n = 7) at a dose of 2.5 µg/kg or saline (CON; n = 7) on 78 ± 1.8 d of gestation. At weaning (21 ± 1.3 d of age), barrows (CON n = 17; LPS n = 17) from each treatment were selected to receive a secondary LPS. Barrows were administered the secondary LPS challenge at a dose of 10 µg/kg 7 d post weaning. Twenty-four hours after the postnatal LPS dose, barrows (31 ± 1.3 d of age) were euthanized, and each LD was removed. The left LD was utilized for morphometric measurements. Two samples from the medial section of the right LD were preserved for immunohistochemical measurements and metabolomic analyses. Mass spectral data were deconvoluted, aligned, and annotated using MS-DIAL. Univariate and multivariate analyses were conducted using MetaboAnalyst. Pathway analysis was conducted and compared to the Homo sapiens pathway library. Morphometric and immunohistochemical measurements were analyzed using the MIXED procedure of SAS version 9.4. Significance for all analyses was declared at P ≤ 0.05 and tendencies were considered at P ≤ 0.10. Average diameter of myosin heavy chain (MHC) type I and IIB/X fibers was increased (P ≤ 0.048) in LPS offspring compared with CON. Average cross-sectional area was increased (P = 0.030) in MHC IIB/X fibers and tended to be increased (P = 0.080) in MHC I fibers of LPS offspring. There were no differences (P = 0.186) between treatment groups for total nuclei or nuclei positive for MYF5, PAX7, or MYF5 and PAX7 nuclei. Metabolomic analyses identified 14 differentially expressed (P < 0.05) metabolites in the LD between treatment groups. There were 10 metabolites within the LD that tended (P ≤ 0.096) to differ between treatment groups. Thus, this study shows that in utero immune stimulation using LPS in gestating sows and a subsequent LPS challenge postnatally alters the metabolomic profile and muscle ultrastructure of the LD in weaned pigs.
Introducing a droit de suite through NFTs in Japan: legal hurdles
Authors: Fafet Manon
Published: November 2024

The Droit de Suite (DDS), designed to offer heightened protection for artists, remains absent from Japan’s legislative framework, potentially creating disparities among creators. The implementation of DDS in Japan encounters hurdles due to its administration’s intricate nature and associated costs. Non-Fungible Tokens (NFTs) have emerged as a promising solution, streamlining DDS processes through token transactions and obviating the need for time-intensive identification procedures. Japanese NFT exchange platforms have already begun providing DDS services, contributing to a more efficient and equitable system. This article delves into the legal complexities of integrating NFTs into the DDS structure, examining their enforceability in Japanese courts and evaluating the efficacy of tokenization within the country. While the discussion is primarily theoretical, the paper explores the concept of DDS, scrutinizes the essence and validity of NFT technology’s cornerstone—smart contracts, and explores the nuances of NFT transfers in Japan, a pivotal element for DDS implementation.
Acceptability of single-dose HPV vaccination schedule among health-care professionals in Kenya: a mixed-methods study
Authors: Umutesi Grace , Weiner Bryan J , Oluoch Lynda , Bukusi Elizabeth , Onono Maricianah , Njoroge Betty , Mecca Lucy , Ngure Kenneth , Mugo Nelly R , Barnabas Ruanne V
Published: November 2024

Background

The World Health Organization recommends a single-dose human papillomavirus (HPV) vaccination schedule for girls and boys to accelerate progress toward cervical cancer elimination. We applied the Theoretical Framework of Acceptability (TFA) within the context of HPV vaccination to assess the acceptability of a single-dose schedule among health-care professionals in Kenya.

Methods

A REDCap survey was developed using relevant Theoretical Framework of Acceptability domains and validated with health-care professionals. Descriptive analyses and multivariate Poisson regression were conducted to assess factors associated with increased acceptability. Free-text responses were analyzed using a rapid qualitative approach, and findings were presented using a joint display.

Results

Among 385 responses, 74.2% of health-care professionals were female and 48.6% were nurses. On average, respondents had been in their position for 60 months, and one-third (33.2%) were based at level-4 facilities. The majority (75.84%) thought that giving a single-dose of the HPV vaccine to adolescent girls and young women was either acceptable or very acceptable. Qualitative findings highlighted that lack of information was the underlying reason for health-care professionals who were resistant, and most clinicians thought that a singled-dose schedule was less burdensome to clinicians and patients. Hospital directors had a non–statistically significantly lower acceptability likelihood than nurses (incident rate ratio = 0.93, 95% confidence interval = 0.45 to 1.71) and health-care professionals at urban facilities had a non–statistically significantly lower acceptability likelihood than clinicians in rural facilities (incident rate ratio = 0.97, 95% confidence interval = 0.83 to 1.13).

Conclusion

Although not statistically significant, predictors of increased acceptability provide information to tailor strategies to increase HPV vaccination coverage and accelerate progress toward cervical cancer elimination.
Evaluating potential program cost savings with a single-dose HPV vaccination schedule: a modeling study
Authors: Slavkovsky Rose , Mvundura Mercy , Debellut Frédéric , Naddumba Teddy
Published: November 2024

Background

There is limited evidence on the magnitude of the potential program cost savings associated with the World Health Organization–endorsed single-dose schedule for the human papillomavirus (HPV) vaccine. The objective of this analysis was to model the delivery and vaccine procurement cost implications of the new schedule.

Methods

The analysis leveraged primary data during a study evaluating the HPV vaccine delivery costs and operational context in 5 countries (Ethiopia, Guyana, Rwanda, Sri Lanka, and Uganda) implementing a two-dose schedule. To estimate the cost for the single-dose schedule, we adjusted the two-dose schedule cost estimates to account for differences in the frequency of activities, whether activities differed by HPV vaccine dose or session, and differences in relative quantity or storage volume of HPV vaccines delivered. We estimated the cost per dose and cost per adolescent receiving the full (single-dose or two-dose) vaccination schedule in 2019 US dollars from a health system perspective.

Results

Modeled results found that cost per dose would increase under a single-dose schedule, whereas cost per adolescent receiving the full schedule would decrease. The financial cost for vaccine procurement and delivery per adolescent receiving the full schedule ranged from $9.64 (Sri Lanka) to $23.43 (Guyana) under a two-dose schedule and decreased to $4.84 and $12.34, respectively, under a single-dose schedule, reflecting savings up to 50%. For economic costs, the range for a single-dose schedule was $7.86 (Rwanda) to $28.53 (Guyana).

Conclusion

A single-dose HPV vaccination schedule could provide cost savings to immunization programs and enhance program affordability and sustainability.
A prospective cohort study comparing efficacy of 1 dose of quadrivalent human papillomavirus vaccine to 2 and 3 doses at an average follow up of 12 years postvaccination
Authors: Malvi Sylla G , Esmy Pulikkottil O , Muwonge Richard , Joshi Smita , Poli Usha Rani Reddy , Lucas Eric , Verma Yogesh , Lucksom Pesona Grace , Shah Anand , Patel Bijal , Zomawia Eric , Pimple Sharmila , Jayant Kasturi , Hingmire Sanjay , Chiwate Aruna , Divate Uma , Vashist Shachi , Mishra Gauravi , Jadhav Radhika , Siddiqi Maqsood , Sauvaget Catherine , Sankaran Subha , Kannan Thiraviam Pillai Rameshwari Ammal , Shastri Surendra S , Pillai M Radhakrishna , Anantharaman Devasena , Bhatla Neerja , Sankaranarayanan Rengaswamy , Basu Partha
Published: November 2024

Background

While recommending a human papillomavirus (HPV) single-dose vaccination schedule in 2022, the World Health Organization highlighted the need for long-term follow-up studies to monitor waning of protection. We report on vaccine efficacy against HPV infections in 1-, 2-, and 3-dose schedules and protection against cervical precancers at a median follow-up of 12 years postvaccination.

Methods

This randomized multicenter study in India was originally designed to vaccinate unmarried girls aged 10-18 years with either 2 or 3 doses of quadrivalent HPV vaccine. A ministerial decree to halt vaccination in trials resulted in the creation of cohorts receiving different doses, including just a single dose. Cohorts were assessed for incident and persistent infections by genotyping cervical samples collected yearly for 4 consecutive years after participants were married. Cervical screening with an HPV test was initiated at age 25 years for married participants. Age- and site-matched unvaccinated married women were recruited to be compared with vaccinated cohorts. Vaccine efficacy was assessed using proportional incidence ratios.

Results

The number of participants in the 1-, 2- (at 0 and 6 months), and 3-dose cohorts was 4949, 4980, and 4348, respectively. Of the recipients, 71%-82% in the different cohorts were eligible to provide samples for genotyping. Vaccine efficacy against persistent HPV 16 and 18 infection was 92.0% (95% confidence interval [CI] = 87.0% to 95.0%) in 3022 recipients of the single dose; and comparable with that observed in the 2-dose arm (94.8%, 95% CI = 90.0% to 97.3%) and the 3-dose arm (95.3%, 95% CI = 90.9% to 97.5%). No high-grade precancer associated with HPV 16 and 18 was detected among vaccinated participants compared with 8 precancers detected among the unvaccinated women.

Conclusion

This observational cohort study has established that a single dose of HPV vaccine provides high protective efficacy against persistent HPV 16 and 18 infections and associated neoplasia 15 years postvaccination.
Pathogen Composition and Fungicide Sensitivity in Rice Spikelet Rot Disease
Authors: Chen Jiaqi , Cao Xiping , Fu Xiaolong , Zhou Mingguo , Chen Changjun , Song Xiu-Shi
Published: November 2024

Rice spikelet rot disease (RSRD) is an emerging threat to rice crops, with sporadic but severe outbreaks in China in recent years. The composition of its pathogenic fungi has not been consistently identified, and chemical control methods remain unclear. This study aims to characterize the pathogen species responsible for RSRD and develop effective control strategies. Regional variations in disease symptoms and pathogen compositions were analyzed, which led to the identification of six novel pathogens, including Fusarium tanahbumbuense, Alternaria gaisen, Curvularia verruculosa, Curvularia brachyspora, Curvularia muehlenbeckiae, and Curvularia hominis. The pathogenic composition of RSRD exhibited considerable variation across different latitudes within China. Specifically, Alternaria spp. predominated in the Heilongjiang and Liaoning Provinces. Whereas Fusarium spp. and Curvularia spp. were more prevalent in the Hainan and Fujian Provinces. In contrast, Fusarium spp. and Alternaria spp. were the dominant pathogens in the Anhui and Jiangsu Provinces. Furthermore, an assessment of the sensitivity of these predominant pathogens to four chemical compounds was conducted, which led to the identification of potential fungicides for effective disease control. This research provides valuable insights into the pathogenic profile of RSRD across different regions and offers strategic recommendations for fungicide-based management of the disease.
Virulence and Diversity of Puccinia striiformis f. sp. tritici Populations in Northwestern and Southwestern Oversummering Regions of China
Authors: Wang Jie , Liu Xinyun , Ma Mengjie , Jin Yongjin , Fu Liyao , Li Mingju , Huang Lili , Kang Zhensheng , Zhan Gangming
Published: November 2024

Stripe rust, caused by Puccinia striiformis f. sp. tritici (Pst), is the most devastating fungal disease affecting wheat in China, particularly in the northwestern (Qinghai, Gansu, and Ningxia) and southwestern (Sichuan, Yunnan, and Guizhou) oversummering regions. In this study, 302 isolates collected from these six provinces were analyzed using virulence testing and single-nucleotide polymorphism (SNP) markers. Virulence testing on 19 Chinese differentials identified 38 previously reported and 49 novel races. CYR34 was the most prevalent race in both the northwestern and southwestern oversummering regions, with frequencies of 24.00% and 21.05%, respectively. In the northwestern oversummering region, the prevalence of CYR32 (10.70%) and G22-14 (10.67%) was nearly identical, whereas in the southwestern oversummering region, CYR32 (13.20%) and G22-14 (9.87%) exhibited significant differences. Additionally, 112 races were identified using 18 Yr single-gene differentials, although none of the isolates showed virulence to either Yr5 or Yr15. The virulence diversity of Pst populations was greater in the southwestern than in the northwestern oversummering region, as indicated by the differential sets. Further molecular analysis with 20 pairs of polymorphic KASP-SNP markers confirmed that the southwestern Pst population exhibited higher genetic diversity than the northwestern population. Both virulence phenotypes and genotype data demonstrated that the Pst population was more diverse in the southwestern oversummering region, despite presence of the exchange of Pst sources between regions. In addition, mutant isolates indicating resistance to tiadimefon fungicide were detected in both regions. This study provides a systematic comparison of Pst populations in the northwestern and southwestern oversummering regions based on virulence phenotyping and SNP marker genotyping, and the findings are crucial for the integrated management of wheat stripe rust in these regions and across the country.
Role for Lumbar Cerebrospinal Fluid Drainage in High-risk Thoracic Endovascular Aortic Repair: A Narrative Review
Authors: Shelton Thomas , Gigax Bradley , Aly Ahmed H. , Choi Katherine , Tili Esmerina , Orion Kristine , Modarai Bijan , Beck Adam , Grocott Hilary P. , Awad Hamdy
Published: November 2024

Lumbar cerebrospinal fluid (CSF) drainage is one of the few preventative and therapeutic practices that may reduce spinal cord ischemia in high-risk thoracic endovascular aortic aneurysm repair (TEVAR). Although this is part of clinical guidelines in open thoracoabdominal aortic repair, there are no randomized controlled trials that provide convincing evidence on the protection conferred by CSF drainage in high-risk TEVAR patients. This gap in knowledge obfuscates clinical decision making given the risk of significant complications of CSF drain insertion and management. The current literature is inconclusive and provides conflicting results regarding the efficacy of, and complications from, CSF drainage in TEVAR. Filling the knowledge gap resulting from the limited current state of the literature warrants additional high-quality randomized controlled clinical trials that balance CSF drainage efficacy with potential complications in high-risk TEVAR patients.
Evaluation of Visual Disturbances After Mild Traumatic Brain Injury—A One-Year Follow-up Study
Authors: Mona-Lisa Möller , Kaisa Mäki , Taina Nybo , Antti Huovinen , Ivan Marinkovic , Susanna Melkas , Jan Johansson
Published: November 2024

Objective:

To examine the persistence of visual symptoms in mild traumatic brain injury (MTBI) during the first months after injury. It is important to recognize visual disturbances because they can delay return to normal activities, while they might be simultaneously treated by visual therapy. Here we describe the results from a 1-year follow-up study of visual disturbances after MTBI.

Participants and Measures:

The study group comprised 26 patients from the Brain Injury Clinic of the Helsinki University Hospital. Inclusion criterion was a high score (≥21p) on the Convergence Insufficiency Symptom Survey (CISS) at an appointment with a neurologist within 6 months after injury. The patients underwent baseline vision evaluation at 4 months on average and follow-up at 14 months after injury. The evaluation included tests for visual acuity, near point of convergence, convergence facility, near point of accommodation, accommodative facility, motility, heterophoria, binocular vision, dynamic visual acuity, and fusional vergence width at near and far distances. Further assessments included the Rivermead Post Concussion Questionnaire for posttraumatic symptoms, a visual analog scale for visual fatigue, and the Developmental Eye Movement Test for saccadic eye movements.

Results:

Both CISS and Rivermead Post Concussion Questionnaire scores improved significantly from baseline to follow-up. The overall level of visual fatigue according to visual analog scale score was lower at follow-up, but the increase in visual fatigue (comparing fatigue before and after assessment session) was significant both at baseline and follow-up. In visual function assessments, spontaneous recovery from baseline to follow-up could be seen in vergence facility and pursuit eye movement but not in near point of convergence, near fusion, distance fusion, heterophoria, and dynamic visual acuity.

Conclusion:

The results point out the importance of evaluation of visual disturbances after MTBI. Early detection of these disturbances may provide an opportunity to provide visual therapy.
Consistency in Self-Reported Race-and-Ethnicity Over Time
Authors: Haas Ann , Martino Steven C. , Haviland Amelia M. , Beckett Megan K. , Dembosky Jacob W. , Binion Joy , Hill Torrey , Elliott Marc N.
Published: November 2024

Background:

Medicare Bayesian Improved Surname and Geocoding (MBISG), which augments an imperfect race-and-ethnicity administrative variable to estimate probabilities that people would self-identify as being in each of 6 mutually exclusive racial-and-ethnic groups, performs very well for Asian American and Native Hawaiian/Pacific Islander (AA&NHPI), Black, Hispanic, and White race-and-ethnicity, somewhat less well for American Indian/Alaska Native (AI/AN), and much less well for Multiracial race-and-ethnicity.

Objectives:

To assess whether temporal inconsistency of self-reported race-and-ethnicity might limit improvements in approaches like MBISG.

Methods:

Using the Medicare Health Outcomes Survey (HOS) baseline (2013–2018) and 2-year follow-up data (2015–2020), we evaluate the consistency of self-reported race-and-ethnicity coded 2 ways: the 6 mutually exclusive MBISG categories and individual endorsements of each racial-and-ethnic group. We compare the consistency of self-reported race-and-ethnicity (HOS) to the accuracy of MBISG (using 2021 Medicare Consumer Assessment of Healthcare Providers and Systems data).

Results:

Concordance (C-statistic) of HOS baseline and follow-up self-reported race-and-ethnicity was 0.95–0.97 for AA&NHPI, Black, Hispanic, and White, 0.83 for AI/AN, and 0.72 for Multiracial using mutually exclusive categories (weighted concordance=0.956). Concordance of MBISG with self-report followed a similar pattern and had similar values, with somewhat lower AI/AN and Multiracial values. The concordance of individual endorsements over time was somewhat higher than for classification (weighted concordance=0.975).

Conclusions:

The concordance of MBISG with self-reported race-and-ethnicity appears to be limited by the consistency of self-report for some racial-and-ethnic groups when employing the 6-mutually-exclusive category approach. The use of individual endorsements can improve the consistency of self-reported data. Reconfiguring algorithms such as MBISG in this form could improve its overall performance.
Characterization of Thrombocytopenia in Pediatric Patients in Noncritical Hospital Setting: An Institutional Review From Pakistan
Authors: Urooj Haleema , Altaf Sadaf , Saadat Eisha , Qadir Mohammad Shahzaib , Moiz Bushra
Published: November 2024

Pediatric thrombocytopenia is frequently observed in critical care and oncology settings with an increased risk of bleeding and platelet transfusions. However, little is known about low platelets in childhood during seasonal influence. This study aimed to evaluate the frequency and severity of pediatric thrombocytopenia in the postflood period. The patients 1 to 18 years of age with thrombocytopenia (platelet count <150×109/L) were studied from August to December 2022 after institutional ethical approval (ERC-Path-2022-8044-23395). Data was collected from electronic health records and laboratory information systems. Of 2318 admitted patients, 192 (8.3%) including 128 males and 64 females had thrombocytopenia. The median (IQR) age was 12 (8 to 15) years. Mild, moderate, and severe thrombocytopenia were seen in 109 (56.8%), 76 (39.5%), and 7 (3.6%) patients, respectively. Concomitant leucopenia was observed in 77 of 192 patients (40.1%). Infection was the predominant cause of low platelets (N=175 or 91.1%). Only 15 patients (7.8%) had grade 1/2 bleeding. Overall, 176 patients (92%) were discharged in stable conditions and no mortality was observed. The frequency of pediatric thrombocytopenia in the noncritical and nononcological care settings was <10% and mostly observed in association with underlying infections. The frequency of bleeding manifestation and platelet transfusions was minimal in this group.
Asymmetry of Directed Brain Connectivity at Birth in Low-Risk Full-Term Newborns
Authors: Chirumamilla Venkata C. , Mulkey Sarah B. , Anwar Tayyba , Baker Robin , Maxwell G. Larry , De Asis-Cruz Josepheen , Kapse Kushal , Limperopoulos Catherine , du Plessis Adre , Govindan R. B.
Published: November 2024

Purpose:

Functional connectivity hubs were previously identified at the source level in low-risk full-term newborns by high-density electroencephalography (HD-EEG). However, the directionality of information flow among hubs remains unclear. The aim of this study was to study the directionality of information flow among source level hubs in low-risk full-term newborns using HD-EEG.

Methods:

A retrospective analysis of HD-EEG collected from a prospective study. Subjects included 112 low-risk full-term (37–41 weeks' gestation) newborns born in a large delivery center and studied within 72 hours of life by HD-EEG. The directionality of information flow between hubs at the source level was quantified using the partial directed coherence in the delta frequency band. Descriptive statistics were used to identify the maximum and minimum information flow. Differences in information flow between cerebral hemispheres were assessed using Student t-test.

Results:

There was higher information flow from the left hemisphere to the right hemisphere hubs (p < 0.05, t-statistic = 2). The brainstem had the highest information inflow and lowest outflow among all the hubs. The left putamen received the lowest information, and the right pallidum had the highest information outflow to other hubs.

Conclusions:

In low-risk full-term newborns, there is a significant information flow asymmetry already present, with left hemisphere dominance at birth. The relationship between these findings and the more prevalent left hemisphere dominance observed in full-term newborns, particularly in relation to language, warrants further study.