bluuebunny/crossref_metadata_2025 huggingface dataset:
Academic and Non-Academic Profile Affecting the Nurse Licensure Examination Performance of the Nursing Graduates of a Higher Education Institution in Davao City
Authors: Pulgarinas Jr. Romeo
Published: June 2023

The Nurse Licensure Examination is conducted by the Professional Regulatory Commission to screen Nursing graduates who will be licensed to practice nursing. The study aimed to determine the academic and non-academic profiles of the respondents and their possible correlation to the respondents’ Nurse Licensure Examination performance. Using total enumeration, sixty-seven Nursing graduates of the pioneering batch under CMO 14 s. 2009 were used as respondents. The academic profile included Nursing Care Management (NCM), Nurse Aptitude Test (NAT), English Proficiency, and Nursing Enhancement Program (NEP). The non-academic profile covered Emotional Quotient, the Otis-Lennon School Ability Test (OLSAT), and the Schedule of Examination. The study used the non-experimental descriptive-correlational research design. Frequency and percentage, mean, Pearson r, Chi-Square, and Linear Regression analysis were the statistical tools employed in the study. Results revealed that all individual parameters in the academic profile are significantly correlated to the licensure examination performance. On the other hand, only the OLSAT in the non-academic profile showed a significant correlation to the licensure examination performance. Finally, the regression model obtained in the study is written as NLEP = 18.139 + 0.413 (NCM) + 0.018 (NAT) – 0.195 (EngProf) + 0.399 (NEP).
Effects of Telephone-based Self-care Intervention for Gynecologic Cancer Patients Receiving Chemotherapy: A Quasi-Experimental Study
Authors: Lee Boyeon , Park Hyojung
Published: June 2023

Purpose: This study aimed to evaluate whether a telephone-based self-care intervention improved self-care knowledge, self-efficacy, and self-care performance of gynecologic cancer patients receiving chemotherapy.Methods: This quasi-experimental study used a non-equivalent control group pretest-posttest design. The participants included 38 gynecologic cancer patients who were admitted to Seoul National University Hospital and received chemotherapy. To reduce the spread of the experimental treatment, the control group was recruited prior to the experimental group, with matching inclusion criteria for age, diagnosis, and chemotherapeutic agent. The experimental group received education on managing chemotherapy side effects in the form of a booklet prior to chemotherapy and four telephone-based self-care interventions after discharge. The control group received only education on managing chemotherapy side effects in the form of a booklet prior to chemotherapy. Data were collected prior to the intervention and 3 weeks after the first-line chemotherapy cycle ended. Outcomes were measured using a self-care knowledge measurement tool, the New General Self-Efficacy Scale and a self-care performance assessment scale. The statistical analysis was performed using the x2 test, Fisher's exact test, Shapiro-Wilk normality test, paired t-test and independent t-test.Results: Significant differences were found between the two groups in scores for self-care knowledge (t=-2.64, p=.012), self-efficacy (t=-4.32, p<.001), and self-care performance (t=-2.53, p=.016) after the telephone-based self-care intervention.Conclusion: This telephone-based self-care intervention was effective for improving self-care knowledge, self-efficacy, and self-care performance.
Factors Affecting Hyperphosphatemia in Patients with Chronic Renal Failure Undergoing Hemodialysis
Authors: Kim Jihyun
Published: June 2023

Purpose: The purpose of this study was to investigate the status of hyperphosphatemia in patients with chronic renal failure (CRF) and to examine the effects of dialysis-related characteristics, nutritional status, self-care, stress, and social support on hyperphosphatemia.Methods: This descriptive research study was designed to identify factors influencing the development of hyperphosphatemia in patients diagnosed with CRF. A convenience sample of 150 patients receiving hemodialysis was selected. Data were collected directly by the researchers from January to March 2022.Results: The regression model showed statistically significant results (x2=137.24, p<.001). Regression analysis demonstrated that body mass index (BMI) and blood urea nitrogen (BUN) were predictive factors. The risk of hyperphosphatemia was 3.09 times (95% CI, 1.15~8.25) higher for a BMI ≥25 kg/m2 than for a BMI 18.5-22.9 kg/m2. The risk of hyperphosphatemia increased by 1.04 times (95% CI, 1.01~1.07) as the BUN levels increased.Conclusion: BMI and BUN were identified as major predictive factors for hyperphosphatemia, which confirms the importance of nutritional intake in dialysis patients. To prevent hyperphosphatemia in hemodialysis patients, regular monitoring for dietary and nutritional status and nutrition education based on the results of monitoring should be carried out. Interdisciplinary strategies are also needed to prevent hyperphosphatemia.
Effects of Job Crafting, Burnout, and Job Satisfaction on Nurses' Turnover Intention: A Path Analysis
Authors: Chung Mihee , Han Sujeong
Published: June 2023

Purpose: This study investigated the direct and indirect effects of factors related to nurses' turnover intention.Methods: The study included 212 nurses working at three university hospitals in Korea. The collected data were subjected to descriptive statistical analysis, correlation analysis, and path analysis.Results: Promotion-focused job crafting had direct effects on burnout (β=-.32, p=.001) and job satisfaction (β=.18, p=.008). Promotion-focused job crafting had an indirect effect on job satisfaction via burnout (β=.13, p<.001). For turnover intention, promotion-focused job crafting had an indirect effect (β=-.18, p=.001) mediated by burnout and job satisfaction. Job satisfaction had a direct effect on turnover intention (β=-.26, p=.001). Additionally, burnout affected turnover intention, both directly (β=.32, p=.001) and indirectly (β=.10, p=.001), mediated by job satisfaction. Finally, promotion-focused job crafting had a dual mediation effect on turnover intention through burnout and job satisfaction (effect=-0.02, p<.001). Including the indirect effect of promotion job crafting, the explanatory power of job satisfaction and burnout on turnover intention was about 25%.Conclusion: Based on the results of this study, the strategy of reducing burnout by strengthening nurses' promotion-focused job crafting and lowering turnover intention by increasing job satisfaction can have a positive effect on organizational performance.
APPROCHE DU MENTEUR UNE ANALYSE ONTOLOGIQUE DU PARADOXE DU CRÉTOIS SUR LE MODE DE LA GÉNÉRICITÉ MASSIVE
Authors: Le Gall Sylvain
Published: June 2023

Este artículo ofrece un análisis de la paradoja del cretense ontológicamente comprometida con el objeto arbitrario, objeto introducido por el lógico K. Fine. El autor se propone como objetivo analizar los individuos denotados en el enunciado de la paradoja, tratándolos bajo el prisma semántico de una genericidad dada de un modo masivo, un prisma de lectura semántica inicialmente propuesto por G. Kleiber para las descripciones definidas y los nombres propios. En esta aproximación referencial, el propio Epiménides se ve otorgado una función de objeto cualquiera, individuo disuelto en la masa de la clase en la que su condición de pertenencia es reconocida. Una traducción del enunciado de la paradoja se propone al final de artículo. La selección de un sistema combinatorio encuentra su justificación en la misma ontología formal postulada por tal lenguaje lógico, así como en la plasticidad de su sintaxis para la traducción de los objetos analizados.
EL OBJETO Y LA PERCEPCIÓN ESTÉTICA EN LA FENOMENOLOGÍA DEL ARTE DE MIKEL DUFRENNE
Authors: Silva Gálvez Nicolás
Published: June 2023

Este artículo problematiza tanto la noción de “objeto estético” como la de “percepción estética” de Mikel Dufrenne (1910-1995). Dufrenne propone una ontología fenomenológica del objeto estético fundamentada en el “mundo” que este objeto configura para sí mismo. Empero, no aclara del todo a qué se refiere con “percepción estética” y, por ello, deviene confuso el estatuto del “objeto estético” mismo. Para resolver esta problemática expongo lo que el filósofo francés entiende por objeto estéticamente percibido y el mundo que dispone para sí mismo. Luego, me centro en la noción de “mundo” entendida a la manera de la fenomenología, con el fin de comprender en qué estriba el mundo de un objeto tal. Enseguida, propongo un breve examen de los tres momentos en que se configura y nace la percepción estética. Junto a ello, me refiero a la cuestión de la profundidad y del sentimiento que un sujeto desprende desde un objeto estético. Para finalizar, se dan ciertas luces para la comprensión de nociones como la de “objeto estético” y “percepción estética” en el marco de la fenomenología del arte de Mikel Dufrenne.
Full Mouth Rehabilitation of a Post COVID-19 Mucormycosis Treated Patient using BarRetained Prosthesis: A Case Report
Authors: Kapadia Archit , Wankhade Sattyam , Khalikar Arun , Deogade Suryakant , Lalsare Samiksha
Published: June 2023

During the second wave of Coronavirus Disease-2019 (COVID-19), the Indian subcontinent had witnessed a steep rise in the postCOVID mucormycosis cases with an alarming rate of about 70 times than that of the rest of the world. Maxillofacial defects amounted to various post-surgical hindrances such as difficulty in mastication, impaired speech, nasal regurgitation, mental despair and socially awkward situations. Dentists all over the world were challenged for fabricating a well-retained and functionally comfortable prosthesis that would contribute in improving the condition of a physiologically-debilitating and psychologically-impaired patient. Here the authors present a case of 65 years old male patient, full mouth rehabilitation of post-COVID mucormycosis treated patient wherein a bar-retained prosthesis was delivered which was not only non-invasive but highly retentive and even pocket-friendly for the patient. This case report also shows that through meticulous planning and execution of the treatment plan, one can achieve the desired results and meet the patient’s expectations.
Benefits and Constraints Associated with the Harmonization of Financial Regulations: An Overview
Authors: Challapalli Surendra Reddy
Published: June 2023

The harmonization of financial regulations offers numerous benefits but also poses constraints and challenges. Cross-border derivative traffic has been on the rise, highlighting the need for a more coordinated, global approach to regulatory frameworks. Extraterritoriality, where regulatory reach extends beyond national borders, leads to duplicated efforts and compliance challenges for financial institutions engaged in cross-border transactions. Double reporting, discrepancies in data alignment and lack of standardized identifiers create complexities and increase costs for reporting to multiple regulatory authorities. Variations in asset pricing and market valuation standards further complicate compliance and reporting. The lack of harmonization between regulatory bodies results in inconsistencies and the need for greater coordination.
Farmers’ Knowledge of Adaptation Strategies to Mitigate Climate Change and Factors Influencing Their Adoption
Authors: Neha  , Ansari M. A.
Published: June 2023

Climate change has emerged as a global threat negatively affecting the productivity and production efficiency of agriculture systems thereby endangering food security and livelihoods of rural communities in most of the developing countries like India. Climate change and extreme climatic events have caused India’s agriculture production to decline and exacerbated food insecurity during the last few decades. Consequently, Indian farmers have developed indigenous practices to mitigate the adverse impacts of climate change on agriculture. This study aims at studying farmers’ knowledge of adaptation strategies, identifying the adoption of adaptation strategies and find out various factors influencing farmers’ adoption of adaptation strategies to cope up with climate change. The present study draws upon data collected through personal interviews with 180 farmers in one district of North-Western Himalayan state of Uttarakhand. The results showed that farmers knowledge of adaptation strategies was found to be medium; most common adaptation strategies employed were – change in sowing time/ date, crop diversification, inter/ mixed cropping, use of drought and heat resistant crop varieties, and short duration and early maturing crop varieties. Further, Using Karl Pearson Correlation, the results indicated that age, farming experience, landholding, annual income, information seeking behavior, scientific orientation, credit and subsidy orientation, decision making ability, extension contact were likely to affect their knowledge of adaptation strategies to cope up with climate change. The results of the present study will provide policy makers with new insights for the government and encourage agricultural extension services providers to promote location specific adoption of coping strategies so as to tackle the adverse impacts of climate change on agriculture.
Study on Development and Storage of Blended Pineapple (Ananas comosus L.) Mango (Mangifera indica L.) Crush
Authors: Sharma Ankita , Mishra Saket , Brar Ranveer Singh
Published: June 2023

The present research work entitled “STUDY ON DEVELOPMENT AND STORAGE OF BLENDED PINEAPPLE (Ananas comosus L.) MANGO (Mangifera indica L.) CRUSH” was carried out at Post Harvest Lab, Department of Horticulture, Naini Agricultural Institute (NAI) SHUATS, Prayagraj (formerly Allahabad), U.P, INDIA, during 2021-2023. The statistical design adopted for the experiment was Completely randomized design (CRD) with three replications and Eight treatment combinations and the product was analyzed for quality parameters and sensory qualities at the interval of 15 Days till 45 Days of storage period at refrigerated conditions (40C). The present investigation revealed about the quality parameters viz. TSS, Reducing sugars, Non-Reducing Sugars and Total sugars, acidity content during storage of 45 Days  .After 45 days of storage, Treatment T5 (Pineapple pulp 50%: Mango pulp 50%) was found superior having TSS (55.850Brix), acidity (0.89%), total sugars (45.42 %), reducing sugar (15.88%) and also give better result in sensory evaluation in colour (7.70), taste (8.02), aroma (8.01), texture (7.98), and overall acceptability (8.02) at refrigerated conditions (40C). Treatment T5 performed well in the economic investment with higher benefit cost ratio i.e., 1.83 which is quite higher than other treatments.
Lessons Learnt from the Management of Severe COVID-19 Disease in a 93-year-old with Chronic Co-Morbidities at a Resource-constrained Centre in Nigeria – A Retrospective Single Case Study
Authors: Nwatu C. B. , Anyim O. B. , Unigwe U. S.
Published: June 2023

Introduction: Severe COVID-19 infection is associated with significant mortality in the elderly. This is even more so, when the elderly patient with the disease also has multiple chronic co-morbidities, and is resident in a resource-constrained area.

Aims/ Objectives: To outline management strategies employed, and important lessons learnt from the successful management of a case of severe COVID-19 disease in a 93-year-old with chronic co-morbidities in a resource-limited setting.

Methods: We utilized a simple COVID-19 severity categorization algorithm on presentation, to assign the index patient to the appropriate COVID-19 disease severity class and subsequently employed patient’s serial, weekly clinical and laboratory parameters to guide a multi-specialty management protocol.

Results: A 93-year-old man was referred to a tertiary hospital in Enugu during the second wave of the COVID-19 pandemic, with a 5-day-history of high grade fever, severe fatigue, and altered sensorium. He had been living with diabetes for 48years; recently had worsening glycemic control, and was yet to pass urine in the previous 12hours. He was also being managed conservatively for prostate carcinoma. Examination revealed signs of severe pneumonia and he was drowsy, dehydrated, and had asterixis. A diagnosis of acute kidney injury from septicemia, following community acquired pneumonia and possibly urinary tract infection was made, with COVID-19 infection as a differential. Samples were collected for laboratory investigations while he was recommended for intensive care unit admission for further care. Para-enteral broad spectrum antibiotics, intravenous fluid therapy, intranasal oxygen therapy, basal-bolus-insulin-regimen, and anti-coagulation prophylaxis were instituted. Following laboratory investigation results which included a positive COVID-19 test (clinically categorized as severe disease), severe systemic inflammation, evidence of uro-tract infection, intravascular thrombosis and severe renal impairment, the Nephrology, Infectious disease, Urology teams were invited to co-manage the patient alongside the Endocrinologists. After 27days of collaborative care, patient was discharged with resolution of his symptoms and signs.

Conclusion: Multi-specialty collaborative care improves patients’ outcome even in the face of severe COVID-19 with associated co-morbidities in elderly patients. Severity stratification ensures life-saving timely care for severe COVID-19 disease.
Alternate Approach (Penalty Approach) to Assignment Problem Solving and Comparison to Existing Approaches
Authors: Mohammed Hudu , Oduro F. T. , Appiah S. K.
Published: June 2023

Assignment problem is an important area in Operation Research and is also discussed in real physical world. In this paper an attempt has been made to solve the assignment problem using a new Method called the Penalty method. We discuss a numerical example by using the new Method and compare it with standard existing method which is the Hungarian method. We compare the optimal solution of the new Method and the Hungarian method. The new method is a simple procedure, easy to apply for solving assignment problem.
The Role of Computerized Accounting Advanced Information Systems in The Efficiency and Effectiveness of Internal Audit
Authors: Almaliki Oday Jasim
Published: June 2023

This study aims to investigate the role played by information systems in enhancing the external audit procedures of financial institutions. Presumably, these systems can help improve the quality of audit reports by allowing financial professionals to access and analyze financial information. An online survey using a questionnaire prepared by the researcher was used to collect data for the study. The data was analyzed using statistical analytics software. SPSS24 The results of the study revealed that the availability of appropriate audit information systems (AIS) led to a significant improvement in certain aspects of the quality of the external auditor. According to external auditors, the important function of these systems in improving the quality of procedures is recognized by them. The results show how an automated identification system can help improve the external audit performance of Iraqi SMEs. It also shows that the various applications and elements of an automated identification system can significantly enhance the quality of the procedures used by these companies. These include planning and executing audits, risk assessments, and the use of computer software components. The importance of this study is due to the increasing number of changes in the way internal audit procedures are conducted, such as the use of computerized software. There has been a lack of studies on the role of accounting information systems (AIS) in this process.
Venous Thromboembolism in Patients With Bullous Pemphigoid
Authors: Schneeweiss Maria C. , Merola Joseph F. , Wyss Richard , Silverberg Jonathan I. , Mostaghimi Arash
Published: June 2023

Importance

Studies have linked bullous pemphigoid (BP) with venous thromboembolism (VTE) across several data sources finding 6-fold to 15-fold increased incidence rates.

Objective

To determine the incidence of VTE in patients with BP compared with similar controls.

Design, Setting, and Participants

This cohort study used insurance claims data from a nationwide US health care database from January 1, 2004, through January 1, 2020. Patients with dermatologist-recorded BP were identified (≥2 diagnoses of BP [International Classification of Diseases, Ninth Revision (ICD-9) 694.5 and ICD-10 L12.0] recorded by dermatologists within 1 year). Risk-set sampling identified comparator patients without BP and free of other chronic inflammatory skin diseases. Patients were followed-up until the first of the following events occurred: VTE, death, disenrollment, or end of data stream.

Exposures

Patients with BP compared with those without BP and free of other chronic inflammatory skin diseases (CISD).

Main outcome

Venous thromboembolism events were identified and incidence rates were computed before and after propensity-score (PS) matching to account for VTE risk factors. Hazard ratios (HRs) compared the incidence of VTE in BP vs non-CISD.

Results

Overall, 2654 patients with BP and 26 814 comparator patients without BP or another CISD were identified. The mean (SD) age in the BP group was 73.0 (12.6) years and 55.0 (18.9) years in the non-CSID group. With a median follow-up time was 2 years, the unadjusted incidence rate (per 1000 person-years) of outpatient or inpatient VTE was 8.5 in the BP group compared with 1.8 in patients without a CISD. Adjusted rates were 6.7 in the BP group compared with 3.0 in the non-CISD group. Age-specific adjusted incidence rates (per 1000 person-years) in patients aged 50 to 74 years was 6.0 (vs 2.9 in the non-CISD group) and in those aged 75 years or older was 7.1 (vs 4.53 in the non-CISD group). After 1:1 propensity-score matching including 60 VTE risk factors and severity markers, BP was associated with a 2-fold increased risk of VTE (2.24 [1.26-3.98]) vs those in the non-CISD group. When restricting to patients aged 50 years or older, the adjusted relative risk of VTE was 1.82 (1.05-3.16) for the BP vs non-CISD groups.

Conclusions

In this nationwide US cohort study, BP was associated with a 2-fold increased incidence of VTE after controlling for VTE risk factors in a dermatology patient population.
Risk of Mortality After a Diagnosis of Melanoma In Situ
Authors: Patel Vishal R. , Roberson Mya L. , Pignone Michael P. , Adamson Adewole S.
Published: June 2023

Importance

The incidence of melanoma in situ (MIS) is increasing more rapidly than any invasive or in situ cancer in the US. Although more than half of melanomas diagnosed are MIS, information about long-term prognosis following a diagnosis of MIS remains unknown.

Objective

To evaluate mortality and factors associated with mortality after a diagnosis of MIS.

Design, Setting, and Participants

This population-based cohort study of adults with a diagnosis of first primary MIS from 2000 to 2018 included data from the US Surveillance, Epidemiology, and End Results Program, which were analyzed from July to September 2022.

Main Outcomes and Measures

Mortality after a diagnosis of MIS was evaluated using 15-year melanoma-specific survival, 15-year relative survival (ie, compared with similar individuals without MIS), and standardized mortality ratios (SMRs). Cox regression was used to estimate hazard ratios (HRs) for death by demographic and clinical characteristics.

Results

Among 137 872 patients with a first-and-only MIS, the mean (SD) age at diagnosis was 61.9 (16.5) years (64 027 women [46.4%]; 239 [0.2%] American Indian or Alaska Native, 606 [0.4%] Asian, 344 [0.2%] Black, 3348 [2.4%] Hispanic, and 133 335 [96.7%] White individuals). Mean (range) follow-up was 6.6 (0-18.9) years. The 15-year melanoma-specific survival was 98.4% (95% CI, 98.3%-98.5%), whereas the 15-year relative survival was 112.4% (95% CI, 112.0%-112.8%). The melanoma-specific SMR was 1.89 (95% CI, 1.77-2.02); however, the all-cause SMR was 0.68 (95% CI, 0.67-0.7). Risk of melanoma-specific mortality was higher for older patients (7.4% for those 80 years or older vs 1.4% for those aged 60-69 years; adjusted HR, 8.2; 95% CI, 6.7-10.0) and patients with acral lentiginous histology results (3.3% for acral lentiginous vs 0.9% for superficial spreading; HR, 5.3; 95% CI, 2.3-12.3). Of patients with primary MIS, 6751 (4.3%) experienced a second primary invasive melanoma and 11 628 (7.4%) experienced a second primary MIS. Compared with patients without a subsequent melanoma, the risk of melanoma-specific mortality was increased for those with a second primary invasive melanoma (adjusted HR, 4.1; 95% CI, 3.6-4.6) and was decreased for those with a second primary MIS (adjusted HR, 0.7; 95% CI, 0.6-0.9).

Conclusions and relevance

The results of this cohort study suggest that patients with a diagnosis of MIS have an increased but low risk of melanoma-specific mortality and live longer than people in the general population, suggesting that there is significant detection of low-risk disease among health-seeking individuals. Factors associated with death following MIS include older age (≥80 years) and subsequent primary invasive melanoma.
Comparison of Stroke Recurrence, Cardiovascular Events, and Death Among Patients With Pregnancy-Associated vs Non–Pregnancy-Associated Stroke
Authors: Béjot Yannick , Olié Valérie , Lailler Gregory , Grave Clémence , Regnault Nolwenn , Duloquin Gauthier , Blacher Jacques , Gabet Amélie
Published: June 2023

Importance

Women with pregnancy-associated stroke might have different risks of stroke recurrence, including during subsequent pregnancies, and other cardiovascular events due to pregnancy-specific stroke risk factors, such as gestational hypertension, preeclampsia, or gestational diabetes.

Objective

To estimate the rate of stroke recurrence, cardiovascular hospitalization, and death in women with pregnancy-associated stroke compared with women with non–pregnancy-associated stroke.

Design, Setting, and Participants

This cohort study included all women aged 15 to 49 years in France who were affiliated with the general scheme of French health care insurance (94% of women) and had a first hospitalization for stroke between January 1, 2010, and December 31, 2018. Women were followed up until December 31, 2020, with the registration of stroke recurrence, hospitalization for cardiovascular conditions, and death. Data were from the French health care database Système National des Données de Santé. Statistical analyses were conducted between December 2021 and September 2022.

Exposure

Pregnancy status at the time of stroke.

Main Outcomes and Measures

Poisson regressions were used to estimate incidence rates of these events with 95% CIs. We used Cox proportional hazards regression models to estimate the hazard ratios (HRs) of each event during the follow-up for women with a pregnancy-associated stroke vs women with a non–pregnancy-associated stroke.

Results

Among women aged between 15 and 49 years between 2010 and 2018 and living in France, 1204 had a pregnancy-associated stroke at a mean (SD) age of 31.5 (5.8) years, and 31 697 had a non–pregnancy-associated stroke at a mean age of 39.6 (8.2) years. Among the 1204 women with a pregnancy-associated stroke, the incidence rate was 11.4 (95% CI, 9.0-14.3) per 1000 person-years, with 2 recurrent events during a subsequent pregnancy. Compared with women with non–pregnancy-associated stroke, women with pregnancy-associated stroke had lower risks of ischemic stroke (adjusted HR, 0.53; 95% CI, 0.36-0.77), cardiovascular events (adjusted HR, 0.58; 95% CI, 0.49-0.69), and death (adjusted HR, 0.42; 95% CI, 0.22-0.79). In contrast, the risk of recurrent intracerebral hemorrhage and cerebral venous thrombosis did not differ significantly, whereas the risks of venous thromboembolism (HR, 2.02; 95% CI, 1.14-3.58) and acute coronary syndrome with ST-segment elevation (HR, 3.93; 95% CI, 1.10-14.0) were increased.

Conclusions and Relevance

In this cohort study, although the risks of ischemic stroke, overall cardiovascular events, and mortality were lower after a pregnancy-associated stroke than after a non–pregnancy-associated stroke, the risks of venous thromboembolism and acute coronary syndrome with ST-segment elevation were higher. Recurrent stroke during a subsequent pregnancy remained rare.
Analysis of Antibiotic Exposure and Development of Acute Graft-vs-Host Disease Following Allogeneic Hematopoietic Cell Transplantation
Authors: Rashidi Armin , Gao Fei , Fredricks David N. , Pergam Steven A. , Mielcarek Marco , Milano Filippo , Sandmaier Brenda M. , Lee Stephanie J.
Published: June 2023

Importance

Certain antibiotic exposures have been associated with increased rates of acute graft-vs-host disease (aGVHD) after allogeneic hematopoietic cell transplantation (allo-HCT). Since antibiotic exposure can both affect and be affected by infections, analyzing time-dependent exposure in the presence of multiple potential confounders, including prior antibiotic exposures, poses specific analytical challenges, necessitating both a large sample size and unique approaches.

Objective

To identify antibiotics and antibiotic exposure timeframes associated with subsequent aGVHD.

Design, Setting, and Participants

This cohort study assessed allo-HCT at a single center from 2010 to 2021. Participants included all patients aged at least 18 years who underwent their first T-replete allo-HCT, with at least 6 months of follow-up. Data were analyzed from August 1 to December 15, 2022.

Exposures

Antibiotics between 7 days before and 30 days after transplant.

Main Outcomes and Measures

The primary outcome was grade II to IV aGVHD. The secondary outcome was grade III to IV aGVHD. Data were analyzed using 3 orthogonal methods: conventional Cox proportional hazard regression, marginal structural models, and machine learning.

Results

A total of 2023 patients (median [range] age, 55 [18-78] years; 1153 [57%] male) were eligible. Weeks 1 and 2 after HCT were the highest-risk intervals, with multiple antibiotic exposures associated with higher rates of subsequent aGVHD. In particular, exposure to carbapenems during weeks 1 and 2 after allo-HCT was consistently associated with increased risk of aGVHD (minimum hazard ratio [HR] among models, 2.75; 95% CI, 1.77-4.28), as was week 1 after allo-HCT exposure to combinations of penicillins with a β-lactamase inhibitor (minimum HR among models, 6.55; 95% CI, 2.35-18.20).

Conclusions and Relevance

In this cohort study of allo-HCT recipients, antibiotic choices and schedules in the early course of transplantation were associated with aGVHD rates. These findings should be considered in antibiotic stewardship programs.
Precision Neuroimaging for Localization-Related Psychiatry
Authors: Laumann Timothy O. , Zorumski Charles F. , Dosenbach Nico U.F.
Published: June 2023

This Viewpoint describes how precision functional mapping may be helpful for associating neuroanatomical regions with specific psychiatric disorders.
Cognitive distortions mediate relationships between early maladaptive schemas and aggression in women and men
Authors: Huang Li Shaun , Molenberghs Pascal , Mussap Alexander J.
Published: June 2023

Difficult childhood experiences can lead to the development of early maladaptive schemas (EMS) that cause emotional and behavioral problems later in life. The present study examined the role of cognitive distortions in mediating relationships between EMS and aggression in adults as a function of sex. Participants were 59 women (Mage = 34.7 years, standard deviation [SD] = 8.0) and 86 men (Mage = 39.3 years, SD = 13.2) who completed the Young Schema Questionnaire—Short Form‐V3, the How I Think Questionnaire of cognitive distortions, and the Buss–Warren Aggression Questionnaire. Multiple mediation analysis identified EMS domain impaired limits to be uniquely and directly related to aggression, and the domain impaired autonomy to be indirectly related via a range of cognitive distortions. Multigroup analyses revealed no sex differences in these relationships, and analysis of covariance with age as a covariate revealed no sex differences in levels of EMS, cognitive distortion, or aggression. The results suggest that impaired limits and impaired autonomy are EMS domains of relevance to aggression regardless of sex. Furthermore, in the case of impaired autonomy, self‐serving, proaggression cognitive distortions appear to be involved. Interventions for aggression may thus benefit by focusing on clients with entitlement/grandiosity traits indicative of impaired limits, and vulnerability/dependence traits indicative of impaired autonomy, and in the latter case consider addressing the self‐serving cognitions that enable the expression of aggression in these clients.
Global Perspective on the Impact of the COVID‐19 Pandemic on Rheumatology and Health Equity
Authors: Hsieh Evelyn , Dey Dzifa , Grainger Rebecca , Li Mengtao , Machado Pedro M. , Ugarte‐Gil Manuel F. , Yazdany Jinoos
Published: June 2023

Although the public health emergency associated with the COVID‐19 pandemic has ended, challenges remain, especially for individuals with rheumatic diseases. We aimed to assess the historical and ongoing effects of COVID‐19 on individuals with rheumatic diseases and rheumatology practices globally, with specific attention to vulnerable communities and lessons learned. We reviewed literature from several countries and regions, including Africa, Australia and New Zealand, China, Europe, Latin America, and the US. In this review, we summarize literature that not only examines the impact of the pandemic on individuals with rheumatic diseases, but also research that reports the lasting changes to rheumatology patient care and practice, and health service use. Across countries, challenges faced by individuals with rheumatic diseases during the pandemic included disruptions in health care and medication supply shortages. These challenges were associated with worse disease and mental health outcomes in some studies, particularly among those who had social vulnerabilities defined by socioeconomic, race, or rurality. Moreover, rheumatology practice was impacted in all regions, with the uptake of telemedicine and changes in health care utilization. While many regions developed rapid guidelines to disseminate scientific information, misinformation and disinformation remained widespread. Finally, vaccine uptake among individuals with rheumatic diseases has been uneven across the world. As the acute phase of the pandemic wanes, ongoing efforts are needed to improve health care access, stabilize rheumatology drug supplies, improve public health communication, and implement evidence‐based vaccination practices to reduce COVID‐19 morbidity and mortality among individuals with rheumatic diseases.
Reconfigurable Neuromorphic Computing: Materials, Devices, and Integration
Authors: Xu Minyi , Chen Xinrui , Guo Yehao , Wang Yang , Qiu Dong , Du Xinchuan , Cui Yi , Wang Xianfu , Xiong Jie
Published: June 2023

Neuromorphic computing has been attracting ever‐increasing attention due to superior energy efficiency, with great promise to promote the next wave of artificial general intelligence in the post‐Moore era. Current approaches are, however, broadly designed for stationary and unitary assignments, thus encountering reluctant interconnections, power consumption, and data‐intensive computing in that domain. Reconfigurable neuromorphic computing, an on‐demand paradigm inspired by the inherent programmability of brain, can maximally reallocate finite resources to perform the proliferation of reproducibly brain‐inspired functions, highlighting a disruptive framework for bridging the gap between different primitives. Although relevant research has flourished in diverse materials and devices with novel mechanisms and architectures, a precise overview remains blank and urgently desirable. Herein, the recent strides along this pursuit are systematically reviewed from material, device, and integration perspectives. At the material and device level, one comprehensively conclude the dominant mechanisms for reconfigurability, categorized into ion migration, carrier migration, phase transition, spintronics, and photonics. Integration‐level developments for reconfigurable neuromorphic computing are also exhibited. Finally, a perspective on the future challenges for reconfigurable neuromorphic computing is discussed, definitely expanding its horizon for scientific communities.
Symmetry Control of Unconventional Spin–Orbit Torques in IrO2
Authors: Patton Michael , Gurung Gautam , Shao Ding‐Fu , Noh Gahee , Mittelstaedt Joseph A. , Mazur Marcel , Kim Jong‐Woo , Ryan Philip J. , Tsymbal Evgeny Y. , Choi Si‐Young , Ralph Daniel C. , Rzchowski Mark S. , Nan Tianxiang , Eom Chang‐Beom
Published: June 2023

Spin–orbit torques generated by a spin current are key to magnetic switching in spintronic applications. The polarization of the spin current dictates the direction of switching required for energy‐efficient devices. Conventionally, the polarizations of these spin currents are restricted to be along a certain direction due to the symmetry of the material allowing only for efficient in‐plane magnetic switching. Unconventional spin–orbit torques arising from novel spin current polarizations, however, have the potential to switch other magnetization orientations such as perpendicular magnetic anisotropy, which is desired for higher density spintronic‐based memory devices. Here, it is demonstrated that low crystalline symmetry is not required for unconventional spin–orbit torques and can be generated in a nonmagnetic high symmetry material, iridium dioxide (IrO2), using epitaxial design. It is shown that by reducing the relative crystalline symmetry with respect to the growth direction large unconventional spin currents can be generated and hence spin–orbit torques. Furthermore, the spin polarizations detected in (001), (110), and (111) oriented IrO2 thin films are compared to show which crystal symmetries restrict unconventional spin transport. Understanding and tuning unconventional spin transport generation in high symmetry materials can provide a new route towards energy‐efficient magnetic switching in spintronic devices.
High‐Mass‐Loading Li–S Batteries Catalytically Activated by Cerium Oxide: Performance and Failure Analysis under Lean Electrolyte Conditions
Authors: Fu Shuting , Wang Hongmin , Zhong Yiren , Schaefer Samuel , Li Min , Wu Mingmei , Wang Hailiang
Published: June 2023

Increasing sulfur mass loading and minimizing electrolyte amount remains a major challenge for the development of high‐energy‐density Li–S batteries, which needs to be tackled with combined efforts of materials development and mechanistic analysis. This work, following the same team's most recent identification of the potential‐limiting step of Li–S batteries under lean electrolyte conditions, seeks to advance the understanding by extending it to a new catalyst and into the high‐sulfur‐mass‐loading region. CeOx nanostructures are integrated into cotton‐derived carbon to develop a multifunctional 3D network that can host a large amount of active material, facilitate electron transport, and catalyze the sulfur lithiation reaction. The resulting S/CeOx/C electrode can deliver a stable areal capacity of 9 mAh cm−2 with a high sulfur loading of 14 mg cm−2 at a low electrolyte/sulfur ratio of 5 µL mg−1. This study discovers that Li||S/CeOx/C cells usually fail during charging at high current density, as a consequence of local short circuiting caused by electrochemically deposited Li dendrites penetrating through the separator, a previously overlooked failure pattern distinctive to cells operating under lean electrolyte conditions. This work highlights the importance of developing new material structures and analyzing failure mechanisms in the advancement of Li–S batteries.
Light‐Induced Metastable Hidden Skyrmion Phase in the Mott Insulator Cu2OSeO3
Authors: Truc Benoit , Sapozhnik Alexey A. , Tengdin Phoebe , Viñas Boström Emil , Schönenberger Thomas , Gargiulo Simone , Madan Ivan , LaGrange Thomas , Magrez Arnaud , Verdozzi Claudio , Rubio Angel , Rønnow Henrik M. , Carbone Fabrizio
Published: June 2023

The discovery of a novel long‐lived metastable skyrmion phase in the multiferroic insulator Cu2OSeO3 visualized with Lorentz transmission electron microscopy for magnetic fields below the equilibrium skyrmion pocket is reported. This phase can be accessed by exciting the sample non‐adiabatically with near‐infrared femtosecond laser pulses and cannot be reached by any conventional field‐cooling protocol, referred as a hidden phase. From the strong wavelength dependence of the photocreation process and via spin‐dynamics simulations, the magnetoelastic effect is identified as the most likely photocreation mechanism. This effect results in a transient modification of the magnetic free energy landscape extending the equilibrium skyrmion pocket to lower magnetic fields. The evolution of the photoinduced phase is monitored for over 15 min and no decay is found. Because such a time is much longer than the duration of any transient effect induced by a laser pulse in a material, it is assumed that the newly discovered skyrmion state is stable for practical purposes, thus breaking ground for a novel approach to control magnetic state on demand at ultrafast timescales and drastically reducing heat dissipation relevant for next‐generation spintronic devices.
Enantioselective C−P Bond Formation through C(sp3)−H Functionalization
Authors: Ardevines Sandra , Horn Devan , Alegre‐Requena Juan V. , González‐Jiménez Marta , Gimeno M. Concepción , Marqués‐López Eugenia , Herrera Raquel P.
Published: June 2023

An enantioselective C−P bond formation has been developed through a C(sp3)−H activation in an oxidation step followed by an organocatalyzed hydrophosphonylation protocol. The asymmetric organocatalytic Pudovik reaction has been achieved following a one‐pot strategy, starting from different benzylic and allylic alcohols and dibenzyl phosphite, using MnO2 as the oxidant and a chiral squaramide as organocatalyst. The scope of the reaction provides enantiomerically enriched α‐hydroxy phosphonates with yields from 40% to >95% and enantioselectivities from 64% to >99%. Furthermore, the use of this methodology has been demonstrated to form a tetrasubstituted carbon stereocenter, generating an acetophenone derivative in situ, using diphenyl phosphite. Therefore, this approach represents an asymmetric strategy for constructing chiral C−P bonds, which are of interest to the pharmaceutical industry.
Boosting Charge Utilization in Self‐Powered Photodetector for Real‐Time High‐Throughput Ultraviolet Communication
Authors: Ouyang Tian , Zhao Xuan , Xun Xiaochen , Gao Fangfang , Zhao Bin , Bi Shuxin , Li Qi , Liao Qingliang , Zhang Yue
Published: June 2023

Ultraviolet (UV) communication is a cutting‐edge technology in communication battlefields, and self‐powered photodetectors as their optical receivers hold great potential. However, suboptimal charge utilization has largely limited the further performance enhancement of self‐powered photodetectors for high‐throughput communication application. Herein, a self‐powered Ti3C2Tx‐hybrid poly(3,4 ethylenedioxythiophene):poly‐styrene sulfonate (PEDOT:PSS)/ZnO (TPZ) photodetector is designed, which aims to boost charge utilization for desirable applications. The device takes advantage of photothermal effect to intensify pyro‐photoelectric effect as well as the increased conductivity of the PEDOT:PSS, which significantly facilitated charge separation, accelerated charge transport, and suppressed interface charge recombination. Consequently, the self‐powered TPZ photodetector exhibits superior comprehensive performance with high responsivity of 12.3 mA W−1 and fast response time of 62.2 µs, together with outstanding reversible and stable cyclic operation. Furthermore, the TPZ photodetector has been successfully applied in an integrated UV communication system as the self‐powered optical receiver capable of real‐time high‐throughput information transmission with ASCII code under 9600 baud rate. This work provides the design insight of highly performing self‐powered photodetectors to achieve high‐efficiency optical communication in the future.
A vision of precision agriculture: Balance between agricultural sustainability and environmental stewardship
Authors: Nath Soumitra
Published: June 2023

Precision agriculture (PA) has become an increasingly popular approach to sustainable intensification in agriculture, with the intent of a balance between agricultural productivity and environmental stewardship. Sustainable intensification aims to increase agricultural productivity while minimizing negative environmental impacts. To assist this, PA has been enabled through the use of advanced technologies such as the Internet of Things, global positioning system, geographic information systems, sensors, drones, and machine learning. These technologies have enabled farmers to practice more efficient and precise farming techniques. This review provides a vision of sustainable intensification and explores the potential of PA to contribute to this goal. This review emphasizes various PA practices, such as precise irrigation and fertilizer management, accurate pest and disease management, and precise livestock farming. PA is also explored for its role in addressing climate change through mitigation and adaptation, while proactively addressing the barriers and challenges that may arise in implementing sustainable PA. Therefore, the future of sustainable precision agriculture lies in technological innovation, sustainable farming practices, data analytics, and policy interventions.
Aneurysms involving the coronary arteries in a neonate with neurofibromatosis 1
Authors: Corona‐Rivera Jorge Román , Barrios‐Prieto Ernestro , Rivera‐Ramírez Berenice , Sánchez‐Uribe Enndy Hollyver , Cortés‐Pastrana Rocío Carolina , Aguilera Cristhian Ernesto Ramírez , de Anda‐Camacho Roberto Gerardo , Peña‐Padilla Christian , Bobadilla‐Morales Lucina , Corona‐Rivera Alfredo
Published: June 2023

Aneurysmal coronary artery disease (ACAD) has been reported rarely in patients with neurofibromatosis type 1 (NF1), mostly in adults. We report on a female newborn affected by NF1 with ACAD disclosed during investigation for an abnormal prenatal ultrasound along with a review of the previously reported cases. The proposita had multiple café‐au‐lait spots and had no cardiac symptoms. Echocardiography, and cardiac computed tomography angiography confirmed aneurysms on the left coronary artery, left anterior descending coronary artery, and of the sinus of Valsalva. Molecular analysis detected the pathogenic variant NM_001042492.3(NF1):c.3943C>T (p.Gln1315*). Literature findings on ACAD in NF1 indicated that this mostly occurs in males, showing predilection for the development of aneurysms at the left anterior descending coronary artery, and manifesting predominantly as acute myocardial infarction, inclusively in teenagers, though it may be also asymptomatic as in our case. This report documents the first case of ACAD in a patient with NF1 diagnosed at birth, emphasizing that its early diagnosis is essential to prevent potential life‐threatening events attributable directly to coronary lesions.