bluuebunny/crossref_metadata_2025 huggingface dataset:
A multipurpose Extracorporeal Life Support Circuit: a concept for multiorgan transplant and circulatory support service Healthcare provider
Authors: Butt Salman Pervaiz , Raposo Nuno , Saleem Yasir
Published: October 2023

The demand for efficient and adaptable life support systems in the field of Extracorporeal Life Support (ECLS) is steadily increasing. To meet this growing need, there is a requirement for a versatile extracorporeal life support circuit that can be effectively applied in various medical scenarios, especially in tertiary hospitals where multiple ECLS services are utilized. These services include Extracorporeal Membrane Oxygenation (ECMO) for addressing respiratory or cardiac problems, Ventricular Assist Device (VAD) as a bridge to recovery or heart transplant, and Venovenous Bypass (VVB) for assisting liver transplantation. In light of this, we propose the creation of a multipurpose circuit that integrates multiple extracorporeal life support (ECLS) functions to cater to diverse medical needs. This innovative circuit not only offers cost-effectiveness and enhanced safety but also ensures optimal utilization, thereby revolutionizing the realm of life support technologies.
An Update Of The Allen & Coggan Equation To Predict 60-Min
Power Output In Cyclists Of Different Performance Levels
Authors: Sitko Sebastian , Cirer-Sastre Rafel , López-Laval Isaac
Published: October 2023

The Allen & Coggan protocol suggests that 95% of the power output
during a 20-min time trial is a valid surrogate for 60-min maximal power. The
validity of this concept has not been studied previously in cyclists with
different performance levels. As a result, we classified 120 cyclists in our
study as recreationally trained, trained, well trained or professional, based on
their maximal oxygen consumption. Participants performed a functional threshold
power testing protocol based on a 20-min time trial and a 60-min time trial,
separated by a 72-hour rest. Sixty-minute maximal power was successfully modeled
with 20-min maximal power and performance group using 2/3 of the dataset
(R2=0.77, 95% CrI [0.74, 0.79]) with different
coefficients for each group: Professional:
PO60min=PO20min × 0.96; well trained:
PO60min=PO20min × 0.95; trained:
PO60min=PO20min × 0.92 and
recreationally trained: PO60min=PO20min ×
0.88. The predictions of the original equation and our model were assessed using
the remaining third of the data. The predictive performance of the updated
equation was better (original: R2=0.51, mean absolute
error=27 W, mean bias=–12 W; updated:
R2=0.54, mean absolute error=25 W, mean
bias=–7 W).
CMD und Manuelle Medizin – Neurophysiologische
Hintergründe und therapeutische Ansätze
Authors: Sammer Andreas , Sammer Felicitas , Feigl Georg , Pascher Arnulf , Dehoust Norber
Published: October 2023

Das rein mechanistische Bild der Blockierung, welches über viele Dekaden
in unserer Vorstellung vorherrschte, wurde dank intensiver Grundlagenforschung
in den letzten Jahren zunehmend durch ein neurophysiologisches Ursachenbild
abgelöst. Daher sind Ausdrücke wie „ausgerenkter oder
herausgesprungener Wirbel“, „eingezwickter Nerv“,
„Blockaden““ inzwischen als obsolet anzusehen. Der
bewährte und halbwegs richtige Begriff „Blockierung“,
welcher im neurophysiologischen Kontext seinen reinen mechanistischen
Hintergrund verloren hat, kann bestehen bleiben.
Effects of a Regular Endurance Training Program on Running Economy and Biomechanics in Runners
Authors: Rodriguez-Barbero Sergio , González Ravé José María , Juárez Santos-García Daniel , Rodrigo-Carranza Victor , Santos-Concejero Jordan , González-Mohíno Fernando
Published: October 2023

A regular endurance training program may elicit different adaptations compared to an isolated training method. In this study, we analyzed the effects of 8 weeks of a regular endurance training program on running economy (RE), particularly neuromuscular and biomechanical parameters, in runners of different athletic abilities. Twenty-four male runners were divided into two groups: well-trained (n=12) and recreational (n=12). Both groups completed a 4-min running bout at 13 and 17 km·h-1, respectively, for the recreational and well-trained group, and a 5-jump plyometric test pre-post intervention. During the training program, participants completed low-intensity continuous sessions, high-intensity interval training sessions, and auxiliary strength training sessions. RE, measured as oxygen cost and energy cost, decreased by 6.15% (p=0.006) and 5.11% (p=0.043), respectively, in the well-trained group. In the recreational group, energy cost of running, respiratory exchange ratio, and leg stiffness decreased by 5.08% (p=0.035), 7.61% (p=0.003), and 10.59% (p=0.017), respectively, while ground contact time increased by 3.34% (p=0.012). The maximum height of the 5-jump plyometric test decreased by 4.55% (p=0.018) in the recreational group. We suggest that 8 weeks of regular endurance training leads to an improvement of ~5% in RE in recreational and well-trained runners with different physiological adaptations between groups and few changes in biomechanical and neuromuscular parameters only in recreational runners.
Vergleich prä- und postoperativer motorisch-propriozeptiver Fähigkeiten von Patienten mit Gonarthrose
Authors: Schröter Viktoria , Könczöl Clemens , Anders Jens O.
Published: October 2023

Eine hohe Zufriedenheit und bestmögliche funktionelle Ergebnisse in kurzer Zeit nach einer Knie-TEP-Operation wollen sowohl Operateure als auch Patienten erreichen. Über ein Tool, das
mobil und mit geringem zeitlichem Aufwand prä- und postoperativ verschiedene Messparameter der Balance und motorischer Fähigkeiten digital aufzeichnet, sind Verlaufsergebnisse dokumentierbar.
Es können so patientenindividuelle Faktoren bestimmt und perspektivisch ein darauf abgestimmter perioperativer Regenerations- und Trainingsprogress entworfen werden.

In einer prospektiven Studie wurden 100 Patienten prä- und 66 Patienten postoperativ nach Implantation einer zementierten Knie-TEP auf folgende Parameter hin untersucht: Balance,
Maximalkraft und Leistung. Alle Messungen wurden mit der KMP Messplattform der Firma MotoSana durchgeführt. Die Zweitmessungen erfolgten jeweils nach einer standardisierten
Anschlussheilbehandlung (AHB).

Es konnte gezeigt werden, dass signifikante Zusammenhänge zwischen personenbezogenen Faktoren wie Alter, Größe, Körpergewicht, präoperativen Werten und den postoperativen Parametern
Maximalkraft und Leistung bestehen. Weiterhin zeigte sich, dass postoperativ bei der Balanceunterstützung größtenteils eine Besserung erzielt werden konnte. Alle Patienten, die sich beim
Einbeinstand über die vorgegebene Zeit von 15 s mit einer Hand oder beiden Händen festhalten mussten, brauchten nach der Operation diese Unterstützung nicht mehr. Zur genaueren Analyse der
Balanceparameter wurden die Stichproben bereinigt und nur mit den Patienten gerechnet, die sich prä- und postoperativ nicht zur Unterstützung festhielten. Bei Patienten mit niedrigen und
mittleren Ausgangswerten vergrößert sich die Schwankungsfläche postoperativ, bei Patienten mit großen Schwankungsflächen sanken diese ab, der Stand wurde stabiler. Im Bereich Maximalkraft und
Leistung hatten Patienten mit hohen Ausgangwerten nach der AHB im Vergleich mit den anderen Patienten immer noch höhere, im Vergleich zu ihren eigenen Vorwerten jedoch geringere Werte.

Patienten mit sehr guten präoperativen motorischen Fähigkeiten konnten im Vergleich zur schwächeren Gruppe einen größeren Zuwachs an motorischen Fähigkeiten erzielen. Alle Patienten
erreichten aber nach Abschluss der AHB noch nicht ihre präoperativen Ausgangswerte. In allen Gruppen waren weiterhin Defizite im Bereich Balance nachweisbar. Mittels der verwendeten
Kraftmessplatte sind messtechnisch abgestimmte Rehabilitationsmaßnahmen vor, während und nach Abschluss der AHB möglich. Eine Rehabilitation mit individualisierter Verbesserung von Balance und
Motorik könnte perspektivisch auch der Unzufriedenheit nach Knieendoprothese z. B. durch muskuläre Dysbalance bei femoropatellaren Schmerzsyndromen vorbeugen.
Multiparametric Oncologic Hybrid Imaging: Machine Learning Challenges and Opportunities
Authors: Küstner Thomas , Hepp Tobias , Seith Ferdinand
Published: October 2023

Background Machine learning (ML) is considered an important technology for future data analysis in health care.

Methods The inherently technology-driven fields of diagnostic radiology and nuclear medicine will both benefit from ML in terms of image acquisition and reconstruction. Within the next few years, this will lead to accelerated image acquisition, improved image quality, a reduction of motion artifacts and – for PET imaging – reduced radiation exposure and new approaches for attenuation correction. Furthermore, ML has the potential to support decision making by a combined analysis of data derived from different modalities, especially in oncology. In this context, we see great potential for ML in multiparametric hybrid imaging and the development of imaging biomarkers.

Results and Conclusion In this review, we will describe the basics of ML, present approaches in hybrid imaging of MRI, CT, and PET, and discuss the specific challenges associated with it and the steps ahead to make ML a diagnostic and clinical tool in the future.

Key Points:
Statement of the Uterus Commission of the Gynecological Oncology Working Group (AGO) on Surgical Therapy for Patients with Stage IA2–IIB1 Cervical
Cancer
Authors: Fehm Tanja , Beckmann Matthias W. , Mahner Sven , Denschlag Dominik , Brucker Sara , Hillemanns Peter , Tempfer Clemens ,   for the Uterus Commission of the AGO and the AGO Working Group
Published: October 2023

The presentation of the results of the prospective randomized international multicenter study AGO-OP.8 – CCTG CX.5 – SHAPE at the annual conference of the American Society of Clinical
Oncology (ASCO) in 2023 will affect the surgical treatment of early-stage cervical cancer. In the SHAPE study, simple total hysterectomy (experimental arm) was found to be non-inferior to
radical hysterectomy (standard arm) to treat patients with early-stage cervical cancer (FIGO stages [2018] IA2 – IB1 ≤ 2 cm with an infiltration depth of < 1 cm); after 3 yearsʼ follow-up
the pelvic recurrence rate was 2.52% (experimental arm) compared to 2.17% (standard arm) with no statistically significant difference with regards to recurrence-free survival and overall
survival rates. After weighing up the results of the SHAPE study published at the conference, the Uterus Organ Commission of AGO is of the opinion that, in addition to the use of radical
hysterectomy to treat patients with invasive cervical cancer which is FIGO stage IA2 – IB1 ≤ 2 cm with an infiltration depth of < 1 cm, simple total hysterectomy may also be considered
for primary surgical therapy on a case-by-case basis after suitable explanation of the associated risks. It will be necessary to wait for the data of the full publication before discussing
whether this approach should be included in official guidelines and defining it as a new therapy standard.
Hyperostosis of the Clavicle as a Cardinal Symptom for Sapho Syndrome
– Presentation and Discussion of a Clinical Case
Authors: Andresen Julian Ramin , Reinke Justyna , Radmer Sebastian
Published: October 2023

SAPHO syndrome comprises a broad clinical spectrum and is based on inflammatory
osteitis with or without association to a dermatological affection. A young man
with chronic recurrent osteomyelitis (CRMO) of the right clavicle as a cardinal
symptom of SAPHO syndrome is reported on. Whole-body MRI has proven effective
for focal detection and assessment of local activity of a possible multifocal
manifestation of CRMO. Multiple medication with NSAIDs, a bisphosphonate,
vitamin D substitution and antibiosis resulted in extensive remission of
symptoms. Biologicals can also be used if there is no effect. The terminology of
chronic nonbacterial osteomyelitis (CNO) in connection with the SAPHO syndrome
is discussed.
Treatment of dyspeptic symptoms with YamatoGast. A non-interventional study of a registered traditional herbal Rikkunshito extract product from Japanese Kampo Medicine in routine practice in Germany
Authors: Reißenweber-Hewel Heidrun , Pehl Christian , Cameron Silke , Thomsen Jörn , Röschmann-Doose Kristina
Published: October 2023

Introduction Dyspeptic symptoms belong to the most frequent reasons to seek medical advice and are a burden both for the individual affected and the healthcare system. In Japan, the traditional herbal Kampo prescription rikkunshito has proven benefit for this indication.

Methods In a prospective, multicentre, non-interventional study (NIS), the effectiveness, safety, and tolerability of a two-week treatment with the registered rikkunshito extract product YamatoGast was assessed in German patients with an acute episode of dyspeptic symptoms of functional origin under real-world conditions. The primary endpoint was the responsiveness to treatment assessed by the overall treatment effect (OTE) score. Secondary endpoints were the change in severity of dyspeptic symptoms and the change in quality of life (QoL). Safety evaluation was based on reported adverse drug reactions, drug compliance, and ratings of tolerability by physicians and patients.

Results Sixty-six patients were enrolled (mean age 48.9 years, 74% females). The treatment was well tolerated and highly beneficial, as expressed by pronounced responder rates of 78.9% for the primary endpoint OTE. All secondary endpoints were also met. The severity of dyspeptic symptoms significantly improved by 62–77% compared to baseline, confirmed by a remarkable improvement of QoL. Significant symptom relief started from the third day of treatment onwards.

Conclusion In this non-interventional study, two-week treatment with YamatoGast resulted in a significant improvement of dyspeptic symptoms and was associated with high patient response and satisfaction. YamatoGast was confirmed as a safe and clinically relevant therapeutic option for patients suffering upper gastrointestinal complaints in routine practice.
Recurrent Non-islet Cell Tumor Hypoglycemia Secondary to Hepatocellular Carcinoma: Case Report and Literature Review
Authors: He Dan , Gong Hongpeng , Pan Jie , Zhu Fangchao , Jiang Xiaofen , Su Huang
Published: October 2023

Rationale Non-islet cell tumor hypoglycemia (NICTH) is a paraneoplastic syndrome caused by tumors other than insulinoma that is primarily due to excessive production of insulin-like growth factor-II (IGF-II). The prevalence of NICTH is likely underestimated because of a lack of clinical recognition.

Patient Concerns A 41-year-old male with massive malignant liver tumors presented with recurrent severe hypoglycemia, weight loss, and liver cirrhosis.

Diagnosis NICTH related to IGF-II produced by hepatocellular carcinoma was diagnosed based on clinical symptoms, biochemical tests, and elevated IGF-II/IGF-I ratio.

Intervention Initial treatment with intravenous glucose and parenteral nutrition showed limited efficacy. Glucocorticoids and recombinant human growth hormone led to progressive improvement in blood glucose levels.

Outcome Due to extensive tumor burden and liver failure, surgical resection was not feasible, and the patient ultimately succumbed to refractory hypoglycemia and passed away in two weeks.

Lessons Early recognition and diagnosis of NICTH are crucial in patients with recurrent hypoglycemia and large tumors. Surgical resection is the preferred treatment option, but supportive care and pharmacological interventions, such as glucocorticoids and growth hormone, can help manage refractory hypoglycemia. Further research is needed to explore novel treatment options, including anti-IGF-I and -IGF-II neutralizing antibodies.
Structured Reporting of Head and Neck Sonography Achieves Substantial
Interrater Reliability
Authors: Weimer Johannes Matthias , Künzel Julian , Ernst Benjamin Philipp , Dörsching Carla , Bozzato Alessandro , Gabrielpillai Jennis , Becker Sven , Froelich Matthias Frank , Kramer Benedikt , Sproll Christoph , Schapher Mirco , Goncalves Miguel , Mansour Naglaa , Hofauer Benedikt , Sommer Wieland H , von Scotti Felix
Published: October 2023

Purpose Ultrasound examinations are often criticized for having higher
examiner dependency compared to other imaging techniques. Compared to free-text
reporting, structured reporting (SR) of head and neck sonography (HNS) achieves
superior time efficiency as well as report quality. However, there are no
findings concerning the influence of SR on the interrater reliability (IRR) of
HNS.

Materials and Methods Typical pathologies (n=4) in HNS were
documented by video/images by two certified head and neck ultrasound
instructors. Consequently, structured reports of these videos/images
were created by n=9 senior physicians at departments of otolaryngology
or maxillofacial surgery with DEGUM instructors on staff. Reports (n=36)
were evaluated regarding overall completeness and IRR. Additionally, user
satisfaction was assessed by a visual analog scale (VAS).

Results SR yielded very high report completeness (91.8%) in all
four cases with a substantial IRR (Fleiss‘ κ 0.73). Interrater
agreement was high at 87.2% with very good user satisfaction (VAS
8.6).

Conclusion SR has the potential to ensure high-quality examination reports
with substantial comparability and very high user satisfaction. Furthermore, big
data collection and analysis are facilitated by SR. Therefore, process quality,
workflow, and scientific output are potentially enhanced by SR.
Mechanisms of Lipid Droplet Accumulation in Steatotic Liver Diseases
Authors: Dempsey Joseph L. , Ioannou George N. , Carr Rotonya M.
Published: October 2023

The steatotic diseases of metabolic dysfunction-associated steatotic liver disease (MASLD), alcohol-associated liver disease (ALD), and chronic hepatitis C (HCV) account for the majority of liver disease prevalence, morbidity, and mortality worldwide. While these diseases have distinct pathogenic and clinical features, dysregulated lipid droplet (LD) organelle biology represents a convergence of pathogenesis in all three. With increasing understanding of hepatocyte LD biology, we now understand the roles of LD proteins involved in these diseases but also how genetics modulate LD biology to either exacerbate or protect against the phenotypes associated with steatotic liver diseases. Here, we review the history of the LD organelle and its biogenesis and catabolism. We also review how this organelle is critical not only for the steatotic phenotype of liver diseases but also for their advanced phenotypes. Finally, we summarize the latest attempts and challenges of leveraging LD biology for therapeutic gain in steatotic diseases. In conclusion, the study of dysregulated LD biology may lead to novel therapeutics for the prevention of disease progression in the highly prevalent steatotic liver diseases of MASLD, ALD, and HCV.
Total Knee Arthroplasty in the Valgus Knee
Authors: Mannino Angelo , Weinberg Maxwell E. , Scuderi Giles R.
Published: October 2023

An estimated 10 to 15% of total knee arthroplasties (TKAs) are implanted for a diagnosis of arthritis when a valgus deformity is present. There are various techniques and considerations that must be considered for a successful TKA in a patient with a valgus deformity. This article provides a detailed summary of the anatomy, pathology, bone preparation, soft tissue management, implant selection, and complications when performing a TKA in a patient with valgus deformity.
Preparation and Carbocupration–Silylation of Allyl Propiolates: Vicinal Functionalization To Form Polysubstituted (E)-Vinylic Silanes
Authors: Snowden Timothy S. , Massey Cameron D. , Jennings Michael P.
Published: October 2023

The preparation and TMSOTf-mediated catalytic carbocupration–silylation of allylic propiolates has been investigated, expanding on previous syntheses of a variety of β-alkyl- and β-aryl-substituted vinylsilanes from an ethyl propiolate precursor. With few exceptions, the series of synthesized O-allyl (E)-vinylsilanes has been isolated in high yields (61–89%) with exceptional diastereoselectivities (E/Z >20:1). Additionally, we demonstrated a novel LDA-initiated, TMSCl-mediated Ireland–Claisen rearrangement of a representative allylic ester.
Hedgehog Signaling: Implications in Liver Pathophysiology
Authors: Dutta Rajesh Kumar , Jun JiHye , Du Kuo , Diehl Anna Mae
Published: October 2023

The purpose of this review is to summarize current knowledge about the role of the Hedgehog signaling pathway in liver homeostasis and disease. Hedgehog is a morphogenic signaling pathway that is active in development. In most healthy tissues, pathway activity is restricted to stem and/or stromal cell compartments, where it enables stem cell self-renewal and tissue homeostasis. Aberrant over-activation of Hedgehog signaling occurs in many cancers, including hepatocellular and cholangio-carcinoma. The pathway is also activated transiently in stromal cells of injured tissues and orchestrates normal wound healing responses, including inflammation, vascular remodeling, and fibrogenesis. In liver, sustained Hedgehog signaling in stromal cells plays a major role in the pathogenesis of cirrhosis. Hedgehog signaling was thought to be silenced in healthy hepatocytes. However, recent studies show that targeted disruption of the pathway in hepatocytes dysregulates lipid, cholesterol, and bile acid metabolism, and promotes hepatic lipotoxicity, insulin resistance, and senescence. Hepatocytes that lack Hedgehog activity also produce a secretome that activates Hedgehog signaling in cholangiocytes and neighboring stromal cells to induce inflammatory and fibrogenic wound healing responses that drive progressive fibrosis. In conclusion, Hedgehog signaling must be precisely controlled in adult liver cells to maintain liver health.
EUS-guided laser lithotripsy for pancreatic duct stones after failed conventional pancreatic endotherapy
Authors: Emmanuel James , Hsin Deborah Chew Chia , Bt Wan Abdullah Wan Zaharatul Ashikin , See Lee Tiong
Published: October 2023

The central dogma of pain in patients with chronic pancreatitis revolves around the pathophysiology of ductal hypertension owing to stones that obstruct the pancreatic duct. Conventional modalities available to decompress the pancreatic duct are occasionally limited by failed selective pancreatic duct cannulation during endoscopic retrograde cholangiopancreatography. We describe a novel endoscopic approach of EUS-guided laser lithotripsy to assist in pancreatic duct (PD) stone fragmentation in two symptomatic patients with underlying chronic pancreatitis who had failed PD cannulation and extracorporeal shock wave lithotripsy (ESWL). In both cases, a 365-micrometer LightTrail TracTip Holmium laser fiber was advanced within a 19G endoscopic ultrasound aspiration needle (Expect Slimline (SL), Boston Scientific, Marlborough, Massachusetts, United States) under endoscopic ultrasound (EUS) guidance to fragment the PD stones. There were no procedure-related complications encountered and follow-up after 1 month of the procedure revealed significant reduction in abdominal pain scores. To the best of our knowledge, these are the first reported cases of EUS-guided laser lithotripsy performed for PD stones. Our approach of performing laser lithotripsy under EUS guidance obviates the need for an ESWL procedure; however, it is technically more challenging and requires precision to avoid injury to the pancreas. Further prospective studies are required to evaluate the safety and efficacy of this novel approach and its applicability as either a rescue procedure or in tandem with conventional pancreatic endotherapy modalities.
Intraoperative Wound Lavage System for Deep Neck Infection: A Retrospective Cohort Study
Authors: Abdul-Hadi Soraya , Perez Francis Beauchamp , Pascual-Marrero Jeamarie
Published: October 2023

Introduction Multiple solutions are currently used to cleanse a deep neck infection (DNI), and a variety of devices are available to deliver wound irrigation solutions. An essential difference between these devices is the pressure that the irrigation solution exerts over the wound tissue.

Objective To compare low-pressure and high-pressure irrigation delivery systems for wound cleansing in DNI.

Methods we designed a retrospective cohort study and reviewed the medical records of patients operated on due to DNI from June 2016 to December 2017 at our institution. One cohort included patients treated with an intraoperative irrigation method that exerts low pressure over the irrigated tissue, and the other cohort, to a system capable of generating higher pressure. The Pearson Chi-squared test was used to analyze the data.

Results A total of 42 patients whose ages ranged from 16 months to 72 years were included. The low-pressure irrigation system was used in 18 patients, and the high-pressure system was used in 24 patients. No statistical differences were observed regarding the irrigation methods, the complexity of the DNI, and the overall outcomes.

Conclusions The present is the first study in which low- and high-pressure systems for wound lavage were evaluated in the treatment of DNI. When comparing these methods, we did not find one to be superior to the other; however, the additional cost associated with the high-pressure devices may not justify their in head and neck procedures.
Effect of Speaking Valves on Tracheostomy Decannulation
Authors: Eichar Bradley W. , Kaffenberger Thomas M. , McCoy Jennifer L. , Padia Reema K. , Muzumdar Hiren , Tobey Allison B. J.
Published: October 2023

Introduction Despite several pediatric tracheostomy decannulation protocols there remains tremendous variability in practice. The effect of tracheostomy capping on decannulation has been studied but the role of speaking valves (SVs) is unknown.

Objective Given the positive benefits SVs have on rehabilitation, we hypothesized that SVs would decrease time to tracheostomy decannulation. The purpose of the present study was to evaluate this in a subset of patients with chronic lung disease of prematurity (CLD).

Methods A retrospective chart review was performed at a tertiary care children's hospital. A total of 105 patients with tracheostomies and CLD were identified. Data collected included demographics, gestational age, congenital cardiac disease, airway surgeries, granulation tissue excisions, SV and capping trials, tracheitis episodes, and clinic visits. Statistics were performed with logistic and linear regression.

Results A total of 75 patients were included. The mean gestational age was 27 weeks (standard deviation [SD] = 3.6) and the average birthweight was 1.1 kg (SD = 0.6). The average age at tracheostomy was 122 days (SD = 63). A total of 70.7% of the patients underwent decannulation and the mean time to decannulation (TTD) was 37 months (SD = 19). A total of 77.3% of the patients had SVs. Those with an SV had a longer TTD compared to those without (52 versus 35 months; p = 0.008). Decannulation was increased by 2 months for every increase in the number of hospital presentations for tracheitis (p = 0.011).

Conclusion The present study is the first, to our knowledge, to assess the effect of SVs on tracheostomy decannulation in patients with CLD showing a longer TTD when SVs are used.
Ethical Considerations in Neuroprognostication Following Acute Brain Injury
Authors: Lissak India A. , Edlow Brian L. , Rosenthal Eric , Young Michael J.
Published: October 2023

Neuroprognostication following acute brain injury (ABI) is a complex process that involves integrating vast amounts of information to predict a patient's likely trajectory of neurologic recovery. In this setting, critically evaluating salient ethical questions is imperative, and the implications often inform high-stakes conversations about the continuation, limitation, or withdrawal of life-sustaining therapy. While neuroprognostication is central to these clinical “life-or-death” decisions, the ethical underpinnings of neuroprognostication itself have been underexplored for patients with ABI. In this article, we discuss the ethical challenges of individualized neuroprognostication including parsing and communicating its inherent uncertainty to surrogate decision-makers. We also explore the population-based ethical considerations that arise in the context of heterogenous prognostication practices. Finally, we examine the emergence of artificial intelligence-aided neuroprognostication, proposing an ethical framework relevant to both modern and longstanding prognostic tools.
2.10 Iron-Catalyzed Cross Coupling of Alkyl Electrophiles
Authors: Adak L. , Sahoo S. , Aoki S. , Kawanaka Y. , Nakamura M.
Published: October 2023

Over the past several decades, significant progress has been made in the field of transition-metal-catalyzed carbon–carbon bond formation. Among these advancements, iron-catalyzed reactions have garnered significant attention in organic chemistry due to their economic and environmental advantages. Iron complexes have emerged as highly promising catalysts for carbon–carbon coupling reactions. They possess several advantageous features, such as low cost, widespread availability, and lower toxicity compared to other transition metals commonly used as catalysts. Through the utilization of iron catalysts, the coupling of organometallic reagents with diverse substrates has been achieved, leading to the synthesis of a wide range of important organic compounds. In this review, the main focus is on iron-catalyzed cross-coupling reactions involving alkyl electrophiles and various organometallic reagents. These organometallic reagents include those based on organomagnesium, organozinc, organoaluminum, and organoboron nucleophiles. The objective is to create C—C bonds through these reactions. Iron salts, when combined with suitable additives or ligands, have been employed as efficient catalysts in these processes.
2.12 Asymmetric C—H Oxidation with Biologically Inspired Manganese and Iron Catalysts
Authors: Vicens L. , Palone A. , Costas M.
Published: October 2023

Enantioselective oxidation of aliphatic C—H bonds is the most straightforward and atom-economical approach to prepare chiral oxygenated hydrocarbon skeletons, which are ubiquitous in molecules of biological and industrial relevance. In Nature, this reaction is carried out by metalloenzymes with high levels of efficiency and selectivity. Due to the exquisite performance of enzymatic systems, their active site has served as inspiration for the exploration of artificial catalysts, such as those based on porphyrins or coordination compounds with tetradentate salen- or bis-amine-bis-pyridine-type ligands. Reviewed herein are the latest advances in enantioselective C—H oxidations using biologically inspired iron and manganese complexes.
China’s mask and vaccine diplomacy in Latin America: a success story?
Authors: Nolte Detlef
Published: October 2023

The article offers a differentiated and encompassing assessment regarding China's mask and vaccine diplomacy as part of a strategy to advance its interests in Latin America. It revises the extant literature on the topic and provides a broad overview of the state of research. While most studies only cover the period until mid-2021, this article provides a comprehensive compilation of descriptive statistics on shipments and donations of COVID-19 vaccine to Latin America until the end of 2021. The data shows how Chinese advantages regarding the delivery of vaccines evaporated in the second half of 2021. While the Chinese government was relatively successful in avoiding damage to its image at the beginning of the pandemic, it failed to consolidate sympathy gains in Latin America. China has also been unable to capitalize on its mask and vaccine diplomacy to further push back Taiwan's influence in the region. Chinese mask and vaccine diplomacy was not a game changer in Latin America, neither in geopolitical nor in geo-economic terms.
Hermeneutic Calvinball versus modest digital humanities in philosophical interpretation
Authors: Alfano Mark
Published: October 2023

In “Calvin and Hobbes,” the character Calvin invents the game of Calvinball. No two games of Calvinball are alike because the only stable rule of Calvinball is that the players make up the rules as they go along, and no rule (other than the one stable rule) can be used twice. Whether a player is winning at a particular game of Calvinball is thus definitionally indeterminate. In philosophy, we risk playing something like Calvinball. It’s often unclear what the rules are, whether there are rules, and who gets to make up the rules as we go along. Even in the more restricted domain of the history of philosophy—the focus of the current paper—it’s often unclear what the rules are, whether there are rules, and who gets to make them up as we go along. Some interpreters of, for instance, Nietzsche, insist on sticking to the letter of the text. Others, most notoriously Heidegger and his followers, insist that what’s most important about a philosopher like Nietzsche is not what he wrote but what he didn’t write. Just like in Calvinball, because people play by different rules and make it up as they go along, it can be hard to tell who is winning an interpretive argument. This paper proposes that digital humanities offers a modest way forward for interpreters who don’t want to play Calvinball. In particular, it is argued that digital humanities methods can be used (1) to set a default for the importance of various concepts, (2) to periodize a philosopher’s works and track the increase or decline in importance of various concepts across a philosopher’s career, and (3) to establish which conceptual connections should or should not be attributed to a philosopher. The value of this approach is demonstrated with a detailed investigation of Nietzsche on the functions of shame.
The European approach to online disinformation: geopolitical and regulatory dissonance
Authors: Casero-Ripollés Andreu , Tuñón Jorge , Bouza-García Luis
Published: October 2023

The COVID-19 health crisis and the invasion of Ukraine have placed disinformation in the focus of European policies. Our aim is to analyze the emerging European policy on counter-disinformation practices and regulations. To do this, we examine developing European Union (EU) strategy, against different forms of fake news, from a multidisciplinary approach that combines Journalism and Geopolitics. Our methodology is based on the critical analysis of documents generated by the EU on disinformation from 2018 to 2022, including reports, communications, statements and other legislative texts. Our findings suggest that the EU’s policy against disinformation is based on two opposing logics that coexist and compete. The first is securitization, which understands this problem as a threat to democracy that legitimizes ‘exceptional decision-making’ from a hard power perspective. The second is based on the self-regulation and voluntarism of digital platforms with a clear orientation towards soft law and minimal intervention. The recent adoption of the Digital Services Act and the stronger regulation of online platforms do not replace this logic, since this legislation adopts a “co-regulatory framework”. The coexistence of these two logics generates internal contradictions and dissonance that can determine the future of European policies on this important topic and its chances of success.
Analysing effective social media communication in higher education institutions
Authors: Capriotti Paul , Zeler Ileana
Published: October 2023

This paper aims to analyse the institutional communication of universities on social media by conducting a content analysis of the communication strategy of 70 higher education institutions (in the United States, Europe and Latin America). The study focuses on three social networks (Facebook, LinkedIn and Twitter) and the analysis three dimensions of social media institutional communication: posting, interactivity and content. Findings reveal that while most universities demonstrate a passive centripetal performance to posting, there is a significant divergence in relation to the level of activity. The study highlights that interactivity focus is predominantly characterised by monologues, despite institutions increasingly integrating various communication resources to foster stakeholder interaction. The majority of universities tend to prioritize exclusive or dominant content combination, with organizational content exhibiting a significantly greater presence. By an integrated analysis of these three key dimensions on social media, this paper this paper offers valuable insights for both academics and practitioners. It contributes to the scholars by facilitating further academic research on social media institutional communication and provides professionals with a practical guide for strategically managing communication on social media.
A sustainable solution to promote interest-based municipal solid waste management
Authors: Xin Fangkun , Wan Xingyue
Published: October 2023

Incineration is a crucial option for municipal solid waste (MSW) management. How to deal with the “Not In My Back Yard” (NIMBY) movement in the construction of incineration stations has become a global public policy issue. This paper explores the impact of local authorities on MSW management when incineration is adopted to process municipal waste. The study uses four open cases from news reporting as the research data and applies the social network analysis (SNA) method for empirical analysis. Our results suggest that intervention by local authorities significantly improves the level of MSW management. The paper shows the following promotion mechanism: local authorities reconstructed the selected incentives of the residents who participated in the NIMBY movements based on their interests rather than on oppression. This is fundamentally different from the literature on how centralized regimes deal with protests. This paper addresses the need to research incineration stations’ impact on MSW management. It provides a specific reference for formulating policy recommendations that are relevant to green finance for MSW management.
An algebraic quantum field theoretic approach to toric code with gapped boundary
Authors: Wallick Daniel
Published: October 2023

Topologically ordered quantum spin systems have become an area of great interest, as they may provide a fault-tolerant means of quantum computation. One of the simplest examples of such a spin system is Kitaev’s toric code. Naaijkens made mathematically rigorous the treatment of toric code on an infinite planar lattice (the thermodynamic limit), using an operator algebraic approach via algebraic quantum field theory. We adapt his methods to study the case of toric code with gapped boundary. In particular, we recover the condensation results described in Kitaev and Kong and show that the boundary theory is a module tensor category over the bulk, as expected.
Numerical studies of shock–vortex interaction over a wedge during shock-wave diffraction—A new approach
Authors: Pal Ribhu , Roy Arnab , Halder Pabitra
Published: October 2023

In this study, shock wave diffraction has been investigated through a numerical simulation of a moving normal shock incident on a sharp-edged wedge. Schardin's problem is revisited using some existing and new mathematical tools. Two-dimensional compressible Navier–Stokes equation is solved using a higher-order version of the rhoCentralFoam solver in the OpenFOAM platform. Overall flow structures are captured with high efficacy. The divergence of the Lamb vector is used to probe the interaction between vorticity bearing and fluid straining motion, which increases dramatically inside the primary vortex after collision with the reflected Mach stem and increases the turbulent kinetic energy (TKE). In the separated shear layer that emerges from the wedge tip, there is a reduction of TKE after the collision between the lambda shock and accelerated shock. The vorticity pumping into the mean flow by the baroclinic torque is dominant in the separated shear layer before the above collision, whereas after collision it is only dominant inside the primary vortex. A new vector M is introduced here, which is the cross product of the vorticity vector and the pressure gradient vector. The divergence of M shows the interaction between the pressure gradient and the vorticity gradient. This interaction affects the separation bubble formed over the base wall of the wedge due to the shock-wave/boundary layer interaction induced by the lambda shock. Dynamic mode decomposition shows a dominant mode at a frequency of 125.7 Hz, which is due to low-frequency shock oscillation.
A production term study of delayed detached eddy simulation for turbulent near wake based on proper orthogonal decomposition
Authors: Bai Ruijie , Ma Mingze , Zhang Jinrong , Jiang Zhenhua , Yan Chao
Published: October 2023

In this study, we investigate the distribution of turbulent kinetic energy (TKE) in the near wake of a circular cylinder in a turbulent flow. Numerical calculations were performed using the delayed detached eddy simulation method, incorporating two different production terms for TKE: one in its original form and the other with the Kato–Launder correction term. Our results demonstrate that the turbulence model utilizing the Kato–Launder correction term exhibits a strong correlation between TKE and the vorticity field, which is related to the calculations of mean velocity, velocity fluctuation, and other parameters that are in closer agreement with direct numerical simulation and experimental values. By employing the proper orthogonal decomposition technique, we extract and reconstruct three significant modes within the flow: the shear layer mode, vortex shedding mode, and near-wake bubble mode. The findings reveal that the Kato–Launder correction term offers a more detailed portrayal closer to the real flow physics. Conversely, the original form of the TKE production term exhibits an uneven energy distribution among the three modes and affects the role of the diffusion term within the flow. This leads to a less accurate representation of the vortex shedding mode and an excessive diffusion effect in the near-wake bubble mode. Finally, possible modifications of the turbulence model in this problem are given to enhance the portrayal of these characteristics. This work presents an analytical framework that enables a comprehensive analysis of turbulence models, providing valuable physical insights and guidance for improvement.
A high-throughput electrophysiology assay to study the response of PIEZO1 to mechanical stimulation
Authors: Murciano Nicoletta , Rotordam Maria Giustina , Becker Nadine , Ludlow Melanie J. , Parsonage Gregory , Darras Alexis , Kaestner Lars , Beech David J. , George Michael , Fertig Niels , Rapedius Markus , Brüggemann Andrea
Published: October 2023

PIEZO1 channels are mechanically activated cation channels that play a pivotal role in sensing mechanical forces in various cell types. Their dysfunction has been associated with numerous pathophysiological states, including generalized lymphatic dysplasia, varicose vein disease, and hereditary xerocytosis. Given their physiological relevance, investigating PIEZO1 is crucial for the pharmaceutical industry, which requires scalable techniques to allow for drug discovery. In this regard, several studies have used high-throughput automated patch clamp (APC) combined with Yoda1, a specific gating modifier of PIEZO1 channels, to explore the function and properties of PIEZO1 in heterologous expression systems, as well as in primary cells. However, a combination of solely mechanical stimulation (M-Stim) and high-throughput APC has not yet been available for the study of PIEZO1 channels. Here, we show that optimization of pipetting parameters of the SyncroPatch 384 coupled with multihole NPC-384 chips enables M-Stim of PIEZO1 channels in high-throughput electrophysiology. We used this approach to explore differences between the response of mouse and human PIEZO1 channels to mechanical and/or chemical stimuli. Our results suggest that applying solutions on top of the cells at elevated pipetting flows is crucial for activating PIEZO1 channels by M-Stim on the SyncroPatch 384. The possibility of comparing and combining mechanical and chemical stimulation in a high-throughput patch clamp assay facilitates investigations on PIEZO1 channels and thereby provides an important experimental tool for drug development.
A nonperturbative approach to Hawking radiation and black hole quantum hair
Authors: Wang Lan
Published: October 2023

We present a nonperturbative derivation of the subleading order in Hawking radiation based on diffeomorphism symmetry breaking during black hole evaporation. The diffeomorphism group of horizon admits a nontrivial phase factor which encodes information about infalling matter during formation. This nonintegrable phase represents the black hole quantum hair as it arises from the diffeomorphisms that change the physical state of the black hole. During evaporation, the decrease in total area breaks the diffeomorphism symmetry and leads to a dynamical shift in that phase factor. This shift affects the usual Hawking spectrum via dispersion relation and results in the subleading term in Hawking radiation. The higher order terms are locally insensitive to the Unruh radiation due to the lack of diffeomorphism groups on the local Rindler horizon at the low energy scale. This explains the generic difference between Hawking radiation and Unruh radiation. In addition, this phase shift indicates the decrease of the total number of degrees of freedom in horizon phase space during evaporation as past Page time. This enables us to escape from the firewall paradox and provide an account for the resolution to the information paradox.
Plasma characteristics of medium voltage AC air arc discharge and its application on arc electrical parameters calculation
Authors: Zhou Tong , Yang Qing , Yuan Tao , He Hengxin , Liu Hongwen
Published: October 2023

Medium voltage (MV) AC air arcs occur frequently in distribution networks. An electric arc can easily cause electrical fires, leading to serious accident consequences. Obtaining the electrical characteristics of arc faults through arc models is a crucial measure to detect and prevent arc faults. The arc electrical characteristics are affected by many factors such as the ambient air pressure, current magnitude, and arc length, and it is difficult to describe it in an analytical form. The widely used conventional black-box arc model reflects the influence of multiple factors on the electrical characteristics of arcs through fitting or empirical formulae. The model ignores the intrinsic physical and chemical processes, and the applicable range of the model is limited. Focusing on this problem, based on the physicochemical processes of the arc in the arcing and post-arcing stages, a relationship between the electrical and plasma characteristics of the MV AC air arc was established. Subsequently, the arc plasma characteristics were determined experimentally, and were applied to the calculation of the arc electric characteristics. Finally, the calculation results of the arc electrical characteristics were verified using the experimental results, providing a basis for related model improvements and applications.