bluuebunny/crossref_metadata_2025 huggingface dataset:
Cholinergic Neurotransmission
Authors: Marrs T. C.
Published: May 2024

Neurotransmitters enable transmission at synapses and from nerve cells to effector organs such as muscles and autonomic effector organs. They are complex: in the case of cholinergic transmission, the system comprises afferent nerves, containing the acetylcholine (ACh), where it is synthesized and stored in vesicles, from which the ACh is released in response to a nerve impulse. At the synapse, neuromuscular junctions and autonomic effector organs, there are specialized receptors, where binding of the neurotransmitter induces a response. There are two main types of receptors: nicotinic receptors, which are ligand-gated ion channels, and muscarinic receptors, which are metabotropic and operate via G proteins. Agonists and antagonists have been identified for each type of receptor and termination of neurotransmission is effected by acetylcholinesterase. Anticholinesterases are substances that antagonize acetylcholinesterase and have important uses as insecticides/acaricides and minor uses in medicine, and certain organophosphates are potentially chemical warfare agents. Cholinergic antagonists have a variety of uses in medicine.
GABAergic Neurotransmission and Toxicity 2: Macrocyclic Lactones
Authors: Woodward Kevin N.
Published: May 2024

The term “macrocyclic lactones” refers to a group of drugs typified by the avermectins and milbemycins. The former group includes abamectin, ivermectin, eprinomectin, doramectin, selamectin and emamectin benzoate, while the latter group comprises moxidectin and milbemycin oxime. They are widely used as antiparasitic agents in veterinary medicine, but ivermectin has been widely used in humans for the prophylaxis and treatment of filariasis, onchocerciasis and loiasis, in addition to other parasitic conditions; while more recently, moxidectin has been authorized for the treatment of onchocerciasis. These drugs have excellent safety profiles in routine toxicity tests at low-to-moderate dosages, but at high doses, neurotoxicity, typified by mydriasis, tremors, convulsions, ataxia and locomotor abnormalities and neurodegeneration, occurs. A specific strain of mouse, the CF-1 mouse, is more susceptible to the toxic effects of macrocyclic lactones than other strains. The CF-1 mouse is deficient in P-glycoprotein in the intestinal epithelium and brain endothelium when compared to non-sensitive animals, permitting greater intestinal absorption of these drugs and higher brain exposure. P-glycoprotein is an efflux pump encoded by the ABCB1 gene. Deficiency or disruption of this gene leads to higher toxicity of the macrocyclic lactones and other drugs in this mouse strain. Some dogs, notably but not exclusively the collie, have defective ABCB1 genes, leading to a greater susceptibility to the neurotoxic effects of some macrocyclic lactones. There is no evidence to suggest that these drugs may pose undue risks to humans when used at the recommended therapeutic doses.
Monoamine Neurotransmission and Toxicity
Authors: Moyano P. , Del Pino J.
Published: May 2024

Monoaminergic system functions are mediated by the action of serotonin (5-HT), noradrenaline (NA), dopamine (DA), and histamine (HT) monoamine neurotransmitters (MNs), which regulate vital bodily functions. Monoaminergic neurotransmission disruption leads to toxic effects, which could end in fatal consequences and could be caused by dysfunction of the enzymes that synthesize and metabolize MNs, the transporters that mediate their reuptake, and the receptors that mediate their action. A wide range of compounds were reported to alter the expression and/or activity of the target proteins that regulate monoaminergic neurotransmission, especially drugs, leading to toxic effects. However, the effects of environmental pollutants on the monoaminergic systems have been less studied, especially in the histaminergic system. Otherwise, the monitorization of MN levels and the activity of some of these target proteins that regulate MN systems were shown to be useful as markers of neurotoxicity. This chapter addresses the mechanisms of MN disruption, the toxic effects that these disruptions produce, the main environmental chemicals that mediate these effects, and the remaining information that needs to be collected.
Testing the hypothesis that solvent exchange limits the rates of calcite growth and dissolution
Authors: Rampal Nikhil , Wang Hsiu-Wen , Brady Alexander B. , Borreguero Jose M. , Biriukov Denys , Mamontov Eugene , Stack Andrew G.
Published: May 2024

Using neutron scattering dynamics measurements to validate molecular dynamic simulations, it is found that the rates of solvent exchange are not likely to limit the rates of calcite crystal growth and dissolution.
Enhancing the electrochemical properties of TiNb2O7 anodes with SP-CNT binary conductive agents for both liquid and solid state lithium ion batteries
Authors: Cheng Li-Qian , Xie Xinyuan , Chen Kai , He Yijuan , Xu Hu , Liu Ruiping , Feng Ming
Published: May 2024

The electrochemical properties of solid state synthesized TiNb2O7 anodes were enhanced with (SP-CNT) binary conductive agents, which construct an efficient electronic conductive network in both liquid and solid state lithium ion batteries.
LiCl in situ decorated metal–organic framework (MOF)-derived porous carbon for efficient solar-driven atmospheric water harvesting
Authors: Guo Simiao , Hu Yue , Fang Zhou , Yao Bing , Peng Xinsheng
Published: May 2024

LiCl in situ decorated MOF-derived porous carbon sorbents (PCl-4) were prepared from Li-MOFs for atmospheric water harvesting. PCl-4 displays excellent water-capture capabilities and efficient solar-driven water release with nice recyclability.
Regulating d0 transition metals and facilitating high-performance Li-excess cation-disordered rock salt cathode materials
Authors: Song Hui , Xie Wenyong , Tian Yinfeng , Guo Min , Wang Tao , Kang Dianwu , Jia Min , Zhang Xiaoyu
Published: May 2024

A systematic study was performed on Ti-doped Li1.2Mn0.43+TixMn0.4−x4+O2, which revealed the fast kinetics of Li diffusion with an improvement in the electrochemical property of MT0−1, thus providing a guideline for DRXs cathode materials design.
Sulfur-assisted ammonia treatment of a fibrous carbon matrix to fabricate a high-content pyrrole-type Fe–N–C catalyst for superior oxygen reduction
Authors: Hu Hongyin , Qiao Rui , Miao Runyang , Sun Huimin , Duan Fang , Zhu Han , Du Mingliang , Lu Shuanglong
Published: May 2024

High-content pyrrole-type iron–nitrogen–carbon sites on a fibrous carbon matrix were successfully prepared through ammonia treatment with pre-doping of sulfur, which shows excellent performance toward the oxygen reduction reaction.
Enhanced urea oxidation catalysis through Ni single-atom doping on Cu2O surfaces: a computational study
Authors: Li Xiaoqing , Lin Haiping , Huang Wenjing , Xiong Shiyun , Huang Shaoming
Published: May 2024

Ni single-atom doped on Cu2O:{110}Cu surface can effectively reduce the overpotential of urea oxidation reaction (UOR).
A bio-ionic liquid based self-healable and adhesive ionic hydrogel for the on-demand transdermal delivery of a chemotherapeutic drug
Authors: Pansuriya Raviraj , Doutch James , Parmar Bhagyesh , Kailasa Suresh Kumar , Mahmoudi Najet , Hoskins Clare , Malek Naved I.
Published: May 2024

A multifunctional [Cho][Gly] and oleic acid based ionic hydrogel for transdermal delivery of the hydrophilic drug 5-FU in breast cancer treatment.
Non-fused ring electron acceptors with an ethynylene linker for non-halogenated solvent-processed organic solar cells
Authors: Luo Dou , Kyaw Aung Ko Ko , Dai Tingting , Zhou Erjun , Wong Wai-Yeung
Published: May 2024

This study explores the design, synthesis and application of two non-fused ring electron acceptors (NFREAs), namely PAcT-Cl and CAcT-Cl, featuring an ethynylene linker, in non-halogenated solvent-processed organic solar cells (OSCs).
Rare-earth UiO-66 for temperature sensing near room temperature
Authors: Djanffar Elias , Bicalho Hudson A. , Ajoyan Zvart , Howarth Ashlee J. , Serier-Brault Hélène
Published: May 2024

Eu-Tb-UiO-66 acts as a highly sensitive luminescent thermometer near room temperature.
Quantum chemical studies of transition metal single-atom catalysts: exploration of catalytic descriptors
Authors: Li Bo , Zheng Mingyue , Lin Shichen , Gu Feng Long , Jiang Jun , Jia Chuanyi
Published: May 2024

This work provides important insight into the structure–activity relationships of transition metal single-atom catalysts. Various traditional, spectral and electronic descriptors are suggested.
Loci cg06256735 and cg15815843 in the MFAP5 gene regulatory regions are hypomethylated in varicose veins apparently due to active demethylation
Authors: Smetanina Mariya A. , Korolenya Valeria A. , Sipin Fedor A. , Oscorbin Igor P. , Sevostyanova Kseniya S. , Gavrilov Konstantin A. , Shevela Andrey I. , Filipenko Maxim L.
Published: May 2024

Varicose vein disease (VVD) is a common health problem worldwide. Microfibril-associated protein 5 (MFAP5) is one of the potential key players in its pathogenesis. Our previous microarray analysis revealed the cg06256735 and cg15815843 loci in the regulatory regions of the MFAP5 gene as hypomethylated in varicose veins which correlated with its up-regulation. The aim of this work was to validate preliminary microarray data, estimate the level of 5-hydroxymethylcytosine (5hmC) at these loci, and determine the methylation status of one of them in different layers of the venous wall. For this, methyl- and hydroxymethyl-sensitive restriction techniques were used followed by real-time PCR and droplet digital PCR, correspondingly, as well as bisulfite pyrosequencing of +/- oxidized DNA. Our microarray data on hypomethylation at the cg06256735 and cg15815843 loci in whole varicose vein segments were confirmed and it was also demonstrated that the level of 5hmC at these loci is increased in VVD. Specifically, among other layers of the venous wall, tunica (t.) intima is the main contributor to hypomethylation at the cg06256735 locus in varicose veins. Thus, it was shown that hypomethylation at the cg06256735 and cg15815843 loci takes place in VVD, with evidence to suggest that it happens through their active demethylation leading to up-regulation of the MFAP5 gene, and t. intima is most involved in this biochemical process.
Few-Shot Named Entity Recognition with the Integration of Spatial Features
Authors: LIU Zhiwei , HUANG Bo , XIA Chunming , XIONG Yujie , ZANG Zhensen , ZHANG Yongqiang
Published: May 2024

The few-shot named entity recognition (NER) task aims to train a robust model in the source domain and transfer it to the target domain with very few annotated data. Currently, some approaches rely on the prototypical network for NER. However, these approaches often overlook the spatial relations in the span boundary matrix because entity words tend to depend more on adjacent words. We propose using a multidimensional convolution module to address this limitation to capture short-distance spatial dependencies. Additionally, we utilize an improved prototypical network and assign different weights to different samples that belong to the same class, thereby enhancing the performance of the few-shot NER task. Further experimental analysis demonstrates that our approach has significantly improved over baseline models across multiple datasets.
Portable Structure Surface Crack Detection System Based on Android Platform
Authors: WANG Huifeng , PENG Haonan , TANG Yu , GUAN Yueyuan , LIANG Yaru , WANG Lisha , ZHAO Yu , WANG Xiaoyan , GAO Rong , HUANG He
Published: May 2024

Cracks, potholes, and other defects often occur on infrastructure such as bridges, among which cracks are one of the most frequent defects. They have diverse shapes and are difficult to detect. Traditional manual inspection methods are inefficient and have low accuracy, while automated inspection machines are bulky and inconvenient to carry and use. Based on the shortcomings of existing detection technologies, this paper proposes a portable structural surface crack detection system based on the Android platform using a portable handheld image acquisition device. The system captures cracks on the structure's surface and obtains high-definition crack images. Then, these images are transmitted to portable smartphone terminals through Wi-Fi. Next, the image is pre-processed using weighted averaging, grayscale linear transformation, and adaptive median filtering. Then, the improved Canny edge detection algorithm is applied to identify crack information, and the edge segmentation algorithm is used to determine the crack width. Finally, based on camera calibration, the pixels are converted into the length data required for actual measurement. The results show that the system is easy to operate, and it not only has crack storage and tracking functions, but also can effectively measure the crack width on the surface of components. The measurement accuracy of this system reaches the sub-pixel level, and in actual testing, compared with the crack width gauge, the maximum relative error does not exceed 6.25%.
Analysis and Key Parameter Optimization Design of Leningrader Seal Performance
Authors: YANG Dongya , WANG Xuelin , WANG Feng , ZHANG Hailong , GAO Gui
Published: May 2024

In order to improve the performance and service life of the Leningrader seal of the Stirling engine piston rod, interference, preload and friction coefficient were taken as influencing factors, and the curved surface response method was adopted to reduce the contact stress of sealing surface and von Mises stress of the sealing sleeve as the response index, with the optimization goal of reducing wear and extending life. The above three key parameters are analyzed and optimized, the influence of each parameter on the sealing performance and service life is obtained, and the best combination scheme of the three is determined. The results show that the interaction between pretightening force and interference fit has the greatest impact on contact stress. The interaction between interference fit and friction coefficient has the most significant effect on von Mises stress. The optimized parameters can reduce the maximum contact stress and maximum von Mises stress of the sealing sleeve by 26.3% and 20.6%, respectively, under a media pressure of 5-9 MPa. Test bench verification shows that the leakage of the optimized sealing device in 12 h is reduced by 0.44 cc·min-1 (1 cc=1 cm3). The wear rate of the sealing sleeve is 1.08% before optimization and 0.45% after optimization, indicating that the optimized parameters in this paper are effective.
„Wo ist die richtige Schwester?“
Authors: Schwencke Silja
Published: May 2024

Pflegekräfte mit Migrationshintergrund werden immer wieder diskriminiert. Dabei
kommen die verbalen Übergriffe nicht nur von Patienten. Auch die eigenen
Kollegen äußern sich rassistisch – bewusst oder auch unbewusst.
„Sonographer“ bringen Licht ins Dunkel – Berufsfeldanalyse in
Deutschland
Authors: Paetzold Katrin
Published: May 2024

Durch technische Innovationen der Medizin können Krankheiten effektiv und
effizient diagnostiziert werden. Eine dieser modernen Untersuchungsverfahren
stellt die Sonografie dar. Das Potenzial einer neuen Diagnostikmethode lässt
sich jedoch nur ausschöpfen, wenn Anwender*innen entsprechend dafür qualifiziert
sind.

Die Durchführung sonografischer Untersuchungen wird international in
verschiedenen Gesundheitsberufen gelehrt. Menschen, welche diese Tätigkeit
hauptberuflich ausführen, werden als Sonographer bezeichnet. In Deutschland
beschränken sich die sonografischen Qualifizierungen auf den ärztlichen Bereich.
Die Praxis zeigt jedoch, dass auch andere Gesundheitsberufe diese Tätigkeit
durchführen, was zu einem Bedarf an Zielgruppen-spezifischen Weiterbildungen
führt.

Daher wurde zur Entwicklung eines Kompetenzprofils eine empirische
Berufsfeldanalyse deutscher Sonographer durchgeführt. Anhand von
Experteninterviews und einer teilnehmenden Beobachtung konnten unter Anwendung
der Grounded-Theory-Methodologie Daten von 4 Sonographern in unterschiedlichen
klinischen Settings erhoben und analysiert werden. Dabei kristallisierten sich
Konzepte der beruflichen Anforderungen heraus, die in deutschen
Weiterbildungsempfehlungen für die Sonografie nicht berücksichtigt werden.

Die Situationen, in denen sich Sonographer täglich wiederfinden, sind komplex.
Sie interagieren gleichzeitig mit Patient*innen in lebensverändernden
Situationen sowie ärztlichem Personal in unterschiedlichen Ausbildungsphasen
oder Führungspositionen. Dies erfordert zusätzlich zum sonografischen Fachwissen
ein hermeneutisches Fallverstehen, wissenschaftliche und pädagogische
Fähigkeiten sowie Kompetenzen des selbstgesteuerten Lernens.

Der Beruf des Sonographers befindet sich in Deutschland noch am Anfang seiner
Entwicklung. Best-Practice-Beispiele für eine Qualifizierung im tertiären
Bereich finden sich bereits in Österreich und im englischsprachigen Raum. Die
Erkenntnisse dieser berufspädagogisch orientierten Arbeit sollen die Grundlage
eines Curriculums für Sonographer darstellen.
Persönliche Schutzausrüstung in der Endoskopie
Authors: Beilenhoff Ulrike
Published: May 2024

Die persönliche Schutzausrüstung (PSA) ist ein wichtiges Instrument in der
Endoskopie, um das untersuchende Team, Patienten und weitere Personen zu
schützen. Die zunehmenden Diskussionen um die Nachhaltigkeit im Gesundheitswesen
bringen die PSA auch in der Endoskopie auf den Prüfstand. Wie sieht die korrekte
Schutzausrüstung in der Endoskopie aus? Worauf kann verzichtet werden? Was ist
essenziell?
DEGEA-DGF-Positionspapier zu erweiterten Pflegekompetenzen im
Krankenhaus im Rahmen des geplanten Pflegekompetenzgesetz des Bundesministerium
für Gesundheit
Authors: Beilenhoff Ulrike , Bichel Silke , Huth Anke , Brodowski Steffen , Edenharter Kathrina , Engelke Monika , Keienburg Christa , Kortgen Maria
Published: May 2024

Als Mitgliedsverbände des Deutschen Pflegerats (DPR) haben die Deutsche Gesellschaft
für Fachkrankenpflege und Funktionsdienste e. V. (DGF) und die Deutsche Gesellschaft
für Endoskopiefachberufe e.V. (DEGEA) bereits ihre Anmerkungen zum vorläufigen
Eckpunktepapier des Pflegekompetenzgesetzes in die kritische Stellungnahme des DPR
eingebracht 1 und befürworten alle dort
genannten Punkte. Darüber hinaus soll in diesem Papier besonders auf die Anliegen
der 2-jährig (fach-)weitergebildeten Pflegefachpersonen in spezialisierten Bereichen
(Intensivstation, Intermediate Care [IMC]) und Funktionsbereichen (OP, Anästhesie,
Endoskopie und Zentrale Notaufnahmen), vor allem im Akutsetting des Krankenhauses,
aufmerksam gemacht werden.
Tanaka and Johnston Space Analysis: Does It Apply to All Populations?
Authors: Al-Zubaydi Fudhla Sadoon , Obaid Dina H. , Nahidh Mohammed , Marrapodi Maria Maddalena , Ronsivalle Vincenzo , Cicciù Marco , Minervini Giuseppe
Published: May 2024

Objectives An accurate analysis is considered a crucial factor that enables the clinician to select the appropriate treatment plan which may include serial extractions, guiding of eruption, maintenance of space or regaining it, or just intervallic patient observation during this period. This study aims to test the applicability of the Tanaka and Johnston prediction equations on Iraqi population.

Materials and Methods One hundred pairs of stone models belonged to 100 Iraqi adult individuals with normal occlusal relationship were utilized in this study. The greatest crown diameters of all teeth except the maxillary incisors and molars in both jaws were measured using digital calipers. The Tanaka and Johnston prediction equations were applied and modification for these equations was developed for Iraqis.

Results The original Tanaka and Johnston method of prediction tends to overestimate the mesiodistal widths of the canine and premolars among Iraqis. Novel regression equations (modified Tanaka and Johnston method) were formulated for Iraqi population and seem to be more accurate than the original one.

Conclusions The original Tanaka and Johnston method cannot be applied for Iraqi population; hence, new equations were developed for both genders and in both dental arches to accurately predict the mesiodistal widths of the unerupted canine and premolars.
Enhancing Pediatric Dental Care: The Influence of Virtual Reality
Authors: Hamdy Sara Faisal , Farag Mohamed Sherif Mohamed Salah , Helmy Yousra Samir , Abo-Elsoud Asmaa Ali
Published: May 2024

Objective The purpose of this study was to assess the effects of virtual reality (VR) in reducing pain and anxiety levels in children. The study also compared active and passive distraction methods using VR during the delivery of inferior alveolar nerve blocks (IANBs) in dental procedures in children.

Material and Methods The study comprised 45 preschool patients, aged between 4 and 6 years, with no prior dental anesthetic experience. The participants were randomly assigned to three groups based on the sort of management style: Group A used the tell-show-do technique, Group B engaged in passive distraction by watching cartoons using a VR headset, and Group C participated in active distraction by playing games using a controller with the VR headset. Pain and anxiety were evaluated using physiological measurements, namely by analyzing the variations in blood pressure, heart rate, and oxygen saturation before and after the administration of IANB. Psychological assessments were conducted using the Wong–Baker faces scale, Modified Dental Anxiety scale questionnaires, and Revised Face, Legs, Activity, Cry and Consolability scale after administering IANB.

Results The physiological outcomes revealed no statistically significant differences in blood pressure and oxygen saturation. However, there was a statistically significant increase in the heart rate in group A compared with groups B and C. In terms of psychological measurements, groups B and C exhibited a significant improvement in pain experience and a decrease in anxiety.

Conclusion This study concluded that VR reduced pain and anxiety levels in its passive and active forms.
The perils of poly- and perfluorinated chemicals on the reproductive health of humans, livestock, and wildlife
Authors: Green Mark P. , Shearer Cameron , Patrick Rebecca , Kabiri Shervin , Rivers Nicola , Nixon Brett
Published: May 2024

Poly- and perfluoroalkyl substances (PFAS) are a prominent class of persistent synthetic compound. The widespread use of these substances in various industrial applications has resulted in their pervasive contamination on a global scale. It is therefore concerning that PFAS have a propensity to accumulate in bodily tissues whereupon they have been linked with a range of adverse health outcomes. Despite this, the true extent of the risk posed by PFAS to humans, domestic animals, and wildlife remains unclear. Addressing these questions requires a multidisciplinary approach, combining the fields of chemistry, biology, and policy to enable meaningful investigation and develop innovative remediation strategies. This article combines the perspectives of chemists, soil scientists, reproductive biologists, and health policy researchers, to contextualise the issue of PFAS contamination and its specific impact on reproductive health. The purpose of this article is to describe the challenges associated with remediating PFAS-contaminated soils and waters and explore the consequences of PFAS contamination on health and reproduction. Furthermore, current actions to promote planetary health and protect ecosystems are presented to instigate positive social change among the scientific community.
A fungal protein organizes both glycogen and cell wall glucans
Authors: Loza Liza , Doering Tamara L.
Published: May 2024

Glycogen is a glucose storage molecule composed of branched α-1,4-glucan chains, best known as an energy reserve that can be broken down to fuel central metabolism. Because fungal cells have a specialized need for glucose in building cell wall glucans, we investigated whether glycogen is used for this process. For these studies, we focused on the pathogenic yeast
Cryptococcus neoformans
, which causes ~150,000 deaths per year worldwide. We identified two proteins that influence formation of both glycogen and the cell wall: glycogenin (Glg1), which initiates glycogen synthesis, and a protein that we call Glucan organizing enzyme 1 (Goe1). We found that cells missing Glg1 lack α-1,4-glucan in their walls, indicating that this material is derived from glycogen. Without Goe1, glycogen rosettes are mislocalized and β-1,3-glucan in the cell wall is reduced. Altogether, our results provide mechanisms for a close association between glycogen and cell wall.
The modal analysis of the Hungarian future auxiliary fog ‘will, be going to’
Authors: Virovec Viktória
Published: May 2024

In this paper it is argued that the Hungarian future auxiliary fog is a modal rather than a
temporal operator. As opposed to previous findings in the literature, the paper claims that it can be used when the proposition is
inferred, therefore it can have an epistemic modal base. The results of a questionnaire study and introspective data are presented
to support this claim. Based on these data, it is argued that the distributional difference between fog and the
non-past cannot be explained by the presence or absence of temporal ambiguity only, the choice also depends on the context.
Namely, the use of the non-past is marginal if the speaker infers the truth of the proposition from contextually known facts,
while fog is natural and acceptable in such cases. The Hungarian data presented further strengthen the hypothesis
that there is a strong connection between future-referring morphemes and epistemic modality.
A contrastive analysis of (-)ish in English and Swedish blogs
Authors: Aijmer Karin
Published: May 2024

The aim is to investigate whether (-)ish is employed in the same structures and functions in
English and Swedish blog data and to describe the adaptations and changes resulting from borrowing. (-)ish is
exceptional because it looks like a suffix but can be taken out of its original context with adjectives and nouns and used as a
clitic or an independent word. Based on samples from the two languages it is shown that there are quantitative differences with
respect to the uses of (-)ish with different base forms and as a freestanding sentence-final item in the two data
sets. The qualitative findings reveal that (-)ish has been borrowed in Swedish as a suffix, a clitic, as a
qualifier with hedging function and as a sentence-final pragmatic marker. The change in the position of (-)ish is
influenced by the existence of a domestic variant typ (‘sort of’, ‘kind of’) which can be placed more freely in
the sentence than the English (-)ish.
The complex L2 self
Authors: Carolan Jordan , Devlin Anne Marie
Published: May 2024

Set against a body of research which tends to either overlook ideological differences between Eastern and Western conceptualizations of motivation or which positions Chinese students as ideologically monolithic, this study aims to explore the dynamic interaction between neoliberal and Neo-Confucian paradigms in shaping motivation for English language learning. By incorporating primary concepts from the Neo-Confucian motivational construct andDörnyei’s (2005)second language (L2) Motivational Self System, this study bridges the gap between Eastern and Western L2 motivational research and investigates how neoliberal/Neo-Confucian ideologies interact to influence Chinese university students’ motivations for learning English. More specifically, it explores how this develops during study abroad in Ireland. It was found that the motivational trajectories of eight participants comprised a complex synthesis of both ideologies during study abroad. Furthermore, their ought-to L2 selves and ideal L2 self imagery underwent dramatic alterations.
On the solvability of boundary value problems for linear differential-algebraic equations with constant coefficients
Authors: Assanova Anar , Trunk Carsten , Uteshova Roza
Published: May 2024

We study a two-point boundary value problem for a linear differential-algebraic equation with constant coefficients by using the method of parameterization. The parameter is set as the value of the continuously differentiable component of the solution at the left endpoint of the interval. Applying the Weierstrass canonical form to the matrix pair associated with the differential-algebraic equation, we obtain a criterion for the unique solvability of the problem.
A Remark on the Kadison-Singer Transform
Authors: Kucerovsky Dan
Published: May 2024

We interpret the recently proven Kadison-Singer conjecture as a transform, giving it a geometric interpretation, and in particular we show that it gives in a natural way a product operation on infinite-dimensional projective space.
The War Within Religion: Towards a More Nuanced Resolution of Religion–Equality Conflicts
Authors: Barak-Corren Netta
Published: May 2024

In the United States, Canada, Israel, Australia, and many parts of Europe, conflicts between religious liberty and gender equality (including LGBTQ equality) are understood and analyzed as “culture wars.” This view has shaped the sociolegal understanding of the conflict—how the legal community makes sense of cases and interprets their social significance—and has narrowed the perceived scope of legal solutions to religion–equality conflicts to zero-sum, either–or decisions: either a carte blanche for religious objectors or a strict and universal enforcement of anti-discrimination law.

Drawing on qualitative (N=41) and experimental (N=559) evidence from the United States and Israel and on cases from a range of countries and contexts, this Article makes two arguments: First, the understanding of religion–equality conflicts shall not be complete unless we recognize that they occur both between and within cultures. The two wars are connected in a feedback loop, as the struggle within religion influences what conflicts are waged at the culture war and what conflicts are resolved internally.

Second, the war within religion has normative implications: in this struggle, religious communities form intermediate solutions to regulate—and mitigate—religion–equality conflicts. These policies can help expand the nuance and scope of legal solutions to the conflict. Showing how, this Article makes a timely intervention in a legal debate that struggles with setting clear rules and seeks to find more nuanced resolutions for the conflict.
Congestion as a crucial factor determining albuminuria in patients with cardiorenal disease
Authors: Llàcer Pau , Cobo Marcos Marta , de la Espriella Rafael , Gayán Ordás Jara , Zegri Isabel , Fort Aleix , Rodríguez Chavarri Adriana , Méndez Ana , Blázquez Zorba , Caravaca Pérez Pedro , Rubio Gracia Jorge , Fernández Cristina , Recio-Mayoral Alejandro , Pomares Antonia , García Pinilla Jose Manuel , Vazquez López-Ibor Jorge , Castro Almudena , Soler Maria Jose , Górriz Jose Luis , Bascompte Claret Ramón , Fluvià Paula , Manzano Luis , Núñez Julio
Published: May 2024

Background

Albuminuria could potentially emerge as a novel marker of congestion in acute heart failure. However, the current evidence linking albuminuria and congestion in patients with congestive heart failure (CHF) remains somewhat scarce. This study aimed to evaluate the prevalence of albuminuria in a cohort of patients with CHF, identify the independent factors associated with albuminuria and analyse the correlation with different congestion parameters.

Methods

This is a subanalysis of the Spanish Cardiorenal Registry, in which we enrolled 864 outpatients with heart failure and a value of urinary albumin:creatinine ratio (UACR) at the first visit.

Results

The median age was 74 years, 549 (63.5%) were male and 438 (50.7%) had a reduced left ventricular ejection fraction. A total of 350 patients (40.5%) had albuminuria. Among these patients, 386 (33.1%) had a UACR of 30–300 mg/g and 64 (7.4%) had a UACR >300 mg/g. In order of importance, the independent variables associated with higher UACR were estimated glomerular filtration rate determined by the Chronic Kidney Disease Epidemiology Collaboration equation (R2 = 57.6%), systolic blood pressure (R2 = 21.1%), previous furosemide equivalent dose (FED; R2 = 7.5%), antigen carbohydrate 125 (CA125; R2 = 6.1%), diabetes mellitus (R2 = 5.6%) and oedema (R2 = 1.9%). The combined influence of oedema, elevated CA125 levels and the FED accounted for 15.5% of the model's variability.

Conclusions

In patients with chronic stable heart failure, the prevalence of albuminuria is high. The risk factors of albuminuria in this population are chronic kidney disease and hypertension. Congestion parameters are also associated with increased albuminuria.
A Balancing Act: Data Protection Compliance of Artificial Intelligence
Authors: Bartels Marvin
Published: May 2024

Neural network based generative artificial intelligence (GenAI) systems, in particular large language models (LLMs), hold huge potential for economic, scientific, and artistic progress. However, they are also the subject of ongoing fierce data protection debates. Some even doubt whether GenAI systems can, at least in principle, comply with the General Data Protection Regulation (EU) 2016/679 (GDPR). This issue was highlighted by a temporary ban of ChatGPT by the Italian data protection authority in March 2023. To answer the question of possible compliance with the GDPR, this paper will first illustrate relevant technical aspects and then examine the extent to which GenAI systems process personal data. A distinction will be made between training, use, and the system itself as stored on a hard drive. On this basis, this paper addresses the key question of the lawfulness of the respective processing activities, bearing in mind that each specific use case of any GenAI system requires a specific data protection assessment. While the issues discussed in this paper are relevant to GenAI systems in general, they are particularly relevant to LLMs trained on large amounts of text-based personal data. As one result, the analysis identifies serious challenges in the application of the GDPR to LLMs. However, with no significant updates to the relevant GDPR provisions in sight, this paper aims to show how pragmatic solutions are both necessary and largely possible even under the current legal framework. This includes practical guidance for developers and users on how to ensure compliance.
Clothing and Equipment Fit Among Male and Female Canadian Armed Forces Members
Authors: Gruevski Kristina M , Sy Adrienne , Bossi Linda , Moon Emma , Bae Junhan , Keefe Allan
Published: May 2024

Introduction

The fit of military clothing and equipment is essential for the health and safety of military operators. Given the aim of increasing the proportion of women and the known biological and morphological differences between male and female soldiers, an understanding of fit across different items of kit is needed. The aim of this study was to quantify subjective fit ratings of 8 items of military clothing and equipment, including combat shirt, combat pants, rucksack, small pack, tactical vest, fragmentation vest, helmet, and ballistic eyewear as a function of relative stature and occupational group among male and female Canadian Armed Forces members.

Materials and Methods

An online survey was distributed to male and female Canadian Armed Forces members, where fit was reported by participants according to a 7-point Likert acceptability scale. Participants were binned into 1 of 6 (3 males, 3 females) standing stature categories based on percentiles in a male and female distribution that included (1) under 35th percentile stature, (2) 35th to 80th percentile stature, and (3) over 80th percentile stature. Additionally, participants were separated according to occupational group: Group A: Infantry, Combat Engineer, Artillery, Armored; group B: Signals, Medical Technician, Intelligence, Signals Intelligence/Cyber Ops; group C: Supply Technician, Weapons Technician, Vehicle Technician, Electronic-Optronic Technician, Ammunition Technician; other: Not in other groups, examples include: Financial Services Administrator, Cook. This study was approved by the Defence Research and Development Canada Human Research Ethics Committee under protocol 2019-048, Amendment 2.

Results

There were significant effects attributable to stature category and occupational group on the fit of equipment. Specifically, fit acceptability of the rucksack helmet, small pack, and tactical vest was significantly affected by occupational group. Differences between stature categories were detected in all items with the exception of the small pack.

Conclusions

Military equipment fit has previously been shown to have implications for protection, performance, and mobility. The results of the investigation demonstrate different patterns of fit acceptability in male and female soldiers across items of clothing and equipment and may require different solutions.
Indications and Outcomes for Adult Extracorporeal Membrane Oxygenation at a Military Referral Facility
Authors: Murphy Samantha , Flatley Meaghan , Piper Lydia , Mason Phillip , Sams Valerie
Published: May 2024

Introduction

Extracorporeal life support, including extracorporeal membrane oxygenation (ECMO), is a potentially life-saving adjunct to therapy in patients experiencing pulmonary and/or cardiac failure. The U.S. DoD has only one ECMO center, in San Antonio, Texas. In this study, we aimed to analyze outcomes at this center in order to determine whether they are on par with those reported elsewhere in the literature.

Materials and Methods

In this observational study, we analyzed data from patients treated with ECMO at the only DoD ECMO center between September 2012 and April 2020. The primary outcome was survival to discharge, and secondary outcomes were discharge disposition and incidence of complications.

Results

One hundred and forty-three patients were studied, with a 70.6% rate of survival to discharge. Of the patients who survived, 32.7% were discharged home; 32.7% were discharged to a rehabilitation facility; and 33.7% were transferred to another hospital, 29.4% of whom were transferred to lung transplant centers. One patient left against medical advice. Incidence of ECMO-related complications were as follows: 64 patients (44.7%) experienced hemorrhagic complications, 80 (55.9%) had renal complications, 61 (42.6%) experienced cardiac complications, 39 (27.3%) had pulmonary complications, and 5 patients (3.5%) experienced limb ischemia. We found that these outcomes were comparable to those reported in the literature.

Conclusions

Extracorporeal membrane oxygenation can be an efficacious adjunct in management of critically ill patients who require pulmonary and/or cardiac support. This single-center observational study demonstrated that the DoD’s only ECMO center has outcomes comparable with the reported data in Extracorporeal Life Support Organization’s registry.
Emerging post-Dobbs liability concerns for providers handling embryos
Authors: Crockin Susan L. , Nardi Francesca E.
Published: May 2024

Purpose of review

This review outlines novel, emerging legal risks for in-vitro fertilization (IVF) providers and patients.

Recent findings

This article reviews recent antiabortion legal developments that create novel legal risks to IVF. This article examines new potential liability for the handling or managing of embryos, and threats to safe, efficient, standard-of-care practice of IVF. It reviews established US and international judicial and regulatory frameworks based on scientifically grounded recognition of IVF embryos as deserving of ‘special respect’, and finds this approach to be an alternative for law and policy makers.

Defining life as ‘beginning at fertilization’ (or ‘conception’) or otherwise embracing ‘embryonic personhood’ creates emerging legal vulnerabilities and concerns for IVF patients and professionals who handle embryos and threatens standard-of-care IVF. Internationally and domestically established, scientifically grounded understandings of IVF embryos, rather than religious beliefs, should be the basis for legal frameworks that accord appropriate – but not unlimited – protections to IVF embryos. This article presents this framework as an alternative to the current path being embraced by some US policymakers and courts, as a means of protecting the rights of patients, providers and the families they create.
The Three-points Chin: A Multilayered Filler Approach Using a Cannula
Authors: Adel Noury
Published: May 2024

The present study was conducted to evaluate the aesthetic results of the three-points chin filler injection using a SoftFil cannula, where the filler product is placed in a multilayered fashion. The study included 40 women who complained about their unaesthetic small chin. Revanesse Versa filler was injected into these patients using a SoftFil cannula in a multilayered fashion, targeting both the deep and superficial fat compartments. For the cannula, three points of entry were chosen depending on a specific anatomical landmark, providing chin beautification in three dimensions. All patients were followed up at the following intervals for recording their satisfaction score: 14 days, 2 months, 4 months, and 6 months. Satisfaction score recorded at 14-days follow-up showed a significant increase in patient satisfaction. This was maintained up to 6 months postoperative. The suggested three-points chin beautification technique using microcannula provides satisfactory results in three dimensions, compared with the original technique.
Prepectoral versus Subpectoral Breast Reconstruction after Nipple-sparing Mastectomy: A Systematic Review and Meta-Analysis
Authors: Nolan Ian T. , Farajzadeh Matthew M. , Bekisz Jonathan M. , Boyd Carter J. , Gibson Ella G. , Salibian Ara A.
Published: May 2024

Background:

Implant-based breast reconstruction after nipple-sparing mastectomy (NSM) presents unique benefits and challenges. The literature has compared outcomes among total submuscular (TSM), dual-plane (DP), and prepectoral (PP) planes; however, a dedicated meta-analysis relevant to NSM is lacking.

Methods:

We conducted a systematic review of studies on immediate breast reconstruction after NSM using TSM, DP, or PP prosthesis placement in PubMed, Embase, and Cochrane databases. In total, 1317 unique articles were identified, of which 49 were included in the systematic review and six met inclusion criteria for meta-analysis. Pooled descriptive outcomes were analyzed for each cohort for all 49 studies. Fixed-effects meta-analytic methods were used to compare PP with subpectoral (TSM and DP) reconstructions.

Results:

A total of 1432 TSM, 1546 DP, and 1668 PP reconstructions were identified for descriptive analysis. Demographics were similar between cohorts. Pooled descriptive outcomes demonstrated overall similar rates of reconstructive failure (3.3%–5.1%) as well as capsular contracture (0%–3.9%) among cohorts. Fixed-effects meta-analysis of six comparative studies demonstrated a significantly lower rate of mastectomy flap necrosis in the PP cohort compared with the subpectoral cohort (relative risk 0.24, 95% confidence interval [0.08–0.74]). All other consistently reported outcomes, including, hematoma, seroma, infection, mastectomy flap necrosis, nipple -areola complex necrosis, and explantation were comparable.

Conclusions:

A systematic review of the literature and meta-analysis demonstrated the safety of immediate prepectoral breast reconstruction after NSM, compared with submuscular techniques. Submuscular reconstruction had a higher risk of mastectomy flap necrosis, though potentially influenced by selection bias.
Identifying a therapeutic window of opportunity for people living with primary sclerosing cholangitis: Embryology and the overlap of inflammatory bowel disease with immune-mediated liver injury
Authors: Kellermayer Richard , Carbone Marco , Horvath Thomas D. , Szigeti Reka G. , Buness Cynthia , Hirschfield Gideon M. , Lewindon Peter J.
Published: May 2024

Primary sclerosing cholangitis (PSC) is a variably progressive, fibrosis-causing autoimmune disorder of the intrahepatic and extrahepatic bile ducts of unclear etiology. PSC is commonly (in 60%–90% of cases) associated with an inflammatory bowel disease (IBD) like PSC-IBD and less commonly with an autoimmune hepatitis (AIH) like PSC-AIH or AIH-overlap disorder. Hepatologists and Gastroenterologists often consider these combined conditions as distinctly different from the classical forms in isolation. Here, we review recent epidemiologic observations and highlight that PSC-IBD and PSC-AIH overlap appear to represent aspects of a common PSC clinico-pathological pathway and manifest in an age-of-presentation-dependent manner. Particularly from the pediatric experience, we hypothesize that all cases of PSC likely originate from a complex “Early PSC”-“IBD”-“AIH” overlap in which PSC defines the uniquely and variably associated “AIH” and “IBD” components along an individualized lifetime continuum. We speculate that a distinctly unique, “diverticular autoimmunity” against the embryonic cecal- and hepatic diverticulum-derived tissues may be the origin of this combined syndrome, where “AIH” and “IBD” variably commence then variably fade while PSC progresses with age. Our hypothesis provides an explanation for the age-dependent variation in the presentation and progression of PSC. This is critical for the optimal targeting of studies into PSC etiopathogenesis and emphasizes the concept of a “developmental window of opportunity for therapeutic mitigation” in what is currently recognized as an irreversible disease process. The discovery of such a window would be critically important for the targeting of interventions, both the administration of current therapies and therapeutic trial planning.
The Association Between Hospital-Based Food Pantry Use and Subsequent Emergency Department Utilization Among Medicaid Patients With Diabetes
Authors: Lim Kenneth , Nguyen Kevin H. , Goutos Demetri , Shafer Paul R. , Buitron de la Vega Pablo , Cole Megan B.
Published: May 2024

We explored the association between the use of a hospital-based food pantry and subsequent emergency department (ED) utilization among Medicaid patients with diabetes in a large safety-net health system. Leveraging 2015-2019 electronic health record data, we used a staggered difference-in-differences approach to measure changes in ED use before vs after food pantry use. Food pantry use was associated with a 7.3 percentage point decrease per patient per quarter (95% confidence interval, −13.8 to −0.8) in the probability of subsequent ED utilization (P = .03). Addressing food insecurity through hospital-based food pantries may be one mechanism for reducing ED use among low-income patients with diabetes.
New Horizons in Emergency Department Management of Pediatric Sickle Cell Disease
Authors: Umana Jasmine , Lapite Ajibike , Ellison Angela M.
Published: May 2024

Sickle cell disease (SCD) is an important topic for emergency medicine audiences because complications of the disease account for a large proportion of hematologic emergencies that are seen in the emergency department each year. Early recognition and aggressive management of emergency complications of SCD can help to reduce the morbidity and mortality associated with this disease. Although the treatment recommendations for some complications of SCD are based on expert opinion, there has been advancement in the understanding of the pathogenesis of the disease and evidence regarding the treatment options available for managing acute complications. This continuing medical education article will provide a summary of the clinical manifestation and management of the most common acute complications of SCD: infection, vaso-occlusive episode, acute chest syndrome, splenic sequestration, stroke, and priapism.