bluuebunny/crossref_metadata_2025 huggingface dataset:
Role of thoracic endovascular aortic repair in T4b esophageal cancer management: a systematic review
Authors: Papaconstantinou Dimitrios , Koliakos Nikolaos , Tzortzis Andrianos-Serafeim , Mandrakas Nikolaos , Bakopoulos Anargyros , Lianos Georgios D , Peroulis Michail , Schizas Dimitrios
Published: July 2024

The incidence of T4b esophageal cancer with aortic invasion but without distant metastasis is estimated to be between 3.8% and 4.6% of all esophageal cancer cases. Development of an aortoesophageal fistula in such cases is a rare but not unlikely event, leading to catastrophic consequences. The aim of this systematic review is to evaluate the importance of aortic stenting (Thoracic Endovascular Aortic Repair—TEVAR) and its optimal timing in the management of locally advanced esophageal cancer. A systematic literature search of the MEDLINE, Scopus, and Google Scholar databases was undertaken to identify relevant studies published up to March 2024. An individual patient data analysis was performed by forming a patient cohort with elective and salvage TEVAR subgroups, depending on the timing of the stenting. The study pool consisted of 25 studies incorporating 101 cases of locally advanced esophageal cancer, with a median age of 64 years (range 45–87 years). Of them, 50 patients underwent elective TEVAR compared with 51 patients receiving TEVAR in an acute salvage setting. Elective or prophylactic TEVAR was found to significantly increase esophageal resection rates (65.6% vs. 16.7% in the salvage subgroup, P < 0.001), concurrently reducing complication rates (8.3% vs. 36.1%, P < 0.001). Overall survival was also prolonged in the elective subgroup (8.3 vs. 4 months, P = 0.001), with elective stenting being the only independent predictor of improved survival. In conclusion, management with aortic stenting in high-risk patients may reduce the catastrophic consequences of massive bleeding, minimize complications, and enhance survival rates.
Value of high-output pace-mapping of the right phrenic nerve for enabling safe radiofrequency ablation of atrial fibrillation: insights from three-dimensional computed tomography segmentation
Authors: Squara Fabien , Supple Gregory , Liuba Ioan , Wasiak Michal , Zado Erica , Desjardins Benoit , Marchlinski Francis E
Published: July 2024

Aims

Right phrenic nerve (RPN) injury is a disabling but uncommon complication of atrial fibrillation (AF) radiofrequency ablation. Pace-mapping is widely used to infer RPN’s course, for limiting the risk of palsy by avoiding ablation at capture sites. However, information is lacking regarding the distance between the endocardial sites of capture and the actual anatomic RPN location. We aimed at determining the distance between endocardial sites of capture and anatomic CT location of the RPN, depending on the capture threshold.

Methods and results

In consecutive patients undergoing AF radiofrequency ablation, we defined the course of the RPN on the electroanatomical map with high-output pacing at up to 50 mA/2 ms, and assessed RPN capture threshold (RPN-t). The true anatomic course of the RPN was delineated and segmented using CT scan, then merged with the electroanatomical map. The distance between pacing sites and the RPN was assessed. In 45 patients, 1033 pacing sites were analysed. Distances from pacing sites to RPN ranged from 7.5 ± 3.0 mm (min 1) when RPN-t was ≤10 mA to 19.2 ± 6.5 mm (min 9.4) in cases of non-capture at 50 mA. A distance to the phrenic nerve > 10 mm was predicted by RPN-t with a ROC curve area of 0.846 [0.821–0.870] (P < 0.001), with Se = 80.8% and Sp = 77.5% if RPN-t > 20 mA, Se = 68.0% and Sp = 91.6% if RPN-t > 30 mA, and Se = 42.4% and Sp = 97.6% if non-capture at 50 mA.

Conclusion

These data emphasize the utility of high-output pace-mapping of the RPN. Non-capture at 50 mA/2 ms demonstrated very high specificity for predicting a distance to the RPN > 10 mm, ensuring safe radiofrequency delivery.
Repeated feeding guild evolution: the impact of competition on diversification
Authors: Powell Gareth S , Saxton Natalie A , Duffy Alexandra G , Bybee Seth M , Cameron Stephen L , Cline Andrew R , McElrath Thomas C , Gimmel Matthew L , Johnson Jerald B , Leschen Richard A B , Skelley Paul E , Gunter Nicole L
Published: July 2024

Adaptive zones are defined as ecological opportunities for lineages to diversify. Cucujoid beetles provide a unique system to investigate adaptive zones, specifically the interplay between factors that may predict diversity and mechanisms such as competition that may limit diversification. Using a taxon-rich, time-calibrated phylogeny of cucujoid beetles, we report clade ages in conjunction with estimated ages for major shifts in feeding ecology within this group. With these ages, we calculate the delay in time-to-colonization of food resources compared with the extant diversity of each group. We uncovered a pattern of increased lineage diversity specifically with shifts to novel food resources probably devoid of competition from other cucujoid beetles. Neither diversity of the food resource, age of the food resource, nor age of the beetle lineage were able to predict species diversity of these groups. Our results provide evidence that shifting to a resource first is a strong predictor of extant diversity.
Editorial: thematic issue on modulating the environment with microbes
Authors: Sood Utkarsh , Garg Gauri , Lal Rup
Published: July 2024

The significance of heme to Enterococcus faecalis is reviewed while also identifying the prevalence of hemoproteins throughout the enterococci and highlighting gaps in knowledge in enterococcal mechanisms of heme homeostasis.
Subjective Successful Aging in the Presence of Mobility Disability
Authors: Khamzina Madina , Rogers Wendy A
Published: July 2024

Background and Objectives

Researchers often define successful aging as freedom from disability and disease, yet the perceptions of older adults living with disability challenge this conception, demonstrating that they can indeed age successfully. This paper adapts a framework of successful aging with disability, basing it on the subjective assessment of key components contributing to success among older adults living with mobility disability due to multiple sclerosis.

Research Design and Methods

Employing a qualitative, theory-grounded methodology, we conducted semi-structured interviews with 20 individuals aged 60-75 who live with mobility disability attributed to multiple sclerosis. The open-ended questions explored their perspectives on the aging process, their definition of successful aging, and the coping strategies they employ in navigating challenges associated with age and their condition.

Results

Despite facing mobility disabilities, the majority (16 out of 20) expressed a sense of successful aging, identifying five key themes: accepting reality, maintaining a positive attitude, fostering independence, nurturing a social life, and preserving cognitive abilities. They achieved successful aging by focusing on alternatives, relying on external support, having a good attitude and faith, and accepting their challenges.

Discussion and Implications

The themes identified in this research contribute to redefining successful aging in future studies and facilitating the development of interventions aimed at improving the quality of life for older adults coping with mobility disability.
In Vitro Exposure of Treponema pallidum to Subbactericidal Doxycycline Did Not Induce Resistance: Implications for Doxycycline Postexposure Prophylaxis
Authors: Tantalo Lauren C , Luetkemeyer Anne F , Lieberman Nicole A P , Nunley B Ethan , Avendaño Carlos , Greninger Alexander L , Celum Connie , Giacani Lorenzo
Published: July 2024

Doxycycline postexposure prophylaxis (doxy-PEP) could significantly reduce syphilis incidence. However, the increase in intermittent doxycycline usage might select resistant Treponema pallidum strains. To assess whether resistance to doxycycline could be induced in this pathogen, we exposed the SS14 strain in vitro, both intermittently and continuously, to a subbactericidal doxycycline concentration that still exerts antibiotic pressure. During and after each exposure experiment, we assessed the doxycycline minimal inhibitory concentration in test and control treponemes and performed whole-genome sequencing, concluding that no resistance developed. This work suggests that doxycycline-resistant T. pallidum is not an immediate threat for doxy-PEP implementation.
The Kinematics of Proal Chewing in Rats
Authors: McParland E D , Mitchell J K , Laurence-Chasen J D , Aspinwall L C , Afolabi O , Takahashi K , Ross C F , Gidmark N J
Published: July 2024

Synopsis

Chewing kinematics are well-documented in several mammal species with fused mandibular symphyses, but relatively understudied in mammals with an unfused symphysis, despite the fact that more than half of extant Mammalia have an unfused mandibular symphysis. The Wistar brown rat (Rattus norvegicus) is widely used in human health research, including studies of mastication or neurological studies where mastication is the output behavior. These animals are known to have unfused mandibular symphyses and proal jaw (rostrocaudal) motion during occlusion, but the lack of high resolution, 3-dimensional analysis of rat chewing leaves the functional significance of symphyseal mobility unknown. We used biplanar fluoroscopy and the X-ray reconstruction of moving morphology workflow to quantify chewing kinematics in 3 brown rats, quantifying overall jaw kinematics, including motions about the temporomandibular joint and unfused mandibular symphysis. During occlusion, the teeth and the mandibular condyle translate almost exclusively anteriorly (proal) during occlusion, with little motion in any other degrees of freedom. At the symphysis, we observed minimal flexion throughout the chew cycle. Overall, there are fundamental differences in jaw kinematics between rats and other mammals and therefore rats are not an appropriate proxy for ancestral mammal jaw mechanics. Additionally, differences between humans and rat chewing kinematics must be considered when using rats as a clinical model for pathological feeding research.
Between Probability and Possibility: Fostering Productive Research in a Dystopian Moment
Authors: Avant Deborah
Published: July 2024

Scholars endeavor to understand the world in order to make it better. To do that, they should pay attention not only to probability but also possibility. I argue that accepting, and centering, the uncertainty endemic to the human condition and human relations could lead to at least two productive shifts. First, it could encourage holding tensions between particularity and generalization, description and theorization, and complexity and simplicity rather than resolving them a priori. This would promote more genuine thinking about the issues we study. Second, it could encourage critical reasoning about both epistemological bias and the limits of utopian ideas, leading to more serious ethical and normative considerations. I encourage honest conversations about the ubiquity of uncertainty and braver efforts to hold tensions, use our judgement and think. Holding space for unpredictability and imperfection promises to both yield better arguments about probability and open up insights into what is possible. It will thus foster research that best meets the demands of our time.
Examining the Impact of Digital Jury Moderation on the Polarization of U.S. Political Communities on Social Media
Authors: Micek Christopher , Solovey Erin T
Published: July 2024

The increased prevalence of misinformation and inflammatory rhetoric online has amplified polarization on social media platforms in the United States, propelling a feedback loop resulting in the erosion of democratic norms. We conducted a study assessing how a social media platform employing appointed moderators would impact the polarization of its users compared to a peer-based digital jury moderation system, which may be better able to harness community knowledge and cultural nuances while fostering a sense of inclusion and trust in the moderation process. Although our study did not observe a significant impact on the polarization of moderators or users, moderators on average viewed the system as just, legitimate and effective at reducing harmful content. Furthermore, there were no significant differences between user perceptions of the content they were shown from either system, indicating that implementing such a peer-based system has the benefit of providing users agency in platform governance without adversely impacting user experience.
Microaerobic-mediated suppression of Klebsiella pneumoniae mucoviscosity is restored by rmpD overexpression
Authors: Sun Wangnan , Rong Chengbo , Chen Liang , Li Jiarui , An Zhijing , Yue Jinglin , Wei Hengkun , Han Kai , Hua Mingxi , Zeng Hui , Chen Chen
Published: July 2024

Aims

Hypervirulent Klebsiella pneumoniae (hvKp) causes invasive community-acquired infections in healthy individuals, and hypermucoviscosity (HMV) is the main phenotype associated with hvKp. This study investigates the impact of microaerobic environment availability on the mucoviscosity of K. pneumoniae.

Methods and results

By culturing 25 clinical strains under microaerobic and aerobic environments, we observed a notable reduction in mucoviscosity in microaerobic environments. RNA sequencing and qRT-PCR revealed downregulated expressions of capsule synthesis genes (galf, orf2, wzi, wza, wzb, wzc, wcaj, manC, manB, and ugd) and regulatory genes (rmpA, rmpD, and rmpC) under microaerobic conditions. Transmission electron microscopy and Indian ink staining analysis were performed, revealing that the capsular thickness of K. pneumoniae decreased by half in microaerobic conditions compared to aerobic conditions. Deletion of rmpD and rmpC caused the loss of the HMV phenotype in both aerobic and microaerobic conditions. However, compared to wild-type strain in microaerobic condition, only rmpD overexpression strain, and not rmpC overexpression strain, displayed a significant increase in capsule thickness in microaerobic conditions.

Conclusions

Microaerobic conditions can suppress the mucoviscosity of K. pneumoniae, but this suppression can be overcome by altering the expression of rmpD, indicating a specific function for rmpD in the oxygen environmental adaptation of K. pneumoniae.
A scoping review of rule-based clinical decision support malfunctions
Authors: Thayer Jeritt G , Franklin Amy , Miller Jeffrey M , Grundmeier Robert W , Rogith Deevakar , Wright Adam
Published: July 2024

Objective

Conduct a scoping review of research studies that describe rule-based clinical decision support (CDS) malfunctions.

Materials and Methods

In April 2022, we searched three bibliographic databases (MEDLINE, CINAHL, and Embase) for literature referencing CDS malfunctions. We coded the identified malfunctions according to an existing CDS malfunction taxonomy and added new categories for factors not already captured. We also extracted and summarized information related to the CDS system, such as architecture, data source, and data format.

Results

Twenty-eight articles met inclusion criteria, capturing 130 malfunctions. Architectures used included stand-alone systems (eg, web-based calculator), integrated systems (eg, best practices alerts), and service-oriented architectures (eg, distributed systems like SMART or CDS Hooks). No standards-based CDS malfunctions were identified. The “Cause” category of the original taxonomy includes three new types (organizational policy, hardware error, and data source) and two existing causes were expanded to include additional layers. Only 29 malfunctions (22%) described the potential impact of the malfunction on patient care.

Discussion

While a substantial amount of research on CDS exists, our review indicates there is a limited focus on CDS malfunctions, with even less attention on malfunctions associated with modern delivery architectures such as SMART and CDS Hooks.

Conclusion

CDS malfunctions can and do occur across several different care delivery architectures. To account for advances in health information technology, existing taxonomies of CDS malfunctions must be continually updated. This will be especially important for service-oriented architectures, which connect several disparate systems, and are increasing in use.
Multi-modality risk prediction of cardiovascular diseases for breast cancer cohort in the All of Us Research Program
Authors: Yang Han , Zhou Sicheng , Rao Zexi , Zhao Chen , Cui Erjia , Shenoy Chetan , Blaes Anne H , Paidimukkala Nishitha , Wang Jinhua , Hou Jue , Zhang Rui
Published: July 2024

Objective

This study leverages the rich diversity of the All of Us Research Program (All of Us)’s dataset to devise a predictive model for cardiovascular disease (CVD) in breast cancer (BC) survivors. Central to this endeavor is the creation of a robust data integration pipeline that synthesizes electronic health records (EHRs), patient surveys, and genomic data, while upholding fairness across demographic variables.

Materials and Methods

We have developed a universal data wrangling pipeline to process and merge heterogeneous data sources of the All of Us dataset, address missingness and variance in data, and align disparate data modalities into a coherent framework for analysis. Utilizing a composite feature set including EHR, lifestyle, and social determinants of health (SDoH) data, we then employed Adaptive Lasso and Random Forest regression models to predict 6 CVD outcomes. The models were evaluated using the c-index and time-dependent Area Under the Receiver Operating Characteristic Curve over a 10-year period.

Results

The Adaptive Lasso model showed consistent performance across most CVD outcomes, while the Random Forest model excelled particularly in predicting outcomes like transient ischemic attack when incorporating the full multi-model feature set. Feature importance analysis revealed age and previous coronary events as dominant predictors across CVD outcomes, with SDoH clustering labels highlighting the nuanced impact of social factors.

Discussion

The development of both Cox-based predictive model and Random Forest Regression model represents the extensive application of the All of Us, in integrating EHR and patient surveys to enhance precision medicine. And the inclusion of SDoH clustering labels revealed the significant impact of sociobehavioral factors on patient outcomes, emphasizing the importance of comprehensive health determinants in predictive models. Despite these advancements, limitations include the exclusion of genetic data, broad categorization of CVD conditions, and the need for fairness analyses to ensure equitable model performance across diverse populations. Future work should refine clinical and social variable measurements, incorporate advanced imputation techniques, and explore additional predictive algorithms to enhance model precision and fairness.

Conclusion

This study demonstrates the liability of the All of Us’s diverse dataset in developing a multi-modality predictive model for CVD in BC survivors risk stratification in oncological survivorship. The data integration pipeline and subsequent predictive models establish a methodological foundation for future research into personalized healthcare.
Association between work productivity and characteristics of adults with X-linked hypophosphatemia: an analysis of the XLH disease monitoring program
Authors: Khan Aliya , Johnson Ben , Nixon Annabel , Dent Jennifer E , Li Zhiyi , Yang Erru , Williams Angela
Published: July 2024

X-linked hypophosphatemia (XLH) is a rare, genetic, progressive, phosphate-wasting disorder that causes skeletal morbidities, stiffness, pain, and impaired physical function. This study used baseline data from the XLH Disease Monitoring Program to evaluate relationships between work productivity and patient characteristics (demographics, medical history, patient-reported, and functional outcomes) in adults with XLH. Bivariate analysis guided the selection of variables for multivariate analysis after adjustment for multicollinearity and conceptual overlap. The analysis comprised 281 subjects (75.4% female; 80.8% from USA; median age 39.2 yr); 53.4% were employed full-time and 31.3% were not employed; 15.3% were receiving disability payments; 47.0% were taking burosumab at study entry. Most employed subjects were working full-time outside the home (69.9%) and in light or sedentary roles (59.6%). In multivariate analyses, patients with fewer orthopedic surgeries (odds ratio [OR] 0.88; 95% confidence interval [CI], 0.81–0.96; p=.002) and better Patient-Reported Outcomes Measurement Information System Physical Function scores (OR 1.08; 95% CI, 1.02–1.15; p=.013) were more likely to be in full-time employment than not employed. Younger patients (OR 0.97; 95% CI, 0.94–0.99; p=.014) and those with fewer orthopedic surgeries (OR 0.83; 95% CI, 0.73–0.95; p=.008) were more likely to be in medium than light or sedentary work. Those with worse WOMAC Pain scores were more likely to be doing heavy/very heavy than light or sedentary activity (OR 1.04; 95% CI, 1.01–1.07; p=.006). Full-time employment levels are low in adults of working age with XLH, and unemployment and disability payment rates are high, suggesting that XLH has a substantial impact on work productivity. Worse physical function and a greater number of orthopedic surgeries are associated with lower work productivity. Worse pain, higher number of orthopedic surgeries, and younger age are associated with heavier work roles; however, causality was not specifically investigated.
Numerical simulations of the acoustic and electrical properties of digital rocks based on tetrahedral unstructured mesh
Authors: Xiao Zhanshan , Zhang Haining , Wang Yi , Ni Hao , Liu Xuefeng , Zhao Jianbing , Zhang Yonghao , Zhang Chenjun , Wei Bo
Published: July 2024

Unconventional reservoirs typically exhibit strong heterogeneity leading to a significant scale effect in digital rock physics simulations. To ensure the reliability of the simulation results, improving computational efficiency and increasing sample sizes are crucial. In this study, we present a numerical finite element simulation method for the acoustic and electrical properties of digital rock cores based on tetrahedral unstructured meshes. We calculated the elastic moduli and electrical resistivity of the Fontainebleau sandstone digital rock samples. A comparison was made between the tetrahedral mesh and the traditional voxel-based hexahedral mesh in terms of the accuracy and efficiency of finite element numerical simulations. The results indicate that this numerical simulation method based on the tetrahedral mesh exhibits high accuracy comparable to experimental results, and its computational efficiency is significantly improved compared to the traditional hexahedral mesh method. These findings highlight the advantages of this finite element simulation method in improving the computational scale and efficiency of digital rock simulations. It effectively addresses common computational resource constraints in dealing with large-scale core systems and facilitates better integration with engineering construction, well-logging instrument simulations, and production applications.
Challenging Consent—Applicant Versus Amicus Curiae Interventions in Sexual Violence Cases in South Africa
Authors: Swemmer Sheena
Published: July 2024

This note presents and analyses the Centre for Applied Legal Studies’ (CALS) considerations regarding whether to intervene as an amicus curiae or a co-applicant in Embrace v. Minister of Justice and Correctional Services (Embrace), a legal case which questions the constitutionality of the mistaken belief in consent defence in relation to rape (and other sexual offences). To present CALS’ litigation considerations, which formed the decision of whether to intervene in Embrace as an amicus curiae or co-applicant, this note presents the legal context around the mistaken belief defence. It then expands on CALS’ position around the framing of mistaken belief, which differs from the two applicants in Embrace. Finally, it presents CALS’ considerations that were required around entering the Embrace case as an applicant as opposed to entering as an amicus curia. The considerations included the benefit of co-applicants to raise new legal issues, and the forms of recourse available to amici versus co-applicants, the principle of the ‘low-hanging fruits’, and finally, potential liability around costs.
Understanding UNITAD
Authors: Rensink Rowie
Published: July 2024

On 21 September 2017, the United Nations (UN) Security Council established the ‘United Nations Investigative Team to Promote Accountability for Crimes Committed by Da’esh/ISIL’ (UNITAD) and tasked it to collect, preserve, and store evidence of international crimes committed by the Islamic State in Iraq. The creation of UNITAD does not stand alone. Since 1963, the UN has mandated more than 80 non- or semi-judicial ad hoc ‘Investigative Mechanisms’ (IM) in response to atrocities and situations of international concern. Recently, the realm of UN investigation witnessed an ‘accountability-turn’: by lack of other criminal justice avenues, IMs are set up and mandated to gather evidence, qualify conducts, attribute responsibility and pave the way for prosecution. Ample attention has been paid to their output and impact, but how they constitute themselves as a means to their ends — how they in actual practice interpret their mandate — has been severely understudied. This study takes UNITAD as a case and explores why it is doing what it does, how it does it, and what the implications hereof can be. Based on a literature review and expert interviews, this explorative study describes the intended purpose, priorities and principles of the written mandate as agreed upon by the UN Security Council and the Government of Iraq, and analyses UNITAD’s interpretation of these parameters in practice. It concludes that UNITAD has taken a restrictive stance with respect to some aspects of the written mandate while seeking leeway with respect to others. This navigation — informed by politics, practicalities and personality — strongly implicates the prospects of transitional justice: whereas UNITAD was mandated to foster criminal accountability, it has and still can facilitate broader forms of justice too.
Personalism and Negotiation during Civil Conflicts
Authors: Cao Ruixing
Published: July 2024

Under what conditions do authoritarian regimes negotiate with the rebels and accept mediation during civil conflicts? While extant literature on autocracies and conflicts has demonstrated that personalist regimes are most likely to experience both interstate and civil wars, scholars have paid less attention to how civil conflicts unfold under these regimes. Meanwhile, the characteristics of the state fighting civil conflicts can profoundly influence the battlefield dynamics, the state's willingness to negotiate, and the involvement of third-party actors. However, extant research on civil war negotiation and mediation has not identified the specific types of states that engage in negotiations. Building on research in authoritarian politics and wartime negotiation, I build a theory that connects personalist regimes with negotiation and mediation during civil conflicts. I argue that personalist regimes are more likely to negotiate with the rebels due to their low military effectiveness and high level of policy flexibility. The repressive nature of personalist regimes and their lack of credibility make bilateral negotiations more difficult to occur, increasing the probability of third-party mediation. Using comprehensive data on authoritarian regimes and civil war negotiations, this article finds support for these arguments.
Bargaining (in)visibility: Rohingya refugees and the politics of visibility in India
Authors: Mitra Rohini , Şahin-Mencütek Zeynep
Published: July 2024

Despite relatively low numbers, Rohingya refugees in India have faced a spiralling, multi-factorial crisis of negative visibility over the past decade, constructed by public opinion, politicians, and media coverage. This paper examines this process of negative visibility, largely outside of the community’s control, its very real consequences, and in response, how refugees navigate within an increasingly hostile policy landscape. Relying on qualitative data collected with refugees, community leaders, and NGOs in Delhi, Jaipur, and Hyderabad (2022–23), we make three interrelated arguments. First, the visibility of the Rohingya as ‘illegal immigrants’ is driven by multiple spatial and episodic factors and actors embedded in India’s fragmented refugee governance. Second, refugees seem to adopt strategic mobilities/immobilities and pursue visibility in both mediated and coerced ways to protect themselves against the risks of negative visibility. Third, these strategies have unintended consequences for reassertion of hierarchical power relations within the community and with state authorities. Empirical evidence from the Rohingya case in India contributes to growing scholarly discussion on the co-constitutive politics of (in)visibility, (im)mobility, and fragmented refugee governance in South Asia.
Assessments and developments in constructing a National Health Index for policy-making, in the UK
Authors: Freni-Sterrantino Anna , Prescott Thomas P , Ceely Greg , Glickman Myer , Holmes Chris
Published: July 2024

Composite indicators are useful for summarizing and comparing changes among different communities. The UK Office for National Statistics has created an annual England Health Index (2015–2018) comprised of three main health domains—lives, places, and people—to monitor health over time and across different geographical areas and evaluate the nation’s health. We reviewed the conceptual coherence and statistical requirements, focusing on three main steps: correlation analysis at different levels, comparison of the implemented weights, and a sensitivity and uncertainty analysis. Based on the results, we have highlighted features that have improved the statistical requirements of the forthcoming UK Health Index.
EU attacks on investor rights
Authors: Devereux Steven M
Published: July 2024

The European Commission, with the cooperation of the Court of Justice of the European Union (CJEU), continues a crusade against investors’ rights. This is done by reducing the rights of access by investors to an independent arbitral tribunal to resolve disputes and by making arbitral awards impossible to enforce. The CJEU judgments which are discussed in this article are arbitrary, lack logical argument, and ignore international law (in particular, the 1969 Vienna Convention on the Law of Treaties). Recent judgments by states that are not EU Member States have restored the validity of arbitral awards that were annulled by EU courts. The judgments show that they do not believe in the CJEU judgments, which have led to the cancellation of inter-EU Bilateral Investment Treaties and the annulment of Energy Charter Treaty awards.
Donor conception, direct-to-consumer genetic testing, choices, and procedural justice: an argument for reform of the Human Fertilisation and Embryology Act 1990
Authors: Redhead Caroline A B , Frith Lucy
Published: July 2024

In this article, using theories of procedural justice and ‘slow violence’, we consider potential reform of the Human Fertilisation and Embryology Act 1990. Our theoretical discussion is underpinned by findings from the ConnecteDNA project, exploring how people affected by donor conception experience direct-to-consumer genetic testing (DTCGT). The negative impacts of DTCGT, especially shock discoveries about the circumstances of someone’s conception in adulthood, are linked to donor anonymity, and how its continued protection is experienced as a barrier to the rights and agency of donor-conceived people. We focus on two key issues relating to the donor information access process set out in section 31ZA of the 1990 Act. The first is that it excludes certain cohorts of donor-conceived people, creating inequalities of access to donor information. The second is the impact of the use of DTCGT to search for that information. We discuss what a procedurally just process of law reform would look like, concluding that, whatever (prospective) approach to donor anonymity is taken, the donor information access process should be the same for all donor-conceived people. We thus argue that, even were the status quo to be maintained, reform of the donor information access process with retrospective effect would be required.
The Military Medicine Leadership Life Cycle: A Model for Longitudinal Leadership Development in Medicine—Undergraduate and Graduate Medical Education
Authors: Barry Erin S , Hartzell Joshua D , Durning Steven J , Yarnell Angela M
Published: July 2024

Physicians must be leaders more than ever with innumerable challenges. Despite this need, there is a paucity of consistent leadership development (LD) from medical student to staff physician. Military medicine has additional challenges—working within a large health care organization, constant turnover, working in a variety of contexts—that make the need for LD even more pressing. The purpose of this paper is to describe the LD life cycle for military undergraduate and graduate medical education (UME and GME), providing examples for other organizations while identifying steps to meet the future needs in military medicine. The Health Professions Scholarship Program produces over 75% of graduates for military medicine each year. Yet, since learners are dispersed throughout civilian medical schools any LD results in a heterogeneous experience. Uniformed Services University has a 4-year LD program required for all students as well as other opportunities for leadership professional growth. Military GME programs are unique, requiring a military unique curriculum to prepare graduates for their initial assignments. Military unique curriculum vary, but include clinical topics relevant to military medicine as well as leadership. There is no Military Healthcare System-wide leadership curriculum used by everyone at this time. Based on these UME and GME approaches to LD, there have been multiple lessons learned formed on the authors experience and published literature: learners do not typically see themselves as leaders; learners want applicable curriculum with less lecturing and more application and discussion; programs are often siloed from one another and sharing curriculum content does not typically occur; no one-size-fits-all model. On the basis of the lessons learned and the current state of UME and GME leadership education, there are 5 recommendations to enhance UME and GME leadership programs: (1) develop a Health Professions Scholarship Program Leadership Curriculum; (2) develop a MHS GME Leadership Curriculum; (3) integrate UME and GME Leadership Curricula; (4) develop faculty to teach leadership; and (5) conduct research on UME and GME in military and share lessons learned. We suggest a roadmap for strengthening LD within military medicine and civilian institutions.
Delayed Diagnosis and Successful Glue Embolization of a Post-Traumatic Bronchial Artery Pseudoaneurysm: A Case Report
Authors: Yu Min-Hyuk , Kang Nam-Gyu , Jung Jae-Hyeop
Published: July 2024

Bronchial artery pseudoaneurysms (BAPs) are rare but potentially fatal vascular anomalies. We present a case of a 21-year-old male soldier who developed a BAP following a fall sustained during a suicide attempt. The BAP was identified on computed tomography angiography (CTA) and successfully treated with trans-arterial glue embolization. The patient’s recovery was uncomplicated. To our knowledge, only one prior case of post-traumatic BAP treated with endovascular intervention has been reported in the literature (29 years ago). Due to the risk of significant morbidity and mortality associated with BAP rupture, prompt diagnosis and treatment are crucial. Endovascular embolization is a safe and effective treatment option for BAPs. This case highlights the effectiveness of glue embolization as a treatment modality for BAPs.
The Gaia-ESO Survey: 3D dynamics of young groups and clusters from GES and Gaia EDR3
Authors: Wright Nicholas J , Jeffries R D , Jackson R J , Sacco G G , Arnold Becky , Franciosini E , Gilmore G , Gonneau A , Morbidelli L , Prisinzano L , Randich S , Worley Clare C
Published: July 2024

We present the first large-scale 3D kinematic study of $\sim$2700 spectroscopically confirmed young stars ($\lt $20 Myr) in 18 star clusters and OB associations (hereafter groups) from the combination of Gaia astrometry and Gaia–ESO Survey spectroscopy. We measure 3D velocity dispersions for all groups, which range from 0.61 to 7.4 km s$^{-1}$ (1D velocity dispersions of 0.35–4.3 km s$^{-1}$). We find the majority of groups have anisotropic velocity dispersions, suggesting they are not dynamically relaxed. From the 3D velocity dispersions, measured radii, and estimates of total mass, we estimate the virial state and find that all systems are super-virial when only the stellar mass is considered, but that some systems are sub-virial when the mass of the molecular cloud is taken into account. We observe an approximately linear correlation between the 3D velocity dispersion and the group mass, which would imply that the virial state of groups scales as the square root of the group mass. However, we do not observe a strong correlation between virial state and group mass. In agreement with their virial state, we find that nearly all of the groups studied are in the process of expanding and that the expansion is anisotropic, implying that groups were not spherical prior to expansion. One group, Rho Oph, is found to be contracting and in a sub-virial state (when the mass of the surrounding molecular cloud is considered). This work provides a glimpse of the potential of the combination of Gaia and data from the next generation of spectroscopic surveys.
Probing cosmic background dynamics with a cosmological-model-independent method
Authors: Liu Yang , Wang Bao , Yu Hongwei , Wu Puxun
Published: July 2024

The Hubble constant $H_0$ tension has emerged as the most serious crisis in modern cosmology, potentially indicating that the $\Lambda$CDM model may not describe our Universe accurately. In this paper, we establish a new, cosmological-model-independent method to study the cosmic background dynamics. Using the latest Pantheon+ Type Ia supernova (SN Ia) sample and the model-independent SN Ia sample (P+1690), we derive values for the luminosity distance, the Hubble parameter, and the deceleration parameter at five different redshift points ranging from 0.12 to 0.52. Our analysis shows that results obtained from the Pantheon+ sample align with the predictions of the $\Lambda$CDM model within 2$\sigma$ confidence level (CL), while those obtained from the P+1690 sample exhibit deviations of about $2\sim 3\sigma$ CL. Furthermore, we explore the equation of state (EoS) of dark energy and find that while the EoS values from the Pantheon+ sample remain consistent with $-1$ within 2$\sigma$ CL, the P+1690 sample does not conform to this standard. These findings remain unchanged after the inclusion of the Hubble parameter measurements in our analysis. Our results indicate that the $\Lambda$CDM model remains compatible with the Pantheon+ SN Ia and the Hubble parameter measurements at 2$\sigma$ CL.
Influence of selection criteria on the interpretation of rotational behaviour of wide-binary star systems
Authors: Cookson S A
Published: July 2024

Binary star systems are expected to follow Newtonian dynamics similarly to planetary systems. However, reports have been made of wide binary systems with separations around 0.01 pc and larger, showing potential deviations from standard Newtonian motion. This phenomenon, suggestive of the flattening of galactic rotation curves, calls for closer inspection. This study presents an analysis of wide binary stars using data from Gaia Data Release 3 (DR3), a space-based astrometry mission funded by the European Space Agency. The study compares different choices of selection criteria to examine the nature of these apparent anomalous kinematics within the solar neighbourhood. The Gaia data set furnishes detailed parameters, including radial velocity, mass, age, and binary probability in addition to standard parameters. A custom Python tool named bynary facilitated both data processing and analysis. This report reveals that the signs of any anomalous signals systematically diminish as the initial selection criteria are relaxed for degrouping while subsequent filtering remains stringent, leading to the complete elimination of any apparent non-Newtonian motion for binary separations within 0.5 pc. The study shows that any observed anomalous behaviour in solar neighbourhood wide binaries within 130 pc must be produced either by faint companion stars orbiting primary or secondary stars, or by flyby stars. The findings emphasize the importance of the choice of selection criteria in disentangling genuine binary dynamics from external influences. The conclusions align with the predictions of Newtonian mechanics and general relativity, though they do not exclude other phenomena at larger scales.
A systematic IR and VUV spectroscopic investigation of ion, electron, and thermally processed ethanolamine ice
Authors: Zhang Jin , Muiña Alejandra Traspas , Mifsud Duncan V , Kaňuchová Zuzana , Cielinska Klaudia , Herczku Péter , Rahul K K , Kovács Sándor T S , Rácz Richárd , Santos Julia C , Hopkinson Alfred T , Craciunescu Luca , Jones Nykola C , Hoffmann Søren V , Biri Sándor , Vajda István , Rajta István , Dawes Anita , Sivaraman Bhalamurugan , Juhász Zoltán , Sulik Béla , Linnartz Harold , Hornekær Liv , Fantuzzi Felipe , Mason Nigel J , Ioppolo Sergio
Published: July 2024

The recent detection of ethanolamine (EtA, HOCH$_2$CH$_2$NH$_2$), a key component of phospholipids, i.e. the building blocks of cell membranes, in the interstellar medium is in line with an exogenous origin of life-relevant molecules. However, the stability and survivability of EtA molecules under inter/circumstellar and Solar System conditions have yet to be demonstrated. Starting from the assumption that EtA mainly forms on interstellar ice grains, we have systematically exposed EtA, pure and mixed with amorphous water (H$_2$O) ice, to electron, ion, and thermal processing, representing ‘energetic’ mechanisms that are known to induce physicochemical changes within the ice material under controlled laboratory conditions. Using infrared (IR) spectroscopy, we have found that heating of pure EtA ice causes a phase change from amorphous to crystalline at 180 K, and further temperature increase of the ice results in sublimation-induced losses until full desorption occurs at about 225 K. IR and vacuum ultraviolet (VUV) spectra of EtA-containing ices deposited and irradiated at 20 K with 1 keV electrons as well as IR spectra of H$_2$O:EtA mixed ice obtained after 1 MeV He$^+$ ion irradiation have been collected at different doses. The main radiolysis products, including H$_2$O, CO, CO$_2$, NH$_3$, and CH$_3$OH, have been identified and their formation pathways are discussed. The measured column density of EtA is demonstrated to undergo exponential decay upon electron and ion bombardment. The half-life doses for electron and He$^+$ ion irradiation of pure EtA and H$_2$O:EtA mixed ice are derived to range between $10.8\!-\!26.3$ eV/16u. Extrapolating these results to space conditions, we conclude that EtA mixed in H$_2$O ice is more stable than in pure form and it should survive throughout the star and planet formation process.
Understanding the local environment in electrocatalysis
Authors: Chen Chaojie , Zheng Yao , Qiao Shi-Zhang
Published: July 2024

This perspective summarizes the understanding about the local reaction environment in the electrocatalysis and underscores the influence of local environment due to its special location.
Ru3@Mo2CO2 MXene single-cluster catalyst for highly efficient N2-to-NH3 conversion
Authors: Zhang Cong , Wang Ze-Hui , Wang Haiyan , Liang Jin-Xia , Zhu Chun , Li Jun
Published: July 2024

Single-cluster catalysts (SCCs) representing structurally well-defined metal clusters anchored on support tend to exhibit tunable catalytic performance for complex redox reactions in heterogeneous catalysis. Here we report a theoretical study on an SCC of Ru3@Mo2CO2 MXene for N2-to-NH3 thermal conversion. Our results show that Ru3@Mo2CO2 can effectively activate N2 and promotes its conversion to NH3 through an association mechanism, in which the rate-determining step of NH2* + H* → NH3* has a low energy barrier of 1.29 eV. Notably, with the assistance of Mo2CO2 support, the positively charged Ru3 cluster active site can effectively adsorb and activate N2, leading to 0.74 |e| charge transfer from Ru3@Mo2CO2 to the adsorbed N2. The supported Ru3 also acts as an electron reservoir to regulate the charge transfer for various intermediate steps of ammonia synthesis. Microkinetic analysis shows that the turnover frequency of the N2-to-NH3 conversion on Ru3@Mo2CO2 is as high as 1.45 × 10−2 s−1 site−1 at a selected thermodynamic condition of 48 bar and 700 K, the performance of which even surpasses that of the Ru B5 site and Fe3/θ-Al2O3(010) reported before. Our work provides a theoretical understanding of the high stability and catalytic mechanism of Ru3@Mo2CO2 and guidance for further designing and fabricating MXene-based metal SCCs for ammonia synthesis under mild conditions.
Construction of chiral crown ethers in robust covalent organic frameworks for electrochromatographic enantioseparation
Authors: Fu Shiguo , Qin Gaizhao , Dong Jinqiao , Yuan Chen , Liu Yan , Yuan Li-Ming , Cui Yong
Published: July 2024

Capillary electrochromatography (CEC) is a rapidly emerging separation technique that merges the high separation efficiency of capillary electrophoresis with the exceptional selectivity of liquid chromatography. However, it remains a synthetic challenge to design functional chiral stationary phases (CSPs) with high chemical stability against acid and base in CEC enantioseparation. Here we demonstrate that incorporating chiral crown ethers into stable covalent organic frameworks (COFs) enables efficient and stable separations of racemates by CEC. This facilitates the crafting of two three-dimensional (3D) chiral COFs by polycondensation of a chiral 1,1'-binaphyl-20-crown-6-derived dialdehyde and tetraamines with diisopropyl substituents. Both feature an 11-fold interpenetrated diamond framework, characterized by tubular open channels decorated with chiral crown ethers serving as enantioselective recognition and binding sites. These frameworks demonstrate excellent stability in water, acid and base, thanks to the presence of bulky isopropyl groups that shield the dynamic imine linkages. Moreover, the precisely defined COF channels enhanced the accessibility of the enclosed crown ethers to the analytes while providing strong protection against harsh environments, rendering them suitable for CSPs in CEC separations. They can effectively separate some important enantiomers, including ketones, epoxides and alkaline substances, when utilized as coatings on chiral columns, particularly facilitating the chiral separation of drugs. This study advances the application of COFs in electrochromatographic separations, expanding the scope of porous materials design and engineering to create COFs with targeted enantioselective properties.