bluuebunny/crossref_metadata_2025 huggingface dataset:
Delirium and Other Altered Cognitive States
Authors: Georgi Elizabeth , Meehan Anita J. , Gardeli Panagiota , Cross Jason
Published: November 2023

Delirium is a common complication following surgery, particularly among older patients. Often described as an ‘acute confusional state’ delirium can take the form of hyperactive, hypoactive, or mixed delirium. Prompt diagnosis, and its causal factors, is vital in optimising management and recovery from delirium. While pharmacological management has its place within delirium care, non-pharmacological care and interventions are central to optimising outcomes. Many practitioners feel they lack knowledge when it comes to the best delirium care although many of the key interventions can be carried out by any healthcare professional.

Dementia and depression can also affect a patient’s experience and their outcomes. While different in their own rights, ‘the 3 D’s’ (dementia, depression, delirium) can be mistaken for each other, leading to misdiagnosis. Practitioners should feel confident in how to recognise each and how the management for each can be both similar and unique. With all cognitive impairments the patient’s ability to give consent, or not, should always be considered. Steps should be taken to optimise their decision-making abilities or confirm a lack of capacity via formal testing.
Rehabilitation
Authors: Beaupre Lauren , Mangione Kathleen , Queirós Carmen
Published: November 2023

Following a fragility fracture, patients face a long journey to recovery and often require extended care from multiple carers/providers in both hospital and community settings. Beyond the physical challenges to recovery, social and psychological factors can also affect the rehabilitation and recovery process. This chapter focuses on rehabilitation across the care continuum, including interprofessional care. The aim of the chapter is to promote the role of nurses and other practitioners in progressing mobility through the rehabilitation process. Decline in mobility after a fragility fracture is common and should be directly addressed by the Rehabilitation Team (rehabilitation nurse, physiotherapist, and/or occupational therapist). Intentionally making exercises more difficult (progressive overload), choosing exercises and activities specific to the patient’s goals and functional level (specificity), and a targeted and concrete plan for continued activity and movement after discharge are all essential to returning the patient to their pre-fracture functional level.
Discharge and Post-hospital Care
Authors: Martinsen Mette Irene , de Lima Maria Eduarda Batista , Rudolph Alcinda Maria
Published: November 2023

A well-planned discharge can reduce the risk of adverse outcomes and readmissions. A multidisciplinary approach and good communication both with the patient and family/informal caregivers as well as primary care throughout the process is essential for a safe discharge. Facilitating patient participation when planning discharge and post-hospital care can increase their health and well-being.

This chapter aims to give an overview of best practice in discharge planning, discharge and post-hospital care following fragility fracture and describe different case management models.
Ethical Issues
Authors: Spirgienė Lina , Blaževičienė Aurelija , Santy-Tomlinson Julie
Published: November 2023

Health and social care professionals meet ethical dilemmas constantly. Being able to make clinical decisions based on sound ethical principles is central to compassionate care and should underpin all the topics covered in this book. The decline in health, and wellbeing that often follows a fragility fracture threatens wellbeing, especially when we have limited capacity or and diminished power over their own lives and decisions. These challenges make a person vulnerable because they may be unable to take care of themselves and/or to protect themselves from loss of dignity, harm, or exploitation. The aim of this chapter is to provide practitioners with information about ethical principles and dilemmas in caring for patients with fragility fractures so that they can provide ethically sensitive care, including at the end of life.
Orthogeriatric and Fragility Fracture Care in the Future
Authors: Hertz Karen , Santy-Tomlinson Julie
Published: November 2023

This chapter aims to outline some of the future goals for fragility fracture care and to offer some thoughts on how some of the more significant challenges need to be approached. The increase in the prevalence of fragility fractures is a growing challenge. Globally, fragility fractures have a varied impact. In resource-rich nations, approximately 10–20% of patients move to residential care after a hip fracture, with accompanying financial and socioeconomic costs. Where healthcare services are less well resourced, much fragility fracture care takes place in the patient’s place of residence or that of their family; placing significant stress on their ability to cope. There is also a chronic worldwide shortage of nurses and, in specialties such as orthogeriatrics and fragility fracture management, there is also high patient acuity and high demand for expert care, often resulting in failure to meet patient and community needs. Care is complex and time and staff intensive, demanding staffing flexibility. Nursing care is likely to be missed when staffing ratios are low and when staffing flexibility is lacking. Inordinate energy must be spent in trying to provide care that meets constantly changing patient needs. Clinicians must also engage with governments, policy makers, leaders, employers, and communities to present evidence, lobby and negotiate for their own working conditions, and the care priorities of those for whom they provide care.

This chapter focuses on several aspects of the future development of fragility fracture and orthogeriatric care. This includes highlighting the need for new ways of working and nursing role development along with ensuring that care is provided by nurses who not only understand the injury and the acute care needs related to the fracture, but who also recognise the specific and complex needs relating to the frail older person with multiple comorbidities. Clinicians must also be skilled in chronic condition management, especially concerning osteoporosis and other comorbidities.

The evidence base for orthogeriatric and fragility fracture nursing is considered throughout this book. Expert care needs a specific and broad body of evidence that identifies exactly what its actions are and what its value is. Hence, the development, conduct, translation, and application of nursing research for the care of patients with fragility fractures is essential and needs to be developed with a global perspective.

Education is the foundation of transforming care and services so that patient outcomes following fragility fracture can be optimised and future fractures prevented. Even though nursing education is paramount in achieving optimum patient care, acknowledging that orthogeriatric and fragility fracture care is, by necessity, interdisciplinary is essential. The benefits of multidisciplinary approaches to care, supported by interdisciplinary education are considered here.
Secondary Fracture Prevention
Authors: Speerin Robyn , Marques Andréa , van Oostwaard Marsha
Published: November 2023

Fragility fractures signal that osteoporosis or osteopenia may be present. These are fractures often sustained through minimal trauma and commonly happen because of a fall from standing height or less. Low bone density due to osteoporosis or osteopenia means that such falls easily result in fractures. Fragility fractures are common, and the incidence is increasing despite global efforts to improve access to secondary prevention. Fragility fractures can lead to hospitalisation, increased risk of death due to complications, worsening chronic health conditions, and frailty. Hip and vertebral fractures are associated with the worst morbidity, mortality, and loss of functional ability. Pain and disability contribute to impaired quality of life.

All people aged 50 years and over who sustain fragility fractures should, therefore, undergo investigation for osteoporosis and, if confirmed, be commenced on osteoporosis medication and be supported to participate in behaviours that are known to improve bone health. Organised and coordinated secondary fragility fracture prevention is the best option to prevent further fractures. This approach requires a multidisciplinary team working across care sectors in collaboration with the patient and family to ensure that care is consistent and person-centred and addresses individual need.

Many communities across the globe who sustain fragility fractures, however, do not have access to diagnosis and evidence-informed treatment to prevent the next fracture despite strong evidence that access to treatment and supportive follow-up prevent many subsequent fractures. This chapter aims to explore how secondary fractures can be prevented through evidence-based interventions and services.
The Nursing Role in Orthogeriatric Comprehensive Geriatric Assessment (CGA)
Authors: Brent Louise , Spirgienė Lina , O’Regan Niamh , Diggin Brid
Published: November 2023

Older people with fragility fractures are a diverse group, and their care needs are complex. Although some have comparatively few health problems, many have several interconnected illnesses alongside psychological and social problems, requiring a range of interventions. The primary focus of care is to meet these needs throughout the care pathway and ensure that they receive the same high standard of specialist care within orthopaedic services as they would within a setting specialising in the care of older people. The central philosophy is holistic care with a person-centred approach that brings the various aspects of specialist care together.

‘Geriatric syndrome’ is a term often used to refer to common health problems in older adults that do not fit into distinct organ-specific disease categories and that have multifactorial causes. This includes frailty, cognitive impairment, delirium, incontinence, malnutrition, falls, gait disorders, pressure ulcers, sleep disorders, sensory deficits, fatigue and dizziness. These are common in older adults and can have a major impact on quality of life (QoL) and disability.

Identifying problems specific to ageing so that interventions can be tailored to meet the needs of patients with fragility fractures needs a detailed and comprehensive assessment that can help clinicians manage these conditions and prevent or delay their complications. This needs to be a collaboration of the whole interdisciplinary team so that the skills of each team member can contribute to building a picture of the patient’s needs. Nursing assessment is a significant part of this whole.

A term often used in relation to the assessment of older people with medical needs is comprehensive geriatric assessment (CGA). The aim of this chapter is to explore the nature of comprehensive geriatric assessment (CGA) for the patient with a fragility fracture and discuss how this can be applied to nursing assessment and care.
Pressure Ulcer Prevention
Authors: Bååth Carina , Brent Louise , Santy-Tomlinson Julie , Hommel Ami
Published: November 2023

Preventing pressure ulcers is fundamental in managing and caring for the patient following a fragility fracture. Patients who have sustained a hip fracture and have had associated surgery are at high risk as ageing skin, frailty, immobility, and multiple comorbidities are significant factors in skin injury.

The causes of pressure ulcers are complex, and their prevention is the responsibility of the entire multidisciplinary team. Accessing evidence and education for practitioners is vital to making a difference in all aspects of care.
Cosmologically varying kinetic mixing
Authors: Gan Xucheng , Liu Di
Published: November 2023

Abstract

The portal connecting the invisible and visible sectors is one of the most natural explanations of the dark world. However, the early-time dark matter production via the portal faces extremely stringent late-time constraints. To solve such tension, we construct the scalar-controlled kinetic mixing varying with the ultralight CP-even scalar’s cosmological evolution. To realize this and eliminate the constant mixing, we couple the ultralight scalar within 10−33eV ≲ m0 ≪ eV with the heavy doubly charged messengers and impose the ℤ2 symmetry under the dark charge conjugation. Via the varying mixing, the keV – MeV dark photon dark matter is produced through the early-time freeze-in when the scalar is misaligned from the origin and free from the late-time exclusions when the scalar does the damped oscillation and dynamically sets the kinetic mixing. We also find that the scalar-photon coupling emerges from the underlying physics, which changes the cosmological history and provides the experimental targets based on the fine-structure constant variation and the equivalence principle violation. To ensure the scalar naturalness, we discretely re-establish the broken shift symmetry by embedding the minimal model into the ℤN-protected model. When N ~ 10, the scalar’s mass quantum correction can be suppressed much below 10−33eV.
Mutant p53R211* ameliorates inflammatory arthritis in AIA rats via inhibition of TBK1-IRF3 innate immune response
Authors: Zeng Yaling , Ng Jerome P. L. , Wang Linna , Xu Xiongfei , Law Betty Yuen Kwan , Chen Guobing , Lo Hang Hong , Yang Lijun , Yang Jiujie , Zhang Lei , Qu Liqun , Yun Xiaoyun , Zhong Jing , Chen Ruihong , Zhang Dingqi , Wang Yuping , Luo Weidan , Qiu Congling , Huang Baixiong , liu Wenfeng , Liu Liang , Wong Vincent Kam Wai
Published: November 2023

Background

Rheumatoid arthritis (RA) is an autoimmune inflammation disease characterized by imbalance of immune homeostasis. p53 mutants are commonly described as the guardian of cancer cells by conferring them drug-resistance and immune evasion. Importantly, p53 mutations have also been identified in RA patients, and this prompts the investigation of its role in RA pathogenesis.

Methods

The cytotoxicity of disease-modifying anti-rheumatic drugs (DMARDs) against p53 wild-type (WT)/mutant-transfected RA fibroblast-like synoviocytes (RAFLSs) was evaluated by MTT assay. Adeno-associated virus (AAV) was employed to establish p53 WT/R211* adjuvant-induced arthritis (AIA) rat model. The arthritic condition of rats was assessed by various parameters such as micro-CT analysis. Knee joint samples were isolated for total RNA sequencing analysis. The expressions of cytokines and immune-related genes were examined by qPCR, ELISA assay and immunofluorescence. The mechanistic pathway was determined by immunoprecipitation and Western blotting in vitro and in vivo.

Results

Among p53 mutants, p53R213* exhibited remarkable DMARD-resistance in RAFLSs. However, AAV-induced p53R211* overexpression ameliorated inflammatory arthritis in AIA rats without Methotrexate (MTX)-resistance, and our results discovered the immunomodulatory effect of p53R211* via suppression of T-cell activation and T helper 17 cell (Th17) infiltration in rat joint, and finally downregulated expressions of pro-inflammatory cytokines. Total RNA sequencing analysis identified the correlation of p53R211* with immune-related pathways. Further mechanistic studies revealed that p53R213*/R211* instead of wild-type p53 interacted with TANK-binding kinase 1 (TBK1) and suppressed the innate immune TBK1–Interferon regulatory factor 3 (IRF3)–Stimulator of interferon genes (STING) cascade.

Conclusions

This study unravels the role of p53R213* mutant in RA pathogenesis, and identifies TBK1 as a potential anti-inflammatory target.
A trajectory surface hopping study of the vibration-induced autodetachment dynamics of the 1-nitropropane anion
Authors: Issler Kevin , Mitric Roland , Petersen Jens
Published: November 2023

In this study, we investigate the autodetachment dynamics of the 1-nitropropane anion after vibrational excitation of the energetically lowest C–H stretching mode using our recently developed extended quantum classical surface hopping approach including the detachment continuum. Therein the detachment from an electronic bound anion state is treated as a nonadiabatic transition into discretized detachment continuum states for an ensemble of classical nuclear trajectories propagated on quantum mechanical potential energy surfaces. The initial ensemble is obtained by sampling a phase space distribution accounting for the vibrational excitation of the C–H stretching mode of the molecule to match the experimental conditions. The simulated kinetic energy distribution of the ejected electrons reproduces characteristic features of the available experimental data. Analysis of the nuclear dynamics points out that the approach to neutral-like geometries with decreased pyramidalization angle of the NO$$_2$$

2

group and reduced the N–O bond lengths are the crucial factors enhancing the ultrafast autodetachment process in vibrationally excited 1-nitropropane. This is facilitated when the dipole-bound first excited state of the anion is populated, which is structurally similar to the neutral system. Although only a small transient population of this state is observed, it acts as an efficient doorway to the detachment continuum and is responsible for a significant amount of the ejected electrons.
Spatial immune composition of tumor microenvironment in patients with pancreatic cancer
Authors: Zwart Eline S. , van Ee Thomas , Affandi Alsya J. , Boyd Lenka N. C. , Rodriguez Ernesto , den Haan Joke M. M. , Farina Arantza , van Grieken Nicole C. T. , Meijer Laura L. , van Kooyk Yvette , Mebius Reina E. , Kazemier Geert
Published: November 2023

This study examined the composition of the immune microenvironment at different sites within resected pancreas specimens from patients with pancreatic ductal adenocarcinoma (PDAC). Therefore, single-cell suspensions were made from fresh tumor and non-tumorous tissue. Fourteen patients were included from whom twelve PDAC and five non-tumorous samples were obtained. These samples were analyzed with a nineteen marker panel on the Aurora spectral flow cytometer. Furthermore, slides from formalin-fixed paraffine PDACs of eight additional patients were stained with eight markers and analyzed by multispectral imaging. These corresponded to central tumor, periphery of the tumor, i.e., invasive front and resected lymph node and were divided into tumor and adjacent tissue. In the single-cell suspension, a decreased ratio between lymphoid and myeloid cells and between M1 and M2 macrophages was observed in the tumor tissue compared to non-tumorous tissue. Furthermore, an increase in CD169 + macrophages in patients undergoing neoadjuvant therapy was found. Using immunofluorescence, more macrophages compared to T cells were observed, as well as a lower ratio of CD8 to M2 macrophage, a higher ratio of CD4–CD8 T cells and a higher ratio of immune-suppressive cells to pro-inflammatory cells in the PDAC area compared to the adjacent non-tumorous tissue. Finally, there were more immune-suppressive cells in the central tumor area compared to the invasive front. In conclusion, we show a gradient in the immune-suppressive environment in PDAC from most suppressive in the central tumor to least suppressive in distant non-tumorous tissue.

Graphical abstract
Performance-based wind engineering assessment of a telecommunication mast utilizing Bayesian extreme wind velocity model
Authors: Kenéz Á. , Joó A. L.
Published: November 2023

A promising design concept, the performance-based wind engineering methodology is adopted, implementing a finite element model (FEM) to analyse the structural behaviour of a telecommunication steel lattice mast. The integration of site-specific wind loading models into the standardized FEM-based design can be a powerful tool for design engineers. The tower being investigated, located in Central Hungary, is equipped with sensors to measure wind velocity and strains in chord members. The stochastic modelling of the extreme wind velocity, i.e., the basic wind velocity is assessed using the peak-over-threshold approach with an automated threshold selection method. To enhance the accuracy of the analysis, Bayesian inference is employed, combining the information from a relatively short duration of measurements collected at the tower site with a more extensive dataset from measurement locations across the country. Numerical model of the telecommunication mast subjected to wind loading is developed in a general-purpose finite element software. The probabilistic design system module is applied for performing probabilistic calculations of both serviceability criterion and load-bearing capacity of the structure using Monte Carlo simulation with Latin hypercube method. Numerical results are compared and validated with measurement data. The accuracy of wind load assessment is examined in this study, considering both the standardized design method according to EN 1993-3-1 and wind tunnel testing. The main objective is to demonstrate the potential of integrating the Performance-based Wind Design framework with a monitoring system and a finite element model, highlighting their combined benefits.
Comparison of linear, generalized additive models and machine learning algorithms for spatial climate interpolation
Authors: Bonsoms Josep , Ninyerola Miquel
Published: November 2023

Geospatial atmospheric data is the input variable of a wide range of hydrological and ecological spatial models, many of which are oriented towards improving the socioeconomic and environmental sustainability. Here, we provide an evaluation of machine learning (ML) methods for the spatial interpolation of annual precipitation, minimum and maximum temperatures for a mountain range, in this case, the Pyrenees. To this end, this work compares the performance and accuracy of multiple linear regressions (MLR) and generalized additive models (GAM) against five ML methods (K-Nearest Neighbors, Supported Vector Machines, Neural Networks, Stochastic Gradient Boosting and Random Forest). The ML algorithms outperformed the MLR and GAM independently of the predictor variables used, the geographical sector analyzed or the elevation range. Overall, the differences between ML algorithms are negligible. Random Forest shows a slightly higher than average accuracy for the spatial interpolation of precipitation (R2 = 0.93; MAE = 70.44 mm), whereas Stochastic Gradient Boosting is the best ML method for the spatial interpolation of the mean maximum annual temperature (R2 = 0.96, MAE = 0.43 ºC). Stochastic Gradient Boosting, Neural Networks and Random Forest have similar performances for the spatial interpolation of the mean minimum annual temperature (R2 = 0.98, MAE = 0.19 ºC). Results presented here can be valuable for the past and future climate spatial analysis, environmental niche modelling, hydrological projections, and water management.
Impact of acetazolamide on the double layer parameters at the R-AgLAFe/chlorates(VII) interface in the presence of ionic surfactants
Authors: Martyna Marlena , Pawlak Alicja , Bazan-Wozniak Aleksandra , Nosal-Wiercińska Agnieszka , Pietrzak Robert
Published: November 2023

Adsorption of acetazolamide (ACT) and formation of a mixed adsorption layers of acetazolamide (ACT)—sodium 1-decanesulfonate (SDS) and acetazolamide—hexadecyltrimethylammonium bromide (CTAB) at the R-AgLAFe/chlorates(VII) interface are described. The systems were characterized by the measurements of differential capacity, potential of zero charge, and surface tension at this potential. The adsorption parameters determined in the studied systems indicate the SDS domination in the adsorption equilibria and the competitive adsorption between the ACT—SDS or mixed micelles. However, acetazolamide dominates at adsorption equilibria of the ACT—CTAB mixture.
Multiple Risk in Pregnancy- Prenatal Risk Constellations and Mother-Infant Interactions, Parenting Stress, and Child Externalizing and Internalizing Behaviors: A Prospective Longitudinal Cohort Study from Pregnancy to 18 Months Postpartum
Authors: Helmikstøl Beate , Moe Vibeke , Smith Lars , Fredriksen Eivor
Published: November 2023

Multiple risk is associated with adverse developmental outcomes across domains. However, as risk factors tend to cluster, it is important to investigate formation of risk constellations, and how they relate to child and parental outcomes. By means of latent class analysis patterns of prenatal risk factors were identified, and relations to interactional quality, parenting stress, and child internalizing and externalizing behaviors were investigated. An array of prenatal risk factors was assessed in 1036 Norwegian pregnant women participating in a prospective longitudinal community-based study, Little in Norway. Mother-infant interactions were videotaped and scored with the Early Relational Health Screen (ERHS) at 12 months. The Parenting Stress Index (PSI) and Infant-Toddler Social and Emotional Assessment (ITSEA) were administered at 18 months. First, we analyzed response patterns to prenatal risks to identify number and characteristics of latent classes. Second, we investigated whether latent class membership could predict mother-child interactional quality, parenting stress, and child internalizing and externalizing behavior after the child was born. Results revealed three prenatal risk constellations: broad risk (7.52%), mental health risk (21.62%) and low-risk (70.86%). Membership in the broad risk group predicted lower scores on interactional quality, while membership in the mental health risk group predicted less favorable scores on all outcome measures. Prenatal risks clustered together in specific risk constellations that differentially related to parent, child and interactional outcomes.
Rapid measurement of ageing by automated monitoring of movement of C. elegans populations
Authors: Zavagno Giulia , Raimundo Adelaide , Kirby Andy , Saunter Christopher , Weinkove David
Published: November 2023

Finding new interventions that slow ageing and maintain human health is a huge challenge of our time. The nematode Caenorhabditis elegans offers a rapid in vivo method to determine whether a compound extends its 2 to 3-week lifespan. Measuring lifespan is the standard method to monitor ageing, but a compound that extends lifespan will not necessarily maintain health. Here, we describe the automated monitoring of C. elegans movement from early to mid-adulthood as a faster healthspan-based method to measure ageing. Using the WormGazer™ technology, multiple Petri dishes each containing several C. elegans worms are imaged simultaneously and non-invasively by an array of cameras that can be scaled easily. This approach demonstrates that most functional decline in C. elegans occurs during the first week of adulthood. We find 7 days of imaging is sufficient to measure the dose-dependent efficacy of sulfamethoxazole to slow ageing, compared to 40 days required for a parallel lifespan experiment. Understanding any negative consequences of interventions that slow ageing is important. We show that the long-lived mutant age-1(hx546) stays active for longer than the wild type but it moves slower in early adulthood. Thus, continuous analysis of movement can rapidly identify interventions that slow ageing while simultaneously revealing any negative effects on health.
Die Bedeutung der von Grundschulkindern wahrgenommenen Beziehung zu ihrer Klassenlehrkraft für deren Einhaltung von Klassenregeln
Authors: Spilles Markus , Huber Christian , Kaspar Kai , Hennemann Thomas
Published: November 2023

Internationale Forschungsergebnisse zeigen, dass Classroom Management (CM) Unterrichtsstörungen effektiv reduzieren kann. Wie CM in der Forschungsliteratur konkret definiert wird, variiert jedoch sehr stark. Grundsätzlich lassen sich eine traditionelle, lehrkraftzentrierte Perspektive von einer erweiterten Perspektive, bei der Schüler*innen stärker miteinbezogen werden, unterscheiden. Einhergehend mit einem erweiterten Begriffsverständnis wird in verschiedenen Arbeiten betont, dass die Basis für ein effektives CM eine tragfähige Lehrkraft-Schüler*innen-Beziehung (LSB) sei. Im Beitrag wird vor diesem Hintergrund untersucht, inwieweit der lehrkraftzentrierte Umgang mit Unterrichtsstörungen (LUU) und die LSB in Zusammenhang mit der Regeleinhaltung von Schüler*innen stehen. Im Rahmen einer Querschnittsuntersuchung mit n = 548 Schüler*innen (49 % weiblich, Alter: M = 9,10, SD = 0,70) aus dritten und vierten Grundschulklassen wurde erörtert, ob a) der durch die Schüler*innen wahrgenommene LUU positiv mit der Regeleinhaltung der Schüler*innen zusammenhängt, b) die durch die Schüler*innen wahrgenommene LSB in positivem Zusammenhang mit der Regeleinhaltung steht und c) eine positive LSB den Zusammenhang von LUU und Regeleinhaltung erhöht. Die Ergebnisse der Mehrebenenanalyse stützen die zweite und dritte Hypothese mit schwachen bis mittleren bzw. sehr schwachen Effekten. Entsprechend könnte im Sinne der dritten Hypothese davon ausgegangen werden, dass der LUU umso effektiver ist, je positiver Schüler*innen die Beziehung zu ihrer Lehrkraft wahrnehmen.
Ethics and Health Security in the Australian COVID-19 Context: A Critical Interpretive Literature Review
Authors: Fehross Anson , Pahlman Kari , Silva Diego S.
Published: November 2023

Background The concept of “health security” is often used to motivate public health responses, yet the ethical values that underpin this concept remain largely unexamined. The recent Australian responses to COVID-19 serve as an important case study by which we can analyse the pre-existing literature to see what ethical values shaped, and continue to shape, Australia’s response. Methods We conducted a critical interpretive literature review of academic and grey literatures within key databases, resulting in 2,220 sources. After screening for duplicates and relevance, we analysed ninety-six sources. Results First, risk and uncertainty are a leading focus, with a heavy concentration on risks to life and health. Second, free movement, safety, and security were recurringly emphasized, albeit narrowly focused upon the safety of the population. Third, legitimacy was a recurring theme, and it is here that discussions of “health security” figured highly. Conclusion Discussions of harm from government and associated official bodies fail to adequately distinguish between various senses of harm. Moreover, while the literature often discusses the balancing of rights, the steps involved in the weighing of these rights is rarely adequately explained and defended. We suggest that decision-makers should endeavour to clearly identify and defend the values undergirding their decisions in the public sphere.
Frontiers of Ovarian Carcinosarcoma
Authors: Ismail Ayden , Choi Sunyoung , Boussios Stergios
Published: November 2023

Opinion statement

Ovarian carcinosarcoma (OCS), also known as a malignant mixed Müllerian tumour (MMMT), is a rare and aggressive form of cancer that accounts for less than 5% of ovarian cancers. It is characterized by high morbidity and mortality rates, with a median overall survival (OS) of less than 2 years. Several factors, including advancing age, nulliparity, reduced lactation rates, decreased use of oral contraceptive pills, genetic mutations in BRCA (breast cancer) genes, and the use of assisted reproductive technology, may increase the risk of OCS. Poor prognostic factors include an advanced stage at diagnosis, older age, lymph node metastasis, suboptimal surgical cytoreduction, the presence of heterologous features on histopathology, and increased expression of vascular endothelial growth factor (VEGF), tumour protein p53, and p53 alongside Wilms tumour 1 (WT1). The main treatment approach for OCS is cytoreductive surgery followed by platinum-based chemotherapy, although immunotherapy is showing promise. Homologous recombination deficiency (HRD) testing may enhance outcomes by enabling personalized immunotherapy and targeted therapies for specific patient groups, thereby reducing unnecessary side effects and healthcare costs. However, there is currently a lack of standardised treatment regimens for OCS patients, with most studies consisting of case reports and a shortage of suitable comparator groups. This article aims to provide clinicians with information on the epidemiology, risk factors, prognostic factors, and latest therapeutic advancements in OCS.
Enhancing the Wettability of Fibre Surface: A Comparative Experimental Study of Different Surface Activation Principles on Single Polyamide Fibre
Authors: Gleissner Carolin , Bechtold Thomas , Pham Tung
Published: November 2023

In this study, we have compared three different principles of surface activation with regard to their effects on the properties of single polyamide fibres. The techniques used include the complexation-mediated surface treatment using CaCl2/EtOH/H2O solution (CEW), the atmospheric pressure plasma treatment with air (APPA) and grafting polymerisation process with 2- hydroxyethyl methacrylate (HEMA). The CEW modification, the plasma treatment and the grafting process induced a decrease in advancing contact angle and thus led to an improved wettability of the polyamide fibre. While for the CEW treatment, the decrease was solely due to a change in topography such as increased surface roughness leading to increased capillary effect, for the APPA and grafting technique the decrease was attributed to a combination of increased surface roughness and increased amount of oxygen or nitrogen-containing groups as detected by XPS. In addition, the fibre fineness decreased in the case of CEW treatment due to a dissolution of polyamide segments during the modification, while it increased in the grafting process due to an additional grafted layer. However, an increase in wetted length was observed for most samples, which was attributed to the increased waviness of the fibres. All treatments induced a decrease in fibre tensile strength that decreased with increasing treatment intensity.
Neural network mapping of gelastic behavior in children with hypothalamus hamartoma
Authors: Guo Zhi-Hao , Zhang Jian-Guo , Shao Xiao-Qiu , Hu Wen-Han , Sang Lin , Zheng Zhong , Zhang Chao , Wang Xiu , Li Chun-De , Mo Jia-Jie , Zhang Kai
Published: November 2023

Background

Hypothalamus hamartomas (HHs) are rare, congenital, tumor-like, and nonprogressive malformations resulting in drug-resistant epilepsy, mainly affecting children. Gelastic seizures (GS) are an early hallmark of epilepsy with HH. The aim of this study was to explore the disease progression and the underlying physiopathological mechanisms of pathological laughter in HH.

Methods

We obtained clinical information and metabolic images of 56 HH patients and utilized ictal semiology evaluation to stratify the specimens into GS-only, GS-plus, and no-GS subgroups and then applied contrasted trajectories inference (cTI) to calculate the pseudotime value and evaluate GS progression. Ordinal logistic regression was performed to identify neuroimaging-clinical predictors of GS, and then voxelwise lesion network-symptom mapping (LNSM) was applied to explore GS-associated brain regions.

Results

cTI inferred the specific metabolism trajectories of GS progression and revealed increased complexity from GS to other seizure types. This was further validated via actual disease duration (Pearson R = 0.532, P = 0.028). Male sex [odds ratio (OR) = 2.611, P = 0.013], low age at seizure onset (OR = 0.361, P = 0.005), high normalized HH metabolism (OR =  − 1.971, P = 0.037) and severe seizure burden (OR =  − 0.006, P = 0.032) were significant neuroimaging clinical predictors. LNSM revealed that the dysfunctional cortico-subcortico-cerebellar network of GS and the somatosensory cortex (S1) represented a negative correlation.

Conclusions

This study sheds light on the clinical characteristics and progression of GS in children with HH. We identified distinct subtypes of GS and demonstrated the involvement of specific brain regions at the cortical–subcortical–cerebellar level. These valuable results contribute to our understanding of the neural correlates of GS.
Transfer of industrial contaminants from the inner to the outer region of Sepetiba Bay (SE Brazil) by dredge spoil dumping activities: a temporal record
Authors: Saibro Murilo Barros , Martins Maria Virgínia Alves , Guerra Josefa Varela , Figueira Rubens Cesar Lopes , de Castro Figueiredo Simões Felipe , Dadalto Tatiana Pinheiro , Trevizani Tailisi Hoppe , de Lima Ferreira Paulo Alves , Silva Cleverson Guizan , dos Reis António Tadeu , Terroso Denise , da Silva Layla Cristine , Bergamaschi Sergio , Rocha Fernando , Heilbron Monica
Published: November 2023

A multiproxy approach involving grain size, geophysical (resistivity, magnetic susceptibility, and P-wave velocity), mineralogical (XRD), and geochemical (elemental, stable isotopes) data has been applied to core SP9 (128 cm long) to reconstruct natural and anthropogenic changes since ≈1850 AD (anno domine) (dating by 210Pb and 127Cs methods) in a distal region of Sepetiba Bay (SB), Rio de Janeiro State (SE Brazil). The analyzed core is a fine-grained sedimentary sequence (except its upper 20 cm). It comprises detrital particles derived from felsic and intermediate source rocks, as suggested by the fields defined by the biplot Zr vs TiO2 and the Al2O3/TiO2 ratios. Despite the increase in particle size at the top of the core, there was a progressive increase in the organic matter and potentially toxic elements (PTEs) contents and nutrients such as N and P. The geophysical data allowed us to identify the presence of subsurface (biogenic) gas, which suggests the occurrence of eutrophication processes in the study area despite its location in the outer region of the bay. Core SP9 records cyclical changes over the last ≈170 years in the mineralogical and elemental composition of the sediments and type of organic matter supplied to the bottom. These changes are associated with phases of more significant oceanic influence, salinity variations in the study area, and greater or lesser oxygen depletion in the sediment. These changes may have resulted from climatic oscillations or variations in the configuration and extension of the Ponta da Pombeba spit. The extent of this structure and the anthropic activities have contributed to the contamination of this area since 1975 AD. However, statistical analyses (Pearson correlations and principal components analysis) suggest that the transport and accumulation of PTEs (mainly Cd and Zn) did not strictly follow the general pattern of sedimentary dynamics prevailing in the studied area. Results indicate that this area became strongly polluted by Cd and Zn and with high ecological risk due to dredging and spoil disposal activities at sites close to the study area. It is noted that the environmental degradation reached higher levels here than in areas close to the primary source of the metals, the disabled Ingá Mercantil Company, in Madeira Island. This work demonstrates the temporal effect of dredge disposal activities in a distal region of Sepetiba Bay for the first time. It is a strong indicator that dredged spoil areas must be selected carefully, since healthy areas can become degraded due to the dumping of polluted waste.
Conceptualised psycho-medical footprint for health status outcomes and the potential impacts for early detection and prevention of chronic diseases in the context of 3P medicine
Authors: Afrifa-Yamoah Ebenezer , Adua Eric , Anto Enoch Odame , Peprah-Yamoah Emmanuel , Opoku-Yamoah Victor , Aboagye Emmanuel , Hashmi Rashid
Published: November 2023

Background

The Suboptimal Health Status Questionnaire-25 (SHSQ-25) is a distinctive medical psychometric diagnostic tool designed for the early detection of chronic diseases. However, the synaptic connections between the 25 symptomatic items and their relevance in supporting the monitoring of suboptimal health outcomes, which are precursors for chronic diseases, have not been thoroughly evaluated within the framework of predictive, preventive, and personalised medicine (PPPM/3PM). This baseline study explores the internal structure of the SHSQ-25 and demonstrates its discriminatory power to predict optimal and suboptimal health status (SHS) and develop photogenic representations of their distinct relationship patterns.

Methods

The cross-sectional study involved healthy Ghanaian participants (n = 217; aged 30–80 years; ~ 61% female), who responded to the SHSQ-25. The median SHS score was used to categorise the population into optimal and SHS. Graphical LASSO model and multi-dimensional scaling configuration methods were employed to describe the network structures for the two populations.

Results

We observed differences in the structural, node placement and node distance of the synaptic networks for the optimal and suboptimal populations. A statistically significant variance in connectivity levels was noted between the optimal (58 non-zero edges) and suboptimal (43 non-zero edges) networks (p = 0.024). Fatigue emerged as a prominently central subclinical condition within the suboptimal population, whilst the cardiovascular system domain had the greatest relevance for the optimal population. The contrast in connectivity levels and the divergent prominence of specific subclinical conditions across domain networks shed light on potential health distinctions.

Conclusions

We have demonstrated the feasibility of creating dynamic visualizers of the evolutionary trends in the relationships between the domains of SHSQ-25 relative to health status outcomes. This will provide in-depth comprehension of the conceptual model to inform personalised strategies to circumvent SHS. Additionally, the findings have implications for both health care and disease prevention because at-risk individuals can be predicted and prioritised for monitoring, and targeted intervention can begin before their symptoms reach an irreversible stage.
A Unified Approach to Hierarchical Random Measures
Authors: Catalano Marta , Del Sole Claudio , Lijoi Antonio , Prünster Igor
Published: November 2023

Hierarchical models enjoy great popularity due to their ability to handle heterogeneous groups of observations by leveraging on their underlying common structure. In a Bayesian nonparametric framework, the hierarchy is introduced at the level of group-specific random measures, and then translated to the observations’ level via suitable transformations. In this work, we propose a new strategy to derive closed-form expressions for the marginal and posterior distributions of each group. Indeed, by directly inserting a suitable set of latent variables into the generative model for the data, we unravel a common core shared by the different hierarchical constructions proposed in the Bayesian nonparametric literature. Specifically, we identify a key identity that underlies these models and highlight its role in the derivation of quantities of interest.
On the interior Bernoulli free boundary problem for the fractional Laplacian on an interval
Authors: Kulczycki Tadeusz , Wszoła Jacek
Published: November 2023

We study the structure of solutions of the interior Bernoulli free boundary problem for

$$(-\Delta )^{\alpha /2}$$

(
-
Δ
)

α
/
2

on an interval D with parameter

$$\lambda > 0$$

λ
>
0

. In particular, we show that there exists a constant

$$\lambda _{\alpha ,D} > 0$$

λ

α
,
D

>
0

(called the Bernoulli constant) such that the problem has no solution for

$$\lambda \in (0,\lambda _{\alpha ,D})$$

λ
∈
(
0
,

λ

α
,
D

)

, at least one solution for

$$\lambda = \lambda _{\alpha ,D}$$

λ
=

λ

α
,
D

and at least two solutions for

$$\lambda > \lambda _{\alpha ,D}$$

λ
>

λ

α
,
D

. We also study the interior Bernoulli problem for the fractional Laplacian for an interval with one free boundary point. We discuss the connection of the Bernoulli problem with the corresponding variational problem and present some conjectures. In particular, we show for

$$\alpha = 1$$

α
=
1

that there exists solutions of the interior Bernoulli free boundary problem for

$$(-\Delta )^{\alpha /2}$$

(
-
Δ
)

α
/
2

on an interval which are not minimizers of the corresponding variational problem.
Muslim converts as a heuristic device for postsecular thinking: agonism as an alternative approach
Authors: Olusola Jeremiah O. A.
Published: November 2023

The public resurgence of religious adherence in the West remains one of the defining qualities of this century. If secularisation theory can be understood to articulate the inevitable secularisation of post-enlightenment European societies, religious converts may be understood to epitomise some of the theory’s failings. Through a narrative-ethnographic investigation into the identity configurations and educational experiences of fifteen millennial (born between 1981 and 1996) Muslim converts, my doctoral research indicates that these converts tend to construct deeply religious identities, characterised by scriptural literalism. Set within the backdrop of an educational context that some perceive as increasingly censorious, these convert Muslims provide a heuristic device with which to examine the contested public spaces in which religious subjectivity can be expressed. This paper will bring literature challenging the securitisation agenda in education, into conversation with theories resistant to the impulse to seek consensus in social and educational debate. Advocating for more agonistic approaches to education, I will present examples from my data that warn of the ways in which ‘hardened’ secular and liberal biases may contribute towards an unmooring of the pluralistic endeavour. Located within contemporary debates about the importance of religion as a discursive aspect of modernity, the chilling of free speech and the place of transgressive thought, the paper encourages an expansion of opportunities to disagree.
A Theory of Secure and Efficient Implementation of Electronic Money
Authors: Buldas Ahto , Draheim Dirk , Saarepera Märt
Published: November 2023

Scalable and secure implementation of central bank digital currencies (CBDC) has been a challenge. Blockchains provide high operator-independent security and enable central banks to outsource CBDC operations while retaining control over the amount of circulating money. Scalability of blockchain depends on the possibility of decomposing the blockchain. We study how the choice of money scheme: accounts, bills, or unspent transaction outputs (UTXOs) influences the existence of secure and decomposable blockchain implementations of CBDC. We give formal definitions to money schemes, their decompositions,atomic decompositionsinspired from the properties of blockchain implementations. For our formalism, we use tools from universal algebra and category theory. We present a general decomposition theory and conditions under which money schemes have atomic decompositions. Bill money schemes meet these conditions but account and UTXO schemes do not. Bill schemes enable scalable and secure implementations of CBDC while the more traditional schemes have some issues.
Diverse Sources of Trust: Sense of School Membership, Generalized Social Trust, and the Role of a Diverse School Population
Authors: Rinnooy Kan Willemijn F. , Munniksma Anke , Volman Monique
Published: November 2023

This study investigated how schools can contribute to students’ generalized social trust (GST). Positive social experiences with trust and the experience of being part of a fair and predictable social system are important sources of trust. Students’ sense of school membership (SSM) reflects these sources. We investigated the association between three aspects of SSM and GST in 9th grade of Dutch secondary schools (78 schools, 230 classrooms, 5167 students). The diversity of the school population, in terms of track and ethnicity, was included as a moderator. All three aspects of SSM appeared to be positively associated with GST. School ethnic diversity strengthened the association between ‘identification and participation’ and GST but weakened the association between ‘peer acceptance’ and GST. This creates an impetus to support all students to experience a sense of school membership and raises the question how students can profit more from the diversity of the school community.