bluuebunny/crossref_metadata_2025 huggingface dataset:
Cytotoxicity of novel hybrid composite materials for making bone fracture plates
Authors: Bihari Aurelia , Gee Aaron , Bougherara Habiba , Brzozowski Pawel , Lawendy Abdel-Rahman , Schemitsch Emil H , Zdero Radovan
Published: April 2024

Bone fracture plates are usually made from steel or titanium, which are much stiffer than cortical bone. This may cause bone ‘stress shielding’ (i.e. bone resorption leading to plate loosening) and delayed fracture healing (i.e. fracture motion is less than needed to stimulate callus formation at the fracture). Thus, the authors previously designed, fabricated, and mechanically tested novel ‘hybrid’ composites made from inorganic and organic materials as potential bone fracture plates that are more flexible to reduce these negative effects. This is the first study to measure the cytotoxicity of these composites via the survival of rat cells. Cubes of carbon fiber/flax fiber/epoxy and glass fiber/flax fiber/epoxy had better cell survival vs. Kevlar fiber/flax fiber/epoxy (57% and 58% vs. 50%). Layers and powders made of carbon fiber/epoxy and glass fiber/epoxy had higher cell survival than Kevlar fiber/epoxy (96%–100% and 100% vs. 39%–90%). The presence of flax fibers usually decreased cell survival. Thus, carbon and glass fiber composites (with or without flax fibers), but not Kevlar fiber composites (with or without flax fibers), may potentially be used for bone fracture plates.
Using clustering to understand intra-city warming in heatwaves: insights into Paris, Montreal, and Zurich
Authors: Zhao Yongling , Strebel Dominik , Derome Dominique , Esau Igor , Li Qi , Carmeliet Jan
Published: April 2024

We introduce a novel methodological advancement by clustering paired near-surface air temperature with the planetary boundary layer height to characterize intra-city clusters for analytics. To illustrate this approach, we analyze three heatwaves (HWs): the 2019 HW in Paris, the 2018 HW in Montreal, and the 2017 HW in Zurich. We assess cluster-based characteristics before, during, and after heatwave events. While the urban clusters identified by this clustering align well with built-up areas obtained from the Moderate Resolution Imaging Spectroradiometer (MODIS) land cover data, additional local hot spots spanning several kilometers can also be recognized, extending outside the built-up areas. Using the objective hysteresis model, we further determine the overall strength coefficient of the hysteresis loop between ground storage flux and all-wave downward radiative flux, ranging from 0.414 to 0.457 for urban clusters and from 0.126 to 0.157 for rural clusters during the heatwave periods. Across all cities, we observe a consistent refueling-restoration mode in the cumulative ground heat flux as the heatwaves progress. Future developments of this proposed two-component clustering approach, with the integration of more influential physics and advances in spatial and temporal resolutions, will offer a more comprehensive characterization of cities for urban climate analytics.
Beta Brownian motion
Authors: Eliazar Iddo
Published: April 2024

Brownian motion (BM) is the paradigmatic model of diffusion. Transcending from diffusion to anomalous diffusion, the principle Gaussian generalizations of BM are Scaled BM (SBM) and Fractional BM (FBM). In the sub/super diffusivity regimes: SBM is characterized by aging/anti-aging, and FBM is characterized by anti-persistence/persistence. BM is neither aging/anti-aging, nor persistent/anti-persistent. Within the realm of diffusion, a recent Gaussian generalization of BM, Weird BM (WBM), was shown to display aging/anti-aging and persistence/anti-persistence. This paper introduces and explores the anomalous-diffusion counterpart of WBM—termed Beta BM (BBM) due to its inherent beta-function kernel structure—and shows that: the weird behaviors of WBM become even weirder when elevating to BBM. Indeed, BBM displays a rich assortment of anomalous behaviors, and an even richer assortment of combinations of anomalous behaviors. In particular, the BBM anomalous behaviors include aging/anti-aging and persistence/anti-persistence—which BBM displays in both the sub and super diffusivity regimes. So, anomalous behaviors that are unattainable by the prominent models of SBM and FBM are well attainable by the BBM model.
Integrable systems of the ellipsoidal, paraboloidal and conical type with magnetic field
Authors: Fazlul Hoque Md , Marchesiello Antonella , Šnobl Libor
Published: April 2024

We construct integrable Hamiltonian systems with magnetic fields of the ellipsoidal, paraboloidal and conical type, i.e. systems that generalize natural Hamiltonians separating in the respective coordinate systems to include nonvanishing magnetic field. In the ellipsoidal and paraboloidal case each this classification results in three one–parameter families of systems, each involving one arbitrary function of a single variable and a parameter specifying the strength of the magnetic field of the given fully determined form. In the conical case the results are more involved, there are two one–parameter families like in the other cases and one class which is less restrictive and so far resists full classification.
Dynamical quantum state tomography with time-dependent channels
Authors: Cao Meng , Deng Tenghui , Wang Yu
Published: April 2024

In this paper, we establish a dynamical quantum state tomography framework. Under this framework, it is feasible to obtain complete knowledge of any unknown state of a d-level system via only one operator of a special type of positive operator-valued measure (POVM) in dimension d. We define a new channel, referred to as the time-dependent average channel. Utilizing this channel, we show that we can acquire a collection of projective operators that is informationally complete (IC) and thus obtain the corresponding informationally complete POVMs (IC-POVMs). Zauner conjectured that for any dimension d there exists a fiducial vector, such that all remaining

d

2

−
1

elements of the desired symmetric informationally complete POVM (SIC-POVM) can be obtained by acting on said vector with unitary matrices representing elements of the Weyl-Heisenberg group. We show that under certain condition, it is possible to obtain infinite families of projective operators that are IC, and obtain infinite families of corresponding IC-POVMs; otherwise, Zauner’s conjecture is incorrect. We also show how to simulate a SIC-POVM on any unknown quantum state by using the time-dependent average channel.
Zhuangzi
Authors: Fraser Chris
Published: April 2024

Zhuāngzǐ: Ways of Wandering the Way presents a richly detailed, philosophically informed interpretation of the personal and interpersonal ethics found in the Daoist classic Zhuāngzǐ, introducing a unique Daoist approach to ethics focusing on the concept of a way and our capacity for following ways. Zhuangist thought reframes our relation to our social and natural setting while offering a distinctive, intriguing view of dào, agency, and the structure and grounds for action. At the same time, it embodies an ethical and epistemic modesty that rejects the idea of there being any uniquely privileged form of the good life or any authoritatively correct way to interact with others. The Zhuangist dào is inherently plural, provisional, and protean, and we are likely to find a variety of justifiable ways of wandering along it. Any number of these might contribute to a well-lived, fulfilling life, marked by appropriate social interaction, provided it is pursued with adept responsiveness to our circumstances and awareness of our place in the larger scheme of things. The book examines what prominent threads of discourse in the Zhuāngzǐ have to say about the nature and content of dào, how we might guide our path along dào, the personal training and cultivation involved, and the criteria by which to evaluate our performance. The discussion illustrates how a Zhuangist outlook in metaethics, ethics, moral psychology, and moral epistemology remains relevant to readers today.
Scepticism and Value
Authors: Fraser Chris
Published: April 2024

Chapter 2 presents an interpretation of the Zhuangist sceptical critique of prevailing conceptions of dào, understood as the way or path and thus, by extension, the apt way of life. This critique can be seen as foundational to ethical, metaethical, metaphysical, and epistemological views in the Zhuāngzǐ, in that it undermines other thinkers’ and texts’ claims to knowledge of determinate, authoritative values or norms. The Zhuangist critique threatens to defeat the justification for any purportedly authoritative system of values or any fixed, invariable path of life, be it the dào of the Confucians or Mohists of the pre-imperial Chinese world or that of a consequentialist, Kantian, neo-Aristotelian, or religious ethics in our own day. The chapter contends that the Zhuāngzǐ presents a metaethical view according to which value is inherently plural, perspectival, heterogeneous, and contingent. This metaethical view underwrites the Zhuangist approach to following dào, as dào is a way of articulating value.
Wandering the Way
Authors: Fraser Chris
Published: April 2024

The chapter develops a reading of the Zhuāngzǐ on which the characteristic feature of a well-lived life is the exercise of dé (virtue, agentive power) in a general mode of activity the text calls yóu (wandering). The chapter argues that the Zhuāngzǐ presents a second-order conception of agents’ flourishing in which the life of dé is not devoted to predetermined substantive ends or activities with a specific substantive content. Rather, it is marked by a distinctive manner of activity and certain characteristic attitudes. This can be considered a ‘eudaimonistic’ view, insofar as it offers a conception of human flourishing, albeit one that—unlike the views of most Hellenistic schools of thought—may be fulfilled by a broad range of activities and ends. The chapter summarizes the justification for Zhuangist eudaimonism and identifies key features of the Zhuangist conception of wandering. It explores connections between wandering and the prominent Zhuangist interest in the performance of skills, suggesting that skills offer concrete, detailed illustrations of the process of wandering. It wraps up by sketching how the wandering ideal shapes the substantive content of the good life while allowing that such a life may proceed in a plurality of directions.
Emotion and Agency
Authors: Fraser Chris
Published: April 2024

This chapter explores the Zhuāngzǐ’s ‘Virtuoso View’ of emotion and its connections with human agency, attempting to show that at least one version of a Zhuangist approach to emotion is indeed plausible. It sketches the theoretical foundation for the Virtuoso View, which involves claims about human agency, the self, psychophysical hygiene, the good life, epistemology, and metaphysics. The chapter defends the Virtuoso View against three objections, namely that it abandons intentionality, that it interferes with a good life, and that it yields a schizophrenic conception of agency. The chapter argues that the Virtuoso View is easily intelligible and largely defensible. It reflects a crucial insight into the unavoidable conflict within a self-aware human agent between an internal, engaged perspective and an external, detached one. Certain apparent conflicts arising from the Virtuoso View actually reflect inherent features of the human predicament and thus are not mere conceptual flaws.
Forget the Deeps and Row!
Authors: Fraser Chris
Published: April 2024

Previous chapters suggested that ‘forgetting’ and ‘emptiness’ are instrumental to the full exercise of dé (virtue, agency). A familiar obstacle to ‘forgetting’ and attaining ‘emptiness’—and thus to fulfilling our capacity for dé—is anxiety, or a nervous inability to focus on the performance of dào. One reason for the notable interest in skills in the Zhuāngzǐ is that skilled performances exemplify the emptiness, concentration, and responsiveness associated with applying dé in competent performance of dào. The present chapter scrutinizes the implications of one specific Zhuāngzǐ skill story, that of a ferryman who steers a sampan through treacherous deeps with preternatural skill. The chapter explores how salient motifs in the ferryman story illustrate broader themes in Zhuangist ethics concerning the flourishing life, in particular that adept performance in any field rests partly on psychological attitudes. To perform well—and to experience the ‘wandering’ mode of agency—agents must overcome anxiety about their circumstances and the stakes of their action—no matter how dangerous or intimidating—and focus on the task before them. The chapter delves into the concrete guidance the ferryman and thematically related passages offer about managing emotions and overcoming anxiety, including techniques for attention control and for defusing potential sources of fear or worry by reframing one’s values.
Evolutionary trends of reproductive phenotype in Cycadales: an analysis of morphological evolution in Ceratozamia
Authors: Martínez-Domínguez Lilí , Nicolalde-Morejón Fernando , Vergara-Silva Francisco , Gernandt David S , Huesca-Domínguez Israel , Stevenson Dennis Wm
Published: April 2024

Background and Aims

The size and shape of reproductive structures is especially relevant in evolution because these characters are directly related to the capacity for pollination and seed dispersal, a process that plays a basic role in evolutionary patterns. The evolutionary trajectories of reproductive phenotypes in gymnosperms have received special attention in terms of pollination and innovations related to the emergence of the spermatophytes. However, variability of reproductive structures, evolutionary trends and the role of environment in the evolution of cycad species have not been well documented and explored. This study considered this topic under an explicitly phylogenetic and evolutionary approach that included a broad sampling of reproductive structures in the genus Ceratozamia.

Methods

We sampled 1400 individuals of 36 Ceratozamia species to explore the evolutionary pattern and identify and evaluate factors that potentially drove their evolution. We analysed characters for both pollen and ovulate strobili within a phylogenetic framework using different methods and characters (i.e. molecular and both quantitative and qualitative morphological) to infer phylogenetic relationships. Using this phylogenetic framework, evolutionary models of trait evolution for strobilar size were evaluated. In addition, quantitative morphological variation and its relation to environmental variables across species were analysed.

Key Results

We found contrasting phylogenetic signals between characters of pollen and ovulate strobili. These structures exhibited high morphological disparity in several characters related to size. Results of analyses of evolutionary trajectories suggested a stabilizing selection model. With regard to phenotype–environment, the analysis produced mixed results and differences for groups in the vegetation type where the species occur; however, a positive relationship with climatic variables was found.

Conclusions

The integrated approach synthesized reproductive phenotypic variation with current phylogenetic hypotheses and provided explicit statements of character evolution. The characters of volume for ovulate strobili were the most informative, and could provide a reference for further study of the evolutionary complexity in Ceratozamia. Finally, heterogeneous environments, which are under changing weather conditions, promote variability of reproductive structures.
CopyVAE: a variational autoencoder-based approach for copy number variation inference using single-cell transcriptomics
Authors: Kurt Semih , Chen Mandi , Toosi Hosein , Chen Xinsong , Engblom Camilla , Mold Jeff , Hartman Johan , Lagergren Jens
Published: April 2024

Motivation

Copy number variations (CNVs) are common genetic alterations in tumour cells. The delineation of CNVs holds promise for enhancing our comprehension of cancer progression. Moreover, accurate inference of CNVs from single-cell sequencing data is essential for unravelling intratumoral heterogeneity. However, existing inference methods face limitations in resolution and sensitivity.

Results

To address these challenges, we present CopyVAE, a deep learning framework based on a variational autoencoder architecture. Through experiments, we demonstrated that CopyVAE can accurately and reliably detect CNVs from data obtained using single-cell RNA sequencing. CopyVAE surpasses existing methods in terms of sensitivity and specificity. We also discussed CopyVAE’s potential to advance our understanding of genetic alterations and their impact on disease advancement.

Availability and implementation

CopyVAE is implemented and freely available under MIT license at https://github.com/kurtsemih/copyVAE.
Intradialytic cardiovascular injury is lowest in high-volume
haemodiafiltration: a randomized cross-over trial in four intermittent dialysis
strategies
Authors: Liu Peiyun , Rootjes Paul A , de Roij van Zuijdewijn Camiel L M , Hau Chi M , Nubé Menso J , Nieuwland Rienk , Wijngaarden Gertrude , Grooteman Muriel P C
Published: April 2024

Background

Intradialytic hypotension (IDH) and subsequent tissue damage may contribute to the poor outcome of chronic haemodialysis (HD) patients. While the IDH-incidence is lower in high-volume haemodiafiltration (HV-HDF) than in standard HD (S-HD), survival is better in HV-HDF. Tissue injury, as measured by extracellular vesicle (EV)-release, was compared between four modalities.

Methods

Forty chronic patients were cross-over randomized to S-HD, cool-HD (C-HD), low-volume HDF (LV-HDF), and HV-HDF. Blood pressure was recorded every 15 minutes. EVs from circulating blood-cell-elements (bio-incompatibility-related) and cardiovascular (CV) tissues (CV-related), were measured before and after dialysis. The influence of modalities and IDH on the rate of change of EVs was assessed. Both crude and haemoconcentration-adjusted analyses were performed.

Results

Leukocyte and erythrocyte-derived EVs increased in all modalities. Platelet-derived EVs increased more in LV-HDF and HV-HDF (68.4 respectively 56.1 × 106/ml) than in S-HD (27.5 × 106/ml), P values for interaction were <.01 respectively .06. Endothelial-derived CD144+ (2.3 × 106/ml in HV-HDF and 9.8 × 106/ml in S-HD) and cardiomyocyte-derived Connexin-43+ (12.0 respectively 31.9 × 106/ml) EVs increased less in HV-HDF than in S-HD (P for interaction .03 respectively .06). Correction for haemoconcentration attenuated all changes, although the increase in platelet-derived EVs remained significant in LV-HDF and HV-HDF, and CD144+ and Connexin-43+ EVs increased most in S-HD. EV release was similar in patients with varying IDH susceptibility and in sessions with and without IDH.

Conclusions

Most EVs increase during HD and HDF. Regarding platelet-derived EVs, HDF appears less biocompatible than HD. Considering CV-related EVs, tissue injury seems less pronounced in HV-HDF. The finding that EV release is IDH-independent needs confirmation.
Left and right ventricular longitudinal systolic function following aortic valve replacement in the PARTNER 2 trial and registry
Authors: Silva Iria , Ternacle Julien , Hahn Rebecca T , Salah-Annabi Mohamed , Dahou Abdellaziz , Krapf Laura , Salaun Erwan , Guzzetti Ezequiel , Xu Ke , Clavel Marie-Annick , Bernier Mathieu , Beaudoin Jonathan , Cremer Paul C , Jaber Wael , Rodriguez Leonardo , Asch Federico M , Weismann Neil J , Bax Jeroen , Ajmone Nina , Alu Maria C , Kallel Faouzi , Mack Michael J , Webb John G , Kapadia Samir , Makkar Raj , Kodali Susheel , Herrmann Howard C , Thourani Vinod , Leon Martin B , Pibarot Philippe
Published: April 2024

Aims

Evaluation of left and right ventricular (RV) longitudinal systolic function may enhance risk stratification following aortic valve replacement (AVR). The study objective was to evaluate the changes in left and RV longitudinal systolic function and RV–pulmonary artery (RV–PA) coupling from baseline to 30 days and 1 year after AVR.

Methods and results

Left ventricular (LV) longitudinal strain (LS), tricuspid annulus plane systolic excursion (TAPSE), and RV–PA coupling were evaluated in patients from the PARTNER 2A surgical AVR (SAVR) arm (n = 985) and from the PARTNER 2 SAPIEN 3 registry (n = 719). TAPSE and RV–PA coupling decreased significantly following SAVR, but remained stable following TAVR. Lower LV LS, TAPSE, or RV–PA coupling at baseline was associated with increased risk of the composite of death, hospitalization, and stroke at 5 years [adjusted hazard ratios (HRs) for LV LS < 15%: 1.24, 95% confidence interval (CI) 1.05–1.45, P = 0.001; TAPSE < 14 mm: 1.44, 95% CI 1.21–1.73, P < 0.001; RV–PA coupling < 0.55 mm/mmHg: 1.32, 95% CI 1.07–1.63, P = 0.011]. Reduced TAPSE at baseline was the most powerful predictor of the composite endpoint at 5 years. Patients with LV ejection fraction <50% at baseline had increased risk of the primary endpoint with SAVR (HR: 1.34, 95% CI 1.08–1.68, P = 0.009) but not with TAVR (HR: 1.12, 95% CI 0.88–1.42). Lower RV–PA coupling at 30 days showed the strongest association with cardiac mortality.

Conclusion

SAVR but not TAVR was associated with a marked deterioration in RV longitudinal systolic function and RV–PA coupling. Lower TAPSE and RV–PA coupling at 30 days were associated with inferior clinical outcomes at 5 years. In patients with LVEF < 50%, TAVR was associated with superior 5-year outcomes.
The influence of breast screening on breast cancer incidence in England: observational study based on cancer registries and bulletins of the NHS Breast Screening Programme
Authors: Autier Philippe , Ould Ammar Romain , Bota Maria
Published: April 2024

Background

To assess the amount of breast cancer overdiagnosis associated with the National Health Service Breast Screening Programme (NHSBSP) that started in 1988 in England.

Methods

First, numbers of breast cancers in women eligible for breast screening not attending screening were estimated for the period 1995–2019, which were extrapolated to all women. A second method was based on ratios of incidence rates of breast cancers in women aged 50–69 to women aged 70 years or more in 1971–1985. The ratio was used for estimating expected numbers of cancers in 1988–2019, and 1995–2019.

Results

From 1995 to 2019, 506,607 non-invasive and invasive breast cancers were diagnosed among women aged 50–64 years (1995–2001) and 50–70 years (2002–2019). A first method estimated that 95,297 cancers were in excess to the number of cancers that would be expected had the NHSBSP not existed. 42,567 screen-detected non-invasive and micro-invasive cancers represented 45.8% of the total excess cancer. 18.8% of all cancers diagnosed among women invited to screening, 25.1% of cancers found in women attending screening, and 35.1% of cancers detected by screening would represent overdiagnosis. A second method estimated that, 18.0% of all cancers diagnosed in 1988–2019, and 18.2% of all cancers diagnosed in 1995–2019 among women invited to screening would represent overdiagnosis.

Conclusion

The two independent methods obtained similar estimates of overdiagnosis. The NHS Breast Screening Programme in England is associated with substantial amount of overdiagnosis.
An integrative miRNA-mRNA expression analysis identifies miRNA signatures associated with SOD1 and TARDBP patient-derived motor neurons
Authors: Dash Banaja P , Freischmidt Axel , Weishaupt Jochen H , Hermann Andreas
Published: April 2024

MicroRNAs (miRNAs) are a subset of small non-coding single-stranded RNA molecules involved in the regulation of post-transcriptional gene expression of a variety of transcript targets. Therefore altered miRNA expression may result in the dysregulation of key genes and biological pathways that has been reported with the onset and progression of neurodegenerative diseases, such as Amyotrophic lateral sclerosis (ALS). ALS is marked by a progressive degeneration of motor neurons (MNs) present in the spinal cord, brain stem and motor cortex. Although the pathomechanism underlying molecular interactions of ALS remains poorly understood, alterations in RNA metabolism, including dysregulation of miRNA expression in familial as well as sporadic forms are still scarcely studied. In this study, we performed combined transcriptomic data and miRNA profiling in MN samples of the same samples of iPSC-derived MNs from SOD1- and TARDBP (TDP-43 protein)-mutant-ALS patients and healthy controls. We report a global upregulation of mature miRNAs, and suggest that differentially expressed (DE) miRNAs have a significant impact on mRNA-level in SOD1-, but not in TARDBP-linked ALS. Furthermore, in SOD1-ALS we identified dysregulated miRNAs such as miR-124-3p, miR-19b-3p and miR-218 and their potential targets previously implicated in important functional process and pathogenic pathways underlying ALS. These miRNAs may play key roles in the neuronal development and cell survival related functions in SOD1-ALS. Altogether, we provide evidence of miRNA regulated genes expression mainly in SOD1 rather than TDP43-ALS.
Global Epidemiology and Geographic Variations of Pediatric-Onset Inflammatory Bowel Disease: A Comprehensive Analysis of the Global Burden of Disease Study 1990 to 2019
Authors: Wang Yichen , Pan Chun-Wei , Huang Yuting , Zheng Xin , Li Si , He Mingyue , Hashash Jana G , Farraye Francis A , Ehrlich Adam C
Published: April 2024

Background

An increasing incidence of pediatric-onset inflammatory bowel disease (PIBD) has been reported in many countries. However, the global burden and distribution of this disease remain less understood. We aimed to examine the global epidemiology and trends of PIBD from 1990 to 2019.

Methods

Data from the 2019 Global Burden of Disease Study, covering 204 countries, were analyzed. We assessed key measures like incidence, prevalence, mortality, and disability-adjusted life years (DALYs) using linear regression to calculate annual percentage changes and assess trends.

Results

Between 1990 and 2019, the PIBD incidence rate increased and the DALY rate and mortality rate declined. The incidence rate was notably elevated in the high Socio-demographic Index (SDI) quintile, reaching 6.3 per 100 000 person-years, corresponding to 13 914 new cases in 2019. Incidence and prevalence of PIBD positively correlated with the SDI, while higher death and DALY burdens were observed in lower-SDI countries. In 2019, the top 5 countries with the highest PIBD incidence rates were Canada (19.9 per 100 000 population), Denmark (12.4 per 100 000 population), Hungary (8.5 per 100 000 population), Austria (8.1 per 100 000 population), and the United States (7.4 per 100 000 population). Several countries experienced significant increases in incidence rates from 1990 to 2019, led by Taiwan (annual percent change 4.2%), followed by China (2.8%), Japan (2.1%), Australia (1.8%), and Hungary (1.6%).

Discussion

PIBD incidence has significantly increased since 1990. High-SDI countries face higher incidence, while lower-SDI countries experience higher mortality and DALY burdens. The study underscores the need for ongoing monitoring and research to address this emerging public health issue.
Energy saving of rural buildings in Henan Province based on rural revitalization in China
Authors: Wang Fang , Cheng Xiaoqian , Zhu Caixia , Liu Xianfei , Zhang Yichi , Pang Dongqing , Liu Mengwei , Du Weifeng , Guo Wenliang
Published: April 2024

Based on rural revitalization in China, the strengths, weaknesses, opportunities and threats model combined with the politics, economy, society and technology model (SWOT-PEST) has been used to comprehensively analyze the advantages, disadvantages, opportunities and threats to the development of rural energy-efficient buildings in Henan Province based on national policies, the local economic development level, the social situation and technology. The results showed that rural energy-efficient buildings have both advantages and disadvantages at the levels of policy, the economy, society and technology, and that overall, rural energy-efficient building development is at an optimum time. On this basis, we proposed energy-saving countermeasures to execute the primary responsibilities of local party committees and governments, enhance innovation in energy-saving technologies and improve the affordability of energy-efficient buildings. These are the three ways to encourage the effective establishment of rural energy-efficient buildings. This study provides references for promoting rural energy transformation and energy-saving policy reform in developing countries.
Recognizing the opportunity to directly de-label no-risk penicillin allergies in community pharmacy: a mystery shopper experience
Authors: Lim Angelina , Khumra Sharmila , Dalley Annika , Bubb Grace , Chien Jacqueline , Kong David C M
Published: April 2024

Objectives

Incorrect labelling of a penicillin allergy can lead to unnecessary use of broad-spectrum, less effective, more harmful, or more costly antibiotics. Community pharmacists are well positioned to educate the public on penicillin allergies, prevent incorrect labelling persisting, and optimize prescribing of antibiotics. This study investigated community pharmacists’ capacity to recognize an opportunity to directly de-label a no-risk penicillin allergy.

Methods

A sequential explanatory mixed methods design using mystery shopping (quantitative) and postvisit reflections (qualitative). Mystery shoppers simulated a case of a previously dispensed prescription (involving nonimmune mediated intolerance ‘thrush’ as the reported allergy) that provided the opportunity for pharmacists to educate on incorrect penicillin allergy. The main outcomes were proportion of community pharmacists who ascertained the nature of the penicillin reaction, provided education on incorrect penicillin allergy labels and its consequences. Knowledge and practices regarding penicillin allergy were collected.

Key findings

Across two major states in Australia, 265 community pharmacists participated. Only 44.5% (118/265) of pharmacists asked about the nature of the reaction; of those, 91.52% (108/118) indicated that ‘thrush’ is not an allergic reaction. No pharmacists took the opportunity to educate on how an incorrect allergy label can impact antibiotic prescribing. Postvisit reflection data revealed five probable explanations for the observations viz. outdated knowledge, lack of knowledge, prioritizing management of adverse drug reaction (thrush), variations in duty of care and assumption of true allergy without an assessment.

Conclusion

Our findings underscore a concerning knowledge and practice gap among community pharmacists regarding penicillin allergy assessment which warrants more support and education in the community pharmacy sector.
Child Victims and the Punishment of UN Peacekeepers for Sexual Exploitation and Abuse
Authors: Comstock Audrey L
Published: April 2024

Abstracts

A growing subset of peacekeeping literature focuses on explaining peacekeeper sexual exploitation and abuse (SEA) of civilians within postconflict protection. However, what happens after the abuse has received limited attention. Most of the time, peacekeepers do not receive any type of punishment following abuse allegations. What explains why peacekeepers are punished for abuse allegations? I argue that the presence of child victims increases the chances that peacekeepers are punished. Two mechanisms are highlighted through which the presence of child victims increases the chance of punishment: (i) the increased moral and legal obligation of UN member states to protect children and (ii) the increased shaming and media focus on child victims, which heightens public focus. The empirical analyses of UN and Troop-Contributing Country punishment actions between 2007 and 2017 provide robust support for the argument that the presence of child victims increases peacekeeper punishment. This research builds on studies of SEA, peacekeeping dynamics, and victimhood.
Sweeping the dirt under the rug: measuring spillovers of an anti-corruption measure
Authors: Tulli Andrea
Published: April 2024

This article studies the spillover effects of an Italian anti-corruption measure targeting municipalities colluding with organized crime. We assess its impact on neighboring municipalities’ procurement practices. Our findings reveal that neighboring municipalities increase contracts falling below the 40,000 Euro threshold, which bear lighter evidentiary requirements, and are consequently harder to monitor. The neighboring municipalities strategically evade stricter regulations by fragmenting major projects into different sub-threshold contracts. Our analysis presents three evidence that this response stems from greater law enforcement monitoring. First, the number of arrests increases in the area after the implementation of the measure. Then, we demonstrate that the spillovers are more pronounced in areas with greater prior law enforcement activity. Lastly, we illustrate how neighboring municipalities react to the dissolution by reducing their engagement in activities that are more susceptible to monitoring. This is evident in their decreased participation in renegotiating public works contracts (JEL D730, H570, K420).
Financial hardship and neighborhood socioeconomic disadvantage in long-term childhood cancer survivors
Authors: Fauer Alex J , Qiu Weiyu , Huang I-Chan , Ganz Patricia A , Casillas Jacqueline N , Yabroff K Robin , Armstrong Gregory T , Leisenring Wendy , Howell Rebecca , Howell Carrie R , Kirchhoff Anne C , Yasui Yutaka , Nathan Paul C
Published: April 2024

Background

Long-term survivors of childhood cancer face elevated risk for financial hardship. We evaluate whether childhood cancer survivors live in areas of greater deprivation and the association with self-reported financial hardships.

Methods

We performed a cross-sectional analysis of data from the Childhood Cancer Survivor Study between 1970 and 1999 and self-reported financial information from 2017 to 2019. We measured neighborhood deprivation with the Area Deprivation Index (ADI) based on current zip code. Financial hardship was measured with validated surveys that captured behavioral, material and financial sacrifice, and psychological hardship. Bivariate analyses described neighborhood differences between survivors and siblings. Generalized linear models estimated effect sizes between ADI and financial hardship adjusting for clinical factors and personal socioeconomic status.

Results

Analysis was restricted to 3475 long-term childhood cancer survivors and 923 sibling controls. Median ages at time of evaluation was 39 years (interquartile range [IQR] = 33-46 years and 47 years (IQR = 39-59 years), respectively. Survivors resided in areas with greater deprivation (ADI ≥ 50: 38.7% survivors vs 31.8% siblings; P < .001). One quintile increases in deprivation were associated with small increases in behavioral (second quintile, P = .017) and psychological financial hardship (second quintile, P = .009; third quintile, P = .014). Lower psychological financial hardship was associated with individual factors including greater household income (≥$60 000 income, P < .001) and being single (P = .048).

Conclusions

Childhood cancer survivors were more likely to live in areas with socioeconomic deprivation. Neighborhood-level disadvantage and personal socioeconomic circumstances should be evaluated when trying to assist childhood cancer survivors with financial hardships.
Creating Boundary Objects Supports Knowledge Co-development Processes: A Case Study Evaluation from the Colorado Front Range
Authors: Brown Hannah L C , Cheng Antony S , Clark Nehalem C , Slack Andrew W , Wolk Brett H
Published: April 2024

This qualitative case study evaluates manager and researcher perceptions of the impact of a place-based, collaborative knowledge co-development process and examines the outcomes of that co-development for changes to management approaches. The USDA Forest Service (Forest Service) Rocky Mountain Research Station General Technical Report 373 (GTR-373) is a codeveloped science synthesis that functions as a boundary object providing a framework for planning, designing, and implementing management action for restoration of ponderosa and dry mixed-conifer forests. The process of creating and socializing the GTR-373 framework fostered continual knowledge exchange and engagement between researchers and managers across different organizations and levels of decision-making. This built trust in the information, improved justification for management action, developed a common foundation for cross-boundary implementation, and increased communication. The framework has been applied across jurisdictions and has been used as a foundational tool for training staff and designing projects. However, adapting the GTR-373 framework across scales remains challenging.

Study Implications: This qualitative case study evaluates a co-development process in which researchers and managers from multiple organizations and agencies collaborated to produce a science-informed restoration framework to support forest management on the Colorado Front Range (GTR-373). The process built trust, improved justification for management action, developed a common foundation for implementation, and increased communication. However, cross-boundary management across spatial scales remains challenging, and managers interpret information through organizational mandates and site-specific context. Sustained collaboration between researchers and land managers can help make science actionable and relevant at the appropriate scale for planning and management across expertise and jurisdictional boundaries.
Facilitation drives tree seedling survival at alpine treelines
Authors: Chen Wensheng , Li Jiangrong , Camarero Jesús Julio , Ding Huihui , Fu Fangwei , Li Yueyao , Zheng Xiangyu , Li Xiaoxia , Shen Wei , Sigdel Shalik Ram , Leavitt Steven W , Liang Eryuan
Published: April 2024

Alpine treelines are considered ecological monitors recording the impacts of climate change on trees and forests. To date, most treeline research has focused on how climate change drives treeline dynamics. However, little is known about how biotic interactions mediate treeline shifts, particularly in the case of tree recruitment, a bottleneck of treeline dynamics. We hypothesized that inter- and intraspecific facilitation determined the establishment and survival of tree seedlings at alpine treelines. To test this hypothesis, 630 Abies georgei var. smithii seedlings with different ages (4–6, 7–9 and 10–15 years old) were transplanted into three growth habitats (canopy-in, canopy-out and meadow) across the alpine treeline ecotone (4300–4500 m) in the Sygera Mountains, on the southeastern Qinghai-Tibetan Plateau. Microclimate, height growth, mortality rates and leaf functional traits of transplanted seedlings were measured over 3 years. We found that the variations in leaf functional traits were driven by microclimate. After the transplantation, the leaf concentrations of soluble sugars and starch and C:P ratio increased, whereas leaf size decreased. The resource use of seedlings gradually shifted to a more conservative strategy as indicated by changes in non-structural carbohydrates and nutrient concentrations. Radiation, temperature and moisture conditions, mediated by plant interactions, influenced seedling mortality and annual growth by affecting leaf morphological traits. Our findings illustrate how facilitation plays a crucial role in altering solar radiation and leaf trait functioning, determining seedling survival and growth at alpine treelines. We provide new insights into the underlying mechanisms for tree establishment and alpine treeline shifts in response to climate change.
Efficacy of a Single Day Extracorporeal Membrane Oxygenation Training Course for Critical Care Air Transport Team Eligible Personnel
Authors: Paredes R Madelaine , Inman Brannon , Davis William T , Castaneda Maria , Mireles Allyson A , Baldwin Darren S , Rodriguez Dylan C , Medellin Kimberly L , Ng Patrick C , Maddry Joseph K
Published: April 2024

Background

Extracorporeal membrane oxygenation (ECMO) is an advanced medical technology that is used to treat respiratory and heart failure. The U.S. military has used ECMO in the care of combat casualties during Operation Enduring Freedom and Operation Iraqi Freedom as well as in the treatment of patients during the recent Coronavirus Disease 2019 pandemic. However, few Military Health System personnel have training and experience in the use of ECMO therapy. To address this dearth of expertise, we developed and evaluated an accelerated ECMO course for military medical personnel.

Objectives

To compare the efficacy of an accelerated ECMO course for Military Health System critical care teams.

Methods

Seventeen teams, each consisting of a physician and nurse, underwent a 5-h accelerated ECMO course. Similar to our previous live-tissue ECMO training program (phases I and II), each team watched prerecorded ECMO training lectures. Subjects then practiced priming the ECMO circuit, cannulating ECMO, initiating ECMO, and correcting common complications on an ECMO simulation model. An added component to this phase III project included transportation and telemedicine consultation availability. Training success was evaluated via knowledge and confidence assessments, and observation of each team attempting to initiate ECMO on a Yorkshire swine patient model, transport the patient model, and troubleshoot complications with the support of telemedicine consultation when desired.

Results

Seventeen teams successfully completed the course. All seventeen teams (100%) successfully placed the swine on veno-arterial ECMO. Of those, 15 teams successfully transitioned to veno-arterial-venous ECMO. The knowledge assessments of physicians and nurses increased by 12.2% from pretest (mean of 62.1%, SD 10.4%) to posttest (mean of 74.4%, SD 8.2%), P < .0001; their confidence assessments increased by 41.1% from pretest (mean of 20.1%, SD 11.8%) to posttest (mean of 61.2%, SD 18.6%).

Conclusions

An abbreviated 1-day lecture and hands-on task-trainer-based ECMO course resulted in a high rate of successful skill demonstration and improvement of physicians’ and nurses’ knowledge assessments and confidence levels, similar to our previous live-tissue training program. When compared to our previous studies, the addition of telemedicine and patient transportation to this study did not affect the duration or performance of procedures.
High Rates of Eye Surgery Cancellation in Veterans Related to Mental Health
Authors: Hanson Justin , Hui Maggie , Strawbridge Jason C , Chatterjee Sayan , Goodyear Kendall , Giaconi JoAnn A , Tsui Irena
Published: April 2024

Introduction

Approximately 9 million veterans receive health care at the Veterans Health Administration, many of whom have psychiatric illnesses. The military continues to have higher rates of psychiatric illness compared to the civilian population. Having a diagnosis such as posttraumatic stress disorder or depression may create challenges in using health care services, such as surgery. The aim of this study was to evaluate eye surgery cancellation, risk factors for cancellation, and areas for intervention within the VA.

Materials and Methods

This was a single-center retrospective cohort study. The Veteran Health Information Systems and Technology Architecture were queried to identify all surgical requests at the West Los Angeles VA in 2019. Data collection included sociodemographic information and comorbid medical conditions, including psychiatric illness. Exploratory analyses using univariate logistic regression were used to evaluate factors associated with surgery cancellation.

Results

A total of 1,115 surgical requests were identified with a cancellation rate of 23.7% (n = 270). Sociodemographic factors were similar between those with completed and cancelled surgery. However, having a psychiatric diagnosis correlated with surgery cancellation. For all subspecialties, patients with schizophrenia were more likely to have cancellation (odds ratio [OR], 2.53, P = .04). For retina surgery, patients with posttraumatic stress disorder were more likely to have cancellation (OR, 4.23, P = .01). Glaucoma patients with anxiety (OR, 5.78, P = .05) and depression (OR, 4.05, P = .04) were more likely to have cancellation.

Conclusions

There was a significant amount of eye surgery cancellations in veterans with variation by subspecialty and comorbid conditions. Having a psychiatric illness was correlated with increased rates of surgery cancellation amongst veterans. Areas to improve surgical utilization include risk stratification and increased support of vulnerable patients before surgery.
Hans Jonas: The Last German Philosopher and His Jewish Challenge to Modernity: Affirming Life
Authors: Kutash Emilie
Published: April 2024

Victorio Hosle called Hans Jonas “the last German philosopher.” Jonas’ Memoirs connect changing philosophical priorities with devastating life events. The shock of learning of his former mentor, Heidegger’s, affiliation to National Socialism, his exile from Germany and his mother’s death in Auschwitz, made the conceptual universe of German Idealism, Husserl and Heidegger, seem nihilistic and akin to a Gnostic denigration of worldliness. The brutal wartime realities exposed a callous removal from nature and any meaningful humanism. After soldiering in the war with “Maccabean rage,” he subsequently created his philosophical biology of organism, one which respected the corporeal, metabolic basis of life. His consequent innovations in Environmental and Medical Ethics had an enormous impact on the German scholarly world. Jonas retained a lifelong attachment to German culture and “saved” German philosophy by making critical amendments. Later in life he wrote in German, spent a sabbatical year in Germany, received the medal of honor from the Federal Republic of Germany and honorary doctorates from several German universities. The “German” Jonas brought a respect for ontology and nature to a philosophy that was prone to sterile abstractions. The life-affirming “Jewish” Jonas restored an ethical mandate for responsibility for the future of the planet and humankind to a bereft ethics.
Establishing the minimal clinically important difference of the Brief Fatigue Inventory for brain or CNS cancer patients undergoing radiotherapy
Authors: Gunn Heather J , Zaniletti Isabella , Breen William G , Leavitt Todd , Bogan Aaron , Mahajan Anita , Brown Paul D , Yan Elizabeth , Vora Sujay A , Merrell Kenneth W , Ashman Jonathan B , Peterson Jennifer L , Leenstra James L , Wilson Zachary C , Laughlin Brady S , Laack Nadia N , DeWees Todd A
Published: April 2024

Background

Minimal clinically important differences (MCIDs) quantify the clinical relevance of quality of life results at the individual patient and group level. The aim of this study was to estimate the MCID for the Brief Fatigue Inventory (BFI) and the Worst and Usual Fatigue items in patients with brain or CNS cancer undergoing curative radiotherapy.

Methods

Data from a multi-site prospective registry was used. The MCID was calculated using distribution-based and anchor-based approaches. For the anchor-based approach, the fatigue item from the PROMIS-10 served as the anchor to determine if a patient improved, deteriorated, or had no change from baseline to end of treatment (EOT). We compared the unadjusted means on the BFI for the 3 groups to calculate the MCID. For the distribution-based approaches, we calculated the MCID as 0.5 SD of the scores and as 1.96 times the standard error of measurement.

Results

Three-hundred and fifty nine patients with brain or CNS tumors undergoing curative radiotherapy filled out the 9-item BFI at baseline and EOT. The MCID for the BFI was 1.33 (ranging from 0.99 to 1.70 across the approaches), 1.51 (ranging from 1.16 to 2.02) and 1.76 (ranging from 1.38 to 2.14) for the usual and worst fatigue items, respectively.

Conclusions

This study provides the MCID ranges for the BFI and Worst and Usual fatigue items, which will allow clinically meaningful conclusions to be drawn from BFI scores. These results can be used to select optimal treatments for patients with brain or CNS cancer or to interpret BFI scores from clinical trials.