bluuebunny/crossref_metadata_2025 huggingface dataset:
Sea Pens. Las plumas del mar
Authors: García Cárdenas Francisco José
Published: July 2023

Las plumas de mar o pennatuláceos, organismos catalogados como Ecosistemas Marinos Vulnerables, constituyen un componente fundamental de las comunidades bentónicas marinas en fondos blandos; se consideran especies bioconstructoras, dado que incrementan la biodiversidad y constituyen la base fundamental de complejos ecosistemas. A pesar de su importante papel ecológico, se sabe muy poco sobre ellos. Esta obra introduce al lector en el mundo submarino de una forma sencilla y didáctica, despertando el interés de mentes curiosas, tanto de naturalistas como de neófitos en el estudio de los corales. La obra desarrolla aspectos generales sobre la morfología, variabilidad, biología y evolución de estas especies. Se ofrece una amplia información, que va desde los estudios científicos clásicos hasta los más recientes, incorporando los resultados de la propia investigación del autor.
Desbordando hashtags de Twitter: La protesta digital k-pop en el Paro Nacional de 2021 en Colombia
Authors: Lombana-Bermudez Andres , Rodriguez Gomez Sergio
Published: July 2023

Este artículo presenta los resultados de un estudio exploratorio y empírico sobre la protesta digital k-pop desplegada durante el Paro Nacional de 2021 en Colombia. Utilizando métodos mixtos y un corpus de 134 144 tuits, se indagó sobre las dinámicas que caracterizan esta forma de activismo político digital y el repertorio de tácticas empleadas por los participantes de esta acción colectiva. Además, por medio de un análisis de contenido multimodal a una muestra aleatoria de 1840 tuits publicados con el hashtag #RepudioAlVándalo, se caracterizaron las imágenes y textos utilizados para controlar el flujo de información y capturar la atención pública en la plataforma digital Twitter. Los resultados de la investigación revelan que las tácticas de resistencia algorítmica, secuestro de hashtags y spam se desplegaron en la acción k-pop de forma efectiva y que consiguieron sabotear los públicos-hashtag que buscaban estigmatizar a los manifestantes y apoyar el uso de la fuerza contra la protesta. A manera de conclusión, se reflexiona sobre la efectividad del movimiento global-local k-pop, la evolución de las tácticas de activismo político digital y su problemática asociación con la terminología de la guerra de la información.
UK Kidney Week (UKKW) Interventional Nephrology Workshop
Authors: Trew Fiona , Selwood Jessica , Das Mohana , Andrews James , Clark Rauri , Willows Jamie , Ryan Rebecca , Nadeem Muhammed , Allan Carol , Sweeney Debra , Sood Bhrigu , Virdee Pritpal , Somalanka Subash , Jiminez Heidi , Stevenson Tamasin , Ahmed Saeed
Published: July 2023

In this article, the outcome of an interventional nephrology workshop at last year's UK Kidney Week is thoroughly reviewed
Selling kidneys
Authors: Ellis Peter
Published: July 2023

This article covers the ethical issues that arise when human organs are bought or sold, and whether there is a place for the sale of kidneys
Patient Reported Experience Measure (PREM): your key to unlocking the patient perspective
Authors: Kercher Claire
Published: July 2023

The PREM results for 2022 are now live. Don't miss the chance to review the feedback from of over 11 000 patients
GE is Back with a Boom
Authors: Wade Andrew
Published: July 2023

First supersonic civil engine since Concorde
How the UK is Reaping Benefits of Collaboration
Authors: Excell Jon
Published: July 2023

The Engineer's c2i awards programme highlights how academia and industry are teaming up to solve real-world problems
Image-based visualization of stents in mechanical thrombectomy for acute ischemic stroke: Preliminary findings from a series of cases
Authors: Yao Qing-Yang , Fu Mao-Lin , Zhao Qing , Zheng Xiao-Ming , Tang Kai , Cao Li-Ming
Published: July 2023

The modern medical education system has gradually evolved starting from 1910 incorporating the suggestions by Abraham Flexner, his public disclosure of the poor conditions at many medical schools provided a means to galvanize all the constituencies needed for reform to occur. He could say what other reformers could not, due to their links to the medical education community. But now we are again going back to a pre-Flexnerian state due to multiple reasons such as gradually diminishing importance of basic science subjects for the students, the decline in the number and quality of investigator initiated research among clinical researchers, lesser emphasis to bedside training by means of detailed clinical examination and making appropriate observation of signs to reach to a diagnosis rather than over reliance on the laboratory tests and radiological modalities for the diagnosis, poor exposure to basic clinical skills starting from college throughout residency and the trend of disrespect and absenteeism from both theoretical and clinical/practical classes. The attitude of students is just to complete their required attendance so that they are not barred from appearing in examinations. This de-Flexnerization trend and regression to pre-Flexnerian era standards, ideologies, structures, processes, and attitudes, are bound to beget pre-Flexnerian outcomes, for you get what you designed for.
Behavior analysis and formative assessments in online oral medicine education during the COVID-19 pandemic
Authors: Ye Jia-Jia , Zhao Ye-Ke , Teng Zhi-Sheng , Ye Hui-Wu , Yuan Qin , Nie Xin
Published: July 2023

The modern medical education system has gradually evolved starting from 1910 incorporating the suggestions by Abraham Flexner, his public disclosure of the poor conditions at many medical schools provided a means to galvanize all the constituencies needed for reform to occur. He could say what other reformers could not, due to their links to the medical education community. But now we are again going back to a pre-Flexnerian state due to multiple reasons such as gradually diminishing importance of basic science subjects for the students, the decline in the number and quality of investigator initiated research among clinical researchers, lesser emphasis to bedside training by means of detailed clinical examination and making appropriate observation of signs to reach to a diagnosis rather than over reliance on the laboratory tests and radiological modalities for the diagnosis, poor exposure to basic clinical skills starting from college throughout residency and the trend of disrespect and absenteeism from both theoretical and clinical/practical classes. The attitude of students is just to complete their required attendance so that they are not barred from appearing in examinations. This de-Flexnerization trend and regression to pre-Flexnerian era standards, ideologies, structures, processes, and attitudes, are bound to beget pre-Flexnerian outcomes, for you get what you designed for.
Primary ovarian angiosarcoma: Two case reports and review of literature
Authors: Zhou Ying , Sun Yi-Wen , Liu Xiao-Yang , Shen Dan-Hua
Published: July 2023

The modern medical education system has gradually evolved starting from 1910 incorporating the suggestions by Abraham Flexner, his public disclosure of the poor conditions at many medical schools provided a means to galvanize all the constituencies needed for reform to occur. He could say what other reformers could not, due to their links to the medical education community. But now we are again going back to a pre-Flexnerian state due to multiple reasons such as gradually diminishing importance of basic science subjects for the students, the decline in the number and quality of investigator initiated research among clinical researchers, lesser emphasis to bedside training by means of detailed clinical examination and making appropriate observation of signs to reach to a diagnosis rather than over reliance on the laboratory tests and radiological modalities for the diagnosis, poor exposure to basic clinical skills starting from college throughout residency and the trend of disrespect and absenteeism from both theoretical and clinical/practical classes. The attitude of students is just to complete their required attendance so that they are not barred from appearing in examinations. This de-Flexnerization trend and regression to pre-Flexnerian era standards, ideologies, structures, processes, and attitudes, are bound to beget pre-Flexnerian outcomes, for you get what you designed for.
Nondestructive Evaluation of 2 by 10 Southern Pine Lumber
Authors: Uzcategui M. G. C. , França F. J. N. , Seale R. D. , Senalik C. A. , Ross R. J.
Published: July 2023

Efficient use of the available wood resources is necessary to sustainably meet the long-term demand for wood products. This paper presents research about the potential of using transverse and longitudinal vibration techniques to evaluate the bending modulus of elasticity MOE (Eb) and tensile properties (Et and UTS) of 2 by 10 No. 2 grade southern pine (Pinus spp.) lumber. A total of 285 lumber pieces were first nondestructively tested using longitudinal vibration (Director HM 200), transverse vibration (Metriguard E-computer), and proof-loading bending tests (Universal Instron Machine). Each specimen was then destructively tested in tension parallel to the grain to determine tension modulus of elasticity (Et) and ultimate tensile stress (UTS). Correlations between growth characteristics, physical, and mechanical properties were analyzed. Excellent correlative relationships between longitudinal and transverse dMOE with the elastic properties Eb, and Et were found. A strong correlation was also found between the elastic properties Eb and Et. The prediction of Eb was improved after adding density to the model. The estimation of UTS was also improved with the addition of density and a secondary nondestructive measurement. Nondestructive techniques are recommended to assess the mechanical properties of southern pine 2 by 10 lumber.
Assessing Income and Risk of Incorporating Pine Straw Production into Slash Pine Plantations
Authors: McConnell T. Eric
Published: July 2023

Slash pine plantation economic returns from both timber and pine straw producing perspectives were compared. Bare land values (BLVs) were calculated for site index 65 (base age 25) across three discount rates (4%, 5%, and 6%), three planting densities [545 (8 by 10 ft), 623 (7 by 10 ft), and 726 (6 by 10 ft) trees per acre], and two sets of timber prices (30-year and 10-year averages). Timber yields were obtained from the Cutover Slash Growth and Yield Simulator. Straw yields were estimated stochastically using a two-parameter Weibull distribution based on findings from a summary of pine straw yields and economic benefits in loblolly, longleaf, and slash pine stands. Straw production at an estimated average of 198 bales per acre (13 by 13 by 26 inches) improved net economic returns across all discount rates and planting densities. Increasing discount rates expectedly lowered BLVs. The BLVs varied much less across spacings, with planting at 7 by 10 ft being the preferred option. From 159 to 164 bales per acre were needed for pine straw operations to break even when planting 623 trees per acre depending on the discount rate. The distance from the average BLV to the 90th percentile was greater than the distance from the average BLV to the 10th percentile across strategies. This implied a greater potential existed for pine straw harvesting to improve BLV, but risk associated with a pine straw enterprise could reduce net income levels below simply choosing to forgo this activity.
Evaluating a novel patient pathway to manage symptomatic breast referrals (the blue flag clinic): a longitudinal observational study
Authors: Hubbard TJE , Liu X , Sulieman M , Drew P , Brown I , English R , Abbas I , Potiszil K , Barta M , Jackson N , King P
Published: July 2023

Introduction

A novel referral pathway for exhibited breast symptom (EBS) referrals to manage increasing referrals of urgent suspected cancer (USC) was implemented in our trust. We report on the safety and effect on compliance with the 2-week-wait rule (2WW).

Methods

A single-centre longitudinal observational study included all patients referred to a UK breast unit during 13 May 2019 to 27 March 2020 (period 1) and 8 February 2021 to 31 January 2022 (period 2). USC referrals were assessed in a one-stop clinic (red flag clinic [RFC]); EBS referrals were assessed in a new clinic in which clinical evaluation was performed and imaging occurred subsequently (blue flag clinic [BFC]). Patients were followed up to determine the symptomatic interval cancer rate.

Results

There were 9,695 referrals; 1,655 referrals (17%) were assessed in the BFC after 63 exclusions. Some 95.9% of patients had a benign clinical examination (P1/P2), 80.1% had imaging (mammogram or ultrasound) and 4% had a tissue biopsy. In total, 16/1,655 (0.97%) BFC patients and 510/7,977 (8.2%) RFC patients were diagnosed with breast cancer (breast cancer detection rate). Some 1,631 patients (with 1,639 referrals) were discharged and followed up for a median of 17 months (interquartile range 12–32) with one subsequent cancer diagnosis (symptomatic interval cancer rate, 0.06%). Implementation of the BFC pathway increased 3-month average trust performance of USC referrals with 2WW standard from 8.5% to 98.7% (period 1) and from 30% to 66% (period 2).

Conclusions

The BFC pathway for EBS patients is safe and implementation led to improvement against the 2WW target for USC referrals, ensuring resources are prioritised to patients with the highest likelihood of breast cancer.
Los contenidos escolares y la idealización del medio rural. Manuales escolares y sentido común en la definición del espacio rural
Authors: García Monteagudo Diego
Published: July 2023

La representación social es una teoría que ha tenido aplicación a la ruralidad y estructura el pensamiento social a partir de los diálogos entre el conocimiento científico y el conocimiento de sentido común e incide en las decisiones que se adoptan en la vida social. La geografía rural académica y otras ciencias sociales han desarrollado estudios sobre la realidad de los espacios rurales, sus cambios y problemáticas, mientras que el conocimiento de sentido común penetra en la geografía escolar con una patente idealización de los contenidos de la ruralidad. Ese conocimiento de sentido común es el que más influencia ejerce en la representación social de la ruralidad, manifestándose en las opiniones y actitudes del alumnado. La aplicación de métodos de investigación mixtos ha revelado la estructura y el significado de la representación de los espacios rurales entre una muestra de 581 estudiantes de educación secundaria de tres áreas (rurales, periurbanas y urbanas) de la provincia de Valencia. El contenido de los libros de texto y las estrategias docentes del profesorado muestran el anclaje en la idealización de los espacios rurales, de acuerdo a la gradación de unas cosmovisiones de la ruralidad que gradúan la comprensión de los espacios rurales a partir de la estructura social del espacio geográfico.
Entrevista a Jordi Àngel Jauset Berrocal
Authors: Carrera-Sabaté Josefina , Jauset Berrocal Jordi Àngel
Published: July 2023

Entrevista a Jordi Àngel Jauset Berrocal per part de Josefina Carrera-Sabaté.
Bases filològiques de l’espai de divulgació lingüística i musical «Parlant de música» (divertimento)
Authors: Hervàs Ruperti Margarida
Published: July 2023

A partir de la feina de documentació d’un possible espai radiofònic sobre la paraula divertimento, es mostra el procés d’elaboració del microespai «Parlant de música», de Catalunya Música (en antena entre 2016 i 2021). Es repassen també els recursos en línia disponibles en l’àmbit lingüisticomusical i com han evolucionat en els últims anys.
Música, aprenentatge i emocions
Authors: Fajula Esturi Eva , Mirabet Figueras Laia , Vilaplana Holgado Àngels , Viñas Gracia Ariadna
Published: July 2023

És una evidència científica que des de fa milers d’anys la música ha estat companya de viatge incondicional de l’ésser humà al llarg de la seva evolució; troballes de restes d’instruments musicals que daten del paleolític superior, com ara flautes fetes a partir d’ossos, ho il·lustren. I és que estem vinculats a la música fins i tot des d’abans de néixer! És innegable que, qui més qui menys, tots tenim la nostra banda sonora particular, composta per melodies o cançons que associem a vivències que ens evoquen records i —de retruc i indiscutiblement— emocions. És justament aquí on enllacem amb l’aprenentatge. Des que la neurociència i la psicologia cognitives han entrat amb força en el camp de la investigació relacionat amb l’educació s’ha fet palès que les emocions participen activament en l’aprenentatge i que són fonamentals a l’hora de plantejar les metodologies pedagògiques. Per aquest motiu, sembla clar que cal un replantejament del paper que ha de jugar la música dins de l’aula de llengua, en tant que font inesgotable d’emocions. Aquest article pretén no només promoure les cançons com a eines valuoses per motivar l’alumnat i transformar l’aula de llengua, sinó també donar mitjans al professorat que vulgui incorporar aquest recurs a les sessions.
Portrait in a Convex Mirror: Seeing Dickinson in Contemporary Spanish-Language Poetry
Authors: Calvillo Juan Carlos
Published: July 2023

Abstract: In the Spanish-speaking world, there are four primary ways in which authors have sought, like Thomas Wentworth Higginson, to take Emily Dickinson by the hand as they try to understand her, eager to communicate her strength to others who are distant from her in space and time and language. Listed in order of closeness and level of interpretation, these four methods or interactions are translation, conversation or dedication, reinterpretation, and influence. This essay studies examples of each and in tracing these varieties of literary transmission explores an important facet of what Dickinson meant when she spoke of circumference.
Plato on False Judgment in the Theaetetus
Authors: Barceló-Aspeitia Axel , González-Varela Edgar
Published: July 2023

abstract: Under what conditions would it be paradoxical to consider the possibility of false judgment? Here we claim that in the initial puzzle of Theaetetus 187e5–188c9, where Plato investigates the question of what could psychologically cause a false judgment, the paradoxical nature of this question derives from certain constraints and restrictions about causal explanation, in particular, from the metaphysical principle that opposites cannot cause opposites. Contrary to all previous interpretations, this metaphysical approach does not attribute to Plato any controversial epistemological assumptions and fits better with the text and its role within the dialectic of the dialogue.
La substance comme "point métaphysique" et le corps étendu. Éclairage de la géométrie sur un problème de métaphysique dans la doctrine leibnizienne du milieu des années 1690
Authors: Debuiche Valérie
Published: July 2023

abstract: La question de la relation entre le point et l'étendue en géométrie résonne, dans la pensée de Leibniz, avec celle du lien entre la substance simple avec le corps matériel dont elle est l'élément constitutif d'un point de vue métaphysique. En effet, comment ce qui est indivisible et sans dimension pourrait-il être le principe de ce qui se présente, au contraire, comme toujours divisé et étendu? Si la philosophie tardive de l'auteur, une fois devenue monadologie après 1700, rencontre en cela un problème presque insurmontable, il ne semble pas en être de même dans les années 1690. Cet article propose de montrer comment, vers 1695, une solution originale en est fournie qui renvoie aux innovations mathématiques de cette période, au sujet du point, de l'étendue et, de façon centrale, de la continuité, étoffant ainsi la toile qui unit les mathématiques de Leibniz avec sa philosophie.
Understanding the Qieyun rhymes
Authors: Shen Zhongwei
Published: July 2023

ABSTRACT: This article shows that the Qieyun rhymes are not necessarily different VC units (VC = vowel and ending), as initially defined by Karlgren in his work Études sur la phonologie chinoise (1915–1926). Karlgren's mistake creates a serious problem in the reconstruction of the vowel system of Middle Chinese. In the proposed reconstructions so far, excessive vocalic distinctions are required. This problem is well acknowledged but no explanations and solutions have been convincingly provided. Based on the information from the poetry rhyming before and at the same time of the Qieyun , our analyses of the Qieyun rhymes with the -ŋ ending indicate that 1) not all the Qieyun rhymes are different VCs, and 2) some Qieyun rhymes are the preservation of historical categories. With the new understanding of the nature of the Qieyun rhymes, the required main vowels of Middle Chinese can be significantly reduced. The twelve Qieyun rhymes with -ŋ require only six main vowels. The observation that not all the Qieyun rhymes are different VCs can be supported by the recent distribution analyses of the Qieyun rhymes. A fundamental viewpoint of this article is that in the study of the phonological history of Chinese, what should be reconstructed is the phonological system of Middle Chinese instead of the so-called " Qieyun system". Because the phonological categories contained in the Qieyun are neither synchronically systematic nor phonologically consistent, the Qieyun does not represent a single phonological system of any historical period in the phonological history of Chinese. 摘要: 本文指出高本汉把《切韵》中的"韵"定义为诗歌押韵中的"韵"是 个错误。汉字"韵"可以是韵书中称作为"韵"的分类单位，也可以 是诗歌押韵单位的"韵"。但是这两个概念从语言学上来说，并不等 同。由于高本汉的定义为学界广泛接受，韵类的语音构拟出现难以克 服的麻烦。主要问题是构拟的主要元音过多，形成了不合理的元音系 统。以带舌根鼻音韵尾-ŋ 的韵类为例，本文说明《切韵》中的不同韵 类并不都是韵基不同。通过对齐梁陈隋诗歌的押韵进行分析，结果显 示：《切韵》的韵类，1)有存古韵类，2)有韵基相同但是介音有别的 韵母。对比近年来对《切韵》韵类的分布分析，诗歌押韵和韵类分布 这两个互相独立的分析有倾向一致的结果，都显示了韵基大大少于 《切韵》中的韵类。因此，《切韵》中的韵类区别不应该是高本汉所 定义的区别，即韵基的不同。本文的基本观点是汉语音韵史研究中需 要构拟的是中古音系，而不是所谓的"切韵音系"。作为韵书，《切 韵》所包含的音类信息并不具有共时系统性，也不具有语音一致性， 因此不代表汉语语音史上任何时期的一个单一语音系统。
Accuracy and intrasession variability of noncycloplegic autorefraction of school-aged children and adolescents
Authors: Kiermasz Justyna , Pniewski Jacek
Published: July 2023

The aims of the study were (1) to compare the accuracy and intrasession variability of noncycloplegic autorefraction (AR) obtained by a photorefractor and conventional and open-field autorefractors and (2) to evaluate the impact of accommodative and binocular vision anomalies on the accuracy of autorefraction. Twenty-nine children and adolescents aged 8–18 years were examined. All instruments gave more myopic results than subjective refraction (SR). Mean differences between the SR and the AR were +0.52/−0.25×96∘ for the photorefractor, +0.63/−0.31×93∘ for the conventional autorefractor, and +0.19/−0.26×94∘ for the open-field instrument. The photorefractor appeared to be the most repeatable. The impact of the examined vision anomalies on the accuracy of autorefraction was not statistically significant.
Similar object shape representation encoded in the inferolateral occipitotemporal cortex of sighted and early blind people
Authors: Xu Yangwen , Vignali Lorenzo , Sigismondi Federica , Crepaldi Davide , Bottini Roberto , Collignon Olivier
Published: July 2023

We can sense an object’s shape by vision or touch. Previous studies suggested that the inferolateral occipitotemporal cortex (ILOTC) implements supramodal shape representations as it responds more to seeing or touching objects than shapeless textures. However, such activation in the anterior portion of the ventral visual pathway could be due to the conceptual representation of an object or visual imagery triggered by touching an object. We addressed these possibilities by directly comparing shape and conceptual representations of objects in early blind (who lack visual experience/imagery) and sighted participants. We found that bilateral ILOTC in both groups showed stronger activation during a shape verification task than during a conceptual verification task made on the names of the same manmade objects. Moreover, the distributed activity in the ILOTC encoded shape similarity but not conceptual association among objects. Besides the ILOTC, we also found shape representation in both groups’ bilateral ventral premotor cortices and intraparietal sulcus (IPS), a frontoparietal circuit relating to object grasping and haptic processing. In contrast, the conceptual verification task activated both groups’ left perisylvian brain network relating to language processing and, interestingly, the cuneus in early blind participants only. The ILOTC had stronger functional connectivity to the frontoparietal circuit than to the left perisylvian network, forming a modular structure specialized in shape representation. Our results conclusively support that the ILOTC selectively implements shape representation independently of visual experience, and this unique functionality likely comes from its privileged connection to the frontoparietal haptic circuit.
COWAVE: A labelled COVID-19 wave dataset for building predictive models
Authors: Pradeep Melpakkam , Raman Karthik
Published: July 2023

The ongoing COVID-19 pandemic has posed a significant global challenge to healthcare systems. Every country has seen multiple waves of this disease, placing a considerable strain on healthcare resources. Across the world, the pandemic has motivated diligent data collection, with an enormous amount of data being available in the public domain. In this manuscript, we collate COVID-19 case data from around the world (available on the World Health Organization (WHO) website), and provide various definitions for waves. Using these definitions to define labels, we create a labelled dataset, which can be used while building supervised learning classifiers. We also use a simple eXtreme Gradient Boosting (XGBoost) model to provide a minimum standard for future classifiers trained on this dataset and demonstrate the utility of our dataset for the prediction of (future) waves. This dataset will be a valuable resource for epidemiologists and others interested in the early prediction of future waves. The datasets are available from https://github.com/RamanLab/COWAVE/.
Tensor decomposition and machine learning for the detection of arteriovenous fistula stenosis: An initial evaluation
Authors: Poushpas Sepideh , Normahani Pasha , Kisil Ilya , Szubert Ben , Mandic Danilo P. , Jaffer Usman
Published: July 2023

Duplex ultrasound (DUS) is the most widely used method for surveillance of arteriovenous fistulae (AVF) created for dialysis. However, DUS is poor at predicting AVF outcomes and there is a need for novel methods that can more accurately evaluate multidirectional AVF flow. In this study we aimed to evaluate the feasibility of detecting AVF stenosis using a novel method combining tensor-decomposition of B-mode ultrasound cine loops (videos) of blood flow and machine learning classification. Classification of stenosis was based on the DUS assessment of blood flow volume, vessel diameter size, flow velocity, and spectral waveform features. Real-time B-mode cine loops of the arterial inflow, anastomosis, and venous outflow of the AVFs were analysed. Tensor decompositions were computed from both the ‘full-frame’ (whole-image) videos and ‘cropped’ videos (to include areas of blood flow only). The resulting output were labelled for the presence of stenosis, as per the DUS findings, and used as a set of features for classification using a Long Short-Term Memory (LSTM) neural network. A total of 61 out of 66 available videos were used for analysis. The whole-image classifier failed to beat random guessing, achieving a mean area under the receiver operating characteristics (AUROC) value of 0.49 (CI 0.48 to 0.50). In contrast, the ‘cropped’ video classifier performed better with a mean AUROC of 0.82 (CI 0.66 to 0.96), showing promising predictive power despite the small size of the dataset. The combined application of tensor decomposition and machine learning are promising for the detection of AVF stenosis and warrant further investigation.
Continuous and early prediction of future moderate and severe Acute Kidney Injury in critically ill patients: Development and multi-centric, multi-national external validation of a machine-learning model
Authors: Alfieri Francesca , Ancona Andrea , Tripepi Giovanni , Rubeis Andrea , Arjoldi Niccolò , Finazzi Stefano , Cauda Valentina , Fagugli Riccardo Maria
Published: July 2023

Background

Acute Kidney Injury (AKI) is a major complication in patients admitted to Intensive Care Units (ICU), causing both clinical and economic burden on the healthcare system. This study develops a novel machine-learning (ML) model to predict, with several hours in advance, the AKI episodes of stage 2 and 3 (according to KDIGO definition) acquired in ICU.

Methods

A total of 16’760 ICU adult patients from 145 different ICU centers and 3 different countries (US, Netherland, Italy) are retrospectively enrolled for the study. Every hour the model continuously analyzes the routinely-collected clinical data to generate a new probability of developing AKI stage 2 and 3, according to KDIGO definition, during the ICU stay.

Results

The predictive model obtains an auROC of 0.884 for AKI (stage 2/3 KDIGO) prediction, when evaluated on the internal test set composed by 1’749 ICU stays from US and EU centers. When externally tested on a multi-centric US dataset of 6’985 ICU stays and multi-centric Italian dataset of 1’025 ICU stays, the model achieves an auROC of 0.877 and of 0.911, respectively. In all datasets, the time between model prediction and AKI (stage 2/3 KDIGO) onset is at least of 14 hours after the first day of ICU hospitalization.

Conclusions

In this study, a novel ML model for continuous and early AKI (stage 2/3 KDIGO) prediction is successfully developed, leveraging only routinely-available data. It continuously predicts AKI episodes during ICU stay, at least 14 hours in advance when the AKI episode happens after the first 24 hours of ICU admission. Its performances are validated in an extensive, multi-national and multi-centric cohort of ICU adult patients. This ML model overcomes the main limitations of currently available predictive models. The benefits of its real-world implementation enable an early proactive clinical management and the prevention of AKI episodes in ICU patients. Furthermore, the software could be directly integrated with IT system of the ICU.
Patient experience in community health services and first choice for medical attention: A cross-sectional study in Wuhan, China
Authors: Tang Changmin , Fang Pengqian , Bai Xue , Min Rui , Liu Chaojie
Published: July 2023

Objectives

In China, it is up to the patients to choose between hospitals and primary care facilities to initiate their medical care. This study aimed to determine the association between patient experience with community health centres (CHCs, a predominant provider of community-based primary care) and patient preference of taking community-based primary care facilities as a first choice for medical attention.

Methods

A questionnaire survey was conducted on 1919 patients who sought medical care in 55 CHCs in Wuhan, China. Respondents were asked to identify their preferred first choice for medical attention and rate their satisfaction with eight aspects of CHCs (basic facility, medical equipment, medical services, nursing services, treatment process, courtesy and responsiveness, time spent with medical doctor, pharmacy services). Multivariate logistic regression models were established to determine the association between the CHC experience and the first choice of providers after adjustment for variations in sociodemographic characteristics.

Results

Over 90% of respondents were satisfied or very satisfied with the eight aspects of CHCs; but only 75% preferred to take community-based primary care facilities as their first choice for medical attention. Those who were older and had a lower income were more likely to choose community-based primary care facilities. Geographic proximity and higher levels of satisfaction with the basic facility, courtesy and responsiveness, and pharmacy services in the CHCs were associated with a higher likelihood of taking community-based primary care facilities as a first choice for medical attention.

Conclusion

The consumers of CHCs are generally satisfied with the services they received. However, one quarter of the CHC patients are yet to be convinced to accept community-based primary care facilities as a preferred first provider for medical care. Geographic proximity and patient experience with CHCs are associated with the patient choice.
Intraperitoneal transplant of Hepatocytes co-Encapsulated with mesenchymal stromal cells in modified alginate microbeads for the treatment of acute Liver failure in Pediatric patients (HELP)—An open-label, single-arm Simon’s two stage phase 1 study protocol
Authors: Fitzpatrick Emer , Filippi Celine , Jagadisan Barath , Shivapatham Dharshene , Anand Hanish , Lyne Mike , Stroud Katherine-Daisy , Newton Rebecca , DeLord Marc , Douiri Abdel , Dhawan Anil
Published: July 2023

Background

Pediatric acute liver failure (PALF) carries a high mortality without liver transplantation (LT) in children. Liver transplantation, though lifesaving, is limited by timely donor organ availability, the risks of major surgery and complications of life-long immunosuppression. Hepatocyte transplantation (HT) improves synthetic and detoxification functions in small animal models. The encapsulation of hepatocytes in alginate protects it from the recipient immune system while the intraperitoneal route of administration allows large volumes to be infused. The safety and possibly short-term efficacy of encapsulated hepatocytes has been observed in a named patient use. A novel type of microbeads (HMB002) has been developed, using a modified alginate and mesenchymal stromal cells (MSCs). Its safety and medium-term efficacy need to be studied in the context of clinical study while optimizing the hepatocyte function and viability using modifications of the alginate and MSCs co-encapsulation.

Methods

A single centre, non-randomised, open-label, single-arm Simon’s two stage study will be conducted to evaluate the safety, biological activity and tolerability of transplantation of a single intraperitoneal dose of microbeads made from an optimum combination of a modified alginate, MSCs and hepatocytes in 17 patients less than 16 years of age with acute liver failure (Stage 1: 9 patients and Stage 2: 8 patient). Safety will be assessed by documenting moderate to severe (including life threatening and death) adverse events due to HMB002 in the first 52 weeks post-procedure. Tolerability will be assessed by observing the proportion of initiated infusions where >80% of infusion is received by the patient. Biological activity will be reflected in patient survival with native liver at 24 weeks post treatment.

Discussion

HMB002, if safe and efficacious in acute liver failure, could be a bridge until the liver regenerates or a suitable organ becomes available. There are multiple advantages to using HT. HT, when delivered by the intraperitoneal route, is less invasive than LT. Hepatocytes from a single donor liver can be used to treat multiple patients. Cryopreserved cells provide an off-the-shelf emergency treatment in PALF. When encapsulated, alginate encapsulation of hepatocytes precludes the need for immunosuppression unlike in LT.
Assessment of residual plant DNA in bulk milk for Grana Padano PDO production by a metabarcoding approach
Authors: Pozzi Anna , Nazzicari Nelson , Capoferri Rossana , Radovic Slobodanka , Bongioni Graziella
Published: July 2023

The aim of this study was to evaluate the ability of DNA metabarcoding, by rbcl as barcode marker, to identify and classify the small traces of plant DNA isolated from raw milk used to produce Grana Padano (GP) cheese. GP is one of the most popular Italian PDO (Protected Designation of Origin) produced in Italy in accordance with the GP PDO specification rules that define which forage can be used for feeding cows. A total of 42 GP bulk tank milk samples were collected from 14 dairies located in the Grana Padano production area. For the taxonomic classification, a local database with the rbcL sequences available in NCBI on September 2020/March 2021 for the Italian flora was generated. A total of 8,399,591 reads were produced with an average of 204,868 per sample (range 37,002–408,724) resulting in 16, 31 and 28 dominant OTUs at family, genus and species level, respectively. The taxonomic analysis of plant species in milk samples identified 7 families, 14 genera and 14 species, the statistical analysis conducted using alpha and beta diversity approaches, did not highlight differences among the investigated samples. However, the milk samples are featured by a high plant variability and the lack of differences at multiple taxonomic levels could be due to the standardisation of the feed rationing, as requested by the GP rules. The results suggest that DNA metabarcoding is a valuable resource to explore plant DNA traces in a complex matrix such as milk.
Universal screening or a universal risk assessment combined with risk-based screening for multidrug-resistant microorganisms upon admission: Comparing strategies
Authors: van der Schoor Adriënne S. , Severin Juliëtte A. , Klaassen Corné H. W. , van den Akker Johannes P. C. , Bruno Marco J. , Hendriks Johanna M. , Vos Margreet C. , Voor in ‘t holt Anne F.
Published: July 2023

Objective

Timely identification of patients who carry multidrug-resistant microorganisms (MDRO) is needed to prevent nosocomial spread to other patients and to the hospital environment. We aimed to compare the yield of a universal screening strategy upon admission to the currently installed universal risk assessment combined with risk-based screening upon admission.

Methods

This observational study was conducted within a prospective cohort study. From January 1, 2018, until September 1, 2019, patients admitted to our hospital were asked to participate. Nasal and perianal samples were taken upon admission and checked for the presence of MDRO. The results of the universal risk assessment and risk-based screening were collected retrospectively from electronic health records.

Results

In total, 1017 patients with 1069 separate hospital admissions participated in the study. Universal screening identified 38 (3.6%) unknown MDRO carriers upon admission (37 individual patients), all carrying extended-spectrum beta-lactamase-producing Enterobacterales. For 946 of 1069 (88.5%) patients, both the universal risk assessment and universal screening were performed. For 19 (2.0%) admissions, ≥1 risk factor was identified. The universal risk assessment identified one (0.1%) unknown carrier, compared to 37 out of 946 carriers for the universal screening (P<0.001). Of the 37 carriers identified through the universal screening, 35 (94.6%) reported no risk factors.

Conclusions

Our results show that in our low endemic setting, a universal screening strategy identified significantly more MDRO carriers than the currently implemented universal risk-assessment. When implementing a universal risk-assessment, risk factors should be carefully selected to be able to identify ESBL-E carriers. While the universal screening identified more MDRO carriers, further research is needed to determine the cost-effectiveness of this strategy.
Clinical and genetic features of 334 Asian patients with Birt–Hogg–Dubé syndrome (BHDS) who presented with pulmonary cysts with or without a history of pneumothorax, with special reference to BHDS-associated pneumothorax
Authors: Namba Yukiko , Ebana Hiroki , Okamoto Shouichi , Kobayashi Etsuko , Kurihara Masatoshi , Sekimoto Yasuhito , Tsuboshima Kenji , Okura Makiko Kunogi , Mitsuishi Yoichiro , Takahashi Kazuhisa , Seyama Kuniaki
Published: July 2023

Background

The clinical pulmonary manifestations and genetic features of Birt–Hogg–Dubé syndrome (BHDS) in Asian patients remained unclear. We aimed to clarify the clinical features of BHDS-associated pneumothorax (PTX) and retrospectively investigate potential contributing factors in the largest Asian cohort to date.

Methods

We reviewed the clinical and genetic data collected in 2006–2017, from the BHDS patients who were Asian and presented with pulmonary cysts with or without a history of PTX.

Results

Data from 334 (41.3% males; 58.7% females) patients from 297 unrelated families were reviewed. Among them, 314 (94.0%) patients developed PTX. The median age at the first occurrence of PTX was 32 years, which was significantly lower in males (P= 0.003) and patients without notable skin manifestations (P< 0.001). Seventy-six (24.2%) patients experienced their first PTX episode before the age of 25 years. PTX simultaneously occurred in the bilateral lungs of 37 (11.8%) patients. Among 149 patients who had their first PTX episode at least 10 years before BHDS diagnosis, PTX occurred more frequently in males (P= 0.030) and light smokers than in nonsmokers (P= 0.014). The occurrence of PTX peaked in the early 30s and gradually decreased with age but remained high in females (P= 0.001). We identified 70 uniqueFLCNgermline variants, including duplications (46.4%), substitutions (7.1%), insertions/deletions (30.0%), and variants affecting splicing (12.5%). Approximately 80% of Asian patients suspected of having BHDS could be genetically diagnosed by examiningFLCNexons 7, 9, 11, 12, and 13. No apparent genotype–phenotype correlation regarding pulmonary manifestations was identified.

Conclusions

Our findings indicate that sex, smoking history, and skin manifestations at BHDS diagnosis significantly influence the clinical features of BHDS-associated PTX. These findings may contribute to the appropriate management and treatment of BHDS-associated PTX.
Rapidly Progressive Portal Cavernoma Cholangiopathy in a Patient With Infeasible Decompressive Shunt Surgery
Authors: Nadinskaia Maria Yu , Ivashkin Vladimir T. , Nekrasova Tatiana Р. , Novruzbekov Murad S. , Zimina Larisa N. , Kodzoeva Khava B. , Strelkova Daria A.
Published: July 2023

We present a 27-year-old man with a 2-year history of extrahepatic portal vein obstruction and selective immunoglobulin A deficiency, referred for acute cholangitis from portal cavernoma cholangiopathy (PCC). Because recurrent cholangitis rapidly led to liver failure, orthotopic liver transplantation (OLT) was successfully performed. To date, this is one of the few cases of patients with symptomatic PCC who required OLT and the first case who had a successful 6-year follow-up. Thus, OLT can be used for symptomatic PCC associated with nonshuntable anatomy, ineffective biliary drainage, and progressive liver damage. Selective immunoglobulin A deficiency may play a role in recurrent cholangitis.
Auf dem Weg zu einer neuen Strategie: Wie die saguf noch transformativer wird
Authors: Bornemann Basil , Stauffacher Michael , Zimmermann Anne B. , Bergman Manfred Max , Carabias Vicente , Fritz Livia , Förster Ruth , Kläy Andreas , Kueffer Christoph , Wäger Patrick , Wallimann-Helmer Ivo , Zingerli Claudia
Published: July 2023

Die saguf macht Nachhaltigkeitstransformation zu ihrem zentralen Thema, engagiert sich für transformatives Forschen und Lernen in der Wissenschaft und intensiviert den Dialog mit der jungen Generation.
Effects of green nudges on consumer valuation of sustainable food: A discrete choice experiment
Authors: Gottselig Valerija , Wuppermann Amelie , Herrmann Christoph
Published: July 2023

Sustainable nutrition is becoming increasingly relevant in society. This empirical study suggests that green nudges can encourage consumers to buy food that has an ecology or animal welfare label.This paper analyzes whether green nudges ‐ displaying nature pictures or providing
information on other people’s behavior before the consumer makes a choice ‐ can promote more environmentally friendly food choices. Based on data from an online, discrete choice experiment conducted in Germany, in which randomly selected groups of participants were shown either
one of the nudges (treatment groups) or no nudge (control group), the study finds that green nudges increase individuals’ willingness to pay more for products that have ecology and animal welfare labels. However, consumers in one of the treatment groups were willing to pay more for meat
rather than the meat alternative, indicating that nudges can have an effect opposite from that intended. Future research should investigate the impact of these relatively cheap interventions with a representative sample and in a field setting.
Evaluation of energy generation potential from municipal solid waste in the North-West province, South Africa
Authors: Chagunda Mapereka Francis , Ruhiiga Tabukeli Musigi , Palamuleni Lobina Gertrude
Published: July 2023

Municipal Solid Waste (MSW) management is rapidly becoming a severe environmental problem worldwide. Developing countries, especially African cities, are the most affected due to inadequate resources to cope with increasing magnitude and complexity of the waste generated as well as the scarcity of land for disposal. As such, strategies which include waste- to-energy (WtE) generation to recover the potent energy from municipal waste could be a better option. This study sought to determine the sustainability of WtE projects for energy access to off-grid residents in the North-West province, South Africa. The study used a quantitative research design coupled with field observations and measurement of elements of the waste chain to generate primary data sets. The information was supplemented by secondary datasets on waste information and waste management at local municipalities. Results revealed that some of the classes of waste have the optimum calorific values and moisture content for WtE. The eligibility of a waste class to be used in WtE generation projects is dependent on the quantities generated. The results also indicate that using paper as fuel in the 240 tonnes/day WtE technology would cover more days of operation than plastics and rubber. Based on the 2020 estimated waste quantities, paper would last 234 days of generating about 6,944 GWh while plastics would last 177 days with energy output of 5, 207 GWh. Waste quantities generated in the North-West province could contribute to sustainable energy access to the off-grid informal settlement residents and advance waste management options through WtE. This study contributes to the literature on renewable energy and waste management in the context of green energy in South Africa.
Characterization of plant growth promoting potential of 3D-printed plant microbial fuel cells
Authors: Palmero Diane Pamela Entienza , Pamintuan Kristopher Ray Simbulan
Published: July 2023

Plant-Microbial Fuel Cell (PMFC) is an emerging technology that converts plant waste into electrical energy through rhizodeposition, offering a renewable and sustainable source of energy. Deviating from the traditional PMFC configurations, additive manufacturing was utilized to create intricate and efficient designs using polymer-carbon composites. Concerning the agricultural sector, the effect of 3D-printed PMFCs on the growth and biomass distribution of Phaseolus lunatus and Ipomoea aquatica was determined. The experiment showed that electrostimulation promoted the average daily leaf number and plant height of both polarized plants, which were statistically proven to be greater than the control (α = 0.05), by energizing the flow of ions in the soil, boosting nutrient uptake and metabolism. It also stimulated the growth of roots, increasing the root dry mass of polarized plants by 155.44% and 66.30% for I. aquatica and P. Lunatus against their non-polarized counterpart. Due to the biofilm formation on the anode surface, the number of root nodules of the polarized P. lunatus was 51.30% higher than the control, while the protein content in the PMFC setup was 42.22% and 8.26% higher than the control for I. aquatica and P. lunatus, respectively. The voltage readings resemble the plants' average growth rate, and the polarization studies showed that the optimum external resistances in the I. aquatica- and P. lunatus-powered PMFC were 4.7 kΩ and 10 kΩ, respectively. Due to other prevailing pathways of organic carbon consumption, such as methanogenesis, the effect of polarization on the organic carbon content in soil is currently inconclusive and requires further study.
Editorial
Authors: Stloukalová Kamila , Skřejpková Petra
Published: July 2023

Editorial