bluuebunny/crossref_metadata_2025 huggingface dataset:
Phenolic compounds induce ferroptosis-like death by promoting hydroxyl radical generation in the Fenton reaction
Authors: Sui Xinyue , Wang Jichao , Zhao Zhiqiang , Liu Bin , Liu Miaomiao , Liu Min , Shi Cong , Feng Xinjun , Fu Yingxin , Shi Dayong , Li Shengying , Qi Qingsheng , Xian Mo , Zhao Guang
Published: February 2024

Phenolic compounds are industrially versatile chemicals, also the most ubiquitous pollutants. Recently, biosynthesis and biodegradation of phenols has attracted increasing attention, while phenols’ toxicity is a major issue. Here, we evolved phloroglucinol-tolerant Escherichia coli strains via adaptive evolution, and three mutations (ΔsodB, ΔclpX and fetAB overexpression) prove of great assistance in the tolerance improvement. We discover that phloroglucinol complexes with iron and promotes the generation of hydroxyl radicals in Fenton reaction, which leads to reducing power depletion, lipid peroxidation, and ferroptosis-like cell death of E. coli. Besides phloroglucinol, various phenols can trigger ferroptosis-like death in diverse organisms, from bacteria to mammalian cells. Furthermore, repressing this ferroptosis-like death improves phloroglucinol production and phenol degradation by corresponding strains respectively, showing great application potential in microbial degradation or production of desired phenolic compounds, and phloroglucinol-induced ferroptosis suppresses tumor growth in mice, indicating phloroglucinol as a promising drug for cancer treatment.
Smart polarization and spectroscopic holography for real-time microplastics identification
Authors: Zhu Yanmin , Li Yuxing , Huang Jianqing , Lam Edmund Y.
Published: February 2024

Optical microscopy technologies as prominent imaging methods can offer rapid, non-destructive, non-invasive detection, quantification, and characterization of tiny particles. However, optical systems generally incorporate spectroscopy and chromatography for precise material determination, which are usually time-consuming and labor-intensive. Here, we design a polarization and spectroscopic holography to automatically analyze the molecular structure and composition, namely smart polarization and spectroscopic holography (SPLASH). This smart approach improves the evaluation performance by integrating multi-dimensional features, thereby enabling highly accurate and efficient identification. It simultaneously captures the polarization states-related, holographic, and texture features as spectroscopy, without the physical implementation of a spectroscopic system. By leveraging a Stokes polarization mask (SPM), SPLASH achieves simultaneous imaging of four polarization states. Its effectiveness has been demonstrated in the application of microplastics (MP) identification. With machine learning methods, such as ensemble subspace discriminant classifier, k-nearest neighbors classifier, and support vector machine, SPLASH depicts MPs with anisotropy, interference fringes, refractive index, and morphological characteristics and performs explicit discrimination with over 0.8 in value of area under the curve and less than 0.05 variance. This technique is a promising tool for addressing the increasing public concerning issues in MP pollution assessment, MP source identification, and long-term water pollution monitoring.
Extracellular vesicles produced by 3D cultured MSCs promote wound healing by regulating macrophage activation through ANXA1
Authors: Deng Hao , Jiang Yuheng , Deng Junhao , Chang Feifan , Chen Junyu , Sun Xinyu , Cheng Dongliang , Wang Zhongqi , Li Ran , Liu Jiang , Li Yi , Zhang Licheng , Yin Pengbin
Published: February 2024

Extracellular vesicles (EVs) produced by 3D-cultured MSCs can modulate macrophage activation through ANXA1, thereby promoting wound healing.
Different anion (NO3− and OAc−)-controlled construction of dysprosium clusters with different shapes
Authors: Xie Jia-Nan , Li Yun-Lan , Wang Hai-Ling , Xiao Zi-Xin , Zhu Zhong-Hong , Liang Fu-Pei , Zou Hua-Hong
Published: February 2024

Slightly different anions were used to induce the construction of a series of lanthanide clusters with different shapes (Dy5, Dy8, and Dy14).
Generation of skyrmions by combining thermal and spin–orbit torque: breaking half skyrmions into skyrmions
Authors: Yang Sheng , Shen Laichuan , Zhao Yuelei , Wu Kai , Li Xiaoguang , Shen Ka , Zhang Senfu , Xu Xiaohong , Åkerman Johan , Zhou Yan
Published: February 2024

The study establishes that Joule heating combined with Spin–Orbit Torque (SOT) effectively induces the stripe domain – skyrmion transition in magnetic materials.
Shape-controlled synthesis of CsPbBr3 nanorods with bright pure blue emission and high stability
Authors: Zhao Qiqi , Chen Feitong , Huang Qi , Wang Kaiyu , Li Changqian , Wang Rui , Liu Chenyang , Xu Wenli , Liu Rui , Zhu Huiling , Wang Kunhua , Zhou Tianliang , Ding Jianxu
Published: February 2024

CsPbBr3 NRs synthesized at 80 °C show bright blue emission at 462 nm and exhibit a high PLQY of 62.65%. The 1 : 1 mixed anti-solvents of EAC and IPA can change the state of NR surface ligands and improve the stability of NRs.
An organohydrogel with tunable fluorescence and shape-memory property for advanced anti-counterfeiting
Authors: Sun Yu , Shang Hui , Le Xiaoxia , Chen Tao
Published: February 2024

The reported organohydrogel consists of hydrophilic and hydrophobic polymer networks fabricated by two-step interpenetrating polymerization. The organohydrogel enables the concealment of encoded fluorescent information in specific three-dimensional shapes.
MFEMDroid: A Novel Malware Detection Framework Using Combined Multitype Features and Ensemble Modeling
Authors: Gu Wei , Xing Hongyan , Hou Tianhao
Published: February 2024

The continuous malicious attacks on Internet of Things devices pose a potential threat to the economic and private information security of end‐users, especially on the dominant Android devices. Combining static analysis methods with deep Learning is a promising approach to defend against that. This kind of method has two limitations: the first is that the current single‐permission mechanism is not insufficient to regulate interapplication resource acquisition; another problem is that current work on feature learning is dedicated to modifying a single network structure, which may result in a suboptimal solution. In this study, to solve the abovementioned problems, we propose a novel malware detection framework MFEMDroid, which combines multitype features analysis and ensemble modeling. The Provider feature, facilitating information requests between applications (apps) and serving as an indispensable data storage method, plays a vital role in characterizing app behavior. Hence, we extract permissions and Provider features to comprehensively characterize app behavior and probe potentially dangerous combinations between or within these features. To address oversparse datasets and reduce feature learning overhead, we employ an auto‐encoder for feature dimensionality reduction. Furthermore, we design an ensemble network based on SENet, ResNet, and the evolutionary convolutional neural network Squeeze Excitation Residual Network (SEResNet) to explore the hidden associations between different types of features from multiple perspectives. We performed extensive experiments to evaluate its method performance on real‐world samples. The evaluation results demonstrate that the proposed framework can detect malware with an accuracy of 95.38%, which is much better than state‐of‐the‐art solutions. These promising experimental results show that MFEMDroid is an effective approach to detect Android malware.
A DOA Estimation Method Based on an Improved Transformer Model for Uniform Linear Arrays with Low SNR
Authors: Wang Wei , Zhou Lang , Ye Kun , Sun Haixin , Hong Shaohua
Published: February 2024

In this paper, the Star‐Transformer model is improved to obtain more accurate direction of arrivals (DOA) estimation of underwater sonar uniform linear array (ULA) under low signal‐to‐noise ratio (SNR) conditions. The ideal real covariance matrix is divided into three channels: real part channel, imaginary part channel, and phase channel to obtain more input features. In training, the real covariance matrix is used under different SNRs. In testing, the covariance matrix of samples in the real environment is used as input. The on‐grid form is used to estimate the DOA of multiple signal sources, which is modelled as a multilabel classification problem. The results show that the model can be effective and can still have a good DOA estimation performance under the conditions of trained and untrained SNRs, different snapshots, signal power mismatch, different separation angles, signal correlation, and so on. It shows that the model has excellent robustness.
Leveraging graph clustering techniques for cyber‐physical system analysis to enhance disturbance characterisation
Authors: Jacobs Nicholas , Hossain‐McKenzie Shamina , Sun Shining , Payne Emily , Summers Adam , Al‐Homoud Leen , Layton Astrid , Davis Kate , Goes Chris
Published: February 2024

Cyber‐physical systems have behaviour that crosses domain boundaries during events such as planned operational changes and malicious disturbances. Traditionally, the cyber and physical systems are monitored separately and use very different toolsets and analysis paradigms. The security and privacy of these cyber‐physical systems requires improved understanding of the combined cyber‐physical system behaviour and methods for holistic analysis. Therefore, the authors propose leveraging clustering techniques on cyber‐physical data from smart grid systems to analyse differences and similarities in behaviour during cyber‐, physical‐, and cyber‐physical disturbances. Since clustering methods are commonly used in data science to examine statistical similarities in order to sort large datasets, these algorithms can assist in identifying useful relationships in cyber‐physical systems. Through this analysis, deeper insights can be shared with decision‐makers on what cyber and physical components are strongly or weakly linked, what cyber‐physical pathways are most traversed, and the criticality of certain cyber‐physical nodes or edges. This paper presents several types of clustering methods for cyber‐physical graphs of smart grid systems and their application in assessing different types of disturbances for informing cyber‐physical situational awareness. The collection of these clustering techniques provide a foundational basis for cyber‐physical graph interdependency analysis.
A new transformerless buck‐boost converter with improved voltage gain and continuous input current
Authors: Hosseinpour Majid , Ahmadi Mahsa , Seifi Ali , Hosseini Seyed Hossein
Published: February 2024

This paper proposes a new transformerless buck‐boost converter with an extended voltage conversion ratio. This converter has semi‐quadratic voltage gain, which provides more gain with lower duty cycles. This converter has a simple structure and easy implementation, which reduces the cost and increases efficiency. The proposed converter operates in continuous conduction mode and provides two operation modes by turning on and off the switches. The suggested converter has continuous input current and low input current ripple, which is important when utilizing renewable energy sources. The calculation of the proposed converter includes ideal and practical voltage gain, current calculations, voltage stresses of the switches and diodes, current stress of the switches, parameter design, efficiency, and a brief analysis of discontinuous conduction mode and boundary conditions. The proposed converter provides efficiency of about 93.1% in boost mode and 92.14% in buck mode at 50 W output power. The suggested converter varies the input voltage from 20 to 48 V in boost mode and changes the input voltage from 20 to 10.4 V in buck mode. Finally, a laboratory prototype has been built to prove and evaluate the simulation results and theoretical analysis of the proposed converter.
New multilevel inverter based on reduced switch basic cell for high voltage levels
Authors: Seifi Ali , Hosseini Seyed Hossein , Hagh Mehrdad Tarafdar , Hosseinpour Majid
Published: February 2024

In this study, to solve total harmonic distortion (THD) and voltage stress on switches, challenges have been made by presenting a new multi‐level inverter (MLI). The proposed topology can operate with both symmetric and asymmetric sources. The proposed topology in symmetric and asymmetric mode with 18 switches can produce 17 and 49 voltage levels, respectively, with THD values of 4.14% and 1.45%, which passes the IEEE harmonic standard. The main advantage of the proposed topology is reducing the number of circuit devices, which reduces the price, volume, and complexity of the circuit by reducing the number of circuit devices. The proposed topology reduces the THD, the number of power electronics components, and voltage stress by increasing the output levels. The proposed topology is compared with other topologies and the advantage of the proposed topology is shown in terms of the number of switches and drivers. In addition, the proposed topology is compared in terms of the cost function. The power losses based on the thermal model of the proposed topology have been analysed and simulated. Simulation and experimental results are presented for different scenarios such as load type, load changes, and modulation index changes to validate the proposed topology.
Gelenkerhaltende Eingriffe bei rheumatischen Erkrankungen –
Aktueller Stand
Authors: Carl Hans-Dieter
Published: February 2024

Mit dem Wandel der medikamentösen Therapie
entzündlich-rheumatischer Erkrankungen seit Beginn dieses Jahrtausends
hat sich auch das Spektrum der operativen Rheumatologie deutlich
geändert. Neben den klassischen gelenkserhaltenden rheumachirurgischen
Eingriffen wie der Synovektomie werden etablierte Verfahren aus der
orthopädischen Chirurgie, wie gelenknahe Umstellungsoperation oder
gelenkerhaltende Vorfuß-Korrekturen, bei entzündlichen
Erkrankungen durchgeführt. Der folgende Artikel soll die aktuellen
Möglichkeiten und Grenzen gelenkerhaltender Eingriffe bei rheumatischen
Erkrankungen darstellen.
Pharmakologisches Neuroenhancement unter jungen Erwachsenen:
Ergebnisse einer Längsschnittstudie zur Verbreitung und zu Risiko- und
Schutzfaktoren
Authors: Schulz Wolfgang , Wolter Emilie , Job Ann-Katrin
Published: February 2024

Ziel Pharmakologisches Neuroenhancement (PNE) bezeichnet die Einnahme
verschreibungspflichtiger Medikamente ohne medizinische Notwendigkeit, um eine
kognitive Leistungssteigerung oder eine Verbesserung des psychischen
Wohnbefindens hervorzurufen. In der vorliegenden Studie wird PNE im jungen
Erwachsenenalter untersucht.

Materialien und Methodik Die betrachtete Stichprobe umfasst junge
Erwachsene (N=279) mit einem überwiegend mittleren und hohen
sozioökonomischen Status aus Deutschland. Untersucht werden neben der
Lebenszeit- und 12-Monatsprävalenz querschnittliche
Zusammenhänge zu soziodemographischen und psychischen Merkmalen
(psychische Belastung, Resilienz, Alkohol-, Zigaretten- und Cannabiskonsum)
sowie in einem 8-Jahres-Längsschnitt, ob sich der PNE-Konsum im jungen
Erwachsenenalter aufgrund von Merkmalen während der Adoleszenz
vorhersagen lässt. Betrachtet werden weiterhin im Quer- und im
Längsschnitt Zusammenhänge zu Elternmerkmalen.

Ergebnisse Die Lebenszeitprävalenz für PNE beträgt
9,3%, die 12-Monats-Prävalenz 6,5%. Das Geschlecht
erwies sich durchgängig als wichtigster Prädiktor: Junge
Männer nutzen PNE sowohl häufiger zur Steigerung ihrer
kognitiven Leistungsfähigkeit als auch zur Verbesserung ihres
psychischen Wohnbefindens als junge Frauen. PNE-Nutzende geben häufiger
depressive Symptome an und bei ihnen besteht häufiger der Verdacht auf
einen Missbrauch/eine Abhängigkeit von Alkohol oder Cannabis.
Der PNE-Konsum im jungen Erwachsenenalter lässt sich signifikant durch
externale Verhaltensauffälligkeiten und Drogenkonsum im Jugendalter
vorhersagen, im multivariaten Modell werden diese Effekte unter Kontrolle des
Geschlechts allerdings nicht mehr signifikant. Zusammenhänge zu
Elternmerkmalen ließen sich weder im Quer- noch im Längsschnitt
ermitteln.

Schlussfolgerung Angesichts der zunehmenden Prävalenzen sollten
verstärkt präventive Maßnahmen angeboten und
über Alternativen zu PNE nachgedacht werden.
Exercise-induced Hypertension and Carotid Intima-media Thickness in
Male Marathon Runners
Authors: Yoon Eun Sun , Kim Young-Joo
Published: February 2024

This study aimed to identify the relationship between exercise-induced
hypertension and carotid artery intima-media thickness in long-distance runners.
Sixty healthy male runners aged 40 to 60 years were assigned to the following
three groups based on resting blood pressure and maximal systolic blood pressure
during a maximal exercise test: normal blood pressure response, exercise-induced
hypertension, and complex hypertension. An exaggerated systolic blood pressure
response was defined as a maximal systolic blood pressure+≥+210 mmHg during the
maximal exercise test, while carotid intima-media thickness was measured using
B-mode ultrasonography. The carotid intima-media thickness mean values were the
highest in the complex hypertension group (0.72±0.11 mm), followed by
exercise-induced hypertension (0.62±0.12 mm) and normal blood pressure groups
(0.55±0.13 mm), with a significant difference between the groups (p+<+0.002).
In linear regression analysis, the mean intima-media thickness was independently
associated with age (p=0.015) and maximal systolic blood pressure (p=0.046) but
not with resting systolic blood pressure. These results suggest that
exercise-induced hypertension is associated with carotid intima-media thickness,
a surrogate marker of cardiovascular disease, in long-distance runners.
Therefore, evaluating the blood pressure response during exercise is important
for the early detection of potential cardiovascular disease risks in
long-distance runners.
Impaired Whole-Blood Fibrinolysis is a Predictor of Mortality in Intensive Care Patients
Authors: Brewer Julie S. , Hvas Christine L. , Hvas Anne-Mette , Larsen Julie B.
Published: February 2024

Background Altered fibrinolysis is considered to play a crucial role in the development of coagulopathy in sepsis. However, routine laboratory tests for fibrinolysis are currently very limited, and the impact of fibrinolytic capacity on clinical outcome is poorly investigated.

Objectives To assess whole-blood fibrinolysis in patients admitted to the intensive care unit (ICU) and compare fibrinolysis in sepsis patients with nonsepsis patients. Further, to investigate associations between fibrinolytic capacity and 30-day mortality and venous thromboembolism (VTE).

Methods This study was designed as a prospective cohort study. Adult ICU patients were included at the Aarhus University Hospital, Denmark. All patients had a blood sample obtained the morning after admission. A modified thromboelastometry (ROTEM®) analysis with tissue plasminogen activator (ROTEM®-tPA) was used to assess fibrinolysis. The primary endpoint was difference in ROTEM®-tPA lysis time between sepsis patients and nonsepsis patients.

Results ROTEM®-tPA revealed fibrinolytic impairment in sepsis patients (n = 30) compared with nonsepsis ICU controls (n = 129), with longer lysis time (median [interquartile range] 3,600 [3,352–3,600] vs. 3,374 seconds [2,175–3,600], p < 0.01), lower maximum lysis (23 [8–90] vs. 94% [14–100], p = 0.02), and lower fibrinolysis speed (0.41 [0.0–1.4] vs. 1.6 mm/min [0.1–2.7], p = 0.01). In the composite ICU population, 61% (97/159) demonstrated prolonged lysis time indicating impaired fibrinolytic capacity. These patients had higher 30-day mortality (adjusted odds ratio [OR]: 2.26 [0.83–6.69]) and VTE risk (OR: 3.84 [0.87–17.8]) than patients with normal lysis time.

Conclusion Sepsis patients showed impaired fibrinolysis measured with ROTEM®-tPA compared with nonsepsis patients and ROTEM®-tPA lysis time was associated with 30-day mortality and VTE in the entire ICU cohort.
Olfaction and Quality of Life in Patients with Eosinophilic CRS Undergoing Endoscopic Sinus Surgery
Authors: Tepedino Miguel Soares , Voegels Richard Louis , Pezato Rogério , Thamboo Andrew , Kosug Eduardo Macoto , Ferrão Ana Clara Miotello , Neves Raíssa de Figueiredo , Castilla Valéria Maria Barcia , Gregório Luis Carlos
Published: February 2024

Introduction Chronic rhinosinusitis (CRS) is a common inflammatory disease. This high prevalence leads to high direct and indirect public health costs, which include medical visits, laboratory tests and imaging, pharmacotherapy, hospitalizations, and surgical treatment. Furthermore, CRS has a substantial impact on patient quality of life, affecting productivity and being a common cause of absence from work CRS-associated olfactory dysfunction is highly prevalent, the actual effectiveness of surgical intervention remains inconsistent. Although there are studies evaluating the postoperative course of patients with eosinophilic Chronic rhinosinusitis (eCRS) treated with high-volume budesonide irrigation, there is little objective information regarding the impact of this intervention on olfactory status and quality of life.

Objective To conduct a pre- and postoperative analysis of olfaction and quality of life in patients with eCRS treated with surgical intervention followed by high-volume budesonide nasal irrigation.

Methods Prospective, descriptive, uncontrolled study of patients with eCRS. All patients underwent pre- and postoperative nasal endoscopy, SNOT-22 questionnaire, and the University of Pennsylvania Smell Identification Text (UPSIT), always by the same previously trained examiner. The SNOT-22 questionnaire and the UPSIT were readministered to all patients at 3 months, 6 months, and 1 year postoperatively, and scores compared with those obtained preoperatively.

Results Twenty patients were included in the study, 13 males and 7 females, between the ages of 23 and 65; 8 patients had comorbid asthma. Quantitative evaluation using the UPSIT test showed a significant improvement in olfaction 3 months after surgery, which remained 6 months and 1 year after surgery (p = 0.0063).

There was no significant association between eosinophil concentrations in polypoid tissue and postoperative SNOT-22 and UPSIT results. Patients with tissue eosinophils >50 had a lower preoperative UPSIT score. As early as 3 months postoperatively, a significant improvement in quality of life was already noticeable, as represented by a decrease in SNOT-22 values, which persisted through the 1-year postoperative follow-up evaluation (p = 0.0005). Quantitative evaluation using the UPSIT test showed a significant improvement in olfaction 3 months after surgery, which remained 6 months and 1 year after surgery (p = 0.0063).

Conclusion Surgery effectively controlled eCRS in patients who adhered to high-volume budesonide nasal irrigation postoperatively. There were significant improvements in quality of life and olfaction, which persisted at least up to one year postoperatively.
Phenobarbital as a Sedation Strategy to Reduce Opioid and Benzodiazepine Burden in Neonatal Extracorporeal Membrane Oxygenation
Authors: Cardona Vilmaris Quinones , Byrne Emma , Mejia Michelle , Joshi Swosti , Menkiti Ogechukwu
Published: February 2024

Objective The study aims to describe our experience with the implementation of phenobarbital as a primary sedation strategy during neonatal extracorporeal membrane oxygenation (ECMO).

Study Design Retrospective chart review in a level IV neonatal intensive care unit between 2011 and 2021 comparing neonatal ECMO patients before and after the implementation of a sedation-analgesia (SA) protocol using scheduled phenobarbital as the primary sedative. Groups were compared for neonatal and ECMO characteristics, cumulative SA doses, and in-hospital outcomes. Comparison between groups was performed using Mann–Whitney test on continuous variables and chi-square on nominal variables.

Results Forty-two patients were included, 23 preprotocol and 19 postprotocol. Birth, pre-ECMO, and ECMO clinical characteristics were similar between groups except for a lower birth weight in the postprotocol group (p = 0.024). After standardization of phenobarbital SA protocol, there was a statistically significant reduction in median total morphine dose (31.38–17.65 mg/kg, p = 0.006) and median total midazolam dose (36.21–6.36 mg/kg, p < 0.001). There was also a reduction in median total days on morphine by 7.5 days (p = 0.026) and midazolam by 6.6 days (p = 0.003). There were no differences in ECMO duration or in-hospital outcomes between groups.

Conclusion In this cohort, short-term use of phenobarbital as primary sedation strategy during neonatal ECMO was associated with reduced opioid and midazolam burden. Such reduction, however, did not affect in-hospital outcomes.

Key Points
Atypical May-Thurner Syndrome Caused by Large Lumbar Osteophyte
Authors: Schaper Nicholas , Pereira Keith
Published: February 2024

An 82-year-old man presented to the emergency department with intermittent left lower extremity swelling for the last 4 to 5 months that limited his daily activities. The patient had a negative lower extremity venous duplex 3 months prior and had been treating symptoms with compression stockings but experienced no improvement. Venography showed venous outflow obstruction in his left common iliac vein and the etiology was confirmed to be a lumbar vertebral osteophyte compressing the vein. The patient underwent endovascular treatment with balloon venoplasty and stent placement over the lesion with return of adequate outflow. This report describes treatment of symptomatic left common iliac venous compression with endovascular therapy alone.
PGAP2-Related Hyperphosphatasia-Mental Retardation Syndrome: Report of a Novel Patient, Toward a Broadening of Phenotypic Spectrum and Therapeutic Perspectives
Authors: Saracino Annalisa , Totaro Martina , Politano Davide , DE Giorgis Valentina , Gana Simone , Papalia Grazia , Pichiecchio Anna , Plumari Massimo , Rognone Elisa , Varesio Costanza , Orcesi Simona
Published: February 2024

PGAP2 gene has been known to be the cause of “hyperphosphatasia, mental retardation syndrome-3” (HPMRS3). To date, 14 pathogenic variants in PGAP2 have been identified as the cause of this syndrome in 24 patients described in single-case reports or small clinical series with pan-ethnic distribution. We aim to present a pediatric PGAP2-mutated case, intending to further expand the clinical phenotype of the syndrome and to report our experience on a therapeutic approach to drug-resistant epilepsy.

We present the clinical, neuroradiological, and genetic characterization of a Caucasian pediatric subject with biallelic pathogenic variants in the PGAP2 gene revealed by next generation sequencing analysis.

We identified a subject who presented with global developmental delay and visual impairment. Brain magnetic resonance imaging showed mild hypoplasia of the inferior cerebellar vermis and corpus callosum and mild white matter reduction. Laboratory investigations detected an increase in alkaline phosphatase. At the age of 13 months, he began to present epileptic focal seizures with impaired awareness, which did not respond to various antiseizure medications. Electroencephalogram (EEG) showed progressive background activity disorganization and multifocal epileptic abnormalities. Treatment with high-dose pyridoxine showed partial benefit, but the persistence of seizures and the lack of EEG amelioration prompted us to introduce ketogenic diet treatment.

Our case provides a further phenotypical expansion of HPMRS3 to include developmental and epileptic encephalopathy. Due to the limited number of patients reported so far, the full delineation of the clinical spectrum of HPMRS3 and indications for precision medicine would benefit from the description of new cases and their follow-up evaluations.
Pericardial Decompression Syndrome: A Comprehensive Review of a Controversial Entity
Authors: Sarode Karan , Patel Amar , Arrington Kedzie , Makhija Rakhee , Mukherjee Debabrata
Published: February 2024

Pericardial decompression syndrome is an ambiguous clinical entity which has generated controversy regarding its existence. Following pericardial decompression, patients experienced clinical deterioration ranging in complications from pulmonary edema to death that could not be attributed to any other distinct clinical pathology. Multiple theories have suggested the pathophysiology behind pericardial decompression syndrome is related to preload-afterload mismatch following pericardial decompression, coronary microvascular ischemia, and stress from high adrenergic state. Our review aims to describe this syndrome by analyzing demographics, etiology of pericardial effusion, method of drainage, volume of pericardial fluid removed, time to decompensation, and clinical outcomes. A systematic review of MEDLINE/PubMed and Google Scholar literature databases were queried for case reports, case series, review articles, and abstracts published in English journals between 1983 and December 2022. Each author's interpretation of echocardiographic and/or pulmonary arterial catheterization data provided in the case reports was used to characterize ventricular dysfunction. Based on our inclusion criteria, 72 cases of pericardial decompression syndrome were included in our review. Our results showed that phenotypic heterogeneity was present based on echocardiographic findings of right/left or biventricular failure with similar proportions in each type of ventricular dysfunction. Time to decompensation was similar between immediate, subacute, and acute cases with presentation varying between hypoxic respiratory failure and shock. This review article highlights theories behind the pathophysiology, clinical outcomes, and therapeutic options in this high mortality condition.
Druck führt zu Fusionen: Krankenhaussektor zentralisiert sich in Eile
Authors: Bornemeier Olaf
Published: February 2024

Die Strukturbereinigung der deutschen Krankenhauslandschaft findet statt! Nicht, weil breit aufgesetzte Förderprogramme sie unterstützt, sondern weil ökonomischer und vermeintlich qualitativer Handlungsdruck sie erzwingt.
Pflegepersonalbemessung im Krankenhaus: Update PPR 2.0
Authors: Heeser Alexandra
Published: February 2024

Die PPR 2.0 ist zum 1. Januar 2024 nicht verpflichtend eingeführt worden. Sie ist jedoch für dieses Jahr avisiert. Wann sie genau kommt, ist noch ungewiss. Derzeit kursiert der 1. April als frühester Starttermin. Was ist der Stand der Dinge zum jetzigen Zeitpunkt?
Eckpunkte zur Notfallreform: Ärzte zweifeln an Umsetzbarkeit
Authors: Doelfs Guntram
Published: February 2024

Gesundheitsminister Prof. Dr. Karl Lauterbach hat seine Pläne für eine Notfallreform vorgestellt. Diese soll Januar 2025 in Kraft treten und die Überlastung von Notaufnahmen in Krankenhäusern beenden. Die Reaktionen auf Lauterbachs Papier fallen jedoch gemischt aus.
Gesundheit Nord: Geno braucht weiterhin Hilfe
Authors: Schmidt Hartmut
Published: February 2024

“Börsenexperte Hartmut Schmidt analysiert für kma die Jahresabschlüsse ausgewählter Kliniken” + “kma Online Ausführliche Berichte lesen Sie jeden Monat auf kma Online unter www.kma-online.de/kassensturz”
Rechtskolumne: Hybrid-DRG-Verordnung – Ersatzvornahme des BMG
Authors: Rybak Christian , Schwiegk Nicole
Published: February 2024

Die Krankenhausreform und die damit verbundene Ambulantisierung nimmt weiter Form an. Bereits mit dem im Dezember 2022 eingeführten Paragrafen 115f SGB V wurde der Weg für die Hybrid-DRGs geebnet.
Thieme Management Award 2023: Auszeichnung für Spitzenmanagement
Authors: Doelfs Guntram
Published: February 2024

Der Thieme Management Award ehrt seit 2004 bedeutende Persönlichkeiten der Gesundheitsbranche. Gemeinsam mit dem Club der Gesundheitswirtschaft (cdgw) verleiht Thieme den Preis in den Kategorien „Manager/-in des Jahres“ und „Senkrechtstarter/-in“.
Manager des Jahres 2023: Prof. Dr. Wolfgang Holzgreve: Der Rastlose
Authors: Hohnstein Aileen
Published: February 2024

Er war Forscher von internationalem Rang, gilt als Pionier der Pränataldiagnostik und ist ein Klinikmanager, der nicht immer dem Mainstream folgt: Prof. Wolfgang Holzgreve hat in vier Jahrzehnten im Gesundheitswesen viel erreicht. Als Ärztlicher Direktor und Vorstandsvorsitzender des Universitätsklinikums Bonn hat er noch einiges vor.
Gutachten der Rhön-Stiftung: Ambulantisierung braucht Qualitätsstandards
Authors: Haeske-Seeberg Heidemarie
Published: February 2024

Der Gesetzgeber drückt beim Thema Ambulantisierung aufs Tempo. Noch fehlt es allerdings an einem Gesamtkonzept für Qualitätsvorgaben in der ambulanten medizinischen Versorgung. Ein Gutachten der Rhön Stiftung hat untersucht, welche Standards notwendig sind und wie diese umgesetzt werden sollten.
Klinikerhalt gescheitert: Wie die Kündigungswelle Holzminden überrollte
Authors: Hofmann Lisa-Marie
Published: February 2024

Ende November 2023 stand es fest – der Versuch das Evangelische Krankenhaus Holzminden zu erhalten, ist gescheitert. Und das, nachdem Stadt und Landkreis sogar finanzielle Unterstützung zugesagt hatten. Ein Überblick, wie es so weit kommen konnte.
Textilien: Zu kostbar zum Verbrennen
Authors: Lang Michael
Published: February 2024

Die Europäische Kommission plant, eine erweiterte Herstellerverantwortung mit Recyclingquoten für Textilien einzuführen. Auch Krankenhaustextilien sind von der neuen Regelung betroffen.
Materialversorgung: Paradigmenwechsel im OP
Authors: Lang Michael
Published: February 2024

Auf einem Fallwagen sind alle Materialien und Instrumente gerichtet, die für einen operativen Eingriff benötigt werden. Logistik-Experte Dr. Sebastian Wibbeling erläutert das Konzept und erklärt, was Kliniken bei der Einführung eines Fallwagens beachten sollten.
Ehrenamt im Gesundheitswesen: Ein Plädoyer für (noch) mehr Bürgersinn und Engagement im Gesundheitswesen
Authors: Meyer Michael
Published: February 2024

Eine Zivilgesellschaft mit einem auf das Gemeinwohl gekennzeichneten Ehrenamt zeichnet sich durch starken Zusammenhalt aus und stärkt die Grundfeste unseres demokratischen Wertesystems. Doch auch wenn bereits rund ein Drittel aller Bundesbürger ehrenamtlich tätig ist, so gibt es doch nach wie vor viele Chancen zur Ausweitung des Engagements – gerade im Gesundheitswesen.
Opportunity costs and global justice
Authors: Armstrong Chris
Published: February 2024

This chapter assesses how one kind of conservation burden—opportunity costs—should be understood and shows that our position on this issue has major implications for global justice. It goes on to argue that the notion of opportunity costs must be moralized, and then explains and defends an egalitarian baseline for calculating those costs. Taking this baseline seriously would suggest that many real-world conservation projects send far more modest resources in the direction of people affected by conservation projects than justice requires, and that they are often exploitative in nature. It examines the implications for conservation academics, practitioners, and policy makers.
Conclusion
Authors: Armstrong Chris
Published: February 2024

Vital efforts to tackle the biodiversity crisis can, if they are not designed carefully, produce considerable injustice. In the past, for example, conservation efforts have involved considerable political, epistemic, and distributive injustices. This conclusion draws together fifteen key arguments from the book, which highlight the perils of unjust conservation policies, and point the way forwards to just and inclusive alternatives. Having mapped the territory, it also aims to encourage others to develop their own visions of global justice as applied to the biodiversity crisis.
Philosophy for an Ending World
Authors: Mulgan Tim
Published: February 2024

This book introduces a new thought experiment—The Ending World—where the world will end in two hundred years, and humanity faces imminent and unavoidable (but not immediate) extinction. The book contains imaginary philosophical debates and lectures within this slowly ending world. The ending world is both a provocative thought experiment and a challenging possible future. Exploring it from within—adopting the perspective of philosophers living in that ending world—helps us to imagine this world from the inside, to evaluate it as a possible future, to discover what we owe to future people who might inhabit such a future, and to explore how we might justify ourselves to them. The book explores contemporary debates about pessimism, the meaning of life, the existence of God, the purpose of the universe, the permissibility of creating new people, the need to connect with past and future people, the rectification of historical injustice, the design of utopias, and the desirability of escaping into virtual realities. A central question throughout the book is whether we could equip our descendants to flourish in an ending world, even if we cannot imagine flourishing there ourselves. The book defends an innovative account of our obligations to future people, based on the need to launch multigenerational projects to transform our inherited traditions and values so that they will still make sense even at humanity’s end.
First Debate
Authors: Mulgan Tim
Published: February 2024

In this debate—set in an ending world where humanity faces unavoidable extinction in two hundred years—the Post-Cataclysm Pessimist argues that losing the indefinite human future is sufficient to make life meaningless. Samuel Scheffler has argued that even apparently present-focused projects presuppose an ongoing background of traditions, values, or relationships that extend into the future. The Post-Cataclysm Pessimist extends Scheffler’s critique, arguing that future-dependent meaning is lost even earlier, because our current (Pre-Cataclysm) values require an indefinite human future. As well as Scheffler, the debate draws on Jonathan Lear’s work on radical hope; nineteenth-century German pessimism, especially Eduard von Hartmann’s argument that meaning can only be found in future cultural progress; and Mark Johnston’s argument that good people literally ‘live on’ in future generations. The Post-Cataclysm Pessimist argues that all secular replacements for a personal afterlife collapse in the face of imminent extinction. The debate contrasts Post-Cataclysm pessimism with three main alternatives. The Perennial Pessimist argues that imminent extinction makes no difference, because life has always been meaningless. The Presentist argues that sufficient meaning can be found in present pleasures and achievements, or in care and compassion for the suffering of others. The Multigenerationalist replies that people living at the start of the ending world could raise new generations for whom meaning, well-being, and value are not dependent on the existence of any (further) future people.
Lecture Two
Authors: Mulgan Tim
Published: February 2024

This lecture—delivered in an ending world where humanity faces unavoidable extinction in two hundred years—introduces procreative ethics. People living at the start of a slowly ending world could create future people. But would this be permissible? In particular, is it permissible to create a last generation who cannot have children of their own? Most contemporary philosophical procreative ethicists share a broad commitment to procreative liberty. This lecture asks whether this commitment to procreative liberty could survive in a world facing imminent extinction, where it is challenged both by anti-natalists who insist that procreation is now forbidden and by ‘pro-natalists’ who argue that, in an uncertain world of impending extinction, procreative obligations are the only reliable way to ensure that enough people have children. The lecture summarises contemporary procreative ethics—covering Parfit’s non-identity problem, procreative asymmetry, and puzzles in aggregation such as Parfit’s repugnant conclusion. It then presents two particular approaches and applies them to the ending world: Elizabeth Harman’s harm-based approach and Melinda Roberts’s person-affecting consequentialism. Procreative ethics is vital to the case for multigenerationalism developed across all six lectures in this book. Multigenerationalism grounds present meaning in collaborations with future people. Therefore, multigenerational projects are permissible only if procreation is permissible. However, the lecture’s central arguments stand alone, and do not presuppose arguments made elsewhere in the book.
Lecture Five
Authors: Mulgan Tim
Published: February 2024

This lecture—delivered in an ending world where humanity faces unavoidable extinction in two hundred years—argues that the multigenerationalist approach introduced in Lecture One is feasible and distinctive. The lecture draws on Allen Buchanan and Russell Powell’s evolutionary defense of the possibility of moral progress; on Jonathan Lear’s philosophical exploration of the life of the Crow leader Plenty Coups who led his people into a future where their whole way of life no longer made sense; on recent work in environmental philosophy; and on Tim Mulgan’s earlier work on moral imaginativeness and possible futures. Against both progressive opponents who claim that future moral transformation is unnecessary, and conservative opponents who dismiss it as impossible, the lecture argues that multigenerationalism’s claims about moral progress, moral imaginativeness, and moral transformation are all credible—given our knowledge of human nature, and of past moral transformations. The lecture also argues that future moral transformation is necessary, not only for multigenerationalists, but for anyone who wants to permissibly create a new generation in a world where humanity faces unavoidable imminent extinction.
How and why to compare incomparables: The Great Gatsby and La Règle du jeu
Authors: Andrew Dudley
Published: February 2024

Comparing The Great Gatsby with any of its adaptations invariably promotes the novel over its derivatives and is far less fertile than putting it alongside Jean Renoir’s La Règle du jeu. During the interwar period, these incomparable masterpieces exhibit strikingly similar plots to address the moral decline of the upper class. Renoir directly borrowed this template from Musset’s 1833 Les Caprices de Marianne, a hallmark of Romanticism. The competing forces of romantic desire, aristocratic values, and aesthetic modernism make these works comparably difficult to classify. The article introduces Orson Welles’ Citizen Kane, which had already been compared to The Great Gatsby and was also filmed at the outset of WWII. Watching Welles’ film beside Renoir’s confirms André Bazin’s view that cinema became modern at just this moment, by taking on a role comparable to that commanded by post-WWI American novels like Fitzgerald’s. And examining Renoir beside Fitzgerald highlights the styles and strategies of both masterpieces as they pursued a large public and an authentic social critique. The article concludes by enumerating reasons and ways to compare ‘original’ works that bear similarities, whether mythic and universal or historical and particular.
Shared decision making in older people after severe stroke
Authors: Mead Gillian
Published: February 2024

Stroke is a major cause of death and lifelong disability. Although stroke treatments have improved, many patients are left with life-changing deficits. Shared decision making and consent are fundamental to good medical practice. This is challenging because stroke often causes mental incapacity, prior views might not be known and prognosis early after stroke is often uncertain. There are no large trials of shared decision making after severe stroke, so we need to rely on observational data to inform practice. Core ethical principles of autonomy, beneficence, non-maleficence and justice must underpin our decision making. ‘Surrogate’ decision makers will need to be involved if a patient lacks capacity, and prior expressed views and values and beliefs need to be taken into account in decision making. Patients and surrogates often feel shocked at the sudden nature of stroke, and experience grief including anticipatory grief. Health care professionals need to acknowledge these feelings and provide support, be clear about what decisions need to be made and provide sufficient information about the stroke, and the risks and benefits of treatments being considered. Shared decision making can be emotionally difficult for health care professionals and so working in a supportive environment with compassionate leadership is important. Further research is needed to better understand the nature of grief and what sort of psychological support would be most helpful. Large randomised trials of shared decision making are also needed.
Effect of Heart-Healthy Dietary Patterns on Blood Pressure: A Systematic Review and Meta-analysis
Authors: Jiao Xueyan , Song Kunpeng , Zhang Ning , Liu Luyao , Zhang Yifan , Chen Yun , Lan Zhenzhen , Liu Shutong , Liu Xincan
Published: February 2024

OBJECTIVE

To systematically evaluate the antihypertensive effect of dietary patterns of blood pressure management.

METHODS

The researchers searched the following databases: PubMed, Embase, the Cochrane Library, Web of Science, Scopus, China Knowledge Network, China Biomedical Literature Service, Wanfang Database, and Wipu.com by computer. Search for randomized controlled trials (RCTs) on the effects of Mediterranean diet, Dietary Approaches to Stop Hypertension (DASH), and Chinese Heart-Healthy (CHH) diet on blood pressure in English and Chinese. RCTs, which were published from the time of the study until 02/2023. The investigators assessed and screened the literature before conducting a systematic evaluation and meta-analysis using Stata 15 software.

RESULTS

This study included 27 publications containing 7,409 study subjects, including 3,677 in the trial group and 3,732 in the control group. Dietary models for blood pressure management were effective in reducing systolic blood pressure [weighted mean difference (WMD) = −3.94, 95% confidence interval (CI): (−5.10, −2.77), P < 0.001] and diastolic blood pressure [WMD = −2.32, 95% CI: (−3.01, −1.63), P < 0.001].

CONCLUSIONS

Dietary models for blood pressure management have a clear positive impact on blood pressure management in patients, and more high-quality studies with standardized design and long intervention period are needed in the future to provide strong evidence for healthy diet-based blood pressure management.
Relationship between publication of a postgraduate year 1 residency research project and subsequent career type at a large academic medical center
Authors: Nguyen Vi , Stevens Craig , Lepkowsky Marcie , Daniels Charles E , Patel Nimish
Published: February 2024

Purpose

The study objectives were to (1) quantify the overall incidence of residency publications of postgraduate year 1 (PGY1) residency alumni; (2) evaluate annual fluctuations in publications over time; and (3) compare the career types of residency alumni who published their PGY1 residency research projects to those for alumni who did not.

Methods

A retrospective cohort study was performed among individuals who completed a PGY1 acute/ambulatory care residency between 2010 and 2021. A list of residency alumni was obtained along with the corresponding titles of their research projects. Each resident’s name was entered into PubMed and Google Scholar to find the corresponding publication. LinkedIn and other publicly available resources were used to determine the career types of residents immediately after residency as well as their current career types.

Results

In total, 178 residency alumni completed an acute/ambulatory care PGY1 residency, of whom 16.7% (30/178) published their residency research project. Publication was associated with career type among those who pursued a postgraduate year 2 residency but was not associated with career type immediately after the PGY1 residency or current career type. The presence of an academic preceptor was associated with a higher probability of publishing compared to residents who did not have an academic preceptor (31.5% vs 10.5%; P < 0.01).

Conclusion

The frequency of publications was within the range reported elsewhere, with fluctuations over time. Presence of an academic preceptor improved the probability of publication.