bluuebunny/crossref_metadata_2025 huggingface dataset:
Development and Evaluation of a Markerless 6 DOF Pose Tracking Method for a Suture Needle from a Robotic Endoscope
Authors: Jiang Yiwei , Zhou Haoying , Fischer Gregory S.
Published: December 2023

Remarkable progress has been made in the field of robot-assisted surgery in recent years, particularly in the area of surgical task automation, though many challenges and opportunities still exist. Among these topics, the detection and tracking of surgical tools play a pivotal role in enabling autonomous systems to plan and execute procedures effectively. For instance, accurate estimation of a needle’s position and posture is essential for surgical systems to grasp the needle and perform suturing tasks autonomously. In this paper, we developed image-based methods for markerless 6 degrees of freedom (DOF) suture needle pose estimation using keypoint detection technique based on Deep Learning and Point-to-point Registration, we also leveraged multi-viewpoint from a robotic endoscope to enhance the accuracy. The data collection and annotation process was automated by utilizing a simulated environment, enabling us to create a dataset with 3446 evenly distributed needle samples across a suturing phantom space for training and to demonstrate more convincing and unbiased performance results. We also investigated the impact of training set size on the keypoint detection accuracy. Our implemented pipeline that takes a single RGB image achieved a median position error of 1.4 mm and a median orientation error of 2.9∘, while our multi-viewpoint method was able to further reduce the random errors.
Enhanced Real-time Scheduling of AVB Flows in Time-Sensitive Networking
Authors: Deng Libing , Zeng Gang , Kurachi Ryo , Takada Hiroaki , Xiao Xiongren , Li Renfa , Xie Guoqi
Published: December 2023

Time-Sensitive Networking (TSN) realizes high bandwidth and time determinism for data transmission and thus becomes the crucial communication technology in time-critical systems. The Gate Control List (GCL) is used to control the transmission of different classes of traffic in TSN, including Time-Triggered (TT) flows, Audio-Video-Bridging (AVB) flows, and Best-Effort (BE) flows. Most studies focus on optimizing GCL synthesis by reserving the preceding time slots to serve TT flows with the strict delay requirement, but ignore the deadlines of non-TT flows and cause the large delay. Therefore, this paper proposes a comprehensive scheduling method to enhance the real-time scheduling of AVB flows while guaranteeing the time determinism of TT flows. This method first optimizes GCL synthesis to reserve the preceding time slots for AVB flows, and then introduces the Earliest Deadline First (EDF) method to further improve the transmission of AVB flows by considering their deadlines. Moreover, the worst-case delay (WCD) analysis method is proposed to verify the effectiveness of the proposed method. Experimental results show that the proposed method improves the transmission of AVB flows compared to the state-of-the-art methods.
Solid-State Fermented Plant Foods as New Protein Sources
Authors: Canoy Tessa S. , Wiedenbein Emma Schack , Bredie Wender L.P. , Meyer Anne S. , Wösten Han A.B. , Nielsen Dennis Sandris
Published: December 2023

The current animal-based production of protein-rich foods is unsustainable, especially in light of continued population growth. New alternative proteinaceous foods are therefore required. Solid-state fermented plant foods from Africa and Asia include several mold- and Bacillus-fermented foods such as tempeh, sufu, and natto. These fermentations improve the protein digestibility of the plant food materials while also creating unique textures, flavors, and taste sensations. Understanding the nature of these transformations is of crucial interest to inspire the development of new plant-protein foods. In this review, we describe the conversions taking place in the plant food matrix as a result of these solid-state fermentations. We also summarize how these (nonlactic) plant food fermentations can lead to desirable flavor properties, such as kokumi and umami sensations, and improve the protein quality by removing antinutritional factors and producing additional essential amino acids in these foods.
Using Participatory Implementation Science to Advance Health Equity
Authors: Ramanadhan Shoba , Alemán Rosa , Bradley Cory D. , Cruz Jennifer L. , Safaeinili Nadia , Simonds Vanessa , Aveling Emma-Louise
Published: December 2023

Participatory approaches to implementation science (IS) offer an inclusive, collaborative, and iterative perspective on implementing and sustaining evidence-based interventions (EBIs) to advance health equity. This review provides guidance on the principles and practice of participatory IS, which enables academic researchers, community members, implementers, and other actors to collaboratively integrate practice-, community-, and research-based evidence into public health and health care services. With a foundational focus on supporting academics in coproducing knowledge and action, participatory IS seeks to improve health, reduce inequity, and create transformational change. The three main sections of this review provide (a) a rationale for participatory approaches to research in implementation science, (b) a framework for integrating participatory approaches in research utilizing IS theory and methods, and (c) critical considerations for optimizing the practice and impact of participatory IS. Ultimately, participatory approaches can move IS activities beyond efforts to make EBIs work within harmful systems toward transformative solutions that reshape these systems to center equity.
Effects of Electrode Curvature in Li-Ion Cells
Authors: Schäfer Robin , Delz Estefane , Kasper Michael , Knoblauch Volker , Wohlfahrt-Mehrens Margret , Waldmann Thomas
Published: December 2023

Bending of electrodes in certain cell designs (cylindrical cells or flat wound jellyrolls) leads to curved electrodes (curvature κ). For double side-coated electrodes, this curvature leads to convex and concave sides of the coating. In this work, we describe the effect of curved electrodes on the microstructure and aging. From a simple elastic model, we find that the porosities of the convex and concave sides of curved electrode coatings can deviate theoretically for first inner winding in a typical cylindrical cell in the order of ±2%, respectively. The elastic model is compared with light microscopy images and Post-Mortem analysis revealing additional plastic deformation for small electrode bending radii. Electrode resistance measurements of the electrode coating as a function of winding radius is added to the overall context. The study concludes with an evaluation and discussion on typical bending radii of electrodes in different cell types (pouch, PHEV1, and 21700) and states (fresh, aged, and abused).
Data from Dual Role of CXCL8 in Maintaining the Mesenchymal State of Glioblastoma Stem Cells and M2-Like Tumor-Associated Macrophages
Authors: Yuan Wei , Zhang Qian , Gu Danling , Lu Chenfei , Dixit Deobrat , Gimple Ryan C. , Gao Yisu , Gao Jiancheng , Li Daqi , Shan Danyang , Hu Lang , Li Lu , Li Yangqing , Ci Shusheng , You Hao , Yan Linping , Chen Kexin , Zhao Ningwei , Xu Chuanhai , Lan Jianyun , Liu Dong , Zhang Junxia , Shi Zhumei , Wu Qiulian , Yang Kailin , Zhao Linjie , Qiu Zhixin , Lv Deguan , Gao Wei , Yang Hui , Lin Fan , Wang Qianghu , Man Jianghong , Li Chaojun , Tao Weiwei , Agnihotri Sameer , Qian Xu , Mack Stephen C. , Zhang Nu , You Yongping , Rich Jeremy N. , Sun Guan , Wang Xiuxing
Published: December 2023

AbstractPurpose:
The dynamic interplay between glioblastoma stem cells (GSC) and tumor-associated macrophages (TAM) sculpts the tumor immune microenvironment (TIME) and promotes malignant progression of glioblastoma (GBM). However, the mechanisms underlying this interaction are still incompletely understood. Here, we investigate the role of CXCL8 in the maintenance of the mesenchymal state of GSC populations and reprogramming the TIME to an immunosuppressive state.
Experimental Design:
We performed an integrative multi-omics analyses of RNA sequencing, GBM mRNA expression datasets, immune signatures, and epigenetic profiling to define the specific genes expressed in the mesenchymal GSC subsets. We then used patient-derived GSCs and a xenograft murine model to investigate the mechanisms of tumor-intrinsic and extrinsic factor to maintain the mesenchymal state of GSCs and induce TAM polarization.
Results:
We identified that CXCL8 was preferentially expressed and secreted by mesenchymal GSCs and activated PI3K/AKT and NF-κB signaling to maintain GSC proliferation, survival, and self-renewal through a cell-intrinsic mechanism. CXCL8 induced signaling through a CXCR2–JAK2/STAT3 axis in TAMs, which supported an M2-like TAM phenotype through a paracrine, cell-extrinsic pathway. Genetic- and small molecule–based inhibition of these dual complementary signaling cascades in GSCs and TAMs suppressed GBM tumor growth and prolonged survival of orthotopic xenograft-bearing mice.
Conclusions:
CXCL8 plays critical roles in maintaining the mesenchymal state of GSCs and M2-like TAM polarization in GBM, highlighting an interplay between cell-autonomous and cell-extrinsic mechanisms. Targeting CXCL8 and its downstream effectors may effectively improve GBM treatment.
Analysis of Changes in Plasma Cytokine Levels in Response to IL12 Therapy in Three Clinical Trials
Authors: Schwarz Emily , Benner Brooke , Yu Lianbo , Tounkara Fode , Carson William E.
Published: December 2023

The ability of IL12 to stimulate natural killer (NK) cell and T-cell antitumor activity makes it an attractive candidate for the immune therapy of cancer. Our group has demonstrated that IL12 enhances the NK cell response to antibody-coated tumor cells and conducted three clinical trials utilizing IL12 with mAbs (OSU-9968, OSU-0167, and OSU-11010). To better characterize IL12-induced immunity, plasma cytokine levels were measured in 21 patients from these trials with favorable and unfavorable responses. t-statistics and linear modeling were used to test for differences within and between response groups by examining levels at baseline and post-IL12 administration. Patients exhibited significant increases in 11 cytokines post-IL12 administration when analyzed collectively. However, several cytokines were differentially induced by IL12 depending on response. GMCSF was significantly increased in complete/partially responding patients, while stable disease patients had significant increases in IL10 and decreases in VEGF-C. Patients who experienced progressive disease had significant increases in CCL3, CCL4, IL18, TNFα, CXCL10, CCL8, CCL2, IL6, and IFNγ. The increases in CCL3, CCL4, and IL6 in progressive disease patients were significantly higher than in clinically benefitting patients and most prominent within the first two cycles of IL12 therapy. This correlative pilot study has identified changes that occur in levels of circulating cytokines following IL12 administration to patients with cancer, but this report must be viewed as exploratory in nature. It is meant to spark further inquiry into the topic via the analysis of additional cohorts of patients with similar characteristics who have received IL12 in a uniform fashion.

Significance:

IL12 activates immune cells and is used to treat cancer. The profile of circulating cytokines was measured in an exploratory fashion in patients with cancer that received IL12 in combination with mAbs. This correlative pilot study could serve as the basis for additional studies of IL12 effects on the production of immune cytokines.
High-Altitude Exposure and Diabetic Retinopathy: Unveiling the Impact and Mechanisms of Alleviation
Authors: Gong Haijun , Zhou Qihang , Gama Zhujue , Lan Yuqing
Published: December 2023

Background: High altitude (HA) is an extremely challenging environment for millions of people who either travel to HA regions or inhabit there permanently. Summary: Significant progress has been made over the past decades in the understanding of physiological adaptations in HA conditions, and recently, more studies regarding its influence on metabolic disease have been published. However, the effect of HA on diabetic retinopathy (DR), the leading cause of blindness, remains unclear. Key Messages: The present article provides an overview of the changes in the principal physiology and clinical characteristics related to DR after HA exposure. Despite conflicting evidence, this review synthesizes the available studies and explores the potential mechanisms, such as genetic adaptations, glucose homeostasis, and related physiological changes, by which long-term exposure to HA may alleviate the progression of DR. By shedding light on this complex relationship, it also provides insights into the interplay between HA and DR, offering valuable implications for clinical practice and further research.
Down Syndrome Patients with Congenital Portosystemic Shunts: A Case Report and Review
Authors: Nohomovich Brian , Nguyen Minh H.N. , Fakhoury Joseph , Cameron Russell C. , Gomes Theotonius
Published: December 2023

Introduction: Down syndrome is due to trisomy 21 and is characterized by intellectual disability, dysmorphic facial features, congenital malformations, and gastrointestinal abnormalities. There is an increased appreciation of congenital portosystemic shunts in Down syndrome patients. Congenital portosystemic shunts have been associated with many defects in body systems, including cardiac, metabolic, and neurological. Case Presentation: Herein, we describe a portosystemic shunt in a Down syndrome patient that resulted in hyperammonemia with altered mental status and choreiform movements. Computed tomography angiography of the abdomen and pelvis identified a connection between the right portal vein and inferior vena cava. An 18 mm Amplatzer PFO closure device was placed within the congenital shunt, significantly improving symptoms. The patient has no sequelae from the related shunt or the device at the 2-year follow-up. We extensively reviewed the literature and identified cases of portosystemic shunts in Down syndrome patients. Shunts can either be extrahepatic or intrahepatic and are classified by vasculature connections. Conclusion: From our literature review and case presentation, we identify other conditions in patients, including cardiac and gastrointestinal defects. We then review the available treatment options, whether observation or surgical, depending on the patient’s clinical picture.
IQ Motif Containing GTPase-Activating Protein 3 Is Associated with Cancer Stemness and Survival in Pancreatic Ductal Adenocarcinoma
Authors: Kido Aya , Ishikawa Akira , Fukui Takafumi , Katsuya Narutaka , Kuraoka Kazuya , Sentani Kazuhiro , Tazuma Sho , Sudo Takeshi , Serikawa Masahiro , Oka Shiro , Oue Naohide , Yasui Wataru
Published: December 2023

Introduction: Pancreatic ductal adenocarcinoma (PDAC) is one of the most lethal types of malignancy, with poor prognosis and rising incidence. IQ motif containing GTPase-activating protein 3 (IQGAP3) is a member of the IQGAPs family of scaffolding proteins that govern multiple cellular activities like cytoskeletal remodeling and cellular signal transduction. This study aimed to analyze the expression and biological function of IQGAP3 in PDAC. Methods: We analyzed IQGAP3 expression in 81 PDAC samples by immunohistochemistry. RNA interference was used to inhibit IQGAP3 expression in PDAC cell lines. Results: Immunohistochemical analysis of IQGAP3 showed that 54.3% of PDACs were positive for cytoplasmic expression of IQGAP3, with no expression found in non-neoplastic tissue. Furthermore, IQGAP3 expression was an independent poor prognostic factor in our immunostaining-based studies and analyses of public databases. Our cohort and the Cancer Genome Atlas database indicated that IQGAP3 is co-localized with kinesin family member C1 (KIFC1), which we previously reported as a cancer stem cell-associated protein. IQGAP3 small interfering RNA treatment decreased PDAC cell proliferation and spheroid colony formation via ERK and AKT pathways. Discussion/Conclusion: These results suggest that IQGAP3, a transmembrane protein, is involved in survival and stemness and may be a promising new therapeutic target for PDAC.
The Process of Sterilizing Tattoo Inks Releases Formaldehyde
Authors: Lee Seung Hee , Kim Myoungjin , Kim Seongnam , Kim Hong Bae
Published: December 2023

Introduction: Around 12% of Europeans and 20% of Americans have at least one tattoo. Tattoo inks, the substances used to create tattoos on the body, consist of chemicals that contain formaldehyde, which can be harmful to human health. The amount of formaldehyde present in commercially available tattoo inks and its causes are not well understood. Methods: We investigated the levels of formaldehyde in tattoo ink products sold in different countries and identified the factors contributing to its production. We also explored methods to reduce formaldehyde generation in tattoo inks. Seven tattoo inks from various brands were tested. Results: Formaldehyde release was predominantly associated with gamma radiation sterilization. Formaldehyde levels were observed to be higher in compositions containing organic components compared to those with inorganic components, irrespective of sterilization method and container type. Glycerin released over seven times more formaldehyde than other components during gamma-ray sterilization. Conclusion: The results suggest that the presence of hydroxyl groups in carbon organic compounds in tattoo ink leads to photodegradation during gamma-ray radiation sterilization, resulting in increased concentrations of formaldehyde. Further research is needed to examine the chemical reactions occurring during sterilization processes and identify alternative sterilization methods that minimize formaldehyde formation. Additionally, the development of tattoo inks with reduced formaldehyde content and the establishment of strict quality control measures can help ensure the safety of tattooing practices.
A Case Report of Infant-Type Hemispheric Glioma with a Novel GAB1-ABL2 Kinase Fusion Treated with Dasatinib
Authors: Buckner-Wolfson Emery , Jung Geena , Kim Timothy , Fatemi Ryan , Liriano Genesis , Dalvi Nagma , Behbahani Mandana , Chin Steven , Martin Allison , Kobets Andrew
Published: December 2023

Introduction: Infant-type hemispheric glioma (IHG) is a rare form of cancer that affects newborns and infants. It is classified as a pediatric-type high-grade glioma and typically harbors receptor tyrosine kinase (RTK) gene fusions. Here, we present the finding of a novel gene fusion IHG treated with a targeted therapy that has yet to be implemented for any other IHG case to date. Case Presentation: We report the case of a 12-month-old boy with IHG who presented with obstructive hydrocephalus due to a large mass in the right frontal lobe. The patient initially underwent mass resection, but subsequent imaging showed rapid interval progression of the residual tumor. Comprehensive molecular analysis of the tumor tissue revealed a novel GAB1-ABL2 gene fusion, and the patient was started on dasatinib, an ABL kinase inhibitor. Shortly after initiation of dasatinib treatment, there was a significant reduction in tumor size and enhancement, followed by stabilization of disease. Discussion: The patient’s robust response to treatment suggests that dasatinib is an effective targeted therapy for IHG harboring a GAB1-ABL2 gene fusion. This finding may inform future investigations into the disease processes of IHG and help guide the diagnosis and treatment of IHG in the absence of previously identified gene fusions, improving clinical management of this vulnerable patient population.
Estimation of Average and Maximum Daily-Life Mobility Performance Using the Timed Up-and-Go: Exploring the Added Value of an Instrumented Timed Up-and-Go
Authors: Heldmann Patrick , Elser Alexander , Kramer-Gmeiner Franziska , Jansen Carl-Philipp , Mellone Sabato , Schwenk Michael
Published: December 2023

Introduction: The association between specific motor capacity variables obtained in a laboratory and parameters of daily-life mobility performance (MP) obtained via wearables is still unclear. The Timed Up-and-Go (TUG) test is a widely used motor capacity tests available either as traditional hand-stopped TUG or as instrumented TUG (iTUG), providing specific information about its subphases. This study aimed to: (1) estimate the association between the TUG and specific parameters reflecting average and maximum daily-life MP, (2) estimate the benefits of the iTUG in terms of explaining MP in daily life compared to the TUG. Methods: The present study was a cross-sectional analysis using baseline data of 294 older persons (mean age: 76.7 ± 5.3 years). Univariate linear regression analysis was performed to delineate the coefficient of determination between TUG time and participants’ MP. MP variables containing mean cadence (MCA) to represent average performance and the 95th percentile of mean cadence of walks with more than three steps (p95>3stepsMCA) to represent maximum performance. To determine whether the iTUG variables give more information about MP, a stepwise multivariate regression analysis between iTUG variables and the p95>3stepsMCA variable to represent maximum performance was conducted. Results: The univariate regression models revealed associations of the TUG with MCA (adjusted R2 = 0.078, p < 0.001) and p95>3stepsMCA (adjusted R2 = 0.199, p < 0.001). The multivariate stepwise regression models revealed a total explanation of maximum daily-life MP (p95>3stepsMCA) of the TUG (adjusted R2 = 0.199, p < 0.001) versus iTUG (adjusted R2 = 0.278, p < 0.010). Discussion/Conclusion: This study shows that the TUG better reflects maximum daily-life MP than average daily-life MP. Moreover, we demonstrate the added value of the iTUG for a more accurate estimation of daily MP compared to the traditional TUG. The iTUG is recommended to estimate maximum daily-life MP in fall-prone older adults. The study is a step toward a specific assessment paradigm using capacity variables from the iTUG to estimate maximum daily-life MP.
Padrões de lesões em casos de homicídios
Authors: Jain Sanjay , Patel Shailendra , Tiwari Gaurav , Singh Puja
Published: December 2023

Morte, uma inevitável parte da vida, incita uma exploração a respeito da maneira e do método de sua ocorrência. Este estudo tem por objetivo analisar os padrões de lesões em casos de homicídios verificados em exames post-mortem. Em 2019, registrou-se um total de 28.918 casos de assassinato na India, mostrando um leve decréscimo de 0,3% em comparação com 2018 (29.017 casos). Este estudo objetiva entender os diferentes padrões de lesão em homicídios. No Departamento de Medicina Forense da Gandhi Medical College, em Bhopal, India, um total de 62 homens, 12 mulheres e uma pessoa de gênero não identificado, foram submetidas à análise post mortem. A maioria dos casos pertencia a áreas urbanas, com principal causa de morte sendo choque e hemorragia seguida de dano crânio cerebral. Este estudo conclui que arestas afiadas e cortes profundos foram os principais padrões de lesões em casos de homicídio.
2023 American Heart Association Focused Update on Adult Advanced Cardiovascular Life Support: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care
Authors: Perman Sarah M. , Elmer Jonathan , Maciel Carolina B. , Uzendu Anezi , May Teresa , Mumma Bryn E. , Bartos Jason A. , Rodriguez Amber J. , Kurz Michael C. , Panchal Ashish R. , Rittenberger Jon C. ,   on behalf of the American Heart Association
Published: December 2023

Cardiac arrest is common and deadly, affecting up to 700 000 people in the United States annually. Advanced cardiac life support measures are commonly used to improve outcomes. This “2023 American Heart Association Focused Update on Adult Advanced Cardiovascular Life Support” summarizes the most recent published evidence for and recommendations on the use of medications, temperature management, percutaneous coronary angiography, extracorporeal cardiopulmonary resuscitation, and seizure management in this population. We discuss the lack of data in recent cardiac arrest literature that limits our ability to evaluate diversity, equity, and inclusion in this population. Last, we consider how the cardiac arrest population may make up an important pool of organ donors for those awaiting organ transplantation.
Timing of Cardiac Surgical Interventions and Postoperative Mortality in Children With Severe Congenital Heart Defects Across Europe: Data From the EUROlinkCAT Study
Authors: Damkjær Mads , Garne Ester , Loane Maria , Urhoj Stine K. , Ballardini Elisa , Cavero‐Carbonell Clara , Coi Alessio , García‐Villodre Laura , Given Joanne , Gissler Mika , Heino Anna , Jordan Sue , Limb Elizabeth , Neville Amanda J , Pierini Anna , Rissmann Anke , Tan Joachim , Scanlon Ieuan , Morris Joan K
Published: December 2023

Background

The purpose of this study was to evaluate the timing of the first cardiac surgery, the number of cardiac surgeries performed, and 30‐day postoperative mortality rate for children with severe congenital heart defects (sCHDs) in their first 5 years of life.

Methods and Results

This was a population‐based data linkage cohort study linking information from 9 European congenital anomaly registries to vital statistics and hospital databases. Data were extracted for 5693 children with sCHDs born from 1995 to 2004. Subgroup analyses were performed for specific types of sCHD. Children with sCHDs underwent their first surgical intervention at a median age of 3.6 (95% CI, 2.6–4.5) weeks. The timing of the first surgery for most subtypes of sCHD was consistent across Europe. In the first 5 years of life, children with hypoplastic left heart underwent the most cardiac surgeries, with a median of 4.4 (95% CI, 3.1–5.6). The 30‐day postoperative mortality rate in children aged <1 year ranged from 1.1% (95% CI, 0.5%–2.1%) for tetralogy of Fallot to 23% (95% CI, 12%–37%) for Ebstein anomaly. The 30‐day postoperative mortality rate was highest for children undergoing surgery in the first month of life. Overall 5‐year survival for sCHD was <90% for all sCHDs, except transposition of the great arteries, tetralogy of Fallot, and coarctation of the aorta.

Conclusions

There were no major differences among the 9 regions in the timing, 30‐day postoperative mortality rate, and number of operations performed for sCHD. Despite an overall good prognosis for most congenital heart defects, some lesions were still associated with substantial postoperative death.
Opportunities to Increase Science of Diversity and Inclusion in Clinical Trials: Equity and a Lack of a Control
Authors: Igwe Joseph‐Kevin , Wangdak Yuthok Tenzin Yeshi , Cruz Erin , Mueller Adrienne , Lan Roy Hao , Brown‐Johnson Cati , Idris Muhammed , Rodriguez Fatima , Clark Kira , Palaniappan Latha , Echols Melvin , Wang Paul , Onwuanyi Anekwe , Pemu Priscilla , Lewis Eldrin F.
Published: December 2023

The United States witnessed a nearly 4‐fold increase in personal health care expenditures between 1980 and 2010. Despite innovations and obvious benefits to health, participants enrolled in clinical trials still do not accurately represent the racial and ethnic composition of patients nationally or globally. This lack of diversity in cohorts limits the generalizability and significance of results among all populations and has deep repercussions for patient equity. To advance diversity in clinical trials, robust evidence for the most effective strategies for recruitment of diverse participants is needed. A major limitation of previous literature on clinical trial diversity is the lack of control or comparator groups for different strategies. To date, interventions have focused primarily on (1) community‐based interventions, (2) institutional practices, and (3) digital health systems. This review article outlines prior intervention strategies across these 3 categories and considers health policy and ethical incentives for substantiation before US Food and Drug Administration approval. There are no current studies that comprehensively compare these interventions against one another. The American Heart Association Strategically Focused Research Network on the Science of Diversity in Clinical Trials represents a multicenter, collaborative network between Stanford School of Medicine and Morehouse School of Medicine created to understand the barriers to diversity in clinical trials by contemporaneous head‐to‐head interventional strategies accessing digital, institutional, and community‐based recruitment strategies to produce informed recruitment strategies targeted to improve underrepresented patient representation in clinical trials.
Intravenous Thrombolysis for Acute Ischemic Stroke in Patients With Recent Direct Oral Anticoagulant Use: A Systematic Review and Meta‐Analysis
Authors: Ghannam Malik , AlMajali Mohammad , Galecio‐Castillo Milagros , Al Qudah Abdullah , Khasiyev Farid , Dibas Mahmoud , Ghazaleh Dana , Vivanco‐Suarez Juan , Morán‐Mariños Cristian , Farooqui Mudassir , Rodriguez‐Calienes Aaron , Koul Prateeka , Roeder Hannah , Shim HyungSub , Samaniego Edgar , Leira Enrique C. , Adams Harold P. , Ortega‐Gutierrez Santiago
Published: December 2023

Background

Intravenous thrombolysis (IVT) is an effective stroke therapy that remains underused. Currently, the use of IVT in patients with recent direct oral anticoagulant (DOAC) intake is not recommended. In this study we aim to investigate the safety and efficacy of IVT in patients with acute ischemic stroke and recent DOAC use.

Methods and Results

A systematic review and meta‐analysis of proportions evaluating IVT with recent DOAC use was conducted. Outcomes included symptomatic intracranial hemorrhage, any intracranial hemorrhage, serious systemic bleeding, and 90‐day functional independence (modified Rankin scale score 0–2). Additionally, rates were compared between patients receiving IVT using DOAC and non‐DOAC by a random effect meta‐analysis to calculate pooled odds ratios (OR) for each outcome. Finally, sensitivity analysis for idarucizumab, National Institutes of Health Stroke Scale, and timing of DOAC administration was completed. Fourteen studies with 247 079 patients were included (3610 in DOAC and 243 469 in non‐DOAC). The rates of IVT complications in the DOAC group were 3% (95% CI, 3–4) symptomatic intracranial hemorrhage, 12% (95% CI, 7–19) any ICH, and 0.7% (95%CI, 0–1) serious systemic bleeding, and 90‐day functional independence was achieved in 57% (95% CI, 43–70). The rates of symptomatic intracranial hemorrhage (3.4 versus 3.5%; OR, 0.95 [95% CI, 0.67–1.36]), any intracranial hemorrhage (17.7 versus 17.3%; OR, 1.23 [95% CI, 0.61–2.48]), serious systemic bleeding (0.7 versus 0.6%; OR, 1.27 [95% CI, 0.79–2.02]), and 90‐day modified Rankin scale score 0–2 (46.4 versus 56.8%; OR, 1.21 [95% CI, 0.400–3.67]) did not differ between DOAC and non‐DOAC groups. There was no difference in symptomatic intracranial hemorrhage rate based on idarucizumab administration.

Conclusions

Patients with acute ischemic stroke treated with IVT in recent DOAC versus non‐DOAC use have similar rates of hemorrhagic complications and functional independence. Further prospective randomized trials are warranted.
Revision of the genus Orbellis Distant, 1913 (Heteroptera: Rhyparochromidae)
Authors: ZÁMBÓ ANDRÁS , KOVÁCS SZILVIA , KONDOROSY ELŐD
Published: December 2023

The authors examined the Malagasy Lygaeoidea material of about 20 European collections, clarified the taxonomic position of Orbellis Distant, 1913 and described 7 new species (O. calcaratus Zámbó & Kondorosy, sp. nov., O. dentifemoralis Zámbó & Kondorosy, sp. nov., O. flavescens Zámbó & Kondorosy, sp. nov., O. guilberti Zámbó & Kondorosy, sp. nov., O. longirostris Zámbó & Kondorosy, sp. nov., O. nigriapicalis Zámbó & Kondorosy, sp. nov. and O. odonnellae Zámbó & Kondorosy, sp. nov.) from Madagascar. Three species: Neolethaeus maculosus Slater and O’Donnell, 1999, N. madagascariensis Slater and O’Donnell, 1999 and N. polhemi Slater and O’Donnell, 1999 are transferred to Orbellis. A key is given to separate the species.
On some benthic hydroids from New Zealand deep waters, with the description of a new species
Authors: CANTERO ÁLVARO LUIS PEÑA
Published: December 2023

Six species, including Symplectoscyphus trabeculatus sp. nov., have been found and studied in a small collection of benthic hydroids from deep waters south of New Zealand’s South Island. All species belong to Leptothecata, in particular to the families Campanulariidae, Hebellidae, Lafoeidae, Sertularellidae, Symplectoscyphidae and Zygophylacidae, all of them represented by a single species. Half of the species represent new records for New Zealand waters and Hebella macroplana Watson, 2019 is found for the second time and its gonotheca, hitherto unknown, is described.
Nonstationarity in the NAO–Gulf Stream SST Front Interaction
Authors: Famooss Paolini Luca , Omrani Nour-Eddine , Bellucci Alessio , Athanasiadis Panos J. , Ruggieri Paolo , Patrizio Casey R. , Keenlyside Noel
Published: December 2023

The interaction between the North Atlantic Oscillation (NAO) and the latitudinal shifts of the Gulf Stream sea surface temperature front (GSF) has been the subject of extensive investigations. There are indications of nonstationarity in this interaction, but differences in the methodologies used in previous studies make it difficult to draw consistent conclusions. Furthermore, there is a lack of consensus on the key mechanisms underlying the response of the GSF to the NAO. This study assesses the possible nonstationarity in the NAO–GSF interaction and the mechanisms underlying this interaction during 1950–2020, using reanalysis data. Results show that the NAO and GSF indices covary on the decadal time scale but only during 1972–2018. A secondary peak in the NAO–GSF covariability emerges on multiannual time scales but only during 2005–15. The nonstationarity in the decadal NAO–GSF covariability is also manifested in variations in their lead–lag relationship. Indeed, the NAO tends to lead the GSF shifts by 3 years during 1972–90 and by 2 years during 1990–2018. The response of the GSF to the NAO at the decadal time scale can be interpreted as the joint effect of the fast response of wind-driven oceanic circulation, the response of deep oceanic circulation, and the propagation of Rossby waves. However, there is evidence of Rossby wave propagation only during 1972–90. Here it is suggested that the nonstationarity of Rossby wave propagation caused the time lag between the NAO and the GSF shifts on the decadal time scale to differ between the two time periods.
A Machine Learning Approach to Model Over-Ocean Tropical Cyclone Precipitation
Authors: Lockwood Joseph W. , Loridan Thomas , Lin Ning , Oppenheimer Michael , Hannah Nic
Published: December 2023

Extreme rainfall found in tropical cyclones (TCs) is a risk for human life and property in many low- to midlatitude regions. Probabilistic modeling of TC rainfall in risk assessment and forecasting can be computationally expensive, and existing models are largely unable to model key rainfall asymmetries such as rainbands and extratropical transition. Here, a machine learning–based framework is developed to model overwater TC rainfall for the North Atlantic basin. First, a catalog of high-resolution TC precipitation simulations for 26 historical events is assembled for the North Atlantic basin using the Weather Research and Forecasting (WRF) Model. The simulated spatial distribution of rainfall for these historical events are then decomposed via principal component analysis (PCA), and quantile regression forest (QRF) models are trained to predict the conditional distributions of the first five principal component (PC) weights. Conditional distributions of rain-rate levels are estimated separately using historical satellite data and a QRF model. With these models, probabilistic predictions of rainfall maps can be made given a set of storm characteristics and local environmental conditions. The model is able to capture storm total rainfall compared to satellite observations with a correlation coefficient of 0.96 and r2 value of 0.93. Additionally, the model shows good accuracy in modeling hourly total rainfall compared to satellite observations. Rain-rate maps predicted by the model are also compared to historical satellite observations and to the WRF simulations during cross validation, and the spatial distribution of estimates captures rainfall variability consistent with TC rainbands, wavenumber asymmetries, and possibly extratropical transition.
Body Satisfaction and Disordered Eating Among Black Women Student Athletes: An Examination of Resilience, Self-Compassion, and Social Support
Authors: Jones Martinque K. , Petrie Trent ,   E. Whitney G. Moore
Published: December 2023

Low levels of body satisfaction have been consistently linked to disordered eating behaviors among women. However, few researchers have explored the mechanisms explaining this relationship among subgroups of women, who because of their social positioning (e.g., gender, race, and athlete status) may differ in the etiology of disordered eating. Accordingly, we surveyed 354 Black women student athletes (ages 18–24) to assess psychosocial health factors (resiliency, self-compassion, and social support) contributing to body satisfaction and disordered eating among this group. First, through a frequency analysis we determined approximately 50–60% of Black women student athletes reported being satisfied with their bodies, particularly with the muscularity and overall size and shape of their bodies. Second, a structural equation model supported the hypothesis that higher levels of self-compassion and social support contributed to greater body satisfaction, which, in turn, predicted athletes reporting fewer disordered eating behaviors. Our results suggest that body satisfaction is multidimensional, and there are specific psychosocial health factors that may bolster body satisfaction and protect against disordered eating among Black women student athletes.
Peer Ethnicity as a Mediator in the Relationship Between Ethnic Identity and Body Appreciation in Black College-Aged Women
Authors: Breiner Courtney E. , Miller McKenzie L. , Sanzari Christina M. , Perry Taylor R. , Hormes Julia M.
Published: December 2023

Strong ethnic identity is recognized as a protective factor against body image concern and eating pathology in Black women as they tend to hold cultural values in line with an acceptance of a variety of body shapes and sizes. Reinforcement of these cultural ideals may occur via same-race peer relationships. The current study examined the mediating role of same-race versus other-race peers in the relationship between ethnic identity and body appreciation in Black women. Participants were 139 Black undergraduate women ( Mage = 18.94 years, MBMI = 25.33) who completed validated measures of ethnic identity and body appreciation and reported on the ethnic makeup of their friends. We conducted mediation analysis examining the role of same-race peers on the relationship between ethnic identity and body appreciation. Same-race peers mediated the relationship between ethnic identity and body appreciation, where having a greater percentage of friends increased both ethnic identity and body appreciation in Black women. The influence of same-race peers should be considered in the development of culturally informed prevention and intervention efforts for eating pathology in Black women.
Comparison of six percent hydroxyethyl starch 130/0.4 and ringer’s lactate as priming solutions in patients undergoing isolated open heart valve surgery: A double-blind randomized controlled trial
Authors: Sheikhi Behzad , Rezaei Yousef , Baghaei Vaji Farnaz , Fatahi Mostafa , Hosseini Yazdi Mehdi , Totonchi Ziae , Banar Sepideh , Peighambari Mohammad Mehdi , Hosseini Saeid , Mestres Carlos - A
Published: December 2023

Objectives

Colloids are added to the priming solution of the cardiopulmonary bypass (CPB) pump to maintain colloid osmotic pressure and prevent fluid overload. This study aimed to compare the effects of 6% hydroxyethyl starch (HES) 130/0.4 and ringer’s lactate (RL) priming solution on patients’ outcomes undergoing isolated heart valve surgery with CPB.

Methods

This randomized clinical trial included one hundred and 20 patients undergoing heart valve surgery, and those were allocated into two groups. Patients in the RL group received 1500 mL of RL, and those in the RL + HES group were given 500 mL of HES and 1000 mL of RL.

Results

The patients’ median age was 52 (IQR 42–60) and 50 (IQR 40–61) years in the RL + HES and the RL group, respectively ( p = .71). The number of cases that required blood product transfusion in both the operating room and intensive care unit was also significantly higher in the RL + HES group compared to the RL group (RR 2.04, 95% CI 1.50–2.76; p < .01 and RR 1.42, 95% CI 1.01–2.01; p = .05, respectively). Declines in postoperative creatinine levels and platelet counts were higher in the RL + HES compared to the RL group (between-subjects effect p = .007 and p = .038, respectively), while the incidence of acute kidney injury was comparable between groups (RR 0.66, 95% CI 0.13–3.30; p = .55).

Conclusions

Among patients undergoing heart valve surgery with CPB, 6% HES added to RL for priming compared with only RL increased the risk of the need for blood product transfusion over the hospitalization period.
Real-Time Camera Image-Guided Nasoenteric Tube Placement in Prone COVID-19 ICU Patients: A Single-Center Study
Authors: Chen Yuequn , Wu Guiqiong , Qu Chaojun , Ye Zimao , Kang Yihao , Tian Xin
Published: December 2023

Background & Aims: This study aims to assess the application value of the real-time camera image-guided nasoenteric tube placement in critically ill COVID-19 patients undergoing endotracheal intubation and prone position ventilation therapy. Methods: We enrolled 116 COVID-19 patients receiving endotracheal intubation and prone position ventilation therapy in the intensive care unit (ICU). Patients were randomly divided into the real-time camera image-guided nasoenteric tube placement (n = 58) and bedside blind insertion (n = 58) groups. The success rate, placement time, complications, cost, heart rate, respiratory rate, Glasgow Coma Scale (GCS), and Acute Physiology and Chronic Health Evaluation II (APACHE-II) scores were compared between the 2 groups. Results: For ICU patients with COVID-19 undergoing prone position ventilation therapy, the success rate and cost were significantly higher in the real-time camera image-guided group compared to the bedside blind group ( P < .05). The placement time and complication incidence were significantly lower in the real-time camera image-guided group ( P < .05). The differences in heart rate, respiratory rate, GCS scores, and APACHE-II scores were insignificant ( P > .05). Conclusions: The real-time camera image-guided nasoenteric tube placement system had advantages for ICU COVID-19 patients undergoing prone position ventilation therapy, including a high success rate, short placement time, and no impact on patient position during tube placement. Real-time camera image-guided nasoenteric tube placement can be performed in any position, and demonstrates high efficiency, safety, and accuracy.
Sociodemographic Correlates of Low Health Literacy Skills Among Cancer Survivors: National Findings From BRFSS 2016
Authors: Chen Qi , Moore John , Noel Lailea , von Sternberg Kirk , Jones Barbara
Published: December 2023

Purpose

This study aimed to explore associations of sociodemographic factors with difficulties in three health literacy (HL) skills and the severity of low HL skills.

Design

Cross-sectional secondary data analysis. Subjects: Data came from 17,834 adults who responded to the HL module with a response rate of 47% in the 2016 Behavioral Risk Factor Surveillance System.

Measures

Independent variables included sex, age, race/ethnicity, education, employment and income. Dependent variables are three HL skills: obtaining, understanding oral, and understanding written health information.

Analysis

We conducted weighted Chi-square tests and multinominal logistic regressions.

Results

Cancer survivors younger than 65 (aged 18-39: AOR = 4.46, P < .001; aged 40-64: AOR = 2.29, P < .001), Hispanic (AOR = 2.17, CI = 1.61-2.50, P < .01) had higher odds of difficulty obtaining health information. Female cancer survivors had lower odds of difficulty comprehending oral (AOR = .69, CI = .55-.87, P < .01) and written (AOR = .58, CI = .46-.74, P < .001) information. The relative risk ratio of having difficulties in three HL tasks was higher for those who were younger than 65 (aged 18-39: RRR = 10.18, CI = 2.41-4.3, P < .01; aged 40-64: RRR = 4.01, CI = 2.09-7.69, P < .001), Hispanic (RRR = 3.24, CI = 1.66-11.34, P < .01), unemployed (RRR = 6.1, CI = 2.88-12.76, P < .001), education levels lower than some college (some high school: RRR = 4.34, P < .01; high school: RRR = 2.62, P < .05) and household income under $25,000 (RRR = 6.99, CI = 2.8-17.5, P < .001).

Conclusion

Intervention and communication materials need to be tailored for patients with different HL skills considering age, gender, socioeconomic status and cultural backgrounds.
A forecasting model for optimizing abrasive water jet machining (AWJM) parameters based on the adaptive neuro-fuzzy inference system and meta-heuristic algorithms
Authors: Jithendra Thandra , Basha S. Sharief
Published: December 2023

Innovative materials have been steadily produced in the machining process, and it has stimulated substantial attention among researchers to assess the ideal parameters for the processing of these materials. In the manufacturing industry, conventional and modern or unconventional machining retains their imprint in delivering quality products. One of the most frequently used contemporary machining processes is abrasive water jet machining (AWJM) for cutting materials. The optimization of parameters, however, is essential to manufacturing high-quality products quickly and affordably. This study focused on optimizing the machining parameters of AWJM using the Adaptive Neuro-Fuzzy Inference System (ANFIS) by encrypting the evolutionary algorithms, including the reptile search algorithm (RSA), beetle antennae search (BAS), and particle swarm optimization (PSO). As a result of the developed methods, the surface roughness of titanium alloy (Ti–6Al–4V) during AWJM machining is predicted by considering inputs such as standoff distance, abrasive flow rate, and traverse speed, which affect the surface roughness. Based on a comparison of the prediction accuracy of the proposed methods, it was found that the combined ANFIS and RSA outperforms the others. In the simulation results, ANFIS-RSA (Adaptive Neuro-Fuzzy Inference System and Reptile Search Algorithm) yielded the most accurate estimates of surface roughness based on the RMSE (0.1241), MAE (0.0961), MAPE (0.0201), and R2 (0.9781) values. In particular, the analysis findings demonstrated that the combination of ANFIS and RSA was the most effective approach for predicting surface roughness on titanium alloy during AWJ machining.