bluuebunny/crossref_metadata_2025 huggingface dataset:
Milling Characteristics and Damage Assessment of Ultrasonic Vibration-Assisted End Milling Cf/SiC Composites
Authors: Wang Zhongwang , Dong Zhigang , Bao Yan , Ran Yichuan , Kang Renke
Published: December 2024

Cf/SiC composites are characterized as anisotropic, heterogeneous, brittle, and hard materials. The process of manufacturing Cf/SiC composites using traditional machining techniques is prone to edge chipping damage and tool wear, which makes it difficult to meet the machining quality and machining accuracy. The purpose of this paper is to investigate the milling characteristics and damage assessment during ultrasonic vibration-assisted end milling (UVAEM) of Cf/SiC composites. Firstly, UVAEM experiments on Cf/SiC composites were carried out at different ultrasonic amplitudes and comparative experiments with conventional milling (CM). In addition, tool wear, surface roughness, surface micromorphology, milling force and subsurface damage (SSD) were measured and analysed. Finally, the SSD factors of Cf/SiC composites were established to quantify machining damage, and analyzed the effect of ultrasonic amplitude on SSD. Furthermore, the formation mechanism of SSD was investigated and discussed. The findings indicate that appropriate ultrasonic amplitude improves the surface quality by UVAEM, while excessive amplitude deteriorates the surface quality. During the UVAEM, micro/macro brittle fracture of the fibers on the surface occurs, leading to machining defects such as fiber breakage, fiber-interface debonding and pits. The milling force gradually decreases with the increase of ultrasonic amplitude. On the other hand, the forms of SSD in CM and UVAEM are mainly fiber pullout, subsurface crack, crack extension and machining pits. Matrix cracking and fiber pullout in SSD were affected by fiber orientation. Moreover, the introduction of ultrasonic vibration plays a significant contribution in the inhibition of the SSD in Cf/SiC composites.
Telemedicine for HIV care: a cross-sectional survey of people living with HIV receiving care at two federally qualified health centers in Los Angeles during a mature phase of the COVID-19 pandemic
Authors: Walker Daisy , Moucheraud Corrina , Butler Derrick , Takayama Christian , Shoptaw Steven , Currier Judith S. , Gladstein Jay , Hoffman Risa
Published: December 2024

Background

The COVID-19 pandemic resulted in the rapid implementation of telemedicine for HIV care at federally qualified health centers (FQHCs) in the United States. We sought to understand use of telemedicine (telephone and video) at two FQHCs in Los Angeles, and the client attitudes towards and experiences with telemedicine as part of future HIV care.

Methods

We conducted surveys with 271 people living with HIV (PLHIV), with questions covering sociodemographic factors, telemedicine attitudes and experiences, technological literacy, and access to technological resources and privacy. Survey data were analyzed utilizing summary statistics, chi-square analyses, and Fisher’s exact test to understand associations between sociodemographic factors and telemedicine attitudes and experiences.

Results

Sixty percent of the sample had used any telemedicine and, of these, 93% utilized only telephone visits. Almost all respondents (95%, n = 257) had access to a functioning smartphone and self-rated their technological literacy as high. Most had consistent access to privacy (88%, n = 239), and those without privacy noted this as a barrier to the use of telemedicine. The main benefits of telemedicine (compared to in person) were savings of time and money, convenience, and ability to complete appointments as scheduled. Just over half of PLHIV said they would feel more comfortable discussing sensitive topics (e.g., substance use, relationship issues) in person than over telephone (60%, n = 164) or video (55%, n = 151). Despite limited experience with video telemedicine, half of all participants desired a mix of telephone and video visits as part of their future HIV care.

Conclusions

During a mature phase of the COVID-19 pandemic, PLHIV in our study showed high satisfaction with telemedicine, largely conducted as telephone visits, and high interest in telemedicine visits as a component of their future HIV care. Future studies should explore barriers to implementing video telemedicine in FQHCs and determine telemedicine’s impact on clinical outcomes, including engagement and viral suppression.
Treatment and counselling preferences of postpartum women with and without symptoms of (childbirth-related) PTSD: findings of the cross-sectional study INVITE
Authors: Horstmann Rosa Hannele , Seefeld Lara , Schellong Julia , Garthus-Niegel Susan
Published: December 2024

Background

Post-traumatic stress disorder (PTSD) in the postpartum period is a prevalent yet under-researched mental health condition. To date, many women who suffer from postpartum PTSD remain unrecognized and untreated. To enhance the accessibility of help for these women, it is crucial to offer tailored treatment and counselling services that align with their needs. This study aimed to understand how support preferences differ between women with and without postpartum PTSD, considering the two subgroups of postpartum PTSD: childbirth-related PTSD (CB-PTSD) and general PTSD (gPTSD).

Methods

This study used data from the cross-sectional INVITE study, comprising telephone interviews with N = 3,874 women conducted six weeks to six months after childbirth. The City Birth Trauma Scale (City BiTS) was used to assess CB-PTSD, while the Primary Care Posttraumatic Stress Disorder Screen for DSM-5 (PC-PTSD-5) was used to assess gPTSD. Service preferences and preferred modes of service provision were measured with self-developed questionnaires. Analyses of variance were used to identify differences between groups.

Results

The support services (family-)midwives and family, friends, or colleagues and the service provision mode as in person communication were preferred most by women across groups. The analyses revealed that women with CB-PTSD had lower overall preferences for services compared to women without postpartum PTSD. Women with CB-PTSD also showed less preference for psychotherapeutic services (e.g. outpatient treatment, inpatient clinics) compared to women without postpartum PTSD. Regarding modes of service provision, women with gPTSD had a higher preference for all service modes compared to women with CB-PTSD and those without postpartum PTSD, with a stronger preference for both direct (e.g. in person, video conference) and delayed communication (e.g. chat, e-mail).

Conclusion

This study was the first to explore the support preferences of women experiencing symptoms of postpartum PTSD. Findings suggest that women differ in their preferences, contingent upon the subgroup of postpartum PTSD. According to women's overall preferences, the expansion and further training of (family-)midwife services is recommended. By tailoring support services accordingly to women’s preferences, it may be possible to bridge the treatment gap for postpartum PTSD and to improve the well-being of affected women and their families.
Assessment of the efficacy of palliative sedation in advanced cancer patients by evaluating discomfort levels: a prospective, international, multicenter observational study
Authors: Rijpstra Maaike , Vissers Kris , Belar Alazne , Van der Elst Michael , Surges Séverine Marie , Adile Claudio , Rojí Rocío , Grassi Yasmine , Bronkhorst Ewald , Mercadante Sebastiano , Radbruch Lukas , Menten Johan , Centeno Carlos , Kuip Evelien , Hasselaar Jeroen
Published: December 2024

Background

Palliative sedation involves the intentional proportional lowering of the level of consciousness in patients with life-limiting disease who are experiencing refractory suffering. The efficacy of palliative sedation needs to be monitored to ensure patient comfort. The aim of this study was to evaluate the efficacy using discomfort levels combined with sedation/agitation levels.

Methods

In this prospective observational study, adult patients with advanced malignancies were recruited from hospice units, palliative care units, and hospital wards in five European countries. Health care professionals used proxy observations of discomfort levels (Discomfort Scale-Dementia of Alzheimer Type, range 0–27) and sedation/agitation levels (Richmond Agitation-Sedation Scale modified for palliative care inpatients), range − 5 to + 4) to evaluate the efficacy of palliative sedation.

Results

In 78 participants, discomfort levels were monitored during palliative sedation. The mean discomfort score before start was 9.4 points (95% CI 8.3–10.5), which showed a significant decrease of 6.0 points (95% CI 4.8–7.1) after start of sedation for the total sedation period. In the multivariable analysis, no significant factors influencing baseline discomfort levels were identified. The discomfort and depth of sedation scores were found to be positively correlated, with an r of 0.72 (95% CI 0.61–0.82). The internal consistency of the discomfort scale was good (0.83), but the “Noisy breathing” item was less informative of the total discomfort score.

Conclusions

The efficacy of palliative sedation can be evaluated by measuring discomfort levels combined with sedation/agitation levels. The measurement of discomfort levels might provide a more specific and detailed evaluation of adequate sedation.

Trial registration

This study is registered at ClinicalTrials.gov since January 22, 2021, registration number: NCT04719702.
Occurrence of Taenia species and Toxoplasma gondii in pigs slaughtered in Bujumbura city, Kayanza and Ngozi provinces, Burundi
Authors: Minani Salvator , Spiessens Emma , Labarrière Alyssa , Niyokwizera Pascal , Gasogo Anastasie , Ntirandekura Jean-Bosco , Trevisan Chiara , Gabriël Sarah
Published: December 2024

Background

Taenia spp. and Toxoplasma gondii are foodborne parasites affecting humans and pigs. The magnitude of the burden of these parasites in pigs in Burundi is not known. Therefore, this study aimed to estimate the prevalence of Taenia spp. infections in pigs by meat inspection, partial carcass dissection and molecular confirmation and estimate the prevalence of Toxoplasma gondii infection in pigs by serology. A cross-sectional study was conducted in pig slaughter slabs located in Bujumbura city, Kayanza and Ngozi provinces. Multisampling strategies were used to sample 576 pigs. Upon pig slaughter, blood samples were collected to perform indirect ELISA for detecting antibodies against the T. gondii P30 protein in the serum. Routine meat inspection was carried out to detect T. solium and T. hydatigena cysticerci. The tongue, heart and masseter muscles were dissected by making slices less than 5 mm thick to estimate the intensity and stages of T. solium cysticerci. A subset of cysticerci and suspected lesions per infected pig were examined using PCR-RFLP to differentiate Taenia spp.

Results

Of the 576 pigs, 14 (2.4%) were positive for T. solium cysticercosis by meat inspection and 67 (11.6%) by partial carcass dissection. After molecular analysis, 66 (11.5%) samples were confirmed to be T. solium infections. The average of T. solium cysticerci in the dissected organs was estimated at 80 cysticerci. Most cysticerci (76.1%) were counted in the masseter muscles, followed by the tongue (18.8%) and the heart (5.1%). The majority of cysticerci (88.3%) were viable, 6.4% were calcified and 5.3% were degenerated. Approximately 69% of the pigs infected with T. solium had light infections, 13.4% had moderate infections and 17.9% had heavy infections. Thirty-two out of 576 pigs (5.5%) were suspected of being infected with T. hydatigena by meat inspection, but 24 pigs (4.2%) were confirmed molecularly to be positive for T. hydatigena infection. The seroprevalence of T. gondii infection in pigs was 17.7%.

Conclusions

This study indicates that T. solium and T. gondii parasites are endemic in Burundi and provides evidence of potential public health risks for the local population. Effective control strategies, including improved pig farming practices, better hygiene and sanitation, increased meat inspection, monitoring of infected pigs, risk-free culinary practices, and treatment of tapeworm carriers, should be implemented to avoid the perpetual contamination of pigs and humans with these zoonotic parasites.
“It’s a delicate balance”: clinicians’ experiences of providing heroin-assisted treatment
Authors: Ellefsen Rune , De Pirro Silvana , Haukland Vegard , Wüsthoff Linda Elise Couëssurel , Arnevik Espen Ajo
Published: December 2024

Background

Little attention has been paid to the experiences of clinicians and health personnel who provide heroin-assisted treatment (HAT). This study provides the first empirical findings about the clinicians’ experiences of providing HAT in the Norwegian context.

Methods

23 qualitative interviews were conducted with 31 clinicians shortly after HAT clinics opened in Norway’s two largest cities: Oslo and Bergen. By inductive thematic analysis of interview transcripts, we identified what research participants experienced and viewed as the chief rewards and challenges of providing HAT. The study aimed to offer an overview of these key rewards and challenges, with insights potentially transferable to HAT programs internationally.

Results

Participants experienced three aspects of providing HAT as particularly rewarding, and three as most challenging. The rewarding aspects were observing harm reduction outcomes; providing holistic care; and having a positive clinic milieu and patient–clinician relationships. The challenging aspects were dosing and overdose risk; rule enforcement and aggression management; and the difficulty of initiating treatments beyond medication and harm reduction. The rewarding and challenging aspects of providing HAT overlapped and were at times contradictory, thus reflecting the duality and tensions in clinicians’ work to provide HAT. The challenges were reported to vary between patient subgroups, according to their degree of instability. The most unstable patients were seen as involving more difficulties as regards the challenging aspects of HAT. Participants expressed uncertainty about HAT’s utility for a small group of the most unstable patients.

Conclusion

While studies about clinical experiences of HAT have usually examined individual or limited aspects of treatment provision, this study provided an overview of the main aspects of the rewards and challenges of providing HAT. Importantly, it also showed the tensions between these overlapping and sometimes contradictory aspects of HAT provision. Because a positive patient–clinician relationship is crucial to patient satisfaction and treatment outcomes in HAT, the provision of training for clinicians on navigating the inherent tensions of HAT provision, nurturing therapeutic alliances with patients, and managing their role as gatekeepers to medical heroin and valuable services, seem particularly important for ensuring that care is patient-centered and staff are adequately supported.
Differentiation status determines the effects of IFNγ on the expression of PD-L1 and immunomodulatory genes in melanoma
Authors: Sævarsson Teitur , de Lomana Adrián López García , Sánchez Ólafur , van Esch Veerle , Ragnarsson Gunnar Bjarni , Brynjólfsson Siggeir Fannar , Steingrímsson Eiríkur , Einarsdóttir Berglind Ósk
Published: December 2024

Background

Melanoma cells frequently dedifferentiate in response to inflammation which can increase responses to certain cytokines. Interferon-γ (IFNγ) is an integral part of the anti-tumor immune response and can directly induce both differentiational changes and expression of immunosuppressive proteins in melanoma cells. How the differentiation status of melanoma cells affects IFNγ responses remains unclear.

Methods

Dedifferentiation of melanoma cells was induced via either siRNA or shRNA mediated MITF knockdown and the cells were subsequently treated with IFNγ. Effects of MITF knockdown and IFNγ treatment on gene expression were evaluated via qPCR and RNA sequencing. A Luminex assay was used to analyze the effects of dedifferentiation and IFNγ treatment on cytokine secretion. Effects on PD-L1 protein expression were analyzed via flow cytometry and western blotting. Inhibition of the JAK kinases, NF-κB and STAT3 with small molecule inhibitors, and siRNA mediated knockdown of STAT1 and IRF1 was applied to investigate the molecular mechanism behind IFNγ induced PD-L1 expression in dedifferentiated melanoma cells. The effects of inhibitor treatments and siRNA mediated knockdowns were evaluated via qPCR and western blotting. Bioinformatic analysis of publicly available RNA sequencing data, consisting of 45 patient derived melanoma cell lines, with or without IFNγ treatment, was conducted to assess the generalizability of the in vitro results.

Results

Dedifferentiation renders 624Mel melanoma cells hypersensitive to IFNγ stimulation in a context-dependent manner, resulting in non-additive upregulation of IFNγ-induced genes, increased PD-L1 protein expression and amplified secretion of CCL2, CXCL10 and IL-10. Furthermore, the intensified PD-L1 protein expression occurs through the JAK-STAT1-IRF1 axis. Lastly, dedifferentiated patient derived melanoma cell lines showed enhanced inflammatory signaling in response to IFNγ compared to differentiated cells, and tended to have higher PD-L1 expression, associated with increased IRF1 expression and activity.

Conclusions

Together, these findings indicate the existence of a molecular context linking dedifferentiation and IFNγ signaling in melanoma which may lead to immune evasion. Additionally, the variability in PD-L1 expression among MITFlow and MITFhigh cells suggests that high IFNγ-induced PD-L1 expression associates with enhanced inflammatory gene expression. These results imply that modulating melanoma differentiation may help shape IFNγ responsiveness.

Graphical Abstract
Supporting teams with designing for dissemination and sustainability: the design, development, and usability of a digital interactive platform
Authors: Kepper Maura M. , L’Hotta Allison J. , Shato Thembekile , Kwan Bethany M. , Glasgow Russell E. , Luke Douglas , Graham Andrea K. , Baumann Ana A. , Brownson Ross C. , Morse Brad
Published: December 2024

Background

Designing for Dissemination and Sustainability (D4DS) principles and methods can support the development of research products (interventions, tools, findings) that match well with the needs and context of the intended audience and setting. D4DS principles and methods are not well-known or used during clinical and public health research; research teams would benefit from applying D4DS. This paper presents the development of a new digital platform for research teams to learn and apply a D4DS process to their work.

Methods

A user-centered design (UCD) approach engaged users (n = 14) and an expert panel (n = 6) in an iterative design process from discovery to prototyping and testing. We led five design sessions using Zoom and Figma software over a 5-month period. Users (71% academics; 29% practitioners) participated in at least 2 sessions. Following design sessions, feedback from users was summarized and discussed to generate design decisions. A prototype was then built and heuristically tested with 11 users who were asked to complete multiple tasks within the platform while verbalizing their decision-making using the ‘think aloud’ procedure. The System Usability Scale (SUS) was administered at the end of each testing session. After refinements to the platform were made, usability was reassessed with 7 of 11 same users to examine changes.

Results

The interactive digital platform (the D4DS Planner) has two main components: 1) the Education Hub (e.g., searchable platform with literature, videos, websites) and 2) the Action Planner. The Action Planner includes 7 interactive steps that walk users through a set of activities to generate a downloadable D4DS action plan for their project. Participants reported that the prototype tool was moderately usable (SUS = 66) but improved following refinements (SUS = 71).

Conclusions

This is a first of its kind tool that supports research teams in learning about and explicitly applying D4DS to their work. The use of this publicly available tool may increase the adoption, impact, and sustainment of a wide range of research products. The use of UCD yielded a tool that is easy to use. This tool's future use and impact will be evaluated with a broader sample of community partners and projects and the tool will continue to be refined and improved.
Daidzein improves muscle atrophy caused by lovastatin by regulating the AMPK/FOXO3a axis
Authors: Wang Keke , Zeng Hao , Yang Hua
Published: December 2024

Background

Lovastatin, the main lipid-lowering component in red yeast rice, is a golden anti-lipid drug, but its long-term application is continuously challenged by potential skeletal muscle atrophy. Daidzein, an isoflavone derived from soybeans and many Chinese medicines, shows therapeutic potential in treating muscle-related diseases and metabolic disorders. However, whether daidzein can improve lovastatin-induced muscle atrophy and the specific mechanism needs to further study.

Methods

Lovastatin-induced mice and zebrafish muscle atrophy models were used to validate the protective effect of daidzein in vivo. And the lovastatin-induced C2C12 myotube atrophy model was employed to validate the therapeutic efficacy and investigate the specific mechanism of daidzein in vitro. We combined specific siRNA targeting FOXO3a and AMPK-selective inhibitor, agonist to elucidate AMPK/FOXO3a-dependent muscle-protective mechanism of daidzein. The anti-atrophy effects of daidzein through blockage of abnormal activation of AMPK/FOXO3a was presented in Immunofluorescence, H&E staining, Western blot, qRT-PCR. Serum creatine kinase level was detected by ELISA and we used mouse muscle grip instrument to detect the strength of mouse muscles.

Results

In this study, we demonstrated that daidzein could dose-dependently alleviate lovastatin-induced mice skeletal muscle atrophy, reduce serum creatine kinase, and improve muscle grip strength in mice. Mechanistically, daidzein inhibited lovastatin-induced FOXO3a phosphorylation caused by AMPK activation, thereby inhibiting FOXO3a nuclear translocation to restrain the expression of muscle-related proteins Atrogin-1 and MuRF-1. In C2C12 myotube, administration of AMPK-selective inhibitor Compound C recapitulated the therapeutic effects of daidzein against lovastatin-induced myotubes atrophy, while the anti-atrophy effects of daidzein were lost in the presence of AMPK-selective agonist MK-3903. In lovastatin-induced mice muscle atrophy models, Compound C elicited similar anti-atrophy effects as daidzein, but this effect was not potentiated when it was applied in combination with daidzein, suggesting that daidzein exerted therapeutic efficacy dependent on blockage of AMPK activity.

Conclusions

Our study identified daidzein as an effective component that ameliorated lovastatin-induced skeletal muscle atrophy through blockage of abnormal activation of AMPK/FOXO3a and transcriptional activation of genes encoding downstream muscle-related proteins. Our results also highlighted the therapeutic potential by regulating the AMPK/FOXO3a axis in management of statin-induced myotoxicity.
A case of subcutaneous metastatic malignant melanoma of the left medial ankle: a case report and review of literature
Authors: Workman Lauren , Fang Lauren , Blazevic Martina , Chen Joanna , Simman Richard
Published: December 2024

Background

Although rare, melanoma confined to the dermis or subcutaneous tissue without evidence of a primary cutaneous site should provoke consideration of melanoma of unknown primary. This diagnosis carries a favorable prognosis when compared with cutaneous metastatic melanoma. Several hypotheses have been proposed for how melanoma of unknown primary develops, two of which were considered in our patient case: (1) spontaneous regression of the primary tumor following metastasis or (2) the traumatic implantation of ectopic melanocytic cells in other tissues, such as the subcutaneous tissue. Although not a true example of melanoma of unknown primary, our case is still noteworthy as it represents a unique instance of melanoma presenting subcutaneously from trauma to a preexisting epidermal nevus.

Case presentation

We present the case of a 66-year-old non-Hispanic Caucasian male who initially sought evaluation for a nontender lump of the left groin. Ultrasound-guided needle biopsy demonstrated stage III malignant melanoma. Upon further history taking, it was discovered that he had a nevus of the left medial ankle that was subjected to traumatic removal. He later developed a subcutaneous nodule at the same site. Positron emission tomography scan results supported the histopathologic findings which demonstrated invasive melanoma centered in the subcutaneous tissue without an epidermal component. Following left inguinal lymph node dissection, the patient received adjuvant immunotherapy and radiation to the left inguinal area. At 6 months following completion of therapy, metastases were identified in the lungs, vertebra, ribs, and liver. The patient is currently receiving immunotherapy with ipilimumab-nivolumab.

Conclusion

As our patient did not have a readily apparent primary epidermal melanoma site at presentation, consideration was given as to whether this case may represent a melanoma of unknown primary, as originally defined by Das Gupta. This case does not meet the proposed criteria, however, as the patient reported a preexisting nevus in the area that was subjected to traumatic removal. Instead, we postulate that this trauma allowed for implantation of melanocytes into the subcutaneous tissue that later resulted in a malignant melanoma.
PATL2 mutations affect human oocyte maternal mRNA homeostasis and protein interactions in cell cycle regulation
Authors: Zhang Yin-Li , Hu Zhanhong , Jiang Huifang , Jin Jiamin , Zhou Yan , Lai Mengru , Ren Peipei , Liu Siya , Zhang Ying-Yi , Rong Yan , Zheng Wei , Zhang Shen , Tong Xiaomei , Zhang Songying
Published: December 2024

Background

Oocyte maturation defect (OMD) and early embryonic arrest result in female infertility. Previous studies have linked biallelic mutations in the PATL2 gene to OMD, yet the underlying mechanism remains largely unknown.

Results

This study uncovers three novel mutations (c.1201G > T, c.1284delA and c.1613 + 2_1613 + 3insGT) and three reported mutations (c.1204 C > T, c.1271T > C, c.223 − 14_223-2delCCCTCCTGTTCCA) in the PATL2 gene across five unrelated individuals exhibiting OMD, oocyte death, and early embryonic arrest. RNA sequencing revealed that PATL2 mutations decreased mRNA storage in human germinal vesicle (GV) oocytes and impeded mRNA decay during maturation and in early embryos. We demonstrate that PATL2 interacts with CPEB1 and TUT7 in human oocytes to maintain mRNA homeostasis. Additionally, we observed a reduction in CCNB1 and CCNE1 mRNA levels in PATL2-mutant GV oocytes, which may be linked to GV arrest. Employing both wild-type and mutated PATL2V401F/R402W variants, we characterized the protein interactome of PATL2, identifying disruptions of PATL2V401F/R402W variants predominantly affecting cell cycle-related proteins, including CDC23, APC1 and MAD2L1. PATL2’s interaction with and stabilization of CDC23 in oocytes may elucidate the mechanisms behind the mutation-induced MI arrest. PALT2 is required for the efficient mRNA translation and it maintains the protein level of CDC23, APC1 and MAD2L1 in mouse GV oocyte.

Conclusion

PATL2 plays a critical role in regulating mRNA accumulation and decay in human oocytes, potentially through interactions with CPEB1 and TUT7, respectively. Mutations in PATL2 lead to oocyte meiosis defects by affecting the mRNA accumulation, mRNA translation, and direct binding to and stabilizing proteins related to cell cycle regulation, such as CCNB1 and CDC23. This study expands the mutational spectrum of PATL2 and provides new insights into the molecular mechanisms underlying PATL2 mutation-associated oocyte maturation disorders.
Association of continuous renal replacement therapy downtime with fluid balance gap and clinical outcomes: a retrospective cohort analysis utilizing EHR and machine data
Authors: Braun Chloe , Takeuchi Tomonori , Lambert Josh , Liu Lucas , Roberts Sarah , Carter Stuart , Beaubien-Souligny William , Tolwani Ashita , Neyra Javier A.
Published: December 2024

Background

Fluid balance gap (FBgap—prescribed vs. achieved) is associated with hospital mortality. Downtime is an important quality indicator for the delivery of continuous renal replacement therapy (CRRT). We examined the association of CRRT downtime with FBgap and clinical outcomes including mortality.

Methods

This is a retrospective cohort study of critically ill adults receiving CRRT utilizing both electronic health records (EHR) and CRRT machine data. FBgap was calculated as achieved minus prescribed fluid balance. Downtime, or percent treatment time loss (%TTL), was defined as CRRT downtime in relation to the total CRRT time. Data collection stopped upon transition to intermittent hemodialysis when applicable. Linear and logistic regression models were used to analyze the association of %TTL with FBgap and hospital mortality, respectively. Covariates included demographics, Sequential Organ Failure Assessment (SOFA) score at CRRT initiation, use of organ support devices, and the interaction between %TTL and machine alarms.

Results

We included 3630 CRRT patient-days from 500 patients with a median age of 59.5 years (IQR 50–67). Patients had a median SOFA score at CRRT initiation of 13 (IQR 10–16). Median %TTL was 8.1% (IQR 4.3–12.5) and median FBgap was 17.4 mL/kg/day (IQR 8.2–30.4). In adjusted models, there was a significant positive relationship between FBgap and %TTL only in the subgroup with higher alarm frequency (6 + alarms per CRRT-day) (β = 0.87 per 1% increase, 95%CI 0.48–1.26). No association was found in the subgroups with lower alarm frequency (0–2 and 3–5 alarms). There was no statistical evidence for an association between %TTL and hospital mortality in the adjusted model with the interaction term of alarm frequency.

Conclusions

In critically ill adult patients undergoing CRRT, %TTL was associated with FBgap only in the subgroup with higher alarm frequency, but not in the other subgroups with lower alarms. No association between %TTL and mortality was observed. More frequent alarms, possibly indicating unexpected downtime, may suggest compromised CRRT delivery and could negatively impact FBgap.
Prediction of Ki-67 expression in gastric gastrointestinal stromal tumors using histogram analysis of monochromatic and iodine images derived from spectral CT
Authors: Liu Xianwang , Han Tao , Wang Yuzhu , Liu Hong , Deng Juan , Xue Caiqiang , Li Shenglin , Zhou Junlin
Published: December 2024

Purpose

To assess and compare the diagnostic efficiency of histogram analysis of monochromatic and iodine images derived from spectral CT in predicting Ki-67 expression in gastric gastrointestinal stromal tumors (gGIST).

Methods

Sixty-five patients with gGIST who underwent spectral CT were divided into a low-level Ki-67 expression group (LEG, Ki-67 < 10%, n = 33) and a high-level Ki-67 expression group (HEG, Ki-67 ≥ 10%, n = 32). Conventional CT features were extracted and compared. Histogram parameters were extracted from monochromatic and iodine images, respectively. The diagnostic efficiency of the histogram parameters from monochromatic and iodine images was assessed and compared between the two groups. Spearman’s correlation analysis was used to correlate histogram parameters with Ki-67 expression.

Results

The HEG was more likely to present with an irregular shape and a larger size than the LEG (all p < 0.05). Regarding histogram parameters, the HEG showed higher maximum, mean, Perc.10, Perc.25, Perc.50, Perc.75, Perc.90, Perc.99, SD, variance, and CV of monochromatic images; higher maximum, Perc.99, and entropy of iodine images, compared with the LEG (all p < 0.003125). ROC analysis showed that significant histogram parameters of monochromatic and iodine images allowed for effective differentiation between LEG and HEG. DeLong’s test showed that the diagnostic efficiency of histogram parameters in monochromatic images (Perc.90) was superior to that of iodine images (maximum) (p = 0.010). A positive correlation was observed between the significant histogram parameters and Ki-67 expression (all p < 0.05).

Conclusion

Both histogram analysis of monochromatic and iodine images derived from spectral CT can predict Ki-67 expression in gGIST, and the diagnostic efficacy of monochromatic images is superior to iodine images.
Facilitators’ experiences with virtual simulation and their impact on learning
Authors: Verkuyl Margaret , Violato Efrem , Southam Theresa , Lavoie-Tremblay Mélanie , Goldsworthy Sandra , MacEachern Diane , Atack Lynda
Published: December 2024

Background

Increasingly, virtual simulations are being integrated into higher education. A successful experience goes far beyond simply offering learners access to a virtual simulation; it requires a facilitator who understands the learners’ needs and course objectives, choses the right virtual simulation for the learner, creates a welcoming space that promotes learning, and evaluates the experience.

Methods

Facilitators from three different healthcare programs and six educational institutions and students from two different healthcare programs were included in this exploratory qualitative research study. Interviews and focus groups and thematic analysis were conducted to understand the role of the facilitator when using virtual simulations and their impact on student learning.

Results

The facilitator themes were supported by the student focus groups. The first theme, the facilitator experience, included sub-themes of simulation pedagogy and debriefing with a practice partner. The second theme was virtual simulation: impact on learning and included sub-themes on student outcomes, technology and design, and repetitive play.

Conclusion

Effective facilitation skills are integral to quality virtual simulation experiences. Trained facilitators help students achieve virtual simulation learning outcomes and prepare for clinical practice.
The study on multi-defect detection for leather using object detection techniques
Authors: Ataç Hasan Onur , Kayabaşı Ahmet , Aslan M. Fatih
Published: December 2024

Leather has played a very important role in human life for thousands of years. Ensuring the quality of leather and addressing surface defects poses significant challenges. Traditionally, human inspectors are responsible for detecting surface defects in tanneries, but this approach is labor-intensive and susceptible to human error. As a result, there is a growing demand for automated systems to detect the defects. Herein, artificial intelligence (AI) was developed to detect the defects on leather surfaces. Six targeted defect types, denoted as insect bites, scratches, holes, stitch marks, diseased and ruptures, were specifically addressed to enhance the overall quality assessment process. AI-based vision techniques were used to detect flaws on the leather on photographs taken with a high-resolution camera. Deep learning algorithms Mask R-CNN, YOLOv8 and within the framework of Detectron2, RetinaNet R101 3x, Faster R-CNN R101-FPN 3x models were performed and a comparison was made between these algorithms. By using the slicing aided hyper-inference (SAHI) algorithm in coordination with these algorithms, the detection rates of small defects on the images were increased. The highest accuracy rate was achieved when the YOLOv8 algorithm had 75 epoch values for training, and the SAHI algorithm had slice height-width values of 256 × 256 pixels.

Graphical Abstract
Reoperation for chronological complete dislodgement of the bioprosthetic aortic valve into the left ventricle due to Takayasu arteritis
Authors: Matsunaga Shogo , Sonoda Hiromichi , Ushijima Tomoki , Kan-o Meikun , Kimura Satoshi , Shiose Akira
Published: December 2024

Background

Takayasu arteritis is a large-vessel vasculitis, in addition to giant cell arteritis. Various post-operative complications associated with the cardiac macrovasculature have been reported. Detachment of the prosthetic valve, pseudoaneurysm formation, and dilatation of the aortic root are well-known post-operative complications associated with vasculitis syndromes, including Takayasu arteritis. Here, we report a rare complication involving aortic bioprosthetic valve dislodgement in the left ventricular outflow tract due to Takayasu arteritis.

Case presentation

A 76-year-old female underwent aortic valve replacement with a 21-mm Carpentier–Edwards Perimount valve for severe aortic regurgitation and a coronary artery bypass graft from the left internal thoracic artery to the left anterior descending artery for ischemic heart disease. Fourteen years after the initial surgery, echocardiography revealed severe aortic valve sclerosis due to structural valve deterioration of the bioprosthesis. Upon scrutiny, the bioprosthetic aortic valve was found to have dislodged into the left ventricular outflow tract. We performed re-implantation of the bioprosthetic aortic valve and replacement of the ascending aorta.

Conclusions

Although dislodgement of the bioprosthetic aortic valve is an extremely rare complication associated with Takayasu arteritis, the possibility that it could occur should be considered when treating the post-operative patients.
Better Alone? Evidence on the Costs of Intermunicipal Cooperation
Authors: Tricaud Clemence
Published: December 2024

This paper provides new evidence on why municipalities are often reluctant to integrate. Exploiting a French reform that made inter-municipal cooperation mandatory, I find that municipalities forced to integrate experienced a large increase in construction, consistent with NIMBYism, explaining their resistance and that rural municipalities ended up with fewer local public services. I do not find the same effects for municipalities that had voluntarily integrated prior to the law, while both types of municipality enjoyed similar benefits in terms of public transport and fiscal revenues. These findings support the fact that municipalities resisted to avoid the local costs of integration. (JEL H70, R38, R51, R53, R58)
Singles, Couples, and Their Labor Supply: Long-Run Trends and Short-Run Fluctuations
Authors: Olsson Jonna
Published: December 2024

Women's increased involvement in the economy has been an important change in labor markets during the past century. I show that a macroeconomic model taking into account gender and household composition in an otherwise parsimonious off-the-shelf setting captures key historical labor supply facts regarding trend and volatility across subgroups. Evaluating the economy's response to aggregate shocks at different points in time shows that the underlying trend growth in married women's employment contributed to the perceived quick employment recoveries after recessions before 1990, and the absence of growth thereafter consequently helps explain the more recent slower recoveries. (JEL D13, E24, E32, J12, J16, J22)
US Treasury Auctions: A High-Frequency Identification of Supply Shocks
Authors: Phillot Maxime
Published: December 2024

We identify Treasury supply shocks using auction data, interpreting changes in futures prices around announcements as shocks to expected supply. We isolate the component of futures price variations pertaining to US Treasury announcements between 1998 and 2020. We study how supply affects financial markets through local projections, using shocks as instruments. We show that increases in Treasury supply cause an upward shift of the yield curve fueled partly by a higher term premium. Stock prices decline, volatility climbs, and corporate bond yields increase. The risk premium rises, the equity premium falls, inflation expectations soar, and the liquidity premium decreases. (JEL E43, E44, E63, G13, G14, H63)
State-Dependent Government Spending Multipliers: Downward Nominal Wage Rigidity and Sources of Business Cycle Fluctuations
Authors: Jo Yoon Joo , Zubairy Sarah
Published: December 2024

In a New Keynesian model with downward nominal wage rigidity (DNWR), we show that government spending is more effective in stimulating output in a low-inflation recession relative to a high-inflation recession. The government spending multiplier is large when DNWR binds, but the nature of recession matters due to the opposing response of inflation and, consequently, for real wages. Using US historical time series data, we provide evidence of larger spending multipliers in low-inflation recessions and the importance of the depth of recessions. We also employ cross-sectional data from US states to document supporting evidence on multipliers and our proposed mechanism. (JEL E12, E24, E31, E32, E62, H50)
Movimentos sociais e a construção da cidadania no Brasil
Authors: Santana Santos dos Anjos Alane
Published: December 2024

As lutas e movimentos sociais de brasileiros contra as desigualdades sociais e econômicas são percebidas desde o Período Colonial (1500-1822). Embora sejam nítidos os esforços políticos para reprimi-los, essas manifestações foram imprescindíveis ao desenvolvimento da cidadania brasileira. Desta forma, este estudo objetiva analisar a relação entre a construção da cidadania no Brasil e movimentos sociais ocorridos entre o Período Imperial (1822-1889) e a Primeira República (1889-1930). A promulgação da Constituição de 1824 deu início ao processo de aquisição de direitos no Brasil. No entanto, foi somente com a Constituição de 1988 que os direitos civis, políticos e sociais foram plenamente reconhecidos. Apesar dessas garantias legais, as desigualdades sociais ainda são evidentes.
Contracultura e Resistência
Authors: Susin Sirtoli Guilherme
Published: December 2024

Neste artigo, analisamos as reverberações contraculturais em práticas artísticas de resistência contra o conservadorismo na Escola de Belas Artes de Pelotas (EBA). Utilizando os processos metodológicos vinculados à micro-história alinhados a perspectiva global, investigamos como, desde 1966, foi possível abrir caminho para novas abordagens artísticas através da iniciativa discente Galeria Crítica Nova. Os relatos e produções de jovens estudantes da EBA sugerem resistências ao conservadorismo vigente, reverberando questões de cunho social e político por meio de seus trabalhos. Através das análises, pôde-se observar diálogos com outras propostas engajadas durante a ditadura civil-militar, articulando, por meio da arte, ações de resistência ao contexto repressivo ditatorial.
Discussions on Ibn Sīnā’s Proof (Ishārah) That Existence Is Not Added to The Necessary: al-Rāzī, al-Ṭūsī, And Ṣadr al-Sharīʿah
Authors: Şensoy Güvenç
Published: December 2024

Later theologians and Peripatetic philosophers concur that existence is added to contingents. However, while philosophers assert that existence is not added to the Necessary, theologians dispute this judgment. According to the argument presented in the fourth namaṭ of Ibn Sīnā’s (d. 428/1037) al-Ishārāt wa-l-tanbīhāt, accepting essence as the cause of existence leads to certain issues. The most prominent of these is taqaddum, which is the precedence of something over itself. This study explores Ibn Sīnā’s argument, al-Rāzī’s (d. 606/1210) objections in his Sharḥ, al-Ṭūsī’s (d. 672/1274) responses to these objections, and Ṣadr al-Sharīʿah’s (d. 747/1346) analysis of al-Ṭūsī’s responses. By focusing on these figures, we can understand how the acceptance of the concept of wujūd (existence), one of the concepts of al-umūr al-ʿāmmah (general concepts), influenced the course of the debate. Unlike the aforementioned scholars, Ṣadr al-Sharīʿah accepts that existence is shared in terms of expression and thus rejects both the distinction between existence and essence and the notion of accidentality. This study will first underscore the critical role of the distinction between existence and essence in the Peripatetic system. After elucidating the position of this distinction within the Peripatetic framework, I will delve into the proof of al-Ishārāt, the central focus of this study. This analysis will examine the approaches of al-Rāzī, al-Ṭūsī, and Ṣadr al-Sharīʿah in terms of their comparative and interconnected perspectives on the proof. Notably, Ṣadr al-Sharīʿah’s approach, which has gained attention in modern scholarship for its methodological significance but has seen less focus on its theological implications, will be particularly emphasized.
Religion Paradigm of Artificial Intelligence
Authors: Yamaç Muhammed , İşbilen Nihal
Published: December 2024

Artificial intelligence (AI) technologies have recently been applied in many fields. In many sectors, such as medicine, transportation, automotive, education, construction, furniture, and e-commerce, robotic experiments with AI are being carried out. These new developments in AI robot technologies, such as autonomous driving vehicles, robotic surgeries, smart education, home, and transportation, indicate that the need for a human labor force will be greatly reduced in the future. The issue of how AI robots, which are developed instead of humans in many jobs and processes to facilitate individual and social life, will continue to evolve and spur many discussions. Among these debates, our study focuses on the religious paradigm of AI. This study aims to understand, make sense of, and analyze the problem of the AI religion paradigm. In this context, various dimensions, such as AI’s conception of God, its religious foundations, how it shapes religious life, and whether it has an apocalyptic background that could bring about the end of humanity, are examined. In addition, the study discusses whether AI will bring good or evil to humanity in the religious dimension, what it promises or contains in the religious sense, and its opportunities, risks, or threats. It is hoped that this study will contribute to the gap in the relevant literature on the paradigms of AI and religion. In this respect, the originality of the study and its contribution to the literature is important. This study adopts a qualitative method and in-depth analysis of documents as a task.
Spiritual Ends: Religion and the Heart of Dying in Japan by Timothy O. Benedict (Oakland: University of California Press, 2023), viii + 191 pp., €36.00
Authors: Thalgi Mohammad
Published: December 2024

Timothy O. Benedict’s Spiritual Ends: Religion and the Heart of Dying in Japan discusses the significance of spirituality and religion in hospice care for terminally ill patients in Japan. He surveys where and how spiritual care is practiced in Japan through broader anthropological research and interviews. The book also examines various sociocultural, historical, and religious factors influencing spiritual care and end-of-life care practices. It presents valuable data regarding the interactions among religion, spirituality, and medicine. The concept of spiritual care is put forth, which is revealed as a somewhat nebulous notion in Japan – such as how patients’ eyes glaze over in relation to words such as “chaplain” or “spiritual”. Although Benedict’s body of work is dedicated to this task, the impressions and experiences he shares also bring to life the everyday aspects of working in the hospice setting. He explains how his perspective on providing spiritual care changed such that he no longer feared making statements that might inflict emotional pain on people. One of the leading figures who inspired the modern hospital/hospice movement, Cicely Saunders, is credited with popularizing the neologism “spiritual anguish” introduced in this chapter. This term encapsulates the unique spiritual pain experienced by many patients. As Benedict argues, spiritual distress in Japan is often experienced as a void within oneself or as boringness. It is also difficult to confront this kind of pain in a culture where most people do not talk openly about religion.