bluuebunny/crossref_metadata_2025 huggingface dataset:
Optimal Procurement of COVID-19 Vaccine with Time-Dependent Holding Cost and Shortages under Cloud Fuzzy Demand Rate
Authors: Shah Nita H. , Patel Milan B. , Shah Pratik H.
Published: February 2023

COVID-19 vaccine has emerged as the most powerful weapon against the spread of the coronavirus. Therefore, the management of the vaccine inventory is undoubtedly the most influential and important task for the global distribution of the vaccine. This paper is an attempt to model the vaccine inventory system having time-varying holding costs and partially backlogged shortages. The concept of fuzzy set and cloud pentagonal fuzzy number has been incorporated to make the models more realistic and applicable. Models are solved and validated through numerical examples and graphical representation. Further, sensitivity analysis has been done to identify the most sensitive parameters of all. Finally, managerial insights and conclusions have been drawn to make the vaccine inventory system more robust.
Unveiling the Effects of Viscous Friction on the Full Annular Rubs in a Piecewise Smooth Rotor/Stator Rubbing System
Authors: Li Yang , Fan Shan , Wang ShunZeng , Hong Ling , Jiang Jun
Published: February 2023

Experimental evidences show that friction during rotor/stator rubbing may not always obey the Coulomb friction law, which is predominantly adopted in the studies of these kinds. This work is devoted to unveiling the effects of viscous damping in the friction model on forward and backward full annular rubbing responses in a piecewise smooth rotor/stator rubbing system. The effects induced by the viscous friction, which are exclusively different from those with pure Coulomb friction, may possibly be used as the signatures for identifying the presence/extent of viscous friction in rotor/stator rubbing tests. In this work, the boundaries of both forward and backward full annular rub motions are analytically derived based on the stability and bifurcation theory. Due to the introduction of viscous friction, the rotor/stator system changes from a piecewise smooth continuous system to a Fillipov one. The results show that the viscous friction has little influence on the region of backward full annular rubbing responses but has significant effects on the region of forward full annular rub motion. With the increase of the viscous friction, the parameter region of the forward full annular rub shrinks significantly, and the boundary of Hopf bifurcation changes increasingly from supercritical to subcritical. This leads to more complex behaviors in the global response characteristics in comparison with those of the rotor/stator rubbing system with Coulomb friction, for instance, two new quasiperiodic rubbing responses appear beside the quasiperiodic partial rub bifurcating from the synchronous full annular rub, including a new quasiperiodic full annular rub motion that is different from the traditional full annular rubs mentioned above.
Stress Distribution in Direct Shear Loading and its Implication for Engineering Failure Analysis
Authors: Li Zhen , Liu Jiachen , Liu Huoxing , Zhao Hongbo , Xu Rongchao , Gurkalo Filip
Published: February 2023

Shear stress concentrations may promote damage and failure processes. Quantities of studies have focused on the direct shear loading test, while the analytical model has not yet been studied in depth. Aiming to fill the knowledge gap, the theoretical and numerical analyses of the shear stress distribution in the shear band were investigated. In order to reflect the variation in the stress state, the differential element method was first used. The shear stress distribution equation was derived from the stress equilibrium, geometric and physical equations. The shear stress distribution was plotted, using the proposed equation. After that, the ratio of yield strength to crack initiation strength was calculated. The analytical model was analyzed with FDEM simulation, and the results were compared with those obtained from the laboratory tests. Using the elastoplastic theory, the damage evolution and process in rock were characterized from laboratory scale. The implication for underground engineering analysis was finally discussed with a case study of strain rockburst in hard rock. The analytical model and results could provide a fundamental basis for stability analysis in geotechnical engineering.
Dynamics and data fitting of a time-delayed SIRS hepatitis B model with psychological inhibition factor and limited medical resources
Authors: Wang Ximei , Ren Xinzhi , Wu Yan , Li Yong
Published: February 2023

Hepatitis B is an infectious disease worthy of attention. Considering the incubation period, psychological inhibition factor, vaccine, limited medical resources and horizontal transmission, an SIRS model is proposed to describe hepatitis B transmission dynamics. In order to describe the behavior changes caused by people’s psychological changes, the non-monotonic incidence rate is adopted in the model. We use the saturated treatment rate to describe the limited medical resources. Mathematical analysis shows the existence conditions of the equilibria, forward or backward bifurcation, Hopf bifurcation and the Bogdanov–Takens bifurcation. During the observation of the case data of hepatitis B in China, it is found that there are mainly three features, periodic outbreaks, aperiodic outbreaks, and periodic outbreaks turns to aperiodic outbreaks. According to the above features, we select three different representative regions, Jiangxi, Zhejiang province and Beijing, and then use our model to fit the actual monthly hepatitis B case data. The basic reproduction numbers that we estimated are 1.7712, 1.4805 and 1.4132, respectively. The results of data fitting are consistent with those of theoretical analysis. According to the sensitivity analysis of [Formula: see text], we conclude that reducing contact, increasing treatment rate, strengthening vaccination and revaccinating can effectively prevent and control the prevalence of hepatitis B.
Improvement in the electrode–electrolyte interface of all-solid-state battery using aerosol deposition technology
Authors: Wang Xinyu , Camacho Ramon Alberto Paredes , Oh Jin An Sam , Zhang Y. F. , Lu Li
Published: February 2023

All-solid-state battery (ASSB) has attracted much attention since it is a potential candidate to solve the safety issue of batteries. However, the rigid contact between the electrode and electrolyte limits the electrochemical performance of ASSB. It is therefore necessary to modify the electrode–electrolyte interface to decrease the interfacial resistance. Herein, we use the aerosol deposition (AD) method to directly deposit the electrode, Na3V2(PO4)3 (NVP), on the Na3Zr2Si2PO12 (NZSP) electrolyte at room temperature. The electrolyte pellet coated with NVP demonstrates a negligible interfacial resistance and low total resistivity of about 1831.64 [Formula: see text] cm[Formula: see text]. Furthermore, the electrochemical performance in terms of cyclic voltammetry and charge/discharge of the ASSB consisting of NVP ∣ NZSP ∣ sodium (Na) metal is also investigated.
Composite materials ferropiezoelectric ceramics-polymer for hydroacoustic receivers
Authors: Smotrakov V. G. , Eremkin V. V. , Sitalo E. I. , Malomyzheva N. V. , Boldyrev N. A.
Published: February 2023

The purpose of this work is to study the processes of interfacial interactions, their influence on the piezoelectric properties in highly elastic composite structures, to establish the patterns that determine the volume-sensitive piezoelectric characteristics of composites and to create effective piezoelectric materials for hydroacoustic receiving devices. In the process of this work, the development of a method for obtaining anisotropic ferropiezoelectric ceramics, the development of methods for the preparation of perfect ceramic powders and composite materials based on thermoplastic fluoropolymers and the study of composite materials based on lead–calcium titanate were carried out. As a result of the study, the dependences of the hydrostatic parameters of the composites on the degree of filling, particle size distribution, piezoelectric anisotropy of the active phase and the elastic properties of the polymer matrix were established. Composite materials were based on ceramics of the PT–CT system and thermoplastic fluoropolymers F-2ME, F-62, F-2N with a degree of filling with a ceramic phase from 30 to 60% vol. The dependences of the hydrostatic piezoelectric moduli [Formula: see text] and [Formula: see text], and the quality factor [Formula: see text] on the degree of filling of the composite for polymers F-62 and F-2ME with different average sizes of ceramic particles are plotted. It has been established that the maximum values [Formula: see text] = 119.1⋅10[Formula: see text]V⋅m/N and the quality factor [Formula: see text] = 6074⋅10[Formula: see text] m2/N are achieved for a polymer with a higher elastic compliance (F-62) at a degree of filling of 60% vol. and the use of granular filler.
Rotor Fault Detection and Identification in Multirotors Based on Supervised Learning
Authors: González-Etchemaite José I. , Pose Claudio D. , Giribet Juan I.
Published: February 2023

This work presents the development of a fault detection and identification module for multirotor unmanned aerial vehicles (UAVs), capable of detecting a total failure in any of its rotors. The solution is based on a supervised learning approach, for which random forest and support vector machine classifiers have been trained using simulated data, and proved to be feasible to implement in real time. To validate these models, experimental proof will be shown of a classifier running in real time onboard a particular fault tolerant hexarotor design, showing the fastest detection times in this vehicle to date.
Semantics and Non-fungible Tokens for Copyright Management on the Metaverse and Beyond
Authors: García Roberto , Cediel Ana , Teixidó Mercè , Gil Rosa
Published: February 2023

Recent initiatives related to the Metaverse focus on better visualization, like augmented or virtual reality, but also persistent digital objects. To guarantee real ownership of these digital objects, open systems based on public blockchains and Non-Fungible Tokens (NFTs) are emerging together with a nascent decentralized and open creator economy. To manage this emerging economy in a more organized way, and fight the so common NFT plagiarism, we propose CopyrightLY, a decentralized application for authorship and copyright management. It provides means to claim content authorship, including supporting evidence. Content and metadata are stored in decentralized storage and registered on the blockchain. A token is used to curate these claims, and potential complaints, by staking it on them. Staking is incentivized by the fact that the token is minted using a bonding curve. The tokenomics include the resolution of complaints and enabling the monetization of curated claims. Monetization is achieved through licensing NFTs with metadata enhanced by semantic technologies. Semantic data makes explicit the reuse conditions transferred with the token while keeping the connection to the underlying copyright claims to improve the trustability of the NFTs. Moreover, the semantic metadata is flexible enough to enable licensing not just in the real world. Licenses can refer to reuses in specific locations in a metaverse, thus facilitating the emergence of creative economies in them.
Review—Earth-Abundant, Mn-Rich Cathodes for Vehicle Applications and Beyond: Overview of Critical Barriers
Authors: Gutierrez Arturo , Tewari Deepti , Chen Jiajun , Srinivasan Venkat , Balasubramanian Mahalingam , Croy Jason R.
Published: February 2023

Broadening the portfolio of cathode active materials for Li-ion battery applications is now more important than ever. Recent focus on enabling diversity and security in supply chains, as well as concerns over sustainability of a massively growing energy storage market, have put emphasis on enabling more Earth-abundant cathode materials as an attractive strategy. With respect to relatively near-term options, manganese-based cathodes are particularly interesting. Herein we discuss some of the challenges associated with advancing the development of manganese-based oxides and, in particular, those that take advantage of complex local structures and/or over-lithiated compositions. Discussion centers on the representative, lithium- and manganese-rich class of cathodes and considerations to future development are given that range from the atomic-scale to the electrode level.
Sulfonated Diels-Alder Poly(phenylene) Membrane for Efficient Ion-Selective Transport in Aqueous Metalorganic and Organic Redox Flow Batteries
Authors: Robb Brian H. , George Thomas Y. , Davis Casey M. , Tang Zhijiang , Fujimoto Cy H. , Aziz Michael J. , Marshak Michael P.
Published: February 2023

Redox flow batteries (RFBs) can achieve long lifetimes and high performance when employing highly selective and conductive membranes. Neutral and alkaline RFBs suffer from higher resistances due to lower cation conductivity, compared to acidic RFBs utilizing proton transport. We report the use of a sulfonated Diels-Alder poly(phenylene) membrane that exhibits low and stable potassium area specific resistance and high efficiency RFB cycling relative to Nafion, as well as undetectable ferricyanide crossover. An alkaline (pH 12) organic anthraquinone derivative RFB using this membrane demonstrates over 10 days of cycling without capacity loss from crossover. A neutral chelated chromium complex RFB using this membrane demonstrates a peak discharge power of 1.23 W cm−2, and 80% energy efficiency (EE) cycling at an average discharge power density of 446.3 mW cm−2. Finally, the membrane exhibits similar favorable conductivity for many monovalent cations, opening the opportunity to improve the cycling and crossover performance of other acidic, neutral, and alkaline RFBs.
Transference Number of Electrolytes from the Velocity of a Single Species Measured by Electrophoretic NMR
Authors: Halat David M. , Mistry Aashutosh , Hickson Darby , Srinivasan Venkat , Balsara Nitash P. , Reimer Jeffrey A.
Published: February 2023

Accurate measurement of the cation transference number is critical for designing batteries with a given electrolyte. A promising approach for measuring this parameter is electrophoretic NMR (eNMR). In the standard approach, the average cation, anion, and solvent velocities under an applied electric field are used to estimate the cation transference number with respect to the solvent velocity,

t

+

0

.

In this study, we show that

t

+

0

can be determined from measurements of the electric-field-induced velocities of individual species. The

t

+

0

values obtained from eNMR experiments on a model electrolyte (LiTFSI/tetraglyme) based on single species velocities are consistent with the standard approach. An important parameter that enters into the analysis is the velocity of the electrode–electrolyte interface which must be finite in an eNMR experiment. Agreement is only obtained after accounting for this velocity. The single-species approach is particularly valuable when one or more components of the electrolytic mixture are not easily accessible by NMR, for example zinc and magnesium cations.
Limiting radial pedal forces greatly reduces maximal power output and efficiency in sprint cycling; an optimal control study
Authors: Kistemaker Dinant A. , Terwiel Robert M. , Reuvers Edwin D. H. M. , Bobbert Maarten F.
Published: February 2023

In the literature, but also in the “cycling field” [e.g., trainers, coaches, and (professional) cyclists], it is often suggested that trying to limit/avoid radial pedal forces enhances cycling technique and with that maximal average power output and efficiency. In this paper, we introduce an optimal control model of a human cyclists (consisting of five segments and driven by nine Hill-type muscle-tendon complex models). With that we not only show, but also explain why limiting radial forces is a bad idea: it will decrease maximal attainable AMPO and will decrease efficiency.
Effect of Pesticides on Peroxisome Proliferator-Activated Receptors (PPARs) and Their Association with Obesity and Diabetes
Authors: Hernández-Valdez J. , Velázquez-Zepeda A. , Sánchez-Meza J. C.
Published: February 2023

Obesity and diabetes mellitus are considered the most important diseases of the XXI century. Recently, many epidemiological studies have linked exposure to pesticides to the development of obesity and type 2 diabetes mellitus. The role of pesticides and their possible influence on the development of these diseases was investigated by examining the relationship between these compounds and one of the major nuclear receptor families controlling lipid and carbohydrate metabolism: the peroxisome proliferator-activated receptors (PPARs), PPARα, PPARβ/δ, and PPARγ; this was possible through in silico, in vitro, and in vivo assays. The present review aims to show the effect of pesticides on PPARs and their contribution to the changes in energy metabolism that enable the development of obesity and type 2 diabetes mellitus.
Artificial Intelligence and Internet of Things-Based Leak Detection Method for the Water Supply Network
Authors: Li Lianxiu , Chen Huifan
Published: February 2023

The good management and safe operation of the urban water supply network are of great significance to residents’ lives and industrial production. In view of the difficulties in supervision and leakage location of the urban water supply network, based on the technology of Internet of things and artificial intelligence algorithm, a leakage detection method of the urban water supply network is proposed. First of all, low-power, low-cost terminal detection equipment and gateway monitoring equipment are developed for remote data transmission through WiFi or cellular data networks. The data organization, storage, release and control are realized by using the data center software platform. Second, the leakage location model of the water supply network is established by using remote pressure monitoring data, and the accurate location of pipe network leakage is realized. Based on ALO and PSO optimization algorithms, the water supply network in an industrial area of a city in China is solved. Finally, the performance of the two optimization algorithms is compared and analyzed. The results show that the designed intelligent monitoring system of the water supply network can monitor the pipe network well. In addition, on the problem of leakage detection, the ALO algorithm is superior to the PSO algorithm in terms of optimization ability and search efficiency. The leakage monitoring method of water supply networks proposed in this study can provide a reference for the design and management of urban water supply networks.
A Novel Integrated Optimization-Driven Design Framework for Minimum-Weight Lateral-Load Resisting Systems in Wind-Sensitive Buildings Equipped with Dynamic Vibration Absorbers
Authors: Wang Zixiao , Giaralis Agathoklis
Published: February 2023

The increasing rate of urbanization in recent decades has resulted in a global surge in the construction of slender high-rise buildings. These structures are prone to excessive wind-induced lateral vibrations in the crosswind direction owing to vortex shedding effects, causing occupant discomfort and, ultimately, dynamic serviceability failure. To reconcile the worldwide accelerated trend in constructing tall buildings with the sustainable building sector agenda, this paper proposes a novel bi-objective integrated design framework that leverages dynamic vibration absorbers (DVAs) to minimize the required material usage in the wind load-resisting structural systems (WLSSs) of occupant comfort-governed tall buildings. The framework couples structural sizing optimization for minimum-weight WLSS design (objective 1), with optimal DVA tuning for floor acceleration minimization to satisfy codified wind comfort design requirements by using the smallest DVA inertia (objective 2). Furthermore, a versatile numerical strategy is devised for the efficient solution of the proposed bi-objective optimization problem. For illustration, the framework is applied to a 15-storey steel building equipped with one of two different DVAs: a widely considered top-floor tuned mass damper (TMD) and an innovative ground-floor tuned inerter damper (TID). The derived Pareto optimal integrated (WLSS-plus-DVA) designs demonstrate that significant reduction in both structural steel usage and embodied carbon emissions can be achieved using either one of the two DVAs with moderate inertia. It is concluded that the proposed optimization-driven design framework and numerical solution strategy offer an alternative innovative approach to achieve material-efficient high-rise buildings under wind hazards.
Mapping Knowledge Domain to Analyze the Building Information Modeling on Building Energy Saving Based on Visualized Analysis Method
Authors: Li Gen , Tian Haining
Published: February 2023

Building information modeling (BIM), as a novel knowledge field of modern engineering management, is bringing different degrees of changes to the construction industry from engineering practice to management concept. In order to analyze the research status of BIM in the field of energy-saving transformation, find its research hotspots, and reveal its future development trend to guide the practice and application of building information model better, the mapping knowledge domain is constructed via the literature visualization analysis method based on the theory of cocitation analysis and the pathfinder algorithm This is to analyze the hot spots and reveal the frontier of building information modeling on building energy saving. This article lists journal articles and review articles included in the web of science database between 2012 and 2022, using the literature visualization analysis software Citespace to establish the knowledge graph of the collected literature, the scholars’ collaboration analysis, the research institutions’ collaboration analysis, the national collaboration analysis, the keyword co-occurrence analysis, the keyword cluster analysis, the time zone analysis, the keywords timeline analysis, and the literature cocitation analysis have been carried out and discussed. According to the analysis results, the research hotspots and future development trends are interpreted and discussed.
On Multiplicative (Generalized)-Derivation Involving Semiprime Ideals
Authors: Alnoghashi Hafedh M. , Naji Sabah , Rehman Nadeem ur
Published: February 2023

Let

A

be any arbitrary associative ring,

P

a semiprime ideal, and

J

a nonzero ideal of

A

. In this study, using multiplicative (generalized)-derivations, we explore the behavior of semiprime ideals that satisfy certain algebraic identities. Moreover, examples are provided to demonstrate that the restrictions imposed on the hypotheses of the various theorems are necessary.
Radiosensitization of IDH-Mutated Gliomas through ZMYND8 – a Pathway to Improved Outcomes
Authors: Sachdev Sean , Dmello Crismita , Sonabend Adam M.
Published: February 2023

Isocitrate dehydrogenase 1–mutant (IDH1m) gliomas are recalcitrant tumors for which radiotherapy remains a standard treatment. A recent study identified ZMYND8 as a key mediator of radioresistance for IDH1m gliomas, and pharmacologic targeting of this pathway may heighten radiotherapy-induced tumor response, providing a prospect of improved clinical outcomes.

See related article by Carney et al., p. 1763
Plants, dreams and metaphors: reflections on Amerindian means of influence
Authors: Luciani José Antonio Kelly
Published: February 2023

This paper is devoted to the means at amerindians’ disposal to augment personal efficacy, that is, props used to increase influence on others. My argument, in a nutshell, is that dreams, magic plants (and other substances classed together with them), and metaphorical discourse are such means of aiding one’s influence on others - or avoiding being the target of others’ influence. The second point is that such props, aids, or intensifying devices must involve the interaction of what are normally translated as ”souls“, ”vital images“, or “doubles“ - the immaterial aspects of the person - if they are to be effective.
Multistream-Based Marked Point Process With Decomposed Cumulative Hazard Functions
Authors: Hachiya Hirotaka , Hong Sujun
Published: February 2023

When applying a point process to a real-world problem, an appropriate intensity function model should be designed based on physical and mathematical prior knowledge. Recently, a fully trainable deep learning–based approach has been developed for temporal point processes. In this approach, a cumulative hazard function (CHF) capable of systematic computation of adaptive intensity function is modeled in a data-driven manner. However, in this approach, although many applications of point processes generate various kinds of information such as location, magnitude, and depth, the mark information of events is not considered. To overcome this limitation, we propose a fully trainable marked point process method for modeling decomposed CHFs for time and mark prediction using multistream deep neural networks. We demonstrate the effectiveness of the proposed method through experiments with synthetic and real-world event data.
Global High-Resolution Random Forest Regression Maps of Ocean Heat Content Anomalies Using In Situ and Satellite Data
Authors: Lyman John M. , Johnson Gregory C.
Published: February 2023

The ocean, with its low albedo and vast thermal inertia, plays key roles in the climate system, including absorbing massive amounts of heat as atmospheric greenhouse gas concentrations rise. While the Argo array of profiling floats has vastly improved sampling of ocean temperature in the upper half of the global ocean volume since the mid-2000s, they are not sufficient in number to resolve eddy scales in the oceans. However, satellite sea surface temperature (SST) and sea surface height (SSH) measurements do resolve these scales. Here we use random forest regressions to map ocean heat content anomalies (OHCA) using in situ training data from Argo and other sources on a 7-day × 1/4° × 1/4° grid with latitude, longitude, time, SSH, and SST as predictors. The maps display substantial patterns on eddy scales, resolving variations of ocean currents and fronts. During the well-sampled Argo period, global integrals of these maps reduce noise relative to estimates based on objective mapping of in situ data alone by roughly a factor of 3 when compared to time series of CERES (satellite data) top-of-the-atmosphere energy flux measurements and improve correlations of anomalies with CERES on annual time scales. Prior to and early on in the Argo period, when in situ data were sparser, global integrals of these maps retain low variance, and do not relax back to a climatological mean, avoiding potential deficiencies of various methods for infilling data-sparse regions with objective maps by exploiting temporal and spatial patterns of OHCA and its correlations with SST and SSH.

Significance Statement

We use a simple machine learning technique to improve maps of subsurface ocean warming by exploiting the relationships between subsurface ocean temperature both sea surface temperature and sea level. Mapping ocean warming is important because it contributes to sea level rise through thermal expansion; impacts marine life through marine heatwaves and changes in mixing, oxygen, and carbon dioxide levels; increases energy available to tropical cyclones; and stores most of the energy building up in Earth’s climate system owing to the accumulation of anthropogenic greenhouse gases in the atmosphere. Our new estimates generally have lower noise energy and higher correlations than other products when compared with global energy fluxes at the top of the atmosphere measured by satellite.
Getting Into One’s Skin: The History of Skin Autografting
Authors: Lodin Daud , Lanteigne Luc , Gatewood Matthew , Young Alexander J. , Buicko Jessic
Published: February 2023

Surgeons who treat and manage complex wounds rely on many techniques and modalities to properly close their wounds. In modern times, the concept of the reconstructive ladder helps practitioners make decisions on which method to employ to create the best result. Skin autografting is a part of that algorithm, but few know of the arduous history of this field. Dating back thousands of years ago, the history of skin autografting is complex and spans several continents and eras. This article discusses the history and nuance of a surgical technique that has had years of refinement. The discussion begins with ancient times and delves into how skin autografting made a resurgence during the renaissance and the late 1800s and the influence that World War I posed on the advancement of this surgical principle.
Pressure Ulcer Trends in the United States: A Cross-Sectional Assessment from 2008-2019
Authors: McAuliffe Phoebe B. , Winter Eric E. , Talwar Ankoor A. , Desai Abhishek A. , Broach Robyn B. , Fischer John P.
Published: February 2023

Introduction

Decubitus ulcers are a morbid and costly problem faced by healthcare systems and patients across the country. We aim to examine current patterns and characteristics of patients admitted to the hospital with a pressure ulcer.

Materials and methods

From a nationally representative sample of hospital discharge records, the Nationwide Inpatient Sample (NIS), patients with a diagnosis of pressure ulcer 2008-2019 were identified. Patient volume, demographic and clinical data were analyzed for change over time.

Results

The volume of pressure ulcer patients as a proportion of all hospital patients remained constant from 2008 to 2019 ( P = .479). During the study period, the proportion of ulcer patients that underwent an ulcer-related procedure significantly decreased ( P < .001) while the proportion of ulcers considered severe significantly increased ( P < .001).

Conclusions

Our analysis suggests the prevalence of decubitus ulcers remained stable during the time period, with increased severity but reduced frequency of operative intervention.
Risk Factors for 30-day Hospital Readmissions After Peripheral Vascular Interventions in Peripheral Artery Disease Patients at the US-Mexico Border
Authors: Mishra Kunal , Mohammad Khan O. , Patel Divyank , Makhija Rakhee , Siddiqui Tariq , Abolbashari Mehran , Cruz Rodriguez Jose B.
Published: February 2023

Peripheral artery disease (PAD) is associated with high rates of readmission following endovascular interventions and contributes to a significant hospital readmission burden. Quality metrics like hospital readmissions affect hospital performance, but must adjust to local trends. Our primary goal was to evaluate risk factors and readmission rates post-percutaneous peripheral intervention in a US-Mexico border city, at a single tertiary university hospital. We performed a retrospective review of patients with PAD undergoing first time peripheral intervention from July 2015 to June 2020. Among 212 patients, 58% were readmitted with median 235-day follow-up (inter-quartile range (IQR) 42–924); 35.3% of readmissions occurred within 30 days, and 30.2% of those were within 7 days. Median time to readmission was 62 days. Active smokers had 84% higher risk of readmission (hazard ratio (HR) 1.84, 95% CI 1.23–2.74, P < .01). Other significant factors noted were insurance status—Medicaid or uninsured (HR 1.94, 95% CI 1.22–3.09), prior amputation (HR 1.69, 95% CI 1.13–2.54), heart failure, both preserved (HR 4.35, 95% CI 2.07–9.16) and reduced ejection fraction (HR 1.88, 95% CI 1.14–3.10). Below the knee, interventions were less likely to be readmitted (adjusted HR .64, 95% CI 0.42–.96). Readmission rates were unrelated to medication adherence.
Low Prognostic Nutritional Index Predicts Adverse Outcomes in Patients With Heart Failure: A Systematic Review and Meta-analysis
Authors: Zhang Xiaole , Su Yongcai
Published: February 2023

The association of low prognostic nutritional index (PNI) with adverse outcomes remains conflicting in heart failure patients. To address these knowledge gaps, we performed this meta-analysis to investigate the predictive value of PNI in patients with heart failure (HF). PubMed and Embase databases were comprehensively searched until January 19, 2023, to identify studies that evaluated the predictive role of PNI in HF patients. Outcomes of interest included all-cause mortality and/or combined endpoint of mortality and re-hospitalization. Twelve studies involving 9365 patients with HF were included and analyzed. Comparison of the lowest with the highest PNI, the pooled multivariate adjusted risk ratio (RR) was 1.79 (95% confidence interval [CI] 1.40-2.30) and 2.67 (95% CI 1.92-3.71) for long-term all-cause mortality and combined endpoint of mortality and re-hospitalization, respectively. Furthermore, per unit reduction in PNI was associated with 8% higher risk of all-cause mortality. However, there was no clear association of low PNI with in-hospital mortality. Low PNI may be an independent predictor of long-term all-cause mortality and re-hospitalization in patients with HF. Estimation of nutritional state using the PNI may provide an important clue for risk stratification in these patients.
Minimizing Thermal Damage During Thulium Laser-Assisted Partial Arytenoidectomy: Pulsed Versus Continuous Cutting in an Ex-Vivo Calf Model
Authors: Barnett Erica , Heaton James T. , Petrillo Robert H. , Purnell Philip , Burns James A.
Published: February 2023

Objectives:

The 2 µm-wavelength thulium laser is an effective cutter during partial arytenoidectomy, but thermal trauma can damage adjacent laryngeal tissue. Pulsing laser energy may reduce trauma when compared to continuous-wave cutting. This study measured temperature changes, thermal trauma, and time to complete partial arytenoidectomy, with and without pulsing, in an ex-vivo calf model.

Methods:

Tissue temperature and time to complete a trans-cartilaginous cut were measured during partial arytenoidectomy on ex-vivo calf vocal folds (N = 24) using a thulium laser in continuous-wave (CW, N = 12) and pulsed-wave (PW, N = 12) modes. Energy was 5 W for CW and PW cuts; pulse-widths were 250, 500, and 750 ms. Thermal damage was analyzed histologically by measuring the depth of lactate dehydrogenase (LDH) inactivation perpendicular to the laser-cut edge at the vocal process. Paired t-tests compared CW and PW modes.

Results:

Change in temperature was lower using CW (6.5°C) compared to PW modes (250 ms = 18°; 500 ms = 16°; 750 = 19°; P < .05). Trans-cartilaginous cuts were completed faster using CW (37 seconds) compared to PW (250 ms = 136 seconds; 500 ms = 61 seconds; 750 = 44 seconds; P < .05), and both modes delivered the same total Joules. The average depth of LDH depletion (thermal damage) was similar for all cuts.

Conclusions:

1. Thulium laser cuts in continuous-mode unexpectedly produced less tissue heating yet created similar thermal damage than pulsed-mode cuts during simulated partial arytenoidectomy. 2. Trans-cartilaginous cuts were completed significantly faster in continuous-mode as compared to pulsed-mode cutting. 3. Pulsing the thulium laser does not minimize thermal damage compared to continuous wave cutting during thulium laser-assisted partial arytenoidectomy.
Machine learning prediction will be part of future treatment of depression
Authors: Lennon Matthew J , Harmer Catherine
Published: February 2023

Machine learning (ML) is changing the way that medicine is practiced. While already clinically utilised in diagnostic radiology and outcome prediction in intensive care unit, ML approaches in psychiatry remain nascent. Implementing ML algorithms in psychiatry, particularly in the treatment of depression, is significantly more challenging than other areas of medicine in part because of the less demarcated disease nosology and greater variability in practice. Given the current exiguous capacity of clinicians to predict patient and treatment outcomes in depression, there is a significantly greater need for better predictive capability. Early studies have shown promising results. ML predictions were significantly better than chance within the sequenced treatment alternatives to relieve depression (STAR*D) trial (accuracy 64.6%, p < 0.0001) and combining medications to enhance depression outcomes (COMED) randomised Controlled Trial (RCT) (accuracy 59.6%, p = 0.043), with similar results found in larger scale, retrospective studies. The greater flexibility and dimensionality of ML approaches has been demonstrated in studies incorporating diverse input variables including electroencephalography scans, achieving 88% accuracy for treatment response, and cognitive test scores, achieving up to 72% accuracy for treatment response. The predicting response to depression treatment (PReDicT) trial tested ML informed prescribing of antidepressants against standard therapy and found there was both better outcomes for anxiety and functional endpoints despite the algorithm only having a balanced accuracy of 57.5%. Impeding the progress of ML algorithms in psychiatry are pragmatic hurdles, including accuracy, expense, acceptability and comprehensibility, and ethical hurdles, including medicolegal liability, clinical autonomy and data privacy. Notwithstanding impediments, it is clear that ML prediction algorithms will be part of depression treatment in the future and clinicians should be prepared for their arrival.
Book review: Naoto Jinji, Xingyuan Zhang and Shoji Haruna (Eds), Deep Integration, Global Firms, and Technology Spillovers
Authors: Mkuna Eliaza
Published: February 2023

Naoto Jinji, Xingyuan Zhang and Shoji Haruna (Eds), Deep Integration, Global Firms, and Technology Spillovers, Springer Nature Singapore Pte Ltd, Singapore, 2022. 196 pp., Open access, ISBN 978-981-16-5209-7.
Predictors of depression among Syrian refugee women: A socio-culturally relevant analysis
Authors: Hosseini Zainab , Bakdash Talah , Ahmad Sadena , Awaad Rania
Published: February 2023

Objectives:

Syrian refugee women have faced myriad adversities as they have navigated the realities of war, increasing the risk for mental health concerns such as depressive symptomatology. This study explores the nuances of relevant sociocultural factors that can contribute to depressive symptomatology among widowed Syrian refugee women who live in an institutionalized care setting. We explored the impact of past trauma exposure, perceived independence, and a desire to leave the current place of displacement and the interplay between them.

Methods:

The PCRF Traumatic Events Questionnaire and Patient Health Questionnaire (PHQ-9) were administered to 57 Syrian refugee women in Lebanon ( Mage = 37; M number of children = 3) to measure levels of trauma exposure and depressive symptoms, respectively. Perceived independence and a desire to leave their current place of residence were measured using 1-item measures.

Results:

Using hierarchical regression models, past trauma exposure ( B = 1.51, p = .002) and perceived independence ( B = 0.33, p = .04) significantly predicted depressive symptoms. A desire to travel ( B = 0.84, p = .07) marginally predicted depressive symptoms. Past trauma exposure attenuated the impact of perceived independence on depressive symptoms such that at lower levels of past trauma exposure, higher perceptions of independence predicted higher depression ( simple slope = 0.29, t = 2.13, p = .05), while at higher levels of past trauma higher perceptions of independence predicted lower depressive symptoms ( simple slope = -0.16, t = -2.21, p = .04). Trauma exposure did not moderate the impact of a desire to leave on depression, but age did.

Conclusion:

These findings suggest that sociocultural factors may influence women’s experiences with depressive symptoms differently, and this heterogeneity must be accounted for when treatment programs are proposed. Further, Syrian refugee women who have lost primary family members may pose different profiles of depressive symptoms than other groups of women.
Health status and quality of life in comorbid physical multimorbidity and depression among adults aged ⩾50 years from low- and middle-income countries
Authors: Felez-Nobrega Mireia , Koyanagi Ai
Published: February 2023

Background:

Data on the clinical and functional significance of comorbid depression in physical multimorbidity in middle-aged and older adults and from low- and middle-income countries (LMICs) are lacking.

Aims:

This study aims to determine the association of comorbid depression in physical multimorbidity with health outcomes and quality of life among adults aged ⩾50 years from six LMICs.

Methods:

Cross-sectional, nationally representative data from the Study on Global Ageing and Adult Health were analyzed. DSM-IV Depression was based on past 12-month symptoms. Eleven chronic physical conditions were assessed. Health status was based on scales ranging from 0 (best) to 100 (worse). The quality of life (8-item WHO Quality of Life) scale ranged from 0 (worse) to 100 (best). Multivariable linear regression analyses were conducted.

Results:

Data on 34,129 individuals aged ⩾50 years [mean (SD) age 62.4 (16.0) years; 52.1% females] were analyzed. Among people with physical multimorbidity, having comorbid depression was associated with significantly worse health status in terms of sleep/energy (β = 14.71: 95% CI [12.23, 17.20]), self-care (13.23: [8.66, 17.82]), pain/discomfort (13.03: [9.59, 16.47]), mobility (11.06: [6.91, 15.21]), cognition (10.41: [7.31, 13.50]), perceived stress (8.35: [4.71, 11.99]), interpersonal activities (7.81: [3.71, 11.91]), and lower quality of life (−8.81: [−10.74, −6.88]).

Conclusions:

Comorbid depression in physical multimorbidity was associated with lower quality of life and poorer scores in multiple domains of health status. Treatment of depression in people with physical multimorbidity may potentially lead to better clinical outcomes, but future studies are needed to determine the most effective intervention to address this comorbidity in LMICs.
Mental health throughout the medical career: A comparison of depression, anxiety, and stress levels among medical students, residents, and physicians
Authors: de Sá e Camargo Maíra Lorenzo , Torres Raquel Vieira , Cotta Keylla Cássia Gomes , Ezequiel Oscarina da Silva , Lucchetti Giancarlo , Lucchetti Alessandra Lamas Granero
Published: February 2023

Background:

Different stages of a physician’s career may be associated with different types of mental health impairment.

Aims:

This study aimed to compare symptoms of anxiety, depression, and stress and their associated factors among medical students, medical residents, and physicians.

Methods:

A cross-sectional study was conducted. Data collection included sociodemographic data, religiosity (Duke University Religion Index), and mental health (21-item Depression, Anxiety and Stress Scale – DASS-21) data. The comparison between the groups was performed using ANOVA, and the associated factors were evaluated via linear regression models.

Results:

The sample consisted of 1,417 participants: 778 medical students, 190 medical residents, and 468 established physicians. Medical students had significantly higher depression, anxiety, and stress scores as compared to medical residents and established physicians. However, regarding DASS 21 scores, no significant differences were found between established physicians and medical residents. The factors associated with mental health in the different groups showed that being married and male were associated with better mental health among physicians and medical residents, while the factors of male gender, being in later years of the course, and lower religious attendance were associated with better mental health in students.

Conclusion:

Medical students had worse mental health outcomes when compared to residents and established physicians. Interventions are needed to minimize suffering during medical education and career.
Effects of graphene, alumina, and their hybrid on dynamic mechanical behavior of epoxy-based nanocomposites
Authors: Ahmed Abdalla , Osman Amr , El-Moaty El-Hakeem Abd , Kaytbay Saleh
Published: February 2023

Graphene has excellent mechanical and thermal properties, while alumina has inexpensive and strong thermal stability, making it ideal for electronic packaging applications. The current work examines the effects of modest loadings of reduced graphene oxide (rGO), alumina (Ala), and their hybrids on the dynamic mechanical characteristics and thermal transitions of epoxy-based nanocomposites. The rGO was made using a modified Hummers’ method. Alumina nanoparticles were used as received. Various epoxy nanocomposite samples with 1 wt% of rGO, 1 wt% of Ala, and 0.5 wt% each of rGO and Ala were created. Then, Raman spectroscopy, XRD, FTIR, XPS, TEM, AFM, and SEM were used to analyze the fillers and their hybrid and epoxy-based nanocomposites. Dynamic mechanical analysis was used to examine the hybrid epoxy-based nanocomposites’ dynamic mechanical behavior. It has been demonstrated that different epoxy nanocomposites with 1 wt% Ala and 1 wt% rGO have higher elastic moduli than those with 0.5 wt% rGO and 0.5 wt% Ala. The rGO-Ala hybrid nanocomposites, on the other hand, exhibit moderate damping and glass transition temperatures. The reason for that may be because Ala filler increases the contact area between the rGO sheets and serves as a bridge between the two fillers, decreasing the resistance to deformation. This may enhance the possibility that these stress concentrations will weaken the composites.
Problems posing as solutions: Criticising pragmatism as a paradigm for mixed research
Authors: Hampson Timothy , McKinley Jim
Published: February 2023

Mixed research is a methodology of growing importance both within and without education. This type of research forces researchers to reconcile conflicting ways of justifying and understanding research with results that have the potential to be forward pointing for all researchers. As mixed research has grown, mixed research has gained an increasingly solidified identity which is increasingly associated with the pragmatic paradigm.

This paper seeks to describe and criticise pragmatism as a paradigm for mixed research. We identify six features of pragmatism which we argue render it unfit for purpose.

1. That it is a “paradigm of convenience”

2. That it takes a consequentialist view of good research.

3. That it takes a consequentialist view of truth.

4. That it assumes the answers to epistemic questions is “somewhere in the middle”

5. That it priorities the research question, rather than ontology or epistemology

6. That it treats itself as a prerequisite for mixed research.

We argue that in prioritising flexibility and practicality over principles, pragmatism loses the ability to offer guidance to researchers. Furthermore, many of the issues with pragmatism arise from a conflation of paradigm and method. I.e., by thinking that there are quantitative and qualitative paradigms. We conclude that traditional paradigms are better served to act as a paradigm for mixed research.
Confronting Reflexivity: Sociological Trajectories of Teaching Sociology in Liberal Arts Spaces
Authors: Tripathi Brijesh Chandra
Published: February 2023

This article invites the reader to reflect on the practice and teaching of sociology through reflexivity in India in a new emerging space of liberal arts in private universities. These spaces can be considered as the fringe of sociology teaching. I argue that students in private universities grapple with a ‘crisis of relatedness’ regarding sociological discourse, and the debates they study leave them with different questions. I suggest that the understanding of social facts and issues is different and distant from those studying in public universities. The different lived experiences produce different sociological imaginations with the engagement of the same sociological texts. Teaching sociology in liberal arts spaces could mark the emergence of a generation of sociologists in India who have their training rooted in private universities. This new location of sociology students asks us to revisit the ongoing debate of skill-based sociology versus critical sociology that generates new questions for reflexivity and social location of both practitioner and student of sociology.