bluuebunny/crossref_metadata_2025 huggingface dataset:
Load response of a two‐rotor floating wind turbine undergoing blade‐pitch system faults
Authors: El Beshbichi Omar , Xing Yihan , Chen Ong Muk
Published: June 2023

Multi‐rotor floating wind turbines are among the innovative technologies proposed in the last decade in the effort to reduce the cost of wind energy. These systems are able to offer advantages in terms of smaller blades deployed offshore, cheaper operations, fewer installations, and sharing of the floating platform. As the blade‐pitch actuation system is prone to failures, the assessment of the associated load scenarios is commonly required. Load assessment of blade‐pitch fault scenarios has only been performed for single‐rotor solutions. In this work, we address the effect of blade‐pitch system faults and emergency shutdown on the dynamics and loads of a two‐rotor floating wind turbine. The concept considered employs two NREL 5‐MW baseline wind turbines and the OO‐Star semi‐submersible platform. The blade‐pitch faults investigated are blade blockage and runaway, that is, the seizure at a given pitch angle and the uncontrolled actuation of one of the blades, respectively. Blade‐pitch faults lead to a significant increase in the structural loads of the system, especially for runaway fault conditions. Emergency shutdown significantly excites the platform pitch motion, the tower‐bottom bending moment, and tower torsional loads, while suppressing the faulty blade flapwise bending moment after a short peak. Shutdown delay between rotors increases significantly the maxima of the torsional loads acting on the tower. Comparison of blade loads with data from single‐rotor spar‐type study show great similarity, highlighting that the faulty blade loads are not affected by (1) the type of platform used and (2) the multi‐rotor deployment.
Annotated Bibliography
Authors: Yetman Cameron C.
Published: June 2023

The following annotated bibliography contains a reasonably complete survey of contemporary work in the philosophy of astrophysics. Spanning approximately 40 years from the early 1980s to the present day, the bibliography should help researchers entering the field to acquaint themselves with its major texts, while providing an opportunity for philosophers already working on astrophysics to expand their knowledge base and engage with unfamiliar material.
Introduction: A New Framework for Green Marketing
Authors: Bengtson Erik , Mossberg Oskar
Published: June 2023

This chapter introduces the idea, at the heart of the book, that we need a constructive turn in the rhetorical study of green marketing, as the negative focus on greenwashing can only ever be part of the solution. We elaborate on some key concepts, discuss the disciplinary position of the work, and provide an overview of the book.
Some Implications for Law
Authors: Bengtson Erik , Mossberg Oskar
Published: June 2023

This chapter argues that the current regulatory framework is focused on the legal equivalent of sins, and discusses how virtue analytics can support legal development by supplying possible new criteria for legal assessment. We maintain, however, that regulatory development can only ever be part of the solution and that several simultaneous and mutually reinforcing shifts are necessary, for there to be a true shift in green marketing practice.
The Framework of Virtue Critique
Authors: Bengtson Erik , Mossberg Oskar
Published: June 2023

This chapter continues building on the virtue framework by supplying five analytical principles for virtue critique. They concern rhetorical situationality, motives, effects, audiences, transparency, and prudence, and they provide not only conceptual scaffolding but also key perspectives for performing in-depth studies of green marketing.
From Muhājir to Āwāra: Figures of Migration and Exile Among Afghans
Authors: Abbasi Khadija , Monsutti Alessandro
Published: June 2023

This paper examines how self-designation among Afghan refugees and migrants is evolving. While terms such as muhājir, “refugee,” with a religious connotation, panāhenda, “refugee,” and mosāfer, “traveller,” were used by Afghans in the 1980s and 1990s, they no longer have the favour of younger people who might have grown up in Iran or Pakistan and often aspire to try their chance in the West. New generations tend to describe their situation with words such as āwāra, sargardān, dar-ba-dar, which generally convey the idea of “wandering,” “vagrancy,” “homelessness,” “lack of purpose.” This evolving terminology suggest that exile has lost the religious and political significance it might have had during the anti-Soviet jihad, on the one hand. It also can be interpreted as a quest for meaning in life, an assertion of agency in an effort to define their place in this world, on the other hand. Social media and blogs run by Afghans evoke an ontology of displacement and mobility, which ultimately elicits a form of cosmopolitanism from bellow and resonates with the social, political and economic unpredictability in Afghanistan.
Migration, Development Within the SAARC Framework: Towards a Migration Governance Model of the Future
Authors: Rajan S. Irudaya , Kumar Ashwin
Published: June 2023

Migration is seen as a major contributing factor to a nation’s social and economic development, and has been recognized as such in various international forums, including the UN Sustainable Development Goals, 2015 as well as the Global Compact on Migration in 2018. International Migration has especially impacted the South Asian region considerably. However, there has been very little research done on the macro-outlook of migration within the South Asian region itself, which is not insignificant. This chapter builds on the narrative of migration and development, concentrated within a South Asian perspective. It looks at the various migration governance systems and policies in the countries that make up the South Asianregion. Later, the chapter also looks at the major migration corridors within the region and the various socio-economic dimensions associated with it. Finally, it proposes a framework for safe and sustainable migration within the region, adhering tothe principlesof the South Asian Association for Regional Cooperation (SAARC), which can provide the perfect platform for all South Asian member countries to get together and jointly work towards ensuring sustainable migration among the countries, thereby helping each other meet their respective Sustainable Development Goal targets.
Non-traditional Migration in South Asia
Authors: Ullah A. K. M. Ahsan , Hossain Mallik Akram , Huque Ahmed Shafiqul
Published: June 2023

Traditional migration drivers are being supplanted in certain situations by non-traditional drivers in South Asian (SA) countries. Traditional factors such as economic, climatic, and political concerns appear to be driving a particular group of people to leave. In recent years, however, some fresh factors have emerged in South Asia that have led to the emergence of a new type of migration, namely wealthy South Asians leaving their countries to settle elsewhere in order to secure their accumulated wealth in ways they do not want to disclose. This results in a reverse remittance flow. This study aims to contribute to the discourse on this new category of migrants, which is distinct from traditional migration flows that include economic and forced migration.
An Analysis of the Impact of International Remittances on Child Education: Evidence from Pakistan
Authors: Oda Hisaya
Published: June 2023

This study examines the impact of international remittances on children’s education in families that receive remittances in Pakistan. Remittances sent from overseas migrants play many roles. At the household level, workers’ remittances are an important source of income for recipient households and are used for a wide range of purposes, including daily consumption and the education of migrants’ children and/or siblings. South Asia is the largest remittance-receiving region, accounting for 25.1% of the world’s remittances in 2019. This flow of money from overseas has a significant positive impact on recipient households. Using data on Khyber Pakhtunkhwa province, taken from the Pakistan Social and Living Standards Measurement (PSLM) Survey 2014–15, this chapter investigates whether receiving remittances influences the middle and secondary school enrollment of children. The findings indicate a positive impact of international remittances on the school enrollment of male children but a non-significant impact on female children. They also show that the probability of enrollment declines if the household receives internal remittances. The study reveals various influences of internal and international remittances on school enrollment and confirms a considerable disparity in middle and secondary school enrollment among male and female children.
Optimal Time-Step for Coupled CFD-DEM Model in Sand Production
Authors: Kazidenov Daniyar , Omirbekov Sagyn , Amanbek Yerlan
Published: June 2023

The coupled Computational Fluid Dynamics and Discrete Element Method (CFD-DEM) is a useful tool for modeling the dynamics of sand production that occurs in oil and gas reservoirs. To perform accurate, physically relevant and efficient calculations, the optimal size of the simulation time-step should be selected. In this study, we investigate the selection of an appropriate time-step interval between CFD and DEM models in sand production simulations. The CPU time, speedup and root mean squared relative error of the obtained results are examined to compare the sand production phenomenon at different coupling numbers. Most of the results including the final sand production rate, bond number and bond ratio indicate that the simulations with coupling numbers of N = 10 and N = 100 produce more accurate results. Moreover, these outcomes demonstrate significant improvements in terms of acceleration of the modeling process.
Natural Fracture Network Model Using Machine Learning Approach
Authors: Merembayev Timur , Amanbek Yerlan
Published: June 2023

A fracture network model is a powerful tool for characterizing fractured rock systems. In this paper, we present the fracture network model by integrating a machine learning algorithm in two-dimensional setting to predict the natural fracture topology in porous media. We also use a machine learning algorithm to predict the fracture azimuth angle for the natural fault data from Kazakhstan. The results indicate that the fracture network model with LightGBM performs better in designing a fracture network parameter for hidden areas based on data from the known area. In addition, the numerical result of the machine learning algorithm shows a good result for randomly selected data of the fracture azimuth.
Agricultural Crops and Spatial Distribution of Migrants: Case Studies in Campania Region (Southern Italy)
Authors: Mauro Giovanni , Ronza Maria , De Simone Claudio Sossio
Published: June 2023

In the current context of increasing stabilization of migrants permanently residing in the Campania region (southern Italy), this paper aims to investigate the relationship between the spatial distribution of migrants and the work opportunities in the agricultural sector. We analyse data in the agriculture and population censuses currently available at the municipality level (referring to 2011) and we apply spatial autocorrelation techniques, using the Local Indicator of Spatial Association (LISA) and Getis-Ord Gi* statistic. The maps clusters of migrants (classified by continent) and agricultural crops or breeding (horticulture, orchards and citrus, buffalo and poultry farms), highlight a positive spatial correspondence between resulting hot spots. Finally, we overlay the resulting cluster maps to understand the significance of any external factors, such as the employment opportunities in the areas where migrants have settled.
Exact $$ \mathcal{N} $$ = 2* Schur line defect correlators
Authors: Hatsuda Yasuyuki , Okazaki Tadashi
Published: June 2023

Abstract

We study the Schur line defect correlation functions in $$ \mathcal{N} $$ = 4 and $$ \mathcal{N} $$ = 2∗ U(N) super Yang-Mills (SYM) theory. We find exact closed-form formulae of the correlation functions of the Wilson line operators in the fundamental, antisymmetric and symmetric representations via the Fermi-gas method in the canonical and grand canonical ensembles. All the Schur line defect correlators are shown to be expressible in terms of multiple series that generalizes the Kronecker theta function. From the large N correlators we obtain generating functions for the spectra of the D5-brane giant and the D3-brane dual giant and find a correspondence between the fluctuation modes and the plane partition diamonds.
Spacelike hypersurfaces in twisted product spacetimes with complete fiber and Calabi–Bernstein-type problems
Authors: Soria Alberto
Published: June 2023

In this article spacelike hypersurfaces immersed in twisted product spacetimes $$I\times _f F$$

I

×
f

F

with complete fiber are studied. Several conditions ensuring global hyperbolicity are presented, and a relation that needs to hold on each immersed spacelike hypersurface in $$I\times _f F$$

I

×
f

F

to be a simple warped product is also derived. When the fiber is assumed to be closed (compact and without boundary) and the ambient spacetime has a suitable expanding behaviour, non-existence results for constant mean curvature hypersurfaces are obtained. Under the same hypothesis, a characterization of compact maximal hypersurfaces and other for totally umbilic ones with a suitable restriction on their mean curvature are presented, and a full description of maximal hypersurfaces in twisted product spacetimes with a one-dimensional Lorentzian fiber is also included. Finally, the mean curvature equation for a spacelike graph on the fiber is computed and as an application, some Calabi–Bernstein-type results are proven.
Topology of Irregular Isomonodromy Times on a Fixed Pointed Curve
Authors: Douçot Jean , Rembado Gabriele
Published: June 2023

We will define and study moduli spaces of deformations of irregular classes on Riemann surfaces, which provide an intrinsic viewpoint on the ‘times’ of irregular isomonodromy systems in general. Our aim is to study the deeper generalisation of the G-braid groups that occur as fundamental groups of such deformation spaces, with particular focus on the generalisation of the full G-braid groups.
Development and validation of a nomogram for predicting the risk of immediate postoperative deep vein thrombosis after open wedge high tibial osteotomy
Authors: Guo Haichuan , Wang Tianyu , Li Chengsi , Yu Jiahao , Zhu Ruoxuan , Wang Maolin , Zhu Yanbin , Wang Juan
Published: June 2023

Purpose

This study aimed to identify independent risk factors for immediate postoperative deep vein thrombosis (DVT) in patients with open wedge high tibial osteotomy (OWHTO) and to develop and validate a predictive nomogram.

Methods

Patients who underwent OWHTO for knee osteoarthritis (KOA) from June 2017 to December 2021 were retrospectively analyzed. Baseline data and laboratory test results were collected, and the occurrence of DVT in the immediate postoperative period was regarded as the study outcome event. Multivariable logistic regression identified independent risk factors associated with a higher incidence of immediate postoperative DVT. The predictive nomogram was constructed based on the analysis results. The stability of the model was further assessed in this study using patients from January to September 2022 as an external validation set.

Results

741 patients were enrolled in the study, of which 547 were used in the training cohort and the other 194 for the validation cohort. Multivariate analysis revealed a higher Kellgren–Lawrence (K–L) grade (III vs. I–II OR 3.09, 95% CI 0.93–10.23. IV vs. I–II OR 5.23, 95% CI 1.27–21.48.), platelet to hemoglobin ratio (PHR) > 2.25 (OR 6.10, 95% CI 2.43–15.33), Low levels of albumin (ALB) (OR 0.79, 95% CI 0.70–0.90), LDL‐C > 3.40 (OR 3.06, 95% CI 1.22–7.65), d‐dimer > 1.26 (OR 2.83, 95% CI 1.16–6.87) and BMI ≥ 28 (OR 2.57, 95% CI 1.02–6.50) were the independent risk factors of immediate postoperative DVT. The concordance index (C‐index) and Brier score of the nomogram were 0.832 and 0.036 in the training set, and the corrected values after internal validation were 0.795 and 0.038, respectively. The receiver‐operating characteristic (ROC) curve, the calibration curve, the Hosmer–Lemeshow test, and the decision curve analysis (DCA) performed well in both the training and validation cohorts.

Conclusion

This study developed a personalized predictive nomogram with six predictors, which allows surgeons to stratify risk and recommended immediate ultrasound scans for patients with any of these factors.

Level of evidence

III.
Generative design of space frames for additive manufacturing technology
Authors: Watson Marcus , Leary Martin , Downing David , Brandt Milan
Published: June 2023

A generative design methodology is presented that solves for minimum volume and compliance space-frame systems, with consideration of stress and buckling constraints. The solution space is explored using formal topology optimisation routines. A parameterisation method converts voxelised topology optimisation solutions into skeletonised connectivity representations. An inequality constrained gradient descent optimisation method optimises and defines cross-sectional geometry. This enables fast and automatic solution generation, providing designers with sets of high-performing problem solutions. Skeleton representations provide an inexpensive modelling tool for parallel analysis of physical problems difficult to model using topology optimisation. Geometry is represented using traditional engineering cross-sections with well understood behaviour. This improves certainty in the performance of solutions, simplifying certification processes. The generative design of a structural aerospace bracket for additive manufacture has been used as a case study within this research. A design of experiments produced 360 topology optimisation results, altering input variables and discretisation resolution to identify their effect on solution outcomes and the performance of parameterisation. The proposed method was found to robustly generate high-performing solutions utilising low-resolution topology optimisation. Additionally, 6 high-performing topologies were identified, providing designers with a set of solutions to select from. Limitations on the parameterisation process were identified, with topology optimisation solutions with volume fractions above 0.2 not parameterising successfully, and simulations with a resolution of 5 mm element size and below generating low performing skeletonised topologies.
A syntactic analysis of a complex motor action: the octopus arm ‘slap’
Authors: Alupay Jean , Mather Jennifer , Iskarous Khalil
Published: June 2023

The analysis of a natural motor action is always difficult, especially when different motor programs are combined within the same interaction with the environment. We analyzed the behavior of an octopus, Abdopus sp., filmed in tidal pools in Okinawa, Japan, which used the kinematic primitives of rotation and translation of its hydrostatic arms, and combined these kinematic behaviors serially and in parallel to ‘slap’ at fish in the wild. In total, 19 slaps were analyzed. The kinematics of arm movement were measured in both external and animal-centered reference frames, while the octopus was slapping at the fish. By combining these primitives, the octopus is able to maintain flexibility while controlling only a few degrees of freedom, a concept we term ‘flexible rigidity’. This slapping action supports Flash and Hochner’s embodied organization view of motor behavior, as well as their idea that motor primitives can combine syntactically to form a complex action. The octopus’s ability to use sensory feedback from the position of a moving fish target, along with the feed-forward motor primitives, allows for the building of complex actions at dynamic equilibrium with the environment. Over all, these findings lead to a more realistic view of how a complex behavior allows an animal to coordinate with its environment.
On the safety of group manipulation
Authors: Peters Hans , Veselova Yuliya
Published: June 2023

Groups of voters have more possibilities to influence the voting result than separate individuals. However, there is a problem with coordinating their actions. This paper considers manipulation by groups of voters who have the same preferences. If a voting result is more preferable for voters of a particular group provided that all its members use the same strategy (report the same insincere preference), then each of these members has an incentive to manipulate. If there is a chance that they will become worse off in case only a subset of the whole group manipulates, then manipulation is unsafe. For several voting rules we study conditions on the numbers of voters and alternatives which allow for an unsafe manipulation or which make manipulation always safe.
OrthopedVR: clinical assessment and pre-operative planning of paediatric patients with lower limb rotational abnormalities in virtual reality
Authors: Sibrina David , Bethapudi Sarath , Koulieris George Alex
Published: June 2023

Rotational abnormalities in the lower limbs causing patellar mal-tracking negatively affect patients’ lives, particularly young patients (10–17 years old). Recent studies suggest that rotational abnormalities can increase degenerative effects on the joints of the lower limbs. Rotational abnormalities are diagnosed using 2D CT imaging and X-rays, and these data are then used by surgeons to make decisions during an operation. However, 3D representation of data is preferable in the examination of 3D structures, such as bones. This correlates with added benefits for medical judgement, pre-operative planning, and clinical training. Virtual reality can enable the transformation of standard clinical imaging examination methods (CT/MRI) into immersive examinations and pre-operative planning in 3D. We present a VR system (OrthopedVR) which allows orthopaedic surgeons to examine patients’ specific anatomy of the lower limbs in an immersive three-dimensional environment and to simulate the effect of potential surgical interventions such as corrective osteotomies in VR. In OrthopedVR, surgeons can perform corrective incisions and re-align segments into desired rotational angles. From the system evaluation performed by experienced surgeons we found that OrthopedVR provides a better understanding of lower limb alignment and rotational profiles in comparison with isolated 2D CT scans. In addition, it was demonstrated that using VR software improves pre-operative planning, surgical precision and post-operative outcomes for patients. Our study results indicate that our system can become a stepping stone into simulating corrective surgeries of the lower limbs, and suggest future improvements which will help adopt VR surgical planning into the clinical orthopaedic practice.
Fetal origins of obesity: a novel pathway of regulating appetite neurons in the hypothalamus of growth-restricted rat offspring
Authors: Han Weiling , Song Zhaoyi , Shan Dan , Shi Qingyun
Published: June 2023

Purpose

Fetal growth restriction causes a series of sequelae, some of which, such as hyperphagia, reduced satiety and postnatal obesity, are believed to be associated with embryonic hypothalamic neurons impairment. The mechanisms underlying the linkage of fetal brain injuries to break the energy homeostasis have not been elucidated completely. Here, we aim to investigate the effect of intrauterine energy restriction on remodeling appetite neurons in the hypothalamus of fetal and postnatal infant rats.

Methods

Low-protein (8%) diet combined with 75% energy restriction was used to establish an animal model. Rats offspring brain tissues, harvested from embryo day 18 and postnatal infant day 1, were sampled for dependent regulator analyses and master neuron assessment.

Results

Growth-restricted rats showed the increased expression of Bsx and NPY in the hypothalamus as well as remodeling hypothalamic neurons differentiation compared to controls. Intriguingly, in cells cultured in vitro test, we found that activated effects of Bsx and NPY could be exacerbated by DNMT1 inhibitor.

Conclusions

In embryonic and early postnatal stage of FGR rats, we detected high concentrations of orexigenic neurons in the hypothalamus. DNMT1 activity is correlated with early embryonic neurogenesis by mediating the expression of Bsx and NPY. It may be one of the reasons for the abnormal development of the appetite regulation pathway and higher susceptibility to obesity in FGR offspring.
Insight in cognitive impairment assessed with the Cognitive Assessment Interview in a large sample of patients with schizophrenia
Authors: Bucci Paola , Mucci Armida , Giordano Giulia M. , Caporusso Edoardo , Giuliani Luigi , Gibertoni Dino , Rossi Alessandro , Rocca Paola , Bertolino Alessandro , Galderisi Silvana ,   on the behalf of the Italian Network for Research on Psychoses, Piegari Giuseppe , Merlotti Eleonora , Brando Francesco , Papalino Marco , Calia Vitalba , Romano Raffaella , Barlati Stefano , Deste Giacomo , Valsecchi Paolo , Pinna Federica , Lai Alice , Lostia Di Santa Sofia Silvia , Signorelli Maria Salvina , Poli Laura Fusar , Surace Teresa , Martinotti Giovanni , Montemitro Chiara , Fatricelli Silvia , Altamura Mario , Angelini Eleonora , Elia Antonella , Calcagno Pietro , Belvederi Murri Martino , Cattedra Simone , Pacitti Francesca , Rossi Rodolfo , Socci Valentina , Giusti Laura , Salza Anna , Mammarella Silvia , de Bartolomeis Andrea , Favaro Angela , Collantoni Enrico , Meneguzzo Paolo , Tonna Matteo , Ossola Paolo , Gerra Maria Lidia , Gramaglia Carla , Binda Valeria , Gambaro Eleonora , Carmassi Claudia , Carpita Barbara , Cremone Ivan Mirko , Corrivetti Giulio , Cascino Giammarco , Del Buono Gianfranco , Brugnoli Roberto , Comparelli Anna , Corigliano Valentina , Buzzanca Antonio , Gerardi Nicoletta , Frascarelli Marianna , Fagiolini Andrea , Goracci Arianna , Bolognesi Simone , Siracusano Alberto , Di Lorenzo Giorgio , Ribolsi Michele , Montemagni Cristiana , Riccardi Cecilia , Del Favero Elisa
Published: June 2023

The Cognitive Assessment Interview (CAI) is an interview-based scale measuring cognitive impairment and its impact on functioning in subjects with schizophrenia (SCZ). The present study aimed at assessing, in a large sample of SCZ (n = 601), the agreement between patients and their informants on CAI ratings, to explore patients’ insight in their cognitive deficits and its relationships with clinical and functional indices. Agreement between patient- and informant-based ratings was assessed by the Gwet’s agreement coefficient. Predictors of insight in cognitive deficits were explored by stepwise multiple regression analyses. Patients reported lower severity of cognitive impairment vs. informants. A substantial to almost perfect agreement was observed between patients’ and informants’ ratings. Lower insight in cognitive deficits was associated to greater severity of neurocognitive impairment and positive symptoms, lower severity of depressive symptoms, and older age. Worse real-life functioning was associated to lower insight in cognitive deficit, worse neurocognitive performance, and worse functional capacity. Our findings indicate that the CAI is a valid co-primary measure with the interview to patients providing a reliable assessment of their cognitive deficits. In the absence of informants with good knowledge of the subject, the interview to the patient may represent a valid alternative.
Antiseizure medications for idiopathic generalized epilepsies: a systematic review and network meta-analysis
Authors: Chu Hongyuan , Zhang Xinyu , Shi Jie , Zhou Zhirui , Yang Xu
Published: June 2023

Objectives

To compare the efficacy and safety of antiseizure medications (ASMs), both as monotherapies and adjunctive therapies, for idiopathic generalized epilepsies (IGEs) and related entities.

Methods

Two reviewers independently searched PubMed, Embase, and the Cochrane Library for relevant randomized controlled trials from December 2022 to February 2023. Studies on the efficacy and safety of ASM monotherapies or adjunctive therapies for IGEs and related entities—including juvenile myoclonic epilepsy, childhood absence epilepsy (CAE), juvenile absence epilepsy, or generalized tonic–clonic seizures alone (GTCA)—were included. Efficacy outcomes were the proportions of patients remaining seizure free for 1, 3, 6, and 12 months; safety outcomes were the proportions of any treatment-emergent adverse event (TEAE) and TEAEs leading to discontinuation. Network meta-analyses were performed in a random-effects model to obtain odds ratios and 95% confidence intervals. Rankings of ASMs were based on the surface under the cumulative ranking curve (SUCRA). This study is registered with PROSPERO (No. CRD42022372358).

Results

Twenty-eight randomized controlled trials containing 4282 patients were included. As monotherapies, all ASMs were more effective than placebo, and valproate and ethosuximide were significantly better than lamotrigine. According to the SUCRA for efficacy, ethosuximide ranked first for CAE, whereas valproate ranked first for other types of IGEs. As adjunctive therapies, topiramate ranked best for GTCA as well as overall for IGEs, while levetiracetam ranked best for myoclonic seizures. For safety, perampanel ranked best (measured by any TEAE).

Conclusions

All of the studied ASMs were more effective than placebo. Valproate monotherapy ranked best overall for IGEs, whereas ethosuximide ranked best for CAE. Adjunctive topiramate and levetiracetam were most effective for GTCA and myoclonic seizures, respectively. Furthermore, perampanel had the best tolerability.
The safety and effectiveness of high-calorie therapy for treating amyotrophic lateral sclerosis: a systematic review and meta-analysis
Authors: Zhu Qiaochu , Xu Dandan , Huang Hai , Li Dong , Yang Dan , Zhou Jing , Zhao Yan
Published: June 2023

Background

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disorder affecting the upper and lower motor neurons, which can lead to death from respiratory failure within 3–5 years after the onset of this disease. Nowadays, no drug can effectively slow down the progression of this disease. High-calorie therapy, an emerging complementary alternative treatment, has been reported in studies to prolong the survival time of patients, prevent muscle atrophy and provide a better prognosis. However, no systematic review and meta-analysis were performed to summarize the evidence of this therapy. This meta-analysis comprehensively evaluates the effectiveness and safety of high-calorie therapy for treating ALS.

Methods

We searched the electronic databases from inception to 1 April 2023: PubMed, Embase, Web of Science, Cochrane Library, Scopus, Ovid/Medline, and ProQuest. Randomized controlled trials (RCTs) that met the inclusion criteria were performed by meta-analysis. All statistical analyses were performed in STATA software.

Results

A total of six eligible RCTs were included in this meta-analysis, involving 370 ALS patients. The meta-analyses showed that high-calorie therapy had superiority in improving body weight (SMD = 1, 95% CI 0.36, 1.65) and BMI (SMD = 0.83, 95% CI 0.02, 1.63). With respect to safety, there was no difference between the high-calorie therapy and the control group regarding the number of adverse events (RR = 3.61, 95% CI 0.08, 162.49). However, ALSFRS-R scores (SMD = 0.34, 95% CI − 0.4, 1.08), survival rate (RR = 1.23, 95% CI 0.98, 1.55), and lipid profile (LDL: SMD = 0.21, 95% CI − 0.33, 0.75; HDL: SMD = 0.17, 95% CI − 0.37, 0.71; TC: SMD = 0.21, 95% CI − 0.33, 0.75), CRP (SMD = 0.85, 95% CI − 1.37, 3.06) showed no significant difference compared to the control groups.

Conclusions

High-calorie therapy is effective in gaining weight and BMI with few side effects. However, no significant superiority was detected in ALSFRS-R scores, survival time, lipid profile, and CRP indicator. The overall quality of the included studies is high, and the results have some credibility, but future corroboration by high-quality RCTs is also expected.
Distress in parents of children with first-onset steroid-sensitive nephrotic syndrome
Authors: Veltkamp Floor , van Oers Hedy A. , Teela Lorynn , Mak-Nienhuis Elske M. , Haverman Lotte , Bouts Antonia H. M. ,   on behalf of the LEARNS consortium, Bael Anna , Bouts Antonia H. M. , Buter Nynke , van der Deure Hans , Dorresteijn Eiske , Florquin Sandrine , Gracchi Valentina , Engels Flore , Kloosterman-Eijgenraam Francis , Levtchenko Elena , Mak-Nienhuis Elske , Mathôt Ron , Oversteege Floor , de Pont Saskia , van Rooij-Kouwenhoven Roos , Schreuder Michiel , Schriemer Rixt , Vos Paul , Walle Johan Vande , van Wijk Joanna
Published: June 2023

Background

Steroid-sensitive nephrotic syndrome (SSNS) is associated with a relapsing–remitting course that can be stressful for parents. As little is known of parental distress at the first onset of SSNS, this study aims to describe parental distress and everyday problems in mothers and fathers of a child with newly diagnosed SSNS participating in a randomized controlled trial of levamisole added to corticosteroids.

Methods

To assess distress, the Distress Thermometer for Parents (DT-P) was used, which includes questions on distress (thermometer score 0–10, ≥ 4 “clinical distress”) and presence of everyday problems in six domains: practical, social, emotional, physical, cognitive, and parenting. The DT-P was completed 4 weeks after the onset of SSNS. Total sum and individual items of everyday problems were compared with reference data from mothers and fathers of the Dutch general population.

Results

There was no difference in clinically elevated parental distress between SSNS mothers (n = 37) and fathers (n = 25) and reference parents. Compared to reference fathers, fathers of a child with SSNS scored significantly higher on emotional problems (P = 0.030), while mothers experienced more parenting problems (P = 0.002). Regression analyses showed that lower parental age and having a girl with SSNS were significantly associated with more practical problems and higher distress thermometer scores, respectively.

Conclusions

Four weeks after onset, SSNS mothers and fathers experience equal distress as reference parents. However, both parents endorsed significantly more everyday problems. Therefore, monitoring parental distress, even in the first weeks of the disease, could contribute to timely interventions and prevent worsening of problems.

Clinical trial registry

Dutch Trial Register (https://onderzoekmetmensen.nl/en/trial/27331).

Graphical abstract
Clinical course of congestive hepatopathy pre/post heart transplantation
Authors: Balcar Lorenz , Semmler Georg , Scheiner Bernhard , Stättermayer Albert Friedrich , Ćosić Stefan , Schwabl Philipp , Kazem Niema , Mandorfer Mattias , Hülsmann Martin , Zuckermann Andreas , Reiberger Thomas
Published: June 2023

Background and aims

Heart failure (HF) might lead to increased hepatic venous pressure, thereby impairing hepatic blood outflow and subsequently inducing congestive hepatopathy. We aimed to evaluate prevalence of congestive hepatopathy in patients undergoing heart transplantation (HTX) as well as their post-transplant course.

Methods

Patients undergoing HTX from 2015–2020 at the Vienna General Hospital were included (n = 205). Congestive hepatopathy was defined by hepatic congestion on abdominal imaging and hepatic injury. Laboratory parameters, ascites severity, and clinical events were assessed and post-HTX outcomes evaluated.

Results

At listing, 104 (54%) patients showed hepatic congestion, 97 (47%) hepatic injury, and 50 (26%) had ascites. Congestive hepatopathy was diagnosed in 60 (29%) patients, who showed more often ascites, lower serum sodium and cholinesterase activity, and higher hepatic injury markers. Mean albumin-bilirubin (ALBI)-score as well as (modified)-model for end-stage liver disease (MELD)-scores were higher in patients with congestive hepatopathy. Median levels of laboratory parameters/scores normalised after HTX, and ascites resolved in most patients with congestive hepatopathy (n = 48/56, 86%). The post-HTX (median follow-up 55.1 months) survival was 87% and liver-related events were rare (3%). Severe ascites, low cholinesterase, and MELD/MELD-XI were associated with ascites persistence/death 1‑year after HTX. Age, male sex, and severe ascites were the only independent predictors of post-HTX mortality. Both ALBI and MELD-scores were robust indicators of post-HTX survival when measured 4 weeks after HTX (ALBI log-rank test p < 0.001; MELD log-rank test p = 0.012).

Conclusion

Congestive hepatopathy and ascites were mostly reversible after HTX. Liver-related scores and ascites improve prognostication in patients after HTX.
Alterations in short-term blood pressure variability related to disease severity and autonomic symptoms in myasthenia gravis patients
Authors: Zawadka-Kunikowska Monika , Rzepiński Łukasz , Cieślicka Mirosława , Klawe Jacek J. , Tafil-Klawe Małgorzata
Published: June 2023

Objectives

We aimed to evaluate beat-to-beat blood pressure variability (BPV) during head-up tilt test (HUTT) in patients with mild and moderate myasthenia gravis (MG) compared to healthy controls (HCs), and its association with the severity of autonomic symptoms.

Methods

A total of 50 MG patients and 30 HCs were evaluated. Patients were stratified into 2 groups regarding Myasthenia Gravis Foundation of America (MGFA) classification: mild (I,II MGFA), moderate form (III MGFA). Autonomic symptoms were assessed by COMPASS-31 questionnaire. Cardiovascular parameters, indices of very short-term systolic (SBPV), and diastolic blood pressure (BP) variability (DBPV) were assessed at rest, and during HUTT.

Results

Moderate MG patients were characterized by an overall shift of sympathovagal balance toward sympathetic predominance, either at rest and during HUTT, as well as lower values of high frequency (HFnu) of DBPV during HUTT, compared to HCs and mild MG. Similarly, moderate MG showed higher resting low frequency (LFnu) of DBPV (p=0.035), higher COMPASS-31 score (p=0.031), and orthostatic intolerance sub-score (p=0.019) than mild MG patients. Compared to HCs, mild MG patients showed lower Δmean BP (p=0.029), Δdiastolic BP (p=0.016). Autonomic symptoms were associated with lower BP values, at rest and during HUTT, and lower LF BPV parameters during HUTT.

Conclusion

MG patients present significant alterations in BPV, both at rest and in response to orthostatic stress, which are related to autonomic symptoms and disease severity. This study confirms the importance of monitoring BPV when evaluating cardiovascular autonomic function and its evolution over the course of MG disease.
Psychometric properties and general population reference values for PROMIS Global Health in Hungary
Authors: Bató Alex , Brodszky Valentin , Mitev Ariel Zoltán , Jenei Balázs , Rencz Fanni
Published: June 2023

Objectives

Patient-Reported Outcomes Measurement Information System–Global Health (PROMIS-GH) is a widely used generic measure of health status. This study aimed to (1) assess the psychometric properties of the Hungarian PROMIS-GH and to (2) develop general population reference values in Hungary.

Methods

An online cross-sectional survey was conducted among the Hungarian adult general population (n = 1700). Respondents completed the PROMIS-GH v1.2. Unidimensionality (confirmatory factor analysis and bifactor model), local independence, monotonicity (Mokken scaling), graded response model fit, item characteristic curves and measurement invariance were examined. Spearman’s correlations were used to analyse convergent validity of PROMIS-GH subscales with SF-36v1 composites and subscales. Age- and gender-weighted T-scores were computed for the Global Physical Health (GPH) and Global Mental Health (GMH) subscales using the US item calibrations.

Results

The item response theory assumptions of unidimensionality, local independence and monotonicity were met for both subscales. The graded response model showed acceptable fit indices for both subscales. No differential item functioning was detected for any sociodemographic characteristics. GMH T-scores showed a strong correlation with SF-36 mental health composite score (rs = 0.71) and GPH T-scores with SF-36 physical health composite score (rs = 0.83). Mean GPH and GMH T-scores of females were lower (47.8 and 46.4) compared to males (50.5 and 49.3) (p < 0.001), and both mean GPH and GMH T-scores decreased with age, suggesting worse health status (p < 0.05).

Conclusion

This study established the validity and developed general population reference values for the PROMIS-GH in Hungary. Population reference values facilitate the interpretation of patients’ scores and allow inter-country comparisons.
Features of ductal carcinoma in situ ultrasound images
Authors: Watanabe Takanori
Published: June 2023

Ultrasound images of ductal carcinoma in situ (DCIS) show a wide range of variations from mass to non-mass lesions. This article describes the characteristics of ultrasound images of DCIS based on the BC-02 study conducted by The Japanese Association of Breast and Thyroid Sonology (JABTS). In the BC-02 study, ultrasound images of 705 DCIS cases were classified by imaging findings. The results showed that non-mass abnormalities accounted for 60% of all lesions and masses for 40%. Looking at each subclassification, hypoechoic areas in the mammary gland were the most common (50% of the total), followed by solid masses (31%), mixed masses (9%), and abnormalities of the ducts (8%). These four classifications accounted for 98% of the total. Echogenic foci without a hypoechoic area, architectural distortion, and clustered microcysts were very rare, accounting for about 1% of the total. The ultrasound images of DCIS were characterized by a wide range of variations from masses to non-masses abnormalities, with hypoechoic areas in the mammary gland being the most common, followed by solid masses.
Managing surgical waiting lists through dynamic priority scoring
Authors: Powers Jack , McGree James M. , Grieve David , Aseervatham Ratna , Ryan Suzanne , Corry Paul
Published: June 2023

Prioritising elective surgery patients under the Australian three-category system is inherently subjective due to variability in clinician decision making and the potential for extraneous factors to influence category assignment. As a result, waiting time inequities can exist which may lead to adverse health outcomes and increased morbidity, especially for patients deemed to be low priority. This study investigated the use of a dynamic priority scoring (DPS) system to rank elective surgery patients more equitably, based on a combination of waiting time and clinical factors. Such a system enables patients to progress on the waiting list in a more objective and transparent manner, at a rate relative to their clinical need. Simulation results comparing the two systems indicate that the DPS system has potential to assist in managing waiting lists by standardising waiting times relative to urgency category, in addition to improving waiting time consistency for patients of similar clinical need. In clinical practice, this system is likely to reduce subjectivity, increase transparency, and improve overall efficiency of waiting list management by providing an objective metric to prioritise patients. Such a system is also likely to increase public trust and confidence in the systems used to manage waiting lists.
BMP-2 (and partially GDF-5) coating significantly accelerates and augments bone formation close to hydroxyapatite/tricalcium-phosphate/brushite implant cylinders for tibial bone defects in senile, osteopenic sheep
Authors: Sachse André , Hasenbein Ines , Hortschansky Peter , Schmuck Klaus D. , Maenz Stefan , Illerhaus Bernhard , Kuehmstedt Peter , Ramm Roland , Huber René , Kunisch Elke , Horbert Victoria , Gunnella Francesca , Roth Andreas , Schubert Harald , Kinne Raimund W.
Published: June 2023

Bilateral defects (diameter 8 mm) in the medial tibial head of senile, osteopenic female sheep (n = 48; 9.63 ± 0.10 years; mean ± SEM) were treated with hydroxyapatite (HA)/beta-tricalcium phosphate (β-TCP)/dicalcium phosphate dihydrate (DCPD; brushite) cylinders coated with BMP-2 (25 or 250 micrograms) or growth differentiation factor (GDF)-5 (125 or 1250 micrograms; left side); cylinders without BMP served as controls (right side). Three, 6, and 9 months post-operation (n = 6 each group), bone structure and formation were analyzed in vivo by X-ray and ex vivo by osteodensitometry, histomorphometry, and micro-computed tomography (micro-CT) at 3 and 9 months. Semi-quantitative X-ray evaluation showed significantly increasing bone densities around all implant cylinders over time. High-dose BMP-2-coated cylinders (3 and 9 months) and low-dose GDF-5-coated cylinders (3 and 6 months) demonstrated significantly higher densities than controls (dose-dependent for BMP-2 at 3 months). This was confirmed by osteodensitometry at 9 months for high-dose BMP-2-coated cylinders (and selected GDF-5 groups), and was again dose-dependent for BMP-2. Osteoinduction by BMP-2 was most pronounced in the adjacent bone marrow (dynamic histomorphometry/micro-CT). BMP-2 (and partially GDF-5) significantly increased the bone formation in the vicinity of HA/TCP/DCPD cylinders used to fill tibial bone defects in senile osteopenic sheep and may be suitable for surgical therapy of critical size, non-load-bearing bone defects in cases of failed tibial head fracture or defect healing.

Graphical Abstract
Quantitative Full-Field Data Fusion for Evaluation of Complex Structures
Authors: Callaghan J. S. , Crump D. , Nielsen A. S. , Thomsen O. T. , Dulieu-Barton J. M.
Published: June 2023

Background

Validation of models using full-field experimental techniques traditionally rely on local data comparisons. At present, typically selected data fields are used such as local maxima or selected line plots. Here a new approach is proposed called full-field data fusion (FFDF) that utilises the entire image, ensuring the fidelity of the techniques are fully exploited. FFDF has the potential to provide a direct means of assessing design modifications and material choices.

Objective

A FFDF methodology is defined that has the ability to combine data from a variety of experimental and numerical sources to enable quantitative comparisons and validations as well as create new parameters to assess material and structural performance. A section of a wind turbine blade (WTB) substructure of complex composite construction is used as a demonstrator for the methodology.

Methods

The experimental data are obtained using the full-field experimental techniques of Digital Image Correlation (DIC) and Thermoelastic Stress Analysis (TSA), which are then fused with each other, and with predictions made using Finite Element Analysis (FEA). In addition, the FFDF method enables a new high-fidelity validation technique for FEA utilising a precise full-field point by point similarity assessment with the experimental data, based on the fused data sets and metrics.

Results

It is shown that inaccuracies introduced because of estimation of comparable locations in the data sets are eliminated, The FFDF also enables inaccuracies in the experimental data to be mutually assessed at the same scale regardless of differences in camera sensors. For example, the effect of processing parameters in DIC such as subset size and strain window can be assessed through similarity assessment with the TSA.

Conclusions

The FFDF methodology offers a means for comparing different design configurations and material choices for complex composite substructures, as well as quantitative validation of numerical models, which may ultimately reduce dependence on expensive and time-consuming full-scale tests.