bluuebunny/crossref_metadata_2025 huggingface dataset:
Process Mineralogy Automatic Detection System in Research of a Gold Polymetallic Mine
Authors: Ji Qiang , Li Guangsheng , Zhu Xingfu , Gao Tengyue , Qin Guanglin , Xu Chao , Cai Mingming , Lu Zhongbo , Chen Yanbo , Zhang Juntong , Qin Xiangwei , Wang Junjie
Published: February 2023

Automatic process mineralogy detection system has been widely used in beneficiation process parameters detection, cause finding, and defect diagnosis in concentrators. A gold ore composition in Shandong is more complex, and recovery is difficult. To clarify the ore properties, mineral composition, main minerals, embedded characteristics, and monomer dissociation characteristics, the scanning electron microscope, BPMA, and energy spectrometer are used for the ore sample process mineralogy research to provide a reliable basis for the study of the selection process. The research shows that the main valuable elements in the ore are gold and copper, copper and gold symbiotic ore. Meanwhile, the gold, copper, and iron-containing minerals are closely embedded, pyrite and magnetite are the main minerals for sulfur recovery, and magnetite and limonite are the main minerals for producing iron concentrate. Automatic process mineralogy has played an important role in determining the selectability research and beneficiation process of the polymetallic gold ore.
Development of an Eight-channel Full-bridge Strain Signal Synchronous Collector
Authors: Tao Aihua , Xu Yue , Liu Wang , Zhou Zhijian , Lyu Qing , Qiao Liyan
Published: February 2023

Wind tunnel test is widely used in automotive, aerospace, and other fields. The overall effect of the test depends on the accuracy of the data collected by the acquisition system. To collect the balanced strain signal with high precision, an eight-channel full-bridge strain signal synchronization collector is developed in this paper. The article gives the hardware and software design of the collector, respectively. The hardware adopts a modular design with STM32H743 MCU and MAX10 series FPGA, which implements the signal condition, the Butterworth low pass filter, the analog to digital conversion, and the wireless data transmission with WIFI. In terms of software design, the article not only gives the firmware of MCU and FPGA but also designs the software of the host computer with LabVIEW. Finally, the data are tested and analyzed according to the requirements of technical indexes.
Application on DCPD Real-Time Monitoring of Fatigue Crack Propagation
Authors: Liu Zhengzhen , Zhuang Zecheng , Huang Mingda , He Mingjian
Published: February 2023

The formation, propagation, and detection of fatigue cracks are the key issues for the life extension of pressure pipelines and metal welded joints. Especially in the high-temperature and high-pressure water environment of nuclear power. Since the interference of measuring instruments and noise would affect the monitoring of potential signals that characterize crack growth. Combined with the relevant information and various methods of fatigue crack growth detection were analyzed, it can be seen that the Direct Current Potential Drop (DCPD) method has significant advantages in many crack detection methods. Firstly, the development history and current situation of fatigue crack research were analyzed. Secondly, its basic principles and key problems were summarized. Based on the existing crack detection methods, the real-time monitoring system was introduced, and the overall research status was evaluated and analyzed, which a reliable scientific basis for the numerical analysis of fatigue life and a reference were provided for the research on this field.
Neural Network Analysis Based on Data Parallelism
Authors: Lu Jiawei
Published: February 2023

With the development of Internet technology, many image data emerge on the Internet, and deep learning algorithms can extract abstract features from these data for image classification by using multi-layer nonlinear transformation. Therefore, deep learning algorithm has become a research hotspot in image processing. Aiming at the complex semantic features of images, an efficient deep learning algorithm has essential research significance for extracting and analyzing the semantic information about images quickly and effectively. This paper mainly explores the application of deep learning in image classification. Three neural models, LeNet, VGG, and ResNet are selected to test CIFAR10, and their training duration and accuracy are compared. Secondly, this paper further explores the impact of trying three neural network models on different graphics cards on their performance, and further researches and learns the application of these models. Finally, this paper tests the data parallelism solution of PyTorch, and the results and problems of the three models in this process are analyzed.
Study on an abnormal temperature detection method for CAFe facility
Authors: Xie N. , Wang B.J. , Guo Y.H. , Gu R.F. , Wang R.
Published: February 2023

Beam availability is an important indicator of the operational stability and safety of the accelerator. As the front-end prototype of CiADS (China initiative Accelerator Driven System), the CAFe (Chinese ADS Front-end Demo Linac) accelerator is used to verify the feasibility of the key technologies of CiADS, which plays an important role in the development of nuclear waste safety treatment technology. The accelerator is often affected by uncontrollable factors during operation, triggering false temperature alarms from the BPM (Beam Position Monitor), causing the accelerator machine protection system to cut the beam, significantly reducing the availability of the beam. In addition, the prevailing method of manually setting the machine protection system threshold increases the beam conditioning time and the probability of false beam cuts. Therefore, it is urgent to study and discriminate the anomalies that cause beam cutting in order to reduce the beam cutting times caused by false alarms. In this paper, a BPM temperature anomaly prediction model based on Isolation Forest is developed, and the historical BPM temperature data from the CAFe accelerator is pre-processed using the Kalman filter to eliminate the influence of noise. The experimental results show that the scheme can accurately predict the abnormal state of the accelerator to remove the anomalous values, thereby avoiding false interlocks, and provide an effective interlock reference for the threshold setting of the machine protection system, thereby improving the beam availability.
Simulation study on optical transmission performance and time resolution of Shashlik tower
Authors: Peng X. , Zhu J. , He L. , Xiao W. , Luo F. , Xiao M. , Wang X.
Published: February 2023

The Shashlik tower is a significant component to measure the energy, time, and position of
photons and electrons in the Electromagnetic Calorimeter (ECal), a vital detector of the
Multi-Purpose Detector (MPD) in the Nuclotron-based lon Collider fAcility (NICA), Dubna,
Russia. Based on the GEANT4 simulation toolkit, a variation of physical behavior in the tower was
simulated, including the changes of photons during transmission, and used the rising edge
detection method to measure the time-resolving ability of the module for natural muons and
electron beams. Results show that 3 GeV electrons enter the tower, photons emitted by the
scintillator are transmitted, 10665 photoelectrons are collected on Silicon Multipliers (SiPMs),
yield is 3555 pe/GeV, and the light output is 0.16%. The time resolution of the module for
muons is better than 160 ps, but the value of each tower is different. In addition, by changing
the electron beam energy in the simulation, we observed that a larger number of photoelectrons
collected by SiPMs leads to a better time resolution. At an electron beam energy of 1 GeV, the
time resolution of the tower could be better than 101 ps. The simulated measuring results, and the
methods of the tower photon transmission performance and the time resolution, will provide
references and new optimum methods for subsequent experiential tests.
O’Connor v Donaldson (1975): Legal Challenges, Psychiatric Authority, and the Dangerousness Problem in Deinstitutionalization
Authors: Hirshbein Laura
Published: February 2023

In 1975, the Supreme Court heard the case of O’Connor v Donaldson, in which Kenneth Donaldson disputed the decision of his psychiatrists at the Florida State Hospital to keep him incarcerated for 15 years for a mental illness, though he was not dangerous or receiving treatment. The Donaldson decision pitted activist attorneys against psychiatrists who were increasingly beleaguered in their efforts to assert expertise about mental illness in American society. This case and its context offer a window into the psychiatric and legal conversations within the deinstitutionalization movement. During a time when both psychiatry and the law were shifting in their professional claims and emphases, each side was captured by an idea of reform based on how they imagined the problems to be configured. Examining themes of place, authority, right to treatment, and dangerousness reveals the limitations of the reforms and the hardening of a narrative that limited state action to the elision of mental illness with dangerousness.
Photosynthetic 1,8-cineole production using cyanobacteria
Authors: Sakamaki Yutaka , Ono Mizuki , Shigenari Nozomi , Chibazakura Taku , Shimomura Kenji , Watanabe Satoru
Published: February 2023

Terpenoid is an important group of compounds not only as biocomponents but also as useful secondary metabolites. A volatile terpenoid 1,8-cineole, which is used as a food additive, flavoring agent, cosmetic, etc., is also attracting attention from a medical perspective due to its antiinflammation and antioxidation. The 1,8-cineole fermentation using a recombinant Escherichia coli strain has been reported, although a carbon source supplement is necessary for a high-yield 1,8-cineole production. We constructed the 1,8-cineole-producing cyanobacteria toward a carbon-free and sustainable 1,8-cineole production. cnsA, the 1,8-cineole synthase gene in Streptomyces clavuligerus ATCC 27064, was introduced and overexpressed in the cyanobacterium Synechococcus elongatus PCC 7942. We succeeded in producing an average of 105.6 µg g−1 wet cell weight of 1,8-cineole in S. elongatus 7942 without supplementing any carbon source. Using the cyanobacteria expression system is an efficient approach to producing 1,8-cineole by photosynthesis.
Looking Inside the Story of Radiology
Authors: Young Terry , Nash Jonathan
Published: February 2023

The desire to look ever more clearly and deeply into the human body has tantalised doctors for generations. Prof Terry Young FBCS and Dr Jonathan Nash FRCR, consultant breast radiologist, explore radiology’s past, present and future.
Reflections on Becoming a New CIO
Authors: Haywood Andy
Published: February 2023

Andy Haywood joined the Welsh Ambulance Services NHS Trust (WAST) in January 2020 as its first director of digital services, an executive CIO role on the trust board. Now a managing consultant at Channel 3 Consulting, he discusses the lessons he learned in two and a half years as a new NHS CIO during the COVID–19 pandemic.
The Key to Instant Healthcare Records
Authors: Groves Heath
Published: February 2023

Healthcare in the UK is made up of hundreds of large and small organisations all working collaboratively to provide cradle–to–grave solutions. The problem is, not all of their systems tie up. Heath Groves FBCS CITP and CEO of Sundown Solutions has an answer.
Leadership
Authors: Hall Jon
Published: February 2023

Jon G Hall CITP FBCS considers whether leaders consider public good in their decisions
The Cinderella Service
Authors: Runciman Brian
Published: February 2023

Everyone will need social care at some point, yet it is a neglected and much misunderstood area – especially in the digital context. Tommy Henderson Reay, a registered social worker and Social Care Digital Engagement specialist at NHS Transformation Directorate, spoke to Brian Runciman MBCS about it.
Digital in Business Life 2023 Report
Authors: Runciman Brian
Published: February 2023

Over the years we have looked at future IT needs in various guises, this year BCS surveyed members who are IT leaders and digital professionals to help us get a feel for differences in perception between the two groups as we look ahead at 2023. Brian Runciman MBCS looks at some of the key findings of BCS’s ‘Digital in Business Life 2023.’
A Quantum Leap Into Art
Authors: Hamilton Johanna
Published: February 2023

Winner of the Lumen Prize BCS Immersive Environment Award, Dr Libby Heaney, talks to Johanna Hamilton MBCS about her quantum computing inspired installation Ent–.
Artificial Intelligence in Inflammatory Bowel Disease Endoscopy: Implications for Clinical Trials
Authors: Ahmad Harris A , East James E , Panaccione Remo , Travis Simon , Canavan James B , Usiskin Keith , Byrne Michael F
Published: February 2023

Artificial intelligence shows promise for clinical research in inflammatory bowel disease endoscopy. Accurate assessment of endoscopic activity is important in clinical practice and inflammatory bowel disease clinical trials. Emerging artificial intelligence technologies can increase efficiency and accuracy of assessing the baseline endoscopic appearance in patients with inflammatory bowel disease and the impact that therapeutic interventions may have on mucosal healing in both of these contexts. In this review, state-of-the-art endoscopic assessment of mucosal disease activity in inflammatory bowel disease clinical trials is described, covering the potential for artificial intelligence to transform the current paradigm, its limitations, and suggested next steps. Site-based artificial intelligence quality evaluation and inclusion of patients in clinical trials without the need for a central reader is proposed; for following patient progress, a second reading using AI alongside a central reader with expedited reading is proposed. Artificial intelligence will support precision endoscopy in inflammatory bowel disease and is on the threshold of advancing inflammatory bowel disease clinical trial recruitment.
A Multi-Community Approach in Biodiversity Assessment of a Peat Bog in the Southern Carpathians (Romania) and Implications for Conservation
Authors: Băncilă Raluca I , Cogӑlniceanu Dan , Manu Minodora , Plăiaş̧u Rodica , Stănescu Florina , Memedemin Daniyar , Skolka Marius , Tofan Lucica , Lăcătuşu Anca
Published: February 2023

Although natural peatlands have been recognized as an important type of wetlands because they support high biodiversity and provide important ecosystem services, the value of peatlands both in biodiversity research and conservation is still largely underestimated. Our study characterizes the biodiversity and conservation value of Peşteana peat bog, an upland mesotrophic peat bog, located in the Southern Carpathians, Romania. More specifically, we: (1) characterized the invertebrate (i.e., top soil, surface litter, and plant-dwelling) and plant communities along a humidity gradient in Peşteana peat bog and nearby habitats (i.e., treeline, ecotone, lowland and highland meadow, and forest), (2) assessed the main environmental factors driving the invertebrate community diversity and composition, and (3) determined the relationship between invertebrate community diversity and vegetation, focusing on the top soil invertebrates. Our study revealed a high diversity of invertebrates spanning over 43 taxonomic groups and a high number of plant indicator species, emphasizing the role of natural peatlands in preserving diverse communities in a small area. The results showed that the composition of top soil invertebrate community was determined by depth of organic layer, vegetation cover, and soil compaction. We found that the diversity of top soil invertebrate community was strongly influenced by habitat type and soil attributes and weakly by vegetation. Overall, the invertebrate and plant communities showed different responses to habitat conditions along the humidity gradient. This highlights the importance of using a multi-community approach to support the design of effective conservation and management actions beneficial for a wide range of taxa.
Digest: Salamanders reveal novel trajectories of amphibian MHC evolution
Authors: Kettenburg Gwenddolen
Published: February 2023

How does amphibian MHC diversity fit in the landscape of vertebrate evolution? Mimnias et al. (2022) address this gap in the field of MHC evolution by focusing on the lesser described MHC class I in salamanders. These findings contribute to understanding MHC diversity and the susceptibility of amphibians to pathogens, which could lead to future research on a major threat to amphibian biodiversity, chytrid fungi.
Large-scale population structure and genetic architecture of agronomic traits of garlic
Authors: Jia Huixia , Zhao Qing , Song Jiangping , Zhang Xiaohui , Yang Wenlong , Du Zhenzhen , Zhu Yue , Wang Haiping
Published: February 2023

Garlic, an asexually propagated crop, is the second important bulb crop after the onion and is used as a vegetable and medicinal plant. Abundant and diverse garlic resources have been formed over thousands of years of cultivation. However, genome variation, population structure and genetic architecture of garlic agronomic traits were still not well elucidated. Here, 1 100 258 single nucleotide polymorphisms (SNPs) were identified using genotyping-by-sequencing in 606 garlic accessions collected from 43 countries. Population structure, principal component and phylogenetic analysis showed that these accessions were divided into five subpopulations. Twenty agronomic traits, including above-ground growth traits, bulb-related and bolt-related traits in two consecutive years were implemented in a genome-wide association study. In total, 542 SNPs were associated with these agronomic traits, among which 188 SNPs were repeatedly associated with more than two traits. One SNP (chr6: 1896135972) was repeatedly associated with ten traits. These associated SNPs were located within or near 858 genes, 56 of which were transcription factors. Interestingly, one non-synonymous SNP (Chr4: 166524085) in ribosomal protein S5 was repeatedly associated with above-ground growth and bulb-related traits. Additionally, gene ontology enrichment analysis of candidate genes for genomic selection regions between complete-bolting and non-bolting accessions showed that these genes were significantly enriched in ‘vegetative to reproductive phase transition of meristem’, ‘shoot system development’, ‘reproductive process’, etc. These results provide valuable information for the reliable and efficient selection of candidate genes to achieve garlic genetic improvement and superior varieties.
A longitudinal analysis of involuntary job loss and communication resilience processes during the COVID-19 pandemic
Authors: Kuang Kai , Wilson Steven R , Betts Timothy , Boumis Josephine K , Hintz Elizabeth A , DeBeck Dennis , Buzzanell Patrice M
Published: February 2023

This longitudinal study explored associations between communication resilience processes, job-search self-efficacy, and well-being for a sample of US adults who involuntarily lost their jobs during the second wave of the COVID-19 pandemic. Based on the communication theory of resilience (CTR), we tested four possible models regarding how the enactment of resilience processes would be associated with job-search self-efficacy and well-being over time. Participants (N = 595) described their job loss story and completed measures of communication resilience processes, job-search self-efficacy, and well-being (perceived stress, mental health, and life satisfaction) in February 2021, then completed measures again 2 and 4 months later. Findings from random intercept cross-lagged panel analyses suggested that after accounting for between-person associations, resilience enactment shared significant within-person reciprocal relationships with job-search self-efficacy, perceived stress, and mental health over time. Theoretical implications for CTR, future directions for communication research, and practical implications for supporting diverse job seekers are discussed.
Tibiofemoral dislocation after total knee arthroplasty treated successfully with an external fixation device
Authors: Galanis Athanasios , Papagrigorakis Eftychios , Vavourakis Michail , Karampinas Panagiotis , Vlachos Christos , Patilas Christos , Pneumaticos Spiros , Vlamis John
Published: February 2023

Tibiofemoral dislocation after primary total knee arthroplasty (TKA) is a rare but potentially devastating complication with various patient-related and surgeon-related predisposing factors. We present the case of an obese 86-year-old woman who sustained an atraumatic posterior tibiofemoral dislocation 3 days after a primary medial-pivot design TKA. The knee remained unstable after reduction, owing to significant hamstring hypertonia. The administration of botulinum toxin injections in the hamstrings resulted in no clinical improvement. The periprosthetic infection workup was negative and the neurological impairment of the patient was excluded. The patient was reoperated with extensive hamstring release and the application of a lateral external fixator. The external fixator was removed 6 weeks postoperatively, and physical therapy was initiated. At 1-year follow-up, the patient had a painless, stable knee with a 0–100° range of motion, without any neuromuscular impairment.
The Interplay Between Developmental Stage and Environment Underlies the Adaptive Effect of a Natural Transposable Element Insertion
Authors: Merenciano Miriam , González Josefa
Published: February 2023

Establishing causal links between adaptive mutations and ecologically relevant phenotypes is key to understanding the process of adaptation, which is a central goal in evolutionary biology with applications for conservation, medicine, and agriculture. Yet despite recent progress, the number of identified causal adaptive mutations remains limited. Linking genetic variation to fitness-related effects is complicated by gene-by-gene and gene-by-environment interactions, among other processes. Transposable elements, which are often ignored in the quest for the genetic basis of adaptive evolution, are a genome-wide source of regulatory elements across organisms that can potentially result in adaptive phenotypes. In this work, we combine gene expression, in vivo reporter assays, CRISPR/Cas9 genome editing, and survival experiments to characterize in detail the molecular and phenotypic consequences of a natural Drosophila melanogaster transposable element insertion: the roo solo-LTR FBti0019985. This transposable element provides an alternative promoter to the transcription factor Lime, involved in cold- and immune-stress responses. We found that the effect of FBti0019985 on Lime expression depends on the interplay between the developmental stage and environmental condition. We further establish a causal link between the presence of FBti0019985 and increased survival to cold- and immune-stress. Our results exemplify how several developmental stages and environmental conditions need to be considered to characterize the molecular and functional effects of a genetic variant, and add to the growing body of evidence that transposable elements can induce complex mutations with ecologically relevant effects.
Speciation Underpinned by Unexpected Molecular Diversity in the Mycorrhizal Fungal GenusPisolithus
Authors: Plett Jonathan M , Miyauchi Shingo , Morin Emmanuelle , Plett Krista , Wong-Bajracharya Johanna , de Freitas Pereira Maira , Kuo Alan , Henrissat Bernard , Drula Elodie , Wojtalewicz Dominika , Riley Robert , Pangilinan Jasmyn , Andreopoulos William , LaButti Kurt , Daum Chris , Yoshinaga Yuko , Fauchery Laure , Ng Vivian , Lipzen Anna , Barry Kerrie , Singan Vasanth , Guo Jie , Lebel Teresa , Costa Mauricio Dutra , Grigoriev Igor V , Martin Francis , Anderson Ian C , Kohler Annegret
Published: February 2023

The mutualistic ectomycorrhizal (ECM) fungal genus Pisolithus comprises 19 species defined to date which colonize the roots of >50 hosts worldwide suggesting that substantial genomic and functional evolution occurred during speciation. To better understand this intra-genus variation, we undertook a comparative multi-omic study of nine Pisolithus species sampled from North America, South America, Asia, and Australasia. We found that there was a small core set of genes common to all species (13%), and that these genes were more likely to be significantly regulated during symbiosis with a host than accessory or species-specific genes. Thus, the genetic “toolbox” foundational to the symbiotic lifestyle in this genus is small. Transposable elements were located significantly closer to gene classes including effector-like small secreted proteins (SSPs). Poorly conserved SSPs were more likely to be induced by symbiosis, suggesting that they may be a class of protein that tune host specificity. The Pisolithus gene repertoire is characterized by divergent CAZyme profiles when compared with other fungi, both symbiotic and saprotrophic. This was driven by differences in enzymes associated with symbiotic sugar processing, although metabolomic analysis suggest that neither copy number nor expression of these genes is sufficient to predict sugar capture from a host plant or its metabolism in fungal hyphae. Our results demonstrate that intra-genus genomic and functional diversity within ECM fungi is greater than previously thought, underlining the importance of continued comparative studies within the fungal tree of life to refine our focus on pathways and evolutionary processes foundational to this symbiotic lifestyle.
Ammonia mapping observations of the Galactic infrared bubble N49: Three NH3 clumps along the molecular filament
Authors: Kohno Mikito , Chibueze James O , Burns Ross A , Omodaka Toshihiro , Handa Toshihiro , Murase Takeru , Yamada Rin I , Nagayama Takumi , Nakano Makoto , Sunada Kazuyoshi , Tachihara Kengo , Fukui Yasuo
Published: February 2023

We have carried out the NH3(J, K) = (1, 1), (2, 2), and (3, 3) mapping observations toward the Galactic infrared bubble N49 (G28.83−0.25) using the Nobeyama 45 m telescope. Three NH3 clumps (A, B, and C) were discovered along the molecular filament with the radial velocities of ∼96, 87, and 89 km s−1, respectively. The kinetic temperature derived from the NH3(2, 2)/NH3(1, 1) shows Tkin = 27.0 ± 0.6 K enhanced at Clump B in the eastern edge of the bubble, where position coincides with massive young stellar objects (MYSOs) associated with the 6.7 GHz class II methanol maser source. This result shows the dense clump is locally heated by stellar feedback from the embedded MYSOs. The NH3 Clump B also exists at the 88 km s−1 and 95 km s−1 molecular filament intersection. We therefore suggest that the NH3 dense gas formation in Clump B can be explained by a filament–filament interaction scenario. On the other hand, NH3 Clumps A and C at the northern and southern sides of the molecular filament might be the sites of spontaneous star formation because these clumps are located ∼ 5–10 pc away from the edge of the bubble.
ALMA Band 6 high-resolution observations of the transitional disk around SY Chamaeleontis
Authors: Orihara Ryuta , Momose Munetake , Muto Takayuki , Hashimoto Jun , Liu Hauyu Baobab , Tsukagoshi Takashi , Kudo Tomoyuki , Takahashi Sanemichi , Yang Yi , Hasegawa Yasuhiro , Dong Ruobing , Konishi Mihoko , Akiyama Eiji
Published: February 2023

In this study, we reported the results of high-resolution (${0{^{\prime \prime}_{.}}14}$) Atacama Large Millimeter/submillimeter Array (ALMA) observations of the 225 GHz dust continuum and CO molecular emission lines from the transitional disk around SY Cha. Our high-resolution observations clearly revealed the inner cavity and the central point source for the first time. The radial profile of the ring can be approximated by a bright narrow ring superimposed on a fainter wide ring. Furthermore, we found that there is a weak azimuthal asymmetry in dust continuum emission. For gas emissions, we detected 12CO(2–1), 13CO(2–1), and C18O(2–1), from which we estimated the total gas mass of the disk to be 2.2 × 10−4 M ⊙ , assuming a CO/H2 ratio of 10−4. The observations showed that the gas is present inside the dust cavity. The analysis of the velocity structure of the 12CO(2–1) emission line revealed that the velocity is distorted at the location of the dust inner disk, which may be owing to a warping of the disk or radial gas flow within the cavity of the dust disk. High-resolution observations of SY Cha showed that this system is composed of a ring and a distorted inner disk, which may be common, as indicated by the survey of transitional disk systems at a resolution of ${\sim}{0{^{\prime \prime}_{.}}1}$.
Gender-specific differences in patients with psoriatic arthritis receiving ustekinumab or tumour necrosis factor inhibitor: real-world data
Authors: Van Kuijk Arno W R , Nurmohamed Mike T , Siebert Stefan , Bergmans Paul , de Vlam Kurt , Gremese Elisa , Joven-Ibáñez Beatriz , Korotaeva T V , Lavie Frederic , Sharaf Mohamed , Noël Wim , Theander Elke , Smolen Josef S , Gossec Laure , van der Horst-Bruinsma Irene E
Published: February 2023

Objective

Investigate effects of gender on disease characteristics and treatment impact in patients with PsA.

Methods

PsABio is a non-interventional European study in patients with PsA starting a biological DMARD [bDMARD; ustekinumab or TNF inhibitor (TNFi)]. This post-hoc analysis compared persistence, disease activity, patient-reported outcomes and safety between male and female patients at baseline and 6 and 12 months of treatment.

Results

At baseline, disease duration was 6.7 and 6.9 years for 512 females and 417 males respectively. Mean (95% CI) scores for females vs males were: clinical Disease Activity Index for Psoriatic Arthritis (cDAPSA), 32.3 (30.3, 34.2) vs 26.8 (24.8, 28.9); HAQ-Disability Index (HAQ-DI), 1.3 (1.2, 1.4) vs 0.93 (0.86, 0.99); total PsA Impact of Disease-12 (PsAID-12) score, 6.0 (5.8, 6.2) vs 5.1 (4.9, 5.3), respectively. Improvements in scores were smaller in female than male patients. At 12 months, 175/303 (57.8%) female and 212/264 (80.3%) male patients achieved cDAPSA low disease activity, 96/285 (33.7%) and 137/247 (55.5%), achieved minimal disease activity (MDA), respectively. HAQ-DI scores were 0.85 (0.77, 0.92) vs 0.50 (0.43, 0.56), PsAID-12 scores 3.5 (3.3, 3.8) vs 2.4 (2.2, 2.6), respectively. Treatment persistence was lower in females than males (P ≤ 0.001). Lack of effectiveness was the predominant reason to stop, irrespective of gender and bDMARD.

Conclusions

Before starting bDMARDs, females had more severe disease than males and a lower percentage reached favourable disease states, with lower persistence of treatment after 12 months. A better understanding of the mechanisms underlying these differences may improve therapeutic management in females with PsA.

Trial registration

ClinicalTrials.gov, https://clinicaltrials.gov, NCT02627768
News from the United Nations Commission on International Trade Law (UNCITRAL): the work of the 55th Commission session
Authors: Mostad-Jensen Anne
Published: February 2023

The United Nations Commission on International Trade Law (UNCITRAL) is the core legal body of the United Nations system in the field of international trade law. It has been carrying out its mandate to further the progressive harmonization and unification of international trade law since 1966.1 This article provides an overview of the 55th session of UNCITRAL and the activities of its working groups and Secretariat from mid-2021 to mid-2022. The annual UNCITRAL session (27 June to 15 July 2022, New York) was held fully in person for the first time since the start of the COVID-19 pandemic. Delegates and observers were also able to listen to the Commission session remotely via the UN webcast system but were not able to intervene using that format. Though the Commission session operated under normal conditions, the activities of the UNCITRAL working groups and the Secretariat during the year were still affected by the pandemic, with the meeting time with interpretation in all six UN languages reduced for hybrid meetings that were held both in-person and via Zoom.
Limiting Oral Intake during Labor: Do We Have It Right?
Authors: Palmer C.M. , Jiang Y.
Published: February 2023

(Anesthesiology. 2022;136:528–530)

A recent study by Bouvet et al compared gastric emptying in 4 groups: laboring parturients with epidural analgesia, laboring parturients without epidural analgesia, nonlaboring pregnant women, and nonpregnant women. They found that, while laboring parturients had a slower rate of gastric emptying than nonpregnant and nonlaboring pregnant women, epidural analgesia did not slow gastric emptying but facilitated it. The majority (9 of 10) of laboring patients without epidural analgesia had solid food in their stomach 2 hours after ingesting a small meal, compared to only 3 of 10 patients who received epidural analgesia.
What is “Genuine” Failure of Neuraxial Anaesthesia?
Authors: Stanford SER
Published: February 2023

(Anaesthesia. 2022;77:523–526)

The study conducted by Patel et al attempted to define inadequate neuraxial anesthesia (NA). While most medical staff present during cesarean delivery (CD) are comfortable in what can be a stressful environment, some clinicians may underestimate the distress of an awake patient during this major surgery and life event. Vogel and Hornitsky encourage understanding and responding to not only pain but also distress in order to create a bond of trust between the care providers and the patient.
Oocytes From Stem Cells
Authors: Herbert M. , Surani A.
Published: February 2023

(N Engl J Med. 2022;386:188–190)

Development of mammalian oocytes initiates early in embryonic development, around day 16 in humans. Primordial germ cells develop independently from fetal gonads, then migrate to the gonads where they both follow a synchronized program of development. The primordial germ cells proliferate and mature to form oogonia, followed by meiosis which brings about the mature oocyte. Once fully developed, the number of embryonic oocytes are fixed throughout life into female adulthood. While oocyte formation and meiosis are genetically independent events, functional meiosis is essential for healthy oocytes that can transmit a single copy of each chromosome for normal sexual reproduction.
Diagnosis and Management of Gestational Trophoblastic Disease: 2021 Update
Authors: Ngan H.Y.S. , Seckl M.J. , Berkowitz R.S. , Xiang Y. , Golfier F. , Sekharan P.K. , Lurain J.R. , Massuger L.
Published: February 2023

(Int J Gynaecol Obstet. 2021;155(suppl 1):86–93)

Gestational trophoblastic disease (GTD) is a premalignant disorder that derives from an abnormal placenta. Biomarker hormone human chorionic gonadotropin found in pregnancy and postpartum can help determine disease progression.
Associations Between Ethnicity and Admission to Intensive Care Among Women Giving Birth: A Cohort Study
Authors: Jardine J. , Gurol-Urganci I. , Harris T. , Hawdon J. , Pasupathy D. , van der Meulen J. , Walker K. ,   the NMPA Project Team
Published: February 2023

(BJOG. 2022;129:733–742)

Intensive care unit (ICU) admission among women giving birth is an indicator of severe maternal morbidity and is associated with a high risk of mortality. Studies in the United Kingdom have shown that patients from ethnic minority groups have worse maternal outcomes compared with White patients. Previous studies in the Netherlands, Canada, and the United States have shown an ethnic disparity in maternal ICU admissions. This study by Jardine et al aimed to determine the association between ethnicity and ICU admission among patients giving birth in the United Kingdom and Wales.
Changes in Obstetrical Practices and Pregnancy Outcomes Following the ARRIVE Trial
Authors: Gilroy L.C. , Al-Kouatly H.B. , Minkoff H.L. , McLaren R.A.
Published: February 2023

(Am J Obstet Gynecol. 2022;226:716.e1–716.e12)

As cesarean delivery rates approach an all-time high in the United States and other developed countries, mothers and neonates are at increased risk for morbidities associated with this mode of birth. Data from the 2018 ARRIVE (A Randomized Trial of Induction Versus Expectant Management) trial showed a decrease in cesarean delivery rates and hypertensive disorders when obstetric practices shifted to prioritize induction for 39-week, low-risk, singleton, nulliparous births. Further, meta-analysis demonstrated 39-week inductions lower the risk of infection in the peripartum period, result in fewer NICU (neonatal intensive care unit) admissions and lessen perinatal mortality. As there is a well acknowledged “evidence-to-practice” gap it is not well understood if there has been wide-spread clinical uptake of the recommendation for obstetricians to offer induction to low-risk nulliparous women at 39 weeks. The question of broad change in obstetrical practice and perinatal outcomes following the ARRIVE trial is investigated.
Confidential Enquiry into Maternal Deaths in the Netherlands, 2006–2018
Authors: Kallianidis A.F. , Schutte J.M. , Schuringa L.E.M. , Beenakkers I.C.M. , Bloemenkamp K.W.M. , Braams-Lisman B.A.M. , Cornette J. , Kuppens S.M. , Rietveld A.L. , Schaap T. , Stekelenburg J. , Zwart J.J. , van den Akker T.
Published: February 2023

(Acta Obstet Gynecol Scand. 2022;101:441–449)

The national maternal mortality ratio (MMR-quantified maternal deaths during pregnancy through 42 days postpartum per 100,000 live births) is an important metric for evaluating health care trends and allows for learning to improve care and prevent further death. While 90% of maternal deaths occur in low- and middle-income countries, from 1990 to 2015 some high-income countries saw increased MMR over previous decades. In the Netherlands, the rise of known risk factors including chronic hypertension and obesity, changes in national demographics, and reduced underreporting are considered significant contributors to the MMR increased observed from 1982-1992 (9.7 per 100,000 live births) to 1993-2005 (12.1). Further inquiry is necessary to update MMR in the Netherlands and evaluate new trends.
Utilization and Outcomes of Extracorporeal Membrane Oxygenation in Obstetric Patients in the United States, 1999-2014: A Retrospective Cross-sectional Study
Authors: Taha B. , Guglielminotti J. , Li G. , Landau R.
Published: February 2023

(Anesth Analg. 2022;135:268–276)

Extracorporeal membrane oxygenation (ECMO) use for critically ill patients is increasing, but data on obstetric patients is lacking. This study analyzes ECMO utilization and outcomes of maternal obstetric patients in the United States.
Associations of SARS-CoV-2 Vaccination During Pregnancy With Pregnancy Outcomes
Authors: Magnus M.C. , Örtqvist A.K. , Dahlqwist E. , Ljung R. , Skår F. , Oakley L. , Macsali F. , Björn P. , Gjessing H.K. , Håberg S.E. , Stephansson O.
Published: February 2023

(JAMA. 2022;327:1469–1477)

While pregnant patients are at a higher risk of severe COVID-19 infection, many may still be concerned about the safety of receiving the vaccines during pregnancy. There is evidence supporting the safety of the approved vaccines from the surveillance systems by the Center for Disease Control and Prevention, a few small studies, and data from unplanned pregnancies in the phase 3 vaccination trials. This study used data from Sweden and Norway to examine risk of adverse outcomes following COVID vaccination during pregnancy.
Anesthesiologists’ Perspectives on Why Dural Punctures Occur: A Multicenter International Survey
Authors: Orbach-Zinger S. , Heesen M. , Ioscovich A. , Shatalin D. , Aptekman B. , Weiniger C.F. , Eidelman L.A. , Frenkel A. , Beilin Y. , Katz D.J. , Schlosberg I. , Binyamin Y.
Published: February 2023

(Reg Anesth Pain Med. 2022;47:249–250)

While risk factors for an accidental dural puncture (ADP) have been identified, we need a better understanding of modifiable etiologies. This survey of anesthesiologists aimed to collect clinician perspectives on contributing factors to ADP.
Tranexamic Acid for the Prevention of Postpartum Hemorrhage in Women Undergoing Cesarean Delivery: An Updated Meta-analysis
Authors: Bellos I. , Pergialiotis V.
Published: February 2023

(Am J Obstet Gynecol. 2022;226:510–523.e22)

Postpartum hemorrhage (PPH) affects 1% to 10% of pregnancies worldwide and is associated with high maternal morbidity and mortality rates. Early diagnosis, prophylactic oxytocin, and prompt treatment is the recommended strategy for reducing blood loss during PPH. Tranexamic acid (TXA) may reduce the risk of death in patients with PPH. While previous meta-analyses on the use of prophylactic TXA during cesarean delivery have only used small sample sizes, the recent Tranexamic Acid for Preventing Postpartum Hemorrhage Following a Cesarean Delivery (TRAAP2) trial is adequately powered and examined long-term risks of prophylactic TXA alongside the benefits. This meta-analysis aimed to compare prophylactic TXA with standard uterotonic agents alone in terms of efficacy and safety in patients having a cesarean delivery.
Conservative Management or Cesarean Hysterectomy for Placenta Accreta Spectrum: The PACCRETA Prospective Study
Authors: Sentilhes L. , Seco A. , Azria E. , Beucher G. , Bonnet M.P. , Branger B. , Carbillon L. , Chiesa C. , Crenn-Hebert C. , Dreyfus M. , Dupont C. , Fresson J. , Huissoud C. , Langer B. , Morel O. , Patrier S. , Perrotin F. , Raynal P. , Rozenberg P. , Rudigoz R.C. , Vendittelli F. , Winer N. , Deneux-Tharaux C. , Kayem G. ,   On behalf of the the PACCRETA Study Group
Published: February 2023

(Am J Obstet Gynecol. 2022;226:839.e1–24)

Placenta accreta spectrum (PAS) is a phenomenon where trophoblasts attach or penetrate the myometrium and occasionally into adjacent organs. This can cause complications with delivery such as massive blood loss and multiple organ failure and is associated with high levels of maternal morbidity. PAS is occurring with increased frequency. The principal option for women with PAS is cesarean hysterectomy; however, alternative approaches include leaving the placenta in situ (conservative management), thus preserving the woman’s fertility. Small prospective have demonstrated conservative management to be associated with improved outcomes but larger studies are needed. This study was designed to assess maternal recovery and outcomes after cesarean hysterectomy compared with conservative management.
Outcome of Subsequent Pregnancies in Women With Complete Uterine Rupture: A Population-based Case-control Study
Authors: Thisted D. , Rasmussen S. , Krebs L.
Published: February 2023

(Acta Obstet Gynecol Scand. 2022;101:506–513)

Complete uterine rupture or the rupture of the myometrium occurs in 0.5% of trial of labor after cesarean delivery (TOLAC) births and is related to several adverse events. Few studies regarding the impact of uterine rupture on future delivery have been conducted and have small population sizes. This study aimed to identify later pregnancy outcomes after uterine rupture, identify complications related to the delivery, and compare early pregnancy complications with a control group.
Neonatal Resuscitation in 22-Week Pregnancies
Authors: Lee C.D. , Nelin L. , Foglia E.E.
Published: February 2023

(N Engl J Med. 2022;386:391–393)

A case vignette is presented to highlight contrasting approaches to the imminent delivery of a 22-week neonate. A 20-year-old, gravida 2 pregnant woman presented at the emergency department with symptoms of premature labor. Her first child was born at 34 weeks by spontaneous vaginal delivery and is a healthy 2-year-old. This parturient has no chronic medical conditions and is receiving routine prenatal care. Her prenatal ultrasonography showed no fetal or placental irregularities. Her vital signs were normal and physical exam is notable only for her active pregnancy. On cervical exam, 3 cm dilation, 40% effacement, and a −2 fetal station. Clinicians are invited to reflect on 2 scenarios regarding whether (1) resuscitation should be recommended for all 22-week neonates; or (2) resuscitation should be offered selectively for 22-week neonates, with opinions offered by experts in favor of positions assigned by the editor.
Fetal Reduction From Twin to Singleton Gestation: A Meta-analysis
Authors: Bardin R. , Gupta M. , Greenberg G. , Nandrajog A. , Tenenbaum-Gavish K. , Gupta N. , Perlman S. , Shmueli A. , Hadar E.
Published: February 2023

(Int J Gynaecol Obstet. 2022;158:260–269)

Fetal reduction may be requested by parents in a multiparous pregnancy with normally developing fetuses in favor of supporting maternal medical conditions, psychological factors, poorly resourced socioeconomic status, or to improve projected pregnancy outcome. This is in contrast to selective termination where there is an abnormal fetus in a multiparous pregnancy. Twin pregnancies carry 2 to 3.5 times increased risk of maternal hypertensive and hyperglycemic complications, and 2 to 3 times increased risk of perinatal and infant mortality. Approximately 50% of twin pregnancies result in preterm birth (PTB), and further early PTB occurs in 14%. The benefits and drawbacks of multifetal reduction in triplets and quadruplets has been studied, but maternal, perinatal, and neonatal results for twins are inconsistent. This meta-analysis helps to clarify issues around fetal reduction compared to ongoing twin pregnancies.
No Pain Management for Labor: Individual and Organizational Determinants: A Secondary Analysis of the 2016 French National Perinatal Survey
Authors: Merrer J. , Chantry A.A. , Blondel B. , Le Ray C. , Bonnet M.P.
Published: February 2023

(Eur J Anaesthesiol. 2022;39:489–497)

Pain management during labor and delivery is a fundamental right for patients in labor. Disparities in women’s access to analgesia in childbirth requires further research. Using national data, this study aims to determine the proportion of women who receive no labor pain management, and its individual and organizational factors.
A Survey of Labor Epidural Practices at Obstetric Anesthesia Fellowship Programs in the United States
Authors: Callahan E. , Yeh P. , Carvalho B. , George R.B.
Published: February 2023

(Can J Anaesth. 2022;69:591–596)

Methods of delivery for labor epidural analgesia (LEA) are varied and numerous, with areas of consensus and departure in the consideration of best practices among anesthesia providers. With variations in placement technique, choosing to use a combined spinal epidural (CSE) with the additional delivery of intrathecal (IT) medication, opting for an initial bolus delivery, and the multiplying variables of analgesic selection in the epidural or IT space, practice heterogeneity may become a norm that is worth reconsidering in favor of an evidence-based consensus. Contemporary LEA practices were surveyed in American Council for Graduate Medical Education (ACGME)-accredited obstetric anesthesiology fellowship training programs to estimate the current thought on optimal LEA care.
Prevention and Management of Intraoperative Pain During Cesarean Section Under Neuraxial Anesthesia: A Technical and Interpersonal Approach
Authors: Plaat F. , Stanford S. , Lucas D. , Andrade J. , Careless J. , Russell R. , Bishop D. , Lo Q. , Bogod D.
Published: February 2023

(Anaesthesia. 2022;77:588–597)

The term failure in literature has several different meanings including no blockage, partial blockage, or the need for general anesthesia. In an effort to support clinicians and patients during anesthesia, this article outlines eleven recommendations created by the Obstetric Anaesthetists’ Association working group and the Obstetric Anaesthetists' Association Executive Committee that are designed to improve care and provide minimum standards for consent, assessment of pain, management of intraoperative pain, follow-up communication, and communication as a whole. A group of varied anesthetists and a psychologist formed these recommendations based on 44 studies and literature published in Medline, Embase, CINAHL, and PubMed through the years of 1980 and 2020.