bluuebunny/crossref_metadata_2025 huggingface dataset:
Low-Dose-Ketamine as an adjunct to morphine for acute pain in the ED:
Authors: Galili Stine Fjendbo
Published: September 2022

Background: Seventy percent of the yearly 1.8 million emergency contacts to the Danish hospitals arrives from patients in pain. Pain management is an essential and challenging part of emergency medicine and ineffective analgesia for patients attending the emergency department (ED) is common and can lead to complications, extended hospital stays and course of illness. Opioid-tolerant patients are an increasing challenge requiring different acute pain management, ie. needing much larger doses of opioids – which for a number of reasons they do not receive.  The rising need for opioid sparing treatment and the difficulties in pain treatment of patients with a current use of opioids calls for clinical studies investigating effect and safety of alternatives. Low-Dose-Ketamine (LDK) has been studied as an analgesic and been shown to be useful in the reduction of acute pain in the postoperative setting. This study will evaluate the efficacy and safety of LDK as an adjunct to morphine in the treatment of pain in the ED. Hypothesis: LDK as an adjunct to morphine will be superior to morphine alone as regards of analgesic effect. The combination of morphine and LDK will result in a larger pain reduction in patients with a current use of opioids than patients with no prior use.

Methods: Randomized, double-blinded trial, investigating the combination of LDK and morphine versus IV morphine alone regarding analgesic effect.  152 patients fulfilling all inclusion criteria and no exclusion criteria will be stratified (prior use of opioids and no prior use of opioids) and randomized in a 1:1 ratio in the two groups. Perspectives:  This is the first study to examine the effect of LDK as an adjunct to morphine in a general patient population in the ED with pain and to compare it with the effect for patients with a prior use of opioids. This study could present a better pain treatment for patients with and without a prior use of opioids.

Results: Pending – study still running.

Conclusion: Pending – study still running.
Photo and video referral in the future Emergency Department?
Authors: Toftkær Ulla
Published: September 2022

In the Danish health system, photo/video contact has been successfully utilized in the telemedicine treatment of patients. In the Sjælland Region patient referrals to the Emergency Department are based on telephone conversations with a Registered Nurse. Holbæk Emergency Department initiated a pilot study in 2019 with the objective of investigating the feasibility and potential of using photo/video as a tool in future referrals. Our hypothesis is that it can improve the referral process.

The pilot study is retrospective and the approach deductive. The inclusion criteria is patients with lacerations who have been referred to the Emergency Department (ED) from the Acute Phone. 12 patients participated and consented to having photos taken of their laceration on the arrival to the ED. Twenty-five experienced Registered Nurses from the 4 Acute Phone sites in the Sjælland Region participated. The study design is based on a control group and an investigation group. The control group is the 12 patient referrals to the ED based on the conversation on the Acute Phone. The investigation group is the 300 patient referrals provided by the retrospective review of the 12 patient photos by 25 Registered Nurses. In retrospective review the Registered Nurses either refer to the ED or own home treatment. The validation of referral with photo is investigated by measuring the congruity of the referrals in the investigation group. The potential is shown by comparing the referrals in the two groups.

Out of 300 photo referrals, the congruity of the Registered Nurses' referrals shows an agreement of 95% and a deviation of 5%, which shows the validity. 4 out of 12 patients with lacerations would have been referred to home treatment in the investigation group, with a referral agreement of 93%. While all 12 patients as the control group were referred to the Emergency Department.

The results point towards a future process including photo/video contact, which will improve the ability of Registered Nurses' to provide appropriate referral and treatment instructions, and increase the number of patients referred to home treatment. Implementation of video contact on the Acute Phone starting January 2020, rolling out regionally in 2021.
Akutte tilstande har forskellig prestige blandt medicinstuderende
Authors: Holdgaard Hans Ole , Christensen Erika Frischknecht , Søvsø Morten Breinholt , Lindskou Tim Alex
Published: September 2022

Ledere har intet resume
Pårørendes forhandlinger med sundhedsprofessionelle i forbindelse med ældres akutte indlæggelse
Authors: Hoffmann Eva
Published: September 2022

Det indsendte er et resumé.
Forankring af styringslaboratorier i offentlige bureaukratier
Authors: Krogh Andreas Hagedorn
Published: September 2022

Offentlige styringslaboratorier anvendes i stigende grad til at udvikle ny og mere meningsfuld styring i den offentlige sektor, men grundet deres svage organisatoriske forankring fører de sjældent til mere end lokal og episodisk idéudvikling. Denne artikel undersøger, hvordan styringslaboratorier forankres i offentlige bureaukratier. Teoretisk udvikles en forståelse af offentlige styringslaboratoriers særlige karakter, værdiskabelse og iboende forankringsparadoks. Igennem et eksplorativt casestudie af tre kommunale styringslaboratorier udledes fire væsensforskellige forankringsformer: plan-, proces-, platforms- og personforankring. Samlet kan de fire forankringsformer anvendes som analytisk optik i studiet af relationen mellem det offentlige bureaukrati og de eksperimenterende og innovative laboratorier. Ligeledes kan offentlige ledere anvende dem som opmærksomhedspunkter i design og facilitering med henblik på at fremme forankring af styringslaboratoriet i den offentlige organisation.
Free communes: An idea that neither dies nor catches on
Authors: Christensen Jørgen Grønnegård
Published: September 2022

The idea of the free communes was born in the 1980s and has been with us ever since. Government upon government has launched its own version of a world where local governments achieved more self-governance. This essay takes stock of the experience with free commune experiments in the Nordic countries. It concludes, not without a certain regret, that local governments are able to manage their own affairs, but they are not allowed to do it. Slightly acrimoniously, the essay reaches double conclusion: removing regulations is a popular program but it is impossible in practice, and the general trust in others that was the mainstay of one the more recent experiments does not survive the encounter with the everyday life of national politics.
COVID-19 as crisis-induced innovation lab
Authors: Torfing Jacob , Bentzen Tina Øllgaard , Jensen Didde Cramer
Published: September 2022

Against a tragic background, this study shows that the COVID-19 pandemic has catalyzed positive innovations in both welfare solutions as well as in public governance solutions of the Danish public sector. Drawing on qualitative as well as quantitative data, this article outlines the character and perceived effects of new welfare solutions among vulnerable citizens, as well as a number of preceding, organizational changes in the administrative machinery of the public sector. Based on this analysis, we generate and discuss a hypothesis about a possible relationship between the governance and welfare innovations that emerged during COVID-19.
Mass extinctions, diversification, and the nature of paleontoloy
Authors: Hoffman Antoni
Published: September 2022

Patterns of extinction and diversification in the Phanerozoic can be accounted for by stochastic models. This result may suggest that these general patterns of biotic evolution represent a huge number of largely independent processes rather than singular processes. Therefore, paleontologists should focus on individual events and chains of events rather than on the general patterns.
Governança multiescalar dos recursos hídricos transfronteiriços na Amazônia
Authors: Sant’anna Fernanda Mello
Published: September 2022

A Bacia Amazônica é compartilhada por Bolívia, Brasil, Colômbia, Equador, Guiana, Peru e Venezuela, e seus recursos hídricos transfronteiriços são foco de vários projetos de infraestrutura e de exploração econômica. Essas atividades causam contaminação e degradação dessa bacia, revelando a necessidade de governança multiescalar para regular o uso internacional, nacional e local desses recursos hídricos. Em escala internacional, foram analisadas instituições como a Organização do Tratado de Cooperação Amazônica (OTCA) e as relações entre os Estados que compartilham as Bacia do rio Acre e do rio Napo. Em escala nacional, buscou-se compreender o arcabouço institucional para gestão dos recursos hídricos na Bolívia, no Brasil, no Equador e no Peru, países que compartilham essas duas bacias. Em escala local, estudou-se a governança das regiões de fronteira das bacias daqueles rios. Nas análises da cooperação entre esses atores sociais, verificou-se que, apesar da cooperação nas bacias analisadas, a governança ainda é incipiente, e os conflitos socioambientais tendem a se agravar.
Entre a literatura e o ensino: a formação do leitor
Authors: Mortatti Maria do Rosario
Published: September 2022

Neste livro, estão reunidos onze textos produzidos durante a atuação profissional da autora, no ensino fundamental e médio, entre 1976 e 1991, e na Universidade Estadual Paulista, desde 1991. Nele, “o leitor vai encontrar, ao lado de instigantes reflexões sobre questões de literatura, leitura e ensino, registros preciosos da formação de um pesquisador. No caso, da autora Maria do Rosario Mortatti, especialista renomada na área de leitura e educação. É com os passos que construíram sua expertise na área que este livro, já de início, nos familiariza. […] Foi por este percurso, e ao longo de todo ele que – creio – foi se tecendo, se fortalecendo e se sofisticando a indagação fundamental que a autora faz a si mesma e a seus leitores: a leitura da literatura é mesmo essencial? E se for – como creio que postula Mortatti e que constitui a tese deste livro – como desenvolver práticas pedagógicas, formais e informais, que promovam acesso humanamente significativo a textos literários? […] Considerando que é a importância da leitura, particularmente a importância da leitura literária que justifica a missão da escola de formar leitores, Mortatti acompanha o percurso histórico cumprido pelas reflexões/preocupações sobre o papel da leitura na escola e (para fora dela) na vida de todos nós.”
Expansão e mudanças tecnológicas no agronegócio canavieiro: impactos na estrutura fundiária e na ocupação agropecuária
Authors: Baccarin José Giacomo
Published: September 2022

A partir de 1975, ocorre uma grande expansão da lavoura canavieira no estado de São Paulo e, no final da década de 1990, o início da mecanização das etapas de plantio e colheita da cultura. Com a expansão produtiva, elevou-se a concentração da posse da terra no estado, com mais de 64% de canaviais plantados em estabelecimentos agropecuários maiores que mil hectares. Nas empresas sucroalcooleiras paulista, o número de pessoas ocupadas nas atividades industriais cresceu proporcionalmente à produção setorial, mas foi reduzido para menos da metade o número dos trabalhadores empregados no corte de cana ou em outras atividades com menor exigência de qualificação profissional. Esses dados indicam que as transformações tecnológicas fizeram a atividade canavieira contribuir de modo negativo para a ocupação agropecuária paulista. Este livro procura estudar os efeitos dessa expansão na estrutura fundiária, apontar as causas da aceleração recente da mecanização das atividades de lavoura e, ao mesmo tempo, analisar seus efeitos sobre a ocupação canavieira e agropecuária no estado de São Paulo.
The Evolution of Agency
Authors: Tomasello Michael
Published: September 2022

A leading developmental psychologist proposes an evolutionary pathway to human psychological agency.

Nature cannot build organisms biologically prepared for every contingency they might possibly encounter. Instead, Nature builds some organisms to function as feedback control systems that pursue goals, make informed behavioral decisions about how best to pursue those goals in the current situation, and then monitor behavioral execution for effectiveness. Nature builds psychological agents. In a bold new theoretical proposal, Michael

Tomasello advances a typology of the main forms of psychological agency that emerged on the evolutionary pathway to human beings.

Tomasello outlines four main types of psychological agency and describes them in evolutionary order of emergence. First was the goal-directed agency of ancient vertebrates, then came the intentional agency of ancient mammals, followed by the rational agency of ancient great apes, ending finally in the socially normative agency of ancient humans. Each new form of psychological organization represented increased complexity in the planning, decision-making, and executive control of behavior. Each also led to new types of experience of the environment and, in some cases, of the organism's own psychological functioning, leading ultimately to humans' experience of an objective and normative world that governs all of their thoughts and actions. Together, these proposals constitute a new theoretical framework that both broadens and deepens current approaches in evolutionary psychology.
Selfie Democracy
Authors: Losh Elizabeth
Published: September 2022

How politicians' digital strategies appeal to the same fantasies of digital connection, access, and participation peddled by Silicon Valley.

Smartphones and other digital devices seem to give us a direct line to politicians. But is interacting with presidential tweets really a manifestation of digital democracy? In Selfie Democracy, Elizabeth Losh examines the unintended consequences of politicians' digital strategies, from the Obama campaign's pioneering construction of an online community to Trump's Twitter dominance. She finds that politicians who use digital media appeal to the same fantasies of digital connection, access, and participation peddled by Silicon Valley. Meanwhile, smartphones and social media don't enable participatory democracy so much as they incentivize citizens to perform attention-getting acts of political expression.

Losh explores presidential rhetoric casting digital media as tools of democracy, describes the conflation of gender and technology that contributed to Hillary Clinton's defeat in 2016, chronicles the Biden campaign's early digital stumbles in 2020, and recounts the TikTok campaign that may have spoiled a Trump rally. She shows that although Obama and Trump may seem diametrically opposed in both style and substance, they both used mobile digital media in ways that reshaped the presidency and promised a new kind of digital democracy. Obama used data and digital media to connect to citizens without intermediaries; Trump followed this strategy to its most extreme conclusion. What were the January 6 insurrectionists doing, as they livestreamed themselves and their cohorts attacking the Capitol, but practicing their own brand of selfie democracy?
Kompetansemål i et yrkesopplæringsperspektiv
Authors: Spetalen Halvor
Published: September 2022

Denne artikkelen handler om utformingen av nye kompetansemål i den nye vg1-læreplanen for utdanningsprogrammet restaurant- og matfag etter fagfornyelsen som ble iverksatt høsten 2020. Det er lett å tenke på kompetansemålene i en læreplan som noe «gitt», og formålet med denne artikkelen er derfor å vise hvilke valg og vurderinger som ligger bak utformingen av kompetansemål i en yrkesfaglig læreplan, nærmere bestemt vg1-læreplanen i restaurant- og matfag.
Siden kompetansemålene, slik de er utformet i læreplanen, har stor betydning for både innhold, læringsaktiviteter og vurdering i yrkesopplæringen, kan ny kunnskap om utforming av kompetansemål få betydning for ikke bare senere læreplanarbeid, men kanskje også for senere læreplananalyse og implementering av nye læreplaner på den enkelte skole.
Artikkelen bygger på intervjuer med medlemmene i læreplangruppen med ansvar for utvikling av den nye vg1-læreplanen i restaurant- og matfag fire ganger i perioden fra oktober 2018 til juni 2019. Da var læreplangruppens arbeid sluttført idet utkastet til ny læreplan ble sendt til Utdanningsdirektoratet (UDIR) for godkjenning.
Resultatet fra intervjuene antyder at læreplangruppen posisjonerer seg i en pragmatisk tradisjon med vekt på eklektisk valg av yrkesteori og relevant yrkespraksis ved bruk av både handlings- og kunnskapsverb i kompetansemålene. Kompetansemålene er relativt vide og åpne for tolkning, men likevel tydelig definerte med ett læringsmoment i hvert mål. Læreplanmålene er også fag- og yrkesnøytrale på den måten at ingen enkeltyrker favoriseres, noe som åpner for at elever med ulike yrkesønsker kan gjennomføre en tidlig spesialisering allerede i vg1. Artikkelen oppsummeres med fire momenter som kan tjene som ramme for senere arbeid med formulering av kompetansemål i yrkesfaglige læreplaner.
El ejercicio de la libertad de culto y sus manifestaciones sonoras en América Latina
Authors:   Universidad de Jaén, López-Sidro López Ángel
Published: September 2022

El ejercicio de la libertad de culto incluye una amplia variedad de manifestaciones religiosas, entre las que se pueden señalar aquellas que generan sonidos que son audibles por personas que no participan en las ceremonias que los producen. El toque de campanas o la música de las celebraciones evangélicas serían los sonidos de origen religioso más conocidos y relevantes, pero no los únicos que se registran en América Latina. Este trabajo aborda la inclusión de dichos sonidos en el marco del derecho de libertad religiosa, así como la conflictividad que ha podido producirse en torno a ellos en la región latinoamericana, de modo similar a como ha ocurrido en Europa, examinando si las decisiones de las autoridades civiles al respecto han puesto en valor su significado religioso cuando han sido denunciados como molestos.
Effect of Different Density on Survival Rate of Gourami Fingerling (Osphronemus goramy) Razor Size on Closed Transportation System
Authors: Lili Walim , Fulki Muhamad Alief , Maulina Ine , Rizal Achmad , Iskandar .
Published: September 2022

The low survival rate of gourami fingerling transportation is a problem. Setting the expected amount can lead to death. This research aims to determine the exact amount of density in the razor-sized gourami fingerling transported during the treatment period and to analyze its effect on the survival of razor-sized gourami fingerling. This research was carried out from April to June 2022. This research method used in the Factorial Randomized Group Design (FRGD) experiment consisted of two factors, namely the density factor of 4 levels (10, 20, 30, 40 fish/2L) and the three-stage transport duration factor levels ( 3, 5 and 7 hours). The transportation system in this study is a closed system. The parameters observed were post-transportation life, post-maintenance life for 7 days and water quality in the form of temperature, ammonia, pH and DO. Based on the results of research showed that the effective density for the transportation of razor-sized gourami fingerling was 30 fish/2L with a transportation duration of 5 hours and the survival rate post-transportation was 97.8% and post-maintenance 7 days was 90.02%.
Malaria and Associated Risk Factors among Pregnant Women attending Antenatal Care in Awka, Anambra State, Nigeria
Authors: Akogu M. , Iwueze M. O. , Akulue J. C. , Elosiuba N. V.
Published: September 2022

Malaria in pregnancy is a major public health problem in endemic areas of sub-Saharan Africa. It is a major contributor to adverse maternal and perinatal outcome.  This work was carried out to determine the prevalence and associated risk factors of malaria among pregnant women attending antenatal clinics in Awka. Microscopy was used to determine the prevalence of malaria among the pregnant women, while structure questionnaire was used to determine the knowledge and use of IPTp and LLINs among thepregnant women. Out of the 300 pregnant women screened for malaria, 184 (61.3%) were positive for malaria parasite.of 184 positive for malaria, 130(47.1%) had mild malaria, 49(27.0%) moderate infection, while 5(2.7%) had severe malaria. Of the 184 pregnant women positive for malaria parasite, those less than 20 years (70.0%) were more infected with malaria parasite, followed by 21-30 years (65.4%), while 41 years and above (20.0%) years were the least infected. Those in their first trimester had the highest prevalence of malaria (76.2%). Primigravidae (64.5%) were more infected than multigravidae (56.1%) Pregnant women with non formal education were most infected (95.0%), followed by primary education (27.3%), while secondary education showed the lowest rate of malaria in pregnancy (92.9%). Farmers reported the highest cases(86.3%) of malaria in pregnancy, while civil servants reported the least (27.3%). Married women showed the highest cases of malaria in pregnancy (65.1%), while single reported the least (51.0%).the knowledge and compliance of IPTp among the pregnant women studied were 84.7% and 52.7% respectively, while knowledge of LLINs was 51.7%. intensified health education is needed to reducethe burden of malaria among pregnant womenin Awka.
Hierarchical Model-based Prediction on the Maximum Gap between Consecutive Primes below an Arbitrary Number
Authors: Liu Dasheng
Published: September 2022

The distribution of the primes in natural number sequence has no simple law, which seems to show a certain degree of randomness. In this paper, we found a hierarchical progression pattern that the prime intervals are gradually tend to be evenly distributed on different orbits belongingto different levels, meanwhile, the prime numbers tend to give priority to spread all over each orbit of lower-energy level, and then gradually fill the orbits of higher-energy level with the expansion of prime number range. Moreover, by analyzing the count of prime numbers in different energy levels and different orbits based on the established hierarchical progression model, we investigated that the count of prime numbers in different energy levels decreases exponentially with the increase of energy levels, and its natural logarithm is approximately linear with the change of energy level. Based on these findings, we propose two kinds of strategies to estimate the value of maximum gap between consecutive primes lessen than a given number. Our developed results reveal that the prime distribution shows a layered increasing law, and give a reliable prediction guide to understand the upper limit of maximum interval below an arbitrary number.
Magic Polygons and Combinatorial Algorithms
Authors: Augusto Danniel Dias
Published: September 2022

In this work, we study the Magic Polygons of order 3 (P(n; 2)) and we introduce some properties that were useful to build an algorithm to find out how many Magic Polygons exists for the regular polygons up to 24 sides. The concepts of Equivalents Magic Polygons and Derivatives Magic Polygons which allowed to classify, and avoid ambiguity about the representations of such elements, are also introduced.
Yield Potentiality and Economic Profitability as Influenced by Conjoint Application of Spent Mushroom Compost, Biofertilizers and Mono Potassium Phosphate (MKP) in Marigold
Authors: Rashid Assma , Singh Arvinder , Laishram Nomita , Pandey R. K.
Published: September 2022

The present investigation was carried out under open field conditions during the year 2018-19 to ascertain the influence of spent mushroom compost, biofertilizers and foliar application of water soluble fertilizer, Mono Potassium Phosphate (MKP) on flower yield and economics of French marigold ‘Local’. The results revealed that the overall cost of cultivation as well as the economics of marigold flower production was significantly influenced by various Integrated nutrient management (INM) schedules. French marigold ‘Local’ plants supplied with 75% RDF + Spent mushroom compost (1 kg/m2) + Biofertilizers + 1% foliar spray of MKP (00:52:34) produced maximum yield of saleable flowers (25000 Kg/ha) followed by 75% RDF + Biofertilizers + 1% foliar spray of MKP (23000 Kg/ha) which was significantly superior over the 100% RDF recording 20000 Kg/ha flower yield. Both the above mentioned treatments also recorded maximum net returns of Rs.339171.60/ha. The highest benefit : cost (B: C) ratio of 2.81 was recorded with the treatment 75% RDF + Biofertilizers + 1% foliar spray of MKP.
A Rare Case Report of Radionecrosis Mandible after Irradiation for Breast Cancer
Authors: Prathap Akhilesh , Varghese George , Nidhin R. S. , Varghese Geethu Philo , Aiswarya R. B.
Published: September 2022

Management of irradiated patients with cancer in the head and neck region is a challenging scenario. Radiotherapy promotes cellular and vascular insufficiency that results in a low response rate in the healing. Consequently, surgical procedures in irradiated tissues present high rates of complication. Osteoradionecrosis (ORN) is the most severe sequelae caused by radiotherapy. ORN can occur due to multiple reasons, of which periodontal disease, traumatic injury induced by ill-fitting dentures and trauma after surgery or tooth extraction are the most common. The management of this side effect is difficult and can result in bone or soft tissue loss, affecting the quality of life since majority of patients with ORN have various comorbidities associated. In this article we present a case report of osteoradionecrosis secondary to irradiation for breast cancer which is not frequently reported in literature.
In vitro Plant Regeneration of Banana cv. Bhimkol (Musa balbisiana, BB) through Shoot Tip Culture
Authors: Rakshi Manjula , Kavitha C. , Pugalendhi L. , Paramaguru P. , Sudhakar D. , Ganesan N. Meenakshi , Soorianathasundaram K.
Published: September 2022

Bhimkol (Musa balbisiana, BB) is a wild diploid seeded cultivar, belonging to the family Musaceae. It is tolerance to pest and diseases, since it has high demand for commercialization for its high nutritive values. Therefore, the present study was undertaken to standardize the protocol for in vitro plant regeneration via shoot tips for further breeding programmes (in vitro mutagenesis). The efforts were made to improve the shoot proliferation efficacy through MS medium enhanced with different combinations of cytokinins (BAP and TDZ) and auxins (NAA) to achieve higher number of multiple shoots with shorter period. Among the different combinations of BAP, TDZ and NAA, T5 (MS + TDZ 0.1 mgL-1 + NAA 0.2 mgL-1) was recorded early response (6.60 days), percentage of explant response to initiation (93.33%), days taken for multiple shoot induction (46.40 days) and the highest number of shoots per explant (8.93). The days taken for rooting, number of roots per shoot and highest root length was noted in the treatment half strength MS + 1.0 mgL-1 IBA + 1.0 g L-1 activated charcoal.
Linear Regression and ARIMA Models for Electricity Demand Forecasting in West Africa
Authors: Semekonawo Kokou Prosper , Kam Sié
Published: September 2022

This article focuses on the predictive study of electricity demand in West African countries based on the multivariate linear regression model and the ARIMA model. The objective of the study is first to establish for each country a linear regression model and ARIMA model, then to compare the two (2) models based on the MAD, RMSE and MAPE coefficients, and finally to deduce of this comparison the best valid model to establish the electricity demand prediction of the country. We have come to the conclusion that the ARIMA model is more adequate for predicting the electricity demand of most of West African countries with the exception of Gambia, Ghana, Guinea, Liberia and Nigeria where the multivariate linear regression model performs better.
Improved YOLOv4 for Water Wastes Detection
Authors: Shaokui Gu , Jinxing Niu , Longyan Li
Published: September 2022

Quantifying plastic refuse in water area helps to understand how plastic refuse accumulates in water area and is essential for targeted cleanup efforts. Currently, the most common methods for quantifying plastic in water area are human visual counting and sampling using nets, but such methods are costly and labor-intensive. This study proposes a watershed refuse identification algorithm based on an improved YOLOv4. Lightweight improvements to YOLOv4. EfficientNetB1 is used to replace the backbone network of YOLOv4, and the Depthwise Convolution is used to replace the original convolution to reduce the number of model parameters and computation. The anchors are re-clustered using k-means algorithm to improve the accuracy. The experimental results show that the improved algorithm improves the detection speed by 11.2% and reduces the number of parameters by 76.54% compared with YOLOv4 at the expense of 0.69% recognition accuracy.
Choroid plexus volume in multiple sclerosis predicts expansion of chronic lesions and brain atrophy
Authors: Klistorner Samuel , Barnett Michael H. , Parratt John , Yiannikas Con , Graham Stuart L. , Klistorner Alexander
Published: September 2022

Objectives

Recent studies suggested that the expansion of long‐standing multiple sclerosis (MS) lesions and an enlargement of choroid plexus may be linked to chronic inflammation and microglial activation. We investigated the potential association between plexus volume and subsequent lesion expansion in patients with relapsing‐remitting MS.

Methods

Pre‐ and post‐gadolinium 3D‐T1, 3D FLAIR and diffusion tensor images were acquired from 49 patients. Choroid plexus (CP) volume (normalised by Total Intracranial Volume, TIV) and lesion activity were analysed between baseline and 48 months. In addition, plexus volume was measured in 40 healthy controls of similar age and gender.

Results

Baseline CP/TIV ratio was significantly larger in RRMS patients compared to normal controls (p < 0.001). CP/TIV ratio remained stable in RRMS patients during follow‐up period. There was a strong correlation between baseline CP/TIV ratio and subsequent rate of chronic lesion expansion (p < 0.001), which was stronger in close proximity to CSF. A cut‐off of 98 × 10−5 CP/TIV ratio predicted future lesion expansion with a sensitivity of 85% and specificity of 76%. CP/TIV ratio larger than a cut‐off was associated with >8‐fold increased risk of chronic lesion expansion. Baseline CP/TIV ratio was also associated with change in Mean Diffusivity (MD) inside of chronic lesions. Furthermore, baseline CP/TIV ratio significantly correlated with central brain atrophy. There was, however, no correlation between CP/TIV ratio and volume of new lesions.

Interpretation

Our data demonstrate that baseline CP/TIV ratio predicts subsequent expansion of chronic periventricular MS lesions and associated tissue damage within and outside of chronic lesions.
A population‐based meta‐analysis of circulating GFAP for cognition and dementia risk
Authors: Gonzales Mitzi M. , Wiedner Crystal , Wang Chen‐Pin , Liu Qianqian , Bis Joshua C. , Li Zhiguang , Himali Jayandra J. , Ghosh Saptaparni , Thomas Emy A. , Parent Danielle M. , Kautz Tiffany F. , Pase Matthew P. , Aparicio Hugo J. , Djoussé Luc , Mukamal Kenneth J. , Psaty Bruce M. , Longstreth William T. , Mosley Thomas H. , Gudnason Vilmundur , Mbangdadji Djass , Lopez Oscar L. , Yaffe Kristine , Sidney Stephen , Bryan R. Nick , Nasrallah Ilya M. , DeCarli Charles S. , Beiser Alexa S. , Launer Lenore J. , Fornage Myriam , Tracy Russell P. , Seshadri Sudha , Satizabal Claudia L.
Published: September 2022

Objective

Expression of glial fibrillary acidic protein (GFAP), a marker of reactive astrocytosis, colocalizes with neuropathology in the brain. Blood levels of GFAP have been associated with cognitive decline and dementia status. However, further examinations at a population‐based level are necessary to broaden generalizability to community settings.

Methods

Circulating GFAP levels were assayed using a Simoa HD‐1 analyzer in 4338 adults without prevalent dementia from four longitudinal community‐based cohort studies. The associations between GFAP levels with general cognition, total brain volume, and hippocampal volume were evaluated with separate linear regression models in each cohort with adjustment for age, sex, education, race, diabetes, systolic blood pressure, antihypertensive medication, body mass index, apolipoprotein E ε4 status, site, and time between GFAP blood draw and the outcome. Associations with incident all‐cause and Alzheimer's disease dementia were evaluated with adjusted Cox proportional hazard models. Meta‐analysis was performed on the estimates derived from each cohort using random‐effects models.

Results

Meta‐analyses indicated that higher circulating GFAP associated with lower general cognition (ß = −0.09, [95% confidence interval [CI]: −0.15 to −0.03], p = 0.005), but not with total brain or hippocampal volume (p > 0.05). However, each standard deviation unit increase in log‐transformed GFAP levels was significantly associated with a 2.5‐fold higher risk of incident all‐cause dementia (Hazard Ratio [HR]: 2.47 (95% CI: 1.52–4.01)) and Alzheimer's disease dementia (HR: 2.54 [95% CI: 1.42–4.53]) over up to 15‐years of follow‐up.

Interpretation

Results support the potential role of circulating GFAP levels for aiding dementia risk prediction and improving clinical trial stratification in community settings.
Vestibular syncope: clinical characteristics and mechanism
Authors: Kwon Hanim , Kwon Eunjin , Kim Hyo‐Jung , Choi Jeong‐Yoon , Kim Ji‐Soo
Published: September 2022

Background and Objectives

Vestibular syncope is a condition in which vertigo‐induced hemodynamic changes cause syncope. This study investigated the clinical and laboratory findings of vestibular syncope and tried to refine our knowledge of the mechanism underlying this newly recognized entity.

Methods

This study retrospectively analyzed 53 patients (33 women, median age = 63 years [interquartile range = 54–71 years]) with vestibular syncope from January 2017 to December 2021. To explain the mechanism of vestibular syncope, we incorporated a velocity‐storage model into the dual reflex pathways comprising the vestibulo‐sympathetic reflex and baroreflex and predicted the cardiovascular responses.

Results

Twenty (37.7%) patients had multiple episodes of vestibular syncope, and seven (13.2%) had potentially life‐threatening injuries. Meniere's disease (20.8%) and benign paroxysmal positional vertigo (9.4%) were the most common underlying vestibular disorders. Abnormal vestibular function tests included impaired cervical vestibular‐evoked myogenic potentials (57.5%) and positive head impulse tests (31.0%). Orthostatic hypotension was found in 19.5% of patients. Dyslipidemia (30.2%) and hypertension (28.3%) were common medical comorbidities. The dual reflex pathways incorporating the function of the velocity‐storage circuit in the brainstem and cerebellum suggest that vestibular syncope is a neurally mediated reflex syncope associated with a sudden hemodynamic change during vertigo. This change can be arterial hypertension triggered by a false downward inertial cue, as suggested previously, or hypotension driven by a false upward inertial cue.

Conclusions

Vestibular syncope is associated with various vestibular disorders and requires careful evaluation and intervention to prevent recurrent falls and significant injuries.
Surface Photon‐Engineered Infrared‐Black Metametal Enabled Enhancement of Heat Dissipation
Authors: Tian Yanpei , Liu Xiaojie , Xie Lijia , Xu Shilin , Chen Fangqi , Mu Ying , Liu Yang , Minus Marilyn L. , Zheng Yi
Published: September 2022

Heat dissipation is a severe barrier for ever‐smaller and more functionalized electronics, necessitating the continuous development of accessible, cost‐effective, and highly efficient cooling solutions. Metals, such as silver and copper, with high thermal conductivity, can efficiently remove heat. However, ultralow infrared thermal emittance (<0.03) severely restricts their radiative heat dissipation capability. Here, a solution‐processed chemical oxidation reaction is demonstrated for transfiguring “infrared‐white” metals (high infrared thermal reflectance) to “infrared‐black” metametals (high infrared thermal emittance). Enabled by strong molecular vibrations of metal‐oxygen chemical bonds, this strategy via assembling nanostructured metal oxide thin films on metal surface yields infrared spectrum manipulation, high and omnidirectional thermal emittance (0.94 from 0 to 60°) with excellent thermomechanical stability. The thin film of metal oxides with relatively high thermal conductivity does not hinder heat dissipation. “Infrared‐black” meta‐aluminum shows a temperature drop of 21.3 °C corresponding to a cooling efficiency of 17.2% enhancement than the pristine aluminum alloy under a heating power of 2418 W m−2. This surface photon‐engineered strategy is compatible with other metals, such as copper and steel, and it broadens its implementation for accelerating heat dissipation.
Robust Nonspiro‐Based Hole Conductors for High‐Efficiency Perovskite Solar Cells
Authors: Akin Seckin , Bauer Michael , Hertel Dirk , Meerholz Klaus , Zakeeruddin Shaik M. , Graetzel Michael , Bäuerle Peter , Dar M. Ibrahim
Published: September 2022

Despite considerable development in performance, both poor operational stability and high costs associated with hole conductors such as 2,2′,7,7′‐tetrakis[N,N‐di(4‐methoxyphenyl)amino]‐9,9′‐spirobifluorene (spiro‐OMeTAD) and Poly[bis(4‐phenyl)(2,4,6‐trimethylphenyl)amine (PTAA) of perovskite solar cells (PSCs) need to be addressed by the research community. Here, two nonspiro hole transporting materials (HTMs), namely HTM‐1 and HTM‐2, are designed and straightforwardly synthesized exhibiting remarkable electrochemical properties and hole mobilities. In particular, the PSC based on the methoxy derivative (HTM‐2) exhibits a remarkable efficiency of 21.2% (stabilized efficiency of 20.8%), which is superior to the benchmark HTM spiro‐OMeTAD (stabilized efficiency of 20.4%). These results establish that the molecular design is effective in improving the performance of PSCs. Importantly, these two HTMs show admissible long‐term stability under different harsh conditions such as thermal stress up to 85 °C, high humidity level of 60% ± 10%, and continuous illumination over 1000 h. These insights allow correlating the impact of molecular design on optoelectronic properties of nonspiro‐based hole conductors with the overall device performance.
Gradient Adhesive Hydrogel Decorated Superhydrophilic Membranes for Ultra‐Stable Oil/Water Separation
Authors: Gao Shoujian , Chen Jinhao , Zheng Yanru , Wang Aqiang , Dong Dianyu , Zhu Yuzhang , Zhang Yatao , Fang Wangxi , Jin Jian
Published: September 2022

Hydrogels are excellent for protecting membranes from oil fouling for oil/water separation. However, conventional hydrogels including adhesive hydrogels have a contradictory between high adhesion on membranes and anti‐oil‐fouling ability. Herein, the design of an adhesive hydrogel on membranes is proposed by ingeniously integrating high adhesion on membranes, outstanding anti‐oil‐fouling ability, ultrathin thickness suitable for membrane decoration and satisfactory durability, where an inside‐out gradient distribution of adhesive protocatechuic acid (PCA) and hydrated calcium alginate (CaAlg) on membranes is constructed. The innermost PCA enables the adhesive hydrogel to tightly adhere to the membranes. The outermost CaAlg defends membranes from oil fouling. The gradient distribution and uniform integration of PCA/CaAlg guarantee an excellent stability. Membranes decorated with the adhesive hydrogel demonstrate superhydrophilicity,  anti‐fouling to various oils, and anti‐abrasion to external damaging. The membranes achieve ultra‐stable and efficient separation of surfactant‐stabilized oil‐in‐water emulsions and crude oil/water mixture with the most advanced cycling ability of ≈100% flux recovery and nearly zero irreversible oil fouling. This study provides a new strategy for designing anti‐oil‐fouling membranes toward practical oil/water separation applications.
Shape‐Controlled NaTaO3 by Flux‐Mediated Synthesis
Authors: Hong Kootak , Tan Shaun , McDermott Matthew J. , Huang Tianyi , Babbe Finn , Kodalle Tim , Gallant Max , Seo Sehun , Toma Francesca M. , Persson Kristin A. , Yang Yang , Sutter‐Fella Carolin M.
Published: September 2022

NaTaO3 is a stable and wide bandgap n‐type semiconductor material with many different applications. Here, a flux‐mediated synthesis method is presented for NaTaO3 resulting in highly distinctive, substrate covering shapes via precursor chemistry variation at comparatively low temperatures. It is found that the microstructure of the resulting NaTaO3 films can be varied from nanocubes to smooth thin films. These shapes and surface chemistries can be correlated by employing density functional theory calculations and surface sensitive X‐ray photoemission spectroscopy. This study provides guidance on how to synthesize the material and tailor its shape and surface termination for different applications. Finally, as a proof of concept of one possible application, NaTaO3 is applied to perovskite solar cells as the electron transport layer, resulting in conversion efficiencies of >19%. This study provides a new strategy for designing ternary oxide thin films for renewable energy applications.
Self‐Powered and Flexible Photodetector with High Polarization Sensitivity Based on MAPbBr3–MAPbI3 Microwire Lateral Heterojunction
Authors: Li Shun‐Xin , Xia Hong , Wang Lei , Sun Xiang‐Chao , An Yang , Zhu He , Bai Ben‐Feng , Sun Hong‐Bo
Published: September 2022

Assembling perovskites into heterojunctions is an effective approach to achieve high‐performance photodetectors. Compared with vertical heterojunctions, in lateral heterojunction‐based photodetectors, the reflection loss is reduced because the active layer is in direct contact with light resulting in higher performance and better stability. However, lateral perovskite–perovskite heterojunctions are difficult to achieve using solution methods because the first formed film is easily dissolved by the solvent of the second precursor. In this study, a two‐step imprinting method is developed to fabricate lateral MAPbI3–MAPbBr3 microwire heterojunctions and realize a high‐performance photodetector with a responsivity and detectivity of 1207 A W−1 and 2.78 × 1013 Jones, respectively. At 0 V bias, the device exhibits a responsivity of up to 233 A W−1, which is more than double the previously reported best results. The high‐quality heterojunction endows the photodetectors with ultra‐high polarization sensitivity (Imax/Imin = 8.2) and long‐term stability, retaining 88.2% of its initial performance even after being exposed to air for 391 d.
Pollen‐Based Magnetic Microrobots are Mediated by Electrostatic Forces to Attract, Manipulate, and Kill Cancer Cells
Authors: Mayorga‐Martinez Carmen C. , Fojtů Michaela , Vyskočil Jan , Cho Nam‐Joon , Pumera Martin
Published: September 2022

Naturally occurring micro/nanoparticles provide an incredible array of potential sources when preparing hybrid micro/nanorobots and their intrinsic properties can be exploited as multitasking functionalities of modern robotics as well as ensuring their mass production availability. Herein, magnetic biological bots (BioBots) prepared from defatted sunflower pollen microparticles by ferromagnetic metal layer evaporation on one side of its surface are described. It is demonstrated that the methodology employed introduces magnetic properties to sunflower pollen microparticles‐based BioBots and enable their magnetic actuation. Interestingly, as‐prepared magnetic sunflower pollen‐based BioBots can naturally attract cancer cells due to their opposite charges (positive and negative, respectively). Such attracted cancer cells can then be transported by microrobots. This strong attraction also allows the delivery of drugs intended to kill the cancer cells. Sunflower‐based BioBots can be fabricated in large quantities, and are naturally programmable, making them promising candidates for cancer cell therapy.
Hierarchically Superhydrophobic Stereo‐Complex Poly (Lactic Acid) Aerogel for Daytime Radiative Cooling
Authors: Liu Xianhu , Zhang Mingtao , Hou Yangzhe , Pan Yamin , Liu Chuntai , Shen Changyu
Published: September 2022

Passive radiative cooling technology provides a sustainable way of cooling by the combination of emitting heat to the cold universe and reflecting solar light without any energy input. However, the massive consumption of non‐degradable radiative cooling materials causes resource waste and environmental pollution. Meanwhile, the cooling efficiency can be easily affected by dirt contamination in outdoor environments. Here, by the combination of biomimetic hierarchical structure design and stereo‐complex crystals, a degradable and superhydrophobic (152°) stereo‐complex poly (lactic acid) aerogel with low thermal conductivity (37 mW m–1 K–1), high compression strength (0.1 MPa) and self‐cleaning ability via a simple water‐assisted thermally induced phase separation method is developed. The optimal aerogel has a high sunlight reflection (89%) and strong infrared emissivity (93%) that gets a temperature drop of 3.5 °C during the daytime and 5.8 °C during the nighttime. This aerogel opens an environmentally sustainable pathway to radiative cooling applications.
Dual‐Functional, Multi‐Targeting GNNQQNY‐AIE Conjugates as Amyloid Probes and Amyloid Modulators via Amyloid Cross‐Seeding Principle
Authors: Tang Yijing , Zhang Dong , Gong Xiong , Zheng Jie
Published: September 2022

Amyloid protein aggregation is associated with many neurodegenerative diseases, including amyloid‐β (Aβ) in Alzheimer disease, human islet amyloid polypeptide (hIAPP) in type II diabetes, and human calcitonin (hCT) in medullary thyroid carcinoma. Significant efforts have been made to develop different diagnostic and prevention strategies for the early detection and intervention of these disease‐causative protein aggregates. However, conventional design wisdoms are mostly limited to the molecules with either single function (amyloid imaging or amyloid prevention) or single targeting protein (Aβ, hIAPP, or hCT). Here, a rational design strategy of an amyloid‐aggregation‐induced emission (AIE)‐active molecule is demonstrated by conjugating an amyloid fragment of GNNQQNY (G7) with an AIE fluorescent molecule of triphenylvinyl benzoic acid (namely, G7‐TBA), making G7‐TBA as multiple‐target, dual‐function, amyloid probes and amyloid modulators for detecting, monitoring, and altering amyloid aggregation of three different amyloid proteins (Aβ, hIAPP, and hCT). G7‐TBA probe shows conformationally specific binding affinities to amyloid aggregates, switching from an “off” state (low fluorescence) for amyloid monomers to an “on” state (high fluorescence) for β‐structure‐rich amyloid oligomers and fibrils in aqueous solution. Further surface immobilization of TBA probes on surface plasmon resonance surfaces allows to amplify detection sensitivity and binding affinity to amyloid aggregates formed at different aggregation stages. G7‐TBA as amyloid modulator enables acceleration of amyloid fibrillization and selectively protects cells from hIAPP‐induced toxicity. The distinct amyloid detection and modulation of G7‐TBA are essentially derived from the cross‐seeding between G7 and amyloid aggregation via β‐structure interaction, which by far exceed the binding affinity between commercial ThT and amyloid aggregates. Such design concepts of amyloid‐AIE conjugates can be further explored as multiple‐function and target probes and/or modulators for biomedical applications.