bluuebunny/crossref_metadata_2025 huggingface dataset:
Multiobjective Optimization of Port Collecting and Distributing Network Considering the Balance Among Efficiency, Environmental Performance, and Disruption to Urban Traffic
Authors: Yang Yi , Liu Bochi , Chen Dongan , Xu Xinglu , Wang Wenyuan
Published: December 2024

Port collecting and distributing network (PCDN) carries both freight traffic flow associated with the port and urban traffic flow, serving as the only channel between the port and the hinterland. The congestion caused by increasing freight traffic seriously disrupts urban traffic and leads to environmental issues such as increased carbon emissions. To address this issue, this study proposes a multiobjective optimization approach for the route selection of freight traffic flow within the PCDN, considering the balance among efficiency, environmental performance, and disruption to urban traffic. First, the generation mechanism and characteristics of freight traffic flow in the PCDN are analyzed, followed by the development of a mathematical model based on the static traffic flow distribution theory and the multiobjective optimization theory. Then, a solution framework with NSGA‐III as the core is developed, and an improved Dial algorithm is utilized to allocate traffic flow. Finally, taking a large‐scale container port as the case study, the solution framework is implemented to address the multiobjective optimization model and obtain the optimal route for freight traffic. The results show that there are significant negative correlations between distributing efficiency and disruption to urban traffic, as well as between distributing efficiency and carbon emissions. Decision‐makers can choose the optimal route according to different preferences or adopt the compromise solution by referencing the Pareto front obtained by the solution framework. The proposed method provides theoretical support for designing the PCDN scientifically.
Eccentric Training to Restore Persistent Functional Loss Following Ruptured Achilles Tendon: The Role of Fascicle Length and Muscle Excursion
Authors: Hoeffner Rikke , Svensson Rene B. , Magnusson S. Peter
Published: December 2024

Background: Persisting deficits are often seen years after an Achilles tendon rupture despite dedicated rehabilitation efforts. A possible reason for reduced function is elongation of the tendon and accompanying shortening of the muscle. Strength training with focus on the eccentric component of loading leads to longer muscle fascicles in healthy persons.

Purpose: To investigate if focused eccentric training would result in increased muscle fascicle length, strength and excursion, reduced fat fraction, and functional improvements.

Study Design: Longitudinal within‐subject exploratory study.

Methods: Fourteen persons, with a prior unilateral Achilles tendon rupture who still experienced functional deficits > 1 year after injury, underwent an isokinetic eccentric training program for 12 weeks. Tendon length, muscle fascicle length, cross‐sectional area, strength, and functional parameters were measured on the injured and uninjured sides before and after 12 weeks of training.

Results: For gastrocnemius fascicle length and fat content in the triceps surae, no significant change over time on the injured or uninjured side was detected. There was a significant interaction effect (p = 0.0065) and side effect (p < 0.0001) for heel‐rise count, resulting in a significantly smaller difference between the sides at 12 weeks compared to baseline. With extended knee, the eccentric and concentric plantar flexion peak torques showed a significant interaction effect (eccentric: p = 0.0074 and concentric: p = 0.0187), as well as a significant side effect (eccentric: p = 0.0002 and concentric: p < 0.0001) and time effect (eccentric p = 0.0179 and concentric p = 0.0093). Between weeks 0 and 12, ATRS significantly improved (mean difference 11.6 points, 95% CI [4–19], p < 0.0001).

Conclusion: Fascicle length was not altered by the intervention. However, plantar flexion toque, heel‐rise count, and, importantly, the patient‐reported outcome measure ATRS improved.
Switching Drivers: Epigenetic Rewiring to Genetic Progression in Glioma
Authors: Drucker Kristen L. , Jenkins Robert B. , Schramek Daniel
Published: December 2024

IDH-mutant low-grade gliomas (LGGs) are slow-growing brain tumors that frequently progress to aggressive high-grade gliomas that have dismal outcomes. In a recent study, Wu and colleagues provide critical insights into the mechanisms underlying malignant progression by analyzing single-cell gene expression and chromatin accessibility across different tumor grades. Their findings support a two-phase model: in early stages, tumors are primarily driven by oligodendrocyte precursor-like cells and epigenetic alterations that silence tumor suppressors like CDKN2A and activate oncogenes such as PDGFRA. As the disease advances, the tumors become sustained by more proliferative neural precursor-like cells, where genetic alterations, including PDGFRA, MYCN, and CDK4 amplifications and CDKN2A/B deletion, drive tumor progression. The study further highlights a dynamic regulation of interferon (IFN) signaling during progression. In low-grade IDH-mutant gliomas, IFN responses are suppressed through epigenetic hypermethylation, which can be reversed with DNMT1 inhibitors or IDH inhibitors, leading to reactivation of the IFN pathway. In contrast, higher-grade gliomas evade IFN signaling through genetic deletions of IFN gene clusters. These findings emphasize a broader epigenetic-to-genetic shift in oncogenic regulation that drives glioma progression, provides a valuable framework for understanding the transition from indolent tumors to lethal malignancies, and has implications for therapy and clinical management.
Supplementary Figure 2 from Tumor Expression of CD83 Reduces Glioma Progression and Is Associated with Reduced Immunosuppression
Authors: McDonald Malcolm F. , Curry Rachel Naomi , O’Reilly Isabella , Lozzi Brittney , Cervantes Alexis , Lee Zhung-Fu , Rosenbaum Anna , He Peihao , Mohila Carrie , Harmanci Arif O. , Serin Harmanci Akdes , Deneen Benjamin , Rao Ganesh
Published: December 2024

Supplementary figure 2.
Figure 1 from Tumor Expression of CD83 Reduces Glioma Progression and Is Associated with Reduced Immunosuppression
Authors: McDonald Malcolm F. , Curry Rachel Naomi , O’Reilly Isabella , Lozzi Brittney , Cervantes Alexis , Lee Zhung-Fu , Rosenbaum Anna , He Peihao , Mohila Carrie , Harmanci Arif O. , Serin Harmanci Akdes , Deneen Benjamin , Rao Ganesh
Published: December 2024

Antigen presenting–like tumor cells express Cd83 in human and mouse glioma. Expression of GO:0002291: T-cell activation via T-cell receptor contact with antigen bound to MHC molecule on APC and GO:0002468: dendritic cell antigen processing and presentation in human IDHWT and IDHmut glioma tumor cells that were differentially expressed (A). scRNA-seq from five IDHmut and seven IDHWT gliomas demonstrate a rare population of CD83+ tumor cells (B and C). Percentage of IDHmut and IDHWT tumor cells from scRNA-seq that expressed different combinations of CD45 and CD83 (D). Immunofluorescence imaging for IDH1R132H tumor cells that express CD83 (E). scRNA-seq from pB-IUE glioma isolates similar murine tumor cells (F). Percentage of murine tumor cells from scRNA-seq that expressed different combinations of CD45 and CD83 (G). Multispectral flow cytometry isolates a distinct population of GFP+CD83+ tumor cells (H). (Created with Biorender.com.)
Data from Tumor Expression of CD83 Reduces Glioma Progression and Is Associated with Reduced Immunosuppression
Authors: McDonald Malcolm F. , Curry Rachel Naomi , O’Reilly Isabella , Lozzi Brittney , Cervantes Alexis , Lee Zhung-Fu , Rosenbaum Anna , He Peihao , Mohila Carrie , Harmanci Arif O. , Serin Harmanci Akdes , Deneen Benjamin , Rao Ganesh
Published: December 2024

Abstract
Malignant glioma, the most lethal form of brain cancer, presents with an immunosuppressive microenvironment that obstructs tumor cell clearance and hampers immunotherapeutic interventions. Despite advancements in characterizing cellular and extracellular profiles in cancer, the immunosuppressive mechanisms specific to glioma remain poorly understood. We conducted single-cell RNA sequencing of glioma samples, which revealed a select subset of human and mouse glioma cells that express CD83, a marker associated with mature antigen-presenting cells. To investigate the impact of tumor cell CD83 expression on glioma outcomes, we used an immunocompetent mouse model of glioma, bioinformatic analyses of human samples, and in vitro assays. Our findings revealed that CD83+ tumor cells contribute to tumor growth suppression and are associated with enhanced cytotoxic T-cell profiles and activated CD8+ T cells. Increased proinflammatory cytokines were identified in CD83-overexpressing tumor conditions, which were also correlated with long-term CD8+ antitumor responses. Importantly, tumor-derived CD83 could mediate communication with T cells, altering the immune microenvironment to potentially enhance immune-related tumor clearance. Collectively, our data suggest that tumor cell expression of CD83 supports the endogenous antitumor T-cell constituency in malignant glioma. Future research endeavors may aim to further investigate whether CD83 expression can enhance immunotherapeutic approaches and improve patient outcomes.
Significance:
Immunosuppression in malignant glioma remains a barrier to therapeutic development. CD83 overexpression in human and mouse glioma increases survival. CD83+ tumor cells promote signatures related to cytotoxic T cells, enhanced activation of CD8+ T cells, and increased proinflammatory cytokines. These findings suggest that tumor-expressed CD83 could mediate tumor–immune communications.
Appendicitis in Pregnancy - A Multidisciplinary Approach and optimal Management from the perspective of Gynecology and Obstetrics: A Case Report
Authors: Zapletal Jan , Sehnal Borek , Drochytek Vit , Hruda Martin , Lochmanova Ivana , Halaska Michael J. , Oliverius Martin
Published: December 2024

Appendectomy for acute appendicitis is the most common surgical procedure performed during pregnancy. The primary treatment for acute appendicitis is emergency surgery, which can be particularly challenging due to altered anatomical conditions. Preoperative and postoperative care may require certain examinations due to pregnancy that are not standard within surgical practice or may be overlooked by the attending gynecologist.
In the presented case report, we demonstrate an example of the appropriate multidisciplinary approach in a patient at 33 weeks of pregnancy, with an analysis of the specific steps that should be taken to maximize the benefit for both the fetus and the mother, as well as the surgical team. In the discussion, we outline the steps that should be followed for patient benefit and forensic reasons.
Cost-effectiveness analysis of endoscopic treatment versus medication strategy for proton pump inhibitor-refractory gastroesophageal reflux disease
Authors: Ishibashi Fumiaki , Suzuki Sho , Mochida Kentaro , Tonishi Takao , Ishibashi Yuichi
Published: December 2024

Introduction: Potassium-competitive acid blockers are effective against proton pump inhibitor-refractory gastroesophageal reflux disease; however, their long-term use is associated with economic disadvantages. Endoscopic procedures may reduce potassium-competitive acid blocker use. This study aimed to determine the optimal treatment strategy for patients with proton pump inhibitor-refractory gastroesophageal reflux disease from a cost-effectiveness perspective.
Methods: Using a Markov state transition model to simulate symptom changes in patients with proton pump inhibitor-refractory gastroesophageal reflux disease, the cost-effectiveness of two strategies was compared: endoscopic treatment (anti-reflux mucosectomy or endoscopic submucosal dissection for gastroesophageal reflux disease) followed by potassium-competitive acid blocker versus medication with high-dose potassium-competitive acid blocker. In both strategies, potassium-competitive acid blocker maintained symptoms at the lowest controllable dose. The time horizon varied from 10 to 50 years. The quality-adjusted life year and incremental cost-effectiveness ratio were calculated. Willingness-to-pay was set at 5,000,000 Japanese yen.
Results: The quality-adjusted life years gained were 0.90 and 0.95 for the endoscopic treatment and medication strategies, respectively. The incremental cost-effectiveness ratio varied with the follow-up period after the initial treatment, with the endoscopic treatment strategy being more cost-effective than the medication strategy at ≥50 years of follow-up. A dose reduction success rate of <84.1% for high-dose potassium-competitive acid blocker and an endoscopic treatment success rate of >66.8% were required to determine the superiority of the endoscopic treatment strategy at the 50-year follow-up after treatment.
Discussion/Conclusions: The endoscopic treatment strategy is not cost-effective unless the patient is followed up for >50 years after the initial treatment.
Nursing Ethics in Risk Management
Authors: Ni Made Ratih Comala Dewi , Ni Komang Sri Wahyuni , I Made Yudi Wahyu , Putu Cintariasih , Kadek Sri Wahyuni Dewi , Luh Gde Nita Sri Wahyuningsih
Published: December 2024

Introduction: Hospitals are obliged to carry out health services that are quality, safe, effective, anti-discrimination, and always prioritize patient safety. Risk management is closely related to the implementation of patient safety in hospitals and has an impact on achieving hospital quality. From an ethical perspective, the value of trust is a prerequisite for success-ful risk management. This value is related to safety culture because it refers to physical safety, psychological safety, and cultural safety. The purpose of this writing is to find out and provide information about nursing ethics in risk management, especially related to patient safety.Methods: The method of free exploration and also the approach of journals, laws and regulations of the Ministry of Health of the Republic of Indonesia. The data sources used three journal databases: ScienceDirect, PubMed, and Google Scholar. Keywords in this literature review are adjust-ed to Medical Subject Heading (MeSH) which consists of “nursing ethics” AND “patient safety” AND “risk management”. Several inclusion criteria were set to obtain eligible articles: published between 2014 and 2024, and written in English or Bahasa. Result: This report presents an explanation of risk management related to patient safety. In the implementation of patient safety programs, one of them is the aspect of nursing ethics that is closely related to patient safety.Conclussion : Patient safety is multidimensional and is the ultimate goal of the healthcare system, which is to ensure the quality and safety of services, it is necessary to have structured policies and processes to pro-mote a shared safety environment.
The Relationship between Gadget Addiction and Emotional Disturbance in Adolescents
Authors: Wraspati Ni Komang Galuh Ayu , Sanjiwani Anak Agung Sri Sanjiwani , Ni Ketut Ayu Mirayanti
Published: December 2024

Introduction: Adolescence is a transitional developmental period characterized by biological, cognitive, and socio-emotional changes. During this stage, adolescents are particularly vulnerable to emotional disturbances. In addition to depression and anxiety, these disturbances may include irritability, frustration, or excessive anger. One of the cur-rent phenomena contributing to adolescents' emotional challenges is gadget addiction. Frequent and excessive use of gadgets increases the risk of emotional and mental development issues in adolescents. The aim of this research is to investigate the relationship between gadget addiction and emotional disturbances in adolescents. Methods: This study employed quantitative descriptive research methods with a cross-sectional approach. The sample was selected using stratified ran-dom sampling techniques, resulting in 279 respondents. Data were ana-lyzed using the Spearman Rank Test. Results: The Spearman Rank Test analysis revealed a p-value of 0.000 (<0.05), indicating a significant re-lationship between gadget addiction and emotional disturbances in adolescents at SMA X Denpasar. The correlation coefficient value was 0.676, demonstrating a strong and positive relationship between gadg-et addiction and emotional disturbances. Among the five subscales of the questionnaire used in this study, most students showed emotional problems related to their learning experiences at school. Additionally, students exhibited symptoms such as restlessness, anxiety, irritability, and difficulty controlling their emotions. Conclusion: Adolescents are encouraged to use gadgets more responsibly and to balance their screen time with physical activities to mitigate emotional disturbances and promote overall well-being.
ЕПІГЕНЕТИЧНІ МЕХАНІЗМИ ВПЛИВУ ФАКТОРІВ НАВКОЛИШНЬОГО СЕРЕДОВИЩА НА ЗДОРОВ’Я ЛЮДИНИ ТА ЇЇ НАЩАДКІВ
Authors: Кашуба М. О. , Кожухарьова М. С.
Published: December 2024

РЕЗЮМЕ. Епігенетика дозволяє розширити наші знання про механізми розвитку багатьох захворювань, викликаних факторами зовнішнього середовища. Нові дослідження в галузі епігенетики встановили, що ряд захворювань, які раніше розцінювали як генетично спадкові, насправді мають епігенетичний характер.
Знання про епігенетику важливі, оскільки дають розуміння того, як наш спосіб життя та навколишнє середовище впливають не тільки на наше здоров’я а й на здоровʼя та тривалість життя майбутніх поколінь. Епігенетика показує, що такі фактори як харчування, фізична активність, стрес, як і фактори навколишнього середовища, можуть змінювати активність генів, впливаючи на ризик розвитку захворювань.
Мета – ознайомити медичних працівників із основами епігенетики, розкрити важливі епігенетичні механізми впливу різних факторів на здоровʼя людини та її потомства.
Матеріал і методи. Літературний пошук у наукових виданнях, в тому числі Інтернет-виданнях, аналіз та інтерпретація результатів представлених в літературі даних.
Висновки. Нові дослідження в галузі епігенетики суттєво змінили розуміння механізмів виникнення захворювань у людини під впливом зовнішніх чинників, в тому числі й способу життя, та можливої передачі цих захворювань або схильності до них наступним поколінням у результаті епігенетичних змін в її геномі. Вони показали, що зовнішні фактори можуть впливати на експресію або депресію генів такими механізмами як метилювання/деметилювання ДНК, інтерференція РНК, зміни в конденсації хроматину тощо.
Епігенетика в медицині відкриває нові шляхи для профілактики, діагностики та лікування різних захворювань. Знання про епігенетичні зміни дозволяють розробляти методи лікування, які можуть бути ефективнішими та більш адаптованими до кожного пацієнта. Це перспективний напрямок, який має великий потенціал для покращення якості життя людини та його подовження.
Водночас, дослідження в цій галузі стикаються з низкою викликів, які потребують нових підходів і технологій для їх подолання. Розвиток епігенетичних досліджень відкриває унікальні можливості для медицини, але вимагає етичного підходу і тривалих досліджень для повного розуміння їхніх ефектів і потенціалу.
ВПЛИВ ВАЛСАРТАНУ І ОЛМЕСАРТАНУ НА ПОЛІМОРФІЗМ ГЕНІВ NO-СИНТАЗИ
Authors: Підручна С. Р. , Янчишина М. А. , Мудра Є. М. , Теренда О. А.
Published: December 2024

РЕЗЮМЕ. Мета роботи – проаналізувати сучасні дані про вплив валсартану та олмесартану на поліморфізм генів NO-синтази та його наслідки для ефективності лікування артеріальної гіпертензії.
Матеріал і методи. Матеріалом для роботи були дані літератури за останні 5–10 років, що стосуються артеріальної гіпертензії, NO-синтази, поліморфізму генів та дії антигіпертензивних препаратів.
Результати. Препарати валсартан та олмесартан, хоча й не впливають безпосередньо на активність NO-синтази, опосередковано збільшують виробництво оксиду азоту. Ефективність цих препаратів залежить від індивідуальних генетичних особливостей пацієнта, зокрема від поліморфізму генів NO-синтази. Вивчено, що генетичний тест може допомогти підібрати оптимальну дозу та комбінацію препаратів для кожного пацієнта з артеріальною гіпертензією. Це дозволяє підвищити ефективність лікування та знизити ризик розвитку небажаних побічних ефектів. Однак для широкого застосування генетичних тестів у клінічній практиці необхідні подальші дослідження та розробка стандартних протоколів. Таким чином, розуміння взаємодії між препаратами та генетичними факторами відкриває нові перспективи для персоналізованої терапії артеріальної гіпертензії.
Висновки. Валсартан та олмесартан непрямо стимулюють вироблення NO. Поліморфізм генів NO-синтази впливає на ефективність цих препаратів. Генетичний тест дозволяє підібрати індивідуальну терапію для пацієнтів з артеріальною гіпертензією, підвищити її ефективність та знизити ризик побічних ефектів. Однак для широкого застосування генетичних тестів потрібні додаткові дослідження.
Ключові моменти:

Валсартан та олмесартан впливають на NO через рецептори ангіотензину II.
Поліморфізм генів NO-синтази впливає на реакцію організму на ці препарати.
Генетичний тест допомагає підібрати оптимальне лікування для кожного пацієнта.
Подальші дослідження необхідні для ширшого використання генетичних тестів у клінічній практиці.
Цей підхід дозволяє персоналізувати лікування артеріальної гіпертензії та покращити прогноз для пацієнтів.
КОНЦЕПЦІЯ МАТЕМАТИЧНОЇ МОДЕЛІ ДЛЯ ПРОГНОЗУ РИЗИКУ РОЗВИТКУ ТРОАКАРНИХ ГРИЖ ПІСЛЯ ЛАПАРОСКОПІЧНОЇ ХОЛЕЦИСТЕКТОМІЇ
Authors: Варварук М.-І. Р. , Дзюбановський І. Я. , Дзюбановський О. І.
Published: December 2024

РЕЗЮМЕ. Післяопераційна троакарна грижа є ускладненням після лапароскопічного оперативного втручання. Поширеність лапароскопічної хірургії невпинно зростає у сучасній хірургічній практиці, тому важливим є вивчення специфічних ускладнень після таких оперативних втручань.
Мета – розробка математичної моделі для прогнозування ризику виникнення троакарної грижі після лапароскопічної холецистектомії.
Матеріал і методи. Ретроспективне дослідження медичних карт 50-ти пацієнтів, які були прооперовані з приводу діагнозу "троакарна грижа". Загалом були оцінені анатомічні локальні та системні детермінанти виникнення даного захворювання. Використовували багатофакторний регресійний аналіз для оцінки якості регресійної моделі, проаналізували гістограму залишкових відхилень та їх нормально-ймовірнісний графік, а також, щоб оцінити прийнятність моделі в цілому, провели аналіз ANOVA.
Результати. Було встановлено значущі фактори, які мають вплив на ризик розвитку троакарної грижі: вік, стать, післяопераційні ускладнення після виконання холецистектомії, індекс маси тіла (ІМТ), захворювання серцево-судинної системи, цукровий діабет, захворювання шлунково-кишкового тракту, дисплазія сполучної тканини, планова/ургентна лапароскопічна холецистектомія, морфологічна форма холециститу катаральний/деструктивний, повторні оперативні втручання в анамнезі, доступ, який використовували при холецистектомії. За результатами проведеного аналізу було встановлено, що до математичної моделі визначення коефіцієнта ризику розвитку троакарних гриж увійшло 6 найбільш значущих факторів: післяопераційні ускладнення після виконання холецистектомії, індекс маси тіла (ІМТ), дисплазія сполучної тканини, планова/ургентна лапароскопічна холецистектомія, повторні оперативні втручання в анамнезі, доступ, який використовували при холецистектомії. За допомогою аналізу ANOVA можна зробити висновок про високий рівень прийнятності моделі прогнозування ризику розвитку троакарних гриж в цілому, оскільки рівень значущості p<0,001, а сама модель буде працювати краще, ніж простий прогноз, використовуючи середні значення.
Висновки. Дану математичну модель слід використовувати для оцінки ризику розвитку троакарних гриж.
ПЕРЕДОПЕРАЦІЙНА ПІДГОТОВКА ПАЦІЄНТІВ ІЗ ОКЛЮЗИВНИМ ПРОЦЕСОМ АОРТО/КЛУБОВО-СТЕГНОВОГО БАСЕЙНУ ПРИ ХРОНІЧНІЙ ЗАГРОЗЛИВІЙ ІШЕМІЇ НИЖНІХ КІНЦІВОК І РИЗИКУ РОЗВИТКУ РЕПЕРФУЗІЙНО-РЕОКСИГЕНАЦІЙНОГО СИНДРОМУ
Authors: Хвалибога Д. В. , Дзюбановський І. Я. , Караневич Х. Г.
Published: December 2024

РЕЗЮМЕ. Технічно вдало виконана операція не гарантує відновлення периферичного кровотоку і збереження нижньої кінцівки, що найчастіше трапляється при реваскуляризації пацієнтів із атеросклеротичною оклюзією аорто/клубово-стегнового басейну в умовах хронічної загрозливої ішемії нижніх кінцівок і високим ризиком розвитку реперфузійно-реоксигенаційного синдрому.
Мета – покращити результати реконструкції у пацієнтів із атеросклеротичною оклюзією аорто/клубово-стегнового басейну в умовах хронічної загрозливої ішемії нижніх кінцівок і загрозою розвитку реперфузійно-реоксигенаційного синдрому.
Матеріал і методи. У статті обговорюються результати реконструктивних операцій на магістральному артеріальному руслі нижніх кінцівок у пацієнтів з атеросклеротичною оклюзією аорто-біфеморального артеріального русла за умов хронічної загрозливої ішемії (ХЗІНК) та ризику розвитку реперфузійно-реоксигенаційного синдрому (РРС). У дослідженні взяли участь 104 пацієнти, поділені на дві групи залежно від ступеня ризику ускладнень.
Результати. У дослідженні взяли участь 104 пацієнти, поділені на дві групи залежно від ступеня ризику ускладнень. Аналіз показав, що післяопераційні ускладнення виникали у значної частини хворих: у період 2014–2018 рр. ускладнення були діагностовані у 78,2 % пацієнтів, тоді як у 2019–2023 рр. їх частота зменшилася до 38,9 %. Це свідчить про ефективність вдосконалених підходів доопераційної підготовки, яка включала епідуральну анестезію, гіпербаричну оксигенацію, введення гіперосмотичного декстрину, препарати на основі алпростадилу та інші заходи. Важливим аспектом є розвиток реперфузійно-реоксигенаційного синдрому (РРС), який виявлявся у 23,3 % пацієнтів у 2014–2018 рр. та у 15,4 % у 2019–2023 рр. Патогенез РРС включає активізацію запальних реакцій, утворення вільних радикалів та погіршення мікроциркуляції, що призводить до серйозних післяопераційних ускладнень, включаючи набряк нижньої кінцівки та ниркову недостатність.
Висновок. Упровадження комплексної патогенетично обґрунтованої доопераційної підготовки продемонструвало позитивний вплив на зниження частоти післяопераційних ускладнень в ранньому післяопераційному періоді у пацієнтів із оклюзією А/КСБ і ХЗАННК та ризиком розвитку РРС у 1,8 раза.
КРИТЕРІЇ ГОТОВНОСТІ МАЙБУТНІХ МЕДИЧНИХ СЕСТЕР ДО ПРОВЕДЕННЯ ДІАГНОСТИЧНИХ ДОСЛІДЖЕНЬ ЗАСОБАМИ КОМП’ЮТЕРНИХ ТЕХНОЛОГІЙ
Authors: Славопас В. А.
Published: December 2024

Вступ. Сучасна медична практика дедалі більше інтегрує комп’ютерні технології в діагностичний процес. Це вимагає від медичних сестер високого рівня готовності до роботи із сучасним програмним забезпеченням, діагностичними платформами та базами даних. Формування цієї готовності є одним із важливих аспектів професійної підготовки. Застосування цифрових інструментів у медицині не лише підвищує точність і швидкість діагностики, але й сприяє оптимізації діяльності медичного персоналу. Це ставить перед медичними сестрами завдання оволодіти сучасним програмним забезпеченням, діаг­ностичними платформами та базами даних, які стають невід’ємною складовою їх щоденної роботи.
Мета роботи – визначити критерії готовності майбутніх медичних сестер до проведення діагностичних досліджень із використанням комп’ютерних технологій.
Основна частина. У дослідженні було виділено три основні компоненти готовності: когнітивний (знання про комп’ютерні технології), практичний (навички роботи з програмним забезпеченням) та мотиваційний (усвідомлення важливості використання сучасних технологій у медичній практиці). Також акцентовано увагу на важливості формування в майбутніх медичних сестер здатності адаптуватися до нових технологій і постійно вдосконалювати свої професійні компетенції. Запропоновано рекомендації для вдосконалення навчальних програм, які включають інтерактивні заняття, симуляційні тренінги, практичні кейси та міждисциплінарний підхід до навчання. Це сприятиме більш ефективному засвоєнню матеріалу та підвищенню рівня готовності студентів до використання сучасних цифрових технологій у професійній діяльності.
Висновки. Розроблені критерії дозволяють оцінити рівень готовності майбутніх медичних сестер до використання комп’ютерних технологій під час проведення діагностичних досліджень. Це сприятиме підвищенню якості медичної освіти та ефективності професійної діяльності медичних працівників.
New fossil Anaxyelidae (Insecta: Hymenoptera: Siricoidea) from the Lower Cretaceous Yixian Formation of northeastern China
Authors: LI YI , RASNITSYN ALEXANDR P. , SHIH CHUNGKUN , REN DONG , WANG MEI
Published: December 2024

One new genus and two new species, Hemisyntexis lepida gen. et sp. nov., Eosyntexis conflata sp. nov., and new material of Parasyntexis khasurtensis Kopylov, 2019 are respectively described and illustrated based on three well-preserved compression fossils from the Lower Cretaceous Yixian Formation of northeastern China. Eosyntexis conflata sp. nov., placed in the genus Eosyntexis Rasnitsyn, together with H. lepida, belongs to the subfamily Syntexinae of Anaxyelidae. The new species provide important morphological characters to enhance our understanding of the subfamily Syntexinae, and to revise the diagnostic characters of Eosyntexis as well. Moreover, we carried out a comprehensive survey of all currently published extant and extinct species of Anaxyelidae to gain a better understanding of the trend of change for the forewing and body length. Furthermore, we formally documented that the Anaxyelidae had four different color patterns for the wings simultaneously in the Jehol Biota of the Lower Cretaceous.
Beyond the Ladder: The Effects of Limited Promotion Opportunities on Bureaucrats’ Career Decisions and Work Effort
Authors: Kim Taeho
Published: December 2024

Public-sector organizations often struggle to provide sufficient promotion incentives, raising concerns that limited advancement opportunities may undermine worker morale and performance. This study examines how frontline bureaucrats’ effort levels and career decisions respond to restricted promotion opportunities. In the Chicago Police Department, strict eligibility criteria for promotion exams unexpectedly reduced promotion chances for some officers compared to otherwise similar officers. This reduction in managerial promotion opportunities led ineligible officers to significantly increase their effort levels, as measured by arrest performance. The increase in arrests cannot be attributed to selective quitting, problematic behavior, or efforts motivated by overtime pay or future promotion. Instead, these officers pursued roles in high-performance tactical teams, which offer prestige and are viewed as a meaningful horizontal alternative to managerial advancement. Together, these results suggest that bureaucrats facing limited promotion opportunities may seek alternative ways to advance their careers and enhance their efforts, highlighting the importance of offering diverse career development options within public-sector organizations.
John Calvin’s Theological Reflection on the Necessity of Prayer: How to Promote a Covenantal Relationship of God and Humanity in Christ
Authors: Ahn Hojin
Published: December 2024

This article explores the perceived tension in John Calvin’s teachings regarding human prayer within the broader theological context of predestination and the bondage of the human will to sin. Contrary to claims of a logical contradiction, I argue that Calvin’s doctrine of prayer aligns with his soteriology, serving as a practical expression of Christian faith. Calvin places prayer within his theological anthropology, emphasizing the renewed human nature post-salvation, empowered by the Holy Spirit. Framed as a dialogue with God, prayer becomes a believer’s responsibility involving discernment, gratitude, and petitionary prayers—a simultaneous response to requests and a discipline of faith. Calvin examines the harmonious interplay of divine and human will in Christ’s prayer for believers, justifying and sanctifying imperfect human petitions through Christ’s mediation. His theological reflection suggests God’s personal response to His children’s requests, elevating them to covenantal partners in realizing his eternal salvific will in Christ.
Combining simulation and reinforcement learning to reduce food waste in food retail
Authors: Pilarski Sebastian , Sidhu Aman , Varró Dániel
Published: December 2024

Extraordinary amounts of fresh produce are never purchased and are discarded as waste. Reinforcement learning (RL) could serve as a means to improve business profits while reducing food waste via control of store pricing and ordering decisions. We present a discrete-event-based simulation framework for food retail which simulates wholesaler, store, and customer interactions. This simulator is critical for driving development and testing of future RL methods. It provides an efficient learning feedback system across a wide gamut of possible scenarios, which cannot be replicated from live observations or pure historical data alone. This is crucial as RL agents cannot learn robust decision-making policies without exposure to many unique scenarios. We evaluate our simulator on a demonstrative case generated from historical consumption and price data using a provided methodology for synthesizing daily demand from monthly and yearly stats. In this demonstrative case, we investigate proximal policy optimization, soft actor–critic, and deep Q networks trained with different reward formulations to decrease food waste and improve profits. These RL methods reduced food waste by 78%–92% on average on an unseen 3-year test period as compared to a baseline mimicking typical food retail waste. Compared to a second popular baseline in literature, the best performing RL algorithm was able to improve profits by up to 12.3%.
‘Proxy Parenting’ and Creating a ‘Golden Touch’: Practices and Discourses of Intensive Grandparenting
Authors: Anving Terese , Eldén Sara , Alenius Wallin Linn , Brodersen Franciska
Published: December 2024

Grandparents’ involvement in their adult children’s families has increased in recent decades, especially in relation to care arrangements around grandchildren. This ‘new army of proxy parents’ calls for the need to critically analyse grandparental care. Drawing on a study on intergenerational care in Sweden, involving grandparents, adult children and grandchildren (63 interviewees including 28 grandparents), we suggest the concept of intensive grandparenting as an analytical lens for understanding contemporary grandparental involvement in care for grandchildren. Intensive grandparenting is done in a complex and ambivalent relation to parenting, making grandparents ‘proxy parents’ that help realise intensive parenting ideals, while also realising ‘good grandparenting’ ideals through adding a ‘golden touch’ to grandparent–grandchild relations. This growing involvement of grandparents, while highly appreciated, risks reproducing gendered and classed inequalities within and between families.
Optimized dead-zone control based on a sliding-mode mechanism for a class of unknown nonlinear dynamic systems
Authors: Ma Shuaihua , Sun Wenxia , Li Bin , Wen Guoxing
Published: December 2024

The article aims to propose an optimized tracking control for the high-order nonlinear dynamic system with the unknown dead zone of the controller. The dead zone refers to a control with zero behavior in some ranges, hence the system performance will be inevitably affected. Since the dead-zone phenomenon is frequently encountered in control systems, it is very necessary to consider the effect in optimized nonlinear control. Because the high-order system contains multiple system states, the optimized dead-zone control is designed by combining both reinforcement learning (RL) and sliding-mode control. Furthermore, an adaptive compensation of the remainder of the dead-zone function is added into the dead-zone input, then the optimized dead-zone control is yielded from the RL under identifier–actor–critic architecture, where the identifier can remove the requirement of known dynamic function. Finally, the effectiveness of this optimized control is proved by Lyapunov stability analysis and a simulation example.
Patient identified with interrupted aortic arch and 22q11.2 deletion syndrome in late pregnancy: a case report
Authors: Pu Kejun , Yang Mengya , Xia Meng , He Shuxin , Song Hongbi , Wu Jing
Published: December 2024

Interrupted aortic arch (IAA) is an uncommon congenital heart malformation that can be fatal with no surgical intervention. Most patients have IAA discovered as newborns because of cardiac symptoms, and atypical adult patients are relatively rare. We report a case of atypical adult IAA in a woman in her 20s. Her first pregnancy and childbirth did not show any obvious abnormalities. Although this patient did not have any major clinical manifestations, she developed tachycardia during her second pregnancy and was diagnosed with IAA by echocardiography. The etiology of IAA was chromosome 22q11.2 deletion syndrome based on the results of whole-exome sequencing. After interdisciplinary diagnosis and treatment to reduce the pulmonary artery pressure and cardiac burden, the patient and her newborn had a favorable prognosis. This case highlights the importance of not overlooking cardiovascular concerns in patients who develop symptoms in pregnancy. Echocardiography can detect IAA, and genetic testing may assist in an etiological diagnosis, which improves the maternal and fetal prognosis.
Spotting and Addressing Bullies’ “Sticky” Storytelling: Serendipitous Findings of a Mixed-Methods Study
Authors: Howard Matthew S. , Embree Jennifer , Kennison Monica , Dzurec Laura
Published: December 2024

Telling stories is central to lived experience, a mechanism for emotionally engaging the storyteller and listeners. For the storyteller, telling stories is a powerful way of bolstering social cooperation. For listeners, stories support sensemaking, or the subconscious ability to rationalize the actions witnessed or heard. The investigators’ previous research demonstrated workplace bullies’ skills in telling stories. Findings of that work highlighted the ways bullies use a tone of voice and body language to make the stories they tell—whether those stories comprise brief one-liners or ongoing diatribes—hard to resist. Bullies’ stories are not always factually accurate. They often solicit substantial social cooperation from stakeholders around the workplace. Most significantly, and of most salience in regard to this study, bullies’ stories, while delivered with a particular style or flair, readily come to define listener perspective despite their often intentionally misleading content. This study tested the utility of a novel intervention designed to help listeners who believe the implications of bullies’ stories—that is, those who are victimized—to recognize the often self-defeating impact of bullies’ narrative affronts. Findings indicated that the study’s primary intervention did not demonstrate the effect intended by the investigators. However, the findings emphasize the significance of acknowledging the impact of bullies’ storytelling on the thoughts and feelings of the individuals they target. It underscores the necessity for providing assistance and empathy to those who have experienced bullying while also considering the significance of the work environment, communication dynamics, and administrative measures in shaping the experiences of those affected by bullying. The findings emerged as an unexpected and valuable discovery that might define a research focus worthy of future consideration and suggest appropriate interventions for workplace administrators.
Won’t Get Fooled Again? Theorizing Discursive Constructions of Novelty in the ‘New’ World of Work
Authors: Aroles Jeremy , Leclercq-Vandelannoitte Aurélie , Hassard John , Foster William M , Granter Edward
Published: December 2024

This article outlines how notions of novelty define today’s work practices and debates what the discursive construction of work as ‘new’ means. On the one hand, we highlight a misplaced emphasis on change and novelty that can lead to unnecessary dichotomization in the characterization and discursive construction of work practices and organizational phenomena. On the other, we specify substantive continuities in a range of strategic, organizational and employment arrangements. As such, we contend that a critical evaluation of key characteristics of contemporary work reveals that they are often not unique. Instead, these characteristics reflect the extending, rebranding or reshaping of measures and processes fashioned in earlier forms of value production. Ultimately, we theorize how the promotion of the ‘new’ world of work reflects structures and practices somehow altered in appearance, yet still analogous in substance, to those found in the traditional employment and production fabric of organizations.
Design of an adapted extended Kalman filter for enhancing UAV navigation with optical flow
Authors: Yao Wu-Sung , Lin Chun-Yi , Wu Yu-Fan , Wang Xiang-Hui
Published: December 2024

In this paper, the modified design of the currently common visual relative motion inertial navigation system (INS) is proposed to enhance the inertial measurement unit (IMU) model algorithm. The aim of the study is to improve the precise landing and indoor positioning-free flight of existing indoor drones. Both the INS and the airborne IMU used for traditional optical flow guidance are designed to input information to the same extended Kalman filter (EKF) functional module, low cost but resulting in signal phase shift and reduced reliability indicators. Unlike large drones, which can easily reduce vibration, for micro drones, the camera usually must be fixed directly to the body, making it very difficult to isolate vibrations. Using traditional methods can easily cause optical flow guidance to drag down the quality of the entire positioning function. In this study, the improved positioning guidance procedure is proposed and is applied to the indoor positioning flight of UAVs. The EKF, based on the kinematics and optical flow characteristic states equations is separated from the main navigation system. The current positioning and heading are predicted in a way where the optical flow INS and IMU are positioned separately. The positioning and heading are estimated through the current trust weighting value of the optical flow INS and the IMU. Experimental results show that the Monte Carlo method is used to simulate the impact of different signal-to-noise ratios (SNR) on acceleration, angular velocity measurement noise, and the number of detected features on the probability of success of the estimation process. At lower SNR, it shows that the proposed method can resist interference more effectively.
Modern pollen distribution across Mizoram, northeastern India, impacted by regional climate and anthropogenic activities
Authors: Mehrotra Nivedita , Shah Santosh K , Malsawmliana  , Kar Ratan
Published: December 2024

Modern pollen-rain analysis was carried out for the first time across central, western and eastern regions of Mizoram, encompassing different regional climatic zones. The vegetation experiences massive ecological pressure as a consequence of environmental factors, including the monsoon winds from the Bay of Bengal, high temperature, precipitation conditions, and varied topography. Additionally, intense human activities in the state of Mizoram impact the forest landscape in the remote northeastern part of India. These include agricultural activities such as shifting cultivation ( Jhum), commercial crop plantations such as banana, rubber, oil palm, tea, etc., pastoral activities and others. We collected moss cushion samples across transects in the central, western and eastern regions of Mizoram, to comprehend the impact of natural and anthropogenic factors on the modern vegetation and resultant pollen taxa on the surface deposits. The modern pollen data were analyzed statistically, including constrained redundancy analysis (RDA). The RDA analysis revealed the impact of bioclimatic variables on the pollen record, such as isothermality, precipitation in the warmest quarter and annual precipitation. The most significant variable was isothermality (bio_3) which indicated the dominance of anthropogenically impacted sites on the species distribution. Here, we identified that an interplay of climate- and anthropogenic-driven forcing were primarily controlling the modern vegetation and pollen-rain across Mizoram. The anthropogenic indicator pollen, such Poaceae (>50 µm), Caryophylaceae, Asteroideae, Cannabaceae, and Palmae at various sites reveal the impact of anthropogenic activities on the modern vegetation. The results reveal the impact of climatic zones, altitude gradients, anthropogenic activities and vegetation distribution on the pollen yield from the surface deposits.
Enhancing Competitiveness of Small Medium-sized Enterprises during the Post-Pandemic through Intellectual Capital and Technology Capabilities
Authors: Sari Synthia Atas , Ahmad Noor Hazlina
Published: December 2024

Companies in developing countries need to make small and medium-sized businesses more competitive in this age of post-pandemic because these businesses make up more than half of a country’s gross domestic product. Reflecting on the pandemic, the uncertainties and disruption further exacerbated the challenges and agility of small and medium-sized enterprises. Some of the problems these businesses still face today are speed, complexity, new ideas and sheer size of technology. The primary objective of this research is to investigate the essentiality of intellectual capital (IC) and technology capabilities in attaining strategic agility (SA) for competitive viability while also encouraging the resilience of small- and medium-sized firms in the context of after pandemic. The methodology of this study is quantitative, with administration of a survey spanned a duration of 8 months, targeting a sample of 188 small and medium-sized enterprises from Indonesia that fulfilled the criteria established for this study. The study utilized partial least squares structural equation modelling to empirically investigate and assess the hypotheses. The outcomes of this study indicate that both constructs have a significant impact on SA, which in turn has a substantial effect on competitiveness. The results derived from the analysis of the importance-performance matrix had business implications that small and medium-sized enterprises should place greater emphasis on improving the performance of their IC to strengthen their SA and eventually augment their competitiveness.
A Scoping Review of Multilevel Patient-Sharing Network Measures in Health Services Research
Authors: Korsberg Ashlee , Cornelius Sarah L. , Awa Fares , O’Malley James , Moen Erika L.
Published: December 2024

Social network analysis is the study of the structure of relationships between social entities. Access to health care administrative datasets has facilitated use of “patient-sharing networks” to infer relationships between health care providers based on the extent to which they have encounters with common patients. The structure and nature of patient-sharing relationships can reflect observed or latent aspects of health care delivery systems, such as collaboration and influence. We conducted a scoping review of peer-reviewed studies that derived patient-sharing network measure(s) in the analyses. There were 134 papers included in the full-text review. We identified and created a centralized resource of 118 measures and uncovered three major themes captured by them: Influential and Key Players, Care Coordination and Teamwork, and Network Structure and Access to Care. Researchers may use this review to inform their use of patient-sharing network measures and to guide the development of novel measures.