bluuebunny/crossref_metadata_2025 huggingface dataset:
Het beloop van suïcidaliteit tijdens de coronapandemie in Nederland
Authors: Schweren Lizanne J. S. , Veerbeek Marjolein , de Bruin Kim , Buster Marcel , Geerdink Maryke , Zeelenberg Geranda , Gilissen Renske
Published: June 2023

Samenvatting

De Commissie Actuele Nederlandse Suïcideregistratie (CANS) monitort sinds de start van de coronapandemie maandelijks de incidentie van suïcide in Nederland, zowel in de hele bevolking als in drie hoogrisicogroepen: jongeren en jongvolwassenen tot dertig jaar, mannen en mensen van middelbare leeftijd (40–70 jaar). Hiertoe is een intuïtief stoplichtsysteem ontwikkeld dat de incidentie van suïcide ten opzichte van een referentieperiode aangeeft, variërend van groen (benedengemiddelde incidentie) naar rood (sterk verhoogde incidentie). Wanneer de cijfers daartoe aanleiding geven, kan de commissie op korte termijn verzoeken om duiding door clinici en/of preventieve maatregelen. In dit artikel beschrijven we fluctuaties in de incidentie van suïcide in Nederland tijdens de coronapandemie (1 maart 2020 tot en met augustus 2022). Sinds de start van de pandemie werden geen aanwijzingen gevonden voor een verhoogde incidentie van suïcide in de gehele populatie of onder mensen van middelbare leeftijd. De dalende trend in de incidentie van suïcide onder mannen die voorafgaand aan de pandemie waarneembaar was, stagneerde tijdens de pandemie. De stijgende trend in de incidentie van suïcide onder jongeren/jongvolwassenen die voorafgaand aan de pandemie zichtbaar was, zette tijdens de pandemie door. Een causale relatie tussen de coronapandemie en suïcide-incidentie kan met het CANS-monitoringsysteem niet worden vastgesteld. Het instrument detecteert zowel snelle pieken als geleidelijke stijgingen in de incidentie van suïcide, en is geschikt voor gebruik tijdens crisissituaties en daarbuiten. Het systeem kan flexibel worden aangepast aan de onderzoeksvragen en/of populaties. De resultaten van dit onderzoek onderschrijven het belang van monitoring en geven aanleiding om de incidentie van suïcide nauwkeurig te blijven volgen.
STORM: een aanpak voor depressie- en suïcidepreventie voor jongeren
Authors: Rasing Sanne , Creemers Daan
Published: June 2023

Samenvatting

Strong Teens and Resilient Minds – STORM – is een aanpak voor depressie- en su﻿ïcidepreventie voor jongeren. Het aantal jongeren dat te maken krijgt met depressieve klachten en su﻿ïcidale gedachten neemt gedurende de adolescentie toe en daarom is preventie in deze leeftijdsfase belangrijk. De STORM-aanpak wordt uitgevoerd in de tweede en vierde klas van het voortgezet onderwijs en in de eerste klas van het middelbaar beroepsonderwijs. Het betreft een samenwerking tussen partners in het onderwijs en de zorg. In dit artikel beschrijven we de inhoud van de aanpak, de wetenschappelijke bevindingen en de wijze waarop de samenwerking tussen de verschillende netwerkpartners wordt vormgegeven.
Does COVID-19 facilitate gender inequality in article submission behavior? To what extent is article submission behavior influenced by career status? An exploration using the German Journal of Exercise and Sport Research as an example
Authors: Henning Lena , Raue-Behlau Charlotte , Halberschmidt Barbara , Peikenkamp Jana , Tietjens Maike
Published: June 2023

During the COVID-19 pandemic, many governments closed schools and imposed social distancing requirements, limiting childcare options and requiring researchers to stay at home. Recent studies indicated that women are particularly negatively affected by the pandemic containment measures. Depending on discipline and type of publication, it is stated that the number of submissions by women has fallen dramatically, but submissions by men have remained constant or even increased. The aim of this study is to examine whether a decrease in article submissions during the COVID-19 pandemic by women also applies to the field of sport and exercise sciences using the German Journal of Exercise and Sport Research as an example. Furthermore, this study aimed to investigate to what extent career status has an influence on submission behavior during COVID-19. The current analysis focuses on 198 submissions to the German Journal of Exercise and Sport Research, which were systematically examined with regard to the first authorship of articles submitted from April 1st, 2019 to March 31st, 2021. Results of a log-linear analysis show that men submitted significantly more articles. The gap between women and men is greatest in the position of professors, which reflects the distribution of women and men in scientific employees. However, no significant differences in submission behavior are found before vs. during the pandemic. This study functions as a starting point for the discipline of sport and exercise science from which submission behavior should be further monitored taking into account individual and social factors which might influence submission behavior.
The Uterine Environment and Childhood Obesity Risk: Mechanisms and Predictions
Authors: Cristian Andreea , Tarry-Adkins Jane L. , Aiken Catherine E.
Published: June 2023

Purpose of Review

Childhood obesity is a growing health problem in many populations, hence the urgent need to unravel the underlying mechanisms. Some evidence suggests that exposure to suboptimal intrauterine environments can program foetal metabolic health, with adverse consequences in later life, including susceptibility to childhood obesity.

Findings

Factors such as high and low foetal birth weight, excessive gestational-weight-gain, maternal stress and smoking are all associated with increased risk of childhood obesity in observational studies. Animal models, where both genetic background and the postnatal environment can be carefully controlled, suggest that several different mechanisms, including epigenetic changes, dysregulation of adipose tissue development and programming of appetite, may be key drivers of developmental programming of childhood obesity. However, the influence of genetics and the post-natal environment are much more difficult to disentangle as independent effects in human studies, which are also complicated by low follow-up rates.

Suboptimal intrauterine environments interact with maternal and foetal genetics and with the postnatal environment to contribute to the risk of childhood obesity. Maternal metabolic challenges, for example obesity and insulin resistance, contribute to the risk of foetal overgrowth and subsequent adiposity in childhood. To protect the long-term health of populations, research focusing on effective means of identifying and intervening in the transgenerational cycle of childhood obesity is required.
Radiation Retinopathy
Authors: Chen Kaylie , Browne Andrew W.
Published: June 2023

Purpose of the Review.

In this review, we bring together recent developments in the detection and management of radiation retinopathy.

Recent Findings

Research into OCT-angiography for radiation retinopathy has led to the identification of biomarkers of early radiation-induced changes in the retinal microvasculature including focal capillary loss and vascular remodeling. These microvasculature changes are detectable after exposure to radiation but prior to the emergence of classical clinical markers historically used to diagnose radiation retinopathy. The ability to detect subclinical changes may present the need to redefine radiation retinopathy diagnostic criteria which may ultimately impact management. Additionally, explorations into prophylactic treatment following radiation exposure and development of newer anti-VEGF agents may present more options for retinal specialists to prevent or treat vision loss and retinal vasculopathy from radiation exposure.

Currently, anti-VEGF injections and/or intravitreal steroids remain the primary treatment following a diagnosis of radiation retinopathy. However, a mainstay treatment and management strategy have not yet been identified. In the future, new anatomical endpoints for radiation retinopathy may be identified with OCT-angiography while prophylactic treatment with anti-VEGF agents following radiation therapy may reduce initial vision loss and changes to the retina.
(Dis)Respect for Fundamental Rights in EU Competition Law Enforcement Proceedings Before National Authorities: In What Way Does Article 3 of the ECN+ Directive Prove To Be too Open-Ended?
Authors: Piszcz Anna , Petr Michal
Published: June 2023

The ECN+ Directive gives national competition authorities more power in order to make them more effective enforcers of EU competition law. However, Art. 3 of the ECN+ Directive counterbalances this by requiring that appropriate safeguards are in place to ensure that undertakings’ fundamental rights are respected in EU competition law enforcement proceedings. The aim of this article is to critically reflect on the requirements of the ECN+ Directive with respect to safeguards for the fundamental rights that fall within the ambit of Art. 3 of the ECN+ Directive and the implementation of those requirements by EU Member States. To this end, the article first provides an overview of this provision. Second, by means of an overview of national laws, it analyses whether the very general Art. 3 is capable of harmonising the safeguards in question. A set of comparative examples from EU Member States, including in particular examples Poland and the Czech Republic, shows how the wording of Art. 3 invites national legislatures to misuse the potential of this provision. This results in undertakings continuing to face disparity in the extent to which their fundamental rights are protected in competition law enforcement proceedings before the various national competition authorities.
On Y-coordinates of Pell equations which are Fibonacci numbers
Authors: Luca Florian , Zottor Faith S.
Published: June 2023

Let$$d \ge 2$$d≥2be an integer which is not a square. We show that if$$(F_n)_{n\ge 0}$$(Fn)n≥0is the Fibonacci sequence and$$(X_m, Y_m)_{m\ge 1}$$(Xm,Ym)m≥1is themth solution of the Pell equation$$X^2 -dY^2 = \pm 1$$X2-dY2=±1, then the equation$$Y_m = F_n$$Ym=Fnhas at most two positive integer solutions (m, n) except for$$d=2$$d=2when it has three solutions$$(m,n)=(1,2),(2,3),(3,5)$$(m,n)=(1,2),(2,3),(3,5).
Novel Use of Cellulose Based Biodegradable Nano Crystals in the Machining of PPS Composites: An Approach Towards Green Machining
Authors: Şap Serhat , Usca Üsame Ali , Tarih Yavuz Selim , Yar Adem , Kuntoğlu Mustafa , Gupta Munish Kumar
Published: June 2023

Because of their biodegradable and regenerative properties, cellulose nanocrystals derived primarily from naturally occurring cellulose fibers serve as a sustainable and environmentally beneficial material for most applications. Although these nanocrystals are inherently hydrophilic, they can be surface functionalized to suit a wide range of demanding requirements, such as those associated with the creation of high-performance nanocomposites in hydrophobic polymer matrices. Therefore, the present work deals with the application of cellulose-based biodegradable nanocrystals as a lubricant in the machining of PPS composites. In this study, milling process was considered to investigate the influence of the sustainable lubricating conditions on the machinability indexes of PPS composites. As a novel cooling approach, water-based solutions enriched by cellulose nanocrystals with different reinforcements (0.25%, 0.5%, and 1%) were used over known methods such as MQL, conventional flood, and dry. According to the research outcomes, cellulose nanocrystals-based nanofluids provided satisfying contributions on retarding the tool wear and reducing the cutting temperatures considerably. Despite the surface-related results such as roughness, topography and texture are promising for the developed strategy; further investigations will be useful to determine ideal water-particle concentration to improve the quality of the machined surface.
HPO-RRT*: a sampling-based algorithm for UAV real-time path planning in a dynamic environment
Authors: Guo Yicong , Liu Xiaoxiong , Jia Qianlei , Liu Xuhang , Zhang Weiguo
Published: June 2023

The real-time path planning of unmanned aerial vehicles (UAVs) in dynamic environments with moving threats is a difficult problem. To solve this problem, this paper proposes a time-based rapidly exploring random tree (time-based RRT*) algorithm, called the hierarchical rapidly exploring random tree algorithm based on potential function lazy planning and low-cost optimization (HPO-RRT*). The HPO-RRT* algorithm can guarantee path homotopy optimality and high planning efficiency. This algorithm uses a hierarchical architecture comprising a UAV perception system, path planner, and path optimizer. After the UAV perception system predicts moving threats and updates world information, the path planner obtains the heuristic path. First, the path planner uses the bias sampling method based on the artificial potential field function proposed in this paper to guide sampling to improve the efficiency and quality of sampling. Then, the tree is efficiently extended by the improved time-based lazy collision checking RRT* algorithm to obtain the heuristic path. Finally, a low-cost path optimizer quickly optimizes the heuristic path directly to optimize the path while avoiding additional calculations. Simulation results show that the proposed algorithm outperforms the three existing advanced algorithms in terms of addressing the real-time path-planning problem of UAVs in a dynamic environment.
In situ detection of product age and argon concentration as measure of the re-use potential of insulating glass units in buildings
Authors: van Nieuwenhuijzen E. J. , Tetteroo J. I. A. , van de Vliet M. , Melet E.
Published: June 2023

High level circular use of post-consumer insulating glass units will contribute to lower the environmental and social impact of insulation glass industry. The application of various circular strategies for insulating glass units (IGU’s) is rising. The product age will give an indication of the remaining life-time of an IGU, but a method which includes screening a technical quality is needed to check if an IGU is indeed suitable for re-use on a high level of circularity. In this study the argon concentration is suggested as discriminative quality. Energy efficient double glazing applied in windows of buildings situated in The Netherlands were studied. Product codes were noted and unraveled. Measurements were performed using the Sparklike Laser Portable, a non-invasive argon measuring device, which generates argon concentration, glass thickness and cavity width values. In addition, measurements were performed with a Glass Check thickness meter. The resulting data were analyzed. Measuring errors were explored and used to setup a testing procedure. Threshold values of the product age and argon concentration were selected for different circular strategies. In conclusion, a screening method using the product age and argon concentration to determine the circular use potential of insulating glass units is proposed.
‘It’s not a priority’: Australian generalist classroom teacher experiences of teaching the Health Education component of Health and Physical Education
Authors: Cruickshank Vaughan , Mainsbridge Casey , Nash Rosie , Pill Shane , Williams John
Published: June 2023

The study purpose was to address a gap in the literature and gain a better understanding of Australian, specifically Tasmanian, primary school classroom teachers’ experiences of teaching health education (HE). By classroom teachers we mean generalist primary teachers, who in Australia typically teach all eight key learning areas (KLAs). In most Australian states and territories, HE exists within the health and physical education (HPE) mandated KLA, but often the delivery of HE is a responsibility assumed by classroom teachers as opposed to HPE specialists. Our study involved 53 primary classroom teacher participants in Tasmania and examined the state of play of HE. We used a mixed methods research design that included an online survey through which participants were subsequently invited to take part in semi-structured interviews. While participants tended to value HPE, we found HE was even more disenfranchised than physical education, within HPE as an already marginalised area, compared to “more academic” KLAs. This “double marginalisation” contributed to reports of inconsistent delivery of HE. Consistent with the health promoting schools agenda, we suggest a whole of school approach in addition to increased collaboration between teachers and increased HE professional learning opportunities for classroom teachers is required to facilitate change and increased prioritisation of HE in schools.
Global functional calculus, lower/upper bounds and evolution equations on manifolds with boundary
Authors: Sánchez Duván Cardona , Kumar Vishvesh , Ruzhansky Michael , Tokmagambetov Niyaz
Published: June 2023

Given a smooth manifold M (with or without boundary), in this paper we establish a global functional calculus, without the standard assumption that the operators are classical pseudo-differential operators, and the Gårding inequality for global pseudo-differential operators associated with boundary value problems. The analysis that we follow is free of local coordinate systems. Applications of the Gårding inequality to the global solvability for a class of evolution problems are also considered.
Furosemide in the management of acute kidney injury in the pediatric intensive care unit—retrospective cohort study
Authors: Vivek Sermadurai , Rameshkumar Ramachandran , Muthu Meera , Karunakar Pediredla , Chidambaram Muthu , Kumar Chinnaiah Govindhareddy Delhi , Selvan Tamil , Mahadevan Subramanian
Published: June 2023

Objective

To evaluate the effects of furosemide administration in critically ill children on the progression of acute kidney injury (AKI) and its outcomes compared to those not receiving furosemide.

Method

A retrospective cohort study involving children aged 1 month (corrected) to 13 years admitted to the pediatric intensive care unit (PICU) and who were diagnosed with AKI within 24 h was screened for enrollment. Those who received furosemide are classified as the furosemide group, and others as no-furosemide group. The primary outcome was the proportion of patients with AKI (risk or injury stage) progressing to a higher stage. The secondary outcomes were kidney replacement therapy (KRT), fluid balance (%FO), urine output, multi-organ dysfunction, kidney recovery, length of mechanical ventilation, hospital stay including PICU, and all-cause mortality (PICU and hospital).

Results

Three hundred sixty-two patients’ data [furosemide group, n = 182; no-furosemide group, n = 180] were enrolled. The median (IQR) pediatric risk of mortality–III score was similar between groups [10, 4–16 vs. 10, 4–16; p = 0.244]. The primary outcome occurred in 51 (28%) in the furosemide and 36 (20%) in the no-furosemide group. The difference was not statistically significant [RR = 1.40, 95% CI 0.96 to 2.04, p = 0.074]. Higher mean (SD) urine output (ml/kg/hr) was noted in the furosemide group [2.3 (0.9) vs. 1.4 (0.6); p =  < 0.001). Significantly higher mean (SD) organ dysfunction score [10 (4) vs. 8.3 (4.4); p < 0.001) and increased median (IQR) length of stay in mechanical ventilation [4, 3–6 vs. 3, 2–6 days; p < 0.001] and hospital [8, 5–11 vs. 6, 5–8 days; p < 0.001] and lower kidney recovery at discharge was noted in the furosemide group [n = 86, 47.3% vs. n = 104, 57.8%; RR = 0.80, 95% CI 0.64 to 0.99; p = 0.044]. No difference was noted in all-cause mortality, fluid balance, and KRT requirement.

Conclusion

Furosemide infusion in AKI management did not reduce the progression to a higher stage of AKI. Nevertheless, it was associated with higher morbidities.
Handedness and test anxiety: An examination of mixed-handed and consistent-handed students
Authors: Thomas Christopher L. , Fitch Savannah B.
Published: June 2023

Test anxiety refers to maladaptive cognitive and physiological reactions that interfere with optimal performance. Self-regulatory models suggest test anxiety occurs when there is a perceived discrepancy between current functioning and mental representations of desired academic goals. Interestingly, prior investigations have demonstrated those with greater interhemispheric communication are better able to detect discrepancies between current functioning and preexisting mental representations. Thus, the current study was designed to investigate the relationship between test anxiety and handedness—a commonly used proxy variable for interhemispheric communication. Undergraduate and graduate students (N = 277, 85.20% female, 68.19% Caucasian,

$ \overline{\chi} $

age = 29.88) (SD = 9.53) completed the FRIEDBEN Test Anxiety Scale and Edinburgh Handedness Inventory – Short Form. A series of Mann–Whitney U tests were used to test for differences in the cognitive, physiological, and social components of test anxiety between mixed- and consistent-handers. The results indicated that mixed-handers had significantly higher levels of cognitive test anxiety than consistent-handers. We believe this information has important implications for our understanding of the role of discrepancy detection and interhemispheric communication in eliciting and maintaining test-anxious responses.
Uniformly distributed floor sources of buoyancy can give rise to significant spatial inhomogeneities within rooms
Authors: Vouriot Carolanne V.M. , Higton Thomas D. , Linden P.F. , Hughes Graham O. , van Reeuwijk Maarten , Burridge Henry C.
Published: June 2023

Displacement ventilation, where cool external air enters a room through low-level vents and warmer air leaves through high-level vents, is characterised by vertical gradients in pressure arising from the warmer indoor temperatures. Models usually assume that horizontal variations of temperature difference are small in comparison and are, therefore, unimportant. Small-scale laboratory experiments and computational fluid dynamics were used to examine these flows, driven by a uniformly heated floor. These experiments and simulations show that the horizontal variations of temperature difference can be neglected for predictions of the bulk ventilation rate; however, they also evidence that these horizontal variations can be significant and play a critical role in establishing the pattern of flow within the room – this renders the horizontal position of the low- and high-level vents (relative to one another) important. We consider two cases: single-ended (where inlet and outlet are at the same end of the room) and opposite-ended. In both cases the ventilation flow rate is the same. However, in the opposite-ended case a dead zone is established in the upper part of the room which results in significant horizontal variations. We consider the formation of this dead zone by examining the streamline patterns and the age of air within the room. We discuss the implications for occupant exposure to pollutants and airborne disease.
Trilobites from theCedaria prolificaZone (Cambrian, upper Guzhangian) of the Precordillera of Mendoza, western Argentina
Authors: Tortello M. Franco
Published: June 2023

Trilobites from the upper Guzhangian of the southern Argentine Precordillera, preliminarily described by Carlos Rusconi in the 1950s, are revised herein. The specimens studied were collected from an allochthonous limestone block of La Cruz Olistoliths at 200 m northwest of Estancia San Isidro locality (San Isidro area, Mendoza). Taxa compriseKormagnostus seclusus(Walcott, 1884),Cedaria prolificaWalcott, 1924,C.puelchanaRusconi, 1954,Tricrepicephalus texanus(Shumard, 1861),Meteoraspis metra(Walcott, 1890),Coosia conicephala(Rusconi, 1954) new combination,Coosella texana? Resser, 1942,Nasocephaluscf.N. nasutusWilson, 1954, andOlenoides proa(Rusconi, 1954) new combination. The North American generaMeteoraspisResser, 1935 andNasocephalusWilson, 1954 are reported confidently from South America for the first time. This assemblage is representative of theCedaria prolificaZone, which correlates with the lowerCrepicephalusZone of the traditional North American genus-based zonation. Most of the genera and species identified were previously described exclusively from Canada, the United States, and northwestern Mexico, a fact that provides new support to an allochthonous Laurentian origin of the Argentine Precordillera.
On more than two decades of Celestial Reference Frame VLBI observations in the deep south: IVS-CRDS (1995–2021)
Authors: Weston S. , de Witt A. , Krásná Hana , Le Bail Karine , Hardin Sara , Gordon David , Fengchun Shu , Fey Alan , Schartner Matthias , Basu Sayan , Titov Oleg , Behrend Dirk , Jacobs Christopher S. , Hankey Warren , Salguero Federico , Reynolds John E.
Published: June 2023

The International VLBI Service for Geodesy and Astrometry (IVS) regularly provides high-quality data to produce Earth Orientation Parameters (EOP), and for the maintenance and realisation of the International Terrestrial and Celestial Reference Frames, ITRF and ICRF. The first iteration of the celestial reference frame (CRF) at radio wavelengths, the ICRF1, was adopted by the International Astronomical Union (IAU) in 1997 to replace the FK5 optical frame. Soon after, the IVS began official operations and in 2009 there was a significant increase in data sufficient to warrant a second iteration of the CRF, ICRF2. The most recent ICRF3, was adopted by the IAU in 2018. However, due to the geographic distribution of observing stations being concentrated in the Northern hemisphere, CRFs are generally weaker in the South due to there being fewer Southern Hemisphere observations. To increase the Southern Hemisphere observations, and the density, precision of the sources, a series of deep South observing sessions was initiated in 1995. This initiative in 2004 became the IVS Celestial Reference Frame Deep South (IVS-CRDS) observing programme. This paper covers the evolution of the CRDS observing programme for the period 1995–2021, details the data products and results, and concludes with a summary of upcoming improvements to this ongoing project.
Is Carbon Risk Priced in the Cross Section of Corporate Bond Returns?
Authors: Duan Tinghua , Li Frank Weikai , Wen Quan
Published: June 2023

This article examines the pricing of a firm’s carbon risk in the corporate bond market. Contrary to the “carbon risk premium” hypothesis, bonds of more carbon-intensive firms earn significantly lower returns. This effect cannot be explained by a comprehensive list of bond characteristics and exposure to known risk factors. Investigating sources of the low carbon alpha, we find the underperformance of bonds issued by carbon-intensive firms cannot be fully explained by divestment from institutional investors. Instead, our evidence is most consistent with investor underreaction to the predictability of carbon intensity for firm cash-flow news, creditworthiness, and environmental incidents.
Quantitative experimental L2 acquisition MALL studies: A critical evaluation of research quality
Authors: Burston Jack , Athanasiou Androulla , Giannakou Konstantinos
Published: June 2023

With more than 1,200 publications over the past two decades, experimental mobile-assisted language learning (MALL) studies targeting second/foreign language (L2) acquisition outcomes are certainly not lacking in quantity. Their research quality, on the other hand, has often been brought into question, most notably with regard to the adequacy of their assessment instruments and statistical analyses. Yet limiting the determination of research quality to the evaluation of testing procedures, and the statistical analysis of the results they produce, ignores the critical relevance of the underlying research parameters that generate the results in the first place. A comprehensive evaluation of quantitative experimental L2 acquisition MALL research quality, encompassing design as well as assessment instruments and statistical analysis, thus remains to be undertaken. The present investigation endeavors to do so based on an extensive compilation of 737 MALL studies published between 2000 and 2021. The research quality of these publications is evaluated according to four main parameters: language acquisition moderators, treatment intervention conditions, assessment instruments, and statistical analysis. These are applied according to a modified version of the Checklist for the Rigor of Education-Experiment Designs (CREED), which classifies research design quality into five levels: low, medium-low, medium, medium-high, high. With over three quarters of all studies falling within the low category, the result leaves much to be desired. Since the modified CREED algorithm developed here can equally be applied to studies from their inception, it offers a way forward to improve the research quality of future experimental MALL studies.
Alterations in the expression pattern of some epigenetic-related genes and microRNAs subsequent to oocyte cryopreservation
Authors: Shadmanesh Ali , Nazari Hassan
Published: June 2023

MicroRNAs (miRNAs) are small non-encoding RNAs that actively regulate biological and physiological processes, and play an important role in regulating gene expression in all cells, especially in most animal cells, including oocytes and embryos. The expression of miRNAs at the right time and place is crucial for the oocyte’s maturation and the embryo’s subsequent development. Although assisted reproductive techniques (ART) have helped to solve many infertility problems, they cause changes in the expression of miRNA and genes in oocytes and preimplantation embryos, and the effect of these changes on the future of offspring is unknown, and has caused concerns. The relevant genomic alterations commonly imposed on embryos during cryopreservation may have potential epigenetic risks. Understanding the biological functions of miRNAs in frozen maturated oocytes may provide a better understanding of embryonic development and a comparison of fertility conservation in female mammals. With the development of new techniques for genomic evaluation of preimplantation embryos, it has been possible to better understand the effects of ART. The results of various articles have shown that freezing of oocytes and the cryopreservation method are effective for the expression of miRNAs and, in some cases, cause changes in the expression of miRNAs and epigenetic changes in the resulting embryo. This literature review study aimed to investigate the effects of oocyte cryopreservation in both pre-maturation and post-maturation stages, the cryopreservation method and the type of cryoprotectants (CPA) used on the expression of some epigenetic-related genes and miRNAs.
Peritoneal catheters in neonates undergoing complex cardiac surgery: a multi-centre descriptive study
Authors: Kwiatkowski David M. , Alten Jeffrey A. , Raymond Tia T. , Selewski David T. , Blinder Joshua J. , Afonso Natasha S. , Coghill Matthew T. , Cooper David S. , Koch Joshua D. , Krawczeski Catherine D. , Mah Kenneth E. , Neumayr Tara M. , Rahman A. K. M. Fazlur , Reichle Garret , Tabbutt Sarah , Webb Tennille N. , Borasino Santiago
Published: June 2023

Background:

The use of peritoneal catheters for prophylactic dialysis or drainage to prevent fluid overload after neonatal cardiac surgery is common in some centres; however, the multi-centre variability and details of peritoneal catheter use are not well described.

Methods:

Twenty-two-centre NEonatal and Pediatric Heart Renal Outcomes Network (NEPHRON) study to describe multi-centre peritoneal catheter use after STAT category 3–5 neonatal cardiac surgery using cardiopulmonary bypass. Patient characteristics and acute kidney injury/fluid outcomes for six post-operative days are described among three cohorts: peritoneal catheter with dialysis, peritoneal catheter with passive drainage, and no peritoneal catheter.

Results:

Of 1490 neonates, 471 (32%) had an intraoperative peritoneal catheter placed; 177 (12%) received prophylactic dialysis and 294 (20%) received passive drainage. Sixteen (73%) centres used peritoneal catheter at some frequency, including six centres in >50% of neonates. Four centres utilised prophylactic peritoneal dialysis. Time to post-operative dialysis initiation was 3 hours [1, 5] with the duration of 56 hours [37, 90]; passive drainage cohort drained for 92 hours [64, 163]. Peritoneal catheter were more common among patients receiving pre-operative mechanical ventilation, single ventricle physiology, and higher complexity surgery. There was no association with adverse events. Serum creatinine and daily fluid balance were not clinically different on any post-operative day. Mortality was similar.

Conclusions:

In neonates undergoing complex cardiac surgery, peritoneal catheter use is not rare, with substantial variability among centres. Peritoneal catheters are used more commonly with higher surgical complexity. Adverse event rates, including mortality, are not different with peritoneal catheter use. Fluid overload and creatinine-based acute kidney injury rates are not different in peritoneal catheter cohorts.
A Systematic Review of PPE Recommendations for First Responders, and Medical Professionals to Nuclear Radiological Events at Nuclear Power Plants
Authors: Noel Chaverle , Ryan Benjamin , Bruce Erica
Published: June 2023

Introduction:

Due to climate change, many countries are exploring nuclear power as a clean, sustainable, and alternative energy source. However, radiophobia stemming from a history of major accidents at nuclear power plants (most recently Fukushima Daiichi) inhibits the expansion of this industry. In an unlikely event of a large-scale accident, the risks posed to humans are minimal when mitigation measures are followed. This includes appropriate Personal Protective Equipment (PPE) for first responders, and medical professionals responding to these emergencies. An examination of the PPE recommendations for these scenarios will highlight best practices for minimizing exposures, and the effects of radiation.

Method:

A systematic literature review will provide a historical baseline of the PPE worn during previous nuclear power plant events. Additionally, current recommendations for PPE levels in response to these emergencies will be explored. Five databases will be utilized for this study, including PubMed, Web of Science, and SCOPUS.

Results:

Many studies examine different types of nuclear radiological exposures, but few focus on nuclear power plant scenarios. More than 5,000 articles emerged from a preliminary survey of the five databases. However, less than 1% of them satisfied the extraction criteria, and reviewed PPE for nuclear power plant accidents. Medical responders caring for “exposed” individuals who present at Emergency Departments have minimal exposure once they’re decontaminated, and everyday PPE is maintained. However, data on PPE recommendations for on-site response remains unexplored. Airtight suits and full-face respirators emerged as industry gold standard for protection, but a closer examination of these types of suits, and responders' self-efficacy utilizing the gear would clarify their actual protective qualities.

Conclusion:

While nuclear power plant accidents do not occur often, many remain fearful of their impact. Maintaining proper PPE (including respiratory habiliment) for event responders is one way to minimize the adverse health effects of these nuclear radiological exposures.
Closer Than We Think: the Management of a European Nuclear Exchange
Authors: Kucik Corry
Published: June 2023

Introduction:

An exhausted, isolated, increasingly desperate Russia, still in possession of over 4,400 nuclear warheads, puts the world at risk. Since the outbreak of war in Ukraine, Russian rhetoric and military doctrine have evinced an increasing nonchalance toward the employment of tactical nuclear weapons as stockpiles of conventional weapons are depleted. Poor targeting control (or outright perfidy), demonstrated by recent events in Poland possibly violating NATO’s collective defense clause, have only incensed an imminently combustible situation. Given this threat, it behooves medical professionals to gain thorough acquaintance with Acute Radiation Sickness (ARS), including an assessment of sources of exposure, presentation, prognostic indicators, immediate treatments, long-term concerns, and sources of consultant support.

Method:

Through thorough review of military and civilian sources, training courses, historical cases, injury mechanisms, first-responder concerns, hospitalization parameters, and laboratory indicators, the ARS spectrum will be explored. Surgical, anesthetic, and intensive care implications will be discussed, as will infection and nutritional concerns. Emerging practices, specialized therapy, and long-term medical sequelae will be covered.

Results:

A thorough discussion of potential sources (civil and military), clinical recognition, and presentation of ARS will focus on best clinical guidance, providing the most up-to-date treatment strategies, and will give clear guidance regarding how best to prepare, treat, and obtain specialist consultation.

Conclusion:

It is the earnest hope of the presenter (a senior naval physician with nuclear power experience, anesthesiology consultant/board examiner, and intensivist, who studied radiation safety and injury for much of his career and wrote a Diploma in the Medical Care of Catastrophes dissertation on radiologic injury management) that the audience will never face the horror of a single radiologic casualty. However, the likelihood of such wishful thinking seems as remote as ever. Attendees will not only learn guidance for treatment and prognostication, but will know how to obtain support and expert consultation.
Will they Panic? The Effect of Risk Messaging on Public Behavior During Non-conventional Terrorism
Authors: Bodas Moran , Ragoler Morel , Rabby Yossi , Krasner Esther
Published: June 2023

Introduction:

Non-conventional terrorism (NCT) is laced with uncertainty that can foster fear and lead to unwanted public behavior. One such example is the masses of worried-well overcrowding hospitals. The purpose of this study was to explore public behavioral intentions during NCT and the effect of risk messaging in attenuating unwanted behavior.

Method:

An online intervention-based study was conducted among 1,802 adult Israeli participants. Threat perception and behavioral intent before and after exposure to hypothetical NCT scenarios were assessed stratified to the media type, exposure to rumors and fake news, and risk messaging.

Results:

Participants perceived the CBRN terrorism threat as low-medium in likelihood, and threat intrusiveness and perceived incident severity were estimated at a medium level. Nearly half (45%) of participants indicated it is highly likely that they would seek medical attention following an NCT incident. Exposure to fake news significantly increased the intention to seek medical attention (p=0.001). However, the odds of participants exposed to risk messaging reporting this intention were 0.470 (95% CI: 0.359, 0.615) times that of participants not exposed to risk messaging (χ2=30.366, p<0.001).

Conclusion:

This study shows that overcrowding hospitals by worried-well following a non-conventional terror incident can be attenuated by risk messaging. In particular, this study suggests that simple, timely, and clear risk messaging is capable of overcoming fake news that otherwise can increase unwanted behavior. Rumors and fake news have limited power to alter threat perception, but they can significantly change behavioral intent and cause unwanted behavior that could jeopardize crisis management. Rational behavior by the public during NCT can be considered an outcome of rational decision-making by crisis managers, especially risk communicators.
The Impact of Chemical, Biological, Radiological, Nuclear and Explosive Events on Emergency Departments: An Integrative Review
Authors: Ranse Jamie , Mackie Benjamin , Heslop David , Currie Jane , Wilson Bridget , Crilly Julia , Mitchell Marion , Weber Sarah , Watkins Nathan , Sharpe Joseph , Handy Michael , Hammad Karen
Published: June 2023

Introduction:

Disasters occur globally and can impact emergency department (ED) services. Chemical, biological, radiological, and nuclear (CBRN) events have different characteristics in terms of onset and duration when compared to other disasters, such as wildfires, floods, and hurricanes. It is important to have an understanding of the impact of CBRN events on EDs to inform disaster preparedness. The purpose of this paper is to identify peer-reviewed published literature that describes the impact on EDs from CBRN events.

Method:

An integrative literature methodology was used, guided by the Preferred Reporting Items of Systematic reviews and Meta-Analysis (PRISMA) Guidelines. MEDLINE, PsycINFO, CINAHL, Pubmed, and Scopus were searched using terms relating to CBRN events and EDs. Papers were included if they focused on the impact of real-world CBRN event(s). Information from each included paper was extracted into a table, including author(s), CBRN event characteristics, ED response characteristics, patient presentation characteristics, and outcome characteristics.

Results:

Of the 15,982 studies that were identified from the database searches, 4,012 were duplicates and 11,696 were irrelevant at the title and abstract screening stage. Therefore, 274 were screened at the full-text stage resulting in 44 studies for inclusion. Included papers were mostly from the United States of America (n=22/44, 50%), followed by Turkey (n=4/44, 9.1%). Most of the events were chemical (n=36/44, 81.9%), with Chlorine (n=9/36, 25%) being the most frequently reported chemical agent. Between 1 and 5,500 people [M=54, IQR: 22-253] presented to EDs because of CBRN events.

Conclusion:

Emergency departments assess and manage patients who present following CBRN events. Of these patients, the majority do not require hospital admission, suggesting that the ED is integral in the health response to CBRN events. As such, EDs should be adequately prepared, from a resource and process perspective to assess, manage and discharge large numbers of CBRN-related patients.
Health and Social Implications of Potential Indo-Pacific Chemical, Biological, Radiological, and Nuclear (CBRN) Proliferation Driven by Adaptation to Population, Climate Change and Geopolitical Upheaval
Authors: Heslop David
Published: June 2023

Introduction:

Future strategic pressures in the Indo-Pacific region will present major policy and strategic challenges driven by rapidly increasing populations, resource depletion and contests, and forced adaptation to a changing climate. While regional countries remain likely to continue on a high growth trajectory, there is growing concern that nations will face difficulty to sustain economic gains in the face of strategic resource depletion and availability, population growth, and increasingly frequent extreme weather events. This mismatch could result in strategic miscalculation and reformulation, driving CBRN proliferation choices that fall outside of historical norms or standards. Such societal stressors are already occurring in the region and themselves may suddenly impact on health and social systems in unpredictable and complex ways.

Method:

Three tabletop exercises called the Boxwood Scenarios were conducted utilizing the Avalanche TTX system, including participants from key intelligence, military, and academic experts. Participants were invited to a Delphi study examining positive and negative drivers, shaping factors, motivators, and consequences of CBRNE proliferation in the Indo-Pacific region. Two rounds of result review were conducted by the group. These results underwent a systematic mixed methods analysis (quantitative and qualitative methods) and interpretation.

Results:

Climate change, demographic and geopolitical pressures were highlighted as key to future potential CBRN proliferation risks, with this nexus resulting in major proliferation concerns as early as 2040. Proliferation decisions driven by, and occurring in parallel to, climate and demographic pressures were identified as of major concern. Such decisions would have profound multi-layered social, health and broader implications for Indo-Pacific countries with declining determinants of national power.

Conclusion:

Climate change and demographic and geopolitical pressures could drive future Indo-Pacific CBRN proliferation. The consequences to human populations, the viability of ongoing international disaster risk reduction and capacity-building efforts, and the increased future risk of major CBRN events cannot be overstated.
Understanding the Healthcare Impacts of Attacks on Infrastructure
Authors: Taubman Cara , Hart Alexander , Hertelendy Attila , Tin Derrick , Hata Ryan , Ciottonne Gregory
Published: June 2023

Introduction:

Healthcare provision depends on reliable infrastructure to power equipment, and provide water for medication and sanitation. Attacks on infrastructure limiting such functions can have a profound and prolonged influence on the delivery of care.

Method:

A retrospective analysis of the Global Terrorism Database (GTD) was performed of all attacks occurring between 1970-2020. Data was filtered using the internal database search function for all events where the primary target was “Utilities”, “Food or Water Supply” and “Telecommunications.” For the purposes of this study the subtype “Food Supply” was excluded. Events were collated based on year, country, region, numbers killed and wounded.

Results:

The GTD listed 7,813 attacks on infrastructure with 6,280 attacks targeting utilities leading to 1,917 persons directly killed and 1,377 wounded. In total there were 1,265 attacks targeting telecommunications causing 205 direct deaths and 510 wounded. Lastly, 268 attacks targeted the water supply with 318 directly killed and 261 wounded. Regionally, South America had the most attacks with 2,236, followed by Central America and the Caribbean with 1,390. Based on infrastructure type, the most attacks on utilities occurred in El Salvador (1,061), the most attacks on telecommunications were in India (140) and Peru (46) had the most attacks on its water supply.

Conclusion:

The regions with the highest number of total attacks targeting infrastructure have historically been in South America, with more attacks against power and utilities than other infrastructure. The numbers of persons directly killed and wounded in these attacks were lower than those with other target types. However, the true impacts these attacks have on lack of health care delivery are not accounted for in these numbers. By understanding the pattern and scope of these attacks, Counter-Terrorism Medicine initiatives can be created to target harden healthcare-related infrastructure.