bluuebunny/crossref_metadata_2025_split huggingface dataset:
The ethics and practice of perinatal care at the limit of viability: FIGO recommendations
Authors: Vidaeff Alex C. , Capito Lourdes , Gupte Sanjay , Antsaklis Aris ,   the FIGO Committee on the Ethical Aspects of Human Reproduction and Women's Health
Published: June 2024

AbstractAn arbitrary gestational age limit of viability cannot be set, and in clinical practice the focus should be on a periviability interval—the so‐called “gray zone” of prognostic uncertainty. For cases within this interval, the most appropriate decision‐making process remains debatable and periviability has emerged as one of the greatest challenges in bioethics. Universally recognized ethical principles may be interpreted differently due to socioeconomic, cultural, and religious aspects. In the case of periviability, there is considerable uncertainty over whether interventions result in a greater balance of clinical good over harm. Furthermore, the fetus or neonate is unable to exercise autonomy and the physicians and parents will act as patient surrogates. When parents and physicians disagree about the infant's best interest, a dialogue without paternalistic attitudes is essential, whereby physicians should only offer, but not recommend, perinatal interventions. Parental choice, based on thorough information, should be respected within the limits of what is medically feasible and appropriate. When disagreements between parents and physicians occur, how is consensus to be achieved? Professional guidelines can be helpful as a framework and starting point for discussion. In reality, however, guidelines only rarely draw categorical lines and in many cases remain vague and ambiguously worded. Local ethics committees can provide counseling and function as moderators during discussions, but ethics committees do not have decision precedence. Counseling assumes the most significant role in periviability discussions, taking into consideration the particular fetal and maternal characteristics, as well as parental values. Several caveats should be observed relative to counseling: message fragmentation or inconsistence should be minimized, prognosis should preferably be presented in a positive framing, and overreliance on statistics should be avoided. It is recommended that decisions regarding neonatal resuscitation in the periviability interval be made before birth and not conditional on the newborn's appearance at birth. Regardless of decision, it is important to assure pre‐ and postnatal coherence. The present article describes how individual physicians, centers, and countries differ in the approach to the decision to initiate or forgo intensive care in the periviability interval. It is impossible to provide a global consensus view and there can be no unifying ethical, moral, or practical strategy. Nevertheless, ethically justified, quality care comprises early involvement of the obstetric and neonatal team to enable a coherent, comprehensible, nonpaternalistic, and balanced plan of care. Ultimately, physicians will need to adjust the expectations to the local standards, local outcome data, and local neonatal support availability.
Legislation strengthening Maternal and Perinatal Death Surveillance and Response systems
Authors: Ngwena Charles G. , Kismödi Eszter , Palestra Francesca , Stahlhofer Marcus , Mohan Kalyani 
Published: July 2024

AbstractHistorically, countries have primarily relied on policy rather than legislation to implement Maternal and Perinatal Death Surveillance and Response systems (MPDSR). However, evidence shows significant disparities in how MPDSR is implemented among different countries. In this article, we argue for the importance of establishing MPDSR systems mandated by law and aligned with the country's constitutional provisions, regional and international human rights obligations, and public health commitments. We highlight how a “no blame” approach can be regulated to provide a balance between confidentiality of the system and access to justice and remedies.
A variant on the CREST iMTD algorithm for noncovalent clusters of flexible molecules
Authors: King Nathanael J. , LeBlanc Ian D. , Brown Alex 
Published: June 2024

AbstractConformational ensemble generation and the search for the global minimum conformation are important problems in computational chemistry. In this work, a variant on the conformer‐rotamer ensemble sampling tool (CREST) iterative metadynamics (iMTD) algorithm designed for determining structural ensembles and energetics of noncovalent clusters of flexible molecules is presented. We term this new algorithm a low‐energy diversity‐enhanced variant on CREST, or LEDE‐CREST. As with CREST, the energies are evaluated using the semiempirical GFN2‐xTB extended tight binding approach. The utility of the algorithm is highlighted by generating ensembles for a variety of noncovalent clusters of flexible or rigid monomers using both CREST and LEDE‐CREST.
Left Atrial Phasic Function Impairment in Subacute and Chronic Pulmonary Embolism Patients With Different Degrees of Obstruction: An MRI Feature Tracking Study
Authors: Shen Meng‐Ting , Li Yuan , Shen Li‐Ting , Qian Wen‐Lei , Yan Wei‐Feng , Fang Han , Min Chen‐Yan , Yang Zhi‐Gang 
Published: June 2024

BackgroundThe alteration of left atrial (LA) phasic function in subacute and chronic pulmonary embolism (PE) patients is unclear.PurposeTo investigate LA phasic strain and LA‐right ventricular (RV) interaction in subacute and chronic PE patients with different degrees of obstruction by MRI‐feature tracking (MRI‐FT).Study TypeRetrospective.PopulationOne hundred three PE patients (54 subacute [2 weeks to 3 months after initial symptoms], 49 chronic [>3 months after initial symptoms]) and 80 controls.Field Strength/Sequence3.0 T/balanced steady state free precession sequence.AssessmentPatients were divided into mild (pulmonary artery obstruction index [PAOI] < 30%, N = 57), moderate (30% ≤ PAOI < 50%, N = 27), and severe (50% ≥ PAOI, N = 19) PE subgroups. LA reservoir, conduit, and active pump longitudinal strains (εs, εe, and εa) and strain rates (SRs, SRe, and SRa) and biventricular global strains were measured. Determinants of LA strains were investigated.Statistical TestsANOVA, t‐tests, Mann–Whitney U tests, linear regression. P < 0.05 was considered statistically significant.ResultsFor both subacute and chronic PE patients, LA reservoir, conduit, and active pump strains and strain rates were significantly lower than in controls. However, there were no significant differences in LA strains between patients with subacute and chronic PE (P = 0.933, 0.625, and 0.630 for εs, εe, and εa). The severe PE subgroup had significantly higher εa and SRa than the mild and moderate PE subgroups. LA strains were significantly correlated with RV diameter and biventricular strains, and RV diameter (β = −6.836, −4.084, and −1.899 for εs, εe, and εa) was independently associated with LA strains after adjustment for other factors (R2 = 0.627, 0.536, and 0.437 for εs, εe, and εa).Data ConclusionLA phasic function evaluated by MRI‐FT was significantly impaired in subacute and chronic PE patients, and LA active pump function in the severe PE subgroup was higher than that in the mild and moderate PE subgroups. The independent association between RV diameter and LA strains demonstrates that RV diameter may be an important indicator for monitoring LA dysfunction in PE patients.Evidence Level3Technical EfficacyStage 3
Association between protein‐energy malnutrition and healthcare use among adult patients after liver transplantation: A retrospective cohort study
Authors: Wang Melinda , Shui Amy M. , Rubin Jessica B. , Pyrsopoulos Nikolaos , Lai Jennifer C. 
Published: June 2024

AbstractBackgroundProtein‐energy malnutrition is associated with poor surgical outcomes in liver transplant patients, but its impact on healthcare use has not been precisely characterized. We sought to quantify the burden of protein‐energy malnutrition in hospitalized patients undergoing liver transplantation.MethodsCurrent Procedural Terminology codes were used to identify United States hospitalizations between 2011 and 2018 for liver transplantation using the Nationwide Inpatient Sample. Patients <18 years old were excluded. Protein‐energy malnutrition was identified by International Classification of Diseases Ninth and Tenth Revision codes. Multivariable regression was used to determine associations between protein‐energy malnutrition and hospital outcomes, including hospital length of stay and hospital charges/costs.ResultsOf 9856 hospitalizations, 2835 (29%) had protein‐energy malnutrition. Patients with protein‐energy malnutrition had greater comorbidity burden and in‐hospital acuity (eg, dialysis, sepsis, vasopressors, or mechanical ventilation). The adjusted median difference of protein‐energy malnutrition vs no protein‐energy malnutrition for length of stay was 6.4 days (95% CI, 5.6–7.1; P < 0.001), for hospital charges was $108,063 (95% CI, $93,172–$122,953; P < 0.001), and for hospital costs was $23,636 (95% CI, $20,390–$26,882; P < 0.001).ConclusionAmong patients undergoing liver transplantation, protein‐energy malnutrition was associated with increased length of stay and hospital charges/costs. The additional cost of protein‐energy malnutrition to liver transplantation programs was $23,636 per protein‐energy malnutrition hospitalization. Our data justify the development of and investment in personnel and programs dedicated to reversing—or even preventing—protein‐energy malnutrition in patients awaiting liver transplantation.
Membranous nephropathy: pathogenesis and treatments
Authors: Wang Mengqiong , Yang Jingjuan , Fang Xin , Lin Weiqiang , Yang Yi 
Published: June 2024

AbstractMembranous nephropathy (MN), an autoimmune disease, can manifest at any age and is among the most common causes of nephrotic syndrome in adults. In 80% of cases, the specific etiology of MN remains unknown, while the remaining cases are linked to drug use or underlying conditions like systemic lupus erythematosus, hepatitis B virus, or malignancy. Although about one‐third of patients may achieve spontaneous complete or partial remission with conservative management, another third face an elevated risk of disease progression, potentially leading to end‐stage renal disease within 10 years. The identification of phospholipase A2 receptor as the primary target antigen in MN has brought about a significant shift in disease management and monitoring. This review explores recent advancements in the pathophysiology of MN, encompassing pathogenesis, clinical presentations, diagnostic criteria, treatment options, and prognosis, with a focus on emerging developments in pathogenesis and therapeutic strategies aimed at halting disease progression. By synthesizing the latest research findings and clinical insights, this review seeks to contribute to the ongoing efforts to enhance our understanding and management of this challenging autoimmune disorder.
Automatic segmentation of spine x‐ray images based on multiscale feature enhancement network
Authors: Du Wenliao , Liu Zhenlei , Fei Heyong , Yu Jianan , Duan Xingyu , Liao Wensheng , Ji Lianqing 
Published: June 2024

AbstractBackgroundAutomatic segmentation of vertebrae in spinal x‐ray images is crucial for clinical diagnosis, case analysis, and surgical planning of spinal lesions.PurposeHowever, due to the inherent characteristics of x‐ray images, including low contrast, high noise, and uneven grey scale, it remains a critical and challenging problem in computer‐aided spine image analysis and disease diagnosis applications.MethodsIn this paper, a Multiscale Feature Enhancement Network (MFENet), is proposed for segmenting whole spinal x‐ray images, to aid doctors in diagnosing spinal‐related diseases. To enhance feature extraction, the network incorporates a Dual‐branch Feature Extraction Module (DFEM) and a Semantic Aggregation Module (SAM). The DFEM has a parallel dual‐branch structure. The upper branch utilizes multiscale convolutional kernels to extract features from images. Employing convolutional kernels of different sizes helps capture details and structural information at different scales. The lower branch incorporates attention mechanisms to further optimize feature representation. By modeling the feature maps spatially and across channels, the network becomes more focused on key feature regions and suppresses task‐irrelevant information. The SAM leverages contextual semantic information to compensate for details lost during pooling and convolution operations. It integrates high‐level feature information from different scales to reduce segmentation result discontinuity. In addition, a hybrid loss function is employed to enhance the network's feature extraction capability.ResultsIn this study, we conducted a multitude of experiments utilizing dataset provided by the Spine Surgery Department of Henan Provincial People's Hospital. The experimental results indicate that our proposed MFENet demonstrates superior segmentation performance in spinal segmentation on x‐ray images compared to other advanced methods, achieving 92.61 ± 0.431 for MIoU, 92.42 ± 0.329 for DSC, and 99.51 ± 0.037 for Global_accuracy.ConclusionsOur model is able to more effectively learn and extract global contextual semantic information, significantly improving spinal segmentation performance, further aiding doctors in analyzing patient conditions.
Silane functionalized cardanol/calcium carbonate epoxy‐reinforced polymer nanocomposites for sustainable microwave absorption applications
Authors: Sathish Kumar M. , Mandhakini M. , Jeferson Santhosh , Jayavel R. 
Published: June 2024

AbstractMicrowave absorption properties of epoxy resin/cardanol (ER/C) and epoxy resin/silane functionalized cardanol (ER/SFC) nanocomposites with various percentages of calcium carbonate nanoplatelets (CCNPs) studied in the frequency range of 8–18 GHz. The CCNPs obtained from the mussel shell were reinforced into a cardanol‐toughened ER matrix to mimic the composite structure of the abalone shell. The phase separation between ER, SFC, and CCNPs encapsulated in a polymer matrix was analyzed with SEM, and the presence of a low level of Fe3O4 magnetic impurities of 0.007 emu/g present as shown and verified by XRD and VSM analyses. The nanocomposites with ER/SFC/CCNPs 3 wt.% demonstrate a high surface roughness of 3.467 nm and an enhanced hydrophobicity, as indicated by a high contact angle of 102°. The silanization‐induced localization of CCNPs facilitates a mutually conducive morphology for excellent viscoelastic and microwave absorption properties. The increase in damping factor ratio of approximately 0.85 augments the microwave absorption property and it observed that ER/SFC/CCNPs 3 wt.% nanocomposites show higher reflection loss (RL) of more than 99.9% with RL of −43 dB at 12 GHz. The research aims to fabricate cost‐effective and multifunctional nanocomposites for microwave absorption applications.Highlights
Excellent hydrophobicity owing to the surface roughness of 3.467 nm.
Maximum contact angle of 102.1° due to the reinforcement of CCNPs and SFC to the epoxy matrix.
Efficient microwave attenuation due to the reflection loss of −43 dB.
Excellent microwave absorption of 99.99% with a damping factor of 0.85.
Higher storage modulus due to the strong inter‐penetrating network of the composite.
Optimal resource allocation in common bus performance sharing systems with transmission loss
Authors: Gu Liudong , Wang Guanjun , Zhou Yifan 
Published: June 2024

AbstractThe reliability modeling and optimization of performance sharing systems (PSSs) are of vital importance due to their wide applications. Existing research mainly focuses on evaluating and maximizing the reliability of PSSs. However, in many practical systems, decision‐makers tend to prioritize the average cost of the system over its reliability. This paper studies the resource allocation optimization in common bus PSSs. In such systems, each unit has binary‐state random performance to satisfy the multi‐state random demand. The surplus performance can be shared via a common bus with transmission loss between the common bus and the unit. The performance allocation, performance transmission, and unsupplied demand incur costs. Resource allocation strategies are determined by optimization models considering different objective functions and constraints. Additionally, transmission loss between the common bus and the unit is considered. A genetic algorithm is employed to efficiently find the optimal allocation strategies. Numerical examples prove the effectiveness of the proposed models in improving system reliability and reducing system costs.
Clinical Pattern and Treatment Outcome of Cutaneous Leishmaniasis Patients in Somali Region, Eastern Ethiopia
Authors: Muse Abdilahi Ibrahim , Ibrahim Muse Obsiye , Ibrahim Muse Ahmed 
Published: June 2024

Abstract

Background
Neglected tropical diseases, affecting over a billion people, include leishmaniasis, a protozoan parasite found in over 20 species. It is classified into three types: visceral, cutaneous, and muco-cutaneous leishmaniasis, with cutaneous leishmaniasis being the most common. Dogs and rodents are the primary reservoirs of leishmaniasis, which is transmitted by infected female sandflies. Cutaneous leishmaniasis, found on exposed parts such as the arms, face and legs, presents with diverse clinical manifestations, including erythematous lesions, large, painless nodules, ulceration and an eventual volcanic form.

Objective
To assess the clinical pattern and treatment outcome of cutaneous leishmaniasis patients in the Somali region of eastern Ethiopia.

Methods
This descriptive study was conducted in the Somali region using neglected tropical disease surveillance data collected from 1 September 2023, to 8 February 2024. The data were cleaned and then exported to STATA version 17 for analysis.

Results
From 1 September 2023, to 8 February 2024, 900 patients were diagnosed with cutaneous leishmaniasis. Of these, 105 (11.67%) patients had localised cutaneous leishmaniasis, 741 (82.33%) had disseminated cutaneous leishmaniasis, 20 (2.22%) had diffuse cutaneous leishmaniasis, 8 (0.89%) had mucocutaneous leishmaniasis, 12 (1.33%) had mucocutaneous and disseminated leishmaniasis and 14 (1.56%) had localised and mucocutaneous leishmaniasis. All of the cases were male; the most common signs and symptoms the patients showed were papule, nodule, ulcer and crust 791 (87.89%) and itching, fever and discharges 758 (84.22%), respectively. Most of the patients, 823 (93.34%), were given systemic pentavalent antimonials, and the cure rate was 886 (98.44%). Of the patients, 14 (100%) who were defaulted on had diffuse cutaneous leishmaniasis.

Conclusions
All the participants had travelled to an area where sandflies were common. The majority of patients complained of itching, fever and discharges, with over two-thirds having disseminated cutaneous leishmaniasis (DCL) and 0.89% having mucocutaneous leishmaniasis. The regional health bureau should set up a strong surveillance system and launch educational campaigns to raise awareness about cutaneous leishmaniasis, its transmission, symptoms and preventive measures. Furthermore, patients should be advised to strictly adhere to their treatment schedule and follow-ups.
Stretchable Tissue‐Like Gold Nanowire Composites with Long‐Term Stability for Neural Interfaces
Authors: Seufert Laura , Elmahmoudy Mohammed , Theunis Charlotte , Lienemann Samuel , Li Yuyang , Mohammadi Mohsen , Boda Ulrika , Carnicer‐Lombarte Alejandro , Kroon Renee , Persson Per O.Å. , Rahmanudin Aiman , Donahue Mary J. , Farnebo Simon , Tybrandt Klas 
Published: June 2024

AbstractSoft and stretchable nanocomposites can match the mechanical properties of neural tissue, thereby minimizing foreign body reactions to provide optimal stimulation and recording specificity. Soft materials for neural interfaces should simultaneously fulfill a wide range of requirements, including low Young's modulus (<<1 MPa), stretchability (≥30%), high conductivity (>> 1000 S cm−1), biocompatibility, and chronic stability (>> 1 year). Current nanocomposites do not fulfill the above requirements, in particular not the combination of softness and high conductivity. Here, this challenge is addressed by developing a scalable and robust synthesis route based on polymeric reducing agents for smooth, high‐aspect ratio gold nanowires (AuNWs) of controllable dimensions with excellent biocompatibility. AuNW‐silicone composites show outstanding performance with nerve‐like softness (250 kPa), high conductivity (16 000 S cm−1), and reversible stretchability. Soft multielectrode cuffs based on the composite achieve selective functional stimulation, recordings of sensory stimuli in rat sciatic nerves, and show an accelerated lifetime stability of >3 years. The scalable synthesis method provides a chemically stable alternative to the widely used AgNWs, thereby enabling new applications within electronics, biomedical devices, and electrochemistry.
Nanofluidic Membrane‐Assisted Organic Electrochemical Transistors for Bioinspired Gustatory Sensation Based on Selective Cation Transport
Authors: Zhang Yue , Ma Yutian , Wang Lili , Li Chunyan , Wu Lijuan , Zhong Chengcheng , Sun Bing , Chen Yupeng , Jiang Lei 
Published: July 2024

AbstractNatural organisms have evolved precise sensing systems relying on unique ion channels, which can efficiently perceive various physical/chemical stimuli based on ionic signal transmission in biological fluid environments. However, it is still a huge challenge to achieve extensive applications of the artificial counterparts as an efficient wet sensing platform due to the fluidity of the working medium. Herein, nanofluidic membranes with selective cation transport properties and solid‐state organic electrochemical transistors (OECTs) with amplified signals are integrated together to mimic human gustatory sensation, achieving ionic gustatory reagent recognition and a portable configuration. Cu‐HHTP nanofluidic membranes with selective cation transport through their uniform micropores are constructed first, followed by assembly with OECTs to form the designed nanofluidic membrane‐assisted OECTs (nanofluidic OECTs). As a result, they can distinguish typically ionic gustatory reagents, and even ionic liquids (ILs), demonstrating enhanced gustatory perception performance under a wide concentration range (10−7–10−1 m) compared with those of conventional OECTs. The linear correlations between the response and the reagent concentration further indicate the promising potential for practical application as a next‐generation sensing platform. It is suggested that nanofluidic membranes mediated intramembrane cation transport based on the steric hindrance effect, resulting in distinguishable and improved response to multiple ions.