bluuebunny/crossref_metadata_2025_split huggingface dataset:
Foundations of radiological protection in space: the integrated multidisciplinary approach for next manned missions in deep space
Authors: Rizzo Alessandro , Borra Enrico Maria , Ciciani Luca , Di Fino Luca , Romoli Giulia , Santi Amantini Giorgia , Sperandio Luciano , Vilardi Ignazio , Narici Livio 
Published: November 2023

AbstractFuture manned missions in deep space toward Moon and Mars represent one of the greatest challenges for radiological protection, which task is to mitigate risks for human life raised by the hostile space radiation environment. The prolonged exposure of astronauts to cosmic rays, mainly ion fields of galactic or solar origin, with a large dynamical behavior in time and space with a wide range of kinetic energies, may result in an unacceptable life risk for the next deep space manned missions. Indeed, these ions can deliver significant doses to astronauts by directly hitting human tissues as well as exposing them to secondary particles (neutron and high-LET nuclear fragments) produced by their interaction with space habitat materials. This radiation environment is very different from work environments on Earth, for example, in nuclear power plants or nuclear medicine departments, for which radioprotection was historically developed. Workers on Earth are mainly exposed to photons ($$\textrm{X}$$
X
-rays and $$\gamma$$
γ
-rays), to $$\alpha$$
α
- and $$\beta$$
β
-particles and neutrons, with lower energies than those in space. This difference marks a significant change in the methodological approach of the radioprotection in space compared to that on ground. The review presents the basic principles of radiation protection in space compared to that on ground and the strategies that must be implemented to mitigate risks in manned missions. In particular, the principles of the integrated multidisciplinary approach proposed by NASA and other space agencies for human space exploration are also discussed, with emphasis on the synergies among the various countermeasures proposed.
Preservation of NATP
Authors: Ahn Jinhoo , Kim Joonhee , Lee Hyoyoon , Lee Junguk 
Published: November 2023

We prove the preservation theorems for NATP; many of them extend the previously established preservation results for other model-theoretic tree properties. Using them, we also furnish proper examples of NATP theories which are simultaneously TP2 and SOP. First, we show that NATP is preserved by the parametrization and sum of the theories of Fraïssé limits of Fraïssé classes satisfying strong amalgamation property. Second, the preservation of NATP for two kinds of dense/co-dense expansions, i.e. the theories of lovely pairs and of [Formula: see text]-structures for geometric theories, and dense/co-dense expansion on vector spaces is proved. Next, we prove the preservation of NATP for the generic predicate expansion and the pair of an algebraically closed field and its distinguished subfield; for the latter, not only NATP, but also the preservation of NTP1 and NTP2 is considered. Finally, we present some proper examples of NATP theories using the results proved in this paper, including the parametrization of DLO and the expansion of an algebraically closed field by adding a generic linear order. In particular, we show that the model companion of the theory of algebraically closed fields with circular orders (ACFO) is NATP.
TeraHAC: Hierarchical Agglomerative Clustering of Trillion-Edge Graphs
Authors: Dhulipala Laxman , Łącki Jakub , Lee Jason , Mirrokni Vahab 
Published: November 2023

We introduce TeraHAC, a (1+ε)-approximate hierarchical agglomerative clustering (HAC) algorithm which scales to trillion-edge graphs. Our algorithm is based on a new approach to computing (1+ε)-approximate HAC, which is a novel combination of the nearest-neighbor chain algorithm and the notion of (1+ε)-approximate HAC. Our approach allows us to partition the graph among multiple machines and make significant progress in computing the clustering within each partition before any communication with other partitions is needed.
We evaluate TeraHAC on a number of real-world and synthetic graphs of up to 8 trillion edges. We show that TeraHAC requires over 100x fewer rounds compared to previously known approaches for computing HAC. It is up to 8.3x faster than SCC, the state-of-the-art distributed algorithm for hierarchical clustering, while achieving 1.16x higher quality. In fact, TeraHAC essentially retains the quality of the celebrated HAC algorithm while significantly improving the running time.
Impact of Medicaid Expansion on Surgical Care and Outcomes for Hepatobiliary Malignancies
Authors: Parina Ralitza , Emamaullee Juliet , Ahmed Saif , Kaur Navpreet , Genyk Yuri , Raashid Sheikh Mohd 
Published: November 2023

Background As part of the Patient Protection and Affordable Care Act, some states expanded Medicaid eligibility to adults with incomes below 138% of the federal poverty line. While this resulted in an increased proportion of insured residents, its impact on the diagnosis and treatment of hepatopancreaticobiliary (HPB) cancers has not been studied. Study Design The National Cancer Database (NCDB) from 2010 to 2017 was used. Patients diagnosed with HPB malignancies in states which expanded in 2014 were compared to patients in non-expansion states. Subset analyses of patients who underwent surgery and those in high-risk socioeconomic groups were performed. Outcomes studied included initiation of treatment within 30 days of diagnosis, stage at diagnosis, care at high volume or academic center, perioperative outcomes, and overall survival. Adjusted difference-in-differences analysis was performed. Results A total of 345,684 patients were included, of whom 55% resided in non-expansion states and 54% were diagnosed with pancreatic cancer. Overall survival was higher in states with Medicaid expansion (HR .90, 95% CI [.88-.92], P < .01). There were also better postoperative outcomes including 30-day mortality (.67 [.57-.80], P < .01) and 30-day readmissions (.87 [.78-.97], P = .02) as well as increased likelihood of having surgery in a high-volume center (1.42 [1.32-1.53], P < .01). However, there were lower odds of initiating care within 30 days of diagnosis (.77 [.75-.80], P < .01) and higher likelihood of diagnosis with stage IV disease (1.09 [1.06-1.12], P < .01) in expansion states. Conclusion While operative outcomes and overall survival from HPB cancers were better in states with Medicaid expansion, there was no improvement in timeliness of initiating care or stage at diagnosis.
Plasma cell-free DNA in patients with acute promyelocytic leukaemia treated with arsenic trioxide
Authors: Fujihara Junko , Nishimoto Naoki , Takeshita Haruo 
Published: November 2023

Background Cell-free DNA (cfDNA) is free DNA found in circulating blood that originates from apoptosis or necrosis, and elevated cfDNA concentrations have been reported in cancers and other diseases. Methods In this study, the concentrations and fragment distributions of plasma cfDNA were preliminary investigated in elderly ( n = 1) and paediatric ( n = 1) patients with acute promyelocytic leukaemia (APL) treated with arsenic trioxide (ATO). Results A slight increase in cfDNA concentrations was observed in the APL patients compared with healthy controls. The change in plasma cfDNA concentrations corresponded to the change in plasma arsenic concentrations during ATO treatment. The fragment distribution pattern did not differ before and during treatment. Three ladder fragments were observed in part of the cfDNA in the second consolidation therapy in an elderly APL patient and the first consolidation therapy of a paediatric APL patient, while two fragments were observed in all other treatment periods. Moreover, APL-related gene mutations were successfully genotyped from plasma cfDNA by using polymerase chain reaction-based methods and these results are consistent with those from leukocytes. Conclusion This study is the first to report the concentrations and fragment patterns of cfDNA from APL patients treated with ATO. The results suggested that plasma cfDNA concentration in APL patients increased with ATO treatment and that cfDNA is released mainly via neutrophil extracellular traps (and/or necrosis) in addition to apoptosis. To confirm whether cfDNA concentrations and fragment patterns can be used as a biomarker for APL treated with ATO, further accumulative data are needed.
Cardiac troponin in hospitalized COVID-19 patients: Incidence, predictors, and outcomes
Authors: Gupta Praveen , Gupta Anunay , Bansal Sandeep , Balakrishnan Ira 
Published: November 2023

Background The incidence, predictors, and association of cardiac troponin with mortality in hospitalized COVID-19 were not adequately studied in the past and were also not reported from an Indian hospital. Methods In this retrospective cohort study, the cardiac troponin of 240 hospitalized COVID-19 patients was measured. The incidence, predictors, and association of elevated cardiac troponin with in-hospital mortality were determined among hospitalized COVID-19 patients. Results The cardiac troponin was elevated in 12.9% (31/240) of the patients. The troponin was elevated in the patients in the older age group (64 years vs. 55 years, p = .002), severe COVID-19 illness (SpO2 < 90%) (93.5% vs. 60.8%, p < .001), low arterial oxygen saturation (SpO2) (80% vs. 88%, p = .001), and low PaO2/FiO2 ratio ( p < .0001). The patients with elevated cardiac troponin had elevated total leukocyte counts (TLC) ( p = .001), liver enzyme ( p = .025), serum creatinine ( p = .011), N-terminal-Pro Brain natriuretic peptide ( p < .0001), and d-dimer ( p < .0001). The majority of the patients with elevated cardiac troponin were admitted to the intensive care unit (90.3% vs. 51.2%; p < .0001), were on a ventilator (61.3% vs. 21.5%; p < .0001), and had higher mortality (64.5% vs. 19.6%; p < .0001). The Kaplan–Meir survival analysis showed that the patients with elevated troponin had worse survival ( p log-rank<.0001). Age, NT-ProBNP, d-dimer, and ventilator were the predictors of elevated troponin in multivariate logistic regression analysis. The Cox-regression analysis showed a significant association between elevated cardiac troponin and in-hospital mortality (adjusted hazard ratio 2.13; 95% confidence interval [CI] 1.145–3.97; p = .017). Two-thirds (65%) of patients with elevated cardiac troponin died during their hospital stay. Conclusions COVID-19 patients with elevated cardiac troponin had severe COVID illness, were more commonly admitted to an intensive care unit, were on a ventilator, and had high in-hospital mortality.
Effectiveness of Safe Patient Handling Equipment and Techniques: A Review of Biomechanical Studies
Authors: Fray Mike , Davis Kermit G. 
Published: November 2023

Objective This review aimed to evaluate all studies that have evaluated the biomechanical effects when using assistive devices. Introduction The physical demands of patient handling activities are well known. One safety strategy for the reduction of the physical risks is use of assistive devices. Method The search process identified articles published in English-speaking journals through Google Scholar, Medline, and ISI Web of Science. The included 56 studies contained a biomechanical assessment of a patient handling activity with assistive devices. Results The biomechanical effects included four groups: changes in body posture (spinal, other joints), subjective assessment (force, effort, discomfort), measured force (hand force, ground reaction force, spine force, joint torque), and physiological measures. The evidence showed caregivers benefited from using lift hoists, air-assisted devices, and to a lesser extent friction reducing devices for lateral transfers and repositioning, while floor and ceiling lifts were most effective for patient transfers. Some gaps were noted in the evidence and other handling tasks such as sit-to-stand, turning patient in bed, limb lifting, and repositioning and some more high hazard activities like supporting people with limited balance and those that fall need to be investigated with respect to biomechanical outcomes. Conclusion There is a growing level of biomechanical evidence to support the use of assistive devices for many patient-handling tasks, but the benefits of equipment use in some transfers remain uninvestigated. Practical Application Evidence indicates the best way to lift patients safely is with floor or ceiling lifts, and air-assisted devices for lateral and repositioning tasks.
Changes in Neck and Shoulder Muscles Fatigue Threshold When Using a Passive Head/Neck Supporting Exoskeleton During Repetitive Overhead Tasks
Authors: Garosi Ehsan , Kazemi Zeinab , Mazloumi Adel , Keihani Ahmadreza 
Published: November 2023

Objective This study aimed to investigate the effects of a head/neck supporting exoskeleton (HNSE) on the electromyographic fatigue threshold (EMGFT) of the neck and shoulder muscles during a simulated overhead work task. Background Overhead work is a well-known risk factor for neck and shoulder musculoskeletal disorders due to the excessive strain imposed on the muscles and joints in these regions. Method Fourteen healthy males performed a repetitive overhead nut fastening/unfastening task to exhaustion while wearing and not wearing the HNSE at two neck extension angles (40% and 80% of neck maximum range of motion). Electromyographic signals were continuously recorded from the right and left sternocleidomastoid (SCMR, SCML), splenius capitis (SCR, SCL), upper trapezius (UTR, UTL), and anterior deltoid (ADR, ADL) muscles. The normalized electromyographic amplitude (nEMG) data was time normalized, and a bisegmental linear regression was applied to determine the muscle fatigue break point. Results The results showed a significant increase in fatigue threshold time in the SCMR ( p < .001), SCML ( p = .002), and UTR ( p = .037) muscles when the HNSE was used. However, the EMGFT times for the right and left deltoid and left trapezius muscles showed a nonsignificant reduction due to the head/neck support exoskeleton use. In addition, the neck extension angle did not reveal a significant effect on muscles’ EMGFT time. Conclusion Overall, the findings confirmed a significant delay in fatigue onset in sternocleidomastoid muscles, as measured by the electromyographic fatigue threshold. This finding suggests that the HNSE can be an effective ergonomic intervention for reducing the risk of musculoskeletal disorders in overhead workers. However, further studies are needed to investigate the effect of the HNSE at other neck extension angles and more realistic tasks to ensure the generalizability of our results. Application The present findings emphasize the application of the fatigue onset time to evaluate the effectiveness of ergonomic interventions, including exoskeletons, which can subsequently be utilized to alleviate postural demands and reduce the risk of musculoskeletal disorders.
Effect of the Caregivers-to-Caregivers Training Programme on informed caregivers of persons with mental disorders: A pilot study
Authors: Jiang Yu Lei , Yin Feng , Lv Zi Yao , Hou Hao , Yang Bing Xiang , Liu Qian , Fu Shi-Yu , Zhang Jia-Ning , Wang Xiao Qin 
Published: November 2023

Objective: Many people with mental disorders are cared for by informed caregivers, but they usually have limited care-related training and lack caregiving capacity and support networks. In order to provide professional training and social support for informed caregivers, we designed the Caregivers-to-Caregivers Training Programme (C2C) and performed a pilot study to assess its effect. Methods: Caregivers of persons with mental disorders who participated in the C2C were asked to participate in a quasi-experimental study to assess their knowledge and skills development, self-care ability, trainer engagement, and training content. A total of 800 participants completed self-designed evaluation questionnaires and two open-ended questions to gather suggestions and feedback. Assessments were carried out at pretest (baseline), post-test, and at 2-month follow-up. Results were analyzed using one-way repeated measures analysis of variance (ANOVA) and pairwise comparison method. Results: At post-test, 667 assessments were considered valid and 515 were deemed valid at 2-month follow-up. One-way repeated-measures ANOVA showed that the main effect of the scores on knowledge and skills development and self-care ability from baseline to 2-month follow-up was significant ( p < .001). Results of pairwise comparison method showed that the scores on each item of knowledge and skills development and self-care ability at post-test and at 2-month follow up were higher than those at baseline ( p < .001). The scores on items of trainer engagement and training content were all above average (4/5). The open-ended questions resulted in 678 comments indicating that participants gained significant support from other caregivers and healthcare professionals in the alliance and wanted more and continuously updated material. Conclusion: This study demonstrated that C2C effectively improved the development of caregivers’ knowledge, skills, and their self-care ability. Available social support for caregivers was better than average, including professional support and peer support.
Developmental Constitutionalism and the Fourth Branch: Ghana’s Independent Constitutional Bodies and the Redress of Poverty and Inequality
Authors: Atuguba Raymond A , Young Katharine G 
Published: November 2023

AbstractGhana’s Constitution has long emphasised the importance of equality, democracy, human rights and development. These principles are entrenched in a separation of powers framework that includes independent constitutional bodies that operate semi-autonomously from the tripartite executive, legislative and judicial branches. As part of a symposium on so-called ‘fourth branch’ institutions that provide redress for poverty and inequality, this article explores two institutions: the Commission on Human Rights and Administrative Justice and the National Development Planning Commission. The first is a 30-year-old national human rights institution, which monitors and investigates alleged violations of human rights, corruption and the misappropriation of public moneys, and provides redress, partly through its increasing focus on economic and social rights and the claims of the most vulnerable, including women, children and persons with disabilities. The second, currently executive body, is the subject of current calls for constitutional reform in Ghana. These reforms would entrench national development planning to enhance features of autonomy, technical capacity and partisan independence. As such, these proposals offer a distinctive and yet also paradigm-defying model of fourth branch arrangements in developmental constitutionalism, raising questions about the usurpation of policymaking and the deficits of democracy that are commonly raised against courts, international financial institutions or other international economic arrangements.
Role of granulocyte colony stimulating factor in the treatment of cirrhosis of liver: a systematic review
Authors: Rajpurohit Siddheesh , Musunuri Balaji , Basthi Mohan Pooja , Bhat Ganesh , Shetty Shiran 
Published: November 2023

Objective We performed a systematic review to analyze the benefits of and risk factors associated with granulocyte colony stimulating factor (GCSF) in patients with liver cirrhosis. Methods PubMed, Scopus, and Embase were searched for randomized controlled trials and case–control studies that compared the use of GCSF with another treatment or control group. The Jadad and Newcastle–Ottawa scales were used to assess the risk of bias in the included studies. The primary outcome studied was mortality; and the secondary outcomes were the disease severity score, liver transplantation criteria, complications, CD34+ cell count, adverse events, and health-related quality of life (HRQOL). PROSPERO registration number CRD42023416014. Results The initial search yielded 2,235 studies, of which seven studies of 670 patients with liver cirrhosis were included. Multiple cycles of GCSF significantly improved the survival rate, disease severity score, CD34+ cell count, and HRQOL; and significantly reduced the incidences of liver transplantation, ascites, infection, and hepatic encephalopathy. Fatigue and backache were the most commonly reported adverse events. Conclusion GCSF significantly improves the survival rate and disease severity scores, and reduces the incidence of complications in patients with liver cirrhosis. The administration of GCSF is likely to be effective in patients awaiting liver transplantation.
A comprehensive overview of diagnosis, imaging and treatment of vitreoretinal lymphoma
Authors: Menean Matteo , Giuffrè Chiara , Cicinelli Maria Vittoria , Marchese Alessandro , Modorati Giulio , Bandello Francesco , Miserocchi Elisabetta 
Published: November 2023

Vitreoretinal lymphoma (VRL) is a rare B-cell intraocular neoplasia characterized by poor long-term prognosis and lack of effective therapies. It mainly involves the vitreous humor, the retina, and the retinal pigment epithelium (RPE), although anterior segment involvement can occur. VRL is classified as a lymphoma of immune privileged sites, along with testis lymphoma and primary central nervous system lymphoma (PCNSL). VRL and PCNSL are strictly connected indeed: 80% of VRL develop PCNSL, while 20% of patients with PCNSL present VRL during natural history of lymphoma. Due to the lack of worldwide consensus about diagnosis, therapy, and follow-up timing, VRL represents one of the most challenging ocular affections. VRL commonly masquerades as a posterior uveitis, and misdiagnosis often occurs because of partial response to topical steroids. Gold standard for diagnosis is cytological analysis of vitreous humor. However, this technique lacks sensitivity and supplemental molecular analyses can improve the diagnostic process. Multimodal imaging allows ophthalmologists to empower their clinical suspicion and a comprehensive examination can highlight typical features of VRL and justify further invasive procedures. There is no consensus about VRL therapy, and none of the therapeutical scheme has demonstrated to prevent cerebral involvement and improve patient's overall survival. Intravitreal injections of chemotherapeutics drugs, ocular radiation therapy and systemic chemotherapy can be considered in the treatment of VRL. Once cerebral involvement occurs, systemic chemotherapy must be included in the treatment as a life-saving therapy. Further multicentric studies are required to find out the best treatment of patients with VRL.
Use of a subpalpebral lavage system as salvage therapy for Pseudomonas aeruginosa panophthalmitis due to an infected scleral buckle
Authors: Gupta Neha , Weisenthal Robert , Swan Robert T. , Spalding Samuel C. , Breazzano Mark P. 
Published: November 2023

Purpose To present a case and surgical technique for management of Pseudomonas aeruginosa panophthalmitis secondary to an infected scleral buckle. Methods Surgical technique video for management of an infected scleral buckle resulting in panophthalmitis with scleral buckle and suture explant and insertion of a subpalpebral lavage system. Results After two months, the visual acuity was restored to hand motion, likely secondary to a fibrotic secondary membrane, and the retina remain attached. This reports the first description of globe salvage for panophthalmitis from a P. aeruginosa-infected scleral buckle. Conclusion This case encourages surgeons to remove all aspects of an exposed scleral buckle, including sutures, and emphasizes the importance of routine culture of all explanted material, even in the absence of clinical infection. In addition, this case encourages the use of a subpalpebral lavage in cases of severe P. aeruginosa ocular infections.