Strong Bipartisan Support for Controlled Psilocybin Use as Treatment or Enhancement in a Representative Sample of US Americans: Need for Caution in Public Policy Persists

The psychedelic psilocybin has shown promise both as treatment for psychiatric conditions and as a means of improving well-being in healthy individuals. In some jurisdictions (e.g., Oregon, USA), psilocybin use for both purposes is or will soon be allowed and yet, public attitudes toward this shift are understudied. We asked a nationally representative sample of 795 US Americans to evaluate the moral status of psilocybin use in an appropriately licensed setting for either treatment of a psychiatric condition or well-being enhancement. Showing strong bipartisan support, participants rated the individual's decision as morally positive in both contexts. These results can inform effective policy-making decisions around supervised psilocybin use, given robust public attitudes as elicited in the context of an innovative regulatory model. We did not explore attitudes to psilocybin use in unsupervised or non-licensed community or social settings.

["L'étudiant expert", a podcast for student nurses]

For the past three years, the Institut de formation interhospitalier Théodore-Simon (Ifits) has been embarking on a magnificent adventure to meet its student nurses, collecting their words and testimonials in a series of podcasts, the main aim of which is to shed as much light as possible on the reality of nursing studies. This article retraces the genesis of the project and demonstrates the added value of this tool for future professionals and trainers alike.

A systematic review of the cognitive effects of the COMT inhibitor, tolcapone, in adult humans

OBJECTIVE

The catechol-o-methyltransferase (COMT) inhibitor tolcapone constitutes a potentially useful probe of frontal cortical dopaminergic function. The aim of this systematic review was to examine what is known of effects of tolcapone on human cognition in randomized controlled studies.

METHODS

The study protocol was preregistered on the Open Science Framework. A systematic review was conducted using PubMed to identify relevant randomized controlled trials examining the effects of tolcapone on human cognition. Identified articles were then screened against inclusion and exclusion criteria.

RESULTS

Of the 22 full-text papers identified, 13 randomized control trials were found to fit the pre-specified criteria. The most consistent finding was that tolcapone modulated working memory; however, the direction of effect appeared to be contingent on the COMT polymorphism (more consistent evidence of improvement in Val-Val participants). There were insufficient nature and number of studies for meta-analysis.

CONCLUSION

The cognitive improvements identified upon tolcapone administration, in some studies, are likely to be due to the level of dopamine in the prefrontal cortex being shifted closer to its optimum, per an inverted U model of prefrontal function. However, the results should be interpreted cautiously due to the small numbers of studies. Given the centrality of cortical dopamine to understanding human cognition, studies using tolcapone in larger samples and across a broader set of cognitive domains would be valuable. It would also be useful to explore the effects of different dosing regimens (different doses; and single versus repeated administration).

Does physical activity influence health behavior, mental health, and psychological resilience under the moderating role of quality of life?

Background

Physical activity significantly influences health-related behaviors, encompassing physical and mental well-being. Physical activity has been linked to enhancing health behavior, mental health, and psychological resilience. The current study is based on participants who were active in physical activity to improve health and well-being.

Objectives

To examine the influences of physical activity on health behavior, mental health, and psychological resilience, considering the moderating role of quality of life.

Method

A thorough cross-sectional online survey was conducted from April 15, 2023, to October 15, 2023. The survey was comprehensive and lasted for six months. The online poll received more than one thousand responses under convenience sampling. The selection criteria for the study were above 21 years old, and participants were active in physical activity to improve health and well-being. The collected data were analyzed using appropriate statistical SPSS-25 and SmartPLS 4.0 software to investigate the proposed research paradigm.

Results

SEM results of model 1 (direct coefficients) show that PA has a positive effect on HeB, MeH, PsR, HeB on MeH, HeB on PsR. Out of six (in model 2), four moderating effects of QOL were significant, and two were statistically insignificant.

Conclusion

It has been observed that the quality of life has a moderating role in the relationships between physical exercise and several aspects, such as psychological resilience, mental health, and health-related behavior. It is imperative to emphasize the importance of fostering consistent engagement in physical activity to cultivate a well-balanced and health-conscious way of life.

Preoperative assessment of fistula-in-ano using SonoVue enhancement during three-dimensional transperineal ultrasound

Background

Accurate preoperative evaluation of fistula-in-ano can guide the choice of surgical procedure and may improve healing rates. This prospective study aimed to evaluate the accuracy of conventional 3D transperineal ultrasound (3D-TPUS) compared with SonoVue (SVE)-enhanced 3D-TPUS for the detection and classification of anal fistula.

Methods

In this prospective study, 3D-TPUS reconstructions were performed before and after SVE enhancement in 60 patients with fistula-in-ano who intended to undergo surgery at the Department of Anorectal Surgery, Qilu Hospital, Cheeloo College of Medicine, Shandong University (P. R. China) between January 2021 and October 2021. Accuracies of anal fistula classification, complexity classification, detection of anal fistula branches, and detection of internal opening between 3D-TPUS and SVE 3D-TPUS were compared based on a reference standard-intraoperative findings.

Results

This study enrolled 60 patients (mean age, 37.1 ± 11.4 years; mean follow-up, 9 ± 3 months). Intraoperative findings showed that the fistula type was intersphincteric in 23 patients (38.3%), trans-sphincteric in 35 (58.3%; 12 high and 23 low), and suprasphincteric in 2 (3.3%). Moreover, 68 internal openings were found. Compared with the accuracy of 3D-TPUS, that of SVE 3D-TPUS was similar in fistula classification [95.0% (57/60) vs 96.7% (58/60), P = 0.392], but significantly higher in internal opening evaluation [80.9% (55/68) vs 97.1% (66/68), P = 0.001], complexity classification [85.0% (51/60) vs 98.3% (59/60), P = 0.018], and detection of fistula branches [70.4% (19/27) vs 92.6% (25/27), P = 0.031].

Conclusions

SVE 3D-TPUS may be a useful examination for patients with perianal fistulae because of its high accuracy and consistency with intraoperative findings, especially in complex fistula-in-ano and difficult cases.

Polysomnography scoring-related training and quantitative assessment for improving interscorer agreement

STUDY OBJECTIVES

To efficiently improve the scoring competency of scorers with varying levels of experience across regions in Taiwan, we developed a training program with a cloud-based polysomnography scoring platform to evaluate and improve interscorer agreement.

METHODS

A total of 70 scorers from 34 sleep centers in Taiwan (job tenure: 0.5-39.0 years) completed a scoring test. All scorers scored a 742-epoch (30 s/epoch) overnight polysomnography recording of a patient with a moderate apnea-hypopnea index. Subsequently, 8 scoring experts delivered 8 interactive online lectures (each lasting 30 minutes). The training program included identifying scoring weaknesses, highlighting the latest scoring rules, and providing physicians' perspectives. Afterward, the scorers completed the second scoring test on the same participant. Changes in agreement from the first to second scoring test were identified. Sleep staging, sleep parameters, and respiratory events were considered for evaluating scoring agreement.

RESULTS

The scorers' agreement in overall sleep stage scoring significantly increased from 74.6 to 82.3% (median score). The proportion of scorers with an agreement of ≥ 80% increased from 20.0% (14/70) to 58.6% (41/70) after the online training program. In addition, the scorers' agreement in overall respiratory-event scoring increased to 88.8% (median score) after training. The scorers with a job tenure of 2.0-4.9 years exhibited the highest level of improvement in overall sleep staging (their median agreement increased from 72.8 to 84.9%; P < .001).

CONCLUSIONS

Our interactive online training program efficiently targeted the scorers' scoring weaknesses identified in the first scoring test, leading to substantial improvements in scoring proficiency.

CITATION

Liao Y-S, Wu M-C, Li C-X, Lin W-K, Lin C-Y, Liang S-F. Polysomnography scoring-related training and quantitative assessment for improving interscorer agreement. J Clin Sleep Med. 2024;20(2):271-278.

M3S-Net: multi-modality multi-branch multi-self-attention network with structure-promoting loss for low-dose PET/CT enhancement

Objective.PET (Positron Emission Tomography) inherently involves radiotracer injections and long scanning time, which raises concerns about the risk of radiation exposure and patient comfort. Reductions in radiotracer dosage and acquisition time can lower the potential risk and improve patient comfort, respectively, but both will also reduce photon counts and hence degrade the image quality. Therefore, it is of interest to improve the quality of low-dose PET images.Approach.A supervised multi-modality deep learning model, named M3S-Net, was proposed to generate standard-dose PET images (60 s per bed position) from low-dose ones (10 s per bed position) and the corresponding CT images. Specifically, we designed a multi-branch convolutional neural network with multi-self-attention mechanisms, which first extracted features from PET and CT images in two separate branches and then fused the features to generate the final generated PET images. Moreover, a novel multi-modality structure-promoting term was proposed in the loss function to learn the anatomical information contained in CT images.Main results.We conducted extensive numerical experiments on real clinical data collected from local hospitals. Compared with state-of-the-art methods, the proposed M3S-Net not only achieved higher objective metrics and better generated tumors, but also performed better in preserving edges and suppressing noise and artifacts.Significance.The experimental results of quantitative metrics and qualitative displays demonstrate that the proposed M3S-Net can generate high-quality PET images from low-dose ones, which are competable to standard-dose PET images. This is valuable in reducing PET acquisition time and has potential applications in dynamic PET imaging.

The support group impact on enhancing the self-worth of women who terminated a pregnancy in adolescence

BACKGROUND

 Terminating a pregnancy can be a traumatic life event, resulting in negative emotions that can diminish women's self-worth. Support from different sources, including health support groups, could be beneficial in restoring a woman's self-worth. This article aimed to present findings on the impact of a support group intervention on the self-worth of women who terminated a pregnancy in adolescence.

METHODS

 A qualitative, exploratory and descriptive approach, using in-depth, semi-structured interviews, was used to collect data. Thematic analysis guided the data analysis.

RESULTS

 Five themes emerged from the data: reasons for joining the support group; enhanced emotional and physical wellbeing; self-forgiveness; spiritual growth and participants' voices.

CONCLUSION

 Participants described why they needed to join the support group. It became clear that the intercession was effective in the short term as it enhanced participants' self-worth by encouraging them to accept themselves thereby altering their self-condemning emotions, replacing them with self-love.Contribution: The study recommends that a support group should be considered as a backup for women who terminated a pregnancy and have lost their self-worth.

Action does not enhance but attenuates predicted touch

Dominant motor control theories propose that the brain predicts and attenuates the somatosensory consequences of actions, referred to as somatosensory attenuation. Support comes from psychophysical and neuroimaging studies showing that touch applied on a passive hand elicits attenuated perceptual and neural responses if it is actively generated by one's other hand, compared to an identical touch from an external origin. However, recent experimental findings have challenged this view by providing psychophysical evidence that the perceived intensity of touch on the passive hand is enhanced if the active hand does not receive touch simultaneously with the passive hand (somatosensory enhancement) and by further attributing attenuation to the double tactile stimulation of the hands upon contact. Here, we directly contrasted the hypotheses of the attenuation and enhancement models regarding how action influences somatosensory perception by manipulating whether the active hand contacts the passive hand. We further assessed somatosensory perception in the absence of any predictive cues in a condition that turned out to be essential for interpreting the experimental findings. In three pre-registered experiments, we demonstrate that action does not enhance the predicted touch (Experiment 1), that the previously reported 'enhancement' effects are driven by the reference condition used (Experiment 2), and that self-generated touch is robustly attenuated regardless of whether the two hands make contact (Experiment 3). Our results provide conclusive evidence that action does not enhance but attenuates predicted touch and prompt a reappraisal of recent experimental findings upon which theoretical frameworks proposing a perceptual enhancement by action prediction are based.

A Nietzschean critique of liberal eugenics

Ethical debates about liberal eugenics frequently focus on the supposed unnaturalness of its means and possible harm to autonomy. I present a Nietzsche-inspired critique focusing on intention rather than means and harm to abilities rather than to autonomy. I first critique subjective eugenics, the selection of extrinsically valuable traits, drawing on Nietzsche's notion of 'slavish' values reducible to the negation of another's good. Subjective eugenics slavishly evaluates traits relative to a negatively evaluated norm (eg, above-average intelligence), disguising a harmful intention to diminish the relative value of that norm. I then argue there is no objective form of eugenics on the Nietzschean ground that abilities are not valuable intrinsically; they are valuable only if one possesses the relative power to exercise them. Abilities frustrated by conflict with other abilities or environment are harmful, while disabilities that empower one's other abilities are beneficial. Consequently, all forms of eugenics are subject to the prior ethical critique of subjective eugenics.

Attempting to counteract vigilance decrement in older adults with brain stimulation

Introduction

Against the background of demographic change and the need for enhancement techniques for an aging society, we set out to repeat a study that utilized 40-Hz transcranial alternating current stimulation (tACS) to counteract the slowdown of reaction times in a vigilance experiment but with participants aged 65 years and older. On an oscillatory level, vigilance decrement is linked to rising occipital alpha power, which has been shown to be downregulated using gamma-tACS.

Method

We applied tACS on the visual cortex and compared reaction times, error rates, and alpha power of a group stimulated with 40 Hz to a sham and a 5-Hz-stimulated control group. All groups executed two 30-min-long blocks of a visual task and were stimulated according to group in the second block. We hypothesized that the expected increase in reaction times and alpha power would be reduced in the 40-Hz group compared to the control groups in the second block (INTERVENTION).

Results

Statistical analysis with linear mixed models showed that reaction times increased significantly over time in the first block (BASELINE) with approximately 3 ms/min for the SHAM and 2 ms/min for the 5-Hz and 40-Hz groups, with no difference between the groups. The increase was less pronounced in the INTERVENTION block (1 ms/min for SHAM and 5-Hz groups, 3 ms/min for the 40-Hz group). Differences among groups in the INTERVENTION block were not significant if the 5-Hz or the 40-Hz group was used as the base group for the linear mixed model. Statistical analysis with a generalized linear mixed model showed that alpha power was significantly higher after the experiment (1.37 μV2) compared to before (1 μV2). No influence of stimulation (40 Hz, 5 Hz, or sham) could be detected.

Discussion

Although the literature has shown that tACS offers potential for older adults, our results indicate that findings from general studies cannot simply be transferred to an old-aged group. We suggest adjusting stimulation parameters to the neurophysiological features expected in this group. Next to heterogeneity and cognitive fitness, the influence of motivation and medication should be considered.

Enhancement of Deep Neural Network Recognition on MPSoC with Single Event Upset

This paper introduces a new finding regarding single event upsets (SEUs) in configuration memory, and their potential impact on enhancing the performance of deep neural networks (DNNs) on the multiprocessor system on chip (MPSoC) platform. Traditionally, SEUs are considered to have negative effects on electronic systems or designs, but the current study demonstrates that they can also have positive contributions to the DNN on the MPSoC. The assertion that SEUs can have positive contributions to electronic system design was supported by conducting fault injections through dynamic reconfiguration on DNNs implemented on a 16nm FinFET technology Zynq UltraScale+ MPSoC. The results of the current study were highly significant, indicating that an SEU in configuration memory could result in an impressive 8.72% enhancement in DNN recognition on the MPSoC. One possible cause is that SEU in the configuration memory leads to slight changes in weight or bias values, resulting in improved activation levels of neurons and enhanced final recognition accuracy. This discovery offers a flexible and effective solution for boosting DNN performance on the MPSoC platform.

Black blood MRI sequences in the acute management of ruptured and unruptured intracranial aneurysms

We present an illustrative case series in which high spatial resolution black blood (BB) MRI sequences were used as an adjunct in the acute management of intracranial aneurysms with diagnostic uncertainty regarding rupture status. Several acute management dilemmas are discussed including the surveillance of previously treated ruptured intracranial aneurysms, identifying culprit lesion(s) amongst multiple ruptured intracranial aneurysms, and risk stratifying incidental unruptured intracranial aneurysms. We present our experience which supports the evaluation of this vessel wall imaging technique in larger multi-centre observational studies. MR imaging was performed on a 3.0 Tesla Siemens Somatom Vida system and sequences used included: Susceptibility Weighted Imaging, Diffusion Weighted Imaging & 3D T1 pre- and post-contrast-enhanced BB sequences.

Low Contrast Volume Protocol in Routine Chest CT Amid the Global Contrast Shortage: A Single Institution Experience

OBJECTIVE

To assess the effectiveness of low contrast volume (LCV) chest CT performed with multiple contrast agents on multivendor CT with varying scanning techniques.

METHODS

The study included 361 patients (65 ± 15 years; M: F 173:188) who underwent LCV chest CT on one of the six 64-256 detector-row CT scanners using single-energy (SECT) or dual-energy (DECT) modes. All patients were scanned with either a fixed-LCV (LCVf, n = 103) or weight-based LCV (LCVw, n = 258) protocol. Two thoracic radiologists independently assessed all LCV CT and patients' prior standard contrast volume (SCV, n = 263) chest CT for optimality of contrast enhancement in thoracic vasculature, cardiac chambers, and in pleuro-parenchymal and mediastinal abnormalities. CT attenuations were recorded in the main pulmonary trunk, ascending, and descending thoracic aorta. To assess the interobserver agreement, pulmonary arterial enhancement was divided into two groups: optimal or suboptimal.

RESULTS

There was no significant difference among patients' BMI (p = 0.883) in the three groups. DECT had a significantly higher aortic arterial enhancement (250 ± 99HU vs 228 ± 76 HU for SECT, p < 0.001). Optimal enhancement was present in 558 of 624 chest CT (89.4%), whereas 66 of 624 chest CT with suboptimal enhancement was noted in 48 of 258 LCVw (18.6%) and 14 of 103 LCVf (13.6%). Most patients with suboptimal enhancement with LCVw injection protocol were overweight/obese (30/48; 62.5%), (p < 0.001).

CONCLUSION

LCV chest CT can be performed across complex multivendor, multicontrast media, multiscanner, and multiprotocol CT practices. However, LCV chest CT examinations can result in suboptimal contrast enhancement in patients with larger body habitus.

A Reanalysis of the Voicing Effect in English: With Implications for Featural Specification

The voicing effect is among the most studied and robust of phonetic phenomena. Yet there remains a lack of consensus on why vowels preceding voiced obstruents should be longer than vowels preceding voiceless obstruents. In this paper we provide an analysis of the voicing effect in a corpus of natural speech, and using production data from a metronome-timed word repetition study. From this evidence, as well as the existing literature, we conclude that vowel duration differences follow from consonant duration differences. The characteristic voicing effect in English is largely limited to words of especially long duration, and preceding vowel duration does not reliably cue obstruent voicing under the following circumstances: when obstruent voicing or duration cues conflict; for lax or unstressed vowels; and for most conversational speech. We show that this behavior can be modeled using a competing-constraints framework, where all segments resist expanding or compressing past a preferred duration. Inherent segment elasticity determines the degree of resistance, but segment duration is ultimately determined by the interaction of these segmental constraints with constraints on the distribution of the lengthening force within the syllable, and how closely target durations are matched. This account of the voicing effect has a number of implications for phonological theory, especially the central role that the concept of prominence plays in the analysis of underlying features.

Heritable genome editing: ethical aspects of a developing domain

In the past decade, scientific developments in human germline genome editing (GGE) have reinvigorated questions about research ethics, responsible innovation, and what it means to do good in the field of reproductive biology and medicine. In recent years, it has become part of the ethical debate on GGE whether categorical objections about (un)naturalness, dignity, respect for the gene pool as common heritage, are and should be supplemented by more pragmatic questions about safety, utility, efficacy, and potential 'misuse', which seem to become more dominant in the moral discussion. This mini-review summarizes the morally relevant aspects of the rapidly developing domain of GGE, focusing on reproductive applications and with special attention to the ethical questions pertaining to how this technology may affect the interests of those that come to be by means of it. While vital, this encompasses more than safety considerations. Taking this perspective, it will be crucial to engage with normative questions about how GGE maps on the importance of accommodating future parents' preference to have genetically related children, and how far we should go to facilitate this. Similarly, a comprehensive ethical debate about 'appropriate application' of GGE cannot shake off the more fundamental question about how notions like 'normalcy', 'quality of life', and 'disability' can be conceptualized. This is crucial in view of respecting persons whichever traits they have and in view of acceptable boundaries to parental responsibilities.

The effect of household corrosive substances on latent fingermark development in the context of deliberate corrosive substance attacks

Corrosive substance attacks (CSA) are a prevalent issue in the UK with 525 offenses involving a corrosive substance reported to the police in the year ending March 2022. Easy availability, low cost, and concealability in public are common reasons for choosing a corrosive substance as a weapon. The Metropolitan Police revealed that 68% of 1849 CSA cases resulted in no suspect identified or evidential difficulties. There is limited research into the effect of corrosive substances on latent fingermarks. This study aimed to determine the potential for fingermarks to be recovered from surfaces exposed to a household corrosive substance within the context of a deliberate CSA. Natural and sebaceous-loaded fingermarks were exposed to Domestos bleach, Harpic limescale remover (hydrochloric acid-based) and lemon juice. Harpic limescale remover had the most detrimental effect, with only 7.1% of fingermarks (n = 378) exposed being identifiable (defined as sufficient clear ridge detail for identification) after enhancement, followed by bleach with only 10.3% of fingermarks (n = 378) identifiable. Lemon juice had the least detrimental effect on fingermarks, with 40.5% fingermarks (n = 378) identifiable compared to 53.4% for the controls (not exposed to any substance; n = 378). Throughout the study, fewer natural fingermarks were identifiable after exposure to corrosive substances compared to sebaceous fingermarks which was as expected. Overall, this study demonstrated that there is potential to recover latent fingermarks, depending on their composition, following exposure to a household corrosive substance. This area warrants further research to establish best practice to maximize the potential to recover identifiable fingermarks.

Motivational Enhancement: What Ancient Technologies of the Self and Recent Biotechnologies Have in Common

Motivational enhancement of any kind can be conceived of either as a way to reduce the need for effort, or as a change in the subjective perception of effort. However, in both cases, effort is not all that matters. In the evaluation of praiseworthy conduct, the practical goals pursued by the subject, their dedication, and the discernment they exercise are equally important. I further argue that not only in terms of the general purpose, but also in terms of the means employed for human enhancement, we cannot, in fact, establish significant differences between the traditional technology of the self and biomedical technologies for enhancing motivation. There are two key features they all share. The traditional techniques of the self also aim at the gradual reduction of effort through their steady practice, and they are all mental conditioning and self-conditioning techniques based on repetition and training.

Contrast enhanced CT on PET/CT imaging in clinical routine: an international survey

Aim

To perform an international survey about PET/CT imaging with contrast enhanced CT (PET/ceCT) in clinical routine worldwide.

Methods

A questionnaire of ten questions was prepared for health professionals, addressing the following issues: (1) general demographic, hospital, and department information; (2) use and diffusion of PET/ceCT worldwide; (3) factors influencing the use of PET/ceCT. An invitation to the survey was sent to the corresponding authors of NM scientific articles indexed in SCOPUS in 2022 and dedicated to PET/CT imaging. Data were analysed per individual responder.

Results

191 individual responders worldwide participated in this survey. Most of the responders are using PET/ceCT in their center (74%). Interestingly, the relative use of PET/ceCT over the total PET/CT scans has an anti-Gaussian distribution (<20% ceCT and > 80% ceCT were most represented). Most of responders are using PET/ceCT in oncological settings (62%) and irrespectively from radiopharmaceuticals (62%). In most cases, PET/ceCT scans are reported by NM physicians alone or together by NM physicians and radiologists with an integrated report (31%).

Conclusion

PET/ceCT imaging is largely used worldwide. Local factors can affect the choice of PET/ceCT in respect to conventional PET/CT imaging. Further cost-benefit analysis could be useful to consider other possible influencing variables, such as technologies, dosimetry, department organization and economics.

Reasons and Reproduction: Gene Editing and Genetic Selection

Many writers in bioethics, science, and medicine contend that embryo selection is a morally better way of avoiding genetic disorders then gene editing, as the latter has risks that the former does not. We argue that one reason to use gene editing is that in many cases it would be better for the person who would develop from the edited embryo, so that not to have done it would have been worse for that person. By contrast, embryo selection is never better for the person who develops from the selected embryo. This reason to use gene editing has, however, been challenged on two grounds: first, that it makes no difference, morally, whether a bad effect is worse for someone, or a good effect better for someone; and, second, that beneficent gene editing would not be unequivocally better for the person who would develop from the edited embryo. We argue that both of these objections can be satisfactorily answered and thus that there is indeed a significant moral reason, at least in some cases, to use gene editing rather than embryo selection.

A Study of Isosorbide Synthesis from Sorbitol for Material Applications Using Isosorbide Dimethacrylate for Enhancement of Bio-Based Resins

Bio-based cross-linkers can fulfill the role of enhancing additives in bio-sourced curable materials that do not compare with artificial resin precursors. Isosorbide dimethacrylate (ISDMMA) synthesized from isosorbide (ISD) can serve as a cross-linker from renewable sources. Isosorbide is a bicyclic carbon molecule produced by the reaction modification of sorbitol and the optimal conditions of this reaction were studied in this work. The reaction temperature of 130 °C and 1% w/w amount of para-toluenesulfonic acid (p-TSA) were determined as optimal and resulted in a yield of 81.9%. Isosorbide dimethacrylate was synthesized via nucleophilic substitution with methacrylic anhydride (MAA) with the conversion of 94.1% of anhydride. Formed ISD and ISDMMA were characterized via multiple verification methods (FT-IR, MS, 1H NMR, and XRD). Differential scanning calorimetry (DSC) proved the curability of ISDMMA (activation energy Ea of 146.2 kJ/mol) and the heat-resistant index of ISDMMA (Ts reaching value of 168.9) was determined using thermogravimetric analysis (TGA). Characterized ISDMMA was added to the precursor mixture containing methacrylated alkyl 3-hydroxybutyrates (methyl ester M3HBMMA and ethyl ester E3HBMMA), and the mixtures were cured via photo-initiation. The amount of ISDMMA cross-linker increased all measured parameters obtained via dynamic mechanical analysis (DMA), such as storage modulus (E') and glass transition temperature (Tg), and the calculated cross-linking densities (νe). Therefore, the enhancement influence of bio-based ISDMMA on resins from renewable sources was confirmed.

Confirmed and presumed canine insulinomas and their presumed metastases are most conspicuous in the late arterial phase in a triple arterial phase CT protocol

Arterial enhancement is the commonly described characteristic of canine insulinomas in contrast-enhanced computed tomography (CECT). However, this finding is also reported as inconsistent. The main aim of this single-center retrospective observational study was to describe the contrast enhancement (CE) pattern of canine presumed and confirmed insulinomas and presumed metastases in three consecutive (early, mid, and late) arterial phases. Included dogs had a medical-record-based clinical or cytological/histopathological diagnosis of insulinoma and quadruple-phase CECT. The arterial phases were identified according to published literature. The arterial enhancement of confirmed and presumed lesions was assessed using a visual grading score. Twelve dogs with a total of 17 pancreatic nodules were analyzed. Three dogs had multiple pancreatic nodules and nine had solitary findings. Four insulinomas were histopathologically confirmed. Late arterial phase (LAP) images demonstrated the largest number of pancreatic nodules reaching the highest enhancement scores (n = 13, 76%). All analyzed dogs had CT evidence of arterially enhancing nodules in the liver (n = 12), seven in the hepatic, splenic, or colic lymph nodes, and three in the spleen. Three out of five sampled livers and three lymph nodes were metastatic. All sampled spleens were benign. Avid arterial enhancement was the most dominant feature of canine presumed and confirmed insulinomas and presumed metastases in quadruple-phase CECT. The highest enhancement scores were observed primarily in LAP, followed by MAP. Authors, therefore, recommend including LAP in the standard CT protocol for dogs with suspected pancreatic insulinomas.

A rare case of multifocal chordoma involving the lower clivus and multiple spine levels: illustrative case

BACKGROUND

Chordomas are rare bone tumors originating from notochord remnants with a predilection for the median axis of the body, primarily in the sacrococcygeal spine, skull base, and cervical spine. This paper presents the first reported case of simultaneous multilevel chordomas with various enhancements.

OBSERVATIONS

A 40-year-old woman presented with right-sided otalgia, headache, nasal obstruction, and facial pressure. The patient's head and spinal magnetic resonance imaging (MRI) demonstrated a midline lesion in the clivus, C2, and T1-5 spinal levels. All lesions were T1 isointense and T2 hyperintense, consistent with chordoma. Interestingly, the clivus lesion was enhancing, whereas the C2 lesion was only slightly enhancing, and the rest of the lesions showed no enhancement. The patient underwent endoscopic endonasal transclival approach surgery for the clival lesion, followed by radiation to the surgical bed and the C2 lesion. The remaining lesions were monitored. Follow-up imaging showed stable disease in the C2 lesion and other lower lesions. The patient's severe pain in the posterior cervical spine was managed with cervical fusion, pain management, and physical therapy.

LESSONS

This case underscores the importance of comprehensive spinal MRI in patients with chordomas, as multiple concurrent primaries may be present. The article summarizes the fundamental distinctions between ecchordosis physaliphora and chordoma and casts doubt on the capacity to always differentiate them.

Enhanced Systemic Humoral Immune Response Induced in Mice by Generalized Modules for Membrane Antigens (GMMA) Is Associated with Affinity Maturation and Isotype Switching

Generalized Modules for Membrane Antigens (GMMA) are outer membrane vesicles derived from Gram-negative bacteria that can be used to design affordable subunit vaccines. GMMA have been observed to induce a potent humoral immune response in preclinical and clinical studies. In addition, in preclinical studies, it has been found that GMMA can be exploited as optimal antigen carriers for both protein and saccharide antigens, as they are able to promote the enhancement of the antigen-specific humoral immune response when the antigen is overexpressed or chemically conjugated to GMMA. Here we investigated the mechanism of this GMMA carrier effect by immunizing mice and using factor H binding protein and GMMA of Neisseria meningitidis B as an antigen-GMMA model. We confirmed that the antigen displayed on the GMMA surface increased the antigen-specific IgG production and, above all, the antibody functionality measured by the serum bactericidal activity. We found that the enhancement of the bactericidal capacity induced by GMMA carrying the antigen on the surface was associated with the increase in antibody affinity to the antigen, and with the switching toward IgG subclasses with more bactericidal potential. Thus, we conclude that the potent carrier effect of GMMA is due to their ability to promote a better quality of humoral immunity.

Development of Positively Charged Poly-L-Lysine Magnetic Nanoparticles as Potential MRI Contrast Agent

A colloidal solution of magnetic nanoparticles (MNPs) modified with biocompatible positively charged poly-L-lysine (PLL) with an oleate (OL) layer employed as an initial coating was produced as a potential MRI contrast agent. The effect of various PLL/MNPs' mass ratios on the samples' hydrodynamic diameter, zeta potential, and isoelectric point (IEP) was studied by the dynamic light-scattering method. The optimal mass ratio for MNPs' surface coating was 0.5 (sample PLL_0.5-OL-MNPs). The average hydrodynamic particle size in the sample of PLL_0.5-OL-MNPs was 124.4 ± 1.4 nm, and in the PLL-unmodified nanoparticles, it was 60.9 ± 0.2 nm, indicating that the OL-MNPs' surface became covered by PLL. Next, the typical characteristics of the superparamagnetic behavior were observed in all samples. In addition, the decrease in saturation magnetizations from 66.9 Am²/kg for MNPs to 35.9 and 31.6 Am²/kg for sample OL-MNPs and PLL_0.5-OL-MNPs also confirmed successful PLL adsorption. Moreover, we show that both OL-MNPs and PLL_0.5-OL-MNPs exhibit excellent MRI relaxivity properties and a very high r₂⁽*⁾/r₁ ratio, which is very desirable in biomedical applications with required MRI contrast enhancement. The PLL coating itself appears to be the crucial factor in enhancing the relaxivity of MNPs in MRI relaxometry.

The Application of Multiple Magnetic Resonance Scanning Techniques in Evaluating the Stability of Intracranial Aneurysms

Purpose

To evaluate the stability of unruptured intracranial aneurysm (UIA) with high-resolution magnetic resonance imaging of the vessel wall (HR-VWI).

Materials and Methods

A total of 92 UIA patients were enrolled. After MRA, HR-VWI imaging, the reconstruction of volume rendering (VR) and maximum intensity projection (MIP) were performed to observe the location and size of aneurysms, AR value (ratio of aneurysm height to aneurysmal diameter), SR value (ratio of maximum tumor depth to proximal parent artery diameter), and signal intensity were measured.

Results

There were 7 aneurysms with UIA located in the anterior cerebral artery, 31 aneurysms with UIA in the middle cerebral artery, 1 aneurysm with UIA in the posterior cerebral artery, 18 aneurysms with UIA in the anterior communication, 5 aneurysms with UIA in the posterior communication, 34 aneurysms with UIA in the intracranial segment of the internal carotid artery and 3 aneurysms with UIA in the vertebral artery. Among them, 8 patients had more than two multiple aneurysms. The lesion size was 2-38mm (6.3 ± 5.09). There are 46 aneurysms with wall enhancement: the maximum SR value was 7.03 and the minimum 1.2, and the maximum AR value was 7.5 and the minimum 1.0. Fifty-five aneurysms showed no enhancement of the tumor wall. The maximum SR value was 4.55 and the minimum 0.58, and the maximum AR value was 4.0 and the minimum 0.6, respectively. Patients were divided into a stable group and an unstable group according to the aneurysm wall. The enhancement rate, SR value, and AR value in the stable aneurysm group were significantly lower than those in the unstable aneurysm group (P < 0.05).

Conclusion

MRA and HR-VWI can objectively reflect the stability of aneurysms by judging the morphology, SR value, and signal enhancement of UIA, and can provide a certain basis for diagnosis and treatment, which has become routine examination.

Advancements in Perovskite Nanocrystal Stability Enhancement: A Comprehensive Review

Over the past decade, perovskite technology has been increasingly applied in solar cells, nanocrystals, and light-emitting diodes (LEDs). Perovskite nanocrystals (PNCs) have attracted significant interest in the field of optoelectronics owing to their exceptional optoelectronic properties. Compared with other common nanocrystal materials, perovskite nanomaterials have many advantages, such as high absorption coefficients and tunable bandgaps. Owing to their rapid development in efficiency and huge potential, perovskite materials are considered the future of photovoltaics. Among different types of PNCs, CsPbBr₃ perovskites exhibit several advantages. CsPbBr₃ nanocrystals offer a combination of enhanced stability, high photoluminescence quantum yield, narrow emission bandwidth, tunable bandgap, and ease of synthesis, which distinguish them from other PNCs, and make them suitable for various applications in optoelectronics and photonics. However, PNCs also have some shortcomings: they are highly susceptible to degradation caused by environmental factors, such as moisture, oxygen, and light, which limits their long-term performance and hinders their practical applications. Recently, researchers have focused on improving the stability of PNCs, starting with the synthesis of nanocrystals and optimizing (i) the external encapsulation of crystals, (ii) ligands used for the separation and purification of nanocrystals, and (iii) initial synthesis methods or material doping. In this review, we discuss in detail the factors leading to instability in PNCs, introduce stability enhancement methods for mainly inorganic PNCs mentioned above, and provide a summary of these approaches.

Increased serum fibroblast growth factor 21 levels are associated with adverse clinical outcomes after intracerebral hemorrhage

Introduction

Intracerebral hemorrhage (ICH) is the most prevalent cause of death. We sought to explore whether serum Fibroblast growth factor 21 (FGF21) is of substantial benefit in predicting poor prognosis in ICH patient.

Methods

A prospective, multicenter cohort analysis of serum FGF21 levels in 418 ICH patients was carried out. At three months following ICH start, the primary endpoint was death or major disability, whereas the secondary endpoint was death. We investigated the association between serum FGF21 and clinical outcomes. We added FGF21 to the existing rating scale to assess whether it enhanced the prediction ability of the original model. Effectiveness was determined by calculating the C-statistic, net reclassification index (NRI), absolute integrated discrimination improvement (IDI) index.

Results

Among 418 enrolled patients, 217 (51.9%) of the all subjects had death or significant disability. Compared with patients in the lowest quartile group, those in the first quartile group had higher risk of the primary outcome (Odds ratio, 2.73 [95%CI,1.42-5.26, p < 0.05]) and second outcome (Hazard ratio, 4.28 [95%CI,1.61-11.42, p < 0.001]). The integration of FGF21 into many current ICH scales improved the discrimination and calibration quality for the integrated discrimination index's prediction of main and secondary findings (all p < 0.05).

Conclusion

Elevated serum FGF21 is associated with increased risks of adverse clinical outcomes at 3 months in ICH patients, suggesting FGF21 may be a valuable prognostic factor.

Challenging Contrast-Enhanced Mammography-Guided Biopsies: Practical Approach Using Real-Time Multimodality Imaging and a Proposed Procedural Algorithm

Contrast-enhanced mammography (CEM) is an emerging functional breast imaging technique that entails the acquisition of dual-energy digital mammographic images after IV administration of iodine-based contrast material. CEM-guided biopsy technology was introduced in 2019 and approved by the U.S. FDA in 2020. This technology's availability enables direct sampling of suspicious enhancement seen only on or predominantly on recombined CEM images and addresses a major obstacle to the clinical implementation of CEM technology. The literature describing clinical indications and procedural techniques of CEM-guided biopsy is scarce. This article describes our initial experience in performing challenging CEM-guided biopsies and proposes a step-by-step procedural algorithm designed to proactively address anticipated technical difficulties and thereby increase the likelihood of achieving successful targeting.

[Preparation of High Specific Surface Thiourea Modified Peanut Shell Carbon and Adsorption of Tetracycline and Copper]

High activity nitrogen and sulfur co-doping high specific surface-modified peanut shell carbon PBC-NS was prepared through one-step carbonization using thiourea and phosphoric acid as modifiers. The TC/Cu(Ⅱ) adsorption characteristics of peanut shell carbon in single and mixed-adsorption systems were discussed, and the enhancement effect and mechanism of modification on TC/Cu(Ⅱ) adsorption were studied. The results showed that the modified peanut shell carbon PBC-NS successfully introduced nitrogen-sulfur functional groups such as Pyridinic N, Graphitic N, C- S-C, and -SH, and the modified specific surface area was as high as 1437 m²·g^-1, which was 2.6 times higher than that before modification. The maximum adsorption capacities of modified peanut shell carbon PBC-NS for single-system TC and Cu(Ⅱ) were 585 mg·g^-1 and 21.2 mg·g^-1, respectively, which were 2.6 times and 2.7 times higher than those before modification. The saturated adsorption capacities of TC and Cu(Ⅱ) in the system were increased by 13 mg·g^-1 and 6.8 mg·g^-1 compared with that in the single system. The adsorption capacity of PBC-NS for TC and Cu(Ⅱ) could still reach 66% and 70% of the initial adsorption capacity after four times of repeated use. Isotherm fitting and modern spectroscopic analysis indicated that the substantial increase in the adsorption capacity of TC/Cu(Ⅱ) on PBC-NS by modification was mainly attributed to the combined effect of chemical chelation of nitrogen-sulfur active functional sites and pore filling caused by high specific surface area. These results indicated that thiourea/phosphoric acid chemical modification could effectively improve the adsorption capacity of peanut shell carbon for TC/Cu(Ⅱ), which can provide a new idea for the structural regulation of mixed-pollution biochar with high adsorption capacity and adsorption treatment of TC/Cu(Ⅱ) water pollution.

Inversion of pop-out for a distracting feature dimension in monkey visual cortex

During visual search, it is important to reduce the interference of distracting objects in the scene. The neuronal responses elicited by the search target stimulus are typically enhanced. However, it is equally important to suppress the representations of distracting stimuli, especially if they are salient and capture attention. We trained monkeys to make an eye movement to a unique "pop-out" shape stimulus among an array of distracting stimuli. One of these distractors had a salient color that varied across trials and differed from the color of the other stimuli, causing it to also pop-out. The monkeys were able to select the pop-out shape target with high accuracy and actively avoided the pop-out color distractor. This behavioral pattern was reflected in the activity of neurons in area V4. Responses to the shape targets were enhanced, while the activity evoked by the pop-out color distractor was only briefly enhanced, directly followed by a sustained period of pronounced suppression. These behavioral and neuronal results demonstrate a cortical selection mechanism that rapidly inverts a pop-out signal to "pop-in" for an entire feature dimension thereby facilitating goal-directed visual search in the presence of salient distractors.

Thermal Conductivity Enhancement of Metal Oxide Nanofluids: A Critical Review

Advancements in technology related to energy systems, such as heat exchangers, electronics, and batteries, are associated with the generation of high heat fluxes which requires appropriate thermal management. Presently, conventional thermal fluids have found limited application owing to low thermal conductivity (TC). The need for more efficient fluids has become apparent leading to the development of nanofluids as advanced thermal fluids. Nanofluid synthesis by suspending nano-size materials into conventional thermal fluids to improve thermal properties has been extensively studied. TC is a pivotal property to the utilization of nanofluids in various applications as it is strongly related to improved efficiency and thermal performance. Numerous studies have been conducted on the TC of nanofluids using diverse nanoparticles and base fluids. Different values of TC enhancement have been recorded which depend on various factors, such as nanoparticles size, shape and type, base fluid and surfactant type, temperature, etc. This paper attempts to conduct a state-of-the-art review of the TC enhancement of metal oxide nanofluids owing to the wide attention, chemical stability, low density, and oxidation resistance associated with this type of nanofluid. TC and TC enhancements of metal oxide nanofluids are presented and discussed herein. The influence of several parameters (temperature, volume/weight concentration, nano-size, sonication, shape, surfactants, base fluids, alignment, TC measurement techniques, and mixing ratio (for hybrid nanofluid)) on the TC of metal oil nanofluids have been reviewed. This paper serves as a frontier in the review of the effect of alignment, electric field, and green nanofluid on TC. In addition, the mechanisms/physics behind TC enhancement and techniques for TC measurement have been discussed. Results show that the TC enhancement of metal oxide nanofluids is affected by the aforementioned parameters with temperature and nanoparticle concentration contributing the most. TC of these nanofluids is observed to be actively enhanced using electric and magnetic fields with the former requiring more intense studies. The formulation of green nanofluids and base fluids as sustainable and future thermal fluids is recommended.

Enhancement and Sensing Application of Ultra-Narrowband Circular Dichroism in the Chiral Nanostructures Based on Monolayer MoS2 and a Distributed Bragg Reflector

Narrowband circular dichroism (CD) has aroused wide concerns in high-sensitivity detections of chiral molecular and chiral catalysis. Nevertheless, the dynamical adjustment of ultra-narrowband (UNB) CD signals is hard to achieve. In this work, single-layer molybdenum disulfide (MoS₂), vanadium dioxide (VO₂), and a distributed Bragg reflector (DBR) are introduced into X-shaped chiral nanostructures (XCNs) for overcoming the above challenge. The simulation results show that XCNs can generate four strong UNB CD signals in the near-infrared band, and XCNs/MoS₂ can further enhance the UNB CD signals. The full width at half-minimum of UNB CD signals can reach 0.14 nm. The electric field distributions of XCNs/MoS₂ show that the four CD signals originate from the coupling between the guided mode resonances along the x and y axes in the VO₂ layer and the Tamm plasmon polaritons along the x and y axes in the DBR layer. Four UNB CD peaks can be actively tuned by varying the structural parameters, the number of MoS₂ layers, and the environmental temperature. The FOM of XCNs/MoS₂ can reach 1487 by changing the refractive index of the DRB layers. These findings contribute to the design of UNB chiral devices and provide new possibilities for environmental monitoring and ultrasensitive detection of chiral molecules.

A comparison of the use of contrast media with different iodine concentrations for enhanced computed tomography

Objective: In this study, we compared the enhancement of blood vessels and liver parenchyma on enhanced computed tomography (CT) of the upper abdomen with two concentrations of contrast media (400 and 300 mg I/mL) based on similar iodine delivery rate (IDR) of 0.88 and 0.9 g I/s and iodine load of 450 mg I/kg. Methods: We randomly assigned 160 patients into two groups: iomeprol 400 mg I/mL (A group) and iohexol 300 mg I/mL (B group). The CT attenuation values of the main anatomical structures in the two groups with different scanning phases were measured and the image quality of the two groups was analyzed and compared. The peak pressure and local discomfort (including fever and pain) during contrast medium injection were recorded. Results: The mean attenuation value of the abdominal aorta was 313.6 ± 29.6 in the A group and 322.4 ± 30.1 in the B group during the late arterial phase (p = 0.8). Meanwhile, the mean enhancement values of the portal vein were 176.2 ± 19.3 and 165.9 ± 24.5 in the A and B groups, respectively, during the portal venous phase (p = 0.6). The mean CT values of liver parenchyma were 117.1 ± 15.3 and 108.8 ± 18.7 in the A and B groups, respectively, during the portal venous phase (p = 0.9). There was no statistical difference in image quality, peak injection pressure (psi), and local discomfort between the two groups (p > 0.05). Conclusion: When a similar IDR and the same iodine load are used, CT images with different concentrations of contrast media have the same subjective and objective quality, and can meet the diagnostic needs.

Strategies of strengthening mechanical properties in the osteoinductive calcium phosphate bioceramics

Calcium phosphate (CaP) bioceramics are widely applied in the bone repairing field attributing to their excellent biological properties, especially osteoinductivity. However, their applications in load-bearing or segmental bone defects are severely restricted by the poor mechanical properties. It is generally considered that it is challenging to improve mechanical and biological properties of CaP bioceramics simultaneously. Up to now, various strategies have been developed to enhance mechanical strengths of CaP ceramics, the achievements in recent researches need to be urgently summarized. In this review, the effective and current means of enhancing mechanical properties of CaP ceramics were comprehensively summarized from the perspectives of fine-grain strengthening, second phase strengthening, and sintering process optimization. What's more, the further improvement of mechanical properties for CaP ceramics was prospectively proposed including heat treatment and biomimetic. Therefore, this review put forward the direction about how to compatibly improve mechanical properties of CaP ceramics, which can provide data and ideas for expanding the range of their clinical applications.

Enhancement and Restoration of Scratched Murals Based on Hyperspectral Imaging-A Case Study of Murals in the Baoguang Hall of Qutan Temple, Qinghai, China

Environmental changes and human activities have caused serious degradation of murals around the world. Scratches are one of the most common issues in these damaged murals. We propose a new method for virtually enhancing and removing scratches from murals; which can provide an auxiliary reference and support for actual restoration. First, principal component analysis (PCA) was performed on the hyperspectral data of a mural after reflectance correction, and high-pass filtering was performed on the selected first principal component image. Principal component fusion was used to replace the original first principal component with a high-pass filtered first principal component image, which was then inverse PCA transformed with the other original principal component images to obtain an enhanced hyperspectral image. The linear information in the mural was therefore enhanced, and the differences between the scratches and background improved. Second, the enhanced hyperspectral image of the mural was synthesized as a true colour image and converted to the HSV colour space. The light brightness component of the image was estimated using the multi-scale Gaussian function and corrected with a 2D gamma function, thus solving the problem of localised darkness in the murals. Finally, the enhanced mural images were applied as input to the triplet domain translation network pretrained model. The local branches in the translation network perform overall noise smoothing and colour recovery of the mural, while the partial nonlocal block is used to extract the information from the scratches. The mapping process was learned in the hidden space for virtual removal of the scratches. In addition, we added a Butterworth high-pass filter at the end of the network to generate the final restoration result of the mural with a clearer visual effect and richer high-frequency information. We verified and validated these methods for murals in the Baoguang Hall of Qutan Temple. The results show that the proposed method outperforms the restoration results of the total variation (TV) model, curvature-driven diffusion (CDD) model, and Criminisi algorithm. Moreover, the proposed combined method produces better recovery results and improves the visual richness, readability, and artistic expression of the murals compared with direct recovery using a triple domain translation network.

Human Nature and Aspiring the Divine: On Antiquity and Transhumanism

Many transhumanists see their respective movement as being rooted in ancient ethical thought. However, this alleged connection between the contemporary transhumanist doctrine and the ethical theory of antiquity has come under attack. In this paper, we defend this connection by pointing out a key similarity between the two intellectual traditions. Both traditions are committed to the "radical transformation thesis": ancient ethical theory holds that we should assimilate ourselves to the gods as far as possible, and transhumanists hold that we should enhance ourselves beyond the physical and intellectual parameters of being human so as to become posthuman. By considering the two views in tandem, we develop an account of the assimilation directive that is palatable to contemporary readers and provide a view of posthumanism worth wanting.

Influences of Efficient Spraying of Cement-Based Slurries on Recycled Coarse Aggregate

The inferior property is usually one of the major problems of recycled coarse aggregate (RCA), and the utilization of the RCA is limited. Strengthening the RCA is being widely explored. Immersing the RCA in the cement-based slurry is an effective approach. However, lots of slurry and time are required, and it is difficult to integrate the immersing method into the production line of the RCA. In this paper, a circular spraying method was proposed to treat the RCA using cement-based slurry. The immersing method was also conducted to verify the feasibility of the spraying method. The crushing value (CV), 24 h water absorption (WA), apparent density (AD) and dynamic water absorption (DWA) were tested, and the micro-morphology was also observed to explore the strengthening mechanism. Results showed that the CV and the WA decreased by up to 30.0% and 14.3% when the spraying method was used. The AD was slightly influenced by the cement-based slurry regardless of the treatment method. Considering the CV, WA and AD, the comprehensive grade of the RCA could be enhanced from III to II by using the spraying method. It was worth noting that the effects of the spraying method and the immersing method were basically equivalent. When the spraying method was adopted, only about 1 min and a small amount of slurry (about 5% of the RCA mass) were required to treat the RCA.

Understanding the learning needs to enhance clinical competence of new professional nurses in public hospitals of South Africa: A qualitative study

BACKGROUND

A competent nursing workforce plays an important role, as it will ensure effective management of the healthcare system by providing quality nursing care. However, from the literature, it is evident that the learning needs of new professional nurses are not well explored and documented.

OBJECTIVE

The objective of this paper was to report identified learning needs of new professional nurses to enhance their clinical competence to ensure that they are able to provide excellent quality nursing care to patients with confidence.

METHODS

A qualitative study design was used to understand the perceptions of operational managers regarding the learning needs of new professional nurses to enhance their clinical competence. The study was conducted at seven public hospitals in the three districts of the North West Province, South Africa, between September and November 2021. Data were analyzed thematic.

RESULTS

Four themes emerged from data analysis: 1) Ethos and professional practice, 2) Management and leadership skills, 3) Assessment and observation skills, and 4) Documentation and record keeping.

CONCLUSION

This study provides valuable information regarding the learning needs of new professional nurses. Understanding these learning needs can provide insight into how to better transition student nurses to registered nurses so that they are able to adequately and safely take care of a diverse patient population and work successfully as new nurses.

Mistaken Compassion: Tibetan Buddhist Perspectives on Neuroethics

For more than 20 years, Western science education has been incorporated into Tibetan Buddhist monastics' training. In this time, there have been a number of fruitful collaborations between Buddhist monastics and neuroscientists, neurologists, and psychologists. These collaborations are unsurprising given the emphasis on phenomenological exploration of first-person conscious experience in Buddhist contemplative practice and the focus on the mind and consciousness in Buddhist theory. As such, Tibetan monastics may have underappreciated intuitions on the intersection of science, medicine, and ethics. Yet despite their overlapping interests, Buddhist perspectives are largely absent in contemporary neuroethical analysis, apart from conceptual arguments for their relevance. This article attempts to fill this gap by presenting the results of eleven semi-structured interviews with Tibetan Buddhist monastics in India on three issues in neuroethics: identity and authenticity, enhancement, and disorders of consciousness. The results of this empirical study reinforce the conclusions of theoretical work on Buddhism and neuroethics while also identifying future areas of inquiry, including the importance of community, the challenges in acting from compassion, and the value of self-directed mental cultivation.

Enhanced Water Evaporation from Å-Scale Graphene Nanopores

Enhancing the kinetics of liquid-vapor transition from nanoscale confinements is an attractive strategy for developing evaporation and separation applications. The ultimate limit of confinement for evaporation is an atom thick interface hosting angstrom-scale nanopores. Herein, using a combined experimental/computational approach, we report highly enhanced water evaporation rates when angstrom sized oxygen-functionalized graphene nanopores are placed at the liquid-vapor interface. The evaporation flux increases for the smaller nanopores with an enhancement up to 35-fold with respect to the bare liquid-vapor interface. Molecular dynamics simulations reveal that oxygen-functionalized nanopores render rapid rotational and translational dynamics to the water molecules due to a reduced and short-lived water-water hydrogen bonding. The potential of mean force (PMF) reveals that the free energy barrier for water evaporation decreases in the presence of nanopores at the atomically thin interface, which further explains the enhancement in evaporation flux. These findings can enable the development of energy-efficient technologies relying on water evaporation.

Thermal Conductivity Measurement of Flexible Composite Phase-Change Materials Based on the Steady-State Method

Phase-change materials (PCMs) are widely used in energy storage and thermal management due to the large latent heat in the phase-change process. As one of the most significantly thermophysical properties of PCMs, the thermal conductivity has been extensively studied. Great attention has been paid to improving the thermal conductivities of PCMs; however, the studies on the thermal conductivities of flexible PCMs are relatively inadequate. In this study, polyethylene glycol 1500 (PEG1500) was used as the base PCM, and expanded graphite (EG) and styrene-butadiene-styrene (SBS) were added to improve the thermal conductivity and flexibility of pure PCMs, respectively. A steady-state experimental test rig was built and verified with the measurement of the thermal conductivity of stainless steel and deionized water, and then the thermal conductivities of PCMs at different phases and qualitative temperatures were measured extensively. Compared to the PEG1500 with 5 wt.% EG, the addition of SBS sharply reduces the thermal conductivity, which is only 0.362 W/(m·K) at 12.5 °C when the addition ratio is 50%. This is approximately a 69% reduction compared with the composite PCMs without SBS. Furthermore, the theoretical thermal conductivities of the composite PCMs were calculated with six theoretical models of multiphase systems. The majority of the models provide a good prediction of thermal conductivities of composite PCM with high SBS concentration, while the average deviation of Agari-Uno model is only 20.5% with different SBS concentration and relatively agrees well with the experimental results.

Tumblr Facts: Antecedents of Self-Disclosure across Different Social Networking Sites

Previous research investigating antecedents of online self-disclosure pointed out two perspectives: social compensation and enhancement hypotheses, showing controversial findings. Furthermore, most contributions have focused on social networking sites (SNSs) considered mainstream, like Facebook and Instagram, and such results are often considered universally valid for all SNSs. Tumblr is a less-studied SNS with peculiar features—such as anonymity, higher control over the presentation of personal aspects, supportive communities—that could particularly lead individuals to self-disclose. As prior contributions highlighted that the features and affordances could define how a medium will be used, this paper aims to investigate the antecedents of online self-disclosure on Tumblr and other mainstream SNSs. We run a survey on 559 Tumblr users (aged 13−70; M = 28.86; SD = 12.34). T-test showed that Tumblr users have a higher willingness to self-disclose on Tumblr compared to another SNSs (t = 22.44, p < 0.001). A path analysis model confirmed the predictive role of some psychological variables on self-disclosure on Tumblr but not on mainstream SNSs. In particular, self-disclosure on Tumblr was predicted by self-esteem, negative emotionality, and preference for online social interactions, which was in turn predicted by social anxiety. These findings partially supported both social compensation and enhancement hypotheses, indicating that the phenomenon is more complex than expected.

An app-enhanced cognitive fitness training program for athletes: The rationale and validation protocol

The core dimensions of cognitive fitness, such as attention and cognitive control, are emerging through a transdisciplinary expert consensus on what has been termed the Cognitive Fitness Framework (CF2). These dimensions represent key drivers of cognitive performance under pressure across many occupations, from first responders to sport, performing arts and the military. The constructs forming the building blocks of CF2 come from the RDoC framework, an initiative of the US National Institute of Mental Health (NIMH) aimed at identifying the cognitive processes underlying normal and abnormal behavior. Similar to physical conditioning, cognitive fitness can be improved with deliberate practice. This paper reports the development of a prototype cognitive fitness training program for competitive athletes and the protocol for its evaluation. The program is focused on primary cognitive capacities and subtending skills for adjusting training rhythms and enhancing readiness for competition. The project is driven by the Australian Psychological Society's College of Sport & Exercise Psychology and includes the development of a Cognitive Gym program for a smartphone app-enhanced implementation. Its key building blocks are training protocols (drills) connected by a periodized training plan. A website with background supporting resources has also been developed as part of the project. National-level training squads will participate in a three-week pilot evaluation protocol, assessing the program's efficacy and usability through gamified cognitive assessment of participants' training gains and coaching staff evaluations, respectively. Both near and far transfer of training effects will be examined.

COVID-19 classification using chest X-ray images: A framework of CNN-LSTM and improved max value moth flame optimization

Coronavirus disease 2019 (COVID-19) is a highly contagious disease that has claimed the lives of millions of people worldwide in the last 2 years. Because of the disease's rapid spread, it is critical to diagnose it at an early stage in order to reduce the rate of spread. The images of the lungs are used to diagnose this infection. In the last 2 years, many studies have been introduced to help with the diagnosis of COVID-19 from chest X-Ray images. Because all researchers are looking for a quick method to diagnose this virus, deep learning-based computer controlled techniques are more suitable as a second opinion for radiologists. In this article, we look at the issue of multisource fusion and redundant features. We proposed a CNN-LSTM and improved max value features optimization framework for COVID-19 classification to address these issues. The original images are acquired and the contrast is increased using a combination of filtering algorithms in the proposed architecture. The dataset is then augmented to increase its size, which is then used to train two deep learning networks called Modified EfficientNet B0 and CNN-LSTM. Both networks are built from scratch and extract information from the deep layers. Following the extraction of features, the serial based maximum value fusion technique is proposed to combine the best information of both deep models. However, a few redundant information is also noted; therefore, an improved max value based moth flame optimization algorithm is proposed. Through this algorithm, the best features are selected and finally classified through machine learning classifiers. The experimental process was conducted on three publically available datasets and achieved improved accuracy than the existing techniques. Moreover, the classifiers based comparison is also conducted and the cubic support vector machine gives better accuracy.

Leveling (down) the playing field: performance diminishments and fairness in sport

The 2018 eligibility regulation for female competitors with differences of sexual development (DSD) issued by World Athletics requires competitors with DSD with blood testosterone levels at or above 5 nmol/L and sufficient androgen sensitivity to be excluded from competition in certain events unless they reduce the level of testosterone in their blood. This paper formalises and then critically assesses the fairness-based argument offered in support of this regulation by the federation. It argues that it is unclear how the biological advantage singled out by the regulation as an appropriate target for diminishment, is relevantly different from other biological advantages that athletes may enjoy, and specifically that Sigmund Loland's recent attempt to drive a wedge between heightened levels of blood testosterone and other biological advantages fails. The paper also suggests that even if heightened blood testosterone levels do differ relevantly from other types of biological advantage, the regulation is further challenged by studies indicating that athletes with blood testosterone at the high end of the normal range have a competitive advantage over athletes with blood testosterone levels at the low end of it. Finally, the paper contends that the premises of the fairness-based argument do not unequivocally support the conclusion that DSD athletes with heightened levels of testosterone should diminish those levels, since, just as powerfully, they support allowing athletes with normal levels of testosterone to use performance-enhancing drugs in the name of fairness.

Laser-Assisted In Situ Keratomileusis (LASIK) Enhancement for Residual Refractive Error after Primary LASIK

Background: To evaluate the safety, efficacy, and predictability of laser-assisted in situ keratomileusis (LASIK) enhancement after primary LASIK and compare to Food and Drug Administration (FDA) criteria. Methods: Patients who underwent LASIK enhancement after primary LASIK between 2002 and 2019 were compared to those who underwent LASIK without retreatment. Patient demographics, preoperative characteristics, visual outcomes, and postoperative complications were compared between groups. Epithelial ingrowth (EI) development was stratified based on duration between primary and secondary procedures. Results: We compared 901 eyes with LASIK enhancement to 1127 eyes without retreatment. Age, sex, surgical eye, sphere, cylinder, and spherical equivalent (SE) were significantly different between groups (p < 0.05). At 12 months post-enhancement, 86% of the eyes had an uncorrected distance visual acuity of 20/20 or better and 93% of eyes were within ±0.50 D of the target. Development of EI (6.1%) demonstrated an odds ratio of 16.3 in the long-term compared to the short-term (95% CI: 5.9 to 45.18; p < 0.0001). Conclusions: Older age at primary LASIK, female sex, right eye, and larger sphere, cylinder and SE were risk factors for enhancement. Risk of EI significantly increased when duration between primary and enhancement procedures exceeded five years. LASIK enhancements produce favorable outcomes and meet FDA benchmarks for safety, efficacy, and predictability.

Ten simple rules to study distractor suppression

Distractor suppression refers to the ability to filter out distracting and task-irrelevant information. Distractor suppression is essential for survival and considered a key aspect of selective attention. Despite the recent and rapidly evolving literature on distractor suppression, we still know little about how the brain suppresses distracting information. What limits progress is that we lack mutually agreed upon principles of how to study the neural basis of distractor suppression and its manifestation in behavior. Here, we offer ten simple rules that we believe are fundamental when investigating distractor suppression. We provide guidelines on how to design conclusive experiments on distractor suppression (Rules 1-3), discuss different types of distractor suppression that need to be distinguished (Rules 4-6), and provide an overview of models of distractor suppression and considerations of how to evaluate distractor suppression statistically (Rules 7-10). Together, these rules provide a concise and comprehensive synopsis of promising advances in the field of distractor suppression. Following these rules will propel research on distractor suppression in important ways, not only by highlighting prominent issues to both new and more advanced researchers in the field, but also by facilitating communication between sub-disciplines.

Can radiomic analysis of a single-phase dual-energy CT improve the diagnostic accuracy of differentiating enhancing from non-enhancing small renal lesions?

BACKGROUND

The value of dual-energy computed tomography (DECT)-based radiomics in renal lesions is unknown.

PURPOSE

To develop DECT-based radiomic models and assess their incremental values in comparison to conventional measurements for differentiating enhancing from non-enhancing small renal lesions.

MATERIAL AND METHODS

A total of 349 patients with 519 small renal lesions (390 non-enhancing, 129 enhancing) who underwent contrast-enhanced nephrographic phase DECT examinations between June 2013 and January 2020 on multiple DECT platforms were retrospectively recruited. Cohort A included all lesions, while cohort B included Bosniak II-IV and solid enhancing renal lesions. Radiomic models were built with features selected by the least absolute shrinkage and selection operator regression (LASSO). ROC analyses were performed to compare the diagnostic accuracy among conventional and radiomic models for predicting enhancing renal lesions.

RESULTS

The individual iodine concentration (IC), normalized IC, mean attenuation on 75-keV images, radiomic model of iodine images, 75-keV images and a combined model integrating all the above-mentioned features all demonstrated high AUCs for predicting renal lesion enhancement in cohort A (AUCs = 0.934-0.979) as well as in the test dataset (AUCs = 0.892-0.962) of cohort B (P values with Bonferroni correction >0.003). The AUC (0.864) of mean attenuation on 75-keV images was significantly lower than those of other models (all P values ≤0.001) except the radiomic model of 75-keV images (P = 0.038) in the training dataset of cohort B.

CONCLUSION

No incremental value was found by adding radiomic and machine learning analyses to iodine images for differentiating enhancing from non-enhancing renal lesions.

A systematic evaluation of Hi-C data enhancement methods for enhancing PLAC-seq and HiChIP data

The three-dimensional organization of chromatin plays a critical role in gene regulation. Recently developed technologies, such as HiChIP and proximity ligation-assisted ChIP-Seq (PLAC-seq) (hereafter referred to as HP for brevity), can measure chromosome spatial organization by interrogating chromatin interactions mediated by a protein of interest. While offering cost-efficiency over genome-wide unbiased high-throughput chromosome conformation capture (Hi-C) data, HP data remain sparse at kilobase (Kb) resolution with the current sequencing depth in the order of 108 reads per sample. Deep learning models, including HiCPlus, HiCNN, HiCNN2, DeepHiC and Variationally Encoded Hi-C Loss Enhancer (VEHiCLE), have been developed to enhance the sequencing depth of Hi-C data, but their performance on HP data has not been benchmarked. Here, we performed a comprehensive evaluation of HP data sequencing depth enhancement using models developed for Hi-C data. Specifically, we analyzed various HP data, including Smc1a HiChIP data of the human lymphoblastoid cell line GM12878, H3K4me3 PLAC-seq data of four human neural cell types as well as of mouse embryonic stem cells (mESC), and mESC CCCTC-binding factor (CTCF) PLAC-seq data. Our evaluations lead to the following three findings: (i) most models developed for Hi-C data achieve reasonable performance when applied to HP data (e.g. with Pearson correlation ranging 0.76-0.95 for pairs of loci within 300 Kb), and the enhanced datasets lead to improved statistical power for detecting long-range chromatin interactions, (ii) models trained on HP data outperform those trained on Hi-C data and (iii) most models are transferable across cell types. Our results provide a general guideline for HP data enhancement using existing methods designed for Hi-C data.