bluuebunny/crossref_metadata_2025 huggingface dataset:
Dynamics of price clustering in the Pakistan stock exchange
Authors: Baig Ahmed S. , Chaudhry Muhammad Imran , DeLisle R. Jared
Published: September 2023

Purpose

In this paper, the authors study the phenomenon of price clustering in the Pakistan Stock Exchange (PSX), a market viewed as one of the best-performing stock markets in the world during 2014–2017. The authors study the effect of stock-level variables on price clustering and analyze the determinants of the cross-sectional patterns of price clustering in the PSX, in particular the causal link between price clustering and political instability.

Design/methodology/approach

The authors' dataset comprises daily observations on 100 PSX stocks spanning from January 1, 2009 to June 30, 2019. The authors use multivariate regression and spectral analysis to shed light on the dynamics of stock price clustering in PSX.

Findings

The authors document abnormally high levels of stock price clustering, particularly on integer increments, in PSX. The nature of stock price clustering in PSX is consistent with the negotiation hypothesis of Harris (1991). The levels of stock price clustering on PSX are persistent and contain a cyclical component. Furthermore, the authors find that political uncertainty in Pakistan is a significant contributor to the high levels of price clustering on PSX. The authors' conclusions are robust to alternative econometric specifications and different measures of price clustering and political uncertainty.

Practical implications

The authors' findings are of interest to investors and policymakers. Since price clustering decreases market quality and degrades the information content of stock prices, the authors' study shows that price efficiency in PSX has not improved despite major reforms over the last decade. One practical implication of the authors' results is that investors should be cautious while rebalancing portfolios around political events such as general elections because stock price clustering increases in the PSX during these periods. As a result, stock prices are likely to deviate from their intrinsic values.

Originality/value

Research on price clustering is limited to developed markets, and emerging/frontier markets have been largely overlooked. The phenomenon of price clustering in the PSX has yet to be studied, despite the relevance of the PSX for emerging/frontier market investors.
Highly expressed long non‐coding RNA SNHG14 activated MSU‐induced inflammatory response in acute gout arthritis through targeting miR‐223‐3p
Authors: Yang Lu , Liu Xiaochuan , Yan Shuyi , Xiong Shili , Bai Xiaosong , Yan Ying
Published: September 2023

Aim

According to reports, long non‐coding RNAs (lncRNAs) are involved in the regulation of many inflammatory diseases. Here, our main purpose was to ascertain the expression data of lncRNA SNHG14 in acute gouty arthritis (AGA) and to explore its possible mechanism in the regulation of AGA.

Method

Reverse transcription quantitative polymerase chain reaction technology was supplied to detect the lncRNA SNHG14 expression. A receiver operating characteristics curve was drawn to estimate the accuracy of lncRNA SNHG14 in AGA diagnosis. An in vitro AGA cell model was constructed by inducing THP‐1 cells with monosodium urate (MSU). The concentrations of inflammatory factors such as interleukin‐1β, interleukin‐6, and tumor necrosis factor‐α were measured by enzyme‐linked immunosorbent assay. The luciferase reporter gene was used to verify the relationship between lncRNA SNHG14 and miR‐223‐3p.

Results

In clinical analysis, the levels of serum lncRNA SNHG14 in AGA patients were significantly higher than those in the control group. Abnormally elevated lncRNA SNHG14 has high sensitivity and specificity for AGA diagnosis. In in vitro cell experiments, silencing lncRNA SNHG14 inhibited the inflammatory response of THP‐1 cells stimulated by MSU, and the luciferase reporter gene proved that lncRNA SNHG14 could bind to miR‐223‐3p. In addition, the level of miR‐223‐3p declined in AGA patients and the AGA cell model. Overexpression of miR‐223‐3p is helpful to alleviate an MSU‐induced inflammatory response.

Conclusion

In the AGA cell model, lncRNA SNHG14, as an miR‐223‐3p sponge, induces a cellular inflammatory response by controlling the level of miR‐223‐3p, so aggravating the disease progress of AGA.
Meta‐analysis of the efficacy and safety of arthroscopic surgery associated with platelet‐rich plasma infusion when treating knee osteoarthritis
Authors: Yang Baiqi , Ma Jinye
Published: September 2023

Objective

To assess the efficacy and safety of arthroscopic surgery associated with platelet‐rich plasma (PRP) infusion in treating knee osteoarthritis (KOA).

Methods

PubMed, EMBASE, ScienceDirect, Cochrane Library, China Knowledge Network Database, China VIP Database, Wanfang Database, and China Biomedical Literature Database online database were searched for the case–control trial of arthroscopic surgery associated with PRP infusion in patients with KOA. During the search period of January 2010 through May 2022, two researchers independently extracted the data. With RevMan5.3, we performed a meta‐analysis on the collected data.

Results

A total of six clinical controlled studies were included, including 333 individuals. Compared with the control group treated only by arthroscopic surgery, the results showed that the visual analogue scores of patients in the arthroscopic surgery and PRP infusion group were significantly lower at 3, 6 and 12 months after operation, and the Western Ontario and McMaster Universities Osteoarthritis Index were significantly lower at 3, 6 and 12 months after operation (p < .05). The meta‐analysis of Hospital for Special Surgery (HSS) knee score and Lisum knee score (LKSS) showed that postoperative HSS score, LKSS score at 3, 6, and 12 months after operation, and SF‐36 quality of life score at 6 and 12 months after operation were higher (p < .05).

Conclusion

Arthroscopic debridement associated with PRP is more successful in relieving knee pain and enhancing knee joint function than arthroscopic debridement in treating KOA. The treatment scheme deserves to be popularized in clinical practice, but further research and longer interventions will be needed to validate it, using high‐quality methods.
Histological evaluation of tissue reaction and new bone formation of different calcium silicate‐based cements in rats
Authors: Bilge K , Ataş O , Yildiz Ş , Çalik İ , Dündar S , Gezer Ataş A
Published: September 2023

Background

The purpose of this study was to evaluate the local reactions and new bone formation of rat subcutaneous and bone tissue to different calcium silicate cements.

Methods

In this study, 80 rats were divided into five groups as control, BIOfactor MTA (BIO), NeoMTA Plus (NEO), MTA Repair Hp (REP), Biodentine (DENT) and then into two subgroups according to sacrification times (7, 30 days; n = 8). Polyethylene tubes filled with appropriate materials (test groups); empty tubes (control group) were implanted into the dorsum of each rat subcutaneously. For intraosseous implantation, materials were placed in the cavities created in tibia of rats. Subcutaneous tissue and tibia samples were stained with haematoxylin‐eosin and subjected to histopathological analysis. A score (0–3) was used to grade inflammatory reaction and new bone formation. Data were analysed by Kruskal–Wallis and Mann–Whitney U tests (P < 0.05).

Results

Inflammatory reaction observed in subcutaneous and intraosseous tissues for 7 days decreased significantly in all groups over time (P < 0.05). It was determined that there was significant increase in new bone formation in REP, BIO, DENT groups over time (P < 0.05).

Conclusion

Four contemporary bioceramic materials induced local inflammation and tissues changes shortly after subcutaneous implantation, which were reduced over time. In ıntraosseous implantation, all materials induced new bone formation over time.

Registration number

ADJ‐03‐23‐0134. © 2023 Australian Dental Association.
Presence of methanogenic archaea in necrotic root canals of patients with or without type 2 diabetes mellitus
Authors: Soza‐Bolaños Ana I. , Domínguez‐Pérez Rubén A. , Ayala‐Herrera José L. , Pérez‐Serrano Rosa M. , Soto‐Barreras Uriel , Espinosa‐Cristóbal León F. , Rivera‐Albarrán Claudia A. , Zaldívar‐Lelo de Larrea Guadalupe
Published: September 2023

Theoretically, a necrotic root canal fulfils all requirements as a niche for methanogens to inhabit. However, their presence in it and its implication in apical periodontitis (AP) is controversial. Therefore, to contribute to ending the controversy, this study aimed to detect and compare methanogens' presence in two distinct niches with supposedly different microenvironments; both were necrotic root canals associated with AP but one from patients with type 2 diabetes mellitus (T2DM) while the other from non‐diabetic patients. A clinical examination was performed on 65 T2DM patients and 73 non‐diabetic controls. Samples from necrotic root canals were obtained, and methanogens were identified. The presence of methanogens was three times higher (27.6%) in the T2DM group than in non‐diabetic patients (8.2%). In addition, methanogens' presence was associated with a higher prevalence of periapical symptoms.
Population pharmacokinetic models of tacrolimus in paediatric solid organ transplant recipients: A systematic review
Authors: Khamlek Kanyaporn , Komenkul Virunya , Sriboonruang Tatta , Wattanavijitkul Thitima
Published: September 2023

Aims

This study aimed to provide up‐to‐date information on paediatric population pharmacokinetic models of tacrolimus and to identify factors influencing tacrolimus pharmacokinetic variability.

Methods

Systematic searches in the Web of Science, PubMed, Scopus, Science Direct, Cochrane, EMBASE databases and reference lists of articles were conducted from inception to March 2023. All population pharmacokinetic studies of tacrolimus using nonlinear mixed‐effect modelling in paediatric solid organ transplant patients were included.

Results

Of the 21 studies reviewed, 62% developed from liver transplant recipients and 33% from kidney transplant recipients. Most studies used a 1‐compartment model to describe tacrolimus pharmacokinetics. Body weight was a significant predictor for tacrolimus volume of distribution (Vd/F). The estimated Vd/F for 1‐compartment models ranged from 20 to 1890 L, whereas the peripheral volume of distribution (Vp/F) for 2‐compartment models was between 290 and 1520 L. Body weight, days post‐transplant, CYP3A5 genotype or haematocrit were frequently reported as significant predictors of tacrolimus clearance. The estimated apparent clearance values range between 0.12 and 2.18 L/h/kg, with inter‐individual variability from 13.5 to 110.0%. Only 29% of the studies assessed the generalizability of the models with external validation.

Conclusion

This review highlights the potential factors, modelling approaches and validation methods that impact tacrolimus pharmacokinetics in a paediatric population. The clinician could predict tacrolimus clearance based on body weight, CYP3A5 genotype, days post‐transplant or haematocrit. Further research is required to determine the relationship between pharmacogenetics and tacrolimus pharmacodynamics in paediatric patients and confirm the applicability of nonlinear kinetics in this population.
Cross‐sectional direct and indirect relationships between the corrupted feared self and obsessive–compulsive symptoms in a clinical sample: The role of mental contamination
Authors: Khosravani Vahid , Samimi Ardestani Seyed Mehdi , Wong Shiu Fung , Moulding Richard , Aardema Frederick , Sharifibastan Farangis , Aminaee Mohammad
Published: September 2023

Objectives

There is a significant relationship between a general feared self and contact contamination concerns in obsessive‐compulsive disorder (OCD), especially when the influence of mental contamination is considered a part of this relationship. However, these associations have not been explored in a clinical OCD sample when using each dimension of the multidimensional conceptualization of the feared self as the predictor (i.e., the corrupted, culpable, and malformed feared selves).

Methods

We tested these associations using a cross‐sectional design. Specifically, a sample of patients diagnosed with OCD (N = 417) completed a series of self‐report measures of OCD symptoms and its related constructs. We also explored these associations with unacceptable thoughts as the outcome, rather than contamination concerns, due to unacceptable thoughts having evidenced strong associations with the feared self and mental contamination.

Results

After controlling for relevant cognitive (i.e., obsessive beliefs) and affective (i.e., depressive symptoms) constructs and comorbidity, the corrupted feared self was found to have a direct link, along with an indirect link through mental contamination, with symptoms of contact contamination and unacceptable thoughts.

Conclusions

The fear of being corrupted may be associated with feelings of contamination in the absence of direct contact with a contaminant, which may then predict OCD symptoms of repugnant obsessional thoughts and contact contamination concerns. The corrupted feared self and mental contamination should therefore be targeted in treatments for repugnant obsessions and contamination‐related OCD.
Association of immune‐related expression profile with sensitivity to chemotherapy in esophageal squamous cell carcinoma
Authors: Tsukamoto Yoshiyuki , Kurogi Shusaku , Fujishima Hajime , Shibata Tomotaka , Fumoto Shoichi , Nishiki Kohei , Suzuki Kosuke , Etoh Tsuyoshi , Shiraishi Norio , Fuchino Takafumi , Hirashita Yuka , Nakada Chisato , Uchida Tomohisa , Inomata Masafumi , Moriyama Masatsugu , Hijiya Naoki
Published: September 2023

Neoadjuvant chemotherapy (NAC) followed by surgery is one of the standard therapeutic approaches in Japan for patients with locally advanced esophageal carcinoma. Recently, the JCOG1109 study revealed that NAC with docetaxel, cisplatin and 5‐fluorouracil (5‐FU) (DCF‐NAC) is superior to NAC with cisplatin and 5‐FU, and has now become the standard preoperative chemotherapy. Using a microarray system, we have previously investigated the expression profiles of endoscopic biopsy samples from patients with esophageal squamous cell carcinoma (ESCC) before DCF‐NAC (preNAC) and identified 17 molecules as biomarkers predictive of a pathologically complete response to DCF‐NAC. Here, we re‐grouped our previous dataset based on the histopathological response grade with the addition of several microarray profiles and conducted a re‐analysis using bioinformatic web tools including DAVID, GSEA, UALCAN, and CIBERSORTx. We identified 204 genes that were differentially expressed between the highly resistant and sensitive groups. Some of these differentially expressed genes (DEGs) were related to the immune response and showed higher expression in the sensitive group. UALCAN showed that high expression of 28 of the top 50 DEGs was associated with a favorable prognosis (p < 0.25), and that this reached a significant (p < 0.05) level for 18 of them, suggesting that patients with high expression of these genes might have benefited from chemotherapy and thus had a better outcome. In preNAC biopsy tissues from a DCF‐sensitive case, we demonstrated the presence of cells expressing mRNA for CXCL9, one of the prognosis‐related DEGs. Our results highlight the association of immune‐related expression profile in preNAC ESCC with the DCF‐NAC efficacy.
Potentiated GABAergic neuronal activities in the basolateral amygdala alleviate stress‐induced depressive behaviors
Authors: Asim Muhammad , Wang Huajie , Chen Xi , He Jufang
Published: September 2023

Aims

Major depressive disorder is a severe psychiatric disorder that afflicts ~17% of the world population. Neuroimaging investigations of depressed patients have consistently reported the dysfunction of the basolateral amygdala in the pathophysiology of depression. However, how the BLA and related circuits are implicated in the pathogenesis of depression is poorly understood.

Methods

Here, we combined fiber photometry, immediate early gene expression (c‐fos), optogenetics, chemogenetics, behavioral analysis, and viral tracing techniques to provide multiple lines of evidence of how the BLA neurons mediate depressive‐like behavior.

Results

We demonstrated that the aversive stimuli elevated the neuronal activity of the excitatory BLA neurons (BLACAMKII neurons). Optogenetic activation of CAMKII neurons facilitates the induction of depressive‐like behavior while inhibition of these neurons alleviates the depressive‐like behavior. Next, we found that the chemogenetic inhibition of GABAergic neurons in the BLA (BLAGABA) increased the firing frequency of CAMKII neurons and mediates the depressive‐like phenotypes. Finally, through fiber photometry recording and chemogenetic manipulation, we proved that the activation of BLAGABA neurons inhibits BLACAMKII neuronal activity and alleviates depressive‐like behavior in the mice.

Conclusion

Thus, through evaluating BLAGABA and BLACAMKII neurons by distinct interaction, the BLA regulates depressive‐like behavior.
Luteolin alleviates depression‐like behavior by modulating glycerophospholipid metabolism in the hippocampus and prefrontal cortex of LOD rats
Authors: Wu Xiaofeng , Xu Hanfang , Zeng Ningxi , Li Huizhen , Yao Gaolei , Liu Kaige , Yan Can , Wu Lili
Published: September 2023

Background

Late‐onset depression (LOD) is defined as primary depression that first manifests after the age of 65. Luteolin (LUT) is a natural flavonoid that has shown promising antidepressant effects and improvement in neurological function in previous studies.

Aims

In this study, we utilized UPLC–MS/MS non‐targeted metabolomics techniques, along with molecular docking technology and experimental validation, to explore the mechanism of LUT in treating LOD from a metabolomics perspective.

Results

The behavioral results of our study demonstrate that LUT significantly ameliorated anxiety and depression‐like behaviors while enhancing cognitive function in LOD rats. Metabolomic analysis revealed that the effects of LUT on LOD rats were primarily mediated through the glycerophospholipid metabolic pathway in the hippocampus and prefrontal cortex. The levels of key lipid metabolites, phosphatidylserine (PS), phosphatidylcholine (PC), and phosphatidylethanolamine (PE), in the glycerophospholipid metabolic pathway were significantly altered by LUT treatment, with PC and PE showing significant correlations with behavioral indices. Molecular docking analysis indicated that LUT had strong binding activity with phosphatidylserine synthase 1 (PTDSS1), phosphatidylserine synthase 2 (PTDSS2), and phosphatidylserine decarboxylase (PISD), which are involved in the transformation and synthesis of PC, PE, and PS. Lastly, our study explored the reasons for the opposing trends of PC, PE, and PS in the hippocampus and prefrontal cortex from the perspective of autophagy, which may be attributable to the bidirectional regulation of autophagy in distinct brain regions.

Conclusions

Our results revealed significant alterations in the glycerophospholipid metabolism pathways in both the hippocampus and prefrontal cortex of LOD rats. Moreover, LUT appears to regulate autophagy disorders by specifically modulating glycerophospholipid metabolism in different brain regions of LOD rats, consequently alleviating depression‐like behavior in these animals.
Postoperative use of steroids for peri‐electrode edema after deep brain stimulation surgery: A retrospective cohort study
Authors: Wu Bin , Ling Yuting , Zhang Changming , Xu Jiakun , Yang Chao , Jiang Nan , Chen Ling , Liu Jinlong
Published: September 2023

Background

To review the incidence and extent of peri‐electrode edema after DBS and to clarify the effect of postoperative use of steroids on the peri‐electrode edema.

Methods

This retrospective cohort study included 250 patients who underwent bilateral subthalamic nucleus (STN) DBS surgery with intact MRI within 1 month after DBS surgery. Patients were divided into steroid and non‐steroid groups, based on postoperative steroids use. The occurrence and extent of peri‐electrode edema were compared between the two groups, and other associated factors were analyzed using univariate and multivariate methods.

Results

Peri‐electrode edema >1 cm3 in at least one hemisphere was reported in 215 (86.00%) patients. The mean volume of peri‐electrode edema observed in the steroid group was significantly smaller than in the non‐steroid group (8.09 ± 8.47 cm3 vs 17.10 ± 16.90 cm3, p < 0.001). In the steroid group, 104 (32.91%) of the 316 implanted electrodes present with edema less than 1 cm3, whereas in the non‐steroid group, only 27 (14.67%) of the 184 implanted electrodes present with edema less than 1 cm3 (p < 0.001). Multivariate analysis indicated that lesser peri‐electrode edema was significantly associated with postoperative steroids use and general anesthesia.

Conclusions

Peri‐electrode edema is common after DBS surgery, and postoperative steroids use reduces the occurrence and extent of peri‐electrode edema.
An Agent‐First Preference in a Patient‐First Language During Sentence Comprehension
Authors: Sauppe Sebastian , Næss Åshild , Roversi Giovanni , Meyer Martin , Bornkessel‐Schlesewsky Ina , Bickel Balthasar
Published: September 2023

The language comprehension system preferentially assumes that agents come first during incremental processing. While this might reflect a biologically fixed bias, shared with other domains and other species, the evidence is limited to languages that place agents first, and so the bias could also be learned from usage frequency. Here, we probe the bias with electroencephalography (EEG) in Äiwoo, a language that by default places patients first, but where sentence‐initial nouns are still locally ambiguous between patient or agent roles. Comprehenders transiently interpreted nonhuman nouns as patients, eliciting a negativity when disambiguation was toward the less common agent‐initial order. By contrast and against frequencies, human nouns were transiently interpreted as agents, eliciting an N400‐like negativity when the disambiguation was toward patient‐initial order. Consistent with the notion of a fixed property, the agent bias is robust against usage frequency for human referents. However, this bias can be reversed by frequency experience for nonhuman referents.
Disparities in telemedicine utilization among kidney transplant patients during the COVID‐19 pandemic: Barriers and opportunities
Authors: Forbes Rachel C. , Johnson Wali R. , D'Souza Nigel , Dreher Anthony , Rega Scott A. , Feurer Irene D. , Concepcion Beatrice P.
Published: September 2023

Introduction

The COVID‐19 pandemic allowed for the rapid implementation of telemedicine for kidney transplant patients; however, widespread adoption may worsen existing health care inequities among vulnerable populations. This study aimed to characterize telemedicine utilization by kidney transplant patients during the early pandemic with particular attention to healthcare equity.

Methods

A retrospective analysis of kidney transplant patients interacting with telemedicine was performed. Patient demographic data and distance to the transplant center were obtained. The National Center for Health Statistics (NCHS) Urban‐Rural Classification Scheme for Counties and Brokamp Neighborhood Deprivation Index (NDI) score were used to characterize patients’ counties of residence. Multivariable logistic regression evaluated associations between patient and community characteristics and the likelihood of an encounter being telemedicine.

Results

This study included 1033 patients who participated in 3727 encounters from March 11 through October 2020. Characteristics associated with decreased likelihood of telemedicine use were increased age (OR = .993; 95% CI = .986‐.999, P = .022), non‐White vs. White race (OR = .826, 95% CI = .697‐.979; P = .028), male vs. female sex (OR = .746, 95% CI = .632‐.880; P < .001), and a higher Brokamp Neighborhood Deprivation Index score (OR = .159; 95% CI = .029‐.873; P = .034). The effect of distance to the transplant center on the likelihood of a telemedicine encounter differed by NCHS Urban‐Rural designation (interaction P = .018), with its likelihood increasing by 2%–3% with each 10‐mile increment among persons residing in medium‐, small‐, and non‐metropolitan counties compared to those residing in the most rural counties.

Conclusions

Telemedicine visits were less often completed by patients of older age, non‐white race, male sex, and those residing in counties having higher NDI scores. While telemedicine has the potential to improve healthcare access and decrease costs, proactive efforts need to be taken to mitigate disparities in vulnerable populations.
Spinal and bulbar muscular atrophy combined with hypertrophic cardiomyopathy and Brugada‐pattern electrocardiographic changes: A case report
Authors: Liu Tian , Weng Haoyu , Ding Wenhui , Chu Xujun , Li Jianping
Published: September 2023

Spinal and bulbar muscular atrophy (SBMA) is a rare X‐linked recessive neurodegenerative disorder caused by the excessive expansion of cytosine‐adenine‐guanine repeat sequences in the androgen receptor gene encoded on the Xq11‐12 chromosome. SBMA primarily affects adult males and is characterized by weakness and atrophy of the proximal limb muscles, often involving the bulbar muscles. In addition to neuromuscular deficits, nonneuronal symptoms such as hypertension, hyperlipidemia, and liver dysfunction are often observed in patients with SBMA. Previous studies have suggested that SBMA patients have been diagnosed with hypertrophic cardiomyopathy (HCM), while gene detection is lacked. Moreover, according to current reports, SBMA patients can carry Brugada syndrome or HCM respectively, while three kinds of diseases have not been reported to exist in the same patient. Here, we report the first case of a male diagnosed with SBMA combined with HCM and two types of Brugada‐pattern electrocardiographic changes, with a heterozygous missense mutation in the TTN gene.
Mechanisms and implications of mitral regurgitation in patients with severe aortic stenosis who received transcatheter aortic valve replacement
Authors: Horinouchi Hitomi , Nagai Tomoo , Ohno Yohei , Miyamoto Junichi , Kamioka Norihiko , Murakami Tsutomu , Yoshioka Koichiro , Ikari Yuji
Published: September 2023

Introduction

This study aimed to investigate the mechanisms and clinical implications of mitral regurgitation (MR) in patients with severe aortic stenosis (AS) who received transcatheter aortic valve replacement (TAVR).

Methods

We conducted retrospective echocardiographic analyses at baseline and 6 months after TAVR in 140 patients with symptomatic AS (85 ± 5 years) who underwent TAVR. We defined significant MR as ≥ moderate based on evaluation of transthoracic echocardiography (TTE).

Results

There were 48 patients (34%) with preexisting MR at the baseline. Among measured TTE parameters, end‐systolic wall stress (ESWS), mitral annulus area, and mitral valve thickening index were independent factors associated with preexisting MR (odds ratio [OR]: 1.013, 95% confidence interval [CI]: 1.005–1.021; OR: 1.740, 95% CI: 1.314–2.376; OR: 2.306, 95% CI: 1.426–3.848; respectively). Six months after TAVR, there were 34 patients with post‐existing MR, A history of atrial fibrillation and ESWS after TAVR were independent factors (OR: 3.013, 95% CI: 1.208–7.556; OR: 1.013, 95% CI: 1.000–1.023; respectively). The Kaplan–Meier plot indicated that preexisting MR was a risk factor for heart failure–related events within 1 year of discharge after TAVR (p = .012).

Conclusions

In patients who underwent TAVR for severe AS, preexisting MR was associated with having a thickened mitral valve and large mitral annulus size induced by high ESWS. These patients may have worse prognosis after TAVR and should be closely monitored in the long term.
Flight and flight energy accumulation related to the daily rhythm of juvenile hormone titer in the wing‐dimorphic cricket Velarifictorus aspersus
Authors: Pang Yin , Zeng Yang , Zhu Dao‐Hong
Published: September 2023

The cricket Velarifictorus aspersus (Walker) (Orthoptera: Gryllidae) exhibits a wing dimorphism mediating two distinct life‐history strategies during early adulthood; long‐winged (LW) females mainly invest resources in flight, whereas short‐winged (SW) females invest more heavily in reproduction than LW females. To understand the relationships among juvenile hormone (JH), flight capacity, and energy accumulation, the daily rhythm of JH titer and flight activity, the concentrations of flight energy substances, and the influence of exogenous JH on flight activity and flight energy substances were investigated in V. aspersus. The results showed that the hemolymph JH titer exhibited a high‐amplitude daily rhythm in 5‐day‐old LW V. aspersus females, and the JH titer rose about 10× at 18:00 hours (6 h before lights off) and dropped to baseline levels after lights off. The females flew inactively (i.e., they floated in the air) from 14:00 to 19:00 hours during the light period, whereas they had a stronger flight capacity in the initial photophase and before lights out. The flight ability of LW females with 20 μg μL−1 JH treatments was significantly improved during periods of flight inactivity. After the peak JH titer, the concentrations of glycogen and trehalose in the flight muscles increased significantly. The LW females treated with JH during the inactive flight period had a significant increase in glycogen after 1 h and trehalose after 3 h. These results suggested that the high‐amplitude daily rhythm of the JH titer was correlated with accumulation of flight energy substance and flight capacity; that is, an elevated JH titer promoted the biosynthesis of flight energy substances, resulting in improvement of flight capacity.
Artificial intelligence‐enhanced epileptic seizure detection by wearables
Authors: Yu Shuang , El Atrache Rima , Tang Jianbin , Jackson Michele , Makarucha Adam , Cantley Sarah , Sheehan Theodore , Vieluf Solveig , Zhang Bo , Rogers Jeffrey L. , Mareels Iven , Harrer Stefan , Loddenkemper Tobias
Published: September 2023

Objective

Wrist‐ or ankle‐worn devices are less intrusive than the widely used electroencephalographic (EEG) systems for monitoring epileptic seizures. Using custom‐developed deep‐learning seizure detection models, we demonstrate the detection of a broad range of seizure types by wearable signals.

Methods

Patients admitted to the epilepsy monitoring unit were enrolled and asked to wear wearable sensors on either wrists or ankles. We collected patients' electrodermal activity, accelerometry (ACC), and photoplethysmography, from which blood volume pulse (BVP) is derived. Board‐certified epileptologists determined seizure onset, offset, and types using video and EEG recordings per the International League Against Epilepsy 2017 classification. We applied three neural network models—a convolutional neural network (CNN) and a CNN–long short‐term memory (LSTM)‐based generalized detection model and an autoencoder‐based personalized detection model—to the raw time‐series sensor data to detect seizures and utilized performance measures, including sensitivity, false positive rate (the number of false alarms divided by the total number of nonseizure segments), number of false alarms per day, and detection delay. We applied a 10‐fold patientwise cross‐validation scheme to the multisignal biosensor data and evaluated model performance on 28 seizure types.

Results

We analyzed 166 patients (47.6% female, median age = 10.0 years) and 900 seizures (13 254 h of sensor data) for 28 seizure types. With a CNN‐LSTM‐based seizure detection model, ACC, BVP, and their fusion performed better than chance; ACC and BVP data fusion reached the best detection performance of 83.9% sensitivity and 35.3% false positive rate. Nineteen of 28 seizure types could be detected by at least one data modality with area under receiver operating characteristic curve > .8 performance.

Significance

Results from this in‐hospital study contribute to a paradigm shift in epilepsy care that entails noninvasive seizure detection, provides time‐sensitive and accurate data on additional clinical seizure types, and proposes a novel combination of an out‐of‐the‐box monitoring algorithm with an individualized person‐oriented seizure detection approach.
Integrating perennial biomass crops into crop rotations: How to remove miscanthus and switchgrass without glyphosate
Authors: Lewin Eva , Kiesel Andreas , Magenau Elena , Lewandowski Iris
Published: September 2023

Perennial energy grasses have gained attention in recent years as a promising resource for the bioeconomy because of their benign environmental profile, high stress tolerance, high biomass yields and low input requirements. Currently, strong breeding efforts are being made to extend the range of commercially available miscanthus and switchgrass genotypes. In order to foster farmers' acceptance of these crops, and especially of novel hybrids, more information is required about how they can be efficiently integrated into cropping rotations, how they can be removed at the end of their productive lifespan, and what effect they have on subsequently grown crops. Farmers in Europe are meanwhile increasingly constrained in the methods available to them to remove these crops, and there is a risk that the herbicide glyphosate, which has been used in many studies to remove them, will be banned in coming years. This study looks at the removal of seven‐year‐old stands of miscanthus and switchgrass over 1 year at an experimental site in Southern‐Germany. Three novel miscanthus genotypes were studied, alongside one variety of switchgrass, and the impact of each crop's removal on the yield of maize grown as a follow‐on crop was examined. A combination of soil tillage and grass herbicides for maize cultivation was successful in controlling miscanthus regrowth, such that yields of maize grown after miscanthus did not differ significantly from yields of maize grown in monoculture rotation (18.1 t dry biomass ha−1). Yields of maize grown after switchgrass (14.4 t dry biomass ha−1) were significantly lower than maize in monoculture rotation caused by insufficient control of switchgrass regrowth by the applied maize herbicide. Although some regrowth of miscanthus and switchgrass was observed in the follow‐on crop maize, complete eradication of both crops was achieved by subsequent winter wheat cultivation.
What's Gained from Depression? A Proposal on Theodicy and Epinosic Gains
Authors: Coblentz Jessica
Published: September 2023

Abstract: Many depression‐sufferers testify to experiences of goodness that arise from their depression, or ‘goodness because of depression’. These realities often inspire efforts to reconcile suffering and divine benevolence. Yet some sufferers who experience ‘goodness because of depression’ reject theodical thinking and therefore seek other frameworks for reflection on their suffering and its accompanying goods. This essay draws from psychology's notion of epinosic gains to propose an analogous framework that aids sufferers in discussing and interpreting instances of ‘goodness because of depression’ apart from theodical justifications. While the proposed framework is grounded in first‐person reflections on depression and is articulated in relation to another Christian framework for depression from Tasia Scrutton, this constructive proposal has the potential to serve theological reflection on a wider range of suffering beyond depression.
Shared decision making with frail people with intellectual disabilities in the palliative phase: A process evaluation of the use of the In‐Dialogue conversation aid in practice
Authors: Noorlandt H. W. , Korfage I. J. , Felet F. M. A. J. , Aarts K. , Festen D. A. M. , Vrijmoeth C. , Van Der Heide A. , Echteld M. A.
Published: September 2023

Background

This study reports the process evaluation of the In‐Dialogue conversation aid to facilitate shared decision‐making with people with intellectual disabilities in the palliative phase.

Methods

Training for In‐Dialogue was evaluated by 53 support staff members through questionnaires. The use of In‐Dialogue in four residential care facilities for frail people with mild to severe intellectual disabilities was evaluated with semi‐structured interviews with five relatives, nine support staff and three people with intellectual disabilities.

Results

Most participants considered the training helpful to apply shared decision‐making. Sixty‐three people with intellectual disabilities participated in In‐Dialogue conversations. Almost all interviewees stated that these conversations provided additional insight into people's concerns and preferences. Involvement of people with profound intellectual disabilities and their relatives appeared to be challenging.

Conclusion

Conversations about illness and the end of life appeared to be feasible with the In‐Dialogue conversation aid and provided insight into people's experiences and preferences.
Elevating EFL learners' professional English achievements and positive learning behaviours: A motivation model‐based digital gaming approach
Authors: Chang Chun‐Chun , Hwang Gwo‐Jen
Published: September 2023

Background

Cultivating staff's professional English has become an imperative and challenging issue in English as a Foreign Language (EFL) countries. English for medical professionals is also the common language around the world for publishing new medical knowledge or reports. Therefore, Medical English for Health Professionals (MEHP) is a crucial required professional training program in nursing education. Its purpose is to improve nursing students' professional English so that they can directly understand the clinical medical information related to patients, thereby reading the latest international medical knowledge and participating in research themselves.

Objective

The MEHP program is commonly conducted in a large‐scale class using the lecturing approach, which is a passive learning mode lacking opportunities for individual students to experience learning contexts and to receive advice and guidance from the teacher. To solve this problem, the present study proposed a motivation model‐based professional English gaming approach.

Method

To verify the effects of the proposed approach, a quasi‐experiment was conducted in an MEHP program of a university to explore the effects of the approach on nursing students' learning achievements. In addition, the higher and lower achievers' behavioural patterns, as well as their perceptions of the learning approach, were investigated.

Results and Conclusions

The results showed that the motivation model‐based digital gaming approach improved the students' professional English achievements in the “application” dimension as well as their positive perceptions of learning professional English more than the conventional learning approach. Moreover, when learning with the proposed approach, the higher achievers revealed more positive behavioural patterns than the lower achievers. The main contributions of the study are the proposal of a motivation model‐based digital gaming approach, and showing the effectiveness of the proposed approach in helping trainees gain a deeper understanding of professional English and facilitating their positive learning behaviours in a course for medical English.
Measuring the Impact of Peer Interaction in Group Oral Assessments with an Extended Many‐Facet Rasch Model
Authors: Jin Kuan‐Yu , Eckes Thomas
Published: September 2023

Many language proficiency tests include group oral assessments involving peer interaction. In such an assessment, examinees discuss a common topic with others. Human raters score each examinee's spoken performance on specially designed criteria. However, measurement models for analyzing group assessment data usually assume local person independence and thus fail to consider the impact of peer interaction on the assessment outcomes. This research advances an extended many‐facet Rasch model for group assessments (MFRM‐GA), accounting for local person dependence. In a series of simulations, we examined the MFRM‐GA's parameter recovery and the consequences of ignoring peer interactions under the traditional modeling approach. We also used a real dataset from the English‐speaking test of the Language Proficiency Assessment for Teachers (LPAT) routinely administered in Hong Kong to illustrate the efficiency of the new model. The discussion focuses on the model's usefulness for measuring oral language proficiency, practical implications, and future research perspectives.
Proanthocyanidin enhances the endogenous regeneration of alveolar bone by elevating the autophagy of PDLSCs
Authors: Liu Zhuo , Li Qilin , Wang Xiangyao , Wu Yaxin , Zhang Zhixing , Mao Jing , Gong Shiqiang
Published: September 2023

Objective

This study aimed to investigate the effect of proanthocyanidin (PA) on osteogenesis mediated by periodontal ligament stem cells (PDLSCs) and endogenous alveolar bone regeneration.

Background

Leveraging the osteogenic potential of resident stem cells is a promising strategy for alveolar bone regeneration. PA has been reported to be effective in osteogenesis. However, the effect and mechanism of PA on the osteogenic differentiation of PDLSCs remain elusive.

Methods

Human PDLSCs were treated with various doses of PA to assess the cell proliferation using Cell Counting Kit‐8. The osteogenic differentiation ability was detected by qRT‐PCR analysis, western blot analysis, Alizarin red S staining, and Alkaline Phosphatase staining. The level of autophagy was evaluated by confocal laser scanning microscopy, transmission electron microscopy, and western blot analysis. RNA sequencing was utilized to screen the potential signaling pathway. The alveolar bone defect model of rats was created to observe endogenous bone regeneration.

Results

PA activated intracellular autophagy in PDLSCs, resulting in enhanced osteogenic differentiation. Moreover, this effect could be abolished by the autophagy inhibitor 3‐Methyladenine. Mechanistically, the PI3K/Akt/mTOR pathway was negatively correlated with PA‐mediated autophagy activation. Lastly, PA promoted the alveolar bone regeneration in vivo, and this effect was reversed when the autophagy process was blocked.

Conclusion

PA may activate autophagy by inhibiting PI3K/Akt/mTOR signaling pathway to promote the osteogenesis of PDLSCs and enhance endogenous alveolar bone regeneration.
Exosomal microRNA‐223 from neutrophil‐like cells inhibits osteogenic differentiation of PDLSCs through the cGMP‐PKG signaling pathway
Authors: Zhang Zheng , Wang Pengcheng , Zheng Youli , Wang Minghui , Chou Jiashu , Wang Zuomin
Published: September 2023

Background and Objective

Neutrophils‐derived exosomes have been shown to cause tissue inflammation in many diseases, but their role in periodontitis, a neutrophil‐mediated disease, is unknown. Here, we investigated the effect of neutrophil‐like cells derived exosomes on osteogenic dysfunction of periodontal ligament stem cells (PDLSCs) in periodontitis.

Methods

Neutrophil‐like cells were derived from HL‐60 cells by dimethylsulfoxide stimulation. Exosomes were isolated by ultracentrifugation and characterized using transmission electron microscopy, nanoflow cytometry and western blot. MicroRNA‐223 (miR‐223) expression were analyzed by real‐time PCR. Western blot, alkaline phosphatase (ALP), and alizarin red staining were conducted to assess whether exosomes could affect the osteogenic differentiation of PDLSCs. The expression of miR‐223 was inhibited in PDLSCs by transfecting with miR‐223 inhibitor. Cyclic guanosine monophosphate (cGMP) expression was determined by enzyme‐linked immunosorbent assay.

Results

We found that miR‐223 was significantly increased in neutrophils and neutrophil‐like cells derived exosomes. Treatment with exosomes derived from neutrophil‐like cells upregulated miR‐223 expression and inhibited the osteogenic differentiation of PDLSCs, while transfection with miR‐223 inhibitor significantly promoted PDLSCs osteogenic differentiation. In addition, co‐treatment with KT5823, a cGMP–PKG pathway inhibitor, markedly abrogated the rescue effects of miR‐223 inhibitor on the osteogenic differentiation of PDLSCs.

Conclusions

Our findings suggest that neutrophil‐like cells derived exosomes might inhibit osteogenic differentiation of PDLSCs by transporting miR‐223 and regulating the cGMP–PKG signaling pathway.
Perceptions of access to care after a rural hospital closure in an economically distressed county of Appalachian Tennessee
Authors: Letheren Amanda , Brown Kathleen C. , Barroso Cristina S. , Myers Carole R. , Nobles Robert
Published: September 2023

Purpose

The rise in rural hospital closures has sparked concern about the potential loss of essential health care services for rural communities. It is crucial to incorporate the perspectives of community residents, which have been largely missing from the literature, when devising strategies to improve health care for this population. The purpose of this study was to describe community residents’ perceptions of access to care following a rural hospital closure in an economically distressed Appalachian county of Tennessee.

Methods

This study used a qualitative descriptive approach to illustrate how community residents perceive accessing care post hospital closure. We conducted semi‐structured interviews with 24 community residents via telephone in May through August of 2020. Interviews were analyzed using conventional content analysis.

Findings

Five themes were identified based on Penchansky and Thomas’ framework of health care: accessibility, availability, affordability, accommodation, and acceptability. Accessibility was identified as the most common concern among participants. Specifically, participants perceived longer travel times to receive care, reduced availability of emergency and specialty care, increased costs associated with ambulance services, and extended wait times to see providers.

Conclusions

Our findings provide a critical perspective to inform local leaders and policymakers on the impacts of a hospital closure in a rural community. As rural hospitals continue to close, it is crucial to develop multi‐level, community‐driven solutions to ensure access to care for rural communities.
Localization and characterization of atrial depolarization waves on the surface electrocardiogram in dogs with rapid supraventricular tachycardia
Authors: Battaia Stefano , Perego Manuela , Cavallini Damiano , Santilli Roberto
Published: September 2023

Background

Supraventricular tachycardias (SVTs), despite having various anatomical substrates and pathophysiological mechanisms, frequently show similar electrocardiographic presentations.

Objectives

To locate and characterize atrial deflections (ADs) on 12‐lead electrocardiograms in dogs with sustained rapid SVT and assess the utility of different electrocardiographic variables in differentiating types of tachycardia.

Animals

Ninety‐two dogs with orthodromic atrioventricular reciprocating tachycardia, 17 with atrial flutter, 33 with focal atrial tachycardia recorded and confirmed by electrophysiological study, and 40 dogs with sinus tachycardia.

Methods

Atrial deflection position on the 12‐lead surface electrocardiogram was assessed according to the sequence of intracardiac activation. Its features were evaluated together with the relationship between AD and QRS complex interval (AD‐R) and QRS complex and AD interval (R‐AD).

Results

Orthodromic atrioventricular reciprocating tachycardia was characterized by an AD‐AD interval of 213 ± 30 ms, mean electrical axis (MEA) of AD of −90 (−90/−78)°, R‐AD interval of 75 (65‐80) ms, and R‐AD/AD‐R of 0.54 (0.45‐0.64). Atrial flutter was characterized by an AD‐AD interval of 199 ± 57 ms, MEA of 76° (72/81), R‐AD of 120 (72‐144) ms, and R‐AD/AD‐R of 0.81 (0.63‐1.13). Focal atrial tachycardia was characterized by an AD‐AD interval of 270 ± 38 ms, MEA of 49 (−72/76)°, R‐AD of 160 (120‐200) ms, and R‐AD/AD‐R of 1.45 (0.92‐1.67). Sinus tachycardia was characterized by an AD‐AD interval of 292 ± 31 ms, MEA of 66° (52/73), R‐AD of 215 (192‐222) ms, and R‐AD/AD‐R of 2.68 (2.25‐3.08).

Conclusions and Clinical Importance

Analyzing AD on 12‐lead electrocardiogram is helpful in differentiating the most common SVTs in dogs.