bluuebunny/crossref_metadata_2025 huggingface dataset:
Detecting sarcasm in multi-domain datasets using convolutional neural networks and long short term memory network model
Authors: Jamil Ramish , Ashraf Imran , Rustam Furqan , Saad Eysha , Mehmood Arif , Choi Gyu Sang
Published: August 2021

Sarcasm emerges as a common phenomenon across social networking sites because people express their negative thoughts, hatred and opinions using positive vocabulary which makes it a challenging task to detect sarcasm. Although various studies have investigated the sarcasm detection on baseline datasets, this work is the first to detect sarcasm from a multi-domain dataset that is constructed by combining Twitter and News Headlines datasets. This study proposes a hybrid approach where the convolutional neural networks (CNN) are used for feature extraction while the long short-term memory (LSTM) is trained and tested on those features. For performance analysis, several machine learning algorithms such as random forest, support vector classifier, extra tree classifier and decision tree are used. The performance of both the proposed model and machine learning algorithms is analyzed using the term frequency-inverse document frequency, bag of words approach, and global vectors for word representations. Experimental results indicate that the proposed model surpasses the performance of the traditional machine learning algorithms with an accuracy of 91.60%. Several state-of-the-art approaches for sarcasm detection are compared with the proposed model and results suggest that the proposed model outperforms these approaches concerning the precision, recall and F1 scores. The proposed model is accurate, robust, and performs sarcasm detection on a multi-domain dataset.
Characteristics of T-cell receptor repertoire of stem cell-like memory CD4+ T cells
Authors: Wang Shiyu , Wang Longlong , Liu Yang , Zhu Yonggang , Liu Ya
Published: August 2021

Stem cell-like memory T cells (Tscm) combine phenotypes of naïve and memory. However, it remains unclear how T cell receptor (TCR) characteristics contribute to heterogeneity in Tscm and other memory T cells. We compared the TCR-beta (TRB) repertoire characteristics of CD4+ Tscm with those of naïve and other CD4+ memory (Tm) in 16 human subjects. Compared with Tm, Tscm had an increased diversity across all stretches of TRB repertoire structure, a skewed gene usage, and a shorter length distribution of CDR3 region. These distinctions between Tscm and Tm were enlarged in top1000 abundant clonotypes. Furthermore, top1000 clonotypes in Tscm were more public than those in Tm and grouped in more clusters, implying more epitope types recognized by top1000 clonotypes in Tscm. Importantly, self-reactive clonotypes were public and enriched in Tscm rather than Tm, of type one diabetes patients. Therefore, this study highlights the unique features of Tscm different from those of other memory subsets and provides clues to understand the physiological and pathological functions of Tscm.
Cut-off points to screening for sarcopenia in community-dwelling older people residents in Brazil
Authors: Fernandes Sabrina Gabrielle Gomes , Lima de Andrade Luiz Eduardo , dos Santos Aguiar Gonçalves Rafaella Silva , Aires da Câmara Saionara Maria , Guerra Ricardo Oliveira , Cavalcanti Maciel Alvaro Campos
Published: August 2021

Background

At a time when the world’s population is aging, one of the most important challenges for the healthcare field is to control the decline of the musculoskeletal system. This decline consists of a reduction in muscle mass and function, which is called sarcopenia and is associated with adverse health outcomes. Although there has been an increase in the number of publications on sarcopenia and its consequences, the reported prevalence varies widely, since these depend on the characteristics of the population studied, the definitions found in the literature and the cut-off points adopted. In this perspective, the heterogeneity in the classification and the different reference values has a critical impact on the epidemiology of sarcopenia, since neither the procedures, the components and the cut-off points are consistent.

Objectives

To develop cut-off points for the screening of sarcopenia in community-dwelling older people residents in the northeast of Brazil and compare the prevalences between the values defined by the consensus and the values of the population studied.

Methods

Community-dwelling older men and women living in three cities in the countryside of Rio Grande do Norte were evaluated. Cutoff points were defined for the variables used to screen for sarcopenia (handgrip strength, SMI, gait speed and SPPB) using the 20th percentile of their population distributions.

Results

The sample was composed of 1,290 older people (62.5% female and 37.5% male), with an average of 69.5 (± 6.05) years of age. Regarding the cutoff points, the handgrip values were defined as 25.3 kg and 16 kg for men and women, respectively. Considering the SMM adjusted according to their height, the values of 7.88 kg/m2 were adopted for men and 5.52 kg/m2 for women. When adjusting by BMI we obtained 0.73 kg/BMI for men and 0.41 kg/BMI for women. For gait speed it was defined 0.71 m/s for men and 0.63 m/s for women. In the case of SPPB, the result was the same for both genders (≤8). When applying the values found in the studied population, a variation in prevalence was observed for both men and women, depending on the cut-off points and consensus used.

Conclusion

The cutoff values found in our population were lower than those adopted by international consensus (EWGSOP2, IWGS and FNIH), except for HGS in woman and SMI/m2 for men. Therefore, using specific cutoff points for different populations can provide an accurate assessment of the presence of sarcopenia and better target health prevention strategies for the older people living in the community.
Experiences of international medical students enrolled in Chinese medical institutions towards online teaching during the COVID-19 pandemic
Authors: Aslam Sarfraz , Akram Huma , Saleem Atif , Zhang BaoHui
Published: August 2021

Introduction

. The COVID-19 pandemic has forced the world to pause. One hundred and eighty-eight countries have imposed countrywide school closures, affecting more than 1.5 billion children and youths. The majority of academic leaders are currently encouraging online education to resolve this crisis. This study aimed to investigate international medical students’ (IMS) experiences of online teaching during the COVID-19 pandemic.

Methods

Data were collected online using a validated questionnaire and one open-ended question, presented on the Google forms platform. The study attracted responses from 1,107 IMS volunteer participants. IBM SPSS v. 25, GraphPad Prism v. 9, and MindManager v. 2018 were used for data analysis. All variables were subjected to descriptive statistical analysis. The Mann–Whitney U test was used in subgroup analysis and the Kruskal-Wallis test was also applied for year-wise comparisons. Open-ended text responses were analyzed qualitatively, extracting themes by which responses were classified.

Results

Among 1,107 respondents, a total of 67.8% were males, and the majority (63.1%) of the IMS were in the age group of 21–23 years. The results show that more than half of the respondents reported their Internet connection quality as poor to average. Poor Internet connection severely affected IMS online learning experience. Persistent and recurrent issues with Internet access became a significant concern for IMS. Lack of electricity is one of the factors that can contribute to poor learning output and dissatisfaction with online teaching. IMS perceive online medical education as unhelpful in several phases of the training, such as improving their clinical skills, knowledge, and discussion skills.

Conclusions

During these unprecedented periods, online teaching has allowed medical education to continue. However, IMS are generally dissatisfied with online teaching. Medical students must visualize the human body, so supportive technologies are important to compensate for the lack of clinical practices. Medical institutions may need to invest in faculty training programs and continually adjust to enhance the content of online training and international partnerships. A switch from conventional face-to-face teaching to a fully functional virtual education framework in the medical education field will take time and experience.
Pathogenic Germline Variants in Patients With Metaplastic Breast Cancer
Authors: Demarest Kaitlin , Anantharajah Arravinth , Maxwell Kara N. , Rohanizadegan Mersedeh , Bradbury Angela , Nathanson Katherine L. , McCarthy Anne Marie , Domchek Susan M. , Nayak Anupma , Shah Payal D.
Published: February 2025

Importance

Metaplastic breast cancer (MpBC) is a rare, heterogeneous disease often associated with inferior outcomes. A growing body of literature describes the clinical and molecular features of MpBC, yet limited data describe the pathogenic germline variants (PGVs) in breast cancer susceptibility genes among affected individuals.

Objective

To examine the frequency and types of PGVs in breast cancer genes among patients with MpBC.

Design, Setting, and Participants

This is a descriptive retrospective cohort study of patients who received a diagnosis of MpBC at the University of Pennsylvania between January 2010 and May 2023. Electronic medical records were reviewed for demographic, clinicopathologic, and germline genetic testing information. Germline variant status was independently confirmed by a licensed genetic counselor and a physician with expertise in genetics. MpBC diagnosis and subtype were confirmed by a breast pathologist. Participants were identified via query of an institutional pathology database for reports signed between January 2010 and May 2023 including the term metaplastic. Among 320 initially obtained reports, 272 individuals had confirmed MpBC and were included in the study.

Exposure

Germline genetic testing to investigate the presence of PGVs in breast cancer susceptibility genes.

Main Outcomes and Measures

The primary outcome measurement was the prevalence of PGVs in breast cancer susceptibility genes among participants. The hypothesis that individuals with MpBC have an enrichment of PGVs in genes associated with inherited breast cancer risk was formulated before data collection.

Results

The total sample size was 272 women, and the median age at diagnosis was 58 years (range, 20-102 years); all were biological female patients; 143 of 272 (52.6%) had documentation of germline genetic testing; and participants with testing were significantly younger than those without (median age, 53 years [range, 20-79 years] vs 63 years [range, 29-102 years]; P < .001). Of the 143 patients, 24 (16.8%) had a PGV in a breast cancer susceptibility gene (BRCA1, n = 17; BRCA2, n = 5; PALB2, n = 1; CHEK2, n = 1). Patients with PGV-associated MpBC received a diagnosis at a younger age than those with sporadic disease, but there were no significant differences in hormone receptor positivity, ERBB2 status, or metaplastic subtype.

Conclusions and Relevance

In this cohort study of patients with MpBC, a substantial proportion of clinically tested patients had a PGV in a breast cancer susceptibility gene, most commonly BRCA1. Germline testing was high yield in patients with MpBC, many of whom would be included in current germline testing eligibility criteria.
Abortion Changes Among Residents of an Abortion Rights Protective State
Authors: DeBie Kelly A. , Gutilla Margaret J. , Keller Kayleigh P. , Peel Jennifer L. , Neophytou Andreas M.
Published: February 2025

This cross-sectional study examines whether passage of a 6-week abortion ban in Texas in 2021 was associated with changes in abortion rates among Colorado residents.
Motor‐Free Soft Robots for Cancer Detection, Surgery, and In Situ Bioprinting
Authors: Nguyen Chi Cong , Davies James , Ashok Aditya , Hoang Trung Thien , Ehteda Anahid , Dang Tran Bach , Nicotra Emanuele , Tran Hien A. , Sharma Bibhu , Zhu Kefan , Phan Phuoc Thien , Ji Adrienne , Wan Jingjing , Rnjak‐Kovacina Jelena , Vittorio Orazio , Phan Hoang‐Phuong , Lovell Nigel Hamilton , Do Thanh Nho
Published: February 2025

Recent advancements in teleoperated surgical robotic systems (TSRSs) for minimally invasive surgery (MIS) have significantly improved diagnostic and surgical outcomes. However, as the complexity of MIS procedures continues to grow, there is an increasing need to enhance surgical tools by integrating advanced functionalities into these instruments for superior medical results. Despite recent advancements, TSRSs face significant challenges, including rigidity, suboptimal actuation methods, large sizes, and complex control mechanisms. This paper presents a portable, motor‐free soft robotic system equipped with soft robotic arms (SRAs) that provides an innovative solution for performing MIS within complex human organs. Unlike conventional approaches, these SRAs leverage a soft fibrous syringe architecture for operation, eliminating the need for complex control systems. This design achieves precise motion control with mean errors <300 µm, effectively minimizing physical tremors. Two SRAs—one with and one without a central lumen—are developed. By integrating microelectrodes into the SRAs, the system demonstrates capabilities to support cancer detection via electrical impedance measurements and to perform radio‐frequency ablation for surgical treatments. Additionally, the system supports biomaterial injections and in situ 3D printing for internal wound healing. This simple, cost‐effective platform represents a promising new direction for developing TSRSs in MIS.
Autonomous, Moisture‐Driven Flexible Electrogenerative Dressing for Enhanced Wound Healing
Authors: Yan Ren , Zhang Xueliang , Wang Hai , Wang Tikang , Ren Guozhang , Sun Qizeng , Liang Fei , Zhu Yangzhi , Huang Wei , Yu Hai‐Dong
Published: February 2025

Electrotherapy has shown considerable potential in treating chronic wounds, but conventional approaches relying on bulky external power supplies and mechanical force are limited in their clinical utility. This study introduces an autonomous, moisture‐driven flexible electrogenerative dressing (AMFED) that overcomes these limitations. The AMFED integrates a moist‐electric generator (MEG), an antibacterial hydrogel dressing, and concentric molybdenum (Mo) electrodes to provide a self‐sustaining electrical supply and potent antibacterial activity against Staphylococcus aureus and Escherichia coli. The MEG harnesses chemical energy from moisture to produce a stable direct current of 0.61 V without external input, delivering this therapeutic electrical stimulation to the wound site through the Mo electrodes. The AMFED facilitates macrophage polarization toward reparative M2 phenotype and regulates inflammatory cytokines. Moreover, in vivo studies suggest that the AMFED group significantly enhances chronic wound healing, with an approximate 41% acceleration compared to the control group. Using a diabetic mouse wound model, the AMFED demonstrates its effectiveness in promoting nerve regulation, epithelial migration, and vasculogenesis. These findings present a novel and efficient platform for accelerating chronic wound healing.
Two Material Properties from One Wavelength‐Orthogonal Photoresin Enabled by a Monochromatic Laser Integrated Stereolithographic Apparatus (Mono LISA)
Authors: Wu Xingyu , Ehrmann Katharina , Gan Ching Thye , Leuschel Benjamin , Pashley‐Johnson Fred , Barner‐Kowollik Christopher
Published: February 2025

Multi‐material printing has experienced critical advances in recent years, yet material property differentiation capabilities remain limited both with regard to the accessible properties – typically hard versus soft – and the achievable magnitude of differentiation. To enhance multi‐material printing capabilities, precise photochemical control during 3D printing is essential. Wavelength‐differentiation is a particularly intriguing concept yet challenging to implement. Notably, dual‐wavelength printing to fabricate hard and soft sections within one object has emerged, where one curing process is insensitive to visible light, while UV irradiation inevitably activates the entire resin, limiting true spatio‐temporal control of the material properties. Until now, pathway‐independent wavelength‐orthogonal printing has not been realized, where each wavelength exclusively triggers only one of two possible reactions, independent of the order in which the wavelengths are applied. Herein, a multi‐wavelength printing technique is introduced employing a tunable laser to monochromatically deliver light to the printing platform loaded with a fully wavelength‐orthogonal resin. Guided by photochemical action plots, two distinct wavelengths – each highly selective toward a specific photocycloaddtion reaction – are utilized to generate distinct networks within the photoresin. Ultimately, together with the printing technique, this orthogonally addressable photoresin allows fabricating multi‐material objects with degradable and non‐degradable properties, in a single fabrication step.
Interfacial π‐Electron Cloud Extension and Charge Transfer Between Preferable Single‐Crystalline Conjugated MOFs and Graphene for Ultrafast Pulse Generation
Authors: Liu Heng , Ding Yixin , Xu Yingtian , Kuai Yue , Chen Jiahao , Zhang He , Lan Yunping , Wei Zhipeng
Published: February 2025

2D conjugated metal‐organic frameworks (MOFs) have attracted significant attention in various fields due to their outstanding characteristics. However, due to the strong interlayer π–π stacking interactions, the preparation of high‐quality and atomic‐scale single‐crystalline conjugated MOF structures continues to pose a significant challenge. The investigation of its nonlinear optical (NLO) property and application for ultrafast photonics is still rare. Herein, the ultrathin Cu3(HHTP)2 and Ni3(HHTP)2 (HHTP = 2,3,6,7,10,11‐hexahydroxytriphenylene) nanosheets (CuHHTPNs and NiHHTPNs) with single‐crystalline characteristic are prepared by surfactant‐assisted solution synthesis strategy. Moreover, the π–π stacked CuHHTPNs(NiHHTPNs)/graphene van der Waals heterostructures (CuNsG‐VHS and NiNsG‐VHS) are achieved by ultrasound‐assisted method. According to characterization analyses and theoretical simulations, this preferable stacking ultrathin van der Waals heterostructures exhibits superior π‐conjugated electron cloud extension, charge transfer, and NLO properties. Noticeably, the third‐order NLO polarizability of CuNsG‐VHS keeps in a relatively high level compared with the reported 2D saturable absorber materials in the near‐infrared wavelength range. Based on these outstanding properties, CuNsG‐VHS can serve as an excellent saturable absorber to achieve fundamental mode‐locking with femtosecond pulse duration, and high‐order harmonic mode‐locking with GHz repetition frequency. These demonstrations provide a valuable strategy for the development of promising conjugated MOFs for ultrafast photonics and advanced optoelectronic devices.
Competitive Phase Transition of NaYS2 in Non‐Vacuum Environment for Cutting‐Edge Anti‐Counterfeiting
Authors: Zhao Wenhua , Shen Lifan , Pun Edwin Yue Bun , Lin Hai
Published: February 2025

Recently, chalcogenides with layered structures exhibit promising applications in the fields of information chaos processing and compilation remodeling, yet facile synthesis of their microcrystals with multi‐temporal and multi‐modal luminescence remains a major challenge. Herein, a competitive phase transition to generate orderly layered NaYS2 microcrystals is achieved by lattice reconstruction with introduction S2− occupying a unique anionic site in non‐vacuum sulfur‐rich environment, revealing crucial role of competitive phase transitions in regulating material structure and properties. Simultaneous photoinduced luminescent chromism and photo‐stimulated luminescence are attained by introducing Pr3+. Interestingly, broadband long‐wavelength visible afterglow emission in 4f15d1 cluster state is achieved and a reversible temporary change in upconversion emission from orange broadband to green narrowband occurs under continuous 980 nm excitation, which is attributed to ordered polarization of Pr3+ in YS6 layer and injection of defects. Furthermore, by integrating long‐lived down‐conversion emission and relatively short‐lived up‐conversion emission in Pr3+‐doped NaYS2, a multilevel dynamic optical anti‐counterfeiting platform is constructed based on transient and long afterglow luminescence. This work implements a competitive phase transition to generate NaYS2 with 2D structure, providing a new model of tunable space‐time resolved emission for spatiotemporal optoelectronic multiplexing, which are applicable to large‐capacity information encryption, optical data storage, and biosensing.
Effect of Steroids on the Progression of Alzheimer's Dementia: A Retrospective Chart Review
Authors: Conic Julijana Zoran , Chetty Alexandra , Chen Lily , Marsh Audrey , Barry Sean , Pattabhi Rodney , Reske Thomas , Aguilar Erwin , Ali Lobna
Published: February 2025

Objectives

Alzheimer's disease (AD) is a prevalent age‐related neurodegenerative disease that affects millions of individuals in the United States. Neuroinflammation is a driver of the neurodegenerative changes that characterize AD, prompting interest in how inflammation can be modulated for treatment and prevention.

Methods

ICD‐10 codes were quarried from electronic medical records to identify patients diagnosed with AD from 2012 to 2020. The patients were then divided into those who used systemic steroids and those who did not before the progression of their disease. Data on medication prescribed was used to measure the disease's progression. Clinical findings and laboratory results were collected to build a propensity score. Patients were followed until disease progression, death, or the last available visit. Kaplan–Meier curves and hazard ratios adjusted for the propensity score were used to compare the two groups.

Results

Of the 459 patients identified, 77 were included in the study, and 13 used steroids. Of the 77 patients included in the study, 59 had progression of their disease, and of those, five used steroids. The median time to progression was 408.00 (191.00, 979.00) days for the overall sample. The hazard ratio (HR) comparing the group using steroids to those not using steroids was 0.26 with a 95% CI of (0.1013, 0.673) and a p value of 0.00064.

Conclusions

In our study, steroid use delayed the progression of dementia. Further study is needed to outline how steroids and anti‐inflammatory medications can be used in the treatment and prevention of AD.
Quantum Chemical Understanding of the O2 Release Process from Nature’s Water Splitting Cofactor
Authors: Guo Yu , Kloo Lars , Sun Licheng
Published: February 2025

Natural photosynthesis plays a vital role in the supply of energy and oxygen necessary for the survival of biological organisms. The current leading proposal of the O‐O bond formation in photosystem II suggests the coupling between the central μ‐oxo (O5) and the additional oxygenic ligand (Ox) of the manganese‐calcium oxide cofactor. However, the subsequent process through which molecular dioxygen is formed remains elusive. In this report, quantum chemical calculations reveal that the O2 process is initiated by the cleavage of the Mn‐O5 bond, without a preliminary conformational change of the peroxide [O5‐Ox]2‐ group. Subsequently, the [O5‐Ox] moiety is converted from the superoxide to the weakly bound quasi‐O2 where the Mn‐Ox bond is cleaved, and after a twist of the quasi‐O2 unit, the free O2 is ultimately released. Alternative pathways display significantly slower kinetics, due to the lower structural stabilities of the rate‐limiting transition states. The cause of the difference is associated with the Jahn‐Teller axial orientation and the local ring strain within the Mn cluster. These findings contribute to unravelling the complex mechanism in an important step of photosynthetic oxygen evolution for a deeper understanding of nature’s water oxidation catalysis.
Synergistic Effect of Alkaline‐Earth Metal (Pyro) Phosphates and Aluminum Trichloride on the Hydrosilylation of Olefins
Authors: Liu Jun , Wang Xinyu , Ouyang Ting , Lan Huilin , Bai Ying , Li Jiayun , Huang Yichen , Peng Jiajian
Published: February 2025

Phosphate and pyrophosphate can advance green chemistry as nontoxic and sustainable catalysts. This study presents the development of a novel series of solid composite catalysts, comprising AlCl3 and alkaline‐earth metal (pyro)phosphates. The efficacy of these catalysts in facilitating the hydrosilylation of olefins with hydrosilanes has been thoroughly examined. Adding aluminum chloride enhances the catalytic activity of calcium phosphate for the catalysis hydrosilylation reaction, enabling efficient conversion of various linear alkenes into corresponding adducts with excellent yields. Furthermore, this catalytic system exhibits remarkable stability, maintaining its activity over 15 cycles without significant decrease.
Preparation and Properties of Cd/Ni Complexes Based on 2,6‐Bis(4′‐carboxyl‐phenyl)pyrazine Ligand
Authors: Liu Wei , Sun Junjun , Yao Wei , Fedin Vladimir P. , Gao Enjun
Published: February 2025

Two transition metal complexes (complex 1 = {[Cd (DCPP)·(H2O)]·(DMF)}n and complex 2 = {[Ni (DCPP)·(H2O)]·(DMF)}n) with the same structure and different functions were synthesized based on 2,6‐bis(4′‐carboxybenzene)pyrazine ligand (H2DCPP) by solvothermal method, and their structure and properties were analyzed and characterized by a variety of characterization methods. Complex 1 was used as a fluorescence sensor to recognize cations and anions in water; it had excellent recognition and anti‐interference ability with Fe3+ and Cr2O72− among cations and anions. Complex 2 (2‐CPE) was used as electrochemical material to perform electrochemical tests on hydrogen peroxide and sodium nitrite with good electrocatalytic effect. This work provides a synthesis strategy for fluorescence and electrochemical sensing materials, respectively.
Empirical dosage determination of vancomycin for a target area under the concentration‐time curve of 400 μg·h/mL in the first 24 h: A prospective multicenter observational study with rich sampling
Authors: Oda Kazutaka , Hiyama Yoko , Ueda Takashi , Furusho Hirokazu , Yamada Tomoyuki , Katanoda Tomomi , Yoshikawa Hiroshi , Tomita Takashi , Ide Takeshi , Jingami Sachiko , Kusaka Yusuke , Jono Hirofumi , Saito Hideyuki
Published: February 2025

Aim

Area under the concentration‐time curve (AUC)‐guided dosing is recommended in vancomycin therapy. This study aims to determine the empirical dosing for achieving an AUC on the first day (AUCf24h) and the optimal number of samplings for Bayesian estimation.

Methods

A multicentric prospective study was conducted across five hospitals. Critically ill patients were included, with rich sampling conducted on the first day and/or days 3‐5 of therapy. Cumulative dose on the first day for the trapezoidal AUCf24h > 400 μg·h/mL and the predictive performances of AUC and clearance in limited sampling were evaluated. The probability of adherence to AUCf24h within 400‐600 μg·h/mL in the guidelines‐compliant or non‐compliant doses were also evaluated.

Results

The study included 27 patients and 395 samplings were performed. The mean cumulative dose (standard deviation) on the first day was higher in the group with AUCf24h > 400 μg·h/mL at 49.3 (4.5) mg/kg compared to the group with AUCf24h < 400 μg·h/mL at 42.1 (6.8) mg/kg (P = 0.01) for patients with creatinine clearance > 90 mL/min, respectively. The biases and variations of Bayesian posterior AUC by using only a trough concentration were improved by using two‐point concentrations at trough and peak. The probability of adherence to AUCf24h was significantly higher in the guidelines‐compliant group (66.7%) than in the non‐compliant group (11.1%, P < .01).

Conclusion

This study suggested an empirical dosage of about 50 mg/kg on the first day of vancomycin therapy and the use of two‐point sampling in Bayesian estimations to enhance accuracy.

Trial registration

Not applicable because this is a non‐intervention study.
Optimizing Stent Placement in Ostial Coronary Lesions With the Floating Balloon Technique: The OSTIAL (Optimizing Stent In Aorto‐Ostial Lesion) Pivotal Study
Authors: Digne Franck , Darmon Arthur , Belguidoum Salim , Nejjari Mohammed , Feignoux Jacques
Published: February 2025

Background

Managing aorto‐ostial coronary lesions during percutaneous coronary interventions (PCI) presents significant challenges due to complex anatomy, catheter instability, and risks of stent misplacement.

Aims

The OSTIAL pivotal study aimed to assess the feasibility and precision of the floating balloon technique for optimizing stent placement in aorto‐ostial lesions (AOL), with post‐procedural coronary computed tomography angiography (CCTA) used to evaluate stent positioning.

Methods

This prospective, dual‐center observational study included 12 patients undergoing PCI for AOL using the floating balloon technique. The technique stabilizes the guiding catheter by positioning a balloon in the aorta, thereby defining the aorto‐ostial landing zone (AOLZ) for precise stent placement. Post‐procedural CCTA were systematically performed to assess the positioning of the stent. The primary outcome was technical success including optimal stent placement within the AOLZ and proximal anatomy‐dependent geographic miss.

Results

The primary outcome was achieved in 83% of cases, with 66% showing complete AOLZ coverage and 17% classified as a proximal anatomy‐dependent geographic miss. Proximal procedure‐dependent geographic miss occurred in only 17% of cases, with limited stent protrusion into the aorta (2.3 and 2.9 mm).

Conclusions

The floating balloon technique demonstrated feasibility and precision in optimizing stent placement in AOL, as assessed by CCTA. It offers a promising, cost‐effective, and practical alternative to other techniques. Larger studies are required to confirm its efficacy and long‐term benefits.
Capital Structure Decisions and Zombie Firms in India
Authors: Rai Asha K. , Sharma Ruchi
Published: February 2025

This study explores the impact of Indian non‐financial firms' capital structure on corporate zombification. The study uses a logit model, with the capital structure mix as a covariate, to determine the likelihood of a firm becoming a zombie. Panel data from 1999 to 2020 for all non‐financial firms were utilised to examine the effect of debt capital on the probability of corporate zombification. The findings reveal that increased debt‐to‐equity financing raises the risk of default. However, the study underscores the importance of maintaining an optimal debt level and conscious capital structure decision‐making by managers that support relevant capital structure theories. Going overboard with debt capital erodes its benefits. Debt financing is associated with an unequal distribution of information and financial commitments. To a certain extent, the conclusions of the present study could guide firm managers to make informed decisions related to capital structure and adjust the intensity and direction of a firm turning into a zombie. By providing practical insights, the study empowers managers to make strategic decisions that can potentially prevent their firms from becoming zombies. The study will further enrich the literature, focusing on the factors responsible for a firm turning into a zombie.
Cachexia Alters Central Nervous System Morphology and Functionality in Cancer Patients
Authors: Simoes Estefania , Uchida Ricardo , Nucci Mariana P. , Duran Fabio L. S. , Lima Joanna D. C. C. , Gama Leonardo R. , Costa Naomi A. , Otaduy Maria C. G. , Bin Fang C. , Otoch Jose P. , Alcantara Paulo , Ramos Alexandre , Laviano Alessandro , Diaz Mauricio Berriel , Esiri Margaret M. , DeLuca Gabriele C. , Herzig Stephan , Filho Geraldo Busatto , Seelaender Marilia
Published: February 2025

Background

Cachexia is a clinically challenging multifactorial and multi‐organ syndrome, associated with poor outcome in cancer patients, and characterised by inflammation, wasting and loss of appetite. The syndrome leads to central nervous system (CNS) function dysregulation and to neuroinflammation; nevertheless, the mechanisms involved in human cachexia remain unclear.

Methods

We used in vivo structural and functional magnetic resonance imaging (Cohort 1), as well as postmortem neuropathological analyses (Cohort 2) in cachectic cancer (CC) patients compared to weight stable cancer (WSC) patients. Cohort 1 included treatment‐naïve adults diagnosed with colorectal cancer, further divided into WSC (n = 12; 6/6 [male/female], 61.3 ± 3.89 years) and CC (n = 10; 6/4, 63.0 ± 2.74 years). Cohort 2 was composed by human postmortem cases where gastrointestinal carcinoma was the underlying cause of death (WSC n = 6; 3/3, 82.7 ± 3.33 years and CC n = 10; 5/5, 84.2 ± 2.28 years).

Results

Here we demonstrate that the CNS of CC patients presents regional structural differences within the grey matter (GM). Cachectic patients presented an augmented area within the region of the orbitofrontal cortex, olfactory tract and the gyrus rectus (coordinates X, Y, Z = 6, 20,−24; 311 voxels; pFWE = 0.023); increased caudate and putamen volume (−10, 20, −8; 110 voxel; pFWE = 0.005); and reduced GM in superior temporal gyrus and rolandic operculum (56,0,2; 156 voxels; pFWE = 0.010). Disrupted functional connectivity was found in several regions such as the salience network, subcortical and temporal cortical areas of cachectic patients (20 decreased and 5 increased regions connectivity pattern, pFDR < 0.05). Postmortem neuropathological analyses identified abnormal neuronal morphology and density, increased microglia/macrophage burden, astrocyte profile disruption and mTOR pathway related neuroinflammation (p < 0.05).

Conclusions

Our results indicate that cachexia compromises CNS morphology mostly causing changes in the GM of cachectic patients, leading to alterations in regional volume patterns, functional connectivity, neuronal morphology, neuroglia profile and inducing neuroinflammation, all of which may contribute to the loss of homeostasis control and to deficient information processing, as well as to the metabolic and behavioural derangements commonly observed in human cachexia. This first human mapping of CNS cachexia responses will now pave the way to mechanistically interrogate these pathways in terms of their therapeutic potential.
Pathophysiology of Urethral Instability: Dysfunction of Smooth Urethral Musculature
Authors: Venema Pieter L. , Elzevier Hendrik W. , van Koeveringe Gommert A. , Kramer Augustinus E. , Kummeling Maxime T. M.
Published: February 2025

Aims

The aim of this study is to elucidate the pathophysiological mechanisms of urethral instability by analyzing and comparing cystometric data from a female individual with urethral instability and another with normal micturition.

Methods

Data were collected from a previous study measuring urethral pressure at three distinct points within the urethra, along with continuous needle electromyography (EMG) recordings of the external striated urethral sphincter. A comprehensive literature review on the function of different urethral muscle groups was also conducted to support the findings.

Results

The findings suggest that urethral instability primarily results from a loss of smooth muscle closure function. This condition is triggered by the interaction of pre‐existing high urethral tension and low‐level vesical afferent firing at the onset of bladder filling, causing relaxation of the urethral smooth musculature and impaired closure function of the urethra. The subsequent entry of fluid into the proximal urethra induces reflex contractions of the external sphincter, in an attempt to close the urethra and prevent urine loss and manifests as urethral instability. Compared to normal micturition, which shows a gradual decline in urethral pressure, the subject with instability exhibited rapid fluctuations in urethral pressure and EMG activity.

Conclusions

This study highlights the role of smooth urethral musculature in maintaining urethral closure function during bladder filling. Therapeutic approaches should focus on reducing basal urethral tension to preserve smooth muscle closure function during bladder filling. Future research may explore pharmacological interventions, particularly adrenergic beta‐3 receptor agonists or alpha blockers, as potential treatments for urethral instability.
Practice Patterns of Surgeons Seeking Board Certification in Urogynecology and Reconstructive Pelvic Surgery
Authors: Plaska Samuel W. , Maymi‐Castrodad Patricia , Gracely Alyssa , Daignault‐Newton Stephanie , Clemens J. Quentin , Ippolito Giulia M.
Published: February 2025

Introduction

Physician shortages are expected to worsen, especially in subspecialties like Urogynecology and Reconstructive Pelvic Surgery (URPS). To meet increasing demand, our study compares clinic visits and surgeries/procedures in URPS by reviewing clinical logs to understand practice pattern nuances.

Methods

URPS clinical logs from 2013 to 2021 were obtained from the American Board of Urology. Encounters were organized into URPS diagnostic groups, and the proportion of clinic visits to corresponding procedures was calculated. Multilevel mixed‐effects logistic regression evaluated variability between surgeons, accounting for surgeon gender, age, certification status, and patient age.

Results

Three hundred seventy URPS urologists submitted 383 424 clinic and 323 929 procedural encounters, with 49% being URPS‐related. Urinary incontinence (UI) was the most common URPS‐diagnosis. The overall proportion of clinic visit encounters to procedural/surgical encounters was 3.9:1, ranging from 1.5:1 to 111:1, depending on the diagnosis. The proportion decreases to 1.1:1 when diagnostic procedures are included in surgeries. Multilevel regression identified that 14% of the variance in our proportion was explained by variation between physicians' practice (interclass correlation, clustering of patients under a physician). In regression models we found that female surgeons had greater than 20% increased odds of evaluating patients in the clinic (vs. procedure) for the diagnoses of overactive bladder (OAB; OR = 1.27, 95% CI = 1.09−1.48, p = 0.002), stress UI (OR = 1.29, 95% CI = 1.07−1.56, p = 0.008), UI (OR = 1.32, 95% CI = 1.15−1.54, p < 0.001), and pelvic organ prolapse (POP; OR = 1.94, 95% CI = 1.56−2.41, p < 0.001).

Conclusion

Urologists applying for URPS certification perform 3.9 clinic visits for every 1 surgery, and 1.1:1 clinic visits for every procedure. We found variation was attributed to clustering under physicians (practice patterns) but also found physician gender to influence the odds of performing surgeries with women surgeons seeing more clinic patients and performing less surgeries for OAB, UI, and POP. Taken together our findings show that clinic encounters and diagnostic procedures represent a substantial portion of URPS practice.

Clinical Trials

This article is not presenting data from a clinical trial nor does it use human subjects. The data set is a deidentified retrospective log of cases.
Health Literacy and Self‐Efficacy in Parents of Toddlers—A Cross‐Sectional Study
Authors: Søreide Ragnhild Makhotso Egenberg , Larsen Marie Hamilton , Wahl Astrid Klopstad , Tschamper Merete Kristin , Urstad Kristin Hjorthaug
Published: February 2025

Aim

Young children depend on their parents to develop in a positive and healthy way. For parents to promote and maintain good health for their children, parent's level of health literacy and self‐efficacy is important. The aim of this study was to explore health literacy in parents of toddlers and investigated the associations between parental health literacy and self‐efficacy.

Design

The study utilised a quantitative cross‐sectional design.

Method

Parents (N = 76) with children between the ages of 6 weeks and 12 months were recruited from a public health centre in Norway. Multidimensional health literacy was measured using the Health Literacy Questionnaire–Parent version while self‐efficacy was measured using the General Self‐Efficacy Scale. The health literacy domains are presented by descriptive analysis. The associations among health literacy domains, demographic variables and self‐efficacy were analysed using bivariate correlations and non‐parametric tests.

Results

Health literacy scores were overall high, and self‐efficacy was positively associated with all nine health literacy dimensions. The highest score of health literacy was found for the feel that healthcare providers understand and support my child's situation dimension (median 3.8 with interquartile range 3.3–4.0). The lowest scores of health literacy were found for the appraisal of health information dimension (median 3.2 with interquartile range 3.0–3.8). Self‐efficacy had a score of median 3.5 with interquartile range 3.2–3.7.

Conclusion

The parents of toddlers in this study had high parental health literacy and self‐efficacy. Self‐efficacy was positively associated with all nine health literacy constructs. Future research should include multiple measure points to assess the dynamic variation on both parental health literacy, self‐efficacy and demographic variables.

Patient or Public Contribution

No patient or public contribution.
Skills and Competencies Needed to Use the Smart Technologies for Industry 4.0
Authors: Crețu Raluca‐Florentina , Țuțui Daniela , Banța Viorel‐Costin , Șerban Elena Claudia , Barna Laura‐Eugenia‐Lavinia , Crețu Romeo‐Cătălin
Published: February 2025

The European Parliament has declared 2023 as the European Year of Skills, which will give new impetus to lifelong learning. In this way, both citizens and economic entities will contribute to the green and digital transition, supporting innovation, creativity and competitiveness, in a world governed by the impulse of artificial intelligence. The objectives of the article consist in redefining the skills required on the labour market, in the context of the 4th Industrial Revolution and the consequences of the implementation of the AI system in economic and business education. In order to achieve these objectives, the authors used mixed research. Data were collected for 27 countries and 13 indicators, in the period of 2015–2021, from the database of the CEDEFOP and were processed with PASW (quantitative research). Qualitative research in the design science of the automation of repetitive processes within economic processes, specifically the economic process of managing special orders, used the experiment as a working tool. The research results indicate certain correlations between various indicators, which will impose a series of changes in the academic environment in terms of adapting disciplines to new requirements, in order to insert new knowledge related to the understanding and use of intelligent technologies.
CRISPR in Zebrafish
Authors: Challa Anil Kumar
Published: February 2025

What You Will Learn in This Chapter

Zebrafish is a good model organism to use with CRISPR technology, in the undergraduate laboratory environment

Important steps involved in undertaking CRISPR work in zebrafish

Possible pitfalls while using CRIPSR-Cas9 methods in the zebrafish system

How CRISPR can be used in zebrafish with UG students
IRMA: Machine learning-based harmonization of $$^{18}$$F-FDG PET brain scans in multi-center studies
Authors: Lövdal S.S. , van Veen R. , Carli G. , Renken R. J. , Shiner T. , Bregman N. , Orad R. , Arnaldi D. , Orso B. , Morbelli S. , Mattioli P. , Leenders K. L. , Dierckx R. , Meles S. K. , Biehl M. ,   for the Alzheimer’s Disease Neuroimaging Initiative
Published: February 2025

Purpose

Center-specific effects in PET brain scans arise due to differences in technical and procedural aspects. This restricts the merging of data between centers and introduces source-specific bias.

Methods

We demonstrate the use of the recently proposed machine learning method Iterated Relevance Matrix Analysis (IRMA) for harmonization of center-specific effects in brain

$$^{18}$$

18

F-Fluorodeoxyglucose (

$$^{18}$$

18

F-FDG) PET scans. The center difference is learned by applying IRMA on PCA-based feature vectors of healthy controls (HC), resulting in a subspace

$$\varvec{V}$$

V

, representing information not comparable between centers, and the remaining subspace

$$\varvec{U}$$

U

, where no center differences are present. In this proof-of-concept study, we demonstrate the properties of the method using data from four centers. After center-harmonization, a Generalized Matrix Learning Vector Quantization (GMLVQ) model was trained to discriminate between Parkinson’s disease, Alzheimer’s disease and Dementia with Lewy Bodies.

Results

At the initial IRMA iteration, the system was able to determine the center origin of the four HC cohorts almost perfectly. The method required six iterations, corresponding to a six-dimensional subspace

$$\varvec{V}$$

V

, to determine the entire center difference. An uncorrected disease classification model was highly biased to center-specific effects, creating a falsely inflated performance when applying internal (cross-) validation. The cross-validation performance of the center-harmonized model remained high, while it generalized significantly better to unseen test cohorts. Furthermore, the framework is highly transparent, providing analytic reconstructions of the correction and visualizations of the data in voxel space.

Conclusion

IRMA can be used to learn and disregard center-specific information in features extracted from brain

$$^{18}$$

18

F-FDG PET scans, while retaining disease-specific information.
Wissen, Lehrumfang und Stereotype bezüglich Psychosen bei Psychotherapeut:innen in Ausbildung
Authors: Petzold Moritz Bruno , Chaurois Morgane , Bröcker Anna-Lena , Betzler Felix , Ströhle Andreas , Bendau Antonia
Published: February 2025

Hintergrund

Psychotherapie bei Menschen mit Psychosen galt lange als kontraindiziert. In der heutigen Zeit empfehlen Leitlinien und die Psychotherapierichtlinie die Psychotherapie in allen Behandlungsphasen. Studien zeigen, dass diese neuen Erkenntnisse nur langsam in die Praxis gelangen und eine große Versorgungslücke in diesem Bereich besteht.

Ziel der Arbeit

Die vorliegende Studie untersucht, was Psychologische Psychotherapeut:innen in Ausbildung über Psychotherapie bei Psychosen wissen, wie viel Lehre sie dazu erhalten, wie gut sie sich auf die Behandlung von Menschen mit einer Psychose vorbereitet fühlen, und welche Stereotype bestehen.

Material und Methoden

Es handelt sich um eine querschnittliche Studie mit einer Gelegenheitsstichprobe von 235 Psychotherapeut:innen in Ausbildung, die mittels Online-Fragebogen untersucht wurden.

Ergebnisse

Nur etwa 40 % der Befragten gaben an, in ihrer Ausbildung konkrete Inhalte einer Psychotherapie bei Menschen mit Psychose vermittelt bekommen zu haben. Im Vergleich zu anderen Störungsbildern fühlten sie sich weniger gut auf die Behandlung von Menschen mit einer Psychosen vorbereitet. Über 70 % der Teilnehmenden äußerten den Wunsch, in der Ausbildung mehr Inhalte vermittelt zu bekommen. Selbstberichtete Stereotype bezüglich Psychosen waren in der Stichprobe sehr niedrig ausgeprägt.

Diskussion

Wenngleich alte Stereotype bezüglich Psychosen bei Psychotherapeut:innen in Ausbildung kaum vorhanden scheinen und ein großes Interesse an Psychosenpsychotherapie besteht, zeigt sich ein deutlicher Verbesserungsbedarf bei der Vermittlung von Wissen und Kompetenzen für die Behandlung von Menschen mit Psychosen in der psychotherapeutischen Ausbildung.