bluuebunny/crossref_metadata_2025 huggingface dataset:
Sustainability partnership as a moderator in the relationship between business sustainability and firm competitiveness
Authors: Saunila Minna , Ukko Juhani , Kinnunen Jorma
Published: June 2023

This paper empirically examines the relationship between business sustainability and firm competitiveness and the role of sustainability partnerships in the relationship between business sustainability and firm competitiveness. By classifying two dimensions (environmental sustainability and social sustainability) that are needed to realize business sustainability, this study suggests that a sustainability partnership serves as a moderator in the relation between business sustainability and firm competitiveness. Three developed hypotheses were tested using regression analysis to find the relationship between business sustainability, sustainability partnership, and firm competitiveness. Using a structured survey questionnaire, the data were collected from 135 firms that operate in construction industries in Finland. The findings suggest that investing in environmental sustainability will directly improve firm competitiveness, but investing in social sustainability will not. In addition, sustainability partnerships serve as a promoter in the relationship between social sustainability and firm competitiveness but inhibit the relationship between environmental sustainability and firm competitiveness.
Identification of predictors of long‐term survival and prognostic outcomes in thymic squamous cell carcinoma: A real‐world study
Authors: Zhou Meng‐Xin , Chen Ye‐Ye , Huang Cheng , Liu Lei , Wang Gui‐Ge , Zhang Jia‐Qi , Bai Wen‐Liang , Zhao Ke , Li Shan‐Qing
Published: June 2023

Background

Although thymic squamous cell carcinoma (TSCC) is among the most prevalent forms of thymic carcinoma, there are relatively few studies on this tumor type, and its staging, optimal treatment strategies, and relevant prognostic factors remain controversial.

Methods

The present study analyzed 79 patients diagnosed with TSCC between January 2008 and January 2021. Kaplan–Meier curves and Cox univariate and multivariate regression analyses were used to explore factors associated with overall survival (OS) and progression‐free survival (PFS) in the overall patient cohort and patient subgroups stratified according to the TNM stage. Time‐dependent receiver operating characteristic (ROC) analyses were used to compare the TNM and Masaoka systems as predictors of patient prognosis.

Results

The 5‐ and 10‐year OS rates in this study were 65.5% and 49.4%, respectively, with corresponding 5‐ and 10‐year PFS rates of 52.3% and 37.9%. Survival outcomes were better for patients with early‐stage disease (p < 0.001) and patients that underwent surgical treatment (p < 0.001). Neither extent of resection (p = 0.820) nor the surgical approach (p = 0.444) influenced patient survival. In individuals with advanced disease, all forms of adjuvant therapy including radiotherapy (p = 0.021), chemotherapy (p = 0.035), and chemoradiation (p = 0.01) significantly improved patient PFS, but only adjuvant chemoradiotherapy improved patient OS (p = 0.035). When predicting the patient survival outcomes, the TNM system was slightly superior to the Masaoka system (area under the ROC curve [AUC] at 5 years: OS, 0.742 vs. 0.723; PFS, 0.846 vs. 0.816).

Conclusion

TSCC is an orphan malignancy with a poor prognosis. TNM staging may be superior to Masaoka staging as a predictor of TSCC patient prognosis. Surgery is the mainstay of TSCC treatment. Video‐assisted thoracoscopy (VATS) should be considered for selected patients. Multimodal therapy was associated with excellent results for patients with advanced TNM stage, particularly when surgery was accompanied by adjuvant chemoradiation.
Immunohistochemistry and oxygen saturation endoscopic imaging reveal hypoxia in submucosal invasive esophageal squamous cell carcinoma
Authors: Minakata Nobuhisa , Sakashita Shingo , Wakabayashi Masashi , Nakamura Yuka , Sunakawa Hironori , Yoda Yusuke , Ishii Genichiro , Yano Tomonori
Published: June 2023

Background

Hypoxic microenvironment is prominent in advanced esophageal squamous cell carcinoma (ESCC). However, it is unclear whether ESCC becomes hypoxic when it remains in the mucosal layer or as it invades the submucosal layer. We aimed to investigate whether intramucosal (Tis‐T1a) or submucosal invasive (T1b) ESCC becomes hypoxic using endoscopic submucosal dissection samples.

Methods

We evaluated the expression of hypoxia markers including hypoxia inducible factor 1α (HIF‐1α), carbonic anhydrase IX (CAIX), and glucose transporter 1 (GLUT1) by H‐score and vessel density by microvessel count (MVC) and microvessel density (MVD) for CD31 and α‐smooth muscle actin (α‐SMA) with immunohistochemical staining (n = 109). Further, we quantified oxygen saturation (StO2) with oxygen saturation endoscopic imaging (OXEI) (n = 16) and compared them to non‐neoplasia controls, Tis‐T1a, and T1b.

Results

In Tis‐T1a, cccIX (13.0 vs. 0.290, p < 0.001) and GLUT1 (199 vs. 37.6, p < 0.001) were significantly increased. Similarly, median MVC (22.7/mm2 vs. 14.2/mm2, p < 0.001) and MVD (0.991% vs. 0.478%, p < 0.001) were markedly augmented. Additionally, in T1b, the mean expression of HIF‐1α (16.0 vs. 4.95, p < 0.001), CAIX (15.7 vs. 0.290, p < 0.001), and GLUT1 (177 vs. 37.6, p < 0.001) were significantly heightened, and median MVC (24.8/mm2 vs. 14.2/mm2, p < 0.001) and MVD (1.51% vs. 0.478%, p < 0.001) were markedly higher. Furthermore, OXEI revealed that median StO2 was significantly lower in T1b than in non‐neoplasia (54% vs. 61.5%, p = 0.00131) and tended to be lower in T1b than in Tis‐T1a (54% vs. 62%, p = 0.0606).

Conclusion

These results suggest that ESCC becomes hypoxic even at an early stage, and is especially prominent in T1b.
YAP/STAT3 inhibited CD8+ T cells activity in the breast cancer immune microenvironment by inducing M2 polarization of tumor‐associated macrophages
Authors: Wang Chen , Shen Ningning , Guo Qingling , Tan Xiaohua , He Shaozhong
Published: June 2023

Background

Breast cancer (BC) is the leading cause of cancer‐related death among women. One of the hallmarks of cancer is sustained angiogenesis. YAP/STAT3 may promote angiogenesis and driving BC progression. This study aimed to investigate how YAP/STAT3 affects the immune microenvironment in BC and understand the underlying mechanism.

Methods

To establish a tumor‐associated macrophages (TAMs) model, macrophages were cultured in the 4T1 cell culture medium. A BC mouse model was created by injecting 4T1 cells. The expression of YAP, STAT3, p‐STAT3, VEGF, VEGFR‐2, and PD‐L1 was analyzed using immunofluorescence, western blotting, and quantitative real‐time PCR. Flow cytometry was used to identify M1 and M2 macrophages, CD4+ T, CD8+ T, and Treg cells. Levels of iNOS, IL‐12, IL‐10, TGF‐β, Arg‐1, and CCL‐22 were measured using enzyme‐linked immunosorbent assay. Co‐IP was used to verify whether YAP binds to STAT3. Hematoxylin–eosin staining was used to observe tumor morphology. Cell counting kit‐8 was selected to detect T‐cell proliferation.

Results

YAP, STAT3, P‐STAT3, VEGF, VEGFR‐2, and PD‐L1 were highly expressed in BC tissues. The M2/M1 macrophages ratio increased in the TAMs group compared with the control group. Inhibiting of YAP and STAT3 decreased the M2/M1 macrophages ratio. YAP was found to bind with STAT3. T‐cell proliferation was enhanced after YAP inhibition, and overexpression of STAT3 reversed the regulation of YAP on T‐cell proliferation. In animal studies, inhibiting YAP inhibited tumor weight and volume development. After YAP inhibition, inflammatory infiltration, M2/M1 macrophage ratio, and Treg cell ratio declined, while CD8+ and CD4+ T‐cell ratio increased.

Conclusion

In conclusion, this study suggested inhibition of YAP/STAT3 reversed M2 polarization of TAMs and suppressed CD8+ T‐cell activity in the BC immune microenvironment. These findings open up new avenues for the development of innovative therapies in the treatment of BC.
Clinical and metabolomic characterization of Brivanib‐Induced hypertension in metastatic colorectal cancer
Authors: Rattner Jodi I. , Kopciuk Karen A. , Vogel Hans J. , Tang Patricia A. , Shapiro Jeremy D. , Tu Dongsheng , Jonker Derek J. , Siu Lillian L. , O'Callaghan Chris J. , Bathe Oliver F.
Published: June 2023

Background

Trials of tyrosine kinase inhibitors (TKI) have not demonstrated dramatic benefits in advanced colorectal cancer (CRC), and this may be a function of poor patient selection. TKI‐induced hypertension is reportedly a surrogate marker for treatment benefit for some tumor types. Our objective was to determine whether hypertension was associated with benefit in the context of CRC treatment, and also to gain insight on the pathogenesis of TKI‐induced hypertension by monitoring associated changes in the circulating metabolome.

Patients and Methods

Clinical data were acquired from clinical trial patients with metastatic CRC randomized to cetuximab ± the TKI brivanib (N = 750). Outcomes were evaluated as a function of treatment‐induced hypertension. For metabolomic studies, plasma samples were taken at baseline, as well as at 1, 4, and 12 weeks after treatment initiation. Samples were submitted to gas chromatography–mass spectrometry to identify treatment‐related metabolomic changes associated with TKI‐induced hypertension, compared to pre‐treatment baseline. A model based on changes in metabolite concentrations was generated using orthogonal partial least squares discriminant analysis (OPLS‐DA).

Results

In the brivanib treated group, 95 patients had treatment‐related hypertension within 12 weeks of initiating treatment. TKI‐induced hypertension was not associated with a significantly higher response rate, nor was it associated with improved progression‐free or overall survival. In metabolomic studies, 386 metabolites were identified. There were 29 metabolites that changed with treatment and distinguished patients with and without TKI‐induced hypertension. The OPLS‐DA model for brivanib‐induced hypertension was significant and robust (R2Y score = 0.89, Q2Y score = 0.70, CV‐ANOVA = 2.01 e‐7). Notable metabolomic features previously reported in pre‐eclampsia and associated with vasoconstriction were found.

Conclusion

TKI‐induced hypertension was not associated with clinical benefit in metastatic CRC. We have identified changes in the metabolome that are associated with the development of worsening brivanib‐induced hypertension that may be useful in future efforts of characterizing this toxicity.
The prognostic and predictive roles of plasma C‐reactive protein and PD‐L1 in non‐small cell lung cancer
Authors: Kuusisalo Saara , Tikkanen Antti , Lappi‐Blanco Elisa , Väisänen Timo , Knuuttila Aija , Tiainen Satu , Ahvonen Jarkko , Iivanainen Sanna , Koivunen Jussi P.
Published: June 2023

Background

Anti‐PD‐(L)1 agents have revolutionized the treatment paradigms of non‐small cell lung cancer (NSCLC), while predictive biomarkers are limited. It has been previously shown that systemic inflammation, indicated by elevated C‐reactive protein (CRP) level, is associated with a poor prognosis in anti‐PD‐(L)1 treated. The aim of the study was to analyze the prognostic and predictive value of CRP in addition to traditional prognostic and predictive markers and tumor PD‐L1 score.

Methods

We identified all NSCLC patients (n = 329) who had undergone PD‐L1 tumor proportion score (TPS) analysis at Oulu University Hospital 2015–22. CRP levels, treatment history, immune checkpoint inhibitor (ICI) therapy details, and survival were collected. The patients were categorized based on CRP levels (≤10 vs. >10) and PD‐L1 TPS scores (<50 vs. ≥50).

Results

In the whole cohort (n = 329), CRP level of ≤10 mg/L was associated with improved survival in univariate (HR 0.30, Cl 95% 0.22–0.41) and multivariate analyzes (HR 0.44, CI 95% 0.28–0.68). With ICI treated (n = 70), both CRP of ≤10 and PD‐L1 TPS of ≥50 were associated with improved progression‐free survival (PFS) in univariate (HR 0.51, CI 95% 0.27–0.96; HR 0.54, CI 95% 0.28–1.02) and multivariate (HR 0.48, CI 95% 0.26–0.90; HR 0.50, CI 95% 0.26–0.95) analyzes. The combination (PD‐L1 TPS ≥50 and CRP >10) carried a high negative predictive value with a median PFS of 4.11 months (CI 95% 0.00–9.63), which was similar to patients with low PD‐L1 (4.11 months, CI 95% 2.61–5.60).

Conclusions

Adding plasma CRP levels to PD‐L1 TPS significantly increased the predictive value of sole PD‐L1. Furthermore, patients with high CRP beard little benefit from anti‐PD‐(L)1 therapies independent of PD‐L1 score. The study highlights the combined evaluation of plasma CRP and PD‐L1 TPS as a negative predictive marker for ICI therapies.
Design, Synthesis, Biological Evaluation and Molecular Docking Studies of Quercetin‐Linker‐H2S Donor Conjugates for the Treatment of Diabetes and Wound Healing**
Authors: He Shibo , Liu Jian , Hu Lifei , Zhan Yifeng , Tong Hang , Zhu Hongda , Guo Huiling , Sun Hongmei , Liu Mingxing
Published: June 2023

Based on the use of quercetin for treating diabetes and H2S for promoting wound healing, a series of three quercetin‐linker‐H2S donor conjugates was designed, synthesized and characterized by 1H‐NMR, 13C‐NMR and MS. Meanwhile, in vitro evaluation of these compounds was also researched by IR‐HepG2 treatment experiment, MTT assay, scratch test and tubule formation experiment. The three compounds could be used to treat insulin resistance induced by high glucose and promote the proliferation of human umbilical vein endothelial cells, wound healing, and the formation of tubules in vitro under a high‐glucose environment. Our results illustrate that these compounds could be used to treat diabetes and promote wound healing at the same time. Furthermore, molecular docking study results of the compounds were consistent with the evaluated biological activity. In vivo research of compounds is underway.
Heterotaxy pattern associated with sinus node dysfunction in an adult: A case report
Authors: Shah Naman , Acharya Sankalp , Tripathi Apoorva , Bisht Himanshi , Shah Maitri , Pareek Aayushi , Gera Asmita , Shrestha Abhigan Babu , Jaiswal Vikash
Published: June 2023

Key Clinical Message

A 26‐year‐old male patient admitted to the hospital ward with experience of repetitive syncopes for a year. The patient was diagnosed with sick sinus syndrome. The aim of this clinical report is to highlight the variability of anatomical findings associated with polysplenia pattern.

This case report presents a 26‐year‐old male patient who presented to the medical ward with a complaint of repeating blackouts for a year. The patient was then diagnosed with sick sinus syndrome, and further investigations revealed left isomerism, polysplenia, and no congenital heart defects. Holter monitoring, ultrasonography, electrocardiography, and computed tomography were used to confirm the diagnosis. The patient underwent DDDR pacemaker implantation for the treatment of SA node dysfunction. The report highlights the variability of anatomical findings associated with polysplenia pattern and the various types of heartbeat disruptions that may occur in the atrial appendages of the left side isomerism.
Renal arteriovenous fistula discovered ~2 years after renal biopsy: A case report
Authors: Oyama Maki , Tamura Hiroshi , Hidaka Yuko , Furuie Keishiro , Kuraoka Shohei
Published: June 2023

Key Clinical Message

Although percutaneous renal biopsy is considered safe, this invasive procedure has complications such as renal arteriovenous fistula (RAVF). Even if complications such as RAVFs are not observed early after renal biopsy, considering the possibility of delayed renal hemorrhage, follow‐up with ultrasound after renal biopsy even in asymptomatic cases could be important.

Although percutaneous renal biopsy is considered safe, this invasive procedure can lead to complications such as renal arteriovenous fistula (RAVF). RAVF occurs when some arteries and veins communicate in the absence of capillaries in the renal hilum or renal parenchyma. It was previously thought to be relatively rare; however, with advances in imaging diagnostics, it is sometimes found asymptomatically. In addition, renal biopsy is the most common cause of acquired RAVF. In this case, RAVF was discovered 2 years after renal biopsy. Late‐onset RAVF is scarce. This case highlights that even if complications such as RAVFs are not observed early after renal biopsy, considering the possibility of delayed RAVF, follow‐up with ultrasound could be important.
A successfully treated gastric mucormycosis in an immunocompetent patient: Case report and literature review
Authors: Albtoosh Asma Salameh , Shaf'ei Moayad , Al Hayek Sa'ed , Ramdan Lara Ibrahim , Abu Shahin Nisreen , Alzyoud Mohammad , Farah Randa
Published: June 2023

Mucormycosis is an opportunistic fungal infection that usually affects patients with diabetes mellitus or immunosuppression. The fungus invades the nearby blood vessels leading to thrombosis and necrosis of the organs involved. Although Mucorales can invade any organ in the body, the gastrointestinal system is an uncommon site for infection. Mucormycosis is a fatal infection, and prompt intervention is required to ensure survival. In this report, we present a case of a 46‐year‐old man with history of valve replacement surgery on warfarin, who admitted with abdominal pain and life‐threatening gastrointestinal bleeding. Esophagogastroduodenoscopy revealed an active gastric ulcer bleeding, and the diagnosis of mucormycosis infection was confirmed with direct microscopy and histopathological evaluation from a tissue biopsy. Typically, antifungal therapy alone is inadequate to control mucormycosis infection and surgical intervention is often required. Our patient was successfully treated using antifungal therapy alone. This report presents a rare case of gastrointestinal mucormycosis in setting of valve replacement and was successfully treated with antifungal therapy.
F‐quad helix for simultaneous maxillary expansion and tooth alignment in patients with unilateral cleft lip and/or palate
Authors: Fahim Fady Hussein , Othman Ahmed , von See Constantin
Published: June 2023

Key Clinical Message

Illustrating F‐quad helix with extension arms that simultaneously expand maxillary arch and rotate its central incisor adjacent to the alveolar cleft while aligning palatally ectopic canines. Incisor rotation occurred before alveolar grafting, while canine traction was performed after alveolar grafting. The construction of this appliance is shown in detail.
Oriented External Electric‐Field Effects on the Activation of Aryl CO Bond in Anisole using Rh(PEP) (E=Al, B, Ga) Catalysts
Authors: Kuriakose Nishamol , Shaik Sason
Published: June 2023

The present work reports a DFT‐based mechanistic investigation of aryl C−O bond activation in anisole catalysed by a Rh−Al pincer‐type complex at room temperature. The study is extended to analogues Rh−E complexes based on Group 13 elements (E=B/Ga). Our results show a preference for the heterolytic cleavage pathway over oxidative addition in the C−O bond activation. The calculated barriers range from 16 to 36 kcal/mol, following the order: E=Al<E=Ga<E=B. A strong correlation between the activation barriers and the local electric field (LEF) at the Rh metal centre for the studied Rh−E complexes was observed. Additionally, the ability of Oriented External Electric Field (OEEF) to lower the reaction barrier by applying the OEEF along the direction of electron reorganization, that is, “the reaction axis”, was examined. Our results demonstrate the significant effect of applied OEEF on the aryl C−O bond activation in Rh−E systems. Furthermore, the effect of OEEF on the C−O bond activation using modified Rh−E (E=B, Al, or Ga) complexes, in which electronic structure modifications enable a more efficient barrier control by the OEEF, was showcased. Notably, applying a moderate field strength reduces the high reaction barrier for the Rh−B system by approximately 13 kcal/mol.
Natural Sesquiterpenoids, Diterpenoids, Sesterterpenoids, and Triterpenoids with Intriguing Structures from 2017 to 2022
Authors: Zhang Xiaotian , Zheng Meijia , Fu Aimin , Li Qin , Chen Chunmei , Zhu Hucheng , Zhang Yonghui
Published: June 2023

Comprehensive Summary

This review covers the isolation, structural determination, plausible biosynthetic pathways, and biological activities of 166 natural terpenoids including 57 sesquiterpenoids, 65 diterpenoids, 15 sesterterpenoids, and 29 triterpenoids from January 2017 to December 2022.
Ecological restoration of tidal flat and its effects on soil characteristic and bacterial community
Authors: Gu Chen , Shi Jiyan , Yu Yanming , Rui Jianliang , Huang Weibin , Lu Zhinai , Chen Yao , Chen Xiaojun , Dong Shudi , Hu Zhijun , Lyu Jianbiao , Ye Chenghua
Published: June 2023

Vegetation restoration is a vital ecological remediation technology for greening saline‐alkaline soils. However, little attention is paid to the seasonal changes of soil remediation under different vegetation coverage. This study investigated a recently restored coastal tidal flat located on the island of Zhoushan, by examining shifts in physicochemical properties, enzyme activities, and bacterial communities over 1 year. Soils under Suaeda australis (SUA), Phragmites australis (PHR), Tamarix chinensis (TAM), and two hybrid treatments (SUA+PHR and SUA+TAM) were collected seasonally. Results showed that the seasonal climate variations and vegetation types played important roles in soil physicochemical properties and soil enzyme activities during vegetation restoration. Vegetation could stimulate the activities of soil microbial enzymes, of which PHR‐covered soils exhibited higher catalase activities, higher alkaline phosphomonoesterase activities were observed in summer except for PHR. The combined communities had the highest urease activities in spring and summer, and the highest levels of polyphenol oxidase activity were found in summer or autumn. Furthermore, the bacterial alpha diversity revealed that SUA‐ and SUA+PHR‐covered soils were not markedly affected as the season progressed, whereas PHR and SUA+TAM were characterized by an increase–decrease trend, as well as TAM exhibited highest in autumn. Proteobacteria, Bacteroidetes, Acidobacteria, Actinobacteria, and Chloroflexi were the dominant phyla in each vegetation types. This study deepens our understanding of the effects of halophyte cultivation on coastal ecosystem phytoremediation.
Insights into the mechanism of plastics’ fragmentation under abrasive mechanical forces: An implication for agricultural soil health
Authors: Bhattacharjee Linkon , Jazaei Farhad , Salehi Maryam
Published: June 2023

The application of agricultural plastic products such as mulch, greenhouse covers, and silage films is increasing due to their economic benefits in providing an early and better‐quality harvest. However, mechanical abrasion of these plastic materials by soil particles could result in generation of microplastic (MP) pollutants that could harm soil organisms and impact food safety. This study aims to better understand the physicochemical mechanisms resulting in the fragmentation of low‐density polyethylene (LDPE). Herein, we used pellets and films to study the impacts of abrasive wear forces on their surface morphology variations and fragmentation behavior. An innovative laboratory approach was developed to abrade the plastic surface under controlled normal loadings and abrasion durations. The investigation of the plastics’ surface morphology variations due to the abrasion process revealed microcutting as the dominant process at low normal force (4 N). However, a combination of microploughing and microcutting occurred for new LDPE films by increasing the normal force to 8 N. Despite the significant surface morphology variations of the new LDPE film due to the abrasion process; the water contact angle did not alter. Furthermore, the fragmentation behavior of photodegraded LDPE pellets and films was compared to the new plastics. The extent of MPs (3 µm < dp < 162 µm) generation due to fragmentation was studied using fluorescence microscopy imaging. The localized stress and strains at the contact sites of plastic and sand particles resulted in abrasion of the plastic surface. According to the results, the normal loadings and duration of abrasion played a significant role in the degree of fragmentation of plastics. Increasing the normal loading applied during the abrasion process from 2 to 8 N linearly increased the number of generated plastic fragments by more than five times for pellets and more than three times for film. Photodegradation significantly enhanced the extent of MPs fragmentation. Moreover, the limitations of this study and the implications for agricultural soil health were discussed.
The cost burden of metastatic prostate cancer in the US populations covered by employer‐sponsored health insurance
Authors: Horný Michal , Yabroff K. Robin , Filson Christopher P. , Zheng Zhiyuan , Ekwueme Donatus U. , Richards Thomas B. , Howard David H.
Published: June 2023

Background

Recent advancements in the clinical management of metastatic prostate cancer include several costly therapies and diagnostic tests. The objective of this study was to provide updated information on the cost to payers attributable to metastatic prostate cancer among men aged 18 to 64 years with employer‐sponsored health plans and men aged 18 years or older covered by employer‐sponsored Medicare supplement insurance.

Methods

By using Merative MarketScan commercial and Medicare supplemental data for 2009–2019, the authors calculated differences in spending between men with metastatic prostate cancer and their matched, prostate cancer‐free controls, adjusting for age, enrollment length, comorbidities, and inflation to 2019 US dollars.

Results

The authors compared 9011 patients who had metastatic prostate cancer and were covered by commercial insurance plans with a group of 44,934 matched controls and also compared 17,899 patients who had metastatic prostate cancer and were covered by employer‐sponsored Medicare supplement plans with a group of 87,884 matched controls. The mean age of patients with metastatic prostate cancer was 58.5 years in the commercial samples and 77.8 years in the Medicare supplement samples. Annual spending attributable to metastatic prostate cancer was $55,949 per person‐year (95% confidence interval [CI], $54,074–$57,825 per person‐year) in the commercial population and $43,682 per person‐year (95% CI, $42,022–$45,342 per person‐year) in the population covered by Medicare supplement plans, both in 2019 US dollars.

Conclusions

The cost burden attributable to metastatic prostate cancer exceeds $55,000 per person‐year among men with employer‐sponsored health insurance and $43,000 among those covered by employer‐sponsored Medicare supplement plans. These estimates can improve the precision of value assessments of clinical and policy approaches to the prevention, screening, and treatment of prostate cancer in the United States.
SpecMap: An efficient spectral partitioning based static application mapping algorithm for 2D mesh NoCs
Authors: Raj R. S. Reshma , Joseph Athul , H. Akhil Sarwar T. , Kalady Saidalavi , B. Jayaraj P.
Published: June 2023

Network‐on‐chip (NoC) is adopted as a flexible and effective communication backbone by multiprocessor systems with core counts ranging from a few to hundreds. The performance of NoC based systems greatly rely on the communication between cores when two dependent tasks of an application are mapped to these cores. Hence, application mapping becomes a critical issue in NoC‐based systems as it affects the overall performance of the system. Application mapping aims to reduce the communication among the cores by carefully mapping the highly communicating tasks. Most of the existing static mapping approaches consider only single‐task platforms. In this article, we propose an efficient multi‐task static mapping algorithm called , for regular 2D NoC systems. consists of three stages namely, (i) graph partitioning, (ii) topology clustering, and (iii) mapping. In the graph partitioning stage, accurately identifies and groups the highly communicating tasks based on spectral graph partitioning. Then, the clustering and mapping stages allocate the most communicating tasks in the same or adjacent multi‐tasking cores. It also eliminates the interference between multiple applications by mapping them into different clusters of the NoC network. Simulations of have been conducted on different synthetic and real‐life applications using Gem5 simulator. The simulation results show considerable improvements for SpecMap in terms of communication cost, average network latency, energy consumption, throughput, and execution time as compared to the state‐of‐the‐art algorithms.
Optimizing Li‐ion Solvation in Gel Polymer Electrolytes to Stabilize Li‐Metal Anode
Authors: Huang Kangsheng , Bi Sheng , Xu Hai , Wu Langyuan , Fang Chang , Zhang Xiaogang
Published: June 2023

Gel polymer electrolytes (GPEs) have potential as substitutes for liquid electrolytes in lithium‐metal batteries (LMBs). Their semi‐solid state also makes GPEs suitable for various applications, including wearables and flexible electronics. Here, we report the initiation of ring‐opening polymerization of 1,3‐dioxolane (DOL) by Lewis acid and the introduction of diluent 1,1,2,2‐tetrafluoroethyl 2,2,3,3‐tetrafluoropropyl ether (TTE) to regulate electrolyte structure for a more stable interface. This diluent‐blended GPE exhibits enhanced electrochemical stability and ion transport properties compared to a blank version without it. FTIR and NMR proved the effectiveness of monomer polymerization and further determined the molecular weight distribution of polymerization by gel permeation chromatography (GPC). Experimental and simulation results show that the addition of TTE enhances ion association and tends to distribute on the anode surface to construct a robust and low‐impedance SEI. Thus, the polymer battery achieves 5 C charge‐discharge at room temperature and 200 cycles at low temperature −20 °C. The study presents an effective approach for regulating solvation structures in GPEs, promoting advancements in the future design of GPE‐based LMBs.
Flow cytometry improves the diagnostic value of fine needle aspiration cytology in a spleen with neuroendocrine tumor: A case report
Authors: Hussain Mahreen , Rawas Faisal , Ali Yasir , Edhayan Gautam , Lyapichev Kirill A. , Nawgiri Ranjana
Published: June 2023

Fine needle aspirations are infrequently performed on the spleen due to concerns for hemorrhagic complications. As a result, splenic lesions can be challenging to diagnose given the limited amount of available specimen. Metastasis to the spleen is rare and metastatic neuroendocrine tumors to the spleen are scarce in literature. The diagnosis of splenic lesions from fine needle aspirate entails processing which prolongs the turnaround time, particularly if the cytomorphology is non‐typical and a limited sample can further complicate this process. We describe a case in which flow cytometry performed on fine needle aspiration of a splenic lesion suggested a diagnosis of neuroendocrine neoplasm involving the spleen. Further workup confirmed this diagnosis. Flow cytometry can recognize neuroendocrine tumors involving the spleen in a timely manner so that appropriate immunohistochemistry tests on limited specimens can be performed to aid in their accurate diagnosis.
Transmission of beneficial yeasts accompanies offspring production in Drosophila—An initial evolutionary stage of insect maternal care through manipulation of microbial load?
Authors: Cho Hanna , Rohlfs Marko
Published: June 2023

Parent‐to‐offspring transmission of beneficial microorganisms is intimately interwoven with the evolution of social behaviors. Ancestral stages of complex sociality–microbe vectoring interrelationships may be characterized by high costs of intensive parental care and hence only a weak link between the transmission of microbial symbionts and offspring production. We investigate the relationship between yeast symbiont transmission and egg‐laying, as well as some general factors thought to drive the “farming” of microscopic fungi by the fruit fly Drosophila melanogaster, an insect with no obvious parental care but which is highly dependent on dietary microbes during offspring development. The process of transmitting microbes involves flies ingesting microbes from their previous environment, storing and vectoring them, and finally depositing them to a new environment. This study revealed that fecal materials of adult flies play a significant role in this process, as they contain viable yeast cells that support larval development. During single patch visits, egg‐laying female flies transmitted more yeast cells than non‐egg‐laying females, suggesting that dietary symbiont transmission is not random, but linked to offspring production. The crop, an extension of the foregut, was identified as an organ capable of storing viable yeast cells during travel between egg‐laying sites. However, the amount of yeast in the crop reduced rapidly during periods of starvation. Although females starved for 24 h deposited a smaller amount of yeast than those starved for 6 h, the yeast inoculum produced still promoted the development of larval offspring. The results of these experiments suggest that female Drosophila fruit flies have the ability to store and regulate the transfer of microorganisms beneficial to their offspring via the shedding of fecal material. We argue that our observation may represent an initial evolutionary stage of maternal care through the manipulation of microbial load, from which more specialized feedbacks of sociality and microbe management may evolve.
Estimating density of forest bats and their long‐term trends in a climate refuge
Authors: Law Bradley , Brassil Traecey , Proud Roland , Potts Joanne
Published: June 2023

For many species, estimating density is challenging, but it is important for conservation planning and understanding the functional role of species. Bats play key ecological roles, yet little is known about their free‐ranging density. We used a long‐term banding study of four species caught in an extensively forested climate refuge and spatial capture–recapture models (SCR) to estimate density and its change over time. Between 1999 and 2020, there were 3671 captures of four bat species, which were all edge‐space foragers. Recaptures represented 16% (n = 587) of all captures, of which 89 were between‐trap‐cluster movements. Closed spatial mark–recapture models estimated plausible densities that varied with elevation. Preferred elevations differed between species, with density averaging 0.63 ha−1forVespadelus darlingtoni(high elevation), 0.43 ha−1forV. pumilus(low elevation), 0.19 ha−1forChalinolobus morio(high elevation), and 0.08 ha−1forV. regulus(high elevation). Overall, densities were higher than most previous published estimates for bats. Forest disturbance history (past timber harvesting) had no detectable effect on density. Density also varied substantially across years, and although annual maximum temperature and rainfall were not supported in models, some time periods showed an apparent relationship between density and annual rainfall (+ve) and/or annual maximum temperature (−ve). The most notable change was an increase in the density ofV. pumilusafter 2013, which tracked an increase in annual temperature at the site, reflecting a warming climate. Bat densities in forests outside of climate refugia are likely to be more sensitive to climate change, but more studies are needed in different habitats and continents and outside climate refugia to place the densities we estimated into a broader context.
Differentiation of epilepsy and psychogenic nonepileptic events based on body fluid characteristics
Authors: Xia Yilin , Lai Wanlin , Li Shihai , Wen Zhining , Chen Lei
Published: June 2023

Objective

Differential diagnosis between epileptic seizures and psychogenic nonepileptic events (PNEEs) is a worldwide problem for neurologists. The present study aims to identify important characteristics from body fluid tests and develop diagnostic models based on them.

Methods

This is a register‐based observational study in patients with a diagnosis of epilepsy or PNEEs at West China Hospital of Sichuan University. Data from body fluid tests between 2009 and 2019 were used as a training set. We constructed models with a random forest approach in eight training subsets divided by sex and categories of tests, including electrolyte, blood cell, metabolism, and urine tests. Then, we collected data prospectively from patients between 2020 and 2022 to validate our models and calculated the relative importance of characteristics in robust models. Selected characteristics were finally analyzed with multiple logistic regression to establish nomograms.

Results

A total of 388 patients, including 218 with epilepsy and 170 with PNEEs, were studied. The AUROCs of random forest models of electrolyte and urine tests in the validation phase achieved 80.0% and 79.0%, respectively. Carbon dioxide combining power, anion gap, potassium, calcium, and chlorine in electrolyte tests and specific gravity, pH, and conductivity in urine tests were selected for the logistic regression analysis. C (ROC) of the electrolyte and urine diagnostic nomograms achieved 0.79 and 0.85, respectively.

Significance

The application of routine indicators of serum and urine may help in the more accurate identification of epileptic and PNEEs.
The impacts of okra consumption on the nutritional status of pregnant women, west Ethiopia
Authors: Kushi Efrem Negash , Belachew Tefera , Tamiru Dessalegn
Published: June 2023

Food‐insecurity and poor‐quality diets remain a challenge for pregnant women. Consumption of okra has a great impact on improving the nutritional status of pregnant women. Okra plays a critical role in the prevention of malnutrition among pregnant women living in resource‐limited settings. The evidence is scarce on the impacts of okra on mid‐upper arm circumference (MUAC) measurement of pregnant women. A community‐based cross‐sectional study was employed among randomly selected 224 pregnant women from June 1 to July 30, 2020. An interviewer‐administered questionnaire was used. The MUAC was measured by using an adult MUAC measuring tape. Data were entered into Epi‐data version 3.1 and exported to SPSS version 25 for analysis by linear regression. The statistical significance of variables was declared at a p‐value of .05, and unstandardized beta (β) coefficients along with a 95% confidence interval were computed. The proportion of pregnant women with low MUAC (≤22 cm) was 42.4%. In the multivariable linear regression model, hemoglobin concentration (β = 0.346, [95% CI: 0.153, 0.539], p = .001), food insecurity (β = −0.887, (95% CI: −1.441, −0.334), p = .002), daily consumption of okra (β = 1.269, [95% CI: 0.583, 1.956], p ≤ .001), and women working in NGO (β = 0.443, [95% CI: 0.256, 0.630], p ≤ .001) were significant variables. The prevalence of malnutrition among pregnant women (MUAC ≤ 22 cm) was 42.4%. Therefore, behavioral change communication interventions to promote okra consumption on regular basis were recommended.
Long‐term arid and hot climate during earlyMid‐Cretaceousindicate by unvaried Cheirolepidiaceae‐dominant palynoflora from the Liupanshan Basin, China
Authors: Zhang Mingzhen , Dai Shuang , Jin Peihong , Liu Junwei , Huang Yongbo , Jiaoba Dunzhu , Li Aijing
Published: June 2023

The Mid‐Cretaceous was characterized by long‐term and stabilized high temperatures confirmed by numerous palaeoclimatic information from marine sedimentary archives. However, few terrestrial records have yet been employed to verify the terrestrial humidity under this long‐term hot climate. The Liupanshan Basin, located in central China during the Cretaceous contains thick Aptian‐Albian sediments. Here, we reconstructed a long‐term palaeovegetational record during late Aptian to Albian from the Huoshizhai Section and Sikouzi Section, Liupanshan Basin. Five palynological assemblages were defined from the bottom to top of these strata, and a total of 124 types of palynomorphs including 47 spore species and 77 gymnosperm pollen species were recognized in the palynological assemblages. Sporopollen analysis revealed that the spore‐pollen spectra of Huoshizhai Section were dominated byPerinopollenitesand Bisaccate pollen. In Sikouzi section, theClassopolliscontent dominate in all samples (average 63.8%), with a few other pollen, including conifer bisaccates types,Perinopollenites,Jiaohepollis,Ephedripites,Cycadopitesand a few spores. The sporopollen assemblage reflected that the flora of the central Asia continent gradually changed from Taxodiacean‐dominated to Cheirolepidiaceae‐dominated in the late Aptian and the Albian, which further indicates that the central Asia continent palaeoclimate gradually changed from a wet and cold climate to a long‐term dry and hot climate with small fluctuation. In addition, theClassopolliscontent also presented a slightly increased trend from late Aptian to late Albian, which probably indicated a gradually intensified hot and dry climate. The thermophilic floral changes and warmer/cooler ratio of the Sporomorph Ecogroup Model at the middle Madonghshan Formation also shows slightly decreased trends which correspond to the global short‐term cooling events at the Aptian‐Albian transition.
Do older adults respond to cognitive behavioral therapy as well as younger adults? An analysis of a large, multi‐diagnostic, real‐world sample
Authors: Pomerleau Vincent Jetté , Sekhon Harmehr , Bajsarowicz Paulina , Demoustier Arnaud , Rej Soham , Myhr Gail
Published: June 2023

Objectives

Older adults (OA; ≥55 years of age) are underrepresented in patients receiving cognitive‐behavioral therapy (CBT). This study evaluates mental health outcomes for OA compared to younger adults (YA; <55 years of age) receiving CBT.

Design

This is a pre‐post study comparing the effectiveness of CBT for OA (n = 99) and YA (n = 601) in a CBT service located in a university‐affiliated tertiary care hospital in Canada. Data was collected between 2001 and 2021. Participants received a mean of 18.5 sessions (SD 10) of standard, evidence‐based CBT with treatment integrity checks. The main outcome was clinically significant change, as measured by the Reliable Change Index (RCI). Secondary outcomes were change in the Global Severity Index (GSI‐SCL) of the Symptoms Checklist‐90 (Revised), and Clinical Global Improvement scores (CGI).

Results

The RCI allowed a comparison of treatment efficacy across diagnoses. Both groups experienced similar improvement on the RCI (2.92 [±3.64] vs. 3.15 [±4.86], p = 0.65). Furthermore, 39% of OA and 42% of YA no longer met criteria for their diagnoses. Groups did not differ with respect to changes in the GSI‐SCL. The CGI severity comparison suggested that OA had milder illness. In all outcomes (RCI, CGI and GSI‐SCL), participants improved over time.

Conclusions

This real‐world study analyzed a large sample of OA and YA undergoing CBT for various mental health conditions. Both groups were found to benefit equally.
Association of subjective cognitive complaints with poor sleep quality: A cross‐sectional study among Chinese elderly
Authors: Hu Qing , Song Yinhua , Wang Shibin , Lin Lihua , Ke Yunfei , Zhang Ping
Published: June 2023

Objectives

Subjective cognitive complaints (SCC) are the earliest symptom of Alzheimer's disease (AD) progression. Increasing evidence shows an association between poor sleep quality and SCC, but the current conclusions regarding the association between poor sleep quality and SCC in older adults are contradictory. Here, we aimed to explore the correlation of SCC with poor sleep quality among older adults without dementia living in nursing home and community in China.

Methods

A cross‐sectional survey on sleep and psychosomatic health of older adults was conducted in Guangdong, China, between November 2020 and March 2021. Socio‐demographic, health‐related information, psychological factors, sleep quality and SCC of participants were evaluated through a face‐to‐face interview. A 9‐item Subjective Cognitive Decline Questionnaire (SCD‐Q9) was used to measure SCC; SCD‐Q9 > 3 was defined as SCC. The Chinese version of the Pittsburgh Sleep Quality Index (PSQI) was used to evaluate sleep quality; PSQI > 7 was defined as poor sleep quality. The relationship between SCC and sleep quality was evaluated using logistics regression analysis.

Results

The study involved 730 participants (mean age 74.14 ± 8.246 years). The total SCC prevalence was 59.59%. The SCC group had poor sleep quality than the reference group (p < 0.05). Adjusted multiple logistic regression analysis revealed an association of poor sleep quality with SCC (OR = 1.841; 95% CI, 1.267–2.647; p = 0.001) after controlling for age, sex, residence, education level, marital status, income, smoking, alcohol consumption, tea drinking, multimorbidity, waist circumference, napping duration, anxiety symptoms, and depression symptoms. Hierarchical logistics regression analysis showed an association between sleep quality and SCC among community older adults (OR = 2.872; 95% CI: 1.787–4.615; p < 0.001), but not in nursing home residents (OR = 0.845; 95% CI: 0.437–1.637; p = 0.619).

Conclusions

Poor sleep quality is associated with SCC in community older adults. Therefore, medical staff should take measures, such as earlier cognitive intervention, to postpone cognitive decline in older adults, in the meantime, earlier management and treatment of sleep disorders should be taken into consideration.
Prediction of complications of pre‐eclampsia using the fullPIERS high risk predictive model
Authors: Sharma Astha , Suri Jyotsna , Khanam Zeba , Pandey Divya , Bachani Sumitra , Sharma Anuradha
Published: June 2023

Objective

To determine the predicted probability percentage of complications in women with pre‐eclampsia using the Pre‐eclampsia Integrated Estimate of Risk (fullPIERS) model within the first 24 h after admission and assess the model's predictive value for complications of pre‐eclampsia.

Methods

This was a prospective cohort study in which the fullPIERS model was applied to 256 pregnant women with pre‐eclampsia within the first 24 h after admission. These women were then followed for 48 h to 7 days for maternal and fetal complications. Reciever operating characteristics (ROC) curves were generated to assess the performance of the fullPIERS model for adverse outcomes of pre‐eclampsia.

Results

Of the 256 women enrolled in the study, 101 women (39.5%) developed maternal complications, 120 women (46.9%) developed fetal complications, and 159 women (62.1%) developed both. With an area under the ROC curve of 0.843 (95% confidence interval 0.789–0.897), the fullPIERS model had good discriminating ability to predict complications at any time point between 48 h and 7 days after admission. The sensitivity and specificity of the model at a ≥5.9% cut‐off value for predicting adverse maternal outcomes were 60% and 97%, respectively; they were 44% and 96%, respectively, for predicting combined fetomaternal complications with a cut‐off value of 4.9%.

Conclusions

The fullPIERS model performs reasonably well in predicting adverse maternal and fetal outcomes in women with pre‐eclampsia.