bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy of hypnotherapy compared to cognitive-behavioural therapy for mild-to-moderate depression: study protocol of a randomised-controlled rater-blind trial (WIKI-D)
Authors: Fuhr Kristina , Schweizer Cornelie , Meisner Christoph , Batra Anil
Published: May 2024

Introduction

Despite a substantial number of studies providing evidence for the efficacy of psychological treatment for mild-to-moderate depression, maximally only 50% of participants respond to treatment, even when using gold-standard treatments such as cognitive-behavioural therapy (CBT) and interpersonal therapy. New approaches such as the ‘third wave’ psychotherapies have provided promising results; however, studies concerning the comparison with evidence-based treatments are lacking. This study aims to compare the efficacy of clinical hypnotherapy (HT) with gold-standard psychotherapy (CBT) in the treatment of mild-to-moderate major depressive episodes.

Methods and analysis

The present study comprises a monocentric, two-armed, randomised-controlled, rater-blind (non-inferiority) clinical trial. A total of 160 participants with mild-to-moderate major depression episode will be randomly assigned to either CBT or HT involving 20 sessions of psychotherapy over a period of 24 weeks. We predict that the average improvement in the Montgomery-Åsberg Depression Rating Scale score will not be inferior in HT compared with CBT (non-inferiority hypothesis).

Further outcome parameters will include the number of participants responding to treatment following the completion of treatment and 1 year after. Additionally, quality of life, treatment expectations and hypnotic susceptibility before and after end of treatment will be assessed.

Ethics and dissemination

The study protocol and the documents for the informed consent have been approved by the Ethics Committee of the University Hospital Tuebingen (061/2015B02). The results of this trial will be submitted for publication in peer-reviewed journals, and will be presented at national and international conferences.

Trial registration number

NCT02375308; Pre-results.
Validation of the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale Dutch language version in patients with hindfoot fractures
Authors: De Boer A Siebe , Meuffels Duncan E , Van der Vlies Cornelis H , Den Hoed P Ted , Tuinebreijer Wim E , Verhofstad Michael H J , Van Lieshout Esther M M
Published: May 2024

Objectives

The American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale is among the most used questionnaires for measuring functional recovery after a hindfoot injury. Recently, this instrument was translated and culturally adapted into a Dutch version. In this study, the measurement properties of the Dutch language version (DLV) were investigated in patients with a unilateral hindfoot fracture.

Design

Multicentre, prospective observational study.

Setting

This multicentre study was conducted in three Dutch hospitals.

Participants

In total, 118 patients with a unilateral hindfoot fracture were included. Three patients were lost to follow-up.

Primary and secondary outcome measures

Patients were asked to complete the AOFAS-DLV, the Foot Function Index and the Short Form-36 on three occasions. Descriptive statistics (including floor and ceiling effects), reliability (ie, internal consistency), construct validity, reproducibility (ie, test–retest reliability, agreement and smallest detectable change (SDC)) and responsiveness were determined.

Results

Internal consistency was inadequate for the AOFAS-DLV total scale (α=0.585), but adequate for the function subscale (α=0.863). The questionnaire had adequate construct validity (82.4% of predefined hypotheses were confirmed), but inadequate longitudinal validity (70.6%). No floor effects were found, but ceiling effects were present in all AOFAS-DLV (sub)scales, most pronounced from 6 to 24 months after trauma onwards. Responsiveness was only adequate for the pain and alignment subscales, with a SDC of 1.7 points.

Conclusions

The AOFAS Ankle-Hindfoot Scale DLV has adequate construct validity and is reliable, making it a suitable instrument for cross-sectional studies investigating functional outcome in patients with a hindfoot fracture. The inadequate longitudinal validity and responsiveness, however, hamper the use of the questionnaire in longitudinal studies and for assessing long-term functional outcome.

Trial registration number

NTR5613; Post-results.
Dietary factors associated with anaemia among pregnant women attending antenatal care clinics in Sekota town, Northern Ethiopia: a facility-based cross-sectional study
Authors: Ayele Kassahun , Demisew Meron
Published: May 2024

Background

Anaemia is a major public health problem during pregnancy, especially in developing countries such as Ethiopia. Poor diet patterns are common contributors to anaemia. This study assessed the dietary factors associated with anaemia among pregnant women attending antenatal care clinics in Sekota town, Northern Ethiopia.

Methods

A facility-based cross-sectional study was conducted from June to August 2021 among 367 pregnant women who were selected using systematic random sampling techniques. A structured questionnaire was used to collect sociodemographic, obstetric and dietary data. The nutritional status of pregnant women was assessed using a mid-upper arm circumference measuring tape, and haemoglobin levels were tested using the haematocrit centrifugation technique. The data were analysed using SPSS V.21. Bivariate and multivariate logistic regression analyses were performed to assess dietary factors associated with anaemia and p<0.05 was used to declare statistical significance.

Results

Dietary pattern predictors such as meal frequency (adjusted OR (AOR)=0.27, 95% CI: 0.12, 0.59), meat consumption frequency (AOR=4.05, 95% CI: 2.46, 33.65), fruit and vegetable consumption frequency (AOR=2.88, 95% CI: 2.08, 26.81), Dietary Diversity Score (AOR=12.81, 95% CI: 3.93, 41.75), food aversion (AOR=0.12, 95% CI: 0.03, 0.47) and undernutrition (AOR=0.22, 95% CI: 0.07, 0.64) were significantly associated with anaemia.

Conclusion

Predictors of dietary pattern, such as meal frequency, Dietary Diversity Score, food aversion, meat consumption frequency, fruit and vegetable consumption frequency, and undernutrition were significantly associated with anaemia among pregnant women in the study area. Therefore, healthcare providers, policymakers, researchers and other stakeholders should pay special attention to maternal dietary patterns to address the identified factors. Programmes should be developed and implemented to improve optimal dietary patterns and proper nutrition during pregnancy to overcome anaemia and other pregnancy complications.
35 Carer-administration of as-needed sub-cutaneous medication for breakthrough symptoms in homebased dying patients: a uk study (CARIAD)
Authors: Wilkinson Clare , Poolman Marlise , Roberts Jessica , Wee Bee , Hiscock Julia , Hughes Dyfrig , Nelson Annmarie , Perkins Paul , Johnstone Rosalynde , Reymond Liz , Foster Betty , O’Connor Julie , Jones Sian , Hoare Zoe , Roberts Rossela , Byrne Anthony , Healy Sue , Lewis Penney
Published: May 2024

Introduction

Whilst the majority of seriously ill people express a wish to die at home (79%), only half of those achieve this. The likelihood of patients remaining at home often depends on availability of able and willing informal carers who take on numerous care tasks, often including the responsibility of assisting patients with oral medications. The role of carers administering subcutaneous injections is not widespread practice in the UK, but has proven to be key in achieving home death in other countries.

Aim

To determine if carer-administration of as-needed subcutaneous medication for four breakthrough symptoms (pain, nausea, restlessness and noisy breathing) in homebased dying patients is feasible and acceptable in the UK.

Methods

One hundred adult patients in the last weeks of life who are likely to lose the oral route and have expressed a preference to die at home will be recruited with their carers to an external randomised pilot trial across three UK sites (North Wales, South Wales and Gloucestershire). Carers randomised to the intervention arm will receive a manualised training package adapted from an existing Australian model and delivered by local district nursing teams. Dyads in the control arm will receive usual care.

Results

The main outcomes of interest will be feasibility, acceptability, recruitment rates, attrition and selection of the most appropriate outcomes measures.

Conclusion

Findings will inform a definitive Phase III randomised controlled trial.

The study is funded by the National Institute for Health Research (HTA project 15/10/37). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.
42 ’Who cares and what matters?’: exploring end of life priorities of homeless adults in the uk
Authors: Webb Wendy Ann , Mitchell Theresa , Nyatanga Brian , Snelling Paul
Published: May 2024

Background

People experiencing homelessness consistently fail to access palliative care services (Care Quality Commission 2016) and while there is much in the literature surrounding the barriers to appropriate health care (Hudson et al 2016), their specific needs and wishes remain poorly understood by health care professionals (Care Quality Commission 2016). This study aims to bridge the gap in knowledge.

The research question

The central question is ‘What matters most to homeless people in the UK as they consider end of life?’.

Aim of study

The aim of this interpretive phenomenological study is to explore the end of life priorities of a sample of homeless adults in the United Kingdom.

Methodology

This qualitative PhD project is a phenomenological study underpinned by the philosophy of French phenomenologist, Maurice Merleau-Ponty. Data is being collected through in-depth, semi-structured, audio-recorded 1:1 interviews with homeless adults across several UK counties. Interviews are taking place at staffed centres providing services for older homeless adults. Data is being analysed iteratively using thematic analysis.

Results

This PhD is a work in progress. Early findings will be shared.

Conclusion

It will not yet be possible to draw full conclusions from preliminary data. However, a deeper understanding of preferences and priorities will assist commissioners and healthcare professionals to plan and provide relevant palliative care services address the problem of homeless people dying without adequate support and with very little dignity or choice.

A Research Scholarship from the Florence Nightingale Foundation has part-funded this PhD.

References

. Care Quality Commission (2016)A different ending: Addressing inequalities in end of life care. Available at: https://www.cqc.org.uk/sites/default/files/20160505 CQC_EOLC_OVERVIEW_FINAL_3.pdf.

. Hudson, B., Flemming, K., Shulman, C. and Candy, B. (2016) ‘Challenges to access and provision of palliative care for people who are homeless: a systematic review of qualitative research’, BMC Palliative Care, 15(96).
45 Programme (LCADP) impact and results of a palliative education initiative: lothian care assistant development
Authors: Cassidy Lyndsay , Kieran Niall
Published: May 2024

Introduction

Social care teams are increasingly leading the delivery of care for elderly clients and their families who are living with a terminal illness. Marie Curie, in partnership with the City of Edinburgh, East Lothian, Midlothian and West Lothian Council’s identified the need for a bespoke education programme. The LCADP encompassed a single study day, followed by an online education programme with mentorship in the participants’ work setting.

Aim

The overall aim of the project was to increase the knowledge and confidence of frontline staff employed by each of the four Lothian councils to care for clients living with a terminal illness.

Methods

A mixed methods approach was used. A survey was completed at four time points, including an impact survey up to six months post completion of the programme. Focus groups and interviews of a sample of social care workers, mentors and managers were also completed.

Results

514 participants completed the single day programme. 71 social care workers continued on to the online module and mentorship programme. Both quantitative and qualitative data will be presented, demonstrating longer term impacts such as team approaches to planning and delivering care. Increased knowledge and confidence by the social care staff has resulted in a more person centred approach to care, prompt recognition of uncontrolled symptoms, and policy change.

Conclusions

Through partnership working, the programme team were able to reach more people and influence the care that is being delivered to people living with a terminal illness in their own homes and in care homes in Lothian.

References

. Badger, F., Thomas, K. & Clifford, C. 2007. Raising Standards for Elderly People Dying in Care Homes.European Journal of Palliative Care,14, 238–241.

. Cagle, J. G., Unroe, K. T., Bunting, M., Bernard, B. & Miller, S. C. 2016. Caring for Dying Patients in the Nursing Home: Voices from Frontline Nursing Home Staff. Journal of Pain and Symptom Management.

. Devlin, M. & Mcilfatrick, S. 2010. Providing Palliative and End-of-Life Care in the Community: The Role of the Home Care Worker.International Journal of Palliative Care,16(4), 195–203.

. Herber, O. R. & Johnston, B. M. 2013. The Role of Healthcare Support Workers in Providing Palliative and End-of-Life Care in the Community: A Systematic Literature Review. Health & Social Care in the Community, 21(3), 225–235.

. Scottish Government. 2015. Strategic Framework for Action on Palliative and End of Life Care. Edinburgh: The Scottish Government.
57 Barriers and facilitators to implementation of end of life care policy in the acute hospital setting in england: a systematic review
Authors: Murigu Nadine
Published: May 2024

Introduction

In 2013, the policy approach to end of life care delivery in English acute hospitals underwent a significant change of direction, and is now characterised by an individualised approach to patient care, instead of a protocol-driven one.1This systematic review identifies and analyses the barriers and facilitators to implementation of current end of life policy in the acute hospital setting, in England.

Methods

This systematic review applied techniques of meta-ethnography to qualitative synthesis of the relevant literature. Barriers and facilitators to policy implementation were identified and analysed through the stepwise development of first, second and third order interpretations from the included studies.

Results

Five ‘clusters’ of determinants of end of life policy implementation were identified: characteristics of healthcare professionals; policy context; characteristics of hospital context; means of policy implementation; and patient perceptions of dying. These clusters formed the central components of a new theory of policy implementation, and were further conceptualised as having the potential to act as either barrier or facilitator in the acute hospital setting. A conceptual divide between the grey literature and peer reviewed literature also emerged; the former focused on sufficiency of education for policy implementation, whereas the latter identified a complex range of other influences on delivery of end of life care.

Conclusion

This review identified that there are multiple, complex determinants for the implementation of end of life care policy in acute hospitals. Bridging the gap between end of life care practice and policy therefore requires robust engagement with this complexity, at regional and national level.

Reference

. Leadership Alliance for Care of Dying People (LACDP)2014,One Chance to get it Right: improving people’s experience of care in the last few days and hours of life. [Online]. London: LACDP. [Accessed 1 June 2017]. Available from: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/323188/One_chance_to_get_it_right.pdf
7 Views of future care planning in patients aged over 70 years old and carers: developing a strategy for qualitative research through co-design
Authors: Bielinska Anna-Maria , Archer Stephanie , Riley Julia , Urch Catherine
Published: May 2024

Introduction

Following an emergency hospital admission in over 70-year-olds, 1 year mortality is approximately 20%, highlighting the need for future care planning (FCP) (Bielinska, 2016).

Conducting research around FCP with patients and carers is an emotive topic; co-designing a research strategy may lead to more acceptable, in-depth interviews. (Borgstrom, 2017).

Aim

To co-design a qualitative research strategy to explore views on FCP in patients over 70 and carers.

Methods

A research collaborative co-designed a qualitative study exploring patient-led FCP for emergency admissions in patients aged 70+years, inclusive of all diagnoses. The research collaborative particularly focused on the co-design of a semi-structured interview schedule and associated linguistic content.

Results

Outputs from iterative reflections with palliative care clinicians and a patient and carer group were incorporated to produce themes for the semi-structured interview.

Co-designed themes: 1) an acceptable approach to FCP, including timing and terminology 2) significance of FCP as perceived benefits or harms 3) expectations of the content of FCP 4) expectations of whether to share FCP with medical or social contacts

Areas of difference: 1) direct questioning for resuscitation orders 2) need for formal assessment scales

Conclusions

Understanding FCP in the 70 years+cohort is important for individualised care; interview co-design can enable sensitive exploration.

An iterative methodology can be useful for co-designing a semi-structured interview schedule

Co-design allows for differences between patient and healthcare perspectives to be reconciled, resulting in the development of a robust and acceptable tool for research.

References

1. Bielinska A, Obanobi A, Riley J, Urch CE. One year mortality: recognising the need for urgent or advance care planning in adults aged over 70 years old following emergency admission. BMJ Supportive & Palliative Care2016;6:385.

2. Borgstrom E, Barclay S. Experience-based design, co-design and experience-based co-design in palliative and end-of-life care. BMJ Support Palliat Care2017;Published Online First: 16 February 2017. doi: 10.1136/bmjspcare-2016-001117
Predictive value of SUVmax from initial 18F-FDG PET/CT scans for treatment outcomes in endometrial cancer patients undergoing fertility sparing management
Authors: Kang Ok-Ju , Park Yonghee , Lee Eun Min , Lee Jong Jin , Lee Shin-Wha , Kim Dae-Yeon , Suh Dae-Shik , Kim Jong-Hyeok , Kim Yong-Man , Park Jeong-Yeol
Published: May 2024

Objective

To evaluate whether the maximum standardized uptake value (SUVmax) from initial 18F-FDG PET/CT (fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography) scans could be a predictor of complete response and recurrence in patients with endometrial cancer who are undergoing fertility sparing management.

Methods

We conducted a retrospective review of patients who were diagnosed with endometrial cancer through biopsy and chose to undergo fertility sparing management using progestin at the Asan Medical Center, from January 2011 to December 2020. Of these, 113 patients who had an 18-FDG-PET/CT scan before starting treatment were included in our study. We measured SUVmax and examined its correlation with complete response and time to progression after achieving complete response to progestin therapy.

Results

Of 113 patients, 73 (64.6%) achieved a complete response through fertility sparing management. The receiver operating characteristic curve analysis revealed that the optimal cut-off value of SUVmax for predicting complete response was 6.2 (sensitivity 79.5%, specificity 57.5%, p=0.006). After analyzing recurrence in the 73 patients who achieved complete response, we found that patients with an SUVmax value >6.2 had a significantly shorter time to progression compared with those with a value &6.2. (p=0.04).

Conclusions

SUVmax values of PET-CT, along with other clinicopathological parameters, could be used to predict treatment response and recurrence risk in patients with stage I endometrial cancer undergoing fertility sparing management.
Sex differences in risk of incident microvascular and macrovascular complications: a population-based data-linkage study among 25 713 people with diabetes
Authors: Gibson Alice A , Cox Emma , Schneuer Francisco J , Humphries Jacob , Lee Crystal MY , Gale Joanne , Chadban Steven , Gillies Mark , Chow Clara K , Colagiuri Stephen , Nassar Natasha
Published: May 2024

Background

The global prevalence of diabetes is similar in men and women; however, there is conflicting evidence regarding sex differences in diabetes-related complications. The aim of this study was to investigate sex differences in incident microvascular and macrovascular complications among adults with diabetes.

Methods

This prospective cohort study linked data from the 45 and Up Study, Australia, to administrative health records. The study sample included 25 713 individuals (57% men), aged ≥45 years, with diabetes at baseline. Incident cardiovascular disease (CVD), eye, lower limb, and kidney complications were determined using hospitalisation data and claims for medical services. Multivariable Cox proportional hazards models were used to assess the association between sex and incident complications.

Results

Age-adjusted incidence rates per 1000 person years for CVD, eye, lower limb, and kidney complications were 37, 52, 21, and 32, respectively. Men had a greater risk of CVD (adjusted hazard ratio (aHR) 1.51, 95% CI 1.43 to 1.59), lower limb (aHR 1.47, 95% CI 1.38 to 1.57), and kidney complications (aHR 1.55, 95% CI 1.47 to 1.64) than women, and a greater risk of diabetic retinopathy (aHR 1.14, 95% CI 1.03 to 1.26). Over 10 years, 44%, 57%, 25%, and 35% of men experienced a CVD, eye, lower limb, or kidney complication, respectively, compared with 31%, 61%, 18%, and 25% of women. Diabetes duration (<10 years vs ≥10 years) had no substantial effect on sex differences in complications.

Conclusions

Men with diabetes are at greater risk of complications, irrespective of diabetes duration. High rates of complications in both sexes highlight the importance of targeted complication screening and prevention strategies from diagnosis.
To invest or not to invest, that is the question: male presence and genetic relatedness as modulators of female reproductive effort in a shrimp
Authors: Tropea Carolina , López Greco Laura Susana
Published: May 2024

The present work was aimed at evaluating whether females of a freshwater shrimp, Neocaridina davidi (Bouvier, 1904), allocate differentially to reproduction when reared in the presence of males and in the presence of brothers/non-brothers. Ovarian growth was evaluated in three consecutive maturation cycles. The composition of biochemical reserves was determined in the eggs (i.e., embryos) laid at the end of the first cycle, in 20-day-old juveniles produced at the end of the second cycle, and in the mature ovary of females at the end of the third cycle. When reared in the absence of males, females took longer to mature the ovaries and stored less proteins, triglycerides, and cholesterol in the mature ovary. Females reared with brothers took longer to mature the ovaries than females reared with non-brothers, with no differences in the biochemical composition of their mature ovaries. The eggs produced by females mated to brothers showed a lower carotenoid content, higher cholesterol content, and a tendency towards lower energy content than those produced by females mated to non-brothers. These results suggest that females are capable of recognizing kin and modulate primary reproductive effort, in terms of ovarian and egg biochemical composition, according to male presence and genetic relatedness.
70Zn-induced fusion reactions for synthesis of superheavy element Z=120
Authors: Madhu S. , Manjunatha H. C. , Sowmya N. , Rajesh B. M. , Seenappa L.
Published: May 2024

In this work, we delved into the intriguing realm of nuclear physics by investigating fusion reactions initiated by [Formula: see text]Zn projectiles colliding with various stable isotopes of thorium nuclei, including [Formula: see text]Th. Our primary objective was the synthesis of the superheavy element [Formula: see text]. To achieve this, we employed an advanced statistical model to evaluate the evaporation residue cross-sections. Remarkably, we observed that the fusion reaction between [Formula: see text]Zn and [Formula: see text]Th exhibited the highest evaporation residue cross-sections, reaching a peak value. Furthermore, the 3n channel within this fusion reaction yielded substantially larger evaporation cross-sections, with a notable value of 0.89 picobarns. The predicted cross-sections fall within the measurable range, making them highly valuable for experimental endeavors aimed at synthesizing the superheavy element [Formula: see text]. This research not only contributes to our understanding of nuclear reactions but also holds promise for expanding our knowledge of the heaviest elements in the periodic table, potentially opening new frontiers in nuclear science.
Bright–dark envelope-optical solitons in space-time reverse generalized Fokas–Lenells equation: Modulated wave gain
Authors: Abdel-Gawad H. I. , Sulaiman Tukur Abdulkadir , Ismael Hajar F.
Published: May 2024

Here, we investigate the impact of space-time reverse (STR) problems, a result of parity-time symmetry in optics and quantum mechanics, on soliton propagation in optical fibers. The STR problems are characterized by the existence of a field and its reverse. The research introduces a new classification of two scenarios: non-interactive and interactive fields and reverse fields. The solutions for the generalized Fokas–Lenells equation (gFLE) with STR and third-order dispersion are derived. To tackle this, adaptive transformations for the field and its reverse are introduced, employing a unified method. In the non-interactive scenario, both exact and approximate solutions are found. However, in the interactive case, only exact solutions are discovered. This work reveals that the presence of the field and its reverse unveils new soliton structures, including bright–dark envelope solitons and right and left envelope-solitons. In the non-interactive case, the field displays a right envelope-soliton, while the reverse field exhibits a left envelope-soliton (or vice versa). The study hypothesizes that the presence of a reverse field might impede soliton propagation in optical fibers.

The research also includes an analysis of modulation instability (MI), determining that MI is initiated when the coefficient of Raman scattering exceeds a critical value. Furthermore, the study examines the modulated wave gain and explores global bifurcation through phase portrait by constructing the Hamiltonian function.
Complex Dynamics of a Discrete-Time Food Chain Model
Authors: Karmakar Sarbari , Kumbhakar Ruma , Garai Shilpa , Parastesh Fatemeh , Jafari Sajad , Pal Nikhil
Published: May 2024

In a food chain, the role of intake patterns of predators is very influential on the survival and extinction of the interacting species as well as the entire dynamics of the ecological system. In this study, we investigate the affluent and intricate dynamics of a simple three-species food chain model in a discrete-time framework by analyzing the parameter plane of the system with simultaneous changes of two crucial parameters, the predation rates of middle and top predators. From the theoretical viewpoint, we study the model by determining the fixed points’ biological feasibility and local asymptotic stability criteria, and performing some analyses of local bifurcations, namely, transcritical, flip, and Neimark–Sacker bifurcations. Here, we initiate the numerical simulation by plotting the changes of the prey population density in terms of a vital parameter of the system, and we observe the switching among different dynamical behaviors of the system. We also draw some phase portraits and plot the time series solutions to show the diverse characteristics of the system dynamics. Further, we move one step ahead to explore the intricate dynamical scenarios appearing in the parameter plane by forming Lyapunov exponent and isoperiodic diagrams. In the parameter plane of the system, we see the emergence of innumerable Arnold tongues. All these Arnold tongues are organized along a particular direction, and the beautiful arrangement of these tongues forms several kinds of period-adding sequences. The study sheds more light on various types of multistability occurring in the model system. We see the coexistence of three periodic attractors in the parameter plane. In this study, the most striking observation is the coexistence of four periodic attractors, which occurs infrequently in ecological systems. We draw the basins of attraction for the tristable and tetrastable attractors, which are complex Wada basins. A system with Wada basin is very sensitive to initial conditions and more erratic in nature than a system with fractal basin. Also, we plot the density of all interacting species in terms of the predation rates of middle and top predators and observe the variation in the population densities of all species with the variability of these two key parameters. In the parameter plane created by the simultaneous changes of two parameters, the system exhibits a variety of intricate and subtle dynamics, which cannot be found by changing only a single parameter.
Balance Sheet Debt Covenants and Seasoned Equity Offerings
Authors: Malikov Kamran T.
Published: May 2024

Synopsis

The research problem

This study examined the effect of having debt contracts that contain balance sheet covenants on the decision to make seasoned equity offerings (SEOs).

Motivation

Prior studies examined the determinants of equity issuance without considering private debt contracts that contain balance sheet covenants. Generally, firms are not restricted from stock issuance when they have financial debt covenants. This might motivate firms to make SEOs when they are more susceptible to balance sheet debt covenant violations. Making SEOs increases firms’ equity capitals in the short term and, therefore, has the direct effect of improving balance sheet covenants in the current period. This effect motivated this study to examine whether firms are more likely to conduct SEOs when their debt contracts include more-restrictive balance sheet covenants.

The test hypothesis

The hypothesis of the study is in the null form, which states that balance sheet covenant restrictiveness is unrelated to the probability of conducting SEOs.

Target population

The target population includes shareholders, debtholders, and firm managers.

Adopted methodology

Panel data estimation was used, specifically, the fixed effects model.

Analyses

The empirical analysis was conducted on a unique sample of UK listed firms with private debt covenants that is hand-collected from annual reports. Equity issuance in the sample is based on private placements, which are a common type of SEO in the UK. The restrictiveness of balance sheet-based covenants is defined as the number of balance sheet covenants in a loan contract or the tightness of net worth covenant slack.

Findings

The results show that balance sheet covenant restrictiveness is positively associated with the probability of conducting SEOs through private placements. The baseline result is robust to the application of a number of the controls often used in the literature, including cash shortage, the use of balance sheet covenants in the previous loan contract, earnings management, and the quality of external governance. It is also robust to excluding the financial crisis period and addressing potential endogeneity concerns using a propensity score-matching procedure. Additionally, further analysis provides some evidence that equity issuance by firms with more-restrictive balance sheet covenants is negatively associated with future operating performance, suggesting that these firms may not efficiently use the raised capital.
XLORE 3: A Large-Scale Multilingual Knowledge Graph from Heterogeneous Wiki Knowledge Resources
Authors: Zeng Kaisheng , Jin Hailong , Lv Xin , Zhu Fangwei , Hou Lei , Zhang Yi , Pang Fan , Qi Yu , Liu Dingxiao , Li Juanzi , Feng Ling
Published: May 2024

In recent years, knowledge graph (KG) has attracted significant attention from academia and industry, resulting in the development of numerous technologies for KG construction, completion, and application. XLORE is one of the largest multilingual KGs built from Baidu Baike and Wikipedia via a series of knowledge modeling and acquisition methods. In this article, we utilize systematic methods to improve XLORE's data quality and present its latest version, XLORE 3, which enables the effective integration and management of heterogeneous knowledge from diverse resources. Compared with previous versions, XLORE 3 has three major advantages: (1) We design a comprehensive and reasonable schema, namely XLORE ontology, which can effectively organize and manage entities from various resources. (2) We merge equivalent entities in different languages to facilitate knowledge sharing. We provide a large-scale entity linking system to establish the associations between unstructured text and structured KG. (3) We design a multi-strategy knowledge completion framework, which leverages pre-trained language models and vast amounts of unstructured text to discover missing and new facts. The resulting KG contains 446 concepts, 2,608 properties, 66 million entities, and more than 2 billion facts. It is available and downloadable online at
https://www.xlore.cn/
, providing a valuable resource for researchers and practitioners in various fields.
Air Traffic Flow Prediction with Spatiotemporal Knowledge Distillation Network
Authors: Shen Zhiqi , Cai Kaiquan , Fang Quan , Luo Xiaoyan
Published: May 2024

Accurate air traffic flow prediction assists controllers formulate control strategies in advance and alleviate air traffic congestion, which is important to flight safety. While existing works have made significant efforts in exploring the high dynamics and heterogeneous interactions of historical air traffic flow, two key challenges still remain. (1) The transfer patterns of air traffic are intricate, subject to numerous constraints and limitations such as controllers, flight regulations, and other regulatory factors. Relying solely on mining historical traffic evolution patterns makes it difficult to accurately predict the constrained air traffic flow. (2) Weather conditions exert a substantial influence on air traffic, making it exceptionally difficult to simulate the impact of external factors (such as thunderstorms) on the evolution of air traffic flow patterns. To address these two challenges, we propose a Spatiotemporal Knowledge Distillation Network (ST‐KDN) for air traffic flow prediction. Firstly, recognizing the inherent future insights embedded within flight plans, we develop a “teacher‐student” distillation model. This model leverages the prior knowledge of upstream‐downstream migration patterns and future air traffic trends inherent in flight plans. Subsequently, to model the influence of external factors and predict air traffic flow disturbed by thunderstorm weather, we propose a student network based on the “parallel‐fusion” structure. Finally, employing a feature‐based knowledge distillation approach to integrate prior knowledge from flight plans and extract meteorological features, our method can accurately capture complex and constrained spatiotemporal dependencies in air traffic and explicitly model the impact of weather on air traffic flow. Experimental results on real‐world flight data demonstrate that our method can achieve better prediction performance than other state‐of‐the‐art comparison methods, and the advantages of the proposed method are particularly prominent in modeling the complicated transfer pattern of air traffic and inferring nonrecurrent flow patterns.
Erosive Tooth Wear, Wine Intake, and Genetic Variation in COMT and MMP2
Authors: Rolim de Lavôr Juliane , Mendonça da Silva Adriana , Søvik Jenny Bogstad , Rosenblatt Aronita , Mulic Aida , Vieira Alexandre Rezende
Published: May 2024

Introduction: Erosive tooth wear (ETW) is a multifactorial condition of increasing prevalence in the younger population. This study aimed to explore the association between different ETW phenotypes with MMP2 and COMT single-nucleotide variants and selected environmental factors. Methods: Saliva samples, erosive wear, and dental caries experience data and dietary/behavioral information from 16- to 18-year-old patients (n = 747) were used. Genotypes were obtained, and phenotypes were further analyzed considering diet and behavioral data, using logistic regression as implemented in PLINK, with an alpha of 0.05. Results: When comparing individuals’ ETW-free with those with mild ETW, an association was found with COMT rs6269 (p = 0.02). The comparison between ETW-free individuals with individuals with severe ETW also showed an association with COMT rs6269 under the recessive model (p = 0.03). Logistic regression showed that in the presence of less common alleles of MMP2 rs9923304 and COMT rs6269, ETW was more likely to occur when individuals drank wine. The GG genotype of COMT rs6269 was associated with the presence of lower (p = 0.02) and higher (p = 0.02) caries experience when individuals with ETW only in enamel were compared with individuals with ETW involving dentin. Conclusion: The results support a role of genes in ETW, with wine consumption being identified as a significant modulator, suggesting that gene-environment interactions may contribute to the development of ETW.
Trichoscopy of Central Centrifugal Cicatricial Alopecia: A Retrospective Study and Literature Review
Authors: Zogob Luiz Paulo Rocha , Cortez de Almeida Rita Fernanda , Tortelly Violeta
Published: May 2024

Introduction: Central centrifugal cicatricial alopecia (CCCA) is the most common cause of scarring alopecia in middle-aged black women. Trichoscopy is a noninvasive tool for diagnosis and follow-up of hair and scalp disorders. To date, limited studies have focused on its applicability to CCCA in existing literature. Methods: The present study aimed to describe the trichoscopic findings of 11 dark-skinned women with confirmed CCCA and provide a comprehensive discussion of our current knowledge regarding trichoscopy of this disease through a literature review. A thorough understanding of CCCA trichoscopy holds significant promise for early confirmation and treatment. Conclusion: By doing so, it is possible to mitigate the development of complications and alleviate the subsequent impact on patients’ quality of life.
Flexible Ureteroscopy with a Tip-Flexible Pressure-Controlling Ureteral Access Sheath for Renal Stones in Children
Authors: Peng Guanghua , Kuang Jin , Chen Yijian , Huang Xin , Song Leming , Deng Xiaolin
Published: May 2024

Introduction: The aim of this study was to evaluate the safety and efficacy of flexible ureteroscopy using a tip-flexible pressure-controlling ureteral access sheath (TFPC-UAS) for renal stones in children. Methods: Consecutive patients aged 5–18 years with renal stones of diameter 1–3 cm were enrolled between January 2022 and November 2023 at Ganzhou People’s Hospital. The patients were treated with flexible ureteroscopy using the TFPC-UAS. The renal pelvic pressure (RPP) parameters were set as follows: control value at −10 mm Hg to 5 mm Hg, warning value at 20 mm Hg, and limit value at 30 mm Hg. The infusion flow rate was set to 100–120 mL/min. A holmium laser (276 μm) was used to fragment the stone at 2.0–2.5 J/pulse with a frequency of 20–30 pulses/s. The cases were analyzed for RPP, operative time, stone-free rate, and complications. Results: A total of 21 consecutive patients were included. Two patients were switched to percutaneous nephrolithotomy owing to sheath placement failure. The RPP was −4.6 ± 2.1 mm Hg. The mean operative time was 56.5 ± 17.1 min. The postoperative hospitalization time was 1.5 ± 0.3 days. The stone-free rates at 1 day and 1 month after surgery were 81.0% and 85.7%, respectively. Residual stones in 2 patients were cleared after extracorporeal shockwave lithotripsy. Three cases of Clavien I complications and one case of Clavien II complications occurred. No major complications (Clavien grade III–V) were observed. Conclusions: Flexible ureteroscopy with a TFPC-UAS is safe and effective for renal stones in children.
Clinical Utility of the Novel Oncological Criteria of Resectability for Advanced Hepatocellular Carcinoma
Authors: Shindoh Junichi , Kawamura Yusuke , Akahoshi Keiichi , Matsumura Masaru , Okubo Satoshi , Akuta Norio , Tanabe Minoru , Kokudo Norihiro , Suzuki Yoshiyuki , Hashimoto Masaji
Published: May 2024

Introduction: Introduction of new systemic therapies for hepatocellular carcinoma (HCC) has led to the development of new oncological criteria of resectability for the resectability of HCC. This study was aimed at validating the prognosticating ability and clinical utility of the resectability classification based on the novel criteria in real-world clinical practice. Methods: This study was conducted in 1,822 patients who had undergone curative resection for HCC (population 1) and 107 patients with unresectable disease who had received lenvatinib therapy (population 2). Patients were classified into three groups according to the novel oncological criteria for resectability (R, resectable; BR1, borderline resectable 1; and BR2, borderline resectable 2), and the prognosticating ability and clinical utility of this classification based on the novel criteria were examined. Results: Multivariate analysis confirmed that classification of the patients according to the oncological resectability criteria was significantly correlated with the overall survival (OS) (BR1: hazard ratio [HR], 1.88; 95% CI, 1.38–2.55; BR2: HR, 4.12; 95% CI, 3.01–5.65) and recurrence-free survival (BR1: HR, 1.86; 95% CI, 1.44–2.41; BR2: HR, 3.62; 95% CI, 2.71–4.82) in population 1. In population 2, the resectability classification was correlated with the rates of successful additional intervention (surgery, transarterial chemoembolization, or radiotherapy) (BR1 65.7% vs. BR2 42.3%, p = 0.023) and curative-intent conversion surgery (BR1 17.1% vs. BR2 4.2%, p = 0.056) after lenvatinib therapy, and was also predictive of the OS (HR, 1.96; 95% CI, 1.13–3.38 for BR2 [vs. BR1]) and time-to-treatment failure (HR, 1.81; 95% CI, 1.04–3.17 for BR2 [vs. BR1]). Conclusion: The resectability classification based on the novel oncological criteria for resectability showed acceptable prognosticating ability in both surgically and medically treated populations with advanced HCC.
Association of Aortic Stiffness and Pressure Pulsatility With Noninvasive Estimates of Hepatic Steatosis and Fibrosis: The Framingham Heart Study
Authors: Cooper Leroy L. , Prescott Brenton R. , Xanthakis Vanessa , Benjamin Emelia J. , Vasan Ramachandran S. , Hamburg Naomi M. , Long Michelle T. , Mitchell Gary F.
Published: May 2024

BACKGROUND:

Arterial stiffening may contribute to the pathogenesis of metabolic dysfunction–associated steatotic liver disease. We aimed to assess relations of vascular hemodynamic measures with measures of hepatic steatosis and fibrosis in the community.

METHODS:

Our sample was drawn from the Framingham Offspring, New Offspring Spouse, Third Generation, Omni-1, and Omni-2 cohorts (N=3875; mean age, 56 years; 54% women). We used vibration-controlled transient elastography to assess controlled attenuation parameter and liver stiffness measurements as measures of liver steatosis and liver fibrosis, respectively. We assessed noninvasive vascular hemodynamics using arterial tonometry. We assessed cross-sectional relations of vascular hemodynamic measures with continuous and dichotomous measures of hepatic steatosis and fibrosis using multivariable linear and logistic regression.

RESULTS:

In multivariable models adjusting for cardiometabolic risk factors, higher carotid-femoral pulse wave velocity (estimated β per SD, 0.05 [95% CI, 0.01–0.09];
P
=0.003), but not forward pressure wave amplitude and central pulse pressure, was associated with more liver steatosis (higher controlled attenuation parameter). Additionally, higher carotid-femoral pulse wave velocity (β=0.11 [95% CI, 0.07–0.15];
P
<0.001), forward pressure wave amplitude (β=0.05 [95% CI, 0.01–0.09];
P
=0.01), and central pulse pressure (β=0.05 [95% CI, 0.01–0.09];
P
=0.01) were associated with more hepatic fibrosis (higher liver stiffness measurement). Associations were more prominent among men and among participants with obesity, diabetes, and metabolic syndrome (interaction
P
values, <0.001–0.04). Higher carotid-femoral pulse wave velocity, but not forward pressure wave amplitude and central pulse pressure, was associated with higher odds of hepatic steatosis (odds ratio, 1.16 [95% CI, 1.02–1.31];
P
=0.02) and fibrosis (odds ratio, 1.40 [95% CI, 1.19–1.64];
P
<0.001).

CONCLUSIONS:

Elevated aortic stiffness and pressure pulsatility may contribute to hepatic steatosis and fibrosis.
Histidine-Rich Glycoprotein Modulates the Toxic Effects of High-Dose Polyphosphate in Mice
Authors: Malik Rida A. , Zhou Ji , Fredenburgh James C. , Crosby Jeff , Revenko Alexey S. , Healey Jeff S. , Weitz Jeffrey I.
Published: May 2024

BACKGROUND:

Polyphosphate (polyP), a procoagulant released from platelets, activates coagulation via the contact system and modulates cardiomyocyte viability. High-dose intravenous polyP is lethal in mice, presumably because of thrombosis. Previously, we showed that HRG (histidine-rich glycoprotein) binds polyP and attenuates its procoagulant effects. In this study, we investigated the mechanisms responsible for the lethality of intravenous polyP in mice and the impact of HRG on this process.

METHODS:

The survival of wild-type or HRG-deficient mice given intravenous synthetic or platelet-derived polyP in doses up to 50 mg/kg or saline was compared. To determine the contribution of thrombosis, the effect of FXII (factor XII) knockdown or enoxaparin on polyP-induced fibrin deposition in the lungs was examined. To assess cardiotoxicity, the ECG was continuously monitored, the levels of troponin I and the myocardial band of creatine kinase were quantified, and the viability of a cultured murine cardiomyocyte cell line exposed to polyP in the absence or presence of HRG was determined.

RESULTS:

In HRG-deficient mice, polyP was lethal at 30 mg/kg, whereas it was lethal in wild-type mice at 50 mg/kg. Although FXII knockdown or enoxaparin administration attenuated polyP-induced fibrin deposition in the lungs, neither affected mortality. PolyP induced dose-dependent ECG abnormalities, including heart block and ST-segment changes, and increased the levels of troponin and myocardial band of creatine kinase, effects that were more pronounced in HRG-deficient mice than in wild-type mice and were attenuated when HRG-deficient mice were given supplemental HRG. Consistent with its cardiotoxicity, polyP reduced the viability of cultured cardiomyocytes in a dose-dependent manner, an effect attenuated with supplemental HRG.

CONCLUSIONS:

High-dose intravenous polyP is cardiotoxic in mice, and HRG modulates this effect.