bluuebunny/crossref_metadata_2025 huggingface dataset:
Minority entrepreneurs and start‐up financing
Authors: Robinson Desmond D.
Published: November 2023

There is a need for additional research on minority entrepreneurs need to access start‐up funding to grow and sustain their businesses. The problem is access to financial capital is a constraint for minority entrepreneurs and negatively impacts their ability to stay in business. Minority borrowers face more difficult borrowing conditions than Caucasian entrepreneurs. The results from this case study demonstrated the pecking order theory and the resource base theory, and that there is no relationship between the source of the funding and the success and failure of 11 minority‐owned small business startups. Case study is an excellent research design for this study because it allows a researcher to investigate the lived experiences of individuals who have shared experiences of a particular event or condition. The results from this case study showed a majority of the research participants indicated that avoidance of debt is a primary motivating factor to use personal savings as a primary choice in funding their respective businesses. This article is designed to assist policymakers at both the state and federal government levels in better understanding how to provide accessible financing to these entrepreneurs. Also, this article is designed for all individuals who have started a business or may be thinking about starting a business to get a better understanding of the obstacles and motivations minority entrepreneurs encounter when attempting to find financing to start their businesses.
Impact of precipitation and grazing on recovery of plant vegetation in temperate grasslands
Authors: Lin Xi , Zhao Hongbin , Zhang Shengwei , Li Ruishen , Li Xiaoyuan , Wang Shuai
Published: November 2023

Grasslands support a rich diversity that plays a pivotal role in ecological balance, carbon sequestration, and climate regulation. Grassland ecosystems are facing a loss of biodiversity and a decline in soil function due to precipitation variations caused by climate change. However, variations in grassland species diversity are not clearly known, especially under the combined effects of precipitation and grazing. Based on a 5‐year split‐plot experiment with two grazing regimes (i.e., moderate grazing and grazing prohibition) along with three precipitation controls (ambient precipitation and ±50% precipitation) in Inner Mongolian grasslands, we researched the response of precipitation variability and grazing prohibition to vegetation diversity indices and investigated the response of vegetation community composition and biomass to these factors. Five years results showed that increasing precipitation resulted in a significant increase in the coverage of perennial forbs, annual and biennial plants, and Gramineae. Grazing prohibition and increased precipitation significantly increased biomass and species richness compared to all other treatment combinations. Interestingly, grazing exclusion significantly reduced the percentage of Amaryllidaceae, especially in the presence of altered precipitation. The vegetation community composition of a typical grassland was correlated with soil volumetric water content (VWC), bulk density (SBD) and pH, soil organic carbon (SOC), and total nitrogen (TN). VWC, SBD, and TN were found to be the most significant factors affecting vegetation diversity under grazing. Partial canonical ordination revealed that soil moisture, soil bulk density, and SOC had the most significant correlation with vegetation diversity under both grazing prohibition and increased precipitation treatment conditions. These results suggested that alterations in precipitation can change the species composition and ecosystem function of plant communities, leading to a close relationship between species diversity and soil properties. Our results underline the importance of species diversity for soil characteristics and environmental factors in a typical Eurasian steppe ecosystem.
Severe Zellweger spectrum disorder due to a novel missense variant in the PEX13 gene: A case report and the literature review
Authors: Su Ling , Peng Min‐Zhi , Chen Xiao‐Dan , Wu Shuang , Liu Li
Published: November 2023

Background

Peroxisome biogenesis disorders (PBDs) are caused by variants in PEX genes that impair peroxisome function. Zellweger spectrum disorders (ZSDs) are the most severe and common subtype of PBDs, affecting multiple organ systems due to peroxisomal involvement in various metabolic functions. PEX13 gene variants are rare causes of ZSDs, with only 21 cases reported worldwide and none in China.

Methods

We describe an infant with biochemically and molecularly confirmed ZSDs due to variants in the PEX13 gene, identified by whole exome sequencing and validated by Sanger sequencing. The patient's treatment and prognosis were followed up. We also reviewed the literature on previously reported cases with PEX13 variants.

Results

The patient had severe hypotonia, seizures, hepatic dysfunction, failure to thrive, and dysmorphic features. Serum analysis revealed elevated levels of very long‐chain fatty acids (VLCFA), phytanic acid, and pipecolic acid. We detected a novel homozygous missense variant c.493G>C (p. Ala165Pro) in the PEX13 gene (NM_002618.3), which caused severe clinical manifestations and was inherited from the consanguineous parents. The patient died at the age of 14 months.

Conclusion

We report the first case of ZSDs due to the PEX13 variant in China. Our findings broaden the mutational spectrum of the PEX13 gene and indicate that missense variants can lead to severe ZSDs phenotypes, which has implications for genotype–phenotype correlations and genetic counseling.
Neuron‐specific deletion of VEGF or its receptor Flk‐1 occludes the antidepressant‐like effects of desipramine and fluoxetine in mice
Authors: Deyama Satoshi , Li Xiao‐Yuan , Duman Ronald S.
Published: November 2023

Vascular endothelial growth factor (VEGF) signaling is known to be involved in the antidepressant‐like effects of conventional antidepressants, such as desipramine (DMI), a tricyclic antidepressant, and fluoxetine (FLX), a selective serotonin reuptake inhibitor; however, the precise role of neuronal VEGF signaling in mediating these effects remains unclear. Using mice with excitatory neuron‐specific deletion of VEGF and its receptor, fetal liver kinase 1 (Flk‐1) in the forebrain, we examined the effects of forebrain excitatory neuron‐specific deletion of VEGF or Flk‐1 on the antidepressant‐like effects of repeated DMI and chronic FLX administration in the forced swim test (FST). Repeated intraperitoneal (i.p.) injections of DMI (10, 10, and 20 mg/kg at 24, 4, and 1 h before the FST, respectively) significantly decreased immobility in control mice; however, this effect was completely blocked in mice with neuron‐specific VEGF or Flk‐1 deletion. Although chronic treatment with FLX (18 mg/kg/day, i.p.) did not impact immobility in control mice 1 day after the 22nd injection, immobility was significantly reduced 1 day after the preswim and the 23rd FLX injection. However, in mice with neuron‐specific Flk‐1 deletion, chronic FLX treatment significantly increased immobility in the preswim and failed to produce antidepressant‐like effects. Collectively, these findings indicate that neuronal VEGF–Flk‐1 signaling contributes to the antidepressant‐like actions of conventional antidepressants.
Metabolite signature of diabetes remission in individuals with obesity undergoing weight loss interventions
Authors: Thaker Vidhu V. , Kwee Lydia Coulter , Chen Haiying , Bahnson Judy , Ilkayeva Olga , Muehlbauer Michael J. , Wolfe Bruce , Purnell Jonathan Q. , Pi‐Sunyer Xavier , Newgard Christopher B. , Shah Svati H. , Laferrère Blandine ,   The Look AHEAD Research Group
Published: November 2023

Objective

This observational study investigated metabolomic changes in individuals with type 2 diabetes (T2D) after weight loss. We hypothesized that metabolite changes associated with T2D‐relevant phenotypes are signatures of improved health.

Methods

Fasting plasma samples from individuals undergoing bariatric surgery (n = 71 Roux‐en‐Y gastric bypass [RYGB], n = 22 gastric banding), lifestyle intervention (n = 66), or usual care (n = 14) were profiled for 139 metabolites before and 2 years after weight loss. Principal component analysis grouped correlated metabolites into factors. Association of preintervention metabolites was tested with preintervention clinical features and changes in T2D markers. Association between change in metabolites/metabolite factors and change in T2D remission markers, homeostasis model assessment of β‐cell function, homeostasis model assessment of insulin resistance, and glycated hemoglobin (HbA1c) was assessed.

Results

Branched‐chain amino acids (BCAAs) were associated with preintervention adiposity. Changes in BCAAs (valine, leucine/isoleucine) and branched‐chain ketoacids were positively associated with change in HbA1c (false discovery rate q value ≤ 0.001) that persisted after adjustment for percentage weight change and RYGB (p ≤ 0.02). In analyses stratified by RYGB or other weight loss method, some metabolites showed association with non‐RYGB weight loss.

Conclusions

This study confirmed known metabolite associations with obesity/T2D and showed an association of BCAAs with HbA1c change after weight loss, independent of the method or magnitude of weight loss.

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Differential gene expression during floral transition in pineapple
Authors: Paull Robert E. , Ksouri Najla , Kantar Michael , Zerpa‐Catanho Dessireé , Chen Nancy Jung , Uruu Gail , Yue Jingjing , Guo Shiyong , Zheng Yun , Wai Ching Man Jennifer , Ming Ray
Published: November 2023

Pineapple (Ananas comosus var. comosus) and ornamental bromeliads are commercially induced to flower by treatment with ethylene or its analogs. The apex is transformed from a vegetative to a floral meristem and shows morphological changes in 8 to 10 days, with flowers developing 8 to 10 weeks later. During eight sampling stages ranging from 6 h to 8 days after treatment, 7961 genes were found to exhibit differential expression (DE) after the application of ethylene. In the first 3 days after treatment, there was little change in ethylene synthesis or in the early stages of the ethylene response. Subsequently, three ethylene response transcription factors (ERTF) were up‐regulated and the potential gene targets were predicted to be the positive flowering regulator CONSTANS‐like 3 (CO), a WUSCHEL gene, two APETALA1/FRUITFULL (AP1/FUL) genes, an epidermal patterning gene, and a jasmonic acid synthesis gene. We confirm that pineapple has lost the flowering repressor FLOWERING LOCUS C. At the initial stages, the SUPPRESSOR OF OVEREXPRESSION OF CONSTANS 1 (SOC1) was not significantly involved in this transition. Another WUSCHEL gene and a PHD homeobox transcription factor, though not apparent direct targets of ERTF, were up‐regulated within a day of treatment, their predicted targets being the up‐regulated CO, auxin response factors, SQUAMOSA, and histone H3 genes with suppression of abscisic acid response genes. The FLOWERING LOCUS T (FT), TERMINAL FLOWER (TFL), AGAMOUS‐like APETELAR (AP2), and SEPETALA (SEP) increased rapidly within 2 to 3 days after ethylene treatment. Two FT genes were up‐regulated at the apex and not at the leaf bases after treatment, suggesting that transport did not occur. These results indicated that the ethylene response in pineapple and possibly most bromeliads act directly to promote the vegetative to flower transition via APETALA1/FRUITFULL (AP1/FUL) and its interaction with SPL, FT, TFL, SEP, and AP2. A model based on AP2/ERTF DE and predicted DE target genes was developed to give focus to future research. The identified candidate genes are potential targets for genetic manipulation to determine their molecular role in flower transition.
Can seed exchange networks explain the morphological and genetic diversity in perennial crop species? The case of the tropical fruit tree Dacryodes edulis in rural and urban Cameroon
Authors: Rimlinger Aurore , Duminil Jérôme , Avana‐Tientcheu Marie‐Louise , Carrière Stéphanie M.
Published: November 2023

Societal Impact Statement

Crop seed exchange networks, shaped by social dynamics, strongly influence the organization and breadth of plant diversity in human‐managed environments. Integrating an urban and market perspective, this study explores the diversity dynamics of a socio‐economically important Central African fruit tree species, the African plum tree. Tree owners in urban, peri‐urban and rural sites use seeds from different origins as their main propagation material, leading to locational variations in genetic diversity and structure. This analysis contributes toward building a framework to inform the research agenda of cultivated African fruit trees, by highlighting the important role of urban centers in safeguarding crop genetic resources.

Biocultural factors constrain the dynamics of crop species diversity. Here, we considered different aspects of the social, spatial and temporal dynamics of morphological and genetic diversity in a multi‐purpose perennial crop, the African plum tree (Dacryodes edulis). We assessed (i) how seed exchange networks were organized along urbanization gradients, and how they influenced the distribution of species diversity; (ii) the temporal dynamic of seed exchange network by characterizing species genetic diversity through time.

To do so, the study was carried out in Cameroon, where we focused on three urbanization gradients, covering urban, peri‐urban and rural areas, corresponding to three different ethnic groups (Bamileke, Bassa, Beti). We combined interviews with tree owners and nuclear microsatellite‐based genetic analyses.

Tree owners from urban and peri‐urban sites primarily used distant seed sources, acquired in the market or from their village of origin, as propagation material, whereas tree owners in rural sites relied primarily on village‐level seeds. In turn, genetic diversity was not evenly distributed, with rural sites exhibiting their own genetic clusters. On the contrary, the genetic diversity of urban sites was enhanced by extensive human‐mediated seed flows. Looking at trees from different age classes, we found that genetic diversity was stable over time.

Overall, this first attempt to combine different levels of diversity for African plum trees in commercially connected areas expands the scope for in situ intraspecific conservation by highlighting the contribution of urbanized areas.
Effects of the HIV‐1 maturation inhibitor GSK3640254 on QT interval in healthy participants
Authors: Zhang Ying , Bush Mark , Yazdani Parto , Zhan Joyce , Wen Bo , Bainbridge Veronica , Wynne Brian R. , Joshi Samit , Lataillade Max
Published: November 2023

GSK3640254 (GSK'254) is a novel HIV‐1 maturation inhibitor with pharmacokinetics supporting once‐daily (QD) therapy for HIV‐1 treatment. This thorough QT/corrected QT (QTc) study evaluated the effect of GSK'254 on cardiac repolarization. In this two‐part, randomized study, healthy participants received GSK'254 or placebo QD for 7 days (part 1) to determine safety and pharmacokinetics of a 500‐mg supratherapeutic dose. Four sequential treatment periods composed the main QTc study (part 2): GSK'254 100 mg, GSK'254 500 mg, placebo QD for 7 days, or placebo QD for 6 days with a 400‐mg moxifloxacin dose on Day 7 (all with a moderate‐fat meal). Concentration‐QTc analyses modeled the relationship between GSK'254 plasma concentrations and placebo‐adjusted change from baseline in QT interval corrected with Fridericia's formula (ΔΔQTcF). Of 50 participants enrolled, 48 completed the study (part 1, 8/8; part 2, 40/42). Least‐squares (LS) mean change from baseline in QTcF for GSK'254 100 mg followed the placebo pattern across time points (maximum LS mean ΔΔQTcF, 1.7 ms); the upper bound of the 90% CI remained <10 ms. Maximum LS mean ΔΔQTcF for GSK'254 500 mg exceeded the 10‐ms threshold: 10.6 ms (90% CI 7.75–13.38). Neither GSK'254 dose had clinically relevant effects on heart rate or cardiac conduction. By concentration‐QTc analysis, no effect on ΔΔQTcF >10 ms is expected up to GSK'254 concentrations of ~3070 ng mL−1. No clinically relevant effects on cardiac parameters were seen in healthy participants with GSK'254 at the 100‐mg dose.
Design and field test of a foldable wing unmanned aerial–underwater vehicle
Authors: Sun Xiangren , Cao Jian , Li Ye , Wang Baoxu
Published: November 2023

This paper presents the design and field test of a foldable wing unmanned aerial–underwater vehicle (UAUV). The vehicle can complete diving and air operations, and still have the ability of multiple trans‐medium water egress and ingress under the condition of carrying mission load during a single flight. The wings can be folded back for drag reduction in underwater sailing and water egress, and unfolded to provide lift for flight after water egress. This paper presents the major components and system design of the vehicle, including the overall structure of the vehicle, the design of the mechanism for self‐locking and quick‐folding, the design of the electrical system, the selection of the propulsion system, and analyzes the performance gains from foldable wings and foldable propellers. Then the trans‐medium field test was introduced, and the analysis and discussion were conducted for the four typical operating conditions of the vehicle, including water sailing, aerial flight, water egress and water ingress. Furthermore, the endurance performance under the corresponding operating conditions is estimated based on experimental data and the current battery energy carried. The presence of foldable wings and a large pitch angle water egress strategy reduces the thrust‐to‐weight ratio requirement for the vehicle. The results of the field tests can provide important experience and data support for the subsequent application‐oriented UAUVs.
Examining the asymmetric effects of fossil fuel consumption, foreign direct investment, and globalization on ecological footprint in Mexico
Authors: Eweade Babatunde S. , Karlilar Selin , Pata Ugur Korkut , Adeshola Ibrahim , Olaifa John O.
Published: November 2023

This paper investigates the asymmetric effects of fossil fuels, foreign direct investment (FDI), and globalization on the ecological footprint (EFP) in Mexico from 1975 to 2020. To this end, the Autoregressive Distributed Lag (ARDL), Nonlinear Autoregressive Distributed Lag (NARDL), and the wavelet coherence approach are conducted. Based on the outcomes of the ARDL method, economic growth and fossil fuel consumption lead to ecological degradation, while foreign direct investment improves environmental conditions. Globalization has no impact on the environment. The NARDL approach illustrates that a positive shock to fossil fuels, FDI, and globalization degrades the environment. The wavelet coherence results emphasize the adverse environmental influence of economic growth and fossil fuels. These results imply that the Mexican government should conduct its economic expansion considering the principle of sustainable development. In this context, policymakers should propagate carbon taxes and similar instruments to promote clean energy sources that can replace fossil fuels and are compatible with sustainable development policies.
Seeded vacuum decay with Gauss-Bonnet
Authors: Gregory Ruth , Hu Shi-Qian
Published: November 2023

Abstract

We investigate false vacuum decay catalysed by black holes under the influence of the higher order Gauss-Bonnet term. We study both bubble nucleation and Hawking-Moss types of phase transition in arbitrary dimension. The equations of motion of “bounce” solutions in which bubbles nucleate around arbitrary dimensional black holes are found in the thin wall approximation, and the instanton action is computed. The headline result that the tunnelling action for static instantons is the difference in entropy of the seed and remnant black holes is shown to hold for arbitrary dimension. We also study the Hawking-Moss transition and find a picture similar to the Einstein case, with one curious five-dimensional exception (due to a mass gap). In four dimensions, we find as expected that the Gauss-Bonnet term only impacts topology changing transitions, i.e. when vacuum decay removes the seed black hole altogether, or in a (Hawking-Moss) transition where a black hole is created. In the former case, topology changing transitions are suppressed (for positive GB coupling α), whereas the latter case results in an enhanced transition.
Der Stellenwert von Leitlinien in der Zahnheilkunde und in der zahnmedizinischen Ausbildung
Authors: Krohn Sebastian , Kopp Ina B. , Proff Peter
Published: November 2023

Im Rahmen von qualitätssichernden Maßnahmen spielen evidenzbasierte Handlungsempfehlungen in der Zahn- und Humanmedizin eine zunehmend bedeutendere Rolle. Die von Expertengremien methodenkritisch evaluierten Wissenschaftserkenntnisse werden dabei zu einfach verständlichen Leitlinien zusammengefasst. Entsprechend der Konsens- und Evidenzgewichtung des Erstellungsprozesses werden die Leitlinien in verschiedenen Entwicklungsstufen qualitativ bewertet. Seit der Gründung in den 1960er-Jahren erfolgen die Publikation von Leitlinien und die Koordination der Leitlinienerstellung durch die Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF). Zum aktuellen Zeitpunkt sind 44 zahnmedizinische Leitlinien verfügbar, die zum größten Teil mit der höchsten Entwicklungsstufe S3 bewertet sind. Dadurch sind Handlungskorridore für eine Vielzahl von Behandlungsmaßnahmen für zahnärztliches Personal der universitären Standorte und Praxen definiert, deren Implementierung in den klinischen Alltag wünschenswert ist. Mangelnde Akzeptanz von Leitlinien und ein hoher Ressourcenaufwand bei deren Erstellung sind wesentliche Limitationen im Ausbau der evidenzbasierten Zahnmedizin. Diese könnten durch Einführung der wissenschaftlichen Grundausbildung innerhalb des Zahnmedizinstudiums und verstärkte Förderung des wissenschaftlichen Nachwuchses überwunden werden, um hohe Behandlungsqualität und Ökonomie in der Zahnheilkunde auch zukünftig zu gewährleisten. Leitlinien können die zahnmedizinische Ausbildung unterstützen, indem sie Studierenden wissenschaftlich abgesicherte Handlungsschablonen bieten und den Lehrenden helfen, den hohen Anforderungen im Rahmen von praktischen Kursen gerecht zu werden.
Analyse der Versorgungssituation bei Epiphyseolysis capitis femoris (ECF) in Deutschland
Authors: Amann Elea , Schwarze Michael , Noll Yvonne , Windhagen Henning , Radtke Kerstin
Published: November 2023

Einführung

Das Behandlungskonzept der Epiphyseolysis capitis femoris wird nach wie vor kontrovers diskutiert. In der Literatur findet sich bislang insgesamt keine einheitliche Empfehlung für ein therapeutisches Vorgehen. Ziel dieser Studie ist daher die Analyse der Versorgungsrealität von Kindern mit ECF in Deutschland.

Methodik

Basierend auf einem Fragebogen zur ECF-Versorgung, der 2021 an ECF-versorgende Ärzte verschickt wurde, erfolgt die Auswertung der Studie. Im Weiteren erfolgt der Abgleich der erhobenen Versorgungsdaten mit Literaturempfehlungen zur ECF.

Ergebnisse

36 von 47 verschickten Bögen wurden eingeschlossen. Dabei konnte insgesamt kein signifikanter Unterschied in der Versorgung der ECF hinsichtlich der jährlichen Fallzahlen oder der Krankenhausgröße nachgewiesen werden.

Schlussfolgerung

Es zeigt sich insgesamt ein inhomogenes Bild bezüglich der ECF-Versorgung. Nach aktueller Literatur gilt das modifizierte Dunn-Verfahren bislang als die beste Therapieoption für schwer abgerutschte Epiphysen und für Patienten mit chronischer ECF. Dieses im Vergleich zu anderen Versorgungsoptionen technisch schwierige und komplikationsreiche Verfahren kann nicht in jedem Krankenhaus angeboten werden. Eine Registererfassung aus versorgenden Kliniken, eine Mindestmengenregelung sowie der Ausbau von Weiterbildungsmaßnahmen können zur Optimierung der Versorgung beitragen.

Graphic abstract
Low central sensitisation inventory score is associated with better post‐operative outcomes of osteotomy around the knee
Authors: Ding Hao , Koga Hideyuki , Katagiri Hiroki , Hasegawa Shoichi , Anzai Tatushiko , Katakura Mai , Yoshihara Aritoshi , Amemiya Masaki , Hoshino Takashi , Ozeki Nobutake , Nakamura Tomomasa , Nakagawa Yusuke
Published: November 2023

Purpose

The purpose of this study was to investigate the potential association between central sensitisation inventory (CSI) scores and post‐operative patient‐reported outcomes (PROs) in patients underwent osteotomy around the knee (OAK), with a CSI cut‐off score specific for knee osteoarthritis.

Methods

CSI scores were collected from 173 patients who underwent OAK, along with their knee injury and osteoarthritis outcome score (KOOS) and pain numeric rating scale (NRS) scores. Patients were divided into high‐CSI score group and low‐CSI score group with a cut‐off score of 17. Multivariate linear regression was performed to test the association between CSI scores and post‐operative outcomes. Pre‐surgery KOOS and NRS scores and the rate of attainment of minimal clinically important difference (MCID) of KOOS scores was analysed as secondary outcomes.

Results

Low‐CSI score group had significantly higher post‐operative KOOS scores and lower pain NRS scores compared to the high‐CSI score group (< p = 0.01) after adjusting for confounding factors. For pre‐operative scores, only the KOOS‐Symptom score was significantly different between the groups (64.7 ± 20.1 when CSI < 17 vs.55.1 ± 19.7 when CSI ≥ 17; p = 0.008). The low‐CSI score group had significantly higher MCID achievement rates of KOOS‐Pain, Symptom, and ADL than the high‐CSI score group (86% vs. 68%; 74% vs. 55%; 86% vs. 67%, respectively; P < 0.05).

Conclusions

This study established an association between post‐operative CSI scores ≥ 17 and poorer outcomes following OAK, highlighting the potential value of the CSI in identifying patients in need of more comprehensive peri‐operative pain management.

Level of evidence

Level III. Retrospective comparative study.
Infraorbital Rejuvenation Combined with Thread-Lifting and Non-cross-linked Hyaluronic Acid Injection: A Retrospective, Case-Series Study
Authors: Liao Zhi-Feng , Yang Wei , Li Xin , Wang Shi-wei , Liu Fang-Cen , Luo Sheng-Kang
Published: November 2023

Background

Infraorbital aging develops during the natural aging process. Various treatment options offer unique benefits, accompanied by diverse side effect profiles, and can be synergistically combined to optimize results. This study aimed to evaluate the efficacy of a comprehensive approach involving non-cross-linked hyaluronic acid injection and smooth absorbable PPDO (poly p-dioxanone) thread insertion for infraorbital rejuvenation.

Methods

This retrospective case series study enrolled ten female patients with infraorbital aging from March 2022 to April 2023. Clinical outcomes, patient satisfaction, and adverse events were assessed at 1, 3, and 6 months posttreatment.

Results

The median Global Aesthetic Improvement Scale scores evaluated by the operator and blinded evaluator were 1.70 ± 0.42 and 1.80 ± 0.35, respectively, at six months posttreatment. The median Allergan Infraorbital Hollows Scale determined by the operator was 1.15 ± 0.34 at six months posttreatment, whereas the scores evaluated by the blinded evaluator were 1.15 ± 0.53. At six months after treatment, 50% of patients were satisfied, and an additional 40% reported strong satisfaction with the clinical improvement following treatment. No serious adverse events, such as infections, lumps, irregularities, Tyndall effect, hematoma, or skin necrosis, occurred during the treatment period.

Conclusions

The combination of PPDO thread insertion and non-cross-linked hyaluronic acid injection yielded satisfactory and effective clinical outcomes with no occurrence of serious adverse events for infraorbital rejuvenation. We anticipate that this study will contribute to the advancement of novel treatment options for infraorbital aging.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
Gender differences in association between expiratory dynamic airway collapse and severity of obstructive sleep apnea
Authors: Kim Soriul , Lee Ki Yeol , Siddiquee Ali Tanweer , Kim Hyeon Jin , Nam Hye Ryeong , Ko Chang Seop , Kim Nan Hee , Shin Chol
Published: November 2023

Objectives

Repetitive unbalances and tensions generated by inspiratory efforts against an obstructive upper airway during sleep predispose the development of expiratory central airway collapse. In addition, structures of the upper airway between men and women have differences and could be the reasons for differences in obstructive sleep apnea (OSA) prevalence between genders. The present study aimed to evaluate the association between parameters of expiratory dynamic tracheal collapse measured using chest multidetector CT and objectively measured OSA severity between men and women.

Materials and methods

A total of 901 participants who underwent chest CT and overnight in-home polysomnography from the Korean Genome and Epidemiology Study were cross-sectionally analyzed (women: 46.2%). The participants were divided into three groups based on OSA severity by apnea–hypopnea index (AHI). Multivariate linear regression analysis was performed to determine the effects of central airway collapse after adjustment for cardiovascular-related covariates.

Results

In a multivariate analysis, percentages of expiratory lumen structure reductions involving area, diameter, and perimeter were associated with AHI (all p values < 0.05) and with OSA severity (moderate-to-severe OSA than no OSA: β = 3.30%, p = 0.03; β = 2.05%, p = 0.02; β = 1.97%, p = 0.02, respectively) in women, whereas men had only a greater percentage of expiratory wall thickness reduction in moderate-to-severe OSA than no OSA (β = 0.72%, p = 0.003). In addition, women with both mild OSA and moderate-to-severe OSA had higher expiratory tracheal collapse than men without OSA, and a moderate effect of sex was observed (p for interaction = 0.007).

Conclusion

The expiratory dynamic tracheal collapse was independently associated with severity of OSA in women than in men.

Clinical relevance statement

Differences of pharyngeal structures and inherent features of airways by genders may affect the dissimilarities in vulnerability to sleep apnea between men and women.

Key Points

• The expiratory dynamic tracheal collapse was independently associated with severity of OSA in women than in men.

• Women with over mild OSA had higher expiratory tracheal collapse than men without OSA, and moderate effect of sex was observed.

• Structural differences of airway may affect differences in susceptibility of sleep apnea between genders.
Künstliche Intelligenz in der Medizin: Von Entlastungen und neuen Anforderungen im ärztlichen Handeln
Authors: Tretter Max , Samhammer David , Dabrock Peter
Published: November 2023

Der folgende Beitrag untersucht, wie der Einsatz von Künstlicher Intelligenz (KI) in der Medizin einerseits dazu beitragen kann, Ärzt*innen einige Aufgaben abzunehmen und sie auf sachlicher Ebene zu unterstützen – wie durch diese KI-Anwendungen andererseits jedoch neue Anforderungen auf der sozialen Ebene ärztlichen Handelns entstehen. Entlang der ethischen wie sozialpsychologischen Konzepte Vertrauen, Nachvollziehbarkeit und Verantwortung wird auf konzeptioneller Ebene aufgezeigt, welche neuen Herausforderungen durch den Einsatz medizinischer KI-Anwendungen entstehen und dass diese primär durch Kommunikation bewältigt werden können. Die Notwendigkeit, diese Herausforderungen kommunikativ anzugehen, wird vor dem Hintergrund professionstheoretischer wie ethischer Überlegungen diskutiert. So kommen wir zu dem Schluss, dass der Einsatz medizinischer KI-Anwendungen zu einer Verschiebung im Anforderungsprofil von Ärzt*innen führen wird. Dabei wird der Fokus von rein fachlichen Kompetenzen auf eine stärkere Betonung der Kommunikationsfähigkeiten verlagert.
Biological enhancement of the cover crop Phacelia tanacetifolia (Boraginaceae) with the nematophagous fungus Pochonia chlamydosporia to control the root-knot nematode Meloidogyne hapla in a succeeding tomato plant
Authors: Uthoff Jana , Jakobs-Schönwandt Desiree , Schmidt Jan Henrik , Hallmann Johannes , Dietz Karl-Josef , Patel Anant
Published: November 2023

Root-knot nematodes cause global economic losses in a wide range of crops. We investigated the potential of seed coatings of the cover cropPhacelia tanacetifolia(Boraginaceae) when inoculated with the nematophagous fungusPochonia chlamydosporia(Hypocreales: Clavicipitaceae) to protect subsequently grown tomato plants from root galling caused by the root-knot nematodeMeloidogyne hapla(Tylenchida: Meloidogynidae). Therefore, seeds ofP. tanacetifoliawere coated withP. chlamydosporiablastospores and planted inM. hapla-infested pots. After 50 days of growth in infested soil,M. haplaeggs were extracted fromP. tanacetifoliaroots and quantified. Tomato plants grown in the remaining soil served as bioindicator ofM. haplainfestation as expressed by the gall index. Results showed that seed coating ofP. tanacetifoliawithP. chlamydosporia(290 ± 51 CFU per seed) reduced the number ofM. haplaeggs up to 95.6% in comparison to untreated controls.Pochonia chlamydosporiaas blastospore suspension (5·108blastospores per 600 ml soil) reduced the number ofM. haplaeggs by up to 75.5%. Additionally, tomato plants grown for 50 days in substrates previously planted withP. tanacetifoliaseeds coated withP. chlamydosporiashowed a significantly lower gall index than plants grown in untreated pots. In conclusion, biological enhancement ofP. tanacetifoliaby seed coating withP. chlamydosporiasuccessfully reducedM. haplaand thus provides an additional tool in the management of this nematode. The method still has potential for further improvement such as increasing blastospore viability within the seed coating by optimized formulation technology.
Tests of Animal Consciousness are Tests of Machine Consciousness
Authors: Dung Leonard
Published: November 2023

If a machine attains consciousness, how could we find out? In this paper, I make three related claims regarding positive tests of machine consciousness. All three claims center on the idea that an AI can be constructed “ad hoc”, that is, with the purpose of satisfying a particular test of consciousness while clearly not being conscious. First, a proposed test of machine consciousness can be legitimate, even if AI can be constructed ad hoc specifically to pass this test. This is underscored by the observation that many, if not all, putative tests of machine consciousness can be passed by non-conscious machines via ad hoc means. Second, we can identify ad hoc AI by taking inspiration from the notion of an ad hoc hypothesis in philosophy of science. Third, given the first and the second claim, the most reliable tests of animal consciousness turn out to be valid and useful positive tests of machine consciousness as well. If a non-ad hoc AI exhibits clusters of cognitive capacities facilitated by consciousness in humans which can be selectively switched off by masking and if it reproduces human behavior in suitably designed double dissociation tasks, we should treat the AI as conscious.
Herbalism and glass-based materials in dentistry: review of the current state of the art
Authors: Singer Lamia , Bourauel Christoph
Published: November 2023

Half a million different plant species are occurring worldwide, of which only 1% has been phytochemically considered. Thus, there is great potential for discovering novel bioactive compounds. In dentistry, herbal extracts have been used as antimicrobial agents, analgesics, and intracanal medicaments. Glass-ionomer cement (GIC) and bioactive glass (BAG) are attractive materials in dentistry due to their bioactivity, adhesion, and remineralisation capabilities. Thus, this review summarizes the evidence around the use of phytotherapeutics in dental glass-based materials. This review article covers the structure, properties, and clinical uses of GIC and BAG materials within dentistry, with an emphasis on all the attempts that have been made in the last 20 years to enhance their properties naturally using the wisdom of traditional medicines. An extensive electronic search was performed across four databases to include published articles in the last 20 years and the search was concerned only with the English language publications. Publications that involved the use of plant extracts, and their active compounds for the green synthesis of nanoparticles and the modification of GIC and BAG were included up to May 2023. Plant extracts are a potential and effective candidate for modification of different properties of GIC and BAG, particularly their antimicrobial activities. Moreover, natural plant extracts have shown to be very effective in the green synthesis of metal ion nanoparticles in an ecological, and easy way with the additional advantage of a synergistic effect between metal ions and the phytotherapeutic agents. Medicinal plants are considered an abundant, cheap source of biologically active compounds and many of these phytotherapeutics have been the base for the development of new lead pharmaceuticals. Further research is required to assess the safety and the importance of regulation of phytotherapeutics to expand their use in medicine.

Graphical Abstract
God’s necessary existence: a thomistic perspective
Authors: Wahlberg Åke
Published: November 2023

There are strong reasons for assuming that Thomas Aquinas conceived of God’s existence in terms of logical necessity in a broad sense. Yet this seems to stand in some tension with the fact that he excludes the possibility of a priori arguments for the existence of God. One apparently attractive way of handling this tension is to use a two-dimensional framework inspired by Saul Kripke. Against this, this article demonstrates that a Kripke-inspired framework is inapt in this context because it allows for the conceivability of God’s non-existence, thereby rendering his non-existence possible in some important, and for Aquinas inacceptable, sense. Drawing on David Chalmers, the article submits that the existence of God can only be necessary if God’s non-existence is ideally inconceivable. On the basis of Aquinas’ own understanding of God, however, the article argues further that God’s non-existence in fact is inconceivable. The alleged conceivability of God’s non-existence is ultimately due to our (human) inability to grasp the nature of being, whereas creatures who grasp the nature of being are unable to conceive of God’s non-existence. This removes God’s non-existence from the realm of relevant conceivability and, therefore, from the range of possible worlds.
Power loss of the chain drive in a race tandem bicycle
Authors: Smit Albert , van der Zwaard Stephan , Janssen Ina , Janssen Thomas W. J.
Published: November 2023

Tandem cycling is a paralympic discipline, in which two cyclists ride on one tandem bicycle. Their performance can be improved by minimizing power losses. This study aimed to quantify power loss due to the chain drive of a tandem bicycle and influence of power input, location of power input, and rear chain wheel size. Power loss was determined by the difference between power input applied on the cranks (front or back rider) and power output measured at the rear wheel. Power output values were set from 100 to 400 W, with 50 W increments, and using two gear ratios, 53-11 and 53-13. Power input was generated at the back crank (with only the primary chain—solo bicycle—and with primary and secondary chain attached) and at the front crank (with primary and secondary chain attached). The power loss for the solo bicycle was 2.1% (± 1.5%). A significantly larger power loss was found for the tandem in the back (3.7 ± 2.4%, p < 0.001) and front positions (3.0 ± 1.8%, p < 0.001), with marginal differences between positions at higher power output. Power loss for the tandem was lower with gear 53-13 (2.9% ± 1.7%) compared to 53-11 (4.0 ± 2.8%, p < 0.001, effect size is medium). Therefore, findings suggest that back and front riders experience similar power losses due to the chain drive, but more than on a solo bicycle. Tandem cyclists can reduce their power loss in the chain drive by selecting larger gear ratios. Coaches may consider these findings for selecting and coaching their tandem cyclists.
Assistant platforms
Authors: Schmidt Rainer , Alt Rainer , Zimmermann Alfred
Published: November 2023

Many assistant systems have evolved toward assistant platforms. These platforms combine a range of resources from various actors via a declarative and generative interface. Among the examples are voice-oriented assistant platforms like Alexa and Siri, as well as text-oriented assistant platforms like ChatGPT and Bard. They have emerged as valuable tools for handling tasks without requiring deeper domain expertise and have received large attention with the present advances in generative artificial intelligence. In view of  their growing popularity, this Fundamental outlines the key characteristics and capabilities that define assistant platforms. The former comprise a multi-platform architecture, a declarative interface, and a multi-platform ecosystem, while the latter include capabilities for composition, integration, prediction, and generativity. Based on this framework, a research agenda is proposed along the capabilities and affordances for assistant platforms.
Genetic risk prediction in Hispanics/Latinos: milestones, challenges, and social-ethical considerations
Authors: Maldonado Betzaida L. , Piqué Daniel G. , Kaplan Robert C. , Claw Katrina G. , Gignoux Christopher R.
Published: November 2023

Genome-wide association studies (GWAS) have allowed the identification of disease-associated variants, which can be leveraged to build polygenic scores (PGSs). Even though PGSs can be a valuable tool in personalized medicine, their predictive power is limited in populations of non-European ancestry, particularly in admixed populations. Recent efforts have focused on increasing racial and ethnic diversity in GWAS, thus, addressing some of the limitations of genetic risk prediction in these populations. Even with these efforts, few studies focus exclusively on Hispanics/Latinos. Additionally, Hispanic/Latino populations are often considered a single population despite varying admixture proportions between and within ethnic groups, diverse genetic heterogeneity, and demographic history. Combined with highly heterogeneous environmental and socioeconomic exposures, this diversity can reduce the transferability of genetic risk prediction models. Given the recent increase of genomic studies that include Hispanics/Latinos, we review the milestones and efforts that focus on genetic risk prediction, summarize the potential for improving PGS transferability, and highlight the challenges yet to be addressed. Additionally, we summarize social-ethical considerations and provide ideas to promote genetic risk prediction models that can be implemented equitably.
Cognitive Functioning of Children in Out-of-Home Care
Authors: Eiberg Misja
Published: November 2023

Purpose: Most children who enter out-of-home care (OHC) have been subjected to prolonged maltreatment. Maltreatment potentially contributes to a cumulative deficit in neurocognitive maturation and development that is likely to proceed with the child’s placement into OHC and persist throughout adulthood. From the theoretical perspective of how maltreatment may affect the developing brain, this study examines the IQ and executive function of children placed in OHC on standardized, norm-referenced measures. Furthermore, the study investigates the prevalence of serious cognitive delays, defined by scores in the clinical range on the administered instruments. Methods: The study included 153 children in foster care (66% female), aged 6–15 (M = 10.5, SD = 2.1). Independent two-sample t-tests were run to test for significant differences between the sample and the norm population on the applied neuropsychological measures. Results: The results showed that discrepancies in cognitive development were global in scope, with the children lagging significantly behind the norm population on all applied measures with discrepancies ranging from 0.61 to 2.10 SD (p < .001). Also, serious developmental delays in all cognitive domains were vastly overrepresented in the sample ranging from 11.3% (IQ) to 66.0% (executive function). Conclusions: The results document a very high prevalence of cognitive deficits and delays among the children in the sample. The implications of identifying the neurocognitive effects of maltreatment in the practices of the child welfare system are discussed in terms of developing suitable assessment and intervention strategies.
Event-triggered model-free adaptive control for nonlinear systems using intuitionistic fuzzy neural network: simulation and experimental validation
Authors: Abd-Elhaleem Sameh , Hussien Mohamed A. , Hamdy Mohamed , Mahmoud Tarek A.
Published: November 2023

This article presents model-free adaptive control based on an intuitionistic fuzzy neural network for nonlinear systems with event-triggered output. Essentially, model-free adaptive control (MFAC) is constructed by establishing an online approximate model of the controlled system using the pseudo-partial derivative (PPD) form. By the proposed scheme, first, an intuitionistic fuzzy neural network (IFNN) is developed as an estimator for time-varying PPD in both compact-form dynamic linearization (CFDL) and partial-form dynamic linearization (PFDL) for the MFAC technique. Second, two periodic event-triggered output methods are integrated with the proposed IFNN-based MFAC in both forms to save communication resources and reduce the computation burden and energy consumption. Based on the Lyapunov theory and BIBO stability approach, necessary conditions are established to guarantee the convergence of the adaptive law of the IFNN controller and the boundary of the tracking error of the closed loop system. Third, regarding the feasibility and the effectiveness of the developed control method, two simulation examples including the continuous stirred-tank reactor (CSTR) system and the heat exchanger system are given. Finally, the practical validation of the proposed data-driven control method is conducted via the speed control of a DC motor.
Soil–Geosynthetic Interaction Under Triaxial Conditions: Shear Strength Increase and Influence of the Specimen Dimensions
Authors: Anjos Rafael , Carlos David Miranda , Gouveia Sónia , Pinho-Lopes Margarida , Powrie William
Published: November 2023

Geosynthetics are extensible reinforcements used to enhance the engineering performance of a soil. The transfer of stresses from the soil to the reinforcement is achieved through soil–geosynthetic interaction. The proposals from the literature to assess the shear strength of the reinforced soil under triaxial conditions use three different approaches. These involve analysing the reinforced soil: (i) as a homogeneous composite material (Approach A), (ii) as two different materials (Approach B), or (iii) as soil having the same fundamental shear strength, with the effect of the reinforcement represented as an additional lateral or confining stress (Approach C). In this paper, triaxial tests data of a soil reinforced with a geosynthetic, and specimens with different dimensions (diameters 70 and 150 mm) were used to assess changes in shear strength and to carry out a statistical analysis. The increases in shear strength of the reinforced soil and of the soil–geosynthetic interface were analysed using equations from the literature. The difference between the triaxial results obtained from specimens of different sizes was assessed using an Analysis of Covariance (ANCOVA). When the joint term of the regression model was not statistically significant, the characterisation from different specimen sizes was used to generate soil failure envelopes. Thus, a new methodology to obtain a failure envelope with different specimen sizes is presented.