bluuebunny/crossref_metadata_2025 huggingface dataset:
Early dark energy during big bang nucleosynthesis
Authors: McKeen David , Omar Afif
Published: November 2024

We study the impact of an early dark energy component (EDE) present during big bang nucleosynthesis (BBN) on the elemental abundances of deuterium D/H, and helium Yp, as well as the effective relativistic degrees of freedom Neff. We consider a simple model of EDE that is constant up to a critical time. After this critical time, the EDE transitions into either a radiation component that interacts with the electromagnetic plasma, a dark radiation component that is uncoupled from the plasma, or kination that is also uncoupled. We use measured values of the abundances and Neff as determined by cosmic microwave background observations to establish limits on the input parameters of this EDE model. In addition, we explore how those parameters are correlated with BBN inputs; the baryon to photon ratio ηb, neutron lifetime τn, and number of neutrinos Nν. Finally, we study whether this setup can alleviate the tension introduced by recent measurements of the primordial helium abundance.

Published by the American Physical Society
2024
The good shepherd: linking artificial intelligence (AI)-driven servant leadership (SEL) and job demands-resources (JD-R) theory in tourism and hospitality
Authors: Radic Aleksandar , Singh Sonali , Singh Nidhi , Ariza-Montes Antonio , Calder Gary , Han Heesup
Published: November 2024

Purpose

This study illustrates the conceptual framework that expands the knowledge of the fundamental components that describe how AI-driven servant leadership (SEL) influences the job resources (JR), work engagement (WE) and job performance (JP) of tourism and hospitality employees.

Design/methodology/approach

The empirical study was conducted on a sample of 953 international tourism and hospitality employees who were selected via a purposive and snowball sampling approach in a cross-sectional survey. The analysis was performed using a partial least square-structural equation modeling.

Findings

The results of this study confirmed the positive impact of AI-driven SEL on employee JR with the boundary conditions of AI-driven SEL.

Practical implications

This study finding assists tourism and hospitality practitioners in understanding that in the near future, AI will have a major effect on the nature of work, including the impact on leadership styles. Hence, AI-driven SEL holds both positive (through direct impact on JR) and negative (via boundary conditions) impacts on employees’ JP and ultimately organizational success. Accordingly, managers should employ AI-driven SEL to increase employees’ JR, and once employees achieve high WE, they should constrict AI-driven SEL boundary conditions and their influence between JR and WE and WE and JP.

Originality/value

This study offers a novel and original conceptual model that advances AI-driven social theory, SEL theory and job demands-resources (JD-R) theory by synthesizing, applying and generalizing gained knowledge in a methodical way.
Comparing DCE‐MRI and DSA: Understanding the embolization of hypervascular spinal metastases
Authors: Adnan Muhammad , Farukh Ameer Mustafa , Ali Syed Muhammad Sinaan , Mubashir Muhammad , Jauhar Imaan , Raheem Abdul
Published: November 2024

This study aims to examine and compare the effectiveness of dynamic contrast‐enhanced magnetic resonance imaging (DCE‐MRI) and Digital Subtraction Angiography (DSA) in evaluating hypervascular spinal metastases. A comprehensive literature review was conducted, utilizing top‐tier databases such as PubMed, Scopus and Google Scholar, to compile an authoritative and up‐to‐date overview of the current advancements in the field. We synthesized key studies focusing on the advantages, limitations and efficacy of both imaging techniques. DCE‐MRI provides a non‐invasive method for evaluating tissue morphology, perfusion and vascularity, offering valuable information for cancer diagnosis and treatment monitoring. In contrast, DSA is an invasive procedure primarily used for embolization and diagnosing cerebrovascular events. Both modalities have distinct features regarding image acquisition, contrast agents, resolution and accessibility. DCE‐MRI shows promise for cancer‐related applications, offering advantages over conventional MRI by incorporating anatomical and hemodynamic parameters. While DSA remains important for cases requiring critical vascular information, further research is necessary to explore its potential therapeutic benefits in assessing vessel patency. Continued investigations are crucial to uncover additional insights and therapeutic applications for both DCE‐MRI and DSA in medical imaging.
Patagonian Imaginary Nature: Colonial Narratives in Documentary Films on Subnational Spaces (1920–1955)
Authors: Zaidenwerg Cielo , Dimant Mauricio
Published: November 2024

This study contributes to the ongoing historical examination of ecological and postcolonial questions in Latin America through the lens of new media genre narratives. Early 20th‐century documentary films of Argentine Patagonia institutionalised a natural binary opposition, positioning those challenging colonial power relations based on natural resources against an ideal and achievable future. These narratives sought to shape dialogues and subjectivities about the region, defining the boundaries within which claims and changes were acknowledged. From this perspective, this research aims to advance the historical examination of the emergence of subnational future narratives and their connection with power dynamics in Latin America.
Essential steps for establishing a large‐scale passive acoustic monitoring for an elusive forest bird species: the Eurasian Woodcock (Scolopax rusticola)
Authors: Holderried Philip , Duschmalé Hanna , Günther Dennis , Isenberg Lars , Coppes Joy
Published: November 2024

In light of global biodiversity loss, comprehensive monitoring of species and biodiversity is fundamental for effective conservation management. Technology‐driven approaches, particularly in the field of bioacoustics, have gained importance, with autonomous recording units (ARUs) such as the AudioMoth being a notable example. However, a systematic application of this technology in large‐scale passive acoustic monitoring (PAM) schemes is challenging because of a lack of species‐specific calibration techniques and information on survey design. Using Eurasian Woodcock Scolopax rusticola as our focal species, we present application‐oriented guidelines for testing and implementing a terrestrial, single‐species PAM scheme. In this process, we assessed the species‐specific detection space of AudioMoths, considering the influence of recording setup and location. ARUs had similar detection rates as a human observer when set up in locations with low vegetation. A further comparative analysis of bioacoustic and traditional roding surveys confirmed the comparability of the two methods. The last step comprised an evaluation of BirdNET as a means of automated species detection. Although BirdNET reliably detected Woodcock occurrence, our results underline the need for rigorous testing of computer‐aided data analysis as well as recording hardware before establishing PAM. We demonstrate that low‐cost open source ARUs and open access analysis tools can yield results on a par with traditional survey methods, and we provide specific recommendations for PAM for Eurasian Woodcock.
Serum N‐Terminal Pro‐B‐Type Natriuretic Peptide Is Associated With Insulin Resistance in Chinese: Danyang Study
Authors: Zheng Ziwen , Liang Junya , Gao Yun , Hua Mulian , Zhang Siqi , Liu Ming , Fang Zhuyuan
Published: November 2024

The association of serum N‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP) with insulin resistance (IR), as measured by homeostasis model assessment of insulin resistance (HOMA‐IR), in the general population is unclear. Our study aimed to characterize its relationship in a large community‐based population. Subjects were recruited from the Danyang city between 2017 and 2019. Serum NT‐proBNP was measured using an enhanced chemiluminescence immunoassay. IR was defined by a HOMA‐IR in the highest sex‐specific quartile. Categorical and continuous analyses were performed with sex‐specific NT‐proBNP tertiles and naturally logarithmically transformed NT‐proBNP (lnNTproBNP), respectively. The 2945 participants (mean age 52.8 years) included 1728 (58.7%) women, 1167 (39.6%) hypertensive patients, 269 (9.1%) diabetic patients, and 736 (25.0%) patients with IR. In simple and multivariate‐adjusted regression analyses, serum lnNTproBNP were both negatively associated with HOMA‐IR (β = −0.19 to −0.25; p < 0.0001). Similar results were also obtained in multiple subgroup analyses. In multiple logistic regression analyses, elevated serum NT‐proBNP was associated with lower risks of IR (odds ratios: 0.68 and 0.39; 95% confidence intervals: 0.61–0.74 and 0.30–0.50 for lnNTproBNP and top vs. bottom tertiles, respectively; p < 0.0001). In conclusion, increased serum NT‐proBNP level was strongly associated with a lower risk of IR in Chinese.
Revalidation of Enteromius crocodilensis (Fowler, 1934) from synonymy with the disjunctly distributed Enteromius argenteus (Günther, 1868) based on molecular and morphological evidence
Authors: Scheepers Martinus , Bragança Pedro H. N. , Chakona Albert
Published: November 2024

The rosefin barb, Enteromius argenteus, as currently described, is a freshwater fish with a distribution that is geographically separated and divided into the northern population in the Kwanza River system in Angola, and the southern population in the Inkomati River system in South Africa and Eswatini. Due to this disjunct distribution pattern, it is likely that the two populations represent distinct species. mtDNA sequence data and detailed examination of morphometric characters revealed considerable genetic (2.8%–3.5%) and morphological differentiation of the two populations, suggesting their recognition as two distinct species. Enteromius crocodilensis is revalidated and redescribed for the southern population that is readily distinguished from E. argenteus by nonoverlapping circumpeduncular scale counts (12–13 vs. 14) and color pattern (presence of a conspicuous dark band along the midline vs. absence of characteristic melanin patterns). Phylogenetic analysis based on mtDNA cytochrome oxidase subunit I (COI) data places both E. argenteus and E. crocodilensis in a well‐supported clade that includes a number of morphologically similar sawfin barb species from southern and central Africa.
Silicone cure inhibition with material jetting additive manufacturing utilized for facial prosthesis fabrication – A clinical report
Authors: Chen Chen , Chao Denny , Jayanetti Jay
Published: November 2024

This clinical report outlines the prosthetic restoration of a 92‐year‐old Caucasian patient who underwent a partial rhinectomy. Utilizing CAD‐CAM technology, scanning and design were accomplished digitally, and material jetting additive manufacturing was used to create a two‐piece mold for a partial nasal silicone prosthesis. An unprecedented challenge was observed involving cure inhibition when the silicone came into contact with the additively manufactured (AM) material, and multiple attempted strategies to remedy this situation were discussed. The report emphasizes the critical need for further research to optimize digital workflows in prosthetic facial rehabilitation.
Direct Antivirals Can Achieve a Cure in All Patients With Chronic Hepatitis C due to Genotype 5: A French Multicentre Study
Authors: Nicolas Carine , Domas Quentin , Pol Stanislas , Bardou‐Jacquet Edouard , Loustaud‐Ratti Véronique , Métivier Sophie , Asselah Tarik , Thabut Dominique , Bourlière Marc , Mathurin Philippe , Foucher Juliette , Larrey Dominique , Varaut Anne , Alric Laurent , Bailly François , Muti Léon , Buchard Benjamin , Abergel Armando
Published: November 2024

Background

Hepatitis C virus genotype 5 (HCV‐GT‐5) is found mainly in South Africa. In our area in central France, the prevalence of HCV‐GT‐5 is 14%.

Methods and Results

Here we evaluated sustained virological response at week 12 post‐treatment (SVR12) in 147 HCV‐GT‐5 patients from 14 French university hospitals (2014–2021) treated with direct‐acting antivirals (DAA) in real‐life. Patients had mainly received sofosbuvir/ledipasvir ± ribavirin, sofosbuvir/velpatasvir, and glecaprevir/pibrentasvir. Overall SVR12 was 98% (144/147). Two patients experienced relapse: one was successfully retreated with the same DAAs (sofosbuvir/ledipasvir) plus ribavirin, and the other refused further DAA treatment. One patient with virological failure (sofosbuvir/velpatasvir) had received a second treatment (sofosbuvir/velpatasvir/voxilaprevir) and progressed to cure.

Conclusions

HCV‐GT‐5 patients treated with a DAA regimen had a 99% SVR12 in intention‐to‐treat (including initial therapy and retreatment) and 100% SVR12 per protocol. Sofosbuvir/ledipasvir, sofosbuvir/velpatasvir, and glecaprevir/pibrentasvir show very good efficacy in real‐world HCV‐GT‐5 patients.
Derrida and Kant's staging of capital punishment
Authors: van Gorkom Joris
Published: November 2024

Jacques Derrida's claim that Immanuel Kant was the most rigorous defender of the death penalty has rekindled interest in this topic in the context of Kant's work. Understandably, most articles have focused on Kant's The Metaphysics of Morals, in which he defends the legitimacy of capital punishment. However, many of these readings ignore the fact that the death penalty is a recurring theme in his writing. This article explores references to capital punishment in Kant's Critique of Practical Reason and uncovers a consistent theme: the connection between morality and acts of self‐sacrifice. It aims to demonstrate the challenges of formulating a philosophical argument for the abolition of the death penalty.
Equity Transfer Guarantee under the Civil Code
Authors: Liu Kaili
Published: November 2024

Equity transfer guarantee is the frustration cost generated by the principle of numerus clausus of real rights. Because the legal types of guarantees cannot meet the needs of the parties, it is a product generated by practice. Before the promulgation of the Civil Code, scholars believed that "transfer guarantee" was invalid because it violated the "principle of numerus clausus of real rights" and the "principle of prohibition of liquidation". However, Article 388 of the Civil Code provides a "new life" for (equity) transfer guarantee. Whether adopting the "ownership structure theory" or the "guarantee right structure theory", the exercise of the rights of the transferee in equity transfer guarantee should be restricted by the parties' agreement and the purpose of guarantee. When the debtor is unable to pay off the debt, the creditor can realize the guarantee by adopting the “attribution liquidation type” method.
Reviewer Acknowledgements for International Journal of Social Science Studies, Vol. 12, No. 5
Authors: Young James
Published: November 2024

International Journal of Social Science Studies (IJSSS) would like to acknowledge the following reviewers for their assistance with peer review of manuscripts for this issue. Many authors, regardless of whether IJSSS publishes their work, appreciate the helpful feedback provided by the reviewers. Their comments and suggestions were of great help to the authors in improving the quality of their papers. Each of the reviewers listed below returned at least one review for this issue.Reviewers for Volume 12, Number 5Bishnu Prasad Dahal, Tribhuvan University, NepalFahri ÖZSUNGUR, Adana Science and Technology University, TurkeyJibrin Ubale Yahaya, National Open University of Nigeria NOUN, NigeriaJulia M. Mack, Gannon University, USAK.O. Aramide, The Polytechnic Ibadan, NigeriaKun Yu, Universiti Putra Malaysia, ChinaLingkai Kong, Izmir University of Economics , TurkeyMartial Fanga, The University of Religions and Denominations, Qom, IranMd. Nasir Uddin, Prime Minister’s Office, BangladeshNAZIAH ABD. KADIR, Universiti Selangor, MalaysiaPeriyasami Anbarasan, Indian Institute of technology Delhi, IndiaQingzhi Huan, Peking University, ChinaSana Ali, Allama Iqbal Open University, Pakistan, and Birmingham City University, United Kingdom, PakistanShaoshu Li, Cornell University , USASusheelabai Srinivasa, University of Texas Rio Grande Valley, United StatesYuhan WANG, Guangdong University of Technology, ChinaYusramizza Md Isa, Universiti Utara Malaysia, Malaysia  James YoungEditorial AssistantOn behalf of,The Editorial Board of International Journal of Social Science StudiesRedfame Publishing9450 SW Gemini Dr. #99416Beaverton, OR 97008, USAURL: http://ijsss.redfame.com
Report on laser-induced fluorescence transitions relevant for the microelectronics industry and sustainability applications
Authors: Kondeti V. S. Santosh K. , Yatom Shurik , Romadanov Ivan , Raitses Yevgeny , Dorf Leonid , Khomenko Andrei
Published: November 2024

A wide variety of feed gases are used to generate low-temperature plasmas for the microelectronics and sustainability applications. These plasmas often have a complex combination of reactive and nonreactive species which may have spatial and temporal variations in density, temperature, and energy. Accurate knowledge of these parameters and their variations is critically important for understanding and advancing these applications through validated and predictive modeling and the design of relevant devices. Laser-induced fluorescence (LIF) provides both spatial and temporally resolved information about the plasma-produced radicals, ions, and metastables. However, the use of this powerful diagnostic tool requires the knowledge of optical transitions including excitation and fluorescence wavelengths which may not be available or scattered through a huge literature domain. In this paper, we collected, analyzed, and compiled the available transitions for laser-induced fluorescence for more than 160 chemical species relevant to the microelectronics industry and the sustainability applications. A list of species with overlapping LIF excitations and fluorescence wavelengths have been identified. This summary is intended to serve as a data reference for LIF transitions and should be updated in the future.
Alcoholic ketoacidosis: confused diagnosis
Authors: Smith Patrick Carlsen , Neutze Dana
Published: November 2024

A woman in her 30s presented with a 3-day history of nausea, vomiting and abdominal pain. She was found to be in ketoacidosis with an elevated serum glucose level of 18.2 mmol/L (328 mg/dL). Based on her initial presentation and test results, she was believed to have new onset diabetic ketoacidosis (DKA) from previously undiagnosed diabetes. Subsequently, she was found to have acidosis caused by acute or chronic alcohol consumption, even though her serum glucose was higher than would be typically expected with alcohol abuse. Alcoholic ketoacidosis usually has lower glucose levels as well as retained mental function when compared with DKA. A haemoglobin A1c, fructosamine level, betahydroxybutyrate to acetoacetate ratio, C-peptide and antibodies to pancreatic beta-cells can help rule out diabetes as the aetiology of the ketoacidosis. This patient was treated with fluids and electrolyte replacement, showed rapid improvement, received alcohol cessation resources and was discharged home.
Colour vision deficiency is associated with increased prevalence of amblyopia, strabismus and ametropia: a large population study
Authors: Barayev Edward , Shapiro Michael , Greenbaum Eran , Ran Yuval , Gershoni Assaf , Dotan Gad
Published: November 2024

Aims

To examine the association between colour vision deficiency (CVD) and other ophthalmic disorders including amblyopia, strabismus and ametropia in a large population study.

Methods

The retrospective, cross-sectional study included 916 388 Israeli army male recruits who had their premilitary medical assessment at the age of 16–18 years from 2000 to 2020, analysing the prevalence of ophthalmic disorders including amblyopia, strabismus and ametropia in army recruits with CVD compared with all other recruits with normal colour vision. Demographic and socioeconomic data were also collected.

Results

The prevalence of amblyopia (1.28% vs 0.71%, p<0.001), strabismus (1.09% vs 0.83%, p<0.001) and ametropia (moderate—less than 6.00 diopters, 35.05% vs 30.50%, p<0.001 and high—higher than 6.00 diopters, 3.18% vs 2.30%, p<0.001) were all higher among 28 001 (3.06%) army recruits with CVD compared with all other individuals with normal colour vision. CVD was more common in individuals with a higher socioeconomic status (high 3.15% vs low 2.93%, p<0.001) and varied according to recruits’ origin. It was most frequent in individuals whose mother was born in the former Soviet Union (4.98%) compared with other European countries (3.89%), North America (3.28%), Asia (2.78%) and Ethiopia (1.63%).

Conclusion

CVD is associated with an increased frequency of amblyopia, strabismus and ametropia, which can all impart vision difficulties besides colour vision impairment alone.
Recent advances in clinical practice: mastering the challenge—managing IBS symptoms in IBD
Authors: Wellens Judith , Sabino João , Vanuytsel Tim , Tack Jan , Vermeire Séverine
Published: November 2024

Many patients with IBD report persisting symptoms, despite resolution of the inflammatory process. Although by definition, a diagnosis of IBS cannot be made, the prevalence of ‘IBS in IBD’ surpasses the rate of IBS in the global population by fivefold. Because IBS-like symptoms are associated with a decreased quality of life and increased healthcare utilisation in IBD, diagnosis and treatment are necessary. In this review, we summarise the current knowledge on IBS-like symptoms in IBD. A pathophysiological common ground is present, which includes genetic susceptibility, environmental triggers, gut microbial dysbiosis, increased intestinal permeability, visceral hypersensitivity and involvement of brain–gut interaction. When symptoms persist after resolution of inflammation, other GI diseases should be excluded based on the chief complaint, considering any possible psychological co-morbidity early in the diagnostic work-up. Subsequent treatment should be initiated that is evidence-based and often multimodal, including classical and non-classical pharmacological agents as well as lifestyle and microbiota-based approaches, spanning the breadth of the gut, brain and its interaction. Treatment goals in this substantial part of the IBD population should be adapted to not only focus on treating the inflammation but taking care of the patient.
Effect of a multicomponent school-based intervention with parental involvement on socioeconomic inequalities in smoking initiation: equity impact analysis of the TOPAS study
Authors: Beeres Dorien , Galanti Maria Rosaria , Nilsson Maria , Pulkki-Brännström Anni-Maria
Published: November 2024

Background

As prevalence of tobacco use falls, socioeconomic inequalities in tobacco use are increasing in many high-income countries. Evidence is lacking on the effect of preventive interventions on socioeconomic inequalities in smoking initiation among adolescents. We evaluated whether a multicomponent school-based prevention programme with parental involvement has differential effects on smoking initiation across socioeconomic groups and affects the magnitude of socioeconomic inequalities in smoking initiation.

Methods

A secondary analysis of data from a 3-year cluster randomised controlled trial, the TOPAS study, conducted in Sweden from 2018 to 2021. Schools were randomised either to the full programme (Tobacco-Free Duo, T-DUO) or minimal intervention (EDU). The analysis was conducted according to intention to treat for the primary outcome, the probability of remaining a non-user of cigarettes at the end of compulsory school (ages 15–16). Parents’ educational attainment was the socioeconomic variable. Differential effects were analysed by comparing adolescents exposed to T-DUO with those exposed to EDU within each socioeconomic group. The effect of the intervention on the magnitude of inequalities was analysed by comparing several measures of absolute and relative inequalities between T-DUO and EDU.

Results

At the end of follow-up, the full programme had a similar, at most moderate effect on smoking initiation in all socioeconomic groups (relative risk 1.13 (95% CI 1.02 to 1.25) in the middle group). The programme did not significantly affect the magnitude of inequalities (Slope Index of Inequality difference 1.49 (95% CI −15.34 to 18.32)).

Discussion

Socioeconomic inequalities in smoking initiation remain substantial. Our results indicate the absence of an effect of the programme T-DUO on these inequalities.
KDM4A facilitates neuropathic pain and microglial M1 polarization by regulating BDNF in a rat model of brachial plexus avulsion
Authors: Guo Jinding , Gao Kaiming , Chen Xi , Liao Chengppeng , Rui Jing , Zhou Yingjie , Lao Jie
Published: November 2024

Background

Many patients with brachial plexus avulsion (BPA) suffer from neuropathic pain, but the mechanism remains elusive. Modifications of histones, the proteins responsible for organizing DNA, may play an important role in neuropathic pain. Lysine demethylase 4A (KDM4A), an essential component of histone demethylase, can modify the function of chromatin and thus regulate the vital gene expressions. However, the mechanism by which KDM4A regulates neuropathic pain following BPA remains unclear.

Methods

The pain model was developed in adult rats that received BPA surgery. Western blot, ELISA, and reverse transcription-PCR were used to examine the protein and mRNA levels of targeted genes. Immunofluorescence studies were conducted to analyze their cellular distribution in the spinal cord. Pharmacological and genetic methods were used to modulate the expression of KDM4A. Co-immunoprecipitation and chromatin immunoprecipitation PCR were used to assess the binding potential between KDM4A and the promoter of brain-derived neurotrophic factor (BDNF).

Results

KDM4A and BDNF levels were significantly upregulated in the ipsilateral spinal cord dorsal horn in the BPA group compared with the sham surgery group. Additionally, knockdown of KDM4A decreased BDNF expression and microgliosis and reduced neuropathic pain-like behaviors in BPA rats. Conversely, KDM4A overexpression increased BDNF expression and microgliosis and exacerbated neuropathic pain. BDNF inhibitors and activators also regulated the activation of spinal microglia and neuropathic pain. Importantly, we showed that KDM4A modulates BDNF expression by regulating the methylation of histone 3 lysine 9 and histone 3 lysine 36 in its promoter region.

Conclusion

Current findings suggest that the upregulation of KDM4A increases BDNF expression in the spinal cord in rats after BPA, contributing to microgliosis, neuroinflammation, and neuropathic pain.
ELPGPT: Large Language Models Enhancing Link Prediction in Electrical Knowledge Graph
Authors: Chen Long , Zhou Yan , Wei Qiang , Sun Baoxin , Zhao Ranran , Zhang Chaolin , Wang Xiaobing
Published: November 2024

Graphs provide essential means for organizing and analyzing complex equipment data. Although link prediction techniques have been widely applied to enhance knowledge graphs, existing methods still show room for improvement in accuracy, especially when dealing with sparse data. To address this, we introduce ELPGPT (Large Language Models Enhancing Link Prediction in Electrical Equipment Knowledge Graph), a novel approach that integrates large language models into link prediction to enhance the accuracy of relation prediction within electrical equipment knowledge graphs. The core of the ELPGPT method lies in the combination of large language models with traditional knowledge graph link prediction techniques. By leveraging the deep semantic understanding capabilities of large language models, this method effectively extracts relational features and enhances the handling of sparse data. Additionally, we employ a Retrieval-Augmented Generation (RAG) approach, which, by integrating external data sources, further enhances the precision and relevance of predictions. Experiments on the Electrical Equipment Knowledge Graph (EEKG) demonstrate that ELPGPT significantly improves performance across several metrics, including Hit@k, Mean Rank (MR), and Mean Reciprocal Rank (MRR). These results validate the effectiveness and potential applications of this method in the domain of link prediction for electrical equipment knowledge graphs.
Various Clinical Phenotypes and Approach to Patients with NSAID Hypersensitivity
Authors: Park Hae-sim
Published: November 2024

Nonsteroidal anti-inflammatory drugs (NSAIDs) can induce hypersensitivity reactions with various clinical manifestations including acute/delayed reactions and three common phenotypes, NSAID/aspirin-exacerbated respiratory disease (NERD or AERD) with/without chronic rhinosinusitis (CRS) and nasal polyps, NSAID-exacerbated cutaneous disease (NECD). NSAID-induced urticaria/angioedema (NIUA). NIAU is commonly combined with anaphylaxis and named as NIUAA. The major pathogenic mechanism is the inhibition of cyclooxygenase-1 with a reduction in prostaglandin E2 levels, leading to the overproduction of cysteinyl leukotrienes and activation of inflammatory cells, including eosinophils and mast cells.

To confirm the diagnosis, provocation testing via the oral route or inhalation remains the gold standard; in vitro diagnostic methods are still not available. Essential managements are: (1) avoidance of cross-reacting NSAIDs along with the use of alternative analgesics; (2) pharmacologic treatment should follow standard guidelines in patients with underlying asthma/rhinitis (NERD, CRS), and urticaria (NECD). Aspirin desensitization and biologic treatment can be done when indicated.

Delayed reactions, including fixed drug eruptions, maculopapular eruptions, and severe cutaneous adverse reactions, are rare and mediated by T-cell responses. Symptomatic treatment with avoidance is essential. NSAID is a cofactor of food-dependent exercise-induced anaphylaxis. In this talk, we will update various clinical phenotypes and discuss practical issues faced in real clinical practice.
Elevating Expectations: Risankizumab’s Impact on Revolutionizing Psoriatic Arthritis Care
Authors: Östör Andrew
Published: November 2024

Psoriatic arthritis (PsA) is a chronic inflammatory arthritis that is associated with psoriasis (PsO) and affects about 20% of patients with psoriasis. PsA is characterized by a wide range of symptoms that can vary over time, affecting both the musculoskeletal system as well as the skin and nails. The heterogeneity of PsA means that patients might experience fluctuating and diverse manifestations of the disease, requiring a nuanced approach to treatment.

In light of this, the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) released their 2021 treatment recommendations, which emphasize the importance of individualized therapy based on six specific domains: peripheral arthritis, enthesitis, dactylitis, axial disease, psoriasis, and nail disease. This domain-based approach is designed to address the multifaceted nature of PsA, ensuring that treatment is tailored to the specific clinical manifestations present in each patient. Following this, the European Alliance of Associations for Rheumatology (EULAR) in their 2023 PsA treatment recommendations also adopted a similar approach. They provided strong endorsements for newer therapeutic classes, such as Interleukin-23 inhibitors (IL-23i), particularly in the treatment of peripheral arthritis, significant skin involvement, and enthesitis.

Risankizumab stands out as the most recently approved IL-23 inhibitor for the treatment of PsA. Its mechanism of action involves specifically binding to the p19 subunit of IL-23, thereby blocking downstream signaling pathways and suppressing inflammatory responses. Recent analyses have demonstrated Risankizumab’s consistent efficacy across various patient demographics and disease characteristics, making it a versatile and effective option for managing PsA.

In this context, Professor Östör will present key trial data and share case experiences with IL-23 inhibitors across the different manifestations of PsA. The aim of this lecture is to enhance the understanding of how to tailor treatment plans according to individual patient preferences and clinical profiles. By delving into these data and case studies, Professor can provide valuable insights into optimizing treatment strategies, ultimately leading to improved patient satisfaction and overall disease control.
Optimizing Lupus Care: Early Intervention to Prevent Organ Damage
Authors: Gómez Puerta Jose Alfredo
Published: November 2024

Dr. Jose Alfredo Gómez Puerta’s upcoming lecture at ICCR 2024 will delve into the critical issue of organ damage in patients with systemic lupus erythematosus (SLE), highlighting the limitations of current standard care practices. He will begin by discussing the risks associated with persistent disease activity and the traditional use of high-dose steroids, which often lead to significant organ damage over time. Dr. Gómez Puerta will then present a paradigm shift in SLE treatment as recommended by the European League Against Rheumatism (EULAR) 2023 guidelines and share the clinical impact brought by the new recommendations. The guidelines advocate for reducing chronic steroid dosage and emphasize early intervention with biologic therapies to minimize the risk of long-term organ damage.

The lecture will feature new evidence supporting the benefits of early biologic intervention in managing SLE. Dr. Gómez Puerta will present data from recent studies demonstrating improved patient outcomes, including reduced disease flares and lower drug-related toxicities. These findings underscore the importance of integrating biologic therapies earlier in the treatment regimen to achieve better disease control and enhance long-term patient health.

In addition to discussing empirical data, Dr. Gómez Puerta will share real-world cases illustrating the positive impacts of early biologic intervention. These case studies will provide practical insights into how this approach can be effectively implemented in clinical practice, showcasing its potential to alter the natural course of SLE by delaying organ damage and improving the quality of life for patients.

Finally, the lecture will emphasize the need to optimize SLE management beyond short-term symptom relief. Dr. Gómez Puerta will advocate for strategies focused on long-term disease management, aiming to reduce flares, mitigate drug toxicities, and ultimately prevent organ damage. This comprehensive approach is crucial for altering the disease’s trajectory and achieving disease modification for SLE patients.
JAKi for Dermatomyositis
Authors: Ye Shuang
Published: November 2024

Dermatomyositis (DM) is a systemic autoimmune rheumatic disease which can affect multi-organs, such as skin, muscle and lung. Five myositis-specific autoantibodies, i.e., TIF1r, MDA5, NXP2, Mi2 and SAE, are sero-markers of diagnostic value. The treatments for DM included glucocorticoids, csDMARDs, IVIg and biologics, e.g., rituximab. Type I IFN pathway is considered to be crucial in the pathogenesis of DM and the evidence of JAK inhibitors as treatment option in DM is accumulating. Herein, four clinical scenarios of DM, i.e., MDA5+DM-ILD, TIF1r+ cancer-associated DM, NXP2+ adult DM with GI involvement, and MSA negative DM, are presented to reveal the trials and tribulations to tackle this very difficult disease.
GI Manifestation in Scleroderma
Authors: Foocharoen Chingching
Published: November 2024

The gastrointestinal (GI) system frequently experiences complications in systemic sclerosis. Pathological changes in the GI system can be revealed from the early onset of the disease, such as esophageal hypomotility, to the late stage of the disease, where severe complications like intestinal pseudo-obstruction may occur. Systemic sclerosis can cause pathological changes throughout the entire gastrointestinal tract. Common symptoms include dysphagia, choking, heartburn, hoarseness, abdominal distension, diarrhea, constipation, and fecal incontinence.

Oropharyngeal involvement in systemic sclerosis presents as weakened pharyngeal muscles, leading to oropharyngeal dysphagia, choking, food leakage, and aspiration, attributed to the dysfunction between the pharyngeal muscles and the upper esophageal sphincter due to muscle weakness. However, weak pharyngeal muscles may also be a clinical feature of the systemic sclerosis-polymyositis overlap syndrome.

Esophageal involvement is frequently observed, with conditions such as esophageal hypomotility and lower esophageal sphincter incompetence, leading to early symptoms of dysphagia, gastroesophageal reflux, and potential complications such as esophagitis, esophageal stricture, Barrett’s esophagus, and aspiration pneumonia. Furthermore, gastric involvement includes gastric antral vascular ectasia, commonly known as “watermelon stomach,” which leads to gastrointestinal bleeding and chronic anemia.

Intestinal manifestations comprise malabsorption, intestinal pseudo-obstruction, and bacterial overgrowth. Additionally, wide-mouthed diverticulosis and fecal incontinence are frequently found.

Liver involvement includes primary biliary cirrhosis, most prevalent in limited cutaneous systemic sclerosis or certain overlap syndromes rather than diffuse cutaneous systemic sclerosis.

The severity of these changes varies among patients, ranging from asymptomatic to severe conditions, which may result in malnutrition. Severe and chronic GI involvement significantly impacts daily life, making normal eating difficult, diminishing the quality of life, and potentially causing depression. Managing patients with systemic sclerosis who have GI involvement requires a multidisciplinary approach, involving collaboration among rheumatologists, gastroenterologists, nutritionists, surgeons, and possibly psychiatrists. This teamwork is essential to achieve successful patient care outcomes.
Vascular Effects of Achieving Low Disease Activity in Axial Spondyloarthritis - A 2-Year Prospective Cohort Study
Authors: Meng Huan , Lau Xerox SL , Cheng Isaac TH , Yan Byran P , Lee Alex P , So Ho , Tam LS
Published: November 2024

Background:

Axial spondyloarthritis (axSpA) is associated with accelerated atherosclerosis driven by chronic inflammation. Achieving LDA may result in significant benefits in articular disease, little is known about its effect on extra-articular disease, including CVD risk in axSpA. To investigate the effect of achieving Ankylosing Spondylitis Disease Activity Score (ASDAS) low disease activity (LDA) using a protocolized treatment strategy on the progression of subclinical atherosclerosis and arterial stiffness in axial spondyloarthritis (axSpA) patients.

Methods:

One hundred consecutive AxSpA patients will participate in this 2-year prospective, hospital-based, cohort study. All participants will receive 2 years of tight-control treatment. Treatment will be adjusted according to a standardized protocol every 3-6 monthly aiming at ASDAS LDA (ASDAS <2.1). Carotid intima-media thickness (IMT) and total plaque area (TPA) will be measured using high-resolution ultrasound. Arterial stiffness is measured by pulse wave velocity (PWV) and augmentation index (AIx). The main outcome measure is the change in subclinical atherosclerosis over a period of 2 years comparing between patients who achieve sustained LDA at year 2 (sLDA group: achieved LDA at both year 1 and year 2) to those who cannot achieve LDA (non-sLDA group). Secondary outcomes include differences in the changes in AIx and PWV over 2 years between the 2 groups.

Results:

In this interim analysis, a total of 56 axSpA patients (age: 38± 10 years, 43 (76.8%) male) who completed 2 year of follow-up were included. A significant improvement in disease activity was observed after 2 years of treatment (ASDAS-CRP at baseline: 2.9± 0.6 vs 1.9± 0.7 at year 2, p<0.001). Forty-one patients achieved LDA at year 1 and 31 patients achieved sustained LDA (sLDA) at year 2. The baseline traditional CV risk factors were comparable between the sLDA and non-sLDA groups. The multivariate analysis demonstrated that the sLDA group exhibited a smaller increase in mean IMT ([Formula: see text]: -0.04, 95%CI -0.07 to -0.01, P=0.025) and max IMT ([Formula: see text]: -0.06, 95%CI -0.12 to -0.004, P=0.038) after adjustment for covariates compared to the non-sLDA group. However, there were no significant differences in the progression of carotid plaque and arterial stiffness markers between the two groups in the multivariate analysis.

Conclusion:

Patients with AxSpA who are able to achieve sLDA through a protocolized treatment algorithm experience reduced progression of subclinical atherosclerosis compared to patients who cannot achieve sLDA. This indicates that effective suppression of inflammation in AxSpA patients who reach sLDA may potentially lower CV risk.
Risk Factors Associated with Difficult-to-treat (D2T) Psoriatic Arthritis - A One-year Analysis from the APLAR SpA Registry
Authors: Cheng Isaac T , So Ho , Yip Carson CY , Leung Katy YY , Angkodjojo Stanley , Shin Kichul , Wei James CC , Chiowchanwisawakit Praveena , Saeed Muhammad Ahmed , Muhammad Haroon , Hadwan Nawal , Chung James HY , Kishimoto Mitsumasa , Tam Lai Shan
Published: November 2024

Background:

Despite the widespread advocacy of the treat-to-target(T2T) strategy for managing psoriatic arthritis (PsA), a significant number of patients fail to achieve minimal disease activity (MDA) even with advanced therapies. While a universal definition of difficult-to-treat(D2T) PsA is absent, investigating the heterogeneity of D2T PsA within a real-life T2T-cohort can offer valuable insights into comprehending this concept.

Methods:

This analysis included the first 111 PsA patients enrolled in the APLAR SpA registry who underwent 1-year T2T management. They were recruited from 6 Asia-Pacific regions. D2T was defined as the failure to achieve MDA despite receiving [Formula: see text]1 conventional synthetic disease-modifying anti-rheumatic drugs(csDMARDs) and [Formula: see text]1 biologic/targeted synthetic DMARDs(b/tsDMARDs) over 6-months.

Results:

A total of 111 patients (mean age: 48± 13 years, 59 [53%] male, mean disease duration: 5.3± 7.3 years) were included. At baseline, the patients exhibited moderate disease activity, with only 35% achieving MDA. After 1-year, a significant improvement in Disease Activity in Psoriatic Arthritis (DAPSA) was observed (16.3± 14.0 at baseline vs 10.1± 9.7 at 1-year, p<0.001), with 56% of patients achieving MDA. At one-year, 17(15%) patients fulfilled the definition of D2T-PsA. Compared to the non-D2T group, patients in the D2T group had lower education level, longer disease duration, worse disease activity across domains, and higher functional disability at baseline (Table 1). During the 1-year treatment, the T2T adherence rate was significantly lower in the D2T group (71% vs 90%, p=0.028). Reasons for not escalating treatment in the D2T group included patients’ preference (60%), physician’s decision (20%), and no alternative treatment available (20%). Using multivariate logistic regression, a lower education level (OR:4.64, 95%CI:1.16-16.9, p=0.029) and higher Ankylosing Spondylitis Disease Activity Score (ASDAS) (OR: 1.81, 95%CI:1.07-3.04, p=0.026) were significantly associated with D2T after adjusting for baseline disease duration, number of dactylitic digits, MDA status and protocol adherence.

Conclusions:

Despite the implementation of the T2T-strategy and increased utilization of b/tsDMARDs, more than 40% of patients were unable to achieve MDA. Factors such as higher axial disease activity and lower education level were associated with D2T PsA. Further studies are required to determine whether a more aggressive treatment approach focusing on the axial domain should be implemented for these individuals.
Naringin Mediated Silver Nanoparticles Attenuate Rheumatoid Arthritis in Mice by Modulation of Autophagy and PI3K/AKT/mTOR Signaling Pathway
Authors: Yadav Ekta
Published: November 2024

Background:

Rheumatoid arthritis (RA) is characterized as an autoimmune inflammatory disease associated with synovial joints. Naringin (NG) is a flavanone type of glycoside found in grapes and citrus fruits, and reported to be active against RA. However, poor bioavailability and low solubility restricted its clinical use. Therefore, considering the issue, the present study was focused on the development, characterization and exploration of the protective efficacy of naringin-mediated silver nanoparticles (AgNNPs) against RA by using in vitro and in vivo methods.

Methods:

AgNNPs were biosynthesized by co-precipitation approach and characterized by different techniques. Biofabricated AgNNPs were employed to analyze the anti-arthritic effects by using an in vivo mouse model, i.e., type II collagen-induced arthritis (CIA) model and various parameters including degree of paw swelling, polyarthritis index score as well as level of cytokines in serum were evaluated. The effect of AgNNPs on the proliferation level of fibroblast-like synoviocytes (FLS) induced by tumor necrosis factor-[Formula: see text](TNF-[Formula: see text]) was also taken into account. Western blot and immunofluorescence staining were employed to detect the status of autophagy and underlying PI3K/AKT/mTOR pathway in the CIA model and FLSs.

Results:

Various characterization techniques confirmed the formation of spherical crystalline nanoparticles with a size range of 40-80 nm. In vivo study results revealed that AgNNPs significantly reduced (P < 0.01) the RA-associated damaging effects such as level of paw edema, and pro-inflammatory cytokines along with inhibition of FLSs proliferation associated with TNF-[Formula: see text]. Level of autophagosome and protein expression of LC3B in TNF-[Formula: see text]induced FLSs, LC3-II and Beclin-1 were enhanced whereas mTOR and AKT phosphorylation were reduced by AgNNPs treatment.

Conclusion:

The study exhibited an ameliorative effect of biosynthesized AgNNPs against RA by modulating autophagy through PI3K/AKT/mTOR signaling pathway.