bluuebunny/crossref_metadata_2025 huggingface dataset:
Accuracy of respiratory muscle assessments to predict weaning outcomes: a systematic review and comparative meta-analysis
Authors: Poddighe Diego , Van Hollebeke Marine , Choudhary Yasir Qaiser , Campos Débora Ribeiro , Schaeffer Michele R. , Verbakel Jan Y. , Hermans Greet , Gosselink Rik , Langer Daniel
Published: March 2024

Background

Several bedside assessments are used to evaluate respiratory muscle function and to predict weaning from mechanical ventilation in patients on the intensive care unit. It remains unclear which assessments perform best in predicting weaning success. The primary aim of this systematic review and meta-analysis was to summarize and compare the accuracy of the following assessments to predict weaning success: maximal inspiratory (PImax) and expiratory pressures, diaphragm thickening fraction and excursion (DTF and DE), end-expiratory (Tdiee) and end-inspiratory (Tdiei) diaphragm thickness, airway occlusion pressure (P0.1), electrical activity of respiratory muscles, and volitional and non-volitional assessments of transdiaphragmatic and airway opening pressures.

Methods

Medline (via Pubmed), EMBASE, Web of Science, Cochrane Library and CINAHL were comprehensively searched from inception to 04/05/2023. Studies including adult mechanically ventilated patients reporting data on predictive accuracy were included. Hierarchical summary receiver operating characteristic (HSROC) models were used to estimate the SROC curves of each assessment method. Meta-regression was used to compare SROC curves. Sensitivity analyses were conducted by excluding studies with high risk of bias, as assessed with QUADAS-2. Direct comparisons were performed using studies comparing each pair of assessments within the same sample of patients.

Results

Ninety-four studies were identified of which 88 studies (n = 6296) reporting on either PImax, DTF, DE, Tdiee, Tdiei and P0.1 were included in the meta-analyses. The sensitivity to predict weaning success was 63% (95% CI 47–77%) for PImax, 75% (95% CI 67–82%) for DE, 77% (95% CI 61–87%) for DTF, 74% (95% CI 40–93%) for P0.1, 69% (95% CI 13–97%) for Tdiei, 37% (95% CI 13–70%) for Tdiee, at fixed 80% specificity. Accuracy of DE and DTF to predict weaning success was significantly higher when compared to PImax (p = 0.04 and p < 0.01, respectively). Sensitivity and direct comparisons analyses showed that the accuracy of DTF to predict weaning success was significantly higher when compared to DE (p < 0.01).

Conclusions

DTF and DE are superior to PImax and DTF seems to have the highest accuracy among all included respiratory muscle assessments for predicting weaning success. Further studies aiming at identifying the optimal threshold of DTF to predict weaning success are warranted.

Trial registration: PROSPERO CRD42020209295, October 15, 2020.
Statistical analysis plan for the PRO B study: open-label, superiority randomised controlled trial of alarm-based patient-reported outcome monitoring in patients with metastatic breast cancer
Authors: Gebert Pimrapat , Karsten Maria Margarete , Hage Anna Maria , Dordevic Adam David , Grittner Ulrike
Published: March 2024

Background

With an increasing collection of patient-reported outcomes (PROs) to measure health-related quality of life (HRQoL) in oncological patients, there is still a lack of standardised strategies on how to interpret and use these data in patient care. Prior research has shown support for the use of digital PRO monitoring together with alarm systems to notify clinicians when the PRO values are deteriorating. This system has demonstrated advantages in improving HRQoL and increasing survival rates among oncology patients. Hence, we designed the PRO B study, a superiority multi-centre randomised controlled trial, to investigate the effects of alarm-based monitoring in metastatic breast cancer patients in Germany. The study protocol for the PRO B study was published in September 2021, and this manuscript describes a formal statistical analysis plan (SAP) for the PRO B study to improve the transparency and quality of this trial.

Methods and design

The trial aimed to recruit 1000 patients with metastatic breast cancer. However, as of the completion of recruitment on June 15, 2023, we have successfully enrolled 924 patients from 52 breast cancer centres. Patients were 1:1 stratified randomised to the intervention and control groups. App-based PRO questionnaires are sent weekly to the intervention group and every 3 months to the control group. Only patients in the intervention group trigger an alarm if their PRO scores deteriorate, and they are subsequently contacted by the local care team within 48 h. The primary outcome is the fatigue score at 6 months, and secondary outcomes are other HRQoL and overall survival. Evaluation of the superiority of the intervention will be done using a linear mixed model with random intercepts for study centres.

Conclusion

This detailed SAP defines the main components of the statistical analysis for the PRO B study to assist the statistician and prevent bias in selecting analysis and reporting findings. Version 1 of the SAP was finalised on January 18, 2024.

Trial registration

DRKS (German Clinical Trials Register) DRKS00024015. Registered on February 15, 2021.
Exploring the potential of fully automated LUMIPULSE G plasma assays for detecting Alzheimer’s disease pathology
Authors: Silva-Spínola Anuschka , Leitão Maria João , Nadal Alicia , Le Bastard Nathalie , Santana Isabel , Baldeiras Inês
Published: March 2024

Background

LUMIPULSE G-automated immunoassays represent a widely used method for the quantification of Alzheimer’s disease (AD) biomarkers in the cerebrospinal fluid (CSF). Less invasive blood-based markers confer a promising tool for AD diagnosis at prodromal stages (mild cognitive impairment (MCI)). Highly sensitive assays for the quantification of amyloid-beta (Aβ) and phosphorylated Tau-181 (p-Tau181) in the blood are showing promising results. In this study, we evaluated the clinical performance of the recently available fully automated LUMIPULSE plasma marker assays for detecting brain AD pathology and for predicting progression from MCI to AD dementia stage.

Methods

A retrospective exploratory cohort of 138 individuals (22 neurological controls [NC], 72 MCI, and 44 AD dementia patients) was included. Data regarding baseline CSF concentrations of Aβ42, Aβ40, t-Tau, and p-Tau181 was available and used to establish the presence of AD brain pathology. Baseline Aβ42, Aβ40, and p-Tau181 concentrations were determined in stored plasma samples using high-throughput fully automated LUMIPULSE assays. Progression from MCI to AD dementia was evaluated during follow-up (mean 6.4 ± 2.5 years). Moreover, a prospective validation cohort of 72 individuals with memory complaints underwent AD biomarker quantification, closely mirroring typical clinical practice. This cohort aimed to confirm the study’s main findings.

Results

In the exploratory cohort, correlations between CSF and plasma were moderate for p-Tau181 (ρ = 0.61, p < 0.001) and weak for Aβ42/Aβ40 ratio (ρ = 0.39, p < 0.001). Plasma p-Tau181 and p-Tau181/Aβ42 concentrations were significantly increased while Aβ42/Aβ40 was significantly decreased (p < 0.001) in patients with AD dementia and prodromal AD, as well as in individuals with CSF abnormal amyloid concentrations (A +). Plasma p-Tau181 showed a robust performance in differentiating patients clinically diagnosed as AD (AUC = 0.89; 95% CI 0.83–0.94); A + vs. A − (AUC = 0.84, 95% CI 0.77–0.91) and also in predicting conversion to AD dementia in MCI patients (AUC = 0.89, 95% CI 0.81–0.96). When tested in the validation cohort, plasma p-Tau181 displayed 83.3% of the overall percentage of agreement according to amyloid status.

Conclusions

Our results show that the measurement of p-Tau181 in plasma has great potential as a non-invasive prognostic screening tool for implementation in a clinical setting.
Comparative analysis of the vaginal bacteriome and virome in healthy women living in high-altitude and sea-level areas
Authors: Li Chaoran , jin Song , Lv Oingbo , Wang Guangyang , Zhang Yue , Li Shenghui , zhang Wei , Long Fang , Shen Zhuowei , Bai Siqi , Zhaxi Duoii , Kong Fandou , Yan Qiulong , Xiao Zhen
Published: March 2024

The vaginal microbiota plays an important role in the health of the female reproductive tract and is closely associated with various pregnancy outcomes and sexually transmitted diseases. Plenty of internal and external factors have strong influence on the changes in a woman's vaginal microbiome. However, the effect of a high-altitude on female vaginal microbiota has not been described. In this study, we characterized the vaginal bacteriome and virome of 13 and 34 healthy women living in high-altitude and sea-level areas, using whole-metagenome shotgun sequencing of their vaginal mucus samples. The results revealed that the vaginal bacteriomes of high-altitude individuals are featured by a significant increase of species diversity, depletion of Lactobacillus crispatus, and more abundant of some anaerobic bacteria, such as Chlamydia trachomatis, Mageeibacillus indolicus, Dialister micraerophilus, and Sneathia amnii). In addition, the vagina samples of sea-level subjects harbor more Lactobacillus strains, whereas the anaerobic bacteroidetes strains mostly appeared in high-altitude subjects. Identified and assembled 191 virus operational taxonomic units (vOTUs), there were significant differences in the abundance of 107 vOTUs between the two groups. Together, the results of this study raised the understanding of bacteriome and virome in the vagina of women at different elevations, and demonstrated that the vaginal microbiome is related to the high-altitude geographic adaptation.
Distinct associations between gratitude, self-esteem, and optimism with subjective and psychological well-being among Japanese individuals
Authors: Nawa Norberto Eiji , Yamagishi Noriko
Published: March 2024

Background

Mounting evidence suggests that the effectiveness of positive psychology interventions is influenced by a variety of factors, including cultural context. Identifying intervention targets that can effectively contribute to improving individual well-being under these boundary conditions is a crucial step when developing viable interventions. To this end, we examined how gratitude disposition, self-esteem, and optimism relate to the subjective well-being (SWB) and psychological well-being (PWB) of Japanese individuals.

Methods

Multivariate regression analysis was employed to quantify the unique relationships between the three potential intervention targets and both SWB and PWB, while accounting for the influence of other variables. Participants (N = 71) also engaged in a 4-week experience sampling study to explore how gratitude, self-esteem and optimism shape the link between momentary affective states in everyday life and evaluations of day satisfaction.

Results

Multivariate regression analysis revealed that self-esteem was predominantly more strongly associated with SWB compared to gratitude disposition, whereas gratitude disposition was more strongly associated with the PWB dimensions, particularly personal growth, positive relations with others and purpose in life. Experience sampling data indicated that while both gratitude disposition and self-esteem moderated the association between momentary positive affect and day satisfaction evaluations, they did so in opposite ways; greater gratitude disposition strengthened the association, while greater self-esteem weakened it.

Conclusions

Overall, the current results suggest that while gratitude, self-esteem, and optimism influence individual well-being as a whole, they likely play distinct roles in facilitating SWB and PWB in the studied cohort.
Spatial comparison of inland water observations from CYGNSS, MODIS, Landsat, and commercial satellite imagery
Authors: Pavur G. K. , Kim H. , Fang B. , Lakshmi V.
Published: March 2024

Accurate and timely inland waterbody extent and location data are foundational information to support a variety of hydrological applications and water resources management. Recently, the Cyclone Global Navigation Satellite System (CYGNSS) has emerged as a promising tool for delineating inland water due to distinct surface reflectivity characteristics over dry versus wet land which are observable by CYGNSS’s eight microsatellites with passive bistatic radars that acquire reflected L-band signals from the Global Positioning System (GPS) (i.e., signals of opportunity). This study conducts a baseline 1-km comparison of water masks for the contiguous United States between latitudes of 24°N-37°N for 2019 using three Earth observation systems: CYGNSS (i.e., our baseline water mask data), the Moderate Resolution Imaging Spectroradiometer (MODIS) (i.e., land water mask data), and the Landsat Global Surface Water product (i.e., Pekel data). Spatial performance of the 1-km comparison water mask was assessed using confusion matrix statistics and optical high-resolution commercial satellite imagery. When a mosaic of binary thresholds for 8 sub-basins for CYGNSS data were employed, confusion matrix statistics were improved such as up to a 34% increase in F1-score. Further, a performance metric of ratio of inland water to catchment area showed that inland water area estimates from CYGNSS, MODIS, and Landsat were within 2.3% of each other regardless of the sub-basin observed. Overall, this study provides valuable insight into the spatial similarities and discrepancies of inland water masks derived from optical (visible) versus radar (Global Navigation Satellite System Reflectometry, GNSS-R) based satellite Earth observations.
Stress field in northeastern Japan and its relationship with faults of recent earthquakes
Authors: Tagami Ayaka , Matsuno Miu , Okada Tomomi , Sakai Shin’ichi , Ohzono Mako , Katsumata Kei , Kosuga Masahiro , Yamanaka Yoshiko , Katao Hiroshi , Matsushima Takeshi , Yakiwara Hiroshi , Hirahara Satoshi , Kono Toshio , Hori Shu’ichiro , Matsuzawa Toru , Kimura Shuutoku , Nakayama Takashi ,   Group for the aftershock observations of the 2011 off the Pacific coast of Tohoku Earthquake
Published: March 2024

Inversion tectonics, in which old normal faults act as reverse faults in current stress fields, are frequently observed in northeastern Japan (Tohoku District); however, the conditions that control these fault activities remain unclear. To improve the identification of faults that are more favorable to slip under current stress conditions, the regional fault mechanisms in the Tohoku District must be better understood. The stress field in the Tohoku District and the likelihood of fault activities were thus estimated using slip tendency (ST) analysis. The results show that in the eastern margin of the Japan Sea (EMJS), the reverse fault type is dominant in the stress field. The maximum horizontal direction changes clockwise from E–W to NW–SE from the northern to the southern regions and counterclockwise from NW–SE to E–W from the Japan Sea to the inland area. In the Tohoku inland area, the estimated direction of the maximum horizontal axis changed after the 2011 Tohoku-Oki earthquake, from E–W to WNW–ESE. ST values were calculated for seven events in the EMJS area. To avoid the influence of the Tohoku-Oki earthquake, only stress field data prior to the 2011 Tohoku-Oki earthquake were used to determine ST values for four of the events in the Tohoku inland area. The results showed eastward-dipping fault planes with low dip angles (approximately 30°–45°) and large ST values (approximately > 0.7). The large ST values indicate that the stress field fault is favorable to slip and the results were consistent with the actual fault plane in the EMJS area. However, in the Tohoku inland area and the southern part of fault model of the 1993 Hokkaido Nansei-Oki earthquake, fault planes with large ST values were found to be inconsistent with the slipped fault plane, thus indicating that slipping was unfavorable. The regional differences are consistent with the volcano distribution and thus, the fluid supply from volcanic activity may have helped the fault slip under difficult stress conditions.

Graphical Abstract
Assessment of forest fire severity and land surface temperature using Google Earth Engine: a case study of Gujarat State, India
Authors: Jodhani Keval H. , Patel Haard , Soni Utsav , Patel Rishabh , Valodara Bhairavi , Gupta Nitesh , Patel Anant , Omar Padam jee
Published: March 2024

Forest fires are a recurring issue in many parts of the world, including India. These fires can have various causes, including human activities (such as agricultural burning, campfires, or discarded cigarettes) and natural factors (such as lightning). The present study presents a comprehensive and advanced methodology for assessing wildfire susceptibility by integrating diverse environmental variables and leveraging cutting-edge machine learning techniques across Gujarat State, India. The primary goal of the study is to utilize Google Earth Engine to compare locations in Gujarat, India, before and after forest fires. High-resolution satellite data were used to assess the amount and types of changes caused by forest fires. The present study meticulously analyzes various environmental variables, i.e., slope orientation, elevation, normalized difference vegetation index (NDVI), drainage density, precipitation, and temperature to understand landscape characteristics and assess wildfire susceptibility. In addition, a sophisticated random forest regression model is used to predict land surface temperature based on a set of environmental parameters. The maps that result depict the geographical distribution of normalized burn ratio and difference normalized burn ratio and land surface temperature forecasts, providing valuable insights into spatial patterns and trends. The findings of this work show that an automated temporal analysis utilizing Google Earth Engine may be used successfully over a wide range of land cover types, providing critical data for future monitoring of such threats. The impact of forest fires can be severe, leading to the loss of biodiversity, damage to ecosystems, and threats to human settlements.
Novel Functional Radiomics for Prediction of Cardiac Positron Emission Tomography Avidity in Lung Cancer Radiotherapy
Authors: Choi Wookjin , Jia Yingcui , Kwak Jennifer , Werner-Wasik Maria , Dicker Adam P. , Simone Nicole L. , Storozynsky Eugene , Jain Varsha , Vinogradskiy Yevgeniy
Published: March 2024

PURPOSE

Traditional methods of evaluating cardiotoxicity focus on radiation doses to the heart. Functional imaging has the potential to provide improved prediction for cardiotoxicity for patients with lung cancer. Fluorine-18 (18F) fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT) imaging is routinely obtained in a standard cancer staging workup. This work aimed to develop a radiomics model predicting clinical cardiac assessment using 18F-FDG PET/CT scans before thoracic radiation therapy.

METHODS

Pretreatment 18F-FDG PET/CT scans from three study populations (N = 100, N = 39, N = 70) were used, comprising two single-institutional protocols and one publicly available data set. A clinician (V.J.) classified the PET/CT scans per clinical cardiac guidelines as no uptake, diffuse uptake, or focal uptake. The heart was delineated, and 210 novel functional radiomics features were selected to classify cardiac FDG uptake patterns. Training data were divided into training (80%)/validation (20%) sets. Feature reduction was performed using the Wilcoxon test, hierarchical clustering, and recursive feature elimination. Ten-fold cross-validation was carried out for training, and the accuracy of the models to predict clinical cardiac assessment was reported.

RESULTS

From 202 of 209 scans, cardiac FDG uptake was scored as no uptake (39.6%), diffuse uptake (25.3%), and focal uptake (35.1%), respectively. Sixty-two independent radiomics features were reduced to nine clinically pertinent features. The best model showed 93% predictive accuracy in the training data set and 80% and 92% predictive accuracy in two external validation data sets.

CONCLUSION

This work used an extensive patient data set to develop a functional cardiac radiomic model from standard-of-care 18F-FDG PET/CT scans, showing good predictive accuracy. The radiomics model has the potential to provide an automated method to predict existing cardiac conditions and provide an early functional biomarker to identify patients at risk of developing cardiac complications after radiotherapy.
The impact of preferential selection mechanism based on average payoff and stability of payoff on the evolution of cooperation
Authors: Li Pengcheng , Ye Tianbo , Fan Suohai
Published: March 2024

Recent studies on memory-based cooperative evolution have focused on random selection of learning objects and only considered average payoff, neglecting stability of payoff. Here, we propose a preference selection mechanism adopting the TOPSIS method, a multi-attribute decision-making approach. We introduce the weighting factors ω
1 and ω
2, which refer to average payoff and stability of payoff, respectively. The probability that an individual select his neighbor is influenced by both average payoff and stability. We investigate the effect of memory length M and ω
1 on the evolution of cooperation. The simulation results indicate that M and ω
1 can both somewhat promote cooperation. Given that

, for small betrayal temptation b, cooperation is more robust for small M, while for large b, large values of M are preferred. Further exploring the impact of ω
1, for relatively small b, the influence of ω
1 on cooperation is gradually revealed and strengthened as M increases. Conversely, for relatively large b, the impact of ω
1 on cooperation slowly diminishes from strong as M increase, reflecting a gradual rise in the importance of stability. These findings enhance the understanding of cooperative behavior in real social environments and make more rational decisions under the multi-factor evaluation based on average payoff and stability.
An Open-label Phase 2 Study of Eneboparatide, a Novel PTH Receptor 1 Agonist, in Hypoparathyroidism
Authors: Takacs Istvan , Mezosi Emese , Soto Alfonso , Kamenický Peter , Figueres Lucile , Galvez Moreno Maria Angeles , Lemoine Sandrine , Borson-Chazot Francoise , Capel Ismael , Ouldrouis Taha , Lucas Nadège , Allas Soraya , Sumeray Mark , Ovize Michel , Mannstadt Michael
Published: March 2024

Context

Hypoparathyroidism is a rare disorder characterized by a deficiency in PTH resulting in hypocalcemia, hyperphosphatemia, and hypercalciuria. Eneboparatide is an investigational peptide agonist of the PTH1 receptor for the treatment of chronic hypoparathyroidism (HP).

Objective

To evaluate the efficacy, safety, and tolerability of eneboparatide in HP patients.

Design

Open-label, phase 2 study.

Participants

Twenty-eight patients (21 women, 7 men), mean age (range): 58 years (28-72), with HP were enrolled into 2 consecutive cohorts (C1, n = 12 and C2, n = 16).

Intervention

Following an optimization period, daily subcutaneous injections of eneboparatide were administered for 3 months at a 20 µg/day (C1) or 10 µg/day (C2) starting dose. Conventional therapy was progressively removed, and eneboparatide could be titrated up to 60 µg (C1) or 80 µg (C2).

Main outcomes

Proportion of patients achieving independence from conventional therapy, albumin-adjusted serum calcium (ADsCa), 24-h urine calcium (uCa), serum bone turnover markers (serum carboxy-terminal telopeptide of type I collagen and procollagen 1 intact N-terminal propeptide), bone mineral density (BMD), and adverse events (AEs).

Results

After 3 months, ≥ 88% of patients achieved independence from conventional therapy while mean ADsCa was maintained within target range (7.8-9 mg/dL). Eneboparatide induced a rapid and sustained reduction of mean 24-hour uCa, even among patients with hypercalciuria. Bone turnover markers slightly increased, and BMD remained unchanged, consistent with progressive resumption of physiologic bone turnover. Eneboparatide was well tolerated with no serious AEs.

Conclusion

Eneboparatide allowed independence from conventional therapy and maintenance of serum calcium within a target range while normalizing uCa excretion and producing a balanced resumption of bone turnover.
The Spectrum of Dysregulated Aldosterone Production: An International Human Physiology Study
Authors: Parksook Wasita W , Brown Jenifer M , Omata Kei , Tezuka Yuta , Ono Yoshikiyo , Satoh Fumitoshi , Tsai Laura C , Niebuhr Yvonne , Milks Julia , Moore Anna , Honzel Brooke , Liu Haiping , Auchus Richard J , Sunthornyothin Sarat , Turcu Adina F , Vaidya Anand
Published: March 2024

Context

Primary aldosteronism is a form of low-renin hypertension characterized by dysregulated aldosterone production.

Objective

To investigate the contributions of renin-independent aldosteronism and ACTH-mediated aldosteronism in individuals with a low-renin phenotype representing the entire continuum of blood pressure.

Design/Participants

Human physiology study of 348 participants with a low-renin phenotype with severe and/or resistant hypertension, hypertension with hypokalemia, elevated blood pressure and stage I/II hypertension, and normal blood pressure.

Setting

4 international centers.

Interventions/Main Outcome Measures

The saline suppression test (SST) to quantify the magnitude of renin-independent aldosteronism; dexamethasone suppression and ACTH-stimulation tests to quantify the magnitude of ACTH-mediated aldosteronism; adrenal venous sampling to determine lateralization.

Results

There was a continuum of nonsuppressible and renin-independent aldosterone production following SST that paralleled the magnitude of the blood pressure continuum and transcended conventional diagnostic thresholds. In parallel, there was a full continuum of ACTH-mediated aldosteronism wherein post-SST aldosterone levels were strongly correlated with ACTH-stimulated aldosterone production (r = 0.75, P < .0001) and nonsuppressible aldosterone production postdexamethasone (r = 0.40, P < .0001). Beyond participants who met the criteria for primary aldosteronism (post-SST aldosterone of ≥10 ng/dL or ≥277 pmol/L), the continuum of nonsuppressible and renin-independent aldosterone production persisted below this diagnostic threshold, wherein 15% still had lateralizing aldosteronism amenable to surgical adrenalectomy and the remainder were treated with mineralocorticoid receptor antagonists.

Conclusion

In the context of a low-renin phenotype, there is a continuum of primary aldosteronism and dysregulated aldosterone production that is prominently influenced by ACTH. A large proportion of individuals with low renin may benefit from aldosterone-directed therapy.
How is prenatal stress transmitted from the mother to the fetus?
Authors: Sze Ying , Brunton Paula J.
Published: March 2024

Prenatal stress programmes long-lasting neuroendocrine and behavioural changes in the offspring. Often this programming is maladaptive and sex specific. For example, using a rat model of maternal social stress in late pregnancy, we have demonstrated that adult prenatally stressed male, but not prenatally stressed female offspring display heightened anxiety-like behaviour, whereas both sexes show hyperactive hypothalamo–pituitary–adrenal (HPA) axis responses to stress. Here, we review the current knowledge of the mechanisms underpinning dysregulated HPA axis responses, including evidence supporting a role for reduced neurosteroid-mediated GABAergic inhibitory signalling in the brains of prenatally stressed offspring. How maternal psychosocial stress is signalled from the mother to the fetuses is unclear. Direct transfer of maternal glucocorticoids to the fetuses is often considered to mediate the programming effects of maternal stress on the offspring. However, protective mechanisms including attenuated maternal stress responses and placental 11β-hydroxysteroid dehydrogenase-2 (which inactivates glucocorticoids) should limit materno-fetal glucocorticoid transfer during pregnancy. Moreover, a lack of correlation between maternal stress, circulating maternal glucocorticoid levels and circulating fetal glucocorticoid levels is reported in several studies and across different species. Therefore, here we interrogate the evidence for a role for maternal glucocorticoids in mediating the effects of maternal stress on the offspring and consider the evidence for alternative mechanisms, including an indirect role for glucocorticoids and the contribution of changes in the placenta in signalling the stress status of the mother to the fetus.
Experimental biology can inform our understanding of food insecurity
Authors: Wilbrecht Linda , Lin Wan Chen , Callahan Kathryn , Bateson Melissa , Myers Kevin , Ross Rachel
Published: March 2024

Food insecurity is a major public health issue. Millions of households worldwide have intermittent and unpredictable access to food and this experience is associated with greater risk for a host of negative health outcomes. While food insecurity is a contemporary concern, we can understand its effects better if we acknowledge that there are ancient biological programs that evolved to respond to the experience of food scarcity and uncertainty, and they may be particularly sensitive to food insecurity during development. Support for this conjecture comes from common findings in several recent animal studies that have modeled insecurity by manipulating predictability of food access in various ways. Using different experimental paradigms in different species, these studies have shown that experience of insecure access to food can lead to changes in weight, motivation and cognition. Some of these studies account for changes in weight through changes in metabolism, while others observe increases in feeding and motivation to work for food. It has been proposed that weight gain is an adaptive response to the experience of food insecurity as ‘insurance’ in an uncertain future, while changes in motivation and cognition may reflect strategic adjustments in foraging behavior. Animal studies also offer the opportunity to make in-depth controlled studies of mechanisms and behavior. So far, there is evidence that the experience of food insecurity can impact metabolic efficiency, reproductive capacity and dopamine neuron synapses. Further work on behavior, the central and peripheral nervous system, the gut and liver, along with variation in age of exposure, will be needed to better understand the full body impacts of food insecurity at different stages of development.
Why Is Productivity Slowing Down?
Authors: Goldin Ian , Koutroumpis Pantelis , Lafond François , Winkler Julian
Published: March 2024

We examine the contribution of different explanations to the slowdown of labor productivity. Comparing the post-2005 period with the preceding decade for five advanced economies, we seek to explain a slowdown of 0.8 to 1.8 pp. No single explanation accounts for the slowdown, but we have identified a combination of factors that, taken together, account for much of what has been observed. In the countries we have studied, these are mismeasurement, a decline in the contribution of capital per worker, lower spillovers from the growth of intangible capital, the slowdown in trade, and a lower growth of allocative efficiency. Sectoral reallocation and a lower contribution of human capital may also have played a role in some countries. In addition to our quantitative assessment of explanations for the slowdown, we qualitatively assess other explanations, including whether productivity growth may be declining due to innovation slowing down. (JEL E23, E24, J24, L16, O33, O47)
From Outcome-Based to Language-Based Preferences
Authors: Capraro Valerio , Halpern Joseph Y. , Perc Matjaž
Published: March 2024

We review the literature on models that try to explain human behavior in social interactions described by normal-form games with monetary payoffs. We start by covering social and moral preferences. We then focus on the growing body of research showing that people react to the language with which actions are described, especially when it activates moral concerns. We conclude by arguing that behavioral economics is in the midst of a paradigm shift toward language-based preferences, which will require an exploration of new models and experimental setups.(JEL C70, C90, D11, D90, Z13)
The Rise and Fall of the Neoliberal Order: America and the World in the Free Market Era
Authors: Kuziemko Ilyana , Naidu Suresh
Published: March 2024

Ilyana Kuziemko of Princeton University and Suresh Naidu of Columbia University review “The Rise and Fall of the Neoliberal Order: America and the World in the Free Market Era” by Gary Gerstle. The Econlit abstract of this book begins: “Examines the history of the political order that took shape under Ronald Reagan and achieved dominance under Bill Clinton in the 1990s and early 2000s, highlighting the sharp distinction of this political order from those that preceded it.”
Individuality and Entanglement: The Moral and Material Bases of Social Life
Authors: Robson Arthur
Published: March 2024

Arthur Robson of Simon Fraser University reviews “Individuality and Entanglement: The Moral and Material Bases of Social Life” by Herbert Gintis. The Econlit abstract of this book begins: “Analyzes human social life as a game with rules, with people as players in this game and politics as the arena in which these rules are affirmed and changed.”
Chip War: The Fight for the World's Most Critical Technology
Authors: Demertzis Maria
Published: March 2024

Maria Demertzis of Bruegel and European University Institute reviews “Chip War: The Fight for the World’s Most Critical Technology” by Chris Miller. The Econlit abstract of this book begins: “Promotes the argument that the contemporary world is defined by semiconductors, detailing how this technology has come to determine the shape of international politics, the structure of the world economy, and the balance of military power.”
Why Not Better and Cheaper? Healthcare and Innovation
Authors: Skinner Jonathan
Published: March 2024

Jonathan Skinner of Dartmouth University reviews “Why Not Better and Cheaper? Healthcare and Innovation” by James B. Rebitzer and Robert S. Rebitzer. The Econlit abstract of this book begins: “Considers why the US health-care system is becoming neither better nor more affordable over time, contending that the health sector generates the wrong kinds of innovation by making it easy to profit from low-value innovations and difficult to do the same from innovations that reduce care costs.”
Състояние на равнищата на езикова компетентност при заекващи деца от предучилищна възраст
Authors: Βενέτης Βασίλειος
Published: March 2024

Η διδακτορική εργασία εξετάζει ένα ελάχιστα μελετηθέν στη λογοθεραπεία θέμα, για τη σχέση μεταξύ του παιδικού τραυλισμού και της λειτουργίας του προφορικού εκφραστικού λόγου. Ο σκοπός της μελέτης καθορίζεται στη βάση βιβλιογραφικών δεδομένων για διακριτές δυσκολίες στα σύνθετα επίπεδα του λόγου (μορφολογικό και συντακτικό) και προσβλέπει στην πειραματικό έλεγχο της κατάστασής τους σε παιδιά με διαταραχή στη ροή του λόγου. Στη μελέτη συμμετείχαν 70 παιδιά ηλικίας 4-6 ετών και 6-7 ετών, χωρισμένα στις ακόλουθες υποομάδες: 30 παιδιά ηλικίας 4-6 ετών (15 με τραυλισμό και 15 χωρίς τραυλισμό) και 40 παιδιά ηλικίας 6-7 ετών (20 με τραυλισμό και 20 χωρίς τραυλισμό). Όλα τα παιδιά έχουν ως μητρική γλώσσα την ελληνική, χωρίς στοιχεία ύπαρξης διγλωσσίας. Η δομική οργάνωση των ομάδων επιτρέπει τον έλεγχο της επίδρασης των ανεξαρτήτων παραγόντων ηλικία και τραυλισμός επί των επιπέδων του προφορικού λόγου. Τα διαγνωστικά εργαλεία περιλαμβάνουν 9 δείγματα, από τα οποία 4 για την αξιολόγηση του λεξιλογικού, 3 για την αξιολόγηση του μορφολογικού και 2 για την αξιολόγηση του συντακτικού επιπέδου του λόγου. Η στατιστική εξέταση των αποτελεσμάτων βασίζεται σε διπαραγοντική ανάλυση διακύμανσης (κριτήριο F – κριτήριο του Fisher) η οποία επέτρεψε τη διαμόρφωση των ακολούθων συμπερασμάτων: 1. Τα παιδιά με τραυλισμό χαρακτηρίζονται από ανομοιόμορφη ανάπτυξη των επιπέδων του γλωσσικού συστήματος 2. Ως προς την κατάσταση του λεξιλογικού επιπέδου, σχετιζομένου με την κωδικοποίηση συγκεκριμένου λεξιλογίου, τα παιδιά με τραυλισμό δεν διαφέρουν ουσιαστικά από τα παιδιά με φυσιολογική ροή του λόγου. Σημαντικές διαφορές μεταξύ των ομάδων παρατηρήθηκαν μόνο σε ασκήσεις δημιουργίας ρηματικού λεξιλογίου 3. Υφίσταται σημαντική επίδραση των ανεξαρτήτων παραγόντων ηλικία και τραυλισμός επί των υψηλοτέρων επιπέδων του λόγου - μορφολογικού και συντακτικού. Η διαγνωστική συστοιχία και τα ληφθέντα αποτελέσματα έχουν αναμφισβήτητη σημασία για τη λογοθεραπευτική θεωρία και πρακτική.
Όψεις του ελληνικού πολιτικού ρομαντισμού στο παράδειγμα του Ίωνος Δραγούμη
Authors: Μαμούτος Σταμάτιος
Published: March 2024

Η διατριβή αφορά την πολιτική σκέψη του Ίωνος Δραγούμη. Στα πλαίσια της παρούσας έρευνας εξετάστηκε αρχικά το ιδεολογικό περιβάλλον με το οποίο συνδέθηκε στις παλαιότερες έρευνες η πολιτική σκέψη του Δραγούμη. Εν συνεχεία αναλύθηκε η πολιτική σκέψη του Δραγούμη για να διαπιστωθεί ποια ήταν η σχέση της με τα συγκεκριμένα ιδεολογικά περιβάλλοντα. Η διατριβή είναι διαμορφωμένη σε τρία μέρη. Στο πρώτο μέρος αναλύεται το πλέγμα των ιδεών που περικλείει τον πολιτικό Ρομαντισμό, τον αντιδιαφωτισμό, τον εθνικισμό, τον φασισμό και τον συντηρητισμό. Στο δεύτερο μέρος της διατριβής εξετάζεται η πολιτική σκέψη του Δραγούμη. Στο τρίτο μέρος καταγράφεται η πολιτική διαδρομή του Δραγούμη. Στο πρώτο μέρος της διατριβής διαμορφώθηκε, τρόπον τινά, ένα ιδεολογικό κάδρο στο οποίο θα φαινόταν στην συνέχεια αν, πώς και κατά πόσο θα χωρούσε η πολιτική σκέψη του Δραγούμη. Προσδιορίστηκε ο τρόπος με τον οποίο χρησιμοποιήθηκε η έννοια «ιδεολογία» και υιοθετήθηκε η ιδέα σύμφωνα με την οποία κάθε ιδεολογία έχει δύο διαστάσεις. Τις «θεμελιώδεις αρχές» και την «λειτουργική υπόσταση». Η κεντρική ιδέα του πρώτου μέρους της διατριβής είναι ότι αποτελεί λάθος να μιλάμε για φασιστική ιδεολογία. Ο φασισμός ήταν ένα πολιτικό φαινόμενο με ιδεολογική, οργανωτική και θεσμική διάσταση. Σε ό,τι αφορούσε το ιδεολογικό του πεδίο ο φασισμός αφομοίωσε μια ιδεολογία που υπήρχε πριν και συνεχίζει να υπάρχει μετά από αυτόν. Στην συνέχεια της έρευνας αναλύθηκε αυτή η ιδεολογία που ονομάστηκε για τις ανάγκες της διατριβής «αντιδιαφωτιστικός πολιτικός Ρομαντισμός». Στο δεύτερο μέρος της διατριβής περιλαμβάνεται ένα βιογραφικό του Ίωνος Δραγούμη και εξετάζεται πώς προσέγγισε ο Δραγούμης, σε όλη την διάρκεια της ζωής του, τις πέντε «θεμελιώδεις αρχές» της ιδεολογίας του «αντιδιαφωτιστικού πολιτικού Ρομαντισμού». Η έρευνα έδειξε ότι η προσέγγιση του Ίωνος Δραγούμη στις «θεμελιώδεις αρχές» τις ιδεολογίας του «αντιδιαφωτιστικού πολιτικού Ρομαντισμού» δείχνει αξιοσημείωτη συνέπεια και περιλαμβάνει λίγες, άνευ μεγάλης σημασίας, αντιφάσεις. Μάλιστα οι όποιες ιδεολογικές αντιφάσεις του Δραγούμη εντοπίζονται, στις περισσότερες των περιπτώσεων, δεν είναι προσωπικές. Αποτελούν εγγενή αντιφατικά γνωρίσματα της ιδεολογίας που υιοθέτησε. Γνωρίσματα τα οποία μπορούν να ανιχνευτούν στους περισσότερους ομοϊδεάτες του διανοητές. Στο τρίτο μέρος της διατριβής εξετάστηκε ο Ίων Δραγούμης ως πολιτικό υποκείμενο. Το ερευνητικό ερώτημα που έπρεπε να απαντηθεί ήταν αν ο Δραγούμης υπήρξε ως πολιτικός συνεπής με τις ιδέες που επεξεργάστηκε ως διανοητής ή αν ήταν ένας αντιφατικός πολιτικός που διαλεγόταν με τις διανοητικές τάσεις της εποχής του, χωρίς να διαθέτει σταθερό ιδεολογικό υπόβαθρο. Το συμπέρασμα που προέκυψε είναι ότι ο Δραγούμης έδρασε βασισμένος σε συγκεκριμένες ιδεολογικές αρχές, τις οποίες μπορεί να υποστήριξε με διαφορετική ένταση κατά καιρούς αλλά ποτέ δεν απαρνήθηκε ούτε μετάβαλε σημαντικά.
Artificial dermis combined with negative pressure wound therapy and platelet-rich plasma to treat traumatic wounds: a retrospective study
Authors: Zhu Jin , Yan Li , Hu Rui , Yang Chunbao , Wu Mingzheng , An Ying , Li Shanqing
Published: March 2024

Objective:

The reconstruction of complex soft tissue defects with exposure of bones and tendons represents an increasing challenge in wound care, especially in large extremity wounds. The aim of this study was to detect the clinical efficacy of combined use of negative pressure wound therapy (NPWT), artificial dermis (ADM), platelet-rich plasma (PRP) and split-thickness skin grafting (STSG) in the reconstruction of large traumatic extremity skin defects.

Method:

In this study, eight cases were treated with combined therapies for repairing complex extremity wounds and the results were reviewed retrospectively. After surgical debridement, all wounds received ADM, PRP and delayed STSG, which were all aided with NPWT.

Results:

The patients consisted of five males and three females, with a mean age of 44 years. A total of six lower extremity wounds were located at the foot/ankle, with exposed tendon in five, bone exposure in three and both in two. Of the group, two patients had exposed tendon on arm/hand wounds. The size of wounds and ADM averaged 126cm2 and 42.3cm2, respectively. ADM was used to cover the exposed bone or tendon, the granulation and muscular tissue were covered with vacuum sealing drainage (VSD) directly, for NPWT. The survival rate of ADM averaged 98.9%. The average time for survival of ADM was 12.8 days and the mean uptake of autologous skin graft was 93.5%. Only one patient received repeated skin grafts. All patients achieved successful healing and reported no complications. The mean length of hospital stay was 36.1 days.

Conclusion:

Our study revealed that ADM in conjunction with NPWT, PRP and STSG could be used for repairing large traumatic extremity wounds. Wound closure was achieved without flaps, the aesthetic and functional outcomes were acceptable, and only one patient developed a 35% loss of skin graft.

Declaration of interest:

This work was supported by grants from the Natural Science Foundation of Hubei Province (grant no. 2020CFB464) and Youth Foundation of Wuhan Municipal Health Commission (grant no. WX20Q15). The authors have no conflicts of interest to declare.
22q11.2 Deletion syndrome: What nurses need to know
Authors: Winter George
Published: March 2024

The chromosomal condition 22qDS encompasses diverse complex medical, developmental, and mental health problems. Here is what the latest research tells us
Miniature, multi-dichroic instrument for measuring the concentration of multiple fluorophores
Authors: Grygoryev Konstantin , Lu Huihui , Sørensen Simon , Talebi Varnosfaderani Omid , Georgel Rachel , Li Liyao , Burke Ray , Andersson-Engels Stefan
Published: March 2024

Identification of tumour margins during resection of the brain is critical for improving the post-operative outcomes. Due to the highly infiltrative nature of glioblastoma multiforme (GBM) and limited intraoperative visualization of the tumour margin, incomplete surgical resection has been observed to occur in up to 80 % of GBM cases, leading to nearly universal tumour recurrence and overall poor prognosis of 14.6 months median survival. This research presents a miniaturized, SiPMT-based optical system for simultaneous measurement of powerful DRS and weak auto-fluorescence for brain tumour detection. The miniaturisation of the optical elements confined the spatial separation of eight select wavelengths into footprint measuring 1.5 × 2 × 16 mm. The small footprint enables this technology to be integrated with existing surgical guidance instruments in the operating room. It’s dynamic ability to subtract any background illumination and measure signal intensities across a broad range from pW to mWs make this design much more suitable for clinical environments as compared to spectrometer-based systems with limited dynamic ranges and high integration times. Measurements using optical tissue phantoms containing mixed fluorophores demonstrate correlation coefficients between the fitted response and actual concentration using PLS regression being 0.95, 0.87 and 0.97 for NADH, FAD and PpIX , respectively. These promising results indicate that our proposed miniaturized instrument could serve as an effective alternative in operating rooms, assisting surgeons in identifying brain tumours to achieving positive surgical outcomes for patients.
Single-fiber probes for combined sensing and imaging in biological tissue: recent developments and prospects
Authors: Li Jiawen , Warren-Smith Stephen C. , McLaughlin Robert A. , Ebendorff-Heidepriem Heike
Published: March 2024

Single-fiber-based sensing and imaging probes enable the co-located and simultaneous observation and measurement (i.e., ‘sense’ and ‘see’) of intricate biological processes within deep anatomical structures. This innovation opens new opportunities for investigating complex physiological phenomena and potentially allows more accurate diagnosis and monitoring of disease. This prospective review starts with presenting recent studies of single-fiber-based probes for concurrent and co-located fluorescence-based sensing and imaging. Notwithstanding the successful initial demonstration of integrated sensing and imaging within single-fiber-based miniaturized devices, the realization of these devices with enhanced sensing sensitivity and imaging resolution poses notable challenges. These challenges, in turn, present opportunities for future research, including the design and fabrication of complex lens systems and fiber architectures, the integration of novel materials and other sensing and imaging techniques.
Influence of laser pulse shape and cleanliness on two-photon microscopy
Authors: Chong Shau Poh , Török Peter
Published: March 2024

Nonlinear microscopy, including two-photon microscopy, requires pulsed lasers as light source. Typically, when choosing the appropriate pulsed laser for two-photon microscopy, the pulse repetition rate, pulse width, total power output, and output beam diameter are among the critical parameters which are often emphasised. Here, we demonstrate that the pulse shape, often overlooked, can have significant impact on the two-photon microscopy excitation efficiency and the effective signal brightness. We provide metrics to ease practical selection of pulsed laser sources for two-photon microscopy.
Role for gene conversion in the evolution of cell-surface antigens of the malaria parasite Plasmodium falciparum
Authors: Letcher Brice , Maciuca Sorina , Iqbal Zamin
Published: March 2024

While the malaria parasite Plasmodium falciparum has low average genome-wide diversity levels, likely due to its recent introduction from a gorilla-infecting ancestor (approximately 10,000 to 50,000 years ago), some genes display extremely high diversity levels. In particular, certain proteins expressed on the surface of human red blood cell–infecting merozoites (merozoite surface proteins (MSPs)) possess exactly 2 deeply diverged lineages that have seemingly not recombined. While of considerable interest, the evolutionary origin of this phenomenon remains unknown. In this study, we analysed the genetic diversity of 2 of the most variable MSPs, DBLMSP and DBLMSP2, which are paralogs (descended from an ancestral duplication). Despite thousands of available Illumina WGS datasets from malaria-endemic countries, diversity in these genes has been hard to characterise as reads containing highly diverged alleles completely fail to align to the reference genome. To solve this, we developed a pipeline leveraging genome graphs, enabling us to genotype them at high accuracy and completeness. Using our newly- resolved sequences, we found that both genes exhibit 2 deeply diverged lineages in a specific protein domain (DBL) and that one of the 2 lineages is shared across the genes. We identified clear evidence of nonallelic gene conversion between the 2 genes as the likely mechanism behind sharing, leading us to propose that gene conversion between diverged paralogs, and not recombination suppression, can generate this surprising genealogy; a model that is furthermore consistent with high diversity levels in these 2 genes despite the strong historical P. falciparum transmission bottleneck.