bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of patient's sex on groin hernia repair: A systematic review and meta‐analysis
Authors: Balthazar da Silveira Carlos André , Mazzola Poli de Figueiredo Sergio , Rasador Ana Caroline Dias , Dias Yasmin Meirelles , Hernandez Martin Rafael Ribeiro , Fernandez Miguel Godeiro , Towfigh Shirin
Published: September 2024

Background

Groin hernia repair (GHR) is a performed procedure worldwide, with approximately 20 million surgeries carried out each year. Despite being less common in females, there is a lack of research on how sex influences the outcomes of GHR. This systematic review and meta‐analysis aim to assess how patient sex impacts results in GHR.

Methods

We performed a systematic review and meta‐analysis according to Preferred Reporting Items for Systematic Review and Meta‐Analyses guidelines. We searched for studies up to October 2023 in MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials. The studies included focused on sex outcomes for both robotic and open GHR procedures. Data extraction and quality assessment were conducted using the Risk of Bias in Non‐Randomized Studies ‐ Of Interventions tool. Our statistical analysis was performed using the metafor package in RStudio.

Results

After screening a total of 3917 articles, we identified 29 studies that met our criteria, comprising a total of 1,236,694 patients. Among them, 98,641 (7.98%) patients were females. Our findings showed that females had higher rates of hernia recurrence (RR 1.28), chronic pain (RR 1.52), and surgical site infections (SSIs) (RR 1.46) compared to males. Females showed a lower tendency to undergo minimally invasive surgery (MIS) with a relative risk of 0.82 (95% CI 0.69–0.97; p = 0.02).

Conclusion

Females tend to face higher rates of complications after GHR such as an elevated risk of chronic pain, recurrence, and surgical site infections (SSI). Moreover, they undergo fewer MIS options compared to males. These results underscore the importance of research to enhance outcomes for women undergoing GHR.
Prognostic value of the postoperative carcinoembryonic antigen level in colorectal cancer: A meta‐analysis
Authors: Liu Furui , Jiang Shuai , Cui Jianli , Wu Yueqiao , Chen Shuhui , Yu Zhan
Published: September 2024

Background

Carcinoembryonic antigen (CEA) is one of the commonly used preoperative biomarkers for colorectal cancer (CRC), but no meta‐analysis has evaluated the findings of all recently published studies to determine whether its postoperative level can serve as a prognostic indicator.

Methods

We conducted a systematic search for eligible literature from the PubMed, EMBASE, and Web of Science databases in October 2023. Studies that investigated the relationship between postoperative serum CEA levels and prognosis in CRC patients were included. Outcome indicators, including overall survival (OS), disease‐free survival (DFS), and progression‐free survival (PFS)/recurrence‐free survival (RFS), were analyzed using a fixed‐effects or random‐effects model. The pooled hazard ratios (HR) with 95% confidence intervals (CI) were used as effective values.

Results

This meta‐analysis included 20 eligible studies involving 10,114 CRC patients from the East Asian and Western countries. A comprehensive analysis revealed that elevated postoperative CEA levels were associated with low OS (HR: 2.92, 95% CI: 2.36–3.62, and p < 0.000), DFS (HR: 2.81, 95% CI: 2.01–3.94, and p < 0.000), and RFS/PFS (HR: 2.52, 95% CI: 1.75–3.62, p < 0.000). A subgroup analysis by region, analysis type, distant metastasis, HR obtain method, sample size, postoperative measurement date, and study design demonstrated that the negative correlation observed between high serum CEA levels after surgery and poor prognosis was not significantly different between the subgroups.

Conclusion

When CEA levels are found to be elevated during postoperative follow‐up, more active intervention measures should be implemented to further improve the patient's survival outcomes.
Clinical and computed tomography outcomes after mesh‐enforced hiatoplasty and anterior hemi‐fundoplication in large hiatal hernia repair
Authors: Süsstrunk Julian , Stimpfle Daniel , Wilhelm Alexander , Ghielmini Enea Marco , Potthast Silke , Zingg Urs
Published: September 2024

Background

The surgical technique in large hiatal hernia (HH) repair is controversially discussed and the outcome measures and follow‐up schemes are highly heterogeneous. The aim of this study is to assess the true recurrence rate using computed tomography (CT) in patients with standardized large HH repair.

Methods

Prospective single‐center study investigating the outcome after dorsal, mesh‐enforced large HH repair with anterior fundoplication. Endoscopy was performed after 3 months and clinical follow‐up and CT after 12 months.

Results

Between 2012 and 2021, 100 consecutive patients with large HH were operated in the same technique. There were two reoperations within the first 90 days for cephalad migration of the fundoplication. Endoscopic follow‐up showed a correct position of the fundoplication and no relevant other pathologies in 99% of patients. Follow‐up CT was performed in 100% of patients and revealed 6% of patients with a cephalad slippage, defined as migration of less than 3 cm of the wrap, and 7% of patients with a recurrent hernia. One patient of each group underwent subsequent reoperation due to symptoms. There was no statistical correlation between abnormal radiological findings and clinical outcomes with 69.2% of patients being asymptomatic. Multivariate logistic regression did not show any prognostic factor for an unfavorable radiologic outcome. Ninety‐four percent of patients rated their outcomes as excellent or good.

Conclusion

Radiological follow‐up after large HH repair using CT allows to detect slippage of the fundoplication wrap and small recurrences. Patients with unfavorable radiological outcomes rarely require operative revision but should be considered for further follow‐up.
Starting From Scratch: Husbandry Techniques to Establish the First Population of 'Akikiki (Oreomystis bairdi) in Human Care Using Wild‐Collected Eggs
Authors: Flanagan Alison M. , Masuda Bryce , Pribble Jennifer , Dancil Kona , Kauka Tatum , Tanaka Carina , Bailey Hannah , Swaisgood Ronald R.
Published: September 2024

Conservation breeding programs can save species from extinction by establishing assurance populations that provide individuals for achieving species recovery goals in the wild. However, keeping animals in human care can result in the selection of phenotypes that may be suboptimal for post‐release survival and reproduction. It is therefore essential that conservation breeding programs provide animals with naturalistic conditions that facilitate the performance of species‐typical behaviors, an endeavor that is also a vital aspect of animal welfare. Here, we describe how we established a conservation breeding program for the 'Akikiki (Oreomystis bairdi), a Hawaiian honeycreeper that is facing imminent extinction in the wild. We share how we utilized the species' native habitat as a template for developing husbandry practices with a primary focus on how we simulate wild environmental conditions in enclosures, mimic naturalistic foraging experiences, and facilitate pair bonding and parental breeding behaviors.
Opportunities for Gene Editing of Sweetpotato
Authors: Huang Debao , Livengood Chase , Yencho G. Craig , Liu Wusheng
Published: September 2024

Sweetpotato plays significant roles in the food supply worldwide. Conventional sweetpotato breeding methods face challenges such as self- and cross-incompatibility and high heterogeneity. Gene editing is an effective and powerful tool for modifying agronomic traits, offering a novel approach to develop cultivars by targeting specific genes for precise modifications. The transformed CRISPR/Cas can be segregated out from the gene-edited end product of sexually propagated crops but not in sweetpotato as sweetpotato is highly heterogeneous and has to be propagated clonally. Thus, innovative sweetpotato breeding methods need to be further developed to improve breeding efficacy and decrease breeding cycle. In the present book chapter, we reviewed the methods used for sweetpotato breeding, the success of gene editing in sweetpotato, and the challenges and constraints and the future perspectives of sweetpotato gene editing.
Trilateral Research Association of Sweetpotato (TRAS) Ipomoea. trifida and I. batatas Sequencing and Crop Improvement Efforts
Authors: Isobe Sachiko , Yoon Ung-Han , Cao Qinghe , Kwak Sang-Soo , Tanaka Masaru , Ma Daifu , Liu Qingchang
Published: September 2024

East Asia is an important region of sweetpotato production and consumption. To promote exchange among scientists studying sweetpotato in East Asia, the Trilateral Research Association of Sweetpotato (TRAS) was established in 2004 by sweetpotato scientists from China, South Korea, and Japan. The TRASgenome sequencing consortium was formally launched in 2014 and established a haploid-resolved and chromosome-scale de novo assembly of autohexaploid sweetpotato genome sequences. Before constructing the genome, we created chromosome-scale genome sequences in Ipomoea trifida using a highly homozygous accession, ‘Mx23Hm’, with PacBio RSII and Hi-C reads. Haploid-resolved genomeassembly was performed for the sweetpotato (I. batatas) cultivar ‘Xushu 18’ by hybrid assembly with Illumina paired-end (PE) and mate-pair (MP) reads, 10X genomics reads, and PacBio RSII reads. Then, 90 chromosome-scale pseudomolecules were generated by aligning the scaffolds onto a sweetpotato linkage map. In total, 34,386 and 175,633 genes were identified on the assembled nucleic genomesof I. trifida and sweetpotato, respectively. The assembled genome sequences have been used for genetic and RNA-Seq analysis for agronomically important traits. The assembled genome sequences are expected to continue to contribute to genetic and genomic analysis and promote sweetpotato breeding.
New Analytical Tools for Molecular Mapping of Quantitative Trait Loci in Sweetpotato
Authors: da Silva Pereira Guilherme , da Silva Carla Cristina , Rosa João Ricardo Bachega Feijó , Sobowale Olusegun Olusesan , de Siqueira Gesteira Gabriel , Mollinari Marcelo , Zeng Zhao-Bang
Published: September 2024

Quantitative trait loci(QTL) mapping is an important tool in sweetpotato research, contributing to the understanding of genetic architecture of various traits, including dry matter, nematode resistance, and flesh color. Early QTL work was carried out by using marker information alone via single marker analysis (SMA), or based on parent-specific linkage map using interval mapping (IM), composite interval mapping (CIM), and multiple interval mapping (MIM). Initially developed for inbred diploid species populations, these methods did not fully consider the complex autopolyploid, outcrossing nature of sweetpotato. Technological and methodological advances made it possible to obtain integrated, fully phased genetic maps for the crop. A random-effect MIM approach that leverages identity-by-descent based on QTL genotype conditional probabilities has been employed since with increasing power and resolution. To illustrate QTL identification in sweetpotato, we used publicly available data from ‘Beauregard’ × ‘Tanzania’ full-sib family ($$N = 315$$

N
=
315

) evaluated for flesh color in Peru. Several methods were able to detect two QTL on chromosomes 3 and 12 each for this trait in the same genomic regions. Despite the importance of such methods, there is need to extend existing models to account for multi-trait or multi-environment data and to evaluate their application in genomic-enabled prediction.
Genomic-Assisted Nutritional and Quality Breeding Efforts in Sweetpotato
Authors: Ssali Reuben Tendo , Oloka Bonny Michael , Amankwaah Victor A. , Yada Benard , Carey Edward , Yencho G. Craig
Published: September 2024

Sweetpotato, Ipomoea Batatas L., is widely considered as a staple food in many developing countries especially in sub-Saharan Africa (SSA). It has storage roots that are rich in starch, micronutrients (especially Fe and Zn), and vitamins A and C. Partly due to its polyploidy, heterogeneity and outcrossing nature, it can be cultivated in a wide range of environments. Sweetpotato additionally comes in a variety textures, colors, flavors, and nutritional profiles thus appealing to many different groups of people. Conventional breeding of sweetpotato to improve nutritional and quality traits has only been moderately successful over the years due to several factors. This is manly true in areas like SSA which are characterized by low adoption of high β-carotene orange-flesh types. The biggest challenge has been to understand, measure and combine cultural preferences for taste and quality with nutritional components. In this work, we look at efforts to measure quality preferences, and accelerate the breeding process of sweetpotato by tapping into new breeding technologies and genomic-assisted breeding approaches.
Constraining |Vcs| and physics beyond the Standard Model from exclusive (semi)leptonic charm decays
Authors: Bolognani Carolina , Reboud Méril , van Dyk Danny , Vos K. Keri
Published: September 2024

Abstract

We study the available data on exclusive leptonic and semileptonic c → sℓ+ν decays within the Standard Model and beyond. Our analysis accounts for theory correlations between the relevant hadronic matrix elements through application of dispersive bounds. We find that, within a global analysis, the dispersive bounds are generally well respected and only mildly affect the extraction of the Cabibbo-Kobayashi-Maskawa (CKM) matrix element |Vcs|. Assuming Standard Model dynamics, we obtain$$ \left|{V}_{cs}\right|=0.957\pm 0.003, $$

V
cs

=
0.957
±
0.003
,

which is compatible with the HFLAV/PDG reference value |Vcs| = 0.975 ± 0.006 at the 2.7σ level. Our findings lead to significant deficits in the second-row and second-column unitarity relations of the CKM matrix. Allowing for beyond the SM contributions in the Weak Effective Theory, we find very strong constraints on potential (pseudo)scalar and tensor effects. However, the data still permits sizeable CP-violating right-handed currents.
Neutrino masses in the mirror twin Higgs with spontaneous ℤ2 breaking
Authors: Bittar Pedro , Costa Davi B. , Burdman Gustavo
Published: September 2024

Abstract

We introduce a mirror twin Higgs model with spontaneous ℤ2 symmetry breaking that ameliorates the constraints in twin Higgs cosmology and, at the same time, generates the Standard Model neutrino masses. The model features an SU(2) triplet with hypercharge 1 alongside its twin counterpart. Spontaneous breaking of both ℤ2 and electroweak symmetry occurs in the scalar sector. The Standard Model neutrinos acquire small masses through the type-II seesaw mechanism. In contrast, their twin counterparts acquire large masses, effectively addressing the dark radiation problem in mirror twin Higgs scenarios. We study the impact of the model on the Neff. constraints, as well as on collider phenomenology.
ADHM Wilson line defect indices
Authors: Hayashi Hirotaka , Nosaka Tomoki , Okazaki Tadashi
Published: September 2024

Abstract

The Coulomb and Higgs indices of the 3d

$$ \mathcal{N} $$

N

= 4 U(N) ADHM theories can be decorated by line defect operators as the line defect correlators. We obtain exact closed-form expressions and various non-trivial algebraic relations for the correlators of the Wilson lines in the fundamental and (anti)symmetric representations by means of the Hall-Littlewood expansion, the Fermi-gas method and the residue calculation. From the large N limit of the correlators we obtain the single particle gravity indices which are expected to encode the spectra of fluctuation modes on the gravity duals of line operators in M2-brane SCFTs.
Radiation in holography
Authors: Ciambelli Luca , Pasterski Sabrina , Tabor Elisa
Published: September 2024

Abstract

We show how to encode the radiative degrees of freedom in 4-dimensional asymptotically AdS spacetimes, using the boundary Cotton and stress tensors. Background radiation leads to a reduction of the asymptotic symmetry group, in contrast to asymptotically flat spacetimes, where a non-vanishing news tensor does not restrict the asymptotic symmetries. Null gauges, such as Λ-BMS, provide a framework for AdS spacetimes that include radiation in the flat limit. We use this to check that the flat limit of the radiative data matches the expected definition in intrinsically asymptotically flat spacetimes. We further dimensionally reduce our construction to the celestial sphere, and show how the 2-dimensional celestial currents can be extracted from the 3-dimensional boundary data.
Solving AdS3 string theory at minimal tension: tree-level correlators
Authors: Dei Andrea , Knighton Bob , Naderi Kiarash
Published: September 2024

Abstract

We revisit the minimal tension (k = 1) string theory on AdS3 × S3 × 𝕋4. We propose a new free-field description of the worldsheet theory and show how localization of string amplitudes emerges from the path integral. We exemplify our proposal by reproducing the worldsheet partition function of the $$ \mathfrak{psu} $$
psu
(1, 1|2)1 WZW model and providing explicit expressions for spectrally-flowed vertex operators and DDF operators. We compute string correlators in the path integral formalism and obtain a precise tree-level match with correlation functions of the boundary symmetric orbifold.
Thermal production of astrophobic axions
Authors: Badziak Marcin , Harigaya Keisuke , Łukawski Michał , Ziegler Robert
Published: September 2024

Abstract

Hot axions are produced in the early Universe via their interactions with Standard Model particles, contributing to dark radiation commonly parameterized as ∆Neff. In standard QCD axion benchmark models, this contribution to ∆Neff is negligible after taking into account astrophysical limits such as the SN1987A bound. We therefore compute the axion contribution to ∆Neff in so-called astrophobic axion models characterized by strongly suppressed axion couplings to nucleons and electrons, in which astrophysical constraints are relaxed and ∆Neff may be sizable. We also construct new astrophobic models in which axion couplings to photons and/or muons are suppressed as well, allowing for axion masses as large as few eV. Most astrophobic models are within the reach of CMB-S4, while some allow for ∆Neff as large as the current upper bound from Planck and thus will be probed by the Simons Observatory. The majority of astrophobic axion models predicting large ∆Neff is also within the reach of IAXO or even BabyIAXO.
A light QCD axion with hilltop misalignment
Authors: Co Raymond T. , Gherghetta Tony , Liu Zhen , Lyu Kun-Feng
Published: September 2024

Abstract

We study the cosmological evolution of a light QCD axion and identify the parameter space to obtain the correct relic dark matter abundance. The axion potential is flattened at the origin, corresponding to the only minimum, while it is unsuppressed at π. These potential features arise by assuming a mirror sector with the strong CP phase $$ \overline{\theta} $$

θ
¯

shifted by π compared to the SM sector, which allows the mirror axion potential to be tuned against the usual QCD axion potential. Before the QCD phase transition, assuming the mirror sector is decoupled and much colder than the SM thermal bath, the mirror sector potential dominates, causing the axion to initially roll to a temporary minimum at π. However, after the QCD phase transition, the potential minimum changes, and the axion relaxes from the newly created “hilltop” near π to the CP-conserving minimum at the origin. As the axion adiabatically tracks this shift in the potential minimum through the QCD phase transition, with non-adiabatic evolution near π and 0, it alters the usual prediction of the dark matter abundance. Consequently, this “hilltop” misalignment mechanism opens new regions of axion parameter space, with the correct relic abundance while still solving the strong CP problem, that could be explored in future experiments.
All-multiplicity amplitudes in impulsive PP-waves from the worldline formalism
Authors: Copinger Patrick , Edwards James P. , Ilderton Anton , Rajeev Karthik
Published: September 2024

Abstract

We use the worldline formalism to derive Bern-Kosower type Master Formulae for the tree-level scattering of a charged particle and an arbitrary number of photons on impulsive PP-waves, where the coupling of the PP-wave to matter is treated fully non-perturbatively. We show that, in a certain kinematic regime characterised by a semi-classical positive energy condition, both off-shell currents and scattering amplitudes exhibit two novel factorisation structures. First, they may be written as currents in vacuum but with a single additional photon, averaged over the momentum of that photon. This converts the all-orders interaction with the PP-wave into a single effective interaction. Second, the currents and amplitudes may be written as a weighted average of the corresponding quantities in an impulsive plane wave background, with the average taken over all possible field strengths of the plane wave. This generalises a known single-photon result to arbitrary multiplicity.
Differential equations for Carrollian amplitudes
Authors: Ruzziconi Romain , Stieberger Stephan , Taylor Tomasz R. , Zhu Bin
Published: September 2024

Abstract

Differential equations are powerful tools in the study of correlation functions in conformal field theories (CFTs). Carrollian amplitudes behave as correlation functions of Carrollian CFT that holographically describes asymptotically flat spacetime. We derive linear differential equations satisfied by Carrollian MHV gluon and graviton amplitudes. We obtain non-distributional solutions for both the gluon and graviton cases. We perform various consistency checks for these differential equations, including compatibility with conformal Carrollian symmetries.
Cosmological correlators for Bogoliubov initial states
Authors: Chopping Alistair J. , Sleight Charlotte , Taronna Massimo
Published: September 2024

Abstract

We consider late-time correlators in de Sitter (dS) space for initial states related to the Bunch-Davies vacuum by a Bogoliubov transformation. We propose to study such late-time correlators by reformulating them in the familiar language of Witten diagrams in Euclidean anti-de Sitter space (EAdS), showing that they can be perturbatively re-cast in terms of corresponding dS boundary correlators in the Bunch-Davies vacuum and in turn, Witten diagrams in EAdS. Unlike the standard relationship between late-time correlators in the Bunch-Davies vacuum and EAdS Witten diagrams, this involves points on the upper and lower sheet of the EAdS hyperboloid which account for antipodal singularities of the two-point functions. Such Bogoliubov states include an infinite one parameter family of de Sitter invariant vacua as a special case, where the late-time correlators are constrained by conformal Ward identities. In momentum space, it is well known that their late-time correlators exhibit singularities in collinear (“folded”) momentum configurations. We give a position space interpretation of such solutions to the conformal Ward identities, where in embedding space they can be generated from the solution without collinear singularities by application of the antipodal map. We also discuss the operator product expansion (OPE) limit of late-time correlators in a generic dS invariant vacuum. Many results are derived using the Mellin space representation of late-time correlators, which in this work we extend to accommodate generic dS invariant vacua.
A Thin Film Model for Meniscus Evolution
Authors: Ghosh Amrita , Velázquez Juan J. L.
Published: September 2024

In this paper, we discuss a particular model arising from sinking of a rigid solid into a thin film of liquid, i.e. a liquid contained between two solid surfaces and part of the liquid surface is in contact with the air. The liquid is governed by Navier–Stokes equation, while the contact point, i.e. where the gas, liquid and solid meet, is assumed to be given by a constant, non-zero contact angle. We consider a scaling limit of the liquid thickness (lubrication approximation) and the contact angle between the liquid–solid and the liquid–gas interfaces close to $$\pi $$
π
. This resulting model is a free boundary problem for the equation $$h_t + (h^3h_{xxx})_x = 0$$

h
t

+

(

h
3

h

xxx

)

x

=
0

, for which we have $$h>0$$

h
>
0

at the contact point (different from the usual thin film equation with $$h=0$$

h
=
0

at the contact point). We show that this fourth order quasilinear (non-degenerate) parabolic equation, together with the so-called partial wetting condition at the contact point, is well-posed. Furthermore, the contact point in our thin film equation can actually move, contrary to the classical thin film equation for a droplet arising from the no-slip condition. Additionally, we show the global stability of steady state solutions in a periodic setting.
Numerical Analysis for a Non-isothermal Incompressible Navier–Stokes–Allen–Cahn System
Authors: Rueda-Gómez Diego A. , Rueda-Fernández Elian E. , Villamizar-Roa Élder J.
Published: September 2024

In this paper we develop the numerical analysis for a non-isothermal diffuse-interface model, in dimension $$N=2, 3,$$

N
=
2
,
3
,

that describes the movement of a mixture of two incompressible viscous fluids. This model consists of modified Navier–Stokes equations coupled with a phase-field equation given by a convective Allen–Cahn equation, and energy transport equation for the temperature; which admits a dissipative energy inequality. We propose an energy stable numerical scheme based on the Finite Element Method, and we analyze optimal weak and strong error estimates, as well as convergence towards regular solutions. In order to construct the numerical scheme, we introduce two extra variables (given by the gradient of the temperature and the variation of the energy with respect to the phase-field function) which allows us to control the strong regularity required by the model, which is one of the main difficulties appearing from the numerical point of view. Having the equivalent model, we consider a fully discrete Finite Element approximation which is well-posed, energy stable and satisfies a set of uniform estimates which allow to analyze the convergence of the scheme. Finally, we present some numerical simulations to validate numerically our theoretical results.
The Asymptotic Expansion of the Spacetime Metric at the Event Horizon
Authors: Kröncke Klaus , Petersen Oliver
Published: September 2024

Hawking’s local rigidity theorem, proven in the smooth setting by Alexakis-Ionescu-Klainerman, says that the event horizon of any stationary non-extremal black hole is a non-degenerate Killing horizon. In this paper, we prove that the full asymptotic expansion of any smooth vacuum metric at a non-degenerate Killing horizon is determined by the geometry of the horizon. This gives a new perspective on the black hole uniqueness conjecture. In spacetime dimension 4, we also prove an existence theorem: Given any non-degenerate horizon geometry, Einstein’s vacuum equations can be solved to infinite order at the horizon in a unique way (up to isometry). The latter is a gauge invariant version of Moncrief’s classical existence result, without any restriction on the topology of the horizon. In the real analytic setting, the asymptotic expansion is shown to converge and we get well-posedness of this characteristic Cauchy problem.
A whole-food, plant-based intensive lifestyle intervention improves glycaemic control and reduces medications in individuals with type 2 diabetes: a randomised controlled trial
Authors: Hanick Cody J. , Peterson Courtney M. , Davis Brenda C. , Sabaté Joan , Kelly John H.
Published: September 2024

Aims/hypothesis

We conducted the largest and longest clinical trial comparing a whole-food, plant-based intervention with standard medical care (SMC) in individuals with type 2 diabetes.

Methods

We randomised (parallel-arm; computerised 1:1 randomisation ratio) 169 adults aged 18–75 years with type 2 diabetes in the Marshall Islands to an intensive whole-food, plant-based intervention with moderate exercise (PB+Ex) or SMC for 24 weeks. The PB+Ex intervention included 12 weeks of meals, exercise sessions and group classes. Primary outcomes were glycaemic control (HbA1c, glucose, insulin and HOMA-IR) and glucose-lowering medication use. Secondary outcomes included lipids, blood pressure, heart rate and C-reactive protein. Only lab analysts were blinded.

Results

Compared with SMC (n=90 randomised; n=70 analysed), the PB+Ex (n=79 randomised; n=66 analysed) intervention decreased HbA1c by an additional 14 mmol/mol (1.3%) at week 12 (−22 vs −7 mmol/mol [−2.0% vs −0.7%]; p<0.0001) and 8 mmol/mol (0.7%) at week 24 (−16 vs −8 mmol/mol [−1.4% vs −0.7%]; p=0.01). Concomitantly, 63% of medicated PB+Ex participants reduced their glucose-lowering medications (vs 24%; p=0.006), and 23% of PB+Ex participants with a baseline HbA1c <75 mmol/mol (<9%) achieved remission. Additionally, the PB+Ex intervention reduced weight (−2.7 kg; p<0.0001), C-reactive protein (−11 nmol/l; p=0.005) and cardiovascular medication use compared with SMC. At intermediate timepoints, it improved glucose, insulin, HOMA-IR, cholesterol, triglycerides and heart rate, but not at week 24.

Conclusions/interpretation

A whole-food, plant-based lifestyle intervention was more effective for improving glycaemic control than SMC. It also reduced the need for diabetes and cardiovascular medications and induced diabetes remission in some participants. Therefore, it is an effective, evidence-based lifestyle option for individuals with type 2 diabetes.

Trial registration

ClinicalTrials.gov NCT03862963

Funding

This research was funded by the Department of the Army (W81XWH-05-1-0547). CJH received support through a National Institutes of Health Predoctoral T32 Obesity Fellowship (T32 HL105349).

Graphical Abstract
Externally forced blow-up and optimal spaces for source regularity in the two-dimensional Navier–Stokes system
Authors: Winkler Michael
Published: September 2024

The Navier–Stokes system

$$\begin{aligned} \left\{ \begin{array}{l} u_t + (u\cdot \nabla ) u =\Delta u+\nabla P + f(x,t), \\ \nabla \cdot u=0, \end{array} \right. \end{aligned}$$

u
t

+

(
u
·
∇
)

u
=
Δ
u
+
∇
P
+
f

(
x
,
t
)

,

∇
·
u
=
0
,

is considered along with homogeneous Dirichlet boundary conditions in a smoothly bounded planar domain

$$\Omega $$

Ω

. It is firstly, inter alia, observed that if

$$T>0$$

T
>
0

and

$$\begin{aligned} \int _0^T \bigg \{ \int _\Omega |f(x,t)| \cdot \ln ^\frac{1}{2} \big (|f(x,t)|+1\big ) dx \bigg \}^2 dt <\infty , \end{aligned}$$

∫
0
T

{

∫
Ω

|
f

(
x
,
t
)

|

·

ln

1
2

(

|
f

(
x
,
t
)

|

+
1

)

d
x

}

2

d
t
<
∞
,

then for all divergence-free

$$u_0\in L^2(\Omega ;{\mathbb {R}}^2)$$

u
0

∈

L
2

(
Ω
;

R

2

)

, a corresponding initial-boundary value problem admits a weak solution u with

$$u|_{t=0}=u_0$$

u
|

t
=
0

=

u
0

. For any positive and nondecreasing

$$L\in C^0([0,\infty ))$$

L
∈

C
0

(

[
0
,
∞
)

)

such that

$$\begin{aligned} \frac{L(\xi )}{\ln ^\frac{1}{2} \xi } \rightarrow 0 \qquad \text{ as } \xi \rightarrow \infty , \end{aligned}$$

L
(
ξ
)

ln

1
2

ξ

→
0

as

ξ
→
∞
,

this is complemented by a statement on nonexistence of such a solution in the presence of smooth initial data and a suitably constructed

$$f:\Omega \times (0,T)\rightarrow {\mathbb {R}}^2$$

f
:
Ω
×

(
0
,
T
)

→

R

2

fulfilling

$$\begin{aligned} \int _0^T \bigg \{ \int _\Omega |f(x,t)| \cdot L\big (|f(x,t)|\big ) dx \bigg \}^2 dt < \infty . \end{aligned}$$

∫
0
T

{

∫
Ω

|
f

(
x
,
t
)

|

·

L

(

|
f

(
x
,
t
)

|

)

d
x

}

2

d
t
<
∞
.

This resolves a fine structure in the borderline case

$$p=1$$

p
=
1

and

$$q=2$$

q
=
2

appearing in results on existence of weak solutions for sources in

$$L^q((0,T);L^p(\Omega ;{\mathbb {R}}^2))$$

L
q

(

(
0
,
T
)

;

L
p

(
Ω
;

R

2

)

)

when

$$p\in (1,\infty ]$$

p
∈
(
1
,
∞
]

and

$$q\in [1,\infty ]$$

q
∈
[
1
,
∞
]

satisfy

$$\frac{1}{p}+\frac{1}{q}\le \frac{3}{2}$$

1
p

+

1
q

≤

3
2

, and on nonexistence if here

$$p\in [1,\infty )$$

p
∈
[
1
,
∞
)

and

$$q\in [1,\infty )$$

q
∈
[
1
,
∞
)

are such that

$$\frac{1}{p}+\frac{1}{q}>\frac{3}{2}$$

1
p

+

1
q

>

3
2

.
Health-Related Quality of Life After Neonatal Treatment of Symptomatic Tetralogy of Fallot: Insights from the Congenital Cardiac Research Collaborative
Authors: Nicholson George T. , Zampi Jeffrey D. , Glatz Andrew C. , Goldstein Bryan H. , Petit Christopher J. , Zhang Yun , McCracken Courtney E. , Qureshi Athar M. , Goldberg Caren S. , Romano Jennifer C. , Law Mark A. , Meadows Jeffery J. , Shahanavaz Shabana , Batlivala Sarosh P. , Maskatia Shiraz A. , Beshish Asaad , O’Byrne Michael L. , Ligon R. Allen , Stack Kathryn O. , Khan Hala Q. , Parekh Shalin , Ilardi Dawn L.
Published: September 2024

To evaluate the association between initial management strategy of neonatal symptomatic Tetralogy of Fallot (sTOF) and later health-related quality of life (HRQOL) outcomes. We performed a multicenter, cross-sectional evaluation of a previously assembled cohort of infants with sTOF who underwent initial intervention at ≤ 30 days of age, between 2005 and 2017. Eligible patients’ parents/guardians completed an age-appropriate Pediatric Quality of Life Inventory, a Pediatric Quality of Life Inventory Cardiac Module Heart Disease Symptoms Scale, and a parental survey. The association between treatment strategy and HRQOL was evaluated, and the entire sTOF cohort was compared to published values for the healthy pediatric population and to children with complex congenital heart disease and other chronic illness. The study cohort included 143 sTOF subjects, of which 59 underwent a primary repair, and 84 had a staged repair approach. There was no association between initial management strategy and lower HRQOL. For the entire cohort, in general, individual domain scores decreased as age sequentially increased. Across domain measurements, mean scores for the sTOF cohort were significantly lower than the healthy pediatric population and comparable to those with other forms of complex CHD and other chronic health conditions. The presence of a genetic syndrome was significantly associated with a poor HRQOL (p = 0.003). Initial treatment strategy for sTOF was not associated with differences in late HRQOL outcomes, though the overall HRQOL in this sTOF cohort was significantly lower than the general population, and comparable to others with chronic illness.
Differential analysis of the impact of lesions’ location on clinical and radiological outcomes after the implantation of a novel aragonite-based scaffold to treat knee cartilage defects
Authors: Conte Pietro , Anzillotti Giuseppe , Crawford Dennis C. , Dasa Vinod , Flanigan David C. , Nordt William E. , Scopp Jason M. , Meislin Robert J. , Strauss Eric J. , Strickland Sabrina M. , Fiorentino Gennaro , Lattermann Christian
Published: September 2024

Purpose

There is limited comparative evidence on patient outcomes following cartilage repair in various knee compartments. The aim of this study was to compare clinical and imaging outcomes after treating cartilage defects in femoral condyles and trochlea with either an aragonite-based scaffold or surgical standard of care (SSoC, i.e., debridement/microfractures) in a large multicentre randomized controlled trial.

Methods

247 patients with up to three knee joint surface lesions (ICRS grade IIIa or above) in the femoral condyles, trochlea or both (“mixed”), were enrolled and randomized to surgery with either a cell-free aragonite scaffold or SSoC. Patients were followed for up to 48 months by analysing subjective scores (KOOS and IKDC), radiological outcomes (defect filling on MRI), as well as treatment failure rates and adverse events. A differential analysis of outcomes for condylar, trochlear and mixed lesions was performed.

Results

The scaffold group significantly outperformed the SSoC group regardless of lesion location with statistically significantly better KOOS Overall scores at 24 months (all p ≤ 0.0009) and 48 months (all p ≤ 0.02). Similar results were observed for KOOS subscales and IKDC scores. For KOOS responder rates, superiority of the implant group was demonstrated at 24, 36, and 48 months (all p ≤ 0.004). Higher defect filling on MRI for implants was observed for all locations. Lower treatment failure rates for the implant were observed in condylar and mixed lesions.

Conclusion

The aragonite-based scaffold was safe and effective regardless of the defect location, providing superior clinical and radiological outcomes compared to SSoC up to four years follow-up.

Level of evidence

I – Randomized controlled trial.
Optimizing individualized therapy decision-making in multiple myeloma (MM): integration and impact of the Revised Myeloma Comorbidity Index in the MM-tumor board
Authors: Dreyling Esther , Ihorst Gabriele , Reinhardt Heike , Räder Jan , Holler Maximilian , Herget Georg , Greil Christine , Wäsch Ralph , Engelhardt Monika
Published: September 2024

Multiple Myeloma (MM) is a hematological disease predominantly affecting elderly patients. The complexity of current treatment necessitates individualized approaches. Therein, functional assessment (FA) tools, such as the Revised Comorbidity Index (R-MCI) at our University- and Comprehensive Cancer Center Freiburg, play a crucial role. This study aimed to determine (a) the implementation of the R-MCI in our MM-tumor board (MM-TB), (b) its impact on treatment guidance at baseline and (c) potential changes during follow-up. This exploratory study investigated R-MCI coverage and distribution in a cohort of patients with multiple TB presentations. Among them, a follow-up patient cohort undergoing subsequent MM-therapy was analyzed to determine treatment adjustments and changes in patients’ condition measured by R-MCI alterations. During our 3-year assessment period, 565 patients were presented in our MM-TB, totaling 1256 TB-presentations. In the multiple TB presentation cohort, the median number of TB presentations was 3 (range: 2–12). R-MCI scores within the MM-TB were available in 94%, whereas in 6%, the R-MCI had not been integrated. Among these, potential failure to identify the need for treatment modifications was determined. In the follow-up cohort, patient characteristics were typical for referral/university centers. Dose reductions were performed in 55% and were more prevalent among patients with ≥ 4 vs. lesser TB presentations. Most patients (55%) showed a fitness stabilization or improvement via follow-up R-MCI. R-MCI integration in MM-TB exceeded > 90%, indicating its successful integration for treatment support. Our results underscore its value in guiding therapy decisions, providing a comprehensive assessment beyond age considerations.
Hypoalbuminemia in children with acute lymphoblastic leukemia: relation to asparaginase therapy and impact on high dose methotrexate elimination
Authors: Christensen Sophie Rex , Jensen Christina Friis , Heldrup Jesper , Taylor Zachary , Ramsey Laura B. , Rosthøj Steen
Published: September 2024

Purpose

High-dose methotrexate (HDMTX) therapy is an important component in treatment regimens for acute lymphoblastic leukemia (ALL). Courses are associated with a risk of renal injury, delayed elimination, and increased systemic toxicity. Recently hypoalbuminemia has been recognized as yet another risk factor.

Methods

To examine the impact of serum albumin we reviewed 325 HDMTX 5 g/m2 courses in a cohort of 51 children treated on the NOPHO ALL 2008 protocol, dividing the courses into four groups with different levels of baseline albumin (A < 25 g/L, B 25–29 g/L, C 30–34 g/L and D ≥ 35 g/L).

Results

Hypoalbuminemia was present in 51% of the courses, mostly in the early phases of chemotherapy while asparaginase therapy is ongoing, and especially if given less than 2 weeks after a dose (78%). Hypoalbuminemia had a significant impact on the end-of-infusion serum MTX, depending on the degree of hypoalbuminemia: MTX > 150 µM was seen in 37%, 32%, 20% and 8% in groups A to D. Serum albumin < 30 g/L was significantly associated with low MTX clearance < 10 L/h/1.73m2 (78% vs. 36%) and high AUC ≥ 1000 µM*h (44% vs. 31%). The frequency of rising creatinine or prolonged elimination was not increased, but the risk of stomatitis was significantly higher (42% vs. 19%).

Conclusion

Low serum albumin is caused by concurrent asparaginase therapy and has a clinically significant impact on MTX disposition. Guidelines for administering HDMTX may need adjustment if serum albumin < 30 g/L, and, if possible, HDMTX courses should not be scheduled soon after asparaginase doses.
Non-linearity and the distribution of market-based loss rates
Authors: Nagl Matthias , Nagl Maximilian , Rösch Daniel
Published: September 2024

We synthesize the extended linear beta regression with a neural network structure to model and predict the mean and precision of market-based loss rates. We can incorporate non-linearity in mean and precision in a flexible way and resolve the problem of specifying the underlying form in advance. As a novelty, we can show that the proportion of non-linearity for the mean estimates is $$14.10\%$$

14.10
%

and $$80.37\%$$

80.37
%

for the precision estimates. This implies that especially the shape of the loss rate distribution entails a large amount of non-linearity and, thus, our approach consistently outperforms its linear counterpart. Furthermore, we derive trainable activation functions to allow a data-driven estimation of their shape. This is important if predictions have to be in a certain interval, e.g., (0, 1) or $$(0,\infty )$$

(
0
,
∞
)

. Conducting a scenario analysis, we observe that our estimated distributions are more refined compared to traditional models, thereby demonstrating their suitability for risk management purposes. These estimated distributions can assist financial institutions in better identifying diverse risk profiles among their creditors and across various macroeconomic states.
Accelerating high order discontinuous Galerkin solvers through a clustering-based viscous/turbulent-inviscid domain decomposition
Authors: Otmani Kheir-Eddine , Mateo-Gabín Andrés , Rubio Gonzalo , Ferrer Esteban
Published: September 2024

We explore the unsupervised clustering technique introduced in Otmani et al. (Phys Fluids 35:027112, 2023) to identify viscous/turbulent from inviscid regions in incompressible flows. The separation of regions allows solving the Navier–Stokes equations including Large Eddy Simulation closure models only in the viscous/turbulent ones, while solving the Euler equations in the remaining of the computational domain. By solving different sets of equations, the computational cost is significantly reduced. This coupling strategy is implemented within a discontinuous Galerkin numerical framework, which allows discontinuous solutions (i.e., different sets of equations) in neighboring elements that interact through numerical fluxes. The proposed strategy maintains the same accuracy at lower cost, when compared to solving the full Navier–Stokes equations throughout the entire domain. Validation of this approach is conducted across diverse flow regimes, spanning from unsteady laminar flows to unsteady turbulent flows, including an airfoil section at Reynolds numbers $$Re=10^3$$

R
e
=

10
3

and $$10^4$$

10
4

and large angles of attack, and the flow past a wind turbine, modelled using actuator lines. The computational cost is reduced by $$25\%$$

25
%

and $$29\%$$

29
%

for the unsteady turbulent flow around an airfoil section and the flow past the wind turbine, respectively. In addition, to further accelerate the simulations, we combine the proposed decoupling with local P-adaptation, as proposed in Tlales et al. (Eng Comput, 2024). When doing so, we reduce the computational cost by $$41\%$$

41
%

and $$45\%$$

45
%

for the flow around the airfoil section and the flow past the wind turbine, respectively.
Correlation of sino-nasal outcome test and nasal polyp score in dupilumab-treated chronic rhinosinusitis with nasal polyps
Authors: Mauthe Tina , Ryser Fabio S. , Brühlmann Catrin , Yalamanoglu Ayla , Meerwein Christian , Steiner Urs C. , Soyka Michael B.
Published: September 2024

Background

The alignment between objective scores and patient-reported outcome measures (PROMs) is underexplored. This study aimed to assess changes in Nasal Polyp Score (NPS) and Sino-Nasal Outcome Test (SNOT) scores in chronic rhinosinusitis with nasal polyps (CRSwNP) patients undergoing dupilumab treatment and explore correlations between these scores.

Methods

CRSwNP patients received dupilumab therapy for six months. SNOT-20 German Adapted Version (GAV)/SNOT-22 scores were assessed weekly, and NPS was measured at baseline and after one, three, and six months. Correlations were analyzed using Spearman’s rank correlation and regression analysis.

Results

69 patients were included. After one, three and six months of dupilumab therapy, SNOT and NPS scores improved significantly. Correlation analysis of SNOT and NPS showed significant correlations only within the nasal subscores, along with a weak trend for SNOT-20. Absolute changes over time lacked significance. However, correlation analysis revealed significant associations between relative changes in SNOT score and NPS, irrespective of timing, and when stratified by baseline NPS of 8, 6, and 4 (r = -0.54, p = 0.01; r = -0.44, p < 0.001; r = -0.7, p < 0.001). This was supported by linear regression modeling, suggesting potential predictive capability of NPS reduction on relative SNOT score improvement.

Conclusion

Dupilumab therapy significantly improved subjective and objective CRSwNP scores, exhibiting weak correlations in absolute values for nasal subscores. Furthermore, evidence indicated a correlation between relative changes in SNOT score and NPS, substantiated by predictive capability. This might be due to subjective perception variability, highlighting the suitability of relative change correlation analysis.