bluuebunny/crossref_metadata_2025 huggingface dataset:
Examining water risk perception and evaluation in the corporate and financial sector: a mixed methods study in Ontario, Canada
Authors: Sandhu Guneet , Weber Olaf , Wood Michael O , Rus Horatiu A , Thistlethwaite Jason
Published: October 2023

As primary users of a socially, economically, and environmentally significant yet increasingly stressed resource like water, the corporate and financial sectors have an important role in sustainable water management. However, extant literature reveals a gap in the empirical assessment of water risk perception and its influence on water risk evaluation and decision-making in the corporate and financial sectors. Our explanatory sequential mixed methods study examined the relationship between water risk perception and risk evaluation (risk ratings), addressing these gaps. We employed a cross-sectional survey (N = 25) followed by semi-structured interviews (N = 22), with a purposive expert sample of analysts, practitioners, and decision-makers in the corporate and financial sector in Ontario, Canada. Our study finds multi-dimensional risk perception factors, including knowledge, professional experience, perceived controllability, values, trust, location, and gender, that influence water risk ratings and vary with the type of risk. Moreover, the in-depth follow-up interviews reveal multiple drivers of different risk ratings, such as proximity bias, sector differences, trust in various institutions, as well as the influence of tacit knowledge, exposure, the role of regulations, media, and financial materiality. Our study empirically concludes that the water risk perception of analysts, practitioners, and decision-makers in the corporate and financial sectors is highly nuanced and impacts the evaluation of different water risks, and should be systematically integrated into risk assessment and decision-making frameworks. Our study advances knowledge in the fields of risk analysis and sustainable water management and contributes by empirically examining and explaining the complex and underexplored relationship between water risk perception factors and evaluation using novel interdisciplinary Risk Theory and mixed methods approaches. Finally, the study’s findings can help integrate sector and location-specific preferences and priorities with analytical data to design contextually-attuned decision support tools for sustainable water management strategies, policies, and practices.
Thin film absorbers for tandem solar cells: an industrial perspective
Authors: Yu Ming L , Los Andrei , Xiong Gang
Published: October 2023

Tandem solar cells have received a lot attention from academia and industrial researchers as the potential next-generation PV technology, with higher efficiency above the limit of single-junction solar cells. Thin-film/thin-film (TF/TF) tandems are attractive due to similar toolset and processes producing the top and bottom cells, which improve scalability and promote cost reduction compared to TF/wafer tandem technologies. TF/TF/tandems additionally offer more absorber bandgap flexibility that promotes photovoltaic conversion efficiency optimization. Many materials not suitable for single junction solar cells can be explored as tandem top or bottom cells. To assess the practical efficiency potential of tandem solar cells limited by non-ideal material and device quality, we present a Shockley–Queisser-like efficiency calculation for tandem devices consisting of non-ideal top and bottom cells and with a range of absorber band gaps. The non-ideality is introduced through an experimentally measurable external radiative quantum efficiency (ERE). We find that a range of top and bottom cell band gaps enabling the highest tandem efficiency shifts from the ideal Shockley–Queisser case and depends on the top and bottom cell ERE. Furthermore, tandem cell efficiency greater than 37% can be achieved with very modest top/bottom cell EREs, for example of only 0.008%/0.5% which is typical for CdTe/CIS cells. Our results indicate that high efficiency tandem solar cells have good probability to be manufactured at high volume within a foreseeable future, despite non-ideal material and device quality due to early stages of development or constraint by manufacturing requirements. Finally, we review a number of mature and emerging thin film absorber material candidates for tandem applications. We discuss properties of these materials and the corresponding device performance as well as the associated technological challenges. We concludes on the promise of each of these materials for tandem applications that is expected to provide guidance to the photovoltaic research community.
Double diamond approach helping multidisciplinary health research team to mitigate infrastructure limitations
Authors: Abensur Silvia Itzcovici , Carlstron Regina , Hoehne Juliana Lopes , Bachiega Helder Luiz , Schor Paulo
Published: October 2023

The Double Diamond approach was used to creatively solve problems during bioengineering projects and facilitate a bioprinting protocol in the hard science. Users reported difficulties while using a inkjet bioprinter for specific research involving overprint and predefined location in ophthalmic applications. Given the laboratory’s limited financial resources, the pursuit of low-cost solutions became essential, and the Double Diamond approach played a pivotal role in finding them. This method was chosen due to its high resolubility focused on generating creative solutions. Moreover, its emphasis on User Experience made it an accessible design process, benefiting both designers and non-designers and enhancing user adherence while enabling easy application within the multidisciplinary team. As a result of this research, a solution was discovered, allowing researchers to overcome the problem and continue their ongoing work while also facilitating the development of new projects. In conclusion, the successful implementation of the Double Diamond approach in this specific application highlights its potential to address challenges across diverse projects. Its adaptable nature and emphasis on user-centricity make it a valuable tool in tackling complex issues in various fields of development.
Enhancement of power quality in grid-connected HRES using UPQC with self-improved Battle Royal Optimizer in IEEE 14 bus system
Authors: Ranjan Ashish , Choudhary Jayanti
Published: October 2023

The integration of hybrid renewable energy systems (HRES) in grid-connected load systems has become popular due to its ability to enhance reliability and reduce losses. However, this integration can lead to power quality (PQ) issues caused by non-linear, critical, and unbalanced load conditions. To address these PQ issues and compensate for load demand in HRES systems, a new method called Self-Improved Battle Royal Optimizer (SI-BRO) has been proposed. This method involves the use of a Unified Power Quality Conditioner (UPQC) device, which is designed to improve the system’s PQ performance. To enhance the performance of the UPQC device, an optimized fuzzy logic controller is introduced in the series and shunt active power filter, and its parameters are optimized using the SI-BRO model. The proposed method is implemented in MATLAB/Simulink, and its effectiveness is evaluated through different scenarios in IEEE 14 Bus system. These scenarios include the introduction of a nonlinear load to create PQ issues, and the comparison of Sag, Swell, and fluctuation of proposed technique i.e. SI-BRO optimizer with BRO,HHO ,EHO optimizer and calculation of THD in proposed technique.In all cases of Sag,Swell, Fluctuation , the proposed techniques gives better results in comparison to BRO,HHO & EHO.
TransIntegrator: capture nearly full protein-coding transcript variants via integrating Illumina and PacBio transcriptomes
Authors: Lin Zhe , Qin Yangmei , Chen Hao , Shi Dan , Zhong Mindong , An Te , Chen Linshan , Wang Yiquan , Lin Fan , Li Guang , Ji Zhi-Liang
Published: October 2023

Genes have the ability to produce transcript variants that perform specific cellular functions. However, accurately detecting all transcript variants remains a long-standing challenge, especially when working with poorly annotated genomes or without a known genome. To address this issue, we have developed a new computational method, TransIntegrator, which enables transcriptome-wide detection of novel transcript variants. For this, we determined 10 Illumina sequencing transcriptomes and a PacBio full-length transcriptome for consecutive embryo development stages of amphioxus, a species of great evolutionary importance. Based on the transcriptomes, we employed TransIntegrator to create a comprehensive transcript variant library, namely iTranscriptome. The resulting iTrancriptome contained 91 915 distinct transcript variants, with an average of 2.4 variants per gene. This substantially improved current amphioxus genome annotation by expanding the number of genes from 21 954 to 38 777. Further analysis manifested that the gene expansion was largely ascribed to integration of multiple Illumina datasets instead of involving the PacBio data. Moreover, we demonstrated an example application of TransIntegrator, via generating iTrancriptome, in aiding accurate transcriptome assembly, which significantly outperformed other hybrid methods such as IDP-denovo and Trinity. For user convenience, we have deposited the source codes of TransIntegrator on GitHub as well as a conda package in Anaconda. In summary, this study proposes an affordable but efficient method for reliable transcriptomic research in most species.
Fuse feeds as one: cross-modal framework for general identification of AMPs
Authors: Zhang Wentao , Xu Yanchao , Wang Aowen , Chen Gang , Zhao Junbo
Published: October 2023

Antimicrobial peptides (AMPs) are promising candidates for the development of new antibiotics due to their broad-spectrum activity against a range of pathogens. However, identifying AMPs through a huge bunch of candidates is challenging due to their complex structures and diverse sequences. In this study, we propose SenseXAMP, a cross-modal framework that leverages semantic embeddings of and protein descriptors (PDs) of input sequences to improve the identification performance of AMPs. SenseXAMP includes a multi-input alignment module and cross-representation fusion module to explore the hidden information between the two input features and better leverage the fusion feature. To better address the AMPs identification task, we accumulate the latest annotated AMPs data to form more generous benchmark datasets. Additionally, we expand the existing AMPs identification task settings by adding an AMPs regression task to meet more specific requirements like antimicrobial activity prediction. The experimental results indicated that SenseXAMP outperformed existing state-of-the-art models on multiple AMP-related datasets including commonly used AMPs classification datasets and our proposed benchmark datasets. Furthermore, we conducted a series of experiments to demonstrate the complementary nature of traditional PDs and protein pre-training models in AMPs tasks. Our experiments reveal that SenseXAMP can effectively combine the advantages of PDs to improve the performance of protein pre-training models in AMPs tasks.
Levodopa suppresses grid-like activity and impairs spatial learning in novel environments in healthy young adults
Authors: Gönner Lorenz , Baeuchl Christian , Glöckner Franka , Riedel Philipp , Smolka Michael N , Li Shu-Chen
Published: October 2023

Accumulated evidence from animal studies suggests a role for the neuromodulator dopamine in memory processes, particularly under conditions of novelty or reward. Our understanding of how dopaminergic modulation impacts spatial representations and spatial memory in humans remains limited. Recent evidence suggests age-specific regulation effects of dopamine pharmacology on activity in the medial temporal lobe, a key region for spatial memory. To which degree this modulation affects spatially patterned medial temporal representations remains unclear. We reanalyzed recent data from a pharmacological dopamine challenge during functional brain imaging combined with a virtual object-location memory paradigm to assess the effect of Levodopa, a dopamine precursor, on grid-like activity in the entorhinal cortex. We found that Levodopa impaired grid cell-like representations in a sample of young adults (n = 55, age = 26–35 years) in a novel environment, accompanied by reduced spatial memory performance. We observed no such impairment when Levodopa was delivered to participants who had prior experience with the task. These results are consistent with a role of dopamine in modulating the encoding of novel spatial experiences. Our results suggest that dopamine signaling may play a larger role in shaping ongoing spatial representations than previously thought.
Anisotropic seismic velocity variations in response to different orientations of tidal deformations
Authors: Takano Tomoya , Nishimura Takeshi , Nakahara Hisashi
Published: October 2023

Microcracks or micropores in rocks cause the elastic moduli to change with the applied strain owing to the nonlinear elasticity of the geomaterial, which causes temporal changes in the seismic wave velocity. Thus, variations in seismic wave velocity can be used as a proxy for understanding the strain or stress variations in the crust, which are crucial for figuring out the dynamics of the fault zones and volcanic domains. According to the theory of nonlinear elasticity, the second- and third-order elastic constants and strain tensors contribute to the strain derivative of seismic wave velocity changes. Although laboratory experiments have estimated third-order elastic constants for rock samples, the in situ values of those constants for the crust are difficult to obtain. In this study, seismic velocity changes were investigated in different directions of tidal deformations to provide constraints on the third-order elastic constants in the shallow crust by applying a seismic interferometry method to ambient noise records. We observed that negative velocity changes were of larger magnitude in the station-pair direction parallel to the tidal strain’s direction. Nonlinear elasticity in shallow crust may cause anisotropic velocity variations in response to tidal deformations. Our results highlight the use of velocity change measurements in different directions of tidal strain to constrain nonlinear elastic parameters on a field scale.
Knocking down a DNA demethylase gene affects potato plant defense against a specialist insect herbivore
Authors: Zhang Yadong , Zhong Jian , Munawar Asim , Cai Yajie , He Wenjing , Zhang Yixin , Guo Han , Gao Yulin , Zhu Zengrong , Zhou Wenwu
Published: October 2023

DNA demethylase (DML) is involved in plant development and responses to biotic and abiotic stresses; however, its role in plant–herbivore interaction remains elusive. Here, we found that herbivory by the potato tuber moth, Phthorimaea operculella, rapidly induced the genome-wide DNA methylation and accumulation of DML gene transcripts in potato plants. Herbivory induction of DML transcripts was suppressed in jasmonate-deficient plants, whereas exogenous application of methyl jasmonate (MeJA) improved DML transcripts, indicating that the induction of DML transcripts by herbivory is associated with jasmonate signaling. Moreover, P. operculella larvae grew heavier on DML gene (StDML2) knockdown plants than on wild-type plants, and the decreased biosynthesis of jasmonates in the former may be responsible for this difference, since the larvae feeding on these two genotypes supplemented with MeJA showed similar growth. In addition, P. operculella adult moths preferred to oviposit on StDML2 knockdown plants than on wild-type plants, which was associated with the reduced emission of β-caryophyllene in the former. In addition, supplementing β-caryophyllene to these two genotypes further disrupted moths’ oviposit choice preference for them. Interestingly, in StDML2 knockdown plants, hypermethylation was found at the promoter regions for the key genes StAOS and StAOC in the jasmonate biosynthetic pathway, as well as for the key gene StTPS12 in β-caryophyllene production. Our findings suggest that knocking down StDML2 can affect herbivore defense via jasmonate signaling and defense compound production in potato plants.
Projective relative unification through duality
Authors: Balbiani Philippe , Gougeon Quentin
Published: October 2023

Unification problems can be formulated and investigated in an algebraic setting, by identifying substitutions to modal algebra homomorphisms. This opens the door to applications of the notorious duality between Heyting or modal algebras and descriptive frames. Through substantial use of this correspondence, we give a necessary and sufficient condition for formulas to be projective. A close inspection of this characterization will motivate a generalization of standard unification, which we dub relative unification. Applying this result to a number of different logics, we then obtain new proofs of their projective—or non-projective—character. Aside from reproving known results, we show that the projective extensions of $\textbf{K5}$ are exactly the extensions of $\textbf{K45}$. This resolves the open question of whether $\textbf{K5}$ is projective.
TODDLERS: a new UV–mm emission library for star-forming regions – I. Integration with SKIRT and public release
Authors: Kapoor Anand Utsav , Baes Maarten , van der Wel Arjen , Gebek Andrea , Camps Peter , Nersesian Angelos , Meidt Sharon E , Smith Aaron , Vicens Sebastien , D’Eugenio Francesco , Martorano Marco , Barrientos Daniela , Sartorio Nina Sanches
Published: October 2023

We present and publicly release a new star-forming regions emission library TODDLERS (Time evolution of Observables including Dust Diagnostics and Line Emission from Regions containing young Stars) for the publicly available radiative transfer code SKIRT. The library generation involves the spherical evolution of a homogeneous gas cloud around a young stellar cluster that accounts for stellar feedback processes including stellar winds, supernovae, and radiation pressure, as well as the gravitational forces on the gas. The semi-analytical evolution model is coupled with the photoionization code Cloudy to calculate time-dependent UV–mm spectral energy distributions (SEDs) from star-forming regions of varying metallicity, star-formation efficiency, birth-cloud density, and mass. The calculated SEDs include the stellar, nebular, and dust continuum emission along with a wide range of emission lines originating from H ii, photodissociation, and molecular gas regimes tabulated at high resolution. The SEDs incorporated in SKIRT are generated by calculating a stellar-mass normalized luminosity, which assumes that each emission source is composed of a power-law population of star-forming clouds. When compared to the previous treatment of star-forming regions in SKIRT, TODDLERS shows a better agreement with low-redshift observational data in the IR wavelength range while offering a more comprehensive line-emission support. This paves the way for a variety of applications using simulated galaxies at low and high redshift.
Internal Displacement and Subjective Well-Being: The Case of Ukraine in 2018
Authors: Perelli-Harris Brienna , Zavisca Jane , Levchuk Nataliia , Gerber Theodore P
Published: October 2023

Ukraine is currently experiencing the largest human displacement crisis in the world. However, armed conflict that started in 2014 had already displaced nearly 1.8 million people in Ukraine, resulting in the largest internally displaced population in Europe. Although ethnically and culturally similar to the local population, Ukrainian Internally Displaced Persons (IDPs) encounter severe economic, housing, and social challenges, as well as residual trauma from violence. In this study we examine the extent to which the subjective well-being (SWB) of IDPs differs from locals who were not displaced. We explore whether the difference in subjective well-being between IDPs and locals is due to economic hardship, inadequate housing, and/or weak social support. Using a unique survey conducted in 2018 and OLS regression methods, we find a sizable gap in SWB between IDPs and locals. The gap shrinks after accounting for economic and housing status, and support from local networks. Measures of loss in housing and social networks additionally account for the gap. However, none of the factors we measure can account for the difference between locals and IDPs who reported only leaving due to violence, pointing to the enduring impact of trauma on SWB.
The fluorescence‐based competitive counterflow assay developed for organic anion transporting polypeptides 1A2, 1B1, 1B3 and 2B1 identifies pentamidine as a selective OATP1A2 substrate
Authors: Ungvári Orsolya , Bakos Éva , Kovacsics Daniella , Özvegy‐Laczka Csilla
Published: October 2023

Organic anion transporting polypeptides OATP1A2, OATP1B1, OATP1B3 and OATP2B1 are Na+‐ and ATP‐independent exchangers of large, organic compounds, encompassing structurally diverse xenobiotics, including various drugs. These OATPs influence intestinal absorption (OATP2B1), hepatic clearance (OATP1B1/3) and blood to brain penetration (OATP1A2, OATP2B1) of their drug substrates. Consequently, OATP‐mediated drug or food interactions may lead to altered pharmacokinetics and toxicity. During drug development, investigation of hepatic OATP1B1 and OATP1B3 is recommended by international regulatory agencies. Most frequently, OATP‐drug interactions are investigated in an indirect assay, i.e., by examining uptake inhibition of a radioactive or fluorescent probe. However, indirect assays do not distinguish between transported substrates and non‐transported OATP inhibitors. To fill this hiatus, a novel assay, termed competitive counterflow (CCF) has been developed and has since been applied for several OATPs to differentiate between substrates and non‐transported inhibitors. However, previous OATP CCF assays, with the exception of that for OATP1B1, used radioactive probes. In the current study, we demonstrate that sulforhodamine 101 or pyranine can be used as fluorescent probes in a CCF assay to identify transported substrates of OATP1A2, or OATPs 1B1, 1B3 and 2B1, respectively. With the help of the newly developed fluorescence‐based CCF method, we identify the FDA‐approved anti‐protozoal drug, pentamidine as a unique substrate of OATP1A2. Furthermore, we confirm the selective, OATP1A2‐mediated uptake of pentamidine in a cytotoxicity assay. Based on our results, OATP1A2 may be an important determinant of pentamidine transport through the blood–brain barrier.
From Two Dimensions to Multidimensions: A Mechanistic Model to Support Deliberate CPD Development, Coordination, and Evaluation
Authors: Sachidanandan Grahanya , Sud Abhimanyu
Published: October 2023

Introduction:

The effectiveness of continuing professional development as an intervention to improve health professional behavior and patient health is variable and contentious. To clarify the causal relationships underlying program outcomes and facilitate a necessary shift from outcomes-only–based approaches to outcome-based and theory-based approaches in program development and evaluation, we developed a model of mechanisms mapped to relevant outcomes.

Methods:

Mechanisms identified in a prior realist synthesis of opioid agonist therapy continuing professional development programs were iteratively tested and refined using purposive and opportunistic sampling and realist approaches against two systematic reviews of programs in analgesic prescribing and palliative care. Further testing involved practical application within programs in sustainable health care and pain management.

Results:

Ninety reports on 75 programs and practical application to multiple additional programs informed the final model consisting of five distinct mechanisms: motivation transformation, expert influence, confidence development, self-efficacy facilitation, and community of practice expansion. The mechanisms and related analysis emphasize that continuing professional development is heterogeneous, complex, and context dependent.

Discussion:

Shifting toward outcome-based and theory-based approaches facilitates further conceptual shifts at intraprogram and interprogram and interintervention levels toward more deliberate program development and evaluation, increased program complementarity and subsequent collaboration. It clarifies opportunities for intercalation of continuing professional development with other intervention sciences. The model presents a resource for practitioners, researchers, and policymakers to advance continuing professional development planning, coordination, and evaluation.
The burden of nonalcoholic fatty liver disease (NAFLD) is rapidly growing in every region of the world from 1990 to 2019
Authors: Paik James M. , Henry Linda , Younossi Youssef , Ong Janus , Alqahtani Saleh , Younossi Zobair M.
Published: October 2023

Background:

The latest meta-analyses suggest NAFLD is increasing globally. Its limitations may preclude accurate estimates. We evaluated the global NAFLD burden and its’ trends in prevalence and NAFLD liver–related mortality (LRM) by sex, age, region, and country over the past 3 decades using data from the Global Burden of Disease (GBD) 2019 study.

Methods:

Crude and age-standardized NAFLD prevalence and NAFLD-LRM rates were obtained for all-age individuals with NAFLD from 204 countries/territories between 1990 and 2019. Joinpoint trend analysis assessed time trends. Weighted average of the annual percent change (APC) over the period 1990–2019 and 2010–2019 were reported.

Results:

All-age (children and adults) crude global NAFLD prevalence increased:10.5% (561 million)–16.0% (1,236 million); an APC increase: + 1.47% (95% CI, 1.44%, 1.50%). Among adults (+20 y), crude NAFLD prevalence increased (1990: 17.6%, 2019:23.4%; APC: + 1.00%, 95% CI: 0.97%, 1.02%). In all-age groups, the crude NAFLD-LRM rate (per 100,000) increased (1990: 1.75%, 2019: 2.18%; APC: + 0.77% (95% CI, 0.70%, 0.84%). By Joinpoint analysis, from 2010 to 2019, worsening all-age trends in NAFLD prevalence and LRM were observed among 202 and 167 countries, respectively. In 2019, there were 1.24 billion NAFLD prevalent cases and 168,969 associated deaths; Asia regions accounted for 57.2% of all-age prevalent cases and 46.2% of all-age NAFLD-LRM. The highest all-age crude NAFLD prevalence rate was the Middle East and North Africa (LRM 26.5%); the highest all-age crude NAFLD-LRM rate was Central Latin America (5.90 per 100,000).

Conclusions:

NAFLD is increasing globally in all-age groups—over 80% of countries experienced an increase in NAFLD and NAFLD-LRM. These data have important policy implications for affected countries and for global health.
Medicaid Expansions and Access to Substance Abuse Treatment Services Among Limited English Proficiency Populations
Authors: Lee Donghoon , Dugan Jerome A.
Published: October 2023

Background:

Although the myriad of provisions under the Affordable Care Act (ACA) have generally increased coverage and financial access to the health systems, language barriers represent a serious challenge to access to care among Limited English Proficiency (LEP) populations.

Objective:

The aim of this study was to examine the effect of Medicaid expansions under the ACA on the availability of language services and Medicaid acceptance in substance abuse treatment (SAT) facilities.

Research Design:

A quasi-experimental difference-in-differences design with multiple time periods was used to compare changes in the availability of language services and Medicaid as a payment source between Medicaid expansion and nonexpansion states. Facility-level observational data in the National Survey of Substance Abuse Treatment Services 2010–2019 was included.

Measures:

Availability of LEP services and Medicaid acceptance in the SAT facilities.

Results:

The proportion of SAT facilities that provide LEP services increased from 40% in 2013 to 53% in 2019. The proportions by state are heterogeneous, ranging from approximately 20% to 70%. The ACA Medicaid expansions are not associated with changes in the availability of LEP services in the facilities. Moreover, Medicaid acceptance in the expansion states increased gradually following the expansion; however, the estimates are not statistically significant.

Conclusion:

The ACA Medicaid expansion had no impact on the availability of LEP services and the acceptance of Medicaid as a payment source in the SAT facilities.
Comparison of 18F-PSMA-1007 and 18F-Choline PET/CT in prostate cancer patients with biochemical recurrence: a phase 3, prospective, multicenter, randomized study
Authors: Panagiotidis Emmanouil , Fragkiadaki Vasiliki , Papathanasiou Nikolaos , Kypraios Charalampos , Liatsikos Evangelos , Klampatsas Athanasios , Paschali Anna , Exarhos Dimitrios , Zarokosta Foteini , Chatzipavlidou Vasiliki , Apostolopoulos Dimitrios , Datseris Ioannis
Published: October 2023

Objectives

This prospective, multicenter, open-label, randomized, crossover trial study was to evaluate the diagnostic performance of 18F-PSMA-1007 (PSMA) vs. 18F-Choline PET/CT (FCH) in prostate cancer (PCa) patients (pts) with biochemical recurrence (BCR).

Methods

One hundred eighty-six pts, who have undergone primary definitive treatment for PCa with BCR, were recruited to this prospective study. All pts underwent one PSMA and one FCH PET/CT examination in randomized order within a time frame of 8 days and were followed up for at least 6 months (182 ± 10 days).

Results

Recurrence of PCa was observed in 176 out of 186 pts. The overall correct detection rate (DR) was 84% (95% CI 0.7967–0.8830) for PSMA and 69% (95% CI 0.6191–0.7489) for FCH, yielding a difference in proportion of 16% (P < 0.0001). PSMA had a sensitivity of 0.8464 and FCH 0.6857 with an odds ratio of 2.5259 (P < 0.0001), with statistically significant greater sensitivity of PSMA (ORs, 2.7877 and 2.1283 respectively) (P < 0.0001). PET/CT imaging led to a more accurate diagnosis in 166 (89.2%) pts, of which PSMA had contributed more than FCH in 91 (54.8%) of them. The DR for cutoff point PSA ≤ 1 ng/ml was higher for PSMA compared to FCH (61.8% vs. 39.5%). DR value of 51.6% for PSMA reached at PSA ≤ 0.3 ng/ml, while FCH reached that DR value with PSA ≤ 2.2 ng/ml.

Conclusion

18F-PSMA-1007 is more efficacious than 18F-Choline for the identification metastatic lesions both in patient and in regional level analysis in PCa patients with BCR.
Potential role of pre-treatment bone marrow SUVmean to liver SUVmean ratio (BM/L) and comparison of primary tumour FDG uptake with brain FDG uptake in predicting survival in limited-stage lung cancers
Authors: Kavurgaci Suna , Özmen Özlem , Tatci Ebru , Söyler Yasemin , Cengiz Tuba İnal , Kabalak Pinar Akin , Kizilgöz Derya , Yilmaz Ülkü
Published: October 2023

Introduction

The survival rates of patients with limited-stage small-cell lung cancer are low despite curative treatment. Accordingly, we investigated the disease prognosis by comparing the pre-treatment bone marrow mean standardised uptake values (SUVmean) / liver SUVmean ratio (BM/L) and primary tumour FDG uptake and brain FDG uptake to prognosis.

Materials and methods

This was an observational, retrospective, single-centre study of patients with limited-stage small-cell lung cancer. Maximum standardised uptake values before treatment SUVmax, mean SUV (SUVmean), metabolic tumor volume (MTV), total lesion glycolysis (TLG), liver (KC) SUVmean, bone marrow SUVmean, BM/L ratio (grouped as BM/L <1 and BM/L<1), FDG uptake level of the primary tumour are higher than brain FDG uptake. The association of low prevalence with overall survival (OS) and progression-free survival (PFS) was evaluated.

Discussion

A total of 125 patients were included in the study. The risk of death was found to be two times higher in patients with primary tumour FDG uptake higher than brain FDG uptake compared to those with less brain involvement. The risk of death in patients with BM/L>1 was found to be 1.6 times higher than in patients with BM/L<1.

Conclusion

Comparison of BM/L, FDG uptake of the primary tumour and brain FDG uptake as new prognostic parameters can be guiding in the classification of patients with LD-SCLC with a higher risk of death or progression and in planning new treatment strategies.
Unveiling the power of imaging techniques: comparing high-resolution ultrasound and functional MR neurography in peripheral nervous system pathology: a short communication
Authors: Parvathy Gauri , Nazir Abubakar , Morani Zoya , Nazir Awais
Published: October 2023

MRI and ultrasonography are used for diagnosing and helping manage peripheral nervous system pathologies. Multiple studies have compared the diagnostic accuracy of these two modalities, but the results can vary depending on the specific conditions being evaluated. In general, high-resolution ultrasound is considered a reliable and accurate tool for evaluating peripheral nerves, with high sensitivity and specificity. High-resolution ultrasound and functional MR neurography are both noninvasive imaging techniques used to evaluate nerve structures in the body. However, they differ in several technical aspects like imaging modality, spatial resolution, field of view, image quality, and accessibility. Establishing consensus on image acquisition techniques, and reporting formats to facilitate effective communication and comparison of results will further enhance the outcomes. The use of advanced ultrasound techniques, such as contrast-enhanced ultrasound, elastography, and ultrasound biomicroscopy, should be promoted for better visualization and characterization of nervous tissues, like transcranial Doppler for cerebrovascular evaluation.
Quality Dashboards in Hospital Settings
Authors: Young Lisa , Vogelsmeier Amy
Published: October 2023

Background:

Dashboards visually display quality and safety data to aid nurses in making informed decisions.

Purpose:

This systematic review evaluated quality improvement (QI) dashboard characteristics associated with interventions to improve patient outcomes and positive end-user evaluation.

Methods:

Literature was searched from 2012 to 2022 in PubMed, CINAHL, Scopus, MEDLINE, and Google Scholar.

Results:

Sixteen articles were included. Varied dashboard characteristics were noted, with mixed patient outcomes and end-user responses. Graphs and tabular presentations were associated with improved patient outcomes, whereas graphs were associated with end-user satisfaction. Benchmarks were noted with improved patient outcomes but not end-user satisfaction. Interactive dashboards were important for end users and improved patient outcomes.

Conclusion:

Nurses can find dashboards helpful in guiding QI projects. Dashboards may include graphs and/or tables, benchmarks, and interactivity but should be useful, usable, and aligned to unit needs. Future research should focus on the use of quality dashboards in nursing practice.
Remote Patient Monitoring Improves Patient Falls and Reduces Harm
Authors: Zimbro Kathie S. , Bridges Charlene , Bunn Sharon , Wilmoth Donna D. , Beck Mark , Smith Catherine V. , Marra Michael , Ver Schneider Patricia , Morgan Merri K.
Published: October 2023

Background:

Minimizing patient falls and fall-related injuries within organizational constraints is a high priority for nurse leaders. The Centers for Medicare & Medicaid Services do not reimburse hospitals for fall-related expenditures. In-person sitters are used to prevent falls but are resource intensive and costly. Remote patient monitoring (RPM) may offer alternatives to in-person sitters to reduce fall-related harm.

Purpose:

The efficacy of RPM to reduce patient falls and fall-related injuries was explored.

Methods:

Electronic health record data were extracted from a 13-hospital integrated health care system. Incidence rate ratios were used to analyze the impact of RPM technology on falls and fall-related injuries.

Results:

When used in conjunction with standard fall precautions, RPM reduced falls 33.7% and fall-related injuries 47.4%. Fall-related expenditures decreased $304 400 with a combined estimated savings systemwide of $2 089 600 annually.

Conclusions:

RPM technology minimized falls and associated harm and improved patient safety, positively impacting hospital expenditures.
Shortage of Mental Health Professionals Doing Research
Authors: Vadukapuram Ramu , Perugula Malathi , Trivedi Chintan , Mansuri Zeeshan , Reddy Abhishek
Published: October 2023

Research plays a crucial role in advancing health care. Physician scientists, who bring together clinical and scientific perspectives, are integral to this effort. However, the pursuit of research careers among physicians has declined due to several obstacles, including inadequate support, training, time, and financial constraints. Emergency medicine and psychiatric specialties receive less support than other specialties, and COVID-19 has worsened the challenges. The COVID-19 has made things harder for physician scientists, increasing clinical demands and causing research delays. To tackle this, future physician scientists should receive organized training that includes mandatory research activities during their training. Large-scale studies should identify barriers to research and offer mentoring for young physician scientists. Encouraging female researchers and involving research faculty in residency training is crucial. Collaboration between physician and PhD researchers is essential for the future of medical research. It is vital to address these to advance health care and improve mental health outcomes.
High TEAD4 Expression is Associated With Aggressive Clear Cell Renal Cell Carcinoma, Regardless of YAP1 Expression
Authors: Park Min A. , Lee Yeong Heon , Gu Mi-Jin
Published: October 2023

Yes-associated protein 1 (YAP1) and transcriptional coactivator TEA domain transcription factor 4 (TEAD4) are the main effectors of the Hippo signaling pathway. Deregulation of the Hippo signaling pathway significantly impacts tumorigenesis and tumor progression. We evaluated the mRNA expression level of YAP1 and TEAD4 using the Gene Expression Profiling Interactive Analysis database and investigated the roles of YAP1 and TEAD4 in 349 surgically resected clear cell renal cell carcinoma (CCRCC) samples through immunohistochemical analysis. High YAP1 and TEAD4 expression were observed in 57 (16.3%) and 131 (37.5%) cases, respectively. High YAP1 expression was associated with a low nuclear grade only. High TEAD4 expression was significantly associated with large tumor size, high nuclear grade, lymphovascular invasion, advanced pT classification, advanced clinical stage, sarcomatous differentiation, and metastasis. CCRCC with YAP1-low/TEAD4-high expression was significantly associated with aggressive clinicopathological variables and poor outcomes. For CCRCC, higher tumor stage, sarcomatous differentiation, and metastasis were the independent prognostic factors for overall survival (OS) and disease-free survival (DFS). High TEAD4 expression was significantly associated with short OS and DFS but was not an independent prognostic factor. High TEAD4 and YAP1-low/TEAD4-high expression significantly correlated with adverse clinicopathological factors and worse OS and DFS in patients with CCRCC. YAP1 expression was not significantly associated with clinicopathological factors or patient survival. Therefore, TEAD4 plays a critical role in CCRCC tumor progression independent of YAP1 and may be a potential biomarker and therapeutic target for CCRCC.
New Histopathologic Risk Model for Early T-stage Oral Squamous Cell Carcinoma
Authors: Chang Hsin-Yi , Hang Jen-Fan , Kuo Ying-Ju
Published: October 2023

Oral squamous cell carcinoma (OSCC) is treated based on the TNM staging. However, early T-stage OSCC still exhibits substantial nodal metastasis and death rates. Recent literature highlights the independent prognostic value of worst pattern of invasion (WPOI) and tumor budding in OSCC. Nevertheless, WPOI-5 is uncommon in early T-stage OSCC, and the definitions of tumor budding and WPOI-4 overlap. Moreover, WPOI assessment is subjective, and tumor budding evaluation varies across studies. To address these limitations, we aimed to develop a modified WPOI system and a novel tumor budding scoring system that assesses single cells and high-density tumor budding. We also evaluated a new histopathologic risk model for early T-stage OSCC. The study cohort comprised 37 pT1 and 64 pT2 OSCCs. The modified WPOI demonstrated superior interobserver agreement compared with the original system (κ value: 0.98 vs. 0.53). In the multivariate analysis, modified WPOI and tumor budding score were independent prognostic factors for nodal metastasis and disease-free survival, while modified WPOI predicted disease-specific survival. By integrating these factors, our risk model stratified the patients into 3 groups. Notably, the intermediate-risk and high-risk groups exhibited significantly higher rates of nodal metastasis, recurrence, and tumor-related death. Conversely, none in the low-risk group had nodal metastasis or succumbed to the disease. Our model offered simplified scoring and potentially improved prognostic predictions. In conclusion, we’ve developed a modified WPOI system, a new tumor budding scoring system, and a reliable risk model that classifies early T-stage OSCC patients into distinct risk groups with significant prognostic differences.
Comparison of Clinical Features of Intussusception in Terms of Age and Duration of Symptoms
Authors: Acer-Demir Tuğba , Güney Lütfi Hakan , Fakıoğlu Ender , Gültekingil Ayşe
Published: October 2023

Objectives

Intussusception is one of the most common surgical emergencies in children. We aimed to analyze the current clinical characteristics of intussusception.

Methods

We retrospectively reviewed 209 children diagnosed with intussusception, who were admitted to our hospital between January 2009 and August 2022. We grouped the patients according to symptom duration (before and after 12 hours and before and after 24 hours) and age (younger and older than 1 year, and younger and older than 2 years).

Results

The median age at admission was 31 months (2–204 months). The median symptom duration was 12 hours (1–420 hours). Most patients (91.4%) were admitted due to abdominal pain, irritability, and/or vomiting. The most common symptoms were vomiting (70.8%) and abdominal pain (60.6%). The classical triad of symptoms was seen in 9 cases (4.3%). In patients aged younger than 1 year, bloody stool, abnormal abdominal radiography findings, and a longer intussusceptum segment were more frequent. In patients aged younger than 2 years, abdominal pain, fever, and defense on physical examination were less frequent, and irritability, bloody stool, and recurrence were more frequent. Patients aged younger than 2 years had a longer intussusceptum segment and less lymphadenopathy based on ultrasonography (USG). The patients admitted more than 12 hours after symptom onset had more diarrhea, fever, abnormal x-ray, peritoneal fluid on USG, and recurrences, and less vomiting. After the symptoms had lasted for 24 hours, fever, mass palpation, and abnormal abdominal radiography findings were more frequent.

Conclusions

We recommend performing abdominal USG, especially in young children admitted to the emergency department with complaints of abdominal pain and/or vomiting, to rule out intussusception. In countries that have reported a high mortality rate from intussusception, we advise precautions such as increasing the availability of USG in emergency departments and educating the population to seek early medical assistance.
Characteristics and Disease Burden of Patients With Eosinophilic Granulomatosis With Polyangiitis Initiating Mepolizumab in the United States
Authors: Silver Jared , Deb Arijita , Packnett Elizabeth , McMorrow Donna , Morrow Cynthia , Bogart Michael
Published: October 2023

Background/Objective

Although the high disease burden associated with eosinophilic granulomatosis with polyangiitis (EGPA) has been established, the disease burden in patients initiating mepolizumab in real-world practice is poorly understood. This study aimed to assess characteristics and burden of real-world patients with EGPA initiating mepolizumab.

Methods

This was a database study (GSK study ID: 214156) of US patients (≥12 years old) with EGPA and ≥1 mepolizumab claim (index date) identified from the Merative MarketScan Commercial and Medicare Supplemental Databases (November 1, 2015, to March 31, 2020). Outcomes assessed in the 12-month baseline period before index (inclusive) included patient characteristics, treatment use, EGPA relapses, asthma exacerbations, health care resource utilization, and costs.

Results

In the 103 patients included (mean age, 51.1 years; 63.1% female), the most common manifestations were asthma (89.3%), chronic sinusitis (57.3%), and allergic rhinitis (43.7%). In total, 91.3% of patients had ≥1 oral corticosteroid (OCS) claim (median dose, 7.4 mg/d prednisone-equivalent), 45.6% were chronic OCS users (≥10 mg/d during the 90 days preindex), 99.0% had ≥1 EGPA-related relapse, and 62.1% ≥1 asthma exacerbation. During the baseline period, 26.2% and 97.1% of patients had EGPA-related inpatient admissions and office visits, respectively. Median all-cause total health care costs per patient were $33,298, with total outpatient costs ($16,452) representing the largest driver.

Conclusions

Before initiating mepolizumab, a substantial real-world EGPA disease burden is evident for patients, with resulting impact on health care systems, and indicative of unmet medical needs. Mepolizumab treatment, with a demonstrated positive clinical benefit-risk profile may represent a useful treatment option for reducing EGPA disease burden.
Subunit Reconstruction With Local and Regional Flaps of a Total Cervicofacial Defect From Necrotizing Fasciitis
Authors: Hoerter Jacob E. , Liang Jonathan , Sukato Daniel
Published: October 2023

A 60-year-old woman with a ∼450 cm2 right cervicofacial defect following successful treatment of necrotizing fasciitis was consulted for reconstruction. She had complete orbital, malar, buccal, labial, submental, and anterolateral neck skin and soft tissue defects and near complete defects of the forehead and nasal sidewall. She underwent reconstruction with a large 24 cm×11 cm supraclavicular, deltopectoral, forehead rotational, and labial advancement flaps with skin grafting of the orbit. Follow-up at 2 months demonstrated complete take of all flaps. The patient was satisfied with her appearance and considered her outcome favorable. She exhibited comparably premorbid speech and oral competence. Large defects of the head and neck require thorough surgical planning and consideration of a subunit reconstruction technique. While free tissue transfer provides a large area of healthy tissue from a suitable donor site, subunit reconstruction with local and regional flaps can provide a superior outcome in the correct patient.