bluuebunny/crossref_metadata_2025 huggingface dataset:
Concordance between ER, PR, Ki67, and HER2‐low expression in breast cancer by MammaTyper RT‐qPCR and immunohistochemistry: implications for the practising pathologist
Authors: Badr Nahla M , Zaakouk Mohamed , Zhang Qi , Kearns Daniel , Kong Anthony , Shaaban Abeer M
Published: April 2024

Background

There are limited data on the role of multigene tests and their correlation with immunohistochemistry (IHC), especially on core biopsy. MammaTyper is a quantitative conformite Europeeanne (CE) marked, National Institute for Health and Care excellence (NICE) approved, in in vitro diagnostic quantitative real‐time polymerase chain reaction (RT‐qPCR) test for assessment of mRNA expression of four biomarkers (ESR1, PGR, ERBB2, MKI67).

Methods

We evaluated the concordance of MammaTyper with oestrogen receptor (ER), progesterone receptor (PR), HER2, and Ki67 by IHC on 133 core needle biopsies of breast cancer. HER2 was positive if IHC 3+ or 2+ and fluorescence in situ hybridization (FISH)‐amplified. Global and hotspot Ki67 expression was analysed using a cutoff of ≥20% assessed manually and by digital image analysis. Agreements were expressed as overall percent agreement (OPA), positive percent agreement (PPA), negative percent agreement (NPA), and Cohen's kappa.

Results

RT‐qPCR results of ESR1 were highly concordant with IHC with OPA of 94.7% using 1% cutoff and 91.7% when the low ER‐positive category was included. The PPA and NPA between RT‐qPCR and IHC for PR was 91.5% and 88.0%, respectively, when using the 1% cutoff. For ERBB2/HER2, the OPA was 95% and the PPA was 84.6%. 40 of 72 HER2 IHC score 0 tumours were classified as ERBB2 low. Best concordance between MKI67 by MammaTyper and Ki67 IHC was achieved using hotspot digital image analysis (OPA: 87.2%, PPA: 90.6%, NPA: 80%).

Conclusion

RT‐qPCR‐based assessment of the mRNA expression of ESR1, PGR, ERBB2, and MKI67 showed high concordance with IHC, suggesting that the MammaTyper test on core needle biopsies represents a reliable, efficient, and reproducible alternative for breast cancer classification and refining HER2 low categorisation.
Discovering fine flavour in Asian single‐origin cocoa: fast GC electronic‐nose aroma fingerprinting of cocoa liquors and consumer acceptability of Tablea in the Philippines
Authors: Juvinal Joel G. , Schouteten Joachim J. , Muhammad Dimas Rahadian Aji , Tayag Geraldine G. , de Leon Alma A. , De Steur Hans , Dewettinck Koen , Gellynck Xavier
Published: April 2024

The recent global cocoa supply decline calls for investigating disease‐resistant and single‐origin cocoa varieties in Asia. While genetic analysis has identified promising clones, information on bean quality and flavour remains limited. This research aims to analyse quality attributes of single‐origin cocoa beans and key volatile organic compounds in cocoa liquors and to determine consumer acceptability of indigenous cocoa beverage (Tablea) from single‐origin cocoa in the Philippines. Aroma fingerprinting of cocoa clones (UF18, BR25, W10) using fast GC electronic nose revealed distinctive profiles. Cocoa clone UF18 exhibited high‐fat content (52.1%), surpassing African cocoa clones. Even more important is the discovery of elevated levels of desirable volatile compounds in cocoa clone W10 such as methyl decanoate (fruity) and phenylacetaldehyde (honey, floral), which marks the first study that identified fine aroma components in single‐origin cocoa beans in Asia. Harnessing potential of these cocoa clones ensures consumer acceptability of the cocoa beverage Tablea.
Efficacy of resilience‐related psychological interventions in patients with long‐term diseases: A meta‐analysis of randomised controlled trials
Authors: Janitra Fitria Endah , Chen Ruey , Lin Hui‐Chen , Sung Chien‐Mei , Chu Hsin , Lee Chiu‐Kuei , Niu Shu‐Fen , Liu Hsin‐I. , Chang Li‐Fang , Banda Kondwani Joseph , Chou Kuei‐Ru
Published: April 2024

Patients with long‐term disease experience low resilience, emphasising the importance of psychological interventions to improve resilience. However, there is no comprehensive evidence on the efficacy of resilience‐related psychological interventions (RRPIs) in this population. Therefore, we performed a meta‐analysis to evaluate and extend knowledge from previous meta‐analyses on the efficacy of RRPIs on resilience, stress, anxiety, depression and quality of life among patients with long‐term disease. Cochrane Library, Embase, Ovid‐MEDLINE, PubMed, Scopus, Web of Science and CINAHL electronic databases were searched until 3 February 2023. The pooled effect size of the efficacy of RRPIs was calculated using the Hedges' g (g) with random‐effects model, while Cochrane Q‐statistics and I2 tests assessed heterogeneity in Comprehensive Meta‐Analysis 3.0 software. The Cochrane Risk of Bias 2.0 tool evaluated the quality of studies. Moderator analysis was used to explore sources of heterogeneity. Twenty randomised controlled trial studies were identified, representing a total of 1388 individuals with long‐term disease. RRPIs significantly enhance resilience (g = 0.79), alleviate stress (g = −0.78), decrease anxiety (g = −1.14), mitigate depression (g = −0.96) and improve quality of life (g = 0.48). Positive psychology, mindfulness, cognitive behavioural therapy, acceptance and commitment‐based intervention exhibited medium effects in strengthening resilience. Short‐term effects of RRPIs on enhancing resilience were observed at 3‐month follow‐up period (g = 0.50). The incorporation of RRPIs into the management of patients with long‐term disease shows a positive impact on their resilience, stress, anxiety, depression and quality of life. The results offer an evidence‐based foundation for nurses in promoting resilience among patients with long‐term disease.
The prevalence and factors of posttraumatic growth among nurses based on the PTGI: A systematic review and meta‐analysis
Authors: Zeng Li , Wang Jialin , Liu Guiling , Yuan Zhongqing , Yang Fengxue , Liu Dong , Li Lan , Peng Yihang
Published: April 2024

Background

The urgency and risk of clinical nursing may cause nurses to experience traumatic stress, but it may also lead to posttraumatic growth. However, no study has comprehensively analyzed the prevalence of posttraumatic growth among nurses using a unified outcome measure and a validated assessment tool.

Aim

This study aims to systematically assess the prevalence and factors of posttraumatic growth among nurses based on the Posttraumatic Growth Inventory (PTGI).

Methods

Ten databases, including The Cochrane Library, PubMed, Web of Science, CINAHL, Springerlink, Embase, Chinese Biomedical (CBM), China National Knowledge Infrastructure (CNKI), WanFang, and VIP databases, were searched as of December 31, 2022. The prevalence of posttraumatic growth was pooled using Stata 17.0 software. The PRISMA guideline was used to report the systematic review and meta‐analysis. PROSPERO registration number: CRD42022365620.

Results

A total of 30 studies were included in this systematic review and meta‐analysis, consisting of 14,022 nurses worldwide from four countries. In our study, the pooled mean score of posttraumatic growth among nurses was 66.34 (95% CI: 61.25–71.43). From 2015 to 2022, nurses’ posttraumatic growth levels gradually increased. In addition, Turkey nurses have the lowest posttraumatic growth levelnurses who experienced workplace violence have a lower posttraumatic growth level compared with other nurses; while nurses aged over 30 and male have higher posttraumatic growth levels.

Conclusions

While several studies on the prevalence of posttraumatic growth among nurses have been published, the reported data are quite different. Our systematic review and meta‐analysis found that nurses’ posttraumatic growth level was “moderate,” and nurses’ posttraumatic growth may vary based on publication year, country, traumatic event, age, and gender.

Implications for nursing and health policy

Our findings may provide a theoretical basis for hospital administrators and policy makers to scientifically manage human resources, comprehensively evaluate nurses’ mental health, and promote nurses’ posttraumatic growth in different traumatic events, which is conducive to the formulation and implementation of relevant policy guidelines.
Self‐reported cultural competence among Czech and Slovakian nurses: A comparative correlation study
Authors: Červený Martin , Tóthová Valérie
Published: April 2024

Aim

This study aimed to compare the level of cultural competence among nurses working in clinical practice in Slovakia and the Czech Republic.

Background

Demographic changes have greatly affected the health sector in Slovakia and the Czech Republic. By identifying the level of nurses’ cultural competence, many of the complications encountered in caring for patients from different cultures can be avoided. However, few studies have explored the cultural competence of nurses in clinical practice in these countries.

Method

This study was cross‐sectional, descriptive, and comparative. It followed the STROBE checklist and used the Cultural Competence Assessment Tool questionnaire to collect data. Descriptive and inferential statistical tests were utilized for data analysis, using SASD 1.5.8 and IBM SPSS Statistics version 28.0.0.

Results

The sample comprised 424 nurses, with 202 from the Czech Republic and 222 from Slovakia, primarily female. Most nurses in both countries have not received cultural diversity training. Nevertheless, nurses in both countries indicate the necessity of conducting a cultural impact assessment of patients’ health. Cultural diversity training significantly increases the level of cultural competence in nurses.

Discussion

Lower cultural competence scores can negatively impact nursing care for patients from different cultures, leading to additional cultural challenges.

Implications for nursing and health policy

The findings highlight the need for enhanced cultural competence among nurses. Nurses need to learn and utilize cultural information to help maximize healthcare for patients from different cultures. By providing nurses with cultural knowledge and skills, they will be able to deliver more effective and culturally competent care to patients from varied cultural backgrounds.
Effects of a structured educational program on nursing students' level of knowledge and awareness toward child neglect and abuse: A quasi‐experimental evaluation
Authors: Öztürk Ayfer
Published: April 2024

Background

Nurses have a key role in the recognition, reporting, and channelization of child abuse and neglect. Nurses should have sufficient knowledge about the presentation of child abuse and neglect. They also need to understand their role in reporting any instance where they detect cases of abuse and neglect.

Purpose

The aim of this study is to determine the effect of a structured Child Neglect and Abuse Educational Program (CNaA‐EP) on the level of knowledge and awareness of nursing students about child neglect and abuse.

Methods

This study conducted with nursing students used a pretest−post‐test quasi‐experimental design. The third‐year nursing students were divided into two groups: experimental (n = 25) and control groups (n = 30). The intervention group received CNaA‐EP. In both groups, pretests were performed using the “Child Abuse and Neglect Awareness Scale,” and “Child Abuse and Neglect Knowledge Test” The posttest was conducted 1 week after the 14‐week CNaA‐EP course was completed. Numbers, percentages, chi‐square test, t‐test, Kolmogorov–Smirnov test, Fisher's exact test were conducted using SPSS 22.00 software.

Results

The education group's scores of child abuse/neglect awareness (t = −2.768 p < 0.05) and child abuse/neglect knowledge (t = −12.416 p < 0.01) were significantly higher than those of the control group. After the education program, a significant difference was found between the education and control groups on the core measures.

Conclusion

A child neglect and abuse education program was an effective method of educating nursing students on knowledge and awareness of child abuse and neglect. For this reason, education programs should be planned and implemented to increase awareness about abuse and neglect problems that threaten children's health and development.
Validation of the RBP‐9801 oscillometric blood pressure monitor in the general population according to the association for the Advancement of Medical Instrumentation/European Society of Hypertension/ International Organization for Standardization Universal Standard
Authors: Yang Shijie , Zhou Zhanyang , Miao Huanhuan , Zhou Qiong , Zhai Mei , Zhang Yuqing
Published: April 2024

The aim of this study was to evaluate the accuracy of the single upper‐arm cuff oscillometric blood pressure (BP) monitor RBP‐9801 developed for office and home BP measurement in the general population according to the Association for the Advancement of Medical Instrumentation/European Society of Hypertension/International Organization for Standardization (AAMI/ESH/ISO) Universal Standard (ISO 81060–2:2018). Subjects were recruited to fulfil the age, gender, BP and cuff distribution criteria of the AAMI/ESH/ISO Universal Standard in general population using the same arm sequential BP measurement method. A total of 105 subjects were recruited and 85 were analyzed. For validation criterion 1, the mean ± SD of the differences between the test device and reference BP readings was 2.3 ± 6.4/3.1 ± 5.8 mmHg (systolic/diastolic). For criterion 2, the SD of the mean BP differences between the test device and reference BP per subject was 5.24/5.03 mmHg (systolic/diastolic). The conclusion is that the RBP‐9801 oscillometric device for office and home BP measurement fulfilled all the requirements of the AAMI/ESH/ISO Universal Standard (ISO 81060–2:2018) in the general population and can be recommended for clinic and self‐use at home.
Interplay of precision therapeutics and MD study: Calocybe indica's potentials against cervical cancer and its interaction with VEGF via octadecanoic acid
Authors: Datta Suhana , Verma Preeti , Dhara Bikram , Kundu Rita , Maitra Swastika , Mitra Arup Kumar , Khan Mohd Shahnawaz , Zughaibi Torki A. , Tabrez Shams , Kumer Ajoy
Published: April 2024

The evolving landscape of personalized medicine necessitates a shift from traditional therapeutic interventions towards precision‐driven approaches. Embracing this paradigm, our research probes the therapeutic efficacy of the aqueous crude extract (ACE) of Calocybe indica in cervical cancer treatment, merging botanical insights with advanced molecular research. We observed that ACE exerts significant influences on nuclear morphology and cell cycle modulation, further inducing early apoptosis and showcasing prebiotic attributes. Characterization of ACE have identified several phytochemicals including significant presence of octadeconoic acid. Simultaneously, utilizing advanced Molecular Dynamics (MD) simulations, we deciphered the intricate molecular interactions between Vascular Endothelial Growth Factor (VEGF) and Octadecanoic acid to establish C.indica's role as an anticancer agent. Our study delineates Octadecanoic acid's potential as a robust binding partner for VEGF, with comprehensive analyses from RMSD and RMSF profiles highlighting the stability and adaptability of the protein–ligand interactions. Further in‐depth thermodynamic explorations via MM‐GBSA calculations reveal the binding landscape of the VEGF–Octadecanoic acid complex. Emerging therapeutic innovations, encompassing proteolysis‐targeting chimeras (PROTACs) and avant‐garde nanocarriers, are discussed in the context of their synergy with compounds like Calocybe indica P&C. This convergence underscores the profound therapeutic potential awaiting clinical exploration. This study offers a holistic perspective on the promising therapeutic avenues facilitated by C. indica against cervical cancer, intricately woven with advanced molecular interactions and the prospective integration of precision therapeutics in modern oncology.
Weekly links among irritability and suicidal thoughts and behaviors in high‐risk youth
Authors: Kaurin Aleksandra , Wright Aidan G.C. , Porta Giovanna , Hamilton Edward , Poling Kimberly , Bero Kelsey , Brent David , Goldstein Tina R.
Published: April 2024

Background

Previous studies demonstrate a link between irritability and suicidal thoughts and behaviors (STBs) in youth samples. However, they have mostly assessed irritability in community samples and as a largely dispositional (i.e. trait‐like) construct. Thus, it remains unclear to what extent links between irritability and STBs reflect within‐person processes of elevated risk in clinically meaningful time periods.

Methods

The present study used clinical data from 689 adolescents aged 12–19 years attending a total of 6,128 visits at a specialty Intensive Outpatient Program for depressed and suicidal youth to examine patterns in weekly assessments of irritability and STBs throughout treatment, including associations among trends and fluctuations departing from these trends via multilevel structural equation modeling. Youth completed self‐report measures of irritability, depression, and STBs weekly as part of standard IOP clinical care.

Results

Overall, two‐thirds of variance in weekly irritable mood was accounted for by between‐person differences and the remaining portion by weekly fluctuations. After controlling for depression, during weeks when youth were more irritable they experienced increased STBs. Rates of change in irritability and STBs tended to track together at early stages of treatment, but these effects were generally accounted for by depression severity.

Conclusions

Our results suggest that although changes in STBs are best accounted for by depression, irritability can be understood as a specific, proximal risk factor for youth STBs that exacerbates youth STBs in clinically informative timeframes above and beyond depression.
Tanshinone IIA suppresses ferroptosis to attenuate renal podocyte injury in diabetic nephropathy through the embryonic lethal abnormal visual‐like protein 1 and acyl‐coenzyme A synthetase long‐chain family member 4 signaling pathway
Authors: Zhu Shuai , Kang Zhiqiang , Zhang Fengjiao
Published: April 2024

Aims/Introduction

Tanshinone IIA (TIIA) is one of the main components of the root of the red‐rooted Salvia miltiorrhiza Bunge. However, the molecular mechanisms underlying TIIA‐mediated protective effects in diabetic nephropathy (DN) are still unclear.

Materials and Methods

High glucose (HG)‐induced mouse podocyte cell line (MPC5) cells were used as the in vitro model of DN and treated with TIIA. Cell viability, proliferation and apoptosis were detected using 3‐(4, 5‐dimethylthiazolyl‐2)‐2, 5‐diphenyltetrazolium bromide, 5‐ethynyl‐2′‐deoxyuridine and flow cytometry assays. The protein levels were assessed using western blot assay. The levels of inflammatory factors were deleted by enzyme‐linked immunoassay. Fe+ level, reactive oxygen species, malondialdehyde and glutathione products were detected using special assay kits. After ENCORI prediction, the interaction between embryonic lethal abnormal visual‐like protein 1 (ELAVL1) and acyl‐coenzyme A synthetase long‐chain family member 4 (ACSL4) was verified using co‐immunoprecipitation assay and dual‐luciferase reporter assays. ACSL4 messenger ribonucleic acid expression was measured using real‐time quantitative polymerase chain reaction.

Results

TIIA repressed HG‐induced MPC5 cell apoptosis, inflammatory response and ferroptosis. ACSL4 upregulation relieved the repression of TIIA on HG‐mediated MPC5 cell injury and ferroptosis. ELAVL1 is bound with ACSL4 to positively regulate the stability of ACSL4 messenger ribonucleic acid. TIIA hindered HG‐triggered MPC5 cell injury and ferroptosis by regulating the ELAVL1–ACSL4 pathway. TIIA blocked DN progression in in vivo research.

Conclusion

TIIA treatment restrained HG‐caused MPC5 cell injury and ferroptosis partly through targeting the ELAVL1–ACSL4 axis, providing a promising therapeutic target for DN treatment.
Implementation of virtual academic detailing in North America: A qualitative study
Authors: Nazari Jonathan L. , Kulbokas Victoria , Smart Mary H. , Hensle Tara R. , Lee Todd A. , Pickard A. Simon
Published: April 2024

Rationale

The shift toward virtual academic detailing (AD) was accelerated by the COVID‐19 pandemic.

Aims and Objectives

We aimed to examine the role of external, contextual, and intrinsic programme‐specific factors in virtual engagement of healthcare providers (HCPs) and delivery of AD.

Methods

AD groups throughout North America were contacted to participate in semistructured interviews. An interview guide was constructed by adapting the Consolidated Framework for Implementation Research (CFIR). A point of emphasis included strategies AD groups employed for provider engagement while implementing virtual AD programmes. Independent coders conducted qualitative analysis using the framework method.

Results

Fifteen AD groups from Canada (n = 3) and the United States (n = 12) participated. Technological issues and training detailers and HCPs were challenges during the transition to virtual AD visits. Restrictions on in‐person activities during the pandemic created difficulties engaging HCPs and fewer AD visits. Continuing education was one strategy to incentivize participation, but credits were often not claimed by HCPs. Groups with established networks and prior experience with virtual AD leveraged connections to mitigate disruptions and continue AD visits. Other facilitators included emphasizing contemporary topics, including opioid education beyond fundamental guidelines. Virtual AD had the additional benefit of expanding geographic reach and flexible scheduling with providers.

Conclusions

AD groups across North America have shifted to virtual outreach and delivery strategies. This trend toward virtual AD may aid outreach to vulnerable rural communities, improving health equity. More research is needed on the effectiveness of virtual AD and its future implications.
The role of tumor‐associated macrophages in hepatocellular carcinoma—from bench to bedside: A review
Authors: Gryziak Maciej , Kraj Leszek , Stec Rafał
Published: April 2024

Hepatocellular carcinoma is one of the most common cancers worldwide. Despite progress in treatment, recurrence after radical treatment is common, and the prognosis remains poor for patients with advanced disease. Therefore, there is a need to identify prognostic and predictive factors for the response to therapy or more intensive surveillance or treatment. Because the tumor microenvironment plays a crucial role in the development of cancer and metastasis, it is a crucial need to understand processes that are involved in carcinogenesis. Within the microenvironment, several immune cells with different roles are present. One of the most important of these is tumor‐associated macrophages. These cells may exert either antitumor or protumor roles. Several studies have suggested that tumor‐associated macrophages can be used as prognostic markers. Furthermore, they may be involved in resistance to immunotherapy or systemic treatment. As they play an important role in cancer development, tumor‐associated macrophages are also a good target for therapy. In this review, we briefly summarize recent progress on knowledge regarding the basic molecular characteristics, impact on prognosis and potential clinical implications of tumor‐associated macrophages in hepatocellular carcinoma.
Enhancing oral function: A case report on mandibular overdenture utilization with custom‐made subperiosteal implant
Authors: Fathi Amirhossein , Nadian Farshad , Ghorbani Mahsa , Razavi Pouyan , Mosharraf Ramin , Ebadian Behnaz
Published: April 2024

Subperiosteal implants, previously set aside because of complications, are now emerging again as effective treatments for severe mandibular atrophy, aided by recent improvements in digital dentistry. Traditional dentures in such cases often face challenges with support and retention, necessitating complex regenerative procedures. This paper presents a case report of a 54‐year‐old male patient with significant mandibular atrophy who received a custom‐made subperiosteal implant, showcasing promising results. The implant was precisely designed utilizing computed tomography (CT) scans, a 3D‐printed model, the selective laser melting (SLM) technique, and constructed with biocompatible Ti6Al4V material. This innovative approach offered a practical solution, resulting in high patient satisfaction and no complications over a year of use.
Development and initial validation of the parental response to adolescents' emotions scale: A mixed methods approach
Authors: Hu Jennifer , Zheng Qinliang , Zhou Ting , Huang Zheng
Published: April 2024

An exploratory mixed methods design was used to explore age‐appropriate characteristics of parental response to emotion (PRE) during adolescence in Chinese families and develop the parental response to adolescents' emotions scale (C‐PRAES). Qualitative interviews with 21 parent–adolescent dyads were employed to explore characteristics of PRE in adolescence and generate item pools. Structural validity, criterion validity, measurement invariance across informants (adolescents vs. parents, mothers vs. fathers) and consistency reliability were examined in the quantitative phase (Nadolescent = 702, Nparent = 476). New age‐appropriate strategies were generated from qualitative phase: Guidance in reappraisal, Allowing independent regulation, and Avoiding escalation of conflict. The formal version of the C‐PRAES comprised items in two dimensions (supportive/non‐supportive) and exhibited good validity, reliability, and measurement invariance.
Using GPT‐4 for LI‐RADS feature extraction and categorization with multilingual free‐text reports
Authors: Gu Kyowon , Lee Jeong Hyun , Shin Jaeseung , Hwang Jeong Ah , Min Ji Hye , Jeong Woo Kyoung , Lee Min Woo , Song Kyoung Doo , Bae Sung Hwan
Published: April 2024

Background and Aims

The Liver Imaging Reporting and Data System (LI‐RADS) offers a standardized approach for imaging hepatocellular carcinoma. However, the diverse styles and structures of radiology reports complicate automatic data extraction. Large language models hold the potential for structured data extraction from free‐text reports. Our objective was to evaluate the performance of Generative Pre‐trained Transformer (GPT)‐4 in extracting LI‐RADS features and categories from free‐text liver magnetic resonance imaging (MRI) reports.

Methods

Three radiologists generated 160 fictitious free‐text liver MRI reports written in Korean and English, simulating real‐world practice. Of these, 20 were used for prompt engineering, and 140 formed the internal test cohort. Seventy‐two genuine reports, authored by 17 radiologists were collected and de‐identified for the external test cohort. LI‐RADS features were extracted using GPT‐4, with a Python script calculating categories. Accuracies in each test cohort were compared.

Results

On the external test, the accuracy for the extraction of major LI‐RADS features, which encompass size, nonrim arterial phase hyperenhancement, nonperipheral ‘washout’, enhancing ‘capsule’ and threshold growth, ranged from .92 to .99. For the rest of the LI‐RADS features, the accuracy ranged from .86 to .97. For the LI‐RADS category, the model showed an accuracy of .85 (95% CI: .76, .93).

Conclusions

GPT‐4 shows promise in extracting LI‐RADS features, yet further refinement of its prompting strategy and advancements in its neural network architecture are crucial for reliable use in processing complex real‐world MRI reports.
Statin initiation after myocardial infarction in patients with alcohol‐related liver disease: A nationwide population‐based study
Authors: Wester Axel , Jepsen Peter , Hagström Hannes
Published: April 2024

Background and Aims

Secondary prevention with statins improves clinical outcomes after myocardial infarction (MI). We aimed to compare odds of statin initiation after MI in patients with co‐existing alcohol‐related liver disease (ALD) to the general population, and the association between statin initiation and mortality in the patients with ALD.

Methods

All statin‐naïve patients with ALD and a first‐time MI between 2006 and 2020 were identified from Swedish healthcare registers and matched for age, sex, and year of MI with up to ten ALD‐free general population controls with a first‐time MI. Logistic regression was used to estimate adjusted odds ratios (OR) for statin initiation within 30 days after MI for ALD patients versus controls. Cox regression was used in patients with ALD to compare mortality between statin initiators and non‐initiators.

Results

Of the 276 patients with a first‐time MI and ALD, 206 (74.6%) were male, the median age was 67 (interquartile range 62–72), 151 (54.7%) had cirrhosis, and 62 (22.5%) had decompensated cirrhosis. 1769 matched controls were included. Initiation of statins was less common in ALD patients (50.0%) than controls (89.2%, adjusted OR = .15, 95% confidence interval [CI] = .10–.20). Among patients with ALD, statin initiators and non‐initiators were followed for a median of 3.9 (interquartile range = 1.8–7.7) and 1.9 years (interquartile range = .5–4.4), respectively. Statin initiators had lower mortality than non‐initiators (adjusted hazard ratio = .41, 95%CI = .28–.59).

Conclusions

Patients with ALD less often initiated statins after MI than the general population. Statin initiation was associated with improved survival, suggesting that patients with ALD might be undertreated following MI.
How structural variants shape avian phenotypes: Lessons from model systems
Authors: Recuerda María , Campagna Leonardo
Published: April 2024

Despite receiving significant recent attention, the relevance of structural variation (SV) in driving phenotypic diversity remains understudied, although recent advances in long‐read sequencing, bioinformatics and pangenomic approaches have enhanced SV detection. We review the role of SVs in shaping phenotypes in avian model systems, and identify some general patterns in SV type, length and their associated traits. We found that most of the avian SVs so far identified are short indels in chickens, which are frequently associated with changes in body weight and plumage colouration. Overall, we found that relatively short SVs are more frequently detected, likely due to a combination of their prevalence compared to large SVs, and a detection bias, stemming primarily from the widespread use of short‐read sequencing and associated analytical methods. SVs most commonly involve non‐coding regions, especially introns, and when patterns of inheritance were reported, SVs associated primarily with dominant discrete traits. We summarise several examples of phenotypic convergence across different species, mediated by different SVs in the same or different genes and different types of changes in the same gene that can lead to various phenotypes. Complex rearrangements and supergenes, which can simultaneously affect and link several genes, tend to have pleiotropic phenotypic effects. Additionally, SVs commonly co‐occur with single‐nucleotide polymorphisms, highlighting the need to consider all types of genetic changes to understand the basis of phenotypic traits. We end by summarising expectations for when long‐read technologies become commonly implemented in non‐model birds, likely leading to an increase in SV discovery and characterisation. The growing interest in this subject suggests an increase in our understanding of the phenotypic effects of SVs in upcoming years.
Anesthetic challenges in patients with multicompartmental lymphatic failure after Fontan palliation undergoing transcatheter thoracic duct decompression
Authors: Groody Kirsten R. , Nicolson Susan C. , Jobes David R.
Published: April 2024

Lymphatic flow abnormalities are central to the development of protein losing enteropathy, plastic bronchitis, ascites and pleural effusions in patients palliated to the Fontan circulation. These complications can occur in isolation or multicompartmental (two or more). The treatment of multicompartmental lymphatic failure aims at improving thoracic duct drainage. Re‐routing the innominate vein to the pulmonary venous atrium decompresses the thoracic duct, as atrial pressure is lower than systemic venous pressure in Fontan circulation. Transcatheter thoracic duct decompression is a new minimally invasive procedure that involves placing covered stents from the innominate vein to the atrium. Patients undergoing this procedure require multiple general anesthetics, presenting challenges in managing the sequelae of disordered lymphatic flow superimposed on Fontan physiology. We reviewed the first 20 patients at the Center for Lymphatic Imaging and Intervention at a tertiary care children's hospital presenting for transcatheter thoracic duct decompression between March 2018 and February 2023. The patients ranged in age from 3 to 26 years. The majority had failed prior catheter‐based lymphatic intervention, including selective embolization of abnormal lympho‐intestinal and lympho‐bronchial connections to treat lymphatic failure in a single compartment. Fourteen had failure in three lymphatic compartments. Patients were functionally impaired (ASA 3–5) with significant comorbidities. Concurrent with thoracic duct decompression, three patients required fenestration closure for the resultant decrease in oxygen saturation. Ten patients had improvement in symptoms, seven had no changes and three have limited follow up. Five (25%) of these patients were deceased as of January 2024 due to non‐lymphatic complications from Fontan failure.
Assistive device utilization among disabled elderly in China: A cross‐sectional study
Authors: Tang Rong , Zhang Xia , Yan Shu , Guan Bi , Li Yan , Luo Qing , Lai Rongmei , Wan Haiyan , Yang Yongxue , Zeng Liangnan
Published: April 2024

Objective

This study aimed to examine the characteristics of assistive device users and influencing factors among disabled elderly in China.

Methods

A total of 13,510 disabled elderly in Sichuan Province were surveyed. Disability was assessed using the Barthel Activities of Daily Living Scale, mental status, sensory perception, and social engagement evaluation. Univariate analysis and logistic regression analysis were employed to identify the impact factors.

Results

The prevalence of assistive device utilization among participants was 79.2% (10,700/13,510, 95% CI 78.5%–79.9%), with the wheelchair being the most commonly used device. Various factors were found to influence the usage of the device, including disability level, somatic disability, age, caregivers, income, caregiver fees, and living situation (p < .05). Additionally, several factors were identified associated with the frequency of device usage, such as somatic disability, education background, income, caregiver fees, living situation, access to acquire assistive devices, duration of assistive device usage, education on assistive devices, and satisfaction level (p < .05).

Conclusions

The use of assistive devices among elderly individuals in China is prevalent. There are many factors that affect the use of assistive devices, which can provide a reference for the formulation of policies in the field of assistive devices.
Choline Dehydrogenase Contributes to Salt Tolerance in Dunaliella through Betaine Synthesis
Authors: Chen Hao‐Hong , Pang Xiao‐Hui , Wang Qian‐Hui , Chen Rui‐Qi , Dai Ju‐Liang , Jiang Jian‐Guo
Published: April 2024

In Dunaliella tertiolecta, a microalga renowned for its extraordinary tolerance to high salinity levels up to 4.5 M NaCl, the mechanisms underlying its stress response have largely remained a mystery. In a groundbreaking discovery, this study identifies a choline dehydrogenase enzyme, termed DtCHDH, capable of converting choline to betaine aldehyde. Remarkably, this is the first identification of such an enzyme not just in D. tertiolecta but across the entire Chlorophyta. A 3D model of DtCHDH was constructed, and molecular docking with choline was performed, revealing a potential binding site for the substrate. The enzyme was heterologously expressed in E. coli Rosetta (DE3) and subsequently purified, achieving enzyme activity of 672.2 U/mg. To elucidate the role of DtCHDH in the salt tolerance of D. tertiolecta, RNAi was employed to knock down DtCHDH gene expression. The results indicated that the Ri‐12 strain exhibited compromised growth under both high and low salt conditions, along with consistent levels of DtCHDH gene expression and betaine content. Additionally, fatty acid analysis indicated that DtCHDH might also be a FAPs enzyme, catalyzing reactions with decarboxylase activity. This study not only illuminates the role of choline metabolism in D. tertiolecta's adaptation to high salinity but also identifies a novel target for enhancing the NaCl tolerance of microalgae in biotechnological applications.
Determinants of digital technologies' adoption in South African manufacturing: Evidence from a firm‐level survey
Authors: Avenyo Elvis Korku , Bell Jason F. , Nyamwena Julius
Published: April 2024

Digital technologies and digitalisation are emerging as new drivers of structural transformation in developing countries. At the firm level, adopting advanced digital technologies offers prospects for improved productivity and competitiveness and, hence, digital industrialisation. However, the determinants of adopting digital technologies in manufacturing firms in developing countries remain anecdotal. This paper uses unique survey data on 516 manufacturing firms in South Africa and a multivariate probit model to examine the determinants of digital technology adoption in South African manufacturing firms. Our results show heterogeneity in the factors explaining digital technology adoption across business functions. Overall, the empirical results reveal that innovation, foreign ownership, exposure to export markets, and higher skilled human capital propel the adoption of digital technologies. In contrast, the lack of capital inhibits the adoption of digital technologies in sampled manufacturing firms in South Africa. We discuss the possible policy implications of these findings and how they fit into the South African Digital Skills policy discourse.
Empirical likelihood M‐estimation for the varying‐coefficient model with functional response
Authors: Zhou Xingcai , Kong Dehan , Pietrosanu Matthew Stephen , Kong Linglong , Karunamuni Rohana J.
Published: April 2024

This work is motivated by a gap in the functional data analysis literature, particularly in the context of neuroimaging, regarding the ability of functional models to robustly accommodate intra‐observation dependence. In response, we propose an M‐estimator based on generalized empirical likelihood for the varying‐coefficient model with a functional response. We develop statistical inference procedures, simultaneous confidence regions, and a global general linear hypothesis test for the model's functional coefficient. Our theoretical results establish the weak convergence of the log‐likelihood ratio process, a nonparametric version of Wilks' theorem for the log‐likelihood ratio, and asymptotic properties of the proposed estimator. Through a simulation study, we show that the proposed confidence sets have close‐to‐nominal coverage probabilities. In a real‐world application to a neuroimaging dataset, we show that mini‐mental state examination score and apolipoprotein E genotype have significant associations with fractional anisotropy, while associations with gender and age are only present at high quantile levels.
Clueless loneliness: Loneliness beyond frustrated pro‐attitudes
Authors: Li Qiannan
Published: April 2024

According to Tom Roberts and Joel Krueger's frustrated pro‐attitude account of loneliness, loneliness is primarily characterized as an affective state in which individuals perceive certain social goods as unattainable. The frustration of pro‐attitudes, or the desire for social connections, plays a significant role in understanding the nature of loneliness. However, in this article, I argue that the frustrated pro‐attitude account falls short in explaining a specific type of loneliness known as clueless loneliness, wherein a person feels lonely without experiencing a salient frustration of pro‐attitude. By analyzing five cases of clueless loneliness—the case of desiring the wrong thing, the case of failing to form concrete desires, the case of having an illusion of desire fulfillment, the case of holding self‐deceptive beliefs about need fulfillment, and the case of lacking a desire for social goods—I propose a revised account that acknowledges the complexity of loneliness and the potential disconnect between perceived social goods and the actual fulfillment of one's need for connection. My objective in this article is to demonstrate that this revised understanding of loneliness provides a more comprehensive framework for examining the nature of loneliness and its impact on different groups of people within society.
Cardiac hemodynamics phenotypes and individual responses to training in coronary heart disease patients
Authors: Kirsch Marine , Vitiello Damien , Trachsel Lukas‐Daniel , Boidin Maxime , Lalongé Julie , Juneau Martin , Bherer Louis , Nigam Anil , Gayda Mathieu
Published: April 2024

Background

In patients with coronary heart disease (CHD), individualized exercise training (ET) programs are strongly recommended to optimize peak oxygen uptake (O2peak) improvement and prognosis. However, the cardiac hemodynamic factors responsible for a positive response to training remain unclear. The aim of this study was to compare cardiac hemodynamic changes after an ET program in responder (R) versus non‐responder (NR) CHD patients.

Methods

A total of 72 CHD patients completed a 3‐month ET program and were assessed by cycle ergometer cardiopulmonary exercise test (CPET: O2peak assessment) with impedance cardiography (ICG) for hemodynamic measurements before and after training. Cardiac hemodynamics (e.g., CO, CI, SV, ESV, EDV, and SVR) were measured by ICG during CPET. The R and NR groups were classified using the median change in O2peak (>the median for R and ≤the median for NR).

Results

In the R group, O2peak (+17%, p < 0.001), CO, CI, SV, and HR increased by 17%, 17%, 13%, and 5%, respectively (p < 0.05) after the training program. In the NR group, O2peak, CO, CI, and SV increased by 0.5%, 5%, 8%, and 6%, respectively (p < 0.01). The SVR decreased in both groups (−19% in R and −11% in NR, p < 0.001).

Conclusion

Among CHD patients, the R group showed a better improvement in peak cardiac output via an increase in peak stroke volume and heart rate and a reduced systemic vascular resistance than the NR group. Different cardiac phenotype adaptations and clinical individual responses were identified in CHD patients according to the aerobic fitness responder's status.
International trademark protection strength: 1990–2020
Authors: Chen Wantao , Yu Xiang , Yang Wei
Published: April 2024

This paper presents a pioneering study that addresses the insufficient attention given to trademark rights in current indices that evaluate the protection of intellectual property rights (IPRs). Our study sets itself apart from previous measures by defining the strength of trademark protection as the level of applicant friendliness within a country's trademark system. We introduce the innovative trademark protection strength (TPS) index, which focuses on 78 countries spanning from 1990 to 2020. Drawing on established theoretical components of the patent system, we deconstruct the TPS index into four distinct dimensions: international mechanisms, legislation, enforcement and administration. Our findings reveal the growth and subsequent stabilisation of global trademark protection strength, with reduced disparities observed after 2005. Importantly, we identify variations in improvement rates among countries with different income levels, thereby highlighting the influence of economic factors. By providing a detailed methodology and transparent construction of the TPS index, we ensure its replicability and potential for future expansion. The index's objective data and extended coverage facilitate the examination of various configurations of IPR systems, policy designs and their impact on the global economy.
The Relationship between Financial Development and Economic Growth in EU Member Countries: Sub-group estimation based on the Countries’ Level of development
Authors: Pușcașu Ela-Andrada
Published: April 2024

The financial systems undergo changes as countries grow, self-financed capital investments being less frequent and being replaced by financing through banking intermediation and later through capital markets. The financial development has an increasing role in the context of globalisation and emergence of market economies, supporting the exchange of funds between participants. Previous research papers present different results regarding the impact of financial development on economic growth; however, their preponderance shows a positive relationship, the financial system stimulating economic growth. This paper investigates the impact of financial development on economic growth using panel regressions for the member countries of the European Union, for the period 1990-2021. The results show that financial development, both through the activity of the banking sector and through the capital market, has a positive impact on economic growth, as long as there is a correspondence between the funds invested and the output of the real sector.
Wrench Estimation and Friction Compensation Using Multiple Shooting Method for Tether Units Augmented to Remote Tendon-Driven Continuum Robots
Authors: Luen Chien Jer , Leong Clarissa , Liu Jingmin , Foong Shaohui
Published: April 2024

Remote-actuated mechanisms that employ tendon sheaths or tether units can transmit mechanical force without directly connecting the actuators to the mechanism, but suffer from undesirable side effects like mechanical friction and induced external wrench disturbances on the distal side of the mechanism. In this work, a multiple shooting method is proposed as a superior method to the single shooting method to solve the Cosserat rod boundary value problems, to obtain the states of the system. With that, numerical experiments are provided to demonstrate the difficulty of solving these boundary value problems, simultaneously showing the validity of the proposed approach. 2D reconstruction experiments were conducted to show shape reconstruction capabilities. In addition, friction loss and 6-degree-of-freedom wrench estimations were also experimentally validated with the proposed mathematical model with 0.1679N and 0.0401Nm for root-mean-squared error (RMSE) force estimation and torque estimation error, respectively, while achieving a 3% mean absolute percentage steady-state friction estimation error. Finally, a modified resolved rate controller was applied to steer a remote tendon-driven continuum robot to compensate for friction loss for 3.1-m long tether units.