bluuebunny/crossref_metadata_2025 huggingface dataset:
Andersonville, the Story of Wilson's Raiders
Authors: Mayer David
Published: December 2023

The concluding American Civil War spectacle-drama, announced and widely publicised as Andersonville, The Story of Wilson's Raiders (1905) , was abruptly retitled The Raiders as the New York Hippodrome's management removed the scene depicting the Confederate prison on the pretext of avoiding partisan sensibilities linked to the war, but more likely to shorten the evening's programme by a half-hour. This essay describes the drama as it was written and rehearsed beginning with a West Point graduation and commissioning ceremony as the announcement of war divides the graduates and separates couples whose romance has spanned northern and southern states. The five-scene drama concludes with a fierce cavalry battle utilising the ‘Thompson and Dundy plunging horses’ in the Hippodrome's flooded arenas. The drama enacts the graduation and commissioning of a young Union officer, his enforced separation from his Southern sweetheart, his capture by Confederate forces, and imprisonment in the notorious and filthy Andersonville prison. We witness his ingenious escape, his reunion with his sweetheart, and his return to battle leading a cavalry detachment. This essay documents the effects created in each scene of the entertainment, which concludes with an imagined re-enactment of a conflict fought by mounted Union and Confederate cavalrymen in the Hippodrome's two arenas, now a vast tank, flooded before the audience's eyes as a part of the overall spectacle. The essay also notes the frequent unsubstantiated claims of historical authenticity made by Fred Thompson and Elmer ‘Skip’ Dundy and, where necessary, corrects them.
A prediction model for risk of low oxygen saturation in patients with post-tuberculosis tracheobronchial stenosis during bronchoscopy
Authors: Chen Hui , Tian Sen , Huang Haidong , Wang Hui , Hu Zhenli , Yang Yuguang , Zhang Wei , Dong Yuchao , Wang Qin , Bai Chong
Published: December 2023

Background:

Low oxygen saturation (LOS) is a frequent occurrence for patients with post-tuberculosis tracheobronchial stenosis (PTTS) during bronchoscopic procedures. However, there are currently no systematic assessment tools to predict LOS risk in PTTS patients during bronchoscopy.

Objectives:

This study aimed to develop an effective preoperative predictive model to guide clinical practice.

Design:

Retrospective cohort study.

Methods:

Data was retrospectively collected from PTTS patients who underwent bronchoscopic interventions between January 2017 and December 2022. Among all patients included in this study, patients between January 2017 and December 2021 were used as training cohort for the logistic regression model, and patients between January 2022 and December 2022 were utilized as validation cohort for internal validation. We used consistency index (C-index), goodness-of-fit test and calibration plot to evaluate the model performance.

Results:

A total of 465 patients who met the inclusion criteria were enrolled in the study. The overall incidence of LOS was 26.0% (121/465). Comorbidity, degree of stenosis, bronchoscopist level, thermal ablation therapy, balloon dilation, and airway stenting, as independent risk factors for the presence of LOS, were used to construct the nomogram prediction model. The C-index of training cohort was 0.827 (95% CI, 0.786–0.869), whereas that of validation cohort was 0.836 (95% CI, 0.757–0.916), combining with the results of the calibration plot and goodness-of-fit test, demonstrating that this model had good predictive ability.

Conclusion:

The predictive model and derived nomogram with good predictive ability has been developed to preoperatively predict the risk of LOS in PTTS patients during bronchoscopy, allowing for individualized interventions for high-risk patients.
Influence of Footwear Selection on Youth Running Biomechanics: A Pilot Study
Authors: Traut Andrew G. , Hannigan J.J. , Ter Har Justin A. , Pollard Christine D.
Published: December 2023

Background:

The relationship of running biomechanics, footwear, and injury has been studied extensively in adults. There has been little research on the effects of footwear on running biomechanics in youth.

Hypothesis:

Running biomechanics of youth will be significantly affected by changes in footwear. Minimal shoe running will demonstrate similarities to barefoot.

Study Design:

Crossover study design: randomized trial.

Level of Evidence:

Level 2.

Methods:

A total of 14 active male youth (8-12 years old) participants with no previous exposure to minimalist shoes or barefoot running had running biomechanics (lower extremity sagittal plane kinematics and vertical ground reaction forces [vGRFs]) collected and analyzed in 3 footwear conditions (barefoot, traditional, and minimal shoe).

Results:

The average vertical loading rate (AVLR) was significantly greater running barefoot (173.86 bodyweights per second [BW/s]) and in the minimal shoe (138.71 BW/s) compared with the traditional shoe (78.06 BW/s), ( P < 0.01). There were significant differences between shoe conditions for knee flexion at initial contact ( P < 0.01), knee sagittal plane excursion ( P < 0.01), peak dorsiflexion ( P < 0.01), and dorsiflexion at initial contact ( P = 0.03). No participants displayed a forefoot-strike during this study.

Conclusion:

The introduction of barefoot and minimalist running in habitually shod youth significantly affected the running biomechanics of youth and caused immediate alterations in both lower extremity kinematics and vGRFs. Running barefoot or in minimal shoes dramatically increased the AVLR, which has been associated with injury, compared with a traditional shoe.

Clinical Relevance:

This study evaluated the effects of footwear on overground running biomechanics, including AVLR, in pre- and early-adolescent youth males. Based on our findings, clinicians should exercise caution in barefoot or minimal shoe transition among young, habitually shod, runners due to the immediate and dramatic increases in AVLRs.
EU social policy and the subsidiarity principle: The end of an illusion?
Authors: Schreurs Sven
Published: December 2023

Social policy at the EU level remains a notably limited enterprise. The Union appears unable to address social inequalities without treading into politicised areas of national decision-making, since intervention in the social domain touches upon core questions of national identity, sovereignty and democracy. In this article, I explore the fraught relationship between EU social policy and the principle of subsidiarity, which has frequently served to legitimate support for as well as opposition to supranational action in the social domain, even when and where the Union has well-defined competences to legislate. The article engages in a conceptual analysis of the implications of subsidiarity for EU social policy and labour law, illustrated with a case study that examines usages of the principle by different institutional actors in recent debates on EU social directives. While it clearly provides a convenient rhetorical instrument to political actors, I argue, the concept of subsidiarity fails to serve as an organising principle for the multilevel governance of social and labour policy. Scholarly and policy debates on the constitution of a more social Europe are therefore best oriented away from the language of subsidiarity and should focus instead on effective and democratically legitimate ways of delivering the social promises of both the EU and its Member States.
Clinical decision support systems for chronic obstructive pulmonary disease (COPD) in hospitals: A systematic review
Authors: Bamgboje-Ayodele Adeola , Borg David N , McPhail Steven M , Baysari Melissa T
Published: December 2023

Objectives

To synthesise the literature on clinical decision support (CDS) systems for chronic obstructive pulmonary disease (COPD). We aimed to (1) describe existing COPD CDS systems that have been designed, developed or are being used in practice, (2) describe the impact of COPD CDS systems on outcomes and (3) identify barriers and facilitators to implementation of COPD CDS systems.

Methods

Five databases were searched to identify relevant studies. All studies in English that described clinician-facing COPD CDS systems designed for, or implemented in, hospitals and hospital-in-the-home settings were included. A qualitative narrative synthesis was undertaken, guided by the RE-AIM framework ( Reach, Effectiveness, Adoption, Implementation and Maintenance).

Results

Twelve studies reporting the use of CDS in hospital ( n = 7) and hospital-in-the-home ( n = 5) settings were included. Implementation efforts to reach target users were scantly reported, and low-to-medium adoption rates were observed. The reported effectiveness of the CDS systems was mixed. Only one study reported facilitators to the implementation of CDS systems, none reported on barriers to the implementation of CDS systems, and none reported any information on successful strategies to maintain implementation of CDS systems.

Conclusion

The use of CDS systems in the management of patients with COPD in hospital-related settings is an important emerging field of research. Evidence suggests that the field has largely focused on systems targeted at physicians, often with incomplete descriptions and limited evaluations. Many opportunities to optimise and evaluate the implementation and use of COPD CDS systems in hospital settings remain, including robust evaluation of their impact on patient, clinician and health service outcomes.
Agricultural Marketing in India: Challenges, Policies and Politics
Authors: Saha Subhomay , Sinha Chaitali , Saha Shrabani
Published: December 2023

This article is an attempt to provide a critical review of the present process of agricultural marketing in India in the wake of the recent discontent amongst the farmers that took place with the passing of the three controversial farm laws in September 2020 and giving respite to the agrarian community of the country by repealing of these new laws in November 2021. The old agricultural system of India needs to be changed. The three farm laws that were passed were of the intention to modernize the Indian agricultural market by encouraging investment and increasing competition. However, there was a country-wide protest from the farmers as they were sceptical that these laws would ultimately withdraw or reduce the security net provided by the states and put them in a vulnerable position. The present review takes a deeper dig into the present agricultural marketing situation of India in the context of the new farm laws and tries to critically evaluate the situation.

JEL Classification: Q13 Q15 Q18
Productivity Shock and Labour Input: Evidence from Correlated Unobserved Component Model
Authors: Singh Jitender , Mitra Arup
Published: December 2023

This note assesses the relationship between labour productivity and employment in the framework of the unobserved component model as well as the vector autoregressive model. In the case of the organized/formal manufacturing sector in India, the transitory increase in productivity is seen to reduce the man-days in the short run, though it is not statistically significant. Permanent shock to productivity decreases labour inputs permanently, and vice versa and their association is also statistically significant. Incentivizing the firms to expand their activities, diversify production and process secondary products may help restore employment in the face of a permanent productivity shock.

JEL Classification: C11, C32, E32
Effectiveness of a video-feedback intervention to promote positive parenting for foster children
Authors: West Delphine , Stas Lara , Van Holen Frank , Gypen Laura , Vanderfaeillie Johan
Published: December 2023

Foster children are at risk for developing disorganized attachment relationships (Van den Dries et al., 2009; Vasileva & Petermann, 2018) and behavioural problems (Goemans et al., 2015; Vanschoonlandt et al., 2012). Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline – Foster Care/Adoption (VIPP-FC/A) is an intervention aimed at improving sensitive parenting in order to promote secure attachment relations and reduce behavioural problems. In this study, a Randomized Controlled Trial (RCT) was used in order to examine the effectiveness of VIPP-FC/A in a Flemish foster care sample ( n = 100), using questionnaires at three measurement moments. The hypothesis was that VIPP-FC/A would increase foster mothers’ sensitive parenting and decrease the externalizing behavioural problems and insecure attachment behaviour of the foster children and parenting stress of the foster mothers. The intervention effects on these four outcome variables were analysed by constructing four multilevel models. After controlling for the baseline measurement, there was no significant main effect of condition for sensitive parenting, externalizing problems, insecure attachment behaviour and parenting stress. There was however a significant effect of condition and age on insecure attachment behaviour: within the group of youngest foster children (under 30 months), children in the intervention group scored lower insecure attachment scores than children in the control group. Additionally, there was a significant effect of condition and type of foster care on externalizing behaviour problems. In the group of children placed in kinship foster care, children in the intervention group had lower external behavior scores than children in the control group.
Atomic scale insights into material removal mechanisms in nanoscale machining of copper beryllium
Authors: Sharma Anuj , Kumar Amit
Published: December 2023

The heterogeneous nature of the copper beryllium (CuBe) workpiece because of the presence of hard particles tends to affect material removal. When machining a CuBe material, it is anticipated that the mechanism of cutting and surface formation may differ from those seen when cutting a homogenous Cu material. Although these mechanisms are popular for the diamond turning of homogeneous materials, they have not been thoroughly studied in relation to CuBe alloys, which contain hard beryllium precipitates. Therefore, the effect of hard particles in the workpiece specimen on the nano-regime diamond turning of CuBe alloy needs to be understood. To explain the influence of Beryllium (Be) particles on the cutting tool and the workpiece surface, a molecular dynamics (MD) simulation was performed. It is revealed that the material removal mechanism in the case of CuBe is phase-dependent. Ductile machining is dominant in the Cu phase, and brittle fracture is dominant in the Be rich phase. It is also observed that the a/r ratio equal to 1 is suitable for cutting in the Cu phase and for ductile regime machining conditions in the Be phase. The a/r ratio higher than 1 causes higher cutting forces, and thus shear plane cutting takes place, which leads to a higher amount of material removal.
The Temporality of Project Success: Vindeby, the World’s First Offshore Wind Farm
Authors: Feddersen Jonathan , Koll Henrik , Geraldi Joana
Published: December 2023

This article advances a temporal understanding of project success through a process study of Vindeby, an exploratory project developing the world’s first offshore wind farm. Pursuing a situated temporal view, our findings reveal how actors constructed Vindeby’s success differently when seeing the project as future, present, and past and how these constructions mutually shaped each other. Adding to prior literature adopting an over-time or in-time perspective, we develop a through-time perspective of project success and a model explaining the interplay of the three perspectives. We discuss how projects may serve as temporal stepping stones toward sustainable futures in the green transition and propose ways for project managers and policymakers to nurture this potential.
Cosmic radiation shielding property of boron reinforced continuous fiber nanocomposites produced by electrospinning
Authors: Özcan Mücahid , Kaya Cengiz , Kaya Figen
Published: December 2023

Electrospinning, a cutting-edge production technique, is used to create boron-reinforced continuous fiber nanocomposites that shield space missions from cosmic radiation, a significant hazard. By incorporating boron, which is known for its exceptional neutron shielding properties, into the polymer matrix, a composite material that is flexible, lightweight, and highly resistant to radiation is produced. The results indicate that continuous fiber nanocomposites reinforced with boron, boric acid, or both have a high shielding efficiency against cosmic radiation. The adaptability and low weight of the manufactured nanocomposites make them ideal for space applications. While boric acid combines with PVA at the molecular level and alters the molecular chain structure of PVA, it is believed that elemental boron is only incorporated as particulates into the PVA polymer. It is known that both boric acid and elemental boron doped nanocomposites provide samples with a thickness of 10 microns with 13.56% neutron shielding and superior photon blocking ability.
Association between plasma L-carnitine levels and mitochondrial DNA copy number
Authors: Li Mingyue , Yang Keming , De Vivo Immaculata , Eliassen A. Heather , Qureshi Abrar A. , Nan Hongmei , Han Jiali
Published: December 2023

Mitochondria are key cytoplasmic organelles in eukaryotic cells that generate adenosine triphosphate (ATP) through the electron transport chain and oxidative phosphorylation. Mitochondrial DNA (mtDNA) copy number (mtDNAcn) is considered a biomarker for both mitochondrial quantity and function as well as cellular oxidative stress level. Previous epidemiologic findings revealed that weight gain, higher body mass index (BMI), smoking, and high insulinemic potential of lifestyle were associated with lower leukocyte mtDNAcn. Carnitines are a group of compounds that play a critical role in energy production. We quantified the associations of plasma L-carnitine levels with leukocyte mtDNAcn. We then examined the association between mtDNAcn and L-carnitine (HMDB0000062) in 538 U.S. men without cancers, diabetes, or cardiovascular disease at blood collection from the Health Professionals Follow-Up Study (HPFS). We found a significant inverse association between L-carnitine and mtDNAcn (ρ = −0.1, P = 0.02). This implies that the carnitine metabolic pathway may be associated with mitochondrial function and oxidative stress.
Pleiotropic genetic association analysis with multiple phenotypes using multivariate response best-subset selection
Authors: Guo Hongping , Li Tong , Wang Zixuan
Published: December 2023

Genetic pleiotropy refers to the simultaneous association of a gene with multiple phenotypes. It is widely distributed in the whole genome and can help to understand the common genetic mechanism of diseases or traits. In this study, a multivariate response best-subset selection (MRBSS) model based pleiotropic association analysis method is proposed. Different from the traditional genetic association model, the high-dimensional genotypic data are viewed as response variables while the multiple phenotypic data as predictor variables. Moreover, the response best-subset selection procedure is converted into an 0-1 integer optimization problem by introducing a separation parameter and a tuning parameter. Furthermore, the model parameters are estimated by using the curve search under the modified Bayesian information criterion. Simulation experiments show that the proposed method MRBSS remarkably reduces the computational time, obtains higher statistical power under most of the considered scenarios, and controls the type I error rate at a low level. The application studies in the datasets of maize yield traits and pig lipid traits further verifies the effectiveness.
GBDT_KgluSite: An improved computational prediction model for lysine glutarylation sites based on feature fusion and GBDT classifier
Authors: Liu Xin , Zhu Bao , Dai Xia-Wei , Xu Zhi-Ao , Li Rui , Qian Yuting , Lu Ya-Ping , Zhang Wenqing , Liu Yong , Zheng Junnian
Published: December 2023

Background

Lysine glutarylation (Kglu) is one of the most important Post-translational modifications (PTMs), which plays significant roles in various cellular functions, including metabolism, mitochondrial processes, and translation. Therefore, accurate identification of the Kglu site is important for elucidating protein molecular function. Due to the time-consuming and expensive limitations of traditional biological experiments, computational-based Kglu site prediction research is gaining more and more attention.

Results

In this paper, we proposed GBDT_KgluSite, a novel Kglu site prediction model based on GBDT and appropriate feature combinations, which achieved satisfactory performance. Specifically, seven features including sequence-based features, physicochemical property-based features, structural-based features, and evolutionary-derived features were used to characterize proteins. NearMiss-3 and Elastic Net were applied to address data imbalance and feature redundancy issues, respectively. The experimental results show that GBDT_KgluSite has good robustness and generalization ability, with accuracy and AUC values of 93.73%, and 98.14% on five-fold cross-validation as well as 90.11%, and 96.75% on the independent test dataset, respectively.

Conclusion

GBDT_KgluSite is an effective computational method for identifying Kglu sites in protein sequences. It has good stability and generalization ability and could be useful for the identification of new Kglu sites in the future. The relevant code and dataset are available at https://github.com/flyinsky6/GBDT_KgluSite.
Time series-based hybrid ensemble learning model with multivariate multidimensional feature coding for DNA methylation prediction
Authors: Yan Wu , Tan Li , Mengshan Li , Weihong Zhou , Sheng Sheng , Jun Wang , Fu-an Wu
Published: December 2023

Background

DNA methylation is a form of epigenetic modification that impacts gene expression without modifying the DNA sequence, thereby exerting control over gene function and cellular development. The prediction of DNA methylation is vital for understanding and exploring gene regulatory mechanisms. Currently, machine learning algorithms are primarily used for model construction. However, several challenges remain to be addressed, including limited prediction accuracy, constrained generalization capability, and insufficient learning capacity.

Results

In response to the aforementioned challenges, this paper leverages the similarities between DNA sequences and time series to introduce a time series-based hybrid ensemble learning model, called Multi2-Con-CAPSO-LSTM. The model utilizes multivariate and multidimensional encoding approach, combining three types of time series encodings with three kinds of genetic feature encodings, resulting in a total of nine types of feature encoding matrices. Convolutional Neural Networks are utilized to extract features from DNA sequences, including temporal, positional, physicochemical, and genetic information, thereby creating a comprehensive feature matrix. The Long Short-Term Memory model is then optimized using the Chaotic Accelerated Particle Swarm Optimization algorithm for predicting DNA methylation.

Conclusions

Through cross-validation experiments conducted on 17 species involving three types of DNA methylation (6 mA, 5hmC, and 4mC), the results demonstrate the robust predictive capabilities of the Multi2-Con-CAPSO-LSTM model in DNA methylation prediction across various types and species. Compared with other benchmark models, the Multi2-Con-CAPSO-LSTM model demonstrates significant advantages in sensitivity, specificity, accuracy, and correlation. The model proposed in this paper provides valuable insights and inspiration across various disciplines, including sequence alignment, genetic evolution, time series analysis, and structure–activity relationships.
Development and validation of a machine learning-based fall-related injury risk prediction model using nationwide claims database in Korean community-dwelling older population
Authors: Heo Kyu-Nam , Seok Jeong Yeon , Ah Young-Mi , Kim Kwang-il , Lee Seung-Bo , Lee Ju-Yeun
Published: December 2023

Background

Falls impact over 25% of older adults annually, making fall prevention a critical public health focus. We aimed to develop and validate a machine learning-based prediction model for serious fall-related injuries (FRIs) among community-dwelling older adults, incorporating various medication factors.

Methods

Utilizing annual national patient sample data, we segmented outpatient older adults without FRIs in the preceding three months into development and validation cohorts based on data from 2018 and 2019, respectively. The outcome of interest was serious FRIs, which we defined operationally as incidents necessitating an emergency department visit or hospital admission, identified by the diagnostic codes of injuries that are likely associated with falls. We developed four machine-learning models (light gradient boosting machine, Catboost, eXtreme Gradient Boosting, and Random forest), along with a logistic regression model as a reference.

Results

In both cohorts, FRIs leading to hospitalization/emergency department visits occurred in approximately 2% of patients. After selecting features from initial set of 187, we retained 26, with 15 of them being medication-related. Catboost emerged as the top model, with area under the receiver operating characteristic of 0.700, along with sensitivity and specificity rates around 65%. The high-risk group showed more than threefold greater risk of FRIs than the low-risk group, and model interpretations aligned with clinical intuition.

Conclusion

We developed and validated an explainable machine-learning model for predicting serious FRIs in community-dwelling older adults. With prospective validation, this model could facilitate targeted fall prevention strategies in primary care or community-pharmacy settings.
Machine learning analyses identify multi-modal frailty factors that selectively discriminate four cohorts in the Alzheimer’s disease spectrum: a COMPASS-ND study
Authors: Bohn Linzy , Drouin Shannon M. , McFall G. Peggy , Rolfson Darryl B. , Andrew Melissa K. , Dixon Roger A.
Published: December 2023

Background

Frailty indicators can operate in dynamic amalgamations of disease conditions, clinical symptoms, biomarkers, medical signals, cognitive characteristics, and even health beliefs and practices. This study is the first to evaluate which, among these multiple frailty-related indicators, are important and differential predictors of clinical cohorts that represent progression along an Alzheimer’s disease (AD) spectrum. We applied machine-learning technology to such indicators in order to identify the leading predictors of three AD spectrum cohorts; viz., subjective cognitive impairment (SCI), mild cognitive impairment (MCI), and AD. The common benchmark was a cohort of cognitively unimpaired (CU) older adults.

Methods

The four cohorts were from the cross-sectional Comprehensive Assessment of Neurodegeneration and Dementia dataset. We used random forest analysis (Python 3.7) to simultaneously test the relative importance of 83 multi-modal frailty indicators in discriminating the cohorts. We performed an explainable artificial intelligence method (Tree Shapley Additive exPlanation values) for deep interpretation of prediction effects.

Results

We observed strong concurrent prediction results, with clusters varying across cohorts. The SCI model demonstrated excellent prediction accuracy (AUC = 0.89). Three leading predictors were poorer quality of life ([QoL]; memory), abnormal lymphocyte count, and abnormal neutrophil count. The MCI model demonstrated a similarly high AUC (0.88). Five leading predictors were poorer QoL (memory, leisure), male sex, abnormal lymphocyte count, and poorer self-rated eyesight. The AD model demonstrated outstanding prediction accuracy (AUC = 0.98). Ten leading predictors were poorer QoL (memory), reduced olfaction, male sex, increased dependence in activities of daily living (n = 6), and poorer visual contrast.

Conclusions

Both convergent and cohort-specific frailty factors discriminated the AD spectrum cohorts. Convergence was observed as all cohorts were marked by lower quality of life (memory), supporting recent research and clinical attention to subjective experiences of memory aging and their potentially broad ramifications. Diversity was displayed in that, of the 14 leading predictors extracted across models, 11 were selectively sensitive to one cohort. A morbidity intensity trend was indicated by an increasing number and diversity of predictors corresponding to clinical severity, especially in AD. Knowledge of differential deficit predictors across AD clinical cohorts may promote precision interventions.
Correlation between PAPP-A serum levels in the first trimester of pregnancy with the occurrence of gestational diabetes, a multicenter cohort study
Authors: Borna Sedigheh , Ashrafzadeh Masoumeh , Ghaemi Marjan , Eshraghi Nasim , Hivechi Nafiseh , Hantoushzadeh Sedigheh
Published: December 2023

Objective

This study aimed to investigate the association between first-trimester Pregnancy-associated plasma protein A (PAPP-A) levels and subsequent gestational diabetes mellitus (GDM) development.

Method

The study was conducted on 5854 pregnant women who attended routine prenatal care. Maternal biomarkers, including PAPP-A and free beta hCG, were measured for all women in a referral laboratory and converted to MoM values. Pregnant women were divided into two groups, based on the serum concentration of PAPP-A, (PAPP-A > 0.4 (normal) and PAPP-A < 0.4 (low)). Data on the screening test for GDM and pregnancy outcomes were collected and analyzed with appropriate tests.

Result

Of the 5854 pregnant women, 889 (15.19%) developed GDM. The maternal PAPP-A MoM concentrations were significantly lower in GDM cases compared to controls. Indeed, gestational age at delivery and birth weight were significantly lower (p < 0.001) in PAPP-A MoM < 0.4, and the rate of intrauterine growth restriction (IUGR) was significantly higher (p < 0.001). ROC analysis revealed that the sensitivity and specificity of MoM concentration for predicting GDM were 53.3% and 51.9%, respectively.

Conclusion

Lower maternal PAPP-A in early pregnancy can lead to glucose intolerance and increase the risk of subsequent GDM development. In addition, decreased serum concentration of PAPP-A is significantly correlated to lower birth weight and IUGR.
PD-1 inhibitors combined with paclitaxel and cisplatin in first-line treatment of esophageal squamous cell carcinoma (ESCC): a network meta-analysis
Authors: Zhao Jia , Zhang Simeng , Guo Xiaoyu , li Ce , Yang Bowen , Qu Xiujuan , Wang Shuo
Published: December 2023

Background

The combinations of PD-1 inhibitors with paclitaxel/cisplatinum (PD-1 + TP) and fluoropyrimidine/cisplatinum (PD-1 + FP) both have been shown to improve overall survival (OS) and progression-free survival (PFS) in patients with previously untreated, advanced esophageal squamous cell carcinoma (ESCC). However, there is no consensus on which chemotherapy regimen combined with PD-1 has better efficacy. To deal with this important issue in the first-line treatment of patients with ESCC, a network meta-analysis (NMA) was performed.

Methods

Data were collected from eligible studies searched in Medline, Web of Science, PubMed, the Cochrane Library and Embase. The pooled hazard ratio (HR) for the OS, and PFS, odds ratio (OR) for the objective response rate (ORR) and ≥ 3 grade treatment-related adverse events (≥ 3TRAEs) were estimated to evaluate the efficacy of PD-1 inhibitors combined with TP or FP.

Results

Five RCTs and one retrospective study involving 3685 patients and evaluating four treatments were included in this NMA. Compared to other treatments, PD-1 + TP was better. For the PFS, the HRs for PD-1 + TP compared to PD-1 + FP, TP and FP were 0.59 (0.44, 0.80), 0.56 (0.51, 0.61) and 0.45 (0.37, 0.56) respectively. For the OS, PD-1 + TP was also a better treatment compared to other treatments. The HRs were 0.74 (0.56, 0.96), 0.64 (0.57, 0.71), 0.53 (0.43, 0.67) respectively. For the ORR, there was no significant difference between PD-1 + TP and PD-1 + FP, and the ORs were 1.2 (0.69, 2.11). Compare with TP and FP, PD-1 + TP had an obvious advantage, ORs were 2.5 (2.04, 3.04) and 2.95 (1.91, 4.63). For ≥ 3TRAEs, PD-1 + TP compared to other treatments, ORs were 1.34 (0.74, 2.46) and 1.13 (0.92, 1.38) and 2.23 (1.35, 3.69).

Conclusion

PD-1 + TP significantly improved both PFS and OS compared to PD-1 + FP. Taking into account both efficacy and safety, PD-1 + TP may be a superior first-line treatment option for ESCC.
Psychometric properties of an Arabic translation of the Big Three Perfectionism Scale–Short Form (BTPS-SF) in a community sample of adults
Authors: Fekih-Romdhane Feten , Rogoza Radoslaw , Hallit Rabih , Malaeb Diana , Sakr Fouad , Dabbous Mariam , Sawma Toni , Obeid Sahar , Hallit Souheil
Published: December 2023

Background

Despite the high clinical relevance of the perfectionism construct as a transdiagnostic contributor to different mental health symptoms, and the recent burgeoning of research in this area across cultures in the past two decades, the Arab region was one of the cultural settings experiencing the slowest progress in this line of research. This study aimed to make a meaningful contribution to the literature by validating an Arabic-language version of the 16-item Big Three Perfectionism Scale–Short Form (BTPS-SF). In particular, we sought to examine structure and concurrent validity, internal consistency, and measurement invariance across gender groups.

Method

A web-based, convenience sampling method was adopted to collect a sample of Arabic-speaking adults from the general population of Lebanon (N = 515; aged 27.55 ± 10.92 years; 69.9% females). The forward-backward method was applied in translating the Arabic version of the BTPS-SF.

Results

The examination of the internal structure, using Confirmatory Factor Analysis (CFA), demonstrated that the three-factor model (i.e., rigid, self-critical, and narcissistic perfectionism) fitted well to the data. All three factors of the Arabic 16-item BTPS-SF yielded excellent reliability estimates, with both Cronbach’s alpha and McDonald’s omega ranging from 0.83 to 0.86. Multi-group CFA revealed that fit indices showed no significant difference in model fit at the configural, metric, and scalar levels, thus suggesting that the factor loadings, pattern structure, and item intercepts are invariant across gender groups. Finally, BTPS-SF subscales scores correlated positively with psychological distress (i.e., depression, stress and anxiety), and inversely with subjective well-being, indicating an acceptable concurrent validity.

Conclusion

The present findings allow us to conclude that the Arabic BTPS-SF permits to capture reliably and validly three main factors of perfectionism. We hope that providing this psychometrically sound scale will encourage its large use not only in empirical research, but also in clinical applications, including psychological screening and treatment monitoring.
The usual Interstitial pneumonia pattern in autoimmune rheumatic diseases
Authors: Luppi Fabrizio , Manfredi Andreina , Faverio Paola , Andersen Michael Brun , Bono Francesca , Pagni Fabio , Salvarani Carlo , Bendstrup Elisabeth , Sebastiani Marco
Published: December 2023

Usual Interstitial Pneumonia (UIP) is characterized by progression of lung parenchyma that may be observed in various autoimmune rheumatic diseases (ARDs), including rheumatoid arthritis and connective tissue diseases. From a diagnostic point of view, a UIP pattern related to ARDs may display imaging and pathological features able to distinguish it from that related to IPF, such as the “straight-edge” sign at HRCT and lymphoplasmacytic infiltrates at histologic specimens. Multidisciplinary approach (MDD), involving at least pulmonologist, rheumatologist and radiologist, is fundamental in the differential diagnosis process, but MDD is also required in the evaluation of severity, progression and response to treatment, that is based on the combination of changes in symptoms, pulmonary function trends, and, in selected patients, serial CT evaluation. Differently from IPF, in patients with ARDs both functional evaluation and patient-reported outcomes may be affected by systemic involvement and comorbidities, including musculoskeletal manifestations of disease. Finally, in regards to pharmacological treatment, immunosuppressants have been considered the cornerstone of therapy, despite the lack of solid evidence in most cases; recently, antifibrotic drugs were also proposed for the treatment of progressive fibrosing ILDs other than IPF. In ARD-ILD, the therapeutic choice should balance the need for the control of systemic and lung involvements with the risk of adverse events from multi-morbidities and -therapies. Purpose of this review is to summarize the definition, the radiological and morphological features of the UIP pattern in ARDs, together with risk factors, diagnostic criteria, prognostic evaluation, monitoring and management approaches of the UIP-ARDs.
Cost-effectiveness of the anti-vascular endothelial growth factor intravitreal injection and panretinal photocoagulation for patients with proliferative diabetic retinopathy in South Korea
Authors: Lee Hyeon-Jeong , Cho Songhee , Park Jungeun , Jin Yan , Kim Hyung Min , Jee Donghyun
Published: December 2023

Background

We determined the cost-effectiveness of the anti-vascular endothelial growth factor (VEGF) intravitreal injection versus panretinal photocoagulation (PRP) for patients with proliferative diabetic retinopathy (PDR) in South Korea.

Methods

We simulated four treatment strategies using PRP and the anti-VEGF injection by constructing a Markov model for a hypothetical cohort of 50-year-old PDR patients: (1) PRP only; (2) anti-VEGF injection only; (3) PRP first; and (4) anti-VEGF injection first.

Results

In this cost-effectiveness analysis, compared with only-PRP, the incremental cost-effectiveness ratio was $95,456 per quality-adjusted life-year (QALY) for PRP first, $34,375 per QALY for anti-VEGF injection first, and $33,405 per QALY for anti-VEGF injection only from a healthcare perspective. From the societal and payer perspective, strategy (2) was more cost-saving and effective than (1). In the probabilistic sensitivity analysis, only-PRP was cost-effective up to the willingness-to-pay (WTP) of about $42,000, while anti-VEGF injection only was cost-effective from a healthcare perspective. From the societal and payer perspectives, regardless of the value of WTP, anti-VEGF injection only was the most cost-effective strategy.

Conclusion

In our study, the anti-VEGF injection for PDR was cost-effective from the payer and societal perspectives.
Alpha-defensins inhibit ERK/STAT3 signaling during monocyte-macrophage differentiation and impede macrophage function
Authors: Lee Jungnam , Mohammad Naweed , Lu Yuanqing , Oshins Regina , Aranyos Alek , Brantly Mark
Published: December 2023

Alpha-1-antitrypsin deficiency (AATD) is a genetic disorder associated with a 5–tenfold decrease in lung levels of alpha-1-antitrypsin (AAT) and an increased risk for obstructive lung disease. α-defensins are cationic broad-spectrum cytotoxic and pro-inflammatory peptides found in the azurophilic granules of neutrophils. The concentration of α-defensins is less than 30 nM in the bronchoalveolar lavage fluid of healthy controls but is up to 6 μM in AATD individuals with significant lung function impairment. Alveolar macrophages are generally classified into pro-inflammatory (M1) or anti-inflammatory (M2) subsets that play distinct roles in the initiation and resolution of inflammation. Therefore, monocyte-macrophage differentiation should be tightly controlled to maintain lung integrity. In this study, we determined the effect of α-defensins on monocyte-macrophage differentiation and identified the molecular mechanism of this effect. The results of this study demonstrate that 2.5 μM of α-defensins inhibit the phosphorylation of ERK1/2 and STAT3 and suppress the expression of M2 macrophage markers, CD163 and CD206. In addition, a scratch assay shows that the high concentration of α-defensins inhibits cell movement by ~ 50%, and the phagocytosis assay using flow cytometry shows that α-defensins significantly reduce the bacterial phagocytosis rate of monocyte-derived macrophages (MDMs). To examine whether exogenous AAT is able to alleviate the inhibitory effect of α-defensins on macrophage function, we incubated MDMs with AAT prior to α-defensin treatment and demonstrate that AAT improves the migratory ability and phagocytic ability of MDMs compared with MDMs incubated only with α-defensins. Taken together, this study suggests that a high concentration of α-defensins inhibits the activation of ERK/STAT3 signaling, negatively regulates the expression of M2 macrophage markers, and impairs innate immune function of macrophages.
The nutritional composition and cell size of microbial biomass for food applications are defined by the growth conditions
Authors: Sakarika Myrsini , Kerckhof Frederiek-Maarten , Van Peteghem Lotte , Pereira Alexandra , Van Den Bossche Tim , Bouwmeester Robbin , Gabriels Ralf , Van Haver Delphi , Ulčar Barbara , Martens Lennart , Impens Francis , Boon Nico , Ganigué Ramon , Rabaey Korneel
Published: December 2023

Background

It is increasingly recognized that conventional food production systems are not able to meet the globally increasing protein needs, resulting in overexploitation and depletion of resources, and environmental degradation. In this context, microbial biomass has emerged as a promising sustainable protein alternative. Nevertheless, often no consideration is given on the fact that the cultivation conditions affect the composition of microbial cells, and hence their quality and nutritional value. Apart from the properties and nutritional quality of the produced microbial food (ingredient), this can also impact its sustainability. To qualitatively assess these aspects, here, we investigated the link between substrate availability, growth rate, cell composition and size of Cupriavidus necator and Komagataella phaffii.

Results

Biomass with decreased nucleic acid and increased protein content was produced at low growth rates. Conversely, high rates resulted in larger cells, which could enable more efficient biomass harvesting. The proteome allocation varied across the different growth rates, with more ribosomal proteins at higher rates, which could potentially affect the techno-functional properties of the biomass. Considering the distinct amino acid profiles established for the different cellular components, variations in their abundance impacts the product quality leading to higher cysteine and phenylalanine content at low growth rates. Therefore, we hint that costly external amino acid supplementations that are often required to meet the nutritional needs could be avoided by carefully applying conditions that enable targeted growth rates.

Conclusion

In summary, we demonstrate tradeoffs between nutritional quality and production rate, and we discuss the microbial biomass properties that vary according to the growth conditions.
Comparison of clinical effectiveness and subsequent fertility between hysteroscopic resection and vaginal repair in patients with cesarean scar defect: a prospective observational study
Authors: Yang Guoxia , Wang Jiamin , Chang Yajie , Chen Yuqing
Published: December 2023

Objective

To evaluate the clinical effectiveness and pregnancy rate after hysteroscopic resection (HR) and/or vaginal repair (VR) in patients with cesarean scar defect (CSD).

Methods

This prospective observational study enrolled 191 patients who received CSD surgery in the First affiliated hospital of Sun Yat-sen University between September 2019 to February 2022 (96 in HR and 95 in VR, respectively). Patient follow-up were performed three months after surgery in both groups by transvaginal ultrasound to confirm the presence of fluid in the niche, along with the resolution of prolonged menses at the same time. The primary outcome was the clinical effectiveness between HR and VR, identified by the resolution of prolonged menses.

Results

The rates of niche-fluid disappearance (70.1% vs 60.2%, P = 0.176) and prolonged menses resolution (74.8% vs 80.0%, P = 0.341) were comparable for HR and VR. A subgroup analysis for niche size revealed that HR provides patients with small niche a more favorable rate of menstrual resolution compared to VR (size of niche ≤ 15 mm2, aOR = 3.423, 95% confidence interval [CI] 1.073–10.918), but patients with large niche experience a lower rate of resolution compared to VR (size of niche > 25 mm2, aOR = 0.286, 95% CI 0.087- 0.938). During follow-up, 41 patients who wanted to conceive became pregnant. Kaplan–Meier estimates of the cumulative probability of pregnancy at 12 months and 24 months were 47.1% (95% CI: 34.5%, 58.8%) and 63.8% (95% CI: 52.5%, 72.9%), respectively. The median pregnancy time was 22 months (95% CI: 14.2, 29.8) after VR and 12 months (95% CI: 8.3, 15.7, Gehan-Breslow-Wilcoxon P = 0.021) after HR. Among patients with subsequent infertility, 31.6% achieved pregnancy by unassisted mode and 29.8% by IVF/ICSI. Moreover, among patients with previously failed IVF/ICSI treatment, 60% (12/20) obtained pregnancy, including 71.4% (10/14) after HR and 33.3% (2/6) after VR.

Conclusions

Hysteroscopic resection is as effective as vaginal repair at relieving symptoms of CSD-associated prolonged menses. Hysteroscopic resection is the modality of choice with an improvement in prolonged menses for small niche, while vaginal might be considered for a large niche. Furthermore, surgical intervention could improve the clinical pregnancy rate of CSD patients. All of these provide evidence for the individualized management of CSD.