bluuebunny/crossref_metadata_2025 huggingface dataset:
Extended state observer-based primary load frequency controller for power systems with ultra-high wind-energy penetration
Authors: Ayyarao Tummala SLV , Nuvvula Ramakrishna SS , Kumar Polamarasetty P , Colak Ilhami , Koten Hasan , Ali Ahmed , Khan Baseem
Published: January 2024

In this paper, a novel extended state observer-based (ESO) load frequency control is implemented. Specifically, the proposed control law focuses on the incorporation of wind energy injection as one of the disturbances, treating it as an additional state within the system. The proposed ESO is designed to estimate both the system states and the net disturbance, thereby enhancing its ability to regulate the overall load frequency performance. The proposed control strategy hinges on the judicious selection of control gains and disturbance gain. The estimated disturbance is then effectively compensated to regulate the load frequency. To evaluate the efficacy of the proposed controller, tests are conducted on both single and three area systems. The results demonstrate superior performance, even under conditions involving load and parameter variations.
Firms and Peacemaking: The Role of Private Firms in Civil War Negotiations
Authors: Melin Molly M. , Modi Mihir , Sosa Santiago
Published: January 2024

Over the last 20 years, scholars have closely examined the political and social conditions that promote peaceful conflict resolution and those that exacerbate violence. Accordingly, there is much greater understanding of violence and peace processes. Mostly lacking from this scholarship, however, is a role for private firms. International firms are often present in societies prone to conflict. Recent research suggests firms can play an important role in conflict prevention and resolution, and business scholars suggest these actors can reduce tensions in conflict zones. Yet, little is known about how multinational corporations impact conflict resolution dynamics. This project explores how the private sector affects conflict. Using new data, the authors show the effects of an active private sector on the occurrence and outcomes of civil war negotiations. The findings show that corporate calls for peace are effective at encouraging states and rebels in democracies to negotiate, but only increase the likelihood of reaching a peace agreement in nondemocracies.
The Relationship Between Obesity and Internet Addiction in University Students: A Cross-Sectional Study
Authors: Yıldız Ülkü , Kuruoğlu Emel , Günvar Tolga , Çöme Oğulcan , Mevsim Vildan
Published: January 2024

Purpose

The purpose of this study was to investigate the relationship between obesity and internet addiction in first-year university students (aged 18-25 years).

Design

The study was designed using a cross-sectional analytic model.

Setting

Data collection took place at Dokuz Eylul University, involving a diverse group of first-year students from different faculties.

Subjects

The study population comprised 12,365 students, with 2890 individuals selected using cluster sampling.

Measures

Internet addiction was evaluated using the Online Cognition Scale (OCS). Data on obesity-related variables and demographic details were collected through a questionnaire. Descriptive statistics, chi-square analysis, t test, and ANOVA were applied for statistical evaluation.

Results

The study included 2105 participants, with 43.8% males and 56.2% females. A significant positive correlation was found between body mass index (BMI) and OCS scores ( P = .000), indicating a higher prevalence of internet addiction among individuals with higher BMI. Males had higher mean OCS scores (91.19 ± 35.14) than females (80.21 ± 30.51) ( P = .00). Overweight and obese individuals exhibited higher scores on OCS sub-dimensions ( P < .005). Notably, individuals with a BMI over 25 were categorized as overweight, and those with a BMI over 30 were classified as obese.

Conclusions

The findings demonstrate a noteworthy relationship between internet addiction and obesity among university students. The study emphasizes the necessity of increased attention to this issue in Turkey for the implementation of effective interventions and preventive measures.
Measuring Smartphone Use: Survey Versus Digital Behavioral Data
Authors: Wenz Alexander , Keusch Florian , Bach Ruben L.
Published: January 2024

While digital technology use and skills have typically been measured with surveys, digital behavioral data that are passively collected from individuals’ digital devices have recently emerged as an alternative method of measuring technology usage patterns in a more unobtrusive and detailed way. In this paper, we evaluate how passively collected smartphone usage data compare to self-reported measures of smartphone use, considering the three usage dimensions amount of use, variety of use, and activities of use. Based on a sample of smartphone users in Germany who completed a survey and had a tracking app installed on their smartphone, we find that the alignment between the survey and digital behavioral data varies by dimension of smartphone use. Whereas amount of use is considerably overreported in the survey data, variety of use aligns more closely across the two data sources. For activities of use, the alignment differs by type of activity. The results also show that the alignment between survey and digital behavioral data is systematically related to individuals’ sociodemographic characteristics, including age, gender, and educational attainment. Finally, latent class analyses conducted separately for the survey and digital behavioral data suggest similar typologies of smartphone use, although the overlap between the typologies on the individual level is rather small.
Investigation on the health evaluation of mechanical system in powertrain based on subjective and objective fusion method
Authors: Wu Jianpeng , Yang Jian , Wang Yuxin , Wang Liyong , Chen Ruihan
Published: January 2024

The powertrain is a core component of military heavy tracked vehicles, and the accurate evaluation of its reliability and health is gradually becoming a key technology to improve our military combat effectiveness. However, the powertrain is a complex system integrating mechanical, electrical, and hydraulic components, which is difficult to achieve its accurate assessment and comprehensive characterization. Therefore, using data-driven and expert opinion fusion method to evaluate the mechanical system health is gradually becoming a research trend. This paper points out the composition of evaluation system, and puts forward how to calculate the index. Then using subjective and objective fusion method to analyze these indexes of mechanical system health and calculate the weights of each index. Based on the weights, the fuzzy comprehensive evaluation method is used to score and summarize the change law of mechanical system health. In conclusion, this study enriches the method of effectively evaluating the mechanical system health, and verifies the accuracy of this evaluation method. It will provide an evaluation basis for improving the mechanical system reliability.
Heat transfer characteristics of liquid cooling system for lithium-ion battery pack
Authors: Zhao Jiawei , Du Wei , Xiang Honglin , Gu Lei
Published: January 2024

To improve the thermal uniformity of power battery packs for electric vehicles, three different cooling water cavities of battery packs are researched in this study: the series one-way flow corrugated flat tube cooling structure (Model 1), the series two-way flow corrugated flat tube cooling structure (Model 2), and the parallel sandwich cooling structure (Model 3). Based on the fluid-solid coupling method, this study analyzes the cooling performance of the three models, including thermal uniformity, heat dissipation, and pressure loss. At a high discharge rate, compared with the series cooling system, the parallel sandwich cooling system makes the average temperature and maximum temperature of the battery pack decrease by 26.2% and 26.9% respectively, and the battery pack temperature difference decreases by 62%, and the coolant pressure loss decreases by 95.8%. The results show that the Model 3 overcomes the temperature accumulation caused by the series flow of coolant and achieves a better level of thermal uniformity while improving the heat dissipation and pressure loss performance. The research provides scholars and industries with a reference for upgrading thermal management and improving the stability of the power battery pack for electric vehicles, which has both theoretical and practical significance.
Transforming Caste Domination and the Challenges of Structural Transformations and Transformation of Consciousness: Ambedkar, Shankara and Beyond
Authors: Giri Ananta Kumar
Published: January 2024

Caste is a multidimensional reality in history and society, and it has manifested itself through varieties of structures of domination which are simultaneously cultural, economic, political and ideological as caste has also been related in complex ways with structures of class and gender domination. These structures of domination have led to the annihilation of self and society. This led Ambedkar to challenge us for annihilating caste. For Ambedkar, annihilation of caste calls for the realization of each person as an individual and not just a caste person. It also calls for the destruction of caste privileges, discrimination and their scriptural legitimation. However, this call for annihilation mainly has been a structural project without enough attention to the project of transformation of consciousness—self and social. There is a hint of this in Ambedkar’s Annihilation of Caste when he urges us to realize each one of us as unique individuals beyond the holes of caste which is further deepened in his Buddha and His Dhamma. Transformation of consciousness is also suggested in Adi Shankara’s treatise on self, Atmastakam. The essay engages itself with Ambedkar, Shankara, Gandhi and Sri Aurobindo, among others, as they help us in the transformation of caste domination and present a new hermeneutics of self-realization and social liberation. It deals with the simultaneous challenges of structural transformation of caste as well as consciousness of caste at the levels of both self and society which can draw on multiple sources of critique, creativity and transformations in India and the world.

Brahminism is the poison which has spoiled Hinduism. You will succeed in saving Hinduism if you will kill Brahminism. There should be no opposition to this reform from any quarter. It should be welcomed even by the Arya Samajists, because this is merely an application of their own doctrine of guna-karma.

Whether you do that or you do not, you must give a new doctrinal basis to your religion—a basis that will be in consonance with liberty, equality and fraternity; in short, with democracy. I am no authority on the subject. But I am told that for such religious principles as will be in consonance with liberty, equality and fraternity, it may not be necessary for you to borrow from foreign sources, and that you could draw for such principles in the Upanishads. Whether you could do so without a complete remoulding, a considerable scraping and chipping off from the ore they contain, is more than I can say. (Ambedkar, 2002[1936], p. 303)
Levels of Regional Inequality of Health Infrastructure and Morbidity Pattern in West Bengal
Authors: Hossain Farhat , Hannan Abdul
Published: January 2024

This article examines the differences in health infrastructural availability in West Bengal. Furthermore, the study looks at the pattern of communicable and non-communicable diseases in the six different regions of the state. It measures and analyses the disparities through the lens of demand and supply gaps in healthcare. The trends, patterns and distribution of various diseases were captured through the NSS unit-level data from 60th and 71st rounds. The study shows that inter-regional and inter-district differences in health infrastructure are striking in West Bengal. The state’s health infrastructure lags behind the national average. The average population served per rural health facility in North Bengal as well as West Bengal is quite high compared to national figures. Similarly, the population served per hospital bed in North Bengal is also substantially higher in comparison to other regions. The inadequacy of hospital beds is one of the major obstacles in reducing the burden of disease in the region. The results for the distribution of diseases of inpatient cases show that the burden of communicable diseases in North Bengal is relatively higher than the other regions in both rounds of NSS. The inpatient cases of water- and food-borne infectious diseases like gastrointestinal diseases are considerably high in North Bengal.
Differences in the Graduate Educational Attainment of Social Groups in India: Preferences for Education Versus Education-Friendly Endowments
Authors: Borooah Vani Kant
Published: January 2024

The focus of this article is on the ‘educational attainment’ of social groups in India, defined as the proportion of 21–29-year-olds in the different social groups that are graduates. Within this context, the article makes three contributions. The first is in terms of decomposition methodology: It shows how decomposition analysis can be used to breakdown graduate educational attainment (GEA) by population subgroups and region to offer insight into the policy levers available for improving the GEA of certain groups. The second is to a methodology for computing probabilities (termed ‘recycled predictions’) for isolating the group-specific probabilities of GEA which can be totally attributed to group identity. The third is to use these probabilities to break down the differences in proportions between social classes into a ‘social group effect’ and an ‘endowments effect’. The data for this article is from India’s Periodic Labour Force Survey for the period 2017–2018.
“My Favourite Self:” A Retrospective Analysis of an Outdoor Orientation Program
Authors: O’Connell Timothy S. , Lathrop Anna H. , Pilato Kelly A.
Published: January 2024

Background: The short-term impacts of outdoor orientation programs (OOPs) have been documented in the literature for close to 40 years. While there is a fair amount of research examining the immediate effects of OOPs, there are relatively few studies exploring long-term impacts. Purpose: This study examined the important longitudinal “lessons learned” from participating in an OOP. Methodology/Approach: This study utilized a retrospective qualitative approach and employed the Most Significant Change technique to understand meaningful lessons learned. Alumni from an OOP participated in semi-structured interviews. Thematic analyses included open coding, focused coding, and axial coding. Findings/Conclusions: Primary themes that emerged from the coding process included community and social connections, mental health and well-being and environmental appreciation and value of nature. Participants reported learning valuable lessons related to community building, coping, stress relief, resiliency and thriving, and connection with nature. Implications: Results provide evidence supporting positive long-term effects of OOPs. A particular highlight is how participants noted the OOP helped shape their “favourite self” years after their university experience. Researchers and practitioners can use these results to inform OOP curricula and to include in program marketing and lobbying efforts.
Literature Review on Interconnectedness of Human Resource for Reforming Practices for Sporting Talent Development in Secondary School Settings
Authors: Simwanza Alfa , Paul Asish
Published: January 2024

Sporting talent isn’t an aspect to be developed in a single day, needs to be sustainable, and starts from childhood through someone's life. The purpose of this article was to find out the interconnectedness of human resource for reforming practices for sports talent development in secondary school settings. A literature review was considered as a methodology for this article. It was found that effective and efficient sporting talent development (STD) requires the deployment of qualified and competent human resource. Systematic working and time devoutness are required for one to attain and excel to the maximum potential. Sporting talent is complex due to its diversity; therefore, needs investment in human resource with appropriate collaboration with decent connection in working. The commonly needed human resources in STD are administrators, teachers, coaches, trainers, heads of schools, parents, nonteaching staff and service providers. STD demands decent monitoring and collaboration with concerned human resource for the sake of having upright outcomes. Therefore, this implies that if the human resource is appropriately organized and interconnected, has an important role toward realizing one's potential through the whole process of reforming practices toward STD.
Familiarity-taxis: A bilateral approach to view-based snapshot navigation
Authors: Steinbeck Fabian , Kagioulis Efstathios , Dewar Alex , Philippides Andrew , Nowotny Thomas , Graham Paul
Published: January 2024

Many insects use view-based navigation, or snapshot matching, to return to familiar locations, or navigate routes. This relies on egocentric memories being matched to current views of the world. Previous Snapshot navigation algorithms have used full panoramic vision for the comparison of memorised images with query images to establish a measure of familiarity, which leads to a recovery of the original heading direction from when the snapshot was taken. Many aspects of insect sensory systems are lateralised with steering being derived from the comparison of left and right signals like a classic Braitenberg vehicle. Here, we investigate whether view-based route navigation can be implemented using bilateral visual familiarity comparisons. We found that the difference in familiarity between estimates from left and right fields of view can be used as a steering signal to recover the original heading direction. This finding extends across many different sizes of field of view and visual resolutions. In insects, steering computations are implemented in a brain region called the Lateral Accessory Lobe, within the Central Complex. In a simple simulation, we show with an SNN model of the LAL an existence proof of how bilateral visual familiarity could drive a search for a visually defined goal.
A Duty to Care: Male Perspectives on the Caregiver Role for Persons With Alzheimer’s or Dementia
Authors: Bueno Michael V.
Published: January 2024

The population of family caregivers (FCGs) of persons with Alzheimer’s disease and related dementias (ADRD) is growing, as is the proportion of males taking on this traditionally female role. Caregiving research has centered around women due to historic roles, resulting in a knowledge gap regarding male caregiving experiences. The purpose of this qualitative descriptive study was to explore the experiences of male FCGs of people with ADRD. Eleven male caregivers were recruited and interviewed by telephone or Zoom/videoconferencing. Data were analyzed using thematic analysis. Four major themes emerged highlighting males’ struggles with the unfamiliar caregiving role and changing identity; their acknowledgment of personal growth and discovery through caregiving; their challenges in finding the “right” kind of support; and their perceived reshaping of masculinity through the caregiving role. Male caregivers expressed unique experiences as FCGs. Findings indicate the need for researchers and clinicians to develop tailored support to address their needs.
Control of the maglev system with a low stiffness elastic track beam by pole assignment and a reduced order state observer
Authors: Li Qin , Wang Hui , Shen Gang
Published: January 2024

A maglev train system is an open loop unstable and strongly nonlinear system. Self-excited coupling vibration between the magnet and the track beam can occur even when the train is stationary. To avoid this, the track beam is generally designed with high stiffness, which directly increases the construction cost of the maglev line. In this research, a new control method for the maglev system with a low stiffness elastic track is proposed based on full state feedback theory and pole assignment theory. In the newly designed controller, track beam DOF is introduced into the control loop with the use of the reduced order state observer (ROSO) to make the control system have the ability to suppress track vibration actively, thus reducing the over dependence of the system stability on track properties. Effectiveness of the proposed control strategy is verified through experiments. Results show that it exhibits a better response compared to the traditional control method, with smaller fluctuations in levitation air gap and magnet acceleration. Furthermore, it can maintain system stability with relatively lower track stiffness, reducing the minimum requirements for track stiffness by 53.4% in the test.
Innovative strategies for effective paclitaxel delivery: Recent developments and prospects
Authors: Wileński Sławomir , Koper Agnieszka , Śledzińska Paulina , Bebyn Marek , Koper Krzysztof
Published: January 2024

Purpose

Paclitaxel is an effective chemotherapeutic agent against a variety of cancer types. However, the clinical utility of paclitaxel is restricted by its poor solubility in water and high toxicity, resulting in low drug tolerance. These difficulties could be resolved by using suitable pharmacological carriers. Hence, it is essential to determine innovative methods of administering this effective medication to overcome paclitaxel's inherent limitations.

Methods

An extensive literature search was conducted using multiple electronic databases to identify relevant studies published.

Results

In this comprehensive analysis, many different paclitaxel delivery systems are covered and discussed, such as albumin-bound paclitaxel, polymeric micelles, paclitaxel-loaded liposomes, prodrugs, cyclodextrins, and peptide–taxane conjugates. Moreover, the review also covers various delivery routes of conventional paclitaxel or novel paclitaxel formulations, such as oral administration, local applications, and intraperitoneal delivery.

Conclusion

In addition to albumin-bound paclitaxel, polymeric micelles appear to be the most promising formulations for innovative drug delivery systems at present. A variety of variants of polymeric micelles are currently undergoing advanced phases of clinical trials.
Impact of intravitreal triamcinolone injection following epiretinal membrane peeling on ectopic inner foveal layer classification
Authors: Su Dan , Li Hong-ni , Chen Qi-cheng , Shen Dan-ping , Huang Ze-tao
Published: January 2024

Purpose

This study aimed to evaluate the impact of intravitreal triamcinolone acetonide (TA) administration after peeling of idiopathic epiretinal membranes (iERM) on both anatomical and visual outcomes, utilizing the ectopic inner foveal layer (EIFL) staging scheme.

Methods

In this retrospective case-control study, we analyzed 43 eyes from 43 patients diagnosed with iERM between June 2019 and December 2021. All participants were categorized into the TA or control groups based on administering intravitreal TA injection following ERM peeling. We thoroughly reviewed the clinical data, including the preoperative and postoperative best-corrected visual acuity (BCVA), central foveal thickness (CFT), and macular cube volume (VOL), with ERM stages classified according to the EIFL staging scheme.

Results

The study enrolled 22 eyes in the TA and 21 in the control groups. Following a mean follow-up period of 11.07 ± 2.02 months, noteworthy improvements in EIFL stages were observed in both cohorts ( p < 0.01), but without significant distinctions between groups. In the TA group, 63.64% of eyes demonstrated improvements in EIFL stages, while the control group exhibited 76.19% ( p = 0.37). At the final visit, both groups experienced a noteworthy reduction in the postoperative CFT and VOL ( p < 0.05), coupled with significant improvement in BCVA ( p < 0.01). No substantial differences appeared between the two groups concerning BCVA, CFT, and VOL (all p > 0.05).

Conclusions

Our study suggested that concurrent intravitreal TA injection following ERM removal did not provide additional benefits regarding anatomical and visual improvement in iERM cases classified as Stages 2 and 3.
“A man doesn’t drink from a straw. Never!” the experience of coming out as gay to oneself and to others
Authors: Sindberg Gustav M , Awad Sarah H
Published: January 2024

We examine in this paper the individual and social process of coming out as gay. Through a sociocultural and developmental psychology theoretical lens, we unfold the process as a liminal experience that starts within the individual and is continuously negotiated in between the person, the social others, and the broader society. Through interviews and autoethnography, we look at this process through the experiences of three young men coming out in Denmark. The findings highlight how coming out is a complex process that starts before one comes out to others and continues to develop as a meaning-making process as the person starts coming out to others, where others’ responses are internalized and continue to form this person’s identification within society.
Changing children's public perception of social work: A narrative evaluation of an educational intervention about social services
Authors: Weitz Ylva Spånberger
Published: January 2024

This article explores children's learning experiences from taking part in an educational intervention about social services in school. Data were collected from six group interviews with 27 children after they had participated in lessons about social services. Following a narrative evaluation approach, the analysis focuses on the narratives of change that are made visible through the children's shared reflections about their learning experiences.

Findings

In their narratives of change, the children presented the educational intervention as meaningful for them because it increased their knowledge about social services as a possible support function for children and families. Some of the children related their previous more negative perceptions of social services to a collective story building on the idea that social services take children away from their families. Through the educational intervention, this collective story changed in part into another collective story building on the idea that social services help children and families to improve their relationships.

Applications

The study shows that an educational intervention about social services in school has the potential to increase children's knowledge about social services and to influence in a positive direction the collective stories that shape public perceptions of social work. Although such changes in collective stories can be expected to benefit social work practice, welfare professionals must be careful to promote opportunities for children to share experiences of social services that challenge, as well as align with, any of these collective stories.
Tension evaluation of prestressed strand based on combined features of nonlinear ultrasonic mixing
Authors: Qian Ji , Zhou Linqiang , Huang Qi , Li Jianbin
Published: January 2024

The estimation of prestressed strand stress levels is of great significance in ensuring the structurally reasonable performance of post-tensioned concrete structures, cable-stayed bridges, and arch bridges. This paper proposes a method to evaluate the remaining tensile stress on the strand through the ultrasonic mixing technique. The relationship between the strand tension and the nonlinear harmonics is established based on the theory of contact acoustic nonlinearity, and the acoustic nonlinear parameters at different tension levels are investigated by finite element analysis and step-loading experiments. The results show that the nonlinear parameters follow a power-law decrease with the increase in the tensile stress. To overcome the shortage of decreasing sensitivity of theoretical nonlinear parameters in monitoring early loosening, support vector regression is introduced to utilize complex high-order nonlinear generations in stress evaluation. With this approach, the accuracy of early-stage stress evaluation based on wave mixing has been remarkably improved.
Glycoprotein inhibitors as a first line rescue treatment after unsuccessful recanalization of endovascular thrombectomy: A systematic review and meta-analysis
Authors: Brake Aaron , Heskett Cody , Alam Naima , Fry Lane , Le Kevin , Mahnken Jonathan D , Abraham Michael
Published: January 2024

Background

Intracranial atherosclerotic disease (ICAD) is a major cause of stroke with a high rate of re-occlusion following mechanical thrombectomy (MT). Among the available rescue options, glycoprotein IIb/IIIa inhibitors (GPI) have shown promise as a potential therapeutic strategy. This systematic review and meta-analysis examine studies exploring the use of glycoprotein inhibitors as a first-line treatment for refractory occlusion or high-grade stenosis following EVT in the setting of ICAD.

Methods

A systematic review and meta-analysis were performed. Studies using GPI as the first-line rescue treatment (GPI-rt) after failed thrombectomy or in the setting with high-grade stenosis (>50%) were included. The primary outcome of interest was good clinical outcomes (defined as a modified Rankin Scale (mRS) score of 0–2 at 90 days). Secondary outcomes of interest were successful recanalization (TICI 2b-3), symptomatic intracranial hemorrhage (sICH), and mortality by 90 days.

Results

Our study processed 2111 articles, which yielded eight relevant studies for review, four single and four double arm. These studies comprised 763 patients, divided into GPI-rt (535 patients) and non-GPI-rt (228 patients) cohorts. The GPI-rt group had higher rates of mRS ≤ 2 at 90 days (58.5% vs 38.9%, p = 0.002) and lower mortality rates (7.8% vs 17.5%, p = 0.04) compared to the non-GPI-rt cohort. mTICI 2b-3 rates and rates of sICH were not significantly different between the cohorts.

Conclusions

First line GPI-rt demonstrates significant clinical benefit and significantly lower mortality without a rise in rates of sICH. GPI are a potential first line rescue treatment of ICAD.
The House Cup: Using Longitudinal Gamification to Improve Didactic Attendance
Authors: Elliott Brian P , Glendening Joseph , Venkatesh Sahana , Ahmad Ammar , Prister James , Burtson Kathryn M
Published: January 2024

OBJECTIVE

Determine if a point-based attendance system combined with longitudinal gamification is feasible and improves didactic session attendance and learner perceptions at our internal medicine residency.

METHODS

A prospective before–after cohort study. Weekly attendance was tracked from June 2022 through April 2023 at our university-affiliated internal medicine residency program. We implemented a point-based longitudinal game incentivizing residents to attend didactics with positive reinforcement in July 2022 (C: carrot). We added tiered positive reinforcement and positive punishment to the game in January 2023 (CS: carrot and stick). Attendance during these periods was compared to pre (P) and postintervention (S). Perceptions were assessed during the P, C, and CS periods with Likert scale ratings.

RESULTS

CS was associated with higher attendance than other study periods ( P = .002). Median attendance was P—51% (IQR 37.5-64.5), C—65% (IQR 50-74), CS—81% (IQR 78-94), and S—66% (IQR 63-71). Perceptions were similar during pre and intervention study periods, including perceptions of camaraderie (P—4.4, C—4.4, CS—4.5; P = .56), interest in attending didactic sessions (P—3.7, C—3.4, CS—3.2; P = .21), and mandate as the primary reason for attending didactics (P—3.1, C—3.1, CS—3.2; P = .96)

CONCLUSIONS

A point-based attendance system combined with a longitudinal game that included tiered positive reinforcement and positive punishment was feasible and associated with higher didactic attendance but not associated with changes in resident perceptions.
MYC rearrangements in HIV-associated large B-cell lymphomas: EUROMYC, a European retrospective study
Authors: Pagani Chiara , Rusconi Chiara , Dalla Pria Alessia , Ravano Emanuele , Schommers Philipp , Bastos-Oreiro Mariana , Verga Luisa , Gini Guido , Spina Michele , Arcaini Luca , Steffanoni Sara , Dalu Davide , Crucitti Lara , Lorenzi Luisa , Balzarini Piera , Cattaneo Chiara , Bongiovanni Lucia , Rosenwald Andreas , Facchetti Fabio , Bower Mark , Ferreri Andrés J. M. , Rossi Giuseppe , Tucci Alessandra , Re Alessandro
Published: January 2024

Large B-cell lymphoma (LBCL) carrying MYC rearrangement, alone or together with BCL2 and/or BCL6 translocations, have shown a poor prognosis when treated with rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) in the HIV population. Scanty data are available on the prevalence and prognostic impact of MYC rearrangements in HIV-associated LBCL. We conducted a retrospective study to evaluate the clinical effect of MYC rearrangement in HIV-associated LBCL. We evaluated clinical characteristics, treatment received, and outcome of LBCL in patients with HIV with MYC rearrangement (MYC+) and without MYC rearrangement (MYC–). A total of 155 patients with HIV who had received fluorescence in situ hybridization analysis for MYC were enrolled in 11 European centers: 43 with MYC+ and 112 MYC–. Among patients with MYC, 10 had double-/triple-hit lymphomas, and 33 had isolated MYC rearrangement (single-hit lymphoma). Patients with MYC+ had more frequently advanced stage, >2 extranodal site at presentation, and higher proliferative index. There were no significant differences in overall survival and progression-free survival (PFS) between the 2 groups. However, patients with MYC+ received more frequently intensive chemotherapy (iCT) (44%) than (R)CHOP alone (35%) or infusional treatment (DA-EPOCH-R and R-CDE) (19%). Among patients with MYC+, those who received iCT achieved a better outcome than patients who received nonintensive treatment (complete remission, 84% vs 52%; P = .028; 5-year PFS, 66% vs 36%; P = .021). Our retrospective results suggest that HIV-associated LBCL with MYC+ could be considered for an intensive therapeutic approach whenever possible, whereas (R)CHOP seems to give inferior results in this subset of patients in terms of complete remission and PFS.
Managing sickle cell disease and related complications in pregnancy: results of an international Delphi panel
Authors: Sharma Deva , Kozanoğlu Ilknur , Ataga Kenneth I. , Benachi Alexandra , Büyükkurt Selim , Lanzkron Sophie , Ozdogu Hakan , Pancham Shivan , Pecker Lydia H. , Robinson Susan E. , Yilmaz Baran Safak , Howard Jo
Published: January 2024

Data to guide evidence-based management of pregnant people with sickle cell disease (SCD) are limited. This international Delphi panel aimed to identify consensus among multidisciplinary experts for SCD management during pregnancy. The 2-round Delphi process used questionnaires exploring 7 topics (antenatal care, hydroxyurea use, transfusion, prevention of complications, treatment of complications, delivery and follow-up, and bottlenecks and knowledge gaps) developed by a steering committee. Thirteen panelists (hematologists, physiologists, obstetricians, maternal fetal medicine, and transfusion medicine physicians) from the United States, the United Kingdom, Turkey, and France completed the first survey; 12 panelists completed the second round. Anonymized responses were collected and summarized by a contract research organization (Akkodis Belgium). Consensus and strong consensus were predefined as 75% to 90% (9-10 of 12) and >90% (≥11 of 12) of panelists, respectively, agreeing or disagreeing on a response to a predefined clinical scenario or statement. In several areas of SCD management, consensus was achieved: experts recommended performing at least monthly multidisciplinary antenatal follow-up, administering prophylactic aspirin for preeclampsia prevention between gestational weeks 12 and 36, initiating prophylactic transfusion therapy in certain cases, or choosing automated red blood cell exchange over other transfusion methods for patients with iron overload or severe acute chest syndrome. No consensus was reached on several topics including the prophylactic aspirin dose, indications for starting infection prophylaxis, routine use of prophylactic transfusions, or use of prophylactic transfusions for preventing fetal complications. These recommendations could inform clinical care for patients with SCD who are pregnant in the absence of large clinical trials involving this population; the identified knowledge gaps can orient future research.
IL-1β promotes MPN disease initiation by favoring early clonal expansion of JAK2-mutant hematopoietic stem cells
Authors: Rai Shivam , Zhang Yang , Grockowiak Elodie , Kimmerlin Quentin , Hansen Nils , Stoll Cedric B. , Usart Marc , Luque Paz Damien , Hao-Shen Hui , Zhu Yexuan , Roux Julien , Bader Michael S. , Dirnhofer Stefan , Farady Christopher J. , Schroeder Timm , Méndez-Ferrer Simón , Skoda Radek C.
Published: January 2024

JAK 2-V617F is the most frequent somatic mutation causing myeloproliferative neoplasm (MPN). JAK2-V617F can be found in healthy individuals with clonal hematopoiesis of indeterminate potential (CHIP) with a frequency much higher than the prevalence of MPNs. The factors controlling the conversion of JAK2-V617F CHIP to MPN are largely unknown. We hypothesized that interleukin-1β (IL-1β)–mediated inflammation can favor this progression. We established an experimental system using bone marrow (BM) transplantations from JAK2-V617F and GFP transgenic (VF;GFP) mice that were further crossed with IL-1β−/− or IL-1R1−/− mice. To study the role of IL-1β and its receptor on monoclonal evolution of MPN, we performed competitive BM transplantations at high dilutions with only 1 to 3 hematopoietic stem cells (HSCs) per recipient. Loss of IL-1β in JAK2-mutant HSCs reduced engraftment, restricted clonal expansion, lowered the total numbers of functional HSCs, and decreased the rate of conversion to MPN. Loss of IL-1R1 in the recipients also lowered the conversion to MPN but did not reduce the frequency of engraftment of JAK2-mutant HSCs. Wild-type (WT) recipients transplanted with VF;GFP BM that developed MPNs had elevated IL-1β levels and reduced frequencies of mesenchymal stromal cells (MSCs). Interestingly, frequencies of MSCs were also reduced in recipients that did not develop MPNs, had only marginally elevated IL-1β levels, and displayed low GFP-chimerism resembling CHIP. Anti–IL-1β antibody preserved high frequencies of MSCs in VF;GFP recipients and reduced the rate of engraftment and the conversion to MPN. Our results identify IL-1β as a potential therapeutic target for preventing the transition from JAK2-V617F CHIP to MPNs.
A phase 1/2 study of mini-hyper-CVD plus venetoclax in patients with relapsed/refractory acute lymphoblastic leukemia
Authors: Short Nicholas J. , Jabbour Elias , Jain Nitin , Senapati Jayastu , Nasr Lewis , Haddad Fadi G. , Li Zhenhua , Hsiao Yu-Chih , Yang Jun J. , Pemmaraju Naveen , Ohanian Maro , Wierda William G. , Montalban-Bravo Guillermo , Borthakur Gautam , Han Lina , Xiao Lianchun , Huang Xuelin , Abramova Regina , Zhao Min , Garris Rebecca , Konopleva Marina , Ravandi Farhad , Kantarjian Hagop
Published: January 2024

Preclinical studies suggest that Bcl-2 inhibition with venetoclax has antileukemic activity in acute lymphoblastic leukemia (ALL) and may synergize with conventional chemotherapy. We designed a phase 1/2 clinical trial to evaluate the safety and efficacy of low-intensity chemotherapy in combination with venetoclax in adults with relapsed or refractory ALL. Patients received the mini-hyper-CVD regimen (dose-attenuated hyperfractionated cyclophosphamide, vincristine, and dexamethasone alternating with methotrexate and cytarabine) in combination with venetoclax (200 mg or 400 mg daily) on days 1 to 14 in cycle 1 and on days 1 to 7 in consolidation cycles. Twenty-two patients were treated. The median number of prior therapies was 2 (range, 1-6). Thirteen patients (59%) had undergone prior allogeneic stem cell transplant (allo-SCT), and 7 of 18 patients (39%) with B-cell ALL had previously received both inotuzumab ozogamicin and blinatumomab. The recommended phase 2 dose of venetoclax in the combination regimen was 400 mg daily. The composite complete remission (CR) and CR with incomplete hematologic recovery (CRi) rate was 57% (CR, 43%; CRi, 14%), and 45% of responders achieved measurable residual disease negativity by multiparameter flow cytometry. Four patients proceeded to allo-SCT. The median duration of response was 6.3 months. The median overall survival was 7.1 months, and the 1-year overall survival rate was 29%. The most common grade ≥3 nonhematologic adverse events were infection in 17 patients (77%) and febrile neutropenia in 4 patients (18%). Overall, the combination of mini-hyper-CVD plus venetoclax was active in heavily pretreated relapsed/refractory ALL. Further development of venetoclax-based combinations in ALL is warranted. This trial is registered at www.clinicaltrials.gov as #NCT03808610.
Endotypic traits of supine position and supine-predominant obstructive sleep apnoea in Asian patients
Authors: Cheng Wan-Ju , Finnsson Eysteinn , Ágústsson Jón S. , Sands Scott A. , Hang Liang-Wen
Published: January 2024

Background

Over half of all cases of obstructive sleep apnoea (OSA) are classified as supine-related OSA; however, the pathological endotype during supine position is not fully understood. This study aims to investigate the endotypic traits of supine-predominant OSA and explore the variations in endotypic traits between the supine and lateral positions.

Methods

We prospectively recruited 689 adult patients with OSA from a single sleep centre between April 2020 and December 2022. Endotypic traits, namely arousal threshold, collapsibility, loop gain and upper airway muscle compensation, were retrieved from polysomnographic signals. We identified spOSA by a supine to non-supine apnoea–hypopnoea index (AHI) ratio >2. We cross-sectionally compared demographic and endotypic traits between supine-predominant OSA and non-positional OSA and examined the associations between supine-predominant OSA and endotypic traits. Additionally, we compared the changes in endotypic traits between supine and lateral positions in patients with supine-predominant OSA and non-positional OSA.

Results

In our study sample, 75.8% of patients were identified as having supine-predominant OSA. Compared to non-positional OSA, supine-predominant OSA was associated with low collapsibility (β= −3.46 %eupnoea, 95% CI −5.93– −1.00 %eupnoea) and reduced compensation (β= −6.79 %eupnoea, 95% CI −10.60– −2.99 %eupnoea). When transitioning from the lateral to supine position, patients with supine-predominant OSA had a substantial decrease in compensation compared to those with non-positional OSA (−11.98versus−6.28 %eupnoea).

Conclusions

Supine-predominant OSA is the prevalent phenotype of OSA in Asian patients. Inadequate upper airway compensation appears to be a crucial underlying pathology in patients with supine-predominant OSA.
Clinical efficacy and satisfaction of a digital wheeze detector in a multicentre randomised controlled trial: the WheezeScan study
Authors: Do Yen Hoang , van Aalderen Wim , Dellbrügger Ellen , Grenzbach Claude , Grigg Jonathan , Grittner Ulrike , Haarman Eric , Hernandez Toro Camilo José , Karadag Bulent , Roßberg Siri , Weichert Tina-Maria , Whitehouse Abigail , Pizzulli Antonio , Matricardi Paolo Maria , Dramburg Stephanie
Published: January 2024

Introduction

Wheezing is common in preschool children and its clinical assessment often challenging for caretakers. This study aims to evaluate the impact of a novel digital wheeze detector (WheezeScan™) on disease control in a home care setting.

Methods

A multicentre randomised open-label controlled trial was conducted in Berlin, Istanbul and London. Participants aged 4–84 months with a doctor's diagnosis of recurrent wheezing in the past 12 months were included. While the control group followed usual care, the intervention group received the WheezeScan™ for at-home use for 120 days. Parents completed questionnaires regarding their child's respiratory symptoms, disease-related and parental quality of life, and caretaker self-efficacy at baseline (T0), 90 days (T1) and 4 months (T2).

Results

A total of 167 children, with a mean±sdage of 3.2±1.6 years, were enrolled in the study (intervention group n=87; control group n=80). There was no statistically significant difference in wheeze control assessed by TRACK (mean difference 3.8, 95% CI −2.3–9.9; p=0.2) at T1 between treatment groups (primary outcome). Children's and parental quality of life and parental self-efficacy were comparable between both groups at T1. The evaluation of device usability and perception showed that parents found it useful.

Conclusion

In the current study population, the wheeze detector did not show significant impact on the home management of preschool wheezing. Hence, further research is needed to better understand how the perception and usage behaviour may influence the clinical impact of a digital support.
Genome-wide association study between copy number variation and feeding behavior, feed efficiency, and growth traits in Nellore cattle
Authors: Benfica Lorena F. , Brito Luiz F. , do Bem Ricardo D. , Mulim Henrique A. , Glessner Joseph , Braga Larissa G. , Gloria Leonardo S. , Cyrillo Joslaine N. S. G. , Bonilha Sarah F. M. , Mercadante Maria E. Z.
Published: January 2024

Background

Feeding costs represent the largest expenditures in beef production. Therefore, the animal efficiency in converting feed in high-quality protein for human consumption plays a major role in the environmental impact of the beef industry and in the beef producers’ profitability. In this context, breeding animals for improved feed efficiency through genomic selection has been considered as a strategic practice in modern breeding programs around the world. Copy number variation (CNV) is a less-studied source of genetic variation that can contribute to phenotypic variability in complex traits. In this context, this study aimed to: (1) identify CNV and CNV regions (CNVRs) in the genome of Nellore cattle (Bos taurus indicus); (2) assess potential associations between the identified CNVR and weaning weight (W210), body weight measured at the time of selection (WSel), average daily gain (ADG), dry matter intake (DMI), residual feed intake (RFI), time spent at the feed bunk (TF), and frequency of visits to the feed bunk (FF); and, (3) perform functional enrichment analyses of the significant CNVR identified for each of the traits evaluated.

Results

A total of 3,161 CNVs and 561 CNVRs ranging from 4,973 bp to 3,215,394 bp were identified. The CNVRs covered up to 99,221,894 bp (3.99%) of the Nellore autosomal genome. Seventeen CNVR were significantly associated with dry matter intake and feeding frequency (number of daily visits to the feed bunk). The functional annotation of the associated CNVRs revealed important candidate genes related to metabolism that may be associated with the phenotypic expression of the evaluated traits. Furthermore, Gene Ontology (GO) analyses revealed 19 enrichment processes associated with FF.

Conclusions

A total of 3,161 CNVs and 561 CNVRs were identified and characterized in a Nellore cattle population. Various CNVRs were significantly associated with DMI and FF, indicating that CNVs play an important role in key biological pathways and in the phenotypic expression of feeding behavior and growth traits in Nellore cattle.