bluuebunny/crossref_metadata_2025 huggingface dataset:
Statistical methods for chemical mixtures: a roadmap for practitioners
Authors: Hao Wei , Cathey Amber L. , Aung Max M. , Boss Jonathan , Meeker John D. , Mukherjee Bhramar
Published: March 2024

Quantitative characterization of the health impacts associated with exposure to chemical mixtures has received considerable attention in current environmental and epidemiological studies. With many existing statistical methods and emerging approaches, it is important for practitioners to understand when each method is best suited for their inferential goals. In this study, we conduct a review and comparison of 11 analytical methods available for use in mixtures research, through extensive simulation studies for continuous and binary outcomes. These methods fall in three different classes: identifying important components of a mixture, identifying interactions and creating a summary score for risk stratification and prediction. We carry out an illustrative data analysis in the PROTECT birth cohort from Puerto Rico. Most importantly we develop an integrated package “CompMix” that provides a platform for mixtures analysis where the practitioner can implement a pipeline for several types of mixtures analysis.

Our simulation results suggest that the choice of methods depends on the goal of analysis and there is no clear winner across the board. For selection of important toxicants in the mixture and for identifying interactions, Elastic net by Zou et al. (Enet), Lasso for Hierarchical Interactions by Bien et al (HierNet), Selection of nonlinear interactions by a forward stepwise algorithm by Narisetty et al. (SNIF) have the most stable performance across simulation settings. Additionally, the predictive performance of the Super Learner ensembling method by Van de Laan et al. and HierNet are found to be superior to the rest of the methods. For overall summary or a cumulative measure, we find that using the Super Learner to combine multiple Environmental Risk Scores can lead to improved risk stratification properties. We have developed an R package “CompMix: A comprehensive toolkit for environmental mixtures analysis”, allowing users to implement a variety of tasks under different settings and compare the findings.

In summary, our study offers guidelines for selecting appropriate statistical methods for addressing specific scientific questions related to mixtures research. We identify critical gaps where new and better methods are needed.
Ethnic variation and structure-function analysis of tauopathy-associatedPERKalleles
Authors: Park Goonho , Galdamez Angela , Song Keon-Hyoung , Le Masako , Kim Kyle , Lin Jonathan H.
Published: March 2024

EIF2AK3, also known as PERK, plays a pivotal role in cellular proteostasis, orchestrating the Unfolded Protein Response (UPR) and Integrated Stress Response (ISR) pathways. In addition to its central position in intracellular stress regulation, human GWAS identify EIF2AK3 as a risk factor in tauopathies, neurodegenerative diseases caused by aberrant tau protein accumulation. Guided by these genomic indicators, our investigation systematically analyzed human PERK variants, focusing on those with potential tauopathy linkages. We assembled a comprehensive data set of human PERK variants associated with Wolcott Rallison Syndrome (WRS), tauopathies, and bioinformatically predicted loss-of-function, referencing the gnomAD, Ensembl, and NCBI databases. We found extensive racial/ethnic variation in the prevalence of commonPERKpolymorphisms linked to tauopathies. Using SWISS-MODEL, we identified structural perturbations in the ER stress-sensing luminal domain dimers/oligomers of tauopathy-associated PERK variants, Haplotypes A and B, in combination with another tauopathy-linked R240H mutation. Recombinant expression of disease-associated variantsin vitrorevealed altered PERK signal transduction kinetics in response to ER stress compared to the predominant non-disease variant. In summary, our data further substantiates that human PERK variants identified in tauopathy genetic studies negatively impact PERK structure, function, and downstream signaling with significant variations in prevalence among different racial and ethnic groups.
A Systematic Review and Meta-Analysis of Automated Methods for Quantifying Enlarged Perivascular Spaces in the Brain
Authors: Waymont Jennifer M.J. , Valdés Hernández Maria C. , Bernal Jose , Coello Roberto Duarte , Brown Rosalind , Chappell Francesca M. , Ballerini Lucia , Wardlaw Joanna M.
Published: March 2024

Research into magnetic resonance imaging (MRI)- visible perivascular spaces (PVS) has recently increased, as results from studies in different diseases and populations are cementing their association with sleep, disease phenotypes, and overall health indicators. With the establishment of worldwide consortia and the availability of large databases, computational methods that allow to automatically process all this wealth of information are becoming increasingly relevant. Several computational approaches have been proposed to assess PVS from MRI, and efforts have been made to summarise and appraise the most widely applied ones. We systematically reviewed and meta-analysed all publications available up to September 2023 describing the development, improvement, or application of computational PVS quantification methods from MRI. We analysed 67 approaches and 60 applications of their implementation, from 112 publications. The two most widely applied were the use of a morphological filter to enhance PVS-like structures, with Frangi being the choice preferred by most, and the use of a U-Net configuration with or without residual connections. Older adults or population studies comprising adults from 18 years old onwards were, overall, more frequent than studies using clinical samples. PVS were mainly assessed from T2-weighted MRI acquired in 1.5T and/or 3T scanners, although combinations using it with T1-weighted and FLAIR images were also abundant. Common associations researched included age, sex, hypertension, diabetes, white matter hyperintensities, sleep and cognition, with occupation-related, ethnicity, and genetic/hereditable traits being also explored. Despite promising improvements to overcome barriers such as noise and differentiation from other confounds, a need for joined efforts for a wider testing and increasing availability of the most promising methods is now paramount.
Simulation of phase change during the freezing of unsaturated porous media by using a coupled lattice Boltzmann model
Authors: Xu Fei , Wang Zheng , Hu Wei , Yang Caihao , Li Xiaolong , Zhang Yaning , Li Bingxi , Xie Gongnan
Published: March 2024

Purpose

The purpose of this paper is to develop a coupled lattice Boltzmann model for the simulation of the freezing process in unsaturated porous media.

Design/methodology/approach

In the developed model, the porous structure with complexity and disorder was generated by using a stochastic growth method, and then the Shan-Chen multiphase model and enthalpy-based phase change model were coupled by introducing a freezing interface force to describe the variation of phase interface. The pore size of porous media in freezing process was considered as an influential factor to phase transition temperature, and the variation of the interfacial force formed with phase change on the interface was described.

Findings

The larger porosity (0.2 and 0.8) will enlarge the unfrozen area from 42 mm to 70 mm, and the rest space of porous medium was occupied by the solid particles. The larger specific surface area (0.168 and 0.315) has a more fluctuated volume fraction distribution.

Originality/value

The concept of interfacial force was first introduced in the solid–liquid phase transition to describe the freezing process of frozen soil, enabling the formulation of a distribution equation based on enthalpy to depict the changes in the water film. The increased interfacial force serves to diminish ice formation and effectively absorb air during the freezing process. A greater surface area enhances the ability to counteract liquid migration.
Sensor fusion-based virtual reality for enhanced physical training
Authors: Li Xiaohui , Fan Dongfang , Deng Yi , Lei Yu , Omalley Owen
Published: March 2024

Purpose

This study aims to offer a comprehensive exploration of the potential and challenges associated with sensor fusion-based virtual reality (VR) applications in the context of enhanced physical training. The main objective is to identify key advancements in sensor fusion technology, evaluate its application in VR systems and understand its impact on physical training.

Design/methodology/approach

The research initiates by providing context to the physical training environment in today’s technology-driven world, followed by an in-depth overview of VR. This overview includes a concise discussion on the advancements in sensor fusion technology and its application in VR systems for physical training. A systematic review of literature then follows, examining VR’s application in various facets of physical training: from exercise, skill development and technique enhancement to injury prevention, rehabilitation and psychological preparation.

Findings

Sensor fusion-based VR presents tangible advantages in the sphere of physical training, offering immersive experiences that could redefine traditional training methodologies. While the advantages are evident in domains such as exercise optimization, skill acquisition and mental preparation, challenges persist. The current research suggests there is a need for further studies to address these limitations to fully harness VR’s potential in physical training.

Originality/value

The integration of sensor fusion technology with VR in the domain of physical training remains a rapidly evolving field. Highlighting the advancements and challenges, this review makes a significant contribution by addressing gaps in knowledge and offering directions for future research.
Obstacle detection and obstacle-surmounting planning for a wheel-legged robot based on Lidar
Authors: Wang Ruoxing , Wang Shoukun , Xue Junfeng , Chen Zhihua , Si Jinge
Published: March 2024

Purpose

This paper aims to investigate an autonomous obstacle-surmounting method based on a hybrid gait for the problem of crossing low-height obstacles autonomously by a six wheel-legged robot. The autonomy of obstacle-surmounting is reflected in obstacle recognition based on multi-frame point cloud fusion.

Design/methodology/approach

In this paper, first, for the problem that the lidar on the robot cannot scan the point cloud of low-height obstacles, the lidar is driven to rotate by a 2D turntable to obtain the point cloud of low-height obstacles under the robot. Tightly-coupled Lidar Inertial Odometry via Smoothing and Mapping algorithm, fast ground segmentation algorithm and Euclidean clustering algorithm are used to recognize the point cloud of low-height obstacles and obtain low-height obstacle in-formation. Then, combined with the structural characteristics of the robot, the obstacle-surmounting action planning is carried out for two types of obstacle scenes. A segmented approach is used for action planning. Gait units are designed to describe each segment of the action. A gait matrix is used to describe the overall action. The paper also analyzes the stability and surmounting capability of the robot’s key pose and determines the robot’s surmounting capability and the value scheme of the surmounting control variables.

Findings

The experimental verification is carried out on the robot laboratory platform (BIT-6NAZA). The obstacle recognition method can accurately detect low-height obstacles. The robot can maintain a smooth posture to cross low-height obstacles, which verifies the feasibility of the adaptive obstacle-surmounting method.

Originality/value

The study can provide the theory and engineering foundation for the environmental perception of the unmanned platform. It provides environmental information to support follow-up work, for example, on the planning of obstacles and obstacles.
Cutting propagation of Bornmuellera tymphaea, a nickel hyperaccumulator for use in agromining: Effects of rooting media and auxins on stem cuttings
Authors: Kyrkas Dimitrios , Mantzos Nikolaos , Patakioutas George , Lampraki Eleni , Filis Evangelos , Dimitrakopoulos Panayiotis G. , Echevarria Guillaume , Konstantinou Maria
Published: March 2024

The nickel hyperaccumulator Bornmuellera tymphaea has been evaluated for use in agromining in Greece with very promising results. This study examines propagation of this species based on cuttings, which provides rapid multiplication and clonal propagation of genotypes with useful genetic traits and offers obvious advantages over propagation by seed. Apical cuttings, 10 cm long, obtained from plants in the field, were propagated on mist benches under greenhouse conditions. Four treatments based on the rooting medium were evaluated: (a) perlite, (b) perlite + peat 1:1 (v/v), (c) ultramafic soil, and (d) ultramafic soil + perlite 1:1 (v/v). Completely randomized blocks were used in a 4 × 2 factorial design, using 4 different propagation rooting media and 2 levels of auxins (with or without the use of indole‐3‐butyric acid [IBA]), with 3 replicates of 28 cuttings. The response to perlite medium was best in terms of rooting: 75% without IBA and 71.33% with IBA, and the dry weight of roots was 0.18 g and of shoots 0.34 g. Perlite + peat 1:1 (v/v) medium also resulted in rooting in more than 55% of cuttings whereas cuttings grown in ultramafic soil showed very low rooting (<27%). Based on the findings, B. tymphaea has an aptitude for vegetative propagation by cuttings with survival values and rooting greater than 70%. Perlite combined with the application of auxin (ΙΒΑ) is recommended.
Integrating space syntax and CPTED in assessing outdoor physical activity
Authors: Safizadeh Mina , Hedayati Marzbali Massoomeh , Abdullah Aldrin , Maghsoodi Tilaki Mohammad Javad
Published: March 2024

The relationship between the spatial configuration of the built environment and outdoor physical activity is supported in the literature. However, the role of crime prevention elements and safety is neglected in that relationship. Using structural equation modelling and considering the effect of demographic factors, this study combined concepts of space syntax for analysis of spatial configuration and Crime Prevention through Environmental Design (CPTED) at property and street scales to investigate the direct and indirect relationships between neighbourhoods’ environments and levels of outdoor physical activity. The theoretical purposes have been to measure CPTED elements in two scales and each as a second‐order construct and to gauge pedestrians’ feeling of safety as mediators in the relationship between space syntax measures and physical activity. The results of structural equation modelling suggest that streets’ CPTED elements mediate the relationship between space syntax measures and feelings of safety. The mediation role of feelings of safety in the relationship between CPTED at the street scale and physical activity is also supported. Thus, the study shows that space syntax measures cannot be considered in relation to physical activity without also thinking about its consequent effects on neighbourhoods’ physical environments andalso provides novel insights into the effects of demographic variables on outdoor physical activity.
Suppressed IgG4 class switching in dupilumab‐ and TNF inhibitor‐treated patients after mRNA vaccination
Authors: Valk Anika M. , Keijser Jim B. D. , van Dam Koos P. J. , Stalman Eileen W. , Wieske Luuk , Steenhuis Maurice , Kummer Laura Y. L. , Spuls Phyllis I. , Bekkenk Marcel W. , Musters Annelie H. , Post Nicoline F. , Bosma Angela L. , Horváth Barbara , Hijnen Dirk‐Jan , Schreurs Corine R. G. , van Kempen Zoé L. E. , Killestein Joep , Volkers Adriaan G. , Tas Sander W. , Boekel Laura , Wolbink Gerrit J. , Keijzer Sofie , Derksen Ninotska I. L. , van Deelen Melanie , van Mierlo Gerard , Kuijpers Taco W. , Eftimov Filip , van Ham S. Marieke , ten Brinke Anja , Rispens Theo ,   T2B! Immunity against SARS‐CoV‐2 study group
Published: March 2024

Background

The noninflammatory immunoglobulin G4 (IgG4) is linked to tolerance and is unique to humans. Although poorly understood, prolonged antigenic stimulation and IL‐4‐signaling along the T helper 2‐axis may be instrumental in IgG4 class switching. Recently, repeated SARS‐CoV‐2 mRNA vaccination has been linked to IgG4 skewing. Although widely used immunosuppressive drugs have been shown to only moderately affect humoral responses to SARS‐CoV‐2 mRNA vaccination, the effect on IgG4 switching has not been investigated.

Methods

Here we study the impact of such immunosuppressive drugs, including the IL‐4 receptor‐blocking antibody dupilumab, on IgG4 skewing upon repeated SARS‐CoV‐2 mRNA vaccination. Receptor‐binding domain (RBD) specific antibody responses were longitudinally measured in 600 individuals, including patients with immune‐mediated inflammatory diseases treated with a TNF inhibitor (TNFi) and/or methotrexate (MTX), dupilumab, and healthy/untreated controls, after repeated mRNA vaccination.

Results

We observed a substantial increase in the proportion of RBD‐specific IgG4 antibodies (median 21%) in healthy/untreated controls after third vaccination. This IgG4 skewing was profoundly reduced in dupilumab‐treated patients (<1%). Unexpectedly, an equally strong suppression of IgG4 skewing was observed in TNFi‐treated patients (<1%), whereas MTX caused a modest reduction (7%). RBD‐specific total IgG levels were hardly affected by these immunosuppressive drugs. Minimal skewing was observed, when primary vaccination was adenoviral vector‐based.

Conclusions

Our results imply a critical role for IL‐4/IL‐13 as well as TNF in vivo IgG4 class switching. These novel findings advance our understanding of IgG4 class switch dynamics, and may benefit humoral tolerance induction strategies, treatment of IgG4 pathologies and mRNA vaccine optimization.
Long‐term impact of low‐energy femtosecond laser and manual cataract surgery on macular layer thickness: A prospective randomized study
Authors: Schwarzenbacher Luca , Schmidt‐Erfurth Ursula , Schartmüller Daniel , Röggla Veronika , Leydolt Christina , Menapace Rupert , Reiter Gregor S.
Published: March 2024

Purpose

To evaluate change in retinal layers 18 months after femtosecond laser‐assisted cataract surgery (LCS) and manual cataract surgery (MCS) in a representative age‐related cataract population using artificial intelligence (AI)‐based automated retinal layer segmentation.

Methods

This was a prospective, randomized and intraindividual‐controlled study including 60 patients at the Medical University of Vienna, Austria. Bilateral same‐day LCS and MCS were performed in a randomized sequence. To provide insight into the development of cystoid macular oedema (CME), retinal layer thickness was measured pre‐operatively and up to 18 months post‐operatively in the central 1 mm, 3 mm and 6 mm.

Results

Fifty‐six patients completed all follow‐up visits. LCS compared to MCS did not impact any of the investigated retinal layers at any follow‐up visit (p > 0.05). For the central 1 mm, a significant increase in total retinal thickness (TRT) was seen after 1 week followed by an elevated plateau thereafter. For the 3 mm and 6 mm, TRT increased only after 3 weeks and 6 weeks and decreased again until 18 months. TRT remained significantly increased compared to pre‐operative thickness (p < 0.001). Visual acuity remained unaffected by the macular thickening and no case of CME was observed. Inner nuclear layer (INL) and outer nuclear layer (ONL) were the main causative layers for the total TRT increase. Photoreceptors (PR) declined 1 week after surgery but regained pre‐operative values 18 months after surgery.

Conclusion

Low‐energy femtosecond laser pre‐treatment did not influence thickness of the retinal layers in any topographic zone compared to manual high fluidic phacoemulsification. TRT did not return to pre‐operative values 18 months after surgery. The causative layers for subclinical development of CME were successfully identified.
Nature‐versus‐nurture considered harmful: Actionability as an alternative tool for understanding the exposome from an ethical perspective
Authors: Safarlou Caspar W. , Bredenoord Annelien L. , Vermeulen Roel , Jongsma Karin R.
Published: March 2024

Exposome research is put forward as a major tool for solving the nature‐versus‐nurture debate because the exposome is said to represent “the nature of nurture.” Against this influential idea, we argue that the adoption of the nature‐versus‐nurture debate into the exposome research program is a mistake that needs to be undone to allow for a proper bioethical assessment of exposome research. We first argue that this adoption is originally based on an equivocation between the traditional nature‐versus‐nurture debate and a debate about disease prediction/etiology. Second, due to this mistake, exposome research is pushed to adopt a limited conception of agential control that is harmful to one's thinking about the good that exposome research can do for human health and wellbeing. To fully excise the nature‐versus‐nurture debate from exposome research, we argue that exposome researchers and bioethicists need to think about the exposome afresh from the perspective of actionability. We define the concept of actionability and related concepts and show how these can be used to analyze the ethical aspects of the exposome. In particular, we focus on refuting the popular “gun analogy” in exposome research, returning results to study participants and risk‐taking in the context of a well‐lived life.
Longitudinal evaluation of adverse events due to steroid use in primary immune thrombocytopenia: A population‐based study
Authors: Wang Jiaan‐Der , Ku Fan‐Chen , Chiang I‐Ju , Ku Meng‐Yun , Chen Yi‐Ming , Chien Li‐Nien
Published: March 2024

This study aimed to investigate the association between the steroid use patterns and the risk of AEs in patients with primary immune thrombocytopenia (ITP). A total of 2691 newly diagnosed adults with ITP between 2011 and 2018 were identified from the National Health Insurance Research Database in Taiwan, and the date of first steroid use was defined as the index date. Post‐index steroid use was calculated on a 90‐day basis as a time‐dependent variable and categorized by the average prednisolone‐equivalent daily dose (<10 mg vs. ≥10 mg) and intensity (medication possession ratio <80% vs. ≥80%). Patients were followed up for 1 year from the index date for acute AE events, while chronic AEs were assessed until death, or end of 2019. Compared to patients with low‐dose+low‐intensity steroid use, those with high‐dose+high‐intensity steroid use were associated with a higher risk of acute AE (adjusted incident rate ratio [aIRR]: 1.57, 95% confidence interval [CI]: 1.38–1.78, p < 0.01) and chronic AE (aIRR: 1.26, 95% CI: 1.08–1.47, p < 0.01). Metabolic/endocrine and ophthalmologic disorders demonstrated the strongest correlation with a high dose and intensity. The joint effect of steroid dose and intensity was observed in patients with ITP, and the findings suggest that steroids should be used carefully.
Analysis of 20 years of turtle exports from theUSreveals mixed effects ofCITESand a need for better monitoring
Authors: Easter Tara , Carter Neil
Published: March 2024

The Convention on International Trade of Endangered Species (CITES) is the primary mechanism for controlling international wildlife trade and preventing overexploitation, but measuring its efficacy is difficult, which complicates management efforts. We examined the effects of CITES listings on the trade of freshwater turtles from the US and compared spatiotemporal trends and dynamics of trade across 16 genera using 20 years of export data, triangulated with mixed qualitative data. For each CITES‐listed genus, we analyzed the average changes, immediate changes, and changes in trends of export volumes and spatial diversity of trade. Boom‐and‐bust trends of exports for different taxa were driven by several factors, including CITES listings, but CITES had mixed effects on export volumes for both Appendix II and III species while the diversity of spatial trade networks consistently declined for CITES and non‐CITES listed genera. These results point to differences in demand and species' availability from captive breeders, farms, or wild harvest which are important to consider in future listing decisions. However, a lack of reliable data on the source of turtles limited our ability to understand these drivers as well as the efficacy of CITES listings in preventing overexploitation.
Associations of diabesity with all‐cause and cardiovascular disease mortality: Findings from the Mexico City Prospective Study
Authors: Petermann‐Rocha Fanny , Apolinar Evelia , Nazar Gabriela , Diaz‐Toro Felipe , Celis Andrés , Deo Salil , Ferrari Gerson , O'Donovan Gary
Published: March 2024

Aim

To investigate the joint associations of diabetes and obesity with all‐cause and cardiovascular disease (CVD) mortality in the Mexico City Prospective Study.

Materials and Methods

In total, 154 128 participants (67.2% women) were included in this prospective analysis. Diabetes was self‐reported, while body mass index was used to calculate obesity. Using diabetes and obesity classifications, six groups were created: (a) normal (no diabetes and normal weight); (b) normal weight and diabetes; (c) overweight but not diabetes (overweight); (d) overweight and diabetes (prediabesity); (e) obesity but not diabetes (obesity); and (f) obesity and diabetes (diabesity). Associations between these categories and outcomes were investigated using Cox proportional hazard models adjusted for confounder factors.

Results

During 18.3 years of follow‐up, 27 197 (17.6%) participants died (28.5% because of CV causes). In the maximally adjusted model, participants those with the highest risk {hazard ratio (HR): 2.37 [95% confidence interval (CI): 2.24‐2.51]}, followed by those with diabesity [HR: 2.04 (95% CI: 1.94‐2.15)]. Similar trends of associations were observed for CVD mortality. The highest CV mortality risk was observed in individuals with diabesity [HR: 1.80 (95% CI: 1.63‐1.99)], followed by normal weight and diabetic individuals [HR: 1.78 (95% CI: 1.60‐1.98)].

Conclusion

This large prospective study identified that diabetes was the main driver of all‐cause and CVD mortality in all the categories studied, with diabesity being the riskiest. Given the high prevalence of both conditions in Mexico, our results reinforce the importance of initiating prevention strategies from an early age.
Dissociations between spontaneous electroencephalographic features and the perturbational complexity index in the minimally conscious state
Authors: Casarotto Silvia , Hassan Gabriel , Rosanova Mario , Sarasso Simone , Derchi Chiara‐Camilla , Trimarchi Pietro Davide , Viganò Alessandro , Russo Simone , Fecchio Matteo , Devalle Guya , Navarro Jorge , Massimini Marcello , Comanducci Angela
Published: March 2024

The analysis of spontaneous electroencephalogram (EEG) is a cornerstone in the assessment of patients with disorders of consciousness (DoC). Although preserved EEG patterns are highly suggestive of consciousness even in unresponsive patients, moderately or severely abnormal patterns are difficult to interpret. Indeed, growing evidence shows that consciousness can be present despite either large delta or reduced alpha activity in spontaneous EEG. Quantifying the complexity of EEG responses to direct cortical perturbations (perturbational complexity index [PCI]) may complement the observational approach and provide a reliable assessment of consciousness even when spontaneous EEG features are inconclusive. To seek empirical evidence of this hypothesis, we compared PCI with EEG spectral measures in the same population of minimally conscious state (MCS) patients (n = 40) hospitalized in rehabilitation facilities. We found a remarkable variability in spontaneous EEG features across MCS patients as compared with healthy controls: in particular, a pattern of predominant delta and highly reduced alpha power—more often observed in vegetative state/unresponsive wakefulness syndrome (VS/UWS) patients—was found in a non‐negligible number of MCS patients. Conversely, PCI values invariably fell above an externally validated empirical cutoff for consciousness in all MCS patients, consistent with the presence of clearly discernible, albeit fleeting, behavioural signs of awareness. These results confirm that, in some MCS patients, spontaneous EEG rhythms may be inconclusive about the actual capacity for consciousness and suggest that a perturbational approach can effectively compensate for this pitfall with practical implications for the individual patient's stratification and tailored rehabilitation.
Multimodal diagnostic imaging and treatment of cheek tooth hypercementosis associated with chronic ocular discharge in a horse
Authors: Scilimati Nicola , Bertoletti Alice , Angeli Giovanni , Nannarone Sara , Sforna Monica , Santi Agnese , Ortolani Flaminia , Gialletti Rodolfo
Published: March 2024

This case report discusses the clinical signs, diagnostic findings, treatment and outcome of a 6‐year‐old Italian Warmblood gelding referred for evaluation of a chronic unilateral ocular mucopurulent discharge that had been ongoing for several months. Dacryocystorhinography and computed tomography dacryocystography (CT‐DCG) allowed the identification of a neoformation associated with tooth 206 connected to a cystic lesion occupying the ipsilateral ventral nasal concha. It is likely that both lesions caused stenosis of the nasolacrimal duct and secondary recurrent ocular discharge. Once the 206 tooth had been surgically removed, a histological diagnosis of nodular hypercementosis associated with a small cystic lesion was made. In this case, CT‐DCG was extremely important in identifying the source of the ocular discharge and guiding the surgical planning for tooth removal. A follow‐up telephone conversation with the owner 6 months postoperatively reported that the horse had not shown further ocular discharge.
Insulin resistance and osteocalcin associate with the incidence and severity of postoperative delirium in elderly patients undergoing joint replacement
Authors: Mi Yang , Wen Ouyang , Lei Zhou , Ge Long , Xing Liu , Xi He
Published: March 2024

Aim

While insulin sensitivity plays an important role in maintaining glucose metabolic homeostasis and cognitive function, its impact on postoperative delirium (POD) remains unclear. This study aimed to investigate the association between POD and indicators of insulin sensitivity, including insulin resistance and osteocalcin.

Methods

A total of 120 elderly patients undergoing joint replacement were recruited and divided into delirium and non‐delirium groups. Plasma and cerebrospinal fluid (CSF) samples were collected for the analysis of biomarkers, including insulin, uncarboxylated osteocalcin (ucOC), total osteocalcin (tOC), and glucose. Insulin resistance was assessed through the homeostatic model assessment of insulin resistance (HOMA‐IR).

Main results

Out of the total, 28 patients (23.3%) experienced POD within 5 days after surgery. Patients with delirium exhibited higher levels of preoperative HOMA‐IR and ucOC in CSF and plasma, and of tOC in CSF (P = 0.028, P < 0.001, P = 0.005, P = 0.019). After adjusting for variables, including age, Mini‐Mental State Examination score, surgical site and preoperative fracture, only preoperative ucOC in CSF and HOMA‐IR were significantly linked to the incidence of delirium (OR = 5.940, P = 0.008; OR = 1.208, P = 0.046, respectively), both of which also correlated with the severity of delirium (P = 0.007, P < 0.001). Receiver operating curve analysis indicated that preoperative HOMA‐IR and ucOC in CSF might partly predict POD (area under the curve [AUC] = 0.697, 95% confidence interval [CI] = 0.501–0.775, AUC = 0.745, 95% CI = 0.659–0.860).

Conclusions

We observed that preoperative elevated HOMA‐IR and ucOC in CSF were associated with the incidence and severity of POD. While these preliminary results need confirmation, they suggest a potential involvement of insulin resistance and osteocalcin in the pathological mechanism of POD. Geriatr Gerontol Int 2024; 24: 421–429.
Does diversified environmental regulation effect the foreign direct investment inflows and technological innovation? A three‐stage least square approach
Authors: Liu Lingcai , Bai Dongbei , Fahad Shah , Ozturk Ilhan
Published: March 2024

Foreign direct investment (FDI) inflows have been significantly impacted by environmental regulation (ER). This study is aiming at analyzing the ER effect on the FDI inflows. By using the data of 2008–2018, we use Three‐stages least square (3SLS) method to assess the connection between FDI inflows and ER. The study results reveal that in Chinese industries, technological innovation (TI) is stipulated by the ER, and as a result, FDI has been engrossed. The results further reveal that TI has been enhanced by capital penetration, and a positive effect is perceived between TI and FDI. The findings of our study also show that there is a significant association between foreign capital (FC) inflows and TI, which indicates that technological policies are effective and advanced environmental policies would intensify the relevant policies between firms. Based on the study outcomes, this research proposes some policy suggestions for constructing a attuned policy system of environmental protection and FDI by regulating the implementation of conforming strategies.
Evaluation of the prognostic significance of clinical features of tumoral lesions in an extensive series of mycosis fungoides
Authors: Atci Tugba , Ozturk Sari Sule , Buyukbabani Nesimi , Besisik Sevgi , Baykal Can
Published: March 2024

Background

Tumors indicating the advanced stage of mycosis fungoides (MF) have a rich clinical spectrum. Although it is known that the prognosis of MF generally worsens following the development of tumors, some cases may have a relatively indolent course, and the role of clinical characteristics regarding prognosis has still not been well understood.

Methods

MF patients were retrospectively evaluated regarding the development of tumors. Besides demographic characteristics, data of the subtype and stage of the disease were recorded. The clinical features of tumors, including number (<5, 5–10, 11–20, or >20), location, dimension (diameter of ≥5 cm), presence of ulceration, and surrounding inflammation, were noted. Univariate and multivariate analyses evaluated the relationship between overall survival (OS) with demographic and clinical features.

Results

Among 730 consecutive MF patients, tumors developed in 8.2% (n = 60), of whom 46.7% were diagnosed with advanced‐stage MF from the beginning. The most common subtype was folliculotropic MF (53.3%). Most patients (55%) had multiple tumors, and the most frequent localization was the trunk (71.7%). Most tumors presented as smooth‐surfaced, indurated papules and/or nodules (70%), while others were reddish‐purple, occasionally accompanied by ulceration (50%), perilesional inflammation (23.3%), and attaining large dimensions (25%). Mortality was recorded in 51.7% of patients, and the 5‐year OS rate from the diagnosis of tumors was 49%. Independent poor prognostic factors for OS in multivariate analysis included older age at the time of diagnosis, presence of tumors at the initial MF diagnosis, presence of over 20 tumors, and the existence of large tumors.

Conclusions

Tumoral MF seen in older patients, the first diagnosis of MF in this stage, presenting with generalized and large tumors, seems to be a predictive factor for OS.
White blood cells scattergram as a valuable tool for COVID‐19 screening: A multicentric study
Authors: Osman Jennifer , Gonnin Cécile , Lambert Jérome , Behier Céline , Chapuis Nicolas , Chevalier Simon , Debus Jérôme , Delaval Anne , Depoorter Maxime , Dumas Cécile , Dumesges Amély , Dussert Pascale , Vacher Corinne Ferrero , Dubois‐Galopin Frédérique , Gerard Delphine , Bollotte Pauline Gravière , Guignedoux Geoffroy , Mayeur‐Rousse Caroline , Mercier‐Bataille Delphine , Ronez Emily , Trichet Catherine , Wiber Margaux , Raggueneau Victoria
Published: March 2024

Introduction

New tools have been developed to distinguish the COVID‐19 diagnosis from other viral infections presenting similar symptomatology and mitigate the lack of sensitivity of molecular testing. We previously identified a specific “sandglass” aspect on the white blood cells (WBC) scattergram of COVID‐19 patients, as a highly reliable COVID‐19 screening test (sensitivity: 85.9%, specificity: 83.5% and positive predictive value: 94.3%). We then decided to validate our previous data in a multicentric study.

Methods

This retrospective study involved 817 patients with flu‐like illness, among 20 centers, using the same CBC instrument (XN analyzer, SYSMEX, Japan). After training, one specialist per center independently evaluated, under the same conditions, the presence of the “sandglass” aspect of the WDF scattergram, likely representing plasmacytoid lymphocytes.

Results

Overall, this approach showed sensitivity: 59.0%, specificity: 72.9% and positive predictive value: 77.7%. Sensitivity improved with subgroup analysis, including in patients with lymphopenia (65.2%), patients presenting symptoms for more than 5 days (72.3%) and in patients with ARDS (70.1%). COVID‐19 patients with larger plasmacytoid lymphocyte cluster (>15 cells) more often have severe outcomes (70% vs. 15% in the control group).

Conclusion

Our findings confirm that the WBC scattergram analysis could be added to a diagnostic algorithm for screening and quickly categorizing symptomatic patients as either COVID‐19 probable or improbable, especially during COVID‐19 resurgence and overlapping with future influenza epidemics. The observed large size of the plasmacytoid lymphocytes cluster appears to be a hallmark of COVID‐19 patients and was indicative of a severe outcome. Furthers studies are ongoing to evaluate the value of the new hematological parameters in combination with WDF analysis.
Complex needs and ethical dilemmas—Care managers processing older clients to gerontological social work
Authors: Kinni Riitta‐Liisa , Tiilikainen Elisa
Published: March 2024

In the times of neoliberal policies, care managers work as gatekeepers to different elder care services. In this study, we examined how care managers categorise older adults' life situations in relation to needs for gerontological social work. Our data consisted of focus group interviews with 19 care managers working in different parts of Finland and were analysed by category analysis. The results show that processing older adults as clients of social work is not unambiguous. The Finnish legislation does not offer a solid foundation for defining the complex needs of older adults in everyday practices of care managers, but abuse and several coincident support needs were recognised as criteria for social work services. Importantly, ethical issues concerning sensitive situations and the self‐determination of older adults were categorised as situations where social work is needed. This sets high expectations for the ethical expertise of social work in elder care.
Conveying the pathogenesis of type 1 diabetes to the blind, low‐vision and diverse needs communities through sensory stimulation
Authors: Tran Mai T , Ciacchi Laura , Ciacchi Lisa , Reid Hugh H
Published: March 2024

To educate members of the blind, low‐vision and diverse needs communities on the pathogenesis of the chronic autoimmune disease, type 1 diabetes, members of our team with research expertise in immune‐mediated diseases, participated in the 2023 Monash Sensory Science (MSS) Exhibition. Using QR code linked audio commentary, participants were guided through tactile displays demonstrating normal insulin action in the regulation of blood glucose levels and its vital role in providing energy to tissues, followed by displays describing the various stages of the immune system's aberrant attack and the eventual complete destruction of the insulin producing beta‐cells of the pancreatic islets in type 1 diabetes. These models conveyed to the participants the huge effect that this autoimmune‐mediated disease has on the quality of life of affected individuals including the subsequent lifelong reliance on insulin injections to maintain glucose homeostasis. This MSS Exhibition provided a unique opportunity for our researchers to engage with under‐represented members of the community and to raise awareness about such a debilitating and common autoimmune disease.
RETRACTED: Effects of predictive nursing interventions on pressure ulcer in older bedridden patients: A meta‐analysis
Authors: Liu Zhu‐Feng , Meng Juan , Jing Na , Liu Xiao‐Yun
Published: March 2024

To evaluate the effect of predictive nursing interventions on pressure ulcers in elderly bedridden patients by meta‐analysis. Applied computer searches of PubMed, Embase, Google Scholar, Cochrane Library, China National Knowledge Infrastructure and Wanfang databases for randomised controlled trials (RCTs) on the effect of predictive nursing in preventing pressure ulcers in elderly bedridden patients from the database inception to November 2023. Two researchers independently screened the literature, extracted data and performed quality assessment based on inclusion and exclusion criteria. Stata 17.0 software was utilised for data analysis. Eighteen RCTs involving 6504 patients were finally included. The analysis revealed the implementation of predictive nursing interventions had a significant advantage in reducing the incidence of pressure ulcers in elderly bedridden patients compared with conventional nursing (odds ratio [OR] = 0.20, 95% confidence interval [CI]: 0.15–0.28, p < 0.001), while the patients' satisfaction with nursing care was higher (OR = 3.70, 95% CI: 2.99–4.57, p < 0.001). This study shows that the implementation of a predictive nursing interventions for elderly bedridden patients can effectively reduce the occurrence of pressure ulcers and significantly improve patients' satisfaction with nursing care, which is worthy of clinical promotion and application.
Modelling of patient journey in chronic spontaneous urticaria: Increasing awareness and education by shorten patients' disease journey in Germany
Authors: Maurer Marcus , Augustin Matthias , Bauer Sabine , Ekanayake‐Bohlig Swarna , Kircher Philipp , Knöll Anja , Kramps Thomas , Kurzen Hjalmar , Laemmel Sonja , Novak Natalija , Oppel Eva , Pirouzmandi Lal , Rebhan Michael , Reimnitz Ulrich , Richter‐Huhn Grit , Schwarz Beate , Schwichtenberg Uwe , Staubach Petra , Termeer Christian , Thielen Antje , Varga Katarina , von Bubnoff Dagmar , Zink Alexander , Gmeiner Benjamin , Nathan Petra
Published: March 2024

Background

Chronic spontaneous urticaria (CSU) is both physically and emotionally stressful, and guideline recommendations are often not optimally implemented in clinical practice. The objective of this study was to provide an overview on the patient journey in CSU and to develop a mathematical model based on solid data.

Methods

The journey of CSU patients in Germany was traced through literature review and expert meetings that included medical experts, pharmacists and representatives of patient organizations. The current situation's main challenges in the patient journey (education, collaboration and disease management) were discussed in depth. Then, a probabilistic model was developed in a co‐creation approach to simulate the impact of three potential improvement strategies: (1) patient education campaign, (2) medical professional education programme and (3) implementation of a disease management programme (DMP).

Results

Chronic spontaneous urticaria patients are severely burdened by delays in diagnosis and optimal medical care. Our simulation indicates that in Germany, it takes on average of 3.8 years for patients to achieve disease control in Germany. Modelling all three optimization strategies resulted in a reduction to 2.5 years until CSU symptom control. On a population level, the proportion of CSU patients with disease control increased from 44.2% to 58.1%.

Conclusions

In principle, effective CSU medications and a disease‐specific guideline are available. However, implementation of recommendations is lagging in practice. The approach of quantitative modelling of the patient journey validates obstacles and shows a clear effect of multiple interventions on the patient journey. The data generated by our simulation can be used to identify strategies for improving patient care. Our approach might helping in understanding and improving the management of patients beyond CSU.
Productivity measurement: Reassessing the production function from micro to macro
Authors: Martin Josh , Riley Rebecca
Published: March 2024

The productivity growth slowdown in advanced economies during the early decades of the 21st century has led to renewed interest in economic measurement. Measured productivity growth has largely evaporated, yet in many ways, the average person is better off than at any time in history and technological advance is ever evident. Are we simply, or at least in part, mismeasuring productivity change? More fundamentally, are we measuring an outdated or otherwise less relevant economic concept? What should and can we measure in the interest of developing evidence‐based policy solutions to support productivity growth? This paper reviews some of the recent advances in economic measurement and points to an expanded productivity measurement research agenda arising from these questions.
Will the real faker please do a shoulder roll? Bodies, labor, and ideology in esports
Authors: Pate George
Published: March 2024

Esports and the broader professionalization of playing video games demonstrates the neoliberal project's continuing expansion across new horizons. By transforming leisure into labor and extracting value from play, major gaming and digital media companies extend the commodity life of video games beyond the sale of the games themselves and into the actual play and even spectatorship of the games. As these companies continue to reframe the actual playing and watching of video games as product, the physical performance of the players' bodies becomes increasingly troublesome, a physical disruption of the media corporations' digital feedback loop.
Extinction risk predictions for the world's flowering plants to support their conservation
Authors: Bachman Steven P. , Brown Matilda J. M. , Leão Tarciso C. C. , Nic Lughadha Eimear , Walker Barnaby E.
Published: March 2024

More than 70% of all vascular plants lack conservation status assessments. We aimed to address this shortfall in knowledge of species extinction risk by using the World Checklist of Vascular Plants to generate the first comprehensive set of predictions for a large clade: angiosperms (flowering plants, c. 330 000 species).

We used Bayesian Additive Regression Trees (BART) to predict the extinction risk of all angiosperms using predictors relating to range size, human footprint, climate, and evolutionary history and applied a novel approach to estimate uncertainty of individual species‐level predictions.

From our model predictions, we estimate 45.1% of angiosperm species are potentially threatened with a lower bound of 44.5% and upper bound of 45.7%.

Our species‐level predictions, with associated uncertainty estimates, do not replace full global, or regional Red List assessments, but can be used to prioritise predicted threatened species for full Red List assessment and fast‐track predicted non‐threatened species for Least Concern assessments. Our predictions and uncertainty estimates can also guide fieldwork, inform systematic conservation planning and support global plant conservation efforts and targets.