bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical Impact of Skeletal Muscle Mass and Nutritional Status in Patients with Recurrent or Advanced Gastric Cancer Treated with Nivolumab
Authors: Hu Qingjiang , Kudo Kensuke , Yukaya Takafumi , Hasuda Hirofumi , Nakanishi Ryota , Nakanoko Tomonori , Ando Koji , Ota Mitsuhiko , Kimura Yasue , Koga Tadashi , Kusumoto Tetsuya , Oki Eiji , Yoshizumi Tomoharu
Published: September 2024

Introduction: This study aimed to evaluate the clinical impact of skeletal muscle mass and nutritional status in gastric cancer patients treated with nivolumab monotherapy as late-line treatment. Methods: We conducted a multi-institutional retrospective study of 90 gastric cancer patients who previously received anti-PD-1 therapy (nivolumab). On computed tomography images captured before nivolumab induction, the skeletal muscle index (SMI, cm2/m2) was defined as the erector muscle area (cm2) divided by the height (m) squared. Patients were divided into two groups: those with SMI-high (n = 45) and those with SMI-low (n = 45). Prognostic nutritional index (PNI) was also calculated before nivolumab induction. The associations of SMI and PNI with response rate (RR), progression-free survival (PFS), overall survival (OS), disease control rate (DCR), and safety were analyzed. Results: The cutoff values for SMI were determined as 13.45 for males and 10.41 for females. SMI-high was significantly associated with a higher RR (odds ratio = 12.36, p = 0.02) and DCR (odds ratio = 2.97, p = 0.02). Although not significant, PNI-high also tended to be associated with a higher RR. Multivariate analysis showed that SMI-high was independently associated with a higher RR and higher DCR in gastric cancer. Moreover, prognostic analyses revealed that SMI-high (log-rank test p = 0.008) and PNI-high (log-rank test p = 0.0008) were significantly associated with longer OS since nivolumab induction. SMI-high was also associated with longer PFS (log-rank test p = 0.03). There were no significant differences in immune-related adverse event between SMI-low and SMI-high. Conclusion: SMI and PNI were associated with nivolumab efficacy in gastric cancer patients. Management of skeletal muscle loss and nutritional status in gastric cancer patients who will receive nivolumab would be beneficial to enhance survival outcomes.
Outcomes of Fedratinib in Routine Treatment of Ruxolitinib-Resistant or -Refractory Patients with Primary and Post-Polycythemia Vera or Essential Thrombocythemia Myelofibrosis: A Nationwide Retrospective Study
Authors: Duek Adrian , Tzinman Alexandra , Maziuk Kira , Levy Assaf , Ellis Martin , Stemer Galia , Shacham Abulafia Adi , Cohen Amos , Lavi Noa , Ronson Aaron , Braester Andrey , Shapira Shirley , Canaani Jonathan , Volchek Yulia , Leiba Ronit , Leiba Merab
Published: September 2024

Introduction: In recent years, fedratinib, a selective JAK2 inhibitor, has emerged as a potential therapeutic option for patients who have failed or are intolerant to ruxolitinib. Despite the promising results observed in clinical studies, real-world evidence from the USA and Europe suggests that the efficacy of fedratinib may be less conclusive. We report the characteristics, treatment patterns, and clinical outcomes of patients with myelofibrosis (MF) treated with fedratinib following ruxolitinib failure in Israel’s clinical practice. Methods: This retrospective patient chart review included adults with a physician-reported diagnosis of MF, who initiated fedratinib after discontinuing ruxolitinib. Descriptive analyses characterized patient characteristics, clinical outcomes, and treatment patterns from MF diagnosis through ruxolitinib and fedratinib treatment. Results: We extracted data for 16 eligible patients. Approximately 62.5% of the patients were female, and the median age was 77 (range: 63–85) years. The median duration of ruxolitinib therapy was 17 months (range: 3–84) months. Before the initiation of fedratinib, the median spleen size by palpation was 15.5 cm below the costal margin (range: 4–22 cm). After 3 months the median spleen size was 13 cm below the costal margin (range: 2–21 cm). Only 2 patients showed minimal improvement after 6 months, while 3 patients progressed, and 2 patients showed no change in the spleen size. The spleen response did not improve after 12 months of treatment. At this point, the median spleen size was 19 cm below the costal margin (range: 2–30 cm). Regarding the MF-related symptoms, 43.75% (n = 7) of patients reported some improvement, 37.5% (n = 6) showed no changes, whereas 18.75% (n = 3) of the population complained of worsening. Gastrointestinal toxicity was the most frequent adverse effect of the drug, while 31% of patients died. Conclusion: Our observations showed that in MF patients who have failed to ruxolitinib, the therapeutic value from fedratinib may be modest, especially when exposure time to ruxolitinib was more than 12 months. Early switching from ruxolitinib to fedratinib may yield a better result.
Fear of Dementia among Middle-Aged and Older Adults in Germany
Authors: Meyer Jan-Luca , Buczak-Stec Elzbieta , König Hans-Helmut , Hajek André
Published: September 2024

Introduction: The objective of this study was to clarify the frequency of fear of dementia and the factors associated with it. Methods: Data were taken from a nationally representative sample (n = 4,000; average age was 54.9 years, SD: 8.5 years, age ranges from 40 to 70 years, 49.6% of the respondents were women). Similar to prior research, fear of dementia was quantified using a tool ranging from 1 (no fear of dementia) to 4 (severe fear of dementia). Results: In sum, 19.0% reported no fear of dementia, 34.6% reported a little fear of dementia, 33.8% reported some fear of dementia, and 12.7% reported severe fear of dementia. Regressions showed that greater fear of dementia was significantly associated with being female, being younger, poorer self-rated health, the presence of at least one chronic disease, not living in the same household with a partner or not being in a relationship at all, having depressive symptoms and anxiety symptoms. Conclusion: Study findings showed that fear of dementia is particularly associated with health-related factors, age and gender. Lifestyle factors and other socioeconomic factors were only occasionally significant. Future research should explore the reasons for such a higher frequency of people’s fear of dementia. It would also be interesting to find out new factors associated with the fear of dementia. Furthermore, further research could focus on cross-country comparisons and could stratify the results by important groups, e.g., by sex or education, but also cultural and ethnic aspects.
Beneficial Effect of Integrated Nutritional Interventions in Patients with Hematological Diseases Undergoing Hematopoietic Stem Cell Transplant
Authors: Geng Mimi , Sun Zihui
Published: September 2024

Introduction: The nutritional status of patients undergoing hematopoietic stem cell transplantation (HSCT) is critically important. This study aimed to assess the impact of comprehensive nutritional interventions on the well-being of individuals with hematological diseases who underwent HSCT. Methods: A total of 175 patients with hematological diseases who underwent HSCT were included, with 94 in the control group and 81 in the research group. Patients in the control group received standard nursing care, while those in the research group underwent integrated nutritional interventions. Nutritional status was evaluated using the mini nutritional assessment (MNA) and subjective global assessment (SGA), along with body measurements and serum levels of albumin, prealbumin, and hemoglobin. Results: There were no significant differences in the proportion of malnourished patients evaluated by MNA or SGA between the control and research groups at admission. However, at discharge and 3 months of post-discharge, fewer patients in the research group were malnourished compared to the control group, as assessed by both MNA and SGA. At admission, there were no significant differences in albumin, prealbumin, hemoglobin levels, weight, calf circumference (CC), triceps skinfold thickness (TSF), or subscapular skinfold thickness (SSF) between groups. However, at discharge and 3 months of post-discharge, the levels of these indicators significantly decreased compared to those upon admission. Levels of albumin, prealbumin, and hemoglobin, as well as weight, CC, TSF, and SSF, were significantly higher in the research group than in the control group at both discharge and 3 months of post-discharge. Conclusion: HSCT led to a decline in nutritional status among patients with hematological diseases, but integrated nutritional interventions effectively improved their nutritional status.
Depth of Radiographic Response as an Independent Prognostic Factor for Patients with Initially Unresectable Hepatocellular Carcinoma Receiving Hepatectomy following Targeted Therapy plus Immunotherapy
Authors: Xu Bin , Wang Lu-Na , Wang Zi-Yi , He Tian , Zhu Xiao-Dong , Shen Ying-Hao , Zhou Jian , Fan Jia , Sun Hui-Chuan , Huang Cheng
Published: September 2024

Introduction: Surgical resection following systemic therapy is feasible in patients with initially unresectable hepatocellular carcinoma (HCC). However, postoperative tumor recurrence is common after surgery, and the factors affecting this recurrence remain unclear. This study aimed to assess factors influencing postoperative outcomes in patients with initially unresectable HCC undergoing hepatectomy after systemic therapy. Methods: This study retrospectively enrolled patients with initially unresectable HCC who underwent hepatectomy after targeted therapy plus immunotherapy (with or without locoregional therapy). Multivariate Cox regression analyses were used to identify the independent prognostic factors for recurrence-free survival (RFS) and overall survival (OS). Machine learning was used to determine the RFS rates at different intervals for different radiographic responses. Results: Eighty-one patients who underwent R0 hepatectomy after systemic therapy were included. With a median follow-up of 17.4 (interquartile range: 7.2–22.3) months, median RFS and OS were not reached. Preoperative tumor downstaging and achieving pathological complete response were associated with improved RFS and OS. Multivariate Cox analyses identified radiographic response as an independent prognostic factor for RFS and OS. Furthermore, a radiographic response >40% (assessed using the Response Evaluation Criteria in Solid Tumors, version 1.1) or >50% (assessed using the modified Response Evaluation Criteria in Solid Tumors) was associated with a longer RFS (p = 0.006 and 0.003, respectively). Conclusion: Radiographic response depth was an independent prognostic factor in patients with initially unresectable HCC who underwent hepatectomy following targeted therapy plus immunotherapy, and the response to systemic therapy may be the determining factor for patient prognosis after surgery.
Treatment of Neuropsychiatric Symptoms in Alzheimer’s Disease with a Cannabis-Based Magistral Formulation: An Open-Label Prospective Cohort Study
Authors: Navarro Cristian E. , Pérez Juan C.
Published: September 2024

Introduction: Neuropsychiatric symptoms (NPS) may be disruptive and problematic for patients with Alzheimer’s disease (AD) and for their caregivers. Cannabidiol (CBD) may be a safer alternative. The objective was to evaluate whether CBD-rich oil was effective, and safe in adults with NPS secondary to AD. Methods: An open-label, prospective cohort, single-center study in patients with AD onset after the age of 65 with untreated NPS. A CBD-rich oil was administrated 0.1 mL sublingually every 8–12 h, up-titrated weekly. The primary outcome was to establish a reduction in the NPI-Q severity score of >30% at 12 weeks compared with the baseline. A p value of <0.05 was statistically significant. Results: Between July 2020 and July 2023, 59 (93.5%) patients completed ≥3 months of follow-up. The patients were under treatment for a mean of 23.2 months, the median dose of CBD was 111 mg/day. The median NPI-Q severity and caregiver’s distress scores at baseline were 24 and 29, respectively. At 3 months, the median NPI-Q severity score shifted to 12 (p < 0.001) and 14 (p < 0.001), respectively. The proportion of patients who achieved a reduction in the NPI-Q severity score of >30% was 94.9%, while a reduction of >50% was achieved by 54.2%. The improvement was maintained for up to 24 months. Conclusion: This study shows that CBD-rich oil is an effective and safe therapy for treating NPS in AD patients, while also reducing the caregivers’ distress.
Unilateral Neck Treatment with either Surgery and/or Radiotherapy for Squamous Cell Carcinoma for the Tonsil
Authors: Razavian Niema B. , Waltonen Joshua D. , Steber Cole R. , Shenker Rachel F. , May Nelson H. , Yang Jae H. , Lanier Claire M. , Greven Kathryn M. , Frizzell Bart A. , Hughes Ryan T.
Published: September 2024

Introduction: Strategies for treatment of tonsil carcinoma are under active investigation. Limiting surgical and radiation treatment volumes to the primary tumor and ipsilateral neck in appropriately selected patients are one such approach. Here, we present our institutional experience with treatment through ipsilateral surgical or radiotherapeutic neck management. Methods: We retrospectively reviewed our institutional database of patients with tonsil carcinoma treated from 2012 to 2020. Patients were included for analysis if they received definitive radiation therapy (RT), definitive surgery (S), or surgery with postoperative radiation therapy (S-PORT) and whose treatment volumes were limited to the primary tumor and involved/elective ipsilateral neck. Patients who received radiation and/or surgery to the contralateral neck (including those with bilateral nodal involvement), as well as patients with metastatic disease, were excluded. Clinical factors including T- and N-stage (AJCC 7th edition), and HPV status (by p16 and/or HPV DNA PCR) were recorded, as were pathologic factors (when applicable) including margin status, extracapsular extension (ECE), lymphovascular invasion (LVSI), and perineural invasion (PNI). Overall survival (OS), progression-free survival (PFS), and locoregional control (LRC) at 2 years were estimated using the Kaplan-Meier method. Results: In total, 71 patients were treated with unilateral neck approaches: S (n = 49), RT (n = 10), and S+PORT (n = 12). Among these patients, 32, 36, and 3 had T1, T2, and T3 disease, respectively. N-stage was N0, N1, N2a, N2b, and N3 in 22, 20, 5, 23, and 1 patient(s), respectively. Concurrent chemotherapy was administered in 12 patients. From those with recorded risk factors, 86% were HPV positive, 20% had LVSI, 7% had PNI, 13% had ECE, and 5% had positive margins. From a median follow-up of 27 months, local, regional, and distant failures occurred in 5, 6, and 5 patients, respectively. No contralateral neck failures were recorded. At 2 years, OS, PFS, and LRC were 92% (95% CI 85–99%), 85% (95% CI 75–95%), and 88% (95% CI 80–98%), respectively. Conclusions: In patients with early T-stage tonsil carcinoma, treatment of the primary tumor and ipsilateral neck is associated with acceptable OS, PFS, and LRC. In this population, the risk of contralateral neck failure is likely very low regardless of primary treatment modality. Additional prospective studies are needed to determine the impact of limiting treatment extent, either surgical or radiotherapeutic, to the unilateral neck.
Tools for Assessing Quality of Life in People with Stroke-Induced Aphasia: A Literature Review
Authors: Babaei Zahra , Yadegari Fariba
Published: September 2024

Background: The quality of life (QOL) of individuals with stroke-induced aphasia is significantly impacted by the condition. Clinicians and researchers are increasingly focusing on QOL assessments for people with aphasia (PWA) to gauge the effects of aphasia and the effectiveness of interventions. While several QOL assessment tools are utilized for PWA, there is limited literature comparing and evaluating their suitability for this population. This review aimed to explore the QOL measurement tools used with PWA, their aphasia-friendly characteristics, their applicability to severe aphasia, and the technical aspects of these questionnaires. Summary: The review process involved two stages. Initially, a search was conducted to identify the tools used for assessing the QOL of PWA in studies published between 1975 and 2022. Various databases such as Google Scholar, PubMed, Scopus, and Web of Science were searched using specific keywords related to stroke, aphasia, QOL, questionnaires, outcome measurements, tools, scales, and instruments. Subsequently, hand searching was employed to gather additional information on the identified tools, including technical properties, communication and language domains, and crucial factors for QOL assessment in PWA. Results revealed that 28 articles met the inclusion criteria, identifying 26 tools for QOL assessment in PWA, comprising 11 generic, 9 stroke-specific, and 6 aphasia-specific tools. Technical details such as research country distribution, publication years (ranging from 1972 to 2015), completion time, administration methods (self-reporting), item formats (question or statement), response types (all tools, except SIP-136, NHP, and SA-SIP30 used Likert type scale for ratings), scoring methods (sum of score or using an algorithm), translation/adaptation status (EQ-5D-3L among generic tools, SIS-16 among stroke-specific questionnaires, and SAQOL-39 among aphasia-specific instruments received the most amount of translation/adaptation), respondent characteristics (almost all the tools except aphasia-specific tests excluded people with severe aphasia), number of dimensions (ranged 1–12), item numbers [6–136], and coverage of communication/language domains (BOSS, CDP, ALA, AIQ-21 covered all language domains) were analyzed. Notably, ALA emerged as the most suitable tool for assessing QOL in PWA due to its alignment with the desired features. Key Messages: Based on the review findings, clinicians and researchers are advised to prioritize the following features when selecting a QOL questionnaire for PWA: aphasia-specific and aphasia-friendly design, comprehensive coverage of QOL dimensions, inclusion of all language domains, and provision of self-reporting opportunities for PWA across all severity levels. ALA stands out as the preferred tool for QOL assessment in PWA based on its adherence to these criteria.
Transamniotic Delivery of Surfactant Protein B mRNA in a Healthy Model
Authors: Moskowitzova Kamila , Naus Abbie E. , Dang Tanya T. , Zurakowski David , Fauza Dario O.
Published: September 2024

Introduction: We sought to determine whether exogenous surfactant protein B (SPB) mRNA could be incorporated and translated by the fetal lung after simple transamniotic administration. Methods: Fetuses (n = 149) of twelve time-dated dams underwent intra-amniotic injections of either human SPB (hSPB) mRNA encapsulated into lipopolyplex (mRNA, n = 99) or lipopolyplex without mRNA (control; n = 50) on gestational day 17 (E17, term = E21–22). Lungs were screened for hSPB by enzyme-linked immunosorbent assay daily until term. Phosphatidylcholine (PC) (a surrogate for surfactant production) was measured in the amniotic fluid by fluorometric assay. Statistical analysis included nonparametric Wilcoxon rank sum test. Results: Significantly improved survival in the mRNA group compared to controls was observed at E18 (100% vs. 85.7%) and E20 (100% vs. 83.3%) (both p < 0.001). When controlled by mRNA-free injections, hSPB protein was detected in the mRNA group’s lungs at E18, 19, and term (p = 0.002 to <0.001). Amniotic fluid PC levels were increased compared to control at term [285.9 (251.1, 363.9) μM versus 263.1 (222.8, 309.1) μM]; however, this did not reach significance (p = 0.33). Conclusions: Encapsulated exogenous SPB mRNA can be incorporated and translated by fetal lung cells following intra-amniotic injection in a healthy rat model. Transamniotic mRNA delivery could become a novel strategy for perinatal surfactant protein replacement.
Trisomy 21 and Congenital Heart Disease: Impact on Health and Functional Outcomes From Birth Through Adolescence: A Scientific Statement From the American Heart Association
Authors: Peterson Jennifer K. , Clarke Shanelle , Gelb Bruce D. , Kasparian Nadine A. , Kazazian Vanna , Pieciak Karyn , Pike Nancy A. , Setty Shaun P. , Uveges Melissa K. , Rudd Nancy A. ,   the American Heart Association Pediatric Cardiovascular Nursing Committee of the Council on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology; Council on Genomic and Precision Medicine; and Council on Cardiovascular Radiology and Intervention
Published: September 2024

Due to improvements in recognition and management of their multisystem disease, the long‐term survival of infants, children, and adolescents with trisomy 21 and congenital heart disease now matches children with congenital heart disease and no genetic condition in many scenarios. Although this improved survival is a triumph, individuals with trisomy 21 and congenital heart disease have unique and complex care needs in the domains of physical, developmental, and psychosocial health, which affect functional status and quality of life. Pulmonary hypertension and single ventricle heart disease are 2 known cardiovascular conditions that reduce life expectancy in individuals with trisomy 21. Multisystem involvement with respiratory, endocrine, gastrointestinal, hematological, neurological, and sensory systems can interact with cardiovascular health concerns to amplify adverse effects. Neurodevelopmental, psychological, and functional challenges can also affect quality of life. A highly coordinated interdisciplinary care team model, or medical home, can help address these complex and interactive conditions from infancy through the transition to adult care settings. The purpose of this Scientific Statement is to identify ongoing cardiovascular and multisystem, developmental, and psychosocial health concerns for children with trisomy 21 and congenital heart disease from birth through adolescence and to provide a framework for monitoring and management to optimize quality of life and functional status.
Dotless Arabic Text for Natural Language Processing
Authors: Al-Shaibani Maged S. , Ahmad Irfan
Published: September 2024

This article introduces a novel representation of Arabic text as an alternative approach for Arabic NLP, inspired by the dotless script of ancient Arabic. We explored this representation through extensive analysis on various text corpora, differing in size and domain, and tokenized using multiple tokenization techniques. Furthermore, we examined the information density of this representation and compared it with the standard dotted Arabic text using text entropy analysis. Utilizing parallel corpora, we also drew comparisons between Arabic and English text analysis to gain additional insights. Our investigation extended to various upstream and downstream NLP tasks, including language modeling, text classification, sequence labeling, and machine translation, examining the implications of both the representations. Specifically, we performed seven different downstream tasks using various tokenization schemes comparing the standard dotted text with dotless Arabic text representations. Performance using both the representations were comparable across different tokenizations. However, dotless representation achieves these results with significant reduction in vocabulary sizes, and in some scenarios showing reduction of up to 50%. Additionally, we present a system that restores dots to the dotless Arabic text. This system is useful for tasks that require Arabic texts as output.
What’s in a Name: The Fulfillment Metaphor in Biblical Hebrew
Authors: Branton Emily
Published: September 2024

English speakers habitually imagine and describe words as conduits through which ideas are communicated—a cognitive framework known as the “Conduit Metaphor.” Expressions of this metaphor represent words as “full” or “empty” of information or emotions. In Biblical Hebrew, however, when utterances are described as “empty” they are inefficacious, and when they are “filled” they are enacted: a metaphorical model this article describes as the “Fulfillment Metaphor.” This juxtaposition between cognitive metaphorical models reveals a more fundamental difference in how ancient Israelite and Judean authors imagined the phenomenon of speech. This difference was recognized by earlier scholarship, though these analyses were subsequently challenged on methodological grounds. In addition to introducing and describing the function of the “fulfillment metaphor” in Biblical Hebrew, this article argues that Conceptual Metaphor Theory can be used not only to describe metaphorical models within the Hebrew Bible, but also as a critical and comparative philological tool.
Exploratory analysis of the genetic diversity for two Phyllodactylus species in contrasting environments
Authors: Ramírez-Reyes Tonatiuh
Published: September 2024

Historically, the genetic diversity of insular species and populations has generally been considered to be lower with respect to their continental counterparts. In this study, I compare for first time the genetic diversity of two gecko species, Phyllodactylus angelensis and P. magnus, that inhabit contrasting environments in Mexico (island and mainland, respectively). Utilizing genomic data for both species generated through genotyping by sequencing (GBS), I performed paired comparisons of various genetic diversity indices analyzing thousands of single nucleotide polymorphism (SNP) variants. The majority of genetic diversity indices demonstrated very similar values between both species, while the observed heterozygosity and genetic diversity within populations was higher for the insular species. The results do not support the generalized assumption of lower genetic diversity in island species. Key aspects such as the effective population size of founders, gene flow, and shared life histories may be involved in explaining the observed pattern.
The Social, Educational, and Early Military Backgrounds of Senior Officers of the British Army of the Second World War, 1944–1945
Authors: Frost Mark Richard
Published: September 2024

Seventy-eight officers held senior command positions at army, corps, and divisional level in Britain’s three main field armies – the Second (North-West Europe), Eighth (Italy), and Fourteenth (Burma) – at the end of the Second World War. Using a range of source material, including their private papers, this article examines their socio-economic and family background, education, and early career development and finds that as a group, they were more representative of the middling classes than heretofore depicted. They were also far more diverse in education and place of birth: twenty-one were born outside Britain. As this article argues, the make-up of the three armies also differed, suggesting the formation of a more elite, home-grown, ‘first team’ for service with the Second Army in North-West Europe.
Lectotypification of Aongstroemia rufipes, a new synonym of Dicranella campylophylla (Dicranaceae, Bryophyta)
Authors: SUÁREZ GUILLERMO M. , LARRAÍN JUAN , HENTSCHEL JÖRN
Published: September 2024

N/A
Garra dohjei, a new species of labeonine fish (Teleostei: Cyprinidae) from Meghalaya, India
Authors: MARNGAR IBANSIEWDOR , MAWLONG BATNGENLANG , LOKESHWOR YUMNAM
Published: September 2024

Garra dohjei, a new labeonine fish with transverse lobe and incipient proboscis is described from the Ñiangdai, a tributary of the Brahmaputra River, Meghalaya, India. The new species is distinguished from its congeners with transverse lobe and incipient proboscis, in having a well-developed transverse lobe with around 9–12 minute tubercles, deep transverse groove between transverse lobe and incipient proboscis, black spot immediately anterior to upper angle of gill opening, 5–6 dark black stripes on caudal peduncle, 33–35 lateral line scales, 9–10 predorsal scales, 16–circumpeduncular scales, 15 branched pectoral-fin rays, and total vertebrae 33.
Chapter 4
Authors: Rudy Kathryn M.
Published: September 2024

Late-medieval courtiers had a voracious appetite for literature and commissioned works that ranged from historical and religious narratives to romantic and didactic literature. They especially had a taste for rhyming texts, which they patronized and performed. This literature, including the chivalric tales and the "Mirror for Princes" guides to statecraft, not only provided entertainment but also served to affirm the identity and legitimacy of the nobility.

The chapter treats a few examples in depth, including a copy of Gautier de Coinci's "Miracles of Our Lady" manuscript, which was read aloud in court. Marks of wear on the folios reveal that the recitations were accompanied by the physical interaction with images. The manuscript reveals how performance, which involved touching and gesturing to the illuminations, enhanced audience engagement, thereby merging visual art with storytelling.

The chapter further explores the shift from Latin to vernacular literature, the versification of prose, and the implications for literacy and the use of manuscripts beyond ecclesiastical or administrative contexts. It discusses the transition from silent, solitary reading to the auditory experience of public readings, contrasting scholarly debates on this shift and presenting evidence of performance practices, such as the use of prolectors.

Ultimately, the chapter underscores how courtly life was reflected and shaped by its literature, with manuscripts functioning as performative objects that engaged audiences and readers in a shared cultural and educational experience. The chapter concludes by suggesting that this interaction with texts and images was not just for entertainment but also a part of the court's ritualistic and moral instruction.
Improved Sea Level Reconstruction from 1900 to 2019
Authors: Wang Jinping , Church John A. , Zhang Xuebin , Chen Xianyao
Published: September 2024

Before the satellite era, global sea level reconstructions depended on tide gauge records and in situ hydrographic observations. However, the available global mean sea level (GMSL) reconstructions, using different methods, indicate a spread in sea level trend over 1900–2008 (1.3 ∼ 2.0 mm yr−1). With better understanding of the causes of sea level change, here we implement an improved sea level reconstruction, building upon previous work by Church and White, and include three additional factors: the sea level fingerprints, the sterodynamic sea level (SDSL) climate change patterns, and more complete local vertical land motion (VLM) estimates. The trend of new GMSL reconstruction is 1.6 ± 0.2 mm yr−1 (90% confidence level) over 1900–2019, consistent with the sum of observation-based sea level contributions of 1.5 ± 0.2 mm yr−1. The lower trend from the new reconstruction compared with the earlier Church and White result is mainly due to the updated VLM correction. The inclusion of sea level fingerprints and SDSL climate change patterns are the dominant contributors for the improved skill of regional reconstruction. Despite GMSL budget closure in terms of long-term trend since 1900, our study shows discrepancies between the trends from available GMSL reconstructions and the sum of independent observation-based contributions over different periods in the twentieth century, e.g., the discrepancy at the beginning of the twentieth century, which could be related to possible bias in the land ice component estimate. The reconstruction methodology developed here, as tested with synthetic sea level fields, could provide a promising way to identify potential biases in the individual sea level components constrained by available global tide gauge observations.
Observation Definitions and Their Implications in Machine Learning–Based Predictions of Excessive Rainfall
Authors: Hill Aaron J. , Schumacher Russ S. , Green Mitchell L.
Published: September 2024

The implications of definitions of excessive rainfall observations on machine learning model forecast skill are assessed using the Colorado State University Machine Learning Probabilities (CSU-MLP) forecast system. The CSU-MLP uses historical observations along with reforecasts from a global ensemble to train random forests to probabilistically predict excessive rainfall events. Here, random forest models are trained using two distinct rainfall datasets, one that is composed of fixed-frequency (FF) average recurrence intervals exceedances and flash flood reports and the other a compilation of flooding and rainfall proxies [Unified Flood Verification System (UFVS)]. Both models generate 1–3-day forecasts and are evaluated against a climatological baseline to characterize their overall skill as a function of lead time, season, and region. Model comparisons suggest that regional frequencies in excessive rainfall observations contribute to when and where the ML models issue forecasts and subsequently their skill and reliability. Additionally, the spatiotemporal distribution of observations has implications for ML model training requirements, notably, how long of an observational record is needed to obtain skillful forecasts. Experiments reveal that shorter-trained UFVS-based models can be as skillful as longer-trained FF-based models. In essence, the UFVS dataset exhibits a more robust characterization of excessive rainfall and impacts, and machine learning models trained on more representative datasets of meteorological hazards may not require as extensive training to generate skillful forecasts.

Significance Statement

Machine learning (ML) models have shown significant promise in recent years when used to predict high-impact weather hazards. Here, we explore two similarly trained ML models tasked with predicting excessive rainfall, but they use datasets that define excessive rainfall differently. We explore how definitions of excessive rainfall, for example, an amount of rainfall that would be expected to fall once per year, contribute to forecast skill through where these observations are reported. Generally, we find that the two models have substantial skill relative to climatology out to 3 days, but skill varies by geographical region and season in part because of the distribution of observations geographically. These results suggest that careful attention should be paid to how ML models are trained to predict meteorological hazards like excessive rainfall.
The preliminary study of delta checks for immunoglobulins and complements in the clinical laboratory
Authors: Gong Xiangmei , He Shukang , Luo Li , Ding Chunyu , Qin Xin , Yuan Yilong , Cai Pengcheng , Yang Lihua
Published: September 2024

Background

To determine delta check limits for immunoglobulins and complements in outpatients and inpatients based on patient data and biological variation due to the lack of relevant studies.

Methods

Patient data for IgA, IgG, IgM, IgE, C3, and C4 from 1 January 2022 to 31 December 2023 was collected from laboratory information system (LIS) in our clinical laboratory of Wuhan Union Hospital, which includes both outpatients and inpatients. The delta difference (DD), delta percent change (DPC), and reference change value (RCV) were calculated based on patient data and biological variation.

Results

For DDs, there are significant differences between outpatients and inpatients in C4, IgE, IgG, and IgM. For DPCs, the corresponding analytes which are significantly different are C3, C4, IgE, IgG, and IgM. Two sources of CVI to calculate the RCV of IgA, IgG, IgM, C3, and C4 were applied in this study, which revealed that two kinds of RCVs based on different biological variation databases are similar to each other, but both were smaller than delta check limits based on patient data, except for C4.

Conclusions

The delta check is a useful tool to monitor potential errors which may occur in total testing process. We hope our findings could be helpful for future studies focused on delta checks in immunological analytes.
Reappraising a Parent can Occur With Non-suggestive Questions: Changing Emotions and Memories of Emotion
Authors: Patihis Lawrence , Herrera Mario E.
Published: September 2024

Whether it is possible to reappraise parents using non-suggestive questions, and whether this has an impact on emotions and memories, is of great interest in both life and psychotherapy. Past research has shown reappraisals of past situations is associated with changes in memories of emotions. In previous work we showed memories of love could be affected by reappraisals, but did not analyze that dataset on other memories of emotion. The current paper investigates the effect of reappraisals toward participants’ mothers on the emotions: happiness, interest, sadness, and anger (and on memories of those emotions in childhood). Results show that emotions appeared to be significantly changed by reappraisals. In Experiment 1 ( N = 301; Mage = 36), we found memories of emotion were affected, especially memory of happiness in childhood, but to a lesser degree compared to current emotions. This offered some confirmation of the cognitive appraisal view of memories of emotions. Experiment 2 ( N = 202; Mage = 36) with pretest and posttest measures showed some similar patterns, but with slightly muted effects. Therapists and clients should be aware that non-suggestive prompts might lead to reappraisals of parents, with knock on effects on emotions and memories. Whether this should be part of informed consent in therapy is open to debate.
The impact of the Cochlear™ Osia® 2 System on patients with mixed or conductive hearing loss: A comparison with Cochlear™ Baha® Attract System outcomes
Authors: Park Kyeong-Suk , Kim Hong-Chan , Lee Sungsu , Cho Hyong-Ho
Published: September 2024

Objective

This prospective study assessed the efficacy of the Cochlear™ Osia® 2 System compared to the previous Baha® Attract System in patients with mixed or conductive hearing loss (MHL/CHL).

Methods

In this prospective case-control study, 10 patients (2 men and 8 women) with MHL/CHL were implanted with the Osia® 2 System. Their audiological outcomes were compared with 13 patients (2 men and 11 women) who had previously been implanted with the transcutaneous Baha® Attract system. We compared the complications and compliance of the two groups. Also, in the Osia 2 System group, subjective satisfaction was assessed using the Korean version of the International Outcome Inventory for Hearing Aids (K-IOI-HA) questionnaire and the Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire.

Results

Complications such as poor magnetization, pain & infection, and abnormal noise were more common in the Baha Attract group, although not statistically significant. Also, the Osia 2 group exhibited better compliance. Subjective satisfaction was assessed using the K-IOI-HA and APHAB questionnaires with the Osia 2 group, revealing significantly improved scores in ease of communication, reverberation, background noise, and higher K-IOI-HA scores post-implantation. Postoperative-aided thresholds with both systems were significantly lower than preoperative-unaided thresholds, with the Osia 2 System demonstrating notably high satisfaction levels. Although both systems showed similar preoperative and postoperative word-recognition scores, the Osia 2 System provided greater audiological gain, especially at 2 kHz and 4 kHz frequencies. Additionally, the functional gain of both systems was comparable across all frequencies.

Conclusions

The Osia 2 System demonstrated high subjective satisfaction and improved audiological outcomes compared to the Baha Attract system in patients with conductive or mixed hearing loss. Its superior audiological gain, particularly at critical frequencies, along with better compliance, suggests it as a favorable option for this patient population.
A prediction method and its application for twist of slub yarn based on micro-element yarn
Authors: Wu Shifeng , Yu Chongwen , Zhang Xiaoye , Zhou Hengshu , Luo Fengxiang , Xu Qiaoli
Published: September 2024

In the authors’ previous work, slub yarn was simulated by randomly determining the fiber position with the Monte Carlo method according to the draft principle of ring-spun slub yarn. In this paper, the total torque of each micro-element yarn was calculated by considering the contribution of fiber bending, twisting and stretching to the torque of yarn body. The micro-element yarn is a regular ring-spun yarn. The twist of each micro-element yarn can be calculated according to the equal torque between micro-element yarns and the conservation law of twists. The twist curve along the yarn axis also can be obtained. The simulation values of the slub twist and base twist can be obtained by calculating the average twist of the slub apparent segment and that of the base apparent segment, respectively. The twist angle and diameters of the slub and base apparent segments of the spun slub yarn were measured using scanning electron microscopy images, enabling determination of the measured values for both slub twist and base twist. The average error rate of the simulated value compared with the measured value for slub twist was 7.654%, while for base twist, it was 7.745%. The relationships between slub length, base length, slub multiple, design twist, and both slub twist and base twist were investigated. The correlation coefficient ( R) of the simulated and measured values was generally above 0.9, and the trend of the two was consistent. The work presented in this paper provides a basis for the development of virtual spinning technology.
Consensus tracking control for nonlinear second-order multi-agent systems with input magnitude and rate constraints
Authors: Liu Weimin , Ji Ning , Xu Feng , Zhao Yandong , Xia Yuanqing , Liu Jinkun
Published: September 2024

In this study, consensus tracking control is considered for a class of nonlinear second-order multi-agent systems in an undirected communication topology subject to input magnitude and rate constraints (MRCs). Initially, the control inputs are designed directly using the smooth hyperbolic tangent function. Subsequently, some auxiliary signals are developed to guarantee input rate constraints simultaneously. By employing the backstepping method, the proposed control scheme can ensure uniform ultimate boundedness of the closed-loop system, and the consensus tracking error of each agent can converge to a small neighborhood near zero. Finally, the single-link robot manipulator multi-agent system model is used to perform numerical simulations to demonstrate the control effect further.
The evolving role of the modern perfusionist: Insights from processed electro-encephalography
Authors: Bouchez Stefaan , Gruenbaum Benjamin F , Van Vaerenbergh Geert , De Somer Filip
Published: September 2024

Introduction: Since its origin in the 1920s, electroencephalography (EEG) has become a viable option for anesthesia and perfusion teams to monitor anesthetic delivery, optimizing drug dosage and enhancing patient safety. Patients undergoing cardiopulmonary bypass (CPB) are at particular high risk for excessive or inadequate anesthetic doses. During CPB, traditional physiological indicators such as heart rate and blood pressure can be significantly altered. These abnormalities are compounded by rapid changes in anesthetic concentration from hemodilution, circuit absorption, and altered pharmacokinetics. Method: This narrative highlights the use of processed EEG with spectral analysis for anesthetic management during CPB. Conclusion: We emphasize that neuromonitoring using processed EEG during CPB can assess adequacy of anesthesia delivery and monitor for pathologic conditions that can compromise brain function such as inadequate cerebral blood flow, emboli, and seizures. This information is highly valuable for the clinical team including the perfusionist, who regularly diagnose and manage these pathological conditions.
Safety, tolerability and pharmacokinetics of the phosphodiesterase 2 inhibitor BI 474121: An overview of phase I randomized trials in healthy volunteers
Authors: Schaible Jennifer , Scholz Andreas , Goeldner Rainer-Georg , Yamamura Norio
Published: September 2024

Background:

Cognitive impairment associated with schizophrenia predicts poor functional outcomes, but currently no efficacious pharmacotherapies are available.

Aims:

Four phase I trials examined the safety, tolerability and pharmacokinetics of the phosphodiesterase 2 inhibitor BI 474121, along with potential drug–drug interactions.

Methods:

Trial 1 evaluated single rising doses (SRDs) of BI 474121 versus placebo in healthy males. The influence of drug formulation and food on drug bioavailability was also examined. Trial 2 evaluated SRD of BI 474121 versus placebo in healthy Japanese males. Trial 3 evaluated multiple rising doses of BI 474121 in healthy young (with/without midazolam) and elderly (without midazolam) participants versus placebo. Trial 4 investigated interactions between itraconazole and single-dose BI 474121 in healthy males.

Results/Outcomes:

No deaths, serious adverse events (AEs), severe AEs or protocol-specified AEs of special interest were observed. BI 474121 absorbed rapidly during fasting, achieved maximum concentration of analyte in plasma and dose proportionality via tablet formulation, and decreased in a multiphasic manner. BI 474121 steady state occurred within 11 days of multiple oral administration. Multiple doses increased BI 474121 plasma concentrations, but did not alter the time course of plasma concentrations. Urinary excretion of unchanged BI 474121 was negligible. No clinically relevant inhibition or induction of CYP3A4 by BI 474121 was observed. Itraconazole co-administration produced higher exposures of BI 474121 versus BI 474121 alone.

Conclusions/Interpretation:

BI 474121 demonstrated favourable safety and pharmacokinetic profiles in healthy Caucasian and Japanese individuals, supporting further clinical development.
Effect of iron ore type on the reduction behavior at multi-stage reduction by H2
Authors: Cho Seongkyu , Rocha Leonardo Tomas Da , Kim Seong-Jin , Kim Dohyeon , Jung Sung-Mo
Published: September 2024

The fluidised bed reduction process is noted as one of the representative clean ironmaking process to replace the blast furnace. Since the multi-stage fluidise bed reduction process operate without sintering, it is necessary to clarify the effect of iron ore properties on the reduction behaviour. The current study employed the thermogravimetric analyses to characterise the four-stage reduction of four kinds of iron ores which are classified by phase of iron oxide and gangue amount. At the first reduction stage where iron ores are reduced to magnetite, iron ore of larger surface area showed higher reduction rate, which is in good agreement with the kinetic analysis results. The diffusion was identified to the rate-controlling step where the pores in the ores acted as channels for hydrogen diffusion into the internal core of the ores. However, the final reduction degrees (RDs) evaluated after four-stage reduction were not correlated with the surface area. The kinetic analyses identified the reduction in wustite to metallic iron to be controlled by chemical reaction. As the amount of SiO2 in the ores increased, the final RDs were relatively smaller. According to X-ray diffraction, it was observed that SiO2 reacted with wustite during reduction to metallic iron to cause the decrease in crystallite size and distortion in the lattice structure of wustite. This was supported by the elemental distribution measured employing electron probe micro-analysis, that is, the area containing Si and Fe in the reduced iron ore expanded as SiO2 amount increased. SiO2 reacted with wustite to form fayalite of low reducibility compared with wustite, which resulted in decreased degree of final reduction. The current study measured that the gangue within the iron ore played a significant role in the reduction of wustite. In addition, different rate-determining steps were identified for each reduction stage, which might be utilised for determining suitable reduction conditions for each stage.