bluuebunny/crossref_metadata_2025 huggingface dataset:
Homonationalism on the Defensive: News Media Responses to Nationalist Anti‐LGBTQ Attacks in Sweden
Authors: Lagerman Julia
Published: October 2023

Examining how gender and sexuality norms are expressed through nationalist ideology, this article argues that homonationalist hegemony is being reinforced through media representations of nationalist social movements attacking LGBTQ people, events, and symbols. The argument builds on a critical discourse analysis of 320 newspaper articles published between 2016 and 2020. The discourses in the material manifest how the neo‐Nazi groups the Nordic Resistance Movement (NRM) and Nordic Youth (NY), as well as the nationalist party Sweden Democrats (SD), have respectively been represented as threats to Swedish national unity in media due to their anti‐LGBTQ attacks or statements. The analysis concludes that nationalism is reproduced through struggles over its symbolic expressions, especially through changing articulations of who belongs to the nation and who constitutes its “Others”. The symbolism of gendered and sexual norms is crucial to these struggles, as the evolvements of homonationalist discourse highlights the struggle to define national unity.
Clinical effectiveness of routine first‐trimester combined screening for pre‐eclampsia in Spain with the addition of placental growth factor
Authors: Garcia‐Manau Pablo , Bonacina Erika , Serrano Berta , Caamiña Sara , Ricart Marta , Lopez‐Quesada Eva , Vives Àngels , Lopez Monica , Pintado Elena , Maroto Anna , Catalan Sara , Dalmau Marta , Del Barco Ester , Hernandez Alina , Miserachs Marta , San Jose Marta , Armengol‐Alsina Mireia , Carreras Elena , Mendoza Manel
Published: October 2023

Introduction

Pre‐eclampsia affects 2%–8% of pregnancies and is one of the leading causes of maternal and perinatal morbidity and mortality. First‐trimester screening using an algorithm that combines maternal characteristics, mean arterial blood pressure, uterine artery pulsatility index and biomarkers (pregnancy‐associated plasma protein‐A and placental growth factor) is the method that achieves a greater diagnostic accuracy. It has been shown that daily salicylic acid administration before 16 weeks in women at a high risk for pre‐eclampsia can reduce the incidence of preterm pre‐eclampsia. However, no previous studies have evaluated the impact of routine first‐trimester combined screening for pre‐eclampsia with placental growth factor after being implemented in the clinical practice.

Material and methods

This was a multicenter cohort study conducted in eight different maternities across Spain. Participants in the reference group were prospectively recruited between October 2015 and September 2017. Participants in the study group were retrospectively recruited between March 2019 and May 2021. Pre‐eclampsia risk was calculated between 11+0 and 13+6 weeks using the Gaussian algorithm combining maternal characteristics, mean arterial pressure, uterine arteries pulsatility index, pregnancy‐associated plasma protein‐A and placental growth factor. Patients with a risk greater than 1/170 were prescribed daily salicylic acid 150 mg until 36 weeks. Patients in the reference group did not receive salicylic acid during gestation.

Results

A significant reduction was observed in preterm pre‐eclampsia (OR 0.47; 95% CI: 0.30–0.73), early‐onset (<34 weeks) pre‐eclampsia (OR 0.35; 95% CI: 0.16–0.77), preterm small for gestational age newborn (OR 0.57; 95% CI: 0.40–0.82), spontaneous preterm birth (OR 0.72; 95% CI: 0.57–0.90), and admission to intensive care unit (OR 0.55; 95% CI: 0.37–0.81). A greater treatment adherence resulted in a significant reduction in adverse outcomes.

Conclusions

Routine first‐trimester screening for pre‐eclampsia with placental growth factor leads to a reduction in preterm pre‐eclampsia and other pregnancy complications. Aspirin treatment compliance has a great impact on the effectiveness of this screening program.
Neurodevelopmental problems, general health and academic achievements in a school‐based cohort of 11‐year‐old Swedish children
Authors: Landgren Valdemar , Svensson Leif , Törnhage Carl‐Johan , Theodosious Michail , Gillberg Christopher , Johnson Mats , Knez Rajna , Landgren Magnus
Published: October 2023

Aim

Assessing rates of neurodevelopmental problems (NDPs) in 11‐year‐old children and possible association with other health complaints and school performance.

Methods

In‐school study of 11‐year‐old children as an add‐on assessment to the 4th grade regular health check‐up, comprising a structured physical neurodevelopmental examination, neuropsychological assessment, behavioural ratings, maternal interview, review of medical records and academic achievements.

Results

Out of 348 children recruited from eight schools, 223 (64%) participated. Any physical condition was found in 102/222 (46%), most commonly atopy (18%). One in five had a BMI z‐score >2 standard deviations over the reference mean. One or more NDP was found in 86/221 (40%) children. The number of failed national tests correlated positively with NDP severity rated with the clinical global impression severity instrument (Spearman's r = 0.41, p < 0.001). The majority of participants with failed national tests, also had co‐occurring health complaints (≥2 of: stomach or extremity ache, headache, difficulties sleeping, internalising symptoms or obesity) and NDPs.

Conclusion

Health complaints, physical conditions and NDPs are very common in 11‐year‐old children and warrant adequately staffed, thoroughly equipped school healthcare services.
China's Leninist State and strategic relations with the United States: Chiang's KMT in Nanjing Decade and implications for the Chinese Communist Party after 1949
Authors: Chen Dean P.
Published: October 2023

This article revisits Chiang Kai‐shek's Kuomintang (KMT) party‐state during the Nanjing Decade (1927–37) of the Republic of China (ROC) and assesses how the actions and ideological propensities of the Nationalist regime affected prewar China's external relations with the United States. While both the KMT and the Chinese Communist Party (CCP) were constituted as Leninist parties in the 1920s, due to the Soviet Union's military and economic aid for Sun Yat‐sen's republican revolution, they had very different political objectives and socioeconomic perspectives on China's state/nation‐building. Consequently, the KMT's and CCP's respective attitudes towards the United States also differed. Though Leninism is an antithesis to Western liberal democracy, it is not inevitable for a Leninist dictatorship to engage in confrontations with Washington, as the central leadership's inclinations and actions would determine how China approaches America. Chiang's Confucian Leninism opened up the friendly ties with the United States in 1928, which eventually consolidated into a strong U.S.‐ROC alliance during WWII and beyond, despite the KMT's autocracy. The essay will contrast briefly with the post‐1949 People's Republic of China (PRC), as the CCP experienced from Mao Zedong's radical Leninism, Deng Xiaoping/Jiang Zemin/Hu Jintao's consultative Leninism, to Xi Jinping's expansionist Leninism today. The evolving CCP positions have also affected the extent of cooperation and hostility between Beijing and Washington and illustrated how the changing attributes of the Chinese Leninist regime are crucial in determining U.S.‐PRC strategic trajectories.
Impact of the geopolitical status quo vis‐à‐vis the Rohingya crisis on the social, economic, and political aspects of Bangladesh
Authors: Zahed Iqthyer Uddin Md
Published: October 2023

The long‐standing Rohingya crisis has become complicated due to geopolitical complexities, and more than a million Rohingya refugees remain stranded in Bangladesh. This situation has had a dramatic impact on Bangladesh. Shortages of international funding exacerbate the situation further, and a regional security threat could be created if the current situation continues unabated. The empirical research undertaken in this paper examines the impact of the Rohingya refugees on the social, economic, and political aspects of Bangladesh from a micro level perspective. This study follows a qualitative research methodology that uses analysis of documents and analytical interpretations of 20 in‐depth interviews from Bangladesh. Environmental destruction and the government's dilemma with controlling law and order are apparent consequences of the Rohingya influx. Competition in the labor market, economic hardships, acquiring land, and deforestation create a conflict between the host community and the Rohingya refugee group. Theoretical and practical implications are discussed.
Small rodent population cycles and plants – after 70 years, where do we go?
Authors: Soininen Eeva M. , Neby Magne
Published: October 2023

Small rodent population cycles characterise northern ecosystems, and the cause of these cycles has been a long‐lasting central topic in ecology, with trophic interactions currently considered the most plausible cause. While some researchers have rejected plant–herbivore interactions as a cause of rodent cycles, others have continued to research their potential roles. Here, we present an overview of whether plants can cause rodent population cycles, dividing this idea into four different hypotheses with different pathways of plant impacts and related assumptions. Our systematic review of the existing literature identified 238 studies from 150 publications. This evidence base covered studies from the temperate biome to the tundra, but the studies were scattered across study systems and only a few specific topics were addressed in a replicated manner. Quantitative effects of rodents on vegetation was the best studied topic, and our evidence base suggests such that such effects may be most pronounced in winter. However, the regrowth of vegetation appears to take place too rapidly to maintain low rodent population densities over several years. The lack of studies prevented assessment of time lags in the qualitative responses of vegetation to rodent herbivory. We conclude that the literature is currently insufficient to discard with confidence any of the four potential hypotheses for plant–rodent cycles discussed herein. While new methods allow analyses of plant quality across more herbivore‐relevant spatial scales than previously possible, we argue that the best way forward to rejecting any of the rodent–plant hypotheses is testing specific predictions of dietary variation. Indeed, all identified hypotheses make explicit assumptions on how rodent diet taxonomic composition and quality will change across the cycle. Passing this bottleneck could help pinpoint where, when, and how plant–herbivore interactions have – or do not have – plausible effects on rodent population dynamics.
Near‐infrared photoimmunotherapy in the models of hepatocellular carcinomas using cetuximab‐IR700
Authors: Takao Seiichiro , Fukushima Hiroshi , King A. Paden , Kato Takuya , Furusawa Aki , Okuyama Shuhei , Kano Makoto , Choyke Peter L. , Escorcia Freddy E. , Kobayashi Hisataka
Published: October 2023

Epidermal growth factor receptor (EGFR) has emerged as an important therapeutic target in many cancers, and overexpression of EGFR is frequently observed in hepatocellular carcinomas (HCCs). Near‐infrared photoimmunotherapy (NIR‐PIT) is a new anticancer treatment that selectively damages the cell membrane of cancer cells after NIR light‐induced photochemical reaction of IR700, which is bound to a targeting antibody on the cell membrane. NIR‐PIT using cetuximab‐IR700 has already been approved in Japan, is under review by the US Food and Drug Administration (FDA) for advanced head and neck cancers, and its safety has been established. However, EGFR has not been investigated as a target in NIR‐PIT in HCCs. Here, we investigate the application of NIR‐PIT using cetuximab‐IR700 to HCCs using xenograft mouse models of EGFR‐expressing HCC cell lines, Hep3B, HuH‐7, and SNU‐449. In vitro NIR‐PIT using EGFR‐targeted cetuximab‐IR700 killed cells in a NIR light dose‐dependent manner. In vivo NIR‐PIT resulted in a delayed growth compared with untreated controls. In addition, in vivo NIR‐PIT in both models showed histological signs of cancer cell damage, such as cytoplasmic vacuolation and nuclear dysmorphism. A significant decrease in Ki‐67 positivity was also observed after NIR‐PIT, indicating decreased cancer cell proliferation. This study suggests that NIR‐PIT using cetuximab‐IR700 has potential for the treatment of EGFR‐expressing HCCs.
A tale of two Youth Expert Groups (YEGs): Learnings from youth activism in research in India and Brazil
Authors: Krishnamurthy Sukanya , Chan Loritta , Powell Mary Ann , Tisdall E. Kay M. , Rizzini Irene , Nuggehalli Roshni K. , Tauro Alicia , Palavalli Bharath
Published: October 2023

This paper explores how research advisory groups can be a vehicle for youth activism. It draws on our experiences with young activists, aged 15–26 years, in India and Brazil, who were advisors on a research project focused on youth livelihoods in cities. These young people played a vital role in supporting youth researchers, identifying research themes and developing engagement and advocacy strategies. Through this paper, we explore how the Youth Expert Group advisory model evolved differently in each location and examine how these were shaped by the context, the ‘adult’ research team and the youth activists themselves. A critically reflexive response in intergenerational partnership is essential to support youth activists in research activities.
Clinical accuracy of partially guided implant placement in edentulous patients: A computed tomography‐based retrospective study
Authors: Wang Baixiang , Yang Jiakang , Siow Lixuen , Wang Yu , Zhang Xinyue , Zhou Yiqun , Yu Mengfei , Wang Huiming
Published: October 2023

Objectives

This retrospective study was intended to evaluate the clinical accuracy of partially guided template in guiding implant placement in edentulous patients.

Methods

A total of 120 implants were placed in 24 patients with at least one completely edentulous arch with a partially guided system. Based on CBCT data, a repeatable method was used to measure linear and angular deviations of implants at 3D level in Mimics medical software. The influence of supporting tissue and implant region on the accuracy was assessed, followed by the evaluation of direction of linear deviations in biologically vital areas.

Results

Linear deviations of all implants were 1.91 ± 0.68 mm, 1.47 ± 0.68 mm, and 1.02 ± 0.69 mm at apical, apical lateral, and apical vertical levels. When at the cervical, cervical lateral, and cervical vertical levels, the linear deviations were 1.53 ± 0.65 mm, 0.98 ± 0.53 mm, and 1.01 ± 0.69 mm, respectively. Angular deviation of all implants was 7.14 ± 3.41°. Implants guided by mucosa + tooth‐supported templates showed higher linear deviations at apical vertical level (1.21 ± 0.72 mm vs. 0.86 ± 0.63 mm, p < .05) and cervical vertical level (1.18 ± 0.72 mm vs. 0.87 ± 0.63 mm, p < .05) than mucosa‐supported templates, and implants in maxilla were found higher angular deviation than mandible (7.89 ± 3.61° vs. 6.29 ± 2.97°, p < .05).

Conclusions

The partially guided template served as clinically viable surgical assistance in implant placement in edentulous patients. When using mucosa + tooth‐supported template or placing implants in maxilla, more caution was required, especially in biologically vital areas.
Invasion trends: An interpretable measure of change is needed to support policy targets
Authors: McGeoch Melodie A. , Buba Yehezkel , Arlé Eduardo , Belmaker Jonathan , Clarke David A. , Jetz Walter , Li Richard , Seebens Hanno , Essl Franz , Groom Quentin , García‐Berthou Emili , Lenzner Bernd , Meyer Carsten , Vicente Joana R. , Wilson John R. U. , Winter Marten
Published: October 2023

The Kunming‐Montreal Global Biodiversity Framework (GBF) calls for a 50% reduction in rates of invasive alien species establishment by 2030. However, estimating changes in rates of introduction and establishment is far from straightforward, particularly on a national scale. Variation in survey effort over time, the absence of data on survey effort, and aspects of the invasion process itself interact in ways that make rate estimates from naive models of invasion trends inaccurate. To support progress toward robust global and national reporting against the GBF invasions target, we illustrate this problem using a combination of simulations, and global and national scale case studies. We provide recommendations and a clear set of steps that are needed for progress. These include routine collection of survey effort data as part of surveillance and monitoring protocols and working closely with researchers to develop meaningful estimates of change in biological invasions. Better awareness of this challenge and investment in developing robust approaches will be required from Parties if progress on Target 6 of the GBF is to be tracked and achieved.
The efficient generation of functional human hepatocytes from chemically induced pluripotent stem cells
Authors: Lv Yun , Rao Ziyan , Liu Lulu , Jia Jun , Wu Chenyang , Xu Jun , Du Yuanyuan , Liu Yinan , Liu Bei , Shi Jihang , Li Guangya , Zhao Dongyu , Deng Hongkui
Published: October 2023

Derivation of human hepatocytes from pluripotent stem cells in vitro has important applications including cell therapy and drug discovery. However, the differentiation of pluripotent stem cells into hepatocytes in vitro was not well recapitulated the development of liver. Here, we developed a differentiation protocol by mimicking the two‐stage development of hepatoblasts, which permits the efficient generation of hepatic progenitor cells from chemically induced pluripotent stem cells (hCiPSCs). Single‐cell RNA sequencing (scRNA‐seq) indicates the similarity between hepatoblasts differentiated in vitro and in vivo. Moreover, hCiPSC‐derived hepatic progenitor cells can further differentiate into hepatocytes that are similar to primary human hepatocytes with respect to gene expression and key hepatic functions. Our results demonstrate the feasibility of generating hepatic progenitor cells and hepatocytes from hCiPSCs with high efficiency and set the foundation for broad translational applications of hCiPSC‐derived hepatocytes.
Artisanal fisheries catch highlights hotspot for threatened sharks and rays in the Republic of the Congo
Authors: Doherty Philip D. , De Bruyne Godefroy , Moundzoho Baudelaire Dissondet , Dilambaka Emmanuel , Okondza Gaston Ngassiki , Atsango Benoit C. , Ngouembe Appolinaire , Akendze Tite R. , Parnell Richard J. , Cournarie Morgane , Malonga Richard , Missamou Antoine , Godley Brendan J. , Metcalfe Kristian
Published: October 2023

Global catch rates of sharks and rays from artisanal fisheries are underreported, leading to a lack of data on population status. This forms a major barrier to developing effective management plans, such is the case in Central and West Africa. Over 3 years, we undertook the first systematic quantitative assessment of sharks and rays landed by an artisanal fishery in the Republic of the Congo. During 507 sampling days (mean 14 surveys per month), we recorded 73,268 individuals. These comprised 42 species, of which 81% are considered at an elevated risk of extinction. Landings were dominated by immature individuals, especially for species of conservation concern. Presence of species thought to have largely disappeared from the region such as the African wedgefish (Rhynchobatus luebberti) and smoothback angelshark (Squatina oculata) suggest Congolese waters are a potential stronghold for these species—warranting increased protection. We identified seasonality of catch within years, but not across years. Both inter‐ and intra‐annual trends varied by species, signifying annual fluctuations in catch of each species but consistent catch of all species year‐on‐year. Analysis showed increased catch between the short‐wet and the long‐wet, and the long‐dry seasons (January–February and August–September). Lowest catch was shown to occur during the short‐wet and the short‐dry seasons (October–December), which may provide an opportunity for seasonal closures or gear restrictions.
Guam's last håyun lågu tree (Serianthes nelsonii) in peril
Authors: Demeulenaere Else , Ickert‐Bond Stefanie M.
Published: October 2023

On the island of Guåhan (Guam) native and endemic species are an integral part of the CHamoru language, rituals, and practices. They are interconnected with their culture and honored together with the ocean, the land, and their ancestors. Presently, this spiritual connection is being jeopardized as military expansion threatens the sacred lands of Tailalo’ and Litekyan. Phylogenetic and ethnographic research, connected to the principles of environmental justice, has brought attention to the social movement to protect the last håyun lågu tree (Serianthes nelsonii) at Tailalo’. This opinion piece is a rallying cry to safeguard the last håyun lågu and to confront the U.S. National Environmental Policy Act and the U.S. Endangered Species Act, as its regulations do not mirror the island's social and cultural system and fail to incorporate Indigenous and scientific perspectives to protect Indigenous biocultural heritage.
Long‐term effects of average calcineurin inhibitor trough levels (over time) on renal function in a prospectively followed cohort of 150 kidney transplant recipients
Authors: Ciancio Gaetano , Gaynor Jeffrey J. , Guerra Giselle , Tabbara Marina M. , Roth David , Kupin Warren , Mattiazzi Adela , Moni Lissett , Burke George W.
Published: October 2023

More favorable clinical outcomes with medium‐term follow‐up have been reported among kidney transplant recipients receiving maintenance therapy consisting of “reduced‐tacrolimus (TAC) dosing,” mycophenolate mofetil (MMF), and low‐dose corticosteroids. However, it is not clear whether long‐term maintenance therapy with reduced‐calcineurin inhibitor (CNI) dosing still leads to reduced renal function. A prospectively followed cohort of 150 kidney transplant recipients randomized to receive TAC/sirolimus (SRL) versus TAC/MMF versus cyclosporine microemulsion (CSA)/SRL, plus low‐dose maintenance corticosteroids, now has 20 years of post‐transplant follow‐up. Average CNI trough levels over time among patients who were still alive with functioning grafts at 60, 120, and 180 months post‐transplant were determined and ranked from smallest‐to‐largest for both TAC and CSA. Stepwise linear regression was used to determine whether these ranked average trough levels were associated with the patient's estimated glomerular filtration rate (eGFR) at those times, particularly after controlling for other significant multivariable predictors. Experiencing biopsy‐proven acute rejection (BPAR) and older donor age were the two most significant multivariable predictors of poorer eGFR at 60, 120, and 180 months post‐transplant (p < 000001 and 0.000003 for older donor age at 60 and 120 months; p = 0.00008 and <0.000001 for previous BPAR at 60 and 120 months). Assignment to CSA also implied a significantly poorer eGFR (but with less magnitudes of effect) in multivariable analysis at 60 and 120 months (p = 0.01 and 0.002). Higher ranked average CNI trough levels had no association with eGFR at any timepoint in either univariable or multivariable analysis (p > 0.70). Long‐term maintenance therapy with reduced‐CNI dosing does not appear to cause reduced renal function.
Applying an artificial intelligence deep learning approach to routine dermatopathological diagnosis of basal cell carcinoma
Authors: Duschner Nicole , Baguer Daniel Otero , Schmidt Maximilian , Griewank Klaus Georg , Hadaschik Eva , Hetzer Sonja , Wiepjes Bettina , Le'Clerc Arrastia Jean , Jansen Philipp , Maass Peter , Schaller Jörg
Published: October 2023

Background

Institutes of dermatopathology are faced with considerable challenges including a continuously rising numbers of submitted specimens and a shortage of specialized health care practitioners. Basal cell carcinoma (BCC) is one of the most common tumors in the fair‐skinned western population and represents a major part of samples submitted for histological evaluation. Digitalizing glass slides has enabled the application of artificial intelligence (AI)‐based procedures. To date, these methods have found only limited application in routine diagnostics. The aim of this study was to establish an AI‐based model for automated BCC detection.

Patients and Methods

In three dermatopathological centers, daily routine practice BCC cases were digitalized. The diagnosis was made both conventionally by analog microscope and digitally through an AI‐supported algorithm based on a U‐Net architecture neural network.

Results

In routine practice, the model achieved a sensitivity of 98.23% (center 1) and a specificity of 98.51%. The model generalized successfully without additional training to samples from the other centers, achieving similarly high accuracies in BCC detection (sensitivities of 97.67% and 98.57% and specificities of 96.77% and 98.73% in centers 2 and 3, respectively). In addition, automated AI‐based basal cell carcinoma subtyping and tumor thickness measurement were established.

Conclusions

AI‐based methods can detect BCC with high accuracy in a routine clinical setting and significantly support dermatopathological work.
Pakistan, China and the Structures of Debt Distress: Resisting Bretton Woods
Authors: Sial Farwa , Jafri Juvaria , Khaliq Abdul
Published: October 2023

Pakistan has received a total of 23 loan packages from the International Monetary Fund (IMF) between 1958 and 2023, and recurrent indebtedness has hindered structural transformation. Recent crises, such as the COVID‐19 pandemic, surging commodity prices, Russia's invasion of Ukraine and diplomatic tensions between the United States and China, have exacerbated Pakistan's indebtedness. This debt has geopolitical importance given the rivalry between the US and China. Multilateral support for restructuring has been complicated by Pakistan's unique alliance with China through the China‒Pakistan Economic Corridor, pivotal to the Belt and Road Initiative. This analysis of Pakistan's debt crisis explores this complexity by considering the Pakistani government's attempts to resist the IMF, particularly between 2018 and 2022, when the potential of China as an alternative source of financial support looked increasingly viable. Unlike less critical political analyses on debt, which tend to be preoccupied with endogenous governance failures and fiscal profligacy, this article focuses on the external drivers of debt. In doing so, it highlights the role of a hostile international legal system, standard‐setting arrangements, rating agencies and arbitrary charges that impose huge economic burdens and undermine financial stability, as well as the constraints embedded in the global investment and financial architecture that persistently limit Pakistan's policy space.
Functional electrical stimulation during walking in children with unilateral spastic cerebral palsy: A randomized cross‐over trial
Authors: Moll Irene , Marcellis Rik G. J. , Fleuren Sabine M. , Coenen Marcel L. P. , Senden Rachel H. J. , Willems Paul J. B. , Speth Lucianne A. W. M. , Witlox M. Adhiambo , Meijer Kenneth , Vermeulen R. Jeroen
Published: October 2023

Aim

To study if functional electrical stimulation (FES) of the peroneal nerve, which activates dorsiflexion, can improve body functions, activities, and participation and could be an effective alternative treatment in individuals with unilateral spastic cerebral palsy (CP).

Method

A randomized cross‐over trial was performed in 25 children with unilateral spastic CP (classified in Gross Motor Function Classification System levels I and II) aged 4 to 18 years (median age at inclusion 9 years 8 months, interquartile range = 7 years–13 years 8 months), 15 patients were male. The study consisted of two 12‐week blocks of treatment, that is, conventional treatment (ankle foot orthosis [AFO] or adapted shoes) and FES, separated by a 6‐week washout period. Outcome measures included the Goal Attainment Scale (GAS), the Cerebral Palsy Quality of Life questionnaire, and a three‐dimensional gait analysis.

Results

Eighteen patients completed the trial. The proportion of GAS goals achieved was not significantly higher in the FES versus the conventional treatment phase (goal 1 p = 0.065; goal 2 p = 1.00). When walking while stimulated with FES, ankle dorsiflexion during mid‐swing decreased over time (p = 0.006, average decrease of 4.8° with FES), with a preserved increased ankle range of motion compared to conventional treatment (p < 0.001, mean range of motion with FES +10.1° compared to AFO). No changes were found in the standard physical examination or regarding satisfaction with orthoses and feelings about the ability to dress yourself. In four patients, FES therapy failed; in 12 patients FES therapy continued after the trial.

Interpretation

FES is not significantly worse than AFO; however, patient selection is critical, and a testing period and thorough follow‐up are needed.
Construction and validation of a nomogram for predicting diabetes remission at 3 months after bariatric surgery in patients with obesity combined with type 2 diabetes mellitus
Authors: Yuan Kaisheng , Wu Bing , Zeng Ruiqi , Zhou Fuqing , Hu Ruixiang , Wang Cunchuan
Published: October 2023

Aim

Bariatric metabolic surgery (BMS) is a proven treatment option for patients with both obesity and type 2 diabetes mellitus (T2DM). However, there is a lack of comprehensive reporting on the short‐term remission rates of diabetes, and the existing data are inadequate. Hence, this study aimed to investigate the factors that may contribute to diabetes remission (DR) in patients with obesity and T2DM, 3 months after undergoing BMS. Furthermore, our objective was to develop a risk‐predicting model using a nomogram.

Methods

In total, 389 patients with obesity and T2DM, who had complete preoperative information and underwent either laparoscopic sleeve gastrectomy or laparoscopic gastric bypass surgery between January 2014 and May 2023, were screened in the Chinese Obesity and Metabolic Surgery Database. The patients were randomly divided into a training set (n = 272) and a validation set (n = 117) in a 7:3 ratio. Potential factors for DR were analysed through univariate and multivariate logistic regression analyses and then modelled using a nomogram. The model's performance was evaluated using receiver operating characteristic curves and the area under the curve (AUC). Calibration plots were used to assess prediction accuracy and decision curve analyses were conducted to evaluate the clinical usefulness of the model.

Results

Glycated haemoglobin, triglycerides, duration of diabetes, insulin requirement and hypercholesterolaemia were identified as independent factors influencing DR. We have incorporated these five indicators into a nomogram, which has shown good efficacy in both the training cohort (AUC = 0.930) and validation cohort (AUC = 0.838). The calibration plots indicated that the model fits well in both the training and the validation cohorts, and decision curve analyses showed that the model had good clinical applicability.

Conclusion

The prediction model developed in this study holds predictive value for short‐term DR following BMS in patients with obesity and T2DM.
Anthropometric measures, predicted visceral adipose tissue and biomarkers of chronic inflammation
Authors: Millar Seán R. , Perry Ivan J. , Phillips Catherine M.
Published: October 2023

Background

Evidence has linked low‐grade systemic inflammation and visceral adipose tissue (VAT) with development of chronic conditions. Cytokines and select proteins released by VAT may promote a low‐grade inflammatory response. A number of equations have been developed to estimate VAT levels. In this study, we compared predicted VAT equation relationships with biomarkers of inflammation.

Methods

This was a cross‐sectional study of 2038 men and women aged 46–73 years. Correlation and linear regression analyses were performed to examine inflammatory biomarker relationships with four commonly assessed anthropometric measures and 10 predicted VAT equations.

Results

Compared with anthropometric measures, predicted VAT equations were found to explain a greater proportion of variance in CRP (R2 = .075, p = .001), IL‐6 (R2 = .060, p = .001), TNF‐α (R2 = .017, p = .005), resistin (R2 = .011, p = .012), monocyte (R2 = .027, p = .001), eosinophil (R2 = .012, p = .01) and basophil (R2 = .015, p = .002) levels in males, and a greater variance in concentrations of C3 (R2 = .175, p = .001), IL‐6 (R2 = .090, p = .001), TNF‐α (R2 = .036, p = .001), adiponectin (R2 = .121, p = .001), the adiponectin‐to‐leptin ratio (R2 = .444, p = .001), resistin (R2 = .025, p = .001), white blood cell count (R2 = .057, p = .001), neutrophils (R2 = .061, p = .001) and lymphocytes (R2 = .020, p = .001) in females.

Conclusion

Equations for assessing VAT levels might be useful to characterise metabolic health. Further studies that examine predicted VAT relationships with disease and mortality outcomes are warranted.
The effect of the simulated aging by thermocycling on the elastic modulus of ethylene‐vinyl acetate brands and stress/strain development during an impact: An in vitro and 3D‐FEA analysis
Authors: Costa Paulo Victor de Moura , Firmiano Tainah Costa , Borges Gilberto Antônio , Dantas Rodrigo Pereira , Veríssimo Crisnicaw
Published: October 2023

Background/Aim

Mouthguards are used to prevent dental trauma and orofacial injuries. The aim of this study was to evaluate the influence of ethylene‐vinyl acetate (EVA) aging by thermocycling on elastic modulus, stress, strain and shock absorption ability of different ethylene‐vinyl acetate brands used for mouthguards.

Methods

Thirty EVA samples with a dimension of 70 × 10 × 3 mm were obtained from four commercial brands (Bioart®, Erkodent®, Polyshok® and Proform®). Fifteen samples were submitted to 10,000 cycles (5°C–55°C) in a thermocycling machine with an immersion time of 30 s and a transfer time of 5 s. The samples were submitted to a uniaxial tensile test in a universal testing machine to calculate the elastic modulus. Data were statistically evaluated by two‐way ANOVA and Holm‐Sidak test. A three‐dimensional model of the anterior maxilla was created using Rhinoceros 5.0. A 3 mm custom‐fitted mouthguard was simulated. The three‐dimensional volumetric mesh was generated using the Patran software (MSC Software) with isoparametrics, 4‐noded tetrahedral elements and exported to Marc/Mentat (MSC Software) as element number 134. A non‐linear dynamic impact analysis was performed in which a rigid object struck the central incisor at a speed of 5 m/s. The stresses were evaluated by the modified von Mises criteria and the strains were also recorded.

Results

Statistically significant differences were observed for elastic modulus values (p < .001). Mean and standard deviation values (MPa) without thermocycling were: Bioart (34.5 ± 0.9), Erkodent (15.0 ± 0.4), Polyshok (17.3 ± 0.4), Proform: (20.6 ± 0.8); and with thermocycling: Bioart (25.4 ± 0.8), Erkodent (10.7 ± 0.5), Polyshok (13.3 ± 0.6), Proform (13.1 ± 0.6). The thermocycling process reduced stress and strain levels regardless of the mouthguard materials. Shock absorption ability calculated based on the strain values was increased with thermocycling process.

Conclusion

The thermocycling process, regardless of the commercial brand, reduced the stress/strain and increased the shock absorption ability of mouthguards.
Displaced universities in Ukraine: Challenges and optimal development models
Authors: Orzhel Olena , Trofymenko Mykola , Porkuian Olha , Drach Iryna , Halhash Ruslan , Stoyka Andriy
Published: October 2023

The article investigates two cases of displaced universities facing challenges after a new phase of Russia's aggression against Ukraine in February 2022. We analyse prospects for displaced universities. Also, we identify models suitable for developing and reinventing universities, aligning their activities with wartime needs and allowing them to play a transformative role during post‐war recovery. Four modern university models were investigated: (1) a traditional university model where the dominating social missions are (I) teaching and learning, and (II) research; (2) a civic university model where the mission to serve society and community engagement (a third social mission; III) is equally as important as the first and second missions; (3) an open university allowing for open access for diverse groups of learners to personal and professional development. We also analyse a European Universities model (4). The fourth model aims at pooling resources and boosting cooperation between several universities and non‐academic institutions. The purpose of the fourth model is to enhance excellence in education, research and innovation in specific subject areas. It also facilitates internationalisation and community service at the local, national and global levels. The civic university was identified as the optimum model for advancing the development of displaced universities. Similarly, a combination of features from the models analysed can be an appropriate solution to ensure a sustainable development of displaced universities during wartime and post‐war recovery. Based on research findings we formulate policy recommendations on the following topics: a review of the missions and strategies of displaced universities, and the launch of the Programme in Support of Displaced Universities. Also, the recommendation to develop crisis management plans at the national and institutional levels to ensure multilevel readiness for future emergencies is discussed.
Identification of clinical factors impacting outcome in patients undergoing autologous hematopoietic cell transplantation after BEAM and TEAM conditioning
Authors: Gherman Radu‐Florian , Ewald Sophie , Ihorst Gabriele , Strüßmann Tim , Zeiser Robert , Wäsch Ralph , Bertz Hartmut , Stolz Daiana , Duyster Justus , Finke Jürgen , Marks Reinhard , Engelhardt Monika , Duque‐Afonso Jesús
Published: October 2023

Organ dysfunction, including pulmonary function impairment, plays a key role in the choice of conditioning chemotherapy before autologous hematopoietic stem cell transplantation (auto‐HSCT). Replacement of BCNU/carmustine as part of BEAM (BCNU/carmustine, etoposide, cytarabine, and melphalan) conditioning protocol by thiotepa (TEAM) reduces pulmonary toxicity while maintaining efficacy. We retrospectively analyzed the association of clinical characteristics, comorbidities, and organ function with outcomes after conditioning with BEAM or TEAM. Three hundred ninety‐six patients undergoing auto‐HSCT (n = 333 with BEAM; n = 63 with TEAM) at our institution between 2008 and 2021 were included in this study. In the multivariate analysis, CO‐diffusion capacity corrected for hemoglobin (DLCOcSB) ≤ 60% of predicted, progressive disease (PD) before auto‐HSCT, Karnofsky performance score (KPS) ≤ 80%, HCT‐CI score ≥ 4, and cardiac disease before auto‐HSCT were associated with decreased overall survival (OS) in patients treated with BEAM. In contrast, only PD before auto‐HSCT was identified in patients treated with TEAM. Patients conditioned with BEAM and DLCOcSB ≤ 60% had higher non‐relapse mortality, including pulmonary cause of death. In summary, we have identified clinical and pulmonary risk factors associated with worse outcomes in patients conditioned with BEAM compared to TEAM. Our data suggest TEAM conditioning as a valid alternative for patients with comorbidities, including pulmonary dysfunction and/or poorer performance scores, before auto‐HSCT.
Treatment sequences and drug costs from diagnosis to death in multiple myeloma
Authors: Seefat M. R. , Cucchi D. G. J. , Groen K. , Donker M. L. , van der Hem K. G. , Westerman M. , Gerrits A. M. , Beeker A. , van de Donk N. W. C. J. , Blommestein H. M. , Zweegman S.
Published: October 2023

Novel therapies for multiple myeloma (MM) have improved patient survival, but their high costs strain healthcare budgets. End‐of‐life phases of treatment are generally the most expensive, however, these high costs may be less justifiable in the context of a less pronounced clinical benefit. To manage drug expenses effectively, detailed information on end‐of‐life drug administration and costs are crucial. In this retrospective study, we analysed treatment sequences and drug costs from 96 MM patients in the Netherlands who died between January 2017 and July 2019. Patients received up to 16 lines of therapy (median overall survival: 56.5 months), with average lifetime costs of €209 871 (€3111/month; range: €3942–€776 185) for anti‐MM drugs. About 85% of patients received anti‐MM treatment in the last 3 months before death, incurring costs of €20 761 (range: €70–€50 122; 10% of total). Half of the patients received anti‐MM treatment in the last 14 days, mainly fully oral regimens (66%). End‐of‐life treatment costs are substantial despite limited survival benefits. The use of expensive treatment options is expected to increase costs further. These data serve as a reference point for future cost studies, and further research is needed to identify factors predicting the efficacy and clinical benefit of continuing end‐of‐life therapy.
Long‐term data reveal contrasting impacts of native versus invasive nest predators in Iceland
Authors: Jónsson Jón Einar , Rickowski Fiona S. , Ruland Florian , Ásgeirsson Árni , Jeschke Jonathan M.
Published: October 2023

Bird species on islands are strongly impacted by biological invasions, with the Icelandic common eider (Somateria mollissima borealis) being particularly threatened. Down collection by local families in Breiðafjörður, West Iceland, provided long‐term datasets of nests from two archipelagos, covering 95 islands over 123 years and 39 islands over 27 years, respectively. Using these exceptional datasets, we found that the arrival of the invasive semi‐aquatic American mink (Neogale vison) was a more impactful driver of population dynamics than climate. This invasive predator heavily reduced eider nest numbers by ca. 60% in the Brokey archipelago. In contrast, we detected an apparently adaptive response to the return of the native fox in the Purkey archipelago, with dense nests on islands inaccessible to the fox and no apparent impact on eider populations. This difference might be due to the eiders lacking a joint evolutionary history with the mink and therefore lacking appropriate antipredator responses.
Long‐term outcome of alcohol withdrawal seizures
Authors: Sansone Giulio , Megevand Pierre , Vulliémoz Serge , Corbetta Maurizio , Picard Fabienne , Seeck Margitta
Published: October 2023

Background and purpose

Alcohol withdrawal seizures (AWS) are a well‐known complication of chronic alcohol abuse, but there is currently little knowledge of their long‐term relapse rate and prognosis. The aims of this study were to identify risk factors for AWS recurrence and to study the overall outcome of patients after AWS.

Methods

In this retrospective single‐center study, we included patients who were admitted to the Emergency Department after an AWS between January 1, 2013 and August 10, 2021 and for whom an electroencephalogram (EEG) was requested. AWS relapses up until April 29, 2022 were researched. We compared history, treatment with benzodiazepines or antiseizure medications (ASMs), laboratory, EEG and computed tomography findings between patients with AWS relapse (r‐AWS) and patients with no AWS relapse (nr‐AWS).

Results

A total of 199 patients were enrolled (mean age 53 ± 12 years; 78.9% men). AWS relapses occurred in 11% of patients, after a median time of 470.5 days. Brain computed tomography (n = 182) showed pathological findings in 35.7%. Risk factors for relapses were history of previous AWS (p = 0.013), skull fractures (p = 0.004) at the index AWS, and possibly epileptiform EEG abnormalities (p = 0.07). Benzodiazepines or other ASMs, taken before or after the index event, did not differ between the r‐AWS and the nr‐AWS group. The mortality rate was 2.9%/year of follow‐up, which was 13 times higher compared to the general population. Risk factors for death were history of AWS (p < 0.001) and encephalopathic EEG (p = 0.043).

Conclusions

Delayed AWS relapses occur in 11% of patients and are associated with risk factors (previous AWS >24 h apart, skull fractures, and pathological EEG findings) that also increase the epilepsy risk, that is, predisposition for seizures, if not treated. Future prospective studies are mandatory to determine appropriate long‐term diagnostic and therapeutic strategies, in order to reduce the risk of relapse and mortality associated with AWS.
Exploring the mechanism of 18F‐fluorodopa uptake in recurrent high‐grade gliomas: A comprehensive histomolecular‐positron emission tomography analysis
Authors: Cobes Nina , Tran Suzanne , Mathon Bertrand , Nichelli Lucia , Bielle Franck , Touat Mehdi , Kas Aurélie , Rozenblum Laura
Published: October 2023

Background

Dihydroxy‐6‐[18F]fluoro‐L‐phenylalanine (18F‐FDOPA) positron emission tomography (PET) is a valuable tool for managing high‐grade gliomas (HGGs), but there is a lack of literature on its relationship with glioma subtypes since the 2021 reclassification of brain tumors. There is also debate surrounding the mechanism of 18F‐FDOPA uptake, particularly after chemoradiation therapy. This study aimed to investigate the correlation between 18F‐FDOPA uptake and histomolecular characteristics, particularly L‐amino acid transporter 1 (LAT1) expression, in recurrent gliomas, and examine their impact on survival in HGGs.

Methods

Thirty‐nine patients with recurrent HGGs (14 isocitrate dehydrogenase [IDH]‐mutant, 25 IDH‐wildtype) who underwent a brain 18F‐FDOPA PET/computed tomography (CT) or PET/magnetic resonance imaging (MRI) followed by surgical resection of the 18F‐FDOPA‐avid lesion within 6 months, were retrospectively reviewed. PET results were compared with histological examination and for SCL7A5/LAT1 immunostaining. The study also examined the relationship between PET parameters, LAT1 expression, and survival outcomes.

Results

Astrocytoma IDH‐mutant G4 had higher 18F‐FDOPA uptake than glioblastoma IDH‐wildtype G4 (maximum tumor‐to‐normal brain ratio [TBRmax] 5 [3.4–9] vs. 3.8 [2.8–5.9], p = 0.02). IDH‐mutant gliomas had higher LAT1 expression than IDH‐wildtype gliomas (100 [14–273] vs. 15.5 [0–137], p < 0.05) as well as higher TBRmax (5 [2.4–9] vs. 3.8 [2.8–6], p < 0.05). In survival analysis, LAT1 score >100 was a predictor for longer progression‐free survival in IDH‐mutant HGGs.

Conclusions

To our knowledge, our study is the first to suggest a link between LAT1 expression and IDH mutation status. We showed that higher TBRmax was associated with higher LAT1 expression and IDH mutation status. Further studies are needed to better understand the mechanisms underlying amino acid PET tracers uptake, especially in the post‐radiation and chemotherapy settings.