bluuebunny/crossref_metadata_2025 huggingface dataset:
The Tyranny of Supply: Natural Resources and Rebel Territorial Control in Civil Conflicts
Authors: Aronson Jacob , Kikuta Kyosuke , Findley Michael , Walsh James Igoe
Published: July 2024

The logic of territorial control is central to the study of internal conflict. Existing studies consider the consequences of territorial control without answering a critical question: what motivates rebel territorial control in the first place? Territorial control requires careful explanation. While it confers important benefits it is also costly to achieve and exposes rebels to state attack. This paper argues that benefits exceed costs when territorial control provides rebels with a reliable source of organizational supply. High-value lootable natural resources—resources available in abundance that are easy to extract and transport for sale—represent key components of a rebel's supply chain. To test the theory's implications, we introduce new cross- and sub-national time-series data on territorial control in sub-Saharan Africa and couple it with a new dataset of local natural resource values. We use an instrumental variable approach to address core endogeneity concerns. Results both substantiate our theoretical approach and provide evidence running contrary to existing arguments. These findings demonstrate that valuable natural resources, logistical supply constraints, and, more broadly, rebel military strategy, are critically important and need to be incorporated into work on civil war, territorial control, and rebel governance.
Spatial heterogeneity and functional zonation of living tissues and organs in situ
Authors: Miyamoto Yu , Ishii Masaru
Published: July 2024

In most organs, resources such as nutrients, oxygen and physiologically active substances are unevenly supplied within the tissue spaces. Consequently, different tissue functions are exhibited in each space. This spatial heterogeneity of tissue environments arises depending on the spatial arrangement of nutrient vessels and functional vessels, leading to continuous changes in the metabolic states and functions of various cell types from regions proximal to these vessels to distant regions. This phenomenon is referred to as ‘zonation’. Traditional analytical methods have made it difficult to investigate this zonation in detail. However, recent advancements in intravital imaging, spatial transcriptomics and single-cell transcriptomics technologies have facilitated the discovery of ‘zones’ in various organs and elucidated their physiological roles. Here, we outline the spatial differences in the immune system within each zone of organs. This information provides a deeper understanding of organs’ immune systems.
Recruitment of neutrophils in glomeruli in early mouse sepsis is associated with E-selectin expression and activation of endothelial nuclear factor kappa-light-chain-enhancer of activated B cells and mitogen-activated protein kinase pathways
Authors: Wang Zhendong , Dayang Erna-Zulaikha , Zwiers Peter J , Hernandez Garcia Martha L , Luxen Matthijs , van Meurs Matijs , Kamps Jan A A M , Moser Jill , Molema Grietje
Published: July 2024

Sepsis is a dysregulated systemic inflammatory response to an infection, which can lead to multiple organ dysfunction syndrome that includes the kidney. Leukocyte recruitment is an important process of the host immune defense in response to sepsis. Endothelial cells (EC) actively regulate leukocyte recruitment by expressing adhesion molecules following the activation of dedicated intracellular signal transduction pathways. Previous studies reported that the expression of adhesion molecules was associated with the activation of endothelial nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) p65 and mitogen-activated protein kinase (MAPK) c-Jun pathways in vitro in response to conditions that mimic processes that occur in inflammation. This study aimed to investigate the spatiotemporal patterns of leukocyte recruitment, expression of adhesion molecules, and endothelial nuclear p65 and c-Jun localization in renal microvascular beds of septic mice. Here, we used a cecal ligation and puncture (CLP) sepsis mouse model and RT-qPCR and immunohistochemical staining. We showed that neutrophils, macrophages, and T lymphocytes were all present in the kidney, yet only neutrophils accumulated in a spatiotemporally discernible pattern, mainly in glomeruli at 4 h after CLP sepsis initiation. E-selectin, not vascular cell adhesion molecule-1 (VCAM-1), was expressed in glomeruli at the same time point. In a subset of mice at 72 h after CLP sepsis started, VCAM-1 expression was prominent in glomerular EC, which was not related to changes in mmu-microRNA(miR)-126a-3p levels, a short noncoding microRNA previously shown to inhibit the translation of VCAM-1 mRNA into protein. Nuclear localization of p65 and c-Jun occurred in EC of all microvascular segments at 4 and 7 h after CLP sepsis initiation. In summary, sepsis-induced recruitment of neutrophils, E-selectin expression, and NF-κB p65 and MAPK c-Jun pathway activation coincided in glomeruli at the early stage of the disease. In the other microvascular beds, sepsis led to NF-κB p65 and MAPK c-Jun pathway activation with limited expression of E-selectin and no association with VCAM-1 expression or leukocyte recruitment.
Combined immunogenicity evaluation for a new single-dose live-attenuated chikungunya vaccine
Authors: Buerger Vera , Maurer Gabriele , Kosulin Karin , Hochreiter Romana , Larcher-Senn Julian , Dubischar Katrin , Eder-Lingelbach Susanne
Published: July 2024

Background

Chikungunya is a serious and debilitating viral infection with a significant disease burden. VLA1553 (IXCHIQ®) is a live-attenuated vaccine licensed for active immunization for prevention of disease caused by chikungunya virus (CHIKV).

Methods

Immunogenicity following a single dose of VLA1553 was evaluated in healthy adults aged ≥18 years in two Phase 3 trials [N = 656 participants (per protocol analysis set)]. Immunogenicity data to 180 days post-vaccination [geometric mean titres (GMTs), seroresponse rate, seroconversion rate] were pooled for the two trials. A comparison of subgroups based on age, sex, body mass index (BMI), race and baseline seropositivity was included. All analyses were descriptive.

Results

Most participants were aged 18–64 years (N = 569/656 [86.7%]), there were slightly more females (N = 372/656 [56.7%]), most were not Hispanic/Latino (N = 579/656 [88.3%]), and most were White (N = 517/656 [78.8%]). In baseline seronegative participants, GMT peaked at Day 29 post-vaccination, and subsequently declined slightly but remained elevated until Day 180. At Days 29, 85 and 180, seroresponse rate was 98.3, 97.7 and 96.4% and seroconversion rate was 98.5, 98.4 and 98.2%. There were no differences in seroresponse rate in participants aged 18–64 years or ≥65 years at Day 29 (98.1 vs 100%), Day 85 (97.4 vs 100%) and Day 180 (96.3 vs 96.5%) nor based on sex, BMI, ethnicity or race. An immune response was shown in a small heterogenous population of baseline seropositive participants, with GMTs showing the same trend as baseline seronegative participants.

Conclusions

A single dose of VLA1553 elicited a very strong immune response by Day 29 that remained elevated at Day 180 in both baseline seronegative and seropositive participants in a combined evaluation of two Phase 3 trials. The vaccine was similarly immunogenic in participants aged ≥65 years and 18–64 years, and there were no differences based on subgroup analyses for sex, BMI, ethnicity or race.
New radiative and collisional atomic data for Sr ii and Y ii with application to Kilonova modelling
Authors: Mulholland L P , McElroy N E , McNeill F L , Sim S A , Ballance C P , Ramsbottom C A
Published: July 2024

The spectra of singly ionized Strontium and Yttrium (Sr ii and Y ii) have been proposed as identifications of certain spectral features in the AT2017gfo spectrum. With the growing demand for non-local-thermodynamic-equilibrium (NLTE) simulations of Kilonovae, there is an increasing need for atomic data for these and other r-process elements. Our goal is to expand upon the current set of atomic data for r-process elements, by presenting transition probabilities and Maxwellian-averaged effective collision strengths for Sr ii and Y ii. The Breit–Pauli and darcR-matrix codes are employed to calculate the appropriate collision strengths, which are thermally averaged according to a Maxwellian distribution to calculate excitation and de-excitation rates. The tardis and ColRadPy packages are subsequently used to perform local thermodynamic equilibrium (LTE) and NLTE modelling, respectively. A complete set of transition probabilities and effective collision strengths involving levels for Sr ii and Y ii have been calculated for temperature ranges compatible with kilonova plasma conditions. Forbidden transitions were found to disagree heavily with the Axelrod approximation, an approximation which is currently employed by other models within the literature. Theoretically important spectral lines are identified with both LTE and NLTE modelling codes. LTE simulations in tardis reveal no new significant changes to the full synthetic spectra. NLTE simulations in ColRadPy provide indications of which features are expected to be strong for a range of regimes, and we include luminosity estimates. Synthetic emission spectra over kilonova densities and temperatures reveal potentially interesting spectral lines in the NIR.
[O iii] λ5007 emissions in extremely red quasars (ERQs) are compact
Authors: Lau Marie Wingyee , Perrotta Serena , Hamann Fred , Gillette Jarred , Rupke David S N , Vayner Andrey , Zakamska Nadia L , Wylezalek Dominika
Published: July 2024

‘Extremely red quasars’ (ERQs) are a non-radio-selected, intrinsically luminous population of quasars at cosmic noon selected by their extremely red colour from rest-frame UV to mid-IR. ERQs are uniquely associated with exceptionally broad and blueshifted [O iii] $\lambda$5007 emission reaching speeds $\gt $6000 km s$^{-1}$. We obtained adaptive optics integral-field spectroscopic observations using Keck/OSIRIS and Gemini/NIFS of a sample of 10 ERQs with bolometric luminosities (10$^{47.0}$–10$^{47.9}$) erg s$^{-1}$ at $z\sim$ (2.3–3.0). The goal is to measure the sizes and spatially resolved kinematics of the [O iii]-emitting regions. We study the surface brightness maps and aperture-extracted spectra and model the point-spread functions. We identify signs of merger activities in the continuum emissions. We identify physically distinct [O iii] kinematic components that are bimodal and respectively trace ERQ-driven outflows of velocity dispersion $\gtrsim$250 km s$^{-1}$ and dynamically quiescent interstellar media. We find that the ERQ-driven ionized outflows are typically at $\sim$1 kpc scales whereas the quiescent ionized gas extend to a few kpc. Compared to normal quasars the extremely fast ERQ-driven [O iii] outflows tend to be more compact, supporting the notion that ERQs are in a young stage of quasar/galaxy evolution and represent unique physical conditions beyond orientation differences with normal quasar populations. The kinematically quiescent [O iii] emissions in ERQs tend to be spatially resolved but less extended than in normal quasars, which can be explained by global and patchy dust obscuration. The hint of ionization cones suggests some of the obscuration can be partially explained by a patchy torus.
Governance fix? Power and politics in controversies about governing generative AI
Authors: Ulnicane Inga
Published: July 2024

The launch of ChatGPT in late 2022 led to major controversies about the governance of generative artificial intelligence (AI). This article examines the first international governance and policy initiatives dedicated specifically to generative AI: the G7 Hiroshima process, the Organisation for Economic Cooperation and Development reports, and the UK AI Safety Summit. This analysis is informed by policy framing and governance literature, in particular by the work on technology governance and Responsible Innovation. Emerging governance of generative AI exhibits characteristics of polycentric governance, where multiple and overlapping centers of decision-making are in collaborative relationships. However, it is dominated by a limited number of developed countries. The governance of generative AI is mostly framed in terms of the risk management, largely neglecting issues of purpose and direction of innovation, and assigning rather limited roles to the public. We can see a “paradox of generative AI governance” emerging, namely, that while this technology is being widely used by the public, its governance is rather narrow. This article coins the term “governance fix” to capture this rather narrow and technocratic approach to governing generative AI. As an alternative, it suggests embracing the politics of polycentric governance and Responsible Innovation that highlight democratic and participatory co-shaping of technology for social benefit. In the context of the highly unequal distribution of power in generative AI characterized by a high concentration of power in a small number of large tech companies, the government has a special role in reshaping the power imbalances by enabling wide-ranging public participation in the governance of generative AI.
Simultaneous indoor radon/thoron and in situ outdoor gamma dose measurements and estimation of annual effective dose in a tin mining area of Jos Plateau, Nigeria
Authors: Waida Jasini , Oyeleke Oyebode A , Ademola Janet A
Published: July 2024

Radon, a radioactive gas can increase the risk of lung cancer when breathe in. Indoor Rn-222 and Rn-220 concentrations were determined using passive radon monitor in some dwellings in a Sn mining area of Jos Plateau. Outdoor gamma radiation was also measured with a hand-held survey meter. The range of Rn-222 and Rn-220 concentrations was from 7–53 Bq m−3 to 41–267 Bq m−3 with averages of 27 ± 17 and 92 ± 65 Bq m−3, respectively. The mean total effective dose due to Rn-222 + Rn-220 was estimated as 2.84 ± 1.57 mSv y−1. Rn-220 contributed between 50 and 95% to the total annual effective dose. There was no correlation between indoor Rn-220 and Rn-222 concentrations in the dwellings. Outdoor gamma radiation measured was between 0.31 ± 0.06 and 0.62 ± 0.08 μSv h−1, and mean annual effective dose calculated was 1.14 ± 0.21 mSv y−1. It is concluded from this study that thoron should not be neglected in dose assessment.
The economic and cultural dimensions of unequal policy representation
Authors: Schakel Wouter , Persson Mikael , Sundell Anders
Published: July 2024

Many scholars have argued that policymaking in Western democracies is biased toward high-income citizens, thereby violating fundamental ideals of political equality. However, studies have paid less attention to other potential sources of unequal representation besides income. In this study, we compare the role of income with that of education. Using an original data set of policy changes and public preferences spanning 43 countries, we find that both produce unequal policy representation. We also find some support for the hypothesis that income and education provide distinct advantages and primarily affect economic and socio-cultural policy, respectively. At the same time, educational inequalities are larger and more robust, producing a bias toward cosmopolitan socio-cultural policy. These findings underline the importance of separating the economic and cultural sources of unequal representation. In addition, they reinforce the role of education as a key dividing line in the politics of established democracies.
The Fundamental Role of Character Coding in Bayesian Morphological Phylogenetics
Authors: Khakurel Basanta , Grigsby Courtney , Tran Tyler D , Zariwala Juned , Höhna Sebastian , Wright April M
Published: July 2024

Phylogenetic trees establish a historical context for the study of organismal form and function. Most phylogenetic trees are estimated using a model of evolution. For molecular data, modeling evolution is often based on biochemical observations about changes between character states. For example, there are 4 nucleotides, and we can make assumptions about the probability of transitions between them. By contrast, for morphological characters, we may not know a priori how many characters states there are per character, as both extant sampling and the fossil record may be highly incomplete, which leads to an observer bias. For a given character, the state space may be larger than what has been observed in the sample of taxa collected by the researcher. In this case, how many evolutionary rates are needed to even describe transitions between morphological character states may not be clear, potentially leading to model misspecification. To explore the impact of this model misspecification, we simulated character data with varying numbers of character states per character. We then used the data to estimate phylogenetic trees using models of evolution with the correct number of character states and an incorrect number of character states. The results of this study indicate that this observer bias may lead to phylogenetic error, particularly in the branch lengths of trees. If the state space is wrongly assumed to be too large, then we underestimate the branch lengths, and the opposite occurs when the state space is wrongly assumed to be too small.
Towards accurate monitoring of water content in woody tissue across tropical forests and other biomes
Authors: Martius Lion R , Mencuccini Maurizio , Bittencourt Paulo R L , Moraes Alves Moisés , Binks Oliver , Sanchez-Martinez Pablo , da Costa Antonio C L , Meir Patrick
Published: July 2024

Forest ecosystems face increasing drought exposure due to climate change, necessitating accurate measurements of vegetation water content to assess drought stress and tree mortality risks. Although Frequency Domain Reflectometry offers a viable method for monitoring stem water content by measuring dielectric permittivity, challenges arise from uncertainties in sensor calibration linked to wood properties and species variability, impeding its wider usage. We sampled tropical forest trees and palms in eastern Amazônia to evaluate how sensor output differences are controlled by wood density, temperature and taxonomic identity. Three individuals per species were felled and cut into segments within a diverse dataset comprising five dicotyledonous tree and three monocotyledonous palm species on a wide range of wood densities. Water content was estimated gravimetrically for each segment using a temporally explicit wet-up/dry-down approach and the relationship with the dielectric permittivity was examined. Woody tissue density had no significant impact on the calibration, but species identity and temperature significantly affected sensor readings. The temperature artefact was quantitatively important at large temperature differences, which may have led to significant bias of daily and seasonal water content dynamics in previous studies. We established the first tropical tree and palm calibration equation which performed well for estimating water content. Notably, we demonstrated that the sensitivity remained consistent across species, enabling the creation of a simplified one-slope calibration for accurate, species-independent measurements of relative water content. Our one-slope calibration serves as a general, species-independent standard calibration for assessing relative water content in woody tissue, offering a valuable tool for quantifying drought responses and stress in trees and forest ecosystems.
Prophylactic Radiologic Interventions for Postpartum Hemorrhage Control in Women With Placenta Accreta Spectrum Disorder
Authors: Bonsen Lisanne R. , Sleijpen Kosma , Hendriks Joris , Urlings Thijs A.J. , Dekkers Olaf M. , le Cessie Saskia , van de Velde Marc , Gurung Pema , van den Akker Thomas , van der Bom Johanna G. , Henriquez Dacia D.C.A.
Published: July 2024

OBJECTIVE:

To quantify the association between prophylactic radiologic interventions and perioperative blood loss during cesarean delivery in women with placenta accreta spectrum disorder through a systematic review and network meta-analysis.

DATA SOURCES:

On January 3, 2023, a literature search was conducted in PubMed, EMBASE, Cochrane Library, and Web of Science. We also checked ClinicalTrials.gov retrospectively. Prophylactic radiologic interventions to reduce bleeding during cesarean delivery involved preoperative placement of balloon catheters, distal (internal or common iliac arteries) or proximal (abdominal aorta), or sheaths (uterine arteries). The primary outcome was volume of blood loss; secondary outcomes were the number of red blood cell units transfused and adverse events. Studies including women who received an emergency cesarean delivery were excluded.

METHODS OF STUDY SELECTION:

Two authors independently screened citations for relevance, extracted data, and assessed the risk of bias of individual studies with the Cochrane Risk of Bias in Non-randomized Studies of Interventions tool.

TABULTATION, INTEGRATION, AND RESULTS:

From a total of 1,332 screened studies, 50 were included in the final analysis, comprising 5,962 women. These studies consisted of two randomized controlled trials and 48 observational studies. Thirty studies compared distal balloon occlusion with a control group, with a mean difference in blood loss of −406 mL (95% CI, −645 to −167). Fourteen studies compared proximal balloon occlusion with a control group, with a mean difference of −1,041 mL (95% CI, −1,371 to −710). Sensitivity analysis excluding studies with serious or critical risk of bias provided similar results. Five studies compared uterine artery embolization with a control group, all with serious or critical risk of bias; the mean difference was −936 mL (95% CI, −1,522 to −350). Reported information on adverse events was limited.

CONCLUSION:

Although the predominance of observational studies in the included literature warrants caution in interpreting the findings of this meta-analysis, our findings suggest that prophylactic placement of balloon catheters or sheaths before planned cesarean delivery in women with placenta accreta spectrum disorder may, in some cases, substantially reduce perioperative blood loss. Further study is required to quantify the efficacy according to various severities of placenta accreta spectrum disorder and the associated safety of these radiologic interventions.

SYSTEMATIC REVIEW REGISTRATION:

PROSPERO, CRD42022320922.
Efficacy of axitinib in a US cohort of patients with programmed cell death protein 1–resistant mucosal melanoma
Authors: Lochrin Sarah E. , Cugliari Marina K. , Yeh Randy , Shoushtari Alexander N.
Published: July 2024

Mucosal melanoma is a rare melanoma subtype, accounting for about 1% of all diagnosed melanomas. It is characterized by an aggressive phenotype with a poor prognosis and a low response rate to approved treatments. We retrospectively analyzed the clinical features, treatments, and outcomes of patients diagnosed with mucosal melanoma treated with axitinib ± anti-programmed cell death protein 1 (PD-1) therapy at a single US referral center between 2018 and 2021. Radiologic response was assessed according to Response Evaluation Criteria in Solid Tumors (RECIST), v1.1. Twenty-three patients were included in this study. In all, 78% were females with a median age of 62 years. The originating site of mucosal melanoma was the sinonasal (35%), genitourinary (35%), and gastrointestinal (30%) tracts. Sixty-five percent of patients had M1c or M1d disease and 0% had BRAF V600 mutations detected. The majority (96%) had prior treatment inclusive of anti-PD-1, with a median of 2 prior lines, and 78% of patients received a combination of axitinib and PD-1 and the median duration of treatment was 3.2 months. The overall response rate was 13% and the disease control rate was 26%. The median progression-free survival was 3.2 months, and the median overall survival was 8.2 months. Overall, the regimen was well tolerated with 39% of patients requiring dose reduction and 9% requiring treatment cessation. Axitinib with anti-PD-1 therapy has modest clinical activity in heavily pretreated patients with mucosal melanoma outside of Asia, including some with long-term benefits. This data supports the worldwide clinical trials evaluating this combination and the role of incorporating vascular endothelial growth factor-based therapy in the therapeutic paradigm for patients with mucosal melanoma.
High-frequency Power Doppler Ultrasonography in Predicting Burn Depth: A Preliminary Case Report
Authors: Saijo Yusaku , Akaishi Satoshi , Kuwahara Hiroaki
Published: July 2024

Accurate burn depth assessment is essential to decide an appropriate surgical procedure. However, most cases of burn depth are diagnosed with subjective judgment by an experienced plastic surgeon. There is a need for a simple, noninvasive, and accurate diagnostic method. Here, the authors present two burn cases in which burn depth was predicted using high-frequency power Doppler ultrasonography. In case 1, the patient showed partial deep burn area prediagnosed by clinical inspection in dorsal area. However, pulsatile microcirculation was detected in the deep dermal layer using high-frequency power Doppler ultrasonography, and we rediagnosed it as deep dermal burn. Tangential excision was performed to debride necrotic tissue, preventing excessive removal of viable dermal tissue. In case 2, the patient showed anterior chest burn covered eschar. Pulsatile microcirculation was detected in the dermis using high-frequency power Doppler ultrasonography. The authors diagnosed the area as superficial dermal burn and opted for conservative treatment. Dermal microvascular damage is a more sensitive indicator of tissue injury. Hence, the burn depth can be assessed using dermal microcirculation. To the best of the authors’ knowledge, there are no reports on the evaluation of blood flow in burn wounds using high-frequency power Doppler ultrasonography. In this case report, the authors introduce the possibility of using high-frequency ultrasonography to assess burn depth.
Role of point-of-care ultrasound (POCUS) in clinical hepatology
Authors: Premkumar Madhumita , Karvellas Constantine J. , Kulkarni Anand V. , Bhujade Harish , Reddy K. Rajender
Published: July 2024

Hospitalized patients with cirrhosis frequently require critical care management for sepsis, HE, respiratory failure, acute variceal bleeding, acute kidney injury (AKI), shock, and optimization for liver transplantation, while outpatients have unique care considerations. Point-of-care ultrasonography (POCUS) enhances bedside examination of the hepatobiliary system and relevant extrahepatic sites. POCUS includes cardiac US and is used to assess volume status and hemodynamic parameters like cardiac output, systemic vascular resistance, cardiac contractility, and pulmonary artery pressure, which aid in the early and accurate diagnosis of heart failure, cirrhotic cardiomyopathy, porto-pulmonary hypertension, hepatopulmonary syndrome, arrhythmia, and pulmonary embolism. This also helps in fluid management and vasopressor use in the resuscitation of patients with cirrhosis. Lung ultrasound (LUS) can help in differentiating pneumonia, effusion, and edema. Further, US guides interventions such as line placement, drainage of abdominal collections/abscesses, relief of tension pneumothorax, drainage of pleural and pericardial effusions, and biliary drainage in cholangitis. Additionally, its role is essential to assess liver masses foci of sepsis, for appropriate sites for paracentesis, and to assess for vascular disorders such as portal vein or hepatic vein thrombosis. Renal US can identify renal and postrenal causes of AKI and aid in diagnosis of prerenal AKI through volume assessment. In this review, we address the principles and methods of POCUS in hospitalized patients and in outpatients with cirrhosis and discuss the application of this diverse modality in clinical hepatology.
Association between frailty and acute kidney injury after cardiac surgery: unraveling the moderation effect of body fat through an international, retrospective, multicohort study
Authors: Bai Yun-Xiao , Wang Zi-Hao , Lv Yong , Liu Jie , Xu Zhen-Zhen , Feng Yi-Qi , Liu Guo-Yang , Yin Ping , Wang Yan-Ting , Dong Nian-Guo , Wu Qing-Ping
Published: July 2024

Background:

Acute kidney injury (AKI) is a common and serious complication after cardiac surgery that significantly affects patient outcomes. Given the limited treatment options available, identifying modifiable risk factors is critical. Frailty and obesity, two heterogeneous physiological states, have significant implications for identifying and preventing AKI. Our study investigated the interplay among frailty, body composition, and AKI risk after cardiac surgery to inform patient management strategies.

Material and methods:

This retrospective cohort study included three international cohorts. Primary analysis was conducted on adult patients who underwent cardiac surgery between 2014 and 2019 at Wuhan Union Hospital, China. We tested the generalizability of our findings with data from two independent international cohorts, the Medical Information Mart for Intensive Care IV (MIMIC-IV) and the eICU Collaborative Research Database. Frailty was assessed using a clinical lab-based frailty index (FI-LAB), while total body fat percentage (BF%) was calculated based on a formula accounting for BMI, sex, and age. Logistic regression models were used to analyze the associations between frailty, body fat, and AKI, adjusting for pertinent covariates.

Results:

A total of 8785 patients across three international cohorts were included in the study. In the primary analysis of 3569 patients from Wuhan Union Hospital, moderate and severe frailty were associated with an increased AKI risk after cardiac surgery. Moreover, a nonlinear relationship was observed between BF% and AKI risk. When stratified by the degree of frailty, lower body fat correlated with a decreased incidence of AKI. Extended analyses using the MIMIC-IV and eICU cohorts (n=3951 and n=1265, respectively) validated these findings and demonstrated that a lower total BF% was associated with decreased AKI incidence. Moderation analysis revealed that the effect of frailty on AKI risk was moderated by the BF%. Sensitivity analyses demonstrated results consistent with the main analyses.

Conclusion:

Higher degrees of frailty were associated with an elevated risk of AKI following cardiac surgery, and total BF% moderated this relationship. This research underscores the significance of integrating frailty and body fat assessments into routine cardiovascular care to identify high-risk patients for AKI and implement personalized interventions to improve patient outcomes.
Assessing the global burden of mesothelioma: trends, socioeconomic influences, and asbestos exposure – a retrospective cohort study
Authors: Zhao Ziran , Li Jiagen , Tan Fengwei , Xue Qi , Gao Shugeng , He Jie
Published: July 2024

Introduction:

Mesothelioma is an uncommon type of cancer that has received little attention. This study aims to evaluate the global disease burden, trends of mesothelioma by age, sex, and geographic locations, and its risk factors at the population level.

Methods:

The Global Cancer Observatory in 2022 and 2019 Global Burden of Disease were accessed for mesothelioma incidence and its risk factors worldwide. Multivariable linear regression analyses were conducted to explore the associations between mesothelioma incidence and key predictors, including Human Development Index (HDI), Gross Domestic Product (GDP) per capita, and occupational asbestos exposure, adjusting for age and sex across global regions.

Results:

This study identified 30 870 global cases of mesothelioma in 2022, with a higher age-standardized incidence rate in males (0.25 per 100 000) compared to females (0.39 per 100 000). Geographical analysis indicated the highest disease burden in Northern Europe, with particular prevalence in more developed regions. The incidence was also significantly associated with a higher HDI, with a β coefficient of 0.133 overall, and GDP per capita, with a β coefficient of 0.101. These socioeconomic factors exhibited stronger associations in the elderly population, especially with HDI (β=0.512) and GDP (β=0.389), than in adults. Additionally, occupational exposure to asbestos remained a significant risk factor across all groups, except for the younger adult population, with an overall β of 0.122 for incidence. The temporal trend analysis revealed a general decrease in mesothelioma incidence, particularly in the 15–49 years age group.

Conclusions:

The analysis indicates a higher mesothelioma incidence in males and in developed regions, with marked disparities noted particularly in Northern Europe. Significant correlations with socioeconomic indicators – HDI and GDP – and occupational asbestos exposure were identified, particularly affecting the elderly. Despite a decline in global incidence, especially among younger individuals, persistent cases in females highlight the need for continued public health measures addressing both occupational and environmental exposures.
Sorting Dietary Advice for Bone Health
Authors: Weaver Connie M. , Wallace Taylor C. , Cao Sisi
Published: July 2024

Healthcare professionals are consistently bombarded with conflicting messages about the role of diet in bone health. Yet, few resources are available that compile the broad scope of dietary factors that influence bone health. This article evaluates the evidence on the association of diet and exercise with bone health, with the aim to provide a resource for healthcare professionals and researchers in the field. This review also highlights gaps in knowledge, provides dialogue around why some studies exhibit conflicting outcomes, and showcases why many remaining questions likely cannot be answered with the current evidence to date. The best evidence to date supports obtaining recommended dairy and calcium intakes for building bone in early life and mitigating bone loss with age. However, nutrients do not solely work in isolation, and there is growing evidence that many other nutrients and dietary bioactives play a synergistic role in supporting bone health. Large randomized controlled trials, particularly in traditionally underserved subpopulations (eg, people of color, transgender individuals, older adults, etc), are needed to fully elucidate the effects of diet and exercise on bone health across the lifespan.
Comparative study between aquatic therapy and land-based exercises in hemiplegic patients after stroke: a randomized controlled trial
Authors: Iatridou Georgia , Stergiou Alexandra N. , Varvarousis Dimitrios N. , Theodorou Areti , Doulgeri Sofia , Pelidou Henrietta-Syngliti , Dimakopoulos George , Ploumis Avraam
Published: July 2024

Objective

This study aimed to assess the effects of aquatic therapy in individuals with hemiplegia compared to those of a conventional land-based exercise program.

Design

This was a blinded, randomized controlled study of chronic stroke patients with hemiplegia. The participants were randomized in to aquatic therapy (experimental) or conventional therapy (control) groups. The aquatic therapy group conducted the exercise program in a swimming pool, and the conventional therapy group performed to an exercise on the land environment three times per week for six weeks. Both interventions focused on posture, balance, and weight-bearing exercises. Outcomes included the Berg Balance Scale, Brunnstrom scale, Motricity Index, muscle strength tests, Modified Ashworth Scale, Postural Assessment Scale for Stroke, Trunk Control Test and Functional Independence Measure. Also, postural sway was evaluated by using the variables of center of pressure displacements in the mediolateral and anteroposterior directions.

Results

The findings of the present study show that the experimental group (26 patients) exhibited significant improvements in spasticity compared to the control group (25 patients) (p = 0.01). The conventional therapy group also achieved significant improvements (p < 0.05) in anteroposterior deviation, mediolateral velocity, and total velocity of center of pressure in a sitting position with eyes closed.

Conclusion

Land-based exercises were more beneficial in the spasticity of chronic stroke patients.
Earliest evidence of avian primary feather moult
Authors: Wang Xiaoli , O'Connor Jingmai , Zheng Xiaoting , Wang Yan , Kiat Yosef
Published: July 2024

Feather moulting is a crucial process in the avian life cycle, which evolved to maintain plumage functionality. However, moulting involves both energetic and functional costs. During moulting, plumage function temporarily decreases between the shedding of old feathers and the full growth of new ones. In flying taxa, a gradual and sequential replacement of flight feathers evolved to maintain aerodynamic capabilities during the moulting period. Little is known about the moult strategies of non-avian pennaraptoran dinosaurs and stem birds, before the emergence of crown lineage. Here, we report on two Early Cretaceous pygostylian birds from the Yixian Formation (125 mya), probably referable to Confuciusornithiformes, exhibiting morphological characteristics that suggest a gradual and sequential moult of wing flight feathers. Short primary feathers interpreted as immature are symmetrically present on both wings, as is typical among extant flying birds. Our survey of the enormous collection of the Tianyu Museum confirms previous findings that evidence of active moult in non-neornithine pennaraptorans is rare and likely indicates a moult cycle greater than one year. Documenting moult in Mesozoic feathered dinosaurs is critical for understanding their ecology, locomotor ability and the evolution of this important life-history process in birds.
Revisiting Perdeck's massive avian migration experiments debunks alternative social interpretations
Authors: Pot Morrison T. , Visser Marcel E. , Helm Barbara , von Rönn Jan A. C. , van der Jeugd Henk P.
Published: July 2024

Whether avian migrants can adapt to their changing world depends on the relative importance of genetic and environmental variation for the timing and direction of migration. In
the
classic series of field experiments on avian migration, A. C. Perdeck discovered that translocated juveniles failed to reach goal areas, whereas translocated adults performed ‘true-goal navigation’. His translocations of > 14 000 common starlings (
Sturnus vulgaris
) suggested that genetic mechanisms guide juveniles into a population-specific direction, i.e. ‘vector navigation’. However, alternative explanations involving social learning after release in juveniles could not be excluded. By adding historical data from translocation sites, data that was unavailable in Perdeck's days, and by integrated analyses including the original data, we could not explain juvenile migrations from possible social information upon release. Despite their highly social behaviour, our findings are consistent with the idea that juvenile starlings follow inherited information and independently reach their winter quarters. Similar to more solitarily migrating songbirds, starlings would require genetic change to adjust the migration route in response to global change.
Analysis of direct traffic at the transport protocol level in the WiMax-1/2 cluster oriented to offload the smart city's wireless ecosystem
Authors: Kovtun Viacheslav , Grochla Krzysztof , Aldosary Saad , Al-Maitah Mohammed
Published: July 2024

Rerouting of direct information traffic under the WiMax-1/2 technology control in the case of licensed frequency spectrum overload ensures communication continuity in the smart city's critical infrastructure. The support of such a process in the WiMax-1/2 cluster has its specificity, worthy of analytical formalization. The article presents a mathematical apparatus that allows the average service duration of an information message during its transfer from the terminal to the WiMax-1/2 base station to be estimated. Unlike analogues, the presented concept adequately describes the investigated process for any number of terminals, taking into account both the queuing effect on their side and the functioning of the cumulative query transmission mechanism inherent in WiMax-1/2 technology. Therefore, the proposed mathematical apparatus, describing the process of servicing an information message, takes into account both the average duration accompanied by potential collisions in the process of sending a request for the allocation of communication resources for its transmission to the base station, and the average duration of the information message's stay in the terminal queue. Experimental studies demonstrated the adequacy of the proposed mathematical apparatus for describing the investigated process. The experimental section also formulates the optimization problem of the investigated process resulting from the management of competitive access parameters.
Sauropod dinosaur tracks from the Purbeck Group (Early Cretaceous) of Spyway Quarry, Dorset, UK
Authors: Butler Richard J. , Edgar Kirsty M. , Haller Lewis , Meade Luke E. , Jones Harry T. , Hill Oliver , Scriven Sam , Reedman Christopher
Published: July 2024

Dinosaur tracks have a long history of discovery and study in the UK, but track sites for sauropodomorph dinosaurs—the group that included the giant, graviportal herbivorous sauropods—are comparatively rare. Here, we provide a description of a sauropod dinosaur track site at Spyway Quarry in Dorset, southern England. The tracks at Spyway were discovered in the late 1990s and occur in the Stair Hole Member of the Durlston Formation in the Purbeck Limestone Group, of earliest Cretaceous age. More than 130 individual tracks of large sauropod dinosaurs are present at the site, but they are generally poorly preserved and do not form clear trackways, although it is likely that they represent multiple individuals. They provide further evidence for sauropods living in or passing through coastal lagoonal environments. Although poorly preserved, Spyway represents the largest
in situ
dinosaur track site currently accessible within the Purbeck Group, with considerable potential for further discoveries through ongoing quarrying in the surrounding area.
Androgen receptor alpha deficiency impacts aromatase expression in the female cichlid brain
Authors: Lopez Mariana S. , Alward Beau A.
Published: July 2024

Steroid hormones bind to specific receptors that act as transcription factors to modify gene expression in the brain to regulate physiological and behavioural processes. The specific genes controlled by steroid hormones in the brain are not fully known. Identifying these genes is integral to establishing a comprehensive understanding of how hormones impact physiology and behaviour. A popular organism for answering this question is the cichlid fish
Astatotilapia burtoni
. Recently, CRISPR/Cas9 was used to engineer
A. burtoni
that lack functional androgen receptor (AR) genes encoding ARα. ARα mutant male
A. burtoni
produced fewer aggressive displays and possessed reduced expression of the gene encoding brain-specific aromatase,
cyp19a1
, in the ventromedial hypothalamus (VMH), an aggression locus. As a follow-up, we investigated whether ARα deficiency affected
cyp19a1
expression in female
A. burtoni
using the same genetic line. We find that female
A. burtoni
possessing one or two non-functional ARα alleles had much higher expression of
cyp19a1
in the preoptic area (POA), while females with one non-functional ARα allele possessed lower expression of
cyp19a1
in the putative fish homologue of the bed nucleus of the stria terminalis (BNST). Thus, ARα may have a sex-specific role in modifying
cyp19a1
expression in the teleost POA and BNST, regions that underlie sex differences across vertebrates.
Physiological state matching in a pair bonded poison frog
Authors: Nowicki Jessica P. , Rodríguez Camilo , Lee Julia C. , Goolsby Billie C. , Yang Chen , Cleland Thomas A. , O'Connell Lauren A.
Published: July 2024

More than a century ago, Charles Darwin hypothesized that the empathy-like phenotype is a phylogenetically widespread phenomenon. This idea remains contentious, due to the challenges of empirically examining emotions, and few investigations among non-mammalian vertebrates. We provide support for Darwin's hypothesis by discovering partial evidence for the most ancestral form of empathy, emotional contagion (i.e. matching another individual's emotional state), in the pair bonding mimetic poison frog,
Ranitomeya imitator
. We found that male corticosterone, a physiological biomarker of stress, positively correlates with female partners in experimental and semi-natural conditions. This does not appear to coincide with behavioural state-matching. However, it is specific to female partners relative to familiar female non-partners, and is independent of effects that commonly confound studies on emotional contagion. Furthermore, this physiological state-matching is irrespective of partnership longevity or lifetime reproductive output. These results physiologically indicate socially selective emotional contagion in a monogamous amphibian, and paradigms that elicit coinciding neural and behavioural indicators and morphogenic co-variation are needed for further corroboration. Further studies on ancestral forms of empathy in non-mammalian vertebrates are warranted.
Reducing Blood Culture Contamination Rates: Introduction of a Combined Education and Skin Antisepsis Intervention
Authors: Mullane Niamh , O'Mara Niall , Coffey Darragh , Connolly Aine , O'Callaghan Isabelle , Kelly Deborah , Broderick Deirdre , Hickey Caitriona
Published: July 2024

Background. Blood culture contamination (BCC) is an important quality concern in clinical microbiology as it can lead to unnecessary antimicrobial therapy in patients and increased workload for laboratory scientists. The Clinical Laboratory and Standards Institute recommend BCC rates to be <3 % and recently updated guidelines have set a new goal of 1 %. The aim of this project was to design and implement interventions to reduce BCC rates at our institution.

Methods. We introduced a combined education and skin antisepsis intervention in a large Model 4 academic teaching hospital in the South of Ireland. BD ChloraPrep skin antisepsis applicators (2 % chlorhexidine gluconate/70 % isopropyl alcohol), licensed for use for blood culture specimen collection, were introduced, replacing Clinell (2 % chlorhexidine gluconate/70 % isopropyl alcohol) wipes. In addition, a multimodal education programme was designed and delivered. This consisted of a video demonstrating the recommended blood culture specimen collection technique using the new applicators as well as simulation training for all interns. The video was uploaded to the intranet as an educational resource available to all staff.

Results. The interventions were implemented in July 2022 and BCC rates pre- and post-intervention were calculated. The average BCC rate for the 12 months preceding the intervention (July 2021 to July 2022) was 2.56 % with highest rates in the Emergency Department. This compared to an average rate of 2.2 % in the 12 months post-intervention (July 2022 to July 2023). In comparing the two rates the reduction in BCC rates between the two periods was not statistically significant (P=0.30).

Conclusion. Overall BCC rates reduced but the difference between the two periods did not reach statistical significance. The resource-intensive nature of providing regular and timely feedback of contamination rates and the larger impact of in-person education and training over virtual modalities may explain the modest reduction. Further investments in these areas, particularly in the Emergency Department, will be necessary to further reduce rates in line with new recommendations.