bluuebunny/crossref_metadata_2025 huggingface dataset:
Can Caffeine Change the Game? Effects of Acute Caffeine Intake on Specific Performance in Intermittent Sports During Competition: A Systematic Review and Meta-Analysis
Authors: Diaz-Lara Javier , Nieto-Acevedo Raúl , Abian-Vicen Javier , Del Coso Juan
Published: August 2024

Background: The benefits of oral caffeine intake to enhance several aspects of physical performance, such as aerobic endurance, strength, power, and muscle endurance performance, are well supported. However, how the physical performance benefits of caffeine supplementation are translated into better specific actions in intermittent sports during real or simulated competition has been the topic of fewer investigations, and their results need to be appropriately reviewed and meta-analyzed. Objective: The aim of the study was to investigate the effects of acute caffeine intake on specific actions in intermittent sports involving decision making and high-intensity efforts (eg, team, racket, and combat sports) during real or simulated competitions. Methods: All studies included had blinded and crossover experimental designs, and we conducted a risk-of-bias analysis. In total, we included 24 studies. A meta-analysis was performed using the random-effects model to calculate the standardized mean difference (SMD) estimated by Hedges g and 95% CIs. Results: Caffeine ingestion increased high-intensity sport-specific actions during competition, such as the number of sprints (SMD: 0.48; 95% CI, 0.23–0.74), body impacts (SMD: 0.28; 95% CI, 0.08–0.49), accelerations (SMD: 0.35; 95% CI, 0.06–0.63), decelerations (SMD: 0.63; 95% CI, 0.12–1.14), and high-intensity offensive efforts (SMD: 0.36; 95% CI, 0.11–0.61). Additionally, caffeine ingestion induced a higher positive or success rate of actions during real or simulated competition (SMD: 0.44; 95% CI, 0.19–0.69). Conclusion: The current meta-analysis provides evidence of caffeine supplementation in increasing high-intensity efforts and the success rate of sport-specific actions during real or simulated competition.
The actin-spectrin submembrane scaffold restricts endocytosis along proximal axons
Authors: Wernert Florian , Moparthi Satish Babu , Pelletier Florence , Lainé Jeanne , Simons Eline , Moulay Gilles , Rueda Fanny , Jullien Nicolas , Benkhelifa-Ziyyat Sofia , Papandréou Marie-Jeanne , Leterrier Christophe , Vassilopoulos Stéphane
Published: August 2024

Clathrin-mediated endocytosis has characteristic features in neuronal dendrites and presynapses, but how membrane proteins are internalized along the axon shaft remains unclear. We focused on clathrin-coated structures and endocytosis along the axon initial segment (AIS) and their relationship to the periodic actin-spectrin scaffold that lines the axonal plasma membrane. A combination of super-resolution microscopy and platinum-replica electron microscopy on cultured neurons revealed that AIS clathrin-coated pits form within “clearings”, circular areas devoid of actin-spectrin mesh. Actin-spectrin scaffold disorganization increased clathrin-coated pit formation. Cargo uptake and live-cell imaging showed that AIS clathrin-coated pits are particularly stable. Neuronal plasticity-inducing stimulation triggered internalization of the clathrin-coated pits through polymerization of branched actin around them. Thus, spectrin and actin regulate clathrin-coated pit formation and scission to control endocytosis at the AIS.
Reductive samarium (electro)catalysis enabled by Sm
III
-alkoxide protonolysis
Authors: Boyd Emily A. , Shin Chungkeun , Charboneau David J. , Peters Jonas C. , Reisman Sarah E.
Published: August 2024

Samarium diiodide (SmI
2
) is a privileged, single-electron reductant deployed in diverse synthetic settings. However, generalizable methods for catalytic turnover remain elusive because of the well-known challenge associated with cleaving strong Sm
III
–O bonds. Prior efforts have focused on the use of highly reactive oxophiles to enable catalyst turnover. However, such approaches give rise to complex catalyst speciation and intrinsically limit the synthetic scope. Herein, we leveraged a mild and selective protonolysis strategy to achieve samarium-catalyzed, intermolecular reductive cross-coupling of ketones and acrylates with broad scope. The modularity of our approach allows rational control of selectivity based on solvent, p
K
a
(where
K
a
is the acid dissociation constant), and the samarium coordination sphere and provides a basis for future developments in catalytic and electrocatalytic lanthanide chemistry.
Alzheimer’s and metabolism wed with IDO1
Authors: Johnson Lance A. , Macauley Shannon L.
Published: August 2024

Kynurenine pathway inhibition reverses deficits in Alzheimer’s mouse models
Natural history of spinal cord compression stage AFMS3 in infants with achondroplasia: retrospective cohort study
Authors: Cheung Moira Shang-Mei , Cocca Alessandra , Harvey Charlotte H , Brett Connor Stephen S , Offiah Amaka C , Borg Stephanie , Jenko Nathan , D’Arco Felice , Thompson Dominic
Published: August 2024

Background and objective

Foramen magnum stenosis (FMS) is a common, serious complication of achondroplasia in infancy and associated with sudden infant death. The Achondroplasia Foramen Magnum Score (AFMS; 0–4) is used to classify the severity of stenosis to inform appropriate neurosurgical management. Infants with AFMS4 are referred for neurosurgery, while well children with AFMS3 undergo repeat MRI routinely after 12 months.

As the natural history of children with AFMS3 is currently unclear, the objective was to review follow-up MRI scans of infants initially classified as AFMS3 to define more clearly the evolution of this degree of stenosis.

Design

This retrospective cohort study, from two tertiary centres, included infants with a confirmed diagnosis of achondroplasia and AFMS3 on initial MRI who subsequently underwent repeat MRI or proceeded straight to neurosurgery.

Results

Twenty-two cases satisfied the inclusion criteria. Mean age in months was 6.23 (SD±3.82) and 17.95 (SD±7.68) at baseline and follow-up scans, respectively. Follow-up MRI showed no change in 23% (N=5), improvement in 36% (N=8) to either AFMS1 (N=5) or AFMS2 (N=3). There was progression in 41% to AFMS4 (N=8). One case had neurosurgey without follow-up MRI (N=1).

Conclusions

These results support MRI screening for FMS in infants with achondroplasia. Furthermore, infants with AFMS3 should undergo follow-up MRI as over 40% progress prompting neurosurgical intervention. There is currently no consensus on frequency or timing of screening for AFMS3 in achondroplasia; however, we suggest that guidance for follow-up imaging is modified to 6 months to detect progression earlier in this at-risk cohort.
Diagnosis journey for children with juvenile idiopathic arthritis: a qualitative study
Authors: Chausset Aurelie , Freychet Caroline , Lohse Anne , Belot Alexandre , Merlin Etienne , Echaubard Stephane , Schott Anne-Marie , Lachal Jonathan
Published: August 2024

Objective

The objective is to explore the journey to diagnosis and referral pathway from the onset of symptoms to the initial assessments at paediatric rheumatology (PR) centres, based on the experience of children with juvenile idiopathic arthritis (JIA) and their parents.

Design

We conducted a qualitative study with semistructured interviews. Our qualitative and phenomenological procedure applied interpretative phenomenological analysis.

Participants

19 families of children diagnosed with JIA 4–24 months before the study began (22 parents, 12 children>11 years), across 4 PR centres.

Main outcome measures

The results highlight the contrasting feelings of children and their parents on the referral pathway and interactions with primary care physicians (PCPs).

Results

Four superordinate themes emerged: (1) the journey undertaken by families from initially trivialising the first symptoms to a growing sense of urgency, (2) the perception gap between the families’ growing disquiet and first medical interventions, (3) the lack of guidance from physicians prompting parents to initiate action and (4) the various elements of the care pathway that influenced the way the diagnosis was experienced and its impact.

Conclusion

The psychosocial consequences of delayed diagnosis in JIA should not be underestimated, especially for adolescents. The views and experiences of children and their parents on the diagnostic journey should be implemented in training programmes and guidelines for PCPs. The development of online supports, integrating the latest medical knowledge with testimonials from families about their experiences, with a common language for physicians and the general population, can facilitate communication and empower families to navigate the healthcare system.

Trial registration number

NCT05696340
.
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Analgesic effectiveness of methoxyflurane inhaler during genicular nerve block in knee osteoarthritis: a randomized controlled trial
Authors: Sawang Saowanee , Kimpee Pretimon , Itthichaikulthol Wichai , Tontisirin Nuj , Limpoon Suwimon , Seangrung Rattaphol , Pasutharnchat Koravee , Cohen Steven Paul
Published: August 2024

Background

Up to 30% of patients with knee osteoarthritis (KOA) have evidence of sensitization, with a similar proportion experiencing severe pain during procedures. Most patients with KOA are elderly and often develop side effects from intravenous sedation. Our study investigated the effectiveness of a methoxyflurane inhaler combined with local anesthesia in reducing procedural pain from genicular nerve block compared with local anesthesia alone.

Methods

42 adults with refractory KOA were randomized into two groups. Methoxyflurane group received a self-titrated methoxyflurane inhaler with local anesthesia whereas lidocaine group received local anesthesia only. The primary outcome was pain score on a 0–10 verbal numerical rating scale (VNRS) during the procedure. Secondary outcomes included changes in VNRS and behavioral pain scale (critical care pain observational tool) during the procedure, hemodynamic changes, anxiety level, sedation score, and adverse events.

Results

42 patients with a mean age of 66±12 years participated in this study. There were no significant baseline differences. During the procedure, the methoxyflurane group experienced a significantly greater VNRS pain reduction from baseline (2 (1, 4) vs −1 (−2, 0); p<0.01) and greater VNRS reduction over time (p=0.01) compared with the lidocaine group, with a higher sedation score (p<0.01). Immediately postprocedure, anxiety levels were lower in the methoxyflurane group compared with the lidocaine group (median State-Trait Anxiety Inventory score 21 (IQR 20, 24) vs 27 (23, 29); p=0.02), but the median reduction in anxiety level was not significant (6 (1, 12) vs 5 (0, 14); p=0.61). There were no differences in behavioral pain scores, hemodynamic parameters, recovery or discharge times, and adverse effects between the two groups.

Conclusion

A methoxyflurane inhaler combined with local anesthesia provided better procedural pain control than local anesthesia alone with no observable differences in adverse effects. Future studies evaluating the impact of a methoxyflurane inhaler on different types of painful procedures are warranted.
Consensus palliative care referral criteria for people with chronic obstructive pulmonary disease
Authors: Philip Jennifer , Chang Yuchieh Kathryn , Collins Anna , Smallwood Natasha , Sullivan Donald Richard , Yawn Barbara P , Mularski Richard , Ekström Magnus , Yang Ian A , McDonald Christine F , Mori Masanori , Perez-Cruz Pedro , Halpin David M G , Cheng Shao-Yi , Hui David
Published: August 2024

Objective

People with advanced chronic obstructive pulmonary disease (COPD) have substantial palliative care needs, but uncertainty exists around appropriate identification of patients for palliative care referral.

We conducted a Delphi study of international experts to identify consensus referral criteria for specialist outpatient palliative care for people with COPD.

Methods

Clinicians in the fields of respiratory medicine, palliative and primary care from five continents with expertise in respiratory medicine and palliative care rated 81 criteria over three Delphi rounds. Consensus was defined a priori as ≥70% agreement. A criterion was considered ‘major’ if experts endorsed meeting that criterion alone justified palliative care referral.

Results

Response rates from the 57 panellists were 86% (49), 84% (48) and 91% (52) over first, second and third rounds, respectively. Panellists reached consensus on 17 major criteria for specialist outpatient palliative care referral, categorised under: (1) ‘Health service use and need for advanced respiratory therapies’ (six criteria, eg, need for home non-invasive ventilation); (2) ‘Presence of symptoms, psychosocial and decision-making needs’ (eight criteria, eg, severe (7–10 on a 10 point scale) chronic breathlessness); and (3) ‘Prognostic estimate and performance status’ (three criteria, eg, physician-estimated life expectancy of 6 months or less).

Conclusions

International experts evaluated 81 potential referral criteria, reaching consensus on 17 major criteria for referral to specialist outpatient palliative care for people with COPD. Evaluation of the feasibility of these criteria in practice is required to improve standardised palliative care delivery for people with COPD.
Relevant Information in TDD Experiment Reporting
Authors: Uyaguari Fernando , Acuña Silvia T. , Castro John W. , Fucci Davide , Dieste Oscar , Vegas Sira
Published: August 2024

Experiments are a commonly used method of research in software engineering (SE). Researchers report their experiments following detailed guidelines. However, researchers do not, in the field of test-driven development (TDD) at least, specify how they operationalized the response variables and, particularly, the measurement process. This article has three aims: (i) identify the response variable operationalization components in TDD experiments that study external quality; (ii) study their influence on the experimental results; (iii) determine if the experiment reports describe the measurement process components that have an impact on the results. We used two-part sequential mixed methods research. The first part of the research adopts a quantitative approach applying a statistical analysis of the impact of the operationalization components on the experimental results. The second part follows with a qualitative approach applying a systematic mapping study (SMS). The test suites, intervention types and measurers have an influence on the measurements and results of the statistical analysis of TDD experiments in SE. The test suites have a major impact on both the measurements and the results of the experiments. The intervention type has less impact on the results than on the measurements. While the measurers have an impact on the measurements, this is not transferred to the experimental results. On the other hand, the results of our SMS confirm that TDD experiments do not usually report either the test suites, the test case generation method, or the details of how external quality was measured. A measurement protocol should be used to ensure that the measurements made by different measurers are similar. It is necessary to report the test cases, the experimental task and the intervention type in order to be able to reproduce the measurements and statistical analyses, as well as to replicate experiments and build dependable families of experiments.
Reflexive Data Curation: Opportunities and Challenges for Embracing Uncertainty in Human–AI Collaboration
Authors: Arzberger Anne , Lupetti Maria Luce , Giaccardi Elisa
Published: August 2024

This article presents findings from a Research through Design investigation focusing on a reflexive approach to data curation and the use of generative AI in design and creative practices. Using binary gender categories manifested in children’s toys as a context, we examine three design experiments aimed at probing how designers can cultivate a
reflexive human-AI practice
to confront and challenge their internalized biases. Our goal is to underscore the intricate interplay between the designer, AI technology, and publicly held imaginaries and to offer an initial set of tactics for how personal biases and societal norms can be illuminated through interactions with AI. We conclude by proposing that designers not only bear the responsibility of grappling critically with the complexities of AI but also possess the opportunity to creatively harness the limitations of technology to craft a
reflexive data curation
that encourages profound reflections and awareness within design processes.
Communication—Forecast of the Impact of Degradation Modes on a Commercial Hard Carbon/Na3V2(PO4)2F3-based Na-ion Battery
Authors: Dubarry Matthieu , Beck David
Published: August 2024

Commercial Na-ion batteries are becoming available with performance forecasted to be similar to that of their lithium counterparts. On the many diagnosis and prognosis techniques developed to characterize batteries in the past four decades, it is essential to assess how many could be directly transferred to Na-ion batteries. In particular, the degradation modes approach is among the most interesting to test because it is widely used and allows to forecast the voltage response of the cells upon degradation. This work investigates the applicability of this approach to a commercial Na-ion cell comprising hard carbon and sodium vanado-fluorophosphate electrodes.
Analyzing Thermal Runaway Propagation in Lithium-Ion Battery Modules with Reduced Flammability Electrolyte Cells
Authors: Sorensen Alexander , Belt Jeffrey
Published: August 2024

A thorough analysis of thermal runaway propagation was conducted, focusing on both module and cell levels, using a range of standard flammability and reduced flammability electrolytes in 18650 cells sourced from Eagle-Picher Technologies. Utilizing techniques such as accelerated rate calorimetry; cell enthalpy, maximum thermal runaway temperature, and thermal runaway onset and initiation temperatures were evaluated, consistently demonstrating their reliability. Employing the NASA X-57 module billet as a strategy for mitigating thermal runaway propagation, the absorption of cell energy during failure events was observed, effectively preventing the spread of thermal runaway between cells. Notably, the use of reduced flammability electrolyte resulted in an average reduction of 104 °C in maximum thermal runaway temperature at the module level, thereby offering decreased risk in preventing thermal runaway propagation during failures. Note the relatively modest 51 °C difference observed between reduced flammability and standard flammability cells during individual cell tests. This underscores the importance of conducting tests at both the cell and module levels in the development of systems for certification, where the cell-level data indicate a 51 °C discrepancy, while the module-level analysis shows a more substantial 104 °C differentiation.
Perirenal Fat Thickness Is Associated With Contrast‐Induced Nephropathy in Type 2 Diabetic Patients Undergoing Coronary Catheterization
Authors: Tang Xixiang , Wang Jiafu , Wu Yuman , Huang Zhuoshan , Ouyang Xiaolan , Wu Hongxing , Chen Qian , Zhong Junlin , Peng Long , Lu Yan , Wu Bingyuan , Ling Yesheng , Li Suhua
Published: August 2024

Background: Deposition of adipose tissue may have a promoting role in the development of diabetic complications. This study is aimed at investigating the relationship between adipose tissue thickness and risk of contrast‐induced nephropathy (CIN) in patients with Type 2 diabetes mellitus (T2DM).

Methods: A total of 603 T2DM patients undergoing percutaneous coronary angiography or angioplasty with suspicious or confirmed stable coronary artery disease were enrolled in this study. The thicknesses of perirenal fat (PRF), subcutaneous fat (SCF), intraperitoneal fat (IPF), and epicardial fat (ECF) were measured by color Doppler ultrasound, respectively. The association of various adipose tissues with CIN was analyzed.

Results: Seventy‐seven patients (12.8%) developed CIN in this cohort. Patients who developed CIN had significantly thicker PRF (13.7 ± 4.0 mm vs. 8.9 ± 3.6 mm, p < 0.001), slightly thicker IPF (p = 0.046), and similar thicknesses of SCF (p = 0.782) and ECF (p = 0.749) compared to those who did not develop CIN. Correlation analysis showed that only PRF was positively associated with postoperation maximal serum creatinine (sCr) (r = 0.18, p = 0.012), maximal absolute change in sCr (r = 0.33, p < 0.001), and maximal percentage of change in sCr (r = 0.36, p < 0.001). In receiver operating characteristic (ROC) analysis, the area under the curve (AUC) of PRF (0.809) for CIN was significantly higher than those of SCF (0.490), IPF (0.594), and ECF (0.512). Multivariate logistic regression analysis further confirmed that thickness of PRF, rather than other adipose tissues, was independently associated with the development of CIN after adjusted for confounding factors (odds ratio (OR) = 1.53, 95% CI: 1.38–1.71, p < 0.001).

Conclusions: PRF is independently associated with the development of CIN in T2DM patients undergoing coronary catheterization.
Enhancement of Magnetization of the Diluted Magnetic Semiconductor (Ga, Mn)As by Hole Doping
Authors: Aredo Tadesse Bekele , Geffe Chernet Amente , Habura Kunsa Haho , Masho Tola Jabessa , Fite Gemechis Mathewos , Dadi Dereje Gelanu , Kasiab Manza Zityab , Likasa Bedasa Wagari
Published: August 2024

In this paper, the effects of hole doping on the magnon specific heat, average number of magnons, magnetization, and Curie temperature (Tc) of the diluted magnetic semiconductor (DMS) (Ga, Mn)As are theoretically studied using Green function formalism and employing a model system Hamiltonian consisting of magnons, holes, and interactions between magnons and holes. The specific heat capacity of magnons and the number of magnons are found to decrease in the presence of holes and hole–magnon interaction strength, whereas magnetization and Curie temperature (Tc) increase. Our study also reveals that at a constant finite temperature, an increased number of holes lead to a significant increase in magnetization. However, at T = 0, the ground state magnetization value does not exhibit any change with increased free holes and hole–magnon interaction strength. The increased magnetization resulting from doping with holes or electron excitations in this study may present an opportunity to utilize the system under consideration for spintronics purposes at room temperature.
Assessment of Sex, Gonad Volume, and Reproductive Maturation Status of the Indian Shad, Tenualosa ilisha, Using Ultrasonic Imaging: A Rapid and Non‐Invasive Tool
Authors: Dasgupta Subrata , Biswas Gouranga , Tripathi Gayatri , Pathan Mujahidkhan A. , Ghoshal Tapas K. , Singh Pratiksha K. , Jana Tanmoy , Mitra Paroma , Samanta Srikanta , De Debasis , Adhikari Subhendu , Manna Ranjan K. , Sahoo Amiya K.
Published: August 2024

To determine sex and maturity stages accurately without any physical injury and stress, especially for sensitive and high‐value fish species, employing a noninvasive ultrasound imaging technique could be a desirable approach. The ultrasound imaging method as a powerful eco‐friendly tool was established to determine sex, gonad volume, gonadosomatic index (GSI), and reproductive stages in the Indian shad, hilsa (Tenualosa ilisha). About 30 hilsa (15 males and 15 females) of different maturity stages were collected from the river Ganga round the year using gill nets. The ultrasound sonography (USG) was then employed in hilsa to determine the computed GSI. The fresh gonad volume of hilsa was determined using a water displacement method to ascertain actual GSI values. There was no significant difference between the calculated, real, and actual GSIs (P > 0.05) in both males and females. The validation of the precise maturity stages of ultrasound images of the gonad by the histological architecture indicated that USG images of the hilsa gonad depicted exact stages of maturity in both sexes except for stages I and II in males. The sex of the fish was accurately ascertained using ovarian ultrasound scanning for all the specimens. The calculated USG‐based ovarian volume was positively correlated (R2 = 0.97) with the actual and real ovarian volumes. The noninvasive and reliable ultrasonography technique was found to be an accurate and valid tool to track gender and gonadal development and predict the spawning periodicity in hilsa.
Inhibition of Lymphangiogenesis: A Protective Role of microRNA 146a‐5p in Breast Cancer
Authors: Liang Wenlong , Wang Haoran , Fu Baiyang , Song Yuan , Zhang Zheng , Liu Xin , Lin Yujia , Zhang Jianguo
Published: August 2024

Breast cancer is the leading cause of death and morbidity among women. A major challenge for clinical management of breast cancer is the dissemination of breast cancer cells from the primary tumor site via lymphatic drainage, resulting in metastatic tumor spread. Recent studies have found that high expression of the microRNA miR‐146a‐5p is associated with better survival outcomes for breast cancer patients. However, the mechanisms for this prognostic benefit are not fully elucidated, including whether or not miR‐146a‐5p plays a role in suppression of lymphatic dissemination. In this study, we investigated the role and uncovered functional mechanisms of miR‐146a‐5p in breast cancer. We found that high expression of miR‐146a‐5p is associated with better clinical outcomes, specifically in the patients with N0 breast cancer. In culture, miR‐146a‐5p overexpression in MCF‐7 breast cancer cells suppressed cell migration and lymphangiogenesis in lymphatic endothelial cells. When implanted in the mammary fat pad of mice, we observed that miR‐146a‐5p overexpressing MCF‐7 suppressed lymphatic dissemination but had no effect on tumor progression in the primary site. This suppression was associated with fewer disseminated cancer cells and reduced lymphangiogenesis in the draining and distal lymph nodes. In conclusion, these results suggest that miR‐146a‐5p can exhibit a protective role against breast cancer metastasis, and it can be a therapeutic target for breast cancer.
GOLD-Grade Specific Disease Characterization and Phenotyping of COPD Using Quantitative Computed Tomography in the Nationwide COSYCONET Multicenter Trial in Germany
Authors: Konietzke Philip , Weinheimer Oliver , Triphan Simon M.F. , Nauck Sebastian , Wuennemann Felix , Konietzke Marilisa , Jobst Bertram J. , Jörres Rudolf A. , Vogelmeier Claus F. , Heussel Claus P. , Kauczor Hans-Ulrich , Biederer Jürgen , Wielpütz Mark O. ,   for the COSYCONET study group
Published: August 2024

Introduction: The aim of this study was to apply quantitative computed tomography (QCT) for GOLD-grade specific disease characterization and phenotyping of air-trapping, emphysema, and airway abnormalities in patients with chronic obstructive pulmonary disease (COPD) from a nationwide cohort study. Methods: As part of the COSYCONET multicenter study, standardized CT in ex- and inspiration, lung function assessment (FEV1/FVC), and clinical scores (BODE index) were prospectively acquired in 525 patients (192 women, 327 men, aged 65.7 ± 8.5 years) at risk for COPD and at GOLD1–4. QCT parameters such as total lung volume (TLV), emphysema index (EI), parametric response mapping (PRM) for emphysema (PRMEmph) and functional small airway disease (PRMfSAD), total airway volume (TAV), wall percentage (WP), and total diameter (TD) were computed using automated software. Results: TLV, EI, PRMfSAD, and PRMEmph increased incrementally with each GOLD grade (p < 0.001). Aggregated WP5–10 of subsegmental airways was higher from GOLD1 to GOLD3 and lower again at GOLD4 (p < 0.001), whereas TD5–10 was significantly dilated only in GOLD4 (p < 0.001). Fifty-eight patients were phenotyped as “non-airway non-emphysema type,” 202 as “airway type,” 96 as “emphysema type,” and 169 as “mixed type.” FEV1/FVC was best in “non-airway non-emphysema type” compared to other phenotypes, while “mixed type” had worst FEV1/FVC (p < 0.001). BODE index was 0.56 ± 0.72 in the “non-airway non-emphysema type” and highest with 2.55 ± 1.77 in “mixed type” (p < 0.001). Conclusion: QCT demonstrates increasing hyperinflation and emphysema depending on the GOLD grade, while airway wall thickening increases until GOLD3 and airway dilatation occur in GOLD4. QCT identifies four disease phenotypes with implications for lung function and prognosis.
MPE beim mutierten NSCLC: Intrapleurale Applikation von Bevacizumab stellt effektive Therapie dar
Authors: Stanzel Dr. Franz
Published: August 2024

Background: Several studies have indicated that intrapleural infusion of bevacizumab is an effective treatment for non-small cell lung cancer (NSCLC) with malignant pleural effusion (MPE). However, the impact of bevacizumab administered through an indwelling pleural catheter (IPC) on the prognosis of these patients is unknown. Methods: Consecutive advanced NSCLC patients with symptomatic MPE receiving an IPC alone or bevacizumab through an IPC were identified in a tertiary hospital. The patient characteristics and clinical outcomes were collected. Results: A total of 149 patients were included, and the median age was 60.3 years. Males and nonsmokers accounted for 48.3% and 65.8%, respectively. A total of 69.8% (104/149) of patients harbored actionable mutations, including 92 EGFR-activating mutations, 11 ALK fusions, and 1 ROS1 fusion. A total of 81.9% (122/149) of patients received IPC alone, and 18.1% (27/149) received bevacizumab through an IPC. The incidence of spontaneous pleurodesis during the first 6 months was greater in the bevacizumab-treated group than in the IPC-treated group in the subgroup with actionable mutations (64.3% vs. 46.9%, P = 0.28). The median overall survival (OS) in patients with actionable mutations treated with bevacizumab through an IPC was 42.2 months, which was significantly longer than the 26.7 months in patients who received an IPC alone (P = 0.045). However, the median OS did not differ between the two arms in the subgroup without actionable mutations (10.8 vs. 41.0 months, P = 0.24). No significant difference between the bevacizumab through an IPC group and the IPC group was detected in the number of participants who had adverse events, either in patients with actionable mutations (14.3% vs. 8.4%; P = 0.42) or in patients without actionable mutations (16.7% vs. 12.8%; P = 1.00). Conclusions: Bevacizumab through an IPC resulted in a significantly improved prognosis for NSCLC patients with MPE and actionable mutations. However, patients without actionable mutations do not benefit from bevacizumab through IPC.
Perinatal Outcomes of Pregnancies with Borderline Oligohydramnios at Term
Authors: Sgayer Inshirah , Elafawi Mohamed , Braude Olga , Abramov Sarah , Lowenstein Lior , Odeh Marwan
Published: August 2024

Introduction: Limited evidence exists on borderline oligohydramnios. Our objective was to determine perinatal outcomes in uncomplicated term pregnancies with borderline oligohydramnios. Methods: This retrospective analysis compared adverse perinatal outcomes among pregnancies during 2018–2022, between those with borderline oligohydramnios defined as amniotic fluid index (AFI) of 5.1–8.0 cm, those with oligohydramnios (AFI ≤5 cm), and those with normal AFI (8.1–25 cm). The latter matched one-to-one to the borderline oligohydramnios group and served as the control group. The outcomes compared included birthweight, cesarean delivery due to fetal distress, the presence of meconium-stained amniotic fluid, Apgar scores, neonatal intensive care unit admission, and the occurrence of small-for-gestational-age (SGA) neonates. Results: During the study period, 140 women had borderline oligohydramnios and 345 had oligohydramnios; the control group included 140 women. Borderline oligohydramnios was associated with increased rates of delivering SGA neonates (adjusted odds ratio [aOR] = 3.6, 95% confidence interval [CI] 1.1–11.6, p = 0.034) and cesarean delivery due to fetal distress (aOR = 3.0, 95% CI 1.1–8.3, p = 0.032). Rates of composite neonatal outcome (including at least one of the following: cesarean delivery due to fetal distress, meconium-stained amniotic fluid, 5-min Apgar score <7, umbilical artery pH <7.15, or neonatal intensive care unit admission) were higher in both the borderline oligohydramnios (20.7%) and oligohydramnios (18.6%) groups compared to the control group (9.3%) (p = 0.019). Conclusions: Pregnancies with borderline oligohydramnios were associated with increased risks of delivering SGA neonates and requiring cesarean delivery due to fetal distress. These findings support considering closer antepartum surveillance for these pregnancies, especially for identifying abnormal fetal growth.
Is John Stuart Mill's On Liberty Obsolete?
Authors: Blasi Vincent
Published: August 2024

In On Liberty, published in 1859, John Stuart Mill argues for the “absolute” protection of the “liberty of thought and discussion.” Ever the empiricist, he maintains that such uncompromised freedom, not for all communication or self-expression but for the subset of those activities that qualifies as thought and discussion, would generate the best overall consequences for societies such as Great Britain and the United States. The advent of digital technology has altered how thought and discussion is generated, distributed, and received in ways that might problematize some of the empirical assumptions upon which Mill's argument in On Liberty is based. This essay explores whether the reasons he advances for the absolute liberty of thought and discussion continue to have purchase in the face of the changed empirical domain in which Mill's cherished activities of inquiry and persuasion now operate.
The Free Speech Clause as a Deregulatory Tool
Authors: Tsesis Alexander
Published: August 2024

The U-S. Supreme Court increasingly leverages a rigid interpretation of the Free Speech Clause to strike regulations that address campaign financing, health care warnings, tax disclosures, collective bargaining agreements, and consumer protections. History has become little more than a slogan that the majority periodically invokes but seldom accurately evaluates. That lack of nuance augments the justices ’ authority to articulate absolutist-sounding rules to the detriment of legislatures’ exercise of traditional governmental functions. Jurists would do better to rely on a more proportionate and less categorical approach to decide whether laws impose direct or peripheral burdens on communications. The level of safeguards enjoyed by expressions should be gauged by their value to political self-determination, personal development, or informational contribution. The degree of protections that speech enjoys should be balanced against countervailing government interests, alternatives available to speakers, fit between law and public ends, and relevant history.
A Machine Learning Approach for Prediction of Surgical Outcomes in Elective Surgery
Authors: Muriithi Dennis , Mwangi Virginia
Published: August 2024

The aim of this research was to design a Machine Learning (ML) approaches to predict surgical outcome associated with perioperative risks factors among patients undergoing elective surgery. The research employed descriptive cross-sectional survey and a sample size of 292 patients. Only adult patients undergoing elective surgery were considered. Machine Learning (ML) Algorithm such as Logistic regression, Support vector machine, k-nearest neighbors and random forest were used to provide insights into how different factors such as patient related perioperative risk, procedure related perioperative risk and health system related perioperative risk influence the likelihood of successful surgical outcome. The study found that Random Forest model achieved the highest cross validation accuracy of 100%, which means it correctly classified all data points in the test set. It implies that the random Forest model was the most suitable for classifying surgical outcome among elective surgery patient at Chuka County Referral Hospital. It had a Kappa of 1 indicating a perfect agreement between its predictions and the ground truth in comparison with other algorithms. In addition, Random Forest model achieves a perfect score (1.0) for sensitivity, precision, F1-Score, and balanced accuracy. This suggests that the model is doing extremely well at correctly classifying both positive and negative cases. Availability of main surgical supplies (health system related perioperative risk factors) had the highest score indicating that it was more important factor for the models predictions than other perioperative risk factors. In this study, the Machine Learning analysis identified unknown parameters associated with successful surgical outcome. An application of Machine Learning algorithms as a decision support tool could enable the medical health practitioners to predict the surgical outcome of patients undergoing elective surgery and consequently optimize and personalize clinical management of patient.
A Generalized Linear Model of HIV/AIDS Patients in Kenya: A Case Study of Nyeri County Referral Hospital
Authors: Ireri Sarah , Esekon Joseph , Kinyua Margaret
Published: August 2024

With millions of new cases and deaths reported every year, HIV/AIDS is a significant worldwide health concern. Creating successful public health policies and interventions requires an understanding of the dynamics of HIV transmission and progression. WHO predicted that by the end of 2022 roughly 39 million individuals worldwide would be living with HIV, out of which 37.5 million are adults, whereas 1.5 million are children. Despite outstanding global gains in HIV/AIDS prevention, treatment and care, Kenya continues to struggle to effectively handle the HIV epidemic, particularly in areas like Nyeri County. Nyeri County Referral Hospital is a critical healthcare institution for HIV/AIDS patients in the region. However, there is still a lack of understanding about the epidemiological characteristics of HIV/AIDS in this particular population. This study’s aim was to use a GLM on HIV/AIDS data in Nyeri County Referral Hospital in Kenya. To determine the significance of model parameters, Likelihood Ratio Test was used whereas significance of regression coefficients was determined using Wald Chi- Square Test. Deviance was utilized to test for the goodness of fit. R software version 4.4.1 was utilized. This project may help health policymakers in developing or refining HIV/AIDS care programs. Findings from the study can help healthcare planners and policymakers allocate resources more efficiently to meet the requirements of HIV/AIDS patients. The fitted model showed that, only ART use was significant (p-value = 2.684562 × 10−13). Because some covariates were not significant, each of them was analyzed separately. Age was a significant predictor (p-value = 0.0001536103). The other variables were not significant. This finding is consistent with previous evidence, which stresses the relevance of ART in lowering viral load, enhancing immunological function, and extending the lives of people living with HIV. To build upon the current findings, future research should explore additional variables that may influence HIV status, for example cultural beliefs, and access to healthcare services. Again, future studies may involve the use of survival analysis through GLM in analyzing similar data.
Assessment of Heavy Metal Contamination and Its Impact on Water Quality and Aquatic Life in Mine Surface Plant Areas
Authors: Chimanga Kashale , Kumaran Santhi , Josephat Kalezhi
Published: August 2024

The Copper mining industry accounts for the country’s largest export earning and creates several jobs. Despite this the mines have been known to be the major contributor to the environmental pollution. It has been observed that in one province of the country, there is high presence of iron and other heavy metals in the surrounding areas. Unfortunately these heavy metals find themselves in water bodies and consequently affect the aquatic life. This study was conducted to develop suitable machine learning prediction models that estimate the impact of mine pollutants on fish production in the Kalumbila area of North-Western Province. The Machine Learning techniques employed include Multiple Linear Regression (MLR), Artificial Neural Networks (ANN), Random Forest (RF) and K-Nearest Neighbors (KNN). These models were evaluated and, in terms of Mean Absolute Error (MAE) and Root Mean Squared Error (RMSE) with the values of 0.25 (25%) and 0.22 (22%) indicating that Random Forest appear to be the best-performing models in terms of prediction accuracy compared to other models. In addition, the RF model also achieved the highest R2 score of 0.94, indicating its ability to explain a greater proportion of the variance in the dependent variable compared to the other models. This means that RF provides a strong prediction accuracy than other models in terms of determining heavy metal contamination in impact on Water Quality and Aquatic Life in Mine Surface Plant Areas. Therefore this study shows the potential of Machine Learning models to assist decision makers in understanding the pollution levels in water bodies.
Study on Methylene Blue Adsorption Properties of Biochar/Montmorillonite Composites
Authors: Han Zhiyong , Wang Kexin , Zhang Yanxia , Xian Ao , Wei Xinpeng , Wang Zixuan
Published: August 2024

The textile printing and dyeing industry, as one of the important pillars of the global economy, has become an environmental problem that needs to be solved because of the increasingly serious pollution of dye wastewater generated during its production process. Dye wastewater not only contains high concentrations of organic dyes, but also often accompanied by heavy metal ions, additives and salts and other pollutants, if discharged directly without effective treatment, will seriously pollute the water body, destroying the ecological balance, and affecting the survival and health of human beings and aquatic organisms. In order to deal with the problems of serious pollution, large discharge and high cost of dye wastewater, it is necessary to develop an efficient, economic and environmentally friendly wastewater treatment system. It is particularly important to develop efficient, economical and environmentally friendly wastewater treatment technologies. Adsorption is considered as a promising method for wastewater treatment. In this study, we focused on the development of new and efficient adsorbent materials. Taking methylene blue, a typical dye, as an example, we skillfully composited modified biochar with montmorillonite, a natural mineral material, through pyrolysis and intercalation strategies, and conducted in-depth investigations on the effects of the composites on the adsorption of methylene blue in water, the factors affecting the regeneration performance of the adsorbents, and the thermodynamic characteristics of the adsorption. The effect of the composite material on the adsorption of methylene blue in water, the factors affecting the regeneration performance of the adsorbent and the adsorption thermodynamic characteristics were investigated in depth, with a view to providing certain theoretical and practical references for the effective treatment of dye wastewater.
Prevalence of Meconium Stained Amniotic Fluid and Predictors for Poor Fetal Outcomes Among Women Delivering at Bugando Medical Centre Mwanza Tanzania
Authors: Kamuli Simon , Kaiza Innocent , Kihunrwa Albert , Chibwe Elieza , Mabega Ndakibae
Published: August 2024

Background: Meconium stained amniotic fluid occurs in up to 20% of all deliveries and is reported to vary in different settings across the world. Babies delivered by these women are at high risk of low score and meconium aspiration syndrome. Limited studies have reported on the predictors for poor fetal outcomes in women presenting with meconium stained amniotic fluid. Methods: This was a cross sectional study involving 209 pregnant women with meconium stained amniotic fluid. Semi structured questionnaire was used for data collection. Data were analyzed using STATA version 12. Results: A total of 1202 women delivered during the study period from December 2017 to February 2018. Amongst, 209 (17.4%) women had meconium stained amniotic fluid. Of the 209 babies, 35 (16.7%) had low score, 41 (19.6%) were admitted due to meconium aspiration syndrome and 3 (1.4%) died due to meconium aspiration syndrome related complications. Predictors for poor fetal outcomes were found to be Thick meconium (Grade III), Meconium as a new event during labor monitoring and null parity. Conclusion: The prevalence of meconium stained amniotic fluid at Bugando Medical Centre was found to be 17.4%. Thick meconium, development of meconium as a new event and nullparous were found to predict for poor fetal outcomes. Immediate interventions are recommended for those with the identified predictors for poor fetal outcome.
Exploring Setting as a Driver of Drama in Fitzgerald’s “Babylon Revisited”
Authors: Assadi Jamal
Published: August 2024

This study provides an in-depth examination of F. Scott Fitzgerald's "Babylon Revisited," focusing on the influential role of setting in shaping the narrative's dramatic elements. Through a nuanced analysis, the research investigates how the depiction of 1920s Paris serves as a catalyst for character motivations and actions, thereby driving the plot forward. Utilizing a combination of textual analysis and literary theory, the study seeks to elucidate the intricate interplay between setting, structure, and dialogue in Fitzgerald's narrative, aiming to uncover the underlying thematic and stylistic elements at play. The primary objective of this research is to explore the profound impact of setting on character development and narrative progression in "Babylon Revisited." By examining the portrayal of Paris as a milieu of extravagance and hedonism, the study aims to explicate how the city functions as both a backdrop and a character in its own right, influencing the behaviors and decisions of the protagonist, Charlie Wales, and other key figures within the narrative. Methodologically, this study employs a combination of qualitative textual analysis and theoretical inquiry to interrogate the relationship between setting and drama in Fitzgerald's work. Drawing upon established literary frameworks and critical perspectives, the research situates "Babylon Revisited" within its broader cultural and historical context, allowing for a nuanced examination of the novel's thematic concerns and stylistic innovations. By engaging with interdisciplinary approaches to literary analysis, the study aims to provide a comprehensive understanding of the ways in which setting functions as a driver of drama in Fitzgerald's narrative. In conclusion, this research contributes to our understanding of "Babylon Revisited" by offering a rigorous analysis of the role of setting in shaping the novel's dramatic elements. Through a meticulous examination of the text and its contextual underpinnings, the study demonstrates how Fitzgerald's adept manipulation of setting, structure, and dialogue enriches the narrative, elevating it to a timeless work of literature. Ultimately, the research underscores the enduring relevance of Fitzgerald's exploration of human behavior and emotion within the framework of a vividly rendered setting, solidifying his status as a preeminent writer of the 20th century.