bluuebunny/crossref_metadata_2025 huggingface dataset:
Navigating the crossroads of GAI and academic English writing
Authors: Klitgård Ida
Published: February 2025

The study investigates how students perceive, use, and evaluate Generative Artificial Intelligence tools in a BA Academic English Writing course. Tools like ChatGPT, Quillbot, and Grammarly have transformed traditional study aids, enhancing the writing process. The research question is: How do students' perceptions of using Generative AI (GAI) as a tool for academic English writing evolve over the course of an academic writing class immediately after the public launch of the large language model (LLM) ChatGPT? The study considers Warschauer et al.’s three paradoxes arising from using GAI for second language writing: the imitation contradiction, the rich get richer contradiction, and the with or without contradiction. Methodology includes pre- and post-course surveys with qualitative questions to capture students' views before and after using GAI. Content analysis reveals varied opinions, from enthusiasm for GAI's efficiency to concerns about academic dishonesty and creativity hindrance. Students also worry about grading bias and increasing exam difficulty. The study underscores the need for balanced and responsible GAI integration to enhance individual efforts and skills while acknowledging potential benefits and risks.
Hérnia umbilical em potros da raça Quarto de Milha: estudo retrospectivo de 14 casos
Authors: Nascimento Pedro Judson Rosa , De Melo Ubiratan Pereira , Ferreira Cintia , Gomes Sabrina Priscila de Araújo
Published: February 2025

Hérnias umbilicais são comuns em equinos, particularmente em potros, e representam uma afecção clínica relevante na medicina veterinária. Este estudo descreve a avaliação e o tratamento cirúrgico de hérnias umbilicais em 14 potros da raça Quarto de Milha, com idades variando entre 4 e 36 meses. As hérnias apresentavam diâmetros de 4 a 8 cm e eram todas redutíveis. Todos os potros foram submetidos a exame clínico, seguido de herniorrafia pela técnica fechada e, em um caso, uso de tela de polipropileno para reforço do anel herniário. O protocolo pós-operatório incluiu anti-inflamatórios, antibioticoterapia e profilaxia antitetânica. Complicações foram observadas em três animais, incluindo drenagem peritoneal transitória e infecção da linha incisional, tratadas com prolongamento da antibioticoterapia e curativos adicionais. Nenhuma recidiva foi registrada após o período de acompanhamento. A herniorrafia fechada demonstrou ser uma técnica eficaz, mesmo em condições de campo, com bons resultados estéticos e funcionais. O estudo reforça a importância do diagnóstico precoce, manejo adequado e acompanhamento pós-operatório rigoroso, contribuindo para o entendimento da abordagem clínica e cirúrgica de hérnias umbilicais em equinos. A ausência de recidivas e a baixa taxa de complicações (21% dos casos) evidenciam a viabilidade da técnica aplicada, destacando seu potencial para uso em situações de infraestrutura limitada.
Does market orientation of small and medium enterprises make differences in the market?
Authors: Alfirevic Ana Marija , Mihanovic Damir , Cupic Julija
Published: February 2025

In market-oriented businesses, market orientation holds a significant position as a business concept focused on recognizing and meeting customer needs (the market). Given the interest in this subject, it is essential to identify and analyze the factors influencing the development of market orientation dimensions (market orientation - MO), conceptualized according to the model proposed by Kohli and Jaworski (1990), and their impact on increasing MO. Based on available literature and previous empirical research, the following factors have been identified to assess their influence on market orientation: professionalization of management in SMEs, quality of communication/dissemination of market information within the company, performance measurement of management staff in SMEs, and their material rewards. This research was conducted on a sample of 26 SMEs in Split-Dalmatia County, Republic of Croatia, using statistical methods of descriptive statistics, correlation, statistical testing, and clustering. Non-parametric statistics were used to overcome certain limitations of the small sample size. The results are discussed in the context of developing entrepreneurial infrastructure and public policies to support entrepreneurship.
Special regimes of state control (supervision): legal regulation
Authors: Golubeva Tat'yana Mihailovna
Published: February 2025

The current stage of reforming control (supervisory) activities is associated with increasing the efficiency and effectiveness of state control (supervision). This goal is achieved through the application of the necessary and sufficient regime of state control (supervision). According to the author, depending on the conditions of implementation, the state control (supervision) regimes are divided into general and special ones. The article discusses such special regimes of state control (supervision) such as monitoring, constant state control (supervision), as well as a constant raid. In addition, the author suggests that temporary regimes should be attributed to special state control (supervision) regimes: a moratorium on inspections, an experiment on the use of remote control in the field of industrial safety, as well as the implementation of state control (supervision) during the operation of experimental legal regimes. The analysis of the current legislation on the regulation of state control (supervision) regimes is carried out.   The methodological basis was provided by general scientific (analysis, synthesis) and special (formal-legal, comparative-legal) methods of cognition. As a result of the conducted research in the field of state control (supervision) through the application of the necessary and sufficient regime of state control (supervision), the following conclusions can be drawn. Firstly, special state control (supervision) regimes are an effective tool for ensuring safety at high-risk facilities (permanent state control (supervision) regime). Secondly, the legal regulation of special state control (supervision) regimes requires improvement through the adoption of additional regulatory acts. Thirdly, it is determined that the implementation of special state control (supervision) regimes, including temporary ones, reduces administrative pressure on business entities. In addition, the author comes to the conclusion that it is necessary to legislate temporary regimes of state control (supervision). as special regimes of state control (supervision).
The potential of citral isomers from lemongrass (Cymbopogon citratus) essential oil as WAT browning agents in obesity by activating AMPK and PPARγ: An in silico approach
Authors: Mashitah Musthika Wida , Widodo Nashi , Permatasari Nur , Rudijanto Achmad
Published: February 2025

Obesity is characterized by abnormal fat accumulation in the white adipose tissue (WAT), posing a significant health risk. Enhancing energy expenditure through WAT browning using dietary components and natural extracts is a promising therapeutic strategy for obesity management. This study explored the efficacy of citral isomers from Cymbopogon citratus (lemongrass) essential oil as agents for WAT browning by activating primarily the proliferator-activated receptor gamma (PPARγ) and AMPK, utilizing an in silico approach. Essentials oil were extracted from lemongrass leaves and stalks via steam-hydro distillation, and the citral isomer content was analyzed through gas chromatography-mass spectrophotometry. Molecular docking was performed using AutoDock Vina, and molecular dynamics simulations were conducted using YASARA. Five citral isomers were identified: geranial, neral, geranial diethyl acetal (GDA), isogeranial, and isoneral isomers. This study identified GDA and neral as the most effective AMPK agonists, acting by directly activating their allosteric sites. Additionally, GDA, isoneral, and neral demonstrate PPARγ agonist properties by stabilising the protein’s active site. In conclusion, citral isomers in lemongrass essential oil hold the potential to act as WAT browning agents in obesity management through the activation of AMPK and PPARγ. Future in vitro and in vivo studies are required to validate these findings.
A molecular proximity sensor based on an engineered, dual-component guide RNA
Authors: Choi Junhong , Chen Wei , Liao Hanna , Li Xiaoyi , Shendure Jay
Published: February 2025

One of the goals of synthetic biology is to enable the design of arbitrary molecular circuits with programmable inputs and outputs. Such circuits bridge the properties of electronic and natural circuits, processing information in a predictable manner within living cells. Genome editing is a potentially powerful component of synthetic molecular circuits, whether for modulating the expression of a target gene or for stably recording information to genomic DNA. However, programming molecular events such as protein-protein interactions or induced proximity as triggers for genome editing remains challenging. Here, we demonstrate a strategy termed ‘P3 editing’, which links protein-protein proximity to the formation of a functional CRISPR-Cas9 dual-component guide RNA. By engineering the crRNA:tracrRNA interaction, we demonstrate that various known protein-protein interactions, as well as the chemically induced dimerization of protein domains, can be used to activate prime editing or base editing in human cells. Additionally, we explore how P3 editing can incorporate outputs from ADAR-based RNA sensors, potentially allowing specific RNAs to induce specific genome edits within a larger circuit. Our strategy enhances the controllability of CRISPR-based genome editing, facilitating its use in synthetic molecular circuits deployed in living cells.
Effects of chemical fungicides combined with plant resistance inducers against Bipolaris sorokiniana in turfgrass
Authors: Ünal Filiz , Kurbetli İlker , Eğerci Yeşim , Cavusoglu Aysun
Published: February 2025

One of the most common and causative diseases problems disease in turfgrass areas in Türkiye is leaf blight, root and crown rot caused by Bipolaris sorokiniana. The fungus causes great damage especially in parks, refuges, and golf courses, and needs to be managed. This study aimed to determine some activators alone or in combination with effective fungicides at different doses against B. sorokiniana, to reduce the use of fungicides in the control of the disease. In the study, the effects of combinations of different doses of some fungicides with Lactobacillus acidophilus, Arthrobacter sp. and a harpin protein determined to be effective in in vitro studies were investigated in greenhouse and field conditions in two different provinces. The highest effect was obtained in the combination of (Lactobacillus acidophilus-(Azoxystrobin+Difenocazole)), which was used at the recommended dose (94.70% effect) and the recommended dose of Azoxystrobin+Difenocazole (92.57% effect). The (Lactobacillus acidophilus-(Azoxystrobin+Difenocazole 1st subdose)) application, in which a lower dose of fungicide was used, ranked 4th with an 89.50% effect. When Lactobacillus acidophilus, Arthrobacter sp. and Harpin were used alone, they were found to be 82.53%, 72.17%, and 66.63% effective against the disease, respectively. As a result, environmentally friendly low-dose fungicide, and activator combination (Lactobacillus acidophilus-(Azoxystrobin+Difenocazole 1. subdose)), and (Arthrobacter sp.-(Epoxiconazole+Pyraclostrobin 1st sub-dose)) applications were found to be promising in the control of B. sorokiniana in turfgrass areas. When considered only as an activator application, the 82.53% effect value obtained in Lactobacillus acidophilus applications was found to be promising for the disease. It can be recommended as a disease suppressant, and at the same time environmentally friendly application.
Graphene History, Technical Applications and Production: A Brief Review
Authors: Dölle Klaus , Purvis Lauren , Cai Mingyu , Jin Chengyu , Qiu Puxi
Published: February 2025

The review paper gives a brief overview of the historical use of carbon materials like graphite and charcoal and graphene and its production.
It reviews the application of graphene for industrial application such as energy storage, electronics, biomedical, and environmental fields, including and sustainable methods for producing graphene from waste products, addressing both the need for advanced materials and the growing problem of plastic pollution. It reviews various graphene production techniques such as catalytic carbonization, flash joule heating, and solid-state chemical vapor deposition for the production of graphene.
Comparative Outcomes of Planned Cesarean Hysterectomy and Conservative Management in Placenta Accreta Spectrum: A Narrative Review
Authors: Ismail Nabeelah
Published: February 2025

Background: Placenta Accreta Spectrum (PAS) is a life-threatening obstetric condition involving abnormal placental adherence or invasion into the uterine wall. Management options include planned cesarean hysterectomy, considered the definitive treatment, and conservative management, which preserves fertility but carries additional risks. Early diagnosis and multidisciplinary care are crucial in improving outcomes.
Aim: This review compares maternal outcomes of planned cesarean hysterectomy versus conservative management in PAS and provides evidence-based recommendations for clinical practice.
Materials and Methods: A comprehensive search of PubMed, Google Scholar, and ScienceDirect identified 32 studies evaluating outcomes of planned cesarean hysterectomy and conservative management, including maternal morbidity, mortality, blood loss, and neonatal health. Data were analyzed and synthesized to address the study objectives.
Results: Planned cesarean hysterectomy was associated with reduced risks of postpartum hemorrhage and readmissions but carried risks of significant intraoperative blood loss (mean
>4,000 mL) and surgical complications, such as bladder injury. Conservative management techniques, including the Triple-P procedure and Modified One-Step Conservative Surgery, achieved uterine preservation in up to 88% of cases but had higher rates of delayed complications, such as infection and hemorrhage. Early antenatal diagnosis and multidisciplinary care improved outcomes for both approaches.
Conclusions: Planned cesarean hysterectomy remains the gold standard for severe PAS, minimizing maternal morbidity and mortality, while conservative management is a viable option in select cases but requires rigorous follow-up.
Knowledge and Attitude towards Cardiopulmonary Resuscitation among Community Members in Selected Communities of Obio/Akpor Lga, Rivers State, Nigeria
Authors: Awajionye Ekanem, Emmanuel , Oluwatosin O. Abimbola,
Published: February 2025

The survival chances of an out of hospital cardiac arrest are significantly increased by provision of bystander cardiopulmonary resuscitation (CPR). Early bystander cardiopulmonary resuscitation has been documented as one of the most important predictors of out-of-hospital cardiac arrests survival. The study was designed to assess the knowledge and attitude towards cardiopulmonary resuscitation among community members in three selected communities in Obio-Akpor, Rivers State. Cross sectional descriptive design utilizing mixed method was adopted. A total of 427 participants were selected by purposive sampling. Structured questionnaire was utilized to assess community members “knowledge on cardiopulmonary Resuscitation. Mean score was determined and mean scores and above was categorized as good knowledge while below mean scores was categorized as poor knowledge. To access the attitude towards cardiopulmonary resuscitation, mean score was determined and mean scores and above was categorized as positive attitude while below mean scores was categorized as negative attitude. The data was analyzed using descriptive analysis and inferential statistics of chi- square to test the set hypothesis at p ≤0.05. Most occurring age group of the respondents were between 31-40 years and 50.5% are single. The findings on knowledge of CPR from this study revealed that 59.8% had poor knowledge while 40.2% had good knowledge of CPR. Overall, 58.5% had negative attitude towards administering CPR while 41.5% of the community members had positive attitude towards administering CPR to out of hospital cardiac arrest victims. There is a significant association between sex, marital status, level of education, occupation and knowledge on CPR as well as marital status and attitude towards CPR. Also, there is statistically significant association between knowledge on CPR and attitude towards CPR.
Development of a Scale to Measure the Empowerment of Soliga Tribal Women in Chamarajanagar District, Karnataka, India
Authors: K. N. Manohar, , V. Govinda Gowda, , Y. N. Shivalingaiah,
Published: February 2025

India has a large number of tribal population as compared to other countries in the world. Despite being considered as first inhabitants of the nation, tribes are deprived of their basic needs of daily life. They are not only socially, economically and educationally backward and also face discrimination in many ways especially among women. Hence the study was conducted on Soliga tribal women who were more vulnerable to development and an attempt was made to develop and standardize a scale to measure the extent of empowerment among Soliga tribal women.  Likert and Edward summated rating scale was employed, based on the procedure 140 statements under six dimensions were identified and sent to 105 judges for the relevancy analysis. After relevancy test 99 statements were retained and tested in non sample area of Soligara colony in Heggadadevana kote taluk of Mysore district. Criterion group was performed to evaluate the individual statements and critical ratio was calculated using t test. The eighty eight statements with the highest t value equal to or greater than 1.69 were subjected to the reliability in non sampling area. Correlation coefficient 0.931 and ‘r’ value of 0.926, which was found significant at one per cent level indicating the high reliability of the scale. Validity coefficient was found to be 0.962 for the scale which was higher than standard requirement of 0.70 which signifies scale was suitable and appropriate under the dimensions of social, economic, health, psychological, political and legal components of Soliga trial women. The developed scale with 88 statements was administered with 32 respondents in non sample area and it was observed that 37.50 per cent of Soliga tribal women belongs to medium empowerment category followed by low (34.38 %) and high (28.12 %) empowerment category.
Implementasi Photovoice dalam Komunitas Tuli: Fotografi sebagai Medium Komunikasi Visual
Authors: Wibowo Yosephien Reynalda Prananda , Ahmad Hafiz Aziz
Published: February 2025

Individu dalam komunitas tuli menghadapi tantangan unik dalam berkomunikasi karena memiliki keterbatasan komunikasi verbal. Komunikasi verbal seringkali tidak memadai untuk menyampaikan pengalaman dan perasaan, sehingga dibutuhkan sarana bagi individu tuli menyampaikan pengalaman melalui medium visual yakni fotografi. Artikel ini bertujuan untuk mengetahui bagaimana pengimplementasian fotografi sebagai medium komunikasi visual pada kegiatan photovoice dalam komunitas Tuli, serta melihat bagaimana fotografi dapat menjadi ekspresi bagi yang tuli. Penelitian ini menggunakan pendekatan kualitatif dengan desain penelitian partisipatif dan eksploratif untuk memahami bagaimana pengimplementasian photovoice dalam komunitas tuli. Photovoice merupakan metode untuk individu mengidentifikasi, mempresentasikan dan memperkuat komunitas melalui teknik fotografi. Hasil penelitian menunjukkan bahwa tahapan photovoice yang diimplementasi dapat disesuiakan dengan kebutuhan penelitian dan dapat digunakan secara lebih luas dan menciptakan peluang partisipasi yang lebih inklusif. Disimpulkan, bahwa pengimplementasian fotografi dalam kegiatan photovoice memberikan kontribusi positif sebagai medium komunikasi visual bagi komunitas tuli dan dapat menciptakan narasi yang kuat yang mungkin sulit diungkapkan melalui kata-kata verbal.
Komunikasi Bisnis Melalui Host Sebagai Opinion Leader Terhadap Interaktivitas Media Live Streaming
Authors: Azzahra Bunga , Afriani Anindita Lintangdesi
Published: February 2025

Live streaming cukup populer di generasi muda. Hal ini dikarenakan live streaming memiliki fitur interaksi secara real-time. Live streaming saat ini juga dimanfaat sebagai sarana bisnis yang berbasis User Generated Content (UGC) yang memanfaatkan kreativitas pengguna dalam menciptakan konten yang kemudian hal tersebut bisa diakses oleh publik. Salah satu aplikasi yang mewadahi konten-konten tersebut adalah Nimo Tv. Nimo Tv merupakan aplikasi live streaming yang membebaskan penggunanya untuk menciptakan kontennya sendiri. Nimo Tv juga memberi peluang para host untuk menghasilkan ratusan hingga ribuan dollar per bulannya. Penonton dapat memberikan pertanyaan serta komentar yang dapat dilihat secara real-time oleh host maupun penonton yang lain. Fitur inilah yang digunakan oleh anak muda untuk memasukkan sisi komunikasi bisnis guna memperoleh tujuan bisnis berupa virtual gifts. Maka dari itu, penelitian ini bertujuan untuk melihat lebih jauh tentang sejauh mana pengaruh host sebagai opinion leader terhadap interaktivitas pada media live streaming. penelitian ini menggunakan metode kuantitatif yang dikelola dengan SPSS. Data dikumpulkan melalui Google Form dengan total 100 sampel sesuai dengan kriteria responden dan membutuhkan 10 hari untuk mengumpulkan data. Penelitian ini menggunakan self determination theory sebagai acuannya. Fokus pada penelitian ini adalah melihat pengaruh host sebagai opinion leader terhadap interaktivitas pada aplikasi Nimo TV. Hasil penelitian menunjukkan bahwa komunikasi bisnis yang dilakukan host sebagai opinion leader berpengaruh terhadap interaktivitas pada media live streaming terutama Nimo Tv.
Urgent Need for Regulatory Oversight of Human Cells, Tissues, and Cellular and Tissue–Based Products
Authors: Dickson Robert P. , Dingell Deborah A.
Published: May 2024

This Viewpoint discusses the death of a patient caused by unregulated biological products and efforts to encourage federal government oversight of such products.
An Asset Framework to Guide Nonhealth Policy for Population Health
Authors: Ettman Catherine K. , Galea Sandro
Published: May 2024

This JAMA Forum discusses 3 types of assets (financial, physical, and social) that unlock access to resources and shape population health.
Endovascular Therapy and Outcomes Among Patients With Very Large Ischemic Core Stroke
Authors: Xie Dongjing , Huang Jiacheng , Fan Shitao , Guo Changwei , Sun Wenzhe , Peng Zhouzhou , Zhang Lingyu , Yue Chengsong , Qiu Zhongming , Sang Hongfei , Liang Dingwen , Hu Jinrong , Yang Jie , Huang Jiandi , Li Linyu , Liu Juan , Yang Dahong , Liu Xiang , Kong Weilin , Liu Shuai , Yang Qingwu , Zi Wenjie , Li Fengli
Published: May 2024

Importance

The association of endovascular therapy (EVT) with outcomes is unclear for patients with very low Alberta Stroke Program Early Computed Tomography Score (ASPECTS) within 24 hours of stroke onset.

Objective

To explore the association of EVT with functional and safety outcomes among patients with ASPECTS of 0 to 2 scored with noncontrast computed tomography.

Design, Setting, and Participants

This cohort study used data from an ongoing, prospective, observational, nationwide registry including all patients treated at 38 stroke centers in China with an occlusion in the internal carotid artery or M1 or M2 segment of the middle cerebral artery within 24 hours of witnessed symptom onset. Patients with ASPECTS of 0 to 2 between November 1, 2021, and February 8, 2023, were included in analysis. Data were analyzed October to November 2023.

Exposures

EVT vs standard medical treatment (SMT).

Main Outcomes and Measures

The primary outcome was favorable functional outcome, defined as modified Rankin Scale score (mRS) of 0 to 3, at 90 days. Safety outcomes included symptomatic intracerebral hemorrhage (sICH) within 48 hours and mortality at 90 days.

Results

A total of 245 patients (median [IQR] age, 71 [63-78] years; 118 [48%] women) with ASPECTS of 0 to 2 were included, of whom 111 patients (45.1%) received SMT and 135 patients (54.9%) received EVT. The EVT group had significantly greater odds of favorable functional outcome at 90 days than the SMT group (30 patients [22.2%] vs 11 patients [9.9%]; P = .01; adjusted odds ratio [aOR], 3.07 [95% CI, 1.29-7.31]; P = .01). Patients in the EVT group, compared with the SMT group, had significantly greater odds of any ICH (56 patients [41.5%] vs 16 patients [11.4%]; P < .001; aOR, 4.27 [95% CI, 2.19-8.35]; P < .001) and sICH (24 patients [17.8%] vs 1 patient [0.9%]; P < .001; aOR, 23.07 [95% CI, 2.99-177.79]; P = .003) within 48 hours. There were no differences between groups for 90-day mortality (80 patients [59.3%] vs 59 patients [53.2%]; P = .34; aOR, 1.38 [95% CI, 0.77-2.47]; P = .28). The results remained robust in the propensity score–matched analysis.

Conclusions and Relevance

In this cohort study of patients with very low ASPECTS based on NCCT within 24 hours of stroke onset, those treated with EVT had higher odds of a favorable functional outcome compared with those who received SMT. Randomized clinical trials are needed to assess these findings.
Comparative Outcomes of Empagliflozin to Dapagliflozin in Patients With Heart Failure
Authors: Modzelewski Katherine L. , Pipilas Alexandra , Bosch Nicholas A.
Published: May 2024

Importance

Sodium-glucose cotransporter-2 (SGLT2) inhibitors have been shown to have benefits when used in patients with heart failure. The comparative outcomes of SGLT2 inhibitors relative to each other has not been well defined and may impact medication selection.

Objective

To determine the comparative outcomes of empagliflozin and dapagliflozin on reducing the composite of all-cause mortality and hospitalizations in patients with heart failure.

Design, Setting, and Participants

This multicenter retrospective cohort study included patients with heart failure from August 18, 2021, and December 6, 2022, in the TriNetX Research Collaborative, a centralized database of deidentified electronic medical record data from a network of 81 health care organizations. Eligible patients had a diagnosis of heart failure, had never received an SGLT2 inhibitor previously, and were newly started on empagliflozin or dapagliflozin. Patients were followed up for 1 year.

Exposure

Initiation of dapagliflozin or empagliflozin.

Main Outcomes and Measures

The primary outcome was the time to the composite of all-cause mortality or hospitalization between study days 1 to 365. Kaplan-Meier analyses, hazard ratios (HRs), and 95% CIs were used to assess the primary outcome.

Results

Among 744 914 eligible patients, 28 075 began empagliflozin (15 976 [56.9%]) or dapagliflozin (12 099 [43.1%]). After nearest-neighbor matching for demographics, diagnoses, and medication use, there were 11 077 patients in each group. Of patients who received empagliflozin, 9247 (57.9%) were male, 3130 (19.6%) were Black individuals, and 9576 (59.9%) were White individuals. Similarly, of those who received dapagliflozin, 7439 (61.5%) were male, 2445 (20.2%) were Black individuals, and 7131 (58.9%) were White individuals. Patients receiving empagliflozin were less likely to experience the composite of all-cause mortality or hospitalization compared with those initiated on dapagliflozin (3545 [32.2%] vs 3828 [34.8%] events; HR, 0.90 [95% CI, 0.86-0.94]) in the year following SGLT2 inhibitor initiation and less likely to be hospitalized (HR, 0.90 [95% CI, 0.86-0.94]). All-cause mortality did not differ between exposure groups (HR, 0.91 [95% CI, 0.82-1.00]). There was no difference in mean hemoglobin A1c or adverse events between groups.

Conclusions and Relevance

In this cohort study, patients who initiated empagliflozin were less likely to experience the composite of all-cause mortality or hospitalization compared with patients who started dapagliflozin. Additional studies are needed to confirm these finding.
Medically Assisted Reproduction and Risk of Cancer Among Offspring
Authors: Rios Paula , Herlemont Philippe , Fauque Patricia , Lacour Brigitte , Jouannet Pierre , Weill Alain , Zureik Mahmoud , Clavel Jacqueline , Dray-Spira Rosemary
Published: May 2024

Importance

Cancer is a leading cause of death among children worldwide. Treatments used for medically assisted reproduction (MAR) are suspected risk factors because of their potential for epigenetic disturbance and associated congenital malformations.

Objective

To assess the risk of cancer, overall and by cancer type, among children born after MAR compared with children conceived naturally.

Design, Setting, and Participants

For this cohort study, the French National Mother-Child Register (EPI-MERES) was searched for all live births that occurred in France between January 1, 2010, and December 31, 2021 (and followed up until June 30, 2022). The EPI-MERES was built from comprehensive data of the French National Health Data System. Data analysis was performed from December 1, 2021, to June 30, 2023.

Exposure

Use of assisted reproduction technologies (ART), such as fresh embryo transfer (ET) or frozen ET (FET), and artificial insemination (AI).

Main Outcomes and Measures

The risk of cancer was compared, overall and by cancer type, among children born after fresh ET, FET, or AI and children conceived naturally, using Cox proportional hazards regression models adjusted for maternal and child characteristics at birth.

Results

This study included 8 526 306 children with a mean (SD) age of 6.4 (3.4) years; 51.2% were boys, 96.4% were singletons, 12.1% were small for gestational age at birth, and 3.1% had a congenital malformation. There were 260 236 children (3.1%) born after MAR, including 133 965 (1.6%) after fresh ET, 66 165 (0.8%) after FET, and 60 106 (0.7%) after AI. A total of 9256 case patients with cancer were identified over a median follow-up of 6.7 (IQR, 3.7-9.6) years; 165, 57, and 70 were born after fresh ET, FET, and AI, respectively. The overall risk of cancer did not differ between children conceived naturally and those born after fresh ET (hazard ratio [HR], 1.12 [95% CI, 0.96 to 1.31]), FET (HR, 1.02 [95% CI, 0.78 to 1.32]), or AI (HR, 1.09 [95% CI, 0.86 to 1.38]). However, the risk of acute lymphoblastic leukemia was higher among children born after FET (20 case patients; HR 1.61 [95% CI, 1.04 to 2.50]; risk difference [RD], 23.2 [95% CI, 1.5 to 57.0] per million person-years) compared with children conceived naturally. Moreover, among children born between 2010 and 2015, the risk of leukemia was higher among children born after fresh ET (45 case patients; HR, 1.42 [95% CI, 1.06 to 1.92]; adjusted RD, 19.7 [95% CI, 2.8 to 43.2] per million person-years).

Conclusions and Relevance

The findings of this cohort study suggest that children born after FET or fresh ET had an increased risk of leukemia compared with children conceived naturally. This risk, although resulting in a limited number of cases, needs to be monitored in view of the continuous increase in the use of ART.
Genetic Testing in Men With Metastatic Castration-Resistant Prostate Cancer
Authors: Barata Pedro C. , Assayag Jonathan , Li Benjamin , Siu Gordon , Niyazov Alexander
Published: May 2024

This cross-sectional study assesses homologous recombination repair mutation genetic testing and associated characteristics among men with metastatic castration-resistant prostate cancer (mCRPC).
Rate of Initial Optic Nerve Head Capillary Density Loss and Risk of Visual Field Progression
Authors: Tansuebchueasai Natchada , Nishida Takashi , Moghimi Sasan , Wu Jo-Hsuan , Mahmoudinezhad Golnoush , Gunasegaran Gopikasree , Kamalipour Alireza , Zangwill Linda M. , Weinreb Robert N.
Published: May 2024

Importance

Rapid initial optic nerve head capillary density loss may be used to assess the risk of glaucoma visual field progression.

Objective

To investigate the association between the rate of initial optic nerve head capillary density loss from optical coherence tomography angiography (OCTA) and visual field progression.

Design, Setting, Participants

This was a retrospective study of a longitudinal cohort at a glaucoma referral center. A total of 167 eyes (96 with primary open-angle glaucoma and 71 with glaucoma suspect) of 109 patients were monitored for a mean (SD) of 5.7 (1.4) years from January 2015 to December 2022. Data analysis was undertaken in April 2023.

Main Outcomes and Measures

The rates of initial capillary density and average retinal nerve fiber layer loss were calculated from the first 3 optic nerve head OCTA and OCT scans, respectively, during the initial follow-up (mean [SD], 2.0 [1.0] years). Based on the median rate, eyes were categorized into fast and slow progressor groups. The association between initial capillary density change or retinal nerve fiber layer thinning and visual field progression was evaluated using linear-mixed and time-varying Cox models.

Results

A total of 167 eyes of 109 patients (mean [SD] age, 69.0 [11.1] years; 56 [51.4%] female and 53 [48.6%] male) were assessed. Eighty-three eyes were slow OCTA progressors, while 84 eyes were fast with mean capillary density loss of −0.45% per year and −1.17% per year, respectively (mean difference, −0.72%/year; 95% CI,−0.84 to −0.60; P < .001). Similarly, 83 eyes were slow OCT progressors, while 84 eyes were fast with mean retinal nerve fiber layer thinning of −0.09 μm per year and −0.60 μm per year, respectively (mean difference, −0.51 μm/year; 95% CI,−0.59 to −0.43; P < .001). The fast OCTA and OCT progressors were associated with more rapid visual field loss (mean difference, −0.18 dB/year; 95% CI,−0.30 to −0.06; P = .004 and −0.17 dB/year; 95% CI,−0.29 to −0.06; P = .002, respectively). Fast OCTA progressing eyes were more likely to have visual field progression (hazard ratio, 1.96; 95% CI, 1.04-3.69; P = .04). Seventeen of 52 eyes (32.7%; 95% CI, 32.5-32.8) with fast OCTA and OCT progression developed subsequent visual field likely progression.

Conclusion and Relevance

Rapid initial optic nerve head capillary density loss from OCTA was associated with a faster rate of visual field progression and a doubling of the risk of developing event progression in this study. These findings may support clinical use of OCTA and OCT optic nerve head measurements for risk assessment of glaucoma progression.
Photokeratitis in Outdoor Event Participants Exposed to UV Radiation Display
Authors: Chan Julia Y. Y. , Chow Vanissa W. S. , Chan Carmen K. M. , Chan Edmund Y. M. , Lau James S. K. , Lai Timothy Y. Y. , Young Alvin L. , Tham Clement C. Y.
Published: May 2024

Importance

While UV radiation displays may be used for recreational purposes at outdoor events, unprotected eyes have been reported to have symptoms consistent with photokeratitis. Such symptoms warrant documentation and evaluation in ophthalmic peer reviewed literature.

Objective

To describe a case series of photokeratitis associated with a single ultraviolet radiation display at an outdoor event.

Design, Setting, and Participants

This case series involved a retrospective record review of 8 patients who presented in public and private health sectors in November 2023 after developing photokeratitis following UV radiation exposure at an outdoor event in Hong Kong on the night of November 4, 2023.

Main Outcomes and Measures

Clinical symptoms, signs, and clinical course of patients who were diagnosed acute photokeratitis following exposure to UV radiation.

Results

The mean time of UV display exposure for the 8 patients (mean [SD] age, 33.12 [5.19] years; 4 [50%] female) was 3.00 (1.41) hours, and symptoms presented at a mean (SD) 8.88 (8.24) hours after the exposure. None of the patients were wearing spectacles during the exposed period. All patients were affected bilaterally. All patients experienced eye pain, 6 experienced red eye, and 5 experienced tearing and photophobia. Mean (SD) presenting visual acuity was logMAR 0.10 (0.14) (approximate Snellen equivalent, 20/25) for right eyes and 0.06 (0.89) (approximate Snellen equivalent, 20/25) for left eyes. On examination, there were findings of cornea and conjunctival involvement with punctate epithelial erosions and ciliary vasodilation, but none of the patients presented with anterior chamber reaction. Corticosteroids, lubricants, and antibiotics, all provided topically, were prescribed. Five patients were not scheduled for a review, and 3 had follow-up visits, with the length of follow-up ranging from 7 to 10 days. All patients had undergone a complete recovery.

Conclusions and Relevance

These findings provide evidence of an association between UV radiation used for recreational purposes and photokeratitis, which may help guide evaluation and management of future cases.
Regulation of cardiac fibroblasts reprogramming into cardiomyocyte‐like cells with a cocktail of small molecule compounds
Authors: Chang Danyang , Sun Changye , Tian Xiangqin , Liu Hongyin , Jia Yangyang , Guo Zhikun
Published: May 2024

Myocardial infarction results in extensive cardiomyocyte apoptosis, leading to the formation of noncontractile scar tissue. Given the limited regenerative capacity of adult mammalian cardiomyocytes, direct reprogramming of cardiac fibroblasts (CFs) into cardiomyocytes represents a promising therapeutic strategy for myocardial repair, and small molecule drugs might offer a more attractive alternative to gene editing approaches in terms of safety and clinical feasibility. This study aimed to reprogram rat CFs into cardiomyocytes using a small molecular chemical mixture comprising CHIR99021, Valproic acid, Dorsomorphin, SB431542, and Forskolin. Immunofluorescence analysis revealed a significant increase in the expression of cardiomyocyte‐specific markers, including cardiac troponin T (cTnT), Connexin 43 (Cx43), α‐actinin, and Tbx5. Changes in intracellular calcium ion levels and Ca2+ signal transfer between adjacent cells were monitored using a calcium ion fluorescence probe. mRNA sequencing analysis demonstrated the upregulation of genes associated with cardiac morphogenesis, myocardial differentiation, and muscle fiber contraction during CF differentiation induced by the small‐molecule compounds. Conversely, the expression of fibroblast‐related genes was downregulated. These findings suggest that chemical‐induced cell fate conversion of rat CFs into cardiomyocyte‐like cells is feasible, offering a potential therapeutic solution for myocardial injury.
Epilepsy in Duchenne and Becker muscular dystrophies
Authors: Armijo Gómez Jesus Alfonso , Fernandez‐Garcia Miguel A. , Camacho Ana , Liz Marlin , Ortez Carlos , Lafuente‐Hidalgo Miguel , Toledo Bravo‐de Laguna Laura , Estévez‐Arias Berta , Carrera‐García Laura , Expósito‐Escudero Jessica , Domínguez‐Carral Jana , Nascimento Andres , Natera‐de Benito Daniel
Published: May 2024

Objective

Duchenne and Becker muscular dystrophies (DMD and BMD) are dystrophinopathies caused by variants in DMD gene, resulting in reduced or absent dystrophin. These conditions, characterized by muscle weakness, also manifest central nervous system (CNS) comorbidities due to dystrophin expression in the CNS. Prior studies have indicated a higher prevalence of epilepsy in individuals with dystrophinopathy compared to the general population. Our research aimed to investigate epilepsy prevalence in dystrophinopathies and characterize associated electroencephalograms (EEGs) and seizures.

Methods

We reviewed 416 individuals with dystrophinopathy, followed up at three centers between 2010 and 2023, to investigate the lifetime epilepsy prevalence and characterize EEGs and seizures in those individuals diagnosed with epilepsy. Associations between epilepsy and type of dystrophinopathy, genotype, and cognitive involvement were studied.

Results

Our study revealed a higher epilepsy prevalence than the general population (1.4%; 95% confidence interval: 0.7–3.2%), but notably lower than previously reported in smaller dystrophinopathy cohorts. No significant differences were found in epilepsy prevalence between DMD and BMD or based on underlying genotypes. Cognitive impairment was not found to be linked to higher epilepsy rates. The most prevalent epilepsy types in dystrophinopathies resembled those observed in the broader pediatric population, with most individuals effectively controlled through monotherapy.

Interpretation

The actual epilepsy prevalence in dystrophinopathies may be markedly lower than previously estimated, possibly half or even less. Our study provides valuable insights into the epilepsy landscape in individuals with dystrophinopathy, impacting medical care, especially for those with concurrent epilepsy.
cAIMD Simulations Guided Design of Atomic Praseodymium Doping In–Bi Nanofibers for High‐Energy‐Efficiency CO2 Electrolysis to Formate in Ultra‐Wide Potential Window
Authors: Li Yumeng , Jin Yingmin , Zhang Xuebai , Fu Mengyu , Lin Ruifan , Li Guanshu , Xiong Yueping
Published: May 2024

The electrochemical CO2 reduction reaction (ECO2RR) has emerged as a promising technology for achieving carbon neutralization. Even though considerable efforts are dedicated to gain deep insight into the understanding of ECO2RR on a mechanism level through density functional theory (DFT) studies, effects of solvent molecules and temperature have long been neglected by conventional DFT calculations as a consequence of limitations in current technologies and computational power of supercomputers. Under this context, the lack of comprehensive understanding over the energy changes in the reaction derived from the only concern on free energy changes between reaction intermediates have arouse an urgent call for exploring feasible calculation options toward generalized theoretical study. Here, a systematic mechanism study is provided toward ECO2RR via constrained ab initio molecular dynamics (cAIMD) simulations, in which the effects of solvent water molecules and temperature are taken into consideration to guide the synthesis of single‐atom alloy (SAA) catalyst. Consequently, the resultant Pr0.05/InBi achieves a maximum Faradic efficiency (FE) of 96.4% and an energy efficacy (EE) of 59.41% for formate. This work offers a novel approach to the design and screening of SAA catalysts, presenting foreseeable future in accelerating the industrial application process of ECO2RR.
Spatially Precise Genetic Engineering at the Electrode‐Tissue Interface
Authors: Xu Ke , Yang Yinan , Ding Jianfei , Wang Jinfen , Fang Ying , Tian Huihui
Published: May 2024

The interface between electrodes and neural tissues plays a pivotal role in determining the efficacy and fidelity of neural activity recording and modulation. While considerable efforts have been made to improve the electrode‐tissue interface, the majority of studies have primarily concentrated on the development of biocompatible neural electrodes through abiotic materials and structural engineering. In this study, an approach is presented that seamlessly integrates abiotic and biotic engineering principles into the electrode‐tissue interface. Specifically, ultraflexible neural electrodes with short hairpin RNAs (shRNAs) designed to silence the expression of endogenous genes within neural tissues are combined. The system facilitates shRNA‐mediated knockdown of phosphatase and tensin homolog deleted on chromosome 10 (PTEN) and polypyrimidine tract‐binding protein 1 (PTBP1), two essential genes associated in neural survival/growth and neurogenesis, within specific cell populations located at the electrode‐tissue interface. Additionally, it is demonstrated that the downregulation of PTEN in neurons can result in an enlargement of neuronal cell bodies at the electrode‐tissue interface. Furthermore, the system enables long‐term monitoring of neuronal activities following PTEN knockdown in a mouse model of Parkinson's disease and traumatic brain injury. The system provides a versatile approach for genetically engineering the electrode‐tissue interface with unparalleled precision, paving the way for the development of regenerative electronics and next‐generation brain–machine interfaces.
Efficient Deep‐Blue Multiple‐Resonance Emitters Based on Azepine‐Decorated ν‐DABNA for CIEy below 0.06
Authors: Mamada Masashi , Aoyama Akio , Uchida Ryota , Ochi Junki , Oda Susumu , Kondo Yasuhiro , Kondo Masakazu , Hatakeyama Takuji
Published: May 2024

Ultrapure deep‐blue emitters are in high demand for organic light‐emitting diodes (OLEDs). Although color coordinates serve as straightforward parameters for assessing color purity, precise control over the maximum wavelength and full‐width at half‐maximum is necessary to optimize OLED performance, including luminance efficiency and luminous efficacy. Multiple‐resonance (MR) emitters are promising candidates for achieving ideal luminescence properties; consequently, a wide variety of MR frameworks have been developed. However, most of these emitters experience a wavelength displacement from the ideal color, which limits their practical applicability. Therefore, a molecular design that is compatible with MR emitters for modulating their energy levels and color output is particularly valuable. Here, it is demonstrated that the azepine donor unit induces an appropriate blue‐shift in the emission maximum while maintaining efficient MR characteristics, including high photoluminescence quantum yield, narrow emission, and a fast reverse intersystem crossing rate. OLEDs using newly developed MR emitters based on the ν‐DABNA framework simultaneously exhibit a high quantum efficiency of ≈30%, luminous efficacy of ≈20 lm W−1, exceptional color purity with Commission Internationale de l’Éclairage coordinates as low as (0.14, 0.06), and notably high operational stability. These results demonstrate unprecedentedly high levels compared with those observed in previously reported deep‐blue emitters.
Metallic Ru─Ru Interaction in Ruthenium Oxide Enabling Durable Proton Exchange Membrane Water Electrolysis
Authors: Zhao Guoqiang , Guo Wei , Shan Minmin , Fang Yanyan , Wang Gongming , Gao Mingxia , Liu Yongfeng , Pan Hongge , Sun Wenping
Published: May 2024

Developing efficient and robust electrocatalysts toward the oxygen evolution reaction (OER) is critical for proton exchange membrane water electrolysis (PEMWE). RuO2 possesses intrinsically high OER activity, but the concurrent electrochemical dissolution leads to rapid deactivation. Here a unique RuO2 catalyst containing metallic Ru─Ru interactions (m‐RuO2) is reported, which maintains stability in practical PEMWE for 100 h at 60 °C and 1 A cm−2. Experimental and theoretical investigations suggest that the presence of Ru─Ru interactions significantly increases the energy barrier for the formation of RuO2(OH)2, which is a key intermediate for Ru dissolution, and hence substantially mitigates the electrochemical corrosion of m‐RuO2. Meanwhile, the Ru4d band center downshifts, accordingly, ensuring the high OER activity, and the participation of lattice oxygen in the OER is also suppressed at the Ru─Ru sites, further contributing to the enhanced durability. Interestingly, such enhanced stability is also dependent on the size of metallic Ru─Ru cluster, where the energy barrier is further increased for Ru3, but is decreased for Ru5. These results highlight the significance of local coordination structure modulation on the electrochemical stability of RuO2 and open a feasible avenue toward the development of robust OER electrocatalysts for high‐performance PEMWE.