bluuebunny/crossref_metadata_2025 huggingface dataset:
Identification of mycoplasma pneumonia in children based on fusion of multi-modal clinical free-text description and structured test data
Authors: Xie Jingna , Wang Yingshuo , Sheng Qiuyang , Liu Xiaoqing , Li Jing , Sun Fenglei , Wang Yuqi , Li Shuxian , Li Yiming , Yu Yizhou , Yu Gang
Published: May 2024

Mycoplasma pneumonia may lead to hospitalizations and pose life-threatening risks in children. The automated identification of mycoplasma pneumonia from electronic medical records holds significant potential for improving the efficiency of hospital resource allocation. In this study, we proposed a novel method for identifying mycoplasma pneumonia by integrating multi-modal features derived from both free-text descriptions and structured test data in electronic medical records. Our approach begins with the extraction of free-text and structured data from clinical records through a systematic preprocessing pipeline. Subsequently, we employ a pre-trained transformer language model to extract features from the free-text, while multiple additive regression trees are used to transform features from the structured data. An attention-based fusion mechanism is then applied to integrate these multi-modal features for effective classification. We validated our method using clinic records of 7157 patients, retrospectively collected for training and testing purposes. The experimental results demonstrate that our proposed multi-modal fusion approach achieves significant improvements over other methods across four key performance metrics.
Anti-swing control of varying rope length tower crane based on adaptive neural network sliding mode
Authors: Zhang Jibin , Zhang Qing , Zhang Lulu , Sun Shuai , Jin Yixin
Published: May 2024

Due to its complex nonlinear, underdriven, and strongly coupled characteristics, the tower crane will cause the load to swing violently when working, which will cause the tower crane to tip over in serious cases, and there exists a huge safety hazard. In this article, a new artificial neural network sliding mode control method is designed for the control problems of tower crane lifting in position and load swing prevention, which has strong robustness to disturbances and unmodeled dynamics, and ensures that the tower crane lifting is accurately tracked in position and suppresses the load swing at the same time. First, a nonlinear dynamics model of a five-degree-of-freedom tower crane considering the actual working conditions is established. Aiming at the problem that it is difficult to effectively control the nonlinear model of the tower crane system, a new neural sliding mode controller and compensation controller are designed based on the sliding mode control theory and using radial basis function neural network. The neural sliding mode controller is used to approximate the sliding mode equivalent controller with uncertainty and strong nonlinearity, and the compensation controller realizes the compensation of the neural sliding mode controller for the difference between the system control inputs and the uncertainty of the system. The convergence and stability of the proposed control system is rigorously demonstrated using the Lyapunov stability theory. Simulation studies have been carried out to verify the correctness of the model established in this article, as well as the excellent control performance of the control system and the ability to deal with system uncertainty, proving its strong robustness.
Writing against the chain transmission of fear: Reflections on institutionalised ethics
Authors: Struwig Mieke
Published: May 2024

As a master's student investigating curricular decolonisation at South African tertiary music departments, I found myself in a chain of fear driven by previous contestations of similar critical projects. Despite stringently following the institutional ethics requirements, ethical concerns regarding the critical content of my work were still raised, perpetuating this fear. In this article, I discuss my concerns that the issues raised stemmed from an environment in which moral knowledge has become codified in a template for ethical research. I consider the problems that occur when ethical procedures such as anonymity, protecting ‘vulnerable’ interviewees and member checking become mere tick-boxes on a template for ethical research, as well as how such templates can become a method of imbuing fear into the researcher. In conclusion, I propose the development of an ethical praxis premised on an ethics of care that enables, rather than stymies, critical research.
Bayesian effect selection in structured additive quantile regression
Authors: Rappl Anja , Carlan Manuel , Kneib Thomas , Klokman Sebastiaan , Bergherr Elisabeth
Published: May 2024

Bayesian structured additive quantile regression is an established tool for regressing outcomes with unknown distributions on a set of explanatory variables and/or when interest lies with effects on the more extreme values of the outcome. Even though variable selection for quantile regression exists, its scope is limited. We propose the use of the Normal Beta Prime Spike and Slab (NBPSS) prior in Bayesian quantile regression to aid the researcher in not only variable but also effect selection. We compare the Bayesian NBPSS approach to statistical boosting for quantile regression, a current standard in automated variable selection in quantile regression, in a simulation study with varying degrees of model complexity and illustrate both methods on an example of childhood malnutrition in Nigeria. The NBPSS prior shows good performance in variable and effect selection as well as prediction compared to boosting and can thus be recommended as an additional tool for quantile regression model building.
The General Factor of Environmental Sensitivity: Relationships with the General Factor of Personality
Authors: Iimura Shuhei , Yano Kosuke
Published: May 2024

Environmental sensitivity is a meta-concept that describes individual differences in susceptibility to both positive and negative environmental influences and has been repeatedly reported to correlate with other established personality traits, including the Big Five. The purpose of this study was to examine the correlation between the general factor of environmental sensitivity (GFS) and the general factor of personality (GFP). A total of 1,046 adult participants (52% female; Mage = 45.15, SDage = 12.70) completed a self-report psychological questionnaire on an online form. Confirmatory factor analysis indicated that GFS had a strong negative correlation with GFP ( r = −.41, 95% CI [−.52, −.30], p < .001). Focusing on the relationship with the Big Five, individuals with higher environmental sensitivity were emotionally unstable and introverted. The trait of environmental sensitivity may be described not only in relation to the Big Five but also in relation to GFP, which is assumed to be an indicator of social effectiveness.
Tacho-less spur gear condition monitoring at variable speed operation using the adaptive application of variational mode extraction
Authors: Hashim Shahis , Shakya Piyush
Published: May 2024

Effective condition monitoring of machine components contributes to a safer working environment for operators and assists in averting critical machinery shutdowns. In real-world industrial scenarios, fault detection must remain simplified, user-friendly and robust despite speed variations. The operational demands of machinery frequently result in speed fluctuations, leading to spectral smearing, thereby compromising the efficiency of the analysis methodology. Furthermore, the intricacies of parameter initialisation often increase the complexity of the analysis methods. This study introduces a fault diagnosis algorithm that requires minimal initialisation and operates independently of tacho pulses. The algorithm proposed in the study incorporates variational mode extraction with the maxima tracking algorithm for instantaneous frequency estimation. Hankel matrix-based selective spectral fusion is proposed to mitigate the impact of frequency tracking errors caused by transient noise. The results of spectral side-band-based fault severity analysis, conducted on an in-house spur gearbox test-bed with seeded tooth chips, underscore the superior performance of the proposed algorithm when compared to contemporary non-stationary analysis methods.
The distinctiveness effect: How cross-country dissimilarities influence governance decisions
Authors: Cuypers Ilya RP , Ertug Gokhan , Noorderhaven Niels G , Kavusan Korcan
Published: May 2024

Transaction cost theory is one of the most commonly used theories to explain how firms govern their economic activities. In the context of cross-border collaborations, transaction cost theory proposes that dissimilarities between the partners’ home countries, which constitute a key source of behavioral uncertainty, affect how collaborations are governed (i.e. whether firms opt for equity joint ventures or non-equity alliances). Although many firms are likely to face more than one dimension of dissimilarity—for example, in terms language and religion, as well as culture—studies in transaction cost theory typically focus on how each source of dissimilarity impacts governance choices independently, in isolation. We integrate insights from research on decision-making and social psychology into the logic of transaction cost theory to theorize about how multiple dimensions of dissimilarity interactively impact governance choices in collaborative agreements, such that the influence of a given level of dissimilarity is not independent of the level of dissimilarity in other dimensions. Specifically, we propose that the impact of dissimilarity on a given dimension on these governance choices will be lower, that is, negatively moderated, when dissimilarities on other dimensions are higher. For example, a given level of cultural distance will have a greater impact on governance choice when linguistic distance is low (because cultural distance becomes more distinctive) as compared to a case when linguistic distance is not low. Our analysis of 21,951 cross-border non-equity alliances and equity joint ventures yields support for our predictions.
Periaortitis Secondary to Evar: Case Report and Literature Review
Authors: Massara M. , Alberti V. , Restifo G. , Alberti A. , Volpe P.
Published: May 2024

Periaortitis post endovascular aortic aneurysm repair (EVAR) represents a very rare complication, described only in 10 cases between 2001 and 2023. It may appear early or late after EVAR and the majority of patients had ureter compression, and all patients were treated with high dose of corticosteroids, with a complete resolution of symptoms except for one patient. We report a literature review and a case of early post-EVAR periaortitis manifested with acute renal failure due to ureter compression, treated with urgent bilateral J stent and high dose of corticosteroid, with complete resolution of symptoms.

Clinical Impact

Even if periaortitis secondary to EVAR is a very rare complication, it is important for the surgeon to know this possible rare complication and its characteristics, in order to immediately recognize it and treat it adequately to avoid complications.
Type III Endoleak Incidence and Outcomes in Endovascular Aortic Repair: Comparison of Anatomical and Proximal Fixation Devices
Authors: Leone Nicola , Andreoli Francesco , Migliari Mattia , Baresi Giovanni Francesco , Silingardi Roberto , Gennai Stefano
Published: May 2024

Purpose:

To evaluate the influence of endograft fixation type on the incidence, treatment, and outcomes of type III endoleaks (TIIIELs).

Materials and methods:

Abdominal aortic aneurysms (AAAs) treated with bifurcated endografts between 1994 and 2020 were prospectively collected and reviewed. The endograft included were classified as “Anatomical Fixation” (AF) (Powerlink [Endologix] and AFX [Endologix]) or “Proximal Fixation” (PF). The primary outcome was the incidence of TIIIEL over time, stratified by fixation type. Secondary outcomes included between-group comparisons of baseline characteristics, intraoperative details during TIIIEL correction, and survival analysis after TIIIEL diagnosis.

Results:

A total of 2065 endovascular aneurysm repairs were performed: 872 (42.2%) with AF and 1193 (57.8%) with PF devices. The estimated incidence of TIIIEL at 1, 5, and 10 years was 0.4%, 4.2%, and 7.3%, and 0.5%, 3.2%, and 4.6% for AF and PF, respectively (p=0.157), and fixation type was not associated with TIIIEL development in the competing risk regression model (p=0.101). The cumulative overall survival rate in patients diagnosed with TIIIEL did not differ significantly between the groups (p=0.077). The rate of recurrent TIIIELs was significantly lower in the AF group (7.1% vs 22.7%; p=0.044); however, no significant difference was found in secondary reintervention between the two groups (11.9% vs 27.3%, p=0.074). Patients with angulated and calcified aortic neck (SHR 3.4, 95% CI 1.2–9.6, p=0.022) and larger aneurysms (SHR 1.2; 95% CI 1.1–1.3; p<0.001) had a higher risk of TIIIEL. Likewise, the use of three or more endograft components increased the risk of TIIIEL by 3.1 times (SHR 3.1; 95% CI 1.7–5.4; p<0.001).

Conclusions:

The occurrence of TIIIELs was not affected by the type of endograft fixation. For larger abdominal aortic aneurysms (AAAs) and aneurysms with angulated and calcified aortic necks, there is a higher likelihood of developing TIIIELs during follow-up, regardless of the endograft type used.

Clinical Impact

The type of fixation does not influence the incidence of TIII ELs. EVAR in larger AAAs and aneurysms with angulated and calcified aortic necks have a higher risk of developing TIII EL. Moreover, the risk of TIII EL is considerably increased by the use of three or more modular components.
Calcium-sensing Receptor, a Potential Biomarker Revealed by Large-scale Public Databases and Experimental Verification in Metastatic Breast Cancer
Authors: Xie Wanlin , Xu Huimin , Cheng Yangyang , Lin Xin , Zeng Jingya , Sun Yihua
Published: May 2024

Introduction

Breast cancer (BC) is a common cancer characterized by a high molecular heterogeneity. Therefore, understanding its biological properties and developing effective treatments for patients with different molecular features is imperative. Calcium-sensing receptor (CaSR) has been implicated in several regulatory functions in various types of human cancers. However, its underlying pathological mechanism in BC progression remains elusive.

Methods

We utilized The Cancer Genome Atlas and Gene Expression Omnibus databases to explore the function of CaSR in the metastasis of BC. Gene ontology analysis, Kyoto Encyclopedia of Genes and Genomes analysis, and Gene Set Enrichment Analysis of biological processes and cell signaling pathways revealed that CaSR could be activated or inhibited. Importantly, quantitative reverse transcriptase-polymerase chain reaction and western blotting were used to verify the gene expression of the CaSR. Wound healing and transwell assays were conducted to assess the effect of CaSR on the migration of BC cells.

Results

We demonstrated that CaSR expression in metastatic BC was higher than that in non-metastatic BC. It is the first time that database information has been used to reveal the biological process and molecular mechanism of CaSR in BC. Moreover, the CaSR expression in normal breast epithelial cells was notably less compared to that in BC cells. The activation of CaSR by Cinacalcet (a CaSR agonist) significantly enhanced the migration of BC cells, whereas NPS-2143 (a CaSR antagonist) treatment dramatically inhibited these effects.

Conclusion and future perspective

Bioinformatics techniques and experiments demonstrated the involvement of CaSR in BC metastasis. Our findings shed new light on the receptor therapy and molecular pathogenesis of BC, and emphasize the crucial function of CaSR, facilitating the metastasis of BC.
Based on Gadolinium Ethoxybenzyl DTPA–Enhanced MRI: Diagnostic Performance of the Category-Modified LR-5 Criteria in Patients At Risk for Hepatocellular Carcinoma
Authors: Li Shaopeng , Deng Kexue , Qiu Jun , Wang Peng , Yin Dawei , Xie Yiju , Yu Yongqiang
Published: May 2024

Introduction: We aimed to modify the LR-5 strategy to improve the diagnostic sensitivity for hepatocellular carcinoma (HCC) in high-risk patients while maintaining specificity. Methods: This study retrospectively analyzed 412 patients with 445 liver observations who underwent preoperative gadolinium ethoxybenzyl DTPA (GD-EOB-DTPA)-enhanced MRI followed by surgical procedures or biopsies. All observations were classified according to LI-RADS v2018, and the classifications were adjusted by modifying major features (MF)(substituting threshold growth with a more HCC-specific ancillary features (AF): presence of blood products within the mass, arterial phase hyperenhancement (APHE) was interpreted with hypointensity on precontrast imaging- isointensity in arterial phase (AP) and extending washout to transitional phase (TP)(2 min)). The specificity, sensitivity, and positive predictive value (PPV) were assessed to compare LR-5 (definitely HCC) diagnostic efficacy between LI-RADS version 2018 and modified LI-RADS. Results: Apart from nonenhancing “capsule”, the interreader agreement of MFs and HCC-specific AFs between the two readers reached substantial or excellent ranges (κ values ranging from 0.631 to 0.911). According to LI-5 v2018, the specificity, sensitivity and PPV of HCC were 90.74%, 82.35%, and 98.17%, respectively. Based on a more HCC-specific AF, signal intensity in AP and TP (2 min), the sensitivity of the three modified strategies were 86.19%, 93.09%, 96.67% (P < .05)), while maintaining high specificity and PPV rates at 88.89% and 98.25% (P > .05) Conclusion: Further investigation into the efficacy of threshold growth as a MF is warranted. By utilizing GD-EOB-DTPA-enhanced MRI, enhancing the sensitivity of the modified LR-5 category may be achieved without compromising specificity and PPV in diagnosing HCC among high-risk patients.
Abnormal Electroencephalogram Findings and Its Correlation With Clinical Features From Pediatric Patients in Psychiatric Clinic
Authors: Ko Young Jun , Han Jae Hyun , Cho Anna , Yoo Heejeong , Kim Hunmin
Published: May 2024

Objective: We aimed to evaluate the occurrence of electroencephalogram (EEG) abnormalities in pediatric patients attending an outpatient psychiatry clinic at a tertiary center. We examined the rates of abnormalities and specific findings based on demographics, specific diagnoses, and clinical severity. Methods: This study included pediatric patients who underwent EEG at the outpatient psychiatry clinic. Patient demographics, psychiatric diagnosis, intellectual disability, intelligent quotient (IQ) score, family history of psychiatric disorders, and Clinical Global Impression-Severity (CGI-S) score were obtained through retrospective electronic health record analysis. The rate of EEG abnormalities was calculated, and specific abnormal findings were reviewed. Relationships between the rate of EEG abnormalities and diagnosis, severity, IQ, and age at EEG examination were analyzed. Results: Of 319 patients who underwent EEG, 21.3% (68 patients) of patients exhibited abnormalities, including background abnormalities (14.7%, 47 patients), interictal epileptiform discharges (IEDs) (10.3%, 33 patients), and a slow posterior dominant rhythm (3.8%, 10 patients). The frontal region was the most commonly affected area. Neurodevelopmental disorders (NDDs) had the most frequent abnormalities (29.8%), followed by anxiety (16.7%), sleep (14.3%), mood (11.7%), psychotic (5%), and conduct disorders (0%). Disease severity did not correlate with the rate of EEG abnormalities. Adjusted for age, sex, severity, and family history, patients with EEG abnormalities exhibited lower IQ scores. Conclusion: EEG abnormalities were common in pediatric patients with psychiatric disorders, with background abnormalities detected as frequently as IEDs. Disease severity was not associated with EEG abnormality, while IQ scores showed a negative correlation.
Efficacy of Unilateral External Oblique Intercostal Fascial Plane Block Versus Subcostal TAP Block in Laparoscopic Cholecystectomy: Randomized, Prospective Study
Authors: Mehmet Selim Çömez , Halide Sağlambilen , Erkan Cem Çelik , Onur Koyuncu , Sedat Hakimoğlu , Senem Urfalı
Published: May 2024

Background

This study aimed to evaluate the effectiveness of unilateral external oblique intercostal nerve block (EOIB) in laparoscopic cholecystectomy surgery.

Material and Methods

After ethics committee approval, ASA I-II patients aged 18-70 who would undergo laparoscopic cholecystectomy surgery were included in the study. The patients were divided into two groups, external oblique intercostal nerve block (Group EOIB) and oblique subcostal transversus abdominis plane block (Group OSTAP). After surgery, EOIB or OSTAP block was administered with 20 mL of .25% bupivacaine then routine analgesia protocol was applied with iv paracetamol, and tramadol. Visual analog scale (VAS) scores and patient-controlled analgesia (PCA) consumption were monitored 24 hours after the operation. It was administered 25 mg pethidine as a rescue analgesic to patients with VAS ≥4.

Results

Thirty six patients for Group EOIB and thirty four patients for Group OSTAP were included in the study. Lower VAS scores were observed in all groups. When PCA consumption, side effects, rescue analgesia consumption, and patient satisfaction were evaluated, there was no statistically significant difference between the groups ( P > .05).

Conclusion

It was observed that EOIB showed similar analgesic activity to the OSTAP block. EOIB may also be a part of postoperative multimodal analgesia by reducing postoperative opioid consumption in LC.
Co-Producing access(ible) Knowledge: Methodological Reflections on a Community-Based Participatory Research
Authors: Huang Shixin , He Jia , Jiang Zhengqiang
Published: May 2024

This paper is a methodological reflection on a community-based participatory research (CBPR) project that used the photovoice method to unravel the educational experiences of disabled college students in China’s higher education institutions. Although CBPR endeavors to nurture equitable community engagement in research processes, there are practical challenges to address the full participation of people with divergent disabilities and access needs. Drawing upon the critical disability studies literature, and particularly upon the activist scholarship of disability justice that revolves around interdependency, collective access, and cross-disability solidarity, we provide an open discussion on the complexities, tensions, and challenges of envisioning and creating access for participants with different disabilities in a visuality-centered CBPR. Our findings suggest that access creation in CBPR should go beyond the checklist style of accommodation and instead be approached as relational, dynamic, and iterative processes that require ongoing reflection, (re)learning, and negotiation among researchers and participants. We implemented nonvisual photography to adapt to the visuality-centered bias in the photovoice method. Nonvisual photography empowered participants with visual disabilities to evoke multiple sensorialities in their photo-taking, displaying, and interpretation. Moreover, the participants without visual disabilities also learned and practiced collective access and interdependency through co-transforming the CBPR into an accessible space for all. The heterogeneity among participants with divergent disabilities and access needs challenged CBPR’s envisioning of a unified community with recognized commonalities. The inclusion of participants across disability groups created an opportunity for all participants to draw meaning from the ableist social and political circumstances that forged them as a community and to develop a sense of belonging and bonding in and through CBPR. In that light, disability justice and access should be reimagined and incorporated into CBPR.
Move analysis of fraud in a mediated online transaction
Authors: Juanda Mochammad Rizki , Kurniawan Eri , Hermawan Budi
Published: May 2024

The fraud genre is executed through the use of language that can deceive victims, enabling scammers to control conversations and guide victims into complying with the scammer’s intentions. This research aims to identify rhetorical moves and linguistic features used by scammers during mediated online transactions on social media. The data used in this study consists of nine conversation transcripts between scammers and victims during the process of selling online game account data through social media. The classification of moves and strategies is an ongoing process throughout the analysis. The analysis results identified 4 moves and 17 strategies employed by scammers in fraudulent transactions involving the sale of online game account data. Strategy 5 – Insisting on using a recommended middleman from the buyer is identified as a strategy that can indicate the potential for fraud in the mediated online transaction process.
Impact of lumacaftor/ivacaftor on the bacterial and fungal respiratory pathogens in cystic fibrosis: a prospective multicenter cohort study in Sweden
Authors: Al Shakirchi Mahasin , Sorjonen Kimmo , Hjelte Lena , Klingspor Lena , Bergman Peter , Ericson Petrea , Svedberg Marcus , Lindberg Ulrika , Hansen Christine , Monestrol Isabelle de
Published: May 2024

Background:

A significant decline in pulmonary exacerbation rates has been reported in CF patients homozygous for F508del treated with lumacaftor/ivacaftor. However, it is still unclear whether this reduction reflects a diminished microbiological burden.

Objectives:

The aim of this study was to determine the impact of lumacaftor/ivacaftor on the bacterial and fungal burden.

Design:

The study is a prospective multicenter cohort study including 132 CF patients homozygous for F508del treated with lumacaftor/ivacaftor.

Methods:

Clinical parameters as well as bacterial and fungal outcomes 1 year after initiation of lumacaftor/ivacaftor were compared to data from 2 years prior to initiation of the treatment. Changes in the slope of the outcomes before and after the onset of treatment were assessed.

Results:

Lung function measured as ppFEV1 ( p < 0.001), body mass index (BMI) in adults ( p < 0.001), and BMI z-score in children ( p = 0.007) were improved after initiation of lumacaftor/ivacaftor. In addition, the slope of the prevalence of Streptococcus pneumoniae ( p = 0.007) and Stenotrophomonas maltophilia ( p < 0.001) shifted from positive to negative, that is, became less prevalent, 1 year after treatment, while the slope for Candida albicans ( p = 0.009), Penicillium spp ( p = 0.026), and Scedosporium apiospermum ( p < 0.001) shifted from negative to positive.

Conclusion:

The current study showed a significant improvement in clinical parameters and a reduction of some of CF respiratory microorganisms 1 year after starting with lumacaftor/ivacaftor. However, no significant changes were observed for Pseudomonas aeruginosa, Staphylococcus aureus, or Aspergillus fumigatus, key pathogens in the CF context.
Care considerations for caesarean births in a non-obstetric hospital
Authors: McCarthy CM , Donnelly JC
Published: May 2024

Background

Births in non-maternity hospitals pose significant challenges to ensure delivery of safe and effective care.

Methods

We conducted a retrospective chart review examining the maternal and neonatal demographics and care needs of women delivering in a non-obstetric general hospital over a 10-year period.

Results

Cardiac conditions and placenta accreta spectrum disorder were the most common reasons for birth in this location. All 37 births occurred on a weekday, with 29 during core working hours (8 a.m.–4 p.m.). All cases required obstetric, midwifery, anaesthesiology, neonatology and inter-hospital transfer services. Level 3 support was required for 15 women following birth. Neuraxial anaesthesia was utilised in the majority of cases (24/37, 64.8%). One in six infants were breastfed on discharge, with a mean gestational age at birth of 34 weeks.

Conclusion

We demonstrate the significant input of the multi-disciplinary and highlight the importance of addressing both obstetric and neonatal considerations outside of their native care setting.
Sensitivity to disgust, but not increased disgust, is associated with disapproval of gays: Experimental evidence from Turkey
Authors: Aktas Busra Eylem , Tosyali Furkan
Published: May 2024

Previous research indicated that exposure to disgusting stimuli often leads to more negative attitudes toward gays. However, these findings primarily stemmed from Western cultures and were inconsistent. It remained uncertain whether the impact of disgust would apply to diverse cultural contexts. This study aimed to fill this gap by investigating whether the influence of disgust, previously observed, extended to an unexplored non-Western setting, Turkey. In Study 1, an online experiment was conducted to explore the connection between disgust and attitudes toward gays. Study 2 aimed to replicate these findings in a laboratory setting and examined the role of political attitudes. Study 1 found no significant link between disgust and disapproval of gays. However, in Study 2, there were significant correlations between political conservatism, disgust sensitivity, and negative attitudes toward gays. Notably, disgust did not significantly affect negativity toward gays in either study. Moreover, while political conservatism would lead to negative attitudes, it did not moderate the relationship between disgust and negativity toward gay individuals in Study 2. Present findings expand the ongoing debate about the causal role of disgust in disapproval of gays, providing original insights into a non-Western cultural context.
A Descriptive Study of Quality of Life Following Neoadjuvant Chemotherapy and Transoral Robotic Surgery for Human Papillomavirus-Associated Oropharyngeal Squamous Cell Carcinoma
Authors: Diaconescu Alina , Silver Jennifer A. , Subramaniam Thava , Sewitch Maida J. , Mascarella Marco A. , Ramirez-Garcia Luna Jose , Golabi Nahid , Richardson Keith , Bouganim Nathaniel , Forghani Reza , Marcin Mlynarek Alex , Hier Michael P. , Sadeghi Nader
Published: May 2024

Background

Patients with oropharyngeal squamous cell carcinoma (OPSCC) treated with radiation-based therapy suffer from short- and long-term toxicities that affect quality of life (QOL). Transoral robotic surgery (TORS) has an established role in the management of early OPSCC but adjuvant treatment is often indicated postoperatively due to the high incidence of nodal metastasis associated with advanced human papillomavirus (HPV)-related OPSCC. To overcome the need for adjuvant radiation therapy (RT), neoadjuvant chemotherapy followed by TORS and neck dissection (ND) is proposed. This study aimed to assess if QOL in HPV-associated OPSCC receiving neoadjuvant chemotherapy followed by TORS and ND returns to baseline within 12 months of completing treatment.

Methods

A 12 month longitudinal study was carried out at McGill University Health Centre in Montreal, Canada, among a convenience sample of patients with American Joint Committee on Cancer Seventh Edition stage III and IVa HPV-related OPSCC who were treated with neoadjuvant chemotherapy followed by TORS and ND. QOL data were obtained pretreatment and at 1, 3, 6, and 12 months following treatment completion using the European Organisation for Research and Treatment of Cancer Core and Head and Neck extension modules. Paired t tests and mixed models for repeated measures analysis were used to assess changes in QOL from baseline to 12 months postoperatively and over time, respectively.

Results

Nineteen of 23 patients (median age 58 years) who received the study treatment fulfilled the eligibility criteria. OPSCC subsites were palatine tonsil (n = 12) and base of tongue (n = 7). All 19 patients were treated per protocol and none required adjuvant RT as per pathology review and protocol requirements at a postoperative multidisciplinary team tumor board discussion. No significant differences were found when comparing 12 month QOL follow-up scores to pretreatment scores in measures that would likely be affected by RT [eg, swallowing ( P = .7), social eating ( P = .8), xerostomia ( P = .9)].

Conclusion

In HPV-related OPSCC, neoadjuvant chemotherapy followed by TORS and ND as definitive treatment is associated with excellent QOL outcomes. Postoperative QOL scores returned to baseline by 3 months and were maintained for all measures, indicating a return to normal function.
Isolation and Bioactivities of Stemona Alkaloid: A Review
Authors: Nguyen-Thi Chung , Vo-Cong Dung , Giang Le Duc , Dau-Xuan Duc
Published: May 2024

Objective/Background: In Chinese, Vietnamese, and Thai traditional medicine of Southeast Asian countries, Stemonaceae plants have long been employed. Various studies have proved that these herbal plants contain Stemona alkaloids with valuable medicinal value. Although some review articles on Stemona alkaloids have appeared in the literature, they are quite outdated. The current study offers a comprehensive review of the isolation and bioactivities of Stemona alkaloids. The article might be useful for chemists who work in alkaloid chemistry as well as pharmaceutical areas. Methods: “ Stemona alkaloids” was the most useful keyword to search for literature data. References have been collected from various resources such as Google Scholar, SciFinder, and PubMed. More than 120 electronic publications were obtained from these resources. Results: More than 250 Stemona alkaloids from 8 groups have been isolated and structurally elucidated from Stemonaceae plants. Extracts from these plants as well as isolated compounds possess a wide range of bioactivities, such as antituberculosis, antibacterial, antifungal, and antihelmintic properties activities. Conclusion: In this review article, we have summarized 116 studies on the isolation and bioactivities of Stemona alkaloids in the literature. More than 250 Stemona alkaloid compounds have been isolated and identified. In addition, the article also gives an overview of the bioactivities of Stemona alkaloids.
Boeing: Reclaiming the lost ground?
Authors: Jasrotia Sahil Singh , Kamila Manoj Kumar , Sinha Priyank
Published: May 2024

Boeing is a leading American aerospace and defense company that has a long history dating back to 1916. William Boeing, in Seattle, Washington, founded the company and focused initially on building seaplanes for commercial and military use. Throughout its history, Boeing has taken several risks that have helped to shape the company into the global powerhouse it is today. One of the earliest examples of this is the company's decision to shift its focus from building seaplanes to building land-based aircraft in the 1920s. This move was risky at the time, as the market for land-based aircraft was still relatively untested, but it ultimately paid off as the demand for air travel proliferated in the following years. Another significant risk that Boeing took was the development of the 747, which was the first wide-body commercial airliner. This massive project required a significant investment in time and money, which later proved to be a huge success and established Boeing as the leader in the commercial aircraft industry. Boeing has traditionally adopted this risky business strategy, popularly known as “bet the business strategy,” which is characterized by a high risk of product failure in every new product development cycle. So far, Boeing has successfully navigated each cycle, allowing the company to maintain its market leadership and generate good financial returns.
Variceal hemorrhage in a patient with cirrhosis and congenital hemophilia A: A therapeutic challenge
Authors: Peña Amaya Rafael Gregorio , Figueredo Peña María del Carmen
Published: May 2024

We describe the case of a 61-year-old male patient with a history of hemophilia A and previous hepatitis C virus infection with sustained virological response and no previous documentation of cirrhosis, who was admitted for variceal bleeding. He was taken for endoscopic evaluation with evidence of active variceal hemorrhage requiring rubber band ligation. Patients with congenital coagulation disorders, such as hemophilia A, are excluded from international guidelines for gastrointestinal bleeding, making their management and counseling challenging. In this article, we describe the specific interventions to be performed in patients with hemophilia A and upper gastrointestinal tract bleeding, specifically variceal bleeding, focusing on pre-endoscopic and endoscopic management.
Assessment of cognitive games to improve the quality of life of Parkinson’s and Alzheimer’s patients
Authors: Llorente Álvaro , del Rio Alberto , Can Semerci Yusuf , Alfonso Kurano Jorge , Jimenez David , Menéndez José Manuel
Published: May 2024

Objectives

The core objectives of this study centre on enhancing the quality of life and well-being of individuals diagnosed with Parkinson’s and Alzheimer’s diseases. Our aim is to facilitate the monitoring of patient information, benefiting both caregivers and healthcare professionals.

Methods

As part of the PROCare4Life platform sensorial ecosystem, a web application with six engaging cognitive games focusing on developing cognitive training and stimulating brain activity are developed. A set of metrics calculated by the application feed machine learning predictive models to evaluate the cognitive status and evolution over time. Long-term analysis of the daily cognitive ability information is used to generate high-level outcomes and identify deviations for each patient from the multimodal fusion engine. And based on these results, a recommender system provides a set of personalized notifications.

Results

A 3-month pilot study that took place in five different countries shows the results obtained from 93 patients. An average of 22.4 games were completed per day and the recommender system generated a total of 260 game notifications, 37.7% of them were marked as read by the patients. The Cognitive State Score and the Deviations in Cognitive Abilities measurement, calculated by the multimodal fusion engine, when used in conjunction present a good overview of the patient’s current state and potential deviations.

Conclusion

The cognitive games application was well-received by elderly individuals who took part in the study. This tool can be valuable for caregivers and healthcare providers in assessing the cognitive function of patients through engaging in cognitive games.
Machine-learning model for predicting depression in second-hand smokers in cross-sectional data using the Korea National Health and Nutrition Examination Survey
Authors: Kim Na Hyun , Kim Myeongju , Han Jong Soo , Sohn Hyoju , Oh Bumjo , Lee Ji Won , Ahn Sumin
Published: May 2024

Objective

Depression among non-smokers at risk of second-hand smoke (SHS) exposure has been a neglected public health concern despite their vulnerability. The objective of this study was to develop high-performance machine-learning (ML) models for the prediction of depression in non-smokers and to identify important predictors of depression for second-hand smokers.

Methods

ML algorithms were created using demographic and clinical data from the Korea National Health and Nutrition Examination Survey (KNHANES) participants from 2014, 2016, and 2018 ( N = 11,463). The Patient Health Questionnaire was used to diagnose depression with a total score of 10 or higher. The final model was selected according to the area under the curve (AUC) or sensitivity. Shapley additive explanations (SHAP) were used to identify influential features.

Results

The light gradient boosting machine (LGBM) with the highest positive predictive value (PPV; 0.646) was selected as the best model among the ML algorithms, whereas the support vector machine (SVM) had the highest AUC (0.900). The most influential factors identified using the LGBM were stress perception, followed by subjective health status and quality of life. Among the smoking-related features, urine cotinine levels were the most important, and no linear relationship existed between the smoking-related features and the values of SHAP.

Conclusions

Compared with the previously developed ML models, our LGBM models achieved excellent and even superior performance in predicting depression among non-smokers at risk of SHS exposure, suggesting potential goals for depression-preventive interventions for non-smokers during public health crises.
Safety and clinical effectiveness of peginterferon beta-1a for relapsing multiple sclerosis in a real-world setting: Final results from the Plegridy Observational Program
Authors: Salvetti Marco , Wray Sibyl , Nelles Gereon , Belviso Nicholas , Kumar Achint , Koster Thijs , Castro-Borrero Wanda , Vignos Megan ,   on behalf of the POP Investigators
Published: May 2024

Background

Interferon beta-1a remains an important treatment option for multiple sclerosis, particularly when safety or tolerability concerns may outweigh the benefits of higher-efficacy disease-modifying therapies. The five-year phase 4 Plegridy Observational Program (POP) study (NCT02230969) collected data on real-world safety and effectiveness of Plegridy® (peginterferon beta-1a) treatment in patients with relapsing multiple sclerosis.

Objective

To explore the real-world safety and effectiveness of peginterferon beta-1a in patients with relapsing multiple sclerosis, including factors influencing treatment discontinuation.

Methods

Data were collected prospectively from patients ≥ 18 years old with relapsing multiple sclerosis for overall population analysis and for subpopulations including newly/previously diagnosed patients, age, and experience with peginterferon beta-1a. Outcome measures included annualized relapse rates, adverse events, and predictors of time to treatment discontinuation.

Results

Mean (SD) treatment duration in the overall population ( N = 1172) was 896.0 (733.15) days. Incidence of adverse events was higher in new than experienced users (79.4% vs. 57.0%). New users were more likely than experienced users to discontinue (hazard ratio = 1.60; P < 0.0001). The adjusted annualized relapse rate was 0.09, and at the end of 5 years, 77.1% of patients were relapse-free.

Conclusions

Peginterferon beta-1a is an effective therapy for managing relapsing multiple sclerosis. The identification of predictors of discontinuation can help inform strategies to enhance treatment persistence.
Hybrid Interventions for Pulmonary Vein Stenosis: Leveraging Intraoperative Endovascular Adjuncts in Challenging Clinical Scenarios
Authors: Kalustian Alyssa B. , Brlecic Paige E. , Gowda Srinath T. , Stapleton Gary E. , Khan Asra , Eilers Lindsay F. , Birla Ravi , Imamura Michiaki , Qureshi Athar M. , Caldarone Christopher A. , Bansal Manish
Published: May 2024

Background: Pediatric pulmonary vein stenosis (PVS) is often progressive and treatment-refractory, requiring multiple interventions. Hybrid pulmonary vein interventions (HPVIs), involving intraoperative balloon angioplasty or stent placement, leverage surgical access and customization to optimize patency while facilitating future transcatheter procedures. We review our experience with HPVI and explore potential applications of this collaborative approach. Methods: Retrospective chart review of all HPVI cases between 2009 to 2023. Results: Ten patients with primary (n = 5) or post-repair (n = 5) PVS underwent HPVI at median age of 12.7 months (range 6.6 months-9.5 years). Concurrent surgical PVS repair was performed in 7/10 cases. Hybrid pulmonary vein intervention was performed on 17 veins, 13 (76%) with prior surgical or transcatheter intervention(s). One patient underwent intraoperative balloon angioplasty of an existing stent. In total, 18 stents (9 bare metal [5-10 mm diameter], 9 drug eluting [3.5-5 mm diameter]) were placed in 16 veins. At first angiography (median 48 days [range 7 days-2.8 years] postoperatively), 8 of 16 (50%) HPVI-stented veins developed in-stent stenosis. Two patients died from progressive PVS early in the study, one prior to planned reintervention. Median time to first pulmonary vein reintervention was 86 days (10 days-2.8 years; 8/10 patients, 13/17 veins). At median survivor follow-up of 2.2 years (2.3 months-13.1 years), 1 of 11 surviving HPVI veins were completely occluded. Conclusions: Hybrid pulmonary vein intervention represents a viable adjunct to existing PVS therapies, with promising flexibility to address limitations of surgical and transcatheter modalities. Reintervention is anticipated, necessitating evaluation of long-term benefits and durability as utilization increases.
A Pilot Study for Measuring Complex Problem-Solving in Jordan: Feasibility, Construct Validity, and Behavior Pattern Analyses
Authors: Alrababah Saleh Ahmad , Wu Hao , Molnár Gyöngyvér
Published: May 2024

In the 21st century, complex problem-solving (CPS) serves as a key indicator of educational achievement. However, the elements of successful CPS have not yet been fully explored. This study investigates the role of strategic exploration and different problem-solving and test-taking behaviors in CPS success, using logfile data to visualize and quantify students’ problem-solving behavior on 10 CPS problems with different characteristics and levels of difficulty. Additionally, in the present study, we go beyond the limits of most studies that focus on students’ problem-solving behavior pattern analyses in European cultures and education systems to examine Arabic students’ CPS behavior. The results show that computer-based assessments of CPS are feasible and valid in Jordanian higher education. The findings also confirm the structural validity of CPS, indicating that the processes of knowledge acquisition (KAC) and knowledge application (KAP) can be distinguished and separated in the problem-solving process. Large differences were identified in students’ test-taking behavior in terms of the efficacy of their exploration strategy. We identified four latent classes based on the students’ exploration strategy behavior. The study thus leads to a better understanding of how students solve problems and behave during the problem-solving process in uncertain situations.
Leading Schools During a Global Crisis: Kazakhstani School Leaders’ Perspectives and Practices
Authors: Durrani Naureen , Makhmetova Zhadyra , Kadyr Yelzhas , Karimova Nazerke
Published: May 2024

This paper comprehensively examines how school leaders in Kazakhstan managed schools during the COVID-19 school closures. An online survey was conducted with 1,298 school leaders, representing 17.5% of all Kazakhstani schools. Anchored in the concept of crisis leadership, the instrument measured school leaders’ views regarding teachers’ digital competence, their support toward teachers in digital pedagogy, as well as their practices in communicating with parents and teacher autonomy and monitoring. The results of bivariate tests indicate that a significant proportion of schools offered teachers online professional development opportunities to improve their digital instruction, with school location and size influencing the level of training in digital pedagogy received by teachers. Notably, school leaders’ confidence in their teachers’ ability to teach effectively online increased significantly after receiving training in digital pedagogy. School leaders also maintained regular communication with parents, but this increased their workload, particularly for women and urban school leaders. Most school leaders allowed teachers to choose online platforms and revise curriculum content, while also monitoring teachers’ attendance and observing online lessons. These practices varied based on the school’s medium of instruction. This study significantly contributes to crisis leadership by examining practices during school closures in addressing teachers’ digital competence, communication challenges, and teacher autonomy, with insights on variations by school type, location, and leaders’ gender. The study’s findings have significant implications for post-pandemic school leadership, emphasizing equity in professional development opportunities for teachers, effective communication with stakeholders, and striking the right balance between teacher autonomy and monitoring.