bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparing outcomes following direct admission and early transfer to specialized trauma centers in open tibial fracture treatment: a systematic review and meta-analysis
Authors: Joosten Pien Gabriele Francien , Borgdorff Marieke Paulina , Botman Matthijs , Bouman Mark-Bram , van Embden Daphne , Giannakópoulos Georgios Fredericus
Published: September 2023

Introduction

Guidelines on the management of open tibia fractures recommend timely treatment in a limb reconstruction center which offer joint orthopedic-trauma and plastic surgery services. However, patient’s transfer between centers remains inevitable. This review aims to evaluate the clinical outcomes and hospital factors for patients directly admitted and transferred patients to a limb-reconstruction center.

Methods

A research protocol adhering to PRISMA standards was established. The search included databases like MEDLINE, EMBASE, and the Cochrane library up until March 2023. Nine articles met the inclusion criteria, focusing on open tibia fractures. Exclusion criteria were experimental studies, animal studies, and case reports. Outcomes of interest were operation and infection rates, nonunion, limb salvage, and the Enneking limb score.

Results

The analysis involved data from 520 patients across nine studies published between 1990 and 2023, with the majority (83.8%) having Gustilo Anderson type III open tibia fractures. Directly admitted patients showed lower overall infection rates (RR 0.30; 95% CI 0.10–0.90; P = 0.03) and fewer deep infections (RR 0.39; 95% CI 0.22–0.68; P = 0.001) compared to transferred patients. Transferred patients experienced an average five-day delay in soft tissue closure and extended hospital stays by eight days. Patients transferred without initial surgical management underwent fewer total surgical procedures. The direct admission group displayed more favorable functional outcomes.

Conclusion:

Low- to moderate-quality evidence indicates worse clinical outcomes for transferred patients compared to directly admitted patients. Early treatment in specialized limb reconstruction units is essential for improved results in the management of open tibia fractures.

Level of evidence

Therapeutic level IIa.
Primary angiitis of the CNS and ANCA-associated vasculitis: from pathology to treatment
Authors: Sherri Alaa , Mortada Mohamad Mahdi , Makowska Joanna , Lewandowska-Polak Anna
Published: September 2023

Vasculitis of the central nervous system can be a localized process, such as primary angiitis of the central nervous system (PACNS), or systemic vasculitis, such as ANCA-associated vasculitis (AAV). Since both conditions share neurological manifestations, the following review will discuss the neurological aspects of both. This review aims to provide a comprehensive comparison of the pathogenesis, clinical manifestation and assessment, diagnostic workup, and treatment protocol for both PACNS and AAV with central nervous system involvement. To provide a comprehensive comparison and update, a literature review was conducted using PubMed and Ovid databases (Embase and Medline). Then, the references were retrieved, screened, and selected according to the inclusion and exclusion criteria. PACNS and AAV share similarities in clinical presentation and neurological symptoms, especially in terms of headache, focal deficits, and cognitive impairment. Additionally, both conditions may exhibit similarities in laboratory and radiological findings, making brain biopsy the gold standard for differentiation between the two conditions. Moreover, the treatment protocols for PACNS and AAV are nearly identical. Comparing PACNS and AAV with CNS involvement highlights the similarities in clinical presentation, radiological findings, and treatment protocols between the two conditions. Further research should focus on establishing a practical diagnostic protocol.
Effects of resection volume on postoperative micturition symptoms and retreatment after transurethral resection of the prostate
Authors: Shin Seung Han , Lee Kwang Suk , Koo Kyo Chul , Cho Kang Su , Hong Chang Hee , Chung Byung Ha , Ryoo Hyun Soo , Ryu Jae Hyun , Kim Yun Beom , Yang Seung Ok , Lee Jeong Kee , Jung Tae Young , Yoo Jeong Woo
Published: October 2023

Purpose

Despite advances in technology, such as advent of laser enucleation and minimally invasive surgical therapies, transurethral resection of the prostate (TURP) remains the most widely performed surgical technique for benign prostatic hyperplasia (BPH). We evaluated resection volume (RV)-derived parameters and analyzed the effect of RV on post-TURP outcomes.

Methods

This observational study used data from patients who underwent TURP at two institutions between January 2011 and December 2021 Data from patients with previous BPH surgical treatment, incomplete data, and underlying disease affecting voiding function were excluded. The collected data included age, prostate-specific antigen, transrectal ultrasound (TRUS)- and uroflowmetry-derived parameters, RV, perioperative laboratory values, perioperative International Prostatic Symptom Score (IPSS), follow-up period, retreatment requirements and interval between the first TURP and retreatment.

Results

In 268 patients without prior BPH medication, there were no differences in prostate volume (PV), transitional zone volume (TZV), or RV according to IPSS. A total of 60 patients started retreatment, including medical or surgical treatment, within the follow-up period. There was a significant difference in RV/PV between the groups without and with retreatment respectively (0.56 and 0.37; p = 0.008). However, preoperative TRUS- and uroflowmetry-derived parameters did not differ between the two groups. Multiple linear regression analysis showed that RV (p = 0.003) and RV/TZV (p = 0.006) were significantly associated with differences in perioperative IPSS. In the multivariate logistic regression analysis, only RV/PV was correlated with retreatment (p = 0.010).

Conclusion

Maximal TURP leads to improved postoperative outcomes and reduced retreatment rate, it may gradually become a requirement rather than an option.
Seasonal variation in sleep time: jackdaws sleep when it is dark, but do they really need it?
Authors: van Hasselt Sjoerd J. , Coscia Massimiliano , Allocca Giancarlo , Vyssotski Alexei L. , Meerlo Peter
Published: October 2023

Sleep is an important behavioural and physiological state that is ubiquitous throughout the animal kingdom. Birds are an interesting group to study sleep since they share similar sleep features with mammals. Interestingly, sleep time in birds has been shown to vary greatly amongst seasons. To understand the mechanisms behind these variations in sleep time, we did an electro-encephalogram (EEG) study in eight European jackdaws (Coloeus monedula) in winter and summer under outdoor seminatural conditions. To assess whether the amount and pattern of sleep is determined by the outdoor seasonal state of the animals or directly determined by the indoor light–dark cycle, we individually housed them indoors where we manipulated the light–dark (LD) cycles to mimic long winter nights (8:16 LD) and short summer nights (16:8 LD) within both seasons. Jackdaws showed under seminatural outdoor conditions 5 h less sleep in summer compared to winter. During the indoor conditions, the birds rapidly adjusted their sleep time to the new LD cycle. Although they swiftly increased or decreased their sleep time, sleep intensity did not vary. The results indicate that the strong seasonal differences in sleep time are largely and directly driven by the available dark time, rather than an endogenous annual clock. Importantly, these findings confirm that sleep in birds is not a rigid phenomenon but highly sensitive to environmental factors.
The warm Arctic-cold north american pattern in CanESM5 large ensemble simulations: Eurasian influence and uncertainty due to internal variability
Authors: Yu Bin , Lin Hai
Published: September 2023

This study examines the warm Arctic-cold North American pattern (WACNA) and its connection with the warm Arctic-cold Eurasia pattern (WACE) using ERA5 reanalysis and a 50-member ensemble of historical climate simulations produced by CanESM5, the Canadian model participated in CMIP6. The results indicate that a negative WACE-like pattern typically precedes a positive WACNA pattern by one month, and the presence of a negative Asian-Bering-North American (ABNA)-like circulation pattern connects Eurasia and North America, along with the Pacific-North American (PNA)-like pattern. The negative ABNA-like pattern can be attributed to anomalous heating in southern Siberia, which is associated with the negative WACE pattern and its featured Eurasian warming. The negative PNA-like pattern is influenced by negative SST anomalies in the tropical Pacific, resembling tropical ENSO variability. Anomalous temperature advection in the lower troposphere follows the circulation anomaly, which supports the formation of WACNA. Conversely, processes with circulation anomalies of opposite sign result in a negative WACNA pattern. The tropical ENSO variability does not significantly impact the WACNA pattern and its linkage with WACE. CanESM5 simulates the WACNA pattern and WACE-WACNA connection well, with some discrepancies in the magnitude of anomalies compared to ERA5 reanalysis. The uncertainty in the simulated WACNA pattern due to internal climate variability is dominated by two modes of inter-member variability: a southeast-northwest phase shift and a local variation in amplitude.
Factors impacting trial participation in people with motor neuron disease
Authors: Beswick Emily , Johnson Micheala , Newton Judith , Dakin Rachel , Stenson Amy , Abrahams Sharon , Carson Alan , Chandran Siddharthan , Pal Suvankar
Published: October 2023

Motor neuron disease (MND) is a rapidly progressive neurodegenerative disorder with limited treatment options. Historically, neurological trials have been plagued by suboptimal recruitment and high rates of attrition. The Motor Neuron Disease–Systematic Multi-Arm Randomised Adaptive Trial (MND–SMART) seeks to identify effective disease modifying drugs. This study investigates person-specific factors affecting recruitment and retention. Improved understanding of these factors may improve trial protocol design, optimise recruitment and retention. Participants with MND completed questionnaires and this was supplemented with clinical data. 12 months after completing the questionnaires we used MND–SMART recruitment data to establish if members of our cohort engaged with the trial. 120 people with MND completed questionnaires for this study. Mean age at participation was 66 (SD = 9), 14% (n = 17) were categorised as long survivors, with 68% (n = 81) of participants male and 60% (n = 73) had the ALS sub-type. Of the 120 study participants, 50% (n = 60) were randomised into MND–SMART and 78% (n = 94) expressed interest an in participating. After the 1-year follow-up period 65% (n = 39) of the 60 randomised participants remained in MND–SMART. Older age was significantly associated with reduced likelihood of participation (OR = 0.92, 95% CI = 0.88–0.96, p = 0.000488). The findings show that people with MND are highly motivated to engage in research, but older individuals remain significantly less likely to participate. We recommend the inclusion of studies to explore characteristics of prospective and current participants alongside trials.
Association between quality of life and emotional overeating — a cross-sectional study in Danish children attending a multicomponent lifestyle camp
Authors: Aagaard Ida , Jakobsen Dorthe Dalstrup , Bruun Jens Meldgaard
Published: September 2023

Emotional eating seems to emerge during the transition from childhood to adulthood; however, limited research has explored the association between emotional overeating and quality of life (QoL) in children with overweight and obesity. Therefore, the aim of this study was to examine the association between QoL and emotional overeating in a Danish sample of children with overweight and obesity. The present cross-sectional study is based on baseline questionnaire data from a nonrandomized controlled trial. Children attending a 10-week multicomponent lifestyle camp from October 2020 to March 2022 was invited to participate. Multiple linear regressions were used to examine if QoL was associated with emotional overeating before starting camp. In total, 229 children were included, and 45 children were excluded due to missing data, leaving 184 children in this study. The children had a mean age of 11.8 years (SD ± 1.38), with 60.9% girls and 39.1% boys, and the majority (94.6%) had overweight or obesity defined by a Body Mass Index Standard Deviation Score (BMI-SDS) > 1 SD. On average, children with a high tendency of emotional overeating had a 13.7 (95% CI 18.9; 8.5, p < 0.01) lower QoL score compared to children with a low tendency of emotional overeating.

  Conclusions: This study shows that children with a high tendency of emotional overeating have lower quality of life, compared to children with a lower tendency of emotional overeating. Due to study limitations, the findings should be supported by further research. (Trial registration: clinicaltrials.gov with ID: NCT04522921).

What is Known:• Emotional eating seems to emerge during the transition from childhood to adulthood.• Limited research has explored the association between quality of life and emotional overeating in children with overweight and obesity.

What is New:• Children with a high tendency of emotional overeating had a lower quality of life compared to children with a lower tendency of emotional overeating.• Emotional overeating was negatively associated with quality of life in children with overweight and obesity.
Glutamic acid intake by formula-fed infants: are acceptable daily intakes appropriate?
Authors: Mennella Julie A. , Smethers Alissa D. , Delahanty Michelle T. , Stallings Virginia A. , Trabulsi Jillian C.
Published: September 2023

The 2017 European Food Safety Authority (EFSA) recommendation of an acceptable daily intake (ADI) of 30 mg glutamic acid/kg bw/day did not take into consideration the primary energy sources during infancy, including infant formulas. In the present study, we determined total daily intakes of glutamic acid in a contemporary cohort of healthy infants who were fed either cow milk formula (CMF) or extensive protein hydrolysate formula (EHF); the formulas differed substantially in glutamic acid content. The infants (n = 141) were randomized to be fed either CMF or EHF. Dietary intakes were determined from weighed bottle methods and/or prospective diet records, and body weights were measured on 14 occasions from 0.5 to 12.5 months. Secondary data analysis determined the glutamic acid content of the diet over time. The trial was registered at http://www.clinicaltrials.gov/ as NCT01700205, 3 October 2012. Glutamic acid intake from formula and other foods was significantly higher in infants fed EHF when compared to CMF. As glutamic acid intake from formula decreased, intake from other nutritional sources steadily increased from 5.5 months. Regardless of formula type, every infant exceeded the ADI of 30 mg/kg bw/day from 0.5 to 12.5 months.

   Conclusion: Given that the ADI recommendation was not based on actual intake data of primary energy sources during infancy, the present findings on the growing child’s ingestion of glutamic acid from infant formula and the complementary diet may be of interest when developing future guidelines and communications to parents, clinical care providers, and policy makers.

What is Known:• The 2017 re-evaluation of the safety of glutamic acid-glutamates and the recommended acceptable daily intake (ADI) of 30 mg/kg bw/d by the European Food Safety Authority (EFSA) did not include actual intake data of the primary energy sources during infancy.

What is New:• During the first year, glutamic acid intake from infant formula and other food sources exceeded the ADI of 30 mg/kg bw/day.
How to support children to develop and express their coping preferences around minor invasive medical procedures: children’s and parents’ perspectives
Authors: Segers Elisabeth W. , Ketelaar Marjolijn , de Man Marjorie A. C. P. , Schoonhoven Lisette , van de Putte Elise M. , van den Hoogen Agnes
Published: October 2023

Invasive medical procedures in hospitals are major sources of stress in children, causing pain and fear. Non-pharmacological interventions are indispensable in effective pain and fear management. However, these interventions must be personalized to be effective. This qualitative study aims to gain insight into children’s and parents’ experiences, needs, and wishes related to supporting children to develop and express their coping preferences for dealing with pain and fear during minor invasive medical procedures in order to decrease pain and fear. A qualitative study using thematic analysis was performed. Data were collected through semi-structured interviews with children and parents who had undergone at least five minor invasive medical procedures in the last year. Nineteen children (8–18 years) and fourteen parents were interviewed individually. The experiences, needs, and wishes expressed in the interviews could be classified into one overarching theme, that of the personal process, and two content-related sub-themes: feeling trust and gaining control. The personal process was divided into two different phases, that of developing and of expressing coping preferences. Children and parents both reported it as a continuous process, different for every child, with their own unique needs. Children and parents expected personalized attention and tailored support from professionals.

     Conclusion: Professionals must combine clinical skills with child-tailored care. In the process of searching for and communicating about coping preferences, children’s unique needs and personal boundaries will thereby be respected. This gives children and parents increased trust and control during invasive medical procedures.

What is Known:• Untreated pain and stress caused by medical procedures can have severe and important short- and long-term consequences for children. Personalized non-pharmacological interventions are an essential element of procedural pain management.

What is New:• A personalized coping strategy is important for children when undergoing medical procedures. Each individual child has a personal way of expressing their own coping strategy. Children and their parents need information and the space to develop and express their individual coping preferences.• Children and parents expect to receive child-tailored care from professionals including respect for their own, unique needs and boundaries. Professionals should build trustful relationships and provide appropriately tailored autonomy around medical procedures.
Global existence and non-uniqueness of 3D Euler equations perturbed by transport noise
Authors: Hofmanová Martina , Lange Theresa , Pappalettera Umberto
Published: October 2023

We construct Hölder continuous, global-in-time probabilistically strong solutions to 3D Euler equations perturbed by Stratonovich transport noise. Kinetic energy of the solutions can be prescribed a priori up to a stopping time, that can be chosen arbitrarily large with high probability. We also prove that there exist infinitely many Hölder continuous initial conditions leading to non-uniqueness of solutions to the Cauchy problem associated with the system. Our construction relies on a flow transformation reducing the SPDE under investigation to a random PDE, and convex integration techniques introduced in the deterministic setting by De Lellis and Székelyhidi, here adapted to consider the stochastic case. In particular, our novel approach allows to construct probabilistically strong solutions on $$[0,\infty )$$

[
0
,
∞
)

directly.
Sim-GAIL: A generative adversarial imitation learning approach of student modelling for intelligent tutoring systems
Authors: Li Zhaoxing , Shi Lei , Wang Jindi , Cristea Alexandra I. , Zhou Yunzhan
Published: October 2023

The continuous application of artificial intelligence (AI) technologies in online education has led to significant progress, especially in the field of Intelligent Tutoring Systems (ITS), online courses and learning management systems (LMS). An important research direction of the field is to provide students with customised learning trajectories via student modelling. Previous studies have shown that customisation of learning trajectories could effectively improve students’ learning experiences and outcomes. However, training an ITS that can customise students’ learning trajectories suffers from cold-start, time-consumption, human labour-intensity, and cost problems. One feasible approach is to simulate real students’ behaviour trajectories through algorithms, to generate data that could be used to train the ITS. Nonetheless, implementing high-accuracy student modelling methods that effectively address these issues remains an ongoing challenge. Traditional simulation methods, in particular, encounter difficulties in ensuring the quality and diversity of the generated data, thereby limiting their capacity to provide intelligent tutoring systems (ITS) with high-fidelity and diverse training data. We thus propose Sim-GAIL, a novel student modelling method based on generative adversarial imitation learning (GAIL). To the best of our knowledge, it is the first method using GAIL to address the challenge of lacking training data, resulting from the issues mentioned above. We analyse and compare the performance of Sim-GAIL with two traditional Reinforcement Learning-based and Imitation Learning-based methods using action distribution evaluation, cumulative reward evaluation, and offline-policy evaluation. The experiments demonstrate that our method outperforms traditional ones on most metrics. Moreover, we apply our method to a domain plagued by the cold-start problem, knowledge tracing (KT), and the results show that our novel method could effectively improve the KT model’s prediction accuracy in a cold-start scenario.
Evaluating ChatGPT responses in the context of a 53-year-old male with a femoral neck fracture: a qualitative analysis
Authors: Zhou Yushy , Moon Charles , Szatkowski Jan , Moore Derek , Stevens Jarrad
Published: September 2023

Purpose

The integration of artificial intelligence (AI) tools, such as ChatGPT, in clinical medicine and medical education has gained significant attention due to their potential to support decision-making and improve patient care. However, there is a need to evaluate the benefits and limitations of these tools in specific clinical scenarios.

Methods

This study used a case study approach within the field of orthopaedic surgery. A clinical case report featuring a 53-year-old male with a femoral neck fracture was used as the basis for evaluation. ChatGPT, a large language model, was asked to respond to clinical questions related to the case. The responses generated by ChatGPT were evaluated qualitatively, considering their relevance, justification, and alignment with the responses of real clinicians. Alternative dialogue protocols were also employed to assess the impact of additional prompts and contextual information on ChatGPT responses.

Results

ChatGPT generally provided clinically appropriate responses to the questions posed in the clinical case report. However, the level of justification and explanation varied across the generated responses. Occasionally, clinically inappropriate responses and inconsistencies were observed in the generated responses across different dialogue protocols and on separate days.

Conclusions

The findings of this study highlight both the potential and limitations of using ChatGPT in clinical practice. While ChatGPT demonstrated the ability to provide relevant clinical information, the lack of consistent justification and occasional clinically inappropriate responses raise concerns about its reliability. These results underscore the importance of careful consideration and validation when using AI tools in healthcare. Further research and clinician training are necessary to effectively integrate AI tools like ChatGPT, ensuring their safe and reliable use in clinical decision-making.
Effect of atmospheric conditions and VPRM parameters on high-resolution regional CO2 simulations over East Asia
Authors: Seo Min-Gyung , Kim Hyun Mee , Kim Dae-Hui
Published: October 2023

Atmospheric CO2 concentrations are largely affected by the surface CO2 flux and atmospheric wind. To estimate atmospheric CO2 concentrations over East Asia, the effects of atmospheric conditions and the parameters of Vegetation Photosynthesis and Respiration Model (VPRM) that simulates biogenic CO2 concentrations were evaluated using the Weather Research and Forecasting model coupled with Chemistry (WRF-Chem) model. The VPRM in WRF-Chem requires parameter optimization for the experimental period and region. Total six experiments with two atmospheric fields (final analysis; FNL and fifth generation of European Centre for Medium-range Weather Forecasts atmospheric reanalysis; ERA5) and three VPRM parameter tables (US, Li, and Dayalu) were conducted to investigate the appropriate atmospheric field and VPRM parameter table for East Asia. For validation, two types of wind observations (SYNOP and SONDE) and two types of CO2 observations (surface CO2 observations and OCO-2 XCO2 observations) were used. The experiments using FNL showed a lower RMSE for surface winds, whereas those using ERA5 showed a lower RMSE for upper-air winds. On average, the surface wind RMSE in the experiments using FNL was lower than that using ERA5. With respect to surface CO2 observations, the experiments using the Li table showed relatively lower RMSEs compared to those using other tables. With respect to OCO-2 XCO2 observations, the Li table with FNL showed lower RMSEs than other combinations. Overall, the combination of the Li table and FNL was the most appropriate for simulating CO2 concentrations in East Asia using WRF-Chem with VPRM.
Earlier clinical response predicts low rates of radiographic progression in biologic-naïve patients with active psoriatic arthritis receiving guselkumab treatment
Authors: Mease Philip J. , Gottlieb Alice B. , Ogdie Alexis , McInnes Iain B. , Chakravarty Soumya D. , Rampakakis Emmanouil , Kollmeier Alexa , Xu Xie L. , Shawi May , Lavie Frederic , Kishimoto Mitsumasa , Rahman Proton
Published: October 2023

Objective

Assess relationship between earlier clinical improvement and radiographic progression (RP) over 2 years in guselkumab-treated patients with active psoriatic arthritis (PsA).

Method

Post hoc analyses combined data from DISCOVER-2 biologic-naïve adults with active PsA randomized to either guselkumab 100 mg every 4 weeks (Q4W) or guselkumab at W0, W4, then Q8W. Correlations (Spearman’s coefficient) between baseline disease parameters and total PsA-modified van der Heijde-Sharp (vdH-S) score were examined. Repeated-measures mixed models, adjusted for known RP risk factors, assessed the relationship between Disease Activity Index in PsA (DAPSA) improvement, DAPSA improvement exceeding the median or the minimal clinically important difference (MCID), or DAPSA low disease activity (LDA) at W8 and RP rate, assessed by change from baseline in vdH-S score through W100.

Results

Baseline age, PsA duration, CRP level, and swollen joint count, but not psoriasis duration/severity, weakly correlated with baseline vdH-S score. Elevated baseline CRP (parameter estimate [β] = 0.17–0.18, p < 0.03) and vdH-S score (β = 0.02, p < 0.0001) significantly associated with greater RP through W100. Greater improvement in DAPSA (β = -0.03, p = 0.0096), achievement of DAPSA improvement > median (least squares mean [LSM] difference: -0.66, p = 0.0405) or > MCID (-0.67, p = 0.0610), or DAPSA LDA (-1.44, p = 0.0151) by W8 with guselkumab significantly associated with less RP through W100. The effect of W8 DAPSA LDA on future RP was strengthened over time among achievers vs. non-achievers (LSM difference enhanced from -1.05 [p = 0.0267] at W52 to -1.84 [p = 0.0154] at W100).

Conclusions

In guselkumab-treated patients with active PsA, earlier improvement in joint symptoms significantly associated with lower RP rates through 2 years, indicating blockade of the IL-23 pathway may modify long-term disease course and prevent further joint damage.

Key Points• Greater improvement in DAPSA at Week 8 of guselkumab treatment was significantly associated with less progression of structural joint damage at 2 years in patients with active psoriatic arthritis (PsA).• Early control of peripheral joint disease activity with blockade of the IL-23 pathway may modify long-term PsA trajectory and prevent further joint damage.
Clinical and imaging features of interstitial lung disease in cancer patients treated with trastuzumab deruxtecan
Authors: Baba Tomohisa , Kusumoto Masahiko , Kato Terufumi , Kurihara Yasuyuki , Sasaki Shinichi , Oikado Katsunori , Saito Yoshinobu , Endo Masahiro , Fujiwara Yutaka , Kenmotsu Hirotsugu , Sata Masafumi , Takano Toshimi , Kato Ken , Hirata Koji , Katagiri Tomomi , Saito Hanako , Kuwano Kazuyoshi
Published: October 2023

Background

Interstitial lung disease/pneumonitis (ILD/pneumonitis) has been identified as a drug-related adverse event of special interest of trastuzumab deruxtecan (T-DXd), but there were a few reports of T-DXd-related ILD/pneumonitis in clinical practice.

Methods

Between May 25, 2020 (the launch of T-DXd in Japan) and February 24, 2022, there were 287 physician-reported potential ILD/pneumonitis cases from the Japanese post-marketing all-case surveillance. By February 27, 2022, an independent adjudication committee assessed 138 cases and adjudicated 130 cases as T-DXd-related ILD/pneumonitis. The clinical features and imaging characteristics of these cases were evaluated.

Results

The majority of adjudicated T-DXd-related ILD/pneumonitis cases were grade 1 or 2 (100/130, 76.9%). The most common radiological pattern types observed were organizing pneumonia patterns (63.1%), hypersensitivity pneumonitis patterns (16.9%), and diffuse alveolar damage (DAD) patterns (14.6%). Eleven cases (8.5%) from 130 resulted in death; the majority of these (8/11, 72.7%) had DAD patterns. The overall proportion of recovery (including the outcomes of recovered, recovered with sequelae, and recovering) was 76.9%, and the median time to recovery was 83.5 days (interquartile range: 42.25–143.75 days). Most cases (59/71, 83.1%) that were treated with corticosteroids were considered responsive to treatment.

Conclusions

This is the first report to evaluate T-DXd-related ILD/pneumonitis cases in clinical practice. Our findings are consistent with previous reports and suggest that patients with DAD patterns have poor outcomes. Evaluation of a larger real-world dataset may further identify predictors of clinical outcome.
Resting-State EEG Microstates and Power Spectrum in Borderline Personality Disorder: A High-Density EEG Study
Authors: Deiber Marie-Pierre , Piguet Camille , Berchio Cristina , Michel Christoph M. , Perroud Nader , Ros Tomas
Published: September 2023

Borderline personality disorder (BPD) is a debilitating psychiatric condition characterized by emotional dysregulation, unstable sense of self, and impulsive, potentially self-harming behavior. In order to provide new neurophysiological insights on BPD, we complemented resting-state EEG frequency spectrum analysis with EEG microstates (MS) analysis to capture the spatiotemporal dynamics of large-scale neural networks. High-density EEG was recorded at rest in 16 BPD patients and 16 age-matched neurotypical controls. The relative power spectrum and broadband MS spatiotemporal parameters were compared between groups and their inter-correlations were examined. Compared to controls, BPD patients showed similar global spectral power, but exploratory univariate analyses on single channels indicated reduced relative alpha power and enhanced relative delta power at parietal electrodes. In terms of EEG MS, BPD patients displayed similar MS topographies as controls, indicating comparable neural generators. However, the MS temporal dynamics were significantly altered in BPD patients, who demonstrated opposite prevalence of MS C (lower than controls) and MS E (higher than controls). Interestingly, MS C prevalence correlated positively with global alpha power and negatively with global delta power, while MS E did not correlate with any measures of spectral power. Taken together, these observations suggest that BPD patients exhibit a state of cortical hyperactivation, represented by decreased posterior alpha power, together with an elevated presence of MS E, consistent with symptoms of elevated arousal and/or vigilance. This is the first study to investigate resting-state MS patterns in BPD, with findings of elevated MS E and the suggestion of reduced posterior alpha power indicating a disorder-specific neurophysiological signature previously unreported in a psychiatric population.
Comparative population genetics of habitat-forming octocorals in two marine protected areas: eco-evolutionary and management implications
Authors: Horaud Mathilde , Arizmendi-Meija Rosana , Nebot-Colomer Elisabet , López-Sendino Paula , Antunes Agostinho , Dellicour Simon , Viard Frédérique , Leblois Raphael , Linares Cristina , Garrabou Joaquim , Ledoux Jean-Baptiste
Published: September 2023

Current efforts to halt the decline of biodiversity are based primarily on protecting species richness. This narrow focus overlooks key components of biological diversity, particularly the infra-species genetic diversity, which is critical to consider with respect to genetic adaptation in changing environments. While comparative population genetics is recognized as a relevant approach to improve biodiversity management, it is still barely considered in practice. Here, a comparative population genetics study was conducted on two key habitat-forming octocoral species, Corallium rubrum and Paramuricea clavata, to contribute to management of two Marine Protected Areas (MPAs) in the northwestern Mediterranean. Contrasting patterns of genetic diversity and structure were observed in the two species, although they share many common biological features and live in similar habitats. Differential genetic drift effects induced by species-specific reproductive strategies and demographic histories most likely explain these differences. The translation of our results into management strategies supports the definition of four management units. We identified a coldspot of genetic diversity, with genetically isolated populations, and a hotspot of genetic diversity that has a central role in the system’s connectivity. Interestingly, they corresponded to the most recent and the oldest protected areas, respectively. This case study shows how moving from a “species pattern” perspective to an “eco-evolutionary processes” perspective can help assess and contribute to the effectiveness of biodiversity management plans.
Measuring Children’s Engagement in Early Childhood Education and Care Settings: A Scoping Literature Review
Authors: Ritoša Andrea , Åström Frida , Björck Eva , Borglund Lisa , Karlsson Elin , McHugh Elaine , Nylander Elisabeth
Published: September 2023

The purpose of this scoping review was to explore operationalizations and related conceptualizations of young children’s engagement in early childhood education and care (ECEC) settings. The literature search was conducted in March 2021 across ERIC, PsycINFO, Scopus, and Web of Science databases, with the aim of identifying studies where child engagement or involvement in ECEC settings was quantitatively assessed. The search resulted in 5965 articles, of which 286 were included in this review. Data were extracted about engagement conceptualization, theoretical frameworks, study population, study design, and engagement measurement tools and methods. Findings show variations in definitions and measurement of child engagement. Almost two-thirds of the studies lacked an explicit definition of child engagement. Young children’s engagement was typically defined as behaviors and interactions with the social and material environment, while involvement was depicted as an internal experience. The most common method of measuring children’s engagement in ECEC was observations by an external observer, followed by teacher surveys. Seventy-seven unique established measures of child engagement were identified. About one-third of the identified studies relied on unestablished measures of child engagement. Measures of general child engagement in ECEC had a focus on behavioral aspects of engagement, whereas most measures with a focus on engagement in academic activities also included cognitive and emotional aspects. To advance the research of child engagement in ECEC settings, more attention should be put into clarifying the concept of child engagement in terms of its generalizability, specificity, and temporality. Corresponding operationalizations should be precisely described. Our recommendations also include validating existing measures of child engagement and developing self-reports for young children.
Effect of Bacillus subtilis on potato virus Y (PVY) disease resistance and growth promotion in potato plants
Authors: Amin Hala A. , El Kammar Hanan F. , Saied Sawsan M. , Soliman Ahmed M.
Published: September 2023

Potato virus Y (PVY) has become the most important viral pathogen of potato. The Bacillus subtilis EMCCN 1211 (B. subtilis) isolate was investigated in the current study as a biocontrol agent for the management of the PVY and Induced Systemic Resistance (ISR) in potato plants under greenhouse conditions. Foliar and soil applications of a B. subtilis suspension at a concentration of 108 CFU/mL was applied at 48 h and 10 days respectively, before and after inoculation with PVY. Treatment of B. subtilis before virus inoculation resulted in a significant reduction in symptoms and entirely negative enzyme-linked immunosorbent assay (ELISA) results compared to untreated infected potato plants. In contrast, the RT-PCR showed PVY amplification (825 bp) in all bacterially treated plants. The soil application using B. subtilis before the PVY inoculation efficiently induced plant resistance and reduced the PVY accumulation level (32.79%) at 10 days post-inoculation (dpi) and continue with percentage increase of virus inhibition up to 72.26% at 35 dpi. The B. subtilis stimulated the plant growth that the potato plants fresh and dry weights increased by 61.40 and 56.6% at p ≤ 0.05 respectively. The transcriptional changes of pathogenesis -related gene (PR-1) was tested at 10 dpi. The results showed that the lower PVY accumulation was associated with the lower suppression of PR-1 defense related gene expression at 10 dpi and showed 0.9659 fold change value comparing with the mock-inoculated control. This data revealed that the soil application of B. subtilis efficiently suppressed, reduced the PVY accumulation level and symptoms severity; therefore it can be used as an antiviral biocontrol agent.
A general approach for evaluating of the coverage, resolution, and representation of streamflow monitoring networks
Authors: Konrad Christopher P. , Anderson Scott W.
Published: September 2023

Streamflow monitoring networks provide information for a wide range of public interests in river and streams. A general approach to evaluate monitoring for different interests is developed to support network planning and design. The approach defines three theoretically distinct information metrics (coverage, resolution, and representation) based on the spatial distribution of a variable of interest. Coverage is the fraction of information that a network can provide about a variable when some areas are not monitored. Resolution is the information available from the network relative to the maximum information possible given the number of sites in the network. Representation is the information that a network provides about a benchmark distribution of a variable. Information is defined using Shannon entropy where the spatial discretization of a variable among spatial elements of a landscape or sites in a network indicates the uncertainty in the spatial distribution of the variable. This approach supports the design of networks for monitoring of variables with heterogeneous spatial distributions (“hot spots” and patches) that might otherwise be unmonitored because they occupy insignificant portions of the landscape. Areas where monitoring will maintain or improve the metrics serve as objective priorities for public interests in network design. The approach is demonstrated for the streamflow monitoring network operated by the United States Geological Survey during water year 2020 indicating gaps in the coverage of coastal rivers and the resolution of low flows.
Long run non-linearity in CO2 emissions: the I(2) cointegration model and the environmental Kuznets curve
Authors: Kivedal Bjørnar Karlsen
Published: September 2023

I utilize the I(2) cointegration model to assess the empirical relevance of the environmental Kuznets curve for CO2 emissions in the US between 1960 and 2014. This takes the non-linearity of CO2 emissions into account by directly incorporating data that are integrated of order two, I(2). As a result, it enables an extensive dynamic analysis of the relationship between emissions and economic growth, as postulated by the environmental Kuznets curve both in the short, medium, and long run. The results indicate that the primary drivers behind the non-linear shape of US CO2 emissions in the long run are an increase in emissions caused by energy use and a decrease caused by more trade and the utilization of less polluting energy sources. GDP only exhibits short run effects. Hence, I do not find evidence in favor of a long-run relationship between economic development and the concave shape of emissions, as suggested by the environmental Kuznets curve.
Influencing factors on women in connection with engineering in New Zealand: a triad of lenses
Authors: Fox-Turnbull Wendy H. , Moridnejad Maryam , Docherty Paul D. , Cooper Josy
Published: September 2023

There is a considerable lack of women in the engineering disciplines at tertiary level in New Zealand. This is an economic issue because innovation and creativity in engineering are supported by diversity which directly and indirectly supports the New Zealand economy. Improving diversity in engineering will also improve equity. Literature suggests that parents, teachers, students’ self-perception, their beliefs, and stereotypical views influence girls’ career selection. Despite the vast number of studies in the international literature regarding the influencing factors on women’s career selection in engineering, this comprehensive study for the first time investigates the factors that contribute to women’s interest in studying engineering in New Zealand. The researchers explored these influencing factors from three lenses; future teachers of children aged 11–13 years, current engineering students and high school students. They found that participants held very strong stereotypical views about engineers, that barriers to selection of engineering pathway for females included a lack of career and subject choice guidance available to students at school, lack of promotion of the profession, and society’s perception of engineers as being masculine. It also found that experiences throughout their lives can steer girls away from a career in engineering.
Biomasonry products from macroalgae: A design driven approach to developing biomaterials for carbon storage
Authors: Scardifield Kate , McLean Nahum , Kuzhiumparambil Unnikrishnan , Ralph Peter J. , Neveux Nicolas , Isaac Geoff , Schork Tim
Published: September 2023

Lowering the embodied carbon of building materials requires a transition away from fossil derived products towards bio-based alternatives, alongside the design and development of new clean tech biomaterials that can function as carbon sinks. This paper presents an overview of historical and existing uses of seaweeds in construction to identify gaps and opportunities for the development of seaweed-based construction materials that can support atmospheric carbon removal through algal photosynthesis. This study highlights the value of interdisciplinary research collaborations that can be situated within the expanding field of biodesign where design research and methods are used to influence the development materials science. It presents as a case study the design of seaweed bricks utilising a biorefinery framework that aims to valorise residual seaweed biomass being grown for waste-water management, identifying value-adding opportunities for this seaweed by-product and new possibilities for carbon storage in the built environment. It details the development of a 1:1 scale prototype for the purposes of an exhibition at the Art Gallery of South Australia in order to demonstrate what biomasonry products from macroalgae can look like, to build social acceptance and to encourage future uptake of sustainable seaweed construction products.
Characterization of durability and reconnection patterns at time of repeat ablation after single-shot pulsed field pulmonary vein isolation
Authors: Ruwald Martin H. , Haugdal Martin , Worck Rene , Johannessen Arne , Hansen Morten Lock , Sørensen Samuel K. , Hansen Jim
Published: September 2023

Background

Pulsed field ablation (PFA) is a novel method of cardiac ablation where there is insufficient knowledge on the durability and reconnection patterns after pulmonary vein isolation (PVI). The aim of this study was to characterize the electrophysiological findings at time of repeat procedure in real-world atrial fibrillation (AF) patients.

Methods

Patients who underwent a repeat procedure (n=26) for symptomatic recurrent arrhythmias after index first-time treatment with single-shot PFA PVI (n=266) from July 2021 to June 2023 were investigated with 3D high-density mapping and ad-hoc re-ablation by radiofrequency or focal PFA.

Results

Index indication for PVI was persistent AF in 17 (65%) patients. The mean time to repeat procedure was 292 ± 119 days. Of the 26 patients (104 veins), complete durable PVI was observed in 11/26 (42%) with a durable vein isolation rate of 72/104 (69%). Two patients (8%) had all four veins reconnected. The posterior wall was durably isolated in 4/5 (80%) of the cases. The predominant arrhythmia mechanism was AF in 17/26 (65%) patients and regular atrial tachycardia (AT) in 9/26 (35%). Reconnection was observed 9/26 (35%) in right superior, 11/26 (42%) in right inferior, 7/26 (27%) in left superior, 5/26 (19%) in left inferior, p=0.31 between veins. The gaps were significantly clustered in the right-sided anterior carina compared to other regions (P=0.009).

Conclusions

Durable PVI was observed in less than half of the patients at time of repeat procedure. No significant difference in PV reconnection pattern was observed, but the gap location was preferentially located at the anterior aspects of the right-sided PVs. Predominant recurrence was AF. More data is needed to establish lesion formation and durability and AT circuits after PFA.