bluuebunny/crossref_metadata_2025 huggingface dataset:
Correlation of Blood Pressure with Microalbuminuria and Dyslipidaemia in Patients with Essential Hypertension: A Case-control Study
Authors: Kiro Jyotsna , Acharya Madhusmita , Tirkey Neelam B , Bhoi Sumitra , Bhoi Sanghamitra
Published: May 2023

Introduction: Hypertension (HTN) is one of the most common disease affecting the people around the world. Microalbuminuria and dyslipidaemia has been considered as an early indicator of vascular damage, endothelial dysfunction and renal disease. Studies, conducted to evaluate microalbuminuria, dyslipidaemia in essential hypertensive patients are scarce. Aim: To assess the microalbuminuria, dyslipidaemia in essential hypertensive patients and also, to correlate these parameters with Blood Pressure (BP). Materials and Methods: This case-control study was conducted in the Department of Biochemistry at Veer Surendra Sai Institute of Medical Sciences and Research (VIMSAR), Sambalpur, Odisha, India, from January 2020 to February 2021. The study included 70 healthy individuals as controls and 70 essential hypertensive patients as cases in the age group of 25 to 55 years. According to Joint National Committee (JNC) 7 guidelines, out of 70, 20 cases were categorised as stage I (BP≥140-159/90-99 mmHg) and 50 as stage II (BP≥160/100 mmHg). Renal profile, lipid profile, total protein and albumin, microalbumin and Albumin-creatinine Ratio (ACR) were evaluated. Pearson correlation coefficient was applied to statistically analyse the data. Results: In the present study, 38 (54.3%) were males and 32 (45.7%) were females. Whereas, in controls, 44 (62.8%) were males and 26 (37.2%) were females. The mean age in cases 44.4±8.58 years, Systolic Blood Pressure (SBP) 156.0±35.1 mmHg, Diastolic Blood Pressure (DBP) 101±12.9 mmHg, serum creatinine 1.08±0.29 mg/dL, serum uric acid 7.37±1.8 mg/dL, serum total cholesterol 171±44.7 mg/dL, serum triglycerides 173±48.4 mg/dL, Low-density Lipoprotein Cholesterol (LDL-C) 107±38.8 mg/dL, Very Low-density Lipoprotein Cholesterol (VLDL-C) 35.1±10.2 mg/dL, microalbuminuria 75±31.9 mg/L, and urinary ACR 78±44.1 were significantly increased and serum High-density Lipoprotein Cholesterol (HDL-C) 31.7±7.07 mg/dL levels were decreased in cases than controls. Urinary ACR was significantly increased in stage II. ACR was positively correlated with SBP, DBP, creatinine, uric acid, total cholesterol, triglycerides, VLDL-C and negatively correlated with HDL-C. Conclusion: Blood pressure was positively correlated with lipid profile parameters, except HDL-C. Increased urinary albumin excretion rate may be useful and inexpensive marker for the identification of patients with higher cardiovascular risk and organ damage.
Bilateral Congenital Macular Coloboma: Section A Case Report
Authors: Nada Manisha , Garg Kiranmai , Phogat, Jitender , Kharolia Anjali , Kumar Surender
Published: May 2023

Macular coloboma is a rare disorder with congenital retinochoroidal defect. It has been divided into three categoriesPigmented macular coloboma, non pigmented macular coloboma and macular coloboma with abnormal vessels. Here, the authors present two cases of bilateral congenital macular coloboma. The first case was a 25-year-old male with diminution of vision in both eyes since childhood with no associated family history and no history of any systemic illness. His serological investigations were unremarkable. Case-2 was a nine-year-old male who was accompanied by his mother with vague history of rubbing of both eyes since two months with no significant medical and family history. Patient was found to have diminished vision bilaterally during ophthalmological examination. No evidence of infectious disease could be found on laboratory investigations. Paediatric consultation of the patient was unremarkable. Diagnosis was made after correlating the clinical and Ocular Computed Tomography (OCT) findings. Case-1 is on regular follow-up since three years while Case-2 was lost to follow-up. It is very important to reach at a diagnosis in such cases as there are many conditions which can mimic macular coloboma and treatment modalities vary accordingly. Although visual prognosis in cases of macular coloboma is poor, regular follow-up of the patient is of utmost importance in order to monitor visual acuity and posterior segment for any retinal breaks at the edge of coloboma.
An Unusual External Genital Lesion and its Treatment- A Case Report
Authors: Naragund Adithya V , Deevish ND , Muddasetty Rohith , Kumar Sharath S
Published: May 2023

Lesions around the external genitalia are embarrassing, physically, socially, and emotionally depressing. Patients generally present late for treatment. Here, the authors describe a case of 32 years old female patient, who presented with multiple giant warts-like lesions involving the external genitalia since past 6 months. Any presence of pain, bleeding from the lesion, or alteration in bowel, bladder, or menstrual habits were denied. Lesion posed diagnostic and therapeutic challenges. She underwent resection of the lesion with reconstruction using a bilateral gluteal fasciocutaneous flap and split skin graft with diversion sigmoid colostomy. She further developed anal stricture and subcutaneous fistula, requiring anal dilatation and seton placement. After a brief period of Keigels’s exercises and anal dilatation, she underwent a reversal of sigmoid colostomy. The patient had to undergo staged surgeries to restore near normal external genitalia. This case is an unusual presentation of a genital lesion which was treated with a multidisciplinary team approach to restore her anatomy.
АНАЛИЗ ПРИБОРНЫХ ТРЕБОВАНИЙ К ГЕТЕРОЭПИТАКСИАЛЬНЫМ СТРУКТУРАМ AlGaN/GaN НА Si ДЛЯ СИЛОВОЙ И СВЧ ЭКБ, "Электронная техника. Серия 3. Микроэлектроника"
Authors: Баранов Г.В. , Беляев А.О. , Дорофеев А.А. , Леоненков Е.И. , Панасенко П.В. , Ромодин М.С.
Published: May 2023

Проведен системный анализ требований, предъявляемых к гетероэпитаксиальным структурам AlGaN/GaN на Si-подложке, для реализации на их основе силовой и СВЧ ЭКБ по HEMT технологии: требования к структуре гетероперехода AlGaN/GaN, пассивирующему слою, конструкции буферного слоя и проводимости кремниевой подложки.
ПРИБОРНО-ТЕХНОЛОГИЧЕСКОЕ МОДЕЛИРОВАНИЕ ЭФФЕКТА БЛИЗОСТИ КАРМАНА И ЕГО ВЛИЯНИЯ НА ПОРОГОВОЕ НАПРЯЖЕНИЕ СУБМИКРОННОГО МОП-ТРАНЗИСТОРА, "Электронная техника. Серия 3. Микроэлектроника"
Authors: Кулиш А.М.
Published: May 2023

При масштабировании элементов интегральной схемы необходимо учитывать неизбежное влияние как соседних компонентов друг на друга, так и особенностей технологических процессов их формирования. В работе показано, что вследствие процессов рассеяния атомов примеси в фоторезистивной маске на этапе легирования кармана расстояние от маски до затвора дает вклад в характеристики транзистора, влияя на концентрацию примеси в области канала. Представлены результаты приборно-технологического моделирования, показывающие влияние положения края фоторезистивной маски относительно затвора на приповерхностную концентрацию примеси в МДП-транзисторах n- и p-типа с длиной затвора L = 0.25 мкм и их пороговые напряжения. Показано, что для рассматриваемой геометрии транзистора и заданных параметров ионной имплантации расстояние между краем маски и затвором, необходимое для нивелирования эффекта близости, составило 3 мкм для n- и p-транистора.
Influence of Phosphorus and Micronutrients on Growth and Yield of Rice (Oryza sativa L.)
Authors: Thrupthi M. G. , Debbarma Victor , Harika Darla
Published: May 2023

A field experiment was conducted during Kharif 2022 at Crop Research Farm, Department of Agronomy, Sam Higginbottom University of Agriculture, Technology And Sciences, Prayagraj (U.P) to determine the “Influence of Phosphorus and Micronutrients on growth and yield of Rice (Oryza sativa L.)”. The experiment was laid out in Randomized Block Design comprising of 10 treatments which include of three levels three Phosphorus viz @ 50,60 and 70 kg/ha. and three levels of micronutrients viz. Zinc @ 10kg/ha, Iron @ 15kg/ha and Boron @ 4 kg/ha.The results showed that treatment 7 [Phoshorus (70 kg/ha)+ Zinc(10 kg/ha)] recorded significantly higher plant height, number of of tillers/hill, plant dry weight (g), number of panicles/plant, number of grains/panicle, test weight, grain yield, straw yield and harvest index.
Explorando a Economia Circular: Perspectivas Internacionais em Foco
Authors: Silva Ferreira Alison , Batista Moreira Nayara , Dias Filho José Maria
Published: May 2023

Este trabalho tem por objetivo investigar o perfil da produção científica mundial acerca da Economia Circular, tomando por base os principais periódicos das áreas de economia, engenharia, contabilidade e negócios. Para tanto, foi utilizada a técnica de análise bibliométrica em 80 periódicos durante os anos de 2015 a 2019. Foram verificados 281 artigos que corresponde a 0,61% de toda a publicação do período. Os resultados obtidos sugerem que as discussões em torno da Economia Circular têm avançado no decorrer dos anos. Porém, não foram encontrados artigos publicados em journals de contabilidade, economia, finanças e negócios, havendo uma necessidade de maior engajamento dessas disciplinas. Estima-se que a concentração de publicações acerca de EC está localizada especialmente na China e na Europa. O Brasil, por sua vez, ficou ranqueado em 12° lugar. No geral, os trabalhos utilizaram, principalmente, abordagens de estudos de caso e aplicações de experimentos. Os achados reforçam e corroboram com literatura anterior, principalmente devido a possibilidade de verificar quais tipos de pesquisas sobre EC vem sendo empregadas pelo mundo, auxiliando pesquisadores a identificarem lacunas de pesquisa para aplicação prática e a agentes de mercado identificarem o panorama atual das novas práticas produtivas circulares no contexto de diferentes negócios.
Agressividade Tributária de Empresas Brasileiras Listadas na B3 e Emissoras de ADRs: Comparação entre Regulações da SOX, SEC e B3
Authors: Lopo Martinez Antonio , Da Silva Gabriela Anacleto
Published: May 2023

O objetivo deste estudo é verificar se as empresas brasileiras listadas na B3 e que emitem ADRs (American Depositary Receipts) são menos agressivas em relação à tributação sobre os lucros. Ao atuar no mercado americano, essas empresas estão sujeitas à SOX e à SEC (Securities and Exchange Commission), que visam proteger os investidores e exigir transparência e confiabilidade nas informações fornecidas. Foram utilizadas ETR, BTD e CashETR como proxies para medir a agressividade tributária. A amostra inclui empresas listadas na B3 entre 2011 e 2019, e para evitar viés de seleção, os algoritmos Nearest Neighbors Matching (NNM) e Propensity Score Matching (PSM) foram usados para criar subamostras com características semelhantes, diferenciando-se pela decisão de emissão do ADR. A pesquisa aponta que uma empresa sujeita à regulamentação da SOX e SEC não é mais agressiva tributariamente do que aquela submetida apenas à B3. Os achados sugerem que a regulação no mercado brasileiro (B3) pode ser tão eficaz quanto a regulação nos Estados Unidos em termos de prevenção de práticas tributárias agressivas.
Type 1 Diabetes Incidence and Risk in Children With a Diagnosis of COVID-19
Authors: Weiss Andreas , Donnachie Ewan , Beyerlein Andreas , Ziegler Anette-G. , Bonifacio Ezio
Published: May 2023

This study used a population-based individual patient data set that included diagnoses of COVID-19 to determine whether there was a temporal association between COVID-19 and type 1 diabetes in children.
Wide Complex Tachycardia Observed During Pregnancy
Authors: Lavelle Michael P. , Morrow John P. , Reiffel James A.
Published: May 2023

This case describes a 39-year-old pregnant woman with intermittent, transient but rapid palpitations, some with momentary lightheadedness.
Time to Confirmatory Study Initiation After Accelerated Approval of Cancer and Noncancer Drugs in the US
Authors: Jazowski Shelley A. , Vaidya Avi U. , Donohue Julie M. , Dusetzina Stacie B. , Sachs Rachel E.
Published: May 2023

This cross-sectional study examines and compares the time taken from the accelerated approval of cancer and noncancer drugs to the initiation of confirmatory studies in the US.
Race and Ethnicity and Fracture Prediction Among Younger Postmenopausal Women in the Women’s Health Initiative Study
Authors: Crandall Carolyn J. , Larson Joseph C. , Schousboe John T. , Manson JoAnn E. , Watts Nelson B. , Robbins John A. , Schnatz Peter , Nassir Rami , Shadyab Aladdin H. , Johnson Karen C. , Cauley Jane A. , Ensrud Kristine E.
Published: May 2023

Importance

The best approach to identify younger postmenopausal women for osteoporosis screening is uncertain. The Fracture Risk Assessment Tool (FRAX), which includes self-identified racial and ethnic information, and the Osteoporosis Self-assessment Tool (OST), which does not, are risk assessment tools recommended by US Preventive Services Task Force guidelines to identify candidates for bone mineral density (BMD) testing in this age group.

Objective

To compare the ability of FRAX vs OST to discriminate between younger postmenopausal women who do and do not experience incident fracture during a 10-year follow-up in the 4 racial and ethnic groups specified by FRAX.

Design, Setting, and Participants

This cohort study of Women’s Health Initiative participants included 67 169 women (baseline age range, 50-64 years) with 10 years of follow-up for major osteoporotic fracture (MOF; including hip, clinical spine, forearm, and shoulder fracture) at 40 US clinical centers. Data were collected from October 1993 to December 2008 and analyzed between May 11, 2022, and February 23, 2023.

Main Outcomes and Measures

Incident MOF and BMD (in a subset of 4607 women) were assessed. The area under the receiver operating characteristic curve (AUC) for FRAX (without BMD information) and OST was calculated within each racial and ethnic category.

Results

Among the 67 169 participants, mean (SD) age at baseline was 57.8 (4.1) years. A total of 1486 (2.2%) self-identified as Asian, 5927 (8.8%) as Black, 2545 (3.8%) as Hispanic, and 57 211 (85.2%) as White. During follow-up, 5594 women experienced MOF. For discrimination of MOF, AUC values for FRAX were 0.65 (95% CI, 0.58-0.71) for Asian, 0.55 (95% CI, 0.52-0.59) for Black, 0.61 (95% CI, 0.56-0.65) for Hispanic, and 0.59 (95% CI, 0.58-0.59) for White women. The AUC values for OST were 0.62 (95% CI, 0.56-0.69) for Asian, 0.53 (95% CI, 0.50-0.57) for Black, 0.58 (95% CI, 0.54-0.62) for Hispanic, and 0.55 (95% CI, 0.54-0.56) for White women. For discrimination of femoral neck osteoporosis, AUC values were excellent for OST (range, 0.79 [95% CI, 0.65-0.93] to 0.85 [95% CI, 0.74-0.96]), higher for OST than FRAX (range, 0.72 [95% CI, 0.68-0.75] to 0.74 [95% CI, 0.60-0.88]), and similar in each of the 4 racial and ethnic groups.

Conclusions and Relevance

These findings suggest that within each racial and ethnic category, the US FRAX and OST have suboptimal performance in discrimination of MOF in younger postmenopausal women. In contrast, for identifying osteoporosis, OST was excellent. The US version of FRAX should not be routinely used to make screening decisions in younger postmenopausal women. Future investigations should improve existing tools or create new approaches to osteoporosis risk assessment for this age group.
Assessment of Screening Tools to Identify Substance Use Disorders Among Adolescents
Authors: Levy Sharon , Brogna Melissa , Minegishi Machiko , Subramaniam Geetha , McCormack Jennifer , Kline Margaret , Menzin Eleanor , Allende-Richter Sophie , Fuller Alyssa , Lewis Mitra , Collins Julia , Hubbard Zach , Mitchell Shannon G. , Weiss Roger , Weitzman Elissa
Published: May 2023

Importance

Efficient screening tools that effectively identify substance use disorders (SUDs) among youths are needed.

Objective

To evaluate the psychometric properties of 3 brief substance use screening tools (Screening to Brief Intervention [S2BI]; Brief Screener for Tobacco, Alcohol, and Drugs [BSTAD]; and Tobacco, Alcohol, Prescription Medication, and Other Substances [TAPS]) with adolescents aged 12 to 17 years.

Design, Setting, and Participants

This cross-sectional validation study was conducted from July 1, 2020, to February 28, 2022. Participants aged 12 to 17 years were recruited virtually and in person from 3 health care settings in Massachusetts: (1) an outpatient adolescent SUD treatment program at a pediatric hospital, (2) an adolescent medicine program at a community pediatric practice affiliated with an academic institution, and (3) 1 of 28 participating pediatric primary care practices. Participants were randomly assigned to complete 1 of the 3 electronic screening tools via self-administration, followed by a brief electronic assessment battery and a research assistant–administered diagnostic interview as the criterion standard measure for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) diagnoses of SUDs. Data were analyzed from May 31 to September 13, 2022.

Main Outcomes and Measures

The main outcome was a DSM-5 diagnosis of tobacco/nicotine, alcohol, or cannabis use disorder as determined by the criterion standard World Mental Health Composite International Diagnostic Interview Substance Abuse Module. Classification accuracy of the 3 substance use screening tools was assessed by examining the agreement between the criterion, using sensitivity and specificity, based on cut points for each tool for use disorder, chosen a priori from previous studies.

Results

This study included 798 adolescents, with a mean (SD) age of 14.6 (1.6) years. The majority of participants identified as female (415 [52.0%]) and were White (524 [65.7%]). High agreement between screening results and the criterion standard measure was observed, with area under the curve values ranging from 0.89 to 1 for nicotine, alcohol, and cannabis use disorders for each of the 3 screening tools.

Conclusions and Relevance

These findings suggest that screening tools that use questions on past-year frequency of use are effective for identifying adolescents with SUDs. Future work could examine whether these tools have differing properties when used with different groups of adolescents in different settings.
Survival Trends in Children With Tetralogy of Fallot in Sweden From 1970 to 2017
Authors: Persson Johanna , Gyllencreutz Castellheim Albert , Dellborg Mikael , Giang Kok Wai , Karazisi Christina , Rawshani Araz , Mandalenakis Zacharias
Published: May 2023

Importance

Mortality in patients with tetralogy of Fallot (TOF) has decreased substantially since the start of surgical correction of this abnormality in the 1950s. However, nationwide data in Sweden comparing survival trends among pediatric patients with TOF with the general population are still limited.

Objective

To study survival trends in pediatric patients with TOF and compare them with matched controls.

Design, Setting, and Participants

A Swedish registry-based, nationwide, matched cohort study was conducted; data were collected from national health registers from January 1, 1970, to December 31, 2017. Patients with a registered diagnosis of TOF as well as controls without TOF matched by birth year and sex were included in the study. Follow-up data were collected from birth to age 18 years, death, or the end of follow-up (December 31, 2017), whichever occurred first. Data analysis was performed from September 10 to December 20, 2022. Survival trends among patients with TOF were compared with matched controls using Cox proportional hazards regression and Kaplan-Meier survival analyses.

Main Outcomes and Measures

All-cause mortality during childhood in patients with TOF and matched controls.

Results

The population included 1848 patients (1064 [57.6%] males; mean [SD] age, 12.4 [6.7] years) with TOF and 16 354 matched controls. The number of patients who underwent congenital cardiac surgery (henceforth, surgery group) was 1527 (897 [58.7%] males). In the whole TOF population from birth until age 18 years, 286 patients (15.5%) died during a mean (SD) follow-up time of 12.4 (6.7) years. In the surgery group, 154 of 1527 patients (10.1%) died during a follow-up time of 13.6 (5.7) years with a mortality risk of 21.9 (95% CI, 16.2-29.7) compared with matched controls. When stratified by birth period, a substantial decrease in the mortality risk was noted in the surgery group, from 40.6 (95% CI, 21.9-75.4) in those born in the 1970s to 11.1 (95% CI, 3.4-36.4) in those born in the 2010s. Survival increased from 68.5% to 96.0%. The risk of mortality for surgery decreased from 0.52 in the 1979s to 0.19 in the 2010s.

Conclusions and Relevance

The findings of this study suggest there has been substantial improvement in survival in children with TOF who underwent surgery from 1970 to 2017. However, the mortality rate is still significantly higher in this group compared with matched controls. Predictors of good and poor outcomes in this group need to be further explored, with the modifiable ones evaluated for further outcome improvements.
The Other Dementia Breakthrough—Comprehensive Dementia Care
Authors: Reuben David B. , Epstein-Lubow Gary , Super Nora
Published: May 2023

This Viewpoint describes barriers to comprehensive dementia care and proposes strategies for overcoming them.
Clinical Utility of Tau Positron Emission Tomography in the Diagnostic Workup of Patients With Cognitive Symptoms
Authors: Smith Ruben , Hägerström Douglas , Pawlik Daria , Klein Gregory , Jögi Jonas , Ohlsson Tomas , Stomrud Erik , Hansson Oskar
Published: May 2023

Importance

It is important to determine the added clinical value for tau positron emission tomography (PET) in the diagnostic workup of patients with cognitive symptoms before widespread implementation in clinical practice.

Objective

To prospectively study the added clinical value of PET detecting tau pathology in Alzheimer disease (AD).

Design, Setting, and Participants

This prospective cohort study (Swedish BioFINDER-2 study) took place from May 2017 through September 2021. A total of 878 patients with cognitive complaints were referred to secondary memory clinics in southern Sweden and then recruited to the study. In total, 1269 consecutive participants were approached, but 391 did not meet inclusion criteria or did not complete the study.

Exposures

Participants underwent a baseline diagnostic workup, including clinical examination, medical history, cognitive testing, blood and cerebrospinal fluid sampling, magnetic resonance imaging of the brain, and a tau PET ([18F]RO948) scan.

Main Outcomes and Measures

The primary end points were change in diagnosis and change in AD drug therapy or other drug treatment between the pre- and post-PET visits. A secondary end point was the change in diagnostic certainty between the pre- and post-PET visits.

Results

A total of 878 participants with a mean age of 71.0 (SD, 8.5) years (491 male [56%]) were included. The tau PET result led to a change in diagnoses in 66 participants (7.5%) and a change in medication in 48 participants (5.5%). The study team found an association with overall increased diagnostic certainty after tau PET in the whole data set (from 6.9 [SD, 2.3] to 7.4 [SD, 2.4]; P < .001). The certainty was higher in participants with a pre-PET diagnosis of AD (from 7.6 [SD, 1.7] to 8.2 [SD, 2.0]; P < .001) and increased even further in participants with a tau PET positive result supporting an AD diagnosis (from 8.0 [SD, 1.4] to 9.0 [SD, 0.9]; P < .001). The association with tau PET results had the largest effect sizes in participants with pathological amyloid-β (Aβ) status, whereas no significant change in diagnoses was seen in participants with normal Aβ status.

Conclusions and Relevance

The study team reported a significant change in diagnoses and patient medication when tau PET was added to an already extensive diagnostic workup that included cerebrospinal fluid AD biomarkers. Including tau PET was associated with a significant increase in certainty of underlying etiology. The effect sizes for certainty of etiology and diagnosis were largest in the Aβ-positive group and the study team suggests that clinical use of tau PET be limited to populations with biomarkers indicating Aβ positivity.
Use and Costs of Instrument-Based Vision Screening for US Children Aged 12 to 36 Months
Authors: Oke Isdin , Lutz Sharon M. , Hunter David G. , Galbraith Alison A.
Published: May 2023

This cohort study examines patterns and out-of-pocket costs of instrument-based screening among children 12 to 36 months.
What Parents Should Know About Returning to Work While Breastfeeding
Authors: Rabinovich Hannah M. , Thompson Lindsay A.
Published: May 2023

This Patient Page describes the challenges of returning to work while breastfeeding, tips on how to transition back to work, and the advantages of breast milk.
MAPTkit: An environmental management decision‐tool for inclusive, equitable and representative stakeholder attribute mapping
Authors: Hoare Victoria , Hinson Caitlin E. , Reyniers Bethany M. , O'Shea Ryan , Howe Caroline
Published: May 2023

Inclusive, comprehensive Stakeholder Identification and Mapping processes are vital for successful environmental management. This is relevant as multi‐disciplinary collaboration becomes increasingly popular, and the diversity of people influenced by, or involved in, the management of most projects is greater than ever before. Understanding how relevant parties are analysed in environmental management programmes is required to enable robust and considered methodologies as well as successful, just and equitable outcomes.

The aim of this study was to improve the attribute mapping process, increasing transparency and ensuring representation is both comprehensive and equitable. A rapid scoping review of Scopus and Web of Science was undertaken to collate and analyse peer‐reviewed, published evidence on stakeholder analysis, with a focus on the mapping processes involved in identifying stakeholders and their attributes.

Of the Initial 359 identified papers, 61 were included after three stages of screening. Our results indicate that there is little consistency among practitioners to ensure that Identifying and Mapping Stakeholders is representative: <20% of Case Studies (n = 9) checked the relevancy of their stakeholders after identification. Additionally, definitions at all stages of the stakeholder analysis process were inconsistent across the case studies. Fewer than half of the Case Studies included a definition of Stakeholder (n = 22) or of stakeholder analysis (n = 25).

Capturing a representative sample of relevant parties, without compromising on efficiency, financial or practical constraints, is difficult. Having consistent definitions for the term Stakeholders and stakeholder analysis within environmental management is an important step. Based on the scoping review, we formalise the Analysis process into six stages.

Through the scoping review findings, a decision support tool, MAPTkit (Mapped Attribute Profiling Toolkit) was developed to visualise the heterogeneity and representation of stakeholders across several user‐determined attributes. This tool is non‐prescriptive, drawing attention to potential issues with stakeholder analysis, such as misrepresentation of real‐world stakeholder communities. This ensures engagement across the full range of people to ensure that environmental management projects are multi‐disciplinary and collaborative, while promoting fair and equitable representation.
AI Autonomy: Self‐initiated Open‐world Continual Learning and Adaptation
Authors: Liu Bing , Mazumder Sahisnu , Robertson Eric , Grigsby Scott
Published: May 2023

As more and more AI agents are used in practice, it is time to think about how to make these agents fully autonomous so that they can (1) learn by themselves continually in a self‐motivated and self‐initiated manner rather than being retrained offline periodically on the initiation of human engineers and (2) accommodate or adapt to unexpected or novel circumstances. As the real‐world is an open environment that is full of unknowns or novelties, the capabilities of detecting novelties, characterizing them, accommodating/adapting to them, and gathering ground‐truth training data and incrementally learning the unknowns/novelties become critical in making the AI agent more and more knowledgeable, powerful and self‐sustainable over time. The key challenge here is how to automate the process so that it is carried out continually on the agent's own initiative and through its own interactions with humans, other agents and the environment just like human on‐the‐job learning. This paper proposes a framework (called SOLA) for this learning paradigm to promote the research of building autonomous and continual learning enabled AI agents. To show feasibility, an implemented agent is also described.
Refining the radiation and contrast medium dose in weight‐grouped scanning protocols for coronary CT angiography
Authors: Zhang Yan , Wang Ying , Li Jing , Zhang Guozhi , Di Aihui , Yuan Huishu
Published: May 2023

Purpose

To refine the currently used, weight‐grouped protocol for coronary computed tomography angiography (CCTA), in terms of the radiation and contrast medium dose, through clinical evaluation.

Methods

Following the current routine setting that varies between three weight groups (group A: 55–65 kg, group B: 66–75 kg, group C: 76–85 kg), three additional reduction protocols were proposed to each group, with different combinations of lowered tube voltage (70–100 kVp), tube current (100–220 mAs), and iodine delivery rate (0.8–1.5 gI/s). A total of 321 patients scheduled for CCTA due to suspected coronary artery disease were enrolled, who were randomly assigned to one of the four subgroups of settings under the corresponding weight group. The resulting objective image quality was compared by measuring the contrast‐to‐noise ratio and signal‐to‐noise ratio. Subjective image quality was graded by two radiologists using a 4‐point Likert scale, on a total of 3848 segments. The optimal protocol for each weight group was determined with respect to the image quality and the applied radiation dose.

Results

For all three groups, no significant difference was noticed in objective images quality between subgroups of dose settings (all p > 0.05). The average score on subjective image quality was ≥3 for every subgroup, while the percentage of score 4 showed greater dependence on the setting, ranging from 83.2% to 91.5%, and was chosen to be the determining factor. The optimal dose settings were found to be 80 kVp, 150 mAs, and 1.0 gI/s for patients of 55–75 kg in weight, and 100 kVp, 170 mAs, and 1.5 gI/s for those of 76–85 kg.

Conclusion

It is feasible to refine the currently used, weight‐grouped protocol for CCTA in terms of radiation and contrast medium dose, by use of an optimization strategy where the balance between dose and image quality can be improved in a routine clinical setting.
Mortality of myasthenia gravis: a national population‐based study in China
Authors: Zhang Chen , Wang Fei , Long Zheng , Yang Jia , Ren Yi , Ma Qingfeng , Li Jiajian , Wen Xinmei , Wang Lijun , Da Yuwei , Zhou Maigeng , Yin Peng , Hao Junwei
Published: May 2023

Objective

As a potentially life‐threatening condition, myasthenia gravis (MG) has limited epidemiological studies on mortality. We aim to provide demographic distribution, geographical variation, and temporal trend of MG‐related mortality in China.

Methods

The national population‐based analysis was conducted based on records derived from the National Mortality Surveillance System of China. All deaths related to MG were identified from 2013 to 2020, and MG‐related mortality was evaluated by sex, age, location, and year.

Results

A total of 4224 deaths were related to MG during 2013–2020, and the median age at death of MG was 59.45 years, significantly lower than that in the general population (75.47 years, P < 0.05). In 2020, the age‐standardized mortality rate of MG was 1.86 per million people and markedly higher in males than in females (2.37 vs. 1.31 per million). The mortality rate per million was lower than 1 in young children, peaking at 2.83 only in males (vs. 0.36 in females) aged 10–19 years, and substantially increased with age, reaching the highest rate of 13.31 for males and 10.58 for females aged 80 years and older. Geographical disparity across China was observed with the highest age‐standardized mortality rate in Southwest (2.53 per million). From 2013 to 2020, MG‐related mortality rate showed an increasing trend with the average annual percentage change of 3.5% (95% CI, 1.4–5.6). The notable increases occurred in age 10–19 years and over 70 years.

Interpretation

In China, MG‐related mortality was notably high among adolescent males and the elderly. The increasing death burden due to MG highlight challenges to disease management.
Unfolding the Mystery Behind the Onset of Chondrocyte Hypertrophy during Chondrogenesis: Toward Designing Advanced Permanent Cartilage‐mimetic Biomaterials
Authors: Majumder Nilotpal , Ghosh Sourabh
Published: May 2023

Successful recapitulation of the anatomical microarchitecture and biomechanics of the native articular cartilage under in vitro culture conditions is still an elusive topic of research. The major roadblock lies in maintaining the stable chondrogenic phenotype in vivo or under long‐term in vitro conditions. Tissue engineers worldwide has coined this aberrant loss of permanent cartilage characteristics to transient cartilage form as “chondrocyte hypertrophy”. Although the following has been validated through the expression of a few known markers but very little is understood regarding the molecular mechanism that dwells underneath. This review summarizes the precise aetiology behind the development and progression of the hypertrophic phenotype in chondrocytes under in vitro chondrogenic conditions. Based on the current literature survey, it is deciphered that the type of cell utilized (chondrocytes or stem cells), the chondrogenic culture conditions (growth factors/biochemical mediators) and the culture microenvironment (oxygen tension, mechanical loading) during chondrogenesis have a direct correlation with the dysregulated activity of the chondrogenic signaling pathways corroborating the onset of hypertrophic maturation of chondrocytes. Furthermore, it is critically analyzed whether to completely inhibit these hypertrophy‐inducing signaling pathways or apply a brake in terms of time‐dependent dose due to their functional duality role in chondrogenesis.
Manipulating Ion Transfer and Interface Stability by A Bulk Interphase Framework for Stable Lithium Metal Batteries
Authors: Liang Hongmei , Wang Li , Song Youzhi , Ren Dongsheng , Wang Aiping , Yang Yang , Xu Hong , Sun Yongming , He Xiangming
Published: May 2023

Lithium metal batteries (LMBs) have attracted widespread concern as the next‐generation energy storage devices with high energy density. At the surface of lithium metal anodes (LMAs) toward electrolytes, lithium plating always competes with interfacial reactions. This makes interfacial reactions light shadow right behind lithium plating, leading to performance degradation. Herein, lithium plating is spatially decoupled from interfacial reactions by constructing a 3D solid electrolyte interphase framework (3D‐SEIF) inside LMAs. Spontaneous while mild chemical reactions between lithium metal and lithium bisfluorosulfonimide/lithium nitrate form the robust 3D‐SEIF, mainly consisting of LiF, Li3N, and LiNxOy. The built‐in 3D‐SEIF avoids electrolyte contact but enables the diffusion and reduction of Li+ ions in the bulk phase, thus isolating the plating sites and electrolyte contact interface. The 3D‐SEIF facilitates large granular plating and the generation of thin, inorganic‐rich SEI. When assembled with high‐loading LiNi0.6Co0.2Mn0.2O2 cathode (3 mAh cm−2), the cells present capacity retention of 92.0% after 130 cycles with barren electrolyte (≈30 µL) at 0.5 C. The conception of 3D inner interphase allows breaking the coupling of interfacial reactions with electrochemical reactions, which is taken for granted in electrochemical consortium. It also desires to inspire new thoughts to develop scalable solutions for the early industrialization of LMBs.
A Sodium Alginate‐Based Multifunctional Nanoplatform for Synergistic Chemo‐Immunotherapy of Hepatocellular Carcinoma
Authors: Huang Cong , Xie Ting , Liu Yufeng , Yan Shuang , OuYang Feijun , Zhang Haitao , Lei Longtianyang , He Dongxiu , Wei Hua , Yu Cui‐Yun
Published: May 2023

Efficient hepatocellular carcinoma (HCC) treatment remains a significant challenge due to the inherent limitations of traditional strategies. The exploration of polysaccharides’ natural immunity for HCC immunotherapy is rarely explored. For this purpose, facile construction of a multifunctional nanoplatform, biotinylated aldehyde alginate‐doxorubicin nano micelle (BEACNDOXM) is reported in this study for synergistic chemo‐immunotherapy by using constant β‐D‐mannuronic acid (M) units and modulated α‐L‐guluronic acid (G) units in the alginate (ALG) structure. The M units show natural immunity and specific binding ability with mannose receptors (MRs) via strong receptor‐ligand interactions, and the G units serve as highly reactive conjugation sites for biotin (Bio) and DOX. Therefore, this formulation not only integrates the natural immunity of ALG and the immunogenic cell death (ICD) triggering function of DOX, but also shows dual targeting properties to HCC cells via MRs and Bio receptors (BRs)‐mediated endocytosis. Notably, BEACNDOXM mediates a tumor inhibitory efficiency 12.10% and 4.70% higher than free DOX and single targeting aldehyde alginate‐doxorubicin nano micelle controls, respectively, at an equivalent DOX dose of 3 mg kg−1 in Hepa1‐6 tumor‐bearing mice. This study reports the first example of integrating the natural immunity of ALG and the ICD effect of anticancer drugs for enhanced chemo‐immunotherapy of HCC.
Rhodium(III)‐Catalyzed [4+1] Oxidative Annulation of Amides with 1,3‐enynes Through 1,4‐Rhodium Migration
Authors: Raji Reddy Chada , Subbarao Muppidi , Rathaur Anjali , Srinivasu Ejjirotu
Published: May 2023

Rh(III)‐catalyzed cascade oxidative C−H functionalization/aza‐annulation of indole and pyrrole‐N‐carboxamides with 1,3‐enynes involving 1,4‐rhodium migration is disclosed. This [4+1] annulation protocol provides an approach for the synthesis of imidazo[1,5‐a]indol‐3(2H)‐ones from easily accessible substrates. Moreover, sulfonamides are also found to be well compatible in this method, leading to the corresponding benzo[d]sultams. The efficacy of this protocol is highlighted by handy downstream conversions of the dienyl‐sultam.
Sequence Variation of Candida albicans Sap2 Enhances Fungal Pathogenicity via Complement Evasion and Macrophage M2‐Like Phenotype Induction
Authors: Lin Lan , Wang Moran , Zeng Jingsi , Mao Yehong , Qin Renjie , Deng Jun , Ouyang Xiaohu , Hou Xiaoshuang , Sun Chunyan , Wang Yadan , Cai Yaohua , Li Mingyue , Tian Chunxia , Zhou Xi , Zhang Min , Fan Heng , Mei Heng , Sarapultsev Alexey , Wang Huafang , Zhang Gensheng , Zipfel Peter F. , Hu Yu , Hu Desheng , Luo Shanshan
Published: May 2023

Candida albicans (C. albicans) is an opportunistic pathogen increasingly causing candidiasis worldwide. This study aims to investigate the pattern of systemic immune responses triggered by C. albicans with disease associated variation of Sap2, identifying the novel evasion strategies utilized by clinical isolates. Specifically, a variation in clinical isolates is identified at nucleotide position 817 (G to T). This homozygous variation causes the 273rd amino acid exchange from valine to leucine, close to the proteolytic activation center of Sap2. The mutant (Sap2‐273L) generated from SC5314 (Sap2‐273V) background carrying the V273L variation within Sap2 displays higher pathogenicity. In comparison to mice infected with Sap2‐273V strain, mice infected with Sap2‐273L exhibit less complement activation indicated by less serum C3a generation and weaker C3b deposition in the kidney. This inhibitory effect is mainly achieved by Sap2273L‐mediated stronger degradation of C3 and C3b. Furthermore, mice infected with Sap2‐273L strain exhibit more macrophage phenotype switching from M0 to M2‐like and more TGF‐β release which further influences T cell responses, generating an immunosuppressed cellular microenvironment characterized by more Tregs and exhausted T cell formation. In summary, the disease‐associated sequence variation of Sap2 enhances pathogenicity by complement evasion and M2‐like phenotype switching, promoting a more efficient immunosuppressed microenvironment.
Reversible Parahydrogen Induced Hyperpolarization of 15N in Unmodified Amino Acids Unraveled at High Magnetic Field
Authors: Vaneeckhaute Ewoud , Tyburn Jean‐Max , Kempf James G. , Martens Johan A. , Breynaert Eric
Published: May 2023

Amino acids (AAs) and ammonia are metabolic markers essential for nitrogen metabolism and cell regulation in both plants and humans. NMR provides interesting opportunities to investigate these metabolic pathways, yet lacks sensitivity, especially in case of 15N. In this study, spin order embedded in p‐H2 is used to produce on‐demand reversible hyperpolarization in 15N of pristine alanine and ammonia under ambient protic conditions directly in the NMR spectrometer. This is made possible by designing a mixed‐ligand Ir‐catalyst, selectively ligating the amino group of AA by exploiting ammonia as a strongly competitive co‐ligand and preventing deactivation of Ir by bidentate ligation of AA. The stereoisomerism of the catalyst complexes is determined by hydride fingerprinting using 1H/D scrambling of the associated N‐functional groups on the catalyst (i.e., isotopological fingerprinting), and unravelled by 2D‐ZQ‐NMR. Monitoring the transfer of spin order from p‐H2 to 15N nuclei of ligated and free alanine and ammonia targets using SABRE‐INEPT with variable exchange delays pinpoints the monodentate elucidated catalyst complexes to be most SABRE active. Also RF‐spin locking (SABRE‐SLIC) enables transfer of hyperpolarization to 15N. The presented high‐field approach can be a valuable alternative to SABRE‐SHEATH techniques since the obtained catalytic insights (stereochemistry and kinetics) will remain valid at ultra‐low magnetic fields.
YBX1‐Mediated DNA Methylation‐Dependent SHANK3 Expression in PBMCs and Developing Cortical Interneurons in Schizophrenia
Authors: Ni Peiyan , Zhou Chuqing , Liang Sugai , Jiang Youhui , Liu Dongxin , Shao Zhicheng , Noh Haneul , Zhao Liansheng , Tian Yang , Zhang Chengcheng , Wei Jinxue , Li Xiaojing , Yu Hua , Ni Rongjun , Yu Xueli , Qi Xueyu , Zhang Yamin , Ma Xiaohong , Deng Wei , Guo Wanjun , Wang Qiang , Sham Pak C. , Chung Sangmi , Li Tao
Published: May 2023

Schizophrenia (SCZ) is a severe psychiatric and neurodevelopmental disorder. The pathological process of SCZ starts early during development, way before the first onset of psychotic symptoms. DNA methylation plays an important role in regulating gene expression and dysregulated DNA methylation is involved in the pathogenesis of various diseases. The methylated DNA immunoprecipitation‐chip (MeDIP‐chip) is performed to investigate genome‐wide DNA methylation dysregulation in peripheral blood mononuclear cells (PBMCs) of patients with first‐episode SCZ (FES). Results show that the SHANK3 promoter is hypermethylated, and this hypermethylation (HyperM) is negatively correlated with the cortical surface area in the left inferior temporal cortex and positively correlated with the negative symptom subscores in FES. The transcription factor YBX1 is further found to bind to the HyperM region of SHANK3 promoter in induced pluripotent stem cells (iPSCs)‐derived cortical interneurons (cINs) but not glutamatergic neurons. Furthermore, a direct and positive regulatory effect of YBX1 on the expression of SHANK3 is confirmed in cINs using shRNAs. In summary, the dysregulated SHANK3 expression in cINs suggests the potential role of DNA methylation in the neuropathological mechanism underlying SCZ. The results also suggest that HyperM of SHANK3 in PBMCs can serve as a potential peripheral biomarker of SCZ.
Advanced Materials Design for Adsorption of Toxic Substances in Cigarette Smoke
Authors: Zeng Ting , Liu Yanxia , Jiang Yingfang , Zhang Lan , Zhang Yagang , Zhao Lin , Jiang Xiaoli , Zhang Qiang
Published: May 2023

Cigarettes, despite being economically important legal consumer products, are highly addictive and harmful, particularly to the respiratory system. Tobacco smoke is a complex mixture containing over 7000 chemical compounds, 86 of which are identified to have “sufficient evidence of carcinogenicity” in either animal or human tests. Thus, tobacco smoke poses a significant health risk to humans. This article focuses on materials that help reduce the levels of major carcinogens in cigarette smoke; these include nicotine, polycyclic aromatic hydrocarbons, tobacco‐specific nitrosamines, hydrogen cyanide, carbon monoxide, and formaldehyde. Specifically, the research progress on adsorption effects and mechanisms of advanced materials such as cellulose, zeolite, activated carbon, graphene, and molecularly imprinted polymers are highlighted. The future trends and prospects in this field are also discussed. Notably, with advancements in supramolecular chemistry and materials engineering, the design of functionally oriented materials has become increasingly multidisciplinary. Certainly, several advanced materials can play a critical role in reducing the harmful effects of cigarette smoke. This review aims to serve as an insightful reference for the design of hybrid and functionally oriented advanced materials.
Systemic mastocytosis in adults: 2023 update on diagnosis, risk stratification and management
Authors: Pardanani Animesh
Published: May 2023

Overview

Systemic mastocytosis (SM) results from clonal proliferation of mast cells (MC) in extracutaneous organs.

Diagnosis

The major criterion is presence of multifocal MC clusters in the bone marrow and/or extracutaneous organs. Minor diagnostic criteria include elevated serum tryptase level, MC CD25/CD2/CD30 expression, and presence of activating KIT mutations.

Risk Stratification

Establishing SM subtype as per the International Consensus Classification/World Health Organization classification systems is an important first step. Patients either have indolent/smoldering SM (ISM/SSM) or advanced SM, including aggressive SM (ASM), SM with associated myeloid neoplasm (SM‐AMN), and mast cell leukemia. Identification of poor‐risk mutations (i.e., ASXL1, RUNX1, SRSF2, NRAS) further refines the risk stratification. Several risk models are available to help assign prognosis in SM patients.

Management

Treatment goals for ISM patients are primarily directed toward anaphylaxis prevention/symptom control/osteoporosis treatment. Patients with advanced SM frequently need MC cytoreductive therapy to reverse disease‐related organ dysfunction. Tyrosine kinase inhibitors (TKI) (midostaurin, avapritinib) have changed the treatment landscape in SM. While deep biochemical, histological and molecular responses have been documented with avapritinib treatment, its efficacy as monotherapy against a multimutated AMN disease component in SM‐AMN patients remains unclear. Cladribine continues to have a role for MC debulking, whereas interferon‐α has a diminishing role in the TKI era. Treatment of SM‐AMN primarily targets the AMN component, particularly if an aggressive disease such as acute leukemia is present. Allogeneic stem cell transplant has a role in such patients. Imatinib has a therapeutic role only in the rare patient with an imatinib‐sensitive KIT mutation.