bluuebunny/crossref_metadata_2025 huggingface dataset:
Applicability of the surgical risk calculator by the American College of Surgeons in the setting of German patients undergoing complete pancreatectomy: multicentre study using data from the StuDoQ|Pancreas registry
Authors: Höhn Philipp , Runde Fabian , Luu Andreas Minh , Fahlbusch Tim , Fein Daniel , Klinger Carsten , Uhl Waldemar , Belyaev Orlin ,   members of StuDoQ|Pancreas registry of the German Society for General and Visceral Surgery (DGAV), Gutt Carsten , Köninger Jörg , Schnitzbauer Andreas , Schafmayer Clemens , Farkas Stefan , Hartwig Werner , Torge Mees Sören , Klammer Frank , Glanemann Matthias , Ghadimi Michael , Anthuber Matthias , Reißfelder Christoph , Piso Pompiliu , Padberg Winfried , Grützmann Robert , Niedergethmann Marco , Pascher Andreas , Prenzel Klaus , Reith Hans-Bernd , Chromik Ansgar Michael , M Krüger Colin , Bektas Hüseyin , Illert Bertram , Hommann Merten , Ritz Jörg-Peter , Döhrmann Axel , Schäfer Nico , Kraus Thomas , Jäger Mark , Tschmelitsch Jörg , Fleck Ullrich , Pauthner Michael , Tröbs Ute , Stier Albrecht , Krones Carsten , Keck Tobias , Werner Jens , Nüssler Natascha , Bartsch Detlef K , Germer Christoph-Thomas , Friess Helmut , Mönch Christian , Oldhafer Karl-Jürgen , Kalff Jörg C
Published: March 2023

Introduction

Surgical risk calculators can estimate risk probabilities for postoperative outcomes utilizing patient-specific risk factors. They provide meaningful information for obtaining informed consent. The aim of the present paper was to evaluate the predictive value of the surgical risk calculators by the American College of Surgeons in German patients undergoing total pancreatectomy.

Methods

Data for patients who underwent total pancreatectomy between 2014 and 2018 were acquired from the Study, Documentation, and Quality Center of the German Society for General and Visceral Surgery. Risk factors were entered manually into the surgical risk calculators and calculated risks were compared with actual outcomes.

Results

Of the 408 patients analysed, predicted risk was higher in patients with complications except for the prediction of re-admission (P = 0.127), delayed gastric emptying (P = 0.243), and thrombosis (P = 0.256). In contrast, classification of patients into below, above, or average risk by the surgical risk calculators only produced meaningful results for discharge to nursing facility (P < 0.001), renal failure (P = 0.003), pneumonia (P = 0.001), serious complications, and overall morbidity (both P < 0.001). Assessment of discrimination and calibration showed poor results (scaled Brier scores 8.46 per cent or less).

Conclusion

Overall surgical risk calculator performance was poor. This finding promotes the development of a specific surgical risk calculator applicable to the German healthcare system.
Towards a better understanding of Prunus (Rosaceae): molecular and morphological notes on Prunus subgenus Cerasus in Turkey
Authors: Ciftci Almila , Gercek Yusuf C , Mollman Rachel , Bostanci Ordu Pinar I , Yazici Ceyda , Yaprak Ahmet E , Morgil Hande , Şik Levent , Erol Osman
Published: March 2023

In this study, we explore the relationships among taxa of Prunus subgenus Cerasus in Turkey using a combination of macromorphology, micromorphology and molecular techniques. We recorded qualitative and quantitative characteristics of flowers, leaves, seeds and endocarp for 96 populations representing 14 taxa of Prunus subgenus Cerasus. ITS, matK, ycf1, trnL-trnF DNA sequence data were used to reconstruct phylogenetic trees for this group. Haplotype analyses results found 11 haplotypes among the samples used in this study. We also note that the infraspecific taxa of Cerasus angustifolia (=P. albicaulis), P. mahaleb, P. microcarpa and P. prostrata, as described by previous authors, do not exhibit significant differences even among the features of foliar morphology that are so often used to distinguish them from one another. As a general rule, our analyses indicate that the highly variable features of leaf micromorphology and endocarp and seed micromorphology are not taxonomically significant. In contrast, although floral morphology is often overlooked in systematic studies of Prunus subgenus Cerasus, we found several taxonomically useful flower characters, including sepal indumentum, hypanthium shape and indumentum and petal shape. This work clarifies the infraspecific relationships of members of Prunus subgenus Cerasus in Turkey and solves some taxonomic problems.
Techno-economic analysis of green hydrogen as an energy-storage medium for commercial buildings
Authors: Urs Rahul Rajeevkumar , Chadly Assia , Al Sumaiti Ameena , Mayyas Ahmad
Published: March 2023

Green-hydrogen production is vital in mitigating carbon emissions and is being adopted globally. In its transition to a more diverse energy mix with a bigger share for renewable energy, United Arab Emirates (UAE) has committed to investing billions of dollars in the production of green hydrogen. This study presents the results of the techno-economic assessment of a green-hydrogen-based commercial-building microgrid design in the UAE. The microgrid has been designed based on the building load demand, green-hydrogen production potential utilizing solar photovoltaic (PV) energy and discrete stack reversible fuel cell electricity generation during non-PV hours. Given the current market conditions and the hot humid climate of the UAE, a performance analysis is derived to evaluate the technical and economic feasibility of this microgrid. The study aims at maximizing both the building microgrid’s independence from the main grid and its renewable fraction. Simulation results indicate that the designed system is capable of meeting three-quarters of its load demand independently from the main grid and is supported by a 78% renewable-energy fraction. The economic analysis demonstrates a 3.117-$/kg levelized cost of hydrogen production and a 0.248-$/kWh levelized cost for storing hydrogen as electricity. Additionally, the levelized cost of system energy was found to be less than the current utility costs in the UAE. Sensitivity analysis shows the significant impact of the capital cost and discount rate on the levelized cost of hydrogen generation and storage.
COVID Keynesianism: locating inequality in the Anglo-American crisis response
Authors: Montgomerie Johnna
Published: March 2023

COVID Keynesianism evaluates the USA and UK’s economic response to the COVID-19 pandemic and compares it to the previous iterations of the Anglo-American policy response template. The analysis details the morbid character of neoliberal state intervention by tracing the distributional routes of monetary and fiscal measures into global corporations and across the domestic economy. The comparative findings show the degree to which emergency economic relief measures, despite their size and early success, have amplified the fault lines of inequality. The argument is that monetary flows generated windfall wealth gains for the already wealthy, while fiscal flows provided temporary gains and provisions for those on low-incomes and in deprived regions. Neoliberal efforts to protect wealth-holdings are discussed with reference to the structural conditions that generate permanent crises.
A hidden problem: peripheral artery disease in women
Authors: Kavurma Mary M , Boccanfuso Lauren , Cutmore Carina , Passam Freda , Patel Sanjay , Hennessy Annemarie , Loa Jacky , Figtree Gemma A , Golledge Jonathan , Robinson David A , Aitken Sarah
Published: March 2023

Peripheral artery disease (PAD) has a huge social and economic burden and is an important contributor to the global health burden. Sex differences in PAD are apparent, with recent data suggesting equal if not greater prevalence in women, and women having worse clinical outcomes. Why this occurs is not clear. To identify underlying reasons for gender inequalities in PAD, we executed a deeper exploration through a social constructive perspective. A scoping review was conducted using the World Health Organization model for analysis of gender-related needs in healthcare. Complex interacting factors, including biological, clinical, and societal variables, were reviewed to highlight gender-related inequities in the diagnosis, treatment, and management of PAD. Current gaps in knowledge were identified and insights into future directions aimed at improving these inequalities were discussed. Our findings highlight the multi-level complexities that need to be considered for strategies to improve gender-related needs in PAD healthcare.
The coral microbiome: towards an understanding of the molecular mechanisms of coral–microbiota interactions
Authors: Mohamed Amin R , Ochsenkühn Michael A , Kazlak Ahmed M , Moustafa Ahmed , Amin Shady A
Published: March 2023

Corals live in a complex, multipartite symbiosis with diverse microbes across kingdoms, some of which are implicated in vital functions, such as those related to resilience against climate change. However, knowledge gaps and technical challenges limit our understanding of the nature and functional significance of complex symbiotic relationships within corals. Here, we provide an overview of the complexity of the coral microbiome focusing on taxonomic diversity and functions of well-studied and cryptic microbes. Mining the coral literature indicate that while corals collectively harbour a third of all marine bacterial phyla, known bacterial symbionts and antagonists of corals represent a minute fraction of this diversity and that these taxa cluster into select genera, suggesting selective evolutionary mechanisms enabled these bacteria to gain a niche within the holobiont. Recent advances in coral microbiome research aimed at leveraging microbiome manipulation to increase coral’s fitness to help mitigate heat stress-related mortality are discussed. Then, insights into the potential mechanisms through which microbiota can communicate with and modify host responses are examined by describing known recognition patterns, potential microbially derived coral epigenome effector proteins and coral gene regulation. Finally, the power of omics tools used to study corals are highlighted with emphasis on an integrated host–microbiota multiomics framework to understand the underlying mechanisms during symbiosis and climate change-driven dysbiosis.
Values of debulking surgery for unresectable well-differentiated metastatic pancreatic neuroendocrine tumors: a comparative study
Authors: Huang Xi-Tai , Xie Jin-Zhao , Chen Liu-Hua , Cai Jian-Peng , Chen Wei , Liang Li-Jian , Zhang Ning , Yin Xiao-Yu
Published: March 2023

Background and objective

The value of debulking surgery for unresectable well-differentiated metastatic pancreatic neuroendocrine tumor (m-PNET) remains poorly defined. This study aimed to evaluate the outcomes of m-PNET following debulking surgery in our institute.

Methods

Patients with well-differentiated m-PNET in our hospital between February 2014 and March 2022 were collected. Clinicopathological and long-term outcomes of patients treated with radical resection, debulking surgery, and conservative therapy were compared retrospectively.

Results

Fifty-three patients with well-differentiated m-PNET were reviewed, including 47 patients with unresectable m-PNET (debulking surgery, 25; conservative therapy, 22) and 6 patients with resectable m-PNET (radical resection). Patients undergoing debulking surgery had a post-operative Clavien–Dindo ≥ III complication rate of 16.0% without mortality. The 5-year overall survival (OS) rate of patients treated with debulking surgery was significantly higher than that of those treated with conservative therapy alone (87.5% vs 37.8%, log-rank P = 0.022). Besides, the 5-year OS rate of patients treated with debulking surgery was comparable to that of patients with resectable m-PNET undergoing radical resection (87.5% vs 100%, log-rank P = 0.724).

Conclusions

Patients with unresectable well-differentiated m-PNET who underwent resection had better long-term outcomes than those who received conservative therapy alone. The 5-year OS of patients undergoing debulking surgery and radical resection were comparable. Debulking surgery could be considered for patients with unresectable well-differentiated m-PNET if no contraindication exists.
EU Copyright Exceptions and Limitations and the Three-Step Test: One Step Forward, Two Steps Back
Authors: Wymeersch Paulien
Published: March 2023

The three-step test, by origin an international provision, restricts copyright exceptions and limitations. The three-step test was incorporated into multiple treaties and trade agreements after being first included in the Berne Convention. Despite some nuances regarding the test’s wording in these legal instruments, the essential part – i.e. the three criteria – has remained unchanged. The European Union (EU) legislator took a step forward by expressly implementing the international three-step test into EU law. Article 5(5) of the 2001 InfoSoc Directive provides for its own EU three-step test, and more recently, the test was included in the 2019 DSM Directive. However, two substantial issues remain. First, there is still uncertainty on the specific meaning of each of these steps, due to scarce case law at the international level. Second, the incorporation of this standard has led to an added discussion on the scope and addressee of the EU three-step test. Due to the InfoSoc Directive’s wording, the question arose whether the three-step test is solely addressed to national legislators, or whether the test can also be applied by national courts. This article features a detailed analysis of the European Court of Justice’s case law on the three-step test, highlighting differing tendencies in its rulings. The Court’s decisions bring little clarification regarding the question of the test’s addressee, leaving the issue unresolved and disputed in the legal literature.
An Econcentric Turn in the Transitional Restorative Justice Process in Colombia
Authors: Ordóñez-Vargas Laura , Peralta Gonzalez L C , Prieto-Rios Enrique
Published: March 2023

ABSTRACT∞

This article reflects on how Colombia, as an important laboratory in transitional restorative justice, a 60-year long internal conflict, is experiencing an ‘ecocentric turn.’ This transition is not free from contradiction, ambivalence or great challenges. For this article, ‘ecocentric turn’ means an epistemological movement from anthropocentrism to ecocentrism, with biocentrism as the middle stage between the two ends. We argue that the ecocentric turn does not exclusively imply postures that are purely anthropocentric or ecocentric, but also ones that are hybrid and eclectic, which for the purposes of this article will be called biocentric positions. The ecocentric turn is reviewed on two levels: the first is the institutional level, focusing on the Special Jurisdiction for Peace (JEP for its name in Spanish); and the second level corresponds to the experience of Palestina, Huila, a non-ethnic campesino community.
Humanizing Chatbots for Political Campaigns: How Do Voters Respond to Feasibility and Desirability Appeals from Political Chatbots?
Authors: Kim Yunju , Lee Heejun
Published: March 2023

Informed by the construal level theory (CLT) and accounting for anthropomorphism, we investigated the effectiveness of political chatbots in influencing voting intentions. This study employed a three-way analysis of variance test with a 2 (anthropomorphism: anthropomorphism vs. non-anthropomorphism) × 2 (message type: feasibility vs. desirability appeal) × 2 (political ideology: conservatives vs. liberals) between-subjects experiment (n = 360). The findings reveal that participants showed higher voting intention after conversing with a highly anthropomorphic chatbot (vs. non-anthropomorphic chatbot) and when the chatbot delivered desirability (vs. feasibility) appeals. Participants also exhibited a higher voting intention when the chatbot was less anthropomorphic and it delivered feasibility (vs. desirability) messages. Moreover, we identified the three-way interaction effects of anthropomorphism, message appeal type and political ideology on voting intention. These findings are discussed in terms of their theoretical and practical implications.
A Practical Guide to Antifungal Susceptibility Testing
Authors: Otto William R , Arendrup Maiken Cavling , Fisher Brian T
Published: March 2023

We review antifungal susceptibility testing and the development of clinical breakpoints, and detail an approach to using antifungal susceptibility results when breakpoints have not been defined. This information may prove helpful when selecting therapy for invasive fungal infections in children.
The JCMT nearby galaxies legacy survey: SCUBA-2 observations of nearby galaxies
Authors: Pattle Kate , Gear Walter , Wilson Christine D
Published: March 2023

We present 850 $\mu$m observations of a sample of 8 nearby spiral galaxies, made using the SCUBA-2 camera on the James Clerk Maxwell Telescope (JCMT) as part of the JCMT Nearby Galaxies Legacy Survey (NGLS). We corrected our data for the presence of the 12CO J = 3 → 2 line in the SCUBA-2 850 $\mu$m bandwidth using NGLS HARP data, finding a typical 12CO contribution of ∼20 per cent. We measured dust column densities, temperatures, and opacity indices by fitting spectral energy distributions constructed from SCUBA-2 and archival Herschel observations, and used archival GALEX and Spitzer data to make maps of surface density of star formation ($\Sigma _{\small {\rm SFR}}$). Typically, comparing SCUBA-2-derived H2 surface densities ($\Sigma _{\rm H_2}$) to $\Sigma _{\small {\rm SFR}}$ gives shallow star formation law indices within galaxies, with SCUBA-2-derived values typically being sublinear and Herschel-derived values typically being broadly linear. This difference is likely due to the effects of atmospheric filtering on the SCUBA-2 data. Comparing the mean values of $\Sigma _{\rm H_2}$ and $\Sigma _{\small {\rm SFR}}$ of the galaxies in our sample returns a steeper star formation law index, broadly consistent with both the Kennicutt–Schmidt value of 1.4 and linearity. Our results show that a SCUBA-2 detection is a good predictor of star formation. We suggest that Herschel emission traces gas in regions which will form stars on time-scales ∼5 − 100 Myr, comparable to the star formation time-scale traced by GALEX and Spitzer data, while SCUBA-2 preferentially traces the densest gas within these regions, which likely forms stars on shorter time-scales.
The use of red flags during the referral chain of patients surgically treated for symptomatic spinal metastases
Authors: van Tol Floris R , Kamm Isabelle M L P , Versteeg Anne L , Suijkerbuijk Karijn P M , Verkooijen Helena M , Oner Cumher , Verlaan Jorrit-Jan
Published: March 2023

Background

The use of so-called “red flags” may be beneficial in identifying patients with metastatic spinal disease. This study examined the utility and efficacy of these red flags in the referral chain of patients surgically treated for spinal metastases.

Methods

The referral chains from the onset of symptoms until surgical treatment for all patients receiving surgery for spinal metastases between March 2009 and December 2020 were reconstructed. The documentation of red flags, as defined by the Dutch National Guideline on Metastatic Spinal Disease, was assessed for each healthcare provider involved.

Results

A total of 389 patients were included in the study. On average, 33.3% of red flags were documented as present, 3.6% were documented as absent, and 63.1% were undocumented. A higher rate of red flags documented as present was associated with a longer time to diagnosis, but a shorter time to definitive treatment by a spine surgeon. Moreover, red flags were documented as present more often in patients who developed neurological symptoms at any point during the referral chain than those who remained neurologically intact.

Conclusions

The association of red flags with developing neurological deficits highlights their significance in clinical assessment. However, the presence of red flags was not found to decrease delays prior to referral to a spine surgeon, indicating that their relevance is currently not sufficiently recognized by healthcare providers. Raising awareness of symptoms indicative of spinal metastases may expedite timely (surgical) treatment and thus improve treatment outcome.
Nutritional and exercise interventions in individuals with sarcopenic obesity around retirement age: a systematic review and meta-analysis
Authors: Eglseer Doris , Traxler Mariella , Schoufour Josje D , Weijs Peter J M , Voortman Trudy , Boirie Yves , Cruz-Jentoft Alfonso J , Reiter Lea , Bauer Silvia ,   for the SO-NUTS Consortium, Weijs Peter , Boirie Yves , Voortman Trudy , Eglseer Doris , Cruz-Jentoft Alfonso , Allouch Somaya Ben , Schoufour Josje , Topinková Eva
Published: March 2023

Context

Retirement is an opportune time for people to establish new healthy routines. Exercise and nutritional interventions are promising in the prevention and treatment of sarcopenic obesity.

Objective

This systematic review aimed

 

to assess the effectiveness of nutritional and exercise interventions for the treatment of sarcopenic obesity in persons of retirement age.

Data Sources

PubMed, Embase, CINAHL, and CENTRAL databases were searched in September 2021 for randomized controlled trials; a manual search was also conducted. The search yielded 261 studies, of which 11 were eligible for inclusion.

Data Extraction

Studies of community-dwelling individuals with sarcopenic obesity receiving any nutritional or exercise intervention ≥ 8 weeks with the mean age  ±  standard deviation between 50 and 70 years were included. Primary endpoint was body composition, and secondary endpoints were body mass index, muscle strength, and physical function. The literature review, study selection, data extraction, and risk-of-bias assessment were performed by two reviewers independently. Data were pooled for meta-analysis when possible.

Results

Meta-analysis was only possible for the exposure “resistance training” and the exposure “training (resistance or aerobic)” in combination with the exposure “added protein” as compared with “no intervention” or “training alone.” Resistance training led to a significant body fat reduction of −1.53% (95%CI, −2.91 to −0.15), an increase in muscle mass of 2.72% (95%CI, 1.23–4.22), an increase in muscle strength of 4.42 kg (95%CI, 2.44–6.04), and a slight improvement in gait speed of 0.17 m/s (95%CI, 0.01–0.34). Protein combined with an exercise intervention significantly reduces fat mass (−0.80 kg; 95%CI, −1.32 to −0.28). Some individual studies of dietary or food supplement interventions for which data could not be pooled showed positive effects on body composition.

Conclusion

Resistance training is an effective treatment for persons of retirement age with sarcopenic obesity. Increased protein intake combined with exercise may increase reductions in fat mass.

Systematic Review Registration

PROSPERO registration no. CRD42021276461.
The effect of omega-3 polyunsaturated fatty acid intake on blood levels of omega-3s in people with chronic atherosclerotic disease: a systematic review
Authors: Nayda Nicole C , Thomas Jolene M , Delaney Christopher L , Miller Michelle D
Published: March 2023

Context

Atherosclerosis is a systemic pro-inflammatory and pro-oxidative disease, accounting for approximately a third of deaths globally. It has been proposed that omega-3s, through their antioxidant and anti-inflammatory properties, mitigate atherosclerotic disease progression. However, due to the systemic pro-inflammatory and pro-oxidative state of atherosclerosis, it is proposed that patients with atherosclerotic disease may have higher omega-3 requirements than the average requirement, due to increased nutrient utilization in anti-inflammatory and anti-oxidant processes.

Objective

The aim of this review was to determine what dose and duration of omega-3 supplementation is required to reach a therapeutic blood level of omega-3s (eicosapentaenoic acid ≥150 µg/mL or omega-3 index ≥8%) in people with chronic atherosclerotic disease.

Data Sources

This systematic review comprehensively searched MEDLINE, Emcare, Scopus, and CINAHL using key search terms for atherosclerotic disease, omega-3, supplementation, and blood levels of omega-3s.

Data Extraction

Two reviewers independently screened 529 randomized controlled trials (RCTs) supplementing omega-3s in patients with chronic atherosclerotic disease.

Data Analysis

In total, 25 journal articles from 17 original RCTs were included and assessed quantitatively. Supplementation at 1.8 g to 3.4 g per day for a 3-month–6-month duration, and at 4.4 g and above for as little as 1 month–6 months were identified as the most effective dosage ranges for increasing blood levels of omega-3s to therapeutic levels in people with atherosclerotic disease.

Conclusions

Consideration should be given to routine omega-3 supplementation and to increasing the omega-3 dietary recommendations and upper limits of daily intake to improve clinical outcomes and reduce the risk of cardiac mortality in this population.
Investigations of Spatial Attention
Authors: Ellison Amanda
Published: March 2023

This chapter will discuss the combined use of transcranial stimulation and visual psychophysics tasks such as visual search in the scientific investigation of human attention. Historically, the identification of the neural network involved in spatial attention have been identified via neuropsychology. However, in latter years, discrete manipulation of nodes on this network using neurostimulation provides a window not only on whether a region is critically involved in the processing of such tasks, but when they are involved. There is also the opportunity to understand the directionality of communication between these regions and indeed their contingency upon one another. The critical involvement of the posterior parietal lobe, V5, superior temporal gyrus, the frontal eye fields, and lateral occipital regions are discussed with respect to their crucial, distinctive, and shared roles in visuospatial attention.
Elucidation of the liver pathophysiology of COVID-19 patients using liver-on-a-chips
Authors: Deguchi Sayaka , Kosugi Kaori , Hashimoto Rina , Sakamoto Ayaka , Yamamoto Masaki , Krol Rafal P , Gee Peter , Negoro Ryosuke , Noda Takeshi , Yamamoto Takuya , Torisawa Yu-suke , Nagao Miki , Takayama Kazuo
Published: March 2023

SARS-CoV-2 induces severe organ damage not only in the lung but also in the liver, heart, kidney, and intestine. It is known that COVID-19 severity correlates with liver dysfunction, but few studies have investigated the liver pathophysiology in COVID-19 patients. Here, we elucidated liver pathophysiology in COVID-19 patients using organs-on-a-chip technology and clinical analyses. First, we developed liver-on-a-chip (LoC) which recapitulating hepatic functions around the intrahepatic bile duct and blood vessel. We found that hepatic dysfunctions, but not hepatobiliary diseases, were strongly induced by SARS-CoV-2 infection. Next, we evaluated the therapeutic effects of COVID-19 drugs to inhibit viral replication and recover hepatic dysfunctions, and found that the combination of anti-viral and immunosuppressive drugs (Remdesivir and Baricitinib) is effective to treat hepatic dysfunctions caused by SARS-CoV-2 infection. Finally, we analyzed the sera obtained from COVID-19 patients, and revealed that COVID-19 patients, who were positive for serum viral RNA, are likely to become severe and develop hepatic dysfunctions, as compared with COVID-19 patients who were negative for serum viral RNA. We succeeded in modeling the liver pathophysiology of COVID-19 patients using LoC technology and clinical samples.
Assessing the variety of collaborative practices in translational research: An analysis of scientists’ ego-networks
Authors: Díaz-Faes Adrián A , Llopis Oscar , D’Este Pablo , Molas-Gallart Jordi
Published: March 2023

Translational research policies aim to reshape how biomedical scientists organize, conceive, and conduct science in order to accelerate healthcare improvements and medical innovations. Yet most analyses and evaluations of these initiatives focus on measuring the outputs generated in the different stages of the research process rather than observing scientists’ research practices directly. In this article, we analyze the collaboration networks formed by the biomedical scientists participating in a large translational research initiative. Based on data derived from a large-scale survey, we examine the network configurations established by biomedical scientists to advance their research in the context of the CIBER program—a Spanish flagship initiative aimed at supporting translational research. We adopt an ego-network perspective and draw on three network attributes—network diversity, tie strength, and tie content—to understand how scientists use their interpersonal connections to mobilize tangible and intangible resources and enable the translation of scientific knowledge into practical applications. Our cluster analysis identifies a range of scientist profiles: downstream-oriented scientists, upstream-oriented scientists, and brokering scientists. It shows that the scientists participating in the CIBER program deploy different types of collaborative behavior and engage in a variety of medical innovation activities. This suggests that the results achieved by a research program aimed at supporting collaborative networks will depend on the types of networks in which the participating scientists engage. Consequently, evaluations of these programs need to capture collaboration patterns, and should focus primarily on the collaborative process rather than the outputs that emerge from the collaboration.
Competition, open innovation, and growth challenges in the semiconductor industry: the case of Europe’s clusters
Authors: Huggins Robert , Johnston Andrew , Munday Max , Xu Chen
Published: March 2023

In recent years, public policymakers in Europe have become increasingly aware of the need to support Europe’s failing semiconductor industry. This is an emerging policy area, and this paper examines the current state of the industry in Europe and assesses its potential future. It contends that the competitiveness of the industry will be related to its innovative capacity, especially its capability to engage in processes of open innovation. The industry in Europe is largely located in a number of discrete regional clusters, and the analysis focuses on data collected from a series of interviews with lead representatives of these clusters. The analysis indicates that the challenges facing the industry stem from the structure of the industry in Europe and the structure of the wider European technology industry. It is concluded that policies, such as the introduction of the European Chips Act, are likely to have a limited, or even negative, impact on the types of open innovation–led growth that will improve long-term competitiveness.
Safety and pharmacodynamics of a single infusion of danavorexton in adults with idiopathic hypersomnia
Authors: Mignot Emmanuel , Bogan Richard K , Emsellem Helene , Foldvary-Schaefer Nancy , Naylor Melissa , Neuwirth Rachel , Faessel Hélène , Swick Todd , Olsson Tina
Published: March 2023

Study Objectives

Idiopathic hypersomnia (IH) is a chronic disorder characterized by excessive daytime sleepiness unexplained by another disorder or drug/medication use. Although the orexin system plays a role in sleep-wake regulation, orexin A levels in the cerebrospinal fluid are normal in people with IH. This phase 1b, randomized, placebo-controlled, crossover study aimed to investigate the safety, pharmacokinetics, and pharmacodynamics of danavorexton, a small-molecule orexin-2 receptor agonist, in adults with IH.

Methods

Adults with IH aged 18–75 years were randomized to one of two treatment sequences of single intravenous infusions of danavorexton 112 mg and placebo. Pharmacodynamic endpoints included the maintenance of wakefulness test (MWT), the Karolinska Sleepiness Scale (KSS), and the psychomotor vigilance task (PVT). Adverse events were monitored throughout the study period.

Results

Of 28 randomized participants, 12 (44.4%) had a treatment-emergent adverse event (TEAE) and 10 (37.0%) had a TEAE considered related to study drug, most of which were mild or moderate. Four participants (18.2%) had urinary TEAEs while receiving danavorexton, all of which were mild in severity. There were no deaths or TEAEs leading to discontinuation. Improvements in MWT, KSS, and PVT scores were observed with danavorexton compared to placebo. Following drug administration, a mean sleep latency of 40 min (maximum value) was observed during the MWT within 2 h of danavorexton infusion in most participants.

Conclusions

A single infusion of danavorexton improves subjective and objective excessive daytime sleepiness in people with IH with no serious TEAEs, indicating orexin-2 receptor agonists are promising treatments for IH.

Clinical Trial: Clinicaltrials.gov. https://clinicaltrials.gov/ct2/show/NCT04091438
A multidimensional pan‐cancer analysis of DCAF13 and its protumorigenic effect in lung adenocarcinoma
Authors: Wei Shan , Lu Kaining , Xing Jing , Yu Wanjun
Published: March 2023

DCAF13 is a substrate recognition protein in the ubiquitin‐proteasome system with oncogenic effects in several malignant tumors. However, it is unclear that the relationship between DCAF13 expression pattern and prognosis across different cancer types. Also unknown is the biological function or effects on the immune microenvironment of DCAF13. In this study, we parsed multiple public databases to explore the potential tumorigenic actions of DCAF13, including correlations with prognosis, microsatellite instability (MSI), tumor mutational burden (TMB), immune checkpoint genes, immune cell infiltration, and immunotherapy response in pan‐cancer. Moreover, we validated DCAF13 expression in a tissue microarray by immunohistochemistry and investigate its effects in vitro and in vivo. The results showed that DCAF13 was upregulated in 17 cancer types and correlated with poor prognosis in many cancers. Also, the correlation between DCAF13 and TMB was found in 14 cancers as well as MSI in nine. The expression level of DCAF13 was found to be notably correlated with immune cell infiltration, showing a negative correlation with CD4 T cell infiltration and a positive correlation with neutrophil infiltration. The oncogene DCAF13 expression was shown to have a positive correlation with CD274 or ADORA2A and negative correlation with VSIR, TNFRSF4, or TNFRSF14 across large subsets of human cancers. Finally, we observed that DCAF13 was highly expressed in a tissue microarray of lung cancer. In immunocompromised mouse models, xenograft growth of human lung cancer cells was significantly inhibited by DCAF13 knockdown. Our results highlighted the value of DCAF13 as a promising independent predictor of poor prognosis through numerous biological processes. High DCAF13 expression often predicts suppressive immune microenvironment and immunotherapy resistance in a pan‐cancer context.
Acute Cardiorenal Syndrome: An Update
Authors: Sohal Sumit , Uppal Dipan , Mathai Sheetal Vasundara , Wats Karan , Uppal Nupur N.
Published: March 2023

The complex dynamic pathophysiological interplay between the heart and kidney causes a vicious cycle of worsening renal and/or cardiovascular function. Acute decompensated heart failure causing worsening renal function defines Type 1 cardiorenal syndrome (CRS). Altered hemodynamics coupled with a multitude of nonhemodynamic factors namely pathological activation of the renin angiotensin aldosterone system and systemic inflammatory pathways mechanistically incite CRS type 1. A multipronged diagnostic approach utilizing laboratory markers, noninvasive and/or invasive modalities must be implemented to enable timely initiation of effective treatment strategies. In this review, we discuss the pathophysiology, diagnosis, and emerging treatment options for CRS type 1.
Control status of hypertension in India: systematic review and meta-analysis
Authors: Kumar S. Mathan , Anandraj Jeyanthi , Sivanatham Parthibane , Essakky Saravanan , Nain Jasvinder , Talukdar Rounik , Loganathan Vignesh , Kar Sitanshu Sekhar
Published: March 2023

Background and aims:

Uncontrolled hypertension is a major risk factor for cardiovascular diseases (CVDs). The present study aimed to conduct a systematic review and meta-analysis to estimate the pooled prevalence of control status of hypertension in India.

Methods and results:

We carried out systematic search (PROSPERO No.: CRD42021239800) in PubMed and Embase published between April 2013 and March 2021 followed by meta-analysis with random-effects model. The pooled prevalence of controlled hypertension was estimated across geographic regions. The quality, publication bias and heterogeneity of the included studies were also assessed. We included 19 studies with 44 994 hypertensive population, among which 17 studies had low risk of bias. We found statistically significant heterogeneity (P ≤ 0.05) and absence of publication bias among the included studies. The pooled prevalence of control status among patients with hypertension was 15% (95% CI: 12–19%) and among those under treatment was 46% (95% CI: 40–52%). The control status among patients with hypertension was significantly higher in Southern India 23% (95% CI: 16–31%) followed by Western 13% (95% CI: 4–16%), Northern 12% (95% CI: 8–16%), and Eastern India 5% (95% CI: 4–5%). Except for Southern India, the control status was lower among the rural areas compared with urban areas.

Conclusion:

We report high prevalence of uncontrolled hypertension in India irrespective of treatment status, geographic regions and urban and rural settings. There is urgent need to improve control status of hypertension in the country.
Predicting Outcomes 2 Months and 1 Year After Inpatient Rehabilitation for Youth With TBI Using Duration of Impaired Consciousness and Serial Cognitive Assessment
Authors: Lundine Jennifer P. , Koterba Christine , Shield Collin , Shi Junxin , Hoskinson Kristen R.
Published: March 2023

Objective:

To examine predictive utility of the Glasgow Coma Scale (GCS), time to follow commands (TFC), length of posttraumatic amnesia (PTA), duration of impaired consciousness (TFC+PTA), and the Cognitive and Linguistic Scale (CALS) scores in predicting outcomes on the Glasgow Outcome Scale–Extended, Pediatric Revision (GOS-E Peds) for children with traumatic brain injury (TBI) at 2 months and 1 year after discharge from rehabilitation.

Setting:

A large, urban pediatric medical center and inpatient rehabilitation program.

Participants:

Sixty youth with moderate-to-severe TBI (mean age at injury = 13.7 years; range = 5-20).

Design:

A retrospective chart review.

Main Measures:

Lowest postresuscitation GCS, TFC, PTA, TFC+PTA, inpatient rehabilitation admission and discharge CALS scores, GOS-E Peds at 2-month and 1-year follow-ups.

Results:

CALS scores were significantly correlated with the GOS-E Peds at both time points (weak-to-moderate correlation for admission scores and moderate correlation for discharge scores). TFC and TFC+PTA were correlated with GOS-E Peds scores at a 2-month follow-up and TFC remained a predictor at a 1-year follow-up. The GCS and PTA were not correlated with the GOS-E Peds. In the stepwise linear regression model, only the CALS at discharge was a significant predictor of the GOS-E Peds at the 2-month and 1-year follow-ups.

Conclusions:

In our correlational analysis, better performance on the CALS was associated with less long-term disability, and longer TFC was associated with more long-term disability, as measured by the GOS-E Peds. In this sample, the CALS at discharge was the only retained significant predictor of GOS-E Peds scores at 2-month and 1-year follow-ups, accounting for roughly 25% of the variance in GOS-E scores. As previous research suggests, variables related to rate of recovery may be better predictors of outcome than variables related to severity of injury at a single time point (eg, GCS). Future multisite studies are needed to increase sample size and standardize data collection methods for clinical and research purposes.
Racial and Ethnic Differences in Deaths by Suicide, Drug Overdose, and Opioid-Related Overdose in a National Sample of Military Members With Mild Traumatic Brain Injury, 1999-2019
Authors: Bahraini Nazanin , Adams Rachel Sayko , Caban Jesus , Kinney Adam R. , Forster Jeri E. , Hoffmire Claire A. , Monteith Lindsey L. , Brenner Lisa A.
Published: March 2023

Objective:

To examine racial and ethnic differences in suicide and drug and opioid-related overdose deaths among a population-based cohort of military service members who were diagnosed with a mild traumatic brain injury (mTBI) during military service.

Design:

Retrospective cohort.

Setting:

Military personnel receiving care within the Military Health System between 1999 and 2019.

Participants:

In total, 356 514 military members aged 18 to 64 years, who received an mTBI diagnosis as their index TBI between 1999 and 2019, while on active duty or activated.

Main Measures:

Death by suicide, death by drug overdose, and death by opioid overdose were identified using International Classification of Diseases, Tenth Revision (ICD-10) codes within the National Death Index. Race and ethnicity were captured from the Military Health System Data Repository.

Results:

Overall crude rates were 38.67 per 100 000 person-years for suicide; 31.01 per 100 000 person-years for drug overdose death; and 20.82 per 100 000 person-years for opioid overdose death. Crude and age-specific rates for military members who self-identified as Other were higher than all other racial/ethnic groups for all 3 mortality outcomes. Adjusting for age, suicide rates for those classified as Other were up to 5 times that of other racial/ethnic groups for suicide, and up to 11 and 3.5 times that of other race/ethnicity groups for drug and opioid overdose death, respectively.

Conclusion:

Findings extend previous knowledge regarding risk for suicide and deaths by drug overdose among those with mTBI and highlight new important areas for understanding the impact of race and ethnicity on mortality. Methodological limitations regarding classification of race and ethnicity must be addressed to ensure that future research provides a better understanding of racial and ethnic disparities in suicide and drug overdose mortality among military members with TBI.
Disparities in Chronic Pain Experience and Treatment History Among Persons With Traumatic Brain Injury: A Traumatic Brain Injury Model Systems Study
Authors: Sander Angelle M. , Williams Michael , Loyo Karina , Leon-Novelo Luis , Ngan Esther , Neumann Dawn , Agtarap Stephanie , Martin Aaron M. , Hoffman Jeanne , Christensen Kelsey , Hanks Robin , Hammond Flora M.
Published: March 2023

Objective:

To determine disparities in pain severity, pain interference, and history of pain treatment for non-Hispanic Whites, non-Hispanic Blacks, and Hispanics with traumatic brain injury (TBI) and chronic pain.

Setting:

Community following discharge from inpatient rehabilitation.

Participants:

A total of 621 individuals with medically documented moderate to severe TBI who had received acute trauma care and inpatient rehabilitation (440 non-Hispanic Whites, 111 non-Hispanic Blacks, and 70 Hispanics).

Design:

A multicenter, cross-sectional, survey study.

Main Measures:

Brief Pain Inventory; receipt of opioid prescription; receipt of nonpharmacologic pain treatments; and receipt of comprehensive interdisciplinary pain rehabilitation.

Results:

After controlling for relevant sociodemographic variables, non-Hispanic Blacks reported greater pain severity and greater pain interference relative to non-Hispanic Whites. Race/ethnicity interacted with age, such that the differences between Whites and Blacks were greater for older participants (for severity and interference) and for those with less than a high school education (for interference). There were no differences found between the racial/ethnic groups in the odds of having ever received pain treatment.

Conclusions:

Among individuals with TBI who report chronic pain, non-Hispanic Blacks may be more vulnerable to difficulties managing pain severity and to interference of pain in activities and mood. Systemic biases experienced by many Black individuals with regard to social determinants of health must be considered in a holistic approach to assessing and treating chronic pain in individuals with TBI.
A Clinicopathological, Etiological Analysis of 136 Cases of Erythroderma: A Single-Center Retrospective Study
Authors: Lu Ling-Yi , Yu Ying-Zhe , Wang Si-Han , Zhang Jing , Fan Xin , Qi Ying , Lin Bing-Jiang
Published: March 2023

Objective:

Erythroderma is an uncommon and severe skin disorder with many underlying causes and identifying its etiology can facilitate further treatments. This study was performed to evaluate the clinical profile and etiology of erythroderma.

Methods:

We collected the data on 136 patients diagnosed with erythroderma with respect to the epidemiological, clinical, biological, and histological data, treatments, and outcomes in The First Affiliated Hospital of Ningbo University from 2011 to 2021. The analyses of qualitative data were performed with the chi-square test or Fisher’s exact test. The groups of quantitative data were compared using a t-test or analysis of variance.

Results:

The patients’ mean age in this study was 65.00 ± 16.51 years, with a male:female ratio of 5.8:1.0. Acute onset occurred in 27 patients (19.9%) and was associated with drug reactions (P = 0.002). The mean length of stay was 19.18 ± 9.75 days. Clinical characteristics were dominated by pruritus (135, 99.3%), fever (44, 32.4%), edema (82, 60.3%), nail changes (14, 10.3%), arrhythmia (16, 11.8%), and superficial lymphadenopathy (57, 41.9%). Combined with biopsy, history inquiry and laboratory testing, this study found that most common causative factor was pre-existing dermatoses (107, 78.7%), followed by drug reactions (15, 11.0%), malignancies (8, 5.9%), and undetermined etiology (6, 4.4%). Among the pre-existing dermatoses, eczema was the most common etiology (33.9%). We also found that psoriasis, solar dermatitis, hypereosinophilic syndrome, atopic dermatitis, scabies, pemphigus foliaceus, and pityriasis rubra pilaris were causes of erythroderma. In the drug-induced group, anticonvulsants were the most frequently implicated drug. Compared to other cause diseases, patients with psoriasis had a significant higher rate of fever (P = 0.022), nail changes (P < 0.001), arthralgia (P < 0.001), and infection (P = 0.007). Eosinophilia and an increased immunoglobulin E concentration were associated with hypereosinophilic syndrome (P = 0.005) and eczema (P = 0.032), respectively compared to other cause diseases. The infection rate was significantly higher in patients with abnormal liver function compared to the patients with normal liver function (P < 0.001).

Conclusion:

Most of the clinical features of erythroderma are unspecific with the exception of fever, nail changes, and arthralgia, which were mostly found in patients with psoriasis. Clinicohistopathological examination helps to establish the etiology of erythroderma and reminder doctors to focus on high-risk populations.