bluuebunny/crossref_metadata_2025 huggingface dataset:
Vitamin K supplementation impact in dialysis patients: a systematic review and meta-analysis of randomized trials
Authors: Andrian Titus , Stefan Anca , Nistor Ionut , Covic Adrian
Published: October 2023

Vitamin K supplementation has been considered recently as a potential treatment for addressing vascular calcification in chronic kidney disease patients.

We conducted a systematic review and meta-analysis to summarize the impact of vitamin K supplementation in dialysis patients. Electronic databases were searched for clinical randomized trials among patients treated with vitamin K. Random effects models were performed and risk of bias was evaluated with Cochrane tools and the search was conducted until 15 of September 2023.

Eleven trials comprising 830 patients (both adult and pediatric, mainly hemodialysis) compared vitamin K with different controls: lower doses of vitamin K, standard care or placebo. Vitamin K supplementation had no effect on mortality. Vitamin K administration improved vitamin K levels and led to lower levels of dp-uc-MGP and moderately increased calcium levels [0.18 (0.04–0.32)]. Vitamin K1 proved more potency in reducing dp-uc-MGP [SMD −1.64 (−2.05, −1.23) vs. −0.56 (−0.82, −0.31)] and also raised serum vitamin K levels in comparison with vitamin K2 [5.69 (3.43, 7.94) vs. 2.25 (−2.36, 6.87)]. While it did not have a proved benefit in changing calcification scores [−0.14 (−0.37 ± 0.09)], vitamin K proved to be a safe product. There was some concern with bias.

Vitamin K supplementation has no impact on mortality and did not show significant benefit in reversing calcification scores. Vitamin K1 improved vitamin K deposits and lowered dp-uc-MGP, which is a calcification biomarker more than vitamin K2. As it proved to be a safe product, additional randomized well-powered studies with improved treatment regimens are needed to establish the true impact of vitamin K in dialysis patients.
Induced polarization of volcanic rocks. Part 7. Kimberlites
Authors: Titov K , Abramov V , Emelianov V , Revil A
Published: October 2023

In the field, kimberlites are characterized by high electrical conductivities (about 0.1 S m−1) compared to most igneous rocks. The reason for these high conductivities has not been fully elucidated to date. We investigate here the spectral induced polarization of seven core samples of kimberlites in the frequency range 1.43 mHz–20 kHz. The measurements are made at pore water conductivities ranging from 0.07 to 2.4 S m−1 (NaCl, 25 °C). We also measured the cation exchange capacity (CEC), the specific surface area (SSA) and the magnetic susceptibility of the core samples. We characterized the samples by optical microscopy as well as the X-ray diffraction and thermogravimetric analyses. Based on the electrical measurements, we obtained values of the surface conductivity produced by the double electrical layer coating the solid particles, and the normalized chargeability values characterizing the polarization magnitude of these materials. Mineralogical analyses show significant amount of magnetite (from 2 to 9 wt. per cent, approximately 1 to 4 per cent in vol. content) and smectite (from 1 to 44 wt. per cent) in the core samples. The main contributor of the CEC is smectite because of its very high CEC. The quadrature conductivity, the normalized chargeability, and the surface conductivity are controlled by the CEC normalized by the tortuosity of the pore space (product of the formation factor by the porosity). Our data demonstrate that the conduction and polarization of kimberlites are both controlled by the presence of smectite rather than associated with magnetite. Comparing the new data set and data recently obtained with volcanic rocks from both shield and strato-volcanoes in the previous papers of this series, we show that the model of polarization of the dynamic Stern layer correctly describes the complex electrical conductivity of kimberlites as well. Our results also explain the cause of electrical conductivity anomalies detected at kimberlite pipes and offer new perspectives in using induced polarization method for the exploration of kimberlites around the world.
Comparison of different inversion strategies for electrical impedance tomography (EIT) measurements
Authors: Wang Haoran , Zimmermann Egon , Weigand Maximilian , Vereecken Harry , Huisman Johan Alexander
Published: October 2023

Electrical impedance tomography (EIT) is a promising method to image the frequency-dependent complex electrical conductivity distribution of the subsurface in the mHz to kHz frequency range. In contrast to the well-developed electrical resistivity tomography (ERT) method, the inversion approach for EIT data is less established. Different inversion strategies have been proposed, but the implications of the differences between these methods have not been investigated yet. In this study, we aim to compare four different inversion strategies for EIT measurements. The first strategy (CVI) formulates the inverse problem in the complex number domain and is mathematically the most elegant method. The second strategy (RVI) is the established real-valued inversion method, which decouples the inversion of the real and imaginary parts and completely ignores the complex nature. The third strategy (ALT) is very similar to the RVI strategy in case of small phase angles, but it considers the complex coupling in the forward operator and alternately updates the real and imaginary parts of the model in the case of large phase angles. The fourth and final strategy (CVI+) was newly formulated in this study. It fully considers the complex nature of EIT measurements but separates the treatment of the real and imaginary part in terms of the data weighting and regularization. The different inversion strategies were tested with two synthetic models. The first model has a small phase contrast and the second model has a large phase contrast. In the case of a small phase contrast, the CVI strategy was able to resolve the distribution of electrical conductivity amplitude, but the inversion result for the phase angle was less reliable. The other three strategies presented similar results and the models were well resolved within the expected data misfit. In the case of a model with large phase contrast, only the newly formulated CVI + strategy was able to produce reliable results. It was found that the extremely large phase angle can have a significant influence on the modelled amplitude of data. The cross-sensitivity (i.e. the imaginary part of the sensitivity) that describes the influence on the real part of data due to a change in the imaginary part of model, or that on the imaginary part of data due to a change in the real part of model, provided unique information during the inversion. It was concluded that the CVI + strategy is theoretically the most comprehensive and correct approach for EIT inversion, but that in the case of small phase angles the RVI strategy has the practical advantage that no complex calculations are required, which substantially reduces the required computational effort.
Business Ethics
Authors: Crane Andrew , Matten Dirk , Glozer Sarah , Spence Laura J.
Published: October 2023

Business Ethics starts with a description and analysis of business ethics. The first part begins with an introduction to business ethics. Next, the text frames business ethics within the contexts of corporate responsibility, stakeholders, and citizenship. Business ethics is then evaluated using normative ethical theories. The text then looks at making decisions in business ethics using descriptive ethical theories. At the end of the first part, the text looks at managing business ethics. The second part is about contextualizing business ethics in terms of the people involved. It looks at shareholders, employees, consumers, suppliers, competitors, government, and civil society. Finally the text makes some conclusions and looks to the future.
Black-box tests for algorithmic stability
Authors: Kim Byol , Barber Rina Foygel
Published: October 2023

Algorithmic stability is a concept from learning theory that expresses the degree to which changes to the input data (e.g. removal of a single data point) may affect the outputs of a regression algorithm. Knowing an algorithm’s stability properties is often useful for many downstream applications—for example, stability is known to lead to desirable generalization properties and predictive inference guarantees. However, many modern algorithms currently used in practice are too complex for a theoretical analysis of their stability properties, and thus we can only attempt to establish these properties through an empirical exploration of the algorithm’s behaviour on various datasets. In this work, we lay out a formal statistical framework for this kind of black-box testing without any assumptions on the algorithm or the data distribution, and establish fundamental bounds on the ability of any black-box test to identify algorithmic stability.
Evaluations of patient-specific bolus fabricated by mold-and-cast method using computer numerical control machine tools
Authors: Yu Geum Bong , Kwon Jimin , Chae Seunghoon , Lee Sung Young , Jung Seongmoon
Published: October 2023

The patient-specific bolus fabricated by a mold-and-cast method using a 3D printer (3DP) and silicon rubber has been adopted in clinical practices. Manufacturing a mold using 3DP, however, can cause time delays due to failures during the 3D printing process. Thereby, we investigated an alternative method of the mold fabrication using computer numerical control (CNC) machine tools. Treatment plans were conducted concerning a keloid scar formed on the ear and nose. The bolus structures were determined in a treatment planning system (TPS), and the molds were fabricated using the same structure file but with 3DP and CNC independently. Boluses were then manufactured using each mold with silicone rubbers. We compared the geometrical difference between the boluses and the planned structure using computed tomography (CT) images of the boluses. In addition, dosimetric differences between the two measurements using each bolus and the differences between the measured and calculated dose from TPS were evaluated using an anthropomorphic head phantom. Geometrically, the CT images of the boluses fabricated by the 3DP mold and the CNC mold showed differences compared to the planned structure within 2.6 mm of Hausdorff distance. The relative dose difference between the measurements using either bolus was within 2.3%. In conclusion, the bolus made by the CNC mold benefits from a stable fabricating process, retaining the performance of the bolus made by the 3DP mold.
Dual-energy computed tomography-based iodine concentration as a predictor of histopathological response to preoperative chemoradiotherapy for pancreatic cancer
Authors: Ohira Shingo , Ikawa Toshiki , Kanayama Naoyuki , Minamitani Masanari , Kihara Sayaka , Inui Shoki , Ueda Yoshihiro , Miyazaki Masayoshi , Yamashita Hideomi , Nishio Teiji , Koizumi Masahiko , Nakagawa Keiichi , Konishi Koji
Published: October 2023

To explore predictors of the histopathological response to preoperative chemoradiotherapy (CRT) in patients with pancreatic cancer (PC) using dual-energy computed tomography-reconstructed images. This retrospective study divided 40 patients who had undergone preoperative CRT (50–60 Gy in 25 fractions) followed by surgical resection into two groups: the response group (Grades II, III and IV, evaluated from surgical specimens) and the nonresponse group (Grades Ia and Ib). The computed tomography number [in Hounsfield units (HUs)] and iodine concentration (IC) were measured at the locations of the aorta, PC and pancreatic parenchyma (PP) in the contrast-enhanced 4D dual-energy computed tomography images. Logistic regression analysis was performed to identify predictors of histopathological response. Univariate analysis did not reveal a significant relation between any parameter and patient characteristics or dosimetric parameters of the treatment plan. The HU and IC values in PP and the differences in HU and IC between the PP and PC (ΔHU and ΔIC, respectively) were significant predictors for distinguishing the response (n = 24) and nonresponse (n = 16) groups (P < 0.05). The IC in PP and ΔIC had a higher area under curve values [0.797 (95% confidence interval, 0.659–0.935) and 0.789 (0.650–0.928), respectively] than HU in PP and ΔHU [0.734 (0.580–0.889) and 0.721 (0.562–0.881), respectively]. The IC value could potentially be used for predicting the histopathological response in patients who have undergone preoperative CRT.
Prediction of late adverse events in pelvic cancer patients receiving definitive radiotherapy using radiation-induced gamma-H2AX foci assay
Authors: Someya Masanori , Hasegawa Tomokazu , Nakamura Asako J , Tsuchiya Takaaki , Kitagawa Mio , Gocho Toshio , Mafune Sho , Ikeuchi Yutaro , Tauchi Hiroshi , Sakata Koh-ichi
Published: October 2023

Radiation can induce DNA double-stranded breaks, which are typically detected by the fluorescence of phosphorylated histone H2AX. In this study, we examined the usefulness of the dynamics of radiation-induced gamma-H2AX foci of peripheral blood lymphocytes (PBLs), as a marker of DNA repair ability, in predicting late adverse events from radiotherapy. A total of 46 patients with cervical, vaginal and anal canal cancers treated with radical radiotherapy between 2014 and 2019 were included in this analysis. Concurrent chemotherapy was administered in 36 cases (78.3%). Peripheral blood was obtained before treatment, and then irradiated ex vivo with 1 Gy X-ray. The ratio of radiation-induced gamma-H2AX foci in PBLs measured at 30 min and at 4 h was defined as the foci decay ratio (FDR). With a median follow-up of 54 months, 9 patients (19.6%) were observed to have late genitourinary or gastrointestinal (GU/GI) toxicity. The FDR ranged from 0.51 to 0.74 (median 0.59), with a significantly higher incidence of Grade 1 or higher late adverse events in the FDR ≥ 0.59 group. In multivariate analysis, FDR ≥ 0.59 and hypertension also emerged as significant factors associated with the development of late toxicities. Overall, our results suggest that measurement of radiation-induced gamma-H2AX foci in PBLs may predict the risk of late GU/GI toxicities from chemoradiotherapy, which can enable tailoring the radiation dose to minimize adverse effects.
Observational investigation of the dynamical tides in massive eccentric binaries
Authors: Çakırlı Ömür , Özdarcan Orkun , Hoyman Barış
Published: October 2023

One of the basics of astrophysics is the construction of a theory to explain tidal interactions and evolution. The accuracy of the theoretical models produced by these theories is relied upon by various other astrophysical fields. As a result, putting observational models to the test is of utmost importance. The foundation of this premise rests on the comparison between predicted models and observed stellar quantities. In order to maximize the potential of the topic, a comprehensive analysis of five massive eccentric binary systems is presented in this study, which is further compared with other sample sets to evaluate the impact of tidal interaction in massive eccentric systems. The amalgamation of radial velocity measurements with photometry has yielded a comprehensive collection of both physical and orbital parameters. The spectra of each binary system were evaluated using a standard atmospheric analysis in order to ascertain the temperatures and metallicities of each component in the binaries. The utilization of high-precision analysis enables us to ascertain the evolutionary status of the components that have been deduced from models of stellar evolution, by examining the positions of these components in the T$_{\rm eff}/\log g\,{\rm Kiel}$ diagram. The examination of the influence of tidal interaction on stars possessing radiative envelopes constitutes an important part of our research. The interpretation of our analysis is situated within the framework of the temporal scales of tidal synchronization and circularization.
Polarized resonance line transfer in a spherically symmetric medium with angle-dependent partial frequency redistribution
Authors: Sampoorna M , Supriya H D
Published: October 2023

In a stellar atmosphere, the resonance line polarization arises from scattering of limb-darkened radiation field by atoms. This spectral line polarization gets affected particularly in the wings, when the line photons suffer scattering on electrons in thermal motion. Scattering of line photons by atoms and electrons are, respectively, described by the atomic and Thomson electron scattering redistribution functions, which in general depend on both the frequencies and directions of incident and scattered photons. In this paper, we consider the polarized spectral line formation in spherically symmetric extended and expanding media accounting for the angle-dependent partial frequency redistribution (AD-PRD) in scattering on both atoms and electrons. We solve this computationally demanding polarized transfer problem using an accelerated lambda iteration method and a method based on orders of scattering approach. In the case of expanding spherical medium, the concerned transfer problem is solved in the comoving frame. Because of the computational limitations, we consider optically thin isothermal spherically symmetric media of different extensions for the static case as well as when the velocity fields are present. For the considered model, we show that the AD-PRD effects on the linear polarization profiles are significant and have to be accounted for.
Spatially resolved Kennicutt–Schmidt relation at z ≈ 7 and its connection with the interstellar medium properties
Authors: Vallini Livia , Witstok Joris , Sommovigo Laura , Pallottini Andrea , Ferrara Andrea , Carniani Stefano , Kohandel Mahsa , Smit Renske , Gallerani Simona , Gruppioni Carlotta
Published: October 2023

We exploit moderately resolved [O $\scriptstyle \rm III$], [C $\scriptstyle \rm II$] and dust continuum ALMA observations to derive the gas density (n), the gas-phase metallicity (Z), and the deviation from the Kennicutt–Schmidt (KS) relation (κs) on $\approx \, \rm sub-kpc$ scales in the interstellar medium (ISM) of five bright Lyman Break Galaxies at the Epoch of Reionization (z ≈ 7). To do so, we use GLAM, a state-of-art, physically motivated Bayesian model that links the [C $\scriptstyle \rm II$]and [O $\scriptstyle \rm III$]surface brightness (Σ[CII], Σ[OIII]) and the SFR surface density (ΣSFR) to n, κs, and Z. All five sources are characterized by a central starbursting region, where the Σgas versus ΣSFR align ≈10 × above the KS relation (κs ≈ 10). This translates into gas depletion times in the range tdep ≈ 80 − 250 Myr. The inner starbursting centres are characterized by higher gas density (log (n/cm−3) ≈ 2.5–3.0) and higher metallicity (log (Z/Z⊙) ≈ −0.5) than the galaxy outskirts. We derive marginally negative radial metallicity gradients (∇log Z ≈ −0.03 ± 0.07 dex/kpc), and a dust temperature (Td ≈ 32 − 38 K) that anticorrelates with the gas depletion time.
Ly α emission in low-redshift most metal-deficient compact star-forming galaxies
Authors: Izotov Y I , Thuan T X , Guseva N G , Schaerer D , Worseck G , Verhamme A
Published: October 2023

We present observations with the Cosmic Origins Spectrograph onboard the Hubble Space Telescope of nine most metal-deficient compact star-forming galaxies with oxygen abundances 12  + log(O/H)  = 6.97–7.23, redshifts z  = 0.02811–0.13320, and stellar masses M⋆ ≤ 107 M⊙. We aim to study the properties of Ly α emission in these extremely metal-deficient objects. We find that all nine galaxies are Ly α emitters (LAEs). We examine various relations between the Ly α escape fraction fesc(Ly α) and other characteristics – such as absolute UV magnitude, oxygen abundance, O32 ratio, stellar mass, Lyman-alpha luminosity, and equivalent width EW(Ly α), ionizing photon production efficiency ξion and velocity separation Vsep between the two peaks of the Ly α profile – of a large sample of LAEs, including our lowest metallicity galaxies and other objects from the literature. We find a relatively tight correlation between fesc(Ly α) and two characteristics, EW(Ly α) and Vsep, whereas no correlation is found between fesc(Ly α) and the oxygen abundance. We also find a relatively tight relation between the Ly α and LyC escape fractions. We propose to use the latter relation to estimate indirectly the escaping ionizing radiation in LAEs, when direct measurements of LyC emission are not possible. We show that the global properties of low-z LAEs are very similar to those of z > 6 galaxies. They are thus ideal local proxies for studying physical processes during the epoch of reionization of the Universe.
Radio haloes and relics from extended cosmic-ray ion distributions with strong diffusion in galaxy clusters
Authors: Keshet Uri
Published: October 2023

A joint hadronic model is shown to quantitatively explain the observations of diffuse radio emission from galaxy clusters in the form of minihaloes, giant haloes, relics, and their hybrid, transitional stages. Cosmic-ray diffusion of order D ∼ 1031–32 cm2 s−1, inferred independently from relic energies, the spatial variability of giant-halo spectra, and the spectral evolution of relics, reproduces the observed spatio-spectral distributions, explains the recently discovered mega-haloes as enhanced peripheral magnetization, and quenches electron (re)acceleration by weak shocks or turbulence. For instance, the hard-to-soft evolution along secondary-electron diffusion explains both the soft spectra in most halo peripheries and relic downstreams, and the hard spectra in most halo centres and relic edges, where the photon index can reach α ≃ −0.5 regardless of the Mach number $\mathcal {M}$ of the coincident shock. Such spatio-spectral modelling, recent γ-ray observations, and additional accumulated evidence are thus shown to support a 2010 claim that the seamless transitions among minihaloes, giant haloes, and relics, their similar energetics, integrated spectra, and delineating discontinuities, the inconsistent $\mathcal {M}$ inferred from radio versus X-rays in leptonic models, and additional observations, all indicate that these diffuse radio phenomena are manifestations of the same cosmic-ray ion population, with no need to invoke less natural alternatives.
The most luminous AGN do not produce the majority of the detected stellar-mass black hole binary mergers in the local Universe
Authors: Veronesi Niccolò , Rossi Elena Maria , van Velzen Sjoert
Published: October 2023

Despite the increasing number of gravitational wave (GW) detections, the astrophysical origin of binary black hole (BBH) mergers remains elusive. A promising formation channel for BBHs is inside accretion discs around supermassive black holes, that power active galactic nuclei (AGN). In this paper, we test for the first time the spatial correlation between observed GW events and AGN. To this end, we assemble all sky catalogues with 1,412 (242) AGN with a bolometric luminosity greater than 1045.5erg s−1 ($10^{46}\, {\rm erg\, s}^{-1}$) with spectroscopic redshift of z ≤ 0.3 from the Milliquas catalogue, version 7.7b. These AGN are cross-matched with localization volumes of BBH mergers observed in the same redshift range by the LIGO and Virgo interferometers during their first three observing runs. We find that the fraction of the detected mergers originated in AGN brighter than $10^{45.5}\, {\rm erg\, s}^{-1}$ ($10^{46}\, {\rm erg\, s}^{-1}$) cannot be higher than 0.49 (0.17) at a 95 per cent credibility level. Our upper limits imply a limited BBH merger production efficiency of the brightest AGN, while most or all GW events may still come from lower luminosity ones. Alternatively, the AGN formation path for merging stellar-mass BBHs may be actually overall subdominant in the local Universe. To our knowledge, ours are the first observational constraints on the fractional contribution of the AGN channel to the observed BBH mergers.
Bird-Snack: Bayesian inference of dust law RV distributions using SN Ia apparent colours at peak
Authors: Ward Sam M , Dhawan Suhail , Mandel Kaisey S , Grayling Matthew , Thorp Stephen
Published: October 2023

To reduce systematic uncertainties in Type Ia supernova (SN Ia) cosmology, the host galaxy dust law shape parameter, RV, must be accurately constrained. We thus develop a computationally inexpensive pipeline, Bird-Snack, to rapidly infer dust population distributions from optical-near-infrared SN colours at peak brightness, and determine which analysis choices significantly impact the population mean RV inference, $\mu _{R_V}$. Our pipeline uses a 2D Gaussian process to measure peak BVriJH apparent magnitudes from SN light curves, and a hierarchical Bayesian model to simultaneously constrain population distributions of intrinsic and dust components. Fitting a low-to-moderate-reddening sample of 65 low-redshift SNe yields $\mu _{R_V}=2.61^{+0.38}_{-0.35}$, with $68~{{\ \rm per\ cent}}(95~{{\ \rm per\ cent}})$ posterior upper bounds on the population dispersion, $\sigma _{R_V}\lt 0.92(1.96)$. This result is robust to various analysis choices, including: the model for intrinsic colour variations, fitting the shape hyperparameter of a gamma dust extinction distribution, and cutting the sample based on the availability of data near peak. However, these choices may be important if statistical uncertainties are reduced. With larger near-future optical and near-infrared SN samples, Bird-Snack can be used to better constrain dust distributions, and investigate potential correlations with host galaxy properties. Bird-Snack is publicly available; the modular infrastructure facilitates rapid exploration of custom analysis choices, and quick fits to simulated data sets, for better interpretation of real-data inferences.
An enhanced abundance of bright galaxies in protocluster candidates at z ∼ 3–5
Authors: Toshikawa Jun , Wuyts Stijn , Kashikawa Nobunari , Liu Chengze , Sawicki Marcin , Overzier Roderik , Kubo Mariko , Uchiyama Hisakazu , Ito Kei , Bremer Malcolm , Ono Yoshiaki , Kodama Tadayuki , Lin Yen-Ting , Saito Tomoki
Published: October 2023

We present a protocluster search covering z ∼ 3 to z ∼ 5 based on the combination of the Hyper SuprimeCam Subaru Strategic Programme and the CFHT Large Area U-band Deep Survey. We identify about 30 protocluster candidates per unit redshift over the $\sim 25\, \mathrm{deg^2}$ area of the Deep/UltraDeep layer. Protocluster candidates are selected as regions with a significantly enhanced surface density of dropout galaxies. With this large sample, we characterize the properties of their individual member galaxies. We compare the number counts of dropout galaxies in protocluster candidates with that of coeval field galaxies. Rest-frame ultraviolet (UV) bright galaxies are overabundant in protocluster candidates, a trend seen across the full redshift range studied. We do not find evidence for their spatial distribution within protocluster candidates to be distinct from their fainter counterparts, nor for their UV colour to be different from that of field galaxies with the same brightness. Cosmological simulations predict this bright-end excess, with the main cause being a richer population of massive galaxies, with only a minor contribution from an enhancement in star formation activity (and therefore UV emission) at fixed mass. U-to-K SED modelling of our observed samples supports this interpretation. This environmental differentiation in number counts is already in place at z ∼ 5, with no significant redshift dependence over the range in lookback times probed . These observational results and model predictions suggest that the cosmic clock is ahead in high-density environments.
Heme oxygenase-1 increases intracellular iron storage and suppresses inflammatory response of macrophages by inhibiting M1 polarization
Authors: Tang Xueyou , Li Yunqin , Zhao Jing , Liang Li , Zhang Kang , Zhang Xiaofeng , Yu Hong , Du Huahua
Published: October 2023

Heme oxygenase-1 (HO-1) catalyzes the first and rate-limiting enzymatic step of heme degradation, producing carbon monoxide, biliverdin, and free iron. Most iron is derived from aged erythrocytes by the decomposition of heme, which happened mainly in macrophages. However, the role of HO-1 on iron metabolism and function of macrophage is unclear. The present study investigated the effect of HO-1 on iron metabolism in macrophages, and explored the role of HO-1 on inflammatory response, polarization, and migration of macrophages. HO-1 inducer Hemin or HO-1 inhibitor zinc protoporphyrin was intravenously injected to C57BL/6 J mice every 4 d for 28 d. We found that HO-1 was mainly located in the cytoplasm of splenic macrophages of mice. Activation of HO-1 by Hemin significantly increased iron deposition in the spleen, up-regulated the gene expression of ferritin and ferroportin, and down-regulated gene expression of divalent metal transporter 1 and hepcidin. Induced HO-1 by Hemin treatment increased intracellular iron levels of macrophages, slowed down the absorption of extracellular iron, and accelerated the excretion of intracellular iron. In addition, activation of HO-1 significantly decreased the expression of pro-inflammatory cytokines including interleukin (IL)-6, IL-1β, and inducible nitric oxide synthase, but increased the expression of anti-inflammatory cytokines such as IL-10. Furthermore, activation of HO-1 inhibited macrophages to M1-type polarization, and increased the migration rate of macrophages. This study demonstrated that HO-1 was able to regulate iron metabolism, exert anti-inflammatory effects, and inhibit macrophages polarization to M1 type.
Animating fossilized invertebrates by motion reconstruction
Authors: Wang Zixin , Zhang Wei , Li Jiahao , Wang Ji , Yang Yunqiang , Bao Tong , Wu Jianing , Wang Bo
Published: October 2023

Taking the motion reconstruction of the Cretaceous hell ants as an example, this study shows how to achieve motion reconstruction in fossil invertebrates and discusses potential challenges and opportunities.
Bivalent Vaccine Effectiveness Among Adults Aged ≥65 Years During the BA.5-Predominant Period in Japan: The VENUS Study
Authors: Mimura Wataru , Ishiguro Chieko , Terada-Hirashima Junko , Matsunaga Nobuaki , Maeda Megumi , Murata Fumiko , Fukuda Haruhisa
Published: October 2023

Background

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron BA.5 became prevalent in July 2022 in Japan. Bivalent messenger RNA (mRNA) vaccines were approved as booster doses for individuals who received the primary series or booster dose by monovalent vaccines. We aimed to assess the effectiveness of bivalent vaccines in Japanese adults aged ≥65 years.

Methods

We conducted a population-based cohort study using data collected from January 2019 to February 2023 in Japan. We included individuals aged ≥65 years in a municipality who received the first or second booster dose of monovalent mRNA vaccines. We estimated the effectiveness of the second or third booster dose of bivalent mRNA vaccines during the Omicron BA.5–predominant period (July–December 2022), compared with ≥90 days after the booster dose of monovalent vaccines. We used a Cox proportional hazard regression model with vaccination status as a time-dependent covariate.

Results

A total of 81 977 individuals aged ≥65 years (mean [standard deviation] age, 78.3 [7.4] years; 33 487 male [40.8%]) were included in the study cohort. Among them, 57 396 were vaccinated with the second or third dose of bivalent vaccines (BA.1 or BA.4/5). The effectiveness against coronavirus disease 2019 (COVID-19) was estimated to be 57.9% (95% confidence interval, 52.7%–62.5%) for ≥14 days after the second or third bivalent booster dose, compared with 90 days after the first or second monovalent booster dose.

Conclusions

The study showed that the bivalent mRNA vaccines as the second and third doses would provide protection against COVID-19 among adults ≥65 years in Japan.
Exploring the Systemic Structures That Affect Access to Physical Therapist Services for Non-Indigenous Black People in Australia
Authors: Rusinga Adelaide , Setchell Jenny , Jang Sarah , Costa Nathalia
Published: October 2023

Objective

Physical therapy is generally considered to be a white profession in Western nations. Australia’s increasingly diverse population, driven largely by growth in immigration, invites Australian health systems to be responsive to factors that may impact on non-white Australian population’s access to health care. Here, the authors sought to explore non-Indigenous Black people’s perspectives of physical therapy in Australia.

Methods

Eligible participants (n = 12) took part in semistructured, in-depth interviews and were prompted to discuss their experiences and perceptions of physical therapy. Interview data were analyzed using critical discourse analysis, underpinned by critical race theory.

Results

Participants were on average 29.4 years (SD = 12.9) from diverse cultural and linguistic backgrounds. Participants described mostly positive experiences with physical therapists, but they noted that it was not widely accessed by their communities, with 2 key discourses underpinning these discussions. Discourse 1, “physiotherapy is a solution for white people,” established physical therapy as primarily accessed by and welcoming of white people. “Whiteness” and the perpetuation of Western norms in physical therapy resulted in little consideration of other cultural practices. Participants’ discussions also pointed to the intersections of systemic racism and social inequities such as low income and language barriers, impacting Black people’s engagement with physical therapy. Discourse 2, “physiotherapists are white,” was mostly concerned with how the perceived “whiteness” of professionals and lack of Black physical therapists impacts cultural safety and comfort when accessing physical therapy.

Conclusion

Our results suggest that Westernization and whiteness persist among discourses surrounding physical therapy. Such discourses are likely to inform Black people’s perceptions and experiences of physical therapy. Our analyses suggest avenues to enhance the cultural diversity of the profession and improve physical therapy accessibility for Black people in Australia by providing culturally appropriate material, including critical reflexivity, epistemic and cultural humility in the curricula, recruiting staff from diverse backgrounds, and providing outreach services to underserved populations.

Impact

These findings highlight the need for increased cultural safety and diversity within the physical therapy profession to improve equity.
Multi-Dimensional Screening: Buyer-Optimal Learning and Informational Robustness
Authors: Deb Rahul , Roesler Anne-Katrin
Published: October 2023

A monopolist seller of multiple goods screens a buyer whose type vector is initially unknown to both but drawn from a commonly known prior distribution. The seller chooses a mechanism to maximize her worst-case profits against all possible signals from which the buyer can learn about his values for the goods. We show that it is robustly optimal for the seller to bundle goods with identical demands (these are goods that can be permuted without changing the buyer’s prior type distribution). Consequently, pure bundling is robustly optimal for exchangeable prior distributions. For exchangeable priors, pure bundling is also optimal for the seller in the information environment (with the reverse timing) where an information designer, with the objective of maximizing consumer surplus, first selects a signal for the buyer, and then the seller chooses an optimal mechanism in response. We derive a formal relationship between the seller’s problem in both information environments.
Advancement of anti‐LAG‐3 in cancer therapy
Authors: Li Yunong , Ju Mingyi , Miao Yuxi , Zhao Lin , Xing Lijuan , Wei Minjie
Published: October 2023

Immune checkpoint inhibitors have effectively transformed the treatment of many cancers, particularly those highly devastating malignancies. With their widespread popularity, the drawbacks of immune checkpoint inhibitors are also recognized, such as drug resistance and immune‐related systematic side effects. Thus, it never stops investigating novel immune checkpoint inhibitors. Lymphocyte Activation Gene‐3 (LAG‐3) is a well‐established co‐inhibitory receptor that performs negative regulation on immune responses. Recently, a novel FDA‐approved LAG‐3 blocking agent, together with nivolumab as a new combinational immunotherapy for metastatic melanoma, brought LAG‐3 back into focus. Clinical data suggests that anti‐LAG‐3 agents can amplify the therapeutic response of other immune checkpoint inhibitors with manageable side effects. In this review, we elucidate the intercellular and intracellular mechanisms of LAG‐3, clarify the current understanding of LAG‐3 in the tumor microenvironment, identify present LAG‐3‐associated therapeutic agents, discuss current LAG‐3‐involving clinical trials, and eventually address future prospects for LAG‐3 inhibitors.
Safety of allergen immunotherapy in children
Authors: Schmidlin Kristin A. , Bernstein David I.
Published: October 2023

Purpose of review

The current review discusses allergen immunotherapy (AIT) safety in children.

Recent findings

AIT is a well tolerated and effective treatment for pediatric allergic conditions. While mostly well tolerated, severe reactions and near fatal reactions may occur with subcutaneous immunotherapy (SCIT) once in every 160 000 visits. Sublingual immunotherapy (SLIT) is associated more with local side effects, but severe systemic reactions, including anaphylaxis, have been rarely reported. Providing informed consent, recognizing risk factors for severe systemic reactions, such as severe or uncontrolled asthma, and mitigating the risk of severe reactions are important components to improving the safety of AIT.

Overall, AIT is well tolerated in children, and data suggest that the incidence of systemic reactions in children receiving SCIT is no less than mixed populations of adult and pediatric patients. SLIT carries less risk for systemic reactions, and local oral site-application reactions are usually mild and resolve within 15 days of treatment.
Positive Intraoperative Cultures in Cup Revisions of THA: What Happens to the Stem?
Authors: Ottink Karsten D. , Dorleijn Desirée M. J. , Spierenburg Willemijn , Ploegmakers Joris J. W. , Zijlstra Wierd P. , Ettema Harmen E. , ten Have Bas L. E. F. , Jutte Paul C. , Wouthuyzen-Bakker Marjan ,   on behalf of the Northern Infection Network Joint Arthroplasty (NINJA)
Published: October 2023

Background

Positive intraoperative cultures (PICs) are encountered in some patients undergoing revision of the acetabular cup after a previous THA. It is unknown whether PIC of the cup indicates whether the stem is infected as well and what happens to the stem during follow-up.

Questions/purposes

(1) What proportion of patients undergoing THA who undergo cup revision have PICs? (2) What is the survival of the stem during follow-up in cup revisions with PICs versus that of those with negative cultures? (3) Does antibiotic treatment of PIC of the cup prevent revision THA during follow-up?

Methods

In this retrospective, comparative multicenter study, five surgeons at four centers performed 338 acetabular cup revisions between January 2015 and December 2017. After evaluating the data, we excluded one patient because of an incomplete dataset and 77 patients because fewer than three intraoperative cultures were obtained during surgery, leaving 260 patients for analysis. Follow-up was 2 years. Patients were stratified into three cohorts: no PIC, one PIC, and two or more PICs.

Results

The proportion of patients with one or more PIC was 15% (39 of 260). A total of 8% (21 of 260) had one and 7% (18 of 260) had two or more PICs. Stem survival was lower in patients with two or more PICs, but stem revision for periprosthetic joint infection was similar between groups. Two-year survival, which was defined as freedom from revision for any cause or infection, was 97% (95% confidence interval 95% to 99%) in the group without PICs, 100% (95% CI 95% to 100%) in the group with one PIC, and 86% (95% CI 68% to 100%; p = 0.08) in the group with two or more PICs. None of the patients in the no PIC and one PIC groups were treated with antibiotics. In the two or more PICs cohort, 12 of 18 patients were treated. The stem survived in one of 12 patients treated with antibiotics versus two of six patients who were not treated with antibiotics.

Conclusion

When treated with antibiotics, more than two PICs isolated during cup revision surgery do not have a major impact on survival of the stem during follow-up. A larger cohort of patients with PICs during cup revision might confirm these findings.

Level of Evidence

Level III, therapeutic study.
Sixty years of the Bruce protocol: reappraising the contemporary role of exercise stress testing with electrocardiographic monitoring
Authors: Vilela Eduardo M. , Oliveira Cátia , Oliveira Cláudia , Torres Susana , Sampaio Francisco , Primo João , Ribeiro José , Teixeira Madalena , Oliveira Marco , Bettencourt Nuno , Viamonte Sofia , Fontes-Carvalho Ricardo
Published: October 2023

The cardiovascular response to exercise has long been a focus of interest. Over a century ago, the first descriptions of electrocardiographic changes occurring during exercise highlighted the possible relevance of this dynamic assessment. In this background, the inception of the Bruce protocol circa 60 years ago allowed for a major leap in this field by providing a standardized framework with which to address this issue, by means of an integrated and structured methodology. Since then, exercise stress testing with electrocardiographic monitoring (ExECG) has become one of the most widely appraised tests in cardiovascular medicine. Notably, past few decades have been profoundly marked by substantial advances in the approach to cardiovascular disease, challenging prior notions concerning both its physiopathology and overall management. Among these, the ever-evolving presentations of cardiovascular disease coupled with the development and implementation of several novel diagnostic modalities (both invasive and noninvasive) has led to a shifting paradigm in the application of ExECG. This technique, however, has continuously shown to be of added value across various momentums of the cardiovascular continuum, as depicted in several contemporary guidelines. This review provides a pragmatical reflexion on the development of ExECG, presenting a comprehensive overview concerning the current role of this modality, its challenges, and its future perspectives.
Stroke Phase Is Essential for Pneumonia in Dysphagia Patients After Cerebral Infarction
Authors: Ke Zi , Liu Wei , Chen Fuyan , Ge Wenyi , Bao Yiru , Wen Jian , Liu Yang , Li Xingping , Fan Xiaonong , Wu Bangqi
Published: October 2023

Background:

The risk of pneumonia increases after stroke, especially in poststroke dysphagia patients. Propensity score matching (PSM) is a statistical method in SPSS, which can be used to balance the difference between the 2 groups of known factors. Nasogastric tube feeding is an important factor of stroke-associated pneumonia. However, few studies have used PSM to eliminate the effect of confounding factor.

Methods:

Our research was a retrospective case-control study. Retrospective review of the patient database between December 1, 2019, and June 30, 2022, to identify consecutive dysphagia patients after cerebral infarction during hospitalization. An 1:1 PSM in SPSS 25.0 was used to balance nasogastric tube feeding between patients with and without pneumonia. The characteristics of these 2 groups were analyzed. Univariate and binary logistic regression analyses were used to screen the risk factors of dysphagia after cerebral infarction.

Results:

After 1:1 PSM, 198 subjects met our criteria and were included in the analysis. Age [odds ratio (OR)=1.047, 95% CI: 1.013-1.081, P=0.006], stroke phase (acute stroke) (OR=5.931, 95% CI: 1.133-31.054, P=0.035), admission National Institutes of Health Stroke Scale score (OR=1.058, 95% CI: 1.004-1.115, P=0.034), and length of hospital stay (OR=1.025, 95% CI: 1.001-1.049, P=0.042) had statistically significant correlation with pneumonia in patients with dysphagia after cerebral infarction.

Conclusion:

In clinical practice, for the prevention of pneumonia in patients with dysphagia after cerebral infarction, we should pay more attention to admission National Institutes of Health Stroke Scale score, age, and stroke phase, especially in acute cerebral infarction patients.
The Covert Impact of Chiari Network and Eustachian Valves on Stroke
Authors: Al-Sabbagh Mohammed Q. , Eswaradass Prasanna
Published: October 2023

Background:

The role of Chiari network (CN) and Eustachian valves (EVs) in cardioembolic strokes is still unclear. There is inconsistency in the literature regarding clinical approach to these lesions to reduce stroke risk. We aimed to describe clinical presentation, neuroimaging and cardioimaging features, as well as management approaches for CN and EV in stroke context.

Review Summary:

A systemic search was carried out using PubMed and Web of Science following PRISMA guidelines, Supplemental Digital Content 1 (http://links.lww.com/NRL/A123). We retrieved 4 case-control studies, 2 cross sectional studies as well 8 case reports, with a total of 883 patients with a mean age of 44.6 years (±13.8). The combined prevalence of EV/CN in stroke-related patent foramen ovale (PFO) patients was 50% (95% CI: 31-68). With isolated prevalence for EV and CN of 43% (95% CI: 25-63), 18% (95% CI: 12-25), respectively. Patients with history of stroke had higher prevalence of EV/CN compared with controls odds ratio=2.45 (95% CI: 1.2-5, P<0.01). All case-control and cross-sectional studies defined EV/CN by transesophageal echocardiography or intracardiac cardiography. In the 8 case reports, 7 cases were diagnosed by transesophageal echocardiography, while only 1 case was diagnosed postmortem.

Conclusion:

EV/CN are relatively common findings in stroke patients with PFO. While it appears that presence of EV/CN with a PFO increases the risk of cardioembolic stroke, they remain underrecognized. EV/CN should be considered as high-risk PFO features. There is a scarcity of research emphasizing their role in clinical decision making, especially PFO closure and antithrombotic therapy choice.
Impact of Frailty on Inpatient Outcomes of Acute Traumatic Spinal Cord Injury
Authors: Chu Hongyu , Chen Liang , Li Jun , Li Jianjun , Yang Degang , Yang Mingliang , Du Liangjie , Wang Maoyuan , Gao Feng
Published: October 2023

Objectives:

Spinal cord injury (SCI) is any spinal cord injury or affliction that results in temporary or permanent impairment of motor or sensory function. This study determined the prevalence of frailty and its impact on in-hospital outcomes of patients admitted with acute traumatic SCI (TSCI).

Methods:

This retrospective study extracted data of adults 18 to 85 years with acute TSCI from the US Nationwide Inpatient Sample (NIS) 2016 to 2018. Frailty status were assessed by the 11-factor modified Frailty Index (mFI-11) through claim codes. Patients with an mFI ≥3 were classified as frail. Associations between study variables and in-hospital mortality, discharge status, prolonged length of stay, severe infection, and hospital costs were determined by univariate and multivariable regression analyses.

Results:

A total of 52,263 TSCI patients were identified, where 12,203 (23.3%) patients were frail. After adjusting for relevant confounders, frailty was independently associated with increased risk for in-hospital mortality [adjusted odds ratio (aOR) = 1.25, 95% CI:1.04-1.49], unfavorable discharge (aOR =1.15, 95% CI: 1.09-1.22), prolonged length of stay (aOR =1.32, 95% CI: 1.24-1.40), and severe infection (aOR =2.52, 95% CI: 2.24-2.83), but not hospital cost. Stratified analyses revealed frailty was associated with higher unfavorable discharge and severe infection regardless of age, Charlson Comorbidity Index, and injury level.

Conclusions:

In acute TSCI, frailty is independently associated with increased risk for adverse inpatient outcomes in terms of in-hospital mortality, prolonged hospital stays, unfavorable discharge, and particularly severe infection.