bluuebunny/crossref_metadata_2025 huggingface dataset:
Pain without inference
Authors: Casser Laurenz
Published: December 2024

A foundational assumption of contemporary cognitive science is that perceptual processing involves inferential transitions between representational states. However, it remains controversial whether accounts of this kind extend to modalities whose perceptual status is a matter of debate. In particular, it remains controversial whether we should attribute inferential mechanisms to the sensory processing underpinning (human) pain experiences. This paper argues that, contrary to recent proposals in the philosophy and science of pain, pain processing is not mediated by inferential transitions. To this end, I show that standard motivations for inferentialism—including appeal to underdetermination, illusion, cue combination, cognitive penetration, perceptual constancy, and invariance—do not carry over to pain. Instead, I suggest that pain's sensory processing may be better characterised as an idiosyncratic form of transduction, distinguishing it both from paradigmatic perceptual modalities and canonical transducers.
ON DURATIVE AND DETELICISATION READINGS ASSOCIATED WITH POR X TEMPO ‘FOR X TIME’ IN BRAZILIAN PORTUGUESE: ARGUMENTS IN FAVOUR OF SYNTACTIC CARTOGRAPHY†
Authors: Bergamini‐Perez João Francisco , Tescari Neto Aquiles
Published: December 2024

By taking into account the methodological guidelines brought by the Cartographic approach (Cinque 1999; Rizzi 1997), this article aims to propose a Cartographic analysis of the temporal adjunct por x tempo (‘for x time’) in Brazilian Portuguese. It particularly seeks to explore how the two possible readings given by the combination of this adjunct with telic and atelic predicates—as reported in the literature (Basso 2007, Basso & Pires de Oliveira 2010, Basso & Bergamini‐Perez 2016, among others)—can be derived in Syntax. We argue that very simple (Minimalist) ingredients, namely external and internal Merge, coupled with the assumption of Cartographic hierarchies—in this particular case, Cinque's (1999) hierarchy—can account for these two readings in a straightforward way, under a view we call Alternative I (which is confronted with a radical competing analysis, Alternative II, whose sole ingredient is recursive merge). We show the advantages of the Cartographic analysis (Alternative I) in directly mapping out to the interpretive system the two readings made available by the combination of por x tempo (‘for x time’) with different predicates.
Competing at Altitude Reduces In-Match Physical Demands of Professional Soccer Players Compared With Sea Level
Authors: Silva Hugo , Girard Olivier , Monteiro Júlio , Gasques Matheus , Sousa Ana , Nakamura Fábio Yuzo
Published: December 2024

Purpose: This study examined whether physical demands during soccer matches differ between sea level and altitude, considering variations by playing position. Methods: Thirty-seven professional players were monitored during 22 matches (11 at sea level and 11 at altitudes of 2200–4090 m) with global navigation satellite systems. Independent mean differences were used to compare in-match physical demands (ie, total distance, distance covered at specific speed intervals, accelerations [ACCs] and decelerations [DECs], and maximal speed) between locations for 5 playing positions (central defenders, fullbacks, central midfielders, wide midfielders, and forwards). Results: At altitude, players covered shorter total distances (P < .001) and less distance in the 14.4- to 19.8-km/h (P < .001), 19.8- to 25.2-km/h (P < .001), and >25.2-km/h (P < .001) speed ranges. They also performed fewer ACCs (2.0–3.5 m/s2, P < .001; 3.5–6.0 m/s2, P < .001) and DECs (−3.5 to −2 m/s2, P < .001; −6.0 to −3.5 m/s2, P < .001) and achieved lower maximal speeds (P < .001). The impact of altitude varied by position: Central midfielders showed reduced performance in all variables, while central defenders (distance > 25.2 km/h, ACCs [2.0 and 3.5 m/s2], DECs [−3.5 and −2.0 m/s2], and maximal speed), fullbacks (distance > 25.2 km/h, ACCs, and DECs [−3.5 and −2.0 m/s2]), and forwards (distances [total, 19.8–25.2 km/h, and >25.2 km/h] and ACCs [−3.5 and −6.0 m/s2]) presented unclear differences (P > .05) between locations. Conclusion: Our study highlights the importance of considering playing positions when assessing the in-match activity profiles of sea-level resident soccer players competing at moderate to high altitudes.
Comediation of voltage gating and ion charge in MXene membrane for controllable and selective monovalent cation separation
Authors: Wang Xu , Zhang Haiguang , Wei Gaoliang , Xing Jiajian , Chen Shuo , Quan Xie
Published: December 2024

Artificial ion channels with controllable mono/monovalent cation separation fulfill important roles in biomedicine, ion separation, and energy conversion. However, it remains a daunting challenge to develop an artificial ion channel similar to biological ion channels due to ion-ion competitive transport and lack of ion-gating ability of channels. Here, we report a conductive MXene membrane with polydopamine-confined angstrom-scale channels and propose a voltage gating and ion charge comediation strategy to concurrently achieve gated and selective mono/monovalent cation separation. The membrane shows a highly switchable “on-off” ratio of ∼9.9 for K
+
transport and an excellent K
+
/Li
+
selectivity of 40.9, outperforming the ion selectivity of reported membranes with electrical gating (typically 1.5 to 6). Theoretical simulations reveal that the introduced high-charge cations such as Mg
2+
enable the preferential distribution of target K
+
over competing Li
+
at the channel entrance, and the surface potential reduces the ionic transport energy barrier for allowing K
+
to pass quickly through the channel.
Integrated design of aluminum-enriched high-entropy refractory B2 alloys with synergy of high strength and ductility
Authors: Qi Jie , Fan Xuesong , Hoyos Diego Ibarra , Widom Michael , Liaw Peter K. , Poon Joseph
Published: December 2024

Refractory high-entropy alloys (RHEAs) are promising high-temperature structural materials. Their large compositional space poses great design challenges for phase control and high strength-ductility synergy. The present research pioneers using integrated high-throughput machine learning with Monte Carlo simulations supplemented by ab initio calculations to effectively navigate phase selection and mechanical property predictions, developing single-phase ordered B2 aluminum-enriched RHEAs (Al-RHEAs) demonstrating high strength and ductility. These Al-RHEAs achieve remarkable mechanical properties, including compressive yield strengths up to 1.7 gigapascals, fracture strains exceeding 50%, and notable high-temperature strength retention. They also demonstrate a tensile yield strength of 1.0 gigapascals with a ductility of 9%, albeit with B2 ordering. Furthermore, we identify valence electron count domains for alloy ductility and brittleness with the explanation from density functional theory and provide crucial insights into elemental influence on atomic ordering and mechanical performance. The work sets forth a strategic blueprint for high-throughput alloy design and reveals fundamental principles governing the mechanical properties of advanced structural alloys.
Naturally arising memory-phenotype CD4
+
T lymphocytes contain an undifferentiated population that can generate T
H
1, T
H
17, and T
reg
cells
Authors: Kawajiri Akihisa , Li Jing , Koinuma Keita , Yang Ziying , Yoon Hye Jin , Yi Jaeu , Nagashima Hiroyuki , Ishii Minami , Gao Feng , Sato Kosuke , Tayama Shunichi , Harigae Hideo , Iwakura Yoichiro , Ishii Naoto , Sher Alan , Ishigaki Kazuyoshi , Zhu Jinfang , Kim Kwang Soon , Kawabe Takeshi
Published: December 2024

Memory-phenotype (MP) CD4
+
T lymphocytes develop from naïve cells via self-recognition at homeostasis. While previous studies defined MP cells as a heterogeneous population that comprises T helper 1 (T
H
1)/17–like subsets, functional significance of the T-bet
−
Rorγt
−
subpopulation remains unknown. Here we show that MP lymphocytes as a whole population can differentiate into T
H
1/17/regulatory T (T
reg
) cells to mediate mild and persistent inflammation in lymphopenic environments, whereas naïve cells exhibit strong, T
H
1-dominated responses. Moreover, we demonstrate that MP lymphocytes comprise not only T
H
1/17-differentiated subsets but a polyclonal, transcriptomically immature “undifferentiated” subpopulation at homeostasis. Furthermore, our data argue that while the T-bet
+
Rorγt
−
MP subset is terminally T
H
1-differentiated, its undifferentiated counterpart retains the capacity to rapidly proliferate to differentiate into T
H
1/17/T
reg
cells, with the latter response tonically constrained by preexisting T
reg
cells. Together, our results identify undifferentiated MP CD4
+
T lymphocytes as a unique precursor that has a diverse differentiation potential to generate T
H
1/17/T
reg
cells to contribute to pathogenesis of inflammation.
Synthesis of defect-rich La
2
O
2
CO
3
supports for enhanced CO
2
-to-methanol conversion efficiency
Authors: Zhang Rui , Wang Xiao , Wang Ke , Wang Huilin , Sun Xudong , Shi Weidong , Song Shuyan , Zhang Hongjie
Published: December 2024

Converting CO
2
to methanol is crucial for addressing fuel scarcity and mitigating the greenhouse effect. Cu-based catalysts, with their diverse surface states, offer the potential to control reaction pathways and generate reactive H* species. However, a major challenge lies in oxidizing active Cu
0
species by water generated during the catalytic process. While nonreducible metal oxides are beneficial in stabilizing metallic states, their limited capability to generate surface oxygen vacancies (O
V
) hinders CO
2
activation. Herein, we present a strategy by doping Nd into a La
2
O
2
CO
3
(LOC) support, enhancing O
V
formation by disrupting its lattice dyadicity. This leads to higher Cu
0
concentration and improved CO
2
activation. The resulting Cu/LOC:Nd catalyst notably outperforms Cu/LOC and CuZnAl catalysts, achieving a methanol yield of 9.9 moles of methanol per hour per mole of Cu. Our approach opens up possibilities for enhancing Cu-based catalysts in CO
2
conversion.
Mammoth featured heavily in Western Clovis diet
Authors: Chatters James C. , Potter Ben A. , Fiedel Stuart J. , Morrow Juliet E. , Jass Christopher N. , Wooller Matthew J.
Published: December 2024

Ancient Native American ancestors (Clovis) have been interpreted as either specialized megafauna hunters or generalist foragers. Supporting data are typically indirect (toolkits, associated fauna) or speculative (models, actualistic experiments). Here, we present stable isotope analyses of the only known Clovis individual, the 18-month-old Anzick child, to directly infer maternal protein diet. Using comparative fauna from this region and period, we find that mammoth was the largest contributor to Clovis diet, followed by elk and bison/camel, while the contribution of small mammals was negligible, broadly consistent with the Clovis zooarchaeological record. When compared with second-order consumers, the Anzick-1 maternal diet is closest to that of scimitar cat, a mammoth specialist. Our findings are consistent with the Clovis megafaunal specialist model, using sophisticated technology and high residential mobility to subsist on the highest ranked prey, an adaptation allowing them to rapidly expand across the Americas south of the Pleistocene ice sheets.
Chromobacterium
biopesticide overcomes insecticide resistance in malaria vector mosquitoes
Authors: Tikhe Chinmay V. , Issiaka Sare , Dong Yuemei , Kefi Mary , Tavadia Mihra , Bilgo Etienne , Corder Rodrigo M. , Marshall John , Diabate Abdoulaye , Dimopoulos George
Published: December 2024

Vector mosquito control is an integral part of malaria control. The global emergence of insecticide resistance in malaria-transmitting
Anophelines
has become an impediment and has created an urgent need for novel mosquito control approaches. Here, we show that a biopesticide derived from the soil-dwelling bacterium
Chromobacterium
sp. Panama (
Csp_P
) kills insecticide-resistant
Anopheles
mosquitoes, regardless of their resistance mechanisms. In addition, sublethal dose of
Csp_P
acts as a synergist to now used chemical insecticides across multiple classes. Moreover,
Csp_P
reduces host-seeking behavior and malaria parasite infection in vector mosquitoes in ways that further decrease transmission. Mosquito glutathione
S
-transferases are essential for
Csp_P
’s mosquito-killing mechanism. Enclosed field trials in Burkina Faso, conducted in diverse ecological settings and supported by a mathematical model, have now demonstrated its potential for malaria control in settings with widespread insecticide resistance.
Pathways to concealed gun carrying
Authors: Sola Justin Lucas
Published: December 2024

Understanding the distinction between adolescent and adult pathways to concealed gun carrying can inform interventions to reduce gun violence.
Upgrading and extending the life cycle of soft robots with in situ free-form liquid three-dimensional printing
Authors: Kanhere Elgar , Calais Théo , Jain Snehal , Plamootil Mathai Aby Raj , Chooi Aaron , Stalin Thileepan , Joseph Vincent Sebastian , Valdivia y Alvarado Pablo
Published: December 2024

Soft robotics hardware, with numerous applications ranging from health care to exploration of unstructured environments, suffers from limited life cycles, which lead to waste generation and poor sustainability. Soft robots combine soft or hybrid components via complex assembly and disassembly workflows, which complicate the repair of broken components, hinder upgradability, and ultimately reduce their life spans. In this work, an advanced extrusion-based additive manufacturing process, in situ free-form liquid three-dimensional printing (iFL3DP), was developed to facilitate functional upgrades and repairs in soft robots. A yield-stress hydrogel—a type of material that can maintain its shape until sufficient stress is applied—was first printed directly onto the robot surface, serving as a support for printing new components. This technique enabled the fabrication of advanced components with seamless integration onto already assembled robots. These components could combine multiple materials with intricate geometries, including overhangs and high–aspect ratio shapes, that are considerably challenging to manufacture and integrate via traditional methods such as casting. This approach was successfully applied to upgrade an existing soft robot by adding three advanced functionalities: whisker-like sensors for tactile feedback, a grasping mechanism, and a multifunctional passive whisker array. This study showcases the easy repairability of features, new and old, substantially extending the robot’s life span. This workflow has potential to enhance the sustainable development of soft robots.
Monte Carlo tree search with spectral expansion for planning with dynamical systems
Authors: Rivière Benjamin , Lathrop John , Chung Soon-Jo
Published: December 2024

The ability of a robot to plan complex behaviors with real-time computation, rather than adhering to predesigned or offline-learned routines, alleviates the need for specialized algorithms or training for each problem instance. Monte Carlo tree search is a powerful planning algorithm that strategically explores simulated future possibilities, but it requires a discrete problem representation that is irreconcilable with the continuous dynamics of the physical world. We present Spectral Expansion Tree Search (SETS), a real-time, tree-based planner that uses the spectrum of the locally linearized system to construct a low-complexity and approximately equivalent discrete representation of the continuous world. We prove that SETS converges to a bound of the globally optimal solution for continuous, deterministic, and differentiable Markov decision processes, a broad class of problems that includes underactuated nonlinear dynamics, nonconvex reward functions, and unstructured environments. We experimentally validated SETS on drone, spacecraft, and ground vehicle robots and one numerical experiment, each of which is not directly solvable with existing methods. We successfully show that SETS automatically discovers a diverse set of optimal behaviors and motion trajectories in real time.
The cold truth about robotics research in the United Kingdom as a Caribbean woman
Authors: Greenidge Nikita Jasmine
Published: December 2024

From St. Lucia to the United Kingdom, my PhD journey highlights minorities’ challenges in academia and the need to foster diverse talent.
Glp1r-Lepr
coexpressing neurons modulate the suppression of food intake and body weight by a GLP-1/leptin dual agonist
Authors: Polex-Wolf Joseph , Deibler Kristine , Hogendorf Wouter Frederik Johan , Bau Sarah , Glendorf Tine , Stidsen Carsten Enggaard , Tornøe Christian Wenzel , Tiantang Dong , Lundh Sofia , Pyke Charles , Tomlinson Abigail J. , Kernodle Stace , Magrisso Irwin Jack , Conde-Frieboes Kilian W. , Myers Martin G. , Knudsen Lotte Bjerre , Seeley Randy J.
Published: December 2024

Glucagon-like peptide-1 (GLP-1) and leptin signal recent feeding and long-term energy stores, respectively, and play complementary roles in the modulation of energy balance. Previous work using single-cell techniques in mice revealed the existence of a population of leptin receptor (
Lepr
)–containing dorsomedial hypothalamus (DMH) neurons marked by the expression of GLP-1 receptor (
Glp1r
; LepR
Glp1r
neurons) that play important roles in the control of feeding and body weight by leptin. Here, we demonstrate the existence of a population of LepR
Glp1r
neurons in the DMHs of nonhuman primates (NHPs), suggesting the potential translational relevance of these neurons. Consequently, we developed a GLP-1R/LepR dual agonist and demonstrated the physiological activity of both components in vivo using leptin-deficient and
Lepr-
deficient murine models. We further found roles for LepR
Glp1r
neurons in mediating the dual agonist’s efficacy on food intake and body weight loss. Ablating
Lepr
in
Glp1r
-expressing neurons (Lepr
Glp1r
KO mice) abrogated the suppression of food intake by the dual agonist. Furthermore, reactivation of
Glp1r
expression in
Lepr
neurons on an otherwise
Glp1r
-null background (Glp1r
Lepr
Re mice) was sufficient to permit the suppression of food intake and body weight by the dual agonist. Hence, LepR
Glp1r
neurons represent targets for a GLP-1R/LepR dual agonist that potently reduces food intake and body weight.
Myeloid cell–specific loss of NPC1 in mice recapitulates microgliosis and neurodegeneration in patients with Niemann-Pick type C disease
Authors: Dinkel Lina , Hummel Selina , Zenatti Valerio , Malara Mariagiovanna , Tillmann Yannik , Colombo Alessio , Monasor Laura Sebastian , Suh Jung H. , Logan Todd , Roth Stefan , Paeger Lars , Hoffelner Patricia , Bludau Oliver , Schmidt Andree , Müller Stephan A. , Schifferer Martina , Nuscher Brigitte , Njavro Jasenka Rudan , Prestel Matthias , Bartos Laura M. , Wind-Mark Karin , Slemann Luna , Hoermann Leonie , Kunte Sebastian T. , Gnörich Johannes , Lindner Simon , Simons Mikael , Herms Jochen , Paquet Dominik , Lichtenthaler Stefan F. , Bartenstein Peter , Franzmeier Nicolai , Liesz Arthur , Grosche Antje , Bremova-Ertl Tatiana , Catarino Claudia , Beblo Skadi , Bergner Caroline , Schneider Susanne A. , Strupp Michael , Di Paolo Gilbert , Brendel Matthias , Tahirovic Sabina
Published: December 2024

Niemann-Pick type C (NPC) disease is an inherited lysosomal storage disorder mainly driven by mutations in the
NPC1
gene, causing lipid accumulation within late endosomes/lysosomes and resulting in progressive neurodegeneration. Although microglial activation precedes neuronal loss, it remains elusive whether loss of the membrane protein NPC1 in microglia actively contributes to NPC pathology. In a mouse model with depletion of NPC1 in myeloid cells, we report severe alterations in microglial lipidomic profiles, including the enrichment of bis(monoacylglycero)phosphate, increased cholesterol, and a decrease in cholesteryl esters. Lipid dyshomeostasis was associated with microglial hyperactivity, marked by an increase in translocator protein 18 kDa (TSPO). These hyperactive microglia initiated a pathological cascade resembling NPC-like phenotypes, including a shortened life span, motor impairments, astrogliosis, neuroaxonal pathology, and increased neurofilament light chain (NF-L), a neuronal injury biomarker. As observed in the mouse model, patients with NPC showed increased NF-L in the blood and microglial hyperactivity, as visualized by TSPO-PET imaging. Reduced TSPO expression in blood-derived macrophages of patients with NPC was measured after
N
-acetyl-
l
-leucine treatment, which has been recently shown to have beneficial effects in patients with NPC, suggesting that TSPO is a potential marker to monitor therapeutic interventions for NPC. Conclusively, these results demonstrate that myeloid dysfunction, driven by the loss of NPC1, contributes to NPC disease and should be further investigated for therapeutic targeting and disease monitoring.
Increasing incidence of Kawasaki disease and associated coronary aneurysm in Aotearoa New Zealand: a retrospective cohort study
Authors: Harrowell Ian , Webb Rachel , Han Dug Yeo , Best Emma , Mitchelson Bryan , Wilson Nigel , Ostring Genevieve
Published: December 2024

Background

Kawasaki disease (KD) is a childhood vasculitis which causes coronary artery aneurysms (CAA). There is a paucity of data regarding KD in Aotearoa New Zealand. We aimed to provide up-to-date epidemiological and clinical data about KD in the Auckland region.

Methods

We conducted a retrospective population-based cohort study in the greater Auckland region between 2017 and 2021. Potential KD cases were identified from hospital discharge records, echocardiogram databases and intravenous immunoglobulin (IVIg) dispensing databases. Clinical records were reviewed and international diagnostic criteria were applied retrospectively.

Results

A total of 161 cases of KD were identified (66.5% complete, 33.5% incomplete), with 84% aged under 5 years. Overall incidence (per 100 000/year under 5 years) was 20.4; this was highest in Asian (43.9) and Pacific (17.7) children. There was no significant difference in incidence between New Zealand European (10.1) and Māori (8.3) children. The mean yearly number of cases reduced during the start of the COVID-19 pandemic (37.6 vs 24.0, p=0.01). All children received at least one infusion of IVIg, with 20.5% receiving a second infusion. Twenty-seven children (16.9%) developed CAA. CAA was more common in children under 1 year, non-response to first dose of IVIg and Pacific children.

Conclusion

Incidence of KD and rate of CAA were higher than previously reported, although case numbers reduced during the COVID-19 pandemic. There was a high incidence of KD among Pacific children, who were most likely to develop CAA. Research focusing on strategies to identify and treat those at highest risk of CAA remains a priority.
Severe vaginal evisceration at a military treatment facility
Authors: Keenan Corey S , Kim Yujin , Rogers Christina , Grasso Samuel L
Published: December 2024

Vaginal evisceration is a rare extrusion of pelvic and/or abdominal viscera through a defect or rupture of the vaginal wall, and it is a true surgical emergency. With less than 100 cases reported in the literature, we present a case of an elderly woman in her 80s who was brought to a military treatment facility with vaginal evisceration after sustaining a ground-level fall. She was activated as a level 1 trauma by the emergency department, which led to efficient evaluation by the trauma team and subsequent emergent surgery to reduce the evisceration and repair the defect. She went on to recover and eventually received definitive surgery via colpocleisis following discharge. Here, vaginal evisceration will be discussed, including expert advice from a urogynaecologist to provide the reader with a fund of information and management strategies should this be encountered in practice.
Retroperitoneal unicentric Castleman disease presenting with paraneoplastic pemphigus
Authors: Paladugu Sree Vani , Tandup Cherring , Mitra Suvradeep , Sahu Swapnesh Kumar
Published: December 2024

Castleman disease is a benign lymph node hyperplasia with two histological subtypes. In the case reported here, a young adult male presented with mucocutaneous lesions mimicking common dermatological conditions. Suspicion of an underlying systemic disease arose when the routine clinical care of the skin lesions failed to cure them. Immunoprecipitation and histological analysis of the lesions pointed towards paraneoplastic pemphigus. The radiological imaging of the abdomen showed a retroperitoneal tumour which supported the paraneoplastic nature of the skin disease. Preoperative biopsy of the retroperitoneal tumour could not provide a definitive diagnosis. So, complete surgical excision of the retroperitoneal tumour was undertaken and pathological evaluation led to the final diagnosis of Castleman disease. We explain how the varied atypical presentation of an underlying rare disease can lead to a delay in the diagnosis, and how we untangled it with sequential work-up leading to successful surgical excision of the disease.
Derivation and external validation of prediction model for hypertensive disorders of pregnancy in twin pregnancies: a retrospective cohort study in southeastern China
Authors: Zheng Shuisen , Chen Yujuan , Gao Yuting , Chen Xiaoling , Lin Na , Han Qing
Published: December 2024

Objective

We aimed to develop and validate an effective prediction model for hypertensive disorder of pregnancy (HDP) in twin pregnancies after 28 weeks of gestation.

Design

Retrospective cohort study.

Setting

Maternity hospital.

Participants

We recruited twin pregnancies who delivered in Fujian Maternity and Child Health Hospital from January 2014 to December 2019 as a training cohort. Besides, we included twin pregnancies delivered at Fujian Maternity and Child Health Hospital; Women and Children’s Hospital of Xiamen University from January 2020 to December 2021 as temporal validation set and geographical validation set, respectively.

Main outcome measures

We performed univariate analysis, the least absolute shrinkage and selection operator regression and Boruta algorithm to screen variables. Then, we used multivariate logistic regression to construct a nomogram that predicted the risk of HDP in twin pregnancies. We employed the bootstrap resampling method for internal validation, used the receiver operating characteristic (ROC) curve to evaluate the predictive performance of the model and constructed decision curve analysis to assess the clinical benefit of the model. Thereafter validated the nomogram through the index of concordance (C-index) and calibration curves in the temporal validation set and geographical validation set.

Results

Multivariate logistic regression showed that primipara (OR=1.284, 95% CI=1.016 to 1.622), the higher pre-pregnancy body mass index (OR=1.077, 95% CI=1.039 to 1.116), the higher uric acid (OR=1.004, 95% CI=1.002 to 1.005), the higher urea nitrogen (OR=1.198, 95% CI=1.087 to 1.321), the higher creatinine (OR=1.011, 95% CI=1.002 to 1.020), the higher lactate dehydrogenase (OR=1.001, 95% CI=1.000 to 1.002), the higher ratio of large platelets (OR=1.034, 95% CI=1.020 to 1.048), the lower albumin (OR=0.887, 95% CI=0.852 to 0.924), the lower calcium (OR=0.148, 95% CI=0.058 to 0.375) are influencing factors of HDP in twin pregnancies. The area under the ROC curve of the prediction model was 0.763. The C-index were 0.842 and 0.746, respectively, on the temporal validation set and geographical validation set.

Conclusions

The new model for predicting HDP in twin pregnancies constructed by clinical characteristics and laboratory indicators had high clinical application value. It can be used to individually evaluate the occurrence of HDP in twin pregnancies after 28 weeks of gestation.
Virtual reality in fibre-optic intubation training: protocol for a systematic review and meta-analysis
Authors: Yang Di , Yang Lei , Xie Min
Published: December 2024

Introduction

Fibre-optic intubation is a crucial technique for the management of difficult airways in clinical practice, and its success rate is positively associated with the operator’s experience. However, because of its low utilisation rate in clinical practice, mastery of this technique by novices often relies heavily on simulation teaching. In recent years, virtual reality (VR) technology has been introduced to simulation training of fibre-optic intubation. However, because of limited sample sizes and conflicting findings, there remains an ongoing debate regarding the widespread adoption of VR technology. The objective of this study is to evaluate the impact of VR technology on the effectiveness of fibre-optic intubation training and to provide evidence-based insights to advance VR simulation methods in this field.

Methods and analysis

We will search the MEDLINE/OVID, Embase/OVID, Cochrane Central Register of Controlled Trials/OVID, CNKI and Wanfang databases from inception to March 2024. We will only include randomised controlled trials, with no restrictions on language of publication. The primary outcome will be the global rating scale score for flexible bronchoscope manipulation. The secondary outcomes will be the fibre-optic skills checklist, intubation time and proportion of successful intubations. We will assess the quality of all included trials according to the Cochrane risk-of-bias V.2 (Risk of Bias 2) tool for randomised trials. We will use the Review Manager software to perform a meta-analysis using a random-effects model and the Grading of Recommendations Assessment, Development and Evaluation approach to evaluate the quality of evidence.

Ethics and dissemination

Ethical approval is not required for this review because we will be using only published data. We plan to submit our review to peer-reviewed academic journals.

PROSPERO registration number

CRD42024525158
Integrated Whole-Life Cycle Accuracy Valvular Heart Disease Epidemiology Cohort Study (iWAVE): protocol for a prospective cohort study
Authors: Liu Xiang , Wang Yuqiang , Cao Tingqian , Jun Shi , Liu Lulu , Zhou Yongzhao , Guo Yingqiang
Published: December 2024

Introduction

Despite the rapid advancements in cardiovascular surgery in China, the prevalence of valvular heart disease (VHD) continues to rise, particularly among the elderly population. In the resource-constrained western regions, the lack of an integrated care management system significantly contributes to the burden of cardiovascular disease. Consequently, a comprehensive cohort data platform that encompasses the entire lifespan of patients with VHD is essential. This prospective cohort study aims to facilitate the examination of risk factor screening, disease progression, diagnostic and treatment strategies, and the long-term functional recovery trajectories of patients following valve surgery.

Methods and analysis

The Integrated Whole-Life Cycle Accuracy Valvular Heart Disease Epidemiology Cohort Study is a prospective cohort study that plans to enrol approximately 10 000 participants, including both patients with VHD and members of the general population, by 2028. Led by the West China Hospital of Sichuan University, it will be conducted in collaboration with 15 medical consortiums and their affiliated community hospitals. This study seeks to assess the disease trajectory of VHD, as well as the risk factors and protective measures that influence its progression and prognosis. This study will collect and analyse basic demographic information, peripheral blood and tissue samples, long-term functional follow-up data, and patient-reported outcome questionnaires. Additionally, electronic health records will be used to document patients with VHD undergoing surgical interventions, along with lifetime endpoint events for the valve clinical study.

Ethics and dissemination

The study protocol was approved by the Biomedical Research Ethics Committee of West China Hospital of Sichuan University (No. 20232422). All participants will be required to provide written informed consent. The study findings will be disseminated via publications in peer-reviewed journals and presentations at scientific conferences.
Relationship between uncertainty in illness and hope in patients undergoing haemodialysis in Iran: a cross-sectional study
Authors: Sajjadi Seyyede Leila , Vahidi Maryam , Anarjani Sar Alireza , Nemati Hossein
Published: December 2024

Objectives

Patients undergoing haemodialysis suffer from uncertainty in illness and hopelessness. The main objective of this study was to examine uncertainty in illness and its relationship with hope in patients undergoing haemodialysis in Iran.

Design

Cross-sectional study.

Setting and participants

This study included 202 haemodialysis patients recruited through proportional sampling. Data were gathered using the Mishel Uncertainty in Illness Scale–Community Form and Snyder’s Hope scale. The data were analysed using descriptive statistics and statistical tests including Pearson’s correlation, independent t-test and analysis of variance.

Results

The mean scores of uncertainty in illness, agency thinking and pathways thinking were 61.91±10.54 (range: 23– 115), 10.30±2.74 (range: 4–16) and 12.04±2.66 (range: 4–16), respectively. The Pearson correlation reflected a significant negative correlation between uncertainty in illness and agency thinking (r=−0.20, p=0.004) and also between uncertainty in illness and pathways thinking (r=−0.21, p=0.002).

Conclusions

The study found that people with higher education and income, younger age, waiting for a kidney transplant and low uncertainty have more agency and pathway thinking. Therefore, these variables should be worked on. According to the negative association between uncertainty in illness and agency and pathways thinking, well-designed interventions to reduce uncertainty in illness and enhance hope in haemodialysis patients are recommended.
‘I need to know, just put me in the picture’: a qualitative study of the lived experiences and supportive care needs of patients with hepatocellular carcinoma
Authors: Acharya Priya , Calnan Cecilia , Girgis Afaf , Levy Miriam Tania
Published: December 2024

Objective

Supportive care is considered an integral part of cancer care, but little is known about the supportive care needs (SCNs) of patients with hepatocellular carcinoma (HCC). This study aimed to examine the lived experience of patients with HCC and report on their SCN.

Methods

A qualitative, semistructured interview of 23 patients with HCC was undertaken. Interviews were recorded and transcribed, and the data were analysed using reflexive thematic analysis to gain insight into the met and unmet SCN of patients with HCC.

Results

Three thematic areas of focus were derived from the analysis: (1) coping with uncertainty; (2) dependence on familial and social networks to meet SCN and (3) communication with healthcare professionals and access to specialised nursing support.

Conclusions

We identified specific informational and practical SCNs of patients with HCC. Our participants largely relied on family and support networks to meet these SCNs, leading to concerns about carer burden. Access to specialised nurses who could assist patients in navigating health and healthcare systems was universally valued by patients as a method by which the health service could meet some of these SCNs.
Effects of urbanisation and seasons on the relationship between frozen road conditions and road traffic injury: a longitudinal study of national emergency medical service data in South Korea
Authors: Won Jun Hee , Yoon Jaehong , Jeong Joo , Chung Younshik , Han Sangjin , Ro Young Sun , Leigh Ja-Ho
Published: December 2024

Background

Frozen road conditions could be a factor in road traffic injuries, and seasonality and urbanisation level are potential influencing factors. However, few studies have considered this relationship. Therefore, we examined the effect of frozen road conditions on road traffic injury rates and the differences across seasons and urbanisation levels.

Methods

We used nationwide data on road traffic injuries and weather from the National Emergency Medical Service Run Sheet and the Korea Meteorological Administration, respectively, from 2018 to 2021. We analysed the relationship between frozen road conditions and road traffic injuries by administrative district and day using a generalised estimating equation with log link function and Poisson distribution, stratified by season and urbanisation level.

Results

After excluding summer, the analysis of 605 254 road traffic injury cases revealed a higher road crash incidence under frozen road conditions, with injuries increasing by 30% (rate ratio (RR): 1.33, 95% CI: 1.30 to 1.37). The relationship between road traffic injury rate and frozen road conditions varied significantly by season and urbanisation level. The stratification analysis showed that the relationship between these two variables was significant in the fall (RR: 2.07, 95% CI: 1.74 to 2.46) and winter (RR: 1.37, 95% CI: 1.34 to 1.40). Furthermore, the road traffic injury rate was higher on frozen road conditions in urban (RR: 1.24, 95% CI: 1.19 to 1.29) and rural areas (RR: 1.47, 95% CI: 1.42 to 1.51), not in metropolitan areas.

Conclusion

The road traffic injury rate increased under frozen road conditions and varied by season and urbanisation level. These findings indicate the need for road safety strategies tailored according to season and urbanisation level.
Report on an audit of two decades’ activities of a clinical ethics committee: the Newcastle upon Tyne Hospitals NHS Foundation Trust Clinical Ethics Advisory Group (CEAG)
Authors: Mohindra Raj K , Louw Stephen J
Published: December 2024

Background

‘The Clinical Ethics Advisory Group’ (CEAG) is the clinical ethics support body for Newcastle upon Tyne Hospitals National Health Service Foundation Trust. A significant change in CEAG’s way of working occurred over the past 5 years as a result of Court decisions, increasing public expectations and an increase in CEAG’s paediatric case flow.

Purpose

Review historical data: (a) as a useful benchmark to look for the early impact of significant service changes and (b) to seek possible reference (‘sentinel’) cases for use with a posited practical (casuistic) case-based reasoning model.

Methods

Audit of the minutes of the first 22 years’ meetings was undertaken by the two chairs of CEAG over that period of time.

Results

223 matters discussed: 86 Trust policy issues; 117 clinical cases (84 adult (32 urgent), 33 child (8 urgent)); 12 CEAG procedural issues and 8 UK Clinical Ethics Network ‘round robin’ cases. The range of topic areas was wide. A broad range of ethical structures were deployed, principlism predominated. Quality was subjectively assessed by each reviewer, but different methods were used. This proved highly concordant between the two reviewers. 47% (105/223) of discussions were ‘excellent’ (*A4C4–A4C4) and 70% (156.5/223) ‘good’ or better (*A4C4–A3C3). By meeting the criteria of ‘excellent’ and ‘prospective’, 92/223 (41%) of matters were deemed potentially suitable as sentinel cases.

Conclusions

The audit provides a rich vein of information. There is demand for CEAG’s services, workload is becoming more complex. Formal funding for such services seems justified.
Sniffed levamisole-adulterated cocaine mimicking acute demyelinating encephalomyelitis
Authors: Yap Joshua , Ward Kayla , Broadley Simon
Published: December 2024

A 38-year-old man developed headache, dysarthria and dysphasia after insufflation of cocaine. Brain imaging showed multiple white matter lesions, suggesting acute disseminated encephalomyelitis (ADEM), but the clinical features were atypical for demyelination. These lesions may represent a levamisole-associated vascular endotheliopathy, with a mechanism similar to posterior reversible encephalopathy syndrome. Levamisole is a no longer used chemotherapeutic agent but is a legally acquirable veterinary antihelminthic and is often used to adulterate cocaine. Given the rise in cocaine-related hospitalisations, this case raises awareness of an important ADEM mimic.
Content analysis of marketing features in US nicotine pouch ads from 2021 to 2023
Authors: Czaplicki Lauren , Tfayli Dana , Spindle Tory R , Ibrahim Maryam , Kennedy Ryan David , Dowd Ashley , Diseker John Rogers , Thrul Johannes , Moran Meghan B
Published: December 2024

Introduction

Since their 2016 US debut, nicotine pouches, which are available in various flavours and strengths, have grown in popularity. Nicotine pouches may appeal to people who use tobacco, but there is also concern that they may appeal to youth and non-nicotine users. This study analysed nicotine pouch advertising trends from 2021 to 2023 to explore advertising features and inform regulatory strategies.

Methods

We conducted a content analysis of 2147 nicotine pouch print, radio, online/mobile, direct emails and social media ads from 2021 to 2023. Ads were coded for flavours, terms and claims. Two trained coders double-coded all ads, and any discrepancies were reconciled. We conducted χ2and post-hoc tests to assess changes over time, using Bonferroni adjustments for multiple comparisons.

Results

Most ads (84.6%) were posted on brands’ social media accounts. Zyn ads comprised 54.5% of ads across media platforms. Most ads (72.3%) featured flavoured products, particularly fruit (27.1%) and mint (26.1%). Common terms included ‘smoke-free’ (19.2%), ‘tobacco-free’ (18.4%), ‘synthetic’ (12.9%) and ‘spit-free’ (10.6%), which all significantly declined from 2021 to 2023. The most common claim featured how convenient the product was to use, which significantly increased over time. Claims about product discreetness and the presence of coupons/discounts also significantly increased over time.

Conclusions

We observed a decline in terms of connecting nicotine pouches to other tobacco products and an increase in potentially youth-appealing convenience claims. Future research should investigate how these features impact risk perceptions and use intentions among people who never and currently use tobacco to inform regulations (ie, restrict youth-appealing claims).
Analysing Direct and Indirect Effects of Time on Internet, Reading, Watching and Listening in Private and Public Place Consumption—An SEM Approach
Authors: Martinho Carla , Silvestre Cláudia , Bansal Rohit
Published: December 2024

This study investigates what determines social media consumption in private and public locals. Based on a survey of 638 citizens, we found that the daily consumption frequency of social networks, and face‐to‐face, both inversely influence consumption in private places, the daily consumption frequency of the Internet inversely influences consumption in both private and public places, and daily consumption frequency of mobile phones inversely influences consumption in the private place. Results conclude that daily consumption frequency of the Internet mediates the effect of time spent on the Internet, watching and listening in private local; daily consumption frequency of mobile phones mediates the effect of time spent on the Internet, reading, watching and listening in private local. We also found that daily consumption frequency of the Internet mediates the effect of time spent on the Internet, reading and listening in public local, and daily consumption frequency of social networks mediates the effect of time spent on the Internet, reading, watching and listening in public local.
Initial Coefficient Estimates for Bi‐Univalent Functions Related to Generalized Telephone Numbers
Authors: Murugusundaramoorthy Gangadharan , Vijaya Kaliappan , Purohit Sunil Dutt , Shyamsunder  , Suthar Daya Lal
Published: December 2024

This study defines three novel classes of bi‐univalent functions connected to generalized telephone numbers for the first time. We produced assessments about the Taylor–Maclaurin coefficients |a2| and |a3| and Fekete–Szegö functional problems for functions involving these novel subclasses for functions in every one regarding these three bi‐univalent function classes. Additional findings are anticipated to emerge after expertise the factors included in our significant outcomes, which have not yet been investigated by subordinating with generalized telephone numbers.
Research Trends of Artificial Intelligence in Lung Cancer: A Combined Approach of Analysis With Latent Dirichlet Allocation and HJ‐Biplot Statistical Methods
Authors: De La Hoz-M Javier , Montes-Escobar Karime , Pérez-Ortiz Viorkis
Published: December 2024

Lung cancer (LC) remains one of the leading causes of cancer‐related mortality worldwide. With recent technological advances, artificial intelligence (AI) has begun to play a crucial role in improving diagnostic and treatment methods. It is crucial to understand how AI has integrated into LC research and to identify the main areas of focus. The aim of the study was to provide an updated insight into the role of AI in LC research, analyzing evolving topics, geographical distribution, and contributions to journals. The study explores research trends in AI applied to LC through a novel approach combining latent Dirichlet allocation (LDA) topic modeling with the HJ‐Biplot statistical technique. A growing interest in AI applications in LC oncology was observed, reflected in a significant increase in publications, especially after 2017, coinciding with the availability of computing resources. Frontiers in Oncology leads in publishing AI‐related LC research, reflecting rigorous investigation in the field. Geographically, China and the United States lead in contributions, attributed to significant investment in R&D and corporate sector involvement. LDA analysis highlights key research areas such as pulmonary nodule detection, patient prognosis prediction, and clinical decision support systems, demonstrating the impact of AI in improving LC outcomes. DL and AI emerge as prominent trends, focusing on radiomics and feature selection, promising better decision‐making in LC care. The increase in AI‐driven research covers various topics, including data analysis methodologies, tumor characterization, and predictive methods, indicating a concerted effort to advance LC research. HJ‐Biplot visualization reveals thematic clustering, illustrating temporal and geographical associations and highlighting the influence of high‐impact journals and countries with advanced research capabilities. This multivariate approach offers insights into global collaboration dynamics and specialization, emphasizing the evolving role of AI in LC research and diagnosis.
Synergistic Effects of Vermicompost and Biochar Amendments on Soil Fertility and Wheat Productivity in Bangladesh Floodplain Soils
Authors: Hasan Ahmed Khairul , Islam Shams Shaila , Jahan Marina , Kheya Sinthia Afsana , Uddin Md. Romij , Islam Md. Shafiqul , Khomphet Thanet
Published: December 2024

Biochar is gaining importance due to its potential to enhance soil health, crop yield, and quality. It may also promote more sustainable farming methods. This study evaluated the combined effects of biochar, vermicompost, and inorganic fertilizers on soil characteristics, growth, and yield in wheat. Ten different treatments were applied to wheat (cultivar BARI Gom‐33). The tallest plants, highest total dry weight, and largest leaf area index were observed in plots where chemical fertilizers, rice husk biochar, poultry manure, and vermicompost were applied together. At harvest, the treatment containing 1/4 recommended fertilizer dose (RFD) + 1/4 poultry manure biochar + 1/4 rice husk biochar + 1/4 vermicompost produced the best yield and yield‐contributing factors. The combination of biochar, vermicompost, and inorganic fertilizers increased grain production by 43.23%–79.48% compared with the control. These treatments also improved soil health by increasing available phosphorus, organic matter, carbon‐to‐nitrogen ratio, and organic carbon. In conclusion, the combined application of 1/4 RFD, 1/4 poultry manure biochar, 1/4 rice husk biochar, and 1/4 vermicompost can replace the sole use of chemical fertilizers and serve as a key component for sustainable crop production.