bluuebunny/crossref_metadata_2025 huggingface dataset:
What do established companies do to factor in sustainability into their business models?
Authors: Ademi Bejtush , Sætre Alf Steinar , Klungseth Nora Johanne
Published: September 2024

This study examines the motivations for businesses to integrate sustainability into their business models (BMs) and how they can innovate those models to become more sustainable. The concept of business model innovation for sustainability (BMIfS) has emerged as a viable means to help companies innovate sustainable business models (SBMs). However, it remains a “black box” for many companies, and a design‐implementation gap has been identified. Utilizing an embedded case study approach, we conducted 49 interviews, observed three meetings, and collected over 1000 pages of archival data. The findings offer practical strategies for BMIfS, clarify the integration between business model innovation and SBM concepts, and provide a framework for adding new SBMs to an existing business portfolio. This research is of interest to scholars and business practitioners involved in integrating sustainability into their business strategies for building a sustainable future.
Partial hepatectomy versus interventional treatment in patients with hepatitis B virus‐related hepatocellular carcinoma and clinically significant portal hypertension: a randomized comparative clinical trial
Authors: Yuan Yichuan , Peng Hong , He Wei , Zheng Yun , Qiu Jiliang , Chen Bin , Zou Ruhai , Wang Chenwei , Lau Wan Yee , Li Binkui , Yuan Yunfei
Published: September 2024

Background

The widely accepted view that portal hypertension (PHT) is a contraindication to hepatectomy for patients with hepatocellular carcinoma (HCC) is being increasingly challenged. The long‐term survival outcomes and safety of partial hepatectomy versus interventional treatment using ablation with or without pre‐ablation transarterial chemoembolization (TACE) in patients with HBV‐related HCC within the Milan criteria and with clinically significant PHT were compared in this study.

Methods

This open‐label randomized clinical trial was conducted on consecutive patients with clinically PHT and hepatitis B virus (HBV)‐related HCC with tumors which were within the Milan criteria. These patients were randomized 1:1 to receive either partial hepatectomy or interventional treatment between December 2012 and June 2018. The primary endpoint was overall survival (OS); secondary endpoints included recurrence‐free survival (RFS) and therapeutic safety.

Results

Each of the 2 groups had 80 patients. The 1‐, 3‐ and 5‐year OS rates in the partial hepatectomy group and the interventional treatment group were 95.0%, 86.2%, 69.5% versus 93.8%, 77.5%, 64.9%, respectively (P = 0.325). The corresponding RFS rates were 78.8%, 55.0%, 46.2% versus 71.3%, 52.5%, 45.0%, respectively (P = 0.783). The partial hepatectomy group had a higher complication rate compared to the interventional group (67.5% vs. 20%, P < 0.001). However, the differences were mainly in Clavien‐Dindo Grade I complications (P < 0.001), while not significant in Grade II/III/IV/V (All P > 0.05).

Conclusions

This study shows that partial hepatectomy treatment did not meet prespecified significance for improved OS and RFS compared to interventional treatment for patients with HBV‐related HCC within the Milan criteria and with clinically significant PHT. However, partial hepatectomy is still a safe procedure and should be considered as a treatment option rather than a contraindication.
Choline Oxidase and Choline Ionic Liquids in Biocatalytic Heme Peroxidase Cascades
Authors: Hallamaa Marleen , Naapuri Janne M. , Silva Rafaela A. L. , Rosatella Andreia A. , Deska Jan
Published: September 2024

Choline oxidase from Alcaligenes sp. (ChOx) is used to generate hydrogen peroxide in situ from choline‐based ionic liquids (ILs) to fuel peroxidase‐mediated biocatalysis while mitigating oxidative degradation of the heme‐dependent enzymes. Horseradish peroxidase (HRP) and chloroperoxidase from Caldariomyces fumago (CPO), in combination with the ChOx, are evaluated in enzymatic cascades for the ability of the biocatalytic systems to withstand elevated concentrations of different choline additives in oxidative and halogenative enzymatic assays. The findings are applied in various synthetic scenarios to produce important oxygen‐ and nitrogen‐containing heterocycles, using choline ILs in a dual‐purpose fashion, as a substrate‐solubilizing component in the reaction medium as well as the source for hydrogen peroxide. The ChOx/HRP couple is used to induce intramolecular cyclizations of hydroxamic acids and hydroxycarbamates in a nitroso‐ene‐type pathway with choline dihydrogen phosphate as IL additive. The ChOx/CPO cascade successfully mediates brominative cyclizations of α‐allenic alcohols, while amphiphilic surfactants are employed to turn the aqueous choline propionate IL media into a colloidal suspension. ChOx/CPO partnering is also evaluated in an oxygenative rearrangement of 1‐furylethanol with choline acetate IL. The results show the wide potential of choline oxidase for hydrogen peroxide‐driven biocatalysis with both aqueous and micellar choline ionic liquid solutions.
Transition‐Metal Free Amination and Hydrodefluorination of Aryl Fluorides Promoted by Solvated Electrons
Authors: Williams Anietie W. , Gilmore Kerry M.
Published: September 2024

Cross‐coupling reactions for constructing C−N bonds represent a pivotal advancement in chemical science. Traditional methodologies, including nucleophilic aromatic substitution (SNAr) and transition metal‐catalyzed cross‐couplings, have limitations concerning aryl scope, reliance on toxic and costly transition‐metal catalysts, and issues related to atom economy and waste generation from ligands and additives. In this work, we introduce a novel method for aminating neutral, electron‐rich, and electron‐deficient aryl halides, eliminating the need for transition metals. Our approach involves the activation of aryl halides using solvated electrons generated from granulated lithium and sonication. This serves as a sustainable source of reducing power, facilitating the efficient formation of C−N bonds under near ambient conditions. Competitive selectivity studies between halide and ester functionalities were explored. Reaction scope and conducted mechanistic studies which supported the proposed radical‐nucleophilic substitution (SRN1) mechanism for the reaction. Notably, the developed reaction has a highly competitive reductive dehalogenation pathway during the C−N coupling reaction, and this mechanistic divergency was thoroughly explored. This work not only broadens the scope of C−N coupling reactions which typically employs aryl bromides and iodides and rarely aryl fluorides which is also equally abundant, but also introduces a new way to do C−N coupling reactions using solvated electrons.
Integrated Identification and Immunotherapy Response Analysis of the Prognostic Signature Associated With m6A, Cuproptosis‐Related, Ferroptosis‐Related lncRNA in Endometrial Cancer
Authors: Qian Yongkang , Chen Hualing , Miao Pengcheng , Ma Rongji , Lu Beier , Hu Chenhua , Fan Ru , Xu Biyun , Chen Bingwei
Published: September 2024

Background

Endometrial cancer (EC) stands as the predominant gynecological malignancy impacting the female reproductive system on a global scale. N6‐methyladenosine, cuproptosis‐ and ferroptosis‐related biomarker is beneficial to the prognostic of tumor patients. Nevertheless, the correlation between m6A‐modified lncRNAs and ferroptosis, copper‐induced apoptosis in the initiation and progression of EC remains unexplored in existing literature.

Aims

In this study, based on bioinformatics approach, we identified lncRNAs co‐expressing with cuproptosis‐, ferroptosis‐, m6A‐ related lncRNAs from expression data of EC. By constructing the prognosis model in EC, we screened hub lncRNA signatures affecting prognosis of EC patients. Furthermore, the guiding value of m6A‐modified ferroptosis‐related lncRNA (mfrlncRNA) features was assessed in terms of prognosis, immune microenvironment, and drug sensitivity.

Method

Our research harnessed gene expression data coupled with clinical insights derived from The Cancer Genome Atlas (TCGA) collection. To forge prognostic models, we adopted five machine learning approaches, assessing their efficacy through C‐index and time‐independent ROC analysis. We pinpointed prognostic indicators using the LASSO Cox regression approach. Moreover, we delved into the biological and immunological implications of the discovered lncRNA prognostic signatures.

Results

The survival rate for the low‐risk group was markedly higher than that for the high‐risk group, as evidenced by a significant log‐rank test (p < 0.001). The LASSO Cox regression model yielded concordance indices of 0.76 for the training set and 0.77 for the validation set, indicating reliable prognostic accuracy. Enrichment analysis of gene functions linked the identified signature predominantly to endopeptidase inhibitor activity, highlighting the signature's potential implications. Additionally, immune function and drug density emphasized the importance of early diagnosis in EC.

Conclusion

Five hub lncRNAs in EC were identified through constructing the prognosis model. Those genes might be potential biomarkers to provide valuable reference for targeted therapy and prognostic assessment of EC.
Attribute expansion relation extraction approach for smart engineering decision‐making in edge environments
Authors: Cui Mengmeng , Zhang Yuan , Hu Zhichen , Bi Nan , Du Tao , Luo Kangrong , Liu Juntong
Published: September 2024

In sedimentology, the integration of intelligent engineering decision‐making with edge computing environments aims to furnish engineers and decision‐makers with precise, real‐time insights into sediment‐related issues. This approach markedly reduces data transfer time and response latency by harnessing the computational power of edge computing, thereby bolstering the decision‐making process. Concurrently, the establishment of a sediment knowledge graph serves as a pivotal conduit for disseminating sediment‐related knowledge in the realm of intelligent engineering decision‐making. Moreover, it facilitates a comprehensive exploration of the intricate evolutionary and transformative processes inherent in sediment materials. By unveiling the evolutionary trajectory of life on Earth, the sediment knowledge graph catalyzes a deeper understanding of our planet's history and dynamics. Relationship extraction, as a key step in knowledge graph construction, implements automatic extraction and establishment of associations between entities from a large amount of sedimentary literature data. However, sedimentological literature presents multi‐source heterogeneous features, which leads to a weak representation of hidden relationships, thus decreasing the accuracy of relationship extraction. In this article, we propose an attribute‐extended relation extraction approach (AERE), which is specifically designed for sedimentary relation extraction scenarios. First, context statements containing sediment entities are obtained from the literature. Then, a cohesive hierarchical clustering algorithm is used to extend the relationship attributes between sediments. Finally, mine the relationships between entities based on AERE. The experimental results show that the proposed model can effectively extract the hidden relations and exhibits strong robustness in dealing with redundant noise before and after sentences, which in turn improves the completeness of the relations between deposits. After the relationship extraction, a proprietary sediment knowledge graph is constructed with the extracted triads.
Artificial intelligence detection of cognitive impairment in older adults during walking
Authors: Obuchi Shuichi P. , Kojima Motonaga , Suzuki Hiroyuki , Garbalosa Juan C. , Imamura Keigo , Ihara Kazushige , Hirano Hirohiko , Sasai Hiroyuki , Fujiwara Yoshinori , Kawai Hisashi
Published: September 2024

INTRODUCTION

To detect early cognitive impairment in community‐dwelling older adults, this study explored the viability of artificial intelligence (AI)‐assisted linear acceleration and angular velocity analysis during walking.

METHODS

This cross‐sectional study included 879 participants without dementia (female, 60.6%; mean age, 73.5 years) from the 2011 Comprehensive Gerontology Survey. Sensors attached to the pelvis and left ankle recorded the triaxial linear acceleration and angular velocity while the participants walked at a comfortable speed. Cognitive impairment was determined using Mini‐Mental State Examination scores. Deep learning models were used to discern the linear acceleration and angular velocity data of 12,302 walking strides.

RESULTS

The models’ average sensitivity, specificity, and area under the curve were 0.961, 0.643, and 0.833, respectively, across 30 testing datasets.

DISCUSSION

AI‐enabled gait analysis can be used to detect signs of cognitive impairment. Integrating this AI model into smartphones may help detect dementia early, facilitating better prevention.

Highlights

Artificial intelligence (AI)‐enabled gait analysis can be used to detect the early signs of cognitive decline.

This AI model was constructed using data from a community‐dwelling cohort.

AI‐assisted linear acceleration and angular velocity analysis during gait was used.

The model may help in early detection of dementia.
Aryl‐Fluorocyclopropane β‐Lactams with Activity Against Mycobacteroides abscessus and Mycobacterium bovis BCG
Authors: Spurling Dominic E. , Baker Emily J. , Kingsley‐Moore George , Ppadath Rifahath Mon Neyya , More Nachiket D. , Al‐Maharik Nawaf , Harrison James , Cox Jonathan A. G. , O'Hagan David
Published: September 2024

A novel series of aryl‐α‐fluorocyclopropyl 1 and α,β,β‐trifluorocyclopropyl 2 β‐lactams have been prepared and their activity explored across various Mycobacteria and also the ESKAPE panel of pathogens. The most active of these compounds 1 a displayed good activity against clinically challenging Mycobacteria such as M. bovis BCG (MIC 0.39 mg/mL)) and did not show any significant activity against the ESKAPE pathogens indicating selectivity for this otherwise challenging class of pathogen. Compound 1 a was however rapidly metabolised and toxic to a human model cell line (HepG2) limiting its clinical development at this stage. The compounds were designed to exploit a fluoride ion elimination mechanism concomitant with β‐lactam ring opening, as the basis of a mechanism induced trigger to generate a reactive intermediate (suicide inhibition). In model alkoxide reactions a representative from both classes 1 and 2 resulted in β‐lactam ring opening but only the more active mono‐fluoro cyclopropane series 1 triggered fluoride ion elimination after ring opening and this may form the basis of its activity.
A multicultural comparative study of self‐stigma in epilepsy: Differences across four cultures
Authors: Iwayama Takayuki , Mizuno Kimihito , Yildiz Esra , Lim Kheng‐Seang , Yi Soon Ming , Lynn Yee Joe , Hin Ching Woon , Jean Jason Chia Zhi , Fong Si‐Lei , Xuen Yu , Qian Ong Zhi , Kuramochi Izumi
Published: September 2024

Objective

Epilepsy is a neurological disorder characterized by recurrent seizures, exhibiting variance in prevalence and treatment availability across diverse geopolitical contexts and cultural milieus. The stigma associated with epilepsy is a significant global issue affecting the quality of life (QOL) of people with epilepsy (PWE). This study aims to examine the relationship between self‐stigma and depressive symptoms in PWE, with a particular emphasis on understanding the manifestations of these across different cultural contexts. We aim to enhance the provision of customized care to diverse cultural settings, fostering the adoption of healthier lifestyles for PWE.

Methods

We recruited PWE who received treatment at specialized medical facilities for epilepsy in Japan, Malaysia (Chinese, Malay), and Turkey from February to October 2023. The Epilepsy Self‐Stigma Scales (ESSS), Neurological Disorders Depression Inventory for Epilepsy (NDDI‐E), and Generalized Anxiety Disorder 7 (GAD‐7) in local languages were used to assess self‐stigma, depressive symptoms, and anxiety.

Results

The ESSS total scores were significantly higher among the Turkish and Japanese cohorts (F [3, 406] = 6.57, p < 0.001, η2 = 0.05). In addition, the self‐stigma observed moderate positive correlations for depressive symptoms (rs = 0.41–0.50, Ps < 0.001) and anxiety (rs = 0.42–0.44, Ps < 0.001). The ANCOVA findings suggested that the notable variations in self‐stigma, as found in the one‐way ANOVA conducted across four cultures, were reduced when taking into consideration depressed symptoms. Our finding highlights the potential influence of mental health factors over cultural factors concerning self‐stigma.

Significance

The manifestation of self‐stigmatization within epilepsy exhibits distinctions across diverse cultural cohorts, regardless of the demographic and clinical variation, yet demonstrates a significant correlation with psychological factors. In subsequent research endeavors, we should comprehensively investigate these subtle differences, their potential impact on patient care, and the development of supportive approaches.

Plain Language Summary

This cross‐cultural study reveals significant variations in self‐stigma among people with epilepsy across different cultural contexts, with Turkish and Japanese cohorts showing higher levels. Self‐stigma demonstrated moderate positive correlations with depressive symptoms and anxiety across all cultures. Notably, differences in self‐stigma were reduced when accounting for depressive symptoms, suggesting that mental health factors may have a stronger influence than cultural factors. These findings underscore the importance of considering both cultural and psychological aspects in developing targeted interventions to address self‐stigma in epilepsy care.
Limited cerebellar gradient extension in temporal lobe epilepsy with dystonic posturing
Authors: Li Wei , Chen Junxia , Qin Yingjie , Jiang Sisi , Li Xiuli , Zhang Heng , Luo Cheng , Gong Qiyong , Zhou Dong , An Dongmei
Published: September 2024

Objective

Dystonic posturing (DP) is a common semiology in temporal lobe epilepsy (TLE). We aimed to explore cerebellar gradient alterations in functional connectivity in TLE patients with and without DP.

Methods

Resting‐state functional MRI data were obtained in 60 TLE patients and 32 matched healthy controls. Patients were further divided into two groups: TLE with DP (TLE + DP, 31 patients) and TLE without DP (TLP‐DP, 29 patients). We explored functional gradient alterations in the cerebellum based on cerebellar–cerebral functional connectivity and combined with independent component analysis to evaluate cerebellar–cerebral functional integration and reveal the contribution of the motor components to the gradient.

Results

There were no obvious differences in clinical features and postoperative seizure outcomes between TLE + DP and TLE‐DP patients. Patients and controls all showed a clear unimodal‐to‐transmodal gradient transition in the cerebellum, while TLE patients demonstrated an extended principal gradient in functional connectivity compared to healthy controls, which was more limited in TLE + DP patients. Gradient alterations were more widespread in TLE‐DP patients, involving bilateral cerebellum, while gradient alterations in TLE + DP patients were limited in the cerebellum ipsilateral to the seizure focus. In addition, more cerebellar motor components contributed to the gradient alterations in TLE + DP patients, mainly in ipsilateral cerebellum.

Significance

Extended cerebellar principal gradients in functional connectivity revealed excessive functional segregation between unimodal and transmodal systems in TLE. The functional connectivity gradients were more limited in TLE + DP patients. Functional connectivity in TLE patients with dystonic posturing involved more contribution of cerebellar motor function to ipsilateral cerebellar gradient.

Plain Language Summary

Dystonic posturing contralateral to epileptic focus is a common symptom in temporal lobe epilepsy, and the cerebellum may be involved in its generation. In this study, we found cerebellar gradients alterations in functional connectivity in temporal lobe epilepsy patients with and without contralateral dystonic posturing. In particular, we found that TLE patients with dystonic posturing may have more limited cerebellar gradient in functional connectivity, involving more contribution of cerebellar motor function to ipsilateral cerebellar gradient. Our study suggests a close relationship between ipsilateral cerebellum and contralateral dystonic posturing.
Superior prognostic accuracy of FIGO staging system in primary female genital tract lymphomas: A retrospective study (IELSG35)
Authors: Pirosa Maria Cristina , Steffanoni Sara , Vanazzi Anna , Esposito Fabiana , Polino Angela , Schena Alberto , Landi Francesco , Cabrera Maria Elena , Akhtar Saad , Gardella Santiago , Bairey Osnat , Pavlovsky Astrid , Stathis Anastasios , Zucca Emanuele
Published: September 2024

Primary lymphoma of the female genital tract (PLFGT) is a rare type of extranodal lymphoma. In this retrospective study from the International Extranodal Lymphoma Study Group, we analyzed clinical data from 60 women diagnosed with PLFGT between 1982 and 2012. The median age was 52 years. Limited stage, as defined by the Ann Arbor and FIGO staging systems, was observed in 55% and 63% of cases, respectively. The uterus was the primary site of lymphoma in 25 cases, with the ovaries as the second most common site (n = 24). The most common histological subtype was diffuse large B‐cell lymphoma (DLBCL, n = 44), followed by follicular lymphoma and marginal zone lymphoma (6 patients each). Two patients received surgery alone as first‐line therapy, while 58 underwent systemic therapy, 16 following major surgery. Thirteen patients received consolidation radiotherapy and six were given central nervous system (CNS) prophylaxis. Twenty patients had disease progression or recurrence. Six patients with DLBCL (14%) experienced CNS relapse, which was the only site of recurrence in five of them. All but one patient with CNS relapse had primary ovarian involvement, and three had bulky disease; none of these patients had received CNS prophylaxis. With a median follow‐up of 60 months, the median overall survival of the DLBCL cohort was approximately 13 years, with a 5‐year survival rate of 77%. In multivariable analysis, advanced disease according to the FIGO system was the only parameter significantly associated with shorter overall, cause‐specific, and progression‐free survival in patients with DLBCL.
Impact of extrathyroidal autoimmune diseases on clinical features and the efficacy of Iodine‐131 therapy in patients with differentiated thyroid cancer
Authors: Long Ya‐hong , Li Na , Ma Le , Zhang Wan‐chun
Published: September 2024

Objective

The aim of this study is to assess the impact of extrathyroidal autoimmune diseases (ADs) on the clinical characteristics and efficacy of iodine‐131 (131I) therapy in patients with differentiated thyroid cancer (DTC).

Methods

Patients with DTC who were received 131I therapy simultaneously were classified into the combination group (n = 35) and noncombination group (n = 146) depending on the presence of ADs. The clinical characteristics, such as gender, age, tumor lesions, lymph node metastasis, distant metastasis, 131I therapy efficacy, and use of levothyroxine, were compared between the two groups. Statistical analysis was conducted using SPSS 26.0 and R 4.0.3.

Results

There was a statistically significant difference in age between the combination and noncombination groups (t = −2.872, p < .01), and the optimal cutoff value was 50.5 years. Propensity score matching was completed effectively on a total of 121 patients, using age as the matching factor, comprising 32 cases in the combination group and 80 cases in the noncombination group. The baseline demographic features of the two groups were equivalent after matching (p > .05), and there was no significant difference in the therapeutic efficacy of 131I between the two groups (p > .05). In the subgroup analysis involving patients aged great than 50.5 years, the levothyroxine/weight (µg/kg) was increased in the combination group, and the difference was statistically significant (p < .05).

Conclusion

While extrathyroidal ADs may enhance the detection of DTC among elderly women, they have no impact on the clinical characteristics of thyroid cancer or the efficacy of 131I therapy. ADs may necessitate higher per‐unit dosages of levothyroxine in patients with DTC, regardless of the clinical status. Consequently, it is not essential for nuclear medicine physicians to consider the presence of ADs when designing treatment plans for patients with DTC.
Mitochondrial metabolism: A moving target in hepatocellular carcinoma therapy
Authors: Komza Monika , Chipuk Jerry Edward
Published: September 2024

Mitochondria are pivotal contributors to cancer mechanisms due to their homeostatic and pathological roles in cellular bioenergetics, biosynthesis, metabolism, signaling, and survival. During transformation and tumor initiation, mitochondrial function is often disrupted by oncogenic mutations, leading to a metabolic profile distinct from precursor cells. In this review, we focus on hepatocellular carcinoma, a cancer arising from metabolically robust and nutrient rich hepatocytes, and discuss the mechanistic impact of altered metabolism in this setting. We provide distinctions between normal mitochondrial activity versus disease‐related function which yielded therapeutic opportunities, along with highlighting recent preclinical and clinical efforts focused on targeting mitochondrial metabolism. Finally, several novel strategies for exploiting mitochondrial programs to eliminate hepatocellular carcinoma cells in metabolism‐specific contexts are presented to integrate these concepts and gain foresight into the future of mitochondria‐focused therapeutics.
No difference in laxity, proprioception and neuromuscular control after suture‐tape augmented ACL repair of acute proximal avulsions versus ACL reconstruction using hamstring autografts in young, active population
Authors: Góralczyk Adrian , Zalewska Paulina , Piszczatowski Szczepan , Hermanowicz Krzysztof , Guszczyn Tomasz
Published: September 2024

Purpose

The purpose of this study is to compare results of suture‐tape augmented anterior cruciate ligament (ACL) repair (internal bracing [IB]) and ACL reconstruction (ACLR) with hamstring autograft in terms of laxity, proprioception and neuromuscular control. The hypothesis was that with strict indications IB may provide better results in proprioception and neuromuscular control.

Methods

Patients with unilateral ACL injury treated with IB or ACLR with hamstring autograft were enroled in this retrospective study. Anterior tibial translation (ATT) in 30° and 90° of flexion was measured with Rolimeter. The joint position sense (JPS) test was performed in 30° and 60° of flexion using Biodex System 4Pro. The time‐synchronized motion capture system and surface electromyography set were used during dynamic tasks to assess knee valgus and semitendinosus (ST) and biceps femoris (BF) activities. Comparisons between both techniques and operated versus contralateral healthy knees were performed.

Results

The study groups involved 28 patients after ACLR (21.8 ± 4.8 years) and 20 patients after IB (25.8 ± 10.5 years) with the average follow‐up 30 ± 18 and 28 ± 15 months, respectively. The ATT did not differ significantly between operated groups. In 30° of flexion ATT for ACLR was significantly higher in operated than in contralateral knee (5.8 ± 2.4 mm vs. 4.3 ± 1.3 mm, p < 0.001). The JPS test and dynamic knee valgus presented no significant differences. The ACLR group presented significantly higher ST (p = 0.048) and BF (p = 0.012) activity comparing operated to contralateral knee in dynamic tasks.

Conclusion

Suture‐tape augmented ACL repair and ACLR with hamstring autograft yield similar results in terms of laxity, proprioception and neuromuscular control.

Level of Evidence

Level III: Retrospective comparative study.
Pretreatment drug resistance among people living with HIV from 2018 to 2022 in Guangzhou, China
Authors: Lv Shiyun , Lan Yun , He Yaozu , Li Quanmin , Ling Xuemei , Li Junbin , Li Liya , Guo Pengle , Hu Fengyu , Cai Weiping , Tang Xiaoping , Chen Jingliang , Li Linghua
Published: September 2024

The presence of pretreatment drug resistance (PDR) is posing an increasing threat to HIV control. Here we investigated drug resistance mutations (DRMs) and PDR among 6831 HIV‐infected individuals from 2018 to 2022 in Guangzhou, China. DRMs were detected among 24.5% of the patients. The overall prevalence of PDR was 7.4%, with resistance rate to nucleotide reverse transcriptase inhibitor (NRTI) being 1.3%, nonnucleoside reverse transcriptase inhibitor (NNRTI) 4.8%, and protease inhibitor (PI) 1.4%. Abacavir (0.8%) resistance was the most common in NRTI, followed by resistance to emtricitabine (0.6%), lamivudine (0.6%), and tenofovir disoproxil fumarate (0.3%). In NNRTI, nevirapine (3.7%) resistance was the most common, followed by efavirenz (3.5%) and rilpivirine (3.4%). Among PI, resistance to tipranavir (0.8%), nelfinavir (0.6%), fosamprenavir (0.2%) and lopinavir (0.1%) was most frequent. Annual prevalence of PDR showed an increase trend from 2018 to 2022, although not significant. In the multivariable logistic regression model, hepatitis B surface antigen positivity, circulating recombinant form (CRF) 55_01B, CRF08_BC, CRF59_01B, and subtype B were demonstrated as associated risk factors for PDR. The overall prevalence of PDR in Guangzhou was moderate, with relatively severe NNRTI resistance. Therefore, it remains crucial to continue monitoring PDR among newly diagnosed HIV‐infected individuals.
Methodology and development of a machine learning probability calculator: Data heterogeneity limits ability to predict recurrence after arthroscopic Bankart repair
Authors: van Spanning Sanne H. , Verweij Lukas P. E. , Hendrickx Laurent A. M. , Allaart Laurens J. H. , Athwal George S. , Lafosse Thibault , Lafosse Laurent , Doornberg Job N. , Oosterhoff Jacobien H. F. , van den Bekerom Michel P. J. , Buijze Geert Alexander ,   the Machine Learning Consortium
Published: September 2024

Purpose

The aim of this study was to develop and train a machine learning (ML) algorithm to create a clinical decision support tool (i.e., ML‐driven probability calculator) to be used in clinical practice to estimate recurrence rates following an arthroscopic Bankart repair (ABR).

Methods

Data from 14 previously published studies were collected. Inclusion criteria were (1) patients treated with ABR without remplissage for traumatic anterior shoulder instability and (2) a minimum of 2 years follow‐up. Risk factors associated with recurrence were identified using bivariate logistic regression analysis. Subsequently, four ML algorithms were developed and internally validated. The predictive performance was assessed using discrimination, calibration and the Brier score.

Results

In total, 5591 patients underwent ABR with a recurrence rate of 15.4% (n = 862). Age <35 years, participation in contact and collision sports, bony Bankart lesions and full‐thickness rotator cuff tears increased the risk of recurrence (all p < 0.05). A single shoulder dislocation (compared to multiple dislocations) lowered the risk of recurrence (p < 0.05). Due to the unavailability of certain variables in some patients, a portion of the patient data had to be excluded before pooling the data set to create the algorithm. A total of 797 patients were included providing information on risk factors associated with recurrence. The discrimination (area under the receiver operating curve) ranged between 0.54 and 0.57 for prediction of recurrence.

Conclusion

ML was not able to predict the recurrence following ABR with the current available predictors. Despite a global coordinated effort, the heterogeneity of clinical data limited the predictive capabilities of the algorithm, emphasizing the need for standardized data collection methods in future studies.

Level of Evidence

Level IV, retrospective cohort study.
Number of conditioning trials, but not stimulus intensity, influences operant conditioning of brain responses after total knee arthroplasty
Authors: Rodriguez Kazandra M. , Krishnan Chandramouli , Palmieri‐Smith Riann M.
Published: September 2024

Purpose

The primary purpose of this randomized, cross‐sectional study was to determine whether operant conditioning of motor evoked torque (MEPTORQUE) in individuals with total knee arthroplasty (TKA) increases quadriceps MEPTORQUE responses within a single session and induces acute corticospinal adaptations by producing sustained increases in MEPTORQUE after training. A secondary purpose was to determine if these changes were affected by the stimulus intensity and number of training trials.

Methods

Thirty participants were block‐randomized into one of three groups based on the participant's active motor threshold (100%, 120%, and 140%) to evaluate the effect of stimulus intensity. Participants received three blocks of conditioning trials (COND), where they trained to increase their MEPTORQUE. Control (CTRL) transcranial magnetic stimulation pulses were provided before and after each COND block to establish baseline corticospinal excitability and to evaluate the effect of the number of training trials. Two MEPTORQUE recruitment curves were collected to evaluate the effect of up‐conditioning on acute corticospinal adaptations.

Results

TKA participants were able to successfully increase their MEPTORQUE in a single session (F3,81 = 10.719, p < 0.001) and induce acute corticospinal adaptations (F1,27 = 20.029, p < 0.001), indicating sustained increases in quadriceps corticospinal excitability due to operant conditioning. While the stimulus intensity used during training did not affect the ability to increase MEPTORQUE (F2,26 = 0.021, n.s.) or its associated acute adaptations (F2,27 = 0.935, n.s.), the number of training trials significantly influenced these outcomes (F3,81 = 10.719, p < 0.001; F3,81 = 4.379, p = 0.007, respectively).

Conclusion

Operant conditioning is a feasible approach for improving quadriceps corticospinal excitability following TKA. While any of the three stimulus intensities evaluated in this study may be used in future operant conditioning interventions, using a low or moderate stimulus intensity and 150 training trials are recommended to improve treatment efficiency and patient adherence.

Level of Evidence

Level II.
Arthroscopic subscapularis augmentation of the classic Bankart repair leads to satisfactory clinical and functional mid‐term outcomes in patients with recurrent anterior shoulder instability and less than a subcritical glenoid bone loss
Authors: Brilakis Emmanouil , Sachinis Nikolaos Platon , Kokkineli Stefania , Pantekidis Ioannis , Natsaridis Prodromos , Gatos George , Antonogiannakis Emmanouil
Published: September 2024

Purpose

The long‐term failure rate of the arthroscopic Bankart repair may reach unacceptable values, raising the need to augment this classic procedure. Arthroscopic subscapularis augmentation is the tenodesis of the upper part of the subscapularis tendon to the anterior glenoid rim. The aim of the study was to evaluate the mid‐term clinical and functional outcomes of patients operated with arthroscopic subscapularis augmentation of the classic Bankart repair due to recurrent anterior shoulder instability.

Methods

This is a retrospective single‐centre case series study with prospectively collected data. All patients suffered from recurrent anterior shoulder instability and had glenoid bone loss less than 13.5% of the inferior glenoid diameter (subcritical glenoid bone loss). Patients with greater anterior glenoid bone defect, engaging Hill–Sachs lesions, multidirectional instability or subscapularis insufficiency were excluded. Postoperatively, all patients were evaluated for recurrence and apprehension. The patient's shoulder range of motion and functional scores were recorded.

Results

The final study cohort included 34 patients with a mean age of 29.3 ± 10.2 years. The mean follow‐up period was 42.4 ± 10.7 months (range, 24–62 months). Two out of 34 patients (5.8%) experienced a re‐dislocation postoperatively, while one additional patient had a subjective feeling of apprehension. External rotation at the last follow‐up was lower compared to preoperative values or the healthy side, but only one patient had restrictions in his sporting activities. The functional scores were significantly increased compared to the preoperative values. Twenty‐two out of 26 patients (84.6%) returned to the same level of sporting activities, and 30/34 patients (88.2%) were highly satisfied with the results.

Conclusion

Arthroscopic subscapularis augmentation of the classic Bankart repair reduces the dislocation recurrence rate and leads to satisfactory clinical and functional mid‐term outcomes in patients with recurrent anterior shoulder instability and less than a subcritical glenoid bone loss.

Level of Evidence

Level IV
Central Hearing Loss in a Pediatric Patient
Authors: Moon Peter K. , Bloom Lauren , Tribble Melissa , Ling Angela H. , Ahmad Iram N. , Yeom Kristen , Cheng Alan G.
Published: September 2024

Sensorineural hearing loss is typically caused by dysfunction of the inner ear or auditory nerve. In pediatric patients diagnosed with sensorineural hearing loss, work‐up often includes genetic testing and imaging studies of the auditory pathway. Here, we report a case of a pediatric patient with a history of sensorineural hearing loss following cisplatin and radiation therapy for brainstem medulloblastoma, developing symptoms and signs of central hearing loss based on audiometric and MRI/diffusion tensor imaging studies. Though rare, central hearing loss should be considered among the causes of sensorineural hearing loss in children. Laryngoscope, 2024
Hot spots drive uptake and short‐term processing of organic and inorganic carbon and nitrogen in intertidal sediments
Authors: Riekenberg Philip M. , Eyre Bradley D. , van der Meer Marcel T. J. , Oakes Joanne M.
Published: September 2024

This study uses dual‐labeled (13C and 15N) stable isotope applications to examine microbial uptake and short‐term processing of carbon (C) and nitrogen (N) from organic and inorganic compounds in subtropical intertidal sediment. Four treatment applications were applied: (1) algal dissolved organic matter (DOM), (2) amino acid mixture, (3) glucose and , and (4) NaHCO3 and to assess bioavailability effects on processing (1 vs. 2) and short‐term processing for OM fixed via microphytobenthos only (pennate diatom dominated) (4) vs. material taken up by the entire microbial community (3) across 24 h. 13C from algal‐DOM was preferentially used by the microbial community vs. 15N. At 24 h more 13C from algal‐DOM remained in microbial biomass indicating use of labeled precursor molecules to form biomass. Conversely, 13C from the amino acid treatment was not incorporated into biomass and was either rapidly respired to DIC or discarded as the in situ microbial community preferentially used and retained 15N from amino acids. Short‐term export of 13C as CO2 from glucose was lower than from microphytobenthos‐C, while retention of 15N from was similar between treatments (3 and 4) despite doubling the application N concentration, suggesting potentially higher glucose‐stimulated 15N export via nitrification–denitrification that was not confirmed via flux measurements in this study. Despite careful site selection for similar tidal exposure and sediment types among the three estuaries, the uptake and processing of labeled substrate varied substantially between replicates and sites which challenged traditional statistical analysis. Disproportionate processing of substrates occurring in sediment hotspots of microbial activity can cause variability spanning orders of magnitude which was found to be widespread through comparison of our results against 19 previous studies in intertidal settings. Development of robust analytical techniques to handle variability from abiotic and biotic factors will allow greater clarity surrounding in situ biogeochemical processing in intertidal environments.
Examining the Properties of (Co)Polymer Networks Prepared by the Phosphane‐Ene Reaction
Authors: Raoofi Mehrnoosh S. , Bosso Jessica L. , Noël James J. , Blacquiere Johanna M. , Gilroy Joe B. , Ragogna Paul J.
Published: September 2024

Polymer networks have emerged as materials with widespread application, including their use in drug delivery, catalysis, and flexible electronics. They have traditionally been derived from organic building blocks using well‐developed reaction types. Advances in main group synthetic chemistry have opened the door for the production of new polymer networks, including those containing phosphorus atoms that offer the traits of Lewis basic phosphorus centers. Here, the radical‐catalyzed phosphane‐ene reaction is used to prepare (co)polymer networks from iBuPH2, trivinyltriptycene (TVT), and 1,3,5‐triallyl‐1,3,5‐triazine‐2,4,6‐trione (TTT), which are the first of their type to include TVT. Networks rich in TVT exhibited greater thermal stability and reduced network mobility compared to those rich in TTT. Despite the rigidity, 3D, and internal free volume associated with the triptycene units present in TVT‐rich networks, their swellability is similar to networks rich in TTT indicating that the presence of phosphines may be a dominating factor in the respective structure‐property relationships.
On locally finite groups whose derived subgroup is locally nilpotent
Authors: Trombetti Marco
Published: September 2024

A celebrated theorem of Helmut Wielandt shows that the nilpotent residual of the subgroup generated by two subnormal subgroups of a finite group is the subgroup generated by the nilpotent residuals of the subgroups. This result has been extended to saturated formations in Ballester‐Bolinches, Ezquerro, and Pedreza‐Aguilera [Math. Nachr. 239–240 (2002), 5–10]. Although Wielandt's result is not true in arbitrary locally finite groups, we are able to extend it (even in a stronger form) to homomorphic images of periodic linear groups. Also, all results in Ballester‐Bolinches, Ezquerro, and Pedreza‐Aguilera [Math. Nachr. 239–240 (2002), 5–10] are extended to locally finite groups, so it is possible to characterize the class of locally finite groups with a locally nilpotent derived subgroup as the largest subgroup‐closed saturated formation such that, for all ‐closed saturated formations , the ‐residual of an ‐group generated by ‐subnormal subgroups is the subgroup generated by their ‐residuals. Our proofs are based on a reduction theorem that is of an independent interest. Furthermore, we provide strengthened versions of Wielandt's result for other relevant classes of groups, among which we mention the class of paranilpotent groups. A brief discussion on the permutability of the residuals is given at the end of the paper.
Transforming the electronic health record from a documentation application to an automated diet program for personalizing neonatal nutrition and improving feeding administration safety through process improvement
Authors: Owen Alisha Harmeson , Husain Ameena , ElHalta David , Chen Suzie A. , Spackman Jennifer , Murphy Jennifer , Chan Belinda
Published: September 2024

Delivering adequate nutrition to preterm and sick neonates is critical for growth. Infants in the neonatal intensive care unit (NICU) require additional calories to supplement feedings for higher metabolic demands. Traditionally, clinicians enter free‐text diet orders for a milk technician to formulate recipes, and dietitians manually calculate nutrition components to monitor growth. This daily process is complex and labor intensive with potential for error. Our goal was to develop an electronic health record (EHR)–integrated solution for entering feeding orders with automated nutrition calculations and mixing instructions. The EHR‐integrated automated diet program (ADP) was created and implemented at a 52‐bed level III academic NICU. The configuration of the parenteral nutrition orderable item within the EHR was adapted to generate personalized milk mixing recipes. Caloric, macronutrient, and micronutrient constituents were automatically calculated and displayed. To enhance administration safety, handwritten milk bottle patient labels were substituted with electronically generated and scannable patient labels. The program was further enhanced by calculating fortifier powder displacement factors to improve mixing precision. Order entry was optimized to allow for more complex mixing recipes and include a preference list of frequently ordered feeds. The EHR‐ADP's safeguarded features allowed for catching multiple near‐missed feeding administration errors. The NICU preterm neonate cohort had an average of 6‐day decrease (P = 0.01) in the length of stay after implementation while maintaining the same weight gain velocity. The EHR‐ADP may improve safety and efficiency; further improvements and wider utilization are needed to demonstrate the growth benefits of personalized nutrition.
Effect of surface treatment on interface properties of carbon fiber reinforced PA6 composites during overmolding
Authors: Kang Dongxu , Qin Yinle , Zhang Xiaoyang , Han Keqing , Cheng Lele , Zhang Yichen , Sun Zeyu , Dai Jinyin , Yu Muhuo
Published: September 2024

Carbon fiber‐reinforced thermoplastic composites have the advantages of lightweight and high strength and have broad application prospects in automotive lightweighting. This study uses the Overmolding process to mold carbon fiber‐reinforced nylon 6 composite materials. By using laser surface treatment and preheating technology, the interfacial bonding performance of the composite material is emphasized. By optimizing the embedding temperature, it was observed that the in‐plane shear strength increased by 13 times to 70 MPa, and the tensile strength increased by 10 times to 44 MPa. Similarly, by adjusting the melting temperature, the in‐plane shear strength was significantly improved, and the mechanical interlock and interfacial bonding were effectively enhanced by laser surface treatment, achieving the same effect as embedding preheating. By establishing a finite element model, the in‐plane tensile and in‐plane shear at the interface were accurately simulated, and the progressive failure process of the interface layer was successfully predicted.

Highlights

Laser energy density strengthens the overmolding interface.

Optimizing insert, mold, and melt temperatures enhances interface bonding.

Shear and tensile tests reveal differences in interface failure behavior.

Finite element model accurately simulates overmolding interface failure.

Laser treatment and temperature control are key to stronger interfaces.