bluuebunny/crossref_metadata_2025 huggingface dataset:
Conclusion
Authors: Altuntaş-Çakır Ravza
Published: May 2023

The conclusion provides a set of reflections on Muslim democracy in a comparative political theory approach. A restatement is made of the necessity of the deconstruction of normative principles explicit in liberal democratic institutions followed by their reconstruction through the insights derived from Islamic political and multiculturalist typologies. The normative case is argued for institutions conceptualised in a political theory of Muslim democracy and its ability to offer a systematic alternative not only to existing pragmatist models of Islamic democracy, but also to orthodox liberal theory.
‘Camelot is a State of Mind’: Professional Product, Independent Spirit, 1979–1982
Authors: Fallows Tom
Published: May 2023

Chapter 3 follows Laurel’s transition into a publicly traded company, surveying the influence this exerted on production content, infrastructure and Romero’s on-set autonomy. Such professionalisation has been under-explored in regard to independent filmmaking, appearing to contradict a rhetoric that situates the sector above corporate and regulatory interests. What these standardised systems of governance meant to Laurel as an independent film practitioner is measured against this apparent dichotomy. In part, this chapter is a remedial to the idealisation of independent cinema, yet Laurel’s professionalisation also sat at odds with the firm’s own anti-establishment corporate identity. A case study of Romero’s Knightriders assays the techniques employed to reassert (or reconfigure) an identity of dissent, with Laurel’s changing structures of governance disclosing an entirely new reading of the film, one that conveys a growing ambivalence regarding a so-called ‘spirit of independence’.
The Once and Future King: Agency and the Limits of Control, 1981–1985
Authors: Fallows Tom
Published: May 2023

Chapter 4 foregrounds agency. The chapter begins by framing Laurel within wider institutional circumstances, looking closely at agency in relation to marketplace trends and the implications on the company’s projects-in-development. A case study of Laurel’s unproduced collaboration with Marvel Comics, entitled Copperhead, asks how such material reflected the firm’s wider objectives and unrealised plans. Against this background, the material affairs that undermined Romero’s creative authority and altered his intent for Day of the Dead are revealed. The chapter concludes by reviewing ‘agency theory’ as a principle of economics, allowing a clearer understanding of the ‘agency relationship’ between Laurel’s co-founders, not least in terms of the conflicting objectives that culminated in Romero’s departure from the company on 19 June 1985.
Character, Writing, and Reputation in Victorian Law and Literature
Authors: Frank Cathrine O.
Published: May 2023

Character, Writing, and Reputation in Victorian Law and Literature is a cultural and narratological study that takes the Victorian obsession with character at face value. Focused on the second half of the nineteenth century and offering new readings of novels by George Eliot, Anne Bronte, Anthony Trollope, Robert Louis Stevenson and Oscar Wilde in conjunction with legal treatises, legislative debate, rules of evidence, and select case law, it pairs literary strategies for characterization with legal developments focused on forms of character evidence, on the reputational harm of libel, and on the increasing value of a legal protection for privacy.
An introduction and five chapters bring together these cognate areas of law into what can be called a jurisprudential theory of character whose operation depends on the dynamics of secrecy and disclosure: between the legal allocation of responsibility in the construction of a criminal case and the allocation of narrative attention in the construction of the novel, both forms adjust the tension between an individual’s, or character’s, capacity to limit access to information and law’s, or literature’s, capacity to compel it in ways that emphasize the importance of individual character-building to the formation and maintenance of communal boundaries as well. Moreover, by utilizing forms of character talk, these processes highlight the narrative underpinnings of legal and literary realities: if it seems self-evident that the novel is a character-system, this book aims to make it equally obvious that law is a character-system, too.
Introduction: Character-Building: Narrative Theory, Narrative Jurisprudence, and the Idea of Character
Authors: Frank Cathrine O.
Published: May 2023

The introduction considers the prevalence and diverse applications of the term character in the nineteenth-century. Retracing studies of character focused on the eighteenth-century novel and the romanticization of character as psychological depth, it provides background for a new exploration of how this understanding of character was formally applied or challenged in legal and literary narratives. From The Scarlet Letter to The Picture of Dorian Gray, the novels discussed provide access to character through the dynamics of secrecy and disclosure, or through the allocation of responsibility or liability for wrongdoing, both of which are shown to hinge on a third dynamic, the narrative control of talk. Working from Catherine Gallagher’s premise that the novel’s provision of access to an inner life signaled its fictionality, this study asks how law participated in the creation of that inner life, how it protected it, and under what conditions it could assume the power to compel disclosure.
Incriminating Character: Revisiting the Right to Silence in Adam Bede and The Scarlet Letter
Authors: Frank Cathrine O.
Published: May 2023

Looked at from a literary-aesthetic and socio-legal perspective, The Scarlet Letter (1851) and Adam Bede (1859) offer a window into a mid-century discourse of character that coincides with contemporary legal discussion of witness competency, the privilege against self-incrimination, and the broader effort to define and allocate responsibility for wrongful actions. Both Hawthorne and Eliot return to an earlier period to explore the effects of remaining silent in the face of pressure to speak. Although the silencing of the accused had relieved this pressure by the time both novels were being written, efforts to dismantle the protection in the interests of gathering the best evidence were also underway. Accused of crime and compelled to speak, both Hester Prynne and Hetty Sorrel appear to exercise a right to silence that did not exist in the historical settings of either novel. For readers in the 1850s, however, the right to silence offered a different way to interpret an absence of women’s speech that would have resonated not only in the legal debate over witness competency, but in the context of women’s political speech, professional writing, and other forms of transgressive individualism.
The English Dreyfus Case: Status as Character in an Illiberal Age
Authors: Frank Cathrine O.
Published: May 2023

Chapter 5 reads Arthur Conan Doyle’s true crime writing in “The Case of George Edalji” (1907) alongside Julian Barnes’s novel Arthur and George (2005). Doyle reclaimed convicted solicitor George Edalji’s character by reconstructing the case against him and highlighting the impact of presumptions about race, ethnicity and national identity, or group-based character, on determinations of an individual’s capacity for criminal behavior. Pitting cosmopolitan newspaper coverage against local report, the Home Secretary against regional authorities, and English values against the French example of Dreyfus, Doyle’s account also drew attention to the impact of the venues where it was tried, especially the absence of a formal Court of Appeal. This chapter argues that Julian Barnes’s recreation of the relationship between Doyle and Edalji enables a comparison of legal, journalistic, and fictional narratives of characters that highlights the role of narrative jurisprudence as an exemplary way of allocating narrative attention within the jurisprudential theory of character. Further, the novel’s publication in 2005 coincides with what Nicola Lacey refers to as the “resurgence of character” or the return of “status” and “character determinism” to processes of assigning responsibility for crimes (173).
Symbolic Economies of Poet and Patron
Authors: Rosenthal Adam R.
Published: May 2023

Chapter Two turns from figures of inspiration and genius, to the relays that constitute patronage structures for Classical and European authors. The institutions of patronage allow for the circulation of the poem, all while maintaining the poem’s distance from the commercial realm, and preventing its designation as a mere commodity. Though, in point of fact, the gap between the market and relays of patronage has never been absolute, as Bourdieu and others have shown, patronage constitutes one of the principal institutions through which aesthetic objects appear to maintain their distance from commercial ones.
Shelley and the Gift of the Name
Authors: Rosenthal Adam R.
Published: May 2023

This chapter offers a reading of Shelley’s ‘Hymn to Intellectual Beauty.’ After addressing earlier readings of the poem, which focus on Shelley’s Platonism, it turns to the ways in which the poem problematizes its own acts of naming. The ‘Hymn’ at once posits its object as ‘Intellectual Beauty’, and shows how its naming of ‘Intellectual Beauty’ in fact fails—or might fail. In this way, the chapter concludes, one can see how Shelley dealt with the traditional function of the poet as name-giver and, in problematizing this function, ultimately produced a similar vision of the poetic work to those later seen in Stein and Heidegger.
Love: Differentiating Groups, Faciality and the Black Hole/White Wall System
Authors: Dutton James
Published: May 2023

Engaging with what both Deleuze and Derrida have written about iterability and repetition, this chapter examines the depiction of love in the Recherche as a complex idealization of a beloved’s conflicting iterations. It explores the shared trope of the face in both Derrida and Deleuze to interpret the drastic attention the Proustian narrator pays to his beloveds’ essential unknowability. It reads specific scenes in the Recherche that dramatize this infinity, including the attention paid to extracting the narrator’s beloved Albertine from her petite bande, as well as “remembering” multiple, conflicting versions of a mole on her face, and the atavistic vision he forges of her sleep. Following that, it takes up Deleuze and Guttarri’s rich, yet almost entirely ignored conception of signification and subjectivity in Mille Plateaux—the black hole/white wall system—to describe the abyssal, literature-like infinity that the beloved plunges the lover beneath. While presenting a significant new reading of a key idea from Deleuze’s œuvre, this model also helps to express the workings of “imaginable” infinity. In concert with Derrida’s thoughts on the idealizing abyss of signification, this concept marries Proust’s depiction of love to the interminable movement of becoming in the novel itself.
Jealousy: Absolute Knowledge as a Dream (of) Writing
Authors: Dutton James
Published: May 2023

Jealousy in the Recherche is tied to the literary imagination, of constructing possible fictions that colour the “sense” of the beloved. This chapter considers Derrida’s reading of the relationship between jealousy and the visual as the invocation of a project towards absolute knowledge to develop an understanding of the infinite production of jealousy’s fictions. Drawing on Derrida and Freud, I suggest that Proust’s jealous lovers experience an overlaid temporality of infinite compossibility—jealousy writes its fictions from multiple, often conflicting versions of the beloved’s image and testimony, and applies the contradictions and verifications (which become the same thing) of these to further generate its veracities, interrogations, and moreover, the sense of its fictions. This “mystic writing pad” has an intimate relation to the significance of inscription, one evident in the Freudian/Derridean reading, but, more unusually, also in Proust’s. Such overlaying phenomenality functions in the same way that Proust describes the sense of dreams: jealousy’s fictions weave together equally possible and impossible versions of the same beloved, giving the lover a richer image of infinity that, like the text of the Recherche itself, is always becoming denser, more dynamic, and more impossible to define.
Grief: The Spectre and the Impossibility of Mourning (Writing)
Authors: Dutton James
Published: May 2023

This chapter suggests a reading of mourning that emphasizes the virtual weaving of absence in Proust’s fiction, and examines how Proust responds to the impossible literary depiction of death. In doing so, a unique model for reading literature—reading reading—emerges: one that has significant implications for theories of literature, psychology and affect. How can an author definitively expel a character who, existing only from and as words, needs only words to come back to “life”? Proust considers this aporia from the intimately spectral perspective of literature’s “life”. And fittingly for a novel structured on deferral, he defers his answer to the question of how to write mourning and death, preferring to die instead, leaving each of his readers to learn for themselves this work of mourning as it becomes their reading of his text. This thanatological end-game sketches out broad consequences for human subjectivity, emerging from Proust’s investment in the virtual power of the literary imagination.
A Study on the Usage of Probiotics as a Safer Antipyretic
Authors: Shrivastava Shantanu , Bhatu Nimisha
Published: May 2023

Most medicines and supplements which include probiotics have both expected clinical outcomes and unwanted side effects, which plays a major role when considering them as a mode of treatment. This review is an update about the advantages and disadvantages associated with the use of probiotics as part of a safe therapeutic armamentarium in health and other diseases. The advantages of probiotics run across multiple tissue systems in the body and a has a wide age spectrum. Probiotics also promote cardiovascular health, accelerate recovery from the condition of antibiotic-associated diarrhoea, decrease the effect of necrotizing enterocolitis with reduced inflammation, and accelerate the healing of the wound. Probiotics also contribute in treating chronic diseases for patients with type 2 diabetes as well as patients with HIV/AIDS. Moreover, probiotics play an important role in the treatment and/or prevention of cancers, especially those of the colon and bladder. On the other hand, probiotics also mimic serious threats to immunocompromised, genetically predisposed bodies, children, and newborns. Using probiotics may lead to bacteremia, fungemia, or septicemia when consumed more. Also, probiotics are found as a causative agent for pneumonia and abdominal abscesses, increase platelet aggregation, and promote antibiotic resistance among others. A huge number of microorganisms inhabit the human gut and consequently cause a compound network of the interactions of those organisms with each other and within the host cells, which stresses the requirement of extra caution in the use of probiotics as treatment therapy.
PENERAPAN TEKNOLOGI BUDIKDAMBER DALAM PEMANFAATAN LAHAN PEKARANGAN
Authors: Rina Astarika  , Deki Zulkarnain  , Muhammad Tair  , Darmatasiah
Published: May 2023

Tujuan kegiatan Ipteks bagi masyarakat desa Semau Kabupaten Tanjung Jabung Barat melalui Teknologi Budidaya Budikdamber (budidaya ikan dan sayuran dalam ember) adalah : (1) Meningkatkan kemampuan kecakapan hidup (life skill) ibu rumah tangga  dan pemuda/pemudi desa Semau, (2) Memberikan pemahaman kepada masyarakat desa Semau tentang budidiaya  budikdamber dan manfaat yang dihasilkan, (3) Menimbulkan semangat wirausaha masyarakat  dengan pemanfaatan teknologi tepat guna guna berbasis sumberdaya alam yang ramah lingkungan dan (4) meningkatkan pendapatan warga desa sekaligus menciptakan kemandirian masyarakat desa. Permasalahan yang dihadapi masyarakat desa Semau Kabupaten Tanjung Jabung Barat adalah bagaimana upaya meningkatkan taraf ekonomi mereka dengan keterbatasan keahlian yang dimiliki dan sumber daya  desa yang terbatas. Mata pencaharian penduduk desa Semau adalah berkebun, padahal wilayah desa Semau merupakan lahan pasang surut yang tidak cocok digunakan untuk tanaman perkebunan.  Banyak lahan di desa Semau dibiarkan begitu saja sehingga menjadi tidak produktif. Berangkat dari permasalahan tersebut maka dilaksanakan kegiatan penerapan tekonologi budidaya ikan dan sayuran dalam ember (Teknologi Budikdamber) kepada masyarakat desa Semau. Metode pelaksanaan yang dilakukan adalah dengan : (1) Mengenalkan pemanfaatan lahan pekarangan di daerah pasang surut (2) Mengenalkan dan memberikan informasi tentang berbagai teknologi tepat guna yang ramah lingkungan kepada masyarakat, (3) pelatihan /pendampingan paket teknologi budidaya budikdamber, (4) pelatihan/pendampingan pembuatan hidroponik tanpa listrik menggunakan panel sutra dan (5) pelatihan/pendampingan pemasaran hasil panen teknologi budikdamber. Hasil dari kegiatan ini adalah mulai berkembangnya teknologi tepat guna di desa semau, meningkatnya pengetahuan dan keterampilan masyarakat tentang teknologi tepat guna yang ramah lingkungan, meningkatnya pendapatan, serta menciptakan kemandirian dan lapangan kerja.
Field evaluation of the sex pheromone of the cacao pod borer (Conopomorpha cramerella Snellen) in the Philippines
Authors: Amalin Divina M. , Arcelo Mercedes , Almarinez Billy Joel M. , Castillo Rhodina C. , Legaspi Jesusa C. , Santos Kris Lord T. , Tavera Mary Angelique A. , Janairo Jose Isagani B. , Zhang Aijun
Published: May 2023

Cacao is a promising high-value crop in the Philippines and is considered one of the key players globally in providing the raw materials for chocolate making. However, before the Philippines can take this market opportunity, production constraints from various pests should be addressed. The cacao pod borer (CPB), Conopomorpha cramerella, is one of the major insect pests of cacao in the Philippines, which can cause up to 50% annual loss or even higher if proper management is not employed. Management of CPB heavily relies on chemical control but is becoming unpopular because of its high cost and health risk to people and the environment. A number of efforts have been made to develop sex pheromones to monitor and control CPB. A field bioassay of the new blend of CPB sex pheromones was conducted in southern Philippines to determine its efficiency and identify the appropriate trap height placement in a cacao field, which is important in maximizing the efficiency of the sex pheromone traps for inclusion in the integrated pest management (IPM) program of CPB. Pheromone lures at four different trap heights (1.0 m, 0.5 m above the canopy, 0.0 m or along the canopy, and 0.5 m below the canopy) and a blank lure (control) placed 1.0 m above the canopy were evaluated in terms of male CPB trap catches. Results showed significantly higher male CPB trap catches when installed at least 0.5 m above the canopy while minimal to zero male CPB catches were obtained from the control traps with blank lures, confirming the attractiveness of the new blend of the CPB sex pheromone in the field. This suggests the reliability of the pheromone-based method to monitor and control CPB and as a major component of the IPM program.
A highly generalized classifier for osteoporosis radiography based on multiscale fractal, lacunarity, and entropy distributions
Authors: Cui Jingnan , Liu Cheng Lei , Jennane Rachid , Ai Songtao , Dai Kerong , Tsai Tsung-Yuan
Published: May 2023

Background: Osteoporosis is a common degenerative disease with high incidence among aging populations. However, in regular radiographic diagnostics, asymptomatic osteoporosis is often overlooked and does not include tests for bone mineral density or bone trabecular condition. Therefore, we proposed a highly generalized classifier for osteoporosis radiography based on the multiscale fractal, lacunarity, and entropy distributions.

Methods: We collected a total of 104 radiographs (92 for training and 12 for testing) of lumbar spine L4 and divided them into three groups (normal, osteopenia, and osteoporosis). In parallel, 174 radiographs (116 for training and 58 for testing) of calcaneus from health and osteoporotic fracture groups were collected. The texture feature data of all the radiographs were pulled out and analyzed. The Davies–Bouldin index was applied to optimize hyperparameters of feature counting. Neighborhood component analysis was performed to reduce feature dimension and increase generalization. A support vector machine classifier was trained with only the most effective six features for each binary classification scenario. The accuracy and sensitivity performance were estimated by calculating the area under the curve.

Results: Interpretable feature trends of osteoporotic pathological changes were depicted. On the spine test dataset, the accuracy and sensitivity of binary classifiers were 0.851 (95% CI: 0.730–0.922), 0.813 (95% CI: 0.718–0.878), and 0.936 (95% CI: 0.826–1) for osteoporosis diagnosis; 0.721 (95% CI: 0.578–0.824), 0.675 (95% CI: 0.563–0.772), and 0.774 (95% CI: 0.635–0.878) for osteopenia diagnosis; and 0.935 (95% CI: 0.830–0.968), 0.928 (95% CI: 0.863–0.963), and 0.910 (95% CI: 0.746–1) for osteoporosis diagnosis from osteopenia. On the calcaneus test dataset, they were 0.767 (95% CI: 0.629–0.879), 0.672 (95% CI: 0.545–0.793), and 0.790 (95% CI: 0.621–0.923) for osteoporosis diagnosis.

Conclusion: This method showed the capacity of resisting disturbance on lateral spine radiographs and high generalization on the calcaneus dataset. Pixel-wise texture features not only helped to understand osteoporosis on radiographs better but also shed new light on computer-aided osteopenia and osteoporosis diagnosis.
Personalization of human body models and beyond via image registration
Authors: Li Xiaogai , Yuan Qiantailang , Lindgren Natalia , Huang Qi , Fahlstedt Madelen , Östh Jonas , Pipkorn Bengt , Jakobsson Lotta , Kleiven Svein
Published: May 2023

Finite element human body models (HBMs) are becoming increasingly important numerical tools for traffic safety. Developing a validated and reliable HBM from the start requires integrated efforts and continues to be a challenging task. Mesh morphing is an efficient technique to generate personalized HBMs accounting for individual anatomy once a baseline model has been developed. This study presents a new image registration–based mesh morphing method to generate personalized HBMs. The method is demonstrated by morphing four baseline HBMs (SAFER, THUMS, and VIVA+ in both seated and standing postures) into ten subjects with varying heights, body mass indices (BMIs), and sex. The resulting personalized HBMs show comparable element quality to the baseline models. This method enables the comparison of HBMs by morphing them into the same subject, eliminating geometric differences. The method also shows superior geometry correction capabilities, which facilitates converting a seated HBM to a standing one, combined with additional positioning tools. Furthermore, this method can be extended to personalize other models, and the feasibility of morphing vehicle models has been illustrated. In conclusion, this new image registration–based mesh morphing method allows rapid and robust personalization of HBMs, facilitating personalized simulations.
A concise in vitro model for evaluating interactions between macrophage and skeletal muscle cells during muscle regeneration
Authors: Kase Naoya , Kitagawa Yohko , Ikenaka Akihiro , Niwa Akira , Saito Megumu K.
Published: May 2023

Skeletal muscle has a highly regenerative capacity, but the detailed process is not fully understood. Several in vitro skeletal muscle regeneration models have been developed to elucidate this, all of which rely on specialized culture conditions that limit the accessibility and their application to many general experiments. Here, we established a concise in vitro skeletal muscle regeneration model using mouse primary cells. This model allows evaluation of skeletal muscle regeneration in two-dimensional culture system similar to a typical cell culture, showing a macrophage-dependent regenerative capacity, which is an important process in skeletal muscle regeneration. Based on the concept that this model could assess the contribution of macrophages of various phenotypes to skeletal muscle regeneration, we evaluated the effect of endotoxin pre-stimulation for inducing various changes in gene expression on macrophages and found that the contribution to skeletal muscle regeneration was significantly reduced. The gene expression patterns differed from those of naive macrophages, especially immediately after skeletal muscle injury, suggesting that the difference in responsiveness contributed to the difference in regenerative efficiency. Our findings provide a concise in vitro model that enables the evaluation of the contribution of individual cell types, such as macrophages and muscle stem cells, on skeletal muscle regeneration.
Esophageal microflora in esophageal diseases
Authors: Zou Qian , Feng Lijuan , Cai Xunchao , Qian Yun , Xu Long
Published: May 2023

With the development of endoscopic technology, an increasing number of patients with esophageal disease are being diagnosed, although the underlying pathogenesis of many esophageal diseases remains unclear. In recent years, a large number of studies have demonstrated that the occurrence and development of various intestinal diseases were related to intestinal flora. As a result, researchers have shifted their focus towards investigating esophageal flora to better understand the pathogenesis, early diagnosis, and treatment of esophageal diseases. This paper reviewed the normal esophageal flora and the changes of esophageal flora under different esophageal disease states. It was observed that there are distinct differences in the composition of esophageal microflora among Gastroesophageal Reflux, Barrett’s esophagus, eosinophilic esophagitis and normal esophagus. The normal esophageal flora was dominated by gram-positive bacteria, particularly Streptococcus, while the esophageal flora under esophagitis was dominated by gram-negative bacteria. Furthermore, the diversity of esophageal flora is significantly decreased in patients with esophageal cancer. Several potential microbial biomarkers for esophageal cancer have been identified, among which Fusobacterium nucleatum showed a close association with esophageal squamous cell carcinoma’s pathological stage and clinical stage.
Different heart failure phenotypes of valvular heart disease: the role of mitochondrial dysfunction
Authors: Zhang Shenghui , Liu Cheng , Zhang Yingyuan , Wu Zongjian , Feng Kaiwei , Lai Yanxian , Pei Jingxian , Guan Tianwang
Published: May 2023

Valvular heart disease (VHD)-related heart failure (HF) is a special subtype of HF with an increasingly concerned heterogeneity in pathophysiology, clinical phenotypes, and outcomes. The mechanism of VHD-related HF involves not only mechanical damage to the valve itself but also valve lesions caused by myocardial ischemia. The interactions between them will lead to the occurrence and development of VHD-related HF subtypes. Due to the spatial (combination of different valvular lesions) and temporal effects (sequence of valvular lesions) of valvular damages, it can make the patient's condition more complicated and also make the physicians deal with a dilemma when deciding on a treatment plan. This indicates that there is still lack of deep understanding on the pathogenic mechanism of VHD-related HF subtypes. On the other hand, mitochondrial dysfunction (MitD) is not only associated with the development of numerous cardiac diseases such as atherosclerosis, hypertension, diabetes, and HF but also occurs in VHD. However, the role of MitD in VHD-related HF is still not fully recognized. In this comprehensive review, we aim to discuss the current findings and challenges of different valvular damages derived from HF subtypes as well as the role of MitD in VHD-related HF subtypes.
Hypoglycemia risk with physical activity in type 1 diabetes: a data-driven approach
Authors: Prasanna Sahana , Barua Souptik , Siller Alejandro F. , Johnson Jeremiah J. , Sabharwal Ashutosh , DeSalvo Daniel J.
Published: May 2023

Physical activity (PA) provides numerous health benefits for individuals with type 1 diabetes (T1D). However, the threat of exercise-induced hypoglycemia may impede the desire for regular PA. Therefore, we aimed to study the association between three common types of PA (walking, running, and cycling) and hypoglycemia risk in 50 individuals with T1D. Real-world data, including PA duration and intensity, continuous glucose monitor (CGM) values, and insulin doses, were available from the Tidepool Big Data Donation Project. Participants' mean (SD) age was 38.0 (13.1) years with a mean (SD) diabetes duration of 21.4 (12.9) years and an average of 26.2 weeks of CGM data available. We developed a linear regression model for each of the three PA types to predict the average glucose deviation from 70 mg/dl for the 2 h after the start of PA. This is essentially a measure of hypoglycemia risk, for which we used the following predictors: PA duration (mins) and intensity (calories burned), 2-hour pre-exercise area under the glucose curve (adjusted AUC), the glucose value at the beginning of PA, and total bolus insulin (units) within 2 h before PA. Our models indicated that glucose value at the start of exercise and pre-exercise glucose adjusted AUC (p < 0.001 for all three activities) were the most significant predictors of hypoglycemia. In addition, the duration and intensity of PA and 2-hour bolus insulin were weakly associated with hypoglycemia for walking, running, and cycling. These findings may provide individuals with T1D with a data-driven approach to preparing for PA that minimizes hypoglycemia risk.
Physiological iodine uptake of the spine’s bone marrow in dual-energy computed tomography – using artificial intelligence to define reference values based on 678 CT examinations of 189 individuals
Authors: Fervers Philipp , Fervers Florian , Rinneburger Miriam , Weisthoff Mathilda , Kottlors Jonathan , Reimer Robert , Zopfs David , Celik Erkan , Maintz David , Große-Hokamp Nils , Persigehl Thorsten
Published: May 2023

Purpose

The bone marrow’s iodine uptake in dual-energy CT (DECT) is elevated in malignant disease. We aimed to investigate the physiological range of bone marrow iodine uptake after intravenous contrast application, and examine its dependence on vBMD, iodine blood pool, patient age, and sex.

Method

Retrospective analysis of oncological patients without evidence of metastatic disease. DECT examinations were performed on a spectral detector CT scanner in portal venous contrast phase. The thoracic and lumbar spine were segmented by a pre-trained neural network, obtaining volumetric iodine concentration data [mg/ml]. vBMD was assessed using a phantomless, CE-certified software [mg/cm3]. The iodine blood pool was estimated by ROI-based measurements in the great abdominal vessels. A multivariate regression model was fit with the dependent variable “median bone marrow iodine uptake”. Standardized regression coefficients (β) were calculated to assess the impact of each covariate.

Results

678 consecutive DECT exams of 189 individuals (93 female, age 61.4 ± 16.0 years) were evaluated. AI-based segmentation provided volumetric data of 97.9% of the included vertebrae (n=11,286). The 95th percentile of bone marrow iodine uptake, as a surrogate for the upper margin of the physiological distribution, ranged between 4.7-6.4 mg/ml. vBMD (p <0.001, mean β=0.50) and portal vein iodine blood pool (p <0.001, mean β=0.43) mediated the strongest impact. Based thereon, adjusted reference values were calculated.

Conclusion

The bone marrow iodine uptake demonstrates a distinct profile depending on vBMD, iodine blood pool, patient age, and sex. This study is the first to provide the adjusted reference values.
Major roles of kupffer cells and macrophages in NAFLD development
Authors: Park Soo-Jeung , Garcia Diaz Josefina , Um Eugene , Hahn Young S.
Published: May 2023

Non-alcoholic fatty liver disease (NAFLD) is an important public health problem with growing numbers of NAFLD patients worldwide. Pathological conditions are different in each stage of NAFLD due to various factors. Preclinical and clinical studies provide evidence for a crucial role of immune cells in NAFLD progression. Liver-resident macrophages, kupffer cells (KCs), and monocytes-derived macrophages are the key cell types involved in the progression of NAFLD, non-alcoholic steatohepatitis (NASH), and hepatocellular carcinoma (HCC). Their unique polarization contributes to the progression of NAFLD. KCs are phagocytes with self-renewal abilities and play a role in regulating and maintaining homeostasis. Upon liver damage, KCs are activated and colonized at the site of the damaged tissue. The secretion of inflammatory cytokines and chemokines by KCs play a pivotal role in initiating NAFLD pathogenesis. This review briefly describes the role of immune cells in the immune system in NAFLD, and focuses on the pathological role and molecular pathways of KCs and recruited macrophages. In addition, the relationship between macrophages and insulin resistance is described. Finally, the latest therapeutics that target KCs and macrophages are summarized for the prevention and treatment of NAFLD.
Association between weight-adjusted-waist index with hepatic steatosis and liver fibrosis: a nationally representative cross-sectional study from NHANES 2017 to 2020
Authors: Shen Yun , Wu Yahui , Fu Minghan , Zhu Kai , Wang Jinsheng
Published: May 2023

Background

The negative effects of obesity on hepatic steatosis and fibrosis have received considerable attention in recent years. The weight-adjusted-waist index (WWI) reflects weight-independent centripetal obesity. Herein, we provide the first investigation of a link between WWI, hepatic steatosis, and liver fibrosis.

Methods

We used data from the National Health and Nutrition Examination Survey 2017-2020 to conduct a cross-sectional study. The linear relationship between WWI, controlled attenuation parameters, and liver stiffness measurements (LSM) was investigated using multivariate linear regression models. The nonlinear relationship was described using fitted smoothed curves and threshold effect analyses. Subgroup analyses were performed based on gender, age, body mass index, diabetes, hypertension, drinking, and smoking.

Results

This population-based study included 7,594 people, 50.74% of whom were men and 49.26% of whom were women. Multivariate linear regression analysis revealed a significant positive relationship between WWI and hepatic steatosis [CAP, β=7.60, 95% confidence interval (CI) (4.42, 10.78), P<0.0001]. This positive association was stronger when excessive alcohol intake was present compared to when it was absent (P for interaction = 0.031), and when hypertension was present compared to when it was not (P for interaction = 0.014). The linear relationship between WWI and liver fibrosis was not statistically significant on multiple regression analysis [LSM, β=0.03, 95% CI (-0.26, 0.32), P=0.84]. However, a U-shaped association was seen between WWI and LSM, with a negative correlation when WWI< 10.92 and a positive correlation when WWI > 10.92.

Conclusion

We report a strong association between WWI and hepatic steatosis, and suggest that it may potentially be used as a simple anthropometric index to predict hepatic steatosis.
Denosumab treatment and infection risks in patients with osteoporosis: propensity score matching analysis of a national-wide population-based cohort study
Authors: Huang Shih-Ting , Chiu Ting-Fang , Chiu Chih-Wei , Kao Yu-Nong , Wang I-Kang , Chang Chi-Tzung , Li Chi-Yuan , Sun Chung-Shu , Lin Cheng-Li , Yu Tung-Min , Kao Chia-Hung
Published: May 2023

Introduction

Denosumab demonstrates efficacy in reducing the incidence of hip, vertebral, and nonvertebral fractures in postmenopausal women with osteoporosis. We present a population-based national cohort study to evaluate the infection risks in patients with osteoporosis after long-term denosumab therapy.

Methods

We used the Taiwan National Health Insurance Research Database (NHIRD) to identify patients with osteoporosis. The case cohort comprised patients treated with denosumab. Propensity score (PS) matching was used to select denosumab nonusers for the control cohort. The study period was between August 2011 and December 2017. Our study comprised 30,106 pairs of case and control patients.

Results

Patients receiving denosumab therapy had high risks of the following infections: pneumonia and influenza (adjusted hazard ratio [aHR]: 1.33; 95% confidence interval [CI]: 1.27 -1.39), urinary tract infection (aHR: 1.36; 95% CI:1.32 -1.40), tuberculosis (aHR: 1.60; 95% CI: 1.36 -1.87), fungal infection (aHR: 1.67; 95% CI:1.46 -1.90), candidiasis (aHR: 1.68; 95% CI: 1.47 -1.93), herpes zoster infection (aHR: 1.27; 95% CI: 1.19 -1.35), sepsis (aHR: 1.54; 95% CI:1.43 -1.66), and death (aHR: 1.26; 95% CI: 1.20 -1.32). However, the longer the duration of denosumab treatment, the lower the risk patients had of developing infections.

Discussion

Denosumab therapy is associated with a higher infection risk at the early periods of treatment. Nevertheless, the risk attenuates significantly after the 2nd year of therapy. Clinicians should closely monitor infection status in patients with osteoporosis during the initial stages of denosumab therapy.
Is Australia weird? A cross-continental comparison of biological, geological and climatological features
Authors: Flores-Moreno Habacuc , Dalrymple Rhiannon L. , Cornwell Will K. , Popovic Gordana , Nakagawa Shinichi , Atkinson Joe , Cooke Julia , Laffan Shawn W. , Bonser Stephen P. , Schwanz Lisa E. , Crean Angela J. , Eldridge David J. , Garratt Michael , Brooks Robert C. , Vergés Adriana , Poore Alistair G. B. , Cohen David R. , Clark Graeme F. , Sen Gupta Alex , Reich Peter B. , Cornelissen J. Hans C. , Craine Joseph M. , Hemmings Frank A. , Kattge Jens , Niinemets Ülo , Peñuelas Josep , Moles Angela T.
Published: May 2023

Australia’s distinctive biogeography means that it is sometimes considered an ecologically unique continent with biological and abiotic features that are not comparable to those observed in the rest of the world. This leaves some researchers unclear as to whether findings from Australia apply to systems elsewhere (or vice-versa), which has consequences for the development of ecological theory and the application of ecological management principles. We analyzed 594,612 observations spanning 85 variables describing global climate, soil, geochemistry, plants, animals, and ecosystem function to test if Australia is broadly different to the other continents and compare how different each continent is from the global mean. We found significant differences between Australian and global means for none of 15 climate variables, only seven of 25 geochemistry variables, three of 16 soil variables, five of 12 plant trait variables, four of 11 animal variables, and one of five ecosystem function variables. Seven of these differences remained significant when we adjusted for multiple hypothesis testing: high soil pH, high soil concentrations of sodium and strontium, a high proportion of nitrogen-fixing plants, low plant leaf nitrogen concentration, low annual production rate to birth in mammals, and low marine productivity. Our analyses reveal numerous similarities between Australia and Africa and highlight dissimilarities between continents in the northern vs. southern hemispheres. Australia ranked the most distinctive continent for 26 variables, more often than Europe (15 variables), Africa (13 variables), Asia (12 variables each), South America (11 variables) or North America (8 variables). Australia was distinctive in a range of soil conditions and plant traits, and a few bird and mammal traits, tending to sit at a more extreme end of variation for some variables related to resource availability. However, combined analyses revealed that, overall, Australia is not significantly more different to the global mean than Africa, South America, or Europe. In conclusion, while Australia does have some unique and distinctive features, this is also true for each of the other continents, and the data do not support the idea that Australia is an overall outlier in its biotic or abiotic characteristics.
Systematic review and meta-analysis of women's awareness of obstetric fistula and its determinants in Ethiopia
Authors: Melis Tamirat , Mose Ayenew
Published: May 2023

Background

Although obstetric fistula has been extensively eliminated in high-income countries due to comprehensive obstetric health care services, in developing countries including Ethiopia, many women and girls are still silently suffering from obstetric fistula due to early marriage, poor socioeconomic status, lack of access to skilled birth attendants, and limited awareness of obstetric fistula.

Objective

To determine the magnitude of women's awareness of obstetric fistula and its contributing factors in Ethiopia.

Methods

To perform this analysis, we strictly adhered to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) recommendations. To evaluate publication bias, we employed an Egger's test and an eye assessment of the funnel plot's symmetry. To look for signs of study heterogeneity, the Cochrane Q-test and I2 statistics were used. A Microsoft Excel spreadsheet was used to extract the data, and STATA version 14 was used to analyze it.

Results

A total of six studies involving 3,024 women were included. The pooled prevalence of women's awareness of obstetric fistula in Ethiopia was 41.24% (95% CI; 32.94%−49.54%). Urban residence (AOR = 2.32, 95% CI: 1.40–3.85), giving birth at a health institution (AOR = 2.84, 95% CI: 1.92–4.21), having secondary or above educational status (AOR = 3.27, 95% CI: 2.15–4.97), receiving antenatal care follow-up (AOR = 2.73, 95% CI: 1.71–4.35), and participation in pregnant women's conferences (AOR = 4.64, 95% CI: 2.88–7.49) were factors associated with good awareness of obstetric fistula in women in Ethiopia.

Conclusion

The pooled prevalence of women's awareness of obstetric fistula was low. Urban residence, giving birth at a health institution, having secondary and above educational status, having antenatal care follow-up, and participating in pregnant women's conferences were factors associated with women's awareness of obstetric fistula. Therefore, enhancing women's awareness of obstetric fistula and promoting institutional delivery and antenatal follow-up is recommended. Furthermore, policymakers and stakeholders should empower women and pay particular attention to the neglected but important public health problem that is obstetric fistula.
PD-1/PD-L1 axis in organ fibrosis
Authors: Zhao Youliang , Qu Yaqian , Hao Changfu , Yao Wu
Published: May 2023

Fibrosis is a pathological tissue repair activity in which many myofibroblasts are activated and extracellular matrix are excessively accumulated, leading to the formation of permanent scars and finally organ failure. A variety of organs, including the lung, liver, kidney, heart, and skin, can undergo fibrosis under the stimulation of various exogenous or endogenous pathogenic factors. At present, the pathogenesis of fibrosis is still not fully elucidated, but it is known that the immune system plays a key role in the initiation and progression of fibrosis. Immune checkpoint molecules are key regulators to maintain immune tolerance and homeostasis, among which the programmed cell death protein 1/programmed death ligand 1 (PD-1/PD-L1) axis has attracted much attention. The exciting achievements of tumor immunotherapy targeting PD-1/PD-L1 provide new insights into its use as a therapeutic target for other diseases. In recent years, the role of PD-1/PD-L1 axis in fibrosis has been preliminarily explored, further confirming the close relationship among PD-1/PD-L1 signaling, immune regulation, and fibrosis. This review discusses the structure, expression, function, and regulatory mechanism of PD-1 and PD-L1, and summarizes the research progress of PD-1/PD-L1 signaling in fibrotic diseases.
Dietary disodium fumarate supplementation alleviates subacute ruminal acidosis (SARA)-induced liver damage by inhibiting pyroptosis via mitophagy-NLRP3 inflammasome pathway in lactating Hu sheep
Authors: Zhang Hongzhu , Shi Huimin , Zhou Shendong , Wei Guozhen , Xie Wan , Meng Meijuan , Chang Guangjun , Shen Xiangzhen
Published: May 2023

Liver damage is common in ruminants with subacute ruminal acidosis (SARA). Disodium fumarate (DF) could regulate rumen microbial community and neutralize ruminal organic acids. This study aimed to evaluate the effect of dietary DF supplementation on SARA-induced liver damage and investigate the underlying mechanism. The results showed that feeding a high-concentrate diet induced decreased rumen fluid pH and increased ruminal LPS. The rumen fluid pH in the HC group was less than 5.6 at 4 time points, indicating that SARA was successfully induced. The histopathological analysis showed that in the HC group, hemorrhage and inflammatory cell infiltration were observed in liver tissue. Using ELISA kits and biochemical analyzer, we identified that the contents of interleukin 1beta (IL-1β), interleukin 18 (IL-18), caspase-1, and the activity of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in hepatic vein were elevated in the HC group. However, DF supplementation increased rumen fluid pH value, decreased ruminal LPS, attenuated hemorrhage and inflammatory cell infiltration in the liver tissue, and decreased contents of IL-1β, IL-18, caspase-1, AST, and ALT in the hepatic vein. Real-time PCR and western blot analysis displayed that SARA-induced increased expression of pyroptosis-related proteins (GSDMD-NT) was attenuated in the HCDF group. Meanwhile, SARA induced increased expression of mitophagy and inflammasome-related proteins (MAP1LC3-II, PINK1, Parkin, cleaved-caspase-11, cleaved-caspase-1, NLRP3, and ASC) and elevated expression of inflammasome-related genes (NLRP3, CASP1, and ASC), which was reversed by DF supplementation. Moreover, SARA activated toll-like receptor 4 (TLR4)-nuclear factor kappa B (NF-κB) signaling pathway and inhibited the entry of forkhead box A2 (FOXA2) into the nucleus, which was reversed by DF supplementation. Collectively, our data suggest that dietary DF supplementation inhibited hepatocyte pyroptosis by regulating the mitophagy-NLRP3 inflammasome pathway and the NF-κB signaling pathway, thus alleviating SARA-induced liver damage in Hu sheep.