bluuebunny/crossref_metadata_2025 huggingface dataset:
A fuzzy cognitive map approach to selecting the best knowledge management strategy
Authors: Yadegari Mahdi , Mohammadi Shahriar
Published: November 2024

Purpose

Selecting an appropriate strategy can significantly influence an organization’s direction, but numerous interrelated factors make this decision complex and uncertain. Identifying these relationships and making informed decisions often involves navigating uncertainty. This paper aims to assist managers in leveraging the organization’s intellectual assets to select the most suitable knowledge management strategy.

Design/methodology/approach

This research proposes fuzzy cognitive maps to model and select the appropriate strategy. Given that knowledge is a company’s most valuable asset and its management is critical, the proposed method for selecting a knowledge management strategy was tested in one of Iran’s largest logistics companies. The factors influencing strategy adoption were treated as concepts in the fuzzy cognitive network, with evaluation criteria applied to three strategies: human-oriented, system-oriented and dynamic.

Findings

The model’s output identifies the most suitable strategy based on knowledge management principles and the specific characteristics of the target project within the organization. Compared to the most cited paper in this field, the proposed model shows a 0.15% improvement in sensitivity and a 0.22% improvement in separation degree.

Originality/value

This study proposes a novel method using fuzzy cognitive maps to assist organizations in selecting the best knowledge management strategy, even amidst multiple influencing factors and uncertain conditions.
Urban expansion and livelihood dynamics in peri‐urban Tamale, Ghana
Authors: Iddrisu Suale , Abass Kabila , Serbeh Richard , Dumedah Gift , Kwadwo Afriyie , Alhassan Joseph , Kpevu Gabriel Alexander , Gyasi Razak M
Published: November 2024

At the heart of this paper are concerns for food security and sustainability—two challenges of wide relevance for geographers. Our work focuses specifically on the Guinea northern savanna ecological zone of Ghana, where poverty is grim and livelihood opportunities are limited and the intersection of urban expansion and livelihood dynamics is not well understood. This study analysed trends in and effects of urban expansion on farmers’ livelihoods in four peri‐urban communities around Tamale in the Republic of Ghana. The study employed a mixed methods design comprising quantitative and qualitative methods. It used geospatial techniques, secondary data, and a qualitative study involving 56 heads of households and seven key informants. Results indicate that while the surface area of farmlands reduced by 77% from 1996 to 2023, urban or built‐up areas increased by 93% in the same period. Findings show that while urban expansion reduced the sizes of farmlands, households’ agricultural output, and income, it created nonfarm livelihood opportunities for some households. To minimise the effects of urbanisation‐induced arable land shrinkage, affected households adopted three strategies: agricultural intensification, agricultural diversification, and adoption of nonfarm livelihood activities. Key policy initiatives by the Tamale Metropolitan Assembly are needed to protect agricultural lands to stem declining agricultural production and to ensure livelihood sustainability in the metropolis.
Macroporous resins combined with UPLC‐QTRAP‐MS/MS for the purification and identification of 3‐deoxyanthocyanidins from Sorghum bicolor L. Moench and their bioactivities
Authors: Wu Yanbei , Yu Xueling , Ding Wei , Xin Mengmeng , Zhang Xu , Wang Lulu , Wang Huan , Wang Jing
Published: November 2024

3‐Deoxyanthocyanidins (3‐DAS) are the unique flavonoid compounds in sorghum. The majority of research to date have concentrated on the biological activity and extraction of 3‐DAS from sorghum and lacked systematic purification and identification investigations. Herein, a facile method for the purification of sorghum 3‐DAS from the acidic methanol solution crude extract using macroporous resins (MARs) was proposed and investigated in this work. Based on the experimental data, commercial MAR AB‐8 was selected to achieve the purification of sorghum 3‐DAS. The adsorption‐desorption experiment confirmed the optimal procedure. With this procedure, the total purity of 3‐DAS was 19.32%, and 3‐DAS content in the purified product was 8.4 times higher than that in the crude extract. UPLC‐QTRAP‐MS/MS identification indicated that the purified 3‐DAS product was mainly composed of apigeninidin, luteolinidin, and their methoxy derivatives. Besides, the purified product exhibited better bioactivities than the crude extract, including the scavenging activities for DPPH, ABTS+, and hydroxyl radicals, the total antioxidant capacity, and the inhibitory effects for α‐amylase, α‐glucosidase, and lipase. This work provides a potential way for the large‐scale purification of bioactive sorghum 3‐DAS from crude extract, which is significant to deepen the applications of sorghum 3‐DAS in the food nutrition and pharmaceutical industries.
Therapeutic potential of Lacticaseibacillus rhamnosus grx10 and its derived postbiotic through gut microbiota and MAPK/MLCK/MLC pathway‐mediated intestinal barrier repairment in ulcerative colitis
Authors: Ye Huilan , Liu Xiaolin , Guan Kaifang , Ma Ying , Liu Rongmei , Liu Yuxuan , Lv Xuepeng , Wang Rongchun , Li Qiming
Published: November 2024

Lacticaseibacillus rhamnosus grx10 (grx10) has shown promising potential in promoting intestinal health as predicted by genomic and metabolomic analyses. Given the increasing prevalence of ulcerative colitis (UC) and the limitations of existing treatments, exploring alternative therapeutic strategies is essential. This study explored the therapeutic effects and underlying mechanisms of grx10 and its derived postbiotic (P‐grx10) in a mouse model of dextran sulfate sodium (DSS)‐induced chronic UC. The intervention with grx10 and P‐grx10 significantly alleviated clinical symptoms and improved biochemical markers in UC mice. These effects included reducing the disease activity index (DAI), improving colon length and histopathological damage, decreasing the secretion of inflammatory cytokines, and preventing the reduction of antioxidant enzymes. Additionally, grx10 and P‐grx10 downregulated key proteins in the Mitogen‐Activated Protein Kinase (MAPK)/myosin light chain kinase (MLCK)/myosin light chain (MLC) pathway, prevented the dissociation of tight junction (TJ) proteins and E‐cadherin, reduced intestinal permeability, and restored the integrity of the intestinal barrier. Furthermore, both grx10 and P‐grx10 modulated the composition and abundance of gut microbiota, helping to maintain intestinal microbiome homeostasis. In conclusion, this study provided evidence regarding the role of grx10 and P‐grx10 in alleviating intestinal barrier dysfunction associated with UC and restoring gut microbiota balance. Notably, P‐grx10 exhibited higher anti‐inflammatory activity and better restoration of intestinal barrier function, whereas the live probiotic grx10 showed a stronger regulatory effect on the gut microbiota. These findings suggest that grx10 and P‐grx10 could serve as promising nutritional adjunct therapies for UC, providing novel insights into the distinct roles of probiotic and its derived postbiotic in UC treatment.
Integrated genome and metabolome mining unveiled structure and biosynthesis of novel lipopeptides from a deep‐sea Rhodococcus
Authors: Ragozzino Costanza , Palma Esposito Fortunato , Buonocore Carmine , Tedesco Pietro , Coppola Daniela , Paccagnella Davide , Ziemert Nadine , Della Sala Gerardo , de de Pascale Donatella
Published: November 2024

Microbial biosurfactants have garnered significant interest from industry due to their lower toxicity, biodegradability, activity at lower concentrations and higher resistance compared to synthetic surfactants. The deep‐sea Rhodococcus sp. I2R has been identified as a producer of glycolipid biosurfactants, specifically succinoyl trehalolipids, which exhibit antiviral activity. However, genome mining of this bacterium has revealed a still unexplored repertoire of biosurfactants. The microbial genome was found to host five non‐ribosomal peptide synthetase (NRPS) gene clusters containing starter condensation domains that direct lipopeptide biosynthesis. Genomics and mass spectrometry (MS)‐based metabolomics enabled the linking of two NRPS gene clusters to the corresponding lipopeptide families, leading to the identification of 20 new cyclolipopeptides, designated as rhodoheptins, and 33 new glycolipopeptides, designated as rhodamides. An integrated in silico gene cluster and high‐resolution MS/MS data analysis allowed us to elucidate the planar structure, inference of stereochemistry and reconstruction of the biosynthesis of rhodoheptins and rhodamides. Rhodoheptins are cyclic heptapeptides where the N‐terminus is bonded to a β‐hydroxy fatty acid forming a macrolactone ring with the C‐terminal amino acid residue. Rhodamides are linear 14‐mer glycolipopeptides with a serine‐ and alanine‐rich peptide backbone, featuring a distinctive pattern of acetylation, glycosylation and succinylation. These molecules exhibited biosurfactant activity in the oil‐spreading assay and showed moderate antiproliferative effects against human A375 melanoma cells.
Temporal Variability in Effective Size (N̂e$$ {\hat{N}}_e $$) Identifies Potential Sources of Discrepancies Between Mark Recapture and Close Kin Mark Recapture Estimates of Population Abundance
Authors: Ruzzante Daniel E. , McCracken Gregory R. , Fraser Dylan J. , MacMillan John , Buhariwalla Colin , Flemming Joanna Mills
Published: November 2024

Although efforts to estimate effective population size, census size and their ratio in wild populations are expanding, few empirical studies investigate interannual changes in these parameters. Hence, we do not know how repeatable or representative many estimates may be. Answering this question requires studies of long‐term population dynamics. Here we took advantage of a rich dataset of seven brook trout (Salvelinus fontinalis) populations, 5 consecutive years and 5400 individuals genotyped at 33 microsatellites to examine variation in estimates of effective and census size and in their ratio. We first estimated the annual effective number of breeders (b) using individuals aged 1+. We then adjusted these estimates using two life history traits, to obtain and subsequently, following Waples et al. (2013). was estimated for the years 2014 to 2019. Census size was estimated by mark recapture using double‐pass electrofishing () (years 2014–2018) as well as by the Close Kin Mark Recapture approach () (years 2015–2017). Within populations, annual variation in (ratio of maximum to minimum ) ranged from 1.6‐fold to 58‐fold. Over all 7 populations, the median annual variation in was around 5‐fold. These results reflect important interannual changes in the variance in reproductive success and more generally in population dynamics. Within population varied between years by a (median) factor of 2.7 with a range from 2 to 4.3. Thus, estimated effective size varied nearly twice as much as did estimated census size. Our results therefore suggest that, at least in small populations like those examined in the present study, any single annual estimate of is unlikely to be representative of long‐term dynamics. At least 3–4 annual estimates may be required for an estimate of contemporary effective size to be truly representative. We then compared to . For five of the seven populations, the estimates of population abundance based on mark recapture () were indistinguishable from those based on close kin mark recapture (). The two populations with discordant and exhibited extremely low ratios and the largest annual variation in (58‐fold and 35.4‐fold respectively). These results suggest that sampling effort in these two streams may have been insufficient to properly capture the genetic diversity of the entire population and that individuals sampled were not representative of the population. Our study further validates CKMR as a method for estimating abundance in wild populations and it demonstrates how knowledge of the temporal variation in can be used to identify potential sources of discrepancies between and .
metaRange: A framework to build mechanistic range models
Authors: Fallert Stefan , Li Lea , Cabral Juliano Sarmento
Published: November 2024

Mechanistic or process‐based models offer great insights into the range dynamics of species facing non‐equilibrium conditions, such as climate and land‐use changes or invasive species. Their consideration of underlying mechanisms relaxes the species‐environment equilibrium assumed by correlative approaches, while also generating conservation‐relevant indicators, such as range‐wide abundance time series and migration rates if demographically explicit. However, the computational complexity of mechanistic models limits their development and applicability to large spatiotemporal extents.

We present the R package “metaRange”: a modular framework to build population‐based and metabolically constrained range models. We also provide a catalogue of biological functions to calculate niche‐based suitability, metabolic scaling, population dynamics, biotic interactions and kernel‐based dispersal, which may include directed movement. The framework's modularity enables the user to combine, extend, or replace these functions, making it possible to customize the model to the ecology of the study system. The package supports an unlimited number of static or dynamic environmental factors as input, including climate and land use.

As examples, we include one single‐species application to predict the range dynamics of the European wildcat (Felis silvestris) in Germany, and one theoretical study in which we simulated 100 virtual species in three scenarios: without competition, with competition, and with competition under a generalist‐specialist trade‐off. Due to the population‐level, the package can execute such extensive simulation experiments on regular end‐user hardware in a short amount of time. We provide detailed technical documentation, both for the individual functions in the package as well as instructions on how to set up different types of model structures and experimental designs.

The metaRange framework enables process‐based simulations of range dynamic of multiple interacting species on a high resolution and low computational demand. We believe that it allows for theoretical insights and hypotheses testing about future range dynamics of real‐world species, which may better support conservation policies targeting biodiversity loss mitigation.
Yes, they're all individuals: Hierarchical models for repeat survey data improve estimates of tree growth and size
Authors: O'Brien Tess , Warton David , Falster Daniel
Published: November 2024

Repeat measurement surveys of tree size are used in forests to estimate growth behaviour, biomass and population dynamics. Although size is measured with error and individuals vary in their growth trajectories, current size‐based growth modelling approaches do not usually or fully account for both of these features, and therefore under‐utilise available data.

We present a new method that leverages the auto‐correlation structure of repeat surveys into a hierarchical Bayesian longitudinal growth model. This new structure allows users to correct for measurement error and capture individual‐level variation in growth trajectories and parameters.

To demonstrate the new method we applied it to a sample of tropical tree survey data from long‐term monitoring sites at Barro Colorado Island. We were able to reduce estimated error in size and growth, and extract individual‐ and population‐level growth parameter estimates. We used simulation to evaluate the ability of the new method to improve estimates of growth rate and size, and estimate individual and species‐level parameters. Our method substantially improved the root mean squared error (RMSE) for growth by an average of 61% compared to existing approaches using pairwise differences and reduced RMSE in estimated size RMSE compared to ‘observed’ values in simulated data. Better numerical integration methods (Runge–Kutta fourth order in comparison to Euler and midpoint) provided better estimates of parameters, but did not improve the estimation of size and growth. The choice of a positive growth function eliminated all negative increments without data exclusion.

Overall, this study shows how we can gain new and improved insights on growth, using repeat forest surveys. Our new method offers improved biomass dynamics estimation through reduced error in sizes over time, coupled with novel information about within‐species variation in growth behaviour that is inaccessible with species average models, such as individual parameters for the growth function which allows for relationships between parameters to be considered for the first time.
Do Carbon Assurance Providers Play a Strategic Role in Moderating the Relationship Between Carbon Emissions and Firms’ Cost of Equity?
Authors: Datt Rina , Segara Reuben , Yang Jin Young
Published: November 2024

This study investigates the impact of a firm's total carbon emissions on its implied cost of equity capital (COE) and explores whether this relationship is moderated by the choice of carbon assurance provider. Our findings show that firms aligning with the shared societal objective of minimizing total carbon emissions can lower their COE, consequently increasing their overall value. This association is enhanced when a firm's carbon emissions are assured by a professional accountant instead of a specialist consultant. This highlights the potential for green firms to maximize their value through the strategic involvement of a professional accountant. By doing so, these firms can proficiently convey and authenticate their corporate sustainability achievements to investors and other stakeholders. Our findings underscore the importance for a firm to carefully consider the reputation and independence of the assurance provider when seeking carbon assurance.
Failure rate of the pulmonary embolism rule‐out criteria rule for adults 35 years or younger: Findings from the RIETE Registry
Authors: Jossein Thibaut , Mazzolai Lucia , Lorenzo Hernández Alicia , Otálora Valderrama Sonia , Zdraveska Marija , Rivas Guerrero Agustina , López Ruiz Antonio , Di Micco Pierpaolo , Monreal Manuel , Hugli Olivier ,   the RIETE Investigators
Published: November 2024

Background

The use of a computed tomography pulmonary angiogram to diagnose pulmonary embolism (PE) has increased, leading not only to higher PE diagnoses but also to overdiagnosis and unnecessary radiation exposure, even in young patients despite a lower PE incidence. The aim of this study was to assess the failure rate of the pulmonary embolism rule‐out criteria 35 (PERC‐35) rule developed to reduce unnecessary testing in individuals aged ≤35 years among patients included in the Registro Informatizado de la Enfermedad TromboEmbolica Venosa (RIETE) Registry.

Methods

This retrospective cohort study used data from the RIETE Registry, an ongoing, international prospective registry of patients with objectively confirmed venous thromboembolism. The primary outcome was the missed PE rate using PERC‐35 criteria. Secondary outcomes included the comparison of demographic and clinical characteristics, PE localization, treatment strategies, and outcomes between PERC‐negative (PERC‐35N) versus PERC‐positive (PERC‐35P) patients.

Results

Of 58,918 adult patients with acute PE, the PERC‐35 rule demonstrated a low missed PE rate of 0.35% (n = 204), with an upper 95% confidence interval [CI] of 0.40%. The missed rate was 7.0% (95% CI 6.0%–7.9%) in the 18‐ to 35‐year subgroup. Compared to PERC‐35P patients, PERC‐35N patients were younger (mean age 28.4 years), with a lower body mass index, and included a higher proportion of pregnant/postpartum women. PERC‐35N patients had a significantly lower rate of chronic diseases and presented less frequently with dyspnea or syncope but more often with chest pain. They showed lower rates of positive D‐dimer and troponin levels. PERC‐35N patients experienced fewer major bleeding episodes, similar recurrence rates of PE/deep vein thrombosis, and no deaths during anticoagulation.

Conclusions

The PERC‐35 rule demonstrated a low failure rate to exclude PE in patients aged 18–35 years and could reduce imaging and radiation exposure in young patients with a low PE pretest probability if confirmed prospectively.
Alcoholic beverage consumption and female breast cancer risk: A systematic review and meta‐analysis of prospective cohort studies
Authors: Sohi Ivneet , Rehm Jürgen , Saab Marian , Virmani Lavanya , Franklin Ari , Sánchez Gonzalo , Jhumi Mihojana , Irshad Ahmed , Shah Hiya , Correia Daniela , Ferrari Pietro , Ferreira‐Borges Carina , Lauby‐Secretan Beatrice , Galea Gauden , Gapstur Susan , Neufeld Maria , Rumgay Harriet , Soerjomataram Isabelle , Shield Kevin
Published: November 2024

Alcohol consumption is an established cause of female breast cancer. This systematic review examines in detail the association between alcohol and female breast cancer overall and among the described subgroups, using all of the evidence to date. A systematic review of PubMed and Embase was performed according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines. The search included articles published up to November 15, 2023. Meta‐analyses and regressions were performed for alcohol consumption of less than 1 standard drink (10 g of ethanol) per day and for a range of alcohol consumption categories in relation to breast cancer. Analyses by menopausal status, hormone receptor status, human epidermal growth factor receptor 2 status, and molecular subtype were performed. The search yielded 5645 publications, of which 23 publications of individual and pooled studies examined the association between overall alcohol consumption and breast cancer incidence. The meta‐regression showed a positive association; relative risks (RR) of breast cancer were 1.05 (95% CI: 1.04, 1.06), 1.10 (95% CI: 1.08, 1.12), 1.18 (95% CI: 1.15, 1.21), and 1.22 (95% CI: 1.19, 1.25) for 0.5, 1, 2, and 3 standard drinks per day compared with nondrinking, respectively. A meta‐analysis of nine studies indicated that for consumption of less than one standard drink per day, the RR estimate of breast cancer was 1.04 (95% CI: 1.01, 1.07) compared with nondrinking. Consumption of an additional 1 standard drink per day was associated with a higher risk of premenopausal (RR: 1.03 (95% CI: 1.01, 1.06)) and postmenopausal (RR: 1.10 (95% CI: 1.08, 1.12)) breast cancer. Alcohol consumption increases female breast cancer risk, even for women who consume one drink per day. Furthermore, alcohol consumption is associated with both pre‐ and postmenopausal breast cancer risk. These findings support evidence‐based cancer prevention guidelines to reduce alcohol‐related risks.
Lactobacillus rhamnosus GG attenuates depression‐like behaviour and cognitive deficits in chronic ethanol exposure mice by down‐regulating systemic inflammatory factors
Authors: Pan Xiaoyu , Guo Anqi , Guan Kaiyu , Chen Congcong , Xu Shengnan , Tang Yali , Li Xi , Huang Zhengwei
Published: November 2024

Ethanol can directly or indirectly lead to cognitive and mental disorders. The long‐term intake of alcohol can directly affect the distribution of gut microbiota. Lactobacillus rhamnosus GG (LGG) is a natural bacterium isolated from healthy human intestines that has the function of preventing cytokine‐induced cell apoptosis and protecting cell barriers. However, the regulatory effect of LGG on cognitive and mental disorders caused by chronic ethanol exposure (CEE) is still unclear. In this study, we established a CEE mouse model through free alcohol consumption and added LGG or antibiotics in the later stages of the model. Sequencing analysis of the 16S rRNA gene showed that CEE resulted in a decrease in the abundance and diversity of mouse gut microbial communities accompanied by alterations in the relative abundance of multiple enterobacterial genera. The use of LGG and antibiotics alleviated the depression‐like behaviour and cognitive impairment of CEE‐induced mice, reduced expression of inflammatory factors such as interleukin (IL)‐6, IL‐1β and tumour necrosis factor (TNF)‐α in the ileum, serum and brain and increased the expression of synaptophysin (SYN), postsynaptic density protein‐95 (PSD‐95) and brain‐derived neurotrophic factor (BDNF) in the hippocampus. Together, LGG can alleviate depression‐like behaviour caused by CEE in mice while also improving cognitive and memory functions through reducing peripheral and nervous system inflammation factors and balancing gut microbiota.
The Case for Shared Decision‐making in Oncology and Why the Philippine Healthcare System is Primed for It
Authors: Bacorro Warren , Cairo Clarito , Baldivia Kathleen , Bautista Aida , Dancel Evelyn , Mariano Jocelyn , Gonzalez Gil , Ortin Teresa Sy , Canlas Rodel
Published: November 2024

Shared decision‐making is ethically imperative, and is a key component in cost‐effective, efficient and equitable cancer care. We review the recent advances in resources, training, tool development, and health policy, supporting the implementation of shared decision‐making, and how the Philippines is primed for it.
Association between self‐reported pain experiences in hospital and ratings of care, readmission and emergency department visits: a population‐based study from New South Wales, Australia
Authors: Prasad Narisha , Penm Jonathan , Watson Diane E. , Tran Bich N. H. , Dai Zhaoli , Tan Edwin C. K.
Published: November 2024

Introduction

Evidence on patient experiences with pain in hospitals and its impact on post‐discharge outcomes is limited. This study investigated the prevalence of pain in hospitals, patient characteristics associated with pain management adequacy, and the link between pain experiences, care ratings, readmission and emergency department visits after discharge.

Methods

We conducted a retrospective cross‐sectional analysis of the 2019 Adult Admitted Patient Survey, focusing on self‐reported pain experiences, including presence, severity and management adequacy. The outcomes included self‐reported overall care ratings; readmission; and emergency department visits within one month of discharge. Multivariable logistic regression adjusted for population weight was used to estimate adjusted odds ratios.

Results

Among 75 large public hospitals, 21,900 patients responded (35% response rate), with 51% of patients reporting pain (mean (SD) age 57 (8.8) y; 54.9% female), 38.3% of whom classified their pain as severe. Aboriginal and/or Torres Strait Islander people and patients who spoke a language other than English were less likely to report adequate pain management (aOR (95%CI) 0.74 (0.58–0.96) and 0.82 (0.70–0.96), respectively). Pain also correlated with poor to very poor care ratings (aOR (95%CI) 2.05 (1.42–2.95)). Those patients who experienced pain were twice as likely to be readmitted (aOR (95%CI) 1.92 (1.55–2.37)) or visit the emergency department after discharge (aOR (95%CI) 1.91 (1.58–2.32)). Conversely, adequate pain management was associated with a lower likelihood of readmission (aOR (95%CI) 0.69 (0.51–0.94)) and emergency department visits (aOR (95%CI) 0.62 (0.44–0.87)). Mediation analysis suggests adequate pain management significantly mediated the relationship between pain severity and hospital rating (50.8%), readmission (11.6%) and emergency department visits (5.9%), after adjusting for all available observed confounders.

Discussion

This study highlights the importance of adequate pain management in patients' perception of care and recovery outcomes, especially among culturally and linguistically diverse patients.
Hepatic Events During Immune Checkpoint Inhibitor Treatment Between Liver and Non‐Liver Malignancies in Hepatitis B Endemic Areas
Authors: Hung Yi‐Ping , Lee Pei‐Chang , Chang Yen‐Hwa , Yang Muh‐Hwa , Chiu Chao‐Hua , Chen Ming‐Huang , Lan Keng‐Hsin , Lee I‐Cheng , Hou Ming‐Chih , Chao Yee , Huang Yi‐Hsiang
Published: November 2024

Background

Notable advances have been made in immune checkpoint inhibitors (ICIs) for cancer treatment. However, the adverse effects of ICIs, especially hepatotoxicity, remain a challenging problem. Whether patients in hepatitis B virus (HBV)‐endemic areas are prone to developing hepatic adverse events during ICI treatment warrants further exploration.

Methods

From 2014 to 2020, the data of all patients with cancer who received ICI treatment at Taipei Veterans General Hospital were retrospectively reviewed. The incidence of and risk factors for hepatic adverse events, including hepatitis flare, immune‐related hepatitis (irHepatitis) and HBV reactivation (HBVr), were analysed through a Cox proportional hazard regression model.

Results

A total of 1283 patients with cancer (190 hepatocellular carcinoma [HCC] patients and 1093 patients with non‐HCC malignancies) were eligible for analysis, of whom 283 (22.1%) were HBsAg‐positive. The incidence of hepatitis flare events of any grade was significantly higher in HCC patients than in non‐HCC patients (45.8% vs. 25.6%, p < 0.001). HCC and baseline alanine aminotransferase (ALT) > 40 U/L were independent risk factors for ≥ grade 3 hepatitis flare events. No difference was observed in irHepatitis risk between HCC patients and non‐HCC patients. ALT > 40 U/L was an independent risk factor for irHepatitis. Among 283 HBsAg‐positive patients, six patients (2.1%) experienced HBVr. HCC patients had a higher risk of HBVr than non‐HCC patients (4.4% vs. 0.6%). No specific risk factor for HBVr could be identified. However, none of the patients under nucleos/tide analogue (NUC) prophylaxis experienced HBVr in this study.

Conclusions

Under ICI treatment, HCC patients had a higher risk of hepatitis flare events than non‐HCC patients. Abnormal baseline ALT levels are a risk factor for hepatic adverse events. NUC prophylaxis can minimise the risk of HBVr.
The financial impact of robotic surgery on hospital gross profits in Japan compared to laparoscopic surgery
Authors: Sakai Yoshiharu , Morishita Tsutomu
Published: November 2024

Robotic surgery is gaining traction in Japan due to its technological advancements, but its financial viability for hospitals remains uncertain. This study investigates the impact of robotic surgery on hospital gross profits, comparing it to laparoscopic surgery using data from surgeries performed at Red Cross Hospital Osaka. The study spans multiple surgical fields, including gastrointestinal, urology, gynecology, and thoracic surgery. While the number of robotic surgeries has increased, they consistently generate lower gross profits for hospitals compared with laparoscopic surgeries, primarily due to the high costs of robotic instruments and maintenance. Certain procedures, such as hernia repair, proximal gastrectomy, and distal pancreatectomy, result in negative profits when performed robotically. This article highlights the financial challenges hospitals face under Japan's current healthcare reimbursement system, where the fees for robotic and laparoscopic surgeries are largely the same. Policy adjustments may be necessary to ensure the financial sustainability of robotic surgery.
Neurophysiological markers in myelodysplastic syndromes: Insights into peripheral neuropathy
Authors: Möhn Nora
Published: November 2024

In their paper, Papantoniou et al. present relevant findings on the prevalence and characteristics of peripheral neuropathy in patients with myelodysplastic syndromes (MDS), underscoring the necessity for a more nuanced understanding of neurophysiological involvement in this complex haematological disorder. Their study not only reveals a higher frequency of neuropathy in MDS patients than previously reported but also illuminates specific neurophysiological patterns that may redefine clinical expectations and diagnostic practices in MDS‐associated peripheral neuropathy.

Commentary on: Papantoniou et al. Clinical and neurophysiological aspects of peripheral neuropathy in patients with myelodysplastic syndromes. Br J Haematol 2024 (Online ahead of print). doi: 10.1111/bjh.19901.
Long‐Term Oral Health Effects of Traumatic Events Among World Trade Center Health Registry Enrolees, 2003–2020
Authors: Akinkugbe Aderonke A. , Midya Vishal , Crane Michael A. , Garcia Dina T. , Clark Uraina S. , Wright Rosalind J.
Published: November 2024

Objectives

Posttraumatic stress disorder (PTSD) is a disabling mental health condition arising from experiencing serious traumatic events. This study investigated if PTSD secondary to the World Trade Center terrorist attack on 11 September 2001 (9/11) is associated with self‐reported doctor's diagnosis of periodontitis and count of missing teeth.

Methods

Data from the World Trade Center Health Registry, 2003–2020 (n = 20 826) were used to prospectively examine the rate of periodontitis and cross‐sectionally the odds of missing teeth among enrolees with/without PTSD post‐9/11 using a modified Poisson regression and generalised logit model, respectively, adjusted for covariates.

Results

Approximately 17% reported a doctor's diagnosis of PTSD post‐9/11 and 7.4% a doctor's diagnosis of periodontitis. There were 355 new cases of periodontitis (incidence rate = 7.6 per 1000 person‐years) among those with PTSD and a rate of 4.3 per 1000 person‐years among those without PTSD. The covariate‐adjusted rate ratio for periodontitis comparing those with and without PTSD = 1.52 (95% CI: 1.33, 1.74). The adjusted odds ratio (OR) (95% CI) comparing those with and without PTSD were, respectively, OR = 1.15 (95% CI: 1.05, 1.25) and OR = 1.41 (95% CI: 1.09, 1.83) for missing 1–5 teeth and all teeth missing, respectively, as compared to no missing teeth.

Conclusions

PTSD post‐9/11 appears to be associated with poorer oral health outcomes, underscoring the far‐reaching consequences of traumatic events on oral health.
Skin sensitisation elicitation: Evaluation of the general threshold and considerations for use
Authors: Palmer Brian , Gao Yuan , Ryan Cindy , Kern Petra
Published: November 2024

Background

Allergic contact dermatitis (ACD) is an immune response to chemical haptens, involving induction and elicitation phases. Quantitative risk assessment (QRA) reviewing the skin sensitisation potential for all ingredients and using chemical‐specific induction thresholds for skin allergens remains the current best approach for the safety evaluation of consumer products. However, elicitation thresholds have utility in secondary protection for pre‐sensitised consumers.

Objectives

The objectives were to (1) review the current elicitation threshold database, (2) evaluate whether predicted relationships between chemical induction and elicitation potencies enable elicitation threshold prediction and (3) discuss elicitation threshold utility as a secondary method of consumer protection.

Methods

In total, 28 publications (with 39 elicitation datasets) were included in non‐linear regression analysis to derive elicitation thresholds for 22 allergens, including fragrances, preservatives and metals.

Results

The median elicitation threshold (ED10) for the expanded database was 0.95 μg/cm2, which supports previously published general elicitation thresholds. The derived ED10 for each chemical had only weak to moderate correlation with corresponding induction thresholds, thus limiting suitability as the predictive model.

Conclusions

Assessment of current EU fragrance allergen labelling and sensitiser labelling under the globally harmonised system in the context of general and chemical‐specific elicitation thresholds shows that current practices are health protective.
Study of Microsatellite Instability by Immunohistochemistry in a Cohort of Patients With Melanoma
Authors: Palacios Diaz Rodolfo David , de Unamuno Bustos Blanca , Pozuelo Ruiz Mónica , Llavador Ros Margarita , Palanca Suela Sarai , Botella Estrada Rafael
Published: November 2024

Background

Microsatellite instability (MSI) has prognostic value and impacts therapy strategies in several malignancies. Data regarding MSI in melanoma are scarce. The aim of this study was to assess MSI through the analysis of MMR protein expression in patients with melanoma.

Methods

An observational retrospective single‐center study was designed based on patients with primary melanoma. We assessed MSI through immunohistochemical staining with anti‐MLH1, anti‐MSH2, anti‐MSH6, and anti‐PMS2 on full–thickness excision tissue.

Results

Ninety‐three patients were included in this study. The complete absence of nuclear staining in tumoral cells was extremely rare, with only one melanoma not expressing MSH6. Most melanomas showed an expression index for MLH1 (77.7%), MSH2 (87.2%), and PMS2 (78.6%) ≥ 75%. Most melanomas (57.8%) exhibited an MSH6 expression index in the range of 1%–74%. A low MSH6 expression index and a reduced combined MMR protein expression index (MMR‐e) were significantly associated with higher melanoma‐specific survival. A mild PMS2 staining intensity was significantly associated with a higher melanoma‐specific survival. The patients with high MMR‐e who received immunotherapy progressed and died more frequently than those with reduced MMR‐e (75% vs. 33.3%).

Conclusion

More studies are needed to further define the role of MSI in melanoma prognosis and response to immunotherapy.
Advancements in Cardiac CT Imaging: The Era of Artificial Intelligence
Authors: Costantini Pietro , Groenhoff Léon , Ostillio Eleonora , Coraducci Francesca , Secchi Francesco , Carriero Alessandro , Colarieti Anna , Stecco Alessandro
Published: November 2024

In the last decade, artificial intelligence (AI) has influenced the field of cardiac computed tomography (CT), with its scope further enhanced by advanced methodologies such as machine learning (ML) and deep learning (DL). The AI‐driven techniques leverage large datasets to develop and train algorithms capable of making precise evaluations and predictions. The realm of cardiac CT is expanding day by day and multiple tools are offered to answer different questions. Coronary artery calcium score (CACS) and CT angiography (CTA) provide high‐resolution images that facilitate the detailed anatomical evaluation of coronary plaque burden. New tools such as myocardial CT perfusion (CTP) and fractional flow reserve (FFRCT) have been developed to add a functional evaluation of the stenosis. Moreover, epicardial adipose tissue (EAT) is gaining interest as its role in coronary artery plaque development has been deepened. Seen the great added value of these tools, the demand for new exams has increased such as the burden on imagers. Due to its ability to fast compute multiple data, AI can be helpful in both the acquisition and post‐processing phases. AI can possibly reduce radiation dose, increase image quality, and shorten image analysis time. Moreover, different types of data can be used for risk assessment and patient risk stratification. Recently, the focus of the scientific community on AI has led to numerous studies, especially on CACS and CTA. This narrative review concentrates on AI's role in the post‐processing of CACS, CTA, FFRCT, CTP, and EAT, discussing both current capabilities and future directions in the field of cardiac imaging.
Untangling the Relationship Between AI‐Mediated Informal Digital Learning of English (AI‐IDLE), foreign Language Enjoyment and the Ideal L2 Self: Evidence From Chinese University EFL Students
Authors: Liu Guangxiang Leon , Zou Minlin Minny , Soyoof Ali , Chiu Ming Ming
Published: November 2024

Artificial intelligence‐mediated informal digital learning of English (AI‐IDLE) might strengthen second language (L2) learners' motivational self‐concept (e.g., the ideal L2 self) and enhance their foreign language enjoyment (FLE) by enabling them to build confidence, engagement, and willingness to practice their English skills in a self‐directed, instant feedback, and non‐judgemental learning environment. In our explanatory mixed‐method study, we collected questionnaire data from 299 Chinese undergraduate English as a foreign language (EFL) learners and interviewed 12 of them. Structural equation modelling showed that students who participated in AI‐IDLE more often reported a clearer ideal L2 self and greater FLE, but those with a greater ideal L2 self did not report more FLE. In addition, gender did not moderate the impact of AI‐IDLE on FLE. Analysis of the interview data not only corroborated the quantitative results but also highlighted that while EFL learners can acquire a sense of FLE and vivid ideal L2 selves as they agentively negotiate the affordances of generative AI for informal language learning purposes, the sense of FLE and motivational force may shift across contexts to shape their continued investment in AI‐IDLE practices. By comparing and integrating the quantitative and qualitative insights, this study highlights the pedagogical potential of AI‐IDLE activities that can strengthen EFL learners' motivation, enjoyment, and commitment to English learning.
Ectopic thyroid carcinoma in the left atrium in a horse
Authors: Wolf N. , Schläpfer J. , Dervas E. , Soto S. , Piotrowski I. L.
Published: November 2024

A 25‐year‐old Irish sport horse was presented for investigation of a 7‐day history of apathy and lethargy. Clinical examination revealed tachycardia, tachypnoea, distended, pulsating jugular veins and ventral oedema. Serum biochemistry showed azotaemia. The ultrasonographic examination of the abdomen and the thorax revealed peritoneal, pleural and pericardial effusion. Following the assessment, the mare was euthanised and a full post‐mortem examination was performed. The main findings included a ruptured mass in the left atrium of the heart with subsequent haemopericardium. By histological examination and immunoreactivity for thyroglobulin‐1, the cardiac mass could be further classified as a thyroid carcinoma. As there was no evidence of thyroid neoplasia in the rest of the carcass, it is likely that the neoplasia originated from ectopic thyroid tissue in the heart. Additional findings included multiple intestinal haemangiomas and perianal melanomas. The case report indicates that cardiac thyroid carcinoma may be a possible differential diagnosis in horses diagnosed with congestive heart failure.
Horse with myopathy caused by consumption of box elder tree seedlings in the Czech Republic
Authors: Jahn P. , Novotná T. , Brumarová R. , Dobešová D. , Ottová L. , Friedecký D. , Maršálek P.
Published: November 2024

An 18‐year‐old Saxon Warmblood gelding was referred to an equine clinic in the Czech Republic in May 2019 for mild colic. The horse had 7 h of grazing and 30–45 min of exercise every day. At the clinic, physical examination ruled out gastrointestinal disease, while clinical pathology confirmed rhabdomyolysis (creatine kinase 29,088 IU/L; reference range 110–250 IU/L). Because of the suspicion of atypical myopathy (AM), metabolomic analysis of hypoglycin A (HGA), 31 acylcarnitines (ACs) and free carnitine was performed in four dry serum and one blood spot. After laboratory confirmation of AM in the patient studied (HGA: 0.757–0.415 μmol/L, ACs elevation), an incriminated pasture was visited and searched for the source of the toxin. No sycamore (Acer pseudoplatanus) was found in the vicinity of the pasture. However, several box elder (Acer negundo) trees were found, and toxicological analysis revealed HGA in the samaras (7.66–296.00 mg/kg), leaves (2.12–9.39 mg/kg) and seedlings (339.00 mg/kg). Not only sycamore but also the box elder tree can be a potential source of poisoning in horses in Europe, particularly in lowland areas with a warm climate.
Generating Skin‐Derived Precursor‐Like Cells From Human‐Induced Pluripotent Stem Cell‐Derived Skin Organoids
Authors: Ahmed Imaan A. , Sun Jane , Kong Min Jie , Khosrotehrani Kiarash , Shafiee Abbas
Published: November 2024

Skin‐derived precursor (SKPs) cells are multipotent stem cells found in the dermis that contribute to wound healing and induce hair follicle neogenesis when transplanted. The clinical application of adult human SKPs, however, is hindered by their loss of potency after in vitro expansion. To overcome this challenge, we aimed to isolate SKPs from human‐induced pluripotent stem cell‐derived skin organoids (SKOs), to enable mass production of these cells for therapeutics. We developed a protocol to isolate skin‐derived precursor‐like cells (SKP‐like cells) from human SKOs. SKP‐like cells derived from SKOs exhibited characteristic spheroid morphology and were capable of self‐renewal in defined SKP growth medium. Immunofluorescence analysis confirmed the expression of key markers, including SOX2, fibronectin and S100β, within the SKP‐like cells. The findings of this pilot study shed light on the potential of SKO‐derived SKP‐like cells for future hair regenerative applications. Furthermore, this research highlights the application of human SKOs as a valuable source for isolating progenitor cells, aiming to advance hair regeneration and restore skin function.
Agenda Setting in Outpatient Consultation of Older Adults With Long‐COVID
Authors: Zhao Hao , Zhang Shuai , Ma Wen
Published: November 2024

Introduction

Agenda setting in doctor–patient interaction refers to the process when various agendas are presented and responded to. This study revealed how Long‐COVID (LC) agenda items are managed by older adults and doctors during outpatient consultations.

Methods

Based on audio recordings, we adopted Conversation Analysis (CA) to unveil under what circumstances the patient or the doctor set the agenda and how they collaboratively work to develop an LC topic. Data was transcribed in accordance with the transcription conventions developed by Jefferson.

Results

Agendas were divided into three categories, namely primary, additional, and unmet agenda items. LC agendas were identified with specific characteristics based on qualitative analysis and older adults tended to seek more medical assistance, particularly concerning their chronic diseases. We observed that patients initiate agendas more often than doctors and it could happen at any stage of the visit, both parties can resist expanding the agenda, mostly in an indirect way, and agendas that contain more information with simpler turn‐constructions are more likely to be well‐addressed.

Conclusions

Better quality of consultation was found when doctors sensitively detect the emotional change and the potential issues of the patients when they prevaricate to avoid the relevance of the previous infection. The findings also suggested that understanding the dynamics of agenda setting in consultations could lead to improvements in medical visit outcomes.

Patient and Public Contribution

Patients and doctors in the study were colleagues in a university hospital. They were involved in various stages of this study to ensure it addresses real‐world concerns and improves healthcare outcomes. Throughout data collection, patients contributed by allowing their consultations to be recorded and providing feedback on their experiences. Findings were discussed with a patient advisory group to ensure the interpretations aligned with patient perspectives. Doctors were also actively engaged in disseminating the results through later consultations, ensuring broad accessibility and practical application of the research outcomes.