bluuebunny/crossref_metadata_2025 huggingface dataset:
The effects and mechanism of hypoxia-inducible factor-1α inhibitor, a potential therapy strategy, on non-alcoholic steatohepatitis
Authors: Zeng Renli , Wen Jielu , Cen Zhipeng , Wang Tengyao , Duan Meng , Huang Xiuyi , Yang Chuan , Chen Sifan
Published: November 2023

Non-alcoholic steatohepatitis (NASH) is the progressive form of
non-alcoholic fatty liver disease (NAFLD) which is the most common
chronic liver disease worldwide. However, there are no FDA-approved
drugs for treating NASH. The roles of hypoxia-inducible factor-1α
(HIF1α) playing in NASH are not fully understood, and the mainstream
view is that HIF1α knockout improved NASH. Here, in order to explore the
clinical translation potential of HIF1α, we used HIF1α inhibitor KC7F2
to treat diet-induced NASH mice for 10 weeks. Surprisingly, it turned
out that KC7F2 intensified liver lipid accumulation, inflammation, and
fibrosis in NASH mice. Mechanistically, a most remarkable increase of
expression of hepatokine Tsukushi (TSKU) was observed among twenty
metabolism-related hepatokines in the liver of NASH mice after KC7F2
treatment. In vitro, we confirmed that inhibiting HIF1α or TSKU
overexpression both significantly intensified lipid accumulation in
hepatocytes, but didn’t increase expression of inflammation markers in
LPS-induced macrophages or fibrosis markers in TGFβ-induced hepatic
stellate cells. Moreover, Tsku knockdown reversed the HIF1α
inhibitor-induced lipid accumulation in hepatocytes. Taken together, we
first found that HIF1α inhibitor exacerbated NASH presumably via
promoting hepatocyte lipid accumulation which was dependent on TSKU,
indicating NASH may be a contraindication for HIF1α inhibitor rather
than an indication.
Uptake, Implementation, Portability, and Operability of the One Nation One Ration Card: A Study
Authors:   Asian Development Bank, Gupta Kanupriya , Rautela Krishan ,   Asian Development Bank, Soni Parul ,   Asian Development Bank, Srinivas K. ,   Deal Advisory Services KPMG India
Published: November 2023

This brief analyzes India’s One Nation One Ration cards that allow poor migrants to access subsidized grains nationwide and assesses how improving awareness and strengthening technological infrastructure could boost their take up. The brief explains the evolution of the cards, which are used at ePos-enabled fair price stores. It offers insights into migrants’ perceptions and use of the cards and illustrates how they helped people access food during the pandemic. It highlights supply chain and technological challenges, emphasizes the need to improve access for women and vulnerable groups, and shows why training and capacity building could help improve food security.
COVID-19 Vaccination-related Complex Regional Pain Syndrome Masquerading as Erythromelalgia: A Case Report
Authors: Lorentzen Kristian L. , Bygum Anette
Published: November 2023

Abstract is missing (Short communication)
Identification of Porphyry Deposit Based On Time Domain Induced Polarization Data Analysis in The Papua Region
Authors: Yatini Y , Rumahorbo Gilvandro , Sutarto Sutarto
Published: November 2023

Papua is one of the islands in Indonesia which has an abundance of economic metal mineralization in Indonesia. The types of mineralized deposits on the island of Papua are porphyry, skarn and epithermal, where porphyry deposits are identified in the study area, which were identified early by geological conditions. The geophysical approach is carried out using Time Domain Induced Polarization data analysis, TDIP measurements are carried out on an area of 2.24km2, with a total of 3 line oriented southeast-northwest along 3 km. Based on TDIP data analysis, there’s low resistivity anomaly correlates with high chargeability which is interpreted as a Potassic body at an elevation of 500m, while above it there are Serisitic-Clay-Chlorite and Serisitic-Clay-Pyrite alterations with high metal sulfide content up to 1100m elevation.
Educación en línea en universidades nacionales de Argentina: diálogos entre plataformas y bibliotecas académicas
Authors: Corda María Cecilia , Viñas Mariela
Published: November 2023

El presente artículo adopta el concepto de educación en línea, por considerarlo el más adecuado para describir y abordar el proceso de aprendizaje y enseñanza que se desarrolla en el entorno de campus virtuales en el ámbito universitario para carreras que se ofrecen en entornos web. A partir de él, focaliza su mirada en las interacciones que se dan entre las plataformas y los servicios bibliotecarios de las bibliotecas académicas en el marco de universidades públicas nacionales que poseen estas propuestas. Metodológicamente, más allá de una revisión bibliográfica vinculada al tema, se efectúo una observación virtualizada de los sitios web de las 59 universidades nacionales. Se empleó una plantilla elaborada ad hoc, y se relevaron resultados que, en su análisis, detectan el uso extendido del software Moodle, la existencia cada vez más creciente de unidades de educación para apoyar las actividades docentes en las plataformas; y la aún escasa articulación entre las bibliotecas y las plataformas de educación en línea. Finalmente, se propone indagar al mismo universo a través de otras metodologías que permitan profundizar aspectos de la interrelación entre plataformas y bibliotecas académicas.
Competencias en información para la formación inicial de profesores en Uruguay: propuesta para sus planes de estudio basada en una revisión sistemática de la literatura
Authors: Behar Patricia Alejandra , Silva Ketia Kellen Araújo da , Díaz Costoff Alicia , Suárez Gabriela da Rosa
Published: November 2023

Los cursos de grado de formación inicial del profesorado resultan ser claves para enfrentar los desafíos de la educación dentro de una sociedad actual cultural y tecnológicamente compleja. Entre estos, un profesorado atravesado por el cambio continuo y por una gran cantidad de información digital disponible. Este artículo pretende plantear una guía para el desarrollo de competencias en información a ser integrada en los planes de estudio de la formación inicial de profesores en Uruguay. Se realizó una revisión bibliográfica sistemática de las competencias en información y de programas para el desarrollo de las mismas. Como resultado, fue elaborada una guía que sugiere lineamientos para el desarrollo de estrategias de búsqueda, de evaluación y selección de la información, de comunicación de la información y de uso ético de la misma. La propuesta pretende así, contribuir para la sistematización del desarrollo de competencias en información para los profesores que están iniciando su formación.
Divulgação científica em bibliotecas universitárias: reflexões e possíveis caminhos
Authors: Farias Maria Giovanna Guedes , Maia Francisca Clotilde de Andrade , Santos Nicolle Negreiros de Lima
Published: November 2023

Este artigo tem como objetivo refletir sobre como as bibliotecas universitárias (Bus) podem atuar na divulgação científica, propondo ações que visem promover a aproximação da comunidade (usuários, potenciais e não usuários, sociedade em geral) com a ciência. A abordagem metodológica utilizada teve como base a revisão de literatura narrativa, se caracterizando como um estudo exploratório, por propor caminhos para que a divulgação do conhecimento científico seja efetivada nas bibliotecas universitárias. Os resultados demonstram que se faz necessário expandir as iniciativas, utilizando, por exemplo, as redes sociais institucionais como ferramentas para fomentar a interação e o engajamento da sociedade, despertando a curiosidade e o interesse pela ciência. Além disso, as autoridades universitárias devem elaborar políticas de fomento à capacitação contínua dos bibliotecários para que possam atuar como divulgadores da ciência, que tenham por base os três paradigmas da divulgação científica, quais sejam: ações formativas e reflexivas para corpo funcional; disseminação; e participação pública. Conclui-se que a BUs demonstram ter um expressivo potencial de atuação junto ao seu entorno e à sociedade que lhe cerca, podendo atuar para que essa sociedade se sinta cada vez mais pertencente aos espaços de ciência e tecnologia e de seus resultados.
STUDENTS’ PERCEPTION OF DIGITAL STORYTELLING TO IMPROVE SPEAKING SKILL AT AN INDONESIAN ISLAMIC HIGHER EDUCATION
Authors: Sahril  , Munir Nurasia , Munir Bayanuddin
Published: November 2023

Digital storytelling is a method that combines the art of storytelling with digital media in various forms such as videos, images, text, and so on. Digital storytelling integrates technology into the classroom to facilitate the learning process. Especially in English language learning, this method supports the improvement of students' English language skills. This study aims to identify students' perceptions of digital storytelling to improve students' speaking skills at an Indonesian Islamic college. This mixed-method study involved 30 second-semester students at Datokarama State Islamic University in Palu. Quantitative data using questionnaires were analysed based on percentages while qualitative data in the form of interviews were analysed with three stages, namely, data reduction, display, and verification. Five aspects of perception are of concern in this study, namely attitude, motivation, interest, experience, and expectations. The research results from the five aspects prove that students have a positive perception of the use of digital storytelling in improving their speaking skills. Digital storytelling makes it easier for students to understand the material well, gives them confidence in interacting and cooperating in the classroom, and creates a fun learning process.
Ofatumumab w leczeniu rzutowo-remisyjnej postaci stwardnienia rozsianego. Opis przypadków
Authors: Marona Monika
Published: November 2023

Stwardnienie rozsiane jest chorobą coraz częściej rozpoznawaną, która jednocześnie jest jedną z głównych przyczyn niepełnosprawności u ludzi młodych i stanowi problem istotny społecznie i ekonomicznie. Jest ona nieuleczalna. Stosowane leczenie modyfikujące przebieg choroby daje szanse na zatrzymanie postępu choroby pod warunkiem, że lek zostanie optymalnie dobrany i wdrożony wcześnie, zaraz po ustaleniu rozpoznania. Jak dotąd nie jest dostępny lek, który byłby skuteczny u wszystkich chorych. Jednocześnie trudno przewidzieć, czy konkretny pacjent będzie odpowiadać (lub nie) na daną terapię. W konsekwencji wielu chorych na stwardnienie rozsiane może wymagać modyfikacji leczenia, aby osiągnąć dobrą kontrolę aktywności choroby. Celem pracy jest omówienie przypadków pacjentów chorujących na rzutowo-remisyjną postać stwardnienia rozsianego w kontekście podejmowanych decyzji terapeutycznych.
Música e linguagem na filosofia de Giorgio Agamben
Authors: Buchard Alan Barbosa
Published: November 2023

O artigo tem por objetivo geral apresentar as reflexões de Giorgio Agamben (1942), filósofo italiano, acerca da música e de sua relação intrínseca com a linguagem. A análise se concentra sobre as obras em que o filósofo aborda o tema, selecionando, especificamente, os trechos em que o nexo música-linguagem aparece com maior relevo. Por se tratar de uma temática sobre a qual Agamben se debruça, de modo assistemático, no decorrer de 4 (quatro) décadas, o objetivo específico do artigo é organizar as referências dispersas no conjunto da obra do filósofo e comentá-las. A partir delas procura-se esclarecer as definições de música como “abertura originária” da linguagem e de filosofia como “música suprema” apresentadas por Agamben nas obras supracitadas. Neste sentido, a finalidade proposta pelo artigo é apresentar um estudo sistemático sobre o nexo música-linguagem, cuja função é permitir a compreensão de uma parte menor de um problema ainda maior e mais central para a filosofia de Giorgio Agamben: a natureza da própria linguagem.
Palavras-chave: Agamben; linguagem; música; filosofia.
A hybrid online and offline teaching model of professional English based on empirical modal decomposition method empowered by digital technology
Authors: Wang Xueqin
Published: November 2023

With the rapid development of artificial intelligence digital technology, its related techniques have penetrated and been applied to the education industry and field. In this paper, we address the limitations of CEEMD in processing student performance prediction data and combine the hybrid gray wolf optimization algorithm with the minimum gating unit recurrent neural network to establish an English performance prediction model by simulating the leadership, hunting, and ranking mechanisms of the gray wolf population, as a way to complete the optimization of EMD limitations. Then, using the empirical modal decomposition method and other auxiliary methods, we conducted an experimental study on the online and offline “hybrid” teaching model for two classes of English majors in the School of Foreign Languages of Huanghe Science and Technology University in 2021 and passed equal-group pre-test and t-test. The results showed that the significance level α of English performance in class B was 0.10, and since the probability value P was less than 0.10, it was considered that there was a significant difference between the two overall means, i.e., there was a significant difference between the overall means of the improvement in the performance of class B and class A. The overall performance of class B students was significantly higher than that of class A. This study combines online and offline teaching modes through digital technology to promote the use of online and offline “hybrid” teaching modes in higher education institutions, which is very important.
Young adult substance use following involuntary job loss
Authors: Jolly Nicholas A. , Davis Gwendolyn
Published: November 2023

This paper uses data from the Panel Study of Income Dynamics to study the relationship between job displacement and substance use among young adults. Results show that displacement is associated with increases in the probability of smoking cigarettes and drinking and the intensity of consuming alcohol and marijuana. Men, whites, and those who live with family/friends at the time of displacement are more likely to use hard drugs after job loss. Findings suggest that government policy designed to aid displaced workers should contain provisions to anticipate and respond to substance use disorders that may arise, particularly among younger job losers.
Investigation of Hybrid Lap Welds of TI6AL4V and Stainless Steel with Bronze Interlayer
Authors: Chmelíčková Hana , Havelková Martina , Hrubantová Aneta , Jílek Vlastimil , Václavek Lukáš , Ingr Tomáš
Published: November 2023

Welding of the austenitic stainless steel AISI 304 and Ti6Al4V is complicated by hard and brittle intermetallic compound formation. In this contribution, we study a laser welding method that partially overcomes this problem using interlayer. Bronze foil (CuSn6) of thickness 100 µm and 200 µm was inserted between steel and titanium sheets and lap welds were realized on pulsed Nd:YAG laser. Representative samples were investigated by nanohardness measurement, SEM/EDS, and XRD analysis to detect the localization of the intermetallic phases. The macrostructure of the weld cross sections was displayed by optical and digital microscopy. The nano-hardness test revealed the presence of very hard intermetallic mainly around the interface between the fusion zone and bottom metal sheet. EDS mapping displayed the main elements Fe, Cr, Cu and Ti distribution in the fusion zone, EDS line scanning detected elements‘ signals in the diagonal and horizontal directions. XRD analysis revealed expected intermetallic compounds FeTi and CuTi2 and solid solution Cu0.8Fe0.2.
Relationship between age, and gender with COVID-19 treatment period for patients with mental disorders at the Aceh Mental Hospital in 2021
Authors: Andayani Novita , Zahra Zulfa , Malawati Malawati , Muhsin Muhsin , Sungkar Muhammad Haekal
Published: November 2023

Introduction: COVID-19 can infect anyone from children to the elderly and is not closed tothe possibility of occurring in people with mental disordersObjectives: This study aims to identify the relationship between age and gender to theCOVID-19 treatment period in patients with mental disorders at the Aceh Mental HospitalMethods Materials: This type of research is observational analytic with a cross-sectional design with a total of 106 subjects. Data obtained from medical records were analyzed using the Spearman's Rank testResults: Research on patients with mental disorders at the Aceh Mental Hospital in 2021shows that the COVID-19 treatment period 14 days is mostly found in the adult age groupand the COVID-19 treatment period ≥ 14 days is mostly found in the pre-elderly age group.In the gender group, the COVID-19 treatment period 14 days and ≥ 14 days, the malegroup was more than the female group.Conclusion: It was concluded that there was a significant influence between age and themass of COVID-19 treatment with a p value = 0.000 (p ≤0.05) and there was no significantinfluence between gender and the COVID-19 treatment period with p = 0.082 (p0.05). Thisstudy recommends further research, especially in patients with mental disorders who havebeen vaccinated against COVID-19.
The possible role of plant derived essential oils against fatigue in post-acute sequelae COVID-19: a literature review based on evidence of essential oils on fatigue
Authors: Satria Fauzi , Widyawati Tri , Rambe Irfah Tut Alawiyah , Yusuf Muhammad , Jalma Monica Dwi
Published: November 2023

Introduction: Persistent symptoms of COVID-19 were discovered in certain individuals even after the initial onset of the illness. Fatigue is among the issues observed in people who have Post-Acute Sequelae Covid-19 (PASC). However, available treatment choices for fatigue in PASC have been constrained so far. In several patient groups, essential oils (EO) extracted from plants have been demonstrated to lessen fatigue. This review's objective is to provide all available data on the advantages of plant-derived EO for fatigue and their capacity to heal PASC that is related to fatigue. The application of EO derived from plants, like Lavender, Sweet Orange; a blend of Lavender, Rosemary, Juniper, and Cananga; an assortment of Ravensara, Frankincense, and Sandalwood; a combination of Peppermint leaves; Evening Primrose, Clove Bud, Black Pepper, Bergamot, and White Grapefruit, has demonstrated to reduce fatigue across various groups of patients when compared to a control group.Conclusion: Considering the existing evidence, EO derived from plants might play a role and offer potential benefits in alleviating fatigue in individuals with PASC.
CALL EVALUATION: STUDENTS' PERCEPTION AND CHALLENGES ON THE USE OF VLE AND GAME-BASED LEARNING
Authors: IGP Adhitya Prayoga  , Made Dewi Firmanda Wardani
Published: November 2023

This study investigates students' perception and challenges on the use of VLE and Game-based learning in their lessons. The samples of this study were taken from students who study in one of private school located in Badung regency, Bali. This school has three different levels of education, such as primary level, secondary level, and high school level. A mixed-method approach was used to gather the data in this study which means the researcher collected and analyzed both quantitative and qualitative data. The quantitative data was taken from questionnaire results, while the qualitative data was taken from interview results. 30 students were asked to fill the questionnaires and only 5 of them were interviewed. The result of the questionnaires shows most of the participants have positive perceptions and interest toward the use of VLE and game-based learning platform. The highest score is 4.00 and the lowest score is 3.30 Furthermore, the average score from all of the participants' responses is 3.69. According to the table of the mean score, 3.69 is categorized high degree. Furthermore, based on the interview result, the participants were also having challenges when using the VLE, like having trouble connecting to the internet. The final result of this study is expected to help educators preparing the right methods of teaching and learning for their students.
Keywords: VLE, Game-based Learning, Perception, Challenges
THE EFFECTIVENESS OF USING VIDEO BLOGS (VLOGS) TO IMPROVE SENIOR HIGH SCHOOL STUDENTS' SPEAKING ABILITY
Authors: Anggraini Ramadhania Nur Wachidah , Nur Chakim
Published: November 2023

This study aimed to examine the effectiveness of utilizing video blogs (vlogs) as a means to enhance the speaking ability of senior high school students. Employing a quantitative approach with a quasi-experimental design, the research involved two classes comprising 37 students each. The participants were assigned randomly to either the experimental group, which received the vlog treatment, or the control group, which did not. Both groups underwent pre-test and post-test assessments to evaluate their speaking ability. The findings from the paired sample t-test demonstrated a significant improvement in the speaking ability of the experimental group (p < .05), indicating the positive impact of vlogs. Furthermore, effect size analysis indicated a substantial effect of vlogs on enhancing students' speaking skills, with an effect size of 0.37. In conclusion, this research provides support for the use of vlogs as an effective tool for improving the speaking ability of senior high school students.
The Influence of Fin Thread Implant Design on Stress Distribution Comparative FEA Study
Authors: Alhamdani Faaiz , Rasheed Khawla , Qassim Mohammed , Mahdi Amjed
Published: November 2023

Background: one of the requirements of long term dental implant success lies within the implant structure and bone- implant interface ability to cope with functional stress. Dental implant ability to withstand different occlusal loads optimizes implant-supported prosthesis function, minimize stress over the surrounding bone, improve osseointegration and reduce the required peri od for implant loading. One of the areas of research on implant geometry is the thread design. Threads increase initial bone contact, enhance implant stability, maximize implant surface area with subsequent improvement of osseointegration. Recently, Fin Thread (FT) and Modified Fin Thread designs (IBS®) have been introduced. These designs on TiG5 dental implant did not seem to receive adequate attention in the current literature. Methods: four dental implant model s (Modified Fin Thread, Fin Thread, V-shaped and Buttress designs) of TiG5 were tested using FEA for stress distributi on using normal and extreme static occlusal loads on 0, 15 and 25ο angles. Results: Modified Fin Thread (MFT) desig n and Fin Thread (FT) design showed almost uniform stress distribution compared to other models under normal occlu sal load. However, MFT design showed better stress distribution with no cortical bone involvement in overloaded occlusal stress (200 and 400N) respectively. Conclusion: Modified Fin Thread Design of Ti G5 seems to be the more suitable dental implant model in terms of stress distribution in norm al and over occlusal load conditions. MFT designs need clinical studies to support this study findings on patients with long fol low up periods.
Subtle Trichilemmal Carcinoma of Neck Initially Misdiagnosed as Benign Cyst and Ultimately Treated with Mohs Micrographic Surgery
Authors: Shahzeidi Parastou , Fezza Reed , Green William
Published: November 2023

Abstract

Trichilemmal carcinoma(TC) is an exceeding rare malignant adnexal lesion, originating from hair follicle cells. Given its rarity, widely variable clinical presentation, and often non-specific appearance, TC is commonly misdiagnosed as a number of different lesions, some benign, which can lead to delays in treatment and suboptimal patient outcomes. In this report, we discuss a 65-year-old man with a neck lesion originally misdiagnosed as benign and later found to be TC all along. We also discuss several treatment options, and ultimately favor Mohs Micrographic Surgery (MMS) as the preferred treatment for TC in this case.
Methotrexate Monitoring in Dermatology: A Follow-Up Retrospective Cohort Study
Authors: Mark Erica , Vittitow Stephany , Zufall Alina , Nguyen Joseph , Flowers Richard
Published: November 2023

Introduction: There have been no large-scale studies looking at the efficacy and safety of methotrexate. Prior research by our team investigated whether certain monitoring practices were associated with lab abnormalities resulting in clinically relevant events (CREs) within the first 90 days of methotrexate treatment and concluded that dermatologists may consider postponing lab monitoring until 15 days after methotrexate initiation in patients without concerning baseline disease. This follow-up study was performed to determine when within the first 90 days of treatment CREs were most likely to occur and to define the specific numeric values at which abnormal labs resulted in a CRE.

Methods: The medical records of 243 dermatology patients were retrospectively reviewed.

Results: Week 11 had the highest percentage of CREs (11.1%, p=0.00003), with slight peaks at weeks 2 and 5. ALT (22%) and AST (27%) were the most commonly abnormal labs, and elevated ALT (p=0.00087) and AST (p=0.03) values were significantly higher in CREs.

Discussion: This data suggests that lab frequency can be reduced within the first few months; optimal timing of lab draws may be around weeks 2-5 and 11-12. In summary, we found that 1) abnormal labs most frequently led to a CRE at week 11 of monitoring, 2) ALT and AST were the most frequently abnormal labs, and 3) abnormal ALT and AST values were significantly higher in patients with CREs. This study provides valuable insight into an understudied dermatologic topic and hopefully will inform clinicians regarding methotrexate laboratory monitoring and spur further investigation.
A US Claims Database Analysis Estimating Risk of All-Cause Mortality in Patients with Generalized Pustular Psoriasis
Authors: Gottlieb Alice , Zimmermann Thomas , Lavasani Layla , Semeco Juan , Lebwohl Mark
Published: November 2023

Introduction: Generalized pustular psoriasis (GPP) is a rare, chronic, neutrophilic skin disease characterized by recurring flares of widespread erythema, edema, coalescing pustules, and possible systemic symptoms. GPP flares may require hospitalization and can be life-threatening. There are limited data describing the mortality burden of GPP in the US. This study compared all-cause mortality among patients with GPP with matched patients with plaque psoriasis (PsO), and the general population without GPP or PsO.

 Methods: Inovalon Insights real-world claims data were used to identify 5 cohorts (All GPP, Comorbid GPP+PsO, GPP Only, PsO Only, General Population) based on the International Classification of Diseases, Tenth Revision (ICD-10) diagnosis codes from Jan 1, 2016, to Dec 31, 2019. GPP Only, PsO Only, and Comorbid GPP+PsO were mutually exclusive. All GPP included GPP Only (excluding PsO) and Comorbid GPP+PsO. General Population comprised qualifying patients without a medical claim for GPP or PsO during pre- and post-index periods. All-cause mortality was assessed both 365 days post-index diagnosis and during a maximum follow-up period (until study period ended or patient experienced an event). Greedy caliper propensity score matching was used to match GPP patients 1:2 to PsO and General Population using index year, age, gender, insurance type, region, and Charlson Comorbidity Index (CCI). All-cause mortality risk was assessed using Cox proportional hazard models.

Results: Patients were primarily female and commercially insured. The GPP Only cohort was older at index and had higher CCI scores than PsO Only and General Population (p<0.001), highlighting the higher severity of GPP. At 365 days follow-up, All GPP had a significantly higher mortality risk than General Population (HR 4.93, 95% CI 2.24-10.88) and PsO Only (HR 2.31, 95% CI 1.32-4.04). GPP+PsO had a significantly higher mortality risk than PsO Only (HR 2.67, 95% CI 1.15-6.20). At 365 days follow-up, GPP Only had a numerically higher mortality risk than PsO; risk was significantly higher at the later timepoint. At maximum follow-up, the mortality risk for All GPP was almost 4 times higher than General Population (HR 3.98, 95% CI 2.92-5.43) and 1.5 times higher than PsO Only (HR 1.49, 95% CI 1.20-1.85). In GPP+PsO and GPP Only, the mortality risk was almost 1.5 times the risk of PsO Only (HR 1.41, 95% CI 1.05-1.90; HR 1.49, 95% CI 1.10-2.03); all comparisons at maximum follow-up were statistically significant.

Conclusion: This study characterizing all-cause mortality in patients with GPP demonstrated a higher risk of mortality in GPP than matched PsO and General Population cohorts. These results fill a gap in the existing literature and reinforce the need for awareness of the mortality burden and the comorbidity burden in GPP
PASI Improvement in the First 12 weeks from the Phase 3 VOYAGE 1, VOYAGE 2, ORION and ECLIPSE Guselkumab Clinical Trials
Authors: Abbarin Nastaran , Papp Kim , Vender Ronald , Langley Richard , Ho Vincent , Park-Wyllie Laura , Miller Megan , You Yin , Yang Ya-Wen
Published: November 2023

Background VOYAGE 1, VOYAGE 2, ORION, and ECLIPSE are Phase 3, double-blind trials of guselkumab 100 mg s/c at Weeks 0, 4, 12, then Q8W in moderate to severe plaque psoriasis. VOYAGE 1 and VOYAGE 2 included placebo and active comparator groups, ORION was placebo controlled, and ECLIPSE included an active comparator control group. The objective of this analysis was to evaluate PASI improvement among subjects treated with guselkumab over the induction phase of treatment. 

Methods Medan (interquartile) PASI improvements were evaluated at W4, W8, and W12. Analyses were performed using treatment failure rules, which considered non-responders as those who discontinued due to lack of efficacy or worsening of PsO, or use of a protocol prohibited PsO treatment.  Mean PASI improvement responses were also assessed.  

Results VOYAGE 1 included 329 subjects randomized to receive guselkumab, while VOYAGE 2, ORION and ECLIPSE trials included 496, 62, and 534 subjects randomized to guselkumab, respectively.  At W4, median PASI improvements were 56.70%, 56.85%, 37.15% and 67.50% for VOYAGE 1, VOYAGE 2, ORION and ECLIPSE, respectively.  At W8, median PASI improvements were 82.60%, 85.00%, 78.55% and 89.70% for the studies, respectively.  Similarly, at W12, median PASI improvements were 92.50%, 91.95%, 93.20% and 95.70%, respectively.    

Conclusions Median PASI improvements of approximately 60% were observed following 1st dose of guselkumab at W4, except ORION, and increased to greater than 90% after the 2nd dose of guselkumab at W12. This analysis provides information on the onset of action of guselkumab during the first few months of treatment.
Efficacy and Safety of Risankizumab Compared with Apremilast in Patients with Moderate Plaque Psoriasis: Mean PASI and BSA Results From the Phase 4 IMMpulse Trial
Authors: Stein Gold Linda , Bagel Jerry , Tyring Stephen Keith , Hong Chih-ho , Pavlovsky Lev , Pinter Andreas , Reich Adam , Drogaris Leonidas , Wu Tianshuang , Photowala Huzefa , Stakias Vassilis , Richter Sven , Papp Kim
Published: November 2023

Introduction

The IMMpulse study (NCT04908475) demonstrated superior efficacy of risankizumab (RZB) compared to apremilast (APR) in systemic-eligible patients with moderate plaque psoriasis (PsO).

Material and Methods

This phase 4, multi-center, randomized, open-label, assessor-blinded, active comparator study compared RZB to APR in adult systemic-eligible patients with moderate plaque PsO. In period A, patients  were randomized 1:2 to receive RZB (150 mg) or APR (30 mg twice daily) for 16 weeks. In period B, all APR-treated patients were re-randomized 1:1 to RZB or APR stratified by their ≥ 75% improvement in psoriasis area and severity index (PASI75) response. All RZB patients in period A continued treatment till week 52. Pre-specified efficacy endpoints included change in PASI and body surface area (BSA) from baseline. Continuous endpoints were assessed using mixed-effect model repeat measures to handle missing data.

Results

Baseline characteristics were similar between the treatment arms. At week 16, PASI75 was achieved by 84.7% (RZB-treated) and 18.8% (APR-treated) patients. Mean PASI improved from 14.6 at baseline to 1.7 (RZB-treated), and from 14.5 at baseline to 8.8 (APR-treated) patients. Mean BSA improved from 13.1% to 2.6% with RZB, and from 13.1% to 10.6% for APR-treated patients. APR-treated patients not achieving PASI75 at week 16 who switched to RZB achieved a mean PASI of 0.7 at week 52, compared to 3.1 at week 52 in patients who continued with APR. In these same patients, those that switched to RZB achieved a mean BSA of 1.4% at week 52 compared to 6.3% for patients who continued APR. Most frequently observed treatment emergent adverse events were COVID-19 and nasopharyngitis for RZB, and diarrhea, nausea, and headache for APR.

Conclusions

These results demonstrate minimal residual disease observed with continuous RZB treatment and support the opportunity to elevate treatment outcomes with RZB in systemic-eligible patients with moderate plaque PsO.
Safety and Tolerability of Tirbanibulin 1% Treatment of Actinic Keratosis on Face and Scalp in Routine Clinical Practice Across the U.S. (PROAK Study)
Authors: Schlesinger Todd , Lebwohl Mark , Del Rosso James , Patel Vishal A. , Kircik Leon , Armstrong April , Berman Brian , Rigel Darrell , Narayanan Siva , Koscielny Volker , Kasujee Ismail , Bhatia Neal
Published: November 2023

Introduction: Actinic Keratosis (AK) has been shown to negatively affect emotional and social functioning and skin-related quality of life of patients [1]. The objective of this analysis was to evaluate safety and tolerability of tirbanibulin in AK treatment, among patients administered tirbanibulin in routine clinical practice across the U.S.

Methods: A single-arm, multicenter, prospective cohort study (PROAK: NCT05260073) was conducted in adult patients with AKs on 25 cm2 on the face or scalp who were newly initiated with once-daily tirbanibulin 1% ointment treatment (5 consecutive days course) as part of usual care. Safety and tolerability endpoints were assessed at Week-8 and Week-24 and included adverse events (AEs), serious AEs (SAE), adverse drug reactions (ADRs), serious ADRs, local skin reactions (LSR), skin scarring and pigmentation (hypo/hyperpigmentation). Number of patients discontinuing treatment because of AEs, ADRs and for any other reasons were also reported. LSR (erythema, flaking/scaling, crusting, swelling, vesiculation/pustulation, and erosion/ulceration) were scored 0-3 (absent-severe) and summed to a composite score (0-18).

Results: A total of 300 patients were included in the safety analysis population (males: 68%; mean age: 67 years; Fitzpatrick skin type II: 89%; AK on the face: 78%). A total of 98% of patients completed the 5-day treatment course. During the study, 5% of patients reported at least one AE, 4% of patients at least 1 SAE, and no patients reported serious ADR. Basal Cell Carcinoma was reported in 1% of patients and Squamous Cell Carcinoma in 2% of patients; all cases were considered not related to treatment.  No patients discontinued the study due to AEs or ADRs. At Week-8, the most reported LSR were erythema (48% mild-moderate, 5% severe) and flaking/scaling (50% mild-moderate, 3% severe). The rest of LSR were reported in 2-8% of patients (8% crusting, 5% swelling, 2% vesiculation/pustulation, and 2% erosion/ulceration) and all were mild-moderate in severity. Mean (min-max) LSR composite score was 0.94 (0-11). At Week-8, scarring or hypo/hyperpigmentation was observed in 1%, 5% and 3% of patients, respectively.  

Conclusions: Once-daily tirbanibulin 1% ointment for 5 consecutive days showed a favorable safety and tolerability profile in the treatment of AK of the face or scalp.

[1] Schlesinger T et al. Skin. 2023;7(3):771-787.
Distribution of SALT scores by Therapeutic Tesponse in Patients with Severe Alopecia After 52 weeks of Baricitinib Therapy
Authors: Atanaskova Natasha , Senna Maryanne , Mostaghimi Arash , Seneschal Julien , McMichael Amy , Somani Najwa , Lu Na , Zou Jianxiang , Jedynak Jakub , Torisu-Itakura Hitoe , Shapiro Jerry
Published: November 2023

Introduction: In pivotal BRAVE-AA1 and AA2 phase 3 clinical trials, the Janus kinase (JAK)1/JAK2 inhibitor baricitinib has demonstrated efficacy in achieving clinically meaningful regrowth of hair in patients with severe alopecia areata. While a significant proportion of patients achieve regrowth by weeks 36 and 52 on baricitinib versus placebo, other patients, particularly those with longer episode duration or with higher disease severity, require more time on therapy to see full treatment benefit. The treatment benefit and distribution of SALT scores at Week 52 across the spectrum of responders is reported here.

Methods: Adults with Severity of Alopecia Tool (SALT) score ≥50 (≥50% scalp hair loss) were enrolled into BRAVE-AA1 and BRAVE-AA2. Patients were randomized 2:2:3 to receive once-daily placebo (N=345), baricitinib 2 mg (BARI-2MG) (N=340), or baricitinib 4 mg (BARI-4MG) (N=515). Patients randomized to baricitinib retained their treatment allocation through Week 52. Pooled outcomes were assessed by baricitinib group and in patients with SALT score ≤20 versus SALT score >20 at Week 52. Median and interquartile range (IQR) of SALT scores was assessed with last observation carried forward.

Results: At baseline, the median SALT score across 1200 randomized patients was 96 (near-total hair loss), with 638 (53.2%) having SALT score 95-100. At Week 52, 24.1% of patients who received BARI-2MG and 41.6% of patients who received BARI-4MG had SALT score ≤20; median (IQR) absolute SALT scores in this group were 7 (1-12) with BARI-2MG treatment and 3 (0-11) with BARI-4MG treatment. 17.9% of patients who received BARI-2MG and 18.8% of patients who received BARI-4MG patients achieved SALT scores of 21-49 at Week 52; median (IQR) scores were 34 (27-41) following BARI-2MG treatment and 31 (26-42) following BARI-4MG treatment.

Conclusions: While a significant proportion of patients achieved SALT ≤20, the findings of this analysis indicate that partial benefit across scalp hair regrowth is achieved even if patients do not meet clinical response criteria of SALT ≤20. There is a substantial proportion of patients who demonstrate movement towards improvement across the SALT score spectrum. In these patients, a longer treatment course may be necessary to achieve optimal treatment outcomes.  

Funded by Eli Lilly and Company.
Prevention of cascading fire development at thermal power plants in Vietnam based on the use of tanks with a protective wall and a wave-reflecting visor
Authors:   State Fire Academy of EMERCOM of Russia, Shvyrkov Sergey A. , Bui Quang Tien ,   Institute of Fire Safety of the Ministry of Public Safety of the Socialist Republic of Vietnam
Published: November 2023

PURPOSE. The article, based on the results of an statistics analysis of vertical steel tanks (VST) destruction with flammable liquids, as well as forecasting the situation on the territory of a thermal power plant (TPP) during destruction of a typical VST-20 000 m3 with fuel oil, substantiates the need to use tanks with protective wall (TPW) and a wave-reflecting visor in tank farms at thermal power plants in Vietnam, as one of the promising methods aimed at preventing the possible cascading fire development at the facility or the occurrence of an emergency situation (ES). The main provisions of the method developed on the basis of performed experimental studies have been presented, which establishes the procedure for calculating the geometric parameters of a protective wall with a horizontal or inclined wave-reflecting visor, designed to completely contain the breakthrough wave during the quasi-instantaneous destruction of the main (internal) VST. METHODS. In the process of research methods of similarity theory and hydraulic laboratory modeling, physical experiment, observation, comparison, finding an empirical relationship based on mathematical processing of experimental data, description and generalization have been used. FINDINGS. The features of the location of thermal power plants in Vietnam have been revealed, consisting in their direct location in populated areas or near water bodies. It has been established that destruction of even one large-sized VST with flammable liquid in the tank farm of a thermal power plant can lead to a cascade development of an accident or emergency occurrence. It has been proven that installing a wave-reflecting visor on the protective wall is an effective way to reduce it to or below the maximum liquid level in the main VST, depending on the distance between the walls and the length of the visor extension. RESEARCH APPLICATION FIELD. The developed method, containing calculation schemes and empirical dependencies, can be the basis for the development of a regulatory document to ensure fire safety of TPW, including when they are located on the territory of tank farms of thermal power plants. CONCLUSIONS. The proposed design of the PWT, improved by installing a wave-reflecting visor, will make it possible to design and operate these types of tanks, ensuring the required level of fire, industrial and environmental safety at the protection site, subject to, among other things, the requirements for the stability of the wall and the visor to the effects of liquid flow and the main VST structures that collapse during an accident.
Expert assessment problems in organization, management and activities of fire extinguishing crews
Authors:   Forensic Expert Institution of the Federal Fire Service “Fire Testing Laboratory for the Irkutsk Region”, Kashin Aleksander N. , Pleshakov Vitaly V. ,   State Fire Academy of EMERCOM of Russia, Ishchenko Andrew D. ,   State Fire Academy of EMERCOM of Russia, Plotnikova Galina V. ,   Forensic Expert Institution of the Federal Fire Service “Fire Testing Laboratory for the Irkutsk Region”
Published: November 2023

PURPOSE. The article deals with the problems associated with the expert assessment of fire extinguishing activities. A group of people interested in conducting assessing activities at extinguishing fires has been identified. The purpose of the analysis is to consider the research comprehensive problems in the field of assessing organization, management and activities of the crews at fire extinguishment during forensic examination. The goals of the study are to assess objectively the methodological approach for solving the problems of “fire-tactical examination”, identify existing drawbacks and form the basis for the development of a methodological approach to “fire-tactical examination”. METHODS. Systemic analysis, comparison and expert analysis methods have been used during the study. FINDINGS. It has been determined that “fire-tactical examination” is part of fire-technical examination. Causal relationship assessment of fire-fighting activities and the consequences occurred is the necessary part of the expert study. The most effective method of studying the effectiveness of organizing firefighting activities is modeling. RESEARCH APPLICATION FIELD. The results can be applied in the development of organizational and scientific-methodological support for “fire-tactical examination”. Solving the identified problems will improve the methodological tools of “fire-tactical expertise”. CONCLUSIONS. To conduct an expert assessment of organization, management, and activities of the crews at fire extinguishment, qualified specialists in conducting fire and technical examinations are needed, who know the basics of the origin, development and fire extinguishment, fire extinction tactics, as well as have practical experience and knowledge for summarizing the materials obtained.
Determining critical foam layer thickness for localization and elimination of liquefied natural gas spills flame combustion
Authors:   State Fire Academy of EMERCOM of Russia, Aleshkov Mikhail V. , Molchanov Viktor P. ,   State Fire Academy of EMERCOM of Russia, Makarov Sergey A. ,   State Fire Academy of EMERCOM of Russia, Ioshchenko Dmitry A. ,   State Fire Academy of EMERCOM of Russia, Bituev Rashid B. ,   State Fire Academy of EMERCOM of Russia, Tretyakov Aleksey V. ,   LLC “Egida PTV”
Published: November 2023

PURPOSE. Increasing attention has been paid recently to applying high-expansion foam as means of localizing and eliminating liquefied natural gas spills flaming combustion. Scientific sources widely discuss the issues of foam expansion rate and elasticity, critical intensity of its supply and application rate. However, critical foam layer thickness is underestimated. At the same time one of the reasons for fire-fighting foam low efficiency is precisely the difficulty in providing required foam layer thickness. The purpose of this publication is to assess relationship between critical foam layer thickness and main parameters of localizing and eliminating liquefied natural gas flaming combustion. METHODS. Review of scientific works covering the issue of flammable liquids and liquefied natural gas foam fire extinguishment has been carried out. Methods for providing required foam layer thickness and determining foam fire extinguishing efficiency are analyzed. Results of researchers’ own experiments have been discussed, taking into account international and domestic experience in conducting similar studies. FINDINGS. Based on researchers’ own experimental data analysis, taking into account information from scientific sources, critical foam layer thickness assessment has been made for foams of various expansions used to localize and eliminate liquefied natural gas spills flaming combustion. Approximate foam layer thickness in centimeters should be at least a quarter of high-expansion foam expansion value. RESEARCH APPLICATION FIELD. The results obtained provide general understanding that to ensure efficiency of liquefied natural gas flaming combustion localization and elimination, it is necessary to ensure not only appropriate foam expansion and application rate, but also required foam layer thickness. The results can be used in scientific research and educational process, as well as by fire services and emergency rescue units in elimination of accidents accompanied by liquefied natural gas spills flaming combustion. CONCLUSIONS. Foam layer thickness is the key parameter for liquefied natural gas spills foam fire extinguishment and providing controlled burning technology. Depending on foam supply intensity the necessary condition for providing liquefied natural gas flaming combustion localization and elimination is to achieve or exceed critical foam layer thickness. Critical foam layer thickness depends on foam expansion ratio. As foam expansion ratio increases, critical foam layer thickness rises, its value can exceed two or more meters.