bluuebunny/crossref_metadata_2025 huggingface dataset:
Intra‐ and Inter‐Rater Reliability of Linear and Nonlinear Measures of Short‐Term Heart Rate Variability Following Combat‐Related Traumatic Injury
Authors: Maqsood Rabeea , Schofield Susie , Bennett Alexander N. , Khattab Ahmed , Bull Anthony M. J. , Fear Nicola T. , Boos Christopher J. ,   for the ADVANCE Study
Published: August 2024

Background

Heart rate variability (HRV) is a marker of autonomic function. However, the reliability of short‐term HRV measurement in individuals with combat‐related traumatic injury (CRTI) remains undetermined.

Methods

An intra‐ and inter‐rater reliability study was conducted using a subsample (n = 35) of British servicemen with CRTI enrolled in the ongoing ADVANCE study. A five‐minute epoch of single‐lead electrocardiogram data collected during spontaneous breathing was used to measure HRV. HRV analyses were independently performed by two examiners using Kubios. Intraclass correlation coefficient (ICC), standard error of measurement (SEM), minimum detectable change (MDC), and coefficient of variance were calculated for linear [root mean square of successive difference (RMSSD), standard deviation of NN interval, low‐frequency, high‐frequency, total power] and nonlinear (SD1‐2, acceleration and deceleration capacities, sample entropy) measures. Bland–Altman %plots were used to assess bias in intra‐ and inter‐rater HRV data.

Results

The mean age of participants was 39.3 ± 6.3 years. An excellent ICC score of 0.9998 (95% CI 0.9997, 0.9999) was observed for intra‐rater analyses of RMSSD, and similar excellent ICC scores were seen for all other HRV measures. The inter‐rater reliability analyses produced an excellent ICC score (range 0.97–1.00). Comparatively, frequency‐domain measures produced higher MDC% and SEM% scores than time‐domain and nonlinear measures in both inter‐ and intra‐rater analyses. The Bland–Altman plots revealed relatively higher bias for frequency‐domain and nonlinear measures than time‐domain measures.

Conclusion

ECG‐related short‐term HRV measures were reliable in injured servicemen under spontaneous breathing. However, the reliability appeared better with the time‐domain measure than frequency‐domain and nonlinear measures in this sample.
Facial growth dynamics dictate optimal facemask fitting during the first year of life
Authors: Haase Bianca , Badinska Ana‐Maria , Sowula Julian , Springer Laila , Schwarz Christoph E. , Stauch Anette , Weismann Christina , Poets Christian F. , Wiechers Cornelia
Published: August 2024

Aim

The aim of this study is to prevent mask leak during ventilation in infant emergencies, appropriate facemask fitting is essential. Therefore, we investigated facial profiles during the first year of life and their correlation with the correct sizing of masks.

Methods

This is a post hoc subgroup analysis of 32 healthy term infants, based on a prospective observational study performed from September 2018 to December 2019 in Tuebingen, Germany. In 3‐monthly intervals, facial aspects were measured based on anatomical landmarks in three‐dimensional frontal photographs to describe their changes across the first year of life. All infants were awake and breathing spontaneously; none required any anaesthesia.

Results

In 130 3D images, mean distance between nasion and gnathion was 54 mm (3.3) measured at birth and 70 mm (3.5) at age 12 months. Gompertz models showed relevant growth‐related changes in the facial profile in vertical but not horizontal direction. Vertical growth occurred mainly in the first 6 months. Boys and girls differed by an average of about 2 mm (boys >girls).

Conclusion

Based on our findings, it should now be verified whether the 50 mm facemasks are suitable for infants from birth to 2 months of age, respectively, the 60 mm version for infants aged three to 12 months.
Non‐invasive analysis of Chinese traditional dyes in royal textiles of the Qing dynasty by excitation–emission matrix fluorescence
Authors: Zhao Li , Wang Yunli , Zhang Yun , Wang Xu , Lei Yong , Gu An
Published: August 2024

Chinese royal textiles of the Qing dynasty are widely collected around the world, creating a significant demand for dye identification in these textiles. However, the need for sampling in conventional analytical methods greatly limits their applicability. To address this issue, a non‐invasive analysis method based on excitation–emission matrix (EEM) fluorescence was developed. In this study, the EEM spectra of 18 typical natural dyeing recipes used for royal textiles of the Qing dynasty were systematically characterized. The results demonstrated that EEM fluorescence is effective in discriminating between natural dyes with similar colour hues and various dyeing techniques. Furthermore, the dyeing recipes of two historical kesi cushions in the Palace Museum, Beijing, were non‐invasively decoded.
Plasma ofCS‐modified CD44 predicts the survival of patients with lung cancer
Authors: Wu Zi‐Yi , Yang Da‐Wei , He Yong‐Qiao , Wang Tong‐Min , Zhou Ting , Li Xi‐Zhao , Zhang Pei‐Fen , Xue Wen‐Qiong , Zhang Jiang‐Bo , Mu Jianbing , Jia Wei‐Hua
Published: August 2024

Plasma levels of oncofetal chondroitin sulfate (ofCS)‐modified CD44 have emerged as a promising biomarker for multi‐cancer detection. Here, we explored its potential to predict the survival of patients with lung cancer. A prospective observational cohort was conducted involving 274 newly diagnosed patients with lung cancer at the Sun Yat‐sen University Cancer Center from 2013 to 2015. The plasma levels of ofCS‐modified CD44 were measured, and Cox regression analysis was performed to assess the association between plasma‐modified CD44 levels and overall survival (OS) as well as other prognostic outcomes. Prognostic nomograms were constructed based on plasma ofCS‐modified CD44 levels to predict survival outcomes for patients with lung cancer. Patients with high expression ofCS‐modified CD44 exhibited significantly worse outcomes in terms of OS (HR = 1.61, 95%CI = 1.13–2.29, p = 0.009) and progression‐free survival (PFS). These findings were consistent across various analyses. The concordance index of the prognostic nomogram for predicting OS in both the training set and validation set were 0.723 and 0.737, respectively. Additionally, time‐dependent receiver operating characteristic (ROC) curves showed that the nomogram could serve as a useful tool for predicting OS in patients with lung cancer. Plasma ofCS‐modified CD44 may serve as an independent prognosis marker for patients with lung cancer. Further validation of its predictive value could enhance prognostic assessment and guide personalized treatment strategies for patients with lung cancer.
A genomic framework to assist conservation breeding and translocation success: A case study of a critically endangered turtle
Authors: Nelson Holly V. , Farquharson Katherine A. , Georges Arthur , McLennan Elspeth A. , DeGabriel Jane L. , Giese Melissa , Ormond Christopher , McFadden Michael , Skidmore Adam , Prangell Jarrad , Belov Katherine , Hogg Carolyn J.
Published: August 2024

Conservation breeding programs are an effective approach to addressing biodiversity loss. Captive populations are managed to maintain genetic diversity, yet there remains an “implementation gap” in effectively translating molecular genetic data into management. Technological advancements are facilitating rapid generation of genetic data, increasing accessibility for breeding programs. In 2010, Frankham and colleagues proposed a six‐stage process for establishing successful conservation breeding and release programs. Here, we describe the conservation breeding program for the critically endangered Bellinger River turtle (Myuchelys georgesi) and characterize the value of genetic sampling for informing management actions. By generating a chromosome‐level genome and population genetic data, we investigated past and present diversity and assessed relatedness among captive founders. We present a framework modeled on Frankham and colleagues six stages to assist managers in implementing genetic data into actionable conservation strategies. This framework, and worked case study, for managers aims to better guide implementation of genetic approaches into conservation breeding programs.
Marshaling science to advance large landscape conservation
Authors: Daskin Joshua H. , Meeks Angeline , Sclater Vivienne L. , Sorfleet Julie M. , Oetting Jon , Hoctor Thomas S. , Guthrie Joseph M. , Swain Hilary M.
Published: August 2024

Applying science to conservation requires deliberate planning and action infrequently taught in academic settings. To illustrate impactful analysis and science communication, we describe scientific activities targeting the needs of land trusts, NGOs, landowners, and government agencies working to conserve the Florida Wildlife Corridor (“Corridor”). This 7.2 million hectare area is prioritized for habitat connectivity conservation in the US state of Florida. Our activities are built on decades of science guiding Florida land conservation. We quantified threats (e.g., average of over 14,000 ha of development/year from 2001 to 2019) and socio‐ecological benefits of Corridor conservation, prioritized yet‐to‐be‐conserved Corridor areas, produced and shared a new statewide connectivity model, and convened groups to identify campaign science needs. The new connectivity model—the Florida Circuit Model—supported the geography of the Corridor, as designated, and facilitates local (10 km radius, or less) conservation planning. Our efforts have contributed to allocation of over $2 billion for land conservation and the permanent protection of over 82,000 ha within the Corridor by state agencies from June 2021 to March 2024. Targeting science to outreach and policy, planning, and management decisions can motivate public, media, researcher, and government support for land conservation, improve conservation interventions, and attract research funding.
Assessing the societal value of health lost to alcohol use in India compared to excise taxes on alcohol sales
Authors: Zadey Siddhesh
Published: August 2024

Introduction

We retrospectively studied the societal value of lost health due to alcohol use and compared it with excise taxes on alcohol sales for India in 2019.

Methods

We estimated the overall alcohol‐attributable disease burden using disability‐adjusted life‐years (DALY) for India and its 30 states for all causes with alcohol use as a risk factor from the GBD 2019 Study. The societal value of lost health was calculated using value of life‐year (VLY) approach by multiplying region‐specific factors from ‘Global Health 2035’, 2019–2020 GDP per capita and DALYs. We acquired the national and state‐level (top 10 states) alcohol sales excise taxes from the Reserve Bank of India. Net losses were assessed by subtracting the revenue collected from excise taxes from VLY. All values are in Indian rupees (INR).

Results

The societal value of health lost due to alcohol use in India was 6.2 (95% uncertainty interval 4.8, 7.8) trillion INR in 2019. The absolute state‐level values varied from 7.3 (4.7, 10.4) billion INR in Mizoram to 1.1 (0.8, 1.4) trillion INR in Maharashtra. The per capita values ranged from 950.2 (642.9, 1285.3) INR for Bihar to 61,332 (39,273.7, 87,288.5) INR for Mizoram. Nationally, excise tax collection from alcohol sales was 1.8 trillion INR depicting a net loss of 4.4 (3.1, 6.0) trillion. Maharashtra had the largest absolute and per capita net loss.

Discussion and Conclusions

These are novel estimates depicting the net losses due to alcohol use in India with direct policy implications to disincentivise sales and adequately raise taxes.
[P3]PP, a stable, long‐acting pancreatic polypeptide analogue, evokes weight lowering and pancreatic beta‐cell‐protective effects in obesity‐associated diabetes
Authors: Tanday Neil , Zhu Wuyun , Tarasov Andrei I. , Flatt Peter R. , Irwin Nigel
Published: August 2024

Aim

To thoroughly investigate the impact of sustained neuropeptide Y4 receptor (NPY4R) activation in obesity‐associated diabetes.

Methods

Initially, the prolonged pharmacodynamic profile of the enzymatically stable pancreatic polypeptide (PP) analogue, [P3]PP, was confirmed in normal mice up to 24 h after injection. Subsequent to this, [P3]PP was administered twice daily (25 nmol/kg) for 28 days to high‐fat‐fed mice with streptozotocin‐induced insulin deficiency, known as HFF/STZ mice.

Results

Treatment with [P3]PP for 28 days reduced energy intake and was associated with notable weight loss. In addition, circulating glucose was returned to values of approximately 8 mmol/L in [P3]PP‐treated mice, with significantly increased plasma insulin and decreased glucagon concentrations. Glucose tolerance and glucose‐stimulated insulin secretion were improved in [P3]PP‐treated HFF/STZ mice, with no obvious effect on peripheral insulin sensitivity. Benefits on insulin secretion were associated with elevated pancreatic insulin content as well as islet and beta‐cell areas. Positive effects on islet architecture were linked to increased beta‐cell proliferation and decreased apoptosis. Treatment intervention also decreased islet alpha‐cell area, but pancreatic glucagon content remained unaffected. In addition, [P3]PP‐treated HFF/STZ mice presented with reduced plasma alanine transaminase and aspartate transaminase levels, with no change in circulating amylase concentrations. In terms of plasma lipid profile, triglyceride and cholesterol levels were significantly decreased by [P3]PP treatment, when compared to saline controls.

Conclusion

Collectively, these data highlight for the first time the potential of enzymatically stable PP analogues for the treatment of obesity and related diabetes.
Reduced insulin clearance in paediatric metabolic (dysfunction)‐associated fatty liver disease and its dual role in beta‐cell offload and diabetes risk
Authors: Jiang Li , Lai Jinxin , Xu Xu , Lu Yang , Gu Kefeng , Chen Sha , Xu Lulian , Liu Kerong
Published: August 2024

Aim

Diminished hepatic insulin clearance (HIC) is observed in obese adults and is presumed to be mediated by fatty liver. However, few reports have examined HIC in Chinese children with metabolic (dysfunction)‐associated fatty liver disease (MAFLD). This study aimed to investigate the correlation between HIC, insulin sensitivity and β‐cell function in obese Chinese children with MAFLD.

Methods

In total, 204 obese children (74 MAFLD) aged 4–17 years were enrolled into this study. HIC, insulin sensitivity and β‐cell function were calculated using the oral glucose tolerance test (1.75 g/kg body weight). Correlation analyses between the HIC and clinical variables were performed using Pearson's product–moment correlation coefficients. HIC and glucose homeostasis were assessed in a high‐fat diet mouse model, and liver samples were collected for molecular analysis.

Results

Obese children with MAFLD exhibited significantly lower HIC (AUCC‐peptide/insulin ratio, p = 0.0019), higher insulin resistance (homeostatic model assessment of insulin resistance, p = 0.002), and increased compensatory β‐cell function (homeostatic model assessment‐β, p = 0.046) than obese children without liver involvement. Notably, HIC was negatively correlated with insulin sensitivity (r = −0.5035, p < 0.0001) and β‐cell function (r = −0.4576, p < 0.0001). However, pancreatic β‐cell dysfunction (p = 0.046) was accompanied by future reduced HIC (p = 0.034) in children with MAFLD in prediabetes. In a high‐fat diet mouse model, MAFLD mice showed a 50% reduction in insulin‐degrading enzyme expression, consistent with the observed decrease in HIC.

Conclusions

A lower HIC may offload pancreatic β‐cells at an early stage. However, obese children with MAFLD are at risk of developing diabetes, and preventive efforts should be prioritized.
Effects of Physical Activity on Disordered Eating Behaviours in Individuals With a Psychotic Disorder
Authors: Carrier Kathya , Abdel‐Baki Amal , Thériault Lorilou , Karelis Antony D. , Lecomte Tania , Romain Ahmed Jérôme
Published: August 2024

Aim

This study aims to determine the effect of physical activity on cognitive restraint, uncontrolled eating and emotional eating in individuals with a psychotic disorder.

Methods

Twenty‐seven participants with a psychotic disorder (55% male; mean age: 30 ± 7.5 years; Caucasian: 66.7%; schizophrenia spectrum disorders: 44.4%; bipolar disorder with psychotic features: 29.6%) took part in a 6‐month bi‐weekly physical activity program (walking, running, yoga, cycling and dancing). The Three‐Factor Eating Questionnaire was used to assess participant's eating behaviours, and the frequency of completed physical activity sessions was compiled.

Results

The mixed models analysis approach revealed that the level of cognitive restraint remained unchanged (pre: 39.2 ± 18.7 vs. post: 44.1 ± 18.3; p = 0.24), while the levels of uncontrolled eating (pre: 39.7 ± 19 vs. post: 31.6 ± 19.7; p = 0.02) and emotional eating (pre: 45.5 ± 22.3 vs. post: 32.2 ± 22.2; p < 0.001) decreased at the end of the 6‐month physical activity program.

Discussion

This study showed that physical activity has positive effects on disordered eating behaviours in individuals with a psychotic disorder, similarly to previous studies on other populations (e.g., overweight and obese participants, postmenopausal women).

Conclusion

Further studies are warranted to better understand the role of physical activity in moderating eating behaviours.
MYC translocation is a valuable marker for the development and relapse of extramedullary disease in multiple myeloma
Authors: Song Yuhang , Du Jianhua , Jin Xianghong , Li Hui , Jia Congwei , Liu Yuanyuan , Li Kaimi , Zhou Daobin , Zhuang Junling
Published: August 2024

Objective

To study the cytogenetic characteristics of extramedullary disease (EMD) in patients with multiple myeloma (MM) and their impact on prognosis.

Methods

Patients with newly diagnosed MM (NDMM) at Peking Union Medical College Hospital (Beijing, China) between June 2007 and December 2019 were recruited for this study. Demographic information, clinical data, fluorescence in situ hybridization (FISH) results of marrow and tissue samples, and survival outcome data were collected.

Results

A total of 439 patients with NDMM were divided into those without EMD (non‐EMD, n = 339), those with EMD with primary paraosseous plasmacytoma (pEMD‐B, n = 48), those with primary EMD with soft‐tissue involvement (pEMD‐S, n = 33), and those with secondary EMD (sEMD, n = 19). The incidence of EMD was 18.5% (81/439) at diagnosis and 22.8% (100/439) throughout the disease course. Comparison of FISH results showed a higher proportion of RB1 deletion (n = 20; 60.0% vs. 20.0%, p = .013) and MYC translocation (n = 12; 44.4% vs. 12.5%, p = .041) in the extramedullary tissues than in the paired bone marrow samples. At diagnosis, the percentage of MYC translocations in the sEMD group was notably higher than that in the non‐EMD group (55.6% vs. 15.5%, p = .012). The median overall survival (OS) of patients with pEMD‐S (32 months) and sEMD (17 months) was significantly shorter (both p = .001) than that of non‐EMD patients (60 months).

Conclusion

Soft‐tissue EMD can be considered a high‐risk condition, even in the era of novel agents. MYC translocation can serve as a valuable marker that correlates with extramedullary spread and relapse in patients with MM and should be considered for inclusion in routine FISH panels in clinical practice.
Joint Declaration on the Doctrine of Justification
Authors: O'Brien Christopher M.
Published: August 2024

The year 2024 marks 25 years since the Lutheran World Federation and the Catholic Church signed the Joint Declaration on the Doctrine of Justification (JDDJ), along with an Official Common Statement and an attached Annex, on 31 October 1999. In reflecting upon the JDDJ, this article attempts to evaluate the impact of the declaration by addressing the following questions: What did the JDDJ accomplish, and what did it fail to achieve? What progress has been made since 1999 to build on the work of the JDDJ? What work still needs to be done moving forward in Catholic–Lutheran dialogue? The article concludes that the JDDJ has had a ground‐breaking impact in ecumenical dialogue – both in and beyond the Catholic–Lutheran context – that continues to unfold today. While there is a long way to go in the ecumenical venture, the JDDJ represents a pivotal moment and a sign of hope for visible Christian unity, which is the goal of ecumenism.
Unlocking the potential: A review of artificial intelligence applications in wind energy
Authors: Dörterler Safa , Arslan Seyfullah , Özdemir Durmuş
Published: August 2024

This paper presents a comprehensive review of the most recent papers and research trends in the fields of wind energy and artificial intelligence. Our study aims to guide future research by identifying the potential application and research areas of artificial intelligence and machine learning techniques in the wind energy sector and the knowledge gaps in this field. Artificial intelligence techniques offer significant benefits and advantages in many sub‐areas, such as increasing the efficiency of wind energy facilities, estimating energy production, optimizing operation and maintenance, providing security and control, data analysis, and management. Our research focuses on studies indexed in the Web of Science library on wind energy between 2000 and 2023 using sub‐branches of artificial intelligence techniques such as artificial neural networks, other machine learning methods, data mining, fuzzy logic, meta‐heuristics, and statistical methods. In this way, current methods and techniques in the literature are examined to produce more efficient, sustainable, and reliable wind energy, and the findings are discussed for future studies. This comprehensive evaluation is designed to be helpful to academics and specialists interested in acquiring a current and broad perspective on the types of uses of artificial intelligence in wind energy and seeking what research subjects are needed in this field.
Environmental reporting in public sector organizations: A review of literature for the future paths of research
Authors: Cappellieri Francesca , Lombardi Rosa , Pizzo Michele , Vinciguerra Rosa
Published: August 2024

This article aims to determine a comprehensive resume of environmental reporting (ER) in the public sector recognizing its role in achieving the environmental sustainable development goals (SDGs). A structured literature review was conducted by content and bibliometric analysis as well as applying the analytical framework by Manes Rossi et al. (2020) to draft the state‐of‐the‐art of ER in public sector organizations and link them to the environmental SDG targets. The analysis develops insights and critical reflections on emerging research areas related to biodiversity disclosure, climate change, and carbon emission disclosure, including ER from a general perspective in the public sector and identifies future research paths that deserve in‐depth‐investigation. The originality of our study derives from the proposal of a set of renewed streams of research addressed to academics and practical communities as well as to decision‐makers and policymakers in taking urgent action to be compliant with emerging legislative issues and to be accountable toward stakeholders in preventing climate change and combating environmental impacts.
The PATCH trial: 5% lidocaine‐medicated plaster for trigeminal neuralgia—Results of a multicentric, enriched enrollment, randomized withdrawal, double‐blind, vehicle‐controlled, parallel‐group study
Authors: Zhao Chunmei , Shrestha Niti , Ren Hao , Zhang Baohui , Shen Ying , Meng Lan , Wu Dasheng , Wang Baoguo , Fan Bifa , Luo Fang
Published: August 2024

Objective

To explore the efficacy and safety of 5% lidocaine‐medicated plaster (LMP) in patients with trigeminal neuralgia (TN).

Background

TN is an excruciatingly painful type of neuropathic facial pain. Anti‐epileptics are the first‐line treatment for TN; however, these oral drugs alone sometimes fail to achieve satisfactory analgesic effects. Two retrospective studies have shown that LMP can be an effective and safe treatment option for some patients with TN. No other high‐quality clinical studies have explored the effect and safety of LMP in patients with TN.

Methods

The PATCH trial is an enriched enrollment with randomized withdrawal, double‐blind, vehicle‐controlled, parallel‐group trial performed at five study centers. Eligible patients with TN received LMP during a 3‐week initial open‐label phase. Patients who met the response criteria entered the double‐blind treatment phase and were randomly assigned for treatment with either LMP (LMP group) or vehicle patches (control group) at a 1:1 ratio. Patients who met the criteria for treatment failure were withdrawn from the double‐blind treatment phase, and treatment was continued in the remaining patients for up to 28 days. The primary outcome was the number of treatment failures. The secondary endpoints were the time to loss of therapeutic response (LTR) in the double‐blind phase and the weekly mean pain severity in both the open‐label phase and the double‐blind phase of the study.

Results

The first patient was enrolled in this study on May 1, 2021, and the enrollment of the last patient was completed on August 26, 2022. A total of 307 patients were initially screened, 226 (74.0%) of whom entered the open‐label phase. Of the 226 respondents, 124 (55.0%) were randomized to the double‐blind phase. In the double‐blind phase, 62 patients were assigned to the LMP group, and 62 were assigned to the control group. For the primary endpoint, 16 (26.0%) patients with LMP and 36 (58.0%) patients with vehicle patches met the treatment failure criteria during the double‐blind phase (relative risk, 0.48; 95% confidence interval [CI], 0.31 to 0.75; p < 0.001). The survival curve of the LTR showed that the LTR of LMP was significantly longer than that of the vehicle patches (hazard ratio, 0.275; 95% CI, 0.15 to 0.50; log‐rank p < 0.001). LMP also significantly reduced the weekly mean pain severity in the double‐blind phase of the study (p = 0.007).

Conclusions

LMP produced partial relief of pain symptoms in some patients with TN. For responders, LMP may be used as an add‐on therapy in a multidrug treatment protocol.
Tumour deposits are associated with worse survival than extranodal extension; a network meta‐analysis on tumour nodules in colorectal cancer
Authors: Brouwer Nelleke P M , van Vliet Shannon , IntHout Joanna , De Wilt Johannes H W , Simmer Femke , Hugen Niek , Nagtegaal Iris D
Published: August 2024

Lymph node metastases (LNM) play a central role in the tumour–node–metastasis (TNM) classification for colorectal cancer (CRC), with extranodal extension (ENE) as an adverse feature. ENE has never been directly compared to tumour deposits (TD). The aim of this study was to perform an up‐to‐date systematic review, including a network meta‐analysis to compare their prognostic value. A comprehensive search was conducted on PubMed, Embase, Web of Science and Cochrane databases to identify all prognostic studies on ENE and TD. A total of 20 studies were included, with 7719 cases. The primary outcome was 5‐year disease‐free survival (DFS); secondary outcomes were overall survival (OS) and disease‐specific survival (DSS). Frequentist paired and network meta‐analyses were performed using the netmeta package in R. For univariable DFS analysis, LNM + TD+ cases had a significantly worse outcome compared with LNM + ENE+ cases [hazard ratio (HR) = 1.27, 95% confidence interval (CI) = 1.06–1.53], which was no longer significant for multivariable DFS analysis (HR = 1.13, 95% CI = 0.87–1.46). All OS and multivariable DSS analyses showed a significantly worse outcome for LNM + TD+ cases compared with LNM + ENE cases. For all outcomes, both LNM + TD+ and LNM + ENE+ had a significantly increased hazard compared with LNM+ cases. This study shows that there is a trend towards worse outcome for LNM + TD+ than LNM + ENE+, not statistically significant in multivariable DFS analysis. Both groups perform significantly worse than cases with LNM only. To improve the accuracy of CRC staging, we recommend to put more emphasis on both ENE and TD in the TNM classification, with the most prominent role for TD.
Examining capillary ketone testing in hospitalised patients: indications and outcomes
Authors: Kent Thomas , Loughran Julie , Halim Bella , Fourlanos Spiros , Hayes Lachlan , Kyi Mervyn
Published: August 2024

Elevated blood ketone levels (ketosis) in inpatients with diabetes can herald diabetic ketoacidosis (DKA). However, ketosis can also occur in individuals without diabetes in certain settings. It is unclear what proportion of inpatients with ketosis are in DKA and which patients are at the highest risk of DKA. This study determined that many ketone tests are performed in individuals at low risk of DKA, and a β‐hydroxybutyrate <1.0 mmol/L had a low incidence of DKA and less need for escalation in their management.
Prevalence of pulmonary nodules detected incidentally on noncancer‐related imaging: a review
Authors: Das Ankush , Bonney Asha , Manser Renee
Published: August 2024

Pulmonary nodules are common incidental findings requiring surveillance. Follow‐up recommendations vary depending on risk factors, size and solid or subsolid characteristics. This review aimed to evaluate the prevalence of clinically significant nodules detected on noncancer‐dedicated imaging and the prevalence of part‐solid and ground‐glass nodules. We conducted a systematic search of literature and screened texts for eligibility. Clinically significant nodules were noncalcified nodules >4–6 mm. Prevalence estimates were calculated for all studies and risk of bias was assessed by one reviewer. Twenty‐four studies were included, with a total of 30 887 participants, and 21 studies were cross‐sectional in design. Twenty‐two studies used computed tomography (CT) imaging with cardiac‐related CT being the most frequent. Prevalence of significant nodules was highest in studies with large field of view of the chest and low size thresholds for reporting nodules. The prevalence of part‐solid and ground‐glass nodules was only described in two cardiac‐related CT studies. The overall risk of bias was low in seven studies and moderate in 17 studies. While current literature frequently reports incidental nodules on cardiovascular‐related CT, there is minimal reporting of subsolid characteristics. Unclear quantification of smoking history and heterogeneity of imaging protocol also limits reliable evaluation of nodule prevalence in nonscreening cohorts.
Towards understanding the role of nanomedicine in targeting TNFR2 in rheumatoid arthritis
Authors: Lambuk Fatmawati , Nordin Nor Asyikin , Mussa Ali , Lambuk Lidawani , Ahmad Suhana , Hassan Rosline , Kadir Ramlah , Mohamud Rohimah , Yahya Nurul Khaiza
Published: August 2024

Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by inflammation of the synovium and progressive joint destruction which significantly affects both quality of life and socioeconomic status. Admittedly, various treatments are available, but they are usually accompanied by various side effects, from mild to severe, and potentially with adverse events. Tumour necrosis factor‐alpha (TNF‐α) plays a crucial role in the pathophysiology of RA. It promotes inflammatory, apoptosis and necroptosis via TNF receptor‐1 (TNFR1) but elicit anti‐inflammatory effects via TNFR2. Herein, targeting TNFR2 has gained attention in RA studies. Understanding the role of nanomedicine in modulating TNFR2 signalling may be the instrument in development of RA therapies. Nanotechnology has made a significant progress in treating various conditions of diseases since its inception. Due to this, nanomedicine has emerged as a promising therapeutics approach for RA. Recent studies have demonstrated the potential of nanomedicine in RA theranostics, combining therapy and diagnostics for improved treatment outcomes. Owing to the challenges and advancements in the field of nanotechnology, nanoparticles are seen as an applicable candidate in the treatment of RA. In this review, we provide an overview of the role of nanomedicine in targeting TNFR2 for the treatment of RA and highlight the limitations of current therapies as well as the potential of nanocarriers with controlled drug release and active targeting abilities.
Introducing sectoral bargaining in the United Kingdom: Why it makes sense and how it might be done
Authors: Sisson Keith
Published: August 2024

This study argues that sectoral bargaining offers a flexible alternative to legal regulation in setting terms and conditions of employment, encourages participation and involvement, brings benefits to employers and improves productivity and performance. It also provides a platform for sector and cross‐sector social dialogue leading to improved policymaking and better macroeconomic outcomes. A statutory framework based on Wages Council‐type arrangements and Advisory, Conciliation and Arbitration Service Codes of Practice is recommended for the United Kingdom, with sectors in the ‘foundational economy’ being prioritised. Sector agreements need to be about much more than pay, though, if they are to realise their potential.
Comparisons of acoustic structures between sexes in a duetting, montane bird
Authors: Liu Huan , Yang Fanghong , Zhang Qi , Liu Pengfei , Sun Yuehua
Published: August 2024

Female song in birds is more widespread than previously thought, and studies across different species are critical for better understanding the entire evolutionary process of bird song. In this study, we recorded the songs of males and females in a duetting, montane bird species, the Elliot's laughingthrush Trochalopteron elliotii, across consecutive breeding seasons. We specifically focused on identifying the number and structure of different song types by males and females, and compared these acoustic structures between the sexes. Our findings revealed that both males and females sang sex‐specific solos. More specifically, females sang a single type of solo that varied significantly in the number of notes, whereas males produced three different solos composed of 2, 3, or 4 notes, respectively. Female solos exhibited significantly more notes and longer song duration compared to males. Male solos typically had a significantly higher maximum frequency for the entire song. No significant differences were observed in the duration of the first note, song rate, and other frequency characteristics between male and female solos. Furthermore, paired males and females coordinated their sex‐specific solos to form duets when challenged by conspecific territory intruders, both within and outside the breeding season. Sex‐specific solos suggested that male and female songs play different roles and may be subject to different selective pressures. Further research is necessary for elucidating the functions of male song, female song, and duets in this montane bird species.
Causal inference and GWAS: Rubin, Pearl, and Mendelian randomization
Authors: Cantet Rodolfo Juan Carlos , Jensen Just
Published: August 2024

Although Genome Wide Analysis (GWAS) have been widely used to understand the genetic architecture of complex quantitative traits, interpreting their results in terms of the biological processes that determine those traits has been difficult or even lacking, because of the variability in responses to the tests of hypotheses within a trait, species, and breed or cross, and the lack of follow‐up studies. It is then essential employing appropriate statistical tests that point out to the causal genes responsible of the relevant fraction of the genetic variability observed. We briefly review the main theoretical aspects of the two schools of causal inference (Rubin's Causal Model, RCM, and Pearl's causal inference, PCI). RCM approachs the hypothesis testing from a randomization perspective by considering a wider space of the observation, i.e. the “potential outcomes”, rather than the narrower space that results from defining “treatment” effects after observing the data. Next, we discuss the assumptions involved to meet the requirements of randomization for RCM with observational data (non‐designed experiments) with special emphasis on the Stable Unit Treatment Analysis (SUTVA). Due to the presence of “confounders” (i.e. systematic fixed effects, environmental permanent effects, interaction among genes, etc.), causal average treatment effects are viewed through the familiar lens of normal linear (or mixed) models. To overcome the difficulties of association analyses, a tests of causal effects is introduced using independent predicted residual breeding values from animal models of genetic evaluation that avoids the effects of population structure and confounder effects. An independent section discusses the issue of whether the additive effects defined at the “gene” level by R. A. Fisher and popularized in D. S. Falconer's textbook of quantitative genetics can be termed causal from either RCM or PCI.
Mapping Corporate Investments Between China and Europe in an Era of Geoeconomic Competition
Authors: Babic Milan , Linsi Lukas
Published: August 2024

The consolidation of geoeconomic competition puts core aspects of global economic interdependence, such as the mutual China‐EU investment relationship, under increased pressure. Headlines about ‘derisking’, ‘decoupling’ or ‘deglobalization’ dominate current debates but tend to be overly simplistic. To push the debate on China‐EU economic relations forward, we provide an empirically driven account of the first phase of the global geoeconomic turn between 2009 and 2021. By triangulating country‐level FDI data, firm‐level ownership information and firm‐level surveys, we find indications of geopolitical hedging by European and Chinese firms, but no clear move towards decoupling or deglobalization. Based on our findings, we advocate for an approach that takes the complexity of state‐firm interactions in global economic relations seriously and integrates different data sources and levels of analysis. With this, we hope to contribute to a more realistic and fine‐grained approach to the important question of China‐EU relations in the 21st century.
Lower hepatocellular carcinoma surveillance in metabolic dysfunction‐associated steatotic liver disease: Impact on treatment eligibility
Authors: Henry‐Blake Connor , Balachandrakumar Vinay , Kassab Mohamed , Devonport Joshua , Matthews Charmaine , Fox James , Baggus Elisabeth , Henney Alexander , Stern Nicholas , Cuthbertson Daniel J , Palmer Daniel , Johnson Philip J , Hughes David M , Hydes Theresa J , Cross Timothy J S
Published: August 2024

Background and Aim

This study aimed to compare the determinants and impact of hepatocellular carcinoma (HCC) surveillance rates for people with metabolic dysfunction‐associated steatotic liver disease (MASLD) versus other chronic liver diseases.

Methods

A dataset of HCC patients from a UK hospital (2007–2022) was analyzed. The Mann–Whitney U‐test compared continuous variables. The χ2 and two‐tailed Fisher exact tests compared categorical data. Regression modeling analyzed the impact of MASLD on the size and number of HCC nodules and curative treatment. The Cox proportional hazards model assessed the influence of MASLD on overall survival.

Results

A total of 176 of 687 (25.6%) HCC patients had MASLD. Fewer people with MASLD HCC were enrolled in HCC surveillance compared to non‐MASLD HCC (38 [21.6%] vs 215 [42.1%], P < 0.001). Patients with MASLD HCC were less likely to have been under secondary care (n = 57 [32.4%] vs 259 [50.7%], P < 0.001) and less likely to have cirrhosis (n = 113 [64.2%] vs 417 [81.6%], P < 0.001). MASLD was associated with a 12.3‐mm (95% confidence interval [CI] 10.8–14.0 mm) greater tumor diameter compared to people without MASLD (P = 0.002). Patients with MASLD HCC had 0.62 reduced odds (95% CI 0.43–0.91) of receiving curative treatment compared to non‐MASLD HCC (P = 0.014). Overall survival was similar for patients with MASLD HCC versus non‐MASLD HCC (hazard ratio 1.03, 95% CI 0.85–1.25, P = 0.748).

Conclusion

Patients with MASLD are less likely to have been enrolled in HCC surveillance due to undiagnosed cirrhosis or presenting with non‐cirrhotic HCC. Patients with MASLD HCC present with larger tumors and are less likely to receive curative treatment.
Hypothalamic obesity: Epidemiology in rare sellar/suprasellar tumors—A German claims database analysis
Authors: Witte Julian , Surmann Bastian , Batram Manuel , Weinert Markus , Flume Mathias , Touchot Nicolas , Beckhaus Julia , Friedrich Carsten , Müller Hermann L.
Published: August 2024

Hypothalamic obesity (HO) is defined as abnormal weight gain resulting in severe persistent obesity due to physical, tumor‐ and/or treatment‐related damage to the hypothalamus. HO epidemiology is poorly understood. We developed a database algorithm supporting the standardized identification of tumor/treatment‐related HO (TTR‐HO) patients. The algorithm is used to estimate incidence rates of TTR‐HO patients in the German healthcare context from a representative claims database (n = 5.42 million) covering 2010–2020. Patients were identified based on surgery/radiotherapy procedures and HO‐associated tumor diagnoses (n = 3976). HO was defined by incident obesity and validated based on incident diabetes insipidus diagnoses and desmopressin prescription within a 12‐month period after surgery/radiotherapy. Uncertainty due to algorithm definitions is explored in sensitivity analyses. Estimated annual incidence of TTR‐HO in Germany is between 0.7 and 1.7 cases per 1,000,000 persons (2019 prevalence: n = 1262 patients). With observed cases in all age groups, two HO‐incidence peaks are identified: children/young adults aged 10–24 years and adults aged 40–44 years. Most frequent HO‐validated tumor diagnoses are benign sellar/suprasellar tumors (6.1/1,000,000 persons over 9 years), including tumors of the craniopharyngeal duct (1.3/1,000,000), neoplasms of the pituitary gland (4.1/1,000,000), and nonspecific brain tumors of endocrine glands (2.4/1,000,000). This is the first real‐world database analysis of TTR‐HO epidemiology, refining current estimates of HO epidemiology and early patient identification. A more comprehensive characterization of patients with HO as well as a better understanding of clinical implications will be crucial in developing optimal treatment strategies to improve patient outcomes.
Einthoven's triangle adapted for horses: Proposal for the Delta configuration
Authors: Paulussen Ellen , Van Steenkiste Glenn , Hermans Ben J. M. , Decloedt Annelies , van Loon Gunther , Delhaas Tammo
Published: August 2024

Background

Reliable ECGs are crucial for diagnosing arrhythmias, yet a lack of standardization impedes arrhythmia diagnosis and treatment in horses.

Objectives

To objectively determine an optimal position of Einthoven's triangle for ECG recordings in horses at rest, which can form the basis for standardized ECG recording and improve diagnosis and treatment of arrhythmias.

Animals

The study involved 72 healthy, warmblood horses aged between 3 and 20 years.

Methods

In view of future 12‐lead studies and vectorcardiography, requiring an orthogonal system, Einthoven's triangle was positioned around the heart, in the transverse plane. Therefore, 11 electrodes were placed encircling the thorax behind the olecranon, to construct triangles with a horizontal base. Electrocardiogram recordings from different triangles were analyzed. Signal processing involved filtering, R peak detection, and median complex generation. Principal component analysis (PCA) and Euclidean distance measures were employed for data analysis.

Results

The left mid‐thoracic and ventral regions had high PCA scores, indicating high information content. Base‐down triangles exhibited higher summed Euclidean distances, contributing to enhanced diagnostic capabilities. A base‐down triangle, called “Delta (Δ) configuration” emerged as most informative, while meeting all criteria.

Conclusions and Clinical Importance

The base‐down “Delta configuration” is the optimal Einthoven's triangle adapted for horses, providing large amplitudes and potential to provide basic insights into the mechanisms and origins of cardiac arrhythmias. Because the Delta configuration is positioned in the transverse plane, it forms the ideal basis for 12‐lead ECG recordings that provide vectorcardiograms in an orthogonal coordinate system. Standardizing electrode positioning could improve ECG data comparability in equine cardiology.
Viral diversity and co‐evolutionary dynamics across the ant phylogeny
Authors: Flynn Peter J. , Moreau Corrie S.
Published: August 2024

Knowledge of viral biodiversity within insects, particularly within ants, is extremely limited with only a few environmental viruses from invasive ant species identified to date. This study documents and explores the viral communities in ants. We comprehensively profile the metagenomes of a phylogenetically broad group of 35 ant species with varied ecological traits and report the discovery of 3710 novel and unique ant‐associated viral genomes. These previously unknown viruses discovered within this study constitute over 95% of all currently described ant viruses, significantly increasing our knowledge of the ant virosphere. The identified RNA and DNA viruses fill gaps in insect‐associated viral phylogenies and uncover evolutionary histories characterized by both frequent host switching and co‐divergence. Many ants also host diverse bacterial communities, and we discovered that approximately one‐third of these new ant‐associated viruses are bacteriophages. Two ecological categories, bacterial abundance in the host and habitat degradation are both correlated with ant viral diversity and help to structure viral communities within ants. These data demonstrate that the ant virosphere is remarkably diverse phylogenetically and genomically and provide a substantial foundation for studies in virus ecology and evolution within eukaryotes. We highlight the importance of studying insect‐associated viruses in natural ecosystems in order to more thoroughly and effectively understand host‐microbe evolutionary dynamics.
Spectacle correction may affect refractive progression in children with unilateral myopic anisometropia: A retrospective study
Authors: Wang Shuai , Zhang Beilei , Liu Qiming , Zhou Fan , Chen Yunyun , Xu Jingjing
Published: August 2024

Objective

To investigate the effect of spectacle correction on refractive progression in children with unilateral myopic anisometropia (UMA).

Methods

In this retrospective study, 153 children with UMA (aged 8–12 years) were recruited and classified into an uncorrected (UC) group (n = 47) and a spectacle (SP) group (n = 106). The spherical equivalent refraction (SER) of the myopic eyes ranged from −0.75 to −4.00 D; the SER of the emmetropic eyes ranged from +1.00 to −0.25 D; anisometropia was ≥1.00 D and the follow‐up duration was 1 year. Nineteen subjects from the SP group with follow‐up records spanning at least 6 months before and after wearing spectacles were selected as a subgroup. Changes in the SER and axial length (AL), the degree of anisometropia and interocular AL differences of the two groups and the subgroup were analysed.

Results

During the 1‐year follow‐up period, AL and SER changes in myopic eyes were significantly greater than those in emmetropic eyes in the UC group (p < 0.001). For the UC group, the degree of anisometropia and AL change increased (all p < 0.001). For the SP group, there were no significant differences in the degree of anisometropia or AL change (all p > 0.05). When comparing the groups, AL elongation of the myopic eyes in the UC group occurred significantly faster than in the SP group (p = 0.02), and AL elongation for the emmetropic eyes in the UC group occurred significantly slower than in the SP group (p = 0.04). For the subgroup, the AL and SER changes in the myopic eyes 6 months before wearing spectacles occurred significantly faster than those after correction (p < 0.001).

Conclusions

Spectacle correction could prevent increased anisometropia in uncorrected children with UMA by slowing myopia progression in the myopic eyes and accelerating the myopic shift in the contralateral eye.