bluuebunny/crossref_metadata_2025 huggingface dataset:
Deep learning system for malignancy risk prediction in cystic renal lesions: a multicenter study
Authors: He Quan-Hao , Feng Jia-Jun , Wu Ling-Cheng , Wang Yun , Zhang Xuan , Jiang Qing , Zeng Qi-Yuan , Yin Si-Wen , He Wei-Yang , Lv Fa-Jin , Xiao Ming-Zhao
Published: May 2024

Objectives

To develop an interactive, non-invasive artificial intelligence (AI) system for malignancy risk prediction in cystic renal lesions (CRLs).

Methods

In this retrospective, multicenter diagnostic study, we evaluated 715 patients. An interactive geodesic-based 3D segmentation model was created for CRLs segmentation. A CRLs classification model was developed using spatial encoder temporal decoder (SETD) architecture. The classification model combines a 3D-ResNet50 network for extracting spatial features and a gated recurrent unit (GRU) network for decoding temporal features from multi-phase CT images. We assessed the segmentation model using sensitivity (SEN), specificity (SPE), intersection over union (IOU), and dice similarity (Dice) metrics. The classification model’s performance was evaluated using the area under the receiver operator characteristic curve (AUC), accuracy score (ACC), and decision curve analysis (DCA).

Results

From 2012 to 2023, we included 477 CRLs (median age, 57 [IQR: 48–65]; 173 men) in the training cohort, 226 CRLs (median age, 60 [IQR: 52–69]; 77 men) in the validation cohort, and 239 CRLs (median age, 59 [IQR: 53–69]; 95 men) in the testing cohort (external validation cohort 1, cohort 2, and cohort 3). The segmentation model and SETD classifier exhibited excellent performance in both validation (AUC = 0.973, ACC = 0.916, Dice = 0.847, IOU = 0.743, SEN = 0.840, SPE = 1.000) and testing datasets (AUC = 0.998, ACC = 0.988, Dice = 0.861, IOU = 0.762, SEN = 0.876, SPE = 1.000).

Conclusion

The AI system demonstrated excellent benign-malignant discriminatory ability across both validation and testing datasets and illustrated improved clinical decision-making utility.

Critical relevance statement

In this era when incidental CRLs are prevalent, this interactive, non-invasive AI system will facilitate accurate diagnosis of CRLs, reducing excessive follow-up and overtreatment.

Key Points

The rising prevalence of CRLs necessitates better malignancy prediction strategies.

The AI system demonstrated excellent diagnostic performance in identifying malignant CRL.

The AI system illustrated improved clinical decision-making utility.

Graphical Abstract
Sampling the user controls in neural modeling of audio devices
Authors: Mikkonen Otto , Wright Alec , Välimäki Vesa
Published: May 2024

This work studies neural modeling of nonlinear parametric audio circuits, focusing on how the diversity of settings of the target device user controls seen during training affects network generalization. To study the problem, a large corpus of training datasets is synthetically generated using SPICE simulations of two distinct devices, an analog equalizer and an analog distortion pedal. A proven recurrent neural network architecture is trained using each dataset. The difference in the datasets is in the sampling resolution of the device user controls and in their overall size. Based on objective and subjective evaluation of the trained models, a sampling resolution of five for the device parameters is found to be sufficient to capture the behavior of the target systems for the types of devices considered during the study. This result is desirable, since a dense sampling grid can be impractical to realize in the general case when no automated way of setting the device parameters is available, while collecting large amounts of data using a sparse grid only incurs small additional costs. Thus, the result provides guidance for efficient collection of training data for neural modeling of other similar audio devices.
Key forecasts and prospects for green transition in the region of Central Asia beyond 2022
Authors: Filipović Sanja , Orlov Andrei , Panić Andrea Andrejević
Published: May 2024

Background

The transition to energy-sustainable systems is a globally accepted concept, but it is implemented with various degrees of success around the world. The aim of this paper is to determine the status of green transition in five Central Asian countries (Tajikistan, Turkmenistan, Uzbekistan, Kazakhstan, and the Kyrgyz Republic) that are among the highest energy consumers globally and the most vulnerable to climate change. Despite a notable improvement in living conditions across all countries over the past two decades, the region remains underdeveloped. Economic growth is based on the export of natural resources and remittance inflows, but the structure of the economy is monolithic.

Main findings

Upon analysing transition indicators for the period 2000–2020, no evidence of significant changes towards a sustainable energy transition is found. All countries in the region (except Uzbekistan) have recorded an increase in carbon emissions, while the carbon intensity of the energy mix is almost the same. While there has been visible progress in reducing energy intensity, the countries in the region remain among the most energy-intensive economies. Despite the region’s substantial potential for renewable energy production, it remains underutilized.

Conclusions

A multitude of varied problems accompanies the green transition in Central Asian countries. The energy market that has not yet been liberalised, along with significant subsidies and low energy tariffs, discourages investments in renewable energy sources and energy efficiency initiatives. A high level of corruption, rigid legislative and institutional infrastructure, and insufficient capital are additional factors that determine the speed, scope, and effectiveness of the green transition. Thus far, the primary focus in these countries has been on ensuring energy security. However, there has been a discernible surge in investments (particularly from China) in renewable energy projects. Although energy efficiency and climate change issues are formally defined, the energy transition goals are often declarative without an action plan that provides concrete steps in transition process. Strategic planing of economic development that includes all related sectors (not only the energy sector) and paying attention to socio-economic and environmental indicators of sustainable development are prerequisites for successfully implementating the energy transition in these countries.
Seasonal freeze‒thaw processes impact microbial communities of soil aggregates associated with soil pores on the Qinghai–Tibet Plateau
Authors: Wang Rui-Zhe , Hu Xia
Published: May 2024

Background

Seasonal freeze‒thaw (FT) processes alter soil formation and cause changes in soil microbial communities, which regulate the decomposition of organic matter in alpine ecosystems. Soil aggregates are basic structural units and play a critical role in microbial habitation. However, the impact of seasonal FT processes on the distribution of microbial communities associated with soil pores in different aggregate fractions under climate change has been overlooked. In this study, we sampled soil aggregates from two typical alpine ecosystems (alpine meadow and alpine shrubland) during the seasonal FT processes (UFP: unstable freezing period, SFP: stable frozen period, UTP: unstable thawing period and STP: stable thawed period). The phospholipid fatty acid (PLFA) method was used to determine the biomass of living microbes in different aggregate fractions.

Results

The microbial biomass of 0.25–2 mm and 0.053–0.25 mm aggregates did not change significantly during the seasonal FT process while the microbial biomass of > 2 mm aggregates presented a significant difference between the STP and UTP. Bacterial communities dominated the microbes in aggregates, accounting for over 80% of the total PLFAs. The microbial communities of soil aggregates in the surface layer were more sensitive to the seasonal FT process than those in other soil layers. In the thawing period, Gram positive bacteria (GP) was more dominant. In the freezing period, the ratio of Gram-positive to Gram-negative bacterial PLFAs (GP/GN) was low because the enrichment of plant litter facilitated the formation of organic matter. In the freezing process, pores of 30–80 μm (mesopores) favored the habitation of fungal and actinobacterial communities while total PLFAs and bacterial PLFAs were negatively correlated with mesopores in the thawing process.

Conclusions

The freezing process caused a greater variability in microbial biomass of different aggregate fractions. The thawing process increased the differences in microbial biomass among soil horizons. Mesopores of aggregates supported the habitation of actinobacterial and fungal communities while they were not conducive to bacterial growth. These findings provide a further comprehension of biodiversity and accurate estimation of global carbon cycle.
A Rasch-based validation of the University of Tehran English Proficiency Test (UTEPT)
Authors: Noroozi Shadi , Karami Hossein
Published: May 2024

Recently, psychometricians and researchers have voiced their concern over the exploration of language test items in light of Messick’s validation framework. Validity has been central to test development and use; however, it has not received due attention in language tests having grave consequences for test takers. The present study sought to examine the validity of the University of Tehran English language proficiency test (UTEPT) using 6 aspects of Messick’s validation framework (i.e., content, structural, external, generalizability, substantive, and consequential). To examine each validity dimension, the Rasch model was considered. To this end, the data of 394 test takers who had taken the test in 2023 were cleaned and analyzed for the assumptions of the Rasch model and then for the 6 aforementioned validity aspects. The results indicated that the structural (i.e., unidimensionality), generalizability (i.e., measurement invariance), and substantive aspects held. However, the evidence for the content, external, and consequential aspects of validity was less definitive. The implications of the findings for the validity of the test, for the realm of language testing, and for item developers and item writers will be discussed.
Image of the five elements and prediction of the geothermal field based on gravity, magnetic and magnetotelluric data in the PanZ area
Authors: Zheng Guolei , Huang Jinshui , Zhai Peng , Wang Gang
Published: May 2024

There are two problems in the prediction of the geothermal field in the PanZ area: (1) the plane scopes have some debates, and (2) the vertical scopes need to be further ascertained. Faced with these two problems, a complete set of methods was developed and summarized, and the details are as follows: a geothermal field can be divided into five elements, i.e., heat source, fault channel, thermal reservoir, cap rock and water; then, they are interpreted and imaged with the help of gravity, magnetic and magnetotelluric (MT) data; and finally, according to the integrity of five elements and the correlation between them, geothermal fields are predicted. In the PanZ area, (1) the normalized vertical derivative of the total horizontal derivative of the Bouguer gravity anomaly was applied to identify the fault channels; (2) the water was recognized using the joint interpretation results from an integrated geophysical profile with gravity and MT data instead of a single MT result; (3) the cap rock was inverted with the Bouguer gravity anomaly, using the Parker–Oldenburg inversion method, and with the help of the MT anomaly in the integrated geophysical profile, the vertical distribution of the geothermal reservoir was further ascertained; and (4) the intermediate acid magmatic rock with radioactivity, i.e., a heat source, was identified with the residual magnetic anomaly, imaged using the magnetic forward formula of the cuboid. Finally, the two geothermal fields were predicted and outlined using the above methods. A comparison of the distributions of the geothermal gradient and the outlet water temperatures of the drill holes indicated that the predicted results are credible. To better understand the effect of the method of predicting the geothermal field, a 3D geological model was constructed from the inverted results using GOCAD software, and the operating mechanism of geothermal system was analyzed based on the migration, storage, heating and insulation of the water element in the other four elements. To determine the reason for the formation of the geothermal field, the geological evolution of four elements was discussed, except the water element.
Effects of variations in po river discharge on physical water characteristics and chlorophyll-a levels in the gulf of manfredonia
Authors: Babagolimatikolaei Javad
Published: May 2024

Rivers remarkably contribute to the transfer of fresh water and nutrients between land and marine ecosystems, underscoring their essential ecological role. The Po River contributes approximately one-third of the total freshwater discharge into the Adriatic Sea. Despite its importance, there is a lack of information regarding the impact of Po River discharge on the physical and biological characteristics of specific regions within the Adriatic Sea, such as the Gulf of Manfredonia. By using ocean model results and satellite data for 2014, 2015, 2016, and 2017, this study attempts to assess how Po River discharge fluctuations affect the Gulf’s physical properties and chlorophyll-a concentrations. We demonstrate here that river discharge, physical characteristics, and chlorophyll-a interact in complex ways within the Gulf of Manfredonia. The Gulf's temperature (correlation coefficient r = −0.33) and salinity (r = −0.38) are inversely correlated with Po River discharge, whereas sea level (r = 0.59) and vertical velocity (r = 0.54) are directly correlated to the discharge. In the Gulf, a seasonal anticyclonic eddy exhibits varying strength and shape throughout the summer and autumn, influenced by the fluctuation in Po River discharge. In December 2014, chlorophyll-a concentrations increased remarkably (over 10 mg m−3) following a remarkable rise in Po River discharges. However, there is a one-month time lag between the discharge increase and the subsequent rise in chlorophyll-a levels in the gulf.
Network pharmacology and molecular docking: combined computational approaches to explore the antihypertensive potential of Fabaceae species
Authors: Shahzadi Zainab , Yousaf Zubaida , Anjum Irfan , Bilal Muhammad , Yasin Hamna , Aftab Arusa , Booker Anthony , Ullah Riaz , Bari Ahmed
Published: May 2024

Hypertension is a major global public health issue, affecting quarter of adults worldwide. Numerous synthetic drugs are available for treating hypertension; however, they often come with a higher risk of side effects and long-term therapy. Modern formulations with active phytoconstituents are gaining popularity, addressing some of these issues. This study aims to discover novel antihypertensive compounds in Cassia fistula, Senna alexandrina, and Cassia occidentalis from family Fabaceae and understand their interaction mechanism with hypertension targeted genes, using network pharmacology and molecular docking. Total 414 compounds were identified; initial screening was conducted based on their pharmacokinetic and ADMET properties, with a particular emphasis on adherence to Lipinski's rules. 6 compounds, namely Germichrysone, Benzeneacetic acid, Flavan-3-ol, 5,7,3',4'-Tetrahydroxy-6, 8-dimethoxyflavon, Dihydrokaempferol, and Epiafzelechin, were identified as effective agents. Most of the compounds found non-toxic against various indicators with greater bioactivity score. 161 common targets were obtained against these compounds and hypertension followed by compound-target network construction and protein–protein interaction, which showed their role in diverse biological system. Top hub genes identified were TLR4, MMP9, MAPK14, AKT1, VEGFA and HSP90AA1 with their respective associates. Higher binding affinities was found with three compounds Dihydrokaempferol, Flavan-3-ol and Germichrysone, −7.1, −9.0 and −8.0 kcal/mol, respectively. The MD simulation results validate the structural flexibility of two complexes Flavan-MMP9 and Germich-TLR4 based on no. of hydrogen bonds, root mean square deviations and interaction energies. This study concluded that C. fistula (Dihydrokaempferol, Flavan-3-ol) and C. occidentalis (Germichrysone) have potential therapeutic active constituents to treat hypertension and in future novel drug formulation.

Graphical Abstract
Parents’ knowledge, perceptions and support around appropriate physical activity, screen time and sleep time levels for children
Authors: Howard Maree , Akhund Shahid A.
Published: May 2024

Background

Many governments worldwide have established guidelines regarding children’s physical activity and sedentary behaviors linked to positive health outcomes. While research has established low adherence to these guideline levels, it is unclear whether parents’ knowledge, perceptions, and support around these behaviors might be barriers to adherence.

Aims

This study examines parents’ knowledge and agreement with guideline levels of physical activity, screen time, and sleep time, as well as their support for these behaviors.

Methods

Parents of 5–12-year-old children who presented to a regional general practitioner (GP) office in New South Wales (NSW) responded to a survey regarding their child’s physical activity, screen, and sleep time, as well as what they believed to be guideline levels, their perceived ideal levels, and the levels of support they provide for each of these behaviors.

Results

Parents’ perceived ideal levels for their child’s physical activity and screen time were more ambitious than government levels and were consistent with sleep time guidelines. There were, however, few associations between parent support levels and children’s actual or perceived ideal levels of these behaviors.

Discussion

The findings suggest that parents’ perceptions of ideal levels of physical activity and sedentary behavior may not hinder adherence to government guidelines. However, inconsistent, or ineffective support strategies can constrain adherence and thus be a viable intervention target.
A Behavioral Perspective for Improving Exercise Adherence
Authors: André Nathalie , Grousset Marine , Audiffren Michel
Published: May 2024

Adherence to exercise is a crucial aspect of behavioral changes related to exercise. However, current models fail to predict behavioral change, and exercise programs struggle to foster adherence. In this Current Opinion article, we defined adherence as a process linking behavior and attitude. More specifically, exercise adherence is the process by which people’s behaviors conform to their attitudes and vice versa. Behavioral change theories should be able to predict changes, transformations, and modifications of behaviors; however, this is not currently the case. Prediction models of behavior are mainly focused on how to predict behavioral changes by affecting attitudes; however, these models have not considered the target behavior as a facilitator of adherence. Herein, a behavioral perspective is considered in three directions: first, exercise is a therapeutic modality that has the potential to improve motivation; second, chronic exercise helps sustain effort over time and increase executive functions and willpower; and third, exercise is an active behavior that has the potential to facilitate attitude change.
Effectiveness of a nurse-led management intervention on systolic blood pressure among type 2 diabetes patients in Uganda: a cluster randomized trial
Authors: Lumu William , Bahendeka Silver , Kibirige Davis , Wesonga Ronald , Mutebi Ronald Kasoma
Published: May 2024

Background

Hypertension (HT) is an orchestrator of atherosclerotic cardiovascular disease (ASCVD) in people living with type 2 diabetes (T2D). Control of systolic blood pressure (SBP) and HT as a whole is suboptimal in diabetes, partly due to the scarcity of doctors. While nurse-led interventions are pragmatic and cost-effective in the control of HT in primary health care, their effectiveness on SBP control among patients with T2D in Uganda is scantly known.

Aim

We evaluated the effectiveness of a nurse-led management intervention on SBP among T2D patients with a high ASCVD risk in Uganda.

Methods

A two-armed cluster randomized controlled trial compared the nurse-led management intervention with usual doctor-led care. The intervention involved training nurses to provide structured health education, protocol-based HT/CVD management, 24-h phone calls, and 2-monthly text messages for 6 months. The primary outcome was the mean difference in SBP change among patients with T2D with a high ASCVD risk in the intervention and control groups after 6 months. The secondary outcome was the absolute difference in the number of patients at target for SBP, total cholesterol (TC), fasting blood glucose (FBG), glycated hemoglobin (HbA1C), low-density lipoprotein (LDL), triglycerides (TG), and body mass index (BMI) after the intervention. The study was analyzed according to the intention-to-treat principle. Generalized estimating equations were used to assess intra-cluster effect modifiers. Statistical significance was set at 0.05 for all analyses.

Results

Eight clinics (n = 388 patients) were included (intervention 4 clinics; n = 192; control 4 clinics; n = 196). A nurse-led intervention reduced SBP by -11.21 ± 16.02 mmHg with a mean difference between the groups of -13.75 mmHg (95% CI -16.48 to -11.02, p < 0.001). An increase in SBP of 2.54 ± 10.95 mmHg was observed in the control group. Diastolic blood pressure was reduced by -6.80 ± 9.48 mmHg with a mean difference between groups of -7.20 mmHg (95% C1 -8.87 to -5.48, p < 0.001). The mean differences in the change in ASCVD score and glycated hemoglobin were -4.73% (95% CI -5.95 to -3.51, p = 0.006) and -0.82% (95% CI -1.30 to -0.35, p = 0.001), respectively. There were significant absolute differences in the number of patients at target in SBP (p = 0.001), DBP (p = 0.003), and TC (p = 0.008).

Conclusion

A nurse-led management intervention reduces SBP and ASCVD risk among patients with T2D. Such an intervention may be pragmatic in the screening and management of HT/ASCVD in Uganda.

Trial registration

Pan African Clinical Trial Registry, PACTR202001916873358, registered on 6th October 2019.
Managing crash risks through supply chain transparency: evidence from China
Authors: Zhong Qiming , Song Qinghua , Lee Chien-Chiang
Published: May 2024

Using data on Chinese non-financial listed firms covering 2009 to 2022, we explore the effect of supply chain transparency on stock price crash risk. Two proxies for supply chain transparency are constructed using the number of supply chain partners’ names and the proportion of their transactions disclosed in annual reports. The results reveal that enhancing supply chain transparency can decrease crash risk, specifically by mitigating tax avoidance and earnings management. Moreover, the analysis suggests that this risk-reduction effect is more prominent in companies where managers are more incentivized to hide negative information and investors possess superior abilities to acquire information. Interestingly, supplier transparency is more influential in mitigating crash risk than customer transparency. These findings emphasize the significance of supply chain transparency in managing financial risk.
Boosting wisdom of the crowd for medical image annotation using training performance and task features
Authors: Hasan Eeshan , Duhaime Erik , Trueblood Jennifer S.
Published: May 2024

A crucial bottleneck in medical artificial intelligence (AI) is high-quality labeled medical datasets. In this paper, we test a large variety of wisdom of the crowd algorithms to label medical images that were initially classified by individuals recruited through an app-based platform. Individuals classified skin lesions from the International Skin Lesion Challenge 2018 into 7 different categories. There was a large dispersion in the geographical location, experience, training, and performance of the recruited individuals. We tested several wisdom of the crowd algorithms of varying complexity from a simple unweighted average to more complex Bayesian models that account for individual patterns of errors. Using a switchboard analysis, we observe that the best-performing algorithms rely on selecting top performers, weighting decisions by training accuracy, and take into account the task environment. These algorithms far exceed expert performance. We conclude by discussing the implications of these approaches for the development of medical AI.
Ethnic representation within virtual reality: a co-design study in a forensic youth care setting
Authors: Klein Schaarsberg Renée E. , van Dam Levi , Widdershoven Guy A. M. , Lindauer Ramón J. L. , Popma Arne
Published: May 2024

Background

Virtual reality (VR) is one of the most cutting-edge digital technologies currently used to extend and adapt mental health interventions. When designing therapeutic VR-applications, bias related to representational and behavioral features can be introduced. Specific bias, that could result from ethnic stereotyping, should be averted. However, structured debates and clear guidelines on how to deal with such bias are lacking.

Objective

In the current paper we describe our iterative, co-design process to develop an augmented version of a 360-degree VR-video that is used in the Street Temptations intervention. In this intervention, aimed at adolescents with disruptive behavior problems, the VR-video provides adolescents with an emotionally engaging situation and forms the basis of Street Temptations’ perspective-taking exercises. By presenting a detailed example of our VR developmental process, specifically focusing on ethnic representation in this virtual environment and related ethical aspects, we aim to positively contribute to the creation of ethically sound therapeutic VR-applications.

Method

We adopted an experience-based co-design approach. The process started by assembling professionals’ experiences with the original VR-video. Following, we conducted four co-design groups with adolescents, young adults, and professionals within the forensic youth care system, as experiential experts, to collaboratively develop an enhanced VR-scenario for the Street Temptations intervention. In total, ten adolescents, four young adults and four professionals participated. The co-design groups were alternated with sessions with a screenwriter, to reflect on the results of the co-design groups. In this way, we enabled continuous feedback on and design of the ameliorated scenario and let development and data collection reinforce each other.

Results

The most important adjustments that were brought forward included explicit incorporation of diversity, establishing a clear storyline for the scenario, keeping the content close to reality, casting actors in a way to avoid obvious stigmatization, and using only names for the characters that are commonly used across different cultural and ethnic backgrounds.

Discussion

By presenting our developmental process, we give a detailed example of how to reflectively develop ethically sound therapeutic VR-content within a forensic youth care setting. We demonstrated that including stakeholders can help in preventing socially irresponsible and conceivably hurtful stereotypes. By describing the process in detail, we hope to contribute to the responsible use of technology within mental health care.
Synchrosqueezing voices through deep neural networks for horizon interpretation
Authors: AlSalmi Haifa , Wang Yanghua
Published: May 2024

Horizon picking is a crucial element in reservoir characterization, but it remains a labor-intensive process. Manually interpreting horizons across thousands of vertical seismic slices in a 3D seismic survey significantly increases the time and labor required for this task. Although several automated methods for extracting the horizons in seismic images have been developed, their effectiveness can be hampered by interruptions in lateral continuity, such as faults and noise. In addition, closely spaced horizons pose a challenge, making it even more difficult to recognize their exact position. To track the horizons through a 3D seismic volume, other seismic attributes extracted from the 3D seismic data must be used. We suggest using spectral voice components together with the original seismic amplitudes to track the surfaces of the target horizons. We generate the time-frequency spectrum using a high-resolution method, namely the synchrosqueezing wavelet transform (SWT), and the real part of the complex SWT spectrum is the voice component. We import the spectral voice component and the seismic amplitude into a neural network. A deep convolutional neural network is used to track the horizon surfaces within a 3D seismic volume. We evaluate this application on a field seismic data set where closely spaced thin layers are located within a complex faulted formation with noisy seismic data with a low signal-to-noise ratio. The integration of the amplitude and phase within the attribute of the voice component indicates that it improves the quality of the generated horizons, especially compared with using the seismic amplitude only for this task. An example from field data demonstrates the ability of our method to accurately delineate the horizons across fault surfaces and in the immediate vicinity of unconformities. This exceeds the current limits of the existing methods for horizon detection.
Development and evaluation of a personalised sleep care plan on child and adolescent in-patient mental health wards
Authors: Anderson Kirstie N. , Bowles Rod , Fyfe Christine , Weddle Ron , Keown Patrick
Published: May 2024

Aims and method

The study evaluated a package of measures to improve sleep on psychiatric wards admitting patients from children and young people's services (CYPS). Sleep disturbance has significant impact on adolescent mental health, and in-patient wards can directly cause sleep disturbance, independent of the problem that led to admission. We developed a CYPS-specific package (TeenSleepWell) that promoted a better sleep environment, enhanced staff education about sleep, screened for sleep disorders, and raised awareness of benefits and side-effects of hypnotics. This included personalised sleep care plans that allowed a protected 8 h sleep period when safe.

Results

Evaluation over 2 years showed enhanced in-patient care: 57% of patients were able to have a protected sleep period. There was no increase in adverse events and there was a decrease in hypnotics issued.

Clinical implications

Improving sleep during in-patient CYPS admissions is possible and personalised sleep care plan should be a care standard.
Characteristics of forensic psychiatric patients with a neurocognitive disorder
Authors: Meijers Jesse , Kuin Niki C. , Scherder Erik J. A. , Harte Joke M.
Published: May 2024

Background

Emotional and behavioural disturbances accompanying neurocognitive disorders may sometimes lead to a criminal offence. Our knowledge of this specific forensic subpopulation is lagging behind the knowledge on, and attention for, ‘classic’ psychiatric disorders in forensic populations.

Aims

To gain knowledge on the prevalence and characteristics of individuals with neurocognitive disorders in the forensic population.

Method

This retrospective database study uses an anonymised data-set of the National Database of penitentiary psychiatric centres (PPC) (N = 8391), which collects data on all patients admitted to one of the four PPCs (mental health clinics within the prison system) in The Netherlands since May 2013. Inclusion criterion for this study was the presence of a Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (DSM-IV-TR) or Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) diagnostic code belonging to the category of neurocognitive disorders.

Results

A DSM-IV-TR or DSM-5 diagnostic code of a neurocognitive disorder was classified in 254 out of 8391 unique individuals, resulting in a prevalence of 3.0% in the total PPC population. The most prevalent diagnosis was unspecified neurocognitive disorder (59.1%). The neurocognitive disorder group significantly differed from a random control group from the database (n = 762) on demographic, clinical and criminological variables.

Conclusions

The prevalence of neurocognitive disorders in this real-world clinical sample is remarkably lower than in two earlier studies in similar populations. Also remarkable is the relatively high prevalence of an unspecified neurocognitive disorder. These findings lead us to hypothesise that neurocognitive disorders may be underdiagnosed in this population. Forensic psychiatric settings should evaluate whether they have sufficient expertise available in neuropsychological assessment.
Survivorship in Advanced Lung Cancer: Understanding a New Landscape and Opportunities
Authors: Presley Carolyn J. , Dalal Nicole , Davenport Ashley P. , Gounden Ashnee , Ramchandran Kavitha , Tonorezos Emily
Published: May 2024

People with advanced lung cancer represent a distinct group whose needs remain understudied, especially compared with people diagnosed with limited-stage disease. Fortunately, novel treatments such as tyrosine kinase inhibitors and immune checkpoint inhibitors are leading to significant advances in prognosis and survival, even among those with advanced disease at the time of diagnosis. However, there are known gaps in symptom management, psychosocial and nutritional support, complex care coordination, health behavior coaching, and health care delivery efforts among patients living with advanced lung cancer. Many of these patients would benefit from survivorship and palliative care approaches. In particular, survivorship care may include health care maintenance, treatment of immune-related adverse events and late- or long-term effects, frailty assessment and rehabilitation, and care coordination. Palliative care may be best suited to discuss ongoing symptom management, advanced care planning, and end-of-life considerations, as well as psychosocial well-being. To this end, we share a review of the current status of the palliative and survivorship care infrastructure for patients with advanced lung cancer and provide suggestions across the care continuum for this diverse group of patients and families.
Spatiotemporal Changes in the Slavery–Inequality Relationship: The Diffusion of the Legacy of Slavery
Authors: O'Connell Heather A. , Curtis Katherine J. , Mikulas Alex , DeWaard Jack , Lee Junho
Published: May 2024

Despite the persistence of relationships between historical racist violence and contemporary Black–White inequality, research indicates, in broad strokes, that the slavery–inequality relationship in the United States has changed over time. Identifying the timing of such change across states can offer insights into the underlying processes that generate Black–White inequality. In this study, we use integrated nested Laplace approximation models to simultaneously account for spatial and temporal features of panel data for Southern counties during the period spanning 1900 to 2018, in combination with data on the concentration of enslaved people from the 1860 census. Results provide the first evidence on the timing of changes in the slavery–economic inequality relationship and how changes differ across states. We find a region-wide decline in the magnitude of the slavery–inequality relationship by 1930, with declines traversing the South in a northeasterly-to-southwesterly pattern over the study period. Different paces in declines in the relationship across states suggest the expansion of institutionalized racism first in places with the longest-standing overt systems of slavery. Results provide guidance for further identifying intervening mechanisms—most centrally, the maturity of racial hierarchies and the associated diffusion of racial oppression across institutions, and how they affect the legacy of slavery in the United States.
Conserved physical mechanisms of cell and tissue elongation
Authors: Boutillon Arthur , Banavar Samhita P. , Campàs Otger
Published: May 2024

Living organisms have the ability to self-shape into complex structures appropriate for their function. The genetic and molecular mechanisms that enable cells to do this have been extensively studied in several model and non-model organisms. In contrast, the physical mechanisms that shape cells and tissues have only recently started to emerge, in part thanks to new quantitative in vivo measurements of the physical quantities guiding morphogenesis. These data, combined with indirect inferences of physical characteristics, are starting to reveal similarities in the physical mechanisms underlying morphogenesis across different organisms. Here, we review how physics contributes to shape cells and tissues in a simple, yet ubiquitous, morphogenetic transformation: elongation. Drawing from observed similarities across species, we propose the existence of conserved physical mechanisms of morphogenesis.
Toxicity of the model protein 3×GFP arises from degradation overload, not from aggregate formation
Authors: Namba Shotaro , Moriya Hisao
Published: May 2024

Although protein aggregation can cause cytotoxicity, such aggregates can also form to mitigate cytotoxicity from misfolded proteins, although the nature of these contrasting aggregates remains unclear. We previously found that overproduction (op) of a three green fluorescent protein-linked protein (3×GFP) induces giant aggregates and is detrimental to growth. Here, we investigated the mechanism of growth inhibition by 3×GFP-op using non-aggregative 3×MOX-op as a control in Saccharomyces cerevisiae. The 3×GFP aggregates were induced by misfolding, and 3×GFP-op had higher cytotoxicity than 3×MOX-op because it perturbed the ubiquitin-proteasome system. Static aggregates formed by 3×GFP-op dynamically trapped Hsp70 family proteins (Ssa1 and Ssa2 in yeast), causing the heat-shock response. Systematic analysis of mutants deficient in the protein quality control suggested that 3×GFP-op did not cause a critical Hsp70 depletion and aggregation functioned in the direction of mitigating toxicity. Artificial trapping of essential cell cycle regulators into 3×GFP aggregates caused abnormalities in the cell cycle. In conclusion, the formation of the giant 3×GFP aggregates itself is not cytotoxic, as it does not entrap and deplete essential proteins. Rather, it is productive, inducing the heat-shock response while preventing an overload to the degradation system.
Characterizing the Exponential Profile of W′ Recovery Following Partial Depletion
Authors: LIEVENS MAARTEN , GHIJS MICHAEL , BOURGOIS JAN G. , VERMEIRE KOBE M. , BOURGOIS GIL , COLOSIO ALESSANDRO L. , BOONE JAN , CAEN KEVIN
Published: May 2024

Purpose

The aim of this study was to characterize W′ recovery kinetics in response to a partial W′ depletion. We hypothesized that W′ recovery following a partial depletion would be better described by a biexponential than by a monoexponential model.

Methods

Nine healthy men performed a ramp incremental exercise test, three to five constant load trials to determine critical power and W′, and 10 experimental trials to quantify W′ depletion. Each experimental trial consisted of two constant load work bouts (WB1 and WB2) interspersed by a recovery interval. WB1 was designed to evoke a 25% or 75% W′ depletion (DEP25% and DEP75%). Subsequently, participants recovered for 30, 60, 120, 300, or 600 s and then performed WB2 to exhaustion to calculate the observed W′ recovery (W′OBS). W′OBS data were fitted using monoexponential and biexponential models, both with a variable and with a fixed model amplitude. Root mean square error and Akaike information criterion (AICc) were calculated to evaluate the models’ goodness-of-fit.

Results

The biexponential model fits were associated with overall lower root mean square error values (0.4% to 5.0%) when compared with the monoexponential models (2.9% to 8.0%). However, ΔAICc resulted in negative values (−15.5 and −23.3) for the model fits where the amplitude was kept free, thereby favoring the use of a monoexponential model for both depletion conditions. For the model fits where the amplitude was fixed at 100%, ΔAICc was negative for DEP25% (−15.0) but positive for DEP75% (11.2). W′OBS values were strongly correlated between both depletion conditions (r = 0.92) and positively associated with V̇O2peak, critical power, and gas exchange threshold (r = 0.67 to 0.77).

Conclusions

The present study results did not provide evidence in favor of a biexponential modeling technique to characterize W′ recovery following a partial depletion. Moreover, we demonstrated that fixed time constants were insufficient to model W′ recovery across different depletion levels, and that W′ recovery was positively associated with aerobic fitness. These findings underline the importance of employing variable and individualized time constants in future predictive W′ models.
Benefits of Individualized Training in Fatigued Patients with Multiple Sclerosis
Authors: ROYER NICOLAS , MIRA JOSÉ , LEPETIT NOA , FAYOLLE EVOLÈNE , CAMDESSANCHÉ JEAN-PHILIPPE , MILLET GUILLAUME Y.
Published: May 2024

Introduction

Chronic fatigue is the most common and debilitating symptom in people with multiple sclerosis (PwMS). Recently, exercise has been proven to alleviate chronic fatigue and improve physical functions. Tailoring the training intervention to the potential fatigue causes could optimize the beneficial effects of training on fatigue. The objective of this study was to compare the effectiveness of an individualized (IND) versus a traditional (TRAD) exercise intervention in reducing chronic fatigue.

Methods

Twenty-nine PwMS with high chronic fatigue were randomly assigned to 12 wk of either a TRAD or IND exercise intervention. TRAD comprised aerobic and resistance exercises according to the guidelines for PwMS. IND specifically addressed identified individual weaknesses. Participants visited the laboratory before and after training for the following assessments: patient-reported outcomes (fatigue, quality of life, depression questionnaires), incremental cycling test (peak oxygen uptake (V̇O2peak)), and cycling fatigue test (maximal voluntary contraction, rating of perceived exertion).

Results

Similar improvements in fatigue, depression, and quality of life were observed between groups (P > 0.05). Compared with TRAD, IND induced a significant greater increase in V̇O2peak (+21.0% ± 13.9% vs 6.8% ± 11.5%, P < 0.05) and a greater reduction in rating of perceived exertion at a given submaximal intensity (−30.3% ± 18.9% vs −12.1% ± 20.4%, P < 0.001), whereas maximal voluntary contraction increased similarly in both groups (P > 0.05).

Conclusions

Although tailored exercise improved similarly fatigue and other subjective parameters (depression, quality of life, sleep quality) compared with than traditional exercise intervention, prescribing an individualized intervention led to greater improvement in V̇O2peak (but not maximal strength) and perception of effort. This may have positive functional consequences for patients.
Chronic Use of Antihypertensive Medications and Peak Exercise Blood Pressure in Adult Men and Women from the BALL ST Cohort
Authors: IDZIK EMILY , IMBODEN MARY T. , PETERMAN JAMES E. , WHALEY MITCHELL H. , KAMINSKY LEONARD A. , FLEENOR BRADLEY S. , HARBER MATTHEW P.
Published: May 2024

An excessive rise in systolic blood pressure (SBP) during exercise has been linked to increased risk of cardiovascular disease. Hypertensive individuals have been shown to have an exaggerated blood pressure (BP) response to exercise. However, research is limited on the impact of chronic antihypertensive medication use on the exercise BP response.

Purpose

To determine if individuals chronically (>1 yr) prescribed antihypertensive medications have a normal BP response to peak exercise compared with unmedicated individuals.

Methods

Participants included 2555 adults from the Ball State Adult Fitness Longitudinal Lifestyle STudy cohort who performed a peak treadmill exercise test. Participants were divided into groups by sex and antihypertensive medication status. Individuals prescribed antihypertensive medications for >1 yr were included. Exaggerated and blunted SBP within each group was categorized using the Fitness Registry and the Importance of Exercise: A National Database (FRIEND) and absolute criteria as noted by the American Heart Association.

Results

The unmedicated group had a greater prevalence (P < 0.05) of blunted SBP responses, whereas the medicated group had a higher prevalence (P < 0.05) of exaggerated SBP responses using both the FRIEND and absolute criteria. Peak SBP was higher (P < 0.01) in medicated compared with unmedicated participants in the overall cohort when controlling for age and sex, but not after controlling for resting SBP (P = 0.613), risk factors (P = 0.104), or cardiorespiratory fitness (P = 0.191). When men and women were assessed independently, peak SBP remained higher in the medicated women after controlling for age and resting SBP (P = 0.039), but not for men (P = 0.311). Individuals on beta-blockers had a higher peak SBP even after controlling for age, sex, risk factors, and cardiorespiratory fitness (P = 0.022).

Conclusions

Individuals on antihypertensive medications have a higher peak SBP response to exercise. Given the prognostic value of exaggerated peak SBP, control of exercise BP should be considered in routine BP assessment and in the treatment of hypertension.
Polygenic Risk Score, Cardiorespiratory Fitness, and Cardiometabolic Risk Factors: WASEDA’S Health Study
Authors: TANISAWA KUMPEI , TABATA HIROKI , NAKAMURA NOBUHIRO , KAWAKAMI RYOKO , USUI CHIYOKO , ITO TOMOKO , KAWAMURA TAKUJI , TORII SUGURU , ISHII KAORI , MURAOKA ISAO , SUZUKI KATSUHIKO , SAKAMOTO SHIZUO , HIGUCHI MITSURU , OKA KOICHIRO
Published: May 2024

Purpose

This study estimated an individual’s genetic liability to cardiometabolic risk factors by polygenic risk score (PRS) construction and examined whether high cardiorespiratory fitness (CRF) modifies the association between PRS and cardiometabolic risk factors.

Methods

This cross-sectional study enrolled 1296 Japanese adults aged ≥40 yr. The PRS for each cardiometabolic trait (blood lipids, glucose, hypertension, and obesity) was calculated using the LDpred2 and clumping and thresholding methods. Participants were divided into low-, intermediate-, and high-PRS groups according to PRS tertiles for each trait. CRF was quantified as peak oxygen uptake (V̇O2peak) per kilogram body weight. Participants were divided into low-, intermediate-, and high-CRF groups according to the tertile V̇O2peak value.

Results

Linear regression analysis revealed a significant interaction between PRS for triglyceride (PRSTG) and CRF groups on serum TG levels regardless of the PRS calculation method, and the association between PRSTG and TG levels was attenuated in the high-CRF group. Logistic regression analysis revealed a significant sub-additive interaction between LDpred2 PRSTG and CRF on the prevalence of high TG, indicating that high CRF attenuated the genetic predisposition to high TG. Furthermore, a significant sub-additive interaction between PRS for body mass index and CRF on obesity was detected regardless of the PRS calculation method. These significant interaction effects on high TG and obesity were diminished in the sensitivity analysis using V̇O2peak per kilogram fat-free mass as the CRF index. Effects of PRSs for other cardiometabolic traits were not significantly attenuated in the high-CRF group regardless of PRS calculation methods.

Conclusions

The findings of the present study suggest that individuals with high CRF overcome the genetic predisposition to high TG levels and obesity.