bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparative Analysis of Psychometric Frameworks and Properties of Scores from Autogenerated Test Forms
Authors: Lee Won‐Chan , Kim Stella Y.
Published: November 2024

This paper explores the psychometric properties of scores derived from autogenerated test forms by introducing three conceptual frameworks: Alternate Test Forms, Randomly Parallel Forms, and Approximately Parallel Forms. Each framework provides a distinct perspective on score comparability, definitions of true score and standard error of measurement (SEM), and the necessity of equating. Through a simulation study, we illustrate how these frameworks compare in terms of true scores and SEMs, while also assessing the impact of equating on score comparability across varying levels of form variability. Ultimately, this study seeks to lay the groundwork for implementing scoring practices in large‐scale standardized assessments that use autogenerated forms.
Deciphering temporal gene expression dynamics during epilepsy development using a rat model of focal neocortical epilepsy
Authors: Chang Bao‐Luen , Walker Matthew C. , Kullmann Dimitri M. , Schorge Stephanie
Published: November 2024

Objective

Epilepsy involves significant changes in neural cells during epileptogenesis. Although the molecular mechanism of epileptogenesis remains obscure, changes in gene regulation play a crucial role in the evolution of epilepsy. This study aimed to compare changes in a subset of specific genes during epilepsy development, focusing on the period after the first spontaneous seizure, to identify critical time windows for targeting different regulators.

Methods

Using a rat model of acquired focal neocortical epilepsy induced by tetanus toxin, we characterized gene expression at acute, subacute, and chronic stages (48–72 h, 2 weeks, and 30 days after first spontaneous seizure, respectively), focusing on genes' potential contribution to epilepsy progression.

Results

We observed dynamic changes in the expression of these genes throughout the period after the first spontaneous seizure. Astrocytic reactions primarily occur early, before epilepsy is well established. Changes in Mtor (mammalian target of rapamycin) and Rest (repressor element 1 silencing transcription factor) signaling pathways are highly dynamic and correlated with the progression of epilepsy development. Ccl2 (chemokine C‐C‐motif ligand) is upregulated at the chronic stage, indicating activation of the neuroinflammatory pathway. Finally, Gabra5 (γ‐aminobutyric acidergic signaling) is downregulated at the late stage after epilepsy is established. Surprisingly, changes in the expression of specific genes are linked to the time since the first seizure, rather than seizure frequency or duration.

Significance

These results suggest that the regulation of specific genes is essentially stage‐dependent during the development of epilepsy, highlighting the importance of targeting specific genes at appropriate stages of epilepsy development.
Magnetoencephalography studies in migraine and headache disorders: A systematic review
Authors: Gopalakrishnan Raghavan , Malan Nitesh Singh , Mandava Nymisha , Dunn Eric J. , Nero Neil , Burgess Richard C. , Mays MaryAnn , Hogue Olivia
Published: November 2024

Background

Understanding the neural mechanisms underlying migraine and other primary headache disorders is critical for the development of long‐term cures. Magnetoencephalography (MEG), an imaging modality that measures neuronal currents and cortical excitability with high temporal and superior spatial resolution, has been increasingly used in neurological research. Initial MEG studies showed promise in directly recording cortical spreading depression—a cortical correlate of migraine with aura. However, lately MEG technology has highly evolved with greater potential to reveal underlying pathophysiology of migraine and primary headache disorders, and aid in the identification of biomarkers.

Objective

To systematically review the use of MEG in migraine and other primary headache disorders and summarize findings.

Methods

We conducted a systematic search and selection of MEG studies in migraine and primary headache disorders from inception until June 8, 2023, in Medline, Embase, Cochrane, and Scopus databases. Peer‐reviewed English articles reporting the use of MEG for clinical or research purposes in migraine and primary headache disorders were selected.

Results

We found 560 articles and included 38 in this review after screening. Twelve studies investigated resting‐state, while others investigated a sensory modality using an evoked or event‐related paradigm with a total of 35 cohort and 3 case studies. Thirty‐two studies focused exclusively on migraine, while the rest reported other primary headache disorders.

Conclusion

The findings show an evolution of MEG from a 7‐ to a 306‐channel system and analysis evolving from sensor‐level evoked responses to more advanced source‐level connectivity measures. A relatively few MEG studies portrayed migraine and primary headache disorders as a sensory abnormality, especially of the visual system. We found heterogeneity in the datasets, data reporting standards (due to constantly evolving MEG technology and analysis methods), and patient characteristics. Studies were inadequately powered and there was no evidence of blinding procedures to avoid selection bias in case–control studies, which could have led to false‐positive findings. More studies are needed to investigate the affective–cognitive aspects that exacerbate pain and disability in migraine and primary headache disorders.
EFL Adolescents' Use of English in the Era of New Digital Media: An Empirical Investigation
Authors: Davydova Julia
Published: November 2024

The study reported here sets out to investigate to what extent Generation Z EFL speakers employ English in their linguistic practices on digital media platforms and how these compare to the patterns of English use on other social occasions. To that end, 630 adolescents (aged 14 to 18) from five grammar schools were targeted in the Austrian province of Vorarlberg. Results of a 27‐item survey pinpoint young individuals’ habitual reliance on English for (i) socializing on Facebook, Twitter, and similar platforms; (ii) consuming content on YouTube and TikTok; and (iii) watching series on various streaming platforms. Simultaneously, English is also revealed as an important linguistic variant underpinning their daily communicative practices, notably interactions with peers. The multiple linear regression analysis pinpoints statistically significant associations between learners’ habits of digital media use and their in‐group conversational practices. This is interpreted as a sign indicating the emergence of ESL‐like qualities in a traditional EFL setting. It is argued that consuming and engaging with digital media products through English may be affecting the psycholinguistic modus operandus of a noticeable cohort of young EFL speakers, who become increasingly bilingual as a result of those practices. Consequently, it is this adjusted psycholinguistic state (from predominantly monolingual to increasingly bilingual) that motivates the addition of English to the sociolinguistic repertoire of conversational practices.
Perturbations in the skin microbiome of infantile and adult seborrheic dermatitis and new treatment options based on restoring a healthy skin microbiome
Authors: Vorapreechapanich Akira , Thammahong Arsa , Chatsuwan Tanittha , Edwards Steven W. , Kumtornrut Chanat , Chantawarangul Karaked , Chatproedprai Susheera , Wananukul Siriwan , Chiewchengchol Direkrit
Published: November 2024

Seborrheic dermatitis (SD) is a common, multifaceted skin condition, but its undefined etiology hampers the development of effective therapeutic strategies. In this review, we describe the intricate relationship between the skin microbiome and the pathogenesis of SD, focusing on the complex interplay between three major groups of organisms that can either induce inflammation (Malassezia spp., Staphylococcus aureus) or else promote healthy skin (Propionibacterium spp.). We describe how the disequilibrium of these microorganisms in the skin microbiome can develop skin inflammation in SD patients. Understanding these complex interactions of the skin microbiome has led to development of novel probiotics (e.g., Vitreoscilla spp. and Lactobacillus spp.) to restore normal skin physiology in SD. There are also differences in the skin microbiomes of healthy and SD infant and adult patients that impact pathogenesis and prompt different management strategies. A deeper understanding of the skin microbiome and its dynamic interactions will provide valuable insights into the pathogenesis of SD and prompt further development of targeted probiotic treatments to restore the balance of the skin microbiome in SD patients.
Safety of abdominal paracentesis in hospitalised patients receiving uninterrupted therapeutic or prophylactic anticoagulants
Authors: Raco Joseph , Bufalini John , Dreer James , Shah Vraj , King Lauren , Wang Li , Evans Matthew
Published: November 2024

Background

Abdominal paracentesis is a frequently performed procedure in hospitalised patients with ascites. Concurrently, most hospitalised adult patients receive pharmacologic anticoagulation, either for therapeutic purposes or prophylactically to prevent venous thromboembolism. Despite this, minimal evidence exists to guide management of anticoagulant therapy pre‐ and post‐paracentesis.

Aims

The authors aimed to investigate the safety of abdominal paracentesis in hospitalised patients receiving therapeutic or prophylactic anticoagulation, including in patients for whom these medications were withheld periprocedurally.

Methods

TriNetX, an electronic health record data set, was queried to identify patients between the ages of 18 and 80 years who received an abdominal paracentesis while hospitalised at the authors' institution between September 2017 and June 2022. Patients receiving prophylactic anticoagulation (137), therapeutic anticoagulation (74) and no anticoagulation because of coagulopathy or thrombocytopenia (15) were compared. Rates of withholding anticoagulation, performing service, pre‐ and post‐paracentesis haemoglobin, bleeding complications, thrombotic complications and need for red blood cell transfusion were analysed.

Results

Procedure‐related bleeding complications occurred in two (1.4%) patients in the prophylactic group and 0 (0%) patients in the therapeutic group (P = 0.54). No thrombotic complications occurred. Rates of red blood cell transfusions post‐paracentesis were similar between groups. Analysis of secondary end‐points identified significant differences in rates of withholding anticoagulation and mean change in haemoglobin between performing services.

Conclusion

Performance of abdominal paracentesis in patients receiving therapeutic or prophylactic anticoagulation appears to be safe regardless of whether anticoagulation was interrupted periprocedurally, with low rates of bleeding complications, thrombotic complications or need for red blood cell transfusions post‐paracentesis.
Patterns and Predictors of Resilience in Frontline Nurses Before and After Public Health Emergencies: A Latent Transition Analysis
Authors: Li Siyuan , Wu Yuze , Yang Jianyi , Shu Huilan , Luo Lanjun , Wei Xuemei
Published: November 2024

Objective

To explore the stability of resilience among frontline nurses and to analyse the predictive role of internal and external factors on the patterns of resilience transformation in China during public health emergencies.

Methods

The study used a longitudinal design and surveyed 258 frontline nurses at three different time points: February–March 2020 (T1), May–June 2020 (T2) and May–June 2022 (T3). The survey included the 10‐item Connor–Davidson resilience scale, the Emotion Regulation Questionnaire and the Simple Coping Style Questionnaire. Latent profile analysis and latent transition analysis were used to examine the potential classes and changes. Multivariate logistic regression analysis was applied to evaluate the predictors of resilience transitions.

Results

The resilience of frontline nurses was divided into three categories: fragile group, general group and high resilience group. From T1 to T2, the general group exhibited the least stability, with a probability of maintaining its original latent state at 72.9%. Marriage and positive coping styles significantly impacted the transition between resilience categories. From T2 to T3, the fragile group showed the lowest stability, with a 74.9% likelihood of retaining its initial latent state. In this context, supportive hospital management (including psychological counselling, restful environments, and both spiritual and material incentives) and individuals' emotional regulation and sleep quality significantly affected the transition between resilience categories.

Conclusions

These findings emphasise the necessity for early intervention. For frontline nurses, conducting initial assessments of resilience coupled with sustained hospital support is crucial for maintaining mental health and improving the quality of nursing care in public health emergencies.

Impact

This study offers a fresh perspective for understanding the resilience of frontline nurses during public health emergencies. At the same time, it reveals the factors that promote or hinder the change in resilience among frontline nurses at both individual and organisational levels. This provides a theoretical basis for future resilience interventions and helps us formulate effective crisis management strategies to respond to future public health emergencies. For frontline nurses with diverse resilience characteristics and relevant transformation factors, a personalised multi‐mode resilience improvement plan can be developed to mitigate public health emergencies' potential adverse psychological impact on frontline nurses, especially those in the fragile group.

Patient or Public Contribution

No patient or public contribution.
Bipolarity and Antitropicality in Marine Taxa: Understanding the Complexities of Latitudinal Distribution
Authors: Chen Emily Yi‐Shyuan , Trudnowska Emilia , Błachowiak‐Samołyk Katarzyna
Published: November 2024

Aim

This systematic review aims to analyse the current status of research on marine bipolar and antitropical distribution patterns by exploring temporal trends, studied taxa, inconsistencies in definitions and the extent of molecular evidence in bipolar and antitropical species.

Location

Global marine environments, with a special focus on Polar Regions.

Time Period

1800s to 2024.

Major Taxa Studied

Marine taxa across all phyla, ranging from algae and zooplankton groups to fish and cetaceans.

Methods

A systematic literature search was conducted using Scopus, PubMed and Google Scholar databases. Studies were screened for relevant publications of marine taxa displaying bipolar or antitropical distributions, and data were extracted in order to perform a numerical summary of aspects including temporal trends, taxa representation and agreement with this article's standardised definitions. Additional data were gathered from The Arctic Register of Marine Species (ARMS) and The Register of Antarctic Marine Species (RAMS) databases. Distribution data were then extracted to verify the potential bipolarity of species present in both databases.

Results

From 221 articles, 665 marine taxa records were extracted, of which 517 records were categorised as antitropical and 148 as bipolar. Molecular evidence existed for 25% of non‐paleontological records. A considerable amount of records (44%) did not match the definitions used in this review. The data taken from ARMS and RAMS revealed 408 shared species, of which 41 species were listed as bipolar by the literature collected in this study.

Main Conclusions

Marine bipolarity and antitropicality have been topics of interest since the 1800s, especially between 2008 and 2017. However, the discrepancy between the number of potentially bipolar species in publicly available species databases and literature‐based estimates underscores the need for further research of neglected taxa. Future research should prioritise including molecular evidence, transparent terminology and interdisciplinary approaches to address the complexities of marine disjunct distributions.
The New CAP and the Participative Method in Decision‐Making: A Textual Analysis of the Italian Case
Authors: Henke Roberto , Pomponi Tommaso , Vassallo Marco , Mazzocchi Giampiero , Monteleone Alessandro , Sorrentino Alessandro
Published: November 2024

The main objective of this article is to analyse the role of the partnership approach in the decision process regarding the new CAP reform that guaranteed higher flexibility and better targeting. What was the impact of the multi‐actor decision‐making process on the reform process? How can policies be designed to increasingly listen to stakeholders' needs? To answer these questions, stakeholder interventions at the Partnership Table were analysed with a text mining and a sentiment analysis applied to the transcripts. Despite several weaknesses and biases in bringing national stakeholders to the institutional tables, the decision process moved towards a higher rate of flexibility, subsidiarity and transparency, overtaking the concept of ‘one size fits all’ that has dominated the CAP. The downside of this aspect is that the reform might favour member states with a solid tradition of CAP reception and administrative efficiency, able to move smoothly towards an effective participatory approach.
Trajectories of attention problems in preschoolers born very preterm
Authors: Camerota Marie , Castellanos Francisco Xavier , Carter Brian S. , Check Jennifer , Helderman Jennifer , Hofheimer Julie A. , McGowan Elisabeth C. , Neal Charles R. , Pastyrnak Steven L. , Smith Lynne M. , O'Shea Thomas Michael , Marsit Carmen J. , Lester Barry M.
Published: November 2024

Background

Children born preterm are at heightened risk for neurodevelopmental impairment, including specific deficits in attention. Few studies have investigated change over time in attention problems prior to school entry. The current study aims to describe trajectories of attention problems from age 2 through 5 years in a cohort of children born <30 weeks of gestational age (GA), identify sociodemographic, medical, and neurobehavioral characteristics associated with attention trajectories, and test whether attention problem trajectories predict the risk of a reported attention‐deficit/hyperactivity disorder (ADHD) diagnosis.

Methods

We studied 608 infants from the Neonatal Neurobehavior and Outcomes in Very Preterm Infants (NOVI) Study, a prospective, multisite study of infants born <30 weeks of GA. Parents reported on child attention problems at ages 2, 3, 4, and 5 years using the Child Behavior Checklist and the Behavior Assessment System for Children. Sociodemographic and medical characteristics were assessed via maternal interview and medical record review. Neurobehavioral characteristics were determined using neonatal and 2‐year assessments. Parent report of child ADHD diagnosis was obtained. We used latent growth curve (LGC) modeling to test our study aims.

Results

A linear LGC model provided the best fit to the data. The average trajectory of attention problems evidenced low initial levels of symptoms and little change over time, yet there was significant heterogeneity in both initial levels and change over time. Individual differences in trajectory parameters were associated with sociodemographic, medical, environmental, and neurobehavioral characteristics. Children with higher initial levels of attention problems as well as steeper increases in attention problems over time were more likely to have a reported ADHD diagnosis.

Conclusions

There is significant heterogeneity in trajectories of attention problems from age 2 to 5 in children born <30 weeks of GA and these differences have clinical relevance. These data could inform follow‐up guidelines for preterm infants.
Advanced Adhesive Approach to Support a Minimally Invasive Full Mouth Rehabilitation
Authors: Orta Amelia , Newberry Nicole , Torosian Aram , Masri Radi
Published: November 2024

Objective

Patients who exhibit severe loss of tooth structure are challenging to rehabilitate. Conventional treatment of these patients may require adjunctive procedures of surgical crown lengthening, elective endodontic therapy and placement of posts and cores to retain full coverage crowns as part of a full mouth rehabilitation. Minimally invasive approaches to treatment of these patients provides opportunity to conserve tooth structure and to reduce adjunctive procedures by using an advanced adhesive approach to retain all ceramic partial coverage restorations as part of a full mouth rehabilitation.

Clinical Considerations

The use of an advanced adhesive approach to perform a full mouth reconstruction restoring occlusal vertical dimension (OVD) is described. This approach emphasizes preserving healthy tooth structure, maximizing restoration adhesion to enamel and dentin, maintaining pulpal vitality and minimizing adjunctive dental procedures. The preparation design focuses on being defect‐oriented to remove only diseased or undermined tooth structure. The all ceramic restorations are additive, where indicated, to further aid in preserving tooth structure. An advanced adhesive approach using an immediate dentin seal and resin coating over exposed dentin and composite resin cement under rubber dam isolation is used to lute the restorations. The restorations are fabricated using micro‐layered lithium disilicate ceramic to maximize the esthetic appearance of the rehabilitation where needed.

Conclusion

An advanced adhesive approach to full mouth rehabilitation should be considered as a treatment option for patients exhibiting tooth surface loss as an alternative to conventional full coverage restorations when clinical parameters allow.
Long‐distance migrations, population mixing, and growth rate of lumpfish (Cyclopterus lumpus) revealed from tag‐recaptures
Authors: Kennedy James , Post Søren , Nøttestad Leif
Published: November 2024

We reveal that lumpfish (Cyclopterus lumpus) frequently migrate over long distances between their summer feeding area in the open ocean and their spring spawning sites in coastal areas, through applying tag‐recapture methodology. A total of 2750 C. lumpus were tagged in the Irminger Sea around Iceland and in the Norwegian Sea over 6 years, of which 17 C. lumpus were recaptured. Interestingly, four individuals were recaptured more than 1000 km distant from where they were tagged. C. lumpus tagged in the Irminger Sea and north of Iceland were recaptured around Iceland, whereas none of the fish tagged in other areas of the Norwegian Sea were recaptured in Iceland. This difference in recapture rate from different areas suggests that a higher proportion of C. lumpus from the Irminger Sea and north of Iceland spawns around Iceland in comparison with C. lumpus in other areas. Two fish tagged east of Iceland were recaptured on the coast of Denmark, with one fish having a displacement distance of 1612 km. The recapture of these two fish in Denmark demonstrates that part of the C. lumpus population spawning in Denmark utilizes the Norwegian Sea as a major feeding area and that the Norwegian Sea is a common feeding area for several distinct populations of C. lumpus. The growth rate of tagged fish varied from 1.2 to 11.1 cm year−1, indicating that males that are >20 cm and females that are >25 cm during the summer are capable of sufficient growth to achieve a suitable size for spawning (≥25 and ≥35 cm for males and females, respectively) the following spring.
Transcutaneous electrical acupoint stimulation for preventing postoperative nausea and vomiting after laparoscopic surgery: A meta‐analysis
Authors: Yuan Lu , Quan Si‐Jie , Li Xin‐Yu , Chen Bo‐Zhu , Huang Yan‐Bing , Zheng Hui
Published: November 2024

Background

Postoperative nausea and vomiting (PONV) is a common adverse event after general surgery. This study aimed to examine the effectiveness and safety of transcutaneous electrical acupoint stimulation (TEAS) for the prevention of nausea and vomiting after laparoscopic surgery.

Method

The Cochrane Library, Pubmed, Embase, and Web of Science databases were accessed from inception to 23 January 2024. The incidence of PONV was the primary outcome measure. The required information size (RIS) of each outcome was estimated by Trial sequential analysis (TSA). The RoB 2.0 tool was used to assess the risk of bias and GRADE to assess the quality of evidence.

Results

Seventeen RCTs including 3698 participants were included. In comparison to the control group, TEAS reduced the incidence of PONV (13 trials, n = 3310; RR, 0.56; 95% CI, 0.46–0.67; I2 = 64%; p < 0.01; RIS = 1100), with the level of evidence graded as low. TEAS reduced the incidence of PON (9 trials, n = 2762; RR, 0.64; 95% CI, 0.52–0.79; I2 = 57%, p < 0.01; RIS = 1595), and was also associated with a lower incidence of POV (9 trials, n = 2797; RR, 0.53; 95% CI, 0.45–0.63; I2 = 0%, p < 0.01; RIS = 773).

Conclusion

The current meta‐analysis and TSA provide reliable evidence that TEAS is an effective and safe method to prevent PONV. It may reduce the workload of nursing professionals, alleviate emotional stress, and decrease exposure risk. Adverse events related to TEAS were mild.

Clinical Relevance

Nurses can incorporate TEAS into the rehabilitation nursing of patients experiencing PONV.
The EU's Artificial Intelligence Act and copyright
Authors: Guadamuz Andres
Published: November 2024

The European Union's (EU's) Artificial Intelligence Act (AI Act), published on 12 July 2024, seeks to establish a consistent legal framework for AI systems within the EU, promoting trustworthy and human‐centric AI while safeguarding various fundamental rights. The Act classifies AI applications into three risk categories: unacceptable risk, high risk, general purpose AI models with systemic risk and low or no risk, each with corresponding regulatory measures. Although initially not focused on copyright issues, the rise of generative AI led to specific provisions addressing general purpose AI models. These provisions include transparency obligations, particularly regarding the technical documentation and content used for training AI models, and policies to respect EU copyright laws. The Act aims to balance the interests of copyright holders and AI developers, ensuring compliance while fostering innovation and protecting rights.
ViT‐based quantification of intratumoral heterogeneity for predicting the early recurrence in HCC following multiple ablation
Authors: Zhang Ke , Ru Jinyu , Wang Wenbo , Xu Min , Mu Lei , Pan Jinhua , Gu Jionghui , Zhang Haoyan , Tian Jie , Yang Wei , Jiang Tianan , Wang Kun
Published: November 2024

Objectives

This study aimed to develop a quantitative intratumoral heterogeneity (ITH) model for assessing the risk of early recurrence (ER) in pre‐treatment multimodal imaging for hepatocellular carcinoma (HCC) patients undergoing ablation treatments.

Methods

This multi‐centre study enrolled 633 HCC patients who underwent ultrasound‐guided local ablation between January 2015 and September 2022. Among them, 422, 85, 57 and 69 patients underwent radiofrequency ablation (RFA), microwave ablation (MWA), laser ablation (LA) and irreversible electroporation (IRE) ablation, respectively. Vision‐Transformer‐based quantitative ITH (ViT‐Q‐ITH) features were extracted from the US and MRI sequences. Multivariable logistic regression analysis was used to identify variables associated with ER. A combined model integrated clinic‐radiologic and ViT‐Q‐ITH scores. The prediction performance was evaluated concerning calibration, clinical usefulness and discrimination.

Results

The final training cohort and internal validation cohort included 318 patients and 83 patients, respectively, who underwent RFA and MWA. The three external testing cohorts comprised of 106 patients treated with RFA, 57 patients treated with LA and 69 patients who underwent IRE ablation. The combined model showed excellent predictive performance for ER in the training (AUC: .99, 95% CI: .99–1.00), internal validation (AUC: .86, 95% CI: .78–.94), external testing (AUC: .83, 95% CI: .73–.92), LA (AUC: .84, 95% CI: .73–.95) and IRE (AUC: .82, 95% CI: .72–.93) cohorts, respectively. Decision curve analysis further affirmed the clinical utility of the combined model.

Conclusions

The multimodal‐based model, incorporating clinic‐radiologic factors and ITH features, demonstrated superior performance in predicting ER among early‐stage HCC patients undergoing different ablation modalities.
Exploring the potential of large language models in identifying metabolic dysfunction‐associated steatotic liver disease: A comparative study of non‐invasive tests and artificial intelligence‐generated responses
Authors: Wu Wanying , Guo Yuhu , Li Qi , Jia Congzhuo
Published: November 2024

Background and Aims

This study sought to assess the capabilities of large language models (LLMs) in identifying clinically significant metabolic dysfunction‐associated steatotic liver disease (MASLD).

Methods

We included individuals from NHANES 2017–2018. The validity and reliability of MASLD diagnosis by GPT‐3.5 and GPT‐4 were quantitatively examined and compared with those of the Fatty Liver Index (FLI) and United States FLI (USFLI). A receiver operating characteristic curve was conducted to assess the accuracy of MASLD diagnosis via different scoring systems. Additionally, GPT‐4V's potential in clinical diagnosis using ultrasound images from MASLD patients was evaluated to provide assessments of LLM capabilities in both textual and visual data interpretation.

Results

GPT‐4 demonstrated comparable performance in MASLD diagnosis to FLI and USFLI with the AUROC values of .831 (95% CI .796–.867), .817 (95% CI .797–.837) and .827 (95% CI .807–.848), respectively. GPT‐4 exhibited a trend of enhanced accuracy, clinical relevance and efficiency compared to GPT‐3.5 based on clinician evaluation. Additionally, Pearson's r values between GPT‐4 and FLI, as well as USFLI, were .718 and .695, respectively, indicating robust and moderate correlations. Moreover, GPT‐4V showed potential in understanding characteristics from hepatic ultrasound imaging but exhibited limited interpretive accuracy in diagnosing MASLD compared to skilled radiologists.

Conclusions

GPT‐4 achieved performance comparable to traditional risk scores in diagnosing MASLD and exhibited improved convenience, versatility and the capacity to offer user‐friendly outputs. The integration of GPT‐4V highlights the capacities of LLMs in handling both textual and visual medical data, reinforcing their expansive utility in healthcare practice.
A Multicenter Study on Hepatocellular Adenomas in Korea: Clinicopathological and Imaging Features With an Emphasis on β‐Catenin Mutated Subtype
Authors: Heo Subin , Kim Bohyun , Kim So Yeon , Kang Hyo Jeong , Song In Hye , Lee Sung Hak , Huh Jimi , Kim Seokhwi , Baek Seunghee , Lee Seung Soo , Choi Sang Hyun , Jang Jong Keon , Park Seong Ho
Published: November 2024

Background & Aims

The clinicopathologic and imaging features of hepatocellular adenomas (HCAs) in Asian population remain unclear. We aimed to analyse clinicopathologic and imaging features of HCAs in Korea and propose an imaging‐based method to differentiate β‐catenin mutated HCA (βHCA) from other subtypes.

Methods

This retrospective multicenter study included pathologically confirmed HCAs from three tertiary institutions in Korea between 2010 and 2023. HCA subtypes were determined according to the current World Health Organization classification using immunohistochemical staining. Two abdominal radiologists reviewed computed tomography and magnetic resonance imaging scans. The clinical characteristics and imaging features of HCA subtypes were compared. A scoring system for βHCA was developed and validated using development (January 2010–April 2021) and validation (May 2021–March 2023) cohorts.

Results

121 patients (47 men; mean age, 39.0 years ±13.5) with 138 HCAs were included. HCAs displayed characteristic clinicopathologic features, including a high proportion of male (38.8%) and obese patients (35.5%), with the inflammatory subtype being the most common (38.4%) and a low percentage of patients using oral contraceptive (5.0%). Each HCA subtype demonstrated distinct clinical and imaging features. The scoring system incorporating tumour heterogeneity and iso to high hepatobiliary phase signal intensity on MRI for differentiating βHCA exhibited high performance in both the development (AUC 0.92, 95% CI: 0.87–0.97) and the validation cohort (AUC 0.91, 95% CI: 0.77–1.00).

Conclusions

This comprehensive analysis of clinicopathologic and imaging features of HCAs in Korea contributes to the characterisation of HCAs across different geographical regions. The imaging‐based scoring system effectively differentiates βHCA.
Infant and young child feeding practices among conflict‐affected Ukrainian households: A cross‐sectional survey in Kyiv, Lviv and Odesa regions
Authors: Majer Jennifer , Mbuto Samuel , Nesterova Viktoriia , King Sarah , Bilukha Oleg
Published: November 2024

Infant and young child feeding practices (IYCF) are crucial for children's growth and development but often deteriorate during periods of instability. A cross‐sectional survey conducted in three oblasts of Ukraine—Kyiv City and Kyiv, Lviv, and Odesa—enroled 724 children 0–23 months of age from 699 households. Using global WHO IYCF Guidelines, 12 indicators of optimal IYCF practices were evaluated. The study found IYCF practices to be relatively stable since 2015, despite the continued escalation of conflict, with an improvement in exclusive breastfeeding (EBF). EBF was reported by 51% of mothers, while breastfeeding was initiated early in 65% of children. Complementary feeding practices were optimal for most children, with 79% having a minimum acceptable diet. Infant formula assistance was independently associated with suboptimal breastfeeding practices in multi‐variable models. Children from households that received formula assistance had 67% (adjusted odds ratio [aOR] 0.33, 95% confidence interval [CI] 0.14–0.73) lower odds of being exclusively breastfed, 65% (aOR 0.35, 95% CI 0.20–0.61) lower odds of continued breastfeeding at 12 months, and 3.3 times (95% CI 2.31–4.78) higher odds of being bottlefed. Baby food assistance did not independently predict a minimum acceptable diet. High levels of optimal complementary feeding sustained since 2015 suggest protective factors for child nutrition in Ukraine, such as domestic agriculture and social safety nets. Additionally, maternal education was consistently linked to better IYCF outcomes, highlighting the need for targeted support for less‐educated mothers. The negative association of formula assistance with EBF warrants further research alongside reinforcement of guidelines to prevent inappropriate formula targeting.
Outside the Western bubble: Explaining anti‐immigrant attitudes in 28 post‐communist countries
Authors: Bell David Andreas , Valenta Marko
Published: November 2024

Most studies on anti‐immigrant attitudes have been conducted within the US or in Western European countries. As a result, the theoretical frameworks utilised to comprehend these attitudes are often based on a limited subset of the global population. Hence, it remains uncertain how these theories apply to regions beyond the Western context. Based on the Life in Transition Survey, we explore whether the theories and factors discussed in Western contexts can be applied to understanding anti‐immigrant attitudes in 28 post‐communist countries. We find that the impact of macroeconomic variables in the post‐communist region differs from what would be expected based on existing theoretical frameworks. The study adds complexity to the debates surrounding the positive impacts of modernisation, economic development and democratisation on anti‐immigrant attitudes. Our research suggests that intolerance levels are notably highest in Central and Eastern European EU countries. Interestingly, these levels are higher than those found in less developed and less democratic post‐communist countries outside the EU. This study highlights the difficulty of deploying a comprehensive theoretical framework that can account for the complexities of attitudes across a broad range of countries.
Genomic analysis provides insights into the origin and divergence of fruit flavor and flesh color of pummelo
Authors: Huang Yue , Makkumrai Warangkana , Fu Jialing , Deng Chongling , Wu Qingjiang , Wang Shaohua , Wang Lun , Wu Xiaoxiao , Gao Junyan , Chen Chuanwu , Guo Lina , Chen Peng , Wu Fangfang , Deng Xiuxin , Wang Xia , Xu Qiang
Published: November 2024

Pummelo (Citrus maxima) is one of the most important citrus crops and have genetically contributed sweet orange, lemon and most citrus cultivars. It has been cultivated for c. 4000 years in China and is also distributed in many Southeast Asian countries. Nevertheless, the origin and dispersal of pummelo remain elusive.

We conducted whole‐genome sequencing for 290 pummelo accessions from China and Southeast Asia (SEA). Our findings indicated that pummelo was originated in Yunnan province. The divergence of the China‐SEA accessions occurred c. 2000 years ago and the divergence was likely facilitated through the Maritime Silk Road.

We detected the divergence of genomic regions associated with fruit flavor and color, indicating different selection by human activities in different regions. A gene encoding lycopene cyclase 2 (LCYB2) exhibited a high degree of divergence in expression and sequence between red‐flesh and white‐flesh pummelos. A SNP in the coding region of LCYB2 resulted in a reduction in lycopene β‐cyclizing enzyme activity, leading to the accumulation of lycopene and the development of the red‐flesh trait.

This study reveals the origin and evolutionary history of pummelo and provides insights into the genomic basis for the divergence of fruit flavor and color.
Deconstructing Professionalism as Code for White (Power): Authenticity as Resistance in Nursing
Authors: Melino Katerina , Bell Blythe , Freborg Kaija
Published: November 2024

The concept of professionalism is embedded into all aspects of nursing education and practice yet is rarely critically interrogated in nursing scholarship. This paper describes how professionalism in nursing is based on whiteness. When actualized, this oppressive construct homogenizes individuals' identities to assist nurses in building and wielding power against each other and against patients, and results in dehumanization and disconnection. Foregrounding an ethic of authenticity as a practice of resistance against white professionalism offers an alternative possibility for how nursing could be taught, practiced and theorized. As such a practice must begin with oneself, the authors outline a reflexive process from which to begin this work.
Simulation of Defoliation Effects on Relay Strip Intercropping Soybean: Elucidating Foliar Shedding and Leaf‐to‐Nodule Growth Plasticity
Authors: Li Yiling , Wang Mingyue , Chen Ping , Luo Kai , Lin Ping , Fu Zhidan , Pu Tian , Wang Xiaochun , Yong Taiwen , Yang Wenyu
Published: November 2024

Extensive foliar shedding in monoculture soybeans post‐anthesis negatively impacts yield, whereas relay strip intercropping prolongs leaf area duration, enhancing productivity. However, little is known about the causes of leaf shedding in monoculture and its impact on physiological functions and plasticity of source and sink organs, we conducted a 4‐year field experiment and leaf‐removal simulations in relay intercropped soybeans. Results revealed that monoculture soybeans experienced severe self‐shading and defoliation, while relay intercropping maintained better light conditions, supporting higher leaf area, nodule numbers, and carbon allocation. Increasing leaf removal initially increased leaf area but eventually reduced it. Extensive leaf‐removal reduced Rubisco and sucrose phosphate synthase (SPS) activity, as well as sucrose, malate, ATP, and energy charge (EC) in nodules, revealing a trade‐off between leaf growth and nodule development. Moderate leaf‐removal (L30), however, balanced compensation and consumption, increasing total non‐structural carbohydrates (TNC) in roots and N and ureide in leaves and pods. Network analysis showed that L30 improved the synergies of functional traits in leaves and nodules, ultimately benefiting overall plant growth and nutrient accumulation in pods. This study elucidates a mechanism of foliar shedding and highlights how relay strip intercropping optimizes source‐sink coordination to enhance photosynthesis and nitrogen fixation.
The impact of malignancy on death anxiety and psychological well‐being in middle‐aged and older patients undergoing abdominal surgery: a quasi‐experimental study
Authors: Akbaş Ebru , Yilmaz Eker Pınar
Published: November 2024

Background

Malignancy is a critical factor affecting death anxiety and psychological well‐being. This study examined the impact of malignancy on death anxiety and psychological well‐being in middle‐aged and older adult patients undergoing abdominal surgery and projected it along with sociodemographic profiles.

Methods

This study is quasi‐experimental in design. It was conducted with patients undergoing abdominal surgery at a university hospital due to suspected malignancy. A total of 93 patients participated in the study: 57 patients diagnosed with malignancy were included in the experimental group, while 36 patients without a malignancy diagnosis were included in the control group. Data were collected using a questionnaire developed by the researchers based on the literature, the ‘Turkish Death Anxiety Scale’, and the ‘Psychological Well‐being Scale’. The analyses revealed that the data were normally distributed, and parametric tests were used to analyze differences between demographic variables and groups. Cohen's d and r values were examined to assess the effect size in the tests.

Results

The study found a significant difference in death anxiety between the experimental and control groups (P < 0.05), with higher mean scores in the experimental group. Malignancy had a large effect on death anxiety (d = 1.42). Additionally, the control group had significantly higher mean psychological well‐being scores compared to the experimental group (P < 0.05).

Conclusions

The study found that malignancy significantly affects death anxiety and psychological well‐being. Increased death anxiety in patients with malignancy was associated with reduced psychological well‐being. Thus, assessing death anxiety and providing targeted nursing care are essential for supporting the psychological well‐being of these patients.
Testing the effects of merit appointments and bureaucratic autonomy on governmental performance: Evidence from African bureaucracies
Authors: Fernandez Sergio , Cheema Faisal
Published: November 2024

Appointing bureaucrats based on merit and protecting them from excessive political interference have become bedrocks of modern bureaucracy. Populist leaders throughout the world, however, are looking to undermine merit systems and politicize bureaucracies. This study analyzes the impact of merit‐based appointments and bureaucratic autonomy on service delivery effectiveness, using longitudinal data from a panel of African countries. Throughout Africa, social, economic, and political conditions have made it difficult for meritocratic and autonomous bureaucracies to take root and flourish as they have elsewhere. Despite these challenges, the study's main finding is that the practice of appointing bureaucrats based on merit has a positive effect on the provision of public services like transportation infrastructure, standardized education, drinking water, sanitation, and waste disposal. Political leaders undercutting meritocratic civil services and expanding patronage appointments do so at their own peril due to the adverse consequences of their actions on governmental performance. Little evidence is found of a relationship between bureaucratic autonomy and service delivery effectiveness.
River restoration effects on dispersal and the development of riparian seed bank: do poor seed banks limit restoration of boreal riparian zones?
Authors: Sarneel Judith M. , Brett Laura , van den Bosch‐Hennink Anoek , Hasselquist Eliza Maher
Published: November 2024

In boreal streams, restoration after channelization typically consists of increasing instream geomorphic complexity with no other active restoration measures (e.g. planting) as it mainly targets fish. Unsurprisingly, this restoration fails to restore riparian vegetation within the time frames needed to meet biodiversity goals. To understand the potential role of dispersal and seed banks in the poor restoration results, we compared deposition patterns from a seed release experiment conducted during spring flood and summer low flow conditions to seed bank‐ and vegetation composition. The experiment was conducted across seven boreal streams, each differing in time since restoration (0–22 years). We found that seed deposition increased due to low flow and local flow obstruction, suggesting the importance of instream boulders. Locations where there was a high deposition likelihood in our seed release experiment had higher Shannon diversity compared to locations with a low seed deposition likelihood. Riparian vegetation composition is related to flow obstruction, while seed bank species composition is correlated to spring flood seed deposition. In general, the sampled riparian seed banks contained few seeds and species. We therefore conclude that (1) restoration of hydrogeomorphic complexity (especially instream boulders) can enhance seed deposition with some effects on species composition of the vegetation and seed bank diversity, and (2) the importance of these generally species poor seed banks for the return of species after restoration boreal streams is questionable. Other (active) methods or more time may therefore be needed to meet biodiversity goals within riparian vegetation restoration.
A generalized multinomial probabilistic model for SARS‐COV‐2 infection prediction and public health intervention assessment in an indoor environment
Authors: Li Victor O. K. , Lam Jacqueline C. K. , Sun Yuxuan , Han Yang , Chan Kelvin , Wang Shanshan , Crowcroft Jon , Downey Jocelyn , Zhang Qi
Published: November 2024

SARS‐CoV‐2 Omicron and its sub‐lineages have become the predominant variants globally since early 2022. As of January 2023, over 664 million confirmed cases and over 6.7 million deaths had been reported globally. Current infection models are limited by the need for large datasets or calibration to specific contexts, making them difficult to apply to different settings. This study aims to develop a generalized multinomial probabilistic model of airborne infection to assist public health decision‐makers in evaluating the effectiveness of public health interventions (PHIs) across a broad spectrum of scenarios. The proposed model systematically incorporates group characteristics, epidemiology, viral loads, social activities, environmental conditions, and PHIs. Assumptions about social distance and contact duration that estimate infectivity during short‐term group gatherings have been made. The study is differentiated from earlier works on probabilistic infection modeling in the following ways: (1) predicting new cases arising from more than one infectious person in a gathering, (2) incorporating additional key infection factors, and (3) evaluating the effectiveness of multiple PHIs on SARS‐CoV‐2 infection simultaneously. Although the results show that limiting group size has an impact on infection, improving ventilation has a much greater positive health impact. The proposed model is versatile and can flexibly accommodate other scenarios or airborne diseases by modifying the parameters allowing new factors to be added.