bluuebunny/crossref_metadata_2025 huggingface dataset:
The addition of tislelizumab to gemcitabine and cisplatin chemotherapy increases thrombocytopenia in patients with urothelial carcinoma: A single‐center study based on propensity score matching
Authors: Gao Zhimin , Qi Nienie , Qin Xu , Li Zhen , Li Gang , Wang Zewei , Wang Junqi , Wen Rumin , Li Hailong
Published: December 2023

Purpose

Whether the addition of tislelizumab to gemcitabine and cisplatin (GC) chemotherapy increases the incidence of myelosuppression has not been well established. This study identified the risk factors for the development of myelosuppression in patients with urothelial carcinoma (UC) after receiving GC chemotherapy with or without tislelizumab.

Materials and Methods

We enrolled 192 UC patients who received GC with or without tislelizumab at the Affiliated Hospital of Xuzhou Medical University between July 2014 and November 2022. Patient baseline characteristics were included in the statistical analyses after adjusting for previously reported risk factors affecting survival using propensity score matching (1:1). Binary logistic regression analysis was used to identify the risk factors associated with posttreatment myelosuppression.

Results

A total of 192 patients were enrolled, of whom 96 were treated with tislelizumab plus gemcitabine and cisplatin (T + GC) and 96 with GC alone. The incidence of leukopenia, anemia, and thrombocytopenia of any grade was 50.0%, 70.8%, and 42.7%, respectively, in the T + GC group and 41.7%, 72.9%, and 20.8%, respectively, in the GC group. In multivariate analysis, patients aged over 70 years (OR = 2.486, 95% CI: 1.067–5.792, p = 0.035) and those who received T + GC (OR = 3.119, 95% CI: 1.576–6.173, p = 0.001) were more likely to develop thrombocytopenia. Patients aged over 70 years (OR = 3.213, 95% CI: 1.254–8.237, p = 0.015) were more likely to develop anemia, and patients with renal insufficiency (OR = 2.105, 95% CI: 1.035–4.280, p = 0.040) were more likely to develop leukopenia. Eventually, 99 (51.6%) patients with UC successfully completed all the treatment cycles.

Conclusions

This study demonstrates that the addition of tislelizumab to GC chemotherapy led to a considerable increase in the occurrence of thrombocytopenia, whereas no significant changes were observed regarding anemia or leukopenia. It is crucial to fully inform patients at increased risk for myelosuppression of potential risks and closely monitor changes in their blood routines.
Stiff‐person syndrome revealing an occult gray zone lymphoma: A diagnostic challenge
Authors: Fakhari Mohammad Sadegh , Poorsaadat Leila , Mohammad Talebi Hooman , Kosari Farid
Published: December 2023

Key Clinical Message

Stiff‐Person Syndrome (SPS) can be associated with various malignancies, including lymphomas. Therefore, clinicians should always remain vigilant for the presence of an underlying malignancy, especially in older patients presenting with SPS.

Stiff‐person syndrome (SPS) is a rare neurological disorder characterized by painful muscle spasms. It can occur as a paraneoplastic syndrome associated with various malignancies. We present a case of an older male adult with a history of recurrent fever episodes and elevated inflammatory markers for 1 year who subsequently developed neurological symptoms. The presence of positive amphiphysin antibodies led to the diagnosis of SPS, which prompted further investigations revealing an underlying Gray Zone lymphoma (GZL). This case highlights the challenges in diagnosing lymphoma and emphasizes the importance of considering SPS as a paraneoplastic syndrome in guiding toward the final diagnosis. The diagnostic challenge in our case is summarized in Chart 1.
Polymer of Intrinsic Microporosity as Binders for both Acidic and Alkaline Oxygen Reduction Electrocatalysis
Authors: Burba Marino , Pargoletti Eleonora , Marken Frank , McKeown Neil B. , Carta Mariolino , Vertova Alberto , Minguzzi Alessandro
Published: December 2023

In this work, a new polymeric binder (polymer of intrinsic microporosity, PIM‐1) has been investigated and discussed to prepare and characterize composite materials for the cathodic oxygen reduction reaction. The new binder is a polymer of intrinsic microporosity, a family of organic compounds with molecularly rigid (glassy) structure, good mechanical and chemical stability. Their influence on the electrocatalytic behaviour of a commercial electrocatalyst during the oxygen reduction reaction in acidic and alkaline media has been investigated, discussed and compared to the behaviour of common cationic and anionic polymer binders, using rotating disk electrode (RDE) techniques. Polymers of intrinsic microporosity perform similarly well, and sometimes better (due to rigidity and gas permeation) when compared to commercial binders. Thus, herein, we showed that PIMs do represent a very promising and versatile alternative as binders in electrocatalysis.
Effect of in‐canopy foliar fungicide applications in corn on spray coverage
Authors: Anderson Nolan R. , Wise Kiersten A.
Published: December 2023

Foliar fungicides are available to suppress Diplodia ear rot (DER), caused by Stenocarpella maydis (Berk.) Sutton and Stenocarpella macrospora (Earle) Sutton) in corn (Zea mays L.), but previous research has indicated these fungicides have limited efficacy against the disease using traditional over‐canopy application methods. In an effort to improve coverage within the canopy and potentially improve disease control of DER, experiments were conducted in 2020, 2021, and 2022 to examine the effect of ground‐driven, in‐canopy fungicide nozzle technology on DER severity and spray coverage on the ear leaf and ear of corn plants. Application methods included over‐canopy nozzles, over‐canopy + drop nozzles, and over‐canopy + 360 Undercover nozzles. Within each application method, treatments consisted of a non‐inoculated control, or were inoculated with a conidial suspension of S. maydis. The fungicides benzovindiflupyr + azoxystrobin + propiconazole and pydiflumetofen + azoxystrobin + propiconazole were applied within each application method to measure efficacy against DER. In all years, neither fungicide product nor application method reduced DER severity. No fungicide applications increased yield compared to the non‐treated control. The addition of drop nozzles or 360 Undercover nozzles to traditional over‐canopy nozzles increased spray coverage on the ear (P < 0.0001) compared to over‐canopy nozzles alone.
Asymmetric Partial Hydrosilylation of 2,2‐Difluoro‐1,3‐diketones with Chiral Frustrated Lewis Pairs
Authors: Liu Ting , Feng Xiangqing , Du Haifeng
Published: December 2023

Comprehensive Summary

The asymmetric partial reduction of 1,3‐diketones stands as a straightforward pathway to access optically active β‐hydroxyketones. In this paper, an asymmetric Piers‐type hydrosilylation of 2,2‐difluoro‐1,3‐diketones was successfully realized by using a frustrated Lewis pair of chiral borane and tricyclohexylphosphine as a catalyst, delivering a variety of α,α‐difluoro‐β‐hydroxyketones in high yields with up to 99% ee. Significantly, no over‐reduced diol products were observed even with an excess amount of silanes. The product can be conveniently converted to α,α‐difluoro‐β‐hydroxyester or 1,3‐anti‐diol via an oxidation with m‐CPBA or a reduction with DIBAL‐H without obvious loss of ee.
An effective data placement strategy for IIoT applications
Authors: Shen Zhijie , Liu Bowen , Dou Wanchun
Published: December 2023

With the rapid development of the Internet of things (IoT) and mobile communication technology, the amount of data related to industrial Internet of things (IIoT) applications has shown a trend of explosive growth, and hence edge‐cloud collaborative environment becomes one of the most popular paradigms to place the IIoT applications data. However, edge servers are often heterogeneous and capacity limited while having lower access delay, so there is a contradiction between capacity and latency while using edge storage. Additionally, when IIoT applications deployed crossing edge regions, the impact of data replication and data privacy should not be ignored. These factors often pose challenges to proposing an effective data placement strategy to take full advantage of edge storage. To address these challenges, an effective data placement strategy for IIoT applications is designed in this article. We first analyze the data access time and data placement cost in an edge‐cloud collaborative environment, with the consideration of data replication and data privacy. Then, we design a data placement strategy based on ‐constraint and Lagrangian relaxation, to reduce the data access time and meanwhile limit the data placement cost to an ideal level. As a result, our proposed data placement strategy can effectively reduce data access time and control data placement costs. Simulation and comparative analysis results have demonstrated the validity of our proposed strategy.
Why and when should organisms elongate their telomeres? Elaborations on the ‘excess resources elongation’ and ‘last resort elongation’ hypotheses
Authors: Gómez‐Blanco David , Tobler Michael , Hasselquist Dennis
Published: December 2023

Telomere length and telomere shortening are thought to be critical cellular attributes and processes that are related to an individual's life span and fitness. The general pattern across most taxa is that after birth telomere length gradually decreases with age. Telomere protection and restoration mechanisms are usually assumed to reduce the rate of shortening or at most keep telomere length constant. However, here we have compiled a list of 26 articles showing that there is an increasing number of studies reporting apparent elongation of telomeres (i.e., a net increase in TL from timet to timet+1) often in a considerable proportion of the individuals studied. Moreover, the few studies which have studied telomere elongation in detail show that increases in telomere length are unlikely to be due to measurement error alone. In this article, we argue that episodes of telomere elongation deserve more attention as they could reflect individual strategies to optimise life histories and maximise fitness, which may not be reflected in the overall telomere dynamics patterns. We propose that patterns of telomere (net) elongation may be partly determined by other factors than those causing telomere shortening, and therefore deserve analyses specifically targeted to investigate the occurrence of telomere elongation. We elaborate on two ecological hypotheses that have been proposed to explain patterns of telomere elongation (the ‘excess resources elongation’ and the ‘last resort elongation’ hypothesis) and we discuss the current evidence for (or against) these hypotheses and propose ways to test them.
The ‘peptide for life’ initiative in the emergency department study
Authors: Bayes‐Genis Antoni , Krljanac Gordana , Zdravković Marija , Ašanin Milika , Stojšić‐Milosavljević Anastazija , Radovanović Slavica , Kovačević Tamara Preradović , Selaković Aleksandar , Milinković Ivan , Polovina Marija , Glavaš Duška , Srbinovska Elizabeta , Bulatović Nebojša , Miličić Davor , Čikeš Maja , Babić Zdravko , Šikić Jozica , Kušljugić Zumreta , Hudić Larisa Dizdarević , Arfsten Henrike , Meems Laura M.G. , Metra Marco , Rosano Giuseppe , Seferović Petar M. ,   Young Investigators of the Peptide for Life Initiative
Published: December 2023

Aims

Natriuretic peptide (NP) uptake varies in Emergency Departments (EDs) across Europe. The ‘Peptide for Life’ (P4L) initiative, led by Heart Failure Association, aims to enhance NP utilization for early diagnosis of heart failure (HF). We tested the hypothesis that implementing an educational campaign in Western Balkan countries would significantly increase NP adoption rates in the ED.

Methods and results

This registry examined NP adoption before and after implementing the P4L‐ED study across 10 centres in five countries: Bosnia and Herzegovina, Croatia, Montenegro, North Macedonia, and Serbia. A train‐the‐trainer programme was implemented to enhance awareness of NP testing in the ED, and centres without access received point‐of‐care instruments. Differences in NP testing between the pre‐P4L‐ED and post‐P4L‐ED phases were evaluated. A total of 2519 patients were enrolled in the study: 1224 (48.6%) in the pre‐P4L‐ED phase and 1295 (51.4%) in the post‐P4L‐ED phase. NP testing was performed in the ED on 684 patients (55.9%) during the pre‐P4L‐ED phase and on 1039 patients (80.3%) during the post‐P4L‐ED phase, indicating a significant absolute difference of 24.4% (95% CI: 20.8% to 27.9%, P < 0.001). The use of both NPs and echocardiography significantly increased from 37.7% in the pre‐P4L‐ED phase to 61.3% in the post‐P4L‐ED phase. There was an increased prescription of diuretics and SGLT2 inhibitors during the post‐P4L‐ED phase.

Conclusions

By increasing awareness and providing resources, the utilization of NPs increased in the ED, leading to improved diagnostic accuracy and enhanced patient care.
Pore to Core Scale Characterization of Hydraulic Flow Units Using Petrophysical and Digital Rock Analyses
Authors: Chandra Viswasanthi , Tallec Gwenole , Finkbeiner Thomas , Vahrenkamp Volker
Published: December 2023

This article illustrates an integrated method for characterizing hydraulic flow units in subsurface reservoirs using multiscale images and petrophysical data analysis from well cores. This method is applied to 35 meters of cores drilled from a Late Jurassic Upper Jubayla Formation outcrop in Saudi Arabia, which is analogous to the lower section of the Arab‐D reservoir. Scanning electron microscope (SEM) imagery, thin‐section petrography, and X‐ray computed tomography (CT) images of whole cores and core plugs are used to visualize and characterize these carbonate rocks across multiple length scales. Core plug porosity and permeability data are used for petrophysical characterization and deriving hydraulic flow units (HFU). The multimodal pore types associated with the HFUs and their connectivity using thin section and SEM image analysis, combined with mercury injection porosimetry are used. Whole‐core CT textures and heterogeneity logs are correlated with HFU and digital image analysis of core plugs. Whole‐core CT data prove to be a highly valuable tool for bridging the scale gap between well data and reservoir models. This methodology can be applied to datasets from a large number of wells, especially when combined with machine learning tools, allowing improved characterization of complex carbonate reservoirs.
New generalized extreme value distribution with applications to extreme temperature data
Authors: Gyasi Wilson , Cooray Kahadawala
Published: December 2023

A new generalization of the extreme value distribution is presented with its density function, having a wide variety of density and tail shapes for modeling extreme value data. This generalized extreme value distribution will be referred to as the odd generalized extreme value distribution. It is derived by considering the distributions of the odds of the generalized extreme value distribution. Consequently, the new distribution is enlightened by not only having all six families of extreme value distributions; Gumbel, Fréchet, Weibull, reverse‐Gumbel, reverse‐Fréchet, and reverse‐Weibull as submodels but also convenient for modeling bimodal extreme value data that are frequently found in environmental sciences. Basic properties of the distribution, including tail behavior and tail heaviness, are studied. Also, quantile‐based aliases of the new distribution are illustrated using Galton's skewness and Moor's kurtosis plane. The adequacy of the new distribution is illustrated using well‐known goodness‐of‐fit measures. A simulation is performed to validate the estimated risk measures due to repeated data points frequently found in temperature data. The Grand Rapids and well‐known Wooster temperature data sets are analyzed and compared to nine different extreme value distributions to illustrate the new distribution's bimodality, flexibility, and overall fitness.
Insights into landslide susceptibility in different karst erosion landforms based on interpretable machine learning
Authors: Sun Deliang , Wang Jing , Wen Haijia , Ding Yuekai , Gu Qingyu , Zhang Jialan , Zhang Fengtai
Published: December 2023

The aim of the present study was to assess differences in the conditioning factors and the performance of landslide susceptibility mapping (LSM), employing the SHapley Additive exPlanations (SHAP) model to gain profound insights into the intrinsic decision‐making mechanism of LSM in diverse landforms. Two typical karst erosion landforms were selected as the research areas. Based on 15 conditioning factors, LSMs for the two areas were developed using the Bayesian optimization random forest (RF) and eXtreme Gradient Boosting (XGBoost). The SHAP model was used to explore the landslide formation mechanisms from both global and local perspectives. The results show that the area under the curve (AUC) values of the XGBoost models were 0.791 and 0.761, and the AUC values of the RF models were 0.844 and 0.817, in the two different landform areas, respectively. The RF model's accuracy was higher than that of the XGBoost model in both regions. In the low‐elevation hills area, the primary three conditioning factors were identified as slope, topographic relief and distance from the river. Conversely, in the microrelief and mesorelief low mountain area, the predominant conditioning factors were elevation, distance from the river and distance from the road. Both karst landform areas exhibited a high sensitivity to the distance from the river, indicating its significant interaction with other factors contributing to landslide occurrences. Notably, the RF model demonstrated superior performance compared to the XGBoost model, rendering it a more suitable choice for conducting landslide susceptibility mapping research in karst erosion landform areas. In the present study, a comprehensive explanatory framework based on the RF‐SHAP model was proposed, which enables both global and local interpretation of landslides in various karst landscapes. Such an approach explores the intrinsic decision‐making mechanism of the model, enhancing the transparency and realism of landslide susceptibility prediction results.
Machine learning based centralized dynamic clustering algorithm for energy efficient routing in vehicular ad hoc networks
Authors: Choksi Amit , Shah Mehul
Published: December 2023

Vehicular ad hoc network (VANET) is a dynamic and self‐configure wireless network that connects vehicles to provide in‐vehicle infotainment services and comfort to both driver and passengers while on the move. Due to the highly dynamic environment, patchy connectivity, roadside barriers, and a scarcity of road side units (RSUs); existing routing protocols of VANET consume high energy during route construction. As a consequence, the VANET lifespan might be shortened. However, saving energy is a critical factor where VANET is projected to play a key role in the building of sustainable green infrastructure. Clustering is an imperative process where vehicle nodes join to make stable clusters based on common mobility features. In VANET, clustering‐based routing algorithms significantly improve network effectiveness and reduce infrastructure costs. This article proposes fuzzy c‐means (FM) machine learning‐based dynamic clustering algorithm (DCA) to identify trustworthy vehicles for energy‐efficient multi‐hop routing by considering different mobility parameters such as position, direction, speed, and remaining energy of each vehicle node. This article also proposes distance and power‐based variation of FM called fuzzy c‐means using distance and residual power (FMDP) to find stable cluster heads (CHs) for performing better data dissemination to the destination. The proposed DCA outperforms the existing k‐means based clustering algorithms as well as topology‐based DSR and AODV routing protocols in terms of packet delivery ratio, application throughput, end‐to‐end delay, network energy consumption, node energy consumption, and RSU energy consumption. Additionally, clustering methods FM and FMDP of suggested DCA improve end‐to‐end delay by 20%, application throughput by 5%, and reduce network energy consumption by 68% compared with the k‐means based clustering model.
Who am I—Teacher or practitioner? Teacher‐practitioners’ experience of identity in higher education—A phenomenological view
Authors: Peri Elina , Jõgi Larissa , Remmik Marvi
Published: December 2023

Practitioners entering academic careers in higher education face many challenges in teacher identity formation. This article is based on ongoing research and aims to understand the phenomenon of experiencing teacher identity in teacher‐practitioners who have interrupted their academic careers in the field of healthcare and social sciences in Estonian higher education institutions. Empirical data was collected using semi‐structured interviews. Data analysis was based on a phenomenological approach and the content analysis method. The experience of the identity of the teacher‐practitioners is contradictory and can be understood as a subjective and collective phenomenon. The findings showed that teacher‐practitioners with a strong specialist identity are not stable in their academic careers. Their identity is characterised by fragility and is associated with decisions to continue or interrupt their academic careers. The study suggests that the efforts of teacher‐practitioners in academic settings need to be professionally supported by the provision of individual, collective and targeted institutional support. The article contributes to studies of professional identity from an interpretative phenomenological perspective.
Attitudes and perceptions about COVID‐19 vaccination in the population with chronic HIV infection: A systematic review
Authors: Shirley Emilia Afonso López , Francisco Jover‐Diaz , Elisabet Delgado Sánchez , Teresa Gea Velázquez de Castro , María Bernabéu Martínez
Published: December 2023

Background and Aims

The coronavirus disease 2019 (COVID‐19)‐infected population has been increasing during the last 3 years worldwide. Moreover, simultaneously, COVID‐19 vaccine clinical trials were launched. By the end of 2020, the Food and Drug Administration had authorized the emergency use of two messenger RNA vaccines against COVID‐19. These fast‐track vaccine approvals have produced controversy about their safety and efficacy. The purpose of this research was to discover attitudes and perceptions regarding vaccination against COVID‐19 disease among vulnerable groups such as human immunodeficiency virus (HIV)‐infected patients.

Methods

Between June 2, 2021 and March 4, 2022, we conducted a cross‐sectional study through a survey of high‐risk patients with severe COVID‐19, such as HIV‐infected patients in the Infectious Diseases Unit (Hospital Clínico Universitario San Juan, Alicante). For the data collection strategy, a nonprobabilistic snowball sampling was adopted. A structured, anonymous, self‐administered questionnaire was developed in which questions and statements were designed to evaluate their attitudes and perceptions about COVID‐19 vaccination. Descriptive and bivariate analyses were performed for the obtained data.

Results

Forty‐eight participants were recruited with a mean age of 51.5 ± 11.9 years. Thirty‐nine of them (81.3%) were male. The acceptance rate of COVID‐19 vaccination was extremely high (95.7%). Bivariate analysis showed older patients significantly received a higher proportion of vaccine doses at the time of the survey (p = 0.047). Older patients were more aware of the vaccine safety controversy (61.1%) compared to younger patients (p = 0.054). There were no other significant differences between groups among questions regarding safety, efficacy, or attitudes about COVID‐19 vaccination.

Conclusion

An extremely high degree of acceptance for COVID‐19 vaccination was reported. Older patients were more aware of the vaccine safety controversy. Medical staff is the most trustworthy source of information, far above all other sources. Social networks and opinion leaders have not been shown to significantly influence our population.
Double‐ended passivator enables dark‐current‐suppressed colloidal quantum dot photodiodes for CMOS‐integrated infrared imagers
Authors: Liu Peilin , Lu Shuaicheng , Liu Jing , Xia Bing , Yang Gaoyuan , Ke Mo , Zhao Xuezhi , Yang Junrui , Liu Yuxuan , Ge Ciyu , Liang Guijie , Chen Wei , Lan Xinzheng , Zhang Jianbing , Gao Liang , Tang Jiang
Published: December 2023

Lead sulfide (PbS) colloidal quantum dot (CQD) photodiodes integrated with silicon‐based readout integrated circuits (ROICs) offer a promising solution for the next‐generation short‐wave infrared (SWIR) imaging technology. Despite their potential, large‐size CQD photodiodes pose a challenge due to high dark currents resulting from surface states on non‐passivated (100) facets and trap states generated by CQD fusion. In this work, we present a novel approach to address this issue by introducing double‐ended ligands that supplementally passivate (100) facets of halide‐capped large‐size CQDs, leading to suppressed bandtail states and reduced defect concentration. Our results demonstrate that the dark current density is highly suppressed by about an order of magnitude to 9.6 nA cm−2 at −10 mV, which is among the lowest reported for PbS CQD photodiodes. Furthermore, the performance of the photodiodes is exemplary, yielding an external quantum efficiency of 50.8% (which corresponds to a responsivity of 0.532 A W−1) and a specific detectivity of 2.5 × 1012 Jones at 1300 nm. By integrating CQD photodiodes with CMOS ROICs, the CQD imager provides high‐resolution (640 × 512) SWIR imaging for infrared penetration and material discrimination.

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Compliant substrates mitigate the senescence associated phenotype of stress induced mesenchymal stromal cells
Authors: Gresham Robert C. H. , Filler Andrea C. , Fok Shierly W. , Czachor Molly , Schmier Natalie , Pearson Claire , Bahney Chelsea , Leach J. Kent
Published: December 2023

Mesenchymal stromal cells (MSCs) are a promising cell population for musculoskeletal cell‐based therapies due to their multipotent differentiation capacity and complex secretome. Cells from younger donors are mechanosensitive, evidenced by changes in cell morphology, adhesivity, and differentiation as a function of substrate stiffness in both two‐ and three‐dimensional culture. However, MSCs from older individuals exhibit reduced differentiation potential and increased senescence, limiting their potential for autologous use. While substrate stiffness is known to modulate cell phenotype, the influence of the mechanical environment on senescent MSCs is poorly described. To address this question, we cultured irradiation induced premature senescent MSCs on polyacrylamide hydrogels and assessed expression of senescent markers, cell morphology, and secretion of inflammatory cytokines. Compared to cells on tissue culture plastic, senescent MSCs exhibited decreased markers of the senescence associated secretory phenotype (SASP) when cultured on 50 kPa gels, yet common markers of senescence (e.g., p21, CDKN2A, CDKN1A) were unaffected. These effects were muted in a physiologically relevant heterotypic mix of healthy and senescent MSCs. Conditioned media from senescent MSCs on compliant substrates increased osteoblast mineralization compared to conditioned media from cells on TCP. Mixed populations of senescent and healthy cells induced similar levels of osteoblast mineralization compared to healthy MSCs, further indicating an attenuation of the senescent phenotype in heterotypic populations. These data indicate that senescent MSCs exhibit a decrease in senescent phenotype when cultured on compliant substrates, which may be leveraged to improve autologous cell therapies for older donors.
Evaluation of Culturally Informed and Flexible Family‐Based Treatment for Adolescents (CIFFTA) implemented in community‐based settings
Authors: Mena Maite P. , Lazarus Rebecca A. , Otero Kristal A. , Santisteban Daniel A.
Published: December 2023

Effective family‐based interventions are needed for youth who are experiencing emotional and behavioral difficulties and who are impacted by powerful environmental stressors. Culturally Informed and Flexible Family‐Based Treatment for Adolescents (CIFFTA) is a manualized and evidence‐based, multicomponent family‐based treatment that has been shown to be efficacious in research settings. The purpose of this paper is to report on the effectiveness of implementing CIFFTA for the treatment of Latino and Black youth and families in community settings. Utilization of services offered and changes in youth presenting problems and family functioning were used to evaluate the program. Two hundred thirty‐two youth (11–18 years of age) and their caregivers were recruited over 2 years and CIFFTA was delivered by experienced masters‐level family therapists over a 12–16‐week period. Seventy‐six percent met the 8‐session criteria for retention in treatment and 71% completed treatment. Results showed significant improvements in youth behavioral and emotional presenting problems, reduction in family conflict and improvement in family cohesion and communication. Caregiver well‐being such as reductions in parental stress, relational frustration, and improvement in parental confidence also showed significant improvement. Analyses of reliable change indices showed a substantial improvement in youth who entered the program in the clinical range of presenting problems. The findings point to CIFFTA's ability to retain youth and families who tend to underutilize needed services, to significant reductions in presenting problems, and to improvements in family functioning when implemented in a community setting.
Trajectories of adaptive functioning from early childhood to adolescence in autism: Identifying turning points and key correlates of chronogeneity
Authors: Chen Yun‐Ju , Duku Eric , Szatmari Peter , Salt Mackenzie , Smith Isabel , Richard Annie , Zwaigenbaum Lonnie , Vaillancourt Tracy , Zaidman‐Zait Anat , Bennett Terry , Elsabbagh Mayada , Kerns Connor , Georgiades Stelios
Published: December 2023

Background

Previous research has demonstrated heterogeneous adaptive outcomes across the autism spectrum; however, the current literature remains limited in elucidating turning points and associated factors for longitudinal variability (chronogeneity). To address these empirical gaps, we aimed to provide a finer‐grained characterization of trajectories of adaptive functioning from early childhood to adolescence in autism.

Methods

Our sample (N = 406) was drawn from an inception cohort of children diagnosed Autistic at ages 2–5. Adaptive functioning was assessed with Vineland Adaptive Behavior Scales (VABS, 2nd Edition) across 6 visits from the time of diagnosis by age 18. Parallel‐process latent growth curve modeling were used to estimate domain‐level VABS trajectories, followed by latent class growth analysis to identify trajectory subgroups. Child characteristics at diagnosis, family demographics, and participation outcomes at adolescence were compared across subgroups.

Results

Piecewise latent growth models best described VABS trajectories with two turning points identified at around ages 5‐6 and 9–10, respectively reflecting transitions into school age and early adolescence. We parsed four VABS trajectory subgroups that vary by level of functioning and change rate for certain domains and periods. Around 16% of the sample exhibited overall adequate functioning (standard score >85) with notable early growth and social adaptation during adolescence. About 21% showed low adaptive functioning (standard score ≤70), with decreasing slopes by age 6 followed by improvements in communication and daily‐living skills by age 10. The other two subgroups (63% in total) were characterized by adaptive functioning between low and adequate levels, with relatively stable trajectories entering school age. These subgroups differed most in their cognitive ability at diagnosis, household income, and social participation in adolescence.

Conclusions

We identified key individual and family characteristics and time windows associated with distinct adaptive functioning trajectories, which have important implications for providing timely and tailored supports to Autistic people across developmental stages.
Assessing the contribution of hospital medicine patients to the tertiary quaternary care mission of an academic medical center
Authors: Peng Theodore , Green Adrienne , Mourad Michelle
Published: December 2023

Academic medical centers must balance caring for patients in their community with their role as referral centers for more profitable tertiary quaternary (T/Q) care. Hospital medicine services, which admit patients largely from the emergency department, often have the lowest proportion of T/Q care and may thus be under pressure to demonstrate their value to the health system. Looking at the 5771 patients that were discharged from our hospital medicine service between 2021 and 2022, we found that three quarters (74.6%) of patients had at least one prior outpatient encounter at our institution, and that more than a third (36.1%) were established patients in departments of strategic importance to our institution. Our study provides a framework for academic hospital medicine services looking to assess their patient population's connection with the broader health system and suggests that our hospital medicine service provides inpatient care to a population critical to the role of the institution in our community both locally and regionally.
Quantification of lung surfactant lipid (dipalmitoylphosphatidylcholine/sphingomyelin) ratio in binary liposomes using Raman spectroscopy
Authors: Veluthandath Aneesh Vincent , Ahmed Waseem , Madsen Jens , Clark Howard W. , Postle Anthony D. , Wilkinson James S. , Murugan Ganapathy Senthil
Published: December 2023

Early diagnosis of neonatal respiratory distress syndrome (nRDS) is important in reducing the mortality of preterm babies. Knowledge of the ratio of two components of lung surfactant, dipalmitoylphosphatidylcholine (DPPC), and sphingomyelin (SM) can be used as biomarkers of lung maturity and inform treatment. Raman spectroscopy is a powerful tool to analyze vibrational spectra of organic molecules which requires only limited sample preparation steps and, unlike IR spectroscopy, is not masked by water absorption. In this paper, we explore the potential of using Raman spectroscopy as a tool to estimate the ratio of DPPC and SM from aqueous vesicles of binary mixture of DPPC and SM. We demonstrate that the ratio of DPPC and SM can be estimated by estimating the ratio of intensity of CO stretch of DPPC and CC stretch of SM as well as CO stretch of DPPC and amide I of SM. Further, we employ a partial least squares regression (PLSR) model to automate the estimation and demonstrate that PLSR method can predict the DPPC and SM ratio with an R2 value of 0.968.
The dynamics of nonlocal diffusion problems with a free boundary in heterogeneous environment
Authors: Shi Linfei , Xu Tianzhou
Published: December 2023

This paper studies two nonlocal diffusion problems with a free boundary and a fixed boundary in heterogeneous environment. The main goal is to understand how the evolution of the two species is affected by the heterogeneous environment. We first prove the existence and uniqueness of a global solution for such systems. Then, for models with Lotka–Volterra type competition or predator–prey growth terms, we establish the spreading‐vanishing dichotomy. Sharp criteria of spreading and vanishing are also obtained. Furthermore, we show that accelerated spreading occurs if and only if the kernel function violates the threshold condition.
Cardiovascular safety of Janus Kinase inhibitor therapy in a multi‐ethnic population
Authors: Sunmboye Kehinde , Petrie Tom , Durrani Maumer
Published: December 2023

Background

Janus Kinase (JAK) inhibitors are a class of drugs that have been shown to be effective in treating a variety of autoimmune rheumatic diseases (ARDs). However, there have been concerns about their potential to increase the risk of cardiovascular events. Some studies have found no ethnic differences. This study aimed to assess the cardiovascular safety of JAK inhibitor therapy in a large multi‐ethnic patient cohort and to identify if there is a correlation between the age of patients in the cohort with an increased risk of cardiovascular events.

Methods

This retrospective cross‐sectional study enrolled 309 patients with ARDs who were treated with JAK inhibitors. Cardiovascular events that occurred while on JAK inhibitor therapy were identified retrospectively.

Results

The mean age of the study cohort was 59.3 years, and 73% were Caucasian and 25% were South Asian in ethnicity. There was a positive and statistically significant correlation between cardiovascular events and age of the patients (rpb = 0.12, n = 309, p = 0.036), but the correlation was weak based on the rpb value of 0.12.

Conclusion

The results of this study suggest that JAK inhibitor therapy is generally safe in older patients with ARDs in a multi‐ethnic population. However, further research is needed to identify any other patient factors that may increase the risk of cardiovascular events. The findings of this study could also have practise implications in the use of JAK inhibitor therapy in patients over 65 years of age.
Precision medicine in myocardial infarction: Nanotheranostic strategies
Authors: Pang Alexander Shao‐Rong , Dinesh Vishalli , Pang Natalie Yan‐Lin , Dinesh Tarini , Pang Kimberley Yun‐Lin , Yip George W. , Bay Boon Huat , Srinivasan Dinesh Kumar
Published: December 2023

Myocardial infarction (MI) is the most prevalent non‐communicable disease worldwide. Nanotheranostics have made significant progress in the biomedical field, presenting an avenue to overcome the limitations of conventional approaches towards MI, in which personalized interventions have enhanced nanotherapeutic efficacy. The pharmacokinetics and pharmacodynamics of nanoscale materials have been modified through alteration of their physical and chemical properties such as structure, size, and surface, thereby improving target sensitivity and specificity. This revolutionary technology has also been accomplished through precision therapeutics in MI. In this review, we discuss advanced nanoparticle designs utilized in the diagnosis and treatment of MI that could be applied to deliver personalized treatment and improve patient outcomes.
Asymptotic bounds for clustering problems in random graphs
Authors: Lykhovyd Eugene , Butenko Sergiy , Krokhmal Pavlo
Published: December 2023

Graph clustering is an important problem in network analysis. This problem can be approached by first finding a large cluster subgraph (i.e., a subgraph in which every connected component is a complete graph), perhaps in a relaxed form (connected components may have missing edges), and then assigning each of the remaining vertices to one of the connected components of the cluster subgraph according to some optimization criteria. The more vertices can be included in the initial cluster subgraph (also referred to as independent union of clusters), the more “clusterable” the graph is. This paper proposes a framework for establishing asymptotic bounds on the cardinality of independent unions of clusters in Erdős‐Rényi random graphs with constant , referred to as uniform random graphs. In particular, sufficient conditions ensuring (where is the number of nodes) upper bounds with probability 1 are developed and shown to be applicable for the maximum independent union of cliques as well as some clique relaxations. In addition, it is shown that every graph must have an independent union of cliques of cardinality at least . Since this bound is asymptotically tight on uniform random graphs, this suggests that these graphs can be viewed as a “least clusterable” class of graphs.
Factorial structure of quality of life, satisfaction with caregiving and caregiver burden in palliative care: A systematic review
Authors: Llop‐Medina Laura , Ródenas‐Rigla Francisco , Gallego‐Valadés Alfonso , Garcés‐Ferrer Jorge
Published: December 2023

Aim

The aim of this research is to identify the main approaches and domains of palliative care quality assessment through three questionnaires used for this purpose.

Design

Systematic review.

Methods

The proposed analysis process consists of three stages from 2000 to 2020: (i) massive literature search, (ii) text mining and (iii) systematic reviews carried out on the QLQ C30, Zarit Burden Interview and FAMCARE questionnaires. The Preferred Reporting Items for Systematic Reviews (PRISMA‐P) have guided our research.

Results

Sixteen papers were included in our study. The main findings have been summarised using a descriptive narrative synthesis approach. Systematic reviews evidenced that such tools present variable factor structures or latent domains. The results obtained are generally representative of the evidence supporting the factor structure of the QLQ‐C30 in the general cancer population. The factor structure of the Zarit Burden Interview remains ambiguous, although the idea of a unifactorial structure predominates. In the case of FAMCARE, most of the factor structures differ from the initial proposal of Kristjanson. The categorisation of the main subjective assessment approaches could be useful for the construction of a coherent system of indicators to be used in nursing practice. For its part, the variability in the latent dimensionality of the questionnaires analysed could be due to: (i) the characteristics of the sample, (ii) the population studied, (iii) cross‐cultural variability, (iv) the design of the questionnaire and (v) the analysis techniques employed.
Water absorption of biomass fillers to impact the degradation of poly(butyleneadipate‐co‐terephthalate) composites
Authors: Gong Zewei , Huang Juncheng , Xie Liangke , Feng Chengqi , Na Haining , Wang Na , Zhu Jin
Published: December 2023

In this work, two kinds of biomass fillers including reed and wheat straw with similar sizes at micrometer scale were used as filler and poly(butyleneadipate‐co‐terephthalate) (PBAT) as matrix to prepare high‐performance composite materials and to use for the research of enzymatic degradation. Accordingly, hard PBAT composites with average bending strength and modulus at 12 and 1100 MPa were prepared. With the progress of enzymatic degradation, water absorption of the biomass fillers to promote the degradation of PBAT matrix was clearly revealed. The strong water absorption of biomass filler led to the large degradation rate. During the degradation within 90 days, the mechanical properties of PBAT/biomass fillers composites decreased to 23.7%. This study revealed the important factors of biomass fillers affecting the degradation behavior of PBAT in composite.

Highlights

• Two different biomass fillers are blended into PBAT to fabricate the composites.

• All of the biomass fillers are similarly controlled at the micrometer level.

• Water absorption of biomass filler promotes the degradation of the PBAT matrix.

• Stronger water absorption induces quicker degradation rate.

• After degradation, bending properties of PBAT composites obviously decrease.
Layer multiplication co‐extrusion of cross‐linked polymer microsphere‐filled systems
Authors: Steinmetz Erik , Maia João
Published: December 2023

Layer multiplication co‐extrusion allows for creation of advance structures with highly tunable properties, with relative ease. Multi‐layer co‐extrusion using the layer multiplication technique was used to create 33‐layered structures of polymer microsphere‐filled layers alternating with unfilled layers. Cross‐linked polyurethane (PU) microspheres (of two different rigidities) and ultra‐highly cross‐linked polymethylmethacrylate (PMMA) microspheres were used to examine the effect of particle rigidity in confinement on overall mechanical properties. Layer structures were successfully created with particle‐filled layers; once layer size approaches the particle size, the particles deform the unfilled counter‐layer. In certain conditions, impingement of the counter‐layer occurs, decreasing the mechanical properties. High‐density polyethylene‐grafted‐maleic anhydride (HDPE‐g‐MA) was subsequently utilized as a compatibilizer to improve the interface between the particles and the matrix. The HDPE‐g‐MA was effective in increasing the mechanical performance of the co‐extruded product made with the PU microspheres but inefficient in improving the product made with the PMMA microspheres.
Talus and its cooling effects on the thermal regime of permafrost: A review
Authors: Lan Shengtao , Cao Bin , Hu Yan , Sun Ziyong , Ma Rui , Li Xin
Published: December 2023

Talus, as the product of movement and accumulation along the slope after the cracking of cliffs or steep rock walls, is a common landform in the mountain periglacial environment. Significant thermal anomalies within talus have been widely reported to be a result of cooling effects. During the cold season, the increased temperature difference between talus and the ambient environment strengthens the intensity of convection (vertical flows) and transforms into upward advection (lateral flows) and exhausts the internal warm current. During the warm season, heat is concentrated on the surface of the talus, and the internal dominant cold current moves downward along the slope by advection. The principle of the proactive cooling effects of talus has been widely utilized in railway construction within permafrost regions as embankments to alleviate degradation of the underlying permafrost. However, limited model studies have examined the cooling effects of blocky debris in nature, and in situ observations are rare. Therefore, it will be important to increase observations and develop process‐based models that couple heat conduction, convection/advection, water transfer processes, and even the latent heat of phase change. This will help to better understand the extent of the cooling effects and its impact on the thermal regime of permafrost.
Structural Evolution of Sequentially Evaporated (Cs,FA)Pb(I,Br)3 Perovskite Thin Films via In Situ X‐Ray Diffraction
Authors: Heinze Karl L. , Schulz Tobias , Scheer Roland , Pistor Paul
Published: December 2023

Evaporation of perovskite thin films for solar cell applications is a solvent‐free, well controllable, and scalable deposition path with promising prospects for commercialization. Compared to commonly applied simultaneous co‐evaporation of various halide precursor salts, sequential evaporation followed by an annealing step allows to better control the amount of deposited precursors, and has the potential to largely improve reproducibility. In this work, Cs/formamidinium (FA)‐based lead iodide perovskites are deposited via sequential evaporation in a vacuum chamber and the phase formation and evolution of different precursor‐stacking sequences and annealing conditions are investigated with in situ X‐ray diagnostics. In addition, some Br is added to investigate the effect of halide intermixing. The stacking sequence is found to strongly influence the formation of dominant phases as well as the preferential orientation and HGHmorphology of the as‐deposited films. These variations in turn affect the diffusion and conversion during thermal annealing and ultimately the conversion ratio of the final perovskite layers. For example, it is found that starting the stacking sequences with the A cations (CsI, FAI) favors a fast and complete conversion of the perovskite phase. However, the result is the formation of perovskite layers with large voids.