bluuebunny/crossref_metadata_2025 huggingface dataset:
Psoriasis and risk of chronic kidney diseases: A population‐based cross‐sectional study and Mendelian randomization analysis
Authors: Yin Saifu , Zhou Zhaoxia , Wu Jiapei , Wang Xianding , Lin Tao
Published: July 2023

Background

Conflicting results have been reported regarding the association between psoriasis and risk of chronic kidney diseases (CKD). Furthermore, the causal nature of the possible association remains unexplored.

Methods

We conducted a population‐based cross‐sectional study using data from National Health and Nutrition Examination Survey (NHANES). Logistic regression analyses were conducted to estimate potential association between psoriasis and CKD risk. Further, we evaluated causality by performing a Mendelian randomization analysis using large‐scale genome‐wide association studies of psoriasis and CKD. Inverse variance‐weighted (IVW) analysis was used as the primary method.

Results

In the observational study, 16 750 participants were included. Overall, 39 of 429 patients with psoriasis had CKD (9.1%) compared with 1481 of 16 321 without psoriasis (9.1%). In the fully adjusted model, psoriasis was not associated with CKD (OR: 0.77, 95%CI: 0.53–1.10). In the MR analysis, 36 single‐nucleotide polymorphisms (SNPs) were selected as instrumental variables. The IVW analysis reported that genetically predicted psoriasis was associated with a higher risk of CKD (OR: 1.025, 95%CI: 1.001–1.049). After removing 2 SNPs associated with heterogeneity, the association remained (OR: 1.028, 95%CI: 1.006–1.050).

Conclusion

Genetically predicted psoriasis was associated with a higher risk of CKD. This association may be important for clinicians to monitor kidney function and prescribe potentially nephrotoxic drugs during psoriasis management.
An immersive simulation strategy to teach canine vaginal cytology: A multi‐centre study
Authors: Marcos Ricardo , Moreira Raquel , Macedo Sónia , Mateus Luisa , Martins‐Bessa Ana , Lopes Graça
Published: July 2023

Vaginal cytology (VC) is an essential technique for monitoring the bitch's estrus cycle. Currently, animal‐free teaching methodologies have not been investigated for VC. Hence, this study aimed to evaluate an immersive simulation with a VC model and augmented reality tools. Students (n = 219) from four universities were enrolled, having learning stations with models for practising VC that provided immediate feedback on the technique. Augmented reality tools comprised QR codes that endorsed students to short videos of owners' avatars reporting the clinical reproductive story of the simulated animals and slides with QR codes leading to microscopy slide navigation videos. Proestrus, estrus, diestrus, anestrus and vaginitis were identified in the learning stations. The students' perceptions were evaluated through questionnaires assessing satisfaction, motivation, confidence, impact on learning and diagnostic accuracy. Before the immersive simulation, students had no experience with VC, being afraid of doing a VC with a live dog. Almost all the students considered practicing VC as essential and 94% reported that repeating the procedure (>2 times) was the most important parameter for learning. The simulation activity lasted ≈3 h and significantly improved the confidence of students, being less afraid of doing a VC in a live animal. Slide navigation videos improved the diagnostic accuracy of the estrus cycle stage, and students diagnosed the estrus and vaginitis cases more accurately. The immersive simulation strategy allowed repeated practice in a safe, motivated and standardized environment, being appraised by students as an essential strategy for learning VC.
Therapeutic solutions for anterior restorations in disabled patients: Systematic review and case report
Authors: Abouzeir Salomé , Gurgel‐Georgelin Marie , Diemer Franck , Esclassan Rémi , Noirrit‐Esclassan Emmanuelle , Canceill Thibault
Published: July 2023

Introduction

Treating anterior restorations is a real challenge for a dentist and conventional protocols are not always applicable. The aim of this study is to determine different therapeutic to conducting anterior restorations in disabled people.

Case report

We begin by presenting the case of a 23‐year‐old, handicapped man, who was brought in consultation to compensate for the loss of the left upper central incisor (#21).

Materials and methods

We then performed a systematic literature review in December 2022, in accordance with the PRISMA guidelines. The publications, on three databases, dealing with dental treatments on disabled people were selected whether they were clinical studies or case reports.

Results

In the end, 14 publications were included. Most of the treatments described in the studies (n = 10; 71.43%) concern people aged under 19. The patients present different types of handicaps with various degrees of severity and the oral diseases described are as heterogeneous as the handicaps retrieved.

Discussion

It is therefore difficult to make common treatment recommendations for all these variable profiles and situations. Most of patients in this study are very young, so there is a need for preventive and therapeutic care as earlier as possible, to preserve the vitality of their teeth and dental occlusion.
Simulating Subject-Specific Aortic Hemodynamic Effects of Valvular Lesions in Rheumatic Heart Disease
Authors: Cebull Hannah L. , Aremu Olukayode O. , Kulkarni Radhika S. , Zhang Samuel X. , Samuels Petronella , Jermy Stephen , Ntusi Ntobeko A.B. , Goergen Craig J.
Published: July 2023

Rheumatic heart disease (RHD) is a neglected tropical disease despite the substantial global health burden. In this study, we aimed to develop a lower cost method of modeling aortic blood flow using subject-specific velocity profiles, aiding our understanding of RHD's consequences on the structure and function of the ascending aorta. Echocardiography and cardiovascular magnetic resonance (CMR) are often used for diagnosis, including valve dysfunction assessments. However, there is a need to further characterize aortic valve lesions to improve treatment options and timing for patients, while using accessible and affordable imaging strategies. Here, we simulated effects of RHD aortic valve lesions on the aorta using computational fluid dynamics (CFD). We hypothesized that inlet velocity distribution and wall shear stress (WSS) will differ between RHD and non-RHD individuals, as well as between subject-specific and standard Womersley velocity profiles. Phase-contrast CMR data from South Africa of six RHD subjects with aortic stenosis and/or regurgitation and six matched controls were used to estimate subject-specific velocity inlet profiles and the mean velocity for Womersley profiles. Our findings were twofold. First, we found WSS in subject-specific RHD was significantly higher (p < 0.05) than control subject simulations, while Womersley simulation groups did not differ. Second, evaluating spatial velocity differences (ΔSV) between simulation types revealed that simulations of RHD had significantly higher ΔSV than non-RHD (p < 0.05), these results highlight the need for implementing subject-specific input into RHD CFD, which we demonstrate how to accomplish through accessible methods.
How Diverse Initial Samples Help and Hurt Bayesian Optimizers
Authors: Kamrah Eesh , Ghoreishi Seyede Fatemeh , Ding Zijian “Jason” , Chan Joel , Fuge Mark
Published: July 2023

Design researchers have struggled to produce quantitative predictions for exactly why and when diversity might help or hinder design search efforts. This paper addresses that problem by studying one ubiquitously used search strategy—Bayesian optimization (BO)—on a 2D test problem with modifiable convexity and difficulty. Specifically, we test how providing diverse versus non-diverse initial samples to BO affects its performance during search and introduce a fast ranked-determinantal point process method for computing diverse sets, which we need to detect sets of highly diverse or non-diverse initial samples. We initially found, to our surprise, that diversity did not appear to affect BO, neither helping nor hurting the optimizer’s convergence. However, follow-on experiments illuminated a key trade-off. Non-diverse initial samples hastened posterior convergence for the underlying model hyper-parameters—a model building advantage. In contrast, diverse initial samples accelerated exploring the function itself—a space exploration advantage. Both advantages help BO, but in different ways, and the initial sample diversity directly modulates how BO trades those advantages. Indeed, we show that fixing the BO hyper-parameters removes the model building advantage, causing diverse initial samples to always outperform models trained with non-diverse samples. These findings shed light on why, at least for BO-type optimizers, the use of diversity has mixed effects and cautions against the ubiquitous use of space-filling initializations in BO. To the extent that humans use explore-exploit search strategies similar to BO, our results provide a testable conjecture for why and when diversity may affect human-subject or design team experiments.
Against a bitter tide: How a small UK charity operationalises dissent to challenge the “hostile environment” for migrant children and families
Authors: Kerr Christian , Watts Nick
Published: July 2023

INTRODUCTION: Dissent is currently under political and ideological assault in the UK and immigration has long been a target for those looking to quell dissenting practices. At the same time, dissent appears increasingly out of place in the contemporary social work context in England. Yet, as the authors argue, dissent is codified within the professional and ethical standards that social workers in England must adhere to.
APPROACH: This article introduces the work of a small UK Charity, Together with Migrant Children, and applies to it key facets of the theoretical basis for dissent through case study and practice-based reflections on challenges in immigration policy and opportunities for dissenting practice.
IMPLICATIONS: The authors set out the challenges and opportunities for dissent in practice in statutory, non-statutory and wider community development settings, illustrating how dissent can bring individual ‘success’ that is located within a cumulative structural and tactical change that points to dissent and its practice as a necessary feature of democracy.
Ka mua, ka muri—Walking backwards into the future
Authors: Lewis Lashana , Walker Shayne , King Paula Toko , Mackay Hunia Te Urukaiata , Talamaivao Natalie , Anderson Daniel , Kemp Susan P
Published: July 2023

INTRODUCTION: Spurred by critical reviews of Oranga Tamariki–Ministry for Children, Aotearoa New Zealand’s statutory child protection agency, and growing calls for services delivered “by Māori, for Māori, with Māori”, the New Zealand government is taking significant steps toward devolving responsibility for supporting the wellbeing of tamariki, rangatahi, and whanau Māori from the Crown to Iwi and Māori social service providers. Frequently overlooked in discussions of Crown–Māori partnerships are community-based Māta Waka (pan-tribal) organisations, which provide a range of much-needed services to tamariki, rangatahi and whānau Māori who are not mana whenua. The purpose of this Kaupapa Māori research was to examine the expectations that kaimahi working for a Māta Waka Kaupapa Māori service provider have of other organisations that: 1) partner with tamariki, rangatahi and whānau Māori; and, 2) partner with Māta Waka.
APPROACH: Drawing on findings from wānanga with kaimahi, this article illuminates the principles and values that guide their practice, using these as a foundation for exploring the complexities, challenges, and opportunities inherent in building effective partnerships with statutory child protection services on behalf of tamariki, rangatahi and whānau Māori across differences in mandate, power, world views, and guiding frameworks or tikanga Māori.
IMPLICATIONS: The study findings have implications for current Crown–Māori partnership efforts and, by extension, for the wellbeing of tamariki, rangatahi, and whānau Māori.
Challenges in porosity characterization of thin films: Cross-evaluation of different techniques
Authors: Baklanov Mikhail R. , Mogilnikov Konstantin P. , Vishnevskiy Alexey S.
Published: July 2023

The review article provides an overview of the most important and popular techniques for evaluating the porosity of thin films developed for various applications. These methods include ellipsometric porosimetry (EP), positron annihilation (lifetime) spectroscopy (PAS/PALS), and grazing incidence small-angle x-ray scattering (GISAXS). Special attention is given to the challenges associated with interpreting the measured data and the inherent limitations of each method. It is demonstrated that EP, GISAXS, and PALS are all informative for studying the pore structure in thin films, with each method offering unique insights. GISAXS, in particular, allows for the evaluation of three-dimensional mesostructures, including pore arrangement, pore spacing, and structural order. On the other hand, PALS has a unique advantage in its capability to analyze extremely small isolated pores (free volume). The advantage of EP lies in its simplicity and the possibility to analyze multiple properties from the same set of measurements. The cross-evaluation of different methods offers important insights into the complex pore structure of materials, highlighting the significance of appropriate modeling and interpretation of data.
Congenital CMV associated with diaphragm dysfunction: a rare cause of tachypnoea
Authors: Carter Rebecca , Yakir Maayan , Ryu Julie , Weiss Katherine
Published: July 2023

A late preterm infant with intrauterine growth restriction developed respiratory distress, tachypnoea and hypoxia after birth, requiring supplemental oxygen. Chest radiographs demonstrated persistent elevation of the right hemidiaphragm. Chest ultrasound initially demonstrated symmetrical bilateral diaphragm motion, but subsequent ultrasounds showed asymmetrical excursion with weaker movement of the right hemidiaphragm. Placental pathology demonstrated chronic infectious villitis secondary to cytomegalovirus (CMV), and subsequent CMV testing on the infant was positive. The infant was microcephalic and head imaging revealed intracranial calcifications, consistent with congenital CMV infection.

CMV is the most common congenital infection and has a wide array of clinical manifestations. This report highlights the rarely described association between congenital CMV infection and respiratory distress due to underlying diaphragm dysfunction. In neonates with respiratory distress and features of congenital CMV infection, clinicians should have a high index of suspicion for diaphragm dysfunction.
Rare case of primary bone lymphoma of the femur
Authors: Kiamos Amy , Boldig Kimberly , Gagadam Vinay , Gujarathi Rahul
Published: July 2023

Primary bone lymphoma is a rare type of lymphoma that arises from skeletal tissue. Most cases described are non-Hodgkin’s lymphoma with diffuse large B-cell lymphoma being the most common subtype. While it is common for non-Hodgkin’s lymphoma to have secondary skeletal system involvement, primary involvement of the skeleton is surprisingly rare. Primary bone lymphoma accounts for less than 5% of all primary bone malignancies, 4%–5% of extranodal lymphomas and less than 1% of all non-Hodgkin’s lymphoma. We present an interesting case of a young adult male who was diagnosed with primary bone lymphoma of the femur. Interestingly, his initial X-ray imaging revealed no osseous abnormality and subsequent MRI revealed an infiltrating mass. The patient was treated with chemotherapy of rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone resulting in complete remission.
Inborn errors of immunity in mainland China: the past, present and future
Authors: Deng Mengyue , Mao Huawei
Published: July 2023

Inborn errors of immunity (IEI), also known as primary immunodeficiency diseases, comprise a group of rare genetic disorders that affect the development or/and function of the immune system. These disorders predispose individuals to recurrent infections, autoimmunity, cancer and immune dysregulations. The field of IEI diagnosis and treatment in mainland China has made significant strides in recent years due to advances in genome sequencing, genetics, immunology and treatment strategies. However, the accessibility and affordability of diagnostic facilities and precision treatments remain variable among different regions. With the increasing government emphasis on rare disease prevention, diagnosis, and treatment, the field of IEI is expected to progress further in mainland China. Herein, we reviewed the development and current state of IEI in mainland China, highlighting the achievements made, as well as opportunities and challenges that lie ahead.
Existential spectrum of suffering: concepts and moral valuations for assessing intensity and tolerability
Authors: Duffee Charlotte
Published: July 2023

This paper has two aims. The first is to defend a recent critique of the leading medical theory of suffering, which alleges too narrow a focus on violent experiences of suffering. Although sympathetic to this critique, I claim that it lacks a counterexample of the kinds of experiences the leading theory is said to neglect. Drawing on recent clinical cases and the longer intellectual history of suffering, my paper provides this missing counterexample. I then answer some possible objections to my defence, before turning to my second aim: an expansion of my counterexample into a spectrum of suffering that varies according to the selves and purposes that suffering affects. Next, I connect this spectrum to the tolerability of suffering, which I distinguish from its affective intensity. I conclude by outlining some applications of this distinction for the psychometric reliability of assessment instruments that measure suffering in clinical contexts.
NIDS-FLGDP: Network Intrusion Detection Algorithm Based on Gaussian Differential Privacy Federated Learning
Authors: Du Jiawei , Yang Kai
Published: July 2023

As a widely used network security defense technology, network intrusion detection has more deep learning methods used to improve the performance of intrusion detection. However, this method requires a large-scale network traffic data set for training, increasing privacy leakage risk. In this paper, a network intrusion detection algorithm based on Gaussian differential privacy federated learning (NIDS-FLGDP) is proposed. NIDS-FLGDP adopts the client–server architecture of federated learning, introduces the differential privacy of the Gaussian mechanism to ensure the security of the calculation process, uses the improved FedAvg algorithm to reduce communication overhead, and uses the improved 1D CNN to participate in collaborative training for the local model. Optimal parameters for Gaussian differential privacy and the optimal number of participating clients were determined from experiments. Model accuracy rates for binary classification and multi-classification training NIDS-FLGDP are 0.97, 0.975, 0.97 and 0.97, 0.985, 0.96, respectively, for KDD CUP99, NSL_KDD, and UNSW_NB15 network intrusion detection datasets. The results show that NIDS-FLGDP improves intrusion detection performance while protecting network traffic privacy compared with the previous methods. Its applicability and effectiveness have been fully verified, which provides a practical reference for the safe processing and analysis of a large number of diversified network traffic data in the future.
Behavior of the Poincaré constant along the Polchinski renormalization flow
Authors: Serres Jordan
Published: July 2023

We control the behavior of the Poincaré constant along the Polchinski renormalization flow using a dynamic version of [Formula: see text]-calculus. We also treat the case of higher order eigenvalues. Our method generalizes a method introduced by Klartag and Putterman to analyze the evolution of log-concave distributions along the heat flow. Furthermore, we apply it to general [Formula: see text]-measures and discuss the interpretation in terms of transport maps.
Ensemble Learning-Based Seismic Response Prediction of Isolated Structure Considering Soil–Structure Interaction
Authors: Fu Bo , Liu Xinrui , Chen Jin
Published: July 2023

To accurately and rapidly predict seismic responses, including the maximum displacement (MaxD) and maximum acceleration (MaxA), of the isolated structure considering the soil–structure interaction (SSI), five ensemble learning models, i.e. random forest (RF), gradient boosting regression tree (GBRT), extreme gradient boosting (XGBoost), light gradient boosting machine (LightGBM) and stacking model, are constructed. Firstly, a total of 96 000 nonlinear time history analyses of the isolated structure considering the SSI are conducted with the aid of OpenSees. The generated database is used for training and testing ensemble learning models. The ensemble learning models have 12 input variables in four categories, i.e. ground motion parameters, structural parameter, isolation parameters and soil parameter, and two output variables, i.e. MaxD and MaxA. The study shows that all ensemble learning models have excellent prediction performance for both training and testing datasets. The determination coefficients are larger than 0.96 and root-mean-square errors (RMSEs) are relatively small. Among the five ensemble learning models, the stacking model exhibits the best performance. In addition, the calculation method of feature importance score for the stacking model is provided. According to the feature importance analysis, the ground motion parameters have greater impact on seismic responses than other three categories of inputs. Finally, six ground motions are randomly selected to verify the generalization ability of the proposed ensemble learning models. The results show that the stacking model has a favorable generalization ability with relatively small prediction errors.
MULTI-STRATEGY IMPROVED TUNA SWARM OPTIMIZATION (TSO)-BASED HYBRID KERNEL EXTREME LEARNING MACHINE MODEL FOR EARLY DIAGNOSIS OF PARKINSON’S DISEASE
Authors: CHEN HONG
Published: July 2023

Parkinson’s disease (PD) is a neurodegenerative disease that progresses slowly. In this study, a tuna swarm optimization (TSO)-based hybrid kernel extreme learning machine (HKELM) method was proposed for early phonetic recognition of PD. Herein, HKELM models were optimized using multi-strategy (reverse learning and greedy selection swarm initialization, sin–cos strategy disturbance, and Weibull variation disturbance) improved TSO for early diagnosis of PD. The HKELM was employed for early diagnosis of PD and its classification accuracy was evaluated. The results of the experiments reveal that, as compared to the unimproved tuna technique for optimizing ELM, the suggested algorithm converges faster, can leap out of the local optimal, and has higher optimization accuracy.
Assessing the Impact of Collaborative Learning Practices on Competency Development in Entrepreneurship Program: A Study of Higher Education Students in Delhi NCR Region of India
Authors: Porkodi S. , Saranya R. , Sultana Arshiya , Mittal Peeyush
Published: July 2023

Higher education aims to inculcate teamwork and leadership, the two primary management skills that empower students to achieve competency. Despite the fact that students gain domain knowledge through higher education, many organisations report that freshmen have a severe lack of collaborative skills. These skills are essential for today’s graduates to compete in the world of tomorrow. Collaborative learning is a set of strategies that help the students achieve management skills in an effective way, leading to deeper learning. It increases the critical thinking level, communication, leadership, and employability skills, as well as responsibility, and prepares the students for real-life social and economic environments. As collaborative learning practises are so important, this study focuses on assessing the impact they have on competency development, specifically in entrepreneurship programs. A qualitative and quantitative survey has been administered to 536 students pursuing higher education in management in India’s Delhi and the NCR region. A questionnaire has been prepared with 20 questions, comprising 15 closed-ended and 5 open-ended questions. With the results obtained from the survey, it is clear that the collaborative learning practise has a positive relationship with the entrepreneurship programme and competence development among students. The result proved that collaborative learning does benefit the students more in developing competency than individual learning through cultivating essential skills such as communication, teamwork, critical thinking, and responsibility.
Nonlinear dynamics of a three-dimensional discrete-time delay neural network
Authors: Naik Parvaiz Ahmad , Eskandari Zohreh
Published: July 2023

This paper examines a three-dimensional delayed discrete neural network model analytically and numerically to determine the existence of different types of bifurcations of the involved fixed points. The model exhibits different bifurcations such as pitchforks, flips, Neimark–Sackers, and flip-Neimark–Sackers. The critical coefficients are used to determine the structure of each bifurcation. The curves are calculated and plotted for each bifurcation when the parameters are changed. Further, these bifurcations are theoretically analyzed and numerically verified. From the obtained results, we observed that by drawing the curves associated with each bifurcation, the numerical simulations are consistent with the analytical results.
Impact of annealing on charge storage capability of thermally evaporated molybdenum oxide thin films
Authors: Kumari Sudesh , Mir Rameez Ahmad , Upadhyay Sanjay , Pandey O. P. , Thakur Anup
Published: July 2023

Rapid technological advancements in recent years have necessitated the creation of energy-related devices. Due to their unique properties, including an exceptional cycling life, safe operation, low processing cost, and a higher power density than batteries, supercapacitors (SCs) have been identified as one of the most promising candidates to meet the demands of human sustainability. To increase the energy density of SCs, several advanced electrode materials and cell designs have been researched during the past few years. Utilizing the Faradaic charge storage process of transition metal cations, transition metal compounds have recently received attention as prospective electrode materials for SCs with high energy densities. In this work, the structure, morphology and electrochemical properties of molybdenum oxide (MoO3) films deposited via thermal evaporation technique and annealed at various temperatures were systematically investigated in order to examine the potential use of MoO3 for supercapacitors. Electrochemical analysis confirmed the pseudocapacitance characteristics of the synthesized films. The annealing temperature affects the oxidation and reduction observed in the cyclic voltammetry (CV) plots. Areal capacitance of thin films annealed at 150°C was found to be maximum and this could be attributed to the formation of hollow tube-like nanostructures which provided more active sites, than films annealed at higher temperatures. This also influences the charge storage ability of the synthesized films. It would be logical to assume that additional research in this area will result in more interesting discoveries and, eventually, the vi-ability of those promising Mo-based compounds in high-tech energy storage systems.
emgr
– EMpirical GRamian Framework Version 5.99
Authors: Himpe Christian
Published: July 2023

Version 5.99 of the empirical Gramian framework –
emgr
– completes a development cycle which focused on parametric model order reduction of gas network models while preserving compatibility to the previous development for the application of combined state and parameter reduction for neuroscience network models. Second, new features concerning empirical Gramian types, perturbation design, and trajectory post-processing, as well as a Python version in addition to the default MATLAB / Octave implementation, have been added. This work summarizes these changes, particularly since
emgr
version 5.4, see
Himpe
, 2018 [Algorithms 11(7): 91], and gives recent as well as future applications, such as parameter identification in systems biology, based on the current feature set.
Data for Digital Forensics: Why a Discussion on “How Realistic is Synthetic Data” is Dispensable
Authors: Göbel Thomas , Baier Harald , Breitinger Frank
Published: July 2023

Digital forensics depends on data sets for various purposes like concept evaluation, educational training, and tool validation. Researchers have gathered such data sets into repositories and created data simulation frameworks for producing large amounts of data. Synthetic data often face skepticism due to its perceived deviation from real-world data, raising doubts about its realism. This paper addresses this concern, arguing that there is no definitive answer. We focus on four common digital forensic use cases that rely on data. Through these, we elucidate the specifications and prerequisites of data sets within their respective contexts. Our discourse uncovers that both real-world and synthetic data are indispensable for advancing digital forensic science, software, tools, and the competence of practitioners. Additionally, we provide an overview of available data set repositories and data generation frameworks, contributing to the ongoing dialogue on digital forensic data sets’ utility.
Necrotizing Soft Tissue Infections of the Breast: A Potentially Lethal Surgical Emergency
Authors: Islam Shariful , Shah Aneela , Maughn Anthony , Dial Sarah , Mahabir Avidesh , Naraynsingh Vijay , Harnarayan Patrick
Published: July 2023

Necrotizing soft tissue infection (NSTI) of the breast is an extremely rare event in surgical practice. It is considered the most aggressive form of soft tissue infection and a true surgical emergency. It is also associated with a high risk of mortality if not diagnosed promptly. Few cases have been documented in the literature; the exact etiology and risk factors vary from those involving the limbs, trunk, and perineum. Early recognition, prompt surgical treatment, and broad-spectrum antibiotic therapy are crucial for reducing morbidity and mortality. These reports present cases of NSTIs in breasts with unique etiologies and challenges in their management.
Data from Early Clearance of Plasma Epidermal Growth Factor Receptor Mutations as a Predictor of Outcome on Osimertinib in Advanced Non-Small Cell Lung Cancer; Exploratory Analysis from AURA3 and FLAURA
Authors: Gray Jhanelle E. , Ahn Myung-Ju , Oxnard Geoffrey R. , Shepherd Frances A. , Imamura Fumio , Cheng Ying , Okamoto Isamu , Cho Byoung Chul , Lin Meng-Chih , Wu Yi-Long , Majem Margarita , Gautschi Oliver , Boyer Michael , Bulusu Krishna C. , Markovets Aleksandra , Barrett J. Carl. , Hodge Rachel , McKeown Astrid , Hartmaier Ryan J. , Chmielecki Juliann , Papadimitrakopoulou Vassiliki A. , Ramalingam Suresh S.
Published: July 2023

Abstract
Purpose: Plasma circulating tumor DNA (ctDNA) analysis is used for genotyping advanced non-small cell lung cancer (NSCLC); monitoring dynamic ctDNA changes may be used to predict outcomes. Experimental design: This was a retrospective, exploratory analysis of two phase III trials (AURA3 [NCT02151981], FLAURA [NCT02296125]). All patients had epidermal growth factor receptor mutation-positive (ex19del or L858R; EGFRm) advanced NSCLC; AURA3 also included T790M-positive NSCLC. Osimertinib (FLAURA, AURA3), or comparator EGFR-TKI (gefitinib/erlotinib; FLAURA), or platinum-based doublet chemotherapy (AURA3) was given. Plasma EGFRm was analyzed at baseline and Weeks 3/6 by droplet digital polymerase chain reaction. Outcomes were assessed by detectable/non-detectable baseline plasma EGFRm and plasma EGFRm clearance (non-detection) at Weeks 3/6. Results: In AURA3 (n=291), non-detectable versus detectable baseline plasma EGFRm had longer median progression-free survival (mPFS) (hazard ratio [HR] 0.48; 95% confidence interval [CI], 0.33–0.68; P<0.0001). In patients with Week 3 clearance versus non-clearance (n=184), respectively, mPFS (months; 95% CI) was 10.9 (8.3–12.6) versus 5.7 (4.1–9.7) with osimertinib and 6.2 (4.0–9.7) versus 4.2 (4.0–5.1) with platinum-pemetrexed. In FLAURA (n=499), mPFS was longer with non-detectable versus detectable baseline plasma EGFRm (HR 0.54; 95% CI, 0.41–0.70; P<0.0001). For Week 3 clearance versus non-clearance (n=334), respectively, mPFS was 19.8 (15.1 to not calculable) versus 11.3 (9.5–16.5) with osimertinib and 10.8 (9.7–11.1) versus 7.0 (5.6–8.3) with comparator EGFR-TKI. Similar outcomes were observed by Week 6 clearance/non-clearance. Conclusions: Plasma EGFRm analysis as early as 3 weeks on-treatment has the potential to predict outcomes in EGFRm advanced NSCLC.
Pregnancy Course of 10 Women Diagnosed with Chronic Lymphocytic Leukemia
Authors: Tadmor Tamar , Melamed Guy , Alapi Hillel , Gazit Sivan , Patalon Tal , Rokach Lior
Published: July 2023

Pregnancies following diagnosis of chronic lymphocytic leukemia (CLL) are rare events, mainly because the disease is typically diagnosed in the elderly. Literature on the topic is based only on case reports, and limited data are available on the influence of pregnancy on CLL course. In this retrospective study, we aimed to summarize the clinical and laboratory course of 10 women with CLL who became pregnant. None of the patients had significant changes in blood count during or after pregnancy or had complications such as infection, autoimmune phenomenon, or preeclampsia. Four out of 10 pregnancies were terminated with an early miscarriage. Following labor, 1 patient started anti-CLL treatment due to preexisting anemia, but none of the women required therapy during CLL progression during the first 2 years of follow-up. We conclude that based on our serial, pregnancy does not negatively impact on CLL course.
Diagnosing Seasonal Forecast Skill of the Indian Ocean Dipole Mode Using Model Analogs
Authors: Wu Yanling , Tang Youmin
Published: July 2023

A retrospective tropical Indian Ocean dipole mode (IOD) hindcast for 1958–2014 was conducted using 20 models from the sixth phase of the Coupled Model Intercomparison Project (CMIP6), with a model-based analog forecast (MAF) method. In the MAF approach, forecast ensembles are extracted from preexisting model simulations by finding the states that initially best match an observed anomaly and tracking their subsequent evolution, with no additional model integrations. By optimizing the key factors in the MAF method, we suggest that the optimal domain for the analog criteria should be concentrated in the tropical Indian Ocean region for IOD predictions. Including external forcing trends improves the skills of the east and west poles of the IOD, but not the IOD prediction itself. The MAF IOD prediction showed comparable skills to the assimilation-initialized hindcast, with skillful predictions corresponding to a 4- and 3-month lead, respectively. The IOD forecast skill had significant decadal variations during the 55-yr period, with low skill after the early 2000s and before 1985 and high skill during 1985–2000. This work offers a computational efficient and practical approach for seasonal prediction of the tropical Indian Ocean sea surface temperature.
Intellectual property strategy and the governance of technological platform-driven global value chains: The case of Qualcomm
Authors: Ding Ke , Hioki Shiro
Published: July 2023

This study investigates the impact of intellectual property (IP) strategy on the governance of technological platform-driven global value chains (GVCs) using a case study of the collaboration between Qualcomm and Chinese smartphone manufacturers. Our findings are twofold. First, even when IP protection is inadequate or technological capabilities of IP users are weak, a well-designed IP strategy can allow a technological platform vendor (Qualcomm) to transfer knowledge to users in developing countries while still protecting their own IPs. Second, by reducing the platform and value chain’s modularity, a good IP strategy can encourage platform vendors to offer more innovation and learning opportunities along GVCs. We show there can be a significant mutual reinforcement mechanism included in an IP strategy that supports the co-evolution of platform vendors and a few selected users (OPPO, VIVO, and Xiaomi) with great potential for learning and innovation in GVCs.
Potential future direction of measurable residual disease evaluation in multiple myeloma
Authors: Mohty Mohamad , Avet-Loiseau Hervé , Malard Florent , Harousseau Jean-Luc
Published: July 2023

Multiple myeloma remains an incurable disease plagued by high relapse rates. Deeper and more sustainable responses, however, have been consistently shown to improve outcomes and could eventually pave the way to achieving a cure. Our understanding of disease response has surpassed complete response (CR), because the current definitions are suboptimal, and the treatment goal should aim even beyond stringent CR, toward molecular and flow CR, that is, measurable residual disease (MRD) negativity. It has been more than 20 years since the discrepancy in the outcome between patients in CR with and without MRD has been demonstrated, and the field has come a long way from multiparameter flow cytometry to next-generation flow and next-generation sequencing, able to detect up to a limit of detection of a single myeloma cell from 1 million healthy counterparts. This review aims to summarize the current available data regarding MRD but also its potential future use as a coprimary outcome both in clinical and trial settings as a survival surrogate as well as its use to evaluate treatment efficacy and for adaptive response-based and early-rescue therapy. Furthermore, we discuss whether these concepts are applicable in different settings (eg, newly diagnosed and relapsed/refractory myeloma, patients who are eligible and ineligible for tansplant, and standard- and high-risk disease).
Mini review: Current status and perspective of S100B protein as a biomarker in daily clinical practice for diagnosis and prognosticating of clinical outcome in patients with neurological diseases with focus on acute brain injury
Authors: Abboud Tammam , Rohde Veit , Mielke Dorothee
Published: July 2023

Prognosticating the clinical outcome of neurological diseases is essential to guide treatment and facilitate decision-making. It usually depends on clinical and radiological findings. Biomarkers have been suggested to support this process, as they are deemed objective measures and can express the extent of tissue damage or reflect the degree of inflammation. Some of them are specific, and some are not. Few of them, however, reached the stage of daily application in clinical practice. This mini review covers available applications of the S100B protein in prognosticating clinical outcome in patients with various neurological disorders, particularly in those with traumatic brain injury, spontaneous subarachnoid hemorrhage and ischemic stroke. The aim is to provide an understandable picture of the clinical use of the S100B protein and give a brief overview of the current limitations that require future solutions.
Primary endodermal sinus tumor originating from the sacral ligament: a case report and review of the literature
Authors: Lu Han , Jia Dongsong , Tang Qionglan , Shu Shanrong
Published: July 2023

Background

Endodermal sinus tumor (EST) is a malignant tumor originating from the ovary or testis. In most case, ultrasound examination shows ovarian mass. But there is a special kind of extra-gonadal endodermal sinus tumor, which occur in organs other than gonads with insidious onset. Here we reported a case of endodermal sinus tumor, which originated from the sacral ligament presenting as an acute lower abdominal pain.

Case presentation

A 14-year-old girl was admitted to the hospital because of acute lower abdominal pain. The ultrasound showed a mass with 72 mm × 64 mm × 50 mm in Douglas, and there was no abnormality in bilateral ovaries and fallopian tubes. Laparoscopic exploration showed a large amount of blood clots in the pelvic cavity. After removal of the blood, we found rotten fish-like tissue in the left sacral ligament, rapid pathology suggested endodermal sinus tumor. After the operation, we retrospectively examined the value of alpha-fetoprotein (AFP), which was found to be elevated, and post-operative paraffin pathology confirmed the diagnosis. After four cycles of BEP chemotherapy, exploratory laparotomy was performed to remove the visible lesion, but postoperative pathology showed no abnormality. At the one-year follow-up, the patient remained recurrence-free.

Conclusion

Extra-gonadal germ cell tumors are rarely reported. When young teenagers complain of acute lower abdominal pain with elevated AFP, but there was no lesion in bilateral ovaries and fallopian tubes, we must think about the possibility of endodermal sinus tumors. Accurate diagnosis facilitates complete resection of lesions and improves patient’s outcomes.
Covered SEMS failed to cure airway fistula closed by an amplatzer device
Authors: Lu Huibin , Li Yahua , Ren Kewei , Li Zongming , Liu Juanfang , Duan Xuhua , Ren Jianzhuang , Han Xinwei
Published: July 2023

Background

Airway fistula is a rare but threatening complication associated with high rates of morbidity and mortality. We report the experience of Amplatzer device application in airway fistulae that failed to be cured with a covered self-expandable metallic stent (SEMS).

Materials and methods

Patients who failed occlusion with a covered self-expandable metallic stent and received Amplatzer device placement from Jan 2015 to Jan 2020 were retrospectively enrolled. A total of 14 patients aged 42 to 66 years (55.14 ± 7.87) were enrolled in this study. The primary diseases, types of fistula, types of stents, duration, size of fistula, and follow-up were recorded.

Results

All 14 patients with airway fistula failed to be occluded with a covered metallic stent and received Amplatzer device placement. Among the 14 patients, 6 had BPF, 3 had TEF and 5 had GBF. The average stent time was 141.93 ± 65.83 days. The sizes of the fistulae ranged from 3 to 6 mm. After Amplatzer device placement, the KPS score improved from 62.14 ± 4.26 to 75.71 ± 5.13 (P < 0.05). No procedure-related complications occurred. During the 1-month, 3-month and 6-month follow-ups, all the Amplatzer devices were partially surrounded with granulation. Only 1 patient with BPF failed with Amplatzer device occlusion due to the recurrence of lung cancer.

Conclusion

In conclusion, the application of the Amplatzer device is a safe and effective option in the treatment of airway fistula that failed to be occluded with SEMSs.
Assessment and evaluation of a serious game for teaching factual knowledge in dental education
Authors: Lemos Martin , Wolfart Stefan , Rittich Anne Barbara
Published: July 2023

Objectives

A serious game application was developed to train factual knowledge and for self-assessment. The aim of the present study was to compare the effects of a game application (intervention group) or paper scripts (control group) on knowledge acquisition and to evaluate the acceptance of the new application among dental students.

Methods

The 4th semester students of the second preclinical prosthodontics course were randomly assigned to one of the two groups (n = 58/51) for two consecutive years. The study was conducted in two phases: First, all participants took a pretest, with the intervention group using the game application and the control group receiving the same set of questions in a paper script. In the second phase, all participants took a post-test. After the post-test, both groups had access to the application for another three weeks. After that, all participants completed standardized questionnaires and a scale to evaluate the usability of the system. Usage statistics were also tracked. Differences between groups were evaluated together and for both years separately in terms of pretest and posttest scores and learning success.

Results

There was no significant difference between the groups with regard to the posttest and learning success. A significant improvement in knowledge between pretest and posttest (p < 0.05) was demonstrated in both groups. Each student played approximately 350 questions. Participants rated the application with the German school grade "good". Participants appreciated the application and rated it positively. They stated that the game motivated them to learn and that they spent more time with the learning content.

Conclusion

Due to the positive perception achieved through the game, this application is able to motivate students to learn. The learning effect achieved is similar to learning on paper.
Defining critical illness using immunological endotypes in patients with and without sepsis: a cohort study
Authors: Balch Jeremy A. , Chen Uan-I , Liesenfeld Oliver , Starostik Petr , Loftus Tyler J. , Efron Philip A. , Brakenridge Scott C. , Sweeney Timothy E. , Moldawer Lyle L.
Published: July 2023

Background

Sepsis is a heterogenous syndrome with limited therapeutic options. Identifying immunological endotypes through gene expression patterns in septic patients may lead to targeted interventions. We investigated whether patients admitted to a surgical intensive care unit (ICU) with sepsis and with high risk of mortality express similar endotypes to non-septic, but still critically ill patients using two multiplex transcriptomic metrics obtained both on admission to a surgical ICU and at set intervals.

Methods

We analyzed transcriptomic data from 522 patients in two single-site, prospective, observational cohorts admitted to surgical ICUs over a 5-year period ending in July 2020. Using an FDA-cleared analytical platform (nCounter FLEX®, NanoString, Inc.), we assessed a previously validated 29-messenger RNA transcriptomic classifier for likelihood of 30-day mortality (IMX-SEV-3) and a 33-messenger RNA transcriptomic endotype classifier. Clinical outcomes included all-cause mortality, development of chronic critical illness, and secondary infections. Univariate and multivariate analyses were performed to assess for true effect and confounding.

Results

Sepsis was associated with a significantly higher predicted and actual hospital mortality. At enrollment, the predominant endotype for both septic and non-septic patients was adaptive, though with significantly different distributions. Inflammopathic and coagulopathic septic patients, as well as inflammopathic non-septic patients, showed significantly higher frequencies of secondary infections compared to those with adaptive endotypes (p < 0.01). Endotypes changed during ICU hospitalization in 57.5% of patients. Patients who remained adaptive had overall better prognosis, while those who remained inflammopathic or coagulopathic had worse overall outcomes. For severity metrics, patients admitted with sepsis and a high predicted likelihood of mortality showed an inflammopathic (49.6%) endotype and had higher rates of cumulative adverse outcomes (67.4%). Patients at low mortality risk, whether septic or non-septic, almost uniformly presented with an adaptive endotype (100% and 93.4%, respectively).

Conclusion

Critically ill surgical patients express different and evolving immunological endotypes depending upon both their sepsis status and severity of their clinical course. Future studies will elucidate whether endotyping critically ill, septic patients can identify individuals for targeted therapeutic interventions to improve patient management and outcomes.