bluuebunny/crossref_metadata_2025 huggingface dataset:
A Bayesian Hierarchical Model for 2-by-2 Tables with Structural Zeros
Authors: Stamey Will , Stamey James D
Published: August 2024

Correlated binary data in a 2x2 table has been analyzed from both the frequentist and Bayesian perspectives, but a fully Bayesian hierarchical model has not been proposed. This is a commonly used model for correlated proportions when considering, for example, a diagnostic test performance where negative subjects are tested a second time. We consider a new hierarchical Bayesian model for the parameters resulting from a 2x2 table with a structural zero. We investigate the performance of the hierarchical model via simulation. We then illustrate the usefulness of the model by showing how a set of historical studies can be used to build a predictive distribution for a new study that can be used as a prior distribution for both the rate ratio and marginal probability of a positive test. We then show how the prior based on historical 2x2 tables can be used to power a future study that accounts for pre-experimental uncertainty. High quality prior information can lead to better decision making by improving precision in estimation and by providing realistic numbers to power studies.
Data-Driven Personalized Nutrition Reduces HbA1c in a Prediabetic and Diabetic Population – a Pilot, Randomized, Placebo-Controlled Clinical Trial
Authors: Vuyisich Momchilo , Antoine Grant , Mehrtash Morvarid , Keiser Hilary , Connell Janelle , Ogundijo Oyetunji , Shen Nan , Julian Cristina , Garimella Madhavi , Banavar Guruduth , Tanton Damon
Published: August 2024

Type 2 Diabetes (T2D) is a major public health concern. We have previously shown that the biochemical functions of the gut microbiome contribute to the postprandial glucose response and built a machine learned (ML) model that can personalize dietary choices using a stool metatranscriptomic test. We integrated this data-driven personalized nutrition process into the Viome Precision Nutrition Program (VPNP), which includes sample collection kits (capillary blood and stool), an AI/ML nutritional recommendation engine, and an app for digital delivery of dietary recommendations. To test the efficacy of VPNP, we conducted a decentralized, blinded, randomized, placebo-controlled trial in a prediabetic and diabetic adult population in the USA, with HbA1c as the primary endpoint. For this pilot trial, we recruited 27 participants and randomized them into two arms. The placebo arm included sample collection, digital delivery of the USDA dietary recommendations, and physical delivery of supplements filled with inert material. The VPNP (interventional) arm included digital delivery of data-driven and personalized dietary recommendations, and physical delivery of precision supplements. The nutritional intervention lasted ~90 days. The ANCOVA analysis method was employed to control for potential confounders measured at baseline. VPNP intervention (n=12) reduced HbA1c more than the placebo (n=15) in a clinically significant manner (HbA1c difference of 0.42%, p = 0.028). We demonstrate that a precision nutrition program based on stool and blood metatranscriptomic data and AI/ML analyses can significantly reduce HbA1c relative to USDA recommended nutrition in a prediabetic and diabetic population. These results suggest that integrating data-driven precision nutrition into the healthcare system could reduce the burden of T2D.
Treatment of Vertigo in Meniere’s Disease by Horizontal Semicircular Canal Obstruction via Ear Canal Approach under Otoendoscopy：a Single-Arm Trial
Authors: Sun Yu , Leng Yangming , Shi Mengwen , Zhou Renhong , Wang Enhao , Li Yongqin , Yu Jintao , Xie Le , Cai Qinming
Published: August 2024

Objectives: In recent years, ear endoscopy has gradually become an important tool in ear surgery. This study further explored its application in ear surgery, to establish a surgical approach for semicircular canal obstruction (SOC) via the ear canal to control vertigo in Meniere's disease. Methods: With the approval of the ethics committee, recruitment started in June 2019. ​Four patients with Meniere's disease who had been treated conservatively for more than six months received SCO via an external ear canal approach under otoendoscopy and were followed for two years after surgery to assess the safety and efficacy of the procedure. Results The control of vertigo after the operation was satisfactory (100%), and the frequency and degree of vertigo were significantly improved. Tinnitus improved in 1 case (25%) and did not progress in the other 3 cases. Hearing loss did not progress in all patients. Postoperative walking instability occurred in 1 patient (25%), and there were no obvious complications. All patients reported significant improvements in their quality of life. Conclusions: SCO via the external auditory canal approach is safe, effective, easy to accept, and an alternative to conservative treatment of Meniere's disease with no actual hearing for more than 6 months.
Optimizing Bipolar Reset Waveform to Improve Grayscale Stability in Active Matrix Electrowetting Displays
Authors: Zhang Taiyuan , Wang Li , Liu Linwei , Li Wei , Wu Shipeng , Guo Jianyang , Zhou Guofu
Published: August 2024

Electrowetting display (EWD) device is a new type of electrowetting-on-dielectric (EWOD) equipment which can achieve a paper-like display effect under the control of electric field. In this microfluidic system, the stability of grayscale could be affected by various factors, such as the physicochemical properties of materials, device structure, and electric field distribution. To improve the grayscale stability of active matrix electrowetting displays (AM-EWDs), the impact of different polarities of driving voltage on oil backflow was investigated in this study. Based on the driving principles of AM-EWD, an optimized inter-frame bipolar reset driving waveform was designed to overcome oil backflow. The proposed driving waveform maintained the stability of the oil state by periodically and rapidly releasing trapped charges in the dielectric layer through a reverse driving voltage. Additionally, the effect of feed through voltage on the pixel driving voltage was eliminated by compensating for the driving voltage on common electrode. Finally, the performance of the designed driving waveform was evaluated with a 6-inch AM-EWD driving platform. Compared to the conventional unipolar reset driving waveform, the backflow speed decreased by 2.70 a.u./s. The standard deviation of the display luminance was also reduced by 11.24 a.u. Experimental results indicated that both the oil backflow speed and the fluctuation range of luminance were effectively suppressed by the proposed driving waveform.
Os entrelaçamentos escola, universidade, cursos de História e públicos: o curso de História da UFPR no seu apogeu como contraexemplo de História Pública
Authors: Fagundes Bruno Flávio Lontra
Published: August 2024

O presente artigo trata do entrelaçamento entre características da formação universitária em História, seu ensino escolar e os campos da história do curso de história e da História Pública, incentivando a análise da articulação entre História Pública e a história do curso da história da Universidade Federal do Paraná. O curso de História da UFPR foi curso consagrado pelo incentivo estrito à pesquisa acadêmica no momento desde o advento da pós-graduação no país em 1971. À luz da história pública e de suas motivações atuais, o artigo argumenta em torno do desenho programático do curso de História da UFPR, avaliando sua ênfase desproporcional à pesquisa em detrimento do ensino de História, deixando um legado de afastamento escola e universidade, para cuja análise uma visão do conhecimento histórico visto em relação com outros públicos aponta para o curso de História da UFPR como um contraexemplo de história pública.
A consciência histórica e a didática da história no Canadá
Authors: Popa Nathalie
Published: August 2024

A atual discussão sobre a consciência histórica no campo do ensino de história no Canadá inscreve-se num contexto intelectual e social particular, marcado por profundas transformações nas relações com o passado e nossa compreensão da história. Com efeito, os historiadores, didáticos e professores de história, aqui como em outros lugares, estão presos há um problema que, conforme Seixas (2012b), é epistemológico (como nós conhecemos o passado?) e ontológico (como nos situamos no tempo enquanto seres dotados de historicidade?). Daí o interesse, realmente presente na didática da história canadense, de melhor compreender a noção de consciência histórica. Contudo, a discussão permanece díspar. Minha intenção, neste artigo, é elaborar um estado dos lugares (dessa produção acadêmica) por meio de uma revisão crítica da literatura. Eu apresentarei uma abordagem sobre o contexto no qual se insere as discussões sobre a consciência histórica e tentarei, em seguida, elaborar um quadro das definições, dos estudos e das justificativas deste conceito. Este artigo advoga pela necessidade crucial de um aprofundamento sobre a questão da consciência histórica, no intuito de que ela possa servir para os debates sobre a história escolar e pública no Canadá.
Direitos humanos em aulas de história
Authors: Oliveira Nucia Alexandra Silva de , Bechtloff Pricila
Published: August 2024

Este artigo apresenta alguns dos resultados de uma pesquisa originada de uma situação de ensino em que o tema dos direitos humanos foi estudado por meio de uma sequência didática organizada com diferentes documentos e metodologias, entre elas a dinâmica do World Café. O trabalho buscou mostrar em que medida as aulas de História poderiam utilizar tal metodologia para situações de ensino e aprendizado de modo consistente, mas também leve e divertido. As proposições de Helenice Rocha subsidiaram a construção da sequência didática e as de bell hooks, Joaquim Prats e Flávia Caimi, entre outros, contribuíram para as percepções sobre ensino de História. Os resultados apresentados evidenciaram que a situação de ensino trouxe discussões importantes para a turma, que articulou boas discussões sobre o tema.
Mundos do trabalho e história do futebol no Brasil
Authors: Rajão Ribeiro Raphael
Published: August 2024

O presente artigo investiga as aproximações entre os mundos do trabalho e a historiografia do esporte no Brasil, por meio das expressões do futebol operário ou de fábrica, ou seja, dos estudos sobre clubes que se constituíram, em diferentes regiões do país, a partir dos pertencimentos dos trabalhadores a uma dada empresa ou a um segmento do universo produtivo. A partir de uma revisão da bibliografia, são exploradas as diferentes abordagens sobre os usos autônomos e tutelados do tempo do lazer; as expressões das culturas operárias, especialmente as masculinas; bem como as diferentes relações laborais do jogador-operário e do operário-jogador. Por meio de uma intervenção pedagógica, são discutidos os desafios da transposição didática dessas questões e quais as suas potencialidades para o desenvolvimento do ensino de História para turmas de Ensino Médio.
Povo Xukuru-Kariri em Alagoas
Authors: Santos da Rocha Adauto , Silva Edson
Published: August 2024

Neste artigo, discutiremos as diversas atuações de trabalho indígena em Alagoas, desde o século XIX, dando ênfase para o povo Xukuru-Kariri, habitante em Palmeira dos Índios, no Agreste/Semiárido alagoano. Nossa pretensão será problematizar as intensas participações indígenas nas construções e consolidações da citada região desde o período provincial, perpassando a chamada “extinção dos aldeamentos”, ocorrida arbitrariamente por amparo jurídico da Lei de Terras de 1850 e os movimentos de reconhecimento étnico com a instalação de um Posto do Serviço de Proteção aos Índios (SPI), em Palmeira dos Índios no decorrer da segunda metade do século XX. A partir do estudo apresentado, iremos propor discussões e atividades sobre como os temas migrações, trabalho e povos indígenas poderão ser abordados no ensino de História, tendo como base situações analisadas e produções audiovisuais.
O ensino de história e os trabalhadores
Authors: Figueiredo Moraes Renata
Published: August 2024

A proposta deste texto é refletir a história do Brasil a partir do trabalho, escravizado ou livre, após uma experiência com professores do ensino básico que participaram de um curso de extensão em 2020. O modo remoto permitiu que quase 100 professores, durante sete semanas, discutissem a história do Brasil a partir do homem e da mulher negro e negra, escravizado ou não, visto como trabalhadores e sujeitos de resistência e de luta por mais direitos e liberdade. Tal dinâmica foi colocada para a turma, que foi instigada em incorporar a temática em suas práticas docentes. O texto visa pensar o Brasil a partir dos trabalhadores, os que chegaram com os europeus, os que foram escravizados, indígenas e africanos, e os demais que viviam em liberdade e os da República. No ensino de história, essa reflexão sobre trabalho pouco aparece na abordagem sobre a colônia e o Império, uma vez que a escravidão era predominante.
Extracorporeal Shockwave Therapy for Greater Trochanteric Pain Syndrome
Authors: Rhim Hye Chang , Shin Jaehyung , Beling Alexandra , Guo Raymond , Pan Xiaoyu , Afunugo Wilma , Ruiz Joseph , Andrew Michael N. , Kim James , Tenforde Adam S.
Published: August 2024

Background:

Greater trochanteric pain syndrome (GTPS) affects 17.6% of adults aged 50 to 79 years, particularly women. While exercise therapy and corticosteroid injections (CSIs) are common treatments, their limitations include inadequate pain control and potential tendon weakening. Extracorporeal shockwave therapy (ESWT) is an emerging alternative for GTPS. This systematic review assessed ESWT's efficacy in GTPS by evaluating pain and functional outcomes at different follow-up intervals.

Methods:

A literature search of PubMed, Embase, and Web of Science for randomized clinical trials (RCTs) was conducted comparing ESWT with other GTPS treatments up to March 1, 2024. Two reviewers independently extracted data, assessing study quality using the Cochrane risk-of-bias tool. A random-effects pairwise meta-analysis compared ESWT with other treatments.

Results:

Eight RCTs involving 754 patients (169 male, 585 female patients) were included. Seven RCTs were deemed high risk of bias, and 1 RCT had some concerns. Five RCTs investigated focused on focused ESWT, and 3 examined radial ESWT. ESWT provided significantly lower pain scores than other treatments at 2 to 4 months (standardized mean difference = −0.431; 95% confidence interval [CI], −0.82 to −0.039; I2 = 83%). Functional improvement (Lower Extremity Functional Scale) was significantly higher at 6 months (weighted mean difference = 6.68; 95% CI, 3.11-10.25; I2 = 0%) but did not exceed the minimal clinically important difference. Focused ESWT provided greater pain reduction than radial ESWT.

Conclusion:

Three weekly ESWT sessions offer short-term pain relief at 2 to 4 months for patients with GTPS, especially with focused ESWT. Functional improvements at 6 months were notable but not clinically significant. These findings suggest ESWT may complement or serve as an alternative to CSIs and exercise. However, caution is needed when interpreting these results due to high risk of bias with the included RCTs and heterogeneity across the studies. Further high-quality trials are needed to confirm ESWT's long-term benefits over other treatments.

Level of Evidence:

Level II. See Instructions for Authors for a complete description of levels of evidence.
Global Impact of Renewable Energy Innovations
Authors: Dia Sari Shalsa Ervina , Ubaidillah Hasan
Published: August 2024

This study explores how product quality, price, and promotional attractiveness impact consumer purchasing decisions on Shopee in Sidoarjo, Indonesia, using a quantitative descriptive approach with 96 respondents. The findings indicate that higher product quality and attractive promotions positively influence purchase intent, while price sensitivity also plays a role. These insights are valuable for businesses in online marketplaces like Shopee, emphasizing the importance of maintaining high product quality, competitive pricing, and effective promotions to enhance consumer decisions and market performance.   Highlight:   Online consumer behavior analysis Quality and price influence purchases Promotions impact buying decisions Keyword:  consumer behavior, online marketplace, purchase decisions, product quality, promotional attractiveness
Boosting Employee Performance in Indonesia Through Environment, Motivation, and Quality
Authors: Asfianto Firda Oktavia , Kusuma Kumara Adji
Published: August 2024

This study examines the impact of the work environment, motivation, and human resource quality on employee performance at PT Indo Lautan Makmur's vacuum department. Using a quantitative approach, data were collected from 120 employees through online questionnaires and analyzed with SPSS. Results indicate that a positive work environment, strong motivation, and high-quality human resources significantly improve employee performance. These findings suggest that enhancing these factors can effectively boost employee performance at PT Indo Lautan Makmur. Highlights: 1. Positive work environment significantly boosts employee performance.2. Motivation alone doesn't always guarantee performance improvement.3. High-quality human resources enhance employee performance. Keywords: Work environment, Motivation, Human resource quality, Employee performance, Quantitative research
Impacts of Brand, Price, and Promotion on Modest Fashion Purchases
Authors: Lailah Elok Zahrotul , Hariasih Misti
Published: August 2024

This research investigates the influence of Brand Image, Price, and Promotion on Purchase Decisions for Gamis Pelangi Hijab in Driyorejo, employing a descriptive quantitative approach. Utilizing multiple linear regression analysis on data collected from 96 respondents via purposive sampling, the study reveals significant effects: (1) Brand Image positively influences purchasing decisions; (2) Price has a significant impact on purchasing choices; (3) Promotional activities affect purchase decisions. Through regression analysis using SPSS 22, the study elucidates the pivotal role of these factors in consumer behavior, providing insights for marketers aiming to enhance consumer engagement and strategic marketing initiatives in the modest fashion industry.
Highlight:

Quantitative analysis of purchase decisions for modest fashion.
Sample selection based on non-probability purposive sampling technique.
Multiple linear regression analysis conducted using SPSS version 22.

 
Keywoard: Gamis Pelangi Hijab, Purchase Decisions, Brand Image, Price, Promotion
Key Financial Metrics Drive Company Value in Indonesia's Retail Sector
Authors: Fauzi Sintya Andriani , Nurasik Nurasik
Published: August 2024

This study investigates the influence of key financial metrics on the value of retail companies in the Indonesian service industry from 2019-2020. Using multiple linear regression analysis on data from 18 companies, the research finds that Total Asset Turnover, Net Profit Margin, and Equity Multiplier positively impact company value, while Return on Investment and Return on Equity do not. These findings suggest that improving asset utilization, profitability margins, and equity leverage can enhance company value, providing valuable insights for company management and investors. Highlights: 1. Total Asset Turnover, Net Profit Margin, and Equity Multiplier increase company value.2. Return on Investment and Return on Equity don't significantly affect value.3. Improve asset utilization, profitability margins, and equity leverage to enhance value. Keywords: Company value, financial metrics, retail industry, asset turnover, profitability
Supportive Care Needs of Parents Caring for Children with Leukemia: a latent class analysis
Authors: WANG Jingting , ZHENG Zhuting , BI Xuanyi , Zhang Wen , WANG Yingwen , WU Huifang , YANG Qi , MA Linyu , Geng Zhaohui , YUAN Changrong
Published: August 2024

Background: Parents’ supportive care needs directly affect their quality of life and the quality of care for their children diagnosed with leukemia.
Objectives: To identify supportive care needs of Chinese parents in the unobserved subgroups who care for children with leukemia and to examine the associations of the latent class membership with individual characteristics.
Methods: A multicenter cross-sectional survey study was conducted. A total of 221 parents who had children with leukemia were surveyed in China with the Chinese version of the Supportive Care Needs Survey for Caregivers of Children with Pediatric Cancer (SCNS-C-Ped-C). Latent class analysis (LCA) was applied to identify latent classes of parents according to supportive care needs. Binary logistic regression model was used to identify the association between individual characteristics and the latent class membership.
Results: LCA results suggested a 2-class solution: Class 1-“high supportive care needs” class (n=150, 67.9%), and Class 2-“low supportive care needs” class (n=71, 32.1%). Parents with children at early stage of treatment, being married, with lower household income, locating in the same city with the treatment hospital, having lower disease cognitive ability and higher person-centered care skills, and with lower balancing caregiving needs and one’s own needs were more likely to be in the “high supportive care” class.
Conclusion: There existed two distinct classes of parents caring for children with leukemia on the basis of supportive care needs. The class membership was significantly associated with children’s treatment duration, parents’ marital status, family income, distance to the hospital, daily caregiving time, and parents’ caregiving ability.
Implications for Practice: These findings may be helpful in the development of personalized supportive care interventions for parents of children with leukemia.
Population Pharmacokinetics and Exposure-Response Analysis of Durvalumab in Combination with Gemcitabine and Cisplatin in Patients with Advanced Biliary Tract Cancer
Authors: Abegesah Aburough , Oh Do-Youn , Lim KyoungSoo , Fan Chunling , Chen Cecil , Kim Chong , Wang Julie , Xynos Ioannis , Żotkiewicz Magdalena , Ren Song , Phipps Alex , Gibbs Megan , Zhou Diansong
Published: August 2024

Purpose: Durvalumab in combination with gemcitabine/cisplatin has shown a favorable benefit-risk profile in the TOPAZ-1 study for advanced biliary tract cancers (BTC). This analysis evaluated the population pharmacokinetics (PopPK) of durvalumab, and exposure-response for efficacy and safety (ERES) of TOPAZ-1.
Methods: The PopPK model for durvalumab was updated using data from 5 previously analysed studies and TOPAZ-1. Individual exposure metrics were derived from the individual empirical Bayes estimates as drivers for exposure-response (ER) analysis related to efficacy and safety.
Results: Consistent with previous analyses, the durvalumab pharmacokinetics in BTC followed a 2-compartment model with time-dependent clearance. The final population parameters were: CL, 0.298 L/day; V1, 3.42 L; V2, 1.99 L; Q, 0.452 L/day; and the time dependent clearance suggests that the clearance could decrease up to 39% over the time course of treatment. There were 111 patients (3.53%) with treatment-emergent ADA positive in the pooled group of 6 studies, and the exposure was comparable for ADA positive and negative patients. Covariates had minimal clinical impact on PopPK parameters. No significant associations were found between exposure and overall survival (OS), progression-free survival (PFS), using Cox proportional analysis (CPH). Logistic regression analysis indicated no significant relationship between the exposure and relevant adverse events measures of Grade 3 and higher treatment-related AE, Grade 3 and higher treatment-related AESI (AEs of special interest), or AE leading to treatment discontinuation.
Conclusions: No dose adjustment for durvalumab is needed based on PopPK and ERES analyses. The analysis supports the TOPAZ-1 regimen for patients with advanced BTC.
Apocynin, a natural acetophenone suppresses cell proliferation, migration and induces cell cycle arrest, apoptosis in ovarian carcinoma cell line A2780
Authors: Zhu Qian , Tang Xuyuan , Wang Ke , Cheng Wei , Zhou Dongmei , Huang Yanhong
Published: August 2024

In this study, the ameliorative effects of apocynin against ovarian cancer cell proliferation, migration, and induction of apoptosis were studied in vitro. A2780 human ovarian carcinoma cells and Vero normal epithelial cells were treated with apocynin and subjected to cytotoxicity assays. Lipid peroxidation and antioxidant status were quantified in apocynin-treated A2780 cells to assess the anticancer effect of apocynin. Staining techniques with DCFH-DA, Rhodamine-123, and AO/EtBr were done to analyze the ROS-induced apoptosis in A2780 cells. A wound scratch assay was performed to examine the effect of apocynin on cell migration. Flow cytometric analysis was done to analyze cell cycle arrest in apocynin-treated A2780 cells. To confirm the apoptosis in apocynin-treated cells, the apoptotic proteins were quantified using kits. Apocynin treatment significantly inhibited growth andpromoted oxidative stress and apoptosis in A2780 cells. The results of fluorescent staining assays clearly state that apocynin increases ROS levels and thereby induces lipid peroxidation, which leads to cell death. Apocynin treatment caused cell cycle arrest and promoted apoptosis in A2780 cells, which were confirmed by the flow cytometry results and an increase in caspases, bax, and a decrease in bcl2 levels, respectively. Apocynin treatment also inhibited cell migration, which was evidenced by our wound scratch assay. Overall, our findings confirm that apocynin significantly inhibits cell proliferation, cell migration, and induced apoptosis in ovarian cancer A2780 cells.
Enhancing Social Functioning using Multi-user, Immersive Virtual Reality
Authors: Holt Daphne J , DeTore Nicole R , Aideyan Babatunde , Utter Lauren , Vinke Louis , Johnson Daniel S , Zimmerman Jordan , Dokholyan Katherine N , Burke Anne
Published: August 2024

Background
Rates of loneliness and other forms of social disconnection have been increasing worldwide over the past decade. Prior studies have suggested that brief behavioral interventions can impact this problem but, currently, access to such interventions is very limited. One previously untested approach for addressing this gap is immersive, multi-user virtual reality (VR).
Methods
To measure the feasibility and preliminary efficacy of this approach, 33 young adults experiencing social discomfort were enrolled in a study of an immersive, multi-user VR behavioral intervention called Reconnecting with Ourselves and Others in virtual Meetings (ROOM), which was adapted from a previously validated, mindfulness-based intervention. Quantitative measures of aspects of social functioning, including social comfort, interpersonal distance and facial affect recognition, were collected before and after participants completed ROOM.
Results
All of the participants attended more than half of the sessions and 90.3% found ROOM to be beneficial and useful. In addition, comfort with others in the real world (p = .02) and facial affect recognition accuracy (p = .02) significantly increased, while interpersonal distances remained unchanged, following ROOM.
Conclusions
An immersive, multi-user VR, mindfulness-based intervention may represent one feasible, scalable approach for disseminating skills that can improve social functioning and connection.
Clinicaltrial.org # NCT06360562
Prediction Model for Individualized Precision Surgery in Breast Cancer Patients with Complete Response on MRI and Residual Calcifications on Mammography after Neoadjuvant Chemotherapy
Authors: Kwon Mi-ri , Ko Eun Young , Lee Jeong Eon , Han Boo-Kyung , Ko Eun Sook , Choi Ji Soo , Kim Haejung , Kim Myoung Kyoung , Yu Jonghan , Lee Hyunwoo , Youn Inyoung
Published: August 2024

Background
To investigate factors predicting calcifications without residual carcinoma (ypCalc_0) or with residual carcinoma (ypCalc_ca) and to develop a prediction model for patients exhibiting residual suspicious calcifications on mammography but complete response on MRI after neoadjuvant chemotherapy (NAC).
Methods
This retrospective study included breast cancer patients undergoing NAC, showing residual suspicious mammographic calcifications but complete response on MRI between January 2019 and December 2020 (development set) and between January 2021 and December 2022 (validation set). Multivariable logistic regression analysis identified significant factors associated with ypCalc_0. The prediction model, developed using a decision tree and factors from logistic regression analysis, was validated in the validation set.
Results
The development set included 134 women (mean age, 50.6 years; 91 with ypCalc_0 and 43 with ypCalc_ca) and validation set included 146 women (mean age, 51.0 years; 108 with ypCalc_0 and 38 with ypCalc_ca). Molecular subtype (P = .0002) and high Ki-67 (P = .02) emerged as significant independent factors associated with ypCalc_0 in the development set. The prediction model, incorporating hormone receptor (HR)−/human epidermal growth factor receptor 2 (HER2) + with high Ki-67 as ypCalc_0 predictors, and HR+/HER2 − cancers or HR+/HER2 + or triple negative (TN) cancers with low Ki-67, as ypCalc_ca predictors, achieved an area under receiver operating characteristic curve of 0.844 (95% CI, 0.774 − 0.914) in the validation set.
Conclusion
Minimized surgery may be considered for managing residual calcifications in HR−/HER2 + with high Ki-67 cancers, while complete excision is recommended for HR+/HER2 − breast cancers or for HR+/HER2 + or TN breast cancers with low Ki-67.
Re-evaluating the Use of Contraction Stress Test in Term Fetal Growth Restriction: A Retrospective Study
Authors: Alter Roie , HERZ Hagar , COHEN Adiel , LESSANS Naama , EZRA Yossef , KABIRI Doron
Published: August 2024

Purpose
This study aimed to evaluate the prognostic utility of the contraction stress test (CST) for fetuses diagnosed with Fetal Growth Restriction (FGR) and its impact on perinatal outcomes.
Methods
A retrospective cohort study analyzed data from term singleton deliveries over two years. FGR was diagnosed with a birthweight below the 3rd percentile or prenatally below the 10th percentile with abnormal Doppler findings. The comparison included SGA fetuses, defined by birthweight between the 3rd and 10th percentiles. The cohort was categorized into three groups: 1) FGR with negative CST, 2) FGR without CST, and 3) SGA fetuses. Primary outcomes were emergency cesarean delivery rates, and secondary outcomes included composite neonatal adverse events and a combined metric of neonatal and maternal adverse events.
Results
The analysis included 1,688 records: 33 FGR with negative CST, 275 FGR without CST, and 1,123 SGA. Emergency cesarean delivery rates were similar between FGR with negative CST (15.2%) and without CST (14.9%), but higher compared to SGA (9.7%, p = .025). Composite neonatal adverse events did not differ significantly between FGR groups (21.2% vs 24.7%) but were higher than SGA (8.1%, p < .001). Combined neonatal and maternal adverse events also did not differ between FGR groups (30.3% vs 33.5%) but were higher than SGA (15.1%, p < .001).
Conclusion
The contraction stress test did not reduce the risk of adverse maternal or neonatal outcomes in fetuses diagnosed with fetal growth restriction.
Screening of flavonoids in Flower buds of Sophora japonica L. with high activity against α-amylase and α-glucosidase and inhibitory mechanism research
Authors: Sun Jinting , Zhang Ranying , Xiong Jiayan , Li Jinlin , Zhang Chaoyang , Ma Yunfeng
Published: August 2024

In this article, a method was established to screen compounds with enzyme activity inhibition in vitro using chromatographic analysis. The flower buds of Sophora japonica L. (FBSJ) were found to contain abundant flavonoids. And then these flavonoids were screened for the high inhibition activity against α-amylase and α-glucosidase using HPLC fingerprint and activity difference analysis. Consistent conclusions were drawn from multiple techniques, including the reported technique, IC50 data, and our method. The inhibitory mechanism was furtherly analyzed through enzyme inhibition kinetics, circular dichroism (CD), fluorescence spectrometry, molecular docking, and molecular dynamics. Among the six flavonoid components studied, quercetin acted as a competitive inhibitor against α-amylase, while kaempferol showed a mixed manner of inhibition against α-glucosidase. Molecular docking and molecular dynamics simulations demonstrated that quercetin and kaempferol had higher binding energy and bind more tightly. Generally, flavonols exhibited higher inhibitory activity than their corresponding flavonol glycosides against α-amylase and α-glucosidase. Quercetin and kaempferol in FBSJ showed potential as inhibitors of α-amylase and α-glucosidase. This study not only presented a novel method for screening compounds with high activity, but also provided a theoretical basis for studying the application and mechanism of flavonoids against α-amylase and α-glucosidase in FBSJ.
Clinical significance of appendicoliths in conservative treatment of acute complicated appendicitis patients with peri-appendiceal abscess: A single-center retrospective study
Authors: Min Lingqiang , Lu Jing , He Hongyong
Published: August 2024

Background
The optimal conservative treatment options for acute complicated appendicitis with peri-appendiceal abscess remain controversial. This study aimed to analyze the clinical data of patients who received conservative treatment for this condition, identify factors influencing the success rate, and improve treatment strategies.
Methods
The clinical data of acute complicated appendicitis patients with peri-appendiceal abscess who received conservative treatment at the Department of Emergency Surgery, Zhongshan Hospital, Fudan University, from January 2016 to March 2023, were retrospectively analyzed. Patients were divided into two groups based on the outcomes of ultrasound-guided drainage, and their clinicopathological and surgery-related features were compared.
Results
A total of 80 patients were included in our study. Patients were divided into two groups based on the outcomes of ultrasound-guided drainage: The Drainage group (n = 28) and Antibiotic group (n = 52). The baseline characteristics of the two groups were comparable. The mean abscess size was 7.0 cm in the Drainage group and 4.5 cm in the Antibiotic group. Additionally, 21.4% of patients in the Drainage group have an appendicolith, compared to 44.2% in the Antibiotic group. Eight patients in the Drainage group and nine in the Antibiotic group underwent surgery. In the Antibiotic group, the surgery rate was 30.4% for patients with an appendicolith and 6.9% for those without. In the Drainage group, the surgery rate was 33.3% for patients with an appendicolith and 27.3% for those without. The presence of an appendicolith significantly correlated with the need for surgery in the Antibiotic group (P = 0.026), but not in the Drainage group (P = 0.771). For patients who underwent surgery, the incidence of surgical site infections did not differ significantly (P = 0.656), and the median length of postoperative hospital stay was similar between the groups (4.0 days vs. 3.0 days, P = 0.337).
Conclusion
The presence of an appendicolith is a risk factor for the failure of antibiotic therapy alone in acute complicated appendicitis patients with peri-appendiceal abscess. However, it does not affect the surgical rate in those who underwent successful drainage.
Moderate benefit of escape room game on learning outcome in medicine
Authors: Fedorcsak Peter
Published: August 2024

Background
Well-designed escape room games engage students with complex problems and challenge clinical and teamwork skills, but their impact on learning has been uncertain. This study aimed to estimate the effect size of escape room game on performance in a broad
knowledge test.
Methods
During clinical rotation in reproductive endocrinology and infertility (REI), medical students participated in a 3-hour small-group class. For 2 semesters, groups had traditional patient visits and case discussions, and for 3 semesters, patient visits and an escape room game including debrief. The game was set up in the outpatient clinic, the puzzles were taken from clinical problems in REI, and challenges included operating an ultrasound scanner on a mannequin. Mid-semester, students completed a test of general knowledge in REI. To estimate the effect of small group class on declarative knowledge, test scores of students who had already had the class (exposed) were compared to scores of those who had not yet had the class (control).
Results
Students were highly satisfied with gamified teaching. Those who attended the small group class without the escape room game achieved similar scores on knowledge test than control students (Cohen's d = 0.05, 95%CI -0.58 to 0.68, n = 71). Students who played the escape room game achieved marginally higher score than respective controls (Cohen's d = 0.22, 95%CI -0.1 to 0.53, n = 182).
Conclusions
Escape room game may improve learning outcome of a traditional small group class, but the effect of a single game on declarative knowledge is modest and is unlikely to exceed related instructional methods like simulation.
Relationship between NLR and PLR ratios and the occurrence and prognosis of progressive hemorrhagic injury in patients with traumatic brain injury
Authors: Wang Tingting , Yang Zheng , Zhou Bin , Chen Yanfei
Published: August 2024

Objective
This study aimed to probe the diagnostic value of neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) ratios for the occurrence of progressive hemorrhagic injury (PHI) in patients with traumatic brain injury (TBI) and the relationship with patients’ neurological prognosis.
Methods
One hundred and sixty-six patients with TBI were selected as study subjects. Clinical data were collected from all patients after enrollment, and peripheral blood neutrophil count (NEUT), lymphocyte count (LYM), and platelet count (PLT) were recorded by routine blood tests within 24 hours after admission, and NLR and PLR ratios were calculated for all patients. Imaging was completed, and the included patients were categorized into the PHI group (77 patients) and the non-PHI group (89 patients). ROC curves were applied to analyze the diagnostic value of NLR and PLR ratios for PHI. Patients with GOS score ≥ 4 were categorized into the good prognosis group (54 cases) and patients with GOS score < 4 were categorized into the poor prognosis group (34 cases). Logistic regression was executed to analyze the independent factors impacting the neurological prognosis of TBI patients.
Results
The patients in the PHI group had lower GCS scores and PaO2 and higher proportion of pupillary reflex disappearance and AIS versus the non-PHI group (all P < 0.05). Patients in the PHI group had higher WBC levels, NLR and PLR ratios, and lower PLT levels than patients in the non-PHI group (all P < 0.05). The AUC of NLR and PLR ratio for the joint diagnosis of PHI was significantly higher than that of NLR and PLR alone. Age, GCS score, PaO2, AIS, NLR and PLR ratios were independent factors influencing prognosis of TBI patients (all P < 0.05).
Conclusion
Elevated NLR and PLR ratio can be used as an effective reference basis for assessing the prognosis of patients with TBI, which is worthy of clinical promotion and application.
Impact of Tortuosity of the V1-Segment Vertebral Artery on Mechanical Thrombectomy
Authors: Kang Zhoucheng , Zhao Hanghang , Wei Dong , Li Yang , Shi Rui , Li Li
Published: August 2024

Background and Objective
Tortuosity of the vasculature poses challenges to mechanical thrombectomy (MT); however, only a few studies have reported the impact of vertebral artery (VA) tortuosity on MT. The present study aimed to investigate the impact of tortuosity of the V1-segment VA on MT in patients with acute vertebrobasilar artery occlusion (AVBAO).
Methods
The patients diagnosed with AVBAO and treated with MT in the Stroke Center of Xijing Hospital from November 2019 to March 2022 were analyzed retrospectively. According to the tortuosity of V1-segment VA, patients were divided into tortuous (coiling and kinking) and non-tortuous groups (straight, single-arc, and multi-arc). A binary logistic regression model was established to analyze the association between the tortuosity of V1-segment VA and successful reperfusion (mTICI ≥ 2b), neurological improvement at 7 days, favorable and poor outcome at 90 days, and symptomatic intracranial hemorrhage (ICH) within 24 h. After adjustment for age, baseline National Institute of health stroke scale (NIHSS) score and puncture-to-recanalization time, the impact of tortuosity of the V1-segment VA on outcomes was analyzed.
Results
After screening, 35 patients were enrolled in this study. The overall rate of successful reperfusion was 74.3% (26/35), and 40% (14/34) patients achieved favorable outcomes at 90 days. Subsequently, 15/35 (42.9%) patients were included in the tortuous group, and the remaining 20 patients comprised the non-tortuous group. After adjustment for age, baseline NIHSS score, and puncture-to-recanalization time, the rate of 90-day favorable outcome in the tortuous group was significantly lower than that of the non-tortuous group (20% vs. 57.9%, P = 0.034), while the rates of reperfusion (80% vs. 73.7%) and 7-day neurological improvement (33.3% vs. 36.8%) were similar between the two groups. The incidence of 24-h symptomatic ICH in the tortuous group was higher than that in the non-tortuous group (26.7% vs. 15.8%), albeit not significantly.
Conclusion
In patients with AVBAO, tortuosity of the V1-segment VA was negatively associated with favorable outcomes 90 days after MT.
Borderline Personality Disorder and Post-traumatic stress disorder in adolescents: Protocol for a comparative study of Borderline Personality Disorder with and without comorbid Post-traumatic Stress Disorder (BORDERSTRESS- ADO)
Authors: Riou Maëlle , Duclos Harmony , Leribillard Méline , Parienti Jean Jacques , Segobin Shailendra , Viard Armelle , Apter Gisèle , Gerardin Priscille , GUILLERY Bérengère , Guénolé Fabian
Published: August 2024

Background
Borderline Personality Disorder (BPD) is a prevalent and debilitating psychiatric condition often accompanied by Post-Traumatic Stress Disorder (PTSD), with a substantial prevalence of trauma history among affected individuals. The clinical, cognitive, and cerebral parallels shared with PTSD suggest a trauma-related etiology for BPD. Studies consistently demonstrate a reduction in hippocampal volume in individuals with BPD, echoing findings in PTSD. However, the interpretation of this shared neurobiological profile remains contentious, with ongoing debates regarding the independence of these pathologies or the potential exacerbation of diminished hippocampal volume in BPD due to concurrent PTSD. Differential impacts on hippocampal subfields across both disorders may further complicate interpretation, suggesting the volume of hippocampal subfields as a potential discriminant biomarker. This study aims to characterize the multidimensional specific and shared profiles of BPD and PTSD-related alterations, with a particular emphasis on hippocampal subfields during adolescence, a crucial period in BPD development.
Methods
This study focuses on female adolescents, who are more prevalent in the BPD population. Participants are categorized into three groups: BPD, BPD with comorbid PTSD, and a control group of matched healthy individuals. Data collection encompasses clinical, cognitive, and neuroimaging domains commonly affected in both disorders, utilizing various imaging markers (including gray matter macrostructure, white matter microstructural integrity, and regional functional connectivity).
Discussion
This study examines adolescent BPD with and without comorbid PTSD on clinical, neuroimaging, and cognitive levels. It is the first to use a comprehensive multi-modal approach within the same sample. Additionally, it uniquely explores hippocampal subfield volume differences in adolescents. Analysis of the relationship between the investigated domains and the effects of PTSD comorbidity will elucidate specific and shared alteration profiles in both disorders.
Trial registration:
IDRCB number 2019-A00366-51 / clinicaltrials.gov ID: NCT0485274. Registered on 21/04/2021
Knowledge, Attitudes, and Practices of Patients with age-related macular degeneration (AMD) towards Anti-VEGF Treatment under One-stop Intravitreal Injection Model
Authors: Tan Liangzhang , Ma Zhiqiong , Miao Qi , Liu Shoukuan , Li Yongtao , Ke Yifeng , Ren Xinjun
Published: August 2024

To evaluate the knowledge, attitudes, and practices (KAP) of patients with age-related macular degeneration (AMD) regarding anti-VEGF treatment within a one-stop intravitreal injection service model. A cross-sectional study was conducted from July 1, 2023, to January 31, 2024, at the One-stop Intravitreal Injection Center at Tianjin Medical University Eye Hospital. Data were collected using a specially designed KAP questionnaire. The study successfully enrolled 493 participants. Of these, 214 (43.4%) were aged between 70 and 79 years, and 226 (45.8%) had been diagnosed with AMD for 1–3 years. The median knowledge, attitude, and practice scores were 6.00 [3.00, 8.00] (possible range: 0–9), 42.00 [37.00, 48.00] (possible range: 11–55), and 23.00 [18.00, 27.00] (possible range: 6–30), respectively. Multivariate logistic regression for practice showed that knowledge score (OR = 1.329, P < 0.001), attitude score (OR = 1.150, P < 0.001), aged 60–69 years (OR = 0.398, P = 0.022) were independently associated with proactive practice. Mediating effect significance showed that knowledge directly affected attitude (β = 0.625), knowledge (β = 0.398) and attitude (β = 0.503) directly affected practice (P < 0.001). Meanwhile, knowledge also indirectly affected practice through attitude (β = 0.315, P < 0.001). Regarding the factors impacting their selection of anti-VEGF treatment, 63.5% of patients emphasized the crucial role of its effectiveness. Additionally, over 40% of patients considered both family circumstances and insurance coverage to be highly significant in their decision-making process. This study found that patients with AMD exhibit suboptimal knowledge yet hold positive attitudes and engage actively in practices concerning anti-VEGF treatment within a one-stop intravitreal injection service model. It is recommended that healthcare providers enhance educational interventions at intravitreal injection centers to boost patient knowledge, which is likely to further improve attitudes and proactive management practices among AMD patients.
The Effect of Parental Autonomy Support on School-aged Children’ s School Adjustment: The Longitudinal Mediating Effect of Executive Function
Authors: Hu Xia , Li Zhu , Xing Xiaopei
Published: August 2024

Objective: To examine the relationship between parental autonomy support and school-aged children’s adjustment in four major domains of school and the longitudinal mediating role of children’s executive function.
Methods: The Psychological Autonomy Support Scale, Behavior Rating Inventory of Executive Function-2 and the Primary School Students’ Psychological Suzhi Measure were used as instruments for three short-term follow-ups with 476 school-aged children and their parents.
Results: (1) Paternal autonomy support could predict the four dimensions of school adjustment significantly and positively, whereas maternal autonomy support only had a positive effect on interpersonal adjustment; (2) The intercept and slope of children’s executive function positively predicted the four dimensions of school adjustment; (3) The “initial level” of children’s executive function fully mediated the relationships between paternal autonomy support and school adjustment, while the“
rate of development” of executive function did not.
Conclusions: Those parental autonomy supportive behavior targeting to improving children’s executive function will be particularly helpful to contribute to children’s school adjustment.