bluuebunny/crossref_metadata_2025 huggingface dataset:
Wide-speed-adaptive sliding mode observer for the fuel cell air compressor controller
Authors: He Tengyu , Liu Qian , Sun Xiuxiu , Jing Guoxi , Zhang Qian
Published: December 2024

The transition from two-stage centrifugal to turbo compressors for fuel cell air compressors is underway to enhance the overall efficiency of fuel cell systems. Shifting from the conventional two-stage compression structure to a single-stage configuration necessitates higher operational velocities with turbine compressors. This study proposes a novel wide-speed-adaptive sliding mode observer (WSA-SMO) for controlling the fuel cell air compressor controller to accommodate this heightened drive frequency. The maximum operating speed of the controller was increased to 120,000 rpm by extending the speed range of the conventional sliding mode observer. The controller underwent systematic calibration with the turbine fuel cell air compressor, validating the efficiency of the newly proposed control strategy.
Generalized Bayesian kernel machine regression
Authors: Mou Xichen , Zhang Hongmei , Arshad S Hasan
Published: December 2024

Kernel machine regression is a nonparametric regression method widely applied in biomedical and environmental health research. It employs a kernel function to measure the similarities between sample pairs, effectively identifying significant exposures and assessing their nonlinear impacts on outcomes. This article introduces an enhanced framework, the generalized Bayesian kernel machine regression. In comparison to traditional kernel machine regression, generalized Bayesian kernel machine regression provides substantial flexibility to accommodate a broader array of outcome variables, ranging from continuous to binary and count data. Simulations show generalized Bayesian kernel machine regression can successfully identify the nonlinear relationships between independent variables and outcomes of various types. In the real data analysis, we applied generalized Bayesian kernel machine regression to uncover cytosine phosphate guanine sites linked to health-related conditions such as asthma and smoking. The results identify crucial cytosine phosphate guanine sites and provide insights into their complex, nonlinear relationships with outcome variables.
Geometric Morphometric Study of ear Shape in Four Chinese Ethnic Minority Populations
Authors: Li Haijun , Zhang Yameng
Published: December 2024

This study aimed to investigate how ear shape in adults changes with age and ethnicity among four Chinese minority groups: Buyi, Tibetan, Tu, and Salar.

We employed a combined approach using linear measurements and 2D geometric morphometrics to comprehensively assess ear shape variation.

Our findings revealed a significant effect of age on ear shape, independent of overall size. Specifically, older adults exhibited a slender helix and antihelix especially in the lower region. Interestingly, the helix showed elongation, while the antihelix became shorter, and the tragus position shifted upwards. While linear measurements increased with age, the overall size (centroid size) remained constant. Although ethnicity displayed greater variability in ear shape compared to age and size, our analysis using Principal Component Analysis and random forest models did not reveal statistically significant differences between the four ethnic groups.

This study suggests that genetic factors play a relatively minor role in shaping ear variation, similar to other cranial features.
First Aid and Basic Life Support Training in the Wilderness
Authors: Fremery Alexis , Mutricy Rémi , Negrello Florian , Pujo Jean , Labrousse Thomas , Epelboin Loïc
Published: December 2024

Introduction

French Guiana is a French territory in South America covered by 90% of tropical forest. Despite regular first aid standards training, some of the workers in isolated areas remain untrained in common problems they may encounter. We present here the knowledge assessment of these workers concerning first aid and a new training program.

Methods

Thirty-two workers operating in remote areas attended a 1-d training course. The program covered infectious diseases, wildlife envenomation, and first aid and basic life support with a wilderness medicine focus. Questionnaires were issued to assess their knowledge and satisfaction with the course.

Results

The learners were 78% male and of intermediate age (26–55 y). The most common profession was forester (53%). Professionals had been working in remote areas for 12 (4–19) y, and 91% had already received first aid training. The common life-threatening emergencies were not well known; only 6 learners (19%) knew how to recognize a cardiac arrest, 7 (22%) recognized symptoms of severe anaphylaxis, and 23 (72%) performed maneuvers not recommended in cases of upper airway partial obstruction. A total of 26 learners (81%) completed the satisfaction questionnaire. The training met the learners’ expectations. However, 92% would like further training, and 96% requested regular renewal.

Conclusions

This training was the first step toward the creation of a specialized wilderness first aid course. This work supports the need to reinforce training for nonmedical personnel by integrating regionally specific topics. This experience permitted the rise of a working group that proposed a medical kit as well as first aid protocols for workers in isolated areas.
ADHD and Academic Performance in College Students: A Systematic Review
Authors: Pagespetit Èlia , Pagerols Mireia , Barrés Natalia , Prat Raquel , Martínez Laura , Andreu María , Prat Gemma , Casas Miquel , Bosch Rosa
Published: December 2024

It is currently accepted that ADHD leads to important difficulties in the educational functioning of children and adolescents. However, its actual relevance on the performance of university students is not yet recognized in the academic milieu and University Management Foundations.

Objectives:

The present study performed a systematic review of the scientific literature that deals with the academic performance of university students with ADHD, collecting the research conducted between 2018 and 2024. Likewise, we aimed to know the factors that influence on academic performance and evaluate the tools used in the collection of ADHD symptoms and educational data.

Methods:

The electronic databases PubMed, PsycInfo, and Scopus were used to search studies using PRISMA guidelines. Quantitative studies selected had to discuss about academic performance in college students with ADHD. For each study, quality of evidence was examined using the Quality Assessment Tool of the National Heart Lung and Blood Institute.

Results:

Fifteen studies with good-fair quality were included in the review. These studies demonstrated that an ADHD diagnosis or significant ADHD symptoms are associated with lower academic performance in college students, particularly those with inattention symptoms. Additionally, factors such as executive functions, medication use, and study strategies also influence the academic performance of these students. The most commonly used instruments for the assessment of ADHD were the screening measures ADHD Self-Report Scale and the ADHD Rating Scale—Self Report Version. To assess academic performance half of the studies collected the Grade Point Average directly from university records, while in other studies, students were asked directly for their grades.

Conclusion:

Overall, ADHD has a relevant impact on the academic performance of university students, but the evaluation methodology used has some differences with respect to child’s evaluations procedures. Therefore, studies in this population must include not only self-reported symptomatology, but also assessments from clinicians specialized in adult ADHD.
A narrative review of vagus nerve stimulation in stroke
Authors: Hu Yanhong , Xiong Ruiqi , Pan Suyue , Huang Kaibin
Published: December 2024

Stroke is a significant health concern impacting society and the health care system. Reperfusion therapy for acute ischemic stroke and standard rehabilitative therapies may not always be effective at improving post-stroke neurological function, and developing alternative strategies is particularly important. Vagus nerve stimulation (VNS) is a treatment option currently approved by the Food and Drug Administration (FDA) for intractable epilepsy, refractory depression, primary headache disorders, obesity, and moderate to severe upper-limb motor dysfunction in chronic ischemic stroke patients. Moreover, VNS has demonstrated potential efficacy in various conditions, including autoimmune diseases, disorders of consciousness, Alzheimer’s disease, Parkinson’s disease, traumatic brain injury, stroke, and other diseases. Although the popularity and application of VNS continue to increase rapidly, the field generally lacks a consensus on the optimal stimulation parameters. The stimulation parameters for VNS are directly related to the clinical outcome, and determining the optimal stimulation conditions for VNS has become an essential concern in its clinical application. This review summarizes the current evidence on VNS for stroke in preclinical models and clinical trials in humans, paying attention to the current types and stimulation parameters of VNS, highlighting the mechanistic pathways involved in the beneficial effects of VNS, critically evaluating clinical implementation challenges and proposing some suggestions for its future research directions. Achieving safe and effective clinical transformation of VNS requires further animal and clinical studies to determine the optimal stimulation parameters and therapeutic mechanisms.
Epstein-Barr virus infection in patients with MOGAD
Authors: Maniscalco Giorgia T , Dinoto Alessandro , Foglia Maria C , Di Battista Maria E , Moreggia Ornella , Di Giulio Cesare Daniele , Williams Michela , Rossi Francesca W , Carta Sara , Chiodega Vanessa , Ferrari Sergio , Viola Assunta , de Paulis Amato , Andreone Vincenzo , Mariotto Sara
Published: December 2024

Background:

Epstein-Barr virus (EBV) infection increases the risk of having multiple sclerosis (MS). Data on adults with myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) are lacking.

Objective:

To compare EBV serological status in MOGAD versus MS.

Methods:

We measured antibodies to Epstein-Barr nuclear antigen (EBNA-1) and viral capsid antigen (VCA) antigens in 129 patients (MS = 74, MOGAD = 55) by chemiluminescence immunoassays.

Results:

VCA-IgG were detected in 97.3% of MS and 96.4% of MOGAD cases, while EBNA-1-IgG in 97.3% of MS and 80% of MOGAD ( p = 0.001). EBNA-1 ( p < 0.001) and VCA ( p = 0.03) antibodies levels were higher in MS patients.

Conclusion:

EBV antibodies are higher in MS versus MOGAD, suggesting a possible different role of EBV in the pathogenesis of the two conditions.
Performative resistance and aestheticized conflicts: Barbie’s ambivalent feminist practice
Authors: Li Qianqian
Published: December 2024

This article examines the film Barbie as an embodiment of the ambivalence of Western popular feminism. The article argues that Barbie demonstrates two forms of ambivalence – performative resistance and aestheticized conflicts. Defining performative resistance as the tendency of cultural products to articulate progressive ideas while integrating oppressive ideologies into their world-building and diegesis, the article focuses on three aspects of performative resistance demonstrated in the film: its simultaneous celebration and critique of consumerism and normative feminine beauty, its ambivalent attitude toward the patriarchal logic of domination and its inclusion of people with disabilities and people of color as part of its ableist and postracial ideologies, showing that the film’s progressive statements often conceal its incorporation of oppressive ideologies. Defining aestheticized conflicts as cultural products’ representation of conflicts and power struggles in a pleasing and appealing manner to create a happy and harmonious atmosphere, the article examines the aestheticization of diegetic conflicts between Barbies and Kens, among Kens, between capitalists and consumers, and between capitalists and workers, finding that the film’s exposure of conflicts paradoxically contributes to their weakening, and downplays both gender and class conflicts. Through a textual and critical discourse analysis of Barbie, the article hopes to show that regressive elements in Western popular feminist discourses can be intimately intertwined with progressive ideas and often reinforce, reproduce and perpetuate themselves by masquerading as progressive, suggesting that Western popular feminism may be entering a new phase in which structural problems are increasingly obscured by their exposure.
Total Phenolic and Flavonoid Content, Lipophilic Components, and Antioxidant Activities of Capsicum annuum Varieties Grown in Omo Nada, Jimma, Ethiopia
Authors: Kebu Zemani , Gure Abera , Molole Guyo Jilo
Published: December 2024

Objective

This study aimed to determine total phenolic content (TPC), total flavonoid content (TFC), lipophilic components, and antioxidant activities of Capsicum annuum L. varieties grown in Omo Nada, Jimma, Ethiopia.

Methods

Fresh, ripe fruits from three commonly cultivated varieties of C. annuum – Mareko Fana, Kolesha, and Gojeb – were investigated. TPC and TFC were measured using Folin-Ciocalteu and aluminum chloride colorimetry methods in methanol and chloroform extracts, expressed as mg gallic acid equivalents (mg GAE/g) and mg quercetin equivalents (mg QE/g), respectively. Lipophilic components were identified in n-hexane extracts using gas chromatography-mass spectrometry (GC-MS). Antioxidant activities were assessed using the 2,2-diphenyl-1-picrylhydrazyl (DPPH) free radical scavenging assay.

Results

Methanol extracts had the highest TPC and TFC across all varieties, with Gojeb exhibiting the highest values (TPC: 22.98 ± 0.08 mg GAE/g; TFC: 7.67 ± 0.07 mg QE/g). GC-MS analysis identified 80 distinct compounds in n-hexane extracts, with m-xylene and p-xylene (6.68-16.82%), capsaicin (4.22-11.25%), dihydrocapsaicin (2.12-8.24%), vitamin E (5.32-14.72%) and (24R)-stigmast-5 -en-3beta-ol (2.19-6.20%) being among the major components across all varieties. The DPPH assay revealed that methanol extracts of Gojeb had the strongest antioxidant activity with EC50 values of 0.40 ± 0.04 mg/mL. Moreover, the EC50 showed strong negative correlation with TPC ((r = −0.87).

Conclusion

The methanol extracts of C. annuum varieties, especially Gojeb, exhibited high TPC, TFC, and antioxidant activity, highlighting its importance as potential sources of natural antioxidants in food or pharmaceutical industries. Despite their lower antioxidant activities, the n-hexane extracts contain valuable health-promoting compounds. Further research, involving chemical isolation and additional bioanalysis could give more insight about the health benefits of the C. annuum varieties investigated.
“If Those Stats Make You Mad, Then You’ve Come to the Right Place”: Theorizing a Women’s Sports Media Counterpublic
Authors: Crawford Monica
Published: December 2024

With over four decades of scholarship assessing sports media coverage through the lens of hegemonic masculinity, this study poses counterpublics as a generative theoretical concept for telling stories about sport differently and locating instances of feminist resistance within sports media. To theorize the nature of a women’s sport counterpublic, this study turns to online women’s sports media organizations. The analysis consists of a critical discourse analysis (CDA) of six identified outlets’ “About” pages and contends that the outlets employ elements of counterpublicity by making statements of (perceived) exclusion, developing their discursive arenas, and maintaining links to mainstream sports media outlets. In posing counterpublics as a valuable conceptual framework for the study of sports media, this study advocates for a paradigmatic shift to focusing on the margins of sport as spaces welcome to a re-imagining of an inclusive future of sport.
Translation and Validation of the Spanish Version of the Banff Patellofemoral Instability Instrument 2.0
Authors: Martinez-Cano Juan Pablo , Iversen Maura D. , Gallego Alejandro , Alfonso Gallon Luis , Askenberger Marie , von Heideken Johan
Published: December 2024

Background:

The Banff Patellofemoral Instability Instrument (BPII) 2.0 is a patient-reported outcome measure (PROM) tailored specifically for patellofemoral instability. The BPII 2.0 was developed in English and has been validated for adolescents and translated into several languages, but not into Spanish.

Purpose/Hypothesis:

This investigation involved translating the BPII 2.0 into Spanish and evaluating and validating its psychometric properties. It was hypothesized that there would be a moderate correlation between the Spanish BPII 2.0 and the Spanish version of the Kujala score.

Study Design:

Cohort study (diagnosis); Level of evidence, 3.

Methods:

The BPII 2.0 underwent forward and backward translations into Colombian Spanish according to the Consensus-Based Standards for the Selection of Health Measurement Instrument guidelines. Colombian patients aged 9 to 18 years who experienced knee symptoms after a primary or recurrent patellar dislocation were recruited from a hospital-based orthopaedic clinic. Participants completed the Spanish BPII 2.0 and the Kujala score during their initial visit (t0) and the Spanish BPII 2.0 again 1 week later (t1). Internal consistency and test-retest reliability were assessed using the intraclass correlation coefficient (ICC). Concurrent validity of the Spanish BPII 2.0 with the Kujala score was explored through Pearson correlation analysis.

Results:

A total of 46 participants (31 [67%] female; mean age, 15.1 ± 2.0 years) were included. The mean time since first patellofemoral dislocation was 22 ± 28 months. Of the 4 participants who received operative treatment for patellar instability, the mean time since surgery was 12 months (range, 7-18 months). All patients completed the BPII 2.0 at t0 and at t1, a mean of 7 days later (range, 6-7 days), and 45 (98%) participants completed the Kujala score at t0. Five Spanish BPII 2.0 items exhibited floor or ceiling effects, however no subscales demonstrated these effects. Th Spanish BPII 2.0 demonstrated excellent internal consistency at both t0 (ICC, 0.94; 95% CI, 0.92-0.96) and t1 (ICC, 0.96; 95% CI, 0.93-0.97), along with excellent test-retest reliability (ICC, 0.98; 95% CI, 0.97-0.99). Concurrent validity of the Spanish BPII 2.0 with the Spanish Kujala score was good to strong ( r = 0.74; 95% CI, 0.57-0.85).

Conclusion:

The Spanish BPII 2.0 had excellent internal consistency and test-retest reliability, suggesting this PROM is a reliable and valid questionnaire.
Knotless Suture Anchors Display Favorable Elongation but an Inferior Ultimate Failure Load Versus Titanium Suture Anchors and All-Suture Anchors: A Biomechanical Comparison in a Porcine Model
Authors: Deichsel Adrian , Rolf Jana , Raschke Michael J. , Milstrey Alexander , Klimek Matthias , Peez Christian , Herbst Elmar , Kittl Christoph
Published: December 2024

Background:

Several types of suture anchors, which differ in their working principles, are available for fixation of ligamentous structures in knee surgery. How the choice of a suture anchor type influences the biomechanical stability of ligament fixation is largely unknown.

Purpose:

To compare the biomechanical properties of different suture anchor designs regarding primary stability for tendon fixation and repair in medial collateral ligament (MCL) surgery.

Study Design:

Controlled laboratory study.

Methods:

The primary stability of MCL fixation was assessed in a porcine model utilizing 1 of 3 suture anchor types: a 5.5-mm titanium suture anchor (TSA), a 2.8-mm all-suture anchor (ASA), or a 5.5-mm polyether ether ketone knotless suture anchor (KLSA). Primary stability was assessed using a uniaxial material testing machine. Cyclic loading at 50 N and 100 N was applied for 500 cycles each, followed by a load-to-failure test.

Results:

After 500 cycles at 50 N, the KLSA (2.4 ± 0.3 mm) showed significantly ( P < .05) reduced elongation in comparison to the TSA (4.0 ± 0.9 mm) and ASA (3.6 ± 0.7 mm), and after 500 cycles at 100 N, the KLSA (6.5 ± 1.4 mm) again showed significantly ( P < .05) reduced elongation in comparison to the TSA (11.0 ± 2.2 mm) and ASA (12.0 ± 3.6 mm). However, the KLSA (213 ± 27 N) showed a significantly ( P < .05) inferior ultimate failure load in comparison to the TSA (300 ± 20 N) and ASA (348 ± 23 N). In comparison to the TSA (113.0 ± 11.0 N/mm) and ASA (113.6 ± 14.4 N/mm), the KLSA (150.7 ± 11.6 N/mm) displayed the highest stiffness ( P < .05). No significant differences were observed regarding yield load.

Conclusion:

KLSAs displayed significantly reduced elongation, at the cost of a reduced ultimate failure load, in comparison to TSAs and ASAs.

Clinical Relevance:

Surgeons should be aware that differences exist between different suture anchor types regarding their biomechanical stability. KLSAs may be favorable for fixation of peripheral ligaments in knee surgery.
Effects of Low-Load Blood Flow Restriction Training on Muscle Volume After Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis
Authors: Lin Qiuxiang , Zhang Yuping , Qin Jiawei , Wu Fuchun
Published: December 2024

Background:

After anterior cruciate ligament (ACL) reconstruction (ACLR), the function and strength of the quadriceps muscle are essential for a successful recovery. Low-load blood flow restriction training (LL-BFRT) is believed to reduce muscle atrophy and restore muscle function.

Purpose:

To systematically analyze the evidence on the effectiveness of LL-BFRT in early rehabilitation after ACLR.

Study Design:

Systematic review; Level of evidence, 1.

Methods:

A systematic review and meta-analysis were conducted consistent with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Comprehensive literature searches were performed in several electronic databases—including Cochrane Library (trials), PubMed, Embase, Web of Science, China National Knowledge Infrastructure, WanFang, China Science and Technology Journal Database, and Sinomed—from inception to October 1, 2023. Included were randomized controlled trials in Chinese and English comparing LL-BFRT within 6 weeks after ACLR with conventional rehabilitation training. Bias risk was assessed using the Cochrane Risk-of-Bias 2 tool. The outcomes measured were quadriceps muscle size, knee joint functional scores, balance function, and complications. The effects of LL-BFRT versus conventional rehabilitation were analyzed using standardized mean differences (SMDs) or weighted mean differences (WMDs).

Results:

A total of 362 studies were initially identified, and 8 were included for analysis. LL-BFRT was significantly more effective in improving quadriceps muscle volume (SMD, 0.37 [95% CI, 0.08 to 0.66]; P = .01) and Lysholm scores (SMD, 0.74 [95% CI, 0.43 to 1.05]; P < .0001) compared with conventional rehabilitation training. However, no significant improvements were observed in the 3 directions of the Y-balance test: anterior (WMD, 0.55 [95% CI, –6.37 to 7.46]; P = .88), posteromedial (WMD, –2.24 [95% CI, –8.76 to 4.29]; P = .50), and posterolateral (WMD, 0.02 [95% CI, –13 to 13.03]; P = 1.0). No complications were reported in any of the included studies.

Conclusion:

The results of this meta-analysis suggested that LL-BFRT within 6 weeks after ACLR has a more pronounced effect on increasing quadriceps muscle volume and improving Lysholm scores compared with conventional rehabilitation training, with no apparent complications.
The Effect of Collaborative Triadic Conversations in Noise on Decision-Making in a General-Knowledge Task
Authors: Örnolfsson Ingvi , Ahrens Axel , Dau Torsten , May Tobias
Published: December 2024

Collaboration is a key element of many communicative interactions. Analyzing the effect of collaborative interaction on subsequent decision-making tasks offers the potential to quantitatively evaluate criteria that are indicative of successful communication. While many studies have explored how collaboration aids decision-making, little is known about how communicative barriers, such as loud background noise or hearing impairment, affect this process. This study investigated how collaborative triadic conversations held in different background noise levels affected the decision-making of individual group members in a subsequent individual task. Thirty normal-hearing participants were recruited and organized into triads. First, each participant answered a series of binary general knowledge questions and provided a confidence rating along with each response. The questions were then discussed in triads in either loud (78 dB) or soft (48 dB) background noise. Participants then answered the same questions individually again. Three decision-making measures – stay/switch behavior, decision convergence, and voting strategy - were used to assess if and how participants adjusted their initial decisions after the conversations. The results revealed an interaction between initial confidence rating and noise level: participants were more likely to modify their decisions towards high-confidence prior decisions, and this effect was more pronounced when the conversations had taken place in loud noise. We speculate that this may be because low-confidence opinions are less likely to be voiced in noisy environments compared to high-confidence opinions. The findings demonstrate that decision-making tasks can be designed for conversation studies with groups of more than two participants, and that such tasks can be used to explore how communicative barriers impact subsequent decision-making of individual group members.
Concerns of Novice Nurses in the First Year of Work: A Qualitative Content Analysis
Authors: Najafi Bahareh , Nasiri Ahmad
Published: December 2024

Introduction

Novice nurses face many concerns at the beginning of their professional careers. The majority of novice nurses have been challenged with stress, inability to work autonomously, insecurity, inexperience, and unpreparedness to work in a clinical setting at the early of their work.

Objective

This study aims to explain novice nurses’ experiences to understand their concerns. This was a qualitative study using conventional content analysis.

Methods

Unstructured in-depth open individual interviews were used for data collection. Sixteen nurses were selected by purposeful sampling. The data were analyzed using the Graneheim and Lundman content analysis approach. After data collection, all interviews were transcribed and reviewed, and categories were extracted.

Results

After analyzing the data obtained from the experiences of novice nurses, three major themes and 11 subthemes were identified. The major themes were initial uncertainty in the novice nurse, loneliness and helplessness alongside colleagues, and concerns about workplace discrimination by managers.

Conclusion

Since the results of this qualitative study showed that novice nurses have such important concerns as confusion, feelings of loneliness and helplessness, and feelings of worry about discrimination at the beginning of their work, so, it is necessary to pay attention to these issues in planning by providers to assist them transitioning in clinical settings.
Are recruiters driving gender segregation? Evidence from the German apprenticeship market
Authors: Minssen Luisa , Levels Mark , Pfeifer Harald , Wehner Caroline
Published: December 2024

Potential drivers of gender discrimination are recruiters, who are more likely to select applicants with characteristics similar to their own. This study explores whether recruiter characteristics (age, gender, and job position) drive gender discrimination in the recruitment of apprentices for gender-segregated occupations. A factorial survey experiment among 1872 firms in Germany estimates recruiters’ heterogeneous gender choices in male, female, and gender-mixed occupations. The study finds that female applicants are chosen less often for male-dominated occupations and more often for female-dominated occupations than male applicants. Moreover, older recruiters and firm owners are less likely to recruit female applicants for male-dominated occupations but more likely to recruit them for female-dominated occupations than younger recruiters and non-firm owners. By contrast, younger recruiters and HR professionals are more likely to recruit gender-neutrally to an occupation’s dominating gender than older recruiters and non-HR professionals. This study shows that apprenticeship applicants of a gender opposed to the dominant gender of an occupation have a disadvantage in the apprenticeship market and that certain recruiters’ characteristics further impact this disadvantage.
Predictors of Vision Loss After Lapse in Antivascular Endothelial Growth Factor Treatment in Patients With Diabetic Macular Edema
Authors: Chalasani Meghana , Maatouk Christopher , Markle Jonathan , Singh Rishi P. , Talcott Katherine E.
Published: December 2024

Purpose: To identify baseline characteristics that predict visual outcomes after a lapse in treatment among patients with diabetic macular edema (DME) who received intravitreal antivascular endothelial growth factor injections. Methods: In this retrospective study, patients with DME who had lapses in treatment of 3 months or longer were separated into 2 groups (stable vision, n = 201; vision loss, n = 61) based on an Early Treatment Diabetic Retinopathy Study vision loss threshold of 10 letters. Stepwise backward logistic regression was used to analyze baseline factors associated with vision loss and to create a predictive algorithm. Results: In the final regression model, the length of lapse in treatment (odds ratio [OR]; 1.15, 95% CI, 1.07-1.25), diabetic foot disease (OR, 3.02; 95% CI, 1.09-8.2), and Medicaid insurance (OR, 4.60; 95% CI, 1.20-18.7) were positively associated with vision loss ( P < .05). Time since diagnosis of diabetic retinopathy (OR, 0.95; 95% CI, 0.91-0.99) was negatively associated with vision loss ( P < .05). The final prediction model had a sensitivity of 20% and a specificity of 84%, with an area under the curve of 65%. Conclusions: For patients with DME at high risk for a lapse in treatment, baseline characteristics can help predict vision loss and guide management.
Intermediate flexibility in cooperation games prevents free riding, polarization, and societal disintegration
Authors: Conrad Matthew , Tabor Whitney
Published: December 2024

We explored the properties of a computational model, “APEM,” inspired by empirical work on human group behavior in a coordination game called “The Slider Game.” Players in a network manipulate sliders on computer screens in an effort to achieve across-the-board aggregation on the same side of the slider. The model is an agent-based dynamical system. We studied the model’s behavior under manipulation of a control parameter called “flexibility,” which determines the willingness of players to adjust their behavior as a function of their agreement with their neighbors. Optimal coordination occurs only in a narrow range near the middle of the parameter space (a “Principle of Intermediacy”). Additionally, the model exhibits two types of non-successful asymptotic states, called “fraught” and “obdurate,” as well as a condition of prohibitively slow convergence where its behavior is very noisy. A review of the anthropological literature provides evidence that each regime of failure is a simple version of an empirically observed condition of flummoxed coordination in human societies: polarization, free-riding, and infrastructure disintegration under societal demise, respectively. Although each of these phenomena has been individually studied at some length, we are aware of no prior integrative treatment.
Myostatin and smad2/smad3 pathway define a differential clinical phenotype in Copd-associated Sarcopenia
Authors: Núñez-Robainas Adriana , Guitart Maria , López-Postigo Adrián , Sancho-Muñoz Antonio , Barreiro Esther
Published: December 2024

Sarcopenia, defined as the loss of muscle mass and function, represents one of the most relevant comorbidities in patients with COPD even at early stages. We hypothesized that sarcopenia defines a specific clinical phenotype in COPD irrespective of the respiratory disease severity. Markers of the myostatin/Smad2/Smad3 and IGF1/PI3K/Akt may be differentially expressed in the vastus lateralis (VL) of patients with COPD-associated sarcopenia. In muscle specimens from VL, markers of the myostatin/Smad2/Smad3, Smad4 and IGF1/PI3K/Akt pathways were evaluated (qRT-PCR, immunoblotting) and correlations between clinical and biological variables of patients with sarcopenia (N=23), and without (N=18), and healthy controls (N=13) were examined. In VL of sarcopenic COPD patients, expression levels of myostatin, Smad2/Smad3, Smad4, and IGF1 increased compared to those in non-sarcopenic patients and healthy controls. In sarcopenic limb muscles of patients with COPD, myostatin Smad2/Smad3 pathway was differentially activated from patients without sarcopenia and healthy controls. Among sarcopenic patients, myostatin and p-Smad3/Smad3 levels negatively correlated with FFMI (r=-0.727, p=0.026 and r=-0.703, p=0.035, respectively) and myostatin and Smad4 levels correlated with quadriceps strength (r=-0.886, p=0.003 and r=-0.431, p=0.040, respectively), and myostatin with diffusion capacity (r=-0.781, p=0.022). Remarkable negative correlations were observed between clinical parameters related to body composition and quadriceps muscle strength and levels of the myostatin Smad2/Smad3 pathway, suggesting its implication in the process of muscle atrophy in COPD. IGF1 gene expression was also upregulated in the VL of the sarcopenic patients. Collectively, these findings offer a potential therapeutic target in COPD-associated sarcopenia.
On the inverse association between the number of QTL and the trait-specific genomic relationship of a candidate to the training set.
Authors: Stricker Christian , Fernando Rohan L. , Melchinger Albrecht , Auinger Hans-Juergen , Schoen Chris-Carolin
Published: December 2024

Background

Accuracy of genomic prediction depends on the heritability of the trait, the size of the training set, the relationship of the candidates to the training set, and the $$\text {Min}(N_{\text {QTL}},M_e)$$

Min
(

N
QTL

,

M
e

)

, where $$N_{\text {QTL}}$$

N
QTL

is the number of QTL and $$M_e$$

M
e

is the number of independently segregating chromosomal segments. Due to LD, the number $$Q_e$$

Q
e

of independently segregating QTL (effective QTL) can be lower than $$\text {Min}(N_{\text {QTL}},M_e)$$

Min
(

N
QTL

,

M
e

)

. In this paper, we show that $$Q_e$$

Q
e

is inversely associated with the trait-specific genomic relationship of a candidate to the training set. This provides an explanation for the inverse association between $$Q_e$$

Q
e

and the accuracy of prediction.

Methods

To quantify the genomic relationship of a candidate to all members of the training set, we considered the $$k^2$$

k
2

statistic that has been previously used for this purpose. It quantifies how well the marker covariate vector of a candidate can be represented as a linear combination of the rows of the marker covariate matrix of the training set. In this paper, we used Bayesian regression to make this statistic trait specific and argue that the trait-specific genomic relationship of a candidate to the training set is inversely associated with $$Q_e$$

Q
e

. Simulation was used to demonstrate the dependence of the trait-specific $$k^2$$

k
2

statistic on $$Q_e$$

Q
e

, which is related to $$N_{\text {QTL}}$$

N
QTL

.

Conclusions

The posterior distributions of the trait-specific $$k^2$$

k
2

statistic showed that the trait-specific genomic relationship between a candidate and the training set is inversely associated to $$Q_e$$

Q
e

and $$N_{\text {QTL}}$$

N
QTL

. Further, we show that trait-specific genomic relationship between a candidate and the training set is directly related to the size of the training set.
Psychotic disorders in HIV-positive versus HIV-negative patients: comparative study of clinical characteristics
Authors: Nakasujja Noeline , Musisi Seggane , Agren Hans , Katabira Elly , Allebeck Peter
Published: December 2024

Background

Clinical characteristics of psychosis in HIV infection have been described, but there have been limited comparative studies in HIV-endemic low-resource regions.

Aim

To compare clinical characteristics of psychosis in HIV-positive and HIV-negative patients at the main psychiatric referral units in Uganda.

Method

Patients with psychosis were consecutively recruited and completed a standardised demographic questionnaire and psychiatric and laboratory assessments including an HIV test. The Mini International Neuropsychiatric Interview was used to diagnose psychiatric illness. Psychosis symptoms were compared between HIV-positive and HIV-negative individuals using bivariate methods. A logistic regression model was used to assess the effects of age, gender and HIV status on different types of psychosis.

Results

There were 478 patients enrolled, of which 156 were HIV positive and 322 were HIV negative. The mean age was 33.2 years (95% CI 31.8–34.5) for the HIV-positive group and 29.6 years (95% CI 28.7–30.5) for the HIV-negative group (P < 0.001). Female patients had a higher proportion of seropositivity 40.6% (95% CI 34.8–46.4) compared with males 21.8% (95% CI 16.1–27.5) (P < 0.001). Psychotic disorder not otherwise specified occurred more in the HIV-positive individuals (88% (95% CI 82.9–93.1) v. 12% (95% CI 8.4–15.5), P < 0.001). Motor activity, irritability, emotional withdrawal, feelings of guilt, mannerisms and posturing, grandiosity, suspiciousness, unusual thoughts, blunted affect, excitement and disorientation were associated with HIV seropositivity.

Conclusion

The presentation of psychosis in patients with HIV is unique to this HIV endemic setting. Characterisation of the symptomatology of patients presenting with psychosis is important for proper diagnosis and care.
Real-World and Clinical Trial Validation of a Deep Learning Radiomic Biomarker for PD-(L)1 Immune Checkpoint Inhibitor Response in Advanced Non–Small Cell Lung Cancer
Authors: Sako Chiharu , Duan Chong , Maresca Kevin , Kent Sean , Schmidt Taly Gilat , Aerts Hugo J.W.L. , Parikh Ravi B. , Simon George R. , Jordan Petr
Published: December 2024

PURPOSE

This study developed and validated a novel deep learning radiomic biomarker to estimate response to immune checkpoint inhibitor (ICI) therapy in advanced non–small cell lung cancer (NSCLC) using real-world data (RWD) and clinical trial data.

MATERIALS AND METHODS

Retrospective RWD of 1,829 patients with advanced NSCLC treated with PD-(L)1 ICIs were collected from 10 academic and community institutions in the United States and Europe. The RWD included data sets for discovery (Data Set A-Discovery, n = 1,173) and independent test (Data Set B, n = 458). A radiomic pipeline, containing a deep learning feature extractor and a survival model, generated the computed tomography (CT) response score (CTRS) applied to the pretreatment routine CT/positron emission tomography (PET)-CT scan. An enhanced CTRS (eCTRS) also incorporated age, sex, treatment line, and lesion annotations. Performance was evaluated against progression-free survival (PFS) and overall survival (OS). Biomarker generalizability was further evaluated using a secondary analysis of a prospective clinical trial (ClinicalTrials.gov identifier:
NCT02573259
) evaluating the PD-1 inhibitor sasanlimab in second or later line of treatment (Data Set C, n = 54).

RESULTS

In RWD Test Data Set B, the CTRS identified patients with a high probability of response to ICI with a PFS hazard ratio (HR) of 0.46 (95% CI, 0.26 to 0.82) and an OS HR of 0.50 (95% CI, 0.28 to 0.92) in the first-line ICI monotherapy cohort, after adjustment for baseline covariates including the PD-L1 tumor proportion score. In Clinical Trial Data Set C, the CTRS demonstrated an adjusted PFS HR of 1.03 (95% CI, 0.43 to 2.47) and an OS HR of 0.33 (95% CI, 0.14 to 0.91). The CTRS and eCTRS outperformed traditional imaging biomarkers of lesion size in PFS and OS for RWD Test Data Set B and in OS for the Clinical Trial Data Set.

CONCLUSION

The study developed and validated a deep learning radiomic biomarker using pretreatment routine CT/PET-CT scans to identify ICI benefit in advanced NSCLC.
High Omega-3, Low Omega-6 Diet With Fish Oil for Men With Prostate Cancer on Active Surveillance: The CAPFISH-3 Randomized Clinical Trial
Authors: Aronson William J. , Grogan Tristan , Liang Pei , Jardack Patricia , Liddell Amana R. , Perez Claudia , Elashoff David , Said Jonathan , Cohen Pinchas , Marks Leonard S. , Henning Susanne M.
Published: December 2024

PURPOSE

Men on active surveillance (AS) for prostate cancer are extremely interested in dietary changes or supplements to prevent progression of their disease. We sought to determine whether a high omega-3, low omega-6 fatty acid diet with fish oil capsules (D + FO) decreases proliferation (Ki-67) in prostate biopsies in men with prostate cancer on AS over a 1-year time period.

METHODS

In this phase II, prospective randomized trial, men (N = 100) with grade group 1 or 2 prostate cancer who elected AS were randomly assigned to the D + FO or a control group. Same-site prostate biopsies were obtained at baseline and 1 year. The primary end point was the change in Ki-67 index from baseline to 1 year from same-site biopsies compared between the groups.

RESULTS

The Ki-67 index decreased in the D + FO group by approximately 15% from baseline to 1 year (1.34% at baseline, 1.14% at 1 year) and increased in the control group by approximately 24% from baseline to 1 year (1.23% at baseline, 1.52% at 1 year), resulting in a statistically significant difference in the change of Ki-67 index between the groups (95% CI, 2% to 52%,
P
= .043). There was no significant difference in the secondary outcomes grade group, tumor length, Decipher genomic score, or prostate-specific antigen between the two groups. Four patients in the D + FO group were withdrawn from the trial because of adverse events related to the FO.

CONCLUSION

A high omega-3, low omega-6 diet with FO for 1 year resulted in a significant reduction in Ki-67 index, a biomarker for prostate cancer progression, metastasis, and death. These findings support future phase III trials incorporating this intervention in men on AS.
Olaparib as Treatment Versus Nonplatinum Chemotherapy in Patients With Platinum-Sensitive Relapsed Ovarian Cancer: Phase III SOLO3 Study Final Overall Survival Results
Authors: Scambia Giovanni , Villalobos Valencia Ricardo , Colombo Nicoletta , Cibula David , Leath Charles A. , Bidziński Mariusz , Kim Jae-Weon , Nam Joo Hyun , Madry Radoslaw , Hernández Carlos , Mora Paulo A.R. , Ryu Sang Young , Ah-See Mei-Lin , Lowe Elizabeth S. , Lukashchuk Natalia , Carter Dave , Penson Richard T.
Published: December 2024

Olaparib treatment significantly improved objective response rate (primary end point) and progression-free survival versus nonplatinum chemotherapy in patients with BRCA-mutated platinum-sensitive relapsed ovarian cancer in the open-label phase III SOLO3 trial (ClinicalTrials.gov identifier:
NCT02282020
). We report final overall survival (OS; prespecified secondary end point), post hoc OS analysis by number of previous chemotherapy lines, and exploratory BRCA reversion mutation analysis. Two hundred sixty-six patients were randomly assigned 2:1 to olaparib tablets (300 mg twice daily; n = 178) or physician's choice of single-agent nonplatinum chemotherapy (pegylated liposomal doxorubicin, paclitaxel, gemcitabine, or topotecan; n = 88). OS was similar with olaparib versus chemotherapy (hazard ratio [HR], 1.07 [95% CI, 0.76 to 1.49];
P
= .71, median 34.9 and 32.9 months, respectively, full analysis set). OS with olaparib was favorable in patients with two previous chemotherapy lines (HR, 0.83 [olaparib
v
chemotherapy] [95% CI, 0.51 to 1.38]; median 37.9
v
28.8 months); however, a potential detrimental effect was seen in patients with at least three previous chemotherapy lines (HR, 1.33 [95% CI, 0.84 to 2.18]; median 29.9
v
39.4 months). BRCA reversion mutations might have contributed to this finding. No patient randomly assigned to olaparib with a BRCA reversion mutation detected at baseline (6 of 170 [3.5%]) achieved an objective tumor response.
Three-Year Overall Survival With Nivolumab Plus Relatlimab in Advanced Melanoma From RELATIVITY-047
Authors: Tawbi Hussein A. , Hodi F. Stephen , Lipson Evan J. , Schadendorf Dirk , Ascierto Paolo A. , Matamala Luis , Castillo Gutiérrez Erika , Rutkowski Piotr , Gogas Helen , Lao Christopher D. , Janoski De Menezes Juliana , Dalle Stéphane , Arance Ana Maria , Grob Jean-Jacques , Ratto Barbara , Rodriguez Saima , Mazzei Antonella , Dolfi Sonia , Long Georgina V.
Published: December 2024

Nivolumab plus relatlimab demonstrated a statistically significant improvement in progression-free survival (PFS), along with a clinically meaningful, but not statistically significant improvement in overall survival (OS) and a numerically higher objective response rate (ORR) compared with nivolumab in the RELATIVITY-047 trial (ClinicalTrials.gov identifier:
NCT03470922
). We report updated descriptive efficacy and safety results from RELATIVITY-047 with a median follow-up of 33.8 months. Median PFS was 10.2 months (95% CI, 6.5 to 15.4) with nivolumab plus relatlimab and 4.6 months (95% CI, 3.5 to 6.5) with nivolumab (hazard ratio [HR], 0.79 [95% CI, 0.66 to 0.95]); median OS was 51.0 months (95% CI, 34.0 to not reached) and 34.1 (95% CI, 25.2 to 44.7) months, respectively (HR, 0.80 [95% CI, 0.66 to 0.99]). ORR was 43.7% (95% CI, 38.4 to 49.0) with nivolumab plus relatlimab and 33.7% (95% CI, 28.8 to 38.9) with nivolumab. Efficacy across the majority of prespecified subgroups favored the combination. No new or unexpected safety signals were identified. Overall, at 3-year follow-up, the benefit observed with nivolumab plus relatlimab compared with nivolumab in patients with advanced melanoma was sustained, with the OS HR 95% CI upper bound now <1. This benefit is accompanied by a safety profile consistent with previous reports.