bluuebunny/crossref_metadata_2025 huggingface dataset:
Quantification of biogenic amines and adaptation of an index as a quality indicator of rendered pig meals
Authors: Contreira Cristiéle Lange , Corezzolla Larissa Rossett , Bedendo Gizelle Cristina , Krabbe Everton Luis , Gopinger Edenilse , de Avila Valdir Silveira , Rutz Fernando
Published: September 2023

The objective of this study was to quantify biogenic amines and to adapt equations for the calculation of the biogenic amine index (BAI) in rendered pig carcass meals (RPCM). Samples of RPCM from three different origins were evaluated: Group 1—experimentally produced meal; Group 2—meal produced in a plant dedicated to rendering pigs dead on the farm due to non-infectious causes; and Group 3—meal produced in commercial rendering plants. Group 1 meals were produced from sow carcasses that were stored either under environmental temperature (ET = 25 °C) or refrigeration temperature (RT = −6 °C), and their biogenic amine contents were analyzed at 0, 24, 48, and 72 h of storage. The levels of the biogenic amines phenylethylamine, putrescine, cadaverine, histamine, tyramine, spermidine, and spermine of all meals were determined by high-performance liquid chromatography, and their BAIs were calculated. Group 1 meals stored at ET presented higher phenylethylamine, putrescine, cadaverine, and tyramine contents compared with those stored at RT after 24 h storage, whereas spermidine and spermine contents decreased after 24 h of storage at ET. The adapted BAI can be used as a quality indicator of RPCM.
Towards Efficient Dynamic Binary Translation Optimizations Based on RISC Architectural Features
Authors: Xie WenBing , Tang DaGuo , Qi FengBin , Chai ZhiLei , Luo QiaoLing , Lin Yuan
Published: September 2023

Dynamic binary translation (DBT) is a core technology that enables the migration of legacy software to different instruction set architectures while maintaining the original semantics. However, the development and maintenance of an efficient cross-DBT system are challenging. Key challenges include memory access overhead, inefficient instruction simulation, and frequent context switches. In this paper, we propose three novel optimization techniques. First, we formalize a register mapping cost model and investigate a hierarchical register mapping approach to bridge the memory access overhead. Second, we accelerate floating point (FP) emulation by surrounding the use of hardware FP unit with high-efficiency non-FP code. Third, we present a function inlining approach to alleviating the overhead associated with indirect control lookup. On the system side, we implement our approach on ARM64 and SW64 architectures based on QEMU and extensively evaluate the effectiveness with the SPEC2006 benchmark suite. The experimental results show that an average of 1.28× performance speedup and 13.41% code size reduction can be achieved on SW64. Similarly, on ARM64, we achieve an average of 1.15× performance speedup and 11.48% code size reduction.
Programmable Analog System Benchmarks Leading to Efficient Analog Computation Synthesis
Authors: Hasler Jennifer , Hao Cong
Published: September 2023

This effort develops the first rich suite of analog and mixed-signal benchmark of various sizes and domains, intended for use with contemporary analog and mixed-signal designs and synthesis tools. Benchmarking enables analog-digital co-design exploration as well as extensive evaluation of analog synthesis tools and the generated analog/mixed-signal circuit or device. The goals of this effort are defining analog computation system benchmarks, developing the required concepts for higher-level analog and mixed-signal tools to utilize these benchmarks, and enabling future automated architectural design space exploration (DSE) to determine the best configurable architecture (e.g., a new FPAA) for a certain family of applications. The benchmarks comprise multiple levels of an
acoustic
, a
vision
, a
communications
, and an analog
filter
system that must be simultaneously satisfied for a complete system.
Regulation of Immune Homeostasis, Inflammation, and HIV Persistence by the Microbiome, Short-Chain Fatty Acids, and Bile Acids
Authors: Enriquez Ana Beatriz , ten Caten Felipe , Ghneim Khader , Sekaly Rafick-Pierre , Sharma Ashish Arunkumar
Published: September 2023

Despite antiretroviral therapy (ART), people living with human immunodeficiency virus (HIV) (PLWH) continue to experience chronic inflammation and immune dysfunction, which drives the persistence of latent HIV and prevalence of clinical comorbidities. Elucidating the mechanisms that lead to suboptimal immunity is necessary for developing therapeutics that improve the quality of life of PLWH. Although previous studies have found associations between gut dysbiosis and immune dysfunction, the cellular/molecular cascades implicated in the manifestation of aberrant immune responses downstream of microbial perturbations in PLWH are incompletely understood. Recent literature has highlighted that two abundant metabolite families, short-chain fatty acids (SCFAs) and bile acids (BAs), play a crucial role in shaping immunity. These metabolites can be produced and/or modified by bacterial species that make up the gut microbiota and may serve as the causal link between changes to the gut microbiome, chronic inflammation, and immune dysfunction in PLWH. In this review, we discuss our current understanding of the role of the microbiome on HIV acquisition and latent HIV persistence despite ART. Further, we describe cellular/molecular cascades downstream of SCFAs and BAs that drive innate or adaptive immune responses responsible for promoting latent HIV persistence in PLWH. This knowledge can be used to advance HIV cure efforts.
A Mammalian Cell's Guide on How to Process a Bacteriophage
Authors: Kan Leo , Barr Jeremy J.
Published: September 2023

Bacteriophages are enigmatic entities that defy definition. Classically, they are specialist viruses that exclusively parasitize bacterial hosts. Yet this definition becomes limiting when we consider their ubiquity in the body coupled with their vast capacity to directly interact with the mammalian host. While phages certainly do not infect nor replicate within mammalian cells, they do interact with and gain unfettered access to the eukaryotic cell structure. With the growing appreciation for the human virome, coupled with our increased application of phages to patients within clinical settings, the potential impact of phage-mammalian interactions is progressively recognized. In this review, we provide a detailed mechanistic overview of how phages interact with the mammalian cell surface, the processes through which said phages are internalized by the cell, and the intracellular processing and fate of the phages. We then summarize the current state-of-the-field with respect to phage-mammalian interactions and their associations with health and disease states.
Influenza: Searching for Pandemic Origins
Authors: Webster Robert G.
Published: September 2023

From a farming family of 13 children in New Zealand, I graduated with a Master of Science degree in microbiology from the University of Otago (Dunedin, Otago, New Zealand). I established the first veterinary virology laboratory at Wallaceville Animal Research Station. I subsequently completed my PhD degree at Australian National University (Canberra, Australia) and a postdoctoral fellowship at the University of Michigan (Ann Arbor, Michigan). While in New South Wales, Australia, a walk on a beach littered with dead mutton birds (shearwaters) with Dr. Graeme Laver led to the surveillance of influenza in seabirds on the Great Barrier Reef Islands and my lifelong search for the origin of pandemic influenza viruses. Subsequent studies established that (a) aquatic birds are a natural reservoir of influenza A viruses, (b) these viruses replicate primarily in cells lining the intestinal tract, (c) reassortment in nature can lead to novel pandemic influenza viruses, and (d) live bird markets are one place where transmission of influenza virus from animals to humans occurs.
Oscillatory Behavior of Noncanonical Quasilinear Second-Order Dynamic Equations on Time Scales
Authors: Hassan A. , Odinaev Ismoil , Hassan Taher S.
Published: September 2023

The objective of this article is to examine the oscillatory behavior of a class of quasilinear second-order dynamic equations on time scales. Our focus will be on the noncanonical case, which has received relatively less attention compared to the more commonly studied canonical dynamic equations. Our approach involves transforming the noncanonical equation into a corresponding canonical equation. By utilizing this transformation and a range of techniques, we develop new, more efficient, and precise oscillation criteria. Finally, we demonstrate the significance and usefulness of our results by applying them to specific cases within the equation being studied.
Clinical and Epidemiological Characteristics of Rhabdomyolysis: A Retrospective Study
Authors: Sun Keke , Shi Zhenhua , Abudureheman Yushanjiang , Liu Qihui , Zhao Yibo , Zhang Xiangqun , Lv Qi , Zhang Yan , Shou Songtao , Jin Heng
Published: September 2023

Background. Rhabdomyolysis (RM) refers to a clinical syndrome in which muscle cells are damaged by various causes and the clinical manifestations are mainly muscle pain, weakness, and dark urine. Acute kidney injury (AKI) is a serious complication of RM with complex mechanisms and high mortality. Therefore, understanding the pathogenesis and clinical manifestations, early diagnosis and treatment of RM are crucial to improve its prognosis. Method. Analysis of medical records of RM patients admitted to Tianjin Medical University General Hospital from October 2019 to October 2022. Statistical software SPSS 25.0 was used to analyze the data. The risk factors of RM-complicated AKI were analyzed by logistic regression. The receiver operating characteristic (ROC) curve was plotted, the area under the curve (AUC) was calculated, and the optimal cutoff value was determined by the Youden index.

P
<
0.05

indicates a statistically significant difference between the groups. Result. Among the 71 patients, the median age of the patients was 53.0 (30.0, 71.0) years and was 2.5 times higher in men than in women. Infection was the most common etiology. History of alcohol consumption, CK, and creatinine were independent influencing factors for AKI due to RM. Logistic regression analysis showed that CK combined with creatinine had a better predictive value than the single index. Conclusion. Our study revealed the clinical and laboratory characteristics of RM in the population attending the Tianjin Medical University General Hospital in the last three years, which is a reference for future multicenter, prospective studies.
Physicochemical Properties of Wild Yam (Dioscorea villosa) Starch
Authors: Oladebeye Abraham Olasupo , Oladebeye Aderonke Adenike , Arawande Jacob Olalekan
Published: September 2023

Native starch extracted from wild yam (Dioscorea villosa) was evaluated for its intrinsic physicochemical properties. From the results, essential metals such as K, Ca, P, and Fe were detected along with some nonessential heavy metals below the WHO permissible limits. Bulk density was 0.13–0.63 g/mL. The water absorption capacity, oil absorption capacity, swelling power, and solubility of the starch were pH-responsive. Thermal profiles showed onset temperature,

T

o

(59.21 °C), peak temperature,

T

p

(60.22 °C), endset temperature,

T

c

(63.12 °C), gelatinization enthalpy,

Δ

H

g
e
l

(0.54 J/g), temperature range of gelatinization,

R

(3.91 °C), and peak height index, PHI (1.87 J/g °C). Exhibiting a crystallite size of 0.03 nm, absorption peaks of 15.3119°, 24.4120°, and 18.4170°, corresponding to interplanar d-spacings of 3.7500 Ǻ, 5.14000 Ǻ, and 4.954610 Ǻ, were obtained. Evidence of C–H at 1338.1 cm-1, C–O at 640.0 cm-1, C–H stretch at 2829.7 cm-1, and a strong and broad O–H group at 3291.2 cm-1 were obtained. The starch granules had low particle sizes, were homogeneous, and were aggregates of irregular shapes. At a lower pH (2-4), the wild yam starch studied could be a potential absorbent material in the production of disposable diapers and female napkins and as biodegradable films due to its high hydrophobicity at a high pH (8-12).
The Art of Scientific Observation: an art-science project on the legacy of Barbara McClintock
Authors: Ziegler Ella , Lehmann Johannes
Published: September 2023

We explore a facet of the scientific method of the Nobel Laureate Barbara McClintock through an artistic process. McClintock’s key scientific insights that she coined the ‘breakage-fusion-bridge cycle’, rest on her observation of maize kernel colors and forms together with the spatial arrangement of chromosomes. These intriguing studies motivated the art project ‘break-fusion-bridge-cycle’ to highlight the role of visual observation in discovery. Four different posters bear irregular diamond shapes with forms reminiscent of X-chromosome shapes and color patterns of the kernels McClintock studied and are inscribed with the words break, fusion, bridge, and cycle using a font type inspired by her drawings of chromosomes. As freely available posters, anyone can experiment with the spatial arrangement of shapes and colors, to reflect on one’s own ability to observe, to make connections and create new insights.
Revision of the genus Metoncholaimus (Nematoda: Enoplida) with description of new species from the South China Sea
Authors: Zograf Julia K. , Efimova Kseniya V. , Trebukhova Yulia A. , Pavlyuk Olga N.
Published: September 2023

The family Oncholaimidae comprises ca 350 species of widespread nematodes. They are common in the seas and oceans and are also found in freshwater lakes and rivers. Here we provide the first description of Metoncholaimus species from the South China Sea. Metoncholaimus placatus sp. n. is characterised by the spicules 2.2-2.8 anal body diam. long, gubernaculum small, nearly parallel to the spicules, S-curved. Supplementary organ is composed of transversely elongated prominence with two sensillar structures (receptors). A pictorial key to the species level of Metoncholaimus species is provided. In this study, the D2-D3 domain of the LSU rDNA and the nearly full-length SSU rDNA were selected as targets for species identification. Phylogenetic relationships within the family Oncholaimidae remained unresolved despite of the various sequences analysed in different loci.
Do Foreign Direct Investment Inflow and Trade Openness Influence International Tourism Demand in Africa? A Study of the Post-Global Financial Crisis Era
Authors: Ogbuabor Jonathan E. , Agu Christian , Mba Ifeoma C.
Published: September 2023

Following the paucity of evidence on the roles of foreign direct investment (FDI) inflow and trade openness in Africa’s tourism development, particularly in the post-Global Financial Crisis era, this study examined the roles of FDI inflow and trade openness as drivers of international tourism demand in Africa. We also investigated how infrastructural development, terrorism, climatic conditions, and institutional quality influence the FDI-tourism and trade openness-tourism relationships in Africa. The system GMM modeling framework and a panel of 42 African countries were used. We find that FDI inflow has not contributed significantly to the growth of tourism demand in Africa. However, infrastructure and climatic conditions on the continent have the potential to positively influence the FDI-tourism relationship, while terrorism hampers it. We also find that trade openness impacts positively on international tourism demand in Africa, but this impact is mainly insignificant. The study made some policy recommendations based on these findings.
Primary neuroendocrine neoplasms of the kidney: a case report and literature review
Authors: Liu Changxun , Qi Yixin , Zhang Youzhi , Yang Xiaokun
Published: September 2023

Primary kidney neuroendocrine tumors (NETs) are rare renal malignancies. However, detecting and monitoring neuroendocrine neoplasms remains challenging because of their nonspecific nature. We herein present a case involving a 53-year-old woman who experienced episodes of intermittent abdominal pain, dizziness, and nausea for a period of 5 days. Computed tomography urography revealed a small (approximately 19- × 16-mm) nodular shadow in the left kidney. The nodular shadow exhibited slightly lower density than the surrounding tissue as well as enhancement, with a portion protruding into the renal sinus region. Histological and immunohistochemical analyses of the biopsy specimen from the mass indicated a well-differentiated NET. After analysis of this case, we performed a literature review and herein discuss various techniques for imaging and pathological diagnosis of renal NETs. Additionally, we provide insights into the treatment options and prognosis for affected patients. By combining this case study with the existing published literature, we aim to offer a valuable reference for clinicians treatment patients diagnosed with renal NETs.
Performance indicators framework for assessment of national libraries using the analytic hierarchy process
Authors: Hassanzadeh Elaheh
Published: September 2023

The National Library and Archives of Iran is the most important library in the country, taking on tasks such as providing and protecting the written and unwritten national heritage and organizing the services of other libraries in Iran. An assessment of the National Library and Archives of Iran is critical to understanding how the organization contributes to organizational and strategic goals. This article aims to show the rankings and priorities of performance indicators based on the four perspectives of the balanced scorecard framework (resources, access and infrastructure; use; efficiency; and potentials and development) and with use of the analytic hierarchy process. The perspectives of resources, use, efficiency, and potentials and development were rated. The top performance indicators included: ‘Level of user satisfaction with searching the National Library and Archives of Iran’s website’, ‘Percentage of acquired books in any medium and multimedia resources entered by legal deposit’ and ‘Qualitative evaluation using case studies of use and value of the collection and services’. Pervious literature shows various applications of a joint balanced scorecard and analytic hierarchy process. This study applies this integrated framework throughout an organization in a new service field.
Stabilizing unstable periodic orbit of unknown fractional-order systems via adaptive delayed feedback control
Authors: Yaghooti Bahram , Safavigerdini Kaveh , Hajiloo Reza , Salarieh Hassan
Published: September 2023

This article presents an adaptive nonlinear delayed feedback control scheme for stabilizing the unstable periodic orbit of unknown fractional-order chaotic systems. The proposed control framework uses the Lyapunov approach and sliding mode control technique to guarantee that the closed-loop system is asymptotically stable on a periodic trajectory sufficiently close to the unstable periodic orbit of the system. The proposed method has two significant advantages. First, it employs a direct adaptive control method, making it easy to implement this method on systems with unknown parameters. Second, the framework requires only the period of the unstable periodic orbit. The robustness of the closed-loop system against system uncertainties and external disturbances with unknown bounds is guaranteed. Simulations on fractional-order duffing and gyro systems are used to illustrate the effectiveness of the theoretical results. The simulation results demonstrate that our approach outperforms the previously developed linear feedback control method for stabilizing unstable periodic orbits in fractional-order chaotic systems, particularly in reducing steady-state error and achieving faster convergence of tracking error.
Adoption Behaviour of Digital Technologies by Firms: Evidence from South Africa’s Manufacturing Sector
Authors: Sichoongwe Kiru
Published: September 2023

The manufacturing industry is vital to the growth and development of most countries. This study investigates the adoption behaviour of digital technologies by manufacturing firms in South Africa. The study employs econometric model to analyze a total of 516 firms in the manufacturing sector. The probit results show that innovation of the firm and firm size have a significant effect on both the current and the expected adoption of digital technologies, whereas capital ownership correlate positively with the current adoption. Likewise, exports and digital-related infrastructure are found to correlate positively with the expected digital technology adoption for customer relations business function. Similarly, study results from the transition probability matrix reveals that a significant persistency pattern is prevalent in all the three business functions of the firms, namely, supplier relations, customer relations and product development. However, product development has considerably higher persistency compared to other types of the firm business functions. Several policies, including supporting business innovation, easy access to core digital tools by firms, developing institutional and systemic support mechanisms, are recommended to encourage firms to engage in digital technology activities.
Issues of identity, perceptions and isolation: An interpretative phenomenological analysis of women’s experience of Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome
Authors: Gilfillan Rebecca , Carter Pelham
Published: September 2023

The objective of this study was to explore the personal experience of women with MRKH, a rare condition characterised by congenital abnormalities of the genital tract. There are very few qualitative studies into the lived experiences of women with MRKH. Interviews were conducted with 13 women with MRKH and analysed using interpretative phenomenological analysis. Four superordinate themes are discovered: maintaining a viable female identity; acceptance and coping; normality, secrecy and shame and the isolating impact of a lack of knowledge amongst the medical profession. This study also suggests that societal ideals of a ‘normal woman’ are influencing how MRKH impacts on the self-experienced psychological health. It is suggested that the psychological wellbeing of women with MRKH could be improved with continued multidisciplinary support beyond the initial diagnosis and alongside any vaginal correction.
Frequent native language use supports phonemic and semantic verbal fluency in L1 and L2: An extended analysis of verbal fluency task performance in an L1 language attrition population
Authors: Lehtinen Nana , Kautto Anna , Renvall Kati
Published: September 2023

Purpose:

Verbal fluency (VF) tasks are an efficient tool for exploring lexical retrieval. Attriters generally produce fewer words in semantic categories than monolinguals, but the processes underlying attriters’ lexical retrieval remain unclear. Phonemic tasks are scarcely applied in language attrition studies. We aim to identify processes underlying attriters’ phonemic verbal fluency (PVF) and semantic verbal fluency (SVF) performance by extending the analysis beyond total scores in the first (L1) and second (L2) language.

Design:

We modeled total scores and temporal aspects of task performance in L1 and L2 for the attriters, with L1 use and length of residence (LoR) as predictors. We analyzed the number and types of errors between languages and compared L1 task performance with a matched monolingual group.

Data and analysis:

Attriters’ ( N = 38) phonemic and semantic task performance in L1 (Finnish) and L2 (English) were modeled, and results were contrasted to a matched monolingual control group ( N = 50).

Findings:

Attriters demonstrated strong proficiency in L1 and similar lexical retrieval processes in L1 and L2 after 20 years of immersive L2 exposure. Frequent L1 use supported overall performance but slowed performance down in both languages. Compared with monolinguals, attriters show a disadvantage in SVF, but not due to slower initiation. Instead, attriters rely more on rapid L1 retrieval than monolinguals.

Originality:

Prior research on VF tasks in language attrition populations has mainly focused on SVF total scores in L1. Our investigation explores underlying mechanisms of L1 and L2 task performance in PVF and SVF within a language attrition population and contrasts L1 performance to a matched monolingual group performance.

Implications:

This study demonstrates the importance of investigating L2 alongside L1 in language attrition studies for a holistic approach to language processing strategies. Our findings enhance understanding of the processes underlying VF task performance, emphasizing the significance of VF task early-stage performance.
External validation of the first prognostic nomogram for older adults with cancer
Authors: Tay Yu Ling , Ong Whee Sze , Liew Sherilyn Zi Hui , Chowdhury Anupama Roy , Chan Johan , Ramalingam Mothi Babu , Rajasekaran Tanujaa , Tan Tira J. , Krishna Lalit , Lai Olive , Chow Agnes Lai Yin , Chen Simon , Kanesvaran Ravindran
Published: September 2023

Background:

The geriatric oncology population tends to be complex because of multimorbidity, functional and cognitive decline, malnutrition and social frailty. Prognostic indices for predicting survival of elderly cancer patients to guide treatment remain scarce. A nomogram based on all domains of the geriatric assessment was previously developed at the National Cancer Centre Singapore (NCCS) to predict overall survival (OS) in elderly cancer patients. This nomogram comprised of six variables (age, eastern cooperative oncology group performance status, disease stage, geriatric depression scale (GDS), DETERMINE nutritional index and serum albumin).

Objectives:

To externally validate the NCCS prognostic nomogram.

Design:

This is a prospective cohort study.

Methods:

The nomogram was developed based on a training cohort of 249 patients aged ⩾70 years who attended the NCCS outpatient geriatric oncology clinic between May 2007 and November 2010. External validation of the nomogram using the Royston and Altman approach was carried out on an independent testing cohort of 252 patients from the same clinic between July 2015 and June 2017. Model misspecification, discrimination and calibration were assessed.

Results:

Median OS of the testing cohort was 3.1 years, which was significantly higher than the corresponding 1.0 year for the training cohort (log-rank p < 0.001). The nomogram achieved a high level of discrimination in the testing cohort (0.7112), comparable to the training cohort (0.7108). Predicted death probabilities were generally well calibrated with the observed death probabilities, as the joint test of calibration-in-the-large estimates at year 1, 2 and 3 from zeros and calibration slope from one was insignificant with p = 0.432. There were model misspecifications in GDS and serum albumin.

Conclusion:

This study externally validated the prognostic nomogram in an independent cohort of geriatric oncology patients. This supports the use of this nomogram in clinical practice.
Two Decades of Accounting Fraud Research: The Missing Meso-Level Analysis
Authors: Lokanan Mark E. , Sharma Prerna
Published: September 2023

Drawing on an analysis of 208 articles, this paper argues that while the fraud literature varies on the diagnosis of fraud, it is rooted in a common narrative as to its nature and causes. Specifically, this paper adopts an investigative approach to understand how fraud is often researched and shapes audit policies and practices. The findings reveal that fraud is generally looked at as an individual and/or organizational phenomenon, thereby allowing the meso-level of analysis to escape scrutiny. A gap, therefore, exists in being able to detect fraud at the meso-level, such as in financial services (i.e., LIBOR rigging). A meso-level analysis of fraud will allow researchers to highlight problems across the general field like the banks rigging the LIBOR or distorting the currency market as in the forex scandal. A meso-level analysis of fraud is important because it highlights the contagious behavior across the field and offers insights for fraud prevention and detection. Recognizing this unique epistemology will allow researchers to uncover new knowledge and not remain wedded to a reified understanding of fraud and fraud risks. Policymakers can derive insights and draft policies that reflect practitioners’ needs.
Cellular Bone Matrix in Spine Surgery – Are They Worth the Risk: A Systematic Review
Authors: Lambrechts Mark J. , Issa Tariq Z. , Mazmudar Aditya , Lee Yunsoo , Toci Gregory R. , D’Antonio Nicholas D. , Schilken Meghan , Lingenfelter Kenneth , Kepler Christopher K. , Schroeder Gregory D. , Vaccaro Alexander R.
Published: September 2023

Study Design

Systematic Review.

Objective

To review the literature for complications and outcomes after the implantation of cellular bone matrix (CBM) during spine fusion.

Methods

The PubMed database was queried from inception to January 31, 2023 for any articles that discussed the role of and identified a specific CBM in spinal fusion procedures. Adverse events, reoperations, methods, and fusion rates were collected from all studies and reported.

Results

Six hundred articles were identified, of which 19 were included that reported outcomes of 7 different CBM products. Seven studies evaluated lumbar fusion, 11 evaluated cervical fusion, and 1 study reported adverse events of a single CBM product. Only 4 studies were comparative studies while others were limited to case series. Fusion rates ranged from 68% to 98.7% in the lumbar spine and 87% to 100% in the cervical spine, although criteria for radiographic fusion was variable. While 7 studies reported no adverse events, there was no strict consensus on what constituted a complication. One study reported catastrophic disseminated tuberculosis from donor contaminated CBM. The authors of 14 studies had conflicts of interest with either the manufacturer or distributor for their analyzed CBM.

Conclusions

Current evidence regarding the use of cellular bone matrix as an osteobiologic during spine surgery is weak and limited to low-grade non-comparative studies subject to industry funding. While reported fusion rates are high, the risk of severe complications should not be overlooked. Further large clinical trials are required to elucidate whether the CBMs offer any benefits that outweigh the risks.
Socio-demographic and health-related determinants of patients’ overall rating and experiences of cancer care
Authors: Arditi Chantal , Eicher Manuela , Junod Julien , Peytremann-Bridevaux Isabelle
Published: September 2023

Background

Understanding how patient-reported experiences of care and overall rating of care vary among patients with different characteristics is useful to help interpret results from patient experience surveys and design targeted improvement interventions. The primary objective of this paper was to identify the socio-demographic and health-related characteristics independently associated with overall rating of cancer care. The secondary objective was to explore if and how these characteristics were associated with specific experiences of cancer care.

Methods

This cross-sectional multicenter study analyzed self-reported data collected from 2696 patients diagnosed with breast, prostate, lung, colorectal, skin, or hematological cancer from four large hospitals in French-speaking Switzerland. Multivariate logistic regressions with purposeful stepwise selection of independent variables were used to identify the socio-demographic and health-related characteristics independently associated with overall rating of cancer care in the primary analyses. In the secondary analyses, we ran the multivariate model from the primary analyses with specific experiences of care as outcomes to estimate the adjusted odds ratios (OR) and 95% confidence intervals (CI) of the selected characteristics.

Results

Respondents’ mean rating of overall cancer care was 8.5 on a scale from 0 to 10, with 17% categorized as reporting a low rating (0–7 rating). Being a woman (OR 1.43, 95% CI 1.12–1.83), not being Swiss (OR 1.47, 95% CI 1.12–1.94), reporting lower health literacy (OR 1.95, 95% CI 1.54–2.47), preferring making medical decisions alone (OR 1.92, 95% CI 1.38–2.67), having forgone care due to cost (OR 1.72, 95% CI 1.29–2.29), having used complementary medicine (OR 1.55, 95% CI 1.22–1.97), and reporting poorer health (OR 3.12, 95% CI 2.17–4.50) were all independently associated with a low rating of overall cancer care. Poorer health, lower health literacy, and having forgone care were the three characteristics most often associated with problematic experiences of care.

Conclusions

Our results identified several patient characteristics consistently associated with lower overall rating of care and specific experiences of cancer care. Among these determinants, health literacy and financial hardship emerged as key recurring factors shaping poor patient experiences that should be prioritized for attention by cancer care services.
Assessing changes in incubation period, serial interval, and generation time of SARS-CoV-2 variants of concern: a systematic review and meta-analysis
Authors: Xu Xiangyanyu , Wu Yanpeng , Kummer Allisandra G. , Zhao Yuchen , Hu Zexin , Wang Yan , Liu Hengcong , Ajelli Marco , Yu Hongjie
Published: September 2023

Background

After the first COVID-19 wave caused by the ancestral lineage, the pandemic has been fueled from the continuous emergence of new SARS-CoV-2 variants. Understanding key time-to-event periods for each emerging variant of concern is critical as it can provide insights into the future trajectory of the virus and help inform outbreak preparedness and response planning. Here, we aim to examine how the incubation period, serial interval, and generation time have changed from the ancestral SARS-CoV-2 lineage to different variants of concern.

Methods

We conducted a systematic review and meta-analysis that synthesized the estimates of incubation period, serial interval, and generation time (both realized and intrinsic) for the ancestral lineage, Alpha, Beta, and Omicron variants of SARS-CoV-2.

Results

Our study included 280 records obtained from 147 household studies, contact tracing studies, or studies where epidemiological links were known. With each emerging variant, we found a progressive shortening of each of the analyzed key time-to-event periods, although we did not find statistically significant differences between the Omicron subvariants. We found that Omicron BA.1 had the shortest pooled estimates for the incubation period (3.49 days, 95% CI: 3.13–4.86 days), Omicron BA.5 for the serial interval (2.37 days, 95% CI: 1.71–3.04 days), and Omicron BA.1 for the realized generation time (2.99 days, 95% CI: 2.48–3.49 days). Only one estimate for the intrinsic generation time was available for Omicron subvariants: 6.84 days (95% CrI: 5.72–8.60 days) for Omicron BA.1. The ancestral lineage had the highest pooled estimates for each investigated key time-to-event period. We also observed shorter pooled estimates for the serial interval compared to the incubation period across the virus lineages. When pooling the estimates across different virus lineages, we found considerable heterogeneities (I2 > 80%; I2 refers to the percentage of total variation across studies that is due to heterogeneity rather than chance), possibly resulting from heterogeneities between the different study populations (e.g., deployed interventions, social behavior, demographic characteristics).

Conclusions

Our study supports the importance of conducting contact tracing and epidemiological investigations to monitor changes in SARS-CoV-2 transmission patterns. Our findings highlight a progressive shortening of the incubation period, serial interval, and generation time, which can lead to epidemics that spread faster, with larger peak incidence, and harder to control. We also consistently found a shorter serial interval than incubation period, suggesting that a key feature of SARS-CoV-2 is the potential for pre-symptomatic transmission. These observations are instrumental to plan for future COVID-19 waves.
The neutrophil–lymphocyte ratio as a risk factor for all-cause and cardiovascular mortality among individuals with diabetes: evidence from the NHANES 2003–2016
Authors: Dong Gaiying , Gan Man , Xu Shilin , Xie Yanlin , Zhou Ming , Wu Liangliang
Published: September 2023

Background

Evidence regarding the neutrophil–lymphocyte ratio (NLR) and mortality risk in diabetes patients is scarce. This study investigated the relationship of the NLR with all-cause and cardiovascular mortality risk in diabetes patients.

Methods

Diabetes patients (n = 3251) from seven National Health and Nutrition Examination Survey (NHANES) cycles (2003–2016) were included in this study. The cause of death and mortality status of the participants were obtained from National Death Index records. Restricted cubic spline (RCS) was used to visualize the association of the NLR with mortality risk. The maximally selected rank statistics method (MSRSM) was used to determine the optimal NLR cutoff value corresponding to the most significant association with survival outcomes. Weighted multivariable Cox regression models and subgroup analyses were adopted to assess the association of the NLR with all-cause and cardiovascular mortality. Time-dependent receiver operating characteristic curve (ROC) analysis was conducted to evaluate the accuracy of the NLR in predicting survival outcomes.

Results

During a median follow-up of 91 months (interquartile range, 55–131 months), 896 (27.5%) of the 3251 diabetes patients died, including 261 (8.0%) with cardiovascular deaths and 635 (19.5%) with noncardiovascular deaths. The RCS regression analysis showed a positive linear association between the NLR and all-cause and cardiovascular mortality (both p > 0.05 for nonlinearity) in diabetes patients. Participants were divided into higher (> 3.48) and lower (≤ 3.48) NLR groups according to the MSRSM. In the multivariable-adjusted model, compared with participants with a lower NLR, those with a higher NLR had a significantly higher risk of both all-cause (HR 2.03, 95% confidence interval (CI) 1.64–2.51, p < 0.0001) and cardiovascular mortality (HR 2.76, 95% CI 1.84–4.14, p < 0.0001). The association was consistent in subgroup analyses based on age, sex, smoking status, drinking status, and hypertension, with no significant interaction between the aforementioned characteristics and the NLR (p interaction > 0.05). The time-dependent ROC curve showed that the areas under the curve of the 1-, 3-, 5-, and 10-year survival rates were 0.72, 0.66, 0.64, and 0.64 for all-cause mortality and 0.69, 0.71, 0.69 and 0.65, respectively, for cardiovascular mortality.

Conclusion

An elevated NLR is independently associated with increased all-cause and cardiovascular mortality in diabetes patients.
Joint-level responses to tofacitinib and methotrexate: a post hoc analysis of data from ORAL Start
Authors: Ciurea Adrian , Distler Oliver , Kwok Kenneth , Jo Hyejin , Wang Lisy , Killeen Tim , Ospelt Caroline , Frank Bertoncelj Mojca
Published: September 2023

Background

Rheumatoid arthritis (RA) has a variable impact on different synovial joints, with inflammation being more commonly observed in some joints than others. Emerging evidence suggests that the anatomical variation in pathophysiology could result in differential responses to treatments across the joints, both within and between modes of action. This analysis aimed to characterize joint-specific responses to tofacitinib and methotrexate monotherapy in patients with RA.

Methods

This was a post hoc analysis of data from the phase III trial ORAL Start (NCT01039688), in methotrexate-naïve patients with RA. A paired joint pathology score (PJPS), derived from bilateral tender/swollen joint counts, was calculated. The percentage change from baseline in PJPS (%∆PJPS) and treatment-specific responses (tofacitinib 5 and 10 mg twice daily [BID] vs methotrexate; tofacitinib 5 vs 10 mg BID) for each patient joint pair, except for those with baseline/post-baseline PJPS = 0, were calculated at month 3, month 6, and month 12. Radiographic progression was similarly assessed using the Modified Total Sharp Score at month 6 and month 12.

Results

In methotrexate-naïve patients, differences in %∆PJPS demonstrated greater responses with tofacitinib vs methotrexate in most joint locations. Lesser responses with tofacitinib vs methotrexate were observed in most joints of the feet, particularly at month 12. Despite this, radiographic progression at month 12 was significantly worse in the foot (and metacarpophalangeal) joints of patients receiving methotrexate vs tofacitinib.

Conclusion

We observed variation in joint-specific responses with tofacitinib and methotrexate monotherapy. Despite a proximal–distal efficacy gradient, with better clinical responses in the feet, patients receiving methotrexate monotherapy demonstrated more radiographic progression in the foot joints compared with those receiving tofacitinib. These findings suggest that body site- and therapy-specific characteristics may interact to produce differential treatment responses.

Trial registration

ClinicalTrials.gov, NCT01039688.
Will metformin use lead to a decreased risk of thyroid cancer? A systematic review and meta-analyses
Authors: Li Hailong , Chen Yue , Hu Lei , Yang Wenzhi , Gao Zongshi , Liu Mengqing , Tao Hui , Li Jie
Published: September 2023

Background

It has been reported that metformin use may reduce the risk of thyroid cancer, but existing studies have generated inconsistent results. The purpose of this study was to investigate such association between metformin use and the risk of thyroid cancer.

Methods

Studies of metformin use for the risk of thyroid cancer were searched in Web of Science, PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, China Biomedical Database, Wanfang Data, and Chinese Scientific Journals Database (VIP) from the establishment date to December 2022. Newcastle–Ottawa scale is adopted for assessing the methodological quality of included studies, and the inter-study heterogeneity was assessed by using the I-squared statistic. Combined odds ratios (ORs) with the corresponding 95% confidence intervals (CIs) were calculated through either fixed-effects or random-effects model according to the heterogeneity. Besides, subgroup analyses, sensitivity analyses and test for publication bias were conducted.

Results

Five studies involving 1,713,528 participants were enrolled in the qualitative and quantitative synthesis. The result of the meta-analyses showed that metformin use was associated with a statistically significant lower risk of thyroid cancer (pooled OR = 0.68, 95% CI = 0.50–0.91, P = 0.011). Moreover, in the subgroup analysis, we found that the use of metformin may also aid in the prevention of thyroid cancer in Eastern population (pooled OR = 0.55, 95% CI = 0.35–0.88, P = 0.012) rather than Western population (pooled OR = 0.89, 95% CI = 0.52–1.54, P = 0.685). Sensitivity analysis suggested the results of this meta-analyses were relatively stable. No publication bias was detected.

Conclusion

Metformin use is beneficial for reducing the risk of thyroid cancer. For further investigation, more well-designed studies are still needed to elucidate the association between metformin use and the risk of thyroid cancer.
Mechanisms and predictors of menses resumption once normal weight is reached in anorexia nervosa
Authors: Galusca Bogdan , Gay Aurélia , Belleton Gwenaëlle , Eisinger Martin , Massoubre Catherine , Lang François , Grouselle Dominique , Estour Bruno , Germain Natacha
Published: September 2023

Background

In cases of Anorexia Nervosa (AN), achieving weight gain recovery beyond the lower limits set by the World Health Organization and normalizing classical nutritional markers appears to be essential for most patients. However, this is not always adequate to restore menstrual cycles. This discrepancy can cause concern for both patients and healthcare providers, and can impact the medical management of these individuals. Thus, the purpose of this study was to assess the ability of anthropometric and hormonal factors to predict the resumption of menstrual cycles in individuals with anorexia nervosa upon reaching a normal body weight.

Method

Patients with AN who had achieved a normal Body Mass Index but had not yet resumed their menstrual cycles (referred to as ANRec) were evaluated on two occasions: first at visit 1 and then again 6 months later, provided their body weight remained stable over this period (visit 2). Among the 46 ANRec patients who reached visit 2, they were categorized into two groups: 20 with persistent amenorrhea (PA-ANRec) and 26 who had regained their menstrual cycles (RM-ANRec). Anthropometric measurements, several hormone levels, Luteinizing Hormone (LH) pulsatility over a 4-h period, and LH response to gonadotropin-releasing hormone injection (LH/GnRH) were then compared between the two groups at visit 1.

Results

Patients in the RM-ANRec group exhibited higher levels of follicular stimulating hormone, estradiol, inhibin B, LH/GnRH, and lower levels of ghrelin compared to those in the PA-ANRec group. Analysis of Receiver Operating Characteristic curves indicated that having ≥ 2 LH pulses over a 4-h period, LH/GnRH levels ≥ 33 IU/l, and inhibin B levels > 63 pg/ml predicted the resumption of menstrual cycles with a high degree of specificity (87%, 100%, and 100%, respectively) and sensitivity (82%, 80%, and 79%, respectively).

Conclusions

These three hormonal tests, of which two are straightforward to perform, demonstrated a high predictive accuracy for the resumption of menstrual cycles. They could offer valuable support for the management of individuals with AN upon achieving normalized weight. Negative results from these tests could assist clinicians and patients in maintaining their efforts to attain individualized metabolic targets.

Trial registration

IORG0004981.
“Quick Response” Economic Stimulus: The Effect of Small-Value Digital Coupons on Spending
Authors: Xing Jianwei , Zou Eric Yongchen , Yin Zhentao , Wang Yong , Li Zhenhua
Published: September 2023

We study a new consumption stimulus program implemented by a large Chinese city that leverages mobile payment platforms to dispense massive amounts of small-value digital coupons. Exploiting a “rush” design of the dispensing process in which over 1 million program participants compete for coupons on a first-come, first-served basis through a digital portal, we estimate that winning coupons increases weekly out-of-pocket spending by US$3 for every US$1 in government subsidy. Coupon-winning consumers practice inter-temporal substitution by moving up purchases that would have been made four months in the future. Customer flow analysis suggests that coupons distort consumption toward pricier options. (JEL D15, E21, E42, H71, O18, P25, P36)