bluuebunny/crossref_metadata_2025 huggingface dataset:
Amplification of Heart Sounds Using Digital Stethoscope in Simulation-Based Neonatal Resuscitation
Authors: Das Anirudha , Adams Kim , Stoicoiu Shelagh , Kunhiabdullah Shafeeque , Mathew Ajith
Published: July 2023

Objective The accuracy, timeliness, and reliability of the current methods of heart rate (HR) determination in neonatal resuscitation are debatable, each having its own limitations. We aim to compare three methods of HR assessment: (1) traditional stethoscope, (2) electrocardiogram and traditional stethoscope, and (3) digital stethoscope with loudspeaker amplification of heart sounds.

Study Design This was a simulated crossover experiment using a high-fidelity manikin. Each team with a physician, a nurse, and a respiratory therapist performed the resuscitations using the three methods (three different scenarios) in different order. The person controlling the HR via manikin controller was blinded, but the single recorder and the providers were not.

Results Eighteen resuscitations were completed (six teams of three methods each). The time to first HR recording (p < 0.001), total number of HR recorded (p < 0.001), and time to recognize dips in HR was significantly improved in the digital stethoscope group (p = 0.009).

Conclusion Use of digital stethoscope with amplification improved documentation of HR and earlier recognition of HR changes.

Key Points
Meaning patterns of the NP de VP construction in modern Chinese: approaches of covarying collexeme analysis and hierarchical cluster analysis
Authors: Zhou Jiangping
Published: July 2023

The NP de VP construction in modern Chinese has been of constant interest to theoretical linguists. Previous studies foregrounded word classes of lexical items in the VP slot, semantic relationships between the VP and the NP, and lexical items that could fill both the VP and the NP slots of the construction. However, in this research, we highlighted typical meanings of this construction and the denoted meaning patterns of lexical items in both the VP and the NP slots by drawing on the covarying collexeme analysis and the hierarchical cluster analysis, respectively. The findings demonstrate that typical meanings of this construction generally include the pairing of “regulations” in the NP slot and “implementation” in the VP slot, the pairing of “systems” in the NP slot and “establishment” in the VP slot, and the pairing of “results” in the NP slot and “achievement” in VP slot. Meaning patterns of the lexical items with significant attraction in the VP slot briefly incorporate such clusters as “cognition”, “augmentation”, “implementation”, “achievement”, “establishment”, and “report”; and those in the NP slot generally include such patterns as “internal traits”, “medical names”, “regulations”, “results”, “systems”, and “business”. The significance of this study lies in that it scientifically identified instances that are capable of expressing the typical meaning of the NP de VP construction and uncovered objectively and precisely the denoted meaning patterns of lexical items in the VP slot and the NP slot of the construction.
How a cloud of insects is (and isn’t) like a magnet
Authors: Miller Johanna
Published: July 2023

The renormalization group, a powerful method that uses the tools of quantum field theory, has found a place in biophysics.
Squaring the quantum computing circle
Authors: Elby Andrew
Published: July 2023

Quantum Computing: From Alice to Bob, Alice Flarend and Bob Hilborn, Oxford U. Press, 2022, $80.00
Me ora te Ngāhere: visioning forest health through an Indigenous biocultural lens
Authors: Reihana Kiri R. , Lyver Phil O’B. , Gormley Andrew , Younger Megan , Harcourt Nicola , Cox Morgan , Wilcox Mahuru , Innes John
Published: July 2023

Explanatory note The following text is described in the Ngāti Rangi mita (dialect), although concepts may be similar e.g. Mouri = Mauri, the spelling reflects the tribal vernacular. Context National biodiversity monitoring in Aotearoa, New Zealand is primarily conducted within Eurocentric conservation frameworks. At present, Māori (Indigenous Peoples of Aotearoa) have limited interaction and role within these programs. Aims We explored a biocultural monitoring tool based on mātauranga (Māori knowledge) to inform Ngāti Rangi (a central North Island Māori tribe) about the health of spatially separate, but ecologically similar, forests within the Ngāti Rangi tribal estate. Methods We did a series of noho taiao (community workshops) and one on one interviews to collect the values that expressed a Ngāti Rangi world view, to measure the health of the ngahere (forest). Gradients and indicators were developed to apply a measure of ngahere health. The metrics were trialled in three forests to create a group understanding. The interviews provided an observation of ngahere health and assessed intergenerational differences in how forest health is perceived. Key results Rongoā, Manu, Ngahere, Wai, and Tangata were themes prioritised by Ngāti Rangi. Biocultural indicators revealed moderate health across the three forest sites, whilst the more ecological-based indicators indicated moderate to strong levels of health. Age-related differences in how forest condition indicated evidence of an inter-generational shift. However, it was agreed that the forest health had declined over the past 30–40 years. Conclusions A full sensory evaluation of forest health facilitates a deep relational connection to place, which coupled with philosophies such as reciprocity and whakapapa, are vital features of a biocultural conservation approach. Implications Cultural–ecological constructs are key in relationships between Indigenous Peoples and their environments. Biocultural approaches can contribute to reversing the current biodiversity crisis, through partnering in placed-based solutions.
Painlevé analysis, infinite dimensional symmetry group and symmetry reductions for the (2+1)-dimensional Korteweg–de Vries–Sawada–Kotera–Ramani equation
Authors: Ren Bo , Lin Ji , Wang Wan-Li
Published: July 2023

The (2+1)-dimensional Korteweg–de Vries–Sawada–Kotera–Ramani (KdVSKR) equation is studied by the singularity structure analysis. It is proven that it admits the Painlevé property. The Lie algebras which depend on three arbitrary functions of time t are obtained by the Lie point symmetry method. It is shown that the KdVSKR equation possesses an infinite-dimensional Kac–Moody–Virasoro symmetry algebra. By selecting first-order polynomials in t, a finite-dimensional subalgebra of physical transformations is studied. The commutation relations of the subalgebra, which have been established by selecting the Laurent polynomials in t, are calculated. This symmetry constitutes a centerless Virasoro algebra which has been widely used in the field of physics. Meanwhile, the similarity reduction solutions of the model are studied by means of the Lie point symmetry theory.
Systematic calculations of cluster radioactivity half-lives with a screened electrostatic barrier*
Authors: Liu Xiao , Jiang Jie-Dong , Qi Lin-Jing , Xu Yang-Yang , Wu Xi-Jun , Li Xiao-Hua
Published: July 2023

In this study, based on Wentzel-Kramers-Brillouin theory, we systematically investigate the cluster radioactivity half-lives of 22 nuclei ranging from

to

using a phenomenological model that considers the screened electrostatic effect of the Coulomb potential. In this model, there are two adjustable parameters, t and g, which are related to the screened electrostatic barrier and the strength of the spectroscopic factor, respectively. The calculated results indicate that this model can effectively reproduce the experimental data, with a corresponding root-mean-square deviation of 0.660. In addition, we extend this model to predict the half-lives of possible cluster radioactive candidates whose cluster radioactivities are energetically allowed or observed but not yet quantified in the evaluated nuclear properties table NUBASE2020. The predicted results are consistent with those obtained using other theoretical models and/or empirical formulas, including the universal decay law proposed by Qi et al. [Phys. Rev. C 80, 044326 (2009)], a semi-empirical model for both α decay and cluster radioactivity proposed by Santhosh et al. [J. Phys. G 35, 085102 (2008)], and a unified formula for the half-lives of α decay and cluster radioactivity proposed by Ni et al. [Phys. Rev. C 78, 044310 (2008)].
Structure-function dynamics of engineered, modular neuronal networks with controllable afferent-efferent connectivity
Authors: Winter-Hjelm Nicolai , Brune Tomren Åste , Sikorski Pawel , Sandvig Axel , Sandvig Ioanna
Published: July 2023

Objective. Microfluidic devices interfaced with microelectrode arrays have in recent years emerged as powerful platforms for studying and manipulating in vitro neuronal networks at the micro- and mesoscale. By segregating neuronal populations using microchannels only permissible to axons, neuronal networks can be designed to mimic the highly organized, modular topology of neuronal assemblies in the brain. However, little is known about how the underlying topological features of such engineered neuronal networks contribute to their functional profile. To start addressing this question, a key parameter is control of afferent or efferent connectivity within the network. Approach. In this study, we show that a microfluidic device featuring axon guiding channels with geometrical constraints inspired by a Tesla valve effectively promotes unidirectional axonal outgrowth between neuronal nodes, thereby enabling us to control afferent connectivity. Main results. Our results moreover indicate that these networks exhibit a more efficient network organization with higher modularity compared to single nodal controls. We verified this by applying designer viral tools to fluorescently label the neurons to visualize the structure of the networks, combined with extracellular electrophysiological recordings using embedded nanoporous microelectrodes to study the functional dynamics of these networks during maturation. We furthermore show that electrical stimulations of the networks induce signals selectively transmitted in a feedforward fashion between the neuronal populations. Significance. A key advantage with our microdevice is the ability to longitudinally study and manipulate both the structure and function of neuronal networks with high accuracy. This model system has the potential to provide novel insights into the development, topological organization, and neuroplasticity mechanisms of neuronal assemblies at the micro- and mesoscale in healthy and perturbed conditions.
Hydrodynamic Model due to Reclamation in Lamong Bay
Authors: Sujantoko  , Mustain M , Wahyudi  , Ikhwani H
Published: July 2023

PT. Teluk Lamong Terminal is one of the busiest port terminals in Indonesia. Such conditions require the development of the facility area for reclamation. This reclamation can potentially change the seabed’s contours and current patterns in the Lamong bay area of Surabaya. Therefore, the Author will conduct a research study to determine the impact of reclamation on the speed and current pattern of the existing and post-reclamation conditions in Lamong bay, Surabaya. This research conducted numerical modeling with Delft3D software. The simulation results show that the current pattern at the highest tide in the existing and reclamation models tends to have a dominant current direction from east to the northwest in the Madura strait. In contrast, some currents from the Madura strait are deflected into the Lamong bay area. On the other hand, during the lowest low tide conditions, both existing and reclamation conditions, the current pattern has a dominant direction coming from the northwest to the east, and the current in the Lamong bay area tends to exit or towards the Madura strait. There is an increase or decrease in current velocity when reclamation is carried out in each tidal condition. The highest increase in current velocity occurs at high tide with a value of 0.02 m/s, while the highest decrease in current velocity occurs at the high tide of 0.13 m/s. At the lowest ebb conditions, the highest current speed increase is 0.12 m/s, and the highest current velocity decrease is 0.03 m/s.
Tidal impacts on the discharge division and freshwater transport in the Berau Delta, East Kalimantan, Indonesia
Authors: Tarya A , Rahmatulloh R , Ningsih N S
Published: July 2023

Flow division at bifurcations is important in controlling material carried from the terrestrial to the coastal zone in tidally influenced deltas. The present study aims to identify the impacts of tides on flow division and freshwater transport in the Berau Delta, East Kalimantan. The Princeton Ocean Model (POM) is applied to simulate the hydrodynamics with forcing from river discharges and tides. Tides at open seas and observed river discharge at upstream locations were used to set model boundaries. Model validation was accomplished by comparing measurements of tidal elevation and salinity time series with model results. The model results reproduce the observed in temporal variations of tidal elevation and salinity. Model results highlight that the tidal amplitude has large influence on discharge division at the tidal junction. Tides enhance equal subtidal flow distribution in the river junctions, with the influence of tide is 15% on subtidal flow distribution in the bifurcations. Freshwater discharge at the Berau Delta flows mainly to the north and middle outlet with 90% of the total discharge. Based on an analysis model results, the decomposition of freshwater transport reveals that advection and tidal pumping are major factor, which are fluctuate in fortnight cycle.
Requisites on material viscoelasticity for exceptional points in passive dynamical systems
Authors: Gupta Abhishek , Thevamaran Ramathasan
Published: July 2023

Recent progress in non-Hermitian physics and the notion of exceptional point (EP) degeneracies in elastodynamics have led to the development of novel metamaterials for the control of elastic wave propagation, hypersensitive sensors, and actuators. The emergence of EPs in a parity-time symmetric system relies on judiciously engineered balanced gain and loss mechanisms. Creating gain requires complex circuits and amplification mechanisms, making engineering applications challenging. Here, we report strategies to achieve EPs in passive non-Hermitian elastodynamic systems with differential loss derived from viscoelastic materials. We compare different viscoelastic material models and show that the EP emerges only when the frequency-dependent loss-tangent of the viscoelastic material remains nearly constant in the frequency range of operation. This type of loss tangent occurs in materials that undergo stress-relaxation over a broad spectrum of relaxation times, for example, materials that follow the Kelvin–Voigt fractional derivative (KVFD) model. Using dynamic mechanical analysis, we show that a few common viscoelastic elastomers, such as polydimethylsiloxane and polyurethane rubber, follow the KVFD behavior such that the loss tangent becomes almost constant after a particular frequency. The material models we present and the demonstration of the potential of a widely available material system in creating EPs pave the way for developing non-Hermitian metamaterials with hypersensitivity to perturbations or enhanced emissivity.
Glymphatic function plays a protective role in ageing-related cognitive decline
Authors: Wang Junjun , Zhou Ying , Zhang Kemeng , Ran Wang , Zhu Xiao , Zhong Wansi , Chen Yuping , Li Jiaping , Sun Jianzhong , Lou Min
Published: July 2023

Objective

The glymphatic pathway, characterised as a cerebral drainage system, influences cognitive function in neurodegenerative diseases; however, evidence is limited in a normal ageing population. The aim of this study was to investigate the effect of glymphatic function on ageing-related cognitive decline.

Methods

We retrospectively reviewed the Cognitive Impairment, Retinopathy, and Cerebrovascular Lesions in the Elderly (CIRCLE) study, and participants with multi-model magnetic resonance imaging (MRI) scans and Mini-Mental State Examinations (MMSE) were enrolled. Glymphatic function was evaluated via the diffusion tensor imaging along the perivascular space (DTI-ALPS) index. Regression models were used to estimate the impact of the DTI-ALPS index on cognitive decline cross-sectionally and longitudinally. We further analysed the mediation effect of the DTI-ALPS on age and cognitive function.

Results

A total of 633 participants were included in this study (48.2% female; mean age, 62.8 ± 8.9 years). The DTI-ALPS index was positively associated with cognitive function cross-sectionally (β = 0.108, P = 0.003), and was an independent protective factor for cognitive decline longitudinally (odds ratio (OR) = 0.029, P = 0.007). The DTI-ALPS index declined progressively with ageing (r = −0.319, P <0.001), and the decrease was more pronounced after 65 years of age. Furthermore, the DTI-ALPS index mediated the relationship between age and MMSE score (β = −0.016, P <0.001). The mediation effect accounted for 21.3%, which was higher in subjects aged over 65 years (25.3%) compared with those aged under 65 years (5.3%).

Conclusion

Glymphatic function played a protective role in normal ageing-related cognitive decline, which may serve as a potential therapeutic target against cognitive decline in future.
More Than Identity: An Intersectional Approach to Understanding Mental-Emotional Well-Being of Emerging Adults by Centering Lived Experiences of Marginalization
Authors: Slaughter-Acey Jaime , Simone Melissa , Hazzard Vivienne M , Arlinghaus Katherine R , Neumark-Sztainer Dianne
Published: July 2023

Understanding social determinants that shape pertinent developmental shifts during emerging adulthood (i.e., ages 18–25 years) and their associations with psychological health requires a nuanced approach. In our exploratory study, we investigated how multiple social identities and lived experiences generated by systems of marginalization and power (e.g., racism, classism, sexism) intersect in connection to the mental-emotional well-being of emerging adults (EAs). Eating and Activity Over Time (EAT, 2010–2018) data were collected from 1,568 EAs (mean age = 22.2 (standard deviation, 2.0) years) recruited initially in 2010 from Minneapolis/St. Paul schools. Conditional inference tree analyses were employed to treat “social location” and systems of marginalization and power as interdependent social factors influencing EAs’ mental-emotional well-being outcomes: depressive symptoms, stress, self-esteem, and self-compassion. Conditional inference tree analyses identified EAs’ subgroups with differing mean levels of mental-emotional well-being outcomes, distinguished primarily by marginalized social experiences (e.g., discrimination, financial difficulties) rather than social identities themselves. The relative positioning of EAs’ experiences of social marginalization (e.g., discrimination) to their social identities (e.g., race/ethnicity) suggests that the social experiences generated by systems of privilege and oppression (e.g., racism) are more adjacent social determinants of mental-emotional well-being than the social identities used in public health research to proxy the oppressive systems that give them social meaning.
Detailed Analysis of Three Major Breast Reconstructions Using BREAST-Q Responses From 1001 Patients
Authors: Tomita Shoichi , Nagai Keita , Matsunaga Noriko , Kerckhove Maiko de , Fujii Miwako , Terao Yasunobu
Published: July 2023

Background

Patient-reported outcomes have become as important as mortality and morbidity in the postoperative evaluation of breast reconstruction surgery. The BREAST-Q is one of the most widely used patient-reported outcomes for breast reconstruction.

Objectives

A comparative analysis of the scores on each of the BREAST-Q modules could help analyze different reconstruction methods. However, few studies have utilized BREAST-Q for this purpose. The aim of this study was therefore to compare breast reconstruction methods in terms of BREAST-Q module ratings.

Methods

The authors retrospectively reviewed the data of 1001 patients who had been followed for more than 1 year after breast reconstruction. The 6 BREAST-Q modules were rated on a scale of 0 to 100 and statistically analyzed by multiple regression. In addition, Fisher's exact test was performed after dividing the responses to each question into high- and low-rating groups.

Results

Microvascular abdominal flap reconstruction scored significantly better than implant-based reconstruction on all modules, except psychosocial and sexual well-being. In terms of satisfaction with the breast, latissimus dorsi flap reconstruction was superior to implant-based reconstruction. However, in terms of the reconstruction method, there were no differences in patients' willingness to make the same choice again or whether they regretted having surgery.

Conclusions

The results highlight the superiority of autologous breast reconstruction. Reconstruction methods should only be performed after a thorough explanation of their characteristics to achieve results that meet patient expectations. The findings are useful for facilitating patient decision-making in breast reconstruction.

Level of Evidence: 4
Beyond winglets: evolutionary scaling of flight-related morphology in stick insects (Phasmatodea)
Authors: Zeng Yu , Park Sehoon , Gonzales Camille , Yom Stephanie , Rahim Faszly , Dudley Robert
Published: July 2023

The first winged insects evolved from a wingless ancestor, but details of the transition to a fully-winged morphology remain unclear. Studying extant pterygotes with partial wings, such as the stick insects (order Phasmatodea), may help us to understand such a transition. Here, we address how a series of flight-related morphological parameters may correlate with flight evolution by studying different phasmids representing a volancy continuum ranging from miniaturized to full-sized wings. Variation in phasmid wing shape, venation, wing mass and the mass of flight muscle can be described by specific scaling laws referenced to wing length and wing loading. Also, the mass distribution of the body-leg system is conserved in spite of a wide range of variation in body shape. With reduced wing size and increased wing loading, the longitudinal position of the wing-bearing thoracic segments is shifted closer to the insects’ centre of body mass. These results demonstrate complex reconfiguration of the flight system during wing morphological transitions in phasmids, with various anatomical features potentially correlated with reduced flight performance attained with partial wings. Although these data represent phasmid-specific features of the flight apparatus and body plan, the associated scaling relationships can provide insight into the functionality of intermediate conditions between wingless and fully-winged insects more generally.
Repeated evolution of pollination syndromes in a highly diverse bromeliad lineage is correlated with shifts in life form and habitat
Authors: Neves Beatriz , Ferreira Paola de L , Prosdocimi Francisco , Kessous Igor M , Couto Dayvid R , Moura Ricardo L , Salgueiro Fabiano , Costa Andrea F , Bacon Christine D , Antonelli Alexandre
Published: July 2023

Mutualistic plant-pollinator interactions play a critical role in the diversification of flowering plants. The spatiotemporal correlates of such interactions can be understood in a phylogenetic context. Here, we generate ddRAD-seq data for the highly diverse Vriesea-Stigmatodon lineage to test for correlated trait evolution among pollination syndromes and life form, habitat type, and altitude. Our results show that pollination syndromes are correlated with changes in life form and habitat type. The ancestor of the Vriesea-Stigmatodon lineage was likely bat pollinated, rock dwelling and inhabited open, mid-elevation forests. Transitions from bat to hummingbird pollination are correlated with transitions to the epiphytic life form in shaded habitats, whereas bat pollination is correlated with the rock-dwelling life form and open habitats. Our dated phylogenetic tree reveals independent origins of hummingbird pollination, occurring twice in Vriesea at c. 5.8 and 5.4 Mya. The timing for the shifts in pollination syndrome coincides with geological and environmental transformations across the Serra do Mar Mountain Chain, which increased habitat heterogeneity where Vriesea and their mutualists diversified. The phylogenetic tree reinforces the non-monophyly of taxonomic sections within the genus Vriesea previously defined by flower morphology, indicating that some lineages should be treated as species complexes. This study identifies synergetic drivers of speciation in a tropical biodiversity hotspot.
RNF213 loss-of-function promotes pathological angiogenesis in moyamoya disease via the Hippo pathway
Authors: Ye Fei , Niu Xingyang , Liang Feng , Dai Yuanyuan , Liang Jie , Li Jiaoxing , Wu Xiaoxin , Zheng Hanyue , Qi Tiewei , Sheng Wenli
Published: July 2023

Moyamoya disease is an uncommon cerebrovascular disorder characterized by steno-occlusive changes in the circle of Willis and abnormal vascular network development. Ring finger protein 213 (RNF213) has been identified as an important susceptibility gene for Asian patients, but researchers have not completely elucidated whether RNF213 mutations affect the pathogenesis of moyamoya disease.

Using donor superficial temporal artery samples, whole-genome sequencing was performed to identify RNF213 mutation types in patients with moyamoya disease, and histopathology was performed to compare morphological differences between patients with moyamoya disease and intracranial aneurysm. The vascular phenotype of RNF213-deficient mice and zebrafish was explored in vivo, and RNF213 knockdown in human brain microvascular endothelial cells was employed to analyse cell proliferation, migration and tube formation abilities in vitro. After bioinformatics analysis of both cell and bulk RNA-seq data, potential signalling pathways were measured in RNF213-knockdown or RNF213-knockout endothelial cells.

We found that patients with moyamoya disease carried pathogenic mutations of RNF213 that were positively associated with moyamoya disease histopathology. RNF213 deletion exacerbated pathological angiogenesis in the cortex and retina. Reduced RNF213 expression led to increased endothelial cell proliferation, migration and tube formation. Endothelial knockdown of RNF213 activated the Hippo pathway effector Yes-associated protein (YAP)/tafazzin (TAZ) and promoted the overexpression of the downstream effector VEGFR2. Additionally, inhibition of YAP/TAZ resulted in altered cellular VEGFR2 distribution due to defects in trafficking from the Golgi apparatus to the plasma membrane and reversed RNF213 knockdown-induced angiogenesis. All these key molecules were validated in ECs isolated from RNF213-deficient animals.

Our findings may suggest that loss-of-function of RNF213 mediates the pathogenesis of moyamoya disease via the Hippo pathway.
Efficacy of anti-programmed cell death protein 1 monoclonal antibody combined with bevacizumab and/or Pseudomonas aeruginosa injection in transplanted tumor of mouse forestomach carcinoma cell gastric cancer in mice and its mechanism in regulating tumor immune microenvironment
Authors: Liu Xiangyong , Yan Chao , Yang Aijie , Yu Enhao , Yu Jie , Zhou Chunyang , Wang Yun , Wang Kai , Sun Ying , Cheng Yufeng
Published: July 2023

Tumor immunotherapy represented by programmed cell death protein 1 (PD-1) inhibitors is considered as the most promising cancer treatment method and has been widely used in the treatment of advanced gastric cancer (GC). However, the effective rate of PD-1 inhibitor monotherapy is low. In this study, we constructed a transplanted tumor model in GC mice by inoculating mouse forestomach carcinoma cell (MFC) GC cells into 615 mice. Interventions were conducted with normal saline, anti-PD-1 monoclonal antibody (mAb), bevacizumab, Pseudomonas aeruginosa-mannose-sensitive hemagglutinin (PA-MSHA), anti-PD-1 mAb combined with bevacizumab, anti-PD-1 mAb combined with PA-MSHA, bevacizumab combined with PA-MSHA, anti-PD-1 mAb combined with bevacizumab and PA-MSHA, respectively. The tumor growth curves were drawn. TUNEL assay, western blotting, and immunohistochemistry were used to detect tumor proliferation and apoptosis. Flow cytometry and ELISA were used to detect the expression of tumor infiltrating lymphocytes and cytokines. This study found that anti-PD-1 mAb alone could not significantly inhibit the growth of transplanted tumors in mice. Anti-PD-1 mAb combined with bevacizumab, anti-PD-1 mAb combined with PA-MSHA, anti-PD-1 mAb combined with bevacizumab and PA-MSHA could all significantly inhibit tumor growth in mice, and the combination of three drugs presented the highest tumor inhibition rate. Anti-PD-1 mAb combined with bevacizumab and PA-MSHA could significantly upregulate the number of Th1-type cells, CD8 + T cells, and Type I tumor-associated macrophages (TAMs), while downregulate the number of Th2-type cells, myeloid-derived suppressor cells, regulatory T cells, and Type II TAMs. Therefore, we conclude that anti-PD-1 mAb combined with bevacizumab and/or PA-MSHA has a synergistic effect. Bevacizumab and PA-MSHA can transform the tumor immunosuppressive microenvironment into a supportive immune microenvironment, thus maximizing the antitumor effect of anti-PD-1 mAb.
ChatGPT, GPT-4, and Other Large Language Models: The Next Revolution for Clinical Microbiology?
Authors: Egli Adrian
Published: July 2023

ChatGPT, GPT-4, and Bard are highly advanced natural language process–based computer programs (chatbots) that simulate and process human conversation in written or spoken form. Recently released by the company OpenAI, ChatGPT was trained on billions of unknown text elements (tokens) and rapidly gained wide attention for its ability to respond to questions in an articulate manner across a wide range of knowledge domains. These potentially disruptive large language model (LLM) technologies have a broad range of conceivable applications in medicine and medical microbiology. In this opinion article, I describe how chatbot technologies work and discuss the strengths and weaknesses of ChatGPT, GPT-4, and other LLMs for applications in the routine diagnostic laboratory, focusing on various use cases for the pre- to post-analytical process.
Premature deindustrialisation: the international evidence
Authors: Özçelik Emre , Özmen Erdal
Published: July 2023

We examine patterns and globalisation-related causes of premature deindustrialisation (PD) in recent decades, using a large panel of advanced, emerging and developing economies (AE, EME and DE). The results verify the existence of PD in EME and DE, except East Asian countries. African countries have been worst affected by PD. Globalisation-related determinants of PD vary across country groups. While trade openness leads to deindustrialisation in DE; it enhances ‘dependent’ industrialisation in Latin American countries and the ‘factory economies’ of East Asia, which have stronger linkages to global value chains. Financial openness fosters industrialisation in severely finance-constrained economies, whereas it brings about deindustrialisation in financially stronger ones. It is our contention that development possibilities can be expanded by aiming at more intense linkages to global value chains, but proactive industrial policies at the levels of EME and DE are required to achieve such expansion.
Disease Recurrence and Long-term Outcomes Following the Development of Intestinal Failure in Crohn’s Disease: Over 20 Years of Experience from a National Reference Centre
Authors: Kopczynska Maja , Crooks Benjamin , Deutsch Liat , Conley Thomas , Stansfield Catherine , Bond Ashley , Soop Mattias , Carlson Gordon , Lal Simon
Published: July 2023

Background and Aims

Intestinal failure [IF] is a recognised complication of Crohn’s disease [CD]. The aim of this study was to identify factors predicting the development and recurrence of CD in patients with IF [CD-IF], and their long-term outcomes.

Methods

This was a cohort study of adults with CD-IF admitted to a national UK IF reference centre between 2000 and 2021. Patients were followed from discharge with home parenteral nutrition [HPN] until death or February 28, 2021.

Results

In all, 124 patients were included; 47 [37.9%] changed disease location and 55 [44.4%] changed disease behaviour between CD and CD-IF diagnosis, with increased upper gastrointestinal involvement [4.0% vs 22.6% patients], p <0.001. Following IF diagnosis, 29/124 [23.4%] patients commenced CD prophylactic medical therapy; 18 [62.1%] had a history of stricturing or penetrating small bowel disease; and nine [31.0%] had ileocolonic phenotype brought back into continuity. The cumulative incidence of disease recurrence was 2.4% at 1 year, 16.3% at 5 years and 27.2% at 10 years; colon-in-continuity and prophylactic treatment were associated with an increased likelihood of disease recurrence. Catheter-related bloodstream infection [CRBSI] rate was 0.32 episodes/1000 catheter days, with no association between medical therapy and CRBSI rate.

Conclusions

This is the largest series reporting disease behaviour and long-term outcomes in CD-IF and the first describing prophylactic therapy use. The incidence of disease recurrence was low. Immunosuppressive therapy appears to be safe in HPN-dependent patients with no increased risk of CRBSI. The management of CD-IF needs to be tailored to the patient’s surgical disease history alongside disease phenotype.
Multi-modality imaging in aortic stenosis: an EACVI clinical consensus document
Authors: Dweck Marc R , Loganath Krithika , Bing Rong , Treibel Thomas A , McCann Gerry P , Newby David E , Leipsic Jonathon , Fraccaro Chiara , Paolisso Pasquale , Cosyns Bernard , Habib Gilbert , Cavalcante João , Donal Erwan , Lancellotti Patrizio , Clavel Marie-Annick , Otto Catherine M , Pibarot Phillipe
Published: July 2023

In this EACVI clinical scientific update, we will explore the current use of multi-modality imaging in the diagnosis, risk stratification, and follow-up of patients with aortic stenosis, with a particular focus on recent developments and future directions. Echocardiography is and will likely remain the key method of diagnosis and surveillance of aortic stenosis providing detailed assessments of valve haemodynamics and the cardiac remodelling response. Computed tomography (CT) is already widely used in the planning of transcutaneous aortic valve implantation. We anticipate its increased use as an anatomical adjudicator to clarify disease severity in patients with discordant echocardiographic measurements. CT calcium scoring is currently used for this purpose; however, contrast CT techniques are emerging that allow identification of both calcific and fibrotic valve thickening. Additionally, improved assessments of myocardial decompensation with echocardiography, cardiac magnetic resonance, and CT will become more commonplace in our routine assessment of aortic stenosis. Underpinning all of this will be widespread application of artificial intelligence. In combination, we believe this new era of multi-modality imaging in aortic stenosis will improve the diagnosis, follow-up, and timing of intervention in aortic stenosis as well as potentially accelerate the development of the novel pharmacological treatments required for this disease.
Long-term outcome of patients with combined post- and pre-capillary pulmonary hypertension
Authors: Titz Anna , Mayer Laura , Appenzeller Paula , Müller Julian , Schneider Simon R , Tamm Michael , Darie Andrei M , Guler Sabina A , Aubert John-David , Lador Frédéric , Stricker Hans , Fellrath Jean-Marc , Pohle Susanne , Lichtblau Mona , Ulrich Silvia
Published: July 2023

Aims

Pulmonary hypertension (PH) is a complex clinical condition, and left heart disease is the leading cause. Little is known about the epidemiology and prognosis of combined post- and pre-capillary PH (CpcPH).

Methods and results

This retrospective analysis of the Swiss PH Registry included incident patients with CpcPH registered from January 2001 to June 2019 at 13 Swiss hospitals. Patient baseline characteristics [age, sex, mean pulmonary artery pressure (mPAP), pulmonary artery wedge pressure (PAWP), pulmonary vascular resistance (PVR), and risk factors, including World Health Organization (WHO)-functional class (FC), 6 min walk distance (6MWD), and N-terminal pro-brain natriuretic peptide (NT-proBNP), treatment, days of follow-up, and events (death or loss to follow-up) at last visit] were analysed by Kaplan–Meier and Cox regression analyses. Two hundred and thirty-one patients (59.3% women, age 65 ± 12 years, mPAP 48 ± 11 mmHg, PAWP 21 ± 5 mmHg, PVR 7.2 ± 4.8 WU) were included. Survival analyses showed a significantly longer survival for women [hazard ratio (HR) 0.58 (0.38–0.89); P = 0.01] and a higher mortality risk for mPAP > 46 mmHg [HR 1.58 (1.03–2.43); P = 0.04] but no association with age or PVR. Patients stratified to high risk according to four-strata risk assessment had an increased mortality risk compared with patients stratified to low-intermediate risk [HR 2.44 (1.23–4.84); P = 0.01]. A total of 46.8% of CpcPH patients received PH-targeted pharmacotherapy; however, PH-targeted medication was not associated with longer survival.

Conclusion

Among patients with CpcPH, women and patients with an mPAP ≤46 mmHg survived longer. Furthermore, risk stratification by using non-invasively assessed risk factors, such as WHO-FC, 6MWD, and NT-proBNP, as proposed for pulmonary arterial hypertension, stratified survival in CpcPH, and might be helpful in the management of these patients.
Identification of grapevine clones via high-throughput amplicon sequencing: a proof-of-concept study
Authors: Urra Claudio , Sanhueza Dayan , Pavez Catalina , Tapia Patricio , Núñez-Lillo Gerardo , Minio Andrea , Miossec Matthieu , Blanco-Herrera Francisca , Gainza Felipe , Castro Alvaro , Cantu Dario , Meneses Claudio
Published: July 2023

Wine cultivars are available to growers in multiple clonal selections with agronomic and enological differences. Phenotypic differences between clones originated from somatic mutations that accrued over thousands of asexual propagation cycles. Genetic diversity between grape cultivars remains unexplored, and tools to discriminate unequivocally clones have been lacking. This study aimed to uncover genetic variations among a group of clonal selections of 4 important Vitis vinifera cultivars: Cabernet sauvignon, Sauvignon blanc, Chardonnay, and Merlot, and use this information to develop genetic markers to discriminate the clones of these cultivars. We sequenced with short-read sequencing technology the genomes of 18 clones, including biological replicates for a total of 46 genomes. Sequences were aligned to their respective cultivar's reference genome for variant calling. We used reference genomes of Cabernet sauvignon, Chardonnay, and Merlot and developed a de novo genome assembly of Sauvignon blanc using long-read sequencing. On average, 4 million variants were detected for each clone, with 74.2% being single nucleotide variants and 25.8% being small insertions or deletions (InDel). The frequency of these variants was consistent across all clones. From these variants, we validated 46 clonal markers using high-throughput amplicon sequencing for 77.7% of the evaluated clones, most of them small InDel. These results represent an advance in grapevine genotyping strategies and will benefit the viticulture industry for the characterization and identification of the plant material.
Social Trust, Human Values, and Anti-immigrant Sentiment: Does Trust Work With or Against Values?
Authors: Ponce Aaron
Published: July 2023

Two separate lines of literature have analyzed the role social trust and human values, such as universalism and conservatism, have on anti-immigrant sentiment. While both show strong effects, the question of whether social trust weakens or strengthens already embodied values has not been addressed. The possibility that trust works against or with conservatism, for example, predicts two opposing forces on anti-immigrant sentiment. This study analyzes the potential moderating effect of trust on human values, and how this varies cross-nationally. It develops a conceptual framework that hypothesizes different models of trust and tests these using eight rounds of the European Social Survey (2002–2016). Findings point to trust consistently working with values, which suggests a magnification of conservative values’ anti-immigrant effects. While there is little evidence for national cultures of trust and values, country-specific results show variation in how trust moderates values, with greater evidence for trust’s moderation of conservatism and some unpredicted patterns in countries like Cyprus. Findings are discussed within the context of anti-immigrant politics and entrenched values, scholarly debates surrounding bridging and bonding, and the resulting extent of social trust’s radius.
Occurrence of Klebsiella pneumoniae ST244 and ST11 extensively drug-resistant producing KPC, NDM, OXA-370 in wastewater, Brazil
Authors: Montenegro Kaylanne , Flores Claudia , Nascimento Ana Paula Alves , Farias Beatriz Oliveira , Brito Andressa S Gonçalves , Magaldi Mariana , Gimenez Aline , de Filippis Ivano , Clementino Maysa Mandetta , Bianco Kayo , Saggioro Enrico , Barrocas Paulo
Published: July 2023

Aims

To investigate the occurrence of carbapenem-resistant Klebsiella pneumoniae (CRKP) and their clonal relationships from hospital and municipal wastewater treatment plants (WWTPs).

Methods and results

Eighteen Kl. pneumoniae strains recovered from three WWTPs were identified by matrix-assisted laser desorption-ionization–time of flight (MALDI-TOF). The antimicrobial susceptibility were evaluated by disk-diffusion and the carbapenemases production by Carbapenembac®. The carbapenemases genes were investigated by real-time PCR and the clonal relationship through multilocus sequence typing (MLST). Thirty nine % (7/18) of isolates were classified as multidrug-resistant (MDR), 61.1% (11/18) extensively drug-resistant (XDR), and 83.3% (15/18) showed carbapenemase activity. Three carbapenemase-encoding genes were found, blaKPC (55%), blaNDM (27.8%) and blaOXA-370 (11.1%) as well five sequencing types ST11, ST37, ST147, ST244, and ST281. ST11 and ST244, sharing four alleles were grouped into clonal complex 11 (CC11).

Conclusions

Our results show the importance of monitoring antimicrobial resistance in WWTPs effluents to minimize the risk of spreading bacterial load and ARGs in aquatic ecosystems, using advanced treatment technologies to reduce these emerging pollutants at WWTPs.
A computable case definition for patients with SARS-CoV2 testing that occurred outside the hospital
Authors: Wang Lijing , Zipursky Amy R , Geva Alon , McMurry Andrew J , Mandl Kenneth D , Miller Timothy A
Published: July 2023

Objective

To identify a cohort of COVID-19 cases, including when evidence of virus positivity was only mentioned in the clinical text, not in structured laboratory data in the electronic health record (EHR).

Materials and Methods

Statistical classifiers were trained on feature representations derived from unstructured text in patient EHRs. We used a proxy dataset of patients with COVID-19 polymerase chain reaction (PCR) tests for training. We selected a model based on performance on our proxy dataset and applied it to instances without COVID-19 PCR tests. A physician reviewed a sample of these instances to validate the classifier.

Results

On the test split of the proxy dataset, our best classifier obtained 0.56 F1, 0.6 precision, and 0.52 recall scores for SARS-CoV2 positive cases. In an expert validation, the classifier correctly identified 97.6% (81/84) as COVID-19 positive and 97.8% (91/93) as not SARS-CoV2 positive. The classifier labeled an additional 960 cases as not having SARS-CoV2 lab tests in hospital, and only 177 of those cases had the ICD-10 code for COVID-19.

Discussion

Proxy dataset performance may be worse because these instances sometimes include discussion of pending lab tests. The most predictive features are meaningful and interpretable. The type of external test that was performed is rarely mentioned.

Conclusion

COVID-19 cases that had testing done outside of the hospital can be reliably detected from the text in EHRs. Training on a proxy dataset was a suitable method for developing a highly performant classifier without labor-intensive labeling efforts.
Not Just about Price: How Benefit Focus Determines Consumers’ Retailer Pricing Strategy Preference
Authors: Hydock Chris , Wathieu Luc
Published: July 2023

Recent research has highlighted a difference in the way consumers approach choice sets. Some consumers focus on products’ quality benefits (vertical differentiation): their selections are driven by the level of quality obtained relative to the price paid. Other consumers focus on products’ taste benefits (horizontal differentiation): their selections are driven by acquiring personal tastes at favorable prices. This article aims to investigate how consumers’ benefit focus, a continuum anchored by quality and taste, drives their preferences between retailers differing in pricing strategies. All else equal, consumers who focus on taste benefits will prefer EDLP stores (infrequent discounters), while consumers who focus on quality benefits will prefer Hi-Lo stores (frequent discounters). Findings from our experiments and an analysis of consumer panel data corroborate this relationship. This work also shows the mediating role of perceived value and the effect of several moderators: the strength of the price–quality relationship, the pattern of discounts, and cherry-picking costs.
The situational window for boundary-spanning infrastructure professions: Making sense of cyberinfrastructure emergence
Authors: Hayes Cassandra , Kulkarni Chaitra , Kee Kerk F
Published: July 2023

In the twenty-first century, professions are complex and difficult to define due to their fluid and interdisciplinary natures. In this study, we examined the personal career stories of professionals in the field of cyberinfrastructure (CI) to identify the narrative patterns used to make sense of CI as a boundary-spanning profession. Overall, we found that professionalization of CI is a sensemaking process of communal, retrospective storytelling. The meaning-making of CI as a profession occurred through three levels of narrative patterns: individual traits of CI professionals, situational introductions to CI, and inspirational convictions about CI. The situational level, which connected innate qualities and internal motivations with external forces to join CI as a career, was especially important to the professionalization of CI. Our findings have implications for re-examining professionalization as an ongoing sensemaking process, as well as offering guidance for recruitment and retention in critical boundary-spanning professions.