bluuebunny/crossref_metadata_2025 huggingface dataset:
The Effect of Consumer Resistance and Trust on the Intention to Accept Fully Autonomous Vehicles
Authors: Wang Dawoon , Choi Hyekyong
Published: October 2023

Fully autonomous vehicles are a new technology that is expected to be widely accepted by consumers because of their various advantages. This study examined consumers’ intention to accept fully autonomous vehicles based on trust and resistance. To this end, consumer data were analyzed by integrating the innovation resistance model and the technology trust model. The subjects of the survey were 400 drivers between the ages of twenty and sixty-nine. As a result of the study, variables related to the “technical characteristics” of fully autonomous vehicles affected the resistance. On the other hand, “experiential characteristics” were confirmed to affect trust. Second, consumers with a high innovation propensity are more likely to accept fully autonomous vehicles when they are commercialized in the future. Third, it was found that resistance had a negative effect and trust had a positive effect on consumers’ intention to accept fully autonomous vehicles. Therefore, for consumers to accept these, technology should be developed in the direction of removing factors affecting resistance and providing factors increasing trust. As such, consumers have anxiety and concerns as well as expectations, even though they have not yet experienced a fully autonomous vehicle. In particular, since fully autonomous vehicles completely change the existing driving paradigm, more careful consideration is required in the diffusion of this technology.
Characteristics of Iranian Probiotic UF White Cheese
Authors: Habibi A. , Shahab Lavasani A. , Mortazavian A. M. , Hoseini S. E. , Zarei H.
Published: October 2023

Cheese is able to transport live probiotics due to its dry matter, fat, and higher pH than yogurt-like products. According to health organizations’ emphasis on promoting the consumption of healthy dairy products and consumers’ desire to eat healthier foods, in this study, the feasibility of producing probiotic UF cheese containing probiotic strains of Bifidobacterium bifidum sp. IR007-113 and Enterococcus faecium sp. IBRC-M 10836 as a single or combined study was investigated. The experimental cheeses used in this study include A: UF cheese as a control sample, B: probiotic UF cheese containing Bifidobacterium bifidum, C: probiotic UF cheese containing Enterococcus faecium, and D: probiotic UF cheese containing a combination of Bifidobacterium bifidum and Enterococcus faecium strains. Viability of probiotic organisms on the basis of log cfu/g and aroma compounds including (acetaldehyde, diacetyl, acetone, and acetic acid all in micrograms per gram) was assessed during the 60-day ripening period. The results showed that the probiotic bacterial population decreased during the 60-day storage period. However, at the end of the storage period, all experimental cheeses contained probiotic strains above 106 cfu/g. The acetaldehyde compound increased during the 60-day storage period, and diacetyl, acetoin, and acetic acid contents decreased during the 60-day storage period except for the control sample. A total of 12 free fatty acids were identified in Iranian probiotic UF white cheese, which had the highest concentration of palmitic acid among saturated fatty acids and oleic acid among unsaturated fatty acids. The sensory scores of flavor increased during the 60-day storage period. Texture sensory scores of all experimental cheeses decreased during the storage period. In terms of acceptability, all experimental cheeses showed an increasing trend. In general, the results showed that it is possible to produce UF probiotic cheese with minimal adverse effects on quality characteristics and sensory acceptability. Also, treatment D had relatively better characteristics compared to other cheese variants.
Table S1 from Characteristics and Spatially Defined Immune (micro)landscapes of Early-stage PD-L1–positive Triple-negative Breast Cancer
Authors: Carter Jodi M. , Polley Mei-Yin C. , Leon-Ferre Roberto A. , Sinnwell Jason , Thompson Kevin J. , Wang Xue , Ma Yaohua , Zahrieh David , Kachergus Jennifer M. , Solanki Malvika , Boughey Judy C. , Liu Minetta C. , Ingle James N. , Kalari Krishna R. , Couch Fergus J. , Thompson E. Aubrey , Goetz Matthew P.
Published: October 2023

Clinicopathologic Features of PD-L1+ TNBC in TMA scored by SP142 or 22C3 assays
CSF Aβ40 Levels Do Not Correlate with the Clinical Manifestations of Alzheimer’s Disease
Authors: Garcia Castro Jesús , Méndez del Sol Helena , Rodríguez Fraga Olaia , Hernández Barral María , Serrano López Soledad , Frank García Ana , Martín Montes Ángel
Published: October 2023

Introduction: Cerebrospinal fluid (CSF) biomarker quantification provides physicians with a reliable diagnosis of Alzheimer’s disease (AD). However, the relationship between their concentration and disease course has not been clearly elucidated. This work aimed to investigate the clinical and prognostic significance of Aβ40 CSF levels. Methods: A retrospective cohort of 76 patients diagnosed with AD using a decreased Aβ42/Aβ40 ratio was subclassified into hyposecretors (Aβ40 <7,755 pg/mL), normosecretors (Aβ40 7,755–16,715 pg/mL), and hypersecretors (Aβ40 >16,715 pg/mL). Potential differences in AD phenotype, Montreal Cognitive Assessment (MoCA) scores, and Global Deterioration Scale (GDS) stages were assessed. Correlation tests for biomarker concentrations were also performed. Results: Participants were classified as hyposecretors (n = 22, median Aβ40 5,870.500 pg/mL, interquartile range [IQR] 1,431), normosecretors (n = 47, median Aβ40 10,817 pg/mL, IQR 3,622), and hypersecretors (n = 7, 19,767 pg/mL, IQR 3,088). The distribution of positive phosphorylated Tau (p-Tau) varied significantly between subgroups and was more common in the normo- and hypersecretor categories (p = 0.003). Aβ40 and p-Tau concentrations correlated positively (ρ = 0.605, p < 0.001). No significant differences were found among subgroups regarding age, initial MoCA score, initial GDS stage, progression to the dementia stage, or changes in the MoCA score. Conclusion: In this study, we found no significant differences in clinical symptoms or disease progression in AD patients according to their CSF Aβ40 concentration. Aβ40 was positively correlated with p-Tau and total Tau concentrations, supporting their potential interaction in AD pathophysiology.
Who and How Should We Screen for Primary Aldosteronism?
Authors: Funder John W.
Published: October 2023

There are mounting data that at least 30% of hypertensives who are appropriately screened have primary aldosteronism (PA), rather than the commonly reported figure of 5% to 10%. Second, there are similar data that undertreated patients with PA have a 3-fold higher risk profile than essential hypertensives with the same blood pressure levels. Third, clinicians managing hypertension measure success as sustainable lowering of blood pressure; untreated hypertensive patients with PA are thus in double jeopardy. Finally, and crucially, fewer than 1% of patients with hypertension are ever screened—let alone investigated—for PA. Accordingly, for “Who should we screen?” the answer is simple—all patients with hypertension. For “How they should be screened?” the answer is also simple—add spironolactone 25 mg/day for 4 weeks and measure the blood pressure response. In established hypertension, a fall of <10 mm Hg means PA is unlikely; above 12 mm Hg PA, it is probable. Newly presenting hypertension is much the same—hold off on first-order antihypertensive(s) and prescribe spironolactone 25 mg/day for 4 weeks. If blood pressure falls into the normal range, continue; if it does not, prescribe a standard antihypertensive. It is likely that the above protocols—a first start, amenable to refinement—will find additional hypertensives with unilateral PA; it is probable that the overwhelming majority will have bilateral disease. What this means is that we have a major public health issue on our hands: how can this be the case?
Hub overload and failure as a final common pathway in neurological brain network disorders
Authors: Stam Cornelis Jan
Published: October 2023

Understanding the concept of network hubs and their role in brain disease is now rapidly becoming important for clinical neurology. Hub nodes in brain networks are areas highly connected to the rest of the brain, which handle a large part of all the network traffic. They also show high levels of neural activity and metabolism, which makes them vulnerable to many different types of pathology. The present review examines recent evidence for the prevalence and nature of hub involvement in a variety of neurological disorders, emphasizing common themes across different types of pathology. In focal epilepsy, pathological hubs may play a role in spreading of seizure activity, and removal of such hub nodes is associated with improved outcome. In stroke, damage to hubs is associated with impaired cognitive recovery. Breakdown of optimal brain network organization in multiple sclerosis is accompanied by cognitive dysfunction. In Alzheimer’s disease, hyperactive hub nodes are directly associated with amyloid-beta and tau pathology. Early and reliable detection of hub pathology and disturbed connectivity in Alzheimer’s disease with imaging and neurophysiological techniques opens up opportunities to detect patients with a network hyperexcitability profile, who could benefit from treatment with anti-epileptic drugs.
The Puzzling Portrait of Hezekiah in 2 Chronicles 32:24–31
Authors: Goswell Gregory
Published: October 2023

2 Chronicles 32:24–31 provides an early reading of Isa 38–39, but the brevity of the account in Chronicles makes its interpretation challenging. There is an additional motif of pride that is not easy to interpret (32:25–26). In this article I suggest that it might have been added by the Chronicler because he had noticed the admission of fault by the sick king in the psalm in Isa 38. Building on the portrait of Hezekiah found in Isa 38, the Chronicler depicts Hezekiah acknowledging that he was not worthy of the benefit received and humbling himself. Hezekiah models for the reader the Chronistic ethic of repentance. When Hezekiah is tested by God (32:31), the statement that “God left him to himself” reflects the Chronicler’s interpretation of what is found in Isa 39, where the king responded as best he could to the arrival of Babylonian envoys without the benefit of prophetic guidance. The glowing depiction of Hezekiah’s achievements in the surrounding verses implies that the Chronicler believed that Hezekiah passed this test.
Bahrain: Recent Developments in the Protection of the Rights of Migrant Workers and of Women
Authors: Kanchana Radhika
Published: October 2023

This survey reviews some of the key legislative and executive measures of the government of Bahrain in the year 2021–2022, which have relevance to mainly the rights of the migrant workers. Further, and in less detail, this survey also refers to some of the developments pertinent to the rights of women living in Bahrain. However, more generally these rights are less relevant to women who are not Bahraini nationals. Bahrain is a member country of the Gulf Cooperation Council (GCC). The GCC comprises six states in the Arab-Gulf region: Oman, Bahrain, the United Arab Emirates (UAE), Kuwait, Qatar and Saudi Arabia. These oil-producing states have significant proportion of foreign workforce in the population. Foreign workers work mostly in the private sector and are also residents in the host countries. At 55 per cent, Bahrain has a relatively lower proportion of migrants in its population among the GCC members (UN DESA, 2020). Therefore, a broader spectrum of governments’ measures relating to the issues like labour, entry and residence, and ownership of property or business touch the lives of the foreign/migrant workers or expatriates in the Gulf country. Governments’ initiatives targeting domestic workers are relevant also for women because they comprise the majority in this group. The survey notes that most of the governmental activity in Bahrain in the past year largely concern new laws or amendments of the existing legislation and regulations linked to labour and residency matters. Some of the more relevant ones that the survey has selected here confirms this. It also marks the period post the pandemic, which had posed considerable economic challenge for the government. Hence, as also some neighbouring Gulf countries, Bahrain has shown a balance of measures. On the one hand, to revive its economic dynamism and competitiveness, measures have been taken aimed at facilitating more ease and benefits to attract and retain foreign labour and investment in the country. On the other hand, measures have been taken that expressly favour the national workforce in order to boost their more active participation in the labour market and to support increased nationalisation efforts. The Bahraini government’s introduction of new labour reforms replacing its Flexi-work permit programme, initiatives to enforce the Wage Protection System, and easing of residence permits are a few notable highlights. The survey has essentially drawn on the government’s documents and announcements as available in English or translated text, in addition to information in the press and other relevant sources.
Palestine
Authors: Awawda Osayd
Published: October 2023

During the last year, the Palestinian President, Mahmoud Abbas, has issued more than seventy decrees-by-law, which are legislative tools that the Palestinian Basic Law allows the President to use only in cases of emergency. However, the President has never shown in any of those decrees-by-law that they were issued to face an emergency, which is an immense, imminent danger that may solely be stopped with a decree-by-law. This is a significant increase in the number of decrees-by-law that the President has issued between 2007, the year in which the coup d’état occurred in Palestine, and 2021, which amounts to thirty decrees-by-law per year. This increase might be the result of Abbas’s clique attempt to shape the legal framework of the Palestinian Authority for its own benefits, fearing that the old, ill, Palestinian President would pass away in the near future, leaving a huge vacuum behind, particularly with regards to who might be his successor, amongst all of the rivalling senior figures of the regime.
Human Rights in Türkiye: Freedom of Expression and the Right to Liberty and Security in 2021/2022
Authors: Kabis-Kechrid Laura
Published: October 2023

Türkiye’s human rights situation continues to deteriorate, especially since the failed coup attempt in 2016. Many of the provisions introduced under the state of emergency remain in force and anti-terrorism laws as well as provisions regarding national security have been used to curtail fundamental rights and freedoms. In 2021, violations of the freedom of expression and the rights to liberty and security ranked first and second respectively in the ECtHR decisions against Türkiye. In the same year, Türkiye ranked first in amounting to the highest number of cases filed against a country with the ECtHR. Türkiye’s new “Disinformation Law” (Law No. 7418) has raised further concerns regarding freedom of expression in the country. This survey seeks to illustrate some of the most important developments regarding human rights in Türkiye in 2021 and 2022, particularly focusing on freedom of expression and the right to liberty and security (arbitrary detentions).
Revisiting “the Great Divergence”: Clarifying the Two Major Modes of Agricultural Change in China and the West
Authors: Huang Philip C. C.
Published: October 2023

Kenneth Pomeranz and Li Bozhong have recently conceded that they had been wrong that “the great divergence” between China and the West occurred only after 1800, but they continue to insist that when it came to agriculture and its labor productivity, their earlier argument still holds. This article summarizes the broad differences between eighteenth-century England’s crops cum animal husbandry agriculture and China’s crops-only agriculture to demonstrate the fundamental differences between the two. It is time we recognize fully how very different the two were and are, and how and why each follows an entirely different pattern to modern development. It is simply wrong to continue to obscure those basic differences by insisting on equivalence between them.
A Political Historical Examination of the Tianhu Embankment Case at Dongting Lake (1937–1949)
Authors: Zeng Gui , Yue Qianhou
Published: October 2023

Water disputes between Hunan and Hubei provinces persisted from the late Qing Dynasty to the Republic of China, and the Tianhu Embankment case stands as a representative conflict between the two provinces concerning lake and river management. The dispute originated from the construction of embankments by people from Hunan in the Datong Lake, a sub-lake of Dongting Lake. People from Hubei argued that the embankments significantly reduced the flood storage capacity of Dongting Lake and that river floods would directly inundate the riverside counties. On the contrary, people from Hunan argued that the construction of the Tianhu Embankment did not hinder water management and that the key to solving the problem of water disasters lay in dredging rivers and not in destroying the fertile farmland that tens of thousands of people relied on for survival. From 1936 until the collapse of the Guomindang government’s rule on mainland China, a dispute lasting over a decade unfolded over the issue of dismantling the Tianhu Embankment. Both provinces used various tactics, such as leveraging local interpersonal networks, creating public opinion through news media, and using “people-oriented” rhetoric. This issue was frequently mentioned in official correspondences between the Executive Yuan of the Guomindang government and the two provinces. Numerous high-ranking officials from both provinces were involved in the dispute, and it even escalated to the point where Chiang Kai-shek had to intervene. Though the case remained unresolved for a long time, it was temporarily concluded at the end of 1947 with the symbolic dismantling of nine outlets in the major dikes of the Dongheng East Islet and the Orphan Embankment. However, these outlets were soon refilled by people from Hunan, making the case an unresolved legacy of the Guomindang Government on the mainland. Reviewing the development and outcome of this case, the Guomindang Government always appeared as a conciliator in the dispute, but ended up yielding ground and making a muted exit. The helplessness and impotence that the Nationalist Government displayed in resolving this problem vividly illustrate its weak governance capability.
The Puppet Regime, Rent-Collecting Groups, and Rent-Tax Relations in Changshu County, Jiangsu Province, during the Japanese Puppet Regime Era
Authors: Yuan Kailin
Published: October 2023

The land tax was a major source of local fiscal revenue in southern Jiangsu during the Japanese puppet regime era. It involved a complex tug-of-war between the puppet “central” and local governments and was closely tied to rent affairs. At the onset of the “Rural Pacification,” the simultaneous imposition of rent and taxes by the Japanese puppet regime infringed upon various stakeholders’ interests but did not aid in increasing land tax revenue or stabilizing the economy. Instead, the regime could only profit from local surcharges via the embezzlement case in Changshu County. In the process of grabbing land taxes and constructing tax collection standards, both the puppet regime and the rent-collecting groups pursued their own interests, colluding and competing with each other. In the meantime, the puppet regime, aiming at extracting land output, disrupted the existing rent-tax management method, thereby reconstructing the urban-rural relationship in southern Jiangsu and increasing the peasants’ burden. The rent-tax issue in Changshu County during the occupation period reflects the entanglement of the three-fold relationships – “central” vs. local, “official” vs. civilian, and landlord vs. tenant – under the Japanese puppet regime. Yet, the acute landlord-tenant contradiction was ultimately replaced by social conflicts provoked by the Japanese puppet regime’s intervention in land ownership and usage rights.
On Metaphysics and Supersessionism
Authors: Mitchell Nicholas
Published: October 2023

Scholars, theologians and lay people are in the midst of a wave of vital conversations about the nature of Christian supersessionism and the possibility of a post-supersessionist theology. This paper seeks to contribute to these conversations by drawing out the presuppositions about evental relationship that underly supersessionistic habits of thought and their alternatives. This effort will proceed primarily through a critique of Alain Badiou’s supersessionistic reading of the Jewish/Christian evental relationship while attempting to salvage his formal concept of evental recurrence as a potential resource for post-supersessionist theology. The bulk of the paper is dedicated to this critique and salvage project. However, it will close with a series of brief reflections on how a non-teleogical metaphysics of evental recurrence might displace some of the teleological thought patterns that drive the dilemmas of supersessionism
Integrating Art and Dynamic Geometry Software into the Teaching and Learning of Middle School Geometry
Authors: Lyublinskaya Irina , Cabral Marta
Published: October 2023

This study focuses on understanding the ways in which integration of art and dynamic geometry software (DGS) into geometry influenced middle school teachers’ understanding of geometric concepts that are difficult to teach, and their perceptions of teaching these topics. The study indicated that art materials combined with DGS played different roles in teachers’ understanding of geometry: in some cases, they helped acquisition of new knowledge and development of deeper conceptual knowledge while addressing misconceptions; in other cases, they helped the retention of knowledge by association with the activity; and in some cases, they facilitated the transfer of knowledge and development of strategic knowledge. Study results also indicated that integration of art combined with DGS led to a higher level of creative engagement that supported productive struggle and helped teachers appreciate and understand pedagogy differently. Lastly, the teachers made connections from learning mathematics content to the pedagogy of teaching that same content.
Notes on sorediate Parmelia species in North America with the first records of P. asiatica and P. barrenoae
Authors: OSSOWSKA EMILIA ANNA
Published: October 2023

The first record of Parmelia asiatica from North America is presented. The species differs from other sorediate Parmelia taxa in having narrow, sublinear lobes with circular or semicircular, terminal or marginal soralia. New records and earlier data together suggest that P. asiatica may be a more common taxon in the Northern Hemisphere than previously reported. Additionally, the first record of P. barrenoae from Canada and the central states of the USA is presented. Notes on similar sorediate species of the genus Parmelia are provided with information about secondary chemistry checked by thin-layer chromatography methods in solvents A and C.
On the identity and distribution of Ischaemum flumineum (Poaceae: Andropogoneae) in India
Authors: LANDGE SHAHID NAWAZ , SHINDE RAJENDRA D.
Published: October 2023

While investigating the identity and distribution of Ischaemum flumineum, we encountered a lack of holotype designation by Bor. Consequently, we took the initiative to designate a lectotype, selecting a specimen from the Kew herbarium. To facilitate a comprehensive understanding, we conducted a brief review of the variable characteristics of I. timorense and I. thomsonianum, drawing on insights from “Grasses of China” and “Grasses of Malaysia” in addition to “Grasses of India”. While these species are the closest relatives to I. flumineum, none of their variable forms exhibit the distinctive basal indumentum found in the latter. To aid in precise differentiation among these three species in India, we revised the key, providing an improved tool for identification. Furthermore, we discussed the distribution of I. flumineum in India with the help of a map, based on the available specimens at BLAT, DD and K herbaria.
Polystichum lionelii (Dryopteridaceae), a new Andean species from northwestern Argentina
Authors: MARTÍNEZ OLGA G. , HERNÁNDEZ MARCELA A. , SERAPIO FABIOLA
Published: October 2023

Polystichum lionelii, a new fern species from the Andean mountain grasslands of northwestern Argentina, is described and illustrated. It is morphologically well differentiated from the other species occurring in the region, showing some relationships especially with P. pycnolepis particularly by the morphology of the pinnules. However, the new species differs from the latter in significant characters, the rhizome scales are ovate to ovate-lanceolate, the basal petiole scales are concolorous, and lamina with filiform scales and multicellular hairs on the abaxial side. An identification key to all Polystichum taxa currently known to occur in the northwestern Argentina is presented.
Neratinib for HER2-positive breast cancer with an overlooked option
Authors: Guo Liting , Shao Weiwei , Zhou Chenfei , Yang Hui , Yang Liu , Cai Qu , Wang Junqing , Shi Yan , Huang Lei , Zhang Jun
Published: October 2023

Positive human epidermal growth factor receptor 2 (HER2) expression is associated with an increased risk of metastases especially those to the brain in patients with advanced breast cancer (BC). Neratinib as a tyrosine kinase inhibitor can prevent the transduction of HER1, HER2 and HER4 signaling pathways thus playing an anticancer effect. Moreover, neratinib has a certain efficacy to reverse drug resistance in patients with BC with previous HER2 monoclonal antibody or targeted drug resistance. Neratinib, as monotherapy and in combination with other therapies, has been tested in the neoadjuvant, adjuvant, and metastatic settings. Neratinib with high anticancer activity is indicated for the prolonged adjuvant treatment of HER2-positive early BC, or in combination with other drugs including trastuzumab, capecitabine, and paclitaxel for the treatment of advanced HER2-positive BC especially cancers with central nervous system (CNS) metastasis to reduce the risk of BC recurrence. This article reviewed the pharmacological profiles, efficacy, safety, tolerability, and current clinical trials pertaining to neratinib, with a particular focus on the use of neratinib in patients with metastatic breast cancer (MBC) involving the CNS. We further discussed the use of neratinib for HER2-negative and HER2-mutant breast cancers, and mechanisms of resistance to neratinib. The current evidence suggests that neratinib has promising efficacy in patients with BC which is at least non-inferior compared to previous therapeutic regimens. The most common AE was diarrhea, and the incidence, severity and duration of neratinib-related grade 3 diarrhea can be reduced with loperamide. Of note, neratinib has the potential to effectively control and prevent brain metastasis in patients with advanced BC, providing a therapeutic strategy for HER2-positive BC.
How tuition fees affected student enrollment at higher education institutions: the aftermath of a German quasi-experiment
Authors: Minor Ralf
Published: October 2023

This study examines the impact of the charging of tuition fees between 2006 and 2014 in several German federal states on the number of first-year student enrollments. Since Germany is known for a tuition-free education policy at public institutions, the fundamental question arises of whether, and if so, to what extent, the temporary tuitions influenced the number of first-year-student enrollments. In this regard, Becker’s human capital theory suggests that rising fees should be associated with declining enrollment rates. The analyses to test the hypothesis are based on a longitudinal administrative panel data set for 206 universities and universities of applied sciences from 2003 to 2018; this means there are 3296 observations before, during, and after the tuition treatment. While no previous study has covered the full period of the policy or undertook more aggregate-level analyses, this study applies an analytical research design that uses several panel-data models and robustness checks to examine causal relations based on a quasi-experimental setting. The results of Fixed effects regressions confirm the hypothesized negative impact and even reveal a persistent negative effect of the treatment. The comparison of higher education institutions with and without tuition fees shows that the former institutions lost approximately between 3.8 and 7 percent of their first-year student enrollments on average.
Characterization and expression profiles of WUSCHEL-related homeobox (WOX) gene family in cultivated alfalfa (Medicago sativa L.)
Authors: Xu Aijiao , Yang Jiaqi , Wang Siqi , Zheng Lin , Wang Jing , Zhang Yunwei , Bi Xiaojing , Wang Hui
Published: October 2023

The WUSCHEL-related homeobox (WOX) family members are plant-specific transcriptional factors, which function in meristem maintenance, embryogenesis, lateral organ development, as well as abiotic stress tolerance. In this study, 14 MsWOX transcription factors were identified and comprehensively analyzed in the cultivated alfalfa cv. Zhongmu No.1. Overall, 14 putative MsWOX members containing conserved structural regions were clustered into three clades according to phylogenetic analysis. Specific expression patterns of MsWOXs in different tissues at different levels indicated that the MsWOX genes play various roles in alfalfa. MsWUS, MsWOX3, MsWOX9, and MsWOX13-1 from the three subclades were localized in the nucleus, among which, MsWUS and MsWOX13-1 exhibited strong self-activations in yeast. In addition, various cis-acting elements related to hormone responses, plant growth, and stress responses were identified in the 3.0 kb promoter regions of MsWOXs. Expression detection of separated shoots and roots under hormones including auxin, cytokinin, GA, and ABA, as well as drought and cold stresses, showed that MsWOX genes respond to different hormones and abiotic stress treatments. Furthermore, transcript abundance of MsWOX3, and MsWOX13-2 were significantly increased after rhizobia inoculation. This study presented comprehensive data on MsWOX transcription factors and provided valuable insights into further studies of their roles in developmental processes and abiotic stress responses in alfalfa.
Atrial fibrillation is not an independent determinant of 28-day mortality among critically III sepsis patients
Authors: Wang Weiping , Dong Yujiang , Zhang Qian , Gao Hongmei
Published: October 2023

This study was conducted to investigate the relationship between atrial fibrillation and the clinical prognosis of patients with sepsis in intensive care unit. A total of 21,538 sepsis patients were enrolled in the study based on the Medical Information Mart for Intensive Care IV database, of whom 6,759 had AF. Propensity score matching was used to compare the clinical characteristics and outcomes of patients with and without AF. Besides, the inverse probability of treatment weighting, univariate and multivariate Cox regression analyzes were performed. Of the 21,538 patients, 31.4% had AF. The prevalence of AF increased in a step-by-step manner with growing age. Patients with AF were older than those without AF. After PSM, 11,180 patients remained, comprising 5,790 matched pairs in both groups. In IPTW, AF was not associated with 28-day mortality [hazard ratio (HR), 1.07; 95% confidence interval (CI), 0.99–1.15]. In Kaplan-Meier analysis, it was not observed difference of 28-day mortality between patients with and without AF. AF could be associated with increased ICU LOS, hospital LOS and need for mechanical ventilation; however, it does not remain an independent short-term predictor of 28-day mortality among patients with sepsis after PSM with IPTW and multivariate analysis.
Operative treatment of periprosthetic fractures of the proximal femur with a contralateral, upside-down LISS plate in elderly patients
Authors: Schmid Marc , Gurschler-Pavotbawan Caroline , Fries Patrick , Kabelitz Method , Dietrich Michael
Published: October 2023

Background

Increasing expectancy of life and levels of activity in the growing geriatric population lead to a rising number of prosthetic implants of the hip and consequently the incidence of periprosthetic fractures of the femur increase. The fracture pattern and the possible instability of the stem are a challenge to the orthopaedic surgeon. Treatment options are complete replacement of the implant or a solitary osteosynthesis. The goal of this study was to analyse the feasibility of the operative intervention using a contralateral reversed anatomic distal femoral LISS® locking plate and the radiological and functional outcome in a geriatric cohort.

Methods

We included all patients older than 75 years of age with a Vancouver type B fracture, which have been treated by osteosynthesis using a LISS® (contralateral reversed) plate in our institution in an interdisciplinary ortho-geriatric setting between 7/2013 and 12/2021. Perioperative morbidities, clinical and radiological outcome during follow-up were retrospectively analysed.

Results

During the observed time period, 83 patients (mean age: 88 years (range: 76–103), male/female: 26/57) were treated. Most fractures were Vancouver type B2 (n = 45, 54%) followed by B1 (n = 20, 24%) and B3 (n = 18, 22%). The most prevalent postoperative surgical complication was anaemia (n = 73, 88%) followed by infections (n = 12, 14%, urinary infections, pneumonia) and cardiovascular decompensation (n = 8, 10%). Clinical and radiological follow up 6–8 weeks postoperative was possible for 59 patients (70%). The majority of them did not describe pain (n = 50, 85%) and had a good or excellent radiological outcome. Three cases needed revision surgery due to infection and another three due to non-union, loosening of the stem or an additional fracture. 1-year mortality was 30%.

Conclusion

We are convinced that the reversed contralateral LISS-plate is an easy-to-use implant with a small complication rate but a very successful and high healing rate in a geriatric, polymorbid cohort.
Associations of multilingualism and language proficiency with cognitive functioning: epidemiological evidence from the SwissDEM study in community dwelling older adults and long-term care residents
Authors: Pacifico Deborah , Sabatini Serena , Fiordelli Maddalena , Annoni Anna Maria , Frei Anja , Puhan Milo , Graf Gwendolyn , Albanese Emiliano
Published: October 2023

Background

We explored whether number of languages spoken and language proficiency are associated with cognitive performance among older adults living in the community and in long-term care (LTC) in Switzerland.

Methods

Among study participants, 664 lived in the community in the Canton of Zurich (Mean age = 72.97 years; SD = 6.08), 386 lived in the community in Ticino (Mean age = 76.24 years; SD = 6.66), and 176 resided in LTC in Ticino (Mean age = 87.61 years; SD = 6.45). We recorded sociodemographic variables, number of languages spoken, language proficiency, and assessed overall cognitive performance, immediate and delayed memory, and verbal fluency with standardized tests. We used adjusted regression models.

Results

A higher number of spoken languages was positively associated with overall cognitive performance, verbal fluency and immediate and delayed memory performance in community-dwelling older adults in the Cantons of Ticino and Zurich, (all p values ≤ 0.012;), but not in in older adults living in LTC homes (all p values ≥ 0.35). Higher language proficiency was associated with better memory performance among individuals living in the community in Ticino (p value = 0.003), and to better performance in verbal fluency and memory tasks in Zurich (p values ≤ 0.002). Among LTC residents, proficiency levels were not associated with cognitive performance.

Conclusions

Multilingualism and greater language proficiency were associated with better cognitive functioning in community-dwelling but not in institutionalized older adults. Multilingualism may contribute to cognitive reserve, as well as protect and delay cognitive decline in late life.
Factors associated with the perceived need for assistance from voluntary services in home-based older adults in Chinese urban areas: a cross-sectional study
Authors: Huang Lei , Wu Hongyan , Zhang Fengjian , Zhao Huimin , Chen Yuqin , Feng Mingjiao , You Yanjie , Peng Xiao , Guan Chunyan , Liu Yilan
Published: October 2023

Background

With China's rapidly aging population, meeting the diverse care needs of senior citizens is becoming more challenging. Although voluntary social services have numerous advantages and are popular among older adults, there is little information on the need for assistance from volunteer-based social services, particularly those with a medical background, and influencing factors among urban home-based older adults. This study aimed to assess the need for assistance from voluntary services and related factors among urban home-based older adults in China.

Methods

A cross-sectional study was conducted in 2022 on communities in four cities in China. The 27-item Home-Based Older Adults Assistance Need Scale was used to measure the assistance needs of 498 participants aged 60 and above. Multiple linear regression models were conducted to identify salient variables associated with the need for assistance from voluntary services.

Results

The mean score of the need for assistance from voluntary services was 88.60 ± 24.37. The mean scores of the items examining four dimensions, namely, health maintenance, visiting communication, social intercourse, and daily life, were 3.64 ± 1.08, 3.49 ± 1.04, 3.33 ± 1.08, and 2.78 ± 1.08, respectively. The level of depression, willingness to assist older adults, attaching importance to health preservation, ability to self-comfort, desire to accept assistance from others, and the presence of more children or none at all were all positively correlated with the perceived need for assistance from voluntary services. In contrast, social care obtained from visiting medical institutions was negatively correlated. These seven factors explained 28.5% of the total variance.

Conclusions

Urban home-based older adults in China were found to have significant requirements for assistance from volunteer services, and several complex factors were associated with more significant assistance needs. These findings may encourage the extremely limited numbers of social volunteers, particularly those with a medical background, to identify priorities in providing assistance services to the large numbers of urban home-based older adults and thus improve service delivery.
Association of severity and prognosis with elevated blood pressure and heart rate levels in patients with intracerebral hemorrhage
Authors: Wang Dandan , Jiang Ruixuan , Kang Kaijiang , Wang Anxin , Zhang Xiaoli , Lu Jingjing , Zhao Xingquan
Published: October 2023

Background

Intracerebral hemorrhage (ICH) has a high mortality and morbidity in the world. Elevated blood pressure (BP) and heart rate (HR) have been identified as independent risk factors, with potential to predict prognosis and recurrence of cardiovascular diseases. Our study aimed to elucidate the association between BP and HR levels and the severity, as well as prognosis, of patients diagnosed with ICH.

Methods

The basic characteristics of patients and laboratory examination results, inclusive of BP and HR levels upon admission, were recorded as baseline data. The modified Rankin Scale and living status were taken into account for all patients at a 1-year follow-up. The relationship between various BP and HR levels and clinical outcome was analyzed using logistic regression and the Kaplan-Meier survival method.

Results

A total of 1,416 patients with acute ICH from 13 hospitals in Beijing were enrolled in our study. Logistic regression analysis indicated that patients with higher HR and BP (group 4), along with those with higher HR but lower BP (group 2), exhibited a poorer prognosis compared to those with lower BP and HR (group 1). This result was particularly pronounced in younger, male subgroups (OR (95% CI) = 4.379(2.946–6.508), P < 0.0001 for group 4; OR (95% CI) = 1.819 (1.219–2.714), P = 0.0034 for group 2). At the 1-year follow-up, group 4 patients demonstrated a significantly higher rate of fatal incidence compared to other groups (P < 0.01).

Conclusions

Higher HR and BP levels, suggestive of an autonomic dysfunction, were independently associated with a poorer 1-year prognosis and reduced survival rate in ICH patients. Our findings underscore the need for early intervention to modulate these physiological parameters in patients with ICH.
The impact of an online educational game on breast cancer awareness among university female students, Malaysia: a pilot study
Authors: Andrew Tong Jun Wey , Hee Mei Qi
Published: October 2023

Background

Breast cancer is one of the world’s most prevalent cancer and the most common type of cancer in Malaysia. Interestingly, breast cancer in young women is more aggressive compared to older women and the survival rate among these groups of individuals is poor. Thus, breast cancer awareness is essential among young women as early detection is possible and treatment will be effective during which the disease is curable. Hence, the purpose of this study is to design and evaluate the impact of an educational game on breast cancer awareness among female university students in Malaysia.

Methods

This is a one-group pre-and post-intervention pilot study. It was conducted in Private and public higher education institutions around Malaysia. An online education game was created and used as the intervention. A self-administered questionnaire was administered to the participants during the pre-and post-intervention test to evaluate the online educational game on breast cancer awareness.

Results

A total of 52 responses were collected. The mean age of the participants was 21.98 (SD = 1.896) years. The findings showed a statistically significant median increase (p < 0.05) in breast cancer knowledge scores among participants in the post-intervention. A median increase in breast cancer knowledge score of 6 was shown when participants were exposed to the online education game (24.00) compared to before they were exposed to it (17.00).

Conclusion

Using online educational games effectively raised awareness of breast cancer among university students. Online games can be used as a health educational tool to promote awareness of a topic of interest, as digital games can be accessed easily, game content can be tailored made or updated, and improve participant engagement in learning.
Study protocol of OmegaROP-2 prospective study: expression of placental fatty acid receptors in preterm newborns with retinopathy of prematurity
Authors: Carré Chloé , Acar Niyazi , Daruich Alejandra , Grégoire Stéphane , Martine Lucy , Buteau Bénédicte , Aho Serge , Eid Petra , Arnould Louis , Bron Alain Marie , Driessen Marine , Kermorvant Elsa , Simon Emmanuel , Creuzot-Garcher Catherine , Gabrielle Pierre-Henry
Published: October 2023

Background

Incomplete vascularization of the retina in preterm infants carries a risk of retinopathy of prematurity (ROP). Progress in neonatal resuscitation in developing countries has led to the survival of an increasing number of premature infants, resulting in an increased rate of ROP and consequently in visual disability. Strategies to reduce ROP involve optimizing oxygen saturation, nutrition, and normalizing factors such as insulin-like growth factor 1 and n-3 long-chain polyunsaturated fatty acids (LC-PUFA). Our previous study, OmegaROP, showed that there is an accumulation or retention of docosahexaenoic acid (DHA) in mothers of infants developing ROP, suggesting abnormalities in the LC-PUFA placental transfer via fatty acid transporting proteins. The present study aims to better understand the LC-PUFA transport dysfunction in the fetoplacental unit during pregnancy and to find a novel target for the prevention of ROP development.

Methods

The study protocol is designed to evaluate the correlation between the expression level of placental fatty acid receptors and ROP occurrence. This ongoing study will include 100 mother-infant dyads: mother-infant dyads born before 29 weeks of gestational age (GA) and mother-infant dyads with full-term pregnancies. Recruitment is planned over a period of 46 months. Maternal and cord blood samples as well as placental tissue samples will be taken following delivery. ROP screening will be performed using wide-field camera imaging according to the International Classification of ROP consensus statement.

Discussion

The results of this study will have a tangible impact on public health. Indeed, if we show a correlation between the expression level of placental omega-3 receptors and the occurrence of ROP, it would be an essential step in discovering novel pathophysiological mechanisms involved in this retinopathy.

Trial registration

NCT04819893.
Physical activity and transitioning to retirement: evidence from the China health and retirement longitudinal study
Authors: Fang Huiyan , Xiong Zihui , Li Yilin , Cui Wenhui , Cheng Ziping , Xiang Ji , Ye Ting
Published: October 2023

Background

The impact of retirement on physical activity among older individuals remains ambiguous. This study aims to investigate the influence of retirement on physical activity and delineate the trajectories of physical activity changes during the retirement transition among elderly Chinese residents. Additionally, we endeavor to examine the factors that contribute to each trajectory.

Methods

This longitudinal cohort study used data from four surveys of the China Health and Retirement Longitudinal Study and included a sample of 428 individuals who underwent formal retirement and provided information on physical activity. We employed generalized estimating equation to explore the impact of the retirement transition on physical activity among Chinese older adults. Latent class growth analysis was used to identify distinct trajectories of physical activity, and binary logistic regression was performed to identify pre-retirement factors influencing changes in physical activity.

Results

Our findings indicate that retirement can lead to a decline in physical activity among older Chinese residents (OR = 0.85, 95%CI 0.75 ~ 0.97). We identified three distinct trajectories of physical activity during the retirement transition: Trajectory 1 – “sustained low level of physical activity” (7.94%); Trajectory 2 – “middle level of physical activity with gradual decline” (69.16%); Trajectory 3 – “sustained high level of physical activity with significant fluctuations” (22.90%). Furthermore, we discovered that individuals in the “middle level of physical activity and gradual decline” trajectory were more likely to have an annual income exceeding 40,000 yuan (OR = 9.69, 95%CI 1.12 ~ 83.63), reside in urban areas (OR = 2.27, 95%CI 1.14 ~ 4.52), and have a fondness for playing Mahjong (OR = 2.42, 95%CI 1.18 ~ 5.00) compared to those in the “sustained high level of physical activity with significant fluctuations” trajectory. Additionally, having an annual income exceeding 40,000 yuan (OR = 19.67, 95%CI 1.30 ~ 298.61) predicted membership in the “sustained low level of physical activity” trajectory when compared to the “sustained high level of physical activity with significant fluctuations” trajectory.

Conclusion

Retirement represents a substantial milestone in the life course and is associated with notable alterations in physical activity patterns. Among older Chinese residents, the trajectories of physical activity during the retirement transition exhibit diverse paths and are influenced by pre-retirement factors, including annual income, residential location, and hobbies. The findings of this study have important implications for the formulation of policies aimed at promoting healthy aging among individuals approaching retirement age.