bluuebunny/crossref_metadata_2025 huggingface dataset:
Tuberculous meningitis patient pathways and delays to diagnosis in Indonesia: a retrospective cohort study
Authors: Nijman Gerine , Imran Darma , Dian Sofiati , Ganiem Ahmad Rizal , Estiasari Riwanti , Maharani Kartika , Yolanda Raesa , Supriatin Mimin , Alisjahbana Bachti , Lestari Bony Wiem , Hamers Raph L , Hill Philip C , van Crevel Reinout
Published: November 2023

Introduction

Delays in diagnosis and treatment contribute to high mortality of tuberculous meningitis (TBM). We studied TBM patient pathways including delays to diagnosis, and their alignment with available diagnostic services in Indonesia.

Methods

We recruited patients admitted to two tertiary hospitals who started TBM treatment. Participants or their relatives were interviewed to recall healthcare visits preceding TBM treatment. We also surveyed available diagnostic capacity for TBM at hospitals that had been visited by at least two patients preceding their study enrolment.

Results

Of 175 participants (median age 31 years, 57.1% men), 85.1% had reduced consciousness or coma, and 46.9% had motor deficits including hemiparesis. Patients attended a first healthcare provider, most often private clinics (38.3%) or informal healthcare providers (22.3%), at a median 14 days (IQR 1–34) after symptom onset. They visited multiple providers (median 5, IQR 3–8) over a prolonged time period (median 31 days, IQR 10–79) preceding TBM diagnosis. Of 40 surveyed hospitals, 52.5% could not or not always perform lumbar puncture, 22.5% lacked cerebral imaging facilities and 31.6% and 84.2%, respectively, could not provide routine microscopy or GeneXpert MTB/RIF on cerebrospinal fluid.

Conclusion

In these urban settings in Indonesia, pathways to TBM diagnosis are complex and lengthy, and patients often visit healthcare providers with limited capacity to diagnose TBM. There is an urgent need for interventions to strengthen health literacy and diagnostic and referral processes in public and private health sectors for complex patient groups like TBM.
Aetiology, diagnosis and management for ischaemic cholecystitis: current perspectives
Authors: Favela Juan Gerardo , Argo Madison B , Huerta Sergio
Published: November 2023

In the absence of gallstones or any other form of mechanical obstruction, hypoperfusion to the gallbladder can lead to inflammation, ischaemia and perforation. This constellation of findings has historically been simply referred to as ‘acalculous cholecystitis’. However, this term makes no distinction between inflammation due to critical illness and poor perfusion, or what we will refer to as ischaemic cholecystitis, versus other non-obstructive aetiologies. Ischaemic cholecystitis presents diagnostic as well as treatment challenges that are unique to patients in the critical care setting. More importantly, the morbidity and mortality of this proposed subcategory of acute gallbladder inflammation is much higher compared with other forms of acute cholecystitis. In the present manuscript, we introduce the concept of ischaemic cholecystitis and the importance of differentiating this clinical diagnosis from other forms of acalculous cholecystitis. Additionally, we elaborate on the most recent diagnostic modalities and treatment options specific to this vulnerable patient population.
Framework humanization optimizes potency of anti-CD72 nanobody CAR-T cells for B-cell malignancies
Authors: Temple William C , Nix Matthew A , Naik Akul , Izgutdina Adila , Huang Benjamin J , Wicaksono Gianina , Phojanakong Paul , Serrano Juan Antonio Camara , Young Elizabeth P , Ramos Emilio , Salangsang Fernando , Steri Veronica , Xirenayi Simayijiang , Hermiston Michelle , Logan Aaron C , Stieglitz Elliot , Wiita Arun P
Published: November 2023

Background

Approximately 50% of patients who receive anti-CD19 CAR-T cells relapse, and new immunotherapeutic targets are urgently needed. We recently described CD72 as a promising target in B-cell malignancies and developed nanobody-based CAR-T cells (nanoCARs) against it. This cellular therapy design is understudied compared with scFv-based CAR-T cells, but has recently become of significant interest given the first regulatory approval of a nanoCAR in multiple myeloma.

Methods

We humanized our previous nanobody framework regions, derived from llama, to generate a series of humanized anti-CD72 nanobodies. These nanobody binders were inserted into second-generation CD72 CAR-T cells and were evaluated against preclinical models of B cell acute lymphoblastic leukemia and B cell non-Hodgkin’s lymphoma in vitro and in vivo. Humanized CD72 nanoCARs were compared with parental (“NbD4”) CD72 nanoCARs and the clinically approved CD19-directed CAR-T construct tisangenlecleucel. RNA-sequencing, flow cytometry, and cytokine secretion profiling were used to determine differences between the different CAR constructs. We then used affinity maturation on the parental NbD4 construct to generate high affinity binders against CD72 to test if higher affinity to CD72 improved antitumor potency.

Results

Toward clinical translation, here we humanize our previous nanobody framework regions, derived from llama, and surprisingly discover a clone (“H24”) with enhanced potency against B-cell tumors, including patient-derived samples after CD19 CAR-T relapse. Potentially underpinning improved potency, H24 has moderately higher binding affinity to CD72 compared with a fully llama framework. However, further affinity maturation (KD<1 nM) did not lead to improvement in cytotoxicity. After treatment with H24 nanoCARs, in vivo relapse was accompanied by CD72 antigen downregulation which was partially reversible. The H24 nanobody clone was found to have no off-target binding and is therefore designated as a true clinical candidate.

Conclusion

This work supports translation of H24 CD72 nanoCARs for refractory B-cell malignancies, reveals potential mechanisms of resistance, and unexpectedly demonstrates that nanoCAR potency can be improved by framework alterations alone. These findings may have implications for future engineering of nanobody-based cellular therapies.
Single-cell RNA-sequencing atlas reveals an FABP1-dependent immunosuppressive environment in hepatocellular carcinoma
Authors: Tang Weiwei , Sun Guangshun , Ji Gu-Wei , Feng Tingting , Zhang Qian , Cao Hengsong , Wu Wenhao , Zhang Xiaoyi , Liu Chuan , Liu Hanyuan , Huang Tian , Liu Li , Xia Yongxiang , Wang Xuehao
Published: November 2023

Background

Single-cell RNA sequencing, also known as scRNA-seq, is a method profiling cell populations on an individual cell basis. It is particularly useful for more deeply understanding cell behavior in a complicated tumor microenvironment. Although several previous studies have examined scRNA-seq for hepatocellular carcinoma (HCC) tissues, no one has tested and analyzed HCC with different stages.

Methods

In this investigation, immune cells isolated from surrounding normal tissues and cancer tissues from 3 II-stage and 4 III-stage HCC cases were subjected to deep scRNA-seq. The analysis included 15 samples. We distinguished developmentally relevant trajectories, unique immune cell subtypes, and enriched pathways regarding differential genes. Western blot and co-immunoprecipitation were performed to demonstrate the interaction between fatty acid binding protein 1 (FABP1) and peroxisome proliferator-activated receptor gamma(PPARG). In vivo experiments were performed in a C57BL/6 mouse model of HCC established via subcutaneous injection.

Results

FABP1 was discovered to be overexpressed in tumor-associated macrophages (TAMs) with III-stage HCC tissues compared with II-stage HCC tissues. This finding was fully supported by immunofluorescence detection in significant amounts of HCC human samples. FABP1 deficiency in TAMs inhibited HCC progression in vitro. Mechanistically, FABP1 interacted with PPARG/CD36 in TAMs to increase fatty acid oxidation in HCC. When compared with C57BL/6 mice of the wild type, tumors in FABP1–/– mice consistently showed attenuation. The FABP1–/– group’s relative proportion of regulatory T cells and natural killer cells showed a downward trend, while dendritic cells, M1 macrophages, and B cells showed an upward trend, according to the results of mass cytometry. In further clinical translation, we found that orlistat significantly inhibited FABP1 activity, while the combination of anti-programmed cell death 1(PD-1) could synergistically treat HCC progression. Liposomes loaded with orlistat and connected with IR780 probe could further enhance the therapeutic effect of orlistat and visualize drug metabolism in vivo.

Conclusions

ScRNA-seq atlas revealed an FABP1-dependent immunosuppressive environment in HCC. Orlistat significantly inhibited FABP1 activity, while the combination of anti-PD-1 could synergistically treat HCC progression. This study identified new treatment targets and strategies for HCC progression, contributing to patients with advanced HCC from new perspectives.
Chimeric antigen receptor T cells to target CD79b in B-cell lymphomas
Authors: Chu Fuliang , Cao Jingjing , Liu Jingwei , Yang Haopeng , Davis Timothy J , Kuang Shao-qing , Cheng Xiaoyun , Zhang Zheng , Karri Swathi , Vien Long T , Bover Laura , Sun Ryan , Vega Francisco , Green Michael , Davis Richard Eric , Neelapu Sattva S
Published: November 2023

Background

Chimeric antigen receptor (CAR) T cells targeting CD19 mediate potent and durable effects in B-cell malignancies. However, antigen loss or downregulation is a frequent cause of resistance. Here, we report development of a novel CAR T-cell therapy product to target CD79b, a pan B-cell antigen, widely expressed in most B-cell lymphomas.

Methods

We generated a novel anti-CD79b monoclonal antibody by hybridoma method. The specificity of the antibody was determined by testing against isogenic cell lines with human CD79b knock-in or knock-out. A single-chain variable fragment derived from the monoclonal antibody was used to make a panel of CD79b-targeting CAR molecules containing various hinge, transmembrane, and co-stimulatory domains. These were lentivirally transduced into primary T cells and tested for antitumor activity in in vitro and in vivo B-cell lymphoma models.

Results

We found that the novel anti-CD79b monoclonal antibody was highly specific and bound only to human CD79b and no other cell surface protein. In testing the various CD79b-targeting CAR molecules, superior antitumor efficacy in vitro and in vivo was found for a CAR consisting CD8α hinge and transmembrane domains, an OX40 co-stimulatory domain, and a CD3ζ signaling domain. This CD79b CAR specifically recognized human CD79b-expressing lymphoma cell lines but not CD79b knock-out cell lines. CD79b CAR T cells, generated from T cells from either healthy donors or patients with lymphoma, proliferated, produced cytokines, degranulated, and exhibited robust cytotoxic activity in vitro against CD19+and CD19–lymphoma cell lines and patient-derived lymphoma tumors relapsing after prior CD19 CAR T-cell therapy. Furthermore, CD79b CAR T cells were highly efficient at eradicating pre-established lymphoma tumors in vivo in three aggressive lymphoma xenograft models, including two cell line-derived xenografts and one patient-derived xenograft. Notably, these CAR T cells did not demonstrate any significant tonic signaling activity or markers of exhaustion.

Conclusion

Our results indicated that this novel CD79b CAR T-cell therapy product has robust antitumor activity against B-cell lymphomas. These results supported initiation of a phase 1 clinical trial to evaluate this product in patients with relapsed or refractory B-cell lymphomas.
Predictors requiring special attention to prevent clavicle fracture nonunion: a systematic review of literature
Authors: Irfan Shayan Ali , Ali Abid Anwar , Ashkar Anusha , Akram Usama , Fatima Sameen , Baig Mirza M Ali , Khan Muhammad Waqas
Published: November 2023

Background

Clavicle fracture (CF) is the tenth most prevalent fracture, accounting for an annual incidence of 37/10,000. This systematic review highlights the factors contributing to the nonunion union of the clavicular fracture.

Method

A systematic search was conducted using three web-based databases up to August 12, 2022, for conducting qualitative analysis. Articles were screened for relevance, and only studies that met inclusion criteria based on PECOS; P (patients): participants diagnosed with clavicular fracture; E (exposure): nonunion, C (control): not applicable; O (outcomes): factors contributing to nonunion or delayed union; S (studies): trials and observational studies. The Newcastle-Ottawa Scale was used to assess the quality of the cohort studies. The Cochrane risk of bias tool was used to assess the bias in randomized control trials.

Results

Ten studies were selected after the final literature search. Two thousand seven hundred and sixty-six adult participants who were radiologically and clinically diagnosed with nonunion clavicular fracture were included to pool the qualitative results. Fall was the most dominant cause of clavicular fracture, followed by road traffic collisions. Open reduction was widely used to treat nonunion correction. The qualitative results suggested a prominent correlation of nonunion with advancing age, female gender, high energy trauma, high Disabilities of the Arm, Shoulder, and Hand Score, smoking, fracture displacement, clavicular shortening, the callus on radiography, and fracture movement. The mid-shaft fracture was the most dominant type of fracture in the included studies; highly associated with nonunion in comparison to medial or lateral CF. The previous history of operation was an independent factor contributing to nonunion.

Conclusion

The results of this systematic review suggested the predictors contributing to nonunion in the CF. Demographic factors such as advancing age with female gender are at higher risk of developing clavicular nonunion. Smoking was the most dominantly highlighted environmental factor contributing to nonunion. Diaphyseal or midshaft fracture was the most common site for nonunion. Therefore, we suggested that patients with the predictors mentioned above require special attention to prevent nonunion of the CFs. More studies should be conducted on this subject to assess the factors that pose a risk associated with the nonunion of the bone for better clinical management and outcomes of the fracture.
Acetabular fractures in elderly patients are associated with high rates of complications during the initial admission
Authors: Simske Natasha , Furdock Ryan , Heimke Isabella , Vallier Heather A
Published: November 2023

Background

Acetabular fractures among the elderly are common. Identification of risk factors predisposing elderly patients to in-hospital complications is critical to mitigating morbidity and mortality.

Methods

A retrospective cohort study was performed including 195 patients ≥60 years old who sustained acetabulum fractures treated at a single level 1 trauma center. Operative (n=110, 56.4%) or non-operative management was undertaken, and complications during the index hospitalization were defined.

Results

Seventy-three patients (37%) developed a complication during their hospitalization. Most common complications were acute respiratory failure: 13.3%, pneumonia: 10.3%, urinary tract infection: 10.3%, cardiac dysrhythmia: 9.7%, and acute kidney injury: 6.2%. On multivariable analysis, factors associated with in-hospital complications were increased age (adjusted OR (AOR): 1.06, 95% CI: 1.01 to 1.11, p=0.013), more comorbidities (AOR: 1.69, 95% CI: 1.07 to 2.65, p=0.024), operative management (AOR: 0.3, 95% CI: 0.12 to 0.76, p=0.011), and increased length of stay (AOR: 1.34, 95% CI: 1.2 to 1.51, p<0.001).

Conclusions

Acetabular fractures in the elderly are associated with high rates of in-hospital complications. Advanced age, more medical comorbidities and longer lengths of stay predicted higher risk of developing complications. Whereas operative management was associated with lower risk of developing complications during the initial admission, it is important to note the selection bias in which healthier patients with improved baseline functionality may be more likely to undergo operative management.

Level of evidence

Level III therapeutic.
Probing gluon saturation via diffractive jets in ultra-peripheral nucleus-nucleus collisions
Authors: Iancu E. , Mueller A. H. , Triantafyllopoulos D. N. , Wei S. Y.
Published: November 2023

We argue that semi-inclusive photo-production of a pair of hard jets via coherent diffraction in nucleus-nucleus ultra-peripheral collisions at high energy is a golden channel to study gluon saturation. The dominant contribution is the diffractive production of three jets in an asymmetric configuration. Two of the jets are hard and propagate at nearly central pseudo-rapidities. The third jet is semi-hard, with transverse momentum comparable to the nuclear saturation momentum, and is well separated in pseudo-rapidity from the hard dijets. The emission of the semi-hard jet allows for strong scattering, thus avoiding the “higher-twist” suppression of the exclusive dijet production due to colour transparency. We compute the trijet cross-section using the diffractive TMD factorisation which emerges from the CGC effective theory at high energy. The cross-section is controlled by gluon saturation, which leaves its imprints on the structure of the final state, notably on the rapidity distribution.
The $$\mathcal{O}(\alpha _t+\alpha _\lambda +\alpha _\kappa )^2$$ correction to the $$\rho $$ parameter and its effect on the W boson mass calculation in the complex NMSSM
Authors: Dao Thi Nhung , Gabelmann Martin , Mühlleitner Margarete
Published: November 2023

We present the prediction of the electroweak $$\rho $$
ρ
parameter and the W boson mass in the CP-violating Next-to-Minimal Supersymmetric extension of the Standard Model (NMSSM) at the two-loop order. The $$\rho $$
ρ
parameter is calculated at the full one-loop and leading and sub-leading two-loop order $${\mathcal {O}}(\alpha + \alpha _t\alpha _s + \left( \alpha _t+\alpha _\lambda +\alpha _\kappa \right) ^2)$$

O
(
α
+

α
t

α
s

+

α
t

+

α
λ

+

α
κ

2

)

. The new $$\Delta \rho $$

Δ
ρ

prediction is incorporated into a prediction of $$M_W$$

M
W

via a full supersymmetric (SUSY) one-loop calculation of $$\Delta r$$

Δ
r

. Furthermore, we include all known state-of-the-art SM higher-order corrections to $$\Delta r$$

Δ
r

. By comparing results for $$\Delta \rho $$

Δ
ρ

obtained using on-shell (OS) and $$\overline{\text {DR}}$$

DR
¯

renormalization conditions in the top/stop sector, we find that the scheme uncertainty is reduced at one-loop order by 55%, at two-loop $${\mathcal {O}}(\alpha _s\alpha _t)$$

O
(

α
s

α
t

)

by 22%, and at two-loop $${\mathcal {O}}(\alpha _t+\alpha _\kappa +\alpha _\lambda )^2$$

O

(

α
t

+

α
κ

+

α
λ

)

2

by 16%, respectively. The influence of the two-loop results on the $$M_W$$

M
W

mass prediction is found to be sub-leading. The new calculation is made public in the computer program . We perform an extensive comparison in the W-mass, Higgs boson mass and the muon anomalous magnetic moment prediction between our calculation and three other publicly available tools and find very good agreement provided that the input parameters and renormalization scales are treated in the same way. Finally, we study the impact of the CP-violating phases on the W-mass prediction which is found to be smaller than the overall size of the SUSY corrections.
The Antibiotic Knowledge, Attitudes, and Behaviors of Patients Purchasing Antibiotics without Prescription: Results of National Survey
Authors: Rachina Svetlana , Zakharenkova Polina , Kozlov Roman , Palagin Ivan , Mamchich Daria , Strelkova Daria
Published: November 2023

Background. The inappropriate and overuse of antimicrobials is a problem worldwide. To target future interventions, a thorough understanding of current behavior reasons is needed. The aim of the study was to explore antibiotic knowledge, attitudes, and behaviors among patients residing in Russia. Methods. In total, 149 semistructured interviews were carried out with respondents using antibiotics without prescriptions. Interviews were used to assess participants’ practices to treat symptoms of a confirmed/suspected infectious disease and their behaviors, knowledge, and attitudes toward the use of antimicrobials. A directed content analysis was applied. Results. Despite regulation, inappropriate use of antibiotics is a common practice. Knowledge on the mechanism of action and indications for the use of antibiotics was generally low. However, self-diagnosis, self-treatment with antimicrobials, and attempts to purchase antibiotics in pharmacies with no prescription were quite common. Family members and friends were involved in decisions about treatment strategy. Time spent for the doctor’s visit, fear to be exposed to additional infections in outpatient clinics/hospitals, previous experience with antimicrobial self-treatment, and “loyal” policy of selling antibiotics influenced the respondents’ decisions of not going to the doctor. COVID-19 made an impact on antimicrobial self-treatment: there was a substantial complexity in contacting a medical healthcare provider. Most of the respondents did not pay much attention or even noticed informational materials on the proper use of antibiotics. Conclusion. Self-treatment with antibiotics in Russia exists. Conducted information campaigns were not effective enough as the low level of knowledge about antimicrobials and antimicrobial resistance was revealed by the present study.
Seismic Behavior Investigations of the Haunched Joint with Ribbed Anchor Webs in CFDST Structures
Authors: Zhang Yufen , Qu Xiaokun , Wang Ling , Bu Hongfan , Cao Shengxi
Published: November 2023

The haunched joint with ribbed anchor webs in the concrete-filled double steel tubular (CFDST) structure was proposed in this study. The CFDST column and the steel beam were connected by ribbed webs, which were anchored inside the column and connected to the beam web by the bolted connection, and haunches were welded to shift plastic hinges from the joint core to the beam end. The cyclic loading test was conducted on three beam-to-column joint specimens. Seismic behaviors, including failure modes, strain and stress responses, hysteretic curves, ductility, and energy dissipation capacity, were, respectively, analyzed. Besides, finite element (FE) modeling was validated and was used to further analyze the seismic behavior in consideration of connection constructional details, geometric dimensions, material strength, and axial compression ratios. The parametric investigation shows that besides ribs and haunches, stiffening diaphragms are practicable to connect the double tubes, especially for the high-strength steel beam; beam-to-column bending stiffness ratio per unit length is appropriate to be 0.3–0.5; choosing low strength grade of concrete is allowed to satisfy engineering requirements; the axial compression ratio should be limited within 0.5.
Compact Millimeter-Wave Antenna Array with Low Sidelobe Level for Vital Sign Monitoring Application
Authors: He Mengxue , Yun Jie , Wang Boning , Zhang Xuning , Liao Xin
Published: November 2023

In this paper, an antenna array fed in series by a novel substrate-integrated waveguide (SIW) power divider is proposed for the millimeter-wave band vital sign monitoring application. The proposed antenna is printed on a single-layer substrate, with the advantages of low profile, low cost, and ease of fabrication. By branching microstrip lines alternatively at both edges of the SIW, an in-phase power divider is first constructed. Then, by appropriately adjusting the depth of microstrip branches into the SIW, the amplitude of the output power can be tuned to obtain the desired amplitude distribution. Patches are connected to the microstrip branches, respectively, and thus, a radiation pattern with a low sidelobe level is realized. More importantly, series patches can be cascaded to enhance the array gain without the additional feeding network. This leads to a compact configuration. Based on the proposed idea, a prototype is designed, implemented, and tested. The results indicate that the proposed array achieves a maximum gain of 17.8 dBi with a low sidelobe level of -25.5 dB. The attractive performance shows that the array is suitable for the millimeter-wave vital sign monitoring application.
Hybrid Deep Learning Algorithm-Based Food Recognition and Calorie Estimation
Authors: Agarwal Ritu , Choudhury Tanupriya , Ahuja Neelu J. , Sarkar Tanmay
Published: November 2023

Every individual requires some sort of system that informs them about portions and calories of food, as well as providing them with directions on how to consume it. In our study, we propose a hybrid architecture that makes use of deep learning algorithms to forecast the number of calories in various food items on a bowl. This consists of three major components: segmentation, classification, and calculating the volume and calories of food items. When we use a Mask RCNN, the images are first segmented. Using the YOLO V5 framework, features are collected from the segmented images and the food item is categorized. In order to determine the dimensions of each food item, we identify the items first. In order to calculate the quantity of the food item, the estimated dimension must be used. The calories are then computed using the food item’s volume. The aforementioned approaches, which were trained on the dataset’s food images, that correctly identified and forecasted a food item’s calories had an accuracy of 97.12%. To Provide directions on how to consume food is expected by individual and will be completed after knowing intake of volume of food.
Chronic Myeloid Leukaemia: A Qualitative Study of Patient and Practitioner Experiences of Managing Treatment
Authors: Hewison Ann , Roman Eve , Smith Alexandra , McCaughan Dorothy , Sheridan Rebecca , Patmore Russell , Atkin Karl , Howell Debra
Published: November 2023

Background. Following the dramatic impact of tyrosine kinase inhibitor (TKI) drugs on chronic myeloid leukaemia (CML) survival, research interest has grown into the long-term impact of treatment, identifying difficulties with medication adherence and ongoing side effects. Qualitative studies suggest the disease has a significant physical and psychological impact on patients, and medication management may be complex. However, only one study worldwide has examined healthcare practitioner (HCP) experiences of managing CML treatment and very little UK qualitative research exists exploring the patient experience. Purpose. Our qualitative study aimed to investigate both patient and HCP experiences of managing CML treatment in the UK. Methods. Patients and HCPs were purposively sampled from within the Haematological Malignancy Research Network (HMRN), a UK population-based patient cohort. Qualitative interviews were carried out with seventeen patients and thirteen HCPs, and data were analysed using thematic analysis. Results. Four themes were developed from interview analysis: “Importance of optimal clinical management,” “Multiple adherence strategies,” “Inconsistent management of adherence,” and “Controlling side effects is complex.” HCPs tended to focus on sometimes complex, clinical decision-making. Patients described various strategies to support adherence and manage side effects, some of which HCPs seemed to be less aware of. Several patients did not discuss non-adherence or side effects with their HCP, who tended to avoid direct enquiry regarding adherence and could be uncertain about adherence advice, whilst relying on medical strategies to manage side effects. Conclusions. Despite HCPs focusing on the medical management of CML treatment, patients may opt to use self-management techniques to control adherence and side effects and can be reluctant to discuss related difficulties. Increased clinic time and clear adherence advice guidance may support such discussion, in addition to adjusting the context of follow-up care through the introduction of shared care with GP services.
Predictors of Academic and Fieldwork Performance in Occupational Therapy Students: A Systematic Review
Authors: Wang Yun , Chung Lai-Ha , Cheng Chao-Yi , Wang Wei-Jiun , Chang Li-Chin , Huang Yu-Ming , Tso Sheng-Yuan , Chen Yu-Lin , Wu Ching-Yi
Published: November 2023

Introduction. Occupational therapy (OT) educational programs are aimed at enrolling a diverse student population that is likely to succeed in the academic and fieldwork components of the program. Comprehending the array of factors that influence students’ learning and academic and fieldwork success is important for university educators. This study investigated the existing literature on predictors of academic and fieldwork performance in OT students. Methods. The search process used in this review included screening, eligibility, and study quality. We searched the PubMed and Cochrane Library databases for literature published in the past 10 years (1 January 2012 to 30 March 2022). As a comprehensive search, the following keywords were used for abstract, title, and keywords sections: occupational therapy student, predictors, fieldwork, academic, academic success, academic performance, fieldwork success, and fieldwork performance. The Medical Education Research Study Quality Instrument was used to assess the quality of studies. Results. The systematic review retrieved 14 articles that met inclusion criteria. Most were cross-sectional studies, followed by cohort, retrospective analysis of secondary data, and exploratory studies. Four articles focused on academic success, eight focused on fieldwork success, and two explored both aspects. Promising predictors of academic performance included the admission grade point average and the student’s approach to studying. Predictors of fieldwork performance included a graduate record examination score, emotional intelligence, and interpersonal relationships. Conclusion. This systematic review explores predictors of academic and fieldwork success in OT students, which provide opportunities to identify early the learning difficulties of students and assist educators to target modifiable predictors so they can provide high-quality education.
Review of Medicinal Plants Traditionally Used to Treat Diarrhea by the People in the Amhara Region of Ethiopia
Authors: Damtie Destaw
Published: November 2023

Background. Diarrheal illness is the second‐most common cause of death in under‐five children. Worldwide, it results in about 1.7 billion illnesses and 525,000 deaths among under‐five children annually. It is the leading cause of malnutrition among under‐five children. Different people use medicinal plants to treat diarrhea. The present study aimed to review the medicinal plants used to treat diarrhea by the people in the Amhara region and to diagnose whether the antidiarrheal activities of the medicinal plants have been confirmed by studies using animal models. Methods. The author searched 21 articles from worldwide databases up to December 2022 using Boolean operators (“AND” and “OR”) and the terms “ethnobotanical studies,” “ethnobiology,” “traditional medicine,” “ethnobotanical knowledge,” and “Amhara region.” Results. From the 21 studies reviewed, 50 plant species grouped into 28 families were reported to treat diarrhea by the people in the Amhara region. The top most used families were Lamiaceae (12%), Fabaceae (8%), Asteraceae, Cucurbitaceae, Euphorbiaceae, and Poaceae (6% each). The modes of administration of the plant parts were orally 98.88% and topically 1.12%. The different extracts of 18 (or 36%) of the medicinal plants traditionally used to treat diarrhea by the people in the Amhara region have been proven experimentally in animal models. Conclusions. The people in the Amhara region use different medicinal plants to treat diarrhea. Most of them take the medicinal plants orally. The traditional claim that 60% of medicinal plants are antidiarrheal has been confirmed in in vitro studies.
Conditional Tabular Generative Adversarial Net for Enhancing Ensemble Classifiers in Sepsis Diagnosis
Authors: Alfakeeh Ahmed , Sharif Mhd Saeed , Zorto Abin Daniel , Pillonetto Thiago
Published: November 2023

Antibiotic-resistant bacteria have proliferated at an alarming rate as a result of the extensive use of antibiotics and the paucity of new medication research. The possibility that an antibiotic-resistant bacterial infection would progress to sepsis is one of the major collateral problems affecting people with this condition. 31,000 lives were lost due to sepsis in England with costs about two billion pounds annually. This research aims to develop and evaluate several classification approaches to improve predicting sepsis and reduce the tendency of underdiagnosis in computer-aided predictive tools. This research employs medical datasets for patients diagnosed with sepsis, and it analyses the efficacy of ensemble machine learning techniques compared to nonensemble machine learning techniques and the significance of data balancing and conditional tabular generative adversarial nets for data augmentation in producing reliable diagnosis. The average F Score obtained by the nonensemble models trained in this paper is 0.83 compared to the ensemble techniques average of 0.94. Nonensemble techniques, such as Decision Tree, achieved an F score of 0.90, an AUC of 0.90, and an accuracy of 90%. Histogram-basedgradient boosting classification tree achieved an F score of 0.96, an AUC of 0.96, and an accuracy of 95%, surpassing the other models tested. Additionally, when compared to the current state-of-the-art sepsis prediction models, the models developed in this study demonstrated higher average performance in all metrics, indicating reduced bias and improved robustness through data balancing and conditional tabular generative adversarial nets for data augmentation. The study revealed that data balancing and augmentation on the ensemble machine learning algorithms boost the efficacy of clinical predictive models and can help clinics decide which data types are most important when examining patients and diagnosing sepsis early through intelligent human-machine interface.
Identification and Development of Synovial B-Cell-Related Genes Diagnostic Signature for Rheumatoid Arthritis
Authors: Tang Jifeng , Xia Jinfang , Sheng Huiming , Lin Jinpiao
Published: November 2023

Background. The aim of the study was to investigate the landscape of B-cell-related gene expression profiling in rheumatoid arthritis (RA) synovium and explore the biological and clinical significance of these genes in RA. Methods. Expression profiling of synovial biopsies from subjects with 152 RA patients, 22 osteoarthritis (OA) patients, and 28 healthy controls was downloaded from the Gene Expression Omnibus database. Single-sample gene set enrichment analysis (ssGSEA) was performed to evaluate the abundance of infiltrated immune cells, and the results were validated using immunohistochemical staining. GSEA was employed to decipher differences in B-cell-related biological pathways. B-cell-related differential expression genes (BRDEGs) were screened, and BRDEGs-based model was developed by machine learning algorithms and evaluated by an external validation set and clinical RA cohort, then biological functions were further analyzed. Results. High levels of immune cell infiltration and B-cell-related pathway activation were revealed in RA synovium. BRDEGs were screened, and three key molecular markers consisting of FAS, GPR183, and TFRC were identified. The diagnosis model was established, and these gene markers have good discriminative ability for RA. Molecular pathological evaluation confirmed RA patients with high-risk scores presented higher levels of B-cell activation and RA characteristics. In addition, a competitive endogenous RNA network was established to elucidate the molecular mechanisms of the posttranscriptional network. Conclusions. We described the B-cell-related molecular landscape of RA synovium and constructed a molecular diagnostic model in RA. The three genes FAS, GPR183, and TFRC may be potential targets for clinical diagnosis and immunoregulatory therapy of RA.
Polylactic Acid-Based Film Modified with Nano-Ag-Graphene-TiO2: New Film versus Recycled Film
Authors: Peter Anca , Nicula Camelia , Mihaly Cozmuta Anca , Drazic Goran , Peñas Antonio , Silvi Stefania , Mihaly Cozmuta Leonard
Published: November 2023

The increase in the polymer-based materials needs has induced along the waste accumulation, thus argued higher interest in recycling. The study aims to assess the structural, morphological, mechanical resistance, physical–chemical and biochemical characteristics, as well as the preservative role during the curd cheese storage of a recycled polylactic acid (PLA)-based film modified with Ag-graphene-TiO2 nanostructured composite, obtained by recovering the composite from the used film, followed by its incorporation in new PLA. The breaking load of the recycled film was 24% lower than that of the new film and 10% higher than of the neat PLA. Differential scanning calorimetry (DSC) showed changes of the recycled PLA’s surface tension and crystallization degree in a greater extent than in the newly prepared film, revealing better incorporation of the recovered composite into the PLA matrix. Fourier transformed infrared spectroscopy showed the formation of C–O–Ti bridges between composite and PLA both in new and recycled film. Oxygen transmission rate (OTR) of the new and recycled film decreased by 33% and 45%, respectively, in comparison with reference PLA. The curd cheese was successfully stored in the recycled packaging; the organoleptic characteristics of cheese wrapped in recycled film were superior in comparison with the new film. The variation of fat and protein contents and mass loss was the lowest when the recycled film was used as packaging material. The study successfully showed the possibility to recover and recycle the used PLA-based films modified with inorganic nanocomposites.
Does Social Enterprises are Financially Different? A Study from Belgium
Authors: Handrito Radityo Putro , Willaert Camille , Willaert Fleur
Published: November 2023

This literature review explores the financing structure of social enterprises compared to traditional enterprises. It highlights the growing interest in social entrepreneurship and the unique challenges social enterprises face in accessing external financing. The review examines different definitions of social entrepreneurship and its impact on society. It also discusses the motivations and management approaches of traditional entrepreneurship. Additionally, the review delves into the concept of capital structure and the role it plays in financing operations. Finally, it addresses profitability as a determinant of a firm's financial health. Overall, the review provides insights into the differences and similarities between social and traditional enterprises in terms of their financing structure.
The Budgetpreneur: Navigating Business Success on a Shoestring Budget for Gen Z
Authors: Prameka Adelia Shabrina , Hakim Abdrrahman , Fakhri Erie Awalil
Published: November 2023

This abstract explores the impact of the Gig Economy on Gen-Z entrepreneurs and the challenges they face due to limited financial resources. It discusses the importance of access to capital, alternative funding options such as crowdfunding, and leveraging non-financial resources and support systems. The abstract also highlights the role of university education in providing the necessary support and environment for aspiring entrepreneurs. Overall, it sheds light on the strategies and resources available to Gen-Z entrepreneurs to navigate the business landscape and succeed despite financial constraints
Increasing SME Competitiveness through Digital Technology Moh. Erfan Arif
Authors: Arif Moh. Erfan
Published: November 2023

Small and medium enterprises (SMEs) need to be supported by various parties so that their strategic roles, such as employment, economic stability, and others, can be felt by the community. SMEs that can make a big contribution to society are those that have competitiveness, have the ability to maintain their position in the market by meeting product supply, and are able to respond quickly to changes in demand. SMEs need to have competitiveness because they face intense competition, not only with local products but also with imported products. This competitiveness can be determined by business environmental factors and the capabilities possessed by SME owners. Competitiveness can be built by improving the quality of human capital, which includes experience, abilities, knowledge, and expertise. One significant effort to increase the competitiveness of SMEs is by utilizing digital technology, which can make it easier to reach the target market. The use of digital technology through various types of platforms in business also opens up opportunities for SMEs to not only serve local markets but also internationally. The opportunity for SMEs to reach foreign markets needs to be fully supported by the government and related parties because the number of export-oriented Indonesian SMEs is still small. In other words, optimizing the use of digital technology by SMEs can expand market reach, both domestic and foreign, which will automatically contribute to the international trade balance.
Bias Financial Behavior on Investment Decisions
Authors: Aisjah Siti , Kalimasada Kalimasada , Fasieh M. Fajrul Islam , Fadilah Wildan
Published: November 2023

This literature review explores the theory of behavioral finance and its application in understanding investor behavior and decision-making processes. Behavioral finance integrates psychological factors into finance to explain irrational financial decisions and anomalies observed in the market. The review examines key theories within behavioral finance, including prospect theory, heuristic models, and the dual-process theory. It also discusses various investment instruments in the capital market, such as stocks and bonds, and their associated risks. Additionally, the review highlights common investment behavioral biases and provides recommendations to mitigate their influence on decisionmaking. Understanding and addressing these biases can lead to more objective and informed investment strategies.
Cambio climático y olas de calor sobre el bienestar subjetivo en jóvenes
Authors: Sandoval-Díaz José , Díaz-Vargas Nadia , Flores-Jiménez Dilan , López-Salazar Camila , Bravo-Ferret Cristóbal
Published: November 2023

(analytical)Climate change and the increasing occurrence of heatwaves have a negative impact on the subjectivewell-being of children and young people. This study examined the well-being of young Chileans during heatwaves. Using interviews and focus groups, ten participants with a range of educational backgrounds and different levels of contact with nature were selected. The results showed that negative perceptions of the climate and unpleasant emotions such as worry and feeling demotivated were prevalent among young people during heatwaves. However, it was identified that young people who have increased contact with nature experienced higher subjective well-being during these climate conditions. The authors conclude that heatwaves associated with climate change negatively affect young people's mental health. However, the role that young people play in climate mitigation and adaptation actions was also emphasized by participants in the study.
µετέχω παιδείας in Sir 51:28
Authors: Fernández-Fidalgo Álvaro
Published: November 2023

This short note interprets µετέχω παιδείας in Sir 51:28 from the Hellenistic background of the expression and points out the protreptic character of Sir 51:13–30.
When Life is Endangered
Authors: Verde Danilo
Published: November 2023

This paper aims to shed new light on the understudied classical Hebrew formulaic expression יום/עת צרה, “day/time of distress,” by investigating the Hebrew Bible, the Hebrew texts of Ben Sira, and the Dead Sea Scrolls. After describing the formulaic dimension of this phrase and its fixed linguistic and conceptual patterns, it will be argued that the concept of narrowness usually attributed to צרה does not stand out when this lexeme is in collocation with יום/עת. The formulaic expression יום/עת צרה indicates the inner turmoil caused by threats to life. The notion of narrowness may belong to the etymology and meaning potential of צרה, but is insufficient to describe the patchwork of emotional states that assaults on life cause in those who go through the יום/עת צרה. It will also be shown that sometimes the idiomatic expression יום/עת צרה is replaced by cognate phrases that, although semantically similar, are usually used to convey ideas that are not intrinsic to the widely used phrase יום/עת צרה.
Ashes still smoking: the influence of fire and land cover on Pantanal ecoregion amphibians
Authors: Moreira Leonardo F.B. , Smaniotto Natália P. , Ceron Karoline , Santana Diego J. , Ferreira Vanda L. , Strüssmann Christine , Galatti Ulisses
Published: November 2023

Fire and land cover are two elements intertwined with the natural history of organisms from seasonally dry environments. Here, we investigated the influence of fire attributes (burned area and frequently-burned area) and land cover on the relative abundance of three amphibians from the Pantanal ecoregion that belong to distinct ecomorphological groups: Chiasmocleis albopunctata, Pseudis platensis, and Scinax acuminatus. We systematically reviewed amphibian ecology studies in the Pantanal and analysed quantitative data between 2000 and 2021, comprising 34 sites from 12 amphibian surveys. Amphibian abundance, land cover, and fire data were assessed within buffers of a 1000 m radius. Species abundance was correlated with burned area and wetland cover. While the abundance of C. albopunctata and P. platensis decreased with burned area in the last three years, the abundance of S. acuminatus increased with wetland cover. Despite the claimed resilience of species inhabiting grasslands and savannas, there was substantial evidence for the influence of burned areas, even under modest human land use. Our findings illustrate that a broad array of land cover and fire attributes may influence amphibian persistence in the Pantanal ecoregion, with the magnitude depending on species traits often overlooked in modelling approaches.
Constructing a Sensory Alternative to the Ongwen Judgment
Authors: Viswanath Raghavi , Li Fangyi
Published: November 2023

Much ink has been spilt criticising the icc’s Ongwen trial judgment for its failure to grasp the cultural context in which the accused Ongwen and the Acholi community were embedded. Some scholars blame this on the poor quality of translation services, others attribute it to the ‘binarism’ of judgments. We offer another explanation for the Ongwen judgment’s deficiencies: its purely textual format. The judgment shows that the continued preference for textual judgments in international criminal law sterilises victims’ experiences, decontextualises evidence, and muffles objectivity. This ties into the historical preference for text over senses, a colonially engineered decision aimed at suppressing non-Western epistemologies. In this paper, we call for the international criminal law judgment to embrace ‘the opportunities of the wider sensory field’. Drawing on the pervasive sensory dimensions of international criminal law, we argue that a sensory reimagination of judgments would better serve international criminal law’s affective potential by empowering survivors and achieving a more reparative and reconstructive justice.