bluuebunny/crossref_metadata_2025 huggingface dataset:
Revisiting the “East African Paradox”: CMIP6 Models Also Struggle to Reproduce Strong Observed Long Rain Drying Trends
Authors: Schwarzwald Kevin , Seager Richard
Published: September 2024

Societies in much of the Horn of Africa are affected by variability in two distinct rainy seasons: the March–May (MAM) “long” rains and the October–December (OND) “short” rains. A recent five-season, La Niña–forced drought has renewed concerns about possible anthropogenic drying trends in the long rains, which had partially recovered after a multidecadal drying trend in the 1980s through the 2000s. Despite observed drying, previous generations of global climate models (GCMs) have consistently projected long-term wetting due to increased greenhouse gas concentrations, an East African “paradox” which complicates the interpretation of East African rainfall projections. We investigate the paradox in new phase 6 of the Coupled Model Intercomparison Project (CMIP6) and seasonal forecast models, leveraging an improved observational record and large ensembles to better differentiate internal and forced trends. We find observed drying trends are at the limits of the GCM spread during the peak paradox period, though the recent recovery is comfortably within the model spread. We find that the apparent paradox is largely removed by prescribing sea surface temperatures (SSTs) and is likely caused by the GCM difficulties in simulating observed tropical Pacific SST trends in recent decades. In line with arguments that these SST trends are at least partially forced anthropogenically, we recommend users of future rainfall projections in East Africa consider the possibility of long-term MAM drying despite GCM wetting and call for future model simulations that better sample the expected spread of SSTs.

Significance Statement

Societies in the Horn of Africa depend on the March–May “long” rains and the September–December “short” rains to support agricultural and pastoral practices on rain-fed lands. Recent major droughts have raised worries about possible anthropogenically forced drying trends in the long rains through global climate models (GCMs) project wetting. This East African “paradox” complicates long-term climate adaptation planning. We find the paradox continues in the newest generation of GCMs and seasonal forecast models; though a recent recovery in rainfall is well-captured, the strongest observed drying trends are rare in simulations. The paradox likely arises from known GCM biases in the Pacific Ocean interacting with natural variability. We recommend that researchers and policymakers consider possible long-term drying despite GCM projections of wetting.
γ-Cyclodextrin-metal organic framework as a carrier for trans-N-p-coumaroyltyramine: A study of drug solubability, stability, and inhibitory activity against α-glucosidase
Authors: Niu Dandan , Zhou Danyang , Zhan Mengke , Lei Lijing , Zhu Jinhua , Liu Xiuhua
Published: September 2024

γ-Cyclodextrin-based metal-organic frameworks (γ-CD-MOF) were successfully synthesized using the solvent diffusion method and applied as carriers for trans-N-p-coumaroyltyramine (N-p-t-CT, NCT) to study the solubability, stability, sustained release and inhibitory activity against α-glucosidase. The solubilization effect of γ-CD-MOF on N-p-t-CT was performed using impregnation (NCT@CD-MOF-1) and co-crystallization (NCT@CD-MOF-2) methods. X-ray diffraction, scanning electron microscope (SEM), fourier transform infrared spectrometer (FTIR), and N2 adsorption/desorption were used to characterize the MOFs before and after loading NCT. The results showed that NCT@CD-MOF-2 had a better solubability for N-p-t-CT, 145.03 μg/mg of drug loading capacity could be achieved, and the solubility of NCT@CD-MOF-2 in water was 366 times higher than free N-p-t-CT. In addition, the stabilities of N-p-t-CT under temperature, UV light and pH conditions were greatly improved after encapsulation in γ-CD-MOF. Furthermore, NCT@CD-MOFs had a sustained release of N-p-t-CT over an extended period in vitro due to the primary encapsulation in pore structures. Notably, γ-CD-MOF loaded with N-p-t-CT showed superior inhibitory activity against α-glucosidase compared to free N-p-t-CT. Cytotoxicity studies demonstrated that NCT@CD-MOF-2 had low toxicity in vitro and perfect biocompatibility with HL-7702 cells, and γ-CD-MOF could reduce the toxicity of free N-p-t-CT at higher concentrations.
Prevalence, predictors and outcomes of self-reported feedback for EMS professionals: a mixed-methods diary study
Authors: Wilson Caitlin , Budworth Luke , Janes Gillian , Lawton Rebecca , Benn Jonathan
Published: September 2024

Background

Providing feedback to healthcare professionals and organisations on performance or patient outcomes may improve care quality and professional development, particularly in Emergency Medical Services (EMS) where professionals make autonomous, complex decisions and current feedback provision is limited. This study aimed to determine the content and outcomes of feedback in EMS by measuring feedback prevalence, identifying predictors of receiving feedback, categorising feedback outcomes and determining predictors of feedback efficacy.

Methods

An observational mixed-methods study was used. EMS professionals delivering face-to-face patient care in the United Kingdom’s National Health Service completed a baseline survey and diary entries between March-August 2022. Diary entries were event-contingent and collected when a participant identified they had received feedback. Self-reported data were collected on feedback frequency, environment, characteristics and outcomes. Feedback environment was measured using the Feedback Environment Scale. Feedback outcomes were categorised using hierarchical cluster analysis. Multilevel logistic regression was used to assess which variables predicted feedback receipt and efficacy. Qualitative data were analysed using content analysis.

Results

299 participants completed baseline surveys and 105 submitted 538 diary entries. 215 (71.9%) participants had received feedback in the last 30 days, with patient outcome feedback the most frequent (n = 149, 42.8%). Feedback format was predominantly verbal (n = 157, 73.0%) and informal (n = 189, 80.4%). Significant predictors for receiving feedback were a paramedic role (aOR 3.04 [1.14, 8.00]), a workplace with a positive feedback-seeking culture (aOR 1.07 [1.04, 1.10]) and white ethnicity (aOR 5.68 [1.01, 29.73]). Feedback outcomes included: personal wellbeing (closure, confidence and job satisfaction), professional development (clinical practice and knowledge) and service outcomes (patient care and patient safety). Feedback-seeking behaviour and higher scores on the Feedback Environment Scale were statistically significant predictors of feedback efficacy. Solicited feedback improved wellbeing (aOR 3.35 [1.68, 6.60]) and professional development (aOR 2.58 [1.10, 5.56]) more than unsolicited feedback.

Conclusion

Feedback for EMS professionals was perceived to improve personal wellbeing, professional development and service outcomes. EMS workplaces need to develop a culture that encourages feedback-seeking to strengthen the impact of feedback for EMS professionals on clinical decision-making and staff wellbeing.
Trends in COPD severe exacerbations, and all-cause and respiratory mortality, before and after implementation of newer long-acting bronchodilators in a large population-based cohort
Authors: Guay Charles-Antoine , Maltais François , Beaudoin Claudia , Carmichael Pierre-Hugues , Laouan Sidi Elhadji Anassour , Perreault Laurie , Sirois Caroline , Provencher Steeve
Published: September 2024

Background

Little is known about the trends in morbidity and mortality at the population level that followed the introduction of newer once-daily long-acting bronchodilators for COPD. The purpose of the study was to evaluate whether the availability of new bronchodilators was associated with changes in the temporal trends in severe COPD exacerbations and mortality between 2007 and 2018 in the older population with COPD; and whether this association was homogeneous across sex and socioeconomic status classes.

Methods

We used an interrupted time-series and three segments multivariate autoregressive models to evaluate the adjusted changes in slopes (i.e., trend effect) in monthly severe exacerbation and mortality rates after 03/2013 and 02/2015 compared to the tiotropium period (04/2007 to 02/2013). Cohorts of individuals > 65 years with COPD were created from the nationally representative database of the Quebec Integrated Chronic Disease Surveillance System in the province of Quebec, Canada. Whether these trends were similar for men and women and across different socioeconomic status classes was also assessed.

Results

There were 130,750 hospitalizations for severe exacerbation and 104,460 deaths, including 24,457 (23.4%) respiratory-related deaths, over the study period (928,934 person-years). Significant changes in trends were seen after 03/2013 for all-cause mortality (-1.14%/month;95%CI -1.90% to -0.38%), which further decreased after 02/2015 (-1.78%/month;95%CI -2.70% to -0.38%). Decreases in respiratory-related mortality (-2.45%/month;95%CI -4.38% to -0.47%) and severe exacerbation (-1,90%/month;95%CI -3.04% to -0.75%) rates were only observed after 02/2015. These observations tended to be more pronounced in women than in men and in higher socioeconomic status groups (less deprived) than in lower socioeconomic status groups (more deprived).

Conclusions

The arrival of newer bronchodilators was chronologically associated with reduced trends in severe exacerbation, all-cause and respiratory-related mortality rates among people with COPD > 65 years. Our findings document population benefits on key patient-relevant outcomes in the years following the introduction of newer once-daily long-acting bronchodilators and their combinations, which were likely multifactorial. Public health efforts should focus on closing the gap between lower and higher socioeconomic status groups.
Cost-effectiveness of proton beam therapy vs. conventional radiotherapy for patients with brain tumors in Sweden: results from a non-randomized prospective multicenter study
Authors: Sampaio Filipa , Langegård Ulrica , de Alva Patricio Martínez , Flores Sergio , Nystrand Camilla , Fransson Per , Ohlsson-Nevo Emma , Kristensen Ingrid , Sjövall Katarina , Feldman Inna , Ahlberg Karin
Published: September 2024

Background

This study assessed the cost-effectiveness of proton beam therapy (PBT) compared to conventional radiotherapy (CRT) for treating patients with brain tumors in Sweden.

Methods

Data from a longitudinal non-randomized study performed between 2015 and 2020 was used, and included adult patients with brain tumors, followed during treatment and through a one-year follow-up. Clinical and demographic data were sourced from the longitudinal study and linked to Swedish national registers to get information on healthcare resource use. A cost-utility framework was used to evaluate the cost-effectiveness of PBT vs. CRT. Patients in PBT group (n = 310) were matched with patients in CRT group (n = 40) on relevant observables using propensity score matching with replacement. Costs were estimated from a healthcare perspective and included costs related to inpatient and specialized outpatient care, and prescribed medications. The health outcome was quality-adjusted life-years (QALYs), derived from the EORTC-QLQ-C30. Generalized linear models (GLM) and two-part models were used to estimate differences in costs and QALYs.

Results

PBT yielded higher total costs, 14,639 US$, than CRT, 13,308 US$, with a difference of 1,372 US$ (95% CI, -4,914–7,659) over a 58 weeks’ time horizon. Further, PBT resulted in non-significantly lower QALYs, 0.746 compared to CRT, 0.774, with a difference of -0.049 (95% CI, -0.195–0.097). The probability of PBT being cost-effective was < 30% at any willingness to pay.

Conclusions

These results suggest that PBT cannot be considered a cost-effective treatment for brain tumours, compared to CRT.

Trial registration

Not applicable.
Artificial intelligence empowering rare diseases: a bibliometric perspective over the last two decades
Authors: Ou Peiling , Wen Ru , Shi Linfeng , Wang Jian , Liu Chen
Published: September 2024

Objective

To conduct a comprehensive bibliometric analysis of the application of artificial intelligence (AI) in Rare diseases (RDs), with a focus on analyzing publication output, identifying leading contributors by country, assessing the extent of international collaboration, tracking the emergence of research hotspots, and detecting trends through keyword bursts.

Methods

In this bibliometric study, we identified and retrieved publications on AI applications in RDs spanning 2003 to 2023 from the Web of Science (WoS). We conducted a global research landscape analysis and utilized CiteSpace to perform keyword clustering and burst detection in this field.

Results

A total of 1501 publications were included in this study. The evolution of AI applications in RDs progressed through three stages: the start-up period (2003–2010), the steady development period (2011–2018), and the accelerated growth period (2019–2023), reflecting this field’s increasing importance and impact at the time of the study. These studies originated from 85 countries, with the United States as the leading contributor. “Mutation”, “Diagnosis”, and “Management” were the top three keywords with high frequency. Keyword clustering analysis identified gene identification, effective management, and personalized treatment as three primary research areas of AI applications in RDs. Furthermore, the keyword burst detection indicated a growing interest in the areas of “biomarker”, “predictive model”, and “data mining”, highlighting their potential to shape future research directions.

Conclusions

Over two decades, research on the AI applications in RDs has made remarkable progress and shown promising results in the development. Advancing international transboundary cooperation is essential moving forward. Utilizing AI will play a more crucial role across the spectrum of RDs management, encompassing rapid diagnosis, personalized treatment, drug development, data integration and sharing, and continuous monitoring and care.
Recruitment of USP10 by GCS1 to deubiquitinate GRP78 promotes the progression of colorectal cancer via alleviating endoplasmic reticulum stress
Authors: Chen Yang , Shen Hengyang , Wang Zhenling , Huang Changzhi , Zhang Hongqiang , Shao Yu , Tong Ying , Xu Lei , Lu Yunfei , Fu Zan
Published: September 2024

Background

Long-term accumulation of misfolded proteins leads to endoplasmic reticulum (ER) stress in colorectal cancer (CRC). However, the precise pathways controlling the decision between survival and apoptosis in CRC are unclear. Therefore, in this study, we investigated the function and molecular mechanism of glucosidase I (GCS1) in regulating ER stress in CRC.

Methods

A public database was used to confirm the expression level of GCS1 in CRC and normal tissues. Clinical samples from our center were used to confirm the mRNA and protein expression levels of GCS1. Cell proliferation, migration, invasion, and apoptosis assays revealed the biological role of GCS1. Immunohistochemical techniques were used to evaluate the expression of key proteins in subcutaneous implanted tumors in nude mice, which provided further evidence for the biological function of GCS1 in promoting cancer in vivo. The results of coimmunoprecipitation-mass spectrometry analysis and immunofluorescence colocalization analysis the interaction between GCS1 and GRP78. In addition, the mechanism of action of USP10, GRP78, and GCS1 at the post- translational level was investigated. Finally, a tissue microarray was used to examine the connection between GCS1 and GRP78 expression and intracellular localization of these proteins using immunohistochemistry and immunofluorescence.

Results

The experimental results revealed that GCS1 was substantially expressed in CRC, with higher expression indicating a worse prognosis. Thus, GCS1 can enhance the proliferation and metastasis while inhibiting the apoptosis of CRC cells both in vivo and in vitro. Mechanistically, GCS1 binds to GRP78, recruits USP10 for deubiquitination of GRP78 to promote its degradation, and decreases ER stress-mediated apoptosis, increasing CRC cell proliferation and metastasis.

Conclusions

In summary, GCS1 stimulates CRC growth and migration and reduces ER stress-mediated apoptosis via USP10-mediated deubiquitination of GRP78. Our findings identify a possible therapeutic target for CRC.
STUB1-mediated K63-linked ubiquitination of UHRF1 promotes the progression of cholangiocarcinoma by maintaining DNA hypermethylation of PLA2G2A
Authors: Chen Junsheng , Wang Da , Wu Guanhua , Xiong Fei , Liu Wenzheng , Wang Qi , Kuai Yiyang , Huang Wenhua , Qi Yongqiang , Wang Bing , Chen Yongjun
Published: September 2024

Background

Cholangiocarcinoma (CCA) is a highly malignant tumor characterized by a lack of effective targeted therapeutic strategies. The protein UHRF1 plays a pivotal role in the preservation of DNA methylation and works synergistically with DNMT1. Posttranscriptional modifications (PTMs), such as ubiquitination, play indispensable roles in facilitating this process. Nevertheless, the specific PTMs that regulate UHRF1 in CCA remain unidentified.

Methods

We confirmed the interaction between STUB1 and UHRF1 through mass spectrometry analysis. Furthermore, we investigated the underlying mechanisms of the STUB1-UHRF1/DNMT1 axis via co-IP experiments, denaturing IP ubiquitination experiments, nuclear‒cytoplasmic separation and immunofluorescence experiments. The downstream PLA2G2A gene, regulated by the STUB1-UHRF1/DNMT1 axis, was identified via RNA-seq.  The negative regulatory mechanism of PLA2G2A was explored via bisulfite sequencing PCR (BSP) experiments to assess changes in promoter methylation. The roles of PLA2G2A and STUB1 in the proliferation, invasion, and migration of CCA cells were assessed using the CCK-8 assay, colony formation assay, Transwell assay, wound healing assay and xenograft mouse model. We evaluated the effects of STUB1/UHRF1 on cholangiocarcinoma by utilizing a primary CCA mouse model.

Results

This study revealed that STUB1 interacts with UHRF1, resulting in an increase in the K63-linked ubiquitination of UHRF1. Consequently, this facilitates the nuclear translocation of UHRF1 and enhances its binding affinity with DNMT1. The STUB1-UHRF1/DNMT1 axis led to increased DNA methylation of the PLA2G2A promoter, subsequently repressing its expression. Increased STUB1 expression in CCA was inversely correlated with tumor progression and overall survival. Conversely, PLA2G2A functions as a tumor suppressor in CCA by inhibiting cell proliferation, invasion and migration.

Conclusions

These findings suggest that the STUB1-mediated ubiquitination of UHRF1 plays a pivotal role in tumor progression by epigenetically silencing PLA2G2A, underscoring the potential of STUB1 as both a prognostic biomarker and therapeutic target for CCA.

Graphical Abstract
Endogenous retroviral ERVH48-1 promotes human urine cell reprogramming
Authors: Peng Yuling , Zhu Jieying , Zhang Qi , Zhang Ran , Wang Zhenhua , Ye Zesen , Ma Ning , Qin Dajiang , Pei Duanqing , Li Dongwei
Published: September 2024

Endogenous retroviruses (ERVs), once thought to be mere remnants of ancient viral integrations in the mammalian genome, are now recognized for their critical roles in various physiological processes, including embryonic development, innate immunity, and tumorigenesis. Their impact on host organisms is significant driver of evolutionary changes, offering insight into evolutionary mechanisms. In our study, we explored the functionality of ERVs by examining single-cell transcriptomic profiles from human embryonic stem cells and urine cells. This led to the discovery of a unique ERVH48-1 expression pattern between these cell types. Additionally, somatic cell reprogramming efficacy was enhanced when ERVH48-1 was overexpressed in a urine cell-reprogramming system. Induced pluripotent stem cells (iPSCs) generated with ERVH48-1 overexpression recapitulated the traits of those produced by traditional reprogramming approaches, and the resulting iPSCs demonstrated the capability to differentiate into all three germ layers in vitro. Our research elucidated the role of ERVs in somatic cell reprogramming.
Anxiety matters: a pilot lab study into food, weight, and virtual body exposure in anorexia nervosa
Authors: Melles Hanna , Jansen Anita
Published: September 2024

Background

Anxiety is a core characteristic of anorexia nervosa and a potential target of exposure therapy, which requires a profound understanding of the patients’ fears in order to be successful. The knowledge about fears in anorexia nervosa that should be targeted during exposure therapy can be enriched by laboratory research to the precise emotional and behavioral responses of anorexia nervosa patients when they are exposed to disorder relevant fear stimuli.

Methods

In the laboratory, patients with anorexia nervosa (n = 15) and healthy controls (n = 51) were exposed to 1. their own body weight and a 10% higher body weight on the scale, 2. a standardized lab breakfast, and 3. five virtual bodies with different BMIs ranging from extreme underweight to lower healthy weight. The participants emotional (anxiety, disgust, satisfaction, acceptance) and behavioral responses (calorie consumption) were assessed. Patients with anorexia nervosa but not the healthy controls then received an intensive exposure treatment (~ 30 individual exposure sessions) targeting their individual fears, next to standard care. After the exposure treatment, it was investigated whether the patients’ responses to the laboratory tasks changed.

Results

Across all tasks, the patients reported more anxiety than healthy controls. The patients also consumed less calories during the breakfast and accepted the different body weights on the scale less than healthy controls. During the virtual body exposure, the patients’ emotional responses did not differ per avatar but they reacted more negatively towards avatars with healthier weights than did healthy controls. After the exposure treatment, the patients reported less fears and they consumed more calories while their BMIs had increased. They were also more accepting of healthier weights.

Conclusions

Exposure to food-, body- and weight-related stimuli in the laboratory induces emotional reactions in patients with anorexia nervosa that are informative for the identification of exposure therapy treatment targets. In addition, exposure therapy targeting individual fears in patients with anorexia nervosa led to symptom reduction and is a promising intervention for the treatment of anorectic fears, though more research is needed to optimize its efficacy.
18F-FDG PET/CT metrics-based stratification of large B-cell lymphoma receiving CAR-T cell therapy: immunosuppressive tumor microenvironment as a negative prognostic indicator in patients with high tumor burden
Authors: Sheng Ling-Shuang , Shen Rong , Yan Zi-Xun , Wang Chao , Zheng Xin , Zhang Yi-Lun , Yang Hao-Xu , Wu Wen , Xu Peng-Peng , Cheng Shu , Bachy Emmanuel , Sesques Pierre , Jacquet-Francillon Nicolas , Jiang Xu-Feng , Zhao Wei-Li , Wang Li
Published: September 2024

Chimeric antigen receptor T (CAR-T) cell therapy has greatly improved the prognosis of relapsed and refractory patients with large B-cell lymphoma (LBCL). Early identification and intervention of patients who may respond poorly to CAR-T cell therapy will help to improve the efficacy. Ninety patients from a Chinese cohort who received CAR-T cell therapy and underwent 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) scans at the screening stage (median time to infusion 53.5 days, range 27–176 days), 1 month and 3 months after CAR-T cell infusion were analyzed, with RNA-sequencing conducted on 47 patients at the screening stage. Patients with maximum diameter of the largest lesion (Dmax) < 6 cm (N = 60) at screening stage showed significantly higher 3-month complete response rate (85.0% vs. 33.3%, P < 0.001), progression-free survival (HR 0.17; 95% CI 0.08–0.35, P < 0.001) and overall survival (HR 0.18; 95% CI 0.08–0.40, P < 0.001) than those with Dmax ≥ 6 cm (N = 30). Besides, at the screening stage, Dmax combined with extranodal involvement was more efficient in distinguishing patient outcomes. The best cut-off values for total metabolic tumor volume (tMTV) and total lesion glycolysis (tTLG) at the screening stage were 50cm3 and 500 g, respectively. A prediction model combining maximum standardized uptake value (SUVmax) at 1 month after CAR-T cell therapy (M1) and tTLG clearance rate was established to predict early progression for partial response/stable disease patients evaluated at M1 after CAR-T cell therapy and validated in Lyon cohort. Relevant association of the distance separating the two farthest lesions, standardized by body surface area to the severity of neurotoxicity (AUC = 0.74; P = 0.034; 95% CI, 0.578–0.899) after CAR-T cell therapy was found in patients received axicabtagene ciloleucel. In patients with Dmax ≥ 6 cm, RNA-sequencing analysis conducted at the screening stage showed enrichment of immunosuppressive-related biological processes, as well as increased M2 macrophages, cancer-associated fibroblasts, myeloid-derived suppressor cells, and intermediate exhausted T cells. Collectively, immunosuppressive tumor microenvironment may serve as a negative prognostic indicator in patients with high tumor burden who respond poorly to CAR-T cell therapy.
Sequence analysis and process mining perspectives to goal setting: What distinguishes business students with high and low self-efficacy beliefs?
Authors: Heikkinen Sami , Cristea Tudor , Saqr Mohammed , Malmberg Jonna , Kleingeld Ad , Snijders Chris , Matzat Uwe , Tedre Matti
Published: September 2024

This study investigates the relationship between students' self-efficacy beliefs, goal-setting, and learning tactics in an online business course. Using sequence analysis and process mining techniques, we analyzed log data from 209 students to identify distinct learning tactics and their association with self-efficacy beliefs, inferred from initial goal-setting and final grades. Four learning tactics were identified, with significant differences observed between students with high and low self-efficacy beliefs. High self-efficacy students demonstrated more varied and adaptive tactics, including greater use of quizzes and project-focused activities. In contrast, low self-efficacy students and those who didn't set goals showed less engagement and fewer monitoring activities. The project-focused tactic had the strongest correlation with final grades and goal achievement. Goal-setting at the course's start was linked to more effective learning behaviors and better outcomes. The study reveals how students' online learning behavior changes based on initial goal-setting and subsequent reflection. These findings contribute to research on self-regulated learning in online environments and offer practical implications for designing online courses and learning analytics interventions. Understanding these differences enables the development of targeted interventions to improve learning tactics and self-efficacy beliefs among students, ultimately enhancing their ability to achieve learning goals in online educational settings.
Volcanic activity around Taipei, Taiwan: new data and perspectives on the Tatun Volcano Group
Authors: Chang Su-Chin , Chu Mei-Fei , Wang Jui-Pin , Lai Yu-Ming , Song Sheng-Rong , Hemming Sidney R. , Ng Samuel Wai-Pan , Chow Timothy Dylan
Published: September 2024

The Tatun Volcano Group (TVG) is located at the northern end of Taiwan, ~ 15 km from the center of Taipei, a metropolitan area of over seven million inhabitants. A volcanic eruption by the TVG of any type or scale could cause catastrophic human and economic impacts. This paper summarizes previous geochemical, geophysical, and geochronological reports and highlights why the widely accepted age model does not comport with the latest observations. This study also reports novel40Ar/39Ar ages for two andesite samples and one basalt sample from the TVG. A sample collected from Chihsingshan yields a robust40Ar/39Ar age of 0.081 ± 0.005 Ma. This provides the first direct evidence of TVG volcanic activity after 0.1 Ma. Two samples yield 0.28 ± 0.02 Ma for Tatunshan and 0.159 ± 0.017 Ma for Honglushan. The younger ages refute previously proposed age models for the TVG. Along with new drone photos and LiDAR images, the age data help resolve eruptive history and advance understanding of volcanic hazards and hazard mitigation in Taiwan and surrounding areas.
Patient engagement as a collaborative process in a large Dutch COVID-19 vaccination study (RECOVAC) – insight into the contribution of patient engagement and learnings for the future
Authors: Vervoort J. P. M. , Konijn W. S. , Jansen D. E. M. C. , Boersma C. , de Zeeuw J. , Ho-dac – Pannekeet M. M. , Gansevoort R. T. , Messchendorp A. L. , Sanders J. S. F. , de Wildt-Liesveld R.
Published: September 2024

Background

The need for patient engagement in health research has been increasingly acknowledged and accepted in recent years. However, implementation is still limited due to lack of evidence on its value and lack of guidance on how to implement patient engagement. This study aims to provide insight into the contribution of patient engagement in the RECOVAC project, which studied COVID-19 vaccination in kidney patients, and formulate concrete practice-based action perspectives for patient engagement.

Methods

We used a qualitative participatory mixed methods approach, based on the Patient Engagement Monitoring and Evaluation (PEME) framework. Patient engagement and data collection were based on the Reflexive Monitoring in Action (RMA) approach. Data collection included participant observations, open ended questionnaires and interactive reflection sessions. Qualitative analysis was done via a thematic approach.

Results

We have described the process of patient engagement systematically, provided insight in its value and found that there is a need for clear aims, expectations and preparations from the start of the engagement process. We have shown that reflection throughout the process is of utmost importance and the same applies to clear communication between researchers and patient representatives. By being part of the consortium patient representatives had direct access to information, straight from the source, on for example the vaccination schedule and medication availability and had indirect influence on decisions made by the National Institute for Public Health and the Environment (RIVM) on preventive measures and treatment against COVID-19. Having experienced patient representatives is important, otherwise training needs to be provided. We also found that patient engagement had impact on conduct and outcomes of research activities itself and may have impact on future research and patient engagement activities in general.

Conclusion

Patient engagement has changed the course of the project. Concrete practice-based action perspectives have been formulated, which are already being implemented by the Dutch Kidney Patients Association (NVN). Studying patient engagement in a high pace project with high public interest has resulted in lessons learned and will help prepare and implement patient involvement in future research projects.

Clinical trial registration

The RECOVAC studies in which the patient engagement took place are registered at clinicialtrial.gov (NCT04741386 registration date 2021-02-04, NCT04841785 registration date 2021-03-22 and NCT05030974 registration date 2021-08-20).
A mixed methods study of suicide protective factors in college students
Authors: Cecchin Hareli Fernanda Garcia , da Costa Hellen Emily Rodrigues , Pacheco Gabriela Ramos , de Valencia Gabriel Barcellos , Murta Sheila Giardini
Published: September 2024

Introduction

Mental health professionals, teachers, families, and public administrators are concerned about suicide rates among young people, particularly in the university context. For every ten college students worldwide, three attempt suicide in their lifetime, and two experience suicidal ideation. Reducing these rates requires interventions that recognize the problem in terms of risk factors and protective factors.

Objective

The general aim of the study was to map the protective factors for suicide among college students, as perceived by them, mental health professionals, and coordinators of undergraduate courses in a public university in the North of Brazil.

Methods

The study followed an exploratory, mixed-method design. Data were collected through interviews and the application of a questionnaire with 54 participants, including college students (n = 20), mental health professionals (n = 22), and course coordinators (n = 12). Data were analyzed using Content Analysis and simple descriptive statistics.

Results

The findings show that the protective factors for suicide most cited among the three groups were social support, strengthening of internal resources, institutional support, and finding meaning about the change to enter the university. Although the three audiences did not converge, the protective factors also frequently reported were psychological treatment, leisure activities, religious engagement, medical treatment, civic engagement, employability, opportunities for social ascension offered by the university, and quality family relationships.

Conclusion

It is suggested that these protective factors are considered when formulating policies to promote mental health and suicide prevention in the university environment.
Carbon dioxide-enhanced angiography for detection of colonic diverticular bleeding and clinical outcomes
Authors: Kitamura Ryoichi , Maruhashi Takaaki , Woodhams Reiko , Suzuki Koyo , Kurihara Yutaro , Fujii Kaoru , Asari Yasushi
Published: September 2024

Purpose

To determine the ability of CO2-enhanced angiography to detect active diverticular bleeding that is not detected by iodinated contrast medium (ICM)-enhanced angiography and its impact on clinical outcomes when used to confirm embolization, particularly the risks of rebleeding and ischemic complications.

Materials and methods

We retrospectively identified a cohort of patients with colonic diverticular bleeding who underwent catheter angiography between August 2008 and May 2023 at our institution. We divided them according to whether they underwent CO2 angiography following a negative ICM angiography study or to confirm hemostasis post-embolization (the CO2 angiography group) or ICM angiography alone in the absence of active bleeding or for confirmation of hemostasis post-embolization (the ICM angiography group). The ability to detect active colonic diverticular bleeding and clinical outcomes were compared between the two groups.

Results

There were 31 patients in the ICM angiography group and 29 in the CO2 angiography group. The rate of detection of active bleeding by CO2 angiography that was not identified by ICM angiography was 48%. The rebleeding rate was 23% in the ICM angiography group and 6.9% in the CO2 angiography group. Among the patients who underwent TAE, the ischemic complications rate was 7.1% in the ICM angiography group and 4.5% in the CO2 angiography group.

Conclusions

CO2 angiography may detect active diverticular bleeding that is not detectable by ICM angiography and appears to be associated with a lower rebleeding rate.

Level of evidence

IV.

Graphical Abstract
Safety and efficacy of early beta-blocker initiation in acute heart failure and cardiogenic shock: systematic review and meta-analysis
Authors: Sinardja Cyndiana Widia Dewi , Jagannatha Gusti Ngurah Prana , de Liyis Bryan Gervais , Kosasih Anastasya Maria
Published: September 2024

Background

The beta-blocker (BB) initiation in acute heart failure (AHF) patients is still controversial. Some show the benefit of BB employment in decreasing the mortality outcome. This study aims to assess the safety and efficacy of in-hospital and long-term outcomes of BB initiation in AHF hospitalized patients. We searched multiple databases examining the outcome of AHF patients who had administered BB as the therapy initiation. Primary outcomes were all-cause mortality, composite endpoint after BB initiation when hospitalized, and post-discharge all-cause mortality. The secondary outcomes were adverse events after in-hospital BB initiation, including hypotension and symptomatic bradycardia after BB initiation when hospitalization and rehospitalization.

Results

Eight cohort studies with 16,639 patients suffering from AHF and cardiogenic shock, with 9923 participants allocated to the early BB group and 6,713 patients in the control group. The follow-up durations ranged from 2 to 24 months. Early BB administration significantly reduced in-hospital composite endpoints (RR: 0.42; 95% CI (0.30–0.58); p < 0.001), in-hospital all-cause mortality (RR: 0.43; 95% CI (0.31–0.61); p < 0.001), discharge mortality (RR: 0.51; 95% CI (0.41–0.63); p < 0.001), and rehospitalization (RR: 0.57; 95% CI (0.44–0.74); p < 0.001). There were no discernible differences in in-hospital BB-related adverse events between the two groups (p = 0.13). Subgroup analyses conducted on AHF patients presenting with cardiogenic shock revealed no significant differences in in-hospital composite endpoint and in-hospital mortality, and similar results were shown in the naive BB population.

Conclusions

The BB initiation in AHF patients shows advantages in efficacy and safety outcome.
An enhanced stochastic error modeling using multi-Gauss–Markov processes for GNSS/INS integration system
Authors: Wu Youlong , Chen Shuai
Published: September 2024

Angular random walk (ARW), rate random walk (RRW), and bias instability (BI) are the main noise types in inertial measurement units (IMUs) and thus determine the navigation performance of IMUs. BI is the flicker noise, which determines the noise level of an inertial sensor. The traditional error modeling approach involves modeling the ARW and BI processes as RRW or Gauss–Markov (GM) processes, and this approach is applied as a suboptimal filter in the global navigation satellite system (GNSS)/inertial navigation system (INS) extended Kalman filter (EKF). In this paper, the random error identification processes for white noise and colored noise for inertial sensors are separated using the Allan variance and power spectral density methods and the equivalence of the stochastic process differential equations of bias instability and a combination of multiple first-order GM processes are derived. A colored noise compensation method is proposed based on the enhanced EKF model. Experimental results demonstrate that, compared to traditional error models, our proposed model reduces positional drift error in dynamic testing from 195 to 49 m, enhancing positional accuracy by 40.2%. These findings confirm the potential and superiority of our method in complex navigation environments.
Development and evaluation of a monoclonal antibody-based competitive ELISA for detecting porcine deltacoronavirus antibodies
Authors: Wang Wei , Fan Baochao , Zhang Xuehan , Yang Shanshan , Zhou Junming , Guo Rongli , Zhao Yongxiang , Zhou Jinzhu , Li Jizong , Li Bin
Published: September 2024

Porcine deltacoronavirus (PDCoV) is an emerging swine enteropathogenic coronavirus that can cause acute diarrhea and vomiting in newborn piglets and poses a potential risk for cross-species transmission. It is necessary to develop an effective serological diagnostic tool for the surveillance of PDCoV infection and vaccine immunity effects. In this study, we developed a monoclonal antibody-based competitive ELISA (cELISA) that selected the purified recombinant PDCoV nucleocapsid (N) protein as the coating antigen to detect PDCoV antibodies. To evaluate the diagnostic performance of the cELISA, 122 swine serum samples (39 positive and 83 negative) were tested and the results were compared with an indirect immunofluorescence assay (IFA) as the reference method. By receiver operating characteristic (ROC) curve analysis, the optimum cutoff value of percent inhibition (PI) was determined to be 26.8%, which showed excellent diagnostic performance, with an area under the curve (AUC) of 0.9919, a diagnostic sensitivity of 97.44% and a diagnostic specificity of 96.34%. Furthermore, there was good agreement between the cELISA and virus neutralization test (VNT) for the detection of PDCoV antibodies, with a coincidence rate of 92.7%, and the κ analysis showed almost perfect agreement (κ = 0.851). Overall, the established cELISA showed good diagnostic performance, including sensitivity, specificity and repeatability, and can be used for diagnostic assistance, evaluating the response to vaccination and assessing swine herd immunity.
Thyroid Autoimmunity is Associated with Dietary Fat Consumption
Authors: Xu Lulian , Liu Zhenzhen , Xu Xu , Wan Qiwen , Zhen Juanying , Jiang Li , Cheung Bernard Man Yung , Li Chao
Published: September 2024

Context

Dietary factors are crucial in the onset and development of autoimmune thyroid disease (AITD), but the relationship between specific fatty acids and AITD remains unexplored.

Methods

We analyzed the US National Health and Nutrition Examination Survey 2007 to 2012 data on 3949 men and 3964 women aged 20 years and over with valid data on antithyroid peroxidase antibodies (TPOAb), antithyroglobulin antibodies (TgAb), and details of fat intake using multivariable regression models to examine the relationship of fat intake and specific fatty acid intake with thyroid autoimmunity.

Results

Of the 7913 participants, 7.5% had TgAb seropositivity and 11.9% had TPOAb seropositivity. The seropositivity of TgAb and TPOAb was more common in low-fat intake participants. In the overall population and men, fats were associated with thyroid autoimmunity before and after full adjustment for age, ethnicity, body mass index, smoking status, and urine iodine concentration [total fat: odds ratio (OR) = 0.64, 95% confidence interval (CI): 0.49-0.83; saturated fatty acid: OR = 0.65, 95% CI: 0.51-0.84; monounsaturated fatty acid: OR = 0.65, 95% CI: 0.50-0.85; polyunsaturated fatty acid: OR = 0.76, 95% CI: 0.57-0.995, after full adjustment in men]. Some specific fatty acids followed a similar pattern. The association between fats and TgAb seropositivity was significant in the overall population and men. The association between fats and TPOAb seropositivity was only found in the overall population.

Conclusion

We found a strong association between fat consumption and thyroid autoimmunity in the overall population and men from the nationally representative population-based survey. Fat and fatty acid consumption may be of benefit to individuals with thyroid autoimmunity.
Point-of-Care Lung Ultrasound to Evaluate Lung Isolation During One-Lung Ventilation in Children: A Blinded Observational Feasibility Study
Authors: Moharir Alok , Yamaguchi Yoshikazu , Aldrink Jennifer H. , Martinez Andrea , Arce-Villalobos Mauricio , Yemele Kitio Sibelle Aurelie , Rice-Weimer Julie , Tobias Joseph D.
Published: September 2024

BACKGROUND:

Minimally invasive thoracic surgical techniques require effective lung isolation using one-lung ventilation (OLV). Verification of lung isolation may be confirmed by auscultation, visual confirmation using fiberoptic bronchoscopy (FOB), or more recently, point-of-care ultrasound (POCUS). The aim of this study was to prospectively compare lung ultrasound with clinical auscultation to confirm OLV before thoracic surgery in pediatric patients.

METHODS:

This prospectively blinded feasibility study included 40 patients ranging in age from 0 to 20 years. After confirmation of lung separation by the primary anesthesia team using FOB, the sonographer and the auscultator, both blinded to the laterality of surgery and lung separation, entered the operating room. The sonographer evaluated for pleural lung sliding and the auscultator listened for breath sounds. Successful lung separation was definitively confirmed by direct visualization of lung collapse during the operation.

RESULTS:

In confirming effective single-lung ventilation, lung ultrasound had a diagnostic accuracy of 95% (95% confidence interval [CI], 82.7%–98.5%). In contrast, auscultation could only reliably confirm lung isolation with 68% accuracy (95% CI, 51.5%–80.4%). The McNemar test showed a statistically significant difference between the use of lung ultrasound and auscultation (P < .001). The median time to perform ultrasonography was 67 seconds (interquartile range [IQR], 46–142) and the median time to perform auscultation was 21 seconds (IQR, 10–32).

CONCLUSIONS:

Based on the initial results of our feasibility trial, lung ultrasound proved to be a fast and reliable method to verify single-lung ventilation in pediatric patients presenting for thoracic surgery with a high degree of diagnostic accuracy.
Intergenerational Transmission of Divorce in Sweden, 1920–2015
Authors: Stanfors Maria , Bergvall Martin
Published: September 2024

Many studies demonstrate an intergenerational transmission of divorce with a focus primarily on more recent decades; however, the extent to which this relationship is deeply rooted or has changed over time remains unclear. Explanations, including sociodemographic and interpersonal factors, have been offered as links between parental divorce and the stability of offspring's marriage. We use individual-level longitudinal data from the Scanian Economic-Demographic Database to estimate the intergenerational transmission of divorce among first marriages in Sweden over the period 1920–2015. Our investigation focuses on the correlation between parental divorce and offspring's divorce during the transition from a low- to a high-divorce regime. Findings reveal surprising stability in the transmission despite fundamental societal change over the years. Notably, the risk of divorce is highest when either the wife or both spouses have experienced parental divorce. Moreover, the transmission of divorce across time appears to be stronger and more stable for women than for men. These results suggest the intergenerational transmission of divorce is part of the divorce transition and highlight the role of women's independence in this intricate but not yet fully understood process.
Introduction
Authors: Croft Clare
Published: September 2024

The introduction provides an overview of Jill Johnston as a writer, with an emphasis on her attention to the sensorial and her commitment to experimentation.
Η πρόβλεψη του εκλογικού αποτελέσματος στο πλαίσιο της διαδικασίας multinomial logistic regression
Authors: Γκολέμη Ζαχαρένια
Published: September 2024

Στην παρούσα διατριβή πραγματοποιήθηκε στρωματοποιημένη, τυχαία δειγματοληψία τηλεφωνικών συνεντεύξεων από τον τηλεφωνικό κατάλογο του ΟΤΕ, στις 13 περιφέρειες της χώρας, από 40 φοιτητές του Τμήματος Πολιτικής Επιστήμης του Πανεπιστημίου Κρήτης, στο Εργαστήριο Κοινωνικής Στατιστικής και Πολιτικής Έρευνας του Π.Κ. Δικαίωμα συμμετοχής στις έρευνες είχαν όλοι οι πολίτες με δικαίωμα ψήφου στις εκλογικές περιφέρειες της χώρας. Στην παρούσα διατριβή, αρχικά πραγματοποιείται μια συνοπτική παρουσίαση της εκλογικής συμπεριφοράς και των μοντέλων αυτής, ακολουθεί η στατιστική ανάλυση και ο έλεγχος ερευνητικών υποθέσεων και τέλος, πραγματοποιείται η σύνθεση και παρουσίαση των συμπερασμάτων των ερευνών.