bluuebunny/crossref_metadata_2025 huggingface dataset:
An Examination of the Impact of Clergy-Involved Mental Health Activities for Their Congregants on Clergy Life Satisfaction, Happiness, and Perceptions of Having a Life Close to Ideal in the USA
Authors: Boateng Augustine Cassis Obeng , Britt Katherine Carroll , Sebu Joshua , Oh Hayoung
Published: August 2024

Clergy play a crucial role in supporting the mental health of their congregants, but the impact on their own well-being is understudied. A review of 2019–2020 data from 636 U.S. religious leaders using generalized estimating equations analysis found that clergy use prayer, preaching, readings on mental health, and referrals to mental health professionals to support congregants’ well-being. Future longitudinal studies are needed to understand the needs of diverse clergy groups.
The Corporate Chief of Staff: Strategic Leadership Influence From Outside the Spotlight
Authors: Zhou Steven , Hiller Nathan J. , Zaccaro Stephen J. , Campbell Lauren N. P. , McCauley Renee , Parris Tyler , Klimoski Richard J.
Published: August 2024

For decades, scholars of strategic leadership have explored the degree to which senior executives and the team of top managers influence firm outcomes. However, one growing quasi-executive role in corporate settings, the chief of staff (COS), has been almost entirely ignored. Our paper presents a novel, foundational exploration of the COS role, including primary job functions and challenges, characteristics and backgrounds of incumbents, and relevance for strategic leadership and upper echelons theory. We synthesize three original sources of data — 2,500 LinkedIn COS profiles, surveys of 108 COSs, and in-depth interviews of 13 current and former COSs — to identify COS tasks and functions that interface with and influence the CEO, the top management team (TMT), and the broader organization. Though not typically considered a member of the TMT, we find compelling evidence for their ‘behind the scenes’ relevance to strategic leadership processes and outcomes. We then lay out a future research agenda comprising four domains: COS influence on CEO attention and psychological states, COS influence on TMT and organizational processes and outcomes, characteristics and conditions of organizations with a COS, and long-term career trajectories of COSs.
Optimization of synthesis process and photocatalytic mechanism of tachysterol under ultraviolet irradiation
Authors: Liu Wuzhang , Shan Yu , Liu Songtao , Zhou Ye , Wang Yan , Li Linwei , Xu Shu , Chen Yu , Feng Xu , Lin Li , Luo Jinyue , Liu Fei
Published: August 2024

Tachysterol is an intermediate product in the synthesis of vitamin D2 from ergosterol and vitamin D3 from 7-dehydrocholesterol under ultraviolet irradiation. Recent studies have shown that tachysterol is also a crucial intermediate in the synthesis of the natural anti-tumor product Chaxine C. Although there have been numerous studies on the synthesis of vitamin D2 and other photoisomers from ergosterol, research on the synthesis of tachysterol is relatively limited. In addition, the yield of tachysterol is not high (57.0%), and the mechanism is unclear. In this study, a method was developed for the qualitative and quantitative analysis of tachysterol. Meanwhile, an efficient synthesis process for tachysterol was reported. The qualitative and quantitative analysis of ergosterol isomers, including tachysterol, a precursor of vitamin D2, and photosterol, was conducted using high-performance liquid chromatography, and the quantitative method for tachysterol was confirmed using quantitative nuclear magnetic resonance. There were strong linear relationships between tachysterol content and the testing parameters, with the correlation coefficients of 0.9997 and 0.9971, respectively. The synthesis process of tachysterol from ergosterol through our self-designed photoreactors was optimized, and the effects of reaction temperature, reaction time, photoprotectants, reaction substrate concentration, and the power of ultraviolet lamps were investigated. The yield of the reaction was 85.7%, which is 28.7% higher than the previously reported results. The mechanism and by-products of the reaction were further studied using ultraviolet spectrophotometry and gas chromatography mass spectrometry. This study explored the potential for the large-scale preparation of tachysterol, particularly for the total synthesis of the anti-tumor natural product Chaxine C. It also offered insights into the synthesis of structural similar compounds and the analysis of photocatalytic reaction products.
Examining the mediating and moderating roles of social marketing behavioural enhancers regarding consistent condom use
Authors: De Jager Johan W. , Ayikwa Lutete Christian
Published: August 2024

Since their importance was highlighted by Ayikwa and De Jager, social marketing behavioural enhancers (SMBEs) have been investigated in terms of their causal and correlational relationships with the intention to use condoms (IUC) and consistent condom use (CCU), as people often fail to act on their intentions. However, scrutiny of their mediating and moderating roles could provide insights pertinent to the design of effective HIV and AIDS preventative programmes. This study examined whether perceived behavioural control (PBC) and IUC interact with exposure to HIV and AIDS information (EI), ease of access to condoms (EAC) and level of related knowledge (KN) in determining CCU. It also investigated whether PBC and IUC predict CCU through increasing EI, EAC, and KN. A quantitative approach was adopted and data were collected from 607 participants, aged at least 18, living in Gauteng Province, South Africa. The questionnaire administered included pre-existing items, validated through exploratory and confirmatory factor analysis procedures. Regression analyses of the data for mediation and moderation testing were performed using PROCESS macro software for SPSS. The results indicated that none of the SMBEs mediated the non-significant PBC–CCU relationship: B = –0.0258, SE = 0.0199, p = 0.195. Nor did they mediate the significant IUC–CCU relationship: B = 0.0395, SE = 0.0195, p = 0.043. Similarly, none of the SMBEs were found to moderate the PBC–CCU relationship (EI*PBC: B = 0.0034, SE = 0.0056, p = 0.540; KN*PBC: B = –0.0006, SE = 0.0064, p = 0.931; EAC*PBC: B = 0.0011, SE = 0.0059, p = 0.854) as IUC–CCU relationship (EI*IUC: B = 0.0036, SE = 0.0054, p = 0.513; KN*IUC: B = –0.0096, SE = 0.0060, p = 0.111; EAC*IUC: B = 0.0044, SE = 0.0061, p = 0.469). A recommendation is made to scrutinise the mediating and moderating roles of SMBEs in the context of health behavioural models other than the theory of planned behaviour, which was considered in this study.
Revision total elbow arthroplasty is associated with a high rate of 30-day complications: A descriptive analysis of a national database
Authors: El-Najjar Dany , Mehta Apoorva , Gupta Puneet , Peterson Joel R , Marigi Erick M , Rogalski Brandon , Trofa David P , Levine William N , Jobin Charles M
Published: August 2024

Introduction

Revision total elbow arthroplasty (TEA) is indicated for component loosening, periprosthetic joint infection, and fractures. Previous investigations into revision TEA complications have small sample sizes and limited exploration of acute complications. This study aims to characterize the 30-day complications and associated demographics of patients undergoing revision TEA using a large national database.

Methods

The 2015–2020 American College of Surgeons National Surgical Quality Improvement Program database was used to identify all revision TEA patients.

Results

The analysis included 158 patients (average age 62.6 years). The overall complication rate was 13.9% ( n = 22). The most common 30-day complications were organ/space surgical site infection (3.8%, n = 6), unplanned readmission (3.2%, n = 5), intraoperative or postoperative transfusion (3.2%, n = 5), and unplanned reoperation (1.9%, n = 3). Patients with a history of dyspnea or steroid/immunosuppressant use for a chronic condition had significantly higher rates of bleeding requiring transfusion ( p = .029 and p = .021, respectively). Additionally, patients aged 80 years or older had a significantly higher rate of unplanned readmission ( p = .032).

Conclusion

Revision TEA has a 13.9% rate of complications within 30-days of surgery, with most involving surgical site infection, unplanned readmission, and blood transfusion.

Level of Evidence

IV.
One AI’s Hallucination is Another Human’s Writing Prompt: Notes From an Autoethnography Journey
Authors: Mercer Ralph
Published: August 2024

To catch an AI in a hallucination, the human must know the answer or know where to find the answer. This raises the question of what happens when both the AI and the Human don’t know the answer. What if the AI's output, the hallucination, was its superpower? Does the ‘prompt and response’ exchange between AI and Human become a discussion between two entities searching at the edges of understanding for an answer?
Evaluation of multiple deep neural networks for detection of intracranial dural arteriovenous fistula on susceptibility weighted angiography imaging
Authors: Sivan Sulaja Jithin , Kannath Santhosh K , Kalaparti Sri Venkata Ganesh Viswanadh , Thomas Bejoy
Published: August 2024

Background

The natural history of intracranial dural arteriovenous fistula (DAVF) is variable and early diagnosis is crucial in order to positively impact the clinical course of aggressive DAVF. Artificial intelligence (AI) based techniques can be promising in this regard, and in this study, we used various deep neural network (DNN) architectures to determine whether DAVF could be reliably identified on susceptibility-weighted angiography images (SWAN).

Materials and Methods

A total of 3965 SWAN image slices from 30 digital subtraction angiographically proven DAVF patients and 4380 SWAN image slices from 40 age-matched patients with normal MRI findings as control group were included. The images were categorized as either DAVF or normal and the data was trained using various DNN such as VGG-16, EfficientNet-B0, and ResNet-50.

Results

Various DNN architectures showed the accuracy of 95.96% (VGG-16), 91.75% (EfficientNet-B0), and 86.23% (ResNet-50) on the SWAN image dataset. ROC analysis yielded an area under the curve of 0.796 ( p < .001), best for VGG-16 model. Criterion of seven consecutive positive slices for DAVF diagnosis yielded a sensitivity of 74.68% with a specificity of 69.15%, while setting eight slices improved the sensitivity to above 80.38%, with a decrease of specificity up to 56.38%. Based on seven consecutive positive slices criteria, EfficientNet-B0 yielded a sensitivity of 73.21% with a specificity of 45.92% and ResNet-50 yielded a sensitivity of 72.39% with a specificity of 67.42%.

Conclusion

This study shows that DNN can extract discriminative features of SWAN for the classification of DAVF from normal with good accuracy, reasonably good sensitivity and specificity.
Staged cerebral and brachiocephalic bypass in a patient with MCA and brachiocephalic steno-occlusion
Authors: Gasparis Christopher , Travers Hannah , Turpin Justin , Ferreira Christian , Stark Katherine , Brinster Derek R , Langer David J , Ballout Ahmad A
Published: August 2024

Background: Brachiocephalic steal is a rare phenomenon that may lead to hemodynamic abnormalities in the ipsilateral vertebral and carotid arteries. Current treatment includes management of vascular risk factors, endovascular stenting, and surgical management depending on the severity of symptoms. Case Information: We describe a patient with multiple vascular risk factors who presented with mild neurological symptoms and chronic right arm weakness associated with concurrent brachiocephalic steal and right MCA M1 stenosis on neuroimaging. Use of right superficial temporal artery to middle cerebral artery bypass and aorta-right subclavian bypass resulted in improved flow to the right hemisphere on quantitative magnetic resonance angiography and single-photon emission computed tomography, significantly lowering the risk of catastrophic ischemic stroke. Conclusion: Complex steal phenomena increase stroke risk. In cases of high-grade occlusion or advanced symptoms, endovascular or surgical management should be considered for optimal stroke prevention.
Biological and chemical weapons legislation in the EU: A need for harmonisation?
Authors: de Vries Barry
Published: August 2024

Biological and chemical weapons are a realistic threat for the EU, which requires concerted effort to combat. The EU has sought to be active in this field by incorporating EU-wide export controls and having EU sanctions against individuals suspected of proliferation activities. However, in many regards the national measures of the member states of the EU are still quite divergent when it concerns chemical and biological weapons, especially regarding criminalization. This raises the question of whether continued convergence in this field is necessary. This submission will look at this by discussing the current activities of the EU in this field and contrasting this with the existing legislation in the 27 member states, with a focus on the criminal prohibitions. It will show the gaps that exist within the EU regulation as well as in the national legislation addressing biological and chemical weapons. Art. 83(1) TFEU allows for the harmonization of national criminal legislation in certain circumstances. While chemical and biological weapons cannot fully be captured under any of the existing areas of crime included in Art. 83(1) TFUE, these can be expanded. The existing gaps in the national penal provisions in combination with the EU-wide effects of any potential use or proliferation of chemical and biological agents warrants the expansion of the areas of crime and harmonisation of national criminal law on the basis of Art. 83 TFEU.
Exploring the use of immersive virtual reality in adults with chronic primary pain: A scoping review
Authors: Astek Anfal , Sparkes Valerie , Sheeran Liba
Published: August 2024

Background

The use of immersive virtual reality, wearing head mounted display, has recently increased for people with chronic pain, with no definitive conclusion of its efficacy on pain-related outcomes.

Objective

To map the available evidence on the use of immersive virtual reality as intervention for adults with chronic primary pain, illustrating gap in knowledge and direct future research.

Methods

The search was performed with a range of study designs, but only those written in English language. A search was created in CINAHL Plus, Medline, AMED, Embase, PsycINFO, ASSIA, Scopus, TripPro, CENTRAL and EmCare.

Results

Thirty-two studies were included. Several chronic conditions were identified including chronic musculoskeletal pain and fibromyalgia. The immersive virtual reality mechanisms included distraction, physical exercises, mindfulness/biofeedback, graded exposure, hypnosis, neuromodulation, and multi-mechanisms, and all these mechanisms were associated with varied dose. The use of customised software, with wide range of head mounted displays were common in clinical setting with some degree of supervision. Motion sickness, head mounted display discomfort and technical issues affect the usability of immersive virtual reality leading to poor engagement and dropouts.

Conclusions

The use of immersive virtual reality for chronic primary pain is in early stages with lack of consensus regarding the mechanisms and associated dose. Future research needs to address the need of customisation, clinical usability of head mounted display as well as safety strategies to enhance the uptake of immersive virtual reality technology in healthcare practice.
Relaxation training via tele-rehabilitation program in patients with breast cancer receiving chemotherapy during COVID-19
Authors: Bahçaci Umut , Uysal Songül Atasavun , Namal Esat
Published: August 2024

Introduction

The COVID-19 pandemic has highlighted the significance of tele-rehabilitation in granting access to physical therapy for breast cancer patients. To mitigate the adverse effects of chemotherapy, Jacobson's relaxation techniques can be performed from the comfort and safety of patients’ homes. The aim of this research was to investigate the effects of relaxation exercises delivered via tele-rehabilitation in breast cancer patients receiving chemotherapy.

Method

A total of 64 patients, were randomly allocated to the exercise group ( n = 33) and to the control group ( n = 31). The exercise group performed supervised “Jacobson Progressive Relaxation” exercises in groups of up to eight participants, three times a week for 6 weeks via WhatsApp© meetings. The control group was provided with a simple relaxation exercise brochure. The primary outcome was the “pain” which was measured by “Brief Pain Inventory.” Fatigue, emotional state, quality of life, cognitive state, sleep quality, and kinesiophobia were considered as secondary outcomes. All measurements were made at the first appointment and after the intervention.

Results

The study was finally completed with 52 participants, 26 in each group. The exercise group demonstrated a statistically significant improvement in pain (all subscales p < 0.05), quality of life (symptom scale p = 0.006), cognitive function (perceived cognitive impairment p = 0.009), and (total p = 0.016) subscales, sleep quality ( p < 0.001), emotional state (depression p = 0.007, anxiety p = 0.003), and fatigue scores ( p = 0.017) compared to the control group in the score change before and after the intervention. No significant difference was found between the groups in terms of kinesiophobia scores ( p > 0.05). Within-group results exhibited improvement across various measures in both groups, with statistical significance ( p < 0.05).

Discussion

The effectiveness of telerehabilitation-based progressive relaxation exercises in improving the pain, quality of life, cognitive status, sleep quality, anxiety–depression, and fatigue levels experienced by breast cancer patients undergoing taxane chemotherapy has been demonstrated in this study.
Audience Musical Absorption: Exploring Attention and Affect in the Live Concert Setting
Authors: Swarbrick D. , Martin R. , Høffding S. , Nielsen N. , Vuoskoski J. K.
Published: August 2024

Musical absorption is a multi-dimensional phenomenon that has been understood in various ways, but is related to strong, immersive, and transformative musical encounters. For this exploratory article, we used a phenomenologically and psychologically informed questionnaire to measure audience members’ reports of musical absorption and affective experiences at the MusicLab Copenhagen research concert with the Danish String Quartet (DSQ). We aimed to examine the relation between musical absorption and (1) attention, mind-wandering, and senses of transformation; (2) affective phenomena of feeling moved or touched and awe; (3) social context, as determined by technological mediation of a livestream; (4) musical context (Beethoven, Schnittke, and folk music); and (5) motion. There were 91 participants in the live audience and 43 participants in the livestreaming audience, who completed questionnaires after each piece in the concert and who had their motion measured through an application that recorded accelerometer data from their smartphones. Drawing on methods from experimental psychology, we found that (1) being “absorbed in the music” was not related to mind-wandering, but it was related to a sense of positive transformation; (2) musical absorption was related to experiences of feeling moved, awe, connectedness, and enjoyment, and to being an “admirer” of the DSQ, as well as to being familiar with the music; (3) being at the live concert facilitated more musical absorption than watching the livestream; (4) the final concert section, containing a collection of folk tunes, promoted the most musical absorption; and (5) within the restrained movement dynamics of the live audience, motion trended as an indicator of an embodied experience of musical absorption. We use these results to engage in a phenomenologically informed and empirically enriched discussion of musical absorption and related affective and attentional dynamics.
Why Does Speech Sometimes Sound Like Song? Exploring the Role of Music-Related Priors in the “Speech-to-Song Illusion”
Authors: Rathcke Tamara , Falk Simone , Dalla Bella Simone
Published: August 2024

The speech-to-song illusion is a perceptual effect emerging at the interplay of two cognitive domains, music and language. It arises upon repetitions of a spoken phrase that shifts to being perceived as song, and varies in the likelihood, ease, and vividness of its occurrence among individuals. A prevailing explanation of the illusion suggests that listeners’ attention shifts to rhythm and melody of the phrase once their involvement with the linguistic meaning subsides. The present study tested this mechanism by manipulating meaning plausibility and structural complexity of French and English phrases and by obtaining measures of attentional and working memory capacity from 80 French and English listeners who were exposed to repetitions of sentences in their native language. The results show that the transformation was facilitated in listeners with fewer cognitive resources and in less plausible, more complex phrases, which is at odds with the previously proposed mechanism underpinning the speech-to-song illusion. The illusion-promoting effect of musical training was visible only in simple but not in complex phrases. We propose a new account of the perceptual transformation from speech to song as a cognitive effect arising from the accumulation of music-related priors in a linguistically ambiguous context of massed repetitions.
Livelihood Resilience and Influential Factors of Nongchuangke: A Case Study of Zhejiang Province, China
Authors: Cao Yirong , Tong Lei , Ge Xinyi , Zhang Hua , Jiang Leyi , Su Fei
Published: August 2024

Nongchuangke refers to a new group of professional farmers that promotes agricultural innovation and sustainable development. Here, a comprehensive evaluation system for the livelihood-resilience index of the Nongchuangke in Zhejiang Province was constructed using three parameters: the buffer, self-organization, and learning capacities of the Nongchuangke. The entropy method was employed to comprehensively evaluate the livelihood resilience level of the Nongchuanke in Zhejiang Province, and a decision-making trail and evaluation laboratory with interpretive structural modeling was employed to clarify the hierarchical relationships among the limiting factors of the livelihood resilience of the Nongchuangke in Zhejiang Province and identify the key limiting factors. The results revealed that the average livelihood resilience level of the Nongchuangke in Zhejiang Province was low. Furthermore, the policy support, attraction of entrepreneurial investment, information-acquisition ability, and the number of Nongchuangke per 10,000 farmers were identified as the key factors influencing the livelihood resilience level of Nongchuangke in Zhejiang Province. Thus, new approaches that improve the identified influencing factors must be considered and implemented to improve the livelihood resilience level of the Nongchuangke.
CEO Overpower and Real Earning Manipulation in Family Businesses: Do Ownership Structures Matter?
Authors: Duong Khoa Dang , Y Phung Nguyen Ngoc , Pham Ha , Nhan Le Ai Ngoc
Published: August 2024

Our study is the first to analyze the influence of CEO power and ownership structures on earning manipulation. This study also clarifies whether different ownership structures discourage powerful CEOs from manipulating earnings in family businesses. The sample data is a balanced panel with 985 observations of 116 family businesses in Vietnam from 2005 to 2020. We primarily employ the dynamic system Generalized Method of Moments with cross-sectional fixed effect to overcome endogeneity and heterogeneity issues. Our findings indicate the negative relationship between CEO power and earning manipulation. Higher state or institutional ownership restrains powerful CEOs from manipulating earnings in family businesses. However, Powerful CEOs in family businesses with higher participation of blockholders increase the earning manipulation. Our robustness results show that CEOs from 50 to 70 years old reduce earning manipulation the most in family businesses. Our findings support agency theory, stewardship theory, resource dependency theory, monitoring and accountability theory, legal framework theory, reputation theory, monitoring theory, Maslow’s need hierarchy, and prior literature. Our study contributes practical policy and management implications to sustainably reduce earning manipulation in family businesses.
Populism’s Influence on News Content: Polarization, Political Parallelism, and Journalistic Professionalism in Rafael Correa’s Ecuador
Authors: Palos Pons Manel
Published: August 2024

This article investigates how populism in power influenced news media in Ecuador during leftist president Rafael Correa’s presidency (2007–2017). Correa’s administration triggered a bold media reform in Ecuador challenging traditional media and promising media democratization, but his government received sharp denunciations from press freedom and media organizations which considered Ecuador as a “not free” country, especially after the passing of a Communication Law in 2013 that regulated media extensively. Through content analysis of news and opinion pieces published in 2005, 2006, 2015, 2016, and 2018 by Ecuador’s main legacy newspapers, El Comercio and El Universo, different legal and political contexts are examined. The main observations suggest an increase in polarization and improvements in journalistic professionalism, two results consistent and divergent to mainstream academic approaches and public discussions about populism. This contradictory situation may be explained by the emergence of a new political parallelism, absent before Correa came to power, which combines consistent stances based on the rejection of Correa’s leadership, with an improvement in professional practices, especially when Correa was in power. These results, and novel approach adopting a detailed content analysis to explore the relationship between populism and journalism in a Latin American media system, may contribute to a better understanding of the influence of populism on news media. This study calls for more comparative and longitudinal analyses in different media systems and populist experiences, focused on the connection of professional practices and political positioning, with or without populist actors in power.
Masculinity and Violence Interconnectedness: Defining and Reconciling the Gender Paradox Among Men With Cumulative Lifetime Violence Histories
Authors: O’Donnell Sue , Taylor Petrea , Vincent Charlene D. , Scott-Storey Kelly , Wuest Judith , Malcolm Jeannie
Published: August 2024

Among men, gender and views about violence contribute to how men, and others, identify and respond to violence and related outcomes. Despite this, little is known about men’s perspectives regarding gender/masculinities and cumulative lifetime violence (CLV) exposure. Using the qualitative method of Interpretative description, the complex relationship between gender and violence for men who have experienced CLV was explored. Interviews with thirty-two men who experienced CLV revealed a complex interrelation between masculinity and violence (MV interconnectedness). This intricate connection is difficult to separate due to persistent normalization and acceptance of violence. Because violence is one way that men live up to pressure to ‘be a man,’ MV interconnectedness positively contributes to men’s sense of self. However, MV interconnectedness also contributes to significant harm. The contradictory nature of MV interconnectedness and the tension that arises when men contemplate the link between gender and violence was labelled ‘the paradox’. As men grapple with the paradox, and the ways that gender and violence have influenced their lives, they are able to move toward disconnecting violence from how they define themselves as men. The paradox is a significant addition to the understanding of how men may reject the narrative that masculinity and violence are interconnected. MV Interconnectedness demonstrates that the link between masculinity and violence perpetration is not straightforward. Normalization and acceptance of violence calls for efforts to counteract the messages and pressures boys and men receive that influence their behaviour.
Does Being an Environmental Citizen Lead to Greater Well-Being? The Self-Determination Theory Approach
Authors: Vijaikis Aivaras , Poškus Mykolas Simas
Published: August 2024

In this study, we examine a potential model based on the Self-Determination Theory, which explains how environmental citizenship and connectedness to nature could be associated with subjective well-being through the satisfaction of basic psychological needs. A convenience sample of 172 adolescents from three Lithuanian schools with a mean age of 15.4 years was gathered (40.1% male, 51.7% female, and 8.1% who preferred not to answer). The tested model showed reasonable fit indices: CFI = 0.941, TLI = 0.928, NFI = 0.913, RMSEA = 0.104 [0.090–0.119], SRMR = 0.073 and χ2 (98) = 281.532, p < .01, and could explain approximately 41% of the variance of subjective well-being. The results show that pro-environmental actions taken by environmental citizens in the private sphere can have a positive impact on mental health as pro-environmental behavior satisfies basic psychological needs.
Patient-Readable Radiology Report Summaries Generated via Large Language Model: Safety and Quality
Authors: Sterling Nicholas W. , Brann Felix , Frisch Stephanie O. , Schrager Justin D.
Published: August 2024

Complex medical terminology utilized in clinical documentation can present barriers to patients understanding their medical findings. We aimed to generate easy-to-understand summaries of clinical radiology reports using large language models (LLMs) and evaluate their safety and quality. Eight board-certified physician reviewers evaluated 1982 LLM-generated radiology report summaries (computed tomography, magnetic resonance imaging, ultrasound, and x-ray) for safety and quality, using predefined rating criteria and the corresponding original radiology reports for reference. Physician reviewers determined 99.2% (1967 out of 1982) of the LLM-generated summaries to be safe. The reviewers scored the quality of the LLM-generated summaries from “5—Very Good” to “1—Very Poor,” respectively, as follows: 80.6%, 11.1%, 5.7%, 1.7%, and 0.9%. Safety varied significantly across imaging modality ( P = .002). Large language models can be used to generate safe and high-quality summaries of clinical radiology reports. Further investigation is warranted to determine the impact of LLM-generated summaries on patient perception of understanding, knowledge of their medical conditions, and overall experience.
Reasoning about self and others: A dynamic process
Authors: Geveke C H , Veenker H J J M , Steenbeek H W
Published: August 2024

Background

It can be very challenging for practitioners to talk with autistic children, especially when the conversation calls for self-regulation. Self-regulation is inextricably linked to awareness of oneself and others in social contexts. Encouraging the need for autonomy could help increase self-awareness and awareness of others in social events, which in turn could strengthen self-regulation. However, little is known about how autonomy influences competence in reasoning about self and others when regarding social events in which autistic children participate. This study explores the reasoning of self-other awareness on a microlevel timescale using ipsative, dynamic approaches to autism. The central question in this study is: to what extent can autonomy-provided scaffolding (APS) elicit high levels of reasoning about self-others in social events (RSS) over time?

Method

We used video-taped interaction data from three sessions between one autistic child and a practitioner, contextualized by a set of animated DSM-5-based items of social events on which the child was asked to reflect. Interaction variables were the child's level of RSS and the practitioner's level of APS. We coded the real-time interaction.

Results

First, when exploring the dynamics of the microdata, we found contingency over time within sessions. Second, over the sessions, the practitioner showed a stable high level of APS, whereas the child's level of RSS increased. Third, a coupling effect between the level of APS and RSS was found within and over sessions. Salient is that the child and practitioner increasingly adapted to each other over the three sessions, and over time, high-level APS of the practitioner elicited higher levels of RSS of the child.

Discussion

Because the child showed a significant improvement in RSS over time, our research question provides a promising perspective. Contrary to what one might expect in autism, APS supported the performance of the child in reasoning about self-others in social situations. These outcomes underline the importance of giving voice to autistic children. The results may encourage researchers to develop strategies and tools that can help give a voice to children, to gain more insight into the child's reasoning. This may further develop self-other awareness and self-regulation in the social events of autistic children.
Complex lives and procedural barriers: Detainees’ “life happens” explanations for breaching orders
Authors: Gately Natalie , Rock Suzanne , Finney James L , Parry Cate
Published: August 2024

The Australian bail system routinely permits most individuals accused of a crime to remain in the community while awaiting a court date under a range of conditions. However, statistics have indicated that a high number of bailees breach the orders placed on them, increasing police and court interactions, and resulting in additional charges. This project utilised the Drug Use Monitoring in Australia – Western Australia (DUMA-WA) collection to survey 230 police detainees about their orders and reasons for breaching recent orders. The results indicated that most understood their orders but disclosed a range of complexities which interfered with compliance. Qualitative responses revealed the themes of life complexities including homelessness and family responsibilities, and procedural challenges which served as barriers to adhering to order requirements. No significant differences were found based on Indigeneity; however, allowances for cultural obligations are essential to reduce breached conditions. General Strain Theory is used to examine the structural elements that arguably contribute to charge pile-ups and criminalisation for those on orders. While this paper utilised WA participants, given the similarities of detained persons in Australia, the issues identified provide suggestions to address the high levels of breaching conditions in other jurisdictions. There urgently needs to be a concerted effort to remove some of the procedural roadblocks to compliance which would reduce additional charges, reduce the workload of police and court staff, and assist with delays in the administration of justice.
Phage therapy: breathing new tactics into lower respiratory tract infection treatments
Authors: Vaezi Atefeh , Healy Thomas , Ebrahimi Golnaz , Rezvankhah Saeid , Hashemi Shahraki Abdolrazagh , Mirsaeidi Mehdi
Published: August 2024

Lower respiratory tract infections (LRTIs) present a significant global health burden, exacerbated by the rise in antimicrobial resistance (AMR). The persistence and evolution of multidrug-resistant bacteria intensifies the urgency for alternative treatments. This review explores bacteriophage (phage) therapy as an innovative solution to combat bacterial LRTIs. Phages, abundant in nature, demonstrate specificity towards bacteria, minimal eukaryotic toxicity, and the ability to penetrate and disrupt bacterial biofilms, offering a targeted approach to infection control. The article synthesises evidence from systematic literature reviews spanning 2000–2023,
in vitro
and
in vivo
studies, case reports and ongoing clinical trials. It highlights the synergistic potential of phage therapy with antibiotics, the immunophage synergy in animal models, and the pharmacodynamics and pharmacokinetics critical for clinical application. Despite promising results, the article acknowledges that phage therapy is at a nascent stage in clinical settings, the challenges of phage-resistant bacteria, and the lack of comprehensive cost-effectiveness studies. It stresses the need for further research to optimise phage therapy protocols and navigate the complexities of phage–host interactions, particularly in vulnerable populations such as the elderly and immunocompromised. We call for regulatory adjustments to facilitate the exploration of the long-term effects of phage therapy, aiming to incorporate this old-yet-new therapy into mainstream clinical practice to tackle the looming AMR crisis.
Numerical Prediction of Ride Comfort of Tracked Vehicle Equipped with Novel Flexible Road Wheels
Authors: Deng Yaoji , Wang Zhiyue , Zhao Youqun , Gong Junjie , Shen Hui , Lin Fen
Published: August 2024

Enhancing ride comfort has always constituted a crucial focus in the design and research of modern tracked vehicles, heavily reliant on the driving system’s performance. While the road wheel is a key component of the driving system, traditional road wheels predominantly adopt a solid structure, exhibiting subpar adhesion performance and damping effects, thereby falling short of meeting the demands for high-speed, stable, and long-distance driving in tracked vehicles. Addressing this issue, this paper proposes a novel type of flexible road wheel (FRW) characterized by a catenary construction. The study investigates the ride comfort of tracked vehicles equipped with flexible road wheels by integrating finite element and vehicle dynamic. First, three-dimensional (3D) finite element (FE) models of both flexible and rigid road wheels are established, considering material and contact nonlinearities. These models are validated through a wheel radial loading test. Based on the validated FE model, the paper uncovers the relationship between load and radial deformation of the road wheel, forming the basis for a nonlinear mathematical model. Subsequently, a half-car model of a tracked vehicle with seven degrees of freedom is established using Newton’s second law. A random road model, considering the track effect and employing white noise, is constructed. The study concludes by examining the ride comfort of tracked vehicles equipped with flexible and rigid road wheels under various speeds and road grades. The results demonstrate that, in comparison to the rigid road wheel (RRW), the flexible road wheel enhances the ride comfort of tracked vehicles on randomly uneven roads. This research provides a theoretical foundation for the implementation of flexible road wheels in tracked vehicles.
Stomatal penetration: the cornerstone of plant resistance to the fungal pathogen Zymoseptoria tritici
Authors: Battache Mélissa , Suarez-Fernandez Marta , Klooster Madison Van’t , Cambon Florence , Sánchez-Vallet Andrea , Lebrun Marc-Henri , Langin Thierry , Saintenac Cyrille
Published: August 2024

Background

Septoria tritici blotch (STB), caused by the foliar fungus Zymoseptoria tritici, is one of the most damaging disease of wheat in Europe. Genetic resistance against this fungus relies on different types of resistance from non-host resistance (NHR) and host species specific resistance (HSSR) to host resistance mediated by quantitative trait loci (QTLs) or major resistance genes (Stb). Characterizing the diversity of theses resistances is of great importance for breeding wheat cultivars with efficient and durable resistance. While the functional mechanisms underlying these resistance types are not well understood, increasing piece of evidence suggest that fungus stomatal penetration and early establishment in the apoplast are both crucial for the outcome of some interactions between Z. tritici and plants. To validate and extend these previous observations, we conducted quantitative comparative phenotypical and cytological analyses of the infection process corresponding to 22 different interactions between plant species and Z. tritici isolates. These interactions included four major bread wheat Stb genes, four bread wheat accessions with contrasting quantitative resistance, two species resistant to Z. tritici isolates from bread wheat (HSSR) and four plant species resistant to all Z. tritici isolates (NHR).

Results

Infiltration of Z. tritici spores into plant leaves allowed the partial bypass of all bread wheat resistances and durum wheat resistance, but not resistances from other plants species. Quantitative comparative cytological analysis showed that in the non-grass plant Nicotiana benthamiana, Z. tritici was stopped before stomatal penetration. By contrast, in all resistant grass plants, Z. tritici was stopped, at least partly, during stomatal penetration. The intensity of this early plant control process varied depending on resistance types, quantitative resistances being the least effective. These analyses also demonstrated that Stb-mediated resistances, HSSR and NHR, but not quantitative resistances, relied on the strong growth inhibition of the few Z. tritici penetrating hyphae at their entry point in the sub-stomatal cavity.

Conclusions

In addition to furnishing a robust quantitative cytological assessment system, our study uncovered three stopping patterns of Z. tritici by plant resistances. Stomatal resistance was found important for most resistances to Z. tritici, independently of its type (Stb, HSSR, NHR). These results provided a basis for the functional analysis of wheat resistance to Z. tritici and its improvement.
Identification of potential biomarkers for atrial fibrillation and stable coronary artery disease based on WGCNA and machine algorithms
Authors: Wu Ke , Chen Hao , Li Fan , Meng Xiangjuan , Chen Lin , Li Nannan
Published: August 2024

Background

Patients with atrial fibrillation (AF) often have coronary artery disease (CAD), but the biological link between them remains unclear. This study aims to explore the common pathogenesis of AF and CAD and identify common biomarkers.

Methods

Gene expression profiles for AF and stable CAD were downloaded from the Gene Expression Omnibus database. Overlapping genes related to both diseases were identified using weighted gene co-expression network analysis (WGCNA), followed by functional enrichment analysis. Hub genes were then identified using the machine learning algorithm. Immune cell infiltration and correlations with hub genes were explored, followed by drug predictions. Hub gene expression in AF and CAD patients was validated by real-time qPCR.

Results

We obtained 28 common overlapping genes in AF and stable CAD, mainly enriched in the PI3K-Akt, ECM-receptor interaction, and relaxin signaling pathway. Two hub genes, COL6A3 and FKBP10, were positively correlated with the abundance of MDSC, plasmacytoid dendritic cells, and regulatory T cells in AF and negatively correlated with the abundance of CD56dim natural killer cells in CAD. The AUCs of COL6A3 and FKBP10 were all above or close to 0.7. Drug prediction suggested that collagenase clostridium histolyticum and ocriplasmin, which target COL6A3, may be potential drugs for AF and stable CAD. Additionally, COL6A3 and FKBP10 were upregulated in patients with AF and CAD.

Conclusion

COL6A3 and FKBP10 may be key biomarkers for AF and CAD, providing new insights into the diagnosis and treatment of this disease.
Interactive molecular causal networks of hypertension using a fast machine learning algorithm MRdualPC
Authors: Kelly Jack , Xu Xiaoguang , Eales James M. , Keavney Bernard , Berzuini Carlo , Tomaszewski Maciej , Guo Hui
Published: August 2024

Background

Understanding the complex interactions between genes and their causal effects on diseases is crucial for developing targeted treatments and gaining insight into biological mechanisms. However, the analysis of molecular networks, especially in the context of high-dimensional data, presents significant challenges.

Methods

This study introduces MRdualPC, a computationally tractable algorithm based on the MRPC approach, to infer large-scale causal molecular networks. We apply MRdualPC to investigate the upstream causal transcriptomics influencing hypertension using a comprehensive dataset of kidney genome and transcriptome data.

Results

Our algorithm proves to be 100 times faster than MRPC on average in identifying transcriptomics drivers of hypertension. Through clustering, we identify 63 modules with causal driver genes, including 17 modules with extensive causal networks. Notably, we find that genes within one of the causal networks are associated with the electron transport chain and oxidative phosphorylation, previously linked to hypertension. Moreover, the identified causal ancestor genes show an over-representation of blood pressure-related genes.

Conclusions

MRdualPC has the potential for broader applications beyond gene expression data, including multi-omics integration. While there are limitations, such as the need for clustering in large gene expression datasets, our study represents a significant advancement in building causal molecular networks, offering researchers a valuable tool for analyzing big data and investigating complex diseases.
Real-world dosing of regorafenib and outcomes among patients with metastatic colorectal cancer: a retrospective analysis using US claims data
Authors: Bekaii-Saab Tanios , Khan Nasreen , Ostojic Helene , Jiao XiaoLong , Chen Guifang , Lin Wenlong , Bruno Amanda
Published: August 2024

Background

The randomized, dose-optimization, open-label ReDOS study in US patients with metastatic colorectal cancer (CRC) showed that, compared with a standard dosing approach, initiating regorafenib at 80 mg/day and escalating to 160 mg/day depending on tolerability increased the proportion of patients reaching their third treatment cycle and reduced the incidence of adverse events without compromising efficacy. Subsequently, the ReDOS dose-escalation strategy was included as an alternative regorafenib dosing option in the National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines. A retrospective analysis was conducted using a US claims database to assess whether inclusion of this dose-escalation strategy in NCCN Guidelines has influenced the use of flexible dosing in routine US clinical practice, and to describe clinical outcomes pre- and post-inclusion in NCCN Guidelines.

Methods

Patients with CRC in the Optum’s de-identified Clinformatics® Data Mart database initiating regorafenib for the first time between January 2016 and June 2020 were stratified based on whether they initiated regorafenib pre- or post-inclusion of ReDOS in NCCN Guidelines, and in two groups: flexible dosing (< 160 mg/day; < 84 tablets in the first treatment cycle) and standard dosing (160 mg/day; ≥ 84 tablets in the first treatment cycle). The primary endpoints were the proportion of patients who initiated their third treatment cycle and the mean number of treatment cycles per group.

Results

703 patients initiated regorafenib during the study period, of whom 310 (44%) initiated before and 393 (56%) initiated after inclusion of ReDOS in NCCN Guidelines. After inclusion in the guidelines, the proportion of patients who received flexible dosing increased from 21% (n = 66/310) to 45% (n = 178/393), the proportion who received standard dosing decreased from 79% (n = 244/310) to 55% (n = 215/393), the proportion who initiated their third treatment cycle increased from 36% (n = 113/310) to 46% (n = 179/393), and the mean (standard deviation) number of treatment cycles increased from 2.6 (2.9) to 3.2 (3.1).

Conclusions

Following inclusion of ReDOS in NCCN Guidelines, real-world data suggest that US clinicians have markedly increased use of flexible dosing in clinical practice, potentially maximizing clinical benefits and safety outcomes for patients with metastatic CRC receiving regorafenib.