bluuebunny/crossref_metadata_2025 huggingface dataset:
Prediction of post-stroke cognitive impairment after acute ischemic stroke using machine learning
Authors: Lee Minwoo , Yeo Na-Young , Ahn Hyo-Jeong , Lim Jae-Sung , Kim Yerim , Lee Sang-Hwa , Oh Mi Sun , Lee Byung-Chul , Yu Kyung-Ho , Kim Chulho
Published: August 2023

Background and objectives

Post-stroke cognitive impairment (PSCI) occurs in up to 50% of patients with acute ischemic stroke (AIS). Thus, the prediction of cognitive outcomes in AIS may be useful for treatment decisions. This PSCI cohort study aimed to determine the applicability of a machine learning approach for predicting PSCI after stroke.

Methods

This retrospective study used a prospective PSCI cohort of patients with AIS. Demographic features, clinical characteristics, and brain imaging variables previously known to be associated with PSCI were included in the analysis. The primary outcome was PSCI at 3–6 months, defined as an adjusted z-score of less than − 2.0 standard deviation in at least one of the four cognitive domains (memory, executive/frontal, visuospatial, and language), using the Korean version of the Vascular Cognitive Impairment Harmonization Standards-Neuropsychological Protocol (VCIHS-NP). We developed four machine learning models (logistic regression, support vector machine, extreme gradient boost, and artificial neural network) and compared their accuracies for outcome variables.

Results

A total of 951 patients (mean age 65.7 ± 11.9; male 61.5%) with AIS were included in this study. The area under the curve for the extreme gradient boost and the artificial neural network was the highest (0.7919 and 0.7365, respectively) among the four models for predicting PSCI according to the VCIHS-NP definition. The most important features for predicting PSCI include the presence of cortical infarcts, mesial temporal lobe atrophy, initial stroke severity, stroke history, and strategic lesion infarcts.

Conclusion

Our findings indicate that machine-learning algorithms, particularly the extreme gradient boost and the artificial neural network models, can best predict cognitive outcomes after ischemic stroke.
A polygenic risk score for Alzheimer’s disease constructed using APOE-region variants has stronger association than APOE alleles with mild cognitive impairment in Hispanic/Latino adults in the U.S.
Authors: Sofer Tamar , Kurniansyah Nuzulul , Granot-Hershkovitz Einat , Goodman Matthew O. , Tarraf Wassim , Broce Iris , Lipton Richard B. , Daviglus Martha , Lamar Melissa , Wassertheil-Smoller Sylvia , Cai Jianwen , DeCarli Charles S. , Gonzalez Hector M. , Fornage Myriam
Published: August 2023

Introduction

Polygenic Risk Scores (PRSs) are summaries of genetic risk alleles for an outcome.

Methods

We used summary statistics from five GWASs of AD to construct PRSs in 4,189 diverse Hispanics/Latinos (mean age 63 years) from the Study of Latinos-Investigation of Neurocognitive Aging (SOL-INCA). We assessed the PRS associations with MCI in the combined set of people and in diverse subgroups, and when including and excluding the APOE gene region. We also assessed PRS associations with MCI in an independent dataset from the Mass General Brigham Biobank.

Results

A simple sum of 5 PRSs (“PRSsum”), each constructed based on a different AD GWAS, was associated with MCI (OR = 1.28, 95% CI [1.14, 1.41]) in a model adjusted for counts of the APOE-$$\epsilon 2$$

ϵ
2

and APOE-$$\epsilon 4$$

ϵ
4

alleles. Associations of single-GWAS PRSs were weaker. When removing SNPs from the APOE region from the PRSs, the association of PRSsum with MCI was weaker (OR = 1.17, 95% CI [1.04,1.31] with adjustment for APOE alleles). In all association analyses, APOE-$$\epsilon 4$$

ϵ
4

and APOE-$$\epsilon 2$$

ϵ
2

alleles were not associated with MCI.

Discussion

A sum of AD PRSs is associated with MCI in Hispanic/Latino older adults. Despite no association of APOE-$$\epsilon 4$$

ϵ
4

and APOE-$$\epsilon 2$$

ϵ
2

alleles with MCI, the association of the AD PRS with MCI is stronger when including the APOE region. Thus, APOE variants different than the classic APOE alleles may be important predictors of MCI in Hispanic/Latino adults.
Coronavirus disease 2019 and malaria coinfection in a middle-aged Ethiopian woman presenting with acute febrile illness and bilateral pleural effusion: a case report
Authors: Solela Gashaw , Aschenek Addis , Dawit Mikale , Wondafrash Getachew
Published: August 2023

Introduction

There could be misdiagnosis of coronavirus disease 2019 for malaria and vice versa because of their similar presentations, particularly when clinicians rely mainly on symptoms for diagnosis. Coinfection with coronavirus disease 2019 and malaria is associated with increased all-cause in-hospital mortality compared with isolated infection with severe acute respiratory syndrome coronavirus 2. Presentation with pleural effusion adds another challenge in the diagnosis of coronavirus disease 2019.

Case presentation

This is a 57-year-old black Ethiopian woman who presented with symptoms of acute febrile illness associated with shortness of breath and coughing. Physical examination was remarkable for fever, hypotension, tachycardia, tachypnea, oxygen desaturation, decreased air entry, and dullness over bilateral lower one-third of the chest. Peripheral blood smear revealed ring-form trophozoites of Plasmodium falciparum; chest X-ray showed bilateral pleural effusion and chest computed tomography revealed bilateral ground-glass opacities and consolidations involving all lung zones with bilateral moderate pleural effusion. She was managed with supportive treatments, antimalarial agents, and antibiotics. Rapid antigen test for severe acute respiratory syndrome coronavirus 2 was negative at the time of her presentation to the emergency department, but polymerase chain reaction testing for coronavirus disease 2019 turned out to be positive after admission to the medical ward.

Conclusion

Clinicians should be aware of the possibility of coronavirus disease 2019 and malaria coinfection in any patient who is from malaria-endemic area and presenting with acute febrile illness symptoms such as fever and headache and respiratory complaints like shortness of breath and cough. Alhough viral etiologies such as coronavirus disease 2019 are rare causes of bilateral pleural effusion, they should be considered after ruling out other common causes.
The high level of IL-1β in the serum of ACLF patients induces increased IL-8 expression in hUC-MSCs and reduces the efficacy of hUC-MSCs in liver failure
Authors: Wang Yong-Hong , Wang Meng-Lan , Tao Ya-Chao , Wu Dong-Bo , Chen En-Qiang , Tang Hong
Published: August 2023

Background

Stem cells play a therapeutic role mainly through immunoregulation. However, the immunomodulatory function of stem cells may be affected by inflammation-related factors in patients’ serum. Therefore, this study aims to investigate the possible mechanism by which acute-on-chronic liver failure (ACLF) patient serum influences the efficacy of hUC-MSCs.

Methods

The serum of surviving and dead ACLF patients was collected to culture hUC-MSCs in vitro, and the hUC-MSCs cultured in the serum of ACLF patients were used to treat acute liver failure (ALF) rats. The therapeutic effect on the rats was evaluated by a survival curve, the transaminase level and liver histopathology. The expression of cytokines in hUC-MSCs was detected by Q-PCR and ELISA.

Results

Serum pretreatment reduced the therapeutic effect of hUC-MSCs on ALF, especially pretreatment in the serum from dead ACLF patients. After hUC-MSCs were cultured in the serum of surviving or dead ACLF patients, the most differentially expressed factor was IL-8. Interfering with the expression of IL-8 in hUC-MSCs can improve the therapeutic effect of hUC-MSCs on ALF. The high level of IL-1β in the serum of dead ACLF patients causes the increased expression of IL-8 in hUC-MSCs through the activation of the NF-κB signaling pathway. Meanwhile, we found that the neutralizing IL-1β in serum from dead ACLF patients can improve the therapeutic effect of hUC-MSCs on ALF.

Conclusion

The high level of IL-1β in ACLF serum can promote the expression of IL-8 in hUC-MSCs through the NF-κB signaling pathway, thus reducing the effect of hUC-MSCs on ALF.
The characteristics and medical applications of antler stem cells
Authors: Liu Qi , Li Jiannan , Chang Jinghui , Guo Yu , Wen Dacheng
Published: August 2023

Antlers are the only fully regenerable mammalian appendages whose annual renewal is initiated by antler stem cells (ASCs), defined as a specialized type of mesenchymal stem cells (MSCs) with embryonic stem cell properties. ASCs possess the same biological features as MSCs, including the capacity for self-renewal and multidirectional differentiation, immunomodulatory functions, and the maintenance of stem cell characteristics after multiple passages. Several preclinical studies have shown that ASCs exhibit promising potential in wound healing, bone repair, osteoarthritis, anti-tissue fibrosis, anti-aging, and hair regeneration. Medical applications based on ASCs and ASC-derived molecules provide a new source of stem cells and therapeutic modalities for regenerative medicine. This review begins with a brief description of antler regeneration and the role of ASCs. Then, the properties and advantages of ASCs are described. Finally, medical research advances regarding ASCs are summarized, and the prospects and challenges of ASCs are highlighted.
Bovine TB in New Zealand – journey from epidemic towards eradication
Authors: Sinclair Jane , New Dallas , Neill Mark
Published: August 2023

Bovine tuberculosis (TB), caused by Mycobacterium bovis, has a unique and complex ecology in New Zealand. Unlike elsewhere in the world, the disease is maintained in Australian brushtail possums (Trichosurus vulpecula) and so they are considered a vector for disease transmission in New Zealand. Possums were initially introduced to the country in the 1800’s to establish a fur industry but later becoming a recognized pest to native New Zealand flora and fauna. The TB programme in New Zealand (TBFree NZ Ltd) is managed by a not-for-profit limited company partnership between primary industries and government (OSPRI – Operational Solutions for Primary Industries) that uses the basic tenets of disease management, movement control and vector control to eliminate TB in farmed cattle and deer. Evidence of resounding success in the TB control programme resulted in the 2016 decision to pursue full biological eradication of disease from the country by 2055, with the interim objectives of TB freedom in livestock herds by 2026 and TB freedom in possums by 2040. The programme has progressed from an all-time high of 1698 infected herds in 1995 to the lowest recorded point prevalence of 18 infected herds in May 2022. Enhancements that have contributed to the success of the programme include testing with gamma-interferon release assay (Bovigam™) of animals in infected herds that are negative to the skin test (parallel interpretation), culturing pooled lymph nodes from animals without visible lesions, increased testing of herds post-clearance and introduction of post-movement testing of high-risk animals.
The effect of the national brand on high-tech exports in selected countries
Authors: Shahabadi Abolfazl , Amjadian Shiva , Ghasemifar Samineh , Shafieian Masoume
Published: August 2023

High-tech exports play a crucial role in the growth and prosperity of the national economy due to higher added value and higher profitability. However, gaining a competitive advantage and increasing high-tech exports is arduous because of the highly competitive environment in global markets. In addition, increasing the value of the national brand through the improvement of foreign customers' mental image of products made in a specific country, can play an undeniable role in the improvement of customer’s loyalty and growth of high-tech exports. In this paper, we evaluate the impact of the national brand on high-tech exports in 12 countries with the most valuable nation-brand, using panel data and a generalized method of moments (GMM), during the period 2015–2021. The results showed the positive and significant impact of the national brand in this group. It means that although improvement of the national brand stimulates the demand for high-tech products from foreign customers, countries that have had more capacity to increase the production and supply of these products have been more successful in meeting the created surplus demand. Therefore, developing countries should take action to improve the national brand, by moving towards a knowledge-based economy, and at the same time, they have to increase their capacity of production and supply of high-tech products to be able to meet the demands of these products in global markets.
Combining bulk and single-cell RNA-sequencing data to develop an NK cell-related prognostic signature for hepatocellular carcinoma based on an integrated machine learning framework
Authors: Feng Qian , Huang Zhihao , Song Lei , Wang Le , Lu Hongcheng , Wu Linquan
Published: August 2023

Background

The application of molecular targeting therapy and immunotherapy has notably prolonged the survival of patients with hepatocellular carcinoma (HCC). However, multidrug resistance and high molecular heterogeneity of HCC still prevent the further improvement of clinical benefits. Dysfunction of tumor-infiltrating natural killer (NK) cells was strongly related to HCC progression and survival benefits of HCC patients. Hence, an NK cell-related prognostic signature was built up to predict HCC patients’ prognosis and immunotherapeutic response.

Methods

NK cell markers were selected from scRNA-Seq data obtained from GSE162616 data set. A consensus machine learning framework including a total of 77 algorithms was developed to establish the gene signature in TCGA–LIHC data set, GSE14520 data set, GSE76427 data set and ICGC–LIRI–JP data set. Moreover, the predictive efficacy on ICI response was externally validated by GSE91061 data set and PRJEB23709 data set.

Results

With the highest C-index among 77 algorithms, a 11-gene signature was established by the combination of LASSO and CoxBoost algorithm, which classified patients into high- and low-risk group. The prognostic signature displayed a good predictive performance for overall survival rate, moderate to high predictive accuracy and was an independent risk factor for HCC patients’ prognosis in TCGA, GEO and ICGC cohorts. Compared with high-risk group, low-risk patients showed higher IPS–PD1 blocker, IPS–CTLA4 blocker, common immune checkpoints expression but lower TIDE score, which indicated low-risk patients might be prone to benefiting from ICI treatment. Moreover, a real-world cohort, PRJEB23709, also revealed better immunotherapeutic response in low-risk group.

Conclusions

Overall, the present study developed a gene signature based on NK cell-related genes, which offered a novel platform for prognosis and immunotherapeutic response evaluation of HCC patients.
Children’s eating attitudes test (ChEAT): validation and reliability in Turkish children
Authors: Bozkurt Osman , Kocaadam-Bozkurt Betul , Köksal Eda , Özalp Ateş Funda Seher
Published: August 2023

Objectives

This study aims to examine the validity and reliability of the children’s eating attitudes test (ChEAT) in Turkish children.

Methods

The participants were 331 children (137 boys and 194 girls, ages 8–15). Data was collected through face-to-face interviews using a questionnaire containing socio-demographic characteristics, the ChEAT, and the children's eating behaviour questionnaire (CEBQ). Exploratory factor analysis (EFA) was performed to determine the factor structure of the Turkish version of the ChEAT. Additionally, the reliability was examined in terms of internal consistency and test–retest reliability. All statistical analyses were performed using Mplus Trial Version and SPSS 11.5 (SPSS, Chicago, IL, USA).

Results

According to the goodness-of-fit statistic, a three-factor solution was appropriate and compatible with clinical considerations. The three factors explained 50.1% of the variance. Cronbach’s alpha coefficient was 0.75 for ChEAT-26, 0.67 for “Preoccupation with thinness and food”, 0.63 for “Social pressure to eat”, and 0.71 for “Dieting”. Furthermore, the test–retest reliability was 0.72, 0.62, 0.59, and 0.59 respectively. Statistically significant correlations between the ChEAT and CEBQ were found (p < 0.05). “Preoccupation with thinness and food” was significantly higher in obese children (p < 0.05), while “Social pressure to eat” was lower (p < 0.001). Sex, grade, BMI, parental education in addition to working status affected the ChEAT-26 scores.

Conclusions

The present study has provided preliminary evidence for the validity and reliability of a Turkish version of the ChEAT.
Prolonged screen watching behavior is associated with high blood pressure among children and adolescents: a systematic review and dose–response meta-analysis
Authors: Farhangi Mahdieh Abbasalizad , Fathi Azar Elahe , Manzouri Ali , Rashnoo Fariborz , Shakarami Amir
Published: August 2023

Background

Numerous cardio-metabolic risk factors influence screen-related behaviors in children and adolescents. Numerous studies with inconsistent results revealed a relationship between blood pressure and screen time in the children and adolescents. This systematic review and meta-analysis summarized the data regarding the relationship between screen time and hypertension (HTN) in children and adolescents.

Methods

We examined three electronic databases, including Scopus, PubMed, and Embase to find the recent research on the relationship between screen time and HTN up to 19 July 2022. Twenty papers were included in the final two-class and dose–response meta-analysis. We conducted subgrouping to identify the source of heterogeneity.

Results

The highest category of screen time increased the odds of HTN by 8% [odds ratio (OR): 1.15; 95% confidence interval (CI): 1.08, 1.23; P < 0.001; I2 = 83.20%] and 1.9 mmHg increase in systolic blood pressure [weighted mean difference (WMD): 1.89; 95% CI: 0.18–3.62; P = 0.030; I2 = 83.4]. However, there was no significant difference in diastolic blood pressure. Moreover, screen time in hypertensive children and adolescents was 0.79 h (47.4 min) higher than normotensive subjects (WMD: 0.79; 95% CI: 0.02, 1.56; P = 0.046; I2 = 92.8). A departure from linearity was observed between increased screen time [digital video discs, personal computers, and video games and HTN (Pnonlinearity = 0.049).

Conclusion

This systematic meta-analysis review is the first to demonstrate a positive correlation between screen time and HTN in children and adolescents.
Healthcare worker perceived barriers and facilitators to implementing a tuberculosis preventive therapy program in rural South Africa: a content analysis using the consolidated framework for implementation research
Authors: van de Water Brittney J. , Wilson Michael , le Roux Karl , Gaunt Ben , Gimbel Sarah , Ware Norma C.
Published: August 2023

Background

South African national tuberculosis (TB) guidelines, in accordance with the World Health Organization, recommend conducting routine household TB contact investigation with provision of TB preventive therapy (TPT) for those who qualify. However, implementation of TPT has been suboptimal in rural South Africa. We sought to identify barriers and facilitators to TB contact investigations and TPT management in rural Eastern Cape, South Africa, to inform the development of an implementation strategy to launch a comprehensive TB program.

Methods

We collected qualitative data through individual semi-structured interviews with 19 healthcare workers at a district hospital and four surrounding primary-care clinics referring to the hospital. The consolidated framework for implementation research (CFIR) was used to develop interview questions as well as guide deductive content analysis to determine potential drivers of implementation success or failure.

Results

A total of 19 healthcare workers were interviewed. Identified common barriers included lack of provider knowledge regarding efficacy of TPT, lack of TPT documentation workflows for clinicians, and widespread community resource constraints. Facilitators identified included healthcare workers high interest to learn more about the effectiveness of TPT, interest in problem-solving logistical barriers in provision of comprehensive TB care (including TPT), and desire for clinic and nurse-led TB prevention efforts.

Conclusion

The use of the CFIR, a validated implementation determinants framework, provided a systematic approach to identify barriers and facilitators to TB household contact investigation, specifically the provision and management of TPT in this rural, high TB burden setting. Specific resources—time, trainings, and evidence—are necessary to ensure healthcare providers feel knowledgeable and competent about TPT prior to prescribing it more broadly. Tangible resources such as improved data systems coupled with political coordination and funding for TPT programming are essential for sustainability.
Nimotuzumab Plus Gemcitabine for K-Ras Wild-Type Locally Advanced or Metastatic Pancreatic Cancer
Authors: Qin Shukui , Li Jin , Bai Yuxian , Wang Zishu , Chen Zhendong , Xu Ruihua , Xu Jianming , Zhang Hongmei , Chen Jia , Yuan Ying , Liu Tianshu , Yang Lin , Zhong Haijun , Chen Donghui , Shen Lin , Hao Chunyi , Fu Deliang , Cheng Ying , Yang Jianwei , Wang Qiong , Qin Baoli , Pan Hongming , Zhang Jun , Bai Xianhong , Zheng Qingshan
Published: August 2023

K-Ras pancreatic cancers benefit overall survival in phase 3 NOTABLE study.
Impact of driver's advanced reaction time in car-following model with optimal velocity deviation under V2X environment
Authors: Yadav Sunita , Siwach Vikash , Redhu Poonam
Published: August 2023

The vehicle-to-everything (V2X) technology has made a significant advancement in the field of intelligent transportation in recent years. When operating a vehicle in a V2X environment, the driver can get real-time updates on the motion of nearby vehicles. In a real-world traffic situation, there is always some deviation between the actual and anticipated traffic information, and this deviation will undoubtedly have a significant effect on traffic flow. Drivers always maintain the flow of traffic by taking some time to assess and decide how the drivers in front of them are behaving behind the car in the traffic system. As a result, by taking into account the driver's advanced reaction time and optimal deviation in a V2X environment, a novel car-following model is developed and the effects of these parameters on the traffic flow are examined. In order to determine the stability requirements for the new model, the linear and nonlinear stability of the proposed model is examined using the perturbation methods. Studies have found that when the driver's reaction time and the velocity deviation are optimized, it can reduce the amplitude of the stability curve, thus enlarging the area of more stable motion. Also, the numerical simulation supports the theoretical research by showing that the new model may effectively reduce traffic congestion and improve the stability of traffic flow as the influence of these factors on the traffic flow increases.
Magnetic field recovery technique based on distance weighting multipole expansion method
Authors: Liu Binbin , Yang Zhen , Qiang Li-e , Peng Xiaodong , Ma Xiaoshan , Xu Peng , Luo Ziren , Tang Wenlin , Zhang Yuzhu , Gao Chen
Published: August 2023

A space-borne gravitational wave detector requires the test mass (TM) to be in an ultra-low disturbance state. However, magnetic field fluctuations will disturb the TM and produce acceleration noise. To assess the influence of the magnetic field on the TM, it is necessary to monitor and reconstruct the magnetic field near the TM in real time. In this paper, a distance weighting multipole expansion (DWME) method was proposed, and its magnetic field reconstruction accuracy was analyzed. The results demonstrated that the proposed DWME method significantly improved the reconstruction precision compared to traditional methods. It reduced the average reconstruction error of the sensitive axial magnetic field from 1.2% to 0.8% and the maximum error from 16% to 8%. In the in-orbit situation, the DWME method also outperforms traditional methods.
Gonadotropin-Releasing Hormone Agonist Therapy and Longitudinal Bone Mineral Density in Congenital Adrenal Hyperplasia
Authors: Flokas Myrto Eleni , Wakim Paul , Kollender Sarah , Sinaii Ninet , Merke Deborah P
Published: August 2023

Context

Children with congenital adrenal hyperplasia (CAH) are at risk for early puberty. Gonadotropin-releasing hormone analog (GnRHa) is frequently used and can decrease bone mineral density (BMD).

Objective

Our aim was to investigate the effect of GnRHa therapy on BMD in a longitudinal study of patients with CAH spanning both childhood and adulthood.

Design and Setting

Sixty-one patients with classic CAH due to 21-hydroxylase deficiency (20 treated with GnRHa) were followed with dual-energy X-ray absorptiometry (DXA) scans at puberty onset, attainment of adult height, and during early adulthood.

Main Outcome Measures

Whole body, lumbar spine, femoral neck, total hip, and distal radius BMD z-score at adult height. Longitudinal BMD and adult height were also assessed.

Results

Twenty patients received GnRHa for an average of 4.5 ± 2 years. There were no differences in BMD between GnRHa-treated and -untreated groups at adult height for all sites. Overall, the follow-up DXA during early adulthood showed decreases in BMD z-scores for whole body (P = .01), lumbar spine (P < .0001), femoral neck (P = .06), total hip (P = .009), and distal radius (P = .05). GnRHa treatment correlated with improved height outcomes compared to predicted height at puberty onset after adjusting for midparental height (P = .02). Patients in both groups achieved similar adult height.

Conclusion

In children with CAH, GnRHa does not compromise BMD. However, BMD decreases with time and during the second and third decades of life is a possible effect of chronic supraphysiologic glucocorticoids. Children with CAH who experience early puberty benefit from GnRHa treatment as evidenced by the positive effect on height.
Association Between Maternal Thyroid Function in Early Pregnancy and Gestational Diabetes: A Prospective Cohort Study
Authors: Huang Kaikun , Su Shaofei , Wang Xueran , Hu Minhui , Zhao Rong , Gao Shen , Zhang Enjie , Liu Jianhui , Xie Shuanghua , Luan Yingyi , Sun Yongqing , Zhang Yue , Yue Wentao , Liu Ruixia , Yin Chenghong
Published: August 2023

Context

Previous studies on the relationship between thyroid gland function and the development of gestational diabetes mellitus (GDM) have reported different results, leading to the need for a cohort study design with a large sample size.

Objective

We aimed to investigate the relationship between thyroid function in early pregnancy and GDM.

Methods

This was a prospective cohort study based on the China Birth Cohort Study (CBCS), from February 2018 to December 2020. The study took place at a tertiary maternal and child health hospital. A total of 36 256 pregnant women were successfully recruited based on the CBCS. The main outcome measure was GDM.

Results

This study consisted of 26 742 pregnant women who met the inclusion criteria, of whom 3985 (14.90%) were diagnosed with GDM, and the women with GDM were older than their healthy counterparts (33.26 ± 4.01 vs 31.51 ± 3.76 years, P < .001). After removing potential influencing variables, we found that increased thyroid-stimulating hormone (TSH) (adjusted odds ratio [aOR] 1.030, 95% CI 1.007, 1.054, P = .012) and subclinical hypothyroidism (aOR 1.211, 95% CI 1.010, 1.451, P = .039), but not free thyroxine or thyroid peroxidase antibody, were associated with the occurrence of GDM. Further analysis indicated a nonlinear relationship between TSH and GDM (P < .05): when TSH ≤ 1.24 mIU/L, the occurrence of GDM was elevated with increasing TSH, but when TSH > 1.24 mIU/L, this trend was not obvious.

Conclusion

High TSH might be associated with increased risk of GDM.
Racial and Ethnic Disparities in the Diagnosis and Treatment of Thyroid Disease
Authors: Gillis Andrea , Chen Herbert , Wang Tracy S , Dream Sophie
Published: August 2023

Context

There are differences in diagnosis, treatment, and outcomes for thyroid between racial and ethnic groups that contribute to disparities. Identifying these differences and their causes are the key to understanding and reducing disparities in presentation and outcomes in endocrine disorders.

Evidence Acquisition

The present study reviews original studies identifying and exploring differences between benign and malignant thyroid diseases. A PubMed, Web of Science, and Scopus search was conducted for English-language studies using the terms “thyroid,” “thyroid disease,” “thyroid cancer,” “race,” “ethnicity,” and “disparities” from inception to December 31, 2022.

Evidence Synthesis

Many racial and ethnic disparities in the diagnosis, presentation, treatment, and outcomes of thyroid disease were found. Non-White patients are more likely to have a later time to referral, to present with more advanced disease, to have more aggressive forms of thyroid cancer, and are less likely to receive the appropriate treatment than White patients. Overall and disease-specific survival rates are lower in Black and Hispanic populations when compared to White patients.

Conclusions

Extensive disparities exist in thyroid disease diagnosis, treatment, and outcomes that may have been overlooked. Further work is needed to identify the causes of these disparities to begin to work toward equity in the care of thyroid disease.
Subtype-specific Body Composition and Metabolic Risk in Patients With Primary Aldosteronism
Authors: Park Seung Shin , Ahn Chang Ho , Kim Sang Wan , Yoon Ji Won , Kim Jung Hee
Published: August 2023

Background

Primary aldosteronism (PA) is associated with increased metabolic risks. However, controversy exists as to which subtype of PA has a higher metabolic risk between bilateral and lateralized PA. This study aimed to assess the body composition of 2 PA subtypes, bilateral PA and lateralized PA, according to sex and autonomous cortisol secretion (ACS) and their contribution to comorbidities.

Design and Methods

A total of 400 patients with PA (females, n = 210) and 1:10 age- and sex-matched healthy controls (n = 4000) were enrolled. The skeletal muscle area (SMA), subcutaneous fat area, and visceral fat area (VFA) at the third lumbar spine were calculated using abdominal computed tomography-based body composition analysis.

Results

Patients with bilateral PA had higher body mass index (BMI) in both sexes (all P < .05). Hemoglobin A1c level and the prevalence of diabetes were higher in female patients with bilateral PA than in those with lateralized PA (all P < .05). The VFA/BMI ratio was significantly higher in bilateral PA patients than in lateralized PA patients (5.77 ± 2.69 vs 4.56 ± 2.35 in men; 4.03 ± 2.58 vs 2.53 ± 2.05 in women, all P < .001). PA patients with ACS showed decreased SMA compared to those without ACS. Compared with healthy controls, all patients with bilateral PA and female patients with lateralized PA showed significantly higher VFA and VFA/BMI.

Conclusions

Patients with bilateral PA were more obese and had higher VFA levels than those with lateralized PA. Despite a milder form of PA, this metabolically unfavorable visceral fat distribution may lead to a higher metabolic risk in patients with bilateral PA.
Return Migration Selection and Its Impact on the Migrant Mortality Advantage: New Evidence Using French Pension Data
Authors: Guillot Michel , Khlat Myriam , Gansey Romeo , Solignac Matthieu , Elo Irma
Published: August 2023

The migrant mortality advantage (MMA) has been observed in many immigrant-receiving countries, but its underlying factors remain poorly understood. This article examines the role of return migration selection effects in explaining the MMA among males aged 65+ using a rich, unique dataset from France. This dataset contains information on native-born and foreign-born pensioners who are tracked worldwide until they die, providing a rare opportunity to assess return migration selection effects and their impact on the MMA. Results provide evidence of substantial and systematic negative return migration selection among foreign-born males in France. Old-age returns, in particular, appear particularly affected by such selection; however, they are not frequent enough to explain the MMA at ages 65+. By contrast, returns at younger ages are much more frequent, and the MMA at ages 65+ essentially disappears once these earlier returns are considered. This study extends the literature on negative selection at return and its impact on the MMA by providing evidence that such negative selection may operate not only at older ages but throughout the life course, with impacts on the MMA that are larger than previously suggested.
The Educational Consequences of Remote and Hybrid Instruction during the Pandemic
Authors: Goldhaber Dan , Kane Thomas J. , McEachin Andrew , Morton Emily , Patterson Tyler , Staiger Douglas O.
Published: August 2023

Using testing data from over two million students in nearly 10,000 schools in 49 states (plus the District of Columbia), we investigate the role of remote and hybrid instruction in widening gaps in achievement by race and school poverty. We find that remote instruction was a primary driver of the widening gaps. Math gaps did not widen in areas that remained in person (although reading gaps did). We estimate that high-poverty districts that went remote in 2020–2021 will need to spend nearly all of their federal aid on helping students recover from pandemic-related academic achievement losses. (JEL H75, I12, I21, I24, I32, J15)
COVID-19 prevention efforts at Al-Zahraa University in the eyes of the students: A cross-sectional study from Iraq
Authors: Al-Kazzaz Hassan
Published: August 2023

Background: For institutions in Iraq, the new coronavirus disease 2019 (COVID-19) pandemic has become a problem. In terms of the dissemination of COVID-19, Al Zahraa University is particularly risky due to the presence of susceptible, high-risk populations there.

Methods: A total of 182 undergraduates at the Health and Medical Technology College took part. A cross-sectional, questionnaire-based study was done to evaluate the COVID-19 preventative measures for students at Al-Zahra University for Women. The study questionnaire received a 100% response rate, and the data were collected and analyzed.

Results: It showed that of the participants, 53 (29.1%) were 20 years old, and 151 (82.9%) lived in Karbala. 120 (65.9%) students did not think the university applied preventive measures against COVID-19, and 94 (52%) thought the university ensured mask-wearing on campus. Regarding social distancing, 161 (88.4%) believed it was not enforced. 158 (86.8%) and 116 (63.7%) of the participants, respectively, thought that there were no preventive measures against Covid-19 in the campus cafeteria or no preventive measures when using university transportation.

Conclusions: During the COVID-19 pandemic, Al-Zahraa University's execution of prevention and control measures were weak. Interventions are urgently needed to improve the effectiveness of its preventive measures. The inadequacy of COVID-19 safety measures highlights the need for national guidance.
Antibiotic utilization and resistance in diarrheagenic Escherichia coli isolated from children under 5 Years in Nakuru County: a case-control study
Authors: Suge Titus , Magu Dennis , Wanzala Peter
Published: August 2023

Background: Children under the age of 5 years continue to suffer the ravaging effects of microbial resistance. Majority of the infections associated with this age are of bacterial and viral nature. Highest mortalities in this age group are those associated with enteric and diarrheal diseases. Diarrheagenic Escherichia coli (DEC) is among the leading causes of these diseases due to their ubiquitous nature.

Methods: The study adopted a case-control design and aimed at investigating antibiotic utilization and resistance in DEC strains isolated from children under 5 years in Nakuru County. A total sample size of 384 children were considered. Stool samples from anal swabs were obtained and cultured on Eosin Methylene Blue (EMB). Antimicrobial susceptibility testing was done using the Kirby-Bauer disk diffusion method to segregate the resistant DEC isolates against amoxicillin, ampicillin, erythromycin, cefoxitin and nalidixic acid.

Results: All the DEC (n=192, 100%) strains were resistant to amoxicillin, n=168, 87.5% were resistant to ampicillin, n=156, 81.3% to erythromycin n=72, 37.5% to cefoxitin and only n=64, 33.3% to nalidixic acid. Based on demographic factors, it was that observed self-medication leads among factors contributing to the observed trend in antimicrobial resistance (AMR). Other factors such the length of antibiotic use did not show any level of significance (p<0.05).

Conclusions: Thus, we conclude that a conglomerate of several factors is associated with the rising cases of AMR among the DEC strains. Notably, the use of first-line antibiotics especially the β-lactams poses a critical health concern being the most resisted class of antibiotics. Therefore, the current study unravels the need to remediate the effects of AMR among the DEC strains through proper formulation and implementation of guidelines on antibiotic usage.
Exploring the Landscape of Latent Autoimmune Diabetes and Maturity Onset Diabetes of the Young in Africa: A Scoping Review
Authors: Ombui Davis , Khalid Ahmed Murtaz
Published: August 2023

Background: Latent autoimmune diabetes in adults (LADA) and maturity onset diabetes of the young (MODY) are two forms of diabetes with varied disease symptoms. The prevalence of LADA is higher in adults than MODY. Both diseases contribute to the general burden of diabetes globally. While LADA is a sporadic autoimmune disorder, MODY is a heritable genetic disorder. The prevalence of LADA and MODY has not been fully documented in Africa due to the lack of robust diagnostic tools and the exorbitantly high cost of the available diagnostic tools.

Methods: To understand the prevalence landscape of LADA and MODY in Africa, we conducted an extensive scoping review and mapped the various studies performed in Africa. We adopted the Joanna Briggs Institute literature review framework to conduct the scoping review of literature.

Results: Research articles were included in the review analysis following exhaustive inclusion criteria to ensure that only qualified articles were included in the final analysis. Overall, 16 research articles met the inclusion criteria and were critically analyzed. An in-house data extraction sheet was used for data extraction from all the shortlisted articles. Information about the sample size, inclusion criteria, age, gender, and study design extracted from all the articles and analyzed. Majority of the studies adopted cross-sectional study design. In terms of sample sizes, the studies used relatively smaller sample sizes due to the high cost of the diagnosis and nature of the diseases. The prevalence rates of LADA and MODY varied in various countries ranging from 1.8 to 18%.

Conclusion: African countries are significantly under-represented. The scarcity of research on LADA and MODY research in Africa is evidence of the urgent need to invest more resources in this area. This would guide future research and shape the road towards understanding diabetes in Africa.
Validation and in vivo characterization of research antibodies for Moesin, CD44, Midkine, and sFRP-1.
Authors: Doolen Suzanne , Ayoubi Riham , Laflamme Carl , Betarbet Ranjita , Zoeller Elizabeth , Williams Sean-Paul G. , Fu Haian , Levey Allan I. , Sukoff Rizzo S. J.
Published: August 2023

Background: A major goal of the Target Enablement to Accelerate Therapy Development for Alzheimer’s disease (TREAT-AD) program is to develop and identify high-quality tools to test target or mechanistic hypotheses. As part of this initiative, it is important that commercial reagents including research antibodies being used to interrogate drug targets have confirmed validation data in knock-out cell lines. Ideally, these antibodies should also have utility for both in vitro and in vivo studies such that the levels of target proteins in target tissues can be quantified.

Methods: We evaluated commercial antibodies against TREAT-AD protein targets Moesin (Uniprot ID: P26038), CD44 (Uniprot ID: P16070), Midkine (Uniprot ID: P21741) and Secreted frizzled-related protein 1, referred to as “sFRP-1” (sFRP-1; Uniprot ID: Q8N474). Moesin, Midkine and sFRP-1, that were confirmed as selective based on data in knock-out cell lines. Western blot analysis was used to compare protein levels in brain homogenates from a mouse model with AD-relevant pathology (5XFAD) versus age-matched C57BL/6J control mice.  

Results: Anti-Moesin ab52490 reacted in mouse brain homogenate with a predicted molecular weight of 68 kDa. Moesin protein expression was 2.8 times higher in 5xFAD compared to WT. Anti-CD44 ab189524 reacted with a band at the predicted size of 82 kDa. CD44 protein expression was 1.9 times higher in 5xFAD compared to WT. Anti-Midkine AF7769 reacted with a band ~16 kDa and a 17.8 times greater expression in 5xFAD compared to WT. Anti-sFRP-1 ab267466 reacted with a band at 35 kDa as predicted. sFRP-1 protein expression was 11.9 times greater in 5xFAD compared to WT.

Conclusions: These data confirm the utility of these selective commercially available antibodies against Moesin, CD44, Midkine, and sFRP-1 for in vivo studies in mice and provide insight into the use of 5XFAD mice for in vivo target engagement studies for these target proteins.
Influence of input parameters to determine the shape of weld bead in cladding on 316L stainless steel using the Taguchi method
Authors: R Raviram , J Sachithananthan , M Mohandass , V Gurusamy
Published: August 2023

Background:  The Cold Metal Transfer (CMT) process, with its low heat input, is selected for cladding carbon steel in demanding industries such as mining, oil, gas, offshore, steel, and metal. Limited research exists on the utilization of Taguchi's technique in welding and cladding processes. The main objective of the present research is to employ the Taguchi approach for determining the impact of CMT parameters on the cladding geometry of 316L stainless steel.

Methods: The influence of process parameters on the weld bead was examined using both Signal-to-Noise (S/N) ratio and Analysis of Variance (ANOVA) by implementing an orthogonal array. A structural steel substrate was coated with nickel-based metal inert gas (MIG) welding wire using the CMT process while being shielded by a 99.9 percent pure argon gas. To attain the desired quality of weld bead, the CMT input parameters and geometry of the bead are separately and collectively optimized.

Results: When the welding current (Iw) is set at 130A, welding speed (V) at 200 mm/min, and the distance between the nozzle and plate (X) at 5 mm, the Taguchi method indicates that the desired outcome is obtained with the following parameters: a penetration (P) of 1.115 mm, a reinforcement (R) of 1.51 mm, a bead width (W) of 4.265 mm, and a percentage of dilution (D) of 21.145%.

Conclusions: The research findings indicate, under certain limitations, the techniques of the Taguchi method be utilized to efficiently manage the CMT cladding process parameters.
Speak with One Voice? Examining Content Coordination and Social Media Engagement During Disasters
Authors: Yoo Changseung , Yoo Eunae , Yan Lu (Lucy) , Pedraza-Martinez Alfonso
Published: August 2023

Speak with One Voice? Examining Content Coordination and Social Media Engagement During Disasters

Practice- and policy-oriented abstract:

Disaster relief organizations (DROs) use social media to share information rapidly and broadly. Many DROs maintain multiple accounts on the same social media platform. Each account represents a different operational entity of a DRO, such as its national headquarters or a local branch. An important problem that DROs with multiple accounts face is how to coordinate the production of social media content across these accounts. One strategy is to have all accounts within the same DRO match their decisions about how content is created and designed (e.g., audience, topic). An alternate strategy is to mismatch these decisions. Using Twitter data collected in partnership with the Canadian Red Cross, we analyze which coordination strategy is best for social media engagement. Our results suggest that, during the immediate aftermath of a disaster, accounts within the same DRO should produce content with similar characteristics by matching their content creation decisions. This leads to a 4.3% lift in engagement. However, when DROs start working on helping impacted communities recover from disasters, engagement is 29.6% higher when their accounts mismatch their content creation decisions and post distinctive content.
Optimal Policies for Dynamic Pricing and Inventory Control with Nonparametric Censored Demands
Authors: Chen Boxiao , Wang Yining , Zhou Yuan
Published: August 2023

We study the classic model of joint pricing and inventory control with lost sales over T consecutive review periods. The firm does not know the demand distribution a priori and needs to learn it from historical censored demand data. We develop nonparametric online learning algorithms that converge to the clairvoyant optimal policy at the fastest possible speed. The fundamental challenges rely on that neither zeroth-order nor first-order feedbacks are accessible to the firm and reward at any single price is not observable due to demand censoring. We propose a novel inversion method based on empirical measures to consistently estimate the difference of the instantaneous reward functions at two prices, directly tackling the fundamental challenge brought by censored demands. Based on this technical innovation, we design bisection and trisection search methods that attain an [Formula: see text] regret for the case with concave reward functions, and we design an active tournament elimination method that attains [Formula: see text] regret when the reward functions are nonconcave. We complement the [Formula: see text] regret upper bound with a matching [Formula: see text] regret lower bound. The lower bound is established by a novel information-theoretical argument based on generalized squared Hellinger distance, which is significantly different from conventional arguments that are based on Kullback-Leibler divergence. Both the upper bound technique based on the “difference estimator” and the lower bound technique based on generalized Hellinger distance are new in the literature, and can be potentially applied to solve other inventory or censored demand type problems that involve learning.

This paper was accepted by Jeannette Song, operations management.

Supplemental Material: The data files and online appendix are available at https://doi.org/10.1287/mnsc.2023.4859 .