bluuebunny/crossref_metadata_2025 huggingface dataset:
Neonatal outcomes in offspring of mothers with pregestational diabetes: a hospital-based multicentre prospective cohort study protocol
Authors: Philip Thurkkada Anju , Kunjukutty Radhamany , Raj Manu , Nair Sobha S , Soman Annie , Ramachandran Sethulakshmi , Bhaskaran Renjitha , Renjith Vishnu
Published: January 2025

Introduction

Pregestational diabetes mellitus (PGDM) occurs when a woman becomes pregnant after having diabetes mellitus. The presence of diabetes during the entire pregnancy can have an adverse impact on fetal and neonatal outcomes. The objective of this study is to examine the association between PGDM and neonatal outcomes at birth.

Methods and analysis

This prospective hospital-based cohort study is ongoing at three tertiary-level hospitals in Kerala, India. The study targets to recruit 1260 pregnant women. All pregnant women above the age of eighteen who had confirmed pregnancy in an early pregnancy scan and in the first trimester of pregnancy visiting the three study sites for antenatal care will be included in the study. Those who will have a miscarriage, an abortion or twin pregnancies will be excluded from the study. All pregnant women will be evaluated for diabetic state via RBS, HbA1c and FBS based on the International Association of Diabetes and Pregnancy Study Groups criteria during their initial visit to the study sites. PGDM will be diagnosed by the following criteria—FBS ≥126 mg% OR HbA1c ≥6.5 mg% OR Random blood glucose ≥200 mg% on the initial visit or documented prior to the index pregnancy. Neonatal outcomes among the newborn babies will be assessed on the day of birth. We will report adjusted ORs with 95% CI for significant associations derived from multivariable logistic regression analysis.

Ethics and dissemination

The present study received ethical approval from the three study sites. Informed consent will be obtained from the study participants before data collection.

Trial registration number

CTRI/2024/06/068978.

Conclusion

Early identification and management of PGDM among mothers will probably help to prevent adverse neonatal outcomes at birth.
Understanding variation in management of early-onset neonatal sepsis in India: a vignette-based survey
Authors: McAleese Samuel , Parikh Tushar B , Ouddi Basma , Schumacher Christina M , Johnson Julia
Published: January 2025

Background

Antibiotic use for early-onset neonatal sepsis (EONS) is common, but prolonged exposure can lead to poor outcomes. Laboratory capacity and infection prevention initiatives may impact antibiotic use for EONS in neonatal intensive care units. The objective of this study was to examine the influence of institutional capacity on antibiotic prescribing for EONS in India.

Methods

Between September 2023 and January 2024, we surveyed Indian paediatricians and neonatologists regarding institutional capacity and antibiotic prescribing practices for EONS. Five vignettes with varying maternal and infant risk profiles explored participants’ decision to initiate empiric antibiotics at birth and the timing of discontinuation of antibiotics in term and preterm infants at risk for EONS. Variation in reported initiation and discontinuation of empiric antibiotic use by institutional capacity and antimicrobial stewardship initiatives were assessed using logistic regression models.

Results

Of 317 respondents, most (91%) reported antimicrobial stewardship initiatives at their institution and 56% reported receiving blood culture results within 48 hours. Screening tests such as complete blood count and C reactive protein were used in 56%–67% of cases, and abnormal results led to longer courses with fewer than 10% of respondents discontinuing antibiotics by 72 hours. When controlling for infant and maternal characteristics, the adjusted OR of observing infants without empiric antibiotics at birth was 0.38 (95% CI 0.16 to 0.70) for participants without infection prevention initiatives and was 1.57 (95% CI 1.05 to 2.35) for participants with timely (<48 hours) reporting of blood culture results, respectively. Infection prevention initiatives and laboratory capacity were not associated with increased odds of early discontinuation of empiric antibiotics for EONS.

Conclusions

Infection prevention and laboratory capacity may decrease the initiation of empiric antibiotics but are not associated with early discontinuation of empiric antibiotics for EONS. The use of sepsis screening tests remains common in Indian neonates and requires additional study.
Real-world data on the use of teduglutide in a UK cohort: 4-year experience of a single centre
Authors: Stevens Phil , Turner Rebecca , Doherty Graeme , Jordan Dawn , Leitch Fiona , Murray Linda , Wadsworth John
Published: January 2025

Background

Phase IV outcome data of novel therapies in an orphan-disease need to be shared. Glucagon-like peptide-2 (GLP-2) analogues for short bowel syndrome chronic intestinal failure (SBS-cIF) were approved for use in NHS Scotland in 2020. The aim of this study was to report early experience introducing GLP-2 to a specialist intestinal failure service.

Method

Retrospective analysis of a patient database was used to describe changes in home parenteral support (HPS), patient tolerance and micronutrient balance following introduction of GLP-2 analogue. These were compared with changes in HPS patients weaned by adaptation, surgery or transplantation.

Results

Of 218 patients managed with HPS at the Glasgow Royal Infirmary between February 2020 and August 2024, 162 (74%) had SBS-cIF. 70 (43%) met inclusion criteria for teduglutide. 11 (15%) received teduglutide, with median dose of 3.0 mg/day during the study period. Overall, 8 (73%) achieved reduction of one or more nights HPS/week and 7 (64%) either an HPS reduction >1.5 L/day or >20% reduction in equivalent daily volumes at 6 months. 6 (55%) retained teduglutide use long term. Patients weaned from HPS with teduglutide compared with those weaned by other means had significantly better liver enzymes, vitamin C and manganese. Indices of renal function may reflect change in lean body mass. Significantly more teduglutide weaned patients had end jejunostomies.

Conclusion

GLP-2 analogue use reduced parenteral support requirement when integrated into our intestinal failure service. These treatments may have extra-enteric hepatoprotective consequences.
New developments in immunotherapy for SCLC
Authors: Dolkar Tsering , Gates Christopher , Hao Zhonglin , Munker Reinhold
Published: January 2025

Small cell lung cancer (SCLC) is an aggressive form of neuroendocrine neoplasm known for its striking initial response to treatment, followed by fast relapse and refractoriness in response to additional lines of therapy. New advances in immunotherapy are paving the way for more effective treatment strategies and have promising results with early clinical trial data. While SCLC rarely harbors actionable mutations, the receptor DLL3 is extensively present in SCLC, making it a potential target for immunotherapy. Three emerging therapeutic options include bispecific T cell engagers targeting DLL3, chimeric antigen receptor T cells (CAR-T cells), and antibody–drug conjugates. Several phase II and phase III clinical trials for bispecific T cell engagers show promise. Additionally, the first CAR-T cell trials in humans for SCLC are currently underway.
Divergent response to radio-immunotherapy is defined by intrinsic features of the tumor microenvironment
Authors: Gadwa Jacob , Yu Justin , Piper Miles , Knitz Michael W , Darragh Laurel B , Olimpo Nicholas , Corbo Sophia , Beynor Jessica I , Neupert Brooke , Nguyen Alexander T , Hodgson Chloe , Nguyen Diemmy , Abdelazeem Khalid NM , Saviola Anthony , Pousse Laurene , Bransi Ali , Pincha Mudita , Klein Christian , Amann Maria , Karam Sana D
Published: January 2025

Background

Treatment with immunotherapy can elicit varying responses across cancer types, and the mechanistic underpinnings that contribute to response vrsus progression remain poorly understood. However, to date there are few preclinical models that accurately represent these disparate disease scenarios.

Methods

Using combinatorial radio-immunotherapy consisting of PD-1 blockade, IL2Rβγ biased signaling, and OX40 agonism we were able to generate preclinical tumor models with conflicting responses, where head and neck squamous cell carcinoma (HNSCC) models respond and pancreatic ductal adenocarcinoma (PDAC) progresses.

Results

By modeling these disparate states, we find that regulatory T cells (Tregs) are expanded in PDAC tumors undergoing treatment, constraining tumor reactive CD8 T cell activity. Consequently, the depletion of Tregs restores the therapeutic efficacy of our treatment and abrogates the disparity between models. Moreover, we show that through heterotopic implantations the site of tumor development defines the response to therapy, as implantation of HNSCC tumors into the pancreas resulted in comparable levels of tumor progression.

Conclusions

This work highlights the complexity of combining immunotherapies within the tumor microenvironment (TME) and further defines the immune and non-immune components of the TME as an intrinsic feature of immune suppression.
Comment on “Complementarity of Hf isotopes from detrital and igneous zircon: an example from the Central Gneiss Belt, Grenville Province, Ontario”
Authors: Dickin Alan , Strong Jacob
Published: January 2025

In a recent paper presenting 30 new Hf isotope analyses for orthogneisses from the Grenvillian Central Gneiss Belt in Ontario, Slagstad et al. (Slagstad, T., Easton, R.M., Huyskens, M., and Culshaw, N. 2024. Complementarity of Hf isotopes from detrital and igneous zircon: an example from the Central Gneiss Belt, Grenville Province, Ontario. Canadian Journal of Earth Sciences, 61: 19) suggested that these new data “may serve as a basis for some cautionary notes on the application of isotopic data alone to distinguish allochthonous from parautochthonous rocks”. These “cautionary notes” evidently arise from the poor fit of the new Hf isotope data to these authors’ expectations based on published work. However, we show that the new data are in complete agreement with our own published tectonic maps, based on Nd isotope mapping supported by other available geological evidence. Far from serving as the basis for “cautionary notes” about our use of Nd isotope mapping, the new data completely validate our approach. On the other hand, we show that the mantle model used by Slagstad et al. (2024) to calculate Hf crustal formation ages was based on erroneous old data, and does not yield realistic Hf model ages for Precambrian gneisses. Therefore, we propose a more robust model, based on applying the principles of DePaolo’s Nd isotope model to Hf mantle evolution. We term the resulting Hf ages TDP model ages and show that they yield realistic crustal formation ages for the Ontario Grenville Province.
Better Health by Design: UX for Health and Wellness
Authors: Miller A.
Published: January 2025

This forum is dedicated to exploring the notion of meaningfulness in design processes, taking the perspectives of community groups, nongovernmental organizations, and those who are marginalized in society as starting points. Authors will reflect conceptually and methodologically on practical engagements.
--- Rosanna Bellini and Angelika Strohmayer, Editors
Physiological Computing for All: Exploring Neural Interface Education
Authors: Crawford Chris S.
Published: January 2025

Community + Culture features practitioner perspectives on designing technologies for and with communities. We highlight compelling projects and provocative points of view that speak to both community technology practice and the interaction design field as a whole.
--- Sheena Erete, Editor
Filamin A C-terminal fragment modulates Orai1 expression by inhibition of protein degradation
Authors: Macias-Díaz Alvaro , Nieto-Felipe Joel , Jardín Isaac , Camello Pedro J. , Martinez-Quintana Eva M. , Salido Gines M. , Smani Tarik , Lopez Jose J. , Rosado Juan A.
Published: January 2025

FLNA cleaving by calpain has been observed in a variety of tumoral, including prostate and colorectal cancer cells, as well as in nontumoral cells, leading to a C-terminal fragment encompassing repeats 16–24. Expression of the FLNA16–24 fragment in HEK-293 cells enhances Orai1 and STIM1 expression, as well as SOCE, a mechanism mediated by attenuation of Orai1α and STIM1 degradation, providing evidence for a novel mechanism for the regulation of SOCE in normal and malignant cells.
L-type calcium channel blockade worsens glucose tolerance and β-cell function in C57BL6/J mice exposed to intermittent hypoxia
Authors: Cardenas Stanley M. Chen , Baker Tess A. , Shimoda Larissa A. , Bernal-Mizrachi Ernesto , Punjabi Naresh M.
Published: January 2025

The results of this study demonstrate the interaction between intermittent hypoxemia (IH) and nifedipine in a murine model. IH raises fasting glucose and insulin levels, with nifedipine exacerbating these disturbances. Glucose tolerance worsens when nifedipine is administered alone, and IH magnifies the impairment in glucose disposal. These findings raise the possibility of potential deleterious effects of L-type calcium channel blockers in patients with obstructive sleep apnea (OSA).
The impact of oral contraceptive pill use on sympathetic transduction at rest in young females
Authors: D’Souza Andrew W. , Hissen Sarah L. , Manabe Kazumasa , Washio Takuro , Annis Meghan C. , Sanchez Belinda , Usselman Charlotte W. , Fu Qi , Shoemaker J. Kevin
Published: January 2025

This study investigated the impact of OCP use on the transduction of MSNA bursts into regional vasoconstriction and blood pressure in premenopausal females. We demonstrated that females using OCPs exhibit attenuated sympathetic transduction into LVC; however, this does not translate to reductions in sympathetic blood pressure transduction. Collectively, these data indicate that OCP use may alter the local vasoconstrictor response to bursts of MSNA; however, compensatory mechanisms may contribute to maintain sympathetic blood pressure transduction.
Timing of resistance exercise and cardiometabolic outcomes in adults with prediabetes: a secondary analysis
Authors: Thomas Jason V. , Davy Brenda M. , Winett Richard A. , Depner Christopher M. , Drummond Micah J. , Estabrooks Paul A. , Hardikar Sheetal , Ou Zhining , Shen Jincheng , Halliday Tanya M.
Published: January 2025

In this secondary analysis, there was no difference between AM and PM exercisers in blood glucose, insulin, body composition, or muscular strength following 12 wk of supervised exercise. However, examining within-group changes, glucose area under the curve (AUC) was significantly reduced in PM exercisers, but not in AM exercisers.
Experimental and Numerical Simulation Study on the Evolution Mechanism of Soil Plugging Effect of Pipe Piles
Authors: Zhang Sifeng , Wang Chaonan , Fan Wei , Han Jianyong , Liu Qian , Ren Guozhang
Published: January 2025

To tackle the issue of relying solely on one research approach and the inadequate examination of the elements influencing the soil plug effect during the penetration of pipe piles, this study combines experimental modeling with numerical simulations. Through these approaches, we explore the formation and progression of the soil plug, delving into its underlying mechanisms from both macro and micro viewpoints. The findings indicate that as wall thickness decreases, tube diameter increases, inner wall roughness diminishes, and relative density of sand and soil rises, along with an uptick in pile sinking rates, the soil plug’s height within the pile increases. Conversely, the level of soil plug blockage decreases, leading to a weakened soil plug effect. Notably, soil layers characterized by higher hardness on top and lower softness beneath are more susceptible to soil plug occlusion. In contrast, configurations with softer upper layers and harder bases tend to provoke soil plug sliding. Furthermore, the static pressure pile sinking method typically results in a lower soil plug height relative to the hammering technique, making complete occlusion more likely to occur. Overall, the soil plug height is reduced with the static method, exhibiting a more pronounced effect compared to hammering, which is also more likely to lead to complete occlusion.
Efficient Detection of West Nile Virus in Urine Specimens by a Novel In‐House RT‐qPCR Detection Kit
Authors: Tuncel Gülten , Akan Gökçe , Kalaycı Melis , Baddal Buket , Bostancı Ayşegül , Suer Kaya , Özverel Cenk Serhan , Şanlıdağ Tamer
Published: January 2025

West Nile Virus (WNV) infection represents a major global public health challenge. Even though most of the patients are asymptomatic, some cases progress to critical condition which may be fatal. Diagnosis traditionally relies on serological methods, but their limitations, including cross‐reactivity, highlight the need for alternative approaches. Here, we present the development and validation of a novel RT‐qPCR assay for precise and rapid detection of WNV RNA in urine, emerging as a promising specimen due to its noninvasive collection and high viral load. The assay demonstrates high efficiency and sensitivity, with a detection limit comparable to commercially available kits. This study highlights the importance of in‐house kit design as a diagnostic tool in regions affected by emerging tropical infections, such as WNV, exemplified Cyprus. It emphasizes the critical role of low‐cost, early detection with high sensitivity and specificity in infection control and surveillance efforts.
Microprolactinoma Growth During Pregnancy With Pituitary Tumor Apoplexy: Case Report and Review of the Literature
Authors: Introini Lucia , Silva Jenifer , Risso Mariana , Mendoza Beatriz , Pineyro Maria M.
Published: January 2025

Prolactinomas are the most prevalent subtype of pituitary adenomas and represent one of the leading etiological factors responsible for amenorrhea and infertility in women. The primary therapeutic approach entails the use of dopamine agonists, which effectively restore fertility. In cases of microprolactinomas, the likelihood of experiencing a symptomatic enlargement of the tumor during pregnancy is exceptionally low, estimated at a mere 2.4%. Consequently, once pregnancy is successfully achieved, the administration of dopamine agonists is discontinued, with ongoing clinical monitoring of the patient’s condition. The incidence of pituitary apoplexy during pregnancy is exceedingly rare. We present a case of a 29‐year‐old patient with microprolactinoma, treated with cabergoline, which was discontinued upon achieving pregnancy. However, at the 16th week of gestation, she presented with persistent headaches and compromised visual acuity, manifesting as left temporal hemianopia. A noncontrast magnetic resonance imaging (MRI) revealed an enlargement of the adenoma, accompanied by evidence of hemorrhage. She was referred to our hospital at 26 weeks of gestation. Cabergoline treatment was reinstated and well tolerated by the patient. Doses were increased to 2 mg per week because bitemporal hemianopia was not improving. A subsequent noncontrast MRI scan performed at 35 weeks of gestation demonstrated a further increase in adenoma size, measuring 17 × 21 × 13 mm, with signs of intratumoral bleeding. A planned cesarean section was performed at 39 weeks of gestation, without encountering maternal–fetal complications. Breastfeeding was not initiated due to the adenoma’s compression of the chiasm. Accordingly, dopamine agonist therapy was continued. During the postpartum follow‐up, the patient experienced a resumption of menstrual cycles, normalization of prolactin levels, and a reduction in tumor size. Ultimately, the diagnosis was established as a microprolactinoma, which had enlarged during pregnancy due to a pituitary tumor apoplexy. Although microprolactinomas typically carry a low risk of symptomatic tumor growth during pregnancy, this case emphasizes the critical importance of vigilant clinical monitoring to swiftly detect and manage this rare complication. This instance serves as an educational example of an uncommon event—a microprolactinoma experiencing apoplexy during pregnancy.
A Case of Atraumatic Splenic Rupture Due to T‐Cell/Histiocyte‐Rich Large B‐Cell Lymphoma and a Potential Role for Massive Transfusion Protocol
Authors: Bohjanen Sara , Ratanawong John P. , Baumgartner Mary , Chandler Bree , Manivel J. Carlos , Rezcallah Anthony T.
Published: January 2025

Splenic rupture leads to massive hemorrhage and requires immediate surgical intervention. Splenic rupture results from trauma or from underlying disease processes. Lymphoma is a rare cause of atraumatic splenic rupture (ASR) with high mortality rates. We present a case of ASR due to T‐cell/histiocyte‐rich large B‐cell lymphoma (THRLBCL) requiring splenectomy and large‐volume transfusion. This case report highlights the necessity of prompt surgical intervention and massive transfusion for hemodynamically unstable ASR. This report also discusses massive transfusion protocol (MTP) and its limited use in nontraumatic surgical patients.
Comparison of Cardiac Magnetic Resonance Imaging Findings and Prognostic Measures in Nondilated Cardiomyopathy and Dilated Cardiomyopathy
Authors: Asghari Ali , Houshmand Golnaz , Aminizadeh Mohammad Javad , Mohammadi Maryam , Taghavi Sepideh , Omidvar Razieh , Mirtajaddini Marzieh , Naderi Nasim
Published: January 2025

Introduction: Nondilated left ventricular cardiomyopathy (NDLVC) is a newly defined category of cardiomyopathy. We sought to evaluate and compare the phenotype of NDLVC with DCM using cardiac magnetic resonance (CMR) imaging and to investigate the prognostic significance of these conditions.

Methods: One hundred and fifty patients suspected of having cardiomyopathy referred for CMR were recruited. We considered 3 groups; Group 1: NDLVC‐reduced EF, (NDLVC‐REF), LVEF ≤ 40%, Group 2: NDLVC‐mildly reduced EF(NDLVC‐MREF), 40 < LVEF < 50, Group 3: Dilated cardiomyopathy (DCM). All selected patients were followed up for a median of 24 months to determine the composite cardiac endpoint consisting of mortality and/or hospitalization for cardiovascular reasons (composite cardiac event (CCE)) as the primary endpoint.

Results: The mean age (SD) was 42.6 (13.7) years (range: 18–77 years). There was no association between the presence of myocardial LGE and the development of atrial and/or ventricular arrhythmias. Atrial fibrillation was most common in the NDLVC groups during the follow‐up period. Myocardial late gadolinium enhancement (LGE) was also more pronounced in the DCM group. Most patients in the NDLVC groups had no LGE. LGE in the midwall was the most common LGE pattern in all three groups and the septal wall was the most commonly affected area of the LV. There was no significant difference between the CMR findings of patients with and without CCE in each subgroup. However, the presence of myocardial replacement fibrosis was higher in patients with a CCE in total study population, (n = 144, 68% versus 32%, p = 0.03), but the difference was not significant in subgroup analyzes.

Conclusion: NDLVC has a relatively good prognosis in recent times. The consideration of NDLVC in a spectrum with DCM can be reasonable. However, the prognostic risk factors need to be investigated in more detail.
Development and Verification of a Spatial Dynamics Code RESTA‐3D for Light Water Reactors
Authors: Cui Yong , Shang Jing , Mei Longwei , Tong Jianfei
Published: January 2025

A neutronics/thermal‐hydraulics (TH) coupled spatial dynamics code, reactor system transient analysis‐three dimensional (RESTA‐3D), has been developed for both static and transient analysis of large advanced light water reactors (LWRs), with a focus on control rod (CR) ejection accidents. The code is based on a neutron diffusion model, employing the widely used “two‐step” strategy in 3D Cartesian coordinates. A polynomial nodal expansion method (NEM) is used to handle spatial variables, while the neutron kinetics solver applies the exponential transformation technique. Additionally, the code integrates a single‐channel TH module and a steam table set at 15.5 MPa. The accuracy of the code has been validated against three transient benchmarks: the 3D‐LRA benchmark for boiling water reactors (BWRs), the NEACRP 3D benchmark, and the mixed oxide (MOX)/UO2 core benchmark for pressurized water reactors (PWRs). These benchmarks address both static and transient behaviors, and the results have been thoroughly analyzed. The close agreement between the RESTA‐3D results and reference data, as well as other codes, confirms its reliability, making it a promising tool for future dynamic analyses of large‐scale advanced PWRs.
Economic and Environmental Benefits of Grid‐Connected PV‐Biomass Systems in a Bangladeshi University: A HOMER Pro Approach
Authors: Ali Md. Feroz , Halim Md. Abdul , Julhash Mir Md. , Ashikuzzaman Md
Published: January 2025

This study addresses Bangladesh’s urgent power crisis by evaluating a grid‐connected PV‐Biomass hybrid system at the Pabna University of Science and Technology (PUST). Using the hybrid optimization of multiple energy resources (HOMER) software, the project showcases a cost‐effective and environmentally friendly solution. The system achieves a cost of energy (COE) of $0.0347/kWh and a net present cost (NPC) of $4,712,218, with annual operating costs of $95,679.09. It significantly reduces carbon dioxide emissions from 1,920,065 kg/yr to 839,600 kg/yr and offers a competitive payback period of 6.52 years. These results highlight the system’s economic viability and environmental advantages, proposing a scalable model for similar institutions in developing countries striving for sustainable energy solutions. This approach not only mitigates the current energy challenges but also aligns with global sustainability goals.
Design and Performance Analysis of a Novel Asymmetrical Multilevel Inverter Structure With Reduced Components Using the Half‐Height Modulation Technique
Authors: Tuhin Naznin Sultana , Arafat Yeasir
Published: January 2025

This paper presents a novel single‐phase 37‐level asymmetrical multilevel inverter with fewer components and less voltage stress at the switches which reduces the cost of the inverter and increases efficiency. Existing multilevel inverters utilize a higher number of components to provide better output quality which increases the cost and the complexity. The proposed inverter circuit generates 37 levels of output voltage by utilizing only four DC sources and thirteen IGBT switches. Reduction of the total harmonic distortion (THD) and improvement of the output quality of the proposed structure are performed by implementing the half‐height modulation technique. The number of components, cost factor, THD, and efficiency of the proposed structure have been compared to those of the inverter structures that are currently in use. The performance of the proposed structure is evaluated by MATLAB/Simulink and simulation results show that the proposed circuit produces higher‐level output voltage with reduced THD by utilizing less components/levels and low‐rated devices which makes the proposed topology cost‐effective and efficient compared to other existing topologies. Also, the proposed structure offers stable performance under a variety of load conditions. Multiple input sources and less distorted output of the proposed topology make it appropriate for renewable energy generating systems which contribute to the reliable, efficient, and sustainable generation of electricity.
Developing a Multicomponent Intervention for Family Caregivers of Older Adults in Singapore: A Delphi Study
Authors: Gao Jonathan , Neo Yu Wei , Soo Stacey , Teng Poh Hoon June , Nai Ze Ling , Chan Ee Yuee
Published: January 2025

Singapore is experiencing both an ageing population and a decreasing birth rate, with fewer adults to care for older adults. Caregiving for older adults can be taxing, and hence, caregivers need support. Using previous literature and the study team’s interactions with caregivers, a multicomponent intervention, consisting of a mobile application, fall detection and response service, and peer support program, was conceptualized. To better understand the needs and challenges of caregivers and to determine the potential usefulness of the multicomponent intervention, the study team engaged ward nurses and Community Health Team (CHT) members, two groups of stakeholders that regularly interact with caregivers in their work, using a modified Delphi technique. Ward nurses and CHT members each formed one Delphi panel and answered statements specific to their panel over two rounds. Nineteen ward nurses and 15 CHT members participated. The final participation rate for both rounds was 100% (19/19) for ward nurses and 93% (14/15) for CHT members. A total of 17/30 statements (57%) and 10/32 statements (31%) reached consensus for ward nurses and CHT members, respectively. Ward nurses agreed that (a) caregivers will benefit from a one‐stop digital resource library (84%), (b) the importance of having a wide array of localized information for this digital resource (79%–89%) and (c) several challenges associated with caregiver training (74%–79%). The CHT members agreed that (a) caregivers do not receive adequate support outside their immediate family (86%), (b) caregivers struggle to manage care recipients’ behaviours and emotions (80%), and (c) there is a lack of relevant community resources for caregivers (71%–93%). The agreements indicated the feasibility of certain components of the intervention. Refinements to the multicomponent intervention were also made based on the findings.
Modified Ridge Regression With Cook’s Distance for Semiparametric Regression Models
Authors: Khan Najeeb Mahmood , Ullah Muhammad Aman , Khan Javaria Ahmad , Raza Salman
Published: January 2025

Multicollinearity and influential cases in semiparametric regression models lead to biased and unreliable estimates distorting leverage and residual patterns. To address these challenges, we propose modified penalized least squares estimators (MPLSEs). We use Cook’s distance and a case deletion approach to evaluate their performance. The effectiveness of MPLSEs is demonstrated through the Longley dataset, where Cook’s distance is applied to the estimated coefficients, fitted values, residuals, and leverages, using a modified ridge parameter. In addition, a Monte Carlo simulation examines the influence of Cook’s distance across varying levels of multicollinearity, influential observations, and sample sizes. We compare MPLSEs with penalized least squares estimators (PLSEs) to assess their relative performance. The results show that MPLSEs outperform existing methods, effectively managing multicollinearity even with influential points. Our study aims to propose and validate a robust approach for addressing the challenges of multicollinearity and influential observations in semiparametric regression models.
Optimization of the n/γ Pulse Shape Discrimination Performance of Plastic Scintillator Coupled With SiPM Arrays
Authors: Wang Mengmeng , Fang Meihua , Wei Zhiyong , Guo Yi , Li Junyu , Li Jiafeng , Zhang Ming , Li Haoxuan
Published: January 2025

This paper studies the influence of bias voltage on pulse waveform, energy resolution, and particle discrimination performance to optimize the performance of n/γ pulse shape discrimination (PSD) for plastic scintillator coupled with SiPM arrays. Experiments were carried out with the EJ‐276 plastic scintillator detection system based on 2 × 2 SiPM arrays in gamma sources (22Na, 60Co, 137Cs) and neutron source (252Cf). And the pulse amplitude, shape, and the dispersion degree of the pulse waveform with bias voltage in the range of 25.8–28.8 V were analyzed. Gauss expansion method and PSD method based on the charge integration were used to obtain accurate energy resolution and PSD parameter, respectively. The results showed that energy resolution and PSD performance improved firstly and then deteriorated as bias voltage increases, and the optimum bias voltage for both energy resolution and PSD performance was 27.6 V. Within the bias voltage range of 25.8–28.8 V, the energy resolutions at the optimal bias voltage were improved by 25.17% (0.341 MeV for 22Na source) and 22.24% (1.062 MeV for 22Na source). Additionally, the PSD performance for n/γ discrimination was improved by 19.6%.
Plant‐Origin Compounds and Materials for Advancing Bone Tissue Engineering and 3D Bioprinting: Traditional Medicine Aspects and Current Perspectives
Authors: Heinämäki Jyrki , Koshovyi Oleh , Botsula Iryna , Shpychak Alina , Vo Hung Quoc , Nguyen Hoai Thi , Raal Ain
Published: January 2025

Bone defects are becoming a true challenge in global health care due to the aging population and higher prevalence of musculoskeletal disorders. The interest in using plant‐origin compounds and plant‐derived biomaterials in bone tissue engineering (BTE) has been increased due to their availability (abundance), safety, biocompatibility, biodegradability, and low cost. Plant‐origin compounds have supportive effects on bone tissue healing, and cell‐laden plant‐derived biomaterials can be applied in formulating bioinks for three‐dimensional (3D) bioprinting to facilitate the preparation of native bone tissue–mimicking structures and customized bone scaffolds. Such plant‐derived materials also have the capacity to improve cell viability and support osteoconductive and osteoinductive properties of a bone construct. In this article, we review the ethnomedical aspects related to the use of medicinal plants and plant‐origin bioactive compounds in bone healing and the recent developments in the 3D bioprinting of bone constructs with plant‐derived biomaterials for advancing BTE. The commonly used 3D‐bioprinting techniques, the properties of plant‐origin compounds and biomaterials (for bone 3D bioprinting), and the selective examples of bone scaffolds fabricated using plant‐derived biomaterials are discussed with a special reference set on applicability, performance, advantages, limitations, and challenges. Plant‐origin compounds, biomaterials, and biomimetic 3D‐bioprinted constructs could be the basis for a next‐generation BTE.
Exploring B7-H4’s Role in Prostate Cancer Dormancy after Androgen Deprivation Therapy: Extracellular Matrix Interactions and Therapeutic Opportunities
Authors: Kang Ning , Xue Hui , Wong Nelson K.Y. , Lin Yen-Yi , Classen Adam , Wu Rebecca , Oo Htoo Zarni , Dong Xin , Trinh Angela , Lin Dong , Daugaard Mads , Ong Christopher , Collins Colin , Gleave Martin , Wang Yuzhuo
Published: January 2025

Prostate cancer is mainly managed with androgen deprivation therapy (ADT), but this often leads to a dormant state and subsequent relapse as lethal castration-resistant prostate cancer (CRPC). Using our unique prostate cancer patient-derived xenograft dormancy models, we investigated this critical dormant phase and discovered a selective increase in B7-H4 expression during the dormancy period following mouse host castration. This finding is supported by observations in clinical specimens of patients with prostate cancer treated with ADT. Differential expression analyses revealed the enrichment of extracellular matrix (ECM)–cell interaction pathways in B7-H4–positive cells. Functional assays demonstrated a crucial role of B7-H4 in maintaining dormancy within the ECM niche. Specifically, B7-H4 expression in LNCaP cells reduced proliferation within the dormant ECM in vitro and significantly delayed relapse in castrated hosts in vivo. These results shed light on the dynamic regulation of B7-H4 during prostate cancer dormancy and underscore its potential as a therapeutic target for preventing CRPC relapse.

Implications: Our study identified membranous B7-H4 expression during ADT-induced dormancy, highlighting its potential as a therapeutic target for managing dormant prostate cancer and preventing fatal CRPC relapse.
Supplementary Figure 6 from Claudin-4 Stabilizes the Genome via Nuclear and Cell-Cycle Remodeling to Support Ovarian Cancer Cell Survival
Authors: Villagomez Fabian R. , Lang Julie , Nunez-Avellaneda Daniel , Behbakht Kian , Dimmick Hannah L. , Webb Patricia G. , Nephew Kenneth P. , Neville Margaret , Woodruff Elizabeth R. , Bitler Benjamin G.
Published: January 2025

Claudin-4 modulation and responses to forskilin and olaparib.
Supplementary Figure 5 from Claudin-4 Stabilizes the Genome via Nuclear and Cell-Cycle Remodeling to Support Ovarian Cancer Cell Survival
Authors: Villagomez Fabian R. , Lang Julie , Nunez-Avellaneda Daniel , Behbakht Kian , Dimmick Hannah L. , Webb Patricia G. , Nephew Kenneth P. , Neville Margaret , Woodruff Elizabeth R. , Bitler Benjamin G.
Published: January 2025

Claudin-4 dependent actin reorganization.
Incidence and clinical features of inguinal metastases of testicular germ cell tumors
Authors: Angerer Markus , Zecha Henrik , Wülfing Christian , Dieckmann Klaus Peter
Published: January 2025

Introduction
Half of all patients with testicular germ cell tumours (GCTs) present with metastases to retroperitoneal lymph nodes or visceral organs. Inguinal metastases (I/M) are very rare. We aimed to evaluate the relative frequency and clinical features of I/M and to look for predisposing factors.
Methods
A cohort of 740 GCT patients treated between 2010-2022 was analyzed. The frequency of I/M and their clinical features were statistically compared among the subgroups.
Results
Eight patients had I/M, with a median age of 55 years, all of whom had primary seminoma, six had previous groin surgery. The relative frequency of I/M is 1.1% and 8.3% in the GCT patient cohort and the metastasized seminoma subgroup, respectively. All patients were cured, six underwent surgery and additional chemotherapy, and two received cisplatin-based chemotherapy alone.
Discussion
Inguinal metastases occur in approximately 1% of GCT patients. Prior groin surgery, bulky retroperitoneal metastases and possibly histology of seminoma represent risk factors for I/M. The presence of I/M does not adversely affect prognosis, and all cases can be cured with standard therapeutic measures. Lymph node excision may be required to establish the diagnosis. In patients with risk factors, follow-up examinations should include the groins.
The Steep Ramp Test as Precursor to Assess Physical Fitness Before Esophagectomy in Cancer Patients
Authors: Crull David J. , Mekenkamp Iris , Mikhal Julia , Ruinemans G. Maarten-Friso , van Det Marc J. , Kouwenhoven Ewout A.
Published: January 2025

Background
Maximum oxygen uptake (VO₂max) is a predictor for postoperative complications after esophagectomy. Cardiopulmonary Exercise Test (CPET) is the golden standard for measuring VO₂max. The alternative Steep Ramp Test (SRT) is less strenuous with several benefits, providing an estimation of VO₂max. This study aims to determine whether SRT is a reliable alternative for CPET to evaluate preoperative fitness.
Methods
A total of 113 patients were included in this study. The agreement between SRT and CPET was analyzed using a t-test, Intraclass Correlation Coefficient (ICC), and the Bland-Altmann analysis. The threshold for adequate preoperative fitness was set at 17.0 ml/kg/min
Results
The mean difference between CPET and SRT was 2.77 ml/kg/min (95% CI 2.14–3.41). The ICC was 0.79 (95% CI 0.70-0.85). The upper limit of agreement of the Bland-Altmann was 9.44. The addition of 9.44 to the CPET-threshold gives an SRT-threshold of 26.44 ml/kg/min. Thirty-one (27.4%) patients scored higher than the SRT-threshold.
Conclusion
The SRT VO2max differs from VO₂max as measured by CPET. However, the difference was found to be clinically irrelevant for a substantial portion of patients. Hence, SRT is a promising alternative to CPET for determining physical fitness, and might render CPET obsolete for fit individuals.
Predictive Value of Preoperative Peak Oxygen Uptake for Postoperative Pulmonary Complications in Lung Cancer Patients with Chronic Obstructive Pulmonary Disease: A Single-center Retrospective Cohort Study
Authors: Noguchi Masaya , Takemoto Toshiki , Shiraishi Masashi , Sugiya Ryuji , Mizusawa Hiroki , Kimura Tamotsu , Tamaki Akira , Tsutani Yasuhiro , Higashimoto Yuji
Published: January 2025

Introduction: The relationship between preoperative peak oxygen uptake/weight (VO2/W) and postoperative pulmonary complications (PPC) in lobectomies, including video-assisted thoracoscopic surgery, remains unclear. Traditional pulmonary function tests are often unreliable in this group, necessitating alternative predictive methods. Therefore, this study aimed to clarify the predictive value of preoperative peak VO2/W for PPC and explore factors related to PPC in lung cancer patients with chronic obstructive pulmonary disease (COPD).
Methods: This single-center retrospective cohort study included 40 patients with lung cancer complicated by COPD who underwent a preoperative cardiopulmonary exercise test between January 2017 and March 2024. Patients were divided into those with and without PPC (PPC and non-PPC groups, respectively). Clinical parameters such as surgical approach, pulmonary function, low attenuation area, and peak VO2/W were compared between the groups. The association between these parameters and PPC was analyzed using multivariate logistic regression.
Results: The preoperative % diffusing capacity of the lung for carbon monoxide (%DLCO) and peak VO2/W were significantly lower in the PPC group than in the non-PPC group (p<0.01 and p<0.001, respectively), while the ventilatory equivalent/ventilatory carbon dioxide (VE/VCO2) was significantly higher in the PPC group than in the non-PPC group (p<0.05). In the multivariate logistic analysis including the %DLCO, peak VO2/W, VE/VCO2, and forced expiratory volume in 1 second, only peak VO2/W was identified as a significant independent factor for predicting PPC. The area under the receiver operating characteristic curve of peak VO2/W to predict PPC was 0.93, with a cutoff value of 14.6 mL/min/kg, sensitivity of 78%, and specificity of 95%.
Conclusions: This study revealed that peak VO2/W was the most important parameter for predicting PPC in lung cancer patients with COPD. Incorporating cardiopulmonary exercise tests into preoperative assessments could improve risk stratification and perioperative management, potentially reducing the incidence of PPC in this high-risk population.
Intrinsic vowel fundamental frequency in children with and without hearing impairment
Authors: Genette Jérémy , Gillis Steven , Verhoeven Jo
Published: January 2025

Introduction
It is well-established that high vowels tend to have a higher F0 than low vowels, a phenomenon known as Intrinsic Vowel F0 (IF0). However, the underlying cause of IF0 remains debated. Previous research suggests that IF0 is entirely of physiological origin, while other research indicates that it is acquired to enhance perceptual contrasts between vowels.
Methods
This study explored the impact of hearing loss on IF0 in six-year-old children, both with and without hearing impairment. The Belgian Dutch vowels produced by the children in both groups during a (non-)word repetition task were acoustically analysed for F0.
Results
The main result was that all children presented IF0. Although IF0 was not significantly different between children with and without hearing impairment, there was a trend towards a smaller IF0 in the hearing-impaired group.
Conclusion
In conclusion, while the results of this study support the physiological hypothesis, they also suggest a potential role for perceptual factors in shaping IF0. The results were interpreted in relation to the combined potential effects of speech organ physiology and perception on IF0.
Contatos culturais no Mediterrâneo antigo: a cerâmica de Canale-Ianchina (Calábria-Itália) no acervo do MAE-USP
Authors: Florenzano Maria Beatriz Borba
Published: January 2025

Entre as peças arqueológicas chegadas ao Museu de Arqueologia e Etnologia da Universidade de São Paulo na década de 1960 por meio de intercâmbio com o governo italiano, encontram-se cinco vasilhas de cerâmica provenientes de Canale, onde uma necrópole foi intensivamente escavada no início do século XX; necrópole relacionada ao núcleo residencial de Ianchina (Calábria – Itália). Nosso objetivo neste texto é dar vida a essas peças conservadas no MAE, inserindo-as no contexto histórico que as produziu.
Fraud or Fiasco? Philo’s Nine Books of Φοινικικὰ (‘Phoenician Affairs’) vis-à-vis Mediterranean archaeology and beyond: a reappraisal long overdue
Authors: Pappa Eleftheria
Published: January 2025

Algo revelador da sorte dos estudos fenícios no ambiente acadêmico europeio (até hoje) é a profusão do ceticismo com que a obra Φοινικικὰ (‘História Fenícia’) de Herênio Filo de Biblos se recebeu desde o início da sua publicação na Europa ocidental. As reservas sobre a historicidade das passagens de Fílo continuou durante séculos até que a oposição à autenticidade da obra histórica se reduziu somente após as escavações de Ugarit no início do século 20, as quais trouxeram as primeiras evidências independentes, fora das passagens da História Fenícia citadas na Preparatio Evagelica do Eusébio de Cesareia, que corroboraram informações fornecidas pelos excertos de Filo, especialmente sobre o panteão cananeu. Embora a pesquisa contemporânea tenha se concentrado no clima ehemerístico para o exame da obra de Filo, tendo sido relegada ao estudo da cultura literária helenística, seu valor para os estudos bíblicos e do Oriente Próximo, além de ser inestimável, se enfraqueceu desde as décadas anteriores. No presente caso, procuro reabilitar um manuscrito dos 9 Livros da História Fenícia de Fílo, publicado há quase dois séculos por Friedrich Wagenfeld em 1837. Demonstro, através de uma série de dados e argumentos, que o manuscrito contenido a obra inteira da História Fenícia era autêntico, demonstrando que o ceticismo era injustificado e que as escavações realizadas no Mediterrâneo oriental e ocidental desde então corroboram várias das informações oferecidas pela publição, mas não disponíveis para alguém vivendo na década de 1830. Algumas obras de Filo sobreviveram em pelo menos três manuscritos, nenhum dos quais foi estudado, reportados por diferentes indivíduos antes no ano 1836, um ano depois de Wagenfeld ter sido totalmente desacreditado como falsificador por seus pares, por motivos mesquinhos. O conteúdo do manuscrito contribui significativamente para o nosso conhecimento da história, cultura e literatura do mundo cananeio-fenício e seus vizinhos.
Softwares específicos utilizados no processamento de imagens de arte rupestre: uma revisão sistemática
Authors: Meneses Francisco Gerson Amorim de , Castelo Branco Lucas Renu Maia , Santos Milena Sotero dos , Vieira John Lenon de Brito
Published: January 2025

Initially, recording and processing images of rock art were done manually. With the advancement of technology, recording began to be done with digital cameras and image processing was done using generic software. Following this evolution, there is a need to have software specifically designed to be used in the processing of rock art images and thus, given that they are aimed at the problem, have better quality. Therefore, the objective of this systematic review is to present the main specific software used in processing rock art images. This review was based on the PRISMA methodology and was applied to the Scopus database. Initially, a chronological and evolutionary analysis of the software and technologies used is presented and, in the final stage of this study, the two main specific software currently used are highlighted.