bluuebunny/crossref_metadata_2025 huggingface dataset:
Time series approach to examine the impact of economic uncertainty, economic growth and financial development on human health
Authors: Zhang Meng , Tian Yao , Khan Muhammad Kamran
Published: April 2024

The present study aims to examine the impact of economic growth, economic uncertainty, health expenditure, environmental policy and life expectancy on human health in China through the application of simultaneous quantile regression analysis. The results of the study suggest that economic growth, environmental policy and life expectancy are found to have a positive and statistically significant impact on human health while economic uncertainty, health expenditure negatively impact human health in China. During periods of economic uncertainty, individuals tend to prioritise attending to immediate needs, potentially leading to a decrease in social cooperation and negative impacts on both physical and financial well‐being. The enhancement of financial development has the potential to stimulate investments in private sector health infrastructure, whilst policymakers can play a crucial role in augmenting public sector expenditure. In order to promote the improvement of human health and well‐being both domestically in China and internationally, it is imperative for authorities to give precedence to the implementation of sustainable environmental practises and allocate resources towards the development of healthcare infrastructure. These efforts should align with the objectives outlined in the Sustainable Development Goals (SDGs), with special emphasis on SDG 13, which pertains to climate action, and SDG 3, which focuses on good health and well‐being. The results of this study provide empirical evidence that lends support to the implementation of policies that aim to achieve a harmonious equilibrium between economic, environmental and health considerations, thereby fostering sustainable development and promoting equitable health outcomes.
Supercritical carbon dioxide technology in food processing: Insightful comprehension of the mechanisms of microbial inactivation and impacts on quality and safety aspects
Authors: Veiga Géssica Cristina da , Mafaldo Ísis Meireles , Barão Carlos Eduardo , Baú Tahis Regina , Magnani Marciane , Pimentel Tatiana Colombo
Published: April 2024

Supercritical carbon dioxide (SC‐CO2) has emerged as a nonthermal technology to guarantee food safety. This review addresses the potential of SC‐CO2 technology in food preservation, discussing the microbial inactivation mechanisms and the impact on food products’ quality parameters and bioactive compounds. Furthermore, the main advantages and gaps are denoted. SC‐CO2 technology application causes adequate microbial reductions (>5 log cfu/mL) of spoilage and pathogenic microorganisms, enzyme inactivation, and improvements in the storage stability in fruit and vegetable products (mainly fruit juices), meat products, and dairy derivatives. SC‐CO2‐treated products maintain the physicochemical, technological, and sensory properties, bioactive compound concentrations, and biological activity (antioxidant and angiotensin‐converting enzyme–inhibitory activities) similar to the untreated products. The optimization of processing parameters (temperature, pressure, CO2 volume, and processing times) is mandatory for achieving the desired results. Further studies should consider the expansion to different food matrices, shelf‐life evaluation, bioaccessibility of bioactive compounds, and in vitro and in vivo studies to prove the benefits of using SC‐CO2 technology. Moreover, the impact on sensory characteristics and, mainly, the consumer perception of SC‐CO2‐treated foods need to be elucidated. We highlight the opportunity for studies in postbiotic production. In conclusion, SC‐CO2 technology may be used for microbial inactivation to ensure food safety without losing the quality parameters.
Lactobacillus fermentum WC2020 increased the longevity of Caenorhabditis elegans via JNK‐mediated antioxidant pathway
Authors: Yang Ximiao , Chen Jianwen , Liao Zhenlin , Xia Zenghui , Huang Huiting , Huang Jieyuxuan , Chen Luoyao , Fang Xiang , Gao Chenghai , Wang Jie
Published: April 2024

Lactobacillus fermentum can exert antiaging effects, but their roles are strain‐specific, and little is known about the molecular mechanisms in some strains. This study investigated the antiaging effects of L. fermentum WC2020 (WC2020) isolated from Chinese fermented pickles and the underlying mechanism of the action in Caenorhabditis elegans. WC2020 enhanced the mean lifespan of L1‐stage and L4‐stage worms by 22.67% and 12.42%, respectively, compared with Escherichia coli OP50 (OP50), a standard food source for C. elegans. WC2020‐induced longevity was accompanied by an increase in body length and mitochondrial transmembrane potential and a reduction in lipid accumulation and the production of reactive oxygen species and malondialdehyde. Moreover, WC2020 increased the production of glutathione, superoxide dismutases, and catalases and altered the transcripts of many phenotype‐related genes. Furthermore, WC2020‐fed jnk‐1 rather than akt‐2 or pmk‐1 loss‐of‐function mutants showed similar lifespans to OP50‐fed worms. Correspondingly, WC2020 significantly upregulated the expression of jnk‐1 rather than genes involved in insulin‐like, p38 MAPK, bate‐catenin, or TGF‐beta pathway. Moreover, the increase in body length, mitochondrial transmembrane potential, and antioxidant capability and the decrease in lipid accumulation induced by WC2020 were not observed in jnk‐1 mutants. Additionally, WC2020 increased the expression of daf‐16 and the proportion of daf‐16::GFP in the nucleus, and increased lifespan disappeared in WC2020‐fed daf‐16 loss‐of‐function mutants. In conclusion, WC2020 activated the JNK/DAF‐16 pathway to improve mitochondria function, reduce oxidative stress, and then extend the longevity of nematodes, suggesting WC2020 could be a potential probiotic targeting JNK‐mediated antioxidant pathway for antiaging in food supplements and bioprocessing.

Practical Application

Aging has a profound impact on the global economy and human health and could be delayed by specific diets and nutrient resources. This study demonstrated that Lactobacillus fermentum WC2020 could be a potential probiotic strain used in food to promote longevity and health via the JNK‐mediated antioxidant pathway.
Small state adaptation and relational autonomy: The case of the United Arab Emirates and South America
Authors: Mason Robert , Rebello Paulo Cesar
Published: April 2024

From the Summit of South American–Arab Countries (ASPA) created in 2005, UAE–South American relations have continued to develop based on a combination of pragmatism, threat perception, political support and expanding economic interests. We argue that the strength of UAE engagement in this region is consistent with its attempts to build, deploy and benefit from soft power globally through economic statecraft in a mutually reinforcing series of bilateral and multilateral relationships. These include forums such as the Southern Common Market (MERCOSUR) and the expanding BRICS grouping (Brazil, Russia, India, China and South Africa). The article draws on primary and secondary data in English, Portuguese and Spanish, focusing mainly on UAE relations with Brazil and Venezuela. We find that through a myriad of growing investment relations and first‐mover advantage on arms and industrial cooperation, the UAE is well positioned vis‐à‐vis other Gulf Cooperation Council (GCC) states to benefit from the economic, diplomatic and security ties that could boost its relational autonomy in a competitive and uncertain regional and international environment.
Affirmative action without competition
Authors: Bengtson Andreas
Published: April 2024

Affirmative action is standardly pursued in relation to admissions to prestigious universities, in hiring for prestigious jobs, and when it comes to being elected to parliament. Central to these forms of affirmative action is that they have to do with competitive goods. A good is competitive when, if we improve A's chances of obtaining the good, we reduce B's chances of obtaining the good. I call this Competitive Affirmative Action. I distinguish this from Noncompetitive Affirmative Action. The latter has to do with noncompetitive goods, for example, being granted early parole or freedom from arbitrary arrest. I argue that some of the most prominent objections against affirmative action—in particular, the reverse discrimination objection and the merit objection—speak less against Noncompetitive Affirmative Action. And that some of the most prominent arguments in favor of affirmative action, insofar as they justify Competitive Affirmative Action, also justify Noncompetitive Affirmative Action.
Immunophenotypic clustering in paediatric acute myeloid leukaemia
Authors: Liu Hui , Wu Kefei , Hu Wenting , Chen Xiaoxiao , Tang Yanjing , Ma Yani , Chen Changcheng , Xie Yangyang , Yu Lisha , Huang Jun , Shen Shuhong , Wang Xiang
Published: April 2024

Acute myeloid leukaemia (AML) is a highly heterogeneous disease, exhibiting diverse subtypes according to the characteristics of tumour cells. The immunophenotype is one of the aspects acquired routinely through flow cytometry in the diagnosis of AML. Here, we characterized the antigen expression in paediatric AML cases across both morphological and molecular genetic subgroups. We discovered a subgroup of patients with unfavourable prognosis that can be immunologically characterized, irrespective of morphological FAB results or genetic aberrations. Cox regression analysis unveiled key antigens influencing the prognosis of AML patients. In terms of underlying genotypes, we observed that the antigenic profiles and outcomes of one specific group, primarily composed of CBFA2T3::GLIS2 and FUS::ERG, were analogous to the reported RAM phenotype. Overall, our data highlight the significance of immunophenotype to tailor treatment for paediatric AML.
Household food wasting in a net‐zero energy neighbourhood: Analyzing relationships between household food waste and pro‐environmentalism
Authors: Everitt Haley , van der Werf Paul , Seabrook Jamie A. , Gilliland Jason A.
Published: April 2024

To address the prominent “value‐action gap” within pro‐environmental behaviour, this novel, cross‐sectional study investigated relationships between household food wasting and pro‐environmentalism. Research was undertaken in 11 neighbourhoods across London, Ontario, Canada, including a net‐zero energy neighbourhood. A direct measurement methodology was used to measure household food waste, and a survey was created to measure knowledge, attitudes, and behaviours related to food wasting. Households in the net‐zero energy neighbourhood sent between 2.59 kg and 2.80 kg of food waste to landfill per week, of which 68% was classified as avoidable and the remaining 32% as unavoidable. Households in this neighbourhood sent less total (p < 0.001) and unavoidable (p < 0.001) food waste to landfill than households in “regular” neighbourhoods within the same city. While participants in the net‐zero neighbourhood had strong, self‐reported pro‐environmental worldviews, pro‐environmentalism was not found to be stronger in this neighbourhood compared to the rest of the city. The presence of stronger, self‐reported pro‐environmental worldviews was associated with a decrease in unavoidable food waste generation (p < 0.01). As the first study of its kind, further research is needed to verify the role of pro‐environmentalism in household food wasting in Canada and beyond.
Import tariffs and transport prices
Authors: Boddin Dominik , Stähler Frank
Published: April 2024

This paper discusses how import tariffs interact with transport prices in episodes of trade liberalization. We develop a model of a transport industry that operates under imperfect competition and economies of scale. Double marginalization due to market power reduces the effects of trade liberalization, while a larger trade volume may support them due to economies of scale. We use a large data set of maritime transport data and combine them with tariff data to find that economies of scale beat market power: a decline in the tariff implies a decline in freight rates.
Half‐ and full‐grafting alveolar ridge preservation with different sealing materials: A three‐arm randomized clinical trial
Authors: Lin Cho‐Ying , Chiu Meng‐Yao , Kuo Pe‐Yi , Wang Hom‐Lay
Published: April 2024

Objective

The objective of this study is to investigate the effect of different alveolar ridge preservation (ARP) approaches on bone resorption and their potential for facilitating implant placement.

Materials and methods

Patients who underwent one or two tooth extractions with a desire for restoration were included in the study. The participants were randomly assigned to one of three groups for ARP. The groups were as follows: (1) Half grafting of bovine bone mineral (DBBM‐C) covered with non‐resorbable dense polytetrafluoroethylene (dPTFE) membrane (Test 1 group); (2) Half grafting of bovine bone mineral (DBBM‐C) covered with collagen membrane (Test 2 group); and (3) Full grafting with collagen membrane (DBBM‐C + Collagen membrane) as the Control group. After 6‐month healing period, the evaluation encompassed clinical, radiographic, implant‐related outcomes, and the factors contributing to hard and soft tissue alterations.

Results

Enrollment in this study comprised 56 patients. At the 6‐month follow‐up, radiographic analysis in computed beam computed tomography images was conducted for 18, 19, and 19 patients with 18, 20, and 20 tooth sites in Test 1, Test 2, and Control groups, respectively. Additionally, a total of 15, 17, and 17 patients with 15, 18, and 17 implants were evaluated. Based on radiographic analysis, all groups showed limited ridge resorption at 1 mm from crest horizontally (Test 1: 1.29 ± 1.37; Test 2: 1.07 ± 1.07; Control: 1.54 ± 1.33 mm, p = 0.328), while the Control group showed greater radiographic bone height gain in mid‐crestal part vertically (Test 1: 0.11 ± 1.02; Test 2: 0.29 ± 0.83; Control: −0.46 ± 0.95 mm, p = 0.032). There were no significant intergroup differences in terms of keratinized mucosal width, bone density, insertion torque, and the need of additional bone graft. However, the use of a dPTFE membrane resulted in a significantly higher vertical mucosal thickness (Test 1: 2.67 ± 0.90; Test 2: 3.89 ± 1.08; Control: 2.41 ± 0.51 mm, p < 0.001).

Conclusions

The study showed comparable dimensional preservation with limited vertical shrinkage, while thin buccal bone plate, non‐molar sites, and large discrepancy between buccal and palatal/lingual height may contribute to greater shrinkage. Thicker mucosa with dPTFE membrane required further investigation for interpretation.

Clinical trial registration number

NCT06049823. This clinical trial was not registered prior to participant recruitment and randomization.
A meta‐analysis of the association between RBP4 rs3758539 genotype and metabolic syndrome factors
Authors: Wu Wen‐Chieh , Wu Pei‐Yu , Lee Ming‐Fen , Chang Chin‐Ming , Chan Chien‐Yi , Huang Chun‐Yin
Published: April 2024

Aim

To explore the link between the RBP4 rs3758539 genotype and metabolic syndrome risk factors and whether the impact of this genetic variation displays any potential race discrepancy.

Materials and Methods

This meta‐analysis followed the PRISMA guidelines and was registered with PROSPERO (registration no. CRD42023407999). PubMed, Web of Science, Embase, Cochrane Library, Google Scholar, Airiti Library and CINAHL databases were used for the study search until October 2023. We evaluated the methodological quality using the Joanna Briggs Institute checklist and determined the correlation using a random‐effects meta‐analysis.

Results

The results indicated that individuals with the rs3758539 GA/AA genotype had a higher risk profile, including lower high‐density lipoprotein levels [correlation: −0.045, 95% confidence interval (CI): −0.080 to −0.009, p = .015, I2 = 46.9%] and higher body mass index (correlation: 0.117, 95% CI: 0.036‐0.197, p = .005, I2 = 82.0%), body fat (correlation: 0.098, 95% CI: 0.004‐0.191, p = .041, I2 = 64.0%), and low‐density lipoprotein levels (correlation: 0.074, 95% CI: 0.010‐0.139, p = .024, I2 = 0%), of developing metabolic syndrome than those with the GG genotype. The subgroup analysis maintained a significantly positive correlation between the rs3758539 GA/AA genotype and body mass index (correlation: 0.163, 95% CI: 0.031‐0.289, p = .016, I2 = 88.9%) but a negative correlation with high‐density lipoprotein levels (correlation: −0.047, 95% CI: −0.087 to −0.006, p = .025, I2 = 65.7%) in the Asian group only.

Conclusion

The current meta‐analysis supports a significant link between the RBP4 rs3758539 GA/AA genotype and the metabolic syndrome.
Over 30 years of STEP: The Pittsburgh experience with first‐episode psychosis
Authors: Wood Helen J. , Jones Nev , Eack Shaun M. , Chengappa K. N. Roy , Prasad Konasale M. , Kelly Christian , Montrose Debra , Schooler Nina R. , Ganguli Rohan , Carter Cameron S. , Keshavan Matcheri S. , Sarpal Deepak K.
Published: April 2024

Aims

For over 30 years, combined research and treatment settings in the US have been critical to conceptualizing care for first‐episode psychosis (FEP). Here we describe an early example of such a context, the Services for the Treatment of Early Psychosis (STEP) clinic, which is affiliated with the University of Pittsburgh.

Methods

We describe STEP's historical roots and establishment in the early 1990s; STEP's research and treatment contributions, alongside its growth and ongoing leadership.

Results

Research‐based clinics, like STEP, preceded and helped pave the way for the Recovery After an Initial Schizophrenia Episode project in the US and the ensuing Coordinated Specialty Care (CSC) approach, now widely adopted in the US. Early clinic‐based research at STEP helped establish protocols for psychopharmacology, the relevance of effective early treatment, including psychosocial approaches, and highlighted disparities in treatment outcomes across race/ethnicity. Multidisciplinary collaboration and dialogue with consumers contributed to early treatment, combining psychosocial and pharmacological approaches. STEP adopted CSC and is situated within a bi‐state Learning Health System. STEP has retained a relatively unique 5‐year treatment model and exists within continuum of care ideally suited to studying psychotic illness and treatment outcomes.

Conclusions

STEP remains the largest academic FEP clinic in Pennsylvania. Academic FEP clinics like STEP will have a critical role within Learning Health Systems nationally to model participatory approaches, sustain early intervention treatment quality and ongoing treatment developments.
Questionnaire survey on hands‐on simulation training using a dental humanoid robot (SIMROID®)
Authors: Kitahara Sayaka , Kusakabe Shusuke , Takagaki Tomohiro , Ishigure Hiroshi , Shimizu Shojiro , Ikeda Masaomi , Burrow Michael F. , Nikaido Toru
Published: April 2024

Introduction

A dental humanoid robot, SIMROID®, is able to replicate the actions characteristic of human beings and enable training for communicating with patients and coping with unexpected situations. This study assessed user experiences via a survey questionnaire following hands‐on training on the SIMROID®.

Materials and Methods

A total of 112 participants, consisting of 50 high school students who visited AUSD (Asahi University School of Dentistry) to participate in open campus events, 42 fourth‐year students at AUSD and 20 dental students from Mexico State Autonomy University, University of Siena and Peking University took the survey. The participants observed the movements and reactions of a SIMROID® robot placed on a dental unit for approximately 20 min after which they completed a questionnaire survey. Both Japanese and English versions of the questionnaire were prepared for local and visiting foreign dental students. The questionnaire comprised 8 items, with a further two items for those undertaking dental training and an open comment field.

Results

All participants who observed the SIMROID® completed the questionnaire giving a 100% response rate. Generally, simulation training with SIMROID® was highly appreciated by all participants. The comprehensive evaluation score for SIMROID® was 4.56 ± 0.50 points for high school students, 4.05 ± 0.82 points for students at AUSD and 4.70 ± 0.47 points for foreign dental students, showing all participants had a very positive experience and impression of the SIMROID®.

Conclusions

Therefore, simulation training using SIMROID® seems beneficial learning tool.
White matter fibre density in the brain's inhibitory control network is associated with falling in low activity older adults
Authors: Simon Colin , Bolton David A. E. , Meaney James F. , Kenny Rose Anne , Simon Vivienne A. , De Looze Céline , Knight Silvin , Ruddy Kathy L.
Published: April 2024

Recent research has indicated that the relationship between age‐related cognitive decline and falling may be mediated by the individual's capacity to quickly cancel or inhibit a motor response. This longitudinal investigation demonstrates that higher white matter fibre density in the motor inhibition network paired with low physical activity was associated with falling in elderly participants. We measured the density of white matter fibre tracts connecting key nodes in the inhibitory control network in a large sample (n = 414) of older adults. We modelled their self‐reported frequency of falling over a 4‐year period with white matter fibre density in pathways corresponding to the direct and hyperdirect cortical–subcortical loops implicated in the inhibitory control network. Only connectivity between right inferior frontal gyrus and right subthalamic nucleus was associated with falling as measured cross‐sectionally. The connectivity was not, however, predictive of future falling when measured 2 and 4 years later. Higher white matter fibre density was associated with falling, but only in combination with low levels of physical activity. No such relationship existed for selected control brain regions that are not implicated in the inhibitory control network. Albeit statistically robust, the direction of this effect was counterintuitive (more dense connectivity associated with falling) and warrants further longitudinal investigation into whether white matter fibre density changes over time in a manner correlated with falling, and mediated by physical activity.
Macaque claustrum, pulvinar and putative dorsolateral amygdala support the cross‐modal association of social audio‐visual stimuli based on meaning
Authors: Froesel Mathilda , Gacoin Maëva , Clavagnier Simon , Hauser Marc , Goudard Quentin , Ben Hamed Suliann
Published: April 2024

Social communication draws on several cognitive functions such as perception, emotion recognition and attention. The association of audio‐visual information is essential to the processing of species‐specific communication signals. In this study, we use functional magnetic resonance imaging in order to identify the subcortical areas involved in the cross‐modal association of visual and auditory information based on their common social meaning. We identified three subcortical regions involved in audio‐visual processing of species‐specific communicative signals: the dorsolateral amygdala, the claustrum and the pulvinar. These regions responded to visual, auditory congruent and audio‐visual stimulations. However, none of them was significantly activated when the auditory stimuli were semantically incongruent with the visual context, thus showing an influence of visual context on auditory processing. For example, positive vocalization (coos) activated the three subcortical regions when presented in the context of positive facial expression (lipsmacks) but not when presented in the context of negative facial expression (aggressive faces). In addition, the medial pulvinar and the amygdala presented multisensory integration such that audiovisual stimuli resulted in activations that were significantly higher than those observed for the highest unimodal response. Last, the pulvinar responded in a task‐dependent manner, along a specific spatial sensory gradient. We propose that the dorsolateral amygdala, the claustrum and the pulvinar belong to a multisensory network that modulates the perception of visual socioemotional information and vocalizations as a function of the relevance of the stimuli in the social context.

Significance statement

Understanding and correctly associating socioemotional information across sensory modalities, such that happy faces predict laughter and escape scenes predict screams, is essential when living in complex social groups. With the use of functional magnetic imaging in the awake macaque, we identify three subcortical structures—dorsolateral amygdala, claustrum and pulvinar—that only respond to auditory information that matches the ongoing visual socioemotional context, such as hearing positively valenced coo calls and seeing positively valenced mutual grooming monkeys. We additionally describe task‐dependent activations in the pulvinar, organizing along a specific spatial sensory gradient, supporting its role as a network regulator.
The 3,4‐methylenedioxymethamphetamine enhances early visual processing for salient socio‐emotional stimuli
Authors: Haggarty Connor J. , Bershad Anya K. , Kumar Mahesh K. , Lee Royce , de Wit Harriet
Published: April 2024

The 3,4‐methylenedioxymethamphetamine (MDMA) has long been used non‐medically, and it is currently under investigation for its potential therapeutic benefits. Both uses may be related to its ability to enhance empathy, sociability, emotional processing and its anxiolytic effects. However, the neural mechanisms underlying these effects, and their specificity to MDMA compared to other stimulants, are not yet fully understood. Here, using electroencephalography (EEG), we investigated the effects of MDMA and a prototypic stimulant, methamphetamine (MA), on early visual processing of socio‐emotional stimuli in an oddball emotional faces paradigm. Specifically, we examined whether MDMA or MA enhance the processing of facial expressions, compared to placebo, during the early stages of visual perception. MDMA enhanced an event‐related component that is sensitive to detecting faces (N170), specifically for happy and angry expressions compared to neutral faces. MA did not affect this measure, and neither drug altered other components of the response to emotional faces. These findings provide novel insights into the neural mechanisms underlying the effects of MDMA on socio‐emotional processing and may have implications for the therapeutic use of MDMA in the treatment of social anxiety and other psychiatric disorders.
Etiological changes of liver cirrhosis and hepatocellular carcinoma‐complicated liver cirrhosis in Japan: Updated nationwide survey from 2018 to 2021
Authors: Enomoto Hirayuki , Akuta Norio , Hikita Hayato , Suda Goki , Inoue Jun , Tamaki Nobuharu , Ito Kiyoaki , Akahane Takemi , Kawaoka Tomokazu , Morishita Asahiro , Ogawa Eiichi , Tateishi Ryosuke , Yoshiji Hitoshi
Published: April 2024

Aim

A nationwide survey in 2018 showed decreasing involvement of viral hepatitis and increasing involvement of nonviral liver diseases in the etiology of liver cirrhosis (LC) in Japan. An updated nationwide survey was undertaken in 2023.

Methods

Cases of LC diagnosed between 2018 and 2021 were collected from 75 institutions, and the etiologies of LC were investigated. In addition, the data obtained were compared with the results of previous studies.

Results

Among the 15 517 cases, alcohol‐related liver disease (ALD)‐associated LC was the most frequent cause (n = 5,487, 35.4%). Hepatitis C virus‐associated LC, nonalcoholic steatohepatitis (NASH)‐associated LC, and hepatitis B virus‐associated LC were ranked as second, third, and fourth, respectively. In comparison to the previous survey, the ratios of viral hepatitis‐associated LC decreased (HBV: from 11.5% to 8.1%; HCV: from 48.2% to 23.4%), while the ratios of ALD‐associated LC and NASH‐associated LC increased (from 19.9% to 35.4% and from 6.3% to 14.6%, respectively). Regarding cases of LC with hepatocellular carcinoma (n = 5906), HCV‐associated LC (1986 cases, 33.6%) was the most frequent cause. Alcohol‐related liver disease‐associated LC, NASH‐associated LC, and HBV‐associated LC were the second‐, third‐, and fourth‐ranked causes, respectively. In comparison to the previous survey, as the cause of hepatocellular carcinoma‐complicated LC, HCV‐associated LC decreased from 60.3% to 33.6%, while the ratios of ALD‐associated LC and NASH‐associated LC increased from 14.2% to 28.6% and from 4.2% to 14.0%, respectively.

Conclusions

The major causes of LC in Japan are suggested to have been shifting from viral hepatitis to nonviral chronic liver diseases.
Preparation of high‐purity α‐Si3N4 powder via multifunctional synergistic catalysis and pretreatment method
Authors: Yuan Zhuang , Zhao Xinqi , Sun Xiaohong , Gong Zhiyou , Zheng Chaoyi , Ren Junbo , Wang Jiawei , Zheng Chunming
Published: April 2024

At present, the Si3N4 powder prepared is not pure enough. Therefore, this work introduces a novel method of preparing high‐purity α‐Si3N4 powder. Si3N4 powder with high α phase content was prepared via a unique two‐stage temperature‐rise (TSTR) process, using KCl and metal Co as dual catalysts through low‐temperature pretreatment for silicon powder and subsequent high‐temperature nitriding reaction. Molten KCl insulates silicon particles in three contact modes during low‐temperature pretreatment, promoting complete and uniform nitriding and absorbing the heat released during the reaction. In addition, Co forms a Co–Si liquid phase, causing the reaction to transition into a gas–liquid–solid reaction with lower potential energy, thereby reducing the reaction temperature. Through the synergistic effect of the two catalysts and optimized unique TSTR process, Si3N4 powder can be obtained at 1250°C, boasting a remarkably high α phase content of 99.1%, distinguished by its layered, needle‐like, and spherical structures. The detailed experiments first provide a comprehensive explanation of the growth mechanism of α‐Si3N4. This innovative method for preparing Si3N4 powder offers a new approach to the facile production of high‐purity phase ceramic powder.
Factors affecting team performance of external auditors in Iran: A Delphi–interpretive structural modelling approach
Authors: Zamani Reza , Lari Dashtbayaz Mahmoud , Hesarzadeh Reza
Published: April 2024

This study employs the Delphi–interpretive structural modelling (ISM) approach to uncover and model factors influencing team performance in external audit. In Delphi interviews, 73 factors were identified, and a subsequent survey revealed 13 crucial factors. Among these, supervisor competence, team members' knowledge, and managers/supervisors' supportive attitudes were emphasized as top priorities among the essential 13 factors. These factors serve as guiding principles for interactions, shaping behaviour and attitudes. Notably, this study goes beyond previous research, which typically focussed on a limited number of factors, by identifying 73 factors influencing audit team performance and then determining and modelling the most critical factors based on expert insights. It also sheds light on the underappreciated role of supervisors, often overshadowed by audit managers or partners. Moreover, the study links these factors with transformational, servant, and ethical leadership theories, fostering a more balanced approach to future research in the auditing profession.
Estimates of Seasonal Influenza Burden That Could Be Averted by Improved Influenza Vaccines in the Australian Population Aged Under 65 Years, 2015–2019
Authors: Stein Alicia N. , Pendrey Catherine G. A. , Muscatello David J. , Van Buynder Paul G. , Fielding James E. , Menche Jason C. , Sullivan Sheena G.
Published: April 2024

Background

The interpretation of relative vaccine effectiveness (rVE) of improved influenza vaccines is complex. Estimation of burden averted is useful to contextualise their potential impact across different seasons. For the population aged under 65 years in Australia, this study estimated the additional morbidity and mortality that could be averted using improved influenza vaccines.

Methods

We used observed, season‐specific (2015–2019) influenza notification and influenza‐coded hospitalisation frequencies and published modelled estimates of influenza‐associated hospitalisations and deaths that occurred under the prevailing influenza vaccination coverage scenario. After back‐calculating to the estimated burden in the population without vaccination, we applied published standard influenza vaccine effectiveness and coverage estimates to calculate the burden potentially averted by standard and improved influenza vaccines. A plausible range of rVE values were used, assuming 50% coverage.

Results

The percentage point difference in absolute vaccine effectiveness (VE) of an improved vaccine compared to a standard vaccine is directly proportional to its rVE and inversely proportional to the effectiveness of the standard vaccine. The incremental burden averted by an improved vaccine is a function of both its difference in absolute VE and the severity of the influenza season. Assuming an rVE of 15% with 50% coverage, the improved vaccine was estimated to additionally avert 1517 to 12,641 influenza notifications, 287 to 1311 influenza‐coded hospitalisations and 9 to 33 modelled all‐cause influenza deaths per year compared to the standard vaccine.

Conclusions

Improved vaccines can have substantial clinical and population impact, particularly when the effectiveness of standard vaccines is low, and burden is high.
A systematic review of large language models and their implications in medical education
Authors: Lucas Harrison C. , Upperman Jeffrey S. , Robinson Jamie R.
Published: April 2024

Introduction

In the past year, the use of large language models (LLMs) has generated significant interest and excitement because of their potential to revolutionise various fields, including medical education for aspiring physicians. Although medical students undergo a demanding educational process to become competent health care professionals, the emergence of LLMs presents a promising solution to challenges like information overload, time constraints and pressure on clinical educators. However, integrating LLMs into medical education raises critical concerns and challenges for educators, professionals and students. This systematic review aims to explore LLM applications in medical education, specifically their impact on medical students' learning experiences.

Methods

A systematic search was performed in PubMed, Web of Science and Embase for articles discussing the applications of LLMs in medical education using selected keywords related to LLMs and medical education, from the time of ChatGPT's debut until February 2024. Only articles available in full text or English were reviewed. The credibility of each study was critically appraised by two independent reviewers.

Results

The systematic review identified 166 studies, of which 40 were found by review to be relevant to the study. Among the 40 relevant studies, key themes included LLM capabilities, benefits such as personalised learning and challenges regarding content accuracy. Importantly, 42.5% of these studies specifically evaluated LLMs in a novel way, including ChatGPT, in contexts such as medical exams and clinical/biomedical information, highlighting their potential in replicating human‐level performance in medical knowledge. The remaining studies broadly discussed the prospective role of LLMs in medical education, reflecting a keen interest in their future potential despite current constraints.

Conclusions

The responsible implementation of LLMs in medical education offers a promising opportunity to enhance learning experiences. However, ensuring information accuracy, emphasising skill‐building and maintaining ethical safeguards are crucial. Continuous critical evaluation and interdisciplinary collaboration are essential for the appropriate integration of LLMs in medical education.
Effect of early mobilization on the development of pneumonia in patients with traumatic brain injury in the neurosurgical intensive care unit: A historical controls study
Authors: Wu Dan , Geng Xin , Wu Hao , Liu Xiaohong , Liu Xiaobin , Ma Lina , Li Yang , Liang Xiu , Lan Qingping , Wang Yuxia , Wang Xiangyu , Wang Yonghong , Shi Shufang , Zhang Xiaohong
Published: April 2024

Background

Pneumonia has a high incidence in traumatic brain injury (TBI) patients and lacks effective treatments. Early mobilization (EM) may be a potentially effective treatment.

Aim

To explore the impact of EM on TBI‐related pneumonia in the neurosurgical intensive care unit (NICU).

Study Design

This study was a historical control study. 100 TBI patients who received EM intervention were prospectively included as the experimental group (EM cohort), and 250 TBI patients were retrospectively included as the control group. The propensity score matching (PSM) method was employed to balance baseline and minimize potential bias. The relationship between EM and TBI‐related pneumonia was investigated by univariate and multivariate logistic regression, then further determined by subgroup analysis. The influence of other variables was excluded by interaction analyses. Finally, the effect of EM on the prognosis of TBI patients was analysed by comparing the Glasgow Coma Scale (GCS) and the hospital stay.

Results

After screening, 86 patients were included in the EM cohort and 199 patients were included in the control cohort. There were obvious differences between the two cohorts at baseline, and these differences were eliminated after PSM, when the incidence of pneumonia was significantly lower in the EM cohort than in the control cohort (35.0% vs. 61.9%, p < .001). Multivariate logistic regression showed that EM was an independent risk factor for TBI‐related pneumonia and was significantly associated with a decreased incidence of pneumonia. This correlation was present in most subgroups and was not affected by other variables (p for interaction >.05). Patients in the EM cohort had shorter length of ICU stay (6 vs. 7 days, p = .017) and higher GCS at discharge (12 vs. 11, p = .010).

Conclusion

EM is a safe and effective treatment for TBI patients in NICU, which can reduce the incidence of pneumonia, help to improve prognosis and shorten the length of ICU stay.

Relevance to Clinical Practice

Although the utilization rate of EM is low in TBI patients for various reasons, EM is still an effective method to prevent complications. Our study confirms that a scientific and detailed EM strategy can effectively reduce the incidence of pneumonia while ensuring the safety of TBI patients, which is worthy of further research and clinical application.
Risk Factors for Surgical Treatment of Lumbar Degenerative Disc Disease in Middle‐aged and Older Women: A Prospective Case–Control Study of 2370 Subjects
Authors: Zhang Yuchen , Yuan Suomao , Chen Xing , Zhang Zhaoqing , Yang Xiaorong , Wang Shuo , Tian Yonghao , Wang Lianlei , Liu Xinyu
Published: April 2024

Objective

Given the distinct physiological and societal traits between women and men, we propose that there are distinct risk factors for lumbar degenerative disc disease surgeries, including lumbar disc herniation (LDH) and lumbar spinal stenosis (LSS), in middle‐aged and older populations. However, few studies have focused on middle‐aged and older women. This study aims to identify these risk factors specifically in this population.

Methods

In this case–control study, the study group comprised 1202 women aged ≥ 45 years who underwent operative treatment of lumbar degenerative disc disease (LDH, n = 825; LSS, n = 377), and the control group comprised 1168 women without lumbar disease who visited a health examination clinic during the same period. The study factors included demographics (age, body mass index [BMI], smoking, labor intensity, and genetic history), female‐specific factors (menopausal status, number of deliveries, cesarean section, and simple hysterectomy), surgical history (number of abdominal surgeries, hip joint surgery, knee joint surgery, and thyroidectomy), and systemic diseases (hypercholesterolemia, hypertriglyceridemia, hyper‐low‐density lipoprotein cholesterolemia, hypertension, diabetes, cardiovascular disease, and cerebrovascular disease). Multivariate binary logistic regression analysis was used to calculate the odds ratio (OR) and 95% confidence interval (95% CI) of associated factors.

Results

The risk factors for surgical treatment of LDH in middle‐aged and older women included BMI (OR = 1.603), labor intensity (OR = 1.189), genetic history (OR = 2.212), number of deliveries (OR = 1.736), simple hysterectomy (OR = 2.511), hypertriglyceridemia (OR = 1.932), and hyper‐low‐density lipoprotein cholesterolemia (OR = 2.662). For surgical treatment of LSS, the risk factors were age (OR = 1.889), BMI (OR = 1.671), genetic history (OR = 2.134), number of deliveries (OR = 2.962), simple hysterectomy (OR = 1.968), knee joint surgery (OR = 2.527), hypertriglyceridemia (OR = 1.476), hyper‐low‐density lipoprotein cholesterolemia (OR = 2.413), and diabetes (OR = 1.643). Cerebrovascular disease was a protective factor against surgery for LDH (OR = 0.267).

Conclusions

BMI, genetic history, number of deliveries, simple hysterectomy, hypertriglyceridemia, and hyper‐low‐density lipoprotein cholesterolemia were independent risk factors for surgical treatment of both LDH and LSS in middle‐aged and older women. Two disparities were found: labor intensity was a risk factor for LDH patients, and knee joint surgery and diabetes were risk factors for LSS patients.
Predicting haemoglobin deferral using machine learning models: Can we use the same prediction model across countries?
Authors: Meulenbeld Amber , Toivonen Jarkko , Vinkenoog Marieke , Brits Tinus , Swanevelder Ronel , de Clippel Dorien , Compernolle Veerle , Karki Surendra , Welvaert Marijke , van den Hurk Katja , van Rosmalen Joost , Lesaffre Emmanuel , Janssen Mart , Arvas Mikko
Published: April 2024

Background and Objectives

Personalized donation strategies based on haemoglobin (Hb) prediction models may reduce Hb deferrals and hence costs of donation, meanwhile improving commitment of donors. We previously found that prediction models perform better in validation data with a high Hb deferral rate. We therefore investigate how Hb deferral prediction models perform when exchanged with other blood establishments.

Materials and Methods

Donation data from the past 5 years from random samples of 10,000 donors from Australia, Belgium, Finland, the Netherlands and South Africa were used to fit random forest models for Hb deferral prediction. Trained models were exchanged between blood establishments. Model performance was evaluated using the area under the precision–recall curve (AUPR). Variable importance was assessed using SHapley Additive exPlanations (SHAP) values.

Results

Across the validation datasets and exchanged models, the AUPR ranged from 0.05 to 0.43. Exchanged models performed similarly within validation datasets, irrespective of the origin of the training data. Apart from subtle differences, the importance of most predictor variables was similar in all trained models.

Conclusion

Our results suggest that Hb deferral prediction models trained in different blood establishments perform similarly within different validation datasets, regardless of the deferral rate of their training data. Models learn similar associations in different blood establishments.
Liver-targeted polymeric prodrugs delivered subcutaneously improve tafenoquine therapeutic window for malaria radical cure
Authors: Pottenger Ayumi E. , Roy Debashish , Srinivasan Selvi , Chavas Thomas E. J. , Vlaskin Vladmir , Ho Duy-Khiet , Livingston Vincent C. , Maktabi Mahdi , Lin Hsiuling , Zhang Jing , Pybus Brandon , Kudyba Karl , Roth Alison , Senter Peter , Tyson George , Huber Hans E. , Wesche David , Rochford Rosemary , Burke Paul A. , Stayton Patrick S.
Published: April 2024

Approximately 3.3 billion people live with the threat of
Plasmodium vivax
malaria. Infection can result in liver-localized hypnozoites, which when reactivated cause relapsing malaria. This work demonstrates that an enzyme-cleavable polymeric prodrug of tafenoquine addresses key requirements for a mass administration, eradication campaign: excellent subcutaneous bioavailability, complete parasite control after a single dose, improved therapeutic window compared to the parent oral drug, and low cost of goods sold (COGS) at less than $1.50 per dose. Liver targeting and subcutaneous dosing resulted in improved liver:plasma exposure profiles, with increased efficacy and reduced glucose 6-phosphate dehydrogenase–dependent hemotoxicity in validated preclinical models. A COGS and manufacturability analysis demonstrated global scalability, affordability, and the ability to redesign this fully synthetic polymeric prodrug specifically to increase global equity and access. Together, this polymer prodrug platform is a candidate for evaluation in human patients and shows potential for
P. vivax
eradication campaigns.
Noncovalently particle-anchored cytokines with prolonged tumor retention safely elicit potent antitumor immunity
Authors: Niu Liqian , Jang Eungyo , Chin Ai Lin , Huo Ziyu , Wang Wenbo , Cai Wenjun , Tong Rong
Published: April 2024

Preclinical studies have shown that immunostimulatory cytokines elicit antitumor immune responses but their clinical use is limited by severe immune-related adverse events upon systemic administration. Here, we report a facile and versatile strategy for noncovalently anchoring potent Fc-fused cytokine molecules to the surface of size-discrete particles decorated with Fc-binding peptide for local administration. Following intratumoral injection, particle-anchored Fc cytokines exhibit size-dependent intratumoral retention. The 1-micrometer particle prolongs intratumoral retention of Fc cytokine for over a week and has minimal systemic exposure, thereby eliciting antitumor immunity while eliminating systemic toxicity caused by circulating cytokines. In addition, the combination of these particle-anchored cytokines with immune checkpoint blockade antibodies safely promotes tumor regression in various syngeneic tumor models and genetically engineered murine tumor models and elicits systemic antitumor immunity against tumor rechallenge. Our formulation strategy renders a safe and tumor-agnostic approach that uncouples cytokines’ immunostimulatory properties from their systemic toxicities for potential clinical application.
Photocatalytic manipulation of Ca
2+
signaling for regulating cellular and animal behaviors via MOF-enabled H
2
O
2
generation
Authors: Zhang Zherui , Luo Yuhao , Ma Yuanhong , Zhou Yaofeng , Zhu Dingcheng , Shen Wanhua , Liu Junqiu
Published: April 2024

The in situ generation of H
2
O
2
in cells in response to external stimulation has exceptional advantages in modulating intracellular Ca
2+
dynamics, including high controllability and biological safety, but has been rarely explored. Here, we develop photocatalyst-based metal-organic frameworks (DCSA-MOFs) to modulate Ca
2+
responses in cells, multicellular spheroids, and organs. By virtue of the efficient photocatalytic oxygen reduction to H
2
O
2
without sacrificial agents, photoexcited DCSA-MOFs can rapidly trigger Ca
2+
outflow from the endoplasmic reticulum with single-cell precision in a repeatable and controllable manner, enabling the propagation of intercellular Ca
2+
waves (ICW) over long distances in two-dimensional and three-dimensional cell cultures. After photoexcitation, ICWs induced by DCSA-MOFs can activate neural activities in the optical tectum of tadpoles and thighs of spinal frogs, eliciting the corresponding motor behaviors. Our study offers a versatile optical nongenetic modulation technique that enables remote, repeatable, and controlled manipulation of cellular and animal behaviors.