bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessing ad-hoc adaptations’ alignment with therapeutic goals: a qualitative study of lay counselor-delivered family therapy in Eldoret, Kenya
Authors: Kaiser Bonnie N. , Kaufman Julia , Wall Jonathan Taylor , Healy Elsa A. Friis , Ayuku David , Aarons Gregory A. , Puffer Eve S.
Published: August 2023

Background

A key question in implementation science is how to balance adaptation and fidelity in translating interventions to new settings. There is growing consensus regarding the importance of planned adaptations to deliver interventions in contextually sensitive ways. However, less research has examined ad-hoc adaptations, or those that occur spontaneously in the course of intervention delivery. A key question is whether ad-hoc adaptations ultimately contribute to or detract from intervention goals. This study aimed to (a) identify ad-hoc adaptations made during delivery of a family therapy intervention and (b) assess whether they promoted or interrupted intervention goals.

Methods

Tuko Pamoja (Swahili: “We are Together”) is an evidence-informed family therapy intervention aiming to improve family dynamics and mental health in Kenya. Tuko Pamoja employs a task-shifting model, delivered by lay counselors who are afforded a degree of flexibility in presenting content and in practices they use in sessions. We used transcripts of therapy sessions with 14 families to examine ad-hoc adaptations used by counselors. We first identified and characterized ad-hoc adaptations through a team-based code development, coding, and code description process. Then, we evaluated to what extent ad-hoc adaptations promoted the principles and strategies of the intervention (“TP-promoting”), disrupted them (“TP-interrupting”), or neither (“TP-neutral”). To do this, we first established inter-coder agreement on application of these categories with verification by the intervention developer. Then, coders categorized ad-hoc adaptation text segments as TP-promoting, TP-interrupting, or TP-neutral.

Results

Ad-hoc adaptations were frequent and included (in decreasing order): incorporation of religious content, exemplars/role models, community dynamics and resources, self-disclosure, and metaphors/proverbs. Ad-hoc adaptations were largely TP-promoting (49%) or neutral (39%), but practices were TP-interrupting 12% of the time. TP-interrupting practices most often occurred within religious content and exemplars/role models, which were also the most common practices overall.

Conclusion

Extra attention is needed during planned adaptation, training, and supervision to promote intervention-aligned use of common ad-hoc adaptation practices. Discussing them in trainings can provide guidance for lay providers on how best to incorporate ad-hoc adaptations during delivery. Future research should evaluate whether well-aligned ad-hoc adaptations improve therapeutic outcomes.

Trial registration

Pilot trial registered at clinicaltrials.gov (C0058)
Role of xylo-oligosaccharides in relieving complications accompanied to carbimazole drug administrated with 1% saline in female Wistar rats
Authors: Foda Doaa S. , Nour Shaimaa A.
Published: August 2023

Background

Ameliorating the complications of pharmaceutical drugs by natural compounds or probiotics is now a medical strategy. The anti-thyroid drug carbimazole was reported to cause some complications as liver and kidneys dysfunction besides the harmful effect on the structure of the thyroid gland in addition to weight gain during thyroid treatment. The aim of the present work was suggesting xylo-oligosaccharides extracted from Aspergillus terreus xylanase degradation of xylan for the first time as a candidate for ameliorating some of the drug-associated complications.

Results

The present work reported that the administration of carbimazole drug only to female Wistar rats for three weeks leads to significant decrease in serum levels of ALT, AST and urea (p ≤ 0.05) which reflected a status of a lazy liver. On the other hand, there was a significant increase in serum levels of total protein content, creatinine and calcium (p ≤ 0.05). A detected non-significant decrease in serum T4 accompanied with significant increased levels of T3 (p ≤ 0.05) and a normal serum TSH were observed in this group compared to the control group. Histological examinations on liver, kidneys and thyroid tissues revealed the effect of the drug on their cells shape which reflected the malfunction of these organs. Co-administration of xylo-oligosaccarides to carbimazole in rats significantly improved most of the changed serum parameters levels in addition to a marked  modulation in the histological examination of both the liver and  kidney tissues. More histological  modulations were displayed in the thyroid tissues than those observed in liver and kidneys tissues.

Conclusion

Accordingly, it can be concluded that xylo-oligosaccarides extracted from Aspergillus terreus xylanase degradation of xylan are suggested to be a safe therapy in ameliorating carbimazole drug-associated complications.
Multistage residual network for intense distributed acoustic sensing background noise attenuation
Authors: Dong Xintong , Lu Shaoping , Cong Zheng , Zhong Tie
Published: August 2023

Owing to its advantages in acquisition properties, distributed acoustic sensing (DAS) is gradually being applied in seismic exploration. Unfortunately, the acquired DAS records are usually contaminated by various unwanted interferences, which are considered one of the main obstacles for subsequent processing, such as inversion and imaging of the seismic data. In general, conventional signal processing methods cannot satisfy the requirements of DAS noise attenuation owing to the limitations in presumption and denoising accuracy. Therefore, deep learning, especially convolutional neural networks (CNNs), has been used to eliminate intense background noise and improve the quality of DAS records. Nevertheless, most CNN-based methods often rely on single-scale features and cannot guarantee denoising performance when dealing with complex DAS data. In this study, we develop a multistage residual network (MSR-Net) aiming to enhance denoising ability for complex DAS background noise. More precisely, the backbone of MSR-Net adopts a multiscale architecture to capture informative features within the DAS data. A modified ringed residual module is also used to enhance the representation ability of potential features. In addition, a feature aggregation spatial attention module is designed to refine and reinforce the primary features, thereby positively impacting the denoising performance. Meanwhile, an authentic training data set is generated based on field noise data and synthetic records obtained by the forward-modeling method. Compared with conventional methods and typical denoising networks, MSR-Net demonstrates superiority in weak signal recovery and intense DAS noise attenuation.
New wiggles from old cables: Acquisition, cable, and data aspects
Authors: Raknes Espen Birger , Foseide Bjarte , Landrø Martin , Dong Hefeng , Brenne Jan Kristoffer , Wienecke Susann , Bjørnstad Steinar , Frivik Svein Arne , Elboth Thomas
Published: August 2023

Seismic imaging is essential for detailed characterization and understanding of the subsurface. Traditionally, marine seismic data have been acquired either using towed streamers or ocean-bottom receivers. Distributed acoustic sensing (DAS) is a novel and fast-emerging technology that makes it possible to use fiber-optic cables for acoustic measurements. The technology turns the fiber-optic cable into a densely sampled receiver array. A controlled source experiment comparing DAS and conventional towed streamer data for seismic imaging purposes is described. An existing 130 km telecommunication fiber-optic cable was interrogated to acquire DAS data to analyze the signal at long distances and for subsurface imaging. A seismic source vessel was used to create seismic data along the full cable length, while at the same time acquiring conventional towed streamer data for comparison. In addition, the telecommunication fiber-optic cable was used to acquire passive DAS data. The results show that seismic signals in the telecommunication fiber-optic cable are detectable at distances above 100 km from the source point. Furthermore, comparisons of the DAS data and towed streamer data show that the DAS technology allows for the acquisition of large offset seismic data that are comparable with conventional seismic data. Analysis of the passive DAS data shows that the infragravity waves correlate with the observed weather conditions during the acquisition.
Phase III Trial of Carboplatin and Paclitaxel Compared With Cisplatin and Paclitaxel in Patients With Optimally Resected Stage III Ovarian Cancer: A Gynecologic Oncology Group Study
Authors: Ozols Robert F. , Bundy Brian N. , Greer Benjamin E. , Fowler Jeffrey M. , Clarke-Pearson Daniel , Burger Robert A. , Mannel Robert S. , DeGeest Koen , Hartenbach Ellen M. , Baergen Rebecca
Published: August 2023

Purpose: In randomized trials the combination of cisplatin and paclitaxel was superior to cisplatin and cyclophosphamide in advanced-stage epithelial ovarian cancer. Although in nonrandomized trials, carboplatin and paclitaxel was a less toxic and highly active combination regimen, there remained concern regarding its efficacy in patients with small-volume, resected, stage III disease. Thus, we conducted a noninferiority trial of cisplatin and paclitaxel versus carboplatin and paclitaxel in this population.

Patients and Methods: Patients with advanced ovarian cancer and no residual mass greater than 1.0 cm after surgery were randomly assigned to receive cisplatin 75 mg/m2 plus a 24-hour infusion of paclitaxel 135 mg/m2 (arm I), or carboplatin area under the curve 7.5 intravenously plus paclitaxel 175 mg/m2 over 3 hours (arm II).

Results: Seven hundred ninety-two eligible patients were enrolled onto the study. Prognostic factors were similar in the two treatment groups. Gastrointestinal, renal, and metabolic toxicity, as well as grade 4 leukopenia, were significantly more frequent in arm I. Grade 2 or greater thrombocytopenia was more common in arm II. Neurologic toxicity was similar in both regimens. Median progression-free survival and overall survival were 19.4 and 48.7 months, respectively, for arm I compared with 20.7 and 57.4 months, respectively, for arm II. The relative risk (RR) of progression for the carboplatin plus paclitaxel group was 0.88 (95% confidence interval [CI], 0.75 to 1.03) and the RR of death was 0.84 (95% CI, 0.70 to 1.02).

Conclusion: In patients with advanced ovarian cancer, a chemotherapy regimen consisting of carboplatin plus paclitaxel results in less toxicity, is easier to administer, and is not inferior, when compared with cisplatin plus paclitaxel.
Phase II Trial of Dabrafenib Plus Trametinib in Relapsed/Refractory BRAF V600–Mutant Pediatric High-Grade Glioma
Authors: Hargrave Darren R. , Terashima Keita , Hara Junichi , Kordes Uwe R. , Upadhyaya Santhosh A. , Sahm Felix , Bouffet Eric , Packer Roger J. , Witt Olaf , Sandalic Larissa , Kieloch Agnieszka , Russo Mark , Cohen Kenneth J. ,   the Investigators involved in the high-grade glioma cohort, Diez Blanca , Cappellano Andrea , Epelman Sidnei , Mancano Bruna , Nysom Karsten , Aerts Isabelle , Bertozzi Anne-Isabelle , Witt Olaf , Kramm Christof , Fleischhack Gudrun , Kordes Uwe , Hernaiz-Driever Pablo , Massimino Maura , Garre Maria Luisa , Locatelli Franco , Terashima Keita , Okada Keiko , Koga Yuki , Van der Lugt Jasper , Maschan Alexey , Lassaletta Alvaro , Holm Stefan , Hargrave Darren , Howell Lisa , Upadhyaya Santhosh , Gauvain Karen , Cohen Kenneth , Baxter Patricia
Published: August 2023

PURPOSE

BRAF V600 mutation is detected in 5%-10% of pediatric high-grade gliomas (pHGGs), and effective treatments are limited. In previous trials, dabrafenib as monotherapy or in combination with trametinib demonstrated activity in children and adults with relapsed/refractory BRAF V600–mutant HGG.

METHODS

This phase II study evaluated dabrafenib plus trametinib in patients with relapsed/refractory BRAF V600–mutant pHGG. The primary objective was overall response rate (ORR) by independent review by Response Assessment in Neuro-Oncology criteria. Secondary objectives included ORR by investigator determination, duration of response (DOR), progression-free survival, overall survival (OS), and safety.

RESULTS

A total of 41 pediatric patients with previously treated BRAF V600–mutant HGG were enrolled. At primary analysis, median follow-up was 25.1 months, and 51% of patients remained on treatment. Sixteen of 20 discontinuations were due to progressive disease in this relapsed/refractory pHGG population. Independently assessed ORR was 56% (95% CI, 40 to 72). Median DOR was 22.2 months (95% CI, 7.6 months to not reached [NR]). Fourteen deaths were reported. Median OS was 32.8 months (95% CI, 19.2 months to NR). The most common all-cause adverse events (AEs) were pyrexia (51%), headache (34%), and dry skin (32%). Two patients (5%) had AEs (both rash) leading to discontinuation.

CONCLUSION

In relapsed/refractory BRAF V600–mutant pHGG, dabrafenib plus trametinib improved ORR versus previous trials of chemotherapy in molecularly unselected patients with pHGG and was associated with durable responses and encouraging survival. These findings suggest that dabrafenib plus trametinib is a promising targeted therapy option for children and adolescents with relapsed/refractory BRAF V600–mutant HGG.
Flavonoids Quercetin and Kaempferol Are NR4A1 Antagonists and Suppress Endometriosis in Female Mice
Authors: Zhang Lei , Mohankumar Kumaravel , Martin Gregory , Mariyam Fuada , Park Yuri , Han Sang Jun , Safe Stephen
Published: August 2023

Nuclear receptor 4A1 (NR4A1) plays an important role in endometriosis progression; levels of NR4A1 in endometriotic lesions are higher than in normal endometrium, and substituted bis-indole analogs (NR4A1) antagonists suppress endometriosis progression in mice with endometriosis. In addition, the flavonoids kaempferol and quercetin are natural products that directly bind NR4A1 and significantly repress the intrinsic NR4A1-dependent transcriptional activity in human endometriotic epithelial and stromal cells and Ishikawa endometrial cancer cells. NR4A1 knockdown and inhibition of NR4A1 by kaempferol and quercetin suppressed proliferation of human endometriotic epithelial cells and Ishikawa cells by inhibiting epidermal growth factor receptor/c-Myc/survivin-mediated growth-promoting and survival pathways, The mammalian target of rapamycin (mTOR) signaling and αSMA/CTGF/COL1A1/FN-mediated fibrosis signaling but increasing Thioredoxin domain Containing 5/SESN2-mediated oxidative/estrogen receptors stress signaling. In human endometriotic stromal cells, NR4A1 knockdown and inhibition of NR4A1 by kaempferol and quercetin primarily inhibited mTOR signaling by suppressing proliferation of human endometrial stromal cells. In addition, kaempferol and quercetin treatment also effectively suppressed the growth of endometriotic lesions in mice with endometriosis compared with the vehicle without any body weight changes. Therefore, kaempferol and quercetin are NR4A1 antagonists with potential as nutritional therapy for endometriosis.
How venom pore placement may influence puncture performance in snake fangs
Authors: Crofts Stephanie B. , Anderson Philip S. L.
Published: August 2023

When designing experimental studies, it is important to understand the biological context of the question being asked. For example, many biological puncture experiments embed the puncture tool to a standardized depth based on a percentage of the total tool length, to compare the performance between tools. However, this may not always be biologically relevant to the question being asked. To understand how definitions of penetration depth may influence comparative results, we performed puncture experiments on a series of venomous snake fangs using the venom pore location as a functionally relevant depth standard. After exploring variation in pore placement across snake phylogeny, we compared the work expended during puncture experiments across a set of snake fangs using various depth standards: puncture initiation, penetration to a series of depths defined by the venom pore and penetration to 15% of fang length. Contrary to our hypothesis, we found almost no pattern in pore placement between clades, dietary groups or venom toxicity. Rank correlation statistics of our experimental energetics results showed no difference in the broad comparison of fangs when different puncture depth standards were used. However, pairwise comparisons between fangs showed major shifts in significance patterns between the different depth standards used. These results imply that the interpretation of experimental puncture data will heavily depend upon which depth standard is used during the experiments. Our results illustrate the importance of understanding the biological context of the question being addressed when designing comparative experiments.
A Road to Efficiency through Communication and Commitment
Authors: Avoyan Ala , Ramos João
Published: August 2023

We experimentally examine the efficacy of a novel pre-play institution in a well-known coordination game—the minimum-effort game—in which coordination failures are robust and persistent phenomena. This new institution allows agents to communicate while incrementally committing to their words, leading to a distinct theoretical prediction: the efficient outcome is uniquely selected in the extended coordination game. We find that commitment-enhanced communication significantly increases subjects’ payoffs and achieves higher efficiency levels than various nonbinding forms of communication. We further identify the key ingredients of the institution that are central to achieving such gains. (JEL C73, C92, D83)
Worth Your Weight: Experimental Evidence on the Benefits of Obesity in Low-Income Countries
Authors: Macchi Elisa
Published: August 2023

I study the economic value of obesity—a status symbol in poor countries associated with raised health risks. Randomizing decision-makers in Kampala, Uganda to view weight-manipulated portraits, I find that obesity is perceived as a reliable signal of wealth but not of beauty or health. Thus, leveraging a real-stakes experiment involving professional loan officers, I show that being obese facilitates access to credit. The large obesity premium, comparable to raising borrower self-reported earnings by over 60 percent, is driven by asymmetric information and drops significantly when providing more financial information. Notably, obesity benefits and wealth-signaling value are commonly overestimated, suggesting market distortions. (JEL D82, G21, G51, I12, O16, Z13)
Clinical impact of 99mTc-HDP SPECT/CT imaging as standard workup for foot and ankle osteoarthritis
Authors: van Hasselt AJ , Pustjens J , de Zwart AD , Dal M , de Vries AJ , van Raaij TM
Published: August 2023

Objective:

The primary aim of this study was to assess to what extent 99mTc-HDP Single photon emission computed tomography/computed tomography (SPECT/CT) will lead to change of diagnosis and treatment, in patients with suspected foot and ankle osteoarthritis (OA). Secondary aim was to assess the intraobserver variability.

Methods:

Retrospectively 107 patients, with suspected foot and/or ankle OA of which a SPECT/CT was made, were included for analysis. All the clinical and radiological data were randomized and blinded before being scored by one experienced orthopaedic surgeon. Firstly, based on the clinical data and conventional radiographs, a diagnosis and treatment plan was scored. Secondly, the observer accessed the SPECT/CT and could change the diagnosis and treatment plan. Additionally, the intraobserver reliability was determined by data of 18 patients that were added in twofold to the dataset, without awareness of the observer and by calculating the κ values.

Results:

The diagnosis changed in 53% (57/107) and treatment plans changed in 26% (28/107) of the patients. Intraobserver reliability for the conventional workup was k = 0.54 (moderate strength of agreement), compared to k = 0.66 (substantial strength of agreement) when SPECT/CT data were added.

Conclusions:

This study describes the influence of SPECT/CT on diagnosis and treatment plans in patients with suspected symptomatic OA. Also, it shows SPECT/CT leads to a higher intraobserver variability. We believe SPECT/CT has a promising role in the workup for foot and ankle OA.

Advances in knowledge:

In addition to what was found in complex foot and ankle cases, this study shows that in patients with non-complex foot and ankle problems, SPECT/CT has a substantial influence on the diagnosis (and subsequent treatment plan).
Does cone beam CT change the treatment decision for maxillary second and third molars? A prospective study
Authors: Hermann Louise , Nørholt Sven Erik , Wenzel Ann , Taneja Pankaj , Matzen Louise Hauge
Published: August 2023

Objectives:

To evaluate whether information from CBCT changes the treatment plan for maxillary second and third molars and to examine clinical and radiographic parameters with an impact on treatment decision.

Methods:

This prospective study included 260 maxillary third molars with superimposition onto the second molar in panoramic images (170 patients; mean age 28 years, range 16–63). An initial treatment plan was based on clinical findings and panoramic images. After CBCT, a final treatment plan was decided. Treatment was undertaken based on the final treatment plan. Through logistic regression analyses, impact of clinical and radiographic parameters on change in treatment plan, removal of the third molar vs no treatment, and removal of the second vs third molar were evaluated.

Results:

The treatment plan changed in 82 cases (32%). Sixteen cases (6%) changed from removal of the third molar to removal of the second molar. Regression analyses showed that severe resorption in the second molar was significantly related to a change in treatment plan. Removal of a third molar was decided in 180 cases and regression analyses identified that mesioangulation of the third molar, marginal bone loss, superficial resorption, and age were significantly related to removal of the third molar vs no treatment. Thirty second molars were removed, and regression analyses showed that severe resorption was significantly related to removal of the second molar instead of the third molar.

Conclusions:

Parameters such as resorption evaluated in CBCT can modify the treatment decision, resulting in removal of the second and/or the third molar.
Examining SRP pathway function in mRNA localization to the endoplasmic reticulum
Authors: Child Jessica R. , Hofler Alex C. , Chen Qiang , Yang Brenda H. , Kristofich JohnCarlo , Zheng Tianli , Hannigan Molly M. , Elles Andrew L. , Reid David W. , Nicchitta Christopher V.
Published: August 2023

Signal recognition particle (SRP) pathway function in protein translocation across the endoplasmic reticulum (ER) is well established; its role in RNA localization to the ER remains, however, unclear. In current models, mRNAs undergo translation- and SRP-dependent trafficking to the ER, with ER localization mediated via interactions between SRP-bound translating ribosomes and the ER-resident SRP receptor (SR), a heterodimeric complex comprising SRA, the SRP-binding subunit, and SRB, an integral membrane ER protein. To study SRP pathway function in RNA localization, SR knockout (KO) mammalian cell lines were generated and the consequences of SR KO on steady-state and dynamic mRNA localization examined. CRISPR/Cas9-mediatedSRPRBKO resulted in profound destabilization of SRA. Pairing siRNA silencing ofSRPRAinSRPRBKO cells yielded viable SR KO cells. Steady-state mRNA compositions and ER-localization patterns in parental and SR KO cells were determined by cell fractionation and deep sequencing. Notably, steady-state cytosol and ER mRNA compositions and partitioning patterns were largely unaltered by loss of SR expression. To examine SRP pathway function in RNA localization dynamics, the subcellular trafficking itineraries of newly exported mRNAs were determined by 4-thiouridine (4SU) pulse-labeling/4SU-seq/cell fractionation. Newly exported mRNAs were distinguished by high ER enrichment, with ER localization being SR-independent. Intriguingly, under conditions of translation initiation inhibition, the ER was the default localization site for all newly exported mRNAs. These data demonstrate that mRNA localization to the ER can be uncoupled from the SRP pathway function and reopen questions regarding the mechanism of RNA localization to the ER.
Association between total body muscle percentage and prevalence of non-alcoholic fatty liver disease in Korean adults findings from an 18-year follow-up: a prospective cohort study
Authors: Ahn Byoung Chan , Park Chul Yong , Hong Jung Hee , Baek Ki Ook
Published: August 2023

Background: This study aimed to elucidate the association between total lean muscle mass and the incidence of non-alcoholic fatty liver disease (NAFLD) in the adult Korean population.Methods: Utilizing data derived from the 18-year prospective cohort of the Korean Genome and Epidemiology Study, NAFLD was diagnosed via the hepatic steatosis index with an established cutoff value of 36. Lean muscle mass was assessed via bioelectrical impedance analysis and subsequently divided into tertiles. A generalized mixed model with a logit link was employed for repeated measures data analysis, accounting for potential confounders.Results: Analysis encompassed 7,794 participants yielding 49,177 measurements. The findings revealed a markedly increased incidence of NAFLD in the lower tertiles of muscle mass, specifically, tertile 1 (odds ratio [OR], 20.65; 95% confidence interval [CI], 9.66–44.11) and tertile 2 (OR, 4.57; 95% CI, 2.11–9.91), in comparison to tertile 3. Age-dependent decreases in the OR were observed within the tertile 1 group, with ORs of 10.12 at age of 40 years and 4.96 at age of 80 years. Moreover, each 1%-point increment in total muscle mass corresponded with an estimated OR of 0.87 (95% CI, 0.82–0.93) for NAFLD resolution.Conclusions: The study demonstrates a significant association between total muscle mass and NAFLD prevalence among Korean adults. Given the potential endocrine role of muscle mass in NAFLD pathogenesis, interventions aimed at enhancing muscle mass might serve as an effective public health strategy for mitigating NAFLD prevalence.
Update on Wilms tumor
Authors: Kister Klaudia , Laskowski Jakub , Bronst Paulina , Mazur Magdalena , Małolepsza Aleksandra , Zach-Źródlak Monika , Czechowska Julia , Rosa Lidia , Rektor Natalia , Szabrańska Anna
Published: August 2023

Background: Wilms' tumor is the most common childhood renal neoplasm. Among the worst prognosis forms are the bilateral form. The symptom complex is non-specific for malignancy; the first symptoms may include hypertension. Hematuria occurs in 30% of patients. The incidence of distant metastases at the time of diagnosis in children with Wilms' tumor is estimated to be about 20%.The purpose of this article is to present a review of the literature on the standardization of diagnosis, the latest treatment standards and to assess the prognosis of Wilms' Tumor.

Matherial and methods:  Using PubMed, SCOPUS and Web of Science databases, the authors reviewed the peer-reviewed international literature from 1980-2023 using the keywords: "Wilms tumor," "renal tumor," "nephroblastoma." 

Discussion: Bilateral tumors have the worst prognosis - according to the National Wilms Tumor Study Group, long-term survival is achieved in only 12% to 56% of patients. The prognosis of Wilms' tumor is also dependent on the occurrence of recurrences - local as well as localized outside the renal tissue. A factor directly affecting long-term survival is recurrence, mainly observed within 24 months after the end of therapy. The limitations of conventional therapies, including surgery, chemotherapy and radiotherapy, in preventing recurrence in WT patients and their potential to cause long-term side effects.

Conclusions:

Bilateral Wilms tumor is associated with more aggressive therapy than unilateral disease.In single kidney disease, therapeutic management is aimed at radical removal of all tumor foci, whereas in bilateral tumor, the goal of any management should additionally be to try to preserve the best possible renal function.

Screening in children is important in cancer. General physicians should refer patients for additional imaging studies when there are any diagnostic doubts, as cancer is characterized by a long, asymptomatic development.
Benzodiazepines and z-drugs - between treatment effectiveness and the risk of addiction
Authors: Cabaj Justyna , Bargieł Julia , Soroka Ewelina
Published: August 2023

Benzodiazepines (BZDs) and Z-drugs are commonly prescribed medications for anxiety and sleep disorders. This review examines their efficacy, associated risks, and alternative treatment options. BZDs enhance the activity of gamma-aminobutyric acid (GABA), reducing anxiety, while Z-drugs selectively target GABA-A receptors' alpha-1 subunits for sedative effects. Despite their effectiveness, both drug classes carry the risk of addiction, physical and psychological dependence, and withdrawal symptoms. Side effects, such as drowsiness, dizziness, and cognitive impairment, are also associated with their use. Recent studies indicate that chronic use of BZDs and Z-drugs may lead to cognitive impairment and an increased risk of dementia in older adults. Furthermore, individual factors, dosage, duration of use, and drug interactions can affect their efficacy. Prescribing trends show a decline in benzodiazepine prescriptions and an increase in Z-drug use due to perceived safety advantages. However, evidence suggests that Z-drugs carry similar risks of adverse effects and addiction potential as benzodiazepines. Healthcare professionals should carefully assess patients before prescribing these drugs and monitor their use to prevent dependence and addiction. Brief interventions, patient education, drug withdrawal support, and cognitive behavioral therapy have shown effectiveness in reducing long-term benzodiazepine and Z-drug use. Alternative treatments, including cognitive behavioral therapy and relaxation techniques, should be considered, particularly for patients with a history of addiction or those at high risk of addiction. In conclusion, the risk of addiction, withdrawal symptoms, and adverse effects associated with benzodiazepines and Z-drugs necessitates cautious prescribing and the exploration of alternative treatment options.
Activities of the Sports Law Research Network Association in the area of law and management
Authors: Bugajska Małgorzata , Raniszewski Szymon , Borek Dominik
Published: August 2023

The article concerns the cooperation agreement between scientific units in the field of sports law. The Network, not having legal personality, uses the legal personality of its members. The network is not a civil law partnership agreement. The coordinator of the network agreement is the John Paul II Catholic University of Lublin in Lublin. The members of the network remained fully independent in their non-target activities. The study used the dogmatic-exegetical research method, which required an analysis of detailed legal regulations in this area. The article presents the personal views of the authors and cannot be interpreted as the position of any authority, entity or institution.
The Strategic Role of Supplier Learning
Authors: Gao Long , Nikoofal Mohammad Ebrahim , Zhang Wei
Published: August 2023

Problem definition: We study a procurement problem, where the supplier holds superior cost information and can learn to improve efficiency over time. Despite its prevalence, the supply chain literature provides limited guidance on how to manage learning suppliers with evolving private information. Methodology/results: We use mechanism design. We show that supplier learning has both efficiency and agency effects, it can induce countervailing incentives, and the agency effect can overwhelm the efficiency effect. As a result, (i) supplier learning can hurt profits, (ii) information asymmetry can improve efficiency, (iii) production distortion can go upward, and (iv) ignoring the agency effect of learning can mislead contract design and inflict severe losses. Managerial implications: Our results suggest that previous studies may have overlooked the downside of learning and overestimated the harm of information asymmetry. Moreover, our results help explain when and why firms should overproduce output and disclose private information voluntarily. By highlighting the strategic role of supplier learning, this study sharpens our understanding of supply chain management.

Funding: L. Gao is partly supported by the CoR research grant at University of California, Riverside. W. Zhang is partly supported by the National Natural Science Foundation of China [Grant 71821002].

Supplemental Material: The online appendix is available at https://doi.org/10.1287/msom.2021.0285 .
O MUSEU (E OS OUTROS MUSEUS) NA CONSTRUÇÃO E RESSIGNIFICAÇÃO DE PETRÓPOLIS COMO DESTINO TURÍSTICO HISTÓRICO
Authors: Perrotta Isabella Vicente
Published: August 2023

Do ponto de vista da história do turismo no Brasil, a cidade de Petrópolis é emblemática, posto que era o local de veraneio da corte imperial de dom Pedro II. Posteriormente, se constituiu num destino de turismo histórico, principalmente a partir da criação do Museu Imperial nas instalações do palácio de verão do imperador. Este artigo discute uma ressignificação turística da cidade, a partir de narrativas expositivas de seus antigos e novos museus. A pesquisa de cunho exploratório articula informações históricas, classificações de turismo e teorias relativas a turismo cultural, economia da cultura e “febre” de museus. Tal discussão baseia-se em referências bibliográficas, informações disponíveis em sites oficiais, e da observação empírica no campo.
Developing an artificial intelligence diagnostic tool for paediatric distal radius fractures, a proof of concept study
Authors: Aryasomayajula S , Hing CB , Siebachmeyer M , Naeini FB , Ejindu V , Leitch P , Gelfer Y , Zweiri Y
Published: August 2023

Introduction

In the UK, 1 in 50 children sustain a fractured bone yearly, yet studies have shown that 34% of children sustaining an injury do not have a visible fracture on initial radiographs. Wrist fractures are particularly difficult to identify because the growth plate poses diagnostic challenges when interpreting radiographs.

Methods

We developed Convolutional Neural Network (CNN) image recognition software to detect fractures in radiographs from children. A consecutive data set of 5,000 radiographs of the distal radius in children aged less than 19 years from 2014 to 2019 was used to train the CNN. In addition, transfer learning from a VGG16 CNN pretrained on non-radiological images was applied to improve generalisation of the network and the classification of radiographs. Hyperparameter tuning techniques were used to compare the model with the radiology reports that accompanied the original images to determine diagnostic test accuracy.

Results

The training set consisted of 2,881 radiographs with a fracture and 1,571 without; 548 radiographs were outliers. With additional augmentation, the final data set consisted of 15,498 images. The data set was randomly split into three subsets: training (70%), validation (10%) and test (20%). After training for 20 epochs, the diagnostic test accuracy was 85%.

Discussion

A CNN model is feasible in diagnosing paediatric wrist fractures. We demonstrated that this application could be utilised as a tool for improving diagnostic accuracy. Future work would involve developing automated treatment pathways for diagnosis, reducing unnecessary hospital visits and allowing staff redeployment to other areas.
Public choice economics of the Ukraine crisis
Authors: Hebert David , Krasnozhon Leonid
Published: August 2023

We use public choice theory to examine the calculus of the Russian aggression against Ukraine. We hypothesize that Putin’s regime acts as a tinpot dictatorship, using political loyalty and repression to stay in office. During Putin’s first two-term presidency, an improvement in Russia’s economic performance increased the supply of political loyalty and resulted in a slow fall in political repression. The global financial crisis deteriorated Russians’ living standards between Putin’s second and third terms in office. The deterioration in the country’s economic performance unambiguously resulted in a fall in the supply of loyalty and increased repression. Consistent with our hypothesis, we argue that Putin’s regime pursued military conquest to increase the aggregate supply of political loyalty.
Intellectual and Developmental Disability Research: Success Through Inclusion and Equity
Authors: Belcher Harolyn M.E. , Love Christina E. , Segal Andrew H. , Lopez-Arvizu Carmen
Published: August 2023

“Toward Equity in Research on Intellectual and Developmental Disabilities” (IDD) is a timely and comprehensive article highlighting gaps in the “dominant culture” approach to current research strategies designed to address IDD. Recentering systems involved in the research enterprise are recommended. This commentary provides additional guidance from a social justice, equity, and inclusion lens, including a clinical anthropology approach to research.
Detection of single ions in a nanoparticle coupled to a fiber cavity
Authors: Deshmukh Chetan , Beattie Eduardo , Casabone Bernardo , Grandi Samuele , Serrano Diana , Ferrier Alban , Goldner Philippe , Hunger David , de Riedmatten Hugues
Published: August 2023

Many quantum information protocols require the storage and manipulation
of information over long times, and its exchange between nodes of a
quantum network across long distances. Implementing these protocols
requires an advanced quantum hardware, featuring, for example, a
register of long-lived and interacting qubits with an efficient
optical interface in the telecommunication band. Here we present the
Purcell-enhanced detection of single solid-state ions in erbium-doped
nanoparticles placed in a fiber cavity, emitting photons at
1536 nm. The open-access design of the cavity allows for
complete tunability in both space and frequency, selecting individual
particles and ions. The ions are confined in a volume two orders of
magnitude smaller than in previous realizations, increasing the
probability of finding ions separated by only a few nanometers, which
could then interact. We report the detection of individual spectral
features presenting saturation of the emission count rate and
linewidth, as expected for two-level systems. We also report an
uncorrected g(2)(0) of 0.24(5) for the emitted field,
confirming the presence of a single emitter. Our fully
fiber-integrated system is an important step towards the realization
of the initially envisioned quantum hardware.
Dietary change without caloric restriction maintains a youthful profile in ageing yeast
Authors: Horkai Dorottya , Hadj-Moussa Hanane , Whale Alex J. , Houseley Jonathan
Published: August 2023

Caloric restriction increases lifespan and improves ageing health, but it is unknown whether these outcomes can be separated or achieved through less severe interventions. Here, we show that an unrestricted galactose diet in early life minimises change during replicative ageing in budding yeast, irrespective of diet later in life. Average mother cell division rate is comparable between glucose and galactose diets, and lifespan is shorter on galactose, but markers of senescence and the progressive dysregulation of gene expression observed on glucose are minimal on galactose, showing that these are not intrinsic aspects of replicative ageing but rather associated processes. Respiration on galactose is critical for minimising hallmarks of ageing, and forced respiration during ageing on glucose by overexpression of the mitochondrial biogenesis factor Hap4 also has the same effect though only in a fraction of cells. This fraction maintains Hap4 activity to advanced age with low senescence and a youthful gene expression profile, whereas other cells in the same population lose Hap4 activity, undergo dramatic dysregulation of gene expression and accumulate fragments of chromosome XII (ChrXIIr), which are tightly associated with senescence. Our findings support the existence of two separable ageing trajectories in yeast. We propose that a complete shift to the healthy ageing mode can be achieved in wild-type cells through dietary change in early life without caloric restriction.
In vivo recording of suprachiasmatic nucleus dynamics reveals a dominant role of arginine vasopressin neurons in circadian pacesetting
Authors: Tsuno Yusuke , Peng Yubo , Horike Shin-ichi , Wang Mohan , Matsui Ayako , Yamagata Kanato , Sugiyama Mizuki , Nakamura Takahiro J. , Daikoku Takiko , Maejima Takashi , Mieda Michihiro
Published: August 2023

The central circadian clock of the suprachiasmatic nucleus (SCN) is a network consisting of various types of neurons and glial cells. Individual cells have the autonomous molecular machinery of a cellular clock, but their intrinsic periods vary considerably. Here, we show that arginine vasopressin (AVP) neurons set the ensemble period of the SCN network in vivo to control the circadian behavior rhythm. Artificial lengthening of cellular periods by deleting casein kinase 1 delta (CK1δ) in the whole SCN lengthened the free-running period of behavior rhythm to an extent similar to CK1δ deletion specific to AVP neurons. However, in SCN slices, PER2::LUC reporter rhythms of these mice only partially and transiently recapitulated the period lengthening, showing a dissociation between the SCN shell and core with a period instability in the shell. In contrast, in vivo calcium rhythms of both AVP and vasoactive intestinal peptide (VIP) neurons in the SCN of freely moving mice demonstrated stably lengthened periods similar to the behavioral rhythm upon AVP neuron-specific CK1δ deletion, without changing the phase relationships between each other. Furthermore, optogenetic activation of AVP neurons acutely induced calcium increase in VIP neurons in vivo. These results indicate that AVP neurons regulate other SCN neurons, such as VIP neurons, in vivo and thus act as a primary determinant of the SCN ensemble period.
Development and validation of risk prediction model for diabetic neuropathy among diabetes mellitus patients at selected referral hospitals, in Amhara regional state Northwest Ethiopia, 2005–2021
Authors: Gelaw Negalgn Byadgie , Muche Achenef Asmamaw , Alem Adugnaw Zeleke , Gebi Nebiyu Bekele , Chekol Yazachew Moges , Tesfie Tigabu Kidie , Tebeje Tsion Mulat
Published: August 2023

Background

Diabetic neuropathy is the most common complication in both Type-1 and Type-2 DM patients with more than one half of all patients developing nerve dysfunction in their lifetime. Although, risk prediction model was developed for diabetic neuropathy in developed countries, It is not applicable in clinical practice, due to poor data, methodological problems, inappropriately analyzed and reported. To date, no risk prediction model developed for diabetic neuropathy among DM in Ethiopia, Therefore, this study aimed prediction the risk of diabetic neuropathy among DM patients, used for guiding in clinical decision making for clinicians.

Objective

Development and validation of risk prediction model for diabetic neuropathy among diabetes mellitus patients at selected referral hospitals, in Amhara regional state Northwest Ethiopia, 2005–2021.

Methods

A retrospective follow up study was conducted with a total of 808 DM patients were enrolled from January 1,2005 to December 30,2021 at two selected referral hospitals in Amhara regional state. Multi-stage sampling techniques were used and the data was collected by checklist from medical records by Kobo collect and exported to STATA version-17 for analysis. Lasso method were used to select predictors and entered to multivariable logistic regression with P-value<0.05 was used for nomogram development. Model performance was assessed by AUC and calibration plot. Internal validation was done through bootstrapping method and decision curve analysis was performed to evaluate net benefit of model.

Results

The incidence proportion of diabetic neuropathy among DM patients was 21.29% (95% CI; 18.59, 24.25). In multivariable logistic regression glycemic control, other comorbidities, physical activity, hypertension, alcohol drinking, type of treatment, white blood cells and red blood cells count were statistically significant. Nomogram was developed, has discriminating power AUC; 73.2% (95% CI; 69.0%, 77.3%) and calibration test (P-value = 0.45). It was internally validated by bootstrapping method with discrimination performance 71.7 (95% CI; 67.2%, 75.9%). It had less optimism coefficient (0.015). To make nomogram accessible, mobile based tool were developed. In machine learning, classification and regression tree has discriminating performance of 70.2% (95% CI; 65.8%, 74.6%). The model had high net benefit at different threshold probabilities in both nomogram and classification and regression tree.

Conclusion

The developed nomogram and decision tree, has good level of accuracy and well calibration, easily individualized prediction of diabetic neuropathy. Both models had added net benefit in clinical practice and to be clinically applicable mobile based tool were developed.
The effect of ticagrelor on coronary microvascular function after PCI in patients with ACS compared to clopidogrel: A systematic review and meta-analysis
Authors: Qiu Xiaohan , Li Xiaohui , Fu Kang , Chen Wentao , Chen Wenqiang
Published: August 2023

Background

The function of coronary microcirculation is an important factor in predicting the prognosis of patients with acute coronary syndrome (ACS) who receive percutaneous coronary intervention (PCI) therapy. Ticagrelor, a type of oral P2Y12 inhibitor, is widely prescribed to ACS patients and can improve prognosis compared to clopidogrel. However, the efficacy of ticagrelor on coronary microcirculation, compared to clopidogrel, remains unclear. The objective of this meta-analysis was to determine the efficacy of ticagrelor on coronary microcirculation.

Methods

The PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), and ClinicalTrials.gov databases were comprehensively searched to identify studies until November 2022. Data was pooled using the fixed effects model or random effects model based on the level of heterogeneity. Sensitivity analyses were performed to measure the effects of potential confounders.

Results

After screening, 16 trials with a total of 3676 participants were ultimately included in the analysis. The meta-analysis revealed that compared to clopidogrel, patients receiving ticagrelor exhibited a more significant reduction in the IMR (WMD: -6.23, 95% CI: -8.41 to -4.04), a reduction in the cTFC (WMD: -1.88; 95% CI: -3.32 to -0.45), and greater increases in CFR (WMD: 0.38; 95% CI: 0.18 to 0.57), MBG (RR 1.29, 95% CI 1.12 to 1.48), and TIMI (RR 1.03, 95% CI 1.00 to 1.06).

Conclusion

Our findings suggest that, compared to clopidogrel, ticagrelor has a significant effect in reducing coronary microcirculatory resistance, enhancing coronary blood flow reserve, and improving myocardial perfusion.