bluuebunny/crossref_metadata_2025 huggingface dataset:
Development and validation of a nomogram for predicting mechanical ventilation need among acutely intoxicated patients with impaired consciousness
Authors: Lashin Heba Ibrahim , Sobeeh Fatma Gaber , Sobh Zahraa Khalifa
Published: August 2024

Background

A considerable portion of acutely intoxicated patients is presented with impaired consciousness. Early identification of those patients who require advanced medical care, such as mechanical ventilation (MV), can improve their prognosis.

Methods

This study included 330 acutely intoxicated patients who were presented with impaired consciousness and admitted to Tanta University Poison Control Center, Egypt, in the period from January 2021 to December 2023. Patients were enrolled in derivation (257 patients) and validation (73 patients) cohorts. Patients’ data were analyzed to develop and validate a predictive nomogram to determine the probability of MV need in acutely intoxicated patients.

Results

Significant predictors for MV need were mean arterial blood pressure (OR = 0.96, p = .014), PaO2 (OR = 0.96, p = .001), pH (OR = 0.00, p < . 001), and glucose/potassium ratio (OR = 1.59, p = .030). These four parameters were used to formulate a bedside nomogram. Receiver-operating characteristic (ROC) analysis for the proposed nomogram shows that area under the curve (AUC) = 95.7%, accuracy = 93.4%, sensitivity = 88.9%, and specificity = 95.1%. The internal validation for the developed nomogram was assessed using a bootstrapping method and calibration curve. Regarding external validation, AUCs for the developed nomogram probability was 96.5%, and for predicted probability using the developed nomogram was 97.8%.

Conclusion

The current study provides a validated nomogram that could be used as a reliable tool for the accurate prediction of MV need among acutely intoxicated patients with impaired consciousness. It could assist in the early identification of patients who will require MV, especially in low-income countries with limited resources.
Bitcoin as a Distinct Asset Class for Hedging and Portfolio Diversification: A DCC-GARCH Model Analysis
Authors: Singh Vikrant Vikram , Singh Harendra , Ansari Aleem
Published: August 2024

Purpose:

Bitcoin, the most popular form of virtual currency, currently holds the highest market capitalization among cryptocurrencies and serves as a benchmark for the typical cryptocurrency. The main goal of this research is to evaluate Bitcoin’s potential as a distinct asset class. This will be achieved by building upon previous studies and investigating its utility as both a hedging instrument and a tool for portfolio diversification.

Methodology:

In this study, Bitcoin is compared with other asset classes, such as key stock indices of India’s Nifty-50 and Sensex, and key currency pairs with the Indian Rupee, including the US dollar ($), Euro (€), Pound sterling (£), and Japanese Yen (¥). Gold, as one of the most precise commodities, is analyzed using descriptive statistics to verify and confirm its properties as a distinct asset class. Additionally, the study employs the DCC-GARCH model to ascertain whether Bitcoin qualifies as both a hedging instrument and a tool for portfolio diversification.

Findings:

The findings of this study indicate that Bitcoins constitute a unique and separate category within alternative assets and investment classes. Various descriptive statistics confirm that Bitcoins exhibit characteristics of an asset class. Additionally, the study reveals and verifies the hedging and portfolio diversification capabilities of Bitcoin based on the results of the DCC-GARCH model.

Practical Implications:

The findings of this study will prove useful for investors considering cryptocurrency (Bitcoin) as an alternative asset class for diversifying their portfolios and hedging against volatility.

Originality/Value:

This study contributes to the research paradigm of Bitcoin finance by providing a perspective from a developing nation on Bitcoin as an asset class, which differs from other asset classes such as Nifty-50, Sensex, USD–INR, EUR–INR, GBP–INR, JPY–INR, and gold. While previous research has predominantly focused on developed nation contexts, this study underscores the importance of examining Bitcoin’s role in portfolio diversification and hedging strategies. To enhance our understanding, this research presents daily observations of recent economic data spanning from 2011 to 2021. Assessing whether Bitcoin qualifies as an alternative investment and a distinct asset class is crucial, as it could significantly influence investment decisions and serve as a valuable tool for risk management and diversification purposes for investors.
Nurses’ Experiences in Communicating With Immigrant Populations During COVID-19: Insights and Suggestions for Future Health Crises
Authors: Mahic Seila , Nortvedt Line , Alpers Lise-Merete
Published: August 2024

Introduction:

When providing health information in a diverse society and during health crises, it is crucial that nurses can adapt their communication to immigrants, as this may have an impact on their health outcomes. This study seeks to identify how nurses experienced and assessed their communication and information work with immigrants during COVID-19 and to discuss measures to improve practice.

Method:

The study has an interpretive and explorative qualitative design, analyzing 10 semi-structured interviews with nurses from the municipal health service in Norway.

Results:

Three themes were created as follows: multilingual infection control teams and cooperation with volunteers, challenges when providing COVID-19 information, and the nurses’ suggestions for improvements in the event of a new pandemic or other health crisis.

Discussion:

Nurses’ cultural competence and their knowledge of immigrants’ health literacy can help them understand how immigrants think and behave during illness. It is important that nurses use discretion during health crises.
Crafting Persuasive Stories: How Uncertainty and Sidedness Influence Narrative Efficacy in Promoting Updated COVID-19 Vaccination
Authors: Huang Yan
Published: August 2024

This study investigates the impact of narratives, message sidedness, and psychological uncertainty on promoting updated COVID-19 vaccination. A 2 (narrative vs. non-narrative) × 2 (one-sided vs. two-sided) × 2 (high vs. low uncertainty) between-subjects online experiment ( N = 600) revealed significant three-way interaction effects between narratives, sidedness, and uncertainty on vaccination attitudes and intentions. Specifically, when participants were primed to experience high uncertainty, the one-sided narrative was more persuasive than both the two-sided narrative and the one-sided nonnarrative message. Yet, under conditions of low uncertainty, distinct message types did not show differential persuasive effects. Moreover, the three-way interaction effects were mediated by emotional responses and counterarguing. Theoretical implications for narrative persuasion and practical implications for campaign message design are discussed.
Structure of Advance Care Planning Practice by Home Health Nurses for Multigenerational Families With Dependent Children and Terminally Ill Grandparents
Authors: Yasui Nagisa , Kawahara Tae , Yamazaki Akemi
Published: August 2024

The present study aimed to identify the structure of advance care planning (ACP) practices implemented by home health nurses (HHNs) for multigenerational families with dependent children and terminally ill grandparents. Interviews of 20 HHNs were conducted. The grounded theory approach was used to describe the interactions among families with dependent children, terminally ill grandparents, and HHNs. The results showed that the structure of ACP practices for multigenerational families with dependent children and terminally ill grandparents was composed of 2 levels. First, HHNs were providing the underlying foundational “Practice of supporting end-of-life care (EOL care) at home” for family members from 2 generations: sandwich generation caregivers (SGCs) and terminally ill grandparents. Second, they were providing “Practices that connect multiple generations,” “Practices that address the children,” and “Practices that involve hands-on experience and communication” for multigenerational families with dependent children and terminally ill grandparents. Practices based on providing stability among family members from 2 generations, SGCs and terminally ill grandparents, were the nursing practice structure that activated ACP for multigenerational families with dependent children and terminally ill grandparents.
Temperature Is a Key Factor Governing the Toxic Impact of Ultra-Violet Radiation-Emitting Nail Dryers When Used on Human Skin Cells
Authors: Finn Elijah , Dussan Lucia , Rosenthal Scott , Simbulan-Rosenthal Cynthia , Rosenthal Dean , Sykora Peter
Published: August 2024

The skin is the largest organ in the body and the only one to come into contact with solar UV radiation (UVR). UVA (320-400 nm) is a significant contributor to UV-related skin damage. The UVA spectrum makes up over 95% of solar-UV energy reaching the earth’s surface causing the majority of the visible signs of skin photoaging. Many consumer products also emit UVA, including nail dryers. There have been sporadic reports suggesting that these units may be contributing to skin cancer incidence. This notion was recently bolstered by a finding that nail dryer-irradiated mammalian skin cells develop a mutational signature consistent with UVA exposure. This report was surprising considering the comparatively low level of UVA to which the skin is exposed during nail treatments. In this research, we investigated how UVA-emitting devices caused cytotoxic/genotoxic impact after only low levels of UVA exposure. Our data showed that levels of UVA in the unit are highly variable and location dependent. We confirm previous reports that using prolonged exposure protocols could induce significant levels of DNA damage. It was also determined that UV-induced DNA damage only partially correlated with the level of UVA fluency. On investigation, we found that the unit had a rapid increase in internal temperature when in use. Exposing human cells to these elevated temperatures acted synergistically with UVA to magnify the cytotoxic and genotoxic impact of UV irradiation.
Ultrasound assessment of short peripheral catheter failure
Authors: Giustivi Davide , Celano Rosita , Cattalani Manuela , Camilli Claudia , Trombetta Lucia , Facchinetti Pietro , Bartoli Arianna , Bizzi Emanuele , Urso Francesco , Donadoni Mattia , Quici Massimiliano , La Cava Leyla , Calloni Maria , Martini Elena , Taino Alba , Cogliati Chiara , Gidaro Antonio
Published: August 2024

Introduction:

Short peripheral catheters (SPCs) are affected by a high complication rate that leads to catheter failure. Currently, the Visual Infusion Phlebitis score (VIP) is the most used tool to verify the presence of inflammatory complications (phlebitis and thrombophlebitis). However, ultrasound signs (US) may be an attractive alternative.

Objective:

This study aims to evaluate the sensitivity and specificity of US and VIP score = 1 in identifying and recognizing early signs of SPC failure. The time to positivity for US and VIP scores was assessed as a secondary outcome.

Methods:

An observational prospective study was conducted. In each patient, US (subcutaneous edema; fibroblastic sleeve; thrombophlebitis) and VIP of the exit site were performed every 24 h until 96 h after insertion. Compared to catheter failure, Sensitivity, Specificity, and Predictive values in both US and VIP were calculated.

Results:

Two hundred patients were enrolled. The presence of ultrasonic pattern suggestive of edema at 72 h ( p = 0.018), fibroblastic sleeve at 24, 48, 72, and 96 h ( p < 0.001), thrombosis at 48 ( p < 0.001) and 72 h ( p = 0.005), and at least one of an abovementioned US at all checkpoints ( p < 0.001) were highly significant predictors of complications. Both US and VIP effectively detect inflammatory events; however, the US showed better sensitivity in overall checkpoints and earlier predictive ability than VIP (1.9 vs 0.47 days).

Conclusions:

An ultrasound inflammatory pattern is correlated with SPC failure. An ultrasound protocol—requiring minimal training—is more effective than VIP in recognizing early signs of device failure.
What is ‘children’s television’ in the streaming era?: Assessing content discoverability through Australian children’s streaming platform fluencies
Authors: Balanzategui Jessica , Baker Djoymi , Clift Georgia
Published: August 2024

In line with international trends, increasing numbers of children in Australia use streaming video platforms to watch television on-demand from extensive catalogues. Child viewers thus tend to negotiate platform interfaces organised by algorithmic curation to select content, rather than accessing content via scheduled linear TV. The deeper implications of this substantial shift in child audience habits around television have yet to be robustly reckoned with across scholarly and national policy approaches. Indeed, policy settings in Australia have not kept pace with these transformations, one result of which has been that 84% less Australian content was aired on free-to-air commercial broadcasters in 2022 compared to 2019. Key producer bodies fear the sector is in serious peril and may not withstand the current instability. Given that local children’s television meets Australian children’s best interests by situating them within their own socio-cultural context, the issue has become a site of significant policy, industry, and cultural concern. At this precarious time for the Australian children’s television sector, this article outlines key findings of a mixed method study with Australian children aged 7–9 ( n = 37) and their adult guardians to illustrate how children understand, identify, and discover ‘local’ and ‘children’s’ content on streaming platforms. This child audience research contributes to current policy and scholarly debates around the ‘routes to content’ audiences develop in the streaming era. A focus of our analysis is how and if children find Australian content. Our aim is to shed light on how ‘discoverability’ issues compound the current state of turmoil for the sector. We elucidate children’s digital fluencies with platform interfaces but highlight their limited cultural literacies with the content itself, which poses significant implications for industry and policy strategy around local content discoverability for child audiences on streaming platforms.
Recurrence Rates after Primary Femoral Hernia Open Repair a Systematic Review
Authors: Romano Lucia , Fiasca Fabiana , Mattei Antonella , Di Donato Giada , Venturoni Andrea , Schietroma Mario , Giuliani Antonio
Published: August 2024

Purpose

Femoral hernia accounts for 22% of groin hernia operations in women and for 1.1% in men. Numerous surgical approaches have been reported but there is no consensus. Many of the recurrence rates are reported in old literature, while recent reports are scarce. The aim of the present study was to review rates of recurrences in patients who underwent open repair of a primary femoral hernia.

Methods

We conducted a systematic search in the electronic literature, using the search terms “femoral hernia” and “recurrence”. We included studies published from 2002 that had as primary or secondary endpoint to evaluate the recurrence after surgery. Risk of bias was assessed by the Cochrane risk of bias tool for RCT and by the Newcastle-Ottawa Scale for cohort studies.

Results

Fifteen eligible articles were included in our systematic review. A total of 1087 procedures were performed according to the defined criteria. The metanalytic evaluation highlighted a higher probability of recurrence for non-mesh than mesh repairs (6.5% vs 1.9%; RR 0.924, 95% CI: 0.857 - 0.996). In patients treated in emergency settings the rate of recurrences was 3.7%; in patients who received elective repairs it was 0.71%. Six studies reported that most of recurrences occurred within the first post-operative year.

Conclusion

We found that crude recurrence rate after open repair of a primary femoral hernia is about 4%. This rate is higher in case of non-mesh techniques and in emergency surgery. Our results support the recommendation that femoral hernias should be repaired with mesh techniques.
Australian Attitudes Towards Waivers of Consent Within the Context of Genomic Data Sharing
Authors: Newett Lyndsay , McWhirter Rebekah , Eckstein Lisa , Warren Vanessa , Nicol Dianne
Published: August 2024

This research identifies the circumstances in which Human Research Ethics Committees (HRECs) are trusted by Australians to approve the use of genomic data – without express consent – and considers the impact of genomic data sharing settings, and respondent attributes, on public trust. Survey results ( N = 3013) show some circumstances are more conducive to public trust than others, with waivers endorsed when future research is beneficial and when privacy is protected, but receiving less support in other instances. Still, results imply attitudes are influenced by more than these specific circumstances, with different data sharing settings, and participant attributes, affecting views. Ultimately, this research raises questions and concerns in relation to the criteria HRECs use when authorising waivers of consent in Australia.
A comparative study of machine learning methods for identifying the 15 CIE standard skies
Authors: Aghimien Emmanuel I , Li Danny HW , Tsang Ernest KW , Agbajor Favour D
Published: August 2024

For energy-efficient building designs, the solar irradiance and daylight illuminance derived from the CIE standard skies are useful. Over time, the sky luminance distributions have been used to identify these standard skies, but these are sparingly measured. Thus, the use of available climatic variables has become a viable alternative. Nevertheless, it is necessary to determine if these climatic variables could correctly identify these skies. This study addresses the lack of luminance distribution measurement by classifying the standard skies using measured climatic data in Hong Kong. The classification approach was improved by using the machine learning (ML) method. For comparative analysis, five popular ML classification algorithms i.e., decision tree (DT), k-nearest neigbhour (KNN), light gradient boosting machine (LGBM), random forest (RF) and support vector machines (SVM) were used. The findings show that accuracies of 68.1, 73.1, 74.3, 74.5, and 75.4% were obtained for the DT, KNN, SVM, LGBM, and RF models, respectively. Similarly, the F1 scores were 66.6, 70.2, 71.8, 72.1 and 72.9%, for the DT, KNN, SVM, LGBM, and RF models. The result shows that the RF model gave the best performance while DT performed the least. Also, the obtained accuracies and F1 scores show that all models would classify the standard skies with reasonable accuracy. Furthermore, feature importance was done, and it was found that Kd, Tv, Kt, α, sun, and cld are the most important input parameters for sky classification. Lastly, vertical solar irradiance ( GVT) and illuminance ( GVL) were estimated using the skies predicted by the proposed models. Upon predictions, it was observed that the GVT ranged from 14.7 to 24.6% while the GVL from 13.8 to 19.9%. Generally, most of the predictions were less than 20%, which shows good predictions were obtained from the models.
Asiatic Acid, Quercetin, and Kaempferol From Centella asiatica as Potential Inhibitors of Alpha-1-Antichymotrypsin in Alzheimer's Disease
Authors: Chatterjee Jhinuk , Atmuri Apoorva , Raichur Eshaana Janardhan , Anil Gouri
Published: August 2024

Selected compounds from Centella asiatica with proven neuroprotective potential and analyzed strong binding affinity with molecular docking can be considered as potential inhibitors for alpha-1-antichymotrypsin in Alzheimer's disease.
Material perception across different media—comparing perceived attributes in oil paintings and engravings
Authors: Zhao Yuguang , Stumpel Jeroen , de Ridder Huib , Wijntjes Maarten W. A.
Published: August 2024

We investigated the influence of the medium on the perception of depicted objects and materials. Oil paintings and their reproductions in engravings were chosen because they are vastly distinctive media while having completely identical content. A total of 15 pairs were collected, consisting of 88 fragments depicting different materials, including fabric, skin, wood and metal. Besides the original condition, we created three manipulations to understand the effect of colour (a greyscale version) and contrast (equalised histograms towards both painting and engraving). We performed rating experiments on five attributes: three-dimensionality, glossiness, convincingness, smoothness and softness. An average of 25 participants finished each of the 20 online experimental sessions (five attributes X four conditions). Besides clear correlations between the two media, the differences mainly show in their means (different levels of perceived attributes) and standard deviations (perceived range). In most sessions, paintings depict a wider range than engravings. In addition, it was the histogram equalisation (global contrast) that made the most impact on perceived attributes, rather than colour removal. This suggests that engravers compensated for the lack of colour by exploiting the possibilities of local contrast.
Factors Influencing Residents’ Willingness to Pay for Mangrove Forest Environmental Services in Phu Long, Vietnam
Authors: Dat Luu Quoc , Chou Shuo-Yan , Tam Pham Minh , Hue Nguyen Thi , Thuy Pham Thu
Published: August 2024

The development of mangrove forest environmental services plays a crucial role in human health, economic development, and the security of countries worldwide. This study aims to establish and validate a model for assessing the factors influencing the willingness-to-pay for mangrove forest environmental services. The proposed model comprises four key factors: attitude, subjective norm, perceived behavior control, and environmental knowledge. Data were collected by surveying 235 individuals from various households in Phu Long commune, Vietnam. The Partial Least Squares—Structural Equation Modeling (PLS-SEM) methodology was employed for data analysis. The research findings reveal that perceived behavior control significantly impacted residents’ willingness-to-pay, followed by attitude, environmental knowledge, and subjective norms. Furthermore, certain demographic characteristics such as gender and family size mediate the relationship between independent and dependent variables. Based on the obtained results, several policy recommendations are put forward.
The Feasibility of Condylar Screws for Occipitocervical Fusion in Arabs: Computed Tomography-Based Morphometric Study
Authors: Marwan Yousef , Jarragh Ali , Algarni Nizar , Sheikh Mehraj , Alsaeed Osama
Published: August 2024

Study Design

Retrospective, cross-sectional study.

Objectives

Occipitocervical fusion is indicated for various conditions. Some techniques require placement of screws in the occipital condyle. The objective of this study was to analyze the morphometric features of the occipital condyle among Arabs.

Methods

Computed tomography (CT)-based morphometric analysis of occipital condyles of 200 Arab skeletally mature patients (400 condyles) was done. Axial width of at least 8 mm and coronal height of at least 6.5 mm are the cutoff values for feasibility of condylar screw placement.

Results

The mean age of the patients was 48.0 ± 18.3 years. Males were 53.5% (107) of the sample. The mean axial condylar width and length were 8.5 ± 1.5 mm and 20.3 ± 2.6 mm, respectively, while the mean axial screw angle was 35.9° ± 5.5° from midline. The mean sagittal condylar length and height were 16.1 ± 1.9 mm and 8.8 ± 1.5 mm, respectively. The mean condylar coronal height was 8.2 ± 1.4 mm. Based on axial width and coronal height measurements, 150 (37.5%) condyles could safely fit a 3.5 mm condylar screw. One hundred and four (55.9% female condyles) condyles cannot fit a screw in females, while 46 (21.5% male condyles) condyles cannot fit a screw in males.

Conclusions

Condylar screw for occipitocervical fusion is feasible for the majority of Arabs in our sample; however, this applies to slightly less than half of the female condyles. Detailed preoperative radiological planning is critical to avoid complications related to occipital condyle screw placement.
Importance of Unconscious Conditioning: Case Study of Mithila
Authors: Mishra Shruti
Published: August 2024

The main aim of the article is to identify and understand the existing ritualistic practices followed in Mithila (a community in India) to nurture and imbibe values among the younger generation. The phenomenon being studied is ‘unconscious conditioning’ within the context of ‘Mithila culture’, using analytical psychology and Triguna theory. Both primary and secondary data have been used for this case study. The respondents were chosen through purposive sampling keeping the objective of the paper in mind. Secondary data included literature in the forms of books, articles and papers which have been written on the said topic. Constructivist grounded theory has been used to analyse the data. The findings show that there are different stages that an individual goes through to gain balance between the conscious and the unconscious. These stages are like stepping stones to attaining wholeness or in Maslow’s terms ‘self-actualization’. Ritualistic practices, traditional motifs and drawings become an integral part of one’s psyche and influence everyday decision-making process. These practices are especially important during major transitions in life—like birth, death, weddings and so on, making it easier and more comfortable for the said individual. The article helps us understand the linkage between analytical psychology, Triguna theory and its implication in our lives.
Sociodemographic Inequalities in Student Achievement: An Intersectional Multilevel Analysis of Individual Heterogeneity and Discriminatory Accuracy (MAIHDA)
Authors: Prior Lucy , Evans Clare , Merlo Juan , Leckie George
Published: August 2024

Sociodemographic inequalities in student achievement are a persistent concern for education systems and are increasingly recognized to be intersectional. Intersectionality considers the multidimensional nature of disadvantage, appreciating the interlocking social determinants which shape individual experience. Intersectional multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA) is a new approach developed in population health but new to educational research. In this study, we introduce and apply this approach to study sociodemographic inequalities in student achievement across two cohorts of students in London, England. We define 144 intersectional strata arising from combinations of student age, gender, free school meal status, special educational needs, and ethnicity. We find substantial stratum-level variation in achievement composed primarily by additive rather than interactive effects with results stubbornly consistent across the two cohorts. We conclude that policymakers should pay greater attention to multiply marginalized students and intersectional MAIHDA provides a useful approach to study their experiences.
Multicenter validation of synthetic FLAIR as a substitute for FLAIR sequence in acute ischemic stroke
Authors: Hamon Guillaume , Legrand Laurence , Hmeydia Ghazi , Turc Guillaume , Hassen Wagih Ben , Charron Sylvain , Debacker Clement , Naggara Olivier , Thirion Bertrand , Chen Bailiang , Lapergue Bertrand , Oppenheim Catherine , Benzakoun Joseph
Published: August 2024

Purpose:

To evaluate performance of synthetic and real FLAIR for identifying early stroke in a multicenter cohort.

Methods:

This retrospective study was conducted using DWI and FLAIR extracted from the Endovascular Treatment in Ischemic Stroke image registry (2017–2021). The database was partitioned into subsets according to MRI field strength and manufacturer, and randomly divided into training set (70%) used for model fine-tuning, validation set (15%), and test set (15%). In test set, five readers, blinded to FLAIR sequence type, assessed DWI-FLAIR mismatch using real and synthetic FLAIR. Interobserver agreement for DWI-FLAIR rating and concordance between synthetic and real FLAIR were evaluated with kappa statistics. Sensitivity and specificity for identification of ⩽4.5 h AIS were compared in patients with known onset-to-MRI delay using McNemar’s test.

Results:

1454 complete MRI sets (1172 patients, median (IQR) age: 73 years (62–82); 762 women) acquired on 125 MRI units were analyzed. In test set (207 MRI), interobserver reproducibility for DWI-FLAIR mismatch labeling was substantial for real and synthetic FLAIR (Fleiss κ = 0.79 (95%CI: 0.73–0.84) and 0.77 (95%CI: 0.71–0.82), respectively). After consensus, concordance between real and synthetic FLAIR was excellent (κ = 0.85 (95%CI: 0.78–0.92)). In 141 MRI sets with known onset-to-MRI delay, diagnostic performances for ⩽4.5 h AIS identification did not differ between real and synthetic FLAIR (sensitivity: 60/71 (85%) vs 59/71 (83%), p = .56; specificity: 65/70 (93%) vs 65/70 (93%), p > 0.99).

Conclusion:

A deep-learning-based FLAIR fine-tuned on multicenter data can provide comparable performances to real FLAIR for early AIS identification. This approach may help reducing MR protocol duration and motion artifacts.
Review on the Fabrication of Surface Functional Structures for Enhancing Bioactivity of Titanium and Titanium Alloy Implants
Authors: Tang Heng , Xu Jiaxiang , Guo Bin , Xie Yansong , Sun Yalong , Lu Yanjun , Tang Yong
Published: August 2024

Titanium and its alloys have been widely applied in many biomedical fields because of its excellent mechanical properties, corrosion resistance and good biocompatibility. However, problems such as rejection, shedding and infection will occur after titanium alloy implantation due to the low biological activity of titanium alloy surface. The structures with specific functions, which can enhance osseointegration and antibacterial properties, are fabricated on the surface of titanium implants to improve the biological activity between the titanium implants and human tissues. This paper presents a comprehensive review of recent developments and applications of surface functional structure in titanium and titanium alloy implants. The applications of surface functional structure on different titanium and titanium alloy implants are introduced, and their manufacturing technologies are summarized and compared. Furthermore, the fabrication of various surface functional structures used for titanium and titanium alloy implants is reviewed and analyzed in detail. Finally, the challenges affecting the development of surface functional structures applied in titanium and titanium alloy implants are outlined, and recommendations for future research are presented.
COI Barcodes combined with multilocus data for representative Aporia taxa shed light on speciation in the high altitude Irano-Turanian mountain plateaus (Lepidoptera: Pieridae)
Authors: Nazari Vazrick , Lukhtanov Vladimir , Naderi Alireza , Bruna Costantino Della , Zahiri Reza , Cesaroni Donatella , Sbordoni Valerio , Todisco Valentina
Published: August 2024

Even though the high plateaus of Qinghai-Tibet and Iran share many faunal elements, the historical biogeography of the species present in this area are not very well understood. We present a complete COI barcode library for Aporia Hübner and a first comprehensive phylogeny for the genus including all known species and majority of subspecies using ten available genes (COI-COII, ND1, ND5, Cytb, EF-1a, Wg, 16S, 28S-D2/D3 and 28S-D8). We then focus on A. leucodice (Eversmann, 1843) and related taxa in order to resolve some long-standing taxonomic issues in this species-group. Based on DNA sequence data as well as morphology, we raise Aporia illumina (Grum-Grshimailo 1890) stat. nov. (= pseudoillumina Tshikolovets 2021 syn. nov.) as a distinct species and designate a lectotype; synonymize Aporia leucodice leucodice Eversmann, 1843 (= A. l. morosevitshae Sheljuzhko, 1908 syn. nov.); and describe a new species, Aporia ahura sp. nov., from the Central Alborz Mountains in northern Iran.
Combining distribution modelling and phylogeography to understand present, past and future of an endangered spider
Authors: Milano Filippo , Casazza Gabriele , Galimberti Andrea , Maggioni Davide , Isaia Marco
Published: August 2024

Background

Understanding how endangered species respond to climatic changes is fundamental for their conservation. Due to its restricted geographic range, its sensitivity to the ongoing global warming and its continuing decline, the Southwestern-Alpine endemic wolf spider Vesubia jugorum is currently classified as Endangered in the IUCN Red List. Here, we combined species distribution modelling (SDM) and phylogeographic inference to describe the present, the past and the future of this species in light of the mtDNA genetic structure of extant populations.

Results

Phylogenetic and network analyses show a high level of genetic differentiation and a strong genetic structure of the populations, likely explicable by a long history of isolation and survival in separate refugia. The SDM projection into past climatic conditions supports these results by showing a smaller distribution range compared to present, mostly restricted to the Maritime and Ligurian Alps, which possibly served as main refugium. Future forecast shows a significant shift in the bioclimatic range towards higher altitudes and latitudes, with a drastic decrease of habitat suitability in the central and south-eastern parts of the range, with consequent general loss of haplotype diversity.

Conclusion

SDM and phylogeographic inference support the hypothesis that the current distribution and the genetic structure of the extant populations mirror the survival in situ of Vesubia jugorum across repeated glacial and interglacial phases, in line with the ‘long-term stability hypothesis’. Future predictions show a significant shift in the bioclimatic range that V. jugorum will be likely unable to track, with profound impact on its long-term survival and its genetic diversity. Our considerations have implication for conservation genetics, highlighting the pivotal role of the transboundary protected areas of the SW-Alps in promoting conservation efforts for this species.
Machine learning-enabled detection of attention-deficit/hyperactivity disorder with multimodal physiological data: a case-control study
Authors: Andrikopoulos Dimitrios , Vassiliou Georgia , Fatouros Panagiotis , Tsirmpas Charalampos , Pehlivanidis Artemios , Papageorgiou Charalabos
Published: August 2024

Background

Attention-Deficit/Hyperactivity Disorder (ADHD) is a multifaceted neurodevelopmental psychiatric condition that typically emerges during childhood but often persists into adulthood, significantly impacting individuals’ functioning, relationships, productivity, and overall quality of life. However, the current diagnostic process exhibits limitations that can significantly affect its overall effectiveness. Notably, its face-to-face and time-consuming nature, coupled with the reliance on subjective recall of historical information and clinician subjectivity, stand out as key challenges. To address these limitations, objective measures such as neuropsychological evaluations, imaging techniques and physiological monitoring of the Autonomic Nervous System functioning, have been explored.

Methods

The main aim of this study was to investigate whether physiological data (i.e., Electrodermal Activity, Heart Rate Variability, and Skin Temperature) can serve as meaningful indicators of ADHD, evaluating its utility in distinguishing adult ADHD patients. This observational, case-control study included a total of 76 adult participants (32 ADHD patients and 44 healthy controls) who underwent a series of Stroop tests, while their physiological data was passively collected using a multi-sensor wearable device. Univariate feature analysis was employed to identify the tests that triggered significant signal responses, while the Informative k-Nearest Neighbors (KNN) algorithm was used to filter out less informative data points. Finally, a machine-learning decision pipeline incorporating various classification algorithms, including Logistic Regression, KNN, Random Forests, and Support Vector Machines (SVM), was utilized for ADHD patient detection.

Results

Results indicate that the SVM-based model yielded the optimal performance, achieving 81.6% accuracy, maintaining a balance between the experimental and control groups, with sensitivity and specificity of 81.4% and 81.9%, respectively. Additionally, integration of data from all physiological signals yielded the best results, suggesting that each modality captures unique aspects of ADHD.

Conclusions

This study underscores the potential of physiological signals as valuable diagnostic indicators of adult ADHD. For the first time, to the best of our knowledge, our findings demonstrate that multimodal physiological data collected via wearable devices can complement traditional diagnostic approaches. Further research is warranted to explore the clinical applications and long-term implications of utilizing physiological markers in ADHD diagnosis and management.
A dual methodology employing ion-pair chromatography and built-in UV spectrophotometry for quantifying recently approved combination of mometasone and indacaterol in a novel combined metered dose inhaler: assessing the greenness, carbon footprint, blueness, and whiteness
Authors: El-Masry Amal A. , Abbas Ahmed Emad F. , Salem Yomna A.
Published: August 2024

Developing analytical techniques that align with green and sustainable chemistry principles is crucial in today's scientific landscape. This work introduces two innovative approaches for the simultaneous quantification of indacaterol (IND) and mometasone (MOM), a recently approved combination therapy for chronic obstructive pulmonary disease. These methods—rapid isocratic ion pair chromatography (IPC) and UV–visible spectrophotometry—demonstrate improved environmental sustainability, cost-effectiveness, and versatility compared to existing techniques. The optimized 4-min IPC method achieved excellent resolution (retention times 2.18 ± 0.1 min for IND and 3.95 ± 0.1 min for MOM), peak symmetry, and sensitivity. It utilizes a low-cost ion pair mobile phase of acetonitrile and acidified water containing 0.025% sodium dodecyl sulfate (50:50% v/v), making it suitable for laboratories with standard chromatographic instruments. The spectrophotometric approach offers two procedures: first derivative and ratio derivative methods. These serve as simplified, low-cost alternatives for resource-limited laboratories without access to advanced instruments. Both techniques feature simplified protocols that minimize extraction and fractionation steps. Comprehensive validation confirmed outstanding accuracy (98–102%) and precision (%2 <). Sustainability assessments using ComplexGAPI, AGREE, carbon footprint, BAGI, and RGB12 tools demonstrated enhanced environmental performance compared to existing methods. The IPC and spectrophotometry methods achieved greenness scores of 0.81 and 0.85, respectively, surpassing the 0.63–0.67 range of reported techniques. Additionally, they showed lower carbon footprints of 0.035 and 0.022 kg CO2 equivalent emissions per sample, compared to 0.079–0.092 kg for conventional procedures. The application of novel "blueness" and "whiteness" concepts using BAGI and RGB12 algorithms further confirmed superior sustainability, with scores of 87.5 & 90 for blueness and 88.1 & 89.8 for whiteness. Successfully applied to quantify IND and MOM in combined capsules, this work provides a model for eco-friendly pharmaceutical analysis that maintains high analytical reliability while improving sustainability metrics.
Efficiency of acetate-based isopropanol synthesis in Escherichia coli W is controlled by ATP demand
Authors: Kutscha Regina , Tomin Tamara , Birner-Gruenberger Ruth , Bekiaris Pavlos Stephanos , Klamt Steffen , Pflügl Stefan
Published: August 2024

Background

Due to increasing ecological concerns, microbial production of biochemicals from sustainable carbon sources like acetate is rapidly gaining importance. However, to successfully establish large-scale production scenarios, a solid understanding of metabolic driving forces is required to inform bioprocess design. To generate such knowledge, we constructed isopropanol-producing Escherichia coli W strains.

Results

Based on strain screening and metabolic considerations, a 2-stage process was designed, incorporating a growth phase followed by a nitrogen-starvation phase. This process design yielded the highest isopropanol titers on acetate to date (13.3 g L−1). Additionally, we performed shotgun and acetylated proteomics, and identified several stress conditions in the bioreactor scenarios, such as acid stress and impaired sulfur uptake. Metabolic modeling allowed for an in-depth characterization of intracellular flux distributions, uncovering cellular demand for ATP and acetyl-CoA as limiting factors for routing carbon toward the isopropanol pathway. Moreover, we asserted the importance of a balance between fluxes of the NADPH-providing isocitrate dehydrogenase (ICDH) and the product pathway.

Conclusions

Using the newly gained system-level understanding for isopropanol production from acetate, we assessed possible engineering approaches and propose process designs to maximize production. Collectively, our work contributes to the establishment and optimization of acetate-based bioproduction systems.

Graphical Abstract
A factor score clustering approach to analyze the biopharmaceutical sector in the Chinese market during COVID-19
Authors: Xi Jiahui , Wen Conghua , Tang Yifan , Zhao Feifan
Published: August 2024

The biopharmaceutical sector is of considerable interest during the COVID-19 pandemic. This study aims to investigate the biopharmaceutical sector using the Shenwan Industry Classification and provides insights into investment strategies. We combine factor and cluster analyses to reduce data dimensions and detect their latent similarities. Specifically, the biopharmaceutical sector is divided into six categories based on second-level industry classification. It is observed that medical devices, medical services, biological products, and chemical pharmaceuticals maintained their upward tendency, while Chinese medicine and pharmaceutical commerce declined slightly. We also develop optimal investment strategies using various metrics for different investor types.
Systematic review of methods used in prediction models with recurrent event data
Authors: Watson Victoria , Smith Catrin Tudur , Bonnett Laura J.
Published: August 2024

Background

Patients who suffer from chronic conditions or diseases are susceptible to experiencing repeated events of the same type (e.g. seizures), termed ‘recurrent events’. Prediction models can be used to predict the risk of recurrence so that intervention or management can be tailored accordingly, but statistical methodology can vary. The objective of this systematic review was to identify and describe statistical approaches that have been applied for the development and validation of multivariable prediction models with recurrent event data. A secondary objective was to informally assess the characteristics and quality of analysis approaches used in the development and validation of prediction models of recurrent event data.

Methods

Searches were run in MEDLINE using a search strategy in 2019 which included index terms and phrases related to recurrent events and prediction models. For studies to be included in the review they must have developed or validated a multivariable clinical prediction model for recurrent event outcome data, specifically modelling the recurrent events and the timing between them.

The statistical analysis methods used to analyse the recurrent event data in the clinical prediction model were extracted to answer the primary aim of the systematic review. In addition, items such as the event rate as well as any discrimination and calibration statistics that were used to assess the model performance were extracted for the secondary aim of the review.

Results

A total of 855 publications were identified using the developed search strategy and 301 of these are included in our systematic review. The Andersen-Gill method was identified as the most commonly applied method in the analysis of recurrent events, which was used in 152 (50.5%) studies. This was closely followed by frailty models which were used in 116 (38.5%) included studies. Of the 301 included studies, only 75 (24.9%) internally validated their model(s) and three (1.0%) validated their model(s) in an external dataset.

Conclusions

This review identified a variety of methods which are used in practice when developing or validating prediction models for recurrent events. The variability of the approaches identified is cause for concern as it indicates possible immaturity in the field and highlights the need for more methodological research to bring greater consistency in approach of recurrent event analysis. Further work is required to ensure publications report all required information and use robust statistical methods for model development and validation.

PROSPERO registration

CRD42019116031.
Comparative study of low-density versus high-density pedicular screw implantations in management of adolescent idiopathic scoliosis: a randomized clinical trial
Authors: Mostafa Hosam Eldin , Moustafa Abdelrhman Saber Sayed , El Zayat Hazem Hassan , Koheil Ahmed , Ragab Omar Abdel Aleem
Published: August 2024

Background

A number of studies have yielded disparate findings regarding the relationship between implant density and curve correction in adolescent idiopathic scoliosis (AIS) surgery. This study compared the efficacy and safety of low-density (LD) versus high-density (HD) pedicular screw implants in the correction of deformity in AIS regarding clinical, radiological, and quality of life outcomes.

Methods

This study was a single-blind, parallel, randomized trial that enrolled 20 adolescent patients with idiopathic scoliosis scheduled for posterior spinal fusion surgery with all pedicle screw constructs. Patients were randomized into two groups of 10 patients each. The LD group included patients in whom the number of screws per fused spinal level had a density of 1.5 or less, while the HD group had a density greater than 1.5. The primary outcomes were the radiological findings of curve correction. The secondary outcomes included the correlation between implant density and curve correction, the amount of blood loss, operation time, number of screws, fusion level, hospital stay duration, and quality of life assessed by the Scoliosis Research Society 22r questionnaire.

Results

Radiologically, the postoperative main curves Cobb angles and their changes were comparable between both approaches without statistical correlation with the implant density (p˃0.05). The LD approach significantly shortened the operative time (p=0.015), number of screws (p=0.011), implant density (p<0.001), and hospital stay (p<0.001). However, quality of life scores before surgery and at final follow-up did not differ between the two techniques (p˃0.05).

Conclusions

The use of a low-density approach is an effective and safe methodology for attaining satisfactory deformity correction in AIS patients. Furthermore, this approach confers the additional advantage of reduced operative time, number of screws, implant density, and hospital stay in comparison to the high-density approach.

Trial registration Pan African Clinical Trial Registry, PACTR202404611444119. Registered 28 March 2024-Retrospectively registered, https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=29382