bluuebunny/crossref_metadata_2025 huggingface dataset:
Physical, thermal and mechanical properties of horse tail and mane hairs
Authors: Üstüntağ Sümeyye , Paşayev Nazim
Published: December 2023

Purpose

This study aims to comparatively reveal the physical, thermal and mechanical properties of horse tail and mane hairs, which have the potential to be used in many areas.

Design/methodology/approach

Physical properties of horsehairs such as diameter, density, moisture and water absorption were measured. Fourier transform infrared, field emission scanning electron microscopy and amino acid analyzes were applied to the hairs. Thermal stability of horsehair was investigated by thermogravimetric analysis and differential scanning calorimetry analysis. In addition, breaking strength and elongation values of mane and tail hairs were measured.

Findings

As a result of morphological analysis of horsehair, it was observed that there are usually gaps in the internal structure of horsehair, but the size and continuity of these gaps vary. It has been determined that there is a significant difference between the tenacity values of tail and mane hairs as well as geometric characteristics. In addition, amino acid analysis has shown that the amino acid contents of horse tail and mane hairs are similar and not much different from sheep’s wool.

Originality/value

Horsehair has been used for various purposes such as clothing, accessories, brushes, upholstery and reinforcement material. To use horsehair in accordance with its application area and performance characteristics, it is necessary to know its physical, thermal and mechanical properties. It is considerable to reveal the similar and different aspects of tail and mane hairs to determine whether they are alternatives to each other. Therefore, revealing the characteristics of tail and mane hairs comparatively constitutes the originality of this study.
Transit and treatment: Aligning systems to address substance use in Connecticut
Authors: Cohen Jeffrey P. , Huleatt Steven , Murphy Shane , Rash Carla J.
Published: December 2023

Objective

Test hypotheses that proximity to new transit improves substance use disorder treatment provider cost efficiency (i.e., economies of scale and scope).

Data Sources and Study Setting

Connecticut substance uses disorder treatment providers/programs. A 2015 rapid transit line opening with 10 stations, near some providers/programs. Providers' annual operating costs from publicly available federal tax forms (2013–2018). Annual client counts, service‐type (including substance use disorder and/or mental health, among others), and location data, for 50 providers and their programs, from Department of Mental Health and Addiction Services, with an unbalanced panel of 285 provider‐years.

Study Design

Economies of scale occur when the percent change in operating costs is less than the percentage change in clients. Economies of scope occur when operating costs fall as providers treat clients with multiple service needs. With our quasi‐experimental, multivariate regressions approach, we test hypotheses that proximity to a new transit line enhances economies of scale and scope (i.e., lowers unit operating costs).

Data Collection/Extraction Methods

Annual provider‐level operating costs merged with new transit station locations and Department of Mental Health and Addiction Services program/provider‐level secondary data (locations, client counts/completions/dates, service types, and average demographics).

Principal Findings

For providers with programs within 1‐mile of new transit (compared with a “control” sample beyond 1‐mile of new transit), (i) a 10% increase in clients leads to a 0.12% lower operating costs per client; (ii) a 10% increase in clients completing treatment results in a 1.5% decrease in operating costs per client; (iii) a 10% increase in clients receiving treatment for multiple services causes a 0.81% lower operating costs per client; (iv) offering multiple services leads to 6.3% lower operating costs.

Conclusions

New transit proximity causes operating cost savings for substance use disorder/mental health treatment providers. System alignment may benefit transit and health care sectors.
The Rapid Development of Bioeconomy Policies in the EU and other Regions of the World
Authors: M'barek Robert , Wesseler Justus
Published: December 2023

In the European Union, the bioeconomy is very broadly defined, encompassing all sectors and associated services and investments that produce, use, process, distribute or consume biological resources, including ecosystem services. It is seen as a natural enabler and result of the transformation proposed by Europe's sustainable growth strategy, the Green Deal. EU Member States and regions also have strategies to further target the implementation of the bioeconomy. The bioeconomy and its related policies have shown a rapid development in the EU and other regions of the world. In challenging times, the sustainable and circular bioeconomy is a central element in supporting the transition to an economy that is climate‐neutral, while preserving the biosphere. From the global agenda of United Nation's Sustainable Development Goals (SDGs), climate change and biodiversity, several other international organisations, global fora, and private initiatives, all provide knowledge, analyses and perspectives for the bioeconomy. Africa's bioeconomy has a huge potential as a catalyser for advancing towards many SDGs. In North America, the US has recently defined bold goals for biotechnology and biomanufacturing. South American countries foster their enormous agricultural and forestry potential in supporting the bioeconomy, while playing a key role for global climate and biodiversity.

The bioeconomy in its different designs is thus an important building block for the global transformation towards a more sustainable economic system.
Awake proning in patients with COVID‐19‐related hypoxemic acute respiratory failure: Endorsement by the Scandinavian Society of Anaesthesiology and Intensive Care Medicine
Authors: Rehn Marius , Chew Michelle , Kalliomäki Maija‐Liisa , Olkkola Klaus T. , Sigurðsson Martin Ingi , Møller Morten Hylander
Published: December 2023

Background

Awake proning in spontaneously breathing patients with hypoxemic acute respiratory failure was applied during the coronavirus disease 2019 (COVID‐19) pandemic to improve oxygenation while avoiding tracheal intubation. An updated systematic review and meta‐analysis on the topic was published.

Methods

The Clinical practice committee (CPC) of the Scandinavian Society of Anaesthesiology and Intensive Care Medicine (SSAI) assessed the clinical practice guideline “Awake proning in patients with COVID‐19‐related hypoxemic acute respiratory failure: A rapid practice guideline” for possible endorsement. The Appraisal of Guidelines for REsearch and Evaluation (AGREE) II tool was used.

Results

Four out of six SSAI CPC members completed the appraisal. The individual domain totals were: Scope and Purpose 90%; Stakeholder Involvement 89%; Rigour of Development 74%; Clarity of Presentation 85%; Applicability 75%; Editorial Independence 98%; Overall Assessment 79%.

Conclusion

The SSAI CPC endorses the clinical practice guideline “Awake proning in patients with COVID‐19‐related hypoxemic acute respiratory failure: A rapid practice guideline”. This guideline serves as a useful decision aid for clinicians caring for critically ill patients with COVID‐19‐related acute hypoxemic respiratory failure and can be used to provide guidance on use of prone positioning in this group of patients.
The role of inflammation in cases with gestational diabetes mellitus: Systemic immune inflammatory index according to trimesters
Authors: Ergani Seval Yılmaz , Yücel Kadriye Yakut , Şahin Büşra , Ateş Cağlayan , Reis Yıldız Akdaş , Köse Caner , Özden Merve Parlak , Akpınar Funda , Çelen Şevki , Üstün Yaprak
Published: December 2023

Problem

This study aims to investigate the role of the systemic immune‐inflammatory index (SII) in inflammation by analyzing SII values by trimester in gestational diabetes mellitus (GDM).

Method of Study

Between May 2019 and June 2020, we retrospectively enrolled 467 pregnant women who were followed from the first trimester to delivery in our hospital. We evaluated the sociodemographic characteristics, laboratory test results, SII values, Apgar scores, and newborn birth weights of pregnant women diagnosed with GDM. We also compared the SII values of GDM for the 1st, 2nd, and 3rd trimesters with the control group.

Results

When examining the SII values of the GDM group in these three trimesters, without including the control group, we found that the SII value of the GDM group in the 3rd trimester was significantly higher than in the 1st trimester, with a gradual increase with each trimester (p = .007). Additionally, the SII value was higher in the GDM group compared to the control group (p = .008). We conducted a Receiver Operating Characteristic (ROC) analysis of the SII value between the groups by trimester. The diagnostic significance of SII between the GDM and control groups was observed in the 3rd trimester, as the area under the curve (AUC) was close to 0.5 and not associated with a specific cutoff value. When examining the relationship between 3rd‐trimester SII and study parameters, we found it had a positive and low correlation with the length of prepartum hospitalization, 50 g Oral Glucose Tolerance Test (OGTT), and maximal vertical pocket.

Conclusion

SII levels were significantly higher in third‐trimester GDM patients; however, despite elevated levels of inflammation, fetuses did not experience harm.
Indocyanine green: A novel marker for assessment of graft quality during ex situ normothermic machine perfusion of human livers
Authors: Lau Ngee‐Soon , Ly Mark , Ewenson Kasper , Toomath Shamus , Ly Hayden , Mestrovic Nicole , Liu Ken , McCaughan Geoff , Crawford Michael , Pulitano Carlo
Published: December 2023

Background

Ex situ machine perfusion facilitates the assessment of livers prior to transplantation. However, currently available markers of liver function poorly predict long‐term graft function. Indocyanine green (ICG) is a liver‐specific dye which, although common in vivo, has never been comprehensively evaluated for the assessment of graft quality during ex situ machine perfusion. This study aimed to assess the utility of ICG in the ex situ setting.

Methods

Using a customized long‐term perfusion system, human livers that were not suitable for transplantation were perfused using a red cell‐based perfusate. ICG was delivered into the perfusate on days 0, 1, and 4 to assess ICG clearance (spectrophotometric absorbance at 805 nm) and ICG fluorescence (near‐infrared camera).

Results

Sixteen partial livers were perfused for a median duration of 172 h (7.2 days). On day 0, the median ICG perfusate disappearance rate (PDR) was 7.5%/min and the median ICG retention at 15 min was 9.9%. Grafts that survived ≥7 days had a significantly higher median ICG PDR on day 0 (14.5%/min vs. 6.5%/min, p = 0.005) but not on days 1 or 4. ICG perfusion demonstrated that long‐surviving grafts had a significantly lower median red‐value (89.8 vs. 118.6, p = 0.011) and a significantly lower median blue‐value (12.9 vs. 22.6, p = 0.045) than short‐surviving grafts.

Conclusion

ICG is a novel marker for the assessment of liver function during ex situ normothermic machine perfusion. ICG PDR and quantitative ICG perfusion can distinguish between long‐ and short‐surviving grafts and demonstrate the utility of ICG in the assessment of graft quality prior to transplant.
Application frequency – key indicator for the efficiency of severe dry eye disease treatment – evidence for the importance of molecular weight of hyaluronan in lubricating agents
Authors: Medic Nika , Boldin Ingrid , Berisha Bujar , Matijak‐Kronschachner Bernadette , Aminfar Haleh , Schwantzer Gerold , Müller‐Lierheim Wolfgang G. K. , van Setten Gysbert‐Botho , Horwath‐Winter Jutta
Published: December 2023

Purpose

Lubricant eye drops are the main therapeutic resource for dry eye disease (DED), with each drop representing the equivalent of ocular surface disease treatment. Thus, any reduction in the frequency of eye drop application reflects a degree of therapeutic success. Considering also the socioeconomic burden of DED, we investigated eye drop application frequency (DF) as a parameter to potentially track the success of therapy in severe DED. Hyaluronan (HA)‐containing eye drops have become the first choice for tear substitution in many countries, and recent data indicate that the average molecular weight (Mw) of HA determines the therapeutic efficacy of such eye drops. This post‐hoc subgroup analysis of a previously published multicentre prospective randomized open‐label study, HYLAN M, is set out to compare the effects of very high Mw HA (hylan A) eye drops to comparator eye drops, containing lower Mw HA (control).

Methods

Patients with severe DED (n = 47), recruited as part of the larger HYLAN M prospective, multicentre, open‐label study, were randomized into two groups: hylan A and control group. In the hylan A group, 24 patients replaced their HA‐containing eye drops with eye drops containing 0.15% hylan A, whereas the 23 control patients continued to use comparator HA eye drops. The DF was recorded daily by all participants over 8 weeks, and other subjective and objective parameters of DED were assessed at the time of inclusion (baseline), as well as at week 4 and 8.

Results

There was a significant decrease in DF in the hylan A users between the baseline and week 4 (p = 0.004), remaining stable until week 8. Indeed, in contrast to the baseline, the hylan A group had a significantly lower DF than the control group at weeks 4 (p = 0.018) and 8 (p = 0.008). Likewise, the ocular surface disease index (OSDI) improved significantly between the time of inclusion and week 4 (p < 0.001) in hylan A users, remaining stable until week 8. The OSDI was similar in both groups at the baseline but it was significantly lower in the hylan A group than in the control group at week 4 (p = 0.002), remaining lower at week 8. Such a decrease in the DF and OSDI was not witnessed in the control group at any time point. The objective parameters assessed did not differ significantly within or between the two groups.

Conclusion

When treating severe DED, the DF can be significantly reduced by using very high Mw HA (3 MDa) lubricant eye drops, which better alleviate DED symptoms and decrease the OSDI scores. These drops not only provide an attractive and comfortable alternative for patients with severe DED but also offer the possibility of reducing the disease's socioeconomic burden, both for affected individuals and society as a whole.
Impact of cleanroom status on the reasons for discarding organ‐cultured corneal transplants in a modern eye bank – More donor corneas thanks to astronaut suit?
Authors: Zilles Marco , Flockerzi Elias , Daas Loay , Weinstein Isabel , Hamon Loic , Seitz Berthold
Published: December 2023

Purpose

This study investigated the influence of cleanroom conditions on the discard rates of donor corneas in a German university eye bank.

Methods

Discard rates were analysed from 2017 to 2020 at the LIONS Cornea Bank at Saarland University Medical Center. 1941 corneas from 971 donors were included. 1262 corneas (65.1%) were stored in a class D cleanroom from 2017 to 2019 and processed in a cleanroom class A sterile bank (group 1). 679 corneas (34.9%) were continuously stored in a class B cleanroom and processed in a class A cleanroom safety cabinet in the same room from 2019 to 2020 (group 2). The target parameter of this work was the number of contamination‐related discards. Although they cannot be influenced by the spatial conditions, the discards due to insufficient endothelial quality, serology, contraindications, scars and technical causes were also recorded. Statistical analysis was performed using SPSS and various testing procedures.

Results

In group 1, significantly more corneas were discarded due to positive serology (6.9%|3.8%, p = 0.020). There was no significant change between both groups for either contamination or the other reasons for discard.

Conclusion

Optimization of hygiene standards from cleanroom class D to B did not reduce contamination. Serology, endothelial quality, medical contraindications and the presence of scars cannot be influenced by cleanroom conditions.
Butyrate acts as a positive allosteric modulator of the 5‐HT transporter to decrease availability of 5‐HT in the ileum
Authors: Cai Jieling , Cheung Jamie , Cheung Samson W. M. , Chin Karie T. C. , Leung Ricky W. K. , Lam Ronald S. T. , Sharma Rakesh , Yiu Jensen H. C. , Woo Connie W.
Published: December 2023

Background and Purpose

Radiation therapy‐induced gastrointestinal distress is partly associated with the elimination of gut microbiota. The effectiveness of 5‐HT receptor antagonists to treat radiation therapy‐induced emesis implies a pathophysiological role of 5‐HT. Peripheral 5‐HT is derived from intestinal epithelium. We have investigated the role of gut microbiota in regulating intestinal 5‐HT availability.

Experimental Approach

A radiation therapy murine model accompanied by faecal microbiota transplantation from donors fed different diets was investigated, and mouse ileal organoids were used for mechanistic studies. The clinical relevance was validated by a small‐scale human study.

Key Results

Short‐term high‐fat diet (HFD) induced gut bacteria to produce butyrate. Irradiated mice receiving HFD‐induced microbiome had the lowest ileal levels of 5‐HT, compared with other recipients. Treatment with butyrate increased 5‐HT uptake in mouse ileal organoids, assayed by the real‐time tracking of a fluorescent substrate for monoamine transporters. Silencing the 5‐HT transporter (SERT) in the organoids abolished butyrate‐stimulated 5‐HT uptake. The competitive tests using different types of selective 5‐HT reuptake inhibitors suggested that butyrate acted as a positive allosteric modulator of SERT. In human gut microbiota, butyrate production was associated with the interconversion between acetate and butyrate. Faecal contents of both acetate and butyrate were negatively associated with serum 5‐HT, but only butyrate was positively correlated with body mass index in humans.

Conclusion and Implications

Short‐term HFD may be beneficial for alleviating gastrointestinal reactions by increasing butyrate to suppress local 5‐HT levels and providing energy to cancer patients given radiation therapy.
Orexin‐A attenuated motion sickness through modulating neural activity in hypothalamus nuclei
Authors: Pan Leilei , Xiao Shuifeng , Xu Zichao , Li Wenping , Zhao Long , Zhang Ling , Qi Ruirui , Wang Junqin , Cai Yiling
Published: December 2023

Background and Purpose

We evaluated the hypothesis that central orexin application could counteract motion sickness responses through regulating neural activity in target brain areas.

Experimental Approach

Thec effects of intracerebroventricular (i.c.v.) injection of orexin‐A and SB‐334867 (OX1 antagonist) on motion sickness‐induced anorexia, nausea‐like behaviour (conditioned gaping), hypoactivity and hypothermia were investigated in rats subjected to Ferris wheel‐like rotation. Orexin‐A responsive brain areas were identified using Fos immunolabelling and were verified via motion sickness responses after intranucleus injection of orexin‐A, SB‐334867 and TCS‐OX2‐29 (OX2 antagonist). The efficacy of intranasal application of orexin‐A versus scopolamine on motion sickness symptoms in cats was also investigated.

Key Results

Orexin‐A (i.c.v.) dose‐dependently attenuated motion sickness‐related behavioural responses and hypothermia. Fos expression was inhibited in the ventral part of the dorsomedial hypothalamus (DMV) and the paraventricular nucleus (PVN), but was enhanced in the ventral part of the premammillary nucleus ventral part (PMV) by orexin‐A (20 μg) in rotated animals. Motion sickness responses were differentially inhibited by orexin‐A injection into the DMV (anorexia and hypoactivity), the PVN (conditioned gaping) and the PMV (hypothermia). SB‐334867 and TCS‐OX2‐29 (i.c.v. and intranucleus injection) inhibited behavioural and thermal effects of orexin‐A. Orexin‐A (60 μg·kg−1) and scopolamine inhibited rotation‐induced emesis and non‐retching/vomiting symptoms, while orexin‐A also attenuated anorexia with mild salivation in motion sickness cats.

Conclusion and Implications

Orexin‐A might relieve motion sickness through acting on OX1 and OX2 receptors in various hypothalamus nuclei. Intranasal orexin‐A could be a potential strategy against motion sickness.
Insulin resistance is associated with the presence and severity of retinopathy in patients with type 2 diabetes
Authors: Xu Yu‐Xin , Pu Sheng‐Dan , Zhang Yi‐Tong , Tong Xue‐Wei , Sun Xiao‐Tong , Shan Yong‐Yan , Gao Xin‐Yuan
Published: December 2023

Background

To assess the relationship between novel insulin resistance (IR) indices and the presence and severity of diabetic retinopathy (DR) in patients with type 2 diabetes.

Methods

This is a cross‐sectional study involving 2211 patients. The study outcomes were DR events. The study exposures were IR indices including estimated glucose disposal rate (eGDR), natural logarithm of glucose disposal rate (lnGDR), metabolic insulin resistance score (METS‐IR), triglyceride glucose index‐body mass index (TyG‐BMI), triglyceride glucose index‐waist‐to‐hip ratio (TyG‐WHR), and triglyceride/high‐density lipoprotein cholesterol(TG/HDL‐c ratio). We used binary and multivariate ordered logistic regression models to estimate the association between different IR indices and the presence and severity of DR. Subject work characteristic curves were used to assess the predictive power of different IR indices for DR.

Results

DR was present in 25.4% of participants. After adjusting for all covariates, per standard deviation (SD) increases in eGDR (ratio [OR] 0.38 [95% CI 0.32–0.44]), lnGDR (0.34 [0.27–0.42]) were negatively associated with the presence of DR. In contrast, per SD increases in METS‐IR (1.97 [1.70–2.28]), TyG‐BMI (1.94 [1.68–2.25]), TyG‐WHR (2.34 [2.01–2.72]) and TG/HDL‐c ratio (1.21 [1.08–1.36]) were positively associated with the presence of DR. eGDR was strongly associated with severity of DR. Of all variables, eGDR had the strongest diagnostic value for DR (AUC = 0.757).

Conclusions

Of the six IR indices, eGDR was significantly associated with the presence and severity of DR in patients with type 2 diabetes. eGDR has a good predictive value for DR. Thus, eGDR maybe a stronger marker of DR.
State of the Art in Efficient Translucent Material Rendering with BSSRDF
Authors: Liang Shiyu , Gao Yang , Hu Chonghao , Zhou Peng , Hao Aimin , Wang Lili , Qin Hong
Published: December 2023

Sub‐surface scattering is always an important feature in translucent material rendering. When light travels through optically thick media, its transport within the medium can be approximated using diffusion theory, and is appropriately described by the bidirectional scattering‐surface reflectance distribution function (BSSRDF). BSSRDF methods rely on assumptions about object geometry and light distribution in the medium, which limits their applicability to general participating media problems. However, despite the high computational cost of path tracing, BSSRDF methods are often favoured due to their suitability for real‐time applications. We review these methods and discuss the most recent breakthroughs in this field. We begin by summarizing various BSSRDF models and then implement most of them in a 2D searchlight problem to demonstrate their differences. We focus on acceleration methods using BSSRDF, which we categorize into two primary groups: pre‐computation and texture methods. Then we go through some related topics, including applications and advanced areas where BSSRDF is used, as well as problems that are sometimes important yet are ignored in sub‐surface scattering estimation. In the end of this survey, we point out remaining constraints and challenges, which may motivate future work to facilitate sub‐surface scattering.
Hepatitis C virus cure from direct‐acting antivirals and mortality: Are people with and without a history of injection drug use in the same boat? (ANRS CO22 Hepather cohort)
Authors: Barré Tangui , Bourlière Marc , Parlati Lucia , Ramier Clémence , Marcellin Fabienne , Protopopescu Camelia , Di Beo Vincent , Cagnot Carole , Dorival Celine , Nicol Jérôme , Zoulim Fabien , Carrat Fabrice , Carrieri Patrizia ,   the ANRS/AFEF Hepather Study group
Published: December 2023

Introduction

The risk of mortality in people with a history of injection drug use (PHID) is high, as is the prevalence of hepatitis C virus (HCV) infection. Although direct‐acting antivirals (DAA) are effective in this population in terms of sustained virological response, it is not known whether PHID benefit as much as people with no history of injection drug use from DAA‐related HCV cure in terms of reduced all‐cause mortality.

Methods

Using Cox proportional hazards models based on the ANRS CO22 Hepather cohort data (n = 9735), we identified factors associated with all‐cause mortality among HCV‐infected people. We tested for interaction effects between drug injection status, HCV cure and other explanatory variables.

Results

DAA‐related HCV cure was associated with a 66% (adjusted hazard ratio [95% confidence interval]: 0.34 [0.29–0.39]) lower risk of all‐cause mortality, irrespective of drug injection status. Detrimental effects of unhealthy alcohol use on mortality were identified in PHID only.

Discussion and Conclusions.

DAA‐related HCV cure led to comparable benefits in terms of reduced mortality in PHID and people with no history of injection drug use. Policies and strategies to enhance DAA uptake among PHID are needed to lower mortality in this population.

Clinical trial registration details: ClinicalTrials.gov: NCT01953458.
Development of a new endoscopy system to visualize bilirubin for the diagnosis of duodenogastroesophageal reflux
Authors: Wada Masafumi , Minoda Yosuke , Ihara Eikichi , Tsuru Hirotaka , Hata Yoshitaka , Nagatomo Shuzaburo , Esaki Mitsuru , Bai Xiaopeng , Tanaka Yoshimasa , Chinen Takatoshi , Ogino Haruei , Ogawa Yoshihiro
Published: December 2023

Objectives

Reflux hypersensitivity (RH) is a form of refractory gastroesophageal reflux disease in which duodenogastroesophageal reflux (DGER) plays a role. This study aimed to determine the usefulness of an endoscopy system equipped with image‐enhanced technology for evaluating DGER and RH.

Methods

The image enhancement mode for detecting bilirubin and calculated values were defined as the Bil mode and Bil value, respectively. First, the visibility of the Bil mode was validated for a bilirubin solution and bile concentrations ranging from 0.01% to 100% (0.002–20 mg/dL). Second, visibility scores of the Bil mode, when applied to the porcine esophagus sprayed with a bilirubin solution, were compared to those of the blue laser imaging (BLI) and white light imaging (WLI) modes. Third, a clinical study was conducted to determine the correlations between esophageal Bil values and the number of nonacid reflux events (NNRE) during multichannel intraluminal impedance‐pH monitoring as well as the utility of esophageal Bil values for the differential diagnosis of RH.

Results

Bilirubin solution and bile concentrations higher than 1% were visualized in red using the Bil mode. The visibility score was significantly higher with the Bil mode than with the BLI and WLI modes for 1% to 6% bilirubin solutions (P < 0.05). The esophageal Bil value and NNRE were significantly positively correlated (P = 0.031). The area under the receiver operating characteristic curve for the differential diagnosis of RH was 0.817.

Conclusion

The Bil mode can detect bilirubin with high accuracy and could be used to evaluate DGER in clinical practice.
Strategic social decision making undergoes significant changes in typically developing and autistic early adolescents
Authors: Liu Wenda , Shah Nikita , Ma Ili , Rosenblau Gabriela
Published: December 2023

Information sampling about others’ trustworthiness prior to cooperation allows humans to minimize the risk of exploitation. Here, we examined whether early adolescence or preadolescence, a stage defined as in between childhood and adolescence, is a significant developmental period for strategic social decisions. We also sought to characterize differences between autistic children and their typically developing (TD) peers. TD (N = 48) and autistic (N = 56) 8‐ to 12‐year‐olds played an online information sampling trust game. While both groups adapted their information sampling and cooperation to the various trustworthiness levels of the trustees, groups differed in how age and social skills modulated task behavior. In the TD group social skills were a stronger overall predictor of task behavior. In the autistic group, age was a stronger predictor and interacted with social skills. Computational modeling revealed that both groups used the same heuristic information sampling strategy—albeit older TD children were more efficient as reflected by decreasing decision noise with age. Autistic children had lower prior beliefs about the trustee's trustworthiness compared to TD children. These lower priors indicate that children believed the trustees to be less trustworthy. Lower priors scaled with lower social skills across groups. Notably, groups did not differ in prior uncertainty, meaning that the priors of TD and autistic children were equally strong. Taken together, we found significant development in information sampling and cooperation in early adolescence and nuanced differences between TD and autistic children. Our study highlights the importance of deep phenotyping of children including clinical measures, behavioral experiments and computational modeling.

Research Highlights

We specified how early adolescents with and without an autism diagnosis sampled information about their interaction partners and made cooperation decisions in a strategic game.

Early adolescence is a significant developmental period for strategic decision making, marked by significant changes in information sampling efficiency and adaptivity to the partner's behavior.

Autistic and non‐autistic groups differed in how age and social skills modulated task behavior; in non‐autistic children behavior was more indicative of overall social skills.

Computational modeling revealed differences between autistic and non‐autistic groups in their initial beliefs about cooperation partners; autistic children expected their partners to be less trustworthy.
Reciprocity versus pseudo‐reciprocity: A false dichotomy
Authors: Carter Gerald G.
Published: December 2023

Reciprocity and pseudo‐reciprocity are two important models for the evolution of cooperation and often considered alternative hypotheses. Reciprocity is typically defined as a scenario where help given causes help received: cooperation is stabilized because each actor's cooperative investments are conditional on the cooperative returns from the receiver. Pseudo‐reciprocity is a scenario where help enables byproduct returns: cooperation is inherently stable because the actor's cooperative investments yield byproduct returns from the receiver's self‐serving behavior. These models are strict alternatives only if reciprocity is defined by the restrictive assumption of zero fitness interdependence, meaning that the helper has no “stake” in the receiver's fitness. Reciprocity and interdependence are, however, not mutually exclusive when helping can increase both reciprocal help and byproduct returns. For instance, helping partners survive can simultaneously increase their willingness to reciprocate, their ability to reciprocate, and byproduct benefits of their existence. Interdependence can “pave the road” to reciprocal helping, and partners who reciprocate help can also become interdependent. However, larger cooperative investments can increase the need for responsiveness to partner returns. Therefore, most long‐term cooperative relationships involve both responsiveness and interdependence. Categorizing these relationships as “reciprocity” can be viewed as ignoring interdependence, but calling them ‘pseudo‐reciprocity’ is confusing because stability also comes from the cooperative investments being conditional on returns. Rather than conceptualizing cooperation into discrete categories, it is more insightful to imagine a coordinate system with responsiveness and interdependence as continuous dimensions. One can ask: To what degree is helping behavior responsive to the partner's behavior? And to what degree does the helper inherently benefit from the receiver's survival or reproduction? The amounts of responsiveness and interdependence will often be hard to estimate, but both are unlikely to be zero. Identifying their relative importance, and how that changes over time, would greatly clarify the nature of cooperative relationships.
A clinical investigation of early‐onset alopecia areata in children: Onset earlier than 4 years of age might have a better short‐term prognosis
Authors: Lim Ji‐Hoon , Kwon Soon‐Hyo , Sim Woo‐Young , Lew Bark‐Lynn
Published: December 2023

Alopecia areata (AA) is a non‐scarring autoimmune hair loss of the scalp or body. While an early onset is considered a primary factor for poor prognosis, children with early‐onset AA show varied responses to treatment. This study aimed to describe the clinical characteristics and assess the prognostic factors of early‐onset AA in children. We performed a retrospective study of AA patients aged <10 years who visited our dermatologic clinic between January 2013 and December 2020, with a follow‐up period >12 months. A clinical review of medical records, photographs, and telephonic interviews was performed. Treatment efficacy was assessed based on the degree of hair regrowth at a 12‐month follow‐up. Of 162 patients treated with topical corticosteroids, alone or in combination with other modalities, 57.4% showed >50% hair regrowth. On comparing the good and poor treatment response groups, no significant differences were observed in the presence of known prognostic factors, except for personal atopic history. In addition, patients aged <4 years at onset responded significantly better than older patients (p = 0.0127). There is a possibility that the patients with early‐onset AA, especially those aged <4 years, demonstrate good treatment response. Further studies on long‐term prognosis are required.
Eribulin for patients with metastatic extramammary Paget disease: Study protocol for a single‐arm phase II trial
Authors: Maeda Takuya , Yanagi Teruki , Tokuchi Keiko , Funakoshi Takeru , Horie Nao , Isoe Toshiyuki , Ito Yoichi M. , Sato Norihiro , Ujiie Hideyuki
Published: December 2023

Extramammary Paget disease (EMPD) is a rare cutaneous malignancy that predominantly affects the anogenital areas of the elderly. Although the efficacy of docetaxel and other cytotoxic agents for advanced EMPD has been reported in small retrospective case studies, no treatment has been proven effective in prospective clinical trials. We established the world's first in vivo EMPD experimental model (a patient‐derived xenograft model). In our treatment experiment, xenograft tumours showed a remarkable response to eribulin. This study evaluates the efficacy of eribulin for patients with advanced EMPD. In October 2022, we started a single‐arm phase II trial to evaluate the efficacy of eribulin as a treatment for adult patients with unresectable EMPD with measurable lesions. Enrolment in this clinical trial is open to patients with any prior treatment for EMPD. The primary endpoint is overall response rate; the secondary endpoints include disease control rate, overall survival, progression‐free survival and adverse events. The study protocol was approved by the Ethics Committee of Hokkaido University and the other collaborating institutions. If the primary endpoint is met, it is our hope that eribulin will be regarded as a standard medication for patients with advanced EMPD.
Integrity and fidelity in highly religious marriages
Authors: Leavitt Chelom E. , Hendricks Justin J. , Clarke Rebecca W. , Marks Loren D. , Dollahite David C. , Rose Andrew H.
Published: December 2023

Objective

We used qualitative data to evaluate how religious and interfaith couples may view the influences of fidelity and/or loyalty on their marriage.

Background

Religion often regulates beliefs surrounding marriage and sexuality. Religion tends to support fidelity to marital vows. Previous quantitative studies indicated that higher religiosity is linked with higher levels of marital stability and satisfaction.

Method

Using semistructured interviews with 261 married couples (N = 522) who were identified as both religious and relational exemplars, the potential connections and processes between religion, relationships, and fidelity or integrity were examined.

Results

Three core themes emerged from systematic team‐based analyses: (1) integrity and/or fidelity strengthened marital quality and stability, (2) integrity and/or fidelity were core marital values and virtues, and (3) religion taught, developed, and motivated marital integrity and fidelity. Three subthemes were identified under this final theme: (3a) religious lifestyle, (3b) religious beliefs, and (3c) commitment to God. Contradictory voices that expressed and described challenges to marital integrity and fidelity are presented.

Conclusion

Couples discussed how their faiths' teachings on integrity and/or fidelity strengthened marital quality and stability, added to their core marital values and virtues, and motivated marital integrity and/or fidelity through a religious lifestyle, religious beliefs and morals, and commitment to God that built commitment and fidelity to spouse.

Implications

Therapists and educators who recognize that these deeply held values contribute to couples' stability and satisfaction within their relationship may be able to ask, understand, and harness religious strengths to facilitate commonalities and satisfaction.
A longline survey for spurdog distribution and life history along the Norwegian coast
Authors: Andrade Hector , Nilsen Tine , Vollen Tone , Harbitz Alf , Junge Claudia , Albert Ole Thomas
Published: December 2023

To improve spatiotemporal data collection and inform future spurdogSqualus acanthiasstock assessment, a new dedicated longline survey was initiated in 2021 in coastal waters of southern Norway. The survey comprised a mixture of randomly predefined stations to facilitate unbiased abundance estimates and supplementary stations including informant putative hotspots. During 25 survey days in autumn 2021, 287 stations were sampled, of which 280 were categorized as “satisfactory” in terms of gear quality deployment. Spurdog catches (n = 954) were more abundant in southeast coastal shallower waters (19–150 m). No length, sex, or maturity stratified schooling behavior was found with increasing catches. Females were more abundant and larger than males, but males were older. Growth and reproduction parameters were within ranges reported for the stock. Our results provide valuable input for spurdog survey designs with regards to optimizing boat time, location of stations, and biological sampling protocols. The survey provides important data for monitoring the spurdog stock and other data‐limited species, especially considering the newly re‐opened spurdog fishery but also to study possible future effects of climatic changes on spurdog distribution.
Potential role of Fibrosis‐4 score in hepatocellular carcinoma screening: The Kangbuk Samsung Health Study
Authors: Shin Sujeong , Sohn Won , Chang Yoosoo , Cho Yoosun , Kwon Min‐Jung , Wild Sarah H. , Byrne Christopher D. , Ryu Seungho
Published: December 2023

Aim

Hepatocellular carcinoma (HCC) is a major cause of cancer‐related death, with low survival rates worldwide. Fatty liver disease (FLD) significantly contributes to HCC. We studied the screening performance of different methods for identifying HCC in patients with FLD or with metabolic risk factors for FLD.

Methods

Korean adults (n = 340 825) without a prior HCC diagnosis were categorized into four groups: normal (G1), ≥2 metabolic risk factors (G2), FLD (G3), and viral liver disease or liver cirrhosis (G4). The National Cancer Registry data were used to identify HCC cases within 12 months. We assessed the area under the receiver operating characteristic curve, sensitivity, specificity, and positive and negative predictive values of individual or combined screening methods.

Results

In 93 HCC cases, 71 were identified in G4, whereas 20 cases (21.5%) in G2 and G3 combined where ultrasound and Fibrosis‐4 performed similarly to alpha‐fetoprotein and ultrasound. In G2, Fibrosis‐4 and ultrasound had the highest area under the receiver operating characteristic curve (0.93 [0.87–0.99]), whereas in G3, the combined screening methods had the highest area under the receiver operating characteristic curve (0.98 [0.95–1.00]). The positive predictive value was lower in G2 and G3 than in G4, but was >5% when restricted to a high Fibrosis‐4 score.

Conclusions

More than 21% of HCC cases were observed in patients with diagnosed FLD or at risk of FLD with metabolic risk factors. Nevertheless, screening for HCC in individuals without cirrhosis or viral hepatitis yielded very low results, despite the potential value of the Fibrosis‐4 score in identifying individuals at high risk of HCC.
OpenAI's GPT‐4 performs to a high degree on board‐style dermatology questions
Authors: Elias Marcus L. , Burshtein Joshua , Sharon Victoria R.
Published: December 2023

Background

Artificial intelligence tools such as OpenAI's GPT‐4 have shown promise in medical education, but their potential in dermatology remains unexplored.

Objectives

To assess GPT‐4's performance on dermatology board‐style questions and determine its value as a supplementary educational tool for trainees and educators.

Methods

This cross‐sectional study evaluated GPT‐4's performance on 250 random dermatology board‐style questions sampled from the American Academy of Dermatology's Board Prep Plus resource. Questions were divided into five subspecialties and various difficulty levels. GPT‐4 responses were compared to the correct answers and evaluated by two physicians.

Results

GPT‐4 achieved an overall accuracy of 75% on the 250 questions, with no significant variation based on subspecialty or question difficulty. The most common errors were factual and misunderstanding inaccuracies. Responses scored high in clarity, accuracy, and relevance but frequently lacked depth and completeness.

Conclusion

GPT‐4 performed to a high degree and demonstrated promising performance as an educational adjunct in dermatology. Improvements in response depth and completeness are needed before its use as an unsupervised learning tool is established.
The effects of oral nutritional supplements interventions on nutritional status in patients undergoing colorectal cancer surgery: A systematic review
Authors: Qin Xiaohong , Sun Jiao , Liu Meiling , Zhang Lianjie , Yin Qing , Chen Si
Published: December 2023

Background

The high incidence of malnutrition in patients undergoing colorectal cancer surgery can lead to unplanned weight loss, sarcopenia and reduced grip strength to the extent that it can seriously affect the prognosis of colorectal cancer patients.

Objective

This study investigated the effect of oral nutritional supplements (ONS) on the prevalence of grip strength, unplanned weight loss and sarcopenia in patients undergoing colorectal cancer surgery.

Methods

We systematically searched randomized controlled studies from CINAHL, PubMed, Embase, Cochrane and Web of Science and three Chinese databases (CNKI, Wan‐Fang database, VIP database) from database creation to September 2023. The risk of bias in individual studies was assessed using the Cochrane Collaboration tool, and the certainty of evidence was assessed using the five GRADE criteria. Statistical analysis was performed using the RevMan 5.3 software, and information that could not be meta‐analysed was reviewed in the form of a literature summary.

Results

Eleven papers met the inclusion criteria with a combined sample size of 1070 cases, including 532 cases in the trial group and 538 cases in the control group. Four papers reported the effect of ONS on grip strength and included very low‐quality evidence supporting no effect of ONS on grip strength. Ten studies reported the effect of ONS on body weight and body mass index (BMI) and included very low‐quality evidence supporting a positive ONS on weight and BMI changes. Meta‐analysis showed a significant reduction in weight loss (12–15 weeks) and BMI loss (12–15 weeks) in patients with colorectal cancer in the ONS group. The effect of ONS on the prevalence of sarcopenia after hospital discharge was reported in two studies, and meta‐analysis showed a significant reduction in the prevalence of postoperative sarcopenia in colorectal cancer patients in the ONS group, but the quality of evidence was low.

Conclusions

This study showed that the use of ONS in patients undergoing surgery for colorectal cancer improved patient weight loss and BMI reduction and reduced the prevalence of postoperative sarcopenia but did not improve patient grip strength. The quality of evidence for inclusion in the article was low or very low, and further studies are needed to provide better evidence.
The experiences and perceptions of immigrant informal caregivers about engaging with professional services in the host country: A scoping review
Authors: Tsai Lily P. , Barr Jennieffer A.
Published: December 2023

Aim

The inquiry explored immigrant informal caregivers' experiences and perceptions about engaging with professional services in the host country.

Background

The number of informal caregivers is rising, with more people providing home caring. Nurses and other health services are crucial in supporting informal caregivers. Research needs to focus more on immigrants, not just other caregivers.

Design

This was a scoping review.

Data Sources

Five databases (January 2017–December 2022) were searched, and 16 articles were included in this inquiry.

Review Methods

This scoping review used the Joanna Briggs Institute Scoping Review methodology. This inquiry asked one question: What is the current knowledge about immigrant informal caregivers' experiences and perceptions when engaging mainstream professional services? Themes were identified using a thematic analysis approach.

Results

Three themes emerged from the review: ‘finding cultural bridges: culturally connecting with services’; ‘building cultural bridges: addressing “them and us” and “acculturation‐sensitive services”’.

Conclusion

Professional service providers are currently not meeting immigrant caregivers' needs. New knowledge is presented, that nurses and health professional services must provide acculturation‐sensitive care, commencing with an assessment of the individual's acculturation status. By understanding acculturation status, nurses are more likely to customize person‐centred care. Acculturation status refers to the degree that the individual has adapted to the new culture while retaining some traditional cultural beliefs and practices. Acculturation‐sensitive care is more likely to provide authentic holistic care that optimizes well‐being.