bluuebunny/crossref_metadata_2025 huggingface dataset:
A Basic Guide to the Propagation and Manipulation of the Clubroot Pathogen, Plasmodiophora brassicae
Authors: Salih Rasha , Javed Muhammad Asim , Brochu Anne‐Sophie , Prakash Priyavashini , Côté Jean‐Dominic , Pérez‐López Edel
Published: April 2024

Clubroot caused by the obligate parasite Plasmodiophora brassicae is a devastating disease affecting the canola industry worldwide. The socio‐economic impact of clubroot can be significant, particularly in regions where Brassica crops are a major agricultural commodity. The disease can cause significant crop losses, leading to reduced yield and income for farmers. Extensive studies have been conducted to understand the biology and genetics of the pathogens and develop more effective management strategies. However, the basic procedures used for pathogen storage and virulence analysis have not been assembled or discussed in detail. As a result, there are discrepancies among the different protocols used today. The aim of this article is to provide a comprehensive and easily accessible resource for researchers who are interested in replicating or building upon the methods used in the study of the clubroot pathogen. Here, we discuss in detail the methods used for P. brassicae spore isolation, inoculation, quantification, propagation, and molecular techniques such as DNA extraction and PCR. © 2024 The Authors. Current Protocols published by Wiley Periodicals LLC.

Basic Protocol 1: Extraction of Plasmodiophora brassicae resting spores and propagation

Support Protocol 1: Evans blue staining to identify resting spore viability

Support Protocol 2: Storage of Plasmodiophora brassicae

Basic Protocol 2: Generation of single spore isolates from P. brassicae field isolates

Basic Protocol 3: Phenotyping of Plasmodiophora brassicae isolates

Basic Protocol 4: Genomic DNA extraction from Plasmodiophora brassicae resting spores

Basic Protocol 5: Molecular detection of Plasmodiophora brassicae
Unveiling Advancements: Trends and Hotspots of Metal‐Organic Frameworks in Photocatalytic CO2 Reduction
Authors: Wang Ziqi , Fei Honghan , Wu Yi‐nan
Published: April 2024

Metal‐organic frameworks (MOFs) are robust, crystalline, and porous materials featured by their superior CO2 adsorption capacity, tunable energy band structure, and enhanced photovoltaic conversion efficiency, making them highly promising for photocatalytic CO2 reduction reaction (PCO2RR). This study presents a comprehensive examination of the advancements in MOFs‐based PCO2RR field spanning the period from 2011 to 2023. Employing bibliometric analysis, the paper scrutinizes the widely adopted terminology and citation patterns, elucidating trends in publication, leading research entities, and the thematic evolution within the field. The findings highlight a period of rapid expansion and increasing interdisciplinary integration, with extensive international and institutional collaboration. A notable emphasis on significant research clusters and key terminologies identified through co‐occurrence network analysis, highlighting predominant research on MOFs such as UiO, MIL, ZIF, porphyrin‐based MOFs, their composites, and the hybridization with photosensitizers and molecular catalysts. Furthermore, prospective design approaches for catalysts are explored, encompassing single‐atom catalysts (SACs), interfacial interaction enhancement, novel MOF constructions, biocatalysis, etc. It also delves into potential avenues for scaling these materials from the laboratory to industrial applications, underlining the primary technical challenges that need to be overcome to facilitate the broader application and development of MOFs‐based PCO2RR technologies.
Impact of different tissue dissociation protocols on endothelial cell recovery from developing mouse lungs
Authors: Palumbo Francesco , Gunjak Miša , Lee Patty J. , Günther Stefan , Hilgendorff Anne , Vadász István , Herold Susanne , Seeger Werner , Mühlfeld Christian , Morty Rory E.
Published: April 2024

Flow cytometry and fluorescence‐activated cell sorting are widely used to study endothelial cells, for which the generation of viable single‐cell suspensions is an essential first step. Two enzymatic approaches, collagenase A and dispase, are widely employed for endothelial cell isolation. In this study, the utility of both enzymatic approaches, alone and in combination, for endothelial cell isolation from juvenile and adult mouse lungs was assessed, considering the number, viability, and subtype composition of recovered endothelial cell pools. Collagenase A yielded an 8‐12‐fold superior recovery of viable endothelial cells from lung tissue from developing mouse pups, compared to dispase, although dispase proved superior in efficiency for epithelial cell recovery. Single‐cell RNA‐Seq revealed that the collagenase A approach yielded a diverse endothelial cell subtype composition of recovered endothelial cell pools, with broad representation of arterial, capillary, venous, and lymphatic lung endothelial cells; while the dispase approach yielded a recovered endothelial cell pool highly enriched for one subset of general capillary endothelial cells, but poor representation of other endothelial cells subtypes. These data indicate that tissue dissociation markedly influences the recovery of endothelial cells, and the endothelial subtype composition of recovered endothelial cell pools, as assessed by single‐cell RNA‐Seq.
Detection of bladder cancer cells using quantitative interferometric label‐free imaging flow cytometry
Authors: Dudaie Matan , Dotan Eden , Barnea Itay , Haifler Miki , Shaked Natan T.
Published: April 2024

Bladder cancer is one of the most common cancers with a high recurrence rate. Patients undergo mandatory yearly scrutinies, including cystoscopies, which makes bladder cancer highly distressing and costly. Here, we aim to develop a non‐invasive, label‐free method for the detection of bladder cancer cells in urine samples, which is based on interferometric imaging flow cytometry. Eight urothelial carcinoma and one normal urothelial cell lines, along with red and white blood cells, imaged quantitatively without staining by an interferometric phase microscopy module while flowing in a microfluidic chip, and classified by two machine‐learning algorithms, based on deep‐learning semantic segmentation convolutional neural network and extreme gradient boosting. Furthermore, urine samples obtained from bladder‐cancer patients and healthy volunteers were imaged, and classified by the system. We achieved accuracy and area under the curve (AUC) of 99% and 97% for the cell lines on both machine‐learning algorithms. For the real urine samples, the accuracy and AUC were 96% and 96% for the deep‐learning algorithm and 95% and 93% for the gradient‐boosting algorithm, respectively. By combining label‐free interferometric imaging flow cytometry with high‐end classification algorithms, we achieved high‐performance differentiation between healthy and malignant cells. The proposed technique has the potential to supplant cystoscopy in the bladder cancer surveillance and diagnosis space.
Volumetric dried blood spots for determination of phosphatidylethanol: Validation of a liquid chromatography tandem masspectrometry method and clinical application
Authors: Beck Olof , Barroso Miguel , Hermansson Sigurd , Widén Cristopher , Wallin Christer , Nilsson‐Wallmark Cecilia , de Bejczy Andrea
Published: April 2024

Phosphatidylethanol (PEth) measurement in whole blood samples is established as a specific alcohol biomarker with clinical and forensic applications. Establishment of dried blood spots (DBSs) as a specimen for PEth determination offers several advantages and was the focus of this work. A liquid chromatography tandem mass spectrometry method using a 96‐well format for sample preparation was developed and validated. PEth was extracted from DBSs by using isopropanol containing PEth‐d5 as internal standard. The blood sampling used a commercial volumetric DBS device having a phosholipase D inhibitor incorporated to stop continuous PEth formation. The method quantified PEth in the range of 0.05–10 μmol/L, with a bias and imprecision of less than 15%. In a clinical study (n = 25) using fingerprick blood, the volumetric device offered more precise quantifications (CV 4.6%) compared with the Whatman 903 Protein Saver card device (CV 16.6%). In another clinical study (n = 48), the use of dried venous and capillary blood, and liquid venous blood was compared under real‐life conditions with samples sent by postal service. The capillary and venous DBS samples gave identical results while the liquid blood gave slightly higher values. Calculation of elimination half‐life (PEth 16:0/18:1) in 31 cases based on two consecutive samples with 2–9 days in between gave results (mean 6.2 days) that agree with literature but several cases with values over 10 days. In conclusion, this study demonstrates that volumetric DBS is a valid specimen for determination of PEth blood concentrations, offering several advantages.
Modular Access to Tetrasubstituted N−H Pyrroles by Catalytic 1,3‐Dipolar Cycloaddition of Azomethine Ylides and α,β‐Ynones
Authors: Huang Qian , Li Zi‐Han , Zhao Zhen‐Ni , Chen Bo‐Ting , He Feng‐Kai , Huang Yi‐Yong
Published: April 2024

The development of efficient synthetic strategies for the preparation of tetrasubstituted N−H pyrrole derivatives, especially in an environmentally benign fashion is important yet challenging. Herein, we report a copper(II)‐catalyzed tandem reaction involving 1,3‐dipolar cycloaddition of α,β‐ynones and glycine iminoesters, followed by copper(II)‐promoted oxidative (air) dehydrogenative aromatization, allowing de novo access to tetrasubstituted N−H pyrroles in up to 81 % yield under green reaction conditions. A possible reaction pathway is tentatively proposed. Finally, fully substituted pyrroles are available by N‐alkylation, and a preliminary phase‐transfer catalytic asymmetric N‐alkylation was also studied to give an axially chiral pyrrole.
Combined approach for predicting the efficacy of nivolumab in head and neck carcinoma by tissue and soluble expressions of PD‐L1 and PD‐L2
Authors: Sato Ryosuke , Komatsuda Hiroki , Inoue Takahiro , Wakisaka Risa , Kono Michihisa , Yamaki Hidekiyo , Ohara Kenzo , Kumai Takumi , Kishibe Kan , Hayashi Tatsuya , Takahara Miki
Published: April 2024

Background

Predictive biomarkers for nivolumab in recurrent or metastatic head and neck squamous cell carcinoma (RMHNSCC) have not yet been established.

Methods

The tumor proportion score (TPS), combined positive score (CPS), and soluble forms of programmed cell death ligand‐1 (PD‐L1) and programmed cell death ligand‐2 (PD‐L2) were retrospectively analyzed in patients with RMHNSCC treated with nivolumab.

Results

The positivity rates for TPS (PD‐L1), CPS (PD‐L1), TPS (PD‐L2), and CPS (PD‐L2) were 73.8%, 78.2%, 56.4%, and 78.2%, respectively. Patients with high TPS (PD‐L1), CPS (PD‐L1), or CPS (PD‐L1 and PD‐L2) showed significantly prolonged progression‐free survival. Favorable overall survival was associated with high CPS (PD‐L1 and PD‐L2) and low soluble PD‐L1 and PD‐L2 levels. The expressions of tissue and soluble PD‐L1/2 were not correlated.

Conclusions

Our study revealed that compared to PD‐L1 expression alone, dual expression of PD‐L1 and PD‐L2 in tissue or soluble form could be feasible biomarkers in patients with RMHNSCC who received nivolumab.
Virtual hospital care development and deployment: A rapid qualitative study of frontline clinicians and leaders
Authors: Sakumoto Matthew , Knees Michelle , Rogers Kendall , Segon Ankur , Westergaard Sara , Yu Amy , Keniston Angela , Burden Marisha
Published: April 2024

Background

Virtual hospitalist programs are rapidly growing in popularity due to worsening clinician shortages and increased pressure for flexible work options. These programs also have the potential to establish sustainable staffing models across multiple hospitals optimizing cost. We aimed to explore the current state of virtual hospitalist services at various health systems, challenges and opportunities that exist in providing virtual care, and future opportunities for these types of services.

Objectives

To identify perspectives on design and implementation of virtual hospitalist programs from academic hospitalist leaders.

Methods

We conducted focus groups with United States academic hospitalist leaders. Semistructured interviews explored experiences with virtual hospitalist programs. Using rapid qualitative methods including templated summaries and matrix analysis, focus group recordings were analyzed to identify key themes.

Results

We conducted four focus groups with 13 participants representing nine hospital systems across six geographic regions and range of experience with virtual hospital medicine care. Thematic analysis identified three themes: (1) a broad spectrum of virtual care delivery; (2) adoption and acceptance of virtual care models followed the stages of diffusion of innovation; and (3) sustainability and scalability of programs were affected by unclear finances.

Conclusions

Hospitalist leader perspectives revealed complex factors influencing virtual care adoption and implementation. Addressing concerns about care quality, financing, and training may accelerate adoption. Further research should clarify the best practices for sustainable models optimized for access, hospitalist experience, patient safety, and financial viability.
A novel applied climate classification method for assessing atmospheric influence on anomalous coastal water levels
Authors: Lee Cameron C. , Sheridan Scott C. , Pirhalla Douglas E. , Ransibrahmanakul Varis , Dusek Gregory
Published: April 2024

Climate classification is a commonly used tool to simplify, visualize and make sense of an otherwise unwieldy amount of climate data in applied climate science research. Typically, these classifications have stemmed from one of two perspectives, either a circulation‐to‐environment (C2E) approach, or an environment‐to‐circulation approach (E2C), each with advantages and drawbacks. This research discusses a novel environment‐to‐circulation‐to‐environment (ECE) perspective to applied climate classification, and develops a specific ECE methodology that utilizes canonical correlation and discriminant analysis—the CANDECE method. The benefits of the ECE approach generally, and the CANDECE methodology specifically, are demonstrated in applying climate classification to aid in modelling anomalous water levels (AWLs) along portions of the East and West coasts of the United States. Results show that the CANDECE method performs better than two traditional classification methods (k‐means and self‐organizing maps [SOMs]) at relating AWLs to their broad‐scale atmospheric setups, especially with regard to both high and low extreme AWLs. It is further demonstrated that, compared with the West coast, the CANDECE method is particularly advantageous along the southeastern US coast, where the primary modes of atmospheric variability (which drive the classifications produced by SOMs and k‐means) do not align with the relevant circulation‐based factors driving AWL variability. While AWLs were utilized for demonstrating the ECE proof‐of‐concept herein, ECE and CANDECE are designed to be useful for any climate application.
Impact of atopic dermatitis lesion locations and extent on patient burden: A real‐world study
Authors: Simpson Eric , Lio Peter , Pierce Evangeline , Cronin Angel , McLean Robert R. , Eckmann Thomas , Atwater Amber Reck , Dawson Zach , Silverberg Jonathan I.
Published: April 2024

Background

Atopic dermatitis (AD) is associated with patient burden, but few studies describe the anatomic distribution of the disease or the impact of number of lesion locations.

Objectives

To describe lesion locations and assess the relationship between the number of lesion locations (disease extent) and disease burden in patients with AD.

Methods

This cross‐sectional study included adults with dermatologist‐ or dermatology practitioner‐diagnosed AD enroled in the CorEvitas AD Registry (2020–2021) who initiated systemic therapy within 12 months prior to or at enrolment or had moderate‐to‐severe AD (vIGA‐AD® ≥3 and EASI ≥12) at enrolment. Thirteen areas of lesion involvement were assessed using a body map, and numbers of lesion locations were categorised as: 0, 1, 2–3, 4–6 and ≥7. Demographics, disease characteristics, PROs by number of lesion locations were descriptively compared using effect sizes (ES). The ES thresholds for small, medium, and large differences, respectively, were 0.10, 0.30, and 0.50 for phi (categorical outcomes) and 0.10, 0.25 and 0.40 for Cohen's f (continuous outcomes).

Results

Among 1211 patients, lesion involvement was most frequent on the arms (69.5%) and lower limbs (61.7%). A total of 10.6%, 9.3%, 20.1%, 26.3% and 33.8% of patients had 0, 1, 2–3, 4–6 and ≥7 lesion locations, respectively. Current use of systemic (≥81.2%) and topical ( ≥74.7%) therapies was common, irrespective of lesion location. Disease severity increased with number of lesion locations: mean total BSA (ES = 1.17), EASI (ES = 1.11), and SCORAD (ES = 1.21). vIGA‐AD ≥3 was observed in 28.3%, 45.3%, 78.0%, and 93.9% of patients with 1, 2–3, 4–6 and ≥7 locations, respectively (ES = 0.63). Greater number of lesion locations was associated with worse PROs: mean POEM (ES = 0.57), sleep loss (ES = 0.41), peak pruritus (ES = 0.50), DLQI (ES = 0.40), and ADCT (ES = 0.53). Uncontrolled AD (ADCT ≥7) was observed in 48.2%, 52.9%, 70.4%, 81.6% of patients with 1, 2–3, 4–6 and ≥7 locations, respectively (ES = 0.42).

Conclusions

AD lesions were reported for each body area assessed. Greater number of lesion locations was associated with increased disease severity, poor disease control, and decreased quality of life. Patients experienced substantial disease burden regardless of number of lesion locations involved.
Attitudes and practices of inflammatory bowel disease patients towards skin cancer risk and sun protection
Authors: Herlihy Maeve , Blake Eve , Carroll Pauline , Courtney Garry
Published: April 2024

Background

Skin cancer is the most common form of cancer in Ireland with over 13,000 new cases diagnosed annually. People with inflammatory bowel disease are at higher risk of developing skin cancer.

Objectives

The aim of this study is to assess inflammatory bowel disease (IBD) patients' awareness around skin cancer risk and photoprotection practices and to identify gaps in patient education regarding skin cancer prevention in IBD patients.

Methods

IBD patients >18 years old were invited to fill out a questionnaire while waiting for their outpatient appointment.

Results

A total of 87 patients (52% women) with IBD (Crohn's disease 62.8%, UC 35%,) were included. A total of 38 patients were diagnosed before age 25 (44%). Most patients were on active treatment for their IBD (96.5%, n = 85). Four patients had a personal history, and seven patients had a family history of skin cancer. Nearly half of participants (47.6%) were unaware or unsure of an increased risk of skin cancer associated with IBD and 42.5% were unaware or unsure of an increased risk with some IBD treatments. Behaviours around sun‐cream were generally good, however, other sun protective methods were suboptimal.

Conclusions

Only half (52.4%) of IBD patients surveyed were aware of a link between skin cancer and IBD. Skin cancer knowledge was generally good, however, photoprotection practices were suboptimal. This underscores the role of healthcare professionals in re‐enforcing sun safety information and skin cancer education in the IBD population.
Meniscal ramp lesion classification systems: A systematic review
Authors: Allende Felicitas , Berreta Rodrigo Saad , Allahabadi Sachin , Mowers Colton , Russo Raffaella , Palco Michelangelo , Simonetta Roberto , Familiari Filippo , Chahla Jorge
Published: April 2024

Purpose

To describe the proposed classification systems for meniscal ramp lesions (RLs) in the literature and evaluate their accuracy and reliability.

Methods

A systematic search was conducted according to the Preferred Reporting Items for Systematic reviews and Meta‐analyses guidelines utilising PubMed, Embase and Cochrane Library databases. Level I–IV studies referencing RLs along with either an arthroscopic‐ or magnetic resonance imaging (MRI)‐based classification system used to describe RL subtypes were included.

Results

In total, 21 clinical studies were included. Twenty‐seven (79%) of the included studies were published in 2020 or later. There were four main classification systems proposed within the literature (two arthroscopic‐, two MRI‐based), describing tear patterns, mediolateral extent, associated ligament disruption and stability of the lesion. The first classification was proposed in 2015 by Thaunat et al. and is referenced in 22 (64.7%) of the included studies. The application of the Thaunat et al. criteria to MRI showed variable sensitivity (31.70%–93.8%) and interobserver agreement (k = 0.55–0.80). The Greif et al. modification to the Thaunat et al. system was referenced in 32.4% of the included studies and had a substantial interobserver agreement (k = 0.8). Stability to probing and specific tear location were each used to classify RLs in 28.6% and 23.8% of the included clinical studies, respectively.

Conclusion

Although there has been a recent increase in the recognition and treatment of meniscal RLs, there is limited consistency in descriptive classifications used for this pathology. Current RL classification systems based on preoperative MRI have variable reliability, and arthroscopic examination remains the gold standard for diagnosis and classification.

Level of Evidence

Level IV.
Good physical function but reduced quality of life in children 3 years after ACL reconstruction
Authors: Lundgaard‐Nielsen Mathilde , Herzog Robert Bennike , Warming Susan , Rathcke Martin Wyman , Magnusson Stig Peter , Krogsgaard Michael Rindom
Published: April 2024

Purpose

To assess children's physical function and subjective knee status 1 and 3 years after anterior cruciate ligament (ACL) reconstruction. It was hypothesised that there was no difference between the operated and normal legs in relation to physical strength and function, that there was <‐2 mm side‐to‐side difference in knee laxity, and that the subjective knee function was better 3 years after ACL reconstruction compared to 1 year after.

Methods

Children (<16 years of age) who had an ACL reconstruction had follow‐up with physical function tests (four hop tests and strength measurement in a power rig [PR]), anterior knee laxity (measured using a Rolimeter) and patient‐reported outcome measures (Pedi‐International Knee Documentation Committee [IKDC] and Knee injury and Osteoarthritis Outcome Score [KOOS]‐Child) 1 and 3 years postoperatively. Changes from 1‐ to 3‐year follow‐up were evaluated with a paired t test.

Results

Out of 148 ACL reconstructed children, 60 had all measures. The four hop tests and the PR all yielded a Limb Symmetry Index >90% at both follow‐ups. There was a significant improvement from 1‐ to 3‐year follow‐up in two‐hop tests (6 m on time and crossover hop). Side‐to‐side knee laxity was >2 mm in four children at 1‐ and 3‐year tests. Pedi‐IKDC scores increased, and KOOS‐Child improved significantly from 1 to 3 years in two of the five domains: ‘Sport’ and ‘Quality of life’, but scores were lower than in a cohort of normal children.

Conclusion

The children had good objective physical function 1 and 3 years after ACL reconstruction. However, scores from the KOOS‐Child sport‐specific function and quality of life domains were lower than in normal children.

Level of evidence

Level II.
Sudden Deafness and Vestibulopathy in a Patient with Antibody Treatment for Metastatic Lung Cancer
Authors: Trache Mihnea Cristian , Köntopf Johannes , Stölzel Katharina , Häußler Sophia Marie
Published: April 2024

We describe the case of a patient who presented with sudden onset vertigo and bilateral deafness while under immune checkpoint therapy for metastatic bronchial carcinoma. Extensive audiologic assessment and vestibular function testing, as well as cranial magnetic resonance imaging (cMRI) and lumbar puncture was performed. The diagnostic workup confirmed bilateral sensorineural deafness and bilateral loss of vestibular function, while imaging revealed enhancement of the vestibulocochlear nerve. Initially, immunotherapy with PD‐L1 antibody atezolizumab was the assumed cause of the described symptoms. However, further findings strengthened the suspicion of meningeosis neoplastica. The differential diagnoses of hearing loss and vestibulopathy in the context of platin‐based chemotherapy, checkpoint inhibitor therapy and metastatic disease should be kept in mind for appropriate workup and therapy. Laryngoscope, 134:4347–4350, 2024
Bivalve tissues as a recorder of multidecadal global anthropogenic and climate‐mediated change in coastal areas
Authors: Liénart Camilla , Fournioux Alan , Garbaras Andrius , Lheureux Arnaud , Blanchet Hugues , Briant Nicolas , Dubois Stanislas F. , Gangnery Aline , Grouhel Pellouin Anne , Le Monier Pauline , De Montaudouin Xavier , Savoye Nicolas
Published: April 2024

Recent rapid changes in climate and environmental conditions have significantly impacted coastal ecosystem functioning. However, the complex interplay between global and local effects makes it challenging to pinpoint the primary drivers. In a multi‐ecosystem study, we analyzed pluri‐decadal trends of bivalve‐δ13C as recorder of global environmental changes. These trends were correlated with large‐scale natural and anthropogenic climate proxies to identify whether coastal biota responded to global effects. Our findings revealed decreasing bivalve‐δ13C trends in all sea regions, mainly linked with increased temperature and atmospheric‐CO2 concentrations, the later generating a decrease in atmospheric‐CO2 δ13C values (Suess effect) because of fossil‐fuel burning. After removing the Suess effect from bivalve‐δ13C trends, ongoing global climate variability continues to affect most ecosystems, possibly intensified by combined, interacting regional or local effects. These results highlight the need to consider large‐scale effects to fully understand ecosystem and food web responses to the multiple effects of global change.
Cash holdings decision‐making in Spanish family firms: Exploring the impact of heterogeneity
Authors: Parrado‐Martínez Purificación , Comino‐Jurado María , Sánchez‐Andújar Sonia
Published: April 2024

Cash holding decision‐making is one of the main corporate challenges for family firms (FFs), with significant consequences for their growth and survival. It is closely connected to key financial decisions such as financing, investments, and dividends. The motivations behind adjusting cash holdings vary, encompassing precautionary, risk avoidance, opportunity cost considerations, and the spending hypothesis. In our study, we aim to integrate specific motivations for cash holding decisions that stem from the influence of family dynamics within these businesses since FFs have unique characteristics, which affect their financial choices. Therefore, we analyze the impact of family involvement in management and the generational stage of FFs on their level of cash holdings. The results of the partial least squares–structural equation modeling, which was estimated on a sample of 7269 unlisted Spanish FFs, show that the higher the level of family involvement in management, as well as the higher the generational stage, the higher the level of cash holdings, with this having a positive effect on the firm's performance. In addition, we find that the positive relationship between family involvement in management and the level of cash holdings is strengthened by family ownership and weakened by family governance. These findings are relevant for a better understanding of the complexity of cash holding decision‐making in FFs and have practical implications not only for the FFs themselves but also for the entities related to them due to the important links between a firm's liquidity and its risk of default and performance.
The impact of Carbon Border Adjustment Mechanism on trade in the Russia‐Ukraine war context
Authors: Yang Yiwen , Wu Hsiu‐Chi , Hsu Sheng‐Ming , Chi Pei‐Yu , Lin Chin‐Ho
Published: April 2024

The Carbon Border Adjustment Mechanism (CBAM) is an impending mechanism that imposes a price on emissions embodied in products imported to the European Union (EU). It is expected to impact international trade substantially. Meanwhile, the Russia‐Ukraine war has been ongoing since March 2022, and resources are being redistributed accordingly. This study simulates the potential impact of CBAM on trade in the Russia‐Ukraine war context by employing the Computable General Equilibrium models. The simulation results show that the CBAM will significantly affect selected countries, and the impact will vary across countries and industries. In the context of the Russia‐Ukraine war, the influence on trade will be considerable.
Dynamics of a discrete one‐predator two‐prey system with Michaelis–Menten‐type prey harvesting and prey refuge
Authors: Song Ning , Li Jing , Zhu Shaotao
Published: April 2024

In this paper, we propose and study a discretized one‐predator two‐prey system along with prey refuge and Michaelis–Menten‐type prey harvesting. The interaction among the species is considered as Holling type III functional response. Firstly, existence and local stability of all the fixed points are derived under certain parametric conditions. Furthermore, a special consideration is made to global asymptotic stability of the interior fixed point. Then, we have shown that the system undergoes different types of bifurcations including transcritical bifurcation, flip bifurcation, and Neimark–Sacker bifurcation by using center manifold theorem, bifurcation theory, and normal form method. Also, Feigenbaum's constant of the system is calculated. It is observed that both harvesting and refuge have a stabilizing effect on the system, and the stabilizing effect of harvesting dominates the stabilizing effect of refuge. Of most interest is the finding of coexisting attractors and multistability. In particular, optimal harvesting policy has been obtained by extension of Pontryagin's maximum principle to discrete system. Finally, some intriguing numerical simulations are provided to verify our analytic findings and rich dynamics of the three species system.
A new analytic approach and its application to new generalized Korteweg‐de Vries and modified Korteweg‐de Vries equations
Authors: Kumar Sachin , Malik Sandeep
Published: April 2024

The current study is important from two perspectives. Firstly, in this article, we suggest a novel analytical technique for creating the exact solutions to nonlinear partial differential equations (NLPDEs). In order to study the dynamical behaviors of various wave phenomena, we can construct the several exact solutions in the form of Jacobi elliptic solutions, hyperbolic solutions, trigonometric solutions, and exponential solutions by using this method. Secondly, we consider a more generalized form of the (2+1)‐dimensional Korteweg–de Vries (KdV) and modified Korteweg‐de Vries (mKdV) equations that plays an important role in describing the shallow water. We successfully extract several soliton solutions for the examined equation. By choosing the appropriate parameters, some graphs of the discovered solutions have been represented in the figures. Every obtained solution has been demonstrated to satisfy the corresponding equation. The findings demonstrate that the method can be applied to solve a number of nonlinear evolution equations. The new solutions and the paper's findings could improve our understanding of how the waves move through shallow water and open up new research avenues.
Clinical VMAT machine parameter optimization for localized prostate cancer using deep reinforcement learning
Authors: Hrinivich William T. , Bhattacharya Mahasweta , Mekki Lina , McNutt Todd , Jia Xun , Li Heng , Song Daniel Y. , Lee Junghoon
Published: April 2024

Background

Volumetric modulated arc therapy (VMAT) machine parameter optimization (MPO) remains computationally expensive and sensitive to input dose objectives creating challenges for manual and automatic planning. Reinforcement learning (RL) involves machine learning through extensive trial‐and‐error, demonstrating performance exceeding humans, and existing algorithms in several domains.

Purpose

To develop and evaluate an RL approach for VMAT MPO for localized prostate cancer to rapidly and automatically generate deliverable VMAT plans for a clinical linear accelerator (linac) and compare resultant dosimetry to clinical plans.

Methods

We extended our previous RL approach to enable VMAT MPO of a 3D beam model for a clinical linac through a policy network. It accepts an input state describing the current control point and predicts continuous machine parameters for the next control point, which are used to update the input state, repeating until plan termination. RL training was conducted to minimize a dose‐based cost function for prescription of 60 Gy in 20 fractions using CT scans and contours from 136 retrospective localized prostate cancer patients, 20 of which had existing plans used to initialize training. Data augmentation was employed to mitigate over‐fitting, and parameter exploration was achieved using Gaussian perturbations. Following training, RL VMAT was applied to an independent cohort of 15 patients, and the resultant dosimetry was compared to clinical plans. We also combined the RL approach with our clinical treatment planning system (TPS) to automate final plan refinement, and creating the potential for manual review and edits as required for clinical use.

Results

RL training was conducted for 5000 iterations, producing 40 000 plans during exploration. Mean ± SD execution time to produce deliverable VMAT plans in the test cohort was 3.3 ± 0.5 s which were automatically refined in the TPS taking an additional 77.4 ± 5.8 s. When normalized to provide equivalent target coverage, the RL+TPS plans provided a similar mean ± SD overall maximum dose of 63.2 ± 0.6 Gy and a lower mean rectum dose of 17.4 ± 7.4 compared to 63.9 ± 1.5 Gy (p = 0.061) and 21.0 ± 6.0 (p = 0.024) for the clinical plans.

Conclusions

An approach for VMAT MPO using RL for a clinical linac model was developed and applied to automatically generate deliverable plans for localized prostate cancer patients, and when combined with the clinical TPS shows potential to rapidly generate high‐quality plans. The RL VMAT approach shows promise to discover advanced linac control policies through trial‐and‐error, and algorithm limitations and future directions are identified and discussed.
Validation of a short form of the practice environment scale of the nursing work index: The PES‐5
Authors: Lake Eileen T. , Gil Jennifer , Moronski Lynne , McHugh Matthew D. , Aiken Linda H. , Lasater Karen B.
Published: April 2024

The Practice Environment Scale of the Nursing Work Index (PES‐NWI) has been utilized for two decades globally to measure nurse work environments. Its 31 items in five domains present a substantial respondent burden, threatening survey response rates. The purpose of this study was to derive and validate a short form: the PES‐5. We conducted a cross‐sectional, secondary analysis of survey data from nurses in 760 hospitals in six U.S. states in 2016 or 2019. One representative item per subscale was selected by highest item‐to‐subscale R2 from the original PES‐NWI publication. Five psychometric properties of the PES‐5 were evaluated. The reproduced structure of the full form was confirmed in the 2016 data by the highest R2 for the selected items. The unidimensional structure of the PES‐5 was confirmed through confirmatory factor analysis. The correlation between the composite values of the 28‐item and 5‐item versions was 0.94. The Cronbach's alpha reliability of the PES‐5 was >0.80. The intraclass correlation coefficient (ICC 1, k), which evaluates the stability of aggregated values when data are clustered, i.e., nurses are nested within hospitals, was >0.80 in both datasets, demonstrating satisfactory aggregate properties. Construct validity was supported by the selected items being ranked highly in their respective subscales by an expert panel. Criterion validity was supported by an analysis of variance of the PES‐5 mean value across responses to a single‐item work environment measure. Similar patterns of relationships with other key variables were identified by statistically significant odds ratios in regression models predicting patient mortality from the PES‐5. The classification accuracy of the PES‐5 was high, with 88% of hospitals classified identically by both versions. The PES‐5 shows promise for measurement of nurses’ work environments while maximizing response rate by reducing participant burden.
Obesity‐related inflammatory protein signature in cardiovascular clinical outcomes: results from the Gutenberg Health Study
Authors: Panova‐Noeva Marina , Koeck Thomas , Schoelch Corinna , Schulz Andreas , Prochaska Jürgen H. , Michal Matthias , Strauch Konstantin , Schuster Alexander K. , Lackner Karl J. , Münzel Thomas , Hennige Anita M. , Wild Philipp S.
Published: April 2024

Objective

The objective of this study was to investigate whether an obesity‐related inflammatory protein signature (OIPS) is associated with adverse cardiovascular events.

Methods

The Olink Target 96 Inflammation panel was performed in 6662 participants from the population‐based Gutenberg Health Study (GHS). The OIPS was selected by a logistic regression model, and its association with cardiovascular outcomes was evaluated by Cox regression analysis. The GHS‐derived OIPS was externally validated in the MyoVasc study.

Results

The identified OIPS entailed 21 proteins involved in chemokine activity, tumor necrosis factor (TNF) receptor binding, and growth factor receptor binding. The signature revealed a novel positive association of axis inhibition protein 1 with obesity. The OIPS was associated with increased risk of all‐cause and cardiac deaths, major adverse cardiovascular events, and incident coronary artery disease, independent of clinical covariates and established risk instruments. A BMI‐stratified analysis confirmed the association of OIPS with increased death in those with obesity and overweight and with increased risk for coronary artery disease in those with obesity. The association of OIPS with increased risk of all‐cause and cardiac deaths was validated in the MyoVasc cohort.

Conclusions

The OIPS showed a significant association with adverse clinical outcomes, particularly in those with overweight and obesity, and represents a promising tool for identifying patients at higher risk for worse cardiovascular outcomes.
Adaptive thermogenesis, at the level of resting energy expenditure, after diet alone or diet plus bariatric surgery
Authors: Lopez Torres Silvia Y. , Aukan Marthe I. , Gower Barbara A. , Martins Catia
Published: April 2024

Objective

The objective of this study was to compare the magnitude of adaptive thermogenesis (AT), at the level of resting energy expenditure (REE), after a very low‐energy diet alone or combined with Roux‐en‐Y gastric bypass or sleeve gastrectomy, as well as to investigate the association between AT and changes in appetite.

Methods

A total of 44 participants with severe obesity underwent 10 weeks of a very low‐energy diet alone or combined with Roux‐en‐Y gastric bypass or sleeve gastrectomy. Body weight and composition, REE, subjective appetite feelings, and plasma concentrations of gastrointestinal hormones were measured at baseline and week 11. AT, at the level of REE, was defined as a significantly lower measured versus predicted (using a regression model with baseline data) REE.

Results

Participants lost 18.4 ± 3.9 kg of body weight and experienced AT, at the level of REE (−121 ± 188 kcal/day; p < 0.001), with no differences among groups. The larger the AT, at the level of REE, the greater the reduction in fasting ghrelin concentrations and the smaller the reduction in feelings of hunger and desire to eat in the postprandial state.

Conclusions

Weight‐loss modality does not seem to modulate the magnitude of AT, at the level of REE. The greater the AT, at the level of REE, the greater the drive to eat following weight loss.
Deep Learning for Automated Image Segmentation of the Middle Ear: A Scoping Review
Authors: Ross Talisa , Tanna Ravina , Lilaonitkul Watjana , Mehta Nishchay
Published: April 2024

Objective

Convolutional neural networks (CNNs) have revolutionized medical image segmentation in recent years. This scoping review aimed to carry out a comprehensive review of the literature describing automated image segmentation of the middle ear using CNNs from computed tomography (CT) scans.

Data Sources

A comprehensive literature search, generated jointly with a medical librarian, was performed on Medline, Embase, Scopus, Web of Science, and Cochrane, using Medical Subject Heading terms and keywords. Databases were searched from inception to July 2023. Reference lists of included papers were also screened.

Review Methods

Ten studies were included for analysis, which contained a total of 866 scans which were used in model training/testing. Thirteen different architectures were described to perform automated segmentation. The best Dice similarity coefficient (DSC) for the entire ossicular chain was 0.87 using ResNet. The highest DSC for any structure was the incus using 3D‐V‐Net at 0.93. The most difficult structure to segment was the stapes, with the highest DSC of 0.84 using 3D‐V‐Net.

Conclusions

Numerous architectures have demonstrated good performance in segmenting the middle ear using CNNs. To overcome some of the difficulties in segmenting the stapes, we recommend the development of an architecture trained on cone beam CTs to provide improved spatial resolution to assist with delineating the smallest ossicle.

Implications for Practice

This has clinical applications for preoperative planning, diagnosis, and simulation.
Comparative Outcomes for Microvascular Free Flap Monitoring Outside the Intensive Care Unit
Authors: Stevens Madelyn N. , Prasad Kavita , Sharma Rahul K. , Gallant Jean‐Nicolas , Habib Daniel R. S. , Langerman Alexander , Mannion Kyle , Rosenthal Eben , Topf Michael C. , Rohde Sarah L.
Published: April 2024

Objective

There is a trend towards nonintensive care unit (ICU) or specialty ward management of select patients. Here, we examine postoperative outcomes for patients transferred to a general ward following microvascular free flap (FF) reconstruction of the head and neck.

Study Design

Retrospective quality control study.

Setting

Single tertiary care center.

Methods

Consecutive patients who underwent FF of the head and neck before and after a change in protocol from immediate postoperative monitoring in the ICU (“Pre‐protocol”) to the general ward setting (“Post‐protocol”). Outcomes included overall length of stay (LOS), ICU LOS, FF compromise, and postoperative complications.

Results

A total of 150 patients were included, 70 in the pre‐protocol group and 80 in the post‐protocol group. There were no significant differences in age, sex, comorbidities, tumor stage, or type of FF. Mean LOS decreased from 8.18 to 7.68 days (P = .4), and mean ICU LOS decreased significantly from 5.2 to 1.7 days (P < .01). There were no significant differences in postoperative or airway‐related complications (P = .6) or FF failure rate (2.9% vs 2.6%, P > .9). There was a non‐significant increase in ancillary consults in the post‐protocol group (45% vs 33%, P = .13) and a significant increase in rapid response team calls, a nurse‐driven safety net for abnormal vitals or mental status (19% vs 3%, P = .003).

Conclusion

We show the successful implementation of a protocol shifting care of FF patients from the ICU to a general ward postoperatively, suggesting management on the floor with less frequent flap monitoring is safe and conserves ICU beds. Additional teaching and familiarity with these patients may over time reduce the rapid response calls.
The Positive Effect of Adenotonsillectomy on Drooling in Children
Authors: Kadosh Orna Katz , Sever Orna , Weiss Oshrat Sella , DeRowe Ari , Tauman Riva
Published: April 2024

Objectives

(1) To investigate the prevalence and severity of drooling among healthy young children referred for adenotonsillectomy; (2) to evaluate the effect of adenotonsillectomy on drooling.

Study Design

Prospective study.

Setting

Tertiary referral center.

Methods

Healthy typically developed children aged 18 to 48 months referred to adenotonsillectomy for upper airway obstruction (UAO) were recruited. Age‐matched children recruited from the community served as controls. Drooling frequency and severity were assessed at baseline and 2 months following surgery based on 2 subjective scales: the Drooling Infants and Preschoolers Scale (DRIPS) and Thomas‐Stonell and Greenberg Saliva Severity Scale (TSGS).

Results

Eighty‐seven children aged 18 to 48 months were included in the study. Forty‐three children referred to adenotonsillectomy (study group) and 44 age‐matched controls. There were significant differences in almost all of the DRIPS items between children in the presurgery group compared to controls. Drooling severity and frequency were greater in the former compared to the latter (TGF‐s severity: 1.4 ± 1.0 vs 0.6 ± 0.8, P = .001; TGF frequency: 1.3 ± 0.9 vs 0.5 ± 0.6, P < .001). After surgery, the scores for all DRIPS and TSGS items decreased significantly and were comparable to the control group.

Conclusions

The frequency and severity of drooling among otherwise young children referred for adenotonsillectomy were greater than those for healthy controls. Following surgery, both the frequency and severity significantly improved and became comparable to those of controls. These findings suggest that a major improvement in drooling is one of the benefits of a surgical intervention in a child with UAO.
Spring‐back of Al/CF/PEEK parts during one‐step hot stamping forming using a CAE chain considering all process steps
Authors: Lu Yan , Li Yibo , Liu Jingsong , Zhang Yong , Huang Minghui
Published: April 2024

Spring‐back is a forming defect in thermoplastic fiber‐metal‐laminate (FML) structures that is influenced by all steps of the forming process. Here, we propose a complete CAE chain to predict spring‐back in a FML parts during one‐step hot stamping by fully considering the material properties, latent heat, thermal mismatch, and modulus mismatch during forming and cooling. Then, constitutive models of the aluminum sheet, a visco‐hyperelastic constitutive model, and an elastic model of the UD CF/PEEK prepregs during hot‐stamping and cooling are introduced to describe the deformation behavior. A Coulombic friction model, latent heat model, and contact resistance model are also proposed to describe the interfacial flow, heat generation, and thermal conductivity. The proposed models and CAE chain are validated by the experimentally determined punching force, geometric shape, temperature, and spring‐back angle. The S‐shaped feature of the FML greatly increases the spring‐back of the FML specimens, and lower punching speeds and higher forming temperatures decreases the S‐shaped feature, thereby reducing the spring‐back angle.

Highlights

A complete CAE chain was proposed to predict spring‐back in a FML curved beam.

A new visco‐hyperelastic constitutive model of the CF/PEEK was applied.

The latent heat and thermal mismatch were considered in cooling simulation.

The S‐shaped feature of the FML greatly increases the spring‐back.

The thermal mismatch increased the S‐shaped feature of the FML.