bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparing rates of agreement between different diagnostic criteria for fetal alcohol spectrum disorder: A systematic review
Authors: Myers Graysen , Burd Michael , Klug Marilyn G. , Popova Svetlana , Burd Larry 
Published: November 2024

AbstractDiagnostic accuracy is important in systems used to diagnose common disorders such as Fetal Alcohol Spectrum Disorder (FASD). Currently, no comprehensive study has examined rates of agreement between different diagnostic criteria for FASD. This study estimates the likelihood that a diagnosis of FASD using one set of diagnostic criteria will result in the same diagnosis when compared to different diagnostic criteria. A systematic review was conducted to identify articles reporting on the comparison of two or more diagnostic criteria for a diagnosis of FASD. Inclusion criteria required that the study present data that estimated agreement for a diagnosis of FASD or no‐FASD between two or more FASD criteria using two‐by‐two tables or presented data that could be used to generate the tables. Meta‐analyses with confidence intervals were included to demonstrate variability in the estimates. Standardized measures of agreement were assessed using the kappa statistic with 95% confidence intervals and the phi coefficient as a measure of correlation between binary outcomes. The search identified six studies reporting on eight different FASD diagnostic criteria. The studies compared agreement between 17 different pairings of the criteria. For individual children, agreement ranged from 53.7% to 91%. The agreement between the eight different diagnostic criteria ranged from 59.4% to 89.5%. The kappa statistic found that five associations had a kappa ranging from 0.6 to 0.8. This study illustrates that comparisons of multiple pairs of diagnostic criteria are likely to result in considerable variation in diagnoses of FASD for individual children and between different criteria. The lack of agreement between these commonly used systems is likely to affect clinical care and studies where diagnosis is a key variable. Large‐scale multicenter research is needed to examine factors contributing to variation in diagnostic outcomes.
Intra‐striatal dopaminergic inter‐subject covariance in social drinkers and non‐treatment‐seeking alcohol use disorder participants
Authors: Chumin Evgeny J. , Dzemidzic Mario , Yoder Karmen K. 
Published: November 2024

AbstractOne of the neurobiological correlates of alcohol use disorder (AUD) is the disruption of striatal dopaminergic function. Although regional differences in dopamine (DA) tone/function have been well studied, interregional relationships (represented as inter‐subject covariance) have not been investigated and may offer a novel avenue for understanding DA tone. Positron emission tomography (PET) data with [11C]raclopride in 22 social drinking controls and 17 AUD participants were used to generate group‐level striatal covariance (partial Pearson correlation) networks, which were compared edgewise as well as on global network metrics and community structure. An exploratory analysis examined the impact of tobacco cigarette use status. Striatal covariance was validated in an independent publicly available [18F]fallypride PET sample of healthy volunteers. Striatal covariance of control participants from both data sets showed a clear bipartition of the network into two distinct communities, one in the anterior and another in the posterior striatum. This organization was disrupted in the AUD participants' network, which showed significantly lower network metrics compared with the control participants' network. Stratification by cigarette use suggests differential consequences on group covariance networks. This work demonstrates that network neuroscience can quantify group differences in striatal DA and that its interregional interactions offer new insight into the consequences of AUD.
Liquidity constraints for variable inputs at planting time and the maize production and marketing decisions of smallholder farmers in Zambia
Authors: Melkani Aakanksha , Mason Nicole M. , Mather David L. , Chisanga Brian , Jayne Thomas 
Published: November 2024

AbstractIncreasing smallholders market participation is acknowledged as an important step towards greater rural prosperity in developing countries. While existing literature identifies high transaction costs and market imperfections as challenges faced by smallholders in accessing agricultural markets, less attention has been paid to the role of constraints to the production of a marketable surplus. Specifically, there is a dearth of empirical evidence about how liquidity constraints during the production period that limit smallholders’ investments in agricultural inputs can affect agricultural production and subsequently their market participation and choice of marketing channel. We explore this issue in the context of the Zambian maize market during a period when the country's parastatal marketing board – the Food Reserve Agency (FRA) – operated alongside private buyers and purchased large volumes of maize at a pan‐territorial price that exceeded average market prices. Although we cannot definitively identify causal effects, we find strong and robust associations indicating that smallholder maize‐growing households who were liquidity‐constrained during the production period harvested less maize, were less likely to sell maize, and were less likely to sell to the FRA, as compared to those who were unconstrained. Liquidity constraints during the production period likely exacerbate the already disproportionate capture of FRA benefits by wealthier farmers.
Association of Systemic Inflammatory Indices and Last Trimester APRI Score With Perinatal Outcomes in Pregnant Women With Pregestational Diabetes–A Prospective Observational Study
Authors: Okutucu Gulcan , Tanacan Atakan , Kara Sengul , Ozkavak Osman Onur , Atalay Aysegul , Kara Ozgur , Sahin Dilek 
Published: November 2024

ABSTRACTAimsTo investigate whether systemic inflammatory indices and the last trimester APRI score change in PGDM and to evaluate the relationship between these alterations and perinatal outcomes.MethodsA total of 240 pregnant women, 120 of whom were pregestational diabetic (40 with T1DM and 80 with T2DM), were analyzed. In each trimester, WBC, NEU, LNF, PLT, NLR, dNLR, PLR, PNR, and SII values, and in the last trimester MON, PMR, SIRI, AST values, and APRI score were recorded and compared between PGDM and control cohorts.ResultsThe first trimester WBC, NEU, and LNF values were higher and the PNR values were lower, the second trimester LNF value was higher and the NLR was lower, the third trimester APRI score was higher in the PGDM group. In diabetic pregnant women, the optimal cut‐off value of NEU for predicting LBW in the first trimester was 6.965 × 10⁹/L (62.5% sensitivity and 61.6% specificity), while the optimal cut‐off value of the last trimester APRI score for predicting preterm delivery was 0.072 (61.9% sensitivity and 61.6% specificity). In predicting NICU, the optimal cut‐off value for second trimester NLR was found to be 3.973 (70% sensitivity and 70% specificity) in the T1DM group, while the optimal cut‐off values for first and second trimester LNF were 2.395 × 10⁹/L (75% sensitivity and 71.1% specificity) and 2.23 × 10⁹/L (75% sensitivity and 68.4% specificity) in the T2DM group, respectively.ConclusionsIn routine clinical practice, the first trimester NLR and last trimester APRI score may be used as additional tools for predicting perinatal outcomes in pregnancies affected by PGDM.
Usefulness of participation of endoscopic surgical skill qualification system‐qualified surgeons in laparoscopic high anterior resection
Authors: Sawada Naruhiko , Mukai Shumpei , Akagi Tomonori , Okamoto Ken , Fujita Fumihiko , Suwa Hirokazu , Ide Yoshihito , Furuhata Tomohisa , Kanazawa Akiyoshi , Shimamura Tsukasa , Kojima Shigehiro , Ohnuma Shinobu , Kinjo Tatsuya , Ichikawa Nobuki , Yamaguchi Shigeki , Taketomi Akinobu , Naitoh Takeshi ,   EnSSURE Study Group Collaboratives in the Japan Society of Laparoscopic Colorectal Surgery
Published: November 2024

AbstractIntroductionA technical qualification system was established by the Japanese Society of Endoscopic Surgery in 2004, and its effectiveness in low anterior resection (LAR) has been reported. We herein performed a subgroup analysis of the effectiveness of the participation of technically qualified surgeons in laparoscopy‐assisted high anterior resection (HAR), a procedure used for the technical qualification of surgeons.MethodsThe EnSSURE study enrolled 3188 patients who underwent laparoscopic rectal resection for rectal cancer between January 2014 and December 2016 at 56 Japanese hospitals. The outcomes of HAR were compared between groups with and without the participation of technically qualified surgeons. The background of the two groups were equalized by propensity score matching.ResultsIn the group with the participation of qualified surgeons, the operative time was significantly shorter (p = .0427), more lymph nodes were dissected (p = .0207), and the conversion rate to open surgery was lower (p = .0016); however, no significant difference was observed in blood loss (p = .0616), the R0 resection rate (p = 1.00), intraoperative complication rate (p = .160), postoperative complication rate (p = 1.00), or reoperation rate (p = .6999) between the two groups. Furthermore, no significant difference was noted in long‐term outcomes (recurrence‐free survival (p = .275) or overall survival (p = .941)).ConclusionsIn HAR, the technical benefits of the participation of qualified surgeons was limited to a shorter operative time and lower conversion rate. Nevertheless, the qualification is unique in that it predicts the usefulness of reducing complications in more technically challenging procedures when its effectiveness in LAR is considered.
Learning Curves and Surgical Outcomes of Laparoscopic Sleeve Gastrectomy Performed by an Attending Surgeon and Trainee Surgeons
Authors: Takahashi Takamasa , Maeda Atsuyuki , Takayama Yuichi , Aoyama Hiroki , Takahashi Daigoro , Hosoi Takahiro , Fujiya Atsushi 
Published: November 2024

ABSTRACTBackgroundLaparoscopic sleeve gastrectomy (LSG) is a commonly performed procedure for bariatric and metabolic surgery. However, few reports exist concerning the learning curves and surgical outcomes of LSG among trainee surgeons. This study aimed to investigate the learning curves and surgical outcomes of LSG for one attending surgeon and trainee surgeons.MethodsIn this study, 90 patients who underwent LSG were retrospectively evaluated. Surgical learning curves for the attending and the trainees were assessed via cumulative sum (CUSUM) analysis. After the attending reached the learning phase, the trainees performed LSG under the guidance of the attending. Surgical and postoperative outcomes were compared retrospectively.ResultsThe CUSUM plot of the attending peaked in the 16th case, began to decrease and reached a plateau in the 49th case. Therefore, we defined the attending in Phase I up to 16 LSGs (n = 16; learning phase), in phase II between 27 and 48 LSGs (n = 22; acquisition phase), and in Phase III from 49 or more LSGs (n = 29; plateau phase). The CUSUM of the trainees' operative time declined from the beginning. The median operative time was significantly shorter in the trainees than in the attending in Phase I (184 [146–266] vs. 161 [111–255], p < 0.01). %EWL was significantly better in the patients of the trainees than in those of the attending (92.4 ± 35.7 vs. 71.0 ± 28.7, p < 0.01). These results indicate that trainees could perform LSG in a stable manner.ConclusionUnder the guidance of experienced surgeons, LSG can be safely performed by trainees without prolonged surgical time.
CEO Dismissals and Financial Restatements: The Role of Ethical Governance and Board Dynamics
Authors: Gao Ru (Tina) , Guo Shijun , Yao Daifei (Troy) 
Published: November 2024

AbstractThis study re‐examines the relationship between CEO dismissals and financial restatements using a new, comprehensive dataset covering S&P 1500 firms from 2000 to 2018. This dataset offers several advantages over previous research: it provides precise data on CEO dismissals, enables large‐sample analysis and includes detailed reasons for executive departures. Our findings confirm a positive relationship between financial restatements and CEO dismissals, with a heightened likelihood of dismissal in recent years reflecting increased board attention to ethical issues. Additionally, restatements are revealed to amplify the negative impact of weak financial performance on CEO turnover, as CEOs of poorly performing firms face a higher risk of dismissal after a restatement, whereas strong financial performance generally offers protection. Furthermore, we explore how board characteristics affect this relationship and reveal significant heterogeneity in board responses. Specifically, female board representation, directors’ financial expertise, CEO–board connections, directors’ experience with prior fraud incidents, and multiple directorships all moderate the likelihood of CEO dismissal following restatements. These findings provide new insights into the complex interplay among financial performance, ethical governance and board dynamics in CEO turnover decisions.
‘It's extremely weird to understand UK culture when you don't live there and just study from abroad’: An empirical investigation of internationalisation at a distance perspectives
Authors: Rienties Bart , Ramanau Ruslan 
Published: November 2024

AbstractFollowing the conceptualisation of a third space of internationalisation at a distance (IaD) in this study, we aim to explore how international students at the largest university in Europe, the Open University, might consider their own identities and perspectives. At present over 5000+ international students study at a distance at the Open University, whereby many are based in the UK. At the same time, hundreds of international students do not live in the UK and might be classified as IaD students. Whether or not there are any meaningful similarities or differences in lived experiences between these two groups of international students has thus far received limited empirical attention. Using a mixed‐methods study of previously validated instruments, we explored the lived experiences of 266 students (72 IaD, 49 IA, 115 IaH, and 30 UK students living overseas), followed by eight interviews. Our quantitative analyses suggest limited empirical support for the IaD framework, while the qualitative lived experiences of students do provide some unique narratives of IaD students.
Practitioner notesWhat is already known about this topic

Global rise of students studying abroad, with an increase in students studying abroad at a distance.
Recent conceptualisations of IaD suggest substantial barriers for IaD students to participate in distance learning.
Limited empirical research to date available in European context.
What this paper adds

In this mixed‐method study, we looked at 266 students at the largest distance university in Europe and compared the lived experiences of academic and social adjustment between four groups (ie, living in the UK or not × born in the UK or born overseas).
Our quantitative findings indicated that IaD students had similar lived experiences as other students when following distance learning.
Our qualitative findings suggest some IaD students did experience adaption issues in particular.
Implications for practice and/or policy

Fostering a greater sense of community and belonging among geographically dispersed IaD students might help to alleviate social isolation.
Consider providing national‐specific communities in online learning to build social support groups.
Ensure that the distance learning format, learning design and content are inclusive of the wide range of international students the university serves.
Evidence generation throughout paediatric medicines life cycle: findings from collaborative work between European Medicines Agency (EMA) and EUnetHTA on use of extrapolation
Authors: Karres Dominik , Pino‐Barrio María José , Benchetrit Sylvie , Benda Norbert , Cochat Pierre , Galluzzo Sara , García‐Solís Alejandro , Gonzalez Sara , de Lisa Roberto , Khan David , Lankester Rita , Lentz Frederike , Martínez‐Ortega Pilar Angustias , Montilla Simona , Morales Daniel R. , Tshinanu Flora Musuamba , Sánchez Sonia Pulido , Montero Ana Rossignoli , Scherer Sabine , Thomson Andrew , Garrido Belén Torres , Umuhire Denise , Wang Siri , Bax Ralph , Hedberg Niklas 
Published: November 2024

AbstractDrug development for children presents unique challenges and is highly regulated. Novel approaches, such as the use of extrapolation to address, for example, the need to avoid unethical studies, whilst supporting robust evidence generation have been developed in support of benefit/risk considerations by regulatory authorities. This is only one step in the decision‐making process towards access, which in Europe also includes health technology assessment (HTA) bodies.Discussions related to evidentiary requirements in small populations using scientific evidence transfer have been identified as a priority action by European Medicines Agency/European Network for Health Technology Assessment 21 (EMA/EUnetHTA 21). We describe the outcome of this work and reflect on the discussions that had taken place on how to leverage prior knowledge through identifying and addressing uncertainties during life cycle management to support regulatory and HTA decision‐making. Using examples, we explore the range of applications for evidence generation and offer regulatory and HTA insights on key design considerations for producing better evidence, reflecting our shared ambition. Early interactions with all respective stakeholders, particularly between regulators and HTA bodies are key to optimise data generation and utility in children.In Europe, the HTA regulation will offer opportunities for collaborations, which are important for all development efforts. We collaboratively explored the unique specific challenges relating to paediatric drug development, ethically and in its ability to leverage prior knowledge, as exemplified using extrapolation. Learnings from these offer opportunities to further develop methodology on how to leverage uncertainties across a product's life cycle for small populations generally.
Nelarabine‐combined chemotherapy improves outcome of T‐cell acute lymphoblastic leukemia but shows more severe neurotoxicity: JALSG T‐ALL213‐O
Authors: Hayakawa Fumihiko , Mori Naoki , Imai Kiyotoshi , Yokoyama Yasuhisa , Katsuoka Yuna , Saito Takeshi , Murayama Tohru , Yamazaki Etsuko , Sato Shinya , Atsuta Yoshiko , Ishikawa Yuichi , Sakaida Emiko , Hatta Yoshihiro , Matsumura Itaru , Miyazaki Yasushi , Kiyoi Hitoshi ,   Japan Adult Leukemia Study Group (JALSG)
Published: November 2024

AbstractWe investigated the effectiveness and safety of nelarabine (NEL)‐combined chemotherapy for newly diagnosed adult T‐cell acute lymphoblastic leukemia (T‐ALL) patients. We conducted a phase II trial, T‐ALL213‐O, where adult T‐ALL patients aged 25 to 64 were treated by a regimen based on that used in our previous study, ALL202‐O. The main modifications from ALL202‐O to T‐ALL213‐O were as follows: (1) NEL‐combined chemotherapy, instead of consolidation (C)1, was used for non‐complete remission (CR) patients after induction therapy (IND)1 as IND2; (2) NEL treatments were inserted into C3 and C5 on day 29. Twenty‐four patients were analyzed. Ten patients did not receive NEL treatment due to therapy termination prior to C3. Three‐year event‐free survival (EFS) was 70%, with 52% as the lower limit of its 90% confidence interval, which exceeded the threshold of 25%; thus, the study treatment was considered effective. The CR rates by IND1, IND2, and both were 75%, 100%, and 88%, respectively. The 5‐year EFS and 5‐year overall survival rates were 66% and 70%, respectively, with median follow‐ups of 7.7 and 7.8 years. The addition of NEL improved the CR rate but not survival, compared with T‐ALL patients in ALL202‐O. Severe neuropathy after NEL administration was observed at a high frequency. Seven (50%) of 14 patients treated with NEL showed grade 3 peripheral neuropathy and/or gait disturbance. The neurotoxicity was considered stronger than that previously reported. Combination therapy of NEL at this dose and intensive multidrug chemotherapy is associated with a high risk of severe neurotoxicity (JALSG T‐ALL213‐O, UMIN000010642).
T cells from newly diagnosed multiple sclerosis patients have enhanced responsiveness to CD46 activation
Authors: Sundvall Linda , Rossen Litten S. , Schack Vivien R. , Bundgaard Bettina , Rasmussen Peter V. , Petersen Thor , Höllsberg Per 
Published: November 2024

AbstractObjectiveTo evaluate the responsiveness of T cells from newly diagnosed multiple sclerosis (MS) patients to CD46 co‐stimulation, a membrane co‐factor protein potentially involved in MS pathogenesis.MethodsT cells from MS patients and non‐diseased symptomatic controls (SC) were activated in vitro with or without αCD46 antibody co‐stimulation. Cytokine responses were measured to assess T‐cell responsiveness. The fold difference between αCD3/CD46 and αCD3/isotype responses was calculated to determine the enhancement of CD46 activation in MS compared with SC. Additionally, the CD46 receptor phenotype, including the expression of the CD46 CYT‐1 and CYT‐2 isoforms, was analyzed.ResultsIn the absence of αCD46 co‐stimulation, MS T cells showed weaker cytokine responses compared to SC. However, CD46 engagement neutralized this deficit, resulting in a higher fold difference in MS αCD3/CD46 responses compared to SC. MS T cells also showed a trend toward a biased CD46 receptor phenotype, with a preference for the CD46 CYT‐2 isoform.ConclusionsCD46 activation enhances T‐cell responses in newly diagnosed MS patients. A bias toward the CD46 CYT‐2 isoform is observed, aligning with the previous findings that the absence of CYT‐2 downregulation in MS might contribute to a pro‐inflammatory environment.