bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of Ex Vivo Adrenocorticotropic Hormone Responsiveness of Human Fetal Testis
Authors: Schröder Mariska A M , Greenald David , Lodewijk Renate , van Herwaarden Antonius E , Span Paul N , Sweep Fred C G J , Mitchell Rod T , Claahsen-van der Grinten Hedi L 
Published: November 2023

Abstract
Testicular adrenal rest tumors (TARTs), commonly occurring in males with congenital adrenal hyperplasia, may arise from chronic stimulation of adrenocorticotropic hormone (ACTH)–sensitive cells in the testes. It is not yet established whether the human fetal testis (HFT) is responsive to ACTH. To investigate this, we cultured HFT tissue with and without ACTH for up to 5 days, and quantified adrenal steroid hormones and expression of adrenal steroidogenic enzymes. Fetal testis and adrenal tissue produced high levels of testosterone and cortisol, respectively, indicating viability. In contrast to fetal adrenal tissues, the expression of ACTH receptor MC2R was either absent or expressed at extremely low levels in ex vivo HFT tissue and no clear response to ACTH in gene expression or steroid hormone production was observed. Altogether, this study suggests that the HFT is unresponsive to ACTH, which would indicate that a TART does not arise from fetal testicular cells chronically exposed to ACTH in utero.
Postnatal Development and Maintenance of Functional Pituitary Gonadotrophs Is Dependent on PI4-Kinase A
Authors: Constantin Stephanie , Sokanovic Srdjan J , Mochimaru Yuta , Smiljanic Kosara , Sivcev Sonja , Prévide Rafael M , Wray Susan , Balla Tamas , Stojilkovic Stanko S 
Published: November 2023

Abstract
Postnatal development of functional pituitary gonadotrophs is necessary for maturation of the hypothalamic-pituitary-gonadal axis, puberty, and reproduction. Here we examined the role of PI4-kinase A, which catalyzes the biosynthesis of PI4P in mouse reproduction by knocking out this enzyme in cells expressing the gonadotropin-releasing hormone (GnRH) receptor. Knockout (KO) mice were infertile, reflecting underdeveloped gonads and reproductive tracts and lack of puberty. The number and distribution of hypothalamic GnRH neurons and Gnrh1 expression in postnatal KOs were not affected, whereas Kiss1/kisspeptin expression was increased. KO of PI4-kinase A also did not alter embryonic establishment and neonatal development and function of the gonadotroph population. However, during the postnatal period, there was a progressive loss of expression of gonadotroph-specific genes, including Fshb, Lhb, and Gnrhr, accompanied by low gonadotropin synthesis. The postnatal gonadotroph population also progressively declined, reaching approximately one-third of that observed in controls at 3 months of age. In these residual gonadotrophs, GnRH-dependent calcium signaling and calcium-dependent membrane potential changes were lost, but intracellular administration of inositol-14,5-trisphosphate rescued this signaling. These results indicate a key role for PI4-kinase A in the postnatal development and maintenance of a functional gonadotroph population.
Severe Insulin Resistance in a Patient Treated With Nivolumab and Brentuximab-Vedotin for Hodgkin Lymphoma
Authors: Tama Elif , Black Meghan , Moustafa Muhamad Alhaj , Hurtado Maria D 
Published: November 2023

Abstract
This is a case of a 26-year-old male patient, with relapsing Hodgkin lymphoma, treated with nivolumab and brentuximab-vedotin, who was admitted with hyperglycemia and severe insulin resistance requiring approximately 2000 units of intravenous insulin per day. He had no prior diagnosis of diabetes. He was eventually diagnosed with massive cytokine release and hemophagocytic lymphohistiocytosis that led to multi-organ failure and death. The mechanisms behind the hyperglycemia with severe insulin resistance remain unclear but are possibly related to hyperinflammation and immune dysregulation resulting from massive cytokine release. Nivolumab among other immunotherapeutic agents, brentuximab-vedotin, and lymphoid malignancies are rare but known risk factors for massive cytokine release and hemophagocytic lymphohistiocytosis.
Effect of Preoperative Home-Based Exercise Training on Quality of Life After Lung Cancer Surgery: A Multicenter Randomized Controlled Trial
Authors: Machado Pedro , Pimenta Sara , Garcia Ana Luís , Nogueira Tiago , Silva Sónia , dos Santos Claúdia Lares , Martins Maria Vitória , Canha André , Oliveiros Bárbara , Martins Raul A. , Cruz Joana 
Published: November 2023

Abstract
Background
Preoperative exercise training is recommended for improvement of clinical outcomes after lung cancer (LC) surgery. However, its effectiveness in preventing postoperative decline in quality of life (QoL) remains unknown. This study investigated the effect of preoperative home-based exercise training (PHET) on QoL after LC surgery.

Methods
Patients awaiting LC resection were randomized to PHET or a control group (CG). The PHET program combined aerobic and resistance exercise, with weekly telephone supervision. Primary outcome was QoL-assessed with the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire C30 (QLQ-C30) at baseline, before surgery, and 1 month after surgery. The secondary outcomes were hospital length of stay and physical performance. The main analysis included a factorial repeated-measures analysis of variance. Additionally, the proportion of patients experiencing clinical deterioration from baseline to post-surgery was assessed.

Results
The study included 41 patients (68.1 ± 9.3 years; 68.3% male) in the intention-to-treat analysis (20 PHET patients, 21 CG patients). A significant group × time interaction was observed for global QoL (p = 0.004). Between-group differences in global QoL were statistically and clinically significant before surgery (mean difference [MD], 13.5 points; 95% confidence interval [CI], 2.4–24.6; p = 0.019) and after surgery (MD, 12.4 points; 95% CI, 1.3–23.4; p = 0.029), favoring PHET. Clinical deterioration of global QoL was reported by 71.4% of the CG patients compared with 30 % of the PHET patients (p = 0.003). Between-group differences in favor of PHET were found in pain and appetite loss as well as in physical, emotional and role functions after surgery (p < 0.05). Compared with CG, PHET was superior in improving preoperative five-times sit-to-stand and postoperative exercise capacity (p < 0.05). No between-group differences in other secondary outcomes were observed.

Conclusion
The study showed that PHET can effectively prevent the decline in QoL after LC surgery.
Perceptions of Readiness for Practice After Complex General Surgical Oncology Fellowship: A Survey Study
Authors: Behrens Shay , Lillemoe Heather A. , Dineen Sean P. , Russell Maria C. , Visser Brendan , Berman Russell S. , Farma Jeffrey M. , Grubbs Elizabeth , Davis Jeremy L. 
Published: November 2023

Abstract
Background
Surgical subspecialty training aims to meet the needs of practicing surgeons and their communities. This study investigates career preparedness of Complex General Surgical Oncology (CGSO) fellowship graduates, identifies factors associated with practice readiness, and explores potential opportunities to improve the current training model.

Methods
The Society of Surgical Oncology partnered with the National Cancer Institute to conduct a 36-question survey of CGSO fellowship graduates from 2012 to 2022.

Results
The overall survey response rate was 38% (221/582) with a slight male predominance (63%). Forty-six percent of respondents completed their fellowship after 2019. Factors influencing fellowship program selection include breadth of cancer case exposure (82%), mentor influence (66%), and research opportunities (38%). Overall, graduates reported preparedness for practice; however, some reported unpreparedness in research (18%) and in specific clinical areas: thoracic (43%), hyperthermic intraperitoneal chemotherapy (HIPEC) (15%), and hepato-pancreato-biliary (15%) surgery. Regarding technical preparedness, 70% reported being “very prepared”. Respondents indicated lack of preparedness in robotic (63%) and laparoscopic (33%) surgery approaches. Suggestions for training improvement included increased autonomy and case volumes, program development, and research infrastructure. Current practice patterns by graduates demonstrated discrepancies between ideal contracts and actual practice breakdowns, particularly related to the practice of general surgery.

Conclusions
This study of CGSO fellowship graduates demonstrates potential gaps between trainee expectations and the realities of surgical oncology practice. Although CGSO fellowship appears to prepare surgeons for careers in surgical oncology, there may be opportunities to refine the training model to better align with the needs of practicing surgical oncologists.
Field Experimental Evidence on the Effect of Pricing on Residential Electricity Conservation
Authors: Burkhardt Jesse , Gillingham Kenneth T. , Kopalle Praveen K. 
Published: November 2023

This study examines how electric utilities and regulators can encourage residential consumers to conserve electricity during the hottest summer days and shift electricity load from the day to off-peak, nighttime hours. We analyze a two-year field experiment involving 280 Texas households that explores approaches to conservation and load-shifting to enable emission reductions and reduce generation costs. Our critical peak pricing intervention reduces electricity consumption by 14% on the peak hours of the hottest days, leading to greenhouse gas emission reductions of about 16%. A key contribution of this study is the use of high-frequency appliance-level data. We show that 74% of the critical peak response is from reducing air conditioning. In a complementary nighttime pilot program, consumers respond strongly to lower prices by programming the timing of electric vehicle charging. Our work highlights how automation can influence the consumer tradeoffs relating to effort costs, discomfort, monetary incentives, and warm glow. This paper was accepted by Rajesh Chandy, Special Section of Management Science on Business and Climate Change. Supplemental Material: The data and online appendices are available at https://doi.org/10.1287/mnsc.2020.02074 .
The Challenge of Understanding What Users Want: Inconsistent Preferences and Engagement Optimization
Authors: Kleinberg Jon , Mullainathan Sendhil , Raghavan Manish 
Published: November 2023

Online platforms have a wealth of data, run countless experiments, and use industrial-scale algorithms to optimize user experience. Despite this, many users seem to regret the time they spend on these platforms. One possible explanation is that incentives are misaligned: platforms are not optimizing for user happiness. We suggest the problem runs deeper, transcending the specific incentives of any particular platform, and instead stems from a mistaken foundational assumption. To understand what users want, platforms look at what users do. This is a kind of revealed-preference assumption that is ubiquitous in the way user models are built. Yet research has demonstrated, and personal experience affirms, that we often make choices in the moment that are inconsistent with what we actually want. The behavioral economics and psychology literatures suggest, for example, that we can choose mindlessly or that we can be too myopic in our choices, behaviors that feel entirely familiar on online platforms. In this work, we develop a model of media consumption where users have inconsistent preferences. We consider a platform which wants to maximize user utility, but only observes behavioral data in the form of the user’s engagement. We show how our model of users’ preference inconsistencies produces phenomena that are familiar from everyday experience but difficult to capture in traditional user interaction models. These phenomena include users who have long sessions on a platform but derive very little utility from it, and platform changes that steadily raise user engagement before abruptly causing users to go “cold turkey” and quit. A key ingredient in our model is a formulation for how platforms determine what to show users: they optimize over a large set of potential content (the content manifold) parametrized by underlying features of the content. Whether improving engagement improves user welfare depends on the direction of movement in the content manifold: For certain directions of change, increasing engagement makes users less happy, whereas in other directions on the same manifold, increasing engagement makes users happier. We provide a characterization of the structure of content manifolds for which increasing engagement fails to increase user utility. By linking these effects to abstractions of platform design choices, our model thus creates a theoretical framework and vocabulary in which to explore interactions between design, behavioral science, and social media. This paper was accepted by Yan Chen, behavioral economics and decision analysis. Funding: This work was supported by the Vannevar Bush Faculty Fellowship and Multidisciplinary University Research Initiative [Grant W911NF-19-0217]. Supplemental Material: The online appendices are available at https://doi.org/10.1287/mnsc.2022.03683 .
Design of an optimized Alvarez lens based on the fifth-order polynomial combination
Authors: Ye Zhichao , Yan Jiapu , Jiang Tingting , Chen Shiqi , Xu Zhihai , Feng Huajun , Li Qi , Chen Yueting 
Published: November 2023

This paper proposes an optimized design of the Alvarez lens by utilizing a combination of three fifth-order X-Y polynomials. It can effectively minimize the curvature of the lens surface to meet the manufacturing requirements. The phase modulation function and aberration of the proposed lens are evaluated by using first-order optical analysis. Simulations compare the proposed lens with the traditional Alvarez lens in terms of surface curvature, zoom capability, and imaging quality. The results demonstrate the exceptional performance of the proposed lens, achieving a remarkable 26.36% reduction in the maximum curvature of the Alvarez lens (with a coefficient A value of 4×10−4 and a diameter of 26 mm) while preserving its original zoom capability and imaging quality.
Performance prediction of a circularly polarized graphene-dielectric resonator-based antenna for THz frequency application using machine learning algorithms
Authors: Kumar Kundan , Sadhu Pradip Kumar 
Published: November 2023

In this article, a graphene-dielectric resonator-based antenna is designed in the THz frequency regime. Circular polarization is achieved by feeding the cylindrical-shaped ceramic using a perturbed square-shaped aperture. Graphene loading over the alumina ceramic provides the frequency reconfigurable feature. In order to overcome the difficulty of simulating the THz antenna (i.e., very large simulation time), machine learning algorithms such as the artificial neural network (ANN) and random forest are used to effectively predict the performance of the designed antenna. The proposed antenna works effectively in between 5.0 and 5.5 THz with a 3 dB axial ratio frequency range from 5.1 to 5.35 THz. There is good correlation found between the predicted, measured, and simulated reflection coefficient and axial ratio. Due to stable radiation properties and good diversity performance within the operating frequency band, the proposed antenna can be employable for different wireless applications in the THz frequency regime.
Parameters of 391  nm lasing from molecular nitrogen ions pumped by a 950  nm femtosecond laser pulse
Authors: Zyatikov Ilya A. , Losev Valery F. 
Published: November 2023

The results of experimental studies of spectral, temporal, and spatial self-seed lasing characteristics at the wavelength of 391 nm in pure nitrogen at different values of specific pump power are presented. Pumping was carried out by a femtosecond radiation pulse at the wavelength of 950 nm. The possibility of obtaining lasing pulse duration close to transform-limited (1.83 ps) is presented. It is shown that far-field radiation divergence decreases with increasing lens focal length, and it correlates well with the geometric dimensions of laser plasma.
How effective is extracorporeal life support for patients with out-of-hospital cardiac arrest initiated at the emergency department? A systematic review and meta-analysis
Authors: Wongtanasarasin Wachira , Krintratun Sarunsorn , Techasatian Witina , Nishijima Daniel K. 
Published: November 2023

Background
Extracorporeal cardiopulmonary resuscitation (ECPR) is commonly initiated for adults experiencing cardiac arrest within the cardiac catheterization lab or the intensive care unit. However, the potential benefit of ECPR for these patients in the emergency department (ED) remains undocumented. This study aims to assess the benefit of ECPR initiated in the ED for patients with out-of-hospital cardiac arrest (OHCA).

Methods
We conducted a systematic review and meta-analysis of studies comparing ECPR initiated in the ED versus conventional CPR. Relevant articles were identified by searching several databases including PubMed, EMBASE, Web of Science, and Cochrane collaborations up to July 31, 2022. Pooled estimates were calculated using the inverse variance heterogeneity method, while heterogeneity was evaluated using Q and I2 statistics. The risk of bias in included studies was evaluated using validated bias assessment tools. The primary outcome was a favorable neurological outcome at hospital discharge, and the secondary outcome was survival to hospital discharge or 30-day survival. Sensitivity analyses were performed to explore the benefits of ED-initiated ECPR in studies utilizing propensity score (PPS) analysis. Publication bias was assessed using Doi plots and the Luis Furuya-Kanamori (LFK) index.

Results
The meta-analysis included a total of eight studies comprising 51,173 patients. ED-initiated ECPR may not be associated with a significant increase in favorable neurological outcomes (odds ratio [OR] 1.43, 95% confidence interval [CI] 0.30–6.70, I2 = 96%). However, this intervention may be linked to improved survival to hospital discharge (OR 3.34, 95% CI 2.23–5.01, I2 = 17%). Notably, when analyzing only PPS data, ED-initiated ECPR demonstrated efficacy for both favorable neurological outcomes (OR 1.89, 95% CI 1.26–2.83, I2 = 21%) and survival to hospital discharge (OR 3.37, 95% CI 1.52–7.49, I2 = 57%). Publication bias was detected for primary (LFK index 2.50) and secondary (LFK index 2.14) outcomes.

Conclusion
The results of this study indicate that ED-initiated ECPR may not offer significant benefits in terms of favorable neurological outcomes for OHCA patients. However, it may be associated with increased survival to hospital discharge. Future studies should prioritize randomized trials with larger sample sizes and strive for homogeneity in patient populations to obtain more robust evidence in this area.
“With group antenatal care, pregnant women know they are not alone”: The process evaluation of a group antenatal care intervention in Ghana
Authors: Zielinski Ruth , Kukula Vida , Apetorgbor Veronica , Awini Elizabeth , Moyer Cheryl , Badu-Gyan Georgina , Williams John , Lockhart Nancy , Lori Jody 
Published: November 2023

Background
An essential component to improving maternal and newborn outcomes is antenatal care. A trial of group antenatal care was implemented in Ghana where 7 health care facilities were randomized to be intervention sites and 7 control sites continued traditional antenatal care. Group antenatal care, where 10–14 women with similar due dates meet together for visits, includes traditional components such as risk assessment with increased opportunity for education and peer support. The study aim was to assess and report the process evaluation of the implementation of a group antenatal care intervention.

Methods
Process evaluation data were collected alongside intervention data and included both quantitative and qualitative data sources. Midwives at the health facilities which were randomized as intervention sites completed tracking logs to measure feasibility of the intervention. Research team members traveled to intervention sites where they conducted structured observations and completed fidelity and learning methods checklists to determine adherence to the model of group antenatal care delivery. In addition, midwives facilitating group antenatal care meetings were interviewed and focus groups were conducted with women participating in group antenatal care.

Results
In the majority of cases, midwives facilitating group antenatal care completed all components of the meetings with fidelity, following best practices such as sitting with the group rather than standing. Across 7 intervention sites, 7 groups (622 pregnant women) were documented in the tracking logs and of these participants, the majority (74%) attended more than half of the meetings, with 32% attending all 8 group meetings. Three themes were identified in both the midwife interviews and focus groups with pregnant women: 1) information sharing, 2) sense of community, and 3) time management challenges. An additional theme emerged from the focus groups with the women: women who had already given birth noticed a disconnect between what they learned and treatment received during labor and birth.

Conclusion
This process evaluation determined that group antenatal care can be implemented with fidelity in low and middle-income countries. Time management was the biggest challenge, however both midwives and pregnant women found the model of care not only acceptable, but preferable to traditional care. The knowledge shared and sense of community built during the meetings was a valuable addition to the individual model of antenatal care.
Predictors of COVID-19 vaccine uptake among persons aged 18 years and above in Ga North Municipality, Ghana using the Health Belief Model: A community-based cross-sectional study
Authors: Nasiratu Imoro , Pencille Lilian Belole , Khuzwayo Nelisiwe , Aboagye Richard Gyan , Tarkang Elvis Enowbeyang 
Published: November 2023

Background
Although the coronavirus disease 2019 (COVID-19) vaccination rollout has been accepted by the population of the Ga North Municipality, a substantial proportion has developed hesitancy to COVID-19 vaccination uptake. This study determined the predictors of COVID-19 vaccine uptake among persons aged 18 years and above in the Ga North Municipality using the Health Belief Model.

Methods
The study used a cross-sectional study design. Structured questionnaires were used to collect data from a multistage sample of 388 respondents. Multivariable binary logistic regression was used to determine the predictors of COVID-19 vaccination uptake at the level of 0.05 and 95% confidence interval.

Results
Vaccination uptake was 72.2%. The odds of COVID-19 vaccination uptake were higher among men than women [AOR = 2.02, 95% Cl: 1.13–3.20] and among singles than the married [AOR = 1.90, 95% Cl: 1.07–3.36], but lower among Muslims than Christians [AOR = 0.33, 95%Cl: 0.18–0.60]. Perceived susceptibility [AOR = 2.43, 95% Cl: 1.36–4.35], perceived barriers [AOR = 0.54, 95%Cl: 0.31–0.95], cues to action [AOR = 2.23, 95% Cl: 1.19–4.21] and self-efficacy [AOR = 3.23 95% Cl: 1.82–5.71] were the significant predictors of COVID-19 vaccination uptake.

Conclusion
The uptake of the COVID-19 vaccine in GA North Municipality is high. Health promotion interventions should focus on increasing perceived susceptibility to COVID-19, minimising barriers to COVID-19 vaccine uptake, and promoting cues and self-confidence for COVID-19 vaccine uptake. It should also target women, the married, and Muslims.