bluuebunny/crossref_metadata_2025_split huggingface dataset:
Decision making for net zero policy design and climate action: considerations for improving translation at the research-policy interface: a UK Carbon Dioxide Removal case study
Authors: Workman Mark , Heap Richard , Mackie Erik , Connon Irena 
Published: December 2023

The impacts of climate change on society and the natural environment are being experienced now, with extreme weather events increasing in frequency and severity across the globe. To keep the Paris Agreement's ambition of limiting warming to 1.5°C above pre-industrial levels there is now also a need to establish and scale a new sector to remove CO2 at Giga-ton scale for over a century. Despite this mounting evidence and warnings, current climate policy in the UK and globally falls far short of achieving the required reductions in CO2 emissions or establishment of a new removal sector needed to stave off the risks posed by climate change. Some of the science on climate risk is well-evidenced, but the policy response is lacking in effectiveness. Other evidence to design policy, such as Carbon Dioxide Removal (CDR), is fraught with deep uncertainty. Why are the plethora of scientific evidence, assessments and decision support tools available to decision and policymakers not always translating into effective climate-net zero policy action? How can emergent evidence be introduced to shape new sectors such as CDR? What are the capacity gaps? Through a combination of literature review, interviews and UK policy workshops over 17 months these are some of the questions that this contribution sought insight. We set out three recommendations for policymakers and other stakeholders, including academic researchers and third sector organizations, to address the identified gaps associated with translating climate risk and net zero decision support into effective climate policy:• Enhance collaboration between decision-makers, policymakers, analysts, researchers, and other stakeholders to co-develop and co-design operational climate risk assessments and policies, relevant to context.• Identify the research and capacity gaps around climate risk decision-making under uncertainty, and work with stakeholders across the decision value chain to ensure those gaps are addressed.• Co-create effective translation mechanisms to embed decision-support tools into policy better, employing a participatory approach to ensure inclusion of diverse values and viewpoints.It is fundamental that there is improvement in our understanding about how we can make good decisions and operationalize them, rather than simply focus on further research on the climate risk and net zero problem.
Below average ChatGPT performance in medical microbiology exam compared to university students
Authors: Sallam Malik , Al-Salahat Khaled 
Published: December 2023

BackgroundThe transformative potential of artificial intelligence (AI) in higher education is evident, with conversational models like ChatGPT poised to reshape teaching and assessment methods. The rapid evolution of AI models requires a continuous evaluation. AI-based models can offer personalized learning experiences but raises accuracy concerns. MCQs are widely used for competency assessment. The aim of this study was to evaluate ChatGPT performance in medical microbiology MCQs compared to the students’ performance.MethodsThe study employed an 80-MCQ dataset from a 2021 medical microbiology exam at the University of Jordan Doctor of Dental Surgery (DDS) Medical Microbiology 2 course. The exam contained 40 midterm and 40 final MCQs, authored by a single instructor without copyright issues. The MCQs were categorized based on the revised Bloom’s Taxonomy into four categories: Remember, Understand, Analyze, or Evaluate. Metrics, including facility index and discriminative efficiency, were derived from 153 midterm and 154 final exam DDS student performances. ChatGPT 3.5 was used to answer questions, and responses were assessed for correctness and clarity by two independent raters.ResultsChatGPT 3.5 correctly answered 64 out of 80 medical microbiology MCQs (80%) but scored below the student average (80.5/100 vs. 86.21/100). Incorrect ChatGPT responses were more common in MCQs with longer choices (p = 0.025). ChatGPT 3.5 performance varied across cognitive domains: Remember (88.5% correct), Understand (82.4% correct), Analyze (75% correct), Evaluate (72% correct), with no statistically significant differences (p = 0.492). Correct ChatGPT responses received statistically significant higher average clarity and correctness scores compared to incorrect responses.ConclusionThe study findings emphasized the need for ongoing refinement and evaluation of ChatGPT performance. ChatGPT 3.5 showed the potential to correctly and clearly answer medical microbiology MCQs; nevertheless, its performance was below-bar compared to the students. Variability in ChatGPT performance in different cognitive domains should be considered in future studies. The study insights could contribute to the ongoing evaluation of the AI-based models’ role in educational assessment and to augment the traditional methods in higher education.
Interaction between triglyceride-glucose index and thyroid hormones on coronary artery disease risk in patient with euthyroid
Authors: Li Li , Cai Gaojun , Lu Wei , Li Feng , Yu Lei , Xiao Jianqiang 
Published: December 2023

BackgroundTriglyceride-glucose (TyG) index is an effective indicator in indentifying in pre-diabetes, diabetes, and coronary artery disease (CAD). However, the value of TyG index combined with thyroid hormones (THs) to affect CAD has not been fully evaluated. Here, we investigated the association between TyG index and THs and further studied the impacts of TyG index and THs on CAD in euthyroid.MethodsSubjects (1,297) with euthyroid who underwent selective coronary angiography (CAG) were enrolled in the present study, including 893 patients with CAD and 404 controls. The association between TyG index and THs were analyzed by linear regression models. Multivariate logistic regression analysis was used to evaluate the interaction of TyG and THs with the risk of CAD. According to the cutoff value of free triiodothyronine (FT3), free thyroxine (FT4), thyroid-stimulating hormone (TSH), and TyG index, the patients were respectively separated into four groups: low TyG/FT3 (low or high), high TyG/FT3 (low or high), low TyG/FT4 (low or high), high TyG/FT4 (low or high), low TyG/TSH (low or high), high TyG/TSH (low or high).ResultsThe baseline analysis showed that FT4 level differs among the three groups according to the tertile of the TyG index. Multiple linear regression analysis revealed decreased serum FT3 level and serum FT4 level as an independent risk factor for elevated TyG index. After adjusting for confounding variables, multiple logistic regression analysis showed that patients with lower TyG index and higher FT3 level had an important protective effect on CAD when considering patients with lower TyG index and FT3 level as reference(OR = 0.536, 95% CI: 0.369–0.778, P = 0.001). Patients with higher TyG index and FT4 level (lower or higher) had a significantly increased risk of CAD (OR 1.656, 95% CI: 1.117–2.455; OR = 1.920, 95% CI: 1.279–2.848, respectively). The area under the curve for the combined diagnosis of CAD by TyG index and FT3 level is 0.615.ConclusionsThese findings suggest that TyG is independently negatively correlated with FT3 or FT4 in euthyroid. In addition, there was a significant interaction between TyG index and THs on the risk of CAD.
Integrated metabolomics and transcriptomics to reveal biomarkers and mitochondrial metabolic dysregulation of premature ovarian insufficiency
Authors: Yu Zhaoyang , Peng Weilong , Li Feiwen , Fu Xiaoqian , Wang Jiajia , Ding Hongfan , Li Mujun , Wu Huimei 
Published: December 2023

BackgroundThe metabolic characteristics of premature ovarian insufficiency (POI), a reproductive endocrine disease characterized by abnormal sex hormone metabolism and follicle depletion, remain unclear. Metabolomics is a powerful tool for exploring disease phenotypes and biomarkers. This study aims to identify metabolic markers and construct diagnostic models, and elucidate the underlying pathological mechanisms for POI.MethodsNon-targeted metabolomics was utilized to characterize the plasma metabolic profile of 40 patients. The metabolic markers were identified through bioinformatics and machine learning, and constructed an optimal diagnostic model by classified multi-model analysis. Enzyme-linked immunosorbent assay (ELISA) was used to verify antioxidant indexes, mitochondrial enzyme complexes, and ATP levels. Finally, integrated transcriptomics and metabolomics were used to reveal the dysregulated pathways and molecular regulatory mechanisms of POI.ResultsThe study identified eight metabolic markers significantly correlated with ovarian reserve function. The XGBoost diagnostic model was developed based on six machine learning models, demonstrating its robust diagnostic performance and clinical applicability through the evaluation of receiver operating characteristic (ROC) curve, decision curve analysis (DCA), calibration curve, and precise recall (PR) curve. Multi-omics analysis showed that mitochondrial respiratory chain electron carrier (CoQ10) and enzyme complex subunits were down-regulated in POI. ELISA validation revealed an elevation in oxidative stress markers and a reduction in the activities of antioxidant enzymes, CoQ10, and mitochondrial enzyme complexes in POI.ConclusionOur findings highlight that mitochondrial dysfunction and energy metabolism disorders are closely related to the pathogenesis of POI. The identification of metabolic markers and predictive models holds significant implications for the diagnosis, treatment, and monitoring of POI.
Comparative diversity in glochidia of Australasian freshwater mussels
Authors: Klunzinger Michael W. , Jones Hugh A. , Humphrey Christopher L. , Melchior Michele , Raadik Tarmo A. , Treby Sarah , Chandler Lisa , Sheldon Fran 
Published: December 2023

Most freshwater mussels have larvae (glochidia in Unionidae, Margaritiferidae and Hyriidae) that are parasitic on fishes. This study describes and compares the diversity of glochidia among 17 species of Australasian Hyriidae. Here, scanning electron microscopy was used to illustrate shell morphology, while patterns of diversity in size, shape and morphological characteristics were analysed quantitatively and qualitatively with Principal Component, Linear Discriminant, and Multiple Correspondence Analyses to separate species with varying degrees of discrimination. Results showed shell lengths ranged from 50 to 390 μm. Shape varied, from sub-oval to sub-triangular, bilaterally symmetrical to scalene, and hook morphology varied from unicuspid, bicuspid, tricuspid or complex with varying length and structure. Unique observations of this study include the consistent variation in glochidial release mechanisms among Australian subfamilies and New Zealand genera. Hyridellini species andEchyridella aucklandica(Gray and Dieffenbach, 1843) are released either freely or as “mesoconglutinates” (presumed brood lures), whereas Velesunioninae andEchyridella menziesii(Gray and Dieffenbach, 1843) release glochidia in “amorphous mucous conglutinates”. Hyridellini predominantly occur within perennially flowing rivers of coastal south-eastern Australia with generally low turbidity, whereas the Velesunioninae occur more typically in slower flowing, intermittent waters, many prone to extended periods of high turbidity. Thus, where Hyridellini occur, mesoconglutinates as visual brood lures may be a more efficient mechanism for infesting host fishes than the passive infestation strategy typical of velesunionine species frequenting more turbid waters. Finally, this study presents systematic descriptions of glochidia and a provisional key for identification of Australasian hyriid glochidia, making an important contribution to the current understanding of taxonomy and life history traits, both critical for hyriid conservation.
Peripheral T lymphocyte and immunocyte subset dynamics: markers of neoadjuvant therapy outcomes in esophageal squamous cell carcinoma
Authors: Nie Xin , He Shuya , Nie Xinming , Li Changding , Du Kunyi , He Wenwu , Li Zhiyu , Ni Kunhan , Lu Simiao , Wang Chenghao , Wang Kangning , Miao Yan , Jiang Longlin , Lv Jiahua , Liu Guangyuan , Fang Qiang , Peng Lin , Xiao Wenguang , Wang Qifeng , Wang Dongsheng , Han Yongtao , Leng Xuefeng 
Published: December 2023

PurposeIn patients with resectable esophageal squamous cell carcinoma (ESCC), neoadjuvant therapy increased the curative resection rate, disease-free survival, and overall survival for patients with resectable ESCC. However, the efficacy of neoadjuvant therapy varies among different patients. We aim to compare the differences in the characteristics of peripheral blood T lymphocyte subsets before and after neoadjuvant therapy in patients with different curative efficacy.MethodThis study enrolled 266 ESCC patients who received neoadjuvant therapy and esophagectomy from August 2018 to August 2022. The postoperative pathological results divided patients into the major pathological response (MPR) and non-MPR groups. Compare the differences in peripheral blood T lymphocyte subsets and analyze the trend of changes in T lymphocyte subsets at different phases of treatment. Propensity score matching was used to reduce the influence of potential confounding factors.ResultsPrior to the neoadjuvant therapy, particularly before the second cycle, the MPR group exhibited significantly higher ratios of CD4/CD8 (P=0.009) and helper T cells (TH ratio, P=0.030) compared to the non-MPR group. In contrast, the suppressor T cell ratio (TS ratio) was lower (P=0.016) in the MPR group. The difference in peripheral blood lymphocyte subsets between the two groups of patients who underwent neoadjuvant chemoradiotherapy is significant.ConclusionIn peripheral blood, T lymphocyte subsets varied significantly based on the effectiveness of neoadjuvant treatment. Prior to the second cycle of neoadjuvant therapy, a higher CD4/CD8 and TH ratio, coupled with a decreased TS ratio, might suggest enhanced treatment outcomes.
Association between physical activity levels and healing in people with venous leg ulcers: secondary analysis of prospective cohort data
Authors: Qiu Yunjing , Osadnik Christian R. , Brusco Natasha K. , Sussman Geoffrey , Reeves Judy , Gleghorn Leanne , Weller Carolina D. , Team Victoria 
Published: December 2023

AimTo explore the relationship between physical activity levels and wound healing and recurrence in people with venous leg ulcers.MethodsQuestionnaires and medical records were used to collect data, with responses used to group participants into different physical activity groups. The differences in healing and recurrence outcomes of ulcers among different physical activity groups were compared using Chi-square, Kaplan Meier survival analysis, Cox proportional hazards regression analysis, and Kruskal-Wallis test. To measure the strength of the association between physical activity levels and patient outcomes, Spearman’s Rho tests were used. We used descriptive analysis to examine how physical activity levels change over 24 weeks.ResultsParticipants were classified into four distinct groups based on physical activity levels reported at baseline and week 12. The survival analysis showed higher physical activity level was associated with a shorter time to healing (log-rank test = 14.78, df = 3; p = 0.002). The persistently moderate-to-vigorous group had a 7.3-fold increased likelihood of healing compared to the persistently sedentary group. High levels of physical activity were also associated with a better quality of life score at baseline (ρ = 0.41, p &lt; 0.000), week 12 (ρ = 0.36, p &lt; 0.001), and week 24 (ρ = 0.49, p &lt; 0.000). Most participants (48.5%) reported low levels of physical activity, which remained low for the entire study period.ConclusionAn increased level of physical activity was linked to a shorter healing time and enhanced quality of life. Low levels of physical activity appeared common among people with venous leg ulcers.
A localized pallidal physiomarker in Meige syndrome
Authors: Zhang Bo , Tian Hong , Yu Yanbing , Zhen Xueke , Zhang Li , Yuan Yue , Wang Liang 
Published: December 2023

ObjectivesOscillatory patterns in local field potentials (LFPs) have been recognized as disease-specific physiomarkers, particularly in the context of Parkinson’s disease and cervical dystonia. This characteristic oscillatory feature is currently employed in adaptive deep brain stimulation (aDBS). However, for other types of dystonia, especially Meige syndrome, a distinct physiomarker of this nature is yet to be identified.MethodsLocal field potentials were recorded during microelectrode-guided deep brain stimulation surgery from 28 patients with primary Meige syndrome. Before surgery, the severity of patients’ motor syndrome were assessed using the Burke-Fahn-Marsden Dystonia Rating Scale-Motor (BFMDRS-M). An instantaneous oscillation detection method was employed to identify true narrowband oscillations. Subsequently, a linear mixed effects model was utilized to examine the relationship between oscillatory activities (including power amplitude and burst duration) and symptom severity.ResultsThe focal peaks of “oscillatory activities” detected were predominantly concentrated in the narrow theta band (4–8 Hz), constituting 81.5% of the total detected oscillations in all recording sites near active DBS contacts in the globus pallidus internus (GPi). The linear mixed effects model revealed a positive correlation between the theta burst duration and the severity of preoperative motor impairment, but no correlation with postoperative motor scores. Additionally, there was no significant lateralization effect observed between the left and right GPi.ConclusionOur findings suggest that the exaggerated narrowband theta activity (mainly the burst duration) in the GPi is predictive of dystonia symptom severity and may be used as a physiomarker for optimized DBS target during surgery and adaptive DBS for the treatment of Meige syndrome.
Eosinophils at diagnosis are elevated in amyotrophic lateral sclerosis
Authors: Yang Jing , Liu Tingting , Zhang Lei , Li Xin , Du Feng Ping , Liu Qi , Dong Hui , Liu Yaling 
Published: December 2023

IntroductionAmyotrophic lateral sclerosis (ALS) is a rare, devastating neurodegenerative disease that affects upper and lower motor neurons. To date, no effective treatment or reliable biomarker for ALS has been developed. In recent years, many factors have been proposed as possible biomarkers of ALS; however, no consensus has been reached. Therefore, a reliable biomarker is urgently needed. Eosinophils may play a crucial role in healthy humans and diseases, and serve as a biomarker for many chronic diseases.MethodsRoutine blood test results were collected from 66 healthy controls and 59 patients with ALS. The percentages and total numbers of each cell population were analyzed, and the correlation between these indicators and patient ALS functional rating scale–revised (ALSFRS-R) score or disease progression rate (ΔFS score) was analyzed.ResultsCompared to healthy controls, the number of blood leukocytes, neutrophils, monocytes, and basophils was significantly decreased in patients with ALS (p = 0.002, p = 0.001, p = 0.049, and p &lt; 0.0001, respectively). There was an increase in the number of eosinophils (p &lt; 0.0001), but no difference in the number of lymphocytes between patients with ALS and healthy controls was found (p = 0.563). Compared to healthy controls, the percentage of neutrophils was decreased and the percentage of lymphocytes and eosinophils was increased in patients with ALS (p = 0.01, p = 0.012, and p = 0.001, respectively). There was no difference between patients with ALS and healthy controls in the percentage of monocytes and basophils (p = 0.622 and p = 0.09, respectively). However, only the percentage and number of eosinophils had a correlation with the ΔFS score. Further multivariate analysis revealed a significant correlation between the disease duration, eosinophil count and percentage, and the disease progression rate (p &lt; 0.0001, p = 0.048, and p = 0.023, respectively). The neutrophil-to-eosinophil ratio (NER), lymphocyte-to-eosinophil ratio (LER), and monocyte-to-eosinophil ratio (MER) were significantly lower in patients with ALS than in healthy controls. However, only the LER was significantly correlated with the ΔFS score.ConclusionThese observations implicate neutrophils, lymphocytes, and eosinophils as important factors, and increasing eosinophil counts were negatively correlated with the ΔFS score in patients with ALS.
Neurorehabilitation of the upper extremity – immersive virtual reality vs. electromechanically assisted training. A comparative study
Authors: Lülsdorff Kira , Junker Frederick Benjamin , Studer Bettina , Wittenberg Heike , Pickenbrock Heidrun , Schmidt-Wilcke Tobias 
Published: December 2023

BackgroundSevere paresis of the contralesional upper extremity is one of the most common and debilitating post-stroke impairments. The need for cost-effective high-intensity training is driving the development of new technologies, which can complement and extent conventional therapies. Apart from established methods using electromechanical devices, immersive virtual reality (iVR) systems hold promise to provide cost-efficient high-intensity arm training.ObjectiveWe investigated whether iVR-based arm training yields at least equivalent effects on upper extremity function as compared to an electromechanically assisted training in stroke patients with severe arm paresis.Methods52 stroke patients with severe arm paresis received a total of ten daily group therapy sessions over a period of three weeks, which consisted of 20 min of conventional therapy and 20 min of either electromechanically assisted (ARMEOSpring®) or iVR-based (CUREO®) arm training. Changes in upper extremity function was assessed using the Action Research Arm Test (ARAT) and user acceptance was measured with the User Experience Questionnaire (UEQ).ResultsiVR-based training was not inferior to electromechanically assisted training. We found that 84% of patients treated with iVR and 50% of patients treated with electromechanically assisted arm training showed a clinically relevant improvement of upper extremity function. This difference could neither be attributed to differences between the groups regarding age, gender, duration after stroke, affected body side or ARAT scores at baseline, nor to differences in the total amount of therapy provided.ConclusionThe present study results show that iVR-based arm training seems to be a promising addition to conventional therapy. Potential mechanisms by which iVR unfolds its effects are discussed.