bluuebunny/crossref_metadata_2025_split huggingface dataset:
Delivery after a previous cesarean section reviewed
Authors: Turner Michael J. 
Published: May 2023

AbstractAt the start of the 20th century, cesarean section (CS) was uncommon in obstetrics. By the end of the century, CS rates had increased dramatically worldwide. Although the explanation for the increase is multifactorial, a major driver in the ongoing escalation is the increase in women who are delivered by repeat CS. This is due, in part, to the fact that there has been a sharp fall in vaginal birth after CS (VBAC) rates as fewer women are offered a trial of labor after CS (TOLAC), due principally to fears of a catastrophic intrapartum uterine rupture. This paper reviewed international VBAC policies and trends. A number of themes emerged. The risk of intrapartum rupture and its associated complications is low and may sometimes be overestimated. Individual maternity hospitals in both developed and developing countries are inadequately resourced to safely supervise a TOLAC. Efforts to mitigate the risks of TOLAC by careful patient selection and good clinical practices may be underutilized. Given the serious short‐term and long‐term consequences of rising CS rates for women and for maternity services generally, a review of TOLAC policies worldwide should be prioritized and consideration given to convening a Global Consensus Development Conference on Delivery after CS.
Experiences of genetic counseling students with disabilities and chronic illnesses: A qualitative study
Authors: Epstein Rachel , Fuerstman Laura , Heidlebaugh Alexis , Schiller Julia , Zayhowski Kimberly 
Published: May 2023

AbstractWhile many patients with disabilities or chronic illnesses are served by genetic counselors, little effort has been made to promote the inclusion of individuals with disabilities and chronic illnesses as professionals in the genetic counseling field. Genetic counselors with disabilities and chronic illnesses have reported insufficient support from their colleagues throughout all stages of their professional journeys, but there is a lack of research exploring these challenges. To gain an understanding of the experiences of this community during graduate training, we conducted semi‐structured interviews with 13 recent graduates of genetic counseling programs who identify as having a disability or chronic illness. Questions explored various aspects of the graduate school experience including challenges, strengths, relationships, disclosure, and accommodations. Qualitative thematic analysis of interview transcripts resulted in six themes: (1) decisions around disclosure are complex, (2) interactions with others contribute to feeling misunderstood, (3) the high‐performance culture in graduate programs makes it challenging to meet personal needs, (4) interpersonal relationships provide support, (5) the accommodation process is often disappointing, and (6) lived experiences are valuable to patients. This study reveals opportunities to better support genetic counseling students with disabilities and chronic illnesses through strengthening inclusion efforts, shifting away from ableist ideologies, and promoting more flexible training options.
A combined diagnostic model based on circulating tumor cell in patients with solitary pulmonary nodules
Authors: Wang Dong , Li Peng , Fei Xiang , Che Shuyu , Li Jinlong , Xuan Yunpeng , Wang Jinglong , Han Yudong , Gu Weiqing , Wang Yongjie 
Published: May 2023

AbstractBackgroundAlthough many prediction models in diagnosis of solitary pulmonary nodules (SPNs) have been developed, few are widely used in clinical practice. It is therefore imperative to identify novel biomarkers and prediction models supporting early diagnosis of SPNs. This study combined folate receptor‐positive circulating tumor cells (FR+CTC) with serum tumor biomarkers, patient demographics and clinical characteristics to develop a prediction model.MethodsA total of 898 patients with a solitary pulmonary nodule who received FR+CTC detection were randomly assigned to a training set and a validation set in a 2:1 ratio. Multivariate logistic regression was used to establish a diagnostic model to differentiate malignant and benign nodules. The receiver operating curve (ROC) and the area under the curve (AUC) were calculated to assess the diagnostic efficiency of the model.ResultsThe positive rate of FR+CTC between patients with non‐small cell lung cancer (NSCLC) and benign lung disease was significantly different in both the training and the validation dataset (p < 0.001). The FR+CTC level was significantly higher in the NSCLC group compared with that of the benign group (p < 0.001). FR+CTC (odds ratio, OR, 95% confidence interval, CI: 1.13, 1.07–1.19, p < 0.0001), age (OR, 95% CI: 1.06, 1.01–1.12, p = 0.03) and sex (OR, 95% CI: 1.07, 1.01–1.13, p = 0.01) were independent risk factors of NSCLC in patients with a solitary pulmonary nodule. The area under the curve (AUC) of FR+CTC in diagnosing NSCLC was 0.650 (95% CI, 0.587–0.713) in the training set and 0.700 (95% CI, 0.603–0.796) in the validation set, respectively. The AUC of the combined model was 0.725 (95% CI, 0.659–0.791) in the training set and 0.828 (95% CI, 0.754–0.902) in the validation set, respectively.ConclusionsWe confirmed the value of FR+CTC in diagnosing SPNs and developed a prediction model based on FR+CTC, demographic characteristics, and serum biomarkers for differential diagnosis of solitary pulmonary nodules.
Synthesis, surface activity and performance in “green” shampoo formulations of new carboxybetaine‐type surfactants
Authors: Lamch Łukasz , Witek Kamila , Oszczęda Weronika , Wilk Kazimiera A. 
Published: May 2023

AbstractNovel zwitterionic surfactants—(N‐methylalkylamide‐derived) [3‐(alkylmethylamino)‐3‐oxopropyl] dimethylammonium acetates (abbr. CnDMPAB, n = 10, 12, 14, and 16) have been rationally designed as multifunctional surface active compounds with the intended characteristics toward their application in natural shampoo formulations. The synthetic routes included the alkylation of N‐methyl‐N‐alkylamines with methyl 3‐(dimethylamino)propionate, followed by betainization, while the purification steps enabled the isolation of high‐purity products for physicochemical analyses. Surface activity and micellization properties of novel CnDMPAB surfactants were studied by surface tension isotherms, and their wettability by advancing and receding contact angle measurements utilizing the Wilhelmy method. The aim of these studies was to exhibit the full potential of CnDMPAB series compounds as the multifunctional components of modern, salt‐free shampoo formulations with confirmed natural origin. The performance activity studies of shampoos, containing CnDMPAB surfactants, as well as model formulation (with commercial cocoamidopropyl betaine), included organoleptic and foaming characteristics, viscosity measurements, dispersibility in distilled and tap water as well as microbiological characteristics. Our studies showed great potential of novel CnDMPAB surfactants in replacing commercial cocoamidopropyl betaine, especially considering their increased viscosity, faster dispersibility as well as enhanced natural origin content.
Utilizing a Functional Lumen Imaging Probe for Evaluation of the Pediatric Airway, A Pilot Study
Authors: Shen Sarek A. , Ding Andy S. , Zhao Jared , Seo Stefanie , Ng Kenneth , Walsh Jonathan 
Published: May 2023

ObjectivesAccurate and reproducible measurements of the pediatric airway are critical for diagnostic evaluation and management of subglottic and tracheal stenosis. The endoluminal functional lumen imaging probe (EndoFLIP) is a catheter‐based imaging probe which utilizes impedance planimetry to calculate luminal parameters, including cross‐sectional area and compliance. Herein, we demonstrate the feasibility of this system for multidimensional evaluation of the pediatric airway.Methods3D‐printed pediatric laryngotracheal models were created based on computed tomography scans, then artificially deformed to simulate both circumferential and posterior subglottic stenosis. Two observers made six measurements of the minimum cross‐sectional area (MCSA) and length of stenosis of each model with EndoFLIP. Agreement between observer measurements and model dimensions was evaluated using Lin's concordance correlation coefficient; inter‐observer reliability was assessed using intraclass correlation.ResultsFour models were created: two without pathology (MCSA: 132.4, 44.3 mm2) and two with subglottic stenosis (MCSA: 28.7, 59.7 mm2, stenotic length 27.8, 24.4 mm). Observer measurements of MCSA and length of stenosis demonstrated high concordance with the models (r = 0.99, 0.95, p < 0.001) with a mean error of 4.5% and 18.2% respectively. There was a low coefficient of variation (0.6%–2.8%) for measurements, indicating high precision. Interrater reliability was high for both MCSA and stenotic length (ICC: 0.99, 0.98).ConclusionsThe EndoFLIP system allows for accurate and reproducible measurements of cross‐sectional area and stenotic length in pediatric airway models. This method may provide further advantages in the evaluation of airway distensibility, as well as measurements of asymmetric airway pathology.Level of EvidenceNA Laryngoscope, 134:108–112, 2024
Dynamic Response of Surface‐Bound Peptides to a pH Perturbation Under Controlled Electrostatic Conditions
Authors: Moonitz Sasha A. , Noriega Rodrigo 
Published: May 2023

AbstractThe dynamic conformations of a thin peptide film covalently‐linked to the surface of a transparent electrode are characterized over the course of a perturbation to their local pH by a photoacid under a controlled electrostatic potential. The local environment at this functionalized electrified interface is probed by the ultrafast fluorescence intensity and transient anisotropy of chromophores sparsely attached to the peptide side chains. A partition of chromophores into two sub‐populations is observed, one buried in the peptide layer and another that is solvent exposed, and their relative contributions to the observed fluorescence signal are affected by both pH and voltage stimuli. The photophysical properties of solvent‐exposed chromophores reveal that while the average conformation of the peptide mat is dictated by the pH of the surrounding electrolyte, their fluctuations are largely determined by the local electrostatic conditions set by the electrode's surface potential.
Optimum fractionation of radiation to combine PD‐1 blockade
Authors: Teng Feifei , Yin Tianwen , Ju Xiao , Wang Peiliang , Wang Yungang , Yu Jinming 
Published: May 2023

AbstractThe optimum fractionation of radiation to combine with immune checkpoint blockade is controversial. This study aimed to investigate the fractionated radiation to maximize immunity during combination therapy. To evaluate the abscopal effect, C57BL/6 hPD‐1 knock‐in mice bearing two syngeneic contralateral MC38 murine colon cancer tumors were treated with four distinct regimens of radiotherapy. Three fractions of 8 Gy were chosen as the optimal fractionation to combine with anti‐PD‐1 as the optimal fractionation for maximizing immunity. Anti‐PD‐1 administration enhanced both local and systemic antitumor immunity in a cytotoxic T cell–dependent manner. Meanwhile, the spleen exhibited decreased myeloid‐derived suppressor cells (MDSCs) under combination treatment. Furthermore, RNA‐sequencing revealed significantly increased tumor necrosis factor (TNF) receptors and cytokines associated with lymphocyte infiltration in the combining group. Here we demonstrate that the hypofractionation of 8 Gy × 3f was the optimum‐fractionated dosage to maximize immunity, and the combination of anti‐PD‐1 showed promising results in boosting abscopal effect. Underlying mechanisms may include the activation of T cells and the reduction of MDSCs, which is achieved through the action of TNF and related cytokines. This study indicates a radioimmunotherapy dosage painting method that can be developed to overcome present limitations in tumor immunosuppression.
Resale in second‐price auctions with private entry
Authors: Cao Xiaoyong , Yang Yunxia , Li Siru 
Published: May 2023

AbstractThis paper investigates the effects of resale on bidders' entry decisions, social welfare, and seller's expected revenue in a second‐price auction with two‐dimensional private information on values and participation costs. We establish the existence of symmetric entry equilibrium and identify sufficient conditions under which the equilibrium is unique. We show that when resale is allowed, the low‐cost bidders become more aggressive on entry, while the high‐cost bidders are less likely to enter. Furthermore, our analysis also suggests resale allowance can increase the social welfare under a sufficient condition, which depends on the magnitude of bargaining power, and its effect on expected revenue is ambiguous.
Can local social norms motivate green innovation: Evidence from China
Authors: An Yahui , Qin Zezheng 
Published: May 2023

AbstractOur research suggests that the attention of local residents to environmental issues can influence green innovation by local firms. We examine the level of local attention to environmental issues (hereafter, local attention) and the number of green patents held by firms headquartered in these locations and find a positive correlation between local attention and the level of green innovation. We also find that this relationship is strengthened by local government subsidies. We provide evidence of the regulatory effect of local attention on chemical releases by local firms and demonstrate that local attention can be an effective estimator of local social norms.
Accelerating the integration of ChatGPT and other large‐scale AI models into biomedical research and healthcare
Authors: Wang Ding‐Qiao , Feng Long‐Yu , Ye Jin‐Guo , Zou Jin‐Gen , Zheng Ying‐Feng 
Published: May 2023

AbstractLarge‐scale artificial intelligence (AI) models such as ChatGPT have the potential to improve performance on many benchmarks and real‐world tasks. However, it is difficult to develop and maintain these models because of their complexity and resource requirements. As a result, they are still inaccessible to healthcare industries and clinicians. This situation might soon be changed because of advancements in graphics processing unit (GPU) programming and parallel computing. More importantly, leveraging existing large‐scale AIs such as GPT‐4 and Med‐PaLM and integrating them into multiagent models (e.g., Visual‐ChatGPT) will facilitate real‐world implementations. This review aims to raise awareness of the potential applications of these models in healthcare. We provide a general overview of several advanced large‐scale AI models, including language models, vision‐language models, graph learning models, language‐conditioned multiagent models, and multimodal embodied models. We discuss their potential medical applications in addition to the challenges and future directions. Importantly, we stress the need to align these models with human values and goals, such as using reinforcement learning from human feedback, to ensure that they provide accurate and personalized insights that support human decision‐making and improve healthcare outcomes.
Pantethine Ameliorates Recognition Impairment in a Mouse Model of Alzheimer's Disease by Modulating Cholesterol Content and Intestinal Flora Species
Authors: Chen Jianfeng , Li Yongsui , Chen Minyu , Liu Xinwei , Chen Jinghong , Li Xinlu , Wang Chao , Wan Guohui , Tian Jing 
Published: May 2023

ScopeAs a natural dietary low‐molecular‐weight thiol, pantethine helps maintain brain homeostasis and function in Alzheimer's disease (AD) mice. The current study aims to investigate the protective effects and underlying mechanisms of pantethine on the mitigation of cognitive deficits and pathology in a triple transgenic AD mouse model.Methods and resultsCompared to control mice, oral administration of pantethine improve spatial learning and memory ability, relieve anxiety, and reduce the production of amyloid‐β (Aβ), neuronal damage, and inflammation in 3×Tg‐AD mice. Pantethine reduces body weight, body fat, and the production of cholesterol in 3×Tg‐AD mice by inhibiting sterol regulatory element‐binding protein (SREBP2) signal pathway and apolipoprotein E (APOE) expression; lipid rafts in the brain, which are necessary for the processing of the Aβ precursor protein (APP), are also decreased. In addition, pantethine regulates the composition, distribution, and abundance of characteristic flora in the intestine; these floras are considered protective and anti‐inflammatory in the gastrointestinal tract, suggesting a possible improvement in the gut flora of 3×Tg‐AD mice.ConclusionThis study highlights the potential therapeutic effect of pantethine in AD by reducing cholesterol and lipid raft formation and regulating intestinal flora, suggesting a new option for the development of clinical drugs for AD.
The strategies and challenges of community foundations in community building: The making of cloakroom communities
Authors: Wang Xiaoyun 
Published: May 2023

AbstractIn a volatile, uncertain, and heterogeneous world, community philanthropic organizations play critical roles in community building. Nevertheless, few studies have examined the strategies of community philanthropic organizations in community building and the tensions they encounter in fluid communities. This study investigated four community foundations in highly mobile and diverse suburban communities and found that the strategies of community building involved highlighting the distinctiveness of locality, protecting the integrity of localities against the control of the metropolis, ensuring geographic representation of foundation leadership, and building an inclusive community identity that acknowledges diversity. Nevertheless, with the concern of alienating donors of dispersed interests, community‐building efforts have only created what Zygmunt Bauman calls the “cloakroom community,” a substitute for genuine communities, where people come together for a time, but their individual concerns are not blended into group interests, and collective actions to address community issues do not occur. This deters community foundations from effectively engaging local people and creating long‐lasting social solidarity.
Treatment adherence and associated factors in older people with type 2 diabetes: A qualitative study
Authors: Maghsoudi Zahra , Sadeghi Amir , Oshvandi Khodayar , Ebadi Abbas , Tapak Leili 
Published: May 2023

AbstractPatient ContributionOlder people with T2D participated in this study to achieve the objective of the study.AimTreatment adherence is an important indicator for evaluating successful diabetes control and overall disease management. It is necessary to identify the hidden themes of the concept of treatment adherence and related factors based on the experiences of older people with T2D. Therefore, the present study was conducted to identify the concept of treatment adherence and its associated factors in older people with type 2 diabetes (T2D).DesignThe study was conducted as a qualitative study using a content analysis approach.MethodsSemi‐structured interviews were conducted with 20 older people with T2D, between May and September 2021. Data were organized using MAXQDA‐10 software and analysed using the Elo and Kyngas qualitative content analysis method. We followed the COREQ Checklist to ensure rigour in our study.ResultsThree themes emerged from the analysis of the data, including: ‘Health literacy’, ‘Support umbrella’ and ‘responsibility’.
Upward bound students' experience with bias in healthcare: An application of critical race theory
Authors: Hilliard Elizabeth , Twiss Brittany , Pearson Michelle 
Published: May 2023

AbstractAimsTo explore how students participating in Trio Upward Bound, a federally funded program for low‐income and future first‐time college students, experience bias when seeking healthcare.DesignQualitative group discussion.MethodsTwenty‐six Trio Upward Bound students participated in a group discussion about their experiences in healthcare. Questions for the discussion were developed using Critical Race Theory. Student comments were analysed and coded using Interpretive Phenomenological Analysis (IPA). Results were reported using Standards for Reporting Qualitative Research.ResultsStudents reported experiencing bias in the healthcare setting because of age, race, native language, traditional dress and/or ability to advocate for their rights. Three themes emerged: communication, invisibility and healthcare rights. Through these themes students expressed how their experiences with healthcare lead to further cultural mistrust and mistrust of healthcare providers. The comments provided by students included examples of the five tenets of Critical Race Theory: the permanence of racism, colorblindness, interest convergence, Whiteness as property, and the critique of liberalism. Among this group of adolescents, early negative experiences in healthcare have led some to avoid seeking treatment. As this continues into adulthood it may further health disparities in these groups. Critical Race Theory is a valuable tool in understanding how race, class and age intersect to create disparities in healthcare.
Key issues in teaching and learning resulting from the Covid‐19 pandemic
Authors: Bates Tony 
Published: May 2023

AbstractThis article examines the impact of emergency remote learning and draws on both current and prior research to suggest ways forward in teaching and learning in higher education. Synchronous online learning was the primary delivery method during the Covid‐19 pandemic, but research has identified many limitations in this form of delivery, as well as some benefits. Many lessons and best practices in online learning had been developed before the pandemic, but these have been largely ignored both during and following the pandemic. The author suggests that hybrid learning (a mix of in‐person and online) is in general the future of teaching and learning in higher education, although there will be important but specific markets for both wholly in‐person and fully online learning. Research has indicated that effective online and hybrid learning requires a major shift in teaching, and particularly in assessment methods, from those used in classroom teaching. This presents a major challenge for faculty development, and some strategies to meet this challenge are suggested.