bluuebunny/crossref_metadata_2025_split huggingface dataset:
Observation versus intervention for incidental common bile duct stones at intraoperative cholangiogram: a systematic review
Authors: Crichton J. , Cox S. , Tong C. , Leow P. , Field X. , Welsh F. 
Published: June 2023

AbstractBackgroundThe natural history of incidental common bile duct stones (CBDS) is poorly understood. Current evidence is conflicting, with several studies suggesting the majority may pass spontaneously. Despite this, guidelines recommend routine removal even if asymptomatic. This study aimed to systematically review the outcomes of expectant management for CBDS detected on operative cholangiography during cholecystectomy.MethodsMEDLINE, Embase and CINAHL databases were systematically searched. Participants were adult patients with CBDS identified by intraoperative cholangiography. Intervention was regarded as any perioperative effort to remove common bile duct stones, including endoscopic retrograde cholangiopancreatography (ERCP), laparoscopic and open bile duct exploration. This was compared to observation. Outcomes of interest included rates of spontaneous stone passage, success of duct clearance and complications. Risk of bias was assessed using the ROBINS‐I tool.ResultsEight studies were included. All studies were non‐randomized, heterogeneous and at serious risk of bias. In patients observed after a positive IOC, 20.9% went on to have symptomatic retained stones. In patients directed to ERCP for positive IOC, persistent CBDS were found in 50.6%. Spontaneous passage was not associated with stone size. Meta‐analysis is dominated by the results from one large database, which recommends intervention for incidental stones, despite low rates of persistent stones seen at postoperative ERCP.ConclusionsFurther evidence is required before a definitive recommendation on observation can be made. There is some evidence that asymptomatic stones may be safely observed. In clinical scenarios where the risks of biliary intervention are considered high, a conservative strategy could be more widely considered.
Environmental ethics beyond conferences: A response to the WCB bioethics in Qatar
Authors: Richie Cristina 
Published: June 2023

AbstractRieke van der Graaf, Karin Jongsma, Martine de Vries, Suzanne van de Vathorst, and Ineke Bolt have done well to voice ethical concerns over the decision of the IAB to host the next WCB in Qatar. Conferences should be more sustainable. Yet, attention to the carbon impact of conferences—and, perhaps, any country that a person might travel to for business or pleasure—are only one small part of environmentally responsible citizenship, especially for those trained in ethics and committed to health. Both bioethics as a discipline and bioethicists as individuals need to interrogate their environmental choices. To this end, some ecological choices are more obvious targets of ethical scrutiny—diet and travel—while others appear sacrosanct, like reproduction and even healthcare use. This underscores the importance of making sustainable and ethical organizational choices, such as where to hold a conference, without absolving environmental accountability in other ethical calculations. Many organizations in academic and clinical medicine need to make drastic alterations in their practices and policies to effectively mitigate carbon. While the burden is not only on bioethics alone, the expectation that it should be remains.
The returns to education and wage penalty from overeducation: New evidence from Vietnam
Authors: Tran Dai Binh , Paweenawat Sasiwimon Warunsiri 
Published: June 2023

AbstractThis study intends to estimate the rate of returns to education in Vietnam, the distributive effects of education on wages, and the wage penalty from the incidence of overeducation in the Vietnamese labor market during 2004–2016. This study employs a pseudo‐panel approach to address omitted variables bias and the unconditional quantile regression to identify the heterogeneity of returns to education across the income distribution. Our main finding indicates that the estimated rate of returns to education in Vietnam is approximately 6.5%, showing a downward bias from previous estimates. The returns vary across wage distributions, where a lower rate of return is observed in lower quantiles and a higher rate among those individuals at the higher quantiles. The returns to education have declined since 2008, confirming the oversupply of highly educated workers in the Vietnamese labor market with an estimated wage penalty of 17%. Government assistance measures are needed to reduce the overeducation and the wage penalty issues in the Vietnamese labor market.
A transitional object for relatedness and self‐development—A meta‐synthesis of youths' experience of engagement in self‐harm content online
Authors: Stänicke Line Indrevoll , Hermansen Marte Hjertås , Halvorsen Margrethe Seeger 
Published: June 2023

AbstractStudies report an increase in self‐harm, and engagement in risk content online has gained growing attention. This study aims to synthesize qualitative studies on youths' (12–25 years of age) engagement in self‐harm content online (SCO). We conducted a systematic database search of studies on first‐person experience and included 16 studies. The meta‐synthesis resulted in two meta‐themes: 1) “Belonging to a community – online engagement with peers who self‐harm” and 2) “Self‐development – online engagement to get to know myself”. Following Winnicott's (1953) thinking, digital activity is discussed as an extended peer arena with a “transitional” quality – neither completely internal, nor external, and potentially bridging an inner and outer world. Engagement in SCO is discussed as a transitional object or activity that enables relatedness and self‐definition – important developmental experiences for the exploration of social roles, borders between self and others and self‐identity during adolescence. However, engagement in SCO comes with a risk for deterioration of mental health. Clinicians should ask directly about digital activity and meet those engaged in digital risks with respect.
Grandparents with different health statuses as primary caregivers: Are they bad for children's health?
Authors: Lu Chunyu , Zong Jingru , Wang Lingli , Wang Qing 
Published: June 2023

AbstractThe prevalence and intensity of grandparenting have continued to increase in the era of rapid aging. However, little is known about grandparents with different health statuses as primary caregivers and their implications for children's health. A nationally representative cohort of over 8990 Chinese children interviewed from 2010 to 2018 was used. Random effects logit models were constructed to assess the association of the primary caregiver type (grandparents vs. parents) and caregiver health with child health. Subsequently, additive interactions between the primary caregiver type and caregiver health were estimated to determine whether children cared for by grandparents with poor health were the most vulnerable children in terms of health. Deterioration of health status was found among children cared for mainly by grandparents, manifested as a higher likelihood of illness, depressive symptoms and unmet health care needs. However, children looked after by healthy grandparents tended to exhibit better health than their counterparts who were cared for by unhealthy parents. Grandparents as primary caregivers might not have a universally detrimental effect on child health. Thus, interventions to prompt child health could consider grandparents as caregivers, especially healthy grandparents.
Efficient clinical data analysis for prediction of coal workers' pneumoconiosis using machine learning algorithms
Authors: Dong Hantian , Zhu Biaokai , Kong Xiaomei , Zhang Xinri 
Published: June 2023

AbstractPurposeThe purpose of this study is to propose an efficient coal workers' pneumoconiosis (CWP) clinical prediction system and put it into clinical use for clinical diagnosis of pneumoconiosis.MethodsPatients with CWP and dust‐exposed workers who were enrolled from August 2021 to December 2021 were included in this study. Firstly, we chose the embedded method through using three feature selection approaches to perform the prediction analysis. Then, we performed the machine learning algorithms as the model backbone and combined them with three feature selection methods, respectively, to determine the optimal predictive model for CWP.ResultsThrough applying three feature selection approaches based on machine learning algorithms, it was found that AaDO2 and some pulmonary function indicators played an important role in prediction for identifying CWP of early stage. The support vector machine (SVM) algorithm was proved as the optimal machine learning model for predicting CWP, with the ROC curves obtained from three feature selection methods using SVM algorithm whose AUC values of 97.78%, 93.7%, and 95.56%, respectively.ConclusionWe developed the optimal model (SVM algorithm) through comparisons and analyses among the performances of different models for the prediction of CWP as a clinical application.
Atypical speech production of multisyllabic words and phrases by children with developmental dyslexia
Authors: Keshavarzi Mahmoud , Di Liberto Giovanni M. , Gabrielczyk Fiona , Wilson Angela , Macfarlane Annabel , Goswami Usha 
Published: June 2023

AbstractThe prevalent "core phonological deficit" model of dyslexia proposes that the reading and spelling difficulties characterizing affected children stem from prior developmental difficulties in processing speech sound structure, for example, perceiving and identifying syllable stress patterns, syllables, rhymes and phonemes. Yet spoken word production appears normal. This suggests an unexpected disconnect between speech input and speech output processes. Here we investigated the output side of this disconnect from a speech rhythm perspective by measuring the speech amplitude envelope (AE) of multisyllabic spoken phrases. The speech AE contains crucial information regarding stress patterns, speech rate, tonal contrasts and intonational information. We created a novel computerized speech copying task in which participants copied aloud familiar spoken targets like “Aladdin.” Seventy‐five children with and without dyslexia were tested, some of whom were also receiving an oral intervention designed to enhance multi‐syllabic processing. Similarity of the child's productions to the target AE was computed using correlation and mutual information metrics. Similarity of pitch contour, another acoustic cue to speech rhythm, was used for control analyses. Children with dyslexia were significantly worse at producing the multi‐syllabic targets as indexed by both similarity metrics for computing the AE. However, children with dyslexia were not different from control children in producing pitch contours. Accordingly, the spoken production of multisyllabic phrases by children with dyslexia is atypical regarding the AE. Children with dyslexia may not appear to listeners to exhibit speech production difficulties because their pitch contours are intact.Research Highlights
Speech production of syllable stress patterns is atypical in children with dyslexia.
Children with dyslexia are significantly worse at producing the amplitude envelope of multi‐syllabic targets compared to both age‐matched and reading‐level‐matched control children.
No group differences were found for pitch contour production between children with dyslexia and age‐matched control children.
It may be difficult to detect speech output problems in dyslexia as pitch contours are relatively accurate.
Association between fibrinogen‐to‐albumin ratio and prognosis of patients with heart failure
Authors: Xu Qianqian , Zhu Chenxi , Zhang Qianqian , Hu Zesong , Ji Kangting , Qian Lu 
Published: June 2023

AbstractBackgroundSystemic inflammation is closely associated with the development and progression of heart failure (HF), increasing vulnerability to thromboembolic events. This retrospective cohort study assessed the potential of the fibrinogen‐to‐albumin ratio (FAR), a new inflammatory biomarker, as a prognostic indicator for HF risk.MethodsOne thousand one hundred and sixty six women and 826 men with a mean age of 70.70 ± 13.98 years were extracted from the Medical Information Mart for Intensive Care‐IV (MIMIC‐IV v2.0) database. Additionally, a second cohort was obtained, including 309 patients from the Second Affiliated Hospital of Wenzhou Medical University. The relationship between FAR and the prognosis of HF was evaluated using multivariate analysis, propensity score‐matched analysis, and subgroup analysis.ResultsFibrinogen‐to‐albumin ratio was an independent risk factor for 90‐day all‐cause mortality (hazard ratio: 1.19; 95% confidence interval (CI): 1.01–1.40), 1‐year all‐cause mortality (hazard ratio: 1.23; 95% confidence interval: 1.06–1.41), and length of hospital stay (LOS) (β: 1.52; 95% CI: 0.67–2.37) in the MIMIC‐IV dataset, even after adjusting for potential covariates. These findings were verified in the second cohort (β: 1.82; 95% CI: 0.33–3.31) and persisted after propensity score‐matching and subgroup analysis. FAR was positively correlated with C‐reactive protein, NT‐proBNP, and Padua score. The correlation between FAR and NT‐proBNP (R = .3026) was higher than with fibrinogen (R = .2576), albumin (R = −.1822), platelet‐to‐albumin ratio (R = .1170), and platelet‐to‐lymphocyte ratio (R = .1878) (ps < .05).ConclusionsFibrinogen‐to‐albumin ratio is an independent risk prognostic factor for 90‐day, 1‐year all‐cause mortality and LOS among HF patients. Inflammation and prothrombotic state may underlie the relationship between FAR and poor prognosis in HF.
Attrition and withdrawal in multiple myeloma randomized controlled trials: A systematic review
Authors: Hentzen Stijn , Meirson Tomer , Koehn Kelly , Goodman Aaron , Chakraborty Rajshekhar , Sborov Douglas , Rubinstein Samuel , Mohyuddin Ghulam Rehman 
Published: June 2023

AbstractObjectivesPatients with multiple myeloma (MM) enrolled in randomized control trials (RCTs) discontinue treatment for various reasons; however, no prior study has analyzed reasons for discontinuation. We performed a systematic review of MM RCTs to investigate reasons for treatment discontinuation, imbalances between trial cohorts, and reporting practices.MethodsA comprehensive search for RCTs in MM from 2015 to 2021 identified 45 studies meeting inclusion criteria.ResultsOf 21 236 randomized patients, 10 161 (47.8%) discontinued therapy by primary endpoint ascertainment. Causes of discontinuation included progression (n = 4790; 22.6% of randomized patients); toxicity (n = 2569; 12.1%); patient/physician withdrawal (n = 1200; 5.7%) and death (n = 495; 2.3%). Of randomized patients, 20 914 (98.5%) were included in the RCT analysis. Imbalances of attrition, defined as trials with greater than 5% absolute difference in discontinuation rate for reasons other than death, progression, and toxicity between intervention and control arms, were found in 11 (24.4%) studies.ConclusionsAlthough progression is the most common reason for RCT treatment discontinuation in patients with MM, over 10% discontinued due to toxicity. Furthermore, 24.4% of trials showed substantial imbalances between trial cohorts; raising concern for informative censoring and emphasizes the importance of detailed characterization of withdrawal in MM RCTs.
Dryness limits vegetation pace to cope with temperature change in warm regions
Authors: Wang Bingxue , Chen Weinan , Tian Dashuan , Li Zhaolei , Wang Jinsong , Fu Zheng , Luo Yiqi , Piao Shilong , Yu Guirui , Niu Shuli 
Published: June 2023

AbstractClimate change leads to increasing temperature and more extreme hot and drought events. Ecosystem capability to cope with climate warming depends on vegetation's adjusting pace with temperature change. How environmental stresses impair such a vegetation pace has not been carefully investigated. Here we show that dryness substantially dampens vegetation pace in warm regions to adjust the optimal temperature of gross primary production (GPP) () in response to change in temperature over space and time. spatially converges to an increase of 1.01°C (95% CI: 0.97, 1.05) per 1°C increase in the yearly maximum temperature (Tmax) across humid or cold sites worldwide (37oS–79oN) but only 0.59°C (95% CI: 0.46, 0.74) per 1°C increase in Tmax across dry and warm sites. temporally changes by 0.81°C (95% CI: 0.75, 0.87) per 1°C interannual variation in Tmax at humid or cold sites and 0.42°C (95% CI: 0.17, 0.66) at dry and warm sites. Regardless of the water limitation, the maximum GPP (GPPmax) similarly increases by 0.23 g C m−2 day−1 per 1°C increase in in either humid or dry areas. Our results indicate that the future climate warming likely stimulates vegetation productivity more substantially in humid than water‐limited regions.
Long‐term changes in forest response to extreme atmospheric dryness
Authors: Shekhar Ankit , Hörtnagl Lukas , Buchmann Nina , Gharun Mana 
Published: June 2023

AbstractAtmospheric dryness, as indicated by vapor pressure deficit (VPD), has a strong influence on forest greenhouse gas exchange with the atmosphere. In this study, we used long‐term (10–30 years) net ecosystem productivity (NEP) measurements from 60 forest sites across the world (1003 site‐years) to quantify long‐term changes in forest NEP resistance and NEP recovery in response to extreme atmospheric dryness. We tested two hypotheses: first, across sites differences in NEP resistance and NEP recovery of forests will depend on both the biophysical characteristics (i.e., leaf area index [LAI] and forest type) of the forest as well as on the local meteorological conditions of the site (i.e., mean VPD of the site), and second, forests experiencing an increasing trend in frequency and intensity of extreme dryness will show an increasing trend in NEP resistance and NEP recovery over time due to emergence of long‐term ecological stress memory. We used a data‐driven statistical learning approach to quantify NEP resistance and NEP recovery over multiple years. Our results showed that forest types, LAI, and median local VPD conditions explained over 50% of variance in both NEP resistance and NEP recovery, with drier sites showing higher NEP resistance and NEP recovery compared to sites with less atmospheric dryness. The impact of extreme atmospheric dryness events on NEP lasted for up to 3 days following most severe extreme events in most forests, indicated by an NEP recovery of less than 100%. We rejected our second hypothesis as we found no consistent relationship between trends of extreme VPD with trends in NEP resistance and NEP recovery across different forest sites, thus an increase in atmospheric dryness as it is predicted might not increase the resistance or recovery of forests in terms of NEP.
Helicobacter pylori induces urease subunit B‐specific CD8+ T cell responses in infected individuals via cytosolic pathway of cross‐presentation
Authors: Zhang Zelin , Chen Xingchi , Li Bin , Xia Tingting , Wu Xiaobin , Wu Chao 
Published: June 2023

AbstractBackgroundUrease subunit B (UreB), a conserved and key virulence factor of Helicobacter pylori (H. pylori), can induce the host CD4+ T cell immune responses to provide protection, but less is known regarding CD8+ T cell responses. The characteristics of H. pylori‐specific CD8+ T cell responses and the mechanism underlying antigen processing and presentation pathways remain unclear. This study was focus on protective antigen recombinant UreB (rUreb) to detect specific CD8+ T cell responses in vitro and elucidate the mechanism of UreB antigen processing and presentation.MethodsThe peripheral blood mononuclear cells (PBMCs) collected from H. pylori‐infected individuals were stimulated with rUreB in vitro to detect specific CD8+ T cell responses after co‐culture with rUreB‐pulsed autologous hMDCs. Through blocking assay, we investigated the potential pathway of UreB antigen processing and presentation via the cytosolic pathway or vacuolar pathway. The cytokines production of UreB specific CD8+ T cell were evaluated as well.ResultsWe demonstrated UreB can induce specific CD8+ T cell immune responses in H. pylori infected individuals. Importantly, we characterized that UreB were mainly processed by proteasome instead of lysosomal proteases and presented through cytosolic pathway of cross‐presentation, which requires endoplasmic reticulum–Golgi transport and newly synthesized MHC‐I molecules, to induce functional‐specific CD8+ T cell (IFN‐γ + TNF‐α + Grz A+ Grz B+) responses.ConclusionsThese results suggest that H. pylori UreB induces specific CD8+ T cell responses through cytosolic pathway of cross‐presentation in infected individuals.
Evaluation of the effectiveness of irrigation methods and fertilization strategies for alfalfa: A meta‐analysis
Authors: Liu Wanlu , Liu Lulu , Gao Jiangbo , Wu Shaohong , Liu Yanhua 
Published: June 2023

AbstractAlfalfa (Medicago sativa L.) plays an important role in livestock production in most regions of the world, but the quantity and quality of alfalfa have been critically affected by drought events in recent years. Thus, quantifying the efficacy of widely used strategies, irrigation methods and fertilization that are aimed at improving drought resistance in alfalfa is a worthy topic that has been addressed in a variety of ways using both field observations and simulation models. Although such strategies play a critical role in climate change adaptation, the global patterns of these strategies in a changing world remain elusive due to regional differences, such as drought features, strategy design and environmental conditions. Thus, by using effect size and statistical analyses, we synthesized three variables, namely, alfalfa yield, water use efficiency (WUE) and crude protein (CP), to examine the efficacy of irrigation methods and fertilization in drought areas based on peer‐reviewed papers from 1990 to 2022. Our results showed that increasing drought stress reduces the alfalfa yield (−34.4%) but can increase the WUE (+13.7%). Both yield and WUE showed a negative relationship with the water deficit, but this phenomenon can be improved by using appropriate irrigation. The yield losses of alfalfa can be offset by implementing a fertilization strategy (+22%) under drought stress, especially for phosphate fertilizer. Overall, our results provide some evidence for the climate change adaptation of alfalfa under drought stress and indicate that fertilization is a more effective adaptation to improve alfalfa drought resistance (both yield and WUE, and yield and CP) than the irrigation method, which shows better performance in improving alfalfa WUE. Our synthesis of the effectiveness of irrigation methods and fertilization on alfalfa drought resistance can be used to develop scientific strategies for climate change adaptation for alfalfa and agriculture under climate change.