bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Internal Mechanical Environment of Porous Scaffolds on Mechano-driven Bone Ingrowth: A Numerical Study
Authors: Huo Mengke , He Siyuan , Liu Qing , Feng Yuxiao , Liu Mengxing , Zhou Ping , Lu Jian 
Published: May 2023

Abstract
Porous cages with lower global stiffness induce more bone ingrowth and enhance bone-implant anchorage. However, it's dangerous for spinal fusion cages, which usually act as stabilizers, to sacrifice global stiffness for bone ingrowth. Intentional design on internal mechanical environment might be a promising approach to promote osseointegration without undermining global stiffness excessively. In this study, three porous cages with different architectures were designed to provide distinct internal mechanical environments for bone remodeling during spinal fusion process. A design space optimization-topology optimization based algorithm was utilized to numerically reproduce the mechano-driven bone ingrowth process under three daily load cases, and the fusion outcomes were analyzed in terms of bone morphological parameters and bone-cage stability. Simulation results show that the uniform cage with higher compliance induces deeper bone ingrowth than the optimized graded cage. Whereas, the optimized graded cage with the lowest compliance exhibits the lowest stress at the bone-cage interface and better mechanical stability. Combining the advantages of both, the strain-enhanced cage with locally weakened struts offers extra mechanical stimulus while keeping relatively low compliance, leading to more bone formation and the best mechanical stability. Thus, the internal mechanical environment can be well-designed via tailoring architectures to promote bone ingrowth and achieve a long-term bone-scaffold stability.
Parapneumonic effusions related toStreptococcus pneumoniae: serotype and disease severity trends from 2006 to 2018 in Bristol, UK
Authors: Hyams Catherine , Arnold David T , Heath Robyn , Amin-Chowdhury Zahin , Hettle David , Ruffino Gabriella , North Paul , Grimes Charli , Fry Norman K , Williams Philip , Challen Robert , Danon Leon , Williams O Martin , Ladhani Shamez , Finn Adam , Maskell Nick 
Published: May 2023

RationaleStreptococcus pneumoniaeepidemiology is changing in response to vaccination and some data suggest that empyema incidence is increasing. However, differences exist between the UK and US studies. We describe trends in the clinical phenotype of adult pneumococcal pleural infection, including simple parapneumonic effusions (SPE) in the pneumococcal conjugate vaccination (PCV) era.ObjectivesTo determine whether there were differences in pneumococcal disease presentation and severity associated with pleural infection.MethodsA retrospective cohort study, all adults ≥16 years admitted to three large UK hospitals, 2006–2018 with pneumococcal disease. 2477 invasive pneumococcal cases were identified: 459 SPE and 100 pleural infection cases. Medical records were reviewed for each clinical episode. Serotype data were obtained from the UK Health Security Agency national reference laboratory.ResultsIncidence increased over time, including non-PCV-serotype disease. PCV7-serotype disease declined following paediatric PCV7 introduction, but the effect of PCV13 was less apparent as disease caused by the additional six serotypes plateaued with serotypes 1 and 3 causing such parapneumonic effusions from 2011 onwards.Patients with pleural infection had a median survival 468 days (95% CI 340 to 590) vs 286 days (95% CI 274 to 335) in those with SPE. Pleural infection associated with frank pus had lower 90-day mortality than pleural infection without pus (0% vs 29%, p<0.0001). 90-day mortality could be predicted by baseline increased RAPID (Renal, Age, Purulence, Infection source, and Dietary factors) score (HR 15.01, 95% CI 1.24 to 40.06, p=0.049).ConclusionsPneumococcal infection continues to cause severe disease despite the introduction of PCVs. The predominance of serotype 1 and 3 in this adult UK cohort is in keeping with previous studies in paediatric and non-UK studies. Rising non-PCV serotype disease and limited impact of PCV13 on cases caused by serotypes 1 and 3 offset the reductions in adult pneumococcal parapneumonic effusion disease burden observed following the introduction of the childhood PCV7 programme.
Impact of cardiac surgery on left-sided infective endocarditis with intermediate-length vegetations
Authors: Scheggi Valentina , Bohbot Yohann , Tribouilloy Christophe , Trojette Faouzi , Di Lena Chloé , Philip Mary , Hubert Sandrine , Menale Silvia , Zoppetti Nicola , Del Pace Stefano , Stefàno Pier Luigi , Habib Gilbert , Marchionni Niccolò 
Published: May 2023

ObjectiveThe best strategy to manage patients with left-sided infective endocarditis (IE) and intermediate-length vegetations (10–15 mm) remains uncertain. We aimed to evaluate the role of surgery in patients with intermediate-length vegetations and no other European Society of Cardiology guidelines-approved surgical indication.MethodsWe retrospectively enrolled 638 consecutive patients admitted to three academic centres (Amiens, Marseille and Florence University Hospitals) between 2012 and 2022 for left-sided definite IE (native or prosthetic) with intermediate-length vegetations (10–15 mm). We compared four clinical groups: medically (n=50) or surgically (n=345) treated complicated IE, medically (n=194) or surgically (n=49) treated uncomplicated IE.ResultsMean age was 67±14 years. Women were 182 (28.6%). The rate of embolic events on admission was 40% in medically treated and 61% in surgically treated complicated IE, 31% in medically treated and 26% in surgically treated uncomplicated IE. The analysis of all-cause mortality showed the lowest 5-year survival rate for medically treated complicated IE (53.7%). We found a similar 5-year survival rate for surgically treated complicated IE (71.4%) and medically treated uncomplicated IE (68.4%). The highest 5-year survival rate was observed in surgically treated uncomplicated IE group (82.4%, log-rank p<0.001). The analysis of the propensity score-matched cohort estimated an HR of 0.23 for uncomplicated IE treated surgically compared with medical therapy (p=0.005, 95% CI: 0.079 to 0.656).ConclusionsOur results suggest that surgery is associated with lower all-cause mortality than medical therapy in patients with uncomplicated left-sided IE with intermediate-length vegetations even in the absence of other guideline-based indications.
Multidisciplinary consensus guideline for the diagnosis and management of spontaneous intracranial hypotension
Authors: Cheema Sanjay , Anderson Jane , Angus-Leppan Heather , Armstrong Paul , Butteriss David , Carlton Jones Lalani , Choi David , Chotai Amar , D'Antona Linda , Davagnanam Indran , Davies Brendan , Dorman Paul J , Duncan Callum , Ellis Simon , Iodice Valeria , Joy Clare , Lagrata Susie , Mead Sarah , Morland Danny , Nissen Justin , Pople Jenny , Redfern Nancy , Sayal Parag P , Scoffings Daniel , Secker Russell , Toma Ahmed K , Trevarthen Tamsin , Walkden James , Beck Jürgen , Kranz Peter George , Schievink Wouter , Wang Shuu-Jiun , Matharu Manjit Singh 
Published: May 2023

BackgroundWe aimed to create a multidisciplinary consensus clinical guideline for best practice in the diagnosis, investigation and management of spontaneous intracranial hypotension (SIH) due to cerebrospinal fluid leak based on current evidence and consensus from a multidisciplinary specialist interest group (SIG).MethodsA 29-member SIG was established, with members from neurology, neuroradiology, anaesthetics, neurosurgery and patient representatives. The scope and purpose of the guideline were agreed by the SIG by consensus. The SIG then developed guideline statements for a series of question topics using a modified Delphi process. This process was supported by a systematic literature review, surveys of patients and healthcare professionals and review by several international experts on SIH.ResultsSIH and its differential diagnoses should be considered in any patient presenting with orthostatic headache. First-line imaging should be MRI of the brain with contrast and the whole spine. First-line treatment is non-targeted epidural blood patch (EBP), which should be performed as early as possible. We provide criteria for performing myelography depending on the spine MRI result and response to EBP, and we outline principles of treatments. Recommendations for conservative management, symptomatic treatment of headache and management of complications of SIH are also provided.ConclusionsThis multidisciplinary consensus clinical guideline has the potential to increase awareness of SIH among healthcare professionals, produce greater consistency in care, improve diagnostic accuracy, promote effective investigations and treatments and reduce disability attributable to SIH.
The Role of Human Resource Analytics: Analyzing the Factors Influencing it in Organizations Using SEM and ANOVA
Authors: Padhi Amarnath 
Published: May 2023

In any organization, employees are more important for the success and sustainability of the business. An organization that attracts talented people, uses talent efficiently, manages talent effectively, and retains employees will secure the long-term success of the business. Human Resources Analytics (HRA) can significantly benefit HR executive decisions regarding employee and organizational performance. This work intends to find the impacting factors of human resource analytics in the organization and also the organization outcomes are impacted by the HRA. The influencing factors considered are technology, organization, environment, and data governance. The organizational outcomes to be measured are planned decision-making, improved performance management, and employee retention. This research involves two segments: (a) information gathering and (b) statistics assessment. An organized feedback form with 30 questions are to be prepared and circulated to the human resource executives and higher managers of organizations. The developed hypotheses are used to construct the poll. With the help of this study, significant relationships between the elements affecting human resource analytics were found.
The Italian domination numbers of some generalized Sierpiński networks
Authors: Liang Zhipeng , Wu Liyun , Yang Jinxia 
Published: May 2023

An Italian dominating function of a graph [Formula: see text] with vertex set [Formula: see text] is defined as a function [Formula: see text], which satisfies the condition that for every [Formula: see text] with [Formula: see text], [Formula: see text]. The weight of an Italian dominating function on [Formula: see text] is the sum [Formula: see text] and the Italian dominating number, and [Formula: see text] indicates the minimum weight of an Italian dominating function [Formula: see text]. In this paper, the structure of the generalized Sierpiński networks is investigated using the bounds of Italian domination number of graphs and the methods of mathematical induction and reduction to absurdity. Then, the Italian domination on the generalized Sierpiński networks [Formula: see text] is obtained, where [Formula: see text] denotes any special class of Path [Formula: see text], Cycle [Formula: see text], Wheel [Formula: see text], Star [Formula: see text], and complete bipartite graph [Formula: see text].
TGFβ Antagonizes IFNγ-Mediated Adaptive Immune Evasion via Activation of the AKT–Smad3–SHP1 Axis in Lung Adenocarcinoma
Authors: Ye Fan , Cai Zihao , Wang Boyu , Zeng Chenxi , Xi Yu , Hu Shaojie , Qu Rirong , Yuan Zhiwei , Yue Jiaqi , Tian Yitao , Wang Xue , Fu Xiangning , Li Lequn 
Published: May 2023

Abstract

IFNγ-mediated signaling in tumor cells can induce immunosuppressive responses and cause tumor resistance to immunotherapy. Blocking TGFβ promotes T lymphocyte infiltration and turns immunologically cold tumors into hot tumors, thereby improving the efficacy of immunotherapy. Several studies have shown that TGFβ inhibits IFNγ signaling in immune cells. We thus sought to determine whether TGFβ affects IFNγ signaling in tumor cells and plays a role in the development of acquired resistance to immunotherapy. TGFβ stimulation of tumor cells increased SHP1 phosphatase activity in an AKT–Smad3-dependent manner, decreased IFNγ-mediated tyrosine phosphorylation of JAK1/2 and STAT1, and suppressed the expression of STAT1-dependent immune evasion–related molecules, e.g., PD-L1, IDO1, herpes virus entry mediator (HVEM), and galectin-9 (Gal-9). In a lung cancer mouse model, dual blockade of TGFβ and PD-L1 led to superior antitumor activity and prolonged survival compared with anti–PD-L1 therapy alone. However, prolonged combined treatment resulted in tumor resistance to immunotherapy and increased expression of PD-L1, IDO1, HVEM, and Gal-9. Interestingly, after initial anti–PD-L1 monotherapy, dual TGFβ and PD-L1 blockade promoted both immune evasion gene expression and tumor growth compared with that in tumors treated with continuous PD-L1 monotherapy. Alternatively, treatment with JAK1/2 inhibitor following initial anti–PD-L1 therapy effectively suppressed tumor growth and downregulated immune evasion gene expression in tumors, indicating the involvement of IFNγ signaling in immunotherapy resistance development. These results demonstrate an unappreciated effect of TGFβ on the development of IFNγ-mediated tumor resistance to immunotherapy.

Significance:
Blocking TGFβ facilitates IFNγ-mediated resistance to anti–PD-L1 therapy due to the role of TGFβ in inhibiting IFNγ-induced immunoevasion by increasing SHP1 phosphatase activity in tumor cells.
Mechanism of Tumor-Platelet Communications in Cancer
Authors: Dudiki Tejasvi , Veleeparambil Manoj , Zhevlakova Irina , Biswas Sudipta , Klein Eric A. , Ford Peter , Podrez Eugene A. , Byzova Tatiana V. 
Published: May 2023

Background:
Thrombosis is one of the main complications in cancer patients often leading to mortality. However, the mechanisms underlying platelet hyperactivation are poorly understood.

Methods:
Murine and human platelets were isolated and treated with small extracellular vesicles (sEVs) from various cancer cell lines. The effects of these cancer-sEVs on platelets were evaluated both in vitro and in vivo using various approaches, including the detection of cancer-sEV-specific markers in murine platelets and patient samples, measurement of platelet activation and thrombosis assays. Signaling events induced by cancer-sEVs and leading to platelet activation were identified, and the use of blocking antibodies to prevent thrombosis was demonstrated.

Results:
We demonstrate that platelets very effectively take up sEVs from aggressive cancer cells. The process of uptake is fast, proceeds effectively in circulation in mice, and is mediated by the abundant sEV membrane protein-CD63. The uptake of cancer-sEVs leads to the accumulation of cancer cell-specific RNA in platelets in vitro and in vivo. The human prostate cancer-sEV-specific RNA marker PCA3 is detected in platelets of ~70% of prostate cancer patients. This was markedly reduced after prostatectomy. In vitro studies showed that platelet uptake of cancer-sEVs induces strong platelet activation in a CD63-RPTPα (receptor-like protein tyrosine phosphatase alpha)-dependent manner. In contrast to physiological agonists ADP and thrombin, cancer-sEVs activate platelets via a noncanonical mechanism. Intravital studies demonstrated accelerated thrombosis both in murine tumor models and in mice that received intravenous injections of cancer-sEVs. The prothrombotic effects of cancer-sEVs were rescued by blocking CD63.

Conclusions:
Tumors communicate with platelets by means of sEVs, which deliver cancer markers and activate platelets in a CD63-dependent manner leading to thrombosis. This emphasizes the diagnostic and prognostic value of platelet-associated cancer markers and identifies new pathways for intervention.
The Evolution of Corporate Law in the Arab World: The Everlasting Grip of the State
Authors: Alzumai Fahad , Al Hayyan Abdullah 
Published: May 2023

Abstract
This article explores the evolution of corporate laws in major Arab economies with emphasis on the role of state in these laws. The article argues that the dominance of the state in these laws is reflected in the absence of substantial number of default rules. These laws are overwhelmed with mandatory rules that are undermining the freedom of parties in companies to structure and manage their companies effectively. The policy background that led to the current Arab corporate laws is also analysed in this paper as the paternalistic nature of Arab states has shaped the policies that led to the current corporate laws in the Arab world. The interventionist nature of political and economic systems in the Arab world is also reflected in their corporate laws. The article argues for the need to reform current corporate laws in the Arab world and liberate these laws from their paternalistic nature and move forward with more enabling rules and empowering freedom of contract to become the governing philosophy of these laws.
A Common Law Approach to the Parties’ Intention in Arbitration Agreements
Authors: Bantekas Ilias 
Published: May 2023

Abstract
Offer and acceptance must be supplemented by the parties’ common intention, failing which there is no contract. Arbitration clauses are separable from the contract in which they are contained and hence constitute distinct contracts, albeit of a procedural nature. Even so, the courts typically conflate the parties’ common intention as expressed or implied in the main contract with the common intention required in the arbitration clause. Although technically incorrect, courts in the common law tradition are generally content with this approach and do not question its rationale. The article argues that while such an approach is acceptable, there may well be cases where a party can validly argue that this conflated common intention was misplaced.
Trial by Fire: Support for Mitigation and Adaptation Policy after the 2020 Oregon Wildfires
Authors: Giordono Leanne , Siddiqi Muhammad Usman Amin , Stelmach Greg , Zanocco Chad , Flora June , Boudet Hilary 
Published: May 2023

Abstract
The September 2020 Oregon wildfires were unprecedented in terms of their geographic scope and the number of communities affected by smoke and wildfire. Although it is difficult to directly attribute the event to climate change, scientists have noted the strong connection between warmer and drier conditions in the western United States—conditions that are linked to climate change—and increasing wildfire risk. These wildfires thus had the potential to act as a “focusing event,” potentially strengthening public support for climate change policy. Political ideology is a well-known driver of public support for climate change mitigation policies in the United States, but few studies have examined adaptation policy support. Moreover, other factors shaping postevent support for the two “pillars” of climate change policy—adaptation and mitigation—have rarely been compared. We conducted a survey of Oregonians within 6 months of the 2020 wildfires (n = 1308) to understand postevent support for climate mitigation and adaptation policies. We found that the magnitude of the association between political ideology and policy support was lower for adaptation policies than for mitigation policies, and there was no association with support for forest management changes. In contrast, selected sociodemographic characteristics played a more important role in support for selected adaptation policies than for mitigation policies.

Significance Statement
Increasing wildfire risk in the western United States is connected to warmer and drier conditions, both of which are linked to climate change. Most research on postevent support for climate change policy has focused on climate change mitigation policies. This study examines and compares public support for both mitigation and adaptation policies after the 2020 Oregon wildfires, yielding important information about the factors that shape support for each.
COVID-Induced Alterations in Surgical Care and Outcomes in Perforated Diverticulitis
Authors: Grimsley Emily A. , Janjua Haroon M. , Read Meagan D. , Kuo Paul C. 
Published: May 2023

Background COVID-19 caused healthcare systems to significantly alter processes of care. Literature on the pandemic’s effect on healthcare processes and resulting surgical outcomes is lacking. This study aims to determine outcomes of open colectomy in patients with perforated diverticulitis during the pandemic. Methods Using CDC data, the highest and lowest COVID mortality rates were calculated and used to establish 9-month COVID-heavy (CH) and COVID-light (CL) timeframes, respectively. Nine-months of 2019 were assigned as pre-COVID (PC) control. Florida AHCA database was utilized for patient-level data. Primary outcomes were length of stay (LOS), morbidity, and in-hospital mortality. Stepwise regression with 10-fold cross-validation determined factors most impacting outcomes. A parallel analysis excluding COVID-positive patients was performed to differentiate COVID-infection from processes of care. Results There were 3862 patients in total. COVID-positive patients had longer LOS, more intensive care unit admissions, and higher morbidity and mortality. After excluding 105 COVID-positive patients, individual outcomes were not different per timeframe. Regression showed timeframe did not affect primary outcomes. Discussion Outcomes following colectomy for perforated diverticulitis were worse for COVID-positive patients. Despite increased stress on the healthcare system during the pandemic, major outcomes were unchanged for COVID-negative patients. Our results indicate that despite COVID-associated changes in processes of care, acute care surgery can still be performed in COVID-negative patients without increased mortality and minimal change in morbidity.
Uniportal versus triportal video-assisted thoracic surgery in the treatment of tuberculous empyema
Authors: Xia Zhaohua , Zheng Shuo , Shi Qinlang , Wang Haijiang , Ning Xinzhong , Huang Pilai , Wen Guohuan , Xiang Ning , Liao Mingfeng , Ma Mingfei , Qiao Kun 
Published: May 2023

Objective To examine the effectiveness of decortication to treat chronic tuberculous empyema (TE) using uniport video-assisted thoracoscopic surgery (VATS) versus conventional triport VATS. Methods Data from consecutive patients with stage II or III TE who underwent decortication with either uniport VATS (uniportal group) between July and December 2017, or triport VATS between January and July 2018 (triportal group), were retrospectively analysed. VATS procedures were performed under general anaesthesia with double lumen endotracheal intubation and clinical outcomes were compared between the two groups. Results Clinical data were comparable between the groups (20 patients in each) regarding demographic and baseline characteristics, operative and postoperative characteristics, surgical procedure-related complications, and postoperative adverse events. No surgical procedure-related complications occurred during the perioperative period in either group. Threshold values for mechanical pain at 8 h postoperatively were significantly higher in the triportal group versus the uniportal group. Furthermore, the incidence of nausea and vomiting was significantly lower in the uniportal versus triportal group. In the triportal group, one patient required readmission and further intervention due to recurrence. Conclusions Uniport VATS decortication for stages II and III TE may be a feasible and safe procedure in selected patients. Moreover, uniport VATS may be less painful than triport VATS.