bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development and validation of a preoperative MRI-based radiomics nomogram to predict progression-free survival in patients with clival chordomas
Authors: Zhai Yixuan , Bai Jiwei , Xue Yake , Li Mingxuan , Mao Wenbin , Zhang Xuezhi , Zhang Yazhuo 
Published: December 2022

ObjectivesThe aim of this study was to establish and validate a MRI-based radiomics nomogram to predict progression-free survival (PFS) of clival chordoma.MethodsA total of 174 patients were enrolled in the study (train cohort: 121 cases, test cohort: 53 cases). Radiomic features were extracted from multiparametric MRIs. Intraclass correlation coefficient analysis and a Lasso and Elastic-Net regularized generalized linear model were used for feature selection. Then, a nomogram was established via univariate and multivariate Cox regression analysis in the train cohort. The performance of this nomogram was assessed by area under curve (AUC) and calibration curve.ResultsA total of 3318 radiomic features were extracted from each patient, of which 2563 radiomic features were stable features. After feature selection, seven radiomic features were selected. Cox regression analysis revealed that 2 clinical factors (degree of resection, and presence or absence of primary chordoma) and 4 radiomic features were independent prognostic factors. The AUC of the established nomogram was 0.747, 0.807, and 0.904 for PFS prediction at 1, 3, and 5 years in the train cohort, respectively, compared with 0.582, 0.852, and 0.914 in the test cohort. Calibration and risk score stratified survival curves were satisfactory in the train and test cohort.ConclusionsThe presented nomogram demonstrated a favorable predictive accuracy of PFS, which provided a novel tool to predict prognosis and risk stratification. Our results suggest that radiomic analysis can effectively help neurosurgeons perform individualized evaluations of patients with clival chordomas.
Fenofibrate suppresses corneal neovascularization by regulating lipid metabolism through PPARα signaling pathway
Authors: Zhou Tong , Yan Ke , Zhang Yuhan , Zhu Linfangzi , Liao Yi , Zheng Xiaoxiang , Chen Yongxiong , Li Xiaoxin , Liu Zuguo , Zhang Zhaoqiang 
Published: December 2022

Purpose: The purpose of this study was to explore the potential underlying mechanism of anti-vascular effects of peroxisome proliferator–activated receptor α (PPARα) agonist fenofibrate against corneal neovascularization (CNV) through the changes of lipid metabolism during CNV.Methods: A suture-induced CNV model was established and the clinical indications were evaluated from day 1 to day 7. Treatments of vehicle and fenofibrate were performed for 5 days after suture and the CNV areas were compared among the groups. The eyeballs were collected for histological analysis, malondialdehyde (MDA) measurement, terminal deoxynucleotidyl transferase 2′-deoxyuridine 5′-triphosphate nick end labeling (TUNEL) staining, western blot, quantitative real-time PCR (qRT-PCR) assays and immunohistochemical (IHC) staining to elucidate pathological changes and the underlying mechanism.Results: Lipi-Green staining and MDA measurement showed that lipid deposition and peroxidation were increased in the CNV cornea while the expression of long-chain acyl-coenzyme A synthetase 1 (ACSL1), carnitine palmitoyltransterase 1A(CPT1A) and medium-chain acyl-coenzyme A dehydrogenase (ACADM), which are key enzymes of fatty acid β-oxidation (FAO) and targeted genes of peroxisome proliferator-activated receptor alpha (PPARα) pathway, were decreased in CNV cornea. Fenofibrate suppressed lipid accumulation and peroxidation damage in the CNV cornea. Fenofibrate upregulated the expression levels of PPARα, ACSL1, CPT1A, and ACADM compared with vehicle group. IHC staining indicated that fenofibrate also decreased the expression of VEGFa, VEGFc, TNFα, IL1β and CD68.Conclusion: Disorder of lipid metabolism may be involved in the formation of suture-induced CNV and fenofibrate played anti-neovascularization and anti-inflammatory roles on cornea by regulating the key enzymes of lipid metabolism and ameliorating lipid peroxidation damage of cornea through PPARα signaling pathway.
Evaluating the benefits of TNF-alfa inhibitor biosimilar competition on off-patent and on-patent drug markets: A Southern European analysis
Authors: Barcina Lacosta Teresa , Vulto Arnold G. , Huys Isabelle , Simoens Steven 
Published: December 2022

Background: The level of competition achieved following biosimilars market availability varies by country, care setting and molecule. Hence, biosimilars contribution to attaining price reductions and extended access to treatments can also vary.Objective: The aim of this study is to capture market dynamics for tumor necrosis factor (TNF)-alpha inhibitors and competing molecules in Southern European markets (2011–2020), and to evaluate the benefits of the competition generated by the availability of biosimilars.Methods: This study is based on a literature review examining market characteristics for TNF-alfa inhibitors and competing immunomodulator molecules, and on the quantitative analysis of market data for these molecules in Italy, Portugal and Spain.Results: Following biosimilars availability in Italian, Portuguese and Spanish markets, there has been an expansion in the overall access to TNF-alfa inhibitor pharmaceuticals. Further, savings have been generated within the TNF-alfa inhibitors class even after the increased use of these molecules. However, the potential of infliximab, etanercept and adalimumab biosimilars to generate price competition outside of their own drug class appeared limited in the studied markets. Considering this limitation and that shifts towards on-patent and higher-cost therapies have occurred after TNF-alfa inhibitor biosimilars availability, the importance of investing in biosimilars development for still on-patent immunology biologics is emphasized.Conclusion: This study highlights the need for policies that do not only seek higher utilization of biosimilars, but that also support a sustainable market for these products. This is expected to foster the future development of biosimilar medicines.
Pericyte heterogeneity identified by 3D ultrastructural analysis of the microvessel wall
Authors: Abdelazim Hanaa , Payne Laura Beth , Nolan Kyle , Paralkar Karan , Bradley Vanessa , Kanodia Ronak , Gude Rosalie , Ward Rachael , Monavarfeshani Aboozar , Fox Michael A. , Chappell John C. 
Published: December 2022

Confident identification of pericytes (PCs) remains an obstacle in the field, as a single molecular marker for these unique perivascular cells remains elusive. Adding to this challenge is the recent appreciation that PC populations may be heterogeneous, displaying a range of morphologies within capillary networks. We found additional support on the ultrastructural level for the classification of these PC subtypes—“thin-strand” (TSP), mesh (MP), and ensheathing (EP)—based on distinct morphological characteristics. Interestingly, we also found several examples of another cell type, likely a vascular smooth muscle cell, in a medial layer between endothelial cells (ECs) and pericytes (PCs) harboring characteristics of the ensheathing type. A conserved feature across the different PC subtypes was the presence of extracellular matrix (ECM) surrounding the vascular unit and distributed in between neighboring cells. The thickness of this vascular basement membrane was remarkably consistent depending on its location, but never strayed beyond a range of 150–300 nm unless thinned to facilitate closer proximity of neighboring cells (suggesting direct contact). The density of PC-EC contact points (“peg-and-socket” structures) was another distinguishing feature across the different PC subtypes, as were the apparent contact locations between vascular cells and brain parenchymal cells. In addition to this thinning, the extracellular matrix (ECM) surrounding EPs displayed another unique configuration in the form of extensions that emitted out radially into the surrounding parenchyma. Knowledge of the origin and function of these structures is still emerging, but their appearance suggests the potential for being mechanical elements and/or perhaps signaling nodes via embedded molecular cues. Overall, this unique ultrastructural perspective provides new insights into PC heterogeneity and the presence of medial cells within the microvessel wall, the consideration of extracellular matrix (ECM) coverage as another PC identification criteria, and unique extracellular matrix (ECM) configurations (i.e., radial extensions) that may reveal additional aspects of PC heterogeneity.
Roles of leptin on energy balance and thermoregulation in Eothenomys miletus
Authors: Chen Huibao , Zhang Hao , Jia Ting , Wang Zhengkun , Zhu Wanlong 
Published: December 2022

Leptin is a hormone mainly synthesized and secreted by white adipose tissue (WAT), which regulates various physiological processes. To investigate the role of leptin in energy balance and thermoregulation in Eothenomys miletus, voles were randomly divided into leptin-injected and PBS-injected groups and placed at 25°C ± 1°C with a photoperiod of 12 L:12 D. They were housed under laboratory conditions for 28 days and compared in terms of body mass, food intake, water intake, core body temperature, interscapular skin temperature, resting metabolic rate (RMR), nonshivering thermogenesis (NST), liver and brown adipose tissue (BAT) thermogenic activity, and serum hormone levels. The results showed that leptin injection decreased body mass, body fat, food intake, and water intake. But it had no significant effect on carcass protein. Leptin injection increased core body temperature, interscapular skin temperature, resting metabolic rate, non-shivering thermogenesis, mitochondrial protein content and cytochrome C oxidase (COX) activity in liver and brown adipose tissue, uncoupling protein 1 (UCP1) content and thyroxin 5′-deiodinase (T45′-DII) activity in brown adipose tissue significantly. Serum leptin, triiodothyronine (T3), thyrotropin-releasing hormone (TRH) and corticotropin-releasing hormone (CRH) concentrations were also increased significantly. Correlation analysis showed that serum leptin levels were positively correlated with core body temperature, body mass loss, uncoupling protein 1 content, thyroxin 5′-deiodinase activity, nonshivering thermogenesis, and negatively correlated with food intake; thyroxin 5′-deiodinase and triiodothyronine levels were positively correlated, suggesting that thyroxin 5′-deiodinase may play an important role in leptin-induced thermogenesis in brown adipose tissue. In conclusion, our study shows that exogenous leptin is involved in the regulation of energy metabolism and thermoregulation in E. miletus, and thyroid hormone may play an important role in the process of leptin regulating energy balance in E. miletus.
Rodent hole detection in a typical steppe ecosystem using UAS and deep learning
Authors: Du Mingzhu , Wang Dawei , Liu Shengping , Lv Chunyang , Zhu Yeping 
Published: December 2022

IntroductionRodent outbreak is the main biological disaster in grassland ecosystems. Traditional rodent damage monitoring approaches mainly depend on costly field surveys, e.g., rodent trapping or hole counting. Integrating an unmanned aircraft system (UAS) image acquisition platform and deep learning (DL) provides a great opportunity to realize efficient large-scale rodent damage monitoring and early-stage diagnosis. As the major rodent species in Inner Mongolia, Brandt’s voles (BV) (Lasiopodomys brandtii) have markedly small holes, which are difficult to identify regarding various seasonal noises in this typical steppe ecosystem.MethodsIn this study, we proposed a novel UAS-DL-based framework for BV hole detection in two representative seasons. We also established the first bi-seasonal UAS image datasets for rodent hole detection. Three two-stage (Faster R-CNN, R-FCN, and Cascade R-CNN) and three one-stage (SSD, RetinaNet, and YOLOv4) object detection DL models were investigated from three perspectives: accuracy, running speed, and generalizability.ResultsExperimental results revealed that: 1) Faster R-CNN and YOLOv4 are the most accurate models; 2) SSD and YOLOv4 are the fastest; 3) Faster R-CNN and YOLOv4 have the most consistent performance across two different seasons.DiscussionThe integration of UAS and DL techniques was demonstrated to utilize automatic, accurate, and efficient BV hole detection in a typical steppe ecosystem. The proposed method has a great potential for large-scale multi-seasonal rodent damage monitoring.
Digital integrated dramatherapy: A feasibility study in women undergoing assisted reproductive technology
Authors: Cercato Maria Cecilia , Pierpaoli Sandra , Pazienza Rosa Maria , Terrenato Irene , Guadagnuolo Cinzia , Cenci Cristina , Nappi Rossella E. 
Published: December 2022

BackgroundDramatherapy is a practice of working and playing that uses action methods to facilitate creativity, imagination, learning, insight and growth.MethodsA pilot study of Digital Integrated Dramatherapy, recruiting women from the digital community “Parole Fertili,” undergoing assisted reproductive technology. On the basis of a previous blended experience, a program based on remote sessions was conducted on a dedicated platform.ResultsA total of 22 women participated in the same intervention in three groups. Participants assessed the feasibility and utility of the method, both in the synchronous and asynchronous phases. The group had a fundamental role: the participants were supportive, and therapeutic benefits were due to strengthening and resilience obtained through a dialogue with other women. Using metaphors, the participants could move from the narration of the Assisted Reproductive Technology pathway to creative and corporeal expression.ConclusionThe study showed that a group based on Digital Integrated Dramatherapy might help women face very difficult emotions by promoting creativity and internal resources.
Chronic stressors and burnout in Dutch police officers: Two studies into the complex role of coping self-efficacy
Authors: Eikenhout Liselotte Marina Josephine , Delahaij Roos , Van Dam Karen , Kamphuis Wim , Hulshof Inge Leonie , Van Ruysseveldt Joris 
Published: December 2022

IntroductionBurnout complaints are high for Dutch police officers. According to Hobfoll’s Conservation of Resources theory, resources such as coping self-efficacy can play an important role in the burnout process. The aim of this study was to investigate the buffering effect of coping self-efficacy on burnout, as well as a possible depletion effect of burnout on coping self-efficacy.MethodsAs such, this research consists of two studies namely, a two-wave study (N = 166) and three-wave study (N = 95) on Dutch police officers. They expand on previous research regarding coping resources and police burnout.ResultsBoth studies show that the chronic stressor, work scheduling, was positively associated with burnout. Also, coping self-efficacy weakened the effect of work scheduling (Study 1) and workload (Study 2) on burnout. Moreover, there was a direct negative relationship between burnout and coping self-efficacy.DiscussionThe results indicate that burnout can lead to lower coping resources, initiating a potential cycle of resource loss and burnout. Further investigation into this depletion effect is required to provide police officers and organisations with tools to prevent burnout.
Sleep disturbances in nurse managers during the early and late stages of the COVID-19 pandemic
Authors: Boned-Galán Ángel , López-Ibort Nieves , Gascón-Catalán Ana 
Published: December 2022

IntroductionWorking conditions during the COVID-19 pandemic have affected health professionals’ quality of sleep. To date, most of the studies that assess the impact of the COVID-19 pandemic on sleep have been carried out with front-line health personnel, and almost none of them have been carried out with managers.ObjectiveTo evaluate the quality of sleep and the level of stress in nurse managers during the early and late stages of the COVID-19 pandemic.MethodsCross-sectional studies were carried out at two time points: after the lockdown period (July 2020) and a year and a half after the start of the pandemic (October 2021). A total of 102 nurse managers of a tertiary hospital were invited to participate. The Perceived Stress Scale (PSS-14) and Pittsburgh Sleep Quality Index (PSQI) were administered to assess stress levels and sleep quality.ResultsThe response rate was 85.2% in 2020 and 81.3% in 2021. Nursing managers showed alterations in sleep quality throughout the pandemic: 70.1% after confinement and 61.4% at the beginning of the second wave. In addition to stress, the fear of contagion by COVID-19 influenced sleep problems. More than a year after the start of the pandemic, the professionals’ fear of contagion decreased. Perceived stress also decreased, but sleep disturbances remained.ConclusionHigh stress and poor sleep quality among nurse managers require special attention, and specific interventions need to be implemented. Hospitals should develop programs that help nurse managers develop skills to mitigate stress levels and thus improve sleep quality and professional quality of life.
Rational speech comprehension: Interaction between predictability, acoustic signal, and noise
Authors: Van Os Marjolein , Kray Jutta , Demberg Vera 
Published: December 2022

IntroductionDuring speech comprehension, multiple sources of information are available to listeners, which are combined to guide the recognition process. Models of speech comprehension posit that when the acoustic speech signal is obscured, listeners rely more on information from other sources. However, these models take into account only word frequency information and local contexts (surrounding syllables), but not sentence-level information. To date, empirical studies investigating predictability effects in noise did not carefully control the tested speech sounds, while the literature investigating the effect of background noise on the recognition of speech sounds does not manipulate sentence predictability. Additionally, studies on the effect of background noise show conflicting results regarding which noise type affects speech comprehension most. We address this in the present experiment.MethodsWe investigate how listeners combine information from different sources when listening to sentences embedded in background noise. We manipulate top-down predictability, type of noise, and characteristics of the acoustic signal, thus creating conditions which differ in the extent to which a specific speech sound is masked in a way that is grounded in prior work on the confusability of speech sounds in noise. Participants complete an online word recognition experiment.Results and discussionThe results show that participants rely more on the provided sentence context when the acoustic signal is harder to process. This is the case even when interactions of the background noise and speech sounds lead to small differences in intelligibility. Listeners probabilistically combine top-down predictions based on context with noisy bottom-up information from the acoustic signal, leading to a trade-off between the different types of information that is dependent on the combination of a specific type of background noise and speech sound.
Therapists’ experiences of remote working during the COVID-19 pandemic
Authors: Morgan Andrew , Davies Cari , Olabi Yasmine , Hope-Stone Laura , Cherry Mary Gemma , Fisher Peter 
Published: December 2022

ObjectivesTo explore the experiences of therapists who delivered remote psychological therapy during the COVID-19 pandemic.DesignThis was a qualitative, phenomenological study. Interpretative Phenomenological Analysis elicited themes from semi-structured interviews.MethodsA purposive sample of eight therapists was recruited from breast cancer services in the United Kingdom.ResultsAnalysis identified three superordinate themes. Participants spoke about how their experience of remote working changed over time from an initial crisis response to a new status quo. They adapted to the specific practical and personal challenges of remote working and struggled to connect with clients as the use of technology fundamentally changed the experience of therapy.ConclusionConsideration should be given to the impact of remote working on therapists and the quality of their practise. Adjustments to ways of working can help to maximize the advantages of remote working while minimizing potential issues.
The language of healthcare worker emotional exhaustion: A linguistic analysis of longitudinal survey
Authors: Belz Franz F. , Adair Kathryn C. , Proulx Joshua , Frankel Allan S. , Sexton J. Bryan 
Published: December 2022

ImportanceEmotional exhaustion (EE) rates in healthcare workers (HCWs) have reached alarming levels and been linked to worse quality of care. Prior research has shown linguistic characteristics of writing samples can predict mental health disorders. Understanding whether linguistic characteristics are associated with EE could help identify and predict EE.ObjectivesTo examine whether linguistic characteristics of HCW writing associate with prior, current, and future EE.Design, setting, and participantsA large hospital system in the Mid-West had 11,336 HCWs complete annual quality improvement surveys in 2019, and 10,564 HCWs in 2020. Surveys included a measure of EE, an open-ended comment box, and an anonymous identifier enabling HCW responses to be linked across years. Linguistic Inquiry and Word Count (LIWC) software assessed the frequency of one exploratory and eight a priori hypothesized linguistic categories in written comments. Analysis of covariance (ANCOVA) assessed associations between these categories and past, present, and future HCW EE adjusting for the word count of comments. Comments with &lt;20 words were excluded.Main outcomes and measuresThe frequency of the linguistic categories (word count, first person singular, first person plural, present focus, past focus, positive emotion, negative emotion, social, power) in HCW comments were examined across EE quartiles.ResultsFor the 2019 and 2020 surveys, respondents wrote 3,529 and 3,246 comments, respectively, of which 2,101 and 1,418 comments (103,474 and 85,335 words) contained ≥20 words. Comments using more negative emotion (p &lt; 0.001), power (i.e., references relevant to status, dominance, and social hierarchies, e.g., own, order, and allow) words (p &lt; 0.0001), and words overall (p &lt; 0.001) were associated with higher current and future EE. Using positive emotion words (p &lt; 0.001) was associated with lower EE in 2019 (but not 2020). Contrary to hypotheses, using more first person singular (p &lt; 0.001) predicted lower current and future EE. Past and present focus, first person plural, and social words did not predict EE. Current EE did not predict future language use.ConclusionFive linguistic categories predicted current and subsequent HCW EE. Notably, EE did not predict future language. These linguistic markers suggest a language of EE, offering insights into EE’s etiology, consequences, measurement, and intervention. Future use of these findings could include the ability to identify and support individuals and units at high risk of EE based on their linguistic characteristics.