bluuebunny/crossref_metadata_2025 huggingface dataset:
Surgical evacuation combined with Shirodkar cervical suture and selective uterine artery embolization: A fertility preserving treatment for 10–15 weeks' live cesarean scar ectopic pregnancies
Authors: Nijjar Simrit , Ngo An , de Braud Lucrezia V. , Stempel Conrad Von , Bottomley Cecilia , Jauniaux Eric , Jurkovic Davor
Published: February 2024

Introduction

Cesarean scar ectopic pregnancies (CSEPs) are associated with significant maternal morbidity and termination is often recommended in the early first trimester. Management of more advanced cases is challenging due to higher risks of major intraoperative hemorrhage. Hysterectomy is currently the intervention of choice for advanced cases. This study aimed to investigate if advanced live CSEPs could be managed effectively conservatively using suction curettage and interventional radiology.

Material and methods

A retrospective single‐center cohort study was performed. A total of 371 women diagnosed with CSEP were identified between January 2008 and January 2023. A total of 6% (22/371) women had an advanced live CSEP with crown‐rump length (CRL) of ≥40 mm (≥10 weeks' gestation). Of these, 77% (17/22) opted for surgical intervention, whilst the remaining five continued their pregnancies. A preoperative ultrasound was performed in each patient. All women underwent suction curettage under ultrasound guidance and insertion of Shirodkar cervical suture as a primary hemostatic measure combined with uterine artery embolization (UAE) if required. The primary outcome was rate of blood transfusion. Secondary outcomes were estimated intraoperative blood loss, UAE, intensive care unit admission, reintervention, hysterectomy, hospitalization duration and rate of retained products of conception. Descriptive statistics were used to describe these variables.

Results

Median CRL of the 17 patients included was 54.1 mm (range: 40.0–85.7) and median gestational age based on CRL was 12 + 3 weeks (range: 10 + 6–15 + 0). On preoperative ultrasound scan placental lacunae were recorded in 76% (13/17) of patients and color Doppler score was ≥3 in 67% (10/15) of patients. At surgery, Shirodkar cervical suture was used in all cases. It was successful in achieving hemostasis by tamponade in 76% (13/17) of patients. In the remaining 24% (4/17) patients tamponade failed to achieve complete hemostasis and UAE was performed to stop persistent arterial bleeding into the uterine cavity. Median intraoperative blood loss was 800 mL (range: 250–2500) and 41% (7/17) women lost >1000 mL. 35% (6/17) needed blood transfusion. No women required hysterectomy.

Conclusions

Surgical evacuation with Shirodkar cervical suture and selective UAE is an effective treatment for advanced live CSEPs.
The Declaration of Helsinki in bioethics literature since the last revision in 2013
Authors: Ehni Hans‐Jörg , Wiesing Urban
Published: February 2024

The World Medical Association has announced that a new revision process of the Declaration of Helsinki has been started. This article will identify the criticisms that have been made in the bioethics literature, particularly since the last revision. In addition, criticisms are discussed that were made in the literature even before the last revision and have not fallen silent. The plausibility of the recommendation for a change in the Declaration of Helsinki is examined.
Abolishing morality in biomedical ethics
Authors: Crutchfield Parker , Scheall Scott
Published: February 2024

In biomedical ethics, there is widespread acceptance of moral realism, the view that moral claims express a proposition and that at least some of these propositions are true. Biomedical ethics is also in the business of attributing moral obligations, such as “S should do X.” The problem, as we argue, is that against the background of moral realism, most of these attributions are erroneous or inaccurate. The typical obligation attribution issued by a biomedical ethicist fails to truly capture the person's actual obligations. We offer a novel argument for rife error in obligation attribution. The argument starts with the idea of an epistemic burden. Epistemic burdens are all of those epistemic obstacles one must surmount in order to achieve some aim. Epistemic burdens shape decision‐making such that given two otherwise equal options, a person will choose the option that has the lesser of epistemic burdens. Epistemic burdens determine one's potential obligations and, conversely, their non‐obligations. The problem for biomedical ethics is that ethicists have little to no access to others' epistemic burdens. Given this lack of access and the fact that epistemic burdens determine potential obligations, biomedical ethicists often can only attribute accurate obligations out of luck. This suggests that the practice of attributing obligations in biomedical ethics is rife with error. To resolve this widespread error, we argue that this practice should be abolished from the discourse of biomedical ethics.
Influence of preexisting structures on salt structures in the Kuqa Depression, Tarim Basin, Western China: Insights from seismic data and numerical simulations
Authors: Yang Keji , Qi Jiafu , Xu Liangwei , Yu Yanqiu , Sun Tong , Shen Fangle , Peng Li , Lv Ji , Zhao Hanting
Published: February 2024

The preexisting structures that developed in the basement and subsalt strata play a key role in the salt structural deformation in the Kuqa Depression, Tarim Basin. The characteristics of preexisting structures and their controls on the salt structure are investigated via the latest three‐dimensional seismic data and numerical modelling. The results show that the preexisting structures that developed in the Kuqa Depression mainly consist of basement faults, palaeouplifts, subsalt slopes and early passive salt diapirs. Basement faults are mainly distributed in the Kelasu and Qiulitag structural belts and control the position of development and deformation style of the Miocene compressive salt structure. The differences in styles and reactivation degrees of basement faults lead to great diversity in the salt structure. The palaeouplifts mainly include the Wensu, western Qiulitag, Xinhe and Yaha‐Luntai palaeouplifts. The original sedimentary range and later deformation space of the salt layer are limited by the palaeouplift, resulting in strong salt thrusting in the Awate sag in the western part of the Kuqa Depression. The heterogeneous spatial distribution of the palaeouplift promoted the development of regional strike‐slip transform belts. Subsalt slopes are located mainly on the northern edge of the western Qiulitag low uplift and block the southward flow of the salt, causing the salt to form salt domes; the size of these domes is closely related to the subsalt slope. Early passive salt diapirs mainly developed in the Quele and Bozidun areas of the western Kuqa Depression, and they were preferentially active during the compression period, inducing the formation of a piercement salt nappe. Numerical modelling revealed that the preexisting structure strongly controlled the stress–strain distribution during the deformation of the salt structure. The spatial distribution heterogeneity of the basement structure is an important factor in the structural zonation along the north–south strike and segmentation along the west–east strike in the Kuqa Depression, as well as an important inducer of the piercement salt structure.
Northward expansion of the Jiaolai Basin during the Early Cretaceous: Insights from source‐to‐sink reconstruction
Authors: Zhang Bo , Liu Shaofeng , Lin Chengfa , Ma Pengfei
Published: February 2024

The Jiaolai Basin, situated in the northern Sulu orogenic belt along East Aisa continental margin, preserves evidence of the extensional events in East Asia and the post‐orogenic evolution of the Sulu orogenic belt during the Cretaceous period. In this study, multiple provenance analyses were employed to reconstruct the source‐to‐sink system of the Laiyang Group within the Jiaolai Basin. These studies reveal a history of northward expansion dictated by two significant rift events. During the early Early Cretaceous period (ca. 135–121 Ma), the Zhucheng and Gaomi sags in southern region developed initially. Subsequently, in the late Early Cretaceous period (ca. 120–113 Ma), the Laiyang sag in northern region emerged. Furthermore, these sags were fed by independent source‐to‐sink systems in their early stages but eventually shared a similar source‐to‐sink system towards the end of the Laiyang Group deposition (ca. 113 Ma). The provenance analysis results indicate that ca. 121 Ma, ultrahigh‐pressure rocks in the northern segment of the Sulu orogenic belt experienced rapid exhumation, while those in the southern segment might have remained concealed until ca. 113 Ma. The two rift events in East Asia, coupled with the alteration in the direction and magnitude of extension documented in the Jiaolai Basin, suggests that trench retreat and the change in subduction direction from E–W to NW–SE of the Izanagi plate played a principal role in driving the extensional events in East Asia during the Early Cretaceous. Our findings imply that the change in Izanagi subduction direction may have occurred ca. 121 Ma.
Clinical and radiographic outcomes of lateral sinus floor elevation with simultaneous hydrophilic implants placement: A retrospective study of 2–5 years
Authors: Qian Yinjie , Zhao Yuxin , Lu Yifan , Bao Siqi , Zhu Weijun , Chen Qianming , Si Misi
Published: February 2024

Aims

To investigate the clinical and radiographic outcomes of a chemically modified sandblasted large‐grit acid‐etched implant (hydrophilic) in lateral sinus floor elevation (LSFE), compared with a conventional one (hydrophobic).

Materials and Methods

A retrospective study design was adopted. Patients who received LSFE with simultaneous implant placement were recruited. According to different types of implant surfaces, patients were divided into two groups (the hydrophilic group and the hydrophobic group). Implant survival rate (SR), endo‐sinus bone stability on the radiographs, mean probing depths, percentage of bleeding on probing, marginal bone loss, and patient satisfaction were evaluated.

Results

A total of 106 patients with 180 implants (hydrophilic:101, hydrophobic:79) in 119 maxillary sinuses were included. The follow‐up period ranged from 2 to 5 years. Three hydrophobic implants and one hydrophilic implant in four different patients failed. The SR of the hydrophilic group was higher than that of the hydrophobic group but without a significant difference (p > .05). The change and change rate of endo‐sinus bone height (ΔESBH and RΔESBH) and bone volume (ΔESBV and RΔESBV) in the hydrophilic group were less than those in the hydrophobic group, with a significant difference at 6 months after implantation. No other significant difference was found between the two groups.

Conclusion

Within the limitations of this study, both hydrophilic and hydrophobic implants were suitable for LSFE with predictable clinical outcomes. Meanwhile, hydrophilic implants could contribute to the grafted endo‐sinus bone stability during healing time.
Pathological features and molecular signatures of early olfactory dysfunction in 3xTg‐AD model mice
Authors: Yu Haitao , Wang Fangzhou , Jia Dongdong , Bi Shuguang , Gong Juan , Wu Jia‐Jun , Mao Yumin , Chen Jia , Chai Gao‐Shang
Published: February 2024

Background

Olfactory dysfunction is known to be an early manifestation of Alzheimer's disease (AD). However, the underlying mechanism, particularly the specific molecular events that occur during the early stages of olfactory disorders, remains unclear.

Methods

In this study, we utilized transcriptomic sequencing, bioinformatics analysis, and biochemical detection to investigate the specific pathological and molecular characteristics of the olfactory bulb (OB) in 4‐month‐old male triple transgenic 3xTg‐AD mice (PS1M146V/APPSwe/TauP301L).

Results

Initially, during the early stages of olfactory impairment, no significant learning and memory deficits were observed. Correspondingly, we observed significant accumulation of amyloid‐beta (Aβ) and Tau pathology specifically in the OB, but not in the hippocampus. In addition, significant axonal morphological defects were detected in the olfactory bulb, cortex, and hippocampal brain regions of 3xTg‐AD mice. Transcriptomic analysis revealed a significant increase in the expression of neuroinflammation‐related genes, accompanied by a significant decrease in neuronal activity‐related genes in the OB. Moreover, immunofluorescence and immunoblotting demonstrated an activation of glial cell biomarkers Iba1 and GFAP, along with a reduction in the expression levels of neuronal activity‐related molecules Nr4a2 and FosB, as well as olfaction‐related marker OMP.

Conclusion

In sum, the early accumulation of Aβ and Tau pathology induces neuroinflammation, which subsequently leads to a decrease in neuronal activity within the OB, causing axonal transport deficits that contribute to olfactory disorders. Nr4a2 and FosB appear to be promising targets for intervention aimed at improving early olfactory impairment in AD.
Dermatopathologist accuracy in classifying angioinvasive fungal infections using virtual microscopy
Authors: Harrison Iris , Patel Basil , Kunzler Elaine , Walker Addie , Missall Tricia , Motaparthi Kiran
Published: February 2024

Background

Due to perceived difficulty in the categorization of angioinvasive fungal infections based on histopathology, variation exists in dermatopathology reporting.

Methods

This study characterized the diagnosis of angioinvasive fungal infections by light microscopy at a single academic institution over an 11‐year period. Subsequently, the accuracy of blinded reclassification by virtual microscopy was measured.

Results

Seventy‐six specimens with hematoxylin–eosin slides were obtained from 33 patients. The mean diagnostic accuracy of dermatopathologists in differentiating mucormycosis, hyalohyphomycosis, and phaeohyphomycosis based on blinded reclassification via virtual microscopy was 74%, with a range of 65%–91%.

Conclusions

While there was a range in diagnostic accuracy, the highest score of 91% and the identification of common sources of error suggest that histopathologic categorization of angioinvasive fungal infections can frequently be performed. However, accurate identification is not always possible given common pitfalls in diagnosis. In addition, standardized and clinically useful reporting should be considered.
Total factor productivity, transitional dynamics and endogenous growth accounting for Latin America: Evidence from two centuries’ data
Authors: Zaman Miethy
Published: February 2024

This study investigates the sources of economic growth for Latin American economies. With two centuries of data and extended growth accounting methods, the study shows that poor total factor productivity (TFP) growth is the key to understanding Latin America's low economic growth relative to other economies. Using a functional form of TFP growth, based on second‐generation growth models, furthers analyses to show some empirical evidence for growth induced by R&D, knowledge spillovers, educational attainment and the distance to the frontier. However, the magnitude effect is very small and when compared to the OECD countries, the gap between the TFP growth generating factors is very substantial. An intricate policy structure should be implemented for Latin America to foster an environment that is conducive to aid permanent TFP and economic growth.
Enhancing elementary school teachers' knowledge in managing traumatic dental injuries: The effectiveness of educational sessions
Authors: Alomari Ahlam , Hashim Raghad , Walia Tarun , Shetty Raghavendra
Published: February 2024

Background/Aims

This study aims to evaluate the short‐ and long‐term effects of educational intervention on elementary school teachers' knowledge of traumatic dental injuries (TDI).

Materials and Methods

The study included all of the elementary schools (29) in the emirate of Ras Al Khaimah, United Arab Emirates. Of the initial 538 participants, 497 teachers completed the full‐length study. The first assessment (T0) was performed prior to intervention using a four‐part validated questionnaire that evaluated demographics, knowledge, attitudes, and self‐assessment in relation to TDIs. The questionnaire was followed by a 30‐min lecture presentation featuring various dental trauma scenarios. Each teacher's knowledge was reassessed immediately after the intervention (T1) and 3 months after the intervention (T2). The data were analyzed using the Cochran test, Wilcoxon signed‐rank test, and chi‐squared test.

Results

Half of the participants had witnessed dental trauma at least once; however, 96.6% of the participants had not attended any training related to dental trauma prior to the educational intervention. Knowledge regarding first aid management of broken teeth and avulsions was disappointing pre‐intervention but was significantly higher post‐intervention (p < .001). Following the workshop, participant self‐assessments indicated improvement in the ability to appropriately respond to cases of dental trauma as necessary (p < .001).

Conclusions

Inadequate knowledge of emergency management of TDI was demonstrated initially. There was a remarkable improvement in the overall knowledge of TDI after the educational sessions. Raising the awareness in dental trauma field by conducting educational sessions is crucial for achieving a better outcome.
Effects of midazolam on high‐frequency oscillations in amygdala and hippocampus of epilepsy patients
Authors: Hebel Jonas M. , Lanz Michael , Malina Thomas , Stodieck Stefan R. G. , Le Van Quyen Michel
Published: February 2024

High‐frequency oscillations (HFOs) are associated with normal brain function, but are also increasingly recognized as potential biomarkers of epileptogenic tissue. Considering the important role of interneuron activity in physiological HFO generation, we studied their modulation by midazolam (MDZ), an agonist of γ‐aminobutyric acid type A (GABAA)–benzodiazepine receptors. Here, we analyzed 80 intracranial electrode contacts in amygdala and hippocampus of 13 patients with drug‐refractory focal epilepsy who had received MDZ for seizure termination during presurgical monitoring. Ripples (80–250 Hz) and fast ripples (FRs; 250–400 Hz) were compared before and after seizures with MDZ application, and according to their origin either within or outside the individual seizure onset zone (SOZ). We found that MDZ distinctly suppressed all HFOs (ripples and FRs), whereas the reduction of ripples was significantly less pronounced inside the SOZ compared to non‐SOZ contacts. The rate of FRs inside the SOZ was less affected, especially in hippocampal contacts. In a few cases, even a marked increase of FRs following MDZ administration was seen. Our results demonstrate, for the first time, a significant HFO modulation in amygdala and hippocampus by MDZ, thus giving insights into the malfunction of GABA‐mediated inhibition within epileptogenic areas and its role in HFO generation.
Seasonal migration and the evolution of an inverse latitudinal diversity gradient in shorebirds
Authors: Dufour Paul , Crochet Pierre‐André , Condamine Fabien L. , Lavergne Sébastien
Published: February 2024

Aim

While the evolution of seasonal migration and its association with biogeography have been the subject of numerous studies, its influence on species diversification has rarely been examined. The aim of this study is to explain the atypical latitudinal diversity gradient in shorebirds: did seasonal migration influence diversification and did the gradient evolve from higher in situ diversification or repeated transitions?

Location

Global.

Time Period

Palaeogene to present.

Major Taxa Studied

Order Charadriiformes (shorebirds and allies). Shorebirds include the species with the longest annual migrations in birds and exhibit an inverse latitudinal diversity gradient, with more species breeding toward higher latitudes.

Methods

We first assessed the temporal and geographical framework of the evolution of migration using a newly reconstructed time‐calibrated phylogeny, and using the fossil record as a complementary source of information. We then used hidden state speciation and extinction models to test whether diversification and thus the latitudinal diversity gradient has been shaped by migratory behaviour or species latitudinal distribution.

Results

We found that the ancestor of Charadriiformes was likely a tropical year‐round resident and that the current clade's distribution of diversity was not shaped by dispersal events out of the tropics but rather by higher in situ diversification in temperate biomes compared to tropical biomes. Seasonal migration did not affect diversification rate in our models. However, the evolution of seasonal migration seems to be a prerequisite to breed in temperate biomes, indirectly enabling the higher diversification observed in temperate biomes.

Main Conclusions

Our results bring original insights into how the migratory behaviour acted as a precursor in the diversification and biogeographical history of a large bird clade, ultimately shaping an atypical latitudinal diversity gradient.
Analysis of the responsiveness to antiandrogens in multiple breast cancer cell lines
Authors: Kuroiwa Yuka , Ito Kagenori , Nakayama Jun , Semba Kentaro , Yamamoto Yusuke
Published: February 2024

Antiandrogens were originally developed as therapeutic agents for prostate cancer but are also expected to be effective for breast cancer. However, the role of androgen signaling in breast cancer has long been controversial due to the limited number of experimental models. Our study aimed to comprehensively investigate the efficacy of antiandrogens on breast cancer. In the present study, a total of 18 breast cancer cell lines were treated with the agonist or antagonists of the androgen receptor (AR). Among the 18 cell lines tested, only T‐47D cells proliferated in an androgen‐dependent manner, while the other cell lines were almost irresponsive to AR stimulation. On the other hand, treatment with AR antagonists at relatively high doses suppressed the proliferation of not only T‐47D cells but also some other cell lines including AR‐low/negative cells. In addition, expression of the full‐length AR and constitutively active AR splice variants, AR‐V7 and ARV567es, was not correlated with sensitivity to AR antagonists. These data suggest that the antiproliferative effect of AR antagonists is AR‐independent in some cases. Consistently, proliferation of AR‐knockout BT‐549 cells was inhibited by AR antagonists. Identification of biomarkers would be necessary to determine which breast cancer patients will benefit from these drugs.
Content validity testing of the INTERMED Self‐Assessment in a sample of adults with rheumatoid arthritis and rheumatology healthcare providers
Authors: Dhiman Kiran , Hall Marc , Crump Trafford , Hoens Alison M. , Lacaille Diane , Rankin James A. , Then Karen L. , Hazlewood Glen , Barnabe Cheryl , Katz Steven , Sutherland Jason , Dempsey Erika , Barber Claire E. H.
Published: February 2024

Background

Care complexity can occur when patients experience health challenges simultaneously with social barriers including food and/or housing insecurity, lack of transportation or other factors that impact care and patient outcomes. People with rheumatoid arthritis (RA) may experience care complexity due to the chronicity of their condition and other biopsychosocial factors. There are few standardised instruments that measure care complexity and none that measure care complexity specifically in people with RA.

Objectives

We assessed the content validity of the INTERMEDS Self‐Assessment (IMSA) instrument that measures care complexity with a sample of adults with RA and rheumatology healthcare providers (HCPs). Cognitive debriefing interviews utilising a reparative framework were conducted.

Methods

Patient participants were recruited through two existing studies where participants agreed to be contacted about future studies. Study information was also shared through email blasts, posters and brochures at rheumatology clinic sites and trusted arthritis websites. Various rheumatology HCPs were recruited through email blasts, and divisional emails and announcements. Interviews were conducted with nine patients living with RA and five rheumatology HCPs.

Results

Three main reparative themes were identified: (1) Lack of item clarity and standardisation including problems with item phrasing, inconsistency of the items and/or answer sets and noninclusive language; (2) item barrelling, where items asked about more than one issue, but only allowed a single answer choice; and (3) timeframes presented in the item or answer choices were either too long or too short, and did not fit the lived experiences of patients. Items predicting future healthcare needs were difficult to answer due to the episodic and fluctuating nature of RA.

Conclusions

Despite international use of the IMSA to measure care complexity, patients with RA and rheumatology HCPs in our setting perceived that it did not have content validity for use in RA and that revision for use in this population under a reparative framework was unfeasible. Future instrument development requires an iterative cognitive debriefing and repair process with the population of interest in the early stages to ensure content validity and comprehension.

Patient or Public Contribution

Patient and public contributions included both patient partners on the study team and people with RA who participated in the study. Patient partners were involved in study design, analysis and interpretation of the findings and manuscript preparation. Data analysis was structured according to emergent themes of the data that were grounded in patient perspectives and experiences.
When passive nest defence is active: support of the leave early and avoid detection hypothesis in a plover
Authors: Sanchez‐Gomez Sonia , Lees Daniel , Weston Michael A. , Maguire Grainne S.
Published: February 2024

Leaving the nest early to avoid detection by an approaching predator is an often‐cited form of nest defence among ground‐nesting birds, yet has rarely been quantitatively demonstrated. During the breeding season, we recorded Flight‐initiation Distances (FIDs) of incubating, off‐duty and non‐breeding Hooded Plovers Thinornis cucuallatus cucuallatus in Victoria, Australia. Hooded Plovers exhibited longer FIDs when incubating compared with when off‐duty or non‐breeding birds (the latter two categories had similar FIDs). Our study supports the Leave Early to Avoid Detection (LEAD) hypothesis, and demonstrates that so‐called ‘passive’ defence is in fact an active decision by the incubator to leave nests at distances which exceed those at which birds without nests or off‐duty commence escape.
Kombucha tea derived from papaya (Carica papaya L.) as a potential functional food: physicochemical parameters, biological activities, and sensory evaluation
Authors: Do Anh Duy , Nguyen Le Bao Xuyen , Pham Dang Quoc , Le Thang Truong , Leya Mwense , Phan Van Thach
Published: February 2024

Fermented foods, such as kombucha, have gained popularity due to their rich content of beneficial bioactive compounds. Papaya leaves, known for their abundance of bioactive substances such as alkaloids, flavonoids, and phenolic compounds, have garnered attention for their potential to improve immune function by neutralising free radicals. This study investigates the suitability of papaya leaves and petioles as substrates for kombucha fermentation. Our findings indicate that papaya leaves and petioles were suitable substrates for kombucha fermentation, indicated by the SCOBY mass accumulation during fermentation. The gradual decrease in brix and pH values over a 14 days fermentation period corresponds to sugar metabolism and the accumulation of acetic acid. Additionally, fermentation increases total polyphenol (PPK: 250.07 ± 3.00 mg/L, PLK: 330.87 ± 15.56 mg/L) and total flavonoid content (PPK: 26.67 ± 6.31 mg/L, PLK: 34.44 ± 5.55 mg/L). Moreover, papaya‐derived kombucha demonstrates enhanced antibacterial properties and inhibits ⍺‐amylase linked to diabetes. Sensory evaluations confirm that papaya kombucha achieves a well‐balanced and appealing sensory profile, catering to diverse palates. In summary, papaya leaves and petiole exhibit promise as substrates for kombucha production, offering elevated nutritional value and potential health advantages.
Delayed treatment with erythropoietin attenuates renal fibrosis in mouse model of unilateral ureteral obstruction
Authors: Nishida Akihiro , Nishida Masashi , Iehara Tomoko
Published: February 2024

Objectives

Erythropoietin (EPO) exerts tissue‐protective effects on various organs including the kidney. However, the effects of EPO on established renal fibrosis remain unclear. In this study, we aimed to examine the therapeutic potential of EPO against established renal fibrosis.

Methods

Renal fibrosis was induced in mice by unilateral ureteral obstruction (UUO) and the mice were treated with recombinant human EPO (rhEPO) daily during 7 and 13 days after UUO. The degrees of renal fibrosis, myofibroblast accumulation, and macrophage infiltration; the mRNA expression levels of transforming growth factor (TGF)‐β1 and α1(I) collagen; and the protein levels of Kelch‐like ECH‐associated protein 1 (Keap1) and nuclear NF‐E2‐related factor 2 (Nrf2) in the kidneys were assessed on day 14 after UUO.

Results

Treatment with rhEPO significantly decreased fibrosis, myofibroblast accumulation, and α1(I) collagen mRNA expression, but it did not significantly affect TGF‐β1 mRNA expression. Although treatment with rhEPO did not significantly affect the total number of interstitial macrophages, it significantly decreased the number of CD86‐positive cells (M1 macrophages), while significantly increased the number of CD206‐positive cells (M2 macrophages) in the interstitium. Treatment with rhEPO did not affect the Keap1/Nrf2 protein level or the peripheral blood hematocrit value.

Conclusions

These results indicate for the first time that EPO exerts antifibrotic effects against the evolution of established renal fibrosis, possibly by influencing the polarization of infiltrating macrophages.
Gap analysis between trainees' subjective competencies and the competencies expected by instructors in urology: A need assessment survey in Japan
Authors: Hori Kanta , Abe Takashige , Abe Noriyuki , Abe Junya , Okada Kazufumi , Takahashi Keita , Harada Shigeru , Furumido Jun , Murai Sachiyo , Kon Masafumi , Hashimoto Kohei , Masumori Naoya , Kakizaki Hidehiro , Shinohara Nobuo
Published: February 2024

Objective

According to the rapid progress in surgical techniques, a growing number of procedures should be learned during postgraduate training periods. This study aimed to clarify the current situation regarding urological surgical training and identify the perception gap between trainees' competency and the competency expected by instructors in Japan.

Methods

Regarding the 40 urological surgical procedures selected via the Delphi method, we collected data on previous caseloads, current subjective autonomy, and confidence for future skill acquisition from trainees (<15 post‐graduate years [PGY]), and the competencies when trainees became attending doctors expected by instructors (>15 PGY), according to a 5‐point Likert scale. In total, 174 urologists in Hokkaido Prefecture, Japan were enrolled in this study.

Results

The response rate was 96% (165/174). In a large proportion of the procedures, caseloads grew with accumulation of years of clinical practice. However, trainees had limited caseloads of robotic and reconstructive surgeries even after 15 PGY. Trainees showed low subjective competencies at present and low confidence for future skill acquisition in several procedures, such as open cystectomy, ureteroureterostomy, and ureterocystostomy, while instructors expected trainees to be able to perform these procedures independently when they became attending doctors.

Conclusion

Trainees showed low subjective competencies and low confidence for future skill acquisition in several open and reconstructive procedures, while instructors considered that these procedures should be independently performable by attending doctors. We believe that knowledge of these perception gaps is helpful to develop a practical training program.
Psychological stress to ovalbumin peptide‐specific T‐cell receptor transgenic mice impairs the suppressive ability of type 1 regulatory T cell
Authors: Liu Xiaoyu , Xu Xuejie , Liao Yun , Yao Wenkai , Geng Xiaorui , Zeng Xianhai , Sun Xizhuo , Tang Aifa , Yang Pingchang
Published: February 2024

Numerous diseases of the immune system can be traced back to the malfunctioning of the regulatory T cells. The aetiology is unclear. Psychological stress can cause disruption to the immune regulation. The synergistic effects of psychological stress and immune response on immune regulation have yet to be fully understood. The intention of this study is to analyse the interaction between psychological stress and immune responses and how it affects the functional status of type 1 regulatory T (Tr1) cells. In this study, ovalbumin peptide T‐cell receptor transgenic mice were utilised. Mice were subjected to restraint stress to induce psychological stress. An airway allergy murine model was established, in which a mouse strain with RING finger protein 20 (Rnf20)‐deficient CD4+ T cells were used. The results showed that concomitant exposure to restraint stress and immune response could exacerbate endoplasmic reticulum stress in Tr1 cells. Corticosterone was responsible for the elevated expression of X‐box protein‐1 (XBP1) in mouse Tr1 cells after exposure to both restraint stress and immune response. XBP1 mediated the effects of corticosterone on inducing Rnf20 in Tr1 cells. The reduction of the interleukin‐10 expression in Tr1 cells was facilitated by Rnf20. Inhibition of Rnf20 alleviated experimental airway allergy by restoring the immune regulatory ability of Tr1 cells. In conclusion, the functions of Tr1 cells are negatively impacted by simultaneous exposure to psychological stress and immune response. Tr1 cells' immune suppressive functions can be restored by inhibiting Rnf20, which has the translational potential for the treatment of diseases of the immune system.
How do patients with rheumatoid arthritis perceive their self‐care and self‐care support? A mixed‐method study
Authors: Westland Heleen , Kuiper Stefan , van den Bovenkamp Cheryl , Blaas Etienne , Jaarsma Tiny
Published: February 2024

Aim

To explore self‐care and needs and preferences towards tailored self‐care support of patients with rheumatoid arthritis at the outpatient clinic.

Design

A sequential explanatory mixed method design.

Methods

The Self‐Care of Chronic Illness Inventory questionnaire, two focus groups and six semi‐structured interviews were conducted between November 2021 and April 2023. Questionnaires of 107 patients were descriptively analysed. Subsequently, 11 patients and 2 healthcare professionals participated in the focus groups and 6 patients in the interviews, which were thematically analysed.

Results

Quantitative and qualitative data corresponded and showed that patients perform various self‐care activities at an adequate level and have strategies to exert control and reduce symptoms. One key theme emerged: ‘Not only being the person with rheumatoid arthritis’ (RA) as patients primarily aim to get on with their lives. Nine subthemes covered self‐care activities for maintaining health including staying physically active, finding the right medication and dose and adapting their diet. Patients differed in how they self‐monitored their symptoms. Recognizing symptoms and finding strategies to manage symptoms included the process of body listening in which patient seek and try different strategies to find what works for them and incorporate routines. Patients experienced positive effects of a warm or cold environment. Patients felt the need for practical and emotional support from others and preferred having credible information.

Conclusion

Patients perform adequate self‐care including a diversity of self‐care activities to get on with their lives and have strategies to reduce and control the symptoms and impact of RA.

Implications

Tailoring self‐care support to patients' individual needs and preferences is necessary to help patients cope with the erratic nature of the disease and maintain their quality of life. Healthcare providers need to provide practical and emotional support and use credible information to allow patients to make self‐care decisions to manage their lives.

Reporting Methods

Quantitative finding are reported according to the STROBE guidelines and qualitative finding are reported according to the COREQ guidelines.

What Does This Paper Add

Patients perform various self‐care activities at an adequate level and have strategies to exert control and reduce symptoms.

Patients primarily aim to continue their lives and not being seen as the person with rheumatoid arthritis.

Healthcare professionals need to provide practical and emotional support and use credible information to inform patients' self‐care decision‐making.

Patient or Public Contribution

No patient or public contribution.
The vomeronasal system of the wolf (Canis lupus signatus): The singularities of a wild canid
Authors: Ortiz‐Leal Irene , Torres Mateo V. , Barreiro‐Vázquez José‐Daniel , López‐Beceiro Ana , Fidalgo Luis , Shin Taekyun , Sanchez‐Quinteiro Pablo
Published: February 2024

Wolves, akin to their fellow canids, extensively employ chemical signals for various aspects of communication, including territory maintenance, reproductive synchronisation and social hierarchy signalling. Pheromone‐mediated chemical communication operates unconsciously among individuals, serving as an innate sensory modality that regulates both their physiology and behaviour. Despite its crucial role in the life of the wolf, there is a lacuna in comprehensive research on the neuroanatomical and physiological underpinnings of chemical communication within this species. This study investigates the vomeronasal system (VNS) of the Iberian wolf, simultaneously probing potential alterations brought about by dog domestication. Our findings demonstrate the presence of a fully functional VNS, vital for pheromone‐mediated communication, in the Iberian wolf. While macroscopic similarities between the VNS of the wolf and the domestic dog are discernible, notable microscopic differences emerge. These distinctions include the presence of neuronal clusters associated with the sensory epithelium of the vomeronasal organ (VNO) and a heightened degree of differentiation of the accessory olfactory bulb (AOB). Immunohistochemical analyses reveal the expression of the two primary families of vomeronasal receptors (V1R and V2R) within the VNO. However, only the V1R family is expressed in the AOB. These findings not only yield profound insights into the VNS of the wolf but also hint at how domestication might have altered neural configurations that underpin species‐specific behaviours. This understanding holds implications for the development of innovative strategies, such as the application of semiochemicals for wolf population management, aligning with contemporary conservation goals.
The impact of Chinese public expenditures on household investment in risky financial assets: Evidence from a national survey
Authors: Ma Qianhui , Ying Yeung , Yao Rui
Published: February 2024

Using data from the 2012, 2013, 2015, 2017, 2018, and 2021 Chinese General Social Survey (CGSS), this paper investigates the effect of public expenditures on household investment in risky financial assets. Our findings show that a higher level of public expenditures significantly increases household investment in stocks and other risky financial assets and that the respondent's overconfidence in their financial well‐being partially mediates such an effect. We further provide evidence that the influence of public expenditures on household investment behavior in risky financial assets is robust after considering various sample heterogeneities by disaggregating public expenditures and risky financial assets into different subcategories and dividing households into different age and socioeconomic groups.
Efficacy and safety of a panthenol‐enriched mask for individuals with distinct impaired skin barrier subtypes
Authors: Zhang Xianghua , Tao Han , Deng Ya , He Xiaofeng , Zhang Zhongxing , Zhong Liming , Wen Yue
Published: February 2024

Background

The protection for different skin types with impaired skin barrier in the market is insufficient.

Aim

To evaluate the efficacy and safety of a panthenol‐enriched mask (La Roche‐Posay Mask Pro) in addressing various skin barrier impairment subgroups, including dry sensitive, oily sensitive, and oily acne skin.

Methods

A total of 177 participants were enrolled in the study and divided into three subgroups based on their skin type. Participants used the mask following the specified protocol, with measurements taken for skin hydration, transepidermal water loss (TEWL), sebum content, and skin redness—factors that are directly influenced by skin barrier function. Assessments were conducted at baseline and after 1 day (tested 15 min post‐application), 7 days, and 14 days of application using Sebumeter, Tewameter, Corneometer, Mexameter, and VISIA.

Results

Results showed significant improvements in skin parameters across all subgroups. In the dry sensitive skin subgroup, the mask increased skin hydration, sebum content, and reduced redness. For the oily sensitive skin subgroup, the mask regulated sebum production and improved skin hydration. In the oily acne skin subgroup, the mask reduced sebum content, redness, TEWL, and post‐inflammatory erythema and hyperpigmentation. Tolerance was excellent for all skin types, with no adverse reactions observed.

Conclusions

This study highlights the efficacy and safety of the panthenol‐enriched LRP Mask Pro for individuals with distinct skin barrier impairment subgroups. The mask's versatile formulation and proven efficacy make it a valuable skincare product for addressing various skin concerns and achieving healthier, more balanced skin.
Skin lightening properties of zerumbone cream: A placebo‐controlled study
Authors: Kuek Wee Nie , Tiang Yi Ru , Yow Hui Yin , Tan Li Kar Stella , How Chee Wun , Looi Qi Hao Daniel , Foo Jhi Biau
Published: February 2024

Objective

Despite the demonstrated anti‐melanogenic and UV protective effects of Zerumbone (ZER) in vitro, there is a lack of clinical trials that have been done to assess these properties. The primary objective of this study was to assess the effectiveness of ZER in lightening the skin tone of human participants with a single‐blind approach.

Methods

Twenty‐six participants were randomly assigned to two groups to investigate the application location (left or right volar forearm) for the placebo and ZER creams. Both creams were topically administered to the volar forearms twice daily over a duration of 4 weeks. Initial skin irritation was assessed before and 30 min after applying creams. The melanin and erythema levels were quantified with Mexameter MX 18.

Results

Twenty participants were included in the analysis. The cream formulation had excellent physical properties and was well‐received by the participants. The initial skin irritation study results indicated that neither of the creams elicited an allergic reaction. The administration of ZER cream resulted in a statistically significant reduction in melanin levels (p < 0.05) after 1 week compared to the initial baseline. Furthermore, after 2 weeks of application, ZER cream demonstrated significant differences in melanin levels compared to placebo (p < 0.05). No adverse effects were observed in the group using ZER cream.

Conclusion

ZER demonstrated significant potential as a skin‐lightening agent.
Placental abruption: Incidence and risk of recurrence in subsequent pregnancies
Authors: Oyelese Yinka , Peltier Morgan , Donovan Bridget , Khadka Nehaa , Chiu Vicki Y. , Fassett Michael J. , Getahun Darios
Published: February 2024

Aim

To estimate the incidence of abruption in first births and recurrence in the subsequent birth in patients of a large US‐based integrated health care system.

Methods

Retrospective population‐based cohort study of patients with first two consecutive singleton births using data from the Kaiser‐Permanente South California health care system who delivered over a period of 30 years (1991–2021), using longitudinally linked electronic health records. ICD‐9/ICD‐10 codes “641.20” and “O45.x” identified placental abruption. We calculated the incidence and rates of abruption in first and second pregnancies. We used logistic regression to estimate the adjusted odds ratios (aOR) for abruption in second pregnancies in patients with and without abruptions in their first pregnancies.

Results

Of the 126 264 patients with first two consecutive singleton births over the period, 805 had abruptions in their first births, and 861 in their second births. Rates of abruption in first and second births were 0.63% and 0.68%, respectively. Twenty‐seven patients had abruptions in both first and second births. Rates of abruption in the second birth among individuals with and without previous placental abruption were 3.35% and 0.66%, respectively, giving an approximately five‐fold increased odds of abruption in a second pregnancy in individuals who had abruption in their first birth when compared with those who did not have placental abruption in their first birth (aOR: 4.95, 95% confidence interval: 3.35–7.31, p < 0.00001). Interpregnancy interval had no statistically significant association with recurrence.

Conclusion

Abruption in a first birth is associated with an approximately five‐fold increased odds of abruption in a second birth.
Nightmare frequency is a risk factor for suicidal ideation during the COVID‐19 pandemic
Authors: Bolstad Courtney J. , Holzinger Brigitte , Scarpelli Serena , De Gennaro Luigi , Yordanova Juliana , Koumanova Silvia , Mota‐Rolim Sérgio , Benedict Christian , Bjorvatn Bjørn , Chan Ngan Yin , Chung Frances , Dauvilliers Yves , Espie Colin A. , Inoue Yuichi , Korman Maria , Koscec Bjelajac Adrijana , Landtblom Anne‐Marie , Matsui Kentaro , Merikanto Ilona , Morin Charles M. , Partinen Markku , Penzel Thomas , Plazzi Giuseppe , Reis Cátia , Ross Biserka , Wing Yun Kwok , Nadorff Michael R.
Published: February 2024

The association between nightmare frequency (NMF) and suicidal ideation (SI) is well known, yet the impact of the COVID‐19 pandemic on this relation is inconsistent. This study aimed to investigate changes in NMF, SI, and their association during the COVID‐19 pandemic. Data were collected in 16 countries using a harmonised questionnaire. The sample included 9328 individuals (4848 women; age M[SD] = 46.85 [17.75] years), and 17.60% reported previous COVID‐19. Overall, SI was significantly 2% lower during the pandemic vs. before, and this was consistent across genders and ages. Most countries/regions demonstrated decreases in SI during this pandemic, with Austria (−9.57%), Sweden (−6.18%), and Bulgaria (−5.14%) exhibiting significant declines in SI, but Italy (1.45%) and Portugal (2.45%) demonstrated non‐significant increases. Suicidal ideation was more common in participants with long‐COVID (21.10%) vs. short‐COVID (12.40%), though SI did not vary by COVID‐19 history. Nightmare frequency increased by 4.50% during the pandemic and was significantly higher in those with previous COVID‐19 (14.50% vs. 10.70%), during infection (23.00% vs. 8.10%), and in those with long‐COVID (18.00% vs. 8.50%). The relation between NMF and SI was not significantly stronger during the pandemic than prior (rs = 0.18 vs. 0.14; z = 2.80). Frequent nightmares during the pandemic increased the likelihood of reporting SI (OR = 1.57, 95% CI 1.20–2.05), while frequent dream recall during the pandemic served a protective effect (OR = 0.74, 95% CI 0.59–0.94). These findings have important implications for identifying those at risk of suicide and may offer a potential pathway for suicide prevention.