bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of in vitro simulated digestion and fermentation characteristics of the crude exopolysaccharide from Levilactobacillus brevis M‐14
Authors: Wang Qi , Li Gen , Qin Wenjun , Cai Jin , Wang Nifei
Published: October 2024

The present study employed an in vitro static digestion model to simulate the saliva‐gastrointestinal digestion and fecal fermentation of exopolysaccharides (EPSs) extracted from Levilactobacillus brevis M‐14, aiming to understand the dynamic changes in physicochemical properties, biological potential of EPS, as well as their impact on the human enteric microorganism. EPS was mainly composed of polysaccharides. The molecular weight (Mw) showed that EPS comprised two parts with a high Mw and a low Mw fraction of 42.81 × 104 and 1.23 × 104 Da, respectively. EPSs mainly consisted of mannose, rhamnose, galacturonic acid, glucose, and galactose in a molar ratio of 0.42∶0.13∶0.21∶0.13∶0.11. In the simulated digestion process, EPS was relatively stable. Furthermore, simulated digestion increased the antioxidant and hypoglycemic capacities of EPS. During the fermentation stage, the total carbohydrate contents of EPS decreased by 20.19%. The Mw of the two components of EPS decreased by 16.37% and 61.67%, respectively, and accompanied by the production of free monosaccharides. EPS had the potential to modulate the composition of gut microbiota, increasing the relative abundance of Enterococcus and Parabacteroides, while decreasing the relative abundance of Bacteroides. The pH decreased and total short‐chain fatty acids contents increased, especially acetic acid and propionic acid. This research provided valuable insights into the potential application of EPS as a prebiotic agent.
Effects of different heat treatment methods on physicochemical characteristics and in vitro digestibility of sweet potato flour and its application in meal replacement flour
Authors: Ma Shunzhang , Zhang Jingwen , Peng Mingjun , Shen Ruiling , Dong Jilin
Published: October 2024

This study examined the effects of various heat treatments on physicochemical properties, functionality, and starch digestibility of sweet potato flour. Heat treatments darkened the color but did not change the chemical structure. Solubility decreased and swelling power increased (17.3%–18.3%) with baking, frying, and microwaving, while extrusion and steaming had opposite effects. Rapidly digestible starch content increased (8.96%–41.91%) in all treatments except steaming, which reduced slowly digestible starch (61.81%–28.97%). Based on the analysis of these studies, using low‐temperature baked and extruded sweet potato flour as the main raw material, combined with the concept of complete nutrition, supplemented by nutritious ingredients such as quinoa, oats, and whey protein, we have successfully developed two sweet potato meal replacement flours (SP‐1 and SP‐2) and found they had good brewing properties and showed shear‐thinning behavior. This study provided theoretical basis for sweet potato deep processing and functional product development.

Practical Application

This paper studied the effects of different heat treatments on sweet potato flour, and developed two meal replacement flour based on this, to provide a theoretical basis for the application of the sweet potato industry.
Improving sunflower oil stability with propolis: A study on antioxidative effects of Turkish propolis during accelerated oxidation
Authors: Baştürk Ayhan , Yavaş Berfin
Published: October 2024

Propolis, a natural resinous substance collected by bees, is known for its potent antioxidant properties. This study investigates the antioxidant activities and total phenolic contents of propolis samples from 16 provinces of Türkiye and their effects on the oxidative stability of sunflower oil. The 1,1‐diphenyl‐2‐picrylhydrazyl (DPPH) inhibition was in the range of 28.1%–92.5% in thirteen propolis samples, whereas this rate was 24.5% in butylated hydroxytoluene (BHT). Although 2,2′‐azino‐bis(3‐ethylbenzotiazolin‐6‐sulfonic acid) (ABTS) value was 224 µmol trolox/g in BHT, this value was in the range of 262–1370 µmol trolox/g in propolis samples, except for one. Propolis methanol extracts 13 applied to sunflower oil at a concentration of 1000 ppm were more efficient than BHT added at 200 ppm for inhibiting the production of peroxide value (PV). Similarly, most propolis extracts (1000 ppm) demonstrated antioxidant activity against the production of p‐anisidine (p‐AV) in sunflower oil under accelerated oxidation conditions. It was determined that Turkish propolis had strong antioxidant properties and delayed oxidation and may be utilized commercially in the food sector to delay the oxidation of fats and oils.
Ethanolic cashew leaf extract: Antifungal activity and its application for shelf‐life extension of dried salted tilapia fillets
Authors: Sinlapapanya Pitima , Palamae Suriya , Buatong Jirayu , Pongsetkul Jaksuma , Fu Yu , Zhang Bin , Benjakul Soottawat
Published: October 2024

Ethanolic cashew leaf extract (ECLE) is rich in phenolic compounds with diverse bioactivities and can serve as a safe natural preservative. This study evaluated the antifungal activity and application of ECLE for shelf‐life extension of dried salted tilapia fillets. Several extraction methods, antifungal activity, and application of ECLE in dried salted tilapia fillets were investigated. Ultrasonication followed by the Soxhlet extraction resulted in the highest yield (26.78%), total phenolic content (TPC), and total flavonoid content (TFC) (p < 0.05). Conversely, the Soxhlet extraction method rendered lower yield (14.35%), TPC, and TFC (p < 0.05). NaCl at high concentrations decreased both TPC and TFC in all ECLE samples, demonstrating the decomposition of those compounds induced by NaCl. ECLE obtained via the Soxhlet extraction method exhibited lower minimum inhibitory concentration (MIC) and minimum fungicidal concentration values than those prepared using other extraction methods. Thus, the former showed higher efficacy in inhibiting fungal growth and reducing mycelium growth than others (p < 0.05), despite being less effective than potassium sorbate. At 4MIC, ECLE inhibited mycelium growth (56.83%–78.66%) and spore germination (87.5%–100%) after 72 h and 10–16 h of treatment, respectively. ECLE (4MIC) could inhibit the toxin production of fungi. For the challenge test, in which ECLE at 400 and 600 mg/kg was added to dried salted tilapia fillet inoculated with Aspergillus flavus, fungal growth was retarded over 9 days of storage at 25 ± 2°C (room temperature). Thus, ECEL could act as a natural food preservative to prevent fungal contamination. Toxin from fungi could be avoided, and the quality of dried salted fish was maintained.

Practical Application

Cashew leaf extract rich in polyphenols can inhibit fungal proliferation, reduce mycelium expansion, prevent spore germination, and limit aflatoxin production. The extract can enhance the safety of dried salted fish, especially when contaminated with Aspergillus flavus in the humid atmosphere (80% relative humidity), particularly for small and medium enterprises. Nevertheless, this extract can also be applied in the fish processing industry, in which the synthetic antifungal agent could be replaced by the natural additive.
Are labor epidural catheters after a combined spinal epidural (CSE) technique more reliable than after a traditional epidural? A retrospective review of 9153 labor epidural catheters
Authors: Sakova Viktoria , Varjola Elina , Pepper James , Jernman Riina , Väänänen Antti
Published: October 2024

Background

The combined spinal epidural (CSE) technique may associate with a lower failure rate of epidural catheters compared to traditional epidural catheters. This may be significant for the parturients as failure of neuraxial analgesia has been associated with a negative impact on birth experience.

Methods

In this one‐year retrospective study, the failure rate of epidural catheters was compared between 3201 and 5952 epidural catheters after initiation of neuraxial analgesia by the CSE or traditional epidural technique, respectively. Parturient background information, labor parameters, and neuraxial interventions were collected from 9153 parturients. Failure was defined as replacement of a used epidural catheter by new regional analgesia procedures or general anesthesia during intrapartum cesarean delivery. The primary outcome was the failure rate of epidural catheters. The secondary outcome was the time from the initial analgesia intervention to the epidural catheter replacement and progression of labor during this time.

Results

The CSE method was used at an earlier stage of labor, and the parturients were more often primiparous and undergoing induced labor. Earlier onset of analgesia, obesity, induced labor, anesthesiologist experience, and cesarean delivery were found to be significant cofactors for catheter failure. The unadjusted failure rate was 168/3201 (5.2%) and 223/5952 (3.7%) (OR 1.42 [1.16–1.75]) after initiation of analgesia by CSE or traditional epidural method. After controlling for the stage of labor, body mass index, induction of labor, and anesthesiologist's experience level, the adjusted OR for epidural catheter replacement was 1.04 (0.83–1.29) p = .736. The mean (SD) time until epidural catheter failure was 6.3 (4.4) and 4.0 (4.1) hours following initiation of analgesia by CSE or traditional epidural technique, respectively (p < .001). Cervical dilatation progressed from 4.3 (1.4) to 6.4 (2.1) cm and 5.1 (1.5) to 6.7 (1.7) cm between primary neuraxial analgesia and epidural catheter replacement.

Conclusion

CSE technique was not associated with a better survival rate of epidural catheters for provision of analgesia or epidural top‐up anesthesia for intrapartum CD. In addition, the time to replacement of the catheter was significantly longer when analgesia was initiated with the CSE technique. Maternal satisfaction scores were lower if catheters required replacement.
SR‐16234, a Unique Selective Estrogen Receptor Modulator, Suppressed Proliferation and Pain‐Related Factor Expression by Inhibition of the Nuclear Factor‐kappa B Pathway in Endometriotic Stromal Cells
Authors: Yamane Emiko , Azuma Yukihiro , Matsumoto Mei , Sato Eri , Ota Yoshiaki , Harada Tasuku , Taniguchi Fuminori
Published: October 2024

Problem

What is the effect of SR‐16234 (SR), a selective estrogen receptor (ER) modulator, on human endometriotic stromal cells (ESCs)?

Method of Study

Endometriotic tissues were obtained from 21 patients undergoing laparoscopic surgery for ovarian endometriomas (OEs). Normal eutopic endometrium during the luteal phase was obtained from 18 patients without endometriosis. ESCs isolated from OEs and normal eutopic endometrial stromal cells (NESCs) were cultured with SR and subsequently exposed to tumor necrosis factor (TNF)‐α. After 48 h of incubation, the effect of SR on cell proliferation was evaluated by the WST‐8 assay. The gene expressions of inflammatory and pain‐related factors, including interleukin (IL)‐6, IL‐8, cyclooxygenase (COX)‐2, transient receptor potential vanilloid (TRPV)1, ESR1, and ESR2, were evaluated by real‐time RT‐PCR. The phosphorylation of Inhibitor κBα (IκBα), extracellular signal‐regulated kinase (ERK)1/2, and Protein Kinase B (AKT) were evaluated by western blot analysis. ILs, prostaglandin (PG) E2, and intranuclear p65 syntheses were assessed by ELISA.

Results

SR treatment repressed TNF‐α‐induced proliferation by 20% in ESCs but not　NESCs. SR also reduced IL‐6, IL‐8, COX‐2, TRPV1, ESR1, and ESR2 mRNA expressions and ILs protein, and PGE2 synthesis in ESCs, whereas in NESCs, only TRPV1 mRNA expression was decreased. SR suppressed TNF‐α‐induced phosphorylated IκBα levels by approximately 50%, and intranuclear p65 protein was reduced by 30% compared to addition of only TNF‐α in ESCs. However, SR did not affect the phosphorylation of AKT and ERK1/2.

Conclusions

SR appears to be a potential therapeutic agent for endometriosis by suppressing inflammatory and pain‐related factor expressions by inhibiting the nuclear factor‐kappa B pathway.
Vaginal Microbiome and the Risk of Preterm Birth in Women Living With HIV: A Scoping Review
Authors: Khan Fouzia Zahid Ali , Ahmed Saifuddin , Powell Anna Maya
Published: October 2024

There are sparse data on the role of the vaginal microbiome (VMB) in pregnancy among pregnant women living with HIV (PWLWH) and its association with spontaneous preterm birth (sPTB). We conducted a scoping review to assess associations between vaginal microbiota and sPTB among PWLWH. Three studies were included, representing a total of 180 PWLWH out of 652 total pregnancies. All studies used modern DNA sequencing methods (16S rRNA amplification, metagenomics, or metatranscriptomics). PWLWH had higher VMB richness and diversity compared to HIV‐uninfected pregnant women and higher sPTB rates in two of three studies. A higher proportion of sPTB among PWLWH was observed in those with Lactobacillus‐deficient, anaerobe‐dominant vaginal microbiota. In two of three studies, higher concentrations of vaginal inflammation markers were associated with increased VMB richness and diversity. HIV status was independently associated with sPTB. It is unclear if increased vaginal microbial diversity among PWLWH or increased vaginal inflammation contributes more to PTB, but HIV does appear to alter the VMB in pregnant individuals and may also affect PTB rates in microbiome‐independent pathways. Given the limited number of studies, heterogeneity in sample size, sample collection methods, and inconsistent results it is difficult to causally link HIV, VMB, inflammatory cytokines, and sPTB.
Phosphodiesterase inhibitors and testicular torsion: A systematic review and meta‐analysis of animal studies
Authors: Oliveira Alessandro V. , Sampaio Ana Luiza N. , Junior Rui W. Mascarenhas , Andriolo Regis B.
Published: October 2024

Background

Testicular torsion is a common urological emergency in children and teenagers that, in most cases, requires surgical exploration and detorsion. However, even after a successful intervention, a high number of patients still develop irreversible damage.

Objectives

To investigate whether the administration of phosphodiesterase inhibitors (PDE) in animal models of testicular torsion can reduce damages caused by the ischemia–reperfusion syndrome.

Materials and methods

A systematic search of the Medline, Web of Science, Embase, and Ovid databases for studies up to December 2023 was performed using PRISMA guidelines. A detailed search was conducted using the following key terms: “testicles,” “ischemia,” “reperfusion,” and “phosphodiesterase inhibitors.” There was no restriction regarding language or year of publication. We investigated spermatogenesis by the Johnsen's biopsy score (JTBS) and histological damage by the Cosentino's biopsy score (CBS). Malondialdehyde (MDA), nitric oxide (NO), superoxide dismutase (SOD), and glutathione peroxidase (GPx) testicular levels were also analyzed.

Results

Initially, 296 articles were identified. However, only 20 studies met the inclusion criteria. PDE inhibitors improved JTBS (MD = 2.53, CI = 1.94 to 3.13), CBS (MD = −1.11, CI = −1.25 to −0.97) and SOD (SMD = 3.27, CI = 1.59 to 4.95) outcomes. PDE did not improve MDA (SMD = −0.93, CI = −2.19 to 0.34), NO (SMD = −0.54, CI = −1.56 to 0.48), and GPx (SMD = 0.77, CI = −0.38 to 1.92) outcomes. A higher dose of PDE inhibitors only improved CBS outcome.

Discussion and conclusion

This review indicates that the administration of PDE inhibitors in rats ameliorated the outcomes, representing a promising complementary strategy for spermatogenesis recovery following testicular torsion. Our review suggests that JTBS and CBS could be translated into future human studies, validating and extending these findings within the context of human physiopathology, while providing applicability of interventions in real clinical practice.
Pedals and throttles: Ride‐along experimental journeys with Hanoi's cyclo and motorbike taxi drivers
Authors: Turner Sarah , Nguyen Binh N.
Published: October 2024

In this article, we analyse the effectiveness of ride‐alongs, a specific mobile method, to better understand the daily realities of informal mobile livelihoods in Hanoi, Vietnam. The field of mobile methods has seen significant advances both within and beyond geography. Yet, there is still an absence of literature comparing the benefits and drawbacks of using a consistent mobile method across different forms of mobility in the same context, such as pedal‐powered versus motorised transport. Additionally, studies specifically addressing the daily experiences of informal cyclo (trishaw) drivers in Vietnam are scarce. Our paper aims to fill these gaps by evaluating the effectiveness of ride‐along interviews in understanding the mobility and livelihood challenges faced by informal cyclo and motorbike taxi (xe ôm) drivers in Hanoi, who navigate the city's dense and chaotic traffic to earn a living. Ride‐alongs provide a unique perspective on the city's informal transportation sector, uncovering new insights into the nuanced micro‐mobilities and rapid decision‐making required of these drivers. Cyclo drivers navigate Hanoi's streets with considerations for tourist appeal, physical exertion, and police avoidance. Meanwhile, xe ôm drivers manoeuvre through alleyways and roads, balancing efficiency, speed, and passenger demands. Both groups are concerned with circumventing often‐corrupt police, managing local traffic conditions, and adapting to changing weather patterns. This comparative study reveals the benefits and insights gained from ride‐along interviews with mobile informal economy workers, highlighting the similarities and differences in the choices and tactics these drivers employ. The method allows for a deeper understanding of how vehicle type, physical demands, and the socio‐political environment shape the split‐second decisions these drivers must make to maintain their livelihoods on Hanoi's streets.
Using functional shocks to assess conventional and unconventional monetary policy in Canada
Authors: Koeppl Thorsten V. , Kronick Jeremy M. , McNeil James
Published: October 2024

We develop a new series of Canadian monetary policy shocks for the time period 1986 to 2023. Our shocks are constructed as the daily change in the Nelson–Siegel yield curve factors on days of monetary policy events such as announcements of the short‐run policy rate and speeches by Bank of Canada officials. This allows us to look at both conventional and unconventional monetary policy. We find that tighter monetary policy lowers inflation and GDP. Monetary policy shocks, however, often twist the yield curve, potentially offsetting changes in the short‐run policy rate. Finally, speeches also tend to move the yield curve with similar effects on inflation and GDP as formal policy announcements.
Outward direct investment as a shelter from external trade policy shocks: Firm‐level investigation of the US–China trade war
Authors: Ding Haoyuan , Fan Haichao , Guo Guangyuan , Liang Guoyong , Qi Tong
Published: October 2024

This study examines the effects of external trade policy shock from the US–China trade war on firm value. Using a merged data set of Chinese‐listed companies, our empirical results reveal that Chinese firms conducting outward direct investment in the US have significantly higher stock returns around the date of the outbreak of the trade war as compared with the lower returns of exporting firms. This indicates a sheltering effect of pre‐existing outward direct investment activities. Moreover, we find that the sheltering effect is more pronounced for production‐oriented projects, high tech industries and tariff‐targeted sectors, while it is weaker for state‐owned companies.
The Role of Nationality in Childhood Caries in Qatar
Authors: Spencer Andrew John , AlKhtib Asmaa Othman , Al Darwish Mohamed Sultan , Mohame Hasaan Gassim Saad , Mathew Tintu , Al Mannai Ghanim Ali , Al Thani Mohammed , Abdulmalik Mariam , de Vries Johann , Do Loc Giang , Chrisopoulos Sergio
Published: October 2024

Childhood primary dentition caries prevalence and experience is higher among Qatari than non‐Qatari nationality children in Qatar but only this bivariate association has been described.

Objectives

There were two objectives. First, to understand the variation of primary dentition caries among 4‐ to 8‐year‐old children in Qatar across nationality classified into four groups, and second, to explore whether the association persisted in the presence of socio‐demographic and behavioural indicators.

Methods

The study used data from the Qatar Child Oral Health Survey 2017 (QCOHS 2017). Detailed information was collected through a parental dual‐language questionnaire and an oral epidemiological examination conducted by calibrated dentist examiners. Children in 20 kindergartens and 40 schools across Qatar were recruited. Data were weighted to represent the Qatar child population.

Results

Overall, 1154 children aged 4–8 years old (48.9% female, 51.1% male) participated. Qatari children made up 26.3%, Non‐Qatari (N‐Q) Arabic children 44.2% N‐Q Indian sub‐continent 16.4% and N‐Q Other 13.1%. There were no significant differences by nationality for age or sex, but differences existed for kindergarten/school type and parents' highest level of education. Among behavioural indicators, Qatari and N‐Q Arabic children began toothbrushing later, and more N‐Q Other children brushed 2+ times a day and had made a check‐up visit in the last 12 months. More Qatari children were in the highest tertial for sugar intake and drank bottled water with no fluoride. All N‐Q children had a significantly lower prevalence and experience of caries. The means ratio (95% CI) for N‐Q Arabic (0.78; 0.65–0.94), Indian (0.58; 0.46–0.72) and other children (0.61; 0.42–0.88) were all significant against Qatari nationality children. Multivariable models showed an attenuation of the association with caries with the means ratio for N‐Q Arabic (0.92; 0.73–1.16), Indian (0.79; 0.57–1.11) and other children (0.94; 0.61–1.44) being non‐significant compared to Qatari nationality children. The variables which were significantly associated with caries were parental education, toothbrushing frequency, sugar intake and check‐up visiting in the last 12 months in the multivariable models.

Conclusions

Primary dentition caries in children resident in Qatar differed by nationality. The association of primary dentition caries with nationality was markedly attenuated and non‐significant in the presence of socio‐demographic and behavioural variables, pointing towards the importance of these variables as the pathways to improving primary dentition caries prevalence and experience of children in Qatar.
Navigating Disparities in Dental Health—A Transit‐Based Investigation of Access to Dental Care in Virginia
Authors: Kim Junghwan , Karki Shashank , Brickhouse Tegwyn , Vujicic Marko , Nasseh Kamyar , Wang Changzhen , Zhang Mengxi
Published: October 2024

Objective

To identify vulnerable areas and populations with limited access to dental care in Virginia, the study aimed (1) to calculate travel time and accessibility scores to dental care in Virginia using a transit‐based accessibility model for all dental clinics and dental clinics participating in the Medicaid dental program and (2) to estimate factors associated with accessibility to dental clinics participating in the Medicaid dental program in Virginia.

Methods

The study used building footprints as origins of transit trips to dental care services (or destinations). The study then computed transit‐based origin–destination travel time matrices based on the detailed trip information, including in‐vehicle and out‐of‐vehicle travel time. Accessibility scores were calculated by counting the number of dental clinics that can be reached within 60 min. Regression analysis was used to measure factors associated with accessibility scores to dental clinics participating in Medicaid.

Results

Residents in smaller regions spent longer travel time to dental clinics by public transit compared with those who resided in larger regions. Medicaid participants also faced longer travel time compared with the general population. Residents spent more than three‐fourths of the time waiting for public transit and walking to clinics regardless of where they live and what type of insurance they have. Associations between sociodemographic factors and accessibility scores to dental clinics participating in the Medicaid dental program varied across regions.

Conclusions

Disparities in dental care accessibility exist depending on the size of regions and Medicaid participation in Virginia. The disparities in transit‐based access to dental clinics and a disproportionate amount of time spent waiting for public transit and walking to dental clinics could be improved through tailored interventions taking into account the sociodemographic and geographic characteristics of each region.
Exploring Belief Systems in Kinship Fostering Practice in Igbo Indigenous Communities of Southeast Nigeria
Authors: Nnama‐Okechukwu Chinwe U. , Okoye Uzoma O.
Published: October 2024

Kinship fostering in Igbo indigenous communities is an enduring alternative child care practice that promotes collective responsibility for child care in a family environment. The practice is believed to be fundamental for family and community continuity. Weakening extended family ties and a lack of social work support services in this care arrangement have cast doubt on the continual viability of this alternative child care practice This is an exploratory study using grounded theory. In‐depth interviews with six community leaders and six senior public social welfare officers provided insight on belief systems promoting kinship fostering in Igbo indigenous communities. Findings were thematically analysed to show continuity of lineage, preservation of family name and challenges associated with kinship fostering. Belief systems on kinship fostering provides insights on how children are viewed in Igbo culture, which can help policymakers design intervention programme that are culturally relevant in child‐care formation in Nigeria given challenges in kinship fostering. The study promotes indigenous knowledge that is vital for social work education and practice in Nigeria. Further study suggests exploring the belief of foster children and their experiences in kinship fostering.
Clinical Benefits of new Systemic Therapy for Small‐Cell Lung Cancer Over Two Decades: A Cross‐Sectional Study
Authors: Chen Yuejing , Liu Honghong , Bai Shaohua , Han Xuejiao , Jin Fei , Cui Bo
Published: October 2024

Introduction

Small cell lung cancer (SCLC) is one of the most lethal malignancies worldwide. This study aimed to examine the clinical benefits of new systemic therapies derived from randomized controlled trials (RCTs) published from 2002 to 2023 based on the magnitude of clinical benefit scale developed by the European Society for Medical Oncology (ESMO‐MCBS).

Methods

We searched PubMed for Phase 3 RCTs on systemic therapy for SCLC published between January 2002 and December 2023. Therapeutic benefit was graded from 5 to 1 according to the ESMO‐MCBS framework, with a score of 4 or 5 representing a meaningful clinical benefit. The statistical power of the trial design was also assessed using ESMO‐MCBS.

Results

Sixty‐four RCTs with 23 683 participants were eligible for inclusion. The number of RCTs related to molecular targeted therapy or immunotherapy has increased over the years. Among the 62 RCTs for which statistical power could be evaluated, 38 (61.3%) were designed to identify an effect size that would meet the ESMO‐MCBS benefit threshold and were less likely to investigate second‐ or subsequent‐line treatment (15.8% vs. 50.0%, p = 0.004), have noninferiority design (0% vs. 25.0%, p = 0.002) and set PFS (0% vs. 16.7%) or response rate (0% vs. 16.7%) as the only primary endpoint (p = 0.002). The ESMO‐MCBS framework was applied in 29 RCTs reporting positive results, and only 8 (27.6%) met the threshold for a clinical benefit. The RCTs designed to detect differences that would meet the thresholds were more likely to demonstrate meaningful clinical benefit (87.5% vs. 50.0%, p = 0.099).

Conclusion

Most positive SCLC‐RCTs did not meet the ESMO‐MCBS threshold for meaningful clinical benefits. Strict power calculations should be adopted in the design of future RCTs.
Survey of Post‐Prophylaxis Delayed‐Onset Cytomegalovirus Management Strategies Among Transplant Providers
Authors: Non Lemuel R. , Tan Chen Sabrina , Ince Dilek , Razonable Raymund R.
Published: October 2024

Background

Preventive strategies for cytomegalovirus (CMV) in the posttransplant period have changed the pattern of CMV infections, now more commonly manifesting as late‐onset occurrences known as post‐prophylaxis delayed‐onset CMV disease (PPDOC). We conducted a survey to investigate provider practices in managing PPDOC.

Methods

A web‐based provider survey on the management of PPDOC was developed using Research Electronic Data Capture (REDCap). It was distributed to the online forums of the American Society of Transplantation communities of practice (COP) for Infectious Diseases (IDCOP), Kidney and Pancreas (KPCOP), Liver and Intestinal (LICOP), and Thoracic and Critical Care (TCCOP). The survey was posted twice within a span of a month.

Results

Fifty‐six respondents, comprising 50 (89%) transplant physicians and 6 (11%) transplant pharmacists, from 46 distinct transplant centers, completed the survey. Universal antiviral prophylaxis (UAP) was the predominant preventive approach for both high‐risk (85%) and moderate‐risk (85%) transplant recipients. Out of 56, 51 respondents completed the questions regarding management of PPDOC. Regular surveillance with nucleic acid amplification tests (NAAT) (88%) was the most commonly used approach in high‐risk recipients, while symptom monitoring (73%) was the most common strategy in moderate‐risk recipients. Immunologic monitoring was used only by a few respondents who found it moderately useful in high‐risk recipients.

Conclusion

Management of PPDOC was highly variable among providers and strategies differed based on patient risk profile. These findings could help shape future studies and guidelines to harmonize CMV management.
Serum creatine kinase elevation following tyrosine kinase inhibitor treatment in cancer patients: Symptoms, mechanism, and clinical management
Authors: Zhang Hang , To Kenneth K. W.
Published: October 2024

Molecular targeted tyrosine kinase inhibitors (TKIs) have produced unprecedented treatment response in cancer therapy for patients harboring specific oncogenic mutations. While the TKIs are mostly well tolerated, they were reported to increase serum levels of creatine kinase (CK) and cause muscle metabolism‐related toxicity. CK is an essential enzyme involved in cellular energy metabolism and muscle function. Elevated serum CK levels can arise from both physiological and pathological factors, as well as triggered by specific drug classes. The incidence of serum CK elevation induced by a few approved TKIs (brigatinib, binimetinib, cobimetinib‐vemurafenib combination [Food and Drug Administration, United States]; aumolertinib, and sunvozertinib [only approved by National Medical Products Administration, China]) were over 35%. CK elevation‐related symptoms include myopathy, myositis, inclusion body myositis (IBM), cardiotoxicity, rhabdomyolysis, rash, and acneiform dermatitis. High‐level or severe symptomatic CK elevation may necessitate dose reduction and indirectly dampen TKI efficacy. This review presents an updated summary about the prevalence rate and recent research about mechanisms leading to TKI‐induced serum CK elevation in cancer patients. The utility of monitoring serum CK levels for predicting TKI‐induced adverse effects and their management will also be discussed.
Sudan's catastrophe: the role of changing dynamics of food and power in the Gezira agricultural scheme
Authors: Elkreem Tamer Abd , Jaspars Susanne
Published: October 2024

This article explores the role of historical, political, and economic processes in understanding war and famine in Sudan after 2023. The focus is on Al‐Gezira, the site of Sudan's largest agricultural scheme. Using ethnography, interviews, and document reviews, the study analyses the Gezira irrigation project in three phases. First, the 1980s and 1990s, when patronage politics dominated its management. Second, the neoliberal strategies of the Gezira Scheme Act of 2005, which enabled Islamist profiteering while increasing vulnerability among farmers and labourers and tensions between them. Third, post 2018, when political movements used evidence of the scheme's deterioration to call for revolution, but once achieved, previous tensions grew and have been manipulated during the war. Sudan provides an example of how decades of war and neoliberal economic strategies have led to a deeply‐rooted, violent, and extractive political economy. This has been to the benefit of business and elites, leaving many to a life of precarity, exploitation, and hunger.
Acceptability and psychometric properties of four scales assessing the impact of Type 2 diabetes on quality of life—Results of ‘YourSAY: Quality of Life’
Authors: Holmes‐Truscott Elizabeth , Broadley Melanie M. , Søholm Uffe , Cooke Debbie D. , Hendrieckx Christel , Coates Elizabeth J. , Heller Simon R. , Speight Jane
Published: October 2024

Aims

To assess and compare the psychometric properties and acceptability of four diabetes‐specific quality of life (QoL) scales among adults with Type 2 diabetes (T2D).

Methods

Adults (≥18 years) with T2D living in the United Kingdom (n = 1465) or Australia (n = 248) completed a cross‐sectional, online survey including the following: ADDQoL, DCP, DIDP and Diabetes QoL‐Q (presented in randomised order), followed by rating scales to assess clarity, relevance, ease of completion, length and comprehensiveness of each scale. Demographic, clinical and psychosocial characteristics were collected. Acceptability (scale completeness and user ratings), response patterns, structure (exploratory and confirmatory factor analyses) and validity (convergent, confirmatory, divergent and known‐groups) were examined. Data were analysed by country to assess cross‐country reproducibility.

Results

High completion rates (≥89%) and positive user ratings were observed across scales indicating broad acceptability. The DIDP was the strongest performing scale: highest completion rate (97%), user ratings (≥84% positive) and most satisfactory psychometric properties (highest variance explained, consistent factor loadings >0.5 on all items and most permissible model fit parameters). Scale‐level floor effects may suggest domain omissions for the brief DIDP.

Conclusions

The current study provides novel insights into the acceptability, validity and reliability of diabetes‐specific QoL measures for adults with T2D. Consistent with the published Type 1 diabetes cohort findings, the DIDP is recommended as a brief, acceptable and psychometrically sound measure. However, selection needs to be considered in the context of the specific research or clinical aims and further evidence (e.g. responsiveness) may be required before it can be recommended for use in trials or prospective studies.
Leveraging Dissent: A Policy Narrative's Power to Sow Distrust
Authors: Lo Jane C. , moore candace
Published: October 2024

The rise of political polarization and disagreement within the United States and other democracies indicates an erosion of the social contract, a deterioration exacerbated by the balkanization of social media, that can negatively impact our social relationships. Recent anti–Critical Race Theory (CRT) narratives in education provide insights into how policy narratives can be used to sow distrust in an educational context. In this paper Jane Lo and candace moore argue for the ways policy narratives can sow distrust as opposed to mistrust. Mistrust points to an ongoing process of determining trustworthiness, while distrust connotes a more decisive and deliberate lack of trust in a person or institution. Lo and moore argue that educational research should pay more attention to the building of trust or mistrust in schools in the current context, where the anti‐CRT policy narrative, through amplifying and manipulating existing anxieties and fears in order to motivate political action, capitalizes on and seeks to reinforce the natural mistrust of schooling.
Nutrition Education and Practice in University Dental and Oral Health Programmes and Curricula: A Scoping Review
Authors: Kataoka Minako , Adam Lee Ann , Ball Lauren Elizabeth , Crowley Jennifer , McLean Rachael Mira
Published: October 2024

Introduction

Dentists and oral health practitioners have a potential role in supporting the prevention and management of noncommunicable diseases. However, the extent to which university education prepares practitioners to provide nutrition care is unclear. This scoping review identifies and synthesises the evidence related to university‐level nutrition education provided to dental and oral health students globally.

Methods

A scoping review identified relevant literature through search terms “dentistry,” “oral health,” or “oral hygiene”; “dental students” or “dental education”; “nutrition education” or “nutrition science.” Articles were included that examined nutrition education in undergraduate oral health training; or nutrition knowledge, attitudes, confidence, or skills or dietary habits; experts' opinion papers; and position statements. No limitations on the publication years or languages of the articles were applied.

Results

A total of 136 articles were included. Half were surveys of students (n = 49) or academic staff (n = 21). The remainder comprised reports of curriculum initiatives (n = 26), opinion papers or narrative reviews (n = 24), position statements (n = 6), curriculum development (n = 6) and curriculum guidelines (n = 9). While dental and oral health students and curriculum experts overwhelmingly recognised the importance of nutrition, most studies that assessed nutrition knowledge of students revealed limited knowledge. Students were not confident in their skills to provide nutrition care. Lack of nutrition experts on teaching teams and unclear expectations about developing nutrition competencies were identified as barriers to greater nutrition education.

Conclusion

Nutrition education in university dental and oral health degrees is highly variable. The potential for oral health professionals of the future to promote oral health through nutrition is unrealised.
Defining Climate Finance Justice: Critical Geographies of Justice Amid Financialized Climate Action
Authors: Gifford Lauren , Sauls Laura Aileen
Published: October 2024

Given the exponential growth in financial investments to support climate change mitigation and adaptation, particularly shaped as capital flows from the Global North to the Global South, an incredible amount of research has come out in recent years interrogating various modes of climate finance. This article provides an overview of “climate finance justice,” an emerging subfield of scholarship that asks “What kinds of justice and injustice do we see in climate finance? How does climate justice influence flows and constructions of capital? And how can finance be more just?” As climate finance is often framed as a response to calls for climate justice, climate finance justice offers a space in which to rigorously and comprehensively analyze the outcomes of these flows of capital, finance and power. Yet the field is still new, and would benefit from further inclusion of a broader array of fields and influences, including postcolonial, poststructural, feminist, indigenous, urban, post‐political and other critical perspectives to inform scholarship, and challenge dominant conceptualizations of justice and equity. This article highlights the field of climate finance justice and explores the United Nations Framework Convention on Climate Change (UNFCCC) and voluntary carbon markets (VCMs) as a means of understanding its applied implications. It situates the evolution of the subfield within the broader literature on neoliberal natures, political ecology, and the critical geographies of the carbon economy.
The Masculine Figure of a University Rector in the Narratives of Polish Female Academic Leaders
Authors: Antonowicz Dominik , Pokorska Anna
Published: October 2024

There is a growing interest in the underlying mechanisms affecting female leaders in higher education. And this paper examines the problem by focusing specifically on Polish public universities which historically stands out by particularly low number of female university rectors. The core of the study is based on 15 in‐depth expert interviews with female university rectors and vice‐rectors. The paper argues that the large deficit of female rectors has been influenced by the traditional masculine figure of a university rector deeply embedded in the Polish academic culture. We demonstrate evidence that the masculine figure of a rector still strongly affects the perception of who is destined to perform the role.
Effectiveness, safety, and patient‐reported outcomes of emtricitabine/tenofovir alafenamide‐based regimens for the treatment of HIV‐1 infection: Final 24‐month results from the prospective German TAFNES cohort study
Authors: Stephan Christoph , Spinner Christoph D. , Rieke Ansgar , Christensen Stefan , Mauss Stefan , Schreiber Sandra , Albuquerque Boris , Heinzkill Marion , Ramroth Heribert , Stellbrink Hans‐Jürgen
Published: October 2024

Background

Tenofovir alafenamide (TAF) was introduced in the European Union in 2015 as a novel prodrug of tenofovir showing similar efficacy in clinical trials and a more favorable safety profile than tenofovir disoproxil fumarate (TDF). The German TAFNES cohort study (2016–2019) was conducted to generate real‐world evidence.

Methods

Treatment‐naïve (TN) and treatment‐experienced (TE) people with HIV (PWH) receiving elvitegravir/cobicistat/emtricitabine/TAF (E/C/F/TAF), rilpivirine/F/TAF (R/F/TAF) or F/TAF + 3rd agent were included. Month (M) 24 outcomes included virologic effectiveness (HIV RNA <50 copies/mL), treatment persistence, adverse drug reactions (ADRs) and patient‐reported outcomes, using the HIV Symptom Index (HIV‐SI), 36‐Item Short Form Health Survey (SF‐36) and HIV Treatment Satisfaction (HIVTSQ) questionnaires.

Results

The study included 767 PWH (92% men, median age 46 years; 301 TN, 466 TE; E/C/F/TAF [n = 318], R/F/TAF [n = 192], F/TAF + 3rd agent [n = 257]). Among TN, 35% had late HIV diagnosis (CD4 < 350/μL and/or AIDS). Of TE, 95% were on suppressive antiretroviral therapy (ART) before switching. D:A:D (Data Collection on Adverse Effects of Anti‐HIV Drugs) 5‐year risks for chronic kidney disease were high for about 1 in 10 TN and 4 in 10 TE. Overall treatment persistence at M24 was 81% (E/C/F/TAF: 88%; R/F/TAF: 86%; F/TAF + 3rd agent: 70%, with ART simplification of multiple‐tablet regimens in 13%). M24 viral suppression (missing = excluded) was 96% (479/501). Discontinuations due to virologic failure or ADRs were rare, 2% (12/767) and 4% (30/767), respectively. HIV‐SI and SF‐36 summary scores improved in TN; HIVTSQ change scores showed an improvement in treatment satisfaction in TE.

Conclusion

Real‐world data confirmed a favorable safety profile and high virologic effectiveness with high treatment satisfaction on F/TAF‐based ART.
Effects of 0.2% Hyaluronic Acid Gel‐Impregnated Dental Floss on Clinical Gingival Parameters: A Randomised Clinical Trial
Authors: Atagün Özlem Saraç , Şen Seval Ceylan , Ustaoğlu Gülbahar , Özcan Erkan
Published: October 2024

Objectives

Gingivitis is a common inflammatory lesion caused by the build‐up of oral biofilm and is an essential precursor to periodontitis. For its treatment, oral hygiene habits, such as dental flossing, must be improved, and adjunctive materials, such as hyaluronic acid, may be used to reduce plaque formation and gingival inflammation. This study aimed to assess the effects of 0.2% hyaluronic acid gel‐impregnated dental floss on the clinical periodontal markers of patients with gingivitis.

Material and Methods

This clinical study adopted a split‐mouth, randomised controlled trial design. After clinical data were assessed at baseline, and supragingival scaling was performed, bilateral gingivitis regions were randomly allocated to either the hyaluronic acid gel‐impregnated floss group or just the floss group using a computer‐generated randomisation table. Clinical parameters were recorded at 1, 2 and 4 weeks after treatment.

Results

Over the 4‐week trial period, all patients showed significant improvements in all clinical periodontal markers. The 1‐week plaque index, 4‐week gingival index and 4‐week papillary bleeding index were significantly lower in the test group than in the control group (p < 0.05).

Conclusions

The use of hyaluronic acid‐impregnated dental floss has resulted in more significant improvements in clinical periodontal parameters compared to dental floss alone. For ease of use, ready‐made products with this innovative formulation may be produced.

Trial Registration: ClinicalTrials.gov identifier: NCT06307041
Outcomes of Nonsurgical Periodontal Therapy in Gingivitis and Periodontitis Patients Treated by Senior Dental Students
Authors: Badahdah Arwa , Bahanan Lina , Barnawi Rasha F. , Alghamdi Afrah A. , Banjar Arwa A.
Published: October 2024

Objectives

This retrospective study aimed to evaluate the outcomes of nonsurgical periodontal therapy performed by senior dental students.

Methods

Electronic records of patients treated by senior dental students at the comprehensive care clinic in King Abdulaziz University Dental Hospital were reviewed retrospectively. Patients diagnosed with gingivitis or periodontitis who had undergone at least one session of scaling and root planing were included in this study. The following periodontal parameters were assessed: BOP, PI, PD and number of residual pockets.

Results

A total of 618 patients were included in this study (60.2% females and 39.8% males). BOP reduced from a median of 40% (IQR: 26.0%–62.0%) at baseline to 13% (IQR: 9.0%–20.3%) at re‐evaluation in the gingivitis group (p < 0.0005). Similarly, a significant reduction in BOP, from 45% (IQR: 28.0%–64.3%) at baseline to 14% (IQR: 9.0%–21.5%) after phase I therapy, was observed in the periodontitis group (p > 0.001). In both groups, 31%–32% of patients had BOP < 10 at re‐evaluation. PD of ≥ 5 mm was observed in 50.8% of patients with periodontitis at baseline; however, 38% of these patients had no residual pockets at re‐evaluation.

Conclusion

NSPT performed by senior dental students was effective in improving the periodontal status of the patients. Both gingivitis and periodontitis patients showed significant improvement in BOP and PI. Approximately, 32% of patients showed a reduction in BOP suggestive of a bleeding score associated with periodontal health. Moreover, patients diagnosed with periodontitis exhibited a significant reduction in the number of sites with deep probing (≥ 5).