bluuebunny/crossref_metadata_2025 huggingface dataset:
Rural maternity and media discourse analysis: Framing new narratives
Authors: Brundell Kath , Vasilevski Vidanka , Farrell Tanya , Sweet Linda
Published: March 2023

Introduction

Continued rural maternity closure across Australia has seen impacts on women and families such as financial pressures, quality and safety concerns, and emotional pressure. This review aimed at understanding how media coverage of rural maternity and closure are presented and what impact this may have on maternity service sustainability.

Objective

This research seeks to examine media discourse and characteristics of online newspaper articles related to rural maternity services.

Design

A narrative review was conducted using thematic discourse analysis to examine online newspaper content published in Victoria, Australia from 2010 to June 2021.

Findings

Local maternity services were a source of community interest for rural people. Coverage of negative outcomes for mothers and babies was highlighted by rural newspapers; however, increased content over the last 12‐month period focused on community support for the sustainability of rural maternity services. Recent community support in newspaper articles coincided with maternity services reviews and retaining some of these rural services.

Discussion

Community support in media may provide a protective social pressure, leading rural health services to consider this when reviewing the sustainability or closure of rural maternity services.

Conclusion

Media attention about sustaining local maternity services by highlighting issues and representing community voices may influence health executive to consider opportunities to remodel and sustain high‐quality and safe maternity care in rural settings. Knowing how rural health executives consider media, community pressure, and how it impacts expediency of maternity service closure decisions is unknown and an important gap in knowledge to explore and understand.
Correlation analysis of deep learning methods in S‐ICD screening
Authors: ElRefai Mohamed , Abouelasaad Mohamed , Wiles Benedict M. , Dunn Anthony J. , Coniglio Stefano , Zemkoho Alain B. , Morgan John , Roberts Paul R.
Published: March 2023

Background

Machine learning methods are used in the classification of various cardiovascular diseases through ECG data analysis. The concept of varying subcutaneous implantable cardiac defibrillator (S‐ICD) eligibility, owing to the dynamicity of ECG signals, has been introduced before. There are practical limitations to acquiring longer durations of ECG signals for S‐ICD screening. This study explored the potential use of deep learning methods in S‐ICD screening.

Methods

This was a retrospective study. A deep learning tool was used to provide descriptive analysis of the T:R ratios over 24 h recordings of S‐ICD vectors. Spearman's rank correlation test was used to compare the results statistically to those of a “gold standard” S‐ICD simulator.

Results

A total of 14 patients (mean age: 63.7 ± 5.2 years, 71.4% male) were recruited and 28 vectors were analyzed. Mean T:R, standard deviation of T:R, and favorable ratio time (FVR)—a new concept introduced in this study—for all vectors combined were 0.21 ± 0.11, 0.08 ± 0.04, and 79 ± 30%, respectively. There were statistically significant strong correlations between the outcomes of our novel tool and the S‐ICD simulator (p < .001).

Conclusion

Deep learning methods could provide a practical software solution to analyze data acquired for longer durations than current S‐ICD screening practices. This could help select patients better suited for S‐ICD therapy as well as guide vector selection in S‐ICD eligible patients. Further work is needed before this could be translated into clinical practice.
Heterogeneity in children at risk of math learning difficulties
Authors: Muñez David , Bull Rebecca , Lee Kerry , Ruiz Carola
Published: March 2023

This study recruited 428 Singaporean children at risk of math learning difficulties (MLD; Mage = 83.9 months, SDage = 4.35 months; 41% female). Using a factor mixture model that considered both quantitative and qualitative differences in math ability, two qualitatively different groups were identified: one with generalized difficulties across different math skills and the other with more focal difficulties in arithmetic fluency. Reading, working memory capacity, and numeracy (number line estimation skills and numerical discrimination) uniquely explained group membership. Children within each group differed in the extent of difficulties they exhibited, with numeracy variables differentially contributing to math ability in each group. Findings speak against a dimensional view of MLD and underscore the conceptual limitations of using basic numeracy performance to profile learning difficulties.
In vitro efficacy of non‐surgical and surgical implant surface decontamination methods in three different defect configurations in the presence or absence of a suprastructure
Authors: Korello Katharina , Eickholz Peter , Zuhr Otto , Ratka Christoph , Petsos Hari
Published: March 2023

Objectives

Analysis of the in vitro efficacy of non‐surgical and surgical dental implant surface decontamination with or without suprastructure.

Materials and Methods

Three hundred and sixty implants were dipped in indelible red and distributed to 30°, 60°, or 90° angulated bone defect models. One hundred and twenty implants were used for each bone defect, 40 of which were assigned to a decontamination method (CUR: curette; SOSC: soundscaler; APA: air powder abrasion). Of these, 20 were subjected to a simulated non‐surgical (NST) or surgical treatment (ST), with/without mucosa mask, of which 10 were carried out with (S+) or without (S−) suprastructure. Uncleaned implant surface was assessed by both‐sided implant surface photography. Surface morphology changes were analyzed using scanning electron microscopy (SEM).

Results

Cleaning efficacy was significantly better within NST if the suprastructure was removed (p < 0.001). No significant difference was found within ST (p = 0.304). Overall, cleaning efficacy in the order APA > SOSC>CUR decreased significantly (p < 0.0001) for both S+ and S− in NST as well as ST. Separated by NST/ST, S+/S−, defect angulation and decontamination method, only isolated significant differences in cleaning efficacy were present. Linear regression analysis revealed significant associations of remnants with the treatment approach, decontamination method, and defect angle (p < 0.0001). SEM micrographs showed serious surface damage after use of CUR and SOSC.

Conclusions

Suprastructure removal is an additional option to improve cleaning efficacy of non‐surgical implant surface decontamination in this in vitro model.
How expert insight into alpine peatland conservation complements global scientific evidence
Authors: Rowland Jessica A. , Moore Joslin L. , Walsh Jessica C.
Published: March 2023

Experts can provide valuable information to fill knowledge gaps in published research on management effectiveness, particularly for threatened ecosystems, for which there is often limited evidence and the need for prompt intervention to ensure their persistence. One such ecosystem, alpine peatland, is threatened by climate change and other pressures, provides vital ecosystem services, and supports unique biodiversity. In a workshop, we gathered and synthesized into an accessible format information from experts on interventions used, threat context, and intervention effectiveness for Australian alpine peatland and used this knowledge to evaluate local relevance of the global literature for this threatened ecosystem. Experts identified 15 interventions used to conserve Australian peatlands, most of which enhanced or restored peatland condition and effectively addressed diverse threats. Experts’ perspectives and global studies were strongly aligned, suggesting that research on peatland management may be broadly relevant across contexts, despite the distinct characteristics of Australian systems. Our workshop‐based expert elicitation approach provided insights into current management practices unavailable in the literature.
A novel near‐infrared fluorescent and colorimetric probe for selective detection of Ag+ and Hg2+
Authors: Min Yuquan , Han Xin , Qi Youguo , Jiang Lin , Song Yanxi , Ma Yilin , Zhang Jian , Li Hongqi
Published: March 2023

It is particularly important to develop effective and specific detection methods for harmful metal ions such as the silver ion (Ag+) and mercury ion (Hg2+). In this article, a new near‐infrared (NIR) fluorescent probe (N‐FP) based on intramolecular charge transfer (ICT) effect was designed and synthesised, which exhibited the characteristics of large Stokes shift (163 nm) and excellent stability. Addition of Ag+ or Hg2+ to the N‐FP solution in ethanol/water (9:1, v/v) caused remarkable enhancement of fluorescence emission at 661 nm, bathochromic shift of ultraviolet‐visible absorption wavelength, and colour change from orange to red or purple. While adding other metal ions including Li+, Na+, K+, Ag+, Cu2+, Fe2+, Zn2+, Co2+, Ni2+, Mn2+, Sr2+, Ca2+, Mg2+, Al3+, Cr3+ and Fe3+ did not bring about substantial spectral and colour change. The detection limit of the N‐FP for Ag+ and Hg2+ was calculated to be 1.1 and 0.72 μM, respectively. The N‐FP could be used to recognise Ag+ and Hg2+ in a wide pH range of 1–10. The sensing mechanism was proposed and demonstrated by proton nuclear magnetic resonance (1H‐NMR), high‐performance liquid chromatography (HPLC) and mass spectrometry (MS) measurements
Implicit gender bias in the diagnosis and treatment of type 2 diabetes: A randomized online study
Authors: Skvortsova A. , Meeuwis S. H. , Vos R. C. , Vos H. M. M. , van Middendorp H. , Veldhuijzen D. S. , Evers A. W. M.
Published: March 2023

Aims

Implicit gender biases (IGBs) are unconscious evaluations about a person based on gender. IGBs of healthcare providers may affect medical decision making. This study investigated whether IGBs and genders of patients and general practitioners (GPs) influence diagnostics and treatment decisions in the context of diabetes type 2.

Methods

Ninety‐nine GPs participated in this randomized online study. Implicit Associations Tasks were used to measure two IGBs, related to lifestyle (women have a healthier lifestyle than men) and communication (men are less communicative than women). Clinical decisions regarding type 2 diabetes were measured with vignettes that included a fictional male or female patient case.

Results

Female GPs exhibited a significant lifestyle IGB (p < 0.001). GPs of both genders exhibited a significant communication IGB (p < 0.001). Several associations between IGBs and clinical decisions were found. The gender of the vignette character affected several outcomes, for example GPs were less certain in the diabetes diagnosis when the character was a woman (p < 0.001).

Conclusion

We demonstrated that GPs have IGBs and these biases as well as patient's gender affect decisions of GP's when they are solving a diabetes vignette case. Future research is needed to understand the most important consequences of IGBs in the context of type 2 diabetes.
ALKBH1 contributes to renal cell carcinoma progression by reducing N6‐methyladenine of GPR137
Authors: Li Lin , Zhu Chongying , Xu Qiang , Xu Shouying , Ye Jianqing , Xu Da , Wang Lei , Gan Sishun , Liu Bing , Tang Chao
Published: March 2023

Background

Renal cell carcinoma (RCC) accounts for approximately 4% of all adult malignancies with high mortality worldwide. Although conventional chemotherapy and radiotherapy treatment has been applied for RCC in clinic, the mortality rate of patients is increasing each year, and patients with metastatic RCC are still suffering from poor prognosis. Thus, further investigation of the molecular mechanisms responsible for the development and progression of RCC is of particular importance.

Methods

Total of 10 pairs of RCC tissues and adjacent nontumor tissues were collected for examination of ALKBH1 and GPR137 expression. The correlations between ALKBH1 and GPR137 expression in RCC patient were assessed by GEPIA online tool and were analyzed using auto best cutoff. The human RCC cell lines Caki‐1, 786‐O, ACHN, Osrc2, A498, and 769‐P, were used for mechanistic investigation.

Results

Here, we report that the expression of AlkB homologue 1 (ALKBH1) is upregulated in RCC tissues, which is correlated with G‐protein‐coupled receptor 137 (GPR137) expression. The elevated expression of ALKBH1 is associated with RCC cell malignant characteristics, including cell proliferation and movement (migration and invasion). Mechanistic investigation further reveals that ALKBH1 reduces m6A levels of GPR137 mRNA in RCC cells, which upregulates GPR137 mRNA levels, resulting in the increased GPR137 protein expression subsequently and the enhanced RCC cell biological actions consequently. In contrast, the suppression of GPR137 effectively alleviates the ALKBH1‐induced malignancies of RCC cells.

Conclusion

Our results indicate that ALKBH1–GPR137 axis might be used as a potential therapeutic target in RCC, contributing to finding new prognostic biomarkers for RCC at an early stage.
Validation of National Early Warning Score and Quick Sequential (sepsis‐related) Organ Failure Assessment in acute myeloid leukaemia patients treated with intensive chemotherapy
Authors: Frairia Chiara , Nicolino Barbara , Secreto Carolina , Messa Emanuela , Arrigo Giulia , Busca Alessandro , Cerrano Marco , D'Ardìa Stefano , Dellacasa Chiara , Evangelista Andrea , Freilone Roberto , Giai Valentina , Priolo Giorgio , Urbino Irene , Audisio Ernesta
Published: March 2023

Objectives

Chemotherapy‐induced neutropenia in acute myeloid leukaemia (AML) is a risk factor for life‐threatening infections. Early diagnosis and prompt interventions are associated with better outcomes, but the prediction of infection severity remains an open question. Recently, National Early Warning Score (NEWS) and quick sequential organ failure assessment (qSOFA) scores were proposed as warning clinical instruments predicting in‐hospital mortality, but their role in the haematological context is still unknown.

Methods

We retrospectively assess the predictive role of NEWS and qSOFA in a large and homogeneous cohort of adult AML patients treated with intensive chemotherapy. In a total of 1048 neutropenic episodes recorded in 334 consecutive patients, the scores were applied to predict outcomes on the same day of fever onset, and after 24 and 48 h from score calculation.

Results

Both NEWS and qSOFA significantly predicted death, with more accuracy on the same day (NEWS AUROC 0.984 and qSOFA AUROC 0.969) and after 24 h (NEWS AUROC 0.928 and qSOFA AUROC 0.887), while remained moderately accurate after 48 h. Furthermore, also ICU admission was accurately predicted at fever onset and after 24 h.

Conclusions

Both scores were useful tools in the management of post chemotherapy neutropenic febrile AML patients.
Social isolation produces a sex‐ and brain region‐specific alteration of microglia state
Authors: Vu Alex P. , Lam David , Denney Cayla , Lee Kelly V. , Plemel Jason R. , Jackson Jesse
Published: March 2023

Social isolation is a profound form of psychological stress that impacts the mental health of a large proportion of society. Other experimental models of stress have demonstrated a microglia response that serves either a protective or pathological function. However, the effect of adult social isolation on microglia has not been thoroughly investigated. We measured microglia territory, branching, end points and phagocytic‐lysosomal activity in group housed C57Bl/6 mice and mice that were socially isolated for 2 weeks. Our results show that the dorsomedial hypothalamus and hippocampal CA2 region of adult male mice undergo increased microglia volume, territory and endpoints following social isolation, whereas females exhibit this increase in the hypothalamus only. Males exhibited decreases in the phagocytic‐lysosomal marker CD68 in microglia in these regions, whereas females showed an increase in CD68 in the hypothalamus suggesting sexually dimorphic and brain region‐specific change in microglia state in response to social isolation. The prefrontal cortex, central amygdala, nucleus accumbens shell and visual cortex did not exhibit changes in microglia structure in either male or female mice. These data show that microglia in different brain regions undergo a distinct response to social isolation which may account for changes in cognition and behaviour associated with this prevalent form of psychological stress.
Transitional care decision‐making through the eyes of older people and informal caregivers: An in‐depth interview‐based study
Authors: Kraun Lotan , van Achterberg Theo , Vlaeyen Ellen , Fret Bram , Briké Sarah Marie , Ellen Moriah , De Vliegher Kristel
Published: March 2023

Background

Older people with multifaceted care needs often require treatment and complex care across different settings. However, transitional care is often inadequately managed, and older people and their informal caregivers are not always sufficiently heard and/or supported in transitional care decision‐making.

Objective

To explore older people's and informal caregivers' experiences with, views on, and needs concerning empowerment in transitional care decision‐making.

Methods

A qualitative descriptive study was conducted in the TRANS‐SENIOR consortium's collaborative research using semistructured in‐depth interviews between October 2020 and June 2021 in Flanders, Belgium. A total of 29 people were interviewed, including 14 older people and 15 informal caregivers who faced a transition from home to another care setting or vice versa. Data were analysed according to the Qualitative Analysis Guide of Leuven.

Findings

Five themes were identified in relation to the participant's experiences, views and needs: involvement in the decision‐making process; informal caregivers' burden of responsibility; the importance of information and support; reflections on the decision and influencing factors.

Conclusions

Overall, older people and informal caregivers wished to be more seen, recognised, informed and proactively supported in transitional care decision‐making. However, their preferences for greater involvement in decision‐making vary and are affected by several factors that are both intrinsic and extrinsic. Therefore, healthcare systems might seek out age‐tuned and person‐centred empowerment approaches focusing on older people's and informal caregivers' empowerment. For future studies, we recommend developing specific strategies for such empowerment.

Patient or Public Contribution

Older persons' representatives were involved in designing the TRANS‐SENIOR programme of research, including the current study. Healthcare professionals and nursing care directors were involved in the study design and the selection and recruitment of participants.
The Politics of Pears: Augustine on the Ethics of Privative Versus Eucharist Communities
Authors: Sweeney Terence
Published: March 2023

In my essay, I interpret Augustine's Confessions as a political text that portrays Augustine's attempt to find a true community. This search includes a critique of various defective communities that cannot provide the public good necessary for a true public. To show this, I focus on Augustine's account of the pear theft as an example par excellence of a privative community. I examine the story as an account of an inexplicable act of willing against the good that unmakes the will. I then argue that the supposed resolution—that Augustine was willing the good of community—in fact exacerbates the inexplicability of the pear theft. In feasting on iniquity, this community un‐makes itself. I conclude by showing how the pear thieves represent a perverted imitation of the eucharistic community, which does not steal but shares the Good and so shares its goods.
Toward controllable material removal of glass–ceramic surface for low‐deformation machining
Authors: Zhou Huaicheng , Feng Chengqiang , Lin Yu , Gao Jian , Yu Bingjun , Qian Linmao
Published: March 2023

Due to its extremely high optical uniformity and excellent hot stability, glass–ceramic serves as a key material for ultraprecision imaging of lithography lens, and low‐deformation machining is of significance for achieving high‐quality surface. Aiming at controllable processing, the annealing of different nanoscratches on glass–ceramic was investigated for revealing the mechanism of material removal and damage repair. The volume change of the single‐pass nanoscratch under various normal loads and sliding velocities before and after the annealing was calculated for quantifying the contribution of shear flow, densification, and residual stress to the material removal, respectively. It is found that ductile removal under high normal load or low sliding velocity is dominated by shear flow, thereby improving removal efficiency and reducing machining deformation and defects caused by densification and residual stress. The changes of microstructures beneath the scratches before and after annealing further reveal that the excess processing energy will be absorbed in glass–crystal interface and form micro‐cracks on crystal surface. For comparison, brittle removal under variable cycles was simulated by multi‐pass nanoscratches, and it reveals that the shear flow ratio raises gradually with the increase of cycle number. These findings provide theoretical guidance for ultraprecision processing of glass–ceramic surfaces.
Dual burden of individual malnutrition in children 1–4 years: Findings from the Colombian nutritional health survey ENSIN 2015
Authors: Castillo Adriana N. , Suarez‐Ortegón Milton F.
Published: March 2023

Background

To date there are no studies with estimation of multiple types of double burden of individual malnutrition (DBIM) and evaluation of associated determinants.

Objective

To estimate the prevalence and social determinants associated with the double burden of individual malnutrition in children aged 1–4 years.

Methods

A cross‐sectional study was conducted using data from Colombian nutritional heath survey ENSIN 2015. Global DBIM was analysed on the basis of excess weight and the presence of one or more micronutrient deficiencies (vitamin A, D, zinc, or iron) and/or stunting. Specific DBIM pairs were also analysed. Logistic regression was used to evaluate variables associated with DBIM.

Results

The sample consisted of 6807 children. The overall DBIM prevalence was 4%. The prevalence of DBIM in children affected by overweight or obesity was 75%. Male sex was associated with global DBIM (OR 2.19 (1.52–3.16) p = 0.000), indigenous children presented 6 times the DBIM due to stunting (OR 6.17 (1.67–22.7) p = 0.007). Children from the Atlantic (OR 3.95 (1.23–12.61) p = 0.021), central (OR 8.80 (2.38–32.49) p = 0.001) and Pacific (OR 4.19 (1.21–14.49) p = 0.024) regions, had a higher chance of DBIM due to iron deficiency. Children from east region (OR 3.03 (1.12–8.16) p = 0.029) and Bogotá city (OR 4.15 (1.65–12.32) p = 0.004) were associated with DBIM due to vitamin D deficiency.

Conclusions

Children with overweight or obesity had a high likelihood of presenting micronutrients deficiencies or stunting. Ethnicity, male sex and country region of residence were variables associated with overall DBIM or specific DBIM.
Effects of couple‐based dyadic interventions on breast cancer patients and their intimate partners: A systematic review and meta‐analysis
Authors: Li Mingfang , Zhang Lijuan , Li Na , Luo Xia , Chen Jing , Zhang Yue , Xiong Chenxia , Zhao Meng , Guo Zijun , yan Jun
Published: March 2023

Aims

To evaluate the effects of couple‐based dyadic interventions on breast cancer patients and their intimate partners and compare the effects between interventions with different durations (<3 months; =3 months; >3 months).

Design

A systematic review and meta‐analysis.

Data sources

Six English databases, PubMed, Embase, Web of Science Core Collection, the Cochrane Library, Medline, PsycINFO, and three Chinese databases, China National Knowledge Infrastructure (CNKI), WanFang, and Weipu (VIP), from database inception to 19 February 2022.

Review Methods

The quality of the included RCTs was evaluated using the Cochrane risk‐of‐bias tool and the data analysis was performed by using RevMan 5.4 and Stata 15. The outcomes were categorized into five aspects: dyadic relationship, overall quality of life (QOL), physical health, psychological health and social adjustment.

Results

Nineteen RCTs were included. For patients' overall effects, couple‐based dyadic interventions can improve sexual frequency, psychological health (anxiety; depression; well‐being; body image) and social adjustment (family function‐cohesion; social function‐total). In the subgroup analysis, it can adjust patients' relationship satisfaction (>3 months), sexual frequency (>3 months), depression (<3 months and >3 months), well‐being (>3 months), and body image (3 months). For intimate partners, no statistically significant overall effects were found, and all results in the subgroup analyses showed no statistical significance.

Conclusions

The results revealed the different effects of couple‐based dyadic interventions on dyads. It also suggested that tailored intervention duration should be a focus in future studies to obtain the potential actor‐partner benefits.

Impact

This study revealed that the overall effects of the couple‐based dyadic interventions include enhancing patients' sexual frequency, psychological health and social adjustment. Clinical practitioners should consider the intimate partners' outcomes and conduct couple‐based dyadic interventions that contain more tailored elements to achieve better effects.

No Patient or Public Contribution

Registration: The systematic review and meta‐analysis of RCTs has been registered in PROSPERO (Number: CRD 42021286679).
The interaction game: A reciprocity‐based minimal paradigm for the induction of social distance
Authors: Biella Marco , Rebholz Tobias R. , Holthausen Miriam , Hütter Mandy
Published: March 2023

The investigation of how social distance affects psychological phenomena has relied mostly on comparisons between strangers and acquaintances. Such an operationalization suffers from a confound between social distance and acquaintance. We propose an experimental paradigm that manipulates social distance while avoiding the aforementioned confound. By relying on reciprocity and known social tie formation mechanisms, the Interaction Game provides researchers with a powerful tool for the investigation of social distance effects without inducing negative affective or emotional states. Four preregistered experiments demonstrate the internal and external validity of the paradigm. The capability of manipulating social distance in a targeted manner constitutes a critical step towards advancing our knowledge of the impact of such metrics on human cognition and behavior. Moreover, Experiment 4 demonstrates that the Interaction Game can induce social distance that is free of acquaintanceship, and that such a minimal manipulation is sufficient for inducing close‐other favoritism in a social discounting task. These findings expand our understanding of social distance as a powerful mechanism underlying social judgments and behaviors.
Hypertension care during the COVID‐19 pandemic in an integrated health care system
Authors: Steiner John F. , Powers J. David , Malone Allen , Lyons Jason , Olson Kari , Paolino Andrea R. , Steiner Claudia A.
Published: March 2023

Retention in hypertension care, medication adherence, and blood pressure (BP) may have been affected by the COVID‐19 pandemic. In a retrospective cohort study of 64 766 individuals with treated hypertension from an integrated health care system, we compared hypertension care during the year pre‐COVID‐19 (March 2019–February 2020) and the first year of COVID‐19 (March 2020–February 2021). Retention in hypertension care was defined as receiving clinical BP measurements during COVID‐19. Medication adherence was measured using prescription refills. Clinical care was assessed by in‐person and virtual visits and changes in systolic and diastolic BP. The cohort had a mean age of 67.8 (12.2) years, 51.2% were women, and 73.5% were White. In 60 757 individuals with BP measurements pre‐COVID‐19, 16618 (27.4%) had no BP measurements during COVID‐19. Medication adherence declined from 86.0% to 80.8% (p < .001). In‐person primary care visits decreased from 2.7 (2.7) to 1.4 (1.9) per year, while virtual contacts increased from 9.5 (12.2) to 11.2 (14.2) per year (both p < .001). Among individuals with BP measurements, mean (SD) systolic BP was 126.5 mm Hg (11.8) pre‐COVID‐19 and 127.3 mm Hg (12.6) during COVID‐19 (p = .14). Mean diastolic BP was 73.5 mm Hg (8.5) pre‐COVID‐19 and 73.5 mm Hg (8.7) during COVID‐19 (p = .77). Even in this integrated health care system, many individuals did not receive clinical BP monitoring during COVID‐19. Most individuals who remained in care maintained pre‐COVID BP. Targeted outreach may be necessary to restore care continuity and hypertension control at the population level.
Association of glucagon‐like peptide‐1 receptor agonist treatment with gastric residue in an esophagogastroduodenoscopy
Authors: Kobori Toshiko , Onishi Yukiko , Yoshida Yoko , Tahara Tazu , Kikuchi Takako , Kubota Tetsuya , Iwamoto Masahiko , Sawada Tomonobu , Kobayashi Reo , Fujiwara Hiroaki , Kasuga Masato
Published: March 2023

Aims/Introduction

Previous studies have reported that the glucagon‐like peptide‐1 receptor agonist (GLP‐1RA) delays gastric emptying, and gastric emptying was assessed by the 13C breath test or paracetamol absorption technique. However, neither of them is clinically familiar in real‐world clinical practice. The purpose of the present study was to investigate the association between GLP‐1RA treatment and gastric residue in an esophagogastroduodenoscopy.

Materials and Methods

This study was a matched pair case–control study. The study population consisted of 1,128 individuals with diabetes who had esophagogastroduodenoscopy at our clinic between July 2020 and June 2022. To account for differences in characteristics, such as age, sex, insulin treatment and glycated hemoglobin, we carried out a one‐to‐one nearest neighbor propensity score matching analysis between diabetes patients with and without GLP‐1RA treatment. After matching, we compared the presence of gastric residue in an esophagogastroduodenoscopy by the McNemar test between patients with and without GLP‐1RA treatment.

Results

After the propensity score matching, we selected 205 pairs. In the propensity score‐matched comparison, the proportion of gastric residue was statistically significantly higher in the GLP‐1RA treatment group (0.49% vs 5.4%, P = 0.004). The details of GLP‐1RA prescribed for the 11 patients with gastric residue were liraglutide once daily 1.8 mg (n = 2), dulaglutide once weekly 0.75 mg (n = 5), semaglutide once weekly 0.5 mg (n = 2) and semaglutide once weekly 1.0 mg (n = 2).

Conclusion

GLP‐1RA treatment is associated with gastric residue in an esophagogastroduodenoscopy in patients with diabetes.
Impact of cold plasma treatment on nutritional, antinutritional, functional, thermal, rheological, and structural properties of pearl millet flour
Authors: Sarkar Ayan , Niranjan Thota , Patel Gopesh , Kheto Ankan , Tiwari Brijesh K. , Dwivedi Madhuresh
Published: March 2023

This study was planned to investigate the effect of atmospheric cold plasma (CP) treatment at different power levels (20–30 kV) for 10–20 min on physicochemical, technofunctional, and intermolecular changes of pearl millet flour (PMF). It was observed that exposure to plasma significantly modified the sample's proximate, antinutritional, functional, thermal, rheological, and morphological properties. A concomitant (p < 0.05) decreases in antinutritional factors (tannin and phytic acid) was noticed in CP‐treated PMF compared to the control sample. Maximum reduction in tannin and phytic acid was observed at 30 kV for 20 min‐treated PMF. However, scanning electron microscopy revealed significant changes in flour starch granular structure, while decreases in relative crystallinity were also observed in CP‐treated samples from 23.45% to 19.31%. In addition, an increase in water absorption capacity (1.32–1.62 g/g), oil absorption capacity (1.11–1.31 g/g), emulsifying capacity (EC; 86.58%–91.25%) and foaming capacity (FC; 10.67–12.84%), as well as a decrease in pH (7.83–6.97) were found at 30 kV for 20 min. Apart from this, high intensity CP‐treated samples showed shear thinning behavior. At the same time, the power–law model was more appropriate for determine the flow behavior index (n) and consistency coefficient (k). On the other hand, CP‐treated samples exhibit higher storage modulus values (G′), indicating an elastic response. Based on the observations, the 30 kV‐20 min‐treated sample could be used for product formulation, contains lower antinutritional factors and retaining the nutritional components and functional properties.

Practical applications

This work has identified that exposure to cold plasma improved the physicochemical, rheological, thermal, and functional properties of pearl millet flour with considerably reducing its antinutritional content, which can be helpful for various food industries. This possibly will encourage its application in the development of various food products, (like cookies, biscuits, bread, beverages, etc.) chiefly as a functional food ingredient.
An overview of protein powders and their use in food formulations
Authors: Ermis Ertan , Tekiner Ismail Hakki , Lee Chi Ching , Ucak Sumeyye , Yetim Hasan
Published: March 2023

Protein quality, as well as quantity, must be taken into account when designing healthy and sustainable diets and food systems. This is particularly crucial for protein powders since there is a wide range of sources and production methods affecting powder and particle properties, and protein functionality and quality. Proteins can be derived from numerous raw materials and converted into powder or particulate form for several reasons, such as ease of transportation and storage stability. Therefore, it is key to understanding the sources, processing methods, powder, and particle properties of protein powders to provide high‐quality products. This study reviews the origins of proteins, extraction techniques, and drying methods employed to produce protein powders. In addition, functional and powder properties, their use in foods, and regulatory issues are highlighted.

Practical applications

Proteins are found in different foods and in food processing side streams such as de‐oiled oilseed meals. Most seeds are typically discarded as food waste worldwide, even though they have high protein content. This review provides an insight into protein sources, extraction methods, powder production techniques, and use in food formulations. It also assessed the effect of powder properties on the functional properties of proteins. To our knowledge, no reviews have been conducted on protein powders. By providing information and insights, this article should contribute to better understanding the protein powders and their use in the production of functional foods.
Care delivery approaches and perceived barriers to improving quality of care: A national survey of skilled nursing facilities
Authors: Chen Amanda C. , Epstein Arnold M. , Joynt Maddox Karen E. , Grabowski David C. , Orav E. John , Barnett Michael L.
Published: March 2023

Background

Nursing home quality of care is a persistent challenge, with recent reports calling for increased reforms to improve quality and safety. Less is known about the clinical approaches currently used and the barriers perceived by skilled nursing facilities (SNFs) to provide care for their short‐stay residents.

Methods

We conducted a nationally representative survey of SNFs from October 2020 to May 2021 to understand their care delivery approaches and perceived barriers. Our primary outcomes were the reported number of 23 separate care delivery approaches and the reported number of 12 separate barriers to reduce spending or improve care for SNF short‐stay residents. We also performed stratified analyses by facility participation in bundled payments and other SNF characteristics.

Results

We received 377 responses from 693 SNFs contacted (response rate = 54%). SNFs reported an average of 16.8 care delivery approaches and an average of 5.0 barriers. While there were some differences observed in SNF characteristics, such as by bundled payments participation or ownership type, there were common care delivery approaches and barriers shared by most facilities. Care management practices, including reviewing the patient census and medication reconciliation on discharge, were the most common delivery approaches reported. SNFs were less likely to ensure the completion of a follow‐up appointment with a primary care provider or track repeat emergency room visits. Issues concerning staffing, such as staff turnover and/or burnout, and lack of resources to provide patients social support, mental health, and substance use services, were the most cited barriers to care delivery.

Conclusions

Nationally, SNFs implemented a wide array of care delivery approaches, but challenges with staffing and limited resources to address patients' social and mental health needs were dominant. Individual SNFs may have limited ability to address these key barriers, so the involvement of many stakeholders across the entire healthcare system may be necessary.
Relationship of blood thiamine pyrophosphate to plasma phosphate and the response to enteral nutrition plus co‐administration of intravenous thiamine during critical illness
Authors: Collie Jake T. B. , Jiang Alice , Abdelhamid Yasmine Ali , Ankravs Melissa , Bellomo Rinaldo , Byrne Kathleen M. , Clancy Annabelle , Finnis Mark E. , Greaves Ronda , Tascone Brianna , Deane Adam M.
Published: March 2023

Background

Hypovitamin B1 occurs frequently during critical illness but is challenging to predict or rapidly diagnose. The aim of this study was to evaluate whether plasma phosphate concentrations predict hypovitamin B1, enteral nutrition prevents hypovitamin B1 and intravenous thiamine supplementation achieves supraphysiological concentrations in critically ill patients.

Methods

Thirty‐two enterally fed critically ill patients, with a plasma phosphate concentration ≤0.65 mmol/L, formed a nested cohort within a larger randomised clinical trial. Patients were assigned to receive intravenous thiamine (200 mg) twice daily, and controls were not administered intravenous thiamine. Thiamine pyrophosphate concentrations were measured at four time points (pre‐ and post‐infusion and 4‐ and 6‐h post‐infusion) on days 1 and 3 in those allocated to thiamine and once in the control group.

Results

Baseline thiamine pyrophosphate concentrations were similar (intervention 88 [67, 93] vs. control 89 [62, 110] nmol/L,p = 0.49). Eight (25%) patients had hypovitamin B1 (intervention 3 vs. control 5), with two patients in the control group remaining insufficient at day 3. There was no association between baseline phosphate and thiamine pyrophosphate concentrations. Intravenous thiamine achieved supraphysiological concentrations 6 h post first infusion, with concentrations increasing to day 3. In the control group, thiamine pyrophosphate concentrations were not statistically different between baseline and day 3 (mean change: 8.6 [−6.0, 23.1] nmol/L,p = 0.25).

Conclusions

Phosphate concentrations did not predict hypovitamin B1, which was observed in 25% of the participants. Enteral nutrition alone prevented the development of new hypovitamin B1. Administration of a single 200‐mg dose of intravenous thiamine achieved supraphysiological concentrations of thiamine pyrophosphate, with repeated dosing sustaining this effect.
Effect modification of socioeconomic status on the association of exposure to famine in early life with osteoporosis in women
Authors: Zhao Hongfei , Fan Lin , Yi Xianhong , Zhu Linghui , Liu Xiaotian , Hou Jian , Zhang Gongyuan , Pan Jun , Wang Chongjian
Published: March 2023

Background

The present study aimed to explore the effect of modification of socioeconomic status (SES) on the association between famine exposure in early life and osteoporosis in adulthood via the baseline data from the Henan Rural cohort study.

Methods

A total of 2669 exposed to famine participants were selected from the Henan Rural cohort, and the questionnaires, physical examination and bone mineral density measurement were completed. Specific birth years were used to define five groups: the fetal exposed group, early‐childhood exposed group, mid‐childhood exposed group, late‐childhood exposed group and unexposed group. And the age‐matched control group was a combination of the unexposed group and late‐childhood exposed group. Multivariable logistic regression models were utilised to analyse the association of famine exposure in early life with osteoporosis in adulthood.

Results

The prevalence rates of osteoporosis of participants exposed to famine during the fetal period, early‐childhood, mid‐childhood and the age‐matched group were 21.67%, 25.76%, 23.90% and 18.14%, respectively. The adjusted odds ratios (95% confidence interval) of participants suffering from famine during the fetal period, early‐childhood and mid‐childhood versus age‐matched group were 1.19 (0.82–1.73), 1.40 (1.04–1.88) and 1.57 (1.16–2.13), respectively. The female participants yielded consistent results. The risk of osteoporosis was higher in more severe famine eara. Moreover, an attenuated effect of early life famine exposure on osteoporosis was observed in female participants with high SES.

Conclusions

Exposure to famine in early life showed a sex‐specific association with an increased risk of osteoporosis in adulthood and the severity of famine may exacerbate this association. In addition, the risk could be modified by SES.
Family carer and professional perceptions of the potential use of telehealth for behavioural support
Authors: Tomlinson S. R. L. , Gore N. , McGill P.
Published: March 2023

Background

Telehealth (i.e. the use of technology across distance) is widespread in many fields. Although its use for behavioural support for people with intellectual or developmental disabilities (IDD) is emerging, there are no known studies examining stakeholder perceptions of this.

Methods

A four‐round Delphi consultation was conducted with 11 professionals and six family carers of children with IDD to generate consensus on what would influence participants' use of telehealth for behavioural support. Data were collected prior to the coronavirus pandemic.

Results

Thirty‐six items reached consensus for professionals (26 advantages and 10 disadvantages/barriers) and 22 for family carers (8 advantages and 14 disadvantages/barriers). A range of solutions were also identified for the disadvantages/barriers.

Conclusions

Participants were willing to use telehealth for behavioural support. However, disadvantages/barriers need to be addressed, and guidelines relating to the use of telehealth in this field are needed. We report a number of practice recommendations including combining telehealth with in‐person supports where possible, incorporating video technologies, and considering client perspectives and confidence with telehealth methodologies.
Milestone Review: Metabolic dynamics of glutamate and GABA mediated neurotransmission — The essential roles of astrocytes
Authors: Andersen Jens V. , Schousboe Arne
Published: March 2023

Since it was first generally accepted that the two amino acids glutamate and GABA act as principal neurotransmitters, several landmark discoveries relating to this function have been uncovered. Synaptic homeostasis of these two transmitters involves several cell types working in close collaboration and is facilitated by specialized cellular processes. Notably, glutamate and GABA are extensively recycled between neurons and astrocytes in a process known as the glutamate/GABA‐glutamine cycle, which is essential to maintain synaptic transmission. The glutamate/GABA‐glutamine cycle is intimately coupled to cellular energy metabolism and relies on the metabolic function of both neurons and astrocytes. Importantly, astrocytes display unique metabolic features allowing extensive metabolite release, hereby providing metabolic support for neurons. Furthermore, astrocytes undergo complex metabolic adaptations in response to injury and pathology, which may greatly affect the glutamate/GABA‐glutamine cycle and synaptic transmission during disease. In this Milestone Review we outline major discoveries in relation to synaptic balancing of glutamate and GABA signaling, including cellular uptake, metabolism, and recycling. We provide a special focus on how astrocyte function and metabolism contribute to sustain neuronal transmission through metabolite transfer. Recent advances on cellular glutamate and GABA homeostasis are reviewed in the context of brain pathology, including glutamate toxicity and neurodegeneration. Finally, we consider how pathological astrocyte metabolism may serve as a potential target of metabolic intervention. Integrating the multitude of fine‐tuned cellular processes supporting neurotransmitter recycling, will aid the next generation of major discoveries on brain glutamate and GABA homeostasis.

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Expression of p53 and Rb reveal subtypes of gastric neuroendocrine carcinoma with distinct prognosis
Authors: Xing Jiazhang , Chen Jingci , You Tingting , Sun Zhao , Lu Tao , Cheng Yuejuan , Wu Huanwen , Bai Chunmei
Published: March 2023

Gastric neuroendocrine carcinoma (NEC) is a rare tumor with a poor prognosis. Due to its rarity and disparity in prevalence across populations, there is limited data on gastric NEC. TP53 and RB1 genetic alterations or expression were reported for predictive value in neuroendocrine neoplasm and classification in pulmonary large cell NEC. This study investigated the genetic alteration and protein expression of TP53 and RB1 in gastric NEC. Thirty‐nine patients were categorized as type A and B subtypes by p53 and Rb expression. Patients with concurrent abnormal p53 and Rb expression were defined as the type A group, and the remainder were defined as the type B group. Significant differences in TNM stages, tumor size, and lymph node metastasis were observed between the two subtypes. Type A characteristic is an independent predictor for worse overall survival (HR: 3.27; 95% CI: 1.12–9.58; p = .022). We further evaluated and compared immunotherapy‐related markers, including PD‐L1 expression, CD8 T cell infiltration, tumor mutation burden, and microsatellite instability in these two subtypes, whereas no significant differences were detected.