bluuebunny/crossref_metadata_2025 huggingface dataset:
Inclusion of Students With Intellectual Disability in Saudi Universities: Understanding the Gap Between Theory and Practice
Authors: Abu‐Alghayth Khalid M. , Alshahrani Basmah F.
Published: November 2024

Background

The global discourse on higher education underscores its pivotal role in personal development, societal progress and economic prosperity. However, actual implementation and practices within universities have not kept pace, and students with intellectual disability still struggle, as their journey towards accessing and succeeding in higher education is marked by intricate challenges. Therefore, this study investigated the gap between theory and practice in Saudi universities, obtaining an in‐depth understanding of the inclusion of students with intellectual disability in universities, current challenges and factors perceived as critical for enhancing these students' enrolment and success.

Methods

We employed a basic interpretive qualitative approach to gain insight into the perceptions of 12 faculty members and four staff members via a series of initial and follow‐up semistructured interviews and focus group. In addition, we analysed a set of relevant documents.

Findings

The findings highlight the following themes: admission process and entry requirements, implementation gaps in educational policies, nondisclosure of disability, accessibility and support, and critical factors for successful inclusion; several subthemes also emerged.

Conclusions

This study underscores the complex dynamics between policy and practice, revealing significant gaps that need to be addressed to ensure genuine inclusivity. Based on the findings, we discuss future directions in terms of research and practice.
Three decades of glucose‐lowering therapy in patients at high cardiovascular risk — A real‐world analysis
Authors: Neyer Magdalena , Vogel Johannes B. , Elsner Pascal , Kuehrer Heike , Saely Christoph H. , Muendlein Axel , Vonbank Alexander , Mader Arthur , Festa Andreas , Drexel Heinz , Leiherer Andreas
Published: November 2024

Aim

Over recent years, therapy options and strategies for type 2 diabetes mellitus (T2DM) have developed substantially. This study investigated glucose‐lowering treatment in patients with high cardiovascular risk over three decades.

Materials and Methods

A total of 2158 patients undergoing elective coronary angiography at a tertiary care hospital in Europe were included in three sequential observational studies (OS): OS1 (1999–2000; n = 672), OS2 (2005–2008; n = 1005) and OS3 (2022–2023; n = 481). Sociodemographic data, patient‐reported medication, medical histories and blood samples were analysed.

Results

A clear trend towards more complex glucose‐lowering therapies was found. A wider array of glucose‐lowering drugs was used over time (OS1: 11; OS2: 21; OS3: 25) and the number of different drugs used in combination therapy in a single patient increased to a maximum of five in OS3. Furthermore, substantial differences in applied medication regimens were observed: Sodium‐glucose cotransporter‐2 inhibitors were the most frequently reported substance class (34.0% of total reported glucose‐lowering drugs) in OS3, whilst metformin remained a key component (OS1: 33.9%; OS2: 41.8%; OS3: 32.0%). Other drug classes like sulfonylureas were largely replaced. A total of 69.2% of patients in OS3 achieved an HbA1c level of < 7% (vs. OS1: 51.9%, OS2: 54.7%; ptrend < 0.001). Over 25% of patients with T2DM were newly diagnosed at admission (OS1: 43.8%, OS2: 29.7%, OS3: 27.2%; ptrend < 0.001) and had therefore no diabetes‐related medication.

Conclusion

These real‐world data emphasize a marked shift in T2DM treatment towards novel substance classes. However, the use of incretin mimetics remained low. Significantly more patients reached HbA1c targets in the most recent cohort.
A continuum from predictive to online feedback in visuomotor interception
Authors: Márquez Inmaculada , Lemus Luis , Treviño Mario
Published: November 2024

Interception, essential for activities like driving and sports, can be characterized by varying degrees of predictive behaviour. We developed a visually guided task to explore how target predictability and visibility influenced interception actions. The task featured a falling dot influenced by horizontal velocity, gravity and air friction, with predictability manipulated through external forces that altered the target's trajectory. We also introduced spatial occlusion to limit visual information. Our results show that low target variability favoured predictive behaviours, while high variability led to more reactive responses relying on online feedback. Manual responses displayed increased variability with changes in target motion, whereas eye trajectories maintained constant curvature across conditions. Additionally, higher target variability delayed the onset of hand movements but did not affect eye movement onset, making gaze position a poor predictor of hand position. This distinction highlights the different adaptive patterns in hand and eye movements in response to target trajectory changes. Participants maintained stable interception behaviours within and across sessions, indicating individual preferences for either predictive or more reactive actions. Our findings reveal a dynamic interplay between target predictability and interception, illustrating how humans combine predictive and reactive behaviours to manage external variability.
A review of the equine suspensory ligament: Injury prone yet understudied
Authors: Guest Deborah J. , Birch Helen L. , Thorpe Chavaunne T.
Published: November 2024

The suspensory ligament (SL) is a key component of the elaborate and highly adapted suspensory apparatus in the horse. In addition to contributing to stabilisation of the metacarpophalangeal joint, the SL has a spring like function to reduce the energetic cost of locomotion. Although the SL is highly prone to injury in horses of all ages and competing in a wide range of disciplines, knowledge regarding fundamental structure–function relationships in the SL is lacking, particularly compared with other injury‐prone tendinous structures such as the superficial digital flexor tendon. In this review, we discuss current knowledge of SL composition, structure and mechanical properties and describe the epidemiology, aetiology and pathophysiology of injuries. We evaluate different diagnostic approaches and treatment modalities and identify key areas for future research.
Transgenerational association of mentalization with child mental health: A scoping review
Authors: Moreira Adelina , Vives Jaume , Ballespí Sergi
Published: November 2024

This scoping review provides an overview of empirical research concerning the association between parents' mentalization and child mental health (0–12 years of age). Specifically, it aims at synthesizing the evidence regarding to what extent mentalization (a) is a protective factor for child mental health, and (b) moderates the transgenerational transmission of psychopathology. A total of 73 studies were selected out of 5112 identified (duplicates excluded). The results hint at a relation between parent's mentalization and child mental health: 88% of the studies showed significant associations between predictor and outcome dimensions across a variety of samples, research procedures, and assessment measures. About the direction of the associations, almost all of them behave as expected, supporting the statement that children of parents with healthy mentalization skills tend to have better functioning and show less psychopathology. The evidence indicates that parents' healthy mentalization strengthens children's well‐being and helps them cope with stressors more effectively so it is acting as a protective factor against mental health problems. Eleven studies found moderating roles of parents' mentalization in the transgenerational transmission of psychopathology. In a context where mental ill‐health is mostly addressed only once there is a problem, these results suggest that fostering parents' mentalization in clinical but also in non‐clinical settings could help to improve child mental health in terms of symptoms, functioning, and well‐being, and stop the growing incidence of mental disorders across development.
Evidence for an Adaptive, Large‐Scale Range Shift in a Long‐Distance Terrestrial Migrant
Authors: Gurarie Eliezer , Beaupré Chloe , Couriot Ophélie , Cameron Matthew D. , Fagan William F. , Joly Kyle
Published: November 2024

Long‐distance migrations are a striking, and strikingly successful, adaptation for highly mobile terrestrial animals in seasonal environments. However, it remains an open question whether migratory animals are more resilient or less resilient to rapidly changing environments. Furthermore, the mechanisms by which animals adapt or modify their migrations are poorly understood. We describe a dramatic shift of over 500 km in the wintering range of the Western Arctic Herd, a large caribou (
Rangifer tarandus
) herd in northwestern Alaska, an area that is undergoing some of the most rapid warming on Earth. Between 2012 and 2020, caribou switched from reliably wintering in maritime tundra in the southwesternmost portion of their range to more frequently wintering in mountainous areas to the east. Analysis of this range shift, in conjunction with nearly 200 documented mortality events, revealed that it was both broadly adaptive and likely driven by collective memory of poor winter conditions. Before the range shift, overwinter survival in the maritime tundra was high, routinely surpassing 95%, but falling to around 80% even as fewer animals wintered there. Meanwhile, in the increasingly used mountainous portion of the range, survival was intermediate and less variable across years compared to the extremes in the southern winter ranges. Thus, the shift only imperfectly mitigated overall increased mortality rates. The range shift has also been accompanied by changes in seasonal patterns of survival that are consistent with poorer nutritional intake in winter. Unexpectedly, the strongest single predictor of an individual's probability of migrating south was the overall survival of animals in the south in the preceding winter, suggesting that the range shift is in part driven by collective memory. Our results demonstrate the importance and use of collective decision making and memory for a highly mobile species for improving fitness outcomes in a dynamic, changing environment.
Activation of the Urokinase Plasminogen Activator/Urokinase Plasminogen Activator Receptor System in Periodontitis: A Case–Control Study
Authors: Khudhur Ahmed , Dowson Christopher , Bissett Susan M. , van de Merwe Rachel , Taylor John J. , Preshaw Philip M. , Jaedicke Katrin M.
Published: November 2024

Introduction

The plasminogen activating (PA) system has a multitude of functions such as wound healing, proteolytic activity, collagen degradation and cell growth, and the role of the urokinase plasminogen activator/urokinase plasminogen activator receptor (uPA/uPAR) system has been studied in many disease states. The aim of this study was to investigate salivary concentrations of uPA, uPAR and uPA activity in patients with periodontitis to identify biomarkers and novel pathogenic relationships.

Methods

Saliva samples were obtained from 169 participants, comprising patients with periodontitis (n = 103) and periodontally healthy volunteers (n = 66) and analysed for uPA and uPAR with a multiplex protein assay using proximity extension analysis in a subset of samples, followed by validation with ELISA. The protease activity of salivary uPA was quantified using a fluorometric assay.

Results

Patients with periodontitis had a 4.0‐fold higher (p < 0.001) salivary uPA and a 2.5‐fold higher (p < 0.001) salivary uPAR concentration in comparison to periodontally healthy participants. The salivary uPA activity (median [IQR]) from patients with periodontitis (123.21 [188.29] U/mL) was 1.6‐fold higher (p < 0.01) than the salivary uPA activity from periodontally healthy participants (76.83 [98.09] U/mL). Levels of uPA and uPAR were strongly correlated with periodontal indices, whereas only weak correlations were found with BMI and age.

Conclusion

Activation of uPA/uPAR likely plays a role in the pathogenesis of periodontal diseases. uPA/uPAR may have potential utility as candidate salivary biomarkers in periodontal pathogenesis.
Cyclic ablation behaviors of mullite‐modified C/C–ZrC–SiC composites prepared by PIP
Authors: Xiong Yufei , He Qinchuan , Wang Yiqun , Yin Xuemin
Published: November 2024

Four mullite‐modified C/C–ZrC–SiC composites with different contents were prepared by precursor infiltration and pyrolysis (PIP). The phase compositions, microstructures, and cyclic ablation behaviors of the composites under 2.38 MW/m2 oxyacetylene flame were investigated. Results show that both insufficient and excessive amounts of mullite limit the ablation resistance of the composites. The composite with mullite content of 8.27 wt% has better ablation resistance, and the mass loss rate and linear loss rate after the second ablative are −0.873 mg/s and 0.272 µm/s, respectively. Appropriate mullite improves the viscosity and thermo‐oxidative barrier properties of the liquid phase and enhances the healing of ablative defects. Meanwhile, mullite inhibits the crystal transformation of ZrO2.
Topographical variations in the skin barrier and their role in disease pathogenesis
Authors: Dajnoki Z. , Kapitány A. , Eyerich K. , Eyerich S. , Törőcsik D. , Szegedi A.
Published: November 2024

The skin barrier can be divided into at least four functional units: chemical, microbial, physical and immunological barriers. The chemical and microbial barriers have previously been shown to exhibit different characteristics in topographically distinct skin regions. There is increasing evidence that the physical and immunological barriers also show marked variability in different areas of the skin. Here, we review recent data on the topographical variations of skin barrier components, the contribution of these variations to the homeostatic function of the skin and their impact on the pathogenesis of specific immune‐mediated skin diseases (such as atopic dermatitis and papulopustular rosacea). Recognition of these topographical barrier differences will improve our understanding of skin homeostasis and disease pathogenesis and provide a basis for body site‐specific targeted therapies.
Integration of Fluorescence Spectroscopy Along with Mathematical Modeling for Rapid Prediction of Adulteration in Cooked Minced Beef Meat
Authors: Saleem Asima , Imtiaz Aysha , Yaqoob Sanabil , Awais Muhammad , Awan Kanza Aziz , Naveed Hiba , Khalifa Ibrahim , Al‐Asmari Fahad , Qian Jian‐Ya
Published: November 2024

This study explores the potential of fluorescence spectroscopy (FS), coupled with principal component analysis (PCA) and partial least square regression (PLSR), to detect meat adulteration rapidly and non‐destructively in cooked minced beef. We aimed at evaluating FS as a simple and efficient tool for identifying cheaper meat species, that is chicken, used as adulterants in beef. Fluorescence spectra were collected at one fixed emission wavelength (410 nm) and three excitation wavelengths (290, 322, and 340 nm) from both pure and adulterated cooked meat samples. Adulteration levels ranging from 10% to 90% were assessed by mixing chicken meat with beef, followed by fluorescence analysis. The results indicated that the PCA model explained 100% of the variance, with 96% accounted for by the first principal component, showing clear discrimination between pure and adulterated samples. PLSR models demonstrated excellent predictive accuracy, with cross‐validated coefficients of determination of 0.95, highlighting FS's capability in distinguishing between pure and adulterated meats even after cooking. The cross‐validated grouping success rate was ~97%, reinforcing the reliability of the technique. This study represents the first investigation using FS to predict adulteration in cooked meat, providing a benchmark for future research. The findings suggest that FS, in combination with mathematical modeling, holds great promise as a rapid, cost‐effective, and nondestructive method for detecting meat adulteration, with significant potential for practical application in food industry quality control.
The anticholinergic burden in patients with chronic kidney disease: Patterns, risk factors, and the link with cognitive impairment
Authors: Mouheb Agathe , Levassort Hélène , Massy Ziad A. , Jacquelinet Christian , Laville Maurice , Alencar de Pinho Natalia , Pépin Marion , Laville Solène M. , Liabeuf Sophie ,   the Chronic Kidney Disease‐Renal Epidemiology and Information Network (CKD‐REIN) Study Group
Published: November 2024

Background

People with chronic kidney disease (CKD) have an elevated risk of cognitive impairment (CI). Medications with anticholinergic activity are recognized for their adverse reactions on central nervous system. The putative association between the anticholinergic burden and CI has not previously been evaluated in patients with CKD. The study aimed to (i) describe prescriptions of medications with anticholinergic activity, (ii) analyze factors associated with these prescriptions, and (iii) evaluate the anticholinergic burden's association with cognitive performance.

Methods

CKD‐REIN, a prospective cohort study, enrolled nephrology outpatients with a confirmed diagnosis of CKD (eGFR <60 mL/min/1.73m2). Drug prescriptions were recorded prospectively during the 5‐year follow‐up. Mini Mental State Examination (MMSE) was assessed at baseline and CI was defined as an MMSE score <24/30. For each patient, the anticholinergic burden was determined by summing the Anticholinergic Cognitive Burden (ACB) scores of all prescription drugs at baseline. Multinomial logistic regression was used to analyze factors associated with the ACB score. Logistic regression was used to evaluate the association between the cognitive impairment and the anticholinergic burden at baseline.

Results

At baseline, 3007 patients (median age [IQR], 69[60–76]; 65% men) had MMSE data and were included. 1549 (52%) of these patients were taking at least one drug with anticholinergic properties. Most (1092; 70%) had a low anticholinergic burden, 294 (19%) had a moderate anticholinergic burden, and 163 (11%) had a high anticholinergic burden. A history of neurological/psychiatric disorders and a higher number of daily drugs were associated with a greater probability of having a high anticholinergic burden (odds ratio (OR) [95% confidence interval (95% CI)] = 1.88[1.29;2.74] and 1.53[1.45;1.61], respectively). Patients with a high anticholinergic burden had a significantly higher probability of presenting cognitive impairment, compared with patients without an anticholinergic burden (OR[95% CI] = 1.76[1.12;2.75]) after adjustment for sociodemographic factors, comorbidities, laboratory data, and the number of medications taken daily.

Conclusions

The results of our study emphasize the need for caution in the prescription of drugs with anticholinergic properties to patients with CKD.
Caring for older adults' social needs in emergency departments: Where to draw the line?
Authors: Goldberg Elizabeth M. , Bloemen Elizabeth , Lindberg Daniel M.
Published: November 2024

See related article by Southerland et al. in this issue.
A Well‐Tolerated Hair Serum Containing New Natural Active Ingredients Reduced Hair Loss and Improved Quality of Life in Women With Chronic Telogen Effluvium: A 16‐Week Controlled Study
Authors: Turlier Virginie , Froliger Mélanie , Ribet Virginie , Mengeaud Valérie , Reygagne Pascal
Published: November 2024

Background

Chronic telogen effluvium (CTE) is characterized by hair loss lasting for more than 6 months and severely impairs quality of life (QoL). There is no specific treatment.

Aims

To assess the dermatological tolerance and clinical efficacy of a hair serum containing three plant‐derived active ingredients (a Silybum marianum extract, Manganese PCA, and a Lespedeza capitata extract) in women with CTE.

Methods

In this 16‐week, open‐label, two‐arm, controlled, parallel‐group study, 64 women aged 46 ± 10 years with CTE and a positive hair pull test were allocated equally to either a treated group (study serum and neutral shampoo) or a control group (neutral shampoo only).

Results

The investigator rated dermatological tolerance of the serum as good at week (W)16. Compared to the control group, reductions in the amount of hair collected by the investigator during hair pull tests were greater in the treated group at W8 (p = 0.027) and W16 (p = 0.030), the amount of hair shed in 60 s (assessed by the subjects) was significantly lower in the treated group from W4, and more subjects in the treated group reported a decrease in hair loss over the study period (p ≤ 0.01; all time points). The treated subjects also perceived a significant improvement in hair volume, density, strength, and thickness, and reported being less depressed, less annoyed and less embarrassed by their hair loss.

Conclusions

The serum was well‐tolerated and had a significant anti‐hair loss effect in women with CTE. This effect positively impacted QoL.
Remnant ureter abscess linked to obstructed hemivagina and ipsilateral renal anomaly syndrome
Authors: Kaneko Meika , Ishikawa Hiroshi , Kaneko Takaoki , Sato Asuka , Shozu Makio , Koga Kaori
Published: November 2024

Patients with obstructed hemivagina and ipsilateral renal anomaly (OHVIRA) syndrome sometimes present with distinct symptoms related to coexisting urogenital abnormalities. We present a case of refractory abscess formation in a blind‐ended remnant ureter associated with ipsilateral renal agenesis. A 15‐year‐old patient with OHVIRA syndrome, who had a blind‐ended remnant ureter, underwent obstructed hemivagina opening 18 months after menarche due to heavy genital bleeding and abdominal pain after the end of menstruation. Four years later, the patient presented with recurring fever and abdominal pain due to a refractory abscess in the ureter. Although the continuity between the ureter and the previously opened hemivagina was not identified, the same bacteria were detected in the abscess and vaginal discharge, indicating that an ascending bacterial infection of the vagina may cause refractory abscess formation in a blind‐ended remnant ureter. Open ureterectomy with partial bladder resection was needed to resolve the symptoms.
Growth Monitoring and Promotion Service Utilization and Associated Factors Among Mothers/Caregivers of Children 0–23 Months in Sude District, Southeast Ethiopia
Authors: Edae Birbirsa Sheri , Yazew Tamiru , Disasa Hiwot Dejene , Kuyu Chala G.
Published: November 2024

Inadequate physical growth and poor development are significant global challenges affecting millions of children. Globally, 149.2 million children under five experience stunted growth and 45.4 million suffer from wasting. Growth monitoring and promotion (GMP) programmes aim to identify growth faltering in children before they develop malnutrition. However, understanding the factors influencing GMP service utilization is crucial for improving its effectiveness in the study area. This community‐based cross‐sectional study in the Sude district of southeastern Ethiopia investigated GMP service utilization among mothers of children aged 0–23 months. The study included 874 participants selected through systematic random sampling. Data collected through a structured questionnaire revealed a GMP service utilization rate of 40.2%. The study identified several factors significantly associated with GMP service utilization. This includes maternal education, husband involvement, institutional delivery, maternal autonomy and birth interval, which are the most significant factors identified to influence GMP service utilization. Mothers with higher levels of education were more likely to utilize GMP services [AOR = 3.70 (95% CI: 2.09, 6.54)]. Discussions about child growth with husbands were linked to increased GMP utilization [AOR = 2.22 (95% CI: 1.24, 3.968)]. Moreover, mothers who delivered at health facilities and with greater autonomy in decision‐making showed higher GMP utilization with [AOR = 1.83 (95% CI: 1.23, 2.72)] and [AOR = 3.79 (95% CI: 2.41, 5.96), respectively. Mothers with longer birth intervals were also more likely to utilize GMP services [AOR = 1.947 (95% CI: 1.39, 2.73)]. The study highlights the importance of addressing these factors to increase GMP service utilization and improve child health outcomes in the study area. Behavioural change communication programmes targeting fathers can promote their engagement in child growth discussions. Moreover, empowering women to make decisions about their children's health and access to healthcare services and promoting open communication within families about child growth and development can raise awareness and support for GMP services. Addressing these factors through targeted interventions will promote GMP utilization and improve child growth and development.
Extreme Environmental Variability Induces Frontloading of Coral Biomineralisation Genes to Maintain Calcification Under pCO2 Variability
Authors: Brown Kristen T. , Dellaert Zoe , Martynek Marcelina P. , Durian Julia , Mass Tali , Putnam Hollie M. , Barott Katie L.
Published: November 2024

Corals residing in habitats that experience high‐frequency seawater pCO2 variability may possess an enhanced capacity to cope with ocean acidification, yet we lack a clear understanding of the molecular toolkit enabling acclimatisation to environmental extremes or how life‐long exposure to pCO2 variability influences biomineralisation. Here, we examined the gene expression responses and micro‐skeletal characteristics of Pocillopora damicornis originating from the reef flat and reef slope of Heron Island, southern Great Barrier Reef. The reef flat and reef slope had similar mean seawater pCO2, but the reef flat experienced twice the mean daily pCO2 amplitude (range of 797 v. 399 μatm day−1, respectively). A controlled mesocosm experiment was conducted over 8 weeks, exposing P. damicornis from the reef slope and reef flat to stable (218 ± 9) or variable (911 ± 31) diel pCO2 fluctuations (μatm; mean ± SE). At the end of the exposure, P. damicornis originating from the reef flat demonstrated frontloading of 25% of the expressed genes regardless of treatment conditions, suggesting constitutive upregulation. This included higher expression of critical biomineralisation‐related genes such as carbonic anhydrases, skeletal organic matrix proteins, and bicarbonate transporters. The observed frontloading corresponded with a 40% increase of the fastest deposited areas of the skeleton in reef flat corals grown under non‐native, stable pCO2 conditions compared to reef slope conspecifics, suggesting a compensatory response that stems from acclimatisation to environmental extremes and/or relief from stressful pCO2 fluctuations. Under escalating ocean warming and acidification, corals acclimated to environmental variability warrant focused investigation and represent ideal candidates for active interventions to build reef resilience while societies adopt strict policies to limit climate change.
Iran and Her Ethicists: A Critical Perspective
Authors: Chamankhah Leila
Published: November 2024

This paper investigates the continuation of Ibn ʿArabī's doctrine of takhalluq bi akhlāq Allāh in the writings of his Iranian expositors in the post‐Ṣadrā era until present. Typical of classical Islamic culture, according to which Man will reach perfection when he is adorned with divine ethics, takhalluq gains a new twist in the writings of Ibn ʿArabī's predecessors, chief among them the Algerian Sufi Aḥmad Ibn ʿAlī al‐Būnī (d. 1230?), who disccuseed the topic in a nuanced way. In line with Būnī and other like‐minded Sufis, al‐Shaykh al‐Akbar discusses the triad of takhalluq, taʿalluq and taḥaquq in several of his writings, including a book with the same title, Kashf ul‐maʿnī ʿan sirr‐i asmāʾ ul‐Allah al‐ḥusnā (the Unveiling of the Meaning from the Secret of the Beautiful Names). If intellectual history is an inquiry that focuses on the role of ideas in the thinking and actions of the human being, the present research first reads and analyzes the writings of a number of Ṣadrīan philosophers to debate the ways in which they undertood the discourse of takhalluq bi akhlāq Allāh. Secondly, it will investigate how their contributions to this legacy have left their imprint on the configuration of politics in post‐revolutionary Iran. The ethicists of takhalluq have been more influential than one imagines in shaping public and political life since 1979 onwards.
Characteristics of Patients With Asymptomatic Atrial Fibrillation and Ischemic Stroke—Insights From the GLORIA‐AF Registry (Phase 2)
Authors: Heer Tobias , Zeymer Uwe , Schwarzbach Christopher J. , Seidl Karlheinz , Rauch‐Kröhnert Ursula , Marler Sabrina , Teutsch Christine , Diener Hans‐Christoph , Senges Jochen , Lip Gregory Y. H. , Huisman Menno V. ,   the GLORIA‐AF Investigators
Published: November 2024

Background

Asymptomatic nonvalvular atrial fibrillation is often suspected in patients with cryptogenic stroke which constitute 20%–30% of ischemic strokes. Detection of atrial fibrillation (AF) and treatment with anticoagulation can reduce the risk of stroke. We sought to investigate the prevalence of asymptomatic atrial fibrillation (aAF) in patients with a history of stroke or an acute stroke on admission.

Methods

From November 2011 until December 2014, 15,308 patients with a first episode of AF were enrolled in phase 2 of the international, prospective, multicenter global registry on long‐term oral anticoagulation treatment in patients with AF (GLORIA‐AF) Registry. For the present analysis, we focused on patients with aAF regarding the prevalence of stroke.

Results

One third of patients (n = 4892, 32%) had aAF. Of these, 611 (12.5%) had a history of stroke or an acute stroke on admission. In contrast, 519 of 10,416 (5.0%) patients with symptomatic AF (sAF) had a history of stroke or an acute stroke on admission. Higher age, male gender, permanent AF, stroke, and the combination of stroke, TIA or systemic embolism were associated with a higher prevalence of aAF on admission. In a multivariable analysis, patients with aAF had a 2.3‐fold (95% confidence interval (CI), 2.02–2.54) risk for stroke compared to patients with sAF. Other independent risk factors for stroke were a history of prior bleeding (odds ratio 1.62, 95% CI, 1.34–1.92), chronic kidney disease (1.38, 1.21–1.56), and diabetes mellitus (1.24, 1.10–1.41).

Conclusion

aAF is reported in about one third of patients with newly diagnosed AF and is associated with a 2.3‐fold risk for stroke compared to sAF. Therefore, screening for aAF in high‐risk patients might be appropriate to prevent further embolic cerebrovascular events.
dciWebMapper: A Data‐Driven and Coordinated View‐Enabled Interactive Web Mapping Framework for Visualizing and Sensing High‐Dimensional Geospatial (Big) Data
Authors: Sarigai Sarigai , Yang Liping , Slack Katie , Lane K. Maria D. , Buenemann Michaela , Wu Qiusheng , Woodhull Gordon , Driscol Joshua
Published: November 2024

We are surrounded by overwhelming big data, which brings substantial advances but meanwhile poses many challenges. A very large portion of big data contains geospatial information and hence geospatial big data, which is crucial for decision making if being utilized strategically. Among others, volumes in size and high dimensions are two major challenges that prevent strategic decision making from geospatial big data. Interactive map‐based and geovisualization enabled web applications are intuitive and useful to construct knowledge. More importantly, such interactive web map applications are powerful to intuitively reveal insights from high‐dimensional geospatial big data for actionable decision making. We propose an interactive and data‐driven web mapping framework, named dciWebMapper, for visualizing and sensing high‐dimensional geospatial (big) data in an interactive and scalable manner. To demonstrate the wide applicability and usefulness of our framework, we have applied our dciWebMapper framework to three real‐world case studies and implemented three corresponding web map applications: iLit4GEE‐AI, iWURanking, and iTRELISmap. We expect and hope the three web maps demonstrated in different domains, from literature big data analysis to world university ranking to scholar mapping, will provide a good start and inspire researchers and practitioners in various domains to apply our dciWebMapper to solve and/or aid in solving impactful problems.
Coccidioidomycosis Transmission Through Solid Organ Transplantation (2013–2022): A Report of the Organ Procurement and Transplantation Network ad hoc Disease Transmission Advisory Committee
Authors: Lee Dong Heun , Abidi Maheen Z. , Fisher Cynthia , Hughart Anna L. , Toda Mitsuru , Williams Samantha , Berry Gerald J. , Graves Riki , Handarova Dzhuliyana , Ho Chak‐Sum , Kittleson Michelle , Levi Marilyn E. , Livelli Taylor , Marboe Charles C. , Annamabhotla Pallavi , Miller Rachel A. , Sharma Tanvi , Sellers Marty T. , Taimur Sarah , Te Helen S. , Trindade Anil J. , Wood R. Patrick , Zaffiri Lorenzo , Pouch Stephanie M. , Danziger‐Isakov Lara
Published: November 2024

Background

Coccidioidomycosis is a fungal infection that poses a serious risk when transmitted through organ transplantation. We analyzed cases reported to the Organ Procurement and Transplantation Network ad hoc Disease Transmission Advisory Committee from 2013 to 2022.

Methods

Donors and/or recipients who had positive Coccidioides immitis/posadasii serology, pathology, and/or culture were included in this study. Cases adjudicated as ‘proven’ or ‘probable’ were analyzed for donor infection risk factors, the timing of infection, transmission by organ type, clinical manifestations, and recipient outcomes. Patient and facility identifiers were removed prior to review.

Results

During this time period, 73 potential instances of Coccidioides donor disease transmission events were reported. Among them, infection was transmitted from seven deceased donors to eight recipients. All seven deceased donors had prior infection or exposure to regions where coccidioidomycosis is endemic. Of 20 individuals receiving organs from these donors, eight developed infection, resulting in a 40% transmission rate. The median time to diagnosis post‐transplant was 39 days. Disseminated disease occurred in six recipients, five of whom died from the infection. Notably, none of the recipients who received prophylactic antifungal treatment died from the infection.

Conclusion

Despite its rarity, donor‐derived Coccidioides infection is a serious concern, particularly due to the high mortality rate in the early post‐transplant period. To mitigate these risks, a thorough assessment of donor exposure history, coupled with donor serology and bronchoalveolar lavage cultures, can effectively guide post‐transplant antifungal prophylaxis. Prompt reporting is crucial to prevent Coccidioides infections among other recipients.

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Estimated Median Waiting Time for Organ Procurement and Transplantation Network Human Immunodeficiency Virus Organ Policy Equity Act Variance Kidney Candidates: A Propensity Score Matched Analysis
Authors: Fritz Amber R. , Howell Jesse , Wolfe Cameron R. , Noreen Samantha M. , Klassen David K.
Published: November 2024

Background

Prior to the 2013 HIV Organ Policy Equity (HOPE) Act, which enabled research on the transplantation of solid organs from donors with human immunodeficiency virus (HIV) to candidates living with HIV, it was prohibited for HIV+ individuals to donate organs in the United States. In 2015, alongside the release of HOPE Act research criteria, the Organ Procurement and Transplantation Network (OPTN) made organ allocation policy and system changes to allow HIV+ to HIV+ transplantation.

Methods

The OPTN database was queried for all adult kidney registrations ever waiting from November 23, 2015, to December 31, 2022; the cohort was split into a HOPE cohort (ever willing to accept an HIV+ kidney) and a non‐HOPE cohort (all remaining). Estimated median waiting times (eMWTs) were calculated using a period prevalent Kaplan‐Meier approach; HOPE registrations were matched 1:5 without replacement to non‐HOPE registrations using a logistic regression propensity score.

Results

Using all waiting time, the eMWT for the HOPE cohort was significantly lower than the matched non‐HOPE cohort (3.04 years [95% confidence interval {CI}: 2.70, 3.41] versus 5.88 years [95% CI: 5.65, 6.18]). This trend persisted when estimating MWT using other active time and geographical definitions (ignoring geography and donor service area).

Conclusion

These results suggest that transplantation through the OPTN HOPE variance yields decreases eMWT, perhaps reducing the medium and longer‐term impacts of living with HIV.

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The medium is the message: The geographies of cryptocurrency remittances to Venezuela
Authors: Robins Daniel
Published: November 2024

Cryptocurrency remittances overcome many regulatory and practical barriers, but there is little empirical research into this increasingly popular remittance medium. In response, this article explores cryptocurrency remittances from Latin America and the Caribbean into Venezuela. Cryptocurrencies as a remittance medium conveys important messages for advocates and critics. To appropriately critique cryptocurrencies, it is important to understand how they are used in the ‘every day’ rather than how their use may be characterised by ideologues. Rather than directly relying on ‘trustless’ and decentralised blockchain technology, ‘really existing’ cryptocurrency remittances are highly intermediated. Access to this medium is often hierarchical, stemming from knowledge barriers but also legal status (and by extension, economic status). The ‘need’ for trusted intermediaries prompts discussions around the relationship between ‘trustless’ blockchain technology and cryptocurrency remittances. This article shows that stablecoins (cryptocurrencies pegged to fiat currencies—usually the US dollar) are the most popular cryptocurrency remittance medium. Stablecoins challenge institutional attempts to geographically restrict currencies, yet also contribute to global processes of dollarisation. This is important to understanding how stablecoins simultaneously undermine spatial barriers to financial access yet may create new ones in the process.
Patternable Joule Heat Film With Ultrafast Heating, High-Temperature, and Oxidation-Resistant Surface
Authors: Shan Yubin , Wang Qin
Published: November 2024

Ultrafast and ultrahigh temperature light sources are critical for advancements in energy, display, and security. However, their practical applications are hindered by limitations in oxidation resistance. Here, we address this challenge by proposing a novel packaging scheme utilizing rapid heating technology and a molten glass coating. This antioxidant heat source enabling Joule heating in air, wind speed detection, and basic nanodigital displays functionality. Encapsulation of a sputtered tungsten metal layer within this coating creates a Joule heater exhibiting remarkable stability. These combined functionalities pave the way for a simple and powerful new approach for Joule thermal synthesis of novel materials, rapid material screening, and micro-area displays.
A Novel Delta-Like Parallel Robot With Three Translations and Two Pitch Rotations for Peg-in-Hole Assembly
Authors: Cheng Peng , Cao Wen-ao , Liu Degang , Cui Jun , Lai Jingpei
Published: November 2024

This paper presents a novel 5-degree-of-freedom (5-DOF) delta-like parallel robot named the double-pitch-delta robot, which can output three translations and two pitch rotations for peg-in-hole assembly. First, the kinematic mechanism of the new robot is designed based on the DOF requirements. Second, the closed-form kinematic model of the double-pitch-delta robot is established. Finally, the workspace of the double-pitch-delta robot is quantitatively analyzed, and a physical prototype of the new robot is developed to verify the effectiveness of the designed mechanism and the established models. Compared with the existing 5-DOF parallel robots with two pitch rotations, the double-pitch-delta robot has a simpler forward displacement model, larger workspace, and fewer singular loci. The double-pitch-delta robot can be also extended as a 6-DOF hybrid robot with the full-cycle tool-axis rotation to satisfy more complex operations. With these benefits, the new robot has a promising prospect in assembly applications.
Experimental Demonstration of a Topology Optimization Method to Generate a Capacity-Specific Device With Cavitation Resistance for Control Valve Applications
Authors: Butler Bruce J. , Alexandersen Joe , Rao Sameer R.
Published: November 2024

Topology optimization (TO) is a powerful method of generating structures that have desirable functional performance, to date most commonly used to improve structural behavior or to optimize pressure drops in laminar flow environments. In this study, we use TO to generate free-form pressure-staging geometries for the purposes of cavitation suppression in a turbulent flow device, an industrial flow control application which has not heretofore been addressed. Using variable permeability gradient-based adjoint TO in conjunction with both an out-of-plane resistance modified two-dimensional (2D) flow model and a penalty-term extended k–ε turbulence model, we generated flow channels of predetermined capacity that gradually reduce static pressure to suppress the initiation of cavitation. Three-dimensional (3D) extrusions of the 2D geometries were then printed using a masked stereolithography apparatus and evaluated using a water flow test in conjunction with acoustic cavitation detection. After testing, the results were compared to single and dual orifice baseline devices of equivalent capacity. The results of the experimental validations showed capacity deviations from target of up to 7% with performance improvements, as characterized by the delay of incipient cavitation, of up to 13% over the capacity-equivalent two-stage baseline device. This study demonstrates a new ability to rapidly generate fit-to-purpose devices at significantly reduced engineering effort using topology optimization methods.
Moderate-Duration Dynamic Stretching During Warm-up Improves Running Economy and Running Performance in Recreational Distance Runners
Authors: Panascì Marco , Ferrando Vittoria , Bisio Ambra , Filipas Luca , Di Gennaro Simone , Puce Luca , Ruggeri Piero , Faelli Emanuela
Published: November 2024

Purpose: The purpose of this study was to investigate, in distance runners, the acute effects of moderate durations (60 s per leg) of static (SS) and dynamic stretching (DS) on running economy (RE) and performance. Methods: Twelve recreational runners completed a randomized crossover design. Initially, the second ventilatory threshold (VT2) and the speed associated with the maximal oxygen uptake (VO2max) (vVO2max) were determined through an incremental test. Then, participants completed submaximal continuous-running (75%VT2 and 85%VT2) and running-until-exhaustion (vVO2max) tests preceded by 3 warm-ups: running plus SS or DS (SS or DS conditions) and running without stretching (NS condition). The SS and DS conditions consisted of 5 minutes of running plus 10 minutes of SS or DS, respectively, and the NS condition consisted of 15 minutes of running without stretching. RE at 75%VT2 and 85%VT2, time to exhaustion, and total running distance were evaluated. Rating of perceived exertion was also assessed. Results: Running economy at 75%VT2 resulted significantly better in the DS than in the NS (P < .001) and in the SS (P < .05). Time to exhaustion and total running distance were significantly improved in DS compared with NS (P < .001) and SS (P < .01). No differences in rating of perceived exertion among conditions were found. Conclusions: Our results showed that, in recreational distance runners, a preexercise moderate-duration bout of DS improved RE and enhanced total running distance and time to exhaustion, whereas 60 seconds of SS did not induce significant improvements. Overall, our study demonstrates the effectiveness of moderate DS durations in optimizing RE and performance parameters, showing that such effects depend on the stretching modality used.
PIEZO-dependent mechanosensing is essential for intestinal stem cell fate decision and maintenance
Authors: Baghdadi Meryem B. , Houtekamer Ronja M. , Perrin Louisiane , Rao-Bhatia Abilasha , Whelen Myles , Decker Linda , Bergert Martin , Pérez-Gonzàlez Carlos , Bouras Réda , Gropplero Giacomo , Loe Adrian K. H. , Afkhami-Poostchi Amin , Chen Xin , Huang Xi , Descroix Stephanie , Wrana Jeffrey L. , Diz-Muñoz Alba , Gloerich Martijn , Ayyaz Arshad , Matic Vignjevic Danijela , Kim Tae-Hee
Published: November 2024

Stem cells perceive and respond to biochemical and physical signals to maintain homeostasis. Yet, it remains unclear how stem cells sense mechanical signals from their niche in vivo. In this work, we investigated the roles of PIEZO mechanosensitive channels in the intestinal stem cell (ISC) niche. We used mouse genetics and single-cell RNA sequencing analysis to assess the requirement for PIEZO channels in ISC maintenance. In vivo measurement of basement membrane stiffness showed that ISCs reside in a more rigid microenvironment at the bottom of the crypt. Three-dimensional and two-dimensional organoid systems combined with bioengineered substrates and a stretching device revealed that PIEZO channels sense extracellular mechanical stimuli to modulate ISC function. This study delineates the mechanistic cascade of PIEZO activation that coordinates ISC fate decision and maintenance.
Natural selection could determine whether
Acropora
corals persist under expected climate change
Authors: Lachs Liam , Bozec Yves-Marie , Bythell John C. , Donner Simon D. , East Holly K. , Edwards Alasdair J. , Golbuu Yimnang , Gouezo Marine , Guest James R. , Humanes Adriana , Riginos Cynthia , Mumby Peter J.
Published: November 2024

Marine heatwaves are intensifying under climate change, exposing populations of reef-building corals to mass mortality and intense selective pressure. It remains unknown whether adaptation can keep pace with warming and maintain reef functioning. We have developed an eco-evolutionary metapopulation model for
Acropora
, an ecologically important yet thermally sensitive coral taxon. We found that, although corals have some adaptation capacity, they will suffer severe heatwave-induced declines over the coming decades. For a future in which emissions lead to ~3°C of global warming, natural selection could allow populations to persist, albeit in severely depleted states with elevated extinction risk and potential loss of ecosystem functioning. Yet, for thermally sensitive coral populations to thrive beyond 2050, there must be rapid reductions of greenhouse gas emissions that limit global warming to 2°C.
A tetramer of BCL11A is required for stable protein production and fetal hemoglobin silencing
Authors: Zheng Ge , Yin Maolu , Mehta Stuti , Chu I-Te , Wang Stacy , AlShaye Alia , Drainville Kirstin , Buyanbat Altantsetseg , Bienfait Frédérique , Tenglin Karin , Zhu Qian , Orkin Stuart H.
Published: November 2024

Down-regulation of BCL11A protein reverses the fetal (HbF, α
2
γ
2
) to adult (HbA, α
2
β
2
) hemoglobin switch and is exploited in gene-based therapy for hemoglobin disorders. Because of reliance on ex vivo cell manipulation and marrow transplant, such therapies cannot lessen disease burden. To develop new small-molecule approaches, we investigated the state of BCL11A protein in erythroid cells. We report that tetramer formation mediated by a single zinc finger (ZnF0) is required for production of steady-state protein. Beyond its role in protein stability, the tetramer state is necessary for γ-globin gene repression, because an engineered monomer fails to engage a critical co-repressor complex. These aspects of BCL11A protein production identify tetramer formation as a vulnerability for HbF silencing and provide opportunities for drug discovery.
Droplet-based microprocessors
Authors: Baret Jean-Christophe
Published: November 2024

Soft devices made of nanoliter hydrogel beads use ions for computation