bluuebunny/crossref_metadata_2025 huggingface dataset:
The testosterone replacement therapy for prostate cancer patients: Time to take the leap?
Authors: Le Guevelou Jennifer , Ploussard Guillaume , Roubaud Guilhem , Sargos Paul
Published: May 2024

The advent of new systemic therapies resulted in a significant decrease in prostate cancer (PCa) death in the past decades. It comes at the cost of an increase in the proportion of men living with long‐term treatment‐induced hypogonadism. In a population of men with no history of PCa, the testosterone replacement therapy (TRT) proved its ability to both improve erectile function and reduce cardiovascular morbidity, translating into an improved overall survival. Whether TRT is safe and efficient in PCa patients remains an open question. Here, we present an overview on the safety of TRT for PCa patients and discuss the optimal population eligible for TRT after the PCa treatment.
Implementation of a geriatric in‐reach service improves acute surgical unit outcomes; a retrospective before‐and‐after study
Authors: Pugliese Matthew , Connell Louis , Turco Jennifer , Trivedi Anand , Foster Amanda , Kumarasinghe Anuttara Panchali W.
Published: May 2024

Background

Australia's ageing population is challenging for surgical units and there is a paucity of evidence for geriatric co‐management in acute general surgery. We aimed to assess if initiating a Geriatric Medicine in‐reach service improved outcomes for older adults in our Acute Surgical Unit (ASU).

Methods

The Older Adult Surgical Inpatient Service (OASIS) was integrated into ASU in 2021. We retrospectively reviewed all patients over age 65 admitted to ASU over a 12‐month period before and after service integration with a length of stay (LOS) greater than 24 h. There was no subsequent truncation or selection. Primary outcomes were 30‐day mortality, LOS, and 28‐day readmissions. Secondary outcomes were discharge disposition, in‐hospital mortality, and hospital‐acquired complications (HACs).

Results

1339 consecutive patients were included in each group, with no differences in baseline characteristics. There was a significant decrease in 28‐day readmissions from 20.2% to 16.0% (P < 0.05), greatest in patients undergoing non‐EL operative procedures (21.9% pre‐OASIS vs. 12.6% post‐OASIS; P < 0.05). Trends towards reduced 30‐day mortality (7.17% vs. 5.90%; P = 0.211), in‐hospital mortality (3.88% vs. 2.91%; P = 0.201), permanent care placement (7.77% vs. 7.09%; P = 0.843) and HACs (8.14% vs. 7.62%; P = 0.667) were seen, although statistical significance was not demonstrated. LOS remained unchanged at 4 days (P = 0.653).

Conclusion

The addition of a geriatric in‐reach service to a tertiary ASU led to a significant reduction in 28‐day readmissions. Downtrends were seen in mortality, permanent care placement, and HAC rates, while LOS remained unchanged.
Letter: Intestinal permeability accounting for ongoing gastrointestinal symptoms following endoscopic remission in IBD—Authors' reply
Authors: Aliu Arta , Bosch Daan H. C. A. , Keszthelyi Daniel , Ardabili Ashkan Rezazadeh , Colombel Jean‐Frederic , Sawyer Rachel , Törnblom Hans , Hart Ailsa , Jonkers Daisy M. A. E. , Pierik Marieke J. , Mujagic Zlatan
Published: May 2024

LINKED CONTENT

This article is linked to Aliu et al papers. To view these articles, visit https://doi.org/10.1111/apt.17988 and https://doi.org/10.1111/apt.18027.
Psychopharmacological treatment in patients planned for hip or knee replacement
Authors: Kornvig Simon , Kehlet Henrik , Jørgensen Christoffer Calov , Fink‐Jensen Anders , Videbech Poul , Lindberg‐Larsen Martin , Gromov Kirill , Rasmussen Mathias Bæk , Bieder Manuel Josef , Varnum Claus
Published: May 2024

Psychopharmacological treatment may be an independent risk factor for increased length of stay and readmission after hip and knee replacement. Thus, temporary perioperative discontinuation may be beneficial. However, little is known regarding the treatments, and not all are feasible to discontinue. Therefore, the aim of this study was to describe the treatments in terms of type, dose, duration, indication and initiating physician to assess the feasibility of temporary perioperative discontinuation. We included 482 patients planned for hip or knee replacement in psychopharmacological treatment for psychiatric disorders from 2021 to 2023 at five orthopaedic departments in Denmark. Most patients were treated with antidepressants (89%); most frequently, either selective serotonin reuptake inhibitors (SSRIs; 48%) or serotonin‐norepinephrine reuptake inhibitors (SNRIs; 21%). The majority received monotherapy (70%); most frequently, an SSRI (36%) or an SNRI (12%). Most antidepressants were initiated by general practitioners (71%), and the treatments had lasted for more than a year (87%). The doses of SSRIs/SNRIs were moderate, and the most frequent indication for antidepressants was depression (77%). These results imply that temporary perioperative SSRI/SNRI discontinuation may be feasible in hip and knee replacement patients and support a future randomized controlled trial investigating the potential benefits of temporary discontinuation.
Which men benefit from prostate cancer screening? Prostate cancer mortality by subgroup in the European Randomised Study of Screening for Prostate Cancer
Authors: Pasanen Niko , Talala Kirsi , Remmers Sebastiaan , Tammela Teuvo L. J. , Hugosson Jonas , Roobol Monique J. , Taari Kimmo , Arnsrud Godtman Rebecka , Bangma Chris , Auvinen Anssi
Published: May 2024

Objective

To evaluate whether a subgroup of men can be identified that would benefit more from screening than others.

Materials and Methods

This retrospective cohort study was based on three European Randomised Study of Screening for Prostate Cancer (ERSPC) centres, Finland, the Netherlands and Sweden. We identified 126 827 men aged 55–69 years in the study who were followed for maximum of 16 years after randomisation. The primary outcome was prostate cancer (PCa) mortality. We analysed three age groups 55–59, 60–64 and 65–69 years and PCa cases within four European Association of Urology (EAU) risk groups: low, intermediate, high risk, and advanced disease.

Results

The hazard ratio (HR) for PCa mortality in the screening arm relative to the control arm for men aged 55–59 years was 0.96 (95% confidence interval [CI] 0.75–1.24) in Finland, 0.70 (95% CI 0.44–1.12) in the Netherlands and 0.42 (95% CI 0.24–0.73) in Sweden. The HR for men aged 60–64 years was 1.03 (95% CI 0.77–1.37) in Finland, 0.76 (95% CI 0.50–1.16) in the Netherlands and 0.97 (95% CI 0.64–1.48) in Sweden. The HR for men aged 65–69 years was 0.80 (95% CI 0.62–1.03) in Finland and 0.57 (95% CI 0.38–0.83) in the Netherlands, and this age group was absent in Sweden. In the EAU risk group analysis, PCa mortality rates were materially lower for men with advanced disease at diagnosis in all three countries: 0.67 (95% CI 0.56–0.82) in Finland, 0.28 (95% CI 0.18–0.44) in the Netherlands, and 0.48 (95% CI 0.30–0.78) in Sweden.

Conclusion

We were unable to unequivocally identify the optimal age group for screening, as mortality reduction differed among centres and age groups. Instead, the screening effect appears to depend on screening duration, and the number and frequency of screening rounds. PCa mortality reduction by screening is largely attributable to stage shift.
Glycyrrhizic acid inhibits DNA damage repair and enhances cisplatin‐induced apoptosis of melanoma cells
Authors: Bian Fang , Niu Fan‐hong , Qu Ping‐yuan , Gong Fang , Yan Jian‐zhou
Published: May 2024

This research was designed to prospect the mechanism and impact of glycyrrhizic acid (GA) on DNA damage repair and cisplatin (CP)‐induced apoptosis of melanoma cells. First, human melanoma cell SK‐MEL‐28 was stimulated using GA for 24, 48, and 72 h. Then, the optimal treatment time and dosage were selected. After that, cell counting kit‐8 (CCK‐8) was employed for testing the cell viability, flow cytometry for the apoptosis, comet assay for the DNA damage of cells, and western blot for the cleaved‐Caspase3, Caspase3, Bcl‐2, and γH2AX protein expression levels. The experimental outcomes exhibited that as the GA concentration climbed up, the SK‐MEL‐28 cell viability dropped largely, while the apoptosis level raised significantly, especially at the concentration of 100 μm. In addition, compared with GA or CPtreatment only, CP combined with GA notably suppressed the viability of melanoma cells and promoted cell apoptosis at the cytological level. At the protein level, the combined treatment notably downregulated the Bcl‐2 and Caspase3 expression levels, while significantly upregulated the cleaved‐Caspase3 and γH2AX expression levels. Besides, CP + GA treatment promoted DNA damage at the DNA molecular level. Collectively, both GA and CP can inhibit DNA damage repair and enhance the apoptosis of SK‐MEL‐28 cells, and the synergistic treatment of both exhibits better efficacy.
Heterogeneous impact of crop diversification on farm net returns and risk exposure: Empirical evidence from Ghana
Authors: Adam Baba , Abdulai Awudu
Published: May 2024

Increasing frequency of extreme weather events threatens the livelihoods of low‐income farm households due to the heavy dependence on rain‐fed agriculture coupled with the under‐developed formal markets for risk management products. Thus, crop diversification is one of the widely used ex ante adaptation strategies to hedge against weather risk exposure. In this study, we use survey data from the northern Savanna zone of Ghana merged with historical weather data to shed light on the heterogeneous impact of crop diversification on farm net returns and risk exposure. We employ the dose response function and instrumental variable techniques to address potential endogeneity concerns. Overall, our findings show that crop diversification is a welfare‐enhancing strategy that significantly increases farm net returns, lowers the probability of crop failure, and thus decreases downside risk exposure. Notably, our dose‐response function analysis demonstrates that the positive benefits of crop diversification are particularly pronounced at lower intensities, reaching an optimal threshold. Beyond this point, the incremental advantages tend to diminish, suggesting the importance of carefully considering the optimal level of diversification for maximum benefits. The results further underscore the significant impact of both access to agricultural extension services and fertilizer usage on the adoption of crop diversification.
Cerebral autoregulation: A reliable predictor of prognosis in patients receiving intravenous thrombolysis
Authors: Guo Zhen‐Ni , Qu Yang , Shen Zi‐Duo , Liu Jia , Wang Zhong‐Xiu , Sun Ying‐Ying , Zhang Ke‐Jia , Chang Junlei , Si Xiang‐Kun , Jin Hang , Sun Xin , Yang Yi
Published: May 2024

Aims

To investigate the characteristics of dynamic cerebral autoregulation (dCA) after intravenous thrombolysis (IVT) and assess the relationship between dCA and prognosis.

Methods

Patients with unilateral acute ischemic stroke receiving IVT were prospectively enrolled; those who did not were selected as controls. All patients underwent dCA measurements, by quantifying the phase difference (PD) and gain, at 1–3 and 7–10 days after stroke onset. Simultaneously, two dCA‐based nomogram models were established to verify the predictive value of dCA for patients with mild‐to‐moderate stroke.

Results

Finally, 202 patients who received IVT and 238 who did not were included. IVT was positively correlated with higher PD on days 1–3 and 7–10 after stroke onset. PD values in both sides at 1–3 days after stroke onset and in the affected side at 7–10 days after onset were independent predictors of unfavorable outcomes in patients who received IVT. Additionally, in patients with mild‐to‐moderate stroke who received IVT, the dCA‐based nomogram models significantly improved the risk predictive ability for 3‐month unfavorable outcomes.

Conclusion

IVT has a positive effect on dCA in patients with acute stroke; furthermore, dCA may be useful to predict the prognosis of patients with IVT.
Outcomes and risk factors for infection after endovascular treatment in patients with acute ischemic stroke
Authors: Jiang Xin , Hu Yaowen , Wang Jian , Ma Mengmeng , Bao Jiajia , Fang Jinghuan , He Li
Published: May 2024

Aims

Infection is a common complication following acute ischemic stroke (AIS) and significantly contributes to poor functional outcomes after stroke. This study aimed to investigate the effects of infection after endovascular treatment (post‐EVT infection) on clinical outcomes and risk factors in patients with AIS.

Methods

We retrospectively analyzed AIS patients treated with endovascular treatment (EVT) between January 2016 and December 2022. A post‐EVT infection was defined as any infection diagnosed within 7 days after EVT. The primary outcome was functional independence, defined as a modified Rankin scale (mRS) score of 0–2 at 90 days. A multivariable logistic regression analysis was conducted to determine independent predictors of post‐EVT infection and the associations between post‐EVT infection and clinical outcomes.

Results

A total of 675 patients were included in the analysis; 306 (45.3%) of them had post‐EVT infections. Patients with post‐EVT infection had a lower rate of functional independence than patients without infection (31% vs 65%, p = 0.006). In addition, patients with post‐EVT infection achieved less early neurological improvement (ENI) after EVT (25.8% vs 47.4%, p < 0.001). For safety outcomes, the infection group had a higher incidence of any intracranial hemorrhage (23.9% vs 15.7%, p = 0.01) and symptomatic intracranial hemorrhage (10.1% vs 5.1%, p = 0.01). Unsuccessful recanalization (aOR 1.87, 95% CI 1.11–3.13; p = 0.02) and general anesthesia (aOR 2.22, 95% CI 1.25–3.95; p = 0.01) were identified as independent predictors for post‐EVT infection in logistic regression analysis.

Conclusion

AIS patients who develop post‐EVT infections are more likely to experience poor clinical outcomes. Unsuccessful recanalization and general anesthesia were independent risk factors for the development of post‐EVT infection.
Successful bilateral lung transplantation in pulmonary alveolar microlithiasis: A case report and review of literature
Authors: Mardani Parviz , Naseri Reyhaneh , Shahriarirad Reza , Mahram Hadiseh , Shafi Masoud , Niknam Tahmoores , Khosravi Mohammad Bagher , Fallahi Mohammad Javad , Amirian Armin
Published: May 2024

Background

Pulmonary alveolar microlithiasis (PAM) is a rare autosomal recessive genetic disorder with approximately 1000 known cases worldwide, in which calcium phosphate microliths deposit in the alveolar air spaces. As of writing this report, no definitive conventional therapy exists, and many PAM cases may progress to severe respiratory failure and potential death. Bilateral lung transplantation (BLx) seems to be the most optimal solution; however, this procedure is challenging along with limited reports regarding the outcome in PAM. We report a case of PAM successfully treated with BLx for the first time in Iran.

Method

We present the case of a 42‐year‐old female with a longstanding history of cough, not responding to conventional antitussive medication, who was diagnosed as a case of PAM following a hospitalization due to coughing, dyspnea on exertion, and hemoptysis. Despite treatment with corticosteroid and medical treatment, no improvement was achieved and she subsequently developed respiratory and right ventricular failure, with oxygen ventilation dependence. Eventually, she was scheduled for BLx. The operation was successful and during her 2‐year follow‐up, no recurrence or significant postoperative complications has been reported.

Conclusion

This case presentation and literature review confirm the effectiveness of BLx as a promising treatment for PAM‐diagnosed patients, improving both life expectancy and quality of life.
Effective ecological monitoring using passive acoustic sensors: Recommendations for conservation practitioners
Authors: Teixeira Daniella , Roe Paul , van Rensburg Berndt J. , Linke Simon , McDonald Paul G. , Tucker David , Fuller Susan
Published: May 2024

Passive acoustic recorders have emerged as powerful tools for ecological monitoring. However, effective monitoring is not simply an act of recording sounds. To have meaning for conservation and management, acoustic monitoring needs to be properly planned and analyzed to yield high quality information. Here, we provide a set of considerations for the design of an effective acoustic monitoring program. We argue that such a program, has the following attributes: (1) has established appropriate partnerships with landowners, Traditional Owners, researchers, or other relevant stakeholders, (2) is based on clear objectives and questions, (3) is explicit in its target sound signals, (4) has considered in‐field sensor placement for a range of factors, including experimental design, statistical power, background noise, and potential impacts on human privacy and animal disturbance, (5) has a justified recording schedule and periodicity, (6) has methods to process sound data in line with objectives, and (7) has protocols for permanent data storage and access. Acoustic monitoring is increasingly used in large‐scale programs and will be important in addressing global biodiversity targets and new biodiversity markets. It is critical that new monitoring programs are designed to effectively and efficiently capture data that address pertinent and emerging issues in conservation.
Suturing with muscle layer grasping and pulling technique for mucosal defect of colorectal endoscopic submucosal dissection
Authors: Yamada Keisaku , Tajika Masahiro , Niwa Yasumasa
Published: May 2024

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Energy flux couples sulfur isotope fractionation to proteomic and metabolite profiles in Desulfovibrio vulgaris
Authors: Leavitt William D. , Waldbauer Jacob , Venceslau Sofia S. , Sim Min Sub , Zhang Lichun , Boidi Flavia Jaquelina , Plummer Sydney , Diaz Julia M. , Pereira Inês A. C. , Bradley Alexander S.
Published: May 2024

Microbial sulfate reduction is central to the global carbon cycle and the redox evolution of Earth's surface. Tracking the activity of sulfate reducing microorganisms over space and time relies on a nuanced understanding of stable sulfur isotope fractionation in the context of the biochemical machinery of the metabolism. Here, we link the magnitude of stable sulfur isotopic fractionation to proteomic and metabolite profiles under different cellular energetic regimes. When energy availability is limited, cell‐specific sulfate respiration rates and net sulfur isotope fractionation inversely covary. Beyond net S isotope fractionation values, we also quantified shifts in protein expression, abundances and isotopic composition of intracellular S metabolites, and lipid structures and lipid/water H isotope fractionation values. These coupled approaches reveal which protein abundances shift directly as a function of energy flux, those that vary minimally, and those that may vary independent of energy flux and likely do not contribute to shifts in S‐isotope fractionation. By coupling the bulk S‐isotope observations with quantitative proteomics, we provide novel constraints for metabolic isotope models. Together, these results lay the foundation for more predictive metabolic fractionation models, alongside interpretations of environmental sulfur and sulfate reducer lipid‐H isotope data.
Social reproduction: Households, public policies, and alternative organizing
Authors: Ruiz‐Castro Mayra , Grau‐Grau Marc , Lupu Ioana , Daskalaki Maria , McGinn Kathleen L.
Published: May 2024

This special issue (SI) contributes to a growing body of work in management and organization studies focusing on the complex relationship between social reproduction and inequalities in paid work and organizations. In this introduction to the SI, we first identify three key areas of inquiry relevant to the study of social reproduction: challenging the boundaries of productive and reproductive labor; inequalities and exploitation; and alternative organizing. We then present the seven papers of the SI that draw on research from Australia, South America, Spain, Turkey, the UK, and the US to contribute to the aforementioned areas, foregrounding distinctive social reproduction dynamics manifesting in the household and alternative organizations (cooperatives), and facilitated by state policies. Based on these contributions, we propose an agenda for future research on social reproduction that aims to address the persistence and potential transformation of the existing gender, class, and race orders. We call for future studies exploring changing parenthood roles and how these affect the organization of re/production tasks; for research revealing and investigating underlying inequalities (re)produced by public policy; for analyses of existing and potential forms of feminist alternative organizing, and how these are sometimes hindered by heteropatriarchal structures; and for the study of social reproduction dynamics across cultural, socioeconomic, and political contexts.
Physicochemical characterisation and impact of Gryllus bimaculatus addition on gluten‐free flour blends
Authors: Kiiru Samuel , Ng'ang'a Jeremiah , Konyole Silvenus , Roos Nanna , Hetzer Birgit , Marel Anna‐Kristina , Orkusz Agnieszka , Harasym Joanna , Kinyuru John
Published: May 2024

Gryllus bimaculatus (field cricket) powder is a prospect in enriching gluten‐free food products' protein and mineral contents. However, the technological impacts of replacing common gluten‐free cereal flours with G. bimaculatus powder are still incipient. This study aimed to characterise nutritional composition, particle morphology, and particle size distribution of G. bimaculatus powder and the gluten‐free flours (maize, rice, finger millet and proso millet). Additionally, it investigated the effects of substituting these gluten‐free flours with 5%, 10%, 15% and 20% G. bimaculatus powder on proximate composition, hydration and colour properties. G. bimaculatus powder showed significantly (P ≤ 0.05) high protein (44.8 g/100 g) content and essential minerals such as zinc (208.5 mg/kg) and iron (132.2 mg/kg). Micrographs of G. bimaculatus powder revealed compact and heterogenous particles while the flours' particles varied in sizes, and the starch granules had different shapes, sizes and arrangements. Flour particles exhibited bi‐and trimodal size distributions ranging from 1.5 μm to 1100 μm with minor peaks preceding major peaks. Finger millet flour had a greater span of 4.12, while proso millet flour had a lower span of 1.97. Particle size correlated negatively with water absorption capacity (WAC) (r = −0.938) and oil absorption capacity (OAC) (r = −0.955), respectively. G. bimaculatus powder addition significantly increased (P ≤ 0.05) fat, protein and fibre contents, decreased (P ≤ 0.05) nitrogen‐free extracts, but had no effect on ash content. Hydration properties differed significantly (P ≤ 0.05) except for WAC in proso millet blends. Samples exhibited significantly higher (P ≤ 0.05) WAC than OAC in exception of G. bimaculatus powder and showed no emulsifying activities. Addition of G. bimaculatus powder significantly (P ≤ 0.05) increased colour differences, reduced redness (a*), yellowness (b*) and lightness. The use of G. bimaculatus powder demonstrates the potential to enhance the nutritional properties and modify the colour and hydration of gluten‐free flours in the development of novel gluten‐free foods.
Automatic classification and segmentation of blast cells using deep transfer learning and active contours
Authors: Ametefe Divine Senanu , Sarnin Suzi Seroja , Ali Darmawaty Mohd , Ametefe George Dzorgbenya , John Dah , Aliu Abdulmalik Adozuka , Zoreno Zadok
Published: May 2024

Introduction

Acute lymphoblastic leukemia (ALL) presents a formidable challenge in hematological malignancies, necessitating swift and precise diagnostic techniques for effective intervention. The conventional manual microscopy of blood smears, although widely practiced, suffers from significant limitations including labor‐intensity and susceptibility to human error, particularly in distinguishing the subtle differences between normal and leukemic cells.

Methods

To overcome these limitations, our research introduces the ALLDet classifier, an innovative tool employing deep transfer learning for the automated analysis and categorization of ALL from White Blood Cell (WBC) nuclei images. Our investigation encompassed the evaluation of nine state‐of‐the‐art pre‐trained convolutional neural network (CNN) models, namely VGG16, VGG19, ResNet50, ResNet101, DenseNet121, DenseNet201, Xception, MobileNet, and EfficientNetB3. We augmented this approach by incorporating a sophisticated contour‐based segmentation technique, derived from the Chan‐Vese model, aimed at the meticulous segmentation of blast cell nuclei in blood smear images, thereby enhancing the accuracy of our analysis.

Results

The empirical assessment of these methodologies underscored the superior performance of the EfficientNetB3 model, which demonstrated exceptional metrics: a recall specificity of 98.5%, precision of 95.86%, F1‐score of 97.16%, and an overall accuracy rate of 97.13%. The Chan‐Vese model's adaptability to the irregular shapes of blast cells and its noise‐resistant segmentation capability were key to capturing the complex morphological changes essential for accurate segmentation.

Conclusion

The combined application of the ALLDet classifier, powered by EfficientNetB3, with our advanced segmentation approach, emerges as a formidable advancement in the early detection and accurate diagnosis of ALL. This breakthrough not only signifies a pivotal leap in leukemia diagnostic methodologies but also holds the promise of significantly elevating the standards of patient care through the provision of timely and precise diagnoses. The implications of this study extend beyond immediate clinical utility, paving the way for future research to further refine and enhance the capabilities of artificial intelligence in medical diagnostics.
Evaluating special representation of non‐resident citizens: Eligibility, constituency and proportionality
Authors: Umpierrez de Reguero Sebastián , Bauböck Rainer , Wegschaider Klaudia
Published: May 2024

So far, 21 countries have introduced—and some thereafter withdrawn—reserved legislative seats for their citizens living abroad. Existing literature on this form of special representation has studied this topic either empirically or normatively. We bring these two approaches together based on the main dimensions of institutional variation of special representation: (1) eligibility, (2) constituency structure and (3) electoral proportionality. We first discuss each dimension from a normative perspective. In the second step, we map the range of empirical variation and highlight the most common arrangements. We conclude that the normative justification for special representation is generally weak, but some institutional configurations pose fewer problems. Specifically, we see fewer issues with special representation when electoral inclusion is limited to the first generation of emigrants and when it is used to limit the electoral influence of non‐resident populations that make up a large share of the overall electorate. By grounding our normative discussion on an empirical mapping, we bridge two disconnected literatures on special representation of non‐resident citizens.
Impact of the COVID‐19 Pandemic on Influenza Circulation During the 2020/21 and 2021/22 Seasons, in Europe
Authors: Sinnathamby Mary A. , Meslé Margaux M. I. , Mook Piers , Stolyarov Kirill ,   The European Region Influenza Network Group Authorship, Pebody Richard
Published: May 2024

Background

The emergence of SARS‐CoV‐2 in late 2019 saw the implementation of public health and social measures (PHSM) by countries across Europe to reduce its transmission and impact on populations. Consequently, countries reported changes in influenza circulation and extensive disruptions to routine surveillance systems.

Methods

We describe the epidemiology of influenza in Europe between Weeks 40/2020 and 39/2022 compared to the 2016/17 to 2019/20 seasons, to assess the impact of the COVID‐19 pandemic and PHSM on surveillance systems and influenza circulation.

Results

Low detections of influenza were observed through primary care sentinel sources during seasonal influenza periods (Week 40 to 20); 56 (of 39,457 specimens tested; < 1% positivity) in 2020/21 and 7261 (of 64,153 specimens tested; 11% positivity) detections in 2021/22 were observed, compared to an average of 18,383 (of 50,544 specimens tested; 36% positivity) detections in 2016/17 to 2019/20. Similarly, 11 (of 19,989 specimens tested; < 1% positivity) and 1488 (of 23,636 specimens tested; 6% positivity) detections were reported through SARI surveillance sources in 2020/21 and 2021/22, respectively, compared to an average of 2850 (of 10,389 specimens tested; 27% positivity) detections in 2016/17 to 2019/20. However, the 2021/22 interseasonal period saw unusual increases in influenza detections across surveillance site types when PHSM were easing.

Conclusion

In conclusion, findings suggest that the restriction and easing of PHSM measures were associated with variations in influenza detections. Our observations of out‐of‐season influenza activity highlight the importance of an integrated respiratory surveillance strategy to monitor circulating respiratory viruses throughout the year to inform optimal prevention and control strategies.
Nursing/midwifery students' perceptions of caring pedagogy and online learning during the COVID‐19 pandemic
Authors: Jones Rikki , Jackson Debra , Rice Kylie , Fisher Murray , Calleja Pauline , Hopkins Martin , West Caryn , Irwin Pauletta , McGough Shirley , Luck Lauretta , Walker Felicity , Whiteing Nicola , Usher Kim
Published: May 2024

Aim

This study aimed to gain a better understanding of nursing/midwifery students' perspectives on a pedagogy of caring and online learning during the COVID‐19 pandemic. In addition, it aimed to determine if the COVID‐19 pandemic impacted students' perceptions and experience of online learning and students' desire to enter the nursing/midwifery workforce.

Design

Mixed methods.

Methods

A multi‐centre cross‐sectional survey of Australian nursing and midwifery students was undertaken to explore students’ experience of learning during the COVID‐19 pandemic.

Results

There are several key findings from this study that may be relevant for the future delivery of undergraduate health education, students transitioning to practice and healthcare workforce retention. The study found that although students were somewhat satisfied with online learning during COVID‐19, students reported significant issues with knowledge/skill acquisition and barriers to the learning process. The students reported feeling less prepared for practice and identified how clinical staff were unable to provide additional guidance and support due to increased workloads and stress. The textual responses of participants highlighted that connection/disconnection, empathy and engagement/disengagement had an impact on learning during COVID‐19.

Conclusion

Connection, engagement and isolation were key factors that impacted nursing students’ online learning experiences. In addition, graduates entering the workforce felt less prepared for entry into practice due to changes in education delivery during COVID‐19 that they perceived impacted their level of clinical skills, confidence and ability to practice as new graduate nurses/midwives.

Patient or Public Contribution

Not applicable.

Impact

Attention must be given to the transition of new graduate nurses and midwives whose education was impacted by pandemic restrictions, to support their professional career development and to ensure retention of future healthcare workforce.

Connection, engagement and isolation were key factors that impacted nursing students' online learning experiences. Educators should consider how connection and engagement can be actively embedded in the online learning environment.
Species richness responds to buffer effectiveness and competitive priorities in simulations of alpine microrefugia
Authors: Malanson George P. , Dullinger Stefan , Pauli Harald , Winkler Manuela , Saccone Patrick , Jiménez‐Alfaro Borja
Published: May 2024

Aim

Microrefugia on alpine slopes may allow species to persist in a warming climate. How plant species richness could respond to of the effectiveness of climatic buffering, defined as the difference in climate change in a microrefugium in comparison to that of an open alpine slope as mediated by competitive priority effects, is explored.

Location

Alpine habitat anywhere.

Taxon

Vascular plants.

Methods

A simple spatially explicit model of plant species with adaptations across a climatic gradient simulates reproduction, dispersal, and mortality through climatic change. The effectiveness of microrefugia in buffering climate change and levels of competitive priority effects are included as factors that alter demographic rates in an experimental framework. Spatial patterns of microrefugia and differences in dispersal are also simulated. Differences in mean species richness were analysed.

Results

The number of species conserved, relative to an instantaneous equilibrium calculation with the same climatic change, decreases with inclusion of a period of change (transient vs. instantaneous, equilibrium change) and further with competitive priority effects. In these simulations, the number of species conserved does not simply increase with buffer effectiveness, as hypothesized, but instead is bimodal.

Main Conclusions

The dip in number of species conserved in the middle range of buffer effectiveness occurs because barriers develop. These are temporal ecological traps, wherein species adapted to the middle of a climatic gradient become extinct, because their colonization of microrefugia is blocked by an extinction debt of resident species. The inertia that allows these demographic consequences is increased by competitive priorities. The highest levels of buffering and resulting inertia will not be ubiquitous but the bimodal pattern indicates that assessments of the role of microrefugia need to recognize the temporal species‐environment and species‐species interactions that will change the number of species conserved versus extinctions.
Comparison of outcomes and required tools between transvenous extraction of pacemaker and implantable cardioverter defibrillator leads: Insight from single high‐volume center experience
Authors: Hayashi Katsuhide , Callahan Thomas , Rickard John , Baranowski Bryan , Martin David O. , Nakhla Shady , Tabaja Chadi , Paul Aritra , Wilkoff Bruce L.
Published: May 2024

Introduction

Reports of comparison with procedural outcomes for implantable cardioverter defibrillator (ICD) and pacemaker (PM) transvenous lead extraction (TLE) are old and limited. We sought to compare the safety, efficacy, and procedural properties of ICD and PM TLE and assess the impact of lead age.

Methods

The study cohort included all consecutive patients with ICD and PM TLE in the Cleveland Clinic Prospective TLE Registry between 2013 and 2022. Extraction success, complications, and failure employed the definitions described in the HRS 2017 TLE guidelines.

Results

A total of 885 ICD leads, a median implant duration of 8 (5−11) years in 810 patients, and 1352 PM leads of 7 (3−13) years in 807 patients were included. Procedural success rates in ICD patients were superior to those of PM in >20 years leads but similar in ≤20 years leads. In the PM group, the complete success rate of TLE decreased significantly according to the increase of lead age, but not in the ICD group. ICD TLE required more extraction tools compared with PM TLE but cases with older leads required non‐laser sheath extraction tools in both groups. The most common injury site in major complication cases differed between ICD and PM TLE, although major complication rates showed no difference in both groups (2.7% vs. 1.6%, p = .12).

Conclusion

The procedural success rate by TLE is greater for ICD patients than PM patients with leads >20 years old but requires more extraction tools. Common vascular complication sites and the impact of lead age on procedural outcomes and required tools differed between ICD and PM TLE.
Contemporary educational methods in periodontology
Authors: Preshaw Philip M. , Ramseier Christoph A. , Loos Bruno G. , Balčiūnaitė Aušra , Crnić Tin , Davey Kevin , Dommisch Henrik , Ettmayer Johanna B. , Roberts Anthony , Verheijck E. Etienne , Walter Clemens , Zappalà Graziano
Published: May 2024

Aim

The 1st European Workshop on Periodontal Education in 2009 made recommendations regarding the scope of periodontal education at undergraduate (UG), postgraduate (PG) and continuing professional development (CPD) levels, defining competencies and learning outcomes that were instrumental at the time in helping to define periodontal teaching curricula. The 19th European Workshop on Periodontology and 2nd European Consensus Workshop on Education in Periodontology (Education in Periodontology in Europe) was held in 2023 to identify changes and future developments in periodontal education (including those informed by the COVID‐19 pandemic) and embracing methods and formats of periodontal teaching and training. The aim of this review was to assess current knowledge regarding education methods in periodontology, including traditional face‐to‐face (F2F) teaching and the move to student‐centred methods, virtual learning methods and use of digital technology, as well as blended teaching and learning (including teaching delivery and assessment) at UG, PG and CPD levels.

Materials and Methods

Systematic searches were conducted to identify relevant studies from the literature. Data were extracted and descriptive summaries collated.

Results

The pandemic was a major disruptor of traditional F2F teaching but provided opportunities for rapid implementation of alternative and supplementary teaching methods. Although online learning has become an integral part of periodontal education, teachers and learners alike favour some form of F2F teaching. Blended teaching and learning are feasible in many areas of periodontal education, both for knowledge and skills acquisition as well as in assessment. Student‐centred methods and blended approaches such as the flipped classroom seem highly effective, and online/virtual classrooms with both synchronous and asynchronous lectures are highly valued. Learning with haptic methods and virtual reality (VR) enhances the educational experience, especially when VR is integrated with traditional methods. The quality of the teacher continues to be decisive for the best knowledge transfer in all its forms.

Conclusions

Live F2F teaching continues to be highly trusted; however, all types of student‐centred and interactive forms of knowledge transfer are embraced as enhancements. While digital methods offer innovation in education, blended approaches integrating both virtual and traditional methods appear optimal to maximize the achievement of learning outcomes. All areas of periodontal education (UG, PG and CPD) can benefit from such approaches; however, more research is needed to evaluate their benefits, both for knowledge transfer and skills development, as well as in assessment.
Circulating netrin‐1 levels are reduced and related to corneal nerve fiber loss in patients with diabetic neuropathy
Authors: Mondal Asif , Bose Chiranjit , Pramanik Subhasish , Dash Debasish , Mukherjee Bidisha , Malik Rayaz A , Mukhopadhyay Satinath
Published: May 2024

Aims/Introduction

Deficiency of neurotropic factors is implicated in diabetic neuropathy (DN). Netrin‐1 is a neurotropic factor, but its association with DN has not been explored. We have assessed the association between serum netrin‐1 levels and early diabetic neuropathy assessed by quantifying corneal nerve fiber loss using corneal confocal microscopy.

Materials and Methods

A total of 72 participants with type 2 diabetes, without and with corneal nerve fiber loss (DN− n = 42, DN+ n = 30), and 45 healthy controls were studied. Serum netrin‐1 levels were measured by enzyme‐linked immunosorbent assay, and corneal nerve morphology was assessed using corneal confocal microscopy.

Results

Corneal nerve fiber density, branch density, fiber length and serum netrin‐1 levels were significantly lower in the DN− and DN+ groups compared with controls (P < 0.001). Netrin‐1 levels correlated with corneal nerve fiber length in the DN+ group (r = 0.51; P < 0.01). A receiver operating characteristic curve analysis showed that a netrin‐1 cut‐off value of 599.6 (pg/mL) had an area under the curve of 0.85, with a sensitivity of 76% and specificity of 74% (P < 0.001; 95% confidence interval 0.76–0.94) for differentiating patients with and without corneal nerve loss.

Conclusions

Serum netrin‐1 levels show a progressive decline with increasing severity of small nerve fiber damage in patients with diabetes. Netrin‐1 could act as a biomarker for small nerve fiber damage in DN.
Criteria for melanocytic lesions in LC‐OCT
Authors: Perez‐Anker J. , Soglia S. , Lenoir C. , Albero R. , Alos L. , García A. , Alejo B. , Cinotti E. , Orte Cano C. , Habougit C. , Dorado Cortes Ch. , Pellegrino L. , Tognetti L. , Castillo P. , Rubegni P. , Suppa M. , Perrot J. L. , del Marmol V. , Puig S. , Malvehy J.
Published: May 2024

Background

Line‐field confocal optical coherence tomography (LC‐OCT) is an emerging diagnostic tool with imaging depth reaching ~400 μm and a novel three‐dimensional (3D) cube providing cellular resolution. As far as we are aware, there are only a limited number of papers that have reported diagnostic criteria for melanocytic lesions using this technique, and none of them have been multicentric.

Objectives

Our aim was to establish the diagnostic criteria for melanocytic lesions using LC‐OCT and identify the most significant architectural and cytologic features associated with malignancy.

Methods

A retrospective evaluation of 80 consecutive melanocytic lesions from a prospective multicentric data set spanning three European centres was conducted. We excluded facial, acral and mucosal lesions from the study. Dermoscopic and LC‐OCT images were evaluated by a consensus of four observers. Multivariate logistic regression with backward elimination was employed.

Results

The main melanoma diagnostic criteria include detecting >10 pagetoid cells in 3D acquisition, irregular 3D epidermal architecture, disrupted dermoepidermal junction (DEJ) and clefting. Significant risk factors were irregular 3D epidermal architecture, >10 pagetoid cells, dendritic cells at DEJ without underlying inflammation. Novel malignancy criteria in vertical view were DEJ disruption and clefting around atypical melanocyte nests. Exclusive melanoma features were epidermal nests, epidermal consumption, dense dermal nests with atypia. Protective features in the absence of any malignancy indicators were DEJ ring pattern, cobblestone, elongated rete ridges (vertical), well‐defined DEJ and wave pattern (vertical).

Conclusions

A series of diagnostic criteria for the identification of melanocytic lesions with LC‐OCT have been established. Validation of these criteria in clinical practice through future studies is essential to further establish their utility.
Association of HBeAg decline rate from mid‐pregnancy to delivery with HBeAg seroconversion after delivery in hepatitis B virus‐infected mothers
Authors: Zhong Wenting , Zheng Jie , Yao Naijuan , Feng Yali , Zhu Yage , Jiao Zhe , Yan Lanzhi , Shi Lei , He Yingli , Chen Tianyan
Published: May 2024

There is still controversy about whether to continue antiviral therapy (AVT) after delivery, especially for pregnant women in the immune tolerance (IT) phase. In this study, a retrospective cohort study was conducted to explore the relationship between hepatitis B e antigen (HBeAg) decline rate (%) from mid‐pregnancy to delivery and HBeAg seroconversion postpartum among patients using nucleos(t)ide analogs (NAs) to prevent mother‐to‐child transmission (MTCT), with the goal of identifying the ideal candidates for postpartum AVT continuation. This retrospective cohort study included 151 postpartum women. Univariate and multivariable logistic regression analyses were conducted to assess the association between the HBeAg decline rate (%) from mid‐pregnancy to delivery and HBeAg seroconversion postpartum. Receiver operating characteristic (ROC) analysis was utilized to evaluate the predictive capacity of the HBeAg decline rate (%) and determine the optimal cut‐off point. The univariate analysis revealed a significant association between the HBeAg decline rate (%) and HBeAg seroconversion postpartum (OR 1.068, 95% CI: 1.034–1.103, p < .001). In the multivariate regression analysis, adjusting for age, hepatitis B surface antigen (HBsAg) titre (log10 IU/mL) at mid‐pregnancy, HBeAg titre (log10 S/CO) at mid‐pregnancy, and hepatitis B virus (HBV) DNA load decline rate (%) from mid‐pregnancy to delivery, the HBeAg decline rate(%) remained significantly associated with HBeAg seroconversion postpartum (OR 1.050, 95% CI: 1.015–1.093, p = .009). Then HBeAg decline rate (%) was treated as a categorical variable (tertiles) for sensitivity analysis. In the three distinct models, taking Tertile1 as a reference, women in Tertile3 still had a 4.201‐fold (OR 4.201, 95% CI: 1.382–12.773, p = .011) higher risk of developing HBeAg seroconversion (p for trend <.05) after adjusting above covariates. The area under the curve (AUC) was 0.723 (95% CI: 0.627–0.819). The optimal cut‐off value was 5.43%, with a sensitivity of 0.561, specificity of 0.791, and Youden's index of 0.352.A higher HBeAg decline rate (%) from mid‐pregnancy to delivery independently correlated with an increased risk of HBeAg seroconversion postpartum. This decline rate can serve as a valuable clinical indicator for predicting HBeAg seroconversion.
Effects of Bacillus cereusYB1 on growth, intestinal digestive enzyme activity, liver antioxidant enzyme activity, and intestinal structure of black rockfish, Sebastes schlegelii
Authors: Wang Tengteng , Wang Fei , Sun Na , Cui Guangxin , Chen Yuzhen , Zhang Mingliang , Sun Shuo , Ma Ruichao , Sun Chunxiao , Han Huizong
Published: May 2024

We aimed to investigate the effects of Bacillus cereus YB1 on the growth, intestinal digestive enzyme activity, liver antioxidant enzyme activity, and intestinal tissue structure of juvenile black rockfish (Sebastes schlegelii). A 50‐day feeding experiment was conducted. Feeding was conducted in four diet groups: control group with no YB1 supplement in diet and three treatment groups E‐L, E‐M, and E‐H containing 105, 106, and 107 CFU/g YB1, respectively. The results revealed that the weight gain and specific growth rate of juvenile fish significantly increased, while the feed coefficient was reduced in all three diet treatment groups. This indicated that the growth of black rockfish was significantly and positively affected by YB1 feeding. Enzyme activity in the intestinal tract was not significantly affected by YB1. However, the activity of protease, amylase, and lipase increased because of YB1 treatment, except for the proteases in the E‐M diet group. Meanwhile, no significant differences were recorded in the activities of the antioxidant enzymes in liver, but the level of catalase, superoxide dismutase, and malondialdehyde activities in treatments shows a better performance compared with the control in overall perspective. Furthermore, the structural features of the intestine (i.e., number of intestinal villi, length of gut villi, and thickness of muscularis) was significantly elevated with the inclusion of B. cereus YB1 in the diet. These results reveal that dietary supplementation of B. cereus YB1 is beneficial to the boosting of enzymatic activities and structure of intestinal tissue as well as the antioxidative ability of liver tissue. Such findings suggest that fish growth would be improved under YB1 feeding conditions.