bluuebunny/crossref_metadata_2025 huggingface dataset:
Acute symptomatic status epilepticus: Splitting or lumping? A proposal of classification based on real‐world data
Authors: Lattanzi Simona , Giovannini Giada , Brigo Francesco , Orlandi Niccolò , Trinka Eugen , Meletti Stefano
Published: August 2023

This study aimed to group acute symptomatic etiologies of consecutive episodes of status epilepticus (SE) into different subcategories and explore their associations with clinical outcome. Etiologies were first categorized as “acute,” “remote,” “progressive,” “SE in defined electroclinical syndromes,” and “unknown.” Four subcategories of acute etiologies were then defined: (1) withdrawal, low levels, or inappropriate prescription of antiseizure medications, or sleep deprivation in patients with pre‐existing epilepsy; (2) acute insults to central nervous system (CNS; “acute‐primary CNS”); (3) CNS pathology secondary to metabolic disturbances, systemic infection, or fever (“acute‐secondary CNS”); and (4) drug/alcohol intoxication or withdrawal. Poor outcome at discharge, defined as worsening of clinical conditions (modified Rankin Scale [mRS] at discharge higher than mRS at baseline), was reported in 55.6% of cases. The etiological categories of acute‐primary CNS (odds ratio [OR] = 3.61, 95% confidence interval [CI] = 2.11–6.18), acute‐secondary CNS (OR = 1.80, 95% CI = 1.11–2.91), and progressive SE (OR = 2.65, 95% CI = 1.57–4.47), age (OR = 1.05, 95% CI = 1.04–1.06), nonconvulsive semiology with coma (OR = 3.06, 95% CI = 1.52–6.17), and refractoriness (OR = 4.31, 95% CI = 2.39–7.77) and superrefractoriness to treatment (OR = 8.24, 95% CI = 3.51–19.36) increased the odds of poor outcome. Heterogeneity exists within the spectrum of acute symptomatic causes of SE, and distinct etiological subcategories may inform about the clinical outcome.
Influences of vitiligo‐associated characteristics on the occurrence of diabetes mellitus: Interactive analysis of a cross‐sectional study
Authors: Li Baizhang , Zhu Guannan , Kang Pan , Chen Jianru , He Kaiqiao , Wang Xinju , Gao Tianwen , Li Chunying , Li Shuli
Published: August 2023

The risk of diabetes mellitus (DM) in vitiligo patients is higher than that in non‐vitiligo population. Our goal was to explore the influencing factors for DM in vitiligo patients. A matched‐pair design of 107 cases with DM and 428 controls without DM was conducted among vitiligo patients in Xijing hospital from January 2010 to October 2021. The baseline characteristics of patients were analysed based on standard descriptive statistics. The vitiligo‐associated characteristics were analysed by logistic regression to identify influencing factors of DM. Interaction analysis was performed to explore the additive interactions between vitiligo‐associated characteristics and baseline characteristics. After adjustment for the baseline characteristics, the severity of vitiligo [odds ratio (OR) = 2.47, 95% confidence interval (CI): 1.47–4.14] and onset age of vitiligo (OR = 0.98, 95% CI: 0.97–0.99) had a significant correlation with occurrence of DM. The severity of vitiligo had additive interaction with family history of diabetes [relative excess risk due to interaction (RERI) = 132.51 (95% CI: 5.51–1100.20), attributable proportion (AP) = 0.91 (95% CI: 0.17–0.95), synergy index (S) = 11.53 (95% CI: 1.32–100.5)] and with smoking history [RERI = 6.54 (95% CI: 0.67–19.83), AP = 0.64 (95% CI: 0.04–0.80), S = 3.48 (95% CI: 1.17–10.36)]. Earlier onset age of vitiligo and greater BSA involvement might be two independent risk factors for DM in vitiligo patients. Interaction assessment identified the severity of vitiligo as additive interaction factors with diabetes family history and with smoking history for the DM occurrence.
Neutrophil extracellular traps formation in the lesional skin of various types of pyoderma gangrenosum
Authors: Ishikawa Masato , Yamamoto Toshiyuki
Published: August 2023

Pyoderma gangrenosum (PG) is a chronic neutrophilic disorder characterized by recurrent painful ulcers. Aseptic inflammation by neutrophils plays an essential role, and neutrophil extracellular traps (NETs) formation can contribute to the pathogenesis of PG. Seventy‐five patients were diagnosed as having PG in our department, among which 58 ulcerative, 4 bullous, 3 pustular and 10 vegetative type. We examined the 20 skin biopsy specimens (11 ulcerative, 3 bullous, 2 pustular and 4 vegetative type), and local NETs formation in various types of PG was compared among each type. The biopsied specimens were double labelled for myeloperoxidase, citrullinated histone H3. Immunofluorescent images indicated that the histopathologic location and depth of NETs formation in PG varied by the clinical subtypes. In ulcerative PG, NETs formation was observed in the upper to deep dermis. In bullous PG, NETs formation was mainly observed in the epidermis. Pustular type showed NETs formation in the epidermis near the pustules, and in vegetative type, showed NETs formation mainly in the upper dermis. These results indicate that NETting neutrophils play an important role in the pathogenesis of various forms of PG, although the location and depth of NETs formation in the skin lesion of PG differ depending on each type. Further studies are necessary to examine what factors identify different clinical features of PG.
Multi‐output regression for imbalanced data stream
Authors: Peng Tao , Sellami Sana , Boucelma Omar , Chbeir Richard
Published: August 2023

In this article, we describe an imbalanced regression method for making predictions over imbalanced data streams. We present MORSTS (Multiple Output Regression for Streaming Time Series), an online ensemble regressors devoted to non‐stationary and imbalanced data streams. MORSTS relies on several multiple output regressor submodels, adopts a cost sensitive weighting technique for dealing with imbalanced datasets, and handles overfitting by means of the K‐fold cross validation. For assessment purposes, experiments have been conducted on known real datasets and compared with known base regression techniques.
Acceptability of a shared cancer follow‐up model of care between general practitioners and radiation oncologists: A qualitative evaluation
Authors: Sandell Tiffany , Schütze Heike , Miller Andrew
Published: August 2023

Introduction

Facilitators to implement shared cancer follow‐up care into clinical practice include mechanisms to allow the oncologist to continue overseeing the care of their patient, two‐way information sharing and clear follow‐up protocols for general practitioners (GPs). This paper aimed to evaluate patients, GPs and radiation oncologists (ROs) acceptance of a shared care intervention.

Methods

Semi‐structured interviews were conducted pre‐ and post intervention with patients that were 3 years post radiotherapy treatment for breast, colorectal or prostate cancer, their RO, and their GP. Inductive and deductive thematical analysis was employed.

Results

Thirty‐two participants were interviewed (19 patients, 9 GPs, and 4 ROs). Pre intervention, there was support for GPs to play a greater role in cancer follow‐up care, however, patients were concerned about the GPs cancer‐specific skills. Patients, GPs and ROs were concerned about increasing the GPs workload. Post intervention, participants were satisfied that the GPs had specific skills and that the impact on GP workload was comparable to writing a referral. However, GPs expressed concern about remuneration. GPs and ROs felt the model provided patient choice and were suitable for low‐risk, stable patients around 2–3 years post treatment. Patients emphasised that they trusted their RO to advise them on the most appropriate follow‐up model suited to their individual situation. The overall acceptance of shared care depended on successful health technology to connect the GP and RO. There were no differences in patient acceptance between rural, regional, and cancer types. ROs presented differences in acceptance for the different cancer types, with breast cancer strongly supported.

Conclusion

Patients, GPs and ROs felt this shared cancer follow‐up model of care was acceptable, but only if the RO remained directly involved and the health technology worked. There is a need to review funding and advocate for health technology advances to support integration.

Patient or Public Contribution

Patients treated with curative radiotherapy for breast, colorectal and prostate cancer, their RO and their GPs were actively involved in this study by giving their consent to be interviewed.
Genetic diversity and gene flow of the soil arthropod (Scolopendra mutilans) in urban landscapes: The roles of rivers, mountains and fragmentation
Authors: Xu Tangjun , Zhou Kexin , Ye Wentao , Huang Yalin , Zhang Yufeng , Zhu Sheng , Ruan Honghua , Liu Hongyi
Published: August 2023

Soil invertebrates are a major element of soil biodiversity, which play critical roles in soil ecosystems. However, the impacts of urban landscapes on the genetic diversity and gene flows of soil arthropods remain unclear.

Here, we studied the genetic diversity and gene flow of Scolopendra mutilans in an urban area using mitochondrial Cytb genes and eight novel microsatellite loci.

A total of 22 haplotypes and 24 variation sites were identified based on 556 bp Cytb sequences from 84 individuals of five populations in Nanjing, Jiangsu Province, China. There were 5.63–8.00 alleles in the average of eight microsatellites found in the S. mutilans arthropod populations, which showed high genetic diversity in urban landscapes. There was no correlation between the natural habitat size and genetic diversity of S. mutilans. The global Fst value based on microsatellites was 0.115, which suggested a medium genetic differentiation and population isolation.

The genetic structure of S. mutilans might be affected by urbanisation, as urban patches might hinder gene flow between populations. Ecological corridors preserved in cities might serve as pathways for population migration, which increases gene flow. The gene flows of S. mutilans might not be hindered by natural barriers within cities, as there were strong relationships between populations separated by rivers.

These results may contribute to the conservation of S. mutilans diversity and elucidate its adaptation to urbanisation.
In vitro assessment of antimicrobial potential of low molecular weight chitosan and its ability to mechanically reinforce and control endogenous proteolytic activity of dentine
Authors: Pascale Christina , Geaman Jay , Mendoza Christine , Gao Feng , Kaminski Amber , Cuevas‐Nunez Maria , Darvishan Behnam , Mitchell John C. , Carrilho Marcela R. , Sigar Ira
Published: August 2023

Aims

Chitosan‐based biomaterials exhibit several properties of biological interest for endodontic treatment. Herein, a low molecular weight chitosan (CH) solution was tested for its antimicrobial activity against Enterococcus faecalis (E. faecalis) and effects on dentine structure.

Methodology

The root canal of 27 extracted uniradicular teeth were biomechanically prepared, inoculated with a suspension of E. faecalis and randomly assigned to be irrigated with either 5.25% sodium hypochlorite (NaClO), 0.2% CH or sterile ultrapure water (W). Bacteriologic samples were collected from root canals and quantified for of E. faecalis colony‐forming units (CFUs). The effectiveness of CH over E. faecalis biofilms was further measured using the MBEC Assay®. Additionally, dentine beams and dentine powder were obtained, respectively, from crowns and roots of 20 extracted third molars. Dentine samples were treated or not with 17% EDTA and immersed in either CH or W for 1 min. The effects of CH on dentine structure were evaluated by assessment of the modulus of elasticity, endogenous proteolytic activity and biochemical modifications.

Results

The number of E. faecalis CFUs was significantly lower for samples irrigated with CH and NaClO. No significant differences were found between CH and NaClO treatments. Higher modulus of elasticity and lower proteolytic activity were reported for dentine CH‐treated specimens. Chemical interaction between CH and dentine was observed for samples treated or not with EDTA.

Conclusions

Present findings suggest that CH could be used as an irrigant during root canal treatment with the triple benefit of reducing bacterial activity, mechanically reinforcing dentine and inhibiting dentine proteolytic activity.
Effect of sorbitol on stabilisation of gardenia blue and food 2D/3D printing
Authors: Wu Chaoyang , Xu Liang , Zhu Juncheng , Cheng Yang , Yang Yuxin , Qiao Shihao , Ma Liang , Zhang Yuhao , Wang Hongxia
Published: August 2023

The stability of gardenia blue is challenged under light and heat. Gardenia blue was designed to be stablised using gelatin, magnesium stearate and sorbitol, and the stabilisation effects and food application were investigated. Effect of sorbitol was studied by CIELab colorimeter, particle size meter, SEM, absorbance, FTIR, XRD, Raman spectrum, and rheometer. Appropriate‐content sorbitol could effectively enhance colour, and promote the UV irradiation stability of gardenia blue encapsulated complex systems, which is mainly owing to the hydrogen bonding, electrostatic interactions and hydrophobic interactions among components. These interactions induced by sorbitol also facilitated the shear‐thinning properties and excellent thermal stability of the complex systems. When writing & drawing on food, and 2D/3D printing food, the complex sample demonstrated the clear colour and outstanding effects. The gardenia blue based complex systems provide some reference for stabilising natural functional materials and illustrates potential application value in food decoration and food functionalisation.
Cutaneous immune‐related adverse events from immune checkpoint inhibitor therapy: Moving beyond “maculopapular rash”
Authors: Allais Blair S. , Fay Christopher J. , Kim Daniel Y. , Semenov Yevgeniy R. , LeBoeuf Nicole R.
Published: August 2023

Uncoupling toxicity from therapeutic effect lies at the foundation of the current state of the field of cutaneous immune‐related adverse events to immune checkpoint inhibitor therapy. This will be achieved through understanding the drivers of toxicity, tumor response, and resistance via large, well‐powered population‐level studies, institutional cohort data, and cellular‐level data. Increasing diagnostic specificity through the application of consensus disease definitions has the power to improve clinical care and each approach to research. Cutaneous immune‐related adverse events are associated with increased survival, and their treatment must invoke the maintenance of a delicate balance between immunosuppression, anti‐tumor effect of immune checkpoint inhibitor therapy, and quality of life. The multidisciplinary care of cancer patients with adverse events is critical to optimizing clinical and translational research outcomes and, as such, dermatologists are vital to moving the study of cutaneous adverse events forward.
Effects of organizational agility on readiness for change in nurses: A cross‐sectional study
Authors: Zeid Mennat Alla G. Abou , Mostafa Boshra , Zoromba Mohamed A. , Abdelnaby Ramy , Elsayed Mohamed , El‐Gazar Heba E.
Published: August 2023

Aim

To investigate the correlation between organizational agility and nurses' readiness for change.

Background

The paradigm of agility in a healthcare organization is a novel concept that embodies the most advantageous organizational status. However, assessing the effects of organizational agility on nurses’ readiness for change has not been previously studied.

Methods

This cross‐sectional study was conducted on 270 nurses working in a university hospital in Egypt. The study took place between January ‐ March 2022, and participation was voluntary. Data were collected using the organizational agility scale and individual readiness for change scales. Data analysis was conducted using descriptive statistics, Pearson correlation, and structured equation modeling (SEM).

Results

The results indicated that nurses in the hospital exhibited a moderate level of agility. Nurses’ readiness for change is high. The SEM showed that organizational agility accounted for 64% of the variance in nurses’ readiness for change.

Conclusions

Organizational agility is a significant predictor of nurses’ readiness for change.

Implications for nursing policymaking

As a means of ensuring that nurses are prepared for changes, nursing institutions should foster agility by instilling a vision for the future, enhancing staff capabilities, encouraging teamwork and open communication, and implementing total quality management, strategic planning, advanced nursing practice, participatory management, shared decision‐making, and policy development.
Nurses’ perceptions about bereavement care in critical care units: A qualitative study
Authors: Ong Keh Kiong , Yong Ying Bing , Kowitlawakul Yanika
Published: August 2023

Aim

To explore critical care nurses’ perceptions of bereavement nursing care in critical care settings at a tertiary hospital in Singapore.

Background

Grief and bereavement are stressful life experiences associated with significant health problems. Critical care nurses play important roles in supporting bereaved family members, and their self‐competence affects the quality of the care they deliver. Exploring critical care nurses’ perceptions of bereavement nursing care is thus essential.

Methods

An exploratory descriptive qualitative study design was adopted. A total of 16 nurses were recruited. One‐on‐one interviews were conducted using a semi‐structured interview guide and were audio‐recorded. The data collected were analysed using thematic analysis. This study was reported according to the Consolidated Criteria for Reporting Qualitative Research checklist.

Findings

Five themes surfaced in the study, namely, family responses, holistic care, psychological impact, self‐competence and organisational dynamics.

Conclusion

This study highlighted the key roles of critical care nurses in providing bereavement care, how their self‐competence impacts care delivery and the significant impacts of organisational policies on their capacity to provide care.

Implications for nursing and nursing policy

Nursing administrators should provide enhanced organisational support to critical care nurses who provide bereavement nursing care, and implement training work plans to ensure nurses are adequately prepared to provide culturally appropriate care. Strategies should be introduced to reduce administrative burden, expand the role of critical care nurses in providing bereavement nursing care, and establish and enlist role models as drivers of bereavement nursing care.
Effects of accrual constraints in cooperative advertising programs for distribution channels with one manufacturer and two retailers
Authors: Liu Bin , Xie Jinxing , Zhong Feimin
Published: August 2023

This paper considers a distribution channel with one manufacturer and two independent retailers and investigates how the accrual rate in a cooperative advertising program affects channel members’ performances. When the two retailers’ profit margins are the same, the accrual rate cannot benefit the manufacturer, which coincides with previous studies. However, if the retailers hold different profit margins, the accrual rate may benefit the manufacturer, which is never reported in existing literature. Specifically, when the market faced by the higher‐profit‐margin retailer exhibits a lower advertising efficacy, the manufacturer always prefers using an accrual rate if his profit margin is sufficiently high. Numerical simulations show that even when the manufacturer's profit margin is low, using an accrual rate may also lead to a Pareto improvement for the channel members. The main findings can be extended to the scenario with more than two retailers or with endogenously decided prices of channel members.
The effect of silicon fertilizers on agronomic performance of bread wheat under drought stress and non‐stress conditions
Authors: Christian Marylyn M. , Shimelis Hussein , Laing Mark D. , Tsilo Toi J.
Published: August 2023

Drought is one of the major constraints of wheat production, especially in rainfed wheat production systems. The objective of this study was to evaluate the effects of different silicon fertilizer formulations on the agronomic performance of diverse wheat genotypes under drought‐stressed conditions. Twenty wheat genotypes were evaluated in field and greenhouse environments under non‐stressed and drought‐stressed and two silicon fertilizer formulations (granular and liquid potassium silicate) and untreated control. The four‐way interaction involving genotype, environment, water regime and silicon formulation had a significant effect (p < .05) for aboveground biomass, productive spike number, hundred seed weight and grain yield. Granular silicon application was the most effective treatment both under non‐stressed and drought‐stressed conditions compared to the liquid and control treatments. Under field and drought conditions, the highest yielding genotype was MC18, which exhibited a mean grain yield of 4.17 t ha−1 with granular silicon, 2.56 t ha−1 with liquid silicon and 2.18 t ha−1 without silicon. The yield of genotype MC18 improved by 91.3% using granular silicon under drought‐stressed and by 44.6% under non‐stressed conditions compared with the untreated control. Granular silicon positively affected the drought stress tolerance indices compared to the liquid silicon and untreated control. The principal component biplot analysis revealed that liquid and granular silicon positively impact yield response for all test genotypes under drought‐stressed and non‐stressed conditions compared with the control. Silicon application reduced genotype variation for agronomic traits and enhanced agronomic trait relationships under drought‐stressed conditions. Drought stress tolerance indices are influenced by silicon application. The effect of silicon has a direct and indirect effect on yield and yield components. Silicon fertilization can be considered as a mitigation measure to cope with the adverse effect of drought stress on wheat.
Registered nurses' cultural orientation competence for culturally and linguistically diverse nurses in the hospital setting: A cross‐sectional study
Authors: Paatela Satu , Pohjamies Netta , Kanste Outi , Haapa Toni , Oikarainen Ashlee , Kääriäinen Maria , Mikkonen Kristina
Published: August 2023

Aims

To explore registered nurses' cultural orientation competence profiles for providing culturally and linguistically diverse (CALD) nurses with orientation in the hospital setting, and to identify which factors are associated with cultural orientation competence profiles.

Design

A descriptive, explorative cross‐sectional study.

Methods

Data were collected from December 2020 to January 2021 using the Preceptors' Orientation Competence Instrument (POCI) and Preceptors' Cultural Orientation Competence Instrument (POCCI). A total of 844 registered nurses from one university hospital district in Finland participated, reflecting a response rate of 10%. A K‐means cluster algorithm was employed to identify different cultural orientation competence profiles.

Results

The cluster analysis identified three cultural orientation competence profiles (A, B and C). Nurses in Profile A evaluated their cultural orientation competence the highest, with members of profiles B and C demonstrating the second highest and lowest, respectively, cultural orientation competence scores. Several factors were associated with cultural orientation competence profiles, namely, orientation education and student mentoring education, support from managers and colleagues, motivation, willingness to act as a preceptor, time to provide orientation, sufficient clinical and theoretical nursing skills and current work title.

Conclusion

Cultural diversity and acceptance of it can be enhanced by building accepting culture towards new incomers and offering continuing education to improve the cultural competence of staff, which can further benefit patient care of CALD patients. Orientation practices can be improved by rewarding staff and building collaborative teamwork culture.

Implications for Profession and/or Patient Care

Organizations can strengthen nurses' cultural orientation competence; for example, by providing adequate orientation education and allocating more time to the orientation process.

Reporting Method

The STROBE criteria were used to report the results of the observations critically.

Patient or Public Contribution

No patient or public contribution.
Tailored ablation index based on left atrial wall thickness assessed by computed tomography for pulmonary vein isolation in patients with atrial fibrillation
Authors: Lee So‐Ryoung , Park Hyoung‐Seob , Kwon Soonil , Choi Eue‐Keun , Oh Seil
Published: August 2023

Introduction

Although left atrial wall thickness (LAWT) is known to be varied, a fixed target Ablation Index (AI) based pulmonary vein isolation (PVI) has been suggested in catheter ablation for atrial fibrillation (AF). We aimed to evaluate the efficacy and safety of PVI applying tailored AI based on LAWT assessed by cardiac computed tomography (CT).

Methods

The thick segment was defined as the segment including ≥LAWT grade 3 (≥1.5 mm). The fixed AI strategy was defined as AI targets were 450 on the anterior/roof segments and 350 on the posterior/inferior/carina segments regardless of LAWT. The tailored AI strategy consisted of AI increasing the targets to 500 on the anterior/roof segments and to 400 on the posterior/inferior/carina segments when ablating the thick segment. After PVI, acute pulmonary vein (PV) reconnection, defined by the composite of residual potential and early reconnection, was evaluated.

Results

A total of 156 patients (paroxysmal AF 72%) were consecutively included (86 for the fixed AI group and 70 for the tailored AI group). The tailored AI group showed a significantly lower rate of segments with acute PV reconnection than the fixed AI group (8% vs. 5%, p = .007). The tailored AI group showed a trend for shorter ablation time for PVI. One‐year AF/atrial tachycardia free survival rate was similar in two groups (87.2% in the fixed AI group and 90.0% in the tailored AI group, p = .606).

Conclusion

Applying tailored AI based on the LAWT was a feasible and effective strategy to reduce acute PV reconnection after PVI.
Efficacy of 3D‐multidetector computed tomography and fluoroscopy fusion for percutaneous left atrial appendage occlusion procedures
Authors: Carneiro Herman A. , Dallan Luis A. P. , Yoon Sung‐Han , Arora Shilpkumar , Knezevich Juliana , Wass Sojin , Lobo Tabitha , Arruda Mauricio , Rashid Imran , Filby Steven J.
Published: August 2023

Introduction

We studied the impact of the use of three‐dimensional multidetector computed tomography (3D‐MDCT) and fluoroscopy fusion on percutaneous left atrial appendage occlusion (LAAO) procedures in relation to procedure time, contrast volume, fluoroscopy time, and total radiation.

Methods

This was a single‐center, prospective, single‐blinded, randomized control trial. Patients meeting criteria for LAAO were randomized to undergo LAAO with the WATCHMAN FLXTMdevice with and without 3D‐MDCT‐fluoroscopy fusion guidance using a prespecified protocol using computed tomography angiography for WATCHMAN FLXTMsizing, moderate sedation, and intracardiac echocardiography for procedural guidance.

Results

Overall, 59 participants were randomly assigned to the fusion (n = 33) or no fusion (n = 26) groups. The median (interquartile range) age was 79 (75–83) years, 24 (41%) were female, and 55 (93%) were Caucasian. The median CHA2DS2VASc and HASBLED scores were 5 (4–6) and 3 (3–4), respectively. At the time of the study, 51 (53%) patients were on a direct acting oral anticoagulant. There were no significant differences between the fusion and no fusion groups in procedure time (52.4 ± 15.4 vs. 56.8 ± 19.5 min,p = .36), mean contrast volume used (33.8 ± 12.0 vs. 29.6 ± 11.5 mls,p = .19), mean fluoroscopy time (31.3 ± 9.9 vs. 28.9 ± 8.7 min,p = .32), mean radiation dose (1177 ± 969 vs. 1091 ± 692 mGy,p = .70), and radiation dose product curve (23.9 ± 20.5 vs. 35.0 ± 49.1 Gy cm2,p = .29). There was no periprosthetic leak in the two groups in the immediate 1‐month postprocedure follow‐up periods.

Conclusions

There was no significant difference with and without 3D‐MDCT‐fluoroscopy fusion in procedure time, contrast volume use, radiation dose, and radiation dose product.
Randomized, multicenter, parallel, open, phase 4 study to compare the efficacy and safety of rosuvastatin/amlodipine polypill versus atorvastatin/amlodipine polypill in hypertension patient with dyslipidemia
Authors: Jung Hae Won , Kim Chang‐Yeon , Hong Seung‐Pyo , Bae Han‐Joon , Choi Ji Yong , Ryu Jae Kean , Lee Jin‐bae , Lee Kyoung‐Hoon , Han Kyoo‐Rok , Yang Dong‐Heon , Park Chang‐Gyu , Yu Gheol‐Woong , Rhee Moo‐Yong , Park Sung‐Ji , Hyon Min‐Su , Shin Joon‐Han , Hong Bum‐Kee , Jin Han‐Young , Lee Sung‐Yun , Seol Sang‐Hoon , Lee Sang‐Rok , Kim Song‐Yi , Lee Kwang‐Je , Cho Eun‐Joo , Nam Chang‐Wook , Park Tae‐Ho , Kim Ung , Kim Kee‐Sik
Published: August 2023

The authors performed this study to investigate the efficacy and safety of a rosuvastatin (RSV)/amlodipine (AML) polypill compared with those of atorvastatin (ATV)/AML polypill. We included 259 patients from 21 institutions in Korea. Patients were randomly assigned to 1 of 3 treatment groups: RSV 10 mg/AML 5 mg, RSV 20 mg/AML 5 mg, or ATV 20 mg /AML 5 mg. The primary endpoint was the efficacy of the RSV 10.20 mg/AML 5 mg via percentage changes in LDL‐C after 8 weeks of treatment, compared with the ATV 20 mg /AML 5 mg. There was a significant difference in the mean percentage change of LDL‐C at 8 weeks between the RSV 10 mg/AML 5 mg and the ATV 20 mg/AML 5 mg (full analysis set [FAS]: −7.08%, 95% CI: −11.79 to −2.38,p = .0034, per‐protocol analysis set [PPS]: −6.97%, 95% CI: −11.76 to −2.19,p = .0046). Also, there was a significant difference in the mean percentage change of LDL‐C at 8 weeks between the RSV 20 mg/AML 5 mg and the ATV 20 mg/AML 5 mg (FAS: −10.13%, 95% CI: −15.41 to −4.84,p = .0002, PPS: −10.96%, 95% CI: −15.98 to −5.93,p < .0001). There was no significant difference in the adverse events rates between RSV 10 mg/AML 5 mg, RSV 20 mg/AML 5 mg, and ATV 20 mg/AML 5 mg. In conclusion, while maintaining safety, RSV 10 mg/AML 5 mg and the RSV 20 mg/AML 5 mg more effectively reduced LDL‐C compared with the ATV 20 mg /AML 5 mg (Clinical trial: NCT03951207).
Visfatin aggravates transverse aortic constriction‐induced cardiac remodelling by enhancing macrophage‐mediated oxidative stress in mice
Authors: Shen Caijie , Fang Renyuan , Wang Jian , Wu Nan , Wang Shuangsuang , Shu Tian , Dai Jiating , Feng Mingjun , Chen Xiaomin
Published: August 2023

Previous studies have reported that visfatin can regulate macrophage polarisation, which has been demonstrated to participate in cardiac remodelling. The aims of this study were to investigate whether visfatin participates in transverse aortic constriction (TAC)‐induced cardiac remodelling by regulating macrophage polarisation. First, TAC surgery and angiotensin II (Ang II) infusion were used to establish a mouse cardiac remodelling model, visfatin expression was measured, and the results showed that TAC surgery or Ang II infusion increased visfatin expression in the serum and heart in mice, and phenylephrine or hydrogen peroxide promoted the release of visfatin from macrophages in vitro. All these effects were dose‐dependently reduced by superoxide dismutase. Second, visfatin was administered to TAC mice to observe the effects of visfatin on cardiac remodelling. We found that visfatin increased the cross‐sectional area of cardiomyocytes, aggravated cardiac fibrosis, exacerbated cardiac dysfunction, further regulated macrophage polarisation and aggravated oxidative stress in TAC mice. Finally, macrophages were depleted in TAC mice to investigate whether macrophages mediate the regulatory effect of visfatin on cardiac remodelling, and the results showed that the aggravating effects of visfatin on oxidative stress and cardiac remodelling were abrogated. Our study suggests that visfatin enhances cardiac remodelling by promoting macrophage polarisation and enhancing oxidative stress. Visfatin may be a potential target for the prevention and treatment of clinical cardiac remodelling.
Subsidiarity Ex Ante and Ex Post: From the Early Warning System to the Court of Justice of the European Union
Authors: Huysmans Martijn , van den Brink Ton , van Gruisen Philippe
Published: August 2023

The subsidiarity principle divides competences between the European Union and its Member States. The Lisbon Treaty suggests a connection between ex ante and ex post subsidiarity review. Ex ante, national parliaments were given a role via the early warning system (EWS). Ex post, legislation is subject to review by the Court of Justice of the European Union (CJEU). More than 10 years after Lisbon, this article is the first to theorize and evaluate whether there is indeed a connection. Our theory predicts a conditional connection. Quantitatively, we provide a two‐way classification of Member States based on their use of the EWS and CJEU subsidiarity cases. Qualitatively, we look back from court cases to the Council stage and analyse the Advocate General's opinions in subsidiarity cases. We find a weak conditional connection. A key explanation appears to be the Court's limited willingness to enforce subsidiarity and hence the limited incentives to go to court.
Sun exposure behaviours as a compromise to paradoxical injunctions: Insight from a worldwide survey
Authors: Passeron Thierry , Lim Henry W. , Goh Chee Leok , Kang Hee Young , Ly Fatimata , Morita Akimichi , Ocampo‐Candiani Jorge , Puig Susana , Schalka Sergio , Liu Wei , Demessant‐Flavigny Anne‐Laure , Le Floc’h Caroline , Kerob Delphine , Dreno Brigitte , Krutmann Jean
Published: August 2023

Background

Behavioural interventions can improve attitudes towards sun protection but the impact remains inconsistent worldwide.

Objective

To assess awareness of and attitudes towards the multiple facets of sun exposure and suggest ways to improve prevention from overexposure to the sun in all geographical zones and multiple skin types.

Methods

Online survey was conducted from 28 September to 18 October 2021. Study population was selected from the Ipsos online Panel (3,540,000 panellists), aged ≥18 years, from 17 countries around the five continents. Demographics, sun‐exposure habits and practices, understanding of risks and information on phototypes were documented and analysed using descriptive statistics.

Results

Eighty‐eight per cent of participants knew that sunlight can cause skin health problems (90% phototypes I‐II, 82% phototypes V‐VI, >90% in American and European countries, 72% in Asia and 85% in Africa). Eighty‐five per cent used some form of protection against sunlight, predominantly: Seeking shade (77%), avoiding the midday sun (66%), facial application of sunscreen (60%) and wearing protective clothing (44%). The perception of sunlight itself is positive (‘it gives energy’ for 82%; ‘tanned skin looks attractive’ for 72%), although less in Asian countries and among individuals with dark skin phototypes. Eighty‐three per cent reported having experienced sunburn, mainly in Australia, Canada, USA, Germany, France and Russia, and among individuals with dark skin phototypes. Only 12% systematically/often used all types of protection during exposure to the sun and 23% believed it is safe to go out in the sun with no protection when their skin is already tanned. From 13% (skin phototype I) to 26% (phototype VI) reported not using any form of protection against the sun. Knowledge and habits were significantly superior among people who are accustomed to seeing a dermatologist for a complete skin exam.

Conclusions

Dermatologists could play a crucial role in relaying novel prevention messages, more finely tailored to specific risks, populations and areas of the world.
Fast, bedside diagnosis of toxic epidermal necrolysis using ex vivo confocal laser scanning microscopy: A retrospective study
Authors: Tonellotto L. , Seremet T. , Vernez M. , Guenova E. , Kuonen F.
Published: August 2023

Background

Toxic epidermal necrolysis (TEN) is a severe life‐threatening drug eruption with rapid evolution. A fast histologic differentiation between TEN and clinically similarly looking staphylococcal scalded skin syndrome is of vital importance for relevant treatment decision. The recently developed ex vivo confocal laser scanning microscopy (CLSM) offers innovative and extremely fast histological visualization of fresh tissue specimens.

Objective

To assess the diagnostic efficacy of ex vivo CLSM in comparison with standard histopathology for TEN.

Methods

We performed side‐by‐side comparison of TEN specimens analysed with ex vivo CLSM and haematoxylin and eosin staining. Analysis focused on typical histopathological features of TEN, including epidermal cleavage in the basal layer and confluent epidermal necrosis. We retrospectively assessed the diagnostic performance of ex vivo CLSM for TEN in clinically confirmed cases.

Results

We report substantial agreement between ex vivo CLSM and classical histology for the detection of subepidermal cleavage and confluent epidermal necrosis. When considering full‐thickness epidermal loss, epidermal cleavage in the basal layer showed the highest diagnostic performance, reaching 87.5% sensitivity and 100% specificity.

Conclusion

Based on our data, ex vivo CSLM appears as a rapid, resource‐optimizing, and reliable approach for morphological TEN emergency screening on fresh skin samples.
The safety of systemic Janus kinase inhibitors in atopic dermatitis: A systematic review and meta‐analysis of randomized controlled trials
Authors: Yoon Sanghyuk , Kim Kihun , Shin Kihyuk , Kim Hoon‐Soo , Kim Byungsoo , Kim Moon‐Bum , Ko Hyun‐Chang , Kim Yun Hak
Published: August 2023

Janus kinase (JAK) inhibitors have been recently approved by the FDA and are widely used in the treatment of patients with atopic dermatitis. However, a comprehensive safety profile of JAK inhibitors in patients with atopic dermatitis has not been analysed. This study aimed to establish clinical evidence for the safety of systemic JAK inhibitors in patients with atopic dermatitis. Medline, Embase, Clinicaltrials.gov, Cochrane Central Register of Controlled Trials (CENTRAL) and International Clinical Trials Registry Platform (ICTRP) were considered for search databases. Randomized controlled trials reporting the adverse events of systemic therapy in patients with atopic dermatitis were included. The risk of 11 adverse events was compared between the JAK inhibitors and placebo groups. Fourteen randomized controlled trials were analysed published between 2019 and 2022. The JAK inhibitors included in the analysis were abrocitinib (10, 30, 100 and 200 mg), baricitinib (1, 2 and 4 mg) and upadacitinib (7.5, 15 and 30 mg). The risk of herpes zoster, headache, acne, elevated blood creatinine phosphokinase and nausea was significantly increased, but the risk of serious infection, non‐melanoma skin cancer (NMSC), malignancies other than NMSC, major adverse cardiovascular event, venous thromboembolism and nasopharyngitis was not increased. This study provides comprehensive clinical evidence on the risk of various adverse events in patients with atopic dermatitis. However, since the follow‐up periods of the studies analysed in this review were mostly limited to 16 weeks or less, it is recommended that comprehensive long‐term observational studies be conducted to determine any potential adverse events associated with major cardiovascular events or malignancies, which typically have prolonged courses.
Environmental effects rather than relatedness determine gut microbiome similarity in a social mammal
Authors: Bensch Hanna M. , Lundin Daniel , Tolf Conny , Waldenström Jonas , Zöttl Markus
Published: August 2023

In social species, group members commonly show substantial similarity in gut microbiome composition. Such similarities have been hypothesized to arise either by shared environmental effects or by host relatedness. However, disentangling these factors is difficult, because group members are often related, and social groups typically share similar environmental conditions. In this study, we conducted a cross-foster experiment under controlled laboratory conditions in group-living Damaraland mole-rats (Fukomys damarensis) and used 16S amplicon sequencing to disentangle the effects of the environment and relatedness on gut microbiome similarity and diversity. Our results show that a shared environment is the main factor explaining gut microbiome similarity, overshadowing any effect of host relatedness. Together with studies in wild animal populations, our results suggest that among conspecifics environmental factors are more powerful drivers of gut microbiome composition similarity than host genetics.

Abstract

Why are gut microbiomes of group members often more similar than non-group members? Is the shared evironment or host relatedness more influential in shaping gut microbiome of social hosts? In this study, we show that the environment overshadowes host relatedness in explaining gut microbiome similarity of experimentally cross-fostered social mole-rats.
Soft selection reduces loss of heterozygosity in asexual reproduction
Authors: Archetti Marco
Published: August 2023

The adaptive value of sexual reproduction is still debated in evolutionary theory. It has been proposed that the advantage of sexual reproduction over asexual reproduction is to promote genetic diversity, to prevent the accumulation of harmful mutations or to preserve heterozygosity. Since these hypothetical advantages depend on the type of asexual reproduction, understanding how selection affects the taxonomic distribution of each type could help us discriminate between existing hypotheses. Here, I argue that soft selection, competition among embryos or offspring in selection arenas prior to the hard selection of the adult phase, reduces loss of heterozygosity in certain types of asexual reproduction. Since loss of heterozygosity leads to the unmasking of recessive deleterious mutations in the progeny of asexual individuals, soft selection facilitates the evolution of these types of asexual reproduction. Using a population genetics model, I calculate how loss of heterozygosity affects fitness for different types of apomixis and automixis, and I show that soft selection significantly reduces loss of heterozygosity, hence increases fitness, in apomixis with suppression of the first meiotic division and in automixis with central fusion, the most common types of asexual reproduction. Therefore, if sexual reproduction evolved to preserve heterozygosity, soft selection should be associated with these types of asexual reproduction. I discuss the evidence for this prediction and how this and other observations on the distribution of different types of asexual reproduction in nature is consistent with the heterozygosity hypothesis.

Abstract

Competition among offspring promotes the types of asexual reproduction that produce offspring with variation in loss of complementation.
Isotopic‐based evidence for reduced benthic contributions to fish after a whole‐lake addition of nanosilver
Authors: Ripku Tyler , Hayhurst Lauren , Metcalfe Chris D. , Rennie Michael
Published: August 2023

Silver nanoparticles (AgNPs) are added as antibacterial and anti‐odor agents to a wide range of textiles, with high potential for release into aquatic environments via domestic wastewater. Previous work demonstrating the negative impacts of AgNP exposure on periphyton production suggests benthic primary production could be reduced in aquatic ecosystems impacted by AgNP discharge. To evaluate the potential for AgNPs to alter benthic–pelagic coupling in aquatic ecosystems, tissue‐stable isotope ratios of carbon and nitrogen from northern pike (Esox lucius) and yellow perch (Perca flavescens) were measured before, during, and after the addition of AgNPs to a whole‐lake ecosystem, and compared to those collected from a nearby reference lake. A shift in carbon isotope ratios toward more negative values was observed in both P. flavescens and E. lucius collected from the lake where AgNPs were added, with no shift in similar magnitude observed in E. lucius from the reference lake. Consequently, Bayesian estimates of benthic energy consumed decreased by 32% for P. flavescens and by 40% for E. lucius collected after AgNP additions relative to pre‐addition estimates, greater in magnitude or opposite in direction of trends observed in our reference lake. Analyses suggest no changes in fish nitrogen isotope ratios related to AgNP additions. We hypothesize that the observed reduction in littoral energy use of fish reported here is a response to AgNP settling in littoral benthic habitats—the main habitat in lakes supporting periphyton—as AgNP has been shown elsewhere to significantly reduce the rates of periphyton production. Further, our study highlights the need to broaden the scope of risk assessments for AgNPs and other emerging contaminants prone to settling to consider habitat‐specific impacts on resource utilization by organisms after their release into aquatic ecosystems.
Interaction of total dissolved gas supersaturation and suspended sediment on swimming performance of bighead carp (Hypopthalmichthys nobilis)
Authors: Zhang Qiyu , Liu Xiaoqing , Shi Haoran , Yang Yao
Published: August 2023

When dams discharge floodwaters, the river downstream often becomes supersaturated in total dissolved gases (TDG) and contains high volumes of suspended sediments (SS). Supersaturated TDG and high SS concentrations in water may affect fish physiologically in ways that manifest in swimming performance. Despite increasing awareness of the separate effects of TDG supersaturation and SS, knowledge about their synergistic effects remains unknown. To explore the interactive effects of TDG and SS on the swimming performance of bighead carp, the juveniles were exposed to 100, 110, 115, 120, 125, 130, 135, and 140% of TDG‐supersaturated water with SS concentrations of 0, 50, 100, and 150 mg/L, respectively, and the critical swimming ability speed (Ucrit) and burst swimming ability speed (Uburst) were measured. The results indicated that the swimming ability (Ucrit and Uburst) decreased when TDG levels and SS concentrations increased. TDG and SS did not interact significantly to decrease both Ucrit and Uburst. In contrast, exposure to TDG alone significantly decreased both Ucrit and Uburst, whereas exposure to SS alone decreased only Uburst. In addition, our results suggested that there was a negative linear relationship between TDG and fatigue time. Swimming ability can decline significantly due to high TDG levels (>130%). Therefore, high TDG levels (>130%) should be restricted during reservoir operation to prevent the stress caused by TDG.