bluuebunny/crossref_metadata_2025 huggingface dataset:
Navigating the grey: Experiences of incremental cannabis reform in Australia
Authors: Barrett Liz , Mellor Richard , Ritter Alison , McLauchlan Laura , Kearnes Matthew
Published: August 2022

Introduction and Aims

There have been many changes to cannabis laws across the globe, some dramatic but more often incremental. This study explored the experiences after an incremental cannabis law reform in the Australian Capital Territory, Australia.

Method

Semi‐structured interviews (n = 30) were conducted in March and April 2021, 14 months after the introduction of cannabis law reform, with people aged 18 and over who had grown and/or consumed cannabis in the previous 12 months. Participants were asked about recent and past cannabis use, growing cannabis and changes to their practices after the introduction of the legislation.

Results

Incremental cannabis law change resulted in regulatory grey areas. How people interpreted and navigated such grey areas were connected to their relative privileges, circumstances and histories. Those who were highly policed were more likely to experience the grey areas negatively. Those who were not highly policed found the grey areas confusing or ‘half‐arse’ (insufficiently executed), but mostly experienced the new laws positively through new cannabis cultivation or perceived reduction in stigma and fear of arrest. Those with self‐identified privilege were unconcerned with grey areas of the legislation.

Discussion and Conclusion

Incremental policy change can result in grey areas that require some navigation. Vulnerable populations appear less likely to experience the full benefits of such incremental drug law reform. It is vital to attend to the inequities that can arise from incremental law reform so that positive experiences are shared across the population regardless of relative privilege.
Lichen planus in Germany – epidemiology, treatment, and comorbidity. A retrospective claims data analysis
Authors: Schruf Eva , Biermann Mona HC , Jacob Josephine , Häckl Dennis , Reinhardt Maximilian , Hertl Michael , Wohlrab Johannes
Published: August 2022

Background and objectives

Lichen planus (LP) is a chronic inflammatory skin disease and is a major burden for affected patients. However, data on this condition are scarce. This study aims to expand the knowledge on the epidemiology and treatment patterns of LP using German health claims data.

Patients and Methods

This retrospective observational study was based on the InGef research database. Prevalent and incident LP patients were identified in the years 2015 and 2018. Descriptive statistics were calculated for demographic characteristics, treatment patterns, and comorbidity.

Results

The prevalence of LP was 95.9 and the incidence was 20.1 per 100,000 individuals in 2018, corresponding to 79,605 prevalent LP cases in Germany. The first LP diagnosis was generally documented by a dermatologist or a primary care physician. Three‐quarters of the incident and half of the prevalent patients received topical therapy, mostly without further systemic therapy. Comorbidity in LP patients was consistent with previously known associations.

Conclusions

Available treatment options remain limited, underscoring the unmet need for safe and efficacious systemic treatment modalities. Lichen planus is frequently accompanied by clinically relevant systemic comorbidity. Taken together, these observations may improve our understanding of the burden of this disease and increase diagnostic awareness among clinicians.
Prevalence, characteristics, and impact of adverse events in 34 Madrid hospitals. The ESHMAD study
Authors: Valencia‐Martín José L. , Vicente‐Guijarro Jorge , San Jose‐Saras Diego , Moreno‐Nunez Paloma , Pardo‐Hernández Alberto , Aranaz‐Andrés Jesús María ,   ESHMAD Director Group and external advisers
Published: August 2022

Introduction

Adverse Events (AE) are one of the main problems in healthcare. Therefore, many policies have been developed worldwide to mitigate their impact. The Patient Safety Incident Study in Hospitals in the Community of Madrid (ESHMAD) measures the results of them in the region.

Methods

Cross‐sectional study, conducted in May 2019, in hospitalised patients in 34 public hospitals using the Harvard Medical Practice Study methodology. A logistic regression model was carried out to study the association of the variables with the presence of AE, calibrated and adjusted by patient.

Results

A total of 9975 patients were included, estimating a prevalence of AE of 11.9%. A higher risk of AE was observed in patients with surgical procedures (OR[CI95%]: 2.15[1.79 to 2.57], vs. absence), in Intensive Care Units (OR[CI95%]: 1.60[1.17 to 2.17], vs. Medical) and in hospitals of medium complexity (OR[CI95%]: 1.45[1.12 to 1.87], vs. low complexity). A 62.6% of AE increased the length of the stay or it was the cause of admission, and 46.9% of AE were considered preventable. In 11.5% of patients with AE, they had contributed to their death.

Conclusions

The prevalence of AE remains similar to the previously estimated one in studies developed with the same methodology. AE keep leading to longer hospital stays, contributing to patient's death, showing that it is necessary to put focus on patient safety again. A detailed analysis of these events has enabled the detection of specific areas for improvement according to the type of care, centre and patient.
A detailed redescription of the mesoderm/neural crest cell boundary in the murine orbitotemporal region integrates the mammalian cranium into a pan‐amniote cranial configuration
Authors: Kuroda Shunya , Adachi Noritaka , Kuratani Shigeru
Published: August 2022

The morphology of the mammalian chondrocranium appears to differ significantly from those of other amniotes, since the former possesses uniquely developed brain and cranial sensory organs. In particular, a question has long remained unanswered as to the developmental and evolutionary origins of a cartilaginous nodule called the ala hypochiasmatica. In this study, we investigated the embryonic origin of skeletal elements in the murine orbitotemporal region by combining genetic cell lineage analysis with detailed morphological observation. Our results showed that the mesodermal embryonic environment including the ala hypochiasmatica, which appeared as an isolated mesodermal distribution in the neural crest‐derived prechordal region, is formed as a part of the mesoderm that continued from the chordal region during early chondrocranial development. The mesoderm/neural crest cell boundary in the head mesenchyme is modified through development, resulting in the secondary mesodermal expansion to invade into the prechordal region. We thus revealed that the ala hypochiasmatica develops as the frontier of the mesodermal sheet stretched along the cephalic flexure. These results suggest that the mammalian ala hypochiasmatica has evolved from a part of the mesodermal primary cranial wall in ancestral amniotes. In addition, the endoskeletal elements in the orbitotemporal region, such as the orbital cartilage, suprapterygoid articulation of the palatoquadrate, and trabecula, some of which were once believed to represent primitive traits of amniotes and to be lost in the mammalian lineage, have been confirmed to exist in the mammalian cranium. Consequently, the mammalian chondrocranium can now be explained in relation to the pan‐amniote cranial configuration.
Average Rank and Adjusted Rank Are Better Measures of College Student Success than GPA
Authors: Wittman Donald
Published: August 2022

I show that there are better measures of student college performance than grade point average (GPA) by undertaking a fine‐grained empirical investigation of grading within a large public university. The value of using GPA as a measure of comparative performance is undermined by academically weaker students taking courses where the grading is more generous. In fact, college courses composed of weaker performing students (whether measured by their relative performance in other classes, SAT scores, or high school GPA) have higher average grades. To partially correct for idiosyncratic grading across classes, alternative measures, student class rank and the student's average class rank, are introduced. In comparison to a student's lower‐division grade, the student's lower‐division rank is a better predictor of the student's grade in the upper‐division course. Course rank and course grade are adjusted to account for different levels of academic competitiveness across courses (more precisely, student fixed‐effects are derived). SAT scores and high school GPA are then used to predict college performance. Higher explained variation (R2) is obtained when the dependent variable is average class rank rather than GPA. Still higher explained variation occurs when the dependent variable is adjusted rank.
Current status and first detection of Xylosandrus germanus (Coleoptera: Curculionidae: Scolytinae) in live trees in the Iberian Peninsula
Authors: Riba‐Flinch Josep M. , Garreta Anna , Aymamí Anna , Lumbierres Belén , Mas Hugo , Gallego Diego
Published: August 2022

The black stem borer Xylosandrus germanus (Blandford, 1894) (Coleoptera: Curculionidae: Scolytinae) is a species native to Eastern Asia that has invaded 24 countries worldwide, including 21 European countries, the USA, Canada and New Zealand. On the Iberian Peninsula it was recorded for the first time in traps placed in the Basque Country (Northern Spain) in 2003, but its host plants were unknown. In the present work, three populations of X. germanus are recorded in the east of Spain in Girona, Tarragona and Valencia provinces (Automomous Community of Catalonia, and Valencia, respectively). Specimens were collected in traps and on host plants, showing a wider distribution range now including the east and north‐east of the Iberian Peninsula. Infested carob trees (Ceratonia siliqua) were found in agricultural and urban green areas in Tarragona. Ceratonia siliqua is therefore reported here as a new host of X. germanus.
Schopenhauer's Critique of Nationalism
Authors: Norberg Jakob
Published: August 2022

In his own era, Arthur Schopenhauer was criticized for his conspicuous lack of patriotism. The critics were correct in the sense that Schopenhauer was a lifelong anti‐nationalist in a period of rising cultural and political nationalism. This article reconstructs Schopenhauer's critique of nationalism. First, it articulates his double ethical and intellectual case against the idea of the nation as a community supposed to give shape to the allegiances and obligations of its members. Second, it turns to his critique of teleological national history, according to which nations are collective agents with a single fate. Third, it reviews his caustic criticism of the increased importance of the vernacular in scholarly communication and the early Germanist attempt to establish an exclusively German literary canon; to Schopenhauer, nationhood was not even a useful category of cultural appreciation. Through this reconstruction, Schopenhauer emerges as a fierce anti‐nationalist who systematically questioned the importance of the nation as a supposedly cohesive community of solidarity and mutual care, a unified collective political and historical subject, or even a meaningful cultural or literary phenomenon.
Improvement of Digestion and Purification Steps for the Determination of Soil Zn Isotopes by MC‐ICP‐MS
Authors: Gu Jiahui , Sun Yufang , Wu Tongliang , Zeng Zhen , Sun Qian , Liu Cun , Wang Yujun
Published: August 2022

Despite the determination of zinc (Zn) isotope in soil being undertaken by several laboratories worldwide, sample preparation steps are varied due to diverse soil properties and compositions. This paper proposes a widely applicable soil acid digestion procedure that has been thoroughly evaluated for both soil and geological reference materials. To ensure the general applicability of this method to large varieties of soil samples, synthetic multi‐element solutions of high matrix element: Zn ratios (M/Zn) were prepared by embracing all possible elemental compositions of forty‐three certified reference materials; the chemical preparation procedure was then tested and optimised using these synthetic solutions. Results show that the recovery rate of Zn could reach 99–100% after the pre‐treatment. Based on this method, the δ66/64Zn data relative to JMC‐Lyon 3‐0749L Zn of previously uncharacterised NIST reference materials (including SRM 2709a San Joaquin soil, SRM 2710a Montana Soil and SRM 2711 Montana Soil) and Chinese certified reference materials (GSS‐1a, GSS‐7a, GSS‐5, GSS‐8, GSS‐14, GSS‐18, GSS‐20, GSS‐24, GSS‐31) were measured using MC‐ICP‐MS with a range from ‐0.08‰ to 0.35‰. The Zn isotope compositions of twenty‐nine soil samples from twenty‐one provinces/municipalities across China were also analysed and were found to fall within typical ranges from ‐0.09‰ to 0.28‰. The intermediate precision of several pure Zn standard solutions was better than ± 0.05‰ (2s) over 22 months of measurement. This method and results are useful for comparison and calibration of data between laboratories as well as providing a solid reference soil dataset for future studies dealing with Zn isotopes.
Research knowledge transfer to improve the care and support of adolescents with sickle cell disease in Ghana
Authors: Poku Brenda A. , Pilnick Alison
Published: August 2022

Introduction

Effective transfer of research findings to key knowledge users, particularly in low‐ and middle‐income countries, is not always achieved, despite being a shared priority among researchers, funders, healthcare and community stakeholders and decision‐makers. A constructivist grounded theory study conducted in 2015–2019 in Ghana that explored sickle cell‐related fatigue in adolescence resulted in numerous implications for practice and policy. Peer‐reviewed funding was obtained to support disseminating these findings to relevant stakeholders.

Methods

Key steps in implementing this study dissemination project included: (1) identifying and attracting target stakeholders from healthcare and community organizations; (2) tailoring tools for communication of research findings for the stakeholder groups and (3) designing interactive workshops to facilitate knowledge sharing and uptake.

Finding

Despite the COVID‐19 pandemic, 50 healthcare and community stakeholders participated in the dissemination workshops. The dissemination activities contributed new layers of understanding to the original research findings through discussions. Through the workshops, participants identified culturally valuable and actionable recommendations that they could take forward to improve care and support for young people with sickle cell disease in Ghana. A follow‐up 6 months post the workshops indicated some positive knowledge usage and benefits.

Conclusion

This dissemination project provided a unique opportunity for researchers and stakeholders to share in the interpretation of research findings and to strategically plan recommendations to improve SCD‐focused care and support for young people in Ghana. Further research dissemination should continue to be grounded in locally generated knowledge, include systematic, long‐term evaluation of dissemination outcomes and be adequately financed.

Patient and Public Contribution

Public involvement in this study was critical to the research dissemination project. The Sickle Cell Association of Ghana (Kumasi chapter) actively supported the project's development, organization and facilitation. Parent members of the Association, the Association's executive members and volunteers, and the health professionals involved in sickle cell care at the Komfo Anokye Teaching Hospital participated in the project workshops. They contributed to the knowledge transfer and uptake.
Multifunctional risk in the adoption of innovative technological products
Authors: Scatulino Patrícia Leite da Silva , Arruda Filho Emílio José Montero
Published: August 2022

This study analyses whether the perceived risk of purchasing technological products is less influential on the process of technological adoption when this effect is moderated by the product's multifunctional category (hedonic vs. utilitarian product characteristics). Four experiments were developed according to scenarios related to the multifunctional content (level of complexity according to the product category) of the technology and the number of functionalities in the products. The perception of risk has less effect on adoption when the product characteristics are manipulated to be more utilitarian or heighten the consumer's social value. This study contributes to the theoretical understanding of which categories are less influenced by the perceived multifunctional risk of purchasing and adopting a new technology, as well as of when individual values overlap with consumers' risk perceptions. It also contributes managerially by identifying the profile of individuals who are more likely to consume innovations characterized by high complexity and functionality, and by providing guidance for the development of innovative products that prioritize utilitarian, rather than hedonic, characteristics.
Anticipation in leisure—Effects on labor‐leisure choice
Authors: Chatterjee Bibaswan , Escobar‐Posada Rolando , Monteiro Goncalo
Published: August 2022

This paper introduces the idea of a forward‐looking reference benchmark on both consumption and leisure in the context of a Ramsey–Cass–Koopmans growth model by assuming that in addition to consumption and leisure the household utility also depends on reference benchmarks of future anticipated consumption and leisure. We analyze the macrodynamic equilibrium, contrasting it to the case when the reference benchmarks are backward‐looking. We investigate if the presence of anticipation in leisure can lead to smoother jumps in labor under productivity shocks and what effect that has on the consumption adjustment at the time of shock. We present our results using numerical simulations that confirm the existence of parameter spaces where a dual anticipation model leads to smaller jumps in labor, albeit sometimes at the expense of higher consumption jumps.
Correlation of exit sites of inducible ventricular tachycardia post‐ST elevation myocardial infarction on electrophysiology study, with region of infarct
Authors: Rao Karan , Danaila Vlad , Bennett Richard G. , Turnbull Samual , Campbell Timothy , Kumar Saurabh
Published: August 2022

Background

Ventricular arrhythmia (VA) is the most common cause of sudden cardiac death post‐ST elevation myocardial infarction (STEMI). Ventricular tachycardia (VT) may be inducible in electrophysiology studies (EPS) early (<40 days) post‐STEMI. Whether it originates from the infarct site remains unknown. We examined the correlation between inducible VT and infarct location post‐STEMI.

Aims

To investigate the correlation between inducible VT and infarct location post‐STEMI.

Methods

We retrospectively analysed 46 patients from 2005 to 2017 with STEMI who underwent early programmed ventricular stimulation through EPS (>48 h post‐STEMI and <40 days from admission). Gated heart pool scans were used to visualise infarct scar regions, and VT exit sites were derived from induction 12‐lead electrocardiography. Patients were followed up for primary outcomes of recurrent VA and all‐cause mortality.

Results

Forty‐six patients were included for analysis, with 50 uniquely induced VT exit sites. Mean left ventricular ejection fraction was 30 ± 8.7% and 22% had impaired right ventricular ejection fraction. Mean time from presentation to EPS was 16 ± 31.3 days. Of the induced VT, 44 (88%) were from within scar and scar‐border regions, whereas 6 (12%) of the induced VT were found to be remote to imaging‐derived scar. Over a median follow‐up period of 75 months, 6 (13%) patients died, and 7 (15%) patients had recurrent VA. No deaths occurred in patients with remote VT.

Conclusion

The majority of early inducible post‐infarct VT arises from acute myocardial scar; however, a small portion arises from sites remote from scars with a possible focal aetiology.
A systematic review of the perceptions and attitudes of mental health nurses towards alcohol and other drug use in mental health clients
Authors: Merrick Tammy Tran , Louie Eva , Cleary Michelle , Molloy Luke , Baillie Andrew , Haber Paul , Morley Kirsten C.
Published: August 2022

Mental and substance use disorders are leading contributing factors for the Australian non‐fatal burden of disease. These disorders frequently co‐occur in the mental health population, and mental health nurses are the largest group of professionals treating dual diagnosis. A comprehensive understanding of mental health nurses' attitudes and perceptions is required to inform future implementation of dual diagnosis training programs. A systematic literature review of sources derived from electronic databases including Medline, CINAHL, SCOPUS review, and PsychINFO, along with Connected Papers. Selection criteria included a focus on mental health nurses' attitudes towards dual diagnosis of mental illness and substance use. Extracted data was qualitatively synthesized. Of the 5232 articles retrieved initially, 12 were included in the review. Four themes emerged from the synthesis: drug and alcohol use among mental health consumers (seven studies), caring for dual diagnosis consumers (eight studies), role perception (six studies), and treatment optimism (five studies). Salient beliefs included substance use as a self‐inflicted choice (71%) or a form of ‘self‐medication’ (29%); a lack of willingness to provide care (75%), or a strong commitment to care (25%); greater comfort with screening and acute medical management rather than ongoing management (83%); and pessimism about treatment effectiveness (100%). Mental health nurses' beliefs and attitudes towards dual diagnosis were often negative, which is likely to result in poor quality care and treatment outcomes. However, the lack of recent studies in this research area indicates the need for up‐to‐date knowledge that can inform the development of training programs.
Improving the properties of fish skin collagen/silk fibroin dressing by chemical treatment for corneal wound healing
Authors: Pourjabbar Bahareh , Biazar Esmaeil , Heidari Keshel Saeed , Baradaran‐Rafii Alireza
Published: August 2022

Natural biomaterials are crucial in ocular tissue engineering because they allow cells to proliferate, differentiate, and stratify while maintaining the typical epithelial phenotype. In this study, membranes as dressings were formed from silk fibroin and collagen (Co) extracted from fish skin and then modified with carbodiimide chemical cross linker in different concentrations. The samples were evaluated by different analyses such as structural, physical (optical, swelling, denaturation temperature, degradation), mechanical, and biological (viability, cell adhesion, immunocytochemistry) assays. The results showed that all membranes have excellent transparency, especially with higher silk fibroin content. Increasing the cross linker concentration and the ratio of silk fibroin to Co increased the denaturation temperature and mechanical strength and, conversely, reduced the degradation rate and cell adhesion. The samples did not show a significant difference in toxicity with increasing cross linker and silk fibroin ratio. In general, samples with a low silk fibroin ratio combined with cross linker can provide desirable properties as a membrane for corneal wound healing.
Particular body odors matter: Disgust sensitivity differs across attachment groups
Authors: Shell Amy , Blomkvist Anna , Mahmut Mehmet K.
Published: August 2022

Extensive research has highlighted how one's attachment style influences the development and maintenance of romantic relationships. Disgust is a construct that conceptually overlaps with attachment style given both include elements of behavioral avoidance. However, no previous study has examined how one's attachment style may influence disgust‐based avoidance of intimacy in romantic relationships. Therefore, the aim of the current study is to determine if adult attachment style is associated with olfactory disgust ratings towards eight body odor (BO) sources from their partner, previous partner, or others. The results revealed that disgust ratings of a partner's BO differed depending on attachment style. Specifically, the participants with a dismissing‐avoidant attachment style rated their partner's BO as more disgusting than the secure, fearful‐avoidant, or preoccupied styles. Moreover, participants with a dismissing‐avoidant attachment style rated their partner's and strangers' BO equally disgusting whereas those in the other attachment groups rated strangers' BO as more disgusting than their partner's.
Methodology for energy demand reduction of potato cold storage process
Authors: Sáenz‐Baños Mercedes , Latorre‐Biel Juan Ignacio , Martínez‐Cámara Eduardo , Jiménez‐Macías Emilio , Longo Francesco , Blanco‐Fernández Julio
Published: August 2022

In order to maintain the quality of the potatoes over time, it is necessary to store them under certain storage conditions, which minimize losses both of quality and product, preferably without using chemical treatments. Conservation chambers consume a considerable amount of energy. Between 60% and 70% of the electricity consumed is used in refrigeration. Good insulation reduces the need for cooling the potato since its optimum storage temperature for consumption is around 4–7°C and relative humidity is 85%–90%. This research studies potatoes’ cold storage process to minimize the cost in the product value chain and to ensure its competitiveness in the market. A model is developed to assess energy consumption and propose measures to reduce energy, environmental, and economic costs. All this to reduce their impact within the value chain of potato consumption.

Practical Applications

In this case study, different energy efficiency measures applied to the cold storage of potatoes have been implemented: replacement or improvement of the performance of refrigeration equipment, insulation and infiltrations in the refrigeration chamber, control of the product entry temperature, thermal conditioning through free‐cooling, improvements in lighting equipment, technical management, and supervision of facilities, and thermographic control. The set of actions implemented has allowed to obtain a reduction in energy demand, standardized through the developed reference line, by 16.41% compared to previous years.
Carbon footprinting for hospital care pathways based on routine diagnosis‐related group (DRG) accounting data in Germany: An application to acute decompensated heart failure
Authors: Zhang Xiange , Albrecht Klaus , Herget‐Rosenthal Stefan , Rogowski Wolf H.
Published: August 2022

A general framework is developed using routine German diagnosis‐related group (G‐DRG) accounting data to estimate carbon footprints of hospital care pathways in the context of patients with acute decompensated heart failure (ADHF) admitted to the Red Cross Hospital Bremen in 2018. Financial activity data encompass G‐DRG material costs from hospital accounting data submitted to the Institute for the Hospital Remuneration System. A set of seven greenhouse gases (GHGs) is included. Environmentally extended input–output emission factors (EFs) compiled by Eurostat are employed. EFs of cost modules are calculated separately considering respective emissions' intensities. Total emissions reach 72,652 kg carbon dioxide equivalent (CO2e) (nonbiogenic: 85.5%; biogenic: 14.5%) for general inpatient care throughout ADHF patient care pathways in 2018. Emissions from normal wards account for the largest proportion (74.8%) of total emissions for ADHF patients. Compared to other matched industry categories, cost‐types covered by the industry category D “electricity, steam and air conditioning supply” cause the vast majority (approximately 87%) of total emissions. GHG emissions per unit of analysis, per bed day, and per euro are estimated at 263, 32, and 0.31 kg CO2e, respectively. Although this framework is currently limited to hospitals that participate in the G‐DRG calculation scheme or apply these accounting standards on a voluntary basis, it has particular advantages that render it amenable to other contexts. It enables the calculation of emissions separately for each cost module considering its specific emission intensity, which can improve the accuracy of estimates.
Spatial and temporal specificity of neuroestradiol provision in the songbird
Authors: Saldanha Colin J.
Published: August 2022

Steroid hormones are often synthesized in multiple tissues, affect several different targets, and modulate numerous physiological endpoints. The mechanisms by which this modulation is achieved with temporal and spatial specificity remain unclear. 17β‐estradiol for example, is made in several peripheral tissues and in the brain, where it affects a diverse set of behaviors. How is estradiol delivered to the right target, at the right time, and at the right concentration? In the last two decades, we have learned that aromatase (estrogen‐synthase) can be induced in astrocytes following damage to the brain and is expressed at central synapses. Both mechanisms of estrogen provision confer spatial and temporal specificity on a lipophilic neurohormone with potential access to all cells and tissues. In this review, I trace the progress in our understanding of astrocytic and synaptic aromatization. I discuss the incidence, regulation, and functions of neuroestradiol provision by aromatization, first in astrocytes and then at synapses. Finally, I focus on a relatively novel hypothesis about the role of neuroestradiol in the orchestration of species‐specific behaviors.
Morbidly obese pregnant woman with congenital leptin deficiency: Follow‐up and obstetric outcome
Authors: Cagliyan Erkan , Ozmen Samican , Timur Hikmet T. , Ozgozen Mehmet E. , Semiz Gokcen G.
Published: August 2022

Congenital leptin deficiency is a rare congenital genetic disease. It is characterized by early‐onset, severe morbid obesity. The disease occurs due to mutations in the LEP gene. Obesity is a severe consequence of the disease. It also causes reproductive and obstetric complications. In this study, we present a 26‐year‐old pregnant case who had been previously diagnosed with congenital leptin deficiency. The pregnancy made it more difficult to regulate the metabolic changes caused by the disease. Problems were held by a multidisciplinary approach, with the contribution of endocrinology and cardiology departments. The patient gave birth to a healthy girl at the 37th week of gestation. Spontaneous pregnancy resulting in a live birth is very uncommon in women with congenital leptin deficiency. The follow‐up and treatment approaches during pregnancy and the obstetric outcome are presented with the literature.
A clinical model and nomogram for early prediction of gestational diabetes based on common maternal demographics and routine clinical parameters
Authors: Zhang Di , Zhang Sujuan , Li Guoyi , Lai Yingsi , Hao Yuan‐tao , Chen Wei‐qing , Wu Yi , Chen Chaogang , Pan Wenjing , Liu Zhao‐min
Published: August 2022

Aim

We aimed to develop a risk prediction model for gestational diabetes mellitus (GDM) based on the common maternal demographics and routine clinical variables in Chinese population.

Methods

Individual information was collected from December 2018 to October 2019 by a pretested questionnaire on demographics, medical and family history, and lifestyle factors. Multivariable logistic regression was performed to establish a predictive model for GDM by variables in pre‐ and early pregnancy. The consistency and discriminative validity of the model were evaluated by Hosmer‐Lemeshow goodness‐of‐fit testing and ROC curve analysis. Internal validation was appraised by fivefold cross‐validation. Clinical utility was assessed by decision curve analysis.

Results

Total 3263 pregnant women were included with 17.2% prevalence of GDM. The model equation was: LogitP = −11.432 + 0.065 × maternal age (years) + 0.061 × pre‐pregnancy BMI (kg/m2) + 0.055 × weight gain in early pregnancy (kg) + 0.872 × history of GDM + 0.336 × first‐degree family history of diabetes +0.213 × sex hormone usages during pre‐ or early pregnancy + 1.089 × fasting glucose (mmol/L) + 0.409 × triglycerides (mmol/L) + 0.082 × white blood cell count (109/L) + 0.669 × positive urinary glucose. Homer‐Lemeshow goodness‐of‐fit testing indicated a good consistency between predictive and actual data (p = 0.586). The area under the ROC curve (AUC) was 0.720 (95% CI: 0.697 ~ 0.744). Cross‐validation suggested a good internal validity of the model. A nomogram has been made to establish an easy to use scoring system for clinical practice.

Conclusions

The predictive model of GDM exhibited well acceptable predictive ability, discriminative performance, and clinical utilities. The project was registered in clinicaltrial.gov.com with identifier of NCT03922087.
Critical Action and Ethnic–Racial Identity: Tools of Racial Resistance at the College Transition
Authors: Mathews Channing J. , Durkee Myles , Hope Elan C.
Published: August 2022

This study examines the reciprocal relationship between critical action and ethnic–racial identity (ERI) exploration in Black college students using a longitudinal cross‐lagged model. Participants were Black students (N = 237; Mage = 18.2; 74% female) from a longitudinal study of college transition. Analyses examined the temporal ordering and directionality of associations between critical action and ERI exploration over four time points from college entry through four years of college. Critical action positively predicted ERI exploration over each year of college, and ERI exploration positively predicted critical action in a reciprocal fashion over the same years. These findings underscore theoretical assertions that critical action and ERI are intertwined in Black youths' development and provide insight into how critical action and ERI overlap beyond adolescence.
Trends and disparities in breastfeeding initiation in France between 2010 and 2016: Results from the French National Perinatal Surveys
Authors: Guajardo‐Villar Andrea , Demiguel Virginie , Smaïli Sabira , Boudet‐Berquier Julie , Pilkington Hugo , Blondel Beatrice , Salanave Benoit , Regnault Nolwenn , Pelat Camille
Published: August 2022

Breastfeeding (BF) initiation rates in French maternity units are among the lowest in Europe. After increasing for several years, they decreased between 2010 and 2016, although several maternal characteristics known to be positively associated with BF in France were more frequent. We aimed to (1) quantify adjusted trends in BF initiation rates between 2010 and 2016; (2) examine associations between BF initiation rates and newborn, maternal, maternity unit, and department‐level characteristics. Using data from the 2010 (n = 12,224) and 2016 (n = 11,089) French National Perinatal Surveys, we analysed BF initiation (exclusive, mixed, and any) through a succession of six mixed‐effect multinomial regression models, progressively adding adjustment covariates. Adjusted exclusive and any BF initiation rates decreased by 9.6 and 4.5 points, respectively, versus by 7.7 and 1.8 points, respectively, in the crude analysis. In both years, adjusted exclusive and any BF initiation rates were lowest in the following categories of mothers: low education level, single, high body mass index and multiple or premature births. Exclusive BF initiation decreased most in primiparous mothers, those with the lowest household income, mothers that had a vaginal delivery, women born in an African country and those who delivered in a maternity unit without Baby‐Friendly Hospital Initiative designation. The 2010–2016 decrease in BF initiation rates in France cannot be explained by changes in mothers' characteristics; quite the opposite, adjustment increased its magnitude. Additional efforts should be put in place to understand why this decrease is particularly sharp in some subgroups of mothers.
Positive selection and heat‐response transcriptomes reveal adaptive features of the Brassicaceae desert model, Anastatica hierochuntica
Authors: Eshel Gil , Duppen Nick , Wang Guannan , Oh Dong‐Ha , Kazachkova Yana , Herzyk Pawel , Amtmann Anna , Gordon Michal , Chalifa‐Caspi Vered , Oscar Michelle Arland , Bar‐David Shirli , Marshall‐Colon Amy , Dassanayake Maheshi , Barak Simon
Published: August 2022

Plant adaptation to a desert environment and its endemic heat stress is poorly understood at the molecular level. The naturally heat‐tolerant Brassicaceae species Anastatica hierochuntica is an ideal extremophyte model to identify genetic adaptations that have evolved to allow plants to tolerate heat stress and thrive in deserts.

We generated an A. hierochuntica reference transcriptome and identified extremophyte adaptations by comparing Arabidopsis thaliana and A. hierochuntica transcriptome responses to heat, and detecting positively selected genes in A. hierochuntica.

The two species exhibit similar transcriptome adjustment in response to heat and the A. hierochuntica transcriptome does not exist in a constitutive heat ‘stress‐ready’ state. Furthermore, the A. hierochuntica global transcriptome as well as heat‐responsive orthologs, display a lower basal and higher heat‐induced expression than in A. thaliana. Genes positively selected in multiple extremophytes are associated with stomatal opening, nutrient acquisition, and UV‐B induced DNA repair while those unique to A. hierochuntica are consistent with its photoperiod‐insensitive, early‐flowering phenotype.

We suggest that evolution of a flexible transcriptome confers the ability to quickly react to extreme diurnal temperature fluctuations characteristic of a desert environment while positive selection of genes involved in stress tolerance and early flowering could facilitate an opportunistic desert lifestyle.
Effect of 1% malic acid spray on diabetes mellitus‐induced xerostomia: A randomized clinical trial
Authors: Muhamed Shaimaa A. , Moussa Eglal M. , Aboasy Noha K. , Gaweesh Yasmin Y.
Published: August 2022

Objective

To evaluate the effectiveness of topical sialogogue spray containing 1% malic acid in the treatment of xerostomia in patients with type 2 diabetes mellitus.

Material and Methods

A randomized double‐blind controlled clinical trial was conducted on 52 patients with type 2 diabetes mellitus suffering from xerostomia. Patients were assigned equally to test group who received a topical sialogogue spray containing 1% malic acid and control group who received a placebo spray. Both groups were instructed to use the spray on demand for 2 weeks. The Summated Xerostomia Inventory‐Dutch Version questionnaire (SXI‐D) and the unstimulated salivary flow rate were evaluated for all patients at baseline, 2 and 4 weeks after malic acid/placebo application.

Results

At 2 week's follow‐up, the unstimulated salivary flow rate increased significantly from 0.059 ± 0.024 to 0.191 ± 0.064 and from 0.055 ± 0.026 to 0.078 ± 0.032 for test and control groups, respectively, with a statistically significant difference favoring the test group. SXI‐D scores showed a significant decrease from 10.73 ± 2.22 to 8.38 ± 2.28 in the test group (p < 0.05), while in the control group it decreased from 10.62 ± 1.75 to 10.23 ± 1.48 (p > 0.05).

Conclusion

A sialogogue spray containing 1% malic acid increased the unstimulated salivary flow rate in patients with type 2 diabetes mellitus suffering from xerostomia.
Systemic immune‐inflammation index in patients with generalized stage III grade C periodontitis
Authors: Mishra Supriya , Johnson Lynn , Gazala M. P. , Dahiya Sheetal , Rahman Waheda , Sreeraj V. S.
Published: August 2022

Objectives

Systemic immune‐inflammation index (SII) is a novel, inflammatory biomarker whose role in predicting several chronic systemic diseases has been recently identified. However, its association with generalized stage III grade C periodontitis in young adults remains unknown.

Material and Methods

The study is a multicentered, double‐blind, hospital‐based case–control clinical study. Periodontal examination comprised of recording plaque index, sites with bleeding on probing, pocket depth and clinical attachment loss for patients with generalized stage III grade C periodontitis and periodontally healthy group. Complete blood counts were obtained and used for calculating SII, neutrophil‐lymphocyte ratio (NLR) and platelet‐lymphocyte ratio. Collected data were then subjected to statistical analyses.

Results

SII was significantly higher in patients with generalized stage III grade C periodontitis compared to periodontally healthy individuals (723.87 vs. 537.74 × 109/L, p < 0.0001). SII is associated with severe periodontitis in young adults (odds ratio [OR]:11.86, 95% CI 9.61–20.76, p < 0.0001) after adjusting for factors found significant in univariate analysis. Receiver operative curve analysis demonstrated a fair predictive validity of SII in detecting generalized stage III grade C periodontitis in young adults (AUC: 0.766, 95%CI 0.731–0.799, p < 0.0001, sensitivity 81.27%, specificity 76.50% and diagnostic accuracy 78.89%). SII did not exhibit superior predictive validity when compared with NLR in the context of generalized stage III grade C periodontitis (AUC for SII: 0.766, 95%CI 0.731–0.799, AUC for NLR: 0.788, 95% CI 0.754–0.819; p = 0.28).

Conclusion

SII is associated with generalized stage III grade C periodontitis in young adults.
Effect of Tranexamic Acid on Blood Management during a High Tibial Osteotomy: A Systematic Review and Meta‐analysis
Authors: Fang Qian , Zhang Zhen , Wang Dong , Wang Limin , Xiong Wei , Tang Yunfeng , Liu Wenzheng , Wang Guanglin
Published: August 2022

This study aimed to evaluate the efficiency and safety of tranexamic acid for blood management during high tibial osteotomy (HTO). A systematic search was conducted in Medline, Embase, and the Cochrane library database. Six studies and 208 patients were included in this meta‐analysis using Review Manager V.5.3 and Stata 15.1 software. For primary outcomes, tranexamic acid lowered the total blood loss (WMD = –219.47, 95% CI [−355.61, −83.33], P = 0.002). For secondary outcomes, a significant reduction was found for decreased hemoglobin (POD1: WMD = –9.86, 95% CI [−13.45, −6.28], P < 0.05; POD2: WMD = –8.41, 95% CI [−11.50, −5.32], P < 0.05; POD5: WMD = –11.48, 95% CI [−14.56, −8.39], P < 0.05) and drainage (total: WMD = –105.93, 95% CI [−187.08, −24.78], P < 0.05; POD1: WMD = –122.195, 95% CI [−168.902, −75.488], P < 0.05). The sex difference (male/female ratio) was determined (total blood loss: P = 0.025; total drainage amount: p = 0.018) using meta‐regression analysis. Females benefited more from tranexamic acid in terms of total blood loss (M/F > 40%: WMD = –53.11, 95% CI [−100.16, −6.05], P = 0.03; 40% ≥ M/F ≥ 20%: WMD = –362.20, 95% CI [−423.96, −300.45], P < 0.05; M/F < 20%: WMD = –263.00, 95% CI [−277.17, −248.83], P < 0.05) and total drainage (M/F > 40%: WMD = –7.11, 95% CI [−10.75, −3.47], P < 0.05; 40% ≥ M/F ≥ 20%: WMD = –104.72, 95% CI [−155.36, −54.08], P < 0.05; M/F < 20%: WMD = –222.00, 95% CI [−297.42, −146.58], P < 0.05). No significant differences were found for drainage on POD2 and POD3, wound complications, orthromboembolic events. In conclusion, tranexamic acid is effective and safe for blood management during HTO. Females appeared to benefit more from it, and an additional postoperative dose is suggested fora better effect.
The Toxicity and Antibacterial Effects of Povidone‐Iodine Irrigation in Fracture Surgery
Authors: Wang Dong , Huang Xinli , Lv Wenrui , Zhou Junlin
Published: August 2022

Objective

Surgical site infection is a common complication of surgery, especially in orthopedics. Povidone‐Iodine (PI) is one of the oldest and most commonly used disinfectants in surgery. However, the toxicity and antimicrobial effect of PI have not been discussed. In addition, no study has explored the optimum PI concentration for sterilization and tissue healing. This study explores the germicidal efficacy of different concentrations PI, in addition, the toxicity and antibacterial effects of PI irrigation in fracture surgery are also discussed.

Methods

Methicillin‐resistant Staphylococcus aureus and Pseudomonas aeruginosa (P. aeruginosa) were used to evaluate the germicidal efficacy of PI in vitro and in vivo. In vitro, the effects of PI on bacterial growth were analyzed. 2.5%, 1.25%, 0.5%, 0.25%, 0.05%, 0.025%, 0.005%, 0.0025% and 0% PI was added into the bacterial suspension, besides, the bacterial algebra and growth rate were tested. Meanwhile, the fluorescence intensity of viable bacteria was also tested to evaluate the effects of PI on bacterial survival. In vivo, first, femoral fracture with wound infection rat models were established. Second, thyroid gland sections, blood thyroxine, urinary iodine, wound local skin, muscle and bone tissue sections, serum creatinine and alanine aminotransferase, serum and bone local tissue interleukin‐6 (IL‐6), interleukin‐10 (IL‐10), bone morphogenetic protein (BMP‐2), vascular endothelial growth factor (VEGF) and transforming growth factor (TGF‐β1) were detected in rat femoral shaft fracture model with 5%, 2.5%, 0.5%, 0.05%, and 0% PI irrigation. Third, tissue bacteria culture was tested in rat femoral fracture with wound infection model with different concentrations PI irrigation.

Results

In vitro, 2.5%, 1.25%, 0.5% PI inhibited the growth of bacteria. 1.25%, 0.5% PI killed all the bacteria, while 0.25%, 0.05% PI had not killed bacteria after about 10 min. The iodine absorption of 5%, 2.5%, 0.5% PI irrigation did not cause thyroid injury. The 5%, 2.5%, 0.5% PI irrigation did not make serum creatinine and alanine aminotransferase abnormal and can remove bacteria from wounds. The 0.5%, 2.5% PI irrigation can promote tissue healing and increase BMP‐2, VEGF, TGF‐β1, IL‐10, in addition, decrease IL‐6. 5% PI irrigation would inhibit tissue healing, and increase IL‐6, decrease BMP‐2, VEGF, TGF‐β1, IL‐10.

Conclusions

Povidone‐Iodine was a widely used disinfectant and 2.5%, 1.25% and 0.5% PI could effectively kill bacteria. Five percent and lower concentration PI irrigation was safe and could not cause thyroid, kidney and liver damage. The 0.5% PI irrigation was beneficial for tissue healing but 5% PI irrigation was the opposite.
Recurrent haploid selection in a population of sweet corn (Zea mays convar. saccharata)
Authors: Aichholz Charlotte , Becker Heiko C. , Horneburg Bernd
Published: August 2022

Recurrent haploid selection is based on the phenotype of haploid plants. This selection method was reported to be very effective because of the high selection pressure. The aim of this study was to quantify the effect of five generations of recurrent haploid selection on a sweet corn population developed by intercrossing 40 hybrid cultivars. We compared the initial population, five cycles of recurrent haploid selection, and mass selection after five cycles in six environments. The results indicated that recurrent haploid selection had no positive effect on yield or quality. For the traits tillering, tip fill, total yield and total number of ears, significant changes from cycle to cycle were observed but in differing directions. The performance per se of single haploid plants has probably a low correlation to their combining ability in a population. Positive mass selection of the best ears resulted in no improvement of total yield, a reduction of marketable yield and about 2‐day delay of flowering. In conclusion, recurrent haploid selection based on the phenotype of individual plants was not an efficient method to improve the sweet corn population investigated.