bluuebunny/crossref_metadata_2025 huggingface dataset:
Consensus‐based recommendations for the diagnosis and treatment of anxiety and depression in children and adolescents with epilepsy: A report from the Psychiatric Pediatric Issues Task Force of the International League Against Epilepsy
Authors: Valente Kette D. , Reilly Colin , Carvalho Rachel M. , Smith Mary Lou , Mula Marco , Wirrell Elaine C. , Wilmshurst Jo M. , Jetté Nathalie , Brigo Francesco , Kariuki Symon M. , Fong Choong Yi , Wang Yuan‐Pang , Polanczyk Guilherme V. , Castanho Viviane , Demarchi Izabel G. , Auvin Stéphane , Kerr Mike
Published: September 2024

The Psychiatric Pediatric Issues Task Force of the International League Against Epilepsy (ILAE) aimed to develop recommendations for the diagnosis and treatment of anxiety and depression in children and adolescents with epilepsy. The Task Force conducted a systematic review and identified two studies that assessed the accuracy of four screening measures for depression and anxiety symptoms compared with a psychiatric interview. Nine studies met the eligibility criteria for treatment of anxiety and depressive disorders or symptoms. The risk of bias and certainty of evidence were assessed. The evidence generated by this review followed by consensus where evidence was missing generated 47 recommendations. Those with a high level of agreement (≥80%) are summarized. Diagnosis: (1) Universal screening for anxiety and depression is recommended. Closer surveillance is recommended for children after 12 years, at higher risk (e.g., suicide‐related behavior), with subthreshold symptoms, and experiencing seizure worsening or therapeutic modifications. (2) Multiple sources of ascertainment and a formal screening are recommended. Clinical interviews are recommended whenever possible. The healthcare provider must always explain that symptom recognition is essential to optimize treatment outcomes and reduce morbidity. (3) Questioning about the relationship between symptoms of anxiety or depression with seizure worsening/control and behavioral adverse effects of antiseizure medications is recommended. Treatment: (1) An individualized treatment plan is recommended. (2) For mild depression, active monitoring must be considered. (3) Referral to a mental health care provider must be considered for moderate to severe depression and anxiety. (4) Clinical care pathways must be developed. (5) Psychosocial interventions must be tailored and age‐appropriate. (6) Healthcare providers must monitor children with epilepsy who are prescribed antidepressants, considering symptoms and functioning that may not improve simultaneously. (7) Caregiver education is essential to ensure treatment adherence. (8) A shared‐care model involving all healthcare providers is recommended for children and adolescents with epilepsy and mental health disorders. We identified clinical decisions in the management of depression and anxiety that lack solid evidence and provide consensus‐based guidance to address the care of children and adolescents with epilepsy.
Influence of infill pattern and layer height on surface characteristics and fatigue behavior of FFF‐printed PEEK
Authors: Greco Alessandro , De Luca Alessandro , Gerbino Salvatore , Lamanna Giuseppe , Sepe Raffaele
Published: September 2024

PolyEther Ether Ketone (PEEK) is a leading thermoplastic biomaterial renowned for its exceptional overall properties and suitability for processing via Fused Filament Fabrication (FFF) Additive Manufacturing (AM). Despite its widespread use in industries, its fatigue behavior remains a critically underexplored aspect. This study aims to investigate the fatigue behavior of FFF‐produced PEEK, considering variations in infill pattern (triangular or rectilinear) and layer height (0.15 mm or 0.25 mm). Fatigue tests revealed a significant influence of the infill pattern on fatigue behavior, with the rectilinear pattern outperforming the triangular one. Layer height had a negligible effect when paired with rectilinear infill. Specimens with rectilinear patterns exhibited superior fatigue performance, achieving infinite fatigue life at maximum applied stress around 70% of ultimate tensile stress. Surface roughness assessment and fracture surface analysis at scanning electron microscope enhanced the interpretation of the results. This pioneering study lays the groundwork for future research in design for AM.
Living to Lithified: Construction and Preservation of Silicified Biomarkers
Authors: Rasmussen Kalen L. , Thieringer Patrick H. , Nevadomski Sophia , Martinez Aaron M. , Dawson Katherine S. , Corsetti Frank A. , Zheng Xin‐Yuan , Lv Yiwen , Chen Xinyang , Celestian Aaron J. , Berelson William M. , Rollins Nick E. , Spear John R.
Published: September 2024

Whole microorganisms are rarely preserved in the fossil record but actively silicifying environments like hot springs provide an opportunity for microbial preservation, making silicifying environments critical for the study of microbial life through time on Earth and possibly other planetary bodies. Yet, the changes that biosignatures may undergo through lithification and burial remain unconstrained. At Steep Cone Geyser in Yellowstone National Park, we collected microbial material from (1) the living system across the active outflows, (2) the silicified areas adjacent to flows, and (3) lithified and buried material to assess the preservation of biosignatures and their changes across the lithification transect. Five biofabrics, built predominantly by Cyanobacteria Geitlerinema, Pseudanabaenaceae, and Leptolyngbya with some filamentous anoxygenic phototrophs contributions, were identified and tracked from the living system through the process of silicification/lithification. In the living systems, δ30Si values decrease from +0.13‰ in surficial waters to −2‰ in biomat samples, indicating a kinetic isotope effect potentially induced by increased association with actively growing biofabrics. The fatty acids C16:1 and iso‐C14:0 and the hydrocarbon C17:0 were disentangled from confounding signals and determined to be reliable lipid biosignatures for living biofabric builders and tenant microorganisms. Builder and tenant microbial biosignatures were linked to specific Cyanobacteria, anoxygenic phototrophs, and heterotrophs, which are prominent members of the living communities. Upon lithification and burial, silicon isotopes of silicified biomass began to re‐equilibrate, increasing from δ30Si −2‰ in living biomats to −0.55‰ in lithified samples. Active endolithic microbial communities were identified in lithified samples and were dominated by Cyanobacteria, heterotrophic bacteria, and fungi. Results indicate that distinct microbial communities build and inhabit silicified biofabrics through time and that microbial biosignatures shift over the course of lithification. These findings improve our understanding of how microbial communities silicify, the biomarkers they retain, and transitionary impacts that may occur through lithification and burial.
Climate change and deer in boreal and temperate regions: From physiology to population dynamics and species distributions
Authors: Felton Annika M. , Wam Hilde Karine , Borowski Zbigniew , Granhus Aksel , Juvany Laura , Matala Juho , Melin Markus , Wallgren Märtha , Mårell Anders
Published: September 2024

Climate change causes far‐reaching disruption in nature, where tolerance thresholds already have been exceeded for some plants and animals. In the short term, deer may respond to climate through individual physiological and behavioral responses. Over time, individual responses can aggregate to the population level and ultimately lead to evolutionary adaptations. We systematically reviewed the literature (published 2000–2022) to summarize the effect of temperature, rainfall, snow, combined measures (e.g., the North Atlantic Oscillation), and extreme events, on deer species inhabiting boreal and temperate forests in terms of their physiology, spatial use, and population dynamics. We targeted deer species that inhabit relevant biomes in North America, Europe, and Asia: moose, roe deer, wapiti, red deer, sika deer, fallow deer, white‐tailed deer, mule deer, caribou, and reindeer. Our review (218 papers) shows that many deer populations will likely benefit in part from warmer winters, but hotter and drier summers may exceed their physiological tolerances. We found support for deer expressing both morphological, physiological, and behavioral plasticity in response to climate variability. For example, some deer species can limit the effects of harsh weather conditions by modifying habitat use and daily activity patterns, while the physiological responses of female deer can lead to long‐lasting effects on population dynamics. We identified 20 patterns, among which some illustrate antagonistic pathways, suggesting that detrimental effects will cancel out some of the benefits of climate change. Our findings highlight the influence of local variables (e.g., population density and predation) on how deer will respond to climatic conditions. We identified several knowledge gaps, such as studies regarding the potential impact on these animals of extreme weather events, snow type, and wetter autumns. The patterns we have identified in this literature review should help managers understand how populations of deer may be affected by regionally projected futures regarding temperature, rainfall, and snow.
Global suitability and spatial overlap of land‐based climate mitigation strategies
Authors: Beaury Evelyn M. , Smith Jeffrey , Levine Jonathan M.
Published: September 2024

Land‐based mitigation strategies (LBMS) are critical to reducing climate change and will require large areas for their implementation. Yet few studies have considered how and where LBMS either compete for land or could be deployed jointly across the Earth's surface. To assess the opportunity costs of scaling up LBMS, we derived high‐resolution estimates of the land suitable for 19 different LBMS, including ecosystem maintenance, ecosystem restoration, carbon‐smart agricultural and forestry management, and converting land to novel states. Each 1 km resolution map was derived using the Earth's current geographic and biophysical features without socioeconomic constraints. By overlaying these maps, we estimated 8.56 billion hectares theoretically suitable for LBMS across the Earth. This includes 5.20 Bha where only one of the studied strategies is suitable, typically the strategy that involves maintaining the current ecosystem and the carbon it stores. The other 3.36 Bha is suitable for more than one LBMS, framing the choices society has among which LBMS to implement. The majority of these regions of overlapping LBMS include strategies that conflict with one another, such as the conflict between better management of existing land cover types and restoration‐based strategies such as reforestation. At the same time, we identified several agricultural management LBMS that were geographically compatible over large areas, including for example, enhanced chemical weathering and improved plantation rotations. Our analysis presents local stakeholders, communities, and governments with the range of LBMS options, and the opportunity costs associated with scaling up any given LBMS to reduce global climate change.
Release of a “forever material” from end‐of‐life boats and glass‐reinforced composite boats is pervasive and entering food chains
Authors: Ciocan Corina , Jha Kethan , Annels Claude , Kozloski Rachel , Steyl Ilse , Bray Simon
Published: September 2024

Building boats of sufficient strength and durability to withstand the harsh water environment has always been a challenge. Composites, particularly glass‐reinforced plastic (GRP), historically provided one of the best low maintenance solutions. Over the past 80 years, GRP boats have become a mainstay of the boating industry while little attention has been given to the consequences of GRP degradation, lack of recycling solutions, and boat abandonment. This paper highlights the widespread glass fiber pollution and alarming levels of glass microparticles entering aquatic food chains. Prospective legal and policy measures are, therefore, required to manage risks to human and marine life.
The Right to Rehabilitation for People With Dementia: A Codesign Approach to Barriers and Solutions
Authors: Layton Natasha , Devanny Catherine , Hill Keith , Swaffer Kate , Russell Grant , Low Lee‐Fay , Lee Den‐Ching A. , Cations Monica , Skouteris Helen , MC O'Connor Claire , Collyer Taya A. , Neves Barbara Barbosa , Andrew Nadine E. , Haines Terry , Srikanth Velandai K. , Petersen Alan , Callisaya Michele L.
Published: September 2024

Introduction

People with dementia of all ages have a human right to equal access to quality health care. Despite evidence regarding its effectiveness, many people living with dementia are unable to access rehabilitation for promoting function and quality of life. Conducted in Australia, this study was designed to (1) explore barriers to access to dementia rehabilitation and (2) identify solutions that improve access to rehabilitation.

Methods

People living with dementia (n = 5) and care partners (n = 8) and health professionals (n = 13) were recruited nationally. Experience‐based codesign across three virtual workshops was used to understand barriers and design solutions to improve access to rehabilitation treatments. Socio‐ecological analyses, using the Levesque Access to Health care framework, were applied to findings regarding barriers and to aid selection of solutions.

Results

There was high attendance (92.3%) across the three workshops. Barriers were identified at a user level (including lack of knowledge, transport, cost and difficulty navigating the health, aged care and disability sectors) and health service level (including health professional low dementia knowledge and negative attitudes, inequitable funding models and non‐existent or fragmented services). Solutions focused on widespread dementia education and training, including ensuring that people with dementia and their care partners know about rehabilitation therapies and that health professionals, aged care and disability co‐ordinators know how to refer to and deliver rehabilitation interventions. Dementia care navigators, changes to Australia's public funding models and specific dementia rehabilitation programmes were also recommended.

Conclusions

Barriers to accessing rehabilitation for people with dementia exist at multiple levels and will require a whole‐community and systems approach to ensure change.

Patient or Public Contribution

People with living experience (preferred term by those involved) were involved at two levels within this research. A Chief Investigator living with dementia was involved in the design of the study and writing of the manuscript. People with living experience, care partners and service providers were participants in the codesign process to identify barriers and design potential solutions.
Hydrothermal corrosion behavior of CrN/Cr2N‐ZrN ceramic as a surrogate nuclear fuel
Authors: Chen Jia‐Hao , Zhu Lin‐Lin , Liao Ye‐Hong , Chen Xu‐Hui , Dong Chen‐Hao , Tan Xing‐Hao , Liu Hong‐Lan , Guo Wei‐Ming , Ren Qi‐Sen , Chen Ming‐Zhou , Lin Hua‐Tay
Published: September 2024

In this study, the hydrothermal corrosion behavior of zirconium nitride (ZrN) ceramics used as a surrogate nuclear fuel of UN, which were added with different amounts of CrN/Cr2N (0, 10, 20, and 30 vol.%), was investigated with the objective of increasing the loss‐of‐coolant accident (LOCA) tolerance of pressurized water reactor fuel. The ZrN‐based ceramic samples with a density exceeding 98% were fabricated by using a spark plasma sintering system at 1700°C and applied stress of 30 MPa. Following 30 min of hydrothermal corrosion at 300°C, the oxidation layer thickness of pure ZrN ceramics was 9.11 ± 1.96 µm, whereas that of 30 vol.% CrN/Cr2N‐ZrN was only 1.23 ± 0.3 µm, which indicated that CrN/Cr2N offered an excellent protection effect for ZrN. This work can, thus, provide engineering design guidance for the UN with high uranium density to increase the LOCA tolerance of current nuclear power generation systems.
Enthalpy relaxation of sodium aluminosilicate glasses from thermal analysis
Authors: Hauke Brittney M. , Mauro John C.
Published: September 2024

The sodium aluminosilicate (NAS) glass family is important for many different industrial applications, but glass relaxation has not yet been thoroughly studied in this system. Thermal analysis techniques such as differential scanning calorimetry (DSC) and modulated differential scanning calorimetry (MDSC) can provide insight into the enthalpy relaxation of glass by measuring the glass transition temperature (Tg), activation energy, and enthalpy of relaxation. MDSC is mostly used to study nonoxide and low Tg glasses, and there is much debate about whether the nonreversing heat flow analysis method is accurate. To the authors’ knowledge, this is the first paper using MDSC to study these NAS compositions, and one of few papers to report MDSC on high Tg oxide glasses. We report on one set of modulation conditions that obtain a linear response using Lissajous curves, as well as comparing the activation energy calculated from DSC with the enthalpy of relaxation obtained from MDSC. Our results show that the activation energy and enthalpy of relaxation do not give the same compositional minimum in relaxation, and therefore more work is needed to investigate the validity of the nonreversing heat flow approach for high Tg oxide glasses.
NEDD4L affects KLF5 stability through ubiquitination to control ferroptosis and radiotherapy resistance in oesophageal squamous cell carcinoma
Authors: Chen Jinjin , Ying Kaijun , Sun Jian , Wang Yao , Ji Mingming , Sun Yunhao
Published: September 2024

Oesophageal squamous cell carcinoma (ESCC) contributes to high mortality. Modulating ferroptosis may reverse resistance to radiotherapy. This article was to explore the ubiquitination modification of KLF5 and its effect on ferroptosis in ESCC. KLF5 was under‐expressed by shRNA plasmids in the cells and ROS levels were analysed by flow cytometry, ferroptotic gene expression was detected by qRT‐PCR, MDA and GSH levels were determined by ELISA, cell morphology was observed by transmission electron microscopy, and Fe ion levels were analysed by immunofluorescence. Cells were treated with Ferrostatin‐1 and NAC and analysed for cell proliferation by colony formation assay, cell migration and invasion by Transwell assays, and apoptosis by flow cytometry. DNA damage in cells was also analysed using comet assay, EdU doping assay, γH2AX fluorescence, DNA‐PKcs and PCR. NEDD4L and KLF5 binding was analysed by immunoprecipitation. Changes in ferroptosis, DNA damage and resistance were analysed in cells with both silencing NEDD4L and KLF5. Changes in tumour resistance to radiation were analysed in mice underexpressing NEDD4L and KLF5. Low expression of KLF5 significantly promotes cellular lipid peroxidation levels, with decreased expression of SOD and GPX4, and increased expression of ACSL4. Concurrently, MDA levels deplete GSH, and cells exhibit typical ferroptotic morphology with increased Fe2+ content. KLF5 inhibition results in enhanced cellular clonogenicity, migration and invasion activities, reduced apoptosis, increased tail DNA, nuclear EdU incorporation, nuclear γH2AX foci and elevated expression of DNA‐PKcs, LIG4, RAD9B and BMI1. Ferrostatin‐1 and NAC reverse these effects. NEDD4L ubiquitination modifies and degrades KLF5, with NEDD4L/KLF5 inhibition mitigating cellular ferroptosis and DNA damage, thereby promoting radiosensitivity both in vitro and in vivo. NEDD4L increases radiosensitivity by accelerating cellular ferroptosis via ubiquitination modification of KLF5.
Comprehensive characterization of long QT syndrome‐associated genes in cancer and development of a robust prognosis model
Authors: Xu Jincheng , Wen Zhengchao , She Yongtao , Li Maohao , Shen Xiuyun , Zhi Fengnan , Wang Shu , Jiang Yanan
Published: September 2024

Cancer is the leading public health problem worldwide. However, the side effects accompanying anti‐cancer therapies, particularly those pertaining to cardiotoxicity and adverse cardiac events, have been the hindrances to treatment progress. Long QT syndrome (LQTS) is one of the major clinic manifestations of the anti‐cancer drug associated cardiac dysfunction. Therefore, elucidating the relationship between the LQTS and cancer is urgently needed. Transcriptomic sequencing data and clinic information of 10,531 patients diagnosed with 33 types of cancer was acquired from TCGA database. A pan‐cancer applicative gene prognostic model was constructed based on the LQTS gene signatures. Meanwhile, transcriptome data and clinical information from various cancer types were collected from the GEO database to validate the robustness of the prognostic model. Furthermore, the expression level of transcriptomes and multiple clinical features were integrated to construct a Nomo chart to optimize the prognosis model. The ssGSEA analysis was employed to analysis the correlation between the LQTS gene signatures, clinic features and cancer associated signalling pathways. Our findings revealed that patients with lower LQTS gene signatures enrichment levels exhibit a poorer prognosis. The correlation of enrichment levels with the typical pathways was observed in multiple cancers. Then, based on the 17 LQTS gene signatures, we construct a prognostic model through the machine‐learning approaches. The results obtained from the validation datasets and training datasets indicated that our prognostic model can effectively predict patient outcomes across diverse cancer types. Finally, we integrated this model with clinical features into a nomogram, demonstrating its potential as a valuable prognostic tool for cancer patients. Our study sheds light on the intricate relationship between LQTS and cancer pathways. A LQTS feature based clinic decision tool was developed aiming to enhance precision treatment of cancer.
Involvement of the Wnt/β‐catenin signalling pathway in heterotopic ossification and ossification‐related diseases
Authors: Zhao Yike , Liu Fangzhou , Pei Yiran , Lian Fengyu , Lin Hui
Published: September 2024

Heterotopic ossification (HO) is a pathological condition characterized by the formation of bone within soft tissues. The development of HO is a result of abnormal activation of the bone formation programs, where multiple signalling pathways, including Wnt/β‐catenin, BMP and hedgehog signalling, are involved. The Wnt/β‐catenin signalling pathway, a conserved pathway essential for various fundamental activities, has been found to play a significant role in pathological bone formation processes. It regulates angiogenesis, chondrocyte hypertrophy and osteoblast differentiation during the development of HO. More importantly, the crosstalk between Wnt signalling and other factors including BMP, Hedgehog signalling, YAP may contribute in a HO‐favourable manner. Moreover, several miRNAs may also be involved in HO formation via the regulation of Wnt signalling. This review aims to summarize the role of Wnt/β‐catenin signalling in the pathogenesis of HO, its interactions with related molecules, and potential preventive and therapeutic measures targeting Wnt/β‐catenin signalling.
Optimism and Overconfidence of Strategic Decision Makers‐Comparing Entrepreneurs and Managers With Employees
Authors: Chochoiek Nadine , Huber Laura Rosendahl , Sloof Randolph
Published: September 2024

Empirical evidence supports the conventional wisdom that entrepreneurs are more optimistic and overconfident than others. However, the same holds true for (top) managers. In a large incentivized survey (), we directly compare entrepreneurs, managers, and employees on a comprehensive set of measures of optimism and overconfidence. We find that on average entrepreneurs and managers are more optimistic than employees in their dispositional optimism and their explanatory style of past events. However, they do not differ from each other in these respects. For two incentivized measures of overconfidence, we also find no differences between entrepreneurs and managers. Both are equally likely to overestimate their own abilities compared to employees. In terms of overestimating general economic prospects differences with employees are much less pronounced. Exploration of within‐group heterogeneities shows that these observations hold true for various subgroups of entrepreneurs and managers. Together these findings tentatively suggest that optimism and overconfidence characterize strategic decision makers more generally, irrespective of whether they bear the full risk of their strategic decisions.
Journeys to functionality: A dimensional analysis of personal narratives of recovery from depression
Authors: Settrisman Ryno , Mishra Ajit K
Published: September 2024

Background

Recovery from depression constitutes a long journey that is understood as a unique and multifaceted process encompassing various dimensions. To understand what constitutes recovery from depression and to develop greater insights into the unique dimensions of the recovery journey, the study of recovery memoirs is essential.

Method

This article performs a dimensional analysis on six Indian first‐hand accounts of recovery from depression collected in Amrita Tripathi and Arpita Anand's Real Stories of Dealing with Depression to examine the journeys toward healing and the uniqueness of the recovery processes. Through the dimensional analysis, four core dimensions of recovery from depression—Problems, Social Supports, Position of Recovery and Functionality—are identified. The process of recovery, consisting of understanding the problems (causes) through sensed adversities (sensed effects), making use of received social supports to transform oneself, finding out the position of recovery, and lastly, functioning peacefully for living, corresponds to the four dimensions of recovery. Drawing on Herbert Blumer's theory of social interactionism, the article examines how different individuals interpret their experiences of depression in unique ways and develop distinctive recovery strategies.

Discussion

The identified dimensions of recovery correspond to the need for unique approaches to recovery articulated by each of the narrators. The selected narratives reveal that the problems are unique, and for each of the unique problems, there has to be a distinctive support mechanism. The recovery narratives are centred around the unique problems wherein the individuals attempt to understand what happened to them and why it happened.

Conclusion

The article concludes by suggesting that healthcare practitioners can utilise the dimensions and the subdimensions as a lead to understand fully how their clients conceptualise their problems and try to understand how each client defines the recovery itself.
Inferring the metabolic rate of zebrafish from ventilation frequency
Authors: Han Tianjun , Lombardelli Giulia , Peterson Sean D. , Porfiri Maurizio
Published: September 2024

Fish schooling has attracted the interest of the scientific community for centuries. Energy savings have been long posited to be a key determinant for the emergence of schooling patterns. Yet, current methodologies do not allow the precise quantification of the metabolic rate of specific individuals within the school, typically leaving researchers with only a single, global measurement of metabolic rate for the collective. In this paper, we demonstrate the feasibility of inferring metabolic rate of swimming fish using the mouth‐opening frequency, a simple proxy that can be scored utilizing video recordings in the laboratory or in the field, even for small fish. The mouth‐opening frequency is independent of hydrodynamic interactions within the school, thereby mitigating potential confounding factors that arise when using locomotory measures associated with tail‐beat motion. We assessed the reliability of mouth‐opening frequency as a proxy for metabolic rate by conducting experiments on zebrafish (Danio rerio) using swimming respirometry. We varied the flow speed from 0.8 to 3.2 body lengths per second and extracted tail‐beat motion and mouth opening from video recordings. Our results revealed a strong correlation between oxygen uptake and mouth‐opening frequency for nonzero flow speeds but not in quiescent water. Contrary to our expectations, we did not find evidence in favor of the use of tail‐beat frequency as a proxy for metabolic rate. Overall, our results open the door to the study of individual metabolic rates in fish schools without confounding factors related to hydrodynamic interactions.
Family caregiver lived experience matters in home‐ and community‐based services
Authors: Boucher Nathan A.
Published: September 2024

This editorial comments on the article by Trivedi et al.
Should doctors prescribe death? Resisting the expansion of assisted suicide
Authors: Jaggard Peter , Sams Richard
Published: September 2024

See related letter by Pope and Brodoff in this issue.
Combined Forehead and Temporal Lifting: An Innovative Approach to Lanluma V Treatment
Authors: Wu Larry , Salti Giovanni
Published: September 2024

Background

Excess skin laxity over the upper face can contribute to aging over the mid and lower face. We describe an innovative nonsurgical technique of facial rejuvenation by injecting Lanluma V over the scalp's vertex and parietal regions. Lanluma V is a poly‐l‐lactic acid (PLLA)‐based collagen stimulator which contains 210 mg of PLLA, distributed by Sinclair Pharmaceutical. Lanluma V works by stimulating collagen regeneration to provide support for the treated area.

Method

A retrospective review of 12 consecutive patients treated with Lanluma V over the vertex and parietal regions of the scalp to achieve nonsurgical rejuvenation of the upper, middle, and lower thirds of the face was conducted. The patients were treated over two sessions, 1 month apart. The treated patients were reviewed by a plastic surgeon and rated under the Global Aesthetic Improvement Scale (GAIS) 6 months after treatment.

Results

The patients achieved an overall average of 1.16 grade improvement in GAIS. The average follow‐up period is 6 months following completion of treatment. There was no reported incidence of non‐scarring alopecia, which has been reported in the use of other, more viscous fillers such as calcium hydroxyapatite or high G' hyaluronic acid.

Conclusion

This innovative method of combined forehead and temporal lifting with Lanluma V allows for an average 1.16 grade improvement in GAIS. There is no reported incidence of non‐scarring alopecia, which has been associated with other fillers.
SOX4 inhibits ferroptosis and promotes proliferation of endometrial cancer cells via the p53/SLC7A11 signaling
Authors: Zhu Hongli , Xu Song
Published: September 2024

Aim

Sex‐determining region Y‐related high‐mobility group box 4 (SOX4) has been reported to play a carcinogenic role in endometrial cancer (EC). However, the biological function and regulatory mechanisms of SOX4 in ferroptosis during the progression of EC are still unknown.

Methods

The mRNA and protein levels were scrutinized by quantitative reverse‐transcription polymerase chain reaction and western blot, respectively. The cell viability and proliferative capability were determined by cell counting kit‐8 assay and 5‐ethynyl‐2′‐deoxyuridine (EdU) assay. Transcriptional regulation of gene expression was investigated by dual‐luciferase reporter assay and chromatin immunoprecipitation. Ferroptosis was evaluated by detection of reactive oxygen species, malondialdehyde, Fe2+, and ferroptosis‐related proteins. The mice test was implemented to confirm the influence of SOX4 on EC tumor growth and ferroptosis in vivo.

Results

We here discovered the elevation of SOX4 in EC tissues and cells. Functionally, SOX4 knockdown hampered proliferation and promoted ferroptosis of EC cells. Mechanistically, SOX4 bound to p53 promoter and inhibited its transcriptional activity in EC cells. In addition, p53 transcriptionally suppressed SLC7A11 expression in EC cells. Downregulation of p53 reverses the effect of SOX4 knockdown on proliferation and ferroptosis of EC cells. Finally, in vivo experiments demonstrated that SOX4 depletion hindered tumor growth and triggered ferroptosis in EC.

Conclusions

These findings collectively suggested that SOX4 inhibited ferroptosis and promoted proliferation of EC cells via the p53/SLC7A11 signaling. Our research unveiled a novel regulatory mechanism of ferroptosis in EC, offering promising perspectives for the development of EC therapies.
Abandonment of paediatric peripheral intravenous catheter insertion in the emergency department: A retrospective cohort study
Authors: Clarke Zoe , Lam Clayton , Sweeny Amy L , Snelling Peter J
Published: September 2024

Aim

Children and their families have reported peripheral intravenous catheter (PIVC) insertion as the most stressful part of their emergency department (ED) encounter, with some enduring multiple attempts without a successful insertion. The purpose of this study was to identify factors associated with abandonment of paediatric PIVC insertion.

Methods

A retrospective cohort study was conducted at the Gold Coast University Hospital. All patients 16 years of age and younger, presented in 2019 with a PIVC insertion attempted in the ED were eligible. The electronic medical records were screened by two reviewers to identify those who required a PIVC insertion. Logistic regression analysis was performed to assess variables associated with PIVC insertion abandonment.

Results

Of 6394 records screened, 2401 (8.3%) had a PIVC insertion attempted, with 99 (4.1%) being abandoned. Age <12 months was the strongest predictor of PIVC abandonment at a rate of 11.3% (38/336), with a >10‐fold increased risk for infants less than 3 months old and 3–12 months old; adjusted odds ratio (95% confidence interval) 12.4 (5.1–30.2) and 14.8 (5.8–37.4), respectively. Indications of ‘infection’ or ‘rehydration’ were associated with a decreased likelihood of abandonment when compared to ‘investigation only’ in multivariate modelling (odds ratio (95% confidence interval): 0.181 (0.099–0.332) and 0.262 (0.100–0.686), respectively).

Conclusions

This study suggests the rate of PIVC insertion abandonment in children is relatively infrequent. However, more than one in 10 children aged <12 months had PIVC attempts without successful insertion. PIVC abandonment was less likely when there was an indication that necessitated PIVC insertion, such as a serious bacterial infection.
Inguinal hernias in children: Update on management guidelines
Authors: Morgado Mariana , Holland Andrew JA
Published: September 2024

Inguinal hernia repair is one of the most performed procedures in children, but aspects of care remain controversial. The aim of this review was to provide a critical appraisal of recently published guidelines on the management of inguinal hernias in children, by the American Academy of Pediatrics (2023) and the European Pediatric Surgeons' Association Evidence and Guideline Committee (2022). This was achieved by delineating areas of controversy and reviewing the most relevant recent literature on these topics. Currently available moderate‐to‐low quality evidence recommends postponing hernia repair in premature infants until after discharge, to reduce the risk of respiratory difficulties and recurrence. Laparoscopic repair provides similar outcomes to open but may shorten operative time in bilateral cases. No clear recommendation can be made for contralateral exploration, therefore should be evaluated case by case. In preterm infants, consideration of regional anaesthesia may reduce post‐operative apnoea and pain, with no difference in neurodevelopment outcomes.
“(…) here I have freedom”—A study of refugees' and asylum seekers' legal consciousness in Greece: Self‐identity, human rights, and expectations from European Union law
Authors: Graca Sofia , Kapageorgiadou Violeta
Published: September 2024

This paper adds to the existing knowledge on migration and the law by empirically exploring the legal consciousness of 33 refugees and asylum seekers in Greece, more specifically, by discussing how their experiences, self‐identity and expectations of the law inform their reactions to the restrictions imposed upon them. The findings suggest that (1) legal knowledge is acquired in the countries of origin and from contact with smugglers, other migrants, law enforcement agents and staff from NGOs; (2) this knowledge allows them to forge an identity as “rights‐bearers,” which (3) together with perceptions and expectations of human rights law and European Union policies on migration, (4) empower them to claim protection from the Greek state, and (5) legitimizes their actions, even if these sometimes involve subterfuge. Despite their particularly vulnerable positions, refugees and asylum seekers are, therefore, not mere passive receivers of state power, but also try to use the law to overcome adversity, in an almost game‐like fashion.
Upholding our PROMISE: Increased representation is not enough to foster belonging in graduate medical education
Authors: Poitevien Patricia , Kas‐Osoka Oriaku , Burns Audrea , Prakash Laura Kester , Marbin Jyothi , Schwartz Alan , Lucas Candice Taylor , Yemane Lahia , Blankenburg Rebecca
Published: September 2024

Purpose

Sense of belonging supports academic achievement and encourages career endurance. The purpose of this study was to characterize what individual and institutional factors influence one's sense of belonging by describing the experiences of underrepresented in medicine (UIM) paediatric and internal medicine–paediatric residents in the United States.

Method

The authors conducted a national survey of paediatric and internal medicine–paediatric residents. The 23‐item anonymous web‐based survey was distributed between October 2020 and January 2021 and included questions on socio‐demographic characteristics and individual perceptions on sense of belonging, value, common mission or values at a program or institution and respect. The authors used linear mixed models and fitted regression models to examine individual factors and environmental factors that impact sense of belonging, value and respect.

Results

Across 29 residency programs, 938 (53%) of 1748 residents completed the survey. One hundred sixty‐seven (18%) self‐identified as UIM. UIM residents had a lower sense of belonging than non‐UIM residents [mean (SD) 3.6 (0.87) vs. 4.0 (0.57)]. Black/AA and Hispanic/Latinx residents had the lowest sense of belonging [3.5 (0.82) and 2.8 (0.93), respectively]. UIM residents demonstrated decreased sense of belonging in programs that lacked bias training and where peers discriminated against them. Sense of belonging was increased in programs where they perceived a sense of support, respect or values alignment. Surprisingly, individual UIM resident sense of belonging was not improved by having more UIM residents in a program.

Conclusion

UIM paediatric residents experience a decreased sense of belonging during training. Programs can support sense of belonging for UIM residents by demonstrating respect and support for them and by offering systems for bias training and reporting bias and discrimination. Recruiting a greater number of UIM trainees remains important; however, compositional diversity alone does not improve a sense of belonging for UIM residents. There is continued need for structural/institutional change, including addressing institutional culture and structural racism.
PeFUS3 Drives Lateral Root Growth Via Auxin and ABA Signalling Under Drought Stress in Populus
Authors: Liu Shu‐Jing , Zhang Han , Jin Xiao‐Ting , Niu Meng‐Xue , Feng Cong‐Hua , Liu Xiao , Liu Chao , Wang Hou‐Ling , Yin Weilun , Xia Xinli
Published: September 2024

Changes in root system architecture are vital for plant adaptation to drought stress, yet the underlying molecular mechanisms of this process remain largely elusive. Here, FUSCA3 (FUS3), a B3 domain transcription factor isolated from Populus euphratica, was found to be an important gene of regulating lateral root (LR) development under drought stress. The expression of PeFUS3 was strongly induced by ABA and dehydration treatments. Overexpressing PeFUS3 in poplar 84 K (P. alba × P. glandulosa) positively regulated LR growth and enhanced drought tolerance, while the knockout lines, generated by the CRISPR/Cas9 system, displayed repressed LR growth and weakened drought tolerance. Further investigation demonstrated that PeFUS3 activated the expression of PIN2, PIN6a and AUX1, which were key genes involved in auxin transport, suggesting PeFUS3 modulated LR development under drought stress through auxin signalling. Moreover, PeFUS3 directly upregulated PePYL3 expression, and overexpressing PePYL3 poplar lines exhibited significantly increased drought resistance. In addition, PeABF2, an ABA responsive transcription factor, interacted with PeFUS3 and activated its transcription, indicating PeFUS3 was involved in ABA signalling pathway. Taken together, PeFUS3 is a key regulator, maintaining root growth of poplar by modulating the crosstalk of auxin and ABA signalling under drought stress.
Possible association of elevated CSF IL‐6 levels with anxiety and frustration in psychiatric disorders
Authors: Enokida Takako , Hattori Kotaro , Okabe Kaori , Noda Takamasa , Ota Miho , Sato Noriko , Ogawa Shintaro , Tatsumi Megumi , Hoshino Mikio , Kunugi Hiroshi , Nakagome Kazuyuki
Published: September 2024

Aim

Neuroinflammation is an important causal factor for a variety of psychiatric disorders. We previously reported increased cerebrospinal fluid interleukin‐6 levels in patients with schizophrenia and major depressive disorder. The present study aimed to examine the possible association of interleukin‐6 levels with anxiety and frustration, negative valence symptoms shared in various psychiatric disorders.

Methods

We included 129 patients with psychiatric disorders and 70 controls. CSF and plasma interleukin‐6 levels were measured by immunoassay kits, and psychological symptoms were assessed with the State–Trait Anxiety Inventory, and the Basic Psychological Need Satisfaction and Frustration Scale. To examine regional cerebral blood flow, patients underwent arterial spin labeling analysis using magnetic resonance imaging.

Results

Cerebrospinal fluid interleukin‐6 levels were significantly correlated with State–Trait Anxiety Inventory‐trait anxiety (r = 0.25, P = 0.046) and Basic Psychological Need Satisfaction and Frustration Scale‐autonomy frustration scores (r = 0.29, P = 0.018). Patients with abnormally high cerebrospinal fluid interleukin‐6 levels (defined >97.5 percentile of the controls) had higher scores for trait anxiety (P = 0.035) and autonomy frustration (P = 0.026), and significantly increased regional cerebral blood flow in the left superior temporal gyrus, bilateral nucleus accumbens, and cerebellum than the remaining patients.

Conclusion

Patients with elevated cerebrospinal fluid interleukin‐6 constitute a subpopulation of psychiatric disorders associated with anxiety and autonomy frustration, which may be related to altered functions in specific brain areas.
Torque Teno Virus Loads as a Marker of Immunosuppression in Pediatric Kidney Transplant Recipients
Authors: Kelly Ellen , Awan Atif , Sweeney Clodagh , Wildes Dermot , De Gascun Cillian , Hassan Jaythoon , Riordan Michael
Published: September 2024

Background

Long‐term renal function and survival after kidney transplantation rely on appropriate immunosuppressive treatment to prevent the risk of rejection. New biomarkers are needed to accurately assess the degree of immunosuppression in renal transplant recipients in order to avoid organ rejection and the development of opportunistic infections. Highly prevalent in humans, torque teno virus (TTV), which belongs to the family Anelloviridae, is a small, nonenveloped, single‐stranded DNA virus which has not been linked with any specific human illness, but which constitutes a major component of the human virome. Host antiviral responses allow TTV levels to be controlled; however, viral persistence remains, explaining the high prevalence in human populations, including healthy individuals. Important confounders of TTV load include time since transplantation, age, gender, obesity, and smoking status.

Aims

TTV‐based guidance of immunosuppressive drug dosing could help with risk stratification, reducing the risk of infection, graft rejection and oncologic disease on an individual level, enabling long‐term patient and graft survival.

Methods

Original studies were accessed by a systematic search from electronic databases including PubMed, ScienceDirect and Wiley Online Library.

Results

The presented data mainly derive from adult transplant recipients showing an association between TTV plasma levels and the immune status of the host: High‐TTV load and high immunosuppression are associated with a risk of infection, and low‐TTV load and low immunosuppression indicate a risk of rejection. However, there is minimal information on pediatric transplant recipients with further research required in this cohort. To date, it has been demonstrated that longer posttransplant times are significantly associated with lower TTV levels in children with renal transplant. Meanwhile, an association between lower TTV loads and increased risk of graft reject during the first year of transplantation was also reported. More recently, Eibensteiner et al. revealed a robust, independent association between TTV plasma load and the onset of Cytomegalovirus and BK virus infections.

Conclusion

Data from randomized controlled trials are still missing, even in adults, but a multicenter randomized controlled trial for TTV‐guided immunosuppression in adult kidney recipients (TTVguideIT) began in 2022. There is, therefore, great promise for TTV levels to be used as a biomarker that could potentially improve both graft and patient survival in transplantation.
Optimizing Piperacillin Dosing in Pediatric Liver Transplant Recipients: A Case Series
Authors: Morales Junior Ronaldo , Hosawi Anhar , Tang Girdwood Sonya , Dong Min , Juodinis Vanessa D’ Amaro , Romano Paschoalina , Ebner Pérsio de Almeida Rezende , Duarte Nilo José Coelho , de Souza Daniela Carla , Santos Silvia Regina Cavani Jorge
Published: September 2024

Background

Pathophysiological changes post‐liver transplantation impact the pharmacokinetics and pharmacodynamics of antibiotics. Piperacillin, often used in combination with tazobactam, is a key antibiotic after transplantation to its broad‐spectrum activity, but there is a lack of specific pharmacokinetic data in this population. This study aims to describe the pharmacokinetic parameters and target attainment of piperacillin in pediatric liver transplant recipients.

Methods

Patients with preserved renal function (estimated glomerular filtration rate > 50 mL/min/1.73 m2) receiving intravenous piperacillin‐tazobactam at 112.5 mg/kg every 8 h (100 mg piperacillin/12.5 mg tazobactam), with a rapid infusion (0.5–1 h), were included. Two blood samples per child were collected during the same interval within 48 h of starting therapy. A Bayesian approach was applied to estimate individual pharmacokinetic parameters and perform dosing recommendations against Enterococcus spp., Enterobacterales and Pseudomonas aeruginosa.

Results

Eight patients with median age of 8 months were included. Median piperacillin clearance and central volume of distribution for the cohort were 11.11 L/h/70 kg and 9.80 L/70 kg, respectively. Seven patients (87.5%) presented with concentrations below the target of 100% fT > MIC. Simulations suggested that these patients required more frequent dosing and extended duration of infusion to ensure target attainment. One patient (12.5%) had trough concentrations that exceed 16 mg/L and could receive a lower daily dose.

Conclusions

This case series highlights the importance of personalized therapy in pediatric liver transplant recipients due to the unpredictable and highly variable piperacillin pharmacokinetics in this population.