bluuebunny/crossref_metadata_2025 huggingface dataset:
Retracted: Maternal traditional Chinese medicine exposure and risk of congenital malformations: a multicenter prospective cohort study
Authors: Peng Ting , Yin Lin‐Liang , Xiong Yu , Xie Feng , Ji Chun‐Ya , Yang Zhong , Pan Qi , Li Ming‐Qing , Deng Xue‐Dong , Dong Jing , Wu Jiang‐Nan
Published: April 2023

Introduction

The potential teratogenic risk of traditional Chinese medicine (TCM) is of widespread concern; however, related evidence is largely absent in humans. This study aimed to compare the prevalence of congenital malformations between pregnant women with and without TCM exposure.

Material and methods

This was a multicenter prospective cohort study of 17 713 women who participated in a survey on periconceptional TCM exposure. Primary outcome was congenital malformations diagnosed from a survey conducted on the day 42 after delivery.

Results

A total of 16 751 pregnant women with 273 congenital malformations were included in the analysis. Fetuses exposed to TCM had an increased risk of congenital malformations compared to those without exposure (odds ratio [OR] 2.10; 95% confidence interval [CI] 1.09–4.02) after controlling for potential confounders. There were significant associations with congenital malformations in women with early pregnant exposure (OR 2.04, 95% CI 1.00–4.20) and for those who received ≥2 TCM formulas (OR 5.84, 95% CI 1.44–23.65). Pre‐pregnancy TCM exposure was significantly associated with an increased risk of congenital heart defects (OR 12.69; 95% CI 3.01–53.51).

Conclusions

Periconceptional TCM exposure is associated with an increased risk of congenital malformation. This effect was cumulative and sensitive to periconceptional age. Therefore, TCM deserves more attention and should be used cautiously for pregnant women and those trying to become pregnant.
Socioeconomic differences in parental financial support, coresidence, and advice: A portrait of undergraduate students in the Canadian Prairies
Authors: Mazurik Kathrina , Williamson Linzi , Knudson Sarah
Published: April 2023

In this paper, we examine the intersections of parental support and family socioeconomic background within an undergraduate sample (N= 596) in a mid‐sized Canadian Prairie city. Coresidence, financial support, and parental and professional financial advice are examined as types of ‘family capital’ that may be distributed unequally across socioeconomic groups. In keeping with previous literature, findings showed that students whose parents had university education and higher incomes received more robust coverage of their housing and school expenses. Students whose parents were university‐educated were also more likely to be living with a parent, though no relationship was found between parental income and coresidence. Contrasting with previous literature, few relationships were found between socioeconomic background and receipt or influence of financial advice. These results contribute to the literature by generalising claims about family capital to a Canadian student sample, where relatively few studies have empirically examined intergenerational transfers as mechanisms for transmitting privilege during the transition to adulthood. With increasing demands for higher education and simultaneous declines in government subsidisation of its costs, disparate access to family capital is likely to intensify the reproduction of social inequality across generations.
Protective effects and mechanism of Paecilomyces cicadaeTJJ1213 intracellular polysaccharide against H2O2‐induced PC12 cells damage
Authors: Tian Juanjuan , Xu Qing , Wang Xiaomeng , Zhang Xueliang , Chen Xiaohong , Rui Xin , Zhang Qiuqin , Dong Mingsheng , Li Wei
Published: April 2023

Oxidative stress is a key process in the development of neurodegenerative diseases. More attention is needed to screen natural antioxidants and explore pharmacological mechanisms. Natural product polysaccharides with no toxic side effects have powerful antioxidant activity. Two purified intracellular polysaccharide fractions (IPS1 and IPS2) from Paecilomyces cicadae TJJ1213 was isolated. Then, a model of H2O2‐induced oxidative stress in PC12 cells was established to investigate the neuroprotective role of IPS and elucidate the potential protection mechanism. Results showed that IPS1 and IPS2 reduced reactive oxygen species (ROS) production, inhibited the leakage of lactate dehydrogenase (LDH) and Ca2+ and attenuated the expression of apoptotic proteins. In addition, western blots displayed that IPS1 and IPS2 significantly inhibited mitophagy induced by H2O2 in PC12 cells via PINK/Parkin pathway. Therefore, IPS1 and IPS2 deserved further investigation as protective agents against neurodegenerative diseases.
The effect of intravenous thrombolysis on patients with successful thrombectomy depends on final reperfusion grade: A retrospective study
Authors: Tang Tao , Li Di , Zhao Man‐Hong , Thomas Aline M. , Chuang Chuang , Fan Tie‐Ping , Li Shen
Published: April 2023

Aims

Although intravenous thrombolysis (IVT) has not shown confirmative effects on the outcomes of patients receiving successful thrombectomy, it might influence the outcomes of a subset of these patients. This study aims to evaluate whether the effects of IVT depend on final reperfusion grade in patients with successful thrombectomy.

Methods

This is a single‐center, retrospective analysis of patients with an acute anterior circulation large‐vessel occlusion and a successful thrombectomy between January 2020 and June 2022. Final reperfusion grade was evaluated by the modified Thrombolysis in Cerebral Infarction (mTICI) score, which was dichotomized into incomplete (mTICI 2b) and complete (mTICI 3) reperfusion. The primary outcome was functional independence (90‐day modified Rankin Scale score 0–2). Safety outcomes were 24‐h symptomatic intracranial hemorrhage and 90‐day all‐cause mortality. Multivariable logistic regression analyses were used to assess the interactions between IVT treatment and final reperfusion grade on outcomes.

Results

When comparing all 167 patients enrolled in the study, IVT did not influence the extent of functional independence (adjusted OR: 1.38; 95% CI: 0.65–2.95;p = 0.397). The effect of IVT on functional independence depended on final reperfusion grade (p = 0.016). IVT benefited patients with incomplete reperfusion (adjusted OR: 3.70; 95% CI 1.21–11.30;p = 0.022), but not those with complete reperfusion (adjusted OR: 0.48, 95% CI: 0.14–1.59;p = 0.229). IVT was not associated with 24‐h symptomatic intracerebral hemorrhage (p = 0.190) or 90‐day all‐cause mortality (p = 0.545).

Conclusions

The effect of IVT on functional independence depended on final reperfusion grade in patients with successful thrombectomy. IVT appeared to benefit patients with incomplete reperfusion, but not those with complete reperfusion. Because reperfusion grade cannot be determined prior to endovascular treatment, this study argues against withholding IVT in IVT‐eligible patients.
Safety assessment of a three‐dimensional‐printed autologous omentum patch: An application on the kidneys as a new treatment approach
Authors: Jo Hyunwoo , Kim Janghwan , Kim Jin‐Wook , Kim Boyun , Choi Bo Young , Kang Kyuyong , Ryu Jina , Kim Min Su
Published: April 2023

Recently, the field of regenerative medicine has made great strides in the development of new treatments for various organ dysfunctions. One of the most promising new approaches is the use of three‐dimensional (3D) printing and autologous tissues. In this study, we evaluated the safety of a 3D‐printed autologous omentum patch to kidneys using large animals. A total of seven micropigs underwent transplantation of the 3D‐printed autologous omentum patch. Twelve weeks after transplantation, the safety was evaluated by measuring body weight, blood, and the renal resistive index. In addition, biopsy samples were histologically analyzed. The results showed no surgical complications, renal functional hematological changes, or inflammatory responses. Therefore, this study provides important insights into direct therapy to kidneys with a 3D‐printed patch made of autologous tissue. Furthermore, it has the potential for the development of new therapies for various organ dysfunction.
The second phantom aquatic leaf beetle in Japan: Macroplea mutica rediscovery in the wetlands (Coleoptera: Chrysomelidae)
Authors: Nakahama Naoyuki , Okano Ryosuke , Nishimoto Yuichiro , Nakatani Yusuke , Noishiki Asato , Ogawa Naoki
Published: April 2023

Wetland biodiversity is currently declining on a global scale. Wetland biodiversity understanding is critical for determining the wetlands' conservation value. In this study, Macroplea Samouelle, 1819 (Coleoptera: Chrysomelidae) was discovered in Aomori Prefecture, Honshu Island, Japan. Only two Macroplea species have been recorded in Japan, M. japana (Jacoby, 1885) and M. mutica (Fabricius, 1792). Macroplea japana had been unrecorded for 60 years before being rediscovered in Honshu Island in 2022, and a single adult M. mutica female was discovered in Hokkaido Prefecture in 2003. The discovered individuals were concluded to be M. mutica based on morphological and molecular analyses. Although morphological differences were observed with the Eurasian M. mutica individuals, the male genitalia was nearly identical to M. mutica. For the molecular phylogenetic analysis based on COI and 28S sequences, Macroplea individuals in Japan were clustered with M. mutica on the Eurasian Continent. This is the first record of this species on Honshu Island (and the second in Japan), as well as the first record of adult males. This species would require conservation policies and additional distributional surveys.
Trait evolution during a rapid global weed invasion despite little genetic differentiation
Authors: Irimia Ramona E. , Montesinos Daniel , Chaturvedi Anurag , Sanders Ian , Hierro José L. , Sotes Gastón , Cavieres Lohengrin A. , Eren Özkan , Lortie Christopher J. , French Kristine , Brennan Adrian Christopher
Published: April 2023

Invasive species often possess a great capacity to adapt to novel environments in the form of spatial trait variation, as a result of varying selection regimes, genetic drift, or plasticity. We explored the geographic differentiation in several phenotypic traits related to plant growth, reproduction, and defense in the highly invasive Centaurea solstitialis by measuring neutral genetic differentiation (FST), and comparing it with phenotypic differentiation (PST), in a common garden experiment in individuals originating from regions representing the species distribution across five continents. Native plants were more fecund than non‐native plants, but the latter displayed considerably larger seed mass. We found indication of divergent selection for these two reproductive traits but little overall genetic differentiation between native and non‐native ranges. The native versus invasive PST–FST comparisons demonstrated that, in several invasive regions, seed mass had increased proportionally more than the genetic differentiation. Traits displayed different associations with climate variables in different regions. Both capitula numbers and seed mass were associated with winter temperature and precipitation and summer aridity in some regions. Overall, our study suggests that rapid evolution has accompanied invasive success of C. solstitialis and provides new insights into traits and their genetic bases that can contribute to fitness advantages in non‐native populations.
Equine retinal detachment in the United Kingdom: 23 cases (2010–2020)
Authors: Halliwell Elizabeth , Malalana Fernando
Published: April 2023

Background

Few reports describe the aetiology, presentation and diagnosis of retinal detachment in horses. Equine recurrent uveitis (ERU) and trauma are the most common causes of equine retinal detachment in the United States, but no studies have characterised the disease within the United Kingdom.

Objectives

To describe clinical presentation, aetiology and diagnostic examination findings of horses with retinal detachment within a UK‐based population.

Study design

Retrospective case series.

Methods

Medical records of horses presented to a single UK referral centre between 2010 and 2020 were reviewed. Horses were diagnosed with retinal detachment by clinical examination and/or ultrasonography, and details of clinical presentation, aetiology and examination findings were recorded.

Results

A total of 23 horses were included. There were 13 geldings and 10 mares with a median age of 9 at presentation (range 4 days to 17 years). Warmbloods were the most common breed (n = 8). Unilateral cases (n = 21) were more common than bilateral (n = 2). ERU was the most common aetiology (n = 10) followed by trauma (n = 8). Three cases presented post‐intraocular surgery, one congenital and one secondary to primary glaucoma. Ultrasound confirmed diagnosis in 23 (100%) cases, but only nine could be visualised by direct ophthalmoscopy. Cataracts, posterior synechiae and vitreal debris were found commonly in both the ipsilateral and contralateral eye affected.

Main limitations

Small sample size. Single‐centre retrospective study which may not be representative of the entire UK population. Histological confirmation of cases was not obtained.

Conclusions

Causes of retinal detachment in the studied population are like those previously reported in the USA and most cases presented with complete detachment. Ocular ultrasound is useful in the diagnosis of retinal detachment when the fundus cannot be directly assessed. The presence of retinal detachment should be considered in non‐visual eyes presenting with cataracts, vitreal debris and posterior synechiae.
Navigating health and well‐being during the COVID‐19 pandemic: Experiences of Latina immigrant mothers in rural Midwestern communities
Authors: Williams Ebony , Greder Kimberly , Kim Dahee , Bao Juan , Dan Karami Na‐Omi Hassane
Published: April 2023

Objective

In this study, we sought to gain insight into the challenges Latina immigrant mothers in rural Midwest communities encountered during the pandemic, strategies they employed to avoid infection of the virus, and impacts of the pandemic on family health and well‐being.

Background

In rural Midwestern communities, the pandemic disproportionately affected immigrants, many of whom are Latino and worked in meatpacking and food processing plants. Latina mothers are commonly viewed as caretakers of the family. This prescribed role placed mothers at the center of safeguarding their families' health during the pandemic.

Method

In this descriptive study, we conducted individual interviews with 124 Latina immigrant mothers across six rural Midwestern communities who participated in one of two previous studies in the communities. Thematic analyses was used to identify themes that aligned with three areas of interest: challenges experienced, strategies employed to avoid virus infection, and impacts of the pandemic on family health and well‐being.

Results

Mothers enacted behaviors (e.g., sanitation practices, wore masks, stayed home) to lessen negative impacts of the pandemic on family health and well‐being. Factors beyond their control (e.g., public policies, work policies and practices) placed families at greater risk for poor health and well‐being. Eleven themes were identified that aligned with the three areas of interest.

Conclusion

Findings build upon and extend prior research that reexposed unjust employment conditions, inadequate health‐care systems, and an anti‐immigrant context during the pandemic that perpetuated health disparities among Latino immigrants and other minoritized populations.

Implications

Ethnographic and longitudinal studies that give voice to populations underrepresented in COVID‐19 research and at high risk for poor health are warranted to inform policies and practices to protect health during public health crises.
Structural insights into the role of SHOC2‐MRAS‐PP1C complex in RAF activation
Authors: Bonsor Daniel A. , Simanshu Dhirendra K.
Published: April 2023

RAF activation is a key step for signalling through the mitogen‐activated protein kinase (MAPK) pathway. The SHOC2 protein, along with MRAS and PP1C, forms a high affinity, heterotrimeric holoenzyme that activates RAF kinases by dephosphorylating a specific phosphoserine. Recently, our research, along with that of three other teams, has uncovered valuable structural and functional insights into the SHOC2‐MRAS‐PP1C (SMP) holoenzyme complex. In this structural snapshot, we review SMP complex assembly, the dependency on the bound‐nucleotide state of MRAS, the substitution of MRAS by the canonical RAS proteins and the roles of SHOC2 and MRAS on PP1C activity and specificity. Furthermore, we discuss the effect of several RASopathy mutations identified within the SMP complex and explore potential therapeutic approaches for targeting the SMP complex in RAS/RAF‐driven cancers and RASopathies.
Characterization of ferredoxins from the thermophilic, acetogenic bacterium Thermoanaerobacter kivui
Authors: Katsyv Alexander , Essig Melanie , Bedendi Giada , Sahin Selmihan , Milton Ross D. , Müller Volker
Published: April 2023

A major electron carrier involved in energy and carbon metabolism in the acetogenic model organism Thermoanaerobacter kivui is ferredoxin, an iron–sulfur‐containing, electron‐transferring protein. Here, we show that the genome of T. kivui encodes four putative ferredoxin‐like proteins (TKV_c09620, TKV_c16450, TKV_c10420 and TKV_c19530). All four genes were cloned, a His‐tag encoding sequence was added and the proteins were produced from a plasmid in T. kivui. The purified proteins had an absorption peak at 430 nm typical for ferredoxins. The determined iron–sulfur content is consistent with the presence of two predicted [4Fe4S] clusters in TKV_c09620 and TKV_c19530 or one predicted [4Fe4S] cluster in TKV_c16450 and TKV_c10420 respectively. The reduction potential (Em) for TKV_c09620, TKV_c16450, TKV_c10420 and TKV_c19530 was determined to be −386 ± 4 mV, −386 ± 2 mV, −559 ± 10 mV and −557 ± 3 mV, respectively. TKV_c09620 and TKV_c16450 served as electron carriers for different oxidoreductases from T. kivui. Deletion of the ferredoxin genes led to only a slight reduction of growth on pyruvate or autotrophically on H2 + CO2. Transcriptional analysis revealed that TKV_c09620 was upregulated in a ΔTKV_c16450 mutant and vice versa TKV_c16450 in a ΔTKV_c09620 mutant, indicating that TKV_c09620 and TKV_c16450 can replace each other. In sum, our data are consistent with the hypothesis that TKV_c09620 and TKV_c16450 are ferredoxins involved in autotrophic and heterotrophic metabolism of T. kivui.
Impacts of sensory multimodality congruence and familiarity with short use on cosmetic product evaluation
Authors: Bourdier Alice , Abriat Anne , Jiang Tao
Published: April 2023

Cross‐modal association between sensory modalities is a natural phenomenon in the perception of our environment. For cosmetic evaluation, touch and smell are the two major sensory modalities involved in the whole product perception. In this study, we investigate whether a specific cosmetic texture is preferentially associated with a specific fragrance: congruence between texture and fragrance. In addition, we investigate whether 1‐week use of a fragrance–texture congruent or non‐congruent product can influence user's whole product appreciation and well‐being. We have conducted a four‐test experiment with 29 participants; first in the laboratory to evaluate: six fragrances and four textures individually with free description (test 1); the same stimuli with a description with cross‐modal descriptors (test 2); 10 fragrance–texture combined products (test 3); and secondly at home, two fragrance–texture combined products: one congruent and one non‐congruent (test 4). Results showed that: (1) For a given texture type, specific olfactory notes are necessary to lead to a congruent cross‐modal pairing product. (2) Sensory modal congruent products produce the highest hedonic response. (3) Real‐life use or familiarisation with a product can influence not only the degree of cross‐modal congruence but also overall cosmetic product appreciation.
Effect of thermal exposure on the microstructure and strength of an alumina‐silica ceramic fiber
Authors: Yang Rui , Zhao Wenqing , Sun Shijie , Yang Jinhua , Jiao Jian
Published: April 2023

The microstructure and mechanical properties of an alumina‐silica ceramic fiber after thermal exposure at 1100–1300°C were investigated by X‐ray diffraction, nuclear magnetic resonance, scanning electron microscopy, transmission electron microscopy analyses and room temperature tensile strength test. The results showed that the fiber was composed of γ‐A12O3 and amorphous SiO2. A phase reaction of γ‐A12O3 and amorphous SiO2 occurred when thermal exposure temperature exceeded 1150°C, and a new mullite phase formed. The grain size of the newly formed mullite increased with the increase of exposure temperature. Both the phase transition and grain growth of mullite had a significant impact on the mechanical properties of the fiber. Tensile strength of the fiber decreased slightly when thermal exposure temperature was below 1150°C, while the strength retention of the fiber decreased sharply to 65.36% as exposure temperature rose to 1200°C. A higher dispersion of tensile strength was also observed at higher exposure temperatures, as revealed by the Weibull statistical model.
Effect of flaxseed lignan on the dynamics of Lactiplantibacillus plantarum and starter cultures in fermented milk
Authors: Thomas Elizabeth , Panjagari Narender Raju , Ganguly Sangita , Rashmi Hogarehalli Mallappa , Damodharan Pulikoden Veettil Swetha , Singh Ashish Kumar
Published: April 2023

The lignan from milled defatted flaxseed powder (DFP) and defatted hull powder (DHP) was extracted using direct alkaline hydrolysis and the quantity of lignan in the extract was estimated to be in the range of 11.74–14.30 mg g−1 flaxseed on a dry matter basis. Qualitative and quantitative analysis of different strains of Lactiplantibacillus plantarum (A1, Lp9, A5) along with yogurt mix culture (NCDC 146), Streptococcus salivarius ssp. thermophilus (NCDC 74) and Lactobacillus delbrueckii ssp. bulgaricus (NCDC 253) revealed that NCDC 74/A5 and NCDC 146/A5 co‐cultures are the most compatible. Buffalo milk containing different concentrations of lignan (100–400 mg of SDG/100 mL milk) was subjected to a fermentation dynamics study. The study revealed that the fermentation dynamics of Lactiplantibacillus plantarum in the milk did not get affected by starter cultures and flaxseed lignan. The results of this study could be useful in developing functional fermented probiotic milk products containing flaxseed lignan.
The biomechanical efficacy of a hybrid support surface in protecting supine patients from sacral pressure ulcers
Authors: Katz Tomer , Gefen Amit
Published: April 2023

Support surfaces are the most important pressure ulcer/injury prevention technology available to clinicians for protecting their at‐risk patients. A hybrid support surface marries the benefits of reactive and active support surfaces, by using high‐quality foam material inside inflatable air cells. When used in its “static mode”, it is a constant low air pressure mattress which delivers pressure redistribution in response to patient bodyweight and movements, by maximising the immersion and envelopment performance of the support surface. When used in its powered “dynamic mode”, this system further delivers alternating pressure care via the connected foam and air cells. Modes of action of hybrid support surfaces were never studied quantitatively before, excluding through the limited scope of interface pressure mapping. In this work, we developed a novel computational modelling framework and simulations to visualise and quantify the state of soft tissue loading at the buttocks of a supine patient positioned on a hybrid support surface, in both the static and dynamic modes. We found that the dynamic mode effectively shifts deep concentrated soft tissue loading from under the sacral bone (towards the sacral promontory) to the tip of the sacrum (coccyx) and vice versa, and thereby, generates a deep tissue offloading effect.
Barriers and facilitators to nurses addressing social needs and associated outcomes in the ambulatory setting in adult patients: Systematic review
Authors: Jackson Carolyn L. , Hood Elizabeth , Jenkins Julie A. , Szanton Sarah L.
Published: April 2023

Aim

To examine the barriers and facilitators nurses experience in addressing social needs in the United States and the associated outcomes of addressing these needs in adults in the ambulatory care setting.

Design

A systematic review with inductive thematic and narrative synthesis.

Data Sources

PubMed, CINAHL, Web of Science, and Embase from 2010 through 2021.

Review Methods

Cochrane Handbook of Systematic Reviews; Risk of Bias‐CASP and the JBI checklist; Certainty of evidence‐GRADE‐CERQual assessment.

Results

After duplicates were removed, 1331 titles and abstracts were screened, and a full‐text review was performed on 189 studies. Twenty‐two studies met inclusion criteria. The most frequently cited barriers to addressing social needs were lack of resources, workload burden, and lack of education in social needs. The most cited facilitators were engaging the person and family in decision‐making, a well‐integrated standardized data tracking and referral documentation system, clear communication within the clinic and with community partners, and specialized education and training. Seven studies measured the nurse's impact of screening for and addressing social needs, and outcomes improved in most of these studies.

Conclusion

Barriers and facilitators specific to nurses in the ambulatory setting and associated outcomes were synthesized. Limited evidence suggests that screening for social needs by nurses may impact outcomes by decreasing hospitalizations, decreasing emergency department utilization, and improving self‐efficacy towards medical and social services navigation.

Impact

These findings inform practice and facilitate changes within nursing towards care that accounts for a person's individual social needs in ambulatory care settings and are most directly applicable to nurses and administrators in the United States.

Reporting Method

PRISMA guidelines, supplemented by the ENTREQ and SWiM guidelines.

No Patient or Public Contribution

This systematic review is the result of work performed by the four authors exclusively.
The feasibility of daily monitoring in adolescents and young adults with mild intellectual disability or borderline intellectual functioning
Authors: Hulsmans Daan H. G. , Poelen Evelien A. P. , Lichtwarck‐Aschoff Anna , Otten Roy
Published: April 2023

Background

It is unclear whether the limitations of young persons with a mild intellectual disability or borderline intellectual functioning preclude feasibility of the daily diary method.

Method

For 60 consecutive days, 50 participants (Mage = 21.4, 56% male) who receive care in an ambulatory, residential, or juvenile detention setting, self‐rated both standardised and personalised diary questions through an app. Diary entries were used for feedback in treatment. Interviews were used to explore acceptability.

Results

Average compliance was 70.4%, while 26% of participants dropped out. Compliance was good in ambulatory (88.9%) and residential care (75.6%), but not in the juvenile detention setting (19.4%). The content of self‐selected diary items varied widely. Participants deemed the method acceptable.

Conclusions

Daily monitoring is feasible for individuals with a mild intellectual disability or borderline intellectual functioning receiving ambulatory or residential care, and can provide scientists and practitioners with important insights into day‐to‐day behavioural patterns.
Surprising pandemic experiences: A confrontation between principle‐based and virtue ethics, and a plea for virtue ethics training for medical students and residents. A rudimentary outline of a four‐step model
Authors: Zuckerman Shlomit , Kimsma Gerrit K. , Devisch Ignaas
Published: April 2023

Background

In past years, physicians have, with a certain continuity, reported increasing numbers of burnout, depression and compassion fatigue in their daily practice. These problems were attributed, not only but also, to a loss of public trust and an increase in violent behaviour of patients and family members towards medical professionals in all walks of life. Recently, however, during the breakout of the coronavirus disease 2019 (COVID‐19) pandemic in 2020, there were public expressions of appreciation and respect for health care workers that almost universally have been assessed as indications of a re‐establishment of public trust in physicians and appreciation for the medical professions' commitments. In other words, shared experiences of what society was in need of: the experience of a ‘common good’. Those responses during the COVID‐19 pandemic increased positive feelings among practicing physicians, such as commitment, solidarity, competency, and experiences concerning obligations for the common good and a sense of belonging to one and the same community for all. Essentially, these responses of raised self‐awareness of commitment and solidarity between (potential) patients and medical personal point towards the social importance and power of these values and virtues. This shared domain in ethical sources of behaviour seems to hold a promise of overcoming gaps between the different spheres of doctors and patients. That promise justifies stressing the relevance of this shared domain of Virtue Ethics in the training of physicians.

Methods

In this article, therefore, we shall make a plea for the relevance of Virtue Ethics before proposing an outline of an educational programme for Virtue Ethics training for medical students and residents. Let us start by very briefly presenting on Aristotelian virtues and its relevance to modern medicine in general, and during the current pandemic in particular.

Results

We shall follow up this short presentation by a Virtue Ethics Training Model and the respective settings in which it takes place. This model has four steps as follows: (a) include moral character literacy in the formal curriculum; (b) provide ethics role modelling and informal training in moral character in the healthcare setting by senior staff; (c) create and apply regulatory guidelines regarding virtues and rules; and (d) assess success of training by evaluation of moral character of physicians.

Conclusion

Applying the four‐step model may contribute to strengthening the development of moral character in medical students and residents, and decrease the negative consequences of moral distress, burnout and compassion fatigue in health care personnel. In the future, this model should be empirically studied.
Nurse‐led shared decision‐making on complementary therapy use by patients with diabetes: An participatory action research
Authors: Chang Hsiao‐Yun , Mao Pei‐Ling , Huang Chun‐Yu
Published: April 2023

Aims

The aim of this study was to develop, implement and evaluate a nurse‐led shared decision‐making model of care for discussing the use of complementary and alternative medicine with diabetic patients and to explore to what extent the risk–benefit assessment of using complementary and alternative medicine can provide a framework for facilitating nurse–patient dialogue and strengthening patient involvement in their disease management.

Design

Participatory action research with pre‐post intervention.

Methods

A two‐run cycle of action and spirals from participatory action research was undertaken using a purposive sampling method to involve healthcare professionals and diabetic patients from September 2021 to June 2022. The nurse‐led shared decision‐making model of care was designed and implemented congruent with participatory action research principles. Quantitative measures were collected about patients' perceived involvement in shared decision‐making and their understanding of the risks and benefits of using complementary and alternative medicine. Patients' outcomes of disease control (fasting plasma glucose and HbA1c) were also collected. Data were analysed using IBM SPSS software (version 28). Interviews were summarized using thematic analysis. An EQUATOR Network guideline for participatory action research supported the preparation of this paper.

Results

Comparison of pre‐post intervention outcomes showed that patients' scale scores on shared decision‐making involvement and understanding of the risk–benefit of using complementary and alternative medicine improved significantly after implementing the model. Fasting plasma glucose improved only slightly after a 3‐month follow‐up.

Conclusions

The care model strengthens patient involvement in their disease management and makes appropriate decisions about CAM use that should reduce potentially harmful side effects or interactions between CAM and conventional medicine.

Implications for the Profession and Patient Care

The shared decision‐making model of care incorporates evidence‐based CAM research into practice, facilitates the standardization of CAM management in diabetes, improves care options for patients and educates nurses about CAM use in managing diabetes.

Patient or Public Contribution

No Patient or Public Contribution.
Opacity in bargaining over public good provision
Authors: Lamprecht Julian , Thum Marcel
Published: April 2023

We consider ultimatum bargaining over the provision of a public good. Offer‐maker and responder can delegate their decisions to agents whose actual decision rules are opaque. We show that the responder will benefit from strategic opacity, even with bilateral delegation. The incomplete information created by strategic opacity choices does not lead to inefficient negotiation failure in equilibrium. Inefficiencies arise from an inefficient provision level. While an agreement will always be reached, the public good provision will fall short of the socially desirable level. Compared with unilateral delegation, bilateral delegation is never worse from a welfare perspective.
Lumbar Intradural Disc Herniation Caused by Injury: A Case Report and Literature Review
Authors: Jin Yuan‐zhang , Zhao Bin , Zhao Xiao‐feng , Lu Xiang‐dong , Fan Zhi‐feng , Wang Chong‐jie , Qi De‐tai , Wang Xiao‐nan , Zhou Run‐tian , Zhao Yi‐bo
Published: April 2023

Background

Intradural disc herniation(IDH) caused by trauma is a rare type of disease，which is difficult to diagnose clinically and is easily misdiagnosed. We received a patient with the disease, reported the case to share the process of diagnosis and treatment and put forward our own opinions, so as to increase the probability of correct diagnosis.

Case Presentation

We report the case of a 48‐year‐old male who fell from a scaffold at a height of 2 m. Later, he developed low back pain, restricted movement, numbness and hyperalgesia of the lower left limb, and decreased left muscle strength. He was diagnosed with IDH. Treatment with posterior decompression and intramedullary decompression with pedicle screw internal fixation was performed. His postoperative course was uneventful, and he underwent regular follow up for 1 year. Good neurologic symptom improvement was achieved.

Conclusions

IDH is rare, and comprehensive consideration and film reading can improve the correct diagnosis rate. Accurate diagnosis and early decompression of laminae and intramedullary decompression can lead to good recovery after neurologic impingement.
Mast cells—fetal mast cells crosstalk with maternal interfaces during pregnancy: Friend or foe?
Authors: Msallam Rasha , Redegeld Frank A.
Published: April 2023

Mast cells (MC) are hematopoietic immune cells that play a major role during allergic reactions in adults by releasing a myriad of vasoactive and inflammatory mediators. MC seed all vascularized tissues and are most prominent in organs with a barrier function such as skin, lungs, and intestines. These secreted molecules cause mild symptoms such as localized itchiness and sneezing to life‐threatening symptoms (i.e., anaphylactic shock). Presently, despite the extensive research on Th2‐mediated immune responses in allergic diseases in adults, we are still unable to determine the mechanisms of the role of MC in developing pediatric allergic (PA) disorders. In this review, we will summarize the most recent findings on the origin of MC and discuss the underappreciated contribution of MC in the sensitization phase to maternal antibodies during pregnancy in allergic reactions and other diseases such as infectious diseases. Then, we will lay out potential MC‐dependent therapeutic strategies to be considered in future investigations to understand the remaining gaps in MC research for a better quality of life for these young patients.
Management of high‐dose intrathecal baclofen pump explant: A case report
Authors: Belisle Haley Campbell , Agrawal Mrinal , Newton Keith , Yeung Brent , Dayal Rakhi
Published: April 2023

Background

Intrathecal baclofen (ITB) is a proven, effective treatment for refractory spasticity and chronic pain, with applications ranging from spinal cord injury to amyotrophic lateralsclerosis (ALS). Despite its effectiveness, the withdrawal syndrome of intrathecal baclofen can be life‐threatening.

Case Report

This case describes the treatment of a patient with chronic spasticity related to ALS with an ITB pump infection requiring explant and a prolonged period of antibiotics before reimplantation. A 62‐year‐old man with ALS‐related spasticity maintained on high‐dose ITB for 20 years presented to the emergency department with one week of fever, confusion, and localized erythema to the R‐side of his abdomen. Laboratories indicated a mild leukocytosis 12.9 K/uL and imaging showed a 2.9‐cm fluid collection with fat stranding surrounding the ITB pump. The pack was explanted, and the patient started on intravenous antibiotics. Due to the high baclofen dosage, our pain service recommended PO (per os) baclofen 30 mg every 6 h via gastrostomy and PO diazepam 10 mg every 6 h via gastrostomy. These doses were titrated carefully to avoid oversedation while preventing withdrawal symptoms. On Day 23 postexplant, the patient had the baclofen pump reimplanted and baclofen titrated over three days to his previous dose of ITB.

Conclusion

This case demonstrates a successful approach to avoiding severe baclofen withdrawal using PO baclofen combined with PO diazepam. The high dose of maintenance ITB (1188.8 mcg/day), the inability to reinsert the patient's intrathecal pump, and the high risk of intubation in a patient with severe neuromuscular dysfunction all made this a challenging case.
SCREENING THE EFFECT OF THE EXPRESSION MEDIUM AND GROWTH CONDITIONS ON THE PERFORMANCE OF ENGINEERED XYLANASE PRODUCED BY IMMOBILIZED RECOMBINANT E. COLI
Authors: Mohamad Fuzi Siti Fatimah Zaharah , Nor Ashikin Nur Atiqah Lyana , Kheng Oon Low
Published: April 2023

Escherichia coli is the most prevalent host organism for the production of recombinant en-zymes. This was feasible due to the possibility of genetic modification and the availability of multiple E. coli strains as recombinant systems. The primary disadvantage of using E. coli as a host, however, is bacterial cell lysis due to tension build-up in the periplasmic space caused by the overexpression of the recombinant enzyme. Therefore, immobilization is preferable to cytoplasmic excretion for directing the expression of recombinant enzymes into the culture medium. This research investigated the effect of graphene oxide (GO) on the xylanase and β-galactosidase activity of immobilized recombinant E. coli. The effect of culture conditions (expression medium, IPTG, post induction temperature, post induction duration, agitation rate, and pH) on xylanase excretion and cell survival of an immobilized cell was studied using the one factor at a time (OFAT) method. After 24 hours of induction, using terrific broth (TB) as a medium increased xylanase excretion to 0.060 U/ml and resulted in decreased β-galactosidase activity (1.218 U/ml). Apart from that, a lower concentration of isopropyl -D-1-thiogalactopyranoside (IPTG) at 0.01 mM, a lower post-induction temperature (25°C), a 5-hour post-induction time, neutral pH, and 150 rpm significantly increased the xylanase excretion of immobilized cells with low β-galactosidase activity. This study established that immobilizing recombinant E. coli on GO may be advantageous for the excretion of recombinant proteins with a high cell viability.
A REVIEW OF POOL BOILING HEAT TRANSFER PROPERTIES BY NANOFLUID
Authors: S. A. M. Najmi , Hassan A.
Published: April 2023

Boiling heat transfer has maintained a high degree of interest due to the range of its applications in the energy sector. In recent years, much research has focused on improving the nucleate pool boiling by modifying the fluid properties. In this review article, the basic properties and characteristics of Al2O3 nanofluids and few other nanofluids are explored and discussed through past research findings. Next, previous studies that involved pool boiling heat transfer enhancement using Al2O3 nanofluid and its performance in terms of critical heat flux (CHF) and heat transfer coefficient (HTC) are further highlighted. These studies have employed methods that affected the performance of CHF and HTC such as electric field and surface modification. Maximum enhancement in CHF measured is approximately 200%. On the other hand, usage of prediction models to predict enhancements are also discussed thoroughly. Regardless of boiling performance enhancements with the deployment of nanofluids, several concerns must first be addressed before it is able to be deployed for practical use.
Applying Latent Dirichlet Allocation and Support Vector Regression to the Aesthetic Design of Medical Nursing Beds
Authors: Yuan Bingkun , Ye Junnan , Wu Xinying , Yang Chaoxiang
Published: April 2023

With the development of social productivity and the improvement in material living standards, emotional value has become the core driver of the enhancement of product market competitiveness. A medical nursing bed, one of the most typical types of medical devices, is designed with little attention to the emotional experience of the users. Therefore, this paper proposes an innovative perceptual design approach under the Kansei engineering (KE) framework for resource-limited and information-poor companies. It guides the aesthetic design of medical nursing beds by constructing a mapping relationship between users’ perceptual needs and the design characteristics of medical nursing beds to maximize users’ emotions. First, latent Dirichlet allocation (LDA) is used to extract usable Kansei semantics from big data, compensating for the subjectivity of traditional KE data input. Then, the design characteristics obtained after deconstructing a medical nursing bed are simplified with rough set theory (RST). Finally, a mapping model between users’ perceptual needs and the core design characteristics of nursing beds is established through support vector regression (SVR), and the optimal design solution is obtained by weighting calculation. The optimal combination of design characteristics for medical nursing beds is finally obtained. The results suggest that the design method proposed in this paper can help designers accurately grasp users’ emotional perceptions in terms of aesthetic design and scientifically guide and complete the design of new medical nursing beds, verifying the feasibility and scientificity of the proposed method in terms of aesthetic design.
An SPNS1-dependent lysosomal lipid transport pathway that enables cell survival under choline limitation
Authors: Scharenberg Samantha G. , Dong Wentao , Ghoochani Ali , Nyame Kwamina , Levin-Konigsberg Roni , Krishnan Aswini R. , Rawat Eshaan S. , Spees Kaitlyn , Bassik Michael C. , Abu-Remaileh Monther
Published: April 2023

Lysosomes degrade macromolecules and recycle their nutrient content to support cell function and survival. However, the machineries involved in lysosomal recycling of many nutrients remain to be discovered, with a notable example being choline, an essential metabolite liberated via lipid degradation. Here, we engineered metabolic dependency on lysosome-derived choline in pancreatic cancer cells to perform an endolysosome-focused CRISPR-Cas9 screen for genes mediating lysosomal choline recycling. We identified the orphan lysosomal transmembrane protein SPNS1 as critical for cell survival under choline limitation. SPNS1 loss leads to intralysosomal accumulation of lysophosphatidylcholine (LPC) and lysophosphatidylethanolamine (LPE). Mechanistically, we reveal that SPNS1 is a proton gradient–dependent transporter of LPC species from the lysosome for their re-esterification into phosphatidylcholine in the cytosol. Last, we establish that LPC efflux by SPNS1 is required for cell survival under choline limitation. Collectively, our work defines a lysosomal phospholipid salvage pathway that is essential under nutrient limitation and, more broadly, provides a robust platform to deorphan lysosomal gene function.
We cannot escape gendering robots
Authors: Murphy Robin R.
Published: April 2023

The novelAutonomousembodies two decades of human-robot interaction studies on the effects of robot gender.
Comparing antibody assays as correlates of protection against COVID-19 in the COVE mRNA-1273 vaccine efficacy trial
Authors: Benkeser David , Montefiori David C. , McDermott Adrian B. , Fong Youyi , Janes Holly E. , Deng Weiping , Zhou Honghong , Houchens Christopher R. , Martins Karen , Jayashankar Lakshmi , Castellino Flora , Flach Britta , Lin Bob C. , O’Connell Sarah , McDanal Charlene , Eaton Amanda , Sarzotti-Kelsoe Marcella , Lu Yiwen , Yu Chenchen , Borate Bhavesh , van der Laan Lars W. P. , Hejazi Nima S. , Kenny Avi , Carone Marco , Williamson Brian D. , Garver Jennifer , Altonen Erin , Rudge Thomas , Huynh Chuong , Miller Jacqueline , El Sahly Hana M. , Baden Lindsey R. , Frey Sharon , Malkin Elissa , Spector Stephen A. , Andrasik Michele P. , Kublin James G. , Corey Lawrence , Neuzil Kathleen M. , Carpp Lindsay N. , Pajon Rolando , Follmann Dean , Donis Ruben O. , Koup Richard A. , Gilbert Peter B. ,   on behalf of the Immune Assays,   Moderna Inc.,   Coronavirus Vaccine Prevention Network (CoVPN)/Coronavirus Efficacy (COVE),   United States Government (USG)/CoVPN Biostatistics Teams
Published: April 2023

The best assay or marker to define mRNA-1273 vaccine–induced antibodies as a correlate of protection (CoP) is unclear. In the COVE trial, participants received two doses of the mRNA-1273 COVID-19 vaccine or placebo. We previously assessed IgG binding antibodies to the spike protein (spike IgG) or receptor binding domain (RBD IgG) and pseudovirus neutralizing antibody 50 or 80% inhibitory dilution titer measured on day 29 or day 57, as correlates of risk (CoRs) and CoPs against symptomatic COVID-19 over 4 months after dose. Here, we assessed a new marker, live virus 50% microneutralization titer (LV-MN
50
), and compared and combined markers in multivariable analyses. LV-MN
50
was an inverse CoR, with a hazard ratio of 0.39 (95% confidence interval, 0.19 to 0.83) at day 29 and 0.51 (95% confidence interval, 0.25 to 1.04) at day 57 per 10-fold increase. In multivariable analyses, pseudovirus neutralization titers and anti-spike binding antibodies performed best as CoRs; combining antibody markers did not improve correlates. Pseudovirus neutralization titer was the strongest independent correlate in a multivariable model. Overall, these results supported pseudovirus neutralizing and binding antibody assays as CoRs and CoPs, with the live virus assay as a weaker correlate in this sample set. Day 29 markers performed as well as day 57 markers as CoPs, which could accelerate immunogenicity and immunobridging studies.