bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy of exclusive enteral nutrition on the mucosal healing of different gastrointestinal segments in children with Crohn's disease
Authors: Tang Wen Juan , Shi Peng , Xia Hai Jiao , Wu Jie , Wang Yu Huan , Huang Ying
Published: April 2024

Objective

To investigate the association between disease location and segmental mucosal healing (SMH) following exclusive enteral nutrition (EEN) in children with Crohn's disease (CD).

Methods

Treatment‐naive pediatric patients with endoscopically active CD treated with EEN alone as induction therapy were retrospectively enrolled from January 1, 2017 to June 30, 2022. The simple endoscopic score for CD (SES‐CD) was employed to score disease activity in the upper gastrointestinal (GI) tract (esophagus, stomach, duodenum), rectum, left colon, transverse colon, right colon, and terminal ileum. While the Lewis score assessed that of the small bowel from the jejunum to the proximal ileum (except the terminal ileum). The variation in the total scores for each segment and SES‐CD subscores for each ileocolonic segment from baseline to 1 year after EEN therapy and the segmental endoscopic outcomes and potential predictors associated with SMH for the segments scored by SES‐CD were evaluated.

Results

Overall, 82 children with CD were enrolled. Except for the upper GI segment, scores in other segments declined significantly from baseline to EEN completion (all P < 0.001). We analyzed 486 segments (79, 80, 81, 82, 82 and 82 from upper GI tract, terminal ileum, right colon, transverse colon, left colon, and rectum) and found that the segmental SES‐CD at baseline (odds ratio [OR] 0.62, 95% confidence interval [CI] 0.55–0.70, P < 0.001) and upper GI location (OR 0.25, 95% CI 0.11–0.55, P = 0.001) were associated with SMH at EEN completion.

Conclusion

Disease location of the upper GI segment in pediatric CD was associated with SMH following EEN therapy.
Alcohol use disorder and risk of specific methods of suicide death in a national cohort
Authors: Edwards Alexis C. , Abrahamsson Linda , Crump Casey , Sundquist Jan , Sundquist Kristina , Kendler Kenneth S.
Published: April 2024

Introduction

Alcohol use disorder (AUD) is among the strongest correlates of suicide death, but it is unclear whether AUD status is differentially associated with risk of suicide by particular methods.

Methods

The authors used competing risks models to evaluate the association between AUD status and risk of suicide by poisoning, suffocation, drowning, firearm, instruments, jumping, or other means in a large Swedish cohort born 1932–1995 (total N = 6,581,827; 48.8% female). Data were derived from Swedish national registers, including the Cause of Death Register and a range of medical registers.

Results

After adjusting for sociodemographic factors and familial liability to suicidal behavior, AUD was positively associated with risk of suicide for each method evaluated (cumulative incidence differences: 0.006–1.040 for females, 0.046–0.680 for males), except the association with firearm suicide in females. AUD was most strongly associated with risk of suicide by poisoning. Sex differences in the effects of AUD and family liability were observed for some, but not all, methods. Furthermore, high familial liability for suicidal behavior exacerbated AUD's impact on risk for suicide by poisoning (both sexes) and suffocation and jumping (males only), while the inverse interaction was observed for firearm suicide (males only).

Conclusions

AUD increases risk of suicide by all methods examined and is particularly potent with respect to risk of suicide by poisoning. Differences in risk related to sex and familial liability to suicidal behavior underscore AUD's nuanced role in suicide risk. Future research should investigate targeted means restriction effectiveness among persons with AUD.
Predation event and shelter site use by a threatened monitor lizard, Varanus rosenbergi, in the Little Desert, Victoria
Authors: Westaway Dylan M. , Thorpe Mirinda , Hosking Iestyn
Published: April 2024

Heath monitors (Varanus rosenbergi) are arguably the most thoroughly studied Australian varanid, largely stemming from long‐term research on Kangaroo Island, South Australia. However, research on other populations within this species' disjunct distribution is limited. We opportunistically tracked a heath monitor in the Little Desert National Park, Victoria, after it consumed a painted dragon (Ctenophorus pictus) which we were radiotracking for another study. We report the first record of a heath monitor depredating a painted dragon, as well as the first record of heath monitors repeatedly using a hollow log for shelter. The hollow log was occupied on 10 consecutive occasions over 18 days, and then again on five occasions 9–11 months later. Our observations identify hollow logs as a habitat resource which should be considered in conservation strategies for this threatened monitor lizard. Furthermore, we observed two individuals in close proximity, possibly a breeding pair, in January. This implies that breeding may occur in summer for the Victorian mallee population, as has been reported in other populations, rather than in spring as has been speculated. Research is sorely needed across this species' disjunct distribution across southern Australia. To date, populations of heath monitors in the Victorian mallee have garnered no scientific study, despite their listing as Critically Endangered.
Review article: Telecare in gastroenterology—Within the COVID‐19 pandemic and beyond
Authors: Hakak Fatima , Patel Rajan N. , Gearry Richard B.
Published: April 2024

Background

Telehealth is a growing model of care, greatly accelerated with the demands of the COVID‐19 pandemic. Telecare is a synchronous audio‐visual or audio‐only format of health delivery.

Aims

To evaluate the existing literature on telecare within adult gastroenterology subspecialties to determine if outcomes are comparable to traditional in‐person consultations and to highlight the Pokapū Network, a local initiative in the Lakes Region of New Zealand, amongst these international findings.

Methods

We completed an OVID MEDLINE search using the terms gastroenterology, endoscopy, digestive system, inflammatory bowel disease, functional, hepatology, liver, telemedicine, telehealth, videoconferencing, remote consultation, video clinic and telephone clinic.

Results

Patients showed positive attitudes towards telecare and, in several reports, would elect to have telecare consults in the future. Telecare reduces travel time and out‐of‐pocket costs for patients and the need for patients to take time off work. Generally, patients engaging with telecare show equivalent health outcomes to patients engaging with traditional models of care. Patients from ethnic minority groups or lower socio‐economic backgrounds, or who are older, are less likely to complete a ‘successful’ telecare consult.

Conclusion

Telecare is a useful model of care to allow gastroenterology centres to function within the context of COVID‐19 isolation and beyond. It has significant benefits for patients who face geographical and financial barriers to accessing healthcare. Telecare models such as the Pokapū Network hold promise in reducing inequities for gastroenterology patients. Such models must be introduced with consideration of digital disparities that exist amongst patients to avoid worsening the digital divide.
Stigma salience increases loneliness among ethnic minorities
Authors: Doyle David Matthew , Barreto Manuela
Published: April 2024

Research shows that ethnic minorities are at increased risk of loneliness compared to the general population of the United Kingdom. We hypothesized that stigma salience increases loneliness among ethnic minorities, conducting two experimental studies with ethnic minorities (Study 1: N = 134, Study 2: N = 267) in which participants were randomly assigned to a stigma salience (recalling a personal experience of discrimination based on ethnicity) or control condition (recalling a past meal in Study 1 and the experience of reading a book in Study 2). Across these two studies, we demonstrated that stigma salience consistently increased self‐reported loneliness relative to the control conditions. Study 1 additionally showed evidence for an indirect effect of stigma salience on loneliness through feelings of anxiety. Study 2 replicated the effect of self‐relevant (but not non‐self‐relevant) stigma salience on loneliness and provided suggestive evidence for a more specific indirect effect through identity‐related social anxiety.
Frontiers of public service motivation research in Canada: A scoping review
Authors: Wranik Wiesława Dominika , McPherson Michelle , Caron Isabelle , Liu Huiyan
Published: April 2024

The Canadian public sector employs around one‐fifth of Canadian workers; they are responsible for policy making, stewarding public funds, and serving the public. Canadian governments struggle with job satisfaction, engagement, retention, and turnover, all of which may be associated with public service motivation (PSM). We conducted a scoping review of Canadian PSM research to synthesize what is known about these associations in the Canadian context. We identified 24 published studies and four works in progress. These demonstrate that PSM exists among Canadian public servants from the early stages of their career until later stages, and that PSM bolsters attraction to public sector work among students. No studies measured PSM among Canadian public servants using a validated instrument. Further research about the contributions of PSM to the quality of Canadian public services and how employers can nurture PSM is recommended, particularly given recent changes in work environments.
Long noncoding RNATUG1 promotes cisplatin resistance in ovarian cancer via upregulation of DNA polymerase eta
Authors: Sonobe Ryosuke , Yang Peng , Suzuki Miho M. , Shinjo Keiko , Iijima Kenta , Nishiyama Nobuhiro , Miyata Kanjiro , Kataoka Kazunori , Kajiyama Hiroaki , Kondo Yutaka
Published: April 2024

Chemoresistance is a major cause of high mortality and poor survival in patients with ovarian cancer (OVCA). Understanding the mechanisms of chemoresistance is urgently required to develop effective therapeutic approaches to OVCA. Here, we show that expression of the long noncoding RNA, taurine upregulated gene 1 (TUG1), is markedly upregulated in samples from OVCA patients who developed resistance to primary platinum‐based therapy. Depletion of TUG1 increased sensitivity to cisplatin in the OVCA cell lines, SKOV3 and KURAMOCHI. Combination therapy of cisplatin with antisense oligonucleotides targeting TUG1 coupled with a drug delivery system effectively relieved the tumor burden in xenograft mouse models. Mechanistically, TUG1 acts as a competing endogenous RNA by downregulating miR‐4687‐3p and miR‐6088, both of which target DNA polymerase eta (POLH), an enzyme required for translesion DNA synthesis. Overexpression of POLH reversed the effect of TUG1 depletion on cisplatin‐induced cytotoxicity. Our data suggest that TUG1 upregulation allows OVCA to tolerate DNA damage via upregulation of POLH; this provides a strong rationale for targeting TUG1 to overcome cisplatin resistance in OVCA.
Caregiver and parent–child relationship during COVID‐19: The mediator role of anxiety and life satisfaction
Authors: Ayran Gülsün , Çevik Özdemir Hamide Nur
Published: April 2024

Aim

This research was conducted to evaluate the mediation effect of anxiety and life satisfaction on the relationship between Care burden and Parent Child Relationship in Turkish parents during the COVID‐19 epidemic.

Methods

The research was carried out with parents (221 women and 219 men) who have children between the ages of 6–18 living in Turkey. Data were collected in June–July 2021 using the demographic data form, “Care Burden Scale,” “Pervasive Anxiety Disorder‐7 Test,” “Satisfaction with Life Scale,” and “Parent Child Relationship Scale.” Path analysis was used to analyse the relationships. In this study, structural equation modelling (SEM) was used to examine the path analysis.

Results

It was found that the burden of care and anxiety of the parents and the parent–child conflict relationship were positively correlated and negatively correlated with the life satisfaction and parent–child closeness relationship (p < 0.05). Path model analyses revealed that the burden of care had a direct effect on anxiety and life satisfaction, and an indirect effect on the parent–child relationship, respectively.

Conclusions

It shows that parents' perceptions of how the COVID‐19 pandemic is affecting their mental health have implications for parent and child well‐being, with stronger relationships for low‐income families. Anxiety and life satisfaction had a mediating effect between care burden and parent–child relationship. Given the demonstrable impact of COVID‐19 on the parent–child relationship, this study may guide the planning of coping strategies and programmes focused on mental health.
A gender‐based violence prevention programme—Young people's participation and activism in Scotland
Authors: Lamb Eilidh , Young Neil , Ledgerwood Vicki , Berry Chloe , Young Leah
Published: April 2024

This article presents a critical reflection from young people and youth workers on their participation in a gender‐based violence prevention programme implemented in Scotland. Authors have focussed their lens on the role of young people's peer education and activism, including using arts‐based methods to reflect on their work. The programme aimed to address the pervasive issue of gender‐based violence and empower young individuals to become agents of change within their communities. The implications of this study contribute to the broader discourse on gender‐based violence prevention and the role of young people in effecting social change.
Matrix stiffness regulates macrophage polarisation via the Piezo1‐YAP signalling axis
Authors: Mei Feng , Guo Yaru , Wang Yu , Zhou Yingying , Heng Boon Chin , Xie Mengru , Huang Xiaofei , Zhang Shihan , Ding Shuai , Liu Fangyong , Deng Xuliang , Chen Lili , Yang Cheng
Published: April 2024

Macrophages play a pivotal role in the immunological cascade activated in response to biomedical implants, which predetermine acceptance or rejection of implants by the host via pro‐ and anti‐inflammatory polarisation states. The role of chemical signals in macrophage polarisation is well‐established, but how physical cues regulate macrophage function that may play a fundamental role in implant‐bone interface, remains poorly understood. Here we find that bone marrow‐derived macrophages (BMDM) cultured on polyacrylamide gels of varying stiffness exhibit different polarisation states. BMDM are ‘primed’ to a pro‐inflammatory M1 phenotype on stiff substrates, while to an anti‐inflammatory M2 phenotype on soft and medium stiffness substrates. It is further observed that matrix stiffening increases Piezo1 expression, as well as leads to subsequent activation of the mechanotransduction signalling effector YAP, thus favouring M1 polarisation whilst suppressing M2 polarisation. Moreover, upon treatment with YAP inhibitor, we successfully induce macrophage re‐polarisation to the M2 state within the implant site microenvironment, which in turn promotes implant osseointegration. Collectively, our present study thus characterises the critical role of the Piezo1‐YAP signalling axis in macrophage mechanosensing and stiffness‐mediated macrophage polarisation and provides cues for the design of immuno‐modulatory biomaterials that can regulate the macrophage phenotype.
Short, frequent, light‐intensity walking activity improves postprandial vascular‐inflammatory biomarkers in people with type 1 diabetes: The SIT‐LESS randomized controlled trial
Authors: Safdar Nawaz Z. , Alobaid Anwar M. , Hopkins Mark , Dempsey Paddy C. , Pearson Sam M. , Kietsiriroje Noppadol , Churm Rachel , Ajjan Ramzi A. , Campbell Matthew D.
Published: April 2024

Aim

To examine the effect of interrupting prolonged sitting with short, frequent, light‐intensity activity on postprandial cardiovascular markers in people with type 1 diabetes (T1D).

Materials and Methods

In a randomized crossover trial, 32 adults with T1D (mean ± SD age 28 ± 5 years, glycated haemoglobin 67.9 ± 12.6 mmol/mol, 17 women) completed two 7‐h laboratory visits separated by >7 days. Participants either remained seated for 7 h (SIT) or interrupted sitting with 3‐min bouts of self‐paced walking at 30‐min intervals commencing 1 h after each meal (SIT‐LESS). Physical activity, insulin regimen, experimental start times, and meal consumption were standardized during each arm. Plasma levels of interleukin (IL)‐1β, tumour necrosis factor (TNF)‐α, plasminogen activator inhibitor (PAI)‐1 and fibrinogen were sampled at baseline, 3.5 and 7 h, and assessed for within‐ and between‐group effects using a repeated measures ANOVA. The estimated glucose disposal rate was used to determine the insulin resistance status.

Results

Vascular‐inflammatory parameters were comparable between SIT and SIT‐LESS at baseline (p > .05). TNF‐α, IL‐1β, PAI‐1 and fibrinogen increased over time under SIT, whereas these rises were attenuated under SIT‐LESS (p < .001). Specifically, over the 7 h under SIT, postprandial increases were detected in TNF‐α, IL‐1β, PAI‐1 and fibrinogen (+67%, +49%, +49% and +62%, respectively; p < .001 for all). Conversely, the SIT‐LESS group showed no change in IL‐1β (−9%; p > .50), whereas reductions were observed in TNF‐α, PAI‐1 and fibrinogen (−22%, −42% and −44%, respectively; p < .001 for all). The intervention showed enhanced effects in insulin‐resistant individuals with T1D.

Conclusions

Interrupting prolonged sitting with light‐intensity activity ameliorates postprandial increases in vascular‐inflammatory markers in T1D.

Trial Registration

The trial was prospectively registered (ISRCTN13641847).
Cardiovascular health metrics defined by Life's Essential 8 scores and subsequent macrovascular and microvascular complications in individuals with type 2 diabetes: A prospective cohort study
Authors: Huang Ze‐Gui , Gao Jing‐Wei , Zhang Hai‐Feng , You Si , Xiong Zhuo‐Chao , Wu Yu‐Biao , Guo Da‐Chuan , Wang Jing‐Feng , Chen Yang‐Xin , Zhang Shao‐Ling , Liu Pin‐Ming
Published: April 2024

Aim

To investigate the association between cardiovascular health metrics defined by Life's Essential 8 (LE8) scores and vascular complications among individuals with type 2 diabetes (T2D).

Materials and Methods

This prospective study included 11 033 participants with T2D, all devoid of macrovascular diseases (including cardiovascular and peripheral artery disease) and microvascular complications (e.g. diabetic retinopathy, neuropathy and nephropathy) at baseline from the UK Biobank. The LE8 score comprised eight metrics: smoking, body mass index, physical activity, non‐high‐density lipoprotein cholesterol, blood pressure, glycated haemoglobin, diet and sleep duration. Cox proportional hazards models were established to assess the associations of LE8 scores with incident macrovascular and microvascular complications.

Results

During a median follow‐up of 12.1 years, we identified 1975 cases of incident macrovascular diseases and 1797 cases of incident microvascular complications. After adjusting for potential confounders, each 10‐point increase in the LE8 score was associated with an 18% lower risk of macrovascular diseases and a 15% lower risk of microvascular complications. Comparing individuals in the highest and lowest quartiles of LE8 scores revealed hazard ratios of 0.55 (95% confidence interval 0.47‐0.62) for incident macrovascular diseases, and 0.61 (95% confidence interval 0.53‐0.70) for incident microvascular complications. This association remained robust across a series of sensitivity analyses and nearly all subgroups.

Conclusion

Higher LE8 scores were associated with a lower risk of incident macrovascular and microvascular complications among individuals with T2D. These findings underscore the significance of adopting fundamental strategies to maintain optimal cardiovascular health and curtail the risk of developing diabetic vascular complications.
Prognostic significance of echocardiographic deformation imaging in adult congenital heart disease
Authors: van Rosendael Philippe J. , Taha Karim , Guglielmo Marco , Teske Arco J. , van der Harst Pim , Sieswerda Gertjan , Cramer Maarten J. , van der Zwaan Heleen B.
Published: April 2024

Background

Due to medical and surgical advancements, the population of adult patients with congenital heart disease (ACHD) is growing. Despite successful therapy, ACHD patients face structural sequalae, placing them at increased risk for heart failure and arrhythmias. Left and right ventricular function are important predictors for adverse clinical outcomes. In acquired heart disease it has been shown that echocardiographic deformation imaging is of superior prognostic value as compared to conventional parameters as ejection fraction. However, in adult congenital heart disease, the clinical significance of deformation imaging has not been systematically assessed and remains unclear.

Methods

According to the Preferred Reporting Items for Systematic Reviews checklist, this systematic review included studies that reported on the prognostic value of echocardiographic left and/or right ventricular strain by 2‐dimensional speckle tracking for hard clinical end‐points (death, heart failure hospitalization, arrhythmias) in the most frequent forms of adult congenital heart disease.

Results

In total, 19 contemporary studies were included. Current data shows that left ventricular and right ventricular global longitudinal strain (GLS) predict heart failure, transplantation, ventricular arrhythmias and mortality in patients with Ebstein's disease and tetralogy of Fallot, and that GLS of the systemic right ventricle predicts heart failure and mortality in patients post atrial switch operation or with a congenitally corrected transposition of the great arteries.

Conclusions

Deformation imaging can potentially impact the clinical decision making in ACHD patients. Further studies are needed to establish disease‐specific reference strain values and ranges of impaired strain that would indicate the need for medical or structural intervention.
Guidelines for conducting, analyzing, and interpreting electrical penetration graph (EPG) experiments on herbivorous piercing–sucking insects
Authors: Walker G. P. , Fereres A. , Tjallingii W. F.
Published: April 2024

The electrical penetration graph (EPG) allows researchers to obtain information on the feeding behavior of herbivorous piercing–sucking insects, mostly Hemiptera. Guidelines are proposed for designing and conducting EPG experiments on insect–plant interactions, and for analyzing and interpreting the data. Several statistical issues common in EPG experiments are discussed. Pre‐recording insect handling, wiring, and being tethered can affect feeding behavior and recommendations are made to minimize such stresses. Recording duration can have a large effect on some variables and interpretation of the data. The pros and cons of long vs. short recording duration are discussed, and suggestions are made for reconciling these conflicting concerns. Replicates lacking a specific waveform pose problems for analyzing variables associated with that waveform. Proper ways for handling these replicates when analyzing data are discussed. The waveform in progress when the recording ends will be terminated before it would naturally end; consequently, its duration will be artificially short (truncated). This creates a problem for calculating mean or median duration of waveform periods (a waveform period is a single occurrence of the waveform), especially for waveforms that tend to occur relatively few times during a recording and in long periods, such as waveforms E2 and G (phloem and xylem sap ingestion for aphids) or Xi (xylem sap ingestion for xylem feeders). Based on a detailed analysis (see the supporting information), guidance is given on how to calculate mean and median duration of waveform periods when the last period is truncated. A modified experimental design is suggested to avoid the problem of truncated waveform periods. Most EPG variables are interdependent, and their values can affect one another. This interdependence should be considered when drawing conclusions from the data. In studies on plant resistance against vascular sap‐feeders, variables that are associated with resistance encountered during the penetration route to the vascular tissue and those encountered in the vascular tissue are discussed.
Surgical treatment of invasive fungal infection in pediatric oncology
Authors: Federica Fati , Elisa Zambaiti , Maria Grazia Petris , Calogero Virgone , Patrizia Dall' Igna , Maria Caterina Putti , Marica De Pieri , Piergiorgio Gamba , DeCorti Federica
Published: April 2024

Background

Invasive fungal disease (IFD) is typically aggressive and related with high mortality in children with a hematological malignancy. The association of medical and surgical treatment may ameliorate the outcome. The aim of this study was to analyze the surgical treatment of fungal infections in pediatric oncological populations.

Methods

Retrospective study (2000–2022) of a single‐center experience. We reviewed the medical record of all patients with hematologic malignancies and IFD, analyzing the outcome.

Results

From the 70 pediatric cases of hematologic malignancies with the diagnosis IFD over 22 years, we included in the present study 44 cases who required surgical approaches for either diagnosis or treatment. Twenty‐one patients were males and the mean age was 11 (range 1–23) years. The main indications for surgery were lack of improvement following medical treatment and/or progression of fungal infection (80%) and diagnosis confirmation (20%). Only five patients needed an emergency operation for rapid worsening of symptoms. The most common site of infection was the lung (80%) and the most frequently identified pathogen was Aspergillus (75%). The most common surgical procedures were lobectomy (performed in 17 patients) and atypical lung resection (10). Complications of surgery were mostly treated by medical approach. The mean time of resumption of oncological treatment was 40 (range 0–150) days.

Conclusions

Surgery is an important step in the multimodal treatment of invasive fungal infection with excellent resolution rate. Overall mortality depends on the underlying malignancy.
High‐resolution mapping of available water content in Senegal using iSDA Africa dataset and USDA Rosetta3 model
Authors: Lavarenne Jérémy , Leroux Louise
Published: April 2024

This data article presents a high‐resolution map of available water content (AWC) for Senegal, derived from the iSDA Africa dataset and the USDA Rosetta3 model, as well as the method used for its production. The map covers the entire country at a resolution of 30 m and provides a valuable resource for hydrological studies and spatialized crop model simulations in the region where water is a limiting factor for crop production. The dataset is based on existing soil properties data and leverages pedotransfer functions (PTFs) to estimate water retention capabilities from soil properties. This AWC map derived from datasets with enhanced accuracy offers a more precise estimate of soil water retention capacity, which can be instrumental in informing water and agricultural management, policy decisions and investments. The dataset, including intermediate variables, is available in geotiff format at Cirad Dataverse under the DOI 10.18167/DVN1/SGNSII and complies with FAIR data principles, allowing its broad reuse. The code used to produce this dataset is also made available under the DOI 10.5281/zenodo.10078399, so that AWC maps can be produced for any territory covered by the iSDA Africa product.
Beyond T cell toxicity – Intrathecal chemokine CXCL13 indicating B cell involvement in immune‐related adverse events following checkpoint inhibition: A two‐case series and literature review
Authors: Otto Ferdinand , Seiberl Michael , Bieler Lara , Moser Tobias , Kleindienst Waltraud , Wallner‐Essl Walter , Koelblinger Peter , Wipfler Peter , Harrer Andrea
Published: April 2024

Background and purpose

This study was undertaken to raise awareness of a role of B cells in immune checkpoint inhibitor (ICI)‐associated neurological immune‐related adverse events (nirAE).

Methods

A systematic literature review was made, with case observations of a melanoma and a non‐small cell lung cancer (NSCLC) patient who developed ICI‐associated nirAE with cerebrospinal fluid (CSF) findings indicating B cell involvement.

Results

Two patients receiving ipilimumab/nivolumab for melanoma and chemotherapy/pembrolizumab for NSCLC developed nirAE in the form of myocarditis/myositis/myasthenia gravis overlap syndrome (triple M) and cerebellitis plus longitudinal transverse myelitis (c‐LETM), respectively. Intrathecal inflammation with chemokine C‐X‐C motif ligand (CXCL13) elevation was present in both patients; the triple M case had acetylcholine receptor antibodies, antititin reactivity, altered CD4/CD8 T cell ratio in blood, and depressed programmed death‐1 (PD‐1) expression on CSF T cells; the c‐LETM case showed intrathecal antibody production and plasma cells. Both patients insufficiently responded to first‐line treatment. The NSCLC case improved upon administration of B cell‐depleting therapy with rituximab, whereas the melanoma patient died before escalation therapy was initiated. Literature research revealed one additional ICI‐associated LETM case with intrathecal CXCL13 elevation, three cases with ICI‐associated aquaporin‐4 antibody neuromyelitis spectrum disorder, and evidence of B cell‐mediated toxicity based on antibody‐mediated immune pathologies in ICI‐associated immune‐related adverse events.

Conclusions

The case observations highlight the plethora of uncertainties in diagnosis and treatment of ICI‐associated nirAE, exemplify the heterogeneity of immune mechanisms involved, and suggest a role of B cells, which may be underdiagnosed. Intrathecal CXCL13 may serve as a biomarker of B cell involvement in nirAE, supported by intrathecal immunoglobulin synthesis, presence of plasma cells, and/or recruitment of cognate immune cells.
Ultimate pose estimation: A comparative study
Authors: Hassan Esraa , Hossain M. Shamim , Elmuogy Samir , Ghoneim Ahmed , AlMutib Khalid , Saber Abeer
Published: April 2024

Pose estimation is a computer vision task used to detect and estimate the pose of a person or an object in images or videos. It has some challenges that can leverage advances in computer vision research and others that require efficient solutions. In this paper, we provide a preliminary review of the state‐of‐the‐art in pose estimation, including both traditional and deep learning approaches. Also, we implement and compare the performance of Hand Pose Estimation (HandPE), which uses PoseNet architecture for hand sign problems, for an ASL dataset by using different optimizers based on 10 common evaluation metrics on different datasets. Also, we discuss some related future research directions in the field of pose estimation and explore new architectures for pose estimation types. After applying the PoseNet model, the experiment results showed that the accuracy achieved was 99.9%, 89%, 97%, 79%, and 99% for the ASL alphabet, HARPET, Yoga, Animal, and Head datasets, comparing those with common optimizers and evaluation metrics on different dataset.
A quantitative residual stiffness model for carbon fiber reinforced polymer tendons
Authors: Wang Chao , Zhang Jiwen , Gonzalez‐Libreros Jaime , Tu Yongming , Elfgren Lennart , Sas Gabriel
Published: April 2024

In this study, tension‐tension fatigue tests were conducted to investigate the residual stiffness degradation of carbon fiber‐reinforced polymer (CFRP) tendons. Different stress levels were used in the tests, and measurements of residual stiffness and the number of loading cycles were taken. Based on experimental data for CFRP tendons, a quantitative residual stiffness model was developed by modifying Yao's model. This model is applicable to various stress levels. To assess its accuracy and applicability, the predicted results of this model were compared with those of cited models from other researchers. The findings revealed a three‐stage degradation of residual stiffness in CFRP tendons under different stress levels. Furthermore, it was observed that the proportion of fatigue life accounted for by Stage III decreased with smaller stress ranges, while the proportion accounted for by Stage II increased. The proposed quantitative residual stiffness model was verified using both experimental and cited data.
Nitrogen subsidies to pelagic food webs through profundal methane‐oxidising bacteria in oligotrophic fresh water
Authors: dela Paz Erica Silk P. , Okuda Noboru , Ho Pei‐Chi , Lin Fan‐Sian , Hsieh Chih‐hao , Lai Chao‐Chen , Fujibayash Megumu , Shiah Fuh‐Kwo , Ko Chia‐Ying
Published: April 2024

Nutrient subsidy of methane‐oxidising bacteria (MOB), an alternative basal resource, to plankton communities through pelagic‐benthic coupling is expected to alter carbon‐to‐nitrogen (C/N) ratios and biomass of zooplankton, and affect biological processes in aquatic food webs. Previous studies indicate that most MOB nutrient subsidies to zooplankton are focused largely on C subsidies; nevertheless, considering that N is important to zooplankton and phytoplankton growth, a better understanding of MOB N subsidies to plankton communities is needed.

We examined changes in nutrients, phytoplankton mass‐specific productivity, MOB reliance, C/N ratios and biomass of zooplankton between summer stratification and winter mixing periods based on in situ investigation in a subtropical deep oligotrophic freshwater ecosystem during 2010–2014.

The results revealed that with increasing reliance on MOB during the winter mixing period, zooplankton C/N ratios decreased and had a significantly nonlinearly inverse relationship with zooplankton biomass. The negative relationship between zooplankton biomass and phytoplankton mass‐specific productivity was further observed in synchronous time.

The profundal MOB enhanced pelagic‐profundal coupling and served as an alternative N support for pelagic plankton food webs during the winter and/or less productive seasons, adding to greater understanding of the role of methanotrophs in aquatic food webs.
Climate warming shifts riverine macroinvertebrate communities to be more sensitive to chemical pollutants
Authors: Sinclair Tom , Craig Peter , Maltby Lorraine L.
Published: April 2024

Freshwaters are highly threatened ecosystems that are vulnerable to chemical pollution and climate change. Freshwater taxa vary in their sensitivity to chemicals and changes in species composition can potentially affect the sensitivity of assemblages to chemical exposure. Here we explore the potential consequences of future climate change on the composition and sensitivity of freshwater macroinvertebrate assemblages to chemical stressors using the UK as a case study. Macroinvertebrate assemblages under end of century (2080–2100) and baseline (1980–2000) climate conditions were predicted for 608 UK sites for four climate scenarios corresponding to mean temperature changes of 1.28 to 3.78°C. Freshwater macroinvertebrate toxicity data were collated for 19 chemicals and the hierarchical species sensitivity distribution model was used to predict the sensitivity of untested taxa using relatedness within a Bayesian approach. All four future climate scenarios shifted assemblage compositions, increasing the prevalence of Mollusca, Crustacea and Oligochaeta species, and the insect taxa of Odonata, Chironomidae, and Baetidae species. Contrastingly, decreases were projected for Plecoptera, Ephemeroptera (except for Baetidae) and Coleoptera species. Shifts in taxonomic composition were associated with changes in the percentage of species at risk from chemical exposure. For the 3.78°C climate scenario, 76% of all assemblages became more sensitive to chemicals and for 18 of the 19 chemicals, the percentage of species at risk increased. Climate warming‐induced increases in sensitivity were greatest for assemblages exposed to metals and were dependent on baseline assemblage composition, which varied spatially. Climate warming is predicted to result in changes in the use, environmental exposure and toxicity of chemicals. Here we show that, even in the absence of these climate‐chemical interactions, shifts in species composition due to climate warming will increase chemical risk and that the impact of chemical pollution on freshwater macroinvertebrate biodiversity may double or quadruple by the end of the 21st century.
City diplomacy of ordinary cities: Harnessing migrant inclusion policies for international engagement in Amadora, Portugal
Authors: Desille Amandine , Lacroix Thomas
Published: April 2024

This paper adds to the literature on urban diplomacy by focusing on the role of smaller cities with an active international engagement in migration matters. What are the motives driving the involvement of these “ordinary” cities in international groupings? What role do these cities play in the circulation of policies related to migration integration? How does it translate into local policies? To do so, we rely on a quantitative analysis of 64 networks around the world and on the case study of Amadora (Portugal). It is argued that “ordinary” cities may gain visibility when participating in transnational networks of cities. However, the research also shows that the city involvement is driven by the search for financial capacities, thereby nurturing a form of dependency from international subsidies. In addition, Amadora's involvement in city networks is not necessarily connected with actual activism in favor of migrant integration. The research shows the tensions between political discourses at national and local levels, and the loopholes of the “transnationalization” of migration governance.
Behaviour, barriers and facilitators of shared decision making in breast cancer surgical treatment: A qualitative systematic review using a ‘Best Fit’ framework approach
Authors: Zheng Hongying , Yang Linning , Hu Jiale , Yang Yan
Published: April 2024

Background

Due to the diversity and high sensitivity of the treatment, there were difficulties and uncertainties in the breast cancer surgical decision‐making process. We aimed to describe the patient's decision‐making behaviour and shared decision‐making (SDM)‐related barriers and facilitators in breast cancer surgical treatment.

Methods

We searched eight databases for qualitative studies and mixed‐method studies about breast cancer patients' surgical decision‐making process from inception to March 2021. The quality of the studies was critically appraised by two researchers independently. We used a ‘best fit framework approach’ to analyze and synthesize the evidence.

Results

Twenty‐eight qualitative studies and three mixed‐method studies were included in this study. Four themes and 10 subthemes were extracted: (a) struggling with various considerations, (b) actual decision‐making behaviours, (c) SDM not routinely implemented and (d) multiple facilitators and barriers to SDM.

Conclusions

Patients had various considerations of breast surgery and SDM was not routinely implemented. There was a discrepancy between information exchange behaviours, value clarification, decision support utilization and SDM due to cognitive and behavioural biases. When individuals made surgical decisions, their behaviours were affected by individual‐level and system‐level factors. Therefore, healthcare providers and other stakeholders should constantly improve communication skills and collaboration, and emphasize the importance of decision support, so as to embed SDM into routine practice.

Patient and Public Contribution

This systematic review was conducted as part of a wider research entitled: Breast cancer patients' actual participation roles in surgical decision making: a mixed method research. The results of this project helped us to better analyze and generalize patients' views.
Novel motivational interviewing‐based intervention improves engagement in physical activity and readiness to change among adolescents with chronic pain
Authors: Forgács‐Kristóf Katalin , Ádám Szilvia , Vargay Adrienn , Major János
Published: April 2024

Introduction

Engaging adolescents with chronic pain in physical activities is challenging. Motivational interviewing (MI) combined with activity promotion may encourage teens to make behavioural changes. This research aimed to assess the feasibility and acceptability of our MI‐based physical activity promotion programme, the M3 training.

Methods

In our exploratory study with 35 adolescent–parent dyads, we evaluated the feasibility by enrolment, drop‐out and retention rates. Acceptability of the M3 training was examined by adherence rates and participation experiences through open‐ended questions. We also assessed changes in pain self‐efficacy and readiness to change after the M3 training intervention.

Results

The M3 training was feasible with an adequate enrolment (77.8%) and retention (85.7%) rate. Both teens and parents found the M3 training acceptable and considered exercise and physical activity the most helpful elements of the programme (36% and 37%, respectively). While self‐efficacy remained unchanged, we identified a significant increase in the readiness to change for adolescents and parents.

Conclusion

M3 training improved physical activity engagement while prioritising adolescents' autonomy. Furthermore, it appears to be a clinically relevant approach and could result in a positive shift in readiness to change within a shorter timeframe.

Patient or Public Contribution

The preliminary version of the M3 training was reviewed and commented upon by the public (adolescents and adults). Adolescents who participated in this study were designing their own movement programme, considering their lived experiences. Participants' feedback was used to create the online version of the M3 training (which will be published elsewhere).
#DryByChristmas: A patient and public involvement study on women's engagement with humorous pelvic floor muscle training digital nudges on social media
Authors: Harper Rosie C. , Sheppard Sally , Miller Elaine , Stewart Carly , Clark Carol J.
Published: April 2024

Introduction

Patient and public involvement (PPI) is essential for women's health research. Little is known about how women engage with humorous social media and behavioural health messaging targeting pelvic floor muscle training (PFMT). This PPI aimed to understand how women engage with a humorous social media campaign encouraging PFMT. The study findings will influence the co‐design of a digital intervention to support women's adherence to PFMT.

Methods

The Guidance for Reporting Involvement of Patients and the Public Version 2 short form was used to report the study's findings. The study examined public engagement with a humorous social media campaign encouraging PFMT in women. A healthcare professional and comedian ran the campaign following the national guidelines for engagement in PFMT. Instagram analytics gave insight into the demographics of the public who engaged, how they engaged and the most popular content. The behaviour change techniques (BCTs) used in the digital nudges that generated the highest levels of engagement were analysed using the Capability Opportunity Motivation Behaviour Change Wheel.

Results

The majority (96%) of the population showing the highest levels of engagement were women aged 35–44 years and were based in the United Kingdom (77%). The Instagram account saw an increase in engagement by 12% over the 3‐month campaign, with 22,032 users seeing digital nudges and 2645 engaging with the digital nudges. The preferred way of engaging was using Likes (9723). The common themes in the digital nudges that generated the highest levels of engagement were BCTs associated with the ‘social influences’ theoretical domain framework that targeted the core behaviour opportunity.

Conclusion

The study findings suggest humour may improve women's engagement with online PFMT programmes; however, more rigorous research is required to better understand diverse women's experiences of humorous online PFMT nudges. Future studies may use PFMT mobile apps instead of social media to capture true user engagement and adherence to PFMT more accurately. The insights gained from the study will be taken forward to co‐design a digital behavioural intervention as part of a larger study.

Public Contribution

Members of the public were involved in the co‐design of a digital health intervention that will be trialled as part of a larger research study. The public was involved using the social media platform Instagram. Public engagement with a humorous social media campaign to encourage women to engage with pelvic floor exercises was captured using Instagram analytics, for example, the timing of engagement.
Deceptive learning in histopathology
Authors: Shahamatdar Sahar , Saeed‐Vafa Daryoush , Linsley Drew , Khalil Farah , Lovinger Katherine , Li Lester , McLeod Howard T. , Ramachandran Sohini , Serre Thomas
Published: April 2024

Aims

Deep learning holds immense potential for histopathology, automating tasks that are simple for expert pathologists and revealing novel biology for tasks that were previously considered difficult or impossible to solve by eye alone. However, the extent to which the visual strategies learned by deep learning models in histopathological analysis are trustworthy or not has yet to be systematically analysed. Here, we systematically evaluate deep neural networks (DNNs) trained for histopathological analysis in order to understand if their learned strategies are trustworthy or deceptive.

Methods and results

We trained a variety of DNNs on a novel data set of 221 whole‐slide images (WSIs) from lung adenocarcinoma patients, and evaluated their effectiveness at (1) molecular profiling of KRAS versus EGFR mutations, (2) determining the primary tissue of a tumour and (3) tumour detection. While DNNs achieved above‐chance performance on molecular profiling, they did so by exploiting correlations between histological subtypes and mutations, and failed to generalise to a challenging test set obtained through laser capture microdissection (LCM). In contrast, DNNs learned robust and trustworthy strategies for determining the primary tissue of a tumour as well as detecting and localising tumours in tissue.

Conclusions

Our work demonstrates that DNNs hold immense promise for aiding pathologists in analysing tissue. However, they are also capable of achieving seemingly strong performance by learning deceptive strategies that leverage spurious correlations, and are ultimately unsuitable for research or clinical work. The framework we propose for model evaluation and interpretation is an important step towards developing reliable automated systems for histopathological analysis.
Integrated preparation of B4C–TiB2 multilayer graded ceramics with high hardness and high toughness
Authors: Tan Wenkang , Zou Ji , Wang Weimin , Ji Wei , Fu Zhengyi
Published: April 2024

The enhancement in the comprehensive performance of hardness, toughness, and strength is significant for ceramic materials. In this study, the B4C–TiB2 multilayer graded ceramics were designed and integrally manufactured by spark plasma sintering method using B4C and TiB2 as raw materials. The B4C–TiB2 multilayer graded ceramics feature a transition from the top layer with high hardness to the bottom layer with high toughness, passing through an intermediate layer. The gradient change of this material is observed in both the hardness and fracture toughness, reaching values of 36.2–28.4 GPa and 2.2–6.2 MPa m.5. The compressive strength reaches up to 2960 MPa, whereas the bending strength gets to 677 MPa in the appropriate loading direction. The structure forms a gradient pattern with high hardness on the front side, high toughness on the back side, and overall low density and high strength. This study may facilitate the development of impact‐resistant performance of lightweight materials.