bluuebunny/crossref_metadata_2025 huggingface dataset:
Effectiveness and safety of intense pulsed light therapy for dry eye symptoms due to meibomian gland dysfunction—A systematic review and meta‐analysis
Authors: Peira Nathalie , Ali Elham Mohammed , Modén Naama Kenan , Fjellgren Eva , Lennmarken Claes , Hultcrantz Monica
Published: November 2024

Background

Dry eye disease is a common ocular condition, affecting quality of life and function for many people worldwide. This systematic review evaluates the effectiveness and safety of intense pulsed light (IPL) therapy for dry eye symptoms due to meibomian gland dysfunction (MGD), as they are not yet established.

Methods

Comprehensive searches were conducted in January 2024 (Cochrane Library, Embase, MEDLINE). We included randomized controlled studies assessing the effects of IPL on dry eye symptoms or any adverse effects in patients with MGD. Two authors independently screened studies and evaluated the risk of bias. Meta‐analysis (random effects model) and Grading of Recommendations Assessment, Development and Evaluation (GRADE) were used to synthesize results and assess certainty of evidence.

Results

In total, 13 studies were included in the review. The risk of bias was assessed as moderate in most results primarily due to the risk of selective reporting. The synthesis and GRADE assessment show that IPL probably results in a clinically relevant reduction in symptoms of dry eyes when compared to placebo (MD = −16 OSDI points; 95% CI = −20 to −12). However, whether the effect is clinically relevant when used as an add‐on to standard care is still unclear (MD = −7 OSDI points; 95% CI = −12 to −3). Furthermore, the evidence on adverse events is very uncertain.

Conclusion

Although IPL probably results in a clinically relevant reduction in symptoms of dry eyes when compared to placebo, in practice IPL would typically be used as an add‐on to standard treatment. It is therefore essential with further studies investigating whether this use would give a clinically relevant reduction in symptoms, and what the potential harm of IPL is when treating MGD.
A review of perioperative mortality in pet rabbits in Australia
Authors: Pieper EG , Carter JE , Firestone SM , Baron HR
Published: November 2024

Introduction

Domestic rabbits have higher perioperative mortality rates (1.39%–4.8%) compared with dogs and cats (0.1%–0.2%), with cardiovascular and respiratory complications reported most. Understanding anaesthetic risk factors is essential to minimise mortality risks.

Objective

To determine the perioperative mortality risks and risk factors in rabbits undergoing general anaesthesia.

Methods

This retrospective cohort study evaluated 1757 records of rabbits that underwent general anaesthesia with inhaled isoflurane, categorised by the American Society of Anesthesiologists (ASA) physical status classification system (January 2019–April 2023). Data were collected on physical characteristics, anaesthetic protocol, airway management and patient outcomes. Potential risk factors were analysed using multivariable logistic regression modelling guided by directed acyclic graphs.

Results

The perioperative mortality risk was 2.05% (95% CI: 1.39, 2.71). Increased mortality was most associated with poorer health status (ASA score) and non‐routine procedures. Following induction of anaesthesia, rabbits with a body mass of less than 1 kg (RR: 7.57, 95% CI: 1.18, 61.2) and Netherland Dwarf rabbits (RR: 23.4, 95% CI: 2.75, 200) were at higher risk. The use of a supraglottic airway device was protective against mortality during anaesthesia compared with endotracheal tubes (RR: 0.27, 95% CI 0, 3.78) and anaesthetic masks (RR: 0.42, 95% CI: 0, 3.71). Increased mortality was observed with a fentanyl‐based protocol compared with a medetomidine‐based protocol (RR: 4.62, 95% CI: 0.477, 44.7).

Discussion

Perioperative mortality was multifactorial, with health status, surgical complexity and physical characteristics representing primary risk factors. Clinicians should choose a suitable anaesthetic protocol, implement effective airway control and follow precautions for brachycephalic rabbit breeds.
Projection of future gastric cancer incidence and health‐care service demand by geographic area in Kanagawa, Japan
Authors: Chei Choy‐Lye , Nakamura Sho , Watanabe Kaname , Watanabe Ryo , Kurokawa Akio , Iwane Taizo , Itoh Sayaka , Narimatsu Hiroto
Published: November 2024

Projections of future gastric cancer incidence and the demand for health‐care services for gastric cancer patients by geographic area will assist local authorities in determining health‐care needs, allocating medical resources, and planning services. This study aims to project the future incidence of gastric cancer, estimate the number of patients per medical institution, and decompose the net changes in cases to assess the impact of population aging by geographic area. Our projections are based on population‐based cancer registry data, census data from 2000 to 2020, and the projected population for 2025–2045 in Kanagawa, Japan. We classified Kanagawa into urban, town, outer city, and rural areas based on geographic and population features. The number of medical institutions providing gastric cancer treatment was used to estimate the number of patients per medical institution. We projected a decrease of 25%, 52%, and 5% in gastric cancer cases in towns, outer cities, and rural areas from 2020 to 2045, respectively. However, cases are expected to increase by 9% in urban areas, primarily due to population aging. The annual number of gastric cancer patients per medical institution in urban areas is expected to increase from 54 to 59, while numbers in other areas are predicted to decline from 2020 to 2045. Our long‐term projections indicate that the number of older gastric cancer patients will continue to increase in urban areas. While current measures effectively reduce gastric cancer risk, they need to be revised to address the impact of population aging.
Pharmacokinetics of infigratinib and its active metabolites in Chinese patients with advanced gastric cancer harboring FGFR2 gene amplification
Authors: Yuan Jiajia , Shen Lin , Liu Tian Shu , Xu HuiTing , Yang Jianwei , Wei Jia , Jiang Haiping , Deng Yanhong , Pan Hongming , Wang Yusheng , Zhang Xiaotian , Peng Zhi , Qi Changsong , Zhang Lingli , Hsu Peiwen , Song Lin , Mu Lei , Sun Qiao , Gong Jifang , Lyu Cheng
Published: November 2024

Infigratinib, an FGFR1‐3 selective oral tyrosine kinase inhibitor, has shown clinical activity in cancers with FGFR alterations. The pharmacokinetics (PK) of infigratinib and its major metabolites have been characterized in global populations. This study examined the PK profile of infigratinib and its metabolites in Chinese patients. In this phase II, open‐label, single‐arm study in China, patients with advanced gastric cancer (GC) or gastroesophageal junction adenocarcinoma (GEJ) harboring FGFR2 gene amplification received 125 mg infigratinib orally once daily in a “3 weeks on, 1 week off” schedule for 28‐day cycles. Plasma PK parameters were calculated with a non‐compartmental model. Data were available from 21 patients (19 GC and two GEJ). After a single dose, peak infigratinib plasma concentration was reached at a median time of 3.1 h, with geometric mean Cmax of 85.9 ng/mL and AUC0‐t of 637 h*ng/mL. After 21‐day dosing, geometric mean infigratinib Cmax,ss of 204 ng/mL was reached at a median of 4.0 h; geometric mean AUC0‐24,ss was 3060 h*ng/mL. The geometric mean Rac,Cmax (%CV) and Rac,AUC0‐24 (%CV) of infigratinib was 2.5 (113.8) and 5.1 (138.2), respectively. A steady state of infigratinib was reached after continuous dosing for 15 days. The metabolites accounting for >10% of infigratinib were BHS697 and CQM157. The PK profiles of infigratinib and its metabolites in Chinese patients with GC or GEJ were largely consistent with known PK profiles of infigratinib from global populations.
Understanding inequities in access to diabetes technologies in children and young people with type 1 diabetes: Qualitative study of healthcare professionals' perspectives and views
Authors: Dlugatch Rachel , Rankin David , Evans Mark , Oliver Nick , Ng Sze May , Lawton Julia
Published: November 2024

Aims

We explored healthcare professionals' perceptions and understandings of the factors and considerations underlying inequities in technology access in children and young people (CYP) with type 1 diabetes.

Methods

We interviewed (n = 29) healthcare professionals working in paediatric diabetes in England recruited from (n = 15) purposively selected sites. We analysed data thematically.

Results

Interviewees highlighted multiple, often overlapping barriers to accessing technology faced by CYP with type 1 diabetes from deprived and/or ethnic minority backgrounds. They described the impacts of deprivation on technology uptake, together with the complex social, ethnic and cultural factors that could also reinforce disparities in technology access. Interviewees further highlighted staffing shortfalls as a significant barrier to supporting CYP to use technology, especially those from under‐represented groups who they perceived as requiring more staff time to be trained to use technology. While interviewees suggested that unconscious bias has become less prominent, they reported being less likely to recommend technology (especially pumps) to CYP/caregivers who they feared would not use it safely and effectively (e.g. those with low literacy levels). Interviewees also highlighted geographical variability in the technology commissioning process (a ‘postcode lottery’).

Conclusions

Our findings suggest that without targeted interventions, technology inequities may continue to persist amongst CYP from the most and least deprived areas and from white and ethnic minority groups in the United Kingdom. Additionally, our findings suggest that closing the technology gap will require large‐scale governmental and health policies aimed at fostering socioeconomic, ethnic and cultural equality alongside targeted measures to improve technology accessibility.
Combating trade‐related fraud: do the Financial Action Task Force recommendations bite?
Authors: Bensassi Sami , Raz Arisyi F.
Published: November 2024

We evaluate the efficacy of the Financial Action Task Force (FATF) Recommendations 2012, which set the global standard on combating money laundering and terrorist financing, by exploiting its staggered adoption in 16 East and South African countries. Using the trade gap as a proxy for trade‐related fraud activities, such as trade‐based money laundering, we find that the adoption of the FATF recommendations is correlated with a 15.3% reduction in trade‐related fraud. The FATF is particularly effective within countries with capable state and low corruption. The amount by which FATF adoption can reduce trade‐related fraud depends on a country's compliance level. Our results are robust to a series of robustness checks and contribute to a lively policy debate surrounding the role of international organizations in combating the financing of organized crimes.
Integrated, multiscale forensic soil science applied to an unsolved murder case in Italy
Authors: Terribile F. , Iamarino M. , Langella G. , Mele Giacomo , Gargiulo L. , Mileti F. A. , Vingiani S. , Dawson L.
Published: November 2024

Soil forensics is not only a well‐established research domain but has also been used in numerous successful international searches for burials and as trace evidence to help police and law enforcement in solving criminal, environmental and terrorism investigations. However, despite the confidentiality and legal constraints in case work in many parts of the world, some actual case studies using soil materials as evidence in court hearings have been published in international journals and books. This paper presents a case from the Campania region in Italy where soil analysis played a pivotal role. Employing a multiscale integrated approach encompassing soil microtomography, morphology, chemical analysis and geography, the study aimed to discern the origin of questioned soil residues found on a victim of crime. Results highlight the significance of considering spatial variability and an appropriate choice of analytical methods. The sequential and multiscale approach facilitated timely investigation without incurring unnecessary costs. Soil morphological and chemical analysis revealed inconsistencies between soil on the victim and soil at the suspected crime scenes, narrowing the investigative area down to approximately one square km. While detailed sampling did not yield statistically significant results, the evidence provided crucial insights, aiding investigators in working out what happened and helped in building a narrative around their case. The analysis indicated contact with a primary scene where the victim was likely dragged (over a Calcisol) and a final deposition site (over an Andosol) where the body was found. While potential murder sites were excluded, final guilt attribution remained inconclusive, and as in all trace evidence evaluation, it is not the role of the forensic soil scientist to consider the level of guilt, but to provide factual soil forensic evidence to assist the justice system. This study exemplifies the use of soil forensics in informing criminal investigations and highlights the complexities that can be involved in establishing comparability between soil samples.
Transition metal transporting P‐type ATPases: terminal metal‐binding domains serve as sensors for autoinhibitory tails
Authors: Hu Qiaoxia , Sitsel Oleg , Bågenholm Viktoria , Grønberg Christina , Lyu Pin , Pii Svane Anna Sigrid , Andersen Kasper Røjkjær , Laursen Nick Stub , Meloni Gabriele , Nissen Poul , Juhl Dennis W. , Nielsen Jakob Toudahl , Nielsen Niels Chr. , Gourdon Pontus
Published: November 2024

Copper is an essential micronutrient and yet is highly toxic to cells at elevated concentrations. P1B‐ATPase proteins are critical for this regulation, providing active extrusion across cellular membranes. One unique molecular adaptation of P1B‐ATPases compared to other P‐type ATPases is the presence of metal‐binding domains (MBDs) at the cytosolic termini, which however are poorly characterized with an elusive mechanistic role. Here we present the MBD architecture in metal‐free and metal‐bound forms of the archetype Cu+‐specific P1B‐ATPase LpCopA, determined using NMR. The MBD is composed of a flexible tail and a structured core with a metal ion binding site defined by three sulfur atoms, one of which is pertinent to the so‐called CXXC motif. Furthermore, we demonstrate that the MBD rather than being involved in ion delivery likely serves a regulatory role, which is dependent on the classical P‐type ATPase E1‐E2 transport mechanism. Specifically, the flexible tail appears responsible for autoinhibition while the metal‐binding core is used for copper sensing. This model is validated by a conformation‐sensitive and MBD‐targeting nanobody that can structurally and functionally replace the flexible tail. We propose that autoinhibition of Cu+‐ATPases occurs at low copper conditions via MBD‐mediated interference with the soluble domains of the ATPase core and that metal transport is enabled when copper levels rise, through metal‐induced dissociation of the MBD. This allows P1B‐ATPase ‘vacuum cleaners’ to tune their own activity, balancing the levels of critical micronutrients in the cells.
Do Mouth‐Infecting Parasites Alter the Foraging Ecology of Host Fish? A Test With the Parasitic Copepod Salmincola markewitschi and White‐Spotted Charr Salvelinus leucomaenis
Authors: Hasegawa Ryota , Koizumi Itsuro
Published: November 2024

Many parasites infect host mouth cavities and are expected to physically impede host foraging. Despite these potential impacts, few studies have evaluated host foraging activities and their findings are equivocal.

We examined the effects of the mouth‐infecting copepod, Salmincola markewitschi, on wild white‐spotted charr Salvelinus leucomaenis foraging using stomach contents analysis. Because the mouth‐infecting copepod occupies a large space in the host mouth cavity, we hypothesized that infected fish exhibit reduced stomach fullness and total prey consumed compared to uninfected fish. In addition, we also hypothesized that infected fish shift their main diets from terrestrial to aquatic invertebrates because parasites reduce host activity, body condition and competitive ability.

Contrary to our predictions, stomach fullness and total prey consumed were not significantly different between infected and uninfected fish: smaller infected fish consumed more prey. We also found that smaller infected hosts foraged on a lower proportion of terrestrial invertebrates than their uninfected counterparts.

Our results suggest that small infected fish increased foraging activities to compensate for energetic loss induced by infection. They also shifted their diet from large terrestrial to small aquatic invertebrates, possibly due to physical impediments and reduced competitive abilities associated with copepod infection.

Our study indicates that mouth‐infecting parasites affect host foraging ecology, but the impacts are weaker than expected and depend on host body size. Nonetheless, behavioural shifts could have important ecological consequences such as loss of host fitness and strengthening trophic cascades in aquatic ecosystems.
A Railway Carpenter in the History of Technology?: New Opportunities From Modern South Asia
Authors: Lanzillo Amanda
Published: November 2024

This article examines interconnected questions that are central to new scholarship on the history of technology in modern South Asia. Which communities, groups and individuals have formed and sustained relationships with knowledge and practices that are seen as representative of technological modernity? Why were some individuals and communities understood—by both the state and various South Asian publics—to be cultivators of technological knowledge, while others were not? And to what degree were claims on technical knowledge and practice made and sustained through South Asian “vernacular” languages, practices, and conceits? The article integrates Punjabi verses written by an early 20th‐century railway carpenter with an analysis of current historiographical trends. In doing so, it explores both the opportunities and limitations of the new social historical turn in the history of technology in South Asia. I argue that recent efforts to expand the “who” of the South Asian history of technology must lead us to new approaches to the social role of technology itself, and to new considerations of technology's relationship with science, labor, the environment, and material culture.
Myxofibrosarcoma with epithelioid morphology: A clinicopathological study of 44 cases with emphasis on differential diagnosis
Authors: Isaacson Alexandra L , Berry Ryan S , Ulici Veronica , Armstrong Susan M , Bena James , John Ivy , Karunamurthy Arivarasan , Billings Steven D , Dermawan Josephine K , Goldblum John , Kilpatrick Scott E , Rubin Brian P , Fritchie Karen J
Published: November 2024

Aims

Epithelioid myxofibrosarcoma (eMFS) is an aggressive morphological variant associated with high rates of local recurrence and metastatic disease. The clinicopathological understanding of this disease is currently limited to a few small case‐series.

Methods and results

We reviewed 44 cases of eMFS and classified them based on the presence of focal (< 50%) or diffuse (> 50%) epithelioid morphology and Fédération Nationale des Centres de Lutte Contre le Cancer (FNCLCC) grade. The patients (28 males; 16 females) had a median age of 71 years (range = 14–90 years). The proximal extremity was the most common site (n = 21), followed by the trunk (n = 11), distal extremity (n = nine) and head/neck (n = two). Of cases with known depth of involvement (n = 41), 39 involved the subcutis, one was limited to the dermis and one limited to the skeletal muscle. Most cases (n = 34, 77%) demonstrated diffuse (> 50%) epithelioid morphology and were FNCLCC grade 3 (n = 29, 66%). Follow‐up data were available for 22 patients. Two developed local recurrence and 10 developed metastases, frequently to regional lymph nodes. All metastatic tumours had a primary lesion with diffuse epithelioid morphology (P = 0.09). There was no association between grade and recurrent or metastatic disease (P = 0.67 and 0.90, respectively). Three cases initially diagnosed as eMFS, one in the neck and two in the axilla, were found to have NRAS Q61R mutations and a high tumour mutation burden and/or ultraviolet (UV)‐light DNA mutational signature.

Conclusions

These findings suggest that UV‐driven malignancies (including melanoma or sarcomatoid squamous cell carcinoma) may histologically mimic eMFS and should be considered in cases of eMFS presenting at atypical anatomical sites.
Aerosols Contamination in the Dental Practice Following Everyday Procedures: An Observational Study
Authors: Mensi Magda , Donnet Marcel , Marchetti Silvia , Mantelli Luca , Scotti Eleonora , Sordillo Annamaria , Calza Stefano , Lang Niklaus P.
Published: November 2024

Objective

The purpose of the present observational study was to evaluate the bacterial load in the air following various dental procedures.

Methods

Air contamination following seven aerosol‐generating dental procedures was assessed. The air volume was sampled by a wet cyclone collector for 10 min during 10 sessions of the following procedures: air‐polishing, ultrasonic instrumentation, manual instrumentation, rubber cup polishing, cavity preparation with a 1:5 red contra‐angle, cavity preparation with turbine and Low Volume Evacuator (LVE), and cavity preparation with turbine and High Volume Evacuator (HVE). Contamination of the sampled solution was determined using ATP (Adenosine TriPhosphate) quantification of the viable bacterial count, and compared to baseline measurements.

Results

The baseline air contamination was 1.45 (0.85–2.04) CFUs/L of air. The highest increase in air contamination was observed after the use of a turbine with LVE, with an average of 7.38 (95% CI 3.87–10.89) CFUs/L of air (p < 0.01). The use of the turbine with HVE and the use of the red hand‐piece resulted in non‐significant increases in bacterial counts compared to baseline (2.98 [1.34–4.63] and 2.70 [0.18–4.22] CFUs/L of air respectively). The application of air polishing, ultrasonic instrumentation, hand instrumentation and rubber cups did not result in a higher bacterial count than the baseline.

Conclusion

Routine professional oral hygiene procedures do not increase air contamination. However, cavity excavation with LVE creates a significantly higher bacterial count in the air.
An Evaluation of a New Ultrasonic Water Irrigator in the Management of Gingival Health: A Randomised Study
Authors: Bissett Susan M. , Gulakova Polina , Unbereit Katrin , Seymour Robin A. , Preshaw Philip M.
Published: November 2024

Introduction

This randomised, single‐blind, controlled study aimed to compare daily adjunctive use of an ultrasonic water irrigation device to dental floss in controlling plaque and gingival inflammation in patients with gingivitis.

Methods

Participants were randomly allocated to either daily use of an ultrasonic water irrigator or dental floss as an adjunct to manual toothbrushing for 4 weeks, with periodontal assessment repeated at 1 and 4 weeks after baseline (Rustogi Modified Navy Plaque Index [PI], Loe and Silness Gingival Index [GI] and bleeding on marginal probing [BOMP]).

Results

Sixty‐two participants completed the investigation. Statistically significant reductions in total and marginal PI at Weeks 1 and 4 were noted in both groups compared to baseline (p < 0.05) with no significant differences between groups. BOMP and GI scores were likewise significantly reduced in both groups at Weeks 1 and 4 compared to baseline (p < 0.01). However, at Week 4, those using the ultrasonic water irrigator showed a significantly greater reduction in GI scores when compared to the floss group (−0.35 ± 0.26 vs. −0.16 ± 0.25, respectively, p < 0.01) and a significantly greater reduction in BOMP scores when compared to floss (−0.26 ± 0.12 vs. −0.15 ± 0.15, respectively, p < 0.01). Those using the ultrasonic water irrigator also reported easier usage scores (p < 0.05) when compared to the floss group.

Conclusion

Daily use of the ultrasonic water irrigator resulted in significantly greater reductions in gingival inflammation (gingival index and BOMP) than dental floss after 4 weeks, whereas plaque removal was similarly effective using the irrigator or floss.
Preparation of chemically strengthened glass with varying B2O3/SiO2 ratios using spodumene mineral residue
Authors: Gu Yuxin , Wang Fu , Zhu Hanzheng , Xu Guoliang , Liao Qilong , Liu Laibao , Dan Yong , Zhao Peng , Liu Yunxiu
Published: November 2024

This study pioneers the use of spodumene mineral residue as a primary raw material for producing chemically strengthened glass, addressing concerns related to sustainable waste management. The resulting glasses achieve over 90% transparency at 550 nm, with compressive stress exceeding 1000 MPa and Vickers hardness surpassing 6.6 GPa. As the B2O3/SiO2 ratio increases, the depth of the compressive stress layer (DOL) of the samples shows a trend of initially decreasing and then stabilizing (DOL: 16–24 µm). The compressive stress (CS) of all samples >1000 MPa. Analysis reveals that [BO4] units hinder ion exchanges while [BO3] promote strengthening. Furthermore, as the B2O3/SiO2 ratio increases, the refractive index rises, thermal stability decreases, and density initially increases before decreasing, while the trend for molar volume is opposite to that of density. This study provides a potential application solution for the treatment of spodumene mineral residue, promoting green and circular economic development.
Perceptual Experiences of Autistic People With an Intellectual Disability and People With Williams Syndrome: A Reflexive Thematic Analysis
Authors: Elise Freya , Irvine Brian , Brinkert Jana , Hamilton Charlie , Farran Emily K. , Milne Elizabeth , Scerif Gaia , Remington Anna
Published: November 2024

Background

Autistic people without intellectual disabilities have increased perceptual capacity: they can process more information at any given time compared to non‐autistic people. We examined whether increased perceptual capacity is evident across the autistic spectrum (i.e. for autistic people with intellectual disabilities) and whether it is specific to autism, or also experienced by people with Williams Syndrome (WS).

Methods

Five autistic adults with intellectual disabilities and five adults with WS took part in accessible, qualitative interviews. Responses were analysed using thematic analysis.

Results

Both groups expressed enjoyment of focussed attention, with autistic participants preferring multiple simultaneous inputs. Responses suggested increased perceptual capacity for autistic participants only. The sensory environment was reported to be anxiety‐inducing for both groups.

Conclusions

This study gives preliminary evidence that increased perceptual capacity may be universal across the autistic spectrum, and specific to autism. Understanding differences in capacity offers more targeted suggestions to support sensory challenges.
Hospital and Post‐Discharge Mortality in Patients With Acute Coronary Syndrome and Ventricular Ectopy
Authors: Sharma Nikhil , Coleman Kristie M. , Cunn Gregory , Kleiman Jeremy , Kossack Andrew , Bimal Tia , Ansari Umair , Yang Bo , Gabriels James , Ismail Haisam , Gandomi Amir , Fishbein Joanna , Mountantonakis Stavros E.
Published: November 2024

Introduction

Ventricular premature depolarizations (VPDs) in the setting of acute coronary syndrome (ACS) were associated with increased hospital mortality in the early revascularization era.

Objective

Examine the predictive value of VPDs and their morphology for hospital and post‐discharge mortality in patients admitted for ACS.

Methods

We identified patients admitted with ACS across 13 Northwell Health Hospitals from 2015 to 2021 and had VPDs captured on a 12‐lead ECG or full disclose telemetry. We characterized and reported descriptively the VPDs based on bundle branch block pattern (right or RBBB vs. left or LBBB), frontal (inferior vs. superior) and horizontal (leftward vs. rightward) axis, QRS width, and coupling interval (CI). Hierarchical generalized linear mixed modeling was used to assess the association between VPDs and hospital mortality, while Cox regression was used for post‐discharge mortality.

Results

Of 18 009 patients admitted for ACS, we identified 627 patients with VPDs with complete data (65.7% RBB, 49.9% superior, and 63.4% leftward axis). Mean VPD QRS width and CI were 175 ± 30 and 523 ± 157 ms, respectively. Hospital mortality was higher in the VPD group (7.8% vs. 4.9%, p < 0.001) with most common mode of death being arrhythmic (28.1% vs. 14.5%). After adjusting for clinical covariates, only VPDs with RBBB patterns were associated with hospital mortality (OR 2.26, 95% CI 1.06−4.82). Conversely, age‐adjusted post‐discharge mortality was higher only for patients with superior axis VPDs (HR 1.59, 95% CI 1.13−2.24).

Conclusion

Among patients with VPDs during an ACS admission, presence of RBBB pattern predicts hospital mortality, whereas superior axis is associated with post‐discharge mortality.
Gestational diabetes in early pregnancy is associated with postpartum glucose intolerance: A perspective from the diabetes and pregnancy outcome for mother and baby study in Japan
Authors: Yokoyama Maki , Miyakoshi Kei , Iwama Noriyuki , Yamashita Hiroshi , Yasuhi Ichiro , Kawasaki Maki , Arata Naoko , Sato Shiori , Imura Yuko , Waguri Masako , Kawaguchi Haruna , Masaoka Naoki , Nakajima Yoshiyuki , Hiramatsu Yuji , Sugiyama Takashi ,   DREAMBee Study Gestational Diabetes Mellitus Group
Published: November 2024

Aims

To compare perinatal outcomes and postpartum glucose tolerance between women diagnosed with gestational diabetes mellitus (GDM) before 20 weeks of gestation (EGDM) and those diagnosed at or after 24 weeks of gestation (LGDM) in a Japanese population.

Materials and Methods

Data were obtained from a prospective GDM registry. Multivariate analysis was conducted to examine the association between the timing of GDM diagnosis (EGDM vs LGDM) and perinatal outcomes (preterm birth, small for gestational age, large for gestational age, pregnancy‐induced hypertension, and neonatal hypoglycemia), as well as postpartum glucose intolerance.

Results

A total of 1,275 mother‐infant pairs were analyzed for perinatal outcomes. Of these, 924 women underwent postpartum testing for glucose intolerance. No significant differences in perinatal outcomes were observed between the EGDM and LGDM groups, except that overweight/obese women with EGDM had 2.5‐fold higher rate of preterm birth than those with LGDM. Postpartum glucose intolerance was 1.5 times more likely in the EGDM group than in the LGDM group.

Conclusions

Women with EGDM had a significantly higher risk of postpartum glucose intolerance than those with LGDM, despite similar perinatal outcomes between the two groups.
Evaluating Large Language Model‐Assisted Emergency Triage: A Comparison of Acuity Assessments by GPT‐4 and Medical Experts
Authors: Haim Gal Ben , Saban Mor , Barash Yiftach , Cirulnik David , Shaham Amit , Eisenman Ben Zion , Burshtein Livnat , Mymon Orly , Klang Eyal
Published: November 2024

Aim

To evaluate the accuracy of the Emergency Severity Index (ESI) assignments by GPT‐4, a large language model (LLM), compared to senior emergency department (ED) nurses and physicians.

Method

An observational study of 100 consecutive adult ED patients was conducted. ESI scores assigned by GPT‐4, triage nurses, and by a senior clinician. Both model and human experts were provided the same patient data.

Results

GPT‐4 assigned a lower median ESI score (2.0) compared to human evaluators (median 3.0; p < 0.001), suggesting a potential overestimation of patient severity by the LLM. The results showed differences in the triage assessment approaches between GPT‐4 and the human evaluators, including variations in how patient age and vital signs were considered in the ESI assignments.

Conclusion

While GPT‐4 offers a novel methodology for patient triage, its propensity to overestimate patient severity highlights the necessity for further development and calibration of LLM tools in clinical environments. The findings underscore the potential and limitations of LLM in clinical decision‐making, advocating for cautious integration of LLMs in healthcare settings.

Reporting Method

This study adhered to relevant EQUATOR guidelines for reporting observational studies.
Who's on the boss's radar? Examination of the antecedent and consequence of leader voice solicitation
Authors: Pang Xingyu , Zhang Limei , Liu Zhaopeng , Liu Mingyue , Xia Yuhuan
Published: November 2024

Whilst the existing literature highlights the importance of leader voice solicitation, limited research has explored its antecedent and consequence from a dyadic perspective. To fill this gap, we draw on signalling theory to investigate the effect of subordinate narcissism on leaders' voice solicitation behaviour towards them and its potential impacts on subordinates' work‐related outcomes. We conducted two field studies with subordinate–leader dyadic samples (Ns = 453 and 393) to test our theoretical model. Both studies showed a positive relationship between subordinate narcissism and leader voice solicitation towards the subordinates, which strengthened as the quality of leader–member exchange increased. Moreover, we found that leader voice solicitation was positively related to subordinates' work engagement and organizational citizenship behaviour, and negatively related to their intention to leave. We also found evidence supporting the mediation and moderated mediation models. Our research provides theoretical and practical implications for voice solicitation literature.
A comparison of veterinary classification schemes, serum ascites albumin gradient, and Boyer's criteria in discriminating transudates from exudates in ascitic dogs
Authors: Busato F. , Gianesini G. , Drigo M. , Zoia A.
Published: November 2024

Objectives

To assess the parameters utilised by and the diagnostic performance of two traditional veterinary classification schemes (named A and B) based on ascites total protein and total nucleated cell count, the Boyer's criteria based on ascites lactic dehydrogenase activity, its serum ratio and the serum total protein, a simplified Boyer's criteria based on ascites lactic dehydrogenase activity and serum total protein only, and finally the serum‐ascites albumin gradient in discriminate the pathophysiological origin of the ascites formation in dogs.

Materials and Methods

Cross‐sectional study including 291 client‐owned dogs with ascites. Ascites aetiology was used to classify the pathophysiology of its formation. Parameters measured and calculated included ascites total protein, ascites total nucleated cell count, ascites lactic dehydrogenase activity and its serum ratio, serum total protein, and the serum‐ascites albumin gradient.

Results

There were 33 transudates due to decreased colloid osmotic pressure, 69 transudates due to increased hydrostatic pressure gradient, and 189 exudates. Simplified Boyer's criteria misclassified 16 of 291 ascites (94.5% accuracy; 95% confidence interval: 91.2 to 96.8) and Boyer's criteria misclassified 21 of 291 ascites (92.8% accuracy; 95% confidence interval: 89.2 to 95.5). The traditional veterinary classification scheme B misclassified 71 of 291 ascites (75.6% accuracy; 95% confidence interval: 70.3 to 80.4) and scheme A 130 of 291 (55.3% accuracy; 95% confidence interval: 49.4 to 61.1). Finally, the serum‐ascites albumin gradient misclassified 100 of 291 ascites (65.6% accuracy; 95% confidence interval: 59.9 to 71.1).

Clinical Significance

The Boyers' criteria and a simplified Boyer's criteria were highly accurate in discriminating exudates from transudates, while the other classification schemes had significantly less diagnostic value in doing so.
Efficiencies of and Motivations for Contracting Out in the Public Sector: The Case of Social Services in Spain
Authors: Chow Danny , Garrido‐Rodríguez Juan Carlos , Zafra‐Gómez José Luis
Published: November 2024

Debates on contracting out to the private sector is primarily focused on the cost efficiency of its provision, drawing on experiences with hard or technical services such as waste and water management. This paper focuses on a growing interest in the role and impact of sourcing decisions in softer or more human‐centered services, such as social services, where sourcing decisions are more complex or multifaceted. Using actual cost data obtained from open access government sources on social services in Spain, the first objective was to compare the cost efficiencies of different sourcing decisions using estimations of Technology Gap Ratios of different municipalities through Order‐M Panel Data. The second objective analyzed motivations for contracting out through a survey of municipal managers in Andalusia using principal components analysis combined with multinominal logit regressions. Our findings suggest that while contracting out to the private sector is, relatively speaking, the most cost efficient, most municipalities have decided to keep service provision in‐house. Decisions to contract out social services are not based only on cost but also incorporate a range of other considerations such as the municipalities' population size, its stakeholder expectations, and other complexities associated with service provision.
Novel Variants in Medium and Low Penetrance Predisposing Genes in a Hungarian Malignant Melanoma Cohort With Increased Risk
Authors: Bokor Barbara Anna , Abdolreza Aliasgari , Kaptás Flóra , Pál Margit , Battyani Zita , Széll Márta , Nagy Nikoletta
Published: November 2024

Both germline and somatic variants contribute to the genetic background and pathogenesis of melanoma. Germline variants include the presence of rare pathogenic or likely pathogenic variants of high, medium, and low penetrance melanoma‐predisposing genes. Rare variants of high penetrance melanoma‐predisposing genes are associated with melanoma development, whereas the medium and low penetrance predisposing genes can significantly increase melanoma risk. In this study, we clarified the germline genetic background of a Hungarian melanoma cohort (n = 17). Using a gene panel of 30 melanoma‐predisposing genes, germline genetic variants were identified in 10 of the 17 patients (58.82%). A novel, likely pathogenic, missense variant (p.Y143C) in a medium penetrance melanoma‐predisposing gene, melanocortin 1 receptor gene (MC1R), and two novel, likely pathogenic nonsense variants in low penetrance genes, p.Q218Ter in caspase 8 (CASP8) and p.Q40Ter in the fat mass‐ and obesity‐associated (FTO) gene were detected. This study highlights the importance of elucidating the germline genetic background of melanoma, which may improve prediction of individual risk and the risk of family members and to optimize preventive, screening, and therapeutic measures for each patient and melanoma‐prone families.
Whole‐genome sequencing analysis of Japanese autism spectrum disorder trios
Authors: Furukawa Sawako , Kushima Itaru , Kato Hidekazu , Kimura Hiroki , Nawa Yoshihiro , Aleksic Branko , Banno Masahiro , Yamamoto Maeri , Uematsu Mariko , Nagasaki Yukako , Ogi Tomoo , Ozaki Norio , Ikeda Masashi
Published: November 2024

Aim

Autism spectrum disorder (ASD) is a genetically and phenotypically heterogeneous neurodevelopmental disorder with a strong genetic basis. Conducting the first comprehensive whole‐genome sequencing (WGS) analysis of Japanese ASD trios, this study aimed to elucidate the clinical significance of pathogenic variants and enhance the understanding of ASD pathogenesis.

Methods

WGS was performed on 57 Japanese patients with ASD and their parents, investigating variants ranging from single‐nucleotide variants to structural variants (SVs), short tandem repeats (STRs), mitochondrial variants, and polygenic risk score (PRS).

Results

Potentially pathogenic variants that could explain observed phenotypes were identified in 18 patients (31.6%) overall and in 10 of 23 patients (43.5%) with comorbid intellectual developmental disorder (IDD). De novo variants in PTEN, CHD7, and HNRNPH2 were identified in patients referred for genetic counseling who exhibited previously reported phenotypes, including one patient with ASD who had profound IDD and macrocephaly with PTEN L320S. Analysis of the AlphaFold3 protein structure indicated potential inhibition of intramolecular interactions within PTEN. SV analysis identified deletions in ARHGAP11B and TMLHE. A pathogenic de novo mitochondrial variant was identified in a patient with ASD who had a history of encephalitis and cognitive decline. GO enrichment analysis of genes with nonsense variants and missense variants (Missense badness, PolyPhen‐2, and Constraint >1) showed associations with regulation of growth and ATP‐dependent chromatin remodeler activity. No reportable results were obtained in the analysis of STR and PRS.

Conclusion

Characterizing the comprehensive genetic architecture and phenotypes of ASD is a fundamental step towards unraveling its complex biology.
Negative Affect and Planning Ability in Preschool Children: A Mediation Model of Working Memory, Inhibition, and Cognitive Flexibility
Authors: Filipiak Sara , Hawrot Anna
Published: November 2024

Past research in developmental psychology has revealed close links between affect and planning ability over the life‐span. However, such links have rarely been studied in children from non‐clinical samples. To address this gap, the present study investigates whether negative affect, understood as a temperamental trait, affects planning ability in 5‐year‐old children. Moreover, it examines whether selected cognitive processes, that is inhibition, verbal working memory, and cognitive flexibility, mediate this relationship. A total of 103 children aged M = 5 years 4 months, SD = 2.7 months, and their parents participated in the study. The analyses, which employed a path mediation model, revealed that negative affect's influence on planning was entirely mediated by flexibility. Moreover, flexibility partially mediated the relationship between inhibition and planning, and verbal working memory had a direct effect on planning. The results provide a new insight into the relationship between negative affect and planning ability in non‐clinical preschool children.
Fertilizer addition effect of novel recycling fertilizers from human excreta in a pot experiment with maize (Zea mays L.)
Authors: Boness Jan‐Ole , Kautz Timo , Hoffmann‐Bahnsen Roland
Published: November 2024

Recycling nutrients from human faeces is a practicable and effective process in terms of the circular economy. To test this, we carried out a pot experiment with a hygienized human faeces compost (HHFC) and a nitrified urine fertilizer (NUF) made from contents of dry toilets to determine the short‐term fertilizer addition effect. HHFC variants were created in increments equivalent to 10, 20, and 30 t ha−1 dry matter weight (DM) and as joint fertilizer application of HHFC and NUF. For the classification of the fertilizer addition effect, soluble concentrations of nitrogen, phosphorus, and potassium in the soil as well as contents in the plant (Zea mays L.) were analysed after a trial period of 8 weeks. Above‐ground biomass, plant height, and chlorophyll content of the leaves were also assessed. The sole compost variants showed no to slightly higher DM yields than the control, whereas the combined compost urine fertilizer variant achieved around 80% of the DM yield of the mineral‐fertilizer applied reference treatment. The soil's total nitrogen storage is significantly increased in our experiment by the addition of HHFC. The concentration of soluble phosphorus in the soil increases significantly with increased compost applications. However, in the combined compost urine fertilizer variant, sufficient nitrogen supply results in a low level of soluble phosphorus because of high plant biomass production. This trend is reflected in the phosphorus content of plant material. HHFC is considered a good phosphorus fertilizer, which is also confirmed in this experiment. A similar picture emerges for the supply of potassium from HHFC. Although the liquid urine fertilizer (combined with HHFC) does not achieve the DM yield of the mineral reference variant in the early phase of plant growth, it has clear advantages in supplying the crop with nitrogen. This study shows that the recycling of nutrients from human faeces is a potential strategy for conserving finite resources and promoting energy‐efficient agricultural practices in line with the circular economy.
GV and GW invariants via the enhanced movable cone
Authors: Nabijou Navid , Wemyss Michael
Published: November 2024

Given any smooth germ of a 3-fold flopping contraction, we first give a combinatorial characterisation of which Gopakumar–Vafa (GV) invariants are non-zero, by prescribing multiplicities to the walls in the movable cone. On the Gromov–Witten (GW) side, this allows us to describe, and even draw, the critical locus of the associated quantum potential. We prove that the critical locus is the infinite hyperplane arrangement of Iyama and the second author and, moreover, that the quantum potential can be reconstructed from a finite fundamental domain. We then iterate, obtaining a combinatorial description of the matrix that controls the transformation of the non-zero GV invariants under a flop. There are three main ingredients and applications: (1) a construction of flops from simultaneous resolution via cosets, which describes how the dual graph changes; (2) a closed formula, which describes the change in dimension of the contraction algebra under flop; and (3) a direct and explicit isomorphism between quantum cohomologies of different crepant resolutions, giving a Coxeter-style, visual proof of the Crepant Transformation Conjecture for isolated cDV singularities.
Comments on EFSUMB recommendations, role of ultrasound in cutaneous neoplasms
Authors: Crisan Diana , Badea Radu , Alfageme Fernando , Scharffetter-Kochanek Karin , Dietrich Christoph F , Crisan Maria
Published: November 2024

The European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) has been publishing guidelines, position papers and also technical reviews. In addition, comments have been published for illustration of such papers including the hepatobiliary system, pancreas, lung and other organs. In the current paper, we aim to summarize the typical sonographic findings of the most commonly seen cutaneous neoplasms.
The crystal and cryo-EM structures of PLCγ2 reveal dynamic interdomain recognitions in autoinhibition
Authors: Shin Young-Cheul , Plummer-Medeiros Ashlee Marie , Mungenast Alison , Choi Hyeong-wook , TenDyke Karen , Zhu Xiaojie , Shepard Jennifer , Sanders Kristen , Zhuang Ningning , Hu Liang , Qian Dongming , Song Kangkang , Xu Chen , Wang John , Poda Suresh B. , Liao Maofu , Chen Yu
Published: November 2024

Phospholipase C gamma 2 (PLCγ2) plays important roles in cell signaling downstream of various membrane receptors. PLCγ2 contains a multidomain inhibitory region critical for its regulation, while it has remained unclear how these domains contribute to PLCγ2 activity modulation. Here we determined three structures of human PLCγ2 in autoinhibited states, which reveal dynamic interactions at the autoinhibition interface, involving the conformational flexibility of the Src homology 3 (SH3) domain in the inhibitory region, and its previously unknown interaction with a carboxyl-terminal helical domain in the core region. We also determined a structure of PLCγ2 bound to the kinase domain of fibroblast growth factor receptor 1 (FGFR1), which demonstrates the recognition of FGFR1 by the nSH2 domain in the inhibitory region of PLCγ2. Our results provide structural insights into PLCγ2 regulation that will facilitate future mechanistic studies to understand the entire activation process.