bluuebunny/crossref_metadata_2025 huggingface dataset:
Ant nests increase litter decomposition to mitigate the negative effect of warming in an alpine grassland ecosystem
Authors: Luo Binyu , Huang Mei , Wang Wenyin , Niu Jiahuan , Shrestha Mani , Zeng Haijun , Ma Lin , Degen A. Allan , Liao Jingkang , Zhang Tao , Bai Yanfu , Zhao Jingxue , Fraser Lauchlan H. , Shang Zhanhuan
Published: June 2023

Warming can decrease feeding activity of soil organisms and affect biogeochemical cycles. The ant
Formica manchu
is active on the nest surface and prefers a hot, dry environment; therefore, warming may provide a favourable environment for its activities. We hypothesized that
F. manchu
benefit from warming and mitigate the negative effects of warming on litter decomposition. We examined the effects of ant nests (nest absence versus nest presence) and warming (+1.3 and +2.3°C) on litter decomposition, soil properties and the plant community in alpine grassland. Decomposition stations with two mesh sizes were used to differentiate effects of microorganisms (0.05 mm) and macroinvertebrates (1 cm) on decomposition. Ant nests increased litter decomposition with and without macroinvertebrates accessing the decomposition station when compared to plots without ant nests. Only litter decomposition in ant nests with macroinvertebrates having access to the decomposition station was not affected negatively by warming. Plots with ant nests had greater soil carbon, nutrient contents and plant growth than plots without ant nests, regardless of warming. Our results suggest that ant nests maintain ecosystem processes and functions under warming. Consequently, a management strategy in alpine grasslands should include the protection of these ants and ant nests.
Gut microbiota associated with the mitigation effect of synbiotics on adverse events of neoadjuvant chemotherapy in patients with esophageal cancer: A retrospective exploratory study
Authors: Sugimoto Takuya , Atobe Satomi , Kado Yukiko , Takahashi Akira , Motoori Masaaki , Sugimura Keijiro , Miyata Hiroshi , Yano Masahiko , Tanaka Koji , Doki Yuichiro , Shiraishi Osamu , Yasuda Takushi , Asahara Takashi
Published: June 2023

Introduction. Our synbiotics (

Lacticaseibacillus paracasei

strain Shirota,

Bifidobacterium breve

strain Yakult, and galacto-oligosaccharides: LBG) helps mitigate serious adverse events such as febrile neutropenia (FN) and diarrhoea in oesophageal cancer patients receiving neoadjuvant chemotherapy (NAC). Unfortunately, LBG therapy does not benefit all patients.

Hypothesis/Gap Statement. Identification of the gut microbiota species involved in adverse events during chemotherapy could help predict the onset of adverse events. Identification of the gut microbiota that influence the efficacy of LBG could also help establish a diagnostic method to identify patients who will respond to LBG before the initiation of therapy.

Aim. To identify the gut microbiota involved in adverse events during NAC and that affect the efficacy of LBG therapy.

Methodology. This study was ancillary to a parent randomized controlled trial in which 81 oesophageal cancer patients were recruited and administered either prophylactic antibiotics or LBG combined with enteral nutrition (LBG+EN). The study included 73 of 81 patients from whom faecal samples were collected both before and after NAC. The gut microbiota was analysed using 16S rRNA gene amplicon sequencing and compared based on the degree of NAC-associated adverse events. Furthermore, the association between the counts of identified bacteria and adverse events and the mitigation effect of LBG+EN was also analysed.

Results. The abundance of

Anaerostipes hadrus

and

Bifidobacterium pseudocatenulatum

in patients with no FN or only mild diarrhoea was significantly higher (P<0.05) compared to those with FN or severe diarrhoea. Moreover, subgroup analyses of patients receiving LBG+EN showed that the faecal

A. hadrus

count before NAC was significantly associated with a risk of developing FN (OR, 0.11; 95 % CI, 0.01–0.60, P=0.019). The faecal

A. hadrus

count after NAC was positively correlated with intestinal concentrations of acetic acid (P=0.0007) and butyric acid (P=0.00005).

Conclusion.

Anaerostipes hadrus

and

B. pseudocatenulatum

may be involved in the ameliorating adverse events and can thus be used to identify beforehand patients that would benefit from LBG+EN during NAC. These results also suggest that LBG+EN would be useful in the development of measures to prevent adverse events during NAC.
Keep it CooL! Results of a two-year CooL-intervention: a descriptive case series study
Authors: Philippens Nicole , Janssen Ester , Kremers Stef , Crutzen Rik
Published: June 2023

Background

Coaching on Lifestyle (CooL) is a two-year healthcare intervention for people with overweight or obesity, stimulating weight reduction by promoting sustained healthier behavior. The objective of this study is to investigate the effects of CooL on participants’ anthropometrics, personal factors and behavioral factors over the two-year timeframe of CooL.

Methods

A descriptive case series study, using a broad set of routinely collected data on anthropometrics, personal factors and behavioral factors of adults living across the Netherlands. The data were collected between November 2018 and December 2021 among participants of CooL (N=746) at three moments during the intervention: at baseline (T0), at 8 months (T1) after completion of phase 1 and at 24 months (T2) after ending CooL. Changes over time were analyzed using paired t-tests comparing baseline to T1 and baseline to T2. In addition, potential differences on outcomes in subgroups based on education level, weight status and group size were examined using paired t-tests and ANOVA-tests.

Results

The results showed changes in the desired direction on all outcomes at 24 months compared to baseline. The largest effects were seen on perceived health, attentiveness towards meal size and meal composition (large effect size). Mean weight loss was 4.13 kilograms (SD 7.54), and mean waist circumference decreased with 4.37 centimeters (SD 8.59), indicating a medium to large effect size. Changes in outcomes were similar across all subgroups consisting of participants with different educational level, BMI at baseline and in different group sizes.

Conclusion

The study showed sustained effects in weight-related outcomes of CooL over the timeframe of 24 months supporting the two-year set-up of CooL. The outcomes indicate that CooL is appropriate and effective for different group sizes and for a wide variety of participants irrespective of gender, age, BMI at baseline or level of education.
Stimulatory effect of monoacylglycerol lipase inhibitor MJN110 on locomotion and step kinematics demonstrated by high-precision 3D motion capture in mice
Authors: Ignatowska-Jankowska Bogna M. , Gurkan Ozer Aysen , Kuck Alexander , Niphakis Micah J. , Ogasawara Daisuke , Cravatt Benjamin F. , Uusisaari Marylka Y.
Published: June 2023

The neuromodulatory endocannabinoid system is a promising target for therapeutic interventions. One of the well-known behavioral effects of cannabinoid CB1receptor activation with exogenous ligands such as THC is the inhibition of locomotor activity. However, the behavioral effects of endogenous cannabinoids are not understood. Enhancing endocannabinoid signaling offers an advantageous therapeutic strategy with limited cannabimimetic side effects, but their effects on motor function remain unclear. To reveal even the finest changes in motor function during voluntary locomotor tasks in mice, we adapted a high-speed, high-resolution marker-based motion capture, which so far has not been available in freely moving mice. Here we show that inhibition of distinct endocannabinoid metabolic pathways produces opposite effects on locomotor behavior that differ from those induced by exogenous cannabinoid receptor ligands. Selective upregulation of endocannabinoids 2-arachidonoylglycerol (2-AG) or N-arachidonoylethanolamine (AEA, anandamide) with inhibitors of their degradation (MJN110 and PF3845, respectively), produced bidirectional effects: MJN110 enhanced and PF3845 suppressed locomotor activity. Consistent differences in whole-body movement and precise step kinematics were found under distinct treatments, while analysis of locomotory episodes revealed invariant temporal microstructure, pointing towards motivational rather than motor-related mechanisms of action. The results show that the effects of manipulations of endocannabinoid system on locomotion are more diverse than previously assumed and result in distinct kinematic phenotypes.
Self-perceived communication competence of adults who stutter following Communication-Centered Treatment (CCT)
Authors: Coalson Geoffrey A. , Werle Danielle , Croft Robyn , Byrd Courtney T.
Published: June 2023

Purpose

The purpose of this study was to assess self-perceived communication competence of adults who stutter following a unique treatment program – Communication-Centered Treatment (CCT) – that focuses on communication competence as one of four clinical goals of the Blank Center CARE Model™(Communication, Advocacy, Resiliency, Education).

Method

Thirty-three adults who stutter completed the Self-Perceived Communication Competence scale (McCroskey & McCroskey, 1988) before and after their CCT program.

Results

Findings indicate significant gains in self-perceived communication competence post- treatment across four speaking contexts (public presentation, large meeting, small group interaction, dyadic interaction) and three audience types (strangers, acquaintances, friends). Pre- treatment stuttering frequency did not predict post-treatment gains in communication competence.

Conclusions

Adults who stutter consider themselves stronger communicators following a treatment designed to increase communication competence. [ClinicalTrials.govNCT05908123;https://clinicaltrials.gov/show/NCT05908123]
Automated Detection of Maternal Vascular Malperfusion Lesions of the Placenta using Machine Learning
Authors: Patnaik Purvasha , Khodee Afsoon , Vasam Goutham , Mukherjee Anika , Salsabili Sina , Ukwatta Eranga , Grynspan David , Chan Adrian D. C. , Bainbridge Shannon
Published: June 2023

Introduction

Hypertensive disorders of pregnancy (HDP) and fetal growth restriction (FGR) are common obstetrical complications, often with pathological features of maternal vascular malperfusion (MVM) in the placenta. Currently, clinical placental pathology methods involve a manual visual examination of histology sections, a practice that can be resource-intensive and demonstrate moderate-to-poor inter-pathologist agreement on diagnostic outcomes, dependant on the degree of pathologist sub-specialty training.

Methods

This study aims to apply machine learning (ML) feature extraction methods to classify digital images of placental histopathology specimens, collected from cases of HDP [gestational hypertension (GH), preeclampsia (PE), PE + FGR], normotensive FGR, and healthy pregnancies, according to the presence or absence of MVM lesions. 159 digital images were captured from histological placental specimens, manually scored for MVM lesions (MVM- or MVM+) and used to develop a support vector machine (SVM) classifier model, using features extracted from pretrained ResNet18. The model was trained with and without data augmentation, and with and without data shuffling, and the performance of the classifiers assessed and compared through measurements of accuracy, precision, and recall using confusion matrices.

Results

The SVM model demonstrated accuracies between 7-78% for WSI-level MVM classification, with poorest performance observed on images with borderline MVM presence, as determined through post hoc observation.

Conclusion

The results are promising for the integration of ML methods into the placental histopathological examination process. Using this study as a proof-of-concept will lead our group and others to carry ML models further in placental histopathology.
A comprehensive overview of the Chloroflexota community in wastewater treatment plants worldwide
Authors: Petriglieri Francesca , Kondrotaite Zivile , Singleton Caitlin , Nierychlo Marta , Dueholm Morten K. D. , Nielsen Per H.
Published: June 2023

Filamentous Chloroflexota are abundant in activated sludge wastewater treatment plants (WWTPs) worldwide and are occasionally associated with poor solid-liquid separation or foaming, but most of the abundant lineages remain undescribed. Here, we present a comprehensive overview of Chloroflexota abundant in WWTPs worldwide, using high-quality metagenome-assembled genomes (MAGs) and 16S rRNA amplicon data from 740 Danish and global WWTPs. Many novel taxa were described, encompassing 4 families, 13 genera and 29 novel species. These were widely distributed across most continents, influenced by factors such as climate zone and WWTP process design. Visualization by fluorescencein situhybridization (FISH) confirmed their high abundances in many WWTPs based on the amplicon data and showed a filamentous morphology for nearly all species. Most formed thin and short trichomes integrated into the floc structure, unlikely to form the typical inter-floc bridging that hinders activated sludge floc settling. Metabolic reconstruction of 53 high-quality MAGs, representing most of the novel genera, offered further insights into their versatile metabolisms and suggested a primary role in carbon removal and involvement in nitrogen and sulfur cycling. The presence of glycogen reserves, detected by FISH-Raman microspectroscopy, seemed widespread across the phylum demonstrating that these bacteria likely utilize glycogen as an energy storage to survive periods with limited resources. This study gives a broad overview of the Chloroflexota community in global activated sludge WWTPs and improves our understanding of their roles in these engineered ecosystems.

Importance

Chloroflexota are often abundant members of the biomass in wastewater treatment plants (WWTPs) worldwide, typically with a filamentous morphology, forming the backbones of the activated sludge (AS) floc. However, their overgrowth can often cause operational issues connected to poor settling or foaming, impairing effluent quality and increases operational costs. Despite the importance, few Chloroflexota genera have been characterized so far. Here, we present a comprehensive overview of Chloroflexota abundant in WWTPs worldwide and an in-depth characterization of their morphology, phylogeny, and ecophysiology, obtaining a broad understanding of their ecological role in activated sludge.
scRNA-seq reveals the diversity of the developing cardiac cell lineage and molecular building blocks of the primary pacemaker
Authors: Nahia Karim Abu , Sulej Agata , Migdał Maciej , Ochocka Natalia , Ho Richard , Kamińska Bożena , Zagorski Marcin , Winata Cecilia L.
Published: June 2023

The heart is comprised of a variety of specialized cell types that work in unison to maintain blood flow. Here we utilized scRNA-seq analysis to delineate the diversity of cardiac cell types in the zebrafish. With the growing use of the zebrafish to model human heart biology, a deeper insight into its complex cellular composition is critical for a better understanding of heart function, development, and associated malformations. We present a high resolution atlas of zebrafish heart single cells transcriptomics, consisting of over 50 000 cells representing the building blocks of the zebrafish heart at 48 and 72 hpf. We defined 18 discrete cell populations comprising major cell lineages and sublineages of the developing heart. We pinpointed a population of cells likely to be the primary pacemaker and identified the transcriptome profile defining this critical cell type. Our analyses identified two genes,atp1b3bandcolec10, which were enriched in the sinoatrial pacemaker cells. CRISPR/Cas9-mediated knockout of these two genes significantly reduced heart rate which is accompanied by arrhythmia or morphological defects, suggesting their novel function in cardiac development and conduction. Additionally, we describe other subpopulations of cardiac cell lineages, including the endothelial and neural cells, whose expression profiles we provide as a resource for further investigations into the cellular and molecular mechanisms of this organ.
Leveraging human resource management practices during mergers and acquisitions: a bibliometric analysis and future research agenda
Authors: Budhiraja Sunil , Thakur Mahima , Yadav Mohini
Published: June 2023

Purpose

Despite enormous literature on Human Resource Management (HRM) practices in the context of Mergers and Acquisitions (M&As), researchers have not come up with a synthesis that integrates the role and importance of HRM practices during M&As. This study aims to identify, analyse and synthesise existing literature to discover associated HRM practices that facilitate organisational change during M&As.

Design/methodology/approach

Bibliometric analysis is performed using 473 research articles entailing 871 authors from 62 countries (published in Scopus and WoS listed journals), followed by a thematic cluster analysis using bibliographic coupling. The analysis is performed using different means as citation analysis, cluster analysis and keyword analysis to reveal the most significant publications, authors, keywords, trends and future research questions.

Findings

The results are primarily descriptive and aim at capturing a panoramic view of what was already written on the topic so far. The bibliometric analysis is conducted using different means like citation analysis, cluster analysis and keyword analysis to reveal the most significant publications, notable authors, keywords, current research trends and future research questions. Further, the bibliographic coupling analysis led to the identification of the following six clusters: (1) coping strategies during and post-M&As; (2) changes in individual and organisational identification during and post-M&As; (3) role of cultural and transformational leadership in M&As success; (4) HRM practices to develop employee capabilities post-M&As; (5) case studies and success stories of M&As; and (6) organisational readiness for M&As.

Practical implications

This study has theoretical and practical implications and suggests future research directions. The authors also propose an abstruse model for HRM practices during M&A process for further investigation.

Originality/value

This is the first bibliometric study to explore the vast extant literature in M&A research related to the role of HRM practices in the execution of successful M&As.
Study on CO2 transport in fractal porous media for a Hausdorff fractal derivative advection-dispersion model
Authors: Chang Ailian , Huang Le , Li Qian-Qian , Vafai Kambiz , Shao Minglu
Published: June 2023

Purpose

The classical advection-dispersion equation (ADE) model cannot accurately depict the gas transport process in natural geological formations. This paper aims to study the behavior of CO2 transport in fractal porous media by using an effective Hausdorff fractal derivative advection-dispersion equation (HFDADE) model.

Design/methodology/approach

Anomalous dispersion behaviors of CO2 transport are effectively characterized by the investigation of time and space Hausdorff derivatives on non-Euclidean fractal metrics. The numerical simulation has been performed with different Hausdorff fractal dimensions to reveal characteristics of the developed fractal ADE in fractal porous media. Numerical experiments focus on the influence of the time and space fractal dimensions on flow velocity and dispersion coefficient.

Findings

The physical mechanisms of parameters in the Hausdorff fractal derivative model are analyzed clearly. Numerical results demonstrate that the proposed model can well fit the history of gas production data and it can be a powerful technique for depicting the early arrival and long-tailed phenomenon by incorporating a fractal dimension.

Originality/value

To the best of the authors’ knowledge, first time these results are presented.
Pre-seed grant as an enabler of learning
Authors: Fauchald Ragnhild Nordeng , Aaboen Lise , Haneberg Dag Håkon
Published: June 2023

Purpose

The paper focuses on how student entrepreneurs learn from the process of applying for low-threshold seed capital grants of about €2500

Design/methodology/approach

An in-depth inductive study was conducted on the seed capital grant initiative TrønderEnergi–Bidraget (TEB). The research design was based on the Zaltman metaphor elicitation technique (ZMET) to capture the interviewees' perceptions about TEB. From the interviews, 596 codes were identified and grouped into 54 categories. The results are illustrated in a consensus map.

Findings

TEB is an enabler of student venture creation processes through both the money awarded and activities fostering learning and development. Learning by doing is visible through two processes: 1) repeated writing of applications and 2) “forced” reflective thinking through the steps in the application process. The iterativeness of these processes due to repeated applications to the low threshold initiative is important for learning.

Practical implications

The authors recommend that university managers and policymakers offer seed funding to student entrepreneurs to ensure that the offering is a low threshold. A low threshold is decisive for generating a positive learning outcome from the application process. The seed funding initiatives should require students to put time and energy into all the integrated processes to make value out of the iterativeness of the processes.

Originality/value

This paper extends the discussion on the additionality of receiving grants by focusing on the process of applying for a grant. This research contributes to the student entrepreneurship literature by suggesting that the design of the application process and forced reflections are important for learning, as well as specifying the antecedents for student motivation for continued entrepreneurial activity in the application process.
Smart destination competitiveness: underscoring its impact on economic growth
Authors: Lasisi Taiwo Temitope , Odei Samuel Amponsah , Eluwole Kayode Kolawole
Published: June 2023

Purpose

The current study is designed to investigate the factors that foster the framing of destination competitiveness and establish the factors that drive the contribution of tourism innovations to economic growth in smart tourism destinations.

Design/methodology/approach

A four-year panel data were extracted from the World Economic Forum's travel and tourism competitiveness index and data were analysed using Poisson Pseudo Maximum Likelihood regression model.

Findings

The findings demonstrate that both the enabling environment and airport infrastructure significantly affect tourism's impact on the economy of the selected smart European tourism destinations. Conversely, human resources and general infrastructure display a negative correlation with tourism's contribution to the economy. However, no data in the sample support the idea that tourism policies, government prioritization or readiness of tourism information and communication technologies impact tourism's contribution to the economy. Additionally, the marginal effects indicate that improving the enabling environment and airport infrastructure can generate additional benefits for the economy through tourism.

Originality/value

The uniqueness of this study is the integration of smart tourism destinations with the measure of destination competitiveness to provide an empirical bridge that links tourism competitiveness to economic growth.
Hormone replacement therapy did not increase risk of melanoma in Chinese female with menopausal and postmenopausal disorders: A population‐based retrospective cohort study in Taiwan
Authors: Ma Jun , Chen Yi‐Hsien , Chiang Chien‐Ping , Wang Wei‐Ming , Chung Chi‐Hsiang , Tsao Chang‐Huei , Weng Zi‐Xeng , Hung Chih‐Tsung , Chien Wu‐Chien
Published: June 2023

Hormone replacement therapy (HRT) is widely used to relieve symptoms of menopause with proven efficacy. However, there has been significant controversy surrounding the use of HRT because of its potential link with an increased risk of cancer, particularly female reproductive organ cancers. That HRT increases the risk of melanoma is also disputed, and several cohort studies have produced variable results. To delineate the association between HRT and melanoma in Taiwan, we conducted a population‐based retrospective cohort study on 14 291 patients who had received HRT and 57 164 population controls in Taiwan between 2000 and 2013. Multivariate odds ratios (ORs) were calculated utilizing conditional logistic regression. Overall, the use of HRT was not significantly correlated with a higher risk of developing melanoma in Taiwan (95% confidence interval 0.386–1.099; p = 0.341). The hazard ratio analysis of melanoma and different HRTs showed there was no significant association between melanoma and the use of oral or external estrogens alone, including conjugated estrogens, estradiol, and estriol. Estrogen plus progesterone combined therapy was associated with a lower risk of melanoma. Only one case of melanoma was observed among the 2880 patients in this subgroup.
Lymphoproliferative disorder risk after methotrexate treatment for rheumatoid arthritis
Authors: Tanaka Keisuke , Ichikawa Ayako , Umezawa Natsuka , Yamamoto Kouhei , Yoshifuji Kota , Okada Keigo , Nogami Ayako , Umezawa Yoshihiro , Nagao Toshikage , Sakashita Chizuko , Mori Takehiko , Tohda Shuji , Koike Ryuji , Yasuda Shinsuke , Yamamoto Masahide
Published: June 2023

Methotrexate (MTX)‐associated lymphoproliferative disorder (MTX‐LPD) is a troublesome problem in patients receiving MTX for rheumatoid arthritis (RA). However, its incidence, prognosis, and risk factors remain unclear. In this retrospective study, we evaluated the actual incidence, prognostic impact, and risk factors of MTX‐LPD. Of the 986 patients with RA treated with MTX, 90 patients experienced 95 new malignancies (NMs), with LPD as the most frequent in 26 patients. The cumulative LPD incidences were 1.3% and 4.7% at 5 and 10 years after MTX initiation, respectively. Among the 24 patients who discontinued MTX after developing LPD, 15 showed sustained regression, without difference in overall survival between patients with LPD and without NM. Inflammatory markers and absolute lymphocyte counts were not useful for early LPD development detection, but most of the patients with LPD had persistently elevated erythrocyte sedimentation ratios. Regarding concomitant drugs, tacrolimus increased the risk only if patients were not receiving biological disease‐modifying antirheumatic drugs (bDMARDs). bDMARDs did not increase the risk for any of the drugs or the number of classes used. The number of LPD cases was lower in patients with IL‐6A even after a long period after MTX, although with no statistically significant difference. Thus, approximately 1 in 20 patients with RA developed MTX‐LPD over the 10 years of MTX treatment, but it did not affect the survival of patients with RA. Tacrolimus increased the risk of developing LPD for certain patients and should be used with caution.
Visual Gaze Labeling for Augmented Reality Studies
Authors: Öney S. , Pathmanathan N. , Becher M. , Sedlmair M. , Weiskopf D. , Kurzhals K.
Published: June 2023

Augmented Reality (AR) provides new ways for situated visualization and human‐computer interaction in physical environments. Current evaluation procedures for AR applications rely primarily on questionnaires and interviews, providing qualitative means to assess usability and task solution strategies. Eye tracking extends these existing evaluation methodologies by providing indicators for visual attention to virtual and real elements in the environment. However, the analysis of viewing behavior, especially the comparison of multiple participants, is difficult to achieve in AR. Specifically, the definition of areas of interest (AOIs), which is often a prerequisite for such analysis, is cumbersome and tedious with existing approaches. To address this issue, we present a new visualization approach to define AOIs, label fixations, and investigate the resulting annotated scanpaths. Our approach utilizes automatic annotation of gaze on virtual objects and an image‐based approach that also considers spatial context for the manual annotation of objects in the real world. Our results show, that with our approach, eye tracking data from AR scenes can be annotated and analyzed flexibly with respect to data aspects and annotation strategies.
Evaluating the safety and efficacy of aminolevulinic acid 20% topical solution activated by pulsed dye laser and blue light in the treatment of facial cutaneous squamous cell carcinoma in situ
Authors: Nestor Mark S. , Han Haowei , Ceci Francesca M. , Lawson Alec , Gade Anita
Published: June 2023

Background

Squamous cell carcinoma (SCC) is the second most common cutaneous malignancy, after basal cell carcinoma (BCC). Photodynamic therapy (PDT) involves converting a photosensitizer to reactive oxygen intermediates, which preferentially bind to hyperproliferative tissue. The most commonly used photosensitizers are methyl aminolevulinate and aminolevulinic acid (ALA). Presently, ALA‐PDT is approved in the US and Canada for the treatment of actinic keratoses on the face, scalp, and upper extremities.

Aims

This cohort study evaluated the safety, tolerability, and efficacy of aminolevulinic acid, pulsed dye laser, and photodynamic therapy (ALA‐PDL‐PDT) for treatment of facial cutaneous squamous cell carcinoma in situ (isSCC).

Methods

Twenty adult patients with biopsy‐confirmed isSCC on the face were recruited. Only lesions 0.4–1.3 cm in diameter were included. Patients underwent two treatments with ALA‐PDL‐PDT spaced 30 days apart. The isSCC lesion was then excised 4–6 weeks following the second treatment for histopathological assessment.

Results

No residual isSCC was detected in 17/20 (85%) patients. Two of the patients with residual isSCC had skip lesions present that explained the treatment failure. Excluding the patients with skip lesions, the posttreatment histological clearance rate was 17/18 (94%). Minimal side effects were reported.

Limitations

Our study was limited by small sample size and lack of long‐term recurrence data.

Conclusions

The ALA‐PDL‐PDT protocol is a safe and well‐tolerated treatment option for isSCC on the face, providing excellent cosmetic and functional results.
The effects of weight management on heart failure: A systematic review and meta‐analysis of randomized controlled trials
Authors: Zhao Qiuge , Zhang Yilin , Dong Xiaoyu , Zhang Xiuting , Fan Xiuzhen
Published: June 2023

Background

Weight management is an important part of disease management in patients with heart failure. However, the effectiveness of reported weight management interventions is inconclusive.

Aims

The aim of this systematic review and meta‐analysis was to assess the effects of weight management on functional status, heart failure‐related hospitalizations, and all‐cause mortality in patients with heart failure.

Methods

PubMed, Web of Science, Embase, and the Cochrane Library were searched on April 3, 2022. This study was registered with PROSPERO (CRD42021283817). Eligible studies assessed functional status, heart failure‐related hospitalizations, and all‐cause mortality in patients with heart failure. Two researchers independently screened the articles, extracted data, and evaluated the risk bias of each study. Dichotomous variables were presented as OR with a 95% confidence interval (CI). The data were analyzed using a fixed effect or random effect model, and heterogeneity was determined using I2 statistics. All statistical analyses were conducted using RevMan 5.3.

Results

Among 4279 studies screened, seven randomized controlled trials were included in this study. The results showed that weight management significantly improved functional status (OR = 0.15, 95% CI [0.07, 0.35], I2 = 52%) and reduced the risk of all‐cause mortality (OR = 0.54, 95% CI [0.34, 0.85], I2 = 0%), but had no significant effect on heart failure‐related hospitalizations (OR = 0.72, 95% CI [0.20, 2.66]).

Linking Evidence to Action

Weight management has effects on improved functional status and reduced all‐cause mortality in patients with heart failure. It is necessary to strengthen the weight management interventions of patients with heart failure to improve patients' functional status and reduce all‐cause mortality.
Supplemental Material: Controls on metal fertility of dioritic intrusions in the Laiwu district, North China Craton: Insights from whole-rock geochemistry and mineral compositions
Authors: Li Si-Yuan , Li Jian-Wei , et al.
Published: June 2023

Table S1: Major- and trace-element geochemistry of whole-rock samples from the Fe-mineralized and barren dioritic intrusions in the Laiwu district. Table S2: Sr-Nd isotopic compositions of whole-rock samples from the Fe-mineralized and barren plutons in the Laiwu district. Table S3: Major- and trace-element compositions of amphibole from the Fe-mineralized and barren plutons in the Laiwu district. Table S4: U-Pb age data and trace elements of zircon from the Fe-mineralized and barren plutons in the Laiwu district. Table S5: Major and trace elements of apatite from the Fe-mineralized and barren plutons in the Laiwu district. Figure S1: Hand specimens of diorites collected from the Kuangshan, Jiaoyu, Jinniushan, and Tietonggou plutons. Figure S2: Cathodoluminescence (CL) images of representative zircons from the Kuangshan, Jiaoyu, Jinniushan, and Tietonggou diorites. Figure S3: U-Pb concordia diagrams of zircons from the Kuangshan, Jiaoyu, Jinniushan, and Tietonggou plutons. Figure S4: Selected oxide element Harker’s plots for the Fe-mineralized and barren plutons in the Laiwu district. 
What is the impact of high-profile end-of-life disputes on paediatric intensive care trainees?
Authors: Bell Clare Emily , Dittborn Mariana , Brierley Joe
Published: June 2023

Introduction

This study explores UK paediatric intensive care (PIC) trainees’ thoughts and feelings about high-profile end-of-life cases recently featured in the press and social media and the impact on their career intentions.

Methods

Semi-structured interviews were conducted with nine PIC-GRID trainees (April to August 2021). Interview transcripts were analysed using thematic analysis.

Results

Six main themes were identified: (1) All participants wished to do what was best for the child, feeling conflicted if this meant disagreeing with parents. (2) Interviewees felt unprepared and expressed deep concern about the effect of high-profile cases on their future career; all had reconsidered their training in PIC due to concerns about future high-profile end-of-life disputes, despite this all were still in training. (3) Specific training on the ethical and legal nuances of such cases is required, alongside targeted communication skills. (4).All cases are unique. (5) All had purposefully minimised their social media presence. (6) Working in a supportive environment is crucial, underscoring the importance of clear and unified team communication.

Conclusion

UK PIC trainees feel unprepared and anxious about future high-profile cases. A parallel can be drawn to child protection improvements following significant educational investment after government reports into preventable child abuse deaths. Models for supporting trainees and establishing formal PIC training are required to improve trainees’ confidence and skills in managing high-profile cases. Further research with other professional groups, the families involved and other stakeholders would provide a more rounded picture.
Barriers and facilitators to implementation of point-of-care lung ultrasonography in a tertiary centre in Benin: a qualitative study among general physicians and pneumologists
Authors: Suttels Veronique , Guedes Da Costa Sofia , Garcia Elena , Brahier Thomas , Hartley Mary-Anne , Agodokpessi Gildas , Wachinou Prudence , Fasseur Fabienne , Boillat-Blanco Noémie
Published: June 2023

Objectives

Owing to its ease-of-use and excellent diagnostic performance for the assessment of respiratory symptoms, point-of-care lung ultrasound (POC-LUS) has emerged as an attractive skill in resource-low settings, where limited access to specialist care and inconsistent radiology services erode health equity.

To narrow down the research to practice gap, this study aims to gain in-depth insights in the perceptions on POC-LUS and computer-assisted POC-LUS for the diagnosis of lower respiratory tract infections (LRTIs) in a low-income and middle-income country (LMIC) of sub-Saharan Africa.

Design and setting

Qualitative study using face-to-face semi-structured interviews with three pneumologists and five general physicians in a tertiary centre for pneumology and tuberculosis in Benin, West Africa. The center hosts a prospective cohort study on the diagnostic performance of POC-LUS for LRTI. In this context, all participants started a POC-LUS training programme 6 months before the current study. Transcripts were coded by the interviewer, checked for intercoder reliability by an independent psychologist, compared and thematically summarised according to grounded theory methods.

Results

Various barriers− and facilitators+ to POC-LUS implementation were identified related to four principal categories: (1) hospital setting (eg, lack of resources for device renewal or maintenance−, need for POC tests+), (2) physician’s perceptions (eg, lack of opportunity to practice−, willingness to appropriate the technique+), (3) tool characteristics (eg, unclear lifespan−, expedited diagnosis+) and (4) patient’s experience (no analogous image to keep−, reduction in costs+). Furthermore, all interviewees had positive attitudes towards computer-assisted POC-LUS.

Conclusions

There is a clear need for POC affordable lung imaging techniques in LMIC and physicians are willing to implement POC-LUS to optimise the diagnostic approach of LRTI with an affordable tool. Successful integration of POC-LUS into clinical routine will require adequate responses to local challenges related to the lack of available maintenance resources and limited opportunity to supervised practice for physicians.
Industry funding of patient organisations in the UK: a retrospective study of commercial determinants, funding concentration and disease prevalence
Authors: Gentilini Arianna , Parvanova Iva
Published: June 2023

Objectives

To assess the relationship between UK-based patient organisation funding and companies’ commercial interests in rare and non-rare diseases in 2020.

Design

Retrospective analysis of the value and volume of payments from pharmaceutical companies to patient organisations in the UK matched with data on the conditions supported by patient organisations and drugs in companies’ approved portfolios and research and development pipelines.

Setting

UK.

Participants

74 pharmaceutical companies making payments to 341 UK-based patient organisations.

Main outcome measures

Alignment between the commercial interests of pharmaceutical companies and the disease area focus of patient organisations; difference in the volume and value of payments to patient organisations broken down by prevalence of conditions; industry funding concentration, measured as the number of companies funding each patient organisation, the share of overall industry funding coming from each contributing company and the share of industry funding of each organisation comprised by the single highest payments.

Results

1422 payments were made by 74 companies to 341 patient organisations. Almost all funds (90%) from pharmaceutical companies were directed to patient organisations that are aligned with companies’ approved drug portfolios and research and development pipelines. Despite rare diseases affecting less than 5% of the UK population, more than 20% of all payments were directed to patient organisations which target such conditions. Patient organisations focusing on rare diseases relied on payments from fewer companies (p value=0.0031) compared to organisations focusing on non-rare diseases.

Conclusions

Companies predominantly funded patient organisations operating in therapeutic areas relevant to companies’ portfolio or drug development pipeline. Patient organisations focusing on rare diseases received more funding relative to the number of patients affected by these conditions and relied more heavily on payments from fewer companies compared to organisations targeting non-rare diseases. Increased independence of patient organisations could help avoid conflicts of interest.
Effect of removing the 4-hour access standard in the ED: a retrospective observational study
Authors: Momesso Tomas , Gokpinar Bilal , Ibrahim Rouba , Boyle Adrian A
Published: June 2023

Background

Time-based targets are used to improve patient flow and quality of care within EDs. While previous research often highlighted the benefits of these targets, some studies found negative consequences of their implementation. We study the consequences of removing the 4-hour access standard.

Methods

We conducted a before and after, retrospective, observational study using anonymised, routinely collected, patient-level data from a single English NHS ED between April 2018 and December 2019. The primary outcomes of interest were the proportion of admitted patients, that is, the admission rate, the length of stay in the ED and ambulance handover times. We used interrupted time series models to study and estimate the impact of removing the 4-hour access standard.

Results

A total of 169 916 attendances were included in the analysis. The interrupted time series models for the average daily admission rate indicate a drop from an estimated 35% to an estimated 31% (95% CI −4.1 to −3.9). This drop is only statistically significant for Majors (Ambulant) patients (from an estimated 38.3% to an estimated 31.4%) and, particularly, for short-stay admissions (from an estimated 18.1% to an estimated 12.8%). The models also show an increase in the average daily length of stay for admitted patients from an estimated 316 min to an estimated 387 min (95% CI 33.5 to 108.9), and an increase in the average daily length of stay for discharged patients from an estimated 222 min to an estimated 262 min (95% CI 6.9 to 40.4).

Conclusion

Lifting the 4-hour access standard reporting was associated with a drop in short-stay admissions to the hospital. However, it was also associated with an increase in the average length of stay in the ED. Our study also suggests that the removal of the 4-hour standard does not impact all patients equally. While certain patient groups such as those Majors (Ambulant) patients with less severe issues might have benefited from the removal of the 4-hour access standard by avoiding short-stay hospital admissions, the average length of stay in the ED seemed to have increased across all groups, particularly for older and admitted patients.
Association of obesity with mild traumatic brain injury symptoms, inflammatory profile, quality of life and functional outcomes: a TRACK-TBI Study
Authors: Eagle Shawn R , Puccio Ava M , Nelson Lindsay D , McCrea Michael , Giacino Joseph , Diaz-Arrastia Ramon , Conkright William , Jain Sonia , Sun Xiaoying , Manley Geoffrey , Okonkwo David O
Published: June 2023

Objectives

Obesity is associated with chronic inflammation, which may impact recovery from mild traumatic brain injury (mTBI). The objective was to assess the role of obesity in recovery of symptoms, functional outcome and inflammatory blood biomarkers after mTBI.

Methods

TRACK-TBI is a prospective study of patients with acute mTBI (Glasgow Coma Scale=13–15) who were enrolled ≤24 hours of injury at an emergency department of level 1 trauma centres and followed for 12 months. A total of 770 hospitalised patients who were either obese (body mass index (BMI) >30.0) or healthy mass (BMI=18.5–24.9) were enrolled. Blood concentrations of high-sensitivity C reactive protein (hsCRP), interleukin (IL) 6, IL-10, tumour necrosis factor alpha; Rivermead Post-Concussion Symptoms Questionnaire (RPQ), Quality of Life After Brain Injury and Glasgow Outcome Score-Extended reflecting injury-related functional limitations at 6 and 12 months were collected.

Results

After adjusting for age and gender, obese participants had higher concentrations of hsCRP 1 day after injury (mean difference (MD)=0.65; 95% CI: 0.44 to 0.87, p<0.001), at 2 weeks (MD=0.99; 95% CI: 0.74 to 1.25, p<0.001) and at 6 months (MD=1.08; 95% CI: 0.79 to 1.37, p<0.001) compared with healthy mass participants. Obese participants had higher concentrations of IL-6 at 2 weeks (MD=0.37; 95% CI: 0.11 to 0.64, p=0.006) and 6 months (MD=0.42; 95% CI: 0.12 to 0.72, p=0.006). Obese participants had higher RPQ total score at 6 months (MD=2.79; p=0.02) and 12 months (MD=2.37; p=0.049).

Conclusions

Obesity is associated with higher symptomatology at 6 and 12 months and higher concentrations of blood inflammatory markers throughout recovery following mTBI.
Core elements of serious illness conversations: an integrative systematic review
Authors: Baxter Rebecca , Pusa Susanna , Andersson Sofia , Fromme Erik K , Paladino Joanna , Sandgren Anna
Published: June 2023

Background

Ariadne Labs’ Serious Illness Care Program (SICP), inclusive of the Serious Illness Conversation Guide (SICG), has been adapted for use in a variety of settings and among diverse population groups. Explicating the core elements of serious illness conversations could support the inclusion or exclusion of certain components in future iterations of the programme and the guide.

Aim

This integrative systematic review aimed to identify and describe core elements of serious illness conversations in relation to the SICP and/or SICG.

Design

Literature published between 1 January 2014 and 20 March 2023 was searched in MEDLINE, PsycINFO, CINAHL and PubMed. All articles were evaluated using the Joanna Briggs Institute Critical Appraisal Guidelines. Data were analysed with thematic synthesis.

Results

A total of 64 articles met the inclusion criteria. Three themes were revealed: (1) serious illness conversations serve different functions that are reflected in how they are conveyed; (2) serious illness conversations endeavour to discover what matters to patients and (3) serious illness conversations seek to align what patients want in their life and care.

Conclusions

Core elements of serious illness conversations included explicating the intention, framing, expectations and directions for the conversation. This encompassed discussing current and possible trajectories with a view towards uncovering matters of importance to the patient as a person. Preferences and priorities could be used to inform future preparation and recommendations. Serious illness conversation elements could be adapted and altered depending on the intended purpose of the conversation.
Assisted suicide and capital punishment: a mirror image?
Authors: Doré Matthew
Published: June 2023

Objectives

To outline the jurisprudential position in UK law regarding capital punishment, the death penalty and contrast this with proposed legislation for assisted dying and euthanasia (AD/E).

Methods

A historical medico-legal jurisprudential research approach, focusing on investigating the case law which resulted in the eventual cessation of capital punishment and contrasting this with the arguments used in current proposed legislation for AD/E.

Results

As a society, we are confronted with a similar choice in AD/E as we did in the 1960s with capital punishment, where it has demonstrated, despite a full judiciary process with a jury, that incorrect decisions have been made, resulting in death. In the context of two doctors making irrevocable decisions with prognosis uncertain, diagnostic errors and autonomy being relational—influenced by how others behave towards us—even campaigners for AD/E admit errors are inevitable. Some will have lethal drugs under a wrong diagnosis, an incorrect timespan or coercive pressures; is this cost acceptable?

Conclusion

If the abolition of capital punishment is hard won, with the risk set that no one incorrectly should die, is this the standard that should be set for lethal drugs today? Is the right to choose so important that others’ lives lost are an acceptable cost to pay? If we do accept a radical individual autonomy ethos, what proportion of incorrect deaths is acceptable?