bluuebunny/crossref_metadata_2025 huggingface dataset:
Exploring the experiences of self‐determination of individuals with mild intellectual disabilities and epilepsy
Authors: Haenen Alexandra , Frielink Noud , van Ool Jans , Tan Francis I. Y. , Embregts Petri J. C. M.
Published: August 2023

Background

While epilepsy can decrease quality of life and self‐determination in individuals without intellectual disabilities, the impact of epilepsy on experienced self‐determination in people with intellectual disabilities remains unclear.

Method

We conducted semi‐structured interviews with six adults (four men, two women) aged 30–61 with mild intellectual disabilities and drug‐resistant epilepsy to investigate their experiences of self‐determination. The data were analysed using Interpretative Phenomenological Analysis.

Results

Three main themes were identified: (A) I am a competent person with epilepsy; (B) My social needs: being accepted as I am and stability in relationships; and (C) Being in control.

Conclusions

In this study, the impact of epilepsy on experienced self‐determination of people with mild intellectual disabilities outweighs the influence of intellectual disabilities. Identity formation, friendships with peers, and autonomy support in risk management are identified as important topics in supporting this group.
Dampening HOTAIR sensitizes the gastric cancer cells to oxaliplatin through miR‐195‐5p and ABCG2 pathway
Authors: Luo Yaomin , Lu Xintong , Ma Wenrong , Xiao Yang , Wei Chen , Yuan Xiaoxia , Wu Yueyue , Wang Yunlin , Xiong Yiman , Yu Xin , Wu Xue , He Siqi , Liu Yayudie , Wang Jinjing , Wu Qing , Zhou Hui , Jiang Zhen
Published: August 2023

Long non‐coding RNAs (lncRNA) have an extensive role in the progression and chemoresistance of gastric cancer (GC). Deeply study the regulatory role of lncRNAs could provide potential therapeutic targets. The aim of this study is to explore the regulatory role of HOTAIR in the progression and oxaliplatin resistance of GC. The expression of HOTAIR in GC and cell lines were detected by using qRT‐PCR. Cell proliferation and apoptosis were analysed by CCK‐8, EdU incorporation and flow cytometry. Luciferase reporter assay was used to identify the interaction between HOTAIR and ABCG2 (ATP‐binding cassette (ABC) superfamily G member 2, ABCG2) via miR‐195‐5p. The regulatory functions were verified by using molecular biology experiments. HOTAIR was significantly overexpressed in GC and associated with poor prognosis. Knock‐down of HOTAIR inhibited the GC cells proliferation and oxaliplatin resistance, while overexpression of HOTAIR showed opposite functions. Further studies found that HOTAIR acted as a competing endogenous RNA (ceRNA) to absorb miR‐195‐5p and elevated the expression of ABCG2, which leads to resistance of GC cells to oxaliplatin. Taken together, our findings demonstrated that HOTAIR regulates ABCG2 induced resistance of GC to oxaliplatin through miR‐195‐5p signalling and illustrate the great potential of developing new therapeutic targets for GC patients.
Oral Porphyromonas gingivalis infection affects intestinal microbiota and promotes atherosclerosis
Authors: Park Sowon , Kim Inyoung , Han Soo Jung , Kwon Soyeon , Min Eun‐Ji , Cho Wonkyoung , Koh Hong , Koo Bon‐Nyeo , Lee Jung Seok , Kwon Jae‐Sung , Seo Kyoung Yul , Ha Jong‐Won , Park Young Mi
Published: August 2023

Aim

The link between periodontitis and intestinal dysbiosis, two factors that contribute to atherosclerosis, has not been clearly defined. We investigated the integrative effects of oral infection with Porphyromonas gingivalis (PG), the major pathogen for periodontitis, on intestinal microbiota and atherosclerosis.

Materials and Methods

ApoE−/− mice were fed a normal chow diet (NC), a Western diet (WD) or a WD with oral PG infection (PG). The PG infection was investigated by placing a total of 109 CFUs of live PG into the oral cavity of each mouse using a feeding needle five times a week for 3 weeks. Atherosclerotic lesions of the aortae were measured, and blood lipoproteins and the expression of molecules related to lipid metabolism in the liver were analysed. We also performed 16S RNA sequencing and a microbiome analysis using faeces.

Results

En face bloc preparation of the aortae showed that the PG group had a 1.7‐fold increase in atherosclerotic lesions compared with the WD group (p < .01). Serum analyses showed that oral PG infection induced a significant decrease in high‐density lipoprotein (HDL) and triglyceride. Western blots of hepatic tissue lysates revealed that PG infection reduced the expression of scavenger receptor class B type 1 (SR‐B1) in the liver by 50%. Faecal microbiota analysis revealed that species richness estimates (Chao1, ACE) decreased immediately after PG infection. PG infection also induced a significant decrease in Shannon diversity and an increase in Simpson's indices in the WD‐fed mice. PG infection significantly increased the phyla Actinobacteria and Deferribacteres, along with the species Mucispirillum schaedleri and Lactobacillus gasseri, in the mice. The functional study showed that PG infection increased the expression of proteins that function in carbohydrate and glucose metabolism, including phosphotransferase system (PTS) proteins and the GntR family transcriptional regulator.

Conclusions

Oral PG infection promotes atherosclerosis and induces significant metabolic changes, including reduced serum HDL and reduced hepatic SR‐B1 and ABCA1 expression, as well as changes in intestinal microbiota. Our study suggests that intestinal dysbiosis accompanies periodontitis and could play a role in atherosclerosis.
Efficacy and safety of a novel triple combination cream compared to Kligman's trio for melasma: A 24‐week double‐blind prospective randomized controlled trial
Authors: Bertold Clémence , Fontas Eric , Singh Tanya , Gastaut Nadia , Ruitort Sandra , Wehrlen Pugliese Sylvia , Passeron Thierry
Published: August 2023

Background

Kligman's trio (KT), combining hydroquinone, retinoic acid and corticosteroid, is considered as the gold standard treatment of melasma. Its efficacy has never been matched before, but it is tempered by frequent adverse effects.

Objective

To assess the efficacy and tolerance of a New Trio (NT) combination with isobutylamido‐thiazolyl‐resorcinol, retinoic acid and cortosteroid compared to KT.

Methods

We conducted a 24‐week monocentric trial, randomized, double‐blind, controlled versus KT, with 40 melasma patients. NT and KT were applied for 12 weeks and associated with the same sunscreen applied for 24 weeks. The primary endpoint was the modified Melasma Area Severity Index (mMASI) at 12 weeks. Patient quality of life was investigated using MelasQoL.

Results

After 12 weeks, KT and NT groups both demonstrated a significant improvement in mMASI, respectively −2.84 (SE 0.69, p < 0.0002) and −4.33 (SE 0.71, p < 0.0001). The mean difference between the two groups was −1.49 (IC 95% −3.52 to 0.54, p = 0.14). MelasQoL improvement was −6.66 (SE 3.29, p = 0.0515) with KT and −12.57 (SE 3.29, p = 0.0006) with NT.

Conclusion

The NT combination appears to be an effective treatment option for treating melasma and could be considered as a well‐tolerated alternative to KT.
Generalised decision curve analysis for explicit comparison of treatment effects
Authors: Hozo Iztok , Djulbegovic Benjamin
Published: August 2023

Rationale

Decision curve analysis (DCA) helps integrate prediction models with treatment assessments to guide personalised therapeutic choices among multiple treatment options. However, the current versions of DCA do not explicitly model treatment effects in the analysis but implicitly or holistically assess therapeutic benefits and harms. In addition, the existing DCA cannot allow the comparison of multiple treatments using a standard metric.

Aims and Objectives

To develop a generalised version of DCA (gDCA) by decomposing holistically assessed net benefits and harms into patient preferences versus empirical evidence (as obtained in the trials, meta‐analyses of clinical studies, etc.) to allow individualised comparison of single or multiple treatments using a common metric.

Methods

We reformulated DCA by (1) decomposing holistic, implicit utilities into specific utilities related to treatment effects and patient's relative values (RV) about disease outcomes versus treatment harms, (2) explicitly modelling each treatment effect at the level of probabilities and/or utilities (outcomes) in a decision tree, and (3) avoiding scaling effects employed in the original DCA to enable comparison of treatment effects against the common metrics. We used data from a published network meta‐analysis of randomised trials to inform the use of statin treatment according to Framingham Risk Model.

Results

We illustrate the analysis by modelling the effects of three statins in the primary prevention of cardiovascular disease. We performed simultaneous comparisons against standard metrics (RV) for all treatments. We examined for which RV values, a predictive model for guiding personalised treatment, outperformed the strategies of treating everyone or treating no one. We found that the magnitude of benefits (efficacy) seems more important than the simple ratio of efficacy/harms.

Conclusion

We describe gDCA for evaluating single or multiple treatments to help tailor therapy toward individual risk characteristics. gDCA further helps integrate the principles of evidence‐based medicine with decision analysis.
Effect of aging and fiber‐reinforcement on color stability, translucency, and microhardness of single‐shade resin composites versus multi‐shade resin composite
Authors: Fidan Muhammet , Yağci Özhan
Published: August 2023

Objective

The purpose of this study was to evaluate the effect of aging and fiber‐reinforcement on the color stability, translucency, and microhardness of single‐shade resin composites versus multi‐shade resin composite.

Materials and Methods

Four resin composites (Filtek Z250, Omnichroma, Vittra APS Unique, Zenchroma) were tested. Three subgroups of specimens were prepared for each of the composites: control, polyethylene fiber‐reinforcement, and glass fiber‐reinforcement‐ groups (n = 10/per group). The samples were subjected to aging for 10,000 thermal cycles. Color differences (ΔE00) were calculated after aging. Relative translucency parameter (RTP00) and microhardness values were calculated before and after aging. A two‐way analysis of variance and the generalized linear model was used (p < 0.05).

Results

The lowest and highest ΔE00values were found for Filtek Z250 (0.6 ± 0.2) and Omnichroma resin composites (1.6 ± 0.4), respectively. The ΔE00value of the polyethylene fiber‐reinforcement group (1.2 ± 0.6) was significantly higher than the ΔE00value of the glass fiber‐reinforcement group (1.0 ± 0.4,p < 0.001). The RTP00value of the glass fiber‐reinforcement group (1.92 ± 0.78) was significantly higher than the RTP00value of the polyethylene fiber‐reinforcement group (1.72 ± 0.77,p < 0.001). The highest microhardness values were found in glass fiber‐reinforcement group (76.48 ± 17.07,p < 0.001).

Conclusion

Single‐shade resin composites were more translucent, had higher color change, and lower hardness than multi‐shade resin composite. For relative translucency and microhardness, statistical significance was found in the material and fiber type interaction. The glass fiber‐reinforcement provided higher translucency, lower color change and higher microhardness values than polyethylene fiber‐reinforcement group after aging. Thermocycling had a significant impact on the color stability, translucency parameter, and microhardness of the tested resin composite materials.

Clinical Significance

Single‐shade resin composite materials have greater color‐changing potential. The glass fiber‐reinforcement optimize resin material mechanical properties and color stability more than polyethylene fiber‐reinforcement.
Not enough geriatricians or not where they are needed?
Authors: Palmer Robert M.
Published: August 2023

This editorial comments on the article by Hogeveen et al. in this issue.
Associations of use of smartphone and internet technologies with loneliness
Authors: Knuutila Mia , Jansson Anu , Rautiainen Laura , Pitkälä Kaisu H.
Published: August 2023

See the Reply by Umoh et al.
GABAA receptors in epilepsy: Elucidating phenotypic divergence through functional analysis of genetic variants
Authors: Absalom Nathan L. , Lin Susan X. N. , Liao Vivian W. Y. , Chua Han C. , Møller Rikke S. , Chebib Mary , Ahring Philip K.
Published: August 2023

Normal brain function requires a tightly regulated balance between excitatory and inhibitory neurotransmissions. γ‐Aminobutyric acid type A (GABAA) receptors represent the major class of inhibitory ion channels in the mammalian brain. Dysregulation of these receptors and/or their associated pathways is strongly implicated in the pathophysiology of epilepsy. To date, hundreds of different GABAA receptor subunit variants have been associated with epilepsy, making them a prominent cause of genetically linked epilepsy. While identifying these genetic variants is crucial for accurate diagnosis and effective genetic counselling, it does not necessarily lead to improved personalised treatment options. This is because the identification of a variant does not reveal how the function of GABAA receptors is affected. Genetic variants in GABAA receptor subunits can cause complex changes to receptor properties resulting in various degrees of gain‐of‐function, loss‐of‐function or a combination of both. Understanding how variants affect the function of GABAA receptors therefore represents an important first step in the ongoing development of precision therapies. Furthermore, it is important to ensure that functional data are produced using methodologies that allow genetic variants to be classified using clinical guidelines such as those developed by the American College of Medical Genetics and Genomics. This article will review the current knowledge in the field and provide recommendations for future functional analysis of genetic GABAA receptor variants.

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How can I measure brain acetylcholine levels in vivo? Advantages and caveats of commonly used approaches
Authors: Mineur Yann S. , Picciotto Marina R.
Published: August 2023

The neurotransmitter acetylcholine (ACh) plays a central role in the regulation of multiple cognitive and behavioral processes, including attention, learning, memory, motivation, anxiety, mood, appetite, and reward. As a result, understanding ACh dynamics in the brain is essential for elucidating the neural mechanisms underlying these processes. In vivo measurements of ACh in the brain have been challenging because of the low concentrations and rapid turnover of this neurotransmitter. Here, we review a number of techniques that have been developed to measure ACh levels in the brain in vivo. We follow this with a deeper focus on use of genetically encoded fluorescent sensors coupled with fiber photometry, an accessible technique that can be used to monitor neurotransmitter release with high temporal resolution and specificity. We conclude with a discussion of methods for analyzing fiber photometry data and their respective advantages and disadvantages. The development of genetically encoded fluorescent ACh sensors is revolutionizing the field of cholinergic signaling, allowing temporally precise measurement of ACh release in awake, behaving animals. Use of these sensors has already begun to contribute to a mechanistic understanding of cholinergic modulation of complex behaviors.

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Individualized management of vasa previa and neonatal outcomes
Authors: Saji Shota , Hasegawa Junichi , Oyelese Yinka , Furuya Natsumi , Homma Chika , Nishimura Yoko , Nakamura Masamitsu , Suzuki Nao
Published: August 2023

Objective

To describe our individualized management protocol for women with an antenatal diagnosis of vasa previa (VP) and to report maternal and neonatal outcomes in patients managed according to our protocol.

Methods

A retrospective study of prospectively collected data of antenatally diagnosed VP managed at our hospital between 2014 and 2021. Obstetric and neonatal outcomes were reviewed and analyzed.

Results

Fourteen cases of antenatally diagnosed VP in 5150 total deliveries were analyzed (0.3%) Five cases (36%) of VP were diagnosed during the routine fetal morphological ultrasound screening, and nine cases (64%) were referred to our hospital due to perinatal complications. There were nine cases that required hospitalization (due to fetal growth restriction [FGR] [1], preterm labor [3], patients' request [5]). The other five were asymptomatic. Eight patients were delivered by scheduled cesarean section at around 36 weeks and only three neonates were admitted to NICU with transient tachypnea of newborn. However, six patients required CS before the scheduled dates because of other complications (preterm labor [3], abnormal cardiotocogram patterns [1], FGR [1] and twin pregnancy [1]). Four neonates born by CS before their scheduled dates were admitted to NICU. No cases required prolonged hospitalization and there were no serious neonatal complications.

Conclusion

Individualized management may lead to favorable outcomes with VP. Outpatient management may be considered in patients without risk factors. However, maternal hospitalization and earlier scheduled CS should be considered in symptomatic patients or those at risk for preterm delivery.
Stationary Jackknife
Authors: Zhou Weilian , Lahiri Soumendra
Published: August 2023

Variance estimation is an important aspect in statistical inference, especially in the dependent data situations. Resampling methods are ideal for solving this problem since these do not require restrictive distributional assumptions. In this paper, we develop a novel resampling method in the Jackknife family called the stationary jackknife. It can be used to estimate the variance of a statistic in the cases where observations are from a general stationary sequence. Unlike the moving block jackknife, the stationary jackknife computes the jackknife replication by deleting a variable length block and the length has a truncated geometric distribution. Under appropriate assumptions, we can show the stationary jackknife variance estimator is a consistent estimator for the case of the sample mean and, more generally, for a class of nonlinear statistics. Further, the stationary jackknife is shown to provide reasonable variance estimation for a wider range of expected block lengths when compared with the moving block jackknife by simulation.
Ecoimmunological differences among congeneric tortoises in the United States
Authors: Sandmeier F. C. , Morales J. , Gomez M. , Kester M. , Gann‐Archuleta K. , Crooker C. , Goessling J. M. , Tracy C. R. , Weitzman C. L.
Published: August 2023

Comparative studies, especially of related species that span across ecoregions, have the potential to increase our understanding of different ecological or evolutionary pressures that may drive host–pathogen dynamics. We quantified differences in immune investment, via differential leukocyte counts and bacteria‐killing assays, across four closely related species ofGopherustortoises, found across a gradient from the desert southwest to the subtropical southeast of the United States. We further quantified differences in a commensal nasal microbe (Pasteurella testudinis) and tested for associations among immune measures,P. testudinis, and previously quantified levels of the pathogenMycoplasma agassiziiand upper respiratory tract disease (URTD). We also evaluated the potential influence of environmental variables on immune investment,P. testudinis, and disease. We found that tortoise species in more arid environments had a reduced investment in inflammatory leukocytes, possibly as a strategy to reduce water loss, and invested more heavily in innate anti‐inflammatory leukocytes. Conversely, we found that species in moister, resource‐rich environments may face greater pathogen pressure, likely due to increased population densities and transmission rates among host tortoises. These tortoises had increased investment in inflammatory cells and appeared to reduce their nasal microbes (includingP. testudinis) when they exhibited URTD. Thus, we quantified two negative correlational patterns: (1) between inflammatory responses and water conservation and (2) between resource quality and transmission rates. We hypothesize that these relationships across species may reflect variable development or evolution of innate immune functions.
Naturally occurring variability in larval period length is associated with intraspecific differences in late tadpoles of a South American true toad
Authors: Regueira E. , Pavón Novarin M. , O'Donohoe M. E. A. , Valchi P. , Tropea C. , Trípodi M. , Hermida G. N.
Published: August 2023

The larval period in anurans is highly plastic. Even though larval period length and larval size have been the most studied characteristics showing intraspecific variability, other features such as morphology, behavior, food preferences and physiology have also been described as plastic. Metamorphic changes are triggered by thyroid and interrenal hormones, and environmental signals modulate the onset of metamorphosis via the hypothalamic–pituitary–interrenal axis. The South American bufonid toad Rhinella arenarum from nearby Buenos Aires City has a larval period of 30–120 days under the same environmental conditions. The goal of this study was to evaluate life‐history traits in tadpoles from different localities and potential morphological differences among tadpoles with different larval period length. For this purpose, we reared under natural conditions tadpoles from two different localities nearby Buenos Aires City and in three different years measured their size at the end of metamorphosis and recorded their larval period length. The external appearance, histo‐morphology and morphometry of the skin and kidney/interrenal complex were studied in metamorphs with short and long larval periods (SLP and LLP, respectively). We observed a larval period lasting 30–120 days in tadpoles from different localities or years. SLP metamorphs were smaller, darker, had less protruding eyes without eyelids, a thinner epidermis and fewer skin glands than LLP metamorphs. The secretion of skin glands from SLP tadpoles had acidic glycoconjugates. Kidney size was similar between LLP and SLP metamorphs, but the former had an adult‐like histomorphology. Interrenal gland in LLP early and late climax tadpoles had cells with a high nucleus/cell diameter ratio, a sign of highly active steroidogenic cells. Overall, these results show that intraspecific variability in size, skin and interrenal gland development is associated with differences in larval period length. Distinct skin gland number and secretion, along with distinct interrenal histology at late climax, could have physiological consequences in the post‐metamorphic life.
Quantifying adaptive evolution and the effects of natural selection across the Norway spruce genome
Authors: Wang Xi , Ingvarsson Pär K.
Published: August 2023

Detecting natural selection is one of the major goals of evolutionary genomics. Here, we sequenced the whole genome of 25Picea abiesindividuals and quantified the amount of selection across the genome. Using an estimate of the distribution of fitness effects, we showed that both negative selection and the rate of positively selected substitutions are very limited in coding regions. We found a positive correlation between the rate of adaptive substitutions and recombination rate and a negative correlation between the rate of adaptive substitutions and gene density, suggesting a widespread influence from Hill–Robertson interference on the efficiency of protein adaptation inP. abies. Finally, the distinct population statistics between genomic regions under either positive or balancing selection with that under neutral regions indicated the impact of natural selection on the genomic architecture of Norway spruce. Further gene ontology enrichment analysis for genes located in regions identified as undergoing either positive or long‐term balancing selection also highlighted the specific molecular functions and biological processes that appear to be targets of selection in Norway spruce.
From helplessness to transformation: An analysis of clinician narratives about the social determinants of health and their implications for training and practice
Authors: Peebles Erin R. , Pack Rachael , Goldszmidt Mark
Published: August 2023

Background

Medical curricula are attempting to prepare trainees to address the social determinants of health, however the life circumstances of patients are often beyond physician control. Little is known about how physicians cope with this dilemma; we sought to examine their perspectives when faced with this challenge to help better prepare trainees for practice.

Methods

We undertook a critical analysis of physician narratives from January 2018 to June 2020. In total, 268 physician‐written narrative social determinant of health pieces from four high impact medical journals were screened and 47 met the inclusion criteria and were analysed.

Results

We identified four storylines that described the physician experience and strategies for coping with the social determinants of health. While Helplessness stories described authors' experiences of emotional distress when unable to support their patients, the other story types described ways they could make a difference. In Shortcoming and Transformation stories, the realisations about shortcomings led to transformation. In Doctor‐patient relationship stories, authors described its importance in theirs and patients' lives, and in System advocacy stories, they described the need for greater advocacy to help change broken systems.

Conclusions

Current approaches to teaching the social determinants of health often focus on the role of physicians in recognising and altering social circumstances. However, the realities of practice do not easily allow physicians to do so and, for some, may lead to distress and burnout. There are other ways to cope and make a difference by improving ourselves, investing in getting to know our patients, and advocating. These results can help better support trainees and physicians for the realities of practice.
Investigation on key aspects of mating biology in the mosquito Aedes koreicus
Authors: Ciocchetta Silvia , Frentiu Francesca D. , Montarsi Fabrizio , Capelli Gioia , Devine Gregor J.
Published: August 2023

Aedes koreicus Edwards, 1917 (Hulecoetomyia koreica) is a mosquito (Diptera: Culicidae) from Northeast Asia with a rapidly expanding presence outside its original native range. Over the years, the species has been discovered in several new countries, either spreading after first introduction or remaining localised to limited areas. Notably, recent studies have demonstrated the ability of the species to transmit zoonotic parasites and viruses both in the field and in laboratory settings. Combined with its invasive potential, the possible role of Ae. koreicus in pathogen transmission highlights the public health risks resulting from its invasion. In this study, we used a recently established population from Italy to investigate aspects of biology that influence reproductive success in Ae. koreicus: autogeny, mating behaviour, mating disruption by the sympatric invasive species Aedes albopictus Skuse, 1894, and the presence of the endosymbiont Wolbachia pipientis Hertig, 1936. Our laboratory population did not exhibit autogenic behaviour and required a bloodmeal to complete its ovarian cycle. When we exposed Ae. koreicus females to males of Ae. albopictus, we observed repeated attempts at insemination and an aggressive, disruptive mating behaviour initiated by male Ae. albopictus. Despite this, no sperm was identified in Ae. koreicus spermathecae. Wolbachia, an endosymbiotic bacterium capable of influencing mosquito reproductive behaviour, was not detected in this Ae. koreicus population and, therefore, had no effect on Ae. koreicus reproduction.
Improved effectiveness of an increased dose of griseofulvin for treating Tinea capitis among refugee children in Israel: A retrospective cohort study
Authors: Kassem R. , Barzilai A. , Baum S. , Kempfner A. , Pavlotsky F.
Published: August 2023

Background

Tinea capitis (TC), a fungal infection that occurs in children, is primarily caused by dermatophytes such as Trichophyton and Microsporum species. For Trichophyton species, treatment with terbinafine is considered more effective than griseofulvin treatment. Specific populations, such as refugee children, are more susceptible to TC.

Objective

This study aimed to describe and compare the response to treatment among Israeli and refugee children with TC.

Patients/Methods

We retrospectively reviewed data collected on refugee and Israeli children with TC between January 2004 and January 2020.

Results

Overall, 3358 children with TC (refugees: 1497; Israelis: 1861) were identified. Among these, 86% of the refugee children had TC caused by Trichophyton violaceum, 65% of the Israeli children had TC caused by Microsporum canis and 83% of all children were treated with griseofulvin. Overall, 14% of the refugees showed a partial response to a griseofulvin dose of ≤25 mg/kg/day; however, they showed a complete response upon increasing the dose to ≥30 mg/kg/day. No significant adverse effects were observed.

Conclusion

The over‐crowded day care centres and dense living make refugee children more susceptible to TC than the general population, and griseofulvin dosage adjustment is necessary. TC, due to Trichophyton species, could benefit from receiving an increased dose of griseofulvin in a suspension form, which is cheaper than terbinafine.
“Maintaining hope for a better future”: An interview with Dr. Crystal Felima
Authors: Felima Crystal , DeeWaard Abigail , Barbier Clara , Cano‐Garcia Erica , Jeronimo Gonzalo , Coleman Nari , Hryshko Nataliya , Schuller Mark
Published: August 2023

While anthropologists have played roles speaking out for marginalized groups, formalized to combat Antisemitism, racism, and xenophobia, they have also aided in the marginalization and oppression of communities, justified colonialism, and put the communities they have studied at risk. In recent decades, anthropologists have rethought the way research is conducted, presented, and justified to reduce harm to communities. Despite these shifts, anthropological training has been slow to include activist work by women of color and other marginalized people, leaving anthropologists‐in‐training with limited concrete guidance on how to apply their anthropological lens to social justice. Addressing this gap, this article centering a Black feminist analysis offers an interview conducted between anthropology students and a professor of anthropology, giving insights into how anthropological thought can be applied to activism and advocacy. Centering Black feminism is not only important to redress historical marginalization within the discipline. By centering the lives of marginalized people within an intersectional lens, Black feminist analysis provides a mandate to rethink theoretical models, such as political ecology, the dominant frame anthropologists have used to address disasters and climate change. Also importantly, centering Black women's bodies and embodied experience uncovers the urgent necessity for self‐care during fieldwork. Prof. Felima embodies both these challenges, and offers candid advice to students, inspiring a two‐way dialogue.
Quality assessment in initial paediatric trauma care: Systematic review from prehospital care to the paediatric intensive care unit
Authors: Buck Sainz‐Rozas Pablo , Casal Angulo Carmen , García Molina Pablo
Published: August 2023

Background

Trauma is the most common cause of death and disability in the paediatric population. There are a huge number of variables involved in the care they receive from health care professionals.

Aim

The aim of this study was to review the available evidence of initial paediatric trauma care throughout the health care process with a view to create quality indicators (QIs).

Study Design

A systematic review was performed from Cochrane Library, Medline, Scopus and SciELO between 2010 and 2020. Studies and guidelines that examined quality or suggested QI were included. Indicators were classified by health care setting, Donabedian's model, risk of bias and the quality of the publication with the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) assessment.

Results

The initial search included 686 articles, which were reduced to 22, with 15 primary and 7 secondary research articles. The snowball sampling technique was used to add a further seven guidelines and two articles. From these, 534 possible indicators were extracted, summarizing them into 39 and grouping the prehospital care indicators as structure (N = 5), process (N = 12) and outcome (N = 3) indicators and the hospital care indicators as structure (N = 4), process (N = 10) and outcome (N = 6) indicators. Most of the QIs have been extracted from US studies. They are multidisciplinary and in some cases are based on an adaptation of the QIs of adult trauma care.

Conclusions

There was a clear gap and large variability between the indicators, as well as low‐quality evidence. Future studies will validate indicators using the Delphi method.

Relevance to Clinical Practice

Design a QI framework that may be used by the health system throughout the process. Indicators framework will get nurses, to assess the quality of health care, detect deficient areas and implement improvement measures.
Socialized to care: Nursing student experiences with faculty, preceptors, and patients
Authors: Hopeck Paula
Published: August 2023

Effective socialization of nurses has led to positive outcomes for both hospitals and nurses, including higher retention and greater job satisfaction. The importance of faculty, preceptors, and patients in the socialization of nursing students has been documented extensively in the literature. The research presented in this article examines data from qualitative, longitudinal interview transcripts of 15 students as they progressed through a 2‐year nursing program to determine how these three types of influence socialize nursing students, and at which points in their education. Using multiple perspective qualitative longitudinal interviews, I interviewed participants every semester of nursing school about their experiences. From the data, these three parties have an impact at different points in their socialization, starting with faculty who socialize students to nursing school by helping them think like nurses. Next, preceptors can be barriers or facilitators of learning by demonstrating how to act like nurses and providing insight about how and why nurses may act the way that they do. Finally, patients help students put everything together by applying classroom lessons to clinical settings. The research concludes with implications for research, practice, and policy.
Diagnosing evapotranspiration responses to water deficit across biomes using deep learning
Authors: Giardina Francesco , Gentine Pierre , Konings Alexandra G. , Seneviratne Sonia I. , Stocker Benjamin D.
Published: August 2023

Accounting for water limitation is key to determining vegetation sensitivity to drought. Quantifying water limitation effects on evapotranspiration (ET) is challenged by the heterogeneity of vegetation types, climate zones and vertically along the rooting zone.

Here, we train deep neural networks using flux measurements to study ET responses to progressing drought conditions. We determine a water stress factor (fET) that isolates ET reductions from effects of atmospheric aridity and other covarying drivers. We regress fET against the cumulative water deficit, which reveals the control of whole‐column moisture availability.

We find a variety of ET responses to water stress. Responses range from rapid declines of fET to 10% of its water‐unlimited rate at several savannah and grassland sites, to mild fET reductions in most forests, despite substantial water deficits. Most sensitive responses are found at the most arid and warm sites.

A combination of regulation of stomatal and hydraulic conductance and access to belowground water reservoirs, whether in groundwater or deep soil moisture, could explain the different behaviors observed across sites. This variety of responses is not captured by a standard land surface model, likely reflecting simplifications in its representation of belowground water storage.
Central and peripheral scleral lens‐induced corneal oedema
Authors: Iqbal Asif , Fisher Damien , Alonso‐Caneiro David , Collins Michael J. , Vincent Stephen J.
Published: August 2023

Purpose

To quantify the magnitude of central and peripheral scleral lens‐induced corneal oedema for a range of fluid reservoir thicknesses, and to compare these experimental results with theoretical models of corneal oedema both with and without limbal metabolic support (i.e., the lateral transport of metabolites and the influence of the limbal vasculature).

Methods

Ten young healthy participants wore scleral lenses (KATT™, Capricornia Contact Lenses) fitted with low (mean 141 μm), medium (482 μm) and high (718 μm) central fluid reservoir thickness values across three separate study visits. The scleral lens thickness, fluid reservoir thickness and stromal corneal oedema were measured using optical coherence tomography. Oedema was quantified across the central (0–2.5 mm from the corneal apex) and peripheral (1.25–3 mm from the scleral spur) cornea. Experimental data were compared with published theoretical models of central to peripheral corneal oedema.

Results

Stromal oedema varied with fluid reservoir thickness (p < 0.001) for both central and peripheral regions. The mean (standard deviation) stromal oedema was greater for the medium (2.08 (1.21)%) and high (2.22 (1.31)%) fluid reservoir thickness conditions compared to the low condition (1.00 (1.01)%) (p ≤ 0.01). Stromal oedema gradually increased from the corneal centre to the periphery by ~0.3% on average (relative increase of 18%), but the change did not reach statistical significance. This trend of increasing, rather than decreasing, oedema towards the limbus is consistent with theoretical modelling of peripheral oedema without metabolic support from the limbus.

Conclusions

The central and peripheral cornea displayed a similar magnitude of oedema, with increasing levels observed for medium and high fluid reservoir thicknesses. The gradual increase in oedema towards the limbus is consistent with a ‘without limbal metabolic support’ theoretical model.
The effects of heterogeneous sanctions on exporting firms: Evidence from Denmark
Authors: Jäkel Ina C. , Østervig Søren , Yalcin Erdal
Published: August 2023

Sanctions encompass a wide set of policy instruments restricting cross‐border economic activities. In this paper, we study how different types of sanctions affect the export behavior of firms to the targeted countries. We combine Danish register data, including information on firm‐destination‐specific exports, with information on sanctions imposed by Denmark from the Global Sanctions Database. Our data allow us to study firms' export behavior in 62 sanctioned countries, amounting to a total of 453 country‐years with sanctions over the period 2000–2015. Methodologically, we apply a two‐stage estimation strategy to properly account for multilateral resistance terms. We find that, on average, sanctions lead to a significant reduction in firms' destination‐specific exports and a significant increase in firms' probability to exit the destination. Next, we study heterogeneity in the effects of sanctions across (i) sanction types and sanction packages, (ii) the objectives of sanctions, and (iii) countries subject to sanctions. Results confirm that the effects of sanctions on firms' export behavior vary considerably across these three dimensions.
The perceived vulnerability to disease scale: Cross‐cultural measurement invariance and associations with fear of COVID‐19 across 16 countries
Authors: Karakulak Arzu , Stogianni Maria , Alonso‐Arbiol Itziar , Shukla Shanu , Bender Michael , Yeung Victoria Wai Lan , Jovanović Veljko , Musso Pasquale , Scardigno Rosa , Scott Riley A. , Stuart Jaimee , Friehs Maria‐Therese , Toh Zena , Albayrak‐Aydemir Nihan , Arvanitis Alexios , Buzea Carmen , Mastrotheodoros Stefanos , Tsang Jo‐Ann , Madeira Filipa , Miconi Diana , Pascual Nicole Russell , Rowatt Wade C. , Al‐Kire Rosemary L. , Amar Moty , Aral Tugce , Itzchakov Guy , Mishra Sushanta Kumar , Porat Roni , Servidio Rocco , Stefenel Delia , Tair Ergyul , Gkomez Alexandros
Published: August 2023

Using cross‐sectional data from N = 4274 young adults across 16 countries during the COVID‐19 pandemic, we examined the cross‐cultural measurement invariance of the perceived vulnerability to disease (PVD) scale and tested the hypothesis that the association between PVD and fear of COVID‐19 is stronger under high disease threat [that is, absence of COVID‐19 vaccination, living in a country with lower Human Development Index (HDI) or higher COVID‐19 mortality]. Results supported a bi‐factor Exploratory Structural Equation Modeling model where items loaded on a global PVD factor, and on the sub‐factors of Perceived Infectability and Germ Aversion. However, cross‐national invariance could only be obtained on the configural level with a reduced version of the PVD scale (PVD‐r), suggesting that the concept of PVD may vary across nations. Moreover, higher PVD‐r was consistently associated with greater fear of COVID‐19 across all levels of disease threat, but this association was especially pronounced among individuals with a COVID‐19 vaccine, and in contexts where COVID‐19 mortality was high. The present research brought clarity into the dimensionality of the PVD measure, discussed its suitability and limitations for cross‐cultural research, and highlighted the pandemic‐related conditions under which higher PVD is most likely to go along with psychologically maladaptive outcomes, such as fear of COVID‐19.
Why do US source plasma donors stop donating?
Authors: Fransen Michelle , Becker Mark , Hershman Janet , Lenart James , Simon Toby L.
Published: August 2023

Background

In the United States, source plasma (SP) donors can donate up to 104 times per year. Considering the global need for SP and plasma‐derived medicinal products, it is critical to maintain the health of frequent donors. This study explores SP donors' self‐reported reasons for a lapse in donating.

Study Design and Methods

There were 5608 SP donors from 14 SP centers who enrolled in a longitudinal cohort study to assess self‐reported functional health and well‐being. Donors were assigned to one of four groups, according to the frequency of SP donation in the 12 months before enrollment. One thousand four hundred forty‐eight SP donors who lapsed in donating during 6 months or greater during the study follow‐up were asked to complete a survey.

Results

There were 545 lapsed SP donors who returned surveys (37.6%); 63% were female. Most responses given for stopping SP donation were categorized as convenience reasons (69.1%). Self‐reported health concerns, including being deferred multiple times, which were categorized as possibly related or unable to determine a relationship to plasmapheresis, represented 45.5% of the responses.

Discussion

Primary reasons US SP donors report for a lapse in donation were categorized as convenience (e.g., schedule conflicts/lack of time). Donor responses categorized as health concerns which have a possible or uncertain relationship to plasmapheresis were less frequent but present in all frequency groups. This study adds to the body of evidence that SP donors cease donating for a variety of self‐reported reasons with the majority not directly related to a perceived negative impact on their health.
Effects of donation frequency on U.S. source plasma donor health
Authors: Fransen Michelle , Becker Mark , Hershman Janet , Lenart James , Simon Toby , McCausland Kristen , Parfitt Alexandra , Weissfeld Lisa
Published: August 2023

Background

Plasma‐derived medicinal products (PDMPs) are essential, life‐saving medicines manufactured from plasma donated by healthy human volunteers. PDMPs are used to treat a range of rare, serious, and chronic conditions, often genetic in origin. Approximately 70% of the Source Plasma (SP) used for PDMP manufacturing comes from United States (US). The hypothesis of the study is that US donation frequency does not impair donor self‐reported functional health and well‐being.

Study Design and Methods

A total of 5608 SP donors from 14 US SP centers were enrolled in a cross‐sectional study to assess self‐reported health related quality of life (HRQoL) and well‐being. By sex, donors were assigned to one of four groups, according to their frequency of SP donation in the 12 months before enrollment. The SF‐36v2® Health Survey (SF‐36v2) and a survey assessing the frequency of various health conditions that may be associated with impaired immune function over different time periods were used.

Results

There were no statistically significant differences in SF‐36v2 scores between any of the donor frequency groups, compared with new donors after controlling for potential confounding and accounting for multiple comparisons among males and females. Cough, cold, occasional fatigue, and sore throat were the most reported health conditions or symptoms, but there was no clear difference among sex or frequency groups.

Discussion

The self‐reported data in this study support the hypothesis that compensated donations at US FDA permitted frequencies and volumes are consistent with maintaining donor health. Compared with the general population, SP donors have comparable or better health than the general population.
A review of Bland–Altman difference plot analysis in the veterinary clinical pathology laboratory
Authors: Moore A Russell
Published: August 2023

Current guidelines recommend using Bland–Altman plots (BA‐plots), also called Difference plots, as part of method comparison evaluation in the veterinary clinical pathology laboratory. Analysis of differences can meaningfully augment linear regression techniques and allows fuller summarization of the performance of two methods relative to each other. This work summarizes the current literature on BA‐plot composition and evaluation. Model data is used to demonstrate data evaluation approaches based on the observed differences, the combined inherent imprecision of the methods, and clinically relevant performance goals. Common limitations of the approaches, including points of frequent misinterpretation, are presented. BA‐plot analysis can be part of an intentionally crafted method comparison study that provides analytically and clinically relevant data.
Simulated effects of ferritin screening on C‐reactive protein levels in recruited blood donors
Authors: Turkulainen Esa , Ihalainen Jarkko , Arvas Mikko
Published: August 2023

Background and Objectives

Ferritin is commonly measured to evaluate iron stores in the body. Some countries have added or considered adding ferritin lower bounds to donor eligibility criteria. Ferritin is also elevated by inflammation. The main goal of this study is to estimate how different ferritin cut‐offs would affect the proportion of donors with a C‐reactive protein (CRP) level over 3 mg/L, which is the decision limit of the highest chronic cardiovascular risk.

Materials and Methods

To simulate recruitment of new blood donors, we selected participants from two Finnish general population cohorts, namely FINRISK 1997 (n = 5369) and Health 2000 (n = 3278), that would likely fulfil the selection criteria of blood donation. We then calculated the proportion of individuals with high‐sensitivity CRP values above 3 mg/L, over a range of ferritin values.

Results

We found that for several ferritin cut‐offs the proportion of potential donors with CRP > 3 mg/L would rise by a statistically significant amount. The trend was significant and similar for all subgroups but weaker for non‐menstruating women as well as men.

Conclusion

Our results show that screening a population of potential blood donors with ferritin cut‐offs raises the number of people with CRP > 3 mg/L within the blood donor population.