bluuebunny/crossref_metadata_2025 huggingface dataset:
IETAFusion: An illumination enhancement and target‐aware infrared and visible image fusion network for security system of smart city
Authors: Guo Shuang , Wu Kun , Jeon Seunggil , Yang Xiaomin
Published: January 2024

In the environmental security monitoring of smart cities, the infrared and visible image fusion method deployed on intelligent systems based on cloud and fog computing plays a vital role in providing enhanced images for target detection systems. However, the fusion quality can be significantly influenced by the illumination of the monitoring scenario in visible images. Therefore, conventional methods typically suffer a severe performance drop under the condition of insufficient illumination. To tackle this issue, we propose an illumination enhancement and target‐aware fusion method‐based on artificial intelligence, which breaks the boundaries between the task of illumination enhancement and image fusion and provide a fusion result with better visual perception in nighttime scene. Specifically, we use a light‐weight contrast enhancement module restore the brightness of the visible image. Moreover, a Swin Transformer‐based backbone network is utilized to facilitate information exchange between the source images and enhance the capabilities of target awareness. Finally, the fused images are reconstructed by the contrast‐texture retention module and reconstructor. The extensive experiments indicate that the proposed approach achieves improved performance both in human perception and quantitative analysis compared with the state‐of‐the‐art methods.
Mineral composition controls the stabilization of microbially derived carbon and nitrogen in soils: Insights from an isotope tracing model
Authors: Wang Xu , Wang Chao , Fan Xianlei , Sun Lifei , Sang Changpeng , Wang Xugao , Jiang Ping , Fang Yunting , Bai Edith
Published: January 2024

Evidence is emerging that microbial products and residues (necromass) contribute greatly to stable soil organic matter (SOM), which calls for the necessity of separating the microbial necromass from other SOM pools in models. However, the understanding on how microbial necromass stabilizes in soil, especially the mineral protection mechanisms, is still lacking. Here, we incubated 13C‐ and 15N‐labelled microbial necromass in a series of artificial soils varying in clay minerals and metal oxides. We found the mineralization, adsorption and desorption rate constants of necromass nitrogen were higher than those of necromass carbon. The accumulation rates of necromass carbon and nitrogen in mineral‐associated SOM were positively correlated with the specific surface area of clay minerals. Our results provide direct evidence for the protection role of mineral in microbial necromass stabilization and provide a platform for simulating microbial necromass separately in SOM models.
Precarity in Burhan Qurbani's Berlin Alexanderplatz (2020)
Authors: Wolf Franziska
Published: January 2024

When Burhan Qurbani's adaptation of Döblin's modernist classic Berlin Alexanderplatz premiered in 2020, criticism included the allegation that Qurbani's protagonist Francis—a Black refugee from Guinea‐Bissau stranded at the outskirts of present‐day Berlin—does not resemble the novel's released prisoner and street vendor Franz Biberkopf. This article presents a comparative investigation of Qurbani's Francis and Döblin's Biberkopf. Drawing on Judith Butler's writing on precarity, grievability, and the quest for a “good life,” I consider how both Francis and Biberkopf face increased risk of injury, occupy a liminal space in society, and cannot fulfill their intention to be morally good while also achieving upward social mobility. Their failure is a direct consequence of their politically and socioeconomically precarious condition: Biberkopf belongs to the underclass of the lumpenproletariat, whereas Francis, as an undocumented immigrant, is exposed to neoliberal hyper‐precarity.
Factors associated with the outcome of root canal treatment—A cohort study conducted in a private practice
Authors: Jurič Rok , Vidmar G. , Blagus R. , Jan Janja
Published: January 2024

Aim

To investigate the association of various pre‐, intra‐ and post‐operative factors on root canal treatment outcome.

Methodology

In this cohort study, primary or secondary root canal treatment of mature permanent teeth was performed by a single endodontist in a private practice over 13 years, and followed 1–4 years after treatment. Treatment details and clinical and radiographic data were collected. The proportion of successfully treated teeth and roots based on strict radiographic (periapical index (PAI) ≤2) and clinical criteria (absence of pain, swelling or sinus tract) was estimated. To evaluate joint associations of prognostic factors and treatment success probability, 44 pre, intra‐ and post‐operative factors were investigated using bivariate associations, and a multiple logistic regression model was fitted using Generalized Estimating Equations.

Results

1259 teeth (2445 roots, 3149 canals) were assessed with a recall rate of 91%. The proportion of successfully treated teeth was 79.9% [95% confidence interval 77.7–82.1]. Eleven prognostic factors were identified that significantly reduced the odds ratio (OR) for treatment success at tooth level. Six were preoperative: injury history (OR = 0.05[0.01–0.24]), root PAI (OR = 0.29[0.20–0.42], 0.21[0.13–0.34] and 0.22[0.12–0.42] for PAI = 3, 4 and 5, respectively, against PAI = 1), lesion diameter (OR = 0.30[0.21–0.43] and 0.24[0.16–0.37] for diameters of 1‐5 mm and ≥6 mm, respectively, against no lesion), tooth type (OR = 0.51[0.27–0.97] and OR = 0.45[0.24–0.83] for premolars and molars, respectively, against incisors or canines), tenderness to periapical palpation (OR = 0.64[0.43–0.94]) and two canals per root (OR = 0.67[0.54–0.83]). Four factors were intraoperative: root filling of unsatisfactory quality (OR = 0.18[0.08–0.40]) or extending beyond or shorter than 2 mm from the apex (OR = 0.44[0.26–0.75] and 0.62[0.40–0.97] respectively), resin sealer (OR = 0.58[0.39–0.87] against bioceramic sealer) and single visit treatment (OR = 0.40[0.21–0.75] against multiple visits). One factor was post‐operative: defective coronal restoration (OR = 0.35[0.21–0.56]).

Conclusion

The following factors were associated with unsuccessful root canal treatment: (i) history of injury, apical periodontitis with increased severity (larger lesion, higher PAI, tenderness to periapical palpation), or complicated anatomic conditions (premolar or molar, two canals in a single root); (ii) technically suboptimal root filling (of unsatisfactory quality or not ending within 2 mm of radiographic apex) performed in a single‐visit, or use of resin sealer instead of novel bioceramic sealer; (iii) suboptimal quality coronal restoration.
Dynamically guided transantral piezoelectric endodontic microsurgery: A case report with technical considerations
Authors: Villa‐Machado Paula Andrea , Restrepo‐Restrepo Felipe Augusto , Tobón‐Arroyave Sergio Iván
Published: January 2024

Aim

Endodontic microsurgery (EMS) of maxillary molars may represent a complex challenge to the clinician due to the location of the roots and the proximity of the maxillary sinus floor. This report aimed to describe the simultaneous use of a computer‐assisted dynamic navigation (C‐ADN) system and piezoelectric bony‐window osteotomy for the transantral microsurgical approach of a maxillary left first molar with adequate root canal filling and symptomatic apical periodontitis.

This case report highlights the importance of C‐ADN to carry out a minimally invasive buccal surgical access to palatal roots affected by apical periodontitis and provides a practical example to help clinicians make treatment decisions based on the available evidence. Clinical and tomographic evaluations were performed before the surgical procedure and at 24‐month follow‐up. This case was treated using a C‐ADN system fitted to a piezotome for the buccal approach of the buccal roots, maxillary sinus membrane lifting, and for transantral location, root‐end resection, cavity preparation, and filling of the palatal root. The navigation system allowed to achieve an accurate apical canal terminus location and root‐end filling of the three roots with a minimally invasive piezoelectric crypt approach. At the 24‐month follow‐up examination, the patient remains asymptomatic, with normal periapical structures, and regeneration of maxillary sinus walls. It was concluded that the combination of dynamic navigation with piezoelectric bony‐window osteotomy offers enhanced accuracy, tissue preservation, diminished risk of iatrogenic complications, and could maximize success and survival rates in transantral EMS.
Reduced C‐reactive protein levels after root canal treatment in clinically healthy young apical periodontitis individuals at cardiovascular risk. A prospective study
Authors: Garrido Mauricio , Bordagaray María José , Schweitzer Catalina , Lucero‐Mora Joaquín , Reyes Montserrat , Pellegrini Elizabeth , Hernández‐Ríos Patricia , Fernández Alejandra , Hernández Marcela
Published: January 2024

Aim

To determine the systemic inflammatory burden, including hsCRP and its monomeric forms, in patients with apical lesions of endodontic origin treated with root canal treatment (RCT).

Methodology

Prospective pre‐/post‐study. Apical periodontitis (AP) individuals aged 16–40 were included (N = 29). Individuals received RCT and were followed at 1 and 6 months. Fasting blood samples were obtained. Apical lesions of endodontic origin (ALEO) diameter (mm), and periapical index (PAI), were recorded. The serum concentrations of total hsCRP were determined by turbidimetry. Tumour necrosis factor (TNF)‐α, interleukin (IL)‐6, IL‐10, IL‐1β, and soluble (s) E‐selectin were assessed by Multiplex assay. Additionally, mCRP forms were determined in the serum of AP patients with a baseline moderate to high cardiovascular risk based on hsCRP stratification (hsCRP ≥1 mg/L) by immunowestern blot (n = 15). Also, CRP isoforms were explored in ALEOs from AP individuals (n = 4). Data were analysed with StataV16.

Results

Periapical index and ALEO sizes were reduced at both follow‐up visits after RCT (p < .05). Serum levels of TNF‐α, IL‐6, IL‐10, IL‐1β, and sE‐selectin did not show significant differences. CRP was borderline reduced at 1 month (p = .04); however, in AP individuals at cardiovascular risk (hsCRP ≥ 1 mg/L), hsCRP and its monomeric isoform significantly decreased at 1 and 6 months (p < .05).

Conclusions

High‐sensitivity CRP and mCRP are reduced after RCT in AP individuals at cardiovascular risk.
Development and preliminary evaluation of a novel procedure for creation of an ileal conduit stoma aimed at preventing parastomal hernia
Authors: Tanaka Toshiaki , Yamasaki Koji , Nofuji Seisuke , Maehana Takeshi , Shindo Tetsuya , Kyoda Yuki , Hashimoto Kohei , Kobayashi Ko , Masumori Naoya
Published: January 2024

Objectives

Our previous study suggested that the operative procedure is critical for the development of parastomal hernia. We developed a novel procedure for the creation of an ileal conduit stoma to prevent parastomal hernia. Herein we evaluate the efficacy and safety of the procedure.

Methods

A total of 113 Japanese patients underwent radical cystectomy and ileal conduit diversion for bladder cancer from January 2017 through December 2021 at our institution. After excluding those with incomplete data, 103 patients consisting of 46 (44.7%) with the conventional procedure and 57 (55.3%) with the novel procedure were consecutively enrolled. The main points of the novel procedure are as follows: (1) the passage of the ileal conduit is ≤2.4 cm in diameter in principle; (2) the posterior rectus sheath and peritoneum are vertically incised 2 cm laterally from the middle of the stoma site to make an oblique passage for the ileal conduit; and (3) the anterior rectus sheath and posterior rectus sheath with peritoneum are fixed to the ileal conduit separately.

Results

Radiography‐based parastomal hernia was observed in 11 patients (10.7%) with a median follow‐up of 22.0 months. The incidences of parastomal hernia were 3.5% and 19.6% in the novel and the conventional procedure groups, respectively (p = 0.011). The former had a significantly lower cumulative incidence of parastomal hernia (p = 0.008, log‐rank test). No specific complications associated with the procedure were observed.

Conclusions

The results of the preliminary cohort study suggest that the novel procedure is safe and effective for the prevention of parastomal hernia.
Identification and function of the Pax gene Bmgsb in the silk gland of Bombyx mori
Authors: Yang Hongguo , Xu Yongping , Yuan Yutong , Liu Xuebing , Zhang Jikailang , Li Jiaojiao , Zhang Ran , Cao Jun , Cheng Tingcai , Liu Chun
Published: January 2024

Paired box (Pax) genes are highly conserved throughout evolution, and the Pax protein is an important transcription factor of embryonic development. The Pax gene Bmgsb is expressed in the silk glands of silkworm, but its biological functions remain unclear. This study aimed to investigate the expression pattern of Bmgsb in the silk gland and explore its functions using RNA interference (RNAi). Here, we identified eight Pax genes in Bombyx mori. Phylogenetic analysis showed that the B. mori Pax genes were highly homologous to the Pax genes in other insects and highly evolutionarily conserved. The tissue expression profile showed that Bmgsb was expressed in the anterior silk gland and anterior part of the middle silk gland (AMSG). RNAi of Bmgsb resulted in defective development of the AMSG, and the larvae were mostly unable to cocoon in the wandering stage. RNA‐seq analysis showed that the fibroin genes fib‐l, fib‐h and p25, cellular heat shock response‐related genes and phenol oxidase genes were considerably upregulated upon Bmgsb knockdown. Furthermore, quantitative reverse transcription‐PCR results showed that the fibroin genes and ubiquitin proteolytic enzyme‐related genes were significantly upregulated in the AMSG after Bmgsb knockdown. This study provides a foundation for future research on the biological functions of B. mori Pax genes. In addition, it demonstrates the important roles of Bmgsb in the transcriptional regulation of fibroin genes and silk gland development.
Attention control in preterm and term 5‐month‐old infants: Cross‐task stability increases with gestational age
Authors: Perra Oliver , Winstanley Alice , Sperotto Rebecca , Gattis Merideth
Published: January 2024

Cross‐task stability refers to performance consistency across different settings and measures of the same construct. Cross‐task stability can help us understand developmental processes, including how risks such as preterm birth affect outcomes. We investigated cross‐task stability of attention control in 32 preterm and 39 term infants. All infants had the same chronological age at time of testing (5 months) but varied in gestational age (GA) at birth (30–42 weeks). Infants completed an experimental attention following task with a researcher and a naturalistic play observation with their mothers. Both preterm and term infants demonstrated attention following in the experimental task. GA and flexibility of attention were related: the likelihood of no turn trials decreased with increasing GA. To evaluate cross‐task stability, we compared attention performance in the experimental and naturalistic settings. Flexible attention shifts on the experimental task were positively related to attention to objects in the naturalistic observation. Furthermore, the association between flexible attention shifts on the experimental task and attention to objects in the naturalistic observation was moderated by GA. Our study provides initial evidence that the consolidation of attention control increases with GA. These findings highlight the value of comparing experimental and observational measures of attention.
Enhancing nurses’ perceptions of having a place to reduce turnover intentions
Authors: Chang Hao‐Yuan , Lee I‐Chen , Huang Tzu‐Ling , Ho Lun‐Hui , Chen Li‐Chen , Cheng T. C. E. , Teng Ching‐I
Published: January 2024

Aim

To investigate whether education, tenure, being an advanced practice nurse, skill level, and time pressure impact perceptions of “having a place” and, further, turnover intentions.

Background

Nursing shortages persist worldwide. Nurses’ turnover intentions are negatively related to their perceptions of “having a place” (i.e., the feeling that the nursing workplace is their territory). However, the sources of nurses’ perceptions of the perception of “having a place” remain unknown.

Methods

Our research employed a cross‐sectional and correlational design. This research was conducted at a large‐scale hospital in northern Taiwan from December 2021 to January 2022. We used personnel data pertaining to 430 nurses as well as scales for time pressure, “having a place” and turnover intentions to assess nurses’ intention to leave their place of employment. The inclusion criteria focused on full‐time nurses who worked for the hospital under investigation. Most of our participants were women. The STROBE statement was used as the EQUATOR checklist (supplemental file).

Results

“Having a place” was positively related to educational level, tenure, and skill level, while being an advanced practice nurse was negatively associated with perceptions of “having a place,” which in turn were negatively related to turnover intention among nurses.

Conclusion

Our study is the first to examine the antecedents of nurses’ perceptions of “having a place,” which include education, tenure, and skill level.

Implications for nursing policy

Nursing policymakers could encourage nurses to pursue higher degrees and update their nursing skills while instilling perceptions of “having a place” in nurses with a brief tenure and advanced practice nurses.
Views of family members on using video calls during the hospital admission of a patient: A qualitative study
Authors: in de Braekt Anna , Coolen Celeste M. , Maaskant Jolanda M. , de Man‐van Ginkel Janneke M. , Eskes Anne M. , Jongerden Irene P.
Published: January 2024

Background

Utilization of video calls on hospital wards to facilitate involvement of and communication with family members is still limited. A deeper understanding of the needs and expectations of family members regarding video calls on hospital wards is necessary, to identify potential barriers and facilitate video calls in practice.

Aim

The aim of this study was to explore the views, expectations and needs of a patient's family members regarding the use of video calls between family members, patients and healthcare professionals, during the patient's hospital admission.

Methods

A qualitative study was carried out. Semi‐structured interviews with family members of patients admitted to two hospitals were conducted between February and May 2022. Family members of patients admitted to the surgical, internal medicine and gynaecological wards were recruited.

Results

Twelve family members of patients participated. Family members stated that they perceive video calls as a supplemental option and prefer live visits during hospital admission. They expected video calls to initiate additional moments of contact with healthcare professionals, e.g. to join in medical rounds. When deploying video calls, family members mentioned that adequate instruction and technical support by nurses should be available.

Conclusion

Family members considered video calls valuable when visiting is not possible or to participate in medical rounds or other contacts with healthcare professionals outside of visiting hours.

Implications

Family members need to be supported in options and use of video calls on hospital wards. Additional knowledge about actual participation in care through video calls is needed as well as the effect on patient, family and healthcare professional outcomes.

Impact

Using video calls on hospital wards can provide family members with flexible alternatives for contact and promote family involvement.

Reporting Method

COREQ guidelines.

Patient or Public Contribution

Family members of patients admitted to hospital have contributed by sharing their perspectives in interviews.

What does this paper contribute to the wider global clinical community?

Family members perceive additional value from the use of video calls on hospital wards.

For family, use of video calls needs to be facilitated with clear instruction materials and support.

Trial and Protocol Registration

Amsterdam UMC Medical Ethics Review Committee (ref number W21_508 # 21.560).
Development and validation of a prediction model for self‐reported hypoglycemia risk in patients with type 2 diabetes: A longitudinal cohort study
Authors: Xu Hongmei , Yu Hangqing , Cheng Zhengnan , Mu Chun , Bao Di , Li Xiaohui , Xing Qiuling
Published: January 2024

Aims/Introduction

To develop and validate a simple prediction model for hypoglycemia risk in patients with type 2 diabetes.

Materials and Methods

We prospectively analyzed the data of 1,303 subjects in a third‐class hospital in Tianjin and followed up their hypoglycemia events at 3 and 6 months. The hypoglycemia risk prediction models for 3 and 6 months were developed and the model performance was evaluated.

Results

A total of 340 (28.4%) patients experienced hypoglycemia within 3 months and 462 (37.2%) within 6 months during the follow‐up period. Age, central obesity, intensive insulin therapy, frequency of hypoglycemia in the past year, and hypoglycemia prevention education entered both model3month and model6month. The area under the receiver operating characteristic curve of model3month and model6month were 0.711 and 0.723, respectively. The Youden index was 0.315 and 0.361, while the sensitivities were 0.615 and 0.714, and the specificities were 0.717 and 0.631. The calibration curves showed that the models were similar to reality. The decision curves implied that the clinical net benefit of the model was clear.

Conclusions

The study developed 3 and 6 month hypoglycemia risk prediction models for patients with type 2 diabetes. The discrimination and calibration of the two prediction models were good, and might help to improve clinical decision‐making and guide patients to more reasonable self‐care and hypoglycemia prevention at home.
Epac2 activation mediates glucagon‐induced glucogenesis in primary rat hepatocytes
Authors: Shiozaki‐Takagi Yusuke , Ozaki Nobuaki , Toyoda Yukiyasu
Published: January 2024

Aims/Introduction

Glucagon plays an essential role in hepatic glucogenesis by enhancing glycogen breakdown, inducing gluconeogenesis, and suppressing glycogenesis. Moreover, glucagon increases cyclic adenosine monophosphate (cAMP) levels, thereby activating protein kinase A (PKA) and cAMP guanine nucleotide exchange factor (also known as Epac). Although the function of PKA in the liver has been studied extensively, the function of hepatic Epac is poorly understood. The aim of this study was to elucidate the role of Epac in mediating the action of glucagon on the hepatocytes.

Materials and Methods

Epac mRNA and protein expression, localization, and activity in the hepatocytes were analyzed by reverse transcription polymerase chain reaction, western blotting, immunofluorescence staining, and Rap1 activity assay, respectively. Additionally, we investigated the effects of an Epac‐specific activator, 8‐CPT, and an Epac‐specific inhibitor, ESI‐05, on glycogen metabolism in isolated rat hepatocytes. Further mechanisms of glycogen metabolism were evaluated by examining glucokinase (GK) translocation and mRNA expression of gluconeogenic enzymes.

Results

Epac2, but not Epac1, was predominantly expressed in the liver. Moreover, 8‐CPT inhibited glycogen accumulation and GK translocation and enhanced the mRNA expression of gluconeogenic enzymes. ESI‐05 failed to reverse glucagon‐induced suppression of glycogen storage and partially inhibited glucagon‐induced GK translocation and the mRNA expression of gluconeogenic enzymes.

Conclusions

Epac signaling plays a role in mediating the glucogenic action of glucagon in the hepatocytes.
Driving among individuals with chronic conditions: A systematic review of applied research using kinematic driving sensors
Authors: Mukherjee Srijani , McDonald Anthony D. , Kesler Shelli R. , Cuevas Heather , Swank Chad , Stevens Alan , Ferris Thomas K. , Danesh Valerie
Published: January 2024

Background

Kinematic driving data studies are a novel methodology relevant to health care, but prior studies have considerable variance in their methods, populations, and findings suggesting a need for critical analysis and appraisal for feasibility and methodological guidelines.

Methods

We assessed kinematic driving studies of adults with chronic conditions for study feasibility, characteristics, and key findings, to generate recommendations for future study designs, and to identify promising directions for applications of kinematic driving data. PRISMA was used to guide the review and searches included PubMed, CINAHL, and Compendex. Of 379 abstract/titles screened, 49 full‐text articles were reviewed, and 29 articles met inclusion criteria of analyzing trip‐level kinematic driving data from adult drivers with chronic conditions.

Results

The predominant chronic conditions studied were Alzheimer's disease and related Dementias, obstructive sleep apnea, and diabetes mellitus. Study objectives included feasibility testing of kinematic driving data collection in the context of chronic conditions, comparisons of simulation with real‐world kinematic driving behavior, assessments of driving behavior effects associated with chronic conditions, and prognostication or disease classification drawn from kinematic driving data. Across the studies, there was no consensus on devices, measures, or sampling parameters; however, studies showed evidence that driving behavior could reliably differentiate between adults with chronic conditions and healthy controls.

Conclusions

Vehicle sensors can provide driver‐specific measures relevant to clinical assessment and interventions. Using kinematic driving data to assess and address driving measures of individuals with multiple chronic conditions is positioned to amplify a functional outcome measure that matters to patients.
Associations of body habitus and its changes with incident dementia in older adults
Authors: Wu Zimu , Owen Alice , Woods Robyn L. , Cribb Lachlan , Alharbi Tagrid , Zhou Zhen , Chong Trevor T.‐J. , Orchard Suzanne G. , Shah Raj C. , Wolfe Rory , Torres Daniel , McNeil John J. , Sheets Kerry M. , Murray Anne M. , Ryan Joanne
Published: January 2024

Background

This study examined the associations of body mass index (BMI) and waist circumference (WC), as well as their short‐ and long‐term changes over time, with incident dementia in older individuals.

Methods

Data came from 18,837 community‐dwelling individuals aged 65+ years from Australia and the United States, who were relatively healthy without major cognitive impairment at enrolment. Anthropometric measures were prospectively assessed at baseline, as well as change and variability from baseline to year two (three time‐points). In a subgroup (n = 11,176), self‐reported weight at age 18 and 70+ years was investigated. Dementia cases satisfied DSM‐IV criteria. Cox regression was used to examine the associations between anthropometric measures and incident risk of dementia.

Results

Compared to normal weight, an overweight (HR: 0.67, 95%CI: 0.57–0.79, p < 0.001) or obese BMI (HR: 0.73, 95%CI: 0.60–0.89, p = 0.002), or a larger WC (elevated, HR: 0.71, 95%CI: 0.58–0.86, p < 0.001; highly elevated, HR: 0.65, 95%CI: 0.55–0.78, p < 0.001; relative to low) at baseline was associated with lower dementia risk. In contrast, substantial increases in BMI (>5%) over 2 years after baseline were associated with higher dementia risk (HR: 1.49, 95% CI: 1.17–1.91, p = 0.001). Increased dementia risk was also seen with an underweight BMI at baseline and a 2‐year BMI decrease (>5%), but these associations appeared only in the first 4 years of follow‐up. Compared to normal weight at both age 18 and 70+ years, being obese at both times was associated with increased dementia risk (HR: 2.27, 95%CI: 1.22–4.24, p = 0.01), while obesity only at age 70+ years was associated with decreased risk (HR: 0.70, 95%CI: 0.51–0.95, p = 0.02).

Conclusions

Our findings suggest that long‐term obesity and weight gain in later life may be risk factors for dementia. Being underweight or having substantial weight loss in old age may be early markers of pre‐clinical dementia.
Energetics and clinical factors for the time required to walk 400 m: The Study of Muscle, Mobility and Aging (SOMMA)
Authors: Cummings Steven R. , Lui Li‐Yung , Glynn Nancy W. , Mau Theresa , Cawthon Peggy M. , Kritchevsky Stephen B. , Coen Paul M. , Goodpaster Bret , Marcinek David J. , Hepple Russell T. , Patel Sheena , Newman Anne B.
Published: January 2024

Background

Walking slows with aging often leading to mobility disability. Mitochondrial energetics has been found to be associated with gait speed over short distances. Additionally, walking is a complex activity but few clinical factors that may be associated with walk time have been studied.

Methods

We examined 879 participants ≥70 years and measured the time to walk 400 m. We tested the hypothesis that decreased mitochondrial energetics by respirometry in muscle biopsies and magnetic resonance spectroscopy in the thigh and is associated with longer time to walk 400 m. We also used cardiopulmonary exercise testing to assess the energetic costs of walking: maximum oxygen consumption (VO2peak) and energy cost–capacity (the ratio of VO2, at a slow speed to VO2peak). In addition, we tested the hypothesis that selected clinical factors would also be associated with 400‐m walk time.

Results

Lower Max OXPHOS was associated with longer walk time, and the association was explained by the energetic costs of walking, leg power, and weight. Additionally, a multivariate model revealed that longer walk time was also significantly associated with lower VO2peak, greater cost–capacity ratio, weaker leg power, heavier weight, hip and knee stiffness, peripheral neuropathy, greater perceived exertion while walking slowly, greater physical fatigability, less moderate‐to‐vigorous exercise, less sedentary time, and anemia. Significant associations between age, sex, muscle mass, and peripheral artery disease with 400‐m walk time were explained by other clinical and physiologic factors.

Conclusions

Lower mitochondrial energetics is associated with needing more time to walk 400 m. This supports the value of developing interventions to improve mitochondrial energetics. Additionally, doing more moderate‐to‐vigorous exercise, increasing leg power, reducing weight, treating hip and knee stiffness, and screening for and treating anemia may reduce the time required to walk 400 m and reduce the risk of mobility disability.
Comment on: Association of sulfonylureas with the risk of dementia: A population‐based cohort study
Authors: Chu Wei‐Min , Wei James Cheng‐Chung
Published: January 2024

See the reply by Swardfage et al.
Reply to: Comment on: Association of sulfonylureas with the risk of dementia: A population‐based cohort study
Authors: Wu Che‐Yuan , Swardfager Walter
Published: January 2024

This letter comments on the letter by Wei‐Min Chu.
Fellowship‐trained physicians who let their geriatric medicine certification lapse: A national survey
Authors: Ross Kathryn , Lynn Lorna , Foley Kevin T. , Barczi Steven R. , Widera Eric , Parks Susan , Luz Clare , Colburn Jessica L. , Leff Bruce
Published: January 2024

Background

Only 62.6% of fellowship‐trained and American Board of Internal Medicine (ABIM)‐certified geriatricians maintain their specialty certification in geriatric medicine, the lowest rate among all internal medicine subspecialties and the only subspecialty in which physicians maintain their internal medicine certification at higher rates than their specialty certification. This study aims to better understand underlying issues related to the low rate of maintaining geriatric medicine certification in order to inform geriatric workforce development strategies.

Methods

Eighteen‐item online survey of internists who completed a geriatric medicine fellowship, earned initial ABIM certification in geriatric medicine between 1999 and 2009, and maintained certification in internal medicine (and/or another specialty but not geriatric medicine). Survey domains: demographics, issues related to maintaining geriatric medicine certification, professional identity, and current professional duties.

Results

153/723 eligible completed surveys (21.5% response). Top reasons for not maintaining geriatric medicine certification were time (56%), cost of maintenance of certification (MOC) (45%), low Medicare reimbursement for geriatricians' work (32%), and no employer requirement to maintain geriatric medicine certification (31%). Though not maintaining geriatric medicine certification, 68% reported engaging in professional activities related to geriatric medicine. Reflecting on career decisions, 56% would again complete geriatric medicine fellowship, 21% would not, and 23% were unsure. 54% considered recertifying in geriatric medicine. 49% reported flexible MOC assessment options would increase likelihood of maintaining certification.

Conclusions

The value proposition of geriatric medicine certification needs strengthening. Geriatric medicine leaders must develop strategies and tactics to reduce attrition of geriatricians by enhancing the value of geriatric medicine expertise to key stakeholders.
Reinvigorating geriatrics: An urgent call for prompt action
Authors: Boult Chad
Published: January 2024

See related articles by Ouslander et al., Colenda and Applegate, and Ross et al. in this issue.
Forelimb muscle activation patterns in American alligators: Insights into the evolution of limb posture and powered flight in archosaurs
Authors: Iijima Masaya , Mayerl Christopher J. , Munteanu V. David , Blob Richard W.
Published: January 2024

The evolution of archosaurs provides an important context for understanding the mechanisms behind major functional transformations in vertebrates, such as shifts from sprawling to erect limb posture and the acquisition of powered flight. While comparative anatomy and ichnology of extinct archosaurs have offered insights into musculoskeletal and gait changes associated with locomotor transitions, reconstructing the evolution of motor control requires data from extant species. However, the scarcity of electromyography (EMG) data from the forelimb, especially of crocodylians, has hindered understanding of neuromuscular evolution in archosaurs. Here, we present EMG data for nine forelimb muscles from American alligators during terrestrial locomotion. Our aim was to investigate the modulation of motor control across different limb postures and examine variations in motor control across phylogeny and locomotor modes. Among the nine muscles examined, m. pectoralis, the largest forelimb muscle and primary shoulder adductor, exhibited significantly smaller mean EMG amplitudes for steps in which the shoulder was more adducted (i.e., upright). This suggests that using a more adducted limb posture helps to reduce forelimb muscle force and work during stance. As larger alligators use a more adducted shoulder and hip posture, the sprawling to erect postural transition that occurred in the Triassic could be either the cause or consequence of the evolution of larger body size in archosaurs. Comparisons of EMG burst phases among tetrapods revealed that a bird and turtle, which have experienced major musculoskeletal transformations, displayed distinctive burst phases in comparison to those from an alligator and lizard. These results support the notion that major shifts in body plan and locomotor modes among sauropsid lineages were associated with significant changes in muscle activation patterns.
Wage–experience profiles in China and Eastern Europe: A large meta‐analysis
Authors: Horie Norio , Iwasaki Ichiro , Kupets Olga , Ma Xinxin , Mizobata Satoshi , Satogami Mihoko
Published: January 2024

This paper conducts a comparative meta‐analysis using 3,098 estimates reported in 125 research works to explore the wage–experience profile in China and Eastern Europe as they experience a systemic transformation from the planned system to a market economy. The results indicate that the relationship between years of work experience and wage levels in China and Eastern Europe in the transition period was structured consistently with economic theories. It is also revealed that both China and Eastern Europe have experienced a flattening of their wage–experience profiles over time. These findings are statistically robust beyond issues of heterogeneity and publication selection bias in the literature.
Environmental filtering is the primary driver of community assembly in forest–grassland mosaics: A case study based on CSR strategies
Authors: Erdős László , Ho Khanh Vu , Bede‐Fazekas Ákos , Kröel‐Dulay György , Tölgyesi Csaba , Bátori Zoltán , Török Péter
Published: January 2024

Aims

Ecological strategies can provide information about plant community assembly and its main drivers. Our aim was to reveal the dominant strategies of the vegetation types of forest–grassland mosaics and to deduce the assembly processes responsible for their species composition.

Location

Hungary.

Methods

We investigated eight vegetation types of Hungarian forest–steppes. The trade‐off between three key traits related to leaf size and economics was used to calculate Grime's competitive–stress tolerance–ruderal (CSR) value for each species, based on which the mean value for each vegetation type was determined. Detrended correspondence analysis (DCA) ordination was used to reveal the compositional differences among the vegetation types under study. To analyze how ecological strategies correlate with the compositional gradient, we used linear regression between plot ordination scores (the first DCA scores) and each strategy (C, S, and R). Linear mixed‐effect models were used to evaluate the differences between the vegetation types regarding each strategy (C, S, and R).

Results

Each vegetation type was dominated by the stress‐tolerator strategy, indicating the prominent role of environmental filtering in community assembly. However, ecological strategies differed significantly among the communities. The importance of the stress‐tolerator strategy decreased toward the less harsh end of the gradient (i.e., from grasslands to forests), while the competitor strategy showed a reverse pattern. The ruderal strategy was weakly correlated with the gradient, although its proportion increased toward the harsh end of the gradient.

Conclusions

With ongoing climate change, an increasing importance of environmental filtering is expected in the assembly of the vegetation types in the studied forest–grassland mosaics. We suggest that CSR strategies offer a useful tool for studying plant‐community assembly rules along environmental gradients.
Lizard host abundances and climatic factors explain phylogenetic diversity and prevalence of blood parasites on an oceanic island
Authors: Megía‐Palma Rodrigo , Palomar Gemma , Martínez Javier , Antunes Bernardo , Dudek Katarzyna , Žagar Anamarija , Serén Nina , Carretero Miguel A. , Babik Wiesław , Merino Santiago
Published: January 2024

Host abundance might favour the maintenance of a high phylogenetic diversity of some parasites via rapid transmission rates. Blood parasites of insular lizards represent a good model to test this hypothesis because these parasites can be particularly prevalent in islands and host lizards highly abundant. We applied deep amplicon sequencing and analysed environmental predictors of blood parasite prevalence and phylogenetic diversity in the endemic lizard Gallotia galloti across 24 localities on Tenerife, an island in the Canary archipelago that has experienced increasing warming and drought in recent years. Parasite prevalence assessed by microscopy was over 94%, and a higher proportion of infected lizards was found in warmer and drier locations. A total of 33 different 18s rRNA parasite haplotypes were identified, and the phylogenetic analyses indicated that they belong to two genera of Adeleorina (Apicomplexa: Coccidia), with Karyolysus as the dominant genus. The most important predictor of between‐locality variation in parasite phylogenetic diversity was the abundance of lizard hosts. We conclude that a combination of climatic and host demographic factors associated with an insular syndrome may be favouring a rapid transmission of blood parasites among lizards on Tenerife, which may favour the maintenance of a high phylogenetic diversity of parasites.
How do validity experts conceptualise argumentation? It's a rhetorical question
Authors: Kinnear Benjamin , Martini Abigail , Varpio Lara , Driessen Erik W. , Schumacher Daniel J.
Published: January 2024

Introduction

Health professions education (HPE) has adopted the conceptualization of validity as an argument. However, the theoretical and practical aspects of how validity arguments should be developed, used and evaluated in HPE have not been deeply explored. Articulating the argumentation theory undergirding validity and validation can help HPE better operationalise validity as an argument. To better understand this, the authors explored how HPE validity scholars conceptualise assessment validity arguments and argumentation, seeking to understand potential consequences of these views on validation practices.

Methods

The authors used critical case sampling to identify HPE assessment validity experts in three ways: (1) participation in a prominent validity research group, (2) appearing in a bibliometric study of HPE validity publications and (3) authorship of recent HPE validity literature. Qualitative semi‐structured interviews were conducted with 16 experts in HPE assessment validity from four different countries. The authors used reflexive thematic analysis to develop themes relevant to their research question.

Results

The authors developed three themes grounded in participants' responses: (1) In theory, HPE validity is a social and situated argument. (2) In practice, the absence of audience and evaluation stymies the social nature of HPE validity. (3) Lack of validity argumentation creates and maintains power differentials within HPE. Participants articulated that current HPE validation practices are rooted in post‐positivist epistemology when they should be situated (i.e. context‐dependent), audience‐centric and inclusive.

Discussion

When discussing validity argumentation in theory, participants' descriptions reflect an interpretivist lens for evaluation that is misaligned with real‐world validity practices. This misalignment likely arises from HPE's adoption of “validity as an argument” as a slogan, without integrating theoretical and practical principles of argumentation theory.
Genome‐wide profiling of piggyBac transposon insertion mutants reveals loss of the F1F0 ATPase complex causes fluconazole resistance in Candida glabrata
Authors: Chow Eve W. L. , Song Yabing , Wang Haitao , Xu Xiaoli , Gao Jiaxin , Wang Yue
Published: January 2024

Invasive candidiasis caused by non‐albicans species has been on the rise, with Candida glabrata emerging as the second most common etiological agent. Candida glabrata possesses an intrinsically lower susceptibility to azoles and an alarming propensity to rapidly develop high‐level azole resistance during treatment. In this study, we have developed an efficient piggyBac (PB) transposon‐mediated mutagenesis system in C. glabrata to conduct genome‐wide genetic screens and applied it to profile genes that contribute to azole resistance. When challenged with the antifungal drug fluconazole, PB insertion into 270 genes led to significant resistance. A large subset of these genes has a role in the mitochondria, including almost all genes encoding the subunits of the F1F0 ATPase complex. We show that deleting ATP3 or ATP22 results in increased azole resistance but does not affect susceptibility to polyenes and echinocandins. The increased azole resistance is due to increased expression of PDR1 that encodes a transcription factor known to promote drug efflux pump expression. Deleting PDR1 in the atp3Δ or atp22Δ mutant resulted in hypersensitivity to fluconazole. Our results shed light on the mechanisms contributing to azole resistance in C. glabrata. This PB transposon‐mediated mutagenesis system can significantly facilitate future genome‐wide genetic screens.
Exogenous application of nanocarrier‐mediated double‐stranded RNA manipulates physiological traits and defence response against bacterial diseases
Authors: Pal Garima , Ingole Kishor D. , Yavvari Prabhu Srinivas , Verma Priyanka , Kumari Ankit , Chauhan Chetan , Chaudhary Darshna , Srivastava Aasheesh , Bajaj Avinash , Vemanna Ramu S.
Published: January 2024

Stability and delivery are major challenges associated with exogenous double‐stranded RNA (dsRNA) application into plants. We report the encapsulation and delivery of dsRNA in cationic poly‐aspartic acid‐derived polymer (CPP6) into plant cells. CPP6 stabilizes the dsRNAs during long exposure at varied temperatures and pH, and protects against RNase A degradation. CPP6 helps dsRNA uptake through roots or foliar spray and facilitates systemic movement to induce endogenous gene silencing. The fluorescence of Arabidopsis GFP‐overexpressing transgenic plants was significantly reduced after infiltration with gfp‐dsRNA‐CPP6 by silencing of the transgene compared to plants treated only with gfp‐dsRNA. The plant endogenous genes flowering locus T (FT) and phytochrome interacting factor 4 (PIF4) were downregulated by a foliar spray of ft‐dsRNA‐CPP6 and pif4‐dsRNA‐CPP6 in Arabidopsis, with delayed flowering and enhanced biomass. The rice PDS gene targeted by pds‐dsRNA‐CPP6 through root uptake was effectively silenced and plants showed a dwarf and albino phenotype. The NaCl‐induced OsbZIP23 was targeted through root uptake of bzip23‐dsRNA‐CPP6 and showed reduced transcripts and seedling growth compared to treatment with naked dsRNA. The negative regulators of plant defence SDIR1 and SWEET14 were targeted through foliar spray to provide durable resistance against bacterial leaf blight disease caused by Xanthomonas oryzae pv. oryzae (Xoo). Overall, the study demonstrates that transient silencing of plant endogenous genes using polymer‐encapsulated dsRNA provides prolonged and durable resistance against Xoo, which could be a promising tool for crop protection and for sustaining productivity.
Importin α2 participates in RNA interference against bamboo mosaic virus accumulation in Nicotiana benthamiana via NbAGO10a‐mediated small RNA clearance
Authors: Wang Jiun‐Da , Hsu Yau‐Heiu , Lee Yun‐Shien , Lin Na‐Sheng
Published: January 2024

Karyopherins, the nucleocytoplasmic transporters, participate in multiple RNA silencing stages by transporting associated proteins into the nucleus. Importin α is a member of karyopherins and has been reported to facilitate virus infection via nuclear import of viral proteins. Unlike other RNA viruses, silencing of importin α2 (α2i) by virus‐induced gene silencing (VIGS) boosted the titre of bamboo mosaic virus (BaMV) in protoplasts, and inoculated and systemic leaves of Nicotiana benthamiana. The enhanced BaMV accumulation in importin α2i plants was linked to reduced levels of RDR6‐dependent secondary virus‐derived small‐interfering RNAs (vsiRNAs). Small RNA‐seq revealed importin α2 silencing did not affect the abundance of siRNAs derived from host mRNAs but significantly reduced the 21 and 22 nucleotide vsiRNAs in BaMV‐infected plants. Deletion of BaMV TGBp1, an RNA silencing suppressor, compromised importin α2i‐mediated BaMV enhancement. Moreover, silencing of importin α2 upregulated NbAGO10a, a proviral protein recruited by TGBp1 for BaMV vsiRNAs clearance, but hindered the nuclear import of NbAGO10a. Taken together, these results indicate that importin α2 acts as a negative regulator of BaMV invasion by controlling the expression and nucleocytoplasmic shuttling of NbAGO10a, which removes vsiRNAs via the TGBp1‐NbAGO10a‐SDN1 pathway. Our findings reveal the hidden antiviral mechanism of importin α2 in countering BaMV infection in N. benthamiana.