bluuebunny/crossref_metadata_2025 huggingface dataset:
Irritability in bipolar disorder and unipolar disorder measured daily using smartphone‐based data: An exploratory post hoc study
Authors: Faurholt‐Jepsen Maria , Busk Jonas , Tønning Morten Lindberg , Bardram Jakob Eyvind , Frost Mads , Vinberg Maj , Kessing Lars Vedel
Published: April 2023

Objective

To investigate (i) the proportions of time with irritability and (ii) the association between irritability and affective symptoms and functioning, stress, and quality of life in patients with bipolar disorder (BD) and unipolar depressive disorder (UD).

Methods

A total of 316 patients with BD and 58 patients with UD provided self‐reported once‐a‐day data on irritability and other affective symptoms using smartphones for a total of 64,129 days with observations. Questionnaires on perceived stress and quality of life and clinical evaluations of functioning were collected multiple times during the study.

Results

During a depressive state, patients with UD spent a significantly higher proportion of time with presence of irritability (83.10%) as compared with patients with BD (70.27%) (p = 0.045). Irritability was associated with lower mood, activity level and sleep duration and with increased stress and anxiety level, in both patient groups (p‐values<0.008). Increased irritability was associated with impaired functioning and increased perceived stress (p‐values<0.024). In addition, in patients with UD, increased irritability was associated with decreased quality of life (p = 0.002). The results were not altered when adjusting for psychopharmacological treatments.

Conclusions

Irritability is an important part of the symptomatology in affective disorders. Clinicians could have focus on symptoms of irritability in both patients with BD and UD during their course of illness. Future studies investigating treatment effects on irritability would be interesting.
The step‐down approach in children with cow's milk allergy: Results of a randomized controlled trial
Authors: Nocerino Rita , Coppola Serena , Carucci Laura , de Giovanni di Santa Severina Anna Fiorenza , Oglio Franca , de Michele Roberta , di Sessa Ilaria , Masino Antonio , Bedogni Giorgio , Berni Canani Roberto
Published: April 2023

Background

The Step‐Down Approach for Cow's Milk Allergy (SDACMA) trial evaluated the tolerability and the rate of immune tolerance acquisition in CMA children starting dietary treatment with amino acid‐based formula (AAF) and then switching to EHCF containing the probiotic Lacticaseibacillus  rhamnosus GG (EHCF + LGG).

Methods

Randomized controlled trial involving IgE‐mediated CMA children receiving AAF from at least 4 weeks. EHCF + LGG tolerance was evaluated by the results of double‐blind placebo‐controlled food challenge (DBPCFC). Subjects tolerating EHCF + LGG were randomly allocated to remain on AAF, or to switch to EHCF + LGG. Immune tolerance acquisition to cow's milk proteins was evaluated with DBPCFC after 12 months of treatment. Allergy screening tests and body growth were also monitored.

Results

Sixty IgE‐mediated CMA children were enrolled. The proportion of children treated with AAF who resulted tolerant to the first exposure of EHCF + LGG was 0.98 (exact 95% CI 0.91–0.99). The rate of the immune tolerance acquisition to cow milk proteins after 12 months treatment was higher in the EHCF + LGG (0.48, 95% exact CI 0.29–0.67, n/N = 14/29) than in the AAF group (0.03, 95% exact CI 0.001–0.17, n/N = 1/30). There was an absolute benefit increase (ABI) of tolerance rate equal to 0.45 (95% CI 0.23–0.63, Newcombe method 10) for EHCF + LGG versus AAF, corresponding to a NNT of 2 (2–4, Bender's method). A normal body growth pattern was observed in the two study groups.

Conclusion

In IgE‐mediated CMA children the step‐down from AAF to EHCF + LGG is well tolerated and could facilitate the immune tolerance acquisition.
Management of vagus nerve stimulation therapy in the peri‐operative period
Authors: Broderick L. , Tuohy G. , Solymos O. , Lakhani S. , Staunton B. , Ennis P. , Clark N. , Moppett I. K. , Chalissery A. , Kilbride R. D. , Sweeney K. J. , O'Brien D. , O'Hare A. , Harvey A. , Larkin C. M.
Published: April 2023

Vagus nerve stimulation is a well‐established treatment option for patients with drug‐resistant epilepsy and has an expanding range of other clinical indications. Side effects of vagus nerve stimulation therapy include: cough; voice changes; vocal cord adduction; rarely, obstructive sleep apnoea; and arrhythmia. Patients with implanted vagus nerve stimulation devices may present for unrelated surgery and critical care to clinicians who are unfamiliar with their function and safe management. These guidelines have been formulated by multidisciplinary consensus based on case reports, case series and expert opinion to support clinicians in the management of patients with these devices. The aim is to provide specific guidance on the management of vagus nerve stimulation devices in the following scenarios: the peri‐operative period; peripartum period; during critical illness; and in the MRI suite. Patients should be aware of the importance of carrying their personal vagus nerve stimulation device magnet with them at all times to facilitate urgent device deactivation if necessary. We advise that it is generally safer to formally deactivate vagus nerve stimulation devices before general and spinal anaesthesia. During periods of critical illness associated with haemodynamic instability, we also advise cessation of vagus nerve stimulation and early consultation with neurology services.
False prosperity: Rethinking government support for farmers’ cooperatives in China
Authors: Chen Feifei , Xu Zhigang , Luo Yufeng
Published: April 2023

The rapid development of farmers’ cooperatives in rural China cannot be separated from government support. To ensure the growth of farmers’ cooperatives, the Chinese government uses it as a key performance indicator for its local institutions. Superficially, rural China's cooperative population and membership size witnessed rapid growth during the first decade after the Farmers’ Specialized Cooperatives Law was enacted in 2007; however, such government intervention also leads to non‐standard phenomena due to market distortion. Using nationally representative survey data from 504 cooperatives in Jiangsu, Jilin, and Sichuan provinces, this paper provides a reliable estimate of the “shell cooperative” rate around 2014. The empirical study sheds further light on the role of government during the period of rapid but chaotic growth by a subset containing 241 marketing cooperatives. Results show that direct administrative intervention leads to the emergence of many shell cooperatives (approximately 37%). Further study also confirms that task‐oriented policy support is only positively associated with the nominal coverage ratio but has no significant relationship with cooperatives’ function. This study provides new insights into the formation of shell cooperatives and suggests that direct administrative intervention may not be a good strategy for promoting the sustainable development of farmers’ cooperatives.
Internal hernia caused by exposed structures after laparoscopic lateral lymph node dissection for rectal cancer: A case report
Authors: Sakamoto Shinya , Inada Ryo , Kuroda Eri , Kumon Kento , Toshima Toshiaki , Okabayashi Takehiro
Published: April 2023

Internal hernias secondary to exposed structures after lateral lymph node dissection (LLND) for rectal cancer are rare. A 53‐year‐old man who underwent laparoscopic ultra‐low anterior resection and bilateral LND presented to our emergency department with sudden‐onset severe abdominal pain and vomiting. Computed tomography demonstrated a closed loop obstruction of the intestine in the right lateral pelvic cavity and a significantly dilated small bowel in the abdominal cavity. Laparoscopic surgery revealed small bowel migration into the space between the right ureter and umbilical artery. The herniated bowel was laparoscopically reduced, and the small bowel exhibited no ischemic changes. Meanwhile, the hernial orifice was left unrepaired. The patient was discharged on the seventh postoperative day without complications. An internal hernia caused by exposed structures after lymphadenectomy should be a differential diagnosis in patients who have undergone LLND for rectal cancer and then present with severe abdominal pain and vomiting.
Laparoscopic treatment for multiple huge diospyrobezoars in the stomach
Authors: Namikawa Tsutomu , Utsunomiya Masato , Yokota Keiichiro , Maeda Hiromichi , Kitagawa Hiroyuki , Martins Rogério Nascimento , Suganuma Narufumi , Kobayashi Michiya , Hanazaki Kazuhiro , Seo Satoru
Published: April 2023

We report a case of a patient with multiple diospyrobezoars, a phytobezoar attributed to persimmons (Diospyros kaki) consumption, in the stomach, who was treated with laparoscopic complete surgical excision. A 76‐year‐old man with gastric phytobezoars presented to our hospital. Abdominal contrast‐enhanced computed tomography revealed three well‐defined, oval, nonhomogeneous masses with a mottled appearance in the stomach. Esophagogastroduodenoscopy revealed three large brown solid phytobezoars and gastric ulcers at the gastric angle. The clinical diagnosis was diospyrobezoar, and, due to the huge masses, the patient eventually underwent laparoscopic treatment when the medical and endoscopic approaches were unsuccessful. After gastrotomy in the anterior wall of the stomach, the phytobezoar was mobile inside the stomach, which was opened beside the gastric incision. The three phytobezoars were removed through the wound protector using sponge‐holding forceps; the hole in the gastrotomy was closed in the mucosal and seromuscular layers with an intracorporeal suture technique. The weight and size of the phytobezoars were 140 g and 115 × 55 × 50 mm, 70 g and 55 × 45 × 35 mm, and 60 g and 50 × 40 × 35 mm, respectively. The patient was discharged on the 8th postoperative day without any complications. Laparoscopic surgery to extract bezoar is the treatment of choice for this rare entity, because it is a safe and effective approach.
A critical role for altered red cell cation permeability in pathogenesis of sickle cell disease and other haemolytic anaemias
Authors: Gibson John S. , Stewart Gordon W.
Published: April 2023

The aetiology of sickle cell disease is well known, but pathogenesis is complicated and details remain uncertain. A thorough understanding may suggest novel ways for designing more effective therapies. One area of importance, covered here in Nader et al., is the altered cation permeability of sickle cells and how the co‐ordinated operation of a number of membrane transport proteins contributes to disease progression, all driven by the initial event of HbS polymerisation. There are echoes here of the cation leaks of hereditary stomatocytosis. Nader et al. propose a central role for PIEZO1, a novel mechanosensitive channel found in red cells, which may be aberrantly activated in sickle cells following HbS polymerisation and which may have potential as a novel target for future chemotherapies.

Commentary on: Nader et al. Piezo1 activation augments sickling propensity and the adhesive properties of sickle red blood cells in a calcium‐dependent manner. Br J Haematol 2023;202:657–668.
Contribution of whole slide imaging‐based deep learning in the assessment of intraoperative and postoperative sections in neuropathology
Authors: Shi Liting , Shen Lin , Jian Junming , Xia Wei , Yang Ke‐Da , Tian Yifu , Huang Jianghai , Yuan Bowen , Shen Liangfang , Liu Zhengzheng , Zhang Jiayi , Zhang Rui , Wu Keqing , Jing Di , Gao Xin
Published: April 2023

The pathological diagnosis of intracranial germinoma (IG), oligodendroglioma, and low‐grade astrocytoma on intraoperative frozen section (IFS) and hematoxylin–eosin (HE)‐staining section directly determines patients' treatment options, but it is a difficult task for pathologists. We aimed to investigate whether whole‐slide imaging (WSI)‐based deep learning can contribute new precision to the diagnosis of IG, oligodendroglioma, and low‐grade astrocytoma. Two types of WSIs (500 IFSs and 832 HE‐staining sections) were collected from 379 patients at multiple medical centers. Patients at Center 1 were split into the training, testing, and internal validation sets (3:1:1), while the other centers were the external validation sets. First, we subdivided WSIs into small tiles and selected tissue tiles using a tissue tile selection model. Then a tile‐level classification model was established, and the majority voting method was used to determine the final diagnoses. Color jitter was applied to the tiles so that the deep learning (DL) models could adapt to the variations in the staining. Last, we investigated the effectiveness of model assistance. The internal validation accuracies of the IFS and HE models were 93.9% and 95.3%, respectively. The external validation accuracies of the IFS and HE models were 82.0% and 76.9%, respectively. Furthermore, the IFS and HE models can predict Ki‐67 positive cell areas with R2 of 0.81 and 0.86, respectively. With model assistance, the IFS and HE diagnosis accuracy of pathologists improved from 54.6%–69.7% and 53.5%–83.7% to 87.9%–93.9% and 86.0%–90.7%, respectively. Both the IFS model and the HE model can differentiate the three tumors, predict the expression of Ki‐67, and improve the diagnostic accuracy of pathologists. The use of our model can assist clinicians in providing patients with optimal and timely treatment options.
Design, synthesis, and molecular docking studies of novel quinoxaline derivatives as anticancer agents
Authors: Ali Sazan Haji , Osmaniye Derya , Sağlık Begüm Nurpelin , Levent Serkan , Özkay Yusuf , Kaplancıklı Zafer Asım
Published: April 2023

As lung cancer was placed foremost part among other types of cancer in terms of mortality. Recent researches are widely focused on developing multi‐targeted and site‐specific targeted drug designs. In the present study, we designed and developed a series of quinoxaline pharmacophore derivatives as active EGFR inhibitors for the treatment of non‐small cell lung cancer. The compounds were synthesized through a condensation reaction between hexane‐3,4‐dione and methyl 3,4‐diaminobenzoate as a first step. Their structures were confirmed by 1H‐NMR, 13C‐NMR, and HRMS spectroscopic methods. Cytotoxicity (MTT) were applied to determine anticancer activity of the compounds against breast (MCF7), fibroblast (NIH3 T3), and lung (A549) cell lines as EGFR inhibitors. Doxorubicin was used as a reference agent, compound 4i exhibited a significant effect among other derivatives with IC50 = 3.902 ± 0.098 μM value against A549 cell line. The docking study showed that the best position on EGFR receptor could be observed with 4i. From the obtained evaluations of the designed series, compound 4i was a promising agent as EGFR inhibitor for further investigation and evaluation studies in the future.
Unaccompanied migrant children and indebted relations: Weaponizing safeguarding
Authors: Leon Lucy , Rosen Rachel
Published: April 2023

UK statutory guidance for practitioners suggests that indebtedness is an area where safeguarding red flags should be raised and action taken to minimize the risk of exploitation. Yet, our research shows that unaccompanied migrant children have complex indebted relationships, which can range from extractive to connective. Drawing on interviews with unaccompanied children, we show that these indebted relationships can include financial debt to smugglers, responsibilities to support transnational families, as well as social obligations to peers and others. Their accounts present a nuanced understanding of the taboo nature of indebted relationships, not to be shared with the practitioners in their lives. This is due, in part, to the potential threat of reporting to the Home Office, which might jeopardize their immigration status. In response to this weaponization of social care, we demonstrate how children turn to peer networks of support, creating their own alternative forms of social protection. In so doing, we complicate critiques of adultification, which traditionally highlight the ways that racially minoritized children may be treated as adults—to their detriment. In so doing, we show that because indebtedness is normatively linked to adulthood, unaccompanied children's hopes and fears may be rendered unsayable and therefore unsupportable in social care, all in the name of safeguarding.
Area‐deprivation, social care spending and the rates of children in care proceedings in local authorities in England
Authors: Doebler Stefanie , Broadhurst Karen , Alrouh Bachar , Cusworth Linda
Published: April 2023

This paper examined relationships between area‐level deprivation, local authorities' social care expenditure and the rates of children entering care proceedings in England using a novel data linkage of de‐identified records provided by the Children and Family Court Advisory Service (Cafcass). Using structural equation modelling, the authors found strong positive relationships between socioeconomic area deprivation and high rates of children undergoing care proceedings in England between 2015 and 2019. Preventative social care expenditure is associated with lower child rates when adjusting for deprivation. Our findings suggest that deprived and underfunded local authorities respond to an increased need by prioritizing care arrangements.
Perceptual learning of random acoustic patterns: Impact of temporal regularity and attention
Authors: Ringer Hanna , Schröger Erich , Grimm Sabine
Published: April 2023

Perceptual learning is a powerful mechanism to enhance perceptual abilities and to form robust memory representations of previously unfamiliar sounds. Memory formation through repeated exposure takes place even for random and complex acoustic patterns devoid of semantic content. The current study sought to scrutinise how perceptual learning of random acoustic patterns is shaped by two potential modulators: temporal regularity of pattern repetition and listeners' attention. To this end, we adapted an established implicit learning paradigm and presented short acoustic sequences that could contain embedded repetitions of a certain sound segment (i.e., pattern) or not. During each experimental block, one repeating pattern recurred across multiple trials, whereas the other patterns were presented in only one trial. During the presentation of sound sequences that contained either temporally regular or jittered within‐trial pattern repetitions, participants' attention was directed either towards or away from the auditory stimulation. Overall, we found a memory‐related modulation of the event‐related potential (ERP) and an increase in inter‐trial phase coherence for patterns that recurred across multiple trials (compared to non‐recurring patterns), accompanied by a performance increase in a (within‐trial) repetition detection task when listeners attended the sounds. Remarkably, we show a memory‐related ERP effect even for the first pattern occurrence per sequence when participants attended the sounds, but not when they were engaged in a visual distractor task. These findings suggest that learning of unfamiliar sound patterns is robust against temporal irregularity and inattention, but attention facilitates access to established memory representations upon first occurrence within a sequence.
Egalitarian sympathies? Adam Smith and Sophie de Grouchy on inequality and social order
Authors: Douglass Robin
Published: April 2023

This article analyses Adam Smith's and Sophie de Grouchy's accounts of sympathy to show how they arrive at strikingly different views on whether inequality is a threat to, or precondition of, social order. Where many scholars have recently sought to recover Smith's egalitarianism, I instead focus on how his account of sympathy in The Theory of Moral Sentiments naturalises socioeconomic inequalities, while also highlighting the wider inegalitarian implications of his analysis. I demonstrate that Grouchy was alert to these implications and reveal how her own account of sympathy challenges the moral psychology underlying Smith's position on inequality. By reconstructing Grouchy's response to Smith, I illustrate how retrieving the insights of long‐overlooked thinkers can reorient the way we understand key debates in the history of philosophy, since Grouchy was far more concerned than Smith with exposing how economic inequality imperils the prospects of relating to one another as equals.
Ezogabine impacts seizures and development in patients with KCNQ2 developmental and epileptic encephalopathy
Authors: Knight Devon , Mahida Sonal , Kelly Mckenna , Poduri Annapurna , Olson Heather E.
Published: April 2023

Genetic variants in KCNQ2 are associated with a range of epilepsies, from self‐ limited (familial) neonatal‐infantile epilepsy to developmental and epileptic encephalopathy (DEE). We retrospectively reviewed clinical data from eight patients with KCNQ2‐related DEE who were treated with ezogabine. Treatment was initiated at a median age of 8 months (range, 7 weeks to 2.5 years) and continued for a median of 2.6 years (range, 7 months to 4.5 years). Five individuals had daily seizures at baseline and experienced at least 50% seizure reduction with treatment, sustained in four. One individual with two to four yearly seizures improved to rare events. Two individuals were seizure‐free; treatment targeted cognition and development. Developmental improvements were reported in all eight patients. Weaning of ezogabine was associated with increased seizure frequency (N = 4), agitation and irritability (N = 2), poor sleep (N = 1), and developmental regression (N = 2). These data suggest that treatment with ezogabine is effective at reducing seizure burden and is associated with improved development. Minimal side effects were observed. Weaning was associated with increased seizures and behavioral disturbances in a subset. An approach targeting potassium channel dysfunction with ezogabine is warranted in patients with KCNQ2‐related DEE.
Progressive search personalization and privacy protection using federated learning
Authors: Sarkar Sagnik , Agrawal Shaashwat , Chowdhuri Aditi , Ramani S.
Published: April 2023

Personalized search comes under recommendation systems which provide more user‐focused query results. Applications such as movie recommendations, document recommendations, and so forth are using machine learning algorithms to suggest user‐tailored content. These algorithms train on historical user query data and predict documents based on user preferences. The existing methodologies on personalization have shown two main limitations: privacy concerns over the usage of personal data and a lack of efficient personalizing strategies for better accuracy and overall standardization. In this paper, we propose a novel federated learning (FL) algorithm for personalized search results using temporal characteristics of the user query data. Individual user query data is used for developing specific client models while the aggregate of such models is developed for general search suggestions. The introduction of time‐series interpretation of queries provides for larger training data as well as a better understanding of a user's current needs and intent. The proposed algorithm is validated using the AOL4PS dataset and is evaluated on the efficiency of personalization, and the amount of data and time required to achieve the results. Its performance is compared with existing state‐of‐the‐art personalization algorithms that utilize deep learning and FL. Mean reciprocal rank (MRR) is the primary metric for measuring the algorithm's performance. After training for 35 federated rounds, the server model yielded an MRR score of 0.8638 while the client models were able to yield an average MRR score of 0.9308.
Criterion validity of the health assessment questionnaire for the national screening program for older adults in Japan: The SONIC study
Authors: Hori Noriko , Ishizaki Tatsuro , Masui Yukie , Yoshida Yuko , Inagaki Hiroki , Ito Kae , Ishioka Yoshiko L. , Nakagawa Takeshi , Ogawa Madoka , Kabayama Mai , Kamide Kei , Ikebe Kazunori , Arai Yasumichi , Gondo Yasuyuki
Published: April 2023

Aim

In our previous study, we proposed that the total score of the 12 frailty‐related items in the health assessment questionnaire for the national screening program for older adults could be used as an indicator of frailty. We aim to examine the criterion validity of the 12 frailty‐related items for frailty.

Methods

The data used in this study were from older Japanese individuals aged 78–81 years (n = 461) who participated in the in‐venue (2019) and mailed questionnaire (2020) surveys of the Septuagenarians, Octogenarians, Nonagenarians Investigation with Centenarians study. A receiver operator characteristic (ROC) curve analysis was used to evaluate the criterion validity of the 12 frailty‐related items for frailty defined based on the Japanese version of the Cardiovascular Health Study criteria. A multivariable logistic regression model was used to examine the independent association of the 12 frailty‐related items with frailty.

Results

The area under the ROC curve of the scores of the 12 frailty‐related items for frailty was 0.79 (95% confidence interval [CI] = 0.73–0.85, P < 0.001). The cut‐off value for frailty was 3 and 4 points, and the sensitivity and specificity were 55.9% and 85.8%, respectively. The multivariable logistic regression model showed that four or more scores of the 12 frailty‐related items were significantly associated with frailty (adjusted odds ratio = 7.75, 95% CI = 4.10–14.65, P < 0.001).

Conclusions

The results of this study suggest that the 12 frailty‐related items in the health assessment questionnaire for older adults may be useful for assessing frailty in community‐dwelling older adults in a simplified manner. Geriatr Gerontol Int 2023; 23: 437–443.
When interruptions can boost sales: An on‐line versus memory‐based perspective
Authors: Xu Lina , Niculescu Mihai , Hyman Michael
Published: April 2023

Consumer research about interruptions either assumes interruption homogeneity or single‐product evaluations. To remedy these problematic assumptions, this research explores the interplay between different interruption features (i.e., timing, frequency, and duration) and information processing modes (i.e., on‐line versus memory‐based) through the lens of impression formation theory. Two experiments show overall evaluations and purchase intentions for single products are highly sensitive to interruption features. For bundled products, this sensitivity disappears, and overall evaluations and purchase intentions remain stable regardless of the interruption's features. These results explain why unexpected marketing outcomes associated with frequent later and short interruptions or one early interruption during a decision process always induce better single‐product evaluations. These results also suggest several salesperson‐customer interaction strategies for practitioners.
Micronutrient retention in high oleic palm oil: effect of refining technique
Authors: Widigdo Iman , Sukarno Wahyu , Christianti Isti , Wassell Paul
Published: April 2023

Retention of micronutrients in high oleic palm oil (HOPO) was evaluated by comparing two methods; standard refining (260 °C) and modified refining (160, 180, 200 °C). Tocopherol analysis showed that α‐tocopherol loss during standard refining was relatively low for both refined bleached and deodorised (RBD) PO control (10%) and RBDHOPO (2%). On the contrary, the carotene loss for both RBDPO control and RBDHOPO in standard refining methods was 99% (1.9 and 5.9 ppm, detected). Modified refining temperatures, can maintain up to 99% more carotenes than standard refining. Applying modified refining to RBDHOPO retains ~78%–83% more carotene than regular RBDPO. This examination shows, suitably processed RBDHOPO has the capability for producing a red palm oil (RPO), enriched with carotenoid for provitamin A function.
RETRACTED: The effect of the use of postoperative antibiotic prophylaxis compared with non‐use for stented distal hypospadias repair wound: A meta‐analysis
Authors: Tang Ruipeng , Wan Li , Yi Zhengjin , Luo Yun , Wei Xupan , Wang Shubin , Xiao Chuan
Published: April 2023

A meta‐analysis investigation to measure the influence of the usage of postoperative antibiotic prophylaxis (POP) compared with non‐usage for stented distal hypospadias repair (SDHR). A comprehensive literature inspection till February 2023 was applied and 1067 interrelated investigations were reviewed. The 10 chosen investigations enclosed 1398 individuals with SDHR in the chosen investigations starting point, 812 of them were using POP, and 586 were not using POP. Odds ratio (OR) in addition to 95% confidence intervals (CIs) were used to compute the value of the effect of the usage of POP compared with non‐usage for SDHR by the dichotomous and continuous approaches and a fixed or random model. No significant difference was found between individuals using POP and not using POP in posthypospadias repair problem (PRP) (OR, 0.99; 95% CI, 0.42–2.34, P = .97) with moderate heterogeneity (I2 = 69%), posthypospadias repair infection problem (PRIP) (OR, 0.56; 95% CI, 0.30–1.06, P = .08) with no heterogeneity (I2 = 15%), and overall composite posthypospadias repair wound healing associated problem (OCPRWHAP) (OR, 1.27; 95% CI, 0.61–2.63, P = .53) with moderate heterogeneity (I2 = 59%) for SDHR. No significant difference was found between individuals using POP and not using POP in PRP, PRIP, and OCPRWHAP for SDHR. However, cautilised of the small sample sizes of several chosen investigations for this meta‐analysis, care must be exercised when dealing with its values, for example, the low P‐value of the PRIP.
Proximal femoral nail anti‐rotation vs dynamic hip screws decrease the incidence of surgical site infections in patients with intertrochanteric fractures: A meta‐analysis
Authors: Dai Peijun , Zhou Huipeng , Mao Xiaoyu , Liu Chang , Wang Zhiwei , Kang Yifan
Published: April 2023

In this study, a meta‐analysis was conducted to comprehensively analyse the effectiveness of using proximal femoral nail anti‐rotation (PFNA) and dynamic hip screws (DHS) to treat intertrochanteric fractures on postoperative surgical site infections (SSI). PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure (CNKI), and Wanfang databases were searched from their inception until December 2022 to identify studies that compared PFNA and DHS in the treatment of intertrochanteric fractures. Two investigators independently screened the retrieved studies to assess their quality and verify their eligibility for inclusion. Meta‐analyses were performed with RevMan 5.4 software. Thirty studies, including 3158 patients, met the inclusion criteria. These studies included 1574 patients treated with PFNA, and 1584 were treated with DHS. The findings of the meta‐analysis revealed a significant reduction in the incidence of SSI in patients treated with PFNA compared with those treated with DHS (2.64% vs 6.76%, odds ratio [OR]: 0.40, 95% confidence intervals [CIs]: 0.28–0.57, P < .001), superficial SSI (2.58% vs 5.01%, OR: 0.53, 95% CIs: 0.33–0.85, P = .008) and deep SSI (1.26% vs 3.43%, OR: 0.41, 95% CIs: 0.19–0.92, P = .03). PFNA was more effective than DHS in reducing the incidence of SSI. Even so, significant variations in sample sizes among the included studies meant that the methodology for some studies had qualitative deficiencies. Therefore, additional studies with large sample sizes are needed to validate these results.
Three bond modes of basic refractories used for Ruhrstahl Heraeus degassing process
Authors: Guo Zongqi , Dai Yajie , Chen Jiahui , Lei Zhongxing , Gao Jianying , Yuan Wenjie
Published: April 2023

Magnesia–spinel brick and unburnt periclase–spinel–Al brick are being employed as a substitution of traditional magnesia–chrome brick in the chromium‐free campaign of lining materials in Ruhrstahl Heraeus (RH) degasser. These three materials are investigated, in terms of physical properties, corrosion resistance and flexibility by wedge splitting test. Tracking their physical alterations and chemical reactions through burning or heating, three bond modes are discovered. Magnesia–chrome brick is subject to a series of phase transformation with rising temperature to yield a liquid envelop around chromite‐ore particles, to further form porous rim while liquid is gradually absorbed by surrounding magnesia and eventually to precipitate secondary chromite spinel lied between magnesia particles by thoroughly dissociating chrome ore. The precipitated chromite spinel functions as the featured bond that enhances hot strength and corrosion resistance to slag, and additionally liquid coexistence improves the flexibility. The direct bond mode of magnesia particles in magnesia–spinel brick endures slag penetration by immanent character of MgO. Spinel incorporation in magnesia effectively improves thermal shock resistance. Due to minor negative value of permanent linear change after reheating, further sintering (densifying) in using at high temperature would bring a risk of loosening and open joints of magnesia–spinel lining. While used in RH degasser, unburnt periclase–spinel–Al bricks undergo a miraculous process of metallic Al melting, gaseous AlN and AlON formation, MgAlON whiskers germination combined with gaseous Mg reduced, and micron‐size whisker network bond domination in their matrix. Such a whisker‐network bond renders the material a successful eco‐friendly alternative to magnesia–chrome refractory.
Simulation of flash flood peaks in a small and steep catchment using rain‐on‐grid technique
Authors: Godara Nitesh , Bruland Oddbjørn , Alfredsen Knut
Published: April 2023

The frequency of extreme events is increasing as the consequences of climate change. In steep terrains, flash floods with high‐flow velocities induce erosion and sedimentation with potentially disastrous changes of flood path. Hence, the analysis of flash floods in steep terrains in terms of inundation area and flow‐velocity to identify critical points becomes more important. The output of a flood simulation with a traditional hydrologic model provides the flood hydrograph which must be combined with a hydraulic model for downstream consequences. In small and steep catchments, the inflow contribution from every section of the water course can be important to determine where critical conditions may arise. In this study, rain‐on‐grid technique in the hydraulic model Telemac‐2D is used to simulate flash‐flood peaks with spatially distributed precipitation as input in a small and steep catchment in western Norway. Seven events were simulated and sensitivity tests on parameters were conducted. A 200‐year design flood was simulated to show the potential consequences in the catchment. The results show that calibrated models can satisfactorily reproduce peak flows and produce relevant information about water velocities and inundation which decision makers can use for mitigation measures. The paper explores the benefits and limitations through a description of model construction, calibration, and test of sensitivities.
Figuring out how to participate in the system: Using reflexive feminist autoethnography to explore intersectional experiences in the professional and political spheres of academia
Authors: Mitchell Sarah
Published: April 2023

The practice of critically reflexive feminist autoethnography—or connecting one's personal experiences and beliefs to professional and political processes—can be a challenging and often invisible process. Nonetheless, it is a method worthy of engagement, given the impact one's positionality often has on one's scholarship. In this article, I reflect on how I understand myself as an intersectional Black, bisexual woman. Furthermore, I discuss the ways in which the personal relates to my professional and political academic life. In making broader connections to larger societal forces, I discuss how I came to study diverse individuals and families with intersecting identities and outline my struggles with my own academic growth and scholastic improvement. I also unpack the uncertainties I have faced in attempting to find my place in academia. Finally, for other intersectional scholars, I offer some suggestions for self‐reflection on research and practice within the academy.
Optimal concentration of Lugol's solution for detecting early esophageal carcinoma: A randomized controlled trial
Authors: Qu Jun‐yan , Li Yan , Liu Guan‐qun , Li Zhen , Zhong Ning , Zhang Ming‐ming , Li Yue‐yue , Yu Tao , Lu Xue‐feng , Li Li‐xiang , Liu Han , Qi Qing‐qing , Li Yan‐qing , Zuo Xiu‐li
Published: April 2023

Background and Aim

Lugol chromoendoscopy is the standard technique to detect an esophageal squamous cell carcinoma (ESCC). However, a high concentration of Lugol's solution can induce mucosal injury and adverse events. We aimed to investigate the optimal concentration of Lugol's solution to reduce mucosal injury and adverse events without degrading image quality.

Methods

This was a two‐phase double‐blind randomized controlled trial. In phase I, 200 eligible patients underwent esophagogastroduodenoscopy and then were randomly (1:1:1:1:1) sprayed with 1.2%, 1.0%, 0.8%, 0.6%, or 0.4% Lugol's solution. Image quality, gastric mucosal injury, adverse events, and operation satisfaction were compared to investigate the minimal effective concentration. In phase II, 42 cases of endoscopic mucosectomy for early ESCC were included. The patients were randomly assigned (1:1) to the minimal effective (0.6%) or conventional (1.2%) concentration of Lugol's solution for further comparison of the effectiveness.

Results

In phase I, the gastric mucosal injury was significantly reduced in 0.6% group (P < 0.05). Furthermore, there was no statistical significance in image quality between 0.6% and higher concentrations of Lugol's solution (P > 0.05, respectively). It also showed that the operation satisfaction decreased in 1.2% group compared with the lower concentration groups (P < 0.05). In phase II, the complete resection rate was 100% in both groups, while 0.6% Lugol's solution showed higher operation satisfaction (W = 554.500, P = 0.005).

Conclusions

The study indicates that 0.6% might be the optimal concentration of Lugol's solution for early detection and delineation of ESCC, considering minimal mucosal injury and satisfied image. The registry of clinical trials: ClinicalTrials.gov (NCT03180944).
Epidemiology, characteristics, and outcomes of patients with acute‐on‐chronic liver failure in Australia
Authors: Chetwood John David , Sabih Abdul‐Hamid , Chan Karen , Salimi Shirin , Sheiban Alexander , Lin Elton , Chin Simone , Gu Bonita , Sastry Vinay , Coulshed Andrew , Tsoutsman Tatiana , Bowen David G. , Majumdar Avik , Strasser Simone I. , McCaughan Geoffrey W. , Liu Ken
Published: April 2023

Background and Aim

Acute‐on‐chronic liver failure (ACLF) is distinct from acute decompensation (AD) of cirrhosis in its clinical presentation, pathophysiology, and prognosis. There are limited published Australian ACLF data.

Methods

We performed a single‐center retrospective cohort study of all adults with cirrhosis admitted with a decompensating event to a liver transplantation (LT) centre between 2015 and 2020. ACLF was defined using the European Association for the Study of the Liver‐Chronic Liver Failure (EASL‐CLIF) definition while those who did not meet the definition were classified as AD. The primary outcome of interest was 90‐day LT‐free survival.

Results

A total of 615 patients had 1039 admissions for a decompensating event. On their index admission, 34% (209/615) of patients were classified as ACLF. Median admission model for end‐stage liver disease (MELD) and MELD‐Na scores were higher in ACLF patients compared with AD (21 vs 17 and 25 vs 20 respectively, both P < 0.001). Both the presence and severity of ACLF (grade ≥ 2) significantly predicted worse LT‐free survival compared with patients with AD. The EASL‐CLIF ACLF score (CLIF‐C ACLF), MELD and MELD‐Na scores performed similarly in predicting 90‐day mortality. Patients with index ACLF had a higher risk of 28‐day mortality (28.1% vs 5.1%, P < 0.001) and shorter times to readmission compared with those with AD.

Conclusion

ACLF complicates over a third of hospital admissions for cirrhosis with decompensating events and is associated with a high short‐term mortality. The presence and grade of ACLF predicts 90‐day mortality and should be identified as those at greatest risk of poor outcome without intervention such as LT.
Modeling of Nonlinear Growth to Improve the Accuracy of Identification Decision Rules
Authors: Finch W. Holmes , Finch Maria E. Hernández , Avery Brooke
Published: April 2023

Progress monitoring using curriculum‐based measures administered to a student at multiple points in time is common in educational settings. Recent research has demonstrated that common approaches to identifying individuals in need of special services, such as the trend line or median techniques, can be negatively impacted by the nonlinear change in scores over time. The purpose of this study was to test and demonstrate a nonlinear regression model for adjusting the linear trend line for the presence of such nonlinearities, thereby improving the accuracy of common methods for identifying students in need of special services. Results demonstrated that use of this nonlinear model improved the accuracy of common methods for identifying students in need of special services.
Treatment of pulmonary mucormycosis with adjunctive nebulized amphotericin B (MUCONAB trial): Results of an open‐label randomized controlled trial
Authors: Muthu Valliappan , Gogineni Ratnakara Rao , Agarwal Ritesh , Prasad Kuruswamy Thurai , Sehgal Inderpaul Singh , Dhooria Sahajal , Aggarwal Ashutosh N. , Rudramurthy Shivaprakash Mandya , Singh Harkant , Garg Mandeep , Chakrabarti Arunaloke
Published: April 2023

Background

The role of nebulized amphotericin B (NAB) in managing pulmonary mucormycosis (PM) is unknown.

Methods

In this open‐label trial, we randomized PM subjects to receive either intravenous liposomal amphotericin B (control arm, 3–5 mg/kg/day) alone or along with nebulized amphotericin B deoxycholate (NAB, 10 mg twice a day, every alternate day). The primary outcomes were: (1) overall response (‘success’ [complete or partial response] or ‘failure’ [stable disease, progressive disease, or death]) at 6 weeks; and (2) the proportion of subjects with adverse events (AE). The key secondary outcome was 90‐day mortality. We performed a modified intention‐to‐treat (mITT) analysis where we included only subjects receiving at least a single dose of NAB.

Results

Fifteen and 17 subjects were randomized to the control and NAB arms; two died before the first dose of NAB. Finally, we included 30 subjects (15 in each arm; mean age 49.8 years; 80% men) for the mITT analysis. Diabetes mellitus (n = 27; 16/27 were COVID‐19‐associated PM) was the most common predisposing factor. The overall treatment success was not significantly different between the control and the NAB arms (71.4% vs. 53.3%; p = .45). Twenty‐nine subjects experienced any AE, but none discontinued treatment. The 90‐day mortality was not significantly different between the control (28.6%) and NAB arm (53.3%; p = .26).

Conclusion

Adjunctive NAB was safe but did not improve overall response at 6 weeks. A different dosing schedule or nebulized liposomal amphotericin B may still need evaluation. More research is needed to explore other treatment options for PM.
Rising vapor‐pressure deficit increases nitrogen fixation in a legume crop
Authors: Monnens Daniel , Denison R. Ford , Sadok Walid
Published: April 2023

Atmospheric vapor‐pressure deficit (VPD) is increasing in many regions and has a large impact on plant productivity. A VPD increase leads to raising transpiration rate (TR) and soil‐water demand, risking productivity penalties. Like water, nitrogen is critical to productivity, but the effect of VPD on legume nitrogen fixation is undocumented.

To address this, we developed a portable system for quantifying nitrogen fixation noninvasively and at a high temporal resolution by tracking the rate of hydrogen gas evolution by root nodules. Combining field and controlled‐environment experiments where we measured leaf gas exchange and H2 production by nodules, we confirmed the ability of the system to track nitrogen fixation dynamics.

Raising VPD from 0.5 to 3 kPa within c. 2.5 h under well‐watered conditions increased nitrogen fixation by up to 25% in addition to TR, consistent with the hypothesis that raising VPD in that range might have alleviated nitrogenase feedback inhibition. Genotypic differences were found in this response, indicating a potential for breeding.

Our study provides evidence for an important environmental effect on nitrogen fixation that is not taken into account in current crop and vegetation models, pointing to untapped avenues for better understanding climate change effects on legumes and nitrogen cycling.
Reduction of left ventricular global longitudinal strain in patients with permanent pacemakers as a predictor of heart failure and mortality outcomes
Authors: Manocha Kevin , Kandola Manjinder S. , Kalil Ramsey , Sciria Christopher , Bassil Guillaume , Patel Nishi , Lerman Bruce B. , Kim Jiwon , Abdelrahman Mohamed , Cheung Jim W.
Published: April 2023

Introduction

Frequent right ventricular (RV) pacing is associated with cardiomyopathy. The impact of RV pacing on left ventricular (LV) global longitudinal strain (GLS) and clinical outcomes is unclear.

Methods

We analyzed GLS via two‐dimensional speckle tracking and LV ejection fraction (EF) on pre‐ and post‐implantation transthoracic echocardiograms of patients undergoing dual chamber pacemaker implantation. We collected long‐term data on strain, LVEF, and clinical outcomes.

Results

One hundred and ten patients (mean age 76 ± 12 years; 59 [54%] female) were followed for mean 23 ± 17 months. Mean baseline LVEF was 58 ± 11% and mean GLS was −17 ± 4%. Twenty‐four (22%) patients had an absolute decrease in LVEF > 10% and 43 (39%) patients had a relative reduction of GLS > 15%. Among patients with a reduction of GLS, a larger proportion of patients had RV pacing burden ≥20% (67% vs. 46%; p = .048). Compared to patients without GLS reduction, more patients with a reduction in GLS reached a composite endpoint of HF hospitalization, CRT upgrade or death (47% vs. 16%; p = .001).

Conclusion

Reduction in LV GLS was seen in nearly four in 10 patients undergoing pacemaker implantation and was significantly associated with increased RV pacing burden. LV GLS reduction was associated with increased risk of adverse outcomes. LV GLS may have utility in predicting outcomes among patients with RV pacing.
Pandemic Roller‐Coaster? Birth Trends in Higher‐Income Countries During the COVID‐19 Pandemic
Authors: Sobotka Tomáš , Zeman Kryštof , Jasilioniene Aiva , Winkler‐Dworak Maria , Brzozowska Zuzanna , Alustiza‐Galarza Ainhoa , Németh László , Jdanov Dmitri
Published: April 2023

We use monthly birth data collected by the Human Fertility Database to analyze the impact of the COVID‐19 pandemic on birth trends until September 2022 in 38 higher‐income countries. We also present estimates of the monthly total fertility rate adjusted for seasonality. Our analysis reveals that the pandemic led to distinct swings in births and fertility rates. The initial pandemic shock was associated with a fall in births in most countries, with the sharpest drop in January 2021. Next, birth rates showed a short‐term recovery in March 2021, following the conceptions after the end of the first wave of the pandemic. Most countries reported a stable or slightly increasing number of births in the subsequent months, especially in autumn 2021. Yet another, quite unexpected, downturn in births started in January 2022, linked with the conceptions in spring 2021 when the pandemic measures were mostly eased out and vaccination was gaining momentum. Taken together and contrary to some initial expectations, the coronavirus pandemic did not bring a lasting “baby bust” in most of the analyzed countries. Especially the Nordic countries, the Netherlands, Germany, and the United States experienced an improvement in their birth dynamics in 2021 compared with the prepandemic period.