bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of remimazolam on oxygen reserve compared with propofol during upper gastrointestinal endoscopy: Randomized controlled study
Authors: Lee Kyuho , Jung Da Hyun , Lee Sung Jin , Yoo Young Chul , Shin Sung Kwan
Published: November 2024

Objectives

Propofol is commonly used for endoscopic sedation. However, it can induce adverse hemodynamic effects. Remimazolam is known to have a fast onset and short duration comparable to that of propofol, but with fewer effects on hemodynamics. We assessed the Oxygen Reserve Index to verify whether a sedative dose of remimazolam would better preserve oxygenation in the mild hyperoxic range than propofol in sedated patients undergoing diagnostic upper gastrointestinal endoscopy.

Methods

Patients scheduled for diagnostic upper gastrointestinal endoscopy were enrolled. Patients were randomly assigned to either the remimazolam or propofol groups and received 0.1 mg/kg remimazolam or 0.5 mg/kg propofol, respectively. Bolus injections of either 0.05 mg/kg remimazolam or 0.25 mg/kg propofol were added if required. The primary outcome was the prevalence of oxygen reserve depletion, defined as the Oxygen Reserve Index decreasing to 0.00, and hypoxia defined as peripheral oxygen saturation falling to <94%.

Results

Among 69 patients, the incidence of oxygen reserve depletion was significantly higher in the propofol group (65.7% vs. 38.2%, P = 0.022). Hypoxia was frequently observed in the propofol group, whereas none was observed in the remimazolam group (11.4% vs. 0%, P = 0.042). Additional sedative injections were frequently required to complete endoscopy in the propofol group. None of the patients in the remimazolam group required airway interventions. Nausea was frequent in the propofol group in the recovery room.

Conclusion

Our results indicate that remimazolam is a safe and useful sedative for upper gastrointestinal endoscopy.
Enacting Civic‐Minded Early Childhood Pedagogy in the Context of Chauvinistic Education Legislation
Authors: Erickson Joy Dangora , Thompson Winston C.
Published: November 2024

Amid efforts to limit “divisive concepts” in educational settings, this article investigates the obstruction of a civic‐focused early childhood curriculum. Joy Dangora Erickson and Winston Thompson analyze the challenges faced by a resourceful kindergarten teacher striving to uphold curriculum goals despite constraints imposed by the state legislature. Through an empirically informed exploration of political and pedagogical factors, this conceptual analysis elucidates the moral complexities of risks, costs, and outcomes as educators navigate non‐ideal political conditions. By doing so, the authors provide valuable insights to scholars and practitioners, suggesting productive avenues for future research on these and related dilemmas of practice.
Internal Validation of the Latvian Version of 16‐Item Prodromal Questionnaire in A Help‐Seeking Adolescent Population: Psychometric Analysis and Associated Factors
Authors: Germanenko Ilana , Vrublevska Jelena , Bezborodovs Nikita , Rancans Elmars
Published: November 2024

Objectives

The prodromal phase of a psychotic disorder is a period of altered functioning before the onset of the acute state; several interviews have been developed to determine whether individuals present with prodromal symptoms. The 16‐item Prodromal Questionnaire (PQ‐16) is a screening tool for evaluating those at risk of developing a psychotic disorder. The study aimed to evaluate the psychometric properties of the Latvian version of the PQ‐16 in a sample of help‐seeking adolescents referred for diagnostic assessment and look for possible associated socio‐demographic and health‐related factors.

Methods

A cross‐sectional study included patients admitted for evaluation between November 2022 and February 2023 in Riga's Children's Clinical University Hospital Child Psychiatry clinic. The data were collected during outpatient consultations by mental health professionals. We used the Latvian translation of PQ‐16 and the socio‐demographic and health‐related factors questionnaire. Data were analysed with IBM SPSS 28; the scale's diagnostic accuracy and internal validity were examined.

Results

The study involved 107 adolescents aged 12% to 17%, 80.5% female, with a mean age of 14.98 (CI 14.70–15.26). Socio‐demographic data and health‐related variables did not significantly differ between the sexes (p > 0.05). The Latvian PQ‐16 demonstrated excellent internal reliability with a Cronbach's alpha of 0.890. All 16 items were found to be valid with p < 0.001. A significant number of participants (73.8%) scored above the current cut‐off of ≥ 6 with a mean of 9.17 (95% CI 8.41–9.93). Certain socio‐demographic factors, such as female gender (p < 0.001), fair school performance (p = 0.048) and recent changes in school performance (p < 0.001), demonstrated a significant association with higher scores. Additionally, there were found significant associations between positive screening and health‐related factors such as obstetric complications (p = 0.044), smoking (p = 0.002), alcohol consumption (p = 0.021), history of bullying in school (p < 0.001) and emotional abuse at home (p = 0.011).

Conclusions

Latvian translation of PQ‐16 showed high internal reliability and validity levels. Positive PQ‐16 screening was associated with female gender, worsened school performance, obstetric complications, substance abuse and experienced emotional violence. The average score of 9.17 positive answers and 73.8% of participants screening positive for attenuated psychotic symptoms is significantly higher than in recent studies under similar conditions.
Acoustic Emission–Based Shear Fracture Characterization of Ultra‐High‐Performance Concrete With Varying Steel Fiber Contents
Authors: Liu Zixian , Fang Menghan , Jiao Yubo , Chen Yaojia , Yang Hua , Wu Qifan
Published: November 2024

This study investigates the shear fracture behaviors in ultra‐high‐performance concrete (UHPC) under direct shear conditions using Z‐shaped specimens and acoustic emission (AE) monitoring. The effect of steel fiber (SSF) contents (1%, 2%, 2.5%, and 3%) on the failure process and the relative slip of cracks at different loading stages were measured and evaluated. The results indicate that increasing the SSF content significantly enhances the ultimate shear stress and ductility, effectively limits crack propagation and formation, and reduces the extent of damage for UHPC. During the failure process, an increase in the SSF content results in higher cumulative AE energy and a tendency for the peak frequency to shift towards the low‐frequency range. Additionally, increasing the SSF content expands the range of wavelet entropy values and delays the occurrence of wavelet entropy. Due to the reinforcement effects of SSF, the primary crack type evolved from shear to tensile during the failure process.
Stress–Strain Response of AISI H13 Steel Subjected to Cyclic Thermomechanical Loading
Authors: Wu Boya , Liu Meichen , Xu Guocai , Li Junwan , Wu Xiaochun
Published: November 2024

This study investigates the stress–strain behavior of AISI H13 hot work die steel under thermomechanical fatigue (TMF) conditions. An electromagnetic‐thermal‐mechanical coupled finite element model was established to analyze the temperature and stress evolution during TMF cycles. Experimental results reveal that as TMF cycles increase, the hysteresis loop areas expand, and maximum tensile and compressive stress values decrease, indicating cyclic softening of AISI H13 steel. After undergoing TMF, observations show martensitic lath recovery and carbide coarsening along boundaries. Numerical results indicate thermal cycles cause temperature field inhomogeneity along the axial direction, which leads to a non‐uniform distribution of internal stresses along the longitudinal axis. Besides, the TMF lifetime under numerical simulation is comparable to that obtained through experiments. Based on experimental and simulation data, four life prediction models are employed, with the Ostergren model showing the highest consistency with a reliability factor of 1.2.
Unraveling University EFL Teachers’ Feedback Beliefs in Teaching English Argumentative Writing
Authors: Wei Xing , Zhang Lawrence Jun
Published: November 2024

Teachers’ beliefs about feedback can affect both the way they provide feedback and its effectiveness in improving students’ writing proficiency. However, research remains scant on belief–practice relationships. This study attempted to fill the gap by investigating such relationships with a sample of 112 Chinese university EFL teachers in teaching argumentative writing. Data were collected through a writing feedback beliefs and practices questionnaire, an argumentative writing teaching beliefs questionnaire, and semi‐structured interviews. The participants were selected using convenience sampling from six universities in Northern China. Quantitative data were analyzed through confirmatory factor analysis, multiple regression, and repeated measures ANOVA to examine the characteristics of these teachers’ writing feedback beliefs and the relationships between the beliefs and relevant practices. Qualitative data from the interviews were analyzed thematically to gain deeper insights into the belief–practice relationships. Results indicated that most teachers believed their feedback was crucial for improving students' argumentative writing, particularly regarding communicative purposes, discourse organization, linguistic expressions, argument construction, and rhetorical techniques. However, a discrepancy was noted between teachers' feedback beliefs and their practices, especially concerning linguistic expressions. These findings highlight the need for targeted support to better align teachers' feedback beliefs with their practices for more effective teaching of EFL writing.
Pleiotropic effects of Ebony on pigmentation and development in the Asian multi‐coloured ladybird beetle, Harmonia axyridis (Coleoptera: Coccinellidae)
Authors: Lin Jing , Xiao Da , Wu Mengmeng , Chen Xu , Xu Qingxuan , Wang Su , Zang Liansheng
Published: November 2024

Melanin plays a pivotal role in insect body pigmentation, significantly contributing to their adaptation to diverse biotic and abiotic environmental challenges. Several genes involved in insect melanin synthesis showed pleiotropic effects on insect development and reproduction. Among these, the N‐β‐alanyl dopamine synthetase gene (Ebony) is integral to the pigmentation process. However, the full spectrum of its pleiotropic impacts is not yet thoroughly understood. In this study, we identified and characterised the HaEbony gene in the Asian multi‐coloured ladybird beetle (Harmonia axyridis) and found that HaEbony gene is a conserved gene within the Coleoptera order. We aimed to further explore the multiple roles of HaEbony in the physiology and behaviour in H. axyridis. The CRISPR/Cas9 system was applied to generate multiple HaEbony knockout allele (HaEbony+/−), showing nucleotide deletion in the G0 and G1 generations. Remarkably, the resultant HaEbony+/− mutants consistently displayed darker pigmentation than their wild‐type counterparts across larval, pupal and adult stages. Furthermore, these HaEbony+/− individuals (G0) demonstrated an enhanced predatory efficiency, evidenced by a higher number of aphids consumed compared to the wild type. A significant finding was the reduced egg hatchability in both G0 and G1 generations of the HaEbony+/− group, highlighting a potential reproductive fitness cost associated with HaEbony deficiency. In conclusion, our study not only sheds light on the multifaceted roles of HaEbony in H. axyridis but also highlights the potential of employing CRISPR/Cas9‐targeted modifications of the Ebony gene. Such genetic interventions could enhance the environmental adaptability and predatory efficacy of ladybirds, presenting a novel strategy in biological control application.
Cardiac Ablation in the Pediatric Population at a Tertiary Care Center in a Developing Country
Authors: Bulbul Ziad , El Ghazawi Alaaeddine , Khazzeka Alicia , Abi‐Saleh Bernard , Tamim Hani , Khoury Maurice , Bitar Fadi , Arabi Mariam , Charafeddine Fatme , Refaat Marwan
Published: November 2024

Introduction

The aim of this study was to describe our experience and outcome of ablation therapy for arrhythmias in pediatrics at a tertiary care center.

Methods

Data was collected retrospectively from the hospital medical records. All pediatrics presenting to AUBMC between 2000 and 2020 who underwent cardiac ablation were included. The data collected included type of arrhythmia, ablation technique, age and weight at ablation, procedure complications, medications used, and outcome assessment.

Results

We had 67 patients who underwent cardiac ablation. Of those, 60% were males with a mean age of 15 years. Structural heart disease was present in 6% of patients. Wolff‐Parkinson‐White syndrome (WPW) was most prevalent at 31%, followed by atrioventricular nodal reentrant tachycardia (AVNRT) at 24%, atrioventricular reentrant tachycardia (AVRT) at 16%, ventricular tachycardia (VT) at 10%, atrial fibrillation (AF) at 3%, and atrial tachycardia (AT) at 1%. The remaining 15% of patients presented with less common types of arrhythmias, including other supraventricular tachycardias (SVTs), retrograde dual atrioventricular nodal reentry, and premature ventricular contractions (PVC). Antiarrhythmic medications were started before the procedure in 59% of our population. Medication regimens postablation included beta‐blockers (68%), type 1c antiarrhythmics (25%), calcium channel blockers (3%), ivabradine (2%), and amiodarone (2%). The completed procedures showed a success rate of 93%.

Conclusion

Ablation of arrhythmias in pediatrics is an effective procedure in the treatment of childhood arrhythmias. More studies are needed on cardiac ablation in this age group and those with structural heart disease in the Middle East region.
Current and Future Probability of Occurrence of the Floodwater Mosquito Aedes vexans (Meigen, 1830) in the Netherlands
Authors: Dellar Martha , Streng Kiki , van Bodegom Peter , Ibáñez‐Justicia Adolfo
Published: November 2024

Aedes vexans (Meigen, 1830) is a floodwater mosquito species that may cause significant nuisance and can serve as a vector for multiple arboviruses. Its distribution is expected to shift in the future as a result of changes in climate and land use. Understanding these shifts is important for estimating future disease risk. This study aims to identify habitat suitability and probability of occurrence of A. vexans. Using the Netherlands as a case study, we utilised an occurrence dataset generated by the Netherlands Centre for Monitoring of Vectors. We employed an auto machine learning approach to model generation, using a variety of modelling methodologies, determining the optimal ratio of presence: Absence datapoints in the training data and ultimately creating a 10‐model ensemble. We selected predictor variables relating to weather, land use, soil properties, flood risk and salinity. The probability of A. vexans presence was predicted on a 1 km grid for both the current Dutch situation and for four scenarios for 2050. Our analysis identified temperature, soil type and land cover as the primary determinants influencing the probability of A. vexans occurrence. Future projections reveal an increase in the likelihood of A. vexans occurrence in the study area, particularly along major river corridors and in regions with increasing amounts of artificial and natural areas. Additionally, the mosquito season is predicted to become longer under all future scenarios. Insights provided in our study can also be applied to other similar areas, such as other north‐western European countries or other urban deltas. This study shows for the first time detailed future occurrence predictions and also future seasonal predictions for this mosquito species. Seasonal predictions allow researchers to study how disease risk changes throughout the year, something which is particularly valuable given the predicted lengthening of the mosquito (and thus disease transmission) season.
Parameters to Improve the Accuracy of Intraoral Scanners for Fabricating Tooth‐Supported Restorations
Authors: Revilla‐León Marta , Kois John C.
Published: November 2024

Objectives

To review the factors that impact the accuracy of intraoral scanners (IOSs) when fabricating tooth‐supported restorations.

Overview

Factors can have a different impact on IOS accuracy depending on the scanning purpose. If the goal is to fabricate tooth‐supported restorations, it is essential to review the following operator‐related factors: IOS technology and system, scan extension and starting quadrant, scanning pattern, scanning distance, and rescanning methods. Additionally, it is critical to interpret the following patient‐related factors differently: edentulous spaces, presence of existing restorations on adjacent teeth, and characteristics of the tooth preparation (build‐up material, geometry, total occlusal convergence [TOC], finish line location, and surface finishing), and interdental spaces (between tooth preparations or between preparation and the adjacent tooth).

Conclusions

For crown or short‐span fixed dental prostheses, a reduced scan extension is recommended. For complete‐arch scans, it is advisable to start the scan in the same quadrant as the preparation. If the IOS permits locking the scan, rescanning may be indicated. Restorations on tooth preparations and adjacent teeth reduce accuracy. The simpler the geometry and the larger the TOC, the higher the IOS accuracy. Intracrevicular finish lines result in lower accuracy than equigingival or supragingival positions. Air‐particle procedures showed better accuracy than coarse and fine grit and immediate dentin sealing. The greater the space between a preparation and the adjacent tooth, the better the accuracy.

Clinical Implications

Dental professionals must understand and handle the factors that impact the scanning accuracy of intraoral scanners differently depending on the purpose of the scan.
An Intelligent Guava Grading System Based on Machine Vision
Authors: Zhang Yinping , Chuah Joon Huang , Khairuddin Anis Salwa Mohd , Chen Dongyang , Li Jingjing , Xia Chenyang
Published: November 2024

Ensuring efficient grading of guavas is crucial for timely postharvest storage and maximizing profits. Currently, the subjective nature of manual grading underscores the need for more sophisticated methodologies. However, employing machine vision for intelligent grading faces hurdles due to the diverse characteristics of guavas and the high development costs. This research targets the limitations in the guava grading process and introduces an intelligent system to overcome them. The system's structure and operational procedures were outlined, establishing diverse standards encompassing guava color, shape, size, and integrity. Image capture and preprocessing of guavas are completed. Employing the RGB model, the study performed color feature extraction and guava recognition, alongside diameter and integrity assessment through edge detection. Following a thorough analysis of various models, ResNet50 emerged as the preferred choice for guava image evaluation and depth recognition. Subsequently, an intelligent guava grading system was developed using Microsoft Visual Studio 2017. Experimental results demonstrated outstanding grading accuracy of 98.05%, with grading speed averaging 5.47 times faster than manual methods. Compared to traditional manual grading techniques, the system excelled in work efficiency, speed, reliability, and robustness.
Determination of Friction Characteristics of Corn Ears at Varying Factors in Mechanical Peeling
Authors: Li Zhenye , Fu Jun , Luo Xiwen , Fu Qiankun , Chen Zhi , Ren Luquan
Published: November 2024

In view of the low bract removal and high corn ear damage in the operation of the current peeling device, this work aimed to accurately measure the coefficients of friction (COFs) involved between peeling rollers and corn ears during the corn peeling. Consequently, the movement state of corn ear in a peeling device and the friction behavior involved were analyzed, and the mechanical model was established. Friction tests were conducted by using the modified tilting table, the modified direct shear apparatus, and the self‐built rolling friction apparatus. The value range and change rule of the COFs between corn ears and peeling rollers were obtained. Linear regression models were described for the COFs depending on moisture content. The results show that the coefficient of static friction (COSF) was 0.391–1.396, the coefficient of sliding friction (CODF) was 0.398–1.318, and the coefficient of rolling friction (CORF) was 0.119–0.377. All COFs were positively correlated with moisture content. Besides, the COFs of two rubber rollers were significantly larger than that of the steel roller. Among the two rubber rollers, the COFs were higher between the fish scale rubber roller and bare corn ears and were lower between the fish scale rubber roller and corn ears with bracts. This meant that the fish scale rubber roller was more likely to cause seed damage under the same conditions. Knowledge concerning these coefficients is believed to provide data support for the improvement and optimization of corn peeling devices.
The pivot to online teaching: an opportunity to create effective problem‐based learning environments for dietetic education
Authors: Griffin Anne
Published: November 2024

Background

Dietetics, as an autonomous profession guided by evidence‐based practice, requires a dynamic and adaptable workforce to meet evolving challenges in healthcare, public health nutrition and epidemiological research. This study aimed to explore the opportunities presented by the transition to online education of preparing dietetic students for professional demands, particularly, through the lens of problem‐based learning (PBL) within the Community of Inquiry (CoI) framework.

Methods

This paper examines the shift from traditional classroom and practice placement education to online and blended learning accelerated by the COVID‐19 pandemic. It focuses on the application of PBL, rooted in constructivist theories and the CoI framework, which includes social, cognitive and teaching presences.

Results

PBL encourages active and collaborative learning, aligning with the multifaceted roles of dietetic professionals. The CoI framework guides the development of effective online learning environments, emphasising the importance of social, cognitive and teaching presence.

Conclusion

The transition to online education presents significant opportunities for dietetic education. Careful instructional design and effective teaching strategies are crucial for creating successful online learning environments, as demonstrated through an illustrative case study.
Beneficial effects of non‐pharmacological interventions for post‐stroke pain: A meta‐analysis
Authors: Saragih Ita Daryanti , Suarilah Ira , Mulyadi Mulyadi , Saragih Ice Septriani , Lee Bih‐O
Published: November 2024

Purpose

Pain is a frequent post‐stroke health concern, and several non‐pharmacological interventions are commonly employed to manage it. However, few reviews have examined the effectiveness of such interventions, making it difficult to draw conclusions about their usefulness. Furthermore, subgroup analysis based on post‐stroke pain level or intervention characteristics is rarely performed. This study aimed to investigate the effectiveness of non‐pharmacological interventions and evaluate the significant factors associated with post‐stroke pain through subgroup analysis.

Design

Systematic review and meta‐analysis.

Methods

Relevant studies were obtained from seven databases, from their commencement up to March 2024, as well as from the gray literature. The PICOS approach was used to evaluate the eligibility criteria of the studies. The RoB‐2 tool was used to determine the risk of bias in each randomized trial. Pooled estimations of standardized mean difference and heterogeneity (quantified with I2) were obtained using a random‐effects model. The stability of the pooled result was then assessed using the leave‐one‐out approach. STATA 17.0 was used to run the meta‐analysis.

Findings

Non‐pharmacological interventions were effective in reducing pain immediately after intervention (pooled SMDs: −0.79; 95% confidence interval [CI]: −1.06 to −0.53; p < 0.001). The approach involving acupuncture, aquatic therapy, or laser therapy and rehabilitation training was effective for post‐stroke hemiplegic shoulder pain. A pooled analysis of non‐pharmacological interventions showed that both less than 4 weeks and more than 4 weeks of interventions were effective in alleviating pain in stroke patients.

Conclusion

Non‐pharmacological approaches appear to be beneficial for reducing post‐stroke pain. The outcomes based on the modalities merit further research.

Clinical relevance

Further studies are needed to determine the effects of different modalities on pain intensity following a stroke. Furthermore, to avoid overestimation of intervention efficacy, future randomized trials should consider blinding approaches to the interventions delivered.
A taste for growth: Rapeseed lecithin improves the feed intake of post‐juvenile rainbow trout (Oncorhynchus mykiss)
Authors: Kaiser Frederik , Schlachter Michael , van der Sande Anja Diekenhorst , Schulz Carsten
Published: November 2024

Feed formulations low in fish meal and fish oil can decrease feed intake and nutrient digestibility. Dietary application of lecithins could improve growth performance and nutrient digestibility; however, knowledge about specific lecithins and their effects in post‐juvenile fish is lacking. This study evaluated the effects of a commercially available rapeseed lecithin mixture on growth performance, feed intake, and nutrient digestibility of post‐juvenile rainbow trout (77.1 ± 12.1 g). A commercially based diet low in fish meal served as the control, while in the remaining three diets, fish oil was replaced with lecithin by 50%, 100% with lecithin, or 100% with a mixture of equal amounts of lecithin and rapeseed oil. Fish were fed to apparent satiation twice per day for 56 days. At the end of the trial, growth parameters, health parameters, nutrient digestibility, and filet coloration were assessed. Overall growth and feed intake were significantly elevated in all lecithin diets compared with the control group. The nutrient digestibility of all diets containing lecithin was similar to the control, and no differences in health parameters were detected. Filet coloration was significantly improved in diets of 100% fish oil replacement. Rapeseed lecithin can act as a feed attractant in fish meal and fish oil‐reduced diets.
Memory and motivation in language revitalization practice
Authors: Taylor‐Adams Allison
Published: November 2024

This article examines the relationship between collective memory and individual second‐language (L2) learning motivation as articulated in a qualitative research study with language revitalization practitioners. These practitioners learn and teach their languages and engage in other activities in order to bring Indigenous or ancestral languages into new use following a period of loss. In this study, 28 revitalization practitioners from eight language communities were interviewed about why they choose to learn their languages, what challenges they face, and what supports them in their practice. Interviews were first analyzed using inductive thematic analysis and were subsequently analyzed deductively to engage with research on the functions of autobiographical memory. Findings show how collective memories are made salient in the language revitalization experience, how individuals grapple with painful memories of what their communities and families endured as a result of colonization, and how these collective memories impact individual L2 motivation. These findings illustrate the importance of collective memory in theorizing L2 motivation in order to enhance understanding of context, dismantle overly individualistic interpretations of L2 motivation models, and open avenues for critically engaging with historical trauma and resistance.
The association of statin use with in‐hospital mortality in patients with acute kidney injury during hospitalization: A retrospective analysis
Authors: Zheng Xi‐Zi , Zhu Yi‐Dan , Tang Ling‐Er , Zhou Qing‐Qing , Xu Ling‐Yi , Xu Da‐Min , Zhao You‐Lu , Lv Ji‐Cheng , Yang Li
Published: November 2024

Aim

Acute kidney injury (AKI) is a severe condition in hospitalized patients and carries high mortality. The influence of statin use on the outcomes of AKI patients remains inconsistent. We aimed to discover the association between statin use and in‐hospital mortality.

Methods

This retrospective study screened all adult admissions in Peking University First Hospital between 1 January 2018 and 31 December 2020, and patients with AKI during hospitalization were included. Exposure was defined as any statin prescription prior to AKI onset. Patients were followed up until death or discharge. The primary outcome was in‐hospital all‐cause mortality; secondary outcomes included cardiovascular‐ and sepsis‐related mortality, elevated transaminases, rhabdomyolysis and kidney nonrecovery at discharge.

Results

A total of 2034 AKI patients were included. 551 (27%) patients were statin users. During a median of 10 days of follow‐up, we documented 283 (14%) in‐hospital deaths. Compared with statin nonusers, statin users experienced a significantly lower risk in in‐hospital all‐cause mortality (adjust hazard ratio [aHR], 0.54; 95% CI, 0.35–0.84) and cardiovascular‐related mortality (aHR, 0.48; 95% CI, 0.24–0.97) after covariate adjustment. The survival benefit of statin use was consistent across subgroups, that is, age, sex, initial AKI stage and major surgery (all P for heterogeneity >.05). For sepsis‐related mortality, elevated transaminases, rhabdomyolysis and kidney nonrecovery, the association was no longer significant in the fully adjusted model. For any type of statins, a statistically significant association was only observed in atorvastatin (aHR, 0.49; 95% CI, 0.30–0.81).

Conclusions

Statin use may improve survival, and atorvastatin may be preferred in patients with AKI.
Nurses' Advocacy in Intensive Care: What Insights Can Nurses' Experiences During the Pandemic Reveal?
Authors: Caram Carolina da Silva , Peter Elizabeth , Velloso Isabela Cancio , Rezende Lilian Cristina , Canever Bruna Pedroso , Rabelo Marcelexandra , Vargas Mara Ambrosina de Oliveira
Published: November 2024

Patient advocacy must be understood as an ethical component of nursing practice that involves respecting and defending patients' rights and autonomy. During the COVID‐19 pandemic, the vulnerability of patients in intensive care units (ICUs) increased requiring that nurses advocate for those patients more than ever in a context in which changes in daily nursing practices of care imposed by the pandemic deeply impacted nurses' advocacy. In this study, we examined ICU nurses' patient advocacy during the pandemic, using feminist ethics as a theoretical lens. Twenty‐five ICU nurses from Brazil participated in individual interviews. Our findings reflect that advocacy is a moral component of nursing identity. This moral identity represents the identity of nurses as a profession as it represents their values and responsibilities which are social in nature. Although the pandemic challenged nurses' advocacy practices these professionals had an important role to give voice to patients and to preserve their autonomy and dignity, strengthening patient‐centered care.
Effect of office‐based vergence and anti‐suppression therapy on binocular vision and accommodation in small‐to‐moderate angle intermittent exotropia: A randomised clinical trial
Authors: Ma Martin Ming‐Leung , Kang Ying , Scheiman Mitchell , Chen Qiwen , Ye Xuelian , Pan Liuqing , Deng Jiayu , Su Guangxing , Zhang Guohui , Chen Xiang
Published: November 2024

Purpose

To evaluate the short‐term (1 week after completion of treatment) effect of office‐based vergence and anti‐suppression therapy (OBVAT) on binocular vision and accommodative function when compared to observation alone in children with small‐to‐moderate angle intermittent exotropia (IXT).

Methods

In this single‐masked (examiner masked), two‐arm, single‐centre randomised clinical trial, 40 participants, 6 to <18 years of age with untreated IXT were randomly assigned to OBVAT or observation alone. Participants assigned to therapy received 16 weeks of OBVAT (60 min per visit, once per week) with home reinforcement (15 min per day, 5 days a week). Therapy included vergence, accommodation and anti‐suppression techniques. This paper reports the results of clinical measures of binocular vision and accommodation, including fusional vergence, near point of convergence, vergence facility, amplitude of accommodation, the Worth 4‐dot test and the Fusion Maintenance Score (FMS).

Results

Treatment group differences at the primary outcome visit significantly favoured the OBVAT group (n = 20) over the observation group (n = 16) in negative fusional vergence break point at both distance (p ≤ 0.001; r = 0.58) and near (adjusted mean difference: 12.3 Δ; 95% CI: 5.3–19.3 Δ; p = 0.001; partial eta squared: 0.28), positive fusional vergence break point at both distance (p = 0.009; r = 0.43) and near (adjusted mean difference: 20.6 Δ; 95% CI: 11.8–29.4 Δ; p ≤ 0.001; partial eta squared: 0.41), vergence facility (adjusted mean difference: 5.6 cpm; 95% CI: 1.9–9.4 cpm; p = 0.005; partial eta squared: 0.22) and the FMS (p = 0.007; r = 0.44).

Conclusions

In this randomised clinical trial of participants aged 6 to <18 years with IXT, those in the OBVAT group had a significantly better fusional vergence range, vergence facility, near Worth 4‐dot test result and FMS than the observation group at the 17‐week visit. The improvement in these areas further support the effectiveness of OBVAT for improving IXT.
Contraceptive Change and Fertility Transition
Authors: Kantorová Vladimíra , Bongaarts John
Published: November 2024

Over the past half‐century, most countries have made progress through their demographic transitions with continuing declines in mortality and fertility. The major driver of fertility decline has been the adoption of contraception by women of reproductive age who increasingly desire smaller families. This paper documents the massive changes in contraceptive behavior that have occurred since 1970 at the global and regional levels and examines contraceptive use differentials by marital status and method. To understand the proximate causes of the rise in contraceptive use, we document the changes in the potential demand for contraception (among women who want to space or limit their childbearing) and the degree to which this potential demand is satisfied by the actual practice of contraception. The paper concludes with a confirmation of the strong inverse relationship between contraceptive use and fertility. The main sources of data for these analyses are comprehensive datasets with country, regional, and global estimates of historical trends in fertility and contraceptive behavior maintained by the Population Division of the United Nations.
Development of Novel InDel Markers for Breeding Applications in Pomegranate (Punica granatum L.)
Authors: Patil Prakash G. , Jamma Shivani M. , N. Manjunatha , K. Dhinesh Babu , Gaikwad Nilesh , Raigond Pinky , P. Shilpa , Murkute Ashutosh A. , Bohra Abhishek , Marathe R. A.
Published: November 2024

The present study aims to enrich the genetic marker resources that are amenable for future trait mapping and quality improvement programmes in pomegranate. We analysed 140 well‐characterized genes that belonged to seven important gene families involved in the growth and development of pomegranate. We retrieved 140 representative genes for seven gene families from four draft genomes of pomegranate, cvs. Tunisia, Dabenzi, Taishanhong and Bhagawa, using BLASTn homology search. A total of 245 InDel primers were designed based on the comparison among four pomegranate genomes for the representative gene sequences, focusing on a size difference of at least 8 base pairs (bp). One hundred forty‐eight (60.41%) markers were in silico verified through e‐PCR on the Tunisia genome and further confirmed on the other three genomes, and we identified 107 polymorphic markers with an average PIC value of 0.62. By using 148 InDel markers physically mapped on the genome, we found that Tunisia had the highest syntenic relations with the Bhagawa (100%), Dabenzi (97.97%) and Taishanhong (97.30%) genomes. Experimental validation of 54 InDel primers on six pomegranate genotypes identified a set of 37 (71.15%) polymorphic markers, 24 of which had PIC values of ≥ 0.48. An investigation on genetic diversity and phenotype correlations in 16 pomegranate genotypes using 16 InDel markers demonstrated the utility of these markers. The developed InDel markers are an excellent resource for diverse applications in pomegranate including genetic diversity, trait mapping, gene discovery and gene editing.
Haploid‐Phased Chromosomal Telomere‐to‐Telomere Genome Assembly of Medicinal Plant Uncaria rhynchophylla Dissects Genetic Controls on the Biosynthesis of Bioactive Alkaloids
Authors: Hu Tao , Duan Lei , Shangguan Liyang , Zhao Qingshi , Hang Ye , Wang Xiaohong , Li Xue , Yang Ningxian , Yan Fulin , Lv Qiuyu , Tang Liu , Liu Miao , Qiang Wei , Wang Xincun , Wang Xuewen , Zhang Mingsheng
Published: November 2024

Natural indole alkaloids provide important medicinal resources and defences to environmental stresses. The Uncaria genus is a recorded traditional medicinal woody plant with high alkaloids. Genomic insights into alkaloid variation remain elusive. Here, we have dissected the haploid‐resolved chromosomal T2T genome assembly of Uncaria rhynchophylla with a size of ~634 Mb and contig N50 of 27 Mb using PacBio HiFi long‐reads plus Hi‐C reads and anchored the contigs on 22 pairs of confirmed chromosomes. This genome contains 56% repeat sequences and ~29 000 protein‐encoding genes. U. rhynchophylla diverged from a common ancestor shared with Coffea around 20 million years ago and contains expanded and contracted gene families associated with secondary metabolites and defences/resistance to stresses. We constructed the pathway and mined genes for rhynchophylline alkaloid biosynthesis. Fifty‐three alkaloids in this pathway and eight differentially expressed genes are the keys to alkaloid accumulation. Elevated alkaloid levels are driven by high copy numbers of critical genes STRs and SGRs involved in strictosidine synthesis and hydrolysis as evidenced by phylogenetic, expression and RNA interference analyses. These results advance our genetic understanding and guide further breeding improvements, stress adaptation studies and pharmaceutical development.
MsERF17 Promotes Ethylene‐Induced Anthocyanin Biosynthesis Under Drought Conditions in Malus spectabilis Leaves
Authors: Xu Yaping , Liu Yixin , Yue Lu , Zhang Shuangyu , Wei Jun , Zhang Yuqin , Huang Yuanxing , Zhao Ruiqing , Zou Wenting , Feng Hui , Li Houhua
Published: November 2024

Drought is an important factor that affects plant anthocyanin biosynthesis. However, the underlying molecular mechanisms remain elusive. Ethylene response factors (ERFs) are pivotal regulators in plant growth and environmental responses, particularly in anthocyanin biosynthesis. This study investigated the leaf colour transition from green to red in Malus spectabilis under drought conditions. This transition was primarily attributed to the accumulation of anthocyanins, specifically cyanidin‐3,5‐diglucoside and cyanidin‐3‐O‐galactoside. Our findings elucidate the pivotal role of MsERF17 in drought‐induced anthocyanin biosynthesis. Biochemical and molecular analyses showed that MsERF17 positively regulates anthocyanin synthesis by binding to promoters of MsbHLH3 and MsF3′ H, thereby activating their expression. Moreover, transient overexpression and virus‐induced gene silencing of MsERF17 in fruit peel and leaves, respectively, regulated anthocyanin synthesis. The stable transformation of calli further corroborated the positive regulatory function of MsERF17 in anthocyanin biosynthesis. Our results provide novel insights into the mechanism by which MsERF17, induced by ethylene, promotes anthocyanin accumulation through the positive regulation of MsbHLH3 and MsF3'H expression under drought conditions in M. spectabilis leaves.
Safety and Immunogenicity of an FhSAMS Vaccine Against Fasciola hepatica in Dairy Cattle
Authors: Viana Kelvinson Fernandes , Sperandio Natânia do Carmo , Neto Felipe Berbari , Donatele Dirlei Molinari , de Souza Adrieli Barboza , dos Santos Angelo Gabriel Vidal , Rivas Açucena Veleh , Barcellos Ema Carolina de Almeida , Martins Isabella Vilhena Freire
Published: November 2024

Fasciolosis is a parasitosis of great importance for livestock, as well as for public health, as it is considered by the WHO as a neglected disease. Disease control is complex and reinfections make the use of therapeutic products an unsustainable method from an economic, environmental and health point of view. The aim of this study was to evaluate a new vaccine formulation for dairy cattle, containing soluble Fasciola hepatica antigens associated with Montanide 763 AVG and saponin adjuvants (FhSAMS). The vaccine was tested with two protocols, a single dose and a booster dose 6 months after the first dose. The FhSAMS vaccine proved to be safe, with no side effects. Furthermore, it was able to generate a more robust humoral immune response when a six‐month booster dose was used, in addition to stimulating greater production of IFN‐ʏ, indicating a Th1 profile immune stimulus.
Navigating the hydrogen landscape: An analysis of hydrogen support mechanisms in the US and the EU
Authors: Penttinen Sirja‐Leena
Published: November 2024

Whilst hydrogen as a substance is not new, the recent surge in interest around hydrogen is prompting new regulatory frameworks and hydrogen strategies to support the uptake of the hydrogen economy. The potential of hydrogen to facilitate the decarbonisation of especially hard‐to‐abate sectors is immense, and various jurisdictions are actively creating regulatory frameworks for hydrogen investments, particularly in their green, clean or low‐carbon forms. This is crucial because hydrogen's environmental impact depends on its production methods. This article explores the United States (US) and the European Union (EU) approaches in implementing measures to support the uptake of hydrogen market. More specifically, it seeks to identify the main similarities and differences of the forerunner jurisdictions' adopted policies. The article focusses on the recent measures proposed or adopted by both jurisdictions, suggesting that their leading positions are becoming more aligned.
The Effects of FDI on School Enrollment in Developing Countries: New Evidence
Authors: Feldmann Horst
Published: November 2024

Using data on 118 developing countries over the period 1973 to 2019, this paper finds that FDI stocks have positive effects on school enrollment rates. The magnitude of the effects is modest. They are larger at the tertiary than at the secondary level. At both levels of education, females benefit more than males. The paper also explores the channels through which FDI might affect enrollment rates and finds that a well‐developed financial sector enhances the positive effects of FDI on schooling. In contrast to almost the entire literature, the paper uses data on stocks rather than inflows of FDI. FDI stocks are more likely to affect schooling decisions because they are much larger and less volatile than FDI inflows. Indeed, the paper finds that FDI inflows do not affect enrollment rates. Throughout, it accounts for endogeneity of FDI and controls for all major determinants of schooling.
Women's Perspectives on the Unique Benefits and Challenges of Self‐Injectable Contraception: A Four‐Country In‐Depth Interview Study in Sub‐Saharan Africa
Authors: Himes Emily , Suchman Lauren , Kamanga Martha , Birabwa Catherine , Gitome Serah , Omoluabi Elizabeth , Okumu Sarah , Nmadu Grace , Kwena Zachary , Liu Jenny , Challa Sneha , Amongin Dinah , Wekesa Pauline , Ndunyu Louisa , Bukusi Elizabeth , Malata Address , Atuyambe Lynn , Nyando Mandayachepa , Okoli Chioma , Tijani Aminat , Vallin Janelli , Jegede Ayobambo , Dimowo Shakede , Maluwa Alfred , Alitubeera Phoebe , Kaudha Betty , Kayego Agnes , Jumbe Tamandani , Mtalimanja Innocencia , Waiswa Peter , Phillips Beth , Holt Kelsey
Published: November 2024

Implementing self‐injection (SI) of subcutaneous depot‐medroxyprogesterone acetate (DMPA‐SC) is a key self‐care strategy for sexual and reproductive health, but SI uptake remains low, and assertions about the potential of SI to increase women's control over contraceptive use lack evidence. We sought to qualitatively explore how women with diverse contraceptive experiences—including those with and without experience using SI—view the benefits and challenges of SI as compared to other methods. We conducted 241 in‐depth interviews with women across four sub‐Saharan African countries and found alignment between the perceived and experienced benefits of SI across our diverse sample. Through the benefits of privacy, easier access, and self‐management, we found SI can promote greater control over the contraceptive experience by facilitating a woman's ability to act on her preferences and control who is involved in or aware of her contraceptive use. Interviews revealed SI's potential is, however, constrained by inherent limitations in the method; for example, it is often not private or accessible enough and many fear injecting themselves. SI has the most potential when implemented with programmatic solutions that mitigate challenges women experience or anticipate and allow more women to benefit from the privacy, easier access, and self‐management that SI offers.
Information frictions and learning dynamics: evidence from tax bunching in Ecuador
Authors: Bohne Albrecht , Nimczik Jan Sebastian
Published: November 2024

We examine how taxpayers learn to minimize personal income tax payments in the context of a rapidly formalizing economy with an expanding tax base. Initially, take‐up of possible generous tax deductions is low among taxpayers in Ecuador who start working in the formal sector. With increasing duration of employment, however, taxpayers become more likely to bunch at the tax exemption threshold using deductions. We exploit rich administrative data on the universe of taxpayers in Ecuador and an event study design to provide causal evidence on the learning mechanisms. We find that the spread of information is driven by the mobility of workers and tax preparers across firms.