bluuebunny/crossref_metadata_2025 huggingface dataset:
Global, regional, and national burden of inguinal, femoral, and abdominal hernias: a systematic analysis of prevalence, incidence, deaths, and DALYs with projections to 2030
Authors: Wang Fan , Ma Bangzhen , Ma Qiuyue , Liu Xiaoli
Published: January 2024

Background:

Hernias, particularly inguinal, femoral, and abdominal, present a global health challenge. While the global burden of disease (GBD) study offers insights, systematic analyses of hernias remain limited. This research utilizes the GBD dataset to explore hernia implications, combining current statistics with 2030 projections and frontier analysis.

Methods:

We analyzed data from the 2019 GBD Study, focusing on hernia-related metrics: prevalence, incidence, deaths, and disability-adjusted life years (DALYs) across 204 countries and territories, grouped into 21 GBD regions by the socio-demographic index (SDI). Data analysis encompassed relative change calculations, as well as annual percentage change (APC) and average annual percentage change (AAPC), both of which are based on joinpoint regression analysis. The study additionally employed frontier analysis and utilized the Bayesian age-period-cohort model for predicting trends up to 2030. Analyses utilized R version 4.2.3.

Results:

From 1990 to 2019, the global prevalence of hernia cases surged by 36%, reaching over 32.5 million, even as age-standardized rates declined. A similar pattern was seen in mortality and DALYs, with absolute figures rising but age-standardized rates decreasing. Gender data between 1990 and 2019 showed consistent male dominance in hernia prevalence, even as rates for both genders fell. Regionally, Andean Latin America had the highest prevalence, with Central Sub-Saharan Africa and South Asia noting significant increases and decreases, respectively. Frontier analyses across 204 countries and territories linked higher SDIs with reduced hernia prevalence. Yet, some high SDI countries, like Japan and Lithuania, deviated unexpectedly. Predictions up to 2030 anticipate increasing hernia prevalence, predominantly in males, while age-standardized death rates and age-standardized DALY rates are expected to decline.

Conclusions:

Our analysis reveals a complex interplay between socio-demographic factors and hernia trends, emphasizing the need for targeted healthcare interventions. Despite advancements, vigilance and continuous research are essential for optimal hernia management globally.
Polymerized Human Hemoglobin–Based Oxygen Carrier Preserves Lung Allograft Function During Normothermic Ex Vivo Lung Perfusion
Authors: Cuddington Clayton , Greenfield Alisyn , Lee Yong Gyu , Kim Jung Lye , Lamb Derek , Buehler Paul W. , Black Sylvester M. , Palmer Andre F. , Whitson Bryan A.
Published: January 2024

Normothermic ex vivo lung perfusion (EVLP) can resuscitate marginal lung allografts to increase organs available for transplantation. During normothermic perfusion, cellular metabolism is more active compared with subnormothermic perfusion, creating a need for an oxygen (O2) carrier in the perfusate. As an O2 carrier, red blood cells (RBCs) are a scarce resource and are susceptible to hemolysis in perfusion circuits, thus releasing cell-free hemoglobin (Hb), which can extravasate into the tissue space, thus promoting scavenging of nitric oxide (NO) and oxidative tissue damage. Fortunately, polymerized human Hb (PolyhHb) represents a synthetic O2 carrier with a larger molecular diameter compared with Hb, preventing extravasation, and limiting adverse reactions. In this study, a next-generation PolyhHb-based perfusate was compared to both RBC and asanguinous perfusates in a rat EVLP model. During EVLP, the pulmonary arterial pressure and pulmonary vascular resistance were both significantly higher in lungs perfused with RBCs, which is consistent with RBC hemolysis. Lungs perfused with PolyhHb demonstrated greater oxygenation than those perfused with RBCs. Post-EVLP analysis revealed that the PolyhHb perfusate elicited less cellular damage, extravasation, iron tissue deposition, and edema than either RBCs or colloid control. These results show promise for a next-generation PolyhHb to maintain lung function throughout EVLP.
Mild airways obstruction: spirometric diagnostic pitfalls and solutions
Authors: Alotaibi Nawaf M. , Eddy Rachel L. , Sin Don D.
Published: January 2024

Purpose of review

Spirometry is a validated tool in the diagnosis of obstructive airways disease. However, it may be insufficiently sensitive in detecting airflow limitation in the small airways. This review highlights common clinical scenarios wherein airflow limitation may be missed or overlooked.

Recent findings

This article covers recent literature on the interpretation of lung function test, focusing on detection of mild obstructive airways disease. It also sheds light on the contextual difficulties of defining mild airflow limitation on spirometry.

We highlight the consensus definition of mild obstructive airways disease and emphasize that this definition does not necessarily mean mild in certain disease-specific contexts. Several spirometric findings outside of a reduced forced expiratory volume in one second/forced vital capacity ratio should raise suspicion of mild obstruction.
Physiatry for Treating Hip, Knee, and Back Pain
Authors: Mohammadi Neema , Sedlak Carol A.
Published: January 2024

Physical Medicine and Rehabilitation (PM&R) is a rapidly expanding field. Physicians who practice PM&R are known as physiatrists and provide care primarily for patients who have disabilities or physical impairments affecting the musculoskeletal system, brain, and spinal cord. Physiatrists may work in an inpatient or outpatient setting, with outpatient physiatrists being an invaluable resource in treating patients experiencing pain. It is worthwhile to refer patients experiencing hip, knee, or back pain to a PM&R specialist because of their skill in making specific and accurate diagnoses, as well as providing a wide range of modalities to treat pain and augment function such as management of pain medications, osteopathic manipulative therapy, trigger point injections, intra-articular steroid injections, orthobiologic therapy, and interventional spinal procedures. Emphasis is on the use of the least invasive modality before employing more invasive treatments. The need for physiatrists to help individuals maximize function and enhance quality of life is increasing with the aging population, expanding workforce of older adults, and a growing population of people with a disability, especially since the COVID-19 pandemic.
Evaluating Treatment Response in GEJ Adenocarcinoma
Authors: Graf Markus , Gawlitza Joshua , Makowski Marcus , Meurer Felix , Huber Thomas , Ziegelmayer Sebastian
Published: January 2024

Background

Neoadjuvant therapy regimens have significantly improved the prognosis of GEJ (gastroesophageal junction) cancer; however, there are a significant percentage of patients who benefit from earlier resection or adapted therapy regimens, and the true response rate can only be determined histopathologically. Methods that allow preoperative assessment of response are lacking.

Purpose

The purpose of this retrospective study is to assess the potential of pretherapeutic and posttherapeutic spectral CT iodine density (IoD) in predicting histopathological response to neoadjuvant chemotherapy in patients diagnosed with adenocarcinoma of the GEJ.

Methods

In this retrospective cohort study, a total of 62 patients with GEJ carcinoma were studied. Patients received a multiphasic CT scan at diagnosis and preoperatively. Iodine-density maps were generated based on spectral CT data. All tumors were histopathologically analyzed, and the tumor regression grade (TRG) according to Becker et al (Cancer. 2003;98:1521–1530) was determined. Two experienced radiologists blindly placed 5 defined ROIs in the tumor region of highest density, and the maximum value was used for further analysis. Iodine density was normalized to the aortic iodine uptake. In addition, tumor response was assessed according to standard RECIST measurement. After assessing interrater reliability, the correlation of IoD values with treatment response and with histopathologic TRG was evaluated.

Results

The normalized ΔIoD (IoD at diagnosis − IoD after neoadjuvant treatment) and the normalized IoD after neoadjuvant treatment correlated significantly with the TRG. For the detection of responders and nonresponders, the receiver operating characteristic (ROC) curve for normalized ΔIoD yielded the highest area under the curve of 0.95 and achieved a sensitivity and specificity of 92.3% and 92.1%, respectively. Iodine density after neoadjuvant treatment achieved an area under the curve of 0.88 and a sensitivity and specificity of 86.8% and 84.6%, respectively (cutoff, 0.266). Iodine density at diagnosis and RECIST did not provide information to distinguish responders from nonresponders. Using the cutoff value for IoD after neoadjuvant treatment, a reliable classification of responders and nonresponders was achieved for both readers in a test set of 11 patients. Intraclass correlation coefficient revealed excellent interrater reliability (intraclass correlation coefficient, >0.9). Lastly, using the cutoff value for normalized ΔIoD as a definition for treatment response, a significantly longer survival of responders was shown.

Conclusions

Changes in IoD after neoadjuvant treatment of GEJ cancer may be a potential surrogate for therapy response.
Bdellovibrio svalbardensis sp. nov., a newly described predator isolated from Svalbard, Norway
Authors: Choi Seong Yeol , Mun Wonsik , Choi Sumin , Lee Kyoung , Mitchell Robert J.
Published: January 2024

Identified as a newly described species from a biocrust in Svalbard, Norway (78° 54′ 8.27″ N 12° 01′ 20.34″ E), isolate PAP01T has different characteristics from any known predatory bacteria. The isolate was vibrio-shaped strain that employed flagellar motility. Phylogenetic analysis based on 16S rRNA gene sequences revealed that the isolate clustered within the genus

Bdellovibrio

in the family

Bdellovibrionaceae

. 16S rRNA gene sequence similarities between strain PAP01T and the type strain (

Bdellovibrio bacteriovorus

HD100) was 95.7 %. The PAP01T genome has a size of 3.898 Mbp and possesses 3732 genes and a G+C content of 45.7 mol%. The results of genetic and physiological tests indicated the phenotypic differentiation of strain PAP01T from the two other

Bdellovibrio

species with validly published names. Based on the physiological and phylogenetic data, as well as the prey range spectrum and osmolality sensitivities, isolate PAP01T represents a novel species within the genus

Bdellovibrio

, for which the name Bdellovibrio svalbardensis sp. nov. is proposed. The type strain is PAP01T (=KCTC 92583T=DSM 115080T).
Is the bacterial genus name Rhodococcus Zopf 1891 illegitimate? Request for an Opinion
Authors: Goodfellow Michael , Oren Aharon , Sangal Vartul , Sutcliffe Iain C.
Published: January 2024

In 2014, it was reported that the bacterial genus name

Rhodococcus

Zopf 1891 was illegitimate due to the priority of the cyanobacterial genus name

Rhodococcus

Hansgirg 1884. Since that time, the consequences of this conclusion have been largely ignored, whilst changes have been made to relevant Rules of the International Code of Nomenclature of Prokaryotes, including significant changes to the way in which the Code treats the names of members of Cyanobacteriota. Given the complexity of the nomenclatural issues, we request the opinion of the Judicial Commission of the International Committee on Systematics of Prokaryotes as to whether the genus name

Rhodococcus

Zopf 1891 (Approved Lists 1980) is illegitimate.
Prophages: an integral but understudied component of the human microbiome
Authors: Inglis Laura K. , Roach Michael J. , Edwards Robert A.
Published: January 2024

Phages integrated into a bacterial genome – called prophages – continuously monitor the vigour of the host bacteria to determine when to escape the genome and to protect their host from other phage infections, and they may provide genes that promote bacterial growth. Prophages are essential to almost all microbiomes, including the human microbiome. However, most human microbiome studies have focused on bacteria, ignoring free and integrated phages, so we know little about how these prophages affect the human microbiome. To address this gap in our knowledge, we compared the prophages identified in 14 987 bacterial genomes isolated from human body sites to characterize prophage DNA in the human microbiome. Here, we show that prophage DNA is ubiquitous, comprising on average 1–5 % of each bacterial genome. The prophage content per genome varies with the isolation site on the human body, the health of the human and whether the disease was symptomatic. The presence of prophages promotes bacterial growth and sculpts the microbiome. However, the disparities caused by prophages vary throughout the body.
The temporal evolution of cancer hallmarks
Authors: Gourmet Lucie , Ramazzoti Daniele , Mallick Parag , Walker-Samuel Simon , Zapata Luis
Published: January 2024

Cancer hallmarks describe key physiological characteristics that distinguish cancers from normal tissues. The temporal order in which these hallmarks appear during cancer pathogenesis is of interest from both evolutionary and clinical perspectives but has not been investigated before. Here, we order hallmarks based on the allele frequency and selective advantage of mutations in cancer hallmark genes across >10k untreated primary tumors and >8K healthy tissues. Using this novel approach, we identified a common evolutionary trajectory for 27 of 32 cancer types with genomic instability as the first and immune evasion as the last hallmark. We demonstrated widespread positive selection in cancer and strong negative selection in normal tissues for all hallmarks. Notable exceptions to the hallmark ordering in tumours were melanomas (uveal and skin) suggesting that strong environmental factors could disrupt common evolutionary paths. Clustering of hallmark trajectories across patients revealed 2 clusters defined by early or late genomic instability, with differential prognosis. Our study is the first to identify the temporal order of cancer hallmarks during tumorigenesis and demonstrate a prognostic value that could be exploited for early detection and risk stratification across multiple cancer types.
A time-series analysis of anxiety diagnoses and prescriptions from January 2018 to January 2023
Authors: Cartwright Brianna M Goodwin , Smits Peter D , Rodriguez Patricia J , Gratzl Samuel , Baker Charlotte , Stucky Nick
Published: January 2024

This research aimed to estimate whether first-time anxiety diagnoses and medication usage during and after the COVID-19 pandemic differed from diagnosis and medication usage rates prior to the COVID-19 pandemic, within groups stratified by age. We observed a significant increase in first-time anxiety diagnoses and prescriptions for 12–17-year-olds during April 2020-March 2021 compared to January 2018-February 2020. These trends were not sustained in subsequent periods. We also observed an increase in first-time prescriptions for 18–29-year-olds during the same time. The study emphasizes the importance of addressing mental health concerns, particularly among adolescents, both during and beyond the pandemic.
Acute to long-term characteristics of impedance recordings during neurostimulation in humans
Authors: Cui Jie , Mivalt Filip , Sladky Vladimir , Kim Jiwon , Richner Thomas J. , Lundstrom Brian N. , Van Gompel Jamie J. , Wang Hai-long , Miller Kai J. , Gregg Nicholas , Wu Long Jun , Denison Timothy , Winter Bailey , Brinkmann Benjamin H. , Kremen Vaclav , Worrell Gregory A.
Published: January 2024

Objective

This study aims to characterize the time course of impedance, a crucial electrophysiological property of brain tissue, in the human thalamus (THL), amygdala-hippocampus (AMG-HPC), and posterior hippocampus (post-HPC) over an extended period.

Approach

Impedance was periodically sampled every 5-15 minutes over several months in five subjects with drug-resistant epilepsy using an experimental neuromodulation device. Initially, we employed descriptive piecewise and continuous mathematical models to characterize the impedance response for approximately three weeks post-electrode implantation. We then explored the temporal dynamics of impedance during periods when electrical stimulation was temporarily halted, observing a monotonic increase (rebound) in impedance before it stabilized at a higher value. Lastly, we assessed the stability of amplitude and phase over the 24-hour impedance cycle throughout the multi-month recording.

Main results

Immediately post-implantation, the impedance decreased, reaching a minimum value in all brain regions within approximately two days, and then increased monotonically over about 14 days to a stable value. The models accounted for the variance in short-term impedance changes. Notably, the minimum impedance of the THL in the most epileptogenic hemisphere was significantly lower than in other regions. During the gaps in electrical stimulation, the impedance rebound decreased over time and stabilized around 200 days post-implant, likely indicative of the foreign body response and fibrous tissue encapsulation around the electrodes. The amplitude and phase of the 24-hour impedance oscillation remained stable throughout the multi-month recording, with circadian variation in impedance dominating the long-term measures.

Significance

Our findings illustrate the complex temporal dynamics of impedance in implanted electrodes and the impact of electrical stimulation. We discuss these dynamics in the context of the known biological foreign body response of the brain to implanted electrodes. The data suggest that the temporal dynamics of impedance are dependent on the anatomical location and tissue epileptogenicity. These insights may offer additional guidance for the delivery of therapeutic stimulation at various time points post-implantation for neuromodulation therapy.
Gravitational radiation from a particle plunging into a Schwarzschild black hole: Frequency-domain and semirelativistic analyses
Authors: Silva Hector O. , Tambalo Giovanni , Glampedakis Kostas , Yagi Kent
Published: January 2024

We revisit the classic problem of gravitational wave emission by a test particle plunging into a Schwarzschild black hole both in the frequency-domain Regge-Wheeler-Zerilli formalism and in the semirelativistic approximation. We use, and generalize, a transformation due to Nakamura, Sasaki, and Shibata to improve the falloff of the source term of the Zerilli function. The faster decay improves the numerical convergence of quantities of interest, such as the energy radiated at spatial infinity through gravitational waves. As a test of the method, we study the gravitational radiation produced by test particles that plunge into the black hole with impact parameters close to the threshold for scattering. We recover and expand upon previous results that were obtained using the Sasaki-Nakamura equation. In particular, we study the relative contributions to the total energy radiated due to waves of axial and polar parity, and uncover an universal behavior in the waveforms at late times. We complement our study with a semirelativistic analysis of the problem, and we compare the two approaches. The generalized Nakamura-Sasaki-Shibata transformation presented here is a simple and practical alternative for the analysis of gravitational-wave emission by unbound orbits in the Schwarzschild spacetime using the frequency-domain Regge-Wheeler-Zerilli formalism.

Published by the American Physical Society
2024
Philanthropy as whiteness: toward racially just philanthropic practices
Authors: Scott Charity P. , Rodriguez Leach Nicole
Published: January 2024

Purpose

Exploring how racism continues to persist throughout public and nonprofit organizations is central to undoing persistent society-wide injustices in the United States and around the globe. The authors provide two cases for identifying and understanding the ways in which philanthropy’s whiteness does harm to K–12 students and communities of color.

Design/methodology/approach

In this article, the authors draw on critical race theory and critical whiteness studies, specifically Cheryl Harris' work to expose the whiteness of philanthropy, not as a racial identity, but in the way that philanthropy is performed. The authors characterize one of the property functions of whiteness, the right to exclude, as working through two mechanisms: neoliberal exclusion and overt exclusion. Drawing on this construction of the right to exclude, the authors present two cases: the Bill & Melinda Gates Foundation and the City Fund.

Findings

Whether intentional or not, the Gates Foundation and the City Fund each exclude communities of color in several ways: from changes to schools and districts, parents' experiences navigating school enrollment due to these changes, to academic assessments and political lobbying.

Originality/value

These cases provide a way for researchers and practitioners to see how organizations in real time reify the extant racial hierarchy so as to disrupt such organizational processes and practices for racial justice.
Effects of mobile-assisted funds-of-knowledge writing practice in developing Latinx English learners’ intercultural sensitivity
Authors: Chen Yan , Hartley Kendall , Schrader P.G. , Zhang Chenghui
Published: January 2024

Purpose

The purpose of this study is to examine relevant demographic and socio-economic factors as they relate to progress towards intercultural communicative competence (ICC) and intercultural sensitivity for ethnic-minority Latinx middle school English learners (ELs) using a mobile-assisted funds-of-knowledge-featured writing practice.

Design/methodology/approach

Through the theoretical lens of funds of knowledge, this three-year study implemented a survey-based quasi-experimental design centered on the Latinx ELs’ ICC development with the implementation of an intercultural sensitivity questionnaire (Chen and Starosta, 2000). The authors first investigated the relationship between ELs’ intercultural sensitivity and associated demographic and socio-economic factors. The authors then examined the changes of ELs’ intercultural sensitivity. Over ten weeks, the intervention group completed five funds-of-knowledge-featured narrative essays using pen and paper and mobile-based writing tools alternatively.

Findings

Findings indicated that ELs’ intercultural sensitivity increased as they advanced to a higher-level grade from sixth to eighth. The embedded mobile-assisted funds-of-knowledge writing practice as intervention promoted ELs’ intercultural sensitivity in interaction engagement, respect of cultural differences, interaction enjoyment and interaction attentiveness. Among the variables, interaction enjoyment was portrayed the most. ELs who reported not speaking English at home were statistically significant in this experiment.

Originality/value

This study acknowledges the robust and variance of funds of knowledge as a niche to address the interculturality and hybridity of ELs’ cultural practices accumulated through Latinx ELs’ family socialization and social development using mobile-assisted writing practice. This study could provide implications for optimizing inclusive experience to promote computer-assisted language learning in a contemporary, postcolonial global world.
Sustainable education on improving the quality of peer assessment: design and implementation of an online deep learning-based peer assessment system
Authors: Lin Kuan-Cheng , Li Nien-Tzu , Chen Mu-Yen
Published: January 2024

Purpose

As global issues such as climate change, economic growth, social equality and the wealth gap are widely discussed, education for sustainable development (ESD) allows every human being to acquire the knowledge, skills, attitudes and values necessary to shape a sustainable future. It also requires participatory teaching and learning methods that motivate and empower learners to change their behavior and take action for sustainable development. Teachers have begun rating pupils based on peer assessment for open evaluation. Peer assessment enables students to transition from passive to active feedback recipients. The assessors improve critical thinking and encourage introspection, resulting in more significant recommendations. However, the quality of peer assessment is variable, resulting in reviewers not recognizing the remarks of other reviewers, therefore the benefits of peer assessment cannot be fulfilled. In the past, researchers frequently employed post-event questionnaires to examine the effects of peer assessment on learning effectiveness, which did not accurately reflect the quality of peer assessment in real time.

Design/methodology/approach

This study employs a multi-label model and develops a self-feedback system in order to use the AIOLPA system in the classroom to enhance students' learning efficacy and the validity of peer assessment.

Findings

The research findings indicate that the better peer assessment through the rapid feedback system, for the evaluator, encourages more self-reflection and attempts to provide more ideas, so bringing the peer rating closer to the instructor rating and assisting the evaluator. Improve self-evaluation and critical thinking for the evaluator, peers make suggestions and comments to help improve the work and support the growth of students' learning effectiveness, which can lead to more suggestions and an increase in the work’s quality.

Originality/value

ESD consequently promotes competencies like critical thinking, imagining future scenarios and making decisions in a collaborative way. This study builds an online peer assessment system with a self-feedback mechanism capable of classifying peer comments, comparing them with scores in a consistent manner and providing prompt feedback to critics.
Self-perceived talent status and employee outcomes: role of the organisational justice in Japanese learning organisations
Authors: Ishiyama Nobutaka , S. Tanaka Hideki
Published: January 2024

Purpose

This study aims to examine the relationship between self-perceived talent status (SPTS) and positive employee outcomes (work engagement and organisational commitment), mediated by organisational justice (distributive and procedural justice). The authors define SPTS as employees’ self-conceptualisation of talent, formed by inferring the organisation’s initiatives regarding training and development opportunities and through informal recognition by others.

Design/methodology/approach

The authors measured SPTS using eight items on a five-point scale. Through an internet survey company, the authors initially surveyed 1,207 full-time employees from 300 Japanese companies with ≥ 300 employees. In the second round of the survey, conducted after approximately two weeks, 876 (82.9%) responses were collected from the initial 1,207 respondents, which were used for the final analysis.

Findings

SPTS was directly and positively related to work engagement, organisational commitment, distributive justice and procedural justice. In learning organisations, SPTS was positively but indirectly related to work engagement and organisational commitment, mediated by distributive justice. In non-learning organisations, SPTS was positively but indirectly related to work engagement and organisational commitment, mediated by procedural justice.

Practical implications

Given SPTS’s positive impact on employee outcomes, to eliminate the information asymmetry between organisations and talent due to strategic ambiguity, organisations should increase SPTS by helping talents perceive the plethora of development opportunities in the talent pool.

Originality/value

The results demonstrate the utility of SPTS for improving employee outcomes based on strategic talent management (TM) mechanisms including talent rewards, talent development opportunities and promotions. Furthermore, the results demonstrate that distributive justice plays an important role in the build-based TM context of learning organisations.
Association between laughter, frailty, and depression in rheumatoid arthritis patients
Authors: Suzuki Mochihito , Kojima Toshihisa , Terabe Kenya , Ohashi Yoshifumi , Sato Ryo , Kosugiyama Hironobu , Hasegawa Junya , Ohno Yusuke , Nagai Kaoru , Ohnishi Chinami , Sugiura Hideshi , Fujita Hitomi , Nagayoshi Mako , Kojima Masayo , Asai Shuji , Imagama Shiro
Published: January 2024

Objective

This study aimed to determine whether there are associations between laughter, disease activity, frailty, and depression in rheumatoid arthritis (RA) patients.

Methods

A total of 240 patients were included in this prospective cohort study on frailty in RA patients between March 2021 and June 2022. Patients were divided into the following four groups according to the frequency of laughter: “almost every day,” “1–5 days per week,” “1–3 days per month,” and “never or almost never.” Patient characteristics were compared among the four groups by analysis of variance. Factors associated with laughter were identified by multivariable logistic analysis.

Results

The mean 28‐joint Disease Activity Score using CRP was 1.91, with 70.7% of patients in remission and 12.6% in low disease activity. For the “almost every day” (42.5% of patients), “1–5 days per week” (40.0%), “1–3 days per month” (11.3%), and “never or almost never” (6.3%) groups, scores of the Kihon Checklist (KCL) for assessing frailty status were 3.5, 4.6, 7.3, and 8.1 (p < .001), respectively, and scores of the Beck Depression Inventory (BDI‐II) were 8.4, 10.7, 15.1, and 16.5 (p < .001), respectively. Multivariable analysis revealed that KCL (OR: 0.81, 95% CI: 0.73–0.90) and BDI‐II (OR: 0.91, 95% CI: 0.86–0.95) scores were independently associated with the frequency of laughter.

Conclusion

Frailty and depression were associated with laughter in RA patients with controlled disease activity. Interventions aimed at not only disease activity control but also frailty prevention may lead to a life filled with laughter.
Extended‐release buprenorphine in pregnancy
Authors: Hubbell Alexander , Aghenta Ese , Jones Cresta , Specker Sheila
Published: January 2024

Background and Objectives

The relative safety and efficacy of monthly extended‐release buprenorphine (XR‐BUP) has not been fully evaluated in pregnant persons.

Methods

Case report of two pregnant individuals receiving XR‐BUP while pregnant.

Results

Both patients had positive experiences and healthy infants.

Discussion and Conclusions

Sparse data regarding the use of XR‐BUP in pregnant patients limits shared decision‐making. Additional evidence will support the growing population of pregnant patients exposed to XR‐BUP.

Scientific Significance

Positive patient experiences using XR‐BUP during pregnancy have been previously unreported. This report will contribute to discussions of risks and benefits for future patients using XR‐BUP during pregnancy.
Plasma protein signatures of adult asthma
Authors: Smilnak Gordon J. , Lee Yura , Chattopadhyay Abhijnan , Wyss Annah B. , White Julie D. , Sikdar Sinjini , Jin Jianping , Grant Andrew J. , Motsinger‐Reif Alison A. , Li Jian‐Liang , Lee Mikyeong , Yu Bing , London Stephanie J.
Published: January 2024

Background

Adult asthma is complex and incompletely understood. Plasma proteomics is an evolving technique that can both generate biomarkers and provide insights into disease mechanisms. We aimed to identify plasma proteomic signatures of adult asthma.

Methods

Protein abundance in plasma was measured in individuals from the Agricultural Lung Health Study (ALHS) (761 asthma, 1095 non‐case) and the Atherosclerosis Risk in Communities study (470 asthma, 10,669 non‐case) using the SOMAScan 5K array. Associations with asthma were estimated using covariate adjusted logistic regression and meta‐analyzed using inverse‐variance weighting. Additionally, in ALHS, we examined phenotypes based on both asthma and seroatopy (asthma with atopy (n = 207), asthma without atopy (n = 554), atopy without asthma (n = 147), compared to neither (n = 948)).

Results

Meta‐analysis of 4860 proteins identified 115 significantly (FDR<0.05) associated with asthma. Multiple signaling pathways related to airway inflammation and pulmonary injury were enriched (FDR<0.05) among these proteins. A proteomic score generated using machine learning provided predictive value for asthma (AUC = 0.77, 95% CI = 0.75–0.79 in training set; AUC = 0.72, 95% CI = 0.69–0.75 in validation set). Twenty proteins are targeted by approved or investigational drugs for asthma or other conditions, suggesting potential drug repurposing. The combined asthma‐atopy phenotype showed significant associations with 20 proteins, including five not identified in the overall asthma analysis.

Conclusion

This first large‐scale proteomics study identified over 100 plasma proteins associated with current asthma in adults. In addition to validating previous associations, we identified many novel proteins that could inform development of diagnostic biomarkers and therapeutic targets in asthma management.
‘Supervising children to be good people’: Parents and children's views of child supervision in Laos
Authors: Ruiz‐Casares Mónica , Phommavong Saithong , Park Sol , Douangphachanh Maliphone
Published: January 2024

Researchers have paid little attention to child supervision in Laos, an ethnically‐diverse country with a community‐informal child protection system, and where many young children are regularly home alone or with another child. To explore what constitutes (in)adequate child supervision and its perceived effects, we conducted individual interviews with community leaders and professionals (n = 23) and focus group discussions with parents/adult caregivers (n = 74) and 12–17 year‐old children (n = 51) in six rural villages in Saravane and Borikhamxay provinces. Adults and children in both provinces described similar understandings and support systems of child supervision. Mothers are the main caregivers of young children, and literate fathers contribute to supervising school‐age children. Grandparents, older siblings and other relatives, teachers, and village authorities contribute substantively to child supervision. The main aims of supervision are child safety, socialization and moral development in cultural context. Parental unavailability due to employment, farming and migration; limited infrastructure; and lack of material resources are the main barriers to adequate supervision and may result in injuries, school dropout, teenage pregnancy and illicit drug use. Understanding the determinants, consequences, and patterns of child supervision across cultural and socio‐economic groups is needed to inform culturally acceptable strategies to support children and families.
Parents' perspectives on the results of mandatory child protection support: A qualitative study
Authors: Doelman Eline H. J. , van der Horst Frank C. P. , Luijk Maartje P. C. M. , Steketee Majone J.
Published: January 2024

In situations where parents do not accept support while their family situation is assessed as unsafe (for instance in cases of child abuse and neglect), it is sometimes necessary to offer mandatory support to families. The aim of the current study is to investigate how parents perceive the results of mandatory support from Child Protection Services (CPS) and which elements of the mandatory support parents mark as crucial for the results of the support. In‐depth semi‐structured interviews were conducted with 18 parents. Parents report mixed feelings about the results of the mandatory support. According to parents, reaching alignment with professionals about the problem definition, as well as the aims of CPS at the start of mandatory CPS, is a crucial element contributing to results of CPS. Additionally, the perceived quality of the support (both on the organizational and professional level) is simultaneous important conditions for a positive view on the support of parents. Implications for practice include the importance of multi‐directed partiality of professionals to reach an agreement about the problems definition and the aims of the mandatory CPS involvement.
Spillover between Medicare and Medicaid: Evidence from decreasing physician reimbursements
Authors: Reddig Kole
Published: January 2024

This paper studies the effect of large changes in Medicaid reimbursement rates on the quantity of care supplied to Medicare beneficiaries. In 2015, the payment parity provision of the Affordable Care Act ended, causing widespread decreases in reimbursements to primary care providers for Medicaid services. Difference‐in‐differences and triple‐differences model estimates show that decreasing physician payments for Medicaid caused a small increase in the number of services provided to Medicare beneficiaries. I explore the mechanisms driving this result, giving context and insight into some current puzzles regarding the effects of the ACA's Medicaid expansion.
Involvement of nr2f genes in brain regionalization and eye development during early zebrafish development
Authors: Chowdhury Gazlima , Umeda Koto , Ohyanagi Takero , Nasu Kouhei , Yamasu Kyo
Published: January 2024

Nuclear receptor subfamily 2 group F (Nr2f) proteins are essential for brain development in mice, but little is known about their precise roles and their evolutionary diversification. In the present study, the expression patterns of major nr2f genes (nr2f1a, nr2f1b, and nr2f2) during early brain development were investigated in zebrafish. Comparisons of their expression patterns revealed similar but temporally and spatially distinct patterns after early somite stages in the brain. Frameshift mutations in the three nr2f genes, achieved using the CRISPR/Cas9 method, resulted in a smaller telencephalon and smaller eyes in the nr2f1a mutants; milder forms of those defects were present in the nr2f1b and nr2f2 mutants. Acridine orange staining revealed enhanced cell death in the brain and/or eyes in all nr2f homozygous mutants. The expression of regional markers in the brain did not suggest global defects in brain regionalization; however, shha expression in the preoptic area and hypothalamus, as well as fgf8a expression in the anterior telencephalon, was disturbed in nr2f1a and nr2f1b mutants, potentially leading to a defective telencephalon. Specification of the retina and optic stalk was also significantly affected. The overexpression of nr2f1b by injection of mRNA disrupted the anterior brain at a high dose, and the expression of pax6a in the eyes and fgf8a in the telencephalon at a low dose. The results of these loss‐ and gain‐of‐function approaches showed that nr2f genes regulate the development of the telencephalon and eyes in zebrafish embryos.
Sialorrhea: Working with people with disability for better outcomes
Authors: Reddihough Dinah Susan
Published: January 2024

This commentary is on the original articles by Fayoux et al. and Orriëns et al. on pages 910–918 and 919–930
Durability of doravirine with dolutegravir dual regimen compared with other dolutegravir‐based dual combinations
Authors: Rossotti Roberto , D'Amico Federico , Bana Nicholas Brian , Nava Alice , Rezzonico Leonardo Francesco , Raimondi Alessandro , Fanti Diana , Chianura Leonardo Gerolamo , Moioli Maria Cristina , Vismara Chiara , Puoti Massimo
Published: January 2024

Objectives

The availability of doravirine (DOR) allowed clinicians to prescribe a dolutegravir (DTG)‐based two‐drug regimen (2DR) in individuals not eligible to receive lamivudine (3TC) or rilpivirine (RPV). The aims of this study were to describe the durability of DTG + DOR compared with DTG/3TC and DTG/RPV and the rate of virological failure and target not‐detected maintenance over time.

Methods

This retrospective, monocentric analysis included all subjects who started a DTG‐based 2DR from 2018 to 2022 as a simplification. Descriptive statistics and non‐parametric tests to describe and compare the groups were applied. Kaplan–Meier probability curves and Cox regression models for regimens durability were used.

Results

The study enrolled 710 individuals: 499 treated with DTG/3TC, 140 with DTG/RPV, and 71 with DTG + DOR. A 2DR with DOR was prescribed to older subjects who had a longer infection, greater exposure to different antiretroviral regimens, a higher proportion of resistance‐associated mutations, and a worse immune‐virologic status. Over a cumulative follow‐up of 68 152 weeks, 42 discontinuations were registered (5.9%). DTG + DOR had a risk of treatment interruption of 7.8% at 48 weeks and 9.8% at 96 weeks, significantly higher than the other 2DRs. In the multivariate Cox model, DTG + DOR and DTG/RPV were significantly associated with discontinuation. The maintenance of target not detected during follow‐up was similar among groups. The rate of virological failure was higher for DTG + DOR through different event definitions.

Conclusions

DTG + DOR durability was high over a long follow‐up albeit lower than for other 2DRs. This combination might be an effective option in people with HIV that has proven difficult to treat.
Type 1 and type 2 diabetes mortality burden: Predictions for 2030 based on Bayesian age‐period‐cohort analysis of China and global mortality burden from 1990 to 2019
Authors: Dong Chunping , Wu Guifu , Li Hui , Qiao Yuan , Gao Shan
Published: January 2024

Aims

This study assessed diabetes (type 1 and type 2) mortality in China and globally from 1990 to 2019, predicting the next decade's trends.

Materials and Methods

Data came from the Global Burden of Disease (GBD) database. The annual percentage change (AAPC) in age‐standardized mortality rates (ASMR) for diabetes (type 1 and type 2) during 1990–2019 was calculated. A Bayesian age‐period‐cohort (BAPC) model predicted diabetes (type 1 and type 2) mortality from 2020 to 2030.

Results

In China, type 1 diabetes deaths declined from 6,005 to 4,504 cases (AAPC −2.827), while type 2 diabetes deaths rose from 64,084 to 168,388 cases (AAPC −0.763) from 1990 to 2019. Globally, type 1 diabetes deaths increased from 55,417 to 78,236 cases (AAPC 0.223), and type 2 diabetes deaths increased from 606,407 to 1,472,934 cases (AAPC 0.365). Both China and global trends showed declining type 1 diabetes ASMR. However, female type 2 diabetes ASMR in China initially increased and then decreased, while males had a rebound trend. Peak type 1 diabetes deaths were in the 40–44 age group, and type 2 diabetes peaked in those over 70. BAPC predicted declining diabetes (type 1 and type 2) mortality burden in China and globally over the next 10 years.

Conclusions

Type 2 diabetes mortality remained high in China and globally despite decreasing type 1 diabetes mortality over 30 years. Predictions suggest a gradual decrease in diabetes mortality over the next decade, highlighting the need for continued focus on type 2 diabetes prevention and treatment.
Calibrating the Conatus in Morphogenetic Régulation: Towards a Problématique of Perseverance
Authors: Knio Karim
Published: January 2024

The intersection between Critical realism, complex system thinking and Luhmannian autopoiesis has been subject to various debates. By showing how a complex system necessitates a trans‐immanent philosophical foundation, Knio proposed in a previous article a problématique of calibration which seeks to bring back to the fore the importance of considering a complex causality generated by environments onto boundaries and systems in an iterative, recursive, and emergentist way. The next step is to understand the motivation behind the actions of a trans‐immanent system. This paper contributes to this discussion by operationalizing the motivation behind action in terms of the Spinozian conatus. In so doing, this research shows how trans‐immanent systems such as people and society not only objectify (socially construct) but objectivate (create) objects behind desire. Finally, the forgoing shows how systemic persistence is not a simple matter of inertia or imitation but it is a matter of empowering reflexivity or, perseverance. This is shown through a thorough overview of the different interpretations of the conatus, followed by their application to several case studies within pre‐existing and prominent theories of institutional change within capitalism. As a result, the conatus as based on a trans‐immanent system offers great potential in institutional analysis; exemplified in the Critical Realist model of social change: Morphogenetic Régulation. This research contributes not only to political, economic, social, and cultural analyses of institutional change but analyses of complex and open systems as a whole, and thus understandings of human empowerment.
Heritage identity and Indigenous language learning motivation: A case of Indigenous Taiwanese high school students
Authors: Huang Hung Tzu , Chan Hsin Yu
Published: January 2024

This study responds to calls to reexamine the L2 motivational self system framework in order to understand motivations to learn languages other than English. Specifically, we explore Indigenous Taiwanese students’ heritage language learning motivation from a possible selves perspective. Following work on the rooted L2 self, the construct of the Indigenous heritage self is incorporated to capture the passion and conviction that motivates learners to maintain language use and revitalize cultural legacies. A nationwide questionnaire survey was administered to 293 indigenous Taiwanese high school students (aged 15–18). Exploratory factor analysis points to the need to include the Indigenous heritage self in an account of the motivation to learn endangered Indigenous languages. The composite elements of the Indigenous heritage self consist of goals focused on preserving the Indigenous language and cultures, as well as an emotional attachment to the heritage culture. Furthermore, multiple regression results show that learners’ Indigenous heritage self and ideal future self are significant contributors to motivational intensity and classroom engagement. Findings indicate that community‐based motivation is equally important as individual learners’ idealized future images in motivating Indigenous language learning. The article concludes by suggesting curriculum initiatives that incorporate motivational strategy instruction aimed at developing an ideal self for speaking the Indigenous language, bridging classroom content and the cultural immersive experiences that students have outside formal environments.
Combining living and deceased donation for pediatric first isolated liver transplantation: A win‐win even in countries with high deceased donor donation rates
Authors: de Ville de Goyet Jean , Grimaldi Chiara , di Francesco Fabrizio , Bici Kejd , Dona Diletta , Cintorino Davide
Published: January 2024

Background

Split and living donor liver transplantations are both key surgical strategies for development of pediatric liver transplant programs. Often, however, teams tend to prioritize only one preferentially.

Methods

In the context of a very active national split liver graft allocation program (Italy), retrospective study of 226 consecutive pediatric first isolated liver transplants performed by a single team using organs from both deceased and living donors. Clinical characterisitics and outcome were compared.

Results

In the context of a steadily slowly decreasing split graft offer, living donation activity steadily increased. Deceased and living donation accounted for 52.6% and 47.4% of transplantations, respectively. Both strategies were equally used for transplanting patients up to 30 kg of weight, while deceased donors were predominantly used for older recipients. Technical variants represented 86% of all transplants, with 183 conisting of left lateral segment grafts (76 split liver grafts and 107 left grafts from living donors). Outcome of both surgical strategies was similar, with excellent outcomes at early, mid‐, and long‐term.

Conclusions

Splitting livers of deceased donors and using living donation were complementary and non‐competitive strategies for developping pediatric liver transplant activity. Implementing both activities in parallell allowed to maintain stable the number of annual transplant in Italy and allowed to reach superior outcomes. This analysis provides evidence that living donation plays a role in Italy despite an existing very active “mandatory‐split” national policy.