bluuebunny/crossref_metadata_2025 huggingface dataset:
Common adverse events of electronic cigarettes compared with traditional nicotine replacement therapies: A systematic review and meta‐analysis
Authors: Anandan Aathavan Shanmuga , Leung Janni , Chan Gary C. K. , Sun Tianze , Connor Jason P. , Hall Wayne D. , Stjepanović Daniel
Published: May 2023

Issues

Established literature suggests that electronic cigarettes (EC) are more effective than traditional nicotine replacement therapies (NRT) as a smoking cessation aid, but the factors that mediate this difference remain poorly understood. We examine how adverse events (AE) associated with EC use relative to NRTs differ, with the view that differences in AEs experienced may drive differences in use and compliance.

Approach

Papers for inclusion were identified via a three‐tiered search strategy. Eligible articles involved healthy participants and compared nicotine ECs to non‐nicotine ECs or NRTs and reported frequency of AE as an outcome. Random‐effects meta‐analyses were conducted to compare the likelihood for each of the AEs between nicotine ECs, non‐nicotine placebo ECs and NRTs.

Key Findings

A total of 3756 papers were identified, of which 18 were meta‐analysed (10 cross‐sectional and 8 randomised controlled trials). Meta‐analytic results found no significant difference in the rates of reported AEs (i.e., cough, oral irritation, nausea) between nicotine ECs and NRTs, and between nicotine and non‐nicotine placebo ECs.

Implications

The variation in the incidence of AEs likely does not explain user preferences of ECs to NRTs. Incidence of common AEs reported because of EC and NRT use did not differ significantly. Future work will need to quantify both the adverse and favourable effects of ECs to understand the experiential mechanisms that drive the high uptake of nicotine ECs relative to established NRTs.

Conclusions

There is inconclusive evidence on the incidence of AEs experience when using ECs compared to NRTs, possibly given the small sample size of studies.
Understanding health disparities affecting people of West Central African descent in the United States: An evolutionary perspective
Authors: Mawson Anthony R.
Published: May 2023

Human populations adapting to diverse aspects of their environment such as climate and pathogens leave signatures of genetic variation. This principle may apply to people of West Central African descent in the United States, who are at increased risk of certain chronic conditions and diseases compared to their European counterparts. Less well known is that they are also at reduced risk of other diseases. While discriminatory practices in the United States continue to affect access to and the quality of healthcare, the health disparities affecting African Americans may also be due in part to evolutionary adaptations to the original environment of sub‐Saharan Africa, which involved continuous exposure to the vectors of potentially lethal endemic tropical diseases. Evidence is presented that these organisms selectively absorb vitamin A from the host, and its use in parasite reproduction contributes to the signs and symptoms of the respective diseases. These evolutionary adaptations included (1) sequestering vitamin A away from the liver to other organs, to reduce accessibility to the invaders; and (2) reducing the metabolism and catabolism of vitamin A (vA), causing it to accumulate to subtoxic concentrations and weaken the organisms, thereby reducing the risk of severe disease. However, in the environment of North America, lacking vA‐absorbing parasites and with a mainly dairy‐based diet that is high in vA, this combination of factors is hypothesized to lead to the accumulation of vA and to increased sensitivity to vA as a toxin, which contribute to the health disparities affecting African Americans. vA toxicity is linked to numerous acute and chronic conditions via mitochondrial dysfunction and apoptosis. Subject to testing, the hypothesis suggests that the adoption of traditional or modified West Central African‐style diets that are low in vA and high in vA‐absorbing fiber hold promise for disease prevention and treatment, and as a population‐based strategy for health maintenance and longevity.
Sustained response of galcanezumab in migraine prevention: Patient‐level data from a post hoc analysis in patients with episodic or chronic migraine
Authors: Tepper Stewart J. , Dong Yan , Vincent Maurice , Wietecha Linda A.
Published: May 2023

Objective

To evaluate, at population and individual patient levels, the sustained response of reduction in migraine headache days in patients with migraine treated with galcanezumab.

Methods

This was a post hoc analysis of double‐blind galcanezumab studies in patients with migraine: two 6‐month episodic migraine (EM; EVOLVE‐1/EVOLVE‐2), one 3‐month chronic migraine (CM; REGAIN), and one 3‐month treatment‐resistant migraine (CONQUER). Patients received monthly subcutaneous galcanezumab 120 mg (after 240 mg initial loading dose), galcanezumab 240 mg, or placebo. In the EM and CM studies, the proportions of patients with ≥50% and ≥75% (EM only) reduction from baseline in average monthly migraine headache days from Months 1 to 3 and Months 4 to 6 were evaluated. A mean monthly response rate was estimated. The sustained effect was defined as maintaining ≥50% response for ≥3 consecutive months in the patient‐level data for EM and CM.

Results

A total of 3348 patients with EM or CM from the EVOLVE‐1/EVOLVE‐2 (placebo, n = 894, galcanezumab, n = 879), REGAIN (placebo, n = 558, galcanezumab, n = 555), and CONQUER (EM: placebo, n = 132, galcanezumab, n = 137; CM: placebo, n = 98, galcanezumab, n = 95) studies were included. Patients were predominantly female, White, and had monthly migraine headache day averages ranging from 9.1 to 9.5 days (EM) and 18.1 to 19.6 days (CM). In patients with EM and CM, 19.0% and 22.6% of galcanezumab‐treated patients, respectively, had significantly higher maintenance of ≥50% response for all months in the double‐blind period compared to 8.0% and 1.5% of placebo‐treated patients. The odds ratios (OR) of achieving clinical response for EM and CM were double with galcanezumab (OR = 3.0 [95% CI 1.8, 4.8] and OR = 6.3 [95% CI 1.7, 22.7], respectively). At the individual patient level, of patients who had ≥75% response at Month 3 in the galcanezumab 120 and 240 mg dose groups and placebo group, 39.9% (55/138) and 43.0% (61/142), respectively, of galcanezumab‐treated patients maintained ≥75% response during Months 4–6 compared to 32.7% (51/156) with placebo.

Conclusion

More galcanezumab‐treated patients achieved ≥50% response within the first 3 months of treatment compared to placebo; responses were sustained during Months 4–6. The odds of achieving ≥50% response were double with galcanezumab.
Friction and wear performances of Si3N4 ceramic matrix composites: A review from the perspectives of doped phase, layered structure design, and laser surface texturing
Authors: Wang Hong‐Jian , Lin Hua‐Tay , Zhou Fei , Chu Rang , Guo Kui‐Kui , Wu Hai‐Dong , Liu Ye
Published: May 2023

Si3N4 ceramic matrix composites (SN‐CMCs) have been designed and widely used in many engineering fields under externally loading conditions. It is well known that the wear of materials is closely related to components’ mechanical reliability and service life. Understanding of the friction and wear performances is very important to provide insights into how to improve the wear resistance of materials. Coefficient of friction and wear rate, in general, are the most critical parameters of tribological behavior of materials. In this paper, friction and wear performances of SN‐CMCs are reviewed from the perspectives of doped phase, layered structure design, and laser surface texturing. The article describes the change of friction and wear performances of SN‐CMCs sintered with different additive phases. Tribological behavior of SN‐CMCs with engineering designed layered structure is also analyzed from the aspects of surface coating and gradient structure. In addition, friction and wear performances of SN‐CMCs under different lubrication conditions are also discussed. As an ideal processing method for hard and brittle ceramic materials, laser surface texturing has been proved to be an effective way to improve the wear resistance of SN‐CMCs. Researches have shown that the better wear resistance can be obtained by combining laser surface texture with layered structure. At the end of paper, studies on friction and wear performances of SN‐CMCs are summarized and prospected.
Microstructure evolution and performance of B4C–NdB6 composites fabricated by in situ hot pressing
Authors: Wang Shuai , Li Huaiqian , Xing Pengfei , Zhuang Yanxin
Published: May 2023

B4C–NdB6 composites were fabricated by in situ hot pressing at different temperatures (1950–2150°C) with B4C and Nd2O3 (2–4 wt%) as raw materials. The microstructure evolution of the composites with sintering temperature and Nd2O3 content was studied in detail, and the influence of pressure on the sintering of B4C with different contents of Nd2O3 was also investigated. The performance of the fabricated composites was researched and the toughening mechanism was discussed. The results indicate that Nd2O3 can react with B4C to form the thin‐sheet intermediate products (Nd(BO2)3, Nd2CO5) first, which then transform to band‐shaped NdB6. Pressure can reduce the distance of B4C and Nd2O3, accelerating the mass transfer and contributing to the formation of NdB6. NdB6 and intermediate products are first in agglomerate structure at 1950°C, and then the agglomerates are broken to form dispersive micron and submicron NdB6 at 2000°C by the synergistic function of pressure, diffusion at high temperature, and liquid phase sintering. NdB6 can enhance the densification owing to the bonding function. Excessive Nd2O3 content leads to residual pores, and excessive temperature (2150°C) results in the coarsening of phases. The coexistence of transgranular and intergranular fracture of NdB6 promote the fracture toughness.
Effects of chia flour as a fat substitute on the physicochemical, nutritional and sensory properties of biscuits
Authors: Yalcin Seda , Atik İlker , Atik Azize
Published: April 2023

The objective of this study is to obtain reduced fat biscuits by using chia flour instead of vegetable fat and to investigate the effects of chia flour on the physicochemical, nutritional and sensory properties of biscuits. Fat was replaced by chia flour at the ratios of 25%, 50%, 75% and 100%. Fat replacement caused a significant decrease in fat, while significant increases in ash, protein, carbohydrate, total dietary fibre, phosphorus, magnesium, calcium, potassium, phenolic compounds, essential fatty acids (linoleic acid and linolenic acid) and hardness of biscuits were observed. Sensory quality was decreased with the increasing level of chia flour in biscuits. Biscuit containing 25% fat replacer was acceptable in terms of overall acceptance. This sample has 14.12% protein, 17.403% linoleic acid and 9.252% linolenic acid, while control has 10.51% protein, 13.068% linoleic acid and 7.751% linolenic acid. In addition, higher total dietary fibre, minerals and phenolic compounds were obtained. This study suggests that chia flour could be used in biscuit production to reduce fat and increase bioactive components of biscuits.
Job satisfaction among expatriate nurses during the COVID‐19 pandemic: A cross‐sectional study
Authors: Yasin Yasin M. , Khraim Fadi , Kehyayan Vahe
Published: May 2023

Aim

To investigate the association between job resources, job satisfaction, and moderating effect of COVID‐19 anxiety and practice setting among expatriate acute care nurses in Qatar.

Background

Expatriate nurses are more vulnerable to reduced job satisfaction. Increased COVID‐19 anxiety and reduced perceived job resources among acute care nurses impact their job satisfaction more than that of general ward nurses.

Method

An online survey was used to recruit 293 expatriate acute care nurses from four public hospitals in Qatar. Data were collected between June and October of 2021. Structural equation modeling was used for data analysis. We ensured to follow STROBE guidelines when doing this research.

Results

Job resources were a significant predictor of job satisfaction among expatriate acute care nurses (β = 0.80, 95% CI: 0.73–0.85, p < 0.001). There was no significant moderating effect of COVID‐19 anxiety (β = 0.055, 95% CI: −0.61 to 0.151, p = 0.329) or workplace setting on this relationship (χ2 = 0.077, df = 1, p = 0.781).

Discussion

Our study found that the relationship between job resources and acute care nurses' job satisfaction is consistent across different workplace settings regardless of the level of COVID‐19 anxiety. This is in line with previous studies that have highlighted the importance of job resources in determining nurses' job satisfaction.

Conclusion

The study emphasizes the need for sufficient job resources for improved job satisfaction among expatriate acute care nurses in Qatar, especially during the COVID‐19 pandemic.

Implications for nursing policy

Nursing leaders must prioritize adequate resources such as staffing, proper training, and policies that increase nurse autonomy to improve job satisfaction and reduce the negative effects of dissatisfaction.
RETRACTED: The effect of the multiple arterial grafts compared with single arterial graft for coronary artery bypass grafting on sternal wound complications: A meta‐analysis
Authors: Yang Xin , Fu Juan , Zhang Songlin
Published: May 2023

A meta‐analysis investigation was executed to measure the influence of multiple arterial grafts (MAGs) compared with single arterial graft (SAG) for coronary artery bypass grafting (CABG) on sternal wound complications (SWCs). A comprehensive literature inspection till February 2023 was applied and 1048 interrelated investigations were reviewed. The seven chosen investigations enclosed 11 201 individuals with CABG in the chosen investigations' starting point, 4870 of them were using MAGs, and 6331 were using SAG. Odds ratio (OR) in addition to 95% confidence intervals (CIs) were utilised to compute the value of the effect of the MAGs compared with SAG for CABG on SWCs by the dichotomous approaches and a fixed or random model. MAGs had significantly higher SWC (OR, 1.38; 95% CI, 1.10–1.73, P = .005) compared with those with SAG in CABG. MAGs had significantly higher SWC compared with those with SAG in CABG. However, care must be exercised when dealing with its values because of the low number of selected investigations for the meta‐analysis.
Association between salt sensitivity of blood pressure and the risk of hypertension in a Chinese Tibetan population
Authors: Zhou Erkai , Lei Ruoyi , Tian Xiaoyu , Liu Ce , Guo Jingzhe , Jin Limei , Jin Hua , Wang Shuxia , Cao Liangjia , Zhuoma Cao , Wang Jianzhong , Luo Bin , Hu Jihong
Published: April 2023

Epidemiological studies have confirmed salt sensitivity as a crucial risk factor for the development of hypertension. However, few studies have investigated the association between salt sensitivity of blood pressure (SSBP) and hypertension in Chinese Tibetan population. Therefore, we conducted a cross‐sectional study based on a Tibetan population to evaluate the association between SSBP and the risk of hypertension. Seven hundred and eighty‐four participants with hypertension and 645 participants without hypertension were included from five villages in Tibetan Autonomous Region of Gannan during 2013–2014. The assessment of salt sensitivity (SS) and non‐salt sensitivity (NSS) was performed according to mean arterial pressure (MAP) changes by the modified Sullivan's acute oral saline load and diuresis shrinkage test (MSAOSL‐DST). Logistic regression models and restricted cubic models were used to examine the association between SSBP and hypertension. There were 554 (70.5%) salt‐sensitive participants with hypertension and 412 (63.9%) salt‐sensitive participants without hypertension in this study. Compared with individuals with NSS, individuals with SS had a significantly increased risk of hypertension, and the multiple‐adjusted odds ratios were 2.582 with 95% confidence interval of 1.357–4.912. Furthermore, a significant linear trend was found between MAP changes and hypertension. Subgroup analyses showed significant and stronger associations between SSBP and the risk of hypertension in the older (age ≥ 55 years old), males and participants who took exercise less than 1 time per week. Our results suggest that SS is associated with an increased risk of hypertension in Tibetan population, indicating a need for clinicians dealing with SSBP to decrease the risk of hypertension.
Veneer tooth preparation utilizing a novel digital designed workflow: A case report
Authors: Figueira Johan , Guaqueta Nicolas , Ramirez Dra. Iveth , Kois John
Published: May 2023

Objective

This article describes a technique to implement guided tooth preparation where the tooth is virtually prepared in the laboratory and preparation templates are created for chairside use.

Clinical Considerations

Prior to any tooth preparation, patient records are acquired with an intra‐oral scanner, both stump and final shades are selected, and digital photos are taken. These digital records are used in combination with digital laboratory tools to do the virtual preparation first, and then to provide chairside templates for guided tooth preparation.

Conclusions

The traditional approach of tooth preparation has evolved from historically preparing a tooth without any pretreatment guidance to, more currently, preparing the tooth through a mock‐up of the desired final restoration. The outcome of these traditional approaches is highly dependent on the operator's skills to produce a successful outcome, and often resulted in more tooth structure removal than necessary. However, CAD/CAM technology now offers a guided tooth approach to tooth preparation which minimizes tooth structure removal and provides an advantage to the beginner dentist.

Clinical Significance

This is a unique approach in digital restorative dentistry.
More–than–relationship quality: A feminist new materialist analysis of relationship quality and the potential of digital couple interventions
Authors: Gabb Jacqui , Aicken Catherine , Di Martino Salvatore , Witney Tom , Lucassen Mathijs
Published: May 2023

Long‐established studies and scales have advanced understandings of family function, marital satisfaction, and couple relationship quality. The underpinning constructs nevertheless remain under‐conceptualized and largely removed from the heuristic of everyday life and the dynamic of contemporary coupledom. We propose that a paradigm shift is required to sufficiently engage with the digital worlds of 21st century intimacies. Ideas in feminist new materialism revitalize the epistemology and ontology of relationship science. This enables a new look at how relationship quality is manifest in and created through human–technology intra–actions. The research tools of feminist new materialism are, however, typically creative and intentionally exploratory. We demonstrate how using a practices approach, which focuses on everyday lived experience, facilitates investigation of multidimensional public–private worlds. We deploy this to build a feminist new materialist analysis of a digital couple intervention. Through this, we develop the concept ofmore–than–relationship quality.
An alternative to shareholder capitalism? A review of Alex Edmans' “Grow the Pie: How Great Companies Deliver Both Purpose and Profit”
Authors: Boustanifar Hamid
Published: May 2023

Alex Edmans' “Grow the Pie: How Great Companies Deliver Both Purpose and Profit” provides an alternative approach to business called Pieconomics. Profits to shareholders play a critical role in Pieconomics (similar as in shareholder capitalism), but the goal of an enterprise is to maximize the social value it creates (somewhat similar as in stakeholder capitalism). This review discusses and critically evaluates this thesis.
Nursing associates 6 years on: A review of the literature
Authors: Thurgate Claire , Griggs Chloe
Published: May 2023

Aim

This paper reviews the empirical research evidence relating to the nursing associate (NA) role since its implementation in England in 2017.

Background

The NA role arose from the findings of the Raising the Bar: Shape of Caring Review (Willis, 2015). The roles' aim is to bridge the gap between healthcare assistant and registered nurse as part of the nursing team, working with people of all ages in a variety of health and social care settings. NAs must successfully complete a trainee programme (usually a Foundation Degree) which, for many, has been completed as an apprentice while remaining in their place of work.

Methods

A literature search was performed using the British Nursing Index and CINAHL Plus, along with Google Scholar. Exact key words were ‘Nursing Associates’ and papers were refined to primary research only. Data restrictions were applied from 2017 to the end of September 2022. Each paper was critically appraised to assess the robustness and validity of the search processes and then thematic analysis was undertaken using Braun and Clarke's (Qualitative Research in Psychology, 3, 2006 and 77) six stages of analysis.

Results

Nineteen papers were identified; six key themes emerged: lack of support from others; career development; organisational readiness; resilience in the face of adversity; cost; and worker and learner identity.

Conclusion

The NA role is allowing career progression for those who would have historically been prevented from accessing the nursing workforce because of entry qualifications and financial limitations. There is a need for organisational readiness to ensure trainee nursing associates (TNA) are supported during their training, that they have equal opportunities to learn, and they are given the status and recognition as a learner. Organisations need to raise awareness among staff to allow the nursing team to understand the NA role.

Relevance to clinical practice

This literature review has relevance for those who employ Nursing Associates or who are considering introducing the role.

No patient or public consultation

Due to being a literature review no patient or public consultation took place; however, local employers identified the need for a review of the literature pertaining to the Nursing Associate role.
Impact of the COVID‐19 pandemic on stress and sleep in emergency room professionals
Authors: García‐Tudela Ángel , Simonelli‐Muñoz Agustín Javier , Gallego‐Gómez Juana Inés , Rivera‐Caravaca José Miguel
Published: May 2023

Aims and Objectives

To analyze stress levels, sleep quality, sleepiness and chronotypes on emergency room (ER) professionals before and during the COVID‐19.

Background

ER healthcare professionals are exposed to high stress levels, and they often present with poor sleep quality.

Design

Observational study conducted into two different phases (before the COVID‐19 and during the first wave of the COVID‐19).

Method

Physicians, nurses and nursing assistants working in the ER were included. Stress, sleep quality, daytime sleepiness and chronotypes were assessed by the Stress Factors and Manifestations Scale (SFMS), the Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale (ESS), and the Horne and Österberg Morningness‐Eveningness questionnaire, respectively. The first phase of the study was performed between December 2019 and February 2020, and the second between April and June 2020. The STROBE checklist was used to report the present study.

Results

In total, 189 ER professionals in the pre‐COVID‐19 phase and 171 (of the initial 189) during COVID‐19 were included. The proportion of workers with a morning circadian rhythm increased during the COVID‐19, and stress levels were significantly higher during COVID‐19 compared to the previous phase (38.34 ± 10.74 vs. 49.97 ± 15.81). ER professionals with poor sleep quality presented higher stress in the pre‐COVID‐19 phase (40.60 ± 10.71 vs. 32.22 ± 8.19) and during COVID‐19 (55.27 ± 15.75 vs. 39.66 ± 9.75). Similarly, workers with excessive sleepiness had higher stress in the pre‐COVID‐19 phase (42.06 ± 10.95 vs. 36.64 ± 10.24) and during COVID‐19 (54.67 ± 18.10 vs. 48.44 ± 14.75). Positive associations were also found between the SFMS and the PSQI, as well as with the ESS in both phases of the study.

Conclusions

Emergency room professionals had increased stress levels during the COVID‐19 pandemic. Stress was particularly higher in those with poor sleep quality or with excessive daytime sleepiness.

Relevance to Clinical Practice

These results should aim to impulse the implementation of measures to improve the working conditions of ER professionals.
Social Comparison Concerns and Competitive Attitudes of North Korean Refugees and South Koreans: Measurement Invariance and Latent Mean Differences1
Authors: Lee Ahlam , Park Eun‐A , Jo HyunJung
Published: April 2023

Although refugees often face competition in their efforts to survive and achieve upward mobility, little is understood about their psychological processes concerning competition. In this regard, we attempted to assess the extent to which North Korean refugees (NKRs) engage in social comparisons and exhibit competitive attitudes compared to their South Korean (SK) host citizens. We targeted NKRs and SKs, as we could control for the shared cultural heritage. First, we tested measurement invariance to determine whether there was a psychometric equivalence in the two latent constructs of social comparison concerns (SCCs) and competitive attitudes (CAs) between NKRs (n1 = 214) and SKs (n2 = 472). Partial scalar invariance was established to demonstrate the association between SCC and CA, suggesting that only certain aspects of the two latent constructs were comparable between NKRs and SKs. Compared to SKs, NKRs exhibit a significantly higher level of SCC for self‐evaluating abilities and opinions of individuals and their significant others, and CA about interpersonal and goal competitiveness with a medium effect size.
The role of rhFGF‐2 in periodontal defect bone fill: A systematic review of the literature
Authors: Pouliou Maria – Myrsini , Fragkioudakis Ioannis , Doufexi Aikaterini – Elisavet , Batas Leonidas
Published: May 2023

Background

Growth factors have been used with success in periodontal regeneration, especially in intrabony defects. Among those, the recombined form of fibroblast growth factor‐2 (rhFGF‐2) has been also examined.

Objective

To address the outcomes of periodontal regeneration using rhFGF‐2 alone or in combination with bone substitutes primarily in terms of Radiographic Bone Fill (RBF%) and secondary Probing Pocket Depth (PPD), and Probing Attachment Levels (PAL).

Material and Methods

A search in MEDLINE and EMBASE using the Ovid interface was conducted from 2000 up to and including the 12th of November 2022. Starting from the initially identified 1289 articles, 34 studies were selected for further analysis. Following the full‐text screening, 7 of the 34 studies met the inclusion criteria and thus were included in the systematic review after assessing their quality according to the Newcastle‐Ottawa scale (NOS). Clinical and radiographic results (bone gain, pocket depth, and clinical attachment level) after the application of FGF‐2 alone or in combination with different carriers were studied in patients with intrabony defects of at least one wall and pocket depth greater than 4 mm.

Results

Primary outcomes: RBF% was higher in studies using a combination of rhFGF‐2 and bone substitutes (74.6 ± 20.0%) compared to others using the specific growth factor alone or negative controls (22.7 ± 20.7%). In terms of secondary outcomes, the analysis failed to show an additional benefit from the use of the rhFGF‐2 alone or in combination with bone substitutes.

Conclusion

rhFGF‐2 can improve RBF% in the treatment of periodontal defects, especially when it is used in combination with a bone substitute.
A reliable automatic algorithm to score fragmentary myoclonus
Authors: Bergmann Melanie , Högl Birgit , Ibrahim Abubaker , Brandauer Elisabeth , Heidbreder Anna , Stefani Ambra , Cesari Matteo
Published: May 2023

Excessive fragmentary myoclonus (EFM) is an incidental polysomnographic finding requiring documentation of ≥20 minutes of NREM sleep with ≥5 fragmentary myoclonus (FM) potentials per minute. Manual FM scoring is time‐consuming and prone to inter‐rater variability. This work aimed to validate an automatic algorithm to score FM in whole‐night recordings. One expert scorer manually scored FM in the anterior tibialis muscles in 10 polysomnographies of as many subjects. The algorithm consisted of two steps. First, parameters of the automatic leg movement identification algorithm of the BrainRT software (OSG, Belgium) were modified to identify FM‐like activity. Second, a post‐processing algorithm was implemented to remove FM activity not meeting sufficient amplitude criteria. The parameter choice and the post‐processing were optimised with leave‐one‐out cross‐validation. Agreement with the human scorer was measured with Cohen's kappa (k) and correlation between manual and automatic FM indices in different sleep stages was evaluated. Agreement in identifying patients with EFM was computed. The algorithm showed substantial agreement (average k > 0.62) for all sleep stages, except for W, where a moderate agreement was observed (average k = 0.58). Nonetheless, the agreement between human scorer and the algorithm was similar to previously reported values of inter‐rater variability for FM scoring. Correlation coefficients were over 0.96 for all sleep stages. Furthermore, the presence/absence of EFM was correctly identified in 80% of the subjects. In conclusion, this work presents a reliable algorithm for automatic scoring of FM and EFM. Future studies will apply it to objectively and consistently evaluate FM indices and the presence of EFM in large populations.
Evaluation of the taxonomic accuracy and pathogenicity prediction power of 16 primer sets amplifying single copy marker genes in the Pseudomonas syringae species complex
Authors: Fautt Chad , Hockett Kevin L. , Couradeau Estelle
Published: May 2023

The Pseudomonas syringae species complex is composed of several closely related species of bacterial plant pathogens. Here, we used in silico methods to assess 16 PCR primer sets designed for broad identification of isolates throughout the species complex. We evaluated their in silico amplification rate in 2161 publicly available genomes, the correlation between pairwise amplicon sequence distance and whole genome average nucleotide identity, and trained naive Bayes classification models to quantify classification resolution. Furthermore, we show the potential for using single amplicon sequence data to predict type III effector protein repertoires, which are important determinants of host specificity and range.
Approximately optimal forest rotation in a nonstationary environment
Authors: Gars Johan , Spiro Daniel
Published: May 2023

The problem of optimal forest rotation in a nonstationary environment can, in general, not be solved analytically. Even qualitatively characterizing how the solution changes over time is only possible in some special cases. In this paper, we consider an approximation of the true solution to the nonstationary problem. We derive an approximate harvesting rule by solving a sequence of stationary problems that assume the growth conditions at that point in time will prevail indefinitely. Each such problem can be solved using the classic Faustmann rule. We numerically compare this approximate solution to the true solution, both in terms of the harvesting rule and the resulting expected profits, for a wide range of scenarios. We find that the harvesting rules are very similar (mostly % difference) and the profit losses associated with following the approximate rule are very small (less than 0.3%).
Normative data for axial elongation in Asian children
Authors: Naduvilath Thomas , He Xiangui , Xu Xun , Sankaridurg Padmaja
Published: May 2023

Aim

To determine the influence of refractive error (RE), age, gender and parental myopia on axial elongation in Chinese children and to develop normative data for this population.

Methods

This is a retrospective analysis of eight longitudinal studies conducted in China between 2007 and 2017. Data of 4701 participants aged 6–16 years with spherical equivalent from +6 to −6D contributed to one, two or three annualised progression data resulting in a dataset of 11,262 eyes of 26.6%, 14.8% and 58.6% myopes, emmetropes and hyperopes, respectively. Longitudinal data included axial length and cycloplegic spherical equivalent RE. Axial elongation was log‐transformed to develop an exponential model with generalised estimating equations including main effects and interactions. Model‐based estimates and their confidence intervals (CIs) are reported.

Results

Annual axial elongation decreased significantly with increasing age, with the rate of decrease specific to the RE group. Axial elongation in myopes was higher than in emmetropes and hyperopes but these differences reduced with age (0.58, 0.45 and 0.27 mm/year at 6 years and 0.13, 0.06 and 0.05 mm/year at 15 years for myopes, emmetropes and hyperopes, respectively). The rate of elongation in incident myopes was similar to that in myopes at baseline (0.33 vs. 0.34 mm/year at 10.5 years; p = 0.32), while it was significantly lower in non‐myopes (0.20 mm/year at 10.5 years, p < 0.001). Axial elongation was greater in females than in males and in those with both parents myopic compared with one or no myopic parent, with larger differences in non‐myopes than in myopes (p < 0.01).

Conclusions

Axial elongation varied with age, RE, gender and parental myopia. Estimated normative data with CIs could serve as a virtual control group.
Effect of SGLT‐2 inhibitors as an add‐on therapy to metformin on P wave indices and atrial electromechanics in type 2 diabetes mellitus patients
Authors: Ziyrek Murat , Dönmez Esra , Özcan Sevgi , Duran Mustafa , Tezcan Hüseyin , İnce Orhan , Özdemir Emrah , Sahin Irfan , Okuyan Ertugrul
Published: April 2023

Introduction

Sodium‐glucose co‐transporter 2 (SGLT‐2) inhibitors have been shown to reduce the risk of atrial fibrillation (AF) occurrence in patients with diabetes mellitus (DM). In this prospective study, we aimed to analyze the effect of SGLT‐2 inhibitors as an add‐on therapy to metformin on P wave indices and atrial electromechanics in patients with type 2 DM.

Methods

A total of 144 patients enrolled. Electrocardiographic indices were recorded on admission and at 3rd and 6th month of the combination therapy. P wave indices and atrial electromechanical coupling intervals were measured and compared.

Results

Although decrease in P wave dispersion (62.78 ± 9.59 vs. 53.62 ± 10.65; p = .002) became significant at 6th month of combination therapy, significant decreases in P wave terminal force in V1 (37.79 ± 3.45 vs. 32.01 ± 5.74; p = .035), left atrial volume index (35.87 ± 6.57 vs. 31.33 ± 7.31; p = .042), left sided intra‐atrial electromechanical delay (32.09 ± 9.17 vs. 27.61 ± 8.50; p = .016), right sided intra‐atrial electromechanical delay (31.82 ± 4.92 vs. 27.65 ± 8.05; p = .042), and interatrial electromechanical delay (29.65 ± 7.52 vs. 25.96 ± 4.30; p = .044) were seen as early as 3rd month of treatment. Besides, there was no statistically significant difference between Empagliflozin and Dapagliflozin subgroups in terms of mentioned parameters.

Conclusion

SGLT‐2 inhibitors as an add‐on therapy to metformin were shown to significantly improve P wave indices and atrial electromechanics in type 2 DM patients as early as the 3rd month of treatment. It was thought that this may be one of the underlying mechanisms of the decrease in the frequency of AF with the use of SGLT2 inhibitors.
Carfilzomib‐based antibody mediated rejection therapy in pediatric kidney transplant recipients
Authors: Cody Ellen M. , Varnell Charles , Lazear Danielle , VandenHeuvel Katherine , Flores Francisco X. , Woodle E. Steve , Hooper David K.
Published: May 2023

Background

To date, the evidence for proteasome‐inhibitor (PI) based antibody mediated rejection (AMR) therapy has been with the first‐generation PI bortezomib. Results have demonstrated encouraging efficacy for early AMR with lesser efficacy for late AMR. Unfortunately, bortezomib is associated with dose‐limiting adverse effects in some patients. We report use of the second generation proteosome inhibitor carfilzomib for AMR treatment in two pediatric patients with a kidney transplant.

Methods

The clinical data on two patients who experienced dose limiting toxicities from bortezomib were collected along with their short‐ and long‐term outcomes.

Results

A two‐year‐old female with simultaneous AMR, multiple de novo DSAs (DR53 MFI 3900, DQ9 MFI 6600, DR15 2200, DR51 MFI 1900) and T‐cell mediated rejection (TCMR) completed three carfilzomib cycles and experienced stage 1 acute kidney injury after the first two cycles. At 1 year follow up, all DSAs resolved, and her kidney function returned to baseline without recurrence. A 17‐year‐old female also developed AMR with multiple de novo DSAs (DQ5 MFI 9900, DQ6 MFI 9800, DQA*01 MFI 9900). She completed two carfilzomib cycles, which were associated with acute kidney injury. She had resolution of rejection on biopsy and decreased but persistent DSAs on follow‐up.

Conclusions

Carfilzomib treatment for bortezomib‐refractory rejection and/or bortezomib toxicity may provide DSA elimination or reduction, but also appears to be associated with nephrotoxicity. Clinical development of carfilzomib for AMR will require a better understanding of efficacy and development of approaches to mitigate nephrotoxicity.
Exploratory assessment: Nurse‐led community health worker delivered HCV intervention for people experiencing homelessness
Authors: Nyamathi Adeline , Salem Benissa E. , Lee Darlene , Yu Zhaoxia , Hudson Angela , Saab Sammy , Shin Sanghyuk S. , Jones‐Patten Alexandria , Yadav Kartik , Alikhani Mitra , Clarke Richard , Chang Alicia , White Kathryn , Gelberg Lillian
Published: May 2023

Background

Getting and maintaining Hepatitis C Virus (HCV) cure is challenging among people experiencing homelessness (PEH) as a result of critical social determinants of health such as unstable housing, mental health disorders, and drug and alcohol use.

Objectives

The purpose of this exploratory pilot study was to compare a registered nurse/community health worker (RN/CHW)‐led HCV intervention tailored for PEH, “I am HCV Free,” with a clinic‐based standard of care (cbSOC) for treating HCV. Efficacy was measured by sustained virological response at 12 weeks after stopping antivirals (SVR12), and improvement in mental health, drug and alcohol use, and access to healthcare.

Methods

An exploratory randomized controlled trial design was used to assign PEH recruited from partner sites in the Skid Row Area of Los Angeles, California, to the RN/CHW or cbSOC programs. All received direct‐acting antivirals. The RN/CHW group received directly observed therapy in community‐based settings, incentives for taking HCV medications, and wrap‐around services, including connection to additional healthcare services, housing support, and referral to other community services. For all PEH, drug and alcohol use and mental health symptoms were measured at month 2 or 3 and 5 or 6 follow‐up, depending on HCV medication type, while SVR12 was measured at month 5 or 6 follow‐up.

Results

Among PEH in the RN/CHW group, 75% (3 of 4) completed SVR12 and all three attained undetectable viral load. This was compared with 66.7% (n = 4 of 6) of the cbSOC group who completed SVR12; all four attained undetectable viral load. The RN/CHW group, as compared to the cbSOC, also showed greater improvements in mental health, and significant improvement in drug use, and access to healthcare services.

Discussion

While this study shows significant improvements in drug use and health service access among the RN/‐CHW group, the sample size of the study limits the validity and generalizability of the results. Further studies using larger sample sizes are necessitated.
Maternal intake of folate and folic acid during pregnancy and pubertal timing in girls and boys: A population‐based cohort study
Authors: Gaml‐Sørensen Anne , Brix Nis , Lunddorf Lea Lykke Harrits , Ernst Andreas , Høyer Birgit Bjerre , Olsen Sjurdur Frodi , Granström Charlotta , Toft Gunnar , Henriksen Tine Brink , Ramlau‐Hansen Cecilia Høst
Published: May 2023

Background

Folate is essential for normal foetal development as it plays an important role for gene expression during different periods of foetal development. Thus, prenatal exposure to folate may have a programming effect on pubertal timing.

Objectives

To study the association between maternal intake of folate during pregnancy and pubertal timing in girls and boys.

Methods

We studied 6585 girls and 6326 boys from a Danish population‐based Puberty Cohort, 2000–2021. Information on maternal intake of folate from diet and folic acid from supplements was obtained from a food‐frequency questionnaire in mid‐pregnancy, and total folate was calculated as dietary folate equivalents. Information on age at menarche in girls, age at first ejaculation and voice break in boys, and Tanner stages, acne and axillary hair in both girls and boys was obtained every 6 months throughout puberty. We estimated mean monthly differences according to exposure groups for each pubertal milestone in addition to a combined estimate for the average age at attaining all pubertal milestones using multivariable interval‐censored regression models. Total folate was analysed in quintiles, continuous and as restricted cubic splines.

Results

Maternal intake of total folate in mid‐pregnancy was not associated with pubertal timing in girls (combined estimate for overall pubertal timing per standard deviation (SD 325 μg/day) decrease in maternal intake of total folate: −0.14 months (95% confidence interval [CI] −0.51, 0.22)). Boys had slightly later overall pubertal timing per standard deviation (SD 325 μg/day) decrease in maternal intake of total folate (combined estimate: 0.40 months, 95% CI 0.01, 0.72). Spline plots supported these findings.

Conclusions

Prenatal exposure to low maternal intake of total folate in mid‐pregnancy was not associated with pubertal timing in girls but associated with slightly later pubertal timing in boys. This minor delay is likely not of clinical importance.
Transcriptomic analysis reveals gene expression changes in peripheral white blood cells of cows after embryo transfer: Implications for pregnancy tolerance
Authors: De los Santos Jorge A. , Andrade João Paulo N. , Cangiano L. R. , Iriarte Andres , Peñagaricano Francisco , Parrish John J.
Published: May 2023

Most embryo losses occur in the first trimester of pregnancy in cows and include losses following embryo transfer. There is a resulting negative economic impact on cattle production systems when this occurs. Cellular and molecular mechanisms behind the maternal immune response to the growing embryo have not been fully characterized. The objective of this study was to examine the gene expression profiles of peripheral white blood cells (PWBCs) from pregnant cows 21 days after an embryo was transferred, and cows that were treated equally but lost the embryo. Specifically, we obtained and compared the transcriptome of PWBC from heifers that became pregnant at day 21 (N = 5) or failed to become pregnant after the embryo transfer (N = 5). Sequencing data can be accessed by Gene Expression Omnibus (GEO) with the accession number GSE210665. A total of 13,167 genes were evaluated for differential expression between groups. A total of 682 genes showed differential expression (p‐value <.01), 302 genes were up‐regulated while 380 were down‐regulated due to pregnancy. The most significant genes were COL1A2, H2AC18, HTRA1, MMP14, CD5L, ADAMDEC1, MYO1A and RPL39, among others. Most of the significant genes are related to the up‐regulation of inflammatory chemokine activity and immune defence response. Our findings extend the current knowledge that pregnancy alters the PWBC by promoting immune tolerance, cell chemotaxis, blood coagulation, angiogenesis, inflammatory response, cell adhesion and cytokine secretion. Our data suggest that pregnancy and ectoparasites could trigger poorly described genes in PWBC of cows, and a few previously escribed genes, such as IFI44. These results could shed light on the genes and mechanisms that promote tolerance to pregnancy and allow survival of the developing embryo.
Income sources, intrahousehold allocation and individual poverty
Authors: Bargain Olivier
Published: May 2023

Policies aimed at redistributing to the most vulnerable individuals must consider inequality within households as much as between households. In that spirit, many cash transfers are targeted at women rather than men. Tax legislations can also contain specific gender provisions that treat men and women differently. Whether these policies operate some intrahousehold redistribution, or are defeated by the household agency problem, is an open question. This paper provides new insights by adapting models of intrahousehold allocation to account for women's and men's net‐of‐tax earnings and targeted benefits as determinants of the household resource sharing function. We suggest applications using household expenditure data for Argentina and South Africa. Net‐of‐tax earnings and benefits commanded by women are often positively related to their and their children's resources. We provide counterfactual simulations to illustrate how women's financial power – and its sources – may modify their consumption share and thus their individual poverty status.
Viral hepatitis is associated with increased risk of decompensated cirrhosis or liver failure in patients positive for liver cytosol antibody type 1
Authors: Wang Rong , Jing Keying , Liu Yang , Zhao Huijuan , Cai Jun
Published: May 2023

Liver cytosol antibody type 1 (anti‐LC1) is reported to be a marker of type 2 autoimmune hepatitis (AIH), a type of autoimmune liver disease (AILD). However, anti‐LC1 is not entirely disease‐specific, and its clinical value in other hepatic diseases has not been well elucidated. Our study aimed to explore the associations between the diagnoses and outcome of decompensated cirrhosis or liver failure (DC/LF) in patients positive for anti‐LC1. A total of 157 patients positive for anti‐LC1 were included in our final analysis. DC/LF was defined as the outcome of patients positive for anti‐LC1. The risk of DC/LF according to diagnosis was estimated using multivariable Cox proportional hazards models, while stratified Cox regression models were used in the subgroup analyses. The diagnoses of patients positive for anti‐LC1 were found to be comprised of various liver disorders. Versus other diagnoses, viral hepatitis was associated with a 2.25‐fold increased risk of DC/LF in these patients, independent of sex, age, disease course, treatment and drinking history. Additionally, the associations were more significant by subgroup analysis in male patients, younger patients, non‐newly diagnosed patients, patients without treatment and patients without drinking history. Anti‐LC1 is not a disease‐specific antibody, as it was found in multiple types of hepatic disease. Furthermore, viral hepatitis rather than AILD was associated with an increased risk of DC/LF in patients positive for anti‐LC1. These findings emphasize the important role of viral hepatitis in the progression of DC/LF in patients positive for anti‐LC1.