bluuebunny/crossref_metadata_2025 huggingface dataset:
In‐vivo high‐frequency quantitative ultrasound‐derived parameters of the anterior sclera correlated with level of myopia and presence of staphyloma
Authors: Hoerig Cameron , Hoang Quan V. , Mamou Jonathan
Published: July 2024

Background

A high‐frequency point‐of‐care (POC) ultrasound instrument was used to evaluate the microstructural and biomechanical properties of the anterior sclera in vivo using parameters computed from quantitative ultrasound (QUS) methods.

Methods

In this cross‐sectional study, both eyes of 85 enrolled patients were scanned with the POC instrument and ultrasound data were processed to obtain QUS parameters. Pearson correlation and multi‐linear regression were used to identify relationships between QUS parameters and refractive error (RE) or axial length. After categorising eyes based on RE, binary support vector machine (SVM) classifiers were trained using the QUS or ophthalmic parameters (anterior chamber depth, central corneal thickness, corneal power, and intraocular pressure) to classify each eye. Classifier performance was evaluated by computing the area under the receiver‐operating characteristic curve (AUC).

Results

Individual QUS parameters correlated with RE and axial length (p < 0.05). Multi‐linear regression revealed significant correlation between the set of QUS parameters and both RE (R = 0.49, p < 0.001) and axial length (R = 0.46, p = 0.001). Classifiers trained with QUS parameters achieved higher AUC (𝑝 = 0.06) for identifying myopic eyes (AUC = 0.71) compared to classifiers trained with ophthalmic parameters (AUC = 0.63). QUS‐based classifiers attained the highest AUC when identifying highly myopic eyes (AUC = 0.77).

Conclusions

QUS parameters correlate with progressing myopia and may be indicative of myopia‐induced microstructural and biomechanical changes in the anterior sclera. These methods may provide critical clinical information complementary to standard ophthalmic measurements for predicting myopia progression and risk assessment for posterior staphyloma formation.
Urinary polycyclic aromatic hydrocarbons and adult obesity among the US population: NHANES 2003–2016
Authors: Mallah Manthar Ali , Hill Jennifer W. , Neupane Bidusha , Ahmad Muhammad Zia , Ali Mukhtiar , Bibi Jannat , Akhtar Muhammad Furqan , Naveed Muhammad , Zhang Qiao
Published: July 2024

Polycyclic aromatic hydrocarbons (PAHs) are naturally occurring environmental pollutants that may contribute to obesity in the adult population. To investigate the relationship between the urinary concentrations of PAH metabolites and adult obesity among the US population, the National Health and Nutritional Examination Survey (NHANES, 2003–2016) was used as a data source for this study. As many as 4464 participants in the NHANES 2003–2016 were included in the final analyses. We used logistic regression to look at the link between urinary PAH metabolites and obesity, using odds ratios (ORs) and 95% confidence intervals (CIs). The study sample comprised 4464 individuals aged ≥18 years, 2199 were male and 2265 were female. The study characteristics for four different quartiles were analyzed, and the average ages of the four urinary PAH quartiles were 49.61 ± 20.01, 46.63 ± 20.33, 44.28 ± 19.19, and 43.27 ± 17.68 years, respectively. In the quartile analysis of all participants, the third quartile was significantly associated with an increased prevalence of obesity (OR = 1.33, 95% CI = 1.12–1.59) with p‐values <.05. In addition, females, but not males, had a strong link between the second, third, and fourth quartiles of urinary PAH and a higher risk of obesity (OR = 1.27, 95% CI = 1.00–1.61; OR = 1.52, 95% CI = 1.19–1.94; and OR = 1.39, 95% CI = 1.09–1.78). In conclusion, the study observed that urinary PAH metabolites were associated with the prevalence of obesity among the US population.
Chronological and Geographical Variations in the Incidence and Acceptance of COVID‐19–Positive Donors and Outcomes Among Abdominal Transplant Patients
Authors: Yang Jason , Endo Yutaka , Sasaki Kazunari , Schenk Austin , Pawlik Timothy M.
Published: July 2024

Introduction

Given the importance of understanding COVID‐19–positive donor incidence and acceptance, we characterize chronological and geographic variations in COVID‐19 incidence relative to COVID‐19–positive donor acceptance.

Methods

Data on deceased donors and recipients of liver and kidney transplants were obtained from the UNOS database between 2020 and 2023. Hierarchical cluster analysis was used to assess trends in COVID‐19–positive donor incidence. Posttransplant graft and patient survival were assessed using Kaplan–Meier curves.

Results

From among 38 429 deceased donors, 1517 were COVID‐19 positive. Fewer kidneys (72.4% vs. 76.5%, p < 0.001) and livers (56.4% vs. 62.0%, p < 0.001) were used from COVID‐19–positive donors versus COVID‐19–negative donors. Areas characterized by steadily increased COVID‐19 donor incidence exhibit the highest transplantation acceptance rates (92.33%), followed by intermediate (84.62%) and rapidly increased (80.00%) COVID‐19 incidence areas (p = 0.016). Posttransplant graft and patient survival was comparable among recipients, irrespective of donor COVID‐19 status.

Conclusions

Regions experiencing heightened rates of COVID‐19–positive donors are associated with decreased acceptance of liver and kidney transplantation. Similar graft and patient survival is noted among recipients, irrespective of donor COVID‐19 status. These findings emphasize the need for adaptive practices and unified medical consensus in navigating a dynamic pandemic.
Continental‐scale identification and prioritisation of potential refugee species; a case study for rodents in Australia
Authors: Smith Kiarrah J. , Pierson Jennifer C. , Evans Maldwyn J. , Gordon Iain J. , Manning Adrian D.
Published: July 2024

A species is expected to be most resilient to environmental change when it occurs across a broad diversity of habitats. However, there is often no visual representation of the past (i.e. prehistoric and historical) context for a species in the range maps published by national and global authorities. Therefore, it is easy to overlook the fact that many species once occupied a broader geographic range, or greater diversity of habitats. Such oversights hinder the effective conservation of species that have become restricted to a subset of their formerly occupied habitats. Here, we quantified the shifted baseline that may underpin some of the ecological misconceptions about species, and developed a rapid assessment method to aid the identification and prioritisation of ‘potential refugee species' (i.e. species that have become restricted to a subset of their formerly occupied niche). The assessment of potential refugee status is different from, but complementary to, the International Union for Conservation of Nature (IUCN) Red List and Green Status frameworks. Our framework defines a continuum of potential refugee status, which was demonstratable in continent‐scale maps drawn from biogeographic regionalisation. Applying this framework to all native rodent species across the continent of Australia (a group that has suffered several extinctions and notable declines), we found that the risk of ecological misconceptions caused by shifted baselines (i.e. resulting from ‘shifting baseline syndrome') was prevalent. This suggests that in many cases, translocation opportunities that might be avoided because they are perceived as conservation introductions (as defined by the IUCN translocation guidelines), may in fact fall within the indigenous range, and should therefore be considered reasonable reintroductions. Ultimately, our potential refugee assessment framework will help to facilitate the undertaking of ambitious translocations that will build species' resilience to environmental change by resuming their adaptation to habitats across all formerly occupied bioregions.
Aberrant early hematopoietic progenitor formation marks the onset of hematopoietic defects in Shwachman–Diamond syndrome
Authors: Lagos‐Monzon Alejandra , Ng Stephanie , Luca Alice M. , Li Hongbing , Sabanayagam Mathura , Benicio Mariana , Moshiri Houtan , Armstrong Richard , Tailor Chetan , Kennedy Marion , Grunebaum Eyal , Keller Gordon , Dror Yigal
Published: July 2024

Shwachman–Diamond syndrome (SDS) is an inherited bone marrow failure disorder that often presents at infancy. Progress has been made in revealing causal mutated genes (SBDS and others), ribosome defects, and hematopoietic aberrations in SDS. However, the mechanism underlying the hematopoietic failure remained unknown, and treatment options are limited. Herein, we investigated the onset of SDS embryonic hematopoietic impairments. We generated SDS and control human‐derived induced pluripotent stem cells (iPSCs). SDS iPSCs recapitulated the SDS hematological phenotype. Detailed stepwise evaluation of definitive hematopoiesis revealed defects that started at the early emerging hematopoietic progenitor (EHP) stage after mesoderm and hemogenic endothelium were normally induced. Hematopoietic potential of EHPs was markedly reduced, and the introduction of SBDS in SDS iPSCs improved colony formation. Transcriptome analysis revealed reduced expression of ribosome and oxidative phosphorylation‐related genes in undifferentiated and differentiated iPSCs. However, certain pathways (e.g., DNA replication) and genes (e.g., CHCHD2) were exclusively or more severely dysregulated in EHPs compared with earlier and later stages. To our knowledge, this study offers for the first time an insight into the embryonic onset of human hematopoietic defects in an inherited bone marrow failure syndrome and reveals cellular and molecular aberrations at critical stages of hematopoietic development toward EHPs.
The generality problem of perception
Authors: Zahnoun Farid , Roccioletti Luca , Myin Erik
Published: July 2024

Much of contemporary philosophy of perception revolves around the question of whether perceptual experience has representational content. On one side of the debate, we find representationalists claiming that perceptual experience is representational in that it always presents the world as being a certain way. Perceptual experience is therefore said to have content, which can be evaluated for truth or accuracy. Against the idea that perception has content, relationalists have leveled an argument based on the generality of content, which we shall here refer to as the generality problem of perception (GPP). We will analyze and assess existing replies to the GPP. Based on these analyses, we will conclude that representationalists have as yet not offered a convincing answer to the problem and that, after almost 20 years, the problem still stands.
Physically based modelling of orientation deviation effect on mechanical behavior for dual‐phase single‐crystal superalloy
Authors: Yin Qian , Li Ming , Wen Zhixun , Gong Xiufang , Wang Jundong , Li Fei , Sun Wei , Yue Zhufeng
Published: July 2024

This work systematically investigates the orientation deviation effect on the elastoplastic deformation of a dual‐phase, nickel‐based single‐crystal superalloy through a combined experimental study and crystal plasticity finite element modelling method (CPFEM). Physically based, dual‐phase microstructural model was developed based on scanning electron microscopy (SEM), which was implemented by finite element (FE) modelling using a representative volume element (RVE) with periodic boundary conditions. An extended equivalent yield criterion coupled with CPFEM was adopted to describe the non‐uniform yield behavior induced by octahedral and cubic slip systems. The predicted results have shown that both the bulk behavior and localized stress–strain nature are orientation deviation dependent and that the first Euler angle plays a more important role in elastoplastic behavior than the second Euler angle. This study has thus advanced the basic understanding of the relationship between orientation deviation and the bulk deformation behavior of the dual‐phase nickel‐based single crystal.
Effect of stocking on brown trout angling catch rates in the Czech Republic during 1996–2018
Authors: Šlapanský Luděk , Janáč Michal , Jurajda Pavel
Published: July 2024

When investigating potential causes of apparent declines in European brown trout angling catch rates over recent decades, fisheries management procedures are rarely considered. Using a 20‐year dataset of brown trout stocking and angling catch rates, we found a significant decline in brown trout angling catch rates in streams of East Bohemia, Czechia, were well predicted by a reduction in the number of brown trout stocked at catchable size (i.e. age‐3+). Increased stocking of smaller sized brown trout, and recent sporadic efforts to stock large brown trout, had no effect on catch rates. Our findings suggest that brown trout catch rates were related to ‘put‐and‐take’ stocking, in which non‐native rainbow trout gradually replaced brown trout in both stocking and catches. Our study stresses the importance of considering historical fisheries management, a sometimes‐neglected factor, when studying angling catches of economically important species.
Resisting silence and stigma: Mothering and sex work
Authors: McGarry Kathryn , Kondrataitė Irma
Published: July 2024

This article will critically explore differing representations of sex work and motherhood linked to competing ideological perspectives on sex work from the perspective that frames it as the definitive transgression of gendered norms, to that which calls out the lack of necessary support and protections for sex workers. Central to this will be the foregrounding of evidence from sex workers' own management of subjective identities and their narratives of working and mothering, which resist stigma and shame.
Connecting art, maintenance, and motherhood: How Ukeles's maintenance art shapes understandings of maintenance
Authors: Gulari Nil , Dziuba Anna , Huopalainen Astrid
Published: July 2024

This paper proposes an alternative feminist understanding of maintenance by investigating the artistic practices and lived experiences of feminist artist Mierle Laderman Ukeles (b. 1939). Our main theoretical and empirical focus lies on maintenance, and we show how art and motherhood as productive connection points proffer different ways of perceiving, understanding, and practicing maintenance. By contextualizing our case within the historical backdrop of New York between the late 1960s and 1980s, we demonstrate how Ukeles's maintenance art proposes novel ways of perceiving the value of maintenance, from the maintenance performed by mothers to considerations of the broader societal implications of maintenance. Such alternative political understanding aligns with critiques of postfeminist societal discourse. We contend that Ukeles's art inspires a political shift in our thinking about maintenance, where maintenance is valued not solely for its indispensable and utilitarian attributes but also it's relational, emotional, and embodied qualities. This nuanced understanding requests visibility for maintenance and foregrounds “more‐than‐I,” agency, and continuity of life, thereby acknowledging the inherent value of the political dimensions of maintenance.
‘Sometimes You Have No Choice but to Give Them Medication’: Experiences of Nurses Caring for People With Auditory Hallucinations in an Acute Unit
Authors: McCluskey Anita , Watson Chanel , Nugent Linda , O'Connor Tom , Moore Zena , Molloy Luke , Patton Declan
Published: July 2024

The aim of this study was to explore psychiatric nurse's experiences of caring for people with auditory hallucinations in an acute unit. A qualitative study was conducted using thematic analysis. The study involved semi‐structured interviews with 18 acute unit nurses all of whom provided interventions to patients with auditory hallucinations. Overall, participants identified their role in the management of risk within an acute unit, the importance of their therapeutic role and a perceived over‐reliance on medication administration as a primary nursing intervention. These findings thus demonstrate the personal and professional conflict that nurses face when working in an acute unit with patients who experience auditory hallucinations. Nurses are in a prime position to provide effective interventions and assistance for people with auditory hallucinations in an acute unit. The findings of this study indicate that mental health nurses may require additional support and education to provide care in a truly recovery‐based manner, with training in specific interventions and engagement skills for people who hear voices. Due to an unpredictable environment and sometimes high‐risk workplace, nurses may also benefit from organisational assistance in this area.
Ultraviolet‐B Stress Increases Epidermal UV‐Screening Effectiveness and Alters Growth and Cell‐Wall Constituents of the Brown Midrib bmr6 and bmr12 Mutants of Sorghum bicolor
Authors: Olson Desirea R. , Ruhland Christopher T.
Published: July 2024

The brown midrib bmr6 and bmr12 mutants of sorghum (Sorghum bicolor) have alterations to the phenylpropanoid pathway impairing the activity of cinnamyl alcohol dehydrogenase (CAD) and/or caffeate5/hydroxyferulate O‐methyl transferase (COMT) enzymes, which inhibit lignin synthesis. Interestingly, these phenylpropanoids can also act as sunscreen compounds in plants and potentially attenuate ultraviolet radiation. We examined the effects of ultraviolet‐B (UV‐B; 280–320 nm) exclusion on growth, cell‐wall constituents and UV‐screening abilities of bmr6, bmr12, a double mutant (bmr6 bmr12; dm) and wild‐type (WT) genotypes of S. bicolor. Plants were grown in a UV‐transparent greenhouse under filters that either transmitted 2.8% (Mylar) or 90% (Aclar) of UV‐B. The greenhouse experiment was a 2 × 4 (UV treatment × genotype) complete factorial design. Sorghum grown under reduced UV were 23% taller and had 22% fewer leaves. Among genotypes, the WT plants were 5%–12% taller than the bmr6, bmr12 and dm mutants. The near‐ambient UV‐B treatment group was more effective at UV screening and had a 16% higher UV‐screening effectiveness than those under reduced UV‐B. Sorghum plants with the bmr6 and dm genotypes had 8%–19% higher UV‐shield than the bmr12 and WT. Plants grown under the reduced UV‐B treatment had 5% less hemicellulose and 6% more cellulose in their cell walls. There were no overall treatment effects on bulk soluble phenolics, chlorophyll fluorescence (Fv/Fm) or lignin concentrations. These results are a possible indication that the bmr mutants of S. bicolor have a varied response to UV‐B exclusion due to alterations in the phenylpropanoid pathway leading to redistribution of metabolites.
Association of the Life's Essential 8 cardiovascular health score with periodontitis among US adults
Authors: Liang Lang , Chen Chia‐Yu , Aris Izzuddin M.
Published: July 2024

Aim

To investigate whether cardiovascular health (CVH) is associated with periodontitis.

Materials and Methods

We used data from the 2009 to 2014 National Health and Nutrition Examination Survey. We quantified CVH using Life's Essential 8, which includes four health behaviours (diet, smoking, physical activity and sleep) and four health factors (body mass index, blood cholesterol, glucose and pressure). We categorized scores as low (0–49), moderate (50–79) and high (80–100). We calculated subscores of health behaviours and factors and categorized them as low, moderate and high. We used logistic regression to assess the association of CVH with periodontitis, adjusting for age, gender, race/ethnicity, education, poverty index, marital status and health insurance. We computed odds ratios (ORs) and 95% confidence intervals (CIs).

Results

This study included 9296 adults ≥30 years old. Multivariable‐adjusted models showed that subjects with moderate (OR, 0.62; 95% CI: 0.52–0.74) or high (OR, 0.43; 95% CI: 0.33–0.57) CVH had significantly lower odds of periodontitis compared to those with low CVH. These results were consistent in the health behaviours model, but the estimates in the health factors model were not significant.

Conclusions

Improving CVH may help prevent periodontitis. Longitudinal studies are needed to confirm our findings.
Consistencies in the dietary and isotopic niche of spotted seatrout, Cynoscion nebulosus, across a salinity gradient within a coastal Louisiana estuary
Authors: MacRae Pamela S. D. , Russell Micah , Cowan James H. , Fry Brian , Moyo Sydney , Polito Michael J.
Published: July 2024

Estuaries are essential habitats for recreational and commercial fish that are shaped by both natural and anthropogenic processes. In Louisiana a combination of climate change and planned coastal restoration actions is predicted to increase freshwater introduction to coastal estuaries. As such there is a need to quantify the relationships between estuarine fish ecology and salinity to aid in predicting how species will respond to shifts in salinity. We investigated the relative abundance and dietary niches of adult (24.5 ± 5.4 cm standard length) spotted seatrout Cynoscion nebulosus across varying salinity regimes (oligohaline, mesohaline, and polyhaline) within Barataria Bay, Louisiana, using a combination of net sampling and gut content and stable isotopes analysis. We found that the relative abundance of C. nebulosus was lowest at the oligohaline site, translating to approximately five fewer fish captured for every single psu decrease in a site's average annual salinity. In contrast, we found that diets and, to a lesser extent, isotopic niches had a high degree of overlap across sites with differing salinity regimes. Fish and penaeid shrimp were the most common and important prey taxa recovered from guts at all sites. The small isotopic differences found among sites were likely due to spatial variation in hydrogeochemical baselines, and the observed isotopic overlap provides support for the idea that C. nebulosus move between adjacent salinity regimes and forage throughout Barataria Bay. Our results contribute to a greater understanding of the salinity preference and trophic ecology of C. nebulosus that can aid in predicting their responses to future salinity and habitat changes within Barataria Bay associated with predicted climate change and planned coastal restoration actions.
Current and future patterns of vascular plant species richness across a forest–grassland–desert transect in East Asia
Authors: Li Binghe , Du Enzai
Published: July 2024

Questions

Rapid climate change has profoundly altered the spatial distribution of terrestrial plants especially in arid and semi‐arid biomes. However, it remains poorly documented how climate shapes the current and future patterns of plant diversity within and across these vulnerable vegetation types.

Location

Parts of Mongolia, southeastern Russia, and northern China (94.78°–126.78°E, 34.60°–54.27°N).

Methods

Using a random forest model trained by a comprehensively compiled database on vascular plant species richness (i.e., the number of species within a defined plot area) and corresponding climate variables, soil conditions and vegetation types (forest, grassland, desert), we assessed the current pattern of vascular plant species richness across a typical forest–grassland–desert transect in East Asia. We further predicted future changes in vascular plant species richness under three climate scenarios (SSP1‐2.6, SSP3‐7.0, and SSP5‐8.5).

Results

Vascular plant species richness generally showed a decrease from northeast to southwest across the transect, mainly explained by spatial variations in growing‐season precipitation and the minimum temperature of the coldest month. More than half of the transect area will likely experience a loss in vascular plant species richness in 2041–2070 under all three scenarios. The decrease in vascular plant species richness will likely occur in a smaller area under the low‐emission scenario (SSP1‐2.6). We also predict distinct changes in vascular plant species richness for different vegetation types, including a slight increase in forests but an overall decrease in both grasslands and deserts.

Conclusions

Our findings suggest a dominant role of growing‐season precipitation in shaping the spatiotemporal patterns of vascular plant species richness across the forest–grassland–desert transect and highlight a risk of plant diversity loss in the regional dryland ecosystems in response to future climate change.
Literature and second language vocabulary learning: The role of text type and teaching approach
Authors: Graham Suzanne , Zhang Pengchong , Hofweber Julia , Fisher Linda , Krüsemann Heike
Published: July 2024

This study considers the relative benefits for vocabulary learning of exposure to two types of texts—literary or nonliterary—used with two teaching approaches. These approaches were termed functional and creative, respectively. In the former, learners’ attention was drawn to factual information and linguistic features in order to develop their linguistic knowledge. In the latter, the aim was to stimulate learners’ personal and emotional response, by drawing their attention to the text's emotional content and how language was used to express meaning. We analyzed data from 160 learners of French in eight schools in England. Learners in four schools studied French poems and those in another four studied French factual texts. Teachers in each text condition employed functional and creative methods of exploitation within a counterbalanced design. We assessed two types of vocabulary knowledge at pre‐ and posttest: meaning recall of vocabulary contained in the texts, and learners’ general vocabulary size. Our results indicated learning gains across both text types. There were, however, important interactions between text type and teaching approach and between text type and the order in which the teaching approaches were used. Finally, we consider the implications of these findings for understanding of vocabulary learning through literature and for classroom practice.
Automatic soft‐tissue analysis on orthodontic frontal and lateral facial photographs based on deep learning
Authors: Chang Qiao , Bai Yuxing , Wang Shaofeng , Wang Fan , Wang Yajie , Zuo Feifei , Xie Xianju
Published: July 2024

Background

To establish the automatic soft‐tissue analysis model based on deep learning that performs landmark detection and measurement calculations on orthodontic facial photographs to achieve a more comprehensive quantitative evaluation of soft tissues.

Methods

A total of 578 frontal photographs and 450 lateral photographs of orthodontic patients were collected to construct datasets. All images were manually annotated by two orthodontists with 43 frontal‐image landmarks and 17 lateral‐image landmarks. Automatic landmark detection models were established, which consisted of a high‐resolution network, a feature fusion module based on depthwise separable convolution, and a prediction model based on pixel shuffle. Ten measurements for frontal images and eight measurements for lateral images were defined. Test sets were used to evaluate the model performance, respectively. The mean radial error of landmarks and measurement error were calculated and statistically analysed to evaluate their reliability.

Results

The mean radial error was 14.44 ± 17.20 pixels for the landmarks in the frontal images and 13.48 ± 17.12 pixels for the landmarks in the lateral images. There was no statistically significant difference between the model prediction and manual annotation measurements except for the mid facial‐lower facial height index. A total of 14 measurements had a high consistency.

Conclusion

Based on deep learning, we established automatic soft‐tissue analysis models for orthodontic facial photographs that can automatically detect 43 frontal‐image landmarks and 17 lateral‐image landmarks while performing comprehensive soft‐tissue measurements. The models can assist orthodontists in efficient and accurate quantitative soft‐tissue evaluation for clinical application.
Clinical and laboratory characteristics of salivary gland ultrasonography‐positive patients with primary Sjögren's syndrome
Authors: Yang Yan , Cheng Lian , Qin Ai‐Ping , Xu Jun
Published: July 2024

Objective

This study aimed to investigate the clinical and laboratory characteristics of salivary gland ultrasonography (SGUS)‐positive patients with primary Sjögren's syndrome (pSS) compared to SGUS‐negative patients and to analyse the diagnostic value of SGUS and labial salivary gland biopsy (LSGB) grading in pSS.

Methods

A retrospective analysis of patients admitted to the Affiliated Hospital of Yangzhou University between May 2019 and November 2023 was conducted. According to the OMERACT scoring system, patients with pSS were divided into an SGUS‐negative group (score <2) and an SGUS‐positive group (score ≥2). The patient's age, gender, clinical symptoms, laboratory parameters and diagnostic examinations were compared and analysed, and Spearman correlation analysis was used to analyse the correlation between SGUS, LSGB and influencing factors.

Results

There was no significant difference in dry mouth, dry eyes, tooth loss, fever, joint pain, fatigue, interstitial lung disease or renal tubular acidosis between the two groups, although there were more patients with salivary gland enlargement in the SGUS‐positive group (p < 0.05). In terms of high levels of immunoglobulin G (IgG), high levels of rheumatoid factor (RF), anti‐nuclear antibody ≥1:320, anti‐Sjögren's syndrome A‐52KD and anti‐Sjögren's syndrome B, the number of cases in the SGUS‐positive group was greater than that in the SGUS‐negative group (p < 0.05). LSGB samples were graded per the Chisholm–Mason system with significant differences between multiple groups. SGUS score negatively correlated with age and positively correlated with LSGB grade.

Conclusion

This study showed that the SGUS score positively correlated with LSGB grade in pSS patients and negatively correlated with patient age. Thus, SGUS and LSGB are consistent in the diagnosis of pSS to reflect the degree of salivary gland involvement, and patients who are SGUS positive have high RF and IgG levels, a variety of autoantibodies positive and a tendency toward salivary gland enlargement.
Disparities in the implantation of secondary prevention implantable cardioverter defibrillator in the United States
Authors: Maraey Ahmed , Yazdi Vahid , Chaaban Nourhan , Aglan Amro , Elzanaty Ahmed , Moustafa Abdelmoniem , Karim Saima , He Beixin Julie
Published: July 2024

Background

The annual incidence of sudden cardiac death is over 300,000 in the United States (US). Historically, inpatient implantation of secondary prevention implantable cardioverter defibrillator (ICD) has been variable and subject to healthcare disparities.

Objective

To evaluate contemporary practice trends of inpatient secondary prevention ICD implants within the US on the basis of race, sex, and socioeconomic status (SES).

Methods

The study is a retrospective analysis of the National Inpatient Sample from 2016 to 2020 of adult discharges with a primary diagnosis of ventricular tachycardia (VT), ventricular flutter, and fibrillation (VF). Adjusted ICD implantation rates based on race, sex, and SES and associated temporal trends were calculated using multivariate regression.

Results

A total of 193,600 primary VT/VF discharges in the NIS were included in the cohort, of which 57,895 (29.9%) had ICD placement. There was a significant racial and ethnic disparity in ICD placement for Black, Hispanic, Asian, and Native American patients as compared to White patients; adjusted odds ratio (aOR): 0.86 [p < .01], 0.90 [p  =  .03], 0.81[p < .01], 0.45 [p < .01], respectively. Female patients were also less likely to receive an ICD compared to male patients (aOR: 0.75, p < .01). Disparities in ICD placement remained stable over the study period (ptrend ≥ .05 in all races, both sexes and income categories).

Conclusion

Racial, sex, and SES disparities persisted for secondary prevention ICD implants in the US. An investigation into contributing factors and subsequent approaches are needed to address the modifiable causes of disparities in ICD implantation as these trends have not improved compared to historic data.
A case of restrictive dermopathy in a Hutterite newborn: Diagnosis and creative skin‐directed management
Authors: Grist Jesse , Green Rebecca , Lodha Abhay , Hunter Charlene , Lach Katherine , Phung Thuy , Perrier Renee , Ramien Michele
Published: July 2024

Restrictive dermopathy is a lethal autosomal recessive disease characterized by tightly adherent skin, distinctive facial dysmorphisms, arthrogryposis, and pulmonary hypoplasia. While clinical findings are unique, histopathology and genetic analysis are critical for early diagnostic confirmation and to initiate appropriate management for this lethal disease. We report on a preterm Hutterite male neonate with biallelic ZMPSTE24 mutations to highlight the clinical and histopathological features of restrictive dermopathy and share our skin‐directed management strategies.
Political censorship feels acceptable when ideas seem harmful and false
Authors: Kubin Emily , von Sikorski Christian , Gray Kurt
Published: July 2024

People seem willing to censor disagreeable political and moral ideas. Five studies explore why people engage in political censorship and test a potential route to decreasing censorship. While Americans report being generally supportive of free speech and against censorship (Study 1), we find that people censor material that seems harmful and false (Study 2), which are often ideas from political opponents (Study 3). Building on work demonstrating the perceived truth of harmful experiences (i.e., experiences of victimization), we test an experience‐sharing intervention to reduce censorship. Among college students, the intervention indirectly decreased students' willingness to censor controversial campus speakers' ideas, through reducing beliefs that these speakers were sharing harmful and false ideas related to gun policy (Study 4). We also find benefits of sharing harmful experiences related to the abortion debate. Americans were less willing to censor and report the social media posts of opponents who base their views on experiences of victimization rather than scientific findings (Study 5).
How I treat: Coronavirus disease 2019 in leukemic patients and hematopoietic cell transplant recipients
Authors: Neofytos Dionysios , Khanna Nina
Published: July 2024

Among immunocompromised hosts, leukemia patients, and hematopoietic cell transplant recipients are particularly vulnerable, facing challenges in balancing coronavirus disease 2019 (COVID‐19) management with their underlying conditions. In this How I Treat article, we discuss how we approach severe acute respiratory syndrome coronavirus 2 infections in daily clinical practice, considering the existing body of literature and for topics where the available data are not sufficient to provide adequate guidance, we provide our opinion based on our clinical expertise and experience. Diagnostic approaches include nasopharyngeal swabs for polymerase chain reaction testing and chest computed tomography scans for symptomatic patients at risk of disease progression. Preventive measures involve strict infection control protocols and prioritizing vaccination for both patients and their families. Decisions regarding chemotherapy or hematopoietic cell transplantation in leukemia patients with COVID‐19 require careful consideration of factors such as COVID‐19 severity and treatment urgency. Treatment protocols include early initiation of antiviral therapy, with nirmatrelvir/ritonavir or remdesivir. For cases of prolonged viral shedding, distinguishing between viable and non‐viable viruses remains challenging but is crucial for determining contagiousness and guiding management decisions. Overall, individualized approaches considering immune status, clinical presentation, and viral kinetics are essential for effectively managing COVID‐19 in leukemia patients.
Expired blood transfusion and mortality outcomes in combat trauma patients
Authors: Riley Brian C. , Phuong Jimmy , Hasan Rida A. , Stansbury Lynn G. , Hess John R. , Roubik Daniel J.
Published: July 2024

Background

Expired blood can be transfused if clinically indicated but outcome data do not exist. We hypothesized that modestly outdated blood can effectively support a hemorrhaging patient until surgical control is achieved. This study assessed whether expired blood was associated with mortality in combat trauma patients.

Study Design and Methods

A retrospective analysis of Armed Services Blood Program and Department of Defense Trauma Registry databases evaluated combat casualty records (2001–2023). The intervention of interest was transfusion of at least one unit of whole blood (WB), red blood cells (RBC), or platelets within one week past expiration. The outcome of interest was mortality at discharge. A control cohort that only received in‐date blood was matched to the treatment cohort for logistic regression analysis.

Results

One hundred patients received expired RBCs (86), WB (11), and platelets (3). Mortality at discharge was 11.6% for expired RBC recipients and 13.4% for the control cohort (p = .97). After adjustment for injury severity, expired RBCs were not associated with mortality (OR = 0.40 [95% CI, 0.14–1.16]; p = .09). Of 10 patients who received the most expired RBCs by volume or storage duration, two were deceased at discharge. All 14 expired WB and platelet recipients were alive at discharge, but sample sizes were underpowered for regression analysis.

Discussion

Transfusion of modestly outdated RBCs was not associated with mortality in combat trauma patients. Expired WB and platelet recipients did well, but sample sizes were too small to draw significant conclusions. Expired blood should be further investigated for possible use in extenuating circumstances.
E-Fuels as Reduced Carbon Emission Options
Authors: Huey Carolyn , Metghalchi Hameed , Levendis Yiannis
Published: July 2024

Synthetic “E-fuels,” or electro-fuels, have been introduced as a potential reduced carbon emissions energy source for power generation and vehicle propulsion applications. Environmental change is needed, with the transportation sector alone producing approximately a quarter of global greenhouse gas (GHG) emissions. Hydrogen, produced from electrolysis to avoid GHG production, is used along with CO2 or nitrogen to generate these electro-fuels, through the Fischer–Tropsch process. Direct air capture (DAC) of atmospheric carbon dioxide or biomass combustion effluents can provide sources for these gases to be combined with hydrogen to generate synthetic methanol, methane, or ammonia—the three most widely discussed E-fuels. In addition, “ER-fuels,” or electrically reformed fuels, are a similar option to E-fuels, where refinery fuel gases, such as ethane or propane, are reformed before synthesis to produce the final fuel. E-fuels, on the other hand, are generated from hydrogen and carbon either captured or produced, not from existing fuels. Redox couples, such as vanadium, can additionally be used as zero emission fuels; they are “electrically rechargeable” in that, through electrolysis, the reducing agent is produced, and then using a fuel cell (FC), the reverse occurs, and electrons plus the oxidizing agent are produced. These synthetic fuels are approximately carbon neutral when the hydrogen is sourced from renewable powered electrolysis, mainly solar and wind energy, as the amount of carbon dioxide consumed is roughly equivalent to the amount produced upon their combustion or FC energy conversion. Combustion in gas turbines or reciprocating piston-cylinder engines and FC electricity generation are the two main uses for extracting energy from E-fuels. Fuel cells are shown to have higher efficiency, but combustion provides fewer infrastructure changes and easier implementation. Both options provide a method for controlling carbon emissions using E-fuels as opportunities for energy storage.
Identification and measurement of intensive economic growth in a Roman imperial province
Authors: Ortman Scott G. , Lobo José , Lodwick Lisa , Wiseman Rob , Bulik Olivia , Harbison Victoria , Bettencourt Luís M. A.
Published: July 2024

A key question in economic history is the degree to which preindustrial economies could generate sustained increases in per capita productivity. Previous studies suggest that, in many preindustrial contexts, growth was primarily a consequence of agglomeration. Here, we examine evidence for three different socioeconomic rates that are available from the archaeological record for Roman Britain. We find that all three measures show increasing returns to scale with settlement population, with a common elasticity that is consistent with the expectation from settlement scaling theory. We also identify a pattern of increase in baseline rates, similar to that observed in contemporary societies, suggesting that this economy did generate modest levels of per capita productivity growth over a four-century period. Last, we suggest that the observed growth is attributable to changes in transportation costs and to institutions and technologies related to socioeconomic interchange. These findings reinforce the view that differences between ancient and contemporary economies are more a matter of degree than kind.
Decreasing global tropical cyclone frequency in CMIP6 historical simulations
Authors: Zhao Haikun , Zhao Kai , Klotzbach Philip J. , Chand Savin S. , Camargo Suzana J. , Cao Jian , Wu Liguang
Published: July 2024

The impact of anthropogenic global warming on tropical cyclone (TC) frequency remains a challenging issue, partly due to a relatively short period of reliable observational TC records and inconsistencies in climate model simulations. Using TC detection from 20 CMIP6 historical simulations, we show that the majority (75%) of these models show a decrease in global-scale TC frequency from 1850 to 2014. We demonstrated that this result is largely explained by weakened mid-tropospheric upward motion in CMIP6 models over the Pacific and Atlantic main development regions. The reduced upward motion is due to a zonal circulation adjustment and shifts in Intertropical Convergence Zone in response to global warming. In the South Indian Ocean, reduced TC frequency is mainly due to the decreased survival rate of TC seeds because of an increased saturation deficit in a warming climate. Our analysis highlights global warming’s potential impact on the historical decrease in global TC frequency.
Lifshitz transition enabling superconducting dome around a charge-order critical point
Authors: Hinlopen Roemer D. H. , Moulding Owen N. , Broad William R. , Buhot Jonathan , Bangma Femke , McCollam Alix , Ayres Jake , Sayers Charles J. , Da Como Enrico , Flicker Felix , van Wezel Jasper , Friedemann Sven
Published: July 2024

Superconductivity often emerges as a dome around a quantum critical point (QCP) where long-range order is suppressed to zero temperature, mostly in magnetically ordered materials. However, the emergence of superconductivity at charge-order QCPs remains shrouded in mystery, despite its relevance to high-temperature superconductors and other exotic phases of matter. Here, we present resistance measurements proving that a dome of superconductivity surrounds the putative charge-density-wave QCP in pristine samples of titanium diselenide tuned with hydrostatic pressure. In addition, our quantum oscillation measurements combined with electronic structure calculations show that superconductivity sets in precisely when large electron and hole pockets suddenly appear through an abrupt change of the Fermi surface topology, also known as a Lifshitz transition. Combined with the known repulsive interaction, this suggests that unconventional
s
±
superconductivity is mediated by charge-density-wave fluctuations in titanium diselenide. These results highlight the importance of the electronic ground state and charge fluctuations in enabling unconventional superconductivity.
IL-12 drives the differentiation of human T follicular regulatory cells
Authors: Castaño Diana , Wang Sidney , Atencio-Garcia Segovia , Shields Emily J. , Rico Maria C. , Sharpe Hannah , Bustamante Jacinta , Feng Allan , Le Coz Carole , Romberg Neil , Tobias John W. , Utz Paul J. , Henrickson Sarah E. , Casanova Jean-Laurent , Bonasio Roberto , Locci Michela
Published: July 2024

T follicular regulatory (T
fr
) cells can counteract the B cell helper activity of T follicular helper (T
fh
) cells and hinder the production of antibodies against self-antigens or allergens. A mechanistic understanding of the cytokines initiating the differentiation of human regulatory T (T
reg
) cells into T
fr
cells is still missing. Herein, we report that low doses of the pro-T
fh
cytokine interleukin-12 (IL-12) drive the induction of a T
fr
cell program on activated human T
reg
cells while also preserving their regulatory function. Mechanistically, we found that IL-12 led to STAT4 (signal transducer and activator of transcription 4) phosphorylation and binding to IL-12–driven follicular signature genes. Patients with inborn errors of immunity in the
IL12RB1
gene presented with a strong decrease in circulating T
fr
cells and produced higher levels of anti-actin autoantibodies in vivo. Overall, this study unveils IL-12 as an inducer of T
fr
cell differentiation in vivo and provides an approach for the in vitro generation of human T
fr
-like cells.
Management of a giant adrenal schwannoma
Authors: Viswanath Aditya , Dales Jolyon , Shah Vikas , Levy Miles
Published: July 2024

In this case report, we present a man in his 60s who presented with an incidentally discovered right adrenal mass, which turned out to be an adrenal schwannoma. This is a very rare tumour that originates from Schwann cells and involves the peripheral nerves. The tumour was removed by open adrenalectomy, and this 15-cm adrenal schwannoma is one of the largest reported in the literature, with none >16 cm having ever been reported. This case highlights the importance of keeping an open mind about the cause of an incidentally discovered adrenal mass, which is an increasingly common way for adrenal tumours to present given the increased access to cross-sectional imaging. As well as presenting the case and the pathological basis behind adrenal schwannomas, we include a review of the literature and a general discussion about incidentally discovered adrenal masses.
Devonian plutons in the eastern Meguma terrane, Nova Scotia, Canada: zircon U–Pb, Lu–Hf, and O isotopic compositions, age, and petrogenetic implications
Authors: Archibald Donnelly B. , Barr Sandra M. , White Chris E. , Nickerson Shae J. , Stern Richard A. , Luo Yan , Pearson Graham D.
Published: July 2024

Abundant granitic plutons intruded the eastern Meguma terrane of Nova Scotia in the middle- to late Devonian. Less voluminous diorite–tonalite and gabbro intrusions are associated with the granitic plutons along the northern margin of the terrane adjacent to the Cobequid–Chedabucto fault zone. All plutons contain metasedimentary xenoliths, and the mafic plutons show magma mingling textures with their adjacent granitic plutons. New U–Pb zircon data from autocrystic zircon in 13 samples indicate coeval emplacement of mafic and granitic plutons between ca. 382 and 368 Ma. However, the zircon grains contain numerous inherited domains that range in age from Palaeoproterozoic to Devonian. These inherited ages correspond to detrital zircon U–Pb dates from the Cambrian to Ordovician metasedimentary host rocks. Zircon oxygen isotopic data (δ18O) are between +7.4 ± 0.2‰ and +9.3 ± 0.3‰ indicating significant involvement of the crust as the magma source or contaminant. If the high δ18Ozrn values are a result of contamination, the contaminant was likely the metasedimentary rocks of the Meguma terrane. Hafnium isotopic data from autocrystic zircon have εHf( t) between −6.0 ± 1.5 and +2.1 ± 2.5. The new zircon U–Pb, O, and Hf isotopic data from plutons in the eastern Meguma terrane are indistinguishable from published data from the South Mountain Batholith. The data suggest that Devonian magmatism in the Meguma terrane post-dated the main orogenic event that caused folding and regional metamorphism and involved the same magma source and/or contaminants throughout the terrane.