bluuebunny/crossref_metadata_2025 huggingface dataset:
Does pre‐school developmental assessment agree with later intellectual assessment? A retrospective cohort study
Authors: Karyadiguna Nugroho , Bernie Charmaine , Barnes Elizabeth H , Williams Katrina , Lo Bee Hong
Published: May 2023

Aim

This study sought to assess the association between early developmental assessment of toddlers with idiopathic global developmental delay (GDD) and their later intelligence test scores.

Methods

Toddlers with idiopathic GDD attending a community clinic over a 6‐year period were assessed initially using the Griffiths Mental Development Scales – Extended Revised version (GMDS‐ER) and later completing formal intelligence testing using the Stanford‐Binet Intelligence Scale – 5th Edition (SB5) at age 4–6 years. Spearman's correlation was used to assess the association of quotient scores across the tools. The composite quotient (GQ) and the subscale quotients of GMDS‐ER were correlated with the full‐scale IQ (FSIQ), verbal and non‐verbal IQ scores from the SB5.

Results

Thirty of 153 children assessed at the clinic were eligible for the study. The correlation between GMDS‐ER GQ and later SB5 FSIQ was strong (r = 0.86, P < 0.001). The subscales' associations were moderate to strong (0.48–0.71). Eighty‐six percent (86%) of children with delay on GMDS‐ER GQ were found later to be in the impaired category based on the FSIQ of the SB5.

Conclusion

There was a strong association between toddlers' early developmental quotients and later IQ scores for children with idiopathic GDD, though agreement between early GDD diagnoses and later intellectual disability is not absolute. Individualised care is needed around prognostic advice and recommendations to caregivers and families in the early years, so they may effectively plan for interventions, supports and later reassessment to optimise their child's development and learning.
Relationship between perceived and measured body size among Pacific 14‐year‐olds in Aotearoa|New Zealand: Findings from the Pacific Islands Families Study
Authors: Lousich Katrina L , Tautolo El‐Shadan , Schluter Philip J
Published: May 2023

Aim

Pacific people carry a disproportionate burden of socio‐cultural and economic determinants of health in Aotearoa | New Zealand (NZ), and 61.7% of Pacific children aged 0–14 years are overweight or obese. Yet Pacific children's self‐perception of their body size is unknown. This population‐based study aimed to investigate the concordance between measured and perceived body size in a cohort of Pacific 14‐year‐olds in NZ, and to assess how this relationship is influenced by their cultural orientation, socio‐economic deprivation and degree of recreational internet use.

Methods

The Pacific Islands Families Study tracks a cohort of Pacific infants born in the year 2000 at Middlemore Hospital, South Auckland. This study is a nested cross‐section of participants at the 14‐year postpartum measurement wave. Following strict measurement protocols, body mass index was measured and categorised according to the World Health Organization classifications. Agreement and logistic regression analysis methods were employed.

Results

Of 834 participants with valid measures, 3 (0.4%) were measured as being underweight, 183 (21.9%) as normal, 235 (28.2%) as overweight and 413 (49.5%) as obese. Overall, 499 (59.8%) perceived their body size to have a lower classification than that when measured. Neither cultural orientation nor deprivation was significantly related to weight misconception but recreational internet use was, with higher use associated with increased misconception.

Conclusions

Improving body size awareness together with the risk of higher recreational internet use is likely to be an important component in any population‐based healthy weight intervention formulation for Pacific adolescents.
Fractional excretion of electrolytes and neutrophil gelatinase‐associated lipocalin as early biomarkers of acute kidney injury in dogs with acute pancreatitis
Authors: Gori E. , Dondi F. , Lippi I. , Monari E. , Pierini A. , Marchetti V.
Published: May 2023

Objectives

To determine if fractional excretion of urinary electrolytes and neutrophil gelatinase‐associated lipocalin could detect different degrees of kidney injury in dogs with naturally occurring acute pancreatitis.

Materials and Methods

We included dogs with acute pancreatitis. Dogs with a history of kidney disease, urinary tract infection, dogs which received potentially nephrotoxic drugs and dogs managed with haemodialysis were excluded. Acute kidney injury was diagnosed if there was an acute onset of clinical signs, haemato‐chemical results compatible with acute kidney injury. Students or staff‐owned dogs were selected to build the healthy group.

Results

The study population was composed of 53 dogs: acute pancreatitis with AKI (n=15), acute pancreatitis alone (n=23), and healthy dogs (n=15). In dogs with acute pancreatitis and AKI, all the FEs of urine electrolytes were significantly higher than dogs with acute pancreatitis alone and healthy ones. Dogs with acute pancreatitis alone had higher uNGAL/uCr than healthy dogs (median 54 ng/mg vs. 0.1 ng/mg) and lower compared to AP‐AKI patients (54 ng/mg vs 209 ng/mg).

Clinical Significance

Some fractional excretion of electrolytes are increased acute kidney injury dogs, however their role in the early detection of renal injury in acute pancreatitis dogs remains doubtful. On the contrary, urinary neutrophil gelatinase‐associated lipocalin had higher concentrations in dogs with acute pancreatitis with or without acute kidney injury compared to healthy controls, suggesting that it may be used as an early marker of renal tubular damage in acute pancreatitis dogs.
Agglutination and hemolytic crossmatching to determine transfusion reaction differences between large and small breed goats
Authors: Kretsch Cileah M. , Alonso Flavio H. , Buktenica Maggie , Heller Meera C.
Published: May 2023

Background

Blood transfusions are performed frequently in goats, but crossmatches are rarely performed.

Hypothesis/Objectives

Determine differences in the frequency of agglutination and hemolytic crossmatch reactions between large and small breed goats.

Animals

Healthy adult goats, 10 large and 10 small breed.

Methods

Two hundred eighty major and minor agglutination and hemolytic crossmatches: 90 large breed donor to large breed recipient (L‐L), 90 small breed donor to small breed recipient (S‐S), 100 large breed donor to small breed recipient (L‐S). A linear mixed model with treatment group (L‐L, S‐S, L‐S) as a fixed effect and individual crossmatch as a random effect was used to identify variations in reaction frequency among groups and individuals.

Results

Frequency of major agglutination reactions for L‐L, S‐S, and L‐S were 3/90 (3.3%), 7/90 (7.8%), and 10/100 (10.0%), respectively. Frequency of major hemolytic reactions for L‐L, S‐S, and L‐S were 27/84 (32.1%), 7/72 (9.7%), and 31/71 (43.7%). Individual pairings and groupings had no effect on agglutination reactions. Individual pairings had no effect on the frequency of hemolytic reactions. For major hemolytic crossmatches, pairwise comparisons identified higher frequencies of reactions when comparing L‐L to S‐S (P = .007) and L‐S to S‐S (P < .001).

Conclusion and Clinical Importance

Goats experience increased frequencies of hemolytic reactions compared to agglutination. Significant increases in hemolysis were seen between large breed donors and small breed recipients, compared to small breed pairings. Additional studies are required to determine correlations between crossmatches and transfusion reactions.
Prognosis of primary pulmonary adenocarcinoma after surgical resection in small‐breed dogs: 52 cases (2005‐2021)
Authors: Ichimata Masanao , Kagawa Yumiko , Namiki Keita , Toshima Atsushi , Nakano Yuko , Matsuyama Fukiko , Fukazawa Eri , Harada Kei , Katayama Ryuzo , Kobayashi Tetsuya
Published: May 2023

Background

Tumor size is an important prognostic factor in lung cancer in dogs, and the canine lung carcinoma stage classification (CLCSC) recently has been proposed to subdivide tumor sizes. It is unclear if the same classification scheme can be used for small‐breed dogs.

Objectives

To investigate whether the tumor size classification of CLCS is prognostic for survival and progression outcomes in small‐breed dogs with surgically resected pulmonary adenocarcinomas (PACs).

Animals

Fifty‐two client‐owned small‐breed dogs with PAC.

Methods

Single‐center retrospective cohort study conducted between 2005 and 2021. Medical records of dogs weighing <15 kg with surgically resected lung masses histologically diagnosed as PAC were examined.

Results

The numbers of dogs with tumor size ≤3 cm, >3 cm to ≤5 cm, >5 cm to ≤7 cm, or >7 cm were 15, 18, 14, and 5, respectively. The median progression‐free interval (PFI) and overall survival time (OST) were 754 and 716 days, respectively. In univariable analysis, clinical signs, lymph node metastasis, margin, and histologic grade were associated with PFI, and age, clinical signs, margin, and lymph node metastasis were associated with OST. Tumor size classification of CLCS was associated with PFI in all categories, and tumor size >7 cm was associated with OST. In multivariable analysis, tumor size >5 cm to ≤7 cm and margin were associated with PFI, and age was associated with OST.

Conclusions and Clinical Importance

The tumor size classification of CLCS would be an important prognostic factor in small‐breed dogs with surgically resected PACs.
The potential of sociolinguistic impact: Lessons from the first 50 years
Authors: Wolfram Walt
Published: May 2023

Along with its focus on foundational research, one of the enduring concerns of variationist sociolinguistics over the past half‐century has been a tradition of application and engagement. As research paradigms have developed in variation studies, so have traditions of engagement with issues of social and educational language equality. In the formative era of the field, the primary concern of engagement was one in which sociolinguists took a strong, united stance on language variation as simply ‘different’ rather than ‘deficient’. This stance has had a strong impact on language assessment in determining language normalcy in early child development and beyond. In the period of ‘proactive engagement’, sociolinguists aligned with technological development, producing sociolinguistic audiovisual materials, physical and digital museums, social media, and other venues for raising language awareness consonant with the age of digitisation. The current period of raciolinguistics examines more critical, systemic issues of colonialism and structural racism confronting the field, ranging from the significant under‐representation of minority scholars in sociolinguistics to confronting sociolinguistic inequality in institutions of higher learning where most sociolinguists reside. The essay further addresses the devaluation of engagement in the academic meritocracy, despite recent attempts to legitimise engaged research, arguing that engagement provides social meaning and personal gratification for the professional sociolinguist.
GmMFT: a potential step forward in soybean breeding for high oil and yield
Authors: Mukherjee Thiya , Tully Trish L. A. , Allen Doug K.
Published: May 2023

This article is a Commentary on Cai et al. (2023), 239: 905–919.
Telling a different story: Historiography, ethics, and possibility for nursing
Authors: Dillard‐Wright Jessica
Published: May 2023

With this paper, I will interrogate some of the implications of nursing's dominant historiography, the history written by and about nursing, and its implications for nursing ethics as a praxis, invoking feminist philosopher Donna Haraway's mantra that ‘it matters what stories make worlds, what worlds make stories.’ First, I will describe what I have come to understand as the nursing imaginary, a shared consciousness constructed both by nurses from within and by those outside the discipline from without. This imaginary is fashioned in part by the histories nursing produces about the discipline, our historical ontology, which is demonstrative of our disciplinary values and the ethics we practice today. I assert that how we choose to constitute ourselves as a discipline is itself an ethical endeavour, bound up with how we choose to be and what we allow as knowledge in nursing. To animate this discussion, I will outline the received historiography of nursing and dwell in the possibilities of thinking about Kaiserswerth, the training school that prepared Nightingale for her exploits in Crimea and beyond. I will briefly consider the normative values that arise from this received history and consider the possibilities that these normative values foreclose upon. I then shift the frame and ask what might be possible if we centred Kaiserswerth's contested legacy as a training school for formerly incarcerated women, letting go of the sanitary and sanitised visions of nursing as Victorian angels in the hospital. Much energy over the past 250 years has been invested in the professionalisation and legitimation of nursing, predicated (at least in our shared imaginary) on the interventions of Florence Nightingale, but this is one possibility of many. I conclude with a speculative dream of the terrain opens up for nursing if we shed this politics and ethos of respectability and professionalism and instead embrace community, abolition and mutual aid as organising values for the discipline.
Effect of different types of exercise on fitness in people with multiple sclerosis: A network meta‐analysis
Authors: Reina‐Gutiérrez Sara , Meseguer‐Henarejos Ana Belén , Torres‐Costoso Ana , Álvarez‐Bueno Celia , Cavero‐Redondo Iván , Núñez de Arenas‐Arroyo Sergio , Guzmán‐Pavón María José , Sánchez‐López Mairena , Martínez‐Vizcaíno Vicente
Published: May 2023

Background

It is assumed that people with multiple sclerosis (MS) who participate in programs of physical exercise improve their physical fitness.

Objective

The aim of this network meta‐analysis (NMA) was to analyze the effect of different types of exercise on muscular fitness and cardiorespiratory fitness (CRF) among people with MS and to determine the best type of exercise according to disease severity.

Methods

MEDLINE, the Physiotherapy Evidence Database, the Cochrane Library, SPORTDiscus, Scopus, and Web of Science were searched from inception to April 2022 to identify randomized controlled trials (RCTs) concerning the effect of physical exercise on fitness in people with MS. We ranked the types of physical exercise by calculating the surface under the cumulative ranking (SUCRA).

Results

We included 72 RCTs involving 2543 MS patients in this NMA. A ranking of five types of physical exercise (aerobic, resistance, combined [aerobic and resistance], sensorimotor training, and mind–body exercises) was achieved. Combined and resistance training had the highest effect sizes (0.94, 95% CI 0.47, 1.41, and 0.93, 95% CI 0.57, 1.29, respectively) and the highest SUCRA (86.2% and 87.0%, respectively) for muscular fitness. The highest effect size (0.66, 95% CI 0.34, 0.99) and SUCRA (86.9%) for CRF was for aerobic exercise.

Conclusions

Combined and resistance training seem to be the most effective exercises to improve muscular fitness and aerobic exercise for CRF in people with MS.
Piebaldism with café‐au‐lait macules resulting from a novel mutation of KIT gene in a three‐generation Chinese family
Authors: Li Xiaorong , Xing Xiaojing , Liang Xiaoqiang , Song Cuihao , Yang Jie , Ren Dan , Zhou Yong
Published: May 2023

Background

Piebaldism is a rare, autosomal dominant, and congenital pigmentary disorder characterized by stable depigmentation of the skin and white forelock. Mutations in KIT or SLUG genes result in piebaldism. Most individuals with piebaldism have a family history of the disorder.

Methods

In this paper, we report a case of piebaldism with café‐au‐lait macules resulting from a novel mutation of KIT gene c.1982C > T (p.Thr661Ile) in a three‐generation Chinese family. The whole‐exome sequencing, mitochondrial gene 3000X, and bioinformatics tools were used to identify the mutation in this new‐found pedigree. In addition, we searched the databases of “Punmed, Chinese National Knowledge Infrastructure, CMJD, WANFANG MED ONLINE”, reviewed 88 cases of piebaldism caused by KIT gene mutation, and summarized the relationship between clinical phenotype and genotype of piebaldism through logistic regression and other statistical methods.

Results

The proband and her affected mother carried a heterozygous c.1982C > T missense mutation (p.Thr661Ile) on KIT gene. Bioinformatics analysis hinted that it had potential pathogenicity. The data showed that piebaldism patients with cafè‐au‐lait macules had KIT mutations almost located in the intracellular tyrosine kinase domain and were mostly related to the severe clinical phenotype of piebaldism.

Conclusion

The new heterozygous c.1982C > T missense mutation on KIT caused piebaldism with café‐au‐lait macules in this Chinese family. This study provides a new reference index for clinicians to judge the severity of clinical phenotypes of piebaldism, broadens the understanding of the correlation between clinical phenotypes and genotypes of piebaldism, and provides reference of genetic counseling and prenatal diagnosis for affected families.
A novel optical coherence tomography‐based in vitro method of anti‐aging skin analysis using 3D skin wrinkle mimics
Authors: Min Daejin , Ahn Yujin , Lee Hae Kwang , Jung Woonggyu , Kim Hyoung‐June
Published: May 2023

Background

Wrinkles represent a characteristic symptom of skin aging. In recent years, various studies have focused on their prevention and/or cure. However, clinical tests are still the only method available to directly detect and evaluate the anti‐wrinkle efficacy of various substances. Moreover, no in vitro strategy for such anti‐aging skin analysis has been reported. Therefore, in this study, we aimed to develop a novel technology to overcome these limitations.

Materials and methods

Full‐thickness (FT) skin wrinkle mimics with various widths and depths were fabricated using a collagen stamping method. These were analyzed and compared using 2D and 3D Swept Source‐Optical Coherence Tomography (SS‐OCT) imaging technologies.

Results

SS‐OCT demonstrated superficial and cross‐sectional images of the wrinkle mimics, and the size of the wrinkles was validated using image analysis. Retinoic acid treatment significantly decreased both the depth and width of wrinkles formed in the FT skin wrinkle mimics.

Conclusions

Using 3D tissue engineering and SS‐OCT imaging technologies, we developed a novel in vitro technique that can directly detect skin wrinkles. This significantly efficient method could lead to an alternative strategy for animal experiments and preclinical anti‐aging research on the skin.
Low Overpotential Electroreduction of CO2 on Porous SnO2/ZnO Catalysts
Authors: Sun Qi , Liu Jianqi , Zhou Bo , Liu Yanping , Tang Yang , Wan Pingyu , Hu Qing , Yang Xiao Jin
Published: May 2023

SnO2-based materials are promising catalysts for CO2 electrochemical reduction due to their attractive selectivity for C1 products (formate and carbon monoxide) but they tend to suffer high overpotential and poor stability. Here, a porous SnO2/ZnO catalyst is synthesized via hydroxides coprecipitation, hydrothermal treatment, and carbon black template calcination. SnO2 nanocrystals are produced by calcination of tin hydroxides while the growth of ZnO nanocrystals is associated with carbon black template. The porous SnO2/ZnO catalyst presents a stable Faradaic efficiency of >90% for CO2 reduction at an applied voltage of −0.7 V versus reversible hydrogen electrode and a C1 current density of 9.53 mA/cm2 over a testing period of 100 h. The improved performance is originated from abundant hetero-junctions and lattice defects of SnO2 and ZnO nanocrystals, large specific surface area, and grain boundary. This study provides a facile method to fabricate porous and nanocrystal metal oxides electrocatalysts for electrochemical processes.
Study on the Bending Behaviors of a Novel Flexible Re-Entrant Honeycomb
Authors: Zhou Yang , Pan Yi , Chen Lin , Gao Qiang , Sun Beibei
Published: May 2023

In order to further improve the bending performance of the traditional re-entrant (RE) honeycomb, a novel auxetic honeycomb architecture, called RE-L honeycomb, was proposed by adding an additional link-wall structure to the RE cell. The bending behaviors of the novel RE-L honeycomb, including the properties under linear elastic deformation and the bending behaviors under large deformation, were comprehensively investigated by the analytical, numerical, and experimental models. Results show that the proposed RE-L honeycomb significantly improves the bending compliance in the x-direction due to the highly flexible performance of the additional structure, where the bending rigidity and the maximum bending force are only 23% and 29.4% of those of the RE honeycomb, respectively. Besides, the additional structure obviously improves the designability and orthotropic properties of the original auxetic honeycomb. In conclusion, the proposed RE-L shows improved bending performance, which deserves more attention in future research and related applications.
Ectocytosis renders T cell receptor signaling self-limiting at the immune synapse
Authors: Stinchcombe Jane C. , Asano Yukako , Kaufman Christopher J. G. , Böhlig Kristin , Peddie Christopher J. , Collinson Lucy M. , Nadler André , Griffiths Gillian M.
Published: May 2023

Cytotoxic T lymphocytes (CTLs) kill virus-infected and cancer cells through T cell receptor (TCR) recognition. How CTLs terminate signaling and disengage to allow serial killing has remained a mystery. TCR activation triggers membrane specialization within the immune synapse, including the production of diacylglycerol (DAG), a lipid that can induce negative membrane curvature. We found that activated TCRs were shed into DAG-enriched ectosomes at the immune synapse rather than internalized through endocytosis, suggesting that DAG may contribute to the outward budding required for ectocytosis. Budding ectosomes were endocytosed directly by target cells, thereby terminating TCR signaling and simultaneously disengaging the CTL from the target cell to allow serial killing. Thus, ectocytosis renders TCR signaling self-limiting.
On the genes, genealogies, and geographies of Quebec
Authors: Anderson-Trocmé Luke , Nelson Dominic , Zabad Shadi , Diaz-Papkovich Alex , Kryukov Ivan , Baya Nikolas , Touvier Mathilde , Jeffery Ben , Dina Christian , Vézina Hélène , Kelleher Jerome , Gravel Simon
Published: May 2023

Population genetic models only provide coarse representations of real-world ancestry. We used a pedigree compiled from 4 million parish records and genotype data from 2276 French and 20,451 French Canadian individuals to finely model and trace French Canadian ancestry through space and time. The loss of ancestral French population structure and the appearance of spatial and regional structure highlights a wide range of population expansion models. Geographic features shaped migrations, and we find enrichments for migration, genetic, and genealogical relatedness patterns within river networks across regions of Quebec. Finally, we provide a freely accessible simulated whole-genome sequence dataset with spatiotemporal metadata for 1,426,749 individuals reflecting intricate French Canadian population structure. Such realistic population-scale simulations provide opportunities to investigate population genetics at an unprecedented resolution.
Implementation, compliance, and pandemic legal obligations
Authors: Eccleston-Turner Mark , Burci Gian-Luca , Liberman Jonathan , Sekalala Sharifah
Published: May 2023

Negotiations ought not focus on enforcement and sanctions
In Other Journals
Authors: Vignieri Sacha , Jiang Di , Stern Peter , Grocholski Brent , Szuromi Phil , Uzogara Ekeoma , Lavine Marc S.
Published: May 2023

Editors’ selections from the current scientific literature
New antibodies that the coronavirus can’t elude
Authors: Service Robert F.
Published: May 2023

Researchers aim to make monoclonal antibodies that mutations in SARS-CoV-2 won’t thwart
Complete Genome Sequence of “
Candidatus
Phytoplasma asteris” QS2022, a Plant Pathogen Associated with Lettuce Chlorotic Leaf Rot Disease in China
Authors: Yan Xiao-Hua , Lin Jixiu , Liu Yanzhi , Huang Peizhi , Liu Jianmi , Hu Qibin , Li Yalu , Pei Shen-Chian , Huang Weijie , Kuo Chih-Horng
Published: May 2023

The complete genome sequence of “
Candidatus
Phytoplasma asteris” QS2022, which consists of one 834,303-bp circular chromosome, is presented in this work. This bacterium is associated with lettuce chlorotic leaf rot disease in Fujian Province, China.
Systematic Microbiome Dysbiosis Is Associated with IgA Nephropathy
Authors: Cai Fengtao , Zhou Chenfen , Jiao Na , Liang Xinling , Ye Zhiming , Chen Wei , Yang Qiongqiong , Peng Hui , Tang Ying , Niu Chaoqun , Zhao Guoping , Wang Zefeng , Zhang Guoqing , Yu Xueqing
Published: May 2023

This study provides microbial profiles of IgAN across multiple niches and underlines the potential of these biomarkers as promising, noninvasive tools with which to differentiate IgAN patients for clinical applications.
Socioeconomic inequalities in interval colorectal cancer are explained by differences in faecal haemoglobin concentration and age: a register-based cohort study
Authors: Deding Ulrik , Kobaek-Larsen Morten , Bøggild Henrik , Kaalby Lasse , Thygesen Marianne Kirstine , Baatrup Gunnar
Published: May 2023

Objective

To estimate the risk of interval colorectal cancer (CRC) in faecal immunochemical test (FIT) negative screening participants according to socioeconomic status.

Design

In this register-based study, first round FIT negative (<20 µg hb/g faeces) screening participants (biennial FIT, citizens aged 50–74) were followed to estimate interval CRC risk. Multivariate Cox proportional hazard regression models estimated HRs based on socioeconomic status defined by educational level and income. Models were adjusted for age, sex and FIT concentration.

Results

We identified 829 (0.7‰) interval CRC in 1 160 902 individuals. Interval CRC was more common in lower socioeconomic strata with 0.7‰ for medium-long higher education compared with 1.0‰ for elementary school and 0.4‰ in the highest income quartile compared with 1.2‰ in the lowest. These differences did not translate into significant differences in HR in the multivariate analysis, as they were explained by FIT concentration and age. HR for interval CRC was 7.09 (95% CI) for FIT concentrations 11.9–19.8 µg hb/g faeces, and 3.37 (95% CI) for FIT between 7.2 and 11.8 compared with those <7.2. The HR rose with increasing age ranging from 2.06 (95% CI 1.45 to 2.93) to 7.60 (95% CI 5.63 to 10.25) compared with those under 55 years.

Conclusion

Interval CRC risk increased with decreasing income, heavily influenced by lower income individuals more often being older and having increased FIT concentrations. Individualising screening interval based on age and FIT result, may decrease interval CRC rates, reduce the social gradient and thereby increase the screening efficiency.
Prevention of COVID-19 with oral vitamin D supplemental therapy in essential healthcare teams (PROTECT): protocol for a multicentre, triple-blind, randomised, placebo-controlled trial
Authors: Ducharme Francine Monique , Tremblay Cécile , Golchi Shirin , Hosseini Banafsheh , Longo Cristina , White John H , Coviello Decio , Quach Caroline , Ste-Marie Louis-Georges , Platt Robert W
Published: May 2023

Introduction

In the COVID-19 pandemic, healthcare workers (HCWs) were at high risk of infection due to their exposure to COVID infections. HCWs were the backbone of our healthcare response to this pandemic; every HCW withdrawn or lost due to infection had a substantial impact on our capacity to deliver care. Primary prevention was a key approach to reduce infection. Vitamin D insufficiency is highly prevalent in Canadians and worldwide. Vitamin D supplementation has been shown to significantly decrease the risk of respiratory infections. Whether this risk reduction would apply to COVID-19 infections remained to be determined. This study aimed to determine the impact of high-dose vitamin D supplementation on incidence of laboratory-confirmed COVID-19 infection rate and severity in HCWs working in high COVID incidence areas.

Methods and analysis

PROTECT was a triple-blind, placebo-controlled, parallel-group multicentre trial of vitamin D supplementation in HCWs. Participants were randomly allocated in a 1:1 ratio in variable block size to intervention (one oral loading dose of 100 000 IU vitamin D3+10 000 IU weekly vitamin D3) or control (identical placebo loading dose+weekly placebo). The primary outcome was the incidence of laboratory-confirmed COVID-19 infection, documented by RT-qPCR on salivary (or nasopharyngeal) specimens obtained for screening or diagnostic purposes, as well as self-obtained salivary specimens and COVID-19 seroconversion at endpoint. Secondary outcomes included disease severity; duration of COVID-19-related symptoms; COVID-19 seroconversion documented at endpoint; duration of work absenteeism; duration of unemployment support; and adverse health events. The trial was terminated prematurely, due to recruitment difficulty.

Ethics and dissemination

This study involves human participants and was approved by the Research Ethics Board (REB) of the Centre hospitalier universitaire (CHU) Sainte-Justine serving as central committee for participating institutions (#MP-21-2021-3044). Participants provided written informed consent to participate in the study before taking part. Results are being disseminated to the medical community via national/international conferences and publications in peer-reviewed journals.

Trial registration number

https://clinicaltrials.gov/ct2/show/NCT04483635.
Continuous palliative sedation in terminally ill patients with cancer: a retrospective observational cohort study from a Chinese palliative care unit
Authors: Tan Fang , Chen Shan , Huang Lan , Chen Yang , Wu Yan
Published: May 2023

Objective

This study aimed to describe a 4-year practice of continuous palliative sedation (CPS) in a palliative medicine ward of an academic hospital in China. To compare the survival time of patients with cancer with and without CPS during end-of-life care, we used the propensity score matching method and explored potential patient-related factors.

Design

A retrospective observational cohort study.

Setting

The palliative ward at a tertiary teaching hospital between January 2018 and 10 May 2022, in Chengdu, Sichuan, China.

Participants

The palliative care unit had 1445 deaths. We excluded 283 patients who were sedated on admission due to mechanical ventilation or non-invasive ventilators, 122 patients who were sedated due to epilepsy and sleep disorders, 69 patients without cancer, 26 patients who were younger than 18 years, 435 patients with end-of-life intervention when the patients’ vital signs were unstable and 5 patients with unavailable medical records. Finally, we included 505 patients with cancer who met our requirements.

Main outcome measures

The survival time and analysis of sedation potential factors between the two groups were compared.

Results

The total prevalence of CPS was 39.7%. Patients who were sedated more commonly experienced delirium, dyspnoea, refractory existential or psychological distress, and pain. After propensity score matching, the median survival was 10 (IQR: 5–17.75) and 9 days (IQR: 4–16) with and without CPS, respectively. After matching, the two survival curves of the sedated and non-sedated groups were no different (HR 0.82; 95% CI 0.64 to 0.84; log-rank p=0.10).

Conclusions

Developing countries also practise palliative sedation. Median survival was not different between patients who were and were not sedated.
Visual identifiers for people with dementia in hospitals: a qualitative study to unravel mechanisms of action for improving quality of care
Authors: Sutton Elizabeth , Armstrong Natalie , Locock Louise , Conroy Simon , Tarrant Carolyn
Published: May 2023

Background

Hospitalised people with dementia (PwD) experience worse care and more patient safety incidents than non-dementia patients. Visual identifiers are commonly used to identify patients who have a diagnosis of dementia, with the aim of promoting more personalised care. However, little is known about how they work in practice, nor about the potential unintended consequences that might arise from their use. We aim to identify the mechanisms through which visual identifiers could support good care for PwD, how and why their use may have negative consequences and the conditions for their effective use.

Methods

We conducted interviews with 21 dementia leads and healthcare professionals, 19 carers and two PwD, and produced case studies of visual identification systems in four UK acute hospital trusts between 2019 and 2021. Analysis drew on the concept of classification to identify and explore mechanisms of action.

Results

We identified four mechanisms through which visual identifiers could help towards providing good care for PwD: enabling coordination of care at organisational level; signalling eligibility for dementia-specific interventions; informing prioritisation of resources on wards; and acting as a quick reference cue for staff. But identifier effectiveness could be undermined by: lack of standardisation and consistency; a lack of closely coupled information about individual needs; and stigma associated with a dementia diagnosis. Identifier effectiveness was dependent on their implementation being supported through staff training, resources directed and efforts to develop a supportive culture for caring for this patient group.

Conclusion

Our research highlights the potential mechanisms of action of visual identifiers and their possible negative consequences. Optimising the use of identifiers requires consensus on the rules of classification and the symbols used, and closely coupled patient information. Organisations need to provide support, offer the right resources and training and engage meaningfully with carers and patients about the use of identifiers.
Establishing key performance indicators for inflammatory bowel disease in the UK
Authors: Quraishi Mohammed Nabil , Dobson Elizabeth , Ainley Rachel , Din Shahida , Wakeman Ruth , Cummings Fraser , Sebastian Shaji , Bloom Stuart , Limdi Jimmy K , Dhar Anjan , Speight R Alexander , Bodger Keith , Kennedy Nicholas A ,   BSG IBD Section members, Lamb Christopher A , Arnott Ian D , Selinger Christian P
Published: May 2023

Background and aims

Healthcare quality improvement (QI) is the systematic process to continuously improve the quality of care and outcomes for patients. The landmark Inflammatory Bowel Disease (IBD) UK National Audits provided a means to measure the variation in care, highlighting the need to define the standards of excellence in IBD care. Through a consensus approach, we aimed to establish key performance indicators (KPIs), providing reliable benchmarks for IBD care delivery in UK.

Methods

KPIs that measure critical aspects of a patient journey within an IBD service were identified though stakeholder meetings. A two-stage Delphi consensus was then conducted. The first involved a multidisciplinary team of IBD clinicians and patients to refine definitions and methodology. The second stage assessed feasibility and utility of the proposed QI process by surveying gastroenterology services across UK.

Results

First, the four proposed KPIs were refined and included time from primary care referral to diagnosis in secondary care, time to treatment recommendation following a diagnosis, appropriate use of steroids and advanced therapies prescreening and assessment. Second, the Delphi consensus reported >85% agreement on the feasibility of local adoption of the QI process and >75% agreement on the utility of benchmarking of the KPIs.

Conclusions

Through a structured approach, we propose quantifiable KPIs for benchmarking to improve and reduce the individual variation in IBD care across the UK.
Magnetic resonance analysis of ventricular volumes in bicuspid and trileaflet aortic regurgitation
Authors: Sevilla Teresa , Rojas Gino , González-Bartol Esther , Candela Jordi , Gil José Francisco , Revilla Ana , Aristizabal-Duque Cristhian , Gomez Salvador Itziar , San Román Calvar José Alberto
Published: May 2023

Objective

To identify differences in left ventricular (LV) remodelling between patients with bicuspid aortic valve (BAV) and trileaflet aortic valve (TAV) with chronic aortic regurgitation (AR).

Methods

Retrospective cohort study of 210 consecutive patients undergoing cardiac magnetic resonance for AR evaluation. We divided the study population according to valvular morphology. Independent predictors of LV enlargement AR were evaluated.

Results

There were 110 patients with BAV and 100 patients with TAV. Patients with BAV were younger (mean age BAV vs TAV: 41±16 years vs 67±11 years; p<0.01), mostly male (% male BAV vs TAV: 84.5% vs 65%, p=0.01) and presented milder degrees of AR (median regurgitant fraction BAV vs TAV: 14 (6–28)% vs 22 (12–35)%, p=0.002). Both groups presented similar indexed LV volumes and ejection fraction. According to the degree of AR, at mild AR, patients with BAV presented larger LV volumes (BAV vs TAV: indexed end diastolic left ventricular volumes (iEDV): 96.5±19.7 vs 82.1±19.3 mL, p<0.01; indexed end systolic left ventricular volumes (iESV): 39.4±10.3 mL vs 33.2±10.5 mL, p=0.01). These differences disappeared at higher degrees of AR. Independent predictors of LV enlargement were regurgitant fraction (EDV: OR 1.118 (1.081–1.156), p<0.001; ESV: OR 1.067 (1.042–1.092), p<0.001), age (EDV: OR 0.940 (0.917–0.964), p<0.001, ESV: OR 0.962 (0.945-0.979), p<0.001) and weight (EDV: OR 1.054 (1.025–1.083), p<0.001).

Conclusions

In chronic AR, LV enlargement is an early finding. LV volumes display a direct correlation with regurgitant fraction and an inverse association with age. Patients with BAV present larger ventricular volumes, especially at mild AR. However, these differences are attributable to demographic disparities; valve type is not independently associated with LV size.
Pipeline embolization device versus Atlas stent assisted coiling for intracranial aneurysm treatment: a retrospective, propensity score matched study with a focus on midterm outcomes and hospital costs
Authors: Wang Chao , Dong Linggen , Liu Jian , Zhang Yisen , Wang Kun , Liu Peng , Yang Xinjian , Lv Ming , Zhang Ying
Published: May 2023

Background

Stent assisted coiling (SAC) and flow diverters (FDs) are common endovascular treatments for wide necked cerebral aneurysms, but studies comparing the new generation Atlas SAC and FDs are scarce. We performed a propensity score matched (PSM) cohort study to compare the Atlas SAC and the pipeline embolization device (PED) for proximal internal carotid artery (ICA) aneurysms.

Methods

Consecutive ICA aneurysms treated at our institution with either the Atlas SAC or PED were studied. PSM was used to control for age, sex, smoking, hypertension, and hyperlipidemia, and the rupture status, maximal diameter, and neck size of the aneurysm (aneurysms >15 mm and non-saccular aneurysms were excluded). Midterm outcomes and hospital costs were compared between these two devices.

Results

A total of 309 patients with 316 ICA aneurysms were included. Following PSM, 178 aneurysms treated with the Atlas SAC and PED were matched (n=89 in each group). Aneurysms treated with the Atlas SAC required a slightly longer procedure time, but had lower hospital costs than those treated with the PED (115.2±24.6 vs 102.4±40.8 min, P=0.012; $27 650.2±$6961.4 vs $34 107.0±$3707.2, P<0.001). Atlas SAC and PED treatments showed equivalent aneurysm occlusion rates (89.9% vs 86.5%, P=0.486), complication rates (5.6% vs 11.2%, P=0.177), and a favorable functional outcome (96.6% vs 97.8%, P=1.0) at follow-up (8.2±3.0 vs 8.4±4.2 months, P=0.652).

Conclusion

In this PSM study, midterm outcomes of the PED and Atlas SAC in the treatment of ICA aneurysms were similar. However, SAC required a longer operation time, and the PED may increase the economic cost of inpatients in Beijing, China.
Testicular germ cell tumour risk by occupation and industry: a French case–control study – TESTIS
Authors: Guth Margot , Coste Astrid , Lefevre Marie , Deygas Floriane , Danjou Aurélie , Ahmadi Shukrullah , Dananché Brigitte , Pérol Olivia , Boyle Helen , Schüz Joachim , Bujan Louis , Metzler-Guillemain Catherine , Giscard d’Estaing Sandrine , Teletin Marius , Ducrocq Berengere , Frapsauce Cynthia , Olsson Ann , Charbotel Barbara , Fervers Béatrice
Published: May 2023

Objective

Testicular germ cell tumours (TGCT) are the most common cancer in men of working age and its incidence has increased notably over the past 40 years. Several occupations have been identified as potentially associated with TGCT risk. The aim of this study was to further explore the relationship between occupations, industries and TGCT risk in men aged 18–45 years.

Methods

The TESTIS study is a multicenter case–control study conducted between January 2015 and April 2018 in 20 of 23 university hospital centers in metropolitan France. A total of 454 TGCT cases and 670 controls were included. Full job histories were collected. Occupations were coded according to the International Standard Classification of Occupation 1968 version (ISCO-1968) and industry according to the 1999 version of Nomenclature d’Activités Française (NAF-1999). For each job held, ORs and 95% CIs were estimated using conditional logistic regression.

Results

A positive association was observed between TGCT and occupation as agricultural, animal husbandry worker (ISCO: 6–2; OR 1.71; 95% CI (1.02 to 2.82)), as well as salesman (ISCO: 4–51; OR 1.84; 95% CI (1.20 to 2.82)). An increased risk was further observed among electrical fitters and related, electrical and electronics workers employed for 2 years or more (ISCO: 8–5; OR≥2 years1.83; 95% CI (1.01 to 3.32)). Analyses by industry supported these findings.

Conclusions

Our findings suggest that agricultural, electrical and electronics workers, and salesmen workers experience an increased risk of TGCT. Further research is needed to identify the agents or chemicals in these high-risk occupations which are relevant in the TGCT development.

Trial registration number

NCT02109926.
Impact of asthma on working life: an analysis of the French CONSTANCES cohort
Authors: Provost Dorothée , Delmas Marie-Christine , Bénézet Laetitia , Ribet Céline , Chesneau Julie , Raherison Chantal , Goldberg Marcel , Dumas Orianne , Le Moual Nicole , Iwatsubo Yuriko
Published: May 2023

Objectives

Asthma has significant occupational consequences. The objective of our study was to investigate the links between asthma and the career path, taking into account gender and age at asthma onset.

Methods

Using cross-sectional data collected at inclusion in the French CONSTANCES cohort in 2013–2014, we studied the links between each career path indicator (number of job periods, total duration of employment, numbers of part-time jobs and work interruptions due to unemployment or health issues, employment status at inclusion) on the one hand, and current asthma and asthma symptom score in the last 12 months on the other hand, as reported by the participants. Multivariate analyses were performed separately for men and women using logistic and negative binomial regression models adjusted for age, smoking status, body mass index and educational level.

Results

When the asthma symptom score was used, significant associations were observed with all of the career path indicators studied: a high symptom score was associated with a shorter total duration of employment as well as a greater number of job periods, part-time jobs and work interruptions due to unemployment or health issues. These associations were of similar magnitude in men and women. When current asthma was used, the associations were more pronounced in women for some career path indicators.

Conclusion

The career path of asthmatic adults is more often unfavourable than that of those without asthma. Efforts should be made to support people with asthma in the workplace, in order to maintain employment and facilitate the return to work.
Electroweak phase transition in a dark sector with CP violation
Authors: Biermann Lisa , Mühlleitner Margarete , Müller Jonas
Published: May 2023

In this paper, we investigate the possibility of a strong first-order electroweak phase transition (SFOEWPT) in the model ‘CP in the Dark’. The Higgs sector of the model consists of two scalar doublets and one scalar singlet with a specific discrete symmetry. After spontaneous symmetry breaking the model has a Standard-Model-like phenomenology and a hidden scalar sector with a viable Dark Matter candidate supplemented by explicit CP violation that solely occurs in the hidden sector. The model ‘CP in the Dark’ has been implemented in the C++ code which performs a global minimisation of the finite-temperature one-loop corrected effective potential and searches for SFOEWPTs. An SFOEWPT is found to be allowed in a broad range of the parameter space. Furthermore, there are parameter scenarios where spontaneous CP violation is generated at finite temperature. The in addition spontaneously broken $${\mathbb {Z}}_2$$

Z
2

symmetry then leads to mixing between the dark and the visible sector so that CP violation in the dark is promoted at finite temperature to the visible sector and thereby provides additional sources of CP violation that are not restricted by the electric dipole moment measurements at zero temperature. Thus, ‘CP in the Dark’ provides a promising candidate for the generation of the baryon asymmetry of the universe through electroweak baryogenesis.
New chemical and mineralogical data on mosaics from the South aisle wall of Monreale Cathedral (Italy)
Authors: Coccato Alessia , Caggiani Maria Cristina , Finocchiaro Claudio , Fugazzotto Maura , Lanzafame Gabriele , Mazzoleni Paolo , Nucatolo Girolamo , Occhipinti Roberta , Starinieri Silvia , Stroscio Antonio , Barone Germana
Published: May 2023

Due to the surprising lack of knowledge concerning raw materials and production technology employed to make mosaics after the twelfth century, an archaeometric investigation was carried out on the materials constituting the mosaic decoration of the South aisle wall of Monreale Cathedral (Italy), taking advantage of a conservation intervention. In this work, fallen coloured or gilded glass tesserae to be repositioned were studied by means of a combination of a molecular technique (Raman spectroscopy) and an elemental one (portable X-ray Fluorescence, pXRF); also, efflorescences affecting the general conservation state and samples of the respective bedding mortar were analysed with the former technique and with X-ray diffraction (XRD). The raw materials used and, consequently, the different compositions characterizing gilded vs. coloured glass tesserae were highlighted with the vibrational spectroscopy; chromophores and trace elements were detected by pXRF. This complementary approach allowed to disclose clues about glass-manufacturing technique and raw materials. The nature of the salts was also ascertained through Raman spectroscopy and XRD, for the benefit of the conservation procedure, and connected to the mortars’ composition.