bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of tinnitus in patients with Temporomandibular Disorders through Axis II of the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) and the Tinnitus Handicap Inventory (THI)
Authors: Minervini Giuseppe , Nucci Ludovica , Barillari Maria Rosaria , Rotolo Rossana Patricia , Grassia Vincenzo , d'Apuzzo Fabrizia
Published: March 2024

Background

Tinnitus is a quite common and bothersome disorder that results in a perceived sound or noise, without an external origin, often causing notable psychological distress. Some interconnections between tinnitus, bodily pain perception, and psychological well‐being were previously reported, thus the relationships between tinnitus and temporomandibular joint (TMJ)‐related muscle issues, resulting in somatosensory tinnitus, must be deeply investigated. This study aims to assess the prevalence of tinnitus in patients with temporomandibular disorders (TMD) and to examine the correlation between tinnitus and scales assessing the severity of TMD as well as psychological‐related parameters.

Materials and Methods

In this cross‐sectional study, a total of 37 adults with TMD symptoms were enrolled. Diagnostic data were collected using the Axis II of the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) and the Tinnitus Handicap Inventory (THI) questionnaire. Statistical analysis included descriptive assessments and significance was set at p < .05.

Results

Individuals with tinnitus and TMD reported a significantly higher number of body pain areas, indicating a link between tinnitus and increased bodily pain perception. Tinnitus did not significantly impact TMJ‐related functions. Significantly higher levels of psychological distress were observed in individuals with tinnitus, as evidenced by elevated scores in depression, generalised anxiety and somatic symptoms.

Conclusion

Tinnitus is a complex condition with significant effects on health and well‐being, requiring an interdisciplinary approach for effective evaluation and care. The study provides deep insights into the prevalence of tinnitus in TMD patients, underscoring the need for comprehensive treatment strategies addressing both TMD and tinnitus.
Clinical features and outcome of 10 dogs with suspected idiopathic vestibular epilepsy
Authors: Al Kafaji Tania , Tocco Fabio , Okonji Samuel , Gallucci Antonella
Published: March 2024

Background

In humans, vestibular epilepsy (VE) is described as focal seizures with transient signs of vestibular disease. In dogs, 2 cases of vestibular episodes, called vestibular paroxysmia, are reported.

Hypothesis/objectives

The objective of this study was to define the clinical features, phenotypical manifestation, and outcome of suspected VE in dogs.

Animals

Ten dogs with recurrent vestibular episodes.

Methods

Retrospective study. Medical records between 2009 and 2023 were reviewed, and dogs with a normal neurological examination, a history of transient signs of vestibular disease, absence of abnormalities detected on blood exams and brain magnetic resonance imaging (MRI) or computed tomography (CT), besides a minimum 10‐month follow‐up were included. Clinical improvement was defined as a ≥50% reduction in frequency or the cessation of clinical signs after the onset of antiseizure medications (ASMs).

Results

Pugs were the most prevalent breed (5/10; 50%). In 2 cases, additional generalized tonic‐clonic (GTC) seizures were reported. MRI exam was performed in most cases (9/10; 90%), whereas 1 dog underwent a CT scan (1/10; 10%). Electroencephalography (EEG) was carried out in 3 dogs that showed interictal spikes in the fronto‐temporal and fronto‐parietal areas. All cases received ASMs, with clinical improvement in 10/10 dogs (100%).

Conclusion and clinical importance

The presence of GTC seizures, EEG interictal spikes, and responsiveness to ASMs supported the hypothesis of an epileptic origin of vestibular episodes and thus the existence of VE in these dogs, with a presumed idiopathic cause and apparent favorable outcome.
Evaluating acidic gastroesophageal reflux with wireless pH monitoring in French bulldogs with sliding hiatal herniation
Authors: Ullal Tarini V. , Marks Stanley L. , Yang Nuen Tsang , Taylor Sandra L.
Published: March 2024

Background

Sliding hiatal herniation (SHH) and gastroesophageal reflux (GER) commonly occur in French bulldogs. Wireless pH monitoring can quantitatively assess acidic GER in dogs affected by SHH.

Hypothesis/Objectives

Measure acidic GER in French bulldogs with SHH, pre‐ and post‐brachycephalic obstructive airway syndrome (BOAS) surgery, utilizing a wireless pH capsule (Bravo Calibration‐free, Medtronic, Minnesota), and correlate with owners' observations of regurgitation.

Animals

Eleven French bulldogs diagnosed with SHH via swallowing fluoroscopy.

Methods

Prospective cohort study. A pH capsule was endoscopically placed in the esophagus. Up to 96 hours of data were acquired as the owner logged clinical signs. Spearman's correlation and Wilcoxon rank‐sum tests evaluated factors correlated with acid exposure time (AET), defined by the % time pH < 4. In 4/11 dogs, Bravo monitoring was repeated 2‐4 months after BOAS surgery.

Results

Medians (Q1‐Q3) for age and weight were 21 months (17‐35.5) and 10.0 kg (8.9‐11.5). BOAS severity was mild (3), moderate (4), or severe (4). Medians (Q1‐Q3) for AET and reflux events were 3.3% (2.6‐6.4) and 70 (34‐173). Clinical score (P = .82) and BOAS severity (P = .60) were not correlated with AET, but age was negatively correlated (rho = −.66, P = .03). Median probability (Q1‐Q3) that regurgitation was associated with a reflux event was 72.5% (0‐99). Percent AET numerically improved in all 4 dogs that underwent BOAS surgery although not statistically assessed.

Conclusions and Clinical Importance

Wireless pH monitoring documented acidic GER in French bulldogs with SHH, captured subclinical events, and showed improvements after BOAS surgery.
Descriptive analysis and prognostic factors in cats with myeloma‐related disorders: A multicenter retrospective study of 50 cases
Authors: Lecot Lorris , Desmas‐Bazelle Isabelle , Benjamin Sarah , De Fornel Pauline , Ponce Frédérique , Kornya Matthew , Desquilbet Loïc , Beaudu‐Lange Claire , Ibisch Catherine , Sayag David , Benchekroun Ghita , Béguin Jérémy
Published: March 2024

Background

Myeloma‐related disorders (MRDs) are rare and poorly documented neoplasms of cats.

Hypothesis/Objectives

To describe clinical, clinicopathologic, and imaging findings, response to treatment, and survival time and to identify factors associated with shorter outcomes in cats with MRD.

Animals

Fifty cats with a diagnosis of MRD.

Methods

Cats with paraproteinemia confirmed by serum protein electrophoresis (SPE) and either intramedullary plasmacytosis >10%, marked cytonuclear atypia with intramedullary plasmacytosis that ranged between 5% and 10%, or cytologically or histologically confirmed visceral infiltration were retrospectively included from several veterinary referral centers.

Results

Bone marrow plasmacytosis and splenic or hepatic involvement were present in 17/27 cats (63%), 36/42 cats (86%), and 27/38 cats (71%), respectively. Anemia was reported in 33/49 cats (67%) and thrombocytopenia in 16/47 cats (34%). Some of the treatments that the cats received included melphalan and prednisolone (n = 19), cyclophosphamide and prednisolone (n = 10), chlorambucil and prednisolone (n = 4), prednisolone (n = 4), or other (n = 4). The overall response rates to melphalan, cyclophosphamide, and chlorambucil in combination with prednisolone were 87%, 90%, and 100%, respectively. Adverse events to melphalan or cyclophosphamide occurred in 65% and 23% of cats, respectively. Median survival time was 122 days (range, 0‐1403) and was not significantly associated with chemotherapy protocol. Anemia (hazard ratio [HR], 3.1; 95% confidence interval [CI], 1.0‐9.8) and thrombocytopenia (HR, 2.7; 95% CI, 1.2‐6.0) were risk factors for shorter survival.

Conclusions and Clinical Importance

Our study confirmed the guarded prognosis of MRD in cats and identified risk factors for shorter survival times.
Enthusiastic claimants, reluctant courts: The empirical and critical analysis of punitive damages in Chinese intellectual property law
Authors: Xiao Baiyang
Published: March 2024

The availability of punitive awards varies across different common law jurisdictions. In recent years, China, as a civil law jurisdiction, has progressively introduced a comprehensive punitive damages system in Intellectual Property (IP) law in recent years. To investigate how this common law product functions in the civil law system, this paper scrutinizes the evolution and functions of punitive damages and depicts the map of punitive damages in Chinese IP law. Then this paper reports and analyses 657 IP judgments involving the application of punitive damages that were tried and decided in all parts of mainland China by all levels of courts from June 1, 2021, to May 31, 2022. Our empirical data shows that punitive damages are frequently sought by claimants, yet courts are reluctant to award them due to the complexities in determining the basis for calculation and judges' reluctance towards detailed legal reasoning. Furthermore, a critical analysis of the application of punitive damages in IP trials is provided, critiquing the court's preference for statutory damages, the complexity in determining the basis and multipliers for calculation, and the strict standard of proof, which accounted for the small portion of punitive damages awarded in judicial practices.
ENPP2/Autotaxin: The potential drug target for alcoholic liver disease identified through Mendelian randomization analysis
Authors: Luo Peiqiong , Yu Xuefeng
Published: March 2024

Background and Aims

At present, there is still a lack of radical drug targets for intervention in alcoholic liver disease (ALD), and drug discovery through randomized controlled trials is a lengthy, risky, and expensive undertaking, so we aimed to identify effective drug targets based on human genetics.

Methods

We used Mendelian randomization (MR) and Bayesian colocalization analysis to investigate 2639 genes encoding druggable proteins and examined the causal effects on ALD (PMID 34737426: 456348 European with 451 cases and 455 897 controls). In addition, we conducted the mediation analysis to explore the potential mechanism using the genome‐wide association study (GWAS) data of blood biomarkers as mediators.

Results

We finally identified the drug target: ENPP2/Autotaxin and genetically proxied ENPP2/Autotaxin was causally associated with the risk of ALD (OR = 2.28, 95% CI: 1.64 to 3.16, p = 7.49E‐7). In addition, we found that the effect of ENPP2/Autotaxin on ALD may be partly mediated by effector memory CD8+ T cell (the proportion of mediation effect: 8.49%).

Conclusions

Our integrative analysis suggested that genetically determined levels of circulating ENPP2/Autotaxin have a causal effect on ALD risk and are a promising drug target.
Trade, industrial, and privatization policies with endogenous market structure
Authors: Chen Shih‐Shen , Ko Po‐Sheng , Lee Jen‐Yao , Tsai Chien‐Shu
Published: March 2024

This study finds that in an international mixed oligopoly at free entry equilibrium, social welfare under import tariff cum privatization is higher than output subsidy cum privatization, and the dual subsidy‐tariff policy cum privatization degenerates into a single tariff policy cum privatization. The reason is that an output subsidy or the dual subsidy‐tariff policy will incentivize domestic private firms to enter the free‐entry equilibrium. Thus, the number of domestic firms with free entry is excessive, and social welfare deteriorates. A privatization policy is pivotal in the long run and is still more effective than a single subsidy policy.
A taxonomic revision of the genus Crocus (Iridaceae) in Iran
Authors: Dolatyari Alireza , Tolyat Abolhasani Majid , Ardalani Fatemeh , Rukšāns Jānis
Published: March 2024

The taxonomic classification of the genus Crocus has undergone substantial revisions over the past half‐century. Likewise, over the last two decades, the number of known species in Iran has tripled with the discovery of 16 additional species. Despite these noteworthy recent findings, there is a lack of an updated taxonomic revision that encompasses all these newcomers. This revision of the genus in Iran is based on comprehensive morphological examinations conducted on fresh plant material collected in the field, cultivated plants, herbarium specimens, and an extensive literature review. Presently, 24 species are recognized in Iran. They are classified into two sections: Crocus and Nudiscapus. Notably, 18 species (75%) are endemic to Iran, with 14 among them being steno‐endemics, the five remaining species are subendemic elements whose distribution is limited to Iran and the adjacent countries. An identification key to all 24 recognized species is presented, accompanied by illustrations, detailed descriptions, distribution maps and information on the conservation status of each species. According to the IUCN criteria, the conservation status of all species, excluding C. caspius, C. damascenus, C. haussknechtii and C. michelsonii is at an alarming level. This revision aims to resolve ambiguities in the Iranian Crocus taxonomy, and offers the opportunity to collectively examine all previously described species in one comprehensive contribution.
Mechanism of Fat Mass and Obesity‐Related Gene‐Mediated Heme Oxygenase‐1 m6A Modification in the Recovery of Neurological Function in Mice with Spinal Cord Injury
Authors: Xu Jinghui , Ren Zhenxiao , Niu Tianzuo , Li Siyuan
Published: March 2024

Objectives

This study examined the mechanism of fat mass and obesity‐related gene (FTO)‐mediated heme oxygenase‐1 (HO‐1) m6A modification facilitating neurological recovery in spinal cord injury (SCI) mice. FTO/HO‐1 was identified as a key regulator of SCI as well as a potential target for treatment of SCI.

Methods

An SCI mouse was treated with pcDNA3.1‐FTO/pcDNA3.1‐NC/Dac51. An oxygen/glucose deprivation (OGD) cell model simulated SCI, with cells treated with pcDNA3.1‐FTO/si‐HO‐1/Dac51. Motor function and neurobehavioral evaluation were assessed using the Basso, Beattie, and Bresnahan (BBB) scale and modified neurological severity score (mNSS). Spinal cord pathology and neuronal apoptosis were assessed. Further, FTO/HO‐1 mRNA and protein levels, HO‐1 mRNA stability, the interaction of YTHDF2 with HO‐1 mRNA, neuronal viability/apoptosis, and HO‐1 m6A modification were evaluated.

Results

Spinal cord injury mice exhibited reduced BBB, elevated mNSS scores, disorganized spinal cord cells, scattered nuclei, and severe nucleus pyknosis. pcDNA3.1‐FTO elevated FTO mRNA, protein expression, and BBB score; reduced the mNSS score of SCI mice; decreased neuronal apoptosis; improved the cell arrangement; and improved nucleus pyknosis in spinal cord tissues. OGD decreased FTO expression. FTO upregulation ameliorated OGD‐induced neuronal apoptosis. pcDNA3.1‐FTO reduced HO‐1 mRNA and protein and HO‐1 m6A modification, while increasing HO‐1 mRNA stability and FTO in OGD‐treated cells. FTO upregulated HO‐1 by modulating m6A modification. HO‐1 downregulation attenuated the effect of FTO. pcDNA3.1‐FTO/Dac51 increased the HO‐1 m6A level in mouse spinal cord tissue homogenate, reduced BBB, boosted mNSS scores of SCI mice, aggravated nucleus pyknosis, and increased neuronal apoptosis in spinal cord tissues, confirming that FTO mediated HO‐1 m6A modification facilitated neurological recovery in SCI mice.

Conclusion

The fat mass and obesity‐related gene modulates HO‐1 mRNA stability by regulating m6A modification levels, thereby influencing HO‐1 expression and promoting neurological recovery in SCI mice.
Episodic deterioration of plant diversity in rich fens with or without in situ oil sands exploration disturbance
Authors: Caners Richard T. , Crisfield Varina , Lieffers Victor J.
Published: March 2024

Peatlands with ground surfaces near the water table may be sensitive to disturbances that reduce this distance to water. Shrubby rich fens (SRF) in northern Alberta, Canada, are restricted to the wettest landscape positions and are characterized by brown mosses and stunted trees on weakly consolidated and saturated substrates. In situ oil sands exploration (OSE) practices have established thousands of drilling pads to explore for deeply buried bitumen deposits, with many located on peatlands. In the development of OSE pads on peatlands, the vegetation layer is removed, eliminating the functionally important hummock‐hollow surface topography. We examined the spontaneous regeneration of bryophytes and vascular plants and surface microtopography on SRF, 7 and again 14 years after pad abandonment. In both sampling years, drilling pad surfaces were closer to the water table (mean pad elevation 2012 = 3.3 cm, 2019 = 5.6 cm) and had minor topography compared to adjacent reference habitat. We found, however, over the 7 years, that for both drilling pads and reference habitat, bryophyte and vascular plant richness decreased, and most species declined in frequency. Furthermore, for pads and reference habitat, density of tree seedlings decreased, and expansion of hummock‐forming mosses was limited. Findings suggest that drilling pads and their natural counterparts on SRF may be prone to episodic reductions in plant diversity and ecosystem retrogression, likely resulting from prolonged surface saturation during summers with high rainfall. Because of their wet landscape positions and environmental vulnerability, SRF are likely the peatland habitats slowest to recover following OSE pad construction.
ε‐ces preferences and trade
Authors: Behrens Kristian , Kichko Sergei , Ushchev Philip
Published: March 2024

Kimball preferences possess properties that make them a powerful tool for multi‐sector applied general equilibrium. While they are homothetic, they also can be made arbitrarily close to constant elasticity of substitution (ces) preferences, thereby sharing some of their properties ‘by continuity’. We develop a trade model which brings together traded and nontraded sectors, variable markups, and costly trade for this rich class of homothetic preferences. We characterize the consequences—for both sectors—of trade liberalization in traded sector. Numerical simulations for a calibrated version of the model reveal that the elasticity of utility with respect to trade costs is about 25%–27%, depending on whether traded and nontrade goods are complements or substitutes.
Welfare service reforms: Arab minority welfare bureau managers assess the outcomes
Authors: Mahajne Ibrahim
Published: March 2024

Welfare bureaus constitute a safety net for the dispossessed Arab minority in Israel who are partially excluded from the state social services. The welfare bureau reforms discussed in this article are consequently crucial to improve welfare services for the underprivileged minority service users. This article partially fills a lacuna in the relevant literature by adopting a critical approach to assess the reforms' actual contributions to improving the organizations' performances for minority population social services. It did this by investigating Arab social workers' views on the outcomes of different welfare services reforms for them. An exploratory study drew data from two tools: content analysis of official documents and in‐depth semi‐structured interviews with 19 Arab welfare bureau managers. The documents indicated that the ‘Change Program’ (1977) produced minimal to no positive outcomes for Arab welfare bureaus. Also, the respondents indicated that the ‘Reform in Local Welfare Services’ (2017) produced insufficient achievements, detailed in five themes. Two Arab representatives were consulted for the proposed ‘Right to Quality Welfare’ program (June 2023), which aims to offer a ‘uniform welfare basket’ to all citizens. The findings indicate that the concept of up‐down comprehensive organizational reforms should be re‐examined, considering instead small but incremental down‐up modifications.
Optimized convolutional neural network for land cover classification via improved lion algorithm
Authors: Preetham Anusha , Vyas Sumit , Kumar Manoj , Kumar Sanjay Nakharu Prasad
Published: March 2024

Dependable land cover data are required to aid in the resolution of a broad spectrum of environmental issues. Land cover classification at a broad scale has been carried out using data from traditional ground‐based information from the Advanced Very High‐Resolution Radiometer. From the merits as well as demerits of the existing works discussed in the literature, this article seeks to establish a novel technique for automatic, fast, as well as precise land cover classification deploying remote sensing data. The proposed approach follows feature extraction and classification stages. From input information, the statistical characteristics are extracted as well as they are subjected to classification via optimized deep convolutional neural network. Particularly, the convolutional layers are optimized for by means of a new Proposed Lion Algorithm with a new Cub pool Update (PLACU) approach. The established model is the advanced level of the standard lion algorithm. The superiority of the established technique is determined by the extant techniques regarding positive and negative metrics. The accuracy of the work that is being presented (PLACU) is superior to the existing methods like Dragonfly algorithm, Jaya algorithm, sea lion optimization, and lion algorithm techniques by 20%, 15%, 112%, and 10%, respectively.
Transfers between health facilities of people living with diabetes attending primary health care services in the Western Cape Province of South Africa: A retrospective cohort study
Authors: Odayar Jasantha , Rusch Jody , Dave Joel A. , Van Der Westhuizen Diederick J. , Mukonda Elton , Lesosky Maia , Myer Landon
Published: March 2024

Objectives

Transfers between health facilities of people living with HIV attending primary health care (PHC) including hospital to PHC facility, PHC facility to hospital and PHC facility to PHC facility transfers occur frequently, affect health service planning, and are associated with disengagement from care and viraemia. Data on transfers among people living with diabetes attending PHC, particularly transfers between PHC facilities, are few. We assessed the transfer incidence rate of people living with diabetes attending PHC, and the association between transfers between PHC facilities and subsequent HbA1c values.

Methods

We analysed data on HbA1c tests at public sector facilities in the Western Cape Province (2016–March 2020). Individuals with an HbA1c in 2016–2017 were followed‐up for 27 months and included in the analysis if ≥18 years at first included HbA1c, ≥2 HbA1cs during follow‐up and ≥1 HbA1c at a PHC facility. A visit interval was the duration between two consecutive HbA1cs. Successive HbA1cs at different facilities of any type indicated any transfer, and HbA1cs at different PHC facilities indicated a transfer between PHC facilities. Mixed effects logistic regression adjusted for sex, age, rural/urban facility attended at the start of the visit interval, disengagement (visit interval >14 months) and a hospital visit during follow‐up assessed the association between transfers between PHC facilities and HbA1c >8%.

Results

Among 102,813 participants, 22.6% had ≥1 transfer of any type. Including repeat transfers, there were 29,994 transfers (14.4 transfers per 100 person‐years, 95% confidence interval [CI] 14.3–14.6). A total of 6996 (30.1%) of those who transferred had a transfer between PHC facilities. Visit intervals with a transfer between PHC facilities were longer (349 days, interquartile range [IQR] 211–503) than those without any transfer (330 days, IQR 182–422). The adjusted relative odds of an HbA1c ≥8% after a transfer between PHC facilities versus no transfer were 1.20 (95% CI 1.05–1.37).

Conclusion

The volume of transfers involving PHC facilities requires consideration when planning services. Individuals who transfer between PHC facilities require additional monitoring and support.
Outcomes of open reduction and internal fixation of calcaneus fractures: A database study comparing patients with and without diabetes
Authors: Johnson Matthew J. , Conover Benjamin M. , Frykberg Robert G. , Raspovic Katherine M. , Lavery Lawrence A. , Wukich Dane K.
Published: March 2024

Treatment of calcaneal fractures in patients with diabetes mellitus (DM) is challenging. The purpose of this study was to compare post‐operative outcomes after open reduction and internal fixation (ORIF) for calcaneus fracture in patients with complicated DM, uncomplicated DM, and patients without DM. A commercially available de‐identified database was queried for all calcaneus fracture diagnoses undergoing ORIF from 2010 to 2021. The patients were separated into three groups for analysis: patients without DM (10,951, 82.6%), uncomplicated DM (1,500, 11.3%) and complicated DM (802, 6.1%). At 1 year, post‐operative adverse events were assessed among the three groups. The odds of adverse event(s) for each group were compared between the three groups with and without characteristic matching. In the unmatched cohorts, patients with complicated DM, when compared with patients without DM and patients with uncomplicated DM, had significantly higher rates of all adverse events with exception of DVT. Rates of CNA were significantly higher in patients with complicated DM compared with no DM (OR 107.7 (CI 24.83–467.6) p < 0.0001) and uncomplicated DM (OR 44.26 (CI 3.86–507.93) p = 0.0002). After matching, non‐union, AKI, sepsis, surgical site infection, and wound disruption were higher in patients with complicated DM compared with patients without DM. There were no significant differences in the three groups with regard to reoperation, DVT, MI, pneumonia, or below the knee amputation. Patients with DM who underwent ORIF for calcaneus fracture experienced higher rates of post‐operative adverse events compared with those patients without DM.
Knowledge and practices related to louse‐ and flea‐borne diseases among staff providing services to people experiencing homelessness in the United States
Authors: Rich Shannan N. , Carpenter Ann , Dell Bree , Henderson Rachel , Adams Sydney , Bestul Nicolette , Grano Christopher , Sprague Briana , Leopold Josh , Schiffman Elizabeth K. , Lomeli Andrea , Zadeh Hassan , Alarcón Jemma , Halai Umme‐Aiman , Nam Yoon‐Sung , Seifu Leah , Slavinski Sally , Crum David , Mosites Emily , Salzer Johanna S. , Hinckley Alison F. , McCormick David W. , Marx Grace E.
Published: March 2024

Background and Aims

Louse‐borne Bartonella quintana infection and flea‐borne murine typhus are two potentially serious vector‐borne diseases that have led to periodic outbreaks among people experiencing homelessness in the United States. Little is known about louse‐ and flea‐borne disease awareness and prevention among staff who provide services to the population. We surveyed staff in seven US states to identify gaps in knowledge and prevention practices for these diseases.

Methods and Results

Surveys were administered to 333 staff at 89 homeless shelters and outreach teams in California, Colorado, Georgia, Maryland, Minnesota, New York and Washington from August 2022 to April 2023. Most participants (>68%) agreed that body lice and fleas are a problem for people experiencing homelessness. About half were aware that diseases could be transmitted by these vectors; however, most could not accurately identify which diseases. Less than a quarter of staff could describe an appropriate protocol for managing body lice or fleas. Misconceptions included that clients must isolate or be denied services until they are medically cleared.

Conclusions

Our findings reveal significant knowledge gaps among staff who provide services to people experiencing homelessness in the prevention and control of louse‐ and flea‐borne diseases. This demonstrates an urgent need for staff training to both reduce disease and prevent unnecessary restrictions on services and housing.
Direccionamiento estratégico (DE) y la rentabilidad financiera de las empresas del sector turístico colombiano
Authors: Chaverra Marquez Jazmin , Arce Gisbert Miguel , Chamorro Gonzalez Candy
Published: March 2024

Este artículo analiza la relación entre las características del direccionamiento estratégico (DE) y la rentabilidad financiera (ROE) de las empresas del sector turístico. Estudia la correlación existente entre ambas variables en las empresas objeto y tiene un alcance correlacional y longitudinal. La muestra estuvo conformada por 290 empresas del sector turístico de Colombia. A través del análisis de regresión múltiple con variables exógenas cualitativas y el método Spearman, los resultados muestran que dentro de los atributos del DE existen correlaciones positivas, negativas y neutras que explican la rentabilidad operativa especial, ROE, hasta en un 8.2 %. Dentro de los atributos estudiados, el control-autorregulación y la asignación de recursos tecnológicos se muestran como los de mayor incidencia porcentual entre las dos variables para este sector. El estudio muestra además la necesidad de desarrollar aún más las capacidades administrativas de las empresas del turismo, debido a que los resultados muestran que el 100 % de las empresas posee por lo menos un atributo de DE. Sin embargo, la totalidad de ellas carece de un sistema DE integral, por lo que sus metas financieras están incididas tal vez, por el buen momento del sector, más que por sus cualidades estratégicas.
Bone-inspired stress-gaining elastomer enabled by dynamic molecular locking
Authors: Wang Yang , Guan Qingbao , Guo Yue , Sun Lijie , Neisiany Rasoul Esmaeely , Guo Xuran , Huang Hongfei , Yang Lei , You Zhengwei
Published: March 2024

The limited capacity of typical materials to resist stress loading, which affects their mechanical performance, is one of the most formidable challenges in materials science. Here, we propose a bone-inspired stress-gaining concept of converting typically destructive stress into a favorable factor to substantially enhance the mechanical properties of elastomers. The concept was realized by a molecular design of dynamic poly(oxime-urethanes) network with mesophase domains. During external loading, the mesophase domains in the condensed state were aligned into more ordered domains, and the dynamic oxime-urethane bonds served as the dynamic molecular locks disassociating and reorganizing to facilitate and fix the mesophase domains. Consequently, the tensile modulus and strength were enhanced by 1744 and 49.3 times after four cycles of mechanical training, respectively. This study creates a molecular concept with stress-gaining properties induced by repeated mechanical stress loading and will inspire a series of innovative materials for diverse applications.
Supercharged precision killers: Genetically engineered biomimetic drugs of screened metalloantibiotics against
Acinetobacter baumanni
Authors: Wei Xianyuan , Xue Bin , Ruan Shuangchen , Guo Jintong , Huang Yujing , Geng Xiaorui , Wang Dan , Zhou Cangtao , Zheng Jun , Yuan Zhen
Published: March 2024

To eliminate multidrug-resistant bacteria of
Acinetobacter baumannii
, we screened 1100 Food and Drug Administration–approved small molecule drugs and accessed the broxyquinoline (Bq) efficacy in combination with various metal ions. Antibacterial tests demonstrated that the prepared Zn(Bq)
2
complex showed ultralow minimum inhibitory concentration of ~0.21 micrograms per milliliter with no resistance after 30 passages. We then constructed the nano zeolitic imidazolate framework-8 (ZIF-8) as a drug carrier of Zn(Bq)
2
and also incorporated the photosensitizer chlorin e6 (Ce6) to trace and boost the antibacterial effect. To further ensure the stable and targeted delivery, we genetically engineered outer membrane vesicles (OMVs) with the ability to selectively target
A. baumannii
. By coating the ZnBq/Ce6@ZIF-8 core with these OMV, the resulted drug (ZnBq/Ce6@ZIF-8@OMV) exhibited exceptional killing efficacy (>99.9999999%) of
A. baumannii
. In addition, in vitro and in vivo tests were also respectively carried out to inspect the remarkable efficacy of this previously unknown nanodrug in eradicating
A. baumannii
infections, including biofilms and meningitis.
Generation of entangled waveguided photon pairs by free electrons
Authors: Rasmussen Theis P. , Echarri Álvaro Rodríguez , Cox Joel D. , de Abajo F. Javier García
Published: March 2024

Entangled photons are a key resource in quantum technologies. While intense laser light propagating in nonlinear crystals is conventionally used to generate entangled photons, such schemes have low efficiency due to the weak nonlinear response of known materials and losses associated with in/out photon coupling. Here, we show how to generate entangled polariton pairs directly within optical waveguides using free electrons. The measured energy loss of undeflected electrons heralds the production of counter-propagating polariton pairs entangled in energy and emission direction. For illustration, we study the excitation of plasmon polaritons in metal strip waveguides that strongly enhance light-matter interactions, rendering two-plasmon generation dominant over single-plasmon excitation. We demonstrate that electron energy losses detected within optimal frequency ranges can reliably signal the generation of plasmon pairs entangled in energy and momentum. Our proposed scheme is directly applicable to other types of optical waveguides for in situ generation of entangled photon pairs.
Design of a proteolytic module for improved metabolic modeling of
Bacteroides caccae
Authors: Paulay Amandine , Grimaud Ghjuvan M. , Caballero Raphaël , Laroche Béatrice , Leclerc Marion , Labarthe Simon , Maguin Emmanuelle
Published: March 2024

The gut microbiota plays a crucial role in health and is significantly modulated by human diets. In addition to Western diets which are rich in proteins, high-protein diets are used for specific populations or indications, mainly weight loss. In this study, we investigated the effect of protein supplementation on
Bacteroides caccae
, a Gram-negative gut symbiont. The supplementation with whey proteins led to a significant increase in growth rate, final biomass, and short-chain fatty acids production. A comprehensive genomic analysis revealed that
B. caccae
possesses a set of 156 proteases with putative intracellular and extracellular localization and allowed to identify amino acid transporters and metabolic pathways. We developed a fully curated genome-scale metabolic model of
B. caccae
that incorporated its proteolytic activity and simulated its growth and production of fermentation-related metabolites in response to the different growth media. We validated the model by comparing the predicted phenotype to experimental data. The model accurately predicted
B. caccae
’s growth and metabolite production (
R
2
= 0.92 for the training set and
R
2
= 0.89 for the validation set). We found that accounting for both ATP consumption related to proteolysis, and whey protein accessibility is necessary for accurate predictions of metabolites production. These results provide insights into
B. caccae
’s adaptation to a high-protein diet and its ability to utilize proteins as a source of nutrition. The proposed model provides a useful tool for understanding the feeding mechanism of
B. caccae
in the gut microbiome.

IMPORTANCE

Microbial proteolysis is understudied despite the availability of dietary proteins for the gut microbiota. Here, the proteolytic potential of the gut symbiont
Bacteroides caccae
was analyzed for the first time using pan-genomics. This sketches a well-equipped bacteria for protein breakdown, capable of producing 156 different proteases with a broad spectrum of cleavage targets. This functional potential was confirmed by the enhancement of growth and metabolic activities at high protein levels. Proteolysis was included in a
B. caccae
metabolic model which was fitted with the experiments and validated on external data. This model pinpoints the links between protein availability and short-chain fatty acids production, and the importance for
B. caccae
to gain access to glutamate and asparagine to promote growth. This integrated approach can be generalized to other symbionts and upscaled to complex microbiota to get insights into the ecological impact of proteins on the gut microbiota.
Attitudes towards transjugular intrahepatic portosystemic shunt (TIPS) in Australia: a national survey of TIPS centres
Authors: Kalo Eric , Read Scott , George Jacob , Roberts Stuart K , Majumdar Avik , Ahlenstiel Golo
Published: March 2024

Background

Transjugular intrahepatic portosystemic shunt (TIPS) is a minimally invasive therapeutic option to treat the sequelae of portal hypertension. It is unclear whether current international recommendations are reflected in current clinical practice across Australia and the extent of variations in care. This study aimed to address this gap in knowledge and benchmark the current landscape of TIPS services in Australia against international guidelines.

Methods

We designed a 42-item questionnaire according to practice-based recommendations and standards of international guidelines to investigate current landscape of TIPS service across four key domains: (1) service provision, (2) patient selection and indications, (3) best procedure practice, and (4) postoperative care.

Results

Gastroenterologist/hepatologists from 23 major liver centres (67.6%) across Australia currently performing TIPS completed the questionnaire. Between 2017 and 2020, there were 456 elective TIPS insertions. Units offering TIPS service had a low median number of TIPS insertions (n=7 per annum). More than half of respondents (56.5%) did not have institutional clinical practice protocols. There was marked variation in practices across institutions in terms of TIPS indications and patient selection. Despite variations, the success rate of elective TIPS was high at 91.7% (79–100%), with 86.6% (29–100%) for rescue TIPS. There was significant variation in postoperative follow-up and care.

Conclusion

Current TIPS practice in Australia varies significantly across institutions. There is a need for a national consensus clinical practice guidelines to improve access and minimise unwarranted variation. A national registry for TIPS could measure, monitor, and report on quality of clinical care and patient outcomes.
Inhaled treprostinil in patients with pulmonary hypertension associated with interstitial lung disease with less severe haemodynamics: a post hoc analysis of the INCREASE study
Authors: Weatherald Jason , Nathan Steven D , El-Kersh Karim , Argula Rahul G , DuBrock Hilary M , Rischard Franz P , Cassady Steven J , Tarver James , Levine Deborah J , Tapson Victor F , Deng Chunqin , Shen Eric , Das Manisit , Waxman Aaron B
Published: March 2024

Background

Inhaled treprostinil (iTre) is the only treatment approved for pulmonary hypertension due to interstitial lung disease (PH-ILD) to improve exercise capacity. This post hoc analysis evaluated clinical worsening and PH-ILD exacerbations from the 16-week INCREASE study and change in 6-minute walking distance (6MWD) in the INCREASE open-label extension (OLE) in patients with less severe haemodynamics.

Methods

Patients were stratified by baseline pulmonary vascular resistance (PVR) of <4 Wood units (WU) versus ≥4 WU and ≤5 WU versus >5 WU. Exacerbations of underlying lung disease, clinical worsening and change in N-terminal prohormone of brain natriuretic peptide (NT-proBNP) in INCREASE were evaluated. For the OLE, patients previously assigned to placebo were considered to have a 16-week treatment delay. 6MWD and clinical events in the OLE were evaluated by PVR subgroup.

Results

Of the 326 patients enrolled in INCREASE, patients with less severe haemodynamics receiving iTre had fewer exacerbations of underlying lung disease and clinical worsening events. This was supported by the Bayesian analysis of the risk of disease progression (HR<1), and significant decreases in NT-proBNP levels. In the OLE, patients without a treatment delay had improved exercise capacity after 1-year compared with those with a 16-week treatment delay (22.1 m vs −10.3 m). Patients with a PVR of ≤5 WU without a treatment delay had a change of 5.5 m compared with −8.2 m for those with a treatment delay. Patients without a treatment delay had a prolonged time to hospitalisation, lung disease exacerbation and death.

Conclusion

Treatment with iTre led to consistent benefits in clinical outcomes in patients with PH-ILD and less severe haemodynamics. Earlier treatment in less severe PH-ILD may lead to better exercise capacity long-term, however, the subgroup analyses in this post hoc study were underpowered and confirmation of these findings is needed.
Sendaway capillary NT-proBNP in pulmonary hypertension
Authors: Stubbs Harrison D , Cannon John , Knightbridge Emily , Durrington Charlotte , Roddis Chloe , Gin-Sing Wendy , Massey Fiona , Knight Daniel S , Virsinskaite Ruta , Lordan James L , Sear Eleanor , Apple-Pinguel Joy , Morris Eleanor , Johnson Martin K , Wort Stephen J
Published: March 2024

Background

N-terminal pro-B-type natriuretic peptide (NT-proBNP) is a biomarker of cardiac ventricular wall stress that is incorporated into pulmonary hypertension (PH) risk stratification models. Sendaway sampling may enable patients to perform NT-proBNP tests remotely. This UK-wide study aimed to assess the agreement of sendaway NT-proBNP with standard venous NT-proBNP and to assess the effect of delayed processing.

Methods

Reference venous NT-proBNP was collected from PH patients. Samples for capillary and venous sendaway tests were collected contemporaneously, mailed to a reference laboratory and processed at 3 and 7 days using a Roche Cobas e411 device. Differences in paired measurements were analysed with Passing-Bablok regression, percentage difference plots and the % difference in risk strata.

Results

113 patients were included in the study. 13% of day 3 capillary samples were insufficient. Day 3 capillary samples were not equivalent to reference samples (Passing Bablok analysis slope of 0.91 (95% CI 0.88 to 0.93) and intercept of 6.0 (95% CI 0.2 to 15.9)). The relative median difference was −7% and there were acceptable limits of agreement. Day 3 capillary NT-proBNP accurately risk stratified patients in 93.5% of cases. By comparison, day 3 venous results accurately risk stratified patients in 90.1% of cases and were equivalent by Passing-Bablok regression. Delayed sampling of sendaway tests led to an unacceptable level of agreement and systematically underestimated NT-proBNP.

Conclusions

Sendaway NT-proBNP sampling may provide an objective measure of right ventricular strain for virtual PH clinics. Results must be interpreted with caution in cases of delayed sampling.
Unveiling the relationship of physical literacy with muscular fitness and muscle-strengthening activities in adolescents: the EHDLA study
Authors: Villa-González Emilio , Faigenbaum Avery D , López-Gil José Francisco
Published: March 2024

Objective

This study evaluated the relationship between physical literacy (PL) and muscular fitness (MF) as well as muscle-strengthening activities (MSA) in adolescents.

Methods

A secondary cross-sectional study included 823 adolescents (45.1% boys) from the Eating Healthy and Daily Life Activities Study. The Spanish Perceived Physical Literacy Instrument for Adolescents (S-PPLI) assessed the participants’ perceived PL. The evaluation of MF in the young population was conducted using the Assessing the Levels of Physical Activity and Fitness (ALPHA-FIT) test battery. MSA were assessed by the following question: ‘In the past week, how many days did you exercise to strengthen or tone the muscle, such as through push-ups, sit-ups or lifting weights?’ To examine the associations between S-PPLI scores and handgrip strength, standing long jump and MSA days in adolescents, we employed generalised additive models.

Results

Participants with high perceived physical literacty (PPL) had the highest handgrip strength (mean=25.1; PPL had the highest handgrip strength (mean=25.1; bias-corrected and accelerated (BCa) bootstrapped 95% CI 24.2 to 26.0) and standing long jump (mean=149.7; confidence interval (CI) 24.2 to 26.0) and standing long jump (mean=149.7; 24.2 to 26.0) and standing long jump (mean=149.7;BCabootstrapped 95% CI 145.8 to 153.5). Conversely, those adolescents with low PPL had the lowest handgrip strength (mean=23.1;BCabootstrapped 95% CI 22.3 to 23.8) and standing long jump (mean=137.3;BCabootstrapped 95% CI 133.9 to 140.6). For MSA, adolescents with high PPL had the highest mean of MSA days (mean=3.0;BCabootstrapped 95% CI 2.8 to 3.3), while the lowest mean was observed for those with low PPL (mean=2.0;BCabootstrapped 95% CI 1.8 to 2.2).

Conclusion

A high level of PL was associated with higher levels of MF and MSA among Spanish adolescents.
Oral manifestations of inflammatory bowel disease: a guide to examination
Authors: Joshi Sandeep , Moore Alice , Mawdsley Joel , Carey Barbara
Published: March 2024

Orofacial symptoms are common in patients with inflammatory bowel disease (IBD). They may present as a primary manifestation of the disease in the oral cavity with oral Crohn’s disease, or as a secondary manifestation of the disease such as iron deficiency, or due to side effects to medications used in treatment. Orofacial manifestations of IBD may result in significant morbidity which can impact patients’ quality of life. Systematic examination and a timely diagnosis are fundamental in initiating appropriate management.

This article provides a guide for gastroenterologists to systematically perform an extraoral and intraoral examination of the orofacial region. The extraoral examination includes evaluation of lymph nodes, lips and perioral skin. Common extraoral features of IBD include lip swelling, lip fissuring, angular cheilitis, perioral erythema and cervicofacial lymphadenopathy. The intraoral examination involves a systematic inspection of all areas of the oral cavity. Intraoral IBD features include ulceration, cobblestoning of the buccal mucosa, gingival erythema and mucosal tags.

Examining the orofacial region is important in the complete assessment of patients with IBD, to diagnose orofacial conditions, to initiate tailored treatments and to identify those patients who would benefit from input from oral medicine specialists.