bluuebunny/crossref_metadata_2025 huggingface dataset:
Association of peri‐operative prescription of non‐steroidal anti‐inflammatory drugs with continued prescription of opioids after total knee arthroplasty: a retrospective claims‐based cohort study
Authors: Hussain N. , Brull R. , Gilron I. , Weaver T. E. , Shahzad H. , D'Souza R. S. , Abdel‐Rasoul M. , Clarke H. , McCartney C. J. L. , Abdallah F. W.
Published: February 2024

Non‐steroidal anti‐inflammatory drugs (NSAIDs) are one of the mainstays of multimodal pain management. While effective for acute pain control, recent pre‐clinical evidence has raised concerns regarding an association between NSAIDs and chronic pain and potential opioid use. Our objective was to explore the association between peri‐operative use of prescription NSAIDs and the need for continued opioid prescriptions lasting 90–180 days in previously opioid‐naïve patients undergoing total knee arthroplasty. A database of health claims in the USA was used to identify all opioid‐naïve adult patients who underwent primary knee arthroplasty between January 2010 and October 2021. We evaluated the magnitude of association between peri‐operative prescription NSAID claims and claims for opioids at 90 days postoperatively using multivariable logistic regression models. Secondary outcomes included: the magnitude of association between peri‐operative NSAID prescription and claims for opioids at 180 days postoperatively; and identifying other potential factors associated with opioid claims at 90 days postoperatively. After risk adjustment using multivariable logistic regression models in the 789,736‐patient cohort, the adjusted odds ratio (95%CI) for a continuous claim of opioids at 90 and 180 days postoperatively among patients with a peri‐operative NSAID prescription within 30 days was 1.32 (1.30–1.35), p < 0.001; and 1.12 (1.10–1.15), p < 0.001, respectively. This estimate of effect remained robust at 90 days after accounting for known potential confounders, including pre‐existing knee pain and acute postoperative pain severity. Similar analysis of other pain medications (e.g. paracetamol) did not detect such an association. This population‐based cohort study suggests that peri‐operative prescription NSAID use may be associated with continued opioid prescription claims at 90 and 180 days after knee arthroplasty, even after adjusting for other observed covariates for continuous opioid claims. These novel findings can inform clinical decision‐making for post‐surgical pain management, risk–benefit discussions with patients and future research.
UK guideline on the transition and management of childhood liver diseases in adulthood
Authors: Joshi Deepak , Nayagam Jeremy , Clay Lisa , Yerlett Jenny , Claridge Lee , Day Jemma , Ferguson James , Mckie Paul , Vara Roshni , Pargeter Henry , Lockyer Rachel , Jones Rebecca , Heneghan Michael , Samyn Marianne
Published: February 2024

Introduction

Improved outcomes of liver disease in childhood and young adulthood have resulted in an increasing number of young adults (YA) entering adult liver services. The adult hepatologist therefore requires a working knowledge in diseases that arise almost exclusively in children and their complications in adulthood.

Aims

To provide adult hepatologists with succinct guidelines on aspects of transitional care in YA relevant to key disease aetiologies encountered in clinical practice.

Methods

A systematic literature search was undertaken using the Pubmed, Medline, Web of Knowledge and Cochrane database from 1980 to 2023. MeSH search terms relating to liver diseases (‘cholestatic liver diseases’, ‘biliary atresia’, ‘metabolic’, ‘paediatric liver diseases’, ‘autoimmune liver diseases’), transition to adult care (‘transition services’, ‘young adult services’) and adolescent care were used. The quality of evidence and the grading of recommendations were appraised using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system.

Results

These guidelines deal with the transition of YA and address key aetiologies for the adult hepatologist under the following headings: (1) Models and provision of care; (2) screening and management of mental health disorders; (3) aetiologies; (4) timing and role of liver transplantation; and (5) sexual health and fertility.

Conclusions

These are the first nationally developed guidelines on the transition and management of childhood liver diseases in adulthood. They provide a framework upon which to base clinical care, which we envisage will lead to improved outcomes for YA with chronic liver disease.
Needle pathogens of Rhytismataceae: Current knowledge and research opportunities for conifer foliar diseases
Authors: Ata Jessa P. , Burns Kelly S. , Stewart Jane E.
Published: February 2024

Needle diseases caused by pathogens within Rhytismataceae are increasing in frequency globally where pines are either a predominate species or are grown commercially, and yet remain poorly understood. Here, we provide background information on the current knowledge and management strategies of needle pathogens in the Rhytismataceae and discuss research opportunities using molecular tools to fill knowledge gaps. Many of the aggressive needle pathogens within this group lack morphological features to delimit species and are difficult to grow in axenic cultures, which complicates scientific investigations. Molecular research has greatly advanced knowledge of this unique group of pathogens. Nucleotide sequences from multiple gene loci identified greater diversity within this group of pathogens than previously thought, as new and cryptic species are being discovered in broader geographic regions. High throughput sequencing and analyses revealed that an endophytic lifestyle is a common trait among fastidious if not obligate needle pathogens within Rhytismataceae. Further, molecular analyses showed the impact these pathogens have on the diversity of endophytic microbiota is underestimated. Early detection in healthy‐looking needles using PCR‐based markers greatly improves capabilities for disease diagnosis and monitoring. Despite growing number of molecular studies on Rhytismataceae needle pathogens, fundamental questions on the taxonomy, phylogeny, ecology and pathology of many Rhytismataceae needle pathogens remain unanswered. Nonetheless, with the projected changes in the occurrence and severity of Rhytismataceae pathogens, increased accessibility to molecular tools vastly expands the potential to gain more insights into understudied needle pathosystems to help define and address its impact under changing environments and consequently inform forest disease management more effectively.
3D‐printed model for gingival flap surgery simulation: Development and pilot test
Authors: Antunes David , Mayeur Olivier , Mauprivez Cédric , Nicot Romain
Published: February 2024

Introduction

To assess the feasibility of a realistic model for learning oral flaps using 3D printing technology.

Materials and Methods

A mould was designed to reproduce the mandibular gingival mucosa, and a mandibular model was created using a three‐dimensional printer for training undergraduate students to perform gingival flaps. After a short interview about its use, the participants were asked to use the simulator and provide feedback using a 5‐point Likert questionnaire.

Results

The 3D‐printed oral surgery flap training model was practical and inexpensive. The model was very realistic, educational and useful for hands‐on training.

Conclusions

3D printing technology offers new possibilities for training in dental treatments that are currently difficult to replicate. The use of this simulator for oral flap surgery was well‐received and considered promising by the participants.
Therapeutic‐like activity of cannabidiolic acid methyl ester in the MK‐801 mouse model of schizophrenia: Role for cannabinoid CB1 and serotonin‐1A receptors
Authors: Richardson Brandon , Clarke Courtney , Blundell Jacqueline , Bambico Francis R.
Published: February 2024

Schizophrenia is a psychotic disorder with an increasing prevalence and incidence over the last two decades. The condition presents with a diverse array of positive, negative, and cognitive impairments. Conventional treatments often yield unsatisfactory outcomes, especially with negative symptoms. We investigated the role of prefrontocortical (PFC) N‐methyl‐D‐aspartate receptors (NMDARs) in the pathophysiology and development of schizophrenia. We explored the potential therapeutic effects of cannabidiolic acid (CBDA) methyl ester (HU‐580), an analogue of CBDA known to act as an agonist of the serotonin‐1A receptor (5‐HT1AR) and an antagonist of cannabinoid type 1 receptor (CB1R). C57BL/6 mice were intraperitoneally administered the NMDAR antagonist, dizocilpine (MK‐801, .3 mg/kg) once daily for 17 days. After 7 days, they were concurrently given HU‐580 (.01 or .05 μg/kg) for 10 days. Behavioural deficits were assessed at two time points. We conducted enzyme‐linked immunosorbent assays to measure the concentration of PFC 5‐HT1AR and CB1R. We found that MK‐801 effectively induced schizophrenia‐related behaviours including hyperactivity, social withdrawal, increased forced swim immobility, and cognitive deficits. We discovered that low‐dose HU‐580 (.01 μg/kg), but not the high dose (.05 μg/kg), attenuated hyperactivity, forced swim immobility and cognitive deficits, particularly in female mice. Our results revealed that MK‐801 downregulated both CB1R and 5‐HT1AR, an effect that was blocked by both low‐ and high‐dose HU‐580. This study sheds light on the potential antipsychotic properties of HU‐580, particularly in the context of NMDAR‐induced dysfunction. Our findings could contribute significantly to our understanding of schizophrenia pathophysiology and offer a promising avenue for exploring the therapeutic potential of HU‐580 and related compounds in alleviating symptoms.
An Efficient Solving Approach for the p‐Dispersion Problem Based on the Distance‐Based Spatially Informed Property
Authors: Oh Changwha , Kim Hyun , Chun Yongwan
Published: February 2024

The p‐dispersion problem is a spatial optimization problem that aims to maximize the minimum separation distance among all assigned nodes. This problem is characterized by an innate spatial structure based on distance attributes. This research proposes a novel approach, named the distance‐based spatially informed property (D‐SIP) method to reduce the problem size of the p‐dispersion instances, facilitating a more efficient solution while maintaining optimality in nearly all cases. The D‐SIP is derived from investigating the underlying spatial characteristics from the behaviors of the p‐dispersion problem in determining the optimal location of nodes. To define the D‐SIP, this research applies Ripley's K‐function to the different types of point patterns, given that the optimal solutions of the p‐dispersion problem are strongly associated with the spatial proximity among points discovered by Ripley's K‐function. The results demonstrate that the D‐SIP identifies collective dominances of optimal solutions, leading to building the spatially informed p‐dispersion model. The simulation‐based experiments show that the proposed method significantly diminishes the size of problems, improves computational performance, and secures optimal solutions for 99.9% of instances (999 out of 1,000 instances) under diverse conditions.
Vulnerability and perceived risks in the peer‐to‐peer sharing economy
Authors: Culiberg Barbara , Kos Koklic Mateja , Kukar‐Kinney Monika , Vida Irena
Published: February 2024

The peer‐to‐peer (P2P) sharing economy, as an attractive alternative to permanent ownership, creates a triadic relationship among three groups of participants: service enablers, providers, and consumers. One of its main features is the expansion of the user's role to the roles of consumer and provider, or “prosumer.” However, in their role as prosumers, individuals may have an aversion to participating in the P2P sharing economy market due to their sense of powerlessness and lack of control, suggesting that their vulnerability needs to be considered. Despite their importance, prosumers have not received commensurate attention in the sharing economy literature. To address this gap, we examined prosumer vulnerability's impact on risk perceptions in the role of prosumer and illuminated these risks' impact on intentions to participate. The results from a U.S. survey indicate that vulnerability is a significant driver of all risk types, for both consumers and providers. Furthermore, psychological risk and security risk are found to significantly decrease intention to participate. Unexpectedly, social risk increases intention to participate among consumers and providers, while privacy and health risks are insignificant.
The correlation between sub‐epidermal moisture measurement and other early indicators of pressure ulcer development—A prospective cohort observational study. Part 1. The correlation between sub‐epidermal moisture measurement and ultrasound
Authors: Wilson Hannah Jane Elizabeth , Patton Declan , Budri Aglecia Moda Vitoriano , Boland Fiona , O'Connor Tom , McDonnell Ciarán Osmond , Rai Himanshu , Moore Zena Elizabeth Helen
Published: February 2024

The correlation between sub‐epidermal moisture (SEM) and other early indicators of pressure ulcer (PU) development is yet to be determined. This three‐part series aims to bridge this knowledge gap, through investigating SEM and its correlation with evidence‐based technologies and assessments. This article focuses on the correlation between SEM and ultrasound. A prospective cohort observational study was undertaken between February and November 2021. Patients undergoing three surgery types were consecutively enrolled to the study following informed consent. Assessments were performed prior to and following surgery for 3 days at the sacrum, both heels and a control site, using a SEM scanner and high‐frequency ultrasound scanner (5–15 MHz). Spearman's rank (rs) explored the correlation between SEM and ultrasound. A total of 60 participants were included; 50% were male with a mean age of 58 years (±13.46). A statistically significant low to moderately positive correlation was observed between SEM and ultrasound across all anatomical sites (rs range = 0.39–0.54, p < 0.05). The only exception was a correlation between SEM and ultrasound on day 0 at the right heel (rs = 0.23, p = 0.09). These results indicate that SEM and ultrasound agreed in the presence of injury; however, SEM was able to identify abnormalities before ultrasound.
Multi‐mode temperature sensing of Lu2WO6:Er3+,Yb3+ up‐conversion materials
Authors: Feng Mengjie , Li Lianjie , Guo Jiajia , Wang Qiang , Pang Tao , Guo Hai
Published: February 2024

To develop multi‐mode fluorescence thermometer with high performance, Lu2WO6:Er3+,Yb3+ materials were successfully designed and prepared. Under 980 nm excitation, the material can achieve accurate temperature measurement under three models. The above three models are based on different parameters, including two FIR (fluorescence intensity ratio) derived from two thermally coupled energy levels (TCELs) (2H11/2/4S3/2) and two non‐thermally coupled energy levels (NTCELs) (2H11/2/4F9/2), as well as fluorescence lifetime (FL) monitoring of the 2H11/2 energy level transition to the ground state. In the FIR mode of TCELs, maximum relative sensitivity (SR‐max) and minimum temperature resolution are 1.261 %K–1 and 0.237 K, respectively. The repeatability of five‐cycle temperature measurements is above 98.5%. The SR‐max value of FIR (NTCELs) and FL mode reach 0.862 and 0.201 %K−1, respectively. The obtained outcomes suggest that Lu2WO6:Er3+,Yb3+ materials might be considered as promising candidates for three‐mode fluorescence thermometry.
Perceptions of surveillance with magnetic resonance imaging among women with a hereditary risk of breast cancer—A phenomenographic study
Authors: Sjöqvist Ann‐Sofi , Holst‐Hansson Annette , Zackrisson Sophia , Gårdling Jenny , Bolejko Anetta
Published: February 2024

Aim

To explore perceptions of annual surveillance with magnetic resonance imaging and perceptions of care during the examination among women with a hereditary risk of breast cancer.

Design

Phenomenography.

Methods

Fourteen face‐to‐face interviews using a semi‐structured interview guide were conducted among women undergoing surveillance in the southern region of Sweden. A seven‐step phenomenographic analysis with investigator triangulation was performed.

Results

‘Considering own risk of developing breast cancer’, ‘Entrusting oneself to surveillance’ and ‘Living in a cycle’ represented descriptive categories of perceptions. Family narratives introduced comprehension of own risk of breast cancer, followed by appraisal of own benefits of participating in surveillance. Entrusting oneself to surveillance included handing over management of diagnostic examinations and dealing with practical issues and diverse emotions related to surveillance. Planning life based around surveillance, struggling with fluctuating emotions, also between the examinations and questioning own identity implied the perception of living in a cycle.

Conclusion

Surveillance for hereditary breast cancer implies living in a cycle of dealing with fluctuating emotions and planning life based around surveillance. Comprehension of one's own risk for breast cancer arises from awareness in the family. Women value the surveillance programme and trust the healthcare system.

Implication for the Profession and Patient Care

Knowledge of women's perceptions of the surveillance programme and care is vital for supporting women in their decision‐making on attendance and providing person‐centred care during surveillance.

Impact

A gap in explorative studies from the perspective of the individual woman in the context of surveillance for breast cancer and care in magnetic resonance imaging in surveillance was addressed. ‘Considering own risk of developing breast cancer’, ‘Entrusting oneself to surveillance’ and ‘Living in a cycle’ represented women's perceptions of surveillance and care. The study results have implications for person‐centred care among women in the surveillance programme.

Patient or Public Contribution

No patient or public contribution.
Exploring behavioural patterns and their relationships with social annotation outcomes
Authors: Li Shan , Huang Xiaoshan , Zhu Gaoxia , Du Hanxiang , Zhong Tianlong , Hou Chenyu , Zheng Juan
Published: February 2024

Background

Social annotation has emerged as a promising educational technology that fosters collaborative reading and discussion of digital resources among learners. While the positive impact of social annotation on students' learning process and performance is widely acknowledged, students' behavioural patterns in social annotation are underexplored.

Objectives

This study investigated patterns in students' use of annotation and response behaviours in social annotation activities. We also explored how students' performance in the behavioural, cognitive, emotional, and social dimensions varied based on their behavioural patterns.

Methods

We recruited 93 undergraduates who were enrolled in an elective course at a large North American University. Students were tasked with collaboratively annotating the class readings uploaded to Perusall, a social annotation platform, over 7 weeks. We used metaclustering to determine the optimal number of clusters pertaining to student behaviours. We compared the differences among clusters across multiple performance dimensions.

Results and Conclusions

Two distinct clusters were identified and defined as initiators and responders. We found that responders had significantly longer active reading time and exhibited greater social annotation effort compared to initiators. However, initiators received more peer acknowledgement, as evidenced by higher upvotes. No significant difference was found in cognitive insight between initiators and responders, but responders demonstrated significantly higher cognitive discrepancy. Additionally, there were no significant differences in positive and negative tones between initiators and responders; however, responders displayed higher levels of prosocial behaviours than initiators. This study has significant practical implications regarding promoting students' collaborative learning experience in social annotation.
Organizations, Institutions, and Symbols: Introduction to a Point‐Counterpoint Conversation
Authors: Muzio Daniel , Dalpiaz Elena , Jancsary Dennis , Moser Christine , Leixnering Stephan , Höllerer Markus , Phillips Nelson , Kornberger Martin , Meyer Renate
Published: February 2024

The symbol is one of the key concepts in organization and management scholarship. Yet as indicated by the authors in this debate, it has not been adequately conceptualized and as such it remains rather blunt and opaque. In what is the first systematic conceptual debate on this topic, the authors of this Point‐Counterpoint debate seek to address this issue. The respective essays, despite marked differences in their approaches, offer novel and thought‐provoking accounts of what the symbol is and how it works. Taken together, these contributions offer a series of exciting new avenues to guide and redirect future research in this area.
A systematic review of the performance of actigraphy in measuring sleep stages
Authors: Yuan Hang , Hill Elizabeth A. , Kyle Simon D. , Doherty Aiden
Published: February 2024

The accuracy of actigraphy for sleep staging is assumed to be poor, but examination is limited. This systematic review aimed to assess the performance of actigraphy in sleep stage classification of adults. A systematic search was performed using MEDLINE, Web of Science, Google Scholar, and Embase databases. We identified eight studies that compared sleep architecture estimates between wrist‐worn actigraphy and polysomnography. Large heterogeneity was found with respect to how sleep stages were grouped, and the choice of metrics used to evaluate performance. Quantitative synthesis was not possible, so we performed a narrative synthesis of the literature. From the limited number of studies, we found that actigraphy‐based sleep staging had some ability to classify different sleep stages compared with polysomnography.
A narrative review of research linking non‐sexual social touch to sleep quality
Authors: Xie Yuxi , Feeney Brooke C.
Published: February 2024

This narrative review describes the current state of the literature that has examined associations between non‐sexual social touch (i.e., affectionate touch, touch therapies, touch with animals and inanimate objects that mimic social touch) and sleep quality. It also highlights areas for future research to clarify the links and to identify underlying mechanisms. Most existing studies have focussed on and shown positive effects of touch therapies (e.g., massage, therapeutic touch) on sleep quality in clinical populations. Although there are fewer studies examining how other forms of social touch are linked with sleep quality, the existing research provides preliminary evidence supporting affectionate touch (e.g., hugging, skin‐to‐skin contact) and tactile contact with animals (e.g., dogs) and objects that mimic social touch (e.g., robots, weighted blankets) as predictors of better sleep quality, while touch deprivation and touch aversion are associated with worse sleep quality. Informed by the existing literature, we additionally reviewed potential relational‐cognitive (e.g., felt‐security) and neurobiological (e.g., oxytocin) mechanisms likely to underlie associations between social touch and sleep quality. Overall, current research supports associations between non‐sexual social touch and sleep quality. However, future research is needed to establish these links for specific forms of social touch (and in various populations), to test explanatory mechanisms, and to identify boundary conditions. Understanding associations between non‐sexual social touch and sleep quality can inform the development of touch‐based interventions to improve sleep quality and health.
Exploring silique number in Brassica napus L.: Genetic and molecular advances for improving yield
Authors: Wang Hui , Li Xiaodong , Meng Boyu , Fan Yonghai , Khan Shahid Ullah , Qian Mingchao , Zhang Minghao , Yang Haikun , Lu Kun
Published: February 2024

Silique number is a crucial yield‐related trait for the genetic enhancement of rapeseed (Brassica napus L.). The intricate molecular process governing the regulation of silique number involves various factors. Despite advancements in understanding the mechanisms regulating silique number in Arabidopsis (Arabidopsis thaliana) and rice (Oryza sativa), the molecular processes involved in controlling silique number in rapeseed remain largely unexplored. In this review, we identify candidate genes and review the roles of genes and environmental factors in regulating rapeseed silique number. We use genetic regulatory networks for silique number in Arabidopsis and grain number in rice to uncover possible regulatory pathways and molecular mechanisms involved in regulating genes associated with rapeseed silique number. A better understanding of the genetic network regulating silique number in rapeseed will provide a theoretical basis for the genetic improvement of this trait and genetic resources for the molecular breeding of high‐yielding rapeseed.
A longitudinal study on the impact of high‐altitude hypoxia on perceptual processes
Authors: Guo Fumei , Wang Changming , Tao Getong , Ma Hailin , Zhang Jiaxing , Wang Yan
Published: February 2024

This study aimed to explore the neural mechanisms underlying high‐altitude (HA) adaptation and deadaptation in perceptual processes in lowlanders. Eighteen healthy lowlanders were administered a facial S1‐S2 matching task that included incomplete face (S1) and complete face (S2) photographs combined with ERP technology. Participants were tested at four time points: shortly before they departed the HA (Test 1), twenty‐five days after entering the HA (Test 2), and one week (Test 3) and one month (Test 4) after returning to the lowlands. Compared with those at sea level (SL), shorter reaction times (RTs), shorter latencies of P1 and N170, and larger amplitudes of complete face N170 were found in HAs. After returning to SL, compared with that of HA, the amplitude of the incomplete face P1 was smaller after one week, and the complete face was smaller after one month. The right hemisphere N170 amplitude was greater after entering HA and one week after returning to SL than at baseline, but it returned to baseline after one month. Taken together, the current findings suggest that HA adaptation increases visual cortex excitation to accelerate perceptual processing. More mental resources are recruited during the configural encoding stage of complete faces after HA exposure. The perceptual processes affected by HA exposure are reversible after returning to SL, but the low‐level processing stage differs between incomplete and complete faces due to neural compensation mechanisms. The configural encoding stage in the right hemisphere is affected by HA exposure and requires more than one week but less than one month to recover to baseline.
Does the use of GIS in geographical education yield better learning outcomes? Evidence from a quasi‐experimental study on air pollution teaching
Authors: Yang Daihu , Wang Chuanbing , Qian Liqing
Published: February 2024

The use of GIS to enhance student learning in geographical education has garnered broad recognition. Notwithstanding this, the diffusion of GIS technology into class teaching has been slow. This study endeavored to examine the effects of GIS usage in air pollution teaching on learning outcomes of secondary school students. To this end, two parallel classes in the same academic year were chosen as the control and experimental groups. A quasi‐experimental research design was used to compare the learning outcomes of the experimental group who were exposed to the use of GIS in air pollution teaching with those of the control group who were not. The results show that GIS‐based teaching does lead to improvement in students' learning outcomes, although not uniformly. More specifically, GIS‐based teaching enhances high‐order cognitive abilities related to application and analysis, highlighting the effectiveness of GIS as a tool in educational settings, especially for developing advanced cognitive abilities.
When do benefits turn to risks? Impact of a 900 mL whole blood donation on Special Forces performance
Authors: Degueldre Julie , Dessy E. , T'Sas F. , Keesebilck E. , Deneys V.
Published: February 2024

Background

Special Forces (SF) teams operate in remote environments with limited medical support. As a result, they may need to rely on buddy transfusions to treat bleeding teammates. Considering that 450 mL has no direct impact on their combat performances, it might be tempting to take more blood from a compatible donor to save a hemorrhaging teammate. This study investigates the effect of a 900 mL blood donation on SF operator performance and recovery time following this donation.

Study Design and Methods

Participants underwent a multifactorial assessment including measures of physiological parameters, vigilance, and physical performance. Results from the day of blood donation were compared with baseline values obtained 1 week earlier (i.e., immediate effect), as well as repeated testing at 7, 14, and approximately 30 days after blood donation (i.e., recovery period).

Results

Hemoglobin levels and heart rate were affected by giving blood. The participants also experienced a significant decrease in physical performance of more than 50% immediately after blood donation. Recovery was slow over the following weeks, remaining significantly different from baseline until full recovery around day 30. However, participants were still able to respond to a simple stimulus and adjust their response, if necessary, even immediately after donating blood.

Discussion

A 900 mL blood donation greatly affects the physical fitness of SF operators. A donation may be worthwhile if it is the only life‐saving procedure available and does not endanger the donor's life. The donor would then become a patient and unable to complete the mission.
Impact of bariatric surgery, lifestyle change, and pharmacotherapy on fertility in men with obesity: a systematic review protocol
Authors: Peel Andrew , Mathews Nicola , Vincent Andrew D. , Jesudason David , Wittert Gary , McPherson Nicole O.
Published: February 2024

Objective:

This review will determine whether various health interventions designed to reduce weight (lifestyle change, bariatric surgery, pharmacotherapy) in men with obesity are associated with improved fertility markers. The review will also establish whether the degree of weight loss achieved through these methods is associated with improvement.

Introduction:

Current preconception guidelines provide limited information for men with obesity. Small studies implementing lifestyle changes in men are associated with improvement in sperm quality, whereas bariatric surgery has not been associated with improvements in sperm quality. Determining the benefit of different interventions and the relationship to weight lost is necessary to optimize male fertility.

Inclusion criteria:

The population will be men younger than 50 years with overweight (BMI >25 kg/m2) or obesity (BMI >30 kg/m2). The exposure of interest will be an intervention undertaken to improve health or reduce weight, categorized as lifestyle change, bariatric surgery, or pharmacotherapy. Outcomes will include time to conception, fecundity rate, assisted reproduction outcomes, and semen quality measures. Secondary analysis will determine whether degree of weight loss achieved is associated with degree of improvement.

Methods:

This review will follow the JBI methodology for systematic reviews of etiology and risk. Databases to be searched will include PubMed, Embase (Ovid), Cochrane Central Register of Controlled Trials, Web of Science Core Collection, and Scopus. Articles not published or translated into English will be excluded. Methodological quality will be assessed using the JBI critical appraisal tools. Data will be extracted using a tool developed by the reviewers. Statistical meta-analysis will be performed where possible to synthesize outcomes of similar methods.

Review registration:

PROSPERO CRD42022349665
Complete Solutions for the Approximate Synthesis of Spherical Four-Bar Function Generators
Authors: O’Connor Sam , Plecnik Mark , Baskar Aravind , Joo James
Published: February 2024

Kinematic synthesis to meet an approximate motion specification naturally forms a constrained optimization problem. Instead of using local methods, we conduct global design searches by direct computation of all critical points. The idea is not new, but performed at scale is only possible through modern polynomial homotopy continuation solvers. Such a complete computation finds all minima, including the global, which allows for a full exploration of the design space, whereas local solvers can only find the minimum nearest to an initial guess. We form equality-constrained objective functions that pertain to the synthesis of spherical four-bar linkages for approximate function generation. We consider the general case where all mechanism dimensions may vary and a more specific case that enables the placement of ground pivots. The former optimization problem is shown to permit 268 sets of critical points, and the latter permits 61 sets. Critical points are classified as saddles or minima through a post-process eigenanalysis of the projected Hessian. The discretization points are contained within the coefficients of the stationarity polynomials, so the algebraic structure of the synthesis equations remains invariant to the number of points. The results of our computational work were used to design a mechanism that coordinates the folding wings. We also use this method to parameterize mechanism dimensions for a family of hyperbolic curves.
Reconfigurable Thick-Panel Structures Based on a Stacked Origami Tube
Authors: Liu Weiqi , Song Yuxing , Chen Yan , Zhang Xiao
Published: February 2024

Variable crease origami that exhibits crease topological morphing allows a given crease pattern to be folded into multiple shapes, greatly extending the reconfigurability of origami structures. However, it is a challenge to enable the thick-panel forms of such crease patterns to bifurcate uniquely and reliably into desired modes. Here, thick-panel theory combined with cuts is applied to a stacked origami tube with multiple bifurcation paths. The thick-panel form corresponding to the stacked origami tube is constructed, which can bifurcate exactly between two desired modes without falling into other bifurcation paths. Then, kinematic analysis is carried out, and the results reveal that the thick-panel origami tube is kinematically equivalent to its zero-thickness form with one degree-of-freedom (DOF). In addition, a reconfigurable physical prototype of the thick-panel origami tube is produced, which achieves reliable bifurcation control through a single actuator. Such thick-panel origami tubes with controllable reconfigurability have great potential engineering applications in the fields of morphing systems such as mechanical metamaterials, morphing wings, and deployable structures.
Prodomain-driven enzyme dimerization: a pH-dependent autoinhibition mechanism that controls
Plasmodium
Sub1 activity before merozoite egress
Authors: Martinez Mariano , Bouillon Anthony , Brûlé Sébastien , Raynal Bertrand , Haouz Ahmed , Alzari Pedro M. , Barale Jean-Christophe
Published: February 2024

Malaria symptoms are associated with the asexual multiplication of
Plasmodium falciparum
within human red blood cells (RBCs) and fever peaks coincide with the egress of daughter merozoites following the rupture of the parasitophorous vacuole (PV) and the RBC membranes. Over the last two decades, it has emerged that the release of competent merozoites is tightly regulated by a complex cascade of events, including the unusual multi-step activation mechanism of the pivotal subtilisin-like protease 1 (Sub1) that takes place in three different cellular compartments and remains poorly understood. Following an initial auto-maturation in the endoplasmic reticulum (ER) between its pro- and catalytic domains, the Sub1 prodomain (PD) undergoes further cleavages by the parasite aspartic protease plasmepsin X (PmX) within acidic secretory organelles that ultimately lead to full Sub1 activation upon discharge into the PV. Here, we report the crystal structure of full-length
P. falciparum
Sub1 (PfS1
FL
) and demonstrate, through structural, biochemical, and biophysical studies, that the atypical
Plasmodium-
specific Sub1 PD directly promotes the assembly of inactive enzyme homodimers at acidic pH, whereas Sub1 is primarily monomeric at neutral pH. Our results shed new light into the finely tuned Sub1 spatiotemporal activation during secretion, explaining how PmX processing and full activation of Sub1 can occur in different cellular compartments, and uncover a robust mechanism of pH-dependent subtilisin autoinhibition that plays a key role in
P. falciparum
merozoites egress from infected host cells.

IMPORTANCE

Malaria fever spikes are due to the rupture of infected erythrocytes, allowing the egress of
Plasmodium
sp. merozoites and further parasite propagation. This fleeting tightly regulated event involves a cascade of enzymes, culminating with the complex activation of the subtilisin-like protease 1, Sub1. Differently than other subtilisins, Sub1 activation strictly depends upon the processing by a parasite aspartic protease within acidic merozoite secretory organelles. However, Sub1 biological activity is required in the pH neutral parasitophorous vacuole, to prime effectors involved in the rupture of the vacuole and erythrocytic membranes. Here, we show that the unusual, parasite-specific Sub1 prodomain is directly responsible for its acidic-dependent dimerization and autoinhibition, required for protein secretion, before its full activation at neutral pH in a monomeric form. pH-dependent Sub1 dimerization defines a novel, essential regulatory element involved in the finely tuned spatiotemporal activation of the egress of competent
Plasmodium
merozoites.
Resolution of gastric antral vascular ectasia following cessation of imatinib
Authors: Maye James A , Baker Olivia , Sheikh Nadim
Published: February 2024

A female patient in her 80s presented with chronic iron-deficiency anaemia secondary to gastric antral vascular ectasia (GAVE), despite repeated endoscopic treatment. Her medical history was notable for chronic myeloid leukaemia, for which she took imatinib. Due to a possible association between imatinib and GAVE described in a small number of case reports, cessation of imatinib was trialled. This led to a significant improvement in the patient’s anaemia and resolution of GAVE on repeat endoscopy. GAVE is an uncommon cause of gastrointestinal bleeding, the aetiology of which is uncertain. This report describes an approach to the differential diagnosis of chronic iron-deficiency anaemia and an overview of GAVE syndrome. It illustrates the benefit of broadening the differential when the diagnosis is uncertain and the utility of case reports in informing the differential diagnosis.
Variably protease-sensitive prionopathy with methionine homozygosity at codon 129 in the prion protein gene
Authors: Clemmensen Frederikke Kragh , Areskeviciute Ausrine , Lund Eva Løbner , Roos Peter
Published: February 2024

Variably protease-sensitive prionopathy (VPSPr) is a recently characterised rare subtype of sporadic prion disease, mainly affecting individuals with valine homozygosity at codon 129 in the prion protein gene, with only seven methionine homozygote cases reported to date. This case presents clinical, neuropathological and biochemical features of the eighth VPSPr case worldwide with methionine homozygosity at codon 129 and compares the features with the formerly presented cases.

The patient, a woman in her 70s, presented with cognitive decline, impaired balance and frequent falls. Medical history and clinical presentation were suggestive of a rapidly progressive dementia disorder. MRI showed bilateral thalamic hyperintensity. Cerebrospinal fluid real-time quaking-induced conversion was negative, and the electroencephalogram was unremarkable. The diagnosis was established through post-mortem pathological examinations. VPSPr should be suspected in rapidly progressive dementia lacking typical features or paraclinical results of protein misfolding diseases.
The brain nebula: minimally invasive brain–computer interface by endovascular neural recording and stimulation
Authors: He Qiheng , Yang Yi , Ge Peicong , Li Sining , Chai Xiaoke , Luo Zhongqiu , Zhao Jizong
Published: February 2024

A brain–computer interface (BCI) serves as a direct communication channel between brain activity and external devices, typically a computer or robotic limb. Advances in technology have led to the increasing use of intracranial electrical recording or stimulation in the treatment of conditions such as epilepsy, depression, and movement disorders. This indicates that BCIs can offer clinical neurological rehabilitation for patients with disabilities and functional impairments. They also provide a means to restore consciousness and functionality for patients with sequelae from major brain diseases. Whether invasive or non-invasive, the collected cortical or deep signals can be decoded and translated for communication. This review aims to provide an overview of the advantages of endovascular BCIs compared with conventional BCIs, along with insights into the specific anatomical regions under study. Given the rapid progress, we also provide updates on ongoing clinical trials and the prospects for current research involving endovascular electrodes.
Personalised preinterventional risk stratification of mortality, length of stay and hospitalisation costs in transcatheter aortic valve implantation using a machine learning algorithm: a pilot trial
Authors: Zisiopoulou Maria , Berkowitsch Alexander , Redlich Leonard , Walther Thomas , Fichtlscherer Stephan , Leistner David M
Published: February 2024

Introduction

Risk stratification based on Euroscore II (ESII) is used in some centres to assist decisions to perform transcatheter aortic valve implant (TAVI) procedures. ESII is a generic, non-TAVI-specific metric, and its performance fades for mortality at follow-up longer than 30 days. We investigated if a TAVI-specific predictive model could achieve improved predictive preinterventional accuracy of 1-year mortality compared with ESII.

Patients and methods

In this prospective pilot study, 284 participants with severe symptomatic aortic valve stenosis who underwent TAVI were enrolled. Standard clinical metrics (American Society of Anesthesiology (ASA), New York Heart Association and ESII) and patient-reported outcome measures (EuroQol-5 Dimension-Visual Analogue Scale, Kansas City Cardiomyopathy Questionnaire and Clinical Frailty Scale (CFS)) were assessed 1 day before TAVI. Using these data, we tested predictive models (logistic regression and decision tree algorithm (DTA)) with 1-year mortality as the dependent variable.

Results

Logistic regression yielded the best prediction, with ASA and CFS as the strongest predictors of 1-year mortality. Our logistic regression model score showed significantly better prediction accuracy than ESII (area under the curve=0.659 vs 0.800; p=0.002). By translating our results to a DTA, cut-off score values regarding 1-year mortality risk emerged for low, intermediate and high risk. Treatment costs and length of stay (LoS) significantly increased in high-risk patients.

Conclusions and significance

A novel TAVI-specific model predicts 1-year mortality, LoS and costs after TAVI using simple, established, transparent and inexpensive metrics before implantation. Based on this preliminary evidence, TAVI team members and patients can make informed decisions based on a few key metrics. Validation of this score in larger patient cohorts is needed.
Real-time ultrasound-guided mid-thoracic epidural access using a novel paramedian cross (PX) view and drip infusion technique: a brief technical report
Authors: Sivashanmugam T , Archana Areti , Nandhini P , Rani P
Published: February 2024

Background

Real-time ultrasound guidance (USG) has been applied for lower thoracic epidural access, but the more challenging mid-thoracic epidural (MTE) access remains underexplored. This report presents a technique of real-time US guidance with a novel paramedian cross view, termed “the PX view,” for securing MTE catheters, along with an outcome analysis from a retrospective case series.

Methods

Medical records of patients who underwent USG-MTE catheter placement with the PX view and drip infusion technique from January to December 2022 were reviewed. All catheters were placed with patients in the prone position under mild to moderate procedural sedation. The process of acquiring the PX view, in-plane needling technique, and the use of drip infusion to identify loss of resistance were detailed. The incidence of successful PX view attainment, the number of attempts, redirections, failures, and any technique-related complications were recorded.

Results

Fifty-one patients underwent USG-MTE catheter attempts, (42 with median sternotomy, 3 fractured ribs, 3 upper abdominal laparotomies, 2 modified radical mastectomies, and 1 thoracotomy). A satisfactory PX view was obtained in all patients, and the epidural space was identified during the first needle entry in 49 cases, resulting in a 96% first-attempt success rate. Seven patients required needle redirections, while two patients needed a second needle entry. No technique-related complications were documented.

Conclusion

The combination of the PX view and the drip infusion method proved effective for real-time ultrasound-guided MTE catheter placement.
Urgent and long overdue: legal reform and drug decriminalization in Canada
Authors: Gruben Vanessa , Hyshka Elaine , Bonn Matthew , Cox Chelsea , Gagnon Marilou , Guta Adrian , Jackman Martha , Mercredi Jason , Munga Akia , Oscapella Eugene , Strike Carol , Virani Hakique
Published: February 2024

The International Guidelines on Human Rights and Drug Policy recommend that states commit to adopting a balanced, integrated, and human rights-based approach to drug policy through a set of foundational human rights principles, obligations arising from human rights standards, and obligations arising from the human rights of particular groups. In respect of the Guidelines and standing obligations under UN Treaties, Canada must adopt stronger and more specific commitments for a human rights-based, people-centered, and public health approach. This approach must commit to the decriminalization of people who use drugs and include the decriminalization of possession, purchase, and cultivation for personal consumption. In this report, we will first turn to the legal background of Canada's drug laws. Next, we will provide an overview of ongoing law reform proposals from civil society groups, various levels of government, the House of Commons, and the Senate. We end with a three-staged approach to reform and a series of targeted recommendationscr.