bluuebunny/crossref_metadata_2025 huggingface dataset:
FLApy: A Python package for evaluating the 3D light availability heterogeneity within forest communities
Authors: Wang Bin , Proctor Cameron , Yao Zhiliang , Li Ninglv , Chen Qifei , Liu Wenjun , Ma Suhui , Jing Chuanbao , Zhou Zhaoyu , Liu Weihong , Ma Yufeng , Wang Zimu , Zhang Zhiming , Lin Luxiang
Published: July 2024

Light availability (LAv) dictates a variety of biological and ecological processes across a range of spatiotemporal scales. Quantifying the spatial pattern of LAv in three‐dimensional (3D) space can promote the understanding of microclimates that are critical to fine‐scale species distribution. However, there is still a lack of tools that are robust to evaluate spatiotemporal heterogeneity of LAv in forests.

Here, we propose the Forest Light Analyzer python package (FLApy), an open‐source computational tool designed for the analysis of intra‐forest LAv variation across multiple spatial scales. FLApy is freely invoked by Python, facilitating the processing of LiDAR point cloud data into a 3D data container constructed by voxels, as well as traversal calculations related to the LAv regime by high performance synthetic hemispherical algorithm. Furthermore, FLApy incorporates 37 indicators, enabling users to expediently export and visualize LAv patterns and the evaluation of heterogeneity of LAv at two scales (voxel scale and 3D‐cluster scale) for a range of fine‐scale ecological study purposes.

To validate the efficacy of the FLApy, we employed a simulated point cloud dataset that simulates forests (varying in canopy closure). Furthermore, to evaluate real world forest, we executed the standard workflow of FLApy utilizing drone‐derived data from three subtropical evergreen broad‐leaved forest dynamics plots within the Ailao Mountain Reserve. Our findings underscore that a series of indices derived from FLApy provide a robust characterization of light availability heterogeneity within diverse forest settings. Additionally, when juxtaposed with conventional monitoring techniques, the metrics offered by FLApy demonstrated better generality in our field assessments.

FLApy offers ecologists a solution for rapid quantification of understory light 3D‐regimes across multiple scales, addressing the disparity between traditional manual approaches and the precision required for contemporary ecological studies. Moreover, FLApy provides robust support for the establishment and expansion of heterogeneity indices based on 3D micro‐environments, enhancing our understanding of the largely uncharted 3D structural patterns. Anticipated outcomes suggest that FLApy will enhance our knowledge concerning the intra‐forest climatic conditions into a 3D context, proving pivotal in the delineation of microhabitats and the development of detailed 3D‐scale species distribution models.
A probabilistic time geographic approach to quantifying seabird‐vessel interactions
Authors: Rutter J. D. , Borrelle S. B. , Bose S. , Carneiro A. P.B. , Clark B. L. , Debski I. , Elliott G. , Fischer J. H. , Walker K. , Pittman S. J.
Published: July 2024

Accounting for uncertainty is essential for precautionary approaches to managing seabird bycatch in commercial fisheries. However, there is no existing mechanism to explicitly quantify the uncertainty of seabird‐vessel interactions (i.e. co‐occurrence in space and time). Here we develop a time geographic method to measure the probability of individual birds encountering (co‐occurring within 30 km) and attending (within 5 km) individual fishing vessels. The approach involves creating voxel‐based probabilistic space–time prisms (PSTPs) to model the movements of individual birds and vessels, with trajectory data from bird‐borne GPS devices and vessel Automatic Identification Systems (AIS). We intersected these PSTPs to quantify the probability of interaction between bird‐vessel pairs over time and space. We demonstrate the approach with a case study of interactions of Endangered Toroa (Antipodean Albatross; Diomedea antipodensis antipodensis) with pelagic longline vessels in part of the South Pacific high seas. We found 15 vessels within 150 km and 3 h of two birds, yet interaction occurred with only two of those vessels. We visualised the probability of encounter and attendance over time and space and determined that interactions lasted several hours each (up to 6.2–14.1 h attendance, 20.8–26.1 h encounter for one bird‐vessel pair). Our time geographic approach adds to existing tools to quantify seabird bycatch risk by providing an explicit measure of uncertainty of seabird‐vessel interactions. We provide a flexible methodological pathway and R scripts, the application of which would allow managers to estimate interaction probability for multiple marine species and fisheries, including those with lower‐resolution positional datasets.
Ruellia blechum: A new case of cleistogamy in Acanthaceae
Authors: Bonzanini Olavo Honório Corrêa , Soares Milena Rodrigues , da Silva Devando Rosa , Matias Raphael
Published: July 2024

Cleistogamy is characterized by the presence of flowers that are permanently closed, yet they still produce fruits and seeds through autonomous self‐pollination. Populations with cleistogamous flowers can also have flowers that open, called chasmogamous, which promote cross‐pollination and genetic variability. Acanthaceae is among the families with the highest frequency of cleistogamy, observed mainly in Ruellia. This study aimed to assess cleistogamy in Ruellia blechum for the first time. In a population in Central Brazil, we analysed the production of cleistogamous and chasmogamous flowers, their fruiting, differences in flower bud size, self‐pollination in cleistogamous flowers and visitors in chasmogamous flowers. Of the flower buds observed, 35.29% remained closed (cleistogamous flowers), with 31.25% of them forming fruit. In contrast, 60.24% of the flowers that opened (chasmogamous) developed fruit. The length of cleistogamous flowers was shorter than that of chasmogamous floral buds in pre‐anthesis. On average, 24.45 pollen grains were self‐deposited on the stigma of a cleistogamous flower. The chasmogamous flowers were visited mainly by small bees. This study is the first to confirm the presence of cleistogamous flowers in R. blechum. However, their co‐occurrence with chasmogamous flowers suggests a fitness advantage for maintaining a mixed mating strategy.
Discrimination experiences and problematic alcohol and cannabis use in young adulthood
Authors: Perez Lilian G. , Troxel Wendy M. , Tucker Joan S. , Dunbar Michael S. , Rodriguez Anthony , Klein David J. , D'Amico Elizabeth J.
Published: July 2024

Background and Objectives

Limited research has examined how discrimination in young adulthood relates to substance use. We examined how multiple and specific types (e.g., race‐based) of experiences of unfair treatment are related to problematic alcohol and cannabis use.

Methods

We analyzed cross‐sectional data from a diverse cohort of young adults (mean age 24.7) predominantly residing in southern California (n = 2303) to examine associations of multiple (count) and specific experiences (race‐, sexual orientation‐, gender‐based) of perceived everyday discrimination with self‐reported alcohol and cannabis use outcomes (consequences, use disorders, and solitary use). We also tested interactions between the three specific discrimination experiences and sociodemographic characteristics (e.g., race‐based discrimination × race/ethnicity).

Results

In this diverse sample (e.g., 47% Latinx/o and 22% Asian; 22% sexual/gender diverse; 56% female) of young adults, about 46% reported up to four different discrimination experiences and 27% reported race‐, 26% gender‐, and 5% sexual orientation‐based discrimination. Race‐ and gender‐based discrimination and experiencing more types of discrimination were associated with worse cannabis use outcomes. Race‐based discrimination was associated with fewer alcohol consequences and lower Alcohol Use Disorders Identification Test (AUDIT) scores. Associations with sexual orientation‐based discrimination and the interactions were not significant.

Discussion and Conclusions

Findings build on limited research on associations of discrimination with cannabis use in young adults. More work is needed to understand the mechanisms by which discrimination influences drinking behaviors.

Scientific Significance

This study advances the field by examining the unique contributions of specific and multiple types of discrimination experiences in young adulthood, a critical developmental period in which substance use peaks.
The impact of impaired intrauterine growth on male fertility: A systematic review and meta‐analysis
Authors: Meng Fucheng , Yao Minglan , Li Sujuan , Tian Anran , Zhang Cai , Luo Xiaoping
Published: July 2024

Background

Adverse intrauterine environment was believed to have deleterious effects on the gonadal function. However, the association between impaired intrauterine growth and fertility in adult males has not been established.

Objectives

To compare the reproductive rates of males born small for gestational age (SGA), with low birth weight (LBW) or very low birth weight (VLBW) with control groups.

Methods

The Preferred Reporting Items for Systematic reviews and Meta‐Analyses (PRISMA) statement was followed to search PubMed, Web of Science, Cochrane Library, and Embase databases from inception to June 16, 2023. Cohort studies investigating the reproductive rates of males born SGA, with LBW or VLBW were included. A random or fixed effects model was used for different exposures.

Results

A total of 10 studies out of 3,801 records were included. Males born SGA showed a higher risk of infertility than the control group (odds ratio, OR = 0.91, 95% confidence interval, 95% CI 0.89–0.93, p = 0.000). The reproductive rates of individuals born with LBW or VLBW were lower than the control group (OR = 0.86, 95% CI 0.78–0.94, p = 0.001; OR = 0.57, 95% CI 0.40–0.81, p = 0.002, respectively). Participants were further divided into two age groups of 18–35 and 35–45 years. In both subgroups, the reproductive rates were lower in males born SGA, with LBW or VLBW compared with controls. Sensitivity analysis showed the robustness of the pooled estimates among LBW and VLBW.

Conclusion

In summary, SGA, LBW, and VLBW were associated with a higher risk of male infertility in both early and middle adulthood. Achieving optimal intrauterine growth would be helpful to prevent male infertility.
Editorial: Treatments for inflammatory bowel disease across the age‐spectrum—Are they the same?
Authors: Ho Agnes Hiu Yan , Mak Joyce Wing Yan
Published: July 2024

LINKED CONTENT

This article is linked to Nordestgaard et al papers. To view these articles, visit https://doi.org/10.1111/apt.18106 and https://doi.org/10.1111/apt.18163
Evaluation of the short‐term complications of intracorporeal anastomosis in right‐sided colectomy
Authors: Nakagawa Masataka , Kochi Masatoshi , Teshima Marino , Kitasaki Nao , Abe Tomoyuki , Hotta Ryuichi , Inoue Masashi , Shimohana Junichi , Toyota Kazuhiro
Published: July 2024

Introduction

The benefits of intracorporeal anastomosis in laparoscopic colorectal cancer surgery remain unclear. Therefore, we aimed to investigate the short‐term postoperative outcomes of intracorporeal anastomosis.

Methods

We retrospectively analyzed 87 patients who underwent laparoscopic surgery for right‐sided colon tumors using a colon database.

Results

Of the 87 patients, 23 underwent intracorporeal anastomosis and 64 underwent extracorporeal anastomosis. Intraoperative bleeding, wound length, exhaust gas, preoperative white blood cell count, and C‐reactive protein (postoperative day 1) were higher in the extracorporeal anastomosis group than in the intracorporeal anastomosis group. The incidence of wound infection was higher in the intracorporeal anastomosis group than in the extracorporeal anastomosis group. In the irrigation water bacterial culture collected after anastomosis, the positive group had a higher white blood cell count on postoperative day 1 and higher C‐reactive protein levels on postoperative day 3 than did the negative group. Patients who underwent chemical preparation had lower C‐reactive protein levels on postoperative day 1 than did the group who did not undergo chemical preparation.

Conclusion

Despite the advantages of intracorporeal anastomosis in terms of wound length and intraoperative bleeding, the risk of infection may increase during the introduction phase. Fever and inflammatory responses are significantly elevated in culture‐positive cases.
A highly selective inhibitor of discoidin domain receptor‐1 (DDR1‐IN‐1) protects corneal epithelial cells from YAP/ACSL4‐mediated ferroptosis in dry eye
Authors: Dai Yiqin , Li Yue , Xu Jianjiang , Zhang Jing
Published: July 2024

Background and Purpose

This study investigated the involvement of discoidin domain receptor (DDR) in dry eye and assessed the potential of specific DDR inhibitors as a therapeutic strategy for dry eye by exploring the underlying mechanism.

Experimental Approach

Dry eye was induced in Wistar rats by applying 0.2% benzalkonium chloride (BAC), after which rats were treated topically for 7 days with DDR1‐IN‐1, a selective inhibitor of DDR1. Clinical manifestations of dry eye were assessed on Day‐7 post‐treatment. Histological evaluation of corneal damage was performed using haematoxylin and eosin (H&E) staining. In vitro, immortalized human corneal epithelial cells (HCECs) exposed to hyperosmotic stress (HS) were treated with varying doses of DDR1‐IN‐1 for 24 h. The levels of lipid peroxidation in dry eye corneas or HS‐stimulated HCECs were assessed. Protein levels of DDR1/DDR2 and related pathways were detected by western blotting. The cellular distribution of acyl‐CoA synthetase long chain family member 4 (ACSL4) and Yes‐associated protein (YAP) was evaluated using immunohistochemistry or immunofluorescent staining.

Key Results

In dry eye corneas, only DDR1 expression was significantly up‐regulated compared with normal controls. DDR1‐IN‐1 treatment significantly alleviated dry eye symptoms in vivo. The treatment remarkably reduced lipid hydroperoxide (LPO) levels and suppressed the expression of ferroptosis markers, particularly ACSL4. Overexpression or reactivation of YAP diminished the protective effects of DDR1‐IN‐1, indicating the involvement of the Hippo/YAP pathway in DDR1‐targeted therapeutic effects.

Conclusions and Implications

This study confirms the significance of DDR1 in dry eye and highlights the potential of selective DDR1 inhibitor(s) for dry eye treatment.
Protocol for a national, multicentre study of post‐endoscopy colorectal and upper gastrointestinal cancers: The POET study
Authors: Xu William , McGuinness Matthew James , Wells Cameron , Varghese Chris , Elliott Brodie , Paterson Luke , Collins Ray , Lill Marianne , Windsor John , Koea Jonathan , Panoho Joy , Walmsley Russell , Wright Deborah , Parry Susan , Harmston Christopher ,   the STRATA Collaborative
Published: July 2024

Aim

The primary aim of the study is to define the post‐colonoscopy colorectal cancer (PCCRC) three‐year rate and the post‐endoscopy upper gastrointestinal cancer (PEUGIC) three‐year rate across public hospitals in Aotearoa New Zealand.

Method

This retrospective cohort study will be conducted via the trainee‐led STRATA Collaborative network. All public hospitals in Aotearoa New Zealand will be eligible to participate. Data will be collected on all adult patients who are diagnosed with colorectal adenocarcinoma within 6 to 48 months of a colonoscopy and all adult patients diagnosed with gastroesophageal cancer within 6 to 48 months of an upper gastrointestinal endoscopy. The study period will be from 2010 to 2022. The primary outcome is the PCCRC 3‐year rate and the PEUGIC 3‐year rate. Secondary aims are to define and characterize survival after PCCRC or PEUGIC, the cause of PCCRC as based on the World Endoscopy Organization System of Analysis definitions, trends over time, and centre level variation.

Conclusion

This protocol describes the methodology for a nationwide retrospective cohort study on PCCRC and PEUGIC in Aotearoa New Zealand. These data will lay the foundation for future studies and quality improvement initiatives.
Robotic versus laparoscopic right colectomy for nonmetastatic pT4 colon cancer: A European multicentre propensity score‐matched analysis
Authors: de'Angelis Nicola , Schena Carlo Alberto , Espin‐Basany Eloy , Piccoli Micaela , Alfieri Sergio , Aisoni Filippo , Coccolini Federico , Frontali Alice , Kraft Miquel , Lakkis Zaher , Le Roy Bertrand , Luzzi Andrea Pierre , Milone Marco , Pattacini Gianmaria Casoni , Pellino Gianluca , Petri Roberto , Piozzi Guglielmo Niccolò , Quero Giuseppe , Ris Frederic , Winter Des C. , Khan Jim ,   MERCY Study Collaborating Group Members
Published: July 2024

Aim

Minimally invasive surgery has been increasingly adopted for locally advanced colon cancer. However, evidence comparing robotic (RRC) versus laparoscopic right colectomy (LRC) for nonmetastatic pT4 cancers is lacking.

Methods

This was a multicentre propensity score‐matched (PSM) study of a cohort of consecutive patients with pT4 right colon cancer treated with RRC or LRC. The two surgical approaches were compared in terms of R0, number of lymph nodes harvested, intra‐ and postoperative complication rates, overall (OS), and disease‐free survival (DFS).

Results

Among a total of 200 patients, 39 RRC were compared with 78 PS‐matched LRC patients. The R0 rate was similar between RRC and LRC (92.3% vs. 96.2%, respectively; p = 0.399), as was the odds of retrieving 12 or more lymph nodes (97.4% vs. 96.2%; p = 1). No significant difference was noted for the mean operating time (192.9 min vs. 198.3 min; p = 0.750). However, RRC was associated with fewer conversions to laparotomy (5.1% vs. 20.5%; p = 0.032), less blood loss (36.9 vs. 95.2 mL; p < 0.0001), fewer postoperative complications (17.9% vs. 41%; p = 0.013), a shorter time to flatus (2 vs. 2.8 days; p = 0.009), and a shorter hospital stay (6.4 vs. 9.5 days; p < 0.0001) compared with LRC. These results were confirmed even when converted procedures were excluded from the analysis. The 1‐, 3‐ and 5‐year OS (p = 0.757) and DFS (p = 0.321) did not significantly differ between RRC and LRC.

Conclusion

Adequate oncological outcomes are observed for RRC and LRC performed for pT4 right colon cancer. However, RRC is associated with lower conversion rates and improved short‐term postoperative outcomes.
When the Ends Justify the Mean: The Endpoint Leverage Effect in Distribution Perception
Authors: Ebert Jonas , Deutsch Roland
Published: July 2024

Previous research described different cognitive processes on how individuals process distributional information. Based on these processes, the current research uncovered a novel phenomenon in distribution perception: the Endpoint Leverage Effect. Subjective endpoints influence distribution estimations not only locally around the endpoint but also influence estimations across the whole value range of the distribution. The influence is largest close to the respective endpoint and decreases in size toward the opposite end of the value range. Three experiments investigate this phenomenon: Experiment 1 provides correlational evidence for the Endpoint Leverage Effect after presenting participants with a numerical distribution. Experiment 2 demonstrates the Endpoint Leverage Effect by manipulating the subjective endpoints of a numerical distribution directly. Experiment 3 generalizes the phenomenon by investigating a general population sample and estimations regarding a real‐world income distribution. In addition, quantitative model analysis examines the cognitive processes underlying the effect. Overall, the novel Endpoint Leverage Effect is found in all three experiments, inspiring further research in a wide area of contexts.
A Hierarchical Bayesian Model of Adaptive Teaching
Authors: Chen Alicia M. , Palacci Andrew , Vélez Natalia , Hawkins Robert D. , Gershman Samuel J.
Published: July 2024

How do teachers learn about what learners already know? How do learners aid teachers by providing them with information about their background knowledge and what they find confusing? We formalize this collaborative reasoning process using a hierarchical Bayesian model of pedagogy. We then evaluate this model in two online behavioral experiments (N= 312 adults). In Experiment 1, we show that teachers select examples that account for learners' background knowledge, and adjust their examples based on learners' feedback. In Experiment 2, we show that learners strategically provide more feedback when teachers' examples deviate from their background knowledge. These findings provide a foundation for extending computational accounts of pedagogy to richer interactive settings.
The interactive walkway provides fit‐for‐purpose fall‐risk biomarkers in the elderly: Comparison of zolpidem and suvorexant
Authors: Koopmans Ingrid , Geerse Daphne , de Ridder Lara , Roerdink Melvyn , Juachon Maria Joanna , Muehlan Clemens , Dingemanse Jasper , van Gerven Joop , Groeneveld Geert Jan , Zuiker Rob
Published: July 2024

Dynamic balance assessments such as walking adaptability may yield a more realistic prediction of drug‐induced falls compared with postural stability measurements, as falls often result from limited gait adjustments when walking. The Interactive Walkway (IWW) measures walking adaptability but sensitivity to medication effects is unknown. If proven sensitive and specific, IWW could serve as a biomarker for targeted fall‐risk assessments in early clinical drug development. In this three‐way crossover study, 18 healthy elderly (age: 65–80 years) subjects received 5 mg zolpidem, 10 mg suvorexant, or placebo in the morning. Assessments were performed pre‐dose and approximately hourly until 9 h post‐dose. IWW assessments included an 8‐meter walking test, goal‐directed stepping, obstacle‐avoidance, and tandem‐walking. Other pharmacodynamic measurements were the Timed‐Up‐and‐Go (TUG) test at a comfortable and fast pace, adaptive tracking, and body sway. A decline in performance was observed for zolpidem compared with placebo for 3 h post‐dose in IWW walking adaptability outcome measures, TUG, adaptive tracking, and body sway. For the IWW tasks, a decrease in walking speed (among others) was observed. IWW parameters were not affected by suvorexant compared with placebo at any timepoint. However, an increase of 9.8% (95%CI: 1.8%, 18.5%) in body sway was observed for suvorexant compared with placebo up to 3 h post‐dose. The IWW successfully quantified drug effects of two hypnotic drugs and distinguished between zolpidem and suvorexant regarding their effects on walking. As a biomarker, the IWW demonstrated sensitivity in assessing dynamic balance and potential fall risk in early phase clinical drug development.
Vacuoles in a bone marrow smear: Not always reactive
Authors: Mayani‐Mayani Karan , Barrios‐Suvelza Marcelo Pedro , Bilbao‐Sieyro Cristina , González‐Arnay Emilio
Published: July 2024

Vacuoles are a common observation in bone marrow smears, often related to reactive causes. The authors report a clinical case with this cytology finding in a 67‐year‐old male patient with systemic symptoms.
Kutane Metastasen: Von der Epidemiologie bis zur Therapie
Authors: Gschnell Martin , Volberg Christian , Hauser Christina , Krönig Lisa
Published: July 2024

Kutane Metastasen treten bei bis zu 10% aller onkologischer Patienten auf, wobei diese abhängig von der Entität an verschiedenen Lokalisationen vorkommen können. Oftmals gehen Hautmetastasen mit einer großen psychischen Belastung einher und sind insbesondere bei Exulzeration für die betroffenen Personen mit Scham und sozialem Rückzug vergesellschaftet. In dieser Übersichtsarbeit werden die entsprechenden diagnostischen und therapeutischen Optionen dargestellt. Hierbei wird auf die häufigsten Tumorentitäten, bei denen kutane Filiae beobachtet werden, eingegangen. Entsprechend des aktuellen Forschungsstandes werden lokale wie systemische Behandlungsoptionen präsentiert.
Real‐World‐Effektivität und Sicherheit der LAight‐Therapie bei Patienten mit Hidradenitis suppurativa
Authors: Strobel Alexandra , Schultheis Michael , Staubach Petra , Grabbe Stephan , Mann Caroline , Hennig Katharina , Szepietowski Jacek C , Matusiak Lukasz , Krajewski Piotr , von Stebut Esther , Garcovich Simone , Bayer Hans , Heise Marcus , Podda Maurizio , Kirschner Uwe , Nikolakis Georgios
Published: July 2024

Hintergrund und Ziele

Hidradenitis suppurativa (HS)/Acne inversa (Ai) ist eine chronische, stark beeinträchtigende Erkrankung mit begrenzten Therapiemöglichkeiten. Die gerätebasierte LAight‐Therapie wurde 2017 in Europa zugelassen. Ziel dieser Studie war es, die Auswirkungen einer Real‐World‐Versorgung mit der LAight‐Therapie auf die Krankheitsaktivität und ‐belastung von 3437 Patienten zu analysieren.

Patienten und Methodik

In die Analyse wurden alle Patienten aufgenommen, die eine HS‐Diagnose und mindestens eine LAight‐Behandlung erhalten hatten. Die Endpunkte Hidradenitis Suppurativa Severity Score System (IHS4), Schmerz auf der numerischen Ratingskala (pain‐NRS) und der Dermatologische‐Lebensqualitäts‐Index (DLQI) wurden mit Hilfe eines linearen gemischten Modells für wiederholte Messungen (MMRM) über 26 Wochen Versorgung mit der LAight‐Therapie analysiert. Darüber hinaus wurden die Responderraten für alle Endpunkte berechnet und das Sicherheitsprofil der Therapie sowie die Patientenzufriedenheit eingehend untersucht.

Ergebnisse

Während der 26‐wöchigen Versorgung mit LAight wurde ein signifikanter Rückgang des IHS4, Schmerz‐NRS und DLQI erreicht. Der BMI hatbei Therapiestart hatte einen signifikant negativen Einfluss auf das Therapieansprechen hinsichtlich Schmerz‐NRS und DLQI.

Schlussfolgerungen

Diese Studie bestätigt, dass die LAight‐Therapie zu einer überzeugenden Krankheitskontrolle in allen Schweregraden führt und eine wertvolle Ergänzung des therapeutischen Repertoires bei HS darstellt.
Kombinationstherapie des Sneddon‐Syndroms zur Senkung der Inzidenz zerebrovaskulärer Komplikationen
Authors: Narwutsch Albert , Wohlrab Johannes , Sperfeld Anne‐D. , Sunderkötter Cord
Published: July 2024

Hintergrund

Das Sneddon‐Syndrom wird als okkludierende Vaskulopathie verstanden, die an der Haut durch eine generalisierte Livedo racemosa und im zentralen Nervensystem durch transitorische ischämische Attacken, Schlaganfälle und kognitive oder motorische Defizite klinisch evident wird. Zur Therapie werden Thrombozytenaggregationshemmer oder Antikoagulanzien empfohlen. Aufgrund der begrenzten therapeutischen Wirksamkeit und der daraus resultierenden schwerwiegenden Komplikationen schlagen wir eine Kombinationstherapie mit zusätzlichen Infusionszyklen von Alprostadil und Captopril vor und berichten über erste Langzeitergebnisse.

Patienten und Methodik

Alle Patienten unserer Klinik mit primärem Sneddon‐Syndrom unter Kombinationstherapie wurden im Zeitraum von 1995 bis 2020 in eine systematische retrospektive Analyse einbezogen. Die Auswertung des therapeutischen Outcomes erfolgte mittels deskriptiver Statistik im Vergleich zu historischen Kontrollgruppen, die eine Monotherapie erhalten hatten. Zudem haben wir die Ereignisrate von Komplikationen bei Unterbrechung der Kombinationstherapie analysiert.

Ergebnisse

Während des Beobachtungszeitraums der Kombinationstherapie von 99,7 Patientenjahren ereignete sich keine transitorische ischämische Attacke und die Schlaganfallrate sank auf 0,02 pro Patientenjahr. Im Vergleich lagen bei den historischen Kontrollen die Raten von transitorischen ischämischen Attacken und Schlaganfällen zwischen 0,08 und 0,035 pro Patientenjahr. Nach Unterbrechung der Alprostadil‐Therapie traten bei drei Patientinnen acht Ereignisse auf.

Schlussfolgerungen

Die Kombinationstherapie reduziert langfristig die Inzidenz von ischämischen Ereignissen bei Patienten mit primärem Sneddon‐Syndrom.
Validierung des Deutschen Pruritusfragebogens zur systematischen Erfassung von chronischem Pruritus
Authors: Weisshaar Elke , Kupfer Jörg P. , Bentz Philipp , Staubach‐Renz Petra , Legat Franz , Kremer Andreas E. , Ständer Hartmut , Streit Markus , Darsow Ulf , Mettang Thomas , Ständer Sonja
Published: July 2024

Hintergrund

Chronischer Pruritus ist ein klinisch heterogenes Symptom unterschiedlicher Dauer, Intensität oder Qualität. Bislang gibt es kein validiertes deutschsprachiges Instrument, das relevante Parameter systematisch erfragt. Mit Unterstützung der Arbeitsgemeinschaft Pruritusforschung (AGP) wurde 2008 ein Fragebogen zur Erfassung von chronischem Pruritus (AGP‐Fragebogen) entwickelt. Das im Nachgang überarbeitete und nun Deutscher Pruritusfragebogen genannte Instrument erfasst pruritus‐spezifische Parameter wie Lokalisation, Verlauf, Intensität und Qualität, anamnestische Daten zum allgemeinen Gesundheitszustand, soziodemografische Daten, Lebensqualität und Art der Bewältigung. Es soll in der vorgelegten Studie validiert werden.

Patienten und Methodik

Der Fragebogen wurde bei 366 Patienten mit chronischem Pruritus unterschiedlicher Ätiologien aus Deutschland (Universitätskliniken Heidelberg, Münster, Mainz, Erlangen, Gießen, Praxis Bad Bentheim, TU München, Nierenzentrum Wiesbaden), Österreich (Universitätsklinik Graz) und der Schweiz (Kantonsspital Aarau) eingesetzt.

Ergebnisse

Die Zuverlässigkeit bei wiederholtem Ausfüllen (Retest‐Reliabilität) bezüglich Lokalisation, Erstauftreten und Begleiterkrankungen wies hohe Werte für Cohens Kappa auf (>0,8). Die Angaben zur Retest‐Reliabilität der Prurituscharakteristika zeigten deutlich geringere Werte (<0,7). Bezüglich der Messbarkeit praktisch relevanter Veränderungen (Veränderungssensitivität) konnten mittlere bis starke Effektgrößen festgestellt werden (0,09–0.19). Eine statistisch signifikante Differenzierung der Pruritusätiologien anhand der erfassten Parameter gelang nicht.

Schlussfolgerungen

Der Deutsche Pruritusfragebogen erlaubt eine umfassende und strukturierte Erfassung patienten‐ und kliniker‐berichteter relevanter Dimensionen des chronischen Pruritus unterschiedlicher Ätiologien. Eine weitere Anpassung und Fortentwicklung soll erfolgen.
Novel perfusion system using continuous liquid‐suction catheter attachment in colorectal endoscopic submucosal dissection with water pressure method (with video)
Authors: Masunaga Teppei , Takatori Yusaku , Sasaki Motoki , Sato Moe , Minezaki Daisuke , Morioka Kohei , Tojo Anna , Sakurai Hinako , Iwata Kentaro , Miyazaki Kurato , Kubosawa Yoko , Mizutani Mari , Akimoto Teppei , Kawasaki Shintaro , Matsuura Noriko , Nakayama Atsushi , Sujino Tomohisa , Takabayashi Kaoru , Nakajima Kiyokazu , Yahagi Naohisa , Kato Motohiko
Published: July 2024

Water pressure method (WPM) is useful for colorectal endoscopic submucosal dissection (ESD), characterized not only by underwater conditions but also by active water pressure via the waterjet function. However, the extension of the colorectum by injecting excess water and contaminating the operative field by stool and bleeding have been issues. This study aimed to evaluate the feasibility of a novel perfusion system using a continuous liquid‐suction catheter attachment (CLCA) in colorectal ESD with WPM. We retrospectively reviewed cases in which the perfusion system was used in colorectal ESD with WPM between August 2022 and September 2023. We evaluated clinical characteristics, treatment outcomes, volume of injection by the waterjet function, volume of suction by the endoscope and CLCA, and concentration of floating matter in the operative field over time. Thirty‐one cases were enrolled. The median lesion size was 30 (range, 15–100) mm. In all cases, en bloc resection was achieved without perforation. The median injection volume was 2312 (range, 1234–13,866) g. The median suction volumes by the endoscope and CLCA were 918 (range, 141–3162) and 1147 (range, 254–11,222) g, respectively. The median concentration of floating matter in the operative field (measured in 15 cases) was 15.3 (range, 7.3–112) mg/mL when the endoscope arrived at the lesion and 8.0 (range, 3.2–16) mg/mL after endoscopically washing at the beginning of the ESD. It ranged from 7.6 to 13.4 mg/dL every 20 min during ESD. This perfusion system could prevent the extension of the lumen and maintain a good field of view in colorectal ESD with WPM.
Open government and US development co‐operation in Colombia: Lessons for locally led development
Authors: Fox Jonathan , Hallock Jeffrey
Published: July 2024

Motivation

“Localization”—direct donor support for national organizations in aid recipient countries—has become a top priority for international development. The United States Agency for International Development (USAID) pledged to raise the proportion of direct funding to national organizations to 25% and for 50% of funding to involve “locally led” input. Independently, USAID commits to proactive disclosure of project information. This study analyses sectoral priorities, access to project data, and localization trends to inform policy discussion about how USAID can reach its twin localization goals, with a focus on Colombia, the largest US aid recipient in Latin America.

Purpose

An open government perspective can shed light on whether and how development agencies are making progress towards localization. Moreover, user‐centred information disclosure by donors is necessary to inform locally led development. The goals of this study are to document USAID's sectoral funding priorities, gaps in data disclosure, implementation actions, and direct local funding percentages to make patterns more visible to stakeholders. We ask: What are the strengths and limitations of public disclosure of data concerning US aid in Colombia?

Approach and methods

This analysis uses open‐source data review methods to bring together different sources of publicly available data. These methods include triangulating government data disbursed across multiple sites, recoding government data to make trends visible, and identifying barriers to data access.

Findings

Public data indicate that US funding for peace‐related projects increased in the years following Colombia's 2016 Peace Accord, though the security share of total US aid remains high. Funding trends demonstrate that USAID is far behind its localization goals in Colombia, though absolute funding totals to local organizations are increasing. Finally, publicly available project data are not user‐centred, require technical acumen to access, and are fragmented across multiple sites.

Policy implications

User‐centred disclosures are key to locally led development to ensure informed participation and accountability to stakeholders.
Left atrial strain parameters to predicting elevated left atrial pressure in patients with atrial fibrillation
Authors: Xu Ying , Zhou Jia‐Wei , Su Bo , Sun Yun‐Juan , Zhou Jing , Liu Yang , Zhou Bing‐Yuan , Zou Cao
Published: July 2024

Objectives

To assess the ability of left atrial (LA) strain parameters to discriminate patients with elevated left atrial pressure (LAP) from patients with atrial fibrillation (AF).

Methods and results

A total of 142 patients with non‐valvular AF who underwent first catheter ablation (CA) between November 2022 and November 2023 were enrolled in the study. Conventional and speckle‐tracking echocardiography (STE) were performed in all patients within 24 h before CA, and LAP was invasively measured during the ablation procedure. According to mean LAP, the study population was classified into two groups of normal LAP (LAP < 15 mmHg, n = 101) and elevated LAP (LAP ≥ 15 mmHg, n = 41). Compared with the normal LAP group, elevated LAP group showed significantly reduced LA reservoir strain (LASr) [9.14 (7.97–11.80) vs. 20 (13.59–26.96), p < .001], and increased LA filling index [9.60 (7.15–12.20) vs. 3.72 (2.17–5.82), p < .001], LA stiffness index [1.13 (.82–1.46) vs. .47 (.30–.70), p < .001]. LASr, LA filling index and LA stiffness index were independent predictors of elevated LAP after adjusted by the type of AF, EDT, E/e′, mitral E, and peak acceleration rate of mitral E velocity. The receiver‐operating characteristic curve (ROC) analysis showed LA strain parameters (area under curve [AUC] .794–.819) could provide similar or greater diagnostic accuracy for elevated LAP, as compared to conventional echocardiographic parameters. Furthermore, the novel algorithms built by LASr, LA stiffness index, LA filling index, and left atrial emptying fraction (LAEF), was used to discriminate elevated LAP in AF with good accuracy (AUC .880, accuracy of 81.69%, sensitivity of 80.49%, and specificity of 82.18%), and much better than 2016 ASE/EACVI algorithms in AF.

Conclusion

In patients with AF, LA strain parameters could be useful to predict elevated LAP and non‐inferior to conventional echocardiographic parameters. Besides, the novel algorithm built by LA strain parameters combined with conventional parameters would improve the diagnostic efficiency.
Assessment of echocardiographic interpretation of dual‐lumen cannula during venovenous extracorporeal membrane oxygenation use for pediatric respiratory failure
Authors: Riley Alan F. , Rose Rachael , Denfield Susan , Thomas James A. , Vogel Adam M. , Coleman Ryan , Lam Fong Wilson
Published: July 2024

Purpose

Echocardiography is considered essential during cannulation placement and manipulations. Literature evaluating transthoracic echocardiography (TTE) usage during pediatric VV‐ECMO is scant. The purpose of this study is to describe the use of echocardiography during VV‐ECMO at a large, quaternary children's hospital.

Methods

A retrospective, single‐year cohort study was performed of pediatric patients on VV‐ECMO via dual‐lumen cannula at our institution from January 2019 through December 2019. For each echocardiogram, final cannula component (re‐infusion port (ReP), distal tip, proximal port and distal port) positions were evaluated by one echocardiographer. For TTEs with ReP in the right atrium, two echocardiographers independently evaluated ReP direction using 2‐point (Yes/No) and 4‐point scales, which were semi‐quantitative protocols using color Doppler images to estimate ReP jet direction to the tricuspid valve. Cohen's kappa or weighted kappa was used to measure interrater agreement.

Results

During study period, 11 patients (64% male) received VV‐ECMO with 49 TTEs and one transesophageal echocardiogram performed. The median patient age was 4.3 years [IQR: 1.1–11.5] and median VV‐ECMO run time of 192 h [90–349]. The median time between TTEs on VV‐ECMO was 34 h [8.3–65]. Most common position for the ReP was the right atrium (n = 33, 67%), and ReP location was not identified in five TTEs (10%). For ReP flow direction, echocardiographers agreed on 82% of TTEs using 2‐point evaluation. There was only moderate agreement between echocardiographers on the 2‐point and 4‐point assessments (k = .54, kw = .46 respectively).

Conclusions

TTE is the predominant cardiac ultrasound modality used during VV‐ECMO for pediatric respiratory failure. Subjective evaluation of VV‐ECMO ReP jet direction in the right atrium is challenging, regardless of assessment method.
An international multicentre study of SwiTching from Intravenous to subcutaneous inflixiMab and vEdolizumab in inflammatory bowel diseases: The TIME study
Authors: D'Amico Ferdinando , Massimino Luca , Palmieri Giulia , Dal Buono Arianna , Gabbiadini Roberto , Caron Benedicte , Moreira Paula , Silva Isabel , Bosca‐Watts Maia , Innocenti Tommaso , Dragoni Gabriele , Bezzio Cristina , Zilli Alessandra , Furfaro Federica , Saibeni Simone , Chaparro María , García María José , Michalopoulos George , Viazis Nikos , Mantzaris Gerassimos J. , Ellul Pierre , Gisbert Javier P. , Magro Fernando , Peyrin‐Biroulet Laurent , Armuzzi Alessandro , Ungaro Federica , Danese Silvio , Fiorino Gionata , Allocca Mariangela
Published: July 2024

Background and Aims

Subcutaneous (SC) formulations of infliximab (IFX) and vedolizumab (VDZ) are approved for the treatment of inflammatory bowel diseases (IBDs). Our aim was to evaluate the effectiveness of switching from intravenous (IV) to SC formulations of IFX and VDZ in IBDs.

Methods

This multicentre, retrospective study collected data of adult patients with Crohn's disease (CD) or ulcerative colitis (UC) switched to SC IFX or VDZ. The primary endpoint was clinical remission at 12 months stratified based on timing of switch. A composite endpoint consisting of therapy discontinuation, reverse‐switch, need for steroids, and drug optimization was evaluated. A multivariate analysis investigated the association between patients' characteristics and outcomes.

Results

Two hundred and thirty‐one patients (59% UC, 53% male, mean age 44 ± 15 years, 68% IFX) from 13 centres were included. The switch occurred at Week 6 in a third of cases (36%). Median time to switch was 13 months. Most patients switched to SC IFX and VDZ were in clinical remission at 3 (87% and 77%), 6 (86% and 83%) and 12 (63% and 60%) months. In the multivariate analysis, there was no difference in clinical remission rate at 12 months; however, patients switched at Week 6 had a higher rate of experiencing any therapeutic changes at 3 (false discovery rate (FDR) = .002), 6 (FDR <1 × 10−10) or 12 months (FDR = .08). Clinical disease activity at baseline (only in UC) (FDR = .07) and previous exposure to biologics (FDR = .001) were risk factors for composite endpoint at 6 and 12 months.

Conclusion

SC IFX and VDZ are effective in daily clinical practice in IBD patients. Switching patients in remission reduces the risk of negative outcomes.
Exploring the interplay between host plant structural defences and origin on behavioural and life‐history traits of two Neotropical danaines
Authors: Ferreira Pedro Paulo da Silva , Mantuano Dulce , Campos Mateus Lorenzo Cavalcanti , Rodrigues Daniela
Published: July 2024

Factors that mediate insect herbivore sabotaging behaviour of host plant latex defences remain under debate. The most prominent hypothesis suggests that the anatomy of the host plant's laticifers determines trenching or vein‐cutting behaviour, but there are inconsistencies in the literature. In addition to latex, other plant defences have been shown to affect plant natural enemies, but experimental studies comparing the effects of multiple defences on herbivore performance and behaviour are scarce. In this study, we investigated the anatomy of the laticifers of Calotropis procera (Aiton) W.T. Aiton (Apocynaceae), an exotic milkweed of southeastern Brazil, as well as the sabotaging behaviour of larvae of southern monarch, Danaus erippus (Cramer), and queen butterfly, Danaus gilippus (Cramer) (Lepidoptera: Nymphalidae) on this host plant. We also reviewed the sabotaging behaviour of larvae reared on the native milkweed Asclepias curassavica L. (Apocynaceae) from previous studies, as well as the description of the anatomy of its laticifers. As we found no correspondence between sabotaging behaviour of southern monarchs and queens and the anatomy of the host plants' laticifers, we tested whether structural defences of C. procera leaves (latex, waxes and trichomes) affected sabotaging behaviour and larval performance of southern monarch larvae. The structural barriers of this well‐defended host affected larvae in different ways: Southern monarchs developed more slowly on control leaves than on leaves from which wax had been removed, and only latex removal reduced the frequency of sabotaging behaviour. Regardless of the defence removal treatment, frequencies of trenching behaviour decreased and vein‐cutting behaviour increased as larvae developed. Overall, our results show that several factors in addition to the anatomy of laticifers affect sabotaging behaviour of southern monarchs and queens, including larval ontogeny, danaine species and latex outflow. This evidence suggests a behavioural plasticity in the sabotaging behaviour of larvae of both southern monarchs and queens.
Impact of fire exclusion and aspect on soil carbon fractions in Afromontane grasslands, Cathedral Peak, South Africa
Authors: Dlamini Lindokuhle X. , Kotzé Elmarie , Thevenot Mathieu , Feig Gregor T. , Mathieu Olivier , Lévêque Jean
Published: July 2024

Despite the importance of South Africa's Afromontane grasslands for ecosystem services (water supply and biodiversity), soil organic carbon (SOC) research remains limited. These grasslands evolved with fire, and fire exclusion leads to native plant afforestation. This study investigated SOC fractions and origin to understand the impact of fire‐exclusion‐driven afforestation and aspect on SOC storage in Afromontane grasslands. This study in Cathedral Peak Research Catchments, initiated in the 1940s, compared an afforested fire‐excluded site (AF) to a periodically burnt (accidental fires, 2–5 years interval) grassland (PB) within the same catchment (Catchment‐IX). Additionally, it compared a south‐facing periodically burnt grassland (Catchment‐IX) to a north‐facing biennially burnt grassland (Catchment‐VI). Soil samples collected at soil‐depth increments (0–5, 5–10, 10–15, 15–20, 20–30, 30–60 and 60–100 cm) revealed that, within Catchment IX, PB had more topsoil SOC stocks and microbial activity than AF but similar active carbon (C) concentrations. As expected, δ13C values revealed that SOC in PB originates from C4 grasses, whilst it mostly originates from C3 plants in AF. The south‐facing slope (Catchment‐IX) had more SOC stocks, microbial activity and active C compared to the north‐facing slope (Catchment‐VI). Fire‐exclusion‐driven afforestation changed SOC input from roots to litter, thus reducing SOC storage. Cooler south‐facing slopes are better C reservoirs. Afromontane grasslands show greater potential for C sequestration than afforested systems.
Soil biological fertility evolution in a chronosequence under long‐term rice cultivation after land reclamation in China
Authors: Pan Jinhua , Wang Jin , Zhuang Shunyao
Published: July 2024

Land use significantly affects soil biological fertility through impacts on carbon (C) and nitrogen (N) cycling. The present study investigated the effects of long‐term rice cultivation after tidal flat reclamation on soil C and N metabolism, microbial biomass and biological fertility. Eighteen composite topsoil (0–20 cm) samples were identified in a chronosequence of coastal reclamation areas (0–700 years old) in subtropical monsoon climate zone, namely tidal flat (T0), salt marsh soil (S10) and paddy soil (P50, P100, P300 and P700). Using ANOVA analysis, mono‐exponential regression model, and multiple linear regressions, soil organic matter (SOM), total nitrogen (TN), cumulative C mineralization content (Ct) and N mineralization content (Nt), basal soil respiration (BSR) and microbial biomass C and N (MBC and MBN) in the P50‐P700 samples were significantly higher than those in the T0 and S10 samples, whereas C metabolic quotients (qCO2) in the P50‐P700 were significantly lower than those in the T0 and S10 samples. The time to steady state for SOM and TN are 357 years and 80 years, respectively; 133 and 221 years for Ct and Nt, respectively; and 318 and 183 years for MBC and MBN, respectively. Also, a soil biological fertility index (SBFI) was calculated on the basis of SOM, BSR, Ct, MBC, qCO2 and qCM. P100‐P300 samples had the highest SBFI score (28.7) and ranked in the class V (very high) of biological fertility, achieving steady‐state conditions after 146 years. SBFI was significantly positively correlated with SOM, TN, MBC, MBN, BSR, Ct and Nt, whereas it was significantly negatively correlated with pH, qCO2 and C mineralization quotient (qCM). MBC and qCM were two independent variables with considerable positive effects on SBFI. Long‐term rice cultivation could facilitate C and N accumulation and enhance biological fertility in soils via microbial activity, especially within 300 years. Our findings demonstrate that rice cultivation has the potential to enhance soil C and N accumulation. Carbon‐related SBFI is suitable for assessing soils under long‐term rice cultivation, mainly because the rice paddy field is an intensive and conservative system.