bluuebunny/crossref_metadata_2025 huggingface dataset:
Association of LDL‐C/HDL‐C Ratio With Hyperuricemia: A National Cohort Study
Authors: Zhang Yanyu , Liu Xiaoyi , Luo Deyun , Chen Bingli , Lai Chenyi , He Chenyu , Yan Luo , Ding Haifeng , Li Shiyang
Published: January 2025

Hyperuricemia (HUA) is a metabolic abnormality syndrome caused by disorders of purine metabolism. This study aimed to investigate the predictive value of the low‐density lipoprotein cholesterol to high‐density lipoprotein cholesterol ratio (LHR) for the risk of developing HUA. We extracted data from the China Health and Retirement Longitudinal Study (CHARLS) database from 2011 to 2016. Multivariable logistic regression, restricted cubic splines (RCSs) analysis, and linear correlation analysis were conducted to evaluate the association between LHR and risk of developing HUA. Subgroup analyses and interaction tests were also performed. A higher LHR was associated with an increased incidence of HUA (7.8% vs. 9.9% vs. 13.9, p < 0.001). The LHR was also higher in the HUA group compared to the non‐HUA group (2.64 ± 1.07 vs. 2.40 ± 0.91, p < 0.001). When assessed as a continuous variable, LHR was independently associated with the risk of HUA (OR = 1.27, 95% CI = 1.16–1.39, p < 0.001). The risk of developing HUA was significantly higher among individuals with the highest LHR subgroup than those with the lowest LHR subgroup (OR = 1.81, 95% CI = 1.47–2.23, p < 0.001). RCS analysis revealed a significant nonlinear association between an increased LHR and a higher risk of developing HUA. The predictive abilities of LHR for HUA were 0.577. The composite variable comprising LHR and other traditional risk factors could significantly enhance the ability to predict HUA (C statistic = 0.677). In conclusion, a higher LHR was associated with an increased risk of developing HUA. Further studies on LHR could be beneficial for preventing and treating HUA.
Evaluation der Hautkrebsfrüherkennung in Deutschland – eine Mikrosimulation
Authors: Baltus Hannah , Hübner Joachim , Garbe Claudia , Hagenström Kristina , Rohr Maren , Hischke Sandra , Augustin Jobst , Augustin Matthias , Katalinic Alexander , Eisemann Nora
Published: January 2025

Hintergrund

In Deutschland wurde 2008 ein flächendeckendes Hautkrebsscreening eingeführt. Welche nachfolgend beobachteten Veränderungen in der Epidemiologie des malignen Melanoms (MM), Plattenepithelkarzinoms (SCC) und Basalzellkarzinoms (BCC) auf das Screening zurückzuführen sind, ist unklar. Mit Simulationsmodellen werden verschiedene Screening‐Szenarien miteinander sowie mit beobachteten Inzidenz‐ und Mortalitätsverläufen verglichen.

Methodik

Es wurde ein Mikrosimulationsmodell für MM, SCC und BCC programmiert und geschlechtsgetrennt an hautkrebsspezifischen Mortalitätsdaten validiert. Neben dem aktuell praktizierten Screening (zweijährliches Angebot, jährliche Teilnahmewahrscheinlichkeit 15%) wurden ein dreijährliches Screening, ein Screening mit erhöhter Teilnahme, zum Beispiel durch Einladungswesen, und kein Screening simuliert. Es wurden Zeitverläufe für Inzidenz, Mortalität, Kosten und gewonnene Lebensjahre für 30 Jahre ab Screeningbeginn erzeugt.

Ergebnisse

Im Vergleich zu keinem Screening wird die Mortalität in der Simulation mit aktuellen Konditionen um 13,8% reduziert. Dieser Effekt ergibt sich in den ersten Jahren nach Screeningbeginn und erreicht nach einigen Jahren ein stabiles Niveau. Wird mehr und häufiger gescreent, steigen in der Simulation Inzidenz, gewonnene Lebensjahre und Kosten, während die Mortalität weiter sinkt. Ein Vergleich von simulierten und beobachteten Effekten zeigt nur wenig Übereinstimmung.

Schlussfolgerungen

Das Modell eignet sich zum Vergleich von Screening‐Szenarien, um mögliche Optimierungsmöglichkeiten im Hautkrebsscreening zu identifizieren. Es sollten zusätzliche, insbesondere risikoadaptierte, Screening‐Szenarien untersucht werden.
Klinische und histopathologische Merkmale fortgeschrittener Plattenepithelkarzinome der Haut mit unterschiedlichem Ansprechen auf Cemiplimab
Authors: Hempel Conrad , Vladimirova Gabriela , Horn Susanne , Horn Lars‐Christian , Ziemer Mirjana
Published: January 2025

Hintergrund

Die meisten, jedoch nicht alle Patienten mit inoperablem lokal fortgeschrittenem oder metastasiertem kutanem Plattenepithelkarzinom (cSCC) profitieren von Cemiplimab. Ziel unserer Studie war es, klinische und histopathologische Merkmale zu identifizieren, die das Ansprechen auf Cemiplimab vorhersagen.

Patienten und Methodik

Wir analysierten 15 mit Cemiplimab behandelte Patienten hinsichtlich klinischer, demografischer, histopathologischer und immunhistochemischer Merkmale und korrelierten diese mit dem Ansprechen auf die Behandlung. Darüber hinaus wurde die Wirksamkeit und Sicherheit der Immun‐Checkpoint‐Therapie in unserer Kohorte bewertet.

Ergebnisse

Unsere Kohorte umfasste 12 Männer und 3 Frauen mit einem Durchschnittsalter von 78,1 Jahren. Die Mehrzahl der Tumoren (66,7%) befand sich im Kopf‐ und Halsbereich. Die Behandlung war insgesamt gut verträglich, mit nur einer Kolitis Grad 3. Es gab keinen Zusammenhang zwischen immunbedingten unerwünschten Ereignissen und dem Ansprechen auf die Behandlung. Non‐Responder waren im Durchschnitt jünger (69,4 vs. 82,5 Jahre). Eine Vorgeschichte von hämatologischen Malignomen korrelierte mit schlechterem Ansprechen. Hohe Mitoserate, schlechter Tumordifferenzierungsgrad, hohe Vimentin‐ und p53‐ sowie geringe E‐Cadherin‐Expression waren mit schlechterem Ansprechen verbunden. Umgekehrt korrelierten höhere Dichte intratumoraler Entzündungsinfiltrate, nekrotische Bereiche und schwächere immunhistochemische Expression von Mismatch‐Reparatur‐Proteinen mit besserem Ansprechen.

Schlussfolgerungen

Cemiplimab ist eine sichere und wirksame Therapie, insbesondere bei älteren Patienten. Bei gut differenzierten Tumoren mit niedrigem Proliferationsindex, intratumoralem Entzündungsinfiltrat und Tumornekrose kann ein besseres klinisches Ansprechen vorhergesagt werden.
Überbrückung der Versorgungslücke durch Telemedizin: Pilotstudie zur Akzeptanz und Nutzung der Teledermatologie bei Urtikaria
Authors: Hindelang Michael , Sitaru Sebastian , Fischer Chiara , Biedermann Tilo , Zink Alexander
Published: January 2025

Hintergrund

Die chronische spontane Urtikaria (CSU) beeinträchtigt die Lebensqualität der Patienten erheblich. Trotz Fortschritten bei Diagnose und Therapie ist die Behandlung immer noch unzureichend. Die Telemedizin bietet eine vielversprechende Lösung zur Verbesserung der Behandlung. Diese Pilotstudie bewertet die Akzeptanz und Nutzung eines digitalen Gesundheitskonzepts für die CSU, untersucht dessen Auswirkungen auf das Krankheitsmanagement und zeigt technische Herausforderungen auf.

Patienten und Methodik

In diese prospektive Pilotstudie wurden CSU‐Patienten einer Universitätsklinik in Deutschland einbezogen. Über einen Zeitraum von 12 Monaten interagierten die Teilnehmer mit Ärzten über eine telemedizinische Plattform, welche die studienspezifische Intervention darstellte. Nach jeder dreimonatigen digitalen Visite wurden die Symptome und die Lebensqualität anhand von digitalen patientenberichteten Ergebnissen (ePROs) und Online‐Fragebögen bewertet. Am Ende bewerteten Patienten und Ärzte die allgemeine Zufriedenheit, die Benutzerfreundlichkeit der Plattform und die technischen Herausforderungen.

Ergebnisse

24 Patienten nahmen an der Studie teil. Die Mehrheit (92%) gab an, dass das digitale Konzept eine vielversprechende Alternative zu herkömmlichen Beratungsgesprächen sein könnte. Die Analyse von Beginn Ende der Studie ergab, dass die Krankheitskontrolle stabil blieb, während sich die Lebensqualität verbesserte. Alle Ärzte empfanden die digitale Anwendung als zuverlässig und zeitsparend.

Schlussfolgerungen

Diese Pilotstudie zeigt die Machbarkeit und hohe Akzeptanz eines digitalen Gesundheitskonzepts für das Management von CSU. Weitere Forschungen mit größeren Kohorten sind erforderlich, um eine breitere Anwendbarkeit zu ermitteln.
Papulonodular mucinosis: a systematic review on clinicopathologic characteristics, course and treatment options
Authors: Luo Si‐Yu , Wang Qin‐Xiao , Zhou Kai‐Yi , Deng Li‐Jia , Fang Sheng
Published: January 2025

Papulonodular mucinosis (PNM) is a rare cutaneous mucinosis recognized as a rare variant of lupus erythematosus. There are no large‐scale cohort studies characterizing its clinicopathological features or evaluating the effectiveness of various treatment options. This study aimed to review the literature on PNMs to identify its clinical and histological features and treatment outcomes. The search includes studies from the PubMed, Embase, and Cochrane Library databases up to the March 1, 2024. A total of 37 studies, encompassing 44 patients, were included in the review. Of these, 20 were males and 24 females, with a mean age at diagnosis of 34.9 ± 1.92 years. PNM lesions are characterized by generalized papules, plaques, and nodules, and histopathologically, they show abundant mucin deposition throughout the dermis. The temporal relationship between PNM and SLE is variable. There is no evidence that SLE patients with PNM are more prone to organ involvement or increased disease activity. A combination of medical history, clinical features, and histopathological findings is essential for diagnosis; however, misdiagnosis is possible until lupus erythematosus (LE) becomes evident. Hydroxychloroquine and systemic glucocorticoids are the current mainstays of treatment for PNM, with most patients achieving partial or complete remission.
Sonic Hedgehog signaling regulates the optimal differentiation pace from early‐stage mesoderm to cardiogenic mesoderm in mice
Authors: Inoue Satoshi , Nosetani Moe , Nakajima Yoshiro , Sakaki Shinichiro , Kato Hiroki , Saba Rie , Takeshita Naoki , Nishikawa Kosuke , Ueyama Atsuko , Matsuo Kazuhiko , Shigeta Masaki , Kobayashi Daisuke , Iehara Tomoko , Yashiro Kenta
Published: January 2025

Sonic Hedgehog (Shh), encoding an extracellular signaling molecule, is vital for heart development. Shh null mutants show congenital heart disease due to left–right asymmetry defects stemming from functional anomaly in the midline structure in mice. Shh signaling is also known to affect cardiomyocyte differentiation, endocardium development, and heart morphogenesis, particularly in second heart field (SHF) cardiac progenitor cells that contribute to the right ventricle, outflow tract, and parts of the atrium. Despite extensive studies, our understanding remains incomplete. Notably, Shh signaling is suggested to promote cardiac differentiation, while paradoxically preventing premature differentiation of SHF progenitors. In this study, we elucidate the role of Shh signaling in the earliest phase of cardiac differentiation. Our meta‐analysis of single‐cell RNA sequencing suggests that cardiogenic nascent mesoderm cells expressing the bHLH transcription factor Mesp1 interact with axial mesoderm via Hh signaling. Activation of Hh signaling using a Smoothened agonist delayed or suppressed the differentiation of primitive streak cells expressing T‐box transcription factor T to Mesp1+ nascent mesoderm cells both in vitro and ex vivo. Conversely, inhibition of Hh signaling by cyclopamine facilitated cardiac differentiation. The reduction of Eomes, an inducer of Mesp1, by Hh signaling appears to be the underlying mechanism of this phenomenon. Our data suggest that SHH secreted from axial mesoderm inhibits premature differentiation of T+ cells to Mesp1+ nascent mesoderm cells, thereby regulating the pace of cardiac differentiation. These findings enhance our comprehension of Shh signaling in cardiac development, underscoring its crucial role in early cardiac differentiation.
Descriptive analysis of the use of and preferences for equine veterinary services
Authors: Gibson O. L. , Adam E. , Stowe C. J.
Published: January 2025

Background

Little is known about horse owners' use of and preferences for equine veterinary services, which are key components of the financial health of equine veterinary practices and challenges facing the profession.

Objectives

The objective of this research is to describe horse owners' use of and preferences for equine veterinary services and assess their willingness to adapt to changes in delivery of services.

Study design

An online survey was used to collect data for the study. The target audience was US residents aged 18+ who were financially responsible for at least one horse, pony, mule or donkey.

Methods

The online survey was distributed through participating organisations' social media and email lists. Microsoft Excel 16 was used to tabulate summary statistics.

Results

The survey received a total of 4915 usable responses from every state in the United States. Most respondents are financially responsible for one to five horses, have a primary equine veterinarian and are visited by a veterinarian two to four times per year. Low rates of equine health savings accounts and health insurance may limit financial access to veterinary care. The majority of respondents report a willingness to accommodate deviations from traditional delivery of services. The most common maximum willingness‐to‐pay for annual vaccinations was $150, lameness exams was $200 and emergency colic surgery was $5000.

Main limitations

The response rate cannot be computed due to the distribution method. The representativeness of the sample cannot be determined due to lack of information on the horse owning population. In stated preference studies, hypothetical bias is common.

Conclusions

The results from this survey provide the first‐known documented evidence on the utilisation of equine veterinary services in the United States, willingness to adapt to changes and willingness to pay for three sample services. These data can inform the profession on attitudes towards services provided.
Assessing Short‐ and Long‐Term Anthropogenic Threats to a Reintroduced Fish in a Restored Urban Riverscape
Authors: Sears Mary M. , Myers Randall A. , Nisbet Mitchell T. , Tidwell M. Travis , Troia Matthew J.
Published: January 2025

Understanding which species can persist in human‐modified environments is essential to biodiversity conservation in the Anthropocene. In urbanised environments, many stressors limit the persistence of imperilled native species via impacts on the abiotic and biotic environment. Habitat restoration followed by reintroduction of native species may be an effective strategy to maintain or even regenerate biodiversity in urbanised environments, but few studies have assessed these two conservation strategies concomitantly in urban freshwater ecosystems.

We assessed short‐term population dynamics and habitat associations of an endemic species of conservation concern, Guadalupe bass (Micropterus treculii, ‘GB’), that was reintroduced in a restored urbanised riverscape already occupied by a generalist congener, largemouth bass (M. salmoides, ‘LMB’). We performed four seasonal surveys of habitat association and one capture‐mark‐recapture survey of the two species at eight sites distributed along a 17 km reach of the San Antonio River within San Antonio, Texas—the seventh largest city in the United States.

Detection of multiple size classes at all eight sites indicated that reintroduced GB have dispersed throughout this riverscape and are naturally recruiting. Juvenile GB were associated with restored riffles and transitioned to pools as adults—an ontogenetic habitat shift documented in rivers draining natural landscapes elsewhere in the GB native range. By contrast, juvenile and adult LMB were associated with pool habitats. Our results indicated that the construction of riffle habitats along this restored riverscape provide essential habitat for juvenile GB that was unavailable prior to restoration. Habitat overlap of adult bass indicated the potential for competition between the two species; however, GB body condition did not vary with LMB abundance across sites or seasons.

Next, we assessed long‐term stressors by comparing dispersal barriers, hydrologic alteration, pollution proxies and fish kill frequencies in the urbanised restored riverscape to minimally‐impacted riverscapes throughout the native GB range. The urbanised restored riverscape was subject to more barriers, flashier hydrology and more pollution; however, these stressors did not translate to more frequently‐documented fish kills in our study.

We showed that restoration of instream habitat followed by reintroduction of native species enhanced urbanised biodiversity. Monitoring population responses to multiple urbanised stressors and mitigating those that threaten the long‐term persistence of reintroduced species remains important.
Entre el Clóset y la (Des)colonización: Explorando la Satisfacción Laboral LGBT+ en el Contexto Chileno
Authors: Jeldes Fabiola , Montenegro Helena , Caceres Javier
Published: January 2025

ABSTRACTA

Ante un contexto global más diverso, se ha vuelto más evidente que las empresas cuentan con un mayor número de empleados LGBT+ en sus filas. Sin embargo, aún se desconocen los factores que influyen en la satisfacción laboral de los empleados LGBT+, y existe poca literatura sobre por qué y cuándo los empleados LGBT+ entran o salen del closet en el lugar de trabajo, influidos por el contexto de (des)colonización que Chile ha experimentado en los últimos años. Este artículo explora los principales factores que determinan la satisfacción laboral de los empleados LGBT+, y la dinámica que adoptan para entrar o salir del closet. Los datos se recopilan y analizan mediante la técnica de incidentes críticos (CIT). Los resultados muestran que los factores de Herzberg operan en contextos modernos, complejos y heterogéneos. Tanto los factores motivacionales como los higiénicos están involucrados en la satisfacción laboral de los empleados LGBT+ y su influencia depende de si el contexto se encuentra (des)colonizado. Por último, identificamos un nuevo factor para estos empleados minoritarios, al que llamamos apertura contextual, que está vinculado con procesos de descolonización que contribuyen a la satisfacción laboral de los empleados LGBT+.
“After Cutting It, Things Have Never Remained the Same”: A Qualitative Study of the Perspectives of Amputees and Their Caregivers
Authors: Ohenewa Esther , Yendork Joana Salifu , Amponsah Benjamin , Owusu‐Ansah Frances Emily
Published: January 2025

Introduction

Physical and emotional loss from amputation and associated physical disability are associated with adverse physical and psychological experiences. However, little research, within the Ghanaian context, has focused on the impact of amputation on the well‐being of amputees and their caregivers and the coping strategies they use to mitigate challenges experienced. Therefore, the present study explored the impact of amputation on the well‐being of amputees and caregivers, and the coping strategies they employ to manage distress associated with amputation and caregiving.

Methods

The aim of this present study was explored using a qualitative descriptive design. Twenty (20) participants (comprising 10 amputees and 10 caregivers) responded to a semi‐structured interview guide.

Results

Findings show that whereas amputees experienced phantom limb sensation and loss of job, caregivers reported economic hardship and fear. Though stress was a common experience, the source of stress was different for amputees and caregivers. Regarding coping, whereas amputees used social distancing, social reference and social support to cope with their traumatic ordeal, caregivers simply coped by encouraging themselves. Both amputees and caregivers used religious coping.

Conclusion

Amputees and their caregivers experience varied stressors yet whereas the amputees get the needed support to deal with their predicament, caregivers lack adequate support.

Patient or Public Contribution

The findings underscore the need for diverse support systems and psychoeducation on adaptive coping strategies for amputees and caregivers.
Comparative study of management strategies for immune checkpoint inhibitor‐induced inflammatory arthritis: rheumatologists versus oncologists
Authors: Yoon Jang S. , Zhao Frances , Masood Hafsa , De Silva Ravini , Binns Jessie , Atkinson Victoria , Thomas Ranjeny , Terrill Matthew
Published: January 2025

Background

Immune checkpoint inhibitors (ICIs) have significantly improved cancer treatment outcomes but are associated with immune‐related adverse events (irAEs), such as inflammatory arthritis (ir‐IA). Management of ir‐IA is evolving, with corticosteroids as the primary treatment, though some cases require steroid‐sparing agents.

Aims

This study aimed to compare initial mean prednisolone doses and disease persistence over 12 months in patients with rheumatoid arthritis (RA)‐like ir‐IA managed by rheumatologists or oncologists.

Methods

This retrospective observational study involved patients who developed RA‐like ir‐IA after ICI treatment for advanced cancers between September 2015 and January 2019 at a tertiary hospital in Brisbane, Australia. Patient records were reviewed up to January 2020 to evaluate chronicity. Data were collected, and statistical analyses compared the management between rheumatologists and oncologists.

Results

A total of 871 patients received ICI and 246 had irAEs, with 20 developing RA‐like ir‐IA. Nine were managed by an oncologist and 11 by a rheumatologist. The mean dose of prednisolone commenced by a rheumatologist was 14 mg compared to 53.3 mg by an oncologist (P = 0.0058). Patients managed by a rheumatologist were more likely to receive conventional synthetic disease‐modifying anti‐rheumatic drugs (csDMARD) (odds ratio 16, P = 0.023). Thirteen patients required ongoing maintenance treatment, while seven had resolution within 12 months of disease onset.

Conclusions

RA‐like ir‐IA comprised 8% of ICI‐related irAEs. During the study period, patients managed by rheumatologists received lower initial prednisolone doses and more frequent csDMARD than oncologists. A multidisciplinary involvement between rheumatologists and oncologists in the event of ir‐IA is crucial.
Rapid Review of Literature Reporting the Experience of Patient and Public Involvement in Prison and Forensic Mental Health Research
Authors: Rutherford Rosie , Pashley Susannah , Bowes Nicola , Heggs Daniel , Cornwell Rosie
Published: January 2025

Health research authorities around the world are increasingly committed to embedding public involvement in health and social care research. However, such involvement in internationally published prison and forensic mental health research remains rare. It is therefore particularly important to understand how people are experiencing collaborative research in this field, barriers they may encounter and how these might be overcome. The aim of this review is to explore how academic, practitioner and lived‐experience researchers have experienced collaborating on prison and forensic mental health research since a previous review of the topic in 2016. A rapid review of literature was completed by searching three databases (MEDLINE, EMBASE and PsycINFO) between 2016 and July 2023 in addition to Google and Google Scholar searches and hand searching the reference lists of all screened‐in documents. We used Reflexive Thematic Analysis to review the screened‐in papers. We had lived‐experience involvement in this study, which is outlined in our Supporting Information. The database search returned 733 unique articles. Internet searches revealed 10 potentially relevant documents. 20 documents were eligible for inclusion; 15 journal articles, three book chapters, a whole book and a PhD thesis. In the analysis, four overarching themes were developed: the positive psychological impact on lived‐experience researchers; it is interpersonally, emotionally and practically challenging; facilitators of the collaborative research process; and positive impact of involvement on the research. Our findings build on the previous review by providing evidence that collaborating on research can have a positive psychological impact on people with lived experience in this setting. It also documents further challenges that are unique to the forensic setting. There was minimal reporting of the experiences of forensic mental health patients involved in research; most included documents focused the experiences of current or former prisoners. Further studies in the topic area are still needed, which utilise a research method to analyse the experiences of conducting collaborative research.
Experiences With End‐of‐Life Care for Patients With Pre‐Existing Severe Mental Disorders, Their Relatives, and Healthcare Professionals
Authors: Bøndergaard Kirstine , Møller Jane Ege , Nielsen Mette Kjærgaard , Videbech Poul , Neergaard Mette Asbjoern
Published: January 2025

Knowledge is needed about end‐of‐life care among patients with pre‐existing severe mental disorders: Schizophrenia, bipolar disorder, and depression. This study aimed to explore the experiences with end‐of‐life care for patients with severe mental disorders, their relatives, specialised palliative care nurses and physicians, and general practitioners. Twenty semi‐structured interviews were conducted and analysed using reflexive thematic analysis, hereby six interviews with patients, three with relatives, five with general practitioners, and six with specialised palliative healthcare professionals. Patients were selected with help from healthcare professionals. Four main themes were produced: thoughts about the future, healthy relations in end‐of‐life, changes in psychiatric condition in end‐of‐life, and the role of openness. Patients with severe mental disorders had wishes and fears for the future, and all participants expressed that healthy relations were crucial for patients at the end‐of‐life. However, sometimes this was challenged by prior complex relationships. It differed whether patients experienced a change in their psychiatric condition after having a terminal disease. Openness about severe mental disorders and end‐of‐life were regarded as important. Having the opportunity to openly discuss both wishes, fears, and mental disorders with healthcare professionals and having healthy relations are important for patients with severe mental disorders at the end‐of‐life. Insecurity about severe mental disorders among specialised palliative care professionals may lead to less openness about severe mental disorders. To optimise end‐of‐life care, patients need professionals to be present and available to discuss problems related to social, physical, existential, and psychiatric conditions.
Is Brief Admission Effective for Individuals With Lived Experience of Borderline Personality Disorder (BPD) When Experiencing Crisis? A Mixed Systematic Review
Authors: Tan Sin‐Ying , Hope Judith
Published: January 2025

Brief admission has been widely used to support individuals with lived experience of borderline personality disorder (BPD) who are experiencing crisis. This study updates a previous 2014 systematic review of the effectiveness of brief admission for individuals with BPD. Following PRISMA guidelines, four databases (MEDLINE, CINAHL, PsychINFO and Cochrane library) were searched from 2011. Two independent reviewers screened titles and abstracts followed by full texts against predefined inclusion criteria. Risk of bias was evaluated using the Mixed Methods Appraisal Tool (MMAT). Due to heterogeneity of studies, meta‐analysis was not conducted. Instead, a convergent segregated mixed method was used for data analysis. A total of 4465 studies were screened. Six studies were included in this review: one randomised controlled trial (RCT), two non‐RCT quantitative studies and three qualitative studies. All the studies were conducted in European countries; all were adjunctive to community treatment. All the eligible qualitative and RCT studies met the full MMAT criterion, whereas the eligible non‐RCT quantitative studies met four of the five criteria. Objective outcomes in terms of rehospitalisation rates showed conflicting evidence. Data integration indicated that the improvement in symptoms and quality of life can be explained by the qualitative findings of positive self‐impact. Brief admission as a crisis management tool is acceptable and can be effective. The quality of inpatient care and preplanning appear important in achieving good outcomes. More rigorous evidence is needed to understand the effect on subsequent admission frequency. The effectiveness of admissions unplanned or unlinked to community treatment remains under‐investigated.
Effect of configurational entropy on the mechanical and thermal properties of rare earth aluminates‐rare earth zirconates composite
Authors: Feng Yingjie , Liu Xiangyang , Han Yi , Zhang Zijian , Wang Wei , Liu Guanghua , Sun Jian , Liu Wei , Pan Wei , Wan Chunlei
Published: January 2025

To improve the working temperature of gas turbines, thermal barrier coatings (TBCs) to replace the meta‐stable Y2O3 partially stabilized ZrO2 have been explored for decades. Rare earth zirconates (RE2Zr2O7) are regarded as an excellent candidate for next‐generation thermal barrier coatings. However, the low fracture toughness of rare earth zirconates is the main hindrance, while the rare earth aluminates (REAlO3) can be imported into the system to toughen the zirconates. In this work, we introduced multiple rare earth elements to explore the effects of configurational entropy on the mechanical and thermal properties of REAlO3‐RE2Zr2O7 composites. When the high entropy REAlO3‐RE2Zr2O7 composites with 3, 4, and 5 rare earth elements on A site were successfully synthesized, the phases of zirconates and aluminates were kept and the rare earth elements were distributed uniformly. We found that the increase in configurational entropy profoundly improved the fracture toughness of the composites by the entropy effect. The fracture toughness of HE‐RAO‐RZO‐5 reached 3.81 ± 0.66 MPam1/2 measured by the single‐edge notched beam (SENB) method, exceeding the fracture toughness given by the mixing rule by ∼18%, which is among the best values of new TBC materials. Meanwhile, the coefficient of thermal expansion can be tuned by the compositions and the hardness, Young's modulus and thermal conductivity of the composites remained almost unchanged. As a result, we proved that the introduction of configurational entropy could be an excellent method to improve the fracture toughness and tailor the thermal properties of REAlO3‐RE2Zr2O7 composites.
Interactions Between Woolly Whiteflies and Their Parasitoid Wasp: Development, Competition, and Reproductive Potential
Authors: Hanuka Gila , Scharf Inon
Published: January 2025

Whiteflies are important pests that severely impact crop yield through feeding and as vectors of pathogens. We focus on the woolly whitefly, Aleurothrixus floccosus, and its parasitoid wasp, Cales noacki, used for biological control. This research is motivated by the challenges of managing whitefly populations, intensified by the limitations of pesticides and the increasing prevalence of whitefly infestations in new regions worldwide. Our findings reveal that parasitism by Cales noacki prolongs the development time of woolly whiteflies when the whitefly eventually overcomes the parasitoid. Wasps emerging from the fourth instar of the whitefly nymphs were larger and had higher reproductive potential than those emerging from earlier instars. We found a positive correlation between wasp size and the number of eggs in the ovary for wasps emerging from the third instar of the whitefly nymphs. However, no such correlation was found for wasps emerging from the fourth instar. Additionally, competition between whiteflies and other common pests, such as citrus mealybugs and citrus mites, seemed to hinder the emergence success of whiteflies, suggesting that multi‐pest interactions could affect biological control strategies. These results demonstrate the complex life‐history interactions between woolly whiteflies and their parasitoid wasps, pointing to the importance of integrating ecological considerations into pest management practices. Understanding these dynamics is important for developing effective control methods, especially in the face of global climate change, which might further reduce the efficiency of parasitoid wasps.
What is a Good Outcome of an Inpatient Perinatal Mental Health Admission? Developing an Innovative Evaluation Plan for a New Unit
Authors: Isobel Sophie , Green Alison , Lim‐Gibson Sylvia
Published: January 2025

Rationale

Developing a feasible and sensitive evaluation strategy for a new mental health service is a challenge that requires consideration of what a service is trying to achieve and what a ‘good’ outcome might look like. Perinatal mental illnesses are complex in their causes and treatment. Mother Baby Units provide specialist perinatal mental health care to parents experiencing mental illness in the perinatal period, with evaluations demonstrating clinical and social outcomes. There has however been remarkably little research on how MBUs achieve these outcomes.

Method

This paper outlines the process and components of designing an evaluation plan for a new perinatal mental health unit, summarising outcome measures considered and the methodology of the evaluation strategy.

Results

A meaningful realist approach was designed. This innovative dualistic methodology is intended to develop theories of what might cause change while also considering what components of interventions parents experience as meaningful.

Conclusion

Articulating the approach to evaluation provides a contribution to evaluation knowledge for others evaluating complex public health interventions. The relational nature of perinatal mental health experiences challenges individualistic approaches to care delivery, funding and evaluation. As part of service establishment, there is a need to consider what a ‘good’ outcome of care might be and to develop evaluation approaches that capture the relational components of recovery as well as the factors that support families to sustain change.
The Role of Double‐Zero‐Event Studies in Evidence Synthesis: Evaluating Robustness Using the Fragility Index
Authors: Wang Zelin , Xing Xing , Mun Eun‐Young , Wu Chong , Lin Lifeng
Published: January 2025

Rationale

Zero‐event counts are common in clinical studies, particularly when assessing rare adverse events. These occurrences can result from low event rates, short follow‐up periods, and small sample sizes. When both intervention and control groups report zero events in a clinical trial, the study is referred to as a double‐zero‐event study, which presents methodological challenges for evidence synthesis. There has been ongoing debate about whether these studies should be excluded from evidence synthesis, as traditional two‐stage meta‐analysis methods may not estimate an effect size for them. Recent research suggests that these studies may still contain valuable clinical and statistical information.

Aims and Objectives

This study examines the role of double‐zero‐event studies from the perspective of the fragility index (FI), a popular metric for assessing the robustness of clinical results. We aim to determine how including or excluding double‐zero‐event studies affects FI derivations in meta‐analyses.

Methods

We conducted an illustrative case study to demonstrate how double‐zero‐event studies can impact FI derivations. Additionally, we performed a large‐scale analysis of 12,184 Cochrane meta‐analyses involving zero‐event studies to assess the prevalence and effect of double‐zero‐event studies on FI calculations.

Results

Our analysis revealed that FI derivations in 6608 (54.2%) of these meta‐analyses involved double‐zero‐event studies. Excluding double‐zero‐event studies could lead to artificially inflated FI values, potentially misrepresenting the results as more robust than they are.

Conclusions

We advocate for retaining double‐zero‐event studies in meta‐analyses and emphasise the importance of carefully considering their role in FI assessments. Including these studies ensures a more accurate evaluation of the robustness of clinical results in evidence synthesis.
The interaction of nutrient uptake with biotic and abiotic stresses in plantsFA
Authors: Wang Lingyan , Ju Chuanfeng , Han Chao , Yu Zhenghao , Bai Ming‐Yi , Wang Cun
Published: January 2025

Plants depend heavily on efficient nutrient uptake and utilization for optimal growth and development. However, plants are constantly subjected to a diverse array of biotic stresses, such as pathogen infections, insect pests, and herbivory, as well as abiotic stress like drought, salinity, extreme temperatures, and nutrient imbalances. These stresses significantly impact the plant's ability to take up nutrient and use it efficiency. Understanding how plants maintain nutrient uptake and use efficiency under biotic and abiotic stress conditions is crucial for improving crop resilience and sustainability. This review explores the recent advancements in elucidating the mechanisms underlying nutrient uptake and utilization efficiency in plants under such stress conditions. Our aim is to offer a comprehensive perspective that can guide the breeding of stress‐tolerant and nutrition‐efficient crop varieties, ultimately contributing to the advancement of sustainable agriculture.
Comparing Caste and Race: A Terrible Idea
Authors: Pal Satanik
Published: January 2025

Isabel Wilkerson's recent publication has sparked an academic debate regarding the true nature of social hierarchies in South Asia and the West. This article conducts a comparative historical sociology of caste in South Asia, and race in the US, to demonstrate structural differences between these two modes of social stratification. Although caste groups in South Asia had greater possibilities of social mobility and intermarriages, interracial sex and marriage were legally prevented between Whites and non‐Whites in the United States. This was because most castes in South Asia were thought to have common origins in the Brahmin caste, whereas most races were thought to have emerged from different species. Furthermore, caste hierarchies often depended on the discretion and power of locally dominant castes, whereas racial hierarchies were legally established through pseudo‐scientific theories and enforced in the United States through state authorities. These divergences in their respective trajectories of development and endurance present to us, a more comprehensive understanding of how caste and race were different in their respective configurations. This is also why sweeping generalizations on such forms of social stratification were discouraged by social scientists such as Cox and Ambedkar.
Creative Moral Responses to Eco‐Reproductive Concerns: Addressing Gaps in Christian Environmental Ethics
Authors: Del Vecchio Kristi
Published: January 2025

Adults in the United States are having fewer biological children in part due to worries about climate change and population growth, yet Christian environmental ethicists frequently avoid or dismiss these “eco‐reproductive” concerns. I argue that these avoidances lead to important limitations in the literature, which I address by employing a pragmatic approach for religious ethics. Learning from environmentalists who are critically engaging with their Christian inheritances, I find that informants draw upon religious repertoires to “kinnovate.” Namely, they expand notions of family beyond biological lineage by taking up vocations as godparents, youth mentors, foster parents, or chosen kin. I claim that these practices of Christian kinnovation are significant because they help to advance creative moral responses to eco‐reproductive concerns in religious contexts—interventions that currently remain underdeveloped in relevant ethical and theological literatures.
Preliminary Study on Cell Wall‐Degrading Enzymes and Host Resistance of Prunus davidiana Infected by Wilsonomyces carpophilus
Authors: Lu Hailong , Zhou Xinmei , Liu Chuli , Ma Xiong , Chen Hongjin , Wang Caixia , Ma Rong
Published: January 2025

The Prunus davidiana (Carrière) Franch. is an important tree species in Northwest China. However, fungal perforation caused by Wilsonomyces carpophilus can harm a variety of stone fruits, such as P. davidiana, seriously affecting the protection of germplasm resources and the cultivation of stone fruit in economic forests. In this study, the main pathogenic factors and host resistance strategies were explored by detecting the main cell wall‐degrading enzymes, the activities of the resistant enzymes and substances produced by the host when W. carpophilus infects P. davidiana. In the present study, the pathogenicity of W. carpophilus (CFCC 71543) was determined on P. davidiana. The changes of six cell wall‐degrading enzymes, including carboxymethyl cellulase (Cx), β‐glucosidase, polymethylgalacturonase (PMG), polygalacturonase (PG), polygalacturonate trans‐eliminase (PGTE) and pectin methyl trans‐eliminase (PMTE), produced by different strains when they invaded the host were determined using 3,5‐dinitrosalicylic acid and ultraviolet colorimetry. Additionally, the changes in phenylalanine ammonia‐lyase (PAL), polyphenol oxidase (PPO), peroxidase (POD), superoxide dismutase (SOD), catalase (CAT), malondialdehyde (MDA), total phenol (TP), plant flavonoids, tannins and four other resistant substances were determined 2–16 days after inoculation. The results showed that the main cell wall‐degrading enzyme of the strain (CFCC 71543) when infecting P. davidiana was PMG, with enzyme activity as high as 1548.456 U/g at 4 dpi, which was 3.988 times that of the control group. The level of five antioxidant enzymes and four resistant substances increased by varying degrees after infection by W. carpophilus. The main resistance enzyme of P. davidiana was POD, and POD activity reached 4184.889 U/g 8 days after inoculation, which was 4.074 times that of the control group. The main resistant substance was MDA, and the MDA content reached a peak of 217.63 nmol/g 8 days after inoculation, which was 2.376 times that in the control group. This is the first study to demonstrate that PMG is key in the infection of P. davidiana by W. carpophilus. The host produces five enzymes to resist infection by pathogenic bacteria, among which POD activity is the highest. Among the four resistant substances, MDA had strong resistance; the content of other resistant substances did not increase exponentially, and the resistance effect was not pronounced. These results provide a theoretical basis for an in‐depth understanding of the pathogenic mechanism and are of great significance for the prevention and control of perforations.
Vegetation history of the central Tibetan region during the late Oligocene–Early Miocene
Authors: Zhang Xin‐Wen , Liu Jia , Spicer Robert A. , Gao Yi , Yao Xuan‐Rong , Qin Xing‐Yuan , Zhou Zhe‐Kun , Su Tao
Published: January 2025

Understanding the Cenozoic vegetation history of what is now the Qinghai–Tibetan Plateau is crucial for elucidating the co‐evolutionary dynamics between plateau development, its environment, and the organisms it hosts. In this study, we conduct a comprehensive analysis of phytoliths within the late Oligocene–Early Miocene lacustrine sedimentary section of the Lunpola Basin, central Qinghai–Tibetan Plateau. The diverse phytolith morphotype assemblages indicate that the vegetation of the central Tibetan region mainly comprised a mixed coniferous and broad‐leaved forest. Grasses in the understory primarily consisted of Pooideae, distinguished by phytolith morphotypes such as rondel, crenate and Stipa‐type bilobate forms. Combined with previous work, we infer that riparian vegetation of the central Tibetan region transitioned from a humid subtropical forest, dominated by broad‐leaved woody plants during the middle Eocene, to a more seasonally arid open woodland containing abundant woody and herbaceous plants during the late Eocene, before developing into a cooler mixed coniferous and broad‐leaved forest during the late Oligocene–Early Miocene. The growth of the central Tibetan region and retreat of the Tethys Ocean, together with the uplift of the Himalaya, contributed to this vegetation change. This study provides new evidence from the phytolith perspective for the evolutionary history of Qinghai–Tibetan Plateau vegetation being tied to plateau formation and regional climate change.
Indirect Consequences of Locally Observed Corruption on Taxpayers' Motivation to Cheat on Taxes
Authors: Siddique Abu Bakkar
Published: January 2025

Corruption undermines the fiscal agreement between governments and taxpayers, thereby reducing the motivation to fulfill tax obligations and leading to a rise in dishonest behavior among citizens. To examine the effects of corruption, this study utilizes the locally observed corruption question, which provides a new measure of corruption at the local level, in contrast to corruption measures offered by the typical national corruption perception question. Employing a multilevel hierarchical mixed‐effect modeling approach, the analysis reveals that locally observed corruption substantially diminishes tax morale, a metric that assesses individuals' willingness not to cheat on taxes. Additionally, this paper identifies various factors that mediate the effects of corruption, including fairness in the tax system, ethnic diversity, and public policies. Furthermore, the study conducts several hypothesis tests to eliminate potential alternative explanations, such as the influence of peers and reduced expected costs of cheating resulting from exposed corruption.
Meaning‐Inferencing Versus Meaning‐Given Procedures: The Case of Idioms
Authors: Boers Frank , Yu Xi , Wang Xiaofei
Published: January 2025

Inferring the meaning of words and then verifying one's interpretations is widely believed to create relatively strong memories of the items. According to the available research, it is when the inferences are accurate that the learning outcomes are the most promising. The present study extends this inquiry to idioms. Fifty‐six ESL learners were presented with 21 English idioms (e.g., toe the line) in brief contexts and they were either prompted to infer the meaning of each idiom or they were given the meaning directly. After each inferencing attempt, the correct meaning was given as feedback. This initial learning stage was followed in the same session by a meaning‐recall task where the learners were again given the correct meanings as feedback. The results of a posttest administered one week later indicate that prompting learners to make inferences is beneficial compared to directly giving the meanings on condition that the inferencing was successful.