bluuebunny/crossref_metadata_2025 huggingface dataset:
The effect of a pharmaceutical ghrelin agonist on lifespan in C57BL/6J male mice: A controlled experiment
Authors: Kaiser Kathryn A. , Kadish Inga , van Groen Thomas , Smith Daniel L. , Dickinson Stephanie , Henschel Beate , Parker Erik S. , Brown Andrew W. , Allison David B.
Published: February 2023

Interventions for animal lifespan extension like caloric restriction (CR) have identified physiologic and biochemical pathways related to hunger and energy‐sensing status as possible contributors, but mechanisms have not been fully elucidated. Prior studies using ghrelin agonists show greater food intake but no effect on lifespan in rodent models. This experiment in male C57BL/6J mice tested the influence of ghrelin agonism for perceived hunger, in the absence of CR, on longevity. Mice aged 4 weeks were allowed to acclimate for 2 weeks prior to being assigned (N = 60/group). Prior to lights off daily (12:12 cycle), animals were fed a ghrelin agonist pill (LY444711; Eli Lilly) or a placebo control (Ctrl) until death. Treatment (GhrAg) animals were pair‐fed daily based on the group mean food intake consumed by Ctrl (ad libitum feeding) the prior week. Results indicate an increased lifespan effect (log‐rank p = 0.0032) for GhrAg versus placebo Ctrl, which weighed significantly more than GhrAg (adjusted for baseline weight). Further studies are needed to determine the full scope of effects of this ghrelin agonist, either directly via increased ghrelin receptor signaling or indirectly via other hypothalamic, systemic, or tissue‐specific mechanisms.
Emerging and Near Future Challenges of Higher Education in East Asia
Authors: Horta Hugo
Published: February 2023

Continuing the advances made in the later parts of the 20th century, East Asian economies and their higher education systems rapidly evolved in the first two decades of the twenty‐first century. Most East Asian countries are categorized as advanced economies with developed societies; however, issues such as aging populations, debt levels, and decreasing salary premiums for education are becoming increasingly apparent. Many of the higher education systems have reached or will soon reach a peak of massification, and a new set of challenges may emerge. In addition to ongoing challenges, for example, the need to foster further equity and internationalization, this study identifies three emergent or near future challenges for policymakers and higher education institution strategists to reflect on: the need to consolidate the system in view of decreasing enrollments; the need to reform higher education institutions to cope with potentially decreasing resources and the emergence of the Fourth Industrial Revolution and automation; and the need to realign academic research systems to ensure that the knowledge produced is more sustainable, collaborative, and meaningful.
Talk May Be Cheap, but Deeds Seldom Cheat: On Political Liberalism and the Assurance Problem
Authors: Wong Baldwin , Li Man‐Kong
Published: February 2023

In a well‐ordered society, democratic officials face an assurance problem. They want to ensure that others will act reasonably when they do the same. According to political liberals, public reason can solve this problem, but the details of how assurance is generated are unclear. This article explains the assurance mechanism in political liberalism. Apart from public reason, mutual assurance is also provided by a long‐term record of civic deeds. By performing civic deeds over time, officials signal their reasonableness to each other. This record of civic deeds is costly to unreasonable officials and thus represents a reliable way to differentiate trustworthy fellows from others. The article also shows that a recent critique of political liberalism, which argues that public reason is merely cheap talk and thus political liberalism fails to provide mutual assurance, misses the point. It overlooks that assurance is created through talks and deeds together.
Stage, treatment and survival of low‐grade serous ovarian carcinoma in the Netherlands: A nationwide study
Authors: De Decker Koen , Wenzel Hans H. B. , Bart Joost , van der Aa Maaike A. , Kruitwagen Roy F. P. M. , Nijman Hans W. , Kruse Arnold‐Jan
Published: February 2023

Introduction

Serous ovarian carcinomas constitute the largest group of epithelial ovarian cancer (60%–75%) and are further classified into high‐ and low‐grade serous carcinoma. Low‐grade serous carcinoma (LGSC) is a relatively rare subtype (approximately 5% of serous carcinomas) and epidemiologic studies of large cohorts are scarce. With the present study we aimed to report trends in stage, primary treatment and relative survival of LGSC of the ovary in a large cohort of patients in an effort to identify opportunities to improve clinical practice and outcome of this relatively rare disease.

Material and Methods

Patients diagnosed with LGSC between 2000 and 2019 were identified from the Netherlands Cancer Registry (n = 855). Trends in FIGO stages and primary treatment were analyzed with the Cochran–Armitage trend test, and differences in and trends of 5‐year relative survival were analyzed using multivariable Poisson regression.

Results

Over time, LGSC was increasingly diagnosed as stage III (39.9%–59.0%) and IV disease (5.7%–14.4%) and less often as stage I (34.6%–13.5%; p < 0.001). Primary debulking surgery was the most common strategy (76.2%), although interval debulking surgery was preferred more often over the years (10.6%–31.1%; p < 0.001). Following primary surgery, there was >1 cm residual disease in only 15/252 patients (6%), compared with 17/95 patients (17.9%) after interval surgery. Full cohort 5‐year survival was 61% and survival after primary debulking surgery was superior to the outcome following interval debulking surgery (60% vs 34%). Survival following primary debulking surgery without macroscopic residual disease (73%) was better compared with ≤1 cm (47%) and >1 cm residual disease (22%). Survival following interval debulking surgery without macroscopic residual disease (51%) was significantly higher than after >1 cm residual disease (24%). Except FIGO stage II (85%–92%), survival did not change significantly over time.

Conclusions

Over the years, LGSC has been diagnosed as FIGO stage III and stage IV disease more often and interval debulking surgery has been increasingly preferred over primary debulking in these patients. Relative survival did not change over time (except for stage II) and worse survival outcomes after interval debulking surgery were observed. The results support the common recommendation to perform primary debulking surgery in patients eligible for primary surgery.
Randomised clinical trial: Safety, tolerability, pharmacodynamics and pharmacokinetics of zastaprazan (JP‐1366), a novel potassium‐competitive acid blocker, in healthy subjects
Authors: Hwang Inyoung , Ji Sang Chun , Oh Jaeseong , Kim Hyojin , Cha Hyunju , Kim John , Lee Chang‐Seok , Yu Kyung‐Sang , Lee SeungHwan
Published: February 2023

Background

Zastaprazan (JP‐1366) is a novel potassium‐competitive acid blocker with favourable preclinical safety and efficacy profile being developed for the treatment of acid‐related diseases.

Aims

To investigate the safety, tolerability, pharmacodynamics and pharmacokinetics of zastaprazan.

Methods

A randomised, open‐label, placebo‐ and active‐controlled, single and multiple ascending dose clinical trial was conducted in healthy Korean male subjects. Intragatric pH and serum gastrin were measured to assess the pharmacodynamics, while serial blood and urine samples were collected to assess the pharmacokinetics. Pharmacogenomic evaluation was conducted to explore genetic variants, which can affect the pharmacodynamics and pharmacokinetics. Safety and tolerability including hepatotoxicity were evaluated.

Results

Suppression of gastric acid secretion increased as the dose of zastaprazan increased. The percentage of time that gastric pH was over 4 (%Time pH >4) with zastaprazan 20 mg (85.19%) and 40 mg (91.84%) were similar to or greater than that with esomeprazole 40 mg (72.06%). Zastaprazan was rapidly absorbed within 2 h and eliminated with a half‐life of 6–10 h. Pharmacogenomic analysis found no genetic variant of drug metabolising enzymes including CYP2C19 or drug transporters associated with the exposure of zastaprazan. Zastaprazan was well tolerated with no clinically significant changes in safety and tolerability assessments.

Conclusions

Zastaprazan was safe and well tolerated after a single oral dose up to 60 mg and multiple oral doses up to 40 mg. It also showed rapid, potent suppression of gastric acid secretion. Pharmacodynamic and pharmacokinetic profile of zastaprazan was suitable for treatment of patients with acid‐related diseases.
Plasma protein and venous thromboembolism: prospective cohort and mendelian randomisation analyses
Authors: Yuan Shuai , Titova Olga E. , Zhang Ke , Gou Wanglong , Schillemans Tessa , Natarajan Pradeep , Chen Jie , Li Xue , Åkesson Agneta , Bruzelius Maria , Klarin Derek , Damrauer Scott M. , Larsson Susanna C.
Published: February 2023

We conducted cohort and Mendelian randomisation (MR) analyses to examine the associations of circulating proteins with risk of venous thromboembolism (VTE) to provide evidence basis for disease prevention and drug development. Cohort analysis was performed in 11 803 participants without baseline VTE. Cox regression was used to estimate the associations between 257 proteins and VTE risk. A machine‐learning model was constructed to compare the importance of identified proteins and traditional risk factors. Genetic association data on VTE were obtained from a genome‐wide meta‐analysis (26 066 cases and 624 053 controls) and FinnGen (14 454 cases and 294 700 controls). The cohort analysis, including 353 incident VTE cases diagnosed during a 6.6‐year follow‐up, identified 21 proteins associated with VTE risk after false discovery rate correction. The machine‐learning model indicated that body mass index and von Willebrand factor (vWF) made the same as well as most of the contributions to the overall model prediction. MR analysis found that genetically predicted levels of vWF, SERPINE1 (plasminogen activator inhibitor 1, known as PAI‐1), EPHB4 (ephrin type‐B receptor 4), TYRO3 (tyrosine‐protein kinase receptor TYRO3), TNFRSF11A (tumour necrosis factor receptor superfamily member 11A), and BOC (brother of CDO) were causally associated with VTE risk.
Mixture‐modelling‐based Bayesian MH‐RM algorithm for the multidimensional 4PLM
Authors: Guo Shaoyang , Chen Yanlei , Zheng Chanjin , Li Guiyu
Published: February 2023

Several recent works have tackled the estimation issue for the unidimensional four‐parameter logistic model (4PLM). Despite these efforts, the issue remains a challenge for the multidimensional 4PLM (M4PLM). Fu et al. (2021) proposed a Gibbs sampler for the M4PLM, but it is time‐consuming. In this paper, a mixture‐modelling‐based Bayesian MH‐RM (MM‐MH‐RM) algorithm is proposed for the M4PLM to obtain the maximum a posteriori (MAP) estimates. In a comparison of the MM‐MH‐RM algorithm to the original MH‐RM algorithm, two simulation studies and an empirical example demonstrated that the MM‐MH‐RM algorithm possessed the benefits of the mixture‐modelling approach and could produce more robust estimates with guaranteed convergence rates and fast computation. The MATLAB codes for the MM‐MH‐RM algorithm are available in the online appendix.
Toward an Atlas of Canonical Cognitive Mechanisms
Authors: Pirrone Angelo , Tsetsos Konstantinos
Published: February 2023

A central goal in Cognitive Science is understanding the mechanisms that underlie cognition. Here, we contend that Cognitive Science, despite intense multidisciplinary efforts, has furnished surprisingly few mechanistic insights. We attribute this slow mechanistic progress to the fact that cognitive scientists insist on performing underdetermined exercises, deriving overparametrized mechanistic theories of complex behaviors and seeking validation of these theories to the elusive notions of optimality and biological plausibility. We propose that mechanistic progress in Cognitive Science will accelerate once cognitive scientists start focusing on simpler explananda that will enable them to chart an atlas of elementary cognitive operations. Looking forward, the next challenge for Cognitive Science will be to understand how these elementary cognitive processes are pieced together to explain complex behavior.
Speech biomarkers in Huntington's disease: A cross‐sectional study in pre‐symptomatic, prodromal and early manifest stages
Authors: Kouba Tomas , Frank Wiebke , Tykalova Tereza , Mühlbäck Alzbeta , Klempíř Jiří , Lindenberg Katrin S. , Landwehrmeyer G. Bernhard , Rusz Jan
Published: February 2023

Background and purpose

Motor speech alterations are a prominent feature of clinically manifest Huntington's disease (HD). Objective acoustic analysis of speech can quantify speech alterations. It is currently unknown, however, at what stage of HD speech alterations can be reliably detected. We aimed to explore the patterns and extent of speech alterations using objective acoustic analysis in HD and to assess correlations with both rater‐assessed phenotypical features and biological determinants of HD.

Methods

Speech samples were acquired from 44 premanifest (29 pre‐symptomatic and 15 prodromal) and 25 manifest HD gene expansion carriers, and 25 matched healthy controls. A quantitative automated acoustic analysis of 10 speech dimensions was performed.

Results

Automated speech analysis allowed us to differentiate between participants with HD and controls, with areas under the curve of 0.74 for pre‐symptomatic, 0.92 for prodromal, and 0.97 for manifest stages. In addition to irregular alternating motion rates and prolonged pauses seen only in manifest HD, both prodromal and manifest HD displayed slowed articulation rate, slowed alternating motion rates, increased loudness variability, and unstable steady‐state position of articulators. In participants with premanifest HD, speech alteration severity was associated with cognitive slowing (r = −0.52, p < 0.001) and the extent of bradykinesia (r = 0.43, p = 0.004). Speech alterations correlated with a measure of exposure to mutant gene products (CAG‐age‐product score; r = 0.60, p < 0.001).

Conclusion

Speech abnormalities in HD are associated with other motor and cognitive deficits and are measurable already in premanifest stages of HD. Therefore, automated speech analysis might represent a quantitative HD biomarker with potential for assessing disease progression.
Disorganized attachment in emerging adulthood: Measurement comparisons and relations to childhood maltreatment and emotion dysregulation
Authors: Whittington Drew
Published: February 2023

There is an abundance of research examining disorganized attachment in childhood. However, few researchers have worked to advance the study of disorganized attachment in the context of emerging adult romantic relationships. As such, consistent and clear measurement of this attachment dimension is lacking. In the current study, emerging adult college students (N = 318) completed two previously designed self‐report measures for assessing adult disorganized attachment in the context of romantic relationships. The two scales were compared in a factor analytic framework to create a single cohesive measure of romantic disorganized attachment, which captures the unique features of disorganized attachment, including fear, distrust and suspicion of attachment figures, as well as odd and disoriented behaviors. The result was a 15‐item measure, which showed good reliability and factorial validity, and was moderately related to existing measures of attachment anxiety and avoidance. Additionally, the new measure demonstrated good test–retest reliability in a follow‐up (n = 52). Finally, path analysis was used to provide evidence that disorganized attachment mediates the relation of childhood maltreatment to difficulties in emotion regulation, above what is captured by anxious and avoidant attachment. The current findings suggest the revised measure is a reliable self‐report measure of disorganized adult romantic attachment to be used to further the study of disorganized attachment in emerging adulthood.
Shifting toward intensive parenting culture? A comparative analysis of top mommy blogs and dad blogs
Authors: Scheibling Casey , Milkie Melissa A.
Published: February 2023

Objective

The purpose of this study is to compare gendered framings of family issues in popular mommy blogs and dad blogs to assess what they reveal about parenting ideologies.

Background

Blogs are cultural arenas where parents navigate what it means to be a “good” mother or father. Despite a growing body of work on parents' use of social media, the content and framing of parenting blogs by gender is understudied.

Method

Through a comparative analysis of 400 written posts from the top 20 mommy bloggers and dad bloggers in the United States and Canada, we examine the scope and construction of family issues in blogs and how they are framed by mothers versus fathers.

Results

Mothers frame parenting in ways that highlight their investment in safeguarding children's futures, often through consumer solutions. Both mothers and fathers extend similar concerns around protecting family health and create a counter‐frame against intensive parenting by admitting and accepting imperfection. Fathers' posts emphasize how work and gender norms constrain men's ability to be involved parents.

Conclusion

Our comparative analysis illustrates gendered nuance in blog framings of family life and presents slight indications of shifting toward a shared culture of intensive parenting.

Implications

This study elucidates the potentials and pitfalls of parenting blogs as platforms for family knowledge mobilization and social advocacy around parenting problems in a consumerist digital society.
When Facebook plays matchmaker: Interactions within an online community dedicated to surrogacy and egg donation
Authors: Lavoie Kévin , Côté Isabel
Published: February 2023

Objective

This article explores the interactions and digital practices of people involved in an online community dedicated to surrogacy and egg donation in the province of Québec, Canada.

Background

Sociodigital networks, with the emergence of platforms such as Facebook groups, provide a space to discuss assisted reproduction, seek advice, offer support, and connect with other Internet users to negotiate and establish a third‐party reproduction agreement.

Method

This study is based on a long‐term ethnographic field within a Facebook group, and individual interviews conducted with 22 members of this community. The data collected were analyzed inductively according to the principles of grounded theory.

Results

Three themes emerged from the online interactions and stories of the women we met. First, the publication of intended parents' testimonies is the preferred method of finding a surrogate or egg donor match and is reminiscent of the language and rituals associated with dating sites. Second, the expression of legal and financial concerns occupies a prominent place in the group discussions, given the lack of a legislative framework in this Canadian province and the variability of interpretations of the current legal framework. Third, the choice made by surrogates and donors to be involved in an online community is not random and sometimes indicates of a desire to establish a sense of control over the process and to negotiate the modalities without the presence of an intermediary.

Conclusion and implications

Facebook groups dedicated to infertility and assisted reproduction appear to be more than simply matchmakers, as the interactions that occur there perform various functions. In the absence of a formal organization dedicated to parents, surrogates, and donors in Québec, the online community becomes a place for information sharing, support, and networking. This offers avenues of intervention for professionals who need to reflect on and consider how online communities dedicated to third‐party reproduction may influence their practice.
Mothers' bereavement and evolving relationships with their dead child in South Korea
Authors: Yi Jaehee , Younce Bobby , Chung Eunbin , Kim Min Ah , Bradbury Laura
Published: February 2023

Objective

This study examined mothers' continuing relationships with their child lost to cancer in South Korea.

Background

Parents who lose a child to cancer experience a deep level of grief and a continuous, seemingly never‐ending grieving process.

Method

Fifteen semistructured interviews were conducted with mothers who had lost a child to cancer. Participants were recruited from a support group for bereaved parents. Most participants were currently unemployed, and the elapsed time since the child's death ranged from 8 months to 13 years. Inductive thematic analysis was conducted to identify themes.

Results

We identified three overlapping themes––regret, longing, and connectedness––and eight subthemes. One major source of regret was focusing too much on pursuing a curative treatment to prevent their child's death and forgetting to show their love toward their dying child. Mothers identified longing for their child as an inexplicably intense and ever‐present loss that will only end with their death, when they will be reunited with their child. Mothers continued to live and communicate with their deceased child, imagining how their child would have grown up if they were still alive.

Conclusion

Mothers who lost a child to cancer used continuing bonds to maintain their parental identity and relationship with the child. Maintaining bonds with deceased children can take various forms and affect coping in the parents' bereavement process.

Implications

Health professionals should support continuing bonds that may help parents construct meaning while simultaneously promoting improved adaptation to the death of a child to cancer in the grieving process.
Provision of and trust in COVID‐19 vaccines information: Perspectives of people who have had COVID‐19
Authors: Schackmann Laura , Hek Karin , Vervloet Marcia , Koster Ellen S. , van Dijk Liset
Published: February 2023

Aim

The aim of this study was to understand the provision and need, quality of and trust in COVID‐19 vaccines information from the perspectives of people who have had COVID‐19 infection.

Method

People who have had a COVID‐19 infection were approached via their general practice and invited to participate in the Nivel Corona Cohort. They completed questionnaires at baseline (Q1), and at three months (Q2). Outcome measures were based on health information‐seeking behaviour, as used in the Comprehensive Model of Information Seeking. Antecedents (i.e., gender, age, education level, health literacy) were used from Q1, and one's beliefs and experiences (i.e., trust in the information and healthcare system, how applicable the information is), information carrier factors (i.e., information quality perceptions and via which sources), health‐information seeking actions (i.e., decision to vaccinate and information sufficiency) and vaccination status from Q2. Data were analysed using descriptive analyses, analysis of variance tests (F‐tests) and χ2 tests with the statistical software STATA.

Results

Of the respondents (N = 314), 96% were vaccinated at least once, mostly after having had the virus. Most retrieved information about COVID‐19 vaccines on the website of the National Institute for Public Health and the Environment (79%), broader via the internet (56%), or from family and friends (35%). Almost all had trust in the information (89%) and healthcare system (94%). Most found the information applicable to their situation (67%). Moreover, most perceived the information as correct (71%) and did not perceive the information to be misleading (85%), while fewer people found the information reliable (59%) and clear (58%). Overall, the majority indicated that the information met their expectations to make a well‐informed decision to vaccinate (89%).

Conclusion

Different characteristics of people who had COVID‐19 and sought information were identified, which is important to offer tailored information. People who had COVID‐19 in this study, mainly middle‐aged, vaccinated and highly educated, were generally positive about the vaccines information, but overall the reliability and clarity could be improved. This is important for a high vaccination uptake, booster programs and coming pandemics.

Patient or Public Contribution

The questionnaire was reviewed by patients who had COVID‐19, one of whom is a health services researcher.
Rapid crystallization of Li1.5Al0.5Ge1.5(PO4)3 glass ceramics via ultra‐fast high‐temperature sintering (UHS)
Authors: Wu Jinghua , Kermani Milad , Cao Lei , Wang Bohan , Dai Zhiquan , Fu Le , Hu Chunfeng , Grasso Salvatore
Published: February 2023

Lithium aluminum germanium phosphate solid electrolyte is a promising candidate for all‐solid‐state batteries. The currently available processing techniques based on melting‐quenching require a rather lengthy crystallization step lasting up to 8 hours. In this work, the newly emerged ultra‐fast high‐temperature sintering (UHS) was proposed to achieve in a single step reactive consolidation of powder mixture (GeO2, Al(PO3)3, LiPO3) and crystallization of the electrolyte within 16 minutes. Samples produced using UHS had a better phase purity, reduced Li loss, and improved ionic conductivity when compared to the counterparts prepared using conventional crystallization at 850°C for 6 h. In fact, specimens prepared by UHS achieved a crystallinity of 90% and ionic conductivity as high as 1.31 × 10−4 S cm−1.
Quality of life measurement in rosacea. Position statement of the European Academy of Dermatology and Venereology Task Forces on Quality of Life and Patient Oriented Outcomes and Acne, Rosacea and Hidradenitis Suppurativa
Authors: Chernyshov P. V. , Finlay A. Y. , Tomas‐Aragones L. , Steinhoff M. , Manolache L. , Pustisek N. , Dessinioti C. , Svensson A. , Marron S. E. , Bewley A. , Salavastru C. , Dréno B. , Suru A. , Koumaki D. , Linder D. , Evers A. W. M. , Abeni D. , Augustin M. , Salek S. S. , Nassif A. , Bettoli V. , Szepietowski J. С. , Zouboulis C. C.
Published: February 2023

The European Academy of Dermatology and Venereology (EADV) Task Forces (TFs) on Quality of Life (QoL) and Patient‐Oriented Outcomes and Acne, Rosacea and Hidradenitis Suppurativa (ARHS) do not recommend the use of any generic instrument as a single method of Health Related (HR) QoL assessment in rosacea, except when comparing quimp (quality of life impairment) in rosacea patients with that in other non‐dermatologic skin diseases and/or healthy controls. The EADV TFs on QoL and Patient‐Oriented Outcomes and ARHS recommend the use of the dermatology‐specific HRQoL instrument the Dermatology Life Quality Index (DLQI) and the rosacea‐specific HRQoL instrument RosaQoL in rosacea patients. The DLQI minimal clinically important difference may be used as a marker of clinical efficacy of the treatment and DLQI score banding of 0 or 1 corresponding to no effect on patients' HRQoL could be an important treatment goal. This information may be added to consensuses and guidelines for rosacea.
Age, growth, maturity and mortality of the tapetail anchovy Coilia brachygnathus (Engraulidae) in Lake Honghu, China
Authors: Yimer Melaku Abelneh , Cao Liang , Shen Jiang‐Zhong , Zhang E
Published: February 2023

The tapertail anchovy Coilia brachygnathus, a commercially important species mainly distributed along the mid‐lower Chang‐Jiang basin, is by far the most dominant species in Lake Honghu. To figure out its success in this semiclosed lake, some basic biological parameters of this anchovy were analysed based on samples seasonally collected from October 2020 to December 2021. The results demonstrated that the age classes of fished individuals varied from 0.5 to 3.5, with the majority (97.36%) being between 0.5 and 3 years old. The size at 50% maturity of 17.2 cm total length (TL) for females and 19.0 cm TL for males corresponded to 1 and 1.6 years, respectively. Coilia brachygnathus has a short life span, early sexual maturity and a relatively fast growth rate. The flourishing of the fish in the lake is mainly attributed to its short life span, early maturity, fast growth rate, closed fishing, pelagic spawners, the availability of plenty of food and low predation effect on it. Age 3.5 year occurs in an extremely small percentage of the total (<3%), indicating that a large number of larger‐sized or older fish died after spawning, which is probably one of the major sources of water pollution if the closed fishing measure is adopted in Lake Honghu. Thus, individuals older than 2 years or more than 20.0 cm TL should be harvested. These findings have important management implications for the fish resources in Lake Honghu and beyond.
Automatable end‐of‐life screening for older adults in the emergency department using electronic health records
Authors: Haimovich Adrian D. , Xu Wenxin , Wei Andrew , Schonberg Mara A. , Hwang Ula , Taylor R. Andrew
Published: February 2023

Background

Emergency department (ED) visits are common at the end‐of‐life, but the identification of patients with life‐limiting illness remains a key challenge in providing timely and resource‐sensitive advance care planning (ACP) and palliative care services. To date, there are no validated, automatable instruments for ED end‐of‐life screening. Here, we developed a novel electronic health record (EHR) prognostic model to screen older ED patients at high risk for 6‐month mortality and compare its performance to validated comorbidity indices.

Methods

This was a retrospective, observational cohort study of ED visits from adults aged ≥65 years who visited any of 9 EDs across a large regional health system between 2014 and 2019. Multivariable logistic regression that included clinical and demographic variables, vital signs, and laboratory data was used to develop a 6‐month mortality predictive model—the Geriatric End‐of‐life Screening Tool (GEST) using five‐fold cross‐validation on data from 8 EDs. Performance was compared to the Charlson and Elixhauser comorbidity indices using area under the receiver‐operating characteristic curve (AUROC), calibration, and decision curve analyses. Reproducibility was tested against data from the remaining independent ED within the health system. We then used GEST to investigate rates of ACP documentation availability and code status orders in the EHR across risk strata.

Results

A total of 431,179 encounters by 123,128 adults were included in this study with a 6‐month mortality rate of 12.2%. Charlson (AUROC (95% CI): 0.65 (0.64–0.69)) and Elixhauser indices (0.69 (0.68–0.70)) were outperformed by GEST (0.82 (0.82–0.83)). GEST displayed robust performance across demographic subgroups and in our independent validation site. Among patients with a greater than 30% mortality risk using GEST, only 5.0% had ACP documentation; 79.0% had a code status previously ordered, of which 70.7% were full code. In decision curve analysis, GEST provided greater net benefit than the Charlson and Elixhauser scores.

Conclusions

Prognostic models using EHR data robustly identify high mortality risk older adults in the ED for whom code status, ACP, or palliative care interventions may be of benefit. Although all tested methods identified patients approaching the end‐of‐life, GEST was most performant. These tools may enable resource‐sensitive end‐of‐life screening in the ED.
Fossorial mammals emphasise the forelimb muscle moment arms used for digging: New indices for reconstruction of the digging ability and behaviours in extinct taxa
Authors: Nakai Daichi , Fujiwara Shin‐ichi
Published: February 2023

Among fossorial mammals, forelimbs are major digging apparatuses for dwelling, sheltering and foraging underground. Forelimb‐diggers have independently evolved in many lineages of mammals; thus, the method of digging with forelimbs varies by taxon. Therefore, the reconstruction of digging behaviours in extinct animals leads us to understand the evolutionary process of fossorial adaptation in each lineage. However, no morphological index was found to reconstruct if, or how, extinct taxa dug with forelimbs. In this study, we used the shoulder and elbow muscle moment arms in relation to the out‐force lever on the manus as indices of the efficiency of motions. The mechanical advantage of two shoulder motions (medial rotation and retraction) and three elbow motions (extension, flexion and adduction) was measured in 381 extant mammal specimens representing 332 species, 279 genera, 103 families and 24 orders. Assuming that both forelimb‐digging and ‐paddling in water require relatively high‐output moment arm efficiency, the studied taxa were categorised into four groups based on the presence or absence of forelimb‐digging and ‐paddling abilities. We found that the efficiencies of all five muscle moment arms in the forelimb‐diggers and ‐paddlers were higher than those of the non‐diggers and non‐paddlers. Furthermore, among the forelimb‐diggers, the taxa that dig compact substrates or frequently burrow tend to emphasise the muscle moment arms compared to the taxa that dig loose substrates or dig less frequently. The comparison among the 53 extant forelimb‐diggers revealed that the efficiency marked among the five muscle moment arms reflects the difference in digging strategy: humeral rotation diggers emphasise the shoulder medial rotator and elbow adductor, hook‐and‐pull diggers emphasise the shoulder retractor and elbow flexor and scratch diggers emphasise the shoulder retractor and elbow extensor. We propose that these indices will be powerful tools for reconstructing the fossorial behaviours of extinct mammals. Applying these indices to extinct taxa, Ceratogaulus, Ernanodon, Metacheiromys and Prozaedyus are capable of more efficient forelimb‐digging, and each may have adopted different digging strategies.
Evolutionary convergence of muscle architecture in relation to locomotor ecology in snakes
Authors: Mathou Adrien , Bonnet Xavier , Daoues Karim , Ksas Rémi , Herrel Anthony
Published: February 2023

The epaxial muscles in snakes are responsible for locomotion and as such can be expected to show adaptations in species living in different environments. Here, we tested whether the structural units that comprise the superficial epaxial muscles (semispinalis‐spinalis, SSP; longissimus dorsi, LD; iliocostalis, IC) were different in animals occupying similar habitats. To do so, we analyzed and compared the muscle architecture (mass, fiber length, and physiological cross‐sectional area) of the superficial epaxial muscle segments in snakes that differ in their habitat use (e.g., arboreal, terrestrial, and aquatic). Our results showed that arboreal species have on average longer muscles and tendons spanning more segments likely important during gap bridging. Moreover, aquatic snakes show relatively heavier semispinalis‐spinalis muscles with a greater cross‐sectional area. The longissimus dorsi muscles also showed a greater cross‐sectional area compared with terrestrial and especially arboreal snakes. Whereas the more strongly developed muscles in aquatic snakes are likely associated with the dense and viscous environment through which they move, the lighter muscles in arboreal snakes may provide an advantage when climbing. Future studies comparing other ecologies (e.g., burrowing snakes) and additional muscle units (e.g., multifidus; hypaxial muscles) are needed to better understand the structural features driving variation in locomotor performance and efficiency in snakes.
Decision coaching for people with kidney failure: A case study
Authors: Buur Louise Engelbrecht , Bekker Hilary Louise , Mathiesen Caroline Løntoft , Holm Lotte Timmerby , Riise Ida , Finderup Jeanette , Stacey Dawn
Published: February 2023

Background

Little is known about the usefulness of decision coaching for people with kidney failure facing decisions about end‐of‐life care.

Objectives

To investigate experiences of people with kidney failure who received decision coaching for end‐of‐life care decisions.

Design

We conducted a prospective case study bound by time (September to December 2021), location (one nephrology department), and guided by the Ottawa Decision Support Framework.

Participants

Adults with kidney failure facing end‐of‐life care decisions.

Measurements

A nurse trained in decision coaching screened for unmet decisional needs with the SURE test and provided decision coaching using the Ottawa Personal Decision Guide. Postcoaching, the participants were rescreened using the SURE test and interviewed to explore their experience with decision coaching. Change in SURE test findings was analysed descriptively and systematic text condensation was used for the analysis of interviews. Recorded decision coaching sessions underwent content analysis using the Decision Support Analysis Tool.

Results

Decision coaching was provided to four adults with kidney failure. Median pre‐SURE test score was 2.5 (range 2–4) and posttest score was 3 (range 3–4), indicating a decrease in decisional needs. Participants described that decision coaching provided an overview of features of options to consider, identified remaining decisional needs for further discussion with relatives and health professionals and clarified next steps. Median Decision Support Analysis Tool score was 9 (range 8–9).

Conclusions

After decision coaching, results suggest that the participants experienced fewer decisional needs and seemed clearer about the next steps in the decision making process.
The effect of a 2 week ketogenic diet, versus a carbohydrate‐based diet, on cognitive performance, mood and subjective sleepiness during 36 h of extended wakefulness in military personnel: An exploratory study
Authors: Henderson Lydia Rose , van den Berg Margo , Shaw David M
Published: February 2023

Extended wakefulness, or sleep deprivation, impairs cognitive performance and brain glucose metabolism. A ketogenic diet (KD) provides an alternative fuel source, ketone bodies, that could elicit a metabolic benefit during sleep deprivation. A randomised, cross‐over trial was conducted with seven male military personnel. Participants ingested an iso‐energetic ketogenic diet or carbohydrate‐based diet for 14 days, immediately followed by 36 h of extended wakefulness and separated by a 12 day washout. Cognitive performance, mood, subjective sleepiness, capillary blood glucose, and D‐β‐hydroxybutyrate concentrations were measured every 2 h during extended wakefulness. Linear mixed models were used to analyse data. D‐β‐hydroxybutyrate was higher (p < 0.001) and glucose was lower (p < 0.01) on the KD compared with the carbohydrate‐based diet. The KD improved psychomotor vigilance task performance (number of lapses, mean reciprocal response time, mean fastest 10% response time (RT), and mean slowest 10% RT; all p < 0.05), running memory continuous performance test performance (RT and number of correct responses per minute; both p < 0.01), and vigour, fatigue, and sleepiness (all, p ≤ 0.001) compared with the carbohydrate‐based diet. In conclusion, a KD demonstrated beneficial effects on cognitive performance, mood, and sleepiness during 36 h of extended wakefulness compared with a carbohydrate‐based diet.
The power struggles of executives and legislators in a kingship budget setting: The role of informal and formal power
Authors: Buanaputra Vogy Gautama , Uddin Shahzad
Published: February 2023

Drawing on the power struggles of executives and legislators in a kingship budget setting, the study sheds light on the role of informal power in budget decisions and what makes one of the key actors more powerful than the other in the budgeting process. The study employs a qualitative case study collecting data through face‐to‐face interviews, observations, and documentary analysis. The paper advances the research stream of budget politics in public administration literature, highlighting the intense exercise of informal power to drive budget decisions. The paper provides evidence that informal power has heavily influenced the interactions between executives and legislators by the King and his fictive kin, exercised by formal and informal mechanisms (e.g., half‐room meetings). Utilizing Weber's traditionalism, we demonstrate that the role of informal power over formal power is especially critical in a context where democratic institutions have no solid foundation.
The contribution of primary care practitioners to interventions reducing loneliness and social isolation in older people—An integrative review
Authors: Thompson Cristina , Halcomb Elizabeth , Masso Malcolm
Published: February 2023

Background

Social connection is a fundamental human need. Its absence can lead to loneliness and social isolation, adversely impacting health and well‐being. Given their regular contact and trusted relationships with older people, practitioners delivering community‐based primary care are well‐positioned to address this issue. However, their contribution to addressing loneliness and social isolation is unclear.

Aim

This integrative review explores the contribution of the primary care workforce to interventions aimed at reducing loneliness and social isolation in community‐dwelling older people.

Method

Using an integrative review method, Scopus, Web of Science, CINAHL and PubMed were searched for original research published between 2000 and 2022. Fourteen papers reporting 13 primary studies were appraised for methodological quality and included in the review. Data were extracted into a summary table and analysed using thematic analysis.

Results

Included studies came from over six countries. Internationally, primary care services have diverse structures, funding and workforces influencing their response to loneliness and social isolation. All but one intervention was multi‐component, with ten studies including a group‐based activity and three providing primarily individual‐level activities. Only six studies reported reductions in loneliness following the intervention. Three themes were identified: characteristics of interventions; implementation context, barriers and facilitators; and differing contributions of primary care practitioners in addressing loneliness and social isolation of older people.

Conclusion

There is increasing demand and scope for primary care practitioners to assist lonely and socially isolated older people. It is important to understand how to equip and incentivise these practitioners to routinely identify, assess and respond to lonely and socially isolated older people despite varying implementation contexts. There is a need for further research that explores how the primary care team can be better utilised to deliver effective interventions that reduce the health impacts of loneliness and social isolation.
Trait continuity: Can parent‐rated infant temperament predict HEXACO personality in early adulthood?
Authors: Kamarova Sviatlana , Dunlop Patrick D. , Parker Sharon K.
Published: February 2023

Examining the Raine cohort study, we tested the trait continuity hypothesis by examining the extent that young adults' (25–29 years old) self‐reported HEXACO personality can be statistically predicted from multi‐dimensional parental temperament ratings collected in infancy (1–2 years old). The study incorporated a lagged design (two waves), a large sample size (n = 563), and examined both temperament and personality as both dimensions and profiles. Overall, we found very limited evidence of trait continuity, with generally very weak and few statistically significant observed associations of infant temperament with early adulthood personality. Relations were weak whether profile or dimension‐based operationalizations of both phenomena were adopted. Additionally, controlling for sex affected the relations of temperament and personality only to a small extent for most of the traits, and moderation effects of sex were generally zero‐to‐trivial in size. Altogether, parent‐rated temperament in infancy seems to provide little information about HEXACO personality in early adulthood.
A sociology of bullying: Placing youth aggression in social context
Authors: Donoghue Christopher , Pascoe C.J.
Published: February 2023

In this paper we review the sociological literature on peer aggression among adolescents and demonstrate how it can form the basis of a new subfield in sociology on the subject of bullying. Although sociologists have mostly avoided the term bullying in classic works on adolescent aggression, these studies suggest that institutional social control, status hierarchies and social inequalities provide important social context for youth aggression. While historically they have not been in dialog with each other, when taken together sociological research on youth status relations and social networks, systemic bias, school culture and social ecology can lay the foundation of a sociology of bullying. We suggest that if sociologists see this work as shedding light on issues of bullying, they can begin to play a larger role in the shaping of the national conversation on bullying and influence anti‐bullying programs in schools to take better account of the social dimensions of bullying.
What Drives Technological Change in Regions? Relatedness and R&D Subsidies in the US from 1981 to 2010
Authors: Simone Andrea
Published: February 2023

R&D subsidisation is acknowledged as a major spurrer of the economic development of regions, but is seldom considered in the literature concerning regional diversification. Conversely, robust evidence has been gathered about the impact of relatedness on the ability of regions to explore new technological domains. The work employs patent data to assess the extent to which related and unrelated diversification processes in the United States, between 1981 and 2010, are influenced by the existing regional knowledge base and the magnitude of R&D public funds, providing evidence for both drivers by means of econometric estimations.
An evaluation of the clinical impacts of 7‐day platelets
Authors: Ning Shuoyan , Gabarin Nadia , Li Na , Liu Yang , Lucier Kayla , Barty Rebecca , Acker Jason , Webert Kathryn E. , Warkentin Theodore E. , Arnold Donald M. , Heddle Nancy M.
Published: February 2023

Background

In August 2017, Canadian Blood Services extended the shelf‐life of platelet concentrates from 5 to 7 days. The clinical impacts of this policy change remain unclear.

Study Design and Methods

We used a before‐after retrospective design of platelet‐transfused adult inpatients in Hamilton, ON, Canada. Data were captured for 18 months before (Period 1: February 2016–July 2017) and 18 months after (Period 2: September 2017–February 2019) 7‐day platelet implementation. Primary outcome was absolute platelet count increment (ACI) in univariate and multivariate analyses adjusted for confounders. Data were obtained from our institution's transfusion database, Ontario's Transfusion Transmitted Injuries Surveillance System, and the blood supplier.

Results

Overall, 1360 patients with single dose platelet transfusions were included in Period 1 and 1211 patients in Period 2. Median age at admission was 66 years, and approximately 40% of patients underwent cardiac surgery. Using a non‐inferiority margin of −10 × 109/L, platelets transfused during the 7‐day storage period were non‐inferior to those transfused in the 5‐day storage period [mean count difference − 4.63 × 109/L (95% CI −7.40 to −1.87, p = 0.0001)]. However, platelet ACIs following transfusion consistently trended lower in the 7‐day group for all patients and subgroups. No differences in secondary clinical outcomes were observed. Platelet expiry reduced from 8.1 to 6.3% (p < 0.0001).

Conclusion

Platelet transfusions following 7‐day storage policy were non‐inferior to transfusions in the 5‐day policy period, although reduced ACIs were observed. There were no increases in adverse clinical outcomes.