bluuebunny/crossref_metadata_2025 huggingface dataset:
Superior sensibility after full breast reconstruction with autologous fat transfer
Authors: Wederfoort Jamilla L.M. , Schop Sander , van der Broeck Lotte C. A. , Hommes Juliette E. , van Kuijk Sander M.J. , Timmermans Floyd , Smit Jan Maerten , Heuts Esther M. , de Wit Thijs , van der Hulst René R.W.J. , Piatkowski Andrzej A.
Published: April 2023

Background:

With developments in screening and treatment, survival rates of breast cancer patients are increasing and so is the number of women opting for breast reconstruction to improve their quality of life (QoL). One factor that could play an important role in improving the QoL, is breast sensibility. Therefore, the aim of this study was to explore breast sensibility in participants of the BREAST-trial: an ongoing randomized controlled trial comparing breast reconstruction with autologous fat transfer (AFT) versus implant-based reconstruction (IBR).

Methods:

This study was conducted on participants of the BREAST-trial who were at least 12 months after final surgery. The Semmes Weinstein monofilaments were used to measure skin sensibility in breast cancer patients who received either a breast reconstruction with AFT or IBR following their mastectomy.

Results:

A total of 46 patients were included in this study, resulting in 62 breast reconstructions (28 AFT breasts and 34 IBR). Significantly higher mean monofilament values were found for skin sensibility after AFT (-0.7; p<0.001), clinically correlating to ‘diminished protective function’, as opposed to the IBR group with clinical values indicating ‘loss of protective function’.

Conclusion:

In this study we found breast cancer patients who underwent a mastectomy had a significantly better sensibility of the breast following AFT for total breast reconstruction as compared to IBR. Larger scaled studies including null measurements are required to further explore these noteworthy results of AFT.
Thematic and Demographic Analysis of Crowdsourcing Practices for Plastic Surgery
Authors: Mark Erica J. , Nguyen Joseph D. , Choudhary Fatima S. , Primas Madisyn A. , Mark Ethan J. , DeGeorge Brent R.
Published: April 2023

Background

In this study, we investigate the characterization of medical crowdsourcing on GoFundMe for plastic surgery procedures, with overall funds raised being the primary end point.

Hypothesis

Certain demographic factors such as sex and race mentioned in campaign narratives are associated with the effectiveness of medical crowdfunding campaigns.

Methods

Search terms were used to aggregate fundraising campaigns for plastic surgery medical procedures on GoFundMe. These studies were then stratified by demographics based on campaign text or author consensus, and were further subdivided into categories based on procedure type.

Results

Men were found to have higher median shares than women—raising an average of $609 more than female counterparts (P < 0.05). Fundraising for themes such as lack of insurance, travel costs, lifesaving treatment, and end-of-life expenses were more successful than the theme of psychosocial effects of disease or social impairment. In addition, those that included a smiling picture of the recipient and those created by a friend/relative raised more funds. Although no significant difference was found in fundraising between demographics based on race, a majority (72.8%) of campaigners were White. Across ~2000 plastic surgery campaigns, a total of $10,186,687 were raised from these data.

Conclusions

We identified both modifiable and nonmodifiable factors that influence success. These successful campaigns can serve as a learning opportunity for many who have been marginalized by the medical and pharmaceutical industry, and they demonstrate a promising area for demographic studies.
Baseline Ethical Principles and a Framework for Evaluation of Policies: Recommendations From an International Consensus Forum
Authors: Gardiner Dale , McGee Andrew , Simpson Christy , Ahn Curie , Goldberg Aviva , Kinsella Austin , Nagral Sanjay , Weiss Matthew J.
Published: April 2023

Background.

To maintain public trust and integrity in organ and tissue donation and transplantation (OTDT), policymakers, governments, clinical leaders, and decision-makers must ensure that policies proposed to increase donation and transplant activity satisfy baseline ethical principles established by international agreement, declaration, and resolution. This article describes the output of the Baseline Ethical Domain group of an international forum designed to guide stakeholders in considering these aspects of their system.

Methods.

This Forum was initiated by Transplant Québec and co-hosted by the Canadian Donation and Transplantation Program partnered with multiple national and international donation and transplantation organizations. The domain working group members included administrative, clinical, and academic experts in deceased and living donation ethics and 2 Patient, Family, and Donor partners. Identification of internationally accepted baseline ethical principles was done after literature reviews performed by working group members, and a framework for consideration of existing or novel policies was completed over a series of virtual meetings from March to September 2021. Consensus on the framework was achieved by applying the nominal group technique.

Recommendations.

We used the 30 baseline ethical principles described in World Health Organization Guiding Principles, Declaration of Istanbul, and Barcelona Principles to generate an ethical framework—presented graphically as a spiral series of considerations—designed to assist decision makers in incorporating these ethical principles into practice and policy. We did not seek to determine what is ethical but instead described a method of evaluation for policy decisions.

Conclusions.

The proposed framework could be applied to new or existing OTDT policy decisions to facilitate the transformation of widely accepted ethical principles into practical evaluations. The framework includes adaptation for local contexts and could be applied broadly internationally.
Morphine exposure during adolescence induces enduring social changes dependent on adolescent stage of exposure, sex, and social test
Authors: King’uyu David N. , Edgar Erin L. , Figueroa Christopher , Kirkland J.M. , Kopec Ashley M.
Published: April 2023

Drug exposure during adolescence, when the ‘reward’ circuitry of the brain is developing, can permanently impact reward-related behavior. Epidemiological studies show that opioid treatment during adolescence, such as pain management for a dental procedure or surgery, increases the incidence of psychiatric illness including substance use disorders. Moreover, the opioid epidemic currently in the United States is affecting younger individuals raising the impetus to understand the pathogenesis of the negative effects of opioids. One reward-related behavior that develops during adolescence is social behavior. We previously demonstrated that social development occurs in rats during sex-specific adolescent periods: early to mid-adolescence in males (postnatal day (P)30-40) and pre-early adolescence in females (P20-30). We thus hypothesized that morphine exposure during the female critical period would result in adult sociability deficits in females, but not males, and morphine administered during the male critical period would result in adult sociability deficits in males, but not females. We found that morphine exposure during the female critical period primarily resulted in deficits in sociability in females, while morphine exposure during the male critical period primarily resulted in deficits in sociability primarily in males. However, depending on the test performed and the social parameter measured, social alterations could be found in both sexes that received morphine exposure at either adolescent stage. These data indicate that when drug exposure occurs during adolescence, and how the endpoint data are measured, will play a large role in determining the effects of drug exposures on social development.
spotter: A single-nucleotide resolution stochastic simulation model of supercoiling-mediated transcription and translation in prokaryotes
Authors: Hacker William C. , Elcock Adrian H.
Published: April 2023

Stochastic simulation models have played an important role in efforts to understand the mechanistic basis of prokaryotic transcription and translation. Despite the fundamental linkage of these processes in bacterial cells, however, most simulation models have been limited to representations of either transcriptionortranslation. In addition, the available simulation models typically either attempt to recapitulate data from single-molecule experiments without considering cellular-scale high-throughput sequencing data or, conversely, seek to reproduce cellular-scale data without paying close attention to many of the mechanistic details. To address these limitations, we here presentspotter(Simulation of Prokaryotic Operon Transcription & Translation Elongation Reactions), a flexible, user-friendly simulation model that offers highly-detailed combined representations of prokaryotic transcription, translation, and DNA supercoiling. In incorporating nascent transcript and ribosomal profiling sequencing data,spotterprovides a critical bridge between data collected in single-molecule experiments and data collected at the cellular scale. Importantly, in addition to rapidly generating output that can be aggregated for comparison with next-generation sequencing and proteomics data,spotterproduces residue-level positional information that can be used to visualize individual simulation trajectories in detail. We anticipate thatspotterwill be a useful tool in exploring the interplay of processes that are crucially linked in prokaryotes.
WNT2B Deficiency Causes Increased Susceptibility to Colitis in Mice and Impairs Intestinal Epithelial Development in Humans
Authors: O’Connell Amy E. , Raveenthiraraj Sathuwarman , Adegboye Comfort , Qi Wanshu , Khetani Radhika S. , Singh Akaljot , Sundaram Nambirajam , Emeonye Chidera , Lin Jasmine , Goldsmith Jeffrey D. , Thiagarajah Jay R. , Carlone Diana L. , Turner Jerrold R. , Agrawal Pankaj B. , Helmrath Michael , Breault David T.
Published: April 2023

Background and aims

WNT2B is a canonical Wnt ligand previously thought to be fully redundant with other Wnts in the intestinal epithelium. However, humans with WNT2B deficiency have severe intestinal disease, highlighting a critical role for WNT2B. We sought to understand how WNT2B contributes to intestinal homeostasis.

Methods

We investigated the intestinal health ofWnt2bknock out (KO) mice. We assessed the impact of inflammatory challenge to the small intestine, using anti-CD3χ antibody, and to the colon, using dextran sodium sulfate (DSS). In addition, we generated human intestinal organoids (HIOs) from WNT2B-deficient human iPSCs for transcriptional and histological analyses.

Results

Mice with WNT2B deficiency had significantly decreasedLgr5expression in the small intestine and profoundly decreased expression in the colon, but normal baseline histology. The small intestinal response to anti-CD3χ antibody was similar inWnt2bKO and wild type (WT) mice. In contrast, the colonic response to DSS inWnt2bKO mice showed an accelerated rate of injury, featuring earlier immune cell infiltration and loss of differentiated epithelium compared to WT. WNT2B-deficient HIOs showed abnormal epithelial organization and an increased mesenchymal gene signature.

Conclusion

WNT2B contributes to maintenance of the intestinal stem cell pool in mice and humans. WNT2B deficient mice, which do not have a developmental phenotype, show increased susceptibility to colonic injury but not small intestinal injury, potentially due to a higher reliance on WNT2B in the colon compared to the small intestine.

WNT2B deficiency causes a developmental phenotype in human intestine with HIOs showing a decrease in their mesenchymal component and WNT2B-deficient patients showing epithelial disorganization.

Data Transparency Statement

All RNA-Seq data will be available through online repository as indicated in Transcript profiling. Any other data will be made available upon request by emailing the study authors.
A new causal centrality measure reveals the prominent role of subcortical structures in the causal architecture of the extended default mode network
Authors: Zarghami Tahereh S.
Published: April 2023

Network representation has been a groundbreaking concept for understanding the behavior of complex systems in social sciences, biology, neuroscience, and beyond. Network science is mathematically founded on graph theory, where nodal importance is gauged using measures ofcentrality. Notably, recent work suggests that the topological centrality of a node should not be over-interpreted as its dynamical or causal importance in the network. Hence, identifying the influential nodes in dynamic causal models (DCM) remains an open question. This paper introducescausal centralityfor DCM, a dynamics-sensitive and causally-founded centrality measure based on the notion ofinterventionin graphical models. Operationally, this measure simplifies to an identifiable expression using Bayesian model reduction. As a proof of concept, the average DCM of the extended default mode network (eDMN) was computed in 74 healthy subjects. Next, causal centralities of different regions were computed for this causal graph, and compared against major graph-theoretical centralities. The results showed that thesubcorticalstructures of the eDMN are more causally central than thecorticalregions, even though the (dynamics-free) graph-theoretical centralities unanimously favor the latter. Importantly, model comparison revealed that only the pattern of causal centrality wascausally relevant. These results are consistent with the crucial role of the subcortical structures in the neuromodulatory systems of the brain, and highlight their contribution to the organization of large-scale networks. Potential applications of causal centrality - to study other neurotypical and pathological functional networks – are discussed, and some future lines of research are outlined.
Detecting AI-generated essays: the ChatGPT challenge
Authors: Cingillioglu Ilker
Published: April 2023

Purpose

With the advent of ChatGPT, a sophisticated generative artificial intelligence (AI) tool, maintaining academic integrity in all educational settings has recently become a challenge for educators. This paper discusses a method and necessary strategies to confront this challenge.

Design/methodology/approach

In this study, a language model was defined to achieve high accuracy in distinguishing ChatGPT-generated essays from human written essays with a particular focus on “not falsely” classifying genuinely human-written essays as AI-generated (Negative).

Findings

Via support vector machine (SVM) algorithm 100% accuracy was recorded for identifying human generated essays. The author discussed the key use of Recall and F2 score for measuring classification performance and the importance of eliminating False Negatives and making sure that no actual human generated essays are incorrectly classified as AI generated. The results of the proposed model's classification algorithms were compared to those of AI-generated text detection software developed by OpenAI, GPTZero and Copyleaks.

Practical implications

AI-generated essays submitted by students can be detected by teachers and educational designers using the proposed language model and machine learning (ML) classifier at a high accuracy. Human (student)-generated essays can and must be correctly identified with 100% accuracy even if the overall classification accuracy performance is slightly reduced.

Originality/value

This is the first and only study that used an n-gram bag-of-words (BOWs) discrepancy language model as input for a classifier to make such prediction and compared the classification results of other AI-generated text detection software in an empirical way.
The role of governmental stakeholder engagement in the sustainability of industrial engineering projects
Authors: Pauna Tommi , Lehtinen Jere , Kujala Jaakko , Aaltonen Kirsi
Published: April 2023

Purpose

The aim of this research was to understand how governmental stakeholder engagement facilitates the sustainability of industrial engineering (IE) projects. A model for governmental stakeholder engagement activities is presented.

Design/methodology/approach

The authors relied on a single-case study of a mining project in Northern Europe, where a novel collaboration and engagement approach with governmental stakeholders was piloted in the project's front-end phase. The analysis focused on the collaborative practices through which the IE project investor engaged governmental stakeholders during the project's front-end phase and how the engagement contributed to solving challenges in the early planning and permitting process and achieving project plans that balanced economic, social and environmental aspects.

Findings

The findings show how four collaborative engagement practices reduced uncertainty and equivocality related to the legal sustainability requirements, enabled the development of sustainable design solutions and overall accelerated the permitting process without compromising the quality of final project plans.

Practical implications

The findings can be used to plan governmental stakeholder engagement and understand related challenges that need to be overcome. The study highlights the need to develop established practices and guidelines for governmental stakeholder engagement.

Originality/value

This study complements prior research on stakeholder engagement and project sustainability by developing an understanding of how governmental stakeholder engagement can be a key mechanism enabling the sustainability of IE project's end product. This research contributes to stakeholder theory by elaborating on a new stakeholder role, intermediary stakeholder.
Effects of consumer animosity on boycotts: the role of cognitive-affective evaluations and xenocentrism
Authors: Xie Jiali , Choo Ho Jung , Lee Ha Kyung
Published: April 2023

Purpose

This study aimed to investigate the influence of brand-targeted animosity on consumers' boycott intentions for target fashion products via their cognitive and affective evaluations, in the context of the “Xinjiang cotton ban” incident. The moderating role of xenocentrism was also examined.

Design/methodology/approach

Data were collected through an online survey in China using convenience sampling, and 411 valid responses were obtained. The collected data were analyzed using SPSS 26.0 for the descriptive statistics, frequency analysis and reliability analysis. AMOS 24.0 was employed for the confirmatory factor and structural equation modeling analyses. Bootstrapping analysis using PROCESS Macro was employed to analyze the moderating effects.

Findings

This study found that consumers' brand animosity directly and positively affected boycott intentions and that this influence was sequentially mediated through cognitive-affective evaluations. However, cognitive product judgment did not directly affect boycott intentions. The results showed that xenocentrism had a moderating effect on the relationship between animosity and cognitive judgment. The higher the xenocentrism of consumers, the weaker the negative effect of animosity was on cognitive judgment.

Originality

This study bridges the gap in the literature on animosity and xenocentrism in a fashion-related context through examining the consequences of brand animosity.
Limited knowledge and informal lobbying: internet regulation through content filters in Swedish public libraries
Authors: Johansson Veronica , Lindh Maria
Published: April 2023

Purpose

The purpose of this paper is to describe and explore the current state of internet regulation through content filters in Swedish public libraries.

Design/methodology/approach

Data was collected through an electronic survey directed to library managers of Sweden’s 290 main municipal libraries. 164 answers were returned, yielding a 57% response rate. The analysis comprises descriptive statistics for quantitative data and an activity theory approach with focus on contradictions for qualitative counterparts.

Findings

In total, 33% of the responding libraries report having content filters; 50% have not; and a surprising 18% do not know. There is a strong correlation between internet misuse and positive attitudes towards filters, and, reversely, between lack of misuse and lack of active stances concerning filters. Rather than seeing this as weakness, the authors suggest that there is strength in a context-bound flexibility open to practical experience and weighting of values, ethics, legislation and local circumstances. More troublesome indications concern the high deferral of decision-making to local authorities (municipalities) whereby libraries are left with limited insight and influence.

Research limitations/implications

The situation calls for professional organisations to address political mandate questions, and educational programs to strengthen future information professionals’ knowledge of IT in general; filter issues in specific; and local authority decision-making. The study highlights the need of adequate information professional competences and mandates to decide on and oversee internet regulation.

Originality/value

To the best of the authors’ knowledge, this is the first internationally published study on content filters in Swedish public libraries.
Covariation among reproductive traits in flowering plants shapes their interactions with pollinators
Authors: B. Lanuza Jose , Rader Romina , Stavert Jamie , Kendall Liam K. , Saunders Manu E. , Bartomeus Ignasi
Published: April 2023

Globally, plants display enormous variation in life‐history strategies and trait combinations. However, evidence suggests that evolutionary and physiological constraints limit the number of plant ecological strategies. Although there have been recent advances in understanding correlations among plant traits, reproductive traits are rarely considered, despite their key role in shaping plant life‐history strategies and interactions with pollinators.

Here, using a global dataset of 18 reproductive traits for 1506 species, we investigate the reproductive spectrum of flowering plants to identify how it shapes interactions with pollinators.

We show that over 50% of all trait variation is explained by the first two reproductive axes, which represent the negative correlation between flower number and flower size, and the negative correlation between autonomous selfing and floral display size. In addition, these reproductive axes were associated with the identity and number of visits of the distinct pollinator guilds. However, reproductive axes explain a relatively small amount of variance in pollinator interactions highlighting the need to incorporate other factors along with reproductive traits to fully explain large‐scale patterns of plant–pollinator interactions.

Our study identifies the major reproductive trait correlations in flowering plants and their role in shaping plant–pollinator interactions at a macro‐ecological scale. These findings emphasise the importance of considering reproductive traits in the global spectrum of plant form and function, and the need to explore beyond floral morphological traits to broaden our understanding of plant–pollinator interactions.

Read the free Plain Language Summary for this article on the Journal blog.
Auditors’ Use of In‐House Specialists
Authors: ZIMMERMAN ALEKSANDRA “ALLY” B. , BARR‐PULLIAM DERECK , LEE JOON‐SUK , MINUTTI‐MEZA MIGUEL
Published: April 2023

Using Public Company Accounting Oversight Board (PCAOB) inspection data from 2006 to 2018, we examine the use of auditor‐employed specialists in audit engagements. First, we find that the use of specialists is increasingly prevalent and related to clients’ size and complex accounting estimates. Second, the use of specialists is positively associated with the incidence of audit process deficiencies (identified by PCAOB inspections) but is not associated with output‐based audit‐quality proxies (restatements or absolute discretionary accruals). Hence, although process deficiencies are more likely to occur in engagements with higher use of specialists, financial reporting quality is not negatively impacted. Third, the use of specialists is positively associated with the likelihood of goodwill impairments and negatively associated with engagement profitability. Finally, cross‐sectional tests suggest that board accounting expertise is a salient condition for more effective use of specialists. Collectively, our findings align with concerns noted by the PCAOB and prior experimental and survey studies. Although specialists assist auditors with the audit of complex estimates, engagements with comparatively high specialist use entail an incremental risk of audit process deficiencies.
Improving ecological data science with workflow management software
Authors: Brousil Matthew R. , Filazzola Alessandro , Meyer Michael F. , Sharma Sapna , Hampton Stephanie E.
Published: April 2023

Pressing environmental research questions demand the integration of increasingly diverse and large‐scale ecological datasets as well as complex analytical methods, which require specialized tools and resources.

Computational training for ecological and evolutionary sciences has become more abundant and accessible over the past decade, but tool development has outpaced the availability of specialized training. Most training for scripted analyses focuses on individual analysis steps in one script rather than creating a scripted pipeline, where modular functions comprise an ecosystem of interdependent steps. Although current computational training creates an excellent starting place, linear styles of scripting can risk becoming labor‐ and time‐intensive and less reproducible by often requiring manual execution. Pipelines, however, can be easily automated or tracked by software to increase efficiency and reduce potential errors. Ecology and evolution would benefit from techniques that reduce these risks by managing analytical pipelines in a modular, readily parallelizable format with clear documentation of dependencies.

Workflow management software (WMS) can aid in the reproducibility, intelligibility and computational efficiency of complex pipelines. To date, WMS adoption in ecology and evolutionary research has been slow. We discuss the benefits and challenges of implementing WMS and illustrate its use through a case study with thetargets rpackage to further highlight WMS benefits through workflow automation, dependency tracking and improved clarity for reviewers.

Although WMS requires familiarity with function‐oriented programming and careful planning for more advanced applications and pipeline sharing, investment in training will enable access to the benefits of WMS and impart transferable computing skills that can facilitate ecological and evolutionary data science at large scales.
The relationship between responsible financial behaviours and financial wellbeing: The case of buy‐now‐pay‐later
Authors: Powell Robert , Do Anh , Gengatharen Denise , Yong Jaime , Gengatharen Rasiah
Published: April 2023

Buy‐now‐pay‐later (BNPL) in Australia is a rapidly growing payment innovation. Regulators and consumer groups have expressed concerns at the financial risks posed by BNPL. As BNPL is not regulated under consumer credit law, financial regulator and consumer groups have recommended that BNPL users adopt a range of responsible financial behaviours for their financial wellbeing. This study, using a survey of BNPL users and structural equation modelling, shows a link between most of these recommended financially responsible behaviours and financial wellbeing and that the financial behaviours of younger users (aged under 25) place them at greater risk of reduced financial wellbeing.
Who are the future farmers? Media representations of youth in agriculture, food security and ‘modern’ farming in Indonesia
Authors: Toumbourou Tessa D. , Dressler Wolfram H. , Sanders Anna , Liu Ekawati , Brown Trent , Utomo Ariane
Published: April 2023

In Indonesia, state and non‐state actors frame youth attrition from agriculture as a food security concern and propose policy solutions focused on ‘modern’ farming techniques. Using a critical framing analysis of five national Indonesian news media sources from 2010 to 2020, we examine how government, development and private sector actors portray youth in agriculture, and the underlying assumptions that inform related policy and development agendas. Our analysis reveals contrasting portrayals of youth in agriculture. Youth are often depicted as averse to farming, while also being innovative adopters of modern farming techniques, equipment, and digital technologies. We argue that media frames reflect and reinforce the dominant discourses of state and non‐state actors, which have a productivist orientation, proposing technical, capital‐intensive agricultural solutions to food insecurity and related issues. News media pays comparatively less attention to structural barriers to youth entry and success in agriculture, such as limited access to land and finance and unfavourable terms of trade.
The role of phylogenetic relatedness on success of non‐native plants crossing the naturalization–invasion transition in North America
Authors: Qian Hong , Sandel Brody
Published: April 2023

Understanding the causes and consequences of biological invasions is a great challenge in ecology and conservation biology. The ability to predict which naturalized species are likely to become invasive would be a great step forward in managing and preventing invasions. The goal of this study is to test whether invasive species are a phylogenetically clustered subset of naturalized species at continental and regional scales, and to compare phylogenetic relatedness of invasive angiosperms with respect to species pools of non‐native naturalized angiosperms in North America. We divided North America into 65 state‐ or province‐level regions, and collated naturalized and invasive species lists of angiosperms for each region. Two phylogenetic metrics (net relatedness index (NRI) and nearest taxon index (NTI)), which represent different evolutionary depths, were used to quantify phylogenetic relatedness of naturalized and invasive angiosperms in North America, with respect to different species pools. We related phylogenetic relatedness of invasive angiosperms to climatic variables. We found that most invasive angiosperm assemblages are a phylogenetically clustered subset of their respective naturalized species pools, and the phylogenetic clustering of invasive species is greater in regions with lower temperature and precipitation. The pattern of phylogenetic clustering of invasive species likely reflects phylogenetic conservatism of traits associated with invasiveness. It may also reflect a tendency towards greater invasiveness for species with novel trait combinations compared to the non‐invasive naturalized species assemblages.
Perampanel for the treatment of people with idiopathic generalized epilepsy in clinical practice
Authors: Trinka Eugen , Alsaadi Taoufik , Goji Hiroko , Maehara Taketoshi , Takahashi Satoru , Jacobs Julia , Renna Rosaria , Gil‐López Francisco José , McMurray Rob , Sáinz‐Fuertes Ricardo , Villanueva Vicente
Published: April 2023

Objective

This study was undertaken to evaluate perampanel (PER) when used under real‐world conditions to treat people with idiopathic generalized epilepsy (IGE) included in the PERaMpanel pooled analysIs of effecTiveness and tolerability (PERMIT) study.

Methods

The multinational, retrospective, pooled analysis PERMIT explored the use of PER in people with focal and generalized epilepsy treated in clinical practice across 17 countries. This subgroup analysis included PERMIT participants with IGE. Time points for retention and effectiveness measurements were 3, 6, and 12 months (last observation carried forward, defined as "last visit," was also applied to effectiveness). Effectiveness was evaluated by seizure type (total seizures, generalized tonic–clonic seizures [GTCS], myoclonic seizures, absence seizures) and included ≥50% responder rate and seizure freedom rate (defined as no seizures since at least the previous visit). Safety/tolerability was monitored throughout PER treatment and evaluated by documenting the incidence of adverse events (AEs), including psychiatric AEs and those leading to treatment discontinuation.

Results

The Full Analysis Set included 544 people with IGE (51.9% women, mean age = 33.3 years, mean epilepsy duration = 18.1 years). At 3, 6, and 12 months, 92.4%, 85.5%, and 77.3% of participants were retained on PER treatment, respectively (Retention Population, n = 497). At the last visit, responder and seizure freedom rates were, respectively, 74.2% and 54.6% (total seizures), 81.2% and 61.5% (GTCS), 85.7% and 66.0% (myoclonic seizures), and 90.5% and 81.0% (absence seizures) (Effectiveness Population, n = 467). AEs occurred in 42.9% of patients and included irritability (9.6%), dizziness/vertigo (9.2%), and somnolence (6.3%) (Tolerability Population, n = 520). Treatment discontinuation due to AEs was 12.4% over 12 months.

Significance

This subgroup analysis of the PERMIT study demonstrated the effectiveness and good tolerability of PER in people with IGE when administered under everyday clinical practice conditions. These findings are in line with clinical trial evidence, supporting PER's use as broad‐spectrum antiseizure medication for the treatment of IGE.
The microbial community dynamics of cocaine sensitization in two behaviorally divergent strains of collaborative cross mice
Authors: Tran Thi Dong Binh , Monroy Hernandez Christian , Nguyen Hoan , Wright Susan ,   Center for Systems Neurogenetics of Addiction, Tarantino Lisa M. , Chesler Elissa J. , Weinstock George M. , Zhou Yanjiao , Bubier Jason A.
Published: April 2023

The gut‐brain axis is increasingly recognized as an important pathway involved in cocaine use disorder. Microbial products of the murine gut have been shown to affect striatal gene expression, and depletion of the microbiome by antibiotic treatment alters cocaine‐induced behavioral sensitization in C57BL/6J male mice. Some reports suggest that cocaine‐induced behavioral sensitization is correlated with drug self‐administration behavior in mice. Here, we profile the composition of the naïve microbiome and its response to cocaine sensitization in two collaborative cross (CC) strains. These strains display extremely divergent behavioral responses to cocaine sensitization. A high‐responding strain, CC004/TauUncJ (CC04), has a gut microbiome that contains a greater amount of Lactobacillus than the cocaine‐nonresponsive strain CC041/TauUncJ (CC41). The gut microbiome of CC41 is characterized by an abundance of Eisenbergella, Robinsonella and Ruminococcus. In response to cocaine, CC04 has an increased Barnsiella population, while the gut microbiome of CC41 displays no significant changes. PICRUSt functional analysis of the functional potential of the gut microbiome in CC04 shows a significant number of potential gut‐brain modules altered after exposure to cocaine, specifically those encoding for tryptophan synthesis, glutamine metabolism, and menaquinone synthesis (vitamin K2). Depletion of the microbiome by antibiotic treatment revealed an altered cocaine‐sensitization response following antibiotics in female CC04 mice. Depleting the microbiome by antibiotic treatment in males revealed increased infusions for CC04 during a cocaine intravenous self‐administration dose–response curve. Together these data suggest that genetic differences in cocaine‐related behaviors may involve the microbiome.
Exogenous carbon turnover within the soil food web strengthens soil carbon sequestration through microbial necromass accumulation
Authors: Kou Xinchang , Morriën Elly , Tian Yijia , Zhang Xiaoke , Lu Caiyan , Xie Hongtu , Liang Wenju , Li Qi , Liang Chao
Published: April 2023

Exogenous carbon turnover within soil food web is important in determining the trade‐offs between soil organic carbon (SOC) storage and carbon emission. However, it remains largely unknown how soil food web influences carbon sequestration through mediating the dual roles of microbes as decomposers and contributors, hindering our ability to develop policies for soil carbon management. Here, we conducted a 13C‐labeled straw experiment to demonstrate how soil food web regulated the residing microbes to influence the soil carbon transformation and stabilization process after 11 years of no‐tillage. Our work demonstrated that soil fauna, as a “temporary storage container,” indirectly influenced the SOC transformation processes and mediated the SOC sequestration through feeding on soil microbes. Soil biota communities acted as both drivers of and contributors to SOC cycling, with 32.0% of exogenous carbon being stabilizing in the form of microbial necromass as “new” carbon. Additionally, the proportion of mineral‐associated organic carbon and particulate organic carbon showed that the “renewal effect” driven by the soil food web promoted the SOC to be more stable. Our study clearly illustrated that soil food web regulated the turnover of exogenous carbon inputs by and mediated soil carbon sequestration through microbial necromass accumulation.
Process development and analyses for the co‐production of 2‐methyltetrahydrofuran and 1,4‐pentanediol from lignocellulosic biomass
Authors: Gong Chaehee , Lee Shinje , Won Wangyun
Published: April 2023

The development of technologies for utilizing biomass has attracted attention because biomass can be produced sustainably worldwide. Biomass‐derived 2‐methyltetrahydrofuran (MTHF), which is a promising alternative to gasoline, has great market potential and a growing demand. However, in conventional biomass conversion processes, the minimum selling price (MSP) of biochemicals is not economically acceptable. Co‐production of biochemicals can increase the economics of biomass utilization. Herein, we developed a process for co‐producing MTHF and 1,4‐pentanediol (1,4‐PDO) from lignocellulosic biomass. After biomass fractionation, cellulose and hemicellulose were converted to levulinic acid (LA), and lignin was used for heat and electricity generation. LA was then converted to γ‐valerolactone (GVL). As a platform material for co‐production, GVL was converted into MTHF and 1,4‐PDO in each subsystem. The split ratio of GVL was controlled to efficiently produce MTHF and 1,4‐PDO according to market conditions. Additionally, we performed a techno‐economic and life‐cycle assessment (TEA and LCA, respectively) for the developed process. The MSP of MTHF was calculated based on the TEA results, and the environmental impacts were quantitatively calculated based on the LCA results. We performed heat integration using pinch analysis and then reduced the energy requirement of the proposed process. The key cost drivers and environmental factors of the proposed process were identified via sensitivity analyses. Consequently, during the processing of 2000 ton/day of corn stover (raw material of lignocellulose), the MSP of MTHF was calculated as $2.64/GGE (gasoline equivalent), and representative environmental impacts such as climate change and fossil depletion were calculated as −0.296 kg CO2 eq and − 0.056 kg oil eq, respectively. As a result, we can increase the economics of commercial production of MTHF and 1,4‐PDO with environmental sustainability. The proposed process can serve as a potential solution to the growing demand for the need for more sustainable biomass utilization.
Breast within a breast: a review of breast hamartomas
Authors: Paraskevopoulos J A , Hosking S W , Stephenson T
Published: April 2023

A 22‐year‐old woman who presented with a large lump in the left breast, subsequently found to be a breast hamartoma, is described. A full review is given of this rare and unusual benign breast lesion, which is likely to be recognised increasingly with the advent of mammographic screening.
AN OPEN STUDY TO ASSESS THE LONG‐TERM SAFETY OF FLUTICASONE PROPIONATE IN ASTHMATIC CHILDREN
Authors: MacKenzie CA , Tsanakas J , Tabachnik E , Radford M , Berdel D , Götz MH , Parker C ,   international study group
Published: April 2023

SUMMARY This study was conducted to assess the long‐term safety of fluticasone propionate 50 μg twice daily (100 μg/day) or 100 μg twice daily (200 μg/day) administered via a dry powder inhaler in children aged 4–17 years with moderately severe asthma. A total of 257 patients received open treatment for 12 months. Of these, 110 had not received treatment with fluticasone propionate in any prior study. The remaining 147 patients had completed one of two previous short‐term inhaled fluticasone propionate studies. In all, 132 patients (51%) reported 273 adverse events, the pattern of which was as expected in an atopic population with asthma; only 26 (10%) of these reports were considered either certainly, probably or possibly related to study treatment. The events most commonly reported either as a single or multiple diagnosis were: asthma and related events (25%), upper respiratory tract infection (13%), and rhinitis (6%). For most patients who reported a worsening of asthma, additional therapy was all that was required to control symptoms, and they continued in the study. There was a low incidence (2%) of pharmacologically predictable adverse events. Eight patients (3%) withdrew from the study because of an adverse event, five of which events (one each of hypertension, hoarseness and asthma and two of oral candidiasis) were recorded as being possibly or probably drug‐related. Sixteen adverse events reported by 15 patients (6%) were classified as serious but none was considered to be related to the study drug. Of these reports 10 (9 patients; 4%) were exacerbations of asthma requiring hospital admission; the other six adverse events were unrelated to asthma. Fluticasone propionate was thus well tolerated during long‐term treatment in children, and asthma control was maintained over the 12 months.
DISEASE‐MODIFYING ANTIRHEUMATIC DRUGS IN RHEUMATOID ARTHRITIS: CURRENT CONCEPTS
Authors: Emery P , Luqmani R , Gordon C
Published: April 2023

SUMMARY Disease‐modifying antirheumatic drugs are used in virtually all patients with established rheumatoid arthritis. An increasingly large number of new drugs is now available. Furthermore, old therapies are being used in novel ways. Treatment is now begun earlier and patients are rarely left untreated. This report summarises recent developments regarding the drugs currently in use and those that may be available in the near future.
MEASUREMENTS OF INTERFACE PRESSURE BETWEEN BODY SITES AND THE SURFACES OF FOUR SPECIALISED AIR MATTRESSES
Authors: Allen V , Ryan DW , Murray A
Published: April 2023

SUMMARY Four specialised air mattresses had interface pressure measured under six body sites prone to pressure sores in 10 subjects, supine and sitting. The mattresses were the Clinirest (SSI) and FirstStep (KCI) continuous airflow mattress overlays, and Airwave (Pegasus) and Nimbus (Huntleigh) alternating pressure air mattresses. On the mattress overlays, average supine interface pressures were 2.33 kPa (scapula), 4.15 kPa (elbow), 1.94 kPa (sacrum) and 2.79 kPa (buttock), although they were higher at the occiput (7.97 kPa) and heel (11.7 kPa). The alternating pressure air mattresses had an average minimum interface pressure close to zero for three sites, rising to 4.28 kPa under the heel. Average maximum interface pressures were 8.61 kPa (occiput), 5.21 kPa (scapula), 4.90 (elbow), 4.85 kPa (sacrum), 4.61 kPa (buttock) and 13.2 kPa (heel). No accepted scientific method exists for comparing the two types of mattress. Our data suggest a clinical benefit at the occiput and heel (supine) in using an alternating pressure air mattress and a benefit in using a continuous airflow mattress overlay at other sites.
SOLITARY BENIGN PAPILLOMA (PAPILLARY ADENOMA) OF THE CYSTIC DUCT: A RARE CAUSE OF BILIARY COLIC
Authors: Loh A , Kamar S , Dickson GH
Published: April 2023

SUMMARY Benign tumours of the extrahepatic bile ducts are rare, mostly occurring in the common bile duct and hepatic ducts. Solitary papillomas occur mainly in the gallbladder or at the ampulla of Vater.1 Tumours of the cystic duct are extremely rare, and we are unaware of any reports of solitary papilloma of the cystic duct. Such a case in a 72‐year‐old woman is presented.
Cerebral Tuberculoma
Authors: White AET , Davies KG , Anwar S , Neal JW , Vafidis JA
Published: April 2023

SUMMARY Intracranial tuberculoma has become a rarity. It remains a curable lesion that responds well to medical therapy. Although diagnosis in developed countries is often made only postoperatively, early and effective treatment can be instituted if a high index of suspicion is maintained and diagnostic criteria are looked for. A case is presented which illustrates the difficulties in reaching a diagnosis, and a review of the literature is given.
TUBERCULOSIS: CURRENT ISSUES IN DIAGNOSIS AND TREATMENT
Authors: Polkey MI , Rees PJ
Published: April 2023

SUMMARY The incidence of tuberculosis began to decline in 1801, which was probably due to improving socioeconomic conditions (certainly not the efforts of the medical profession). Patients cannot be treated unless they are detected, which underlines the importance of notification and case finding. Full multiagent chemotherapy is necessary to give the best chance of permanent cure and to prevent the emergence of resistance; compliance with treatment is increased by making it readily accessible and increasing the degree of supervision. With the resurgence of interest in tuberculosis since the rising incidence of the late 1980s a review of the state of diagnosis and treatment is due. This one covers some areas of current interest: the role of vaccination, chemoprophylaxis, tuberculosis and HIV, new methods of diagnosis, drug resistance and alternative approaches to treatment.
EOSINOPHIL CATIONIC PROTEIN AND PROPHYLACTIC TREATMENT IN POLLINOSE IN NATURAL ALLERGEN PROVOCATION
Authors: Kato M , Hattori T , Takahashi M , Yanagita N , Nakashima I
Published: April 2023

SUMMARY In this study, prophylactic treatment with ketotifen and examination of subjective symptoms, blood eosinophil count and serum eosinophil cationic protein (ECP) values were carried out from the pre‐ to postpollinosis season to evaluate the effects of ECP and characterise the effects of prophylactic treatment on the appearance of these mediators in relation to clinical symptoms. We found that: serum ECP values during the season and post‐season were significantly higher than those during the pre‐season; there was a significant correlation between serum ECP value and blood eosinophil count during the season; and the levels for all three of the above parameters in the prophylactic treatment group were significantly lower than those in the no‐treatment group during the season.
A SURVEY OF NEUROLOGICAL DISABILITY AT A DISTRICT GENERAL HOSPITAL
Authors: Playford ED , Crawford P , Monro PS
Published: April 2023

SUMMARY Neurological disease accounts for 20% of all admissions to medical wards, but the number of inpatients with neurological disability is unknown. The notes of all adult inpatients in a district general hospital were reviewed to identify all those with a neurological disorder. Over 40% of inpatients on medical wards and 4% on surgical wards had a neurological disorder. Stroke was the most common neurological diagnosis, accounting for 36% of neurological disorders and 22% of all patients on medical wards. Other neurological diagnoses included dementias 10%, degenerative disorders 10%, epilepsy 7%, demyelination 4%, and head injuries 3%. Neurological patients have long inpatient stays (mean 80 days), and often remain in hospital awaiting changes in accommodation. Seven patients under 65 years stayed more than 6 months awaiting long‐term care. Neurological disorders contribute significantly to the inpatient workload. Identifying those requiring rehabilitation and concentrating them on one ward could improve the quality and efficiency of their care.