bluuebunny/crossref_metadata_2025 huggingface dataset:
Antinutrients and metabolomic compounds of Bambara groundnut (Vigna subterranean) as affected by traditional processing by smallholder farmers
Authors: Pretorius Beulah , Otto Margot , Schönfeldt Hettie C.
Published: July 2023

Bambara groundnut (BG) (Vigna subterranean) is an underutilized, indigenous crop in South Africa that has nutritional and associated health benefits. Decreasing the antinutrients in food sources can potentially increase the digestibility of proteins and mineral absorption. To determine the effect of traditional processing (cooking) on the antinutrient content and metabolome of this crop, BG was sampled from 12 rural farms in three districts of the Mpumalanga province, South Africa. The four main colors that were identified (cream, orange, brown, and purple) were pooled together according to the district they were obtained from. One‐half of each color sample obtained from each of the three districts was dehulled, color sorted, milled, and subjected to subsequent antinutrient and metabolome analyses, while the other half was cooked, air‐dried, and milled prior to analyses. Samples were analyzed for phytate and tannins (antinutrients) by hydrochloric acid extraction methods as well as metabolome constituents by ultraperformance liquid chromatography coupled with quadrupole time‐of‐flight mass spectrometry (UPLC–QTOF‐MS). Phytate, tannins, as well as other metabolomic constituents, namely, catechin, epicatechin, procyanidin, as well as citric acid, were identified in all raw and cooked BG samples. The cooking process resulted in a significant decrease (p < 0.05) in the phytate and tannin content as well as an increase in the health‐associated phenolic compounds.
Congenital heart defects in CTNNB1 syndrome: Raising clinical awareness
Authors: Sinibaldi Lorenzo , Garone Giacomo , Mandarino Alessandra , Iarossi Giancarlo , Chioma Laura , Dentici Maria Lisa , Merla Giuseppe , Agolini Emanuele , Micalizzi Alessia , Mancini Cecilia , Niceta Marcello , Macchiaiolo Marina , Diodato Daria , Onesimo Roberta , Blandino Rita , Delogu Angelica Bibiana , De Rosa Gabriella , Trevisan Valentina , Iademarco Mariella , Zampino Giuseppe , Tartaglia Marco , Novelli Antonio , Bartuli Andrea , Digilio Maria Cristina , Calcagni Giulio
Published: July 2023

CTNNB1 [OMIM *116806] encodes β‐catenin, an integral part of the cadherin/catenin complex, which functions as effector of Wnt signaling. CTNNB1 is highly expressed in brain as well as in other tissues, including heart. Heterozygous CTNNB1 pathogenic variations are associated with a neurodevelopmental disorder characterized by spastic diplegia and visual defects (NEDSDV) [OMIM #615075], featuring psychomotor delay, intellectual disability, behavioral disturbances, movement disorders, visual defects and subtle facial and somatic features. We report on a new series of 19 NEDSDV patients (mean age 10.3 years), nine of whom bearing novel CTNNB1 variants. Notably, five patients showed congenital heart anomalies including absent pulmonary valve with intact ventricular septum, atrioventricular canal with hypoplastic aortic arch, tetralogy of Fallot, and mitral valve prolapse. We focused on the cardiac phenotype characterizing such cases and reviewed the congenital heart defects in previously reported NEDSDV patients. While congenital heart defects had occasionally been reported so far, the present findings configure a higher rate of cardiac anomalies, suggesting dedicated heart examination to NEDSDV clinical management.
Alveolar ridge preservation in sockets with severe periodontal destruction using autogenous partially demineralized dentin matrix: A randomized controlled clinical trial
Authors: Yang Fan , Ruan Yan , Bai Xiaolei , Li Qi , Tang Xiaodong , Chen Jianping , Chen Yunfang , Wang Linhong
Published: July 2023

Background

The preservation and reconstruction of alveolar ridge volume in extraction sockets of molars affected by severe periodontitis is a critical challenge that requires clinical attention.

Purpose

This randomized controlled clinical trial was designed to evaluate the efficiency of autogenous partially demineralized dentin matrix (APDDM) for alveolar ridge preservation (ARP) in severely periodontally compromised sockets compared to spontaneous healing (SH) on radiographic and histomorphometric outcomes.

Materials and Methods

Thirty‐two patients with 32 periodontally compromised molars were randomized into either the test group, which received ARP using APDDM covered with a collagen sponge, or the control group, which underwent SH. Linear and volumetric changes were assessed using superimposed cone‐beam computed tomography (CBCT) acquired pre‐extraction and after a 4‐month healing time. Histomorphometric evaluation was performed on trephine cores harvested during implant placement.

Results

All sites healed uneventfully. The ridge width at 1 mm apical to the bone crest increased by 5.03, 4.50, and 5.20 mm in the mesial, middle, distal area in the APDDM group, while decreasing by −1.98, −2.19, and −1.98 mm in the SH group, respectively (p < 0.05). The height increase of the central bone was significantly higher in the APDDM group than in the SH group (p < 0.05). The height decrease of the buccal (mesial, middle, distal) bone plate was lower in the APDDM group than in the SH group (p < 0.05). After a 4‐month healing time, bone volume increased by 37.07% in the APDDM group and by only 2.33% in the SH group (p < 0.05). Histomorphometric analysis revealed that APDDM particles were surrounded by newly formed bone, with partially absorbed residual APDDM materials observed. New bone, APDDM remnants, and connective tissue occupied 39.67 ± 8.28%, 23.66 ± 9.22%, and 36.67 ± 17.05% of the areas in the APDDM group, respectively.

Conclusions

ARP using APDDM was effective, resulting in a significant increase in both linear and volumetric changes in severely periodontally compromised extraction sockets compared to SH. These findings suggest that APDDM may serve as a promising new clinical option for the reconstruction of alveolar ridge dimensions.
A rare case of cutaneous myxoma with trichofolliculoma‐like features
Authors: Johnson Kirsten M. , Plaza Jose A. , Sopkovich Jennifer A.
Published: July 2023

Carney complex is a rare genetic disorder associated with a number of cutaneous lesions, especially cutaneous myxomas. We present a rare case of cutaneous myxoma (superficial angiomyxoma) with trichofolliculoma‐like features in a patient with Carney complex, and explore how the associated histopathology provides critical context for elucidating the etiology of this benign neoplasm.
Fat‐to‐muscle ratio is associated with insulin resistance and cardiometabolic disorders in adults with type 1 diabetes mellitus
Authors: Huang Fansu , Ji Xiaolin , Wang Zhen , Yin Yixuan , Fan Li , Li Juan , Zhou Zhiguang , Li Xia
Published: July 2023

Aims

This study aimed to investigate the correlation of the fat‐to‐muscle ratio (FMR) with insulin resistance (IR) and cardiometabolic disorders (CMD) in patients with type 1 diabetes mellitus (T1DM).

Materials and Methods

We retrospectively recruited 420 adults with T1DM [52.6% men, median age 32.4 (24.5, 43.0) years]. Body composition was assessed by bioelectrical impedance analysis and FMR was calculated. The characteristics of the overall participants were compared between tertiles of FMR. Logistic regression analyses were performed to assess the association of FMR tertiles with IR and cardiometabolic risk factors.

Results

Median age and median haemoglobin A1c of all participants were 32.4 (24.5, 43.0) years and 7.4 (6.5, 8.7)%, respectively. The prevalence of IR and CMD was 18% and 38.6%. The FMR significantly differed between men and women [0.39 (0.31, 0.53) vs. 0.74 (0.63, 0.92), respectively, p < .001]. The proportion of IR and CMD gradually increased as the FMR increased. The multivariable‐adjusted odd ratios for IR and CMD in FMR tertile 3 compared with tertile 1 were 4.8 [95% confidence interval (CI): (1.9, 12.1)] and 9.7 (95% CI: 4.2, 22.3), respectively, in men. For women, the corresponding odd ratios were 4.0 (95% CI: 1.2, 12.9) for IR and 5.8 (95% CI: 2.4, 13.6) for CMD.

Conclusions

FMR is associated with IR and CMD in adults with T1DM and could be used as a promising parameter for targeting treatment in T1DM.
Effect of glycemic control on fetal hearts of pregestational diabetic women by tissue doppler and M‐mode imaging
Authors: Menekse Beser Dilek , Oluklu Deniz , Uyan Hendem Derya , Yildirim Muradiye , Turgut Ezgi , Sahin Dilek
Published: July 2023

Objective

To determine whether changes in fetal heart function according to glycemic control in pregnant women with Type 1 and Type 2 diabetes using spectral tissue Doppler imaging (TDI) and M‐mode imaging.

Methods

This study included 68 pregestational diabetic women (DM) at 30–32 gestational weeks. All participants were divided into two groups: type 1(n = 17) and type 2(n = 51), and then these groups were divided into the subgroups as well‐controlled and poorly controlled, according to fasting glucose (FG) and 1‐h postprandial glucose (PPG) values. Cardiac parameters were compared for well‐ and poorly‐controlled groups with TDI and M‐mode imaging. The correlation of cardiac parameters with FG, PPG, and HbA1c values was evaluated. Their roles in predicting neonatal outcomes were also assessed.

Results

Thickness measurements, early diastolic annular peak velocity (E’), late diastolic annular peak velocity (A’), tissue isovolumetric relaxation time (IRT’), and tissue myocardial performance index (MPI’) were increased in both poorly controlled groups. Tissue ejection time (ET') was significantly reduced in the poorly controlled groups, while tissue isovolumetric contraction time (ICT') was not significantly changed in any group. Tricuspid, mitral, and septal annular plane excursions (TAPSE, MAPSE, and SAPSE, respectively) were significantly decreased in all poorly controlled subgroups. E', E'/A’, MPI’, IRT', ET', and M‐mode imaging parameters significantly correlated with FG notably.

Conclusion

Maternal hyperglycemia leads to subtle changes in systolic and diastolic functions both in the interventricular septum and ventricles, so it is essential to ensure glycemic control in both Type 1 and Type 2 DM.
Outcomes among youth attending inpatient treatment for co‐occurring disorders
Authors: Rosenkranz Susan E. , Courtney Darren , Chen Sheng , Ma Clement
Published: July 2023

Aim

An emerging body of research is identifying effective outpatient integrated treatment approaches for youth with co‐occurring psychiatric and substance use disorders, though few studies exist examining inpatient treatment. The current study aimed to address this gap by examining response to treatment during admission to, and in the year following discharge from, a specialized inpatient program for youth with co‐occurring disorders.

Methods

A single‐cohort longitudinal design examined change in adaptive functioning, mental health symptoms, and substance use frequency among N = 142 youth (69.1% female) aged 14–21 (M = 16.9, SD = 1.5) attending the program. Participants completed self‐report measures at admission, discharge, and 1‐, 6‐ and 12‐months post‐discharge.

Results

Analyses indicated significant improvements in adaptive functioning, internalizing and externalizing symptoms, and substance use frequency during admission. There was some loss of gains in adaptive functioning over the 12‐months post‐discharge. Improvements were maintained in internalizing symptoms and substance use frequency, and improvements in externalizing symptoms continued over the 12‐months post‐discharge. There was no significant interaction between change in functioning and internalizing symptoms at admission or type of substance use disorder diagnosis. There was a significant interaction with externalizing symptoms, such that those with clinically significant levels of externalizing symptoms at admission experienced greater improvement in functioning, though the groups ended treatment with comparable functioning scores.

Conclusions

The results provide preliminary support for integrated treatment for co‐occurring disorders delivered in an inpatient setting. However, the results also reflect the significant needs of youth with co‐occurring disorders and the importance of ongoing care post‐discharge from intensive treatment settings.
Microbial redox cycling enhances ecosystem thermodynamic efficiency and productivity
Authors: Seto Mayumi , Kondoh Michio
Published: July 2023

Microbial life in low‐energy ecosystems relies on individual energy conservation, optimizing energy use in response to interspecific competition and mutualistic interspecific syntrophy. Our study proposes a novel community‐level strategy for increasing energy use efficiency. By utilizing an oxidation–reduction (redox) reaction network model that represents microbial redox metabolic interactions, we investigated multiple species‐level competition and cooperation within the network. Our results suggest that microbial functional diversity allows for metabolic handoffs, which in turn leads to increased energy use efficiency. Furthermore, the mutualistic division of labour and the resulting complexity of redox pathways actively drive material cycling, further promoting energy exploitation. Our findings reveal the potential of self‐organized ecological interactions to develop efficient energy utilization strategies, with important implications for microbial ecosystem functioning and the co‐evolution of life and Earth.
What's going to be on the menu with global environmental changes?
Authors: Hallam Jane , Harris Nyeema C.
Published: July 2023

Ongoing anthropogenic change is altering the planet at an unprecedented rate, threatening biodiversity, and ecosystem functioning. Species are responding to abiotic pressures at both individual and population levels, with changes affecting trophic interactions through consumptive pathways. Collectively, these impacts alter the goods and services that natural ecosystems will provide to society, as well as the persistence of all species. Here, we describe the physiological and behavioral responses of species to global changes on individual and population levels that result in detectable changes in diet across terrestrial and marine ecosystems. We illustrate shifts in the dynamics of food webs with implications for animal communities. Additionally, we highlight the myriad of tools available for researchers to investigate the dynamics of consumption patterns and trophic interactions, arguing that diet data are a crucial component of ecological studies on global change. We suggest that a holistic approach integrating the complexities of diet choice and trophic interactions with environmental drivers may be more robust at resolving trends in biodiversity, predicting food web responses, and potentially identifying early warning signs of diversity loss. Ultimately, despite the growing body of long‐term ecological datasets, there remains a dearth of diet ecology studies across temporal scales, a shortcoming that must be resolved to elucidate vulnerabilities to changing biophysical conditions.
Synthetic Witherite for Standardisation of Clumped Isotope (Δ47) Measurements
Authors: Kong Kai , Guo Yangrui , Deng Wenfeng , Wei Gangjian
Published: July 2023

Carbonate clumped isotope, quantified by Δ47 value, has wide application potential in Earth science. A recently proposed carbonate standardisation scheme based on community‐available reference materials (i.e., ETH‐1–4) has proven to improve interlaboratory comparability in Δ47 measurement. However, the shortage of these reference materials may be problematic in future; therefore, developing traceable and supplementary in‐house reference materials may become necessary, especially when supplies run out. Here, we describe a method of producing synthetic witherite carbonates with variable bulk isotopic compositions and clumped isotope ordering states, for which Δ47 values were determined together with ETH carbonate reference materials. Results indicate that the witherite carbonates allow effective corrections for instrumental linearity and scale variations, improving long‐term reproducibility. Additionally, by normalising witherite Δ47 values to agreed ETH carbonate values on the Intercarb‐Carbon Dioxide Equilibrium Scale, the witherite reference materials can be used to determine Δ47 values without using equilibrated gases and reduce the consumption of ETH carbonates.
Predicting recurrence in pancreatic neuroendocrine tumours: role of ARX and alternative lengthening of telomeres (ALT)
Authors: Neyaz Azfar , Crotty Rory , Rickelt Steffen , Pankaj Amaya , Stojanova Marija , Michelakos Theodoros P , Sekigami Yurie , Kontos Filippos , Parrack Paige H , Patil Deepa T , Heaphy Christopher M , Ferrone Cristina R , Deshpande Vikram
Published: July 2023

Background

While many pancreatic neuroendocrine tumours (PanNET) show indolent behaviour, predicting the biological behaviour of small nonfunctional PanNETs remains a challenge. Nonfunctional PanNETs with an epigenome and transcriptome that resemble islet alpha cells (ARX‐positive) are more aggressive than neoplasms that resemble islet beta cells (PDX1‐positive). In this study, we explore the ability of immunohistochemistry for ARX and PDX1 and telomere‐specific fluorescence in situ hybridisation (FISH) for alternative lengthening of telomeres (ALT) to predict recurrence.

Methods

Two hundred fifty‐six patients with PanNETs were identified, and immunohistochemistry for ARX and PDX1 was performed. Positive staining was defined as strong nuclear staining in >5% of tumour cells. FISH for ALT was performed in a subset of cases.

Results

ARX reactivity correlated with worse disease‐free survival (DFS) (P = 0.011), while there was no correlation between PDX1 reactivity and DFS (P = 0.52). ALT‐positive tumours (n = 63, 31.8%) showed a significantly lower DFS (P < 0.0001) than ALT‐negative tumours (n = 135, 68.2%). ARX reactivity correlated with ALT positivity (P < 0.0001). Among nonfunctional tumours, recurrence was noted in 18.5% (30/162) of ARX‐positive tumours and 7.5% (5/67) of ARX‐negative tumours. Among WHO grade 1 and 2 PanNETs with ≤2 cm tumour size, 14% (6/43) of ARX‐positive tumours recurred compared to 0 of 33 ARX‐negative tumours and 33.3% (3/9) ALT‐positive tumours showed recurrence versus 4.4% (2/45) ALT‐negative tumours.

Conclusion

Immunohistochemistry for ARX and ALT FISH status may aid in distinguishing biologically indolent cases from aggressive small low‐grade PanNETs, and help to identify patients who may preferentially benefit from surgical intervention.
Kapoor, Ria. Making Refugees in India. Oxford University Press. pp.272
Authors: Lahiri Sangbida
Published: July 2023

Ria Kapoor's book, Making Refugees in India, explores the history of refugees in India, tracing the way the figure of ‘refugee’ makes its appearance in the subcontinent since colonial times. The motivation for the book stems from the Citizen Amendment Act passed in the Indian Parliament in 2019, and through the book, Kapoor explores the past histories and the struggles of refugees in independent India for last seventy‐five years. Through the historicizing of the concept of refugee, Kapoor touches on various periods of history within the subcontinent.
Climate, floods, and migration in Pakistan
Authors: Kamal Ahsan
Published: July 2023

This commentary offers a glimpse into the complex landscape of climate‐induced migration in rural Pakistan. By shedding light on the interplay between gradual ecological shifts and rapid climate shocks, it exposes the misalignment between climate policies and the mobility strategies of marginalized communities. The vulnerabilities of rural Pakistanis facing climate and ecological shocks, like the 2022 floods, are rooted in the historical mismanagement of land and water commons. The current focus on infrastructure‐heavy interventions does not address the rigidity introduced by colonial and postcolonial interventions, which have undermined the seasonal mobility and fluidity of pastoralists, peasants, fishers and the landless in rural Pakistan. Thinking climate and migration together requires us to consider the socio‐economic constraints and drivers of migration, burgeoning political conflicts, and the ecological consequences of infrastructure‐heavy climate adaptation strategies by global investors and the Pakistani state.
Analysing Creative Design Process: A Set of Tools to Understand Activity in its Socio‐cultural and Historic Context
Authors: Saris Brenda , Doyle Stephanie , Loveridge Judith
Published: July 2023

Previous theoretical frameworks used to research and explain creative design processes tend to privilege individual expression and not address the context in which the process occurs. This is problematic due to the ways in which creative activities are embedded in and shaped by socio‐cultural and historic contexts. In this article we focus on the ways in which cultural historic activity theory (CHAT) and its analytical activity systems can be used to reveal creative processes in context. We draw on the tools and concepts of CHAT and data from a study of visual communication design (VCD) students and lecturers situated within a transnational higher education (TNHE) context at a university in China. An analytical framework was constructed to research practices used in creative design process learning. The dynamic nature of CHAT offers design process research methods a set of analytical tools to capture the powerful parts played by artifacts and interactions within specific sociocultural and historic learning contexts.
Surveillance and patient safety in nursing research: A bibliometric analysis from 1993 to 2023
Authors: Doyon Odette , Raymond Louis
Published: July 2023

Aims

To identify and characterize the thematic foci, structure and evolution of nursing research on surveillance and patient safety.

Design

Bibliometric analysis.

Methods

Bibliometric methods were employed to analyse 1145 articles, using Bibliometrix and VOSviewer software.

Data Source

The Scopus bibliographic database was searched on April 7, 2023.

Results

A keyword co‐occurrence analysis found the most frequently occurring keywords to be: patient safety, nursing, nurses, adverse events, monitoring, critical care, quality improvement, vital signs, safety, alarm fatigue, education, nursing care, surveillance, clinical alarms, failure to rescue, evidence‐based practice, acute care, clinical deterioration, communication, intensive care. Network mapping, clustering and time‐tracking of the keywords revealed the focal themes, structure and evolution of the research field.

Conclusion

By assessing critical areas of the nursing research field, this study extends and enriches the current discourse on surveillance and patient safety for nursing researchers and practitioners. Critical challenges still have to be met by nurses, however, including the failure to rescue deteriorating patients. Further knowledge and understanding of surveillance and patient safety must be successfully translated from research to practice.

Implications for the Profession

This study highlights the gaps in nursing knowledge with regard to surveillance and patient safety and encourages nursing professionals to turn to evidence‐based surveillance practices.

Impact

In addressing the problem of surveillance and its effect on patient safety, this study found that, in most clinical care settings, preventing failures to rescue and adverse patient outcomes still remains a challenge for the nursing profession. This study should have an impact on nursing academics' future research themes and on nursing professionals' future clinical practices.

Reporting Method

Relevant EQUATOR guidelines have been adhered to by employing recognized bibliometric reporting methods.
Repeated asynchronous evolution of single‐species endemics of ivies (Hedera L.) in Macaronesian archipelagos
Authors: Gallego‐Narbón Angélica , Alonso Alejandro , Valcárcel Virginia , Fernández‐Mazuecos Mario
Published: July 2023

Aim

Evolutionary studies of oceanic island endemics are usually focused on lineages that have experienced in situ radiation, while those that speciated once on the island or archipelago but have not further diversified (single‐species endemics) remain understudied. The Macaronesian archipelagos, in the Atlantic Ocean, are home to significant numbers of single‐species endemics. The genus Hedera L. (12 species) includes three single‐species endemics from three Macaronesian archipelagos with putatively independent origins. Here, we tested the role of phylogenetic niche conservatism in their evolution. To that end, we (1) reconstructed the spatio‐temporal origin of Macaronesian ivies using phylogenomics, and (2) assessed the role of climatic niche during their colonization and speciation.

Location

Azores, Canary Islands, Madeira, western Mediterranean.

Taxon

Hedera spp.

Methods

We used 166 samples representing all Hedera species to generate genotyping‐by‐sequencing (GBS) libraries and performed time‐calibrated phylogenomic and biogeographic analyses. Climatic preferences and climatic niche evolution were assessed using a geo‐referenced database of the western ivy species (2,297 records).

Results

Independent and asynchronous colonization and speciation were estimated for the three Macaronesian ivies, resulting in different degrees of phylogenetic and climatic niche differentiation: H. canariensis displayed an early divergence (7.5–12 Ma) and high phylogenetic and niche isolation; H. azorica had intermediate phylogenetic isolation and niche divergence from its closest relative H. helix (4.4–6.8 Ma) and H. maderensis was embedded within the climatically similar H. iberica (2.8–4.6 Ma). A strong phylogenetic signal was suggested for climatic niche in the western clade of Hedera, where the three Macaronesian ivies are placed.

Main Conclusions

The three Macaronesian ivies represent the evolutionary stages leading to the emergence of single‐species island endemics. Climatic niche conservatism appears to be involved in the evolution of single‐species endemics, first by facilitating island colonization, and then by limiting in situ diversification.
Comparison of Check‐All‐That‐Apply and Adapted‐Pivot‐Test methods for wine sensory characterization with a panel of untrained students
Authors: Nougarède Sylvain , Diot Alice , Maza Elie , Samson Alain , Olivier‐Salvagnac Valérie , Caillé Soline , Geffroy Olivier , Chervin Christian
Published: July 2023

The Check‐All‐That‐Apply (CATA) method was compared with the Adapted‐Pivot‐Test (APT) method, a recently published method based on pair comparisons between a coded wine and a reference sample, called pivot, and using a set list of attributes as in CATA. Both methods were compared using identical wines, correspondence analyses and Chi‐square test of independence, and very similar questionnaires. The results showed that CATA was more robust and more descriptive than the APT with 50–60 panelists. The p‐value of the Chi‐square test of independence between wines and descriptors dropped below 0.05 around 50 panelists with the CATA method, when it never dropped below 0.8 with the APT. The discussion highlights differences in settings and logistics which render the CATA more robust and easier to run. One of the objectives was also to propose an easy set‐up for university and food industry laboratories.

Practical Applications

Our results describe a practical way of teaching and performing the CATA method with university students and online tools, as well as in extension courses. It should have applications with consumer studies for the characterization of various food products. Additionally, we provide an improved R script for correspondence analyses used in sensory characterization and a Chi‐square test to estimate the number of panelists leading to robust results. Finally, we give a set of data that could be useful for sensory and statistics teaching.
Voting status of people with an intellectual disability in four French–speaking cantons of Switzerland: A survey
Authors: Fontana‐Lana Barbara , Petragallo Isabelle , Bach Manon , Petitpierre Geneviève
Published: July 2023

Switzerland is a direct democracy, so its citizens are very often called to vote on various issues. Gaining voter status is, however, a very difficult process for many Swiss citizens with intellectual disability. This research describes the voting status of people with intellectual disability in four French–speaking cantons of Switzerland. It tries to understand systemic or structural factors, such as the guardianship legislation and the legal frameworks, that might have an impact on the voting status of these people. Three hundred individuals with intellectual disability (18–72 years) took part in the study. They were recruited in 11 facilities through a full selection or a letter‐cluster sampling procedure depending on the age group. A questionnaire for each participant was anonymously completed by a support person in the facilities. The questionnaire was constructed with the assistance of self–advocates with intellectual disability, as well as that of people with various roles in decisions regarding voting rights, or providing support to people with intellectual disability, in the participating cantons. Descriptive analyses have been used. The results show that on average slightly more than one person with intellectual disability out of two received voting material, and about one out of two used it. Non‐receipt of voting material is significantly linked to general curatorship, higher financial allowance, living in less independent conditions and/or working in the most protective sectors. People who use their rights more are those who live in more protective environments. Having an intellectual disability implies a higher risk of being deprived of one's political rights, even when the law does not systematically prescribe such a restriction. Even a tailor‐made gradual guardianship system can result in rigid applications of the law, characterized by illegitimate deprivation of rights, such as the right to vote.
Communicative action, a path through the dissonance between nursing and corporate healthcare values
Authors: Buss Julia , Arnold Darrell
Published: July 2023

There is tension in the US healthcare system due to conflicting goals of maximizing the public's health and at the same time ensuring shareholder profit among the many private organizations that provide care to those in need. As a result, nurses (often the frontline workers in this mixed public/private and economized system) may experience dissonance between their professional values and the capitalistic values embodied in the healthcare system. Beyond the workplace, nurses are also committed to championing health and wellness, to advocating for social justice, and driving health policy. Yet, constrained by the conflicts between neoliberal values in an economized system and the values of care that inspire many to join the healthcare profession, nurses may lose the ability to live up to their moral ideals, to champion social justice, and to improve public health outcomes. In this paper, we use the critical theory of Juergen Habermas to explore these tensions and to suggest a path forward for nurses. We suggest that by engaging in dialog with each other and the public, and working for greater inclusivity, nurses can find ways to deconstruct ideologies inherent in our current healthcare system, to consider alternatives, and liberate healthcare from the dominance of market forces.
Interleukin‐38: A crucial player in periodontitis
Authors: Korkmaz Hilal , Hatipoğlu Mükerrem , Kayar Nezahat Arzu
Published: July 2023

Background

The objective of this study was to compare the levels of gingival crevicular fluid (GCF), salivary, and serum matrix metalloproteinase‐9, interleukin (IL)‐17, IL‐36γ, and IL‐38 in individuals with healthy periodontium, gingivitis, and periodontitis and to evaluate their correlations with clinical periodontal parameters.

Materials and Methods

Ninety systemically healthy and nonsmoking volunteers divided into a healthy (H) group (n = 30), a gingivitis (G) group (n = 30), and a periodontitis (P) group (n = 30) were included in this study. Clinical periodontal parameters of volunteers were recorded, and GCF, unstimulated saliva, and serum samples were collected. Data analysis was done with enzyme‐linked immunosorbent assays. The Kruskal–Wallis test and Bonferroni correction were used for multiple comparisons and post hoc statistical analyses.

Results

The group H had significantly lower clinical parameters than the group P (p < 0.001). GCF and salivary IL‐36γ and IL‐38 levels were significantly higher in the group P than in the H and G groups (p < 0.05). Positive correlations between biochemical findings and clinical periodontal parameters were observed.

Conclusions

IL‐36γ and IL‐38 levels in GCF, saliva, and serum correlate with clinical periodontal parameters and may play a role in determining the activity of periodontitis.
Periodontitis‐induced neuroinflammation impacts dendritic spine immaturity and cognitive impairment
Authors: Xie Changfu , Zhang Qiuyang , Ye Xinyi , Wu Weiliang , Cheng Xiaojuan , Ye Xiaoan , Ruan Jianyong , Pan Xiaodong
Published: July 2023

Objective

This study investigated the spinal changes in ligature‐induced periodontitis and the role of periodontitis in cognitive impairment.

Methods

Twenty mice were randomized into the control and chronic periodontitis (CP) groups, with the latter receiving ligature‐induced periodontitis. Cognitive performance was assessed by fear conditioning test. Periodontal inflammation and alveolar bone resorption were evaluated by micro‐computed tomography and histopathology. The hippocampal microglial activation was evaluated by immunohistochemistry (IHC). The expressions of hippocampal cytokines (TNF‐α, iNOS, IL‐1β, IL‐4, IL‐10, and TREM2) were measured by reverse transcription–polymerase chain reaction. The morphology and density of the dendritic spines were determined by Golgi–Cox staining.

Results

The CP mice reported significant inflammatory cell infiltration and alveolar bone resorption, with marked increases in cytokine levels (TNF‐α, iNOS, IL‐1β, and TREM2) in the brain. Moreover, the CP mice showed significantly reduced freezing to the conditioned stimulus in the cued and contextual tests, indicating impaired memory. Further analyses revealed, in the hippocampus of the CP mice, enhanced microglial activation, decreased dendritic spine density, and increased proportion of thin dendritic spines.

Conclusions

Periodontitis‐induced neuroinflammation may impair the cognitive function by activating hippocampal microglia and inducing dendritic spine immaturity.
Efficacy of epidural analgesia for intractable cancer pain: A systematic review
Authors: Hsieh Yu‐Lien , Chen Hui‐Yu , Lin Chung‐Ren , Wang Chi‐Fei
Published: July 2023

Background

Epidural analgesia is a common technique for managing perioperative and obstetric pain. Patients with cancer who cannot tolerate opioids or not responding to conventional treatment may benefit from epidural analgesia. Therefore, this systematic review aimed to analyze the efficacy and safety of epidural analgesia in patients with intractable cancer pain.

Methods

We searched PubMed, Embase, and the Cochrane Central Register of Controlled Trials to identify studies on patients with cancer who received epidural analgesia. We assessed the quality of all included studies using the risk‐of‐bias tool or Newcastle‐Ottawa scale. The primary outcome was pain relief after epidural analgesia, and the secondary outcome was quality of life, analgesic consumption, and adverse events. The studies were grouped based on the medications used for epidural analgesia. A descriptive synthesis was performed following the Synthesis Without Meta‐analysis reporting guideline.

Results

Our systematic review included nine randomized controlled trials (n = 340) and 15 observational studies (n = 926). Two randomized controlled trials suggested that epidural opioids were not superior to systemic opioids in relieving pain. Epidural opioids combined with local anesthetics or adjuvants, including calcitonin, clonidine, ketamine, neostigmine, methadone, and dexamethasone, offered better analgesic effects. No significant difference in pain relief between an intermittent bolus and a continuous infusion of epidural morphine was observed. Epidural opioids had more analgesic effects on nociceptive pain than neuropathic pain. The methods used to evaluate the quality of life and the corresponding results were heterogeneous among studies. Six observational studies demonstrated that some patients could have decreased opioid consumption after epidural analgesia. Adverse events, including complications and drug‐related side effects, were reported in 23 studies. Five serious complications, such as epidural abscess and hematoma, required surgical management. The heterogeneity and methodological limitations of the studies hindered meta‐analysis and evidence‐level determination.

Conclusion

Coadministration of epidural opioids, local anesthetics, and adjuvants may provide better pain relief for intractable cancer pain. However, we must assess the patients to ensure that the benefits outweigh the risks before epidural analgesia. Therefore, further high‐quality studies are required.
Mapping children by ALT 4–5 years after liver transplant: Potential individual and population applications
Authors: Dixon Wesley , Perito Emily R. , Bucuvalas John , Feng Sandy
Published: July 2023

Introduction

Although clinicians repeatedly measure ALT to assess allograft health in children with liver transplants, they generally make decisions based on single values or qualitative trends without quantitative aggregation or synthesis. We therefore aimed to derive and test a holistic ALT metric for the 5th post‐transplant year (Yr 4–5) that may better guide clinical decision‐making and/or population comparisons.

Methods

We derived the “adjusted mean Yr 4–5 ALT” for children transplanted in 2005–2016 by averaging the median ALT from each month. Patients in quartiles (Q1–4) defined by the adjusted mean Yr 4–5 ALT were compared by clinical variables, Yr 5–8 outcomes, and tacrolimus standard deviation (MLVI).

Results

For 97 children [49 male; 77 deceased donors; median (IQR) age at LT 2.5 (0.8–11.7) years], the 25th, 50th, and 75th percentile thresholds for adjusted mean Yr 4–5 ALT were 19, 28, and 47 U/L, respectively. Age, donor type, LT indication, rejection history, and mean tacrolimus levels did not differ between quartiles (Q). Children in Q4 had more Yr 4–5 acute rejection episodes (p < .01), higher Yr 4–5 MLVI (p < .01), and more Yr 5–8 for‐cause liver biopsies (p < .01) than those in Q1 + Q2. Children in Q3 also had higher Yr 4–5 MLVI than Q1 + Q2 (p = .047). Rates of chronic rejection and therapeutic liver‐related procedures were higher in Q4 but the difference did not reach significance.

Conclusion

An integrated ALT metric calculated utilizing all available ALT values correlates with MLVI and future for‐cause biopsies. Further study of this novel ALT metric as a predictor of clinical outcomes and descriptor of populations is warranted.
Intestinal ultrasound may be a useful tool in monitoring acute rejection following intestinal transplantation
Authors: Couper Michael R. , Valamparampil Joseph , Thyagarajan Manigan , Hartley Jane , Gupte Girish
Published: July 2023

Background

Acute rejection is the leading cause of mortality and morbidity for children following intestinal transplantation. Rapid detection and prompt treatment are critical; however, the only reliable method of diagnosis and monitoring is endoscopic graft biopsies. The required regular anesthetics are particularly problematic in children, and non‐invasive strategies are needed.

Methods

We describe the intestinal ultrasound findings of three children before and after treatment for rejection. Ultrasounds were performed within 24 h of endoscopically obtained biopsies which were used to establish a diagnosis of rejection and to define severity. A single sonographer performed the ultrasounds and was blinded to biopsy results at the time of the scanning. These findings are provided in the context of the ultrasound appearance of seven children who had no features of rejection on surveillance biopsies.

Results

Intestinal ultrasound demonstrated increased bowel wall thickness, vascularity, and mesenteric inflammation during moderate to severe rejection episodes. The submucosal layer was particularly thickened, which may represent a finding more specific for rejection. All patients demonstrated improvement in all quantitative ultrasound features correlating with the resolution of acute cellular rejection on histology. Patients with no evidence of rejection on biopsy had a bowel wall thickness range of 0.9–2.8 mm, suggesting a normal upper limit of 3 mm.

Conclusion

Moderate and severe acute rejection may be detected and response to treatment can be monitored by intestinal ultrasound and, correlating with clinical improvement, can aid in follow‐up.
Effects of free textbooks on academic performance: Evidence from China's compulsory education
Authors: Liu Xinran
Published: July 2023

Since little is known about the effects of free textbooks on compulsory school students in China, this paper examines the effects of free textbooks on the academic performance of Chinese middle school students. It combines propensity score matching and difference‐in‐difference estimation to control for both observable and unobservable factors that affect the probability of obtaining free textbooks as well as students' academic performance. Results indicate that free textbooks significantly improve the midterm scores of girls and rural students, and the effects vary across different subjects. Moreover, the impact mechanisms of free textbooks are different for different groups and different subjects.
A transfusion risk stratification score to facilitate quality management in cardiopulmonary bypass
Authors: Zhang Qiaoni , Gao Yuchen , Tian Yu , Gao Sizhe , Diao Xiaolin , Ji Hongwen , Wang Yuefu , Ji Bingyang
Published: July 2023

Background

Our previous showed that a blood management program in the cardiopulmonary bypass (CPB) department, reduced red blood cell (RBC) transfusion and complications, but assessing transfusion practice solely based on transfusion rates was insufficient. This study aimed to design a risk stratification score to predict perioperative RBC transfusion to guide targeted measures for on‐pump cardiac surgery patients.

Study Design and Methods

We analyzed data from 42,435 adult cardiac patients. Eight predictors were entered into the final model including age, sex, anemia, New York Heart Association classification, body surface area, cardiac surgery history, emergency surgery, and surgery type. We then simplified the score to an integer‐based system. The area under the receiver operating characteristic curve (AUC), Hosmer–Lemeshow goodness‐of‐fit test, and a calibration curve were used for its performance test. The score was compared to existing scores.

Results

The final score included eight predictors. The AUC for the model was 0.77 (95% CI, 0.76–0.77) and 0.77 (95% CI, 0.76–0.78) in the training and test set, respectively. The calibration curves showed a good fit. The risk score was finally grouped into low‐risk (score of 0–13 points), medium‐risk (14–19 points), and high‐risk (more than 19 points). The score had better predictive power compared to the other two existing risk scores.

Discussion

We developed an effective risk stratification score with eight variables to predict perioperative RBC transfusion for on‐pump cardiac surgery. It assists perfusionists in proactively preparing blood conservation measures for high‐risk patients before surgery.
A role for vitamin D and the vitamin D receptor in keloid disorder
Authors: Hahn Jennifer M. , Combs Kelly A. , Powell Heather M. , Supp Dorothy M.
Published: July 2023

Keloids are disfiguring fibroproliferative lesions that can occur in susceptible individuals following any skin injury. They are extremely challenging to treat, with relatively low response rates to current therapies and high rates of recurrence after treatment. Although several distinct genetic loci have been associated with keloid formation in different populations, there has been no single causative gene yet identified and the molecular mechanisms guiding keloid development are incompletely understood. Further, although it is well known that keloids are more commonly observed in populations with dark skin pigmentation, the basis for increased keloid risk in skin of colour is not yet known. Because individuals with dark skin pigmentation are at higher risk for vitamin D deficiency, the role of vitamin D in keloid pathology has gained interest in the keloid research community. A limited number of studies have found lower serum vitamin D levels in patients with keloids, and reduced expression of the vitamin D receptor (VDR) in keloid lesions compared with uninjured skin. Vitamin D has documented anti‐inflammatory, anti‐proliferative and pro‐differentiation activities, suggesting it may have a therapeutic role in suppression of keloid fibrosis. Here we review the evidence supporting a role for vitamin D and VDR in keloid pathology.
Demographic patterns in Lyme borreliosis seasonality over 25 years
Authors: Goren Asena , Mysterud Atle , Jore Solveig , Viljugrein Hildegunn , Bakka Haakon , Vindenes Yngvild
Published: July 2023

Lyme borreliosis, the most common vector‐borne disease in Europe and North America, is attracting growing concern due to its expanding geographic range. The growth in incidence and geographic spread is largely attributed to climate and land‐use changes that support the tick vector and thereby increase disease risk. Despite a wide range of symptoms displayed by Lyme borreliosis patients, the demographic patterns in clinical manifestations and seasonal case timing have not been thoroughly investigated and may result from differences in exposure, immunity and pathogenesis. We analysed 25 years of surveillance data from Norway, supplemented by population demography data, using a Bayesian modelling framework. The analyses aimed to detect differences in case seasonality and clinical manifestations of Lyme borreliosis across age and sex differentiated patient groups. The results showed a bimodal pattern of incidence over age, where children (0–9 years) had the highest incidence, young adults (20–29 years) had low incidence and older adults had a second incidence peak in the ages 70–79 years. Youth (0–19 years) presented with a higher proportion of neuroborreliosis cases and a lower proportion of arthritic manifestations compared to adults (20+ years). Adult males had a higher overall incidence than adult females and a higher proportion of arthritis cases. The seasonal timing of Lyme borreliosis consistently occurred around 4.4 weeks earlier in youth compared to adults, regardless of clinical manifestation. All demographic groups exhibited a shift towards an earlier seasonal timing over the 25‐year study period, which appeared unrelated to changes in population demographics. However, the disproportionate incidence of Lyme borreliosis in seniors requires increased public awareness and knowledge about this high‐risk group as the population continues to age concurrently with disease emergence. Our findings highlight the importance of considering patient demographics when analysing the emergence and seasonal patterns of vector‐borne diseases using long‐term surveillance data.