bluuebunny/crossref_metadata_2025 huggingface dataset:
Potential effects of a mobile stroke unit on time to treatment and outcome in patients treated with thrombectomy or thrombolysis: A Danish–German cross‐border analysis
Authors: Bluhm Susanna , Schramm Peter , Spreen‐Ledebur Yannic , Bluhm Sebastian , Münte Thomas F. , Eiersted Morten Rye , Wolfram Frauke , van Hooff Robbert‐Jan Roderick , Wienecke Troels , Royl Georg
Published: April 2024

Background and purpose

A mobile stroke unit (MSU) reduces delays in stroke treatment by allowing thrombolysis on board and avoiding secondary transports. Due to the beneficial effect in comparison to conventional emergency medical services, current guidelines recommend regional evaluation of MSU implementation.

Methods

In a descriptive study, current pathways of patients requiring a secondary transport for mechanical thrombectomy were reconstructed from individual patient records within a Danish (n = 122) and an adjacent German region (n = 80). Relevant timestamps included arrival times (on site, primary hospital, thrombectomy centre) as well as the initiation of acute therapy. An optimal MSU location for each region was determined. The resulting time saving was translated into averted disability‐adjusted life years (DALYs).

Results

For each region, the optimal MSU location required a median driving time of 35 min to a stroke patient. Time savings in the German region (median [Q1; Q3]) were 7 min (−15; 31) for thrombolysis and 35 min (15; 61) for thrombectomy. In the Danish region, the corresponding time savings were 20 min (8; 30) and 43 min (25; 66). Assuming 28 thrombectomy cases and 52 thrombolysis cases this would translate to 9.4 averted DALYs per year justifying an annual net MSU budget of $0.8M purchasing power parity dollars (PPP‐$) in the German region. In the Danish region, the MSU would avert 17.7 DALYs, justifying an annual net budget of PPP‐$1.7M.

Conclusion

The effects of an MSU can be calculated from individual patient pathways and reflect differences in the hospital infrastructure between Denmark and Germany.
Can the HB‐EGF/EGFR pathway restore injured neurons?
Authors: Adrain Colin , Badenes Marina
Published: April 2024

Heparin‐binding epidermal growth factor‐like growth factor (HB‐EGF) is a transmembrane protein that, when cleaved by metalloproteases through a process called ectodomain shedding, binds to the EGF receptor (EGFR), activating downstream signaling. The HB‐EGF/EGFR pathway is crucial in development and is involved in numerous pathophysiological processes. In this issue of The FEBS Journal, Sireci et al. reveal a previously unexplored function of the HB‐EGF/EGFR pathway in promoting neuronal progenitor proliferation and sensory neuron regeneration in the zebrafish olfactory epithelium in response to injury.
An enhanced fatigue damage model based on Weibull strength distribution
Authors: Liu Zhi , Liu Ying , Zhou Jing , Bai Xuehang , Ye Nanhai
Published: April 2024

Considering the inherent characteristics of strength degradation, a residual strength model is improved reasonably through the incorporation of the two‐parameter Weibull distribution. Building upon this foundation, an enhanced nonlinear fatigue damage accumulation model that is closer to the actual situation is proposed in view of the randomness of fatigue damage. The model takes into account the effect of load action on fatigue damage. To ascertain the feasibility of the proposed model, the time‐varying reliability of the model is evaluated by applying the probability density evolution method. The model's precision in predicting residual life is corroborated through five experimental data sets under bilevel and multilevel loading conditions. The results demonstrate that the proposed model exhibits excellent applicability and remarkable precision, thereby confirming its potential value in practical applications.
Prevalence of Helicobacter pylori infection among Slovenian children and adolescents: A prospective cohort study
Authors: Šterbenc Anja , Godnov Uroš , Vodičar Polona Maver , Simčič Saša , Jeverica Samo , Zaletel Živa , Homan Pia , Mojškerc Eva Miler , Homan Matjaž
Published: April 2024

Background

Helicobacter pylori (H. pylori) infection is primarily acquired in childhood and is notably influenced by socioeconomic variances across different geographical regions. The aim of this study is to assess the prevalence of H. pylori infection in Slovenian children and to identify potential risk factors that facilitate the infection.

Materials and Methods

Between 2019 and 2022, we conducted a multi‐center prospective cross‐sectional study among healthy children residing in three different administrative regions in Slovenia. H. pylori infection status was determined using a monoclonal antibody‐based stool antigen test (SAT). A standardized questionnaire was designed to evaluate the influence of various H. pylori‐associated risk factors, including demographics and socioeconomic, housing and sanitation conditions.

Results

During the 3‐year period, we recruited a total of 421 children and adolescents (age range 2–18 years, mean age 10.29 ± 4.95 years). Overall, 46 (10.9%) were diagnosed with H. pylori infection. No associations were found between H. pylori prevalence rates and increasing age, sex, parental education level, country of birth of the child or their parents, number of household members, household income, having a dishwasher, owning a pet, duration of breastfeeding, fruit intake frequency, drinking tap water, and handwashing practices. The only parameters associated with an increased risk of infection were the location of the school (p < 0.001) and living in an urban area (p = 0.036). The odds of infection were approximately 4.77 times higher if the child attended school in the Central Slovenian compared to other regions (OR = 4.77; 95% CI 0.87–2.34).

Conclusions

This is the first study providing information on the prevalence of H. pylori infection among Slovenian children and adolescents. Using SAT, we have shown that the burden of H. pylori infection in our pediatric population is low; however, it seems to depend on regional rather than socioeconomic factors.
Risk factors and early detection of joint damage in patients with psoriasis: a case–control study
Authors: Yao Amin , Wang Li , Qi Fei , Li Jialu , Meng Juan , Jiang Tao , Zhao Yi , He Yanling
Published: April 2024

Background

Our aim was to target the unsatisfied need for early detection of the at‐risk population and determine the subgroup of patients whose psoriasis (PsO) could transform into psoriatic arthritis (PsA).

Methods

A retrospective and longitudinal case–control study was conducted at Beijing Chao‐yang Hospital. It included 75 patients who were clinically diagnosed with PsA in the case group and 345 who solely suffered from PsO without PsA in the control group. A variety of baseline covariates were gathered from every patient with PsO. Univariate and multivariate analyses and receiver operating characteristic (ROC) curves were used to identify underlying risk factors and determine whether it was necessary to examine the imaging of PsO patients.

Results

In multivariate logistic regression analysis, age ≥40 (odds ratio (OR): 1.04, 95% confidence interval (CI): 1.02–1.06, P < 0.01), nail involvement (OR: 1.17, 95% CI: 1.09–1.32, P < 0.01), erythrocyte sedimentation rate (ESR) (OR: 1.03, 95% CI: 1.01–1.06, P < 0.05) and elevated high‐sensitivity C‐reactive protein (hs‐CRP) (OR: 1.31, 95% CI: 1.13–1.53, P < 0.01) were perceived to be risk factors for the transformation from PsO into clinical PsA. By combining magnetic resonance imaging (MRI)‐detected enthesitis with tenosynovitis, combined predictors demonstrated better diagnostic efficacy, with an improvement in specificity (94.3% vs. 69%) and similarities in sensitivity (89% vs. 84.6%). The areas under the ROC curve (AUCs) amounted to 0.925 (95% CI: 0.882–0.967, P < 0.01) and 0.858 (95% CI: 0.814–0.903, P < 0.01).

Conclusions

It was identified that age ≥40, nail involvement, as well as an elevated ESR, and hs‐CRP served as independent risk factors for PsO transforming into PsA. Additionally, MRI provides additional value for the early recognition of PsA.
The role of social transfers in reducing the poverty risk for larger families in the European Union
Authors: Ilmakunnas Ilari , Mäkinen Lauri , Hiilamo Aapo
Published: April 2024

Child poverty is impacted to a great extent by family demography, with large families and single parents having a greater risk of being poor. Using the EU‐SILC microdata, we examine the extent to which social transfers reduce the risk of poverty among large families compared with smaller families in 29 European countries. Large families are defined as families with three or more children. First, we look at the reduction of poverty rates before and after the social transfers for large and small families. Second, we examine which types of social benefits are of most importance in alleviating poverty of large families. Poverty threshold is set at 60% of the national equivalent disposable income. In addition to poverty rates, poverty gaps are analysed. Results show that European countries seem to have different kinds of profiles in terms of overall child poverty reduction and whether the reduction is stronger among large families.
The role of motivation in the initiation and maintening mentoring relationships among nurses and midwives
Authors: Kakyo Tracy Alexis , Xiao Lily Dongxia , Chamberlain Diane
Published: April 2024

Aim

To understand clinicians’ motivations to engage in mentoring to support newly graduated nurses and midwives working in hospital settings.

Background

Nursing and midwifery literature has established the benefits of mentoring and challenges that affect the effectiveness of formal mentoring programmes. No studies have explored hospital nurses’ and midwives’ motivations to mentor in the absence of the obligatory status and associated rewards of institutionalised mentoring.

Methods

A qualitative descriptive study with 35 nurses and midwives working in three public hospitals in the western, northern and northwestern parts of Uganda. Data were collected using semistructured interviews. Reflexive thematic analysis was applied to interpret the data. We have adhered to COREQ reporting guidelines.

Results

The study revealed three salient themes that capture nursing and midwifery professionals' mentoring perspectives. Participants expressed confidence in their inherent mentoring capacities and were often motivated by a desire to reciprocate prior mentoring experiences. Their mentoring approaches varied between self‐focused and other‐focused motivations, with some overlap in perspectives on hierarchical versus relational mentoring. Across the board, there was a strong consensus on the need of mentoring for individual clinicians, healthcare institutions and the broader profession. The study highlights five opportunities that can be harnessed to design future mentoring programmes.

Conclusions

The findings delineate a complex interplay between self‐centred and altruistic mentoring motivations, aligning with hierarchical or mutually beneficial mentoring paradigms.

Implications for nursing policy

Nurse managers should tailor mentoring programmes to align with these intrinsic motivations, affirm the enduring need for mentoring, and leverage existing institutional resources to create both acceptable and efficient mentoring frameworks.
A survey of skin failure perceptions amongst pressure injury management staff in China: A cross‐sectional study
Authors: Lu Xiaodan , Wu Bingbing , Li Qian , Wang Xuyang , Fan Li , Li Min , Wang Lizhu
Published: April 2024

This study sought to evaluate the perceptions of pressure injury (PI) management staff regarding skin failure (SF). Additionally, an analysis of influencing factors based on the collected data was conducted to establish a foundation for targeted SF training. A descriptive, cross‐sectional survey was undertaken in October–November 2023, utilising a convenience sampling method involving selected management staff of PI from 16 provinces in China. A total of 501 nursing participants were included, exhibiting an overall perception level that was moderately low. Although the majority were aware of the possibility of SF (n = 417, 83.23%), only 60% reported an understanding of the fundamentals of SF, with the lowest level of comprehension observed in differentiating between SF and PI (n = 212, 42.31%). Overall attitudes were generally positive. Regarding behaviour, active learning was more prevalent (n = 340, 67.86%), but training is less (n = 287, 57.29%). Family education (n = 401, 80.04%) and nursing record monitoring (n = 426, 85.03%) demonstrated better behaviour. Further analysis revealed that training (t = 13.937, p < 0.001) and professional title (F = 4.681, p = 0.010) had a significant effect on participants' perceptions. These findings underscore that there remains a substantial lack of perception about SF amongst participants. Overall, participants exhibited a positive attitude towards SF, highlighting the need for future improvements in SF training.
Genetic parameters for mid‐infrared‐spectroscopy‐predicted mastitis phenotypes and related traits
Authors: Rienesl Lisa , Fuerst‐Waltl Birgit , Mészáros Gábor , Koeck Astrid , Egger‐Danner Christa , Gengler Nicolas , Grelet Clément , Sölkner Johann
Published: April 2024

Genetic improvement of udder health in dairy cows is of high relevance as mastitis is one of the most prevalent diseases. Since it is known that the heritability of mastitis is low and direct data on mastitis cases are often not available in large numbers, auxiliary traits, such as somatic cell count (SCC) are used for the genetic evaluation of udder health. In previous studies, models to predict clinical mastitis based on mid‐infrared (MIR) spectral data and a somatic cell count‐derived score (SCS) were developed. Those models can provide a probability of mastitis for each cow at every test‐day, which is potentially useful as an additional auxiliary trait for the genetic evaluation of udder health. Furthermore, MIR spectral data were used to estimate contents of lactoferrin, a glycoprotein positively associated with immune response. The present study aimed to estimate heritabilities (h2) and genetic correlations (ra) for clinical mastitis diagnosis (CM), SCS, MIR‐predicted mastitis probability (MIRprob), MIR + SCS‐predicted mastitis probability (MIRSCSprob) and lactoferrin estimates (LF). Data for this study were collected within the routine milk recording and health monitoring system of Austria from 2014 to 2021 and included records of approximately 54,000 Fleckvieh cows. Analyses were performed in two datasets, including test‐day records from 5 to 150 or 5 to 305 days in milk. Prediction models were applied to obtain MIR‐ and SCS‐based phenotypes (MIRprob, MIRSCSprob, LF). To estimate heritabilities and genetic correlations bivariate linear animal models were applied for all traits. A lactation model was used for CM, defined as a binary trait, and a test‐day model for all other continuous traits. In addition to the random animal genetic effect, the fixed effects year‐season of calving and parity‐age at calving and the random permanent environmental effect were considered in all models. For CM the random herd‐year effect, for continuous traits the random herd‐test day effect and the covariate days in milk (linear and quadratic) were additionally fitted. The obtained genetic parameters were similar in both datasets. The heritability found for CM was expectedly low (h2 = 0.02). For SCS and MIRSCSprob, heritability estimates ranged from 0.23 to 0.25, and for MIRprob and LF from 0.15 to 0.17. CM was highly correlated with SCS and MIRSCSprob (ra = 0.85 to 0.88). Genetic correlations of CM were moderate with MIRprob (ra = 0.26 and 0.37) during 150 and 305 days in milk, respectively and low with LF (h2 = 0.10 and 0.11). However, basic selection index calculations indicate that the added value of the new MIR‐predicted phenotypes is limited for genetic evaluation of udder health.
PBAC: A pathway‐based attention convolution neural network for predicting clinical drug treatment responses
Authors: Deng Dexun , Xu Xiaoqiang , Cui Ting , Xu Mingcong , Luo Kunpeng , Zhang Han , Wang Qiuyu , Song Chao , Li Chao , Li Guohua , Shang Desi
Published: April 2024

Precise and personalized drug application is crucial in the clinical treatment of complex diseases. Although neural networks offer a new approach to improving drug strategies, their internal structure is difficult to interpret. Here, we propose PBAC (Pathway‐Based Attention Convolution neural network), which integrates a deep learning framework and attention mechanism to address the complex biological pathway information, thereby provide a biology function‐based robust drug responsiveness prediction model. PBAC has four layers: gene‐pathway layer, attention layer, convolution layer and fully connected layer. PBAC improves the performance of predicting drug responsiveness by focusing on important pathways, helping us understand the mechanism of drug action in diseases. We validated the PBAC model using data from four chemotherapy drugs (Bortezomib, Cisplatin, Docetaxel and Paclitaxel) and 11 immunotherapy datasets. In the majority of datasets, PBAC exhibits superior performance compared to traditional machine learning methods and other research approaches (area under curve = 0.81, the area under the precision‐recall curve = 0.73). Using PBAC attention layer output, we identified some pathways as potential core cancer regulators, providing good interpretability for drug treatment prediction. In summary, we presented PBAC, a powerful tool to predict drug responsiveness based on the biology pathway information and explore the potential cancer‐driving pathways.
Decreased intranuclear cardiac troponin I impairs cardiac autophagy through FOS/ATG5 in ageing hearts
Authors: Liu Rui Min , Huang Shan , Hu Di , Liu Lingjuan , Sun Hui Chao , Tian Jie , Pan Bo
Published: April 2024

In our previous study, intranuclear cardiac troponin I (cTnI) may function as a co‐factor of Yin Yang 1(YY1). Here, we aimed to explore the role of intranuclear cTnI in ageing hearts. Nuclear translocation of cTnI was demonstrated using Western blot and immunofluorescence. The potential nuclear localization sequences (NLSs) of cTnI were predicted by a web server and then verified in 293T cells by putative NLS‐eGFP‐GST and NLS‐mutant transfection. The ratio of Nuclear cTnI/ Total cTnI (Nu/T) decreased significantly in ageing hearts, accompanied with ATG5‐decline‐related impaired cardiac autophagy. RNA sequencing was performed in cTnI knockout hearts. The differential expressed genes (DEGs) were analysed by overlapping with YY1 ChIP‐sequencing data. cTnI gain and loss experiments in vitro determined those filtered DEGs' expression levels. A strong correlation was found between expression patterns cTnI and FOS. Using ChIP‐q‐PCR, we demonstrated that specific binding DNA sequences of cTnI were enriched in the FOS promoter −299 to −157 region. It was further verified that pcDNA3.1 (−)‐cTnI could increase the promoter activity of FOS by using luciferase report assay. At last, we found that FOS can regulate the ATG5 (autophagy‐related gene 5) gene by using a luciferase report assay. Taken together, our results indicate that decreased intranuclear cTnI in ageing hearts may cause impaired cardiac autophagy through the FOS/ATG5 pathway.
Long‐term effectiveness and persistence rate of ustekinumab dose intensification in a South East Asian inflammatory bowel disease center
Authors: Lim Chong‐Teik , Tay Shu‐Wen , Elangovan Sakktivel , Ong Wan‐Chee , Lim Gek‐Hsiang , Salazar Ennaliza , Chan Webber P W , Tan Malcolm T K
Published: April 2024

Background and Aims

Ustekinumab (UST) is an effective biologic for treatment of inflammatory bowel disease (IBD). However, some patients treated with UST have suboptimal clinical response with standard dosing. The aims of this study were to determine the effectiveness of UST dose intensification (DI), identify factors associated with DI, cumulative incidence of DI and persistence of UST among treated patients.

Methods

Clinical data of patients with Crohn's disease (CD) and ulcerative colitis (UC) who received UST from September 2017 to October 2022 in Singapore General Hospital were collected. Primary outcome was defined as achieving corticosteroid‐free clinical remission, biochemical remission, endoscopic healing and/or transmural healing (CD). Statistical analysis was performed to identify factors, which are predictive of UST DI and effectiveness of UST DI.

Results

Forty‐two patients (34 CD and 8 UC) underwent UST DI to either 6‐weekly (n = 19, 45.2%) or 4‐weekly (n = 23, 35.9%) and the median time to intensification was 31.1 weeks (17.8–65.7). Presence of perianal disease in CD (HR 4.9; 1.47–16.4) was associated with DI. After DI, 16 (38%) patients achieved primary outcome by week 52. The overall drug persistence rates at 1 year and 2 years were 75.7% (95% CI 62.9–84.6) and 63.5% (95% CI 49.9–74.3), respectively.

Conclusion

Two third of IBD patients underwent DI while on UST treatment and the median time to DI was about 6 months after induction. CD patients with perianal disease is more likely to undergo DI. More than one third of dose‐intensified patients achieved remission by week 52.
Optimal follow‐up with somatostatin receptor PET/CT imaging in patients with small intestinal neuroendocrine tumours
Authors: Ohlsson Håkan , Spaak Elisabeth , Gålne Anni , Sundlöv Anna , Almquist Martin
Published: April 2024

Somatostatin receptor positron emission tomography with computerised tomography imaging (SRI) has a high sensitivity for the detection of small intestinal neuroendocrine tumors (siNET), which makes it ideal for follow‐up. The aim of the present study was to investigate whether follow‐up with SRI in patients with siNET led to any change in the treatment of the patient and if patient and/or tumour factors were associated with such change. Adults with siNET who had undergone at least two SRI scans between 2013 and 2021 were identified. Data on age, sex, comorbidities, tumour stage, grade, and most recent levels of serum Chromogranin A (CgA) and 24‐h urine 5‐hydroxyindoleacetic acid (5‐HIAA) before each SRI scan were obtained. The major change was defined as new treatment previously not received or discontinuation of ongoing treatment. Univariate and multivariate mixed models logistic regression on variables with a presumed biological relationship with major change and with backwards stepwise exclusion of variables with p > .1 was performed. A total of 164 patients with siNET diagnosis had undergone 570 SRI scans. The median follow‐up was 3.1 years. Only 82 of 570, 14%, of SRI scans led to a major change in treatment. Female sex, age below 75 years, elevated or missing CgA, elevated or missing urine 5‐HIAA, progress on last SRI scan and distant extrahepatic disease were all independently associated with increased odds ratios for major change after follow‐up with SRI. A small proportion of SRI scans (14%) led to a major change in treatment. Six independent risk factors with increased odds of major change, all available before each SRI scan, were identified. While validation of these risk factors is needed in a separate cohort, these findings could help clinicians individualise follow‐up for siNET patients in the future.
The e‐cigarette assessment for youth—Revised (EAsY‐R): Preliminary results of a pilot study of measure refinement via cognitive interviewing
Authors: Hartmann Sarah A. , Cristello Julie V. , Manresa Odette , Trucco Elisa M.
Published: April 2024

The prevalence of youth vaping has, in a relatively short time, become an “epidemic.” In the wake of such labeling by the Surgeon General, a number of important examinations of vaping have been conducted. These have largely focused on high school and college‐age youth as this demographic shows the greatest prevalence of use. Nonetheless, no measure has been made available which might allow for the comprehensive assessment of quantity and frequency of vaping among this age group, thus aiding in standardization across settings. The current study utilized cognitive interviews with high school and college‐age youth who use vaping devices to inform the preliminary development of such an assessment. The sample consists of eight students between the ages of 15 and 24 (Mage = 18.75, SD = 2.73, 62.5% female, 75.0% Hispanic/Latino/a/x, 100.0% White). Interviewing and measure refinement were conducted in a two‐phase iterative fashion. Suggestions made during cognitive interviews resulted in the refinement of assessed content type, updated categories and pictures of vaping devices, as well as updated and age‐relevant terminology. Further, instructions were streamlined, and assessment items and multiple‐choice options were refined to maximize clarity and to minimize participant confusion. The result of this study, the E‐Cigarette Assessment for Youth Revised, is a unique tool for standardizing examinations of the quantity and frequency of vaping behaviors among high school students and college‐age youth.
Missed opportunities for human papillomavirus vaccination using Iowa's Immunization Registry Information System
Authors: Loper Ona R. , Schultz Jessica M. , Kintigh Bethany F. , Callaghan Donald J.
Published: April 2024

Purpose

Adolescent human papillomavirus (HPV) vaccination rates continue to remain lower than other adolescent vaccines, both nationwide and in Iowa. This study examined predictors of missed opportunities for first‐dose HPV vaccine administrations in Iowa in order to conduct more targeted outreach and improve adolescent HPV vaccine uptake.

Methods

A retrospective study was conducted to identify predictors of missed opportunities for first‐dose HPV vaccination in Iowa adolescents using Iowa's Immunization Registry Information System. The study population included 154,905 adolescents aged 11‐15 years between 2019 and 2022. Missed opportunity for first‐dose HPV vaccination was defined as a vaccination encounter where an adolescent received a Tdap and/or MenACWY vaccine but did not receive the first‐dose HPV vaccine during the same encounter.

Findings

Over a third of the study population experienced a missed opportunity for HPV vaccination between 2019 and 2022. Missed opportunity for vaccination was most common among individuals living in a rural county (aOR = 1.36), underinsured adolescents (aOR = 1.74), males (aOR = 1.12), teens 13‐15 years of age (aOR = 1.76), and White race and non‐Hispanic ethnicity.

Conclusion

This study builds on previously reported predictors of missed opportunity for HPV vaccination in adolescents. Increased understanding of provider needs and barriers to administering HPV vaccination and further analysis of how the Vaccines for Children Program can play a role in HPV vaccination uptake is necessary to improve HPV vaccination rates among adolescents in Iowa and more specifically in rural communities.
How rural is All of Us? Comparing characteristics of rural participants in the National Institute of Health's All of Us Research Program to other national data sources
Authors: Graves Janessa M. , Beese Shawna R. , Abshire Demetrius A. , Bennett Kevin J.
Published: April 2024

Purpose

The National Institute of Health's All of Us Research Program represents a national effort to develop a database to advance health research, especially among individuals historically underrepresented in research, including rural populations. The purpose of this study was to describe the rural populations identified in the All of Us Research Program using the only proxy measure currently available in the dataset.

Methods

Currently, the All of Us Research Program provides a proxy measure of rurality that identifies participants who self‐reported delaying care due to far travel distances associated with living in rural areas. Using the All of Us Controlled Tier Dataset v6, we compared sociodemographic and health characteristics of All of Us rural participants identified via this proxy to rural US residents from nationally representative data sources using chi‐squared tests.

Results

3.1% of 160,880 All of Us participants were rural, compared to 15%‐20% of US residents based on commonly accepted rural definitions. Proportionally more rural All of Us participants reported fair or poor health status, history of cancer, and history of heart disease (P<.01).

Conclusions

The All of Us measure may capture a subset of underserved participants who live in rural areas and experience health care access barriers due to distance. Researchers who use this proxy measure to characterize rurality should interpret their findings with caution due to differences in population and health characteristics using this proxy measure rural compared to other commonly used rural definitions.
Hindlimb myology in two piscivorous raptorial birds: a quantitative comparison of the osprey and the white‐tailed sea eagle (Aves, Accipitriformes)
Authors: Mosto M. C. , Picasso M. B. J. , Tudisca A. M. , Krone O.
Published: April 2024

The hindlimbs of Accipitriformes are vital for capturing prey. Research on hindlimb musculature has primarily focused on species preferring avian and mammalian prey, whereas piscivorous species have received limited attention. This study aims to investigate the quantitative characteristics of hindlimb muscles in two piscivorous Accipitriformes, Pandion haliaetus and Haliaeetus albicilla, to discern potential muscular features associated with their specific food preference. The mass and proportion of all hindlimb muscles in both species were assessed based on their primary function (flexion or extension). A Kruskal‐Wallis test was employed to analyze possible differences in muscle mass between species. The allometric relationships between the muscles and body mass were explored with the reduced major axis method. Additionally, a study on the architectural parameters of the primary gripping muscles in P. haliaetus was conducted, using published information from other raptorial birds for comparison. The isometric scaling relationship predominated in the majority of individual muscles helping maintain a proportional relationship relative to body mass. Both species exhibited a similar pattern in terms of quantitative muscle features, implying a preservation of muscle characteristics linked to their predatory capabilities. The largest proportion of hindlimb muscle mass was dedicated to digit flexion in accordance with the grasping abilities of birds of prey. The muscles tibialis cranialis, flexor digitorum longus and flexor hallucis longus exhibited the greatest mass, high physiological cross‐sectional area values, and long fibre, categorizing them as high‐power specialists. These muscles are crucial in the flexion movements that produce the gripping action that characterizes birds of prey. Although no statistically significant differences were detected, each species displayed slightly distinct muscular characteristics, particularly in the architectural properties of the flexor muscles controlling digits II, III, and IV. These variations seem to be associated with differences in their prey preferences.
Niche conservatism and spread explain introgression between native and invasive fish
Authors: Hartman Jordan H. , Corush Joel , Larson Eric R. , Tiemann Jeremy S. , Willink Philip W. , Davis Mark A.
Published: April 2024

Hybridisation can be an important driver of evolutionary change, but hybridisation with invasive species can have adverse effects on native biodiversity. While hybridisation has been documented across taxa, there is limited understanding of ecological factors promoting patterns of hybridisation and the spatial distribution of hybrid individuals. We combined the results of ecological niche modelling (ENM) and restriction site‐associated DNA sequencing to test theories of niche conservatism and biotic resistance on the success of invasion, admixture, and extent of introgression between native and non‐native fishes. We related Maxent predictions of habitat suitability based on the native ranges of invasive Eastern Banded Killifish (Fundulus diaphanus diaphanus Lesueur 1817) and native Western Banded Killifish (Fundulus diaphanus menona Jordan and Copeland 1877) to admixture indices of individual Banded Killifish. We found that Eastern Banded Killifish predominated at sites predicted as suitable from their ENM, consistent with niche conservatism. Admixed individuals were more common as Eastern Banded Killifish habitat suitability declined. We also found that Eastern Banded Killifish were most common at sites closest to the presumed source of this invasion, whereas the proportion of admixed individuals increased with distance from the source of invasion. Lastly, we found little evidence that habitat suitability for Western Banded Killifish provides biotic resistance from either displacement by, or admixture with, invasive Eastern Banded Killifish. Our study demonstrates that ENMs can inform conservation‐relevant outcomes between native and invasive taxa while emphasising the importance of protecting isolated Western Banded Killifish populations from invasive conspecifics.
Investigating a Vocal Improvisatory Genre (Mawwāl) in Arab Music: a Case Study of a Mawwāl Performance by Wadī‘ al‐Ṣāfī
Authors: Shair Nabil
Published: April 2024

Although recent decades have witnessed a significant growth and expansion of studies dealing with the performing practice of Arab music improvisation, most such studies are focused on instrumental, not vocal, performing practices. As a result, Arab vocal performing practice, especially that of vocal improvisatory genres, still lacks a comprehensive theoretical approach. In this article I examine the maqām (Arab modal framework) phenomenon by analysing a piece in its pre‐eminent improvisatory genre (mawwāl) composed and performed by an eminent musician: mawwāl ‘Ṭal al‐Ṣabāḥ’ by Wadī‘ al‐Ṣāfī. Most vocal improvisation is presented in Arab music literature without a defined or definite melodic (or rhythmic) structure. I posit that the mawwāl genre has defined and quasi‐defined structures on the macro and micro levels of the piece, since a major part of those structures is manifested as recurring, defined compositional devices and interrelationships throughout the piece within the improvisational frame of the mawwāl genre, a reflection of its structural intricacy. This article thus contributes to the existing literature on classical Arab vocal performance by implementing the theory of natural schemata as an analytical framework along with a structural analysis based on a detailed descriptive transcription of the piece, and thus characterising the largest and smallest strata of musical structures in the mawwāl genre.
Redox signalling in plant–nematode interactions: Insights into molecular crosstalk and defense mechanisms
Authors: Hasan M. Shamim , Lin Ching‐Jung , Marhavy Peter , Kyndt Tina , Siddique Shahid
Published: April 2024

Plant–parasitic nematodes, specifically cyst nematodes (CNs) and root‐knot nematodes (RKNs), pose significant threats to global agriculture, leading to substantial crop losses. Both CNs and RKNs induce permanent feeding sites in the root of their host plants, which then serve as their only source of nutrients throughout their lifecycle. Plants deploy reactive oxygen species (ROS) as a primary defense mechanism against nematode invasion. Notably, both CNs and RKNs have evolved sophisticated strategies to manipulate the host's redox environment to their advantage, with each employing distinct tactics to combat ROS. In this review, we have focused on the role of ROS and its scavenging network in interactions between host plants and CNs and RKNs. Overall, this review emphasizes the complex interplay between plant defense mechanism, redox signalling and nematode survival tactics, suggesting potential avenues for developing innovative nematode management strategies in agriculture.
Epstein–Barr virus‐associated post‐transplant lymphoproliferative disorders in pediatric transplantation: A prospective multicenter study in the United States
Authors: Tajima Tetsuya , Martinez Olivia M. , Bernstein Daniel , Boyd Scott D. , Gratzinger Dita , Lum Grant , Sasaki Kazunari , Tan Brent , Twist Clare J. , Weinberg Kenneth , Armstrong Brian , Desai Dev M. , Mazariegos George V. , Chin Clifford , Fishbein Thomas M. , Tekin Akin , Venick Robert S. , Krams Sheri M. , Esquivel Carlos O.
Published: April 2024

Background

Epstein–Barr virus (EBV)‐associated post‐transplant lymphoproliferative disorders (PTLD) is the most common malignancy in children after transplant; however, difficulties for early detection may worsen the prognosis.

Methods

The prospective, multicenter, study enrolled 944 children (≤21 years of age). Of these, 872 received liver, heart, kidney, intestinal, or multivisceral transplants in seven US centers between 2014 and 2019 (NCT02182986). In total, 34 pediatric EBV+ PTLD (3.9%) were identified by biopsy. Variables included sex, age, race, ethnicity, transplanted organ, EBV viral load, pre‐transplant EBV serology, immunosuppression, response to chemotherapy and rituximab, and histopathological diagnosis.

Results

The uni−/multivariable competing risk analyses revealed the combination of EBV‐seropositive donor and EBV‐naïve recipient (D+R−) was a significant risk factor for PTLD development (sub‐hazard ratio: 2.79 [1.34–5.78], p = .006) and EBV DNAemia (2.65 [1.72–4.09], p < .001). Patients with D+R− were significantly more associated with monomorphic/polymorphic PTLD than those with the other combinations (p = .02). Patients with monomorphic/polymorphic PTLD (n = 21) had significantly more EBV DNAemia than non‐PTLD patients (p < .001) and an earlier clinical presentation of PTLD than patients with hyperplasias (p < .001), within 6‐month post‐transplant. Among non‐liver transplant recipients, monomorphic/polymorphic PTLD were significantly more frequent than hyperplasias in patients ≥5 years of age at transplant (p = .01).

Conclusions

D+R− is a risk factor for PTLD and EBV DNAemia and associated with the incidence of monomorphic/polymorphic PTLD. Intensive follow‐up of EBV viral load within 6‐month post‐transplant, especially for patients with D+R− and/or non‐liver transplant recipients ≥5 years of age at transplant, may help detect monomorphic/polymorphic PTLD early in pediatric transplant.
“Take it or leave it”: Analysis of pediatric heart offers for transplantation in Switzerland
Authors: Maire Stéphane , Schweiger Martin , Immer Franz , Prêtre René , Di Bernardo Stefano , Kadner Alexander , Glöckler Martin , Balmer Christian
Published: April 2024

Background

There is a shortage of donor hearts in Switzerland, especially for pediatric recipients. However, the rate and reason for refusals of pediatric donor hearts offered in Switzerland has not been systematically analyzed.

Methods

The national transplant database, Swiss Organ Allocation System, was searched for all hearts from Swiss and foreign donors younger than 16 years from 2015 to 2020. The numbers of accepted and refused hearts and early outcome were assessed, and the reasons for refusal were retrospectively analyzed.

Results

A total of 136 organs were offered to the three Swiss pediatric heart centers and foreign donor procurement organizations. Of these, 26/136 (19%) organs were accepted and transplanted: 18 hearts were transplanted in Switzerland, and 13 of these were foreign. Reasons for refusal were (1) no compatible recipient due to blood group or weight mismatch, 89.4%; (2) medical, meaning organ too marginal for transplantation, 7.4%; (3) logistic, 1.4%; and (4) other, 1.8%. Five organs were refused in Switzerland by one center but later accepted and successfully transplanted by another center. Hearts from outside Switzerland were transplanted significantly less than Swiss hearts (n = 16/120 vs. 10/16, p < .001).

Conclusion

The most common reason for refusing a pediatric donor heart is lack of compatibility with the recipient. Few hearts are refused for medical reasons. A more generous acceptance seems to be justified in selected patients. Switzerland receives a high number of foreign offers, but their rate of acceptance is lower than that of Swiss donations.
Analysis of an age‐space structured tuberculosis model with treatment and relapse
Authors: Wang Jinliang , Lyu Guoyang
Published: April 2024

This paper concerns with the global threshold dynamics of a Tuberculosis (TB) model incorporating age‐space structure, treatment, and relapse. The original model is converted into a hybrid system comprising two Volterra integral equations and two partial differential equations by integrating along the characteristic line. The well‐posedness for the model is demonstrated by using the fixed point theory in conjunction with the induction method. In order to discuss whether a disease is persistent or extinct, we provide the explicit formulation of the basic reproduction number. By analyzing the distribution of the characteristic roots of the characteristic equations and constructing the proper Lyapunov functionals, the local and global stability for the steady states are addressed. Numerical simulations are conducted to confirm the conclusions of our analytical results and reveal that reduction of the TB transmission coefficient, reduction of infectiousness of treated individuals infected with TB, and increasing the treatment rate of infectious class are three feasible measures to control the transmission of TB.
Socioeconomic inequalities and the role of sectoral foreign aid in developing countries
Authors: Maruta Admasu Asfaw , Banerjee Rajabrata
Published: April 2024

Using a panel threshold regression approach, we consider multiple dimensions of socioeconomic inequalities and examine their heterogeneous relationships with sectoral foreign aid. Conditioned on the level of socioeconomic development, three types of inequality and four channels of sectoral foreign aid are considered. We use a comprehensive dataset covering 65 aid‐recipient countries from 1990 to 2017 and find that education aid effectively reduces inequalities but only when the level of institutional quality and other socioeconomic factors is above its 75th percentile value in our sample. These results are robust to alternative measures of income inequality, aid and estimation strategies.
A comprehensive MRI investigation to identify potential biomarkers of Osgood Schlatter disease in adolescents: A cross sectional study comparing Osgood Schlatter disease with controls
Authors: Sørensen L. B. , Holden S. , Oei E. H. G. , Magnusson S. P. , Olesen J. L. , Dean B. J. F. , Hever M. , Lyng K. , Rathleff M. S.
Published: April 2024

Background

Osgood–Schlatter disease (OSD) is the most common knee pain complaint among adolescents playing sports. Despite this, there remains controversy over the pathophysiology and whether specific anatomical characteristics are associated with OSD.

Purpose

This study aimed to systematically and comprehensively characterize adolescents with OSD using magnetic resonance imaging (MRI) compared to pain‐free controls, including both tissue abnormalities that may be associated with OSD, as well as anatomical characteristics. A secondary objective was to identify potential imaging biomarkers associated with pain.

Study Design

Cross‐sectional study.

Methods

Adolescents with OSD and controls were recruited from 2020 to 2022. Following a clinical exam, demographics, pain, sports participation, and Tanner stage were collected. Knee MRI was conducted on the participants' most symptomatic knee (OSD) or the dominant leg (controls).

Results

Sixty‐seven adolescents (46 with OSD and 30 controls) were included. 80% of participants with OSD had at least one tissue alteration compared to 54% of controls. Compared to controls, OSD had 36.3 (95%CI 4.5 to 289.7) higher odds of bony oedema at the tibial tuberosity, and 32.7 (95%CI 4.1 to 260.6) and 5.3 (95%CI 0.6 to 46.2) higher odds of bony oedema at the  tibial epiphysis and metaphysis respectively. Participants with OSD also had higher odds of fluid/oedema at the patellar tendon (12.3 95%CI 3.3 to 46.6), and superficial infrapatellar bursitis (7.2).  Participants with OSD had a more proximal tendon attachment (mean tibial attachment portion difference, −0.05, 95% CI: −0.1 to 0.0, p = 0.02), tendon thickness (proximal mean difference, −0.09, 95% CI: −0.4 to 0.2, p = 0.04; distal mean difference, −0.6, 95% CI: −0.9 to −0.2, p = 0.01). Those with bony/tendon oedema had 1.8 points (95% CI: 0.3 to 3.2) higher pain on palpation than those without (t = −2.5, df = 26.6, p = 0.019), but there was no difference between these groups in a functional single leg pain provocation.

Conclusion

Adolescents with OSD present with tissue and structural abnormalities on MRI that differed from age‐matched controls. The majority had findings in the patellar tendon and bone, which often co‐occurred. However, a small proportion of OSD also presents without alterations. It appears these findings may be associated with clinical OSD‐related pain on palpation of the tibial tuberosity.

Clinical Relevance

Our highlight the pathophysiology on imaging, which has implications for understanding the mechanism and treatment of OSD.
A Protocol for When Social Media Goes Private: Studying archaeological or heritage discourses in closed Facebook groups
Authors:   Carleton University, Davidson Katherine , Graham Shawn ,   Carleton University, Huffer Damien ,   University of Queensland
Published: April 2024

Our major project explores the discourses that surround the buying and selling of human remains over social media. We discuss the research ethics framework established in Canada by the 'Tri-Council' research agencies as it pertains to studying social media in general. Issues of privacy and consent are paramount. Human remains trading happens in both public and private social media. We detail the process we went through, and the protocol that we evolved as a result, for studying private social media posts in closed Facebook groups. This process, protocol, and rationale may be useful for other researchers studying how archaeology and cultural heritage are framed or discussed in these venues. What people say in public is not what might be said in private, and researchers need ethical approaches to study such discourses.
In Vitro Assessment of Knee Joint Biomechanics Using a Virtual Anterior Cruciate Ligament Reconstruction
Authors: Vakili Samira , Vivacqua Thiago , Getgood Alan , Willing Ryan
Published: April 2024

Understanding the biomechanical impact of injuries and reconstruction of the anterior cruciate ligament (ACL) is vital for improving surgical treatments that restore normal knee function. The purpose of this study was to develop a technique that enables parametric analysis of the effect of the ACL reconstruction (ACLR) in cadaver knees, by replacing its contributions with that of a specimen-specific virtual ACLR that can be enabled, disabled, or modified. Twelve ACLR reconstructed knees were mounted onto a motion simulator. In situ ACLR graft forces were measured using superposition, and these data were used to design specimen-specific virtual ACLRs that would yield the same ligament force-elongation behaviors. Tests were then repeated using the virtual ACLR in place of the real ACLR and following that in ACL deficient knee by disabling the virtual ACLR. In comparison to the ACL deficient state, the virtual ACLRs were able to restore knee stability to the same extent as real ACLRs. The average differences between the anterior tibial translation (ATT) of the virtual ACLR versus the real ACLR were +1.6 ± 0.9 mm (p = 0.4), +2.1 ± 0.4 mm (p = 0.4), and +1.0 ± 0.9 mm (p = 0.4) during Anterior drawer, Lachman and Pivot-shift tests, respectively, which is small in comparison to the full ATT range of motion (ROM) of these knees. Therefore, we conclude that a virtual ACLR can be used in place of real ACLR during biomechanical testing of cadaveric knees. This capability opens the door for future studies that can leverage parameterization of the ACLR for surgical design optimization.