bluuebunny/crossref_metadata_2025 huggingface dataset:
Blood pressure thresholds for the diagnosis of hypertensive disorders of pregnancy in sickle cell disease
Authors: Early Macy L. , Raja Maidah , Luo Amy , Solow Marissa , Matusiak Kristine , Eke Ahizechukwu C. , Shehata Nadine , Kuo Kevin H. M. , Lanzkron Sophie , Malinowski Ann Kinga , Pecker Lydia H.
Published: December 2023

In this retrospective cohort study of singleton pregnancies in people with sickle cell disease (SCD) delivered at two academic centres between 1990 and 2021, we collected demographic and SCD‐related data, pregnancy outcomes, and the highest systolic and diastolic blood pressure (SBP and DBP) at seven time periods. We compared the characteristics of subjects with new or worsening proteinuria (NWP) during pregnancy to those without. We then constructed receiver operating characteristic (ROC) curves to determine the blood pressure (BP) that best identifies those with NWP. The SBP or DBP thresholds which maximized sensitivity and specificity were 120 mmHg SBP (sensitivity: 55.2%, specificity: 73.5%) and 70 mmHg DBP (sensitivity: 27.6%, specificity: 67.7%). The existing BP threshold of 140/90 mmHg lacked sensitivity in both genotype groups (HbSS/HbSβ0: SBP = 21% sensitive, DBP = 5.3% sensitive; HbSS/HbSβ+: SBP = 10% sensitive, DBP = 0% sensitive). Finally, percent change in SBP, DBP and MAP were all poor tests for identifying NWP. Existing BP thresholds used to diagnose hypertensive disorders of pregnancy (HDP) are not sensitive for pregnant people with SCD. For this population, lowering the BP threshold that defines HDP may improve identification of those who need increased observation, consideration of early delivery and eclampsia prophylaxis.
Platelet purinergic receptors and non‐thrombotic diseases
Authors: Pitchford Simon C. , Pan Dingxin
Published: December 2023

LINKED ARTICLES

This article is part of a themed issue on Platelet purinergic receptor and non‐thrombotic disease. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v181.4/issuetoc
Retrospective review of acute post‐tracheostomy complications and contributing risk factors
Authors: Erickson Ericka L. , Katta Juhi , Sun Shuai , Shan Lingpeng , Lemeshow Stanley , Schofield Minka L.
Published: December 2023

Objective

Tracheostomy is performed for various indications ranging from prolonged ventilation to airway obstruction. Many factors may play a role in the incidence of complications in the immediate post‐operative period including patient‐related factors. Chronic obstructive pulmonary disease and asthma are some of the most common pulmonary pathologies in the United States. The relationship between obstructive pulmonary diseases and acute post‐tracheostomy complications has been incompletely studied.

Design

A retrospective chart review was designed in order to answer these objectives. Medical records were reviewed for the technique used, complications, and contributing patient factors. Post‐operative complications were defined as any tracheostomy‐related adverse event occurring within 14 days.

Setting

The study took place at an academic comprehensive cancer.

Participants

Inclusion criteria included patients from January 2017 through December 2018 who underwent a tracheostomy. Exclusion criteria included presence of stomaplasty, total laryngectomy, and tracheostomies performed at outside hospitals.

Main outcome measures

Patient factors examined included demographics, comorbidities, and body mass index with the primary outcome measured being the rate of tracheostomy complications.

Results

The most common indication for tracheostomy among the 321 patients that met inclusion criteria was airway obstruction or a head and neck cancer surgical procedure. Obstructive sleep apnea was associated with acute complications in bivariate analysis (29.4% complications, p = .003). Chronic obstructive pulmonary disease and asthma were not associated with acute complications in bivariate analysis (11.6% complications, p = .302). Among the secondary outcomes measured, radiation was associated with early complications occurring in post‐operative days 0–6 (1.1%, p = .029).

Conclusion

Patients with obstructive sleep apnea may have a higher risk of acute post‐tracheostomy complications that might be due to the patient population at risk for obstructive sleep apnea. Patients with obstructive pulmonary pathologies such as asthma or chronic obstructive pulmonary disorder did not have an elevated risk of complications which is clinically significant when considering the utility of ventilation and tracheostomy in the management of acute respiratory failure secondary to these conditions.
Influence of climate and landscape on genetic differentiation of aardvarks (Orycteropus afer)
Authors: Epps Clinton W. , Crowhurst Rachel S. , Spaan Robert , Weldy Matthew , Tavalire Hannah F.
Published: December 2023

Aim

As climate change accelerates, assessing how climate shapes gene flow and neutral and adaptive genetic differentiation on landscapes is increasingly important. Aardvarks (Orycteropus afer) are ecologically important in sub‐Saharan Africa but are sensitive to human pressures and increasing aridity. We used individual, population and landscape genetic approaches to infer the influence of landscape, climate and potential adaptive differences on gene flow.

Location

We surveyed 8 protected and 4 privately owned areas in South Africa, 2 protected areas in Eswatini and one location in Kenya during 2016–2018.

Methods

We developed microsatellite markers and methods for DNA extraction from faeces, collected and genotyped faecal samples from focal areas and estimated genetic structure. We inferred space use from individual redetections, tested for close relatives and estimated genetic neighbourhood distance. We applied individual‐based landscape genetic analyses at multiple scales to test hypotheses about genetic differentiation by landscape resistance and potential adaptive differences.

Results

We developed 19 variable microsatellite loci and collected 253 faecal samples from 13 focal areas. We genotyped 104 samples successfully at ≥8 loci as needed for individual identification. The genetic structure suggested 3 regional divisions in South Africa. We detected individuals at locations ≤7.3 km distant and closely related individuals at ≤44 km; genetic neighbourhood distance was <55 km. Lower precipitation increased landscape resistance and strongly predicted genetic differentiation at most spatial scales. Temperature differences at sampling sites also influenced structure, suggesting climate‐associated adaptive differences.

Main Conclusions

The genetic structure of aardvarks is strongly shaped by climate, with arid areas limiting gene flow and reflects apparent isolation by adaptation associated with temperature. Dispersal distances likely are <55 km. The markers we developed will facilitate studies of space use, dispersal, population density or survival. Aridification will increase fragmentation and we recommend monitoring aardvark presence as an indicator of ecosystem change associated with aridification.
An alternative approach using hs‐CRP levels and age of onset in diagnostics of HNF1A‐MODY
Authors: Kickova Terezia , Skopkova Martina , Dobiasova Zuzana , Lackova Gabriela , Belicova Zita , Schenkova Katarina , Stanik Juraj , Gasperikova Daniela
Published: December 2023

Aims

The aim is to identify people with HNF1A‐MODY among individuals in diabetic cohort solely based on low hs‐CRP serum level and early diabetes onset.

Methods

In 3537 participants, we analyzed the hs‐CRP levels. We analyzed the HNF1A gene in 50 participants (1.4% of the cohort) with type 1 or type 2 diabetes who had hs‐CRP ≤0.25 mg/L and were diagnosed with diabetes mellitus (DM) at the age of 8–40 years. We functionally characterized two identified missense variants.

Results

Three participants had a rare variant in the HNF1A gene, two of which we classified as likely pathogenic: c.1369_1384dup (p.Val462Aspfs*92) and c.737T>G (p.Val246Gly), and one as likely benign: c.1573A>T (p.Thr525Ser). Our functional studies revealed that p.Val246Gly decreased HNF1α transactivation activity to ~59% and the DNA binding ability to ~16% of the wild‐type, while p.Thr525Ser variant showed no effect on transactivation activity, DNA binding, nor nuclear localization. Based on the two identified HNF1A‐MODY patients among 3537 people with diabetes, we estimate 0.057% as the minimal HNF1A‐MODY prevalence in Slovakia. A positive predictive value of hs‐CRP ≤0.25 mg/L for finding HNF1A‐MODY individuals was 4.0% (95% CI 0.7%, 13.5%).

Conclusions

Hs‐CRP value and age of DM onset could be an alternative approach to current diagnostic criteria with a potential to increase the diagnostic rate of HNF1A‐MODY.
Sentinel lymph node biopsy for breast cancer during pregnancy: A comprehensive update
Authors: Bothou Αnastasia , Margioula‐Siarkou Chrysoula , Petousis Stamatios , Margioula‐Siarkou Georgia , Zervoudis Stefanos , Sotiriadis Alexandros , Amant Fréderic , Dinas Konstantinos
Published: December 2023

Background

Pregnant patients diagnosed with breast cancer (PrBC) may receive substantially different treatments compared to general population, considering that certain treatment options cannot be applied during pregnancy due to their potential harmful effects to the foetus. Regarding the use of sentinel lymph node biopsy (SLNB) in pregnant patients, potential concerns include foetal harm from radiation exposure, possible teratogenic effects of blue dyes and maternal anaphylaxis to isosulfan.

Objective

The main objective of the present systematic review is to summarize and present current knowledge and up‐to‐date evidence about the safety and efficacy of SLNB in PABC.

Methods

MEDLINE, Google Scholar and UpToDate databases were searched up to 22 January 2023. Articles studying the safety and effectiveness of SLNB in patients for PrBC were eligible for inclusion in the present review.

Results

In total, 63 articles that met the inclusion criteria were included in this study. Forty‐seven articles were strongly in favour of performing SLNB in PABC, 4 articles were partially in favour, 10 articles were strongly against and 2 articles were partially against performing SLNB in PABC. Sub‐categorization based on type of study showed that the majority of studies in favour were of higher level of evidence than those against. Furthermore, there were overall 12 studies reporting on outcomes. There were overall 382 women with PrBC that underwent SLNB. Full data were reported for 237 cases. Overall live birth rate was 95.8%, while overall neonatal complication rate was 3.4%.

No case of maternal side effects or anaphylactic reaction, maternal death, stillbirth and neonatal death was reported (0%).

Conclusions

Sentinel lymph node biopsy seems to be safe and effective technique for breast cancer during pregnancy.
Rent–wage inequality in Mexico City, 1770–1930
Authors: Challú Amílcar E. , Solares Israel García , Gómez‐Galvarriato Aurora
Published: December 2023

This article traces trends of income inequality in Mexico City from 1770 to 1930 by measuring the gaps between urban real estate rents and unskilled wages. The article presents the first long‐term series of real estate values and rental income for Mexico. One series summarizes the price of an apartment in tenement housing (the prevalent type of popular housing in Mexico), while the other relies on newspaper ads, notarial records, and other sources to estimate property values and rental yield (rental revenue relative to property values). From these wage and rental income series, we calculate rental–wage ratios that are broadly representative of the income gaps between the wealthy and unskilled workers. We find that, at the end of the eighteenth century, inequality moderately increased, followed by a more egalitarian period in the first half of the nineteenth century, and a ballooning in the last quarter of the nineteenth century that persisted into 1930. While inequality receded after the insurrection in the 1810s, it remained high after the Mexican Revolution. We hypothesize that inequality was sensitive to economic growth, and that generalized violence did not universally temper inequality.
Mitigating the impact of intimate partner violence in pregnancy and early childhood: A dyadic approach to psychotherapy
Authors: Ponting Carolyn , Tomlinson Rachel C. , Chu Ann , Lieberman Alicia F.
Published: December 2023

Intimate partner violence (IPV) is often considered an adult problem despite profound consequences for the children who are exposed toviolent relational patterns. About a third of children and adolescents report past exposure to parental IPV, and a majority were first exposed as infants. Exposure to IPV during pregnancy through the first 5 years of a child's life has consequences ranging from adverse birth outcomes to diagnosable emotional problems and lasting physiological dysregulation. This article reviews risks and consequences of IPV in pregnancy and early childhood and discusses a relational psychotherapeutic treatment approach (Child–Parent Psychotherapy) applied to both developmental stages to mitigate the adverse consequences of family violence on parents and their children. Research evidence for the effectiveness of Child–Parent Psychotherapy (CPP) among IPV‐exposed families is reviewed as are specific treatment components which seek to restore relational safety following familial violence. Additionally, clinical considerations unique to families with histories of or ongoing exposure to IPV are discussed. Finally, recommendations are presented to improve the integration between medical and early childhood behavioral health systems for families at highest risk for chronic IPV.
SARC‐F and modified versions using arm and calf circumference: Diagnostic performance for sarcopenia screening and the impact of obesity
Authors: Lee Shi‐Teng , Lim Jun‐Pei , Tan Cai‐Ning , Yeo Audrey , Chew Justin , Lim Wee‐Shiong
Published: December 2023

Aim

SARC‐F is limited by low sensitivity for sarcopenia identification. As surrogates of muscle mass, mid‐arm circumference (MAC) and/or calf circumference have been proposed as additions to SARC‐F to enhance sarcopenia identification. The aim of this study was to evaluate the diagnostic performance of SARC‐F, SARC‐CalF, SARC‐F + MAC, and SARC‐CalF + MAC in sarcopenia detection, and to assess the impact of obesity on their diagnostic performance.

Methods

We studied 230 healthy non‐frail community‐dwelling older adults age >50 years. We performed receiver operating characteristic curve analysis for SARC‐F, SARC‐CalF, SARC‐F + MAC and SARC‐CalF + MAC against sarcopenia diagnosed by the Asian Working Group for Sarcopenia (AWGS) 2019 as the reference standard. Obesity was defined by high waist circumference (men ≥90 cm, women ≥80 cm). We performed subgroup analysis to compare between obese and non‐obese groups.

Results

The prevalence of sarcopenia was 27.0% by AWGS 2019. SARC‐CalF + MAC had the best diagnostic performance (area under the curve [AUC] 0.74, 95% confidence interval [CI] 0.67–0.81; sensitivity 66.1%; specificity 69.1%), followed by SARC‐CalF (AUC 0.70, 95% CI 0.62–0.78; sensitivity 21.0%; specificity 95.8%). SARC‐F (AUC 0.57, 95% CI 0.49–0.66; sensitivity 0%; specificity 100%) performed significantly worsethan its modified versions (P < 0.05). There was higher accuracy of sarcopenia identification in obese compared with non‐obese groups for SARC‐F + MAC (AUC 0.75, 95% CI 0.65–0.85 vs. 0.58, 95% CI 0.46–0.70) and SARC‐CalF + MAC (AUC 0.75, 95% CI 0.66–0.85 vs. 0.70, 95% CI 0.59–0.81).

Conclusions

The addition of arm circumference to SARC‐CalF confers better diagnostic accuracy for sarcopenia identification, especially in the obese group. Thus, MAC may complement SARC‐CalF for community screening of sarcopenia amongst healthy community‐dwelling older adults by increasing sensitivity for the detection of sarcopenic obesity. Geriatr Gerontol Int 2024; 24: 182–188.
Clinician perspectives on voluntary assisted dying and willingness to be involved: a multisite, cross‐sectional survey during implementation in New South Wales, Australia
Authors: Light Edwina , Kerridge Ian , Skowronski George , Venkatesha Venkatesha , Krishnamurthy Aravind , Kuper Suzanne , Noonan Kerrie , Hoyle Philip , Arnold Mark , Manley Stephen , Stedman Wade , Sheahan Linda
Published: December 2023

Background

In the context of nationwide law reform, New South Wales (NSW) became the last state in Australia to legalise voluntary assisted dying (VAD) – commencing 28 November 2023. Clinicians have divergent views regarding VAD, with varying levels of understanding, support, and willingness to be involved, and these may have a significant impact on the successful implementation.

Aims

To understand levels of support, understanding and willingness to be involved in VAD among clinical staff across NSW during implementation of VAD.

Methods

A multisite, cross‐sectional online survey of clinicians across four local health districts, assessing relevant demographics, awareness of and support for VAD legislation and willingness to be involved in different levels of VAD‐related clinical activities.

Results

A total of 3010 clinical staff completed the survey. A majority of participants were aware of VAD legislation in NSW (86.35%) and supportive of it (76%), with nursing and allied health clinicians significantly more likely than medical specialists to express support. Among medical specialists, support was statistically more likely in those who did not care for patients at the end of life and those with limited knowledge of the legislation. Willingness of medical specialists to perform key roles was significantly lower, with 41.49% willing to act in coordinating or consulting roles, and only 23.21% as administering practitioners.

Conclusions

The majority of clinical staff surveyed across NSW supported VAD legislation. While many eligible clinicians were reluctant to be actively involved, sufficient numbers appear willing to provide VAD services, indicating that successful implementation should be possible.
Time trend of respiratory viruses before and during the COVID‐19 pandemic in severe acute respiratory virus infection in the Sultanate of Oman between 2017 and 2022
Authors: Al Kindi Hanan , Meredith Luke William , Al‐Jardani Amina , Sajina Fathima , Al Shukri Intisar , al Haj Rehan , Alyaquobi Fatma , Al Wahaibi Adil , Al Maani Amal
Published: December 2023

Introduction

Severe acute respiratory illness (SARI) is a potentially lethal condition, necessitating thorough medical care. COVID‐19 underscored the SARI threat, but other high‐risk pathogens require monitoring alongside SARS‐CoV‐2. Oman instituted a comprehensive testing system to gauge the prevalence of these pathogens between 2017 and 2021, aiding resource allocation and public health responses to potential respiratory pathogen outbreaks.

Methods

Samples from SARI cases admitted to ICU were tested for pathogens using the Fast‐Track Diagnostic (FTD) molecular assay, a respiratory virus panel (RVP) that tests for 21 pathogens, including 20 viruses, by qPCR.

Results

Between 2017 and 2022, ~30 000 samples were analysed using the RVP panel. Among SARI patients, 8%–42% tested positive for respiratory pathogens, with 4% showing multiple infectious agents, especially in children under 10. A drop in positivity during 2020–2021 can be attributed to SARS‐CoV‐2 control measures, followed by a rebound in infections in early 2022.

Discussion

The COVID‐19 pandemic heightened awareness of respiratory pathogens' spread without adequate control measures. Influenza A/B, human rhinoviruses and respiratory syncytial virus constituted over 50% of severe acute respiratory illness cases in Oman over the past 5 years. During the pandemic, the incidence of these infections significantly declined, demonstrating the efficacy of COVID‐19 prevention measures in reducing spread of other pathogens.
Assessing Mailuoning injection in wound healing and thrombophlebitis management: A rat model study
Authors: Xiao Junqi , Xie Yang , Liu Jianping , Liu Tao , Ye Rong , Duan Xunhong , Le Zhibiao , Deng Nan , Duan Qing
Published: December 2023

Thrombophlebitis is the inflammatory condition characterized by obstruction of one or more vessels, commonly in the legs, due to the formation of blood clots. It has been reported that traditional Chinese medicine, including Mailuoning injection, is advantageous for treating inflammatory and blood disorders. This research assessed the therapeutic efficacy of Mailuoning injection in the treatment of thrombophlebitis in rodents, as well as investigated its impact on fibrinolysis, inflammation, and coagulation. An experimental setup for thrombophlebitis was established in rodents via modified ligation technique. Five groups comprised the animals: sham operation group, model group, and three Mailuoning treatment groups (low, medium, and high dosages). The pain response, edema, coagulation parameters (PT, APTT, TT, FIB), serum inflammatory markers (IL‐6, TNF‐α, CRP), and expression levels of endothelial markers (ICAM‐1, VCAM‐1, NF‐κB) were evaluated. Blood flow and vascular function were further assessed by measuring hemorheological parameters and the concentrations of TXB2, ET, and 6‐k‐PGF1α. In contrast to the sham group, model group demonstrated statistically significant increases in endothelial expression levels, coagulation latencies, and inflammatory markers (p < 0.05). The administration of mailing, specifically at high and medium dosages, resulted in a substantial reduction in inflammatory markers, enhancement of coagulation parameters, suppression of ICAM‐1 and VCAM‐1 expression, and restoration of hemorheological measurements to baseline (p < 0.05). Significantly higher concentrations of 6‐k‐PGF1α and lower levels of TXB2 and ET were observed in high‐dose group, suggesting that pro‐ and anti‐thrombotic factors were restored to equilibrium. Utilization of Mailuoning injection in rat model of thrombophlebitis exhibited significant therapeutic impact. This effect was manifested through pain alleviation, diminished inflammation, enhanced blood viscosity and facilitation of fibrinolysis. The study indicated that Mailuoning injection may serve as a viable therapeutic option for thrombophlebitis, potentially aiding in the improvement of wound healing by virtue of its anti‐inflammatory and blood flow‐enhancing characteristics.
Soil toxicity and species dominance rather than nutrient availability drive plant species richness in swamp forests of Central Europe
Authors: Slezák Michal , Douda Jan , Hegedüšová Vantarová Katarína , Jarolímek Ivan , Kochjarová Judita , Májeková Jana , Hrivnák Richard
Published: December 2023

Aim

A resource based conceptual model of plant diversity (RBCM) assumes direct relationships between resource supply and the diversity of a local plant assembly. However, the RBCM largely ignores variation in soil toxicity imposed by climatic effects. Both soil limiting resources and soil toxicity vary along climatic gradients but their net and interactive effects on plant species diversity remain unknown. We asked how climatic gradients shape resource availability, soil toxicity and dominance of herb‐layer graminoids, and how these predictors control local species diversity of herbs and bryophytes.

Location

Swamp forests, Central Europe.

Taxon

Vascular plants, bryophytes.

Methods

Alpha taxonomic diversity of vascular plants and bryophytes was counted for 101 vegetation plots sampled in temperate swamp forests distributed along an 800‐km geographical gradient across the Continental, Alpine and Pannonian biogeographical regions. Path analysis (structural equation modelling) was used to quantify the direct and indirect effects of climatic variable (potential evapotranspiration; PET), limiting resources (soil N/P, Ca, C/N, proxies for light and water availability) and soil toxicity (Mn) on graminoid dominance and community diversity.

Results

PET negatively influenced species richness of both groups analysed either directly or indirectly through its positive effect on the cover of graminoid species. Alpha diversity of herbs was additionally reduced by soil toxicity (Mn). Limiting resources correlated either with species dominance (canopy shading, soil Ca) or with PET (soil N/P ratio), but they did not control species richness pattern.

Main Conclusions

Climate, soil toxicity and species dominance determined alpha diversity instead of the expected importance of soil limiting resources. These results are key to advancing the theoretical framework of the RBCM. Increased soil toxicity (Mn) in well‐watered regions favours the dominance of plant competitors at the expense of less tolerant species. This implies a potential threat to wetland diversity under ongoing climate change.
A value‐based healthcare model for initiating and switching psoriasis therapies—Results from the prospective multicentre IMPROVE study
Authors: Nielsen V. W. , Johansen C. B. , Todberg T. , Skov L. , Nissen C. V. , Dodge R. , Egeberg A. , Thyssen J. P. , Thomsen S. F.
Published: December 2023

Background

Little is known about the therapeutic benefits of a value‐based healthcare model compared to a traditional activity‐based incentive model in psoriasis (PsO).

Objectives

This prospective non‐interventional study evaluated an outcome‐based, patient‐centred management model for patients with PsO.

Methods

In total, 49 patients with a Psoriasis Area and Severity Index (PASI) ≥3 who were starting or switching between treatments were included. Patients were assessed at baseline, 3 and 9 months. The patient benefit index (PBI) was calculated using predefined questionnaires. An expected PBI was calculated and adjusted for risk factors known to complicate treatment, that is overweight and smoking. The model remunerated the department on whether the observed PBI exceeded the expected PBI to incentivize over‐performance.

Results

In total, 40 patients (80%) completed all three visits; 32.7% were smokers and 73.5% were overweight. Mean PASI at baseline was 11.5 (SD 9.1); PASI improved significantly from baseline through 3 months: mean reduction, 8.0 (SD 9.2), p < 0.001 and was maintained until 9 months: mean further reduction, 0.1 (SD 3.3), p = 0.893. The mean PBI was 2.5 (SD 1.3) and 2.8 (SD 1.1) at 3 and 9 months, respectively. A PBI ≥1 was achieved by 87.8% at 3 and 95.1% at 9 months. Overall, the department was remunerated a mean 2721.1 DKK (SD 4472.8) per patient. In subgroup analysis, the department was remunerated a mean of, respectively, 2428.6 (SD 5089.5), 2636.6 (SD 4471.3) and 3196.5 (SD 4497.1) DKK for patients with none, 1 or 2 risk factors, that is smoking or/and overweight.

Conclusions

The model evaluated herein is the first value‐based model to calculate remuneration from patient reported outcomes and showed to successfully predict the expected PBI and remunerate treatment based on whether the expected treatment goal was met or exceeded. This can be utilized in the patient‐centred management of PsO.
Open‐source hardware‐ and software‐based cryomicroscopy system for investigation of phase transitions in cryobiological research
Authors: Pakhomov Oleksandr , Shevchenko Nadiia , Chernobai Nadiia , Prokopiuk Volodymyr , Yershov Serhii , Bozhok Galyna
Published: December 2023

The development of inexpensive equipment adapted for the study of a specific biological object is very important for cryobiology. In the presented work, we have proposed a simple system for microscopy utilising open‐source platform Arduino. Testing this system showed that it had sufficient sensitivity to determine the physical processes occurring in a cryopreserved sample such as intra‐ and extracellular water crystallisation and salt eutectic. Utilising this system, we investigated the mechanisms of cryoprotection and cryodamage of testis interstitial cells (ICs) in cryoprotective media, which included cryoprotective agents such as dimethyl sulphoxide (Me2SO), as well as foetal bovine serum or polymers (dextran, hydroxyethyl starch and polyethylene glycol). It was shown that a serum‐/xeno‐free medium that included 0.7 M Me2SO and 100 mg/mL dextran was able to reduce intracellular water crystallisation in cells, change the structure of extracellular ice, and reduce salt eutectic and recrystallisation. All these effects correlated with better IC survival after cryopreservation in the medium. This medium is potentially less toxic as it has lower concentrations of Me2SO compared to serum‐containing media developed for cryopreservation of testicular cells. This would pave a way for the creation of nontoxic serum‐free compositions that does not require removal before use of cryopreserved living cells for laboratory practice or in clinics.
A longitudinal investigation of structural empowerment profiles among healthcare employees
Authors: Cougot Baptiste , Gillet Nicolas , Morin Alexandre J. S. , Gauvin Jules , Ollierou Florian , Moret Leïla , Tripodi Dominique
Published: December 2023

Purpose

Research on structural empowerment has typically adopted a variable‐centered perspective, which is not ideal to study the combined effects of structural empowerment components. This person‐centered investigation aims to enhance our knowledge about the configurations, or profiles, of healthcare employees' perceptions of the structural empowerment dimensions present in their workplace (opportunity, information, support, and resources). Furthermore, this study considers the replicability and stability of these profiles over a period of 2 years, and their outcomes (perceived quality of care, and positive and negative affect).

Design

Participants completed the same self‐reported questionnaires twice, 2 years apart.

Methods

A sample of 633 healthcare employees (including a majority of nurses and nursing assistants) participated. Latent transition analyses were performed.

Results

Five profiles were identified: Low Empowerment, High Information, Normative, Moderately High Empowerment, and High Empowerment. Membership into the Normative and Moderately High Empowerment profiles demonstrated a high level of stability over time (79.1% to 83.2%). Membership in the other profiles was either moderately stable (43.5% for the High Empowerment profile) or relatively unstable (19.7% to 20.4% for the Low Empowerment and High Information profiles) over time. More desirable outcomes (i.e., higher positive affect and quality of care, and lower negative affect) were observed in the High Empowerment profile.

Conclusions

These results highlight the benefits of high structural empowerment, in line with prior studies suggesting that structural empowerment can act as a strong organizational resource capable of enhancing the functioning of healthcare professionals. These findings additionally demonstrate that profiles characterized by the highest or lowest levels of structural empowerment were less stable over time than those characterized by more moderate levels.

Clinical Relevance

From an intervention perspective, organizations and managers should pay special attention to employees perceiving low levels of structural empowerment, as they experience the worst outcomes. In addition, they should try to maintain high levels of structural empowerment within the High Empowerment profile, as this profile is associated with the most desirable consequences. Such attention should be fruitful, considering the instability of the High Empowerment and Low Empowerment profiles over time.

Registration

NCT04010773 on ClinicalTrials.gov (4 July, 2019).
Agricultural intensification increases farmers' income but reduces food self‐sufficiency and bee diversity: Evidence from southeast Mexico
Authors: Vides‐Borrell Eric , Gasselin Pierre , Ferguson Bruce G. , Porter‐Bolland Luciana , Dangla‐Pelissier Tiffany , Ayvayan Simon , Vandame Rémy
Published: December 2023

The tropical region of Hopelchén, southeastern Mexico, is a place of high contrasts in terms of the agricultural intensity of production systems and landscape configuration: It presents enormous areas of conserved forest and at the same time the highest rate of deforestation in Mexico. The consequences of agricultural intensification in this region are the subject of our research. We surveyed 80 farmers, whom we grouped into seven types, and developed an index of agricultural intensity based on sowing intensity, frequency of pesticide application and frequency of tractor use. We evaluated the economic potential and added value for farmers, such as food security and self‐sufficiency, as well as bee diversity in the agricultural intensification gradient. Our results show that agricultural intensification generates higher added value, but not economic potential, and does not necessarily lead to higher food security. However, it does negatively affect bee diversity and pollination potential, which compromises the sustainable development of the region.
The risk assessment of imminent inpatient aggression: A cross‐cultural validation study of the dynamic appraisal of situational aggression in Estonia
Authors: Lenk‐Adusoo Margit , Kangro Raul , Haring Liina
Published: December 2023

Introduction

The reason for this study was void of a data‐driven imminent risk assessment instrument for aggression in psychiatry clinics in Estonia. The predictive accuracy of the observer‐rated Dynamic Assessment of Situational Aggression (DASA) has been repeatedly demonstrated. However, the research gap remains regarding a deeper conceptual understanding of the underlying latent structure of the DASA.

Aim

Comprehensively evaluate the psychometric properties of the Estonian DASA version for cross‐cultural clinical use.

Method

We used a prospective repeated measure design and collected 6097 risk evaluations from 381 adult inpatients, 151 of whom committed 1013 aggressive incidents during the study.

Results

The Estonian DASA version has acceptable inter‐rater reliability (Kendall's τ = 0.74) and is a useful instrument with excellent predictive validity (AUC = 0.86) for identifying potentially aggressive inpatients. In our sample, the DASA has a bi‐factorial structure which explains 83% of the total variance.

Discussion

The adapted DASA has acceptable validity and reliability indices for measuring imminent aggression risk in adult inpatient units.

Implications for Practice

Evidence‐based risk assessment of aggression in psychiatric clinics enhances recognition of the signs of potentially aggressive behaviour in order to apply preventive actions and reduce aggression, thereby improving the quality of the care provided.
Menopausal hormone therapy and risk for dementia in women with CKD: A nationwide observational cohort study
Authors: Huh Hyuk , Kim Minsang , Jung Sehyun , Cho Jeong Min , Kim Seong Geun , Park Sehoon , Lee Soojin , Kang Eunjeong , Kim Yaerim , Kim Dong Ki , Joo Kwon Wook , Han Kyungdo , Cho Semin
Published: December 2023

Aim

The risk for dementia is increased in postmenopausal women. The incidences of premature menopause and dementia have increased in patients with chronic kidney disease (CKD). The potential benefits of hormone replacement therapy (HRT) on cognitive function may be a more critical issue for patients with CKD.

Methods

Women aged >40 years with or without HRT were identified using the 2009 National Health Screening Questionnaire. Women who were newly diagnosed with CKD between 2009 and 2013 were enrolled. HRT was used as an exposure variable, and participants were followed from the day CKD was diagnosed to December 2019. The hazard ratio (HR) for dementia was evaluated using Cox proportional hazards regression analysis.

Results

We included 755 426 postmenopausal women with CKD. The median follow‐up period was 7.3 (IQR, 5.8–8.7) years. All‐cause dementia, Alzheimer's disease, and vascular dementia occurred in 107 848 (14.3%), 87 833 (11.6%), and 10 245 (1.4%) women, respectively. HRT was significantly associated with a lower risk for dementia in the adjusted Cox regression model (all‐cause dementia: HR 0.80; 95% confidence interval [CI] 0.78–0.82; p < 0.001; Alzheimer's disease: HR 0.80; 95% CI 0.77–0.82; p < 0.001; vascular dementia: HR 0.80; 95% CI 0.74–0.87; p < 0.001).

Conclusions

HRT was significantly associated with a lower risk for CKD‐related cognitive dysfunction in postmenopausal women. Prospective studies are needed to determine whether HRT lowers the risk for dementia in menopausal women with CKD.
Maize DDK1 encoding an Importin‐4 β protein is essential for seed development and grain filling by mediating nuclear exporting of eIF1A
Authors: Huang Xing , Huang Yongcai , Qin Li , Xiao Qiao , Wang Qiong , Wang Jiechen , Wang Wenqin , Lu Xiaoduo , Wu Yongrui
Published: December 2023

Nuclear‐cytoplasmic trafficking is crucial for protein synthesis in eukaryotic cells due to the spatial separation of transcription and translation by the nuclear envelope. However, the mechanism underlying this process remains largely unknown in plants.

In this study, we isolated a maize (Zea mays) mutant designated developmentally delayed kernel 1 (ddk1), which exhibits delayed seed development and slower filling. Ddk1 encodes a plant‐specific protein known as Importin‐4 β, and its mutation results in reduced 80S monosomes and suppressed protein synthesis.

Through our investigations, we found that DDK1 interacts with eIF1A proteins in vivo. However, in vitro experiments revealed that this interaction exhibits low affinity in the absence of RanGTP. Additionally, while the eIF1A protein primarily localizes to the cytoplasm in the wild‐type, it remains significantly retained within the nuclei of ddk1 mutants. These observations suggest that DDK1 functions as an exportin and collaborates with RanGTP to facilitate the nuclear export of eIF1A, consequently regulating endosperm development at the translational level.

Importantly, both DDK1 and eIF1A are conserved among various plant species, implying the preservation of this regulatory module across diverse plants.
Is distinct location evidence of distinct objects? Multilocation and the problem of parsimony
Authors: Harmon David
Published: December 2023

For an object to be multilocated is for it to wholly occupy disjoint spatial regions simultaneously. If multilocation is possible, it is possible that a multilocated particle is wholly located at 1080 distinct locations, such that it constitutes a particle‐for‐particle duplicate of the actual universe. Such a universe would presumably be perceptually identical to the actual universe. If we take multilocation as possible, we are thus presented with two accounts between which our perceptual evidence cannot adjudicate: one wherein the universe is constituted by many particles and another wherein it is constituted by one radically multilocated particle. Parsimony concerns dictate that the latter is the more rational to accept. Since this is absurd, we should reject that multilocation is possible. Mooney responds to the problem by arguing that distinct location is evidence of non‐identity, even if acceptance of the possibility of multilocation entails that this evidence is not decisive. If this is right, then the evidence favors a theory featuring many particles. In this paper, I contend that our commitment to taking distinct location as evidence of nonidentity is motivated by a more fundamental intuition that does not apply in the relevant context.
Altered carbohydrate oxidation during exercise in overreached endurance athletes is applicable to training monitoring with continuous glucose monitors
Authors: Coates Alexandra M. , Thompson Kyle M. A. , Grigore Monica M. , Baker Ryleigh E. , Pignanelli Christopher , Robertson Alexa A. , Frangos Sara M. , Cheung Christian P. , Burr Jamie F.
Published: December 2023

Purpose

The purpose of the study was to investigate whether carbohydrate utilization is altered during exercise in overreached endurance athletes and examine the utility of continuous glucose monitors (CGM) to detect overreaching status.

Methods

Eleven endurance athletes (M:8, F:3) completed a 5‐week training block consisting of 1 week of reduced training (PRE), 3 weeks of high‐intensity overload training (POST), and 1 week of recovery training (REC). Participants completed a Lamberts and Lambert Submaximal Cycling Test (LSCT) and 5 km time‐trial at PRE, POST, and REC time points, 15 min following the ingestion of a 50 g glucose beverage with glucose recorded each minute via CGM.

Results

Performance in the 5 km time‐trial was reduced at POST (∆‐7 ± 10 W, p = 0.04,  = 0.35) and improved at REC (∆12 ± 9 W from PRE, p = 0.01,  = 0.66), with reductions in peak lactate (∆‐3.0 ± 2.0 mmol/L, p = 0.001,  = 0.71), peak HR (∆‐6 ± 3 bpm, p < 0.001,  = 0.86), and Hooper‐Mackinnon well‐being scores (∆10 ± 5 a.u., p < 0.001,  = 0.79), indicating athletes were functionally overreached. The respiratory exchange ratio was suppressed at POST relative to REC during the 60% (POST: 0.80 ± 0.05, REC: 0.87 ± 0.05, p < 0.001,  = 0.74), and 80% (POST: 0.93 ± 0.05, REC: 1.00 ± 0.05, p = 0.003,  = 0.68) of HR‐matched submaximal stages of the LSCT. CGM glucose was reduced during HR‐matched submaximal exercise in the LSCT at POST (p = 0.047,  = 0.36), but not the 5 km time‐trial (p = 0.07,  = 0.28) in overreached athletes.

Conclusion

This preliminary investigation demonstrates a reduction in CGM‐derived glucose and carbohydrate oxidation during submaximal exercise in overreached athletes. The use of CGM during submaximal exercise following standardized nutrition could be employed as a monitoring tool to detect overreaching in endurance athletes.
Real‐time loop‐mediated isothermal amplification (real‐time LAMP) assay for rapid diagnosis of amoebic liver abscess
Authors: Khunger Sandhya , Mewara Abhishek , Kaur Upninder , Duseja Ajay , Ray Pallab , Kalra Naveen , Sharma Navneet , Sehgal Rakesh
Published: December 2023

Among the parasitic diseases, amoebic liver abscess (ALA) ranks second to malaria in terms of mortality. Due to the poor sensitivity of conventional diagnostic methods, there is a need for the development of effective and rapid diagnostic methods for ALA. Thus, the purpose of this work was to develop a real‐time loop‐mediated isothermal amplification (RT‐LAMP) assay specific to Entamoeba histolytica. Further, we compared the performance of real‐time LAMP with conventional and real‐time PCR (RT‐PCR) targeting 18S small subunit ribosomal RNA (18S SSU rRNA) gene of E. histolytica in patients with ALA. A total of 126 liver samples were obtained for the study. Of these, 96 aspirated pus samples were obtained from patients suffering from an ALA (serology confirmed, anti‐amoebic immunoglobulin IgG positive), 19 aspirated pus samples from patients with pyogenic liver abscess (PLA, 16S RNA gene positive) and 11 autopsy liver tissues. The results showed that the DNA of E. histolytica was detected in 81 samples by conventional PCR, 93 by RT‐PCR and 95 by RT‐LAMP. The analytical sensitivity of the RT‐LAMP assay was much higher than the other two techniques. RT‐LAMP assay was able to amplify up to one copy of the targeted gene of E. histolytica while conventional PCR and RT‐PCR could amplify up to 103 and 102 copies of the targeted gene of E. histolytica, respectively. In conclusion, RT‐LAMP proved to be a sensitive, specific and rapid test which can be utilised as an effective tool for the diagnosis of ALA.
Fever in focus: Symptoms, diagnoses and treatment of febrile children in Ghana—A longitudinal hospital study
Authors: Rautman Lydia Helen , Maiga‐Ascofaré Oumou , Eibach Daniel , Hogan Benedikt , Dekker Denise , Jaeger Anna , Akenten Charity Wiafe , Owusu‐Dabo Ellis , Boateng Felix Osei , Hanson Henry , Boahen Kennedy Gyau , Sarpong Nimako , Adu‐Sarkodie Yaw , Kreuels Benno , May Jürgen , Krumkamp Ralf
Published: December 2023

Background

Healthcare resources are often limited in areas of sub‐Saharan Africa. This makes accurate and timely diagnoses challenging and delays treatment of childhood febrile illness. We explored longitudinal characteristics related to symptoms, diagnosis and treatment of hospitalised febrile children in a rural area of Ghana highly endemic for malaria.

Methods

Febrile children under 15 years, admitted to the study hospital paediatric ward, were recruited to the study and clinical data were collected throughout hospitalisation. Descriptive statistics were reported for all cases; for longitudinal analyses, a subset of visits with limited missing data was used.

Results

There were 801 hospitalised children included in longitudinal analyses. Malaria (n = 581, 73%) and sepsis (n = 373, 47%) were the most prevalent suspected diagnoses on admission. One‐third of malaria suspected diagnoses (n = 192, 33%) were changed on the discharge diagnosis, compared to 84% (n = 315) of sepsis suspected diagnoses. Among malaria‐only discharge diagnoses, 98% (n/N = 202/207) received an antimalarial and 33% (n/N = 69/207) an antibiotic; among discharge diagnoses without malaria, 28% (n/N = 108/389) received an antimalarial and 83% (n/N = 324/389) an antibiotic.

Conclusions

Suspected diagnoses were largely based on clinical presentation and were frequently changed; changed diagnoses were associated with lingering symptoms, underscoring the need for faster and more accurate diagnostics. Medications were over‐prescribed regardless of diagnosis stability, possibly because of a lack of confidence in suspected diagnoses. Thus, better diagnostic tools are needed for childhood febrile illnesses to enhance the accuracy of and confidence in diagnoses, and to cut down unjustified medication use, reducing the risk of antimicrobial and malaria resistance.
Mathematical modelling of fiber optic cable with an electro-optical cladding by incommensurate fractional-order differential equations
Authors: Ersoy Büşra , Daşbaşı Bahatdin , Aslan Ekin
Published: December 2023

In this study, the mathematical model through incommensurate fractional-order differential equations in Caputo meaning are presented for time-dependent variables given as the numerical aperture, critical angle, and acceptance angle characteristics of a fiber optic cable with electro-optical cladding. The qualitative analysis including the existence and stability of the equilibrium points of the proposed model has been made according to the used parameters, and then, the results obtained from this analysis are supported through numerical simulations by giving the possible values that can be obtained from experimental studies to these parameters in the model. In this way, a stable equilibrium point of the system for the core refractive index, cladding refractive index and electrical voltage is obtained according to the threshold parameter. Thus, the general formulas for the critical angle, acceptance angle and numerical aperture have been obtained when this fixed point is stable.
General Containment Development and Configurations
Authors:   Commentary Task Group
Published: December 2023

The material presented herein summarizes the progress that has been made in the analysis, design, and testing of concrete structures. Many of the most outstanding papers presented from SMiRT 1 to SMiRT 9 are referenced and at times conclusions are summarized.
Examples Radial Shear and Radial Tension Tie
Authors:   Commentary Task Group
Published: December 2023

These are excerpts from “BC-TOP-5A, PRESTRESSED CONCRETE NUCLEAR CONTAINMENT STRUCTURES, H. Reuter et al, FEBRUARY 1975” Bechtel Power Corporation
Detailed Shell Design
Authors:   Commentary Task Group
Published: December 2023

This design example is presented to show the methods employed and the factors considered to establish the level of prestress for a prestressed concrete containment. Calculations are also given which are performed to assure that structural integrity is maintained. It must be pointed out that this example does not analyze all possible material properties, or all load combinations and locations in the structure which must be investigated. Calculations here are samples only and individual containments should be thoroughly checked by the designer.
Liner Plate Design Example, Test Results and Studies
Authors:   Commentary Task Group
Published: December 2023

The report gives a thorough description of the liner plate together with figures illustrating all the applicable details. Problem areas and factors affecting the liner plate and anchorage system design are covered in great detail. The loads considered in the liner plate design are discussed and the approximate strains in the liner plate resulting from these loads are stated.