bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical course of small gastric subepithelial lesion less than 20 mm diagnosed by endoscopic ultrasound‐guided fine‐needle aspiration
Authors: Kobayashi Ryosuke , Hirasawa Kingo , Ozeki Yuichiro , Sawada Atsushi , Nishio Masafumi , Sato Chiko , Miwa Haruo , Kaneko Takashi , Sugimori Kazuya , Maeda Shin
Published: March 2024

Background and Aim

Gastrointestinal stromal tumors (GISTs) are treated as malignant gastric subepithelial lesions (SELs), and resection is recommended. However, small gastric SELs < 20 mm with no malignant features are monitored without histopathological examination, and the frequency of malignancy is unknown. This study aimed to clarify the clinicopathological findings and clinical course of gastric SELs < 20 mm measured by endoscopic ultrasound (EUS).

Methods

This retrospective cohort study included consecutive patients with small gastric SELs < 20 mm diagnosed using EUS at a tertiary referral center between 2009 and 2021. The clinical course after diagnosis using EUS‐guided fine‐needle aspiration (EUS‐FNA) was reviewed.

Results

Among 333 patients with small gastric SELs, 104 patients with 105 lesions underwent EUS‐FNA. The pathological diagnosis was confirmed in 87 patients. GISTs were the most common pathology (47%). Among the 87 patients, 43 underwent therapeutic interventions, including tumor resection and chemotherapy. In groups of tumor resection, the pathological tumor size on the resected specimen was significantly larger than the size measured by EUS (19.5 mm vs 15.0 mm, P < 0.001), and 37% of resected SELs were 20 mm or over. No recurrence was observed after tumor resection during a mean follow‐up period of 40 months.

Conclusions

Approximately 40% of small gastric SELs were malignant tumors, such as GIST, with most of them requiring treatment. Additionally, considering that the EUS measurement is 5 mm smaller than the pathological tumor diameter, further examinations, such as systematic EUS‐FNA, may be required for SEL, including those smaller than 20 mm.
Price Stickiness Heterogeneity and Equilibrium Determinacy
Authors: LEE JAE WON , PARK WOONG YONG
Published: March 2024

Monetary policy can achieve equilibrium determinacy with considerably weak responses to inflation under price stickiness heterogeneity. The result holds in a sticky‐price model with the constant elasticity‐of‐substitution aggregator and no trend inflation, and with a variable elasticity‐of‐substitution aggregator and historical trend inflation. The evidence in favor of the view that the U.S. economy was subject to self‐fulfilling expectations‐driven fluctuations in the pre‐Volcker period and the systematic shift in monetary policy was crucial in subsequent stabilization of inflation appears much weaker through the lens of price stickiness heterogeneity than previously concluded in the literature under price stickiness homogeneity.
The potential of Paeonia lactiflora pall seeds oil as a pure natural cosmetics raw material: In Vitro findings
Authors: Chen Zhixiong , Hong Ni , Yan Cui , Zheng Zhongbo , Xi Jie , Cao Ping
Published: March 2024

Background

As a traditional Chinese herbal medicine, Paeonia lactiflora Pall is rich in various active ingredients such as polysaccharides and total flavonoids while having ornamental value. It has potential application value in the development of food and cosmetics.

Objective

To study the in vitro efficacy of Paeonia lactiflora Pall seeds oil.

Methods

Firstly, the levels of linolenic acid and linoleic acid in Paeonia lactiflora Pall seeds oil were quantified using gas chromatography. The impact of Paeonia lactiflora Pall seeds oil on the proliferation rate of B16F10 cells was assessed through the CCK‐8 method, while the melanin content of B16F10 cells was determined using the sodium hydroxide lysis method. The inhibitory effects of Paeonia lactiflora Pall seeds oil on elastase, collagenase and hyaluronidase were evaluated by biochemical techniques in vitro. Lastly, the hen's egg chorioallantoic membrane test (HET‐CAM) was conducted to confirm the absence of eye irritation caused by Paeonia lactiflora Pall seeds oil.

Results

Paeonia lactiflora Pall seeds oil within a certain volume concentration range (0.5%–4%) had no effect on the proliferation of B16F10 cells. Paeonia lactiflora Pall seeds oil showed significant inhibition of elastase, collagenase and hyaluronidase. Notably, the highest concentration tested, 4% Paeonia lactiflora Pall seed oil, yielded the most pronounced outcomes without causing any irritation.

Conclusion

A certain concentration of Paeonia lactiflora Pall seeds oil has a significant effect on decreasing the melanin content in B16F10 cells and inhibiting the activities of elastase, collagenase, and hyaluronidase, which can provide a reference for the development of pure natural cosmetics raw materials.
The effects of a real‐time temperature monitoring non‐ablative monopolar radiofrequency technology on vulvovaginal atrophy symptoms in postmenopausal Chinese women
Authors: Cheng Vivian , Chi‐Shing William Tai , Lee Athena , Lee Rita
Published: March 2024

Background

Vulvovaginal atrophy (VVA) includes a wide range of conditions affecting the reproductive and urinary systems, often requiring careful evaluation and management for optimal health.

Aims

This study aims to evaluate the symptom management effects of a real time temperature‐monitored non‐ablative RF device for the treatment of postmenopausal Chinese women with VVA symptoms.

Methods

This pilot study involved 24 postmenopausal Chinese women with one or more VVA symptoms, who wished to remain sexually active. VHIS, VAS, and FSFI were used to track and evaluate various aspects of the patient's condition. Analyses were conducted at the end of the study to verify the statistical significance of the treatment's results.

Results

All patients reported substantial, statistically significant, improvements on every VVA symptom tracked. Approximately 80% of the patients reported total symptom reversal at 12‐week post‐treatment follow‐up.

Conclusion

This pilot study demonstrated that non‐ablative, monopolar RF technology equipped with real time temperature monitoring is feasible and safe in the treatment of postmenopausal women with VVA symptoms, and efficacious at up to 12 weeks post‐treatment.
A pilot study on the efficacy of a seaweed mud application in the treatment of cellulite
Authors: Amuso Domenico , Medoro Alessandro , Scapagnini Giovanni , Gambacorta Angela , Davinelli Sergio , Iorio Eugenio Luigi , Bonetti Luca Reggiani , Sbarbati Andrea
Published: March 2024

Background

Cellulite represents a common multi‐factorial condition that affects nearly all women and is now recognized as a clinical condition associated with systemic factors and negative psychological effects. Several noninvasive and minimally invasive treatments were developed during the last few years, but limited evidence supports many of them due to lack of evidence, insufficient participants, and potential adverse effects.

Methods

This study aimed to evaluate the efficacy of a seaweed mud application in improving both the structure and function of tissues affected by cellulite. Sixty women with cellulite underwent 4‐week applications of seaweed mud on the buttocks and thighs. The following assessments were performed at baseline and after the last treatment: photographic, clinical, and anthropometric evaluation; tests for elasticity and hydration; ultrasonography of cellulite nodules; and cellulite biopsies in the trochanteric region. Patient satisfaction was assessed using a 5‐point Likert‐scale questionnaire.

Results

The treatment resulted in a significant improvement in the severity of cellulite severity between the initial assessment and the 4‐week follow‐up, with enhanced structure, elasticity, and hydration of the affected tissues. Microscopic analysis of the cellulite biopsies revealed a significant restoration of dermal organization with induced collagen synthesis and reduced inflammation, edema, and lipid deposition following the 4‐week seaweed mud applications. Additionally, the treatment led to a remarkable improvement in comfort and satisfaction as well as a reduction in body circumferences.

Conclusions

The cosmetic application of seaweed mud has proven to be a safe, non‐invasive treatment for improving the tissue alterations characteristic of cellulite.
Why moral psychology needs personality psychology
Authors: Sun Jessie , Smillie Luke D.
Published: March 2024

People vary in how they perceive, think about, and respond to moral issues. Clearly, we cannot fully understand the psychology of morality without accounting for individual differences in moral functioning. But decades of neglect of and explicit skepticism toward such individual differences has resulted in a lack of integration between moral psychology and personality psychology—the study of psychological differences between people. In recent years, these barriers to progress have started to break down. This special issue aims to celebrate and further increase the visibility of the personality psychology of morality. Here, we introduce the articles in this special issue by highlighting some important contributions a personality‐based perspective has to offer moral psychology—particularly in comparison to the currently prominent social psychological approach. We show that personality psychology is well‐placed to (a) contribute toward a rigorous empirical foundation for moral psychology, (b) tackle the conceptualization and assessment of stable moral tendencies, (c) assess the predictive validity of moral traits in relation to consequential outcomes, (d) uncover the mechanisms underlying individual differences in moral judgments and behavior, and (e) provide insights into moral development. For these reasons, we believe that moral psychology needs personality psychology to reach its full scholarly potential.
Use of fermented malted barley by‐product as partial feed replacement and carbon source for rearing Nile tilapia (Oreochromis niloticus) juveniles
Authors: Cabanillas‐Gámez Miguel , Gómez‐Cadena Juan , Galaviz Mario A. , de Oca Gustavo Alejandro Rodríguez‐Montes , Figueroa‐Saavedra Fernando , López Lus M. , Trejo‐Escamilla Idaly , Barreto‐Curiel Fernando , López‐Valencia Gilberto
Published: March 2024

The present research evaluates the performance of the Nile tilapia (Oreochromis niloticus) (initial weight 11.5 ± 0.07 g) with biofloc technology. For this purpose, spent grains (malted barley) from the brewing industry after aerobic fermentation were used, as both a carbon source (suspended solids) and partial substitute for the diets at 0, 10, 20, 30, and 40% levels (settleable solids). The partial 20% substitution of the diet did not have significant effects on the biological parameters: final body weight, weight gained, average body weight, specific growth rate, daily growth index, condition factor, feed conversion ratio, protein efficiency rate, and viscerosomatic and hepatosomatic indices. However, the dietary substitution showed a significant effect on the final biofloc chemical composition. Nitrogen compounds, NH4+, NO2−, and NO3−, were adequate for tilapia cultivation in all the treatments. No clear effect of partial dietary substitution was observed on meat quality parameters: pH, color, water holding capacity, and amino acid and fatty acid profile of fillet. The results suggest that a 20% substitution of the diet for malted barley is suitable for satisfactory biological parameters and Nile tilapia fillet quality.
Recipient age influences survival after liver transplant: Results of the French national cohort 2007–2017
Authors: Lerosey Lea , Ksiasek Elea , Abrahamowicz Michal , Antoine Corinne , Dharancy Sébastien , Dumortier Jérôme , Doussot Alexandre , Di Martino Vincent , Houssel‐Debry Pauline , Conti Filomena , Francoz Claire , Pageaux Georges‐Philippe , Salame Ephrem , Faitot François , Coilly Audrey , Hardwigsen Jean , Decaens Thomas , Chermak Faiza , Muscari Fabrice , Anty Rodolphe , Duvoux Christophe , Abergel Armand , Minello Anne , Mouillot Thomas , Binquet Christine , Latournerie Marianne
Published: March 2024

Background

In recent years, age at liver transplantation (LT) has markedly increased. In the context of organ shortage, we investigated the impact of recipient age on post‐transplantation mortality.

Methods

All adult patients who received a first LT between 2007 and 2017 were included in this cross‐sectional study. Recipients' characteristics at the time of listing, donor and surgery data, post‐operative complications and follow‐up of vital status were retrieved from the national transplantation database. The impact of age on 5‐year overall mortality post‐LT was estimated using a flexible multivariable parametric model which was also used to estimate the association between age and 10‐year net survival, accounting for expected age‐ and sex‐related mortality.

Results

Among the 7610 patients, 21.4% were aged 60–65 years, and 15.7% over 65. With increasing age, comorbidities increased but severity of liver disease decreased. Older recipient age was associated with decreased observed survival at 5 years after LT (p < .001), with a significant effect particularly during the first 2 years. The linear increase in the risk of death associated with age does not allow any definition of an age's threshold for LT (p = .832). Other covariates associated with an increased risk of 5‐year death were dialysis and mechanical ventilation at transplant, transfusion during LT, hepatocellular carcinoma and donor age. Ten‐year flexible net survival analysis confirmed these results.

Conclusion

Although there was a selection process for older recipients, increasing age at LT was associated with an increased risk of death, particularly in the first years after LT.
CaIAA2‐CaARF9 module mediates the trade‐off between pepper growth and immunity
Authors: Cai Weiwei , Tao Yilin , Cheng Xingge , Wan Meiyun , Gan Jianghuang , Yang Sheng , Okita Thomas W. , He Shuilin , Tian Li
Published: March 2024

To challenge the invasion of various pathogens, plants re‐direct their resources from plant growth to an innate immune defence system. However, the underlying mechanism that coordinates the induction of the host immune response and the suppression of plant growth remains unclear. Here we demonstrate that an auxin response factor, CaARF9, has dual roles in enhancing the immune resistance to Ralstonia solanacearum infection and in retarding plant growth by repressing the expression of its target genes as exemplified by Casmc4, CaLBD37, CaAPK1b and CaRROP1. The expression of these target genes not only stimulates plant growth but also negatively impacts pepper resistance to R. solanacearum. Under normal conditions, the expression of Casmc4, CaLBD37, CaAPK1b and CaRROP1 is active when promoter‐bound CaARF9 is complexed with CaIAA2. Under R. solanacearum infection, however, degradation of CaIAA2 is triggered by SA and JA‐mediated signalling defence by the ubiquitin‐proteasome system, which enables CaARF9 in the absence of CaIAA2 to repress the expression of Casmc4, CaLBD37, CaAPK1b and CaRROP1 and, in turn, impeding plant growth while facilitating plant defence to R. solanacearum infection. Our findings uncover an exquisite mechanism underlying the trade‐off between plant growth and immunity mediated by the transcriptional repressor CaARF9 and its deactivation when complexed with CaIAA2.
Unveiling the mechanism of source‐sink rebalancing in cucumber‐pumpkin heterografts: the buffering roles of rootstock cotyledon
Authors: Pu Dan , Wen Zheng‐Yang , Sun Jing‐Bo , Zhang Meng‐Xia , Zhang Feng , Dong Chun‐Juan
Published: March 2024

Grafting onto pumpkin rootstock is widely applied in cucumber production to improve growth and yield, as well as to overcome soil‐borne diseases and enhance resistance to abiotic stresses. In this study, we constructed the cucumber‐pumpkin heterografts with the one‐cotyledon grafting method, and examined the effects of heterografting on biomass allocation and sugar partitioning, with cucumber and pumpkin self‐grafts used as control. Compared with cucumber self‐grafts, heterografting onto pumpkin rootstock promoted photosynthesis in cucumber scion, and led to higher sucrose contents in the 1st true leaf (source) and newly emerged leaf (sink). Thereby, the scion part of heterografts accumulated more biomass than cucumber self‐grafts. In contrast, when compared to pumpkin self‐grafts, grafting with cucumber scion reduced root vigor and biomass but promoted cotyledon growth in pumpkin rootstock. The roots (sink) of heterografts contained less sucrose and hexoses, and showed reduced sucrose synthase (SuSy) and hexokinase (HXK) activities. However, the rootstock cotyledon (source) contained more sucrose and starch, and showed higher activities of HXK, cell‐wall invertase (CWIN), and enzymes for starch synthesis and degradation. Furthermore, removal or shade of rootstock cotyledon led to reduced growth of root and scion. Silencing of CmoMEX1a gene in rootstock cotyledon inhibited maltose export and reduced root growth of heterografts. These results indicated that rootstock cotyledon, especially its starch content, played a buffering role in the growth regulation of cucumber‐pumpkin heterografts. Taken together, our results provided a major contribution to our understanding of source‐sink sugar partitioning and scion‐rootstock growth balancing in cucumber‐pumpkin heterografts.
Measured leaf dark respiratory CO2‐release is not controlled by stomatal conductance
Authors: Bruhn Dan , Faber Andreas H. , Cristophersen Kaare Sloth , Nielsen Jakob Svanekær , Griffin Kevin L.
Published: March 2024

Leaf dark respiratory CO2‐release (RD) is, according to some literature, dependent on the rate of leaf transpiration. If this is true, then at a given vapor pressure deficit, the leaf stomatal conductance (gs) will be expected to be a controlling factor of measured RD at any given time. We artificially lowered leaf gs by applying abscisic acid (ABA). Although leaf RD generally covaried temporally with gs, artificially lowering gs by applying ABA does not affect the measured leaf RD. These results indicate that observed diel fluctuations in gs are not directly influencing the measured leaf RD, thereby simplifying both future studies and the interpretation of past studies of the underlying environmental‐ and physiological drivers of temporal variation in leaf RD.
Beyond the scenery: Understanding the impact of rural tourism development on household consumption in China
Authors: Wei Binhui , Zhao Chunkai , Luo Mingzhong , Jia Zhimin , Xia Hailong
Published: March 2024

The positive effects of rural tourism are widely recognized, yet its influence on local household consumption has been insufficiently explored. Our study fills this gap by investigating the relationship between rural tourism development and household consumption, using the Leisure Agriculture and Rural Tourism Demonstration County (LARTDC) policy as a quasi‐natural experiment framework. Employing a staggered difference‐in‐differences (DID) method, we found that rural tourism development contributes to a 4.91% increase in per capita household consumption. The robustness of our main results is confirmed using advanced techniques such as Bacon decomposition and DIDM estimations. We attributed this positive impact to the rise in nonfarm employment and infrastructure development. Our heterogeneity analysis further reveals the inclusive nature of rural tourism, showing its significant role in improving household consumption patterns, diminishing consumption inequality, and enhancing welfare, especially in disadvantaged rural households. Further analysis confirms that greater LARTDC policy exposure may lead to higher levels of household consumption. Moreover, we revealed that rural tourism increased the freedom of employment, especially for the elderly and women; however, it did not squeeze out leisure time or hurt the quality of life and welfare. Theoretically, this study contributes to the discourse on tourism's role in fostering economic growth and social equity, addressing the patterns of high savings and low consumption in rural China. Practically, our findings suggest that post‐COVID‐19 recovery strategies in developing countries may emphasize rural tourism development, aiming to stimulate household spending and achieve balanced growth.
Surprise RNA paints colorful patterns on butterfly wings
Authors: Pennisi Elizabeth
Published: March 2024

Understudied means of regulating genes is likely widespread in butterflies—and perhaps other animals
Final spending bills offer gloomy outlook for science
Authors:   Science News Staff
Published: March 2024

Congress makes sizable cuts at key funding agencies
Skin side effects stymie advance of HIV vaccine
Authors: Cohen Jon
Published: March 2024

Strategy of using multiple mRNA shots to hone powerful antibodies hits a pothole
Implementation of a high-throughput whole genome sequencing approach with the goal of maximizing efficiency and cost effectiveness to improve public health
Authors: Dickinson Michelle C. , Wirth Samantha E. , Baker Deborah , Kidney Anna M. , Mitchell Kara K. , Nazarian Elizabeth J. , Shudt Matthew , Thompson Lisa M. , Gubbala Venkata Sai Laxmi , Musser Kimberlee A. , Mingle Lisa
Published: March 2024

This manuscript describes the development of a streamlined, cost-effective laboratory workflow to meet the demands of increased whole genome sequence (WGS) capacity while achieving mandated quality metrics. From 2020 to 2021, the Wadsworth Center Bacteriology Laboratory (WCBL) used a streamlined workflow to sequence 5,743 genomes that contributed sequence data to nine different projects. The combined use of the QIAcube HT, Illumina DNA Prep using quarter volume reactions, and the NextSeq allowed the WCBL to process all samples that required WGS while also achieving a median turn-around time of 7 days (range 4 to 10 days) and meeting minimum sequence quality requirements. Public Health Laboratories should consider implementing these methods to aid in meeting testing requirements within budgetary restrictions.

IMPORTANCE

Public Health Laboratories that implement whole genome sequencing (WGS) technologies may struggle to find the balance between sample volume and cost effectiveness. We present a method that allows for sequencing of a variety of bacterial isolates in a cost-effective manner. This report provides specific strategies to implement high-volume WGS, including an innovative, low-cost solution utilizing a novel quarter volume sequencing library preparation. The methods described support the use of high-throughput DNA extraction and WGS within budgetary constraints, strengthening public health responses to outbreaks and disease surveillance.
The Proteome of Extracellular Membrane Vesicles from Bacillus pumilus 3-19
Authors: Kurdy W. , Zelenikhin P. V. , Yakovleva G. Yu. , Sinyagina M. N. , Kolpakov A. I. , Ilinskaya O. N.
Published: March 2024

Abstract—Production of extracellular membrane vesicles plays an important role in communication in bacterial populations and in bacteria–host interactions. Vesicles as carriers of various regulatory and signaling molecules may be potentially used as disease biomarkers and promising therapeutic agents, including vaccine preparations. The composition of membrane vesicles has been deciphered for a limited number of Gram-negative and Gram-positive bacteria. In this work, for the first time, extracellular membrane vesicles of a streptomycin-resistant strain Bacillus pumilus 3-19, a producer of extracellular guanyl-preferring ribonuclease binase, are isolated, visualized, and characterized by their genome and proteome composition. It has been established that there is no genetic material in the vesicles and the spectrum of the proteins differs depending on the phosphate content in the culture medium of the strain. Vesicles from a phosphate-deficient medium carry 49 unique proteins in comparison with 101 from a medium with the high phosphate content. The two types of vesicles had 140 mutual proteins. Flagellar proteins, RNase J, which is the main enzyme of RNA degradosomes, phosphatases, peptidases, iron transporters, signal peptides, were identified in vesicles. Antibiotic resistance proteins and amyloid-like proteins whose genes are present in B. pumilus 3-19 cells are absent. Phosphate deficiency-induced binase was found only in vesicles from a phosphate-deficient medium.
Immunocompromised teenager with meningitis caused byUreaplasma parvum
Authors: Ehrnström Birgitta , Haugan Maria Schei , Andreasen Jo Bønding , Ellingsen Asbjørn
Published: March 2024

Infection in the immunocompromised patient is often challenging on multiple levels. It can be difficult to distinguish between manifestations of the underlying disease, infection or malignancy. Symptoms may be vague or even absent, deviations in the common inflammatory parameters discrete, imaging findings scarce and the causative microbe may be a true pathogen as well as opportunistic. Here, we report an immunosuppressed female in her late teens with a purulent meningitis due toUreaplasma parvum—a very rare cause of infection in the central nervous system of adults. We wish to highlight the relevance of intracellular pathogens and the need to actively search for these microbes, especially when response to broad-spectrum antibiotic treatment is absent. Furthermore, we emphasise the need for adequate molecular microbial diagnostics in search of microbes that are difficult to identify by culture and where serology and antigen tests may be absent or unreliable due to immune suppression.
Maternal and perinatal health research during emerging and ongoing epidemic threats: a landscape analysis and expert consultation
Authors: Bonet Mercedes , Babinska Magdalena , Buekens Pierre , Goudar Shivaprasad S , Kampmann Beate , Knight Marian , Meaney-Delman Dana , Lamprianou Smaragda , Rivas Flor Muñoz , Stergachis Andy , Toscano Cristiana M , Bhatia Joycelyn , Chamberlain Sarah , Chaudhry Usman , Mills Jacqueline , Serazin Emily , Short Hannah , Steene Asher , Wahlen Michael , Oladapo Olufemi T
Published: March 2024

Introduction

Pregnant women and their offspring are often at increased direct and indirect risks of adverse outcomes during epidemics and pandemics. A coordinated research response is paramount to ensure that this group is offered at least the same level of disease prevention, diagnosis, and care as the general population. We conducted a landscape analysis and held expert consultations to identify research efforts relevant to pregnant women affected by disease outbreaks, highlight gaps and challenges, and propose solutions to addressing them in a coordinated manner.

Methods

Literature searches were conducted from 1 January 2015 to 22 March 2022 using Web of Science, Google Scholar and PubMed augmented by key informant interviews. Findings were reviewed and Quid analysis was performed to identify clusters and connectors across research networks followed by two expert consultations. These formed the basis for the development of an operational framework for maternal and perinatal research during epidemics.

Results

Ninety-four relevant research efforts were identified. Although well suited to generating epidemiological data, the entire infrastructure to support a robust research response remains insufficient, particularly for use of medical products in pregnancy. Limitations in global governance, coordination, funding and data-gathering systems have slowed down research responses.

Conclusion

Leveraging current research efforts while engaging multinational and regional networks may be the most effective way to scale up maternal and perinatal research preparedness and response. The findings of this landscape analysis and proposed operational framework will pave the way for developing a roadmap to guide coordination efforts, facilitate collaboration and ultimately promote rapid access to countermeasures and clinical care for pregnant women and their offspring in future epidemics.
State-level variation in distribution of oxycodone and opioid-related deaths from 2000 to 2021: an ecological study of ARCOS and CDC WONDER data in the USA
Authors: Solgama Jay P , Liu Edward , Davis Mellar , Graham Jove , McCall Kenneth L , Piper Brian J
Published: March 2024

Objectives

This study aims to characterise oxycodone’s distribution and opioid-related overdoses in the USA by state from 2000 to 2021.

Design

This is an observational study.

Setting

More than 80 000 Americans died of an opioid overdose in 2021 as the USA continues to struggle with an opioid crisis. Prescription opioids play a substantial role, introducing patients to opioids and providing a supply of drugs that can be redirected to those seeking to misuse them.

Methods

The Drug Enforcement Administration annual summary reports from the Automation of Reports and Consolidated Orders System provided weights of oxycodone distributed per state by business type (pharmacies, hospitals and practitioners). Weights were converted to morphine milligram equivalents (MME) per capita and normalised for population. The Centers for Disease Control and Prevention Wide-ranging ONline Data for Epidemiologic Research provided mortality data for heroin, other opioids, methadone, other synthetic narcotics and other/unspecified narcotics.

Results

There was a sharp 280.13% increase in total MME/person of oxycodone from 2000 to 2010, followed by a slower 54.34% decrease from 2010 to 2021. Florida (2007–2011), Delaware (2003–2020) and Tennessee (2012–2021) displayed consistent and substantial elevations in combined MME/person compared with other states. In the peak year (2010), there was a 15-fold difference between the highest and lowest states. MME/person from only pharmacies, which constituted >94% of the total, showed similar results. Hospitals in Alaska (2000–2001, 2008, 2010–2021), Colorado (2008–2021) and DC (2000–2011) distributed substantially more MME/person over many years compared with other states. Florida stood out in practitioner-distributed oxycodone, with an elevation of almost 15-fold the average state from 2006 to 2010. Opioid-related deaths increased +806% from 2000 to 2021, largely driven by heroin, other opioids and other synthetic narcotics.

Conclusions

Oxycodone distribution across the USA showed marked differences between states and business types over time. Investigation of opioid policies in states of interest may provide insight for future actions to mitigate opioid misuse.
Evaluations of virtual exercise programmes for adults with mobility limitations: a scoping review protocol incorporating an equity lens to inform the development of strategies to optimise participation of under-represented groups
Authors: dos Santos Renato Barbosa , Lin Jing , Badwal Anchal , Singh Hardeep , Jaglal Susan Brenda , Sperling Christina , Salbach Nancy Margaret
Published: March 2024

Introduction

For individuals with mobility limitations, virtual exercise programmes can address the challenges of in-person participation in community exercise programmes. A synthesis of studies of virtual exercise programmes targeting mobility limitations provided outside of conventional rehabilitation services and strategies used to optimise equitable access and inclusivity in these programmes is lacking. We aim to characterise evaluations of virtual exercise programmes for adults with mobility limitations, and the nature of and extent to which equity, diversity and inclusion considerations are integrated in the research process.

Methods and analysis

A scoping review following a six-stage methodological framework, including a consultation exercise, is proposed. A comprehensive strategy will be used to search Medline, Embase, PEDro, CINAHL and Scopus to identify peer-reviewed studies evaluating virtual exercise programmes for adults with mobility limitations living in the community. Three trained reviewers will select studies independently. Data (eg, study methodology, programme structure and content, participant characteristics) will be extracted using a standardised form, and collated and summarised using quantitative and qualitative methods. The PROGRESS-Plus and International Classification of Functioning, Disability and Health frameworks will be used to classify participant characteristics and study outcomes, respectively. During the consultation exercise, key knowledge users, including exercise participants, programme providers and coordinators, and members of community organisations for persons living with disabilities and under-represented groups, will be asked to provide insights regarding the applicability of review findings. A directed content analysis of data from the consultation exercise will be performed.

Ethics and dissemination

The research ethics board at the University of Toronto approved the consultation exercise. Findings will be disseminated through peer-reviewed publications and conference presentations. Findings will enhance understanding of current research evaluating virtual exercise programmes and inform future research and strategies for promoting equitable access and outcomes for individuals with mobility limitations.

Registration details

https://doi.org/10.17605/OSF.IO/X5JMA.
Prognostic and clinicopathological significance of the Controlling Nutritional Status (CONUT) score in patients with lymphoma: a meta-analysis
Authors: Li Lili , Shou Lihong
Published: March 2024

Objectives

The role of the Controlling Nutritional Status (CONUT) scores in predicting the prognosis of lymphoma cases has been extensively explored, with no consistent results. The present meta-analysis focused on accurately evaluating whether CONUT could be used to predict the prognosis of lymphoma cases and its clinicopathological value.

Design

The present meta-analysis was reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The prognostic significance of CONUT to overall survival (OS) and progression-free survival (PFS) in lymphoma was estimated by calculating pooled HRs with 95% CIs. The relationship between CONUT and clinicopathological characteristics was measured based on pooled ORs with 95% CIs.

Data sources

PubMed, Web of Science, Embase and Cochrane Library databases were comprehensively searched from inception through 24 March 2023.

Statistical methods

Either a random-effects model or a fixed-effects model was selected depending on the level of heterogeneity among the included studies.

Results

This meta-analysis enrolled seven articles, containing 2060 patients with lymphoma. According to the pooled analysis, a higher CONUT score significantly predicted poor OS (HR=1.94, 95% CI 1.46 to 2.57, p<0.001) as well as poorer PFS (HR=1.51, 95% CI 1.04 to 2.20, p=0.031). Furthermore, according to the combined analysis, a higher CONUT score was significantly associated with Ann Arbor stages III–IV (OR=3.75, 95% CI 2.96 to 4.75, p<0.001), an Eastern Cooperative Oncology Group performance status of 2–4 (OR=5.14, 95% CI 3.97 to 6.65, p<0.001), high-intermediate/high National Comprehensive Cancer Network International Prognostic Index (OR=8.05, 95% CI 5.11 to 12.66, p<0.001), B symptoms (OR=4.97, 95% CI 2.89 to 8.52, p<0.001), extranodal disease (OR=3.25, 95% CI 2.24 to 4.70, p<0.001), bone marrow involvement (OR=4.86, 95% CI 3.25 to 7.27, p<0.001) and elevated lactate dehydrogenase levels (OR=3.21, 95% CI 2.37 to 4.34, p<0.001).

Conclusions

According to our results, higher CONUT scores were significantly associated with poor OS and PFS in lymphoma.
Attrition from longitudinal ageing studies and performance across domains of cognitive functioning: an individual participant data meta-analysis
Authors: Hernandez Raymond , Jin Haomiao , Lee Pey-Jiuan , Schneider Stefan , Junghaenel Doerte U , Stone Arthur A , Meijer Erik , Gao Hongxin , Maupin Daniel , Zelinski Elizabeth M
Published: March 2024

Objectives

This paper examined the magnitude of differences in performance across domains of cognitive functioning between participants who attrited from studies and those who did not, using data from longitudinal ageing studies where multiple cognitive tests were administered.

Design

Individual participant data meta-analysis.

Participants

Data are from 10 epidemiological longitudinal studies on ageing (total n=209 518) from several Western countries (UK, USA, Mexico, etc). Each study had multiple waves of data (range of 2–17 waves), with multiple cognitive tests administered at each wave (range of 4–17 tests). Only waves with cognitive tests and information on participant dropout at the immediate next wave for adults aged 50 years or older were used in the meta-analysis.

Measures

For each pair of consecutive study waves, we compared the difference in cognitive scores (Cohen’s d) between participants who dropped out at the next study wave and those who remained. Note that our operationalisation of dropout was inclusive of all causes (eg, mortality). The proportion of participant dropout at each wave was also computed.

Results

The average proportion of dropouts between consecutive study waves was 0.26 (0.18 to 0.34). People who attrited were found to have significantly lower levels of cognitive functioning in all domains (at the wave 2–3 years before attrition) compared with those who did not attrit, with small-to-medium effect sizes (overall d=0.37 (0.30 to 0.43)).

Conclusions

Older adults who attrited from longitudinal ageing studies had lower cognitive functioning (assessed at the timepoint before attrition) across all domains as compared with individuals who remained. Cognitive functioning differences may contribute to selection bias in longitudinal ageing studies, impeding accurate conclusions in developmental research. In addition, examining the functional capabilities of attriters may be valuable for determining whether attriters experience functional limitations requiring healthcare attention.
Results from a cross-specialty consensus on optimal management of patients with chronic kidney disease (CKD): from screening to complications
Authors: Arici Mustafa , Assaad-Khalil Samir Helmy , Bertoluci Marcello Casaccia , Choo Jason , Lee Yau-Jiunn , Madero Magdalena , Rosa Diez Guillermo Javier , Sánchez Polo Vicente , Chung Sungjin , Thanachayanont Teerawat , Pollock Carol
Published: March 2024

Background

Chronic kidney disease (CKD) affects around 10% of the global population and has been estimated to affect around 50% of individuals with type 2 diabetes and 50% of those with heart failure. The guideline-recommended approach is to manage with disease-modifying therapies, but real-world data suggest that prescribing rates do not reflect this in practice.

Objective

To develop a cross-specialty consensus on optimal management of the patient with CKD using a modified Delphi method.

Design

An international steering group of experts specialising in internal medicine, endocrinology/diabetology, nephrology and primary care medicine developed 42 statements on aspects of CKD management including identification and screening, risk factors, holistic management, guidelines, cross-specialty alignment and education. Consensus was determined by agreement using an online survey.

Participants

The survey was distributed to cardiologists, nephrologists, endocrinologists and primary care physicians across 11 countries.

Main outcomes and measures

The threshold for consensus agreement was established a priori by the steering group at 75%. Stopping criteria were defined as a target of 25 responses from each country (N=275), and a 4-week survey period.

Results

274 responses were received in December 2022, 25 responses from Argentina, Australia, Brazil, Guatemala, Mexico, Singapore, South Korea, Taiwan, Thailand, Turkey and 24 responses from Egypt. 53 responses were received from cardiologists, 52 from nephrologists, 55 from endocrinologists and 114 from primary care physicians. 37 statements attained very high agreement (≥90%) and 5 attained high agreement (≥75% and <90%). Strong alignment between roles was seen across the statements, and different levels of experience (2–5 years or 5+ years), some variation was observed between countries.

Conclusions

There is a high degree of consensus regarding aspects of CKD management among healthcare professionals from 11 countries. Based on these strong levels of agreement, the steering group derived 12 key recommendations focused on diagnosis and management of CKD.
Impacts of armed conflicts on tuberculosis burden and treatment outcomes: a systematic review
Authors: Gebreyohannes Eyob Alemayehu , Wolde Haileab Fekadu , Akalu Temesgen Yihunie , Clements Archie C A , Alene Kefyalew Addis
Published: March 2024

Objectives

This systematic review aimed to summarise existing literature on the impacts of armed conflicts on tuberculosis burden and treatment outcomes.

Design

A systematic review following the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines.

Data sources

PubMed, Web of Science, Cumulative Index to Nursing and Allied Health Literature Plus, Scopus, ScienceDirect, Embase and medRxiv.

Data extraction and synthesis

Three reviewers independently screened, selected eligible studies and extracted data. A narrative review was undertaken to summarise the findings qualitatively.

Results

Eleven studies were included in this review, reporting on tuberculosis incidence rates, prevalence and treatment outcomes, including mortality. Overall, the impact of armed conflicts on case notifications was variable. Six studies reported overall increases in tuberculosis case notifications following the onset of conflicts, while three studies reported overall decreases in tuberculosis case notifications. Factors, including limited access to healthcare services, challenges in surveillance and laboratory confirmation, the destruction of health systems and incapacitating the healthcare workforce, contributed to a decrease in the number of notified cases. The higher tuberculosis notification in some of the studies could be attributed to the disruption of tuberculosis prevention and control programmes as well as increased socioeconomic deprivation, including malnutrition, mass migration, poor living conditions and overcrowding that are worsened during conflicts. Armed conflicts without effective interventions were associated with worse tuberculosis treatment outcomes, including lower proportions of people with treatment success and higher proportions of people with loss to follow-up, mortality and treatment failure. However, implementing various interventions in conflict settings (such as establishing a National Tuberculosis Control Programme) led to higher tuberculosis notification rates and treatment success.

Conclusion

The impact of armed conflicts on tuberculosis notification is complex and is influenced by multiple factors. The findings of this review underscore the importance of concerted efforts to control tuberculosis in conflict settings using available resources.
Astigmatism and maternal myopia as important factors affecting success rate of DIMS lens treatment
Authors: Domsa Patricia , Bankó Éva M , Körtvélyes Judit , Meigen Christof , Széchey Rita , Lantos Krisztina , Nagy Zoltán Zsolt , Csutak Adrienne
Published: March 2024

Objective

To assess the efficacy of myopia control spectacle lenses (defocus incorporated multiple segments/DIMS) in slowing myopia progression among a diverse Central European paediatric population and investigate the contribution of baseline parameters on treatment outcomes.

Methods and analysis

This retrospective observational study included 62 individuals aged 4–17 years (mean±SD: 10.21±2.70) with progressing myopia but without ocular pathology with a range of −0.88 to −8.25 D spherical equivalent refraction (SER) (−3.73±1.56), coupled with astigmatism up to −3.25 D cylindrical. All participants were prescribed DIMS (Hoya MiyoSmart) spectacles. Key outcome variables were cycloplegic SER, measured for all participants and axial length (AL), assessed in a subset of patients, recorded at baseline, 6 months and 12 months. Quality of life assessments were conducted at baseline, at 2 weeks, and 3, 6, 9 and 12 months. Additionally, parental myopic dioptre was recorded when applicable.

Results

At the 12-month mark, myopia progression in patients (mean±SE: −0.40±0.05) mirrored findings from prior European DIMS studies, but with 50% of patients showing no progression. A multivariate analysis of covariance model revealed that baseline astigmatism and younger age adversely affected therapy outcomes in both SER and AL, while severe maternal myopia led to greater SER progression. In contrast, only young age but not astigmatism was associated with AL increase in a comparable group of children with myopia, part of the LIFE Child Study, wearing single-vision spectacles. Patients reported consistent satisfaction with treatment, with minimal side effects, which diminished over the year.

Conclusion

In the European population, astigmatism, young age and severe maternal myopia are risk factors for suboptimal outcomes following DIMS therapy. Further research is necessary to elucidate the impact of astigmatism on myopic defocus therapy.
Relative energy deficiency in dance (RED-D): a consensus method approach to REDs in dance
Authors: Allen Nick , Kelly Shane , Lanfear Martin , Reynolds Andy , Clark Richard , Mountjoy Margo Lynn , Wyon Matthew , Wolman Roger
Published: March 2024

Relative energy deficiency in sport (REDs) is a potentially severe, challenging, broad-spectrum syndrome with potential negative health and performance outcomes. The numerous research publications and International Olympic Committee consensus statements relating to REDs testify to the challenges faced in early identification or screening, diagnosis and management. Like sport, dance, in its simplest form, can be identified as an activity resulting in physiological energy demands and, as such, requires appropriate energy availability concerning energy expenditures. However, the specificity of physiological and psychological demands in dance must be considered when considering REDs. An environment where physical activity can exceed 30 hours per week and where culture may instil a value that thinness is required puts dancers at increased risk for REDs. The purpose of this study was to provide dance-specific guidance dance on this complex condition. An RAND/UCLA Delphi Panel method with nominal group technique was used to review the literature from REDs to evaluate how it may relate to dance. In addition to the EP, which was assembled from a multidisciplinary background with expertise in REDs and multiple genres of dance, six focus groups were commissioned. Four of the focus groups were drawn from the EP members and two additional focus groups formed by dancers and artistic leaders. These panels were used to guide the development of a RED-D diagnosis pathway, management plan and risk stratification and return to dance pathway. The dance-specific pathways are designed to be a practical tool for guiding and supporting clinicians managing RED-D. Furthermore, this paper represents an important focus of this area in dance and serves to stimulate discussion and further research within the sector.