bluuebunny/crossref_metadata_2025 huggingface dataset:
A study on the cross-platform influence mechanism of physicians’ live streaming behavior on performance
Authors: Chen Chen , Wu Hong
Published: April 2024

Purpose

The advent of online live streaming platforms (OLSPs) and online health communities (OHCs) has expedited the integration of traditional medical services with Internet new media technology. Since the practice of physicians conducting live streaming is a relatively new phenomenon, the potential cross-platform effects of such physicians’ live streaming have not received adequate attention.

Design/methodology/approach

This study collected data from 616 physicians specializing in cardiology, obstetrics and gynecology and neurology between April and November 2022 on Live.Baidu.com and WeDoctor.com. It constructed a panel data set comprising a total of 4,928 observations over an 8-month period and validated the model using empirical analysis with the fixed-effects method.

Findings

We find evidence of cross-platform influence in online healthcare. Physicians’ live streaming behavior (whether live or not and the heat of their streams) on OLSPs positively impacts both their consultation and reputation on OHCs. Additionally, physicians’ ability positively moderates the relationships between live streaming heat and their performance (in terms of consultation volume and reputation) on OHCs. However, ability does not moderate the relationship between physicians’ live streaming status (live or not) and their performance (in terms of consultation and reputation) on OHCs. Furthermore, the attractive appearance of the physicians also significantly moderates the impact in a positive way.

Originality/value

This is one of the pioneering studies on physicians’ live streaming. The study offers vital guidance for physicians and patients utilizing dual platforms and holds significant reference value for platform operators (such as OLSPs and OHCs) aiming to optimize platform operations and for the government in policy formulation and industry regulation.
The evolution of sustainability accounting and reporting in the United States: applications of the ecological anthropology and industrial ecology frameworks
Authors: Sisaye Seleshi , Birnberg Jacob G.
Published: April 2024

Purpose

The primary objective of this research is to chronicle how the Environmental Protection Agency (EPA) and other United States Federal Government Agencies (USFGA) agencies have played a role in shaping the trajectory of financial reporting for sustainability, with a particular emphasis on triple bottom line (TBL). This exploration extends to other indexes reporting sustainability data encompassed within financial, social and environmental reporting.

Design/methodology/approach

This study adopts an illustrative methodology, utilizing data sourced from governmental, business and international organizational documents.

Findings

Sustainability accounting predominantly finds its place within the framework of TBL. However, it is crucial to note that sustainability reporting remains voluntary rather than mandatory. Nevertheless, accounting firms and professional accounting societies have embraced it as a supplementary facet of financial accounting reporting.

Originality/value

The research highlights the historical evolution of sustainability within the USFGA and corporate entities. Corporations’ interest in accounting for sustainability performances has significantly contributed to the emergence of voluntary sustainability accounting rules, as embodied by the TBL.
Is tax avoidance one of the purposes of financial data manipulation? The case of Romania
Authors: Lucut Capras Isabella , Achim Monica Violeta , Mara Eugenia Ramona
Published: April 2024

Purpose

Companies avoid taxes in a variety of ways and use different methods to do that, one of the most common being earnings management. The purpose of this paper is to investigate whether companies manipulate their financial data in order to reduce taxes paid.

Design/methodology/approach

We considered a sample of 63 listed Romanian companies for the period 2016–2021. The Beneish model was used for estimating earnings management, and the effective tax rate was used to measure tax avoidance. The analysis was carried out using regression analysis in Stata13 software.

Findings

The findings of the research indicate a negative and statistically significant association between effective tax rate and earnings management, implying that one of the main reasons why companies manipulate their earnings to reduce tax burden and avoid taxes. Moreover, our results show that return on assets (ROA) has a statistically significant negative influence on the effective tax rate. Furthermore, our analysis reveals that firm size, growth, and Big4 audit have no effect on effective tax rate.

Research limitations/implications

Because it analyzes concrete cases using financial data and provides some recommendations for addressing the issue of tax avoidance, this work is useful in advancing both quantitative and qualitative research on this topic. This research is relevant for businesses, governments, regulators, audit professionals and investors.

Originality/value

The study, by analyzing concrete cases using reported financial data, contributes in filling the gap within the literature that results from a lack of scientific research on the relationship between tax avoidance and earnings management, and then it clarifies the nature of the causal connection between them. Moreover, it considers a combination of firm related variables including performance, size and also audit quality.
Design and analysis of solid ankle foot orthosis by employing mechanical characterization and a low-cost scanning approach for additive manufacturing
Authors: Abas Muhammad , Habib Tufail , Noor Sahar
Published: April 2024

Purpose

This study aims to investigate the fabrication of solid ankle foot orthoses (SAFOs) using fused deposition modeling (FDM) printing technology. It emphasizes cost-effective 3D scanning with the Kinect sensor and conducts a comparative analysis of SAFO durability with varying thicknesses and materials, including polylactic acid (PLA) and carbon fiber-reinforced (PLA-C), to address research gaps from prior studies.

Design/methodology/approach

In this study, the methodology comprises key components: data capture using a cost-effective Microsoft Kinect® Xbox 360 scanner to obtain precise leg dimensions for SAFOs. SAFOs are designed using CAD tools with varying thicknesses (3, 4, and 5 mm) while maintaining consistent geometry, allowing controlled thickness impact investigation. Fabrication uses PLA and PLA-C materials via FDM 3D printing, providing insights into material suitability. Mechanical analysis uses dual finite element analysis to assess force–displacement curves and fracture behavior, which were validated through experimental testing.

Findings

The results indicate that the precision of the scanned leg dimensions, compared to actual anthropometric data, exhibits a deviation of less than 5%, confirming the accuracy of the cost-effective scanning approach. Additionally, the research identifies optimal thicknesses for SAFOs, recommending a 4 and 5 mm thickness for PLA-C-based SAFOs and an only 5 mm thickness for PLA-based SAFOs. This optimization enhances the overall performance and effectiveness of these orthotic solutions.

Originality/value

This study’s innovation lies in its holistic approach, combining low-cost 3D scanning, 3D printing and computational simulations to optimize SAFO materials and thickness. These findings advance the creation of cost-effective and efficient orthotic solutions.
Sex differences in neural response to an acute stressor in individuals with an alcohol use disorder
Authors: Grodin Erica N. , Kirsch Dylan , Belnap Malia , Ray Lara A.
Published: April 2024

Background

Alcohol use disorder (AUD) and stress influence overlapping neural circuits in the brain. The literature is mixed regarding the presence of sex differences in the neural response to acute stressors, and this issue has not been examined in individuals with AUD. We validated a stress functional magnetic resonance imaging (fMRI) paradigm in individuals with AUD and tested for sex differences.

Methods

Twenty‐five treatment‐seeking individuals with AUD (15M/10F) were recruited to participate in the neuroimaging study linked to a clinical trial of ibudilast (NCT03594435). To assess social‐evaluative stress, participants completed the Montreal Imaging Stress Task (MIST). Whole brain and amygdala region‐of‐interest analyses were conducted. Subjective ratings of anxiety and distress were collected. Repeated measures ANCOVAs were performed to evaluate the effect of stress on anxiety and distress and to evaluate sex differences.

Results

There were trend‐level effects of stress on anxiety ratings and amygdala activation (p's = 0.06). There was a significant effect of stress in the bilateral thalamus, ventral tegmental area, and paracingulate (Z's > 4.09, p's < 0.03). There was a trend‐level effect of sex on subjective ratings of stress (p's = 0.07). Females had higher amygdala activation in response to stress (p = 0.02). Females also had greater activation than males in the precuneus, posterior cingulate cortex, and right inferior frontal gyrus during acute stress (Z's > 3.56, p's < 0.03).

Conclusions

This study provides an initial validation of the MIST in a sample of individuals with AUD. It also provides preliminary evidence of sex differences in the response to social‐evaluative stress, which is important, given the relevance of stress and negative emotionality as motivators for alcohol use in females.
Insulin‐like growth factor‐1 promotes the testicular sperm production by improving germ cell survival and proliferation in high‐fat diet‐treated male mice
Authors: Liu Guoqiang , Liu Di , Zhu Minggang , Zhang Mingrui , Li Chunyang , Xu Xiaohong , Pan Feng
Published: April 2024

Background

A decrease in semen volume among men is comparable to the rising prevalence of obesity worldwide. The anabolic hormone insulin‐like growth factor‐1 (IGF‐1) can promote proliferation and differentiation in cultured mouse spermatogonial stem cells and alleviate abnormal in vitro spermatogenesis. Additionally, serum IGF‐1 level is negatively correlated with body mass index. Whereas the role of IGF‐1 in the sperm production in obese men remains unclear.

Objective

To investigate the therapeutic effect and potential mechanism of IGF‐1 on spermatogenesis of high‐fat diet (HFD)‐induced obesity mice.

Methods

An HFD‐induced obesity mouse model was established. Alterations in testicular morphology, sperm count, proliferation, and apoptosis were observed by H&E staining,immunohistochemistry, immunofluorescence, and Western blotting. Exogenous recombinant IGF‐1 was administered to obese mice to investigate the correlations between altered testicular IGF‐1 levels and sperm production.

Results

The sperm count was reduced, the testicular structure was disordered, and sex hormone levels were abnormal in HFD‐fed mice compared with normal diet‐fed mice. The expression of proliferation‐related antigens such as proliferating cell nuclear antigen (PCNA) and Ki‐67 was decreased, while that of proapoptotic proteins such as c‐caspase3 was increased in testes from HFD‐fed mice. Most importantly, the phosphorylation of insulin‐like growth factor‐1 receptor (IGF‐1R) in testes was decreased due to reductions in IGF‐1 from hepatocytes and Sertoli cells. Recombinant IGF‐1 alleviated these functional impairments by promoting IGF‐1R, Akt, and Erk1/2 phosphorylation in the testes.

Conclusions

Insufficient IGF‐1/IGF‐1R signaling is intimately linked to damaged sperm production in obese male mice. Exogenous IGF‐1 can improve survival and proliferation as well as sperm production. This study provides a novel theoretical basis and a target for the treatment of obese men with oligozoospermia.
Shared risk and shared responsibility: the ethics of male contraceptives
Authors: Campelia Georgina D. , Adashi Eli Y. , Amory John K.
Published: April 2024

Introduction

Efforts to develop reversible male contraceptives analogous to female oral contraceptives are underway and may be introduced in the next decade. The advent of novel male contraceptives provides an opportunity for an ethical reformulation of the contraceptive paradigm given the relational, rather than individual, nature of sexual relationships, and family planning. For individuals in any sexual relationship that could result in pregnancy, issues of reproductive autonomy, freedom, equality in reproductive decision‐making and risks—both of side effects and of unintended pregnancies—are significant. Historically, however, women have been attributed the greatest responsibilities simultaneously with the most restrictions on their freedom of choice and access to reproductive care.

Objectives

In this paper, we extend our prior “shared risk” model of male contraception to one of “shared risk and responsibility” to ethically inform this discourse.

Conclusions

This updated framework more fully captures the complexity of this novel technology and may be of use to regulatory and legal agencies grappling with an intervention that poses medical risks to the member of the relationship who does not face risks of becoming pregnant.
Early warning signals observed in motor activity preceding mood state change in bipolar disorder
Authors: Jakobsen Petter , Côté‐Allard Ulysse , Riegler Michael Alexander , Stabell Lena Antonsen , Stautland Andrea , Nordgreen Tine , Torresen Jim , Fasmer Ole Bernt , Oedegaard Ketil Joachim
Published: April 2024

Introduction

Alterations in motor activity are well‐established symptoms of bipolar disorder, and time series of motor activity can be considered complex dynamical systems. In such systems, early warning signals (EWS) occur in a critical transition period preceding a sudden shift (tipping point) in the system. EWS are statistical observations occurring due to a system's declining ability to maintain homeostasis when approaching a tipping point. The aim was to identify critical transition periods preceding bipolar mood state changes.

Methods

Participants with a validated bipolar diagnosis were included to a one‐year follow‐up study, with repeated assessments of the participants' mood. Motor activity was recorded continuously by a wrist‐worn actigraph. Participants assessed to have relapsed during follow‐up were analyzed. Recognized EWS features were extracted from the motor activity data and analyzed by an unsupervised change point detection algorithm, capable of processing multi‐dimensional data and developed to identify when the statistical property of a time series changes.

Results

Of 49 participants, four depressive and four hypomanic/manic relapses among six individuals occurred, recording actigraphy for 23.8 ± 0.2 h/day, for 39.8 ± 4.6 days. The algorithm detected change points in the time series and identified critical transition periods spanning 13.5 ± 7.2 days. For depressions 11.4 ± 1.8, and hypomania/mania 15.6 ± 10.2 days.

Conclusion

The change point detection algorithm seems capable of recognizing impending mood episodes in continuous flowing data streams. Hence, we present an innovative method for forecasting approaching relapses to improve the clinical management of bipolar disorder.
Evidence for dystonia reduction in cerebral palsy remains limited
Authors: Lumsden Daniel E.
Published: April 2024

This commentary is on the clinical practice guideline by Fehlings et al. on pages 1133–1147 of this issue.
Real‐world effectiveness and safety of insulin glargine 100 U/mL plus lixisenatide in adults with type 2 diabetes: An international, multicentre, 12‐month, prospective observational study
Authors: Malik Rayaz A. , Hwu Chii‐Min , Jammah Anwar A. , Arteaga‐Díaz Juan M. , Djaballah Khier , Pilorget Valerie , Alvarez Agustina , Vera Carine , Vikulova Olga
Published: April 2024

Aim

To assess the impact of insulin glargine (100 U/mL) and lixisenatide (iGlarLixi) fixed‐ratio combination therapy on the overall management of glycaemia in patients with type 2 diabetes (T2D), previously inadequately controlled with oral antidiabetic drugs ± basal insulin or glucagon‐like peptide‐1 receptor agonists (GLP‐1 RAs).

Materials and Methods

This 12‐month, international, multicentre, prospective, observational study included patients (age ≥ 18 years) with T2D who had initiated iGlarLixi within 1 month prior to study inclusion. Data were collected at study inclusion, month 3, month 6 and month 12 from patient diaries, self‐measured plasma glucose, and questionnaires. The primary endpoint was change in HbA1c from baseline to month 6.

Results

Of the 737 eligible participants (mean age: 57.8 [standard deviation: 11.2] years; male: 49%), 685 had baseline and post‐baseline HbA1c data available. The least squares mean change in HbA1c from baseline to month 6 was −1.4% (standard error [95% confidence interval (CI)]: 0.05 [−1.5, −1.3]). The absolute change from baseline at month 12 was −1.7% ± 1.9% (95% CI: −1.9, −1.5). There were 72 hypoglycaemia events reported during the study period, with a very low incidence of severe hypoglycaemia (two participants [rate: 0.003 events per patient‐year]).

Conclusions

This real‐world observational study shows that initiation of iGlarLixi in people with T2D inadequately controlled on oral antidiabetic drugs ± basal insulin or GLP‐1 RAs improves glycaemic control with a low incidence of hypoglycaemia.
Life‐giving Flesh: Deity, Humanity, and the Efficacy of the Atonement – Part One
Authors: Duby Steven J.
Published: April 2024

The life‐giving power of Christ's flesh and the unique efficacy of his atoning death are grounded in the fact that the flesh belongs to a divine person, the eternal Word. Though some theologians have argued that this should be explained by a divine sort of suffering taking place on the cross, this essay briefly critiques the idea of divine suffering in the atonement and proceeds to offer constructive discussion of other ways in which the life‐giving power of Christ's flesh and the efficacy of his atoning death are grounded in his deity. This first requires a consideration of the way in which Christ's humanity is empowered and supported by his deity in his suffering and atoning death, which will be articulated in dialogue with several patristic, medieval, and early modern theologians. A second essay will then elaborate further on the relationship between the efficacy of the atonement and the deity of Christ by discussing the way in which the ransom that Christ pays on the cross derives its infinite worth from his deity.
Trends and determinants of mental illness in humanitarian migrants resettled in Australia: Analysis of longitudinal data
Authors: Handiso Demelash Woldeyohannes , Paul Eldho , Boyle Jacqueline A. , Shawyer Frances , Meadows Graham , Enticott Joanne C.
Published: April 2024

Given the frequent exposure of humanitarian migrants to traumatic or stressful circumstances, there exists a potential predisposition to mental illness. Our objective was to pinpoint the trends and determinants of mental illness among humanitarian migrants resettled in Australia. This study considered five waves of longitudinal data involving humanitarian migrants resettled in Australia. Post‐traumatic stress disorder (PTSD) and psychological distress were assessed using PTSD‐8 and Kessler‐6 screening tools. Through a Generalised Linear Mixed model (GLMM), variables displaying a 95% CI that excluded the value of 1.0 for the odds ratio were identified as associated factors for both PTSD and elevated psychological distress. The selection of multivariable covariates was guided by causal loop diagrams and least absolute shrinkage and selection operators methods. At baseline, there were 2399 humanitarian migrants with 1881 retained and at the fifth yearly wave; the response rate was 78.4%. PTSD prevalence decreased from 33.3% (95% CI: 31.4–35.3) at baseline to 28.3% (95% CI: 26.2–30.5) at year 5. Elevated psychological distress persisted across all waves: 17.1% (95% CI: 15.5–18.6) at baseline and 17.1% (95% CI: 15.3–18.9) at year 5. Across the five waves, 34.0% of humanitarian migrants met screening criteria for mental illness, either PTSD or elevated psychological distress. In the multivariate model, factors associated with PTSD were loneliness (AOR 1.5, 95% CI: 1.3–1.8), discrimination (AOR 1.6: 1.2–2.1), temporary housing contract (AOR 3.7: 2.1–6.7), financial hardship (AOR 2.2:1.4–3.6) and chronic health conditions (AOR 1.3: 1.1–1.5), whereas the associated factors for elevated psychological distress were loneliness (AOR 1.8: 1.5–2.2), discrimination (AOR 1.7: 1.3–2.2) and short‐term lease housing (AOR 1.6: 1.0–1.7). The prevalence, persistence and consequential burden of mental illness within this demographic underscore the urgent need for targeted social and healthcare policies. These policies should aim to mitigate modifiable risk factors, thereby alleviating the significant impact of mental health challenges on this population.
Working effectively with consumers: Perspectives from students, teachers, nurses, and consumers
Authors: Hall Karen , Skues Jason , Kiegaldie Debra
Published: April 2024

Preparing enrolled nurses (ENs) to effectively work with mental health consumers is crucial to meeting Australia's healthcare demands. This qualitative study aimed to explore various stakeholders’ perceptions regarding the mental health knowledge, skills, and attributes (KSAs) required by ENs to engage with individuals experiencing mental health issues, thus guiding future training priorities. The sample comprised 44 participants including 18 students, 3 graduate ENs, 5 experienced ENs, 5 registered nurses (RNs), 4 nurse unit managers (NUMs), 5 teachers, and 5 consumers of mental health services. Focus groups were used to collect data from the students, whilst individual interviews were conducted with all other participants. A thematic analysis revealed communication was the most vital skill for effectively working with mental health consumers. Skills such as critical thinking and clinical reasoning were also deemed crucial, given the volatile nature of the mental health inpatient environment, necessitating effective responses to acute escalations to prevent adverse outcomes for both staff and consumers. Essential knowledge components included understanding mental health disorders, symptoms, and treatments, particularly medications used for mental health issues. Participants also emphasised the importance of attributes like confidence and empathy in supporting and caring for consumers, who often experienced trauma and vulnerability. These findings provide valuable insights into the content that should be incorporated into the diploma of nursing (DN) training to produce competent graduate ENs.
Impact of omitting the intravenous heparin bolus on outcomes of leadless pacemaker implantation
Authors: Huang Jingwen , Bhatia Neal K. , Lloyd Michael S. , Westerman Stacy , Shah Anand , Delurgio David , Patel Anshul M. , Tompkins Christine , El‐Chami Mikhael F. , Merchant Faisal M.
Published: April 2024

Background

Early guidance recommended a bolus of intravenous heparin at the beginning of leadless pacemaker (LP) implantation procedures. However, due to concern about bleeding complications, more recent practice has tended toward omitting the bolus and only running a continuous heparin infusion through the introducer sheath. The impact of omitting the heparin bolus on procedural outcomes is not clear.

Methods

We reviewed all Medtronic Micra LP implants at our institution from 9/2014 to 9/2022. The decision to bolus with heparin was at operator discretion.

Results

Among 621 LP implants, 326 received an intravenous heparin bolus, 243 did not, and 52 patients were excluded because heparin bolus status could not be confirmed. There was a trend toward more frequent omission of the heparin bolus with more recent implants. Median follow‐up after LP implant was 14.3 (interquartile range [IQR]: 8.4–27.9) months. There was no difference between heparin bolus and no bolus groups in the number of device deployments/recaptures (1.42 ± 0.81 vs. 1.31 ± 0.66, p = .15). Implant‐related adverse events were also similar between heparin bolus and no bolus groups: access‐site hematoma requiring intervention (7 vs. 5, p = .99), pseudoaneurysm (1 vs. 1, p = .99), cardiac perforation (1 vs. 1, p = .99), intraprocedural device thrombus formation (2 vs. 4, p = .41), 30‐day rehospitalization (21 vs. 15, p = .98), and 30‐day all‐cause mortality (16 vs. 14, p = .70). There was one additional nonfatal cardiac perforation in a patient who was excluded due to unknown heparin bolus status. Regarding device electrical parameters between heparin bolus and no bolus groups, there were no significant differences at the time of implant: pacing capture threshold 0.5 ± 0.4 vs. 0.5 ± 0.3, p = .10; pacing impedance 739.9 ± 226.4 vs. 719.1 ± 215.4, p = .52; R wave sensing 11.7 ± 5.7 vs. 12.0 ± 5.4, p = .34). Long‐term device performance was also similar between groups.

Conclusion

Omission of the systemic heparin bolus at the time of LP implantation appears safe in appropriately selected patients. Heparin bolus may still be considered in long cases requiring multiple device deployments or in patients at high risk for thrombotic complications.
The β3‐AR agonist BRL37344 ameliorates the main symptoms of X‐linked nephrogenic diabetes insipidus in the mouse model of the disease
Authors: Milano Serena , Saponara Ilenia , Gerbino Andrea , Carmosino Monica , Svelto Maria , Procino Giuseppe
Published: April 2024

X‐linked nephrogenic diabetes insipidus (X‐NDI) is a rare congenital disease caused by inactivating mutations of the vasopressin type‐2 receptor (AVPR2), characterized by impaired renal concentrating ability, dramatic polyuria, polydipsia and risk of dehydration. The disease, which still lacks a cure, could benefit from the pharmacologic stimulation of other GPCRs, activating the cAMP‐intracellular pathway in the kidney cells expressing the AVPR2. On the basis of our previous studies, we here hypothesized that the β3‐adrenergic receptor could be such an ideal candidate. We evaluated the effect of continuous 24 h stimulation of the β3‐AR with the agonist BRL37344 and assessed the effects on urine output, urine osmolarity, water intake and the abundance and activation of the key renal water and electrolyte transporters, in the mouse model of X‐NDI. Here we demonstrate that the β3‐AR agonism exhibits a potent antidiuretic effect. The strong improvement in symptoms of X‐NDI produced by a single i.p. injection of BRL37344 (1 mg/kg) was limited to 3 h but repeated administrations in the 24 h, mimicking the effect of a slow‐release preparation, promoted a sustained antidiuretic effect, reducing the 24 h urine output by 27%, increasing urine osmolarity by 25% and reducing the water intake by 20%. At the molecular level, we show that BRL37344 acted by increasing the phosphorylation of NKCC2, NCC and AQP2 in the renal cell membrane, thereby increasing electrolytes and water reabsorption in the kidney tubule of X‐NDI mice. Taken together, these data suggest that human β3‐AR agonists might represent an effective possible treatment strategy for X‐NDI.
Should gestational weight gain charts exclude individuals with excess postpartum weight retention?
Authors: Socha Peter M. , Johansson Kari , Bodnar Lisa M. , Hutcheon Jennifer A.
Published: April 2024

Background

High gestational weight gain is associated with excess postpartum weight retention, yet excess postpartum weight retention is not an exclusion criterion for current gestational weight gain charts. We aimed to assess the impact of excluding individuals with high interpregnancy weight change (a proxy for excess postpartum weight retention) on gestational weight gain distributions.

Methods

We included individuals with an index birth from 2008 to 2014 and a subsequent birth before 2019, in the population‐based Stockholm‐Gotland Perinatal Cohort. We estimated gestational weight gain (kg) at 25 and 37 weeks, using weight at first prenatal visit (<14 weeks) as the reference. We calculated high interpregnancy weight change (≥10 kg and ≥5 kg) using the difference between weight at the start of an index and subsequent pregnancy. We compared gestational weight gain distributions and percentiles (stratified by early‐pregnancy body mass index) before and after excluding participants with high interpregnancy weight change.

Results

Among 55,723 participants, 17% had ≥10 kg and 34% had ≥5 kg interpregnancy weight change. The third, tenth, 50th, 90th and 97th percentiles of gestational weight gain were similar (largely within 1 kg) before versus after excluding participants with high interpregnancy weight change, at both 25 and 37 weeks. For example, among normal weight participants at 37 weeks, the 50th and 97th percentiles were 14 kg and 23 kg including versus 13 kg and 23 kg excluding participants with ≥5 kg interpregnancy weight change.

Conclusions

Excluding individuals with excess postpartum weight retention from normative gestational weight gain charts may not meaningfully impact the charts' percentiles.
The road less taken: Dihydroflavonol 4‐reductase inactivation and delphinidin anthocyanin loss underpins a natural intraspecific flower colour variation
Authors: Wong Darren C. J. , Wang Zemin , Perkins James , Jin Xin , Marsh Grace Emma , John Emma Grace , Peakall Rod
Published: April 2024

Visual cues are of critical importance for the attraction of animal pollinators, however, little is known about the molecular mechanisms underpinning intraspecific floral colour variation. Here, we combined comparative spectral analysis, targeted metabolite profiling, multi‐tissue transcriptomics, differential gene expression, sequence analysis and functional analysis to investigate a bee‐pollinated orchid species, Glossodia major with common purple‐ and infrequent white‐flowered morphs. We found uncommon and previously unreported delphinidin‐based anthocyanins responsible for the conspicuous and pollinator‐perceivable colour of the purple morph and three genetic changes underpinning the loss of colour in the white morph – (1) a loss‐of‐function (LOF; frameshift) mutation affecting dihydroflavonol 4‐reductase (DFR1) coding sequence due to a unique 4‐bp insertion, (2) specific downregulation of functional DFR1 expression and (3) the unexpected discovery of chimeric Gypsy transposable element (TE)‐gene (DFR) transcripts with potential consequences to the genomic stability and post‐transcriptional or epigenetic regulation of DFR. This is one of few known cases where regulatory changes and LOF mutation in an anthocyanin structural gene, rather than transcription factors, are important. Furthermore, if TEs prove to be a frequent source of mutation, the interplay between environmental stress‐induced TE evolution and pollinator‐mediated selection for adaptive colour variation may be an overlooked mechanism maintaining floral colour polymorphism in nature.
Motor dysfunction of the gut in Duchenne muscular dystrophy: A review
Authors: Subhan Fazal , Zizzo Maria Grazia , Serio Rosa
Published: April 2024

Background

Duchenne's muscular dystrophy (DMD) is a severe type of hereditary, neuromuscular disorder caused by a mutation in the dystrophin gene resulting in the absence or production of truncated dystrophin protein. Conventionally, clinical descriptions of the disorder focus principally on striated muscle defects; however, DMD manifestations involving gastrointestinal (GI) smooth muscle have been reported, even if not rigorously studied.

Purpose

The objective of the present review is to offer a comprehensive perspective on the existing knowledge concerning GI manifestations in DMD, focusing the attention on evidence in DMD patients and mdx mice. This includes an assessment of symptomatology, etiological pathways, and potential corrective approaches. This paper could provide helpful information about DMD gastrointestinal implications that could serve as a valuable orientation for prospective research endeavors in this field. This manuscript emphasizes the effectiveness of mdx mice, a DMD animal model, in unraveling mechanistic insights and exploring the pathological alterations in the GI tract. The gastrointestinal consequences evident in patients with DMD and the mdx mice models are a significant area of focus for researchers. The exploration of this area in depth could facilitate the development of more efficient therapeutic approaches and improve the well‐being of individuals impacted by the condition.
Predictors of irritable bowel syndrome‐like symptoms in quiescent inflammatory bowel disease
Authors: Ahmed Mehwish , Pu Autumn , Jencks Kara , Bishu Shrinivas , Higgins Peter , Chey William D. , Rao Krishna , Lee Allen
Published: April 2024

Background

Many patients with quiescent inflammatory bowel disease (IBD) suffer from irritable bowel syndrome (IBS)‐like symptoms. Although these symptoms cause significant reductions in quality of life, evidence‐based treatments are lacking as risk factors and pathophysiology of these symptoms are not clearly defined. We aimed to identify risk factors for development of IBS‐like symptoms in IBD patients with quiescent disease.

Methods

We performed a single‐center retrospective cohort study of adults with IBD from 2015 to 2021. Quiescent IBD was defined by a fecal calprotectin level <250 μg/g of stool or endoscopic evidence of quiescent disease. Cox regression was performed to identify variables that were independently associated with the incident development of IBS‐like symptoms in IBD patients.

Key Results

A total of 368 IBD patients were included for analysis, including 278 patients with UC and 88 with Crohn's disease. 15.5% of quiescent IBD patients developed IBS symptoms, with an incidence rate of (95% CI 48.0–82.0) 63.3 per 1000 person‐years. In the multivariate model, mood disorders (including anxiety and depression) and Crohn's disease were associated with increased risk for developing IBS symptoms. Male sex and higher iron levels conferred lower risk for developing IBS symptoms. Results from the multivariable model were similar in sensitivity analysis with quiescent IBD defined by fecal calprotectin level <150 mcg/g.

Conclusions & Inferences

Mood disorder and Crohn's disease were positively associated with IBS‐like symptoms in quiescent IBD, whereas male sex and iron levels were protective. Our results were robust to different fecal calprotectin levels, arguing against inflammation as a mechanism for IBS‐like symptoms. This data suggests noninflammatory mechanisms may be important in the pathogenesis of IBS‐like symptoms in quiescent IBD. Future work may address whether modifying these risk factors may alter disease course.
Biomechanical effects of clear aligner with different shape design at extraction space area during anterior teeth retraction
Authors: Mao Bochun , Tian Yajing , Xiao Yujia , Liu Jiayi , Liu Dawei , Li Jing , Zhou Yanheng
Published: April 2024

Objective

This study aimed to investigate the biomechanical effects of clear aligner (CA) with different shape designs at extraction space (CAES) area during space closing.

Materials and Methods

A finite‐element method (FEM) model of mandibular dentition, periodontal ligaments, attachments, and corresponding CA was established. The connecting rod design of CAES was modelled for the control group. Eight test groups with different heights of CAES from −4 mm to +4 mm were designed. Tooth displacement tendencies were calculated. The maximum principal stress in PDLs, teeth, and CAs was analysed. Both global coordinate system and local coordinate system were also used to evaluate individual tooth movements.

Results

Across all groups, stresses concentrated on the lingual outer surface of CAESs. For the lowered CAES groups, both the stress value and the stress distribution area at CAESs were increased. The lowered CAES groups showed reduced movement in anterior teeth and less tipping tendency of the canines.

Conclusion

The shape of CAES has a biomechanical impact on anterior teeth movement and should be considered in aligner design. The results suggest that increasing the height of CAES can enhance anterior teeth retraction, while lowered CAES may facilitate controlled root movement. Changes in the shape of CAES represent a potential direction for biomechanical improvement of clear aligner in extraction cases and are worth exploring.
PARAMETRIC DIFFERENCES BETWEEN ENGLISH AND KOREAN RESPONSE PARTICLES: A DISCOURSE‐BASED HPSG APPROACH1
Authors: Kim Jong‐Bok
Published: April 2024

Across languages, polarity particles like yes and no can be used as a response to the polar (yes/no) question. This paper offers a discourse‐based account for the distribution and interpretation of response particles in languages like English and Korean. The paper supports the view that response particles are anaphoric in nature and their interpretation is determined by the salient antecedent evoked by the context in question. The paper also suggests that the parametric differences between English‐style polarity‐based and Korean‐style truth‐based answering systems have to do with tight interactions between the anaphoric nature of response particles and discourse structure, rather than with the position of negation in syntactic structures. This direction, formalized in the framework of HPSG, offers a simpler account for the parametric differences between the two different answering systems as well as other related puzzles concerning variations in contextual bias.
Physician educators' perceptions of experiences contributing to teaching
Authors: Ma TingLan , Costello Joseph A. , Dong Ting , Durning Steven J. , Maggio Lauren A.
Published: April 2024

Introduction

Physician educators are essential in training the next generation of physicians. However, physician educators' perspectives about what experiences they find beneficial to their teaching and the prevalence of these experiences remain unknown. Guided by social cognitive career theory (SCCT) and communities of practice (CoP), we explored what experiences physician educators perceive as beneficial in preparing them to teach.

Methods

In 2019, the Uniformed Services University School of Medicine in the United States surveyed its physician alumni to understand their education experiences during medical school, their current career path and what has contributed to their teaching role. Content analysis was applied to extract themes across the text response. Chi‐square analysis was applied to examine if perceived contributing factors vary based on physician educators' gender, specialty and academic ranks.

Results

The five most prevalent contributing factors participants (n = 781) identified are (1) experiences gained during residency and fellowship (29.8%), (2) teaching as faculty member (28.9%) and (3) class experiences and peer interaction during medical school (26%). We organised three themes that reflected major avenues of how physician educators acquire teaching skills: reflection about quality teaching, journey as learners and learning by doing. Gender and clinical specialty were differentially associated with contributing factors such as faculty development and meta‐reflection.

Conclusion

The results are in line with theories of SCCT and CoP, in which we identified self‐directed learning and regulation in shaping physician educators' teaching. The findings also revealed gaps and potential contexts for more formalised teaching practices to develop physician educators.
Dissipation-induced collective advantage of a quantum thermal machine
Authors: Carrega Matteo , Razzoli Luca , Erdman Paolo Andrea , Cavaliere Fabio , Benenti Giuliano , Sassetti Maura
Published: April 2024

Do quantum correlations lead to better performance with respect to several different systems working independently? For quantum thermal machines, the question is whether a working medium (WM) made of N constituents exhibits better performance than N independent engines working in parallel. Here, by inspecting a microscopic model with the WM composed by two non-interacting quantum harmonic oscillators, we show that the presence of a common environment can mediate non-trivial correlations in the WM leading to better quantum heat engine performance—maximum power and efficiency—with respect to an independent configuration. Furthermore, this advantage is striking for strong dissipation, a regime in which two independent engines cannot deliver any useful power. Our results show that dissipation can be exploited as a useful resource for quantum thermal engines and are then corroborated by optimization techniques here extended to non-Markovian quantum heat engines.
Tuning the emission wavelength by varying the Sb composition in InGaAs/GaAsSb “W” quantum wells grown on GaAs (001) substrates
Authors: Zon  , Lo Tzu-Wei , Li Zhen-Lun , Vorathamrong Samatcha , Cheng Chao-Chia , Liu Chun-Nien , Chiang Chun-Te , Hung Li-Wei , Hsu Ming-Sen , Liu Wei-Sheng , Chyi Jen-Inn , Tu Charles W.
Published: April 2024

InGaAs/GaAsSb “W” quantum wells with GaAsP barriers are grown on GaAs (001) substrates by molecular beam epitaxy. We investigate the effect of the Sb composition in GaAsSb on the photoluminescence (PL) wavelength. X-ray rocking curve (XRC) measurements and simulations are performed to investigate the material composition and layer thickness. Low-temperature PL spectra are consistent with the XRC results. At the lowest Sb composition of 6%, the PL intensity is the strongest, and room-temperature PL is realized at ∼1100 nm. By increasing the Sb composition in the GaAsSb layer, low-temperature (20 K) PL emits at longer wavelength up to ∼1400 nm at 21% Sb while the PL intensity is the weakest. The XRC is also degraded. The strained bandgap simulation reveals the type-I to type-II band alignment transition as the Sb composition is ≥9%.
Custom-tailored hole transport layer using oxalic acid for high-quality tin-lead perovskites and efficient all-perovskite tandems
Authors: Zhu Jingwei , Xu Yuliang , Luo Yi , Luo Jincheng , He Rui , Wang Changlei , Wang Yang , Wei Kun , Yi Zongjin , Gao Zhiyu , Wang Juncheng , You Jiayu , Zhang Zhihao , Lai Huagui , Ren Shengqiang , Liu Xirui , Xiao Chuanxiao , Chen Cong , Zhang Jinbao , Fu Fan , Zhao Dewei
Published: April 2024

All-perovskite tandem solar cells (TSCs) have exhibited higher efficiencies than single-junction perovskite solar cells (PSCs) but still suffer from the unsatisfactory performance of low-bandgap (LBG) tin-lead (Sn-Pb) subcells. The inherent properties of PEDOT:PSS are crucial to high-performance Sn-Pb perovskite films and devices; however, the underlying mechanism has not been fully explored and revealed. Here, we report a facile oxalic acid treatment of PEDOT:PSS (OA-PEDOT:PSS) to precisely regulate its work function and surface morphology. OA-PEDOT:PSS shows a larger work function and an ordered reorientation and fiber-shaped film morphology with efficient hole transport pathways, leading to the formation of more ideal hole-selective contact with Sn-Pb perovskite for suppressing interfacial nonradiative recombination losses. Moreover, OA-PEDOT:PSS induces (100) preferred orientation growth of perovskite for higher-quality Sn-Pb films. Last, the OA-PEDOT:PSS–tailored LBG PSC yields an impressive efficiency of up to 22.56% (certified 21.88%), enabling 27.81% efficient all-perovskite TSC with enhanced operational stability.
From
13
C-lignin to
13
C-mycelium:
Agaricus bisporus
uses polymeric lignin as a carbon source
Authors: Duran Katharina , Kohlstedt Michael , van Erven Gijs , Klostermann Cynthia E. , America Antoine H. P. , Bakx Edwin , Baars Johan J. P. , Gorissen Antonie , de Visser Ries , de Vries Ronald P. , Wittmann Christoph , Comans Rob N. J. , Kuyper Thomas W. , Kabel Mirjam A.
Published: April 2024

Plant biomass conversion by saprotrophic fungi plays a pivotal role in terrestrial carbon (C) cycling. The general consensus is that fungi metabolize carbohydrates, while lignin is only degraded and mineralized to CO
2
. Recent research, however, demonstrated fungal conversion of
13
C-monoaromatic compounds into proteinogenic amino acids. To unambiguously prove that polymeric lignin is not merely degraded, but also metabolized, carefully isolated
13
C-labeled lignin served as substrate for
Agaricus bisporus
, the world’s most consumed mushroom. The fungus formed a dense mycelial network, secreted lignin-active enzymes, depolymerized, and removed lignin. With a lignin carbon use efficiency of 0.14 (g/g) and fungal biomass enrichment in
13
C, we demonstrate that
A. bisporus
assimilated and further metabolized lignin when offered as C-source. Amino acids were high in
13
C-enrichment, while fungal-derived carbohydrates, fatty acids, and ergosterol showed traces of
13
C. These results hint at lignin conversion via aromatic ring-cleaved intermediates to central metabolites, underlining lignin’s metabolic value for fungi.
Observation of parity-time symmetry in diffusive systems
Authors: Cao Pei-Chao , Ju Ran , Wang Dong , Qi Minghong , Liu Yun-Kai , Peng Yu-Gui , Chen Hongsheng , Zhu Xue-Feng , Li Ying
Published: April 2024

Phase modulation has scarcely been mentioned in diffusive physical systems because the diffusion process does not carry the momentum like waves. Recently, non-Hermitian physics provides a unique perspective for understanding diffusion and shows prospects in thermal phase regulation, exemplified by the discovery of anti-parity-time (APT) symmetry in diffusive systems. However, precise control of thermal phase remains elusive hitherto and can hardly be realized, due to the phase oscillations. Here we construct the PT-symmetric diffusive systems to achieve the complete suppression of thermal phase oscillation. The real coupling of diffusive fields is readily established through a strong convective background, and the decay-rate detuning is enabled by thermal metamaterial design. We observe the phase transition of PT symmetry breaking with the symmetry-determined amplitude and phase regulation of coupled temperature fields. Our work shows the existence of PT symmetry in dissipative energy exchanges and provides unique approaches for harnessing the mass transfer of particles, wave dynamics in strongly scattering systems, and thermal conduction.
Serine enrichment in tumors promotes regulatory T cell accumulation through sphinganine-mediated regulation of c-Fos
Authors: Ma Sicong , Sandhoff Roger , Luo Xiu , Shang Fuwei , Shi Qiaozhen , Li Zhaolong , Wu Jingxia , Ming Yanan , Schwarz Frank , Madi Alaa , Weisshaar Nina , Mieg Alessa , Hering Marvin , Zettl Ferdinand , Yan Xin , Mohr Kerstin , ten Bosch Nora , Li Zhe , Poschet Gernot , Rodewald Hans-Reimer , Papavasiliou Nina , Wang Xi , Gao Pu , Cui Guoliang
Published: April 2024

CD4
+
regulatory T (T
reg
) cells accumulate in the tumor microenvironment (TME) and suppress the immune system. Whether and how metabolite availability in the TME influences T
reg
cell differentiation is not understood. Here, we measured 630 metabolites in the TME and found that serine and palmitic acid, substrates required for the synthesis of sphingolipids, were enriched. A serine-free diet or a deficiency in Sptlc2, the rate-limiting enzyme catalyzing sphingolipid synthesis, suppressed T
reg
cell accumulation and inhibited tumor growth. Sphinganine, an intermediate metabolite in sphingolipid synthesis, physically interacted with the transcription factor c-Fos. Sphinganine c-Fos interactions enhanced the genome-wide recruitment of c-Fos to regions near the transcription start sites of target genes including
Pdcd1
(encoding PD-1), which promoted
Pdcd1
transcription and increased inducible T
reg
cell differentiation in vitro in a PD-1–dependent manner. Thus, Sptlc2-mediated sphingolipid synthesis translates the extracellular information of metabolite availability into nuclear signals for T
reg
cell differentiation and limits antitumor immunity.
Complete genome sequence of
Clostridium butyricum
DKU-11, isolated from healthy infant feces
Authors: Mo SangJoon
Published: April 2024

Clostridium butyricum
DKU-11, a bacterium has been isolated from the stools of breastfed infants near Cheonan-Asan city, Republic of Korea, and has a genome sequence of 4,630,814 bp. The GC content is 28.7% and a total of 4,137 coding sequences in two contigs.