bluuebunny/crossref_metadata_2025 huggingface dataset:
Nanoemulsion‐based transdermal delivery of third‐generation steroidal and non‐steroidal aromatase inhibitors in preclinical models
Authors: Gao Lanyang , Gao Lin , Huang Shiyao , Sun Lei , Li Mei , Shen Chen , Chen Youyou , Tan Ruihao , Chen Yuji , Zhan Chengguo , Wieland Frank Heinrich , Liu Yingying , Zhang Yinan , Luo Yao
Published: September 2024

Aromatase inhibitors are effective in treating hormone receptor‐positive breast cancer, particularly in postmenopausal women. However, the challenges of inconsistent dissolution, variable absorption and side effects with oral administration persist. To address these issues, transdermal delivery has emerged as a viable alternative. In our study, we have developed nanoemulsion‐based transdermal creams containing third‐generation aromatase inhibitors Exemestane (EXE) or Letrozole (LE) and evaluated their toxicity, anti‐tumour effects and androgenic potency using preclinical models including Bama minipigs, DMBA‐induced breast cancer rats and orchidectomized male rats. The results of our study are significant, suggesting that both creams effectively penetrated the skin, demonstrating an impressive anti‐breast cancer effect. Importantly, EXE cream had no organ toxicity at the tested dose, providing a reassuring safety profile for its use. In contrast, LE cream displayed reversible toxicity from drug molecule itself in animals at the given dose, dissipating after 3 weeks of withdrawal and recovery. This study establishes a solid foundation for the safe clinical use of third‐generation aromatase inhibitors. It highlights transdermal creams as a promising drug delivery carrier for administering them.
Transplantation of the heart and both lungs: Initial experience of twelve operations in ten patients
Authors: Reichart B. , Blaschke F. , Cooper D. K. C. , Novitzky D. , Reichenspurner H. , Odell J. A. , Rose A. G. , Kemkes B. M. , Klinner W.
Published: September 2024

From February 1983 to December 1986, 12 heart‐lung transplantations were performed in 10 patients at the Munich University Hospital and the University of Cape Town. The pre‐operative diagnoses were primary pulmonary hypertension in 4 patients, Eisenmenger's syndrome in 3 fibrosing alveolitis, emphysema in 1 case and primary pulmonary fibrosis in 1 other case. Two retransplantations were performed due to chronic obliterative bronchiolitis and tuberculosis in 1 case and acute pulmonary failure in the other. Four patients are alive, spanning from 3 years to 6 months after surgery. Infection was a major cause of death. Acute rejection turned out to be a major non‐lethal complication. According to our experience, in most cases solitary pulmonary rejection occurred, which always was treated successfully. The differential diagnosis between pulmonary rejection and infection is still difficult but different methods such as cyto‐immunological monitoring or endobronchial biopsies have proved to be helpful.
Does race affect renal transplant results? A single institution study
Authors: Matas Arthur J , Tellis Vivian A. , Perez Luis , Quinn Theresa A. , Glicklich Daniel , Soberman Robert , Veith Frank J.
Published: September 2024

The effect of race on renal transplant results is controversial. Blacks have been reported to have decreased graft survival and hispanics increased graft survival when compared to whites. We studied the effect of race on transplant results at a single institution where immunosuppression for each time period was consistent, and there was a wide range of socioeconomic conditions for each racial group. Between 1/76 and 7/86, 341 patients received first cadaver transplants. Forty‐five percent of the patients were white, 36% black and 19% hispanic. HLA and DR matching was not used; routine blood transfusion was started in 1979; cyclosporine was first utilized in 1983. There was no difference in patient or graft survival between groups. Similarly, when separated by immunosuppressive protocols (azathioprine vs cyclosporine) there was no difference between groups. Strikingly, although 51% of our patient population was black or hispanic, only 24% of transplanted kidneys were from black or hispanic donors. Kidneys from white donors resulted in equivalent graft survival when transplanted to white, black or hispanic recipients. There were insufficient numbers of black and hispanic donors for significant statistics. We conclude that when socioeconomic and immunosuppressive factors are controlled, race is irrelevant to renal transplant results.
Ciclosporin alone or combined with steroid in the treatment of cadaveric renal transplant recipients
Authors: De Vecchi Amedeo , Tarantino Antonio , Montagnino Giuseppe , Aroldi Adriana , Aniasl Alina , Vegeto Antonio , Ponticelli Claudio
Published: September 2024

Fifty‐one consecutive adult recipients of cadaveric renal transplant were randomly given CsA and MP (group 1) or CsA alone (Group 2) from the day of surgery. Seven patients who were started on CsA alone are still not being given steroid while, in the other 18, steroid therapy was started and has been continued. The graft and patient survival rates were significantly lower in patients started with steroid. Rejection episodes occurred earlier and were more frequent in group 2 patients and the incidence of irreversible rejections did not differ between the two groups. The incidence of noninfectious complications and mean plasma creatinine were similar in the two groups. Delaying or avoiding steroid administration might reduce the risk of life‐threatening infections without increasing the risk of irreversible rejection.
Awareness and attitudes of Northwest Native Americans regarding organ donation and transplantation
Authors: Blagg Christopher R. , Helgerson Steven D. , Warren Charles W. , Keen‐Denton Karyn , Seely Michael , Peterson Lauri , Kimball Ernest H. , Oge Linda L. , Acton Kelly , Evans Roger W.
Published: September 2024

There is a large unmet need for organs for transplantation and it appears that the organ donation rate for Native Americans is disproportionately low compared to the Native American proportion of the U.S. population. Therefore, we surveyed adult Native Americans in the Northwest to ascertain their attitudes regarding organ donation and transplantation. Subjects were drawn from a random sample of adult Native Americans living in two rural and two urban communities in the Northwest. The survey was conducted in person by trained Native American interviewers using questions derived from an earlier telephone‐administered national organ donation survey. The attitudes reported by Northwest Native Americans were very similar to those reported by the general U.S. population. These Native Americans were very aware of organ donation and transplantation and 32% were willing to donate their organs after their death. While only 10% of those willing to donate were carrying an organ donor card, 93% of those who were not said that they would do so if asked. Forty‐three percent of the Native American respondents said they would donate the organs of a family member who had just died. While their overall attitudes towards organ retrieval efforts were favorable, Native American respondents stressed the importance of involving close family members in organ retrieval decisions. As with the general population, Northwest Native Americans with less than high school education were less likely than those with more education to be willing to donate their own or a deceased family member's organs. We conclude that many Northwest Native Americans are potentially willing to donate organs. Efforts involving the communities in this study are underway to increase the number of persons carrying organ donor cards and to increase the number of organs donated.
Risk of postoperative infection after liver transplantation: A univariate and stepwise logistic regression analysis of risk factors in 150 consecutive patients
Authors: Mora Nicholas P. , Gonwa Thomas A. , Goldstein Robert M. , Husberg Bo S. , Klintmalm Goran B.
Published: September 2024

Between March 1988 and December 1989, 180 orthotopic liver transplants were performed in 150 adult patients. We have retrospectively reviewed all charts to determine incidence, timing and etiology of major postoperative infections. Major postoperative infection occurred during the 90‐day period following transplantation in 47% of liver transplant patients. Bacterial infections dominated early, while viral and protozoal infections presented later. The most common organisms were Staphylococcus, Enterococcus, and cytomegalovirus. Significant variables associated with infection included pretransplant status, preoperative renal dysfunction, rejection, OKT3 therapy, postoperative renal and liver graft dysfunction, and amount of blood products transfused. By using a stepwise logistic regression analysis, we determined that the best predictors of postoperative infection were rejection and postoperative transfusion requirements. This study emphasizes the need to develop newer immunosuppressive strategics to prevent rejection, but more importantly reemphasizes the critical importance of surgical technique.
Pathology of heart transplantation: Study of autopsied and explanted allografts with emphasis on possible biopsy findings*
Authors: Goswitz Joseph J. , Braunlin Elizabeth , Kubo Spencer H. , III R. Morton Bolman , Nakhleh Raoul E.
Published: September 2024

We studied 28 cardiac allografts (26 autopsied, 2 explanted) from 27 patients aged 4 to 57 years (mean 35 yr). The duration of transplant was 1 day to 6 yr (mean 13 months). A spectrum of pathology was seen in the whole hearts including chronic transplant vasculopathy (12 cases), acute cellular rejection (7 cases), fungal infection (4 cases), and Epstein‐Barr virus‐related lymphoma (1 case). Length of transplant for cases with chronic transplant vasculopathy was 38 d to 6 yr and all transplants over 1 yr duration had chronic transplant vasculopathy. The lymphocytic infiltrate in acute cellular rejection was diffuse in 2 cases, but patchy in 5 with areas of spared myocardium. Subendocardial involvement was equal to that of other myocardial areas. Four patients with acute cellular rejection were biopsied within 4 d of death and only 1 biopsy was positive for rejection. Reasons for false negative results included a previous biopsy site confusing the inflammatory picture, a change in the clinical course after biopsy, and sampling error due to patchy lymphocytic infiltrate. A recent biopsy of the heart with lymphoma was misinterpreted as acute cellular rejection. We conclude that patchy lymphocytic infiltrates are common in acute cellular rejection, but a variety of factors produced false results in endomyocardial biopsies. Chronic transplant vasculopathy was universal in long‐term allografts that failed.
Medical student education and organ donation – A medical school survey
Authors: Pollak Raymond
Published: September 2024

A survey was undertaken of all 127 Medical Schools in the United States to establish whether the subjects of transplantation and organ and tissue donation were included in the curriculum. Seventy‐seven (60.6%) medical schools responded, of whom 32 (41.6%) offered a class/ lecture in organ transplantation. Sixty‐nine (89.6%) schools had organ transplant programs within the department of surgery, while 61 (79%) offered a rotation on the transplant service. An organ procurement agency (OPA) was associated with 70 (91%) schools but was involved in student education in only 36 (46.8%) instances. Numerous diverse suggestions were made by the responding schools for ways to increase or maximize organ donation, while most (62, 80.5%) felt that a lack of professional education is partially to blame for the organ donor shortage. In conclusion, it is evident that medical student exposure to the concepts of organ and tissue donation as well as transplantation is extremely variable. Since physicians are “critical links” within the organ donation process, medical schools, perhaps with the involvement of a local OPA, need to substantially increase their educational efforts in this regard to help alleviate the critical organ donor shortage.
Metabolic changes in renal transplant patients managed with and without cyclosporin
Authors: Irish Ashley B. , Simons Leon A. , Savdie Elliott , Hayes James M. , Simons Judith
Published: September 2024

Cardiovascular disease is the leading cause of death in renal transplantation. Cyclosporin may contribute to hypercholesterolemia and glucose intolerance post‐transplantation. We measured lipids, apolipoproteins Al, B and lipoprotein (a) [Lp(a)], glucose and insulin levels in 53 renal transplant patients, 41 of whom were receiving prednisolone, azathioprine and cyclosporin (CyA group) and 12 conventional therapy with prednisolone and azathioprine (PA group). The PA group had significantly better renal function (creatinine=0.20±0.12 mmol/l CyA, 0.13± 0.03 mmol/l PA; p< 0.005) and longer time since transplantation (CyA = 35 ± 31, PA = 103 ±61 mont1hs; p<0.001). There was no significant difference in total or LDL cholesterol between the two groups (CyA=6.48, 4.35; PA = 6.46, 4.14 mmol/l) but HDL cholesterol was significantly lower in the CyA group (CyA = 1.16±0.37; PA = 1.55±0.53 mmol/I; p<0.01). Median Lp(a) levels and mean apo‐Al and apo‐B in the CyA group (90 mg/1; 1.34, 1.10 g/1) were not significantly different from the PA group (120 mg/l; 1.38, 1.03 g/1). The CyA group had glucose and insulin concentrations similar to the PA group. There remained no significant effect of cyclosporin on any lipid or lipoprotein parameter after controlling for age, body mass index, renal function, proteinuria, drug dosage, time post‐transplantation or history of diabetes or vascular disease. These results suggest that low‐dose cyclosporin does not adversely influence lipids, apolipoproteins Al and B, lipoprotein (a) levels, or glucose tolerance as compared with traditional PA protocols in patients treated by renal transplantation.
Phenytoin administration in renal allograft recipients on cyclosporine immunosuppression
Authors: Schweitzer Eugene J. , Canafax Daniel M. , Gillingham Kristen J. , Najarian John S. , Matas Arthur J.
Published: September 2024

Phenytoin reduces blood levels of cyclosporine and increases the metabolism of corticosteroids. The current study was designed to determine whether patients taking phenytoin at the time of kidney transplantation experienced a worse outcome. Thirteen patients receiving phenytoin at the time of transplantation were retrospectively compared to a similar cohort not receiving phenytoin with regard to patient and graft survival, rejection episodes, and drug dosing. We did not detect any adverse impact of phenytoin administration on recipients of renal allografts, other than a requirement for higher doses of cyclosporine. There was no significant difference in 5‐year actuarial patient or graft survival (PHENYTOIN 92% and 85% vs. NO PHENYTOIN 84% and 77%, respectively), the total number of rejection episodes in 1 yr (10 vs. 6, N.S.), serum creatinine at 1 yr (1.4 ± 0.2 vs. 1.8 ± 0.1, N.S.), or number of days of hospitalization during the transplant admission (18 ± 6 vs. 11 ±2, N.S.). Generalized seizures occurred in 38% of phenytoin‐treated patients in the postoperative period. Despite close monitoring, the levels of cyclosporine during the first 3 months after transplantation were still significantly lower in the patients on phenytoin (136 ± 14 vs. 182±16 ng/ml, p = 0.04). In the patients taking phenytoin, the average requirement for cyclosporine in the 1st yr was more than twice that of patients not taking phenytoin (11.5± 1.2 vs. 5.3±0.3 mg/kg/d, p<0.001). These data illustrate the need for attentive cyclosporine monitoring in patients taking phenytoin. If cyclosporine levels are adjusted appropriately, phenytoin administration probably does not markedly influence the results of renal transplantation.
Prevalence of “low blood glucose” symptoms and quality of life in pancreas transplant recipients
Authors: Zehrer Cindy L. , Gross Cynthia R.
Published: September 2024

One hundred and twenty‐nine Type I diabetic pancreas transplant recipients who were at least 1 year post‐transplant (n = 62 functioning graft, n = 67 non‐functioning graft) completed a quality of life questionnaire that included self‐report ratings of symptoms. Reports of frequent low blood glucose symptoms, distress due to low blood glucose symptoms, and subjective ratings of poorer blood glucose control were significantly and highly correlated with dissatisfaction ratings on diabetes‐specific measures of satisfaction with lifestyle, health and treatment (r = 0.43 to 0.67, p<0.0l). Overall life satisfaction and physical functioning were also significantly correlated with these symptom perceptions (r = 0.23 to 0.43, p<0.01). Symptoms had a significant impact on quality of life measures even after adjustement for the effects of pancreas graft status and other case‐mix factors. The prevalence of reported low blood glucose symptoms in the previous month was about one‐third for patients with a functioning pancreas graft (n= 19) compared to almost all patients in the non‐functioning group (31% vs. 97%, p<0.0001). A limitation of this study is the absence of documented blood glucose values to correlate with symptom perceptions. Perceived low blood glucose symptoms could be inaccurate, particularly for very mild symptoms, and correlation with actual blood glucose may be very low. The symptomatic patients with functioning grafts generally reported a few mild symptoms per month, and this study was not able to demonstrate that symptomatic patients with functioning grafts have reduced quality of life. Thus, while the prevalence of transient self‐reported symptoms of hypoglycemia in successful pancreas transplant recipients is 31% in this series, the severity of their symptoms is insufficient to impact quality of life measures.
Thromboembolic complications in renal allograft recipients: Triple‐drug therapy in comparison with cyclosporine A‐prednisone
Authors: Kronenberg Florian , Lhotta Karl , Joannidis Michael , Königsrainer Alfred , Margreiter Raimund , König Paul
Published: September 2024

From January 1984 to March 1990, 244 renal transplant patients were followed up regularly for at least 1 year. Among them were 42 diabetics. Immunosuppressive therapy in 118 of the patients consisted of cyclosporine A combined with prednisone (CsA‐P), while 126 received a triple‐drug therapy (CsA + P + azathioprine). A total of 41 thromboembolic complications were suffered by 33 patients during the 1st yr, most being thromboses of the leg veins, myocardial infarctions and cerebrovascular accidents. A significantly higher incidence of 19.5% was noted in those cases receiving CsA — P therapy as compared with 7.9% in patients on the triple‐drug regimen. A significant increase in the above complications was also seen in patients over 60 yr of age. Especially pronounced was the rate of thrombosis in diabetics, which was three limes as high as in non‐diabetics. Contrary to expectation, nephrotic syndrome following renal transplantation did not prove to be an additional risk factor for thromboembolic complications. On the basis of these observations, the application of a thrombocyte aggregation inhibitor in the 1st yr posllransplant should be considered for all diabetics as well as for non‐diabetics aged 35 to 45 yr and older.
Predictors of long‐term primary cadaveric renal transplant survival
Authors: Tesi Raymond J. , Henry Mitchell L. , Elkhammas Elmahdi A. , Ferguson Ronald M.
Published: September 2024

The factors which predict long‐term kindey allograft survival have been difficult to determine due to the reliance on multi‐center data. A retrospective review of the post‐transplant course of 665 consecutive primary cadaveric (CAD) kidney transplants performed at a single center over an 8‐ycar period was performed in an attempt to identify what demographic, immunologic and post‐transplant factors are important in predicting long‐term kidney graft function. All recipients were treated with a uniform management strategy including sequential quadruple immunosuppression and histologic confirmation of all episodes of graft dysfunction. The average length of follow‐up was 56 months and no patient had less than 12 months of follow‐up. Actuarial 8‐year (yr) patient and graft survival was 76% and 57% respectively. Exclusion of 64 patients who died with a functioning graft from non‐transplant related cause resulted in an improvement of 8‐yr graft survival to 71%. Evaluation of factors predicting long‐term graft survival with Cox analysis demonstrated that the presence of ONE or greater than ONE (>ONE) rejection episode (relative risk [RR] = 6.45), diabetes mellitus (RR = 1.72), and black race (RR= 1.31) were independent risk factors for graft loss. Censored graft survival for patients with NONE, ONE, or >ONE rejection episodes was 83%, 69% and 45% respectively. Rejection episodes occurred in 47% of recipients. Two‐third of rejection episodes occurred before 60 days and acute rejection episodes were rare after 1 yr. No immunologic factors including sex, current or maximum PR A, HLA mismatch, race or presence of diabetes mellitus predicted the risk of developing ONE or >ONE rejection episodes. These data suggest that patients wihout an episode of acute rejection have excellent long‐term graft survival regardless of demographic or immunologic risk‐factors pre‐transplant. The presence of ONE or >ONE rejection episode is the most important determinant of long‐term renal allograft survival. Attempts to prevent rejection episodes should focus on better immunosuppression, and not on better matching, in recipients of first CAD kidney transplants.
Renal allograft preservation: A comparison of University of Wisconsin solution and of hypothermic continuous pulsatile perfusion
Authors: Veller Martin G. , Botha J. René , Britz Russel S. , Gecelter Gary R. , Beale Peter G. , Margolius Larry P. , Meyers Kevin E. C. , Thompson Peter D. , Meyers Anthony M. , Myburgh J. Albertus
Published: September 2024

A study was performed to compare early allograft function in kidneys preserved with University of Wisconsin (UW) solution to kidneys preserved by hypothermic pulsatile perfusion. The study consisted of two sets of data. The first set was a donor‐paired study (matched data) of 30 heart‐beating, hemodynamically stable donors. After removal from the donor each cooled kidney was individually prepared for preservation. One kidney was flushed with ± 500 ml of UW solution and stored in UW solution on slushed ice. The other kidney was continuously perfused with cooled (4–6°C) cryoprecipitated plasma. The kidneys were transplanted into suitable recipients in a random sequence. Twelve donors were excluded from the study because one or both kidneys were transplanted into recipients who had previously been transplanted. The remaining 36 kidneys were implanted into two similar groups after a mean of 19 hours in the pulsatile perfusion group and 18 hours in the UW solution group. The second set of data consisted of all the kidneys preserved in UW solution (n=62) at our institution and of 57 kidneys preserved by hypothermic continuous pulsatile perfusion during the same period (mixed data) and was used to evaluate the effect of prolonged preservation (longer than 24 hours) on delayed graft function. Both of these groups were also comparable. Acute tubular necrosis (ATN) was defined as the need for dialysis during the 1st week after transplantation, and delayed function as the delayed clearance of creatinine during the early postoperative phase. In the donor‐matched data study the incidence of ATN (UW solution 28%; pulsatile perfusion 33%), delayed function (UW solution 44%; pulsatile perfusion 44%), and the 1‐year graft survival (UW solution 83%; pulsatile perfusion 82%) were similar. In addition, ATN occurred in all kidneys (n = 2) stored for longer than 24 hours in the UW solution group compared to 2 of 5 kidneys in the pulsatile perfusion group. In the mixed data study, ATN occurred in 12 of 15 kidneys (80%) preserved in UW solution for 24 hours or longer, compared to 6 of 13 kidneys (46%) in the hypothermic continuous pulsatile perfusion group (Fisher's exact test; p = 0.07). This study demonstrates that there is no difference in the incidence of ATN, delayed function, and in the 1‐year graft survival in kidneys preserved in UW solution when compared to kidneys preserved by hypothermic continuous pulsatile perfusion. The incidence of ATN does, however, appear to increase dramatically if kidneys are preserved in UW solution for longer than 24 hours. Such problems do not occur in kidneys preserved with hypothermic continuous pulsatile perfusion.
High one‐month liver graft failure rates in flow cytometry crossmatch‐positive recipients
Authors: Ogura Kensuke , Terasaki Paul I. , Koyama Hiroto , Chia Jennifer , Imagawa David K. , Busuttil Ronald W.
Published: September 2024

In a retrospective study of 84 primary cadaver donor orthotopic liver transplants (OLTs). we investigated the damaging effect of preformed donor‐specific antibodies by a standard T‐cell warm crossmatch test (TWXM) and a more sensitive flow cytometry crossmatch test (FCXM). The incidence of a positive crossmatch was 12% (10/84) by TWXM and 24% (20/84) by FCXM, respectively. The incidence of 1‐month graft failure was 30% (3/10) for patients with a positive TWXM, compared with 23% (17/74) for a negative TWXM. The deleterious effect was more pronounced when the patients were examined by FCXM. Nine of 20 (45%) FCXM‐positive recipients lost their grafts within 1 month (p = 0.01) and 8 of those 9 failures occurred within 2 weeks posttransplant. A comparison of graft survival rates at 6 months demonstrated that FCXM‐positive patients had a 25% lower survival rate (p=0.01) than those with a negative FCXM. The positive rate of FCXM was 4 times higher in sensitized patients (PRA 11‐100). However, 9 patients in the non‐sensitized group (PRA 0‐10) had a positive FCXM, and 5 of 9 patients had graft failure within 1 month, suggesting that even a low level of antibodies or non‐complement fixing antibodies may have a very damaging effect. This study shows that preformed donor‐specific antibodies do have a deleterious effect on allografts. Although the effect is not necessarily expressed as hyperacute rejection, the antibody response is capable of damaging the allografted organs within 1 month. Consideration should be given to crossmatching OLT patients in order to avoid transplantation over a positive crossmatch.
Necrosis of the femoral head after kidney transplantation
Authors: Lausten Gunnar Schwarz , Lemser Tom , Jensen Peder Klement , Egfjord Martin
Published: September 2024

We reviewed the medical records of 750 patients (445 men, 305 women), who had received a kidney transplant during the period 1968‐1995, for any sign of necrosis of the femoral head. For post‐operative immunosuppression, 374 patients had received high‐dose corticosteroids (average 12.5 g during the first year post‐operatively), while 376 patients had received low‐dose corticosteroids (average 6.5 g during the first year post‐operatively) and cyclosporin A. Survival curves according to Kaplan and Meier (J Am Stat Ass 1958: 53: 457‐481) were constructed. In the high‐dose steroid group, 42/374 patients (11.2%) developed femoral head necrosis, at an average of 26.2 months posttransplantation. In the low‐dose steroid group, only 19/376 (5.1%) patients developed this complication, at an average of 20.5 months post‐transplantation. This difference in numbers of femoral head necroses was highly significant (p <0.005). We conclude that steroid doses should be minimized whenever feasible in post‐transplant immunosuppression therapy.
Benefits of pre‐emptive dose reduction for Sandimmune to Neoral conversion in stable renal transplant recipients
Authors: Hricik Donald E , Dixit Ashwin , Knauss Thomas C , Donley Vicki , Bartucci Marilyn R , Schulak James A
Published: September 2024

In an effort to minimize nephrotoxicity resulting from greater exposure to cyclosporine after Sandimmune to Neoral conversion, we compared two conversion regimens using different dosing ratios. Serial serum creatinine concentrations and trough cyclosporine levels were measured in 26 patients converted from Sandimmune to Neoral using a 1:0.8 dosing ratio (Group 1) and compared to those of 26 patients converted using a 1:1 dosing ratio (Group 2). The percentage change in peak serum creatinine concentration after conversion was greater in Group 2. However, at last follow‐up, the dose reductions in each group were comparable. Following conversion, patients in Group 1 required fewer dose adjustments and follow‐up blood tests. Compared to conversion using a 1:1 dosing ratio, conversion from Sandimmune to Neoral using a 1:0.8 ratio results in comparable dose reductions and less short‐term nephrotoxicity, while requiring less frequent laboratory monitoring.
Construction and application of a decision support tool for determining venous access in breast cancer chemotherapy patients
Authors: Wu Meng , Liao Yan‐yan , Lin Zheng
Published: September 2024

Objective

To construct a decision support tool for determining venous access in chemotherapy of breast cancer.

Methods

A decision support tool for determining venous access was developed through semi‐structured interviews, literature analysis, expert inquiry, and user adaptation. The subjects of the study were breast cancer patients with chemotherapy who planned to have deep vein catheterization in a Grade IIIA hospital in Nanjing from August to December 2023. The enrolled patients were then divided into the control group and the intervention group, with 44 cases in each group. The control group received routine pre‐catheterization interviews, while the intervention group used the decision support tool on this basis. Further comparison was conducted on the willingness of and actual participation in decision‐making, decisional conflict, decision‐making satisfaction, and decision regret between the two groups using t‐test and chi‐square test.

Results

This study constructed a decision support tool for determining venous access in chemotherapy of breast cancer, including 8 primary indicators and 40 secondary indicators. The intervention group actually participated in treatment decisions more than the control group, and the intervention group was more willing to participate in treatment decisions (p < 0.05). Furthermore, the intervention group had significantly higher degrees of actual participation in decision‐making and satisfaction with decision‐making compared to the control group (p < 0.05); while the former group had significantly lower decisional conflict, decision regret at 1 month and 3 months after discharge than those in the latter group (p < 0.05).

Conclusion

The decision support tool for determining venous access in chemotherapy of breast cancer is scientific and practical to promote patient participation in decision‐making, reduce decisional conflicts, improve decision‐making quality, and achieve joint decision‐making between doctors and patients.
Methodological approach to investigating spatial cognition in Arctic charr (Salvelinus alpinus)
Authors: Dellinger Marion , Suret Léo , Choblet Maxime , Jozet‐Alves Christelle , Benhaïm David
Published: September 2024

Assessing cognitive traits poses consistent methodological challenges. We describe a method for testing Arctic charr by incorporating a T‐maze into their housing, which reduced stress and improved the engagement of the tested fish in the task. We outline the phases of testing to evaluate learning efficiency and determine which orientation strategies, such as motor response versus beaconing, are prioritized by the animals. We emphasize the stress management aspects of the design, aiming to inspire other researchers tackling similar obstacles, rather than delving into the specific aspects of cognitive abilities assessment.
Interpersonal Perception of Adult Playfulness at Zero‐Acquaintance: A Conceptual Replication Study of Self‐Other Agreement and Consensus, and an Extension to Two Accuracy Criteria
Authors: Brauer Kay , Proyer René T.
Published: September 2024

Objective

We replicated and extended previous research examining the accuracy of judgments of four facets of adult playfulness (Other‐directed, Lighthearted, Intellectual, and Whimsical; OLIW) at zero‐acquaintance.

Method

We conducted a conceptual replication study. One hundred sixty targets provided self‐ratings for the OLIW facets, textual self‐descriptions (≤ five sentences), daily self‐ratings of playfulness for 14 consecutive days, and ratings by knowledgeable others. Six unacquainted judges provided rated targets' playfulness based on their self‐descriptions. We replicated findings on trait‐wise self‐other agreement (SOA) and consensus and extended prior research by testing SOA for profiles of the four facets and two distinct accuracy criteria (i.e., targets' diary data and aggregates of targets' self‐reports and those from knowledgeable others).

Results

All interpersonal perception indicators showed that facets of playfulness can be perceived above chance (SOA ≥ 0.26; consensus ≥ 0.29, accuracies ≥ 0.16). SOA extends from single facets to profiles, also when controlling for stereotype effects.

Conclusions

Playfulness can be accurately observed from minimal textual information at zero acquaintance. Our study highlights the robustness of findings on the interpersonal perception of playfulness across samples and methods, and degrees of acquaintanceship. We discuss implications for playfulness in social relationships.
Efficacy of different protocols of non‐surgical periodontal therapy in patients with type 2 diabetes: A systematic review and meta‐analysis
Authors: Corbella Stefano , Alberti Alice , Donos Nikolaos , Morandi Benedetta , Ercal Pinar , Francetti Luca , Calciolari Elena
Published: September 2024

The aim of the present systematic review of the literature and meta‐analysis was to evaluate the efficacy of different protocols of NSPT without any adjunctive therapy in subjects with type 2 diabetes, by considering clinical and patient‐centered outcomes. For the purposes of the study randomized controlled clinical trials with more than 3‐month follow‐up were searched in MEDLINE, EMBASE, and Cochrane Central. Then the articles were screened for inclusion and considered based on the protocols adopted, the outcome measure, follow‐up, and the level of glycemic control. A total of 23 articles about 22 studies were included. NSPT was more effective than just oral hygiene measures/no treatment in reducing periodontal probing depth (PPD) and clinical attachment loss (CAL) at 3 months (0.47 mm [0.29–0.65 mm] and 0.50 mm [0.24–0.76 mm], respectively) and 6 months (0.56 mm [0.28–0.84 mm] and 0.45 mm [0.13–0.77 mm], respectively for PPD and CAL) follow‐up (very low and low level of evidence). The meta‐analysis found no evidence of a difference between full‐mouth disinfection versus quadrant protocol clinical outcomes (very low level of evidence). One study found no evidence of a difference in periodontal clinical response between good versus poor glycemic control. Based on the results of the present research NSPT protocols could be considered more efficacious than others in terms of clinical outcomes in subjects with type 2 diabetes. Moreover, NSPT resulted in efficacious improvement of periodontal parameters and HbA1c levels compared to no treatment or oral hygiene instructions alone.
Individual‐ and environmental‐level determinants of fruit and vegetable intakes in rural Georgia
Authors: Antonacci Cerra C. , Kegler Michelle C. , Bigger Lauren , Hermstad April , Ebey‐Tessendorf Karen , Haardörfer Regine
Published: September 2024

Objective

To investigate the ways in which food insecurity, food acquisition behaviors, and perceived and objective food access influence fruit and vegetable intakes among rural Georgians.

Design

A population‐based survey was merged with USDA's Food Access Research Atlas, and multilevel modeling was used to determine individual‐level (eg, food insecurity, food acquisition behaviors, perceived access) and environmental‐level (eg, census tract food access) predictors of fruit and vegetable intakes.

Setting

Twenty‐four rural census tracts in 6 counties in Georgia, USA.

Participants

One thousand four hundred and seventy‐four adults.

Results

Residing in a low food access census tract was not associated with fruit or vegetable intake. Food insecurity had negative effects on both fruit and vegetable intakes. Perceived access to fresh fruits and vegetables was positively associated with fruit intake, and obtaining fresh fruits and vegetables from community or home gardens was positively associated with both fruit and vegetable intakes.

Conclusions

Findings are unique from previous research on census tract‐level fruit and vegetable determinants, underscoring the need for a better understanding of influences on fruit and vegetable intakes among rural populations. Interventions to increase fruit and vegetable consumption in rural areas should prioritize food security.
Neural mechanisms associated with sleep‐dependent enhancement of motor learning after brain injury
Authors: Lequerica Anthony H. , Tong Tien T. , Rusnock Paige , Sucich Kai , Chiaravalloti Nancy , Ebben Matthew R. , Chau Patrick , Dobryakova Ekaterina
Published: September 2024

This study aimed to examine the improvement in performance and functional magnetic resonance imaging correlates of motor learning after a daytime nap versus a period of resting wakefulness among individuals with traumatic brain injury. A sample of 32 individuals with traumatic brain injury was randomly assigned to a Sleep (N = 17) or Wake (N = 15) group after a period of training on a motor sequential learning task. A 45‐min nap opportunity was provided for the Sleep group, while the Wake group watched a documentary for 45 min. Performance at the end of training was compared with their performance after the nap or wake intervention. Before and after the intervention, the motor sequential learning task was completed in the magnetic resonance imaging scanner to examine the relationship between change in performance and neural activation. Participants in the Sleep group showed significant gains from the end of training to after the intervention, whereas the Wake group did not. The functional magnetic resonance imaging results showed that relative to the Wake group, the Sleep group showed significantly decreased activation post‐intervention in the anterior cingulate/paracingulate, cerebellum, cuneus/precuneus, and inferior parietal lobule including angular and supramarginal gyri. Importantly, across both groups, increased task performance at post‐intervention was associated with decreased activation in the anterior cingulate/paracingulate and cerebellum. This study demonstrated the enhancing effect of a nap on motor learning performance in a sample of individuals with traumatic brain injury, with patterns of neural activation suggesting that the sequence was more automatized in the Sleep group. Strategic placement of a nap after an intense period of motor learning in the medical rehabilitation setting may have important implications for maximizing recovery after traumatic brain injury.
Disorders of gut–brain interaction through the lens of polyvagal theory
Authors: Porges Stephen W.
Published: September 2024

This paper introduces a metric capable of tracking a hypothetical brainstem “switching” mechanism involved in regulating the afferent influence of blood pressure on the vagal efferent control of heart rate. In theory, this metric could be applied to evaluate the “efficiency” of brainstem pathways involved in common mechanisms of autonomic function involving the vagal influences on the gut as well as the heart. Thus, by exploring the dynamic “efficiency” of the brainstem feedback circuit linking heart rate to posture, a clinically relevant index of vagal flexibility might be extracted that would provide a generalizable window into the vagal regulation of both the heart and gut. Recent research supports this contention and has documented that this metric, VE, appears to covary with disorders of the gut. Clinical application of this metric might identify individual vulnerabilities that frequently reflect symptoms assumed to have features of a dysregulated autonomic nervous system (i.e., dysautonomia). If this is confirmed by additional research, then this objective measure of neural regulation of autonomic function might provide insight into the pathogenesis of disorders of gut–brain interaction.
Mechanical mowing of semi‐natural grasslands compromises soil quality and survival of a conservation target plant species
Authors: Vandermeeren Merel , Devriese Arne , Van Acker Kasper , Peeters Gerrit , Honnay Olivier , Ceulemans Tobias
Published: September 2024

Mowing is a crucial management strategy for conservation and restoration of semi‐natural grasslands. In the past decades, dominant mowing methods have changed from manual to mechanical, using heavy machines causing soil compaction. Whereas the negative effects of compaction are well understood in agriculture and forestry, they have received little attention so far in nature management. This study aims to investigate the effects of compaction on soil quality, arbuscular mycorrhizal fungal communities, and survival of a target plant species. We subjected seven grasslands to three contrasting mowing types: manual mowing with a brush cutter, softtrack mowing—designed to minimize soil compaction—and tractor mowing. We compared compaction, soil properties, and arbuscular mycorrhizal communities among the types. Additionally, we experimentally subjected intact grassland sods containing Devil's bit scabious (Succisa pratensis Moench), a target species of grassland conservation, to compaction levels corresponding to the three mowing types. Subsequently, we assessed plant survival. We found that soil compaction, soil nutrient availability, and toxic soil elements were significantly higher in the softtrack‐ and tractor‐mown parts of grassland sites compared to the manually mown parts. Also, the arbuscular mycorrhizal community composition differed significantly among mowing types, with the largest differences between “manual” and “tractor.” Succisa pratensis survival significantly decreased by 43 and 71% on the short term and by 71 and 86% on the longer term with increasing compaction. Consequently, mowing‐associated soil compaction compromises nature management targets via at least four mechanisms: nutrient enrichment, soil toxicity, changes in arbuscular mycorrhizal communities, and decreased survival of the target plant species.
Informal governance and transnational access in world politics
Authors: Squatrito Theresa , Sommerer Thomas
Published: September 2024

The governance turn in political research has led to increased attention to informal institutions. For scholars of international relations this has contributed to recent scholarship that reveals a notable growth in the number of informal intergovernmental organizations (IIGOs). Many aspects of IIGOs remain unknown, including whether they involve transnational actors (TNAs). Yet, whether IIGOs are open to TNAs or not may affect their performance and legitimacy. Given the importance of TNA access to IIGOs, this article explores IIGOs openness to TNAs. We illustrate that IIGOs vary whether they are open or not and that arrangements for TNA access differ. Theoretically, we build on existing literature to posit that the political costs of involvement, TNA resources, and the institutional environment affect whether IIGO are open or closed to TNAs. Empirically, we present new data on TNA access to 94 IIGOs and examine the variation in IIGO openness to explore the validity of our theoretical expectations. We find that no single account can be offered to understand access across IIGOs, and our explanatory factors show variegated effects across different subgroups of the sample. Our findings have implications for debates on the rise of informal global governance and the openness of global governance.
Ethnicity, Violence and Binary oppositions: Frames of the Wadi Salib Events in the Israeli Press from a Postcolonial Perspective
Authors: Katz Nissim
Published: September 2024

This article analyzes the frames of the Wadi Salib events in the postcolonial perspective. The aim of this article is to show how to take historic events and analyze them according to a new perspective in media research. The events of Wadi Salib were a series of street demonstrations and riots that took place in 1959 in the Wadi Salib neighborhood of Haifa at Israel. The events were a social revolt against ethnic and socio‐economic discrimination. This article uses the grounded theory method and the framing method in order to examine the coverage techniques used by three major newspapers—Yedioth Aharonoth, Haaretz, and Maariv.

The findings show three main frames. The first was the assignment of blame. The second was the frame of ethnicity. The third framing pointed to binary oppositions. The conclusion is that these frames pointed that the demonstrators are dangerous felons with criminal records who will use any means to subvert the foundations of society, while the police and the government are the defenders of the public against those insurgents.
Satisfying the composite probe on the Topic head in Mandarin Chinese
Authors: Chou C.‐T. Tim
Published: September 2024

This paper investigates two puzzles concerning gapped topicalization in Chinese: (i) DPs are restricted from undergoing multiple gapped topicalization via Agree and movement, while prepositional phrases do not face this limitation; (ii) DP gapped topicalization, typically viewed as an instance of Ā‐movement, is able to feed anaphoric binding, a property conventionally associated with A‐movement. I propose that these two puzzles can be elucidated by adopting three hypotheses: (i) Van Urk's (2015) featural approach to A/Ā‐distinction, (ii) Coon & Bale's (2014) composite probing mechanism, and (iii) Deal's (2015, 2024) interaction/satisfaction model of Agree. I will also demonstrate how this proposal readily provides a systematically consistent derivational mechanism to generate successive‐cyclic topicalization in Chinese.