bluuebunny/crossref_metadata_2025 huggingface dataset:
Climate‐associated variation in the drivers of benthic macroinvertebrate species–area relationships across shallow freshwater lakes
Authors: He Hu , Li Yan , Peng Kai , Zhang You , Rutter Robert P. , Jyväsjärvi Jussi , Hämäläinen Heikki , Kelly David , Chase Jonathan M. , Ntislidou Chrysoula , Loskutova Olga , Alcocer Javier , Jovem‐Azevêdo Daniele , Molozzi Joseline , Wang Jianjun , Zhang Min , Li Kuanyi , Liu Zhengwen , Johansson Liselotte S. , Søndergaard Martin , Cai Yongjiu , Wang Haijun , Jeppesen Erik
Published: November 2023

The island species–area relationship (ISAR) describes how species richness increases with increasing area of a given island or island‐like habitat, such as freshwater lakes. While the ISAR is one of the most common phenomena observed in ecology, there is variation in both the form of the relationship and its underlying mechanisms.

We compiled a global data set of benthic macroinvertebrates from 524 shallow freshwater lakes, ranging from 1 to 293,300 ha in area. We used individual‐based rarefaction to determine the degree to which ISAR was influenced by mechanisms other than passive sampling (larger islands passively sample more individuals from the regional pool and, therefore, have more species than smaller islands), which would bias results away from expected relationships between rarefied species richness (and other measures that capture relative abundances) and lake area. We also examined how climate may alter the shape of the ISARs.

We found that both rarefied species richness (the number of species standardized by area or number of individuals) and a measure of evenness emphasizing common species exhibit shallow slopes in relationships with lake area, suggesting that the expected ISARs in these lakes most likely result from passive sampling. While there was considerable variation among ISARs across the investigated lakes, we found an overall positive rarefied ISAR for lakes in warm (i.e. tropical/subtropical) regions (n = 195), and in contrast, an overall negative rarefied ISAR in cool (i.e. north temperate) lakes (n = 329). This suggested that mechanisms beyond passive sampling (e.g. colonization–extinction dynamics and/or heterogeneity) were more likely to operate in warm lakes. One possible reason for this difference is that the area‐dependent intensity of fish predation, which can lead to flatter ISARs, is weaker in warmer relative to cooler lakes.

Our study illustrates the importance of understanding both the pattern and potential processes underlying the ISARs of freshwater lakes in different climatic regions. Furthermore, it provides a baseline for understanding how further changes to the ecosystem (i.e. in lake area or climate) might influence biodiversity patterns.
Albumin use in patients with septic shock—Post‐hoc analyses of an international randomised fluid trial
Authors: Meyhoff Tine Sylvest , Granholm Anders , Hjortrup Peter Buhl , Sivapalan Praleene , Lange Theis , Laake Jon Henrik , Cronhjort Maria , Jakob Stephan M. , Cecconi Maurizio , Nalos Marek , Ostermann Marlies , Malbrain Manu L. N. G. , Møller Morten Hylander , Perner Anders
Published: November 2023

Background

Albumin administration is suggested in patients with sepsis and septic shock who have received large volumes of crystalloids. Given lack of firm evidence, clinical practice variation may exist. To address this, we investigated if patient characteristics or trial site were associated with albumin use in septic shock.

Methods

We conducted a post‐hoc study of the CLASSIC international, randomised clinical trial of fluid volumes in septic shock. Associations between selected baseline variables and trial site with albumin use during ICU stay were assessed in Cox models considering death, ICU discharge, and loss‐to‐follow‐up as competing events. Baseline variables were first assessed individually, adjusted for treatment allocation (restrictive vs. standard IV fluid), and then adjusted for allocation and the other baseline variables. Site was assessed in a model adjusted for allocation and baseline variables.

Results

We analysed 1541 of 1554 patients randomised in CLASSIC (99.2%). During ICU stay, 36.3% of patients in the restrictive‐fluid group and 52.6% in the standard‐fluid group received albumin. Gastrointestinal focus of infection and higher doses of norepinephrine were most strongly associated with albumin use (subgroup with highest quartile of norepinephrine doses, hazard ratio (HR) 2.58, 95% CI 1.89 to 3.53). HRs for associations between site and albumin use ranged from 0.11 (95% CI 0.05 to 0.26) to 1.70 (95% CI 1.06 to 2.74); test for overall effect of site: p < .001.

Conclusions

In adults with septic shock, gastrointestinal focus of infection and higher doses of norepinephrine at baseline were associated with albumin use, which also varied substantially between sites.
Perinatal outcome and long‐term hospitalization of triplets according to birth order
Authors: Sabag David Nadav , Pariente Gali , Sheiner Eyal , Miodownik Shayna , Wainstock Tamar
Published: November 2023

Purpose

The association between birth order and adverse perinatal outcomes has been well studied in twin pregnancies. However, little is known about the differences in immediate perinatal outcomes as well as long‐term hospitalization of the offspring in triplet pregnancies according to their birth order. As such, we aimed to assess the differences in immediate perinatal outcomes and long‐term hospitalizations among triplets by their birth order.

Methods

In a retrospective hospital‐based cohort study, immediate perinatal outcomes and long‐term hospitalizations were compared among triplet siblings according to their birth order. Deliveries occurred between the years 1991 and 2021 in a tertiary medical center. The study groups were followed until 18 years of age for cardiovascular, respiratory, neurological, and infection‐related hospitalizations. Generalized estimation equation (GEE) models were used to control for confounders. Kaplan–Meier survival curves were used to compare cumulative long‐term hospitalization incidences and Cox proportional hazards models were performed to control for confounders.

Results

The study included 117 triplet deliveries. Rates of small for gestational age (SGA) infants increased linearly by birth order (6.0%, 7.7%, and 15.4% for the first, second, and third siblings, respectively; p‐value for trends = 0.035). Using a GEE model controlling for maternal age, being born third in a triplet pregnancy was independently associated with SGA (third vs. first sibling, adjusted OR 3.0, 95% CI 1.38–6.59, p = 0.005). No significant differences in cardiovascular, respiratory, neurological, and infection‐related hospitalizations were noted among the first, second, and third siblings. Likewise, using Kaplan–Meier survival analyses, no significant differences in the cumulative incidence of long‐term pediatric hospitalizations were noted between the siblings. In Cox proportional hazards models, controlling for weight and gender, birth order in a triplet pregnancy did not exhibit an association with long‐term hospitalizations of the offspring.

Conclusion

Despite the association between birth order and SGA, birth order in triplets does not seem to have an impact on the risk for long‐term offspring hospitalization.
Do you feel up when you go up? A pilot study of a virtual reality manic‐like mood induction paradigm
Authors: Glas Roanne V. F. J. , de Kleijn Roy E. , Regeer Eline J. , Kupka Ralph W. , Koenders Manja A.
Published: November 2023

Objectives

In order to understand the working mechanisms of mania, it is necessary to perform studies during the onset of manic (‐like) mood states. However, clinical mania is difficult to examine experimentally. A viable method to study manic mood like states is mood induction, but mood induction tasks thus far show variable effectiveness.

Methods

In this pilot study, a new paradigm to induce mood through virtual reality (VR) is examined. Both state characteristics, namely changes in emotion, and trait characteristics, such as high and low scores on the hypomanic personality scale (HPS), were measured in 65 students. These students participated in either a neutral VR mood induction or an activating VR mood induction in which excitement, goal directedness, and tension (being aspects of mania) were induced. All participants performed a risk‐taking behavioural task, Balloon Analogue Risk Task (BART).

Results

The experimental VR task induced excitement and tension. In participants with higher sensitivity to hypomanic personality (HPS), irritation increased in response to activation whereas it decreased in the low HPS group, and excitement increased more steeply in the low HPS group. There were no effects on the behavioural task.

Conclusions

The VR task is effective in inducing relevant state aspects of hypomania and is suitable as a paradigm for future experimental studies. Activation of dual affective states (excitement and tension) is an essential aspect in manic‐like mood induction paradigms.
The view of the three monotheistic religions toward xenotransplantation
Authors: Tarabeih Mahdi , Amiel Aliza , Na'amnih Wasef
Published: November 2023

Xenotransplantation, transplanting animal organs into humans, may offer a solution to the shortage of organs for transplantation. This would increase the chances for scheduled, elective transplantation, even for patients currently ineligible for receiving a human organ. However, xenotransplantation raises specific ethical and philosophical issues, that is, a personal identification of the body parts with the soul and spirit, the relationships between humans and animals, and challenges related to issues of medical and social ethics. The three monotheistic religions have laws and perspectives pertaining to xenotransplantation. This scholarly review examines the theology and viewpoints of the three monotheistic religions and their concerns regarding xenotransplantation (interspecies) in terms of religious‐legal rulings, the ethical considerations related to the procedure, through religious scriptures and rulings of scholars of the three faith communities. This review should be viewed as a continuation of an extensive investigation of these issues, as the field of transplantation advances toward clinical trials. It was found that there are no fundamental religious reasons presented by any of the three religions to prohibit the use of animal organs as a means of treating severe and life‐threatening conditions. However, there are certain limitations prescribed by each religion relating to the treatment of the animals and the choice of organs to be transplanted.
Neglect scoring modifications in the National Institutes of Health Stroke Scale improve right hemisphere stroke lesion volume prediction
Authors: Silva Adriana Henriques , Alves Pedro Nascimento , Fonseca Ana Catarina , Pinho‐e‐Melo Teresa , Martins Isabel Pavão
Published: November 2023

Background

The National Institutes of Health Stroke Scale (NIHSS) does not equitably assess stroke severity in the two cerebral hemispheres. By attributing a maximum of two points for neglect and seven for language, it undervalues right hemisphere deficits. We aimed to investigate if NIHSS equally predicts right hemisphere lesion volumes in patients with and without neglect, and if a modification of the neglect scoring rules could increase its predictive capacity.

Methods

We analyzed a prospective cohort of acute right middle cerebral artery ischemic stroke patients. First, we calculated the correlation between NIHSS scores and lesion volume and analyzed the partial correlation of neglect. Then, we applied different modifications in the neglect scoring rules and investigated how they interfered with lesion volume predictive capacity.

Results

A total of 162 ischemic stroke patients were included, 108 with neglect and 54 without. The correlation between lesion volume and NIHSS was lower in patients with neglect (r = 0.540 vs. r = 0.219, p = 0.004) and neglect was a statistically significant covariate in the partial correlation analysis between NIHSS and lesion volume (p = 0.017). With the neglect score tripled and with the duplication or triplication of all neglect modalities, the correlation was significantly higher than with the standard NIHSS (p = 0.043, p = 0.005, p = 0.001, respectively). With these modifications, neglect was no longer a significant covariable in the partial correlation between lesion volume and NIHSS.

Conclusion

A modification of NIHSS neglect scoring might improve the scale's capacity to predict lesion volume.
The effects of rivastigmine on neuropsychiatric symptoms in the early stages of Parkinson's disease: A systematic review
Authors: Reilly Siobhan , Dhaliwal Simran , Arshad Usman , Macerollo Antonella , Husain Nusrat , Costa Antonio Da
Published: November 2023

Background and purpose

Neuropsychiatric symptoms including depression, apathy and psychosis occur frequently in patients with Parkinson's disease. A subgroup of patients develop cognitive impairment, which may increase the risk of falls due to reduced attention. The acetylcholinesterase inhibitor rivastigmine is beneficial in Parkinson's disease dementia, but whether the use of rivastigmine is effective earlier in the disease course is unclear. The aim of this systematic review was to assess the evidence for rivastigmine in the treatment of neuropsychiatric symptoms in Parkinson's disease without dementia.

Methods

Embase, Medline, PsychINFO, Cochrane CENTRAL, NGLC, National Institute for Health and Care Excellence Evidence and medRxiv.org were searched for studies with terms relating to population (Parkinson's disease) and intervention (rivastigmine). Of 1922 references identified, 358 were duplications. Following title and abstract review, 1331 articles were excluded. After full‐text review, nine articles remained.

Results

Outcomes were heterogenous, therefore, the results are presented in narrative form. The articles included six randomized controlled trials, two open‐label trials and one case series. Outcome measures included: time to develop psychosis; frequency of rapid eye movement sleep behaviour disorder (RBD) episodes; apathy; gait variability; falls; cognitive ability; Neuropsychiatric Inventory score; and regional spontaneous brain activity.

Conclusions

There is evidence that rivastigmine is beneficial for RBD and apathy in Parkinson's disease patients without dementia. There is high level evidence that rivastigmine reduces falls, which may be due to improved attention. The impact of rivastigmine on psychotic symptoms is less clear, but is supported by current theoretical models which involve acetylcholine dysfunction in the generation of visual hallucinations in Parkinson's disease.
Microstructural and functional alterations of the ventral pallidum are associated with levodopa‐induced dyskinesia in Parkinson's disease
Authors: Gan Yawen , Su Dongning , Zhang Zhe , Zhang Zhijin , Yan Rui , Liu Zhu , Wang Zhan , Zhou Junhong , Lam Joyce S. T. , Wu Tao , Jing Jing , Feng Tao
Published: November 2023

Background and purpose

The ventral pallidum (VP) regulates involuntary movements, but it is unclear whether the VP regulates the abnormal involuntary movements in Parkinson's disease (PD) patients who have levodopa‐induced dyskinesia (LID). To further understand the role of the VP in PD patients with LID (PD‐LID), we explored the structural and functional characteristics of the VP in such patients using multimodal magnetic resonance imaging (MRI).

Methods

Thirty‐one PD‐LID patients, 39 PD patients without LID (PD‐nLID), and 28 healthy controls (HCs) underwent T1‐weighted MRI, quantitative susceptibility mapping, multi‐shell diffusion MRI, and resting‐state functional MRI (rs‐fMRI). Different measures characterizing the VP were obtained using a region‐of‐interest‐based approach.

Results

The left VP in the PD‐LID group showed significantly higher intracellular volume fraction (ICVF) and isotropic volume fraction (IsoVF) compared with the PD‐nLID and HC groups. Rs‐MRI revealed that, compared with the PD‐nLID group, the PD‐LID group in the medication ‘off’ state had higher functional connectivity (FC) between the left VP and the left anterior caudate, left middle frontal gyrus and left precentral gyrus, as well as between the right VP and the right posterior ventral putamen and right mediodorsal thalamus. In addition, the ICVF values of the left VP, the FC between the left VP and the left anterior caudate and left middle frontal gyrus were positively correlated with Unified Dyskinesia Rating Scale scores.

Conclusion

Our multimodal imaging findings show that the microstructural changes of the VP (i.e., the higher ICVF and IsoVF) and the functional change in the ventral striatum–VP–mediodorsal thalamus–cortex network may be associated with pathophysiological mechanisms of PD‐LID.
Exploring genetic associations between vitiligo and mental disorders using Mendelian randomization
Authors: Wang Yingwei , Yao Tao , Lin Yunlu , Ye Lili , Li Shuting , Gao Yu , Wu Jianming
Published: November 2023

Although a large number of existing studies have confirmed that people with vitiligo are prone to mental disorders, these observational studies may be subject to confounding factors and reverse causality, so the true causal relationship is inconclusive. We conducted a bidirectional Mendelian randomization (MR) analysis to assess the causality between vitiligo and mental disorders, namely depression, anxiety, insomnia, schizophrenia, bipolar disorder, obsessive‐compulsive disorder (OCD) and attention‐deficit hyperactivity disorder (ADHD). Summary statistics from large available genome‐wide association study (GWAS) datasets for generalized vitiligo (n = 44 266), depression (n = 173 005), anxiety (n = 17 310), insomnia (n = 386 988), schizophrenia (n = 130 644), bipolar disorder (n = 413 466), OCD (n = 9725) and ADHD (n = 225 534) were utilized. Inverse‐variance weighted (IVW), MR‐Egger and weighted median were employed to estimate causal effects. Sensitivity analysis and MR Pleiotropy Residual Sum and Outliers (MR PRESSO) were conducted to assess heterogeneity and pleiotropy, ensuring the robustness of the results. Additionally, we corrected for estimating bias that might be brought on by sample overlap using MRlap. In our findings, none of the rigorous bidirectional MR analyses uncovered a significant causal association. Even after applying the MRlap correction, the effect sizes remained statistically nonsignificant, thereby reinforcing the conclusions drawn via IVW. In summary, our genetic‐level investigation did not reveal a causal link between generalized vitiligo and mental disorders.
Safety, pharmacokinetics and efficacy of a subcutaneous recombinant FVIII (OCTA101) in adult patients with severe haemophilia A
Authors: Lissitchkov Toshko , Jansen Martina , Bichler Johann , Knaub Sigurd
Published: November 2023

Introduction

Regular, prophylactic intravenous (i.v.) FVIII can be challenging for some patients with haemophilia A. Subcutaneous (s.c.) FVIII administration could provide an alternative treatment option with greater convenience and without the complications associated with venous access.

Aim

To assess the safety, pharmacokinetics (PK), bioavailability and efficacy of s.c. OCTA101, a recombinant FVIII with a recombinant von Willebrand factor fragment dimer.

Methods

This was a single‐centre, prospective, open‐label, phase I/II study (NCT04046848). Previously treated male patients (≥18 years) with severe haemophilia A were eligible for the study. The primary objective of the study was to assess the safety (including immunogenicity) of OCTA101. Secondary objectives included assessments of PK, bioavailability, and the efficacy of prophylaxis.

Results

Thirty patients were treated with OCTA101. FVIII inhibitors developed in five (16.7%) patients during daily prophylaxis with 40–60 IU/kg (three cases) and 12.5 IU/kg (two cases) OCTA101. The trial was therefore terminated. OCTA101 had a 2.5‐fold longer terminal half‐life compared with i.v. rFVIII, and bioavailability was 16.6%. Efficacy data at study termination indicated that daily prophylaxis with 40–60 IU/kg OCTA101 was efficacious in the absence of FVIII inhibitors.

Conclusions

Despite promising PK and efficacy results, the trial was terminated due to the incidence of FVIII inhibitors. The occurrence of inhibitors at two dose levels suggests that their development may be related to the subcutaneous route of administration.
Consumers' behavioral intention toward online shopping in the post‐COVID‐19 period
Authors: Khatoon Sabiha , Anwar Imran , Shamsi Mushahid Ali , Chaudhary Asiya
Published: November 2023

Infectious COVID‐19 transformed the world overnight, freezing all physical activities and forcing the majority toward online mode. Technology came up as a savior to alleviate the consequences of COVID‐19 on the economy, causing a rapid transformation in consumers' behavior, and an overall jump in the sale of e‐commerce could be witnessed globally. This paper aims to explore the factors that caused the transformation in consumers' behavioral attitude (AT) and intention toward online shopping (BITOS). The study integrates the TPB and UTAUT models while adding two additional variables, namely, perceived risks (PR) and perceived benefits (PB), to predict consumers' BITOS. A survey was conducted to collect a sample of 402 consumers Aligarh city, and the National Capital Region of India using the mall intercept sampling method. The data were analysed to establish the measurement model and test the hypothesized structural model with the Smart‐PLS software. The study's findings confirmed that PB, subjective social norms, perceived ease of use, and perceived usefulness positively affect AT and BITOS, whereas PR does not influence AT and BITOS. The study also indicated that AT has a positive effect on BITOS. Concerning AT, it does not mediate the relationship between PR and BITOS; however, it mediates between the direct link PB and BITOS, making it stronger. The study's findings help the E‐commerce industry understand consumers' transformed attitudes/intentions and restructure their strategies to strengthen their online business further. Despite its regional and design limitations, it contributes significantly to the current research on online shopping behavior in India during COVID‐19.
Transmissibility of severe acute respiratory syndrome coronavirus 2 among household contacts of coronavirus disease 2019‐positive patients: A community‐based study in India
Authors: Sreedevi Aswathy , Mohammad Ahmad , Satheesh Mini , Ushakumari Anuja , Kumar Anil , Raveendran Geetha , Narayankutty Saritha , Gopakumar Soumya , Rahman Anisur , David Sachin , Mathew Minu Maria , Nair Prem
Published: November 2023

Background

This study identified the risk factors for severe acute respiratory syndrome coronavirus 2 infection among household contacts of index patients and determined the incubation period (IP), serial interval, and estimates of secondary infection rate in Kerala, India.

Methods

We conducted a cohort study in three districts of Kerala among the inhabitants of households of reverse transcriptase polymerase chain reaction‐positive coronavirus disease 2019 patients between January and July 2021. About 147 index patients and 362 household contacts were followed up for 28 days to determine reverse transcriptase polymerase chain reaction positivity and the presence of total antibodies against SARS‐CoV‐2 on days 1, 7, 14, and 28.

Results

The mean IP, serial interval, and generation time were 1.6, 3, and 3.9 days, respectively. The secondary infection rate at 14 days was 43.0%. According to multivariable regression analysis persons who worked outside the home were protected (adjusted odds ratio [aOR], 0.45; 95% confidence interval [CI], 0.24–0.85), whereas those who had kissed the coronavirus disease 2019‐positive patients during illness were more than twice at risk of infection (aOR, 2.23; 95% CI, 1.01–5.2) than those who had not kissed the patients. Sharing a toilet with the index patient increased the risk by more than twice (aOR, 2.5; 95% CI, 1.42–4.64) than not sharing a toilet. However, the contacts who reported using masks (aOR, 2.5; 95% CI, 1.4–4.4) were at a higher risk of infection in household settings.

Conclusions

Household settings have a high secondary infection rate and the changing transmissibility dynamics such as IP, serial interval should be considered in the prevention and control of SARS‐CoV‐2.
Transmissibility and severity of COVID‐19 in a humanitarian setting: First few X investigation of cases and contacts in Juba, South Sudan, 2020
Authors: Lako Richard Lino Loro , Meagher Niamh , Wamala Joseph Francis , Ndyahikayo John , Ademe Tegegne Ayesheshem , Olu Olushayo Oluseun , Price David J. , Rajatonirina Soatiana , Farley Elise , Okeibunor Joseph Chukwudi , Mize Valerie Ann
Published: November 2023

Background

The first few ‘X’ (FFX) studies provide evidence to guide public health decision‐making and resource allocation. The adapted WHO Unity FFX protocol for COVID‐19 was implemented to gain an understanding of the clinical, epidemiological, virological and household transmission dynamics of the first cases of COVID‐19 infection detected in Juba, South Sudan.

Methods

Laboratory‐confirmed COVID‐19 cases were identified through the national surveillance system, and an initial visit was conducted with eligible cases to identify all close contacts. Consenting cases and close contacts were enrolled between June 2020 and December 2020. Demographic, clinical information and biological samples were taken at enrollment and 14–21 days post‐enrollment for all participants.

Results

Twenty‐nine primary cases and 82 contacts were included in the analyses. Most primary cases (n = 23/29, 79.3%) and contacts (n = 61/82, 74.4%) were male. Many primary cases (n = 18/29, 62.1%) and contacts (n = 51/82, 62.2%) were seropositive for SARS‐CoV‐2 at baseline. The secondary attack rate among susceptible contacts was 12.9% (4/31; 95% CI: 4.9%–29.7%). All secondary cases and most (72%) primary cases were asymptomatic. Reported symptoms included coughing (n = 6/29, 20.7%), fever or history of fever (n = 4/29, 13.8%), headache (n = 3/29, 10.3%) and shortness of breath (n = 3/29, 10.3%). Of 38 cases, two were hospitalised (5.3%) and one died (2.6%).

Conclusions

These findings were used to develop the South Sudanese Ministry of Health surveillance and contract tracing protocols, informing local COVID‐19 case definitions, follow‐up protocols and data management systems. This investigation demonstrates that rapid FFX implementation is critical in understanding the emerging disease and informing response priorities.
Citalopram‐induced Photopigmentation
Authors: I˚nalöz H. Serhat , Kirtak Necmettin , Herken Hasan , Özgöztaşi Orhan , Aynacioğlu A. Şükrü
Published: November 2023

Citalopram is one of the newer and most potent selective serotonin re‐uptake inhibitor (SSRI) drugs. It has a well‐established antidepressive action with a favorable adverse event profile. We present a fifty‐year‐old woman with diffuse photopigmentation who had been diagnosed as suffering from depression. The patient was given citalopram (40 mg/day) for her psychiatric condition and diffuse photopigmentation was noted thereafter. To our knowledge, such an adverse event has not been reported previously.
CD56‐Positive Cutaneous Lymphoma with Multicentric Castleman's Disease‐like Systemic Manifestations
Authors: Amo Yasuyuki , Ogata Fuyuki , Okabe Seigo , Yonemoto Kohzoh , Katsuoka Kensei
Published: November 2023

We report a 55‐year‐old Japanese male with CD56+ cutaneous lymphoma. The patient had multiple cervical lymphadenopathy, a red nodule on his neck, and parotid gland nodularity. Histologic features of the biopsied cervical lymph node showed follicular hyperplasia with numerous plasma cells. A biopsied skin specimen of the nodule on his neck demonstrated dense infiltration of atypical large lymphocytes into the dermis. Immunohistochemical study of this specimen revealed CD3+, CD4+, and CD56+ expression in the majority of neoplastic cells. Polymerase chain reaction assays for the detection of Epstein‐Barr virus sequences were positive for lymph node and skin DNA. Laboratory examinations showed polyclonal gammopathy, pancytopenia, and high serum interleukin‐6 levels. These clinical and histological findings resembled those of multicentric Castleman's disease.
A Case of Proliferative Fasciitis in the Abdominal Region
Authors: Honda Yoshihide , Oh‐i Tsunao , Koga Michiyuki , Serizawa Hiromi
Published: November 2023

A 20‐year‐old woman complained of a subcutaneous nodule accompanied by spontaneous pain and tenderness in the right hypochondriac region approximately two weeks prior to initial evaluation. The spontaneous pain and tenderness gradually worsened. Histopathological examination revealed a proliferative lesion that extended from the deep dermis to the fatty tissue and consisted predominantly of stellate or spindle‐shaped fibroblast‐like cells intermingled with gangliocyte‐like giant cells. Consequently, proliferative fasciitis was diagnosed. Our investigation revealed only 19 cases of proliferative fasciitis reported in Japan. The overall age range of them is 20 to 75 years (mean, 57.6 years). The lesion site in them is the head and neck in 10%, the trunk in 30%, and the extremities in 60%. It follows that the extremities are predominantly the site of proliferative fasciitis, and truncal lesions are relatively rare. It is rare for proliferative fasciitis to occur at a young age or in the abdominal region. We therefore examined the differences between proliferative fasciitis and similar disorders, namely proliferative myositis and nodular fasciitis, based on summaries of cases reported in Japan.
The Induction of Heme Oxygenase‐1 by Exogenous Nitric Oxide in ex vivo Normal Human Skin
Authors: Shimizu Kazuhiro , Naito Shinji , Urata Yoshishige , Takamiyagi Atsushi , Bae Sang Jae , Ogawa Fumihide , Kondo Takahito , Katayama Ichiro
Published: November 2023

Gaseous carbon monoxide (CO) has received attention as a neurotransmitter and as a material involved in persistent dilatation of vessels. CO is released by heme oxygenase (HO) during the process from heme to bilirubin or biliverdin. Many reports have revealed that exogenous nitric oxide (NO) can induce HO‐1 in vitro, which is the induced isoform of HO. In the present study, we attempted an ex vivo system as an explant culture. A quantitative analysis was performed in combination with a reverse transcription–competitive polymerase chain reaction method, which proved to be very accurate, as well as a qualitative analysis with an immunohistochemistry. With this system we confirmed the induction of HO–1 mRNA and protein by exogenous NO in normal human skin. Our results concluded that this ex vivo system was very useful, because skin samples could be handled easily under conditions close to the in vivo situation.
Relative Frequency of the Different Types of Cutaneous T Cell and Natural Killer Cell Lymphomas in Korea Based on the Proposed WHO Classification and the EORTC Classification
Authors: Chang Sung‐Eun , Jee Min‐Sun , Kim Kyoung Jin , Choi Jee‐Ho , Sung Kyung‐Jeh , Moon Kee‐Chan , Koh Jai‐Kyoung
Published: November 2023

The R.E.A.L. classification was largely adopted recently by the proposed WHO classification. The usefulness of this classification in cutaneous T cell and natural killer (NK) cell lymphomas in Korea was evaluated compared to that of the European Organization for Research and Treatment of Cancer (EORTC) classification. Overall, 78 patients with cutaneous T cell and NK cell lymphomas were diagnosed in Asan Medical Center in the 1990's. The clinical records, slides of H&E and immunohistochemical stainings were reviewed. By the proposed WHO classification, mycosis fungoides (20 cases), lymphomatoid papulosis (13 cases), nasal type NK/T‐cell lymphoma (10 cases), CD30+ anaplastic large cell lymphoma (8 cases), subcutaneous panniculitis‐like T‐cell lymphoma (6 cases), peripheral T‐cell lymphoma, unspecified (3 cases), Sézary syndrome (1 case) and blastic NK cell lymphoma (1 case) comprised the primary cases. Secondary or undetermined cases included peripheral T‐cell lymphoma, unspecified (10 cases), nasal type NK/T‐cell lymphoma (5 cases), and angioimmunoblastic T‐cell lymphoma (1 case). EORTC classification for cutaneous T cell and NK cell lymphomas did not include nasal and nasal type NK/T‐cell lymphomas, unspecified non‐pleomorphic T‐cell lymphoma, undetermined cases among primary or secondary ones and some rare types of skin lymphomas which can be classified by WHO. The WHO classification is more useful for skin lymphomas in Korea since it encompassed all the various types of skin T cell and NK cell lymphomas in Korea.
Stevens‐Johnson Syndrome with Idiopathic Thrombocytopenic Purpura Treated with Dexamethasone Pulse Therapy
Authors: Barman Krishna Deb , Verma Kaushal K. , Agrawal Sudha , Agarwalla Arun , Rijal Arpana
Published: November 2023

Stevens‐Johnson syndrome (SJS) is a severe, episodic, acute, mucocutaneous hypersensitivity reaction often caused by drugs. We herewith report a case of SJS with idiopathic thrombocytopenic purpura (ITP) that did not respond to daily oral prednisolone therapy. When treated with dexamethasone pulse therapy, the response was found to be very good. Therefore, we concluded that dexamethasone pulse therapy can be a good and an effective alternative therapy for treatment of such patients. However, to establish its role, further trials in more patients are needed.
A Case of Baboon Syndrome Associated with Group A Streptococcal Infection
Authors: Ichimiya Makoto , Hamamoto Yoshiaki , Muto Masahiko
Published: November 2023

We described a 21‐year‐old Japanese patient with sore throat, fever, and diffuse erythema on the neck, trunk, and limbs. Erythema markedly appeared on the neck, axillary, antecubital, and popliteal fossae. However, other skin signs of scarlet fever such as red strawberry tongue and linear petechial eruption did not appear. Before his visit to our clinic, he had been diagnosed as pharyngitis and treated with cefaclor 750 mg daily for six days. However, the symptoms did not improve. Oral prednisolone of 20 mg daily rapidly improved all the symptoms. Pharyngeal culture grew Streptococcus pyogenes that was sensitive to cefaclor. Laboratory findings showed elevated serum levels of antibody against streptolysin O. Together with the distribution of erythema, culture of Streptococcal pyogenes, and elevated anti‐streptolysin O titer, the diagnosis of baboon syndrome associated with streptococcal infection was made. This seems to be the first report of baboon syndrome due to streptococcal infection.
The perspectives of internationally qualified nurses regarding their specialty skill transition to Australia: A cross‐sectional survey
Authors: Kurup Chanchal , Burston Adam Scott , Betihavas Vasiliki , Jacob Elisabeth Ruth
Published: November 2023

Aim

To identify barriers and facilitators of speciality skill transfer for internationally qualified nurses in Australia from the nurses' perspective.

Design

A cross‐sectional study.

Methods

A cross‐sectional online survey was distributed through social media, snowballing and nursing professional organization. Data analysed using Statistical Package for the Social Sciences.

Data Sources

Online survey data from participants matching the inclusion criteria were collected from July to September 2022.

Results

Survey results reveal facilitators (competence, scope of practice, linguistic sufficiency, understanding of decision‐making) and barriers (lack of opportunity, transition pathways, confidence in overseas education, financial instability) for internationally qualified nurses' speciality skill utilization in Australia.

Conclusion

Identifying and addressing barriers and facilitators, along with developing tailored transition pathways, are crucial for maximizing speciality skill utilization among internationally qualified nurses. These findings have implications for policymakers, healthcare organizations and nurses. They highlight the need to address barriers, facilitate smooth transitions and implement proactive measures for internationally qualified nurses to effectively utilize their specialty skills.

Impact

The study addresses maximizing skill usage for internationally qualified nurses, identifies barriers and facilitators for specialty skill transfer in Australia and will impact policymakers, healthcare organizations and nurses by guiding strategies for safe nursing service delivery and optimizing patient care.

Reporting Method

STROBE checklist.

Patient or Public Contribution

A total of 71 internationally qualified nurses contributed their experiences and opinions.

What Does this Paper Contribute to the Wider Global Clinical Community?

Lack of opportunity and the lack of transition pathways inhibit the use of specialty nursing skills by internationally qualified nurses.

This study's findings contradict the result of other studies that suggest language is a significant obstacle to the utilization of specialty skills of internationally qualified nurses.

Trial and Protocol Registration

The protocol is registered on OSF. The data for this study are available for sharing with the reviewers upon request. However, it is worth noting that ethical approval has not been obtained specifically for web sharing, and therefore, the data has not been posted in any repositories or public platforms.
Women's experiences of online antenatal education: An integrative literature review
Authors: Whitworth Kassie , Donnellan‐Fernandez Roslyn , Fleet Julie‐Anne
Published: November 2023

Aim

To identify what is currently known about how women experience online antenatal education.

Design

Integrative literature review.

Review Methods

This integrative review applied the five‐stage methodological framework outlined by Whittemore and Knafl (2005), supporting rigour in problem identification, selection and critical appraisal of quality literature, data analysis and synthesis of findings.

Data Sources

A literature search was conducted in May/June 2022, utilizing databases including OVID Embase, CINAHL, Joanna Briggs Institute EBP database, Nursing and Allied Health database, Wiley Online Library, Google scholar search engine and related reference lists. The search was limited to English language and primary research articles published in the last 10‐year period (2012–2022).

Results

12 articles met inclusion criteria. Three primary themes were identified: Comprehensibility: Looking back – understanding women's needs and preferences; Manageability: In the moment – flexibility versus social connection; and Meaningfulness & sustainability: Looking forward – the future of digital maternity education.

Conclusion

Findings identified a marked digital divide for women accessing online antenatal education, placing vulnerable women at risk of continuing inequity. E‐health literacy frameworks need to be implemented to create genuine accessibility, comprehensibility and cultural responsiveness to best meet the needs of users.

Implications for the Profession and/or Health Care Consumer

As digital health is an emerging field, there is strong evidence that online antenatal education requires further evaluation to better meet the needs of pregnant women and their support people. Enhancing digital health literacy for health professionals will also promote a greater understanding for how to uphold and support the socio‐technical dimensions of online service delivery.

Patient or Public Contribution

There were no patient or public contributions as part of this integrative review of the literature.
Convergent evolution of the environmental adaptability of high‐elevation populations of waist‐shaped bugs
Authors: Wang Shujing , Li Yanfei , Zhou Jiayue , Chen Juhong , Jiang Kun , Ye Zhen , Xue Huaijun , Bu Wenjun
Published: November 2023

Aim

Similar environmental selection pressures drive the occurrence of convergent evolution among species. However, studies on this phenomenon are scarce at the population level. Here, we used two waist‐shaped bugs to test the hypothesis that similar high‐elevation habitat environments could lead to similar genetic adaptations among populations of different species.

Location

East Asia.

Taxa

Malcus sinicus Štys, 1967 & Malcus insularis Štys, 1967.

Methods

Population genetic structure was determined by phylogenetic and phylogeographical analyses. Demographic history was inferred by comparing simulated history models. Suitable habitat from the last interglacial period (LIG) to the present was predicted by ecological niche modelling (ENM). Convergent evolutionary processes were jointly assessed by the comparison of population ecological differences and the principal component analysis of environmentally related single‐nucleotide polymorphisms (SNPs).

Results

Our results showed that the land bridge in the Pleistocene helped ancestral populations of M. sinicus and M. insularis diffuse from mainland China to Taiwan Island. Subsequently, the geographical barrier imposed by the Taiwan Strait promoted the species differentiation. Geographic isolation and adaptive evolution jointly promoted the population differentiation in M. sinicus. Genetic similarity was found between the populations of M. sinicus in southwestern China (sin‐YN) and M. insularis on Taiwan Island (ins‐TW). Temperature‐related environmental factors and elevation were found to similarly and significantly clustered with ins‐TW and sin‐YN and were clearly distinguished from the other low−/mid‐elevation populations of M. sinicus (sin‐EA). Furthermore, the SNPs related to these environmental factors presented the same clustering results.

Main Conclusions

Our study revealed a novel disjunct distribution pattern between southwestern China and Taiwan Island at the population level and provided evidence of convergent evolution of local populations in high‐elevation environments. Here, we revealed that similar environmental selection pressures can drive the occurrence of convergent evolution at the population level among different species.
‘When I stood up for something it's because I felt a… moral violation’: Trainees' acts of resistance against social harm and injustice
Authors: Wyatt Tasha R. , Jain Vinayak , Ma Ting Lan
Published: November 2023

Introduction

As medical students around the world enter their chosen profession, they inherit a system that they did not design nor create, yet are still responsible for it. This system is rooted in centuries of social harm and inequity. This study examines trainees' professional acts of resistance to understand what trainees hope to accomplish in their resistance efforts, why they are resisting, and the tactics they use.

Methods

Drawing on counter‐storytelling and critical theory, we collected in‐depth qualitative interviews from nine medical students and nine residents/fellows across North America. Using theoretical guidance on how to study acts of resistance, data were analysed using a combination of coding techniques to understand resistors' intentions in resisting and the tactics they used to understand what, why, and how trainees were resisting. The analysis was returned to participants for member checking.

Results

Trainees described resisting systems of harm and injustice bequeathed to them by an older generation whose values and practices were reflective of a different time. Their motivations stemmed from deep‐seated moral distress from the mistreatment of patients and learners. They hoped to re‐envision medical education to be patient‐ and learner‐centred. The tactics they chose depended on the level of power they had in the system and the extent to which they wished to have their efforts known.

Discussion

Trainees described intentional and deliberate acts of resistance to the social harm and injustice embedded in the broader profession to re‐create the profession. Given that these acts spanned a large geographical area, this study suggests that trainees may be part of a larger social movement aimed at creating widespread change within the profession.
CD52 mRNA expression predicts prognosis and response to immune checkpoint blockade in melanoma
Authors: de Vos‐Hillebrand Luka , Fietz Simon , Hillebrand Philip , Kulcsár Zsófi , Diop Marie Yatou , Hollick Sarah , Maas Alexander Philippe , Strieth Sebastian , Landsberg Jennifer , Dietrich Dimo
Published: November 2023

The immune‐modulating protein CD52 attenuates lymphocyte function and is associated with autoimmune disorders, for example, multiple sclerosis (MS). CD52 represents a therapeutic target in MS and chronic lymphocytic leukemia (CLL). Its expression has prognostic and predictive value in CLL and is prognostic in breast cancer. Its significance in melanoma is unclear. We analyzed CD52 mRNA expression data from tumor bulk tissues of N = 445 untreated melanoma patients from The Cancer Genome Atlas (TCGA) Research Network and of N = 121 melanoma patients undergoing anti‐PD‐1 immune checkpoint blockade (ICB) with regard to outcome (overall survival [OS], disease control [DC], and progression‐free survival [PFS]), single‐cell RNA‐Seq data of N = 4645 cells from N = 19 melanoma tissues, and N = 15,457 cells from normal skin provided by N = 5 donors. Higher CD52 mRNA expression was associated with favorable OS (hazard ratio (HR) = 0.820, [95% CI 0.734–0.916], p < .001) in non‐ICB‐treated melanoma and with PFS (HR = 0.875, [95% CI 0.775–0.989], p = .033) and DC (p = .005) in ICB‐treated melanoma. CD52 expression correlated significantly with distinct immune cell subsets and correlated negatively with immune checkpoint expression in T cells. Moreover, our results suggest CD52 expression by a certain type of tissue‐resident macrophages. CD52 mRNA was expressed in a small subgroup (8%) of immune checkpoint coexpressing melanoma cells. CD52 expression is associated with features of ICB response in melanoma. Concomitant ICB and anti‐CD52 treatment requires critical review.
Functionalism and tacit knowledge of grammar
Authors: Balcarras David
Published: November 2023

In this article, I argue that if tacit knowledge of grammar is analyzable in functional‐computational terms, then it cannot ground linguistic meaning, structure, or sound. If to know or cognize a grammar is to be in a certain computational state playing a certain functional role, there can be no unique grammar cognized. Satisfying the functional conditions for cognizing a grammar G entails satisfying those for cognizing many grammars disagreeing with G about expressions' semantic, phonetic, and syntactic values. This threatens the Chomskyan view that expressions have such values for speakers because they cognize grammars assigning them those values. For if this is true, semantics, syntax, and phonology must be indeterminate, thanks to the indeterminacy of grammar‐cognizing (qua functional‐computational state). So, the fact that a speaker cognizes a grammar cannot explain the determinate character of their language.