bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of mobile health interventions on health‐related outcomes in older adults with type 2 diabetes: A systematic review and meta‐analysis
Authors: Lee Jovin Jie Ning , Abdul Aziz Alia , Chan Sok‐Teng , Raja Abdul Sahrizan Raja Syazwani Farhanah binti , Ooi Angeline Ying Ying , Teh Yi‐Ting , Iqbal Usman , Ismail Noor Azina , Yang Aimin , Yang Jingli , Teh Daniel Boon Loong , Lim Lee‐Ling
Published: January 2023

Background

Type 2 diabetes mellitus (T2DM) is a chronic metabolic condition that is associated with multiple comorbidities. Apart from pharmacological approaches, patient self‐management remains the gold standard of care for diabetes. Improving patients' self‐management among the elderly with mobile health (mHealth) interventions is critical, especially in times of the COVID‐19 pandemic. However, the extent of mHealth efficacy in managing T2DM in the older population remains unknown. Hence, the present review examined the effectiveness of mHealth interventions on cardiometabolic outcomes in older adults with T2DM.

Methods

A systematic search from the inception till May 31, 2021, in the MEDLINE, Embase, and PubMed databases was conducted, and 16 randomized controlled trials were included in the analysis.

Results

The results showed significant benefits on glycosylated hemoglobin (HbA1c) (mean difference −0.24%; 95% confidence interval [CI]: −0.44, −0.05; p = 0.01), postprandial blood glucose (−2.91 mmol/L; 95% CI: −4.78, −1.03; p = 0.002), and triglycerides (−0.09 mmol/L; 95% CI: −0.17, −0.02; p = 0.010), but not on low‐density lipoprotein cholesterol (−0.06 mmol/L; 95% CI: −0.14, 0.02; p = 0.170), high‐density lipoprotein cholesterol (0.05 mmol/L; 95% CI: −0.03, 0.13; p = 0.220), and blood pressure (systolic blood pressure −0.82 mm Hg; 95% CI: −4.65, 3.00; p = 0.670; diastolic blood pressure −1.71 mmHg; 95% CI: −3.71, 0.29; p = 0.090).

Conclusions

Among older adults with T2DM, mHealth interventions were associated with improved cardiometabolic outcomes versus usual care. Its efficacy can be improved in the future as the current stage of mHealth development is at its infancy. Addressing barriers such as technological frustrations may help strategize approaches to further increase the uptake and efficacy of mHealth interventions among older adults with T2DM.
Sex differences in the risk of arterial stiffness among adults with different glycemic status and modifications by age
Authors: Zhang Xiaoyun , Yang Qianqian , Zheng Ruizhi , Zhao Zhiyun , Li Mian , Wang Tiange , Xu Min , Lu Jieli , Wang Shuangyuan , Lin Hong , Wang Weiqing , Ning Guang , Bi Yufang , Xu Yu , Chen Yuhong
Published: January 2023

Background

Studies indicate lower, comparable, and higher cardiovascular risks in women vs men in normal glucose regulation (NGR), prediabetes, and diabetes, respectively. However, this sex difference is uncertain and aging might play a part. We aimed to estimate sex differences in arterial stiffness in NGR, prediabetes, or diabetes and the potential modifications by age.

Methods

We used baseline data of 9618 participants aged ≥40 years in a large community‐based cohort study in Shanghai. Glycemic status was determined by history of diabetes, fasting and 2‐h post‐load glucose levels, and hemoglobin A1c levels. Arterial stiffness was examined by brachial‐ankle pulse wave velocity (ba‐PWV). Multivariable linear regression analysis was conducted to examine the associations between sex and ba‐PWV levels in glycemic and age categories.

Results

Before adjustment for age, women had lower, comparable, and higher ba‐PWV vs men in the NGR, prediabetes, and diabetes groups, respectively. In participants aged 40–59 years, women were associated with lower ba‐PWV levels in generally all glycemic strata after adjustment for age and other confounders. In participants aged ≥60 years, women were associated with significantly higher ba‐PWV levels (β coefficient = 71.5; 95% confidence interval = 23.4, 119.7) and the sex difference was attenuated in the groups of prediabetes and diabetes with a borderline significant interaction between sex and glycemic status (p for interaction = .068).

Conclusions

The sex difference in cardiovascular risks in adults with NGR, prediabetes, or diabetes was dependent on age. Our findings provide new evidence for prioritizing preventive treatment against atherosclerosis in men vs women with different glycemic status.
Genome‐wide association study reveals the candidate genes for reproduction traits in Yunong black pigs
Authors: Li Mengyu , Li Xin , Liu Chuang , Han Jinyi , Han Xuelei , Wang Kejun , Qiao Ruimin , Yang Feng , Li Xiu‐Ling , Li Xin‐Jian
Published: January 2023

Enhancing pig reproductive efficiency has the potential to have a significant positive economic impact on the pig business. We collected four reproduction records of 734 Yunong black pigs in this study, including the total number of piglets born (TNB), the number born alive (NBA), the average birth interval of piglets (ABI) and the average birth weight (ABW). A total of 453 Yunong black pigs were genotyped with Porcine 50K SNP BeadChip. Twenty‐five SNPs and 35 genomic areas were found to have a substantial impact on the reproductive performance of Yunong black pigs by single‐locus GWAS and single‐step GWAS (ssGWAS). For the ssGWAS, we found that the two genomic regions (12.67–13.85 and 14.26–15.01 Mb) on Sus scrofa chromosome X were associated with TNB, NBA and ABI. It is worth noting that CNC10110530 and CNC100141254 significantly affected the TNB by both GWAS methods. Finally, we further determined the gene functions by enrichment analysis and a literature search, and identified 28 of them as candidate genes affecting the reproductive performance of Yunong black pigs, including RET, EIF1AX, NELL2, CTPS2, S100G, RBBP7 and PDHA1. This study further promotes understanding of the genetic mechanism of porcine reproductive performance, and also provides more molecular markers for pig breeding.
Electrocardiographic and echocardiographic predictors of greater carotid intima‐media thickness in tactical athletes: The CHIEF atherosclerosis study
Authors: Lin Yen‐Po , Hsu Yi‐Chiung , Tsai Kun‐Zhe , Huang Wei‐Chun , Han Chih‐Lu , Lin Gen‐Min
Published: January 2023

Objective

Both electrocardiographic and echocardiographic left ventricular hypertrophy (LVH) have been reported with an association with greater carotid intima‐media thickness (cIMT), a marker of subclinical atherosclerosis in patients with hypertension, while the associations are unclear in physically fit young adults.

Methods

A total of 1822 Taiwanese military personnel, aged 18–40 years, received an annual health examination including electrocardiography (ECG) and echocardiography in 2018–2020. Left carotid bulb cIMT was measured by high‐resolution ultrasonography. Multiple logistic regression analysis with adjustments for age, sex, smoking, alcohol consumption, body mass index, mean blood pressure, and physical fitness was used to determine the associations between echocardiographic and ECG parameters and the highest quintile of cIMT (≥0.8 mm).

Results

Cornell‐based LVH, Myers et al.‐based RVH and heart rate ≥75/min were associated with cIMT ≥0.8 mm [odds ratios (ORs) and 95% confidence intervals: 1.54 (1.01, 2.35), 1.66 (1.18, 2.33), and 1.39 (1.06, 1.83), respectively], while echocardiographic LVH defined as ≥46.0 g/m2.7 for men and ≥38.0 g/m2.7 for women was inversely associated with cIMT ≥0.8 mm [OR: 0.45 (0.24, 0.86)].

Conclusion

In tactical athletes of military, the associations of ECG and echocardiographic LVH with cIMT were in opposite directions. Higher physical fitness may cause cardiac muscle hypertrophy and reduce the atherosclerosis severity, possibly leading to the paradoxical echocardiographic finding. This study suggests that ECG‐based LVH remains a good marker of subclinical atherosclerosis in our military population.
Meta‐analysis: Enhanced liver fibrosis test to identify hepatic fibrosis in chronic liver diseases
Authors: Hinkson Alexander , Lally Hannah , Gibson Hannah , Jones Rebecca , Rowe Ian A. , Shinkins Bethany , Parker Richard
Published: January 2023

Background & Aims

Patients with liver disease can be stratified for risk of liver‐related ill health by degree of hepatic fibrosis. The Enhanced liver fibrosis (ELF) test was developed to quantify hepatic fibrosis non‐invasively and is widely used. The objective of this review was to identify and synthesise the evidence on the diagnostic accuracy of the ELF test for staging of hepatic fibrosis.

Approach & Results

Searches of PubMed and EMBASE were conducted between October 2020 and November 2021 to identify studies reporting the diagnostic accuracy of the ELF test compared to histology in liver disease patients. QUADAS‐2 was used to assess risk of bias in each study. Meta‐analysis using the multiple thresholds model described by Steinhauser S, Schumacher M, Rücker G. Modelling multiple thresholds in meta‐analysis of diagnostic test accuracy studies. BMC Med. Res. Methodol. 2016;16. 10.1186/s12874‐016‐0196‐1 allowed synthesis of 2 × 2 data at different cut‐offs. Sixty‐three studies were included in this review. These studies included 19,285 patients with or at risk of liver disease from viral hepatitis, Non‐Alcoholic Fatty Liver Disease, Alcohol‐related Liver Disease and other mixed chronic liver diseases. The prevalence of significant fibrosis, advanced fibrosis and cirrhosis was 47.5%, 39.2% and 4.4%, respectively. Cut‐offs with maximal Youden index were generated with AUROC = 0.811 (95% CI: 0.736–0.870), 0.812 (95% CI: 0.758–0.856) and 0.810 (95% CI: 0.694–0.888) to detect significant fibrosis, advanced fibrosis or cirrhosis, respectively. Diagnostic accuracy of the ELF test varied between different liver diseases and cut‐offs to detect each stage with 95% sensitivity or specificity were also generated.

Conclusions

Meta‐analysis revealed considerable variability in the ability of ELF to stage fibrosis across disease aetiologies. Research has mostly focused on viral hepatitis and NAFLD. There is currently a lack of data on the value of the ELF test in Alcohol‐related liver disease and patients in primary care settings.
Detection and genetic diversity of porcine rotavirus A, B and C in eastern Australian piggeries
Authors: Genz B , Gerszon J , Pollock Y , Gleeson B , Shankar R , Sellars MJ , Moser RJ
Published: January 2023

Rotaviruses (RV) have a high prevalence in piggeries worldwide and are one of the major pathogens causing severe diarrhoea in young pigs. RV species A, B, and C have been linked to piglet diarrhoea in Australian pig herds, but their genetic diversity has not been studied in detail. Based on sequencing of the structural viral protein 7 (VP7) RVA G genotypes G3, G4 and G5, and RVC types G1, G3, G5, and G6 have been identified in Australian piggeries in previous studies. Although occurrence of RVB was reported in Australia in 1988, no further genetic analysis has been conducted. To improve health management decisions in Australian pig herds, more information on RV prevalence and genetic diversity is needed. Here, 243 enteric samples collected from 20 pig farms within Eastern Australia were analysed for the presence of RV in different age groups using a novel PCR‐based multiplex assay (Pork MultiPath™ enteric panel). RVA, RVB, and RVC were detected in 10, 14, and 14 farms, respectively. Further sequencing of VP7 in selected RV‐positive samples revealed G genotypes G2, G5, G9 (RVA), G6, G8, G14, G16, G20 (RVB), and G1, G3, G5, G6 (RVC) present. RVA was only detected in young (<10 weeks old) pigs whereas RVB and RVC were also detected in older animals (>11 weeks old). Interestingly, RVB and RVC G‐type occurrence differed between age groups. In conclusion, this study provides new insights on the prevalence and diversity of different RV species in pig herds of Eastern Australia whilst demonstrating the ability of the Pork MultiPath™ technology to accurately differentiate between these RV species.
Identification of POLR3B biallelic mutations‐associated hypomyelinating leukodystrophy‐8 in two siblings
Authors: Yang Fan , Sun Huaqin , Yang Yanting , Wang Yanan , Dai Siyu , Lin Ziyuan , Shen Ying , Liu Hongqian
Published: January 2023

POLR3B gene encodes the 2nd largest catalytic subunit and affects the function of RNA polymerase III enzymes in transcription. Bi‐allelic variants in POLR3B pathogenically cause hypomyelinating leukodystrophy‐8 (HLD8). Herein, we recruited a family with two patients, who presented clinically with cerebellar atrophy, intellectual disability, hypogonadotropic hypogonadism, and visual problems. We identified the two affected siblings carrying the compound heterozygous variations (c.165_167del; c.1615G>T) in POLR3B by trio‐whole‐exome sequencing (trio‐WES). The qPCR and western blot showed that both transcriptional and translational levels of the mutation (c.165_167del, p.I55_K56delinsM) were sharply attenuated. Following that, a thorough functional examination of a zebrafish line disrupted for human POLR3B validated the pathogenic effects of the two mutations. Our research broadens the spectrum of HLD8‐related pathogenic POLR3B mutations and provides new molecular and animal evidence.
Human‐induced pluripotent stem cell‐derived cerebral organoid of leukoencephalopathy with vanishing white matter
Authors: Deng Jiong , Zhang Jie , Gao Kai , Zhou Ling , Jiang Yuwu , Wang Jingmin , Wu Ye
Published: January 2023

Introduction

Leukoencephalopathy with vanishing white matter (VWM) is a rare autosomal recessive leukoencephalopathy resulting from mutations in EIF2B1‐5, which encode subunits of eukaryotic translation initiation factor 2B (eIF2B). Studies have found that eIF2B mutation has a certain influence on embryonic brain development. So far, the effect of the eIF2B mutations on the dynamic process of brain development is not fully understood yet.

Aims

Three‐dimensional brain organoid technology has promoted the study of human nervous system developmental diseases in recent years, providing a potential platform for elucidating the pathological mechanism of neurodevelopmental diseases. In this study, we aimed to investigate the effects of eIF2B mutation on the differentiation and development of different nerve cells during dynamic brain development process using 3D brain organoids.

Results

We constructed eIF2B mutant and wild‐type brain organoid model with induced pluripotent stem cell (iPSC). Compared with the wild type, the mutant brain organoids were significantly smaller, accompanied by increase in apoptosis, which might be resulted from overactivation of unfolded protein response (UPR). Neuronal development was delayed in early stage, but with normal superficial neuronal differentiation in later stage. eIF2B mutations resulted in immature astrocytes with increased expression of GFAPδ, nestin, and αB‐crystallin, and there were increased oligodendrocyte progenitor cells, decreased mature oligodendrocytes, and sparse myelin in mutant cerebral organoids in the later stage.

Conclusion

we constructed the first eIF2B mutant cerebral organoids to explore the dynamic brain development process, which provides a platform for further research on the specific pathogenesis of VWM.
Young Children's Engagement with Objects in Science Museums: A Rapid Evidence Assessment of Research
Authors: Flewitt Rosie , Bangpan Mukdarut , Manyukhina Yana , Wyse Dominic
Published: January 2023

This rapid evidence assessment (REA) of literature was conducted to aggregate knowledge about young children's engagement with objects in science museums. The review focuses on empirical studies published between 2000 and 2020 reporting on children in the age range from birth to eight years. Scrutiny of a final sample of 48 peer‐reviewed papers indicated that certain museum object characteristics may arouse children's curiosity more than others. Children's interest in museum objects is enhanced and sustained by dialogical and collaborative activity with peers and adults, by sensory, emotional and cognitive engagement with objects, and by children having choice and freedom to explore museum spaces on their own terms. The review identifies there is limited evidence pertaining to children's visits to STEM museums and a need for theoretically robust empirical research with children, museum educators, teachers and parents from diverse communities.
Residential instability during adolescence predicts earlier age at onset of psychosis: The moderating role of extraversion
Authors: Ku Benson S. , Walker Elaine F. , Druss Benjamin G. , Murray Camille R. , Compton Michael T.
Published: January 2023

Introduction

Residential instability (RI) during adolescence is associated with poor health outcomes. Also, extraversion has been shown to be a moderator of these associations. However, the associations between RI, extraversion, and age at onset of psychosis (AOP) remain unknown.

Methods

Data were collected from patients with first‐episode psychosis (FEP). Linear regression models assessed the association between RI during adolescence and AOP. Extraversion was tested as a moderator using the interaction term RI‐by‐extraversion.

Results

Among 89 participants with FEP, both RI (adjusted β = −.278, p = .006) and the interaction term RI‐by‐extraversion (adjusted β = .290, p < .001) were associated with earlier AOP. Stratified analyses showed that RI was only significantly associated with earlier AOP among those with low extraversion (adjusted β = −.598, p < .001).

Conclusions

RI predicted earlier AOP and this association was moderated by extraversion. These findings suggest that extraversion may buffer the negative relationship between RI and AOP. Future research should replicate these findings.
The pedagogical value of parallel charts for dental students in clinical education: A qualitative study
Authors: Marty Mathieu , Bédard Ulysse , Gendron Bénédicte , Vergnes Jean‐Noel , Valéra Marie‐Cécile
Published: January 2023

Introduction

Narrative medicine is a novel approach aimed at attending to the socio‐emotional aspects of illness and care. Parallel charts represent one of the tools of narrative medicine and are brief accounts of care in which practitioners can express their feelings and emotions towards patients and treatments. They are, therefore, intended to collect practitioners' feedback in the form of “narrative” tools to encourage reflection.

Materials and Methods

This is a single‐centre observational pilot study comprising the setting up and analysis of parallel charts in two classes of 5th and 6th year students in a Paediatric Dentistry Department in France. Forty‐four students completed 126 parallel charts. A qualitative, thematic, analysis was conducted and the charts were also classified according to the three types of description of illness made by Arthur Kleinman.

Results

This work showed that dental students mainly compiled parallel charts from a disease‐centred perspective. The qualitative analysis identified the various themes addressed by the student: relationship with patients and managing children's anxiety, student stress, relationship with the environment or with lecturers.

Conclusion

The qualitative analysis highlighted the usefulness of compiling parallel charts by the students to allow them to express both positive and negative feelings, and thus to adopt a self‐evaluative approach regarding their practices based on emotional impact. Parallel charts may improve patient‐practitioner relationship, but more extensive studies over longer periods of time need to be undertaken.
The gut microbiome in intravenous immunoglobulin‐treated chronic inflammatory demyelinating polyneuropathy
Authors: Svačina Martin K. R. , Sprenger‐Svačina Alina , Tsakmaklis Anastasia , Rüb Alina M. , Klein Ines , Wüstenberg Hauke , Fink Gereon R. , Lehmann Helmar C. , Vehreschild Maria J. G. T. , Farowski Fedja
Published: January 2023

Background and purpose

The gut microbiome is involved in autoimmunity. Data on its composition in chronic inflammatory demyelinating polyneuropathy (CIDP), the most common chronic autoimmune disorder of peripheral nerves, are currently lacking.

Methods

In this monocentric exploratory pilot study, stool samples were prospectively collected from 16 CIDP patients (mean age 58 ± 10 years, 25% female) before and 1 week after administration of intravenous immunoglobulin (IVIg). Gut microbiota were analyzed via bacterial 16S rRNA gene sequencing and compared to 15 age‐matched healthy subjects (mean age 59 ± 15 years, 66% female).

Results

The gut microbiota of CIDP patients showed an increased alpha‐diversity (p = 0.005) and enrichment of Firmicutes, such as Blautia (p = 0.0004), Eubacterium hallii (p = 0.0004), or Ruminococcus torques (p = 0.03), and of Actinobacteriota (p = 0.03) compared to healthy subjects. IVIg administration did not alter the gut microbiome composition in CIDP in this short‐term observation (p = 0.95).

Conclusions

The gut microbiome in IVIg‐treated CIDP shows distinct features, with increased bacterial diversity and enrichment of short‐chain fatty acid producing Firmicutes. IVIg had no short‐term impact on the gut microbiome in CIDP patients. As the main limitation of this exploratory pilot study was small cohort size, future studies also including therapy‐naïve patients are warranted to verify our findings and to explore the impact of long‐term IVIg treatment on the gut microbiome in CIDP.
The JAK–STAT pathway in keloid pathogenesis: a systematic review with qualitative synthesis
Authors: Yin Qi , Wolkerstorfer Albert , Lapid Oren , Niessen Frank B. , Van Zuijlen Paul P. M. , Gibbs Susan
Published: January 2023

Keloid tissues contain inflammatory cells and upregulated pro‐inflammatory cytokines. The Janus kinase (JAK)‐signal transducer and activator of transcription (STAT) pathway mediate cellular responses to these cytokines. We performed a systematic review on the role of the JAK–STAT pathway in keloid pathogenesis and the evidence for JAK–STAT inhibitors in keloid treatment. The search combined the terms (1) keloid and (2) JAK or TYK or STAT and included MeSH terms and synonyms. Two reviewers screened the articles and assessed the full texts on eligibility. Data were collected on the tested drugs and molecules, the type of cells and tissues used in the experiments, and study findings on the association between the JAK–STAT pathway and keloid cells and tissues. A total of twenty preclinical studies were included. Eleven preclinical studies proved that STAT3 expression and phosphorylation are enhanced in keloid tissue and keloid fibroblasts. Thirteen different JAK and/or STAT inhibitors were investigated. Tested drugs inhibited keloid progression as demonstrated by different processes, including reduced collagen production, cell proliferation and migration, increased cell cycle arrest and apoptosis, enhanced antioxidant responses, decreased (paracrine) signalling, and decreased profibrotic gene expression. No clinical studies have been published to date. Preclinical studies indicate a role for the JAK–STAT pathway in keloid pathogenesis and a potential role for JAK–STAT inhibitors in keloid treatment. The effect of these drugs should be further investigated on relevant biomarkers in a human keloid skin model, preferably including immune cells besides keloid fibroblasts and keratinocytes and in clinical studies.
Gender representation in police organizations: Do upper‐level and street‐level female bureaucrats differ in their roles?
Authors: Pyo Sunyoung , Lee Hongseok
Published: January 2023

Some representative bureaucracy literature has suggested that increasing the share of female bureaucrats, particularly in supervisory positions, would not have a substantial influence on producing policy outcomes in favor of female clients because of the potential impact of organizational socialization. However, there has been little empirical investigation into how passive female representation across hierarchical ranks and its interaction influence policy outcomes for women. By analyzing data on 360 local U.S. police organizations in 2013 and 2016, we found that a higher proportion of female officers in first‐line supervisory level positions was negatively linked to arrest performance for rape offenses, while a higher share of female street‐level officers was not significantly linked to arrest performance for the same offenses. However, we noticed a positive interactive effect of the proportion of female street‐level officers and female officers at the intermediate‐level on rape arrests. These results imply that promoting female representation across different hierarchical ranks in police organizations will help to ensure the benefits of representative bureaucracy.
Management and outcomes of persistent headache after accidental dural puncture in the obstetric population: A 9‐year prospective audit
Authors: Niraj G. , Critchley Peter
Published: January 2023

Objective

To assess the effectiveness and safety of a novel management pathway in the obstetric population presenting to a pain medicine clinic with persistent headache after accidental dural puncture (PHADP).

Background

Accidental dural puncture (ADP) can result in headaches that persist for months to years. These headaches can be a therapeutic challenge, often cause severe disability, and management pathway remains obscure.

Methods

Obstetric patients with PHADP referred to a pain medicine physician were prospectively followed up in a longitudinal audit of a novel management pathway. ADP reports dated from 2008 until 2019. Initial management included brain imaging and pharmacological agents. Patients who failed to respond were offered greater occipital nerve (GON) block with depot methylprednisolone followed by pulsed radiofrequency (PRF) treatment. A headache diary was completed for 4 weeks prior to commencing treatment and maintained for 24 weeks following an intervention. Data collected included use of epidural blood patch to manage postdural puncture headache, past history of headache, severity of headache, duration of persistent headache, low back pain, and employment status.

Results

Over the 9‐year period, a cohort of 54 obstetric patients with PHADP with a 16‐gauge Tuohy needle were reviewed in the pain clinic. Forty patients presented with chronic daily headache (40/54, 74%). Brain imaging did not reveal any sign of intracranial hypotension in 50 patients (50/54, 93%). Mean follow‐up period was 5.7 years. Two patients were lost to follow‐up (2/54, 4%). Pharmacological management was effective in 17 patients (17/52, 33%). Medical management failed to improve symptoms in 35 patients (35/52, 67%), and they were offered GON block. Fourteen (14/35, 40%) patients refused the intervention. Nerve block was performed in 21 patients and produced durable benefit lasting 24 weeks in 18 patients (18/21, 86%). Three patients underwent PRF treatment to GONs and all three (100%) reported durable benefit. At final follow‐up, mean monthly headache frequency was 5.9 for the medical management group, 8.6 for the refused nerve block group, and 4.1 in patients who received GON treatment (p < 0.001).

Conclusion

ADP can cause chronic headaches that persist beyond 3 years. Interventions targeting the GONs appear to have a role in the management of PHADP.
Changes in gamma‐aminobutyric acid and glutamate/glutamine levels in the right thalamus of patients with episodic and chronic migraine: A proton magnetic resonance spectroscopy study
Authors: Zhang Xueyan , Wang Wei , Bai Xiaoyan , Zhang Yingkui , Yuan Ziyu , Tang Hefei , Zhang Xue , Li Zhiye , Zhang Peng , Hu Zhangxuan , Zhang Yaqing , Yu Xueying , Man Xue , Sui Binbin , Wang Yonggang
Published: January 2023

Objective

To explore gamma‐aminobutyric acid (GABA) and glutamate/glutamine (Glx) levels in the right thalamus of patients with episodic migraine (EM) and chronic migraine (CM) and their effects on the chronification of migraine.

Background

Migraine affects approximately 1 billion people worldwide, with 2.5%–3% of people with EM progressing to CM each year. Magnetic resonance spectroscopy studies have revealed altered GABA and Glx levels in the thalamus of patients with migraine without aura, but these neurometabolic concentrations are underexplored in the thalamus of patients with CM.

Methods

In this cross‐sectional study, patients with EM and CM were recruited. Mescher‐Garwood point resolved spectroscopy sequence was used to acquire neurotransmitter concentrations in the right thalamus of patients with EM and CM and matched healthy controls (HCs).

Results

A total of 26 patients (EM, n = 11; CM, n = 15) and 16 age‐ and sex‐matched HCs were included in the analysis. There were significantly lower GABA+/Water levels in the right thalamus of the CM group (mean ± standard deviation: 2.27 ± 0.4 [institutional units]) than that of the HC group (2.74 ± 0.4) (p = 0.026; mean difference [MD] = −0.5 [i.u.]), and lower Glx/Cr levels in the EM group (mean ± SD: 0.11 ± < 0.1) than in the HCs (0.13 ± < 0.1) and CM group (0.13 ± < 0.1) (p = 0.023, MD < −0.1, and p = 0.034, MD < −0.1, respectively). The GABA+/Glx ratio was lower in the CM group (mean ± SD: 0.38 ± 0.1) compared to the EM group (0.47 ± 0.1) (p = 0.024; MD = −0.1). The area under the curve for GABA+/Water levels in differentiating patients with CM from HCs was 0.83 (95% confidence interval 0.68, 0.98; p = 0.004). Correlation analyses within the migraine group revealed no significant correlation between metabolite concentration levels and headache characteristics after Bonferroni correction.

Conclusion

Reduced GABA+/Water levels and imbalance of excitation/inhibition in the right thalamus may contribute to migraine chronification.
An exploratory study evaluating the 30 medications most commonly associated with headaches in the FDA Adverse Event Reporting System
Authors: Musialowicz Brett , Kamitaki Brad , Zhang Pengfei
Published: January 2023

Objective

This project seeks to identify the top 30 drugs most commonly associated with headaches in the U.S. Food and Drug Administration Adverse Event Reporting System (FAERS), as well as their respective reporting odds ratios (RORs).

Background

Headache secondary to medication use is a well‐known entity. However, which medications are most likely to cause headaches on a global scale is unknown.

Methods

We extracted case identifiers, adverse events, and attributed medications for entries in the FAERS database from July 1, 2018, to March 31, 2020. Entries were split into two datasets based on whether or they contained the word “headache(s).” Non‐medication words were then excluded. The medications most commonly associated with headaches were then identified.

Results

We extracted 2,673,081 entries, of which 86,086 contain the word “headache(s).” The 30 most frequently appearing medications were then ranked by ROR values with associated 95% confidence intervals. The three medications with the greatest association with headaches were selexipag (ROR 16.7, 95% CI 15.8–17.7), epoprostenol (ROR 11.7, 95% CI 10.8–12.7), and glecaprevir (ROR 8.7, 95% CI 8.3–9.2). Immunosuppressants, antivirals, as well as pulmonary hypertension medication classes were most commonly associated with headache.

Conclusion

Our study offers a potential list of the medication classes commonly associated with iatrogenic headaches.
Significance of a multidisciplinary approach to congenital extrahepatic portosystemic shunt: A changing paradigm for the treatment
Authors: Uchida Hajime , Sakamoto Seisuke , Yanagi Yusuke , Shimizu Seiichi , Fukuda Akinari , Ono Hiroshi , Miyazaki Osamu , Nosaka Shunsuke , Schlegel Andrea , Kasahara Mureo
Published: January 2023

Aim

To review the current institutional practice to treat patients with congenital extrahepatic portosystemic shunt (CEPS) and to determine the optimal strategy.

Methods

We retrospectively reviewed the records of 55 patients diagnosed with CEPS at our center between December 2008 and March 2022.

Results

Among these 55 patients, 44 (80.0%) received treatment for CEPS at a median age of 4.7 years. The most common indication for treatment was cardiopulmonary complications (45.5%). Therapeutic intervention included shunt closure by endovascular techniques (50.0%) or surgery (40.9%), and liver transplantation (9.1%). A total of 11 were classified as short shunt types, and surgical ligation was performed in all to preserve the major vascular system and prevent complications (p < 0.001). Children who received a surgical ligation were more likely to develop complications after shunt closure (p = 0.02). Among seven patients with portopulmonary hypertension (POPH), one patient, who received a shunt ligation at <1 year‐of‐age, was only able to completely discontinue medication. Most other CEPS‐related complications were completely resolved. Post‐treatment complications, including thrombosis and symptoms of portal hypertension, were seen in 16 patients. After shunt closure, one patient was scheduled to undergo liver transplantation for progressive POPH and large residual hepatocellular adenoma. During follow‐up, one patient without any treatment for CEPS developed POPH 16 years from the diagnosis.

Conclusion

Earlier therapeutic interventions should be strongly considered for patients with POPH related to CEPS. However, in view of the invasiveness and treatment complications, special attention should be paid to the management of patients with short shunt types.
Exploring patients' perspectives of gestational diabetes mellitus screening and counselling in Ontario: A grounded theory study
Authors: Ruby Emma , McDonald Sarah D. , Berger Howard , Melamed Nir , Li Jenifer , Darling Elizabeth K. , Barrett Jon , G. Ray Joel , Geary Michael , Murray‐Davis Beth ,   DOH‐NET (Diabetes, Obesity and Hypertension in Pregnancy Research) and SOON (Southern Ontario Obstetrical Network) Investigators™
Published: January 2023

Introduction

Gestational diabetes mellitus (GDM) is associated with adverse perinatal outcomes. Approaches to screening for GDM continue to evolve, introducing potential variability of care. This study explored the impact of these variations on GDM counselling and screening from the perspectives of pregnant individuals.

Methods

Following a Corbin and Strauss approach to qualitative, grounded theory we recruited 28 individuals from three cities in Ontario, Canada who had a singleton pregnancy under the care of either a midwife, family physician or obstetrician. Convenience and purposive sampling techniques were used. Semi‐structured telephone interviews were conducted and transcribed verbatim between March and December 2020. Transcripts were analysed inductively resulting in codes, categories and themes.

Results

Three themes were derived from the data about GDM screening and counselling: ‘informing oneself’, ‘deciding’ and ‘screening’. All participants, regardless of geographical region, or antenatal care provider, moved through these three steps during the GDM counselling and screening process. Differences in counselling approaches between pregnancy care providers were noted throughout the ‘informing’ and ‘deciding’ stages of care. Factors influencing these differences included communication, healthcare autonomy and patient motivation to engage with health services. No differences were noted within care provider groups across the three geographic regions. Participant experiences of GDM screening were influenced by logistical challenges and personal preferences towards testing.

Conclusion

Informing oneself about GDM may be a crucial step for facilitating decision‐making and screening uptake, with an emphasis on information provision to facilitate patient autonomy and motivation.

Patient or Public Contribution

Participants of our study included patients and service users. Participants were actively involved in the study design due to the qualitative, patient‐centred nature of the research methods employed. Analysis of results was structured according to the emergent themes of the data which were grounded in patient perspectives and experiences.
Physicochemical and sensory properties of corn grits and pineapple stem starch‐based extruded snacks enriched with oyster mushroom powder
Authors: Tangsrianugul Nuttinee , Hongsanyatham Sornsawan , Kapcum Chutikarn , Sungayuth Nongnuch , Boonsanong Natt , Somprasong Natdanai , Smith Siwaporn Meejoo , Amornsakchai Taweechai , Pinyo Jukkrapong , Wongsagonsup Rungtiwa
Published: January 2023

This study aimed to evaluate physicochemical and sensory characteristics of corn grits and pineapple stem starch‐based extruded snacks enriched with oyster mushroom powder (OMP). Base materials (corn grits and pineapple stem starch at a ratio of 1:1) were mixed with OMP at levels of 5, 10 and 15% (w/w, total dry ingredients basis). The mixtures of dry ingredients were adjusted to 15% moisture content, followed by adding 4% palm oil. The mixtures were kept at room temperature overnight before being extruded using a twin‐screw extruder with barrel temperatures of 80–140 °C and screw speed of 450 rpm. Increasing levels of OMP resulted in increased bulk density, hardness, redness, cell wall thickness, total phenolic content and antioxidant activity of extruded snacks but decreased expansion ratio, lightness and yellowness values. X‐ray diffraction showed that extruded snacks with increasing levels of OMP resulted in higher amounts of V‐type crystals, indicating to the greater formation of amylose‐lipid complex. Sensory evaluation showed that extruded snacks with 5% OMP had the highest preference levels for all sensorial attributes. This study demonstrates that pineapple stem starch and OMP can be used to produce nutritionally enriched and acceptable extruded snacks.
Catheter ablation of idiopathic left fascicular ventricular tachycardia: Implications of false tendons for mapping and ablation
Authors: Ma Wei , Qiu Jiuchun , Lu Fengmin , Michael Shehata  , Wang Xunzhang , He Le , Zhang Fan , Fan Shaobo , Zhang Enyuan , Wu Dongyan , Wang Zulu , Xu Jing
Published: January 2023

Introduction

The anatomical substrate for idiopathic left ventricular tachycardia (ILVT) remains speculative. Purkinje networks surrounding false tendons (FTs) might be involved in the reentrant circuit of ILVT. The objective was to evaluate the anatomical and electrophysiological features of false tendons FTs in relation to ILVT.

Methods

Intracardiac echocardiography (ICE) was conducted on patients with ILVT. The relationship of the FTs with ILVT was determined using electro‐anatomical mapping.

Results

Electrophysiological evaluation and radiofrequency ablation were conducted in 23 consecutive patients with ILVT. FTs were identified in 19/23 cases (82.6%) with P1 potentials during VT recorded at the FT in 14 of these patients (73.7%). Three FT types were identified. In type 1, the FT attached the septum to the base of the posteromedial papillary muscle (PPM) (4/19); type 2 FTs ran between the septum and the PPM apex (3/19), while in type 3, the connection occurred between the septum and apex (11/19) or between the septum and the LV free wall (1/19). The effective ILVT ablation sites were situated at the FT‐PPM (3/19) and the FT‐septum (16/19) attachment sites.

Conclusions

This series demonstrates the association between Purkinje fibers and FTs during catheter ablation of ILVT and verifies that left ventricular FTs are an important substrate in this type of tachycardia.
Duvelisib attenuates bleomycin‐induced pulmonary fibrosis via inhibiting the PI3K/Akt/mTOR signalling pathway
Authors: Li Xiaohe , Ma Xiaoyang , Miao Yang , Zhang Jianwei , Xi Buri , Li Wenqi , Zhang Qianyi , Chen Li , Yang Yue , Li Hongli , Wei Luqing , Zhou Honggang , Yang Cheng
Published: January 2023

Idiopathic pulmonary fibrosis (IPF) is a chronic progressive interstitial lung disease that seriously threatens the health of patients. The pathogenesis of IPF is still unclear, and there is a lack of effective therapeutic drugs. Myofibroblasts are the main effector cells of IPF, leading to excessive deposition of extracellular matrix (ECM) and promoting the progression of fibrosis. Inhibiting the excessive activation and relieving autophagy blockage of myofibroblasts is the key to treat IPF. PI3K/Akt/mTOR pathway plays a key regulatory role in promoting fibroblast activation and autophagy inhibition in lung fibrosis. Duvelisib is a PI3K inhibitor that can simultaneously inhibit the activities of PI3K‐δ and PI3K‐γ, and is mainly used for the treatment of relapsed/refractory chronic lymphocytic leukaemia (CLL) and small lymphocytic lymphoma tumour (SLL). In this study, we aimed to examine the effects of Duvelisib on pulmonary fibrosis. We used a mouse model of bleomycin‐induced pulmonary fibrosis to evaluate the effects of Duvelisib on pulmonary fibrosis in vivo and further explored the potential pharmacological mechanisms of Duvelisib in lung fibroblasts in vitro. The in vivo experiments showed that Duvelisib significantly alleviated bleomycin‐induced collagen deposition and improved pulmonary function. In vitro and in vivo pharmacological experiments showed that Duvelisib dose‐dependently suppressed lung fibroblast activation and improved autophagy inhibition by inhibiting the phosphorylation of PI3K, Akt and mTOR. Our results indicate that Duvelisib can alleviate the severity of pulmonary fibrosis and provide potential drugs for the treatment of pulmonary fibrosis.
Practitioner Review: It's time to bridge the gap – understanding the unmet needs of consumers with attention‐deficit/hyperactivity disorder – a systematic review and recommendations
Authors: Bisset Matthew , Brown Louise E. , Bhide Sampada , Patel Pooja , Zendarski Nardia , Coghill David , Payne Leanne , Bellgrove Mark A. , Middeldorp Christel M. , Sciberras Emma
Published: January 2023

Objective

Understanding the unmet needs of healthcare consumers with attention‐deficit/hyperactivity disorder (ADHD) (individuals with ADHD and their caregivers) provides critical insight into gaps in services, education and research that require focus and funding to improve outcomes. This review examines the unmet needs of ADHD consumers from a consumer perspective.

Methods

A standardised search protocol identified peer‐reviewed studies published between December 2011 and December 2021 focusing on consumer‐identified needs relating to ADHD clinical care or research priorities.

Results

1,624 articles were screened with 23 studies that reviewed examining the needs of ADHD consumers from Europe, the U.K., Hong Kong, Iran, Australia, the U.S.A. and Canada. Consumer‐identified needs related to: treatment that goes beyond medication (12 studies); improved ADHD‐related education/training (17 studies); improved access to clinical services, carer support and financial assistance (14 studies); school accommodations/support (6 studies); and ongoing treatment efficacy research (1 study).

Conclusion

ADHD consumers have substantial unmet needs in clinical, psychosocial and research contexts. Recommendations to address these needs include: improving access to and quality of multimodal care provision; incorporating recovery principles into care provision; fostering ADHD health literacy; and increasing consumer participation in research, service development and ADHD‐related training/education.
Are shark teeth proxies for functional traits? A framework to infer ecology from the fossil record
Authors: Cooper Jack A. , Griffin John N. , Kindlimann René , Pimiento Catalina
Published: January 2023

Modern sharks have an evolutionary history of at least 250 million years and are known to play key roles in marine systems, from controlling prey populations to connecting habitats across oceans. These ecological roles can be quantified based on their functional traits, which are typically morphological (e.g., body size) or behavioural (e.g., feeding and diet). Nonetheless, the understanding of such roles of extinct sharks is limited due to the inherent incompleteness of their fossil record, which consists mainly of isolated teeth. As such, establishing links between tooth morphology and ecological traits in living sharks could provide a useful framework to infer sharks' ecology from the fossil record. Here, based on extant sharks from which morphological and behavioural characteristics are known, the authors assess the extent to which isolated teeth can serve as proxies for functional traits. To do so, they first review the scientific literature on extant species to evaluate the use of shark dental characters as proxies for ecology to then perform validation analyses based on an independent data set collected from museum collections. Their results reveal that 12 dental characters have been used in shark literature as proxies for three functional traits: body size, prey preference and feeding mechanism. From all dental characters identified, tooth size and cutting edge are the most widely used. Validation analyses suggest that seven dental characters – crown height, crown width, cutting edge, lateral cusplets, curvature, longitudinal outline and cross‐section outline – are the best proxies for the three functional traits. In particular, tooth size (crown height and width) was found to be a reliable proxy of all three traits; the presence of serrations on the cutting edge was one of the best proxies for prey preference; and tooth shape (longitudinal outline) and the presence of lateral cusplets were among the best indicators of feeding mechanism. Overall, the authors’ results suggest that in the absence of directly measurable traits in the fossil record, these seven dental characters (and different combinations of them) can be used to quantify the ecological roles of extinct sharks. This information has the potential to provide key insights into how shark functional diversity has changed through time, including their ecological responses to extinction events.
Smooth muscle “microsphincters” in the gastric mucosa of stingrays (Elasmobranchii, Dasyatidae)
Authors: Henderson Aaron C. , Bruns Stephan , Al Hameli Shamsa
Published: January 2023

The occurrence of smooth muscle sphincters around gastric gland tubules in the cardiac stomach of some elasmobranch species is reported for the first time. These “microsphincters” took the form of a twisted torus, approximately 12–16 muscle fibres thick, that could fully constrict the gland tubules. However, their inconsistent positioning does not suggest a role in partitioning the tubules from the stomach lumen or in modulating secretory activity. Further research is required to ascertain the full taxonomic occurrence of these structures across the Elasmobranchii and to elucidate their function.