bluuebunny/crossref_metadata_2025 huggingface dataset:
Variation in clinical practice guideline recommendations for medication use in pregnancy in Australia: A systematic review
Authors: Cron Hayley T. , Simm Peter , Said Joanne M. , Cheong Jeanie L. Y. , Cranswick Noel , Hu Yanhong Jessika
Published: December 2023

Background

Medication use in pregnancy is common; however, it is unknown if clinical practice guideline (CPG) prescribing recommendations referred to in Australia at the state, national and international level are consistent.

Aims

This systematic review aimed to: (1) identify sources of CPGs that inform prescribing during pregnancy in Australia; (2) assess CPG quality; and (3) evaluate variation within CPG recommendations for medication use in three common conditions in pregnancy: prophylactic antibiotics following premature rupture of membranes (PROM) at term, antidepressants in pregnancy and metformin in gestational diabetes mellitus (GDM).

Materials and Methods

A literature search was conducted across PubMed, Scopus and EMBASE databases. Grey literature was identified through publicly available Australian policy statements. Prescribing recommendations for prophylactic antibiotics following PROM at term, antidepressants in pregnancy and metformin in GDM, were compared at the state, national and international levels. CPG quality was assessed using the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument.

Results

We identified 39 CPG sources that inform prescribing during pregnancy in Australia. CPG quality varied between resources. There was minor variation in recommendations for antibiotic prophylaxis in PROM at term. Recommendations regarding metformin use in GDM were also variable, with CPGs either recommending its use as a first‐line agent when lifestyle modifications are not effective or when insulin therapy is not practicable. Recommendations for antidepressant use were consistent across CPGs analysed.

Conclusion

Multiple CPGs exist to inform prescribing during pregnancy in Australia, with variation present within CPG quality and recommendations. These findings offer insight into potential sources of variation in maternal and neonatal health outcomes.
Climate change perception scale: Adaptation and psychometric properties in the Indonesian context
Authors: Adiwena Bartolomeus Yofana , Bramanwidyantari Maria
Published: December 2023

One of the crucial factors in changing behaviour towards pro‐environmental actions is climate change perception. The latest measurement tool for assessing this variable is the Climate Change Perception Scale (CCPS). However, CCPS has not gained widespread adoption and usage across different cultures, including Indonesia, and no analyses have been conducted to adapt and validate CCPS in the Indonesian context. Therefore, this study aimed to adapt, validate, and assess the measurement tool's consistency in Indonesia's cultural context. To investigate the instrument's psychometric properties, two studies (n = 358, 415) were conducted in Indonesia to provide evidence of the internal consistency, convergent validity, and predictive validity of CCPS. The results of a confirmatory factor analysis (CFA) showed that the Indonesian version of CCPS, which consists of 15 items, with three for each dimension, accurately and reliably measured perception of climate change. CCPS also demonstrated good convergent validity, as indicated by the significant correlations with a nature relatedness (r = 0.425, p < 0.01) and biospheric value (r = 0.341, p < 0.01) construct. Furthermore, it exhibited predictive validity by predicting pro‐environmental behaviour, β = 0.243, b = 0.176, t(413) = 5.10, p < 0.01. However, the Indonesian version of CCPS still needs to be tested and confirmed through various studies, considering the poor validity of the temporal dimension and the weak factor loading of the consequence dimension in Study 2.
Higher parental education was associated with good cognitive outcomes in infants with hypoxic‐ischaemic encephalopathy
Authors: Varga Zsuzsanna , Andorka Csilla , Pataki Margit , Meder Unoke , Szakmar Eniko , Szabo Attila J. , Szabo Miklos , Jermendy Agnes
Published: December 2023

Aim

Predicting neurodevelopmental outcomes in hypoxic‐ischaemic encephalopathy (HIE) remains imprecise, despite advanced imaging and neurophysiological tests. We explored the predictive value of socio‐economic status (SES).

Methods

The cohort comprised 93 infants (59% male) with HIE, who had received therapeutic hypothermia. Patients underwent magnetic resonance imaging, and brain injuries were quantified using the Barkovich scoring system. Family SES was self‐reported using a questionnaire. Adverse outcomes were defined as mild to severely delayed development with a score of ≤85 in any domain at 2 years of age, based on the Bayley Scales of Infant Development, Second Edition. Data are presented as odds ratios (OR) with 95% confidence intervals (95% CI).

Results

Multiple regression modelling revealed that higher parental education was strongly associated with good cognitive development, when adjusted for gestational age, serum lactate and brain injuries (OR 2.20, 95% CI 1.16–4.36). The effect size of parental education (β = 0.786) was higher than one score for any brain injury using the Barkovich scoring system (β = −0.356). The literacy environment had a significant effect on cognitive development in the 21 infants who had brain injuries (OR 40, 95% CI 3.70–1352).

Conclusion

Parental education and the literacy environment influenced cognitive outcomes in patients with HIE.
Looking beyond vaccines: Cultural tightness–looseness moderates the relationship between immunization coverage and disease prevention vigilance
Authors: Ma Mac Zewei , Chen Sylvia Xiaohua , Wang Xijing
Published: December 2023

Advancements in vaccination technologies mitigate disease transmission risks but may inadvertently suppress the behavioral immune system, an evolved disease avoidance mechanism. Applying behavioral immune system theory and utilizing robust big data analytics, we examined associations between rising vaccination coverage and government policies, public mobility, and online information seeking regarding disease precautions. We tested whether cultural tightness–looseness moderates the relationship between mass immunization and disease prevention vigilance. Comprehensive time series analyses were conducted using American data (Study 1) and international data (Study 2), employing transfer function modeling, cross‐correlation function analysis, and meta‐regression analysis. Across both the US and global analyses, as vaccination rates rose over time, government COVID‐19 restrictions significantly relaxed, community mobility increased, and online searches for prevention information declined. The relationship between higher vaccination rates and lower disease prevention vigilance was stronger in culturally looser contexts. Results provide initial evidence that mass immunization may be associated with attenuated sensitivity and enhanced flexibility of disease avoidance psychology and actions. However, cultural tightness–looseness significantly moderates this relationship, with tighter cultures displaying sustained vigilance amidst immunization upticks. These findings offer valuable perspectives to inform nuanced policymaking and public health strategies that balance prudent precautions against undue alarm when expanding vaccine coverage worldwide.
Protist symbionts of termites: diversity, distribution, and coevolution
Authors: Gile Gillian H.
Published: December 2023

The symbiosis between termites and their hindgut protists is mutually obligate and vertically inherited. It was established by the late Jurassic in the cockroach ancestors of termites as they transitioned to wood feeding. Since then, protist symbionts have been transmitted from host generation to host generation by proctodeal trophallaxis (anal feeding). The protists belong to multiple lineages within the eukaryotic superphylum Metamonada. Most of these lineages have evolved large cells with complex morphology, unlike the non‐termite‐associated Metamonada. The species richness and taxonomic composition of symbiotic protist communities varies widely across termite lineages, especially within the deep‐branching clade Teletisoptera. In general, closely related termites tend to harbour closely related protists, and deep‐branching termites tend to harbour deep‐branching protists, reflecting their broad‐scale co‐diversification. A closer view, however, reveals a complex distribution of protist lineages across hosts. Some protist taxa are common, some are rare, some are widespread, and some are restricted to a single host family or genus. Some protist taxa can be found in only a few, distantly related, host species. Thus, the long history of co‐diversification in this symbiosis has been complicated by lineage‐specific loss of symbionts, transfer of symbionts from one host lineage to another, and by independent diversification of the symbionts relative to their hosts. This review aims to introduce the biology of this important symbiosis and serve as a gateway to the diversity and systematics literature for both termites and protists. A searchable database with all termite‐protist occurrence records and taxonomic references is provided as a supplementary file to encourage and facilitate new research in this field.
RUNX2‐related metaphyseal dysplasia with maxillary hypoplasia: A rare skeletal disorder resembling SFRP4‐related Pyle disease
Authors: Hordyjewska‐Kowalczyk Ewa , Wuyts Wim , Boeckx Nele , Verdonck An , Hendrickx Gretl , Mortier Geert
Published: December 2023

Metaphyseal dysplasia with maxillary hypoplasia with or without brachydactyly (MDMHB) is an ultra‐rare skeletal dysplasia caused by heterozygous intragenic RUNX2 duplications, comprising either exons 3 to 5 or exons 3 to 6 of RUNX2. In this study, we describe a 14‐year‐old Belgian boy with metaphyseal dysplasia with maxillary hypoplasia but without brachydactyly. Clinical and radiographic examination revealed mild facial dysmorphism, dental anomalies, enlarged clavicles, genua valga and metaphyseal flaring and thin cortices with an osteoporotic skeletal appearance. Exome sequencing led to the identification of a de novo heterozygous tandem duplication within RUNX2, encompassing exons 3 to 7. This duplication is larger than the ones previously reported in MDMHB cases since it extends into the C‐terminal activation domain of RUNX2. We review previously reported cases with MDMHB and highlight the resemblance of this disorder with Pyle disease, which may be explained by intersecting molecular pathways between RUNX2 and sFRP4. This study expands our knowledge on the genotypic and phenotypic characteristics of MDMHB and the role of RUNX2 in rare bone disorders.
Conditional knockout of AIM2 in microglia ameliorates synaptic plasticity and spatial memory deficits in a mouse model of Alzheimer's disease
Authors: Ye Lei , Hu Mengsha , Mao Rui , Tan Yi , Sun Min , Jia Junqiu , Xu Siyi , Liu Yi , Zhu Xiaolei , Xu Yun , Bai Feng , Shu Shu
Published: December 2023

Aims

Synaptic dysfunction is a hallmark pathology of Alzheimer's disease (AD) and is strongly associated with cognitive impairment. Abnormal phagocytosis by the microglia is one of the main causes of synapse loss in AD. Previous studies have shown that the absence of melanoma 2 (AIM2) inflammasome activity is increased in the hippocampus of APP/PS1 mice, but the role of AIM2 in AD remains unclear.

Methods

Injection of Aβ1‐42 into the bilateral hippocampal CA1 was used to mimic an AD mouse model (AD mice). C57BL/6 mice injected with AIM2 overexpression lentivirus and conditional knockout of microglial AIM2 mice were used to confirm the function of AIM2 in AD. Cognitive functions were assessed with novel object recognition and Morris water maze tests. The protein and mRNA expression levels were evaluated by western blotting, immunofluorescence staining, and qRT‐PCR. Synaptic structure and function were detected by Golgi staining and electrophysiology.

Results

The expression level of AIM2 was increased in AD mice, and overexpression of AIM2 induced synaptic and cognitive impairments in C57BL/6 mice, similar to AD mice. Elevated expression levels of AIM2 occurred in microglia in AD mice. Conditional knockout of microglial AIM2 rescued cognitive and synaptic dysfunction in AD mice. Excessive microglial phagocytosis activity of synapses was decreased after knockout of microglial AIM2, which was associated with inhibiting complement activation.

Conclusion

Our results demonstrated that microglial AIM2 plays a critical role in regulating synaptic plasticity and memory deficits associated with AD, providing a new direction for developing novel preventative and therapeutic interventions for this disease.
Efficacy of noiiglutide injection on body weight in obese Chinese adults without diabetes: A multicentre, randomized, double‐blind, placebo‐controlled, phase 2 trial
Authors: Li Yijun , Cheng Zhifeng , Lu Weiping , Li Ping , Jiang Hongwei , Yang Jing , Xu Jing , Zhang Cheng , Zhang Lili , Wang Yao , Bian Fang , Guo Weiying , Yu Xuefeng , Chen Xiaopan , Zhao Dong , Feng Bo , Qu Shen , Qin Jie , Zhang Yifei , Wang Lin , Chen Hong , Mu Yiming
Published: December 2023

Aim

To evaluate the effect of noiiglutide as an adjunct to lifestyle intervention on the reduction in body weight and tolerability in obese Chinese adults without diabetes.

Materials and Methods

In this 24‐week, randomized, double‐blind, placebo‐controlled phase 2 trial, 254 obese adults with a body mass index of 28.0‐40.0 kg/m2 and without diabetes were enrolled. Participants were initially randomized in a 1:1:1 ratio to one of three dose levels: 0.12, 0.24, or 0.36 mg of the study treatment. Within each dose level, participants were further randomized in a 3:1 ratio to receive either subcutaneous injection of noiiglutide or a matching placebo. The primary endpoint was the change in body weight from baseline to week 24.

Results

Across all noiiglutide dosage levels, least squares mean reductions in body weight from baseline to week 24 ranged from 8.03 to 8.50 kg, compared with 3.65 kg in the placebo group (all p‐values <.0001). In the noiiglutide groups (0.12, 0.24, 0.36 mg/day), a significantly higher proportion of participants achieved a weight loss ≥5% (68.8%, 60.0%, 73.0%) and ≥10% (37.5%, 36.9%, 39.7%), compared with the pooled placebo group (≥5%: 29.0%; ≥10%: 8.1%). Gastrointestinal adverse events, such as nausea, diarrhoea and vomiting, were more common in all noiiglutide groups (15.4%‐30.2%, 18.8%‐22.2%, 15.6%‐18.5%) than in the pooled placebo group (8.1%, 6.5%, 0%).

Conclusions

In obese Chinese adults without diabetes, once‐daily subcutaneous noiiglutide significantly reduced body week at week 24 compared with placebo, and had a manageable safety profile, primarily involving gastrointestinal disorders.
Anatomical and physiological consequences of beech leaf disease in Fagus grandifolia L.
Authors: Fletcher Leila R. , Borsuk Aleca M. , Fanton Ana C. , Johnson Kate M. , Richburg Jennifer , Zailaa Joseph , Brodersen Craig R.
Published: December 2023

Beech leaf disease (BLD) is a foliar disease of American Beech (Fagus grandifolia L.) causally linked to the nematode Litylenchus crenatae mccannii and has rapidly spread throughout central and northeastern North America. This study aimed to characterize the anatomical and physiological differences between asymptomatic and symptomatic leaves to provide evidence for a mechanistic link between abnormal leaf development associated with BLD and the long‐term decline of affected trees. We found that leaf mass per area (LMA) and leaf thickness were 45% and 249% higher in symptomatic regions, respectively. The difference in leaf thickness was largely attributable to the spongy mesophyll being 410% thicker in symptomatic as compared with asymptomatic regions of the leaves, but palisade mesophyll and abaxial epidermal tissues were also thicker in symptomatic regions. While major vein density was not significantly different, minor vein density was significantly lower in symptomatic regions, suggesting that the effects on leaf development occur after the formation and initial development of first‐ and second‐order veins. Stomatal density was also lower in symptomatic leaves. Maximum photosynthetic rates were approximately 61% lower in symptomatic leaves and respiration rate increased as the percentage of affected leaf tissue increased. Collectively, our data show reduced photosynthetic capacity, increased respiration rates, and higher leaf construction costs, which will likely have a negative, long‐term impact on the carbon balance of trees affected by BLD.
Overexpression of SESN1 improves mitochondrial damage and mitophagy, a potential therapeutic strategy for cognitive dysfunction after anaesthesia
Authors: Sun Li , Hong Xiaoya , Wang Daliang , Li Yangyang
Published: December 2023

Postoperative cognitive dysfunction (POCD) is a prevalent central nervous system complication predominantly observed in elderly patients. Sevoflurane, a general anaesthetic agent, has been implicated in the development of POCD, yet the underlying regulatory mechanisms potentially involving Sestrin1 (SESN1), a stress‐responsive protein that plays a critical role in cellular homeostasis and protection against stress‐induced damage, including oxidative stress and DNA damage, remain elusive. This study endeavoured to elucidate the impact of SESN1 on sevoflurane‐induced cognitive impairment in rats. Employing a model in which SESN1 was transfected into SD male rats and cognitive dysfunction was induced by sevoflurane. The Morris Water Maze test was used for behavioural evaluation, Enzyme‐Linked Immunosorbent Assay, Western blotting and immunofluorescence were applied to assess the influence of SESN1 on the inflammatory response and mitophagy in the rat hippocampus. The study further aimed to uncover the putative mechanism by which SESN1, through SIRT1, might modulate cognitive function. Concurrently, levels of malondialdehyde, superoxide dismutase and mitochondrially produced ATP within the rat hippocampus were quantified. Experimental outcomes suggested that SESN1 overexpression significantly mitigated the deleterious effects of sevoflurane anaesthesia, ameliorated neuroinflammation and inflammasome activation, modified mitochondrial function and facilitated mitophagy. Additionally, SESN1, via the activation of SIRT1, may suppress inflammasome activation and mitochondrial dysfunction. Collectively, these findings underscore SESN1's integral role in counteracting sevoflurane‐induced cognitive impairment, impeding inflammasome activation, enhancing mitochondrial function and fostering mitophagy, which appear to be intricately linked to SESN1‐mediated SIRT1 activation. SESN1 is a novel therapeutic target for POCD, potentially advancing neuroprotective strategies in clinical settings.
Aberrant morphometric networks in Alzheimer's disease have hemispheric asymmetry and age dependence
Authors: Maruoka Hiroyuki , Hattori Takaaki , Hase Takeshi , Takahashi Kunihiko , Ohara Masahiro , Orimo Satoshi , Yokota Takanori
Published: December 2023

Alzheimer's disease (AD) is associated with abnormal accumulations of hyperphosphorylated tau and amyloid‐β proteins, resulting in unique patterns of atrophy in the brain. We aimed to elucidate some characteristics of the AD's morphometric networks constructed by associating different morphometric features among brain areas and evaluating their relationship to Mini‐Mental State Examination total score and age. Three‐dimensional T1‐weighted (3DT1) image data scanned by the same 1.5T magnetic resonance imaging (MRI) were obtained from 62 AD patients and 41 healthy controls (HCs) and were analysed by using FreeSurfer. The associations of the extracted six morphometric features between regions were estimated by correlation coefficients. The global and local graph theoretical measures for this network were evaluated. Associations between graph theoretical measures and age, sex and cognition were evaluated by multiple regression analysis in each group. Global measures of integration: global efficiency and mean information centrality were significantly higher in AD patients. Local measures of integration: node global efficiency and information centrality were significantly higher in the entorhinal cortex, fusiform gyrus and posterior cingulate cortex of AD patients but only in the left hemisphere. All global measures were correlated with age in AD patients but not in HCs. The information centrality was associated with age in AD's broad brain regions. Our results showed that altered morphometric networks due to AD are left‐hemisphere dominant, suggesting that AD pathogenesis has a left–right asymmetry. Ageing has a unique impact on the morphometric networks in AD patients. The information centrality is a sensitive graph theoretical measure to detect this association.
Proximity extension assay‐based proteomics studies in neurodegenerative disorders and multiple sclerosis
Authors: Arioz Burak I. , Cotuk Aysen , Yaka Emiş Cansu , Genc Sermin
Published: December 2023

Neurodegenerative diseases impact the structure and operation of the nervous system, causing progressive and irreparable harm. Efforts for distinguishing neurodegenerative diseases in their early stages are continuing. Despite several biomarkers being identified, there is always search for more accurate and abundant ones. Additionally, it can be difficult to pinpoint the precise neurodegenerative disorder affecting a patient as the symptoms of these conditions frequently overlap. Numerous studies have shown that pathological changes occur years before clinical signs appear. Therefore, it is crucial to discover blood‐based biomarkers for neurodegenerative diseases for easier and earlier diagnosis. Proximity extension assay is a unique proteomics method that uses antibodies linked to oligonucleotides for quantifying proteins with real‐time PCR. Proximity extension assay can identify even low‐quantity proteins using a small volume of specimens with increased sensitivity compared to conventional methods. In this article, we reviewed the employment of proximity extension assay technology to detect biomarkers or protein profiles for several neurodegenerative diseases.
A European stakeholder survey on soil science skills for sustainable agriculture
Authors: Veenstra Jennifer , Coquet Yves , Melot Romain , Walter Christian
Published: December 2023

The European Union's soil strategy for 2030 has set the objective of achieving ‘healthy soils’ in Europe by 2050. To achieve this ambitious goal, dedicated soil science skills will be needed in the future. This article presents the results of a survey on soil science skills for the future conducted within the framework of the European Joint Program—EJP SOIL. The survey was distributed online in the 24 countries participating in the EJP SOIL. The skills were expressed as having knowledge in particular topics related to soils, practical know‐hows or abilities or outcomes of knowledge and know‐hows put into action. No significant differences in the importance of soil‐science related skills were found between countries or stakeholder categories. The two groups of skills that ranked at the top of stakeholders' concern were ‘Having a scientific basis of knowledge on soils and their functioning’ and ‘Knowing how to mobilise agronomic drivers to manage and protect soils’. This means that there is a need for people with an in‐depth knowledge in soil science, but also soil scientists with integrated knowledge in agronomy and crop production. Three important findings relate to the knowledge of soil science itself: (i) there is a clear need to develop the knowledge of the biological and ecological functioning of soil; (ii) this should not happen at the expense of a strong general knowledge of the fundamentals of soil science; (iii) future soil scientists should be trained to have a more holistic appreciation of soil rather than be trained as a specialist of a specific aspect of soil science only. Being able to exchange knowledge with farmers, knowing how to assess soil fertility, quality or health and how to improve them are viewed as essential skills for the future. These findings offer a clear path for the evolution of soil science education curricula across Europe.
Viability and oxidative stress of dental pulp cells after indirect application of chemomechanical agents: An in vitro study
Authors: Lins‐Candeiro Caio Luiz , Paranhos Luiz Renato , de Oliveira Neto Nilson Ferreira , Ribeiro Rafael Antônio Oliveira , de‐Souza‐Costa Carlos Alberto , Guedes Fernanda Rodrigues , da Silva Washington Henrique Themoteo , Turrioni Ana Paula , Santos Filho Paulo César de Freitas
Published: December 2023

Aim

This study evaluated the transdentinal cytotoxic effects of enzymatic agents (EA) for chemomechanical carious tissue removal on human dental pulp cells.

Methodology

The groups were based on the performed dentine treatments (n = 8): G1: Positive Control (PC ‐ no treatment); G2: Negative Control (NC ‐ 35% H2O2 for 2 min); G3: Brix 3000™ (BX) for 30 s; G4: BX for 2 min; G5: Papacarie Duo™ (PD) for 30 s; G6: PD for 2 min. The cells were evaluated for viability (VB; MTT assay) and production of reactive oxygen species (ROS; DCFH‐DA assay) and nitric oxide (NO; Griess reagent). A scanning electron microscope provided morphological chemical analyses and energy‐dispersive X‐ray spectroscopy. The data were submitted to the one‐way anova statistical test complemented by Tukey (p < .05).

Results

Cell viability decreased by 21.1% and 58.4% in G5 and G6, respectively. ROS production in G3 and G4 maintained basal levels but increased by 171.2% and 75.1% in G5 and G6, respectively.

Conclusions

The Brix3000™ enzymatic agent did not cause indirect cytotoxic effects on pulp cells, regardless of the application time. Conversely, Papacarie Duo™ reduced viability and increased ROS production by pulp cells.
A review on the application of UV‐C treatment on food and food surfaces: association with food microbiology, predictive microbiology and quantitative microbial risk assessment
Authors: Ramos Gustavo Luis P. A. , Esper Luciana Maria R. , Gonzalez Alice G. M.
Published: December 2023

The so‐called emerging technologies have gained prominence in the field of food processing, compared to conventional heat treatments, due to technological, sensorial and microbiological safety benefits. Ultraviolet radiation (UV), more specifically UV‐C radiation, is inexpensive and has been one of the most studied technologies. This work seeks to summarise the application of UV‐C treatment, contextualising its efficiency in the inactivation of microorganisms in different food matrices and surfaces associated with food handling and allowing the visualisation of trends in the combination of UV‐C radiation with other technologies. Still, the technology is related to quantitative tools associated with food microbiology. Factors related to processing parameters, characteristics of the microbial population and food properties have a direct influence on the effectiveness of UV‐C technology. The UV‐C treatment parameters must be rigorously defined, considering the particularities of each food matrix, so that undesirable identity or sensory changes do not occur. The application of mathematical tools, such as predictive microbiology and quantitative microbial risk assessment, is fundamental in the planning and definition of processing parameters for UV‐C radiation technology.
Platelet‐to‐lymphocyte ratio and absolute monocyte count have prognostic potential in primary myelodysplastic neoplasms
Authors: Qu Huiting , Chu Jingxue , Wang Lu , Zhang Jie , Han Jingyin , Li Zhen , Hou Haifeng , Wang Yong , Liu Yigang , Wu Huanling
Published: December 2023

Introduction

The platelet‐to‐lymphocyte ratio (PLR), peripheral blood absolute monocyte count (AMC), and monocyte‐to‐lymphocyte ratio (MLR) are considered biomarkers of systemic immune and inflammation response. However, their prognostic potential in patients with myelodysplastic neoplasms (MDS) remains unclear. This study aimed to explore the predictive impact of PLR, MLR, and AMC on MDS outcomes.

Methods

In total, 334 patients with primary MDS were included between January 2016 and December 2021 and were retrospectively followed up until December 31, 2022. The prognostic significance of PLR, MLR, and AMC was assessed using univariate and multivariate analyses, and predictive models were generated to estimate MDS outcomes. The area under their receiver operating curves was computed to compare the predictive power of these models.

Results

Fifty‐one patients had disease progression, and 103 patients died during follow‐up. In multivariate analyses, a higher PLR was an adverse independent factor for overall survival (OS) (p = 0.011), whereas a higher AMC indicated shorter progression‐free survival (p = 0.003). The prognostic model incorporating PLR, MLR, and AMC with the Revised International Prognostic Scoring System (IPSS‐R) risk categorization showed higher performance in predicting OS than the model that only utilized the IPSS‐R category.

Conclusion

Elevated PLR and increased AMC had independent prognostic value for adverse outcomes in patients with MDS. PLR, MLR, and AMC enhanced the IPSS‐R risk categorization for OS prediction in MDS.
Exploring the impact of audio self‐modelling on Chinese as a foreign language students' tone pronunciation skill, self‐efficacy, and motivation
Authors: Li Linghong , Valcke Martin , Badan Linda , Anderl Christoph
Published: December 2023

Background study

Chinese tone pronunciation instruction gains increasingly attention and various instructional strategies have been studied to develop effective tones in students. Students usually listen to successful pronunciation stimuli provided by the teacher or peers, to be copied by themselves. However, individuals seem more sensitive to learn from their own voice to develop adequate tone pronunciation. Self‐Modelling is an instructional strategy that builds on learning from ones' own behaviour to develop target behaviours. Most available research builds on visual cues; hence the label Visual Self Modelling (VSM) that presents learners with videoclips of their own behaviour. VSM had been found to be successful to develop a range of skills. However, when focusing on language pronunciation, audio cues are to be preferred to direct the modelling process. This inspired the authors to the design of audio self‐modelling (ASM) that starts from recordings of students' pronunciation. These auditory recordings are hypothesized to be more appropriate as a base for self‐modelling.

Objectives

The purpose of this study is to investigate the effectiveness of ASM when training Chinese as a foreign language students' tone pronunciation (focus on contour, pitch, duration. Additionally, the study explores the impact of ASM on students' self‐efficacy and motivation and the relationship between students' tone pronunciation skill, self‐efficacy, and motivation.

Method

A quasi‐experimental design was adopted, involving 26 students in a six‐week intervention to study the improvement of their pronunciation of Chinese tones at word level. Seventeen students in the experimental condition were trained via ASM; the other nine students studied pronunciation as usual on the base of teacher provided pronunciation stimuli and corrective feedback. Students in the ASM were also individually interviewed about their learning experience.

Results

Analysis of the quantitative pre‐ and post‐tests scores show that ASM results in a significantly higher posttest score for in each of the tone criteria as compared to the control group (contour, pitch and duration). Also, students' self‐efficacy and motivation improved to a significantly higher extent in the ASM research condition. No significant correlations were found between CFL students' tone pronunciation performance and their self‐efficacy and motivation. Analysis of the interview data further indicated that CFL students put forward positive attitudes and perceptions about ASM, next to some concerns.

Conclusion

The significant findings present empirical evidence as to the efficacy of ASM as an instructional strategy to develop L2 skills, and push the idea to adopt self‐modelling on the base of person auditory recordings to direct L2 pronunciation instruction.
Estimated small dense low‐density lipoprotein cholesterol and nonalcoholic fatty liver disease in nonobese populations
Authors: Huang Hangkai , Xie Jiarong , Hou Linxiao , Miao Min , Xu Lei , Xu Chengfu
Published: December 2023

Aims/Introduction

To explore the association between estimated small dense low‐density lipoprotein cholesterol (sdLDL‐C) and the risk of incident nonalcoholic fatty liver disease (NAFLD) in nonobese populations.

Materials and Methods

This study included participants who underwent health checkups in 2014 and were followed up until 2019. We carried out Cox proportional hazards regression analyses to evaluate the association of estimated sdLDL‐C with NAFLD. Discordance analyses were carried out to estimate the relative NAFLD risk in estimated sdLDL‐C versus low‐density lipoprotein cholesterol (LDL‐C) discordant/concordant groups. Estimated sdLDL‐C was calculated by equations based on LDL‐C and triglycerides. The diagnosis of NAFLD was based on the presence of abdominal ultrasonography after excluding other causes of chronic liver disease.

Results

Over a mean follow‐up period of 26,694 person‐years, 844 incident NAFLD cases were recorded. Compared with the first quartile of estimated sdLDL‐C, the fourth quartile was associated with a 2.933‐fold increased risk of NAFLD (95% confidence interval 2.095–4.107). With the increase in estimated sdLDL‐C, the risk of NAFLD gradually increased both in participants within the normal range of LDL‐C (hazard ratio 2.854, 95% confidence interval 1.650–5.617) and beyond the normal range of LDL‐C (hazard ratio 2.636, 95% confidence interval 1.263–5.502). In addition, the inconsistent high estimated sdLDL‐C/low LDL‐C group was associated with an increased risk of NAFLD, but not the low estimated sdLDL‐C/high LDL‐C group.

Conclusions

Estimated sdLDL‐C was positively associated with the risk of incident NAFLD in a nonobese population, independent of LDL‐C.
Reporting, handling, and interpretation of time‐varying drug treatments in observational studies using routinely collected healthcare data
Authors: Wang Wen , He Qiao , Xu Jiayue , Liu Mei , Wang Mingqi , Li Qianrui , Zhang Xia , Huang Yunxiang , Zhang Yuanjin , Li Ling , Zou Kang , Li Guowei , Lu Kevin , Gao Pei , Chen Feng , Guo Jeff Jianfei , Yang Min , Sun Xin
Published: December 2023

Background

Time‐varying drug treatments are common in studies using routinely collected health data (RCD) for assessing treatment effects. This study aimed to examine how these studies reported, handled, and interpreted time‐varying drug treatments.

Methods

A systematic search was conducted on PubMed from 2018 to 2020. Eligible studies were those used RCD to explore drug treatment effects. We summarized the reporting characteristics and methods employed for handling time‐varying treatments. Logistic regressions were performed to investigate the association between study characteristics and the reporting of time‐varying treatments.

Results

Two hundred and fifty‐six studies were included, and 225 (87.9%) studies involved time‐varying treatments. Of these, 24 (10.7%) reported the proportion of time‐varying treatments and 105 (46.7%) reported methods used to handle time‐varying treatments. Multivariable logistic regression showed that medical studies, prespecified protocol, and involvement of methodologists were associated with a higher likelihood of reporting the methods applied to handle time‐varying treatments. Among the 105 studies that reported methods, as‐treated analyses were the most commonly used analysis sets, which were employed in 73.9%, 75.3% and 88.2% of studies that reported approaches for treatment discontinuation, treatment switching and treatment add‐on. Among the 225 studies involved time‐varying treatments, 27 (12.0%) acknowledged the potential bias introduced by treatment change, of which 14 (51.9%) suggested that potential biases may impact acceptance or rejection of the null hypothesis.

Conclusions

Among observational studies using RCD, the underreporting about the presence and methods for handling time‐varying treatments was largely common. The potential biases due to time‐varying treatments have frequently been disregarded. Collaborative endeavors are strongly needed to enhance the prevailing practices.
A cross‐sectional study quantifies the independent contribution of nurses and midwives in child health outcomes
Authors: You Wenpeng , Donnelly Frank
Published: December 2023

Introduction

As the largest profession within the healthcare industry, nursing and midwifery workforce (NMW) provides comprehensive healthcare to children and their families. This study quantified the independent role of NMW in reducing under‐5 mortality rate (U5MR) worldwide.

Design

A retrospective, observational and correlational study to examine the independent role of NMW in protecting against U5MR.

Methods

Within 266 “countries”, the cross‐sectional correlations between NMW and U5MR were examined with scatter plots, Pearson's r, nonparametric, partial correlation and multiple regression. The affluence, education and urban advantages were considered as the potential competing factors for the NMW–U5MR relationship. The NMW–U5MR correlations in both developing and developed countries were explored and compared.

Results

Bivariate correlations revealed that NMW negatively and significantly correlated to U5MR worldwide. When the contributing effects of economic affluence, urbanization and education were removed, the independent NMW role in reducing U5MR remained significant. NMW independently explained 9.36% U5MR variance. Multilinear regression selected NMW as a significant factor contributing an extra 3% of explanation to U5MR variance when NMW, affluence, education and urban advantage were incorporated as the predicting variables. NMW correlated with U5MR significantly more strongly in developing countries than in developed countries.

Conclusion

NMW, indexing nursing and midwifery service, was a significant factor for reducing U5MR worldwide. This beneficial effect explained 9.36% of U5MR variance which was independent of economic affluence, urbanization and education. The NMW may be a more significant risk factor for protecting children from dying under 5 years old in developing countries. As a strategic response to the advocacy of the United Nations to reduce child mortality, it is worthy for health authorities to consider a further extension of nurses and midwives' practice scope to enable communities to have more access to NMW healthcare services.
Acupuncture for vitiligo: An overview of systematic reviews and meta‐analysis
Authors: Zhao Jisen , Gong Xueqing , Hou RuiRui , Guo Dong
Published: December 2023

Background

Vitiligo is a kind of refractory, autoimmune locally, or systemically generalized depigmentation spots caused by the disappearance of melanocyte function in the skin. Acupuncture and related therapies are extensively utilized for treating vitiligo in China. The objective of this study is to succinctly encapsulate and meticulously assess the methodological and reporting caliber of systematic reviews (SRs) pertaining to acupuncture and associated therapeutic approaches, while concurrently offering an all‐encompassing body of evidence elucidating their efficacy and safety in the treatment of vitiligo.

Methods

We performed an electronic literature search in eight databases to identify SRs that evaluated the efficacy of acupuncture therapy for vitiligo. The Assessment of Multiple Systematic Reviews 2 (AMSTAR 2) tool was used to evaluate the methodological and reporting quality of these SRs. The preferred reporting items for SRs and meta‐analyses were followed according to PRISMA (2020) guidelines. Additionally, the risk of bias in systematic reviews (ROBIS) was assessed to evaluate potential bias. The quality of evidence for outcome measures was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework.

Results

This study included 10 SRs and assessed a total of 13 outcome measures, all of which were published before June 2023. Acupuncture therapy was more effective than control conditions for the treatment of Vitiligo. The AMSTAR‐2 results indicated a critical deficiency in the methodological quality of all SRs, with items 7 and 16 demonstrating notably low quality. The reporting quality of the included SRs according to PRISMA was deemed unsatisfactory, with significant reporting flaws identified in the areas of Protocol and registration, Risk of bias across studies, Study selection, and Limitations. According to the ROBIS assessment, 5 out of the total number of SRs (50.00%) were found to have a high risk of bias. Out of the total of 62 outcomes evaluated using the GRADE framework, 9 outcomes (14.51%) exhibited high‐quality evidence, 20 outcomes (32.26%) demonstrated moderate‐quality evidence, 19 outcomes (30.65%) presented low‐quality evidence, while 14 outcomes (22.58%) indicated very low‐quality evidence.

Conclusions

This overview shows that Acupuncture therapy was more effective than the control treatment for Vitiligo. Nevertheless, given the subpar methodological quality of the reviews, we recommend conducting studies with stricter designs, larger sample sizes, and improved methodological and reporting quality to yield more robust evidence.
An independent comparison of the Novolytix salivary melatonin radioimmunoassay with the new Novolytix salivary melatonin enzyme‐linked immunosorbent assay
Authors: Burgess Helen J. , Kagan David , Rizvydeen Muneer , Swanson Leslie M. , Kim Hyungjin M.
Published: December 2023

The dim light melatonin onset (DLMO) is the current gold standard biomarker of the timing of the central circadian clock in humans and is often assessed from saliva samples. To date, only one commercially available salivary melatonin assay is considered accurate at the low daytime levels required to accurately detect the DLMO (Novolytix RIA RK‐DSM2). The aim of this study was to conduct the first independent evaluation of a newly improved enzyme‐linked immunosorbent assay (ELISA; Novolytix MLTN‐96) and compare it with the recommended radioimmunoassay (RIA)—both in terms of melatonin concentrations and derived DLMOs. Twenty participants (15 females, 18–59 years old) provided saliva samples every 30 min in dim light starting 6 h before their habitual bedtime, yielding a total of 260 saliva samples. Both the RIA and ELISA yielded daytime melatonin concentrations <2 pg/mL, indicating adequate accuracy to detect the DLMO. The melatonin concentrations from the two assays were highly correlated (r = .94, p < .001), although the RIA yielded lower levels of melatonin concentration than the ELISA, on average by 0.70 pg/mL (p = .006). Seventeen DLMOs were calculated from the melatonin profiles and the DLMOs from both assays were not statistically different (p = .36) and were highly correlated (r = .97, p < .001). Two DLMOs derived from the RIA occurred more than 30 min earlier than the DLMO derived from the ELISA. These results indicate that the new Novolytix ELISA is an appropriate assay to use if the Novolytix RIA is not feasible or available.
Target degradation specificity of phytoplasma effector phyllogen is regulated by the recruitment of host proteasome shuttle protein
Authors: Suzuki Masato , Kitazawa Yugo , Iwabuchi Nozomu , Maejima Kensaku , Matsuyama Juri , Matsumoto Oki , Oshima Kenro , Namba Shigetou , Yamaji Yasuyuki
Published: December 2023

Phytoplasmas infect a wide variety of plants and can cause distinctive symptoms including the conversion of floral organs into leaf‐like organs, known as phyllody. Phyllody is induced by an effector protein family called phyllogens, which interact with floral MADS‐box transcription factors (MTFs) responsible for determining the identity of floral organs. The MTF/phyllogen complex then interacts with the proteasomal shuttle protein RADIATION SENSITIVE23 (RAD23), which facilitates delivery of the MTF/phyllogen complex to the host proteasome for MTF degradation. Previous studies have indicated that the MTF degradation specificity of phyllogens is determined by their ability to bind to MTFs. However, in the present study, we discovered a novel mechanism determining the degradation specificity through detailed functional analyses of a phyllogen homologue of rice yellow dwarf phytoplasma (PHYLRYD). PHYLRYD degraded a narrower range of floral MTFs than other phyllody‐inducing phyllogens, resulting in compromised phyllody phenotypes in plants. Interestingly, PHYLRYD was able to bind to some floral MTFs that PHYLRYD was unable to efficiently degrade. However, the complex of PHYLRYD and the non‐degradable MTF could not interact with RAD23. These results indicate that the MTF degradation specificity of PHYLRYD is correlated with the ability to form the MTF/PHYLRYD/RAD23 ternary complex, rather than the ability to bind to MTF. This study elucidated that phyllogen target specificity is regulated by both the MTF‐binding ability and RAD23 recruitment ability of the MTF/phyllogen complex.
Entomological, parasitological and molecular investigations in a new focus of cutaneous leishmaniasis in Youssoufia region, Morocco
Authors: Amane Mounia , El Mazini Sara , Echchakery Mohamed , Hafidi Mohamed , Lemrani Meryem , Boussaa Samia
Published: December 2023

Background and Aims

Leishmaniasis is a neglected tropical infection caused by Leishmania parasite that affect human and animal. In Morocco, the cutaneous leishmaniasis has spread substantially to the new areas. The surveillance limited to active foci may underestimate the occurrence of cutaneous leishmaniasis (CL). This study aims to investigate the local transmission of CL in rural districts of Youssoufia province, central Morocco, as a potential focus of CL.

Methods

For this purpose, parasitological, molecular and entomological investigations were carried out in this area. Data collection concerns potential vectors and human cases. Thus, 402 patients were examined for suspected leishmaniasis lesions in three localities of the province of Youssoufia. In these same localities, 983 sand flies were collected by CDC light traps and sticky paper during one‐night per month during 6 months. These sand flies were all identified morphologically using the Moroccan identification key.

Results

The results showed that among the 25 skin lesions detected in a population of 402 individuals, 18 were confirmed by kDNA nested PCR as CL positive patients, of which only 25% were positive by direct examination. Leishmania tropica and Leishmania major were identified as causative agents of CL in the study area. Direct parasitological examination showed a low sensitivity (27.78%), especially for L. major, although its specificity was evaluated at 100%. Regarding entomological results, both genera of the Moroccan sand fly were collected in the study area: Genus/Phlebotomus (75.28%) and Sergentomyia (24.72%). Phlebotomus (P) papatasi, the proven vector of L. major, was the most abundant species (33.98%), followed by Paralongicollum sergenti (22.58%), the confirmed vector of L. tropica; while Sergentomyia (S) minuta, P. longicuspis, S. fallax and P. kazeruni were collected with, respectively, 17.60%, 16.99%, 7.12% and 1.73%.

Conclusion

This study constitutes the first report of CL in the study areas, as well as the coexistence of L. tropica and L. major in these rural localities. Local transmission of CL is highly probable, as indicated by the prevalence of the two proven vectors of L. major and L. tropica. To control the spread of this disease, our results suggest the use of highly sensitive molecular methods to detect CL cases in potential leishmaniasis foci, which will improve surveillance.