bluuebunny/crossref_metadata_2025 huggingface dataset:
Diagnostic Validity of Drinking Behaviour for Identifying Alcohol Use Disorder: Findings from a Nationally Representative Sample of Community Adults and an Inpatient Clinical Sample
Authors: Garber M.L. , Samokhvalvov A. , Chorny Y. , LaBelle O. , Rush B. , Costello J. , MacKillop J.
Published: September 2024

Background and Aims

Alcohol consumption is an inherent feature of alcohol use disorder (AUD), and drinking characteristics may be diagnostically informative. This study had three aims: (1) to examine the classification accuracy of several drinking quantity/frequency indicators in a large representative sample of U.S. community adults; (2) to extend the findings to a clinical sample of adults; and (3) to examine potential sex differences.

Design

This retrospective study utilized receiver operating characteristic (ROC) curves to evaluate area under the curve (AUC). Optimal cut-offs were identified using the Youden Index. Diagnostic validity was evaluated using accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV).

Measurements

Index tests included measures of quantity/frequency (e.g., drinks/drinking day, largest drinks/drinking day, number of drinking days, and heavy drinking frequency). The reference standard was AUD status as determined via a clinical interview (community sample) or a symptom checklist (clinical sample).

Setting and Participants

Two samples were examined: A large, nationally representative random sample of U.S. community adults who reported past-year drinking (N=25,778, AUD=20%) and a consecutive drinking clinical sample from a Canadian mental health and addictions inpatient treatment centre (N=1,341, AUD=82%).

Findings

All drinking indicators performed much better than chance at classifying AUD (AUCs=0.60-0.92,ps<.0001). Heavy drinking frequency indicators performed optimally in both the community (AUCs=0.78-0.87; accuracy=0.72-0.80) and clinical (AUC=0.85-0.92; accuracy =0.77-0.89) samples. Collectively, the most discriminating drinking behaviors were heavy drinking episodes and exceeding NIAAA drinking low-risk guidelines. No substantive sex differences in optimal cut-offs or variable performance were observed.

Conclusions

Drinking patterns performed well at classifying AUD in both a nationally representative and large inpatient sample, robustly identifying AUD at rates much better than chance and above accepted benchmarks, with limited differences by sex. Findings broadly support the potential utility of quantitative drinking indicators as being diagnostically informative in clinical settings.
A next generation CRISPR diagnostic tool to survey drug resistance in Human African Trypanosomiasis
Authors: Antón Elena Pérez , Dujeancourt-Henry Annick , Rotureau Brice , Glover Lucy
Published: September 2024

The WHO aims to eliminate thegambienseform of human African trypanosomiasis (HAT) by 2030. With the decline of reported cases, maintaining efficient epidemiological surveillance is essential, including the emergence of drug-resistant strains. We have developed new highly specific diagnostic tools using Specific High-Sensitivity Reporter Enzymatic UnLOCKing (SHERLOCK) technology for monitoring the presence of drug-resistant genotypes that (1) are already circulating, such as the AQP2/3(814)chimera providing resistance to pentamidine and melarsoprol, or (2) could emerge, such asTbCPSF3 (N232H), associated to acoziborole resistance in lab conditions. The melarsoprol - pentamidineAQP2/3(814)SHERLOCK assay detected RNA from both cultured parasites and field isolated strains from gHAT patients in relapse following treatment. The acoziboroleCPSF3(SNV)SHERLOCK assay discriminated between wild-typeCPSF3RNA andCPSF3with a single A-C mutation that confers resistance to acoziborolein vitro.
Deriving Imaging Biomarkers for Primary Central Nervous System Lymphoma Using Deep Learning
Authors: Zhu Joshua , Destito Michela , Dhanireddy Chitanya , Hager Tommy , Hossain Sajid , Chadha Saahil , Sritharan Durga , Dhawan Anish , Kandala Keervani , Pedersen Christian , Anzalone Nicoletta , Calimeri Teresa , De Momi Elena , Spadea Maria Francesca , Aboian Mariam S. , Aneja Sanjay
Published: September 2024

Abstract

Purpose

Primary central nervous system lymphoma (PCNSL) is typically treated with chemotherapy, steroids, and/or whole brain radiotherapy (WBRT). Identifying which patients benefit from WBRT following chemotherapy, and which patients can be adequately treated with chemotherapy alone remains a persistent clinical challenge. Although WBRT is associated with improved outcomes, it also carries a risk of neuro-cognitive side effects. This study aims to refine patient phenotyping for PCNSL by leveraging deep learning (DL) extracted imaging biomarkers to enable personalized therapy.

Methods

Our study included 71 patients treated at our institution between 2009-2021. The primary outcome of interest was overall survival (OS) assessed at one-year, two-year, and median cohort survival cutoffs. The DL model leveraged an 8-layer 2D convolutional neural network which analyzed individual slices of post-contrast T1-weighted pre-treatment MRI scans. Survival predictions were made using a weighted voting system related to tumor size. Model performance was assessed with accuracy, sensitivity, specificity, and F1 scores. Time-dependent AUCs were calculated and C-statistics were computed to summarize the results. Kaplan-Meier (KM) survival analysis assessed differences between low and high-risk groups and statistically evaluated using the log-rank test. External validation of our model was performed with a cohort of 40 patients from an external institution.

Results

The cohort’s average age was 65.6 years with an average OS of 2.80 years. The one-year, two-year, and median OS models achieved AUCs of 0.73 (95% C.I., 0.60-0.85), 0.70 (95% C.I., 0.58-0.82), and 0.73 (95% C.I., 0.58-0.82) respectively. KM survival curves showcased discrimination between low and high-risk groups in all models. External validation with our one-year model achieved AUC of 0.64 (95% C.I., 0.63-0.65) and significant risk discrimination. A sub-analysis showcased stable model performance across different tumor volumes and focality.

Conclusions

DL classifiers of PCNSL MRIs can stratify patient phenotypes beyond traditional risk paradigms. Given dissensus surrounding PCNSL treatment, DL can augment risk stratification and treatment personalization, especially with regards to WBRT decision making.
Association of air pollution from a landfill site with primary care consultation
Authors: Jordan Kelvin P , Muller Sara , Usman Muhammad , Bailey James , Burton Claire , Lawton Sarah A , Mallen Christian D , Mason Kayleigh J , Wathall Simon , van der Windt Danielle A
Published: September 2024

Background

Waste landfill sites are associated with gaseous emissions and this air pollution can cause unpleasant smells (“malodour”). This causes concerns about its impact on the health of the local population. This study assessed change in general practice consultation behaviour during a period of increased complaints associated with air pollution at a UK landfill site.

Methods

The study period was October 2020 to December 2021. The age-sex standardised prevalence and incidence of consultations for mental health, respiratory, and other symptoms hypothesised to be impacted by the air pollution issues were determined and compared between: i) 6 practices located close to the landfill site (zone A), ii) 6 practices located a mid-distance from the site (zone B), iii) 6 practices located further away and expected to have had less impact (zone C).

Results

Whilst there was an increased consultation for mental health problems in practices nearest to the landfill site compared to those furthest away, consultation frequencies for respiratory and other potentially associated symptoms were lower and likelihood of consultation was consistently highest in practices located in zone B.

Conclusion

This study did not show clear evidence of an increase in recorded primary healthcare contacts for conditions and symptoms hypothesised to be connected to air pollution. It highlighted the challenges of examining the impact of air pollution on the health of local populations. Since this study focussed on coded consultations in primary care and not symptoms present in the general population, an impact on the health of individuals cannot be ruled out.

How this fits in

Air pollution from waste landfill sites may impact on the health of the local population.

We did not find consistent evidence of increased healthcare consultations to general practices which were nearest to such pollution.

This study highlights the challenges in examining the impact of air pollution on health.

Symptoms may still be increased in the general population and an impact on the health of individuals cannot be ruled out.
Exploring subthreshold functional network alterations in women with phenylketonuria by higher criticism
Authors: Sundermann Benedikt , Feldmann Reinhold , Mathys Christian , Garde Stefan , Rau Johanna M. H. , McLeod Anke , Weglage Josef , Pfleiderer Bettina
Published: September 2024

Objective: Phenylketonuria (PKU) is an inherited disorder of amino acid metabolism. Despite early dietary treatment, cognitive functioning of patients has been reported as being inferior to healthy controls. Objective of this study was to assess functional connectivity (FC) alterations in PKU in cognition-related brain networks by resting-state functional magnetic resonance imaging. We followed a hierarchical analysis approach partially based on higher criticism (HC) statistics as previously applied in a larger sister-project in fetal alcohol syndrome. Results: After exclusions for excessive head movement, 11 female young adults with early-treated PKU (age: 27.2 +- 3.7 years) and 11 age-matched female healthy controls (age: 25.9 +- 3.8 years) were included in the analysis. We observed effects within attention networks and the default mode network, but not in fronto-parietal networks, at the HC-based intermediate analysis level. No between-network FC differences were found. In the most detailed analysis level, we could not identify single affected functional connections. Despite statistical power limitations in this small sample, findings are in line with previously reported FC alterations in PKU and the cognitive profile in young adults with PKU, particularly with the still uncertain notion that cognitive control deficits might become less pronounced when PKU patients reach adulthood.
Association of Item-Level Responses to Cognitive Function Index with Tau Pathology and Hippocampal volume in The A4 Study
Authors: Demirsoy Idris , Ghanbarian Elham , Khorsand Babak , Nallapu Bhargav T. , Ezzati Ali
Published: September 2024

Background

Alzheimer’s Disease (AD) has a lengthy asymptomatic preclinical phase during which individuals may show pathological signs like β-amyloid (Aβ) pathology and tau tangles without noticeable objective cognitive impairments. Subjective cognitive impairment reports may offer valuable and early insights into individuals’ cognitive functioning and serve as indicators of early stages of cognitive decline.

Objective

To investigate the associations of the item-level response to Cognitive Function Index (CFI) by participant and study partner with tau pathology and adjusted hippocampal volume (HVa).

Method

Participants were 339 cognitively unimpaired, Aβ positive, individuals enrolled in the Anti-Amyloid Asymptomatic Alzheimer’s (A4) Study who underwent tau-PET imaging. Participants and their study partners assessed subjective changes in cognition and function over the past year using the 15-item CFI questionnaire. For each CFI item, the relationship among tau, HVa, and CFI reports was investigated.

Result

Participants were on average 72.38 (SD = 4.87) years old, 58.1% were female, and 23.6% were tau positive. Higher tauMTLwas significantly associated with participant report of decline on three CFI items including depending on written notes, seeing a doctor for memory concern, and feeling lost while navigating. Higher tauMTLwas associated with study partner report of decline on two different items: needing help from others to remember appointments/occasions and asking same questions. Additionally, HVa was linked to challenges with driving for participants and noticeable memory decline for study partners.

Conclusion

We showed that early changes reported on specific items of the CFI are associated with higher tauMTLand lower HVa in Aβ+ participants. Different CFI items were associated with tau and hippocampal volume for participants and study partners, highlighting the importance of both perspective.
Comparative Risk of the Onset of Atrial Fibrillation after Icosapent Ethyl versus Omega-3 –Acid-Ethyl-Esters Adjuvant to Statins
Authors: Sarker Jyotirmoy , Kim Michael , Patton Samantha , Radwański Przemysław B. , Munger Mark A. , Kim Kibum
Published: September 2024

Background

Icosapent ethyl (ICP), an ethyl ester of eicosapentaenoic acid (EPA), and omega-3 acid ethyl esters (DHA/EPA), comprised of ethyl esters of EPA and doxosahexaenoic acid (DHA), are approved as adjunctive therapy to statins for reducing adverse cardiovascular events (CV) in patients with CV risks. However, there are concerns regarding a potential association between ICP and atrial fibrillation (AF). This study evaluated the incidence of AF onset between ICP and DHA/EPA when used as adjuvant therapy with statins.

Methods and Results

This retrospective study utilized administrative healthcare claims to analyze adult AF-naïve patients from one year preceding their first prescription for ICP or DHA/EPA. These patients were followed for two years, spanning from2013-2021. AF incidence was assessed during active treatment with either ICP or DHA/EPA as adjunct statin therapy. A propensity score (PS) matched cohort controlled for baseline characteristics and the effect of calendar year on the use of ICP or DHA/EPA. The cumulative incidence of AF was estimated using a product-limit estimator and compared between groups using a Cox proportional hazards regression model. The PS-matched cohort included 17,638 participants with a mean age 56 years, predominantly male (65.7% ICP vs. 64.5% DHA/EPA). Over two years, the cumulative incidence of AF from ICP and DHA/EPA was 5.32% and 3.99% respectively, resulting in a HR of 1.242 (95% CI: 1.061 to 1.455).

Conclusions

In adult AF-naïve patients, ICP, when compared to DHA/EPA in conjunction with statin therapy, was associated with a significantly higher significant risk of developing AF.

RESEARCH PERSPECTIVE

What is New?

Does icopasent ethyl (ICP), an ethyl ester of eicosapentaenoic acid (EPA) and omega-3 acid ethyl esters comprised of ethyl esters of EPA and doxosahexaenoic acid (DHA) in atrial fibrillation (AF)-naïve patients taking statins increase the incidence of AF?

Over two years, the cumulative incidence of AF from ICP and DHA/EPA was 5.32% and 3.99% respectively, resulting in a HR of 1.242 (95% CI: 1.061 to 1.455).

In adult AF-naïve patients, ICP, when compared to DHA/EPA in conjunction with statin therapy was associated with a higher significant risk of developing AF.

What Question Should be Addressed Next?

What should be considered as clinical and demographic factors in identifying patients at risk of atrial fibrillation prior to being prescribed ICP or DHA/EPA agents.

Investigation into the underlying mechanism of the increase in atrial fibrillation with marine omega-3 ethyl esters should continue.

Understanding AF outcomes from ICP or DHA/EPA use including AF burden, need for AF medical or electrophysiological interventions, and health-care total costs.
A longitudinal study of depressive symptom trajectories and risk factors in congestive heart failure
Authors: Gallucci Julia , Ng Justin , Secara Maria T. , Jones Brett D.M. , Hawco Colin , Husain M. Omair , Husain Nusrat , Chaudhry Imran B. , Voineskos Aristotle N. , Husain M. Ishrat
Published: September 2024

Background

Depression is prevalent among patients with congestive heart failure (CHF) and is associated with increased mortality and healthcare utilization. However, most research has focused on high-income countries, leaving a gap in knowledge regarding the relationship between depression and CHF in low-to-middle-income countries (LMICs). This study aimed to delineate depressive symptom trajectories and identify potential risk factors for poor outcomes among CHF patients.

Methods

Longitudinal data from 783 patients with CHF from public hospitals in Karachi, Pakistan was analyzed. Depressive symptom severity was assessed using the Beck Depression Inventory (BDI). Baseline and 6-month follow-up BDI scores were clustered through Gaussian Mixture Modeling to identify distinct depressive symptom subgroups and extract trajectory labels. Further, a random forest algorithm was utilized to determine baseline demographic, clinical, and behavioral predictors for each trajectory.

Results

Four depressive symptom trajectories were identified: ‘good prognosis,’ ‘remitting course,’ ‘clinical worsening,’ and ‘persistent course.’ Risk factors associated with persistent depressive symptoms included lower quality of life and the New York Heart Association (NYHA) class 3 classification of CHF. Protective factors linked to a good prognosis included less disability and a non-NYHA class 3 classification of CHF.

Conclusions

By identifying key characteristics of patients at heightened risk of depression, clinicians can be aware of risk factors and better identify patients who may need greater monitoring and appropriate follow-up care.

Clinical Perspective

What is new?

To the best of our knowledge, this is the first study to use machine learning techniques to investigate depressive symptom trajectories in CHF patients from an LMIC.

Four distinct depressive symptom trajectories were identified, ranging from good prognosis to persistent depressive symptoms.

This study highlights protective and risk factors associated with these trajectories based on patients’ demographics and clinical presentations at baseline.

What are the clinical implications?

Personalized interventions based on identified protective factors for high-risk CHF patients could enhance both mental health and cardiovascular outcomes.

Early detection and management of depression, particularly in patients with poor quality of life or advanced heart failure, may help reduce healthcare utilization and mortality.

This study emphasizes the importance of routine depression screening in CHF patients, especially in LMICs, to enhance overall patient care and outcomes.
Full-length RNA transcript sequencing traces brain isoform diversity in house mouse natural populations
Authors: Zhang Wenyu , Guenther Anja , Gao Yuanxiao , Ullrich Kristian , Huettel Bruno , Ahmad Aftab , Duan Lei , Wei Kaizong , Tautz Diethard
Published: September 2024

The ability to generate multiple RNA transcript isoforms from the same gene is a general phenomenon in eukaryotes. However, the complexity and diversity of alternative isoforms in natural populations remain largely unexplored. Using a newly developed full-length transcript enrichment protocol with 5′ CAP selection, we sequenced full-length RNA transcripts of 48 individuals from outbred populations and subspecies ofMus musculus, and from the closely related sister speciesMus spretusandMus spicilegusas outgroups. The data set represents the most extensive full-length high-quality isoform catalog at the population level to date. In total, we reliably identify 117,728 distinct isoforms, of which only 51% were previously annotated. We show that the population-specific distribution pattern of isoforms is phylogenetically informative and reflects the segregating single nucleotide polymorphism (SNP) diversity between the populations. We find that ancient housekeeping genes are a major source of the overall isoform diversity, and that the generation of alternative first exons plays a major role in generating new isoforms. Given that our data allow us to distinguish between population-specific isoforms and isoforms that are conserved across multiple populations, it is possible to refine the annotation of the reference mouse genome to a set of about 40,000 isoforms that should be most relevant for comparative functional analysis across species.
Chromosome-level subgenome-aware de novo assembly provides insight intoSaccharomyces bayanusgenome divergence after hybridization
Authors: Gardner Cory , Chen Junhao , Hadfield Christina , Lu Zhaolian , Debruin David , Zhan Yu , Donlin Maureen J. , Ahn Tae-Hyuk , Lin Zhenguo
Published: September 2024

Interspecies hybridization is prevalent in various eukaryotic lineages and plays important roles in phenotypic diversification, adaptation, and speciation. To better understand the changes that occurred in the different subgenomes of a hybrid species and how they facilitate adaptation, we have completed chromosome-level de novo assemblies of all chromosomes for a recently formed hybrid yeast,Saccharomyces bayanusstrain CBS380, using Oxford Nanopore Technologies' MinION long-read sequencing. We characterize theS. bayanusgenome and compare it with its parent species,Saccharomyces uvarumandSaccharomyces eubayanus, and otherS. bayanusgenomes to better understand genome evolution after a relatively recent hybridization event. We observe multiple recombination events between the subgenomes in each chromosome, followed by loss of heterozygosity (LOH) in nine chromosome pairs. In addition to maintaining nearly all gene content and synteny from its parental genomes,S. bayanushas acquired many genes from other yeast species, primarily through the introgression ofSaccharomyces cerevisiae, such as those involved in the maltose metabolism. Finally, the patterns of recombination and LOH suggest an allotetraploid origin ofS. bayanus. The gene acquisition and rapid LOH in the hybrid genome probably facilitated its adaptation to maltose brewing environments and mitigated the maladaptive effect of hybridization. This paper describes the first in-depth study using long-read sequencing technology of anS. bayanushybrid genome, which may serve as an excellent reference for future studies of this important yeast and other yeast strains.
Axion Emission from Strange Matter in Core-Collapse SNe
Authors: Cavan-Piton Maël , Guadagnoli Diego , Oertel Micaela , Seong Hyeonseok , Vittorio Ludovico
Published: September 2024

The duration of the neutrino burst from the supernova event SN 1987A is known to be sensitive to exotic sources of cooling, such as axions radiated from the dense and hot hadronic matter thought to constitute the inner core of the supernova. We perform the first quantitative study of the role of hadronic matter beyond the first generation—–in particular strange matter. We do so by consistently including the full baryon and meson octets, and computing axion emissivity induced from baryon-meson to baryon-axion scatterings as well as from baryon decays. We consider a range of supernova thermodynamic conditions, as well as equation-of-state models with different strangeness content. We obtain the first bound on the axial axion-strange-strange coupling, as well as the strongest existing bound on the axion-down-strange counterpart. Our bound on the latter coupling can be as small as O(10−2) for fa=109  GeV.

Published by the American Physical Society
2024
Testing the Origins of Neutrino Mass with Supernova-Neutrino Time Delay
Authors: Ge Shao-Feng , Kong Chui-Fan , Smirnov Alexei Y.
Published: September 2024

The origin of neutrino masses remains unknown. Both the vacuum mass and the dark mass generated by the neutrino interaction with dark matter (DM) particles or fields can fit the current oscillation data. The dark mass squared is proportional to the DM number density and, therefore, varies on the galactic scale with much larger values around the Galactic Center. This affects the group velocity and the arrival time delay of core-collapse supernovae (SN) neutrinos. This time delay, especially for the νe neutronization peak with a sharp time structure, can be used to distinguish the vacuum and dark neutrino masses. For illustration, we explore the potential of the Deep Underground Neutrino Experiment (DUNE), which is sensitive to νe. Our simulations show that DUNE can distinguish the two neutrino mass origins at more than 5σ C.L., depending on the observed local value of neutrino mass, the neutrino mass ordering, the DM density profile, and the SN location.

Published by the American Physical Society
2024
Power-Law Scaling Relating the Average Charge State and Kinetic Energy in Expanding Laser-Driven Plasmas
Authors: Sheil J. , Poirier L. , Lassise A. C. , Hemminga D. J. , Schouwenaars S. , Braaksma N. , Frenzel A. , Hoekstra R. , Versolato O. O.
Published: September 2024

A universal power-law scaling z¯∝E0.4 in the correlation between the average ion charge state z¯ and kinetic energy E in expanding laser-driven tin plasmas is identified. Universality here refers to an insensitivity to all experimental conditions: target geometry, expansion direction, laser wavelength, and power density. The power law is accurately captured in an analytical consideration of the dependence of the charge state on temperature and the subsequent transfer of internal to kinetic energy in the expansion. These analytical steps are individually, and collectively, validated by a two-dimensional radiation-hydrodynamic simulation of an expanding laser-driven plasma. This power-law behavior is expected to hold also for dense plasma containing heavier, complex ions such as those relevant to current and future laser-driven plasma light sources.

Published by the American Physical Society
2024
Liouvillian skin effects and fragmented condensates in an integrable dissipative Bose-Hubbard model
Authors: Ekman Christopher , Bergholtz Emil J.
Published: September 2024

Strongly interacting nonequilibrium systems are of great fundamental interest, yet their inherent complexity make them notoriously hard to analyze. We demonstrate that the dynamics of the Bose-Hubbard model, which by itself evades solvability, can be solved exactly at any interaction strength in the presence of loss tuned to a rate matching the hopping amplitude. Remarkably, the full solvability of the corresponding Liouvillian, and the integrability of the pertinent effective non-Hermitian Hamiltonian, survives the addition of disorder and generic boundary conditions. By analyzing the Bethe ansatz solutions we find that even weak interactions change the qualitative features of the system, leading to an intricate dynamical phase diagram featuring non-Hermitian Mott-skin effects, disorder induced localization, highly degenerate exceptional points, and a Bose glasslike phase of fragmented condensates. We discuss realistic implementations of this model with cold atoms.

Published by the American Physical Society
2024
Trends in instructional technologies used in education of people with special needs due to intellectual disability and autism
Authors: Kalemkuş Fatih
Published: September 2024

The purpose of this study is to analyse trends in articles on the use of instructional technologies in the education of individuals with special needs, specifically those with mental disabilities and autism. The research was conducted in accordance with the PRISMA statement, and the studies were analysed through content analysis. Between 2015 and 2023, 452 articles were retrieved from ScienceDirect, Web of Science, SpringerLink, ERIC, Google Scholar, SOBIAD, Taylor & Francis and SCOPUS databases on the use of instructional technologies in the education of students with intellectual disabilities or autism. The analysis included 128 articles that met the research criteria. The research indicates that publications on instructional technologies for individuals diagnosed with intellectual disabilities were mostly published in 2019, 2020 and 2021. Among these technologies, technology‐supported learning and augmented reality were found to be the most preferred. These studies focused on the effects of instructional technologies on communication and social skills. They were mostly conducted on students aged 15–25. Publications for individuals diagnosed with autism were mostly published in 2022. These individuals have mostly preferred technology‐supported learning, virtual reality and robot‐assisted learning as instructional technologies. These studies focused on the effects of instructional technologies on communication and social skills in students aged 5–10.
Belgium: Political Developments and Data in 2023
Authors: BAUDEWYNS PIERRE , VANDELEENE AUDREY , WINTER LIEVEN DE , DERUETTE SERGE
Published: September 2024

In the final full year ahead of the 2024 general elections, tensions within the Belgian federal government were as intense as they were since its inception. If the De Croo I large coalition had been able to present a united front in the face of the need to respond to the pandemic and the energy crisis in its first years, its fragile character emerged in 2023, but yet without breaking. No large reform was implemented as if the coalition parties were already more preoccupied with positioning themselves for the 2024 elections than achieving a pension, tax or institutional reform. After years of relative stability in terms of party leaders, several Belgian political parties held leadership elections in 2023 or decided to postpone them until after the general elections.
Pesticide regulatory heterogeneity, foreign sourcing, and global agricultural value chains
Authors: Fiankor Dela‐Dem Doe , Dalheimer Bernhard , Mack Gabriele
Published: September 2024

Regulations on the production and consumption of goods are very heterogeneous across countries. Whereas the effects of regulations on exports are well known, the responses of importers to heterogeneous and frequently changing country‐specific regulations are not well understood. We combine Swiss firm‐level import customs transaction data with country‐product‐year‐specific maximum residue limits to investigate the effect of pesticide regulatory heterogeneity on firm‐level imports and assess the moderating role of firm size and global value chain participation. Relying on a global sourcing model, we find that regulatory heterogeneity reduces imports but less so in larger and diversified firms. Participating in global value chains also improves firms' flexibility toward heterogeneous regulation. Business diversification—although reducing the gains from trade and scale—could help firms cope with heterogeneous international regulations.
Effect of chronic periodontitis on the endothelial glycocalyx of rat penile corpus cavernosum
Authors: Xia Yuanhang , Zeng Yang , Jiang Rui
Published: September 2024

Background

Chronic periodontitis may induce erectile dysfunction (ED), however, the specific mechanism involved is unclear. The endothelial glycocalyx (eGlx) is a structure that can regulate endothelial nitric oxide synthase (eNOS) phosphorylation on the cavity surface of vessels.

Aim

To investigate whether chronic periodontitis leads to ED by affecting the eGlx.

Methods

Twenty‐four 4‐week‐old male Sprague‒Dawley rats were randomly divided into four groups (n = 6): the control group, chronic periodontitis group, chronic periodontitis + heparin group (subcutaneous heparin 200 U/kg/day, 7 days), and control + heparin group. Four weeks after the induction of periodontitis in the rats, the maximum intra‐cavernous pressure/mean arterial pressure (ICPmax/MAP), serum C‐reactive protein (CRP), tumor necrosis factor alpha (TNF‐α), interleukin‐6 (IL‐6), nitric oxide (NO), heparin sulfate (HS), syndecan‐1 (SDC‐1), heparanase (HPSE), eNOS, and phosphor‐eNOS (p‐eNOS) concentration were measured, and the eGlx of the penile corpus cavernosum was observed by transmission electron microscopy (TEM).

Outcomes

Chronic periodontitis can degrade eGlx on the rat penile corpus cavernosum by increasing serum CRP, TNF‐α, and IL‐6 levels, reducing the p‐eNOS/eNOS ratio and the NO concentration in the penile corpus cavernosum, and resulting in the inhibition of the erectile function.

Results

Serum CRP, TNF‐α, and IL‐6 levels and HPSE expression in penile cavernous tissue were significantly greater in the chronic periodontitis group than in the control group and the chronic periodontitis + heparin group (P < 0.05). The average thickness of the eGlx muscle in the penile corpus cavernosum in the chronic periodontitis group was significantly lower than those in the control group and chronic periodontitis + heparin group (P < 0.05). The HS concentration, SDC‐1 expression, p‐eNOS/eNOS, NO concentration, and ICPmax/MAP in the chronic periodontitis group were significantly lower than those in the control group and chronic periodontitis+ heparin group (P < 0.01).

Clinical implications

The eGlx on penile cavernosum vessels may be a new therapeutic target for the treatment of ED.

Strengths and limitations

This study revealed that chronic periodontitis promotes the decomposition of vascular eGlx in the rat penile corpus cavernosum, however, it is not clear whether chronic periodontitis inhibits the synthesis of eGlx.

Conclusion

Chronic periodontitis can degrade eGlx on the rat penile corpus cavernosum by increasing serum CRP, TNF‐α, and IL‐6 levels, reducing the p‐eNOS/eNOS ratio and the NO concentration in penile cavernous tissue, and resulting in the inhibition of the erectile function. Heparin inhibited eGlx decomposition and improved erectile function in rats with chronic periodontitis.
Aortic isthmus flow reversal in fetal coarctation of the aorta and the associated factors
Authors: Chen Guihong , Han Yongfeng , Sun Congxin , Xiang Wei , Zhao Wei , Zhou Pei , Yu Tianxiao , Chen Zhuo , Gao Bulang , Ge Shuping , Mi Jie
Published: September 2024

Introduction

The aim of this study was to investigate the presence of aortic isthmus flow reversal and its associated factors in fetuses with positive and false‐positive coarctation of the aorta (CoA) compared with normal controls.

Material and Methods

Pregnant women with fetuses suspected of CoA and normal control were enrolled, and these women experienced prenatal ultrasound scan and followed up for 6 months after birth to confirm the presence of CoA. All the ultrasound parameters were analyzed.

Results

A total of 134 pregnant women were enrolled, with 43 CoA‐positive fetuses and 91 CoA false‐positive fetuses, and 334 matched pregnant women were enrolled in the control group. Aortic isthmus flow reversal occurred in 28 (65.1%) fetuses in the CoA‐positive group, significantly (p < 0.05) more than in the false‐positive (37 or 40.7%) or control group (64 or 19.2%). Aortic isthmus flow reversal was mostly in the full systole (n = 17 or 60.7%) or late systole and early‐middle diastole (n = 10 or 35.7%) in the CoA‐positive fetuses (n = 27 or 96.4%), significantly (p < 0.001) different from that in the false‐positive or control group. The aortic isthmus flow reversal peak systolic velocity (PSV), flow volume, and ratio of reversed flow/forward flow were significantly (p < 0.05) increased in the CoA‐positive and false‐positive groups than in the control group. The aortic isthmus flow reversal incidence was significantly (p < 0.05) correlated with the middle cerebral artery (MCA) PSV in the total three groups or in the false‐positive group but was significantly (p < 0001) negatively correlated with the MCA resistance index (RI) in the CoA‐positive group. The incidence of the aortic isthmus flow reversal was significantly (p < 0.05) positively correlated with the umbilical artery (UA) RI in the false‐positive group and with the UA RI in the total three groups. Independently associated factors for aortic isthmus flow reversal were isthmic flow volume/CCO (combined cardiac output) in the CoA‐positive group.

Conclusions

Reversal of flow in the aortic isthmus is much more common in true‐positive cases of CoA as compared to controls, and isthmic flow reversal in the full systolic phase only suggests presence of CoA. The aortic isthmic reversed flow volume accounts for over half of the isthmic forward flow volume in the CoA‐positive fetuses than in the normal controls.
Editorial: DoesESWL‐ERCPfor pancreatic duct stone removal change the natural course of symptomatic chronic calcific pancreatitis?
Authors: Kozarek Richard
Published: September 2024

LINKED CONTENT

This article is linked to Yiu et al papers. To view these articles, visithttps://doi.org/10.1111/apt.18224andhttps://doi.org/10.1111/apt.18284
The effect of down‐titration and discontinuation of heart failure pharmacotherapy in older people: A systematic review and meta‐analysis
Authors: Duong Mai H. , Gnjidic Danijela , McLachlan Andrew J. , Redston Mitchell R. , Goyal Parag , Mathieson Stephanie , Hilmer Sarah N.
Published: September 2024

The aim of this study was to investigate whether interventions to discontinue or down‐titrate heart failure (HF) pharmacotherapy are feasible and associated with risks in older people. A systematic review and meta‐analysis were conducted according to PRISMA 2020 guidelines. Electronic databases were searched from inception to 8 March 2023. Randomized controlled trials (RCTs) and observational studies included people with HF, aged ≥50 years and who discontinued or down‐titrated HF pharmacotherapy. Outcomes were feasibility (whether discontinuation or down‐titration of HF pharmacotherapy was sustained at follow‐up) and associated risks (mortality, hospitalization, adverse drug withdrawal effects [ADWE]). Random‐effects meta‐analysis was performed when heterogeneity was not substantial (Higgins I2 < 70%). Sub‐analysis by frailty status was conducted. Six RCTs (536 participants) and 27 observational studies (810 499 participants) across six therapeutic classes were included, for 3–260 weeks follow‐up. RCTs were conducted in patients presenting with stable chronic HF. Down‐titrating a renin‐angiotensin system inhibitor (RASI) in patients with chronic kidney disease was 76% more likely than continuation (risk ratio [RR] 1.76, 95% confidence interval [CI] 1.14–2.73), with no difference in mortality (RR 0.64, 95% CI 0.30–1.64). Discontinuation of beta‐blockers were feasible compared to continuation in preserved ejection fraction (RR 1.00, 95% CI 0.68–1.47). Participants were 25% more likely to re‐initiate discontinued diuretics (RR 0.75, 95% CI 0.66–0.86). Digoxin discontinuation was associated with 5.5‐fold risk of hospitalization compared to continuation. Worsening HF was the most common ADWE. One observational study measured frailty but did not report outcomes by frailty status. The appropriateness and associated risks of down‐titrating or discontinuing HF pharmacotherapy in people aged ≥75 years is uncertain. Evaluation of outcomes by frailty status necessitates investigation.
The Anaesthetic Efficacy of Tetracaine and Oxymetazoline Compared With Co‐Phenylcaine in Healthy Individuals
Authors: Hale Samuel J. M. , Lengyel Olivia , Louis Deanna , Kim Raymond , Douglas Richard G.
Published: September 2024

Objectives

Nasal anaesthetic‐decongestant sprays are commonly used prior to nasal instrumentation, such as flexible and rigid nasal endoscopy. Co‐phenylcaine (lignocaine 5%, phenylephrine 0.5%, ENT Technologies Pty Ltd., Melbourne, VIC, Australia) is a combination spray commonly used for this purpose. However, lignocaine is less potent than other local anaesthetics, and both active constituents of Co‐phenylcaine have a bitter taste. It was hypothesised that a combination spray containing tetracaine and oxymetazoline would both offer more potent topical anaesthesia and have a better taste.

Methods

Four anaesthetic‐decongestant nasal sprays were tested in 10 healthy participants (Co‐phenylcaine, and tetracaine 0.5%, 1% and 2% with oxymetazoline 0.05%). Sensory thresholds were sequentially measured at the head of the inferior turbinate using Semmes‐Weinstein monofilaments over the following hour. Participants also rated taste on a Likert‐style scale, and reported whether they experienced subjective numbness of the maxillary teeth.

Results

A median peak sensory threshold of 60 g (the maximum tested) was observed with Co‐phenylcaine, but this threshold was exceeded by all the tetracaine‐based sprays. Tetracaine 2% with oxymetazoline 0.05% had a significantly more rapid onset than Co‐phenylcaine (4 min vs. 6 min, p < 0.05) and a longer duration of action. Eight participants reported dental numbness after administration of tetracaine 2% with oxymetazoline 0.05%, but only one participant after Co‐phenylcaine. Tetracaine‐based sprays were generally perceived to taste less unpleasant than Co‐phenylcaine.

Conclusion

Tetracaine 2% with oxymetazoline 0.05% is a more potent and rapidly acting anaesthetic‐decongestant spray than Co‐phenylcaine, with a longer duration of action.
Kleptoparasitism in seabirds—A potential pathway for global avian influenza virus spread
Authors: Gorta Simon B. Z. , Berryman Alex J. , Kingsford Richard T. , Klaassen Marcel , Clarke Rohan H.
Published: September 2024

Wild birds have experienced unprecedented, near‐global mass mortalities since 2021, driven by outbreaks of high‐pathogenicity avian influenza virus (HPAIV) H5N1 lineage 2.3.4.4b. Managing this panzootic requires identification of transmission pathways. We investigated potential HPAIV transmission via kleptoparasitism (food theft) by examining the distribution, behaviors, and movements of two globally widespread and commonly kleptoparasitic seabird families: Fregatidae (frigatebirds) and Stercorariidae (skuas). These kleptoparasites force other seabirds (targets) to regurgitate food, which the kleptoparasite then ingests, potentially facilitating direct transfer of viral particles from target to kleptoparasite. Scavenging and predation probably contribute further to viral spread. Although frigatebirds use kleptoparasitism on a year‐round basis, skuas more commonly do so outside of the breeding season. Both frequently forage, disperse, or migrate across oceans and hemispheres. Dense aggregations of kleptoparasitic and target seabirds at breeding and/or roosting sites may facilitate the spread of HPAIV. In addition, the migration of these species could also facilitate broadscale geographic spread of HPAIV. Surveillance of kleptoparasites for HPAIVs could aid in early detection and may be important for seabird conservation.
Expanding Water Privatization in Mozambique: Producing Success, Reproducing Neoliberal Water
Authors: Büscher Chris
Published: September 2024

This article examines how and why water privatization has been in place for nearly three decades in Mozambique, expanding from cities to towns despite a lack of conclusive evidence of its merits. Drawing on primary data and secondary sources, the article argues that powerful actors driving water privatization in Mozambique ‘produced success’ out of what has been a messy and problematic process of implementing water privatization in cities in the 2000s. This strategy is cultural, in that actors constructed and mobilized a success narrative to legitimize the retention of water privatization in cities and to widen its spatial scope to towns. Yet, because water privatization in cities was not actually successful — quite the contrary — the retention and expansion of water privatization necessarily relied on a political economic process that buttressed this cultural production of success. That is, proponents expended power and resources in critical decision‐making moments to ensure water privatization and its underlying neoliberal water imaginary would be sustained, at the expense of alternative (post‐neoliberal) modes of water supply. As such, this article concludes that water privatization in Mozambique represents an exemplary case of neoliberal resilience.
The Political Economy of Land Reparations in South Africa
Authors: Pheko Lebohang Liepollo
Published: September 2024

This article examines white settler colonialism and racial capitalism as the primary mechanisms for the historical and ongoing land dispossession of Afrikan people in South Africa. It argues that by addressing land dispossession through land restitution, South Africa could begin to meaningfully address the ongoing impacts of settler colonial displacement of Afrikan people. It contends that land reparations are central not only to restorative physical and spatial justice but also to physical healing. The aim of this contribution is to historicize and herstoricize the South African land question; situate this within the context of racial capitalism and settler colonialism; provide a framing of the racialization and feminization of the land economy; and expound on the particularities of misogynoir and critical feminist theory in theorizing the acute land dispossession of Afrikan women. Situated within the Azanian School of thought, its essential contribution is the suggestion that land restoration is a necessary and meaningful reparative measure for South Africans.
Clinical utility and psychometric properties of tools for early detection of developmental concerns and disability in young children: A scoping review
Authors: Burgess Andrea , Luke Carly , Jackman Michelle , Wotherspoon Jane , Whittingham Koa , Benfer Katherine , Goodman Sarah , Caesar Rebecca , Nesakumar Tiffney , Bora Samudragupta , Honeyman David , Copplin Danielle , Reedman Sarah , Cairney John , Reid Natasha , Sakzewski Leanne , Boyd Roslyn N.
Published: September 2024

Aim

To explore the clinical utility and psychometric properties of standardized tools for the early detection of developmental concerns or disability in young children.

Method

Systematic reviews and clinical practice guidelines containing psychometric data on tools appropriate for use with children from birth to 5 years 11 months were searched for in MEDLINE, CINAHL, Embase, and PsycINFO for the years 2000 to 2023, with no language restrictions.

Results

Eighty‐six systematic reviews and six clinical practice guidelines guided identification of tools. A total of 246 tools were identified across domains of neurological, motor, cognition, communication/language, social–emotional, sensory processing, and/or specific diagnostic conditions of attention‐deficit/hyperactivity disorder, autism spectrum disorder, cerebral palsy, developmental coordination disorder, and fetal alcohol spectrum disorder. After critical evaluation, 67 tools were included in the recommendations. Recommendations for screening and diagnostic assessment tools were based on best available evidence for predictive and discriminative validity, diagnostic accuracy, together with consideration of resource use and accessibility.

Interpretation

This comprehensive scoping review provides recommendations on the best tools for primary care, medical, allied health professionals, nursing, and other health workers to detect and identify developmental concerns or disability in young children using evidence‐based tools.