bluuebunny/crossref_metadata_2025 huggingface dataset:
The child's place in the foster family: Use of conventional names and adoption intentions throughout childhood
Authors: Kaiser Sabine , Mabille Geraldine , Thørnblad Renee , Skoglund Jeanette
Published: August 2023

This longitudinal study examines the child's place in the foster family through the use of conventional names for familial figures (e.g., ‘mum/dad’) and through the foster parents' intention to adopt the child. Data were collected at two time points during childhood and adolescence, among children placed in kinship and non‐kinship foster care in Norway. Children placed at a younger age and children in non‐kinship foster care were more likely to call their foster parents for ‘mum/dad’. Children placed at an older age and children in non‐kinship care were more often presented as ‘foster child’ by their foster parents. Only 25%–34% of foster parents reported having considered adoption. The most common reason for not considering adoption was that they already deemed to be a family. The use of conventional names for familial figures in foster families might not necessarily reflect the child's integration into a foster family as it seems to be related to the age of the child at placement rather than to the duration of placement. Intention to adopt was relatively low, mostly because foster parents considered adoption as not necessary.
Effect of internal connection type and screw channel angle on the screw stability of anterior implant‐supported zirconia crowns
Authors: Çakmak Gülce , Güven Mehmet Esad , Donmez Mustafa Borga , Kahveci Çiğdem , Schimmel Martin , Abou‐Ayash Samir , Yilmaz Burak
Published: August 2023

Objectives

To investigate the effect of implant–abutment connection and screw channel angle on screw stability by comparing a newly introduced and an established connection, before and after cyclic loading.

Materials and Methods

Implants (N = 44) with Torcfit (TF) or Crossfit (CF) connection were divided to be restored with a straight (CFS and TFS) or an angled screw access channel (CFA and TFA) titanium‐base abutment (n = 11). CFA and TFA received screw‐retained crowns, whereas CFS and TFS received hybrid zirconia abutments and cement‐retained crowns. The initial torque value (ITV) of each complex (ITVI) and removal torque value (RTV) after 24 h (RTVI) were measured. Screws were replaced with new ones, ITVs were recorded again (ITVF), and crowns were cyclically loaded (2.4 million cycles, 98 N) to measure RTVs again (RTVF). Percentage torque loss was calculated. Data were analyzed (α = 0.05).

Results

ITVs were similar among groups (p ≥ .089). CF led to higher RTVs (p ≤ .002), while CFS had higher RTVI than CFA (p = .023). After 24 h, CFS had lower percentage torque loss than TF, while CFA had lower percentage torque loss than TFA (p ≤ .011). After cyclic loading, CF led to lower percentage torque (p < .001).

Conclusion

The implant–abutment connection affected the removal torque values. However, no screw loosening occurred during cyclic loading, which indicated a stable connection for all groups. Screw access channel angle did not affect screw stability after cyclic loading.
Personalized brain MRI revealed distinct functional and anatomical disruptions in Creutzfeldt‐Jakob disease and Alzheimer's disease
Authors: Guo Yanjun , Ren Jianxun , Cui Weigang , Dahmani Louisa , Wang Danhong , Fu Xiaoxuan , Li Meiling , Li Shiyi , Zhang Yi , Lin Xue , Zhen Zhen , Xu Yichen , Xie Dan , Guan Hongzhi , Yi Fang , Wang Jiawei , Shi Qi , Liu Hesheng
Published: August 2023

Aims

Creutzfeldt‐Jakob disease (CJD) is a lethal neurodegenerative disorder, which leads to a rapidly progressive dementia. This study aimed to examine the cortical alterations in CJD, changes in these brain characteristics over time, and the differences between CJD and Alzheimer's disease (AD) that show similar clinical manifestations.

Methods

To obtain reliable, subject‐specific functional measures, we acquired 24 min of resting‐state fMRI data from each subject. We applied an individual‐based approach to characterize the functional brain organization of 10 patients with CJD, 8 matched patients with AD, and 8 normal controls. We measured cortical atrophy as well as disruption in resting‐state functional connectivity (rsFC) and then investigated longitudinal brain changes in a subset of CJD patients.

Results

CJD was associated with widespread cortical thinning and weakened rsFC. Compared with AD, CJD showed distinct atrophy patterns and greater disruptions in rsFC. Moreover, the longitudinal data demonstrated that the progressive cortical thinning and disruption in rsFC mainly affected the association rather than the primary cortex in CJD.

Conclusions

CJD shows unique anatomical and functional disruptions in the cerebral cortex, distinct from AD. Rapid progression of CJD affects both the cortical thickness and rsFC in the association cortex.
The use of non‐invasive brain stimulation techniques to reduce body weight and food cravings: A systematic review and meta‐analysis
Authors: Alhindi Yousef Abdullah , Khalifa Najat , Al‐Khyatt Waleed , Idris Iskandar
Published: August 2023

Several studies demonstrated non‐invasive brain stimulation (NIBS) techniques such as transcranial direct current stimulation (tDCS) and transcranial magnetic stimulation (TMS) are safe and simple techniques that can reduce body weight, food cravings, and food consumption in patients with obesity. However, a systematic to evaluate the efficacy of active NIBS versus sham stimulation in reducing body weight and food cravings in patients with obesity is not available. We conducted a systematic review and meta‐analysis of randomized controlled trials (RCTs) using PubMed, Embase, MEDLINE, and Cochrane Central Register of Control Trial between January 1990 and February 2022. Mean differences (MDs) for continuous outcome variables with 95% confidence intervals (95% CIs) were used to examine the effects of NIBS on body weight and body mass index (BMI), whereas the hedges's g test was used to measure the effects on food craving. Nineteen RCTs involving 571 participants were included in this study. Active neurostimulation (TMS and tDCS) was significantly more likely than sham stimulation to reduce body weight (TMS: −3.29 kg, 95% CI [−5.32, −1.26]; I2 = 48%; p < .001; tDCS: −0.82 kg, 95% CI [−1.01, −0.62]; I2 = 0.0%; p = .00) and BMI (TMS: −0.74, 95% CI [−1.17, −0.31]; I2 = 0% p = .00; tDCS: MD = −0.55, 95% CI [−2.32, 1.21]; I2 = 0% p = .54) as well as food cravings (TMS: g = −0.91, 95% CI [−1.68, −0.14]; I2 = 88 p = .00; tDCS: g = −0.32, 95% CI [−0.62, −0.02]; p = .04). Compared with sham stimulation, our findings indicate that active NIBS can significantly help to reduce body weight and food cravings. Hence, these novel techniques may be used as primary or adjunct tools in treating patients with obesity.
The impact of state Medicaid eligibility and benefits policy on neonatal abstinence syndrome hospitalizations
Authors: Soni Aparna , Bullinger Lindsey , Andrews Christina , Abraham Amanda , Simon Kosali
Published: August 2023

Rates of neonatal abstinence syndrome (NAS) resulting from opioid misuse are rising. However, policies to treat opioid misuse during pregnancy are unclear. We apply a difference‐in‐differences design to national pediatric discharge records to examine the effects of state Medicaid policies on NAS. Among states in which Medicaid covered two clinically‐recommended medications for treating opioid misuse (buprenorphine, methadone), the Affordable Care Act's Medicaid expansion reduced Medicaid‐covered NAS hospitalizations. Medicaid expansion did not affect NAS hospitalizations in other expansion states. These findings imply a nuanced relationship between Medicaid policy and NAS that should be considered in addressing opioid misuse among pregnant women.
Effect of blood flow restriction with low‐load exercise on muscle damage in healthy adults: A systematic review of randomized controlled trials
Authors: Yang Jinchao , Ma Fenghao , Wang Qian , Cui Yuanfen , Zheng Jun
Published: August 2023

Introduction

Blood flow restriction (BFR) is a relatively new rehabilitative technique and low‐load exercise combined with BFR (LL‐BFR) can increase muscle strength and muscle mass. However, it is currently unknown whether LL‐BFR causes muscle damage. Therefore, the aim of this study is to investigate the effects of LL‐BFR on muscle damage and provide recommendations for sports training and physical exercise.

Materials and Methods

A systematic search was conducted using PubMed, Web of Science, Medline, Cochrane Library and Physiotherapy Evidence Database (PEDro) with a cut‐off of March 2022. Randomized controlled trials (RCTs) and English‐language studies were selected. Two independent assessors used the PEDro scoring scale to evaluate the methodological quality and risk of bias of the included studies.

Results

Of the 2935 articles identified, 15 RCTs were included in this systematic review. Two studies demonstrated that LL‐BFR could induce muscle damage in healthy individuals; however, two studies presented contrasting findings in the short term. Four studies found that no muscle damage occurred after LL‐BFR in the long term. The remaining seven articles showed that it was unclear if LL‐BFR could cause muscle damage, regardless of whether these participants were trained or not.

Conclusion

Although LL‐BFR may induce muscle damage within 1 week, it will help gain long‐term muscle strength and muscle hypertrophy. However, the lack of sufficient evidence on the effect of LL‐BFR on muscle damage in clinical practice warrants additional RCTs with large sample sizes in the future.
Repeat pediatric heart transplantation: A united network for organ sharing database analysis
Authors: Rowe Georgina , Gill George , Zubair M. Mujeeb , Chen Qiudong , Thomas Jason , Timbalia Shrishiv A. , Osho Asishana A. , Emerson Dominic , Kim Richard , Bowdish Michael E. , Chikwe Joanna , Turek Joseph W.
Published: August 2023

Background

A history of congenital heart disease and previous transplantation are each independently associated with worse survival following pediatric heart transplantation. This study aimed to evaluate the characteristics and outcomes of children undergoing repeat heart transplantation in the United States based on the underlying diagnosis.

Methods

The United Network for Organ Sharing database was used to identify 8111 patients aged <18 years undergoing isolated heart transplantation from 2000 to 2021, including 435 (5.4%) repeat transplants. Restricted cubic spline analysis assessed the non‐linear relationship between inter‐transplant interval and the primary outcome of all‐cause mortality or re‐transplantation. Multivariable Cox regression assessed the impact of re‐transplantation on the primary outcome. Median follow‐up was 5.0 (interquartile range 1.9–9.9) years.

Results

Repeat transplant patients were older (median age 12 vs. 4 years; p < .001), and less likely to be in UNOS status 1A (66.0%, n = 287 vs. 81.0% n = 6217; p < .001) than primary transplant patients. Freedom from the primary outcome was 51.4% (95% confidence interval [CI] 45.5–57.2) among repeat transplants and 70.5% (95% CI 69.2–71.8) among primary transplants at 10 years (p < .001). Among repeat transplant patients, the relative hazard of the primary outcome became non‐significant when the inter‐transplant interval >3.6 years. Congenital heart disease was an independent predictor of mortality among primary (HR 1.8, 95% CI 1.6–1.9) but not repeat transplant (HR 1.1, 95% CI .8–1.6) patients.

Conclusions

Long‐term outcomes remain poor for patients undergoing repeat heart transplantation, particularly those with an inter‐transplant interval <3.6 years. Underlying diagnosis does not impact outcomes after repeat transplantation, after accounting for other risk factors.
Factors associated with a positive phosphatidylethanol test during liver transplantation evaluation
Authors: Segal Antú , Pearl Elise , Fatabhoy Megha , Zohr Samantha J. , Bryce Kelly , Gonzalez Humberto C. , Miller‐Matero Lisa R.
Published: August 2023

Background

Early identification of alcohol use is crucial for informing recommendations of appropriate follow‐up treatment pre‐liver transplant and optimizing post‐liver transplant outcomes. The purpose of the study was to investigate whether there are psychosocial factors associated with a positive PEth test.

Methods

All patients who underwent a routine pre‐surgical psychological evaluation for liver transplant listing (all etiologies, including acute liver failure, dual organ, and re‐transplantation) at a single health care system in 2020 were included in a retrospective chart review. Data extraction included results from PEth testing and information from the psychological evaluation (i.e., demographic, psychiatric symptoms, and cognitive functioning).

Results

There were 158 patients (73.8%) who had a PEth test, of whom 21.5% had a positive result (n = 34). Younger age was associated with a positive PEth (p < .001). ALD status and type of ALD (hepatitis vs. cirrhosis) were also associated with a positive PEth test. Other demographic characteristics and psychiatric symptoms were not associated with a positive PEth result (p > .05).

Conclusion

Younger age was the only significant demographic variable associated with a positive PEth test. Given the difficulty of predicting who may be using alcohol, it may be useful to use PEth testing for all patients during the pre‐liver transplant evaluation and while patients are listed for liver transplant. Early identification of alcohol use through routine PEth testing will help identify patients who are using alcohol and need further treatment for alcohol use to optimize health and post‐transplant outcomes.
Automatische Körperteil‐Identifikation in dermatologischen klinischen Bildern durch maschinelles Lernen
Authors: Sitaru Sebastian , Oueslati Talel , Schielein Maximilian C , Weis Johanna , Kaczmarczyk Robert , Rueckert Daniel , Biedermann Tilo , Zink Alexander
Published: August 2023

Hintergrund

Dermatologische Erkrankungen sind in allen Bevölkerungsgruppen weit verbreitet. Das betroffene Körperteil ist für ihre Diagnose, Therapie und Forschung von Bedeutung. Die automatische Identifizierung der abgebildeten Körperteile in dermatologischen Krankheitsbildern könnte daher die klinische Versorgung verbessern, indem sie zusätzliche Informationen für klinische Entscheidungsalgorithmen liefert, schwer zu behandelnde Bereiche aufdeckt und die Forschung durch die Identifizierung neuer Krankheitsmuster unterstützt.

Patienten und Methodik

In dieser Studie wurden 6219 annotierte dermatologische Bilder aus unserer klinischen Datenbank verwendet, womit ein neuronales Netz trainiert und validiert wurde. Als Anwendung wurden mit diesem System qualitative Heatmaps für die Verteilung von Körperteilen bei häufigen dermatologischen Erkrankungen erstellt.

Ergebnisse

Der Algorithmus erreichte eine mittlere balancierte Genauigkeit (Accuracy) von 89% (74,8%–96,5%). Die Fotos von nichtmelanozytärem Hautkrebs betrafen vor allem das Gesicht und den Oberkörper, während die größte Häufigkeit der Ekzem‐ und Psoriasis‐Bildverteilung den Oberkörper, die Beine und die Hände umfassten.

Schlussfolgerungen

Die Genauigkeit dieses Systems ist vergleichbar mit den besten bisher veröffentlichten Algorithmen für Bildklassifizierungsaufgaben, was darauf hindeutet, dass dieser Algorithmus die Diagnose, Therapie und Forschung bei dermatologischen Erkrankungen verbessern könnte.
The role of candidate transport proteins in β‐cell long‐chain fatty acid uptake: Where are we now?
Authors: Clavelo‐Farrow Christina , Thomas Patricia
Published: August 2023

Type 2 diabetes (T2D) in humans is typically preceded by elevated levels of circulatory long‐chain free fatty acids (LC‐FFA). These excess LC‐FFA are widely thought to be taken up by pancreatic β‐cells, contributing to their dysfunction and death during the development of T2D; a process that has been termed lipotoxicity. Depending on their degree of saturation and carbon chain length, LC‐FFA can exert different effects on pancreatic β‐cells viability and function in vitro. Long‐chain saturated fatty acids (LC‐SFA) are thought to be toxic, whereas monounsaturated fatty acids are not and may even offer protection against the toxic effects of LC‐SFAs. However, the mechanism of LC‐FFA uptake into pancreatic β‐cells is poorly understood, partly because it has been an understudied area of research. Determining how LC‐FFA are taken up into β‐cells is crucial for later formulation of therapies to prevent potential cellular overload of LC‐FFA, thereby slowing the onset of T2D. In this work, we detail more than 40 years of literature investigating the role of membrane‐associated transport proteins in LC‐FFA uptake. By focussing on what is known in other cell types, we highlight where we can extrapolate our current understanding of protein‐mediated transport to β‐cells and uncover where further understanding is required.
Risk prediction of bladder cancer among person with diabetes: A derivation and validation study
Authors: Wong Martin C. S. , Huang Junjie , Wang Harry H. X. , Yau Sarah T. Y. , Teoh Jeremy Y. C. , Chiu Peter K. F. , Ng Chi‐Fai , Leung Eman Yee‐Man
Published: August 2023

Aims

This study aimed to devise and validate a clinical scoring system for risk prediction of bladder cancer to guide urgent cystoscopy evaluation among people with diabetes.

Methods

People with diabetes who received cystoscopy from a large database in the Chinese population (2009–2018). We recruited a derivation cohort based on random sampling from 70% of all individuals. We used the adjusted odds ratios (aORs) for independent risk factors to devise a risk score, ranging from 0 to 5: 0–2 ‘average risk’ (AR) and 3–5 ‘high risk’ (HR).

Results

A total of 5905 people with diabetes, among whom 123 people with BCa were included. The prevalence rate in the derivation (n  = 4174) and validation cohorts (n  = 1731) was 2.2% and 1.8% respectively. Using the scoring system constructed, 79.6% and 20.4% in the derivation cohort were classified as AR and HR respectively. The prevalence rate in the AR and HR groups was 1.57% and 4.58% respectively. The risk score consisted of age (18–70: 0; >70: 2), male sex (1), ever/ex‐smoker (1) and duration of diabetes (≥10 years: 1). Individuals in the HR group had 3.26‐fold (95% CI = 1.65–6.44, p  = 0.025) increased prevalence of bladder than the AR group. The concordance (c‐) statistics was 0.72, implying a good discriminatory capability of the risk score to stratify high‐risk individuals who should consider earlier cystoscopy.

Conclusions

The risk prediction algorithm may inform urgency of cystoscopy appointments, thus allowing a more efficient use of resources and contributing to early detection of BCa among people planned to be referred.
Improving data quality from routine clinical appointments—Development of a minimum dataset for traumatic dental injuries in children and adolescents
Authors: Kenny Kate P. , Pavitt Sue , Foy Robbie , Day Peter F.
Published: August 2023

Background/Aims

It is currently difficult to evaluate the success or not of treatment for dental injuries due to poor recording of diagnostic and treatment codes in clinical dentistry. A minimum dataset comprises a standardised minimum set of outcomes along with a specified outcome measurement instrument, to allow aggregated use of data from routine clinical care appointments. This study aimed to determine which outcomes should be included in a minimum dataset for traumatic dental injuries (TDI).

Materials and Methods

This is a three‐stage sequential, mixed‐methods study, using evidence‐based best practice for dataset development. Normalisation process theory informed the development of the study protocols. In Stage 1, semi‐structured interviews with patients and their parent or guardian were undertaken to identify outcomes of importance to patients. In Stage 2, an online Delphi survey was undertaken to identify outcomes of importance to clinicians. In Stage 3, a National Consensus Meeting was undertaken involving patient representatives, clinicians and other stakeholders, to agree which outcomes should be included in the minimum dataset.

Results

Stage 1: Eleven participants were recruited, five children and six parents. Two key themes emerged from the analysis—communication and aesthetics. In Stage 2, 34 dentists were recruited, and 32 completed both rounds of the survey (97% retention). Most outcomes were deemed by participants to be of ‘critical importance’, with three outcomes deemed ‘important’ and none to be ‘of limited importance’. In Stage 3, 15 participants took part in the consensus meeting. Participants agreed that the dataset should comprise a list of clinician‐important outcomes (pulp healing, periodontal healing, discolouration, tooth loss) and a list of patient‐important outcomes (communication, aesthetics, pain, quality of life).

Conclusion

A Minimum Dataset for TDI has been developed using a robust and transparent methodology.
Is online‐only learning as effective as blended learning? A longitudinal study comparing undergraduate students' performance in oral radiology
Authors: Mücke Katharina , Busch Caroline , Becker Jürgen , Drescher Dieter , Becker Kathrin
Published: August 2023

Introduction

Blended learning seems to be an effective teaching concept in oral radiology. During the COVID‐19 pandemic, blended learning shifted towards online‐only learning. The aim of the present study was to compare the effectiveness of pandemic online‐only and pre‐pandemic blended learning in three consecutive oral radiology courses (C1, C2 and C3) and to examine whether additional video‐based e‐learning modules (VBLMs) had a positive impact on undergraduate students' performance during pandemic semesters.

Materials and Methods

Data from 205 undergraduate dental students participating either in a blended learning or an online‐only learning concept were analysed. Pre‐pandemic blended learning comprised face‐to‐face seminars and access to an oral radiology platform (ORP). Pandemic online‐only learning comprised online seminars, access to the ORP and additional VBLMs (two VBLMs for C1, four VBLMs for C2 and six VBLMs for C3). Through standardised e‐exams at the beginning and end of each semester, performance in final exams and knowledge gain were compared between the two groups.

Results

No significant differences in scores in final exams (p = .11) and knowledge gain (p = .18) were found when comparing the pre‐pandemic and pandemic groups. On course level, however, students receiving a lower number of VBLMs performed significantly worse in final exams (C1: p < .01, C2: p = .02) and showed inferior knowledge gain (C2: p < .01) during the pandemic.

Conclusions

Within the limitations of the study, the present investigation confirmed that pandemic online‐only learning involving VBLMs might be as effective as pre‐pandemic blended learning.
Frequency and phenotypic spectrum of spinocerebellar ataxia 27B and other genetic ataxias in a Spanish cohort of late‐onset cerebellar ataxia
Authors: Iruzubieta Pablo , Pellerin David , Bergareche Alberto , Albajar Inés , Mondragón Elisabet , Vinagre Ana , Fernández‐Torrón Roberto , Moreno Fermín , Equiza Jon , Campo‐Caballero David , Poza Juan José , Ruibal Marta , Formica Alessandro , Dicaire Marie‐Josée , Danzi Matt C. , Zuchner Stephan , Croitoru Ioana , Ruiz Montserrat , Schlüter Agatha , Casasnovas Carlos , Pujol Aurora , Brais Bernard , Houlden Henry , López de Munain Adolfo , Ruiz‐Martínez Javier
Published: August 2023

Background and purpose

Dominantly inherited GAA repeat expansions in the fibroblast growth factor 14 (FGF14) gene have recently been shown to cause spinocerebellar ataxia 27B (SCA27B). We aimed to study the frequency and phenotype of SCA27B in a cohort of patients with unsolved late‐onset cerebellar ataxia (LOCA). We also assessed the frequency of SCA27B relative to other genetically defined LOCAs.

Methods

We recruited a consecutive series of 107 patients with LOCA, of whom 64 remained genetically undiagnosed. We screened these 64 patients for the FGF14 GAA repeat expansion. We next analysed the frequency of SCA27B relative to other genetically defined forms of LOCA in the cohort of 107 patients.

Results

Eighteen of 64 patients (28%) carried an FGF14 (GAA)≥250 expansion. The median (range) age at onset was 62.5 (39–72) years. The most common clinical features included gait ataxia (100%) and mild cerebellar dysarthria (67%). In addition, episodic symptoms and downbeat nystagmus were present in 39% (7/18) and 37% (6/16) of patients, respectively. SCA27B was the most common cause of LOCA in our cohort (17%, 18/107). Among patients with genetically defined LOCA, SCA27B was the main cause of pure ataxia, RFC1‐related disease of ataxia with neuropathy, and SPG7 of ataxia with spasticity.

Conclusion

We showed that SCA27B is the most common cause of LOCA in our cohort. Our results support the use of FGF14 GAA repeat expansion screening as a first‐tier genetic test in patients with LOCA.
Real‐world challenges in the diagnosis of primary progressive multiple sclerosis
Authors: Blok Katelijn M. , Smolders Joost , van Rosmalen Joost , Martins Jarnalo Carine O. , Wokke Beatrijs , de Beukelaar Janet
Published: August 2023

Background and purpose

Despite the 2017 revisions to the McDonald criteria, diagnosing primary progressive multiple sclerosis (PPMS) remains challenging. To improve clinical practice, the aim was to identify frequent diagnostic challenges in a real‐world setting and associate these with the performance of the 2010 and 2017 PPMS diagnostic McDonald criteria.

Methods

Clinical, radiological and laboratory characteristics at the time of diagnosis were retrospectively recorded from designated PPMS patient files. Possible complicating factors were recorded such as confounding comorbidity, signs indicative of alternative diagnoses, possible earlier relapses and/or incomplete diagnostic work‐up (no cerebrospinal fluid examination and/or magnetic resonance imaging brain and spinal cord). The percentages of patients fulfilling the 2010 and 2017 McDonald criteria were calculated after censoring patients with these complicating factors.

Results

A total of 322 designated PPMS patients were included. Of all participants, it was found that n = 28/322 had confounding comorbidity and/or signs indicative of alternative diagnoses, n = 103/294 had possible initial relapsing and/or uncertainly progressive phenotypes and n = 73/191 received an incomplete diagnostic work‐up. When applying the 2010 and 2017 diagnostic PPMS McDonald criteria on n = 118 cases with a full diagnostic work‐up and a primary progressive disease course without a better alternative explanation, these were met by 104/118 (88.1%) and 98/118 remaining patients (83.1%), respectively (p = 0.15).

Conclusion

Accurate interpretation of the initial clinical course, consideration of alternative diagnoses and a full diagnostic work‐up are the cornerstones of a PPMS diagnosis. When these conditions are met, the 2010 and 2017 McDonald criteria for PPMS perform similarly, emphasizing the importance of their appropriate application in clinical practice.
The impact of specific program components on romantic relationship satisfaction
Authors: Kanter Jeremy B. , Lannin Daniel G. , McCaig Jessica , Sprecher Susan , Rauer Amy J. , Yazedjian Ani
Published: August 2023

Objective

The goal was to determine if time spent in specific Healthy Marriage Initiative program components (relationship education courses, supplemental activities, and family support services) was associated with future relationship satisfaction and to examine if effects differed depending on the degree of economic disadvantage.

Background

Healthy Marriage Initiatives (HMI) generally have small, short‐term positive effects on relationship outcomes. It remains unclear, however, which programming components are responsible for those effects and for whom programming is most effective.

Method

Using two waves of data from over 2,000 lower‐income couples in the Supporting Healthy Marriages study, we conducted path models and a multigroup model to address our research aims.

Results

Time spent in family support services was the only component positively associated with future satisfaction, controlling for the influence of other program components, initial relationship satisfaction, and expectations of the program's effectiveness. Economic disadvantage did not moderate any of these associations.

Conclusion

Results suggest that many HMI programs may potentially be beneficial to relationship functioning because of the provision of supplementary support services that partially aim to alleviate external stressors and provide personalized assistance to families.

Implications

Practitioners should not only consider how relationship education programming may influence intimate bonds, but also how complementary programs may also factor into program efficacy.
Traits for transport: Alien wetland plants gain an advantage during endozoochorous seed dispersal by waterfowl
Authors: Lovas‐Kiss Ádám , Navarro‐Ramos María J. , Vincze Orsolya , Löki Viktor , Urgyán Renáta , Pallér‐Kapusi Felícia , van Leeuwen Casper H. A. , Green Andy J. , Lukács Balázs András
Published: August 2023

The expansion of alien plant species is of global concern, yet our understanding of their dispersal mechanisms is limited. Here we address the potential of alien plant seeds to disperse via ingestion, transport and egestion in waterfowl (endozoochory). Based on their general rapid expansions, we expected alien plant species to have several advantages for endozoochory compared to native plant species. We hypothesised that seeds of alien species would have higher passage rate, longer gut retention times, higher germinability after gut passage and shorter time‐to‐germination after egestion by waterfowl.

In order to test our hypotheses, we compared the endozoochorous dispersal ability of six pairs of congeneric alien and native wetland plant species in a feeding experiment with mallards (Anas platyrhynchos). We focused on differences in seed survival, gut retention time, germinability and time‐to‐germination. In the analyses we corrected for seed shape and volume as these seed traits are known to have important effects.

With gut passage, alien species had higher passage rates and germinated slower, whereas native species had shorter retention times and greater germinability. Controlling for seed traits did not alter these conclusions, but seed traits affected all aspects of the endozoochory process. This suggests that alien species may have particular traits correlated with a higher endozoochory potential. Among control seeds, alien seeds germinated faster and their germinability was higher than natives. Seed traits explained differences in germinability and time‐to‐germination in control seeds.

Seeds of alien plant species have traits that correlate with successful endozoochory. This may provide alien species with a competitive advantage over native plant species by ensuring higher endozoochory rates in new environments, potentially enabling their rapid expansions. Our study underlines the important role of seed traits in the endozoochory potential of alien and native plant species, notably through their influence on retention time and germination.
Litter and soil biodiversity jointly drive ecosystem functions
Authors: Liu Shengen , Plaza César , Ochoa‐Hueso Raúl , Trivedi Chanda , Wang Juntao , Trivedi Pankaj , Zhou Guiyao , Piñeiro Juan , Martins Catarina S. C. , Singh Brajesh K. , Delgado‐Baquerizo Manuel
Published: August 2023

The decomposition of litter and the supply of nutrients into and from the soil are two fundamental processes through which the above‐ and belowground world interact. Microbial biodiversity, and especially that of decomposers, plays a key role in these processes by helping litter decomposition. Yet the relative contribution of litter diversity and soil biodiversity in supporting multiple ecosystem services remains virtually unknown. Here we conducted a mesocosm experiment where leaf litter and soil biodiversity were manipulated to investigate their influence on plant productivity, litter decomposition, soil respiration, and enzymatic activity in the littersphere. We showed that both leaf litter diversity and soil microbial diversity (richness and community composition) independently contributed to explain multiple ecosystem functions. Fungal saprobes community composition was especially important for supporting ecosystem multifunctionality (EMF), plant production, litter decomposition, and activity of soil phosphatase when compared with bacteria or other fungal functional groups and litter species richness. Moreover, leaf litter diversity and soil microbial diversity exerted previously undescribed and significantly interactive effects on EMF and multiple individual ecosystem functions, such as litter decomposition and plant production. Together, our work provides experimental evidence supporting the independent and interactive roles of litter and belowground soil biodiversity to maintain ecosystem functions and multiple services.
Patient research priority setting partnership in human T‐cell lymphotropic virus type I
Authors: Adonis Adine , Russell Anne‐Marie , Taylor Graham P. , Preston Melanie , Shields Alpheus , Strachan Sue , Young Sky , Diallo Haissata , Ashford Stephen , Cassidy Elizabeth
Published: August 2023

Introduction

Human T‐cell lymphotropic virus type 1 (HTLV‐1) is a chronic infection affecting 5–10 million people worldwide. Ten percent develop HTLV‐1‐associated diseases, and 3%–5% develop HTLV‐1‐associated myelopathy (HAM)/tropical spastic paraparesis. Low health‐related quality of life (HRQoL) is a significant concern for those with HTLV‐1, and little is known about how it impacts daily life or what patients need from healthcare services. To address this, we report on patient involvement workshops aimed at identifying research priorities for HTLV‐1 health service provision.

Methods

Participants recruited through HTLV‐1 clinics in England attended six 90‐min virtual workshops over 10 months, and two 60‐min consolidation workshops. Content developed iteratively from topic focussed group discussions. All workshops were video‐recorded with consent, transcribed verbatim and thematically analysed. Using consensus voting rounds, participants individually ranked their top six and then collectively their top three research priorities from the themes inferred from the analysis. A final feedback session explored the experiences of participating in the workshops.

Findings

Twenty‐seven people with HTLV‐1 engaged with the workshops with up to 22 participants attending each meeting. The majority were diagnosed with HAM (n = 22). The top three research priorities were identified as understanding disease progression, psychosocial wellbeing, and information and knowledge. Participants valued being asked to set research priorities that directly addressed their needs and enjoyed the workshops. They stressed the importance of patient advocates for promoting research that positively impacts everyday life.

Conclusion

This is the first of this type of research engagement with people with HTLV‐1 in the United Kingdom. Participants identified several avenues of investigation that could lead to improvements in healthcare services and HRQoL. Participants believed the workshops signified the start of a conversation to progress person‐centred and meaningful research in HTLV‐1.

Patient or Public Contribution

People living with HTLV‐1 were involved in the iterative design, conduct, analysis, writing and dissemination of this project through the patient involvement workshops. As a result of this engagement, a patient led advisory group has been set up to assist with the dissemination of the findings.
A future agenda for research on climate change and human mobility
Authors: Oakes Robert , Van der Geest Kees , Schraven Benjamin , Adaawen Stephen , Ayeb‐Karlsson Sonja , de Sherbinin Alexander , Etzold Benjamin , Groth Juliane , Hermanns Kathleen , Lakeman Silvana , Nawrotzki Raphael , Rademacher‐Schulz Christina , Romankiewic Clemens , Serraglio Diogo , Sterly Harald , Thalheimer Lisa , Wiederkehr Charlotte , Williams David
Published: August 2023

In the past 15 years, research activities focusing on the interlinkages between climate change and human mobility have intensified. At the same time, an increasing number of actors and processes have sought to address human mobility in the context of climate change from a policy perspective. Hitherto, research has been limited in terms of geographical preferences as well as conceptual and methodological focus areas. This paper argues that to address the evolving policy space, future research on climate change in the context of human mobility needs to become more differentiated, integrated and generalized. This includes concerted efforts to better integrate researchers from the global South, improved cross‐linkages between different datasets, approaches and disciplines, more longitudinal and comparative studies and development of innovative qualitative and quantitative methods.
Custodians of contemporary pluralism? Acas' evolving role in addressing conflict during a time of economic and regulatory flux
Authors: Hann Deborah , Latreille Paul , Nash David , Saundry Richard
Published: August 2023

This paper charts the development of Acas over the last two decades as it responds to the changing context of British employment relations. While dispute resolution services have evolved to focus on individual disputes, Acas has remained true to its pluralist roots through its training and advisory services that continue to promote ‘good employment relations’.
Influenza‐associated respiratory illness among five cohorts of pregnant women and their young infants (0–6 months), Bangladesh, 2013–2017
Authors: Akhtar Zubair , Ghosh Probir , Bhuiyan Mejbah , Sturm‐Ramirez Katharine , Rahman Mohammed , Howlader Md. , Dawood Fatimah , Chowdhury Fahmida , Iuliano Danielle
Published: August 2023

Background

Pregnant women with their infants are considered at higher risk for influenza‐associated complications, and the World Health Organization (WHO) recommends influenza vaccination during pregnancy to protect them, including their infants (0–6 months). There are limited data on the influenza burden among pregnant women and their infants (0–6 months), and there are no routine influenza vaccinations in Bangladesh.

Methods

Five annual cohorts (2013–2017) of pregnant women were enrolled from the eight sub‐districts of Bangladesh before the influenza season (May–September); they were contacted weekly to identify new onset of influenza‐like illness (ILI) (subjective or measured fever and cough) and acute respiratory illness (ARI) (at least two of these symptoms: cough, rhinorrhea, or difficulty in breathing) among their infants from birth to 6 months of age. We collected nasopharyngeal swabs from ILI and ARI cases, tested by real‐time reverse transcription polymerase chain reaction (rRT‐PCR) for influenza virus (including types and subtypes) and estimated influenza incidence (95% CI)/10000 pregnant women‐months or infant‐months, respectively.

Results

We enrolled 9020 pregnant women, followed for 26,709 pregnancy‐months, and detected 1241 ILI episodes. We also followed 8963 infants for 51,518 infant‐months and identified 5116 ARI episodes. Influenza positivity was 23% for ILI and 3% for ARI cases. The overall incidence (2013–2017) of influenza among pregnant women was 158.5/10000 pregnant women‐months (95% CI: 141.4–177.6) and that among infants was 21.9/10000 infant‐months (95% CI: 18.2–26.5).

Conclusions

Although the data was collected more than 5 years ago, as the only baseline data, our findings illustrate evidence of influenza burden among pregnant women and infants (0–6 months), which may support preventive policy decisions in Bangladesh.
Identifying infection in chronic wounds in a community setting: A systematic review of diagnostic test accuracy studies
Authors: Edwards George , Carter Adam , Wallis Chloe , Hayward Gail , Moore Abigail
Published: August 2023

Aim

To determine the diagnostic accuracy of different methods currently available to identify infection in chronic wounds applicable to adult patients in a community setting.

Design

Systematic review of diagnostic test accuracy studies.

Review Methods

Two authors independently completed screening, data extraction and quality and bias assessments (QUADAS2). Eligible studies compared a method (index test) for detecting infection (diagnosis of interest) with microscopy and culture of either deep tissue biopsy or wound swab (reference test) in adult patients with wounds of >4 weeks duration (participants). The results were synthesized narratively.

Data Sources

We systematically searched CINAHL, Embase and Medline from 2011 to April 2022.

Results

Four studies were included, all recruiting from secondary care wound clinics. Two studies assessed the diagnostic accuracy of Moleculight i:X, a bacterial fluorescence imaging device against deep tissue biopsy culture. One study assessed the diagnostic accuracy of the elevation of various enzymes detected in wound fluid against wound swab microscopy of culture. One study assessed the diagnostic accuracy of bacterial protease activity against wound swab microscopy and culture. Sensitivities of these methods ranged from 50 to 75% and specificities from 47 to 100%.

Conclusion

Only a small number of studies were included in this systematic review due to our strict inclusion criteria. We have not identified any methods for diagnosing infection in chronic wounds with either a sufficient quality of evidence to recommend their use in community settings at present. Further research is needed to develop and evaluate appropriate diagnostics for this purpose.

Impact

This study highlights the paucity of research into wound diagnostics in a community setting and should prompt further research in this area. Accurate diagnostic tests have the potential to improve community‐based wound care by optimizing antibiotic use and potentially improving healing time.

Reporting Method

PRISMA‐DTA checklist.

Patient or Public Contribution

The PPI group for the NIHR Community Healthcare MIC were supportive of this topic of work.
How is complexity measured and detected among community dwelling older people aged 65 years and over? A scoping review
Authors: Boak Jennifer , Rasekaba Tshepo , Baxter Pamela , Blackberry Irene
Published: August 2023

Aim

To identify and explore tools that measured and detected complexity of care among community dwelling people aged 65 years and older.

Data Sources

Databases were searched for articles published up to 23 September 2022 including CINAHL, EMBASE and MEDLINE, Cochrane database for trials and grey literature.

Methods

A scoping review was conducted and reported in accordance with the PRISMA guidelines. Eligible articles included those with participants aged over 65 years, living in the community and studies that included care complexity detection or assessment and how this related to care delivered. Covidence was used to screen titles, abstracts and full‐text articles.

Results

Eighteen full texts were reviewed; four studies were included in the final review. All selected studies included people aged over 65 years living in the community. A high level of reliability for the items included in the interventions was found. The selected studies included tools for assessing older person's needs with nurses involved in the assessment.

Conclusion

The review identified four tools for measuring complexity in community dwelling older people. Two tools have the capacity to objectively measure complexity due to the holistic nature of items included and appear easy to use to support clinical judgement decisions.

Impact

The review places a spotlight on the concept of complexity and highlights the lack of definition of care complexity. The synthesized result highlights the need to explore detection of care complexity of older people further and consider ways of supporting clinical judgement and decision making of community nurses. The use of a validated tool may enhance clinical judgement regarding care complexity and may lead to a more consistent and timely approach to care.

Patient or Public Contribution

During the development phase, the study was presented to a consumer group from the researcher's workplace.

Prospero Registration

CRD42022299336.
Wire ThRoUgh Snare Twice (Wire TRUST) technique: A novel method to grasp a lead with inaccessible ends as a supportive femoral approach for transvenous lead extraction
Authors: Kasai Yuhei , Haraguchi Takuya , Morita Junji , Kitai Takayuki , Okada Takuya , Tamura Takashi , Munakata Yumetsugu , Tsujimoto Masanaga , Kasai Jungo , Fujita Tsutomu
Published: August 2023

Introduction

Transvenous lead extraction (TLE) is a crucial procedure for managing cardiac implantable electronic devices. The use of a combined superior and femoral approach has been found to enhance the success rate of TLE. This report introduces a novel technique, named “Wire ThRoUgh Snare Twice” (Wire TRUST), for effectively grasping a lead without a free end during TLE.

Method

The Wire TRUST technique was applied in a case involving a 49‐year‐old male patient requiring TLE due to electrical artifact on the right ventricular (RV) lead, replacement of the RV lead, and pacemaker generator exchange. The Wire TRUST technique involved the insertion of a 4‐Fr pigtail catheter and a 6‐Fr snare catheter through the 14‐Fr sheath inserted from the right common femoral vein. The 4‐Fr pigtail catheter was hooked to the RV lead under multidirectional fluoroscopic guidance in the right atrium. The 0.014‐in. guidewire was advanced through the pigtail catheter, crossing the RV lead until reaching the inferior vena cava. Subsequently, the distal end of the 0.014‐in. guidewire was captured using a snare and pulled, facilitating externalization of the guidewire. After externalization, both ends of the 0.014‐in. guidewire were passed through the snare outside the body and reinserted into the 14‐Fr sheath. By simultaneously advancing and closing the snare while applying tension to the 0.014‐in. guidewire, a secure grip on the lead without free ends was achieved.

Results

The Wire TRUST technique enabled successful lead extraction and replacement without any complications. The technique facilitated the co‐axial alignment of the powered sheath with the RV lead, ensuring safe and efficient extraction.

Conclusion

The Wire TRUST technique presents a novel and effective approach for grasping leads with inaccessible ends during TLE.