bluuebunny/crossref_metadata_2025 huggingface dataset:
Hummingbird diversity in a fragmented tropical landscape in the Chocó biogeographic zone
Authors: Huh Kyu Min , Ellis Mike , Castillo Fernando , Carrasco Luis , Rivero de Aguilar Juan , Bonaccorso Elisa , Browne Luke , Karubian Jordan
Published: January 2023

Forest loss and fragmentation drive widespread declines in biodiversity. However, hummingbirds seem to exhibit relative resilience to disturbance, characterized by increasing abundance alongside declining species richness and evenness. Yet, how widespread this pattern may be, and the mechanisms by which it may occur, remain unclear. To fill in this knowledge gap, we investigated habitat‐ and site‐level patterns of diversity, and community composition of hummingbirds between continuous forest (transects n = 16 in ~3500 ha) and more disturbed surrounding fragments (n = 39, 2.5–48.0 ha) in the Chocó rain forest of northwestern Ecuador. Next, we assessed within‐patch and patch‐matrix characteristics associated with hummingbird diversity and composition. We found higher hummingbird species richness in forest fragments relative to the continuous forest, driven by increased captures of rare species in fragments. Community composition also differed between continuous forest and fragments, with depressed evenness in fragments. Increased canopy openness and density of medium‐sized trees correlated with hummingbird diversity in forest fragments, although this relationship became nonsignificant after applying false discovery rate (p < .01). Higher species richness in fragments and higher evenness in the continuous forest highlight the complex trade‐offs involved in the conservation of this ecologically important group of birds in changing Neotropical landscapes.

Abstract in Spanish is available with online material.
How do you frame ill‐defined problems? A study on creative logics in action
Authors: Pham Cristina Tu Anh , Magistretti Stefano , Dell'Era Claudio
Published: January 2023

Problem framing is pivotal to fostering knowledge and innovation, especially in the modern environment where problems are often ill defined. However, the managerial literature has thus far mainly addressed problem framing from an outcome perspective, overlooking the processes that lead to the outcomes. A common view is that the complexity, ambiguity and uncertainty of ill‐defined problems call for a creative process. Therefore, through ethnographically observing six design thinking workshops, this study adopts a qualitative approach to explore the problem framing creative process. Specifically, we unpack three thinking modalities involved in the creative process (i.e. creative logics) of problem framing: analogical reasoning, associative thinking and abductive reasoning. We suggest that individuals enact these through seven creative operations. In addition, we link these creative operations to two types of problem framing outcomes: referenced frames and crafted frames. From a practitioner perspective, this study casts new light on the importance of problem framing for creativity and innovation, highlighting the ways in which individuals operationalize the creative logics to frame ill‐defined problems as original problems worth solving.
Arginine‐stimulated copeptin in children and adolescents
Authors: Binder Gerhard , Weber Karin , Peter Andreas , Schweizer Roland
Published: January 2023

Objective

Copeptin is secreted in isomolar amounts along with arginine vasopressin peptide (AVP) from the neurohypophysis. Its stability makes it a perfect candidate for the endocrine approach in the diagnosis of AVP deficiency (AVPD; cranial diabetes insipidus; CDI). However, pediatric reference values are lacking.

Design and Patients

This is a monocentric retrospective analysis of donated residual serum samples from 72 children and adolescents who underwent arginine or growth hormone‐releasing hormone‐arginine stimulation to test GH secretory capacity from 2018 to 2022.

Measurements

Copeptin was measured in baseline, 30‐, and 60‐min samples by BRAHMS Copeptin proAVP Kryptor immunofluorescence assay.

Results

Of the 72 patients, 4 suffered from complete AVPD (CDI). The baseline level of copeptin in the 68 non‐AVPD (non‐CDI) patients was highly variable (range: 1.3–44.4 pmol/L). The increase after arginine was moderate (30 min range: 1.6–40.4 pmol/L). The median baseline and peak copeptin levels were 5.6 and 8.0 pmol/L, respectively. The 2.5th percentile of the baseline and peak values of copeptin were 2.1 and 3.3 pmol/L, respectively. The increase and peak value of copeptin were inversely related to age (R = −.405; p = .011, and R = −.335; p = .0072, respectively) but not to gender, body mass index (standard deviation score) or GH secretion. In the four patients with AVPD (CDI), baseline or stimulated copeptin was below the 2.5th percentile of non‐AVPD (non‐CDI) patients.

Conclusions

Stimulated copeptin is a promising parameter for the differential diagnosis of polyuria‐polydipsia syndrome. However, the low copeptin increase after arginine and the high limit of quantification of the assay are problematic for use in paediatrics.
PDViz: A Visual Analytics Approach for State Policy Data
Authors: Han Dongyun , Nayeem Abdullah‐Al‐Raihan , Windett Jason , Cho Isaac
Published: January 2023

Sub‐national governments across the United States implement a variety of policies to address large societal problems and needs. Many policies are picked up or adopted in other states. This process is called policy diffusion and allows researchers to analyse and compare the social, political, and contextual characteristics that lead to adopting certain policies, as well as the efficacy of these policies once adopted. In this paper, we introduce PDViz, a visual analytics approach that allows social scientists to dynamically analyse the policy diffusion history and underlying patterns. It is designed for analysing and answering a list of research questions and tasks posed by social scientists in prior work. To evaluate our system, we present two usage scenarios and conduct interviews with domain experts in political science. The interviews highlight that PDViz provides the result of policy diffusion patterns that align with their domain knowledge as well as the potential to be a learning tool for students to understand the concept of policy diffusion.
Prognostic prediction of lung adenocarcinoma by integrative analysis of RHOH expression and methylation
Authors: Kuang Muyu , Zhou Zhenhua , Lu Zhongyuan , Shen Weina , Ge Haiyan , Tao Xiaoting , Zhao Yue , Zhuge Lingdun , Sun Yihua , Ji Dongmei , Zhang Huibiao
Published: January 2023

Background and objective

The development of epigenetics holds great promise for diagnosis and treatment of lung adenocarcinoma (LUAD). The purpose of this work was to analyze the correlation between Ras Homolog Gene Family Member H (RHOH) expression and methylation in patients with LUAD and its association with survival.

Methods

Data related to gene expression, DNA methylation, and clinical features of LUAD from The Cancer Genome Atlas (TCGA) database were analyzed. A total of 50 patients were included in verification group. The methylation level of RHOH in verification group was detected by bisulfite amplicon sequencing.

Results

The RHOH methylation level in TCGA cohort was significantly and negatively correlated with its expression level (Cor = −0.5, p = 2.687e−33). Patients with hypermethylation and low expression of RHOH had significantly worse prognosis than patients with hypomethylation and low expression of RHOH (TCGA: p = 0.004; validation cohort: p = 0.006, HR: 4.740, 95% CI: 1.567–14.340).

Conclusion

Our research revealed that RHOH may prove to be a new potential prognostic predictor for LUAD patients.
Perinatal inflammation exposure and developmental outcomes 7 years after neonatal arterial ischaemic stroke
Authors: Giraud Antoine , Dinomais Mickaël , Garel Pauline , Chevin Mathilde , Thébault Guillaume , Renaud Cyrille , Presles Émilie , Raia‐Barjat Tiphaine , Sébire Guillaume , Chabrier Stéphane
Published: January 2023

Aim

To test the association between perinatal inflammation exposure and Full‐Scale IQ (FSIQ) score 7 years after neonatal arterial ischaemic stroke (NAIS).

Method

We conducted a cross‐sectional ancillary study nested in a multicentric longitudinal French cohort of infants born at term with NAIS between November 2003 and October 2006. Seventy‐three children were included (45 males, 28 females). The a priori defined primary outcome measure was the FSIQ score assessed with the Wechsler Intelligence Scale for Children, Fourth Edition at 7 years of age.

Results

Seventeen (23%) of the included children were exposed to perinatal inflammation. Exposure to perinatal inflammation was independently associated with an increase of FSIQ score (coefficient 13.4, 95% confidence interval 1.3–25.4; p = 0.03). Children exposed to perinatal inflammation had a higher median cerebral volume, a lower median lesion volume, and less extensive lesion distributions compared to non‐exposed children.

Interpretation

We propose the existence of two NAIS categories: arteritis‐associated NAIS in children exposed to perinatal inflammation and embolism‐associated NAIS in children non‐exposed to perinatal inflammation. Identifying these two NAIS categories would open the possibility for specific curative strategies: anti‐inflammatory strategy in arteritis‐associated NAIS and recanalization strategy in embolism‐associated NAIS.
Is soil an organic carbon sink or source upon erosion, transport and deposition?
Authors: Liu Lin , Zhang Qinghui , Liu Qianjin , Li Zijun
Published: January 2023

Soil may be a carbon source or sink under the effect of sediment and soil organic carbon (SOC) erosion, transport and deposition. Partial SOC processes to determine whether soil subjected to water erosion is a carbon sink or source have not been clarified but are essential for increasing and predicting SOC storage. In this review, the associations between SOC mineralization, stability and stock at erosion sites, in transported sediments and at deposition sites are clarified. An overview is given for possible determination standards that define soil carbon sinks and sources. Methods for enhancing SOC sequestration and suggestions for improving SOC prediction are also presented. Particle transport is an important intermediate process that determines the material base for SOC stability and sequestration in each erosion and deposition element. When subject to water erosion, a high probability of SOC physical stabilization and a thick soil layer are essential for soil to function as a SOC sink. Sediment transport weakens SOC physical protection in eroded areas but can promote aggregation factors at deposition sites in some cases while increasing the depth of SOC in the soil. In this circumstance, a good soil environment for plant growth facilitates the occurrence of carbon sinks. A concept for critical erosion intensity is proposed to understand SOC sink determination; the concept is presented as the volume of soil erosion per square kilometre (m3 km−2) for which the maximum reduction in vegetation cover or plant biomass still permits plants to provide enough organic matter to compensate for erosion‐induced SOC loss. If erosion intensity is higher than critical erosion intensity at the erosion site, soil degradation is obvious, and soil is presented as an OC source, and vice versa. Finally, the SOC burial method for increasing the soil carbon storage amounts in regions with thick soil layers is presented to explore the SOC sequestration potential in deep soil. The factors considered for SOC prediction should vary with research scale. We hope our review will have direct implications for the modelling of SOC dynamics under water erosion on both slopes and at large scales.

Highlights

Changes in soil texture and soil thickness greatly affect the amount of SOC storage at erosion and deposition sites.

Selective transport of soil materials or chemical elements promotes soil aggregation.

Possible standards that define soil carbon sinks and sources and suggestions for improving SOC prediction are presented.

SOC burial may be a good method for increasing C storage amounts in regions with thick layers of fine soil.
A unified hypothesis ofSUDEP: Seizure‐induced respiratory depression induced by adenosine may lead toSUDEPbut can be prevented by autoresuscitation and other restorative respiratory response mechanisms mediated by the action of serotonin on the periaqueductal gray
Authors: Faingold Carl L. , Feng Hua‐Jun
Published: January 2023

Sudden unexpected death in epilepsy (SUDEP) is a major cause of death in people with epilepsy (PWE). Postictal apnea leading to cardiac arrest is the most common sequence of terminal events in witnessed cases of SUDEP, and postconvulsive central apnea has been proposed as a potential biomarker of SUDEP susceptibility. Research in SUDEP animal models has led to the serotonin and adenosine hypotheses of SUDEP. These neurotransmitters influence respiration, seizures, and lethality in animal models of SUDEP, and are implicated in human SUDEP cases. Adenosine released during seizures is proposed to be an important seizure termination mechanism. However, adenosine also depresses respiration, and this effect is mediated, in part, by inhibition of neuronal activity in subcortical structures that modulate respiration, including the periaqueductal gray (PAG). Drugs that enhance the action of adenosine increase postictal death in SUDEP models. Serotonin is also released during seizures, but enhances respiration in response to an elevated carbon dioxide level, which often occurs postictally. This effect of serotonin can potentially compensate, in part, for the adenosine‐mediated respiratory depression, acting to facilitate autoresuscitation and other restorative respiratory response mechanisms. A number of drugs that enhance the action of serotonin prevent postictal death in several SUDEP models and reduce postictal respiratory depression in PWE. This effect of serotonergic drugs may be mediated, in part, by actions on brainstem sites that modulate respiration, including the PAG. Enhanced activity in the PAG increases respiration in response to hypoxia and other exigent conditions and can be activated by electrical stimulation. Thus, we propose the unifying hypothesis that seizure‐induced adenosine release leads to respiratory depression. This can be reversed by serotonergic action on autoresuscitation and other restorative respiratory responses acting, in part, via the PAG. Therefore, we hypothesize that serotonergic or direct activation of this brainstem site may be a useful approach for SUDEP prevention.
Climate‐based identification of suitable cropping areas for giant reed and reed canary grass on marginal land in Central and Southern Europe under climate change
Authors: Ferdini Sofia , von Cossel Moritz , Wulfmeyer Volker , Warrach‐Sagi Kirsten
Published: January 2023

Giant reed (GR) and reed canary grass (RCG) have emerged as promising perennial industrial crops for providing sustainable bioenergy from marginal land. However, there is great uncertainty among farmers and researchers about where these crops can be grown in the future due to climate change, which complicates a timely transition to a bioeconomy. Therefore, this study quantifies marginal land and suitable cropping areas for GR and RCG in Europe, as well as their overlap. To derive these areas, the present (1991–2020) and future (2071–2100, RCP8.5) growing degree days, growing season length, annual precipitation, and aridity index were analyzed using the E‐OBS observational dataset and EURO‐CORDEX regional climate simulations. The study concludes that while marginal land will decrease by ~18%, GR and RCG will profit from the changing European climate, increasing by ~24% and ~13%, respectively. Looking at regions of overlap between marginal land and the selected crops, a decrease of ~87% and an increase of ~462% is projected for RCG and GR, respectively. This is due to marginal land shifting southward, benefitting the warm‐season grass GR, while RCG prefers cooler climates.
Co‐creating system‐wide improvement for people with traumatic brain injury across one integrated care system in the United Kingdom to initiate a transformation journey through co‐production
Authors: Manley Kim , Saunders Karen , Wilkinson David , Faruqui Rafey , Sakel Mohamed
Published: January 2023

Background and Objective

There is a need for better integration of services across communities and sectors for people living with traumatic brain injury (TBI) to meet their complex needs. Building on insights gained from earlier pilot work, here we report the outcomes of a participatory workshop that sought to better understand the challenges, barriers and opportunities that currently exist within the care pathway for survivors of TBI.

Methods

A diverse range of stakeholders from the acute and rehabilitation care pathway and the health and social care system were invited to participate in a 3‐h workshop. The participants worked in four mixed subgroups using practice development methodology, which promotes person‐centred, inclusive and participatory action.

Results

Thematic analysis identified shared purposes and values that were used to produce a detailed implementation and impact framework for application at both the level of the care interface and the overarching integrated care system. A variety of enablers were identified that related to collective values and behaviours, case management, team leadership and integrated team working, workforce capability, evidence‐based practice and resourcing. The clinical, economic, cultural and social outcomes associated with these enablers were also identified, and included patient safety, independence and well‐being, reduced waiting times, re‐admission rates, staff retention and professional development.

Conclusion

The co‐produced recommendations made within the implementation and impact framework described here provide a means by which the culture and delivery of health and social care services can be better tailored to meet the needs of people living with TBI. We believe that the recommendations will help shape the formation of new services as well as the development of existing ones.

Patient or Public Contribution

Patient and public involvement have been established over a 10‐year history of relationship building through a joint forum and events involving three charities representing people with TBI, carers, family members, clinicians, service users, researchers and commissioners, culminating in a politically supported event that identified concerns about the needs of people following TBI. These relationships formed the foundation for the interactive workshop, the focus of this publication.
TRADING AMBIGUITY: A TALE OF TWO HETEROGENEITIES
Authors: Mukerji Sujoy , Ozsoylev Han N. , Tallon Jean‐Marc
Published: January 2023

We consider markets with heterogeneously ambiguous assets and heterogeneously ambiguity‐averse investors whose preferences are a parsimonious extension of the mean–variance framework. We study portfolio choice and trade upon arrival of public information, and show systematic departures from the predictions of standard theory, that occur in the direction of empirical regularities. In particular, our theory speaks to several phenomena in a unified fashion: the asset allocation puzzle, the observation that earnings announcements are followed by significant trading volume with small price change, and that increases in uncertainty are positively associated with increased trading activity and portfolio rebalancing toward safer assets.
Social media influencers and consumer engagement: A review and future research agenda
Authors: Pradhan Bandinee , Kishore Kaushal , Gokhale Nilesh
Published: January 2023

The rise of social media influencers (SMIs) in the recent decade garnered wide interest from academicians and marketers. Academicians try to understand the effect of influencers on consumer behaviour, while marketers use influencers as part of their strategy to achieve marketing objectives. Although, plenty of practical and conceptual research is available in this area, literature reviews in the domain of SMIs and consumer engagement are scarce as it is still developing, and most of the studies have focused on these two concepts separately. In this study, the authors attempted to combine and understand how social media influencers affect consumers engagement. This systematic review of the literature offers a comprehensive view of previous research on social media influencers and consumer engagement. The study reviewed articles published in the Australian Business Deans Council (ABDC), Scopus, and Web of Science indexed journals till 5 June 2021. To understand consumers' engagement with SMIs, authors identified and theorized the antecedents, decision and outcome of such engagement. It also discusses the influencer‐follower parasocial relationship on different social media platforms. The study proposes an integrated conceptual framework that can be further used to test and validate the impact of social media influencer's marketing efforts on consumer engagement. This framework also may serve as a foundation for marketers to develop effective influencer strategies for brand promotions. The review concludes the discussion by highlighting theories, methodology, and context of studies conducted by past researchers.
How tablets/applications enhance social connections and social support in people with dementia: A qualitative systematic review
Authors: Zhu Xiangning , He Meng , Dong Yueyang , Zhang Shuang , Fang Shuyan , Wang Wenxia , Zhang Mengting , Sun Jiao
Published: January 2023

The 2020 Lancet issue identified social isolation as one of 12 modifiable risk factors for dementia and revealed that enhanced social connections and social support can effectively reduce the incidence of social isolation. During the COVID‐19 pandemic, technology attracted an increasing amount of attention, and it is necessary to synthesize ideas from existing evidence. First, we explored how people with dementia experienced changes in social connection and social support due to tablet/app use. Second, we explored the attitudes of people with dementia towards tablets and mobile applications. Third, we explored the feasibility of using tablets and mobile applications to enhance social connection and social support among people with dementia. We systematically searched the PubMed, Web of Science, Cochrane Library, Embase, CINAHL, CNKI, WanFang, and VIP databases. Two reviewers independently screened the titles and abstracts of studies, extracted the data and performed critical appraisals of each included study. The data synthesis was conducted using thematic analysis. A total of nine studies were included. Eight studies used mobile applications via tablets, and one study collected textual data from Twitter for analysis. Four themes were synthesized: (1) change from the perspective of caregivers; (2) growth of nonsingle aspects; (3) emotional feeling of belonging; and (4) feasibility of using digital technology. Tablet‐ and mobile application‐based interventions can enhance both online and offline social connections and provide multiple types of social support among people with dementia. People with dementia have positive attitudes towards tablets and mobile applications. Overall, it is feasible for people with dementia to use technology.
Temperature‐stable Na0.5Bi0.5TiO3‐based ceramics with favorable low‐temperature dielectric and energy storage property
Authors: Su Yingchun , Zhou Xuefan , Xue Guoliang , Luo Hang , Zhang Dou
Published: January 2023

In this work, (1 − x)(0.94Na0.5Bi0.5TiO3–0.06BaTiO3)–xKTaO3 (x = 0–0.30) ceramics are developed for dielectric capacitor applications. The introduction of KTaO3 from x = 0 to 0.30 increases the tolerance factor t from 0.984 to 1.005 and causes the decrease of ferroelectric rhombohedral phase in the ceramics. Besides, a gradual structural change toward a higher symmetry can be detected, accompanied by the obvious domain refinement. In the aspect of electrical property, the strengthened dielectric relaxation leads to the greatly enhanced thermal stability of dielectric response. The decline in Ts from 98 to −96°C causes a significant widening of the low‐temperature region with temperature‐stable dielectric constant εr and low dielectric loss tan δ. The x = 0.30 ceramic shows a high εr (25°C) of 1094 with the temperature coefficient of capacitance ≤±15% over −70 to 200°C, which exceeds the X9R standard. Meanwhile, tan δ is less than 0.02 in a wide temperature range of −35 to 300°C. In addition, the ultrafine grain size of 290 nm, large bandgap of 3.22 eV, and high resistance of the x = 0.30 ceramic contribute to its electrical breakdown strength. A linear‐like P–E loop with the large discharged energy density WD ∼ 3.50 J/cm3 and high energy efficiency η ∼ 90.1% is obtained under 28 kV/mm at room temperature. The thermal stability of the energy storage performance is also satisfactory with the variation of WD less than 15% over −40 to 200°C, and the η is higher than 85%.
Fearing the Trojan horse: Motives attributed to the outgroup and rejection of outgroup help
Authors: Zagefka Hanna , dela Paz Erwine , Macapagal Ma. Elizabeth J. , Ghazal Saima , Bilgen Emine , Cheso Diana
Published: January 2023

Decisions to give and receive help are often influenced by group memberships, social identities, and intergroup relations. Two studies were conducted to test how perceived political relations between countries are related to willingness to accept offers of intergroup help. Respondents in two low‐income countries, the Philippines (N = 289) and Pakistan (N = 275), indicated their willingness to accept (or not) Covid‐19 vaccine donations from two higher‐status countries (China and the United States) during the Covid pandemic. Results showed that the perceived motivation of the outgroup nation for providing help was associated with rejection or acceptance of help, mediated by emotional reactions to the help. A perception that outgroup nations donate vaccines to demonstrate and assert their superiority and power, that they donate vaccines to keep the outgroup dependent on the ingroup, and a perception that they donate vaccines out of self‐interest, were all associated with rejection of vaccine donations. A perception that donations by the outgroup are motivated by genuine concern for the ingroup was associated with acceptance of help. Findings confirm that political intergroup relations are related to attitudes about whether the ingroup nation should accept intergroup help or not. Theoretical and applied implications are discussed.
Prevalence and management of hyperkalemia in chronic kidney disease and heart failure patients in the Gulf Cooperation Council (GCC)
Authors: AlSahow Ali , AbdulShafy Mohammad , Al‐Ghamdi Saeed , AlJoburi Harith , AlMogbel Osama , Al‐Rowaie Fadel , Attallah Nizar , Bader Feras , Hussein Hisham , Hassan Mohamed , Taha Khaldoun , Weir Matthew R. , Zannad Faiez
Published: January 2023

Hyperkalemia is a frequent complication in patients with chronic kidney disease (CKD) or heart failure (HF) and associated with neuromuscular manifestations, changes in the electrocardiogram, and increased risk of mortality. While data on the prevalence and management of hyperkalemia in the gulf region are scarce, risk factors such as preference for potassium‐rich foods (e.g., dates and dried fruits/vegetables), periods of intense fasting (e.g., Ramadan), and diabetes (an ancestor of CKD and HF) are common. Therefore, a panel of nephrologists and cardiologists from countries of the Gulf Cooperation Council (GCC) convened to collate and review available data on the prevalence, regional drivers, and current practice in the management of hyperkalemia in the region. Eventually, this review provides consensus recommendations on a balanced utilization of dietary and pharmacological options including new potassium binders for achieving and sustainably maintaining desirable serum potassium levels in countries of the GCC region. Alignment with regional habits and practice was a key aspect to facilitate the uptake of the recommendations into physicians’ practice and patients’ lives.
Neutrophil‐lymphocyte ratio in Guillain‐Barré syndrome: A prognostic biomarker of severe disease and mechanical ventilation in Bangladesh
Authors: Jahan Israt , Ahmed Rasel , Ahmed Jigishu , Khurshid Sarah , Biswas Pritha Promita , Upama Ismat Jahan , Hamid Yameen , Papri Nowshin , Islam Zhahirul
Published: January 2023

In addition to cellular and humoral immunity, inflammatory markers play an important role in the pathogenesis of Guillain‐Barré syndrome (GBS) and are used to predict prognosis in many autoimmune diseases. The aim of this study was to identify whether the neutrophil‐lymphocyte ratio (NLR), platelet‐lymphocyte ratio, and monocyte‐lymphocyte ratio in the early stages of GBS have prognostic value for severe disease, mechanical ventilation (MV) and poor long‐term outcome. A prospective cohort study of 140 adult patients with GBS and 140 healthy controls (HC) was performed in Bangladesh during 2019–2022. Clinicodemographic characteristics of the patients were recorded, and hematological parameters were measured using an automated hematology analyzer. Median patient age was 35 (44–23) years; 71% were male; 88% were severely affected (GBS Disability Score> 3); 32% required MV. Patients had higher NLR than HC (P< .0001). Among patients, elevated NLR was associated with severe GBS and MV (P= .001 and <.0001, respectively) and moderately positively correlated with poor outcomes at 4 weeks (r = 0.423). Multiple logistic regression revealed NLR was an independent risk factor for severe GBS (OR = 5.2, 95% CI = 1.6–17.4) and MV (OR = 1.5 1.1–2.1). No significant association was observed between elevated NLR and the long‐term outcome of GBS. Receiver operating characteristic curves revealed NLR cut‐off values of ≥ 2.432 and ≥ 4.4423 predicted severe disease (sensitivity = 71%, specificity = 75%, AUC = 0.750, 95% CI = 0.651–0.849, P = .001) and MV (sensitivity = 65.9%, specificity = 81.7%, AUC = 0.804, 95% CI=0.724–0.884; P< .001). The NLR in the early stage of GBS may represent an independent prognostic factor of severe GBS and the requirement for MV.
Axolemmal nanoruptures arising from paranodal membrane injury induce secondary axon degeneration in murine Guillain‐Barré syndrome
Authors: Cunningham Madeleine E. , McGonigal Rhona , Barrie Jennifer A. , Campbell Clare I. , Yao Denggao , Willison Hugh J.
Published: January 2023

The major determinant of poor outcome in Guillain‐Barré syndrome (GBS) is axonal degeneration. Pathways leading to primary axonal injury in the motor axonal variant are well established, whereas mechanisms of secondary axonal injury in acute inflammatory demyelinating polyneuropathy (AIDP) are unknown. We recently developed an autoantibody‐and complement‐mediated model of murine AIDP, in which prominent injury to glial membranes at the node of Ranvier results in severe disruption to paranodal components. Acutely, axonal integrity was maintained, but over time secondary axonal degeneration occurred. Herein, we describe the differential mechanisms underlying acute glial membrane injury and secondary axonal injury in this model. Ex vivo nerve‐muscle explants were injured for either acute or extended periods with an autoantibody‐and complement‐mediated injury to glial paranodal membranes. This model was used to test several possible mechanisms of axon degeneration including calpain activation, and to monitor live axonal calcium signalling. Glial calpains induced acute disruption of paranodal membrane proteins in the absence of discernible axonal injury. Over time, we observed progressive axonal degeneration which was markedly attenuated by axon‐specific calpain inhibition. Injury was unaffected by all other tested methods of protection. Trans‐axolemmal diffusion of fluorescent proteins  and live calcium imaging studies indirectly demonstrated the presence of nanoruptures in the axon membrane. This study outlines one mechanism by which secondary axonal degeneration arises in the AIDP variant of GBS where acute paranodal loop injury is prominent. The data also support the development of calpain inhibitors to attenuate both primary and secondary axonal degeneration in GBS.
Healthy financial habits in young adults: An exploratory study of the relationship between subjective financial literacy, engagement with finances, and financial decision‐making
Authors: Sinnewe Elisabeth , Nicholson Gavin
Published: January 2023

This paper provides insights into young adults' financial habits and decision‐making considerations as they enter the workforce. We use 28 semi‐structured interviews with Australian university graduates to explore how their motivation to engage with personal finances and their subjective financial literacy, i.e., self‐reported, support healthy financial habits. Our findings show that a young adult's social context and exposure to financial hardship rather than their financial confidence determine the health of their financial habits. We observed research participants in a romantic partnership as more focused on their future. This future focus motivates them to engage more with their finances and manifests as explicit goal setting, formal budgeting, or adherence to strict bucket systems. These insights might be useful for policymakers and educators: social context matters when designing financial health interventions, while financial education programs predominately should aim at demystifying complex long‐term financial decision‐making such as investments and retirement.
A meta‐synthesis on the older adults' perspective of advance care planning
Authors: Tang Jia Min Shvonn , Cher Bi Xia Bernadynn Bessandra , Lim Su‐Fee , Siah Chiew Jiat Rosalind
Published: January 2023

Aim

To synthesise the evidence regarding older adults' perception of advance care planning in preparation for end‐of‐life care.

Background

Advance care planning involves continuous communication of end‐of‐life care goals involving an individual's medical treatment preferences. However, its uptake among older adults remains low.

Design

The meta‐synthesis was conducted according to the Enhancing Transparency in Reporting the Synthesis of Qualitative research (ENTREQ) guidelines and thematic synthesis was employed to synthesise the qualitative findings in an inductive manner.

Data Source

A search was completed on six electronic databases (PubMed, EMBASE, CINAHL, PsycINFO, Web of Science, Scopus), for publications from 1 January 2000 to 4 December 2021.

Review Method

The certainty of the evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation and Confidence (GRADE‐CERQual) in the Evidence from Reviews of Qualitative research. Two independent reviewers conducted this process, and disagreements were resolved through discussions.

Results

Fourteen studies were analysed. Four major themes and eleven subthemes emerged from the thematic synthesis: (1) psychosocial preparedness, (2) medical preparedness, (3) psychological barriers towards advance care planning and (4) extrinsic barriers towards advance care planning.

Discussion

These themes consolidated older adults' views of advance care planning and how engagement in this planning affected their end‐of‐life preparedness.

Conclusion

This review suggested psychological and extrinsic factors were barriers to the uptake of advance care planning and provided directions for future research to achieve a holistic understanding of the impact of advance care planning on end‐of‐life preparedness.

Relevance to Clinical Practice

Healthcare professionals could maintain close communication with older adults and families periodically to evaluate their readiness to discuss advance care planning to improve their preparedness. Healthcare professionals could also provide psychological support during the discussion of clinical decision‐making to enhance readiness and confidence among older adults and their families.
Family members' experiences of COVID‐19 visiting restrictions in the intensive care unit—A qualitative study
Authors: Forsberg Tomas , Isaksson Maria , Schelin Caroline , Lyngå Patrik , Schandl Anna
Published: January 2023

Objective

To describe how family members of critically ill patients experienced the COVID‐19 visiting restrictions in Sweden.

Background

In Sweden, the response to COVID‐19 was less invasive than in many other countries. However, some visiting restrictions were introduced for intensive care units, with local variations. Although there is a growing body of literature regarding healthcare professionals' and family caregivers' perspectives on visiting restriction policies, there may be inter‐country differences, which remain to be elucidated.

Design

This study has a qualitative descriptive design. Focus group interviews with 14 family members of patients treated for severe COVID‐19 infection were conducted. The interviews took place via digital meetings during the months after the patients' hospital discharge. Qualitative content analysis was used to interpret the interview transcripts. Reporting of the study followed the COREQ checklist.

Results

Two categories—dealing with uncertainty and being involved at a distance—described family members' experiences of coping with visiting restrictions during the COVID‐19 pandemic. These restrictions were found to reduce family members' ability to cope with the situation. Communication via telephone or video calls to maintain contact was appreciated but could not replace the importance of personal contact.

Conclusions

Family members perceived that the visiting restriction routines in place during the COVID‐19 pandemic negatively influenced their ability to cope with the situation and to achieve realistic expectations of the patients' needs when they returned home.

Relevance to Clinical Practice

This study suggests that, during the COVID‐19 pandemic, the visiting restrictions were experienced negatively by family members and specific family‐centred care guidelines need to be developed for use during crises, including the possibility of regular family visits to the ICU.

Patient and Public Contribution

None in the conceptualisation or design of the study.
Two lateral parametria in radical hysterectomy: History and outcome
Authors: Yabuki Yoshihiko
Published: January 2023

Aim

Some anatomic concepts for 20th century radical hysterectomy (RH) did not conform to progress in surgical technique. The purpose of this article was to put forward a new practical anatomy and application to surgical procedures.

Methods

Following a historical review the author reexamined his surgical procedures from 1980 to 2005 on 131 patients with cervical cancer. One hundred and eight of these patients had undergone RH and 23 super RH plus neoadjuvant chemotherapy, 7 had RH combined with a total mesorectal excision because of infiltration into the lateral rectal ligament due to rectal cancer. Also reviewed were data on surgical procedures and anatomy following a series of mock RH on 26 donated female cadavers.

Results

It was found that the cardinal ligament and transverse cervical ligament must be distinguished. The vesicohypogastric fascia, transverse cervical ligament, and lateral rectal ligament formed a continuum with their relationship to the organs being perpendicular. The surgical technique for an RH is total excision of the transverse cervical ligament, whereas the one for a semi‐RH is partial or total excision of the deep uterine vein. The paracolpium is the caudal extension of the cardinal ligament, not the medial extension of the superior fascia of pelvic diaphragm.

Conclusion

New practical anatomy and surgical technique were established through recognition of morphology of the living body being transformed by surgical maneuvers.
T1/T2 ratio from 3T MRI improves multiple sclerosis cortical lesion contrast
Authors: Manning Abigail R. , Beck Erin S. , Schindler Matthew K. , Nair Govind , Clark Kelly A. , Parvathaneni Prasanna , Reich Daniel S. , Shinohara Russell T. , Solomon Andrew J.
Published: January 2023

Background and Purpose

Cortical demyelinated lesions are prevalent in multiple sclerosis (MS), associated with disability, and have recently been incorporated into MS diagnostic criteria. Presently, advanced and ultrahigh‐field MRIs—not routinely available in clinical practice—are the most sensitive methods for detection of cortical lesions. Approaches utilizing MRI sequences obtainable in routine clinical practice remain an unmet need. We plan to assess the sensitivity of the ratio of T1‐weighted and T2‐weighted (T1/T2) signal intensity for focal cortical lesions in comparison to other high‐field imaging methods.

Methods

3‐Tesla and 7‐Tesla MRI collected from 10 adults with MS were included in the study. T1/T2 images were calculated by dividing 3T T1‐weighted (T1w) images by 3T T2‐weighted (T2w) fluid‐attenuated inversion recovery images for each participant. A total of 614 cortical lesions were identified using 7T T2*w and T1w images and corresponding voxels were assessed on registered 3T images. Signal intensities were compared across 3T imaging sequences, including T1/T2, T1w, T2w, and inversion recovery susceptibility‐weighted imaging with enhanced T2 weighting (IR‐SWIET) images.

Results

T1/T2 images demonstrated a larger contrast between median lesional and nonlesional cortical signal intensity (median ratio = 1.29, range: 1.19‐1.38) when compared to T1w (1.01, 0.97‐1.10, p < .002), T2w (1.17, 1.07‐1.26, p < .002), and IR‐SWIET (1.21, 1.01‐1.29, p < .03).

Conclusion

T1/T2 images are sensitive to cortical lesions. Approaches incorporating T1/T2 could improve the accessibility of cortical lesion detection in research settings and clinical practice.
Rhabdomyosarcoma of the oral cavity in children aged 0–2 years: A scoping review
Authors: Nunes Mariana Mota , da Costa Adriana Aparecida Silva , Tavares Thalita Soares , Aguiar Maria Cássia Ferreira , Martins Carolina Castro , Caldeira Patrícia Carlos
Published: January 2023

Background

The aim of this study was to collect, synthesize, and analyze the clinic‐demographic data of rhabdomyosarcoma affecting the oral cavity of young children.

Methods

The clinical question was “What are the clinical characteristics of oral rhabdomyosarcoma in children aged zero to two years?” Two independent reviewers selected the studies, extracted data, and assessed the methodological quality through the Joanna Briggs Institute Checklist. Descriptive statistics were performed in SPSS. (protocol: osf.io/b9hvy).

Results

Thirty case reports with 41 patients were included (22 males; mean age at diagnosis: 15 months). All studies had some methodological limitations, mainly due to the lack of clarity for a final judgment. More than 70% of the cases affected the tongue or lips. Tumors had a fast growth (mean 2.5 months), usually with red coloration, and variable shape and consistency. Embryonal (63.41%) and alveolar (29.27%) were the most common histological subtypes. Treatment was quite variable but usually included surgery. Most patients (53.66%) were alive without disease at follow‐up.

Conclusion

Oral rhabdomyosarcoma is rare in children aged 0–2 years without a marked gender predilection. The tumor presents as a fast and infiltrative growth leading to local and/or systemic symptoms, and a favorable prognosis for most patients.
Racial and Religious Convergences and Divergences among Christian Students’ Approaches to Color‐Blindness, Color‐Cognizance, and Race in Christian Organizations
Authors: Chan Esther , Jeong Isaiah , Jeong Elijah
Published: January 2023

Drawing on survey data of Christian students (N = 4261) enrolled at 11 colleges that are part of the Council for Christian Colleges and Universities, we examine color‐blindness, different types of color‐cognizance, and views on race in Christian organizations. We find significant differences between students of color and White students in color‐blindness and color‐cognizance but find racial convergence in the importance of racial reconciliation. Net of controls, greater evangelical orthodoxy is associated with color‐cognizant views that perceive prejudicial treatment against White people, undercut the experiences of people of color, and is associated with more positive views of Christian organizations’ roles in race relationships. Concurrently, upper year students differ significantly from first years in their racial attitudes and views on race in Christian organizations, suggesting that Christian education may shape racial views positively. Our findings have implications for theorizing how evangelical Christianity and evangelical colleges maintain and challenge color‐blindness and White supremacy.
Contribution of voriconazole N‐oxide plasma concentration measurements to voriconazole therapeutic drug monitoring in patients with invasive fungal infection
Authors: Boglione‐Kerrien Christelle , Morcet Jeff , Scailteux Lucie‐Marie , Bénézit François , Camus Christophe , Mear Jean‐Baptiste , Gangneux Jean‐Pierre , Bellissant Eric , Tron Camille , Verdier Marie‐Clémence , Lemaitre Florian
Published: January 2023

Background

Voriconazole (VRC), a widely used triazole antifungal, exhibits significant inter‐ and intra‐individual pharmacokinetic variability. The main metabolite voriconazole N‐oxide (NOX) can provide information on the patient's drug metabolism capacity.

Objectives

Our objectives were to implement routine measurement of NOX concentrations and to describe the metabolic ratio (MR), and the contribution of the MR to VRC therapeutic drug monitoring (TDM) by proposing a suggested dosage‐adjustment algorithm.

Patients and Methods

Sixty‐one patients treated with VRC were prospectively included in the study, and VRC and NOX levels were assayed by LC–MS/MS. A mixed logistic model on repeated measures was implemented to analyse risk factors for the patient's concentration to be outside the therapeutic range.

Results

Based on 225 measurements, the median and interquartile range were 2.4 μg/ml (1.2; 4.2), 2.1 μg/ml (1.5; 3.0) and 1.0 (0.6; 1.9) for VRC, NOX and the MR, respectively. VRC Cmin <2 μg/ml were associated with a higher MR during the previous visit. MR values >1.15 and <0.48 were determined to be the best predictors for having a VRC Cmin lower than 2 μg/ml and above 5.5 μg/ml, respectively, at the next visit.

Conclusions

Measurement of NOX resulted useful for TDM of patients treated with VRC. The MR using NOX informed interpretation and clinical decision‐making and is very interesting for complex patients. VRC phenotyping based on the MR is now performed routinely in our institution. A dosing algorithm has been suggested from these results.
A major genetic locus in neighbours controls changes of gene expression and susceptibility in intraspecific rice mixtures
Authors: Pélissier Rémi , Ducasse Aurélie , Ballini Elsa , Frouin Julien , Violle Cyrille , Morel Jean‐Benoit
Published: January 2023

Reports indicate that intraspecific neighbours alter the physiology of focal plants, and with a few exceptions, their molecular responses to neighbours are unknown. Recently, changes in susceptibility to pathogen resulting from such interactions were demonstrated, a phenomenon called neighbour‐modulated susceptibility (NMS). However, the genetics of NMS and the associated molecular responses are largely unexplored.

Here, we analysed in rice the modification of biomass and susceptibility to the blast fungus pathogen in the Kitaake focal genotype in the presence of 280 different neighbours. Using genome‐wide association studies, we identified the loci in the neighbour that determine the response in Kitaake. Using a targeted transcriptomic approach, we characterized the molecular responses in focal plants co‐cultivated with various neighbours inducing a reduction in susceptibility.

Our study demonstrates that NMS is controlled by one major locus in the rice genome of its neighbour. Furthermore, we show that this locus can be associated with characteristic patterns of gene expression in focal plant. Finally, we propose an hypothesis where Pi could play a role in explaining this case of NMS.

Our study sheds light on how plants affect the physiology in their neighbourhood and opens perspectives for understanding plant–plant interactions.