bluuebunny/crossref_metadata_2025 huggingface dataset:
Emulsifying salts and P2O5 content as promising strategies to control Bacillus cereus growth during storage of processed cheese
Authors: Fusieger Andressa , Russo Nunziatina , Nero Luís Augusto , Carvalho Antonio Fernandes de , Randazzo Cinzia , Caggia Cinzia
Published: November 2023

Bacillus contamination in processed cheese (PC) has been reported and can lead to substantial economic consequences. We investigated the ability of six emulsifying salt solutions, each containing phosphorus pentoxide (P2O5), to inhibit the growth of B. cereus in PC. This study encompassed an assessment of the impact of PC processing methods (pasteurisation and creaming), storage temperature (6°C and 30°C) and storage time (up to 120 days). Our findings revealed that lower storage temperatures and the choice of emulsifying salt significantly influenced the B. cereus growth in PC. Notably, the creaming process and a higher P2O5 content demonstrated an enhanced inhibitory effect. This study underscores the potential effectiveness of appropriate emulsifying salts as a promising strategy for controlling B. cereus in PC.
Evaluating the use of clinical decision aids in an Australian emergency department: A cross‐sectional survey
Authors: Michaleff Zoe A , Hattingh Laetitia , Greenwood Hannah , Mickan Sharon , Jones Mark , van der Merwe Madeleen , Thomas Rae , Carlini Joan , Henry David , Stehlik Paulina , Glasziou Paul , Keijzers Gerben
Published: November 2023

Objective

To identify healthcare professionals' knowledge, self‐reported use, and documentation of clinical decision aids (CDAs) in a large ED in Australia, to identify behavioural determinants influencing the use of CDAs, and healthcare professionals preferences for integrating CDAs into the electronic medical record (EMR) system.

Methods

Healthcare professionals (doctors, nurses and physiotherapists) working in the ED at the Gold Coast Hospital, Queensland were invited to complete an online survey. Quantitative data were analysed using descriptive statistics, and where appropriate, mapped to the theoretical domains framework to identify potential barriers to the use of CDAs. Qualitative data were analysed using content analysis.

Results

Seventy‐four healthcare professionals (34 medical officers, 31 nurses and nine physiotherapists) completed the survey. Healthcare professionals' knowledge and self‐reported use of 21 validated CDAs was low but differed considerably across CDAs. Only 4 out of 21 CDAs were reported to be used ‘sometimes’ or ‘always’ by the majority of respondents (Ottawa Ankle Rule for ankle injury, Wells' criteria for pulmonary embolism, Wells' criteria for deep vein thrombosis and PERC rule for pulmonary embolism). Most respondents wanted to increase their use of valid and reliable CDAs and supported the integration of CDAs into the EMR to facilitate their use and support documentation. Potential barriers impacting the use of CDAs represented three theoretical domains of knowledge, social/professional role and identity, and social influences.

Conclusions

CDAs are used variably by healthcare professionals and are inconsistently applied in the clinical encounter. Preferences of healthcare professionals need to be considered to allow the successful integration of CDAs into the EMR.
Are emergency departments leader identity workspaces? A qualitative study of emergency physicians
Authors: Rixon Andrew , Wong Lee Yung , Wilson Samuel
Published: November 2023

Objective

Emergency medicine is a discipline with complex leadership demands, which are experienced by junior and senior emergency physicians alike. In this environment, emergency physicians can struggle to work out what it means to be a leader and develop professional identities as leaders, necessitating a leader identity workspace. The aim of the present study is to explore whether emergency physicians view their work environment as leader identity workspaces.

Methods

An online qualitative survey was used that included open‐ended questions about emergency physicians' experience of their workplace as a ‘space’ to craft their leadership identity. Participants' responses were analysed using reflexive thematic analysis.

Results

Three themes, comprising several subthemes, were identified that related to emergency physicians' ideal leader selves (leader dreams and desired leader selves), their experience of the community of clinicians in hospitals (confrontational sentient communities) and the types of rituals emergency physicians yearn for to support and legitimate their leadership (seeking vital leadership rites of passage).

Conclusion

Our results suggest that neither EDs nor hospitals more generally exhibit the properties of, or are experienced by emergency physicians, as leader identity workspaces.
Neuroimaging manifestations of paediatric histiocytoses
Authors: Tan Hsern Ern Ivan , Lakshmanan Rahul , Warne Richard , Walwyn Thomas , Roebuck Derek
Published: November 2023

Histiocytoses are rare multi‐system disorders marked by abnormal histiocyte cell proliferation, affecting children with diverse clinical presentations. Classified into five groups in 2016, including Langerhans‐related (L), cutaneous (C), malignant (M), Rosai–Dorfman disease (R) and haemophagocytic lymphohistiocytosis (H), newer entities such as ALK‐positive histiocytosis have also emerged, heralding the era of molecular (sub)classification. Common entities include Langerhans cell histiocytosis (LCH), Erdheim–Chester disease (ECD), Rosai–Dorfman disease (RDD) and haemophagocytic lymphohistiocytosis (HLH). This pictorial essay aids radiologists in recognising and differentiating paediatric histiocytoses based on unique neuroimaging features.
Evaluating the effects of nicotine concentration on the appeal and nicotine delivery of oral nicotine pouches among rural and Appalachian adults who smoke cigarettes: A randomized cross‐over study
Authors: Keller‐Hamilton Brittney , Alalwan Mahmood A. , Curran Hayley , Hinton Alice , Long Lauren , Chrzan Kirsten , Wagener Theodore L. , Atkinson Leanne , Suraapaneni Sriya , Mays Darren
Published: November 2023

Background and aims

Oral nicotine pouches (ONPs) probably offer reduced harm compared with cigarettes, but independent data concerning their misuse liability are lacking. We compared nicotine delivery and craving relief from ONPs with different nicotine concentrations to cigarettes.

Design

This was a single‐blind, three‐visit (≥ 48‐hour washout), randomized‐cross‐over study. Participants were encouraged to complete all study visits in less than 1 month.

Setting

The study took place in Rural/Appalachian Ohio.

Participants

Participants comprised 30 adults who smoke cigarettes. Participants (meanage = 34.5) were 60% men and 90% White.

Intervention

Participants who were ≥ 12‐hour tobacco‐abstinent used: (1) a 3‐mg nicotine concentration ONP, (2) a 6‐mg nicotine concentration ONP and (3) usual brand cigarette in separate visits. ONPs (wintergreen Zyn) were used for 30 minutes; cigarettes were puffed every 30 sec for 5 minutes.

Measurements

Plasma nicotine and self‐reported craving were assessed at t = 0, 5, 15, 30, 60 and 90 minutes. The primary outcome was plasma nicotine concentration at t = 30 minutes. A secondary outcome was craving relief at t = 5 minutes.

Findings

At t = 30, mean [95% confidence interval (CI)] plasma nicotine was 9.5 ng/ml (95% CI = 7.1, 11.9 ng/ml) for the 3 mg nicotine ONP, 17.5 ng/ml (95% CI = 13.7, 21.3) for the 6 mg nicotine ONP and 11.4 ng/ml (95% CI = 9.2, 13.6 ng/ml) for the cigarette. Mean plasma nicotine at t = 30 minutes differed between the 3‐ and 6‐mg nicotine ONPs (P = 0.001) and between the 6‐mg nicotine ONP and cigarette (P = 0.002). Mean (95% CI) craving at t = 5 minutes was lower for the cigarette (mean = 1.00, 95% CI = 0.61, 1.39) than either the 3 mg (mean = 2.25, 95% CI = 1.68, 2.82; P < 0.0001) or 6 mg nicotine (mean = 2.19, 95% CI = 1.60, 2.79; P < 0.0001) ONP.

Conclusions

Among adult smokers, using 6‐mg nicotine concentration oral nicotine pouches (ONPs) was associated with greater plasma nicotine delivery at 30 minutes than 3‐mg ONPs or cigarettes, but neither ONP relieved craving symptoms at 5 minutes as strongly as a cigarette. Accelerating the speed of nicotine delivery in ONPs might increase their misuse liability relative to cigarettes.
Evaluation of sex differences in pelvis and femur x‐ray images in British shorthair cats by geometric morphometric method
Authors: Özkan Ermiş , Pazvant Gülsün
Published: November 2023

The study covers British Shorthair cats, which is a popular domestic cat breed in our country and defined as ‘brachycephalic’ in terms of skull structure. Article focuses on the pelvis and femur region of cats which gynaecological and orthopaedic diseases of this cat breed, which are frequently encountered in clinical practice, is found to be important. It is aimed to reveal the shape differences between male and female individuals using geometric morphometric method. X‐ray images were used to examine the pelvis and femurs of cats via geometric method. Radiological images were obtained from a total of 40 British Shorthair cats (20 females and 20 males) in two positions, ventro‐dorsal (VD) and latero‐lateral (LL), and shape differences between the sexes were examined. As result, it is seen that the measurement points taken from the males are more outward and have sharper angles than the females. Study also shows pelvis is a better choice than femur when it comes to sex discrimination. Although traditional morphometric methods are more useful in clinical practice, it is thought that is important to support or re‐evaluate the data with the geometric morphometric method in academic field for a further approach.
Validation of vaginal microbiome proxies for in vitro experiments that biomimic Lactobacillus‐dominant vaginal cultures
Authors: Zahra Abir , Menon Ramkumar , Bento Giovana Fernanda Cosi , Selim Jessica , Taylor Brandie D. , Vincent Kathleen L. , Pyles Richard B. , Richardson Lauren S.
Published: November 2023

The vaginal microbiome includes diverse microbiota dominated by Lactobacillus [L.] spp. that protect against infections, modulate inflammation, and regulate vaginal homeostasis. Because it is challenging to incorporate vaginal microbiota into in vitro models, including organ‐on‐a‐chip systems, we assessed microbial metabolites as reliable proxies in addition to traditional vaginal epithelial cultures (VECs). Human immortalized VECs cultured on transwells with an air‐liquid interface generated stratified cell layers colonized by transplanted healthy microbiomes (L. jensenii‐ or L. crispatus‐dominant) or a community representing bacterial vaginosis (BV). After 48‐h, a qPCR array confirmed the expected donor community profiles. Pooled apical and basal supernatants were subjected to metabolomic analysis (untargeted mass spectrometry) followed by ingenuity pathways analysis (IPA). To determine the bacterial metabolites’ ability to recreate the vaginal microenvironment in vitro, pooled bacteria‐free metabolites were added to traditional VEC cultures. Cell morphology, viability, and cytokine production were assessed. IPA analysis of metabolites from colonized samples contained fatty acids, nucleic acids, and sugar acids that were associated with signaling networks that contribute to secondary metabolism, anti‐fungal, and anti‐inflammatory functions indicative of a healthy vaginal microbiome compared to sterile VEC transwell metabolites. Pooled metabolites did not affect cell morphology or induce cell death (∼5.5%) of VEC cultures (n = 3) after 72‐h. However, metabolites created an anti‐inflammatory milieu by increasing IL‐10 production (p = .06, T‐test) and significantly suppressing pro‐inflammatory IL‐6 (p = .0001), IL‐8 (p = .009), and TNFα (p = .0007) compared to naïve VEC cultures. BV VEC conditioned‐medium did not affect cell morphology nor viability; however, it induced a pro‐inflammatory environment by elevating levels of IL‐6 (p = .023), IL‐8 (p = .031), and TNFα (p = .021) when compared to L.‐dominate microbiome‐conditioned medium. VEC transwells provide a suitable ex vivo system to support the production of bacterial metabolites consistent with the vaginal milieu allowing subsequent in vitro studies with enhanced accuracy and utility.
Cervix cytology samples revealed increased methylation of the human markers FAM19A4/miR124‐2 up to 8 years before adenocarcinoma
Authors: Lindroth Ylva , Pedersen Louise , Alssamaray Jacob , Berglund Tim , Sundqvist Avalon , Borgfeldt Christer , Forslund Ola
Published: November 2023

Introduction

Methylation analysis of the promoter region of tumor‐suppressor genes has previously shown high sensitivity for detection of high‐grade cervical intraepithelial neoplasia (CIN) and cancer. HPV‐testing has a high sensitivity to identify women at risk to develop cancer, and has been implemented in cervical screening programs in several countries. But in most HPV‐positive women the infection will clear and they will not develop cancer. Testing for methylation could help to identify women who have potentially progressive cervical disease and need closer follow‐up. The goal of the present study was to investigate the potential use of methylation as a triage test of HPV‐positive women in the screening program.

Material and methods

A collection of liquid‐based cytology (LBC) samples from 106 women, collected between 4 months and 8 years before histologically confirmed cervical cancer or CIN3, was analyzed for hypermethylation of the human genes FAM19A4 and miR124‐2.

Results

Methylation was detected in 45% (33/73) of normal LBC samples from women who later developed CIN3+, compared with 10% (3/31) of normal LBC samples from women without subsequent dysplasia (P = 0.0006). Overall, methylation was detected in 39% (14/36), 51% (19/37), 61% (14/23) and 70% (7/10) of LBC samples from women who later developed CIN3, adenocarcinoma in situ (AIS), squamous cell carcinoma (SCC) and adenocarcinoma (ADC), respectively. Positive methylation analysis was not significantly more frequent than abnormal cytology of atypical squamous cells of unclear significance or worse (ASCUS+) in LBC samples collected 4 months to 8 years before SCC or AIS; however, prior to the development of ADC, methylation was observed in 7/10 LBC samples, despite normal cytology. Overall, LBC samples collected before invasive cancer (ADC and SCC) were more frequently positive in the methylation analysis than in cytological analysis of ASCUS+ (P = 0.048). For LBC samples collected more than 2 years before the development of AIS, SCC or ADC, methylation analysis showed a higher positivity rate than cytology did.

Conclusions

Testing for methylation of FAM19A4/miR124‐2 as a triage for HPV‐positive women would be useful to identify women at risk of cancer development, especially adenocarcinoma. Further studies are needed to estimate the cost‐effectiveness before introducing methylation testing in the screening program.
Role of dexamethasone in controlling the proinflammatory cytokine cascade in the first episode of paediatric acute pyelonephritis
Authors: Rius‐Gordillo Neus , Ferré Natàlia , González Juan David , Ibars Zaira , Parada‐Ricart Ester , Escribano Joaquín ,   the DEXCAR Study Group
Published: November 2023

Aim

Febrile urinary tract infection is a common bacterial infection in childhood. The kidney damage after acute pyelonephritis (APN) could be related to the stimulation of the proinflammatory response. We aimed to investigate the role of inflammatory cytokines and the effect of dexamethasone after a first episode of APN.

Methods

Subanalysis of the DEXCAR RCT in which children with confirmed APN (1 month–14 years) were randomly assigned to receive a 3 days course of either intravenous dexamethasone or placebo. Urinary cytokine levels at diagnosis and after 72 h of treatment were measured.

Results

Ninety‐two patients were recruited. Younger patients, males and those with abnormalities in the ultrasound study or vesicoureteral reflux showed higher values of urinary cytokines. Patients with severe APN had higher Tumour Necrosis Factor (TNF)α levels (81.0 ± 75.8 vs. 33.6 ± 48.5 pg/mg creatinine, p = 0.015). Both intervention groups showed similar basal clinical characteristics, including urinary cytokine levels. Treatment reduced urinary cytokine levels irrespective of dexamethasone administration. Neither the intervention group nor the urinary cytokine levels modulated the development of kidney scars.

Conclusion

Basal urinary cytokines were associated with age, abnormal ultrasound and vesicoureteral reflux. Patients with severe APN had higher TNFa urinary levels. Administration of dexamethasone in children with APN does not improve the control of the proinflammatory cytokine cascade.
Antimicrobial susceptibilities and genomic characteristics of methicillin‐resistant Staphylococcus aureus resistant to mupirocin in Stockholm, Sweden
Authors: Vestberg Nora , Razavi Mohammad , Giske Christian G. , Fang Hong
Published: November 2023

The aim of this study was to investigate antimicrobial susceptibilities and genomic characteristics of mupirocin‐resistant MRSA isolates in Stockholm, Sweden. In total, 44 non‐duplicate mupirocin‐resistant MRSA isolates detected in Stockholm during 2010–2022 were investigated. Antimicrobial susceptibility testing was performed using broth microdilution method and further tested for high‐level mupirocin‐resistance (MuH) and rifampicin by Etest®. All isolates were subjected to whole genome sequencing. 41 isolates presented MuH with MICs ≥1024 mg/L whilst three isolates displayed low‐level mupirocin resistance (MuL). mupA‐gene was detected in all MuH isolates. Point mutations in ileS gene leading to N213D and V588F were identified in the three MuL isolates. Mutation in rpoB (H481N) was detected in a rifampicin‐resistant isolate. Among the isolates, 15 multi‐locus sequence types (MLST) were identified, with the four most common sequence types (ST22, ST72, ST8, and ST125) accounting for 66% of the isolates. Mupirocin‐resistant MRSA in Stockholm was uncommon, with a percentage of <0.5% among MRSA cases during 2010–2022. In the present study, most mupirocin‐resistant isolates were MuH and mupA‐positive, predominantly linked to ST22 or ST72 isolates. MuL‐resistance was associated with a point mutation in the IleS protein. A multidrug‐resistant ST1‐MRSA‐IV strain was resistant to both mupirocin and rifampicin.
Antagonistic symbiosis: The social construction of China's foreign policy
Authors: Eves Lewis
Published: November 2023

China is often considered as motivated by a desire to challenge the international status quo, a challenge the West is trying to mitigate. Social constructivists account for this challenge via a norm of nationalistic assertiveness in Chinese foreign policy; a norm constructed in the synergetic relationship between China's Communist Party and its nationalist movement. However, this work argues that Chinese foreign policy is motivated, in part, by nationalist pressure arising from an antagonistically symbiotic relationship between the Communist Party and China's nationalist movement. This understanding is significant as it indicates that western policies are paradoxically factoring in the emergence of a challenger China. © 2023 Victoria University of Wellington and John Wiley & Sons Australia, Ltd.
Laparoscopic spleen‐preserving distal pancreatectomy: A novel technique with splenic artery resection and splenic vein preservation
Authors: Shindo Yoshitaro , Tokumitsu Yukio , Nakajima Masao , Kimura Yuta , Matsui Hiroto , Iida Michihisa , Suzuki Nobuaki , Takeda Shigeru , Ioka Tatsuya , Nagano Hiroaki
Published: November 2023

Introduction

Laparoscopic spleen‐preserving distal pancreatectomy (LSDP) is widely performed to treat benign and low‐grade malignant diseases. Although preservation of splenic vessels may be desirable considering the risk of postoperative complications, it is sometimes difficult due to tumor size, inflammation, and proximity of the tumor and splenic vessels. Herein, we present the first case of LSDP with splenic artery resection and splenic vein preservation.

Materials and Surgical Technique

A 40‐year‐old woman with a pancreatic tumor was referred to our hospital. Contrast‐enhanced computed tomography (CT) revealed a tumor in the pancreatic tail that was in contact with the splenic artery and distant from the splenic vein. The splenic artery and vein were separated from the pancreas near the dissection line. The splenic artery was resected after pancreatic dissection using a linear stapler. After the pancreatic tail was separated from the splenic hilum while preserving the splenic vein, the distal side of the splenic artery was resected, and the specimen was removed. The postoperative course was uneventful and the patient was discharged on postoperative Day 9. Four months after surgery, postoperative follow‐up CT findings showed neither splenic infarction nor gastric varices.

Discussion

This technique is an alternative method of splenic preservation when there is no attachment of the tumor to the splenic vein or uncontrolled expected bleeding of the splenic artery using the Kimura technique.
Factors associated with mental health among Hong Kong children: A population‐based study of 4884 individuals
Authors: Huang Junjie , Keung Vera M. W. , Cheung Calvin K. M. , Lo Amelia S. C. , Chan Sze Chai , Pang Wing Sze , Mui Lancelot W. H. , Lee Albert , Wong Martin C. S.
Published: November 2023

Background

This cross‐sectional study aimed to investigate the association between negative mental health conditions and demographic characteristics, socioeconomic background and health‐related parameters in both Hong Kong's primary and secondary school students.

Methods

A self‐administrated survey was conducted and investigated the prevalence of negative mental health conditions (psychological stress, depression and suicidality) in students from 30 primary schools and 25 secondary schools in Hong Kong in 2017. The Kessler Psychological Distress Scale (K6) was chosen as the instrument to evaluate non‐specific psychological distress. Depression was evaluated using the prolonged feeling of despair as a proxy. Suicidality was measured by four questions on whether they had ever intentionally injured themselves, seriously considered attempting suicide, planned how they would attempt suicide and had attempted suicide. Multiple logistic regression models examined the explanatory factors' association with mental health conditions after adjusting for confounding, using the enter method.

Results

A total of 4884 responses were collected. It is found that both very high and low parent expectations were risk factors for multiple conditions, namely suicidality and psychological distress among primary school students, and psychological distress among secondary school students. As for primary school students, the experience of being bullied was a significant risk factor for all conditions. A significant association was found between having one's own bedroom and suicidality amongst primary school students; whilst having three close friends or more and higher life satisfaction levels were significantly associated with a lower risk of negative mental health conditions among secondary school students.

Conclusions

It was found that having one's own bedroom was a risk factor for suicidality among primary school student. Parents should be alert to the risky behaviours of children, have more involvement in children's daily life and build a supportive and caring family environment for children. For secondary school students, as the importance of friends is greatly increased, teachers should encourage students to engage in extra‐curricular activities in school.
A randomized controlled trial to assess the impact of psychoeducation on the quality of life of parents with children with congenital heart defects—Quantitative component
Authors: Rodrigues Marisa Garcia , Rodrigues José Daniel , Moreira Jorge Antunes , Clemente Fátima , Dias Cláudia Camila , Azevedo Luís Filipe , Rodrigues Pedro Pereira , Areias José Carlos , Areias Maria Emília
Published: November 2023

Purpose

To develop, implement and assess the results of psychoeducation to improve the QoL of parents with CHD newborns.

Methods

Participants were parents of inpatient newborns with the diagnosis of non‐syndromic CHD. We conducted a parallel RCT with an allocation ratio of 1:1 (intervention vs. control), considering the newborns, using mixed methods research. The intervention group received psychoeducation (Parental Psychoeducation in CHD [PPeCHD]) and the usual routines, and the control group received just the regular practices. The allocation concealment was assured. PI was involved in enrolling participants, developing and implementing the intervention, data collection and data analysis. We followed the Consolidated Standards of Reporting Trials (CONSORT) guidelines.

Results

Parents of eight newborns were allocated to the intervention group (n = 15 parents) and eight to the control group (n = 13 parents). It was performed as an intention‐to‐treat (ITT) analysis. In M2 (4 weeks), the intervention group presented better QoL levels in the physical, psychological, and environmental domains of World Health Organization Quality of Life instrument (WHOQOL‐Bref). In M3 (16 weeks), scores in physical and psychological domains maintained a statistically significant difference between the groups.

Conclusions

The PPeCHD, the psychoeducational intervention we developed, positively impacted parental QoL. These results support the initial hypothesis. This study is a fundamental milestone in this research field, adding new essential information to the literature.
Management aspects of congenital adrenal hyperplasia during adolescence and transition to adult care
Authors: Balagamage Chamila , Arshad Amynta , Elhassan Yasir S. , Ben Said Wogud , Krone Ruth E. , Gleeson Helena , Idkowiak Jan
Published: November 2023

The adolescent period is characterised by fundamental hormonal changes, which affect sex steroid production, cortisol metabolism and insulin sensitivity. These physiological changes have a significant impact on patients with congenital adrenal hyperplasia (CAH). An essential treatment aim across the lifespan in patients with CAH is to replace glucocorticoids sufficiently to avoid excess adrenal androgen production but equally to avoid cardiometabolic risks associated with excess glucocorticoid intake. The changes to the hormonal milieu at puberty, combined with poor adherence to medical therapy, often result in unsatisfactory control exacerbating androgen excess and increasing the risk of metabolic complications due to steroid over‐replacement. With the physical and cognitive maturation of the adolescent with CAH, fertility issues and sexual function become a new focus of patient care in the paediatric clinic. This requires close surveillance for gonadal dysfunction, such as irregular periods/hirsutism or genital surgery‐associated symptoms in girls and central hypogonadism or testicular adrenal rest tumours in boys. To ensure good health outcomes across the lifespan, the transition process from paediatric to adult care of patients with CAH must be planned carefully and early from the beginning of adolescence, spanning over many years into young adulthood. Its key aims are to empower the young person through education with full disclosure of their medical history, to ensure appropriate follow‐up with experienced physicians and facilitate access to multispecialist teams addressing the complex needs of patients with CAH.
A retrospective review of the association between maternal body mass index and the risk of congenital anomalies
Authors: Movva Vani C. , Spangler Brooke , Young Amanda J. , Paglia Michael J. , Angras Kajal
Published: November 2023

The objective of the study was to examine the association of congenital anomalies with the specific classes of pre‐pregnancy BMI. An IRB‐approved retrospective cohort study was performed using the data from the Natality Public Use File from the National Center for Health Statistics (2019). We included all singleton live births and excluded pregnancies with suspected or confirmed chromosomal abnormalities and people with pre‐existing diabetes mellitus and missing pertinent data. The primary outcome was the incidence of any major congenital anomalies in liveborn infants. The incidence of anomaly was analyzed across all BMI classes, using individuals with BMI between 18.5 and 24.9 kg/m2 as the comparison group. A test of trend was also performed to determine if the risk increased as the BMI class increased. A total of 3 047 382 maternal‐neonatal dyads were included in the analysis. A non‐significant higher incidence of any major anomaly was noted among people who had underweight and class III BMI. The risk of open neural tube defects, omphalocele, and cleft lip/palate increased and the risk of gastroschisis decreased with an increase in maternal BMI class (p < 0.05). The incidence of congenital anomalies increases as the pre‐pregnancy BMI increases. Individuals should be encouraged to optimize their weight prior to conception and if feasible, they should obtain screening for fetal anatomy assessment by a Maternal‐Fetal Medicine specialist.
Retrospective observational study analysing the trends in ventilation tube insertion in children in Scotland between 2001 and 2018
Authors: Wescott Robert A. , Downie Laura S. , Kubba Haytham
Published: November 2023

Objectives

Otitis media with effusion (OME) is common, affecting up to 90% of children. Around 25% will have a persistent effusion with conductive hearing loss which can impact their development. Ventilation tubes (VTs) can improve their hearing in the short term. This study aims to analyse the trends in VT insertion rates across Scotland.

Design

Retrospective observational study.

Setting

All mainland Scottish health boards.

Participants

All children aged 0–16 who underwent a VT insertion procedure from 2001 to 2018 were included.

Main outcome measures

Data were provided by the Scottish Public Health Observatory, using Scottish Morbidity Records. Mid‐year population estimates were obtained from the National Records Office of Scotland. Socioeconomic deprivation was estimated based on area of residence using the Scottish Index of Multiple Deprivation. VT insertion rates were calculated and trends analysed.

Results

A total of 35 878 VT procedures were performed in total with a mean rate of 2.02 per 1000 children per year. The highest insertion rates were observed in children aged 4–6. VT insertion rates reduced during the study period (R = −0.729, p = .001). Variability in VT insertion rates between health boards reduced. There was a significant association between socioeconomic deprivation and VT insertion rate, with the most deprived children having the highest rate (p < .001).

Conclusions

VT insertion rates and the variability between Scottish health boards have reduced over the past two decades, suggesting a more equitable system. Our data intimates that the decision to perform VT insertion is based upon disease prevalence rather than clinician preference.
Neurocognitive outcomes in pediatric hematological cancer survivors post‐HSCT: A systematic review
Authors: Ansari Saniya , Garg Aakriti , Khan Mohd. Ashif
Published: November 2023

Background

Pediatric hematological cancer survivors who undergo hematopoietic stem cell transplantation (HSCT) may experience long‐term neurocognitive impairments. This systematic review aims to assess the neurocognitive outcomes in pediatric hematological cancer survivors at least 5 years post‐HSCT.

Methodology

A comprehensive search was conducted in multiple databases, including PubMed, ScienceDirect, Cochrane Library, and ClinicalTrials.gov, until October 2022. Relevant studies assessing the neurocognitive affect after 5 years of HSCT were identified and included in the review. The quality of included studies was assessed using the ROBINS‐I tool to evaluate the risk of bias.

Results

A total of five studies met the inclusion criteria and were included in the review. The studies consistently demonstrated adverse effects of HSCT on neurocognitive outcomes in pediatric hematological cancer survivors after 5 years of the treatment. The most prominent impact was observed on global cognitive outcomes, including intelligence, attention, memory, and executive functioning. Specific cognitive domains, such as processing speed and academic achievement, were also significantly affected. Several studies reported a relationship between HSCT‐related factors (e.g., age at transplantation, radiation therapy, graft‐versus‐host disease) and neurocognitive impairments.

Conclusion

This systematic review provides evidence of the adverse impact of HSCT on neurocognitive outcomes in pediatric hematological cancer survivors at least 5 years post‐transplantation. The findings highlight the importance of long‐term monitoring and intervention strategies to mitigate these neurocognitive sequelae. Future research should focus on identifying risk factors and developing targeted interventions to optimize the neurocognitive functioning of this vulnerable population. Healthcare professionals involved in the care of pediatric hematological cancer survivors should be aware of these potential long‐term neurocognitive effects and incorporate appropriate assessments and interventions into survivorship care plans.
Unveiling cardiac insights: Exploring early left ventricular dysfunction in polycythemia vera through 4D‐STE and fragmented QRS analysis
Authors: Karasu Mehdi , Berber İlhami , Karaca Yücel , Cansel Mehmet , Ulutaş Zeynep
Published: November 2023

Background

Polycythemia vera (PV), characterized by elevated red blood cell counts, poses challenges to cardiovascular health with potential impacts on cardiac function. Myocardial infarction (MI) and heart failure are major causes of mortality in PV patients. Early detection of left ventricular systolic dysfunction is crucial for optimizing outcomes.

Methods

Fifty‐two PV patients and 45 healthy controls were recruited. Four‐dimensional speckle tracking echocardiography (4D‐STE) and fragmented QRS complexes (fQRS) on electrocardiograms were utilized to assess cardiac mechanics. Hematological and echocardiographic parameters were measured, and statistical analyses were performed.

Results

PV patients exhibited significantly higher hematocrit and red cell distribution width compared to controls. Global longitudinal strain (GLS), global circumferential strain (GCS), global radial strain (GRS), and global area strain (GAS) were lower in PV patients. fQRS complexes were associated with longer disease duration and reduced GCS and GAS values. Hematocrit correlated positively with LV‐GCS and LV‐GAS. Multiple linear regression revealed that disease duration and fQRS presence independently predicted LV‐GAS.

Conclusion

This study underscores the intricate link between elevated red blood cell counts, disease duration, and cardiac function in PV patients. Combining 4D‐STE and fQRS complexes enhances the identification of early left ventricular systolic dysfunction. These findings offer potential improvements in recognizing and managing cardiovascular complications in PV patients, with implications for future research and clinical practice. Further investigations are needed to elucidate underlying mechanisms and validate these markers in larger cohorts.
Identification and fungicide sensitivity of Fusarium asiaticum causing seedling rot of Hinoki cypress in a Forest nursery in South Korea
Authors: Choi Hyeongju , Paul Narayan Chandra , Kim Hyun‐Jun , Sang Hyunkyu
Published: November 2023

In 2021, a seedling rot disease was observed on Hinoki cypress (Chamaecyparis obtusa) seedlings in a bareroot forest nursery in Naju‐si, Jeollanam‐do Province, South Korea. Infected seedlings were yellowing at the disease outset but became black after severe infection. At onset of disease, seedlings began yellowing. As disease progressed, black rot of the leaves and roots was common and eventually wilt and seedling death was observed. Seedling mortality was about 30%. The causal organism was isolated from the seedlings on potato dextrose agar media. A total of nine isolates were recovered and two representative isolates were identified as Fusarium asiaticum based on morphological characterization and phylogenetic analysis of the internal transcribed spacer (ITS) region, translation elongation factor (EF1–α) and RNA polymerase II (RPB2) genes. Pathogenicity and fungicide sensitivity were tested to confirm pathogen viability and control efficacy of the disease. The fungal isolate caused severe disease in the inoculated Hinoki cypress seedlings. Also, the isolates were sensitive to benomyl, hexaconazole and pyraclostrobin and showed reduced sensitivity to penthiopyrad. In planta assays showed 98.81 and 100% disease control by the application of pyraclostrobin and hexaconazole, respectively. The pathogen was re‐isolated from the inoculated seedlings and its identity was confirmed by morphological analysis fulfilling Koch's postulates. The pathogen‐causing disease in the Hinoki cypress is the first reported in the host worldwide.
Magnetic resonance imaging findings in Kenyans and South Africans with active convulsive epilepsy: An observational study
Authors: Kariuki Symon M. , Wagner Ryan G. , Gunny Roxana , D'Arco Felice , Kombe Martha , Ngugi Anthony K. , White Steven , Odhiambo Rachael , Cross J. Helen , Sander Josemir W. , Newton Charles R. J. C.
Published: November 2023

Objective

Focal epilepsy is common in low‐ and middle‐income countries. The frequency and nature of possible underlying structural brain abnormalities have, however, not been fully assessed.

Methods

We evaluated the possible structural causes of epilepsy in 331 people with epilepsy (240 from Kenya and 91 from South Africa) identified from community surveys of active convulsive epilepsy. Magnetic resonance imaging (MRI) scans were acquired on 1.5‐Tesla scanners to determine the frequency and nature of any underlying lesions. We estimated the prevalence of these abnormalities using Bayesian priors (from an earlier pilot study) and observed data (from this study). We used a mixed‐effect modified Poisson regression approach with the site as a random effect to determine the clinical features associated with neuropathology.

Results

MRI abnormalities were found in 140 of 240 (modeled prevalence = 59%, 95% confidence interval [CI]: 53%–64%) of people with epilepsy in Kenya, and in 62 of 91 (modeled prevalence = 65%, 95% CI: 57%–73%) in South Africa, with a pooled modeled prevalence of 61% (95% CI: 56%–66%). Abnormalities were common in those with a history of adverse perinatal events (15/23 [65%, 95% CI: 43%–84%]), exposure to parasitic infections (83/120 [69%, 95% CI: 60%–77%]) and focal electroencephalographic features (97/142 [68%, 95% CI: 60%–76%]), but less frequent in individuals with generalized electroencephalographic features (44/99 [44%, 95% CI: 34%–55%]). Most abnormalities were potentially epileptogenic (167/202, 82%), of which mesial temporal sclerosis (43%) and gliosis (34%) were the most frequent. Abnormalities were associated with co‐occurrence of generalized non‐convulsive seizures (relative risk [RR] = 1.12, 95% CI: 1.04–1.25), lack of family history of seizures (RR = 0.91, 0.86–0.96), convulsive status epilepticus (RR = 1.14, 1.08–1.21), frequent seizures (RR = 1.12, 1.04–1.20), and reported use of anti‐seizure medication (RR = 1.22, 1.18–1.26).

Significance

MRI identified pathologies are common in people with epilepsy in Kenya and South Africa. Mesial temporal sclerosis, the most common abnormality, may be amenable to surgical correction. MRI may have a diagnostic value in rural Africa, but future longitudinal studies should examine the prognostic role.
Research on low‐cycle fatigue behavior of Ni‐based single crystal superalloy with shaped film cooling holes at high temperature
Authors: Li Zhenwei , Wen Zhixun , Meng Li , Haiqing Pei , Fei Li , Jundong Wang , He Pengfei , Yue Zhufeng
Published: November 2023

Film cooling holes (FCHs) geometric structure significantly affects low‐cycle fatigue (LCF) of the single crystal turbine blade. This study investigates the LCF behavior of Ni‐based single crystal plate specimens with two different structure FCHs, including elliptical and fan‐shaped FCHs, by high temperature fatigue tests and crystal plasticity simulation. The results show that the LCF life of the fan‐shaped FCHs is shorter than those of the elliptical FCHs. The fracture characteristics and microstructure evolution of different structure FCHs are dissimilar. Oxidation affects the fatigue crack nucleation process at the FCH edge. The resolved shear stress (RSS) around fan‐shaped FCHs is greater than elliptical FCHs under one cyclic stress, and the area with larger RSS is consistent with fatigue crack nucleation position. The early LCF failure is mainly attributed to the high temperature oxidation of the local slip deformation induced by RSS concentration around the FCHs.
Deconstructing the benefits of reading‐while‐listening on L2 reading comprehension: The influence of cross‐orthographic distance
Authors: Koh Joanne
Published: November 2023

Reading‐while‐listening (RWL) has been suggested to facilitate reading comprehension by establishing letter‐to‐sound correspondences in the word recognition process. However, previous findings are inconsistent regarding the effect of RWL on foreign language (L2) reading comprehension. To understand why such inconsistency occurs, the moderating role of L2 orthographic characteristics in the effects of RWL on L2 propositional comprehension was examined. The orthographic characteristics of a language are of particular relevance as languages differ in the time course and the degree to which visual and phonological coding strategies are involved in word recognition. L1 Korean (alphabetic, shallow orthography) intermediate undergraduate learners of Chinese (nonalphabetic), English (alphabetic, deep orthography), and Spanish (alphabetic, shallow orthography) read and read‐while‐listened to authentic reading texts in their target language, and solved a set of written, untimed multiple‐choice questions to test their propositional comprehension. Results indicated that learners of an L2 with a larger distance (i.e., Chinese) from the L1 benefitted more from RWL, indicating that L2 orthographic characteristics interacted with input modality. Pedagogical implications for the use of RWL are discussed coupled with qualitative findings of students' perceptions.
Treatment outcomes of regenerative endodontic therapy in immature permanent teeth with pulpal necrosis: A systematic review and network meta‐analysis
Authors: Sabeti Mohammad , Ghobrial Daniel , Zanjir Maryam , da Costa Bruno R. , Young Yating , Azarpazhooh Amir
Published: November 2023

Aim

The aim of this study was to assess which treatment modality regarding scaffold selection for immature permanent teeth with pulpal necrosis will be the most successful for regenerative endodontic treatment (RET).

Methodology

PubMed, Cochrane, Web of Science and Embase, and additional records until August 2022 were searched providing a total of 3021 articles, and nine of these articles were included for quantitative synthesis. The reviewers selected eligible randomized controlled trials and extracted pertinent data. Network meta‐analysis was conducted to estimate treatment effects for primary outcomes (clinical and radiographic healing) and secondary outcomes (apical closure, root length and root wall thickness increase) following RET [mean difference (MD); 95% credible interval (CrI) and surface under the cumulative ranking curve (SUCRA)]. The quality of the included studies was appraised by the revised Cochrane risk of bias tool, and the quality of evidence was assessed using the GRADE approach.

Results

Six interventions from nine included studies were identified: blood clot scaffold (BC), blood clot scaffold with basic fibroblast growth factor, blood clot scaffold with collagen, platelet pellet, platelet‐rich plasma (PRP) and platelet‐rich fibrin (PRF). The PRP scaffold showed the greatest increase in root lengthening at 6–12 months (MD = 4.2; 95% CrI, 1.2 to 6.8; SUCRA = 89.0%, very low confidence). PRP or PRF achieved the highest level of success for primary and secondary outcomes at 1–6 and 6–12 months. Blood clot scaffold (with collagen or combined with basic fibroblast growth factor (bFGF)) achieved the highest level of success for secondary outcomes beyond 12 months follow‐up. A very low to low quality of evidence suggests that both PRP and PRF exhibit the greatest success evaluating primary and secondary outcomes within 12 months postoperatively compared to the traditional blood clot scaffold protocol.

Conclusion

Limited evidence suggests both PRP and PRF exhibit success in the short‐term, not long‐term. The value of this information stems in its recommendation for future randomized trials prioritizing both of these materials in their protocol.
Epidemiology, clinical profiles, and prognostic value of COVID‐19‐related cutaneous manifestations in African populations: a rapid narrative review
Authors: Nyasulu Peter S. , Tamuzi Jacques L.
Published: November 2023

Background

Skin manifestations’ true prognostic value, and clinical and epidemiological pictures in SARS‐CoV‐2 infection in African populations are poorly described and understudied. More familiarity with COVID‐19 cutaneous manifestations may aid in early clinical diagnosis or guide prognosis.

Methods

In this literature review, we looked for potential studies published from December 2019 to March 2023 on COVID‐19 cutaneous lesions in African populations. Our key questions were focused on the prognostic values of cutaneous manifestations related to COVID‐19.

Results

Our findings show that cutaneous manifestations of COVID‐19 vary by country and severity of COVID‐19, primarily multisystem inflammatory syndrome (MIS). Significant differences were also found between various dermatological lesions, primarily MIS, erythema multiforme‐like, livedoid, vesicular, or varicella‐like rashes, urticarial, maculopapular or morbilliform rashes, and chilblain‐like or pernio‐like rashes. There were 47.5% (115/242) of MIS cases reported in nine published African studies. Our findings also revealed that MIS may be diagnosed in 2–7 days due to early onset rash. Advanced age, obesity, diabetes, cardiovascular disease, HIV, tuberculosis, asthma, atopic disease, underweight, malnutrition, and malignancy were found to be associated with COVID‐19 cutaneous manifestations in African populations.

Conclusions

COVID‐19‐related skin manifestations in African populations are important as a driving force in COVID‐19 prognosis.