bluuebunny/crossref_metadata_2025 huggingface dataset:
Transitional Shock in Newly Graduated Registered Nurses From the Perspective of Self‐Depletion and Impact on Cognitive Decision‐Making
Authors: Yingnan Zhao , Ziqi Zhang , Ting Wang , Liqin Chen , Xiaoqing Shi , Lan Xu
Published: October 2024

Background: Newly graduated registered nurses face more challenges than their experienced counterparts, as they not only confront the high pressures of an increasingly complex medical environment but also need to quickly adapt to their jobs and role transitions. The emotional burden arising at this stage is referred to as transitional shock. Self‐depletion, as proposed by Baumeister, refers to the process by which individuals exhaust their internal psychological control resources when facing challenges, subsequently affecting cognition and emotion. The occurrence of transitional shock and the process of individual self‐depletion appear to be closely related. However, to our knowledge, there has been limited research exploring the occurrence of transitional shock from the perspective of self‐depletion theory.

Aim: Investigating the emergence process of transition shock through the lens of self‐depletion theory entails an examination of the mechanisms by which individuals engage in self‐regulation when confronted with challenges and how transition shock manifests throughout this process.

Designs: A descriptive qualitative study.

Methods: Between August and November 2023, using maximum variation sampling and purposive sampling methods, 16 nurses were selected for semistructured interviews at a tertiary hospital in Suzhou, China.

Results: Employing thematic analysis, three interconnected themes were identified, encompassing the entry‐level workforce challenges, the subsequent effects of energy depletion, and the sources and replenishment of energy.

Conclusion: As new nurses adapt to their roles and environments, they encounter numerous pressures that markedly drain their psychological energy. This ongoing depletion of self‐regulation energy can lead to transitional shock, impulsive decision‐making, and missed nursing care.

Implications for Nursing Management: Managers should implement comprehensive support strategies, including optimized work environments, enhanced training, and personal development, to help newly graduated nurses successfully transition and improve care quality and retention.
Evaluation of Microleakage of Orthograde Root‐Filling Materials in Immature Permanent Teeth
Authors: Das Upma , Gautam Vanita , Shubham Snigdha , Raut Shristi
Published: October 2024

Introduction: The absence of a barrier in an open root apex makes endodontic treatment challenging as root‐filling material can easily reach the surrounding tissue. The aim of the study was to compare the apical microleakage associated with mineral trioxide aggregate (MTA), biodentine, custom‐made gutta‐percha with MTA plus and custom‐made gutta‐percha with Adseal in immature permanent teeth by dye penetration method.

Methods: Apical 2 mm of 60 single‐rooted mandibular premolar teeth was resected to create divergent open apices and 10 teeth each were filled with Biodentine plug, MTA plug, custom‐made gutta‐percha with MTA plus sealer and custom‐made gutta‐percha with Adseal sealer. Ten teeth each acted as positive and negative controls. All the samples were stored at 37°C at 100% humidity for 5 weeks and then immersed in 2% Rhodamine B dye for 24 h. Transverse sectioning was done apically at 1 mm and 3 mm to evaluate dye penetration under a fluorescence microscope using ImageJ software.

Results: There was a significantly greater microleakage at 1 mm cross section compared to 3 mm (p < 0.0001). At 1 mm cross section, the apical microleakage was the highest for the MTA plug with a mean leakage percentage of 48.08 ± 16.38, a mean depth of leakage of 0.46 ± 0.10 mm and a mean area of leakage of 1.35 ± 0.74 mm2, compared to other groups, and the difference was statistically significant. However, at a 3 mm cross section, MTA plus sealer with gutta‐percha demonstrated the highest mean leakage percentage (25.01 ± 7.77) compared to other groups and the difference was statistically significant (p = 0.03).

Conclusion: It can be concluded that the 3‐mm‐thick apical plug provided better sealing of the open apex compared to the 1 mm apical plug and there was no significant difference in microleakage among the Biodentine plug, MTA plug and Adseal sealer with gutta‐percha plug at 3 mm cross section.
Structural Characterization and Immunomodulatory Activities of a Novel Polysaccharide From Sacha Inchi (Plukenetia volubilis L.) Shell
Authors: Huang Junyuan , Chen Yanlan , Wang Kun , Chen Changan , Yang Yang , Zou Zebin , Li Yanli , Du Bing , Tang Danfeng , Li Pan
Published: October 2024

The novel bioactive polysaccharide, Sacha inchi shell polysaccharide‐3 (SISP‐3), was isolated from the Sacha inchi (Plukenetia volubilis L.) shell using anion exchange and gel filtration chromatography. This neutral polysaccharide fraction, characterized by a triple‐helix structure and a molecular weight of 17,684 Da, was successfully isolated. The composition analysis of SISP‐3 revealed the presence of Rha, Ara, Gal, Glc, and Fru in molar ratios of 7.2%:41.7%:40.3%:4.1%:6.7%. The dominant glycosidic linkage in SISP‐3 was identified as ⟶4)‐Galp‐(1⟶, accompanied by a complex branching pattern. The results from RAW264.7 cell experiments showed that SISP‐3 significantly enhanced cell viability, phagocytosis, and NO production. Additionally, it significantly stimulated the production of cytokines, including TNF‐α, IL‐1β, and IL‐6, in RAW264.7 cells. These findings suggest that SISP‐3 serves as an immune active agent with immunomodulatory properties, indicating its potential as a natural immunomodulatory agent for various applications.
BRCA1 Protein Expression in Epithelial Ovarian Cancer and Associated Clinicopathological Factors in Uganda
Authors: Okecha Tonny , Abila Derrick B. , Nabbale Dorothy L. , Katongole Fauz , Yahaya James J. , Lukande Robert , Kalungi Sam , Nalwoga Hawa
Published: October 2024

Background: BRCA1 gene dysfunction seen in epithelial ovarian carcinomas often results from germline mutations, somatic mutations, and promoter methylation. Identification of tumors with loss of BRCA1 protein expression has shown to have therapeutic and prognostic implications. The aim of this study was to determine the expression of BRCA1 protein in epithelial ovarian cancer (EOC) and the associated clinicopathological characteristics.

Methods and Results: This was a cross‐sectional laboratory‐based study that used paraffin‐embedded tissue blocks of patients histologically diagnosed with EOC from January 2010 to August 2018. Tissue sections were stained with hematoxylin and eosin (H&E) for histological confirmation and with immunohistochemistry (IHC) using a mouse‐derived monoclonal antibody MS110 for BRCA1 protein expression. The association between BRCA1 protein expression and independent variables was determined using Pearson’s Chi‐square test. A total of 104 tissue blocks from patients with EOC were included in the study with a mean age of 48.7 ± 12.8 years. Serous tumors were the most common which comprised 74.0% (77/104) of all the tumors and majority of them 75.3% (58/77) were high grade. Loss of expression of BRCA1 protein expression was found in 33.7% (33/98) of all the cases. There was no statistically significant association between BRCA1 expression and age of patients, tumor grade, and histological subtype.

Conclusion: There is a high expression of altered BRCA1 expression in tissues of EOC. Although it has not shown association with age of patients, histology types, and tumor grade, further studies need to assess its influence of the survival of cancer patients with EOC.
Technoeconomic Conservation Voltage Reduction–Based Demand Response Approach to Control Distributed Power Networks
Authors: Pourfarzin Shahram , Daemi Tahere , Akbari Hamidreza
Published: October 2024

This manuscript investigates the transformative shift in electricity generation and distribution towards distributed power networks, particularly microgrids, amid escalating energy demand and environmental concerns. Emphasizing a pioneering technoeconomic conservation voltage reduction–based demand response approach, the study integrates conservation voltage reduction as a controllable demand response method within distributed power networks, highlighting the developed droop control method for effective regulation. Conservation voltage reduction, a no‐cost procedure for minimizing loss, is applied to reduce voltage during peak periods to conserve power, decrease active and reactive power losses through precise load modeling, and enhance consumption efficiency. The most significant challenge of this project is the simultaneous use of conservation voltage reduction with the uncertainties of distributed generation sources, resulting to reduce losses and ultimately lower operating costs, a topic not previously studied in existing literature. The contributions include introducing a novel approach based on droop control to manage resources and presenting a detailed control strategy tailored to distributed power networks for improving voltage stability with minimal costs. Importantly, the proposed method demonstrates superior accuracy, achieving up to an 18% improvement over existing methods. This research contributes to comprehensive solutions for optimizing energy consumption, enhancing grid stability, and adapting to the evolving distributed power systems landscape.
Protocol Link from Phase 1 Trial of ALRN-6924, a Dual Inhibitor of MDMX and MDM2, in Patients with Solid Tumors and Lymphomas Bearing Wild-type TP53
Authors: Saleh Mansoor N. , Patel Manish R. , Bauer Todd M. , Goel Sanjay , Falchook Gerald S. , Shapiro Geoffrey I. , Chung Ki Y. , Infante Jeffrey R. , Conry Robert M. , Rabinowits Guilherme , Hong David S. , Wang Judy S. , Steidl Ulrich , Naik Gurudatta , Guerlavais Vincent , Vukovic Vojislav , Annis D. Allen , Aivado Manuel , Meric-Bernstam Funda
Published: October 2024

A link to the protocol as referenced in this manuscript.
Supplementary Methods, Supplementary Table 1-4 and Supplementary Figure legends from Tumor-Specific Major Histocompatibility-II Expression Predicts Benefit to Anti–PD-1/L1 Therapy in Patients With HER2-Negative Primary Breast Cancer
Authors: Gonzalez-Ericsson Paula I. , Wulfkhule Julia D. , Gallagher Rosa I. , Sun Xiaopeng , Axelrod Margaret L. , Sheng Quanhu , Luo Na , Gomez Henry , Sanchez Violeta , Sanders Melinda , Pusztai Lajos , Petricoin Emanuel , Blenman Kim R.M. , Balko Justin M.
Published: October 2024

Supplementary Methods: detailed protocol. Supplementary Table 1: Antibodies used for RPPA. Supplementary Table 2: Rates of tumor-specific MHC-II/HLA-DR expression across HER2-negative primary breast cancers. Supplementary Table 3: Univariate and multivariate analysis for achieving pCR to pembrolizumab and neoadjuvant chemotherapy or chemotherapy alone. Supplementary Table 4: Cox proportional Hazard ratio univariate analysis for 3-year event-free survival associated with pembrolizumab and neoadjuvant chemotherapy or chemotherapy alone. Supplementary Figure legends.
Table 3 from Targeting the Epidermal Growth Factor Receptor Pathway in Chemotherapy-Resistant Triple-Negative Breast Cancer: A Phase II Study
Authors: Yam Clinton , Patel Miral , Hill Holly A. , Sun Ryan , Bassett Roland L. , Kong Elisabeth , Damodaran Senthil , Koenig Kimberly B. , Abouharb Sausan , Saleem Sadia , Bisen Ajit K. , Murthy Rashmi K. , Ramirez David L. , Rauch Gaiane M. , Adrada Beatriz E. , Candelaria Rosalind P. , Wang Xiaoping , Mittendorf Elizabeth A. , Thompson Alastair M. , White Jason B. , Ravenberg Elizabeth E. , Clayborn Alyson R. , Ding Qing-Qing , Booser Daniel J. , Oke Oluchi , Brewster Abenaa M. , Hortobagyi Gabriel N. , Ibrahim Nuhad K. , Litton Jennifer K. , Valero Vicente , Arun Banu K. , Tripathy Debu , Chang Jeffrey T. , Chen Ken , Korkut Anil , Moulder Stacy L. , Huo Lei , Lim Bora , Ueno Naoto T.
Published: October 2024

Exposure to panitumumab
Figure 2 from Targeting the Epidermal Growth Factor Receptor Pathway in Chemotherapy-Resistant Triple-Negative Breast Cancer: A Phase II Study
Authors: Yam Clinton , Patel Miral , Hill Holly A. , Sun Ryan , Bassett Roland L. , Kong Elisabeth , Damodaran Senthil , Koenig Kimberly B. , Abouharb Sausan , Saleem Sadia , Bisen Ajit K. , Murthy Rashmi K. , Ramirez David L. , Rauch Gaiane M. , Adrada Beatriz E. , Candelaria Rosalind P. , Wang Xiaoping , Mittendorf Elizabeth A. , Thompson Alastair M. , White Jason B. , Ravenberg Elizabeth E. , Clayborn Alyson R. , Ding Qing-Qing , Booser Daniel J. , Oke Oluchi , Brewster Abenaa M. , Hortobagyi Gabriel N. , Ibrahim Nuhad K. , Litton Jennifer K. , Valero Vicente , Arun Banu K. , Tripathy Debu , Chang Jeffrey T. , Chen Ken , Korkut Anil , Moulder Stacy L. , Huo Lei , Lim Bora , Ueno Naoto T.
Published: October 2024

Genomic alterations and pathological response to therapy. Oncoplot showing somatic mutations in the EGFR pathway assessed by WES for each patient sample obtained at the time of diagnosis (n = 23). TMB was defined as the number of somatic mutations per megabase (Mb) of the sequenced genome.
Figure 1 from Targeting the Epidermal Growth Factor Receptor Pathway in Chemotherapy-Resistant Triple-Negative Breast Cancer: A Phase II Study
Authors: Yam Clinton , Patel Miral , Hill Holly A. , Sun Ryan , Bassett Roland L. , Kong Elisabeth , Damodaran Senthil , Koenig Kimberly B. , Abouharb Sausan , Saleem Sadia , Bisen Ajit K. , Murthy Rashmi K. , Ramirez David L. , Rauch Gaiane M. , Adrada Beatriz E. , Candelaria Rosalind P. , Wang Xiaoping , Mittendorf Elizabeth A. , Thompson Alastair M. , White Jason B. , Ravenberg Elizabeth E. , Clayborn Alyson R. , Ding Qing-Qing , Booser Daniel J. , Oke Oluchi , Brewster Abenaa M. , Hortobagyi Gabriel N. , Ibrahim Nuhad K. , Litton Jennifer K. , Valero Vicente , Arun Banu K. , Tripathy Debu , Chang Jeffrey T. , Chen Ken , Korkut Anil , Moulder Stacy L. , Huo Lei , Lim Bora , Ueno Naoto T.
Published: October 2024

Response to AC. Waterfall plot showing percent sonographic volumetric change to initial AC chemotherapy received prior to enrollment in study. One of the 43 patients enrolled in this study is not represented on this plot as an ultrasound was not done at the end of AC. Colors represent the total number of cycles of AC received prior to enrollment in study (red = 1; gray = 2; blue = 4). Horizontal dashed line indicates an 80% decrease in calculated tumor volume when compared with baseline measurements.
Blended Phenotypes of Sexual Development Disorder and Coenzyme Q10 Deficiency, Together with a Sibling with Homozygous Variants in the AHI1 Gene
Authors: Atasay Rumeysa , Yilmaz Leyla Nur , Gulec Ayten , Canpolat Mehmet , Per Huseyin , Kardas Fatih , Ozsait Selcuk Bilge , Karaman Birsen , Kiraz Aslihan , Dundar Munis
Published: October 2024

Introduction: In consanguineous marriages, different homozygous variants in a single gene may occur in the same family. This may lead to blended phenotypes. This study presents a family in which different rare mechanisms come together as a result of consanguineous marriage. Primary coenzyme Q10 deficiency is a very rare disease that occurs due to homozygous or compound heterozygous variants in the COQ4 gene. Case Presentation: A 2-year-old proband with a blended phenotype with sex development disorder and coenzyme Q (CoQ) 10 deficiency has psychomotor retardation, dysmorphic findings, hypotonia, micropenis, and bilateral cryptorchidism. The patient’s cytogenetic analysis results were compatible with SRY-positive 46,XX sex reversal disease. In the subsequent whole-exome analysis, a c.437T>G (Phe146Cys) missense homozygous probable pathogenic variant was detected in the 5th exon of the COQ4 gene (NM_016035) that explains other clinical findings. The brother of the index was previously deceased due to hydrocephalus and had a nonsense homozygous variant c.1051C>T p.(Arg351*) in the 7th exon of the AHI1 gene (NM_001134830). Discussion: Alterations in exons 5–7 of the COQ4 gene manifest early in life, resulting in neonatal fatality and a more pronounced clinical trajectory. Conversely, mutations occurring in exons 1–4 emerge later and exhibit a less severe clinical progression. Interestingly, the c.437T>G variant within exon 5 of the COQ4 gene induces comparatively milder clinical symptoms, deviating from the documented cases in the literature. To our knowledge, there is no other reported case in the literature with a blended phenotype of a sexual development anomaly and primary CoQ10 deficiency.
Immediate Versus Staged Complete Revascularization for Patients With ST‐Segment–Elevation Myocardial Infarction and Multivessel Disease: A Network Meta‐Analysis of Randomized Trials
Authors: Elbadawi Ayman , Hamed Mohamed , Gad Mohamed , Elseidy Sheref A. , Barghout Mohamed , Jneid Hani , Mamas Mamas A. , Alfonso Fernando , Elgendy Islam Y.
Published: October 2024

Background

The comparative outcomes with immediate, staged in‐hospital, and staged out‐of‐hospital complete revascularization for patients with ST‐segment–elevation myocardial infarction and multivessel disease remain unclear.

Methods and Results

An electronic search of MEDLINE, SCOPUS, and Cochrane databases was performed through August 2023 for randomized trials evaluating immediate, staged in‐hospital, and staged out‐of‐hospital complete revascularization for patients with ST‐segment–elevation myocardial infarction and multivessel disease. The primary outcome was major adverse cardiac events (MACEs). The final analysis included 9 trials with 4270 patients. The weighted follow‐up duration was 13.8 months. On pairwise meta‐analysis, there were no statistically significant differences between immediate versus staged nonculprit percutaneous coronary intervention (PCI) in MACEs (odds ratio, 0.79 [95% CI, 0.54–1.16]). Network meta‐analysis showed that there was no statistically significant difference in MACEs with staged in‐hospital nonculprit PCI (odds ratio, 1.29–[95% CI, 0.91–1.82]) compared with immediate nonculprit PCI, while there were higher odds of MACEs with out‐of‐hospital nonculprit PCI (odds ratio, 1.67–[95% CI, 1.21–2.30]) compared with immediate nonculprit PCI. Compared with immediate nonculprit PCI, there were higher odds of ischemia‐driven repeat revascularization with staged out‐of‐hospital nonculprit PCI (odds ratio, 2.26–[95% CI, 1.37–3.72]), but not with in‐hospital staged nonculprit PCI. There were no significant differences for the other outcomes among the 3 strategies.

Conclusions

Among patients with ST‐segment–elevation myocardial infarction with multivessel disease, an immediate nonculprit PCI approach was associated with similar clinical outcomes to the staged nonculprit PCI approach. The staged out‐of‐hospital nonculprit PCI approach was associated with a higher incidence of MACEs compared with the other strategies, which was driven by higher risk for ischemia‐driven repeat revascularization.
Long‐Term Durability of Transcatheter Aortic Valve Prostheses in Patients With Bicuspid Versus Tricuspid Aortic Valve
Authors: Li Hong‐De , Li Wei‐Ya , Li Jun‐Li , Peng Shi‐Qin , Feng Yuan , Peng Yong , Wei Jia‐Fu , Zhao Zhen‐Gang , Xiong Tian‐Yuan , Ou Yuan‐Wei Xiang , Wang Yan , Li Qing , Yang Hao‐Ran , Song Cheng‐Xiang , Yao Yi‐Jun , Zhu Zhong‐Kai , Liu Qi , Wang Xi , Chen Mao
Published: October 2024

Background

Currently, there is a lack of evidence for the long‐term bioprosthetic valve durability of patients with bicuspid aortic valve (BAV) following transcatheter aortic valve replacement (TAVR).

Methods and Results

This study aimed to evaluate hemodynamic outcome, structural valve deterioration, and bioprosthetic valve failure during long‐term follow‐up after TAVR in patients with BAV versus patients with tricuspid aortic valve (TAV). Patients with BAV and TAV who underwent TAVR between 2012 and 2020, with echocardiography followed for at least 3 years, were included. Baseline characteristics, long‐term valve hemodynamic performance, structural valve deterioration, and bioprosthetic valve failure were compared between patients with BAV and TAV. A total of 170 patients with BAV and 145 patients with TAV were included. The mean duration of follow‐up for patients with BAV and TAV was 5.2±1.8 and 5.0±1.7 years. No significant differences were observed in the rates of structural valve deterioration and bioprosthetic valve failure between patients with BAV and TAV: structural valve deterioration, BAV 20 (11.8%) versus TAV 16 (11.0%) at last follow‐up (
P
=0.861); bioprosthetic valve failure, BAV 3 (1.8%) versus TAV 7 (4.8%) at last follow‐up (
P
=0.196). More than moderate intravalvular aortic regurgitation (1.8% versus 4.8%,
P
=0.196) and
paravalvular leak
(6.5% versus 3.4%,
P
=0.305) were rare in both patients with BAV and patients with TAV.

Conclusions

This study indicated satisfactory long‐term valve durability of TAVR in patients with BAV. Comparable hemodynamic outcome, structural valve deterioration, and bioprosthetic valve failure could be achieved in patients with BAV and TAV during long‐term follow‐up after TAVR.
Epigenetic Study of Cohort of Monozygotic Twins With Hypertrophic Cardiomyopathy Due to MYBPC3 (Cardiac Myosin‐Binding Protein C)
Authors: Peñarroya Alfonso , Lorca Rebeca , Rodríguez Reguero José Julián , Gómez Juan , Avanzas Pablo , Tejedor Juan Ramon , Fernandez Agustín F. , Fraga Mario F.
Published: October 2024

Background

Hypertrophic cardiomyopathy is an autosomal dominant cardiac disease. The mechanisms that determine its variable expressivity are poorly understood. Epigenetics could play a crucial role in bridging the gap between genotype and phenotype by orchestrating the interplay between the environment and the genome regulation. In this study we aimed to establish a possible correlation between the peripheral blood DNA methylation patterns and left ventricular hypertrophy severity in patients with hypertrophic cardiomyopathy, evaluating the potential impact of lifestyle variables and providing a biological context to the observed changes.

Methods and Results

Methylation data were obtained from peripheral blood samples (Infinium MethylationEPIC BeadChip arrays). We employed multiple pair‐matched models to extract genomic positions whose methylation correlates with the degree of left ventricular hypertrophy in 3 monozygotic twin pairs carrying the same founder pathogenic variant (
MYBPC3
p.Gly263Ter). This model enables the isolation of the environmental influence, beyond age, on DNA methylation changes by removing the genetic background. Our results revealed a more anxious personality among more severely affected individuals. We identified 56 differentially methylated positions that exhibited moderate, proportional changes in methylation associated with left ventricular hypertrophy. These differentially methylated positions were enriched in regions regulated by repressor histone marks and tended to cluster at genes involved in left ventricular hypertrophy development, such as
HOXA5
,
TRPC3
,
UCN3
, or
PLSCR2
, suggesting that changes in peripheral blood may reflect myocardial alterations.

Conclusions

We present a unique pair‐matched model, based on 3 monozygotic twin pairs carrying the same founder pathogenic variant and different phenotypes. This study provides further evidence of the pivotal role of epigenetics in hypertrophic cardiomyopathy variable expressivity.
Effectiveness and Safety of the ESC‐TROP (European Society of Cardiology 0h/1h Troponin Rule‐Out Protocol) Trial
Authors: Mokhtari Arash , Forberg Jakob Lundager , Sandgren Jenny , Hård af Segerstad Caroline , Ellehuus Catarina , Ekström Ulf , Björk Jonas , Lindahl Bertil , Khoshnood Ardavan , Ekelund Ulf
Published: October 2024

Background

European guidelines recommend the use of a 0h/1h hs‐cTn (high‐sensitivity cardiac troponin) protocol in patients with acute chest pain. We aimed to determine the performance of this protocol in routine care when supplemented with patient history and ECG and a recommendation to refrain from noninvasive testing in low‐risk patients.

Methods and Results

This was a pre‐ and postimplementation study with concurrent controls. Patients with chest pain were enrolled at 5 Swedish emergency departments (EDs) during a 10‐month period in both 2017 and 2018. All hospitals used a 0h/3h hs‐cTnT protocol in 2017 and 3 EDs implemented a 0h/1h hs‐cTnT protocol during 10 months in 2018. The 2 coprimary outcomes were the incidence of acute myocardial infarction and all‐cause death within 30 days and ED length of stay. The study included 26 040 consecutive patients. In the intervention hospitals, 21 (0.40%) of the discharged patients had an acute myocardial infarction/death event during the control period (0h/3h testing) and 22 (0.45%) in the intervention period (0h/1h testing), which met the criteria for noninferiority. There was no significant difference in ED length of stay (ratio 0.99,
P
=0.48) or ED discharge rate between the periods in the intervention versus the control hospitals. A total of 3142 patients met low‐risk 0h/1h hs‐cTnT criteria and were discharged, of whom 2 had an acute myocardial infarction/death event.

Conclusions

A 0h/1h hs‐cTnT protocol incorporating patient history and ECG was as safe as using a 0h/3h protocol but did not reduce ED length of stay or increase the discharge rate. Refraining from noninvasive testing in patients identified as low risk was safe.

Registration

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT03421873.
Women in the Labor Force in the Arab World
Authors: Azhar Muhammad
Published: October 2024

Female participation in economic development is crucial for female empowerment. It further indicates the maturity and level of emancipation of a society. The labor market is a very significant indicator of this phenomenon. The Arab labor market has its unique features. This paper aims to study the prevailing trends in the Arab labor market. The paper has included in its scope women’s unemployment both for educated and uneducated women in the Arab world. It also brings into its ambit aspects of supply and demand. It discusses the various constraints in this context. The paper is able to locate various factors responsible for the present state of female labor participation in the Arab world.
Understanding Cycles of Protest and Elections in Lebanon
Authors: Deets Stephen , Abou Harb Larissa
Published: October 2024

While contentious politics literature links protest and voting as connected forms of claim making, in Lebanon, scholars, activists, and citizens generally have treated them as distinct phenomena, resulting in cycles of anti-system protests and elections characterized by wins by the status quo and low turnout. This unusual situation reflects how confessionalism has become deeply intertwined with neoliberalism, closing off necessary opportunity structures for change. Neoliberal policies, even while causing general harm to the average Lebanese citizen, generated high rents which sectarian parties could then distribute to supporters. To keep this system going, the collusive sectarian elite consciously and largely successfully removed economic policy as an electoral issue. By starting from how the ruling sectarian parties dominate the economy, it is possible to explain the cycles of protest and voting behavior.
Apachyus madseni (Dermaptera: Apachyidae) sp. nov. from the Ypresian Fur Formation of Denmark: the first fossil record of the enigmatic earwig family Apachyidae
Authors: SIMONSEN THOMAS J. , SYLVESTERSEN RENÉ L. , OLSEN KENT , RASMUSSEN JAN A.
Published: October 2024

We describe Apachyus madseni sp. nov. based on an almost complete fossil from the Fur Formation in northwestern Denmark. The fossil is the second Dermaptera species described from the early Ypresian Fur Formation and the first fossil representative of the enigmatic family Apachyidae. Today, Apachyidae are restricted to Central Africa, and the Orient from southern India to the Philippines and northern Australia. The new fossil thus represents not only a new addition to the fossil mo-clay fauna, but also a considerable expansion of the historical biogeographical ranges of Apachyidae.
Comparative study between the roles of intrauterine misoprostol versus the sublingual route for prevention of postpartum blood loss in elective cesarean sections: a randomized controlled trial
Authors: Atef Adel , Shehata Hadeer Salah Eldin Abdelrahman Moha , Bassiouny Yasmin Ahmed , Al-Inany Hesham Gaber
Published: October 2024

Background

The prostaglandin E1 analog “misoprostol” is a drug that has powerful ecbolic effects and can be beneficial in the prevention and treatment of postpartum hemorrhage, which is the leading cause of maternal mortality worldwide.

Objectives

To assess the value of adding intrauterine misoprostol together with intravenous oxytocin injection compared with sublingual misoprostol together with intravenous oxytocin injection during elective cesarean section to reduce blood loss intraoperatively and prevent postpartum hemorrhage.

Methods

A total of 192 pregnant women were counseled and recruited from the labor and delivery unit at Kasr Al Aini Hospital, Cairo University, and equally randomized into two groups. Group (A) included 96 women who received intrauterine misoprostol (400 mg) + oxytocin. Group (B) included 96 women who received sublingual misoprostol (400 mg) + oxytocin. The primary outcome of our study was estimation of the amount of blood loss during and after cesarean delivery. The secondary outcomes were the incidence of PPH within the first 6 h after labor, the need for blood transfusion, the need for any supplementary ecbolic drugs, the need for additional surgical intervention for PPH, changes in hematocrit and hemoglobin in both groups after delivery, and the incidence of side effects of the study medications.

Results

We observed a significant discrepancy between the two groups in terms of postoperative Hb and Hct, postoperative differences (pre- and post-Hb and post-Hct) and EBL favoring the intrauterine group. However, no significant difference was observed between the groups with respect to excessive blood loss > 1000 ml in the 1st six hours, the need for supplementary ecbolics, the necessity for blood or blood prod, the need for additional surgical intervention (for PPH) or side effects.

Conclusion

Intrauterine misoprostol combined with oxytocin intravenous infusion is more effective than sublingual misoprostol combined with oxytocin intravenous infusion in lowering intraoperative blood loss and preventing postpartum hemorrhage in elective cesarean section.

Trial registration

This trial was retrospectively registered with the ClinicalTrials.gov Registry on 12-April-2024 (registration number: NCT06364098).
‘What is the most important lesson you learnt as a neuroscience master's student?’ A single-question study in postgraduate neuroscience education
Authors: Sandrone Stefano
Published: October 2024

Introduction

Neuroscience is a young discipline and an expanding field of study and research. The number of neuroscience postgraduate courses has risen much more rapidly than in any other field of biomedical research. However, from a scholarship perspective, the master's experience has been understudied. This work focuses on the answers given by a group of neuroscience alumni, a rarely examined academic cohort, to a straightforward question: ‘What is the most important lesson you learnt as a master's student?’.

Methods

Thematic analysis was performed on 27 entries hosted by a public-facing blog of a STEM-intense university across four academic years.

Results

Four themes emerged: Skills, Theoretical knowledge, Attitudes and Community. Beyond replicating previous findings on the importance of skills and theoretical knowledge, an ‘imbalance’ between them has been reported for the first time. What emerges in our work is the overwhelming importance the alumni place in attitudes, especially resilience, and in the social/community aspects of learning, along with the role played by fellow students, faculty and laboratory colleagues.

Discussion

The master's level can be the ideal one for increasing awareness of resilience and learning how to make the most of it. Institutions should consider strategies for strengthening informal learning and supporting the development of professional identities. These findings can be of interest to a wide range of neuroscience educators and provide useful insights for designing effective postgraduate training courses. Future works can investigate the how beyond the what and explore the roles played by attitudes, emotions and feelings across neuroscientists’ career stages.
Effect of the second and third COVID-19 pandemic waves on routine outpatient malaria indicators and case management practices in Uganda: an interrupted time series analysis
Authors: Mukisa Pius , Kitutu Freddy Eric , Mpimbaza Arthur , Okiring Jaffer , Kalyango Joan N. , Nankabirwa Joaniter I.
Published: October 2024

Background

Reports on the impact of COVID-19 pandemic on the quality of malaria care and burden in sub Saharan Africa have provided a mixed picture to date. The impact of the 2nd (Delta) and 3rd (Omicron) COVID-19 waves on outpatient malaria indicators and case management practices was assessed at three public health facilities with varying malaria transmission intensities in Uganda.

Methods

Individual level data from all patients presenting to the out-patient departments (OPD) of the three facilities (Kasambya, Walukuba and Lumino) between January 2019 and February 2022 were included in the analysis. Outcomes of interest included total number of outpatient (OPD) visits, proportion of patients suspected to have malaria, proportion of suspected malaria cases tested with a malaria diagnostic test, test positivity rates (TPR) and proportion of malaria cases prescribed artemether-lumefantrine (AL). Using the pre-COVID-19 trends between January 2019 and February 2020, interrupted time series analysis was used to predict the expected trends for these study outcomes during the 2nd wave (May 2021–August 2021) and 3rd wave (November 2021–February 2022). The observed trends of the study outcomes were compared with the expected trends.

Results

There were no significant differences between the observed versus expected overall outpatient visits in the 2nd wave, however, a significant decline in OPD attendance was observed during the 3rd wave (15,101 vs 31,154; incidence rate ratio (IRR) = 0.48 [0.41–0.56]). No significant differences in the overall observed versus expected proportions of suspected malaria cases and test positivity rates in both COVID waves. However, a significant decrease in the overall proportion of suspected malaria cases tested with a malaria diagnostic test was observed during the 3rd wave (99.86% vs 99.99%; relative percent ratio [RPR] = 0.99 [0.99–0.99]). Finally, a significant decline in the overall proportion of malaria cases prescribed AL was observed during the 2nd wave (94.99% vs 99.85%; RPR = 0.95 [0.92–0.98]) but not the 3rd wave.

Conclusion

Significant declines in OPD attendance and suspected malaria cases tested with malaria diagnostic test were observed during the 3rd COVID-19 wave, while AL prescription significantly reduced during the 2nd COVID-19 wave. These findings add to the body of knowledge highlighting the adverse impact of COVID-19 pandemic on the malaria which could explain the increase in the malaria burden observed during this period.
Novel TBC1D8B variant causes neonatal nephrotic syndrome combined with acute kidney injury
Authors: Xu Yuanyuan , Dai Chao , He Jing , Liang Yaping , Zhu Ying , Deng Fang , Wang Chang , Jin Danqun
Published: October 2024

Background

Nephrotic syndrome (NPHS), characterized by proteinuria, hypoalbuminemia, and edema, can be caused by genetic variations. TBC1D8B was recently discovered as a novel disease-causing gene for X-linked NPHS. With only a few reported cases, the clinical manifestations associated with variants of this gene need to be further examined.

Methods

We recruited a newborn with NPHS complicated by acute kidney injury (AKI) and his parents and tested the potential genetic cause of the disease through trio-whole exome sequencing and Sanger sequencing. Western blotting (WB) was performed using a mutant plasmid to evaluate mutant protein expression levels. Since the TBC1D8B protein interacts with RAB proteins to catalyze the GTPase hydrolysis process, immunofluorescence (IF) can be used to verify the interaction between the TBC1D8B mutant protein and RAB11A/RAB11B, and thus to confirm its effect on the endocytosis and vesicle recycling functions of RAB proteins within the cell.

Results

The child, at 1 month, showed severe edema and proteinuria and unexplained coma with epilepsy. Ultrasound examination revealed multiple organ enlargement, and MRI showed nonspecific high diffusion-weighted imaging signal characteristics in the splenium of the corpus callosum. Hematoxylin and eosin staining showed diffuse inflammatory cell infiltration in the renal interstitium and multifocal renal tubule lumen expansion. Diffuse fusion of podocyte foot processes was observed under electron microscopy, indicating glomerular podocyte lesions. Genetic testing revealed a maternally inherited novel hemizygous variant, NM_017752: c.628 A > T, p.Lys210Ter, in TBC1D8B. In vitro functional experiments showed that this variant may lead to TBC1D8B protein degradation. IF results showed disrupted interaction with RAB11A/RAB11B, that then affects the biological function of RAB proteins in the process of cell intimal vesicle formation and intracellular transport.

Conclusion

This study will enrich the mutational and phenotypic spectra of TBC1D8B and demonstrate the potential of this gene variants to cause early-onset NPHS leading to severe kidney disease.
An introduction to causal discovery
Authors: Huber Martin
Published: October 2024

In social sciences and economics, causal inference traditionally focuses on assessing the impact of predefined treatments (or interventions) on predefined outcomes, such as the effect of education programs on earnings. Causal discovery, in contrast, aims to uncover causal relationships among multiple variables in a data-driven manner, by investigating statistical associations rather than relying on predefined causal structures. This approach, more common in computer science, seeks to understand causality in an entire system of variables, which can be visualized by causal graphs. This survey provides an introduction to key concepts, algorithms, and applications of causal discovery from the perspectives of economics and social sciences. It covers fundamental concepts like d-separation, causal faithfulness, and Markov equivalence, sketches various algorithms for causal discovery and discusses the back-door and front-door criteria for identifying causal effects. The survey concludes with more specific examples of causal discovery, e.g., for learning all variables that directly affect an outcome of interest and/or testing identification of causal effects in observational data.
Comparative Assessment of Thermal Damage Induced by Bipolar Forceps in a Bovine Liver
Authors: Çavuşoğlu Neslihan , Güngör Abuzer , Aksu Muhammed Emin , Emel Erhan , Berker Berk Burak , Doğruel Yücel , Türe Uğur
Published: October 2024

BACKGROUND AND OBJECTIVES:

Bipolar electrocautery systems in neurosurgical procedures may induce thermal damage to adjacent tissues, especially neural tissues. Therefore, it is crucial to control thermal spread from the tips of bipolar forceps into adjacent tissues. The goal of this study was to compare the thermal damage induced in unintended adjacent tissues during coagulation with 6 different bipolar forceps.

METHODS:

Fresh ex vivo bovine liver tissues were coagulated with 6 different bipolar forceps: Aesculap® nonstick, Atlas Choice™, ISOCOOL®, SilverGlide®, Spetzler™-Malis®, and VersaTru® (45 trials per bipolar forceps). For all forceps, coagulation was performed with a power setting of 35 Malis units, 1-mm tip spacing, and 3-second activation time. Tissue samples were evaluated for the extent of thermal damage (30 trials per bipolar forceps). Tissue temperatures were measured with thermocouples placed in the tissues (15 trials per bipolar forceps). The area and maximum depth of thermal damage were measured manually with image analysis software.

RESULTS:

The injury area induced by ISOCOOL® and Atlas Choice™ bipolar forceps was significantly less than that of the Aesculap® nonstick (P < .001), SilverGlide® (P < .001), Spetzler™-Malis® (P < .001), and VersaTru® (P < .001). The areas of thermal injury caused by the ISOCOOL® and Atlas Choice™ forceps were not statistically significantly different from each other (P = .08). Lesions from the ISOCOOL® and Atlas Choice™ forceps showed significantly less depth of injury than the Aesculap® nonstick (P = .001), SilverGlide® (P < .001), Spetzler™-Malis® (P < .001), and VersaTru® (P < .001). There was no statistically significant difference in the depth of thermal injury between the ISOCOOL® and Atlas Choice™ forceps (P = 1.0).

CONCLUSION:

Bipolar forceps that effectively limit excessive thermal dissipation reduce the risk of unintended injury to adjacent or peripheral tissues. In an ex vivo bovine liver model, coagulation tests with ISOCOOL® and Atlas Choice™ bipolar forceps resulted in less depth and lower mean injury areas compared with other forceps.
The Inverse Product Differentiation Logit Model
Authors: Fosgerau Mogens , Monardo Julien , de Palma André
Published: October 2024

We introduce the inverse product differentiation logit (IPDL) model, a micro-founded inverse market share model for differentiated products that captures market segmentation according to one or more characteristics. The IPDL model generalizes the nested logit model to allow richer substitution patterns, including complementarity in demand, and can be estimated by linear instrumental variable regression with market-level data. Furthermore, we provide Monte Carlo experiments comparing the IPDL model to the workhorse empirical models of the literature. Lastly, we demonstrate the empirical performance of the IPDL model using a well-known dataset on the ready-to-eat cereal market. (JEL C25, D11, D12, L66, L81)
The Status Quo and Belief Polarization of Inattentive Agents: Theory and Experiment
Authors: Novák Vladimír , Matveenko Andrei , Ravaioli Silvio
Published: October 2024

We show that rational but inattentive agents can become polarized ex ante. We present how optimal information acquisition and subsequent belief formation depend crucially on the agent-specific status quo valuation. Beliefs can systematically—in expectations over all possible signal realizations conditional on the state of the world—update away from the realized truth, and even agents with the same initial beliefs might become polarized. We design a laboratory experiment to test the model’s predictions. The results confirm our predictions about the mechanism (rational information acquisition) and its effect on beliefs (systematic polarization), and they provide general insights into demand for information. (JEL C92, D72, D83, D91)
Noncompete Agreements and the Welfare of Consumers
Authors: Lipsitz Michael , J. Tremblay Mark
Published: October 2024

Employee spin-offs harm incumbent firms by increasing competition (benefiting consumers) and preventing firm owners from making beneficial investments in workers who may later spin off (harming consumers). We model noncompete agreements (NCAs) as solutions for the firm and analyze the resulting trade-off for consumers. We show that market structure and the nature of investment play large roles. Counterintuitively, increased investment benefits have the potential to harm consumers such that industries where firms value NCAs the most are those where harm is greater. Finally, we draw two analogies between NCAs and antitrust and show how those areas inform NCA policy. (JEL D42, D43, J41, K21, L26, M13, M53)
Fair Shares and Selective Attention
Authors: Amasino Dianna R. , Pace Davide D. , van der Weele Joël J.
Published: October 2024

Attitudes toward fairness and redistribution differ along socioeconomic lines. To understand their formation, we conduct a large-scale experiment on attention to merit and luck and the effect of attention on fairness decisions. Randomly advantaged subjects pay less attention to information about true merit and retain more economic surplus, and this effect persists in subsequent impartial decisions. Attention also has a causal role: encouraging subjects to look at merit reduces the effect of an advantaged position on allocations. This suggests that attention-based policy interventions may be effective in reducing polarized views on inequality. (JEL C91, D63, D83)
Dual Moral Hazard and the Tyranny of Success
Authors: Ide Enrique
Published: October 2024

I explain why current success can undermine an organization’s ability to innovate. I consider a standard bandit problem between a safe and a risky arm with two modifications. First, a principal allocates resources. Second, an agent must install the risky arm, which is not contractible. If the principal cannot commit to a resource policy, a dual moral hazard problem emerges: The agent’s pay must be tied to the risky arm’s success to encourage installation, inducing the principal to stop experimenting with the arm prematurely. This problem intensifies as the safe arm becomes more profitable, potentially leaving the organization worse off. (JEL D21, D82, D86, O31)
Decentralized Matching with Transfers: Experimental and Noncooperative Analyses
Authors: He Simin , Wu Jiabin , Zhang Hanzhe , Zhu Xun
Published: October 2024

We experimentally examine the Becker-Shapley-Shubik two-sided matching model. In the experiment, the aggregate outcomes of matching and surplus are affected by whether equal split is in the core and whether efficient matching is assortative; the canonical cooperative theory predicts no effect. In markets with an equal number of participants on both sides, individual payoffs cannot be explained by existing refinements of the core, but are consistent with our noncooperative model’s predictions. In markets with unequal numbers of participants, noncompetitive outcomes, are not captured by the canonical cooperative model, but are included in the set of predictions in our noncooperative model. (JEL C71, C72, C78)
Kindergarten teachers’ opinions on dealing with the topic of climate change
Authors: Jõgi Kaire , Kikkas Aigi , Kiisk Marilin
Published: October 2024

Lapsepõlves omandatud käitumisel on mõju keskkonnale. Õpetajatel on laste suunamisel tähtis osa ja selle edukus sõltub õpetajate teadmistest, arusaamadest ning hoiakutest. Uurimuse eesmärk oli välja selgitada õpetajate hinnangud oma teadmistele ning arvamused kliimamuutustest ja teema käsitlemisvõimalustest lasteaias. Eesmärgi saavutamiseks vastasid juhuvalimisse sattunud õpetajad (N = 50) autorite koostatud küsimustikule. Vastajad hindasid kõrgemalt oma teadmisi kliimamuutuste põhjuste, tagajärgede ja leevendamise, aga madalamalt muutustega toimetuleku võimaluste kohta. Laste arendamisel pidasid nad oluliseks isiklikku eeskuju, kliimateemalisi üritusi ja loodusvaatlusi. Küsitletud arvasid, et kliimateadlikkuse kujundamisega võiks alustada koolieelses eas, mil on kõige tõhusam omandada uusi teadmisi ja kujundada erinevaid käitumismustreid. Samas ei olnud kolmandik vastanutest kliimamuutuste teemat lastega käsitlenud. Soovitame riiklikus õppekavas lisaks keskkonnahoidliku mõtteviisi kujundamisele sõnastada selgemalt eesmärgid, mis aitavad muutuvas kliimas toime tulla, ning pakkuda õpetajate toetamiseks teemakohaseid koolitusi.
Summary