bluuebunny/crossref_metadata_2025 huggingface dataset:
Transgender Is the Next Big Thing We Have to Really Face Psychoanalytically: What Research Can Tell Us About How Psychoanalytic, Psychodynamic and Jungian Psychotherapists Work Clinically with Transgender Clients
Authors: Full Wayne
Published: January 2025

This paper discusses the challenges and perspectives of psychoanalytic, psychodynamic and Jungian psychotherapists in thinking about and working clinically with transgender clients, based on interviews conducted by the author as part of a PhD study.
Experiences of South African Learners With Severe Intellectual Disabilities From Low Socioeconomic Backgrounds on Their Educational Challenges During the COVID‐19 Pandemic
Authors: Mudali Mandie Cecilia , Munongi Lucia
Published: January 2025

Background

The global COVID‐19 pandemic brought various challenges for learners around the world. This paper reports on the perceptions of learners with Severe Intellectual Disabilities coming from low socioeconomic backgrounds in the South African context on the educational challenges that they experienced during the COVID‐19 pandemic.

Methods

Using the qualitative research methodology, data were collected from six learners (three females and three males) using semi‐structured individual interviews.

Results

Thematic data analysis yielded four themes, namely, loss of learning time, lack of interaction with others, lack of access to resources and lack of parental support.

Conclusion

Despite the pandemic affecting every learner negatively, in this study, among those with Severe Intellectual Disabilities who came from low socioeconomic backgrounds, the challenges faced by children with severe intellectual disabilities were unique and likely worsened by having Severe Intellectual Disabilities.
Lymphocytes‐Associated Extracellular Vesicles Activate Natural Killer Cells in HNSCC
Authors: Li Chuwen , Liu Chun , Ma Hailong , Zhang Zhiyuan , Zhang Jianjun
Published: January 2025

Small extracellular vesicles (sEVs) facilitate intercellular communication and play a pivotal role in tumor progression. Accumulated evidence has indicated the diversity of sEVs but with limited results revealing the landscape of heterogeneity of sEVs. The heterogeneity of cargo RNA in sEVs presents the different cell origins and indicates different functions. Here, we analyzed the heterogeneity of sEVs at droplet levels from single‐cell RNA sequencing results of head and neck squamous cell carcinoma (HNSCC) with the previously reported algorithm SEVtras. With the sEVs secretion activity calculated by SEVtras, we also found that the T cells held the major role of sEVs secretion. In addition, we found these sEVs secreted by T cells increased the cytotoxic ability of natural killer cells (NK cells), which illustrated an indirect manner for the anti‐tumor function of T cells. These results revealed the heterogeneity of cargo RNA of sEVs in HNSCC and underlined a sEVs‐dependent manner in which T cells act on NK cells and anti‐tumor immunity.
Prevalence and Predictive Features of CT‐Derived Nonalcoholic Fatty Liver Disease in Metabolically Healthy MACS
Authors: Candemir Burcu , Kisip Kadir , Akın Şafak , Sanal Hatice Tuba , Taşar Mustafa , Candemir Mustafa , Gülçelik Neşe Ersöz
Published: January 2025

Objective

Patients with mild autonomous cortisol secretion (MACS) are at increased risk of cardiometabolic outcomes, such as hyperglycemia, metabolic syndrome, and cardiovascular diseases. Nonalcoholic fatty liver disease (NAFLD) is also associated with increased cardiometabolic risk. We aimed to investigate the prevalence and predictors of NAFLD in metabolically healthy subjects with MACS.

Methods

Forty patients with MACS and 60 patients with nonfunctioning adrenal incidentaloma (NFAI) matched for age, gender, and body mass index were included. We excluded various diseases that may lead to NAFLD, such as diabetes, cardiovascular diseases, and liver disorders. Non‐alcoholic fatty liver disease was evaluated with unenhanced abdominal computed tomography and noninvasive fatty liver indices.

Results

Patients with MACS had lower mean liver attenuation values (Hounsfield units, HU) than those with NFAI (p = 0.001). Visceral adiposity index, hepatic steatosis index, and fatty liver index were higher in the MACS group than in the NFAI group (p = 0.009, p = 0.002, p = 0.023, respectively). However, there was no significant association between the mean liver HU value and these indices. There was a significant association between serum cortisol level after the 1 mg dexamethasone suppression test (DST) and mean liver HU value independent of other traditional risk factors in various models performed in multivariable linear regression analysis.

Conclusions

Our findings suggest that MACS is associated with an increased risk of NAFLD, and serum cortisol level after 1 mg DST is an independent predictor of NAFLD in patients with MACS.
A Comparison of the Predictive Value of International Medullary Thyroid Carcinoma Grading System (IMTCGS) With That of Other Risk Factors in a Chinese Medullary Thyroid Carcinoma Cohort
Authors: Ni Jiajia , Zhang Xinyi , Liu Yalan , Ling Yan
Published: January 2025

Background

The International Medullary Thyroid Carcinoma Grading System (IMTCGS) was recently introduced in medullary thyroid carcinoma (MTC). This study aimed to assess the predictive value of the IMTCGS for disease response and survival, and compare its predictive ability with that of other traditional risk factors in a Chinese MTC cohort.

Methods

The data of 137 MTC patients undergoing initial surgery between January 2004 and June 2023 were included for analysis. Histologic features were reviewed by two pathologists. Kaplan‐Meier survival analysis and Cox proportional hazard model were performed to analyse the association between risk factors (including IMTCGS high vs low grade) and progression‐free survival (PFS) and disease‐specific survival (DSS). ROC analysis and Delong's test were used to compare the predictive ability of IMTCGS with that of other risk factors.

Results

Local recurrence, distant metastasis, and disease‐specific death were observed in 14/134 (10.45%), 3/134 (2.24%), and 6/137 (4.38%) MTC patients, respectively. IMTCGS, TNM stage, postoperative calcitonin, postoperative CEA, and vascular invasion were associated with PFS in Kaplan‐Meier survival analysis (all p < 0.05). Postoperative calcitonin was the only independent predictor for PFS in multivariate analysis (HR = 1.002, p = 0.002). ROC analysis and Delong's test showed that postoperative calcitonin had superior predictive value for structural recurrence than IMTCGS (AUC 0.90 vs. 0.64, p = 0.002). IMTCGS, TNM stage, and vascular invasion were associated with DSS in Kaplan−Meier survival analysis (both p < 0.05). In multivariate analysis, IMTCGS was the only independent predictor for DSS (HR = 11.23, p = 0.05). The AUC of IMTCGS was 0.81 (p = 0.01) for disease‐specific death.

Conclusion

In this Chinese MTC cohort, IMTCGS was a powerful predictor of disease‐specific death, while postoperative calcitonin was a powerful predictor of structural recurrence.
Novel Phenotypes and Genotype–Phenotype Correlations in a Large Clinical Cohort of Patients With Kleefstra Syndrome
Authors: Frazier Zoë J. , Kilic Seyda , Osika Hailey , Mo Alisa , Quinn Meg , Ballal Sonia , Katz Tamar , Shearer A. Eliot , Horlbeck Max A. , Pais Lynn S. , Dies Kira A. , O'Donnell‐Luria Anne , Kossowsky Joe , Lipton Jonathan O. , Kleefstra Tjitske , Srivastava Siddharth
Published: January 2025

Kleefstra syndrome (KLEFS) is a genetic neurodevelopmental disorder caused by haploinsufficiency of EHMT1. The full spectrum of clinical features and genotype–phenotype correlations is currently not fully understood. We performed a retrospective chart review of patients with KLEFS evaluated at the Boston Children's Hospital Kleefstra Clinic. There were 65 individuals (40 females, 25 males, mean age 9.3 years). 17% had large 9q34 deletions (≥ 1 Mb), 29% had small 9q34 deletions (< 1 Mb), and 54% had sequence variants. Global developmental delay (GDD) or intellectual disability (ID) was present in 77%. Behavioral disorders, such as autism spectrum disorder (38%), were common. Epilepsy affected 15%. Systemic health issues included structural cardiac defects (40%), hearing loss (32%), and constipation (31%). Novel features including subgroups with significant motor impairment (24%) and refractory epilepsy (9%), as well as small numbers with opsoclonus‐like eye movements (n = 2), thrombocytopenia (n = 2), progressive cerebral atrophy (n = 1), and adrenal carcinoma (n = 1). 9q34 deletion subgroups had higher rates of GDD/ID (p = 0.037), significant motor impairment (p = 0.01), epilepsy (p = 0.004), and cortical visual impairment (p = 0.003) compared to the subgroup with sequence variants. This information may be used to improve clinical care as well as inform research and future therapeutic initiatives.
S‐Nitrosylation of Dexras1 Controls Post‐Stroke Recovery via Regulation of Neuronal Excitability and Dendritic Remodeling
Authors: Han Zhou , Song Yixuan , Qin Cheng , Zhou Haihui , Han Dan , Yan Simin , Ni Huanyu
Published: January 2025

Aims

Stroke is a major public health concern leading to high rates of death and disability worldwide, unfortunately with no effective treatment available for stroke recovery during the repair phase.

Methods

Photothrombotic stroke was induced in mice. Adeno‐associated viruses (AAV) were microinjected into the peri‐infarct cortex immediately after photothrombotic stroke. Grid‐walking task and cylinder task were used to assess motor function. Western blotting, Golgi staining, and electrophysiology recordings were performed to uncover the mechanisms.

Results

The ternary complex of neuronal nitric oxide synthase (nNOS), carboxy‐terminal PDZ ligand of nNOS (CAPON) and dexamethasone‐induced ras protein 1 (Dexras1) is structurally beneficial for S‐nitrosylation of Dexras1 (SNO‐Dexras1). In our previous study, uncoupling nNOS‐CAPON interaction by Tat‐CAPON‐12C promoted functional recovery after stroke. Here, we show that ischemia elevated the levels of nNOS‐Dexras1 complex and SNO‐Dexras1 in the peri‐infarct cortex in the days 4–10 after stroke induction, and as excepted, Tat‐CAPON‐12C, a peptide disrupting nNOS‐CAPON interaction, significantly reversed these changes. The above information implies that repressed SNO‐Dexras1 may mediate functional‐promoting effects of Tat‐CAPON‐12C and SNO‐Dexras1 could be the vital molecular substrate for post‐stroke functional recovery in the repair phage. Inhibiting the ischemia‐induced SNO‐Dexras1 by AAV vector‐mediated knockdown of Dexras1 or over‐expression of dominant negative Dexras1 (Dexras1‐C11S) produced sustained recovery of motor function from stroke. In contrast, up‐regulation of SNO‐Dexras1 by over‐expressing Dexras1 worsened stroke outcome. Using electrophysiology recordings, we also observed that silence of Dexras1 in the peri‐infarct cortex increased the spike number and the miniature excitatory postsynaptic currents (mEPSCs) frequency, suggesting enhancement of neuronal excitability. In addition, silence of Dexras1 increased dendritic complexity in cultured neuron and more importantly enhanced dendritic spine density in the peri‐infarct cortex, implying dendritic remodeling.

Conclusion

Thus, inhibition of SNO‐Dexras1 positively regulates post‐stroke functional recovery via enhanced neuronal excitability and dendritic remodeling. Our results identify that SNO‐Dexras1 may serve as a novel target for promoting motor functional restoration from stroke in the delayed phase, shedding light on stroke treatment.
Internal Disruption: Examining the Relationship Between Interim CEO Successions and Executive Turnover
Authors: Langan Robert , Deuschel Nicolas
Published: January 2025

Research Question/Issue

Although research on interim CEO successions has increased, there remains limited knowledge about what internal repercussions interim CEO appointments have on firms, notably on incumbent executives. This study seeks to understand whether and how interim CEO appointments are related to executive turnover, focusing on the role and involvement of the board in the interim succession process.

Research Findings/Insights

Interim CEO successions are related to higher executive turnover compared to direct CEO successions. This turnover is further augmented either when the preceding CEO was fired or when the interim CEO is also the board chair. We also find that, when the preceding CEO was fired, the executive turnover related to interim CEO successions is related to poorer subsequent firm performance.

Theoretical/Academic Implications

This research fills an important gap in the interim CEO succession literature, focusing on the internal repercussions of interim CEO appointments, particularly how incumbent executives may be affected and how this may influence firm performance. It reconciles the view that interim CEOs may engage in limited decision‐making, whereas the board uses the interim period to plan for the firm's future.

Practitioner/Policy Implications

This paper highlights the potential disruptions caused by interim CEO successions and offers some insights into how these may affect executives and firm performance. Moreover, this paper acts as a guide for stakeholders on the nuanced governance decisions around interim CEO appointments.
Thermochromic paint with three‐stage colour transition effect based on thermochromic microcapsules and its crosslinking modification
Authors: Tang Jingli , Wang Yichao , He Mengjuan , Huang Liqian , Wang Xueli , Yu Jianyong
Published: January 2025

To expand the colour change range of thermochromic materials, two types of thermochromic microcapsules (TCMs) with different colour change temperatures and effects were utilised to prepare a TCMs blending system exhibiting a three‐stage colour transition at temperatures ranging from 10 to 60°C. Thermochromic paints were then prepared based on this TCMs blending system using a modified waterborne polyurethane (WPU). The thermochromic properties of the TCMs blending system and the impact of crosslinking modification on the coating properties were investigated. The findings revealed that the ratio of TCMs influences the colour change effect and temperature of the blending system. With temperature variations, the colour of the TCMs blending system can reversibly transition between blue, green and yellow, offering a more vibrant thermochromic effect compared with conventional thermochromic materials. The modified WPU enabled the preparation of paint from the blending system, which was applied to fabric surfaces to create multistage thermochromic fabrics. The mechanical properties, water resistance and adhesion of the modified coating were enhanced, and the colour fastness to washing of the fabrics improved by two grades. This study has practical significance for the application of TCMs and the development of colour‐changing textiles.
Genomic Introgression Between Critically Endangered and Stable Species of Darwin's Tree Finches on the Galapagos Islands
Authors: Dudaniec Rachael Y. , Yadav Sonu , Catchen Julian , Kleindorfer Sonia
Published: January 2025

Natural hybridisation among rare or endangered species and stable congenerics is increasingly topical for the conservation of species‐level diversity under anthropogenic impacts. Evidence for beneficial genes being introgressed into or selected for in hybrids raises concurrent questions about its evolutionary significance. In Darwin's tree finches on the island of Floreana (Galapagos Islands, Ecuador), the Critically Endangered medium tree finch (Camarhynchus pauper) undergoes introgression with the stable small tree finch (Camarhynchus parvulus), and hybrids regularly backcross with C. parvulus. Earlier studies in 2005–2013 documented an increase in the frequency of Camarhynchus hybridisation on Floreana using field‐based and microsatellite data. With single nucleotide polymorphism (SNP) data from the same Floreana tree finches sampled in 2005 and 2013 (n = 95), we examine genome‐wide divergence across parental and hybrid birds and evidence for selection in hybrids. We found that just 18% of previously assigned hybrid birds based on microsatellites could be assigned to hybrids using SNPs. Over half of the previously assigned hybrids (63%) were reassigned to C. parvulus, though parental species showed concordance with prior assignments. Of 4869 private alleles found in hybrid birds, 348 were at a high frequency (≥ 0.30) that exceeded their parental species of origin 89%–96% of the time. For private alleles detected in both years (N = 536) between 11%–76% of alleles underwent a frequency increase and 13%–61% a frequency decrease between 2005 and 2013, which was sensitive to sampling effort. We identified 28 private alleles that were candidates under selection via local PCA and outlier tests. Alleles were annotated to genes associated with inflammation, immunity, brain function and development. We provide evidence that introgression among a critically endangered and stable species of Darwin's tree finch across years may aid in the retention of adaptive alleles and genetic diversity in birds threatened with extinction.
Body mass index affects imatinib exposure: Real‐world evidence from TDM with adaptive dosing
Authors: Maroselli Paul , Fanciullino Raphaelle , Colle Julien , Farnault Laure , Roche Pauline , Venton Geoffroy , Costello Régis , Ciccolini Joseph
Published: January 2025

Background

Imatinib is the treatment of elderly or frail patients with chronic myeloid leukemia (CML). Trough levels of around 1000 ng/ml are considered as the target exposure.

Objectives

We searched for baseline parameters associated with imatinib pharmacokinetics, and studied the clinical impact of subsequent adaptive dosing.

Methods

We present data from 60 adult CML patients upon imatinib with therapeutic drug monitoring (TDM) and adaptive dosing.

Results

Mean trough levels after treatment initiation were 994.2 ± 560.6 ng/ml with 56% inter‐patient variability). Only 29% of patients were in the therapeutic range. Body weight, height, body surface area, body mass index (BMI), and age were associated with imatinib plasma levels on univariate analysis. Age and BMI remained the only parameters associated with imatinib trough levels on multivariate analysis. As severe toxicities have been previously reported in patients with low BMI treated with standard imatinib, we evaluated the extent to which low BMI may lead to plasma overexposure. We found a statistically significant difference in trough imatinib levels in patients with BMI < 18.5 kg/m2, with exposure +61.5% higher than in patients with 18.5 < BMI ≤  24.9 and +76.3% higher than in patients with BMI ≥ 25. After TDM with adaptive dosing, a statistically significant difference in dosing between patients was observed, with doses ranging from 200 to 700 mg. No difference in toxicity or efficacy was observed regardless of BMI after adaptive dosing.

Conclusion

Our data suggest that low BMI has a significant impact on imatinib exposure but that pharmacokinetically‐guided dosing limits its clinical impact in patients.
Pollinator visits increase with bloom amount but decline with building height on extensive green roofs
Authors: Underwood Shannon M. , Sookhan Nicholas , Hung Keng‐Lou James , MacIvor J. Scott
Published: January 2025

Green roofs provide foraging and nesting resources for pollinators that would otherwise be absent. However, green roofs are isolated from ground level, limiting habitat to only species that can reach them. In Eastern North America, green roof design often prioritises water conservation and plant survival, and so species in the genera Sedum and Phedimus (hereafter, stonecrops) that are hardy and drought tolerant are mainly planted.

The purpose of this study was to investigate how building height and bloom amount shape flower‐visiting insect communities on extensive green roofs (EGRs). Bees, wasps, and flies (hereafter, pollinators) were surveyed on five plant species (four non‐native stonecrops: Sedum acre, Sedum album, Phedimus kamtschaticus, Phedimus spurius, and one native herbaceous plant: Rudbeckia hirta) from six EGRs and two replicated ground‐level control sites in 2019.

We identified 26 pollinator species and found that stonecrops and Rudbeckia showed distinct blooming periods, with the stonecrops flowering from June to August and Rudbeckia from August to September. Percent flowering stonecrops during the early bloom was significantly positively correlated with bee abundance and species richness. Pollinator communities determined from distinct stonecrop species were compositionally more alike to one another than R. hirta. The inclusion of R. hirta lengthened the bloom period of stonecrop‐dominated EGRs and attracted five additional bee species. We further determined that pollinator abundance and species richness were negatively correlated with building height.

Despite its limited scope, our data suggest that pollinator habitat design on EGRs should prioritise low‐rise buildings and flowering species with abundant blooms that occur at different times than stonecrops, ensuring complementary flowering periods.
Recognition of Self and Viral Ligands by NK Cell Receptors
Authors: Mariuzza Roy A. , Singh Pragya , Karade Sharanbasappa S. , Shahid Salman , Sharma Vijay Kumar
Published: January 2025

Natural killer (NK) cells are essential elements of the innate immune response against tumors and viral infections. NK cell activation is governed by NK cell receptors that recognize both cellular (self) and viral (non‐self) ligands, including MHC, MHC‐related, and non‐MHC molecules. These diverse receptors belong to two distinct structural families, the C‐type lectin superfamily and the immunoglobulin superfamily. NK receptors include Ly49s, KIRs, LILRs, and NKG2A/CD94, which bind MHC class I (MHC‐I) molecules, and NKG2D, which binds MHC‐I paralogs such MICA and ULBP. Other NK receptors recognize tumor‐associated antigens (NKp30, NKp44, NKp46), cell–cell adhesion proteins (KLRG1, CD96), or genetically coupled C‐type lectin‐like ligands (NKp65, NKR‐P1). Additionally, cytomegaloviruses have evolved various immunoevasins, such as m157, m12, and UL18, which bind NK receptors and act as decoys to enable virus‐infected cells to escape NK cell‐mediated lysis. We review the remarkable progress made in the past 25 years in determining structures of representatives of most known NK receptors bound to MHC, MHC‐like, and non‐MHC ligands. Together, these structures reveal the multiplicity of solutions NK receptors have developed to recognize these molecules, and thereby mediate crucial interactions for regulating NK cytolytic activity by self and viral ligands.
Nurses' Perception of Their Role in Leading Nurse‐Led Interventions in Intrinsic Capacity Assessment to Improve Nursing Care of Older Adults
Authors: Goh Si Hui Elaine , Zhang Di , Tan Khim Hee , Koh Siew Lin Serena
Published: January 2025

Aim

To explore nurses' perceptions of their role in leading nursing interventions for each domain of intrinsic capacity, based on the Integrated Care for Older People (ICOPE) framework to enhance care for older adults in acute settings.

Design

A qualitative descriptive design was adopted.

Methods

Conducted in a Singapore acute hospital from August to November 2023, recruited 21 inpatient nurses with at least 2 years of experience through purposive sampling. Data were collected via semi‐structured interviews with 20 participants and one pilot participant. Inductive thematic analysis identified themes from the responses.

Results

Four key themes emerged regarding nurses' roles in implementing the ICOPE framework: (1) Creating Awareness: emphasises communication to enhance understanding of ICOPE; (2) Providing Education: highlights structured educational initiatives; (3) Executing ICOPE: recognises nurses' role in interventions amid autonomy and workload challenges; and (4) Gathering Feedback: ensuring continuous input to enhance care quality.

Conclusion

The findings emphasise nurses' roles within the ICOPE framework, advocating for empowerment and collaboration to enhance care quality for older adults in acute settings.

Implications

This study highlights the need for nurses to understand their roles and independently lead nurse‐led interventions. Healthcare institutions should facilitate this empowerment by reviewing existing nursing assessments to avoid duplication and optimise nurses' integration into the framework.

Impact

This study demonstrates the feasibility of the ICOPE framework in Singapore, empowering nurses to initiate interventions that enhance older adults' care and intrinsic capacity.

Reporting Method

Adheres to the COREQ guidelines for qualitative research.

Patient or Public Contribution

None.
A case of third trimester uterine prolapse resulting in vaginal delivery by placement of an intravaginal balloon
Authors: Tezuka Satoshi , Fukuhara Ken , Terai Yusaku , Tanaka Yu , Kiyokawa Hikaru , Honda Tetsuro
Published: January 2025

Pregnancies complicated by uterine prolapse are rare, occurring in 1 in 10 000 to 15 000 deliveries. We report a case of uterine prolapse at 36 weeks of gestation that resulted in vaginal delivery by placement of a colpeurynter (intravaginal balloon). The patient was a 33‐year‐old pregnant woman with a history of uterine prolapse during her previous pregnancy. At 36 weeks and 4 days of gestation, she presented to her previous physician with uterine prolapse and genital bleeding. Due to severe edema of the uterine cervix, she was referred to our hospital for specialized care. The cervix was manually repositioned into the vagina and the patient was discharged. Concerned about recurrence of uterine prolapse and cervical incarceration at delivery, labor was induced at 39 weeks and 5 days of gestation by oral prostaglandin preparations with concurrent placement of a colpeurynter, resulting in vaginal delivery. Colpeurynter placement is a simple procedure and may be useful in preventing uterine prolapse at delivery.
Learning processes as mediators of the impact of workplace coaching interventions on goal attainment
Authors: Antoni Conny H. , Tatar Alexandra
Published: January 2025

This study contributes to research on how workplace coaching works by examining learning processes as a mediating mechanism of the impact of problem‐specific interventions on goal attainment. This has rarely been investigated. Fifty‐five coach–coachee dyads with 51 coaches and 55 coachees participated in the study. Workplace coaching lasted seven to eight coaching sessions in average. Coaches and coachees gave ratings in each session. We analysed this data (NLevel2 = 55, NLevel1 = 335–407) using longitudinal multilevel structural equation modelling accounting for the nested data structure. As expected, coachees' perceived goal attainment increased throughout the coaching process. The results of the study also revealed the mediating role of learning processes in the impact of problem‐specific interventions, specifically clarification of meaning and mastery/coping, and, but to a lesser extent, implementation actuation, on goal attainment in coaching. Data for all hypothesised models showed a good or acceptable model fit. In contrast, the model fit was poor, when we explored differential mediation effects, which supported only single‐loop learning as a mediator. These results underscore the importance of stimulating learning processes through specific interventions to improve the effectiveness of workplace coaching.
A European Survey to Identify Challenges in the Management of Metabolic Dysfunction‐Associated Steatotic Liver Disease
Authors: Castera Laurent , Alazawi William , Bugianesi Elisabetta , Caussy Cyrielle , Federici Massimo , Romero‐Gómez Manuel , Schattenberg Jörn M. , Basuroy Ron , Prasad Preethy , Estulin Dmitry , Lazarus Jeffrey V.
Published: January 2025

Background and Aims

Metabolic dysfunction‐associated steatotic liver disease (MASLD) and its more severe subtype, metabolic dysfunction‐associated steatohepatitis (MASH), are highly prevalent and strongly associated with obesity and type 2 diabetes (T2D). This study sought to identify challenges to the diagnosis, treatment and management of people living with MASLD and MASH and understand the key barriers to adopting relevant clinical guidelines.

Methods

A real‐world, cross‐sectional study (BARRIERS‐MASLD) consisting of a quantitative survey and qualitative interviews of physicians in France, Germany, Italy, Spain and the United Kingdom was conducted from March to September 2023. Descriptive statistics were used for data analysis.

Results

A total of 626 physicians completed the survey; n = 10 from each country participated in the qualitative interviews. Physicians considered the presence of MASH to be highly impactful on how they treated people living with obesity (66%) and T2D (69%). Over one‐third (35%) of the respondents could not identify any MASH‐specific clinical guidelines issued by medical societies or associations top‐of‐mind, but overall awareness rose when prompted about country‐specific guidelines. Physicians said they would need evidence of success (48%) and clinical guidelines that address common MASLD comorbidities (38%) to increase their adoption.

Conclusions

This study found that lack of awareness around MASLD and MASH clinical guidelines and clearly established care pathways, particularly for addressing common comorbidities, was a key factor preventing physicians from optimising care for people living with MASH in Europe. This research highlights opportunities to improve education and training about clinical guidelines and care coordination.
Prognostic Implications of Cardiac Geometry in Cirrhosis: Findings From a Large Cohort
Authors: Jia Yu , Liu Lidi , Zhou Yiheng , Yao Yi , Cheng Yu , Cheng Yonglang , Shen Can , Yang Rong , Zeng Rui , Wan Zhi , Zhao Qian , Li Dongze , Yuan Bo , Liao Xiaoyang
Published: January 2025

Background and Aims

Cirrhosis is characterised by hyperdynamic circulation, which contributes to cirrhotic cardiomyopathy (CCM). However, the expert consensus on CCM did not initially include cardiac structure because of scant evidence. Therefore, this study investigated the associations of cardiac chamber geometry with mortality and CCM.

Methods

We retrospectively included 2514 cirrhotic patients from 2011 to 2023. In accordance with the guidelines for echocardiography, left ventricular (LV) hypertrophy (LVH) and LV, left atrial (LA), right ventricular (RV), and right atrial (RA) enlargement were evaluated. Cox and logistic regression analyses were performed to examine the relationships among cardiac chamber, all‐cause mortality, and CCM.

Results

The prevalence rates of LV hypertrophy and LV, LA, RV, and RA enlargement were 21.9%, 21.3%, 30.4%, 5.9%, and 10.9%, respectively. Concentric LVH (HR: 1.305, 95% confidence interval (CI): 1.153–1.466), eccentric LVH (HR: 1.272, 95% CI: 1.139–1.426), LV enlargement (HR: 1.305, 95% CI: 1.153–1.466), and LA enlargement (HR: 1.254, 95% CI: 1.130–1.379) were significantly associated with mortality during the median follow‐up of 2.1 years. In a subcohort of 1898 individuals, CCM, with a prevalence of 29.0%, was independently associated with concentric LVH (OR: 1.834, 95% CI: 1.214–2.707), eccentric LVH (OR: 3.063, 95% CI: 2.379–3.903), LV enlargement (OR: 2.519, 95% CI: 2.150–2.977), LA enlargement (OR: 3.559, 95% CI: 2.770–4.321), and RA enlargement (OR: 1.416, 95% CI: 1.025–1.915). LV abnormalities showed 90% specificity and 35% sensitivity for CCM diagnosis.

Conclusions

Geometric pattern changes in the LV and LA are prevalent and independently associated with all‐cause mortality and CCM. These indicators have potential for hazard stratification and CCM redefinition.
Factors Associated With Prelacteal Feeding of Commercial Milk Formula: An Analysis of Cohort Data From the BADUTA Study in Indonesia
Authors: Nurokhmah Siti , Htet Min Kyaw , Ferguson Elaine , Dibley Michael J. , Fahmida Umi
Published: January 2025

Introducing commercial milk formula (CMF) as prelacteal feeds can disturb exclusive breastfeeding and shorten breastfeeding duration. However, the prelacteal feeding of CMF has been growing alongside its increasing sales in Indonesia. This study examined predictors of the CMF feeding in the Malang and Sidoarjo districts of Indonesia. This analysis used post‐delivery data collected from 676 mothers in a cohort evaluation of a cluster randomised controlled trial (Baduta study). Multivariate random effects logistic models were employed to assess factors associated with the CMF feeding. A total of 467 (69.1%) respondents reported giving CMF to their infants during the first 3 days after delivery. Mothers with low breastfeeding self‐efficacy (BFSE) were at a higher risk of providing CMF within 3 days of birth compared to those with medium or high BFSE (adjusted odds ratio (aOR) 8.12; 95% confidence interval (CI) (4.26–15.48). Receiving explanations to solve breastfeeding problems from health professionals (aOR: 1.87; 97% CI: 1.12–3.11) and primipara parity (aOR: 1.71; 95% CI: 1.12–3.04) were positively associated with the CMF feeding. Early initiation of breastfeeding (EIBF) was protective against CMF feeding (aOR: 0.40; 95% CI: 0.22–0.58). There was an interaction between EIBF and BFSE. EIBF was protective among mothers with high or medium BFSE, but had no effect among those with low BFSE. CMF feeding was prevalent in Indonesia. Future strategies should focus on improving health‐staff capacity to strengthen BFSE during pregnancy and provide adequate counselling for mothers with breastfeeding problems.
Sex Differences, Menses‐Related Symptoms and Menopause in Disorders of Gut–Brain Interaction
Authors: Sarnoff Rachel P. , Hreinsson Johann P. , Kim Joanna , Sperber Ami D. , Palsson Olafur S. , Bangdiwala Shrikant I. , Chang Lin
Published: January 2025

Background

Disorders of gut–brain interaction (DGBI) predominate in women, but little is known about sex differences in menses‐related or menopause symptoms.

Methods

Using data from the Rome Foundation Global Epidemiology Survey, we assessed Rome IV DGBI symptoms in individuals in 26 countries who met criteria for ≥ 1 of 5 DGBI: irritable bowel syndrome (IBS), functional dyspepsia (FD), functional constipation (FC), functional diarrhea (FDr), or functional bloating (FB). Participants included pre‐ and post‐menopausal women with DGBI and age‐matched men. Odds ratios estimated sex and age differences for symptom by sex or pre‐ vs. post‐menopause in logistic regression; standardized mean difference (SMD) provided effect sizes.

Key Results

14,570 participants met criteria for ≥ 1 of the 5 DGBI. Women exceeded men in most symptoms. In FD, women stopped eating due to early satiety more than men (11.1 vs. 8.9 days/month, SMD 0.21). Symptoms were generally increased in premenopausal women and younger men compared to older counterparts; however, only premenopausal IBS, FD, and FC women reported increased constipation‐associated symptoms. Compared to premenopausal women, postmenopausal women had increased accidental stool leakage in IBS and FDr, and increased digital manual maneuvers in FC (18% vs. 25% frequency, SMD −0.25). IBS and FD had the most menses‐associated symptoms.

Conclusions and Inferences

Women had higher symptom frequency across the 5 DGBI compared to men. Our findings suggest that premenopausal women have greater visceral perception than postmenopausal women, although increased outlet symptoms in postmenopausal women indicate greater anorectal/pelvic dysfunction. While age alone has some influence on symptoms, female sex hormones may also increase visceral perception.
Clients' experiences of psychotherapeutic interventions addressing trauma
Authors: Lepistö R. , Ahmad A. , Kangaslampi S. , Peltonen K.
Published: January 2025

Purpose

This systematic review aimed to evaluate and synthesise qualitative research on adult clients' experiences of psychotherapeutic interventions addressing trauma across multiple modalities.

Methods

Six databases (PsycINFO, MEDLINE, The Cochrane Central Register of Controlled Trials, Web of Science, Scopus, and CINAHL) were systematically searched. Google Scholar and reference lists of included and other relevant reviews were also searched, and in total 37 studies met the inclusion criteria. Relevant data were extracted, quality assessed following the Critical Appraisal Skill Programme checklist, and data synthesised using thematic synthesis.

Results

The specific helpful factors and perceived impact of the interventions aligned with their theoretical bases. Certain factors were perceived to be helpful or challenging regardless of the modality used, such as relational factors between the client and the therapist, and within group settings. Towards the end of the interventions, feelings of ambivalence and emotional struggles which pervaded the process gradually resolved, as a majority of the clients expressed a sense of benefit from the whole experience. Most of the studies included in this review were published post‐2020, underscoring research interest towards clients' psychotherapeutic experiences.

Conclusions

The review provides a comprehensive understanding of helpful and challenging factors of interventions addressing trauma, as perceived by clients. The analysis serves as a foundation for future intervention development. Also, it highlights the importance of therapist responsiveness and discussions with clients at various intervention stages to foster a sense of safety, prevent early drop‐outs, and emphasise clients as agents of change in their therapeutic process.
Exploration of Psychological, Social, and Familial Issues of Females Living in the Shelter in Iraqi Kurdistan Through an Art‐Based Qualitative Study
Authors: Abdulla Bayar Mohammed Omar , Abdulah Deldar Morad , Mustafa Zuhair Rushdi
Published: January 2025

Objective

Female young prisoners may not be willing to discuss their familial and social issues through direct interviews. Therefore, other academic techniques, such as art‐based techniques, could be used in this context. We aimed to explore female prisoners' psychological, familial, and social issues through an art‐based approach.

Methods

In this thematic qualitative study, we conducted a 2‐h painting training program for females (21–48 years) who were confined in women's shelters in the Kurdistan Region. To carry out this initiative, we collaborated with the administration of women's prisoners in Duhok, Erbil, and Sulaymaniyah governorates in the Kurdistan Region.

Results

The paintings included in this study explored the social and familial issues faced by girls and women who were imprisoned for various reasons. The paintings of the participants were categorized under the following three main headings: familial issues, social pressure, and women's rights. The artwork expresses that these girls and women suffer from a wide range of familial and social issues. They share that they lack the rights, as men do, to discuss their opinions and feelings within their societies and families. Additionally, these women experience pressure from their families and society for various reasons, as mentioned hereafter.

Conclusions

This study revealed that the lack of meeting females' rights and their inability to practice their wishes and rights could be the main reason for the familial and social issues in Kurdish society. The findings suggest that the restrictions and limitations placed on women's agency and autonomy contribute significantly to the challenges and hardships faced by women within their families and communities. Addressing these issues and promoting gender equality may be essential in fostering a more inclusive and harmonious society in the Kurdistan region.
From Micro to Macro: Understanding the Far‐Reaching Consequences of B12 Deficiency on Women's Health
Authors: Zacharias Betsy Sara , Upendra Sheela , Dumbre Dipali
Published: January 2025

Background

Vitamin B12 (B12), playing the role of a coenzyme in one‐carbon metabolism, is an important vitamin necessary for human health.

Objectives

To systematically review evidence to identify the complications of B12 deficiency among women.

Methods

We conducted a systematic search of quantitative studies on disorders associated with B12 deficiency among women, published in English in the last 25 years (1999–2024), using electronic databases such as Scopus, Web of science, CINAHL, PubMed, and Medline.

Conclusion

The search produced 28 full‐text articles. B12 deficiency prevalence among women identified by the selected studies ranges from 0.6% to 45.5%. The deficiency of B12 is connected with the risk for depression/post‐partum depression, breast cancer, recurrent pregnancy loss, gestational diabetes mellitus, insulin resistance, and obesity among women. It is necessary to monitor and correct the B12 deficiency among women in order to prevent complications
The Effect of Motivational Interview‐Based Education on Nutrition Exercise Behavior, Sedentary Activity Duration, and Anthropometric Outcomes in Obese Adolescents
Authors: Evcimen Hasan , Bilgin Sonay
Published: January 2025

Purpose

The aim of this study was to examine the effect of motivational interview‐based training on nutrition exercise behavior, sedentary behavior duration, and anthropometric outcomes in adolescents.

Method

This randomized controlled single‐blind experimental study was conducted between January 2021 and March 2023. The research sample consisted of 76 adolescents with obesity (intervention: 38 and control: 38) determined by power analysis. The intervention group received a 6‐session motivational interview‐based training program. No intervention was applied to the control group. Data were collected using a personal information form, nutrition exercise behavior scale, adolescent sedentary activity questionnaire, and body mass ındex measurement form. Data collection tools were administered to both groups before the intervention, at the last session and at the 3rd month follow‐up. In the analysis of the data, chi‐square test, independent sample t‐test and two‐way mixed design ANOVA were used.

Results

There was no statistically significant difference between the pretest nutrition exercise behavior scale, sedentary activity questionnaire, and body mass index z‐scores of the intervention and control groups (p > 0.05). After the motivational interview‐based education program, nutrition exercise behaviors improved (p: 0.00), sedentary behavior duration and BMI decreased (p: 0.00) in the intervention group. No significant difference was observed in the control group. Nutritional exercise behavior, duration of sedentary behavior and BMI values of the intervention group showed a significant difference compared to the control group (p: 0.00).

Conclusıon

It was determined that motivational interviewing applied to adolescents with obesity created a positive change on nutritional exercise behavior, sedentary behavior durations, and anthropometric results. It is recommended that nurses should use motivational interviewing in the management of nutrition and exercise behaviors of adolescents with obesity.

Trial Registration: Clinical Trials ID: NCT05268653.
Amino acid substrate specificities and tissue expression profiles of the nine CYP79A encoding genes in Sorghum bicolor
Authors: Koleva Donka Teneva , Liu Mengqi , Dusak Barbara , Ghosh Stavaniya , Krogh Camilla Timmermann , Hellebek Ida Rye , Cortsen Mathilde Troensegaard , Motawie Mohammed Saddik , Jørgensen Flemming Steen , McKinley Brian Adam , Mullet John E. , Sørensen Mette , Møller Birger Lindberg
Published: January 2025

Cytochrome P450s of the CYP79 family catalyze two N‐hydroxylation reactions, converting a selected number of amino acids into the corresponding oximes. The sorghum genome (Sorghum bicolor) harbours nine CYP79A encoding genes, and here sequence comparisons of the CYP79As along with their substrate recognition sites (SRSs) are provided. The substrate specificity of previously uncharacterized CYP79As was investigated by transient expression in Nicotiana benthamiana and subsequent transformation of the oximes formed into the corresponding stable oxime glucosides catalyzed by endogenous UDPG‐glucosyltransferases (UGTs). CYP79A61 uses phenylalanine as a substrate, whereas CYP79A91, CYP79A93, and CYP79A95 use valine and isoleucine as substrates, with CYP79A93 showing the ability also to use phenylalanine. CYP79A94 uses isoleucine as a substrate. Analysis of 249 sorghum transcriptomes from two different sorghum cultivars showed the expression levels and tissue‐specific expression of the CYP79As. CYP79A1 is the committed gene in dhurrin formation and was the highest expressed gene in most tissues/organs. CYP79A61 was primarily expressed in fully developed leaf blades and leaf sheaths. CYP79A91 and CYP79A92 were expressed mainly in roots >200 cm below ground, while CYP79A93 and CYP79A94 were most highly expressed in the leaf collar and leaf sheath, respectively. The possible signalling effects of the oximes and their metabolites produced in different sorghum tissues are discussed.
Placenta accreta spectrum: imaging and diagnosis
Authors: Self Alice , Cavallaro Angelo , Collins Sally L.
Published: January 2025

Key content

Antenatal imaging is a screening tool integral to ensuring women are cared for in the most appropriate setting.

The pretest probability of PAS should be considered before any imaging is performed.

PAS is an iatrogenic disease. Any process which disrupts the endometrium increases the risk. Caesarean birth is the most common cause.

Specialist placental assessment in asymptomatic women should be offered between 24 and 28 weeks.

Ultrasound and MRI have similar diagnostic value, and MRI should only be used as an adjunct following ultrasound assessment by a specialist in placental imaging.

Learning objectives

To understand the pathophysiology of PAS.

To understand the distinction between screening for and diagnosis of PAS.

To increase confidence in the interpretation of sonographic features of PAS.

To provide a rationale for PAS care being provided in centres of excellence.

Ethical issues

If women increasingly prefer caesarean section over vaginal birth, it is likely that this trend will result in increasing numbers of complex caesarean deliveries and PAS cases.

Many studies have shown decreased morbidity and mortality if PAS cases are managed by an experienced multi‐disciplinary team (MDT) in a PAS centre of excellence; therefore, accurate screening and timely referral are vital to improve patient care for women with risk factors.