bluuebunny/crossref_metadata_2025 huggingface dataset:
Body mass index trajectories and time in target range after delivery and long‐term type 2 diabetes risk in women with a history of gestational diabetes mellitus
Authors: Zhang Lixia , Shen Yun , Liu Huikun , Li Weiqin , Wang Leishen , Zhang Shuang , Leng Junhong , Li Wei , Liang Zhaoxia , Yu Zhijie , Yang Xilin , Hu Gang
Published: October 2024

Aims

This study aims to determine whether postpartum body mass index (BMI) trajectories and its time in target range (TTR) are associated with long‐term type 2 diabetes risk in women with a history of gestational diabetes mellitus (GDM).

Materials and Methods

The present study included 1057 women with a history of GDM who participated in the Tianjin Gestational Diabetes Mellitus Prevention Program (TGDMPP). Oral glucose tolerance tests or physician‐diagnosed information were used to diagnose type 2 diabetes after a median follow‐up period of 8.47 years. Latent class modelling was applied to identify trajectories of BMI after delivery. TTR was defined as the proportion of time that BMI was within the standard range (18.5 ≤ BMI < 24.0 kg/m2). The associations of BMI trajectories and TTR with type 2 diabetes risk were analysed using multivariable Cox modelling.

Results

Five distinct trajectories of postpartum BMI were identified. Compared with low‐stable class, the multivariable‐adjusted hazard ratios of type 2 diabetes were 2.02 (95% confidence interval 0.99–4.10) for median‐stable class, 3.01 (1.17–7.73) for high‐stable class, 2.15 (0.63–7.38) for U‐shape class and 7.15 (2.08–24.5) for inverse U‐shape class (p for trend = 0.012), respectively. Multivariable‐adjusted hazard ratios of type 2 diabetes associated with postpartum BMI TTR of 100%, >43.4%–<100%, >0%–≤43.4% and 0% were 1.00, 1.84 (0.72–4.73), 2.75 (1.23–6.15) and 2.31 (1.05–5.08) (p for trend = 0.039), respectively.

Conclusions

Postpartum BMI trajectories of high‐stable and inverse U‐shape class as well as lower TTR were associated with an increased risk of type 2 diabetes among women with a history of GDM. Reducing BMI to a normal range in the early postpartum period and maintaining stable over time could attenuate the development of long‐term type 2 diabetes.
Multimodality Imaging in the Management of Tricuspid Valve Regurgitation
Authors: Ryffel Christoph , Praz Fabien , Berto Martina Boscolo , de Marchi Stefano , Brugger Nicolas , Pilgrim Thomas , Buechel Ronny R , Windecker Stephan , Gräni Christoph
Published: October 2024

Approximately 5% of elderly patients suffer from moderate or severe tricuspid valve regurgitation, which is an independent predictor of high morbidity and mortality. Surgical treatment of isolated tricuspid valve regurgitation has been associated with elevated fatality rate, leading to a growing interest in minimal invasive, transcatheter‐based therapies such as transcatheter edge‐to‐edge repair and transcatheter valve replacement. Nevertheless, despite high procedural efficacy and safety of transcatheter‐based therapies, a number of challenges limit their rapid adoption in routine clinical practice. In particular, the wide range of transcatheter approaches to address the significant variability in tricuspid valve pathology challenges the reproducibility of clinical outcomes. Multimodality imaging is pivotal for grading the regurgitation severity, determining the underlying pathology, assessing RV function and pulmonary pressures, identifying concomitant cardiac disease, and selecting the most beneficial treatment modality and access. This article reviews the role of different imaging modalities in guiding the management of patients with significant tricuspid valve regurgitation.
Leveraging Communities of Practice for STEAM Education: A Study on Engagement and Professional Development
Authors: Spyropoulou Natalia , Kameas Achilles
Published: October 2024

This study investigates the multifaceted roles and competences of STEAM (Science, Technology, Engineering, Arts and Mathematics) educators and their engagement in Communities of Practice (CoPs). Through an online survey of Greek educators who have implemented STEAM educational projects, employing both closed and open‐ended questions, this research uncovers the complexities of the STEAM educators' role and illustrates how engagement in CoPs can be critical for their professional development and pedagogical practices. The findings highlight the benefits of collaboration, experience exchange and the adoption of best practices within these communities, emphasising CoPs' transformative potential in enhancing STEAM education. By focusing on the educators' perceptions and the contributions of CoPs to teaching, learning and professional growth, this study offers insight that may benefit other European countries without a formal STEAM curriculum, advocating for the integration of art in STEM fields and the importance of CoPs in advancing educational practices towards a more equitable, inclusive and vibrant society.
“What makes me uncertain?” Czech mothers' experiences of parenting 13‐ to 17‐month‐old toddlers
Authors: Návratová Hana , Lacinová Lenka , Pátková Daňsová Petra , Lacina Radim , Neužilová Michalčáková Radka , Kaňa Štěpán
Published: October 2024

Objectives

This qualitative study aimed to gain an in‐depth understanding of mothers' experiences of uncertainty in parenting 13‐ and 17‐month‐old toddlers.

Background

The transition to parenthood is universally acknowledged as a challenging period, particularly for first‐time mothers, with societal expectations emphasizing perfection in childcare. This study explores specific uncertainties faced by Czech mothers in caring for toddlers.

Method

A thematic analysis was conducted after individual semistructured interviews conducted during home visits between 2016 and 2018 with 90 Czech women whose children were aged between 13 and 17 months.

Results

Five overarching themes and 13 subthemes reflecting how Czech mothers experienced feelings of uncertainty in parenting their toddlers were identified: (a) uncertainties connected to a purposefulness in parenting, (b) uncertainties connected to fulfilling physical needs, (c) dealing with current parenting issues, (d) uncertainties connected to the mother's characteristics and her family relationships, (e) uncertainties connected to developing the child.

Conclusion

This study contributes to early motherhood literature by detailing uncertainties experienced by Czech mothers during the toddlerhood phase.

Implications

Our study illuminates the uncertainties experienced by Czech mothers during early toddlerhood, emphasizing the need for counsellors to renegotiate societal ideals of motherhood, foster resilience in parent–child relationships, and embrace uncertainties as natural aspects of parenting.
PGC‐1α regulation by FBXW7 through a novel mechanism linking chaperone‐mediated autophagy and the ubiquitin‐proteasome system
Authors: Eleuteri Simona , Wang Bao , Cutillo Gianni , Zhang Fang Tracy Shi , Tao Kai , Qu Yan , Yang Qian , Wei Wenyi , Simon David K
Published: October 2024

Peroxisome proliferator‐activated receptor gamma coactivator 1‐alpha (PGC‐1α) is a key regulator of mitochondrial biogenesis and antioxidative defenses, and it may play a critical role in Parkinson's disease (PD). F‐box/WD repeat domain‐containing protein (FBXW7), an E3 protein ligase, promotes the degradation of substrate proteins through the ubiquitin‐proteasome system (UPS) and leads to the clearance of PGC‐1α. Here, we elucidate a novel post‐translational mechanism for regulating PGC‐1α levels in neurons. We show that enhancing chaperone‐mediated autophagy (CMA) activity promotes the CMA‐mediated degradation of FBXW7 and consequently increases PGC‐1α. We confirm the relevance of this pathway in vivo by showing decreased FBXW7 and increased PGC‐1α as a result of boosting CMA selectively in dopaminergic (DA) neurons by overexpressing lysosomal‐associated membrane protein 2A (LAMP2A) in TH‐Cre‐LAMP2‐loxp conditional mice. We further demonstrate that these mice are protected against MPTP‐induced oxidative stress and neurodegeneration. These results highlight a novel regulatory pathway for PGC‐1α in DA neurons and suggest targeted increasing of CMA or decreasing FBXW7 in DA neurons as potential neuroprotective strategies in PD.
From fat storage to immune hubs: the emerging role of adipocytes in coordinating the immune response to infection
Authors: Sinton Matthew C. , Kajimura Shingo
Published: October 2024

Adipose tissue is a rich source of diverse cell populations, including immune cells, adipocytes and stromal cells. Interactions between these different cell types are now appreciated to be critical for maintaining tissue structure and function, by governing processes such as adipogenesis, lipolysis and differentiation of white to beige adipocytes. Interactions between these cells also drive inflammation in obesity, leading to an expansion of adipose tissue immune cells, and the secretion of proinflammatory cytokines from immune cells and from adipocytes themselves. However, in evolutionary terms, obesity is a recent phenomenon, raising the question of why adipocytes evolved to express factors that influence the immune response. Studies of various pathogens indicate that adipocytes are highly responsive to infection, altering their metabolic profiles in a way that can be used to release nutrients and fuel the immune response. In the case of infection with the extracellular parasite Trypanosoma brucei, attenuating the ability of adipocytes to sense the cytokine IL‐17 results in a loss of control of the local immune response and an increased pathogen load. Intriguingly, comparisons of the adipocyte response to infection suggest that the immune responses of these cells occur in a pathogen‐dependent manner, further confirming their complexity. Here, with a focus on murine adipose tissue, we discuss the emerging concept that, in addition to their canonical function, adipocytes are immune signalling hubs that integrate and disseminate signals from the immune system to generate a local environment conducive to pathogen clearance.
Crop Water Stress Index and Yield Relationships for Winter Wheat (Triticum aestivum) Crops Grown Under Different Drip and Flood Irrigated Treatments
Authors: Yadav Aditi , Upreti Hitesh , Singhal Gopal Das
Published: October 2024

The Crop Water Stress Index (CWSI) is a widely used method for quantifying crop water status and predicting yield. However, its evaluation across different irrigation methods and its stage‐specific response to crop yield is rarely evaluated. In this study, controlled field experiments were conducted on winter wheat using drip irrigation (DI) and flood irrigation (FI) during the 2021–2022 and 2022–2023 seasons in western Uttar Pradesh, India. The irrigation treatments included 50% MAD (maximum allowable depletion) (DI), 55% MAD (DI), 60% MAD (DI), 50% MAD (FI), local farmer's field replication (FI), rain‐fed, and well‐watered treatment (DI). The derived mean CWSI values for the irrigation treatments ranged from 0.03 to 0.66 in season 1 and 0.06 to 0.57 in season 2 across treatments. The seasonal mean CWSI for 50% MAD (DI) was 0.12 (season 1) and 0.11 (season 2), while 50% MAD (FI) yielded higher mean CWSI values of 0.29 (season 1) and 0.22 (season 2). The 50% MAD (DI) treatment produced the highest grain yield and water use efficiency in both seasons. A comprehensive analysis of stage‐specific CWSI values and grain yields revealed that grain yield was more sensitive to post‐heading CWSI as compared to pre‐heading CWSI values. Among the growth stages, CWSI values during the flowering stage were the most critical for predicting wheat yield. The study recommends that the CWSI values in the flowering and post‐heading stages are more relevant in predicting wheat yield accurately as compared to the pre‐heading and seasonal mean CWSI.
Decreasing 30‐day hospital readmissions by addressing social determinants of health using a bundled discharge approach: An evidence‐based practice project recommendations
Authors: Jacob Ani , Enzinger Iwona , Gopinadh Neethu , LaMaina Laura , Shapiro Zack
Published: October 2024

Introduction

Evidence from the literature suggests that social determinants of health (SDOH) account for 80% of health outcomes and are associated with hospital readmissions. Readmissions negatively impact the quality of life of patients and increase healthcare costs. The Agency for Healthcare Research and Quality reports that there were 3.8 million 30‐day adult hospital readmissions in 2018 with an average readmission cost of $15,000.

Methods

A literature search in CINAHL, PubMed, ClinicalKey, Google Scholar, and Medline databases using the keywords “SDOH”, “social determinants of health”, “healthcare disparities”, “patient discharge”, “readmission”, “interdisciplinary”, and “multidisciplinary” yielded 287 articles. After title and abstract screening and a full‐text review of 90 articles, five articles were selected for critical appraisal. We used the critical appraisal skills programme (CASP) and Appraisal of Guidelines for Research & Evaluation II (AGREE II) tools for the selected articles’ appraisal process.

Results

Ten high‐quality strong evidence recommendations emerged from the evidence review process. These recommendations were bundled together to create an evidence‐based methodology to decrease 30‐day readmissions.

Conclusion

The findings provide strong evidence of the effectiveness of a bundled discharge approach in reducing hospital readmissions and improving patient outcomes.
Research on doctor‐patient communication teaching for oncology residents: a new teaching model
Authors: Yang Dong , Ai Xiaohong , Cai Manbo , Tong Qin , Mei Kai , Yang Qiao , Li Pian , Li Zhimin , He Junyan , Li Yi
Published: October 2024

Background

At present, there is no specific teaching method for doctor‐patient communication for oncology residents. This study combined BOPPPS (bridge‐in, learning objective, pretest, participatory learning, posttest, and summary) teaching model and SBAR (situation‐background‐assessment‐recommendation) communication model to try a new teaching and assessment model of doctor‐patient communication, aiming to explore and improve the teaching method of doctor‐patient communication for oncology residents.

Methods

Ninety residents were randomly divided into two groups: the experimental group (n = 45) was trained with the BOPPPS teaching model combined with the SBAR communication model, the routine teaching method was adopted in the control group (n = 45). Indicators of assessment included doctor‐patient communication skills, satisfaction with teaching, and patient satisfaction.

Results

The scores for doctor‐patient communication ability were significantly better in experimental group than control group (p < 0.05). The degree of satisfaction degree (very satisfied + satisfied) of the experimental group were higher than control group (p < 0.05). The overall teaching satisfaction of the experimental group was 100.00%, the control group was 77.78%, p < 0.001. Patients' satisfaction with the residents in the experimental group (93.3%) was significantly higher than control group (80.0%), p = 0.043.

Conclusion

The application of the BOPPPS combined with the SBAR can effectively enhance residents’ doctor‐patient communication ability and improve teaching satisfaction and patient satisfaction. This new model can effectively improve resident physician‒patient communication ability, which is worth actively promoting in clinical teaching work.
Intergenerational coparenting and child development outcomes: A systematic review
Authors: Xu Weiman , Parra Gilbert R. , Carter Ma'Kiya
Published: October 2024

Grandparents often serve important childrearing roles. The present study is a systematic review of research that examined the association between intergenerational coparenting and children's development. Following the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines, 220 records were identified, and 16 studies were included in the final review. The review provided a detailed analysis of the methodological characteristics of research in this area. Findings indicated that better intergenerational coparenting was associated with higher levels of children's social competence, executive functioning, and attachment security. Evidence also suggests parenting mediates the relation between intergenerational coparenting and child development. Several directions for future research emerged from the review including the need (a) for measurement strategies that reflect the multidimensional nature of intergenerational coparenting, (b) to consider the various parent‐grandparent dyads, and (c) to incorporate other family factors and processes (e.g., quality of parent‐grandparent relationships) into studies that focus on intergenerational coparenting.
Capacity assessment for euthanasia in dementia: A qualitative study of 60 Dutch cases
Authors: van den Bosch Arne , Marijnissen Radboud M. , Hanssen Denise J. C. , Oude Voshaar Richard C.
Published: October 2024

Background

The number of patients with dementia who are granted euthanasia or assisted suicide (EAS) increases yearly in the Netherlands. By law, patients need to be decisionally competent or have an advance directive. Assessment of decisional capacity is challenging as dementia progressively affects cognitive performance. We aimed to assess qualitatively which factors, and how, influence the judgment of decisional capacity in EAS cases with dementia.

Methods

We performed a qualitative study of 60 dementia EAS case summaries published by the Dutch regional euthanasia review committees between 2012 and 2021. Included reports were evaluated using the grounded theory approach. All quotes related to decisional capacity were coded independently by two researchers and compared in an iterative process to formulate an overarching framework on the assessment of decisional capacity. We selected 20 patients who had an advance directive and were judged to be decisionally compromised, as well as a selection of 40 EAS cases judged to be decisionally competent, half of which also had an advance directive (purposive sampling).

Results

Decisional capacity was present in every case report. Predefined, external criteria were rarely described explicitly, but physicians indirectly referred to the (cognitive) criteria set by Appelbaum and Grisso. Whether the thresholds for these dimensional criteria were met was influenced by six supporting factors (level of communication, psychiatric comorbidity, personality, presence of an advance directive, consistency of the request, and, finally, the patient–physician relationship) that also directly contributed to the judgment of capacity. The involved physicians and executed investigations were the two contextual factors providing a background.

Conclusions

Decisional capacity regarding euthanasia is a multidimensional construct, often implicitly assessed and influenced by supporting and contextual factors. The subjectivity of the final judgment poses ethical and legal issues and argues for continuous quality improvement processes.
The landscape of city‐level GHG emission accounts in Africa
Authors: Liu Binyuan , Shan Yuli , Kuik Riemer , Ji Xiande , Chapungu Lazarus , Yang Xiaofan , Hubacek Klaus
Published: October 2024

Cities are important actors in the global challenge of tackling climate change. They are not only responsible for the majority of emissions but also highly capable of taking action. An important precondition for effective climate mitigation is a city‐level greenhouse gas emission inventory to guide mitigation action. Yet, most cities in developing countries, in particular African cities, lack that crucial information. This study aims to assess the current state of the development of African cities' emission inventories. A total of 270 inventories from 137 cities across 54 African countries were identified from 15 research articles, 5 reports, and 3 data platforms. We find the lack of standardized protocols results in inventories that are often not comparable, while data scarcity emerged as a common problem. We observe that insufficient engagement from local governments impedes the creation of a data‐rich environment. Additionally, current inventory protocols do not fully address the data limitations faced by African cities, further hindering inventory development. To mitigate these challenges, multi‐agent collaboration is essential to enhance the accounting capabilities of local governments. Developing refined protocols that consider data constraints is necessary. Moreover, advanced technologies may provide opportunities to overcome data bottlenecks.
Carbon disclosures and information asymmetry: Empirical evidence on the importance of text in understanding numerical emission allowance disclosures
Authors: Steindl Tobias , Habermann Florian , Küster Stephan
Published: October 2024

Carbon disclosures are essential for investors to evaluate firms’ efforts to combat climate change. In this study, we focus on a specific type of carbon disclosures—namely, emission allowance disclosures—that capture how firms implement emission reductions under the European Union emission trading system (EU ETS). Given the continuously changing institutional features of the EU ETS and the lack of authoritative guidance on how firms should account for emission allowances in their financial statements, it is exceedingly difficult for investors to understand numerical emission allowance disclosures and to compare them across—and even within—firms. Motivated by this criticism, we hypothesize and find that textual disclosures complementing numerical emission allowance disclosures are associated with lower information asymmetries between firms and their investors. Further analyses show that textual disclosures that: (i) describe the accounting approach, and (ii) contain institutional information on the EU ETS, respectively, are particularly important for improving the information environment of numerical emission allowance disclosures. Overall, our findings suggest that text can improve the understanding of numbers in a carbon disclosure context. Therefore, our study not only contributes to the (industrial ecology) literature but also has important implications for regulators, policymakers, investors, financial analysts, and firms.
Bonds versus Equities: Information for Investment
Authors: CHANG HUIFENG , D'AVERNAS ADRIEN , EISFELDT ANDREA L.
Published: October 2024

We provide a simple model of investment by a firm funded with debt and equity and empirical evidence to demonstrate that, once we control for the debt overhang problem with credit spreads, asset volatility is an unambiguously positive signal for investment, while equity volatility sends a mixed signal: Elevated volatility raises the option value of equity and increases investment for financially sound firms, but exacerbates debt overhang and decreases investment for firms close to default. Our study provides a simple unified understanding of the structural and empirical relationships between investment, credit spreads, equity versus asset volatility, leverage, and Tobin's .
Mortgage Lock‐In, Mobility, and Labor Reallocation
Authors: FONSECA JULIA , LIU LU
Published: October 2024

We study the impact of rising mortgage rates on mobility and labor reallocation. Using individual‐level credit record data and variation in the timing of mortgage origination, we show that a 1 percentage point decline in the difference between mortgage rates locked in at origination and current rates reduces moving by 9% overall and 16% between 2022 and 2024, and this relationship is asymmetric. Mortgage lock‐in also dampens flows in and out of self‐employment and the responsiveness to shocks to nearby employment opportunities that require moving, measured as wage growth within a 50‐ to 150‐mile ring and instrumented with a shift‐share instrument.
Between‐firm sorting and parenthood wage gaps in the US service sector
Authors: O'Herron Charlotte , Schneider Daniel , Harknett Kristen
Published: October 2024

Objective

We assess how the distribution of parents across firms contributes to parenthood wage gaps in a low‐wage US labor market and examine the role of understudied compensating differentials relevant to precarious work.

Background

In the United States, parenthood drives a wedge in wages, as mothers often earn less than women without children, whereas fathers typically earn more than men without children. Firms bear influence over setting wages and sorting workers, yet firms are largely omitted from research on parental wage gaps in the United States.

Method

We draw on novel employer–employee matched data on 74,086 hourly service‐sector workers to decompose parental wage gaps into their within‐ and between‐firm components. We leverage uniquely rich data on compensating differentials to test if they sort parents across firms.

Results

We found that mothers are overrepresented in lower‐wage firms, accounting for 68% of mothers' wage gap. In contrast, fathers' wage gap accrued within firms. We found limited evidence that compensating differentials, even schedule quality, produce parental wage gaps.

Conclusion

We show for the first time that in a major US industry, mothers are segregated in low‐paying firms compared to women without children, while fathers are paid more than men without children in the same firms. Our findings largely do not tell a story of parents voluntarily choosing between wages and job quality, instead calling for more research on firm practices.
Standardised Tool for the Assessment of Bruxism: Translation, Cultural Adaptation and Pilot Testing in Italy
Authors: Colonna Anna , Lobbezoo Frank , Ahlberg Jari , Bracci Alessandro , Pollis Matteo , Val Matteo , Nykänen Laura , Manfredini Daniele
Published: October 2024

Background

Recently, the Standardised Tool for the Assessment of Bruxism (STAB) has been developed for use in clinical and research settings.

Objectives

The aim of the present study is to describe the process of forward and back translation and pilot testing of the STAB into Italian.

Methods

The English version of the STAB was adopted as a template for translation into other languages, according to a step‐by‐step procedure led by the expert STAB bruxism panel and mother tongue experts in the field. In detail, the translation team was made up of 12 subjects: three study coordinators, two forward translators, two back‐translators and five expert panellists.

Following the translation process, a pilot test in patients, dentists and dental students was performed using the ‘probing’ method (i.e., subjects were questioned by the examiners about the perceived content and interpretation of the items) with the aim to assess the comprehensibility of the questions and response options, and the feasibility of the tool.

Results

This paper describes the translation process of the STAB and provides the outcomes of the pilot testing phase and the face validity assessment. The preliminary results suggest that, from a global point of view, the STAB reflects the characteristics required in clinical and research settings.

Conclusion

Thanks to the translation process, the Italian version of the STAB can be assessed on‐field and introduced in the clinical and research field to get deeper into the study of bruxism epidemiology in Italy.
Daytime sleepiness and BMI exhibit gender and age differences in patients with central disorders of hypersomnolence
Authors: Ferrazzini Laura , Schmidt Markus , Zhang Zhongxing , Khatami Ramin , Dauvilliers Yves , Barateau Lucie , Mayer Geert , Pizza Fabio , Plazzi Giuseppe , Gool Jari K. , Fronczek Rolf , Lammers Gert Jan , del Rio‐Villegas Rafael , Peraita‐Adrados Rosa , Partinen Markku , Overeem Sebastiaan , Sonka Karel , Santamaria Joan , Heinzer Raphael , Canellas Francesca , da Silva Antonio Martins , Högl Birgit , Veauthier Christian , Wierzbicka Aleksandra , Feketeova Eva , Buskova Jitka , Lecendreux Michel , Miano Silvia , Kallweit Ulf , Heidbreder Anna , Bassetti Claudio L. A. , van der Meer Julia
Published: October 2024

The aim of the present study was to examine gender and age‐specific effects on subjective daytime sleepiness (as measured by the Epworth Sleepiness Scale), body weight and eating behaviour in patients with central disorders of hypersomnolence. Based on the European Narcolepsy Network database, we compared 1035 patients with narcolepsy type I and 505 patients with other central disorders of hypersomnolence (“narcoleptic borderland”), including narcolepsy type II (N = 308) and idiopathic hypersomnia (N = 174), using logistic regression and general linear models. In the entire study population, the Epworth Sleepiness Scale was higher in women (N = 735, mean age = 30 years, mean Epworth Sleepiness Scale = 16.6 ± SD 3.9) than in men (N = 805, mean age = 32 years, mean Epworth Sleepiness Scale = 15.8 ± SD 4.4). In women with narcolepsy type I (N = 475), both Epworth Sleepiness Scale and body mass index increased in parallel with age. In women of the narcoleptic borderland (N = 260), the Epworth Sleepiness Scale markedly peaked in their early 30s, while body mass index only started to rise at that age. This rise in body mass index following the Epworth Sleepiness Scale peak cannot be explained by sleepiness‐induced uncontrolled eating, as self‐reported uncontrolled eating was negatively associated with the Epworth Sleepiness Scale in this group. We propose that the narcoleptic borderland harbours a unique cluster of women in their fertile years with an unexplored aetiology requiring further investigation towards tailored interventions.
How many drugs are repositioned each year in Europe?
Authors: Liddicoat Johnathon , Hamidzadeh Ashleigh , Liddell Kathleen , Aboy Mateo
Published: October 2024

For two decades, commentators have argued for law and policy reform to incentivise organisations to develop new indications for (already) authorised drugs, an area of drug development known as ‘repositioning’. In short, they argue that hurdles in patent and pharmaceutical law hinder repositioning and, therefore, reform is required to increase its use. Yet, these arguments are made primarily on anecdotes; the empirical evidence is scant. One foundational question is how many drugs are repositioned each year in Europe. This study develops a method to examine the number authorised each year. The results show a marked increase in repositioning over the last 3 years, and that the number per year is comparable, though slightly fewer than, the number of new compounds, indicating modest to higher‐than‐expected activity. This study considers what the results mean for four suggested reform options, including the EU Commission's recent proposal. We conclude that the reforms may not achieve their goals or that further evidence is required before we can know whether they will be effective. Lastly, this paper explains how the method and data in this study could serve as a benchmark for evaluating the success of future reforms.
Long‐term outcome of tacrolimus‐based immunosuppressive treatment for patients with paediatric‐onset lupus nephritis
Authors: Tanaka Hiroshi , Aizawa Tomomi , Endo Morito
Published: October 2024

Aim

We have previously reported the mid‐term efficacy and safety of tacrolimus (Tac)‐based immunosuppressive therapy in such patients, and herein, we aimed to determine their long‐term outcomes (over 10 years).

Methods

We retrospectively evaluate the data of 13 consecutive patients with biopsy‐proven long‐standing LN who underwent a long‐term Tac‐based treatment regimen. Tac was administered once daily at a dose of 3 mg as reinduction or maintenance treatment. Treatment outcomes were defined using the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI), urinary protein/creatinine ratio (Up/cr), serum creatinine, estimated glomerular filtration rate (eGFR) and serological lupus markers (complement C3, complement hemolytic activity [CH 50], and anti‐dsDNA antibody titre), and the concomitantly administered prednisolone (PDN) dose. Data on clinical parameters and serological lupus activity were collected annually from each patient throughout the study period.

Results

The patients' baseline characteristics at the treatment initiation were as follows: mean age, 18 years; Up/cr, 0.63 ± 0.69; serum C3 level, 57.2 ± 22.4 mg/dL (normal range, 79–152 mg/dL); CH50, 27.9 ± 15.7 U/mL (normal range, 23.0–46.0 U/mL); serum anti‐dsDNA antibody titre, 111.7 ± 123.4 IU/mL (normal range, <12.0 IU/mL); serum creatinine, 0.60 ± 0.19 mg/dL; eGFR, 115.6 ± 21.3 mL/min and SLEDAI, 13 ± 8.1. Despite the gradual tapering of the concomitantly administered PDN dose from 18.7 ± 13.5 mg/day at baseline to 3.5 ± 2.8 mg/day at 10 years (p = .002), a marked improvement in the outcomes, compared with the baseline values, was observed within a year. Additionally, these favourable changes persisted throughout study period in most patients. Compared with the baseline values, the following measures confirmed sustained outcome improvements after a 10‐year treatment: SLEDAI, 1.7 ± 2.0; serum C3 level, 83.8 ± 16.1 mg/dL; CH50, 45.6 ± 10.9 U/mL (all p < .01) and Up/cr, 0.16 ± 0.18 and serum anti‐dsDNA antibody titre, 25.8 ± 28.8 IU/mL (both p < .05). Serum creatinine level and eGFR remained within the normal range in all study participants except for one patient who experienced several flare‐ups. No serious adverse effects were observed.

Conclusion

Our results suggest that long‐term Tac‐based immunosuppressive treatment as maintenance therapy is beneficial and has low cytotoxicity. Therefore, it represents an attractive option for the treatment of selected patients with paediatric‐onset LN in a real‐world setting.

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Disorders of puberty and neurodevelopment: A shared etiology?
Authors: Read Jordan E. , Vasile‐Tudorache Alexandru , Newsome Angel , Lorente María José , Agustín‐Pavón Carmen , Howard Sasha R.
Published: October 2024

The neuroendocrine control of puberty and reproduction is fascinatingly complex, with up‐ and down‐regulation of key reproductive hormones during fetal, infantile, and later childhood periods that determine the correct function of the hypothalamic–pituitary–gonadal axis and the timing of puberty. Neuronal development is a vital element of these processes, and multiple conditions of disordered puberty and reproduction have their etiology in abnormal neuronal migration or function. Although there are numerous documented cases across multiple conditions wherein patients have both neurodevelopmental disorders and pubertal abnormalities, this has mostly been described ad hoc and the associations are not clearly documented. In this review, we aim to describe the overlap between these two groups of conditions and to increase awareness to ensure that puberty and reproductive function are carefully monitored in patients with neurodevelopmental conditions, and vice versa. Moreover, this commonality can be explored for clues about the disease mechanisms in these patient groups and provide new avenues for therapeutic interventions for affected individuals.
Randomized Controlled Trial Comparing Training of Transseptal Puncture With or Without Intracardiac Echocardiography
Authors: Guo Qi , Sang Caihua , Lai Yiwei , Gao Mingyang , Guo Xueyuan , Dai Wenli , Li Songnan , Liu Nian , Zuo Song , Long Deyong , Dong Jianzeng , Ma Changsheng
Published: October 2024

Background

Intracardiac echocardiography (ICE) has been widely used in the catheter ablation of atrial fibrillation (AF). However, the value of ICE in the training of transseptal puncture (TSP) is unclear.

Methods

ICE‐Training Study was a single‐center, parallel‐group, unmasked, randomized controlled trial registered in ChineseClinicalTrials.gov. Participants were randomly assigned (1:1) to different groups (1) the ICE simulator training group (ICE‐ST), in which TSP was trained and performed under the guidance of both ICE and x‐ray; and (2) the conventional simulator training group (Con‐ST), in which TSP was trained and performed only under the guidance of x‐ray. The trainees need to undergo the training stage and the evaluation stage.

Results

From October 2022 to December 2022, 18 consecutive fellows (age 32.4 ± 4.4 years, 12 males) without experience of TSP were included. The training period (16.9 ± 6.6 vs. 29.6 ± 8.7 times, p = 0.003) and the fluoroscopy time (120.3 ± 25.3 vs. 189.3 ± 40.2 s, p < 0.001) of the ICE‐ST group was significantly shorter than that of the Con‐ST group. No significant difference was found in the comprehensive performance of TSP in the ICE‐ST group (composite score 96.7 ± 5.7) and the Con‐ST group (composite score 95.9 ± 6.3, p = 0.62), but the selection of TSP sites in the ICE‐ST group was commonly better than that in the Con‐ST group.

Conclusions

ICE could improve the efficiency of TSP training and optimize the site of TSP to facilitate catheter manipulation in the ablation.

Trial Registration

ChineseClinicalTrials.gov identifier: ChiCTR2200058377
Catheter Ablation of Tachycardia Involving Twin/Single Atrioventricular Node in Patients With Right Isomerism
Authors: Terashi Eiko , Suzuki Tsugutoshi , Yoshida Yoko , Fukudome Keisuke , Nakamura Yoshihide
Published: October 2024

Aims

In addition to well‐documented tachycardias involving twin atrioventricular (AV) nodes, tachycardias involving a single node have been clinically experienced in right atrial isomerism (RAI). This study aimed to characterize the AV node involvement patterns and evaluate the outcome of ablation therapy in RAI patients with tachycardias.

Methods

We retrospectively analyzed the medical records of 16 RAI patients who underwent catheter ablation of tachycardias involving twin or single AV nodes at our center between April 2006 and March 2020.

Results

A total of 22 ablation procedures were performed in 16 patients. The median age and body weight were 2 years (range 20 months–31 years) and 11.2 kg (range 7.4–42 kg), respectively. Two QRS complexes were confirmed in 11/16 patients, and a single QRS complex in 5/16. The dominant AV node was anterior in 7/16. Four patterns of tachycardias were identified: tachycardias reciprocating between two AV nodes with retrograde conduction through the anterior AV node (3/16) or through the posterior AV node (4/16); and reentrant tachycardias involving the anterior AV node only (3/16) or posterior AV node only (6/16). Ablation successfully eliminated the tachycardias in 15/16 patients (93.8%). Recurrence was reported in 7/16 (44%) during a median follow‐up period of 96.5 months. Five of those 7 patients underwent additional ablation, and the tachycardias were eliminated in 3/5 patients. None of the patients developed ventricular asynchrony after ablation.

Conclusion

Transcatheter ablation was effective in RAI patients with tachycardias involving twin or single AV nodes, and deterioration of the cardiac function was rare.
Precision Phenotyping in Crop Science: From Plant Traits to Gene Discovery for Climate‐Smart Agriculture
Authors: Visakh Ravindran Lalithambika , Anand Sreekumar , Reddy Sathanur Bhaskar , Jha Uday Chand , Sah Rameswar Prasad , Beena Radha
Published: October 2024

The global population is placing unprecedented demand on food systems, which can be met only through a complex interplay of technology, sustainable food production intensification methods and climate resilience. To address such compounded requirements, developing high‐yielding crop varieties using precise plant breeding methods bolstered with efficient and nondestructive plant trait documentation approaches is vital. High‐throughput crop phenotyping (HTCP) platforms have prominently emerged as a mainstream approach for reducing the phenotyping bottleneck in breeding programmes. HTCP has the potential to provide detailed quantitative information of large plant populations under different growth stages across diverse environmental regimes, facilitating accelerated plant breeding strategies. New imaging platforms also enable nondestructive characterization of a wide range of above and below‐ground crop parameters. The specificity in use of sensors, automation of data collection, large‐scale data handling systems and accurate analytical tools have a substantial role in dynamic crop monitoring and big data interpretation. HTCP platforms are capable of making precise measurements of a wide range of physiological, morphological, biochemical and stress responses in plants. Developments of sensors with improved precision, intervention of unmanned aerial vehicles, robotics, computed tomography and machine learning have given a dramatic developmental leap to precise and large‐scale crop phenotyping. This review provides an avenue for understanding various high‐throughput phenotyping platforms, working principles, current developments and contributions to high‐throughput phenotyping of various crops under laboratory and field conditions. A detailed comparative idea on the advantages and pitfalls of these available platforms can help researchers in choosing the right technology suiting specific practical requirements. Furthermore, the review aims to provide novel future prospects and developmental requirements that can potentially widen the application and utilization of these HTCP technologies in agriculture.
“Weak characters” easily shaped, or strong‐minded conscientious objectors impervious to change?
Authors: Perkins Gary
Published: October 2024

Commentaries on the World War I history of the International Bible Students Association in their USA homeland usually feature decisions made by the movement's leadership and their subsequent arrest and prosecution, supposedly for conspiring to violate the Espionage Act and attempting to cause refusal of duty in the armed forces of the United States. In so doing, these neglect to consider the enthusiastic support and voices of their adherents. In contrast, and in response to Zoe Knox's April 2019 Peace & Change article, this study unmutes the voices of their conscientious objectors and proposes that their experiences were profoundly significant in shaping the movement over the following century.
Virulence characterization of wheat stripe rust population in China in 2023
Authors: Zhang Xingzong , Huang Liang , Tang Wanqiang , Qiu Age , Li Xin , Zhou Xinli , Yang Suizhuang , Wang Meinan , Chen Xianming , Chen Wanquan , Liu Tai‐guo , Xia Chongjing
Published: October 2024

Wheat stripe rust, caused by Puccinia striiformis f. sp. tritici (Pst), significantly impacts global wheat production, including China. Monitoring Pst virulence is crucial for disease management. This study used 18 Yr single‐gene isogenic lines of wheat to characterize the virulence of 2023 Pst collections in China. A total of 103 isolates were collected from 11 provinces, and 61 races were identified. Frequencies of virulence to the 18 Yr genes varied from 0% to 95.1%, with low frequencies (defined as less than 10%) to Yr85 (7.8%) and Yr10 (8.7%); moderate frequencies (10%–40%) to Yr24 (15.5%), Yr32 (16.5%), YrSP (37.9%) and Yr76 (37.9%); and high frequencies (>40%) to Yr7 (47.6%), Yr1 (68.0%), Yr9 (69.9%), Yr27 (69.9%), Yr17 (79.6%), Yr6 (89.3%), YrExp2 (92.2%), Yr43 (93.2%), Yr8 (95.1%) and Yr44 (95.1%). Yr6, Yr8, Yr17, Yr27, Yr43, Yr44 and YrExp2 have almost lost their effectiveness in all provinces, while Yr10, Yr24, Yr32 and Yr85 are effective in Hebei, Shandong, Shaanxi, Gansu and Anhui. No isolate was virulent to Yr5 or Yr15, indicating their effectiveness against Pst populations in China. The Pst isolates had a wide virulence spectrum ranging from 3 to 16 virulence factors, with an average of 9.5. Comparing 2023 to 2021, the PstCN‐040 and races sharing virulence to Yr1, Yr6, Yr7, Yr8, Yr9, Yr17, Yr43, Yr44 and YrExp2 predominated, with frequencies 16.4% and 25.2%. This study provides valuable information on the virulence composition of Pst populations in China, helping to guide the development of genetic resistance for wheat in China.
Singular loci of algebras over ramified discrete valuation rings
Authors: KC Nawaj
Published: October 2024

When is a field, the classical Jacobian criterion computes the singular locus of an equidimensional, finitely generated ‐algebra as the closed subset of an ideal generated by appropriate minors of the so‐called Jacobian matrix. Recently, Hochster‐Jeffries and Saito have extended this result for algebras over any unramified discrete valuation ring of mixed characteristic via the use of ‐derivations. Motivated by these results, in this paper, we state and prove an analogous Jacobian criterion for algebras over ramified discrete valuation rings of mixed characteristic.
The Lubin–Tate theory of configuration spaces: I
Authors: Brantner D. Lukas B. , Hahn Jeremy , Knudsen Ben
Published: October 2024

We construct a spectral sequence converging to the Lubin–Tate theory, that is, Morava ‐theory, of unordered configuration spaces and identify its ‐page as the homology of a Chevalley–Eilenberg‐like complex for Hecke Lie algebras. Based on this, we compute the ‐theory of the weight summands of iterated loop spaces of spheres (parametrising the weight operations on ‐algebras), as well as the ‐theory of the configuration spaces of points on a punctured surface. We read off the corresponding Morava ‐theory groups, which appear in a conjecture by Ravenel. Finally, we compute the ‐homology of the space of unordered configurations of particles on a punctured surface.
Supporting professional practice transition in undergraduate nursing education: a scoping review protocol
Authors: Orr Elizabeth , Kuipers Meredith , Yates Elizabeth , Halverson Kathryn
Published: October 2024

Objective:

This scoping review will describe educational programming that supports undergraduate student nurses’ transition-to-practice and/or enhances practice readiness.

Introduction:

The period of transition from nursing student to professional nurse is fraught with challenges stemming from the evolving role and the increasing demands of independent practice. While transition-to-practice programming exists for the new graduate nurse, there is less focus on preparing the student in their final year of education. A scoping review will identify educational programming delivered to nursing students approaching graduation that facilitate transition-to-practice success and/or improve practice readiness.

Inclusion criteria:

This review will consider literature describing educational programming that supports transition-to-practice success and/or practice readiness and that demonstrates evidence of evaluation. Studies that involve primarily pre-licensure, undergraduate, or baccalaureate nursing students will be included. Reports of primary studies, reviews, dissertations and theses, conference proceedings, and nursing trade publications that describe quantitative, qualitative, or mixed methods will be included.

Methods:

The proposed review will adhere to the JBI methodology for scoping reviews. A comprehensive search will be conducted in CINAHL (EBSCOhost), MEDLINE (Ovid), Healthstar (Ovid), and Nursing and Allied Health (ProQuest) using a search strategy developed in consultation with an expert university librarian. Two independent reviewers will screen articles by title and abstract and assess the full text of each selected citation against inclusion criteria. Quantitative methods (descriptive statistics) and basic qualitative content analysis will be used to analyze the data, and results will be reported in narrative and graphic formats.

Review registration:

Open Science Framework osf.io/2vsbq