bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of the efficacy of drug‐coated balloon angioplasty and conventional balloon angioplasty in the endovascular treatment of thrombosed arteriovenous dialysis fistulas
Authors: Ozdemir Mustafa , Taydas Onur
Published: August 2024

Introduction

To evaluate the efficacy and safety of paclitaxel‐coated balloon angioplasty in the treatment of thrombosed arteriovenous fistulas.

Methods

This prospective, randomized, controlled study investigated the use of drug‐eluting balloons in the treatment of the thrombosis of arteriovenous fistulas (AVFs) at our center between January 2018 and January 2023. A total of 246 patients were included in the study. The mean age of the patients was 61.3 ± 11.5 years. Of the patients, 150 (61%) were male and 96 (39%) were female. Angioplasty was performed using a plain balloon (PB) in 126 patients (51.2%) and a drug‐coated balloon (DCB) in 120 (48.8%). The control images of the patients were obtained at the sixth and 12th months. Patency was evaluated during the follow‐up.

Results

There was no significant difference between the two groups in terms of age, gender, hypertension, hyperlipidemia, diabetes, fistula location, or stenosis length. No significant difference was observed between the groups regarding the number of complications observed during and after the procedure. At the end of the sixth month, the patency rate was found to be 86.7% in the DCB group and 78.6% in the PB group. The 12th‐month patency rate was 77.5% in the DCB group and 57.9% in the PB group. A significant difference was detected between the two groups in relation to the 6th‐ and 12th‐month patency rates (p = 0.034 and p = 0.046, respectively).

Conclusion

Drug‐coated balloon angioplasty is an effective approach to the treatment of thrombosed AVFs, especially in terms of prolonging primary patency and reducing the need for secondary procedures.
Agri‐environmental Schemes Require Improved Design for Better Outcomes
Authors: Nguyen Chi , Latacz‐Lohmann Uwe , Hanley Nick
Published: August 2024

Advocacy for a shift from an individual farm‐level to a landscape‐level approach in agri‐environmental policy is a focal point in the reform of the Common Agricultural Policy. Such a shift aims to address spatial mismatches between ecological processes and targeted environmental outcomes, and to harness potential ecological gains from spatial coordination. However, there remains limited understanding of how to design effective mechanisms aimed at encouraging coordination among landholders. Do landscape configurations influence the effectiveness of coordination mechanisms? This article aims to assess the effectiveness of alternative coordination mechanisms incorporated in the design of a conservation auction across alternative landscape configurations, that is, in terms of the spatial relationship between some measure of environmental benefit – such as wild bird species diversity – and the profitability of farmland. These mechanisms include landholder‐to‐landholder communication, disclosure of spatial environmental scoring rules, and the Agglomeration Bonus. We used lab experiments to evaluate these options. Our results suggest that there is no panacea for promoting landscape‐level environmental outcomes. Communication proves capable of significantly facilitating coordination, whilst information disclosure policies can serve as an effective coordination mechanism in multiple landscape types. By contrast, the Agglomeration Bonus was only found to effectively promote coordination in a positively correlated landscape type. It leads to lower cost‐effectiveness in all landscape types.
Incorporating whole soybean pulp into wheat flour for nutrient‐enriched steamed bread: Exploring the impact on physical and nutritional characteristics
Authors: Han Feng , Song Jialin , Qi Mingming , Li Yueming , Xu Mei , Zhang Xin , Yan Chuangshuo , Chen Shanfeng , Li Hongjun
Published: August 2024

This research explored the impact of incorporating various levels of whole soybean pulp (WSP) (10%, 20%, 30%, 40%, and 50%) into wheat flour on the physical and nutritional qualities of steamed bread. In comparison with the traditional steamed bread, the substitution of up to 20% WSP did not significantly alter the specific volume, hardness, and chewiness of the steamed bread. Additionally, the crumb texture of the steamed bread with 20% WSP maintained small and uniform pores, with optimal springiness and cohesiveness. Nutritionally, the substitution of 10%–50% WSP enhanced total dietary fiber, total phenolics, and protein by 9.40%–89.79%, 14.96%–116.31%, and 3.45%–34.36%, respectively. Isoflavones in the steamed bread increased markedly from 22.92 µg/g to a range of 140.12–997.12 µg/g. The expected glycemic index showed a decrease from 90.24 to between 85.85 and 70.75, whereas amino acid scores improved from 59.22 to a range of 64.58–65.08, with lysine (Lys) scores notably increasing from 59.22 to between 64.96 and 88.80. In conclusion, partially replacing wheat flour with WSP is an effective method for enhancing the nutritional profile and addressing the essential amino acid imbalance in steamed bread.

Practical Application

This study partially replaced flour with WSP to improve the steamed bread's nutritional quality. The optimal substitution level was determined to be 20% WSP, which improves the bread's nutritional value without significantly impacting its physical qualities. Furthermore, WSP is produced from soaked soybeans through hot water milling. This process simplifies soybean processing, lowers energy consumption and costs, and reduces pollution. It also effectively retains essential nutrients, such as protein, dietary fiber, polyphenols, and soy isoflavones, ensuring the full utilization of soybeans.
Influence of growth medium on the species‐specific interactions between algae and bacteria
Authors: Jonynaite Kamile , Stirke Arunas , Gerken Henri , Frey Wolfgang , Gusbeth Christian
Published: August 2024

In this study, we investigated a species‐specific algal–bacterial co‐culture that has recently attracted worldwide scientific attention as a novel approach to enhancing algal growth rate. We report that the type of interaction between Chlorella vulgaris and bacteria of the genus Delftia is not solely determined by species specificity. Rather, it is a dynamic process of adaptation to the surrounding conditions, where one or the other microorganism dominates (temporally) depending on the growth conditions, in particular the medium. Under laboratory conditions, we found that Delftia sp. had a negative effect on C. vulgaris growth when co‐cultured in a TAP medium. However, the co‐culture of algae and bacteria under BG‐11 and BG‐11 + acetic acid resulted in an increase in algal concentration compared to algal cultures without bacteria under the same conditions. Additional chemical analysis revealed that the presence of different carbon (the main organic carbon source—acetic acid in TAP or BG‐11 + acetic acid medium and inorganic carbon source—Na2CO3 in BG‐11 or BG‐11 + acetic acid medium) and nitrogen (NH4Cl in TAP medium and NaNO3 in BG‐11 or BG‐11 + acetic acid medium) species in the growth medium was one of the main factors driving the shift in interaction type.
A “Battle for hearts and minds”? EU digital diplomacy toward the Global South
Authors: Sottilotta Cecilia Emma
Published: August 2024

Against the backdrop of the polarization created by Russia's invasion of Ukraine in February 2022 and growing competition between the US and China, a “battle for the hearts and minds” of the Global South is taking place, with the digital realm serving as a major theater for such a battle. Based on a review of the literature, an analysis of official documents as well as data collected via expert interviews with EU officials, this study delves into the state of the art of EU digital diplomacy toward the Global South, problematizing key concepts and categories; exploring the role of actors, audiences, and messages; and providing some policy recommendations.
First pediatric pelvic surgery with the Senhance® robotic surgical system: A case series
Authors: Kato Daiki , Uchida Hiroo , Shirota Chiyoe , Tainaka Takahisa , Makita Satoshi , Amano Hizuru , Satomi Miwa , Yasui Akihiro , Nakagawa Yoichi , Maeda Takuya , Ishii Hiroki , Ota Kazuki , Nagata Naoki , Hinoki Akinari
Published: August 2024

The Senhance® robotic system (Senhance [Asensus Surgical Inc., Naderhan, NC, USA]) is a new surgical assistive robot following the da Vinci Surgical System that has been demonstrated to be safe and efficacious. Herein, we report the first case series of pediatric pelvic surgery using Senhance. Two anorectoplasties and one rectal pull‐through coloanal anastomosis for rectal stenosis were performed in three children (5–9 months, 7–9 kg) using a 10‐mm three‐dimensional (3D) 4K camera and 3 and 5 mm forceps operated with Senhance. None of the patients had intraoperative complications or a good postoperative course. Pediatric pelvic surgery with Senhance could be performed precisely and safely with a small body cavity. With its beautiful 3D images, motion of forceps with reduced tremor, and availability of 3‐mm forceps, Senhance may be better suited for children compared with other models.
OTULIN's influence on neuroinflammation and pain modulation in trigeminal neuralgia
Authors: Wang Haiyang , Wang Heng , Zheng Wenhao , Wang Ding , Sun Chenglong , Dong Jun , Yu Wenhua , Du Quan
Published: August 2024

Introduction

Trigeminal neuralgia (TN), marked by chronic pain from neural damage, is closely associated with inflammation. The role of OTULIN, a key regulator in inflammation and autophagy, is not fully understood in TN. The regulatory mechanism of OTULIN, a key protein involved in modulating inflammatory responses and autophagy processes, remains incompletely elucidated, particularly in the context of TN and neuroinflammation.

Methods

An infraorbital nerve ligation‐induced rat model of TN was used. OTULIN's expression was modulated using adenovirus vectors and short hairpin RNA. The impact on pain and inflammatory responses was assessed via quantitative real‐time polymerase chain reaction, western blot, immunofluorescence, and transcriptomic analysis.

Results

Enhanced OTULIN expression significantly increased head withdrawal thresholds and reduced pain sensitivity and neuroinflammatory markers in the model. Conversely, silencing OTULIN exacerbated pain and inflammation. Transcriptomic data revealed OTULINs influence on both inflammatory and autophagy pathways, specifically in suppressing NLR family pyrin domain containing 3 (NLRP3) inflammasome and promoting autophagy. In vitro experiments demonstrated OTULIN's inhibition of inflammatory markers in microglia and neurons.

Conclusion

OTULIN is crucial in modulating TN, reducing neuropathic pain and neuroinflammation by activating the autophagy pathway and inhibiting the NLRP3 inflammasome.
Tert‐butylhydroquinone and tert‐butylcatechol positivity as warning lights of skin sensitization to tert‐butylphenol derivatives in adhesives and diabetes devices
Authors: Dendooven Ella , Naessens Tania , Foubert Kenn , Hermans Nina , Aerts Olivier
Published: August 2024

Introduction

Tert‐butylphenol (TBP) derivatives, antioxidants in adhesives and diabetes devices, may provoke allergic contact dermatitis (ACD).

Objectives

The objective of this study is to report sensitization to TBP derivatives in medical devices and to highlight that tert‐butylhydroquinone (BHQ) and tert‐butylcatechol (TBC) are potential screeners in this regard.

Methods

Fifteen patients with ACD from adhesives and diabetes devices were patch tested to different TBPs: BHQ 1% pet., TBC 0.25% pet., BHA 2% pet., BHT 2% pet., 4‐tert‐butylphenol (TBP) 1% pet. and 2,4‐di‐tert‐butylphenol (di TBP) 1% pet. The culprit devices (medical adhesives, sanitary pads, diabetes devices) and TBP patch preparations were analysed using gas chromatography‐mass spectrometry (GC–MS).

Results

BHQ (9/13), TBC (7/13), and to a lesser extent BHT (3/15), BHA (2/15) and TBP (2/13) gave positive reactions. Seven patients had developed ACD from adhesives and diabetes devices, respectively, and one patient from sanitary pads. GC–MS analyses of the medical devices and patch test materials confirmed the presence of the patch‐test positive TBPs, or chemically related derivatives, or, interestingly, tert‐butylbenzoquinones (BBQ) were found, that is, spontaneously formed, highly reactive TBP metabolites, likely (pseudo‐) cross reacting with the patch tested TBPs.

Conclusion

TBPs might be overlooked sensitizers in medical devices, and BHQ and TBC are potential screeners in this regard.
Increasing Multiorgan Heart Transplantations From Donation After Circulatory Death Donors in the United States
Authors: Madan Shivank , Teitelbaum Jill , Saeed Omar , Hemmige Vagish , Vukelic Sasha , Rochlani Yogita , Murthy Sandhya , Sims Daniel B. , Shin Jooyoung , Forest Stephen J. , Goldstein Daniel J. , Patel Snehal R. , Jorde Ulrich P.
Published: August 2024

Introduction

Donation after circulatory death (DCD) donors are becoming an important source of organs for heart‐transplantation (HT), but there are limited data regarding their use in multiorgan‐HT.

Methods

Between January 2020 and June 2023, we identified 87 adult multiorgan‐HTs performed using DCD‐donors [77 heart–kidney, 6 heart–lung, 4 heart–liver] and 1494 multiorgan‐HTs using donation after brain death (DBD) donors (1141 heart–kidney, 165 heart–lung, 188 heart–liver) in UNOS. For heart–kidney transplantations (the most common multiorgan‐HT combination from DCD‐donors), we also compared donor/recipient characteristics, and early outcomes, including 6‐month mortality using Kaplan–Meier (KM) and Cox hazards‐ratio (Cox‐HR).

Results

Use of DCD‐donors for multiorgan‐HTs in the United States increased from 1% in January to June 2020 to 12% in January–June 2023 (p < 0.001); but there was a wide variation across UNOS regions and center volumes. Compared to recipients of DBD heart–kidney transplantations, recipients of DCD heart–kidney transplantations were less likely to be of UNOS Status 1/2 at transplant (35.06% vs. 69.59%) and had lower inotrope use (22.08% vs. 43.30%), lower IABP use (2.60% vs. 26.29%), but higher durable CF‐LVAD use (19.48% vs. 12.97%), all p < 0.01. Compared to DBD‐donors, DCD‐donors used for heart–kidney transplantations were younger [28(22–34) vs. 32(25–39) years, p = 0.004]. Recipients of heart–kidney transplantations from DCD‐donors and DBD‐donors had similar 6‐month survival using both KM analysis, and unadjusted and adjusted Cox‐HR models, including in propensity matched cohorts. Rates of PGF and in‐hospital outcomes were also similar.

Conclusions

Use of DCD‐donors for multiorgan‐HTs has increased rapidly in the United States and early outcomes of DCD heart–kidney transplantations are promising.
Reasons pregnant people use cannabis to self‐treat health conditions during pregnancy: Results from a US population‐based survey
Authors: Zaugg Claudia , Terplan Mishka , Mailman Kieran , Roberts Sarah C. M.
Published: August 2024

Introduction

Little is known about reasons pregnant people self‐treat health conditions and pregnancy‐related symptoms with cannabis.

Methods

We administered a cross‐sectional survey to 3571 pregnant and recently pregnant people from US population‐based panels. Participants who used cannabis at some point during pregnancy were asked which health conditions or symptoms they used cannabis to treat and reasons they used cannabis for self‐treatment. We explored differences in reasons for self‐treatment by sociodemographics.

Results

Nine‐hundred forty‐six participants indicated they used cannabis during pregnancy. Fifty‐seven percent (n = 578) of those who used cannabis during pregnancy indicated they used cannabis exclusively for health purposes; 39% (n = 347) indicated they used cannabis for health and recreation. The most common reasons for self‐treatment were believing cannabis was safer and more effective than other medications or treatments. Some participants reported not having health insurance or a health care provider as reasons for self‐treatment. Black and Hispanic people, and people with household income under $25,000, were more likely than White people and people with household income between $25,000–$49,999 to report barriers to other medications or treatments as reasons for self‐treatment. People with high school education were more likely than people with more education to report viewing cannabis as safe and effective for self‐treatment.

Discussion and Conclusions

Most pregnant people self‐treating health conditions or symptoms with cannabis are doing so because they consider it safer and more effective than other medications or treatments. Some people, particularly people of colour and low‐income people, may also self‐treat because they face barriers to other treatments.
The prevalence and magnitude of price promotions in online alcohol retail outlets
Authors: Davies Tazman , O'Brien Paula , Bowden Jacqueline , Petticrew Mark , Pettigrew Simone
Published: August 2024

Introduction

We examined the prevalence of price promotions (i.e., proportion of products on price promotion) and the magnitude of price promotions (i.e., size of the price discount compared to the regular price) among online alcohol retailers.

Methods

In August 2023, we web‐scraped product information for all alcoholic beverages available for sale in the online stores of two leading alcohol retailers in Sydney, Australia. Products were classified into five primary alcohol categories: wine, spirits, beer, cider and premix drinks. We considered three types of price promotion: temporary price discounts (e.g., ‘was $5 now $4’), multi‐buy discounts (e.g., buy one get one free) and ‘any six’ discounts (e.g., 5% off when purchased in a bundle of any six similar products). The prevalence and mean magnitude of price promotions were estimated overall and by product category and price promotion type.

Results

In total, data for 11,184 products were collected. Of these, 62% were the subject of at least one of the assessed forms of price promotion. The most frequently price‐promoted category was wine (91% of products), followed by spirits (35%), premix drinks (30%), cider (28%) and beer (21%). Of all price promotions, 61% were ‘any six’ discounts, 31% were temporary price discounts, and 7% were multi‐buy discounts. Across all price promotions, the mean magnitude of price discount relative to the regular price was 11% and ranged from less than 1% to 71%.

Discussion and Conclusions

Policymakers should consider restricting price promotions as part of a suite of strategies to reduce alcohol‐related harms.
Using joint species distribution modelling to identify climatic and non‐climatic drivers of Afrotropical ungulate distributions
Authors: Cranston Alex , Cooper Natalie , Bro‐Jørgensen Jakob
Published: August 2024

The relative importance of the different processes that determine the distribution of species and the assembly of communities is a key question in ecology. The distribution of any individual species is affected by a wide range of environmental variables as well as through interactions with other species; the resulting distributions determine the pool of species available to form local communities at fine spatial scales. A challenge in community ecology is that these interactions (e.g. competition, facilitation, etc.) often are not directly measurable. Here, we used hierarchical modelling of species communities (HMSC), a recently developed framework for joint species distribution modelling, to estimate the role of biotic effects alongside environmental factors using latent variables. We investigate the role of these factors determining species distributions in communities of Artiodactyla, Perissodactyla and Proboscidea in the Afrotropics, an area of peak species richness for hoofed mammals. We also calculate pairwise trait dissimilarity between these species, from a mixture of morphological and behavioural traits, and investigate the relationship between dissimilarity and estimated residual co‐occurrence in the model. We find that while ungulate distributions appear to be predominantly determined (~ 70%) by climatic variables, such as precipitation, a substantial proportion of the variance in ungulate species distributions (~ 30%) can also be attributed to modelled latent variables that likely represent a combination of dispersal barriers and biotic factors. Although we find only a weak relationship between residual co‐occurrence and trait dissimilarity, we suggest that our results may show evidence that biotic factors, likely influenced by historical barriers to species dispersal, are important in determining species communities over a continental area. The HMSC framework can be used to provide insight into factors affecting community assembly at broad scales, and to make more powerful predictions about future species distributions as we enter an era of increasing impacts from anthropogenic change.
Multi agent collaborative search algorithm with adaptive weights
Authors: Cao Li , Wang Maocai , Vasile Massimiliano , Dai Guangming
Published: August 2024

This paper presents a new version of Multi Agent Collaborative Search (MACS) with Adaptive Weights (named MACS‐AW). MACS is a multi‐agent memetic scheme for multi‐objective optimization originally developed to mix local and population‐based search. MACS was proven to perform well on a number of test cases but had three limitations: (i) the amount of computational resources allocated to each agent was not proportional to the difficulty of the sub‐problem the agent had to solve; (ii) the population‐based search (called social actions in the following) was using only one differential evolution (DE) operator with fixed parameters; (iii) the descent directions were not adapted during convergence, leading to a loss of diversity. In this paper, we propose an improved version of MACS, that implements: (i) a new utility function to better manage computational resources; (ii) new social actions with multiple adaptive DE operators; (iii) an automatic adaptation of the descent directions with an innovative trigger to initiate adaptation. First, MACS‐AW is compared against some state‐of‐art algorithms and its predecessor MACS2.1 on some standard benchmarks. Then, MACS‐AW is applied to the solution of two real‐life optimization problems and compared against MACS2.1. It will be shown that MACS‐AW produces competitive results on most test cases analysed in this paper. On the standard benchmark test set, MACS‐AW outperforms all other algorithms in 11 out of 30 cases and comes second in other 8 cases. On the two real engineering test set, MACS‐AW and its predecessor obtain same results.
Renal protective roles of macrophage matrix metalloproteinase‐12 in mice with obstructed kidneys
Authors: Hanai Shunichiro , Nakagomi Daiki , Suzuki Kotaro , Nakajima Hiroshi , Furuya Fumihiko
Published: August 2024

Matrix metalloproteinase (MMP)‐12 has been reported to have diverse functions, including regulation of immune reactions and anti‐inflammatory effects, but the potential roles of MMP‐12 in kidney injury have not been fully elucidated. This study aimed to determine whether MMP‐12 contributes to tubulointerstitial injury in a unilateral ureteric obstruction (UUO) model. MMP‐12‐deficient (MMP‐12−/−) mice and C57BL/6J mice as controls (MMP‐12+/+) were subjected to UUO and analysed 7 days after UUO. To analyse the functions of MMP‐12 on monocytes/macrophages, we generated MMP‐12‐deficient, irradiated, chimeric mice (BM‐MMP‐12−/−) and performed UUO. Bone marrow‐derived macrophages (BMDMs) were isolated from both groups of mice and used for investigations. MMP‐12−/− mice showed exacerbation of macrophage accumulation and interstitial fibrosis in the UUO‐kidney compared with control mice. BM‐MMP‐12−/− mice also showed exacerbation of kidney injury. UUO induced accumulation of Ly6C+ macrophages in MMP‐12−/− mice compared with control mice. Increases in inflammatory cytokine (tumour necrosis factor α, interleukin [IL]‐1β, IL‐6) levels from BMDMs after lipopolysaccharide stimulation were higher in MMP‐12−/− mice than in MMP‐12+/+ mice. MMP‐12 may play protective roles against kidney injury by UUO in mice, decreasing inflammatory cytokines from BMDMs and macrophage accumulation.
How the use of animated versus static emojis in online post‐purchase communication affects consumer attitude
Authors: Wang Tingyi , Chen Rong
Published: August 2024

The communication style between seller and consumer is an important component of post‐purchase communication, yet little research has examined the role of nonverbal language in online post‐purchase communication. Given the prevalence of emojis, which convey a sender's emotion, in both social and business communication online, this article aims to examine how the use of animated emojis in online post‐purchase communication differs from the use of static emojis. Through three laboratory experiments, this research shows that consumers' attitudes are more positive when they communicate with sellers who use animated emojis than with sellers who use static emojis in online post‐purchase communications (Studies 1 and 2). We also demonstrate that sellers' use of animated emojis, rather than static emojis, increases consumers' perceived emotional support, which subsequently boosts consumers' positive attitudes (Study 2). Notably, when consumers discuss embarrassing products in online post‐purchase communications, sellers' use of static emojis is more effective than that of animated emojis (Study 3). These findings therefore provide insights into why and when consumers prefer animated emojis and how sellers can use them appropriately in online post‐purchase communications.
Spray skin protectant versus standard moisturiser in the prevention of radiodermatitis in patients with anal canal and rectal cancer: A randomised clinical trial
Authors: Simões Fabiana Verdan , da Silva e Silva Thamiris , Pires Aline Aniceto , França Caio Ribeiro Muzzi , Velasco Nathália Sodré , Santos Valdete Oliveira , Moreira Katia , da Silva Marcelle Miranda , Brandão Marcos Antônio Gomes , de Oliveira Beatriz Guitton Renaud Baptista , da Silva Rafael Celestino
Published: August 2024

The evidence on products for the prevention of radiodermatitis is limited. The primary objective was to analyse the effectiveness of the spray skin protectant ‘non‐burning barrier film’ in the prevention of radiodermatitis with moist desquamation in patients with the anal canal and rectal cancer followed in nursing consultations compared to a standardised moisturiser based on Calendula officinalis and Aloe barbadensis. Single‐blind randomised clinical trial. The study was performed in a hospital in Rio de Janeiro, Brazil, with 63 patients undergoing anal canal and rectal cancer treatment, randomised into one of the following two groups: an experimental group, which used a spray skin protectant and a control group, which used a moisturiser. Data were collected using an initial and subsequent evaluation form and were assessed using descriptive and inferential analyses. Participants who used the spray skin protectant had a lower chance of presenting radiodermatitis with moist desquamation and a longer time without this outcome when compared to the control group. The overall incidence of radiodermatitis was 100%, with 36.5% being severe. Furthermore, 17.5% of participants discontinued radiotherapy due to radiodermatitis. There were no differences between the groups regarding the severity of radiodermatitis and the number of patients who discontinued radiotherapy. The skin protectant was effective in preventing radiodermatitis with moist desquamation amongst patients with anal canal and rectal cancer.
Interpretable machine learning models based on shear‐wave elastography radiomics for predicting cardiovascular disease in diabetic kidney disease patients
Authors: Dai Ruihong , Sun Miaomiao , Lu Mei , Deng Lanhua
Published: August 2024

Background

The risk of cardiovascular complications is significantly elevated in patients with diabetic kidney disease (DKD). Recognizing the link between the progression of DKD and an increased risk of cardiovascular disease (CVD), it is crucial to focus on the early prediction and management of CVD risk factors among these patients to potentially enhance their health outcomes.

Objective

This study sought to bridge the existing gap by developing and validating machine learning (ML) models that utilize clinical data and shear wave elastography (SWE) radiomics features to identify patients at risk of CVD, ultimately aiming to improve the management of DKD.

Materials and Methods

This study conducted a retrospective analysis of 586 patients with DKD, dividing them into training and external validation cohorts. We categorized patients based on the presence or absence of CVD. Utilizing SWE imaging, we extracted and standardized radiomics features to develop multiple ML models. These models underwent internal validation using radiomics features alone, clinical data, or a combination thereof. The optimal model was then identified, and its feature importance was assessed through the Shapley Additive Explanations (SHAP) method, before proceeding to external validation.

Results

Among the 586 patients analyzed, 30.7% (180/586) were identified as at risk for CVD. The study pinpointed six significant radiomics features related to CVD, alongside six critical pieces of clinical data. The Support Vector Machine (SVM) model outperformed others in both internal and external validations. Further, SHAP analysis highlighted five principal determinants of CVD risk, comprising three clinical indicators and two SWE radiomics features.

Conclusions

This study highlights the effectiveness of an SVM model that combines clinical and radiomics features in predicting CVD risk among DKD patients. It enables early prediction of CVD in this patient group, thereby supporting the implementation of timely and suitable interventions.
Factors influencing inpatient bowel preparation: a scoping review
Authors: Marchildon Marianne , Jackson Jennifer , Rankin Janet
Published: August 2024

Background and Aim

Inpatients undergoing colonoscopy experience a higher‐than‐average rate of inadequate bowel preparation (compared to outpatients) leading to canceled procedures, increased stress on the patient, increased time in hospital, and increased cost to the healthcare system. The aim of this scoping review was to identify research surrounding inpatient bowel preparation and to identify modifiable and non‐modifiable factors that influence the adequacy of bowel preparation in hospitalized patients undergoing colonoscopy and establish areas where nursing interventions may help improve overall bowel preparation rates.

Methods

An initial search of MEDLINE, CINAHL, Scopus, and Embase was undertaken to identify seed articles, followed by a structured search using keywords and subject headings. Studies conducted between 2000 and 2022 and published in English were included. A total of 37 full‐text studies were screened for inclusion, with 22 meeting inclusion criteria.

Results

Advanced age, decreased mobility, constipation, extended length of stay, and multiple comorbidities were identified as non‐modifiable factors associated with inadequate bowel preparation. Narcotic use, failure to follow preparation instruction, and delayed time to colonoscopy were identified as modifiable factors associated with poor bowel preparation.

Conclusions

Educational interventions and interprofessional programs, using a multifaceted approach, increase the odds of adequate bowel preparation, including nursing tip sheets, troubleshooting flowsheets, and bowel movement assessment scoring.
Racial and ethnic disparities in potentially inappropriate medication use in patients with dementia
Authors: Zhu Carolyn W. , Choi Justin , Hung William , Sano Mary
Published: August 2024

Introduction

Racial and ethnic disparities in potentially inappropriate medication (PIM) use among older adults with dementia are unclear.

Methods

Data were drawn from the baseline visits of participants who were ≥60 years old and diagnosed with dementia in the National Alzheimer's Coordinating Center Uniform Data Set (NACCUDS) recruited from National Institute on Aging (NIA)‐funded Alzheimer's Disease Research Centers (ADCs) throughout the United States. PIM utilization was evaluated using the 2019 American Geriatrics Society Beers Criteria for PIM Use in Older Adults. We estimated the association between race and ethnicity and the following outcomes and estimation models: (1) any PIM use, any PIM in each drug class, and any PIM best avoided in dementia patients using logistic regression models, (2) total number of medications, total number of PIMs, and anticholinergic burden scale (ACBS) using Poisson or negative binomial regression models, and (3) proportion of total medications that were PIMs using generalized linear models (GLM).

Results

Compared to White participants, Black, Hispanic, and Asian participants reported taking fewer total medications (incidence rate ratio [IRR] ± standard error[SE] = 0.903 ± 0.017, 0.875 ± 0.021, and 0.912 ± 0.041, respectively, all p < 0.01). Asian participants were less likely to be exposed to any PIM (odds ratio [OR] ± SE = 0.619 ± 0.118, p < 0.05). Compared to White participants, Black participants were less likely to be exposed to benzodiazepine (OR ± SE = 0.609 ± 0.094, p < 0.01) and antidepressant (OR ± SE = 0.416 ± 0.103, p < 0.001) PIMs, but greater antipsychotic (OR ± SE = 1.496 ± 0.204, p < 0.01), cardiovascular (OR ± SE = 2.193 ± 0.255, p < 0.001), and skeletal muscle relaxant (OR ± SE = 2.977 ± 0.860, p < 0.001) PIMs. Hispanic participants were exposed to greater skeletal muscle relaxant PIMs and had lower anticholinergic burden. Asian participants were exposed to fewer benzodiazepine PIMs.

Discussion

Significant racial and ethnic disparities in exposure to PIMs and PIMs by medication category in dementia research participants who have access to dementia experts found in the study suggest that disparities may be wider in the larger community.
Immersive virtual reality is more effective than non‐immersive devices for developing real‐world skills in people with intellectual disability
Authors: Franze A. , Loetscher T. , Gallomarino N. C. , Szpak A. , Lee G. , Michalski S. C.
Published: August 2024

Background

People with intellectual disability (ID) demonstrate persistent challenges around developing life skills. Immersive virtual reality (IVR) is gaining interest as a tool for training life skills as it enables individuals to engage in hands‐on learning in a safe, controlled and repeatable environment. However, there are concerns about the potential drawbacks of IVR, such as cybersickness and practical challenges with using the equipment, which may hinder its widespread adoption in educational settings. The current study aimed to compare the effectiveness of training in IVR and a non‐immersive virtual environment for improving real‐world skills in people with ID.

Methods

In the present study, 36 adults (16 female, 20 male) with ID were recruited from a disability organisation. Participants completed a real‐world assessment of waste management skills before and after training in either the IVR or non‐immersive group.

Results

Consistent with our hypotheses, the IVR group scored significantly higher in the real‐world assessment after virtual training (d = 1), and at the 1‐week follow‐up (d = 1.12), compared with the non‐immersive group. Further analyses showed that the IVR group, but not the non‐immersive group, significantly improved performance in the real‐world assessment across timepoints.

Conclusions

The findings indicate that IVR was more effective for improving and retaining real‐world waste management skills. This study supports IVR as a viable tool for professionals and caregivers to develop skills for independent living among people with ID.
Investigating the inhibitory effects of carotenoids‐fortified Helix aspersa slime on oxidative stress, collagenase and tyrosinase enzyme activities
Authors: Alkhadhrh Mohammed , Issa Reem , Al‐Halaseh Lidia Kamal , Alnsour Lilian , Alsarayreh Ahmad , Al Qaisi Yaseen , Matalqah Sina M. , Aladwan Safwan
Published: August 2024

Background

The investigations of snail slime and its possible biological activities have been performed recently.

Aim

This study aimed to evaluate the properties of Helix aspersa snail slime (HAS), and carotenoids‐fortified slime (HASC).

Methods

Snails were fed with carrots for 10 days. Slime was collected and extracted using water. Saponins identification, antioxidant, collagenase, and tyrosinase enzyme inhibition activities, carotenoids, total phenols, and flavonoids content, were determined. UHPLC–MS/MS analysis was performed for phytochemical characterization.

Results

Saponins were detected in the HAS extract only. However, HASC was shown to contain a higher carotenoid content than HAS (29.51 ± 0.4 vs. 18.11 ± 0.2 μg/g). similarly, total phenolic and flavonoid content were higher for the the HASC extract compared to the HAS (182.3 ± 5.2 vs. 150.28 ± 3.3 mg/g equivalent to gallic acid), and (77.62 ± 1.2 vs. 14.19 ± 0.9 mg/g equivalent to quercetin). As expected, the HASC extract exhibited higher antioxidant activity compared to the HAS, using DPPH and the ABTS assays (IC50 = 7.75 ± 0.14 vs. 20.1 ± 0.4 μg/mL), and (IC50 = 7.6 ± 0.26 vs. 19.57 ± 1.4 μg/mL). UHPLC–MS/MS analysis revealed the presence of several phytocomponents of which, hexadecanoic acid and ascorbic acid, were observed in the HASC extract. Furthermore, HASC extract exhibited superior inhibitory activity compared to HAS against collagenase and tyrosinase enzymes (IC50 = 8.4 ± 1.19 vs. 15.3 ± 1.12 μg/mL) and (IC50 = 30.1 ± 0.91 vs. 35 ± 1.3 μg/mL).

Conclusion

These findings highlight the potential of HASC as a valuable ingredient in various pharmaceutical applications, due to their content of various phenolic, antioxidants, carotenoids, hexadecanoic, and ascorbic acids. The latter is well known for its great cosmeceutical applications used for slowing the process of skin aging.
Deceitful autocratization: Subverting democracy through electoral reform in Mexico
Authors: Monsiváis‐Carrillo Alejandro
Published: August 2024

Antipluralist incumbents often resort to opaque and deceptive strategies to subvert democracy. One such strategy involves devising formal institutions that pretend to promote and deepen democracy while enforcing authoritarian rule instead. This study labels such a strategy as “deceitful autocratization” and argues that a case that illustrates how antipluralist presidents promote it is the electoral reform launched by Andrés Manuel López Obrador in Mexico. The analysis shows that López Obrador is a populist leader who also features prominent illiberal and antipluralist attributes. The article examines the political process that led to the legal modifications he introduced, which aimed at an overhaul of the country's system of electoral governance, one of the crucial foundations of Mexican democracy. The reform was supposed to democratize the regime, eliminate electoral fraud, and reduce the cost of elections. In fact, it represented a step forward in establishing competitive authoritarianism.
Multi‐state evaluation of Candida infections in burn patients
Authors: Salimi Maryam , Javidnia Javad , Abastabar Mahdi , Mobayen Mohammad Reza , Moslemi Azam , Rahimzadeh Golnar , Yazdani Charati Jamshid , Mirzaei Tirabadi Nahid , Nouranibaladezaei Seyedehzahra , Asghari Hassan , Sobouti Behnam , Dahmardehei Mostafa , Seyedmousavi Seyedmojtaba , Shokohi Tahereh
Published: August 2024

Background

Burn patients are at high risk of developing secondary invasive fungal infections due to their compromised skin barrier, extensive use of antibiotics, and immunosuppression.

Objectives

We investigated demographic characteristics and clinical factors associated with Candida infections in intensive care unit (ICU) burn patients, and the in vitro antifungal susceptibility of species of isolates.

Methods

A total of 353 burn patients admitted to three major ICUs of burn centers in Iran were evaluated between 2021 and 2023. Patients were considered as colonisation and candidemia. Demographic characteristics, burn‐related factors, and clinical conditions were compared among the groups. Furthermore, we identified fungi at the species level and performed antifungal susceptibility testing according to CLSI guidelines.

Results

Overall, 46.2% of patients were colonised with a Candida species, leading to candidemia in 15.3%. The most frequently isolated species from candidemia and burn wound colonisation were Candida parapsilosis (37.0%) and Candida albicans (31.9%), respectively. Risk factors linked to candidemia included larger total body surface area (TBSA) (>50%), older patients, indwelling catheters, diabetes, and an extended ICU stay. Mortality rate was higher among candidemia patients (82.5%) compared to colonised patients (7.3%). The resistance rate of the strains isolated from candidemia to fluconazole and voriconazole was 28% and 18.2%, respectively.

Conclusion

We found that a higher percentage of TBSA burn injuries, longer hospital stays, and catheterization are important predictors of candidemia. The mortality rate was significantly higher in people infected with non‐albicans Candida species. Prevention and treatment strategies for candidemia should be based on updated, regional epidemiological data.
Anthropology at speed, at scale, in action: The CommuniVax example
Authors: Brunson Emily K. , Schoch‐Spana Monica
Published: August 2024

This special issue presents accounts of different aspects of the CommuniVax Coalition and its work—a project that conducted rapid, multisited, applied anthropological research to deliver guidance during the COVID‐19 pandemic. Our purpose in writing these articles is to provide details of our work so anthropologists interested in similar types of research can learn from our efforts. While anthropological research has been, and largely still is, an endeavor of individuals at a relatively slow pace, the future of the discipline, and especially of anthropologists working outside traditional academia, is team‐based, rapid research. As such, anthropologists need to know how to conduct research at speed, participate as members of research teams and, more importantly, how to organize and lead teams to conduct timely, collaborative, focused, and practical research.
Rikkunshito improves anorexia through ghrelin‐ and orexin‐dependent activation of the brain hypothalamus and mesolimbic dopaminergic pathway in rats
Authors: Yakabi Koji , Yamaguchi Naomi , Takayama Kiyoshige , Hosomi Eriko , Hori Yutaro , Ro Shoki , Ochiai Mitsuko , Maezawa Kosuke , Yakabi Seiichi , Harada Yumi , Fujitsuka Naoki , Nagoshi Sumiko
Published: August 2024

Background

Rikkunshito (RKT), a traditional Japanese medicine, can relieve epigastric discomfort and anorexia in patients with functional dyspepsia. RKT enhances the orexigenic hormone, ghrelin. Ghrelin regulates food motivation by stimulating the appetite control center in the hypothalamus and the brain mesolimbic dopaminergic pathway (MDPW). However, the effect of RKT on MDPW remains unclear. Here, we aimed to investigate the central neural mechanisms underlying the orexigenic effects of RKT, focusing on the MDPW.

Methods

We examined the effects of RKT on food intake and neuronal c‐Fos expression in restraint stress‐ and cholecystokinin octapeptide‐induced anorexia in male rats.

Key Results

RKT treatment significantly restored stress‐ and cholecystokinin octapeptide‐induced decreased food intake. RKT increased c‐Fos expression in the ventral tegmental area (VTA), especially in tyrosine hydroxylase‐immunoreactive neurons, and nucleus accumbens (NAc). The effects of RKT were suppressed by the ghrelin receptor antagonist [D‐Lys3]‐GHRP‐6. RKT increased the number of c‐Fos/orexin‐double‐positive neurons in the lateral hypothalamus (LH), which project to the VTA. The orexin receptor antagonist, SB334867, suppressed RKT‐induced increase in food intake and c‐Fos expression in the LH, VTA, and NAc. RKT increased c‐Fos expression in the arcuate nucleus and nucleus of the solitary tract of the medulla, which was inhibited by [D‐Lys3]‐GHRP‐6.

Conclusions & Inferences

RKT may restore appetite in subjects with anorexia through ghrelin‐ and orexin‐dependent activation of neurons regulating the brain appetite control network, including the hypothalamus and MDPW.
Hydrogen isotope fractionation in plants with C3, C4, and CAM CO2 fixation
Authors: Schuler Philipp , Rehmann Oliver , Vitali Valentina , Saurer Matthias , Oettli Manuela , Cernusak Lucas A. , Gessler Arthur , Buchmann Nina , Lehmann Marco M.
Published: August 2024

Measurements of stable isotope ratios in organic compounds are widely used tools for plant ecophysiological studies. However, the complexity of the processes involved in shaping hydrogen isotope values (δ2H) in plant carbohydrates has limited its broader application.

To investigate the underlying biochemical processes responsible for 2H fractionation among water, sugars, and cellulose in leaves, we studied the three main CO2 fixation pathways (C3, C4, and CAM) and their response to changes in temperature and vapor pressure deficit (VPD).

We show significant differences in autotrophic 2H fractionation (εA) from water to sugar among the pathways and their response to changes in air temperature and VPD. The strong 2H depleting εA in C3 plants is likely driven by the photosynthetic H+ production within the thylakoids, a reaction that is spatially separated in C4 and strongly reduced in CAM plants, leading to the absence of 2H depletion in the latter two types. By contrast, we found that the heterotrophic 2H‐fractionation (εH) from sugar to cellulose was very similar among the three pathways and is likely driven by the plant's metabolism, rather than by isotopic exchange with leaf water.

Our study offers new insights into the biochemical drivers of 2H fractionation in plant carbohydrates.
Evolutionary arms race: the role of xylan modifications in plant–pathogen interactions
Authors: Mortimer Jenny C. , Scheller Henrik V.
Published: August 2024

This article is a Commentary on Yu et al. (2024), 244: 1024–1040.
Economic Growth Analysis When Balanced Growth Paths May Be Time Varying
Authors: Mountford Andrew
Published: August 2024

The determinants of an economy's growth path for income per head may vary over time. In this paper, we apply unobserved components analysis to an otherwise standard panel model of economic growth dynamics so that an economy's long‐run relative income per head can change at any point of time. We apply this model to data for US states for 1929–2021 and the world economy for 1970–2019. In both datasets an economy's initial relative income per head is a good predictor of its long‐run relative income per head. Relatively poor economies on average remain relatively poor.