bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy of imeglimin treatment versus metformin dose escalation on glycemic control in subjects with type 2 diabetes treated with a dipeptidyl peptidase‐4 inhibitor plus low‐dose metformin: A multicenter, prospective, randomized, open‐label, parallel‐group comparison study (MEGMI study)
Authors: Takahashi Akihiro , Nomoto Hiroshi , Yokoyama Hiroki , Yokozeki Kei , Furusawa Sho , Oe Yuki , Kameda Reina , Kawata Shinichiro , Miyoshi Arina , Nagai So , Miya Aika , Kameda Hiraku , Nakamura Akinobu , Atsumi Tatsuya ,   the MEGMI study group
Published: December 2024

Aims

To compare the efficacy of adding imeglimin versus that of metformin dose escalation on glycemic control in subjects with type 2 diabetes treated with a dipeptidyl peptidase‐4 inhibitor plus low‐dose metformin (500–1000 mg/day).

Materials and Methods

In this multicentre, open‐labelled, prospective, randomized, parallel‐group comparison study, the addition of imeglimin (2000 mg/day) or metformin escalation was applied for 24 weeks in eligible subjects. The primary endpoint was the mean change in glycated haemoglobin (HbA1c) over 24 weeks. As the secondary endpoints, the occurrence of adverse events, changes in metabolic parameters, biomarkers and factors associated with HbA1c improvement were analysed.

Results

Seventy‐three eligible subjects were enrolled. Of them, 65 participants comprised the full analysis set. At 24 weeks, the addition of imeglimin (n = 33) resulted in greater improvement in HbA1c compared with metformin dose escalation (n = 32) (from 7.61 ± 0.48% to 6.93 ± 0.49% in imeglimin and from 7.56 ± 0.61% to 7.09 ± 0.56% in metformin escalation; change difference: −0.21% [95% confidence interval: −0.41%, −0.01%] [p = 0.038]); however, seven subjects in the imeglimin group discontinued imeglimin because of serious adverse events on gastrointestinal tract. In intra‐group pre/post comparisons, imeglimin treatment significantly reduced body weight and improved liver enzyme elevation. There was a significant correlation between improvement levels of HbA1c and indicators of fatty liver disease in the imeglimin group.

Conclusions

Imeglimin in combination with a dipeptidyl peptidase‐4 inhibitor and low‐dose metformin improved HbA1c compared with metformin dose escalation.
Hitting and Unhitting the Pause Button: Variable Hatching Patterns of Annual Killifish Embryos Over a Wetland Wet–Dry Cycle
Authors: Weber Vinicius , Alonso Felipe , Godoy Robson Souza , Lanés Luis Esteban Krause , Pires Mateus Marques , Stenert Cristina , Gava Adriana , Maltchik Leonardo
Published: December 2024

Hatching dynamics is key to population structure of annual fishes in temporary wetlands. Given the risk of false starts due to unpredictable hydroperiods, annual fish may employ risk‐spreading strategies in their hatching patterns consistent with bet hedging (such as the partial hatching of their egg bank and variable number of hatching cues) after being exposed to floods. However, the extent to which annual fish resort to bet hedging (as well as their potential drivers) over a wet–dry cycle is poorly understood. We assessed the hatching patterns of a South American killifish (Matilebias cyaneus; Cyprinodontiformes: Rivulidae) collected at different hydrological phases of a temporary wetland to test for variation in bet hedging over a wet–dry cycle. We incubated wild eggs of M. cyaneus obtained from male–female pairings separately reared in tanks originating in the ‘early‐wet’, ‘drying’ and ‘late‐wet’ phases of a temporary wetland and examined hatching patterns across a sequence of hydration trials under common‐garden conditions. We found variation in (i) the number of hatched and unhatched eggs and (ii) the number of hatched eggs across hydration trials among clutches from each phase (while controlling for parentage). Our results show that M. cyaneus variably commit to bet‐hedging hatching strategies over a wet–dry cycle, and suggest that the environmental conditions at specific periods of the year and the parental age at which eggs are produced drive annual fish hatching patterns.
What Deserve Studying the Most? A Q‐Methodology Approach to Explore Stakeholders' Perspectives on Research Priorities in GenAI‐Supported Second Language Education
Authors: Wu Hanwei , Pan Ziwen
Published: December 2024

Recently, there has been a significant increase in research on Generative Artificial Intelligence (GenAI) in the domain of second language (L2) education. Given the limited resources, it is essential for GenAI research to focus on key areas. However, there is still uncertainty about which topics should be prioritised. Research priorities are often shaped by individual researchers' personal interests, which can skew the focus of many studies. Additionally, stakeholder perspectives on these topics can vary widely. Therefore, this study employs the Q methodology to reveal the consensus among different stakeholder groups. To this end, a total of 19 participants, including six researchers, six teachers and seven students, engaged in a Q‐sort exercise involving 34 statements. Through KADE software, the subsequent Centroid Factor Analysis and varimax rotation were used to extract patterns. The analysis revealed three common perspectives across stakeholder groups: psychological factors of teachers and students, multiple scenarios of measurement and the improvement of L2 competence. These findings provide valuable insights that can inform and refine research agendas in GenAI for L2 education, optimising the allocation of resources.
Urgent, but How? Developing English Foreign Language Teachers' Digital Literacy in a Professional Learning Community Focusing on Large Language Models
Authors: Xue Lina
Published: December 2024

With the advent of chatGPT, burgeoning research have been conducted to explore AI technologies' impact on the EFL teaching and learning. However, little is known about how language teachers navigate the shifting education landscape and develop the digital literacy in the AI era. This preliminary qualitative study aims to investigate the processes of how 9 Chinese EFL teachers in a university‐based professional learning community improve their digital literacy, and reveal the factors influencing their digital literacy improvement. To achieve the research objectives, triangle data have been collected including the community meeting records, interviews of participants, class observations, and the participants' reflective journals. In the data analysis section, thematic analysis method has been employed. The findings indicate three distinct types of digital literacy improving processes for the novice teachers, the veteran teachers, and the lead teachers in the heterogeneous and interactive community. Meanwhile, these processes were influenced by the community factors such as artefacts, mediated activities, and social interactions, and the individual factors such as years of teaching experience, teaching subjects, teachers' belief about AI, teachers' theoretical base and research experience. Accordingly, implications are presented to EFL teachers, teacher educators and administrators.
Comparison of HiDAC Versus FLAG‐IDA in the Treatment of Relapsed Acute Myeloid Leukemia and High‐Risk Myelodysplastic Syndrome
Authors: Tang Man Wai , Van der Tuin Deborah , Aydin Mesire , Heijmans Jarom , Van de Loosdrecht Arjan A. , Meijer Ellen , Rutten Caroline E. , Wondergem Mariëlle , Janssen Jeroen J. W. M. , Donker Marjolein L. , Hazenberg Mette D. , Zweegman Sonja , Biemond Bart J. , De Leeuw David C. , Nur Erfan
Published: December 2024

Background

Relapsed acute myeloid leukemia (AML) and high‐risk myelodysplastic syndrome (HR‐MDS) are associated with a poor prognosis. It is unknown which re‐induction therapy provides the highest chance of durable remission. Commonly used therapies are high dose cytarabine (HiDAC) and triple therapy consisting of fludarabine, cytarabine, and idarubicin combined with granulocyte colony‐stimulating factor (FLAG‐IDA).

Methods

Two patient cohorts with relapsed AML or HR‐MDS treated with HiDAC or FLAG‐IDA between October 2015 and December 2021 in two academic hospitals in the Netherlands were retrospectively analyzed.

Results

Patients were treated with either HiDAC (n=22) or FLAG‐IDA (n=25). Rates of CR (71% vs. 74%, P=0.85), 1‐year OS (47% vs. 51%, P=0.99) and EFS (38% vs. 35%, P=0.71) were comparable between HiDAC and FLAG‐IDA. Durations of neutropenia (median 24 days (IQR 20‐26) vs. 30 days (IQR 22‐39), P=0.014) and thrombocytopenia (22 days (IQR 17‐26) vs. 36 days (IQR 26‐53)) were significantly shorter in the HiDAC group than in the FLAG‐IDA group.

Conclusion

While remission rates and survival outcomes were similar, FLAG‐IDA was associated with longer periods of myelosuppression and transfusion dependency compared to HiDAC in these two cohorts. HiDAC can be considered as a salvage chemotherapyfor relapsed AML/HR‐MDS based on our study.
Still Functional but Limited Postural Adaptation for Individuals With Parkinson's Disease in Goal‐Directed Visual Tasks
Authors: Kechabia Yann‐Romain , Defebvre Luc , Delval Arnaud , Bonnet Cédrick T.
Published: December 2024

Patients with Parkinson's disease (PD) notably exhibit impairments in posture and visual attention. The objective of the present study was to determine whether PD patients were able to exhibit adaptive postural control in a goal‐directed visual task. We hypothesized that the patients would reduce their centre of pressure (COP) movement and/or postural sway to a lesser extent than age‐matched controls in the goal‐directed visual (search) task, compared with the control free‐viewing task (i.e., a lower degree of relative postural adaptation). We also expected the PD patients to sway more than controls in the goal‐directed task (i.e., a lower degree of absolute adaptive postural control). The study included 39 PD patients (mean age: 59; mean Hoehn and Yahr stage: 2.1; mean Movement Disorder Society‐Unified Parkinson's Disease Rating Scale score: 22; mean Montreal Cognitive Assessment score: 28 (on‐drug)) and 40 age‐matched adults (mean age: 62 years). The participants gazed at domestic ecological images (visual angle: 100°). Movements of the COP, head, upper back and lower back and variations in pupil dilatation were analysed. As expected, PD patients exhibited greater COP and body sway than controls in both tasks (p < 0.05). Unexpectedly, the difference in COP and/or body sway between the two tasks was greater in PD patients than in controls (p < 0.05). Our results showed that PD patients are able to exhibit adaptive postural control for goal‐directed visual tasks. On a practical level and at a more general level, our findings emphasize the likely benefits of rehabilitation with goal‐directed tasks requiring a visual attentional focus (walking on footprints on the ground, etc.).
Current Psychometric Models and Some Uses of Technology in Educational Testing
Authors: Brennan Robert L.
Published: December 2024

This paper addresses some issues concerning the use of current psychometric models for current (and possibly future) technology‐based educational testing (as well as most licensure and certification testing). The intent here is to provide a relatively simple overview that addresses important issues, with little explicit intent to argue strenuously for or against the particular uses of technology discussed here.
Amelioration of signaling deficits underlying metabolic shortfall in TREM2R47H human iPSC‐derived microglia
Authors: Vasilopoulou Foteini , Piers Thomas M. , Wei Jingzhang , Hardy John , Pocock Jennifer M.
Published: December 2024

The microglial triggering receptor expressed on myeloid cells 2 (TREM2) is required for diverse microglia responses in neurodegeneration, including immunometabolic plasticity, phagocytosis, and survival. We previously identified that patient iPSC‐derived microglia (iPS‐Mg) harboring the Alzheimer's disease (AD) TREM2R47H hypomorph display several functional deficits linked to metabolism. To investigate whether these deficits are associated with disruptions in metabolite signaling, we generated common variant, TREM2R47H and TREM2−/− variant human iPS‐Mg. We assessed the ability of supplementation with citrate or succinate, key metabolites and cell cycle breaking points upon microglia activation, to overcome these functional deficits with potential impact on neurons. Succinate supplementation was more effective than citrate at overcoming mitochondrial deficits in OXPHOS and did not promote a glycolytic switch. Citrate enhanced the lipid content of TREM2R47H iPS‐Mg and was more effective at overcoming Αβ phagocytic deficits, whereas succinate increased lipid content and phagocytic capacity in TREM2−/− iPS‐Mg. Microglia cytokine secretion upon pro‐inflammatory activation was moderately affected by citrate or succinate showing a condition‐dependent increasing trend. Neither metabolite altered basal levels of soluble TREM2 shedding. In addition, neither citrate nor succinate enhanced glycolysis; instead, drove their effects through oxidative phosphorylation. IPS‐neurons exposed to conditioned medium from TREM2 variant iPS‐Mg showed changes in oxidative phosphorylation, which could be ameliorated when iPS‐Mg were first treated with citrate or succinate. Our data point to discrete pathway linkage between microglial metabolism and functional outcomes with implications for AD pathogenesis and treatments.
Multisubstrate‐based system: a kinetic mechanism study of catechol‐O‐methyltransferase
Authors: Wang Fangyuan , Zhou Xianglu , Wang Haonan , Zhou Ziqiong , Yang Ling , Hu Yonghong , Qi Shenglan , Wang Ping
Published: December 2024

Catechol‐O‐methyltransferase (COMT, EC 2.1.1.6) can transfer the methyl group from S‐adenosyl‐l‐methionine (SAM) to one of the hydroxyl groups of a catechol substrate in the presence of Mg2+. However, there is no consensus view of the kinetic mechanism of COMT involving multiple substrates. Further progress requires the development of methods for determining enzyme kinetic behavior and the binding mode of ligands to the protein. Here, we establish a multisubstrate kinetic system covering the fluorescence and mass spectrometry techniques to quantify the products in a COMT‐catalyzed reaction. The catechol substrate, 3‐BTD, can be methylated by COMT to form a single product, 3‐BTMD, with a sensitive fluorescence response and the conversion of SAM to S‐adenosyl‐l‐homocysteine (SAH) was monitored by LC–MS/MS. The kinetic assays suggested that the reaction occurred via an ordered sequential mechanism, in which SAM first bound to COMT, followed by the addition of Mg2+ and 3‐BTD. The chemical step involved a quaternary complex of COMT‐SAM‐Mg2+‐3‐BTD, followed by the ordered dissociation of 3‐BTMD, Mg2+, and SAH. In cooperation with molecular dynamics simulation, the binding of COMT to Mg2+ induced a shape change in the catechol‐binding site, which accommodated 3‐BTD binding and facilitated catalysis. These findings provide new insights into the kinetic mechanism of COMT, contributing to the development of previously undescribed functional COMT ligands.
Traditional and Contemporary Measures of Recreational Fishing Activity to Inform Sustainable Management of Blue Swimmer Crab (Portunus armatus) Fisheries in Western Australia
Authors: Smallwood Claire B. , Ryan Karina L. , Lai Eva K. M. , Tate Alissa C.
Published: December 2024

Recreational fishing is a popular activity that has many social and economic benefits. Monitoring has traditionally centred around measuring fishing effort and catch. However, contemporary measures, such as fisher demographics and behaviours, which may be linked to social and economic objectives, are now recognised as necessary to meet expectations that all aspects of resource use are considered for fisheries management. The challenge for recreational fisheries is how to regularly provide information across a growing diversity of metrics, and at a scale relevant to specific fisheries, with limited resources. The Blue Swimmer Crab (Portunus armatus) is one of the most commonly recreationally harvested species in Western Australia. This species served as a case study to explore if data from five broad‐scale phone‐diary surveys between 2011–2012 and 2020–2021 could be adapted to meet expanded information needs. Twelve discrete fisheries represented small spatial‐scale areas for fisheries management, with some variation in management arrangements (i.e., bag limits). Robust estimates of traditional and contemporary measures could be produced for three fisheries: Peel‐Harvey Estuary, Swan‐Canning Estuary and Geographe Bay. Traditional measures of participation, fishing effort, total catch and harvest from 2011–2012 to 2020–2021 were generally consistent for Swan‐Canning Estuary but decreased for Peel‐Harvey Estuary and Geographe Bay. The proportion of harvest from recreational and commercial fishing varied from mixed use (Swan‐Canning Estuary, Peel‐Harvey Estuary) to recreational only (Geographe Bay). Variation in contemporary measures was also evident, with recreational fishing largely undertaken by local residents in Swan‐Canning Estuary, while participation was more uniform between local and non‐local residents in Peel‐Harvey Estuary and Geographe Bay. We found that broad‐scale surveys could be successfully adapted to meet the growing need for information on contemporary measures to support a holistic approach to sustainable fisheries management for small spatial‐scale recreational fisheries.
Quality of Life and Oral Function in Patients With Jaw Defects Following Oral Tumour Surgery
Authors: Kosaka Takayuki , Tsuji Manami , Kida Momoyo , Fushida Shuri , Akema Suzuna , Hasegawa Daisuke , Ikebe Kazunori
Published: December 2024

Objectives

To evaluate various oral functions in patients with jaw defects after oral tumour surgery and to clarify factors associated with their quality of life (QoL).

Background

In patients with jaw defects, oral function and QoL are severely impaired. No studies have evaluated oral functions of patients with jaw defects and examined their relationships with QoL.

Materials and Methods

The study participants were 72 patients (mean age: 70.7 ± 10.1 years, range 48–93 years) who underwent prosthetic treatment with a removable denture to treat a jaw defect following oral tumour surgery. Masticatory performance, maximum bite force, oral dryness, tongue pressure, and tongue‐lip motor function (oral diadochokinesis, /pa/, /ta/, /ka/ syllables) were evaluated after prosthetic treatment. The Japanese version of the EORTC QLQ‐H&N 35 was used to assess QoL. From the QoL assessment, the “Pain”, “Swallowing”, “Sense”, “Speech”, “Social eating”, and “Social contact” scales were extracted. Multiple regression analysis was conducted using each QoL scale as the dependent variable and oral functions as explanatory variables.

Results

In the multiple regression model for “Swallowing”, the oral diadochokinesis /ta/ was a significant explanatory variable. In the model for “Sense”, tongue pressure was a significant explanatory variable. In the model for “Speech”, age was a significant explanatory variable. In the model for “Social contact”, tongue pressure was the significant explanatory variable.

Conclusion

In patients with jaw defects following oral tumour surgery, lower tongue pressure is associated with poorer QoL in a wider range of ways than other oral functions are.
Effectiveness of switching strategies in CGRP monoclonal antibody therapy for migraine: A retrospective cohort study
Authors: Jaimes Alex , Gómez Andrea , Pajares Olga , Rodríguez‐Vico Jaime
Published: December 2024

Objective

To evaluate the effectiveness of first switching between monoclonal antibodies (mAbs) targeting calcitonin gene–related peptide (CGRP) or its receptor in the treatment of migraine.

Background

Although mAbs targeting CGRP or its receptor have emerged as a leading treatment for migraine prevention, a proportion of patients do not respond. While switching between these antibodies is a common clinical practice in such cases, the effectiveness remains a subject of study.

Methods

We conducted a retrospective cohort study at a tertiary headache center, analyzing data from clinical records of patients treated with anti‐CGRP mAbs from January 2020 to March 2024. Baseline was defined as the monthly headache days (MHDs) in the 3 months prior to the start of the second mAb. The primary endpoint was the change in MHDs at month 3 and month 6 following the switch. Additionally, we evaluated response rates in both periods. Subgroup analyses were conducted based on changes in mechanism of action. Finally, we assessed the influence of the number of doses of the first mAb and the inter‐treatment interval.

Results

Out of 1244 initially identified patients, 185 were included in the month‐3 analysis and 123 in the month‐6 evaluation. The median MHDs decreased from 27.0 (interquartile range [IQR] 16.1, 30.0; range 5.0, 30.7) at baseline to 21.0 (IQR 10.0, 30.0; range 0.0, 30.0; p < 0.001) at month 3, and to 20.0 (IQR 10.0, 30.0; range 0.0, 31.0; p < 0.001) at month 6. Subgroup analyses revealed no significant differences in MHDs between maintaining the same target or changing it (baseline: 28.0 [IQR 16.2, 30.0; range 5.0, 31.0] vs. 27.0 [IQR 6.0, 31.0; range 6.0, 31.0]; month 3: 23.0 [IQR 10.0, 30.0; range 0.0, 31.0] vs. 19.0 [IQR 11.0, 30.0; range 1.0, 31.0], p = 0.144; month 6: 24.0 [IQR 11.0, 30.0; range 0.0, 31.0] vs. 17.0 [IQR 10.0, 30.0; range 3.0, 31.0], p = 0.170). There was no association between a ≥50% reduction in MHDs and the number of previous doses of the first mAb (odds ratio [OR] 1.0; 95% confidence interval [CI] 1.0, 1.1; p = 0.189) or the inter‐treatment interval (OR 1.0; 95% CI 0.9, 1.1; p = 0.914).

Conclusion

Switching between anti‐CGRP mAbs resulted in a reduction in MHDs, with no significant differences based on the mechanism of action. Factors such as the number of doses of the first mAb and the inter‐treatment interval did not appear to predict a ≥50% reduction in MHDs at month 3. Our findings support the viability of switching as an effective treatment option for patients with migraine who do not respond to initial mAb therapy.
Italian version of the Headache Disability Inventory: Cross‐cultural adaptation, validity, and reliability
Authors: Rosa Riccardo , Lionetto Filippo , Angilecchia Domenico , Carmillo Laura , Castaldo Matteo , Giovannico Giuseppe , Di Lorenzo Cherubino , Pellicciari Leonardo
Published: December 2024

Objective

To translate and cross‐culturally adapt the Headache Disability Inventory (HDI) into Italian and study its reliability and validity.

Methods

A total of 132 participants with primary and secondary headaches were included. The translation was performed following international guidelines with forward and back translation procedures. Structural validity, internal consistency, test–retest reliability, measurement error, and construct validity were studied. Test–retest reliability and measurement error were tested on a subsample of 32 participants.

Results

The cross‐cultural adaptation into Italian was performed without issues. Confirmatory factor analysis supports the structural validity partially (comparative fit index = 0.963; Tucker–Lewis index = 0.959; root mean square error of approximation = 0.051; standardized root mean square residual = 0.084), showing a two‐factor structure (i.e., emotional and functional). Each subscale presented high internal consistency (α = 0.87 and 0.87 for the emotional and functional subscales, respectively), excellent and good test–retest reliability (intraclass correlation coefficient = 0.93 and 0.88 for the emotional and functional subscales, respectively), and acceptable measurement error (standard error of the measurement [SEM] = 3.6 points, minimal detectable change [MDC] = 10.0 points for the emotional subscale; SEM = 3.8 points, MDC = 10.7 points for the functional subscale). Construct validity was satisfactory for the emotional subscale and moderate for the functional subscale, as 85.7% (6/7) and 57.1% (4/7) of a priori hypotheses were met, respectively.

Conclusion

The HDI was successfully translated into Italian and has acceptable psychometric properties. The Italian version of the HDI can be used in daily clinical practice and research to assess the functional and emotional impact of primary and secondary headaches. Further research should study other psychometric properties (i.e., content validity, responsiveness, and reliability in a larger sample).
Combatting Helicobacter pylori: A Focus on Nanomaterials
Authors: Wang Xuanping , Chan Xihui Felicia , Go Yuyo , Wang Yishen , Li Tingyu , Wang Gangshi
Published: December 2024

Developing effective non‐antibiotic antimicrobial strategies is essential for combating global antibiotic resistance, including resistance stemming from Helicobacter pylori (H. pylori) treatment. Nanomaterials offer a promising and innovative approach for non‐antibiotic anti‐H. pylori treatment strategies. This review highlights the progress made in the use of metallic and nonmetallic nanoparticles, as well as nanozymes, to directly inhibit H. pylori growth. Moreover, we summarize advances made in the direct targeting of H. pylori by nanomaterials and the stimuli‐responsive release of nanoparticles in the stomach. Additionally, we explore the recent advancements in multifunctional nanoplatforms that integrate physical methods, such as light, heat, ultrasound, and magnetism, with nanomaterials to synergistically treat H. pylori infections. Finally, we briefly address the existing challenges and future directions in this field. In summary, we highlight that with ongoing research, nanomaterials may serve as a promising treatment strategy for H. pylori eradication.
HIV, measles, and syphilis: histopathologic characteristics of lymphatic system involvement of three reemerging infectious diseases
Authors: Auerbach Aaron , Schmieg John J , Klassen Mary , Nelson Ann , Aguilera Nadine S
Published: December 2024

The resurgence of measles, syphilis, and HIV presents a significant threat to global health, especially in the wake of the COVID‐19 pandemic. These three infections involve lymph nodes and have unique pathologic findings in lymph nodes. We explore the pathological and clinical characteristics of these infections, focusing on their involvement of lymph nodes and their pathologic diagnosis in lymph node specimens. For HIV, lymph nodes are sites of viral replication and reservoirs, and the disease demonstrates multiple patterns within lymph nodes. The recent increase in measles, due in part to declining vaccination rates, signals the need for pathologists to be able to identify the characteristic Warthin–Finkeldey cells present in lymph node specimens. Syphilis, a reemerging sexually transmitted infection, often presents with lymphadenopathy and can mimic other conditions, complicating clinical diagnosis. By revisiting well‐established findings and presenting new insights into the histopathological changes within lymphoid tissues, this review provides essential knowledge for pathologists and clinicians to improve diagnostic accuracy and treatment outcomes.
Global prevalence of excessive daytime sleepiness among nurses: A systematic review and meta‐analysis
Authors: Gu Kaini , Chen Huigang , Shi Hong , Hua Cui
Published: December 2024

Background

Nurses face significant risks of excessive daytime sleepiness (EDS), which adversely affects workplace safety and productivity. Yet, the extent of EDS in this workforce remains inadequately characterized.

Aim

The aims of this systematic review were to assess the pooled prevalence of EDS among nurses.

Methodology

We systematically searched PubMed, Embase, Scopus, and ISI Web of Science for observational studies reporting the prevalence of EDS, as measured by the Epworth Sleepiness Scale (ESS), from database inception to May 1, 2024, with no language restrictions. Study quality was evaluated using JBI's critical appraisal tool. Pooled estimates were calculated through random‐effects meta‐analysis, with subgroup and meta‐regression analyses assessing associations between EDS prevalence and study‐level factors. Linear regression modeling was used to assess time trends. This study was registered with PROSPERO (CRD42024535109).

Results

We included 36 unique studies encompassing 2677 nurses from 20 countries. EDS occurred in 14.0%–55.6% of nurses. The results of the meta‐analysis showed a pooled prevalence of EDS of 32.2% (95% confidence interval [CI]: 28.5–36.1; I2 = 92.6). Prevalence estimate did not vary substantially in terms of study‐level data (i.e., region, country income, pre/post covid era, hospital type, proportion of female nurse, average nursing experience, or proportion of married nurses). The prevalence of EDS in nurses has remained unchanged over time.

Conclusions

This meta‐analysis identifies a high global prevalence of EDS among nurses, affecting nearly one‐third of this workforce. The findings underscore the urgent need for targeted interventions to mitigate EDS across diverse geographic and economic contexts.

Implication for nursing and nursing policy

This study highlights the pervasive issue of EDS among nurses worldwide, necessitating comprehensive strategies to address this challenge across all regions, income levels, hospital settings, and demographic groups.
How Nursing Home Professionals Frame the Perspective on Residents' Safety Management: A Q‐Methodology Approach
Authors: Hong You Jung , Chang Sung Ok
Published: December 2024

Aim

To identify a frame of reference for resident safety management in nursing homes.

Design

Q‐methodology.

Methods

This study was conducted using Q‐methodology to identify shared perspectives about resident safety management among nursing home professionals. Data were collected from 13 May 2023, through 29 August 2023. Thirty‐four professionals, including nurses, care workers, social workers and physical therapists, classified Q‐samples into a normal distribution grid through Q‐sorting. Data analysis was performed using the PQmethod programme. Q‐factors were interpreted by integrating interview transcripts, demographic data and factor arrays that organised the analysis results.

Results

The analysis included the Q‐sort of 33 professionals, with an average age of 46.03 years and 6.53 years of nursing home experience, after excluding one individual who did not fit any Q‐factor. Four Q factors explaining 63% of the total variance were identified: constructing individualised possible risk trajectories, utilising ingrained safety principles, creating supportive safety environments and coordinating safety principles with individual needs.

Conclusion

Understanding the diverse subjectivities of professionals can help develop strategies that promote collaboration among nursing home professionals and support preventive safety management practices.

Implications for Profession and/or Patient Care

The frame of reference derived from nursing home professionals' perspectives suggests a resident‐tailored framework.

Impact

This study supports the development of interprofessional education tailored to the specific needs of nursing home settings by identifying shared perspectives among nursing home professionals. The findings highlight the need for clear guidelines to help professionals balance resident autonomy with safety and assess the impact of family involvement.

Reporting Method

Reporting involved qualitative and quantitative approaches, in compliance with the MMAT criteria for mixed‐method research.

Patient or Public Contribution

No Patient or Public Contribution.
No support for solar radiation as a major evolutionary driver of malar stripes in falcons
Authors: Vrettos Michelle , Reynolds Chevonne , Amar Arjun
Published: December 2024

The malar stripes of falcons (Falco spp.) are often hypothesised to function by reducing the amount of solar glare reflected into the falcon's eyes while hunting, thereby aiding foraging efficiency in bright conditions. This ‘solar glare hypothesis' is supported by intraspecific trends in peregrine falcons Falco peregrinus, in which populations inhabiting regions of higher average annual solar radiation exhibit larger and darker malar stripes on average. Here, we extend the methodological approach previously used in peregrine falcons to examine both intra‐ and interspecific relationships between solar radiation and malar stripe morphology across all extant falcon species, thereby providing a more robust test of the hypothesis that falcon malar stripes evolved as an adaptation against negative visual effects of solar glare. We obtained web‐sourced photographs of all extant falcon species, taken across each species' geographic range, and related mean breeding season solar radiation at each photograph location to the size and darkness of the birds' malar stripes, simultaneously testing for intraspecific and interspecific relationships between malar stripe characteristics and solar radiation, and including phylogeny and relevant ecological traits as covariates. We found no consistent interspecific relationship between solar radiation and malar stripe characteristics Likewise, in 38 out of 39 species, malar stripe characteristics were not positively intraspecifically related to solar radiation, with only peregrine falcons showing trends towards larger and darker malar stripes in brighter regions. Falcon malar stripes are thus unlikely to represent an adaptation against visual effects of solar glare, and their adaptive significance is more likely to be explained by crypsis or social signalling, if indeed they do represent an adaptive trait. Malar stripes may have become co‐opted for solar glare reduction in peregrine falcons due to the species' specialisation for high‐speed aerial hunting, although the intraspecific patterns observed may alternately be explained by phylogeography.

Keywords: avian colouration, dark eye markings, facial plumage, falcon, malar stripe, solar glare
Annual Research Review: How did COVID‐19 affect young children's language environment and language development? A scoping review
Authors: Zuniga‐Montanez Cecilia , Davies Catherine , Ligoxygakis Laurie , Kašćelan Draško , Gonzalez‐Gomez Nayeli
Published: December 2024

A diverse body of research conducted since the start of Covid‐19 has investigated the impact of the pandemic on children's environments and their language development. This scoping review synthesises the peer‐reviewed research literature on this topic between 2020 and 2023. Following the Joanna Briggs Institute methodology and the PRISMA extension for scoping reviews, we searched five databases for studies that fulfilled the following inclusion criteria: studies with neurotypical (monolingual or multilingual) 0‐6‐year‐old children; studies focusing on any area of language development, including sources describing literacy or educational practices that impacted language development; studies focusing in the context of the COVID‐19 pandemic, with no restrictions of geographical location or language used by participants. Ninety‐four eligible studies were identified for review. The extracted data were synthesised using frequency tables and narrative descriptions. Eligible studies used a wide range of data collection periods, methods, research sites, sample ages, sizes, and roles to fulfil 15 broad aims. They show that children's language‐learning environments were significantly impacted, with variability over time and across the socioeconomic spectrum. Together they investigated diverse language domains, as well as several home, educational, and demographic factors that were hypothesised to impact children's language development. Of those studies that focused on language outcomes, most converge to suggest a decline in typical expectations of children's language development, including their social communication, vocabulary, morphosyntax, literacy, and language of schooling, as well as general communication skills, school readiness, and other areas of academic progress. Our synthesis suggests that children's language and environment were significantly impacted by COVID‐19. This scoping review will support families, researchers, practitioners, and policymakers working with pandemic‐era children to further understand the effects of the pandemic on children's development.
Parent–child relationship quality buffers the association between mothers' adverse childhood experiences and physiological synchrony
Authors: Gray Sarah A.O. , Miller Jonas G. , Glackin Erin B. , Hatch Virginia , Drury Stacy S.
Published: December 2024

Background

Family environment plays a critical role in shaping stress response systems. Concordance between mothers' and children's physiological states, specifically their Respiratory Sinus Arrhythmia (RSA), reflects dyadic co‐regulation. Negative or weakened RSA synchrony during interactions is linked to various psychosocial risks, but existing research has focused on risks in the mother or child as opposed to the dyad. This study examined the association between maternal‐child RSA synchrony and maternal ACEs, given documented associations with offspring RSA, as well as more proximal documented risks, including maternal psychopathology and children's early adversity and psychopathology. Given that sensitive parent–child relationships are a powerful source of resilience, we tested whether parent–child relationship quality buffered associations between maternal ACEs and RSA synchrony.

Methods

In a community sample of mother–child dyads experiencing high sociodemographic risk and oversampled for exposure to adversity, mothers (n = 123) reported on their ACEs (43.1% ≥4), their 3–5‐year‐old children's exposure to violence, and psychological symptoms. Dyads completed a puzzle task while EKG was recorded, from which maternal and child RSA was derived; parent–child relationship quality during interactions was coded observationally. Multilevel models examined within‐dyad mother–child RSA synchrony across the interaction and between‐dyad predictors of synchrony.

Results

Parent–child relationship quality and maternal ACEs co‐contributed to offspring and dyadic physiology. Maternal ACEs predicted dampened RSA in the child and dampened RSA synchrony in the dyad, only among dyads with low observer‐rated parent–child relationship quality during the interaction. In other words, high‐quality parent–child relationship quality buffered the association between maternal ACEs and dampened offspring and dyadic physiology.

Conclusions

Results suggest that mothers' early adversity may disrupt physiological regulation at both the individual child and dyadic level. High‐quality parent–child relationships mitigated this effect.
Asia‐Pacific Survey on the Management of Helicobacter pylori Infection
Authors: Otani Koji , Hang Dao Viet , Pittayanon Rapat , Liu Henry , Chuah Kee Huat , Hsiang John , Zhang Ning , Higashimori Akira , Fujiwara Yasuhiro ,   The Upper GI Focus Group of the APAGE‐ELC
Published: December 2024

Background and Aim

Gastric cancer (GC)‐related incidence and mortality rates remain high owing to Helicobacter pylori infection in Asia, and the importance of primary and secondary prevention of GC has been well recognized. We aimed to investigate the extent of overall agreement among clinicians in the Asia‐Pacific region regarding the management of H. pylori infection.

Methods

The Upper Gastrointestinal (GI) Focus Group of the Asian Pacific Association of Gastroenterology‐Emerging Leaders Committee developed an international survey, which was distributed to 98 clinicians in the Asia‐Pacific region, compromising an online questionnaire focusing on the management of H. pylori infection.

Results

Participants responded from Japan (15, 15.3%), Hong Kong (15, 15.3%), Thailand (33, 33.7%), Vietnam (23, 23.5%), Malaysia (4, 4.1%), Singapore (3, 3.1%), and others (5, 5.1%). The most common first‐line eradication regimen was clarithromycin (CAM) triple therapy, including proton pump inhibitor (PPI), amoxicillin (AMPC), and CAM (64.3%) for 14 days (70.4%). The most common second‐line eradication regimen was levofloxacin (LVX) triple therapy, including PPI, AMPC, and LVX (22.4%) for 14 days (67.3%). Eradication therapy was deemed necessary for all asymptomatic adults and minors (aged ≤ 17 years) currently infected with H. pylori by 81.6% and 64.3% of respondents, respectively, with 82.7% considering upper GI endoscopy for GC screening useful in the secondary prevention of GC.

Conclusion

There appears to be a growing consensus among clinicians, acknowledging the necessity of eradication therapy. We anticipate that this study will establish a new benchmark in preventive medicine aimed at eradicating GC in the Asia‐Pacific region.
Implementation of Function Focused Care for Acute Care Using the Evidence Integration Triangle
Authors: Resnick Barbara , Boltz Marie , Galik Elizabeth , McPherson Rachel , Kuzmik Ashley , Drazich Brittany , Kim Nayeon , Zhu Shijun , Wells Chris
Published: December 2024

Background

The purpose of this study was to test the impact of Function Focused Care for Acute Care Using the Evidence Integration Triangle (FFC‐AC‐EIT) on hospitalized patients living with dementia.

Methods

This was a clustered randomized clinical trial including 12 hospitals from two states and 455 patients living with dementia. Hospitals were randomized to FFC‐AC‐EIT versus FFC Education Only. The mean age of the participants was 82.5 (SD = 8.5), the majority were women (62.6%), White (65.3%), married (64.4%), and had 3.0 (SD = 2.4) comorbidities. Outcome measures included the Barthel Index; the Physical Activity Survey, the Confusion Assessment Method Short Form (CAM‐S), the Neuropsychiatric Inventory (NPI), and the Pain Assessment in Advanced Dementia.

Results

At discharge, both groups improved in function and physical activity, patients in the intervention group had less increase in pain than those in the control group (β = −0.58, 95% confidence interval [95% CI] (−0.89, −0.26), p < 0.001). There were no group differences in behavioral symptoms or delirium. At 1 month post‐discharge there was a significant improvement in function (β = 5.55, 95% CI [0.36, 10.75], p = 0.036) and physical activity (β = 3.07, 95% CI [1.87, 4.28], p < 0.001).

Conclusions

Exposure to information about function focused care may help staff in acute care settings maintain and increase function and physical activity for older patients living with dementia during the hospital stay and help facilitate an increase in function and physical activity after discharge.
Advancing loss reserving: A hybrid neural network approach for individual claim development prediction
Authors: Schneider Judith C. , Schwab Brandon
Published: December 2024

Accurately estimating loss reserves is critical for the financial health of insurance companies and informs numerous operational decisions. We propose a novel neural network architecture that enhances the prediction of incurred loss amounts for reported but not settled claims. Moreover, differing from other studies, we test our model on proprietary datasets from a large industrial insurer. In addition, we use bootstrapping to evaluate the stability and reliability of the predictions and Shapley additive explanation values to provide transparency and explainability by quantifying the contribution of each feature to the predictions. Our model shows superiority in estimating reserves more accurately than benchmark models, like the chain ladder approach. Particularly, our model exhibits nuanced performance at the branch level, reflecting its capacity to effectively integrate individual claim characteristics. Our findings emphasize the potential of using machine learning in enhancing actuarial forecasting and suggest a shift towards more granular data applications.
Ganglioside GD2 Contributes to a Stem‐Like Phenotype in Intrahepatic Cholangiocarcinoma
Authors: Mannini Antonella , Pastore Mirella , Giachi Alessia , Correnti Margherita , Spínola Lasso Elena , Lottini Tiziano , Piombanti Benedetta , Tusa Ignazia , Rovida Elisabetta , Coulouarn Cédric , Andersen Jesper B. , Lewinska Monika , Campani Claudia , Battula V. Lokesh , Yuan Bin , Aureli Massimo , Carsana Emma V. , Peraldo Neia Caterina , Ostano Paola , Tani Alessia , Nosi Daniele , Vanni Anna , Maggi Laura , Di Tommaso Luca , Comito Giuseppina , Madiai Stefania , Arcangeli Annarosa , Marra Fabio , Raggi Chiara
Published: December 2024

Background & Aims

GD2, a member of the ganglioside (GS) family (sialic acid‐containing glycosphingolipids), is a potential biomarker of cancer stem cells (CSC) in several tumours. However, the possible role of GD2 and its biosynthetic enzyme, GD3 synthase (GD3S), in intrahepatic cholangiocarcinoma (iCCA) has not been explored.

Methods

The stem‐like subset of two iCCA cell lines was enriched by sphere culture (SPH) and compared to monolayer parental cells (MON). GS profiles were evaluated by chromatography, after feeding with radioactive sphingosine. Membrane GD2 expression was evaluated by FACS, and the expression of enzymes of GS biosynthesis was analysed by RT‐qPCR. The modulation of stem features by GS was investigated in vitro and in vivo using GD3S‐overexpressing cells and corroborated by global transcriptomic analysis.

Results

GS composition was markedly different comparing SPH and MON. Among complex GS, iCCA‐SPH showed increased GD2 levels, in agreement with the high expression levels of GD3 and GM2/GD2 synthases. iCCA cells overexpressing GD3S had higher sphere‐forming ability, invasive properties and drug resistance than parental cells. NOD/SCID mice implanted with CCLP1 cells overexpressing GD3S developed larger tumours than control cells. By global transcriptomic analysis, ontology investigation identified 74 processes shared by the iCCA‐SPH and GD3S‐transfected cells, with enrichment for development and morphogenesis processes, MAPK signalling and locomotion. In a cohort of patients with iCCA, GD3S expression was correlated with lymph node invasion, indicating a possible relevance of GD3S in the clinical setting.

Conclusions

The profile of GS derivatives regulates the stem‐like properties of iCCA cells.
Seasonality in Reproduction and Reproductive Physiology of Caviomorphs
Authors: Guenther Anja , Tachinardi Patricia , Valentinuzzi Veronica Sandra , Sobrero Raúl , Eberhardt Ayelen T. , Trillmich Fritz
Published: December 2024

Animals experience seasonal fluctuations of photoperiod, food availability, temperature and precipitation. This affects their energy budget, often leading to seasonal reproduction.

We review available literature and (re)‐analyse existing datasets on seasonal reproduction of South American caviomorph rodents that are characterised by long pregnancies, typically precocial young and short lactation.

While births occur nearly year‐round in many species, reproductive investment and reproductive output (litter size, offspring mass and growth) vary seasonally, with largest litters often occurring in spring/summer. Male, as well as female, reproductive physiology varies across seasons in most of the investigated species. Experimental studies manipulating environmental aspects that usually change seasonally (photoperiod, nutrition, density) indicate a slightly different mechanistic basis driving seasonal reproduction in caviomorphs than in rodents of the Northern Hemisphere.

Caviomorphs are a key component of various ecosystems and knowledge of their reproduction and how it might be influenced by climate change (i.e., mean and variance of temperature and rainfall) is urgently needed to predict future population trends.