bluuebunny/crossref_metadata_2025 huggingface dataset:
Landscapes of nausea: Successful conditioned taste aversion in a wild red fox population
Authors: Andrewartha Tim , Evans Maldwyn , Blencowe Anton , Brewer Kyle , Gordon Iain J. , Manning Adrian D.
Published: July 2023

Predation by invasive mammalian species is one of the key drivers of native species' population declines and extinctions. Current management of invasive species focuses on their removal from the landscape. However, total removal can be difficult, costly and even impossible. If eradication is not achieved, reductions in predator numbers are often temporary. New tactics are needed to target predators in situ, to reduce their negative impacts. We test the efficacy of conditioned taste aversion (CTA), a tactic that could reduce the impact of predation on target prey species. By associating nausea with a specific food source, it may be possible to condition an aversion to a target bait, and ultimately to live animals in the wild. To assess if wild invasive red foxes (Vulpes vulpes) can be conditioned to avoid a specific food source, we used baits (fried deboned chicken) containing encapsulated levamisole, an anthelmintic agent known to induce nausea leading to emesis and/or diarrhea at high dosages with no long‐term side effects. We buried baits at 30 stations across an open landscape. After treatment, reductions in control baits taken (at least 30%) were observed for 68 days, indicating the use of CTA had successfully reduced bait consumption by red foxes in a wild context. To our knowledge, this study represents the first successful test of CTA to a meat bait in a wild red fox population. Our results suggest that CTA shows promise as a tool to reduce the predation of vulnerable animals providing an alternative tactic to manage the impacts of invasive mammalian predators where eradication is currently impossible.
Variants within the LPL gene confer susceptility to diabetic kidney disease and rapid decline in kidney function in Chinese patients with type 2 diabetes
Authors: Wu Yu , Cheng Si , Gu Hongqiu , Yang Kaixuan , Xu Zhe , Meng Xia , Wang Yilong , Jiang Yong , Li Hao , Zhou Yilun , Wang Yongjun
Published: July 2023

Aim

To examine the association between lipoprotein lipase (LPL) polymorphisms and susceptibility to diabetic kidney disease (DKD) and early renal function decline in Chinese patients with type 2 diabetes (T2D).

Methods

The association of eight LPL single nucleotide polymorphisms (SNPs) with DKD was analysed in 2793 patients with T2D from the third China National Stroke Registry. DKD was defined as either an urine albumin‐to‐creatinine ratio (UACR) of 30 mg/g or higher at baseline and 3 months, or an estimated glomerular filtration rate (eGFR) of less than 60 mL/min/1.73 m2 at baseline and 3 months. Rapid decline in kidney function (RDKF) was defined as a reduction in the eGFR of 3 mL/min/1.73 m2 or greater per year. Logistic regression models were used to evaluate the association of LPL SNP and DKD with an additive model.

Results

The SNPs rs285 C>T (OR = 1.40, P = .0154), rs328 C>G (OR = 2.24, P = .0104) and rs3208305 A>T (OR = 1.85, P = .0015) were identified to be significantly associated with DKD defined by eGFR. Among 1241 participants with follow‐up data, 441 (35.5%) showed RDKF over a mean follow‐up period of 1 year, and the rs285 C allele was associated with higher odds of RDKF (OR = 1.31, 95% CI 1.04‐1.66; P = .025) after adjustment for multiple variables.

Conclusions

These results suggest that LPL‐related SNPs are new candidate factors for conferring susceptibility to DKD and may promote rapid loss of renal function in Chinese patients with T2D.
Performance of different rapid antigen testing strategies for SARS‐CoV‐2: A living rapid review
Authors: Shaver Nicole , Bennett Alexandria , Beck Andrew , Vyas Niyati , Zitiktye Gabriele , Lam Eric , Whelan Barbara , O'Regan Rhea , Conway Aileen , Skidmore Becky , Moher David , Little Julian
Published: July 2023

Background

Rapid antigen detection tests (RADTs) for SARS‐CoV‐2 testing offer several advantages over molecular tests, but there is little evidence supporting an ideal testing algorithm. We aimed to examine the diagnostic test accuracy (DTA) and the effectiveness of different RADT SARS‐CoV‐2 testing strategies.

Methods

Following PRISMA DTA guidance, we carried out a living rapid review and meta‐analysis. Searches were conducted in Ovid MEDLINE® ALL, Embase and Cochrane CENTRAL electronic databases until February 2022. Results were visualized using forest plots and included in random‐effects univariate meta‐analyses, where eligible.

Results

After screening 8010 records, 18 studies were included. Only one study provided data on incidence outcomes. Seventeen studies were DTA reports with direct comparisons of RADT strategies, using RT‐PCR as the reference standard. Testing settings varied, corresponding to original SARS‐CoV‐2 or early variants. Strategies included differences in serial testing, the individual collecting swabs and swab sample locations. Overall, specificity remained high (>98%) across strategies. Although results were heterogeneous, the sensitivity for healthcare worker‐collected samples was greater than for self‐collected samples. Nasal samples had comparable sensitivity when compared to paired RADTs with nasopharyngeal samples, but sensitivity was much lower for saliva samples. The limited evidence for serial testing suggested higher sensitivity if RADTs were administered every 3 days compared to less frequent testing.

Conclusions

Additional high‐quality research is needed to confirm our findings; all studies were judged to be at risk of bias, with significant heterogeneity in sensitivity estimates. Evaluations of testing algorithms in real‐world settings are recommended, especially for transmission and incidence outcomes.
Expanding Antarctic biogeography: microbial ecology of Antarctic island soils
Authors: Lebre Pedro H. , Bosch Jason , Coclet Clément , Hallas Rebecca , Hogg Ian D. , Johnson Jenny , Moon Katherine L. , Ortiz Max , Rotimi Adeola , Stevens Mark I. , Varliero Gilda , Convey Peter , Vikram Surendra , Chown Steven L. , Cowan Don A.
Published: July 2023

The majority of islands surrounding the Antarctic continent are poorly characterized in terms of microbial macroecology due to their remote locations, geographical isolation and access difficulties. The 2016/2017 Antarctic Circumnavigation Expedition (ACE) provided unprecedented access to a number of these islands. In the present study we use metagenomic methods to investigate the microbial ecology of soil samples recovered from 11 circum‐Antarctic islands as part of ACE, and to investigate the functional potential of their soil microbial communities. Comparisons of the prokaryote and lower eukaryote phylogenetic compositions of the soil communities indicated that the various islands harbored spatially distinct microbiomes with limited overlap. In particular, we identified a high prevalence of lichen‐associated fungal taxa in the soils, suggesting that terrestrial lichens may be one of the key drivers of soil microbial ecology on these islands. Differential abundance and redundancy analyses suggested that these soil microbial communities are also strongly shaped by multiple abiotic factors, including soil pH and average annual temperatures. Most importantly, we demonstrate that the islands sampled in this study can be clustered into three distinct large‐scale biogeographical regions in a conservation context, the sub‐, Maritime and Continental Antarctic, which are distinct in both environmental conditions and microbial ecology, but are consistent with the widely‐used regionalization applied to multicellular Antarctic terrestrial organisms. Functional profiling of the island soil metagenomes from these three broad biogeographical regions also suggested a degree of functional differentiation, reflecting their distinct microbial ecologies. Taken together, these results represent the most extensive characterization of the microbial ecology of Antarctic island soils to date.
The Spatial Autoregressive Panel Data Model with Spatial Moving Average Errors
Authors: Tan Chang , Elhorst J. Paul
Published: July 2023

This paper advocates the wider use of the spatial autoregressive (AR) panel data model with spatial moving average (MA) errors, individual and time effects, and different spatial weight matrices for each spatial lag. We demonstrate the practical relevance of this model, derive and investigate the asymptotic properties of a simple quasi maximum likelihood within estimator when is large and is finite, and provide an empirical example explaining military expenditures in 144 countries over the period 1993–2007.
RETRACTED: Prevalence of surgical wound infection and related factors in patients after long bone surgery: A systematic review and meta‐analysis
Authors: Asadi Kamran , Tehrany Pooya M. , Salari Amir , Ghorbani Vajargah Pooyan , Mollaei Amirabbas , Sarafi Milad , Ashoobi Mohammad Taghi , Esmaeili Delshad Mohammad Sadegh , Takasi Poorya , Fouladpour Amin , Karkhah Samad , Farzan Ramyar , Aris Arash
Published: July 2023

The goal of this systematic review and meta‐analysis is to provide an overview of the prevalence of surgical wound infection and related factors in patients after long bone surgery. A comprehensive, systematic search was conducted in different international electronic databases, such as Scopus, PubMed, Web of Science and Persian electronic databases such as Iranmedex and Scientific Information Database using keywords extracted from Medical Subject Headings such as “Prevalence”, “Surgical wound infection”, “Surgical site infection” and “Orthopedics” from the earliest to the May 1, 2023. The appraisal tool for cross‐sectional studies (AXIS tool) evaluates the quality of the included studies. A total of 71 854 patients undergoing long bone surgery participated in 12 studies. The pooled prevalence of surgical wound infection in patients who underwent long bone surgery reported in the 12 studies was 3.3% (95% CI: 1.5%–7.2%; I2 = 99.39%; p < 0.001). The pooled prevalence of surgical wound infection in male and female patients who underwent long bone surgery was 4.6% (95% CI: 1.7%–11.7%; p < 0.001; I2 = 99.34%) and 2.6% (95% CI: 1.0%–6.3%; I2 = 98.84%; p < 0.001), respectively. The pooled prevalence of surgical wound infection in patients with femur surgery sites reported in nine studies was 3.7% (95% CI: 2.1–6.4%; I2 = 93.43%; p < 0.001). The pooled prevalence of surgical wound infection in open and close fractures was 16.4% (95% CI: 8.2%–30.2%; I2 = 95.83%; p < 0.001) and 2.9% (95% CI: 1.5%–5.5%; I2 = 96.40%; p < 0.001), respectively. The pooled prevalence of surgical wound infection in patients with diabetes mellitus (DM), hypertension (HTN) and cardiovascular disease (CVD) was 4.6% (95% CI: 2.3%–8.9%; I2 = 81.50%; p < 0.001), 2.7% (95% CI: 1.2%–6.0%; I2 = 83.82%; p < 0.001) and 3.0% (95% CI: 1.4%–6.4%; I2 = 69.12%; p = 0.006), respectively. In general, the different prevalence of surgical wound infection in patients undergoing surgical treatment after long bone fracture may be caused by underlying factors (gender and co‐morbidity) and fracture‐related factors (surgery site and type of fracture).
A qualitative study exploring nurses' experiences of supporting South Asian people with dementia and their family carers
Authors: Jenkins Catharine , Kamal Atiya
Published: July 2023

Aims

To explore nurses' experiences of providing support to South Asian (SA) people with dementia and their family carers and to identify barriers and enablers of good transcultural care.

Design

A qualitative, phenomenological design was used.

Methods

Fifteen registered community and in‐patient nurses were recruited via one NHS Mental Health Foundation Trust. Nurses were from diverse backgrounds (Black, Ghanaian, Irish, Mauritian and White), 13 females and 2 males, and had been qualified from between 2 and 49 years. One‐to‐one semi‐structured interviews were conducted between July and October 2019.

Results

A thematic analysis identified three themes. ‘Communication challenges’ highlighted the impact of language barriers and the consequences of misunderstandings due to a dissonance in cultural values between nurses and interpreters. ‘The bi‐directional impact of culture’ identified the two‐way dynamics of transcultural work, the process of countering mutual stigma, and revealed an original perspective on how ‘cultural desire’ grows through practice experiences rather than being a prior motivation for learning. ‘Learning experiences’ showed that most learning was informal, experiential and prolonged, with nurses feeling they had unmet learning needs.

Conclusion

Nurses have minimal training opportunities and are under‐supported in their transcultural work, potentially perpetuating the disadvantages that SA people with dementia and their families face in relation to healthcare. Enhanced cultural understanding of self and others and application of specific communication strategies could support nurses, together with interpreters, to build rapport and effective working relationships with each other and service users.

Impact

Transcultural nursing is a key competency, but nurses experience difficulties with providing care which is recognized as effective by SA family carers. The development of more acceptable and effective services requires improved mutual cultural understanding between nurses, interpreters and families, underpinned by joint brief training interventions, leading to more effective professional communication, better care outcomes and improved satisfaction with services.
Integrative oral medicine: Dentistry's role in improving health outcomes
Authors: Thompson Doug
Published: July 2023

Objective

This article describes the importance of identifying inflammation‐inducing conditions in the dental office that are prevalent in the population and have significant systemic health risks for the patient. The role of the dental biofilm will be presented, as will the clinical protocols for treating an unhealthy biofilm. Methods for testing and maintaining a healthy biofilm are also presented.

Clinical Considerations

Periodontal disease, dental caries, and periapical infections are inflammation‐inducing diseases that can be identified in the dental office. Additionally, sleep apnea has been linked to chronic systemic inflammation. Dentists can identify risk factors and provide treatments that lower the risk of serious systemic outcomes, such as atherosclerosis, cardiac arrest, and stroke.

Conclusions

A thorough dental examination, including a comprehensive periodontal evaluation, can provide important information that can be used to improve or maintain a patient's systemic health. Treatments provided to improve oral health have been shown to improve systemic indicators of cardiovascular health. This is the basis of integrative oral medicine, a collaboration between the medical and dental providers, which can offer patients the best opportunity for improved health outcomes.

Clinical Significance

Periodontal disease, caries, periapical infections, and sleep apnea all have negative systemic health consequences for the patient (DiMatteo, Inside Dent, 2017, 13, 30; Nakano, Oral Microbiol Immunol, 2009, 24, 64; El Ouarti, BMC Oral Health, 2021, 21, 124; Lamberg, Steve). Periodontal disease, caries, and root end infections influence the health of the oral biofilm. If the biofilm becomes pathogenic the host inflammatory response can be stimulated, resulting in a cascade of inflammatory processes that damage the supporting structures of the teeth and harm the patient's overall health. A thorough dental exam that includes a comprehensive periodontal evaluation will identify patients with active inflammation or oral conditions that contribute to chronic inflammation. Dentists can integrate this information into treatment strategies that reduce the inflammatory burden and assist in better overall health outcomes.
Ultra‐processed food consumption in Argentina according to income level and its association with the intake of healthy foods
Authors: Zapata María Elisa , Arrieta Ezequiel , Beltramo Belén , Rovirosa Alicia
Published: July 2023

Ultra‐processed foods (UPFs) are associated with unhealthy diets and chronic diseases. Hence, knowing the consumption pattern of UPFs in the general population is crucial to design policies to improve public health, such as the recently approved law for the Promotion of Healthy Eating in Argentina (Law N° 27.642). The aim of the study was to characterise the consumption of UPFs according to income level and to assess their association with the intake of healthy foods in the Argentinian population. Healthy foods were defined in this study as those non‐UPF groups that have been shown to reduce the risk of non‐communicable diseases and excluded certain natural or minimally processed foods such as red meat, poultry and eggs. We retrieved data from the 2018–2019 National Nutrition and Health Survey (ENNyS 2), a cross‐sectional, nationally representative survey performed in Argentina, including 15 595 inhabitants. We classified the 1040 food items recorded by the degree of processing using the NOVA system. UPFs represented nearly 26% of daily energy. The intake of UPFs increased with income, with a difference of up to 5 percentage points between the lowest (24%) and the highest (29%) income levels (p < 0.001). Cookies, industrial pastries, cakes and sugar‐sweetened beverages were the most consumed UPF items, accounting for 10% of daily energy intake. We found that UPF intake was associated with a decrease in consumption of healthy food groups, mainly fruits and vegetables, where a difference of −28.3 g/2000 kcal and −62.3 g/2000 kcal between tertile 1 and tertile 3 was estimated, respectively. Therefore, Argentina still maintains a UPF consumption pattern of a low‐ and middle‐income country, where UPF intake increases with income, but these foods also compete with the intake of healthy foods.
The Arabidopsis eIF4E1 regulates NRT1.1‐mediated nitrate signaling at both translational and transcriptional levels
Authors: Li Na , Duan Yawen , Ye Qing , Ma Yuhan , Ma Rongjie , Zhao Lufei , Zhu Sirui , Yu Feng , Qi Shengdong , Wang Yong
Published: July 2023

Identifying new nitrate regulatory genes and illustrating their mechanisms in modulating nitrate signaling are of great significance for achieving the high yield and nitrogen use efficiency (NUE) of crops.

Here, we screened a mutant with defects in nitrate response and mapped the mutation to the gene eIF4E1 in Arabidopsis. Our results showed that eIF4E1 regulated nitrate signaling and metabolism. Ribo‐seq and polysome profiling analysis revealed that eIF4E1 modulated the amount of some nitrogen (N)‐related mRNAs being translated, especially the mRNA of NRT1.1 was reduced in the eif4e1 mutant.

RNA‐Seq results enriched some N‐related genes, supporting that eIF4E1 is involved in nitrate regulation. The genetic analysis indicated that eIF4E1 worked upstream of NRT1.1 in nitrate signaling. In addition, an eIF4E1‐interacting protein GEMIN2 was identified and found to be involved in nitrate signaling. Further investigation showed that overexpression of eIF4E1 promoted plant growth and enhanced yield and NUE.

These results demonstrate that eIF4E1 regulates nitrate signaling by modulating NRT1.1 at both translational and transcriptional levels, laying the foundation for future research on the regulation of mineral nutrition at the translational level.
ZEB1 interferes with human periodontal ligament stem cell proliferation and differentiation
Authors: Qian Liwen , Ni Jing , Zhang Zhechen
Published: July 2023

Background

Periodontitis can eventually contribute to tooth loss. Zinc finger E‐box binding homeobox 1 (ZEB1) is identified as overexpressed in the gingival tissue of mice with periodontitis. This study is designed to decipher the mechanism of ZEB1's involvement in periodontitis.

Methods

Human periodontal mesenchymal stem cells (hPDLSCs) were exposed to LPS to mimic the inflammation in periodontitis. Following ZEB1 silencing, FX1 (an inhibitor of Bcl‐6) treatment or ROCK1 overexpression, cell viability, and apoptosis were analyzed. Alkaline phosphatase (ALP) staining, Alizarin red staining, RT‐qPCR, and western blot were performed to evaluate osteogenic differentiation and mineralization. hPDLSCs were processed for luciferase reporter assay and ChIP‐PCR to confirm the association between ZEB1 and ROCK1.

Results

The induction of ZEB1 silencing resulted in reduced cell apoptosis, enhanced osteogenic differentiation, and mineralization. Nevertheless, these effects were significantly blunted by FX1. ZEB1 was confirmed to bind to the promoter sites of ROCK1 and regulate the ROCK1/AMPK. Whereas ROCK1 overexpression reversed the effects of ZEB1 silencing on Bcl‐6/STAT1, as well as cell proliferation and osteogenesis differentiation.

Conclusion

hPDLSCs displayed decreased proliferation and weakened osteogenesis differentiation in response to LPS. These impacts were mediated by ZEB1 regulating Bcl‐6/STAT1 via AMPK/ROCK1.
Dexmedetomidine versus fentanyl for sedation in extremely preterm infants
Authors: Nakauchi Chiharuko , Miyata Masafumi , Kamino Shigemitsu , Funato Yusuke , Manabe Masahiko , Kojima Arisa , Kawai Yuri , Uchida Hidetoshi , Fujino Masayuki , Boda Hiroko
Published: July 2023

Background

Few studies have compared the efficacy and complications of dexmedetomidine (DEX) and fentanyl (FEN) in extremely preterm infants.

Methods

We conducted a single‐institution, retrospective controlled before and after study of preterm infants before 28 weeks of gestation admitted between April 2010 and December 2018 to compare the complications and efficacy of DEX and FEN for preterm infants. Patients were administered FEN prior to 2015 and DEX after 2015 as the first‐line sedative. A composite outcome of death during hospitalization and developmental quotient (DQ) < 70 at a corrected age of 3 years was compared as the primary outcome. Secondary outcomes including postmenstrual weeks at extubation, days of age when full enteral feeding was achieved and additional sedation by phenobarbital (PB) were compared.

Results

Sixty‐six infants were enrolled into the study. The only perinatal factor that differed between the FEN (n = 33) and DEX (n = 33) groups was weeks of gestation. The composite outcome of death and DQ < 70 at a corrected age of 3 years were not significantly different. Postmenstrual weeks at extubation did not significantly differ between groups after adjustment for weeks of gestation and being small for gestational age. On the other hand, full feeding was significantly prolonged by DEX (p = 0.031). Additional sedation was less common in the DEX group (p = 0.044).

Conclusion

The composite outcome of death and DQ < 70 at a corrected age of 3 years were not significantly different by DEX or FEN for primary sedation. Prospective randomized controlled trials should examine the long‐term effects on development.
Multi-Furcation Variations of Two Novel Double-Centered Mechanisms Based on Higher Order Kinematic Analyses and Singular Value Decomposition
Authors: Tang Zhao , Dai Jian S.
Published: July 2023

This paper explores a class of extended double-centered linkages and presents two novel multi-bifurcated double-centered metamorphic and reconfigurable mechanisms. Higher order kinematic analyses and singular value decomposition are combined to demonstrate the characteristics of multi-furcation and to reveal motion branch transformation. These findings show that the presented double-centered linkages are able to evolve to distinct motion branches including two spherical 4R linkages, line-symmetric Bricard linkage or Bennett linkage. Furthermore, by exploring the local properties of singular configurations on geometric constraints and algebraic relationships, a systematic approach for the synthesis of the singular configurations can be designed to discover more novel multi-bifurcated metamorphic and reconfigurable mechanisms.
Iohexol-Measured Glomerular Filtration Rate and Urinary Biomarker Changes between Vancomycin and Vancomycin Plus Piperacillin-Tazobactam in a Translational Rat Model
Authors: Chang Jack , Pais Gwendolyn M. , Marianski Sylwia , Valdez Kimberly , Lesnicki Emily , Barreto Erin F. , Scheetz Marc H.
Published: July 2023

Recent clinical studies have reported additive nephrotoxicity with the combination of vancomycin and piperacillin-tazobactam. However, preclinical models have failed to replicate this finding.
Legionella pneumophila Rhizoferrin Promotes Bacterial Biofilm Formation and Growth within Amoebae and Macrophages
Authors: Lopez Alberto E. , Grigoryeva Lubov S. , Barajas Armando , Cianciotto Nicholas P.
Published: July 2023

Previously, we showed that
Legionella pneumophila
secretes rhizoferrin, a polycarboxylate siderophore that promotes bacterial growth in iron-deplete media and the murine lung. Yet, past studies failed to identify a role for the rhizoferrin biosynthetic gene (
lbtA
) in
L. pneumophila
infection of host cells, suggesting the siderophore’s importance was solely linked to extracellular survival.
Breadth and Durability of SARS-CoV-2-Specific T Cell Responses following Long-Term Recovery from COVID-19
Authors: Dang Thi Thu Thao , Anzurez Alitzel , Nakayama-Hosoya Kaori , Miki Shoji , Yamashita Kazuo , de Souza Mark , Matano Tetsuro , Kawana-Tachikawa Ai
Published: July 2023

RNA viruses, including SARS-CoV-2, evade host immune responses through mutations. As broader T cell responses against multiple viral proteins could minimize the impact of each single amino acid mutation, the breadth of memory T cells would be one essential parameter for effective protection.
Identification of Potential Novel B-Cell Epitopes of Capsid Protein VP2 in Senecavirus A
Authors: Ru Yi , Hao Rongzeng , Wu Chunping , Li Yajun , Lu Bingzhou , Liu Huanan , Tian Hong , Li Dan , Shi Zhengwang , Luo Juncong , Ma Kun , Zhang Guicai , Liu Xiangtao , Zheng Haixue
Published: July 2023

The clinical symptoms and lesions caused by SVA are indistinguishable from those of other vesicular diseases in pigs. SVA has been associated with recent outbreaks of vesicular disease and epidemic transient neonatal losses in several swine-producing countries.
Secondary haemophagocytic lymphohistiocytosis in a patient with new-onset systemic lupus erythematosus: the challenges of timely diagnosis and successful treatment
Authors: Shao Daming , Pena Oscar , Sekulic Miroslav , Valdez Imbert Ronald , Vegivinti Charan Thej Reddy , Jim Belinda
Published: July 2023

Haemophagocytic lymphohistiocytosis (HLH) is an immune-mediated disease driven by abnormal macrophage activation and regulatory cell dysfunction. HLH can be primary due to genetic mutations or secondary due to infection, malignancy or autoimmune conditions. We describe a woman in her early 30s who developed HLH while being treated for newly diagnosed systemic lupus erythematosus (SLE) complicated by lupus nephritis as well as concomitant cytomegalovirus (CMV) reactivation from a dormant infection. The trigger for this secondary form of HLH may have been either aggressive SLE and/or CMV reactivation. Despite prompt treatment with immunosuppressive therapies for SLE consisting of high-dose corticosteroids, mycophenolate mofetil, tacrolimus, etoposide for HLH and ganciclovir for CMV infection, the patient developed multiorgan failure and passed away. We demonstrate the difficulty in identifying a specific cause for secondary HLH when multiple conditions are present (SLE and CMV) and the fact that, despite aggressive treatment for both conditions, the mortality for HLH remains high.
Value of a UK medical degree for international students (VISION): a cross-sectional study
Authors: Li Chun Hei , Ganesananthan Sashiananthan , Pinchemain Trevor , Godoi Amanda , Lim Shan Ming , Baskaran Ravanth , Mukhopadhyay Srinjay , Foo Eu Fang , Ooi Setthasorn Zhi Yang , Woo Timothy , Yeo Vanessa ,   VISION collaborators, Sweetland Helen
Published: July 2023

Objectives

It is estimated that NHS staff consist of over 200 different nationalities, with a reported 30.7% of doctors holding a nationality other than British. Despite this, international medical students represent 7.5% of all medical students studying in the UK and pay on average, 4–6 times more in tuition fees when compared with the £9250 per annum (Great British Pounds (£) in 2021) paid by home students. This study’s aim and objective are to evaluate the perception of the financial cost and value of the UK medical degree for international students and their motivations for pursuing such a degree.

Methods

This is a cross-sectional observational study enquiring about international premedical, medical and medical school graduates’ perception of the value of the UK medical degree and factors influencing their decision to study in the UK.

A questionnaire was developed and distributed to 24 medical schools and 64 secondary schools both internationally and across the UK.

Results

A total of 352 responses from 56 nationalities were recorded. 96% of international students identified clinical and academic opportunities as the most important factors to study medicine in the UK, closely followed by quality of life (88%). The least important factor was family reasons, with 39% of individuals identifying this factor. Only 4.82% of graduates in our study considered leaving the UK after training. Overall, 54% of students felt the UK degree was value for money. This belief was significantly higher in premedical students compared with existing students and graduates (71% vs 52% and 20%, p<0.001 for all comparisons).

Conclusion

The quality of medical education and international prestige are attractive factors for international students to study medicine in the UK. However, further work is needed to ascertain reasons for the differing perceptions of the value by international students at different stages in their clinical training.
Does value-based healthcare support patient-centred care? A scoping review of the evidence
Authors: Kidanemariam Martha , Pieterse Arwen H , van Staalduinen Dorine J , Bos Willem Jan W , Stiggelbout Anne M
Published: July 2023

Background

Standardisation of outcome measures is integral to value-based healthcare (VBHC), which may conflict with patient-centred care, focusing on personalisation.

Objectives

We aimed to provide an overview of measures used to assess the effect of VBHC implementation and to examine to what extent the evidence indicates that VBHC supports patient-centred care.

Design

A scoping review guided by the Joanna Briggs Institute methodology.

Sources of evidence

We searched the following databases on 18 February 2021: Cochrane Library, EMBASE, MEDLINE and Web of Science.

Eligibility criteria

We included empirical papers assessing the effect of the implementation of VBHC, published after introduction of VBHC in 2006.

Data extraction and synthesis

Two independent reviewers double-screened papers and data were extracted by one reviewer and checked by the other. We classified the study measures used in included papers into six categories: process indicator, cost measure, clinical outcome, patient-reported outcome, patient-reported experience or clinician-reported experience. We then assessed the patient-centredness of the study measures used.

Results

We included 39 studies using 94 unique study measures. The most frequently used study measures (n=72) were process indicators, cost measures and clinical outcomes, which rarely were patient-centred. The less frequently used (n=20) patient-reported outcome and experience measures often measured a dimension of patient-centred care.

Conclusion

Our study shows that the evidence on VBHC supporting patient-centred care is limited, exposing a knowledge gap in VBHC research. The most frequently used study measures in VBHC research are not patient-centred. The major focus seems to be on measures of quality of care defined from a provider, institution or payer perspective.
Cortisol dynamics in undergraduate nursing students during clinical practice: protocol for an exploratory cross-sectional study
Authors: Loureiro Fernanda , Família Carlos , Barroso Maria Helena , Baúto Ricardo Ventura , Antunes A. Vanessa
Published: July 2023

Introduction

This paper presents a protocol for the Investigation of Cortisol Dynamics in Undergraduate Nursing Students, a funded project aiming to understand the fluctuations in anxiety and salivary cortisol levels due to clinical setting changes and the anxiety associated with clinical practice.

Methods and analysis

This study is an exploratory, cross-sectional, observational study that will be conducted at a health and science school in Portugal. Data collection will involve phycological assessment instruments for personality, anxiety, stress, depression and saliva cortisol levels. The target population consists of undergraduate nursing students enrolled in our institution for the academic year of 2022/2023 (N=272), of whom we aim to recruit 35% (N=96) to the study.

Ethics and dissemination

The project obtained approval from the Institutional Review Board of the Egas Moniz—Cooperativa de Ensino Superior, CRL, on 5 July 2022 (ID: 116/21.22) and ethical approval from the Egas Moniz Ethics Committee on 28 July 2022 (ID:1110.22). Informed consent will be obtained from those who wish to participate, ensuring students’ voluntary participation in the project. The results of this study will be disseminated through open-access peer-reviewed publications and presented at scientific events.
Effectiveness of physical exercise programmes in reducing complications associated with secondary lymphoedema to breast cancer: a protocol for an overview of systematic reviews
Authors: Aguilera-Eguía Raúl Alberto , Gutiérrez-Arias Ruvistay , Zaror Carlos , Seron Pamela
Published: July 2023

Introduction

Breast cancer-related lymphoedema (BCRL) is one of the most underestimated and debilitating complications associated with the treatment that women with breast cancer receive. Several systematic reviews (SRs) of different physical exercise programmes have been published, presenting disperse and contradictory clinical results. Therefore, there is a need for access to the best available and summarised evidence to capture and evaluate all the physical exercise programmes that focus on reducing BCRL.

Objective

To evaluate the effectiveness of different physical exercise programmes in reducing the volume of lymphoedema, pain intensity and improving quality of life.

Method and analysis

The protocol of this overview is reported following the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols, and its methodology is based on Cochrane Handbook for Systematic Reviews of Interventions. Only those SRs involving physical exercise by patients with BCRL will be included, whether on its own or combined with other exercises or other physical therapy interventions.

The outcomes of interest to be considered will be lymphoedema volume, quality of life, pain intensity, grip strength, range of motion, upper limb function and any adverse event. The MEDLINE/PubMed, Lilacs, Cochrane Library, PEDro and Embase databases will be searched for reports published from database inception to April 2023.

Two researchers will perform study selection, data extraction and risk of bias assessment independently. Any discrepancy will be resolved by consensus, or ultimately, by a third-party reviewer. We will use Grading of Recommendations Assessment, Development and Evaluation System to assess the overall quality of the body of evidence.

Ethics and dissemination

The results of this overview will be published in peer-reviewed scholarly journals and the scientific dissemination will take place in national or international conferences. This study does not require approval from an ethics committee, as it does not directly collect information from patients.

PROSPERO registration number

CRD42022334433.
Increasing utilisation of a rebound hyperbilirubinaemia calculator in two newborn nurseries
Authors: Germana Sarah , Shaikh Sophie Kay
Published: July 2023

Neonatal hyperbilirubinaemia requiring phototherapy treatment is a common problem impacting the length of hospital stay and rates of hospital readmission. Previous guidelines included guidance for initiating phototherapy treatment but not for discontinuing phototherapy treatment during initial newborn admission.

In response to dissatisfaction from trainees, staff and families regarding the variable approach to discontinuing phototherapy among attending nursery providers, we used quality improvement methodologies to increase utilisation of a rebound hyperbilirubinaemia calculator as a more consistent method for guiding the timing of phototherapy discontinuation. The aim was to increase utilisation of the rebound hyperbilirubinaemia calculator for newborns treated with phototherapy in two newborn nurseries to >90% within 2 years.

Sequential interventions focused on increasing provider awareness of the rebound hyperbilirubinaemia calculator and making the calculator simple to access and use.

At the university medical centre nursery, the use of the calculator increased from 8.7% to 100%, exceeding the project goal. In the community hospital nursery, there was a statistically significant increase in the rate of utilisation from 3.7% to 79.4%, but this fell slightly below the goal of >90%.

Electronic Health Record integration, along with education and addition of prompts to providers, increased utilisation of a rebound hyperbilirubinaemia calculator as a consistent approach for guiding decisions about discontinuing phototherapy treatment in newborns.
Coseismic Coulomb stress changes on intraplate faults in the western Quebec seismic zone following three major earthquakes in the past century
Authors: Rimando Jeremy M. , Peace Alexander L. , Goda Katsuichiro , Sirous Navid , Rosset Philippe , Chouinard Luc
Published: July 2023

There is currently no active fault map for the intraplate western Quebec seismic zone (WQSZ) in eastern Canada, and consequently, no detailed finite-fault source models, which are critical for seismic hazard assessments in this region with a rapidly growing population. While previous numerical stress modelling studies have shown that mostly NNW–SSE to NW–SE-striking faults exhibit the highest potential for reactivation under the present-day tectonic stress field, such modelling is unable to take into account the interaction of faults and earthquakes. This study attempts to identify possible future rupture zones using Coulomb stress analysis. We explore the static stress transfer caused by the 1935 M W 6.1 Témiscaming, 1944 M W 5.8 Cornwall–Massena, and 2013 M W 4.7 Ladysmith earthquakes, which are proximal to faults in the WQSZ that exhibit a relatively high reactivation potential, to determine whether these faults have an increased potential for failure. The significance of Coulomb stress changes (ΔCFS) observed on the nearby “receiver” faults varied widely. Among the events analyzed in this study, only the 1935 M W 6.1 Témiscaming earthquake caused extensively positive ΔCFS (≥0.1 bar) on its receiver fault. The areal extent of the receiver fault that has been promoted to failure suggests that earthquakes with a comparable magnitude to the 1935 event can be triggered. This work is the first attempt to provide a physical basis for seismic hazard assessment input parameters in the WQSZ based on the results of numerical stress modelling.
Suppression of spin polarization as an indicator of QCD critical point
Authors: Singh Sushant K. , Alam Jane
Published: July 2023

We study the impact of the QCD critical point (CP) on the spin polarization of $$\Lambda $$
Λ
-hyperon generated by the thermal vorticity in viscous quark gluon plasma (QGP). The equations of the relativistic causal viscous hydrodynamics have been solved numerically in (3+1) dimensions to evaluate the thermal vorticity. The effects of the CP have been incorporated through the equation of state (EoS) and the scaling behavior of the transport coefficients. We observe a significant suppression of the spin polarization around mid-rapidity region induced by the CP and propose that such changed behaviour of the spin polarization can be used to detect the CP. To the best of our knowledge this is the first study on the effects of critical point on the spin polarization in QCD matter.
Potential Factors for Retention and Intent to Drop-out in Brazilian Computing Programs
Authors: Duran Rodrigo , Bim Silvia Amélia , Gimenes Itana , Ribeiro Leila , Correia Ronaldo Celso Messias
Published: July 2023

Motivation
: Enrollments in Brazilian computing degrees are at an all-time high, but graduation numbers have not increased at the same rate. Moreover, enrollment growth has mainly attracted male students, steadily expanding the gender gap in Brazilian computing programs. Such high attrition rates have a great economic impact and may disproportionately affect women and students of color. Previous works investigated reasons for student drop-out and retention in specific courses or barriers to entrance in computing programs in narrower contexts or in a single institution.
Objectives
: We investigate potential actionable factors for intent to drop out in computing programs and what factors might lead students to remain in a computing program in several Brazilian institutions. We investigated how such factors may be affected by students’ race/ethnicity, gender, and socioeconomic status.
Method
: We analyzed Likert-style answers from an online survey with 3,193 students currently enrolled in Brazilian computing programs.
Results
: The results show that students value salary/job-related factors as the most important factors to potentially remain in a computing program. The excess of theoretical courses and the difficulty of programming and mathematics courses are the top-ranked factors by students to potentially abandon a computing degree. However, while there is little effect of gender, race/ethnicity, or socioeconomic status in retention factors, potential drop out factors such as a the fact that it is a male-dominated field, harassment, and the difficulty of courses were rated as more important by women. Also, costs and the difficulty of courses are relevant factors for the intent to drop out when analyzing students’ race/ethnicity and socioeconomic status.
Discussion
: We explore the implications of our findings for Computing programs, particularly (but not restricted to) the Brazilian context. We conjecture reasons for such students’ perspectives regarding intent to drop out and retention factors and provide recommendations of actions for instructional designers, curriculum developers, and other key stakeholders to address issues related to gender, students’ wellness, perceived authenticity of courses, and other relevant factors. Since we only observed small interactions between race/ethnicity and retention and intent to drop out factors, which may indicate a lack of sensitivity from the instrument, we present suggestions to address such limitations in future work.
Specialized Networks for Social Cognition in the Primate Brain
Authors: Deen Ben , Schwiedrzik Caspar M. , Sliwa Julia , Freiwald Winrich A.
Published: July 2023

Primates have evolved diverse cognitive capabilities to navigate their complex social world. To understand how the brain implements critical social cognitive abilities, we describe functional specialization in the domains of face processing, social interaction understanding, and mental state attribution. Systems for face processing are specialized from the level of single cells to populations of neurons within brain regions to hierarchically organized networks that extract and represent abstract social information. Such functional specialization is not confined to the sensorimotor periphery but appears to be a pervasive theme of primate brain organization all the way to the apex regions of cortical hierarchies. Circuits processing social information are juxtaposed with parallel systems involved in processing nonsocial information, suggesting common computations applied to different domains. The emerging picture of the neural basis of social cognition is a set of distinct but interacting subnetworks involved in component processes such as face perception and social reasoning, traversing large parts of the primate brain.
Investigation of Up Conversion Emissions of Er3+/Yb3+ Codoped TeO2-B2O3-Nb2O5-ZnO-WO3-TiO2 Glass Systems for Optical Thermometry
Authors: Caner Tülay Feyiz , Sümer Işık , Doğan Anıl , Erdem Murat , Esmer Kadir , Eryürek Gönül
Published: July 2023

The conventional melt quenching technique was used to create Er3+/Yb3+ doped TeO2-B2O3-Nb2O5-ZnO-WO3-TiO2 glasses. The upconversion luminescence characteristics of the glasses were examined under 975 nm laser excitation at different powers. Luminescence intensities increased with increasing pump power until a certain power value was reached, at which point they declined. Lower pump power levels resulted in stronger green emissions, while higher pump power values resulted in stronger red emissions. The intensity-power curve was used to compute the number of transition photons. The calculations show that the 2H11/2 → 4I15/2 and 4S3/2 → 4I15/2 transitions are based the sequential absorption of two photons. With increased pump power, the (x, y) color coordinates shifted from green to red on the CIE diagram. The glasses’ temperature-dependent luminescence was obtained. The intensity ratio approach was used to calculate the temperature sensitivity of the glasses. Maximum absolute sensitivity was found to be 0.0032 K−1 at 560 K for the TeO2 based glass with 1.25 mol% Er3+.
MicroRNA-22 Regulates the Pro-inflammatory Responses and M1 Polarization of Macrophages by Targeting GLUT1 and 4-1BBL
Authors: Kang Young Jun
Published: July 2023

Many microRNAs (miRNAs) are selectively expressed in mammalian immune cells and have been linked to immune responses in host defense and autoimmune disease. In macrophages, miRNAs regulate cell metabolism by repressing the expression of genes such as transcription factors, enzymes, and metabolism-related molecules, as well as the expression of genes that impact inflammatory responses and phenotype determination. Previous studies showed that miR-22 plays a role in a variety of biological processes, such as cancer cell growth, cell survival, and cell expansion. In CD4 + T cells of inflammatory bowel disease patients, miR-22 is upregulated and regulates inflammasome-mediated responses. However, it has not yet been determined how miR-22 contributes to the activation of innate immune cells. In this study, we identified a mechanism of toll-like receptors- (TLR-) dependent miR-22 induction that regulates the downstream signaling pathway linking inflammatory responses and macrophage polarization. MiR-22 is induced via TLR-signaling, which regulates the induction of Slc2a1 (glucose transporter 1 and Glut1) and Tnfsf9 (tumor necrosis factor 9, 4-1BB ligand, and 4-1BBL) mRNAs that contribute to sustained inflammatory responses and the polarization of macrophages. Our observations support further efforts to explore a potential therapeutic strategy using miR-22 for the modulation of excessive macrophage activation for the treatment of inflammatory diseases.