bluuebunny/crossref_metadata_2025 huggingface dataset:
The diagnosis of bipolar disorder in children and adolescents: Past, present and future
Authors: Malhi Gin S. , Jadidi Maedeh , Bell Erica
Published: July 2023

Aims

This article examines the ongoing debate concerning the diagnosis of bipolar disorder in children and adolescents. This contentious issue has generated robust discussion over the past two decades without consensus, and as such the true prevalence of so‐called paediatric bipolar disorder (PBD) remains unknown. In this article we offer a solution to break this deadlock.

Methods

Recent meta‐analyses and additional literature concerning the definition and prevalence of PBD was critically reviewed with a view to understanding the perspectives of those developing the taxonomy of PBD, and those engaged in research and clinical practice.

Results

A key finding is the lack of iteration and meaningful communication between the various groups interested in PBD that stems from deep‐seated problems within our classificatory systems. This undermines our research efforts and complicates clinical practice. These problems make the already difficult diagnosis of bipolar disorder in adults even more challenging to transpose to younger populations, and additional complexities arise when parsing clinical phenomenology from normative developmental changes in youth. Therefore, in those manifesting bipolar symptoms post‐puberty, we argue for the use of adolescent bipolar disorder to describe bipolar symptoms whereas in pre‐pubertal children, we propose a reconceptualisation that allows symptomatic treatment to be advanced whilst requiring critical review of these symptoms over time.

Conclusion

Significant changes in our current taxonomy are necessary and to be clinically meaningful, these revisions to our diagnoses need to be developmentally‐informed.
Unlocking big data to understand health services usage and government funding during pregnancy and early childhood, evidence in Australia
Authors: Hu Yanan , Zhang Xin , Callander Emily
Published: July 2023

Background

Maternity care is a high‐volume and high‐cost area of health care, which entails various types of service use throughout the course of the pregnancy. Thus, the aim of this study was to explore the most common reasons and related costs of health services used by women and babies from pregnancy to 12‐month postbirth.

Methods

We used linked administrative data from one state of Australia, which contained all births in Queensland between 01/07/2017 and 30/06/2018. Descriptive analyses were used to identify the 10 most frequent reasons and related costs for accessing inpatient, outpatient, emergency department, and Medicare services. These are reported separately for women and babies in different periods.

Results

We included 58,394 births in our data set. The results have highlighted that there was relatively uniform use of inpatient, outpatient, and Medicare services by women and babies, with the 10 most common services accounting for more than half of the total services accessed. However, the emergency department service use was more diverse. Medicare services accounted for the greatest volume (79.21%) of service events but only 10.21% of the overall funding, compared with inpatient services, which accounted for less volume (3.62%) but the highest amount of overall funding (75.19%).

Conclusion

Study findings provide empirical evidence about the full spectrum of services used by birthing families and their babies, and could assist health providers and managers to understand the services women and infants actually access during pregnancy, birth, and postbirth.
A dose–response relationship found between the Ten Steps to Successful Breastfeeding indicators and in‐hospital exclusive breastfeeding in US hospitals
Authors: Bookhart Larelle H. , Anstey Erica H. , Kramer Michael R. , Perrine Cria G. , Ramakrishnan Usha , Young Melissa F.
Published: July 2023

Background

In‐hospital exclusive breastfeeding (EBF) is associated with longer breastfeeding durations, yet only 64% of US newborns are EBF for 7 days. The Ten Steps to Successful Breastfeeding (Ten Steps) are a set of evidenced‐based maternity practices shown to improve breastfeeding outcomes; these were updated in 2018.

Methods

Using hospital‐level data from the 2018 Maternity Practices in Infant Nutrition and Care Survey (n = 2045 hospitals), we examined the prevalence of implementation of Ten Steps indicators (each step and total number of steps implemented). Using linear regression, we also examined the association between the steps and EBF prevalence adjusted for hospital characteristics and all other steps. Discharge support was not included in the models since it primarily occurs after hospital discharge.

Results

The most frequently implemented step was the provision of prenatal breastfeeding education (95.6%). Steps with low implementation included rooming‐in (18.9%), facility policies supportive of breastfeeding (23.4%), and limited formula supplementation (28.2%). After adjusting for hospital characteristics and all other steps, limited formula supplementation (difference = 14.4: 95% confidence interval [CI]: 12.6, 16.1), prenatal breastfeeding education (difference = 7.0; 95% CI: 3.3, 10.8), responsive feeding (difference = 6.3; 95% CI: 3.7, 9.0), care right after birth (skin‐to‐skin; difference = 5.8; 95% CI: 4.2, 7.4), and rooming‐in (difference = 2.4; 95% CI: 0.4, 4.6) were associated with higher in‐hospital EBF prevalence. We found a dose–response relationship between the number of steps implemented and in‐hospital EBF prevalence.

Conclusion

Increased implementation of the updated Ten Steps may improve EBF and infant and maternal health outcomes.
Nephrectomy for kidney tumour increases the risk of de novo arterial hypertension
Authors: Bigot Pierre , Bernhard Jean‐Christophe , Khene Zine‐Eddine , Dariane Charles , Lebdai Souhil , Doumerc Nicolas , Nouhaud François Xavier , Ouzaid Idir , Saulnier Patrick , Méjean Arnaud , Roupret Morgan , Bensalah Karim ,   the French Committee of Urologic Oncology
Published: July 2023

Objective

To evaluate prospectively the effects of surgical excision of renal tumours on blood pressure (BP).

Patients and Methods

In a multicentre prospective study, we evaluated 200 patients who underwent nephrectomy for renal tumour between 2018 and 2020 at seven departments of the French Network for Kidney Cancer, the UroCCR. All patients had localized cancer without pre‐existing hypertension (HTN). Blood pressure was measured the week before nephrectomy, and at 1 month and 6 months after nephrectomy, according to the recommendations for home BP monitoring. Plasma renin was measured 1 week before surgery and 6 months after surgery. The primary endpoint was the occurrence of de novo HTN. The secondary endpoint was clinically significant increase in BP at 6 months, defined by an increase in systolic and/or diastolic ambulatory BP ≥10 mmHg or requirement for medical antihypertensive treatment.

Results

Blood pressure and renin measurements were available for 182 (91%) and 136 patients (68%), respectively. We excluded from the analysis 18 patients who had undeclared HTN detected on preoperative measurements. At 6 months, 31 patients (19.2%) had de novo HTN and 43 patients (26.3%) had a significant increase in their BP. Type of surgery was not associated with an increased risk of HTN (21.7% partial nephrectomy [PN] vs 15.7% radical nephrectomy [RN]; P = 0.59). There was no difference between plasmatic renin levels before and after surgery (18.5 vs 16; P = 0.46). In multivariable analysis, age (odds ratio [OR] 1.07, 95% confidence interval [CI] 1.02–1.12; P = 0.03) and body mass index (OR 1.14, 95% CI 1.03–1.26; P = 0.01) were the only predictors of de novo HTN.

Conclusion

Surgical treatment of renal tumours is associated with significant changes in BP, with de novo HTN occurring in almost 20% of the patients. These changes are not impacted by the type of surgery (PN vs RN). Patients who are scheduled to undergo kidney cancer surgery should be informed of these findings and have their BP closely monitored after the operation.
Children's self‐evaluation of their prosociality when comparing themselves with a specific versus abstract other
Authors: Levy‐Friedman Bar , Kogut Tehila
Published: July 2023

This study examines the development of children's self‐assessment of their prosociality in normative social comparisons with an average peer, who was either a concrete individual, or an abstract one, at a school of average socioeconomic level in south Israel (N = 148, Age 6–12 years, 51% females; June 2021). Results show that older children exhibited the better‐than‐average (BTA) effect by perceiving themselves as more generous than their average peer. Conversely, younger children exhibited a worse‐than‐average effect, in that they assumed that their peers would act more generously than themselves (). Only the older children (aged 8 years onward) were significantly affected by the concreteness of the target of comparison by exhibiting the BTA effect only when the average peer was abstract (not concrete).
Hypoxic postconditioning drives protective microglial responses and ameliorates white matter injury after ischemic stroke
Authors: Zhang Wei , Li Sijie , Yun Ho Jun , Yu Wantong , Shi Wenjie , Gao Chen , Xu Jun , Yang Yu , Qin Linhui , Ding Yuchuan , Jin Kunlin , Liu Fengyong , Ji Xunming , Ren Changhong
Published: July 2023

Background

Ischemic stroke (IS) is a cerebrovascular disease with high incidence and mortality. White matter repair plays an important role in the long‐term recovery of neurological function after cerebral ischemia. Neuroprotective microglial responses can promote white matter repair and protect ischemic brain tissue.

Aims

The aim of this study was to investigate whether hypoxic postconditioning (HPC) can promote white matter repair after IS, and the role and mechanism of microglial polarization in white matter repair after HPC treatment.

Materials & Methods

Adult male C57/BL6 mice were randomly divided into three groups: Sham group (Sham), MCAO group (MCAO), and hypoxic postconditioning group (HPC). HPC group were subjected to 45 min of transient middle cerebral artery occlusion (MCAO) immediately followed by 40 min of HPC.

Results

The results showed that HPC reduced the proinflammatory level of immune cells. Furthermore, HPC promoted the transformation of microglia to anti‐inflammatory phenotype on the third day after the procedure. HPC promoted the proliferation of oligodendrocyte progenitors and increased the expression of myelination‐related proteins on the 14th day. On the 28th day, HPC increased the expression of mature oligodendrocytes, which enhanced myelination. At the same time, the motor neurological function of mice was restored.

Discussion

During the acute phase of cerebral ischemia, the function of proinflammatory immune cells was enhanced, long‐term white matter damage was aggravated, and motor sensory function was decreased.

Conclusion

HPC promotes protective microglial responses and white matter repair after MCAO, which may be related to the proliferation and differentiation of oligodendrocytes.
Internal governance and internal control material weaknesses
Authors: Dao Mai , Pham Trung , Xu Hongkang
Published: July 2023

Research Question/Issue

The objective of this study is to examine whether the effectiveness of internal governance is associated with internal control material weaknesses. We employ the concept of internal governance as the checks‐and‐balances mechanism that subordinate executives apply to the chief executive officer (CEO). We predict that with long horizons and long‐term interests aligned with firms' long‐term growth, subordinate executives may have the incentive to support a high‐quality internal control system, which is an important factor contributing to firms' long‐term success.

Research Findings/Insights

Using data on CEOs' and other highest paid executives' age and compensation to measure the effectiveness of internal governance, we empirically find consistent evidence that internal governance effectiveness is associated with higher internal control quality. In particular, we find that effective internal governance is related to a lower likelihood of firms reporting internal control material weaknesses, fewer material weaknesses in internal control (ICMWs), a lower chance of firms disclosing internal control weaknesses for multiple years, and a lower probability of firms reporting entity‐level and/or account‐level material weaknesses in internal control. We also show that among the two factors forming the internal governance measure, only subordinate executives' horizon is associated with the probability of firms disclosing ICMWs. Our further analysis reveals that the probability of reporting ICMWs is lower for growth firms with effective internal governance.

Theoretical/Academic Implications

Our findings contribute to the literature on internal governance and internal control quality. The impact of the checks‐and‐balances mechanism inherent in internal governance on firms' investment in the internal control system and thus the probability of disclosing ICMWs has not received sufficient attention from accounting researchers. While prior studies focus on individual members of the management team, our finding implies that the quality of the internal control system is a result of the joint effort of the whole management team. Unlike the extant literature that captures only certain aspects of reporting quality and information disclosures, our study emphasizes the role of the horizon dimension of internal governance in enhancing the reliability of financial reporting (measured as the quality of the internal control system).

Practitioner/Policy Implications

Our results shed light on the important role of subordinate executives in monitoring CEOs' short‐term interests.
Challenging the formality bias: The organization of informal work, working relations, and collective agency in Kenya and Tanzania
Authors: Riisgaard Lone , Torm Nina , Kinyondo Godbertha , Mitullah Winnie , Kamau Anne , Gervas Aloyce , Indimuli Raphael
Published: July 2023

Motivation

Formal social protection systems, such as health insurance and representation, are often biased in favour of formal workers, thereby excluding most of the world's working population who make a living in the informal economy.

Purpose

The article extends existing critiques of formality bias by investigating the reality of work for people in the informal economy in Kenya and Tanzania and analysing related social protection challenges. Specifically, we look at: (1) the governance of work; (2) the organization of work relations; and (3) collective agency. In terms of social protection, we focus on formal and informal forms of social insurance and representation.

Methods and approach

We draw on interview and survey data from people working in micro trading, transport, and construction in Nairobi and Kisumu in Kenya, and Dar es Salaam and Dodoma in Tanzania. A total of 1,462 workers were surveyed and 24 focus group discussions were held with such workers. Interviews were conducted with 120 key informants: leaders and members of informal workers' associations in the three sectors, as well as representatives of authorities, trade unions, and business associations. Data were collected from June 2018 to December 2019.

Findings

Formal social insurance and representation do not fit the real experience of most people working in the informal economy. They have been modelled on and designed to support workers in formal standard employment relations. At the same time, informal workers' associations play important roles in meeting—albeit inadequately—the social insurance and representational needs of their members.

Policy implications

Meaningful engagement with the reality of work and collective agency in the informal economy is necessary to inform more appropriate policies and measures to provide informal workers with appropriate social protection measures, particularly social insurance and representation. Their reality should not have to conform to an inadequate model; rather, the model should fit their reality.
Liver fibrosis is associated with an increased risk of non‐fatal myocardial infarction
Authors: Riccio Alessia , Mazzanti Camilla , Vero Laura , Fiorentino Teresa Vanessa , Succurro Elena , Rubino Mariangela , Massimino Mattia , Mannino Gaia Chiara , Sciacqua Angela , Andreozzi Francesco , Cefalo Chiara Maria Assunta , Sesti Giorgio
Published: July 2023

Introduction

Liver fibrosis is a risk factor for liver‐related adverse outcomes and cardiovascular disease (CVD). Recently, the non‐invasive Hepamet fibrosis score (HFS) has been validated as a tool capable to identify with good diagnostic accuracy subjects with advanced liver fibrosis. It is unsettled whether HFS is capable to identify individuals at higher risk of CVD. To investigate whether individuals with liver fibrosis measured with HFS have higher risk of myocardial infarction (MI) in adults participating in the CATAnzaro MEtabolic RIsk factors (CATAMERI) study.

Methods

Participants (n = 2948) were divided into three groups according to HFS: low risk of fibrosis (<0.12); intermediate risk of fibrosis (≥0.12 to <0.47); high risk of fibrosis (≥0.47). The association between the liver fibrosis risk and MI was analysed by a logistic regression analysis.

Results

As compared with those having the lowest risk (5.3%), a higher proportion of subjects with moderate or high risk of liver fibrosis had MI (12.9% and 24.4%, respectively; p < 0.001). In a logistic regression analysis, individuals at increased risk of liver fibrosis exhibited a threefold increased risk of having MI as compared to those with low risk (OR 3.18; 95% CI 1.31–7.70) independently of confounders including smoking, cholesterol, triglycerides, anti‐hypertensive, lipid‐lowering and glucose‐lowering therapies.

Conclusions

In this cross‐sectional study, individuals with higher values of HFS show a higher risk of MI, suggesting that HFS may be a useful tool to identify not only individuals with liver fibrosis but also those at the increased risk of CVD.
Prognostic value of the mutation types and dynamics of FLT3‐ITD in acute myeloid leukemia
Authors: Koo Mosae , Song Ik‐Chan , Kim Jimyung , Kwon Gye Cheol , Kim Seon Young
Published: July 2023

Objective

The prognostic value of the mutation types and dynamics of FLT3‐ITD in acute myeloid leukemia (AML) and other known factors were studied.

Methods

Initial and follow‐up samples from 45 AML patients with FLT3‐ITD mutations were analyzed by fragment length analysis, Sanger sequencing, and next‐generation sequencing.

Results

Some patients (13%) had multiple FLT3‐ITD mutations, and many of them had acute promyelocytic leukemia (APL). FLT3‐ITD mutations were classified according to mutation types, including duplication‐only FLT3‐ITD (52%) and FLT3‐ITD with duplications and insertions (dup + ins) (48%). The dup + ins FLT3‐ITD variant was independently associated with poor prognosis among non‐APL patients (odds ratio, 2.92) in addition to FLT3‐ITD with ≥50% variant allele frequency (VAF). The VAFs of FLT3‐ITD were low (median 2.2%) when detected during morphologic complete remission (CR) after conventional chemotherapy; however, in two patients treated with gilteritinib after relapse, the VAFs of FLT3‐ITD were much higher (>95% and 8.1%) in the morphologic CR state.

Conclusions

The type of FLT3‐ITD mutation is important in prognosis, and the dup + ins type of FLT3‐ITD can be an indicator of poor prognosis. In addition, the FLT3‐ITD mutation status may unexpectedly not match the morphologic examination results after gilteritinib treatment.
Long and short whiskers differently guide snout/pellet interaction in rat oral grasping
Authors: Parmiani Pierantonio , Lucchetti Cristina , Viaro Riccardo , Franchi Gianfranco
Published: July 2023

We studied the role of rat whisker/snout tactile sense during oral grasping, comparing control data with those obtained, respectively, 1–3 and 5–7 days after bilateral long or short whisker trimming and 3–5 and 8–10 days after bilateral infraorbital nerve (ION) severing. Two behavioural phases were identified: whisker–snout contact by nose‐N or lip‐L and snout–tongue contact. The second phase involved either: snout passing over stationary pellet (Still pellet); pellet rolling as the snout passed over it (Rolling pellet); pellet being pushed forward by the snout (Pushed pellet); or pellet being hit and pushed away (Hit/Lost pellet). In controls, success was 100%, with N‐contact prevailing over L‐contact in the first phase and Still pellet in the second. In long whisker‐trimmed versus controls, success was still 100%, but L‐contact increased in frequency, Pushed pellet prevailed and the second phase duration increased. In short whisker‐trimmed versus controls, success remained 100%, with increased L‐contact frequency; the first phase duration did not change, but the second phase increased since in pushed trials, the pellet rolled around the snout. In ION‐severed versus controls, both phases changed drastically: L‐contact frequency increased, Pushed pellet prevailed and contact was persistently maintained; Hit/Lost pellet emerged, Still and Rolling pellets disappeared and the oral‐grasping sequence was not triggered. These results suggest that long and short whiskers, respectively, optimize the first and second phases of snout–pellet interaction and that whisker/snout sense is necessary to trigger oral grasping. Kinematic trajectory analysis supports the conclusion that movement from whisker to snout contact is an orientation response.
TUFM variants lead to white matter abnormalities mimicking multiple sclerosis
Authors: Chen Shihan , Mitchell Grant A. , Soucy Jean‐Francois , Gauthier Julie , Brais Bernard , La Piana Roberta
Published: July 2023

Background and purpose

Defects in the mitochondrial respiratory chain (MRC) can lead to combined MRC dysfunctions (COXPDs) with heterogenous genotypes and clinical features. We report a patient carrying heterozygous variants in the TUFM gene who presented with clinical features compatible with COXPD4 and radiological findings mimicking multiple sclerosis (MS).

Methods

A 37‐year‐old French Canadian woman was investigated for recent onset of gait and balance problems. Her previous medical history included recurrent episodes of hyperventilation associated with lactic acidosis during infections, asymptomatic Wolff–Parkinson–White syndrome, and nonprogressive sensorineural deafness.

Results

Neurological examinations revealed fine bilateral nystagmus, facial weakness, hypertonia, hyperreflexia, dysdiadochokinesia, dysmetria, and ataxic gait. Brain magnetic resonance imaging (MRI) showed multifocal white matter abnormalities in cerebral white matter as well as cerebellar hemispheres, brainstem, and middle cerebellar peduncles, some of which mimicked MS. Analysis of native‐state oxidative phosphorylation showed a combined decrease in CI/CII, CIV/CII, and CVI/CII. Exome sequencing detected two heterozygous TUFM gene variants. Little clinical progression was noted over a 5‐year follow‐up. Brain MRI remained unchanged.

Conclusions

Our report broadens the phenotypic and radiological spectrum of TUFM‐related disorders by adding milder, later onset forms to the previously known early onset, severe presentations. The presence of multifocal white matter abnormalities can be misinterpreted as due to acquired demyelinating diseases, and thus TUFM‐related disorders should be added to the list of mitochondrial MS mimickers.
Non‐demyelinating disorders mimicking and misdiagnosed asNMOSD:a literature review
Authors: Zara Pietro , Dinoto Alessandro , Carta Sara , Floris Valentina , Turilli Davide , Budhram Adrian , Ferrari Sergio , Milia Stefania , Solla Paolo , Mariotto Sara , Flanagan Eoin P. , Lopez Chiriboga A. Sebastian , Sechi Elia
Published: July 2023

Background

Differentiating neuromyelitis optica spectrum disorder (NMOSD) from its mimics is crucial to avoid misdiagnosis, especially in the absence of aquaporin‐4‐IgG. While multiple sclerosis (MS) and myelin oligodendrocyte glycoprotein‐IgG associated disease (MOGAD) represent major and well‐defined differential diagnoses, non‐demyelinating NMOSD mimics remain poorly characterized.

Methods

We conducted a systematic review on PubMed/MEDLINE to identify reports of patients with non‐demyelinating disorders that mimicked or were misdiagnosed as NMOSD. Three novel cases seen at the authors' institutions were also included. The characteristics of NMOSD mimics were analyzed and red flags associated with misdiagnosis identified.

Results

A total of 68 patients were included; 35 (52%) were female. Median age at symptoms onset was 44 (range, 1–78) years. Fifty‐six (82%) patients did not fulfil the 2015 NMOSD diagnostic criteria. The clinical syndromes misinterpreted for NMOSD were myelopathy (41%), myelopathy + optic neuropathy (41%), optic neuropathy (6%), or other (12%). Alternative etiologies included genetic/metabolic disorders, neoplasms, infections, vascular disorders, spondylosis, and other immune‐mediated disorders. Common red flags associated with misdiagnosis were lack of cerebrospinal fluid (CSF) pleocytosis (57%), lack of response to immunotherapy (55%), progressive disease course (54%), and lack of magnetic resonance imaging gadolinium enhancement (31%). Aquaporin‐4‐IgG positivity was detected in five patients by enzyme‐linked immunosorbent assay (n = 2), cell‐based assay (n = 2: serum, 1; CSF, 1), and non‐specified assay (n = 1).

Conclusions

The spectrum of NMOSD mimics is broad. Misdiagnosis frequently results from incorrect application of diagnostic criteria, in patients with multiple identifiable red flags. False aquaporin‐4‐IgG positivity, generally from nonspecific testing assays, may rarely contribute to misdiagnosis.
Sex‐specific heritabilities for length at maturity among Pacific salmonids and their consequences for evolution in response to artificial selection
Authors: Gamble Madilyn M. , Calsbeek Ryan G.
Published: July 2023

Artificial selection, whether intentional or coincidental, is a common result of conservation policies and natural resource management. To reduce unintended consequences of artificial selection, conservation practitioners must understand both artificial selection gradients on traits of interest and how those traits are correlated with others that may affect population growth and resilience. We investigate how artificial selection on male body size in Pacific salmon (Oncorhynchus spp.) may influence the evolution of female body size and female fitness. While salmon hatchery managers often assume that selection for large males will also produce large females, this may not be the case—in fact, because the fastest‐growing males mature earliest and at the smallest size, and because female age at maturity varies little, small males may produce larger females if the genetic architecture of growth rate is the same in both sexes. We explored this possibility by estimating sex‐specific heritability values of and natural and artificial selection gradients on length at maturity in four populations representing three species of Pacific salmon. We then used the multivariate breeder's equation to project how artificial selection against small males may affect the evolution of female length and fecundity. Our results indicate that the heritability of length at maturity is greater within than between the sexes and that sire–daughter heritability values are especially small. Salmon hatchery policies should consider these sex‐specific quantitative genetic parameters to avoid potential unintended consequences of artificial selection.
The m6A modification of Il17a in CD4+ T cells promotes inflammation in psoriasis
Authors: Yuan Liyan , Chen Shijun , Ding Ke , Wang Xiaobo , Lv Weiqi , Liu Yuchen , He Shuang , Yu YingDian , Yang Bin , Huang Tao
Published: July 2023

Psoriasis is a chronic inflammatory skin disorder. The mechanism of psoriasis pathogenesis is not entirely clear. Here, we reported that the level of the N6‐methyladenosine (m6A) modification was increased in psoriatic CD4+ T cells compared with healthy controls. In the psoriasis mouse model, depletion of the RNA demethylase, Alkbh5, from CD4+ T cells promoted the psoriasis‐like phenotype and inflammation. Intriguingly, this phenotype and inflammation were alleviated by the ablation of the m6A methyltransferase Mettl3 in CD4+ T cells. Mechanistically, we found that the m6A modification of IL17A mRNA increased the expression of IL‐17A (an important pro‐inflammatory factor in psoriasis) and promoted psoriasis. Thus, our study provided evidence that the m6A modification of IL17A in CD4+ T cells regulates inflammation in psoriasis.
Associations between parents' and grandparents' depressive symptoms, intergenerational coparenting relationships, and (grand)parenting behaviors: An actor–partner interdependence mediation model
Authors: Chen Jia , Zhou Xiaochen , Bai Xue
Published: July 2023

Intergenerational coparenting has become an increasingly common family phenomenon across the globe. In this study, we examined the associations among depressive symptoms, perceptions of intergenerational coparenting relationships, and (grand)parenting behaviors. Participants were parents and grandparents most involved in child care from 464 Chinese coparenting families sampled in urban China. The results from a test of the actor–partner interdependence mediation model showed that the depressive symptoms of parents and grandparents were indirectly and positively related to their harsh discipline of children or negatively related to their supportiveness toward children, and the association was mediated via their own perceptions of the coparenting relationship. In addition, parents' depressive symptoms were indirectly and positively related to grandparental harsh parenting or negatively related to grandparental supportive parenting through grandparents' perceived coparenting relationship. Grandparents' depressive symptoms were indirectly and positively related to parental harsh parenting or negatively related to parental supportive parenting through parents' perceptions of the coparenting relationship. This study highlights the importance of uncovering the processes and dynamics of parent–grandparent coparenting practices through a lens of family systems and interdependence theories as well as a dyadic approach. It also has practical implications for family interventions in the context of intergenerational coparenting. Specifically, this study recommends parallel (grand)parenting intervention sessions for parents and grandparents simultaneously to benefit the well‐being of all three generations.
Structural insights into hydrolytic defluorination of difluoroacetate by microbial fluoroacetate dehalogenases
Authors: Khusnutdinova Anna N. , Batyrova Khorcheska A. , Brown Greg , Fedorchuk Tatiana , Chai Yao Sheng , Skarina Tatiana , Flick Robert , Petit Alain‐Pierre , Savchenko Alexei , Stogios Peter , Yakunin Alexander F.
Published: July 2023

Fluorine forms the strongest single bond to carbon with the highest bond dissociation energy among natural products. However, fluoroacetate dehalogenases (FADs) have been shown to hydrolyze this bond in fluoroacetate under mild reaction conditions. Furthermore, two recent studies demonstrated that the FAD RPA1163 from Rhodopseudomonas palustris can also accept bulkier substrates. In this study, we explored the substrate promiscuity of microbial FADs and their ability to defluorinate polyfluorinated organic acids. Enzymatic screening of eight purified dehalogenases with reported fluoroacetate defluorination activity revealed significant hydrolytic activity against difluoroacetate in three proteins. Product analysis using liquid chromatography‐mass spectrometry identified glyoxylic acid as the final product of enzymatic DFA defluorination. The crystal structures of DAR3835 from Dechloromonas aromatica and NOS0089 from Nostoc sp. were determined in the apo‐state along with the DAR3835 H274N glycolyl intermediate. Structure‐based site‐directed mutagenesis of DAR3835 demonstrated a key role for the catalytic triad and other active site residues in the defluorination of both fluoroacetate and difluoroacetate. Computational analysis of the dimer structures of DAR3835, NOS0089, and RPA1163 indicated the presence of one substrate access tunnel in each protomer. Moreover, protein‐ligand docking simulations suggested similar catalytic mechanisms for the defluorination of both fluoroacetate and difluoroacetate, with difluoroacetate being defluorinated via two consecutive defluorination reactions producing glyoxylate as the final product. Thus, our findings provide molecular insights into substrate promiscuity and catalytic mechanism of FADs, which are promising biocatalysts for applications in synthetic chemistry and bioremediation of fluorochemicals.
A global synthesis of peer‐reviewed research on the effects of hatchery salmonids on wild salmonids
Authors: McMillan John R. , Morrison Brian , Chambers Nick , Ruggerone Greg , Bernatchez Louis , Stanford Jack , Neville Helen
Published: July 2023

Hatcheries have long produced salmonids for fisheries and mitigation, though their widespread use is increasingly controversial because of potential impacts to wild salmonids. We conducted a global literature search of peer‐reviewed publications (1970–2021) evaluating how hatchery salmonids affected wild salmonids, developed a publicly available database, and synthesized results. Two hundred six publications met our search criteria, with 83% reporting adverse/minimally adverse effects on wild salmonids. Adverse genetic effects on diversity were most common, followed by effects on productivity and abundance via ecological and genetic processes. Few publications (3%) reported beneficial hatchery effects on wild salmonids, nearly all from intensive recovery programs used to bolster highly depleted wild populations. Our review suggests hatcheries commonly have adverse impacts on wild salmonids in freshwater and marine environments. Future research on less studied effects—such as epigenetics—could improve knowledge and management of the full extent of hatchery impacts.
Anticoagulation against portal vein thrombosis reduces mortality and liver cirrhosis‐related complications: A propensity score‐matched study
Authors: Sato Ayako , Watanabe Sho , Iseki Mari , Yamada Yurina , Kobayashi Ryohei , Furuya Makoto , Arai Katsuhiro , Ohshina Eri , Tashiro Yoshihiro , Nozaka Takahito , Matsuoka Mana , Yauchi Masato , Kobayashi Katsumasa , Matsumoto Taichi , Furumoto Yohei , Asano Toru , Azuma Seishin
Published: July 2023

Aim

Portal vein thrombosis (PVT) is one of the common complications of liver cirrhosis. Although anticoagulation contributes to thrombus resolution and is considered the first‐choice treatment, its impact on patients' prognosis is still controversial. This study aimed to clarify the benefit of anticoagulation on mortality, liver function, and the incidence of liver cirrhosis‐related complications in cirrhotic PVT patients.

Methods

We conducted a multicenter retrospective review in which we included 78 eligible patients with PVT out of 439. After propensity score matching, 21 cirrhotic PVT patients were included in each one of the untreated control and anticoagulation groups.

Results

Overall survival was significantly improved in the anticoagulation group compared with the control group (p = 0.041), along with PVT size reduction (53.3% vs. 108.2%, p = 0.009). At the time of CT follow‐up, the anticoagulation group showed a lower ALBI score (p = 0.037) and its prevalence of massive ascites was significantly lower (p = 0.043) compared with the control group. The incidence of overt encephalopathy was also lower in the anticoagulation group (p = 0.041). The cumulative incidence of bleeding events did not differ significantly between the two groups.

Conclusions

Anticoagulation improves the survival of patients with cirrhotic PVT. Preserved liver function and reduced risks of cirrhosis‐related complications under the treatment may have contributed to a better prognosis. Given its efficacy and safety, anticoagulation is worth initiating in patients with PVT.
Conscientious objection to caring for transgender people: An ethical right or a discriminatory attitude?
Authors: Milionis Charalampos , Toska Aikaterini
Published: July 2023

Background

In modern society, health professionals are often asked to use their technical skills to serve purposes other than treating illnesses. In such cases, some clinicians may express ethical reluctance to fulfill their patients' preferences. Conscientious objection in health care is the refusal by providers to perform a legally valid and scientifically approved clinical intervention because of moral concerns. Although health services and staff are obliged to respect gender identity and prohibit discrimination, some clinicians may exempt themselves from caring for transgender people, citing ethical reasons. The decision of health professionals to object to medical activities related to transgender care may collide with the interests of trans people and further marginalizes the already underprivileged gender‐diverse population.

Aim

This discussion paper analyses the concept of ‘conscientious objection’ and its application in health care settings in relation to transgender‐related care.

Findings and Conclusion

In general, the right of health professionals to abstain from contested duties on moral grounds must be protected. However, claims to conscience cannot be accepted within centers specialized in gender transitioning and for services unrelated to gender affirmation such as routine and urgent care. Personal responsibility and discretion on the part of clinicians is the most appropriate way to compromise between protecting the moral integrity of health professionals and shielding trans persons‘ access to care. Guidance is proffered on how to resolve the apparent impasse emerging from the denial of various types of health services to transgender people.
The association of cognitive frailty and the risk of falls among older adults: A systematic review and meta‐analysis
Authors: Wang Shanshan , Wang Mian , Leung Isaac Sze Him , Ge Song , Xu Xinyi , Chen Shucheng , Yin Yueheng
Published: July 2023

Background

Falls lead to numerous negative health outcomes and jeopardize the physical function and quality of life in older adults. Cognitive impairment and physical frailty were found to be associated with the risk of falls, but there was no systematic review that estimated the association between cognitive frailty and the risk of falls.

Methods

A systematic literature search of the cross‐sectional, cohort, and case–control studies in Cochrane library, Scopus, CINAHL, EMBASE and PsycINFO was conducted on 3 September 2021. Study quality was assessed by using the Joanna Briggs Institute critical appraisal tool. A random effects meta‐analysis was performed to estimate the odds ratio of the incidence of falls in older adults with cognitive frailty.

Results

Seven studies were included. The overall quality of the included studies was acceptable. The meta‐analysis of cohort studies showed older adults aged 60 and above with cognitive frailty had a pooled odds ratio of 1.45 (95% confidence interval 1.30, 1.61) for at least one fall compared with those without cognitive frailty. The meta‐analysis of cross‐sectional studies showed that the odds of older adults with cognitive frailty experiencing at least one fall was 1.64 times (95% confidence interval 1.51, 1.79) higher than those without cognitive frailty.

Conclusion

The association between cognitive frailty and the risk of falls is statistically significant. Timely detection of cognitive frailty is essential especially in the community nursing level for preventing falls.
Rheumatic complications of checkpoint inhibitors: Lessons from autoimmunity
Authors: Reynolds Gary
Published: July 2023

Immune checkpoint inhibitors are now an established treatment in the management of a range of cancers. Their success means that their use is likely to increase in future in terms of the numbers of patients treated, the indications and the range of immune checkpoints targeted. They function by counteracting immune evasion by the tumor but, as a consequence, can breach self‐tolerance at other sites leading to a range of immune‐related adverse events. Included among these complications are a range of rheumatologic complications, including inflammatory arthritis and keratoconjunctivitis sicca. These superficially resemble immune‐mediated rheumatic diseases (IMRDs) such as rheumatoid arthritis and Sjogren's disease but preliminary studies suggest they are clinically and immunologically distinct entities. However, there appear to be common processes that predispose to the development of both that may inform preventative interventions and predictive tools. Both groups of conditions highlight the centrality of immune checkpoints in controlling tolerance and how it can be restored. Here we will discuss some of these commonalities and differences between rheumatic irAEs and IMRDs.
PSMC4 promotes prostate carcinoma progression by regulating the CBX3–EGFR‐PI3K‐AKT‐mTOR pathway
Authors: Liu Kaifeng , Zhang Shengmin , Gong Yongzhan , Zhu Panyan , Shen Weigan , Zhang Qi
Published: July 2023

Proteasome 26S subunit ATPase 4 (PSMC4) could regulate cancer progression. However, the function of PSMC4 in prostate carcinoma (PCa) progression requires further clarification. In the study, PSMC4 and chromobox 3 (CBX3) levels were verified by TCGA data and tissue microarrays. Cell counting kit‐8, cell apoptosis, cell cycle, wound healing, transwell and xenograft tumour model assays were performed to verify biological functions of PSMC4 in PCa. RNA‐seq, PCR, western blotting and co‐IP assays were performed to verify the mechanism of PSMC4. Results showed that PSMC4 level was significantly increased in PCa tissues, and patients with PCa with a high PSMC4 level exhibited shorter overall survival. PSMC4 knockdown markedly inhibited cell proliferation, cell cycle and migration in vitro and in vivo, and significantly promoted cell apoptosis. Then further study revealed that CBX3 was a downstream target of PSMC4. PSMC4 knockdown markedly reduced CBX3 level, and inhibited PI3K‐AKT‐mTOR signalling. CBX3 overexpression markedly promoted epidermal growth factor receptor (EGFR) level. Finally, PSMC4 overexpression showed reverse effect in DU145 cells, and the effects of PSMC4 overexpression on cell proliferation, migration and clonal formation were rescued by the CBX3 knockdown, and regulated EGFR‐PI3K‐AKT‐mTOR signalling. In conclusion, PSMC4 could regulate the PCa progression by mediating the CBX3‐EGFR‐PI3K‐AKT‐mTOR pathway. These findings provided a new target for PCa treatment.
Geriatric assessment in the emergency department reduces healthcare costs—So when will CMS pay for it?
Authors: Southerland Lauren T. , Biese Kevin , Hwang Ula
Published: July 2023

This editorial comments on the article by Haynesworth et al. in this issue.
Economic and environmental assessment of automotive plastic waste end‐of‐life options: Energy recovery versus chemical recycling
Authors: Stallkamp Christoph , Hennig Malte , Volk Rebekka , Richter Frank , Bergfeldt Britta , Tavakkol Salar , Schultmann Frank , Stapf Dieter
Published: July 2023

Most automotive plastic waste (APW) is landfilled or used in energy recovery as it is unsuitable for high‐quality product mechanical recycling. Chemical recycling via pyrolysis offers a pathway toward closing the material loop by handling this heterogeneous waste and providing feedstock for producing virgin plastics. This study compares chemical recycling and energy recovery scenarios for APW regarding climate change impact and cumulative energy demand (CED), assessing potential environmental advantages. In addition, an economic assessment is conducted. In contrast to other studies, the assessments are based on pyrolysis experiments conducted with an actual waste fraction. Mass balances and product composition are reported. The experimental data is combined with literature data for up‐ and downstream processes for the assessment. Chemical recycling shows a lower net climate change impact (0.57 to 0.64 kg CO2e/kg waste input) and CED (3.38 to 4.41 MJ/kg waste input) than energy recovery (climate change impact: 1.17 to 1.25 kg CO2e/kg waste input; CED: 6.94 to 7.97 MJ/kg waste input), while energy recovery performs better economically (net processing cost of −0.05 to −0.02€/kg waste input) compared to chemical recycling (0.05 to 0.08€/kg waste input). However, chemical recycling keeps carbon in the material cycle contributing to a circular economy and reducing the dependence on fossil feedstocks. Therefore, an increasing circularity of APW through chemical recycling shows a conflict between economic and environmental objectives.
Dehydration as alternative sample preparation for soft X‐ray tomography
Authors: Chatzimpinou Anthoula , Funaya Charlotta , Rogers David , O'Connor Stephen , Kapishnikov Sergey , Sheridan Paul , Fahy Kenneth , Weinhardt Venera
Published: July 2023

Soft X‐ray tomography (SXT) is an imaging technique to visualise whole cells without fixation, staining, and sectioning. For SXT imaging, cells are cryopreserved and imaged at cryogenic conditions. Such ‘near‐to‐native’ state imaging is in high demand and initiated the development of the laboratory table‐top SXT microscope. As many laboratories do not have access to cryogenic equipment, we asked ourselves whether SXT imaging is feasible on dry specimens. This paper shows how the dehydration of cells can be used as an alternative sample preparation to obtain ultrastructure information. We compare different dehydration processes on mouse embryonic fibroblasts in terms of ultrastructural preservation and shrinkage. Based on this analysis, we chose critical point (CPD) dried cells for SXT imaging. In comparison to cryopreserved and air‐dried cells, CPD dehydrated cells show high structural integrity although with about 3–7 times higher X‐ray absorption for cellular organelles. As the difference in X‐ray absorption values between organelles is preserved, 3D anatomy of CPD‐dried cells can be segmented and analysed, demonstrating the applicability of CPD‐dried sample preparation for SXT imaging.

LAY DESCRIPTION: Soft X‐ray tomography (SXT) is an imaging technique that allows to see the internal structures of cells without the need for special treatments like fixation or staining. Typically, SXT imaging involves freezing and imaging cells at very low temperatures. However, since many labs lack the necessary equipment, we explored whether SXT imaging could be done on dry samples instead. We compared different dehydration methods and found that critical point drying (CPD) was the most promising for SXT imaging. CPD‐dried cells showed high structural integrity, although they absorbed more X‐rays than hydrated cells, demonstrating that CPD‐dried sample preparation is a viable alternative for SXT imaging.