bluuebunny/crossref_metadata_2025 huggingface dataset:
European eel (Anguilla anguilla) survival modeling based on a 22‐year capture‐mark‐recapture survey of a Mediterranean subpopulation
Authors: Hoste Amélie , Bouchard Colin , Poggiale Jean‐Christophe , Nicolas Delphine
Published: October 2024

Since the 1980s, the European eel (Anguilla anguilla) has declined by over 90% in recruitment across its European and North African distribution area. This diadromous fish spawns at sea and migrates into continental waters, where it grows for three to more than 30 years, depending on habitat conditions and location. During their growth, different habitat use tactics can locally influence the life‐history traits of eels, including their survival rates. Thus, the spatio‐temporal dimension of this species is crucial for management. Based on a rare Mediterranean long‐term survey of more than 20 years (2001–2022) in an artificial drainage canal connected to a vast brackish lagoon (the Vaccarès lagoon), we aimed to study the dynamics of one subpopulation's life‐history traits. We used Bayesian multistate capture‐mark‐recapture (CMR) models to assess the temporal variability in survival and abundance at both seasonal and inter‐annual scales, considering life‐stage structure. High survival rates and low detection probabilities were found for the undifferentiated and female yellow stages. In contrast, female silver eels exhibited lower survival rates and higher capture probabilities. Estimating detection probabilities and survival rates enabled accurate assessment of relative abundance across different life stages and time periods. Our findings indicated a substantial decrease in the abundance of undifferentiated and female yellow eels in the early 2000s, whereas the abundance of female silver eels remained consistently low yet stable throughout the study period. Considering the life stage seemed essential to study the dynamics of the eel during its continental growing period. The present results will provide key elements to propose and implement suitable sustainable environmental management strategies for eel conservation.
Responses to sound in three Centrarchid species: Do heterospecific interactions change behavior?
Authors: Bendig Taylor A. , Dycha Grace M. , Higgs Dennis M.
Published: October 2024

Due to the increasing prevalence and variety of underwater anthropogenic noise sources, and the growing human population, anthropogenic noise has the potential to negatively impact aquatic organisms. With this growing threat, the question of how fishes respond to this stressor in their natural environments becomes more urgent. The current study used behavioral trials with bluegill sunfish Lepomis macrochirus, pumpkinseed sunfish Lepomis gibbosus, and rock bass Ambloplites rupestris, both in isolation and in a heterospecific trial, to determine how behaviors indicative of stress were influenced by interspecific interactions when exposed to recordings of pure tones and boat motors. Regardless of social context, all three species experienced an increase in fin beats per second, an increase in time spent at the bottom of the pen, and a decrease in time spent swimming when exposed to boat noise. Fishes in heterospecific trials experienced more fin beats per second and spent less time swimming, but there was no significant difference when comparing time spent at the bottom of pen with fish in individual trials. Our findings of behavioral changes when exposed to acoustic stimuli, in two social contexts, allow for a deeper understanding of interspecific effects and provide insight into how varied field studies can be useful in studying fish behavior when encountering acoustic stressors.
The influence of assistance in home‐based exercise programmes for individuals with intellectual disabilities
Authors: Noerr K. L. , Swinford R.
Published: October 2024

Background

Regular physical activity (PA) decreases the risk of comorbidities associated with a sedentary lifestyle in individuals with intellectual disabilities (IDs). They also may experience additional barriers that may prevent PA, including access, proper instruction and support. At‐home PA programming is a feasible alternative to long‐term adherence. This study aimed to determine (1) how an at‐home DVD programme affects PA adherence and (2) the extent to which caregiver support influences PA.

Methods

Thirty‐one adolescent or adult‐aged participants with mild or moderate ID were randomised into a DVD or control group exercise intervention. Participants were given autonomy to choose what type of PA modality from the intervention they would like to participate in. Caregiver support during the PA was also measured.

Results

The two‐way repeated‐measures MANOVA demonstrated that the intervention DVD group was statistically significant, with a large effect size in PA minutes (P = 0.014, ηP2 = 0.236) and rate of perceived exertion (P = 0.002, ηP2 = 0.342) compared with the control group.

Conclusions

The findings demonstrated that using an adapted DVD increased PA minutes and the rate of perceived exertion without high levels of caregiver support.
Chronic hyperglycemia alters retinal astrocyte microstructure and uptake of cholera toxin B in a murine model of diabetes
Authors: Holden Joseph M. , Bossardet Olivia L. , Bou Ghanem Ghazi , Calkins David J. , Wareham Lauren K.
Published: October 2024

Astrocytes are the principle glial cells of the central nervous system and play an active role in maintaining proper metabolism in surrounding neurons. Because of their involvement in metabolic control, it is likely that their physiology changes in response to metabolic diseases such as diabetes and associated diabetic retinopathy. Here, we investigated whether microstructural changes in astrocyte morphology occur during the early stages of chronic hyperglycemia that may be indicative of early pathogenic programs. We used MORF3 mice in conjunction with streptozotocin‐induced hyperglycemia to investigate the morphology of single retinal astrocytes at an early timepoint in diabetic disease. We report that astrocytes initiate a morphological remodeling program, which depends on both the glycemic background and the presence of intravitreal injury, to alter the amount of the neuronal‐associated pad and bristle microstructural motifs. Additionally, hyperglycemia increases astrocyte uptake of cholera toxin B, possibly reflecting changes in glycolipid and glycoprotein biosynthesis. Chronic hyperglycemia coupled with intravitreal injection of cholera toxin B also causes extensive leukocyte infiltration into the retina. Our results have important clinical relevance as current therapies for diabetic retinopathy involve intravitreal injection of pharmaceuticals in individuals with often poorly controlled blood glucose levels.

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How compactness affects long bone resistance to compression—An investigation into the rhinoceros humerus
Authors: Etienne Cyril , Viot Jérémie , Watson Peter J. , Fagan Michael J. , Houssaye Alexandra
Published: October 2024

The functional signal of bone internal structure has been widely studied. Isolated form‐function relationships have often been assumed from the observation of presumed morphofunctional relationships, but have never been truly tested. Indeed, distinct bone microanatomical feature co‐evolve in response to various constraints that are difficult to detangle. This study tested for the first time the impact of various microanatomical parameters taken one by one, plus some in pairs, on bone strength under compression using biomechanical modelling. We carried out finite element analyses on humerus models, obtained from a white rhinoceros, with different heterogeneous internal structures, and analysed the magnitude and distribution of von Mises stresses. These tests validated earlier hypotheses of form‐function relationships about the greater resistance to compression provided by the thickening of the cortex and the filling of the medullary area by trabecular bone and highlighted the stronger impact of increasing trabecular bone compactness than of avoiding an open medullary cavity. By making it possible to estimate the relative impact of each parameter and of combinations of microanatomical features, they also showed the more limited impact of the trabecular bone compactness in the epiphyses to resist compression, and the fact that microanatomical changes of opposite but of similar amplitude impact can compensate each other, but that the impact of the sum of two negative microanatomical changes far exceeds the sum of the impacts of each of the two changes taken separately. These results contribute to a better understanding of bone adaptation and form‐function relationships so that they later can be used with confidence for palaeobiological inferences on fossil specimens, contributing to a better understanding of skeletal evolution during the evolutionary history of vertebrates. They also highlight the potential of taking internal structure into account in the bone biomechanical analyses. In addition, they can be used in bioinspiration to design resistant structures subjected to compression.
Variation in air sac morphology and postcranial skeletal pneumatization patterns in the African grey parrot
Authors: Lawson Adam B. , Martinez Aracely , Hedrick Brandon P. , Echols M. Scott , Schachner Emma R.
Published: October 2024

The anatomy of the avian lower respiratory system includes a complex interaction between air‐filled pulmonary tissues, pulmonary air sacs, and much of the postcranial skeleton. Hypotheses related to the function and phylogenetic provenance of these respiratory structures have been posed based on extensive interspecific descriptions for an array of taxa. By contrast, intraspecific descriptions of anatomical variation for these features are much more limited, particularly for skeletal pneumatization, and are essential to establish a baseline for evaluating interspecific variation. To address this issue, we collected micro‐computed tomography (μCT) scans of live and deceased African grey parrots (Psittacus erithacus) to assess variation in the arrangement of the lungs, the air sacs, and their respective invasion of the postcranial skeleton via pneumatic foramina. Analysis reveals that the two pairs of caudalmost air sacs vary in size and arrangement, often exhibiting an asymmetric morphology. Further, locations of the pneumatic foramina are more variable for midline, non‐costal skeletal elements when compared to other pneumatized bones. These findings indicate a need to better understand contributing factors to variation in avian postcranial respiratory anatomy that can inform future intraspecific and interspecific comparisons.
Differences in the Clinical Characteristics of Male Patients With Different Ages of Rosacea: A Retrospective Study of 215 Male Outpatients
Authors: Huang Yuwei , Chen Siliang , Liu Xu , Du Dan , Jiang Xian
Published: October 2024

Background

Rosacea is more common in women and Caucasians, leading to little research on rosacea in Asian men. Additionally, there is limited research on the patients across different age groups.

Aims

The aim of this study is to analyze and compare the characteristics of male patients of rosacea among different age groups.

Methods

A retrospective analysis was conducted on 215 male patients with rosacea, investigating their characteristics, clinical symptoms, exacerbating factors, complications, psychological status, and treatment, as well as exploring factors influencing the early onset of male rosacea.

Results

The patients were divided into three age groups (≤ 30 years, 31–44 years, and ≥ 45 years), with the study revealing an average age of 38.59 ± 13.13 years among the patients. The most common subtype of rosacea in men was erythematotelangiectatic rosacea (ETR), followed by phymatous rosacea (PhR). The main reported features included persistent erythema (87.4%) and telangiectasia (71.2%), predominantly affecting the nose (58.6%) and cheeks (56.3%). Twenty‐six percent of patients reported concurrent skin diseases, with 14.0% reporting systemic diseases. Significant differences were observed among different age groups regarding family history, clinical features, lesion distribution, symptom severity, aggravating factors, presence of systemic diseases, and treatment preferences. Subjective skin typing, Fitzpatrick phototype, and positive family history were identified as factors influencing the age of onset of rosacea in men.

Conclusion

Male patients with rosacea exhibit distinct clinical characteristics, with a greater prevalence of nasal involvement and nasal lesions among male patients. Clinical features vary among different age groups, with patients aged ≥ 45 experiencing more complex and severe symptoms. Patients aged ≤ 30 may be more influenced by genetic factors and have higher treatment expectations.
Depression and risk of stroke and mortality after percutaneous coronary intervention: A nationwide population study
Authors: Cheon Dae Young , Park Yong‐Moon , Park Myung Soo , Choi Jae Hyuk , Oh Mi‐Sun , Han Seongwoo , Yu Kyung‐Ho , Lee Byung‐Chul , Han Kyungdo , Lee Minwoo
Published: October 2024

Background

Limited evidence exists on the role of depression in the risk of developing stroke and other cardiovascular outcomes in patients who have undergone percutaneous coronary interventions (PCI). We investigated this relationship with data from the Korean National Health Insurance Service database.

Methods

Our nationwide retrospective cohort study included 164,198 patients who had undergone PCI between 2010 and 2017. Depression was defined with the ICD‐10 codes recorded prior to the PCI. The primary outcome was a new‐onset stroke following the PCI. Secondary outcomes included PCI with myocardial infarction (MI), revascularization (PCI or coronary artery bypass grafting), and all‐cause mortality. A multivariable Cox proportional hazards regression analysis was used to calculate adjusted hazard ratios (aHR) and 95% confidence intervals (CI), adjusting for potential confounders, including sociodemographic and lifestyle factors, comorbidities, and MI at the index PCI.

Results

Over a median follow‐up of 5.0 years, acute stroke occurred in 5.7% of patients with pre‐existing depression (17.4% of the study population), compared to 3.5% of those without depression. Depression was associated with a 27% increased risk of acute stroke (aHR 1.27, 95% CI 1.20–1.35). Additionally, depression was linked with a 25% elevated risk of all‐cause death (aHR 1.25, 95% CI, 1.21–1.29) and an 8% increased risk of revascularization (aHR 1.08, 95% CI 1.04–1.11). The associations with the risk of stroke and all‐cause mortality were stronger in patients under 65 years.

Conclusions

Our findings suggest that pre‐existing depression may increase the risk of stroke and all‐cause mortality following PCI, particularly in patients under 65 years. Additionally, depression was significantly associated with an increased need for revascularization. This underscores the potential benefits of managing depression to reduce stroke risk and overall cardiovascular outcomes following PCI.
A simplified approach to define cervical vertebral levels in spinal cord MRI studies
Authors: Papinutto Nico , Perretti Ilaria , Mallott Jacob , Cheng Shuiting , Cooper Tiffany , Gomez Refujia , Stern William A. , Pichiecchio Anna , Caverzasi Eduardo , Henry Roland G.
Published: October 2024

Background and Purpose

Spinal cord (SC) cross‐sectional areas (CSAs) assessed with MRI have proven to be extremely valuable imaging markers in several diseases. Among the challenges is the delineation of vertebral levels to determine level‐dependent changes in cord atrophy. With this study, we aimed to (1) test the hypothesis that there is proportionality in the position of the first six intervertebral discs and the length of the upper portion of the SC and (2) show that a proportionality approach can simplify the CSA assessment across vertebrae offering good reliability.

Methods

Forty‐six volunteers underwent standard T2‐weighted and T1‐weighted cervical SC MRI acquisitions. The distance between the obex and the intervertebral discs (from C2‐C3 to T1‐T2) was measured on the T2‐weighted acquisitions of the entire cohort. In a test‐retest experiment on 12 subjects, the % disc position values were used to define vertebral levels, and a comparison was performed with manual vertebrae assignment in terms of mean CSA and its coefficient of variation.

Results

The mean upper cord length for the cohort was 144.0 ± 13.1 mm. The discs’ level % position in the upper cord was found to be fairly consistent, with standard deviations of 0.8%‐1.7%. The mean vertebral CSA obtained with the proportionality method was substantially equivalent to the manual approach in terms of mean CSA values and test‐retest reliability.

Conclusions

With this study, we propose a proportionality method for the assignment of cervical SC vertebral levels that can simplify the processing of MRI datasets in the context of CSA measurements.
Evaluation of an Australian community‐based model of care for adults with intellectual and developmental disabilities undergoing procedures under sedation
Authors: Golder Janet , Adams Reece , Calleja Shenae , Templeton Michelle , Foster Abby
Published: October 2024

Background

Adults with intellectual and developmental disabilities (IDDs) have higher healthcare needs, but experience difficulties accessing preventative healthcare. Despite this inequity, models of care that address barriers and provide customized treatment are limited, exacerbating vulnerabilities and poorer health outcomes. This study describes the development of a procedural model of care (PMOC) for adults with intellectual and developmental disabilities, and evaluates the sedation tier, exploring procedure and sedation outcomes.

Methods

Development of the PMOC was informed by current evidence and themes identified in stakeholder consultation and literature. A retrospective cohort study evaluated the sedation option within the model, conducted at a community‐based disability service in Melbourne, Australia. All records over a 14‐month period were included. Descriptive statistics and univariate logistic regression analysis were used to analyze data.

Results

The PMOC includes assessment, intervention, and evaluation tiers. Intervention options range from least to most invasive, culminating in the sedation level (mild; oral psychoactive, moderate; midazolam and nitrous oxide, high; general anesthetic). A total of 127 adults with IDDs received procedures under sedation; median age was 26 years, 61% lived with family, and 81% had multiple disabilities. A total of 197 procedures were referred to CDDH, including immunization (61%) and oral health reviews (23%), and resulted in 98% completion rate. Mild (n = 36) and moderate (n = 95) sedation were used for 67% of procedures. The PMOC correctly predicted 91% of sedation requirements. Living with family (OR 2.211, 95% CI 1.001–4.885, p = 0.05); immunization (OR 7.935, 95% CI 4.025–15.644, p <0.001); and multiple disabilities (OR 3.064, 95% CI 1.123–8.362, p = 0.029) were associated with mild, moderate and high sedation options, respectively.

Conclusions

Models of care offering individualized interventions can support adults with IDDs to receive preventative procedures. Demographic variables may be able to predict sedation requirements. Wider application of this model may reduce health inequity within this vulnerable population.
Moving toward a time‐based and balanced quality of life
Authors: Sgaramella Teresa Maria
Published: October 2024

Current complex life conditions and changing developmental contexts draw attention to the concept of capabilities, the various combinations of functions a person can do or can be, and the opportunities to achieve them. A future‐oriented time perspective is a dimension along which individuals express meaning‐making of experiences and expectations regarding their lives, a benchmark for the well‐being and satisfaction of the quality of life they experience. Findings from research studies involving adults with disabilities and family members of persons with a disability provide evidence for a time‐based model, an approach tapping into both the concept and measurement of quality of life and balancing both current and expected quality of life.
Multiple Low‐Level Viraemia Suggest Hindered Liver Fibrosis Regression in Chronic Hepatitis B Patients During Antiviral Therapy
Authors: Lu Zhengzhao , Sun Ya‐Meng , Chen Shuyan , Meng Tongtong , Wang Bingqiong , Zhou Jialing , Wu Xiaoning , Zhao Xinyan , Ou Xiaojuan , Kong Yuan‐Yuan , Jia Jidong , Zhao Xinyu , You Hong
Published: October 2024

Low‐level viraemia (LLV) occurs in chronic hepatitis B (CHB) patients despite antiviral treatment, which may cause failed histological regression. Our study aimed to investigate the impact of different LLV types on fibrosis regression. The prospective study enrolled CHB patients with paired liver biopsies before and after 260 weeks of entecavir treatment. Fibrosis regression was defined by the Ishak score or P‐I‐R system. Patients were grouped as the SVR (HBV DNA < 20 IU/mL persistently) or LLV (HBV DNA between 20 and 2000 IU/mL), which were further grouped as very low‐level viraemia (VLLV, HBV DNA < 50 IU/mL), occasionally LLV (OLLV, HBV DNA ≥ 50 IU/mL only once) and multiple LLV (MLLV, HBV DNA ≥ 50 IU/mL more than once). Logistic regression models were used to calculate the adjusted odds ratios (aORs) and 95% confidence intervals (CIs). The analysis included 111 CHB patients. In the SVR group (n = 54), 39 (72.2%) patients had fibrosis regression, which was higher than the LLV (56.1%, p = 0.080). The fibrosis regression rates for VLLV (30 patients), OLLV (17 patients) and MLLV (10 patients) were 70.0%, 52.9% and 30.0%, respectively. Compared with SVR, VLLV (aOR = 0.78; 95% CI: 0.28–2.21; p = 0.644) was not associated with fibrosis regression, but patients with non‐VLLV (aOR = 0.27; 95% CI: 0.09–0.85; p = 0.025), especially with MLLV (aOR = 0.19; 95% CI: 0.04–0.97; p = 0.046) is significantly associated with hindered fibrosis regression. Our study suggests that patients with detectable serum HBV DNA levels higher than 50 IU/mL need to be monitored carefully, especially in those with more than once.

Trial Registration: ClinicalTrials.gov identifiers NCT01938781 and NCT01938820
Patterns and drivers of alien plant invasion in Uruguayan grasslands
Authors: Guido Anaclara , Altesor Alice , Cayssials Valerie , Lezama Felipe , Mello Ana Laura , Paruelo José , Baeza Santiago
Published: October 2024

Question

Understanding the patterns of alien plant invasions and their underlying drivers is a key step in conserving the remaining native grasslands of Uruguay. We addressed the level of invasion by considering the four invasive alien plants of these ecosystems, Cynodon dactylon, Eragrostis plana, Senecio madagascariensis and Ulex europaeus, throughout the country.

Location

Remnant native grasslands of Uruguay, constituting part of the Río de la Plata grasslands.

Methods

Extensive fieldwork was carried out over five years of data collection, including hierarchically randomized observations (around 2000) nested in 137 10 × 10‐km2 squares covering different geomorphological regions. For each invasive alien species, we constructed distribution maps to show their patterns; for the two most abundant, we fitted models to identify the main explanatory variables at different spatial scales.

Results

We found that 77% of the squares were invaded by at least one target species. The level of invasion varied between regions and target plants. The most abundant invasive alien species were Cynodon dactylon and Senecio madagascariensis; while Eragrostis plana and Ulex europaeus were scarce. Cynodon dactylon cover was related to a set of variables at different spatial scales, including climate, topography and several local community descriptors. Senecio madagascariensis cover was positively associated with grassland fragmentation and anthropic disturbance at the landscape, and a few local descriptors.

Conclusions

The large sampling effort at the country level, with a randomized design, allowed for a reliable assessment of the level of invasion of Uruguayan grasslands and its possible drivers. This is an important step in the design of policies to conserve Uruguay's remaining native grasslands. We suggest that the prevention should focus on the Basaltic Cuestas region, while control and containment should prioritize the eastern and south‐central parts of the country, focusing mainly on Cynodon dactylon management.
Evaluating What Works in the Classroom: Best Practice and Future Opportunities
Authors: Bowen Astrid E. J. , Palmer Lucy R. J. , Perry Roisin C. , Thomas Michael S. C. , Tolmie Andrew , Borst Grégoire , Van Herwegen Jo
Published: October 2024

Despite a high level of interest and investment in “gold standard” evaluations of interventions in education, the gap between teaching practice and the latest research on learning appears wider than ever; likewise, persistent attainment gaps between certain groups remain. This report summarizes the presentations and discussion from a roundtable event that brought together representatives from educational practice, research, and policy to explore challenges and solutions in relation to establishing “what works” in different educational contexts. The commentary addresses issues surrounding (a) who is involved and when, (b) a need for methodological innovation, (c) communication, and (d) understanding and use of evidence by educators and policymakers. Suggestions for best practice in relation to addressing these issues using national and international examples are presented. Identified recommendations related to facilitating a research culture within the teaching profession, the promotion of data sharing and communication, and conducting realistic evaluations. Outstanding questions are highlighted.
Girmitiya nationalism: Lived cultures and diasporic bonding in a plural society
Authors: Gowricharn Ruben
Published: October 2024

Nationalism studies tend to focus on a relatively closed and abstract nation. This paper addresses these features by analysing the case of Girmitiya nationalism, a nationalism in the Indian diaspora that broadens the exclusive focus on the nation. It introduces the concept of lived culture that makes the nationalism of an ethnic diaspora community concrete and specifies the interaction between global forces and local life. Using data obtained as a member of the studied ethnic community and deploying additional concepts such as ethnogenesis, Creole hegemonic nationalism, ethnification, diaspora bonding and Girmitiya ideology, the paper demonstrates the usefulness of the concept of lived culture. The concept of lived culture thus discloses the specificities of Girmitiya nationalism, while countervailing the tendency to restrict the focus on the nation and offering a route to broaden the focus.
Are ‘coercive’ language policies fair?
Authors: Pena‐Tarradelles Joana
Published: October 2024

This paper provides a normative justification regarding the fairness of ‘coercively’ protecting minority languages in mixed societies where the minority group already knows the majority language. To do so, it adopts first a theory‐testing approach and examines, by using the Catalan case, the validity of the arguments presented in Morales‐Gálvez's (2017) ‘protectionist’ theory of linguistic justice. In this vein, it argues that some of the ideas this author uses to defend the ‘coercive’ protection of minority languages still work when the minority group is bilingual. Yet, there are others that appear to be problematic. As such, this paper then unfolds using a theory‐building approach and reframes these concepts with the objective of proposing complementary arguments. This article concludes that ‘coercive’ policies to protect the language of a bilingualised minority group are fair and necessary if they aim to accomplish active reciprocal bilingualism and hence ensure equal rights for all speakers.
A systematic review and meta‐analysis of functional vitamin B12 status among adult vegans
Authors: Niklewicz Ali , Hannibal Luciana , Warren Martin , Ahmadi Kourosh R.
Published: October 2024

The dietary intake of vitamin B12 among unsupplemented vegans is notably lower compared to both vegetarians and omnivores. Prolonged low intakes of vitamin B12, such as seen in those adhering to a vegan diet, lead to physiological deficiency of vitamin B12 and an elevated risk of B12‐related morbidity. However, while serum B12 serves as a conventional biomarker for assessing B12 status, its utility is limited given its sensitivity and specificity in ascribing physiological deficiency of B12 and the functional vitamin B12 status of those adhering to vegan diets is unclear. We conducted a systematic review and meta‐analysis using data based on the full panel of biomarkers of vitamin B12 status to test whether adherence to a vegan diet is associated with an elevated risk of functional vitamin B12 deficiency compared to vegetarian or omnivorous diets. In addition, subgroup analysis was carried out to look at the effect of vitamin B12 supplement use on B12 status among vegans. Our search identified 4002 records, of which 19 studies met the inclusion criteria for the systematic review and 17 studies were taken forward for the meta‐analysis. Meta‐analysis results revealed significantly lower serum B12, pmol/ (−0.72 [−1.26, −0.18]; p = 0.01) and elevated total homocysteine, μmol/L (tHcy) (0.57 [0.26, 0.89]; p < 0.001) concentrations, alongside elevated methylmalonic acid, nmol/L (MMA) (0.28 [−0.01, 0.57]; p = 0.06) and lower holotranscobalamin, pmol/ (HoloTC) (−0.42 [−0.91, 0.07]; p = 0.09) levels among vegan adults compared to omnivores, indicating increased functional B12 deficiency in addition to low vitamin B12 status in vegan adults. There were no differences between vegans and vegetarians in HoloTC (0.04 [−0.28, 0.35]; p = 0.814) or MMA (−0.05 [−0.29, 0.20]; p = 0.708), but differences were found in serum B12 (−0.25 [−0.40, −0.10]; p = 0.001) and for tHcy (0.24 [0.09, 0.39]; p = 0.002) concentrations. Subgroup analyses indicated that the use of vitamin B12 supplements among vegans contributes to significant improvements in all biomarker concentrations compared to their unsupplemented counterparts. Our findings underscore the need for improved strategies to redress poor vitamin B12 status with appropriate B12 supplementation use among those adhering to vegetarian and vegan diets.
Comparison of measurement of integrated relaxation pressure by esophageal manometry with analysis of swallowing sounds with artificial intelligence in patients with achalasia
Authors: Lankarani Kamran B. , Aboulpor Nahid , Boostani Reza , Saeian Samira
Published: October 2024

Background

Esophageal motility disorders are mainly evaluated with high‐resolution manometry (HRM) which is a time‐consuming and uncomfortable procedure with potential adverse events. Acoustic characterization of the swallowing has the potential to be an alternative noninvasive procedure.

Methods

We compared the findings on HRM and swallowing sounds in 43 patients who were referred for evaluation of dysphagia. The sound analysis was done with empirical mode decomposition method and with artificial intelligence (AI) and the estimated integrated relaxation pressure (IRP) from a two‐layer neural network method was compared to measured IRP on HRM. The model then was tested in five patients.

Key Results

IRP was estimated with high accuracy using the model developed with two‐layer neural network method.

Conclusions & Inferences

The analysis of acoustic properties of swallowing has the potential to be used for evaluation of esophageal motility disorders, this needs to be further evaluated in larger studies.
Laxative and purgative actions of phytoactive compounds from beetroot juice against loperamide‐induced constipation, oxidative stress, and inflammation in rats
Authors: Ayari Ala , Dakhli Nouha , Jedidi Saber , Sammari Houcem , Arrari Fatma , Sebai Hichem
Published: October 2024

Background

Chronic constipation is a gastrointestinal functional disorder which affects patient quality of life. Therefore, many studies were oriented to search herbal laxative agents. In this study, we investigated the phytochemical composition of beetroot juice (BJ) and its laxative potential in an experimental model of constipation and colonic dysmotility induced by loperamide (LOP) in Wistar rats.

Methods

Animals were concurrently pretreated with LOP (3 mg/kg, b.w., i.p.) and BJ (5 and 10 mL/kg, b.w., p.o.), or yohimbine (2 mg/kg, b.w., i.p.), during 1 week. The laxative activity was determined based on the weight, frequency, and water content of the feces matter. The gastric‐emptying test and intestinal transit were determined. Colon histology was examined, and oxidative status was evaluated using biochemical‐colorimetric methods.

Key results

The in vivo study revealed that LOP induced a significant inhibition of gastrointestinal motility, negative consequences on defecation parameters, oxidative stress, and colonic mucosa lesions. Conversely, administration of BJ reestablished these parameters and restored colonic oxidative balance. Importantly, BJ treatment protected against LOP‐induced inflammatory markers (pro‐inflammatory cytokines and WBC) and the increase in intracellular mediators such as hydrogen peroxide, free iron, and calcium levels.

Conclusions & inferences

This study demonstrated that the bioactive compounds in BJ provided an anti‐constipation effect by modulating intestinal motility and regulating oxidative stress and inflammation induced by LOP intoxication.
Symptom bothersomeness and life interference support Rome clinical criteria as clinically relevant indicators of DGBI
Authors: Coitinho Biurra Yao , Naude Colette , Marchese Sara H. , Evans Subhadra , Barber Emily , Parigi Elesha , Cheah Suiyin , Palsson Olafur , Sperber Ami D. , Tack Jan , Drossman Douglas , Mikocka‐Walus Antonina , Taft Tiffany
Published: October 2024

Background

Irritable bowel syndrome (IBS) and functional dyspepsia (FD) are common disorders of gut‐brain interaction (DGBI). The Rome IV criteria are the gold standard for research when diagnosing DGBI. However, bothersomeness, or the degree to which symptoms are distressing or disruptive to a person's daily life, is a potential treatment‐seeking motivator that is not assessed by the Rome criteria. The Rome Foundation developed and published diagnostic criteria for clinical practice that include bothersomeness. We aimed to evaluate these constructs via patient focus groups to determine what prompts healthcare‐seeking as a means to assess its value in the Rome clinical criteria.

Methods

Adults meeting Rome IV criteria for IBS, FD, or both participated in focus groups in Australia and the United States. Semi‐structured interview transcripts were analyzed using Template Thematic Analysis, with three a priori and other a posteriori themes refined iteratively through team discussion and consensus.

Key Results

Participants confirmed the frequency and duration of symptoms was not sufficient to reflect illness experience. Four major themes emerged: (1) Bothersomeness should be included in assessments of IBS and FD; (2) Patients find many DGBI symptoms bothersome; (3) Bothersomeness traverses multiple domains of quality of life; (4) Patients may hesitate to seek medical advice due to past negative experiences.

Conclusions and Inferences

These findings support the value of the Rome Clinical Criteria. They emphasize the importance of expanding assessments of patients with DGBI to include how bothersome they perceive symptoms to be, how much symptoms interfere with their daily life, and what may moderate their decisions to seek treatment.
Distal contractile integral and other key predictors of mean nocturnal baseline impedance: The role of esophageal peristaltic vigor in mucosal permeability
Authors: Fass Ofer Z. , Kamal Afrin N. , Jiang Yan , Clarke John O.
Published: October 2024

Background

Understanding the relationship between distal contractile integral (DCI) and mean nocturnal baseline impedance (MNBI) could shed light on new diagnostic and treatment strategies, specifically concerning nocturnal reflux. This study aimed to assess this relationship to enhance our comprehension of the interplay between esophageal contractility and mucosal permeability.

Methods

We identified adult patients who had high resolution esophageal manometry and pH‐impedance tests performed within a 30‐day period between December 2018 and March 2022. A random forest model was used to identify significant predictors of MNBI, assisting with variable selection for a following regression analysis. Subsequently, both univariable and multivariable regression models were utilized to measure the association between predictors and MNBI.

Key Results

Our study included 188 patients, primarily referred for testing due to reflux. The most common motility diagnoses were normal (62%) followed by possible esophagogastric junction outflow obstruction (22%). The mean DCI was 2020 mmHg∙s∙cm and MNBI was 3.05 kΩ. The random forest model identified 12 significant predictors for MNBI, key variables being acid exposure time (AET), total proximal reflux events, intraabdominal lower esophageal sphincter length, hiatal hernia presence, and DCI. Subsequent multivariable regression analyses demonstrated log AET (β = −0.69, p = <0.001), total proximal reflux events (β = −0.16, p = 0.008), hiatal hernia presence (β = −0.82, p = 0.014), log DCI (β = 1.26, p < 0.001), and age (β = −0.13, p = 0.036) as being significantly associated with MNBI.

Conclusions and Inferences

DCI is a key manometric predictor of MNBI emphasizing the role of manometry in detecting reflux risk and the need for its consideration in reflux management.
Efficacy and safety of linaclotide in treatment‐resistant chronic constipation: A multicenter, open‐label study
Authors: Yoshihara Tsutomu , Kessoku Takaomi , Takatsu Tomohiro , Misawa Noboru , Ashikari Keiichi , Fuyuki Akiko , Ohkubo Hidenori , Higurashi Takuma , Iwaki Michihiro , Kurihashi Takeo , Nakatogawa Machiko , Yamamoto Koji , Terada Izuru , Tanaka Yusuke , Morita Masataka , Nakajima Atsushi
Published: October 2024

Background

This study aimed to evaluate the efficacy and safety of linaclotide in patients with chronic constipation (CC) or irritable bowel syndrome with constipation (IBS‐C) who did not respond to treatment with magnesium oxide (MgO).

Methods

This study was designed as a multicenter, open‐label, single‐arm, exploratory study. Patients with CC or IBS‐C who took MgO and those meeting the medication initiation criteria were administered linaclotide at a daily dosage of 500 μg for 12 weeks. The primary endpoint was a change in the Japanese version of the Patient Assessment of Constipation Quality of Life (JPAC‐QOL) score from baseline, which was evaluated by using a paired t‐test.

Key Results

The patients' mean age (± standard deviation) was 67.6 ± 13.82 years. The full analysis set included 61 patients. The JPAC‐QOL total score was 1.60 at baseline and 0.70 at 12 weeks, with a significant mean change of −0.89 ± 0.721 (p < 0.001). Several secondary endpoints also showed improvement. The frequency of spontaneous bowel movement (SBM) and complete SBM increased by 2.70 ± 7.254 (p < 0.01) and 2.81 ± 5.254 times, respectively (p < 0.001). The Bristol Stool Form Scale, abdominal bloating severity, and straining severity scores improved by 1.33 ± 1.274 (p < 0.001), −0.16 ± 0.563 (p < 0.05), and −0.46 ± 0.795 (p < 0.001) points, respectively. The safety analysis set included 65 patients, 7 of whom had diarrhea, which improved with dose reduction and drug withdrawal.

Conclusion & Inferences

The study was conducted in an older adult population, similar to real clinical practice. Linaclotide may be an option for treating CC that shows an inadequate response to conventional therapy.
Gaining or cutting SLAC: the evolution of plant guard cell signalling pathways
Authors: Sussmilch Frances C. , Maierhofer Tobias , Herrmann Johannes , Voss Lena J. , Lind Christof , Messerer Maxim , Müller Heike M. , Bünner Maria S. , Ache Peter , Mayer Klaus F. X. , Becker Dirk , Roelfsema M. Rob G. , Geiger Dietmar , Schultz Jörg , Hedrich Rainer
Published: October 2024

The evolution of adjustable stomatal pores, enabling CO2 acquisition, was one of the most significant events in the development of life on land. Here, we investigate how the guard cell signalling pathways that regulate stomatal movements evolved.

We compare fern and angiosperm guard cell transcriptomes and physiological responses, and examine the functionality of ion channels from diverse plant species.

We find that, despite conserved expression in guard cells, fern anion channels from the SLAC/SLAH family are not activated by the same abscisic acid (ABA) pathways that provoke stomatal closure in angiosperms. Accordingly, we find an insensitivity of fern stomata to ABA. Moreover, our analysis points to a complex evolutionary history, featuring multiple gains and/or losses of SLAC activation mechanisms, as these channels were recruited to a role in stomatal closure.

Our results show that the guard cells of flowering and nonflowering plants share similar core features, with lineage‐specific and ecological niche‐related adaptations, likely underlying differences in behaviour.
Crystal structure and function of a phosphate starvation responsive protein phosphatase, GmHAD1‐2 regulating soybean root development and flavonoid metabolism
Authors: Zhang Zeyu , Mo Xiaohui , Zhao Hongbo , Lu Xing , Fan Shilong , Huang Xiaojia , Mai Huafu , Liao Hong , Zhang Yinghe , Liang Cuiyue , Tian Jiang
Published: October 2024

Phosphate (Pi) availability is well known to regulate plant root growth. However, it remains largely unknown how flavonoid synthesis participates in affecting plant root growth in response to Pi starvation.

In the study, the crystal structure of a plant protein phosphatase, GmHAD1‐2, was dissected using X‐ray crystallography for the first time. It was revealed that GmHAD1‐2 contained a modified Rossmannoid class of α/β folds with three layered α/β sandwich.

Transcripts of GmHAD1‐2 were increased by Pi starvation in soybean roots, especially in lateral root tips. GmHAD1‐2 suppression or overexpression significantly influenced soybean lateral root length and number, as well as phosphorus (P) content. Furthermore, GmHAD1‐2 was found to interact with a chalcone reductase, GmCHR1. Suppression of GmHAD1‐2 significantly changed the flavonoid biosynthesis pathway in soybean roots.

Taken together, the results highlight that GmHAD1‐2 can regulate soybean root growth by influencing flavonoid metabolism.
Conceptualising constructive resistance as a thriving strategy for men in nursing
Authors: Bayuo Jonathan , Awunyo Wise , Agbakpe Noble Agbenu , Kodjo Matilda Mawusi , Akpalu Emmanuel , Kru Kennedy Kofi , Dordor Cynthia , Abotsi Dziedzorm , Adjei Priscilla , Donkere David Buufu‐ire , Obuba Claudia , Agbinku Ethel , Udeoha Mary Adaeze , Tettegah Eric , Criswell Dzawu Obed , Azumah Nicholas Kwablah
Published: October 2024

Nursing has improved over the centuries from the physician's handmaiden to a recognised profession. Yet, the image of a nurse is often associated with notions of caring and nurturing‐ attributes considered feminine. Indeed, cultural, and societal biases exist that can deter men from entering the nursing profession where their sense of masculinity is questioned. Several studies have highlighted the existence of gender‐based stereotypes, stigma, rejection, loneliness and discrimination which impact the retention of men in the nursing profession. Despite the established evidence regarding negative experiences, it appears limited attention has been paid to the men who decide to stay in nursing: how do they thrive in a profession wherein biases are evident within and in the wider societal context? Undoubtedly, several factors such as job security and financial incentives may contribute to men remaining in nursing. Beyond these, we borrow the notion of ‘constructive resistance’ to underscore that though the biases may be apparent, male nurses are able to construct alternatives that accommodate the image of a man in the nursing profession. Strategies such as developing the image as a ‘super nurse’ can create opportunities for male nurses to be preferred by other healthcare providers as well as female nurses. Thus, although resistance may usually appear as a negative phenomenon, constructive resistance represents hidden advantages which offers an opportunity to retain male nurses. These need to be highlighted and explored more as they can offer deeper insight into strategies that can be employed to improve retention and representation of men in nursing particularly at a time when the impact of nursing shortage remains a global issue.
Drawing from the insights of biology, sustainable healthcare systems should prioritise robustness over optimisation
Authors: Lecocq Dan
Published: October 2024

The concept of performance has gradually become established in health policies. Presented as necessary and positive, it is often reduced to efficiency, which results in policies and management styles aimed at optimisation. While they are supposed to guarantee the sustainability of our healthcare systems, these practices have made them fragile. Insights from the life sciences help us understand why. Indeed, biologists observe that living beings do not prioritise optimisation but robustness. To cope with fluctuations, a robust organisation operates with redundancies, apparent waste, heterogeneity, organised fluctuations, slowness, and hesitation. It functions sub‐optimally. This article offers a theoretical reflection and management directions for more robust healthcare systems.
Regional/ethnic differences in ocular axial elongation and refractive error progression in myopic and non‐myopic children
Authors: Naduvilath Thomas , He Xiangui , Saunders Kathryn , Demir Pelsin , Leighton Rebecca , McCullough Sara , Tran Huy , Ha Thao , Macedo Antonio Filipe , Xun Xu , Sankaridurg Padmaja , Tahhan Nina
Published: October 2024

Aim

To determine the regional and ethnic differences in ocular axial elongation and refractive error progression in myopic and non‐myopic children.

Methods

A retrospective analysis of 15 longitudinal clinical and population‐based studies was conducted in the UK, Sweden, Australia (classified as European), China, and Vietnam (classified as East Asian) between 2005 and 2021. A total of 14,593 data points from 6208 participants aged 6–16 years with spherical equivalent from +6 to −6 D were analysed. Progression was annualised from longitudinal axial length and cycloplegic spherical equivalent (SE) refraction. Generalised estimating equation models including main effects and interactions were used for model building. Age and region‐specific estimates for myopes and non‐myopes and confidence intervals are reported.

Results

Factors affecting axial elongation and SE progression in children included being myopic, followed by age, region/ethnicity and sex. The magnitude of regional/ethnic differences was dependent on myopia and age. Axial elongation and SE progression were lower in European compared with East Asian children, but differences were reduced with increasing age and differences in axial elongation were larger in myopes than non‐myopes. Age‐specific regional/ethnic differences indicated that axial elongation for a 6‐year‐old East Asian myopic child was greater than a European child by 0.15 mm/year (0.58 vs. 0.43 mm/year) and by 0.09 mm/year (0.35 vs. 0.26 mm/year) for a 10‐year‐old myope. SE progression was lower in a 6‐year‐old European myope by 0.48 D/year and at 10 years of age by 0.34 D/year compared with an East Asian myope.

Conclusions

There are regional/ethnic differences in age‐specific refractive and axial growth patterns in both myopic and non‐myopic eyes, with more marked differences in younger East Asian children who demonstrated a higher axial growth and greater negative SE shift than their non‐Asian peers. Regional/ethnic differences in progression reflect environmental and ethnic variations. Age and region/ethnicity‐specific estimates could contribute as a reference for future comparisons.