bluuebunny/crossref_metadata_2025 huggingface dataset:
Sex-related differences in oncological surgery and postoperative outcomes: comprehensive, nationwide study in France
Authors: Jochum Floriane , Hamy Anne-Sophie , Gougis Paul , Dumas Élise , Grandal Beatriz , Sauzey Mathilde , Laas Enora , Feron Jean-Guillaume , Fourchotte Virginie , Gaillard Thomas , Girard Noemie , Pauly Lea , Gauroy Elodie , Darrigues Lauren , Hotton Judicael , Lecointre Lise , Reyal Fabien , Lecuru Fabrice , Akladios Cherif
Published: August 2024

Background

The main objective of this study was to undertake an exhaustive investigation of sex-related differences in cancer surgery.

Methods

This observational study used data from the French national health insurance system database covering 98.8% of the population. Patients diagnosed with non-sex-specific solid invasive cancers between January 2018 and December 2019 were included. The main outcomes were likelihood of undergoing cancer surgery, type of oncological surgery performed, and associated 30-, 60-, and 90-day postoperative reoperation and mortality rates, by sex.

Results

For the 367 887 patients included, women were 44% more likely than men to undergo cancer surgery (OR 1.44, 95% c.i. 1.31 to 1.59; P < 0.001). However, the likelihood of surgery decreased with advancing age (OR 0.98, 0.98 to 0.98; P < 0.001), and with increasing number of co-morbid conditions (OR 0.95, 0.95 to 0.96; P < 0.001), especially in women. Men had higher 90-day reoperation (21.2 versus 18.8%; P < 0.001) and mortality (1.2 versus 0.9%; P < 0.001) rates than women, overall, and for most cancer types, with the exception of bladder cancer, for which the 90-day mortality rate was higher among women (1.8 versus 1.4%; P < 0.001). After adjustment for age, number of co-morbid conditions, and surgical procedure, 90-day mortality remained higher in men (OR 1.16, 1.07 to 1.26; P < 0.001), and men were 21% more likely than women to undergo reoperation within 90 days (OR 1.21, 1.18 to 1.23; P < 0.001).

Conclusion

Women were much more likely than men to undergo cancer surgery than men, but the likelihood of surgery decreased with advancing age and with increasing number of co-morbid conditions, especially in women. These findings highlight a need for both increased awareness and strategies to ensure gender equality in access to oncological surgical treatment and improved outcomes.
‘We can no longer fill prisons with men and cemeteries with women’: exploring carceral and abolitionist feminist discourses on gendered violence in Albania and Kosovo through photo elicitation
Authors: Malaj Diana , Pali Brunilda
Published: August 2024

Over two decades, extensive research and heated debate have addressed tensions between carceral and abolitionist responses to gendered violence within feminism. Disagreements arise from the existing multiplicity of feminist approaches and divergent socio-economic and political contexts in which such violence occurs. At the same time, different conceptions of the state and community also impact on feminist organizing around these issues in particular contexts. This article analyses the tensions between so-called carceral feminism and abolitionist feminism in the context of Albania and Kosovo, two countries not only heavily impacted by domestic and sexualized violence and feminicide but also with a significantly rising feminist mobilization. Using the photo-elicitation method, we interviewed feminist activists and academics regarding the ways they interpret gendered violence, the strategies and interventions they deem most relevant in addressing it, and the contradictions and tensions that exist in their discourses and practices. Our aim is to offer a contextualized critique of carceral feminism, while illustrating the reasons and lack of alternatives that have impeded a transformative imagination towards abolitionist feminism.
Pachydermoperiostosis: cosmetic implications in a multisystem genetic condition
Authors: Dickens James W , Lim Kian Wah , Roy Matthew , Wainman Hannah
Published: August 2024

Pachydermoperiostosis is a rare genetic condition characterized by clubbing, periostosis and pachydermia. We present a case with a severely affected phenotype, with significant cosmetic implications impacting wider presentation. Recognition and multidisciplinary management are essential when considering disease associations such as myelofibrosis and gastric ulceration. Further research is needed into the medical management of this condition’s dermatological features.
Preferences for Redistribution: Two Decades of Gender Gaps and Generational Differences in Europe
Authors: Bozzano Monica , Scabrosetti Simona
Published: August 2024

We provide a concise overview of the literature concerning the factors influencing preferences for redistribution, with particular attention to works that have integrated considerations of gender and/or cohort heterogeneity into their analyses. We then present a series of stylized facts on preferences for redistribution based on data from the European Social Survey for a wide array of European countries over the period spanning from 2002 to 2022. We document that, since 2002, the average preferences for redistribution have increased. While the gender gap has remained substantially unchanged, the generational gap has widened over time. Distinguishing women and men by a set of individual characteristics, instead, there exists a not negligible heterogeneity both ‘between’ and ‘within’ women and men. At the country level, the overall gender gap in preferences for redistribution increases as the country’s per capita income or gender equality increase. Conversely, the gender gap decreases in more income, unequal, and religious countries. Finally, looking at the two exogenous shocks, that is, the 2008 financial and economic crisis and the Covid-19 pandemic, we observe that average individual attitudes towards redistribution react to both events but in a surprisingly opposite way, with a relevant heterogeneity across different sub-groups of women and men.
Constructing a novel I-BiOBr/CQD composite for near-infrared–driven photocatalysis
Authors: Fan Maozhou
Published: August 2024

In this study, a novel composite of Iodine-doped bismuth oxybromide (I-BiOBr)/carbon quantum dots was synthesized using a simple chemical precipitation method at ambient temperature. The bandgap energy of bismuth oxybromide (BiOBr) can be reduced from 2.78 to 2.28 eV by introducing I-ions, aligning it with the upconverted emission spectrum of carbon quantum dots. Consequently, the photodegradation efficiency of I-BiOBr/carbon quantum dots reached a 95% degradation rate for methyl orange after 120 min of visible light irradiation, which is 4.2 times than that of BiOBr.
Percutaneous patent foramen ovale closure for hypoxaemia at the age of 73: a case report showing immediate benefit
Authors: Witte Lars S , Straver Bart , Bouma Berto J , de Winter Robbert J , Beijk Marcel A M
Published: August 2024

Background

Approximately 25% of the general population has a patent foramen ovale (PFO) that remains asymptomatic in the vast majority. Right-to-left shunt (RLS)-mediated hypoxaemia is a rare associated condition of PFO.

Case summary

This report describes a case of percutaneous PFO closure for hypoxaemia in a 73-year-old patient showing immediate clinical benefit. She experienced progressive dyspnoea on exertion requiring oxygen therapy. SaO2 was 87% at rest without oxygen therapy, which increased to 98% after percutaneous PFO closure.

Discussion

Most PFOs remain clinically insignificant but RLS-mediated hypoxaemia is a rare phenomenon that can occur even at advanced age. Percutaneous PFO closure is a safe and effective therapy option that provides immediate improvement of hypoxaemia.
Management of dyslipidaemia in patients with comorbidities: facing the challenge
Authors: Mayer Gert , Dobrev Dobromir , Kaski Juan Carlos , Semb Anne Grete , Huber Kurt , Zirlik Andreas , Agewall Stefan , Drexel Heinz
Published: August 2024

Dyslipidaemia is a common chronic kidney disease (CKD) and contributes to excessively elevated cardiovascular mortality. The pathophysiology is complex and modified by comorbidities like the presence/absence of proteinuria, diabetes mellitus or drug treatment. This paper provides an overview of currently available treatment options. We focused on individuals with CKD and excluded those on renal replacement therapy (haemodialysis, peritoneal dialysis, or kidney transplantation). The use of statins is safe and recommended in most patients, but guidelines vary with respect to low-density lipoprotein (LDL) cholesterol goals. While no dedicated primary or secondary prevention studies are available for pro-protein convertase subtilisin/kexin type 9 inhibitors, secondary analyses of large outcome trials reveal no effect modification on endpoints by the presence of CKD. Similar data have been shown for bempedoic acid, but no definite conclusion can be drawn with respect to efficacy and safety. No outcome trials are available for inclisiran while the cholesterol lowering effects seem to be unaffected by CKD. Finally, the value of fibrates and icosapent ethyl in CKD is unclear. Lipid abnormalities contribute to the massive cardiovascular disease burden in CKD. Lowering of LDL cholesterol with statins (and most likely PCSK9 inhibitors) reduces the event rate and thus statin therapy should be initiated in almost all individuals. Other interventions (bempedoic acid, inclisiran, fibrates, or icosapent ethyl) currently need a case-by-case decision before prescription.
Addition of testosterone to endocrine care for transgender women: a dose-finding and feasibility trial
Authors: Gieles Noor C , Kroon Maurice A G M , Both Stephanie , Heijboer Annemieke C , Kreukels Baudewijntje P C , den Heijer Martin
Published: August 2024

Objective

Transgender women who underwent gonadectomy have lower serum testosterone concentrations than cisgender women. There is uncertainty regarding the dosing and side effects of supplementation of testosterone in transgender women. This study aimed to assess the feasibility of dosing testosterone to the cisgender female physiological range in transgender women. In addition, we explored changes in cardiovascular parameters, virilizing side effects, and clinical symptoms.

Design

This is an open-label, single-arm feasibility study. Participants initially went through a dose-titration phase with 2-week intervals of 0.07-0.09-0.13 mL (277-318-403 μg bioavailable testosterone) testosterone 2% gel to establish a dose leading to serum testosterone concentrations between 1.5 and 2.5 nmol/L. This dose was then continued for 8 weeks.

Methods

Participants applied daily transdermal testosterone 2% gel (Tostran®) at the prescribed dosage. Testosterone was measured every 2-4 weeks. Laboratory analyses, side effects, and clinical symptoms were evaluated.

Results

In total, 12 participants were included. Most participants required a dose of 0.07 mL (277 μg bioavailable testosterone) or 0.09 mL (318 μg bioavailable testosterone) to reach serum testosterone concentrations of 1.5-2.5 nmol/L. Continuing this dose, testosterone concentrations remained stable throughout the study. Changes in clinical outcomes were in the desired direction, and side effects were mild.

Conclusions

The use of testosterone supplementation in transgender women seems feasible and safe in the short term. Although dosing requires personalized titration, stable testosterone levels can be established. A blinded, placebo-controlled, randomized clinical trial is needed to study the clinical benefit.
The humanized platelet glycoprotein VI Fab inhibitor EMA601 protects from arterial thrombosis and ischaemic stroke in mice
Authors: Navarro Stefano , Talucci Ivan , Göb Vanessa , Hartmann Stefanie , Beck Sarah , Orth Valerie , Stoll Guido , Maric Hans M , Stegner David , Nieswandt Bernhard
Published: August 2024

Background and Aims

Glycoprotein VI (GPVI) is a platelet collagen/fibrin(ogen) receptor and an emerging pharmacological target for the treatment of thrombotic and thrombo-inflammatory diseases, notably ischaemic stroke. A first anti-human GPVI (hGPVI) antibody Fab-fragment (ACT017/glenzocimab, KD: 4.1 nM) recently passed a clinical phase 1b/2a study in patients with acute ischaemic stroke and was found to be well tolerated, safe, and potentially beneficial. In this study, a novel humanized anti-GPVI antibody Fab-fragment (EMA601; KD: 0.195 nM) was developed that inhibits hGPVI function with very high potency in vitro and in vivo.

Methods

Fab-fragments of the mouse anti-hGPVI IgG Emf6.1 were tested for functional GPVI inhibition in human platelets and in hGPVI expressing (hGP6tg/tg) mouse platelets. The in vivo effect of Emf6.1Fab was assessed in a tail bleeding assay, an arterial thrombosis model and the transient middle cerebral artery occlusion (tMCAO) model of ischaemic stroke. Using complementary-determining region grafting, a humanized version of Emf6.1Fab (EMA601) was generated. Emf6.1Fab/EMA601 interaction with hGPVI was mapped in array format and kinetics and quantified by bio-layer interferometry.

Results

Emf6.1Fab (KD: 0.427 nM) blocked GPVI function in human and hGP6tg/tg mouse platelets in multiple assays in vitro at concentrations ≥5 µg/mL. Emf6.1Fab (4 mg/kg)-treated hGP6tg/tg mice showed potent hGPVI inhibition ex vivo and were profoundly protected from arterial thrombosis as well as from cerebral infarct growth after tMCAO, whereas tail-bleeding times remained unaffected. Emf6.1Fab binds to a so far undescribed membrane proximal epitope in GPVI. The humanized variant EMA601 displayed further increased affinity for hGPVI (KD: 0.195 nM) and fully inhibited the receptor at 0.5 µg/mL, corresponding to a >50-fold potency compared with ACT017.

Conclusions

EMA601 is a conceptually novel and promising anti-platelet agent to efficiently prevent or treat arterial thrombosis and thrombo-inflammatory pathologies in humans at risk.
Accelerometer-measured intensity-specific physical activity, genetic predisposition, and the risk of venous thromboembolism: a cohort study
Authors: Ye Rui , Yang Honghao , Li Shiwen , Ji Chao , Chen Liangkai , Zhao Yuhong , Zhao Li , Xia Yang
Published: August 2024

Objectives

The association between physical activity and venous thromboembolism (VTE) remains unclear. Therefore, we investigated the prospective dose–response associations between accelerometer-measured intensity-specific physical activity and new-onset VTE, accounting for genetic risk.

Methods and results

In total, 85 116 participants from the UK Biobank were included. Incident VTE was identified via linked hospital records and death registries. A weighted polygenic risk score (PRS) was used to quantify genetic risk for VTE, with higher values indicating a high genetic risk. Cox proportional hazard models were used to calculate the hazard ratios (HRs) and 95% confidence intervals (95% CIs) of the associations. Overall, 1182 incident VTE cases were documented during a median follow-up of 6.18 years. In the overall study population, the participants in the highest level of the total volume of physical activity [0.60 (0.45, 0.79)], moderate-to-vigorous-intensity physical activity [0.66 (0.51, 0.86)], and light-intensity physical activity [0.66 (0.51, 0.85)] had lower adjusted HRs (95% CIs) for VTE than those of participants in the lowest level. Both the total volumes of physical activity and light-intensity physical activity were negatively associated with VTE risk in participants with low, intermediate, and high PRS. However, moderate-to-vigorous-intensity physical activity was only protective against VTE in participants with low and intermediate PRS, with a significant interaction (P for interaction = 0.02).

Conclusion

Higher levels of physical activity of any intensity were associated with a lower risk of new-onset VTE. However, the negative association between moderate-to-vigorous-intensity physical activity and new-onset VTE was significant only in participants with low and intermediate genetic predispositions to VTE.
Challenging the status quo: a scoping review of value-based care models in cardiology and electrophysiology
Authors: Osoro Lucia , Zylla Maura M , Braunschweig Frieder , Leyva Francisco , Figueras Josep , Pürerfellner Helmut , Merino Josè Luis , Casado-Arroyo Ruben , Boriani Giuseppe
Published: August 2024

Aims

The accomplishment of value-based healthcare (VBHC) models could save up to $1 trillion per year for healthcare systems worldwide while improving patients’ wellbeing and experience. Nevertheless, its adoption and development are challenging. This review aims to provide an overview of current literature pertaining to the implementation of VBHC models used in cardiology, with a focus on cardiac electrophysiology.

Methods and results

This scoping review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis for Scoping Reviews. The records included in this publication were relevant documents published in PubMed, Mendeley, and ScienceDirect. The search criteria were publications about VBHC in the field of cardiology and electrophysiology published between 2006 and 2023. The implementation of VBHC models in cardiology and electrophysiology is still in its infant stages. There is a clear need to modify the current organizational structure in order to establish cross-functional teams with the patient at the centre of care. The adoption of new reimbursement schemes is crucial to moving this process forward. The implementation of technologies for data analysis and patient management, among others, poses challenges to the change process.

Conclusion

New VBHC models have the potential to improve the care process and patient experience while optimizing the costs. The implementation of this model has been insufficient mainly because it requires substantial changes in the existing infrastructures and local organization, the need to track adherence to guidelines, and the evaluation of the quality of life improvement and patient satisfaction, among others.
Niche evolution during allopatric and sympatric diversification of Aeonium (Crassulaceae) on the Canary Islands
Authors: dos Santos Patrícia , Oliveira M Alexandra , Karger Dirk N , Lucek Kay , Branquinho Cristina , de Vos Jurriaan M
Published: August 2024

Although species radiations on island archipelagos are broadly studied, the geographic and ecological modes of speciation that underlie diversification are often not fully understood. Both allopatry and sympatry play a role during radiations, particularly on islands with profound habitat diversity. Here, we use the most diverse Canary Island plant radiation, Aeonium (Crassulaceae), to phylogenetically test two hypotheses: (i) allopatric speciation, which predicts that closely related taxa are ecologically similar but do not co-occur, and (ii) sympatric speciation, whereby closely related taxa co-occur geographically but are ecologically distinct. We fitted niche and spatial distribution models based on extensive field surveys to quantify geographic and ecological divergence among taxa integrated in a phylogenetic context. Contrary to our expectation, phylogenetically closely related species tend to occupy similar ecological niches, revealing that ecological niche divergence among species accumulates slowly, even in sympatry. This suggests that evolutionary young taxa may be partially reproductively isolated due to subtle phenotypic differences, such as reproductive morphology and phenology, rather than by ecological niche and may putatively exacerbate divergence among populations. Thus, allopatry and sympatry are complementary speciation mechanisms on oceanic islands, jointly spurring this enigmatic radiation.
Heterologous expression and purification of the phage lysin-like bacteriocin LysL from Lactococcus lactis LAC460
Authors: Mokhtari Samira , Saris Per E J , Takala Timo M
Published: August 2024

The wild-type Lactococcus lactis strain LAC460 produces two bacteriocin-like phage lysins, LysL and LysP. This study aimed to produce and secrete LysL in various heterologous hosts and an in vitro cell-free expression system for further functional studies. Initially, the lysL gene from L. lactis LAC460 was cloned into Lactococcus cremoris NZ9000 and L. lactis N8 strains, with and without the usp45 signal sequence (SSusp45), under a nisin-inducible promoter. Active LysL was primarily produced intracellularly in recombinant L. lactis N8, with some secretion into the supernatant. Recombinant L. cremoris NZ9000 lysed upon nisin induction, indicating successful lysL expression. However, fusion with Usp45 signal peptide (SPUsp45–LysL) weakened LysL activity, likely due to incomplete signal peptide cleavage during secretion. Active LysL was also produced in vitro, and analysed in SDS-PAGE, giving a 42-kDa band. However, the yield of LysL protein was still low when produced from recombinant lactococci or by in vitro expression system. Therefore, His-tagged LysL was produced in Escherichia coli BL21(DE3). Western blot confirmed the intracellular production of about 44-kDa His-tagged LysL in E. coli. His-tagged active LysL was then purified by Ni-NTA affinity chromatography yielding sufficient 4.34 mg of protein to be used in future functional studies.
Hypomorphic mutation in the large subunit of replication protein A affects mutagenesis by human APOBEC cytidine deaminases in yeast
Authors: Dennen Matthew S , Kockler Zachary W , Roberts Steven A , Burkholder Adam B , Klimczak Leszek J , Gordenin Dmitry A
Published: August 2024

Human APOBEC single-strand (ss) specific DNA and RNA cytidine deaminases change cytosines to uracils (U’s) and function in antiviral innate immunity and RNA editing and can cause hypermutation in chromosomes. The resulting U’s can be directly replicated, resulting in C to T mutations, or U–DNA glycosylase can convert the U’s to abasic (AP) sites which are then fixed as C to T or C to G mutations by translesion DNA polymerases. We noticed that in yeast and in human cancers, contributions of C to T and C to G mutations depend on the origin of ssDNA mutagenized by APOBECs. Since ssDNA in eukaryotic genomes readily binds to replication protein A (RPA) we asked if RPA could affect APOBEC-induced mutation spectrum in yeast. For that purpose, we expressed human APOBECs in the wild-type (WT) yeast and in strains carrying a hypomorph mutation rfa1-t33 in the large RPA subunit. We confirmed that the rfa1-t33 allele can facilitate mutagenesis by APOBECs. We also found that the rfa1-t33 mutation changed the ratio of APOBEC3A-induced T to C and T to G mutations in replicating yeast to resemble a ratio observed in long persistent ssDNA in yeast and in cancers. We present the data suggesting that RPA may shield APOBEC formed U’s in ssDNA from Ung1, thereby facilitating C to T mutagenesis through the accurate copying of U’s by replicative DNA polymerases. Unexpectedly, we also found that for U’s shielded from Ung1 by WT RPA, the mutagenic outcome is reduced in the presence of translesion DNA polymerase zeta.
Multidimensional Care Poverty Among East Asian and Nordic Older Adults
Authors: Chou Yueh-Ching , Mathew Puthenparambil Jiby , Kröger Teppo , Pu Christy
Published: August 2024

Background and Objectives

This study uses the care poverty framework, focusing on both individuals and structures. In this context, structures are represented by 2 welfare states: Taiwan, an East Asian welfare system and Finland, a Nordic welfare state. This study explores multidimensional care poverty rates and examines 3 realms of individual factors (health status, sociodemographic factors, and care support availability) among older adults in these long-term care (LTC) models.

Research Design and Methods

We analyzed data from the 2019 Taiwan Longitudinal Study on Ageing Survey and the 2020 Daily Life and Care in Old Age Survey in Finland to compare the rates and factors of care poverty in these 2 culturally and structurally different countries.

Results

Our analysis revealed different rates of care poverty in personal, practical, and socioemotional care needs in the 2 countries. Under a familistic welfare regime, Taiwanese older adults had higher personal care poverty rates than their Finnish counterparts. Those living alone faced more personal and practical care poverty. Conversely, Finnish older adults, under the Nordic welfare model, experienced more practical and socioemotional care poverty. Those with high care needs and disadvantaged social status and support were more likely to experience personal and practical care poverty. Socioemotional care poverty varied with the availability of support and health status in both countries.

Discussion and Implications

The study highlights the impact of 2 LTC policies and cultures on older adults’ multidimensional care poverty, identifying disadvantaged older adults under different welfare-transforming LTC models. Taiwan’s budget-constrained LTC policies and high family reliance contrast with Finland’s inadequate attention to the practical and socioemotional needs of its aging population. This study suggests that holistic LTC policies are needed in both countries to improve the well-being of older adults with limited support and health issues.
Simulation analysis of recovering time-varying gravity fields based on Starlink-like constellation
Authors: Liu Youjian , Li Jiancheng , Xu Xinyu , Wei Hui , Li Zhao , Zhao Yongqi
Published: August 2024

Time-varying gravity fields play a crucial role in understanding and analysing geodynamic processes, particularly the migration of matter across the Earth's surface. However, the current limitations in spatiotemporal resolution hinder their accurate representation. In this context, the use of a giant constellation of low-orbit satellites holds great potential for accurately recovering time-varying gravity fields with high spatiotemporal resolution. Based on the orbital parameters of 5199 satellites in 123 different orbital planes in the first phase configuration of the Starlink constellation and the orbital parameters of the Bender constellation in the next generation gravity mission, we conducted a closed-loop simulation to analyse the recovery ability of time-varying gravity field in 9 d using the short-arc integral method. The errors of aliasing AOHIS signal (Atmosphere, Ocean, Hydrology, Ice and Solid Earth), ocean tide models, orbit positions, intersatellite range rates and accelerometer observations were considered in the numerical simulation. Compared with the Bender constellation, the Starlink-like constellation can effectively decrease the aliasing errors in the spatial- and frequency domain when the observation noise is not considered. The Starlink-like constellation can also effectively improve the reliability of low-degree coefficients (below degree 15) of retrieved time-varying gravity field models and present higher time resolution (within 9 d) for the full-degree spherical harmonic solutions than the Bender constellation when the observation noise is considered. The aliasing effect on the low-degree part of the Bender constellation can be significantly decreased by combining the Starlink-like and Bender constellations, and the accuracy of the recovered time-varying gravity field within degree 30 can be improved by about 0.5–1 order of magnitude. Our results can provide a technical reference for the design of future gravity satellite mission.
Predictors of telehealth use after the Minnesota Telehealth Act: analysis using the Minnesota All Payer Claims Database
Authors: Ghosh Arkadipta , Jacobs Ethan , Greener Elizabeth , Evans Alyssa , Lee Mark , Wang Rui , Mink Pamela , Burian Michael
Published: August 2024

During the COVID-19 pandemic, the federal government and many state governments instituted expanded coverage for telehealth (TH) services and since have maintained it. Using data from the Minnesota All Payer Claims Database and publicly available data sources, we examined TH use among commercially insured and Medicare Advantage (MA) patients in Minnesota. In 2022, 30.4% of commercially insured patients and 24.4% of MA patients used TH services. Living in a metropolitan area, an area with a high proportion of Black, Indigenous, and People of Color residents, having greater disease burden, and being younger were associated with a greater likelihood of using TH. Living in an area with limited broadband access reduced the likelihood of TH use. Two patient subgroups more likely to use TH—younger patients in metropolitan areas and high-risk patients with depression—received a similar proportion of ambulatory visits via TH.
Lessons for cannabinoid regulation from electronic nicotine delivery system product regulation
Authors: Yagi Brian , Veuger Stan , Miller Brian J , Larkin Paul
Published: August 2024

Cannabis legalization continues to spread, with 38 states permitting the use of medical marijuana, 22 states permitting recreational use, and growing political momentum for federal legalization. The last time the Food and Drug Administration (FDA) was tasked with regulating a new product occurred with 2009's Family Smoking Prevention and Tobacco Control Act, which created the Center for Tobacco Products (CTP). Thus, the time is ripe to review the history of CTP with particular attention to difficulties the nascent center faced in regulating novel products such as e-cigarettes or electronic nicotine delivery systems (ENDS). Specifically, FDA has struggled with defining its scope of authority, determining which review pathway(s) to utilize, and promulgating timely and transparent product standards for marketing authorization—all of which offer lessons for improving cannabis product oversight and enforcement.
Vineyard management systems influence arbuscular mycorrhizal fungi recruitment by grapevine rootstocks in New Zealand
Authors: Moukarzel Romy , Jones E Eirian , Panda Preeti , Larrouy Justine , Ramana John V , Guerin-Laguette Alexis , Ridgway Hayley J
Published: August 2024

Aims

Arbuscular mycorrhizal fungi (AMF) can perform significant functions within sustainable agricultural ecosystems, including vineyards. Increased AMF diversity can be beneficial in promoting plant growth and increasing resilience to environmental changes. To effectively utilize AMF communities and their benefits in vineyard ecosystems, a better understanding of how management systems influence AMF community composition is needed. Moreover, it is unknown whether AMF communities in organically managed vineyards are distinct from those in conventionally managed vineyards.

Methods and Results

In this study, vineyards were surveyed across the Marlborough region, New Zealand to identify the AMF communities colonizing the roots of different rootstocks grafted with Sauvignon Blanc and Pinot Noir in both conventional and organic systems. The AMF communities were identified based on spores isolated from trap cultures established with the collected grapevine roots, and by next-generation sequencing technologies (Illumina MiSeq). The identified AMF species/genera belonged to Glomeraceae, Entrophosporaceae, and Diversisporaceae. The results revealed a significant difference in AMF community composition between rootstocks and in their interaction with management systems.

Conclusions

These outcomes indicated that vineyard management systems influence AMF recruitment by rootstocks and some rootstocks may therefore be more suited to organic systems due to the AMF communities they support. This could provide an increased benefit to organic systems by supporting higher biodiversity.
The impact of heat treatment on E. coli cell physiology in rich and minimal media considering oxidative secondary stress
Authors: Vo Khanh C , Sakamoto Jin J , Furuta Masakazu , Tsuchido Tetsuaki
Published: August 2024

Aims

This study investigates the cell physiology of thermally injured bacterial cells, with a specific focus on oxidative stress and the repair mechanisms associated with oxidative secondary stress.

Methods and results

We explored the effect of heat treatment on the activity of two protective enzymes, levels of intracellular reactive oxygen species, and redox potential. The findings reveal that enzyme activity slightly increased after heat treatment, gradually returning to baseline levels during subculture. The response of Escherichia coli cells to heat treatment, as assessed by the level of superoxide radicals generated and redox potential, varied based on growth conditions, namely minimal and rich media. Notably, the viability of injured cells improved when antioxidants were added to agar media, even in the presence of metabolic inhibitors.

Conclusions

These results suggest a complex system involved in repairing damage in heat-treated cells, particularly in rich media. While repairing membrane damage is crucial for cell regrowth and the electron transport system plays a critical role in the recovery process of injured cells under both tested conditions.
Development and evaluation of an artificial intelligence-based workflow for the prioritization of patient portal messages
Authors: Yang Jie , So Jonathan , Zhang Hao , Jones Simon , Connolly Denise M , Golding Claudia , Griffes Esmelin , Szerencsy Adam C , Wu Tzer (Jason) , Aphinyanaphongs Yindalon , Major Vincent J
Published: August 2024

Objectives

Accelerating demand for patient messaging has impacted the practice of many providers. Messages are not recommended for urgent medical issues, but some do require rapid attention. This presents an opportunity for artificial intelligence (AI) methods to prioritize review of messages. Our study aimed to highlight some patient portal messages for prioritized review using a custom AI system integrated into the electronic health record (EHR).

Materials and Methods

We developed a Bidirectional Encoder Representations from Transformers (BERT)-based large language model using 40 132 patient-sent messages to identify patterns involving high acuity topics that warrant an immediate callback. The model was then implemented into 2 shared pools of patient messages managed by dozens of registered nurses. A primary outcome, such as the time before messages were read, was evaluated with a difference-in-difference methodology.

Results

Model validation on an expert-reviewed dataset (n = 7260) yielded very promising performance (C-statistic = 97%, average-precision = 72%). A binarized output (precision = 67%, sensitivity = 63%) was integrated into the EHR for 2 years. In a pre-post analysis (n = 396 466), an improvement exceeding the trend was observed in the time high-scoring messages sit unread (21 minutes, 63 vs 42 for messages sent outside business hours).

Discussion

Our work shows great promise in improving care when AI is aligned with human workflow. Future work involves audience expansion, aiding users with suggested actions, and drafting responses.

Conclusion

Many patients utilize patient portal messages, and while most messages are routine, a small fraction describe alarming symptoms. Our AI-based workflow shortens the turnaround time to get a trained clinician to review these messages to provide safer, higher-quality care.
Incorporating patient, caregiver, and provider perspectives in the co-design of an app to guide Hospital at Home admission decisions: a qualitative analysis
Authors: Kowalkowski Marc , Eaton Tara , Reeves Kelly W , Kramer Justin , Murphy Stephanie , Hole Colleen , Chou Shih-Hsiung , Aneralla Amanda , McWilliams Andrew
Published: August 2024

Objective

Hospital at Home (HaH) programs currently lack decision support tools to help efficiently navigate the complex decision-making process surrounding HaH as a care option. We assessed user needs and perspectives to guide early prototyping and co-creation of 4PACS (Partnering Patients and Providers for Personalized Acute Care Selection), a decision support app to help patients make an informed decision when presented with discrete hospitalization options.

Methods

From December 2021 to January 2022, we conducted semi-structured interviews via telephone with patients and caregivers recruited from Atrium Health’s HaH program and physicians and a nurse with experience referring patients to HaH. Interviews were evaluated using thematic analysis. The findings were synthesized to create illustrative user descriptions to aid 4PACS development.

Results

In total, 12 stakeholders participated (3 patients, 2 caregivers, 7 providers [physicians/nurse]). We identified 4 primary themes: attitudes about HaH; 4PACS app content and information needs; barriers to 4PACS implementation; and facilitators to 4PACS implementation. We characterized 3 user descriptions (one per stakeholder group) to support 4PACS design decisions. User needs included patient selection criteria, clear program details, and descriptions of HaH components to inform care expectations. Implementation barriers included conflict between app recommendations and clinical judgement, inability to adequately represent patient-risk profile, and provider burden. Implementation facilitators included ease of use, auto-populating features, and appropriate health literacy.

Conclusions

The findings indicate important information gaps and user needs to help inform 4PACS design and barriers and facilitators to implementing 4PACS in the decision-making process of choosing between hospital-level care options.
Nephrocalcinosis and kidney function in children and adults with X-linked hypophosphatemia: baseline results from a large longitudinal study
Authors: Portale Anthony A , Ward Leanne , Dahir Kathryn , Florenzano Pablo , Ing Steven W , Jan de Beur Suzanne M , Martin Regina M , Meza-Martinez Adriana I , Paloian Neil , Ashraf Ambika , Dixon Bradley P , Khan Aliya , Langman Craig , Chen Angel , Wang Christine , Roberts Mary Scott , Tandon P K , Bedrosian Camille , Imel Erik A
Published: August 2024

Background

In patients with X-linked hypophosphatemia (XLH), conventional therapy with oral phosphate salts and active vitamin D has been associated with nephrocalcinosis. However, the nature of the relationships among XLH, its treatment, nephrocalcinosis, and kidney function remain poorly understood.

Methods

Renal ultrasounds were performed and glomerular filtration rates were estimated (eGFR) at baseline in burosumab-naïve patients with XLH who participated in burosumab clinical trials (NCT02181764, NCT02526160, NCT02537431, NCT02163577, NCT02750618, NCT02915705) or enrolled in the XLH Disease Monitoring Program (XLH-DMP; NCT03651505). In this cross-sectional analysis, patient, disease, and treatment characteristics were described among patients with and without nephrocalcinosis.

Results

The analysis included 196 children (mean [SD] age 7.6 [4.0] yr) and 318 adults (40.3 [13.1] yr). Mean (SD) height z-score was −1.9 (1.2) for children and −2.3 (1.7) for adults. Nearly all children (97%) and adults (94%) had previously received conventional therapy. Nephrocalcinosis was detected in 22% of children and 38% of adults. In children, reduced eGFR <90 mL/min/1.73 m2 was more prevalent in those with nephrocalcinosis (25%) than in those without (11%), a finding that was not observed in adults. Children with nephrocalcinosis had lower mean values of TmP/GFR (p<.05), serum 1,25(OH)2D (p<.05), and eGFR (p<.001) and higher mean serum calcium concentrations (p<.05) than did those without nephrocalcinosis. Adults with nephrocalcinosis had lower mean serum phosphorus (p<.01) and 1,25(OH)2D (p<.05) concentrations than those without. Exploratory logistic regression analyses revealed no significant associations between the presence of nephrocalcinosis and other described patient or disease characteristics.

Conclusions

Nephrocalcinosis was observed in nearly one-quarter of children and more than one-third of adults with XLH. Further study is needed to better understand the predictors and long-term consequences of nephrocalcinosis, with surveillance for nephrocalcinosis remaining important in the management of XLH.
Microvascular disease and early diabetes onset are associated with deficits in femoral neck bone density and structure among older adults with longstanding type 1 diabetes
Authors: Johannesdottir Fjola , Tedtsen Trinity , Cooke Laura M , Mahar Sarah , Zhang Meng , Nustad Jordan , Garrahan Margaret A , Gehman Sarah E , Yu Elaine W , Bouxsein Mary L
Published: August 2024

Adults with type 1 diabetes (T1D) have increased hip fracture risk, yet no studies have assessed volumetric bone density or structure at the hip in older adults with T1D. Here, we used previously collected 3D CT scans of the proximal femur from older adults with longstanding T1D and non-diabetic controls to identify bone deficits that may contribute to hip fracture in T1D. In this retrospective cohort study, we identified 101 adults with T1D and 181 age-, sex-, and race-matched non-diabetic controls (CON) who received abdominal or pelvis CT exams from 2010 to 2020. Among adults with T1D, 33 (33%) had mild-to-moderate nephropathy, 61 (60%) had neuropathy, and 71 (70%) had retinopathy. Within the whole cohort, adults with T1D tended to have lower FN density, though differences did not reach statistical significance. The subset of the T1D group who were diagnosed before age 15 had lower total BMC (−14%, TtBMC), cortical BMC (−19.5%, CtBMC), and smaller Ct cross-sectional area (−12.6, CtCSA) than their matched controls (p<.05 for all). Individuals with T1D who were diagnosed at a later age did not differ from controls in any bone outcome (p>.21). Furthermore, adults with T1D and nephropathy had lower FN aBMD (−10.6%), TtBMC (−17%), CtBMC (−24%), and smaller CtCSA (−15.4%) compared to matched controls (p<.05 for all). Adults with T1D and neuropathy had cortical bone deficits (8.4%–12%, p<.04). In summary, among older adults with T1D, those who were diagnosed before the age of 15 yr, as well as those with nephropathy and neuropathy had unfavorable bone outcomes at the FN, which may contribute to the high risk of hip fractures among patients with T1D. These novel observations highlight the longstanding detrimental impact of T1D when present during bone accrual and skeletal fragility as an additional complication of microvascular disease in individuals with T1D.
The identities of Pinnotheres villosulus Guérin-Méneville, 1832, P. edwardsi De Man, 1887, and P. trichopus Tesch, 1918, with description of a new Indo-West Pacific genus of pinnotherid crab (Decapoda: Brachyura: Pinnotheridae)
Authors: Ahyong Shane T , Ng Peter K L
Published: August 2024

Nepinnotheres villosulus (Guérin-Méneville, 1832) [Guérin-Méneville, 1829–1837] [type locality: Timor] and Nepinnotheres edwardsi (De Man, 1887) [type locality: Mergui Archipelago], as currently understood, are both reportedly widespread in Southeast Asia and northern Australia, and unique in the genus in having females densely covered by a setal tomentum that completely obscures the surfaces of the carapace and pereiopods. Based on the limited information contained in the type accounts, N. edwardsi and N. villosulus appear indistinguishable, but this cannot currently be confirmed by comparing type material because the holotype of N. villosulus, the senior name, is lost. A neotype is therefore designated for N. villosulus to fix its identity and taxonomic status as a senior synonym of N. edwardsi. In addition to the unique setation pattern of female N. villosulus, males of the species also present important differences from those of male Nepinnotheres sensu stricto. Pinnotheres trichopusTesch, 1918 [type locality: Elat, Great Kei Island, Indonesia], is also shown to be a junior synonym of P. villosulus. Moreover, recent molecular phylogenetic analyses determined that N. villosulus is phylogenetically distant from Nepinnotheres sensu stricto. As such, we establish a new genus for N. villosulus.
The Politics of Ambiguous Loss: Missing Persons and Social Ecologies after Armed Conflict
Authors: Robins Simon
Published: August 2024

This article seeks to understand how the concept of ambiguous loss can help explain why and how the issue of missing persons becomes a tool of politics, in terms of being instrumentalized to advance particular political agendas. Ambiguous loss is constructed relationally within the social systems that family members of the missing occupy and, as a result, social and political contexts play a crucial role in both defining ambiguity and in mediating the impacts of ambiguous loss. Because ambiguity is discursively and relationally constructed and meaning made from it subject to existing power relations, it is inherently political. The extreme and chronic trauma of ambiguous loss reshapes individuals’, families’ and, potentially, communities’ perspectives on events in which people have gone missing, making the trauma of ambiguous loss one that lends itself to being framed as a collective trauma with impacts for the entire group. More than this, the impacts of ambiguous loss resonate with what have been called ‘chosen traumas’, used to create group identities in the light of extreme experiences. In particular, the importance in ambiguous loss of meaning making and of the challenge of forgetting resonates with what makes collective traumas effective tools of politics.
International Crimes and Double Standards
Authors: Goldston James A
Published: August 2024

The law’s aspiration to impartiality, central to its legitimacy, is impaired by concerns that judicial systems treat similarly situated persons or factual situations differently for improper reasons. In few fields is this truer than the sphere of international criminal justice, where the political stakes are high and judicial institutions are relatively young. The conflicts in Ukraine and Israel/Palestine have fuelled claims on all sides that the search for accountability has been marred by double standards. How these are addressed — by courts, states, and civil society — matters for the victims of grave crimes, and for the international justice project itself. This article argues that, while those who wish to advance international justice cannot eliminate double standards, they can adopt concrete measures to combat and minimize them. Given how important perceptions are in this debate, even small steps matter.
The importance of acetate, pyruvate, and citrate feeding times in improving xanthan production by Xanthomonas citri
Authors: Moravej Roya , Azin Mehrdad , Mohammadjavad Samaneh
Published: August 2024

Xanthan gum is a microbial polysaccharide produced by Xanthomonas and widely used in various industries. To produce xanthan gum, the native Xanthomonas citri-386 was used in a cheese-whey-based culture medium. The culture conditions were investigated in batch experiments based on the response surface methodology to increase xanthan production and viscosity. Three independent variables in this study included feeding times of acetate, pyruvate, and citrate. The maximum xanthan gum production and viscosity within 120 h by X. citri-386 using Box–Behnken design were 25.7 g/l and 65 500 cP, respectively, with a 151% and 394% increase as compared to the control sample. Overall, the findings of this study recommend the use of X. citri-386 in the cheese-whey-based medium as an economical medium with optimal amounts of acetate, pyruvate, and citrate for commercial production of xanthan gum on an industrial scale. The adjustment of the pyruvate and acetate concentrations optimized xanthan gum production in the environment.
Blakean anti-wisdom in Thomas Merton’s proverbs
Authors: Myers Ben
Published: August 2024

This paper explores William Blake’s reception in the work of the twentieth-century monastic writer Thomas Merton. The paper explores the way Blakean proverbs function in Merton’s work as a model of social critique. Following Blake, Merton came to see “wisdom” as a kind of subtraction: not an addition of meaning but a corrosive acid that burns away the falsehoods and illusions of social and religious norms, allowing an authentic spiritual vision to emerge.