bluuebunny/crossref_metadata_2025 huggingface dataset:
An Overview of Reproductive Carrier Screening Panels for Autosomal Recessive and/or X-Linked Conditions: How Much Do We Know?
Authors: Wang Tianjiao , Scuffham Paul , Byrnes Joshua , Delatycki Martin B. , Downes Martin
Published: April 2024

(Abstracted from Prenatal Diagnosis 2023;43:1416–1424

Reproductive carrier screening is designed to identify couples who are at a high risk of passing genetic disorders to their children. Advances in genetic screening technology have recently allowed for the commercial development and availability of genetic tests that can screen for autosomal recessive and X-linked genes for many disorders simultaneously.
Advancements in the application of uterine ultrasound elastography
Authors: Barrett Francesca , Willson Stephanie , Werner Marie
Published: April 2024

Purpose of review

This article reviews recent advances in ultrasound elastography in diagnosing and evaluating the normal nongravid uterus and the infertile uterus in the gynecologic patient.

Recent findings

Focusing on the most recent primary literature, studies have demonstrated new findings among a breadth of gynecologic clinical settings. Studies in the nongravid uterus have found that menopausal status, age, and menstrual phase have not been associated with changes in uterine tissue stiffness. Focusing on myometrial disease, there have been conflicting data regarding the ability to distinguish uterine fibroids from adenomyosis. One area of expanding research surrounding uterine elastography includes the infertile population, where ongoing studies attempt to provide a predictive model using shear wave elastography (SWE) in patients undergoing in-vitro fertilization.

Ultrasound elastography has become an increasingly studied and utilized tool in assessing physiologic and pathologic processes in the field of gynecology. Evaluating tissue stiffness through strain and SWE can serve to improve diagnosis of various uterine and cervical lesions, as well as prognosticate outcomes after fertility treatments. This growing area of research will continue to establish the role and application of ultrasound elastography into clinical practice.
Clinical Presentations of Bupropion Prescription Drug Misuse
Authors: Noe Greg , Shah Kaushal , Ongchuan Samantha , Munjal Sahil
Published: April 2024

Background

Among prescribers, bupropion is considered a substance of low misuse potential, with some studies showing lesser misuse potential than caffeine. However, several case reports exist of recreational bupropion misuse and diversion. Our goal is to understand at-risk populations, clinical courses, interventions, and outcomes after acute ingestion of bupropion via oral, intravenous route, and insufflation.

Methods

The systematic review was registered with PROSPERO on August 5, 2023. We conducted a systematic literature search on July 30, 2023, utilizing 8 databases with the help of the Medical Subject Headings (MeSH) term “Bupropion” in the context of misuse and abuse. Ultimately, we found 17 articles with qualitative synthesis relevant to our study objective and meeting our inclusion/exclusion criteria.

Results

Bupropion insufflation and intravenous injection occur almost exclusively in patients with a substance use disorder history, with a preponderance of patients with stimulant use disorder or multiple substance use disorders. Additionally, many were dual-diagnosis patients with a history of attention deficit hyperactivity disorder and stimulant use disorder, treated with bupropion. Patients describe the effects of bupropion insufflation/IV injection as a milder “cocaine-like” high that is brief, with less severe withdrawal effects of anxiety and agitation. The most common side effect at presentation was tachycardia, followed by seizures responsive to IV benzodiazepines. IV injection seems particularly insulting to the vascular system, with cellulitis, tissue necrosis, and digital ischemia as documented adverse effects.

Conclusions

This systematic review highlights the bupropion misuse potential in certain patient populations and serves to increase awareness among clinicians. Additional patient screening, monitoring and follow-up, surveillance, and further research are needed to investigate and prevent bupropion misuse in at-risk patient populations entirely.
Consensus on the clinical diagnosis and treatment of grade 3 pancreatic neuroendocrine tumors
Authors: Chen Jie , Wu Wenming , Bai Chunmei , Chi Yihebali , Huo Li , Jiang Liming , Ji Yuan , Luo Jie , Li Jie , Li Jingnan , Lou Wenhui , Shao Chenghao , Shen Lin , Wang Feng , Wang Yu , Xue Ling , Xu Jin , Yuan Chunhui , Yu Xianjun , Yin Xiaoyu , Zhao Hong , Zhu Xiongzeng , Zhao Yupei
Published: April 2024

The World Health Organization (WHO) 2017 classifications for neuroendocrine neoplasms (NENs) subdivided grade 3 pancreatic neuroendocrine neoplasms (pNENs) into G3 well-differentiated pancreatic neuroendocrine tumors (G3 pNETs) and poorly differentiated pancreatic neuroendocrine carcinomas (pNECs), according to the mitotic count, Ki-67 index, and cell differentiation. As a new category, G3 pNETs remain a challenging group of tumors to manage by lacking large randomized trials and consensus to support its clinical practice. Therefore, the Chinese Pancreatic Surgery Association, Chinese Society of Surgery, Chinese Medical Association gathered experts in this field to formulate this consensus for the diagnosis and treatment of G3 pNETs.
Patient Preferences for Disposable and Reusable Vaginal Specula and Their Willingness to Compromise in the Era of Climate Change: A Cross-Sectional Study
Authors: Ten Buuren Amber A.A. , Poolman Tessa B. , Bullens Lauren M. , Van Hanegem Nehalennia , Bongers Marlies Y. , Klerkx Wenche M. , Timmermans Anne , Zuithoff Nicolaas P.A. , Kwee Anneke
Published: April 2024

(Abstracted from BJOG. 2024;131:684–689

The World Health Organization emphasizes that the climate crisis is the single biggest health threat facing humanity, and more than 200 medical journals have called on world leaders to take more and faster action against climate change. Despite this, hospitals have increasingly relied on disposable instruments such as plastic specula, which are incinerated after a single use.
Screening for Critical Congenital Heart Defects in Sweden
Authors: Lannering Katarina , Kazamia Kalliopi , Bergman Gunnar , Östman-Smith Ingegerd , Liuba Petru , Dahlqvist Jenny Alenius , Elfvin Anders , Mellander Mats
Published: April 2024

(Abstracted from Pediatrics 2023;152:e2023061949

Critical congenital heart defects (CCHDs) affect between 1 and 3 of every 1000 live-born infants and require intervention in the short term after birth. Early identification of affected infants contributes to significantly to better outcomes in both the short- and long-term.
Three-Tiered Fetal Heart Rate Interpretation System and Adverse Neonatal and Maternal Outcomes: A Systematic Review and Meta-analysis
Authors: Zullo Fabrizio , Di Mascio Daniele , Raghuraman Nandini , Wagner Steve , Brunelli Roberto , Giancotti Antonella , Mendez-Figueroa Hector , Cahill Alison G. , Gupta Megha , Berghella Vincenzo , Blackwell Sean C. , Chauhan Suneet P.
Published: April 2024

(Abstracted from Am J Obstet Gynecol 2023;229(4):377–387

Electronic fetal monitoring is used on more than 3.8 million parturients a year. Despite its ubiquitous use, fetal heart rate tracing (FHRT) is marred by intraobserver variability and inconsistent use of terms to describe contraction patterns.
Dual-Energy Computed Tomography Virtual Noncalcium Imaging of Intracranial Arteries in Acute Ischemic Stroke: Differentiation Between Acute Thrombus and Calcification
Authors: Shinohara Yuki , Ohmura Tomomi , Sasaki Fumiaki , Sato Yuichiro , Inomata Takato , Itoh Toshihide , Kinoshita Toshibumi
Published: April 2024

Objective

Hyperdense artery sign (HAS) on noncontrast brain computed tomography (CT) indicates an acute thrombus within the cerebral artery. It is a valuable imaging biomarker for diagnosing large-vessel occlusion; however, its identification may be challenging with the presence of vascular calcification. Dual-energy CT virtual noncalcium (VNCa) imaging using a 3-material decomposition algorithm is helpful for differentiating between calcification and hemorrhage. This study aimed to clarify the potential of VNCa imaging for differentiating HAS from vascular calcification.

Methods

Patients with acute ischemic stroke and large-vessel occlusion identified on MR angiography, who also underwent noncontrast dual-energy CT, were included. The 80 kV/Sn 140 kV mixed images, with a weighting factor of 0.4, were considered 120 kVp-equivalent images. Postprocessing using a 3-material decomposition algorithm to differentiate between calcium (Ca), cerebrospinal fluid, and hemorrhage was performed via a commercially available 3-dimensional workstation. A mixed image, VNCa image, color-coded Ca image, and color-coded Ca image with VNCa image overlay (color-coded Ca-overlay image) were obtained, and axial reconstruction with a 1-mm slice thickness was performed for each image type. Two experienced neuroradiologists conducted imaging evaluations in consensus.

Results

Thirty-four patients (mean age, 76.0 years; 21 male and 13 female patients) were included. The mixed and VNCa images revealed an HAS (indicating an acute clot) corresponding to the large-vessel occlusion site in 30 patients. Among them, the VNCa and color-coded Ca-overlay images enabled clear differentiation between the acute thrombus and adjacent vessel wall calcification in 5 patients. Among the other 4 patients, the VNCa, Ca-overlay, and Ca images identified calcified cerebral emboli in the M1 segment in 1 patient. For the other 3 patients, no high attenuation corresponding to magnetic resonance angiography findings was observed in any of the mixed, VNCa, Ca-overlay, or Ca images.

Conclusions

VNCa and color-coded Ca-overlay images obtained via dual-energy brain CT enabled differentiation of acute thrombus from vessel wall calcification and calcified cerebral emboli in patients with acute ischemic stroke.
Fannyhessea vaginae causing bacteraemia and vertebral osteomyelitis: first report of invasive disease in a male
Authors: Jordan Victoria , Akram Ayesha , Pickles Robert , Arnold Alyssa , Naqvi Syeda
Published: April 2024

Introduction.
Fannyhessea vaginae (formerly Atopobium vaginae) is an anaerobic organism commonly associated with female genital flora, with rare cases of invasive disease reported in females.

Case report. We discuss the case of an 81-year-old male who presented with an acute history of back pain and signs of urinary tract infection in the context of intermittent self-urinary catheterisation. Multiple blood cultures grew Fannyhessea vaginae with a later finding of lumbar vertebral osteomyelitis as the cause of back pain. Treatment was commenced with ampicillin, later switched to ceftriaxone, with improvement of acute signs of infection.

Conclusion. Gram-positive anaerobic organisms including Fannyhessea vaginae are possibly under-recognised causes of urinary tract particularly in older males. These bacteria may prove challenging to grow in standard protocols for urine culture; anaerobic or extended incubation could be considered particularly in complicated cases of urinary tract infection without an identifiable pathogen.
An atypical case of esophageal actinobacillosis in a cow
Authors: KUMAR RAHUL , Kumar Gulshan , Pandey R. P.
Published: April 2024

Present case report describes an unusual instance of esophageal actinobacillosis in an adult cow presented to the university hospital with a history of inability to drink and swallow. Clinical evaluation revealed a noticeable five-inch swelling in the Juglar groove, while radiographic imaging indicated the presence of a small, round, and mildly radio-opaque lesion. In response, an exploratory surgical excision was performed as a palliative measure, and the excised tissue was subsequently preserved in 10% buffered formalin for histopathological examination. Histopathology revealed pyogranulomatous inflammation characterized by radiating eosinophilic club shaped bodies surrounding small colonies of coccobacilli. Grams and Zeil Neelson stains confirmed the presence of gram negative and non-acid fast coccobacilli. Additionally, following a thorough review of relevant literature on atypical actinobacillosis, the authors assert the rarity of esophageal involvement, with this case representing only the second documented instance globally.
Time-resolved function of cell polarity kinases PRKCZ and PRKCI in CNS myelination
Authors: Mercau Maria E. , Hackbarth Rieke-Marie , Liu Xinran , Wang Haowei , Zhang Le , Basu Malay K. , Rothlin Carla V. , Ghosh Sourav
Published: April 2024

The atypical Protein Kinase C (aPKC) is a critical component of the PAR polarity complex, as well as of cell polarity in general. There are two paralogs of aPKC in the mammalian genome. Their expression pattern and functional role in oligodendrocyte lineage differentiation and development remains heretofore uncharacterized. Here we show that both paralogs of aPKC – PRKCI, the primary transcript ofPrkciand PKMz, an alternate transcript ofPrkcz– are expressed during oligodendrocyte differentiation, yet are functionally non-redundant. Asymmetric cell division and early specification of the oligodendrocyte fate stage required both paralogs. By contrast, the stage of oligodendrocyte maturation involving membrane polarization and myelination of axons continued to require PKMz, but no longer needed PRKCI. Taken together, our results indicate to a two-stage role of aPKCs and cell polarity in oligodendrocyte differentiation and development.
Design of a self-regulating mRNA gene circuit
Authors: Dykeman Eric C.
Published: April 2024

Protein expression from mRNAin vivois predominately controlled via regulatory feedback mechanisms that adjust the level of mRNA transcription. However, for positive sense single-stranded RNA viruses, protein expression is often controlled via secondary structural elements, such as internal ribosomal entry sites, that are encoded within the mRNA. The self-regulation of mRNA translation observed in this class of viruses suggests that it may be possible to design mRNAs that self-regulate their protein expression, enabling the creation of mRNAs for vaccines and other synthetic biology applications where protein levels in the cell can be tightly controlled without feedback to a transcriptional mechanism. As a proof of concept, I design a polycistronic mRNA based on bacteriophage MS2, where the upstream gene is capable of repressing synthesis of the downstream gene. Using a computational tool that simulates ribosome kinetics and the co-translational folding of the mRNA in response, I show that mutations to the mRNA can be identified which enhance the efficiency of the translation and the repression of the downstream gene. The results of this study open up the possibility of designing bespoke mRNA gene circuits in which the amount of protein synthesised in cells are self-regulated for therapeutic or antigenic purposes.
Developing urban infrastructure constructions for increasing e-commerce sales: the moderating roles of aging population
Authors: Shou Minghuan , Jia Furong , Yu Jie
Published: April 2024

Purpose

The aging population, a higher proportion of older adults (aged 65+), is considered a global and severe problem, while the information systems (IS) literature on detecting the relationship between the aging population and the development of electronic commerce (e-commerce) is limited and insufficient. Hence, the main objective of this paper is to examine whether an aging population can moderate the effect of infrastructure constructions on e-commerce sales and whether an aging population can affect e-commerce sales.

Design/methodology/approach

To investigate the relationship between the aging population and e-commerce sales, this study proposes two potential influential mechanisms: moderating the effects of infrastructure development on e-commerce sales and direct influence. Subsequently, a sample of 31 Chinese provinces from 2013 to 2019 is utilized to conduct regression analyses in order to examine these hypotheses.

Findings

The findings suggest that the development of urban transportation infrastructure and network constructions can significantly contribute to the enhancement of e-commerce sales, and the influence cannot be affected by aging population. Furthermore, it is noteworthy that an aging population can have a positive effect on e-commerce sales.

Practical implications

The findings can inform future infrastructure constructions by assessing the potential of infrastructure projects to boost e-commerce sales and examining whether this effect varies in an aging population context.

Originality/value

The findings substantiate the pivotal role of older adults in the e-commerce industry. Moreover, the obtained results establish a positive relationship between an aging population and e-commerce sales, thereby offering diverse perspectives on existing theories.
Bank ownership and credit risk: an empirical study of Indonesian Islamic local banks
Authors: Sudarsono Heri , Sholihin Mahfud , Susamto Akhmad Akbar
Published: April 2024

Purpose

This study aims to determine the effect of bank ownership on the credit risk of Indonesian Islamic local banks (ILBs).

Design/methodology/approach

This study uses the system generalized method of moments (GMM) estimation technique with a sample of 155 Islamic local banks in Indonesia from 2012 to 2019.

Findings

The results show that commissioner board (D.COW) ownership has a negative effect on credit risk. This indicates that an increase in the number of shares of Islamic local banks owned by the commissioner board reduces credit risk. On the other hand, government ownership (D.GOW), the Sharia supervisory board (D.SOW) and the director board (D.DOW) do not affect credit risk.

Practical implications

The government, Sharia supervisory board and director board need opportunities to easily own more Islamic local bank shares. Therefore, the provisions regarding the share ownership rights of the government, Sharia supervisory board and director board need to be improved to increase their role in reducing credit risk.

Originality/value

Previous researchers have not studied the effect of government ownership, the commissioner board, the Sharia supervisory board and the ownership of directors on credit risk at the ILB in Indonesia.
Exploring customer engagement tensions when pursuing responsible business practices
Authors: Gallan Andrew S. , Hildebrand Diogo , Komarova Yuliya , Rubin Dan , Shay Ronen
Published: April 2024

Purpose

Designing and developing responsible business practices can create various tensions for service organizations. The purpose of this research is to develop a deeper understanding of the relationship between customer engagement (CE) and responsible business practices (e.g. environmental, social and/or governance [ESG], corporate social responsibility [CSR] and diversity, equity, and inclusion [DEI]) and explore customer engagement tensions that service organizations may face.

Design/methodology/approach

This research develops a list of CE-related responsible business practice tensions and empirically explores their relevance through in-depth interviews with nine ESG professionals.

Findings

This paper makes three important contributions. First, we find support for nine distinct but related tensions with implications for CE that organizations must navigate when pursuing responsible business practices. Second, interview participants provide some suggestions for tackling these tensions, which we support with relevant theories. Finally, we develop a conceptual framework that may stimulate future service research and inform the implementation of ESG strategies.

Originality/value

To the best of the authors’ knowledge, this research is the first to conceptualize and empirically explore the tensions that emerge between responsible business practices and CE. The authors develop a novel analysis of the CE-related tensions that emerge when pursuing an ESG strategy.

Research limitations/implications

The findings are based on a small sample of ESG professionals. Future research may take a quantitative approach to further evaluate the role that these tensions play in engaging customers.

Practical implications

This research provides a conceptual framework that may guide ESG professionals in understanding, framing and navigating CE-related tensions when pursuing responsible business practices.

Social implications

A social benefit may be found when service organizations are better able to successfully navigate CE-related tensions when pursuing responsible business practices.
Slow drawdown, fast recovery: Stream macroinvertebrate communities improve quickly after large dam decommissioning
Authors: Atristain Miren , Solagaistua Libe , Larrañaga Aitor , von Schiller Daniel , Elosegi Arturo
Published: April 2024

Dam removal is increasingly considered as a river restoration tool for impoundments that harm the environment or have exceeded their lifespan. However, few studies report the ecological consequences of large dam removal.

We performed a multiple before‐after/control‐impact (mBACI) study to investigate the consequences of the decommissioning of a large dam (42 m high) on instream habitat and invertebrate communities in a temperate, forested catchment of northern Spain.

Before decommissioning, lack of fine sediments and high concentrations of manganese and iron occurred below the dam but decreased downstream. Invertebrate taxa richness and diversity were reduced, and pollution‐sensitive taxa were missing just below the dam.

The drawdown of the reservoir, the first step towards its decommissioning, mobilized stored sediments causing frequent turbidity peaks downstream, which nevertheless, caused no detrimental effects on macroinvertebrate communities. One year after drawdown, the communities downstream from the dam, as well as those in the newly formed stream in the area formerly impounded by the reservoir, became very similar to those in control reaches, showing a successful restoration project.

Synthesis and applications. Dam decommissioning helps restore instream habitats and facilitates the recovery of invertebrate communities in a very short time frame if there are nearby sources of potential colonizers. Slow drawdown reduces the transport of the sediments accumulated in the reservoir and their potential downstream impacts, even more if prior to drawdown the reservoir is kept full for years to promote the deposition of sediments in marginal areas that will later be readily colonized by trees.
Pesticide risk during commercial apple pollination is greater for honeybees than other managed and wild bees
Authors: Mueller Tobias G. , Baert Nicolas , Muñiz Paige A. , Sossa David E. , Danforth Bryan N. , McArt Scott H.
Published: April 2024

Most pesticide research has focussed on risk to managed honeybees, but other managed and wild bees are also exposed to pesticides. Critically, we know little about the magnitude and sources of risk to honeybees compared with other bees during crop pollination.

To compare pesticide exposure and risk across wild and managed bees, we sampled the main bee groups present during bloom in 20 apple orchards, including managed honeybees (Apis mellifera), managed bumblebee workers (Bombus impatiens), wild mining bees (Andrena spp. and Andrena [Melandrena] spp.), bumblebee foundress queens (Bombus impatiens) and eastern carpenter bees (Xylocopa virginica). We screened all bees for 92 pesticides and computed a Risk Quotient using available toxicity data (honeybee LD50s), adjusting for differences in toxicity known to scale with body mass. To gain insight into exposure origin, we compared residues in bees to those in focal orchard apple and dandelion flowers.

Nearly all bee samples contained pesticides (95%), with the average contamination level ranging from 7.1 ± 2.8 parts per billion (ppb) in B. impatiens workers to 388.4 ± 146.2 ppb in Andrena. Exposure profiles were similar for all bees except A. mellifera, whose unique exposure profile included high levels of the neonicotinoid insecticide thiamethoxam.

All bee groups except wild B. impatiens queens had at least one sample exceeding a US Environmental Protection Agency or European Food Safety Authority exposure level of concern. Apis mellifera experienced significantly greater risk than other bee groups, with 63% and 81% of samples exceeding an acute or chronic exposure level of concern, respectively. Risk to honeybees was driven primarily by high thiamethoxam levels not found in focal orchard flowers and likely originating outside the orchard.

Synthesis and applications: We find that pesticide exposure and risk differ between honeybees and other managed and wild bees during apple pollination. Furthermore, pesticide exposure is a landscape‐scale phenomenon and therefore measures to reduce exposure must consider the surroundings beyond focal farms. Limiting orchard sprays, while reducing on‐farm exposures, will not protect far‐foraging bees from off‐farm exposures such as thiamethoxam, which we hypothesize is coming from nearby seed‐treated corn fields planted during apple bloom.
How UN peacekeeping missions enforce peace agreements
Authors: Mailhot Cameron
Published: April 2024

How do UN peacekeeping missions enforce peace agreements, and what effect do higher rates of enforcement have on agreement implementation and conflict termination? Peace agreement enforcement forms a central component of peacekeeping effectiveness, yet missions are often mandated to enforce a minority of agreement provisions, and they vary across both time and space in the ways in which they do so. I identify the three dimensions along which enforcement operates—the proportion and type of provisions that missions are mandated to enforce, alongside their mandated level of involvement in their implementation—and theorize about their positive effects on agreement implementation and conflict termination. Analyzing the Peacekeeping Enforcement Dataset, an original data set of the enforcement patterns of all UN peacekeeping missions (1989–2015), I find that each dimension of enforcement has, at various time points, a distinct impact on agreement implementation and preventing conflict recidivism.
Cassia angustifolia and tacrolimus interaction in a liver transplant patient, a case report
Authors: Beltrá‐Picó Iván , Díaz‐González Marcos , Nalda‐Molina Ricardo , Ramon‐Lopez Amelia , Pascual‐Bartolomé Sonia , Miralles‐Macià Cayetano F. , Rodríguez‐Soler María , Más‐Serrano Patricio
Published: April 2024

Cassia angustifolia is a species of plant from the Senna family that has traditionally been used as a laxative in different herbal products and commercial medicines. Even though there are few documented drug–plant interactions, the use of C. angustifolia with different drugs may have additive effects, such as with other laxatives or potassium‐depleting diuretics. Its use also increases peristalsis which, may reduce drug absorption. The combination with digoxin has been associated with an increased risk of digoxin toxicity, probably due to an increase in plasma digoxin concentrations and hypokalaemia. We present a case with supratherapeutic trough concentration of tacrolimus, an immunosuppressive agent, and a herbal product in a liver transplant patient after concomitant intake of tacrolimus and a herbal product based on C. angustifolia, suggesting a possible drug–lant interaction through by P‐glycoprotein. We observed an increase in the patient’s blood concentration 2.8‐fold and the area under the curve at steady state 2.1‐fold. This interaction could be of clinical relevance, given the dose‐dependent side effects of tacrolimus, such as nephrotoxicity, neurotoxicity, hypertension, hyperglycaemia, or electrolyte alterations.
On subjective measures of decision quality
Authors: Debrabander Jasper
Published: April 2024

In times of person‐centered care, it is all the more important to support patients in making good decisions about their care. One way to offer such support to patients is by way of Patient Decision Aids (PDAs). Ranging from patient brochures to web‐based tools, PDAs explicitly state the decisions patients face, inform them about their medical options, help them to clarify and discuss their values, and ultimately make a decision. However, lingering discussions surround effectiveness research on PDAs. In this article, I focus on two subjective measures of decision quality that are widely used as outcome measures in effectiveness research on PDAs (i.e., the Decisional Conflict Scale (DCS) and measures of regret). Although these measurement instruments have attracted critical attention in the scientific literature, bioethicists have hardly engaged with them. Therefore, I set myself to analyze the relationship between (the different subscales of) the DCS and measures of regret, on the one hand, and ethical principles such as beneficence and autonomy, on the other hand. In light of that analysis, I will clarify some discussions regarding the use of these measures of decision quality in effectiveness research on PDAs. This should help us to align the way we evaluate PDAs with ethical principles and avoid that our attempts to support patients in making good decisions about their care that is so central to person‐centered care point in unethical directions.
Prognostic impact of genetic abnormalities in 536 first‐line chronic lymphocytic leukaemia patients without 17p deletion treated with chemoimmunotherapy in two prospective trials: Focus on IGHV‐mutated subgroups (a FILO study)
Authors: Nguyen‐Khac Florence , Baron Marine , Guièze Romain , Feugier Pierre , Fayault Alexandra , Raynaud Sophie , Troussard Xavier , Droin Nathalie , Damm Frederik , Smagghe Luce , Susin Santos , Leblond Véronique , Dartigeas Caroline , Van den Neste Eric , Leprêtre Stéphane , Bernard Olivier A. , Roos‐Weil Damien ,   on behalf the FILO (French Innovative Leukaemia Organization) Group
Published: April 2024

The potential prognostic influence of genetic aberrations on chronic lymphocytic leukaemia (CLL) can vary based on various factors, such as the immunoglobulin heavy variable (IGHV) status. We conducted an integrative analysis on genetic abnormalities identified through cytogenetics and targeted next‐generation sequencing in 536 CLL patients receiving first‐line chemo(immuno)therapies (CIT) as part of two prospective trials. We evaluated the prognostic implications of the main abnormalities, with specific attention to their relative impact according to IGHV status. In the entire cohort, unmutated (UM)‐IGHV, complex karyotype, del(11q) and ATM mutations correlated significantly with shorter progression‐free survival (PFS). Focusing on the subset of mutated IGHV (M‐IGHV) patients, univariate analysis showed that complex karyotype, del(11q), SF3B1 and SAMHD1 mutations were associated with significant lower PFS. The prognostic influence varied based on the patient's IGHV status, as these abnormalities did not affect outcomes in the UM‐IGHV subgroup. TP53 mutations had no significant impact on outcomes in the M‐IGHV subgroup. Our findings highlight the diverse prognostic influence of genetic aberrations depending on the IGHV status in symptomatic CLL patients receiving first‐line CIT. The prognosis of gene mutations and cytogenetic abnormalities needs to be investigated with a compartmentalized methodology, taking into account the IGVH status of patients receiving first‐line BTK and/or BCL2 inhibitors.
On the Dialectical Dialogue in Supervision
Authors: Yerushalmi Hanoch
Published: April 2024

Whereas the therapeutic action centres on emotional participation and containment of the patient's intolerable experiences, the supervisory action centres on interpreting the reconstructed therapeutic reality. Since the emergent interpretation is subjective and contextual, it requires processing in a dialogue between the supervisor and the supervisee. However, their existential need to define and assert themselves as professionals often urges them to highlight the differences between their perceptions and beliefs and keenly convince each other. Uncontained, this dialectical tension might disrupt the supervisory process and the participants' well‐being. Despite the existential urges, when the supervisor and the supervisee recognize and validate each other as independent and autonomous professionals, they can restrain their competitiveness, maintain a productive dialectical dialogue, achieve creative and integrated understandings of the therapeutic process and consolidate their professional identities. Moreover, despite the hierarchical supervisory relationship, acknowledging their vulnerability helps supervisors recognize and validate their supervisees and facilitate the dialectical supervisory dialogue.
Child and Family Social Work as a Space for Promoting Social Cohesion
Authors: Dierckx Melissa , Vandenbroeck Michel , Devlieghere Jochen
Published: April 2024

Promoting social cohesion is frequently mentioned as an objective for child and family social work from a policy perspective. However, it is unclear how policies shape concrete child and family social work practices. The aim of the current study is to analyse how early childhood services in Flanders (Belgium) commit to the promotion social cohesion. An explorative multiple case study in Flanders, using (non)participatory observations (N = 40), was performed in child and family social work practices to answer the following research question: What is going on in child and family social work regarding the promotion of social cohesion? The research indicates that in the context of child and family social work, it is important to pay attention to the meaning of these light encounters as a possible way to foster social cohesion. Given the importance of light encounters in child and family social work, a reflection on the role of the infrastructure should be made. To end, a clear need and challenge became visible regarding the diversity in child and family social work practices. It is necessary to reach a diversity of families, but this implies that practitioners have the knowledge and know‐how in approaching and dealing with diversity issues.
Forming Evaluations of Moral Character: How Are Multiple Pieces of Information Prioritized and Integrated?
Authors: Landy Justin F. , Perry Alexander D.
Published: April 2024

Evaluating other people's moral character is a crucial social cognitive task. However, the cognitive processes by which people seek out, prioritize, and integrate multiple pieces of character‐relevant information have not been studied empirically. The first aim of this research was to examine which character traits are considered most important when forming an impression of a person's overall moral character. The second aim was to understand how differing levels of trait expression affect overall character judgments. Four preregistered studies and one supplemental study (total N = 720), using five different measures of importance and sampling undergraduates, online workers, and community members, found that our participants placed the most importance on the traits honest, helpful, compassionate, loyal, and responsible. Also, when integrating the information that they have learned, our participants seemed to engage in a simple averaging process in which all available, relevant information is combined in a linear fashion to form an overall evaluation of moral character. This research provides new insights into the cognitive processes by which evaluations of moral character are formed.
Unusual isolated cytomegalovirus cutaneous infections: A subtle histopathologic diagnosis with review of the literature
Authors: Hartsough Emily M. , Nazarian Rosalynn M. , Cornejo Kristine M. , Stagner Anna M.
Published: April 2024

Cytomegalovirus (CMV) infection is common and often self‐limited. Reactivation results in a variety of disease presentations, especially in the setting of immunocompromise. While cutaneous manifestations of systemic CMV infection are rare, dermatologic manifestations of CMV are increasingly reported with a wide morphologic spectrum clinically. Three male patients, with untreated human immunodeficiency virus (HIV), penile lichenoid dermatitis treated with long‐term topical and intralesional corticosteroids, and metastatic Merkel cell carcinoma on immune checkpoint inhibitor therapy, each presented with isolated cutaneous ulcers. The ulcers were located on the perianal skin, glans of the penis, and distal thumb. In each case, nonspecific histopathologic features were seen. However, very rare dermal cytomegalic cells with nuclear and cytoplasmic inclusions were present and highlighted with an immunohistochemical stain for CMV. Isolated ulcers due to CMV infection may occur in the setting of systemic or localized immunosuppression. A high index of suspicion is needed upon histopathologic evaluation, as few cytomegalic cells may be present and accurate diagnosis is crucial for prompt and appropriate clinical management.
Are repeat neuroimaging studies needed in PHACE syndrome?
Authors: Siegel Dawn H. , Frieden Ilona J.
Published: April 2024

This commentary is on the original article by Hausman–Kedem et al. on pages 1348–1360 of this issue.
Mental health profiles of depressive symptoms and personal well‐being among active‐duty military families
Authors: O'Neal Catherine Walker , Lavner Justin A. , Jensen Todd M. , Lucier‐Greer Mallory
Published: April 2024

Although some research has examined the mental health of individual family members in military families, additional research is needed that considers mental health among multiple members of the family system simultaneously and that characterizes subsets of families with distinct patterns. Mental health patterns of depressive symptoms and well‐being in and among families were identified using latent profile analysis with a community sample of 236 military families with a service member (SM) parent, civilian partner, and adolescent. Drawing from the Family Adjustment and Adaptation Response model, we examined several military‐related family demands (e.g., relocations, deployments) and capabilities (e.g., family cohesion, social support outside the family) as correlates of the family profiles. Three profiles emerged: thriving families (62.3% of the sample where all three family members reported relatively low depressive symptoms and high personal well‐being), families with a relatively distressed SM (24.2%), and families with a relatively distressed adolescent (13.5%). Overall, there were no differences between the groups of families regarding military‐related demands, yet there were differences between the groups regarding their capabilities, namely family cohesion and social support. In general, families in the thriving profile tended to have higher family cohesion and social support as reported by multiple family members compared to the other two profiles. Findings can inform the development of family needs assessments and tailored interventions (and intervention points) based on family profiles and current capabilities.
Neotropical mammal responses to megafires in the Brazilian Pantanal
Authors: Bardales Rocío , Boron Valeria , Passos Viana Diego Francis , Sousa Lara L. , Dröge Egil , Porfirio Grasiela , Jaramillo Maricruz , Payán Esteban , Sillero‐Zubiri Claudio , Hyde Matthew
Published: April 2024

The increasing frequency and severity of human‐caused fires likely have deleterious effects on species distribution and persistence. In 2020, megafires in the Brazilian Pantanal burned 43% of the biome's unburned area and resulted in mass mortality of wildlife. We investigated changes in habitat use or occupancy for an assemblage of eight mammal species in Serra do Amolar, Brazil, following the 2020 fires using a pre‐ and post‐fire camera trap dataset. Additionally, we estimated the density for two naturally marked species, jaguars Panthera onca and ocelots Leopardus pardalis. Of the eight species, six (ocelots, collared peccaries Dicotyles tajacu, giant armadillos Priodontes maximus, Azara's agouti Dasyprocta azarae, red brocket deer Mazama americana, and tapirs Tapirus terrestris) had declining occupancy following fires, and one had stable habitat use (pumas Puma concolor). Giant armadillo experienced the most precipitous decline in occupancy from 0.431 ± 0.171 to 0.077 ± 0.044 after the fires. Jaguars were the only species with increasing habitat use, from 0.393 ± 0.127 to 0.753 ± 0.085. Jaguar density remained stable across years (2.8 ± 1.3, 3.7 ± 1.3, 2.6 ± 0.85/100 km2), while ocelot density increased from 13.9 ± 3.2 to 16.1 ± 5.2/100 km2. However, the low number of both jaguars and ocelots recaptured after the fire period suggests that immigration may have sustained the population. Our results indicate that the megafires will have significant consequences for species occupancy and fitness in fire‐affected areas. The scale of megafires may inhibit successful recolonization, thus wider studies are needed to investigate population trends.
Transect walks and malaise traps differ in temperature sensitivity but reveal consistent drivers of pollinator richness
Authors: Kerner Janika M. , König Sebastian , Maihoff Fabienne , Bofinger Lukas , Sauer Nikki , Ssymank Axel , Väth Peter , Classen Alice
Published: April 2024

While transect walks have long been the preferred monitoring method for many flying insect taxa, malaise traps combined with DNA metabarcoding have gained growing prominence. However, it remains unclear whether both methods reveal comparable species richness and the same ecological drivers along environmental gradients.

We selected three groups of pollinators (wild bees, hoverflies and butterflies) and one group of herbivores (grasshoppers) as functionally important and conservation‐relevant model groups, comparing results of both methods along an elevational gradient in the German Alps.

Across the study region, both methods detected a similarly high species richness of pollinators with ~50% overlap of species pools, but transect walks revealed more species per site, especially in higher elevations and under low temperatures. Body size spectra differed between methods, with on average more large butterfly and more small bee species in transect walks. Nevertheless, temperature and flower richness were consistent drivers of pollinator richness, independent of the sampling method. Grasshopper richness from transect walks was considerably higher than from malaise traps. Both methods identified temperature and only malaise traps also identified management as drivers of grasshopper richness.

We conclude that malaise traps are principally suitable substitutes for the more time‐consuming pollinator transect walks. However, the effectiveness of these passive traps is more susceptible to changes in sampling temperature, and in some pollinator groups, body size classes are presented differently, which is important to consider during analyses. For grasshoppers, transect walks appear to be more suitable to assess species richness, as considerably more species can be monitored.
Association between STAT4 gene polymorphism and susceptibility to pulmonary tuberculosis in the Moldavian population
Authors: Varzari Alexander , Tudor Elena , Corloteanu Andrei , Axentii Ecaterina , Vladei Iurie , Deyneko Igor V.
Published: April 2024

Signal transducer and activator of transcription 4 (STAT4) plays a crucial role in the host immune response against Mycobacterium tuberculosis. This study investigates the association between STAT4 gene polymorphisms and pulmonary tuberculosis (TB) risk in the Moldavian population. A total of 272 TB patients and 251 community‐matched controls underwent screening for functional single‐nucleotide polymorphisms (SNPs) rs897200 and rs7574865 in the STAT4 gene. The minor T allele and the TT/CT genotype of rs897200 demonstrated a significant association with reduced pulmonary TB risk (allelic model: adjusted OR = .74, p = .025; log‐additive model: adjusted OR = .72, p = .02; and dominant model: adjusted OR = .65, p = .023), indicating a protective effect. Similar associations, characterized by an even more pronounced reduction in risk, were observed among females and late‐onset TB patients (>44 years). No significant associations were found for rs7574865. In addition, a combined genotype analysis incorporating 43 SNPs from our previous studies revealed potential associations, such as STAT4 rs897200 CT with IFNG rs2430561 AA (adjusted OR = .36, p = .0025) and STAT4 rs897200 CT with TNFA rs1800629 GA (adjusted OR = .33, p = .0012). This study emphasizes the significant association of STAT4 rs897200 with pulmonary TB risk in the Moldavian population, underscoring its role in the disease development.
Indications and outcomes of transjugular intrahepatic portosystemic shunt insertion in two regional Australian hepatology centres
Authors: Commins Natalie , Subhaharan Deloshaan , Kurup Rajiv , Wickremeratne Tehara , Mitchell Jonathan , Elmes Julie , Braund Alicia , Funakoshi Natalie , Langton Jonathan , Leschke Paul , O'Beirne James
Published: April 2024

Background

Transjugular intrahepatic portosystemic shunt (TIPS) is an important therapy for complications of portal hypertension but remains underutilised in regional settings.

Aims

The aim of this study is to explore the demographics, indications, outcomes and complications in patients undergoing TIPS in two regional hepatology centres.

Methods

Retrospective analysis was undertaken of all patients undergoing TIPS at two regional centres between January 2017 and March 2023. The primary outcome measures were efficacy and complications of TIPS. Patient demographics (such as age, baseline liver severity scores and aetiology of liver disease) and indications for TIPS are detailed.

Results

Forty‐eight patients underwent TIPS. Median age was 56 years (interquartile range (IQR): 46–65). The most common indications for TIPS were refractory ascites (n = 17) and failure of secondary prophylaxis of variceal bleeding (n = 13). Cumulative survival at 3 months and 1 year was 93% and 77% respectively. There was no significant difference in outcomes based on TIPS indication. The median number of paracenteses in patients undergoing TIPS for refractory ascites 1 year pre‐ and post‐TIPS were 10 (IQR: 4.5–16) and 2 (IQR: 0–4) respectively (P < 0.001). There were no procedure‐related deaths. Inpatient management of liver disease complications had a mean cost of $32 874.67 (SEM: 7779) in 1 year pre‐TIPS compared with $12 304.70 (SEM: 3531.1) in 1 year post‐TIPS (P < 0.001).

Conclusions

TIPS is a safe and effective treatment to reduce complications of portal hypertension and can be performed successfully in the regional setting.