bluuebunny/crossref_metadata_2025 huggingface dataset:
UCRAID (Ukrainian Citizen and refugee electronic support in Respiratory diseases, Allergy, Immunology and Dermatology) action plan
Authors: Bousquet Jean , Samolinski Boleslaw , Kaidashev Igor , Maurer Marcus , Roche Nicolas , Sousa‐Pinto Bernardo , Kurchenko Andrii , Stepanenko Roman , Tsaryk Vladyslav , Klimek Ludger , Ventura Maria Teresa , Bedbrook Anna , Czarlewski Wienczyslawa , Lysanets Yuliia , Kupczyk Maciej , Skolimowski Łukasz , Kulus Marek , Del Giacco Stefano , Ollert Markus , Garcia‐Aymerich Judith , Robalo Cordeiro Carlos , Yorgancioglu Arzu , Schlapbach Christoph , Amaral Rita , Bonaglia Cristina , Bossé Isabelle , Buquicchio Rosalba , Christou Demetrios , Fedoruk Galyna , Fontanesi Pietro , Gemicioglu Bilun , Giuliano Antonio F. M. , Lepore Paolo , Nakonechna Alla , Neisinger Sophia , Pereira Ana M. , Ramanauskaite Aiste , Raciborski Filip , Sitkauskiene Brigita , Sokhatska Oksana , Stepanenko Viktor , Stevanovic Katarina , Syzon Orysya , Kvedariene Violeta , de Vries Govert , van Eerd Michiel , Valiulis Arunas , Fonseca Joao A. , Anto Josep M. , Haahtela Tari , Schünemann Holger , Zuberbier Torsten
Published: August 2023

Eight million Ukrainians have taken refuge in the European Union. Many have asthma and/or allergic rhinitis and/or urticaria, and around 100,000 may have a severe disease. Cultural and language barriers are a major obstacle to appropriate management. Two widely available mHealth apps, MASK‐air® (Mobile Airways Sentinel NetworK) for the management of rhinitis and asthma and CRUSE® (Chronic Urticaria Self Evaluation) for patients with chronic spontaneous urticaria, were updated to include Ukrainian versions that make the documented information available to treating physicians in their own language. The Ukrainian patients fill in the questionnaires and daily symptom‐medication scores for asthma, rhinitis (MASK‐air) or urticaria (CRUSE) in Ukrainian. Then, following the GDPR, patients grant their physician access to the app by scanning a QR code displayed on the physician's computer enabling the physician to read the app contents in his/her own language. This service is available freely. It takes less than a minute to show patient data to the physician in the physician's web browser. UCRAID—developed by ARIA (Allergic Rhinitis and its Impact on Asthma) and UCARE (Urticaria Centers of Reference and Excellence)—is under the auspices of the Ukraine Ministry of Health as well as European (European Academy of Allergy and Clinical immunology, EAACI, European Respiratory Society, ERS, European Society of Dermatologic Research, ESDR) and national societies.
Navigating privacy tensions when responding to online aggression at postsecondary institutions
Authors: Byrne Virginia L. , Hollingsworth Juana , Kumar Priya C.
Published: August 2023

Postsecondary institutions have a legal responsibility to ensure that students have access to a safe learning environment. While institutions adopt policies and hire administrators to protect students from harm, many are underprepared to support students when these harmful incidents happen online. This is of increased concern now that online aggression is pervasive across universities worldwide. While faculty, administrators and students agree that online aggression is a significant issue and that institutions ought to provide prevention and response services, there is concern that these efforts might violate privacy norms. We used the theory of privacy as contextual integrity (CI) to explore the tensions that postsecondary students and staff perceive regarding student privacy when responding to incidents of online aggression. To do so, we conducted focus groups with undergraduate students and student affairs administrators from a Historically Black College and University (HBCU) in the Mid‐Atlantic USA. Our analysis surfaced three considerations that inform students' and staff's decision to report an incident of online aggression: their closeness to the person making the post, their perception of the online post content as a real threat and their knowledge of an authority figure who could help resolve the situation. We used CI theory to explain how these considerations can inform institutional policy, practice and future research.

Practitioner notes

What is already known about this topic

Online aggression is a pervasive issue at postsecondary institutions worldwide that can contribute to psychological, academic and developmental issues.

Postsecondary students and staff are unsure of how to respond to incidents of online aggression.

There is a gap in policies and procedures for responding to online aggression at postsecondary institutions.

What this paper adds

A novel use of Nissenbaum's (2010) theory of contextual integrity to understand students' and staff's perceptions of privacy.

Students' and staff's decisions to intervene or report an online aggression incident are determined by their relationship to the perpetrator, the severity of the social media post and their knowledge of who to tell on campus.

Students and staff are reluctant to inform the police out of fear of violence against the perpetrator.

Implications for practice and/or policy

Raise awareness about responding to online aggression incidents.

Implement online bystander intervention training programs to increase awareness and self‐efficacy to intervene in unclear situations.

Develop clear policies regarding online aggression, as well as a trustworthy procedure for how to respond.
The accuracy of dynamic computer assisted implant surgery in fully edentulous jaws: A retrospective case series
Authors: Wang Jiayi , Ge Yanjun , Mühlemann Sven , Pan Shaoxia , Jung Ronald E.
Published: August 2023

Objectives

To evaluate the accuracy of implant placement using a dynamic navigation system in fully edentulous jaws and to analyze the influence of implant distribution on implant position accuracy.

Materials and Methods

Edentulous patients who received implant placement using a dynamic navigation system were included. Four to six mini screws were placed in the edentulous jaw under local anesthesia as fiducial markers. Then patients received CBCT scans. Virtual implant positions were designed in the planning software based on CBCT data. Under local anesthesia, implants were inserted under the guidance of the dynamic navigation system. CBCTs were taken following implant placement. The deviation between the actual and planned implant positions was measured by comparing the pre‐ and postsurgery CBCT.

Results

A total of 13 edentulous patients with 13 edentulous maxillae and 7 edentulous mandibles were included, and 108 implants were placed. The average linear deviations at the implant entry point and apex were 1.08 ± 0.52 mm and 1.15 ± 0.60 mm, respectively. The average angular deviation was 2.85 ± 1.20°. No significant difference was detected in linear and angular deviations between the maxillary and mandibular implants, neither between the anterior and posterior implants.

Conclusions

The dynamic navigation system provides high accuracy for implant placement in fully edentulous jaws, while the distribution of the implants showed little impact on implant position accuracy.
Impact of new allocation system on length of stay following heart transplantation in the United States
Authors: Doulamis Ilias P. , Gemelli Marco , Rempakos Athanasios , Tzani Aspasia , Oh Nicholas A. , Kampaktsis Polydoros , Guariento Alvise , Kuno Toshiki , Alvarez Paulino , Briasoulis Alexandros
Published: August 2023

Background

United Network for Organ Sharing (UNOS) allocation criteria changed in 2018 to accommodate the increased prevalence of ventricular assist device use as a bridge to heart transplant, which consequently prioritized sicker patients. We aimed to assess the impact of this new allocation policy on the length of stay following heart transplantation. Secondary outcomes include other risk factors for prolonged hospitalization and its effect on mortality and postoperative complications.

Methods

The UNOS Registry was queried to identify patients who underwent isolated heart transplants in the United States between 2001 and 2023. Patients were divided into quartiles according to their respective length of stay.

Results

A total of 57 020 patients were included, 15 357 of which were allocated with the new system. The median hospital length of stay was 15 days (mean 22.7 days). Length of stay was longer in the new allocation era (25 ± 30 vs. 22 ± 27 days, p < .001). The longer length of stay was associated with increased 5‐year mortality in the new allocation system (aHR: 1.18; 95% CI: 1.15, 1.20; p‐value: < .001).

Conclusion

Longer hospital stays and associated observed increased risk for mortality in the era after the allocation criteria change reflect the rationale of this shift which was to prioritize heart transplants for sicker patients. Further studies are needed to track the progress of surgical and perioperative management of these studies over time.
Circulating tumour DNA testing in metastatic breast cancer: Integration with tissue testing
Authors: Ranghiero Alberto , Frascarelli Chiara , Cursano Giulia , Pescia Carlo , Ivanova Mariia , Vacirca Davide , Rappa Alessandra , Taormina Sergio Vincenzo , Barberis Massimo , Fusco Nicola , Rocco Elena Guerini , Venetis Konstantinos
Published: August 2023

Breast cancer biomarker profiling predominantly relies on tissue testing (surgical and/or biopsy samples). However, the field of liquid biopsy, particularly the analysis of circulating tumour DNA (ctDNA), has witnessed remarkable progress and continues to evolve rapidly. The incorporation of ctDNA‐based testing into clinical practice is creating new opportunities for patients with metastatic breast cancer (MBC). ctDNA offers advantages over conventional tissue analyses, as it reflects tumour heterogeneity and enables multiple serial biopsies in a minimally invasive manner. Thus, it serves as a valuable complement to standard tumour tissues and, in certain instances, may even present a potential alternative approach. In the context of MBC, ctDNA testing proves highly informative in the detection of disease progression, monitoring treatment response, assessing actionable biomarkers, and identifying mechanisms of resistance. Nevertheless, ctDNA does exhibit inherent limitations, including its generally low abundance, necessitating timely blood samplings and rigorous management of the pre‐analytical phase. The development of highly sensitive assays and robust bioinformatic tools has paved the way for reliable ctDNA analyses. The time has now come to establish how ctDNA and tissue analyses can be effectively integrated into the diagnostic workflow of MBC to provide patients with the most comprehensive and accurate profiling. In this manuscript, we comprehensively analyse the current methodologies employed in ctDNA analysis and explore the potential benefits arising from the integration of tissue and ctDNA testing for patients diagnosed with MBC.
Diabetes prevention at scale: Narrative review of findings and lessons from the DIPLOMA evaluation of the NHS Diabetes Prevention Programme in England
Authors: Bower Peter , Soiland‐Reyes Claudia , Heller Simon , Wilson Paul , Cotterill Sarah , French David , Sutton Matt
Published: August 2023

Aims

The NHS Diabetes Prevention Programme (NHS DPP) is a large‐scale, England‐wide behaviour change programme for people at high risk of progressing to type 2 diabetes. We summarise the findings of our six‐year DIPLOMA evaluation of its implementation and impact and highlight insights for future programmes.

Methods

Using qualitative interviews, document analysis, observation, surveys and large dataset analysis, eight interlinked work packages considered: equity of access; implementation; service delivery and fidelity; programme outcomes; comparative effectiveness and cost‐effectiveness in reducing diabetes incidence; and patient decision making and experience.

Results

Delivery of the NHS DPP encountered barriers across many aspects of the programme, and we identified inequalities in terms of the areas, organisations and patient populations most likely to engage with the programme. There was some loss of fidelity at all stages from commissioning to participant understanding. Despite these challenges, there was evidence of significant reductions in diabetes incidence at individual and population levels. The programme was cost‐effective even within a short time period.

Conclusions

Despite the challenge of translating research evidence into routine NHS delivery at scale, our findings suggest that an individual‐level approach to the prevention of type 2 diabetes in a ‘high‐risk’ population was more effective than usual care. By embedding evaluation with programme delivery and working closely with the NHS DPP team, we provided actionable insights for improving communications with potential participants, supporting primary care referral, honing the delivery model with better provider relationships and more patient choice, increasing understanding of behaviour change techniques, and enriching the educational and health coaching content.
Combined tricuspid atresia‐ AV septal defect—a rare congenital cardiac abnormality
Authors: Bassam Khalil , Farhat Aziz , El‐Rassi Issam , Bitar Fadi , Arabi Mariam
Published: August 2023

Introduction

Congenital heart diseases (CHDs) are one of the most common birth defects worldwide with a prevalence of 1%. CHDs can be classified into cyanotic and acyanotic diseases based on the presence or absence of the characteristic bluish discoloration of skin and mucus membranes. A subset of cyanotic diseases is single ventricle malformations. This group of disorders comprises 1% of all CHDs. A remarkable yet rare and underreported entity of single ventricle malformations is combined tricuspid atresia (TA) and atrioventricular (AV) septal defect which is characterized by the anatomical features of both entities. Combined TA‐AV septal malformation was first anatomically described in 1953 and further explored through echocardiography and cardiac catheterization in 1987 and then 1991. Since then, no studies have been documented in the literature prompting us to share our findings.

Methods

Herein we are describing a rare and underreported cardiac lesion based of a retrospective revision of medical charts at the American University of Beirut Medical Center (AUBMC) Children's Heart Center, a tertiary medical center in the Middle East

Results

Out of 200 cases with confirmed single ventricle physiology, we identified a few patients with characteristics of combined TA‐AV septal defect. Our patients exhibited characteristic echocardiographic findings of primum ASD, VSD, atretic RAVV, and clefted LAVV.

Conclusion

In short, TA‐AV septal defect is a rare, underreported congenital malformation. Tracking our patients’ clinical profiles will help improve our understanding of the prognosis of this entity. Our findings may also improve treatment modalities since replacing the left‐sided valve is often overlooked if the defect is inaccurately diagnosed. In addition, such findings can help shed light on the embryological development of the rarely encountered variation of AV septal malformation.
Development of the PSYCHS: Positive SYmptoms and Diagnostic Criteria for the CAARMS Harmonized with the SIPS
Authors: Woods Scott W. , Parker Sophie , Kerr Melissa J. , Walsh Barbara C. , Wijtenburg S. Andrea , Prunier Nicholas , Nunez Angela R. , Buccilli Kate , Mourgues‐Codern Catalina , Brummitt Kali , Kinney Kyle S. , Trankler Carli , Szacilo Julia , Colton Beau‐Luke , Ali Munaza , Haidar Anastasia , Billah Tashrif , Huynh Kevin , Ahmed Uzair , Adery Laura L. , Marcy Patricia J. , Allott Kelly , Amminger Paul , Arango Celso , Broome Matthew R. , Cadenhead Kristin S. , Chen Eric Y. H. , Choi Jimmy , Conus Philippe , Cornblatt Barbara A. , Glenthøj Louise Birkedal , Horton Leslie E. , Kambeitz Joseph , Kapur Tina , Keshavan Matcheri S. , Koutsouleris Nikolaos , Langbein Kerstin , Lavoie Suzie , Diaz‐Caneja Covadonga Martinez , Mathalon Daniel H. , Mittal Vijay A. , Nordentoft Merete , Pasternak Ofer , Pearlson Godfrey D. , Gaspar Pablo A. , Shah Jai L. , Smesny Stefan , Stone William S. , Strauss Gregory P. , Wang Jijun , Corcoran Cheryl M. , Perkins Diana O. , Schiffman Jason , Perez Jesus , Mamah Daniel , Ellman Lauren M. , Powers Albert R. , Coleman Michael J. , Anticevic Alan , Fusar‐Poli Paolo , Kane John M. , Kahn Rene S. , McGorry Patrick D. , Bearden Carrie E. , Shenton Martha E. , Nelson Barnaby , Calkins Monica E. , Hendricks Larry , Bouix Sylvain , Addington Jean , McGlashan Thomas H. , Yung Alison R. ,   The Accelerating Medicines Partnership Schizophrenia
Published: August 2023

Aim

To harmonize two ascertainment and severity rating instruments commonly used for the clinical high risk syndrome for psychosis (CHR‐P): the Structured Interview for Psychosis‐risk Syndromes (SIPS) and the Comprehensive Assessment of At‐Risk Mental States (CAARMS).

Methods

The initial workshop is described in the companion report from Addington et al. After the workshop, lead experts for each instrument continued harmonizing attenuated positive symptoms and criteria for psychosis and CHR‐P through an intensive series of joint videoconferences.

Results

Full harmonization was achieved for attenuated positive symptom ratings and psychosis criteria, and modest harmonization for CHR‐P criteria. The semi‐structured interview, named Positive SYmptoms and Diagnostic Criteria for the CAARMS Harmonized with the SIPS (PSYCHS), generates CHR‐P criteria and severity scores for both CAARMS and SIPS.

Conclusions

Using the PSYCHS for CHR‐P ascertainment, conversion determination, and attenuated positive symptom severity rating will help in comparing findings across studies and in meta‐analyses.
Whole blood transcriptional profiling reveals highly deregulated atherosclerosis genes in Philadelphia‐chromosome negative myeloproliferative neoplasms
Authors: Skov Vibe , Thomassen Mads , Kjær Lasse , Larsen Morten Kranker , Knudsen Trine A. , Ellervik Christina , Kruse Torben A. , Hasselbalch Hans Carl
Published: August 2023

Background

The Philadelphia‐negative chronic myeloproliferative neoplasms (MPNs) are associated with a huge comorbidity burden, including an increased risk of cardiovascular diseases. Recently, chronic inflammation has been suggested to be the driving force for clonal evolution and disease progression in MPN but also potentially having an impact upon the development of accelerated (premature) atherosclerosis.

Objectives

Since chronic inflammation, atherosclerosis, and atherothrombosis are prevalent in MPNs and we have previously shown oxidative stress genes to be markedly upregulated in MPNs, we hypothesized that genes linked to development of atherosclerosis might be highly deregulated as well.

Methods

Using whole blood gene expression profiling in patients with essential thrombocythemia (ET; n = 19), polycythemia vera (PV; n = 41), or primary myelofibrosis (PMF; n = 9), we herein for the first time report aberrant expression of several atherosclerosis genes.

Results

Of 84 atherosclerosis genes, 45, 56, and 46 genes were deregulated in patients with ET, PV, or PMF, respectively. Furthermore, BCL2L1, MMP1, PDGFA, PTGS1, and THBS4 were progressively significantly upregulated and BCL2 progressively significantly downregulated from ET over PV to PMF (all FDR <0.05).

Conclusions

We have for the first time shown massive deregulation of atherosclerosis genes in MPNs, likely reflecting the inflammatory state in MPNs in association with in vivo activation of leukocytes, platelets, and endothelial cells being deeply involved in the atherosclerotic process.
Real‐world practice of Helicobacter pylori management: A survey among physicians in Southeast Asia
Authors: Quach Duc Trong , Vilaichone Ratha‐korn , Luu Mai Ngoc , Lee Yeong Yeh , Ang Tiing Leong , Miftahussurur Muhammad , Aye Than Than , Basir Dewi Norwani , Vutha Ky , Vannarath Sengdao , Sollano Jose D. , Mahachai Varocha
Published: August 2023

Background

Multidrug‐resistant Helicobacter pylori strains are emerging in Southeast Asia. This study evaluates the region's real‐world practice in H. pylori management.

Materials and Methods

Physicians who managed H. pylori eradication in daily practice across 10 Southeast Asian countries were invited to participate in an online questionnaire, which included questions about the local availability of antimicrobial susceptibility tests (ASTs) and their preferred eradication regimens in real‐world practice. An empiric regimen was considered inappropriate if it did not follow the local guidelines/consensus, particularly if it contained antibiotics with a high reported resistance rate or was recommended not to be empirically used worldwide.

Results

There were 564 valid responses, including 314 (55.7%) from gastroenterologists (GIs) and 250 (44.3%) from non‐GI physicians. ASTs were unavailable in 41.7%. In countries with low and intermediate clarithromycin resistance, the most common first‐line regimen was PAC (proton pump inhibitor [PPI], amoxicillin, clarithromycin) (72.7% and 73.2%, respectively). Regarding second‐line therapy, the most common regimen was bismuth‐based quadruple therapy, PBMT (PPI, bismuth, metronidazole, tetracycline) (50.0% and 59.8%, respectively), if other regimens were used as first‐line treatment. Concomitant therapy (PPI, amoxicillin, clarithromycin, metronidazole) (30.5% and 25.9%, respectively) and PAL (PPI, amoxicillin, levofloxacin) (22.7% and 27.7%, respectively) were favored if PBMT had been used as first‐line treatment. In countries with high clarithromycin resistance, the most common first‐line regimen was PBMT, but the utilization rate was only 57.7%. Alarmingly, PAC was prescribed in 27.8% of patients, ranking as the second most common regimen, and its prescription rate was higher in non‐GI physicians than GI physicians (40.1% vs. 16.2%, p < 0.001).

Conclusions

Choosing inappropriate regimens containing antibiotics with high resistance rates is not uncommon in Southeast Asia, especially among non‐GI physicians. In countries with high clarithromycin resistance, the PBMT regimen is underutilized.
Ceftazidime reduces cellular Skp2 to promote type‐I interferon activity
Authors: Qiao Caixia , Huang Fan , He Jiuyi , Wu Qiuyu , Zheng Zhijin , Zhang Tingting , Miao Ying , Yuan Yukang , Chen Xiangjie , Du Qian , Xu Yang , Wu Depei , Yu Zhengyuan , Zheng Hui
Published: August 2023

Skp2 plays multiple roles in malignant tumours. Here, we revealed that Skp2 negatively regulates type‐I interferon (IFN‐I)‐mediated antiviral activity. We first noticed that Skp2 can promote virus infection in cells. Further studies demonstrated that Skp2 interacts with IFN‐I receptor 2 (IFNAR2) and promotes K48‐linked polyubiquitination of IFNAR2, which accelerates the degradation of IFNAR2 proteins. Skp2‐mediated downregulation of IFNAR2 levels inhibits IFN‐I signalling and IFN‐I‐induced antiviral activity. In addition, we uncovered for the first time that the antibiotic ceftazidime can act as a repressor of Skp2. Ceftazidime reduces cellular Skp2 levels, thus enhancing IFNAR2 stability and IFN‐I antiviral activity. This study reveals a new role of Skp2 in regulating IFN‐I signalling and IFN‐I antiviral activity and reports the antibiotic ceftazidime as a potential repressor of Skp2.
Improved densification in cold sintering of gadolinia‐doped ceria with reactive sintering aids
Authors: Zhao Yuye , Tang Jian , Xu Hongliang , Zhu Lei , Ni Na
Published: August 2023

This study explores a novel reactive cold sintering method for improving the density of gadolinia‐doped ceria (GDC) ceramics while reducing the annealing temperature. Instead of using deionized water as an aid in conventional cold sintering, stoichiometrically mixed Ce(NO3)3·6H2O and Gd(NO3)3·6H2O precursors were added as additives during the CSP in this study. The effects of processing parameters such as sintering temperature and additive content on the relative density of the compacts were investigated using synthesized GDC and commercial GDC powders as raw materials. The results showed that with the aid of precursors, GDC ceramics were sintered up to 90% of their theoretical densities at 850°C and up to 94% at 950°C when the synthesized nanopowder GDC was used. Additionally, the sintering mechanism was investigated, and it was found that the GDC generated by the precursor reaction effectively filled the gaps between the original particles, promoting densification of the sample after cold‐pressing.
Preparation of granite powder–based geopolymer by synergistic action of calcination and phosphoric acid
Authors: Jia Luxia , Huang Min , Huang Muyang , Luo Yongpeng , Zhang Xiuze , Liao Xianqing , Bao Shenxu
Published: August 2023

Using the solid waste of granite powder (GP) to prepare green cementitious materials is of great significance for the sustainable development of the construction industry. In this study, a phosphoric acid–based geopolymer (PABG) was directly prepared from GP through a combination of phosphoric acid and calcination processes. Reaction mechanism of phosphoric‐activated GP is studied by techniques of X‐ray diffraction, thermal analysis, Fourier transform infrared spectroscopy, SE mode, and mercury intrusion porosimetry (MIP) taking calcination temperature, calcination time, and phosphoric acid as variables. The results indicated that the addition of 15 wt.% phosphoric acid and calcination at the temperature of 200°C for 90 min significantly increased compressive strength from 0.70 to 20.92 MPa. The calcination temperature was the most important factor in the synthesis of PABG using GP. The decrease of the peak value of mineral phase after calcination indicates that high temperature promotes the reaction between phosphoric acid and GP. According to the results of MIP, the gel generated by the reaction of phosphoric acid and GP refines the pore structure, which is conducive to the improvement of geopolymer properties. These research results provide a reference for the preparation of geopolymers directly using low pozzolanic active GP.
Hidradenitis suppurativa: Detangling phenotypes and identifying common denominators
Authors: Vișan Maria‐Alexandra , Căruntu Constantin , Costache Raluca Simona , Tiplica George , Costache Daniel Octavian
Published: August 2023

Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease with a severe impact on patients' quality of life through its recurrent and painful nature, as well as its comorbidity burden. The shift in the pathogenic paradigm from a condition of the apocrine glands to an autoinflammatory disease associated with follicular destruction has rendered its understanding difficult, as there are still large gaps in pinpointing the underlying mechanisms, which cannot currently explain the existing clinical variation and as a result, translate into suboptimal therapy. Multifactorial involvement is hypothesized, with an implication of genetic mutations, microbiome dysbiosis, cytokine upregulation and environmental factors. Clinical observation is fundamental for diagnosis, however, the marked heterogeneity in presentation leads to delays in detection and challenges in treatment selection, showcasing clear limits in defining the link between genetic aspects of HS, the role of epigenetic factors and its pathogenic pathways. There have been attempts to formulate phenotypes that could aid in prognostication and management, however, current classification schemata show significant overlap and no validation through longitudinal studies. In this context, nomenclature poses a great challenge due to the lack of global agreement in the definition of lesions, which should be addressed by future research to enable simplified recognition and allow for more precise severity scoring. This could be complemented by the addition of extra dermatologic findings or paraclinical assessment in constructing phenotypes. The development of valid, predictive and reliable classifications of HS may lead to an improvement in comprehending its pathophysiology, favouring a more personalized approach in management. This could be achieved through consensus in the characterization of clinical features and data gathering, as well as validation attempts for described phenotypes. Ultimately, the genotype‐endotype‐phenotype correlation in HS requires targeted, systematic inquiries and should be addressed more largely to broaden the perspective on this debilitating entity.
Elevated baseline soluble FcεRI may be linked to early response to omalizumab treatment in chronic spontaneous urticaria
Authors: Moñino‐Romero S. , Kolkhir P. , Ohanyan T. , Szépfalusi Z. , Weller K. , Metz M. , Scheffel J. , Maurer M. , Altrichter S.
Published: August 2023

Background

Omalizumab, an anti‐IgE monoclonal antibody, is an effective treatment in chronic spontaneous urticaria (CSU). Predictors of fast and good response for omalizumab treatment have not yet been identified and characterized.

Objective

To evaluate whether soluble FcεRI (sFcεRI), a marker of IgE‐mediated mast cell activation, predicts the time of response to omalizumab in CSU.

Methods

Sera of 67 CSU patients were obtained before omalizumab treatment and analysed for sFcεRI levels by ELISA (2 ng/mL was used as cut‐off for elevated sFcɛRI). Treatment response during the first 4 weeks was assessed with the urticaria activity score (UAS7), urticaria control test (UCT) and the rolling UAS7 (rUAS7).

Results

Elevated pre‐treatment sFcɛRI levels were detected in more than 70% of patients with completely controlled disease (UCT = 16) and well‐controlled disease (UCT = 12–15) and were significantly associated with disease control (χ2 = 4.94, p < 0.05). More than half of the patients (14/25) with low levels had poor disease control (UCT < 12). Of the patients who achieved complete and marked UAS7 response, respectively, 75% and 63% had elevated baseline sFcɛRI levels. Post‐treatment UAS7 scores were lower in patients with elevated sFcɛRI levels reaching statistical significance at Week 3 (p < 0.05). Patients with elevated baseline sFcɛRI levels achieved rUAS7 ≤ 6 and = 0 earlier than those with lower levels (Days 9 vs. 13 and Days 12 vs. 14, respectively).

Conclusion

Elevated sFcεRI serum levels predict early and good response to treatment with omalizumab, which may help to better design treatment options for CSU patients.
Exploring morphometric frontiers: A comprehensive study of otolith growth patterns in brown comber Serranus hepatus (Linnaeus, 1758)
Authors: Castro‐Gutiérrez Jairo , Madera‐Santana Sara , Rodríguez‐García Carlos , Domínguez‐Bustos Ángel Rafael , Sarmiento‐Carbajal Jésica , Gonçalves‐Neto José Belquior , Cabrera‐Castro Remedios
Published: August 2023

Otoliths are widely employed in marine sciences to gain insights into fish growth, age, migrations, and population structure. This study investigates the relationships between morphometric measurements, otolith characteristics, and length size patterns in the brown comber (Serranus hepatus) from the Gulf of Cádiz, a species discarded in artisanal trawl fisheries. Our findings reveal significant changes in otolith shape indices as fish grow, with symmetry observed between left and right otolith measurements. Otolith size is found to be related to fish size, supporting its use in estimating body length at different life stages. Otolith shape analysis has potential applications in stock identification, detecting catch misreporting, and studying marine predator diets. Combining otolith shape analysis with other data types can clarify relationships among taxa and inform spatial management strategies, contributing to the long‐term sustainability of fish populations and the assessment of the impact of management strategies on fish size and growth. This study enhances our understanding of the broader implications of morphometric and otolith analyses in fisheries research and supports the development of more sustainable fisheries management practices.
Precision cancer medicine: Concepts, current practice, and future developments
Authors: Edsjö Anders , Holmquist Louise , Geoerger Birgit , Nowak Frédérique , Gomon Georgy , Alix‐Panabières Catherine , Staaf Johan , Ploeger Carolin , Lassen Ulrik , Le Tourneau Christophe , Lehtiö Janne , Ott Patrick A. , von Deimling Andreas , Fröhling Stefan , Voest Emile , Klauschen Frederick , Dienstmann Rodrigo , Alshibany Aisha , Siu Lillian L. , Stenzinger Albrecht
Published: August 2023

Precision cancer medicine is a multidisciplinary team effort that requires involvement and commitment of many stakeholders including the society at large. Building on the success of significant advances in precision therapy for oncological patients over the last two decades, future developments will be significantly shaped by improvements in scalable molecular diagnostics in which increasingly complex multilayered datasets require transformation into clinically useful information guiding patient management at fast turnaround times. Adaptive profiling strategies involving tissue‐ and liquid‐based testing that account for the immense plasticity of cancer during the patient's journey and also include early detection approaches are already finding their way into clinical routine and will become paramount. A second major driver is the development of smart clinical trials and trial concepts which, complemented by real‐world evidence, rapidly broaden the spectrum of therapeutic options. Tight coordination with regulatory agencies and health technology assessment bodies is crucial in this context. Multicentric networks operating nationally and internationally are key in implementing precision oncology in clinical practice and support developing and improving the ecosystem and framework needed to turn invocation into benefits for patients. The review provides an overview of the diagnostic tools, innovative clinical studies, and collaborative efforts needed to realize precision cancer medicine.
Disseminating cognitive behavioural therapy (CBT) for insomnia at scale: capitalising on the potential of digital CBT to deliver clinical guideline care
Authors: Espie Colin A. , Henry Alasdair L.
Published: August 2023

Cognitive behavioural therapy (CBT) is the recommended first‐line treatment for insomnia. However, guideline care is very seldom available and most patients receive no treatment, or less effective second‐line pharmacotherapy or sleep hygiene, neither of which are evidence‐based for chronic insomnia. The primary challenge for CBT has been supply. There are not enough therapists to meet the enormous demand. We must accelerate clinician training, but this approach can never be sufficient, even with abbreviated, efficient therapies. Fortunately, however, the treatment landscape has also changed dramatically. Fully‐automated digital CBT (dCBT) has emerged as a safe, effective, and scalable treatment delivery format. dCBT is software only, so it can be disseminated as readily and widely as sleep medication. Moreover, dCBT can be integrated into services. Just as medications can be delivered through health professionals and health systems, approved dCBT programmes can be the same. However, an ecosystem of psychologically‐based care should not necessitate a medical prescription model. Our proposed stepped care framework, comprises both population health and clinical health service initiatives, enabling universal access to guideline care for insomnia. The diverse ways in which CBT may be delivered (in‐person, face‐to‐face, using telehealth, group therapy, digitally) can operate congruently and efficiently to optimise treatment for people at all levels of complexity and need. With safe and clinically effective dCBT products now set to become established as treatments, clearly differentiated from wellness apps, there is potential to rapidly transform insomnia services and, for the first time, to deliver clinical guideline care at international scale.
Left atrial strain and ventricular global longitudinal strain in cirrhotic patients using the new criteria of Cirrhotic Cardiomyopathy Consortium
Authors: Skouloudi Marina , Bonou Maria S. , Adamantou Magdalini , Parastatidou Despoina , Kapelios Christos , Masoura Konstantina , Efstathopoulos Efstathios , Aggeli Constantina , Papatheodoridis George V. , Barbetseas John , Cholongitas Evangelos
Published: August 2023

Background

The new criteria of Cirrhotic Cardiomyopathy Consortium (CCC) propose the use of left ventricular global longitudinal strain (LV‐GLS) for evaluation of systolic function in patients with cirrhosis. The aim of this study was to evaluate LV‐GLS and left atrial (LA) strain in association with the severity of liver disease and to assess the characteristics of cirrhotic cardiomyopathy (CCM).

Methods

One hundred and thirty‐five cirrhotic patients were included. Standard echocardiography and speckle tracking echocardiography (2D‐STE) were performed, and dual X‐ray absorptiometry was used to quantify the total and regional fat mass. CCM was defined, based on the criteria of CCC, as having advanced diastolic dysfunction, left ventricular ejection fraction ≤50% and/or a GLS <18%.

Results

LV‐GLS lower or higher than the absolute mean value (22.7%) was not associated with mortality (logrank, p = 0.96). LV‐GLS was higher in patients with Model for end stage liver disease (MELD) score ≥15 compared to MELD score <15 (p = 0.004). MELD score was the only factor independently associated with systolic function (LV‐GLS <22.7% vs. ≥22.7%) (Odds Ratio:1.141, p = 0.032). Patients with CCM (n = 11) had higher values of estimated volume of visceral adipose tissue compared with patients without CCM (median: 735 vs. 641 cm3, p = 0.039). On multivariable Cox regression analysis, MELD score [Hazard Ratio (HR):1.26, p < 0.001] and LA reservoir strain (HR:0.96, p = 0.017) were the only factors independently associated with the outcome.

Conclusion

In our study, absolute LV‐GLS was higher in more severe liver disease, and LA reservoir strain was significantly associated with the outcome in patients with end‐stage liver disease.
Primary cauda equina lymphoma confirmed by autopsy: A case report
Authors: Ishizawa Keisuke , Komori Takashi , Shimazaki Rui , Nakata Yasuhiro , Tamaru Jun‐ichi , Sasaki Atsushi , Takahashi Kazushi
Published: August 2023

Compared with those involving the central nervous system, lymphomas involving the peripheral nervous system, namely neurolymphomatosis, are extremely rare. Neurolymphomatosis is classified as primary or secondary; the former is much rarer than the latter. Herein, we present an autopsied case of primary cauda equina lymphoma (PCEL), a type of primary neurolymphomatosis, with a literature review of autopsied cases of PCEL as well as primary neurolymphomatosis other than PCEL (non‐PCEL primary neurolymphomatosis). A 70‐year‐old woman presented with difficulty walking, followed by paraplegia and then bladder and bowel disturbance. On magnetic resonance imaging, the cauda equina was diffusely enlarged and enhanced with gadolinium. The brainstem and cerebellum were also enhanced with gadolinium along their surface. The differential diagnosis of the patient included meningeal tumors (other than lymphomas), lymphomas, or sarcoidosis. The biopsy of the cauda equina was planned for a definite diagnosis, but because the patient deteriorated so rapidly, it was not performed. Eventually, she was affected by cranial nerve palsies. With the definite diagnosis being undetermined, the patient died approximately 1.5 years after the onset of disesase. At autopsy, the cauda equina was replaced by a bulky mass composed of atypical B‐lymphoid cells, consistent with diffuse large B‐cell lymphoma (DLBCL). The spinal cord was heavily infiltrated, as were the spinal/cranial nerves and subarachnoid space. There was metastasis in the left adrenal. The patient was finally diagnosed postmortem as PCEL with a DLBCL phenotype. To date, there have been a limited number of autopsied cases of PCEL and non‐PCEL primary neurolymphomatosis (nine cases in all, including ours). The diagnosis is, without exception, B‐cell lymphoma including DLBCL, and the histology features central nervous system parenchymal infiltration, nerve root involvement, and subarachnoid dissemination (lymphomatous meningitis). Metastases are not uncommon. All clinicians and pathologists should be aware of lymphomas primarily involving the peripheral nervous system.
Using a handheldUVdevice for disinfection in the patient care environment: A descriptive qualitative study
Authors: Keene Robin , Chatterjee Piyali , Jinadatha Chetan , Williams Marjory
Published: August 2023

Frontline nurses play a critical role in the prevention of healthcare‐acquired infections (HAIs) through daily practices of hand hygiene and decontamination of surfaces. Despite these practices, environmental contamination and HAIs persist. Emerging use of UV light at wavelengths safe for human exposure provides additional strategies for disinfecting the patient care environment. The purpose of this qualitative study is to explore frontline nursing feedback regarding a novel handheld UV device prototype. A convenience sample of nurses were invited to participate in facilitated individual or small group discussions led by one member of the research team. Thematic analysis of discussion transcripts was completed by two members of the research team. Sixteen registered nurses participated. Four themes found in the study were time considerations, complexity, safety (patient and nurse), and characteristics of technology to improve patient care. Findings suggest that while nursing staff are willing to use technology, it must be considered valuable to patient care and should not hinder the provision of care. Inclusion of inputs from nursing staff for development of technology identifies potential barriers to acceptance and use in the practice environment.
Decolonial, intersectional pedagogies in Canadian Nursing and Medical Education
Authors: Bhandal Taqdir K. , Browne Annette J. , Ahenakew Cash , Reimer‐Kirkham Sheryl
Published: August 2023

Our intention is to contribute to the development of Canadian Nursing and Medical Education (NursMed) and efforts to redress deepening, intersecting health and social inequities. This paper addresses the following two research questions: (1) What are the ways in which Decolonial, Intersectional Pedagogies can inform Canadian NursMed Education with a focus on critically examining settler‐colonialism, health equity, and social justice? (2) What are the potential struggles and adaptations required to integrate Decolonial, Intersectional Pedagogies within Canadian NursMed Education in service of redressing intersecting health and social inequities? Briefly, Decolonial, Intersectional Pedagogies are philosophies of learning that encourage teachers and students to reflect on health through the lenses of settler‐colonialism, health equity, and social justice. Drawing on critical ethnographic research methods, we conducted in‐depth interviews with 25 faculty members and engaged in participant observation of classrooms in university‐based Canadian NursMed Education. The research findings are organized into three major themes, beginning with common institutional features influencing pedagogical approaches. The next set of findings addresses the complex strategies participants apply to integrate Decolonial, Intersectional Pedagogies. Lastly, the findings illustrate the emotional and spiritual toll some faculty members face when attempting to deliver Decolonial, Intersectional Pedagogies. We conclude that through the application of Decolonial, Intersectional Pedagogies teachers and students can support movements towards health equity, social justice, and unlearning/undoing settler‐colonialism. This study contributes new knowledge to stimulate dialog and action regarding the role of health professions education, specifically Nursing and Medicine as an upstream determinant of health in settler‐colonial nations such as Canada, United States, Australia, and New Zealand.
Effect of tidal volume change on pressure‐based prediction of fluid responsiveness in children
Authors: Ji Sang‐Hwan , Jang Young‐Eun , Park Jung‐Bin , Kang Pyoyoon , Cho Sung‐Ae , Kim Eun‐Hee , Lee Ji‐Hyun , Kim Hee‐Soo , Kim Jin‐Tae
Published: August 2023

Introduction

It is known that pulse pressure variation and systolic pressure variation cannot predict fluid responsiveness in children. In adults, the ability of these dynamic parameters to predict fluid responsiveness is improved by increasing tidal volume. We planned to investigate whether pulse pressure variation or systolic pressure variation can predict fluid responsiveness in children when augmented by increasing tidal volume by conducting a prospective study.

Methods

We enrolled children younger than 7 years who underwent cardiac surgery for atrial septal defect or ventricular septal defect. After sternum closure, pulse pressure variation and systolic pressure variation were continuously recorded while changing the tidal volume to 6, 10, and 14 mL/kg. Fluid loading was done with 10 mL/kg of crystalloids for 10 min, and stroke volume index was measured via transesophageal echocardiography. Children whose stroke volume index increased by more than 15% after the fluid loading were defined as responders to fluid therapy. We set primary outcome as the predictability of pulse pressure variation and systolic pressure variation for fluid responsiveness and measured the area under the curve of receiver operating characteristics curve.

Results

Twenty‐six children were included, of which 15 were responders. At the tidal volume of 14 mL/kg, the area under the curves of receiver operating characteristics curves of pulse pressure variation and systolic pressure variation were 0.576 (p = .517) and 0.548 (p = .678), respectively. The differences in dynamic parameters between responders and nonresponders were not significant.

Discussion

Failure of pulse pressure variation or systolic pressure variation at augmented tidal volume in children may be due to difference in their arterial compliance from those of adults. Large compliance of thoracic wall may be another reason.

Conclusions

Augmented pulse pressure variation or systolic pressure variation due to increased tidal volume cannot predict fluid responsiveness in children after simple cardiac surgery.
3. Pain originating from the lumbar facet joints
Authors: Van den Heuvel Sandra A. S. , Cohen Steven P. C. , de Andrès Ares Javier , Van Boxem Koen , Kallewaard Jan Willem , Van Zundert Jan
Published: August 2023

Introduction

Pain originating from the lumbar facets can be defined as pain that arises from the innervated structures comprising the joint: the subchondral bone, synovium, synovial folds, and joint capsule. Reported prevalence rates range from 4.8% to over 50% among patients with mechanical low back pain, with diagnosis heavily dependent on the criteria employed. In well‐designed studies, the prevalence is generally between 10% and 20%, increasing with age.

Methods

The literature on the diagnosis and treatment of lumbar facet joint pain was retrieved and summarized.

Results

There are no pathognomic signs or symptoms of pain originating from the lumbar facet joints. The most common reported symptom is uni‐ or bilateral (in more advanced cases) axial low back pain, which often radiates into the upper legs in a non‐dermatomal distribution. Most patients report an aching type of pain exacerbated by activity, sometimes with morning stiffness. The diagnostic value of abnormal radiologic findings is poor owing to the low specificity. SPECT can accurately identify joint inflammation and has a predictive value for diagnostic lumbar facet injections. After “red flags” are ruled out, conservatives should be considered. In those unresponsive to conservative therapy with symptoms and physical examination suggesting lumbar facet joint pain, a diagnostic/prognostic medial branch block can be performed which remains the most reliable way to select patients for radiofrequency ablation.

Conclusions

Well‐selected individuals with chronic low back originating from the facet joints may benefit from lumbar medial branch radiofrequency ablation.