bluuebunny/crossref_metadata_2025 huggingface dataset:
The effect of the right care, right place, right time (R3) initiative on Medicare health service use among older affordable housing residents
Authors: Tavares Jane , Simpson Liz , Miller Edward Alan , Nadash Pamela , Cohen Marc
Published: October 2022

Objective

To determine the effect of an affordable housing‐based supportive services intervention, which partnered with health and community service providers, on Medicare health service use among residents.

Data Sources

Analyses used aggregated fee‐for‐service Medicare claims data from 2017 to 2020 for beneficiaries living in 34 buildings in eastern Massachusetts.

Study Design

Using a quasi‐experimental design, a “difference‐in‐differences” framework was employed to isolate changes in outcomes, focusing on changes in pre‐ and post‐intervention health service use across two stages of the intervention. Phase 1 encompassed the initial implementation period, and Phase 2 introduced a strategy to target residents at high risk of poor health outcomes. Key health service outcomes included hospitalizations, 30‐day hospital readmission, and emergency department use.

Data Collection

Medicare claims data for 10,412 individuals were obtained from a Quality Improvement Organization and aggregated at the building level.

Principal Findings

Analyses for Phase 1 found that hospital admission rates, emergency department admissions and payments, and hospital readmission rates grew more slowly for intervention sites than comparison sites. These findings were strengthened after the introduction of risk‐targeting in Phase 2. Compared to selected control buildings, residents in intervention buildings experienced significantly lower rates of increases in inpatient hospitalization rates (−16% vs. +6%), hospital admission days (−25% vs. +29%), average hospital days (−12% vs. +14%), hospital admission payments (−22% vs. +33%), and 30‐day hospital readmission rates (−22% vs. +54%). When accounting for the older age of the intervention residents, the size of the decline recorded in emergency department admissions was 6.7% greater for the intervention sites than the decline in comparison sites.

Conclusions

A wellness‐focused supportive services intervention was effective in reducing select health service use. The introduction of risk‐targeting further strengthened this effect. Age‐friendly health systems would benefit from enhanced partnerships with affordable housing sites to improve care and reduce service use for older residents.
Effects of Medicare Advantage on preventive care use and health behavior
Authors: Park Sungchul
Published: October 2022

Objective

To examine the effects of Medicare Advantage (MA) enrollment on preventive care use and health behavior.

Data Sources

The Medicare Current Beneficiary Survey, the Area Health Resources File, the Geographic Variation Public Use File, and the Centers for Medicare and Medicaid Services annual risk and ratebook files for 2012–2016.

Study Design

Outcomes included 11 measures of preventive care use and six measures of health behavior. My primary independent variable was MA enrollment. For each outcome, I first conducted linear regression analysis while adjusting for individual‐level and county‐level characteristics. Then, I conducted the following alternative analyses to account for differences in observed and/or unobserved characteristics between MA and traditional Medicare (TM) enrollees: propensity score (PS) matching analysis and instrumental variable (IV) analysis.

Data Collection/Extraction Methods

I extracted 9399 MA enrollees and 15,543 TM enrollees.

Findings

Linear regression and PS matching analyses showed that MA enrollment was statistically significantly associated with higher likelihood of having blood pressure measurement, cholesterol measurement, and influenza vaccine, lower likelihood of receiving an HbA1C test, and higher likelihood of currently smoking. However, the magnitude of the associations was small. There were no statistically significant associations in other measures. IV analyses also found no or limited evidence that MA enrollment led to statistically significant changes in preventive care use and health behavior. Specifically, MA enrollment led to statistically significant improvements in the likelihood of doing any physical activities (1.29 [95% CI: 0.51–2.07]) or doing muscle‐strengthening activities (0.72 [95% CI: 0.03–1.41]). No statistically significant changes were observed in other measures.

Conclusions

MA plans may not necessarily increase the use of preventive services and improve health behaviors. As improvements in preventive services and health behavior may have the potential to achieve better outcomes while lowering costs, policy makers should consider developing targeted interventions for MA to achieve those improvements.
The rise and falls of electronic scooters: A Tasmanian perspective on electronic scooter injuries
Authors: Jamieson Jennifer , Hawkins Jenni , Collins Clare , Mahoney Adam
Published: October 2022

Objective

Electronic scooter (eScooter) popularity has soared, despite public concerns around injury risk. We aimed to explore the burden of injury from eScooters presenting to Tasmania's major trauma centre during the first 6 months of the Hobart eScooter trial.

Methods

We screened all ED presentations and interhospital transfers from 11 December 2021 to 26 June 2022 to identify eScooter‐associated injury. All injuries were coded using the Abbreviated Injury Scale and an Injury Severity Score (ISS) was computed for each presentation. Data were entered into the Tasmanian Trauma Registry and then exported into standard statistical software for descriptive analysis.

Results

There were 135 eScooter presentations to the ED and 31 were admitted. Patients were mostly young (median age 27 years) with an even sex distribution. Injuries were mostly minor (median ISS of 2) with injuries to soft tissues and the head and neck predominating. Approximately, one‐third required operative interventions, but none required intensive care. Injured patients were less likely to have been wearing protective gear (36% helmet wearing) and alcohol intoxication was common (41% overall, 71% admitted patients).

Conclusion

Overall, our 6‐month prospective dataset shows that the Hobart eScooter trial has been associated with few major injuries.
From signal to alert: A cluster of exposures to counterfeit alprazolam tablets containing five novel benzodiazepines
Authors: Syrjanen Rebekka , Schumann Jennifer , Hodgson Sarah E , Abouchedid Rachelle , Rotella Joe‐Anthony , Graudins Andis , Greene Shaun L
Published: October 2022

Objective

To illustrate the toxicosurveillance role of the Emerging Drugs Network of Australia – Victoria (EDNAV) project in informing timely harm minimisation interventions.

Methods

Utilisation of an ethics approved clinical registry storing de‐identified clinical and analytical data on Victorian ED illicit drug‐related presentations.

Results

In April 2022, six adults presented to hospital with varying levels of sedation, following the use of counterfeit benzodiazepines. Comprehensive toxicological analysis identified five separate novel benzodiazepines within blood samples from each patient. A public ‘Drug Alert’ was subsequently issued, and local emergency physicians were notified.

Conclusion

Toxicosurveillance projects, such as EDNAV, are critical to the continued monitoring and reporting of illicit substance use in the community.
Longer times in computed tomography for trauma patients result in a decrease in body temperature
Authors: Ong Qi‐Zheng , Vandewege Annelies , Ellis Daniel Y
Published: October 2022

Objective

To determine if lower ambient temperatures in computed tomography (CT) rooms contribute to accidental hypothermia (≤35°C) in trauma patients.

Methods

Prospective, observational study of trauma patients undergoing a CT scan at the Royal Adelaide Hospital.

Results

Among a cohort of 81 trauma patients, 54 met level 1 call‐out criteria. Mean time in CT was 11 min. Longer time spent in CT contributes to greater decrease in body temperature (∆T/t = −0.1483°C/min, P = 0.0026).

Conclusion

Increasing time spent in CT leads to a decrease in body temperature in trauma patients. Clinicians should actively reduce time spent in the CT room and take active warming measures.
Utility of prehospital call center ambulance dispatch data for COVID‐19 cluster surveillance: A retrospective analysis
Authors: Janagama Srinivasa Rao , Strehlow Matthew C. , Rao Ramana G. V. , Kohn Michael A. , Newberry Jennifer A.
Published: October 2022

Introduction

Cluster surveillance, identification, and containment are primary outbreak management techniques; however, adapting these for low‐ and middle‐income countries is an ongoing challenge. We aimed to evaluate the utility of prehospital call center ambulance dispatch (CCAD) data for surveillance by examining the correlation between influenza‐like illness (ILI)‐related dispatch calls and COVID‐19 cases.

Methods

We performed a retrospective analysis of state‐level CCAD and COVID‐19 data recorded between January 1 and April 30, 2020, in Telangana, India. The primary outcome was a time series correlation between ILI calls in CCAD and COVID‐19 case counts. Secondarily, we looked for a year‐to‐year correlation of ILI calls in the same period over 2018, 2019, and 2020.

Results

On average, ILI calls comprised 12.9% (95% CI 11.7%–14.1%) of total daily calls in 2020, compared to 7.8% (95% CI 7.6%–8.0%) in 2018, and 7.7% (95% CI 7.5%–7.7%) in 2019. ILI call counts from 2018, 2019, and 2020 aligned closely until March 19, when 2020 ILI calls increased, representing 16% of all calls by March 23 and 27.5% by April 7. In contrast to the significant correlation observed between 2020 and previous years' January–February calls (2020 and 2019—Durbin‐Watson test statistic [DW] = 0.749, p < 0.001; 2020 and 2018—DW = 1.232, p < 0.001), no correlation was observed for March–April calls (2020 and 2019—DW = 2.012, p = 0.476; 2020 and 2018—DW = 1.820, p = 0.208). In March–April 2020, the daily reported COVID‐19 cases by time series significantly correlated with the ILI calls (DW = 0.977, p < 0.001). The ILI calls on a specific day significantly correlated with the COVID‐19 cases reported 6 days prior and up to 14 days after (cross‐correlation > 0.251, the 95% upper confidence limit).

Conclusions

The statistically significant time series correlation between ILI calls and COVID‐19 cases suggests prehospital CCAD can be part of early warning systems aiding outbreak cluster surveillance, identification, and containment.
Comparison of the diagnostic performance of changes in signal intensity and volume from multiparametric MRI for assessing response of rectal cancer to neoadjuvant chemoradiotherapy
Authors: Tan Zhengwu , Cheng Lan , Xie Lingling , Zhang Lan , Lin Zhenyu , Han Ping , Li Xin
Published: October 2022

Aim

To evaluate the change in signal intensity (SI) and volume (V) from multiparametric magnetic resonance imaging (MRI) for assessing the response of locally advanced rectal cancer (LARC) to chemoradiotherapy (CRT).

Materials and methods

Eight‐two LARC patients who underwent pre‐ and post‐CRT T2‐weighted (T2W), apparent diffusion coefficient (ADC), and contrast‐enhanced T1‐weighted (ceT1W) MRI were retrospectively analyzed. The change of volume (%△V) and relative SI ratio (%△SIR) from each sequence were determined. All LARCs were confirmed pathologically and classified as tumor regression grade (TRG) ‐0, 1, 2,or 3. Descriptive statistics and receiver operating characteristic (ROC) analysis, with calculation of area under the curve (AUC), were used to compare the diagnostic performances.

Results

Sixteen patients had TRG‐0, 15 had TRG‐1, 35 had TRG‐2, and 16 had TRG‐3. Except for ADC‐%△SIR, the remaining %△V and %△SIR values on MR sequences had significant differences among the four groups. The %△V and %△SIR (alone or together) did not distinguish TRG‐1 from TRG‐2, nor TRG‐2 from TRG‐3; however, differences between other TRGs were identified by %△V and %△SIR. The combined use of ADC‐%△V and T2W‐%△SIR provided the best diagnostic performance in distinguishing of TRG‐0 from TRG‐2 (AUC: 0.954) and from TRG‐3 (AUC: 1.000).

Conclusions

Preoperative MRI of LARC patients after CRT has high diagnostic value for determination TRG, and may therefore improve the selection of patients most suitable for surgery.
Stereotype content of players of violent and non‐violent games
Authors: Miriyagalla Upekha Pathumi , Kashima Emiko S. , Stukas Arthur
Published: October 2022

Since the introduction of commercial video games in the 1970s, video game players have attracted the perhaps undeserving but negative stereotype of being unpopular and socially dysfunctional. However, with gamers increasing in numbers that now reach billions worldwide, the contents of gamer stereotypes may be in flux. The current study investigated the content of gamer stereotypes along the dimensions of physical/social attractiveness, warmth, competence, and morality as a function of genre violence level and gamer identity. Male and female participants (656 U.S. and 428 Indian) completed an online survey on the MTurk platform, rating social stereotypes of gamers in high‐violence and low‐violence genres on 22 adjective pairs and answering questions about gamer identity. Results revealed positive gamer stereotypes, especially in the low‐violence genres in both the United States and India. Low‐identifiers' stereotypes were less favourable in the high‐violence than in the low‐violence genres; this tendency diminished among high‐identifiers. This study suggests that, whereas once gamers were seen negatively, they are now seen remarkably positively. The implications of such positive views of those engaging in violent gaming are discussed.
Outcomes of systemic bivalirudin and sodium bicarbonate purge solution for Impella 5.5
Authors: Bashline Michael , DiBridge Julie , Klass Wyatt J. , Morelli Brian , Kaczorowski David , Schmidhofer Mark , Horn Edward T. , Gomez Hernando , Ramanan Raj , Hickey Gavin W. , Rivosecchi Ryan M.
Published: October 2022

Background

Impella 5.5 (Abiomed; Danvers, MA) (IMP5) is a commonly used, surgically implanted, tMCS device that requires systemic anticoagulation and purge solution to avoid pump failure. To avoid heparin‐induced thrombocytopenia (HIT) from unfractionated heparin (UFH) use, our program has explored the utility of bivalirudin (BIV) for systemic anticoagulation and sodium bicarbonate‐dextrose purge solution (SBPS) in IMP5.5.

Methods

This single center, retrospective study included 34 patients supported on IMP5.5 with BIV based AC and SBPS between December 1st 2020 to December 1st 2021.The efficacy and safety end points were incidence of development of HIT, Tissue Plasminogen Activator (tPA) use for suspected pump thrombosis, stroke, and device failure as well as clinically significant bleeding.

Results

The median duration of IMP5.5 support was 9.8 days (IQR: 6–15). Most patients were bridged to HTX (58%) followed by recovery (27%) and LVAD implantation (15%). Patients were therapeutic on bivalirudin for 64% of their IMP5.5 support. One patient (2.9%) suffered from ischemic stroke and 26.5% (9) patients developed clinically significant bleeding. tPA was administered to 7(21%) patients. One patient in the entire cohort developed HIT.

Conclusions

Our experience supports the use of systemic BIV and SBPS as a method to avoid heparin exposure in a patient population predisposed to the development of HIT.
Editorial: differences in altered duodenal T‐cell immunology in alcoholic liver damage versus NAFLD
Authors: Francque Sven M. A.
Published: October 2022

LINKED CONTENT

This article is linked to Maccioni et al papers. To view these articles, visit https://doi.org/10.1111/apt.17177
Letter: what explains improved survival from statin exposure after liver transplantation?
Authors: Zhou Guang‐Peng , Jiang Yi‐Zhou , Sun Li‐Ying , Zhu Zhi‐Jun
Published: October 2022

LINKED CONTENT

This article is linked to Becchetti et al. papers. To view these articles, visit https://doi.org/10.1111/apt.17192 and https://doi.org/10.1111/apt.17245
Letter: Autoimmune hepatitis and metabolic syndrome‐associated disease development – a US cohort study
Authors: Deng Liling , Deng Wuquan
Published: October 2022

LINKED CONTENT

This article is linked to Jalal et al papers. To view these articles, visit https://doi.org/10.1111/apt.17191
Letter: comedication use and dementia risk in patients with inflammatory bowel disease
Authors: Chang Hui‐Chin , Gau Shuo‐Yan
Published: October 2022

LINKED CONTENT

This article is linked to Rønnow Sand et al papers. To view these articles, visit https://doi.org/10.1111/apt.17119 and https://doi.org/10.1111/apt.17249
Letter: what explains improved survival from statin exposure after liver transplantation? Authors' reply
Authors: Becchetti Chiara , Dirchwolf Melisa , Schropp Jonas , Berzigotti Annalisa , Bosch Jaime
Published: October 2022

LINKED CONTENT

This article is linked to Becchetti et al papers. To view these articles, visit https://doi.org/10.1111/apt.17192 and https://doi.org/10.1111/apt.17228
Remote graphic elicitation: A critical reflection on the emotional affordance and disruption management in caregiver research
Authors: Lowe Thomas A. , Osborne Tess , Bell Sarah
Published: October 2022

Graphic elicitation, an arts‐based method that focuses on participant‐led drawing activities, is often conducted with the researcher in situ and discussed in an interview setting, either during or after drawing. However, the COVID‐19 pandemic and the subsequent lockdowns have meant that using graphic elicitation in its current form required a re‐evaluation. Reflecting on a research project that undertook graphic elicitation remotely, this paper considers the emotional affordance and disruption management of the method in caregiver research. While informal caregiving may be an emotionally fraught topic for the participants, we demonstrate how graphic elicitation explores emotions and experiences with sensitivity and care. Furthermore, we show that graphic elicitation enabled us to acknowledge the pandemic but maintain focus on caregiving itself. The caregivers were responsive to the method and found it rewarding and insightful, albeit with some initial hesitancy and ingrained perceptions of arts‐based outputs. Through our discussions, we show the potential for remote graphic elicitation in geography as a method to explore potentially sensitive, emotionally charged topics like caregiving.
Deceitful when insecure: The effect of self‐efficacy beliefs on the use of deception in negotiations
Authors: Sobral Filipe , Tavares Gustavo Moreira , Furtado Liliane , Lagowska Urszula , Neto José Andrade Moura
Published: October 2022

This article investigates if and how negotiators' self‐efficacy beliefs affect their use of deception in negotiation. Specifically, we propose that self‐efficacy can be interpreted as a threat to self‐concept, which encourages individuals to temporarily bypass self‐regulatory obstacles by morally disengaging their cognitive moral filters, thereby enabling them to use deception in negotiation. We test our hypotheses in three independent experimental studies involving an interactive negotiation simulation, totalizing 460 participants. We find that negotiators with low self‐efficacy regarding their negotiation abilities are more likely to use deception than those with high self‐efficacy beliefs. Furthermore, we find that moral disengagement mediates the effects of self‐efficacy on deception. Our findings suggest that self‐efficacy plays a key role in shaping negotiators' ethical behaviors and we identify the psychological mechanism underlying this relationship.
How ethical and political identifications drive adaptive behavior in the digital piracy context
Authors: Miocevic Dario , Kursan Milakovic Ivana
Published: October 2022

Today, digital piracy remains a growing challenge for both legislators and businesses operating in the entertainment industry. This study explores when and why consumers make trade‐offs between illegal and legal streaming services. By drawing on protection motivation theory, we find that consumers' threat and coping appraisals increase their adaptive behavior, i.e., lower intention to consume illegal and higher intention to consume legal streaming services. We also show that the strength of consumers' inherent ethical (relativism) and political (economic liberalism) identities conditions adaptive behavior through social identity theory. We find that low relativism strengthens the adaptive behavior through threat appraisal, while economic liberalism strengthens the adaptive behavior through coping appraisal. Our robustness checks show that these results hold when the model accounts for the level of consumers' digital piracy attitudes. We used a scenario‐based approach to test our hypotheses and surveyed 244 consumers who use streaming services. Our study contributes to the literature by showing that consumers' adaptive behavior envisioned through protection motivation theory can be weakened or strengthened by their ethical and political identities.
Brain‐specific loss of Abcg1 disturbs cholesterol metabolism and aggravates pyroptosis and neurological deficits after traumatic brain injury
Authors: Xu Heng , Zheng Le‐xin , Chen Xue‐Shi , Pang Qiu‐yu , Yan Ya‐nan , Liu Rong , Guo Han‐mu , Ren Zhi‐yang , Yang Yan , Gu Zhi‐ya , Gao Cheng , Gao Yuan , Luo Cheng‐liang , Zhao Ying , Wang Ying , Wang Tao , Tao Lu‐yang
Published: October 2022

Based on accumulating evidence, cholesterol metabolism dysfunction has been suggested to contribute to the pathophysiological process of traumatic brain injury (TBI) and lead to neurological deficits. As a key transporter of cholesterol that efflux from cells, the ATP‐binding cassette (ABC) transporter family exerts many beneficial effects on central nervous system (CNS) diseases. However, there is no study regarding the effects and mechanisms of ABCG1 on TBI. As expected, TBI resulted in the different time‐course changes of cholesterol metabolism‐related molecules in the injured cortex. Considering ABCG1 is expressed in neuron and glia post‐TBI, we generated nestin‐specific Abcg1 knockout (Abcg1‐KO) mice using the Cre/loxP recombination system. These Abcg1‐KO mice showed reduced plasma high‐density lipoprotein cholesterol levels and increased plasma lower‐density lipoprotein cholesterol levels under the base condition. After TBI, these Abcg1‐KO mice were susceptible to cholesterol metabolism turbulence. Moreover, Abcg1‐KO exacerbated TBI‐induced pyroptosis, apoptosis, neuronal cell insult, brain edema, neurological deficits, and brain lesion volume. Importantly, we found that treating with retinoid X receptor (RXR, the upstream molecule of ABCG1) agonist, bexarotene, in Abcg1‐KO mice partly rescued TBI‐induced neuronal damages mentioned above and improved functional deficits versus vehicle‐treated group. These data show that, in addition to regulating brain cholesterol metabolism, Abcg1 improves neurological deficits through inhibiting pyroptosis, apoptosis, neuronal cell insult, and brain edema. Moreover, our findings demonstrate that the cerebroprotection of Abcg1 on TBI partly relies on the activation of the RXRalpha/PPARgamma pathway, which provides a potential therapeutic target for treating TBI.
Identification of a novel target of SETD1A histone methyltransferase and the clinical significance in pancreatic cancer
Authors: Ishii Takeshi , Akiyama Yoshimitsu , Shimada Shu , Kabashima Ayano , Asano Daisuke , Watanabe Shuichi , Ishikawa Yoshiya , Ueda Hiroki , Akahoshi Keiichi , Ogawa Kosuke , Ono Hiroaki , Kudo Atsushi , Tanabe Minoru , Tanaka Shinji
Published: October 2022

Although histone H3K4 methyltransferase SETD1A is overexpressed in various cancer types, the molecular mechanism underlying its overexpression and its target genes in pancreatic ductal adenocarcinoma (PDAC) remain unclarified. We conducted immunohistochemical staining for SETD1A in 105 human PDAC specimens to assess the relationship between SETD1A overexpression and clinicopathological features. The function and target genes of SETD1A were investigated using human pancreatic cancer cell lines. SETD1A expression was upregulated in 51.4% of patients with PDAC and was an independent prognostic factor associated with shorter disease‐free survival after resection (p < 0.05). Knockdown and overexpression of SETD1A showed that SETD1A plays a crucial role in increasing the proliferation and motility of PDAC cells. SETD1A overexpression increased tumorigenicity. RNA sequencing of SETD1A‐knockdown cells revealed downregulation of RUVBL1, an oncogenic protein ATP‐dependent DNA helicase gene. ChIP analysis revealed that SETD1A binds to the RUVBL1 promoter region, resulting in increased H3K4me3 levels. Knockdown of RUVBL1 showed inhibition of cell proliferation, migration, and invasion of PDAC cells, which are similar biological effects to SETD1A knockdown. High expression of both SETD1A and RUVBL1 was an independent prognostic factor not only for disease‐free survival but also for overall survival (p < 0.05). In conclusion, we identified RUVBL1 as a novel downstream target gene of the SETD1A‐H3K4me3 pathway. Co‐expression of SETD1A and RUVBL1 is an important factor for predicting the prognosis of patients with PDAC.
Effects of aromatase inhibitor therapy on visceral adipose tissue area and cardiometabolic health in postmenopausal women with early and locally advanced breast cancer
Authors: Cheung Yee‐Ming M. , Hoermann Rudolf , Van Karen , Wu Damian , Healy Jenny , Chao Michael , White Shane , Yeo Belinda , Zajac Jeffrey , Grossmann Mathis
Published: October 2022

Objective

Aromatase inhibitor (AI) therapy provides oncological benefits in postmenopausal women with oestrogen receptor‐positive breast cancer. However, AI treatment has been associated with increased cardiovascular risk. In nonbreast cancer populations, experimentally induced low oestrogen states and natural transition to menopause have been associated with increases in visceral adipose tissue (VAT), a known surrogate marker for cardiometabolic risk. Given that AI treatment blocks oestradiol production, we hypothesized that AI treatment would increase VAT.

Methods

We conducted a prospective 12‐month cohort study of 52 postmenopausal women newly initiating AI treatment (median age: 64.5 years) and 52 women with breast pathology not requiring endocrine therapy (median age: 63.5 years). VAT area and other body composition parameters were measured at baseline, 6 months and 12 months using dual X‐ray absorptiometry. Other risk markers of cardiometabolic health were also assessed.

Results

In women initiating AI treatment, there was no statistically significant difference in VAT area after 12 months when compared to controls, with a mean adjusted difference of −5.00 cm2 (−16.9, 6.91), p = .55. Moreover, changes in total fat mass, lean mass, subcutaneous adipose tissue area, hepatic steatosis and measures in endothelial function were also not statistically different between groups after 12 months. Findings were similar after adjustments for activity levels and coronavirus disease 2019 lockdown duration.

Conclusions

These data provide reassurance that over the initial 12 months of AI therapy, AI treatment is not associated with metabolically adverse changes in body composition, hepatic steatosis or vascular reactivity. The impact of extended AI therapy on cardiometabolic health requires further study.
Pairwise comparison of hydrochlorothiazide and chlorthalidone responses among hypertensive patients
Authors: Chekka Lakshmi Manasa S. , Cooper‐DeHoff Rhonda M. , Gums John G. , Chapman Arlene B. , Johnson Julie A.
Published: October 2022

This study conducted a pairwise comparison of antihypertensive and metabolic effects of hydrochlorothiazide (HCTZ) and chlorthalidone (CTD) at 25 mg/day in the same individuals to address the clinical dilemma on preferred thiazide for hypertension (HTN) management. We included 15 African American (AA) and 35 European American (EA) patients with HTN treated with HCTZ and CTD as part of the Pharmacogenomic Evaluation of Antihypertensive Responses (PEAR) and PEAR‐2 trials, respectively. Mean reduction in systolic/diastolic blood pressure (SBP/DBP) with HCTZ versus CTD was 8/5 versus 16/8 mmHg among EA patients (p < 1.0e−5 SBP, p = 0.002 DBP) and 11/8 versus 20/11 mmHg among AA patients (p = 0.03 SBP, p = 0.22 DBP). While CTD showed clinically meaningful benefit over HCTZ in two‐thirds of participants with respect to SBP reduction and half of EA patients with respect to DBP reduction, a majority of AA patients (53%) showed similar DBP reduction with both thiazides. Sixty percent of AA patients and 29% of EA patients attained blood pressure (BP) <140/90 mmHg with both thiazides. Mean potassium (K+) reduction was greater with CTD compared to HCTZ both in EA patients (mean difference = 0.35, p = 0.0002) and AA patients (0.49, p = 0.043). While 31% of AA patients developed severe hypokalemia on CTD, <5% of others developed severe hypokalemia. Although 46% of AA patients on CTD required K+ supplementation, only 6%–11% of others required supplementation. Overall, in the majority of EA patients, CTD was superior to HCTZ, whereas among AA patients, it was superior in a minority, and was associated with significant potassium‐related risk, suggesting that guideline preferences for CTD over HCTZ are reasonable in EA patients but may be less reasonable in AA patients, particularly if the target is <140/90 mmHg.
Screening and characterization of myositis‐related autoantibodies in COVID‐19 patients
Authors: Teo Kai‐Fa , Chen Der‐Yuan , Hsu Jeh‐Ting , Lai Yi‐Hua , Chang Ching‐Kun , Hsueh Po‐Ren , Lan Joung‐Liang , Hsu Jye‐Lin
Published: October 2022

An efficient host immune response against severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2, COVID‐19) appears to be crucial for controlling and resolving this viral infection. However, many studies have reported autoimmune characteristics in severe COVID‐19 patients. Moreover, clinical observations have revealed that COVID‐19‐associated acute distress respiratory syndrome shares many features in common with inflammatory myopathy including interstitial lung disease (ILD), most particularly rapidly progressive (RP)‐ILD. This study explored this phenomenon by seeking to identify and characterize myositis‐specific and related autoantibodies in 25 COVID‐19 patients with mild or severe symptoms. Line blot analysis with the EUROLINE Myopathies Ag kit identified 9 (36%) patients with COVID‐19 with one or more autoantibodies against several myositis‐related antigens (Jo‐1, Ku, Mi‐2β, PL‐7, PL‐12, PM‐Scl 75, PM‐Scl 100, Ro‐52, and SRP); no anti‐MDA5 antibodies were detected. As the presence of antibodies identified by line blots was unrelated to disease severity, we further characterized the autoantibodies by radioimmunoassay, in which [35S]methionine‐labeled K562 cellular antigens were precipitated and visualized by gel electrophoresis. This result was confirmed by an immunoprecipitation assay and immunoblotting; 2 patients exhibited anti‐Ku70 and anti‐Ku80 antibodies. Our data suggest that it is necessary to use more than one method to characterize and evaluate autoantibodies in people recovered from COVID‐19, in order to avoid misinterpreting those autoantibodies as diagnostic markers for autoimmune diseases.
Extramammary myofibroblastoma of the oral cavity
Authors: Weigelt Maximillian A. , Franklin Matthew J. , Patel Manojkumar T. , Bergfeld Wilma F.
Published: October 2022

Myofibroblastoma is a rare, benign mesenchymal tumor first described as a neoplasm of the breast. Extramammary myofibroblastoma is a histopathologically and genetically identical lesion occurring outside the breast. Herein is presented a case of extramammary myofibroblastoma arising in the oral cavity. A 59‐year‐old woman presented with a 1.5 cm nodule on the buccal surface of the lower lip. Wide local excision was performed. Histopathologic examination revealed haphazard fascicles of monomorphic spindle cells with hyalinized collagen bundles without fat. The spindled cells were diffusely positive for CD34, and focally for progesterone receptor. Desmin, smooth muscle actin, estrogen receptor, androgen receptor, S100, and STAT6 were negative. Rb1 expression was lost in tumor cells. Thus, the diagnosis of extramammary myofibroblastoma was made. Differential diagnoses include spindle‐cell lipoma and angiofibroma. All three tumors are members of the 13q14 deletion/RB1 loss family. Indolent but locally aggressive (solitary fibrous tumor, desmoid fibromatosis) and frankly malignant (low‐grade peripheral nerve sheath tumor, dermatofibrosarcoma protuberans) entities can be excluded by immunohistochemistry and careful microscopic examination. Extensive sampling extramammary myofibroblastoma is important to exclude the possibility of malignancy. Clinicians and pathologists alike should be aware of this entity and its potential to arise rarely in unusual locations.
Diabetes mellitus and the risk of post‐acute COVID‐19 hospitalizations—a nationwide cohort study
Authors: Nørgård Bente Mertz , Zegers Floor Dijkstra , Juhl Claus Bogh , Kjeldsen Jens , Nielsen Jan
Published: October 2022

Aims

This cohort study, based on Danish health registers, examined the post‐acute consequences of hospitalization for COVID‐19 in patients with diabetes.

Methods

The study population comprised all Danish citizens (≥18 years old) who had diabetes when the pandemic started. A patient was exposed if he/she had a hospitalization with COVID‐19 after 1 March 2020. A patient was unexposed when he/she was not hospitalized with COVID‐19 between 1 March 2020 and the end of follow‐up (4 January 2022), or the first registered event of interest. The outcomes included post‐COVID‐19 hospitalizations and death. We used a Cox proportional hazards model with time varying exposure estimating the hazards ratio (HR) to analyze if the hazard for an outcome of interest was impacted by being hospitalized with COVID‐19.

Results

In patients with type 1 diabetes, 101 were hospitalized with COVID‐19, and 25,459 were not. We did not have sufficient statistical power to identify differences in risk for those with type 1 diabetes. In type 2 diabetes, 1515 were hospitalized with COVID‐19, and 95,887 were not. The adjusted HRs of post‐acute hospitalization for respiratory diseases and infections were 1.71 (95% CI 1.45–2.03) and 1.87 (95% CI 1.61–2.18), respectively. The HR of death was 2.05 (95% CI 1.73–2.43). Patients with uncertain type had results similar to those with type 2 diabetes.

Conclusions/Interpretation

In type 2 diabetes and diabetes of uncertain type, hospitalization with COVID‐19 was associated with an increased risk of post‐acute hospitalization for respiratory diseases, infections and death.
Evaluation of a broken instrument removal training course for general dentistry residents
Authors: Xie Kexian , Li Yuangao , Wang Xiao
Published: October 2022

Introduction

To help general dentistry residents better manage the intracanal broken instrument situation, we introduced a hands‐on training course into the endodontic curriculum of a general dentistry residency programme.

Materials and Methods

Thirty general dentistry residents and 30 residents with endodontic specialty training background in a general hospital served as the experimental group and reference group, respectively. The experimental group underwent a training course including a 30‐min lecture and two hands‐on sessions (2 h each). After the course, residents from both groups were asked to perform the instrument removal procedure on simulated root canals. Success rate, procedure time and canal volume change were compared between groups. Questionnaire results were also analysed.

Results

All residents successfully managed to remove the broken instruments in the test. Procedure time was significantly longer for general dentistry residents (15.8 ± 5.7 min vs 13.7 ± 4.5 min, Mann–Whitney U test, p = .038). Canal volume change was significantly greater for general dentistry residents (8.53 ± 3.82 μl vs 5.94 ± 2.73 μl, independent‐samples t‐test, p = .004). In the questionnaires, trainees gave overall positive ratings for the course. The marginal homogeneity test on before and after scores of the questionnaire items showed the training helped the trainees to reduce the stress level associated with instrument breakage (p < .001). It also motivated the trainees to remove the broken instrument in some straightforward cases (p < .001).

Conclusion

The broken instrument removal training course could help the general dentistry residents better manage the intracanal broken instrument situation.
Improving dental student confidence through the use of simulated patient cases
Authors: Marsden Jonathan E. , Deboo Stephen P. , Cripps Matt , Longridge Nicholas N. , Aspden Michael , Fox Kathryn
Published: October 2022

Introduction

This study investigates whether student confidence could be improved through the use of simulated patient case‐based scenarios.

Materials and Methods

Students in their 4th and 5th year of undergraduate study completed an online e‐portfolio workbook consisting of activities related to five simulated patient cases. Following completion of the relevant learning activities within the e‐portfolio, students then viewed a tutor case presentation video and attended simulated clinic sessions to complete corresponding exercises involving 3D‐printed teeth related to the case. Subsequently, students undertook online self‐reflection and goal‐setting activities to aid their development. An anonymous questionnaire was distributed to all participants to gain insight into the themes of student confidence and learning support. The Cronbach's Alpha coefficient was calculated for both sections of the student questionnaire. The values for “student confidence” and “learning support” were α = 0.91 and α = 0.87, respectively.

Results

There was a total of 89 valid student responses to the questionnaire (65%). A Spearman's correlation of rs = 0.50 (p < .001) suggests a tentative causative correlation between the learning support offered through the simulated patient cases and student confidence. There was a positive directional relationship between engagement with the learning support of the simulated patient cases and student confidence scores.

Conclusion

Student confidence increased following the completion of simulated patient cases and students found the learning support offered beneficial to their development. This learning intervention has the potential to improve student self‐efficacy, develop contextual competency and facilitate reflective practice. Simulated patient cases may be a useful precursor or adjunct to traditional patient clinics.
Prognostic scores in status epilepticus: A systematic review and meta‐analysis
Authors: Yuan Fang , Damien Charlotte , Gaspard Nicolas
Published: October 2022

The performance of prognostic scores of status epilepticus (SE) has been reported in very heterogeneous cohorts. We aimed to provide a summary of the available evidence on their respective performance. PubMed and EMBASE were searched for relevant articles. Studies were reviewed for eligibility for meta‐analysis of the area under the receiver‐operating characteristic curve (AUC) and for meta‐analysis of sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) in predicting in‐hospital mortality with scores in which at least two external evaluations had been published. This study was registered with PROSPERO (international prospective register of systematic reviews) (CRD42022325766). Study quality was assessed using Prediction model Risk Of Bias ASsessment Tool (PROBAST). In the meta‐analysis of AUC, 21 studies were pooled for STESS (Status Epilepticus Severity Score), five for EMSE‐EAC (Epidemiology‐based Mortality Score in Status Epilepticus ‐ Etiology, Age, level of Consciousness), five for EMSE‐EACE (EMSE ‐ Etiology, Age, level of Consciousness, EEG), and two for ENDIT (Encephalitis, nonconvulsive status epilepticus, Diazepam resistance, Imaging abnormalities, Tracheal intubation). The pooled AUC of STESS, EMSE‐EAC, EMSE‐EACE, and ENDIT was 0.74 (95% CI: 0.71–0.78), 0.68 (95% CI 0.63–0.72), 0.77 (95% CI: 0.72–0.81), and 0.78 (95% CI: 0.70–0.87), respectively. The pooled sensitivity of STESS‐3, STESS‐4, EMSE‐EACE‐64, and ENDIT‐4 was 0.83 (95% CI: 0.80–0.86), 0.60 (95% CI: 0.55–0.65), 0.76 (95% CI: 0.67–0.83), and 0.70 (95% CI: 0.55–0.82), respectively. Their pooled specificity was 0.50 (95% CI: 0.48–0.52), 0.74 (95% CI: 0.72–0.76), 0.63 (95% CI: 0.59–0.67), and 0.65 (95% CI: 0.61–0.70), respectively. Their pooled PPV was 0.27 (95% CI: 0.24–0.30), 0.35 (95% CI: 0.29–0.41), 0.33 (95% CI: 0.24–0.43), and 0.20 (95% CI: 0.13–0.27). Their pooled NPV was 0.94 (95% CI: 0.93–0.96), 0.90 (95% CI: 0.89–0.92), 0.89 (95% CI: 0.80–0.98), and 0.95 (95% CI: 0.92–0.98). Variations in performance were observed in patients' subgroups, such as critically ill patients and refractory cases. Investigated scores only have acceptable AUC, sensitivity, and specificity for predicting in‐hospital mortality, with the EMSE‐EAC having a lower discriminative power. STESS‐3 has the highest sensitivity, and STESS‐4 the highest specificity, but neither combines acceptable sensitivity and specificity. All these scores had high NPV but very low PPV. Caution should be exercised in their clinical use. Further studies are required to develop more accurate scores.
Getting the clock back on its feet: targeting the circadian clock to treat osteoarthritis
Authors: Mortimer Thomas
Published: October 2022

Growing evidence suggests that circadian clock dysfunction may contribute to the pathology of osteoarthritis. In this issue, He et al. use in vivo and human‐derived osteoarthritis models to demonstrate the therapeutic potential of pharmacologically manipulating components of the cartilage circadian clock. In doing so, the authors provide an important proof‐of‐principle supporting circadian clock‐targeted therapy as a treatment option for osteoarthritis.

Comment on: https://doi.org/10.1111/febs.16601
Capacity of deep‐sea corals to obtain nutrition from cold seeps aligned with microbiome reorganization
Authors: Osman Eslam O. , Vohsen Samuel A. , Girard Fanny , Cruz Rafaelina , Glickman Orli , Bullock Lena M. , Anderson Kaitlin E. , Weinnig Alexis M. , Cordes Erik E. , Fisher Charles R. , Baums Iliana B.
Published: October 2022

Cold seeps in the deep sea harbor various animals that have adapted to utilize seepage chemicals with the aid of chemosynthetic microbes that serve as primary producers. Corals are among the animals that live near seep habitats and yet, there is a lack of evidence that corals gain benefits and/or incur costs from cold seeps. Here, we focused on Callogorgia delta and Paramuricea sp. type B3 that live near and far from visual signs of currently active seepage at five sites in the deep Gulf of Mexico. We tested whether these corals rely on chemosynthetically‐derived food in seep habitats and how the proximity to cold seeps may influence; (i) coral colony traits (i.e., health status, growth rate, regrowth after sampling, and branch loss) and associated epifauna, (ii) associated microbiome, and (iii) host transcriptomes. Stable isotope data showed that many coral colonies utilized chemosynthetically derived food, but the feeding strategy differed by coral species. The microbiome composition of C. delta, unlike Paramuricea sp., varied significantly between seep and non‐seep colonies and both coral species were associated with various sulfur‐oxidizing bacteria (SUP05). Interestingly, the relative abundances of SUP05 varied among seep and non‐seep colonies and were strongly correlated with carbon and nitrogen stable isotope values. In contrast, the proximity to cold seeps did not have a measurable effect on gene expression, colony traits, or associated epifauna in coral species. Our work provides the first evidence that some corals may gain benefits from living near cold seeps with apparently limited costs to the colonies. Cold seeps provide not only hard substrate but also food to cold‐water corals. Furthermore, restructuring of the microbiome communities (particularly SUP05) is likely the key adaptive process to aid corals in utilizing seepage‐derived carbon. This highlights that those deep‐sea corals may upregulate particular microbial symbiont communities to cope with environmental gradients.
Afterword: Rising temperatures
Authors: Kennedy‐Pipe Caroline , Depledge Duncan
Published: October 2022

This piece reviews the contributions of this special edition noting comments and insights into the rapidly changing politics of the Arctic. It highlights how the recent Russian invasion of Ukraine has had a profound impact on the High North, its peoples and its security.
Foreword: Rising temperatures
Authors: Kennedy‐Pipe Caroline , Depledge Duncan
Published: October 2022

As an introduction to a special section on remote politics in the Arctic. We introduce how the various authors have analysed the consequences of a warming Arctic for the peoples who inhabit it and for those states seeking to retain or expand influence in this resource‐rich region. We hope to start a conversation between scholars in International Relations and those in Geography to understand this rapdily warming region.
Diversification increases the resilience of European grassland‐based systems but is not a one‐size‐fits‐all strategy
Authors: Dumont Bertrand , Franca Antonello , López‐i‐Gelats Feliu , Mosnier Claire , Pauler Caren M.
Published: October 2022

Diversification of grassland‐based systems is highly valued in agroecology, organic farming and other forms of regenerative agriculture. For lowlands, mountain and Mediterranean areas, we illustrate that diversification of grassland types, livestock species, products and farm labour allows coping with market, climatic and workforce‐related risks. However, diversification is not a one‐size‐fits‐all strategy and the type of diversification strategy should be adapted according to socio‐economic, structural, technical and pedoclimatic conditions of each farm. Farmers' technical skills and ability to re‐organise and monitor the system must be considered to avoid ineffectiveness of the diversified system. Moreover, it is essential to account for site‐specific conditions so that the ecological processes to be optimised can provide the expected benefits. Diversification occurs on different levels, from grassland management to the entire farm activity. There may be trade‐offs among these different levels impairing grassland ecosystem services. For instance, if diversification of farm activities dilutes the workforce, simplified grassland management can lead to the loss of vegetation communities of high ecological value. In contrast, case‐adapted diversification benefits from local opportunities, available resources and external supports to secure the system and favour sustainable resource management. Diversification thereby preserves grassland ecosystem services and enhances farm socio‐economic resilience to withstand perturbations.