bluuebunny/crossref_metadata_2025 huggingface dataset:
Percutaneous tibial nerve stimulation for the overactive bladder: A single‐arm trial
Authors: Kyaw Hnin Yee , Krause Hannah G. , Goh Judith T.W.
Published: April 2024

Aims

We hypothesise that PTNS is a safe and effective treatment for OAB. Overactive bladder (OAB) is estimated to affect 11.8% of women worldwide, causing diminished quality of life. Lifestyle modifications, muscarinic receptor antagonist and beta‐adrenoreceptor agonist remain the mainstay of treatment but are limited by their efficacy and adverse effects. Access to third‐line therapies of intravesical botulinum toxin type A or sacral neuromodulation is limited by their invasive nature. Percutaneous tibial nerve stimulation (PTNS) has emerged as a non‐invasive treatment option for OAB.

Methods

This study was a single‐arm trial of women requesting third‐line treatment for OAB. The primary treatment outcome was patient‐reported visual analogue score (VAS) improvement of at least 50%. Secondary outcome measures were Urinary Distress Inventory Short Form (UDI‐6) score and two‐day bladder diary. Patients also provided feedback on adverse effects encountered.

Results

In the 84 women recruited, initial treatment protocol showed a success rate of 77.2% among those who completed treatment based on VAS, with a statistically significant improvement in mean UDI‐6 score of 20.13 (P < 0.01, standard deviation: 12.52). Continued success following tapering protocol of 60.8% and a mean maintenance protocol of 14.2 months was achieved. No adverse effects were reported.

Conclusion

The results from this study are in concordance with previously published literature on the effectiveness and safety of PTNS as a treatment modality for OAB. Further randomised controlled trials to evaluate the optimal treatment protocol are warranted to establish a standardised regime.
Obstetrician views on Fetal Pillow® device use and research in Aotearoa New Zealand: A cross‐sectional survey
Authors: Sadler Lynn , Cronin Robin , Browne Erena , Harvey Amanda , Hill Meghan G
Published: April 2024

Background

There is anecdotal evidence of Fetal Pillow® use, but no formal local information on clinician practices and perspectives.

Aims

To assess obstetrician use of the Fetal Pillow®, knowledge of relevant research, and interest in a proposed randomised controlled trial in Aotearoa New Zealand.

Materials and Methods

Anonymous cross‐sectional survey of practising obstetricians and obstetric trainees in Aotearoa New Zealand distributed by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

Results

Of 136 respondents (69% specialists and 31% trainees), 130 had heard of the Fetal Pillow® device, and 108 had used it at least once (43% more than ten times). The device was available in 17/21 units represented. The 108 users of the device reported this was most commonly on collegial advice (63%) or after personal experience of a difficult delivery (33%) and most (80%) believed it reduced maternal morbidity. Only around one‐third of the 130 respondents who had heard of the device agreed there was adequate research demonstrating its efficacy for maternal (36%) and neonatal (30%) morbidity. The majority reported they would change practice in response to a randomised trial, although they were more likely to start use (81% of current non‐users) than stop (53% of users). Most (70%) respondents agreed they would encourage patients to participate in a randomised trial.

Conclusions

The Fetal Pillow® is available in most maternity units in Aotearoa New Zealand. The majority of obstetric clinicians believe it reduces maternal morbidity, while acknowledging the lack of scientific evidence. Most would support a randomised trial.
Real‐Time Underwater Spectral Rendering
Authors: Monzon Nestor , Gutierrez Diego , Akkaynak Derya , Muñoz Adolfo
Published: April 2024

The light field in an underwater environment is characterized by complex multiple scattering interactions and wavelength‐dependent attenuation, requiring significant computational resources for the simulation of underwater scenes. We present a novel approach that makes it possible to simulate multi‐spectral underwater scenes, in a physically‐based manner, in real time. Our key observation is the following: In the vertical direction, the steady decay in irradiance as a function of depth is characterized by the diffuse downwelling attenuation coefficient, which oceanographers routinely measure for different types of waters. We rely on a database of such real‐world measurements to obtain an analytical approximation to the Radiative Transfer Equation, allowing for real‐time spectral rendering with results comparable to Monte Carlo ground‐truth references, in a fraction of the time. We show results simulating underwater appearance for the different optical water types, including volumetric shadows and dynamic, spatially varying lighting near the water surface.
High response diversity and conspecific density‐dependence, not species interactions, drive dynamics of coral reef fish communities
Authors: Ruiz‐Moreno Alfonso , Emslie Michael J. , Connolly Sean R.
Published: April 2024

Species‐to‐species and species‐to‐environment interactions are key drivers of community dynamics. Disentangling these drivers in species‐rich assemblages is challenging due to the high number of potentially interacting species (the ‘curse of dimensionality’). We develop a process‐based model that quantifies how intraspecific and interspecific interactions, and species’ covarying responses to environmental fluctuations, jointly drive community dynamics. We fit the model to reef fish abundance time series from 41 reefs of Australia's Great Barrier Reef. We found that fluctuating relative abundances are driven by species’ heterogenous responses to environmental fluctuations, whereas interspecific interactions are negligible. Species differences in long‐term average abundances are driven by interspecific variation in the magnitudes of both conspecific density‐dependence and density‐independent growth rates. This study introduces a novel approach to overcoming the curse of dimensionality, which reveals highly individualistic dynamics in coral reef fish communities that imply a high level of niche structure.
Prevalence, recovery and phenotype of dysphagia in patients with ischaemic cerebellar stroke
Authors: Schaefer Jan Hendrik , Luft Felix , Seiler Alexander , Harborth Elena , Kaffenberger Sara , Polkowski Christoph , Foerch Christian , Lapa Sriramya
Published: April 2024

Background and purpose

Swallowing is a complex task, moderated by a sophisticated bilateral network including multiple supratentorial regions, the brainstem and the cerebellum. To date, conflicting data exist about whether focal lesions to the cerebellum are associated with dysphagia. Therefore, the aim of the study was to evaluate dysphagia prevalence, recovery and dysphagia pattern in patients with ischaemic cerebellar stroke.

Methods

A retrospective analysis of patients consecutively admitted to an academic stroke centre with ischaemic stroke found only in the cerebellum was performed. The presence of dysphagia was the primary end‐point and was assessed by a speech‐language pathologist, according to defined criteria. Dysphagia pattern was evaluated by analysing the videos of the flexible endoscopic evaluation of swallowing. Brain imaging was used to identify lesion size and location associated with dysphagia.

Results

Between January 2016 and December 2021, 102 patients (35.3% female) with a mean age of 52.8 ± 17.3 years were included. Thirteen (12.7%) patients presented with dysphagia. The most frequently observed flexible endoscopic evaluation of swallowing phenotype was premature spillage (n = 7; 58.3%), whilst significant residues or aspiration did not occur. One patient died (7.7%); the other patients showed improvement of dysphagia and one patient (7.7%) was discharged with dietary restrictions.

Conclusions

Although the involvement of the cerebellum in deglutition has become increasingly evident, isolated lesions to the cerebellum are less likely to cause clinically relevant and persisting dysphagia compared to other brain regions. The observed dysphagia pattern shows a lack of coordination and control, resulting in premature spillage or fragmented bolus transfer in some patients.
Transliterated multilingualism/globalisation: English disguised in non‐Latin linguistic landscapes as new type of world Englishes?
Authors: Gu Chonglong , Manan Syed Abdul
Published: April 2024

English has, for historical reasons, risen to global prominence as the unchallenged lingua franca internationally. World Englishes (WE) has, as a result, established itself as a visible line of research, exploring localised/indigenised varieties of English from around the world (e.g. India, Sri Lanka, Pakistan, Hong Kong, Singapore, Nigeria). However, most of the discussions so far concern English written in the Latin script as people would normally expect. Against a backdrop of globalisation and the juggernaut of English, this article points to an increasingly salient phenomenon that English especially in superdiverse and/or (post)colonial societies (e.g. India and Pakistan) may disguise in seemingly inscrutable and ‘mysterious’ local scripts (e.g. Perso‐Arabic script and Devanagari script) and even ‘pass off’ as local languages in these countries’ linguistic landscapes through phonetic transliteration. This emerging trend begs the question whether these should be understood as new varieties of local languages or new kinds of world Englishes disguised in non‐Roman scripts. This phenomenon is theorised in this paper conceptually. To illustrate our point, examples of authentic signs taken from the linguistic landscapes relating to South Asia and South Asian communities are discussed. As English is increasingly glocalised and becomes part of other less dominant languages, this article calls on researchers in World Englishes (WE) and (socio)linguistics in general to look beyond English written in the Latin script in a conventional/traditional sense and to expand the scope and remit of WE research to explore how English, as a dominant code, becomes indigenised using local scripts and morphs into and even ‘passes off’ as ‘local’ surreptitiously. This fundamentally calls for the crucial need for researchers from diverse and multilingual backgrounds to work together to better understand English and other non‐dominant languages’ role in the 21st century.
TLR8‐activating miR‐146a‐3p is an intermediate signal contributing to fetal membrane inflammation in response to bacterial LPS
Authors: Georges Hanah M. , Cassin Caterina , Tong Mancy , Abrahams Vikki M.
Published: April 2024

Preterm birth is the largest contributor to neonatal morbidity and is often associated with chorioamnionitis, defined as inflammation/infection of the fetal membranes (FMs). Chorioamnionitis is characterised by neutrophil infiltration of the FMs and is associated with elevated levels of the neutrophil chemoattractant, interleukin (IL)‐8 and the proinflammatory cytokine, IL‐1β. While FMs can respond to infections through innate immune sensors, such as toll‐like receptors (TLRs), the downstream mechanisms by which chorioamnionitis arises are not fully understood. A novel group of non‐classical microRNAs (miR‐21a, miR‐29a, miR‐146a‐3p, Let‐7b) function as endogenous danger signals by activating the ssRNA viral sensors TLR7 and TLR8. In this study, the pro‐inflammatory roles of TLR7/TLR8‐activating miRs were examined as mediators of FM inflammation in response to bacterial lipopolysaccharide (LPS) using an in vitro human FM explant system, an in vivo mouse model of pregnancy, and human clinical samples. Following LPS exposure, miR‐146a‐3p was significantly increased in both human FM explants and wild‐type mouse FMs. Expression of miR‐146a‐3p was also significantly elevated in FMs from women with preterm birth and chorioamnionitis. FM IL‐8 and inflammasome‐mediated IL‐1β production in response to LPS was dependent on miR‐146a‐3p and TLR8 downstream of TLR4 activation. In wild‐type mice, LPS exposure increased FM IL‐8 and IL‐1β production and induced preterm birth. In TLR7−/−/TLR8−/− mice, LPS exposure was able to initiate but not sustain preterm birth, and FM inflammation was reduced. Together, we demonstrate a novel signalling mechanism at the maternal‐fetal interface in which TLR8‐activating miR‐146a‐3p acts as an intermediate danger signal to drive FM inflammasome‐dependent and ‐independent mechanisms of inflammation and, thus, may play a role in chorioamnionitis and subsequent preterm birth.
On the structure and properties of hydrothermally toughened soda–lime silicate float glass
Authors: Sorarù Gian Domenico , Mariazzi Sebastiano , Barozzi Mario , Canteri Roberto , Cassetta Michele , Pellegrini Damiano , Daldosso Nicola , Brusa Roberto Sennen , Biesuz Mattia
Published: April 2024

Hydrothermal treatments of soda–lime silicate glass cause a remarkable improvement in the resistance to flaw formation with an increase of the critical load to ≈1 kgf. This remarkable effect is achieved even if the reaction layer between the glass and water solution is well below 1 µm. Positron Doppler broadening spectroscopy (DBS) reveals that the hydrothermal treatment causes a drop in the free volume of the glass network near the surface connected with the diffusion of molecular water whose presence was further confirmed by Fourier transformed infrared (FTIR) spectroscopy and secondary ion mass spectrometry (SIMS). Based on FTIR and SIMS, we also argue that the hydrothermal ion exchange is a double‐step process: first H+ substitutes Na+ in the network, and following molecular water permeates the system. Moreover, we show that the presence of water in the network is fundamental in stabilizing the modified glass surface leading to toughening. Once molecular water is released, the network is quickly polymerized and becomes more brittle. Hydrothermal toughening is only a partially reversible process, once water is released it is not possible to reobtain the same properties with a second treatment. Finally, it is shown that air and tin side of the float glass perform differently as a result of different water diffusion kinetics related to dissimilarities in the network density.
New parameters for in vitro development of cell lines of the species Astyanax bimaculatus (Linnaeus, 1758) and Geophagus proximus (Castelnau, 1855)
Authors: de Oliveira Furo Ivanete , Nogueira Lygia S. , de Sousa Rodrigo Petry Corrêa , Silva‐Oliveira Glaucia Caroline , dos Santos da Silva Diovanna Mirella , Costa‐Malaquias Allan , de Oliveira Edivaldo H. C.
Published: April 2024

Intending to compare in vitro cell growth in different conditions, we established cell cultures using fin biopsies of two freshwater fishes, Astyanax bimaculatus and Geophagus proximus. Three different culture media (Leibovitz–L‐15, Dulbecco's Modified Eagle Medium [DMEM], and 199) were employed, with or without the addition of AmnioMax, maintaining a standard temperature of 29°C. Based on the results obtained, we standardized a cell growth protocol in which medium 199 was less efficient for both species. Notably, G. proximus cells exhibited superior proliferation in DMEM and L‐15 media, whereas A. bimaculatus cells demonstrated better parameters exclusively in the DMEM medium. Successful subculturing of cells with good proliferation index was observed, accompanied by preserved morphological characteristics. Therefore, the methodology outlined in this study represents an advancement in establishing fish cell cultures.
Use of non‐invasive diagnostic tools for metabolic dysfunction‐associated steatohepatitis: A qualitative exploration of challenges and barriers
Authors: Tsochatzis Emmanuel A. , Valenti Luca , Thiele Maja , Péloquin Sophie , Lazure Patrice , Masson Mounia Heddad , Allen Alina M. , Lazarus Jeffrey V. , Noureddin Mazen , Rinella Mary , Tacke Frank , Murray Suzanne
Published: April 2024

Background and Aims

Non‐invasive tests (NITs) are underutilized for diagnosis and risk stratification in metabolic dysfunction‐associated steatotic liver disease (MASLD), despite good accuracy. This study aimed to identify challenges and barriers to the use of NITs in clinical practice.

Methods

We conducted a qualitative exploratory study in Germany, Italy, United Kingdom and United States. Phase 1 participants (primary care physicians, hepatologists, diabetologists, researchers, healthcare administrators, payers and patient advocates; n = 29) were interviewed. Phase 2 participants (experts in MASLD; n = 8) took part in a group discussion to validate and expand on Phase 1 findings. Finally, we triangulated perspectives in a hybrid deductive/inductive thematic analysis.

Results

Four themes hindering the use of NITs emerged: (1) limited knowledge and awareness; (2) unclear referral pathways for patients affected by liver conditions; (3) uncertainty over the value of NITs in monitoring and managing liver diseases; and (4) challenges justifying system‐level reimbursement. Through these themes, participants perceived a stigma associated with liver diseases, and primary care physicians generally lacked awareness, adequate knowledge and skills to use recommended NITs. We identified uncertainties over the results of NITs, specifically to guide lifestyle intervention or to identify patients that should be referred to a specialist. Participants indicated an ongoing need for research and development to improve the prognostic value of NITs and communicating their cost‐effectiveness to payers.

Conclusions

This qualitative study suggests that use of NITs for MASLD is limited due to several individual and system‐level barriers. Multi‐level interventions are likely required to address these barriers.
FLOURY ENDOSPERM24, a heat shock protein 101 (HSP101), is required for starch biosynthesis and endosperm development in rice
Authors: Wu Hongming , Ren Yulong , Dong Hui , Xie Chen , Zhao Lei , Wang Xin , Zhang Fulin , Zhang Binglei , Jiang Xiaokang , Huang Yunshuai , Jing Ruonan , Wang Jian , Miao Rong , Bao Xiuhao , Yu Mingzhou , Nguyen Thanhliem , Mou Changling , Wang Yunlong , Wang Yihua , Lei Cailin , Cheng Zhijun , Jiang Ling , Wan Jianmin
Published: April 2024

Endosperm is the main storage organ in cereal grain and determines grain yield and quality. The molecular mechanisms of heat shock proteins in regulating starch biosynthesis and endosperm development remain obscure.

Here, we report a rice floury endosperm mutant flo24 that develops abnormal starch grains in the central starchy endosperm cells. Map‐based cloning and complementation test showed that FLO24 encodes a heat shock protein HSP101, which is localized in plastids. The mutated protein FLO24T296I dramatically lost its ability to hydrolyze ATP and to rescue the thermotolerance defects of the yeast hsp104 mutant.

The flo24 mutant develops more severe floury endosperm when grown under high‐temperature conditions than normal conditions. And the FLO24 protein was dramatically induced at high temperature. FLO24 physically interacts with several key enzymes required for starch biosynthesis, including AGPL1, AGPL3 and PHO1. Combined biochemical and genetic evidence suggests that FLO24 acts cooperatively with HSP70cp‐2 to regulate starch biosynthesis and endosperm development in rice.

Our results reveal that FLO24 acts as an important regulator of endosperm development, which might function in maintaining the activities of enzymes involved in starch biosynthesis in rice.
Vertebrate grazing can mitigate impacts of nutrient addition on plant diversity and insect abundance in a semi‐natural grassland
Authors: Veen G. F. (Ciska) , Vermaat Annika T. , Sitters Judith , Bakker Elisabeth S.
Published: April 2024

Human‐induced nutrient eutrophication is a major threat to grassland biodiversity, because it promotes the dominance of fast‐growing plants. Negative impacts of fertilization on plant biodiversity may be offset by grazing by large vertebrate herbivores. However, whether grazers also mitigate impacts of nutrient addition on insects is less well understood. We use a field experiment to test how plant communities and abundances of pollinators and grasshoppers respond to nutrient addition and grazing by different assemblages of large herbivores, i.e. access by all herbivores (including cattle and horses), access by wild herbivores only (wild boar and deer), no access by large herbivores. Plant biomass increased, plant diversity decreased and community composition shifted towards lower forb cover in response to fertilization, but only in the absence of all herbivores. Flower visitation by Hymenoptera (bees and wasps), i.e. the most abundant pollinator group, was reduced by nutrient addition only in the absence of all herbivores and was positively related to flowering plant richness. In contrast, flower visitation by Diptera (e.g. hoverflies) was enhanced by fertilization, but not affected by grazing. Orthoptera (grasshopper) abundance was reduced by grazing and enhanced by nutrient addition, with positive impacts of fertilization tending to be stronger in plots with only wild or no herbivores. The abundance of grasshoppers was positively related to grass biomass. We conclude that vertebrate herbivores can offset impacts of fertilization on both plant and insect communities, making grazing by large mammals an essential tool to protect insects, particularly pollinators. Most responses to nutrient addition were only apparent in plots without any large herbivores, suggesting that wild herbivores alone could already mitigate nutrient impacts. We also show that insects with contrasting feeding guilds may be favoured by fertilized, ungrazed conditions. Therefore, creating a mosaic of patches grazed at different intensities will enhance overall insect biodiversity.
Transcriptome scale analysis to decode the differential sucrose accumulation mechanisms in sugarcane under the effect of gibberellin
Authors: Roopendra Kriti , Priyanka  , Chandra Amaresh , Akhter Yusuf , Saxena Sangeeta
Published: April 2024

In the present study, we analyzed GA3 (gibberellin)‐treated sugarcane samples at the transcriptomic level to elucidate the differential expression of genes that influence sucrose accumulation. Previous research has suggested that GA3 application can potentially delay sink saturation by enhancing sink strength and demand, enabling the accommodation of more sucrose. To investigate the potential role of GA‐induced modification of sink capacity in promoting higher sucrose accumulation, we sought to unravel the differential expression of transcripts and analyze their functional annotation. Several genes homologous to the sugar‐phosphate/phosphate translocator, UTP‐glucose‐1‐phosphate uridylyltransferase, and V‐ATPases (vacuolar‐type H+ ATPase) were identified as potentially associated with the increased sucrose content observed. A differentially expressed transcript was found to be identical to the mRNA of an unknown protein. Homology‐based bioinformatics analysis suggested it to be a hydrolase enzyme, which could potentially act as a stimulator of sucrose buildup. The database of differentially expressed transcripts obtained in this study under the influence of GA3 represents a valuable addition to the sugarcane transcriptomics and functional genomics knowledge base.
A meta‐analysis of the state and local government borrowing costs
Authors: Gerrish Ed , Ivonchyk Mikhail , Charles Cleopatra , Greer Robert A. , Moldogaziev Temirlan T.
Published: April 2024

State and local governments seek to save money through fiscal efficiency. One such mechanism widely studied in the literature is through the choice for financial underwriting of debt. The extant literature generally suggests that state and local governments can lower borrowing costs through a competitive method of sale. In a meta‐analysis of 418 effects from 97 studies, we find that competitive sales do enjoy a statistically significant reduction in borrowing costs However, these effects are moderated when using key control variables, the use of more recent data, as well as due to measurement and methodological choices. Consequently, despite a large number of studies in this area, more research specific to small borrowers, new and understudied contexts, or those using sophisticated selection and causal methods is needed to understand whether the practical preference for competitive sales should persist.
Therapeutic bronchoscopy for malignant central airway obstructions caused by non‐bronchogenic cancers: Results from the EpiGETIF registry
Authors: Daigmorte Clément , Usturoi Daniela , Fournier Clément , Wallyn Frederic , Lorut Christine , Héluain Valentin , Mazières Julien , Legodec Julien , Escarguel Bruno , Egenod Thomas , Cellerin Laurent , Favrolt Nicolas , Lachkar Samy , Crutu Adrian , Briault Amandine , Gut‐Gobert Christophe , Bourinet Valerian , Camuset Juliette , Loïc Perrot , Schlossmacher Pascal , Porzio Michele , Luchez Antoine , Vergnon Jean‐Michel , Pajiep Chapda Marie‐Christelle , Roy Pascalin , Dutau Hervé , Guibert Nicolas
Published: April 2024

Background and Objective

Little is known about malignant central airway obstruction (MCAO) complicating the metastatic spread of non‐bronchogenic solid cancers (NBC) and their bronchoscopic management. This study aimed to describe the epidemiology of this population and determine prognostic factors before therapeutic bronchoscopy (TB).

Methods

In this multicenter study using the EpiGETIF registry, we analysed patients treated with TB for MCAO caused by NBC between January 2019 and December 2022.

Results

From a database of 2389 patients, 436 patients (18%) with MCAO and NBC were identified. After excluding patients with direct local invasion, 214 patients (8.9%) were analysed. The main primaries involved were kidney (17.8%), colon (16.4%), sarcoma (15.4%), thyroid (8.9%) and head and neck (7.9%) cancers. Most patients (63.8%) had already received one or more lines of systemic treatment. Obstructions were purely intrinsic in 58.2%, extrinsic in 11.1% and mixed in 30.8%. Mechanical debulking was used in 73.4% of cases, combined with thermal techniques in 25.6% of cases. Airway stenting was required in 38.4% of patients. Median survival after TB was 11.2 months, influenced by histology (p = 0.002), performance status (p = 0.019), initial hypoxia (HR 1.45 [1.01–2.18]), prior oncologic treatment received (HR 1.82 [1.28–2.56], p < 0.001) and assessment of success at the end of the procedure (HR 0.66 [0.44–0.99], p < 0.001). Complications rate was 8.8%, mostly mild, with no procedure‐related mortality.

Conclusion

TB for MCAO caused by a NBC metastasis provides rapid improvement of symptoms and prolonged survival. Patients should be promptly referred by medical oncologists for bronchoscopic management based on the prognostic factors identified.
Anti‐D immunization after D positive platelet transfusions in D negative recipients: A systematic review and meta‐analysis
Authors: Hubert Tamar , Kerkhoffs Jean Louis , Brand Anneke , Schonewille Henk
Published: April 2024

Background

Anti‐D can be formed after D‐incompatible platelet transfusions due to contaminating D+ red blood cells. These antibodies are of particular importance in women of childbearing potential, because anti‐D is most often involved in severe cases of hemolytic disease of the fetus and newborn. This systematic review determined the frequency of anti‐D after D+ platelet transfusions and risk factors for D alloimmunization.

Study Design and Methods

Relevant literature was searched using PubMed, Embase and Web of Science until December 2022. Overall anti‐D frequency and risk factors were estimated using a random effects meta‐analysis.

Results

In 22 studies, a total of 3028 D‐ patients received a mean of six D+ platelet transfusions. After a mean follow‐up of seven months 106 of 2808 eligible patients formed anti‐D. The pooled anti‐D frequency was 3.3% (95% CI 2.0–5.0%; I2 71%). After including only patients with an undoubtable follow‐up of at least 4 weeks, 29 of 1497 patients formed anti‐D with a pooled primary anti‐D rate of 1.9% (95% CI 0.9–3.2%, I2 44%). Women and patients receiving whole blood derived platelets had two and five times higher anti‐D rates compared with men and patients receiving apheresis derived platelets, respectively.

Discussion

Anti‐D immunization is low after D incompatible platelet transfusions and dependent on recipients' sex and platelet source. We propose anti‐D prophylaxis in girls and women, capable of becoming pregnant in the future, that received D+ platelets, regardless of platelet source, to reduce the risk of anti‐D induced hemolytic disease of the fetus and newborn.
Directed and acyclic synaptic connectivity in the human layer 2-3 cortical microcircuit
Authors: Peng Yangfan , Bjelde Antje , Aceituno Pau Vilimelis , Mittermaier Franz X. , Planert Henrike , Grosser Sabine , Onken Julia , Faust Katharina , Kalbhenn Thilo , Simon Matthias , Radbruch Helena , Fidzinski Pawel , Schmitz Dietmar , Alle Henrik , Holtkamp Martin , Vida Imre , Grewe Benjamin F. , Geiger Jörg R. P.
Published: April 2024

The computational capabilities of neuronal networks are fundamentally constrained by their specific connectivity. Previous studies of cortical connectivity have mostly been carried out in rodents; whether the principles established therein also apply to the evolutionarily expanded human cortex is unclear. We studied network properties within the human temporal cortex using samples obtained from brain surgery. We analyzed multineuron patch-clamp recordings in layer 2-3 pyramidal neurons and identified substantial differences compared with rodents. Reciprocity showed random distribution, synaptic strength was independent from connection probability, and connectivity of the supragranular temporal cortex followed a directed and mostly acyclic graph topology. Application of these principles in neuronal models increased dimensionality of network dynamics, suggesting a critical role for cortical computation.
Centering Earth in policy-making
Children of a Modest Star: Planetary Thinking for an Age of Crises
Jonathan S. Blake and Nils Gilman
Stanford University Press, 2024. 326 pp.
Authors: Ellis Erle C.
Published: April 2024

A pair of authors advocate scaling governance structures to better address planetary crises
Participant recruitment and attrition in surgical randomised trials with placebo controls versus non-operative controls: a meta-epidemiological study and meta-analysis
Authors: Natarajan Pragadesh , Menounos Spiro , Harris Laura , Monuja Masiath , Gorelik Alexandra , Karjalainen Teemu , Buchbinder Rachelle , Harris Ian A , Naylor Justine M , Adie Sam
Published: April 2024

Objective

To compare differences in recruitment and attrition between placebo control randomised trials of surgery, and trials of the same surgical interventions and conditions that used non-operative (non-placebo) controls.

Design

Meta-epidemiological study.

Data sources

Randomised controlled trials were identified from an electronic search of MEDLINE, EMBASE and Cochrane Central Register of Controlled Trials from their inception date to 21 November 2018.

Study selection

Placebo control trials evaluating efficacy of any surgical intervention and non-operative control trials of the same surgical intervention were included in this study. 25 730 records were retrieved from our systemic search, identifying 61 placebo control and 38 non-operative control trials for inclusion in analysis.

Outcome measures

Primary outcome measures were recruitment and attrition. These were assessed in terms of recruitment rate (number of participants enrolled, as a proportion of those eligible) and overall attrition rate (composite of dropout, loss to follow-up and cross-overs, expressed as proportion of total sample size). Secondary outcome measures included participant cross-over rate, dropout and loss to follow-up.

Results

Unadjusted pooled recruitment and attrition rates were similar between placebo and non-operative control trials. Study characteristics were not significantly different apart from time to primary timepoint which was shorter in studies with placebo controls (365 vs 274 days, p=0.006). After adjusting for covariates (follow-up duration and number of timepoints), the attrition rate of placebo control trials was almost twice as high compared with non-operative controlled-trials (incident rate ratio (IRR) (95% CI) 1.8 (1.1 to 3.0), p=0.032). The incorporation of one additional follow-up timepoint (regardless of follow-up duration) was associated with reduced attrition in placebo control surgical trials (IRR (95% CI) 0.64 (0.52 to 0.79), p<0.001).

Conclusions

Placebo control trials of surgery have similar recruitment issues but higher attrition compared with non-operative (non-placebo) control trials. Study design should incorporate strategies such as increased timepoints for given follow-up duration to mitigate losses to follow-up and dropout.

PROSPERO registration number

CRD42019117364.
Cavitron ultrasonic surgical aspirator (CUSA) compared with conventional pancreatic transection in distal pancreatectomy: study protocol for the randomised controlled CUSA-1 pilot trial
Authors: Holze Magdalena , Loos Martin , Hüttner Felix , Tenckhoff Solveig , Feisst Manuel , Knebel Phillip , Klotz Rosa , Mehrabi Arianeb , Michalski Christoph , Pianka Frank
Published: April 2024

Background

Postoperative pancreatic fistula (POPF) remains the most common and serious complication after distal pancreatectomy. Many attempts at lowering fistula rates have led to unrewarding insignificant results as still up to 30% of the patients suffer from clinically relevant POPF. Therefore, the development of new innovative methods and procedures is still a cornerstone of current surgical research.

The cavitron ultrasonic surgical aspirator (CUSA) device is a well-known ultrasound-based parenchyma transection method, often used in liver and neurosurgery which has not yet been thoroughly investigated in pancreatic surgery, but the first results seem very promising.

Methods

The CUSA-1 trial is a randomised controlled pilot trial with two parallel study groups. This single-centre trial is assessor and patient blinded. A total of 60 patients with an indication for open distal pancreatectomy will be intraoperatively randomised after informed consent. The patients will be randomly assigned to either the control group with conventional pancreas transection (scalpel or stapler) or the experimental group, with transection using the CUSA device. The primary safety endpoint of this trial will be postoperative complications ≥grade 3 according to the Clavien-Dindo classification. The primary endpoint to investigate the effect will be the rate of POPF within 30 days postoperatively according to the ISGPS definition. Further perioperative outcomes, including postpancreatectomy haemorrhage, length of hospital stay and mortality will be analysed as secondary endpoints.

Discussion

Based on the available literature, CUSA may have a beneficial effect on POPF occurrence after distal pancreatectomy. The rationale of the CUSA-1 pilot trial is to investigate the safety and feasibility of the CUSA device in elective open distal pancreatectomy compared with conventional dissection methods and gather the first data on the effect on POPF occurrence. This data will lay the groundwork for a future confirmatory multicentre randomised controlled trial.

Ethics and dissemination

The CUSA-1 trial protocol was approved by the ethics committee of the University of Heidelberg (No. S-098/2022). Results will be published in an international peer-reviewed journal and summaries will be provided in lay language to study participants and their relatives.

Trial registration number

DRKS00027474.
Facing the digital frontier: exploring user acceptance of electronic health records in an urban, rural and remote setting in the Philippines
Authors: De Mesa Regine Ynez H , Galingana Cara Lois T , Tan-Lim Carol Stephanie C , Javelosa Mark Anthony U , Panganiban Janelle Micaela S , Fabian Noleen Marie C , Calderon Ysabela , Rey Mia P , Bernal-Sundiang Nannette , Sanchez Josephine T , Dans Leonila F , Casile Ray U , Dans Antonio L
Published: April 2024

Objectives

A thorough understanding of user needs and behavioural intent-to-use underpins the development of a responsive health information system. This study aimed to examine health workers’ intent-to-use an electronic health record (EHR) system in an urban, rural and remote setting in the Philippines.

Methods

Following the Unified Theory of Acceptance and Use of Technology framework, user acceptance and the factors influencing intent-to-use the EHR were examined through a self-administered questionnaire. A total of 128 EHR users, comprising physicians, nurses, midwives,barangayhealth workers and administrative staff, were surveyed. Median scores for each domain were compared across the sites using the Kruskal-Wallis test. Ridge regression analysis was used to identify factors associated with behavioural intent-to-use.

Results

Over 94% of users across all sites reported their intent-to-use the EHR in the near future. Of the seven predictor variables examined, only self-efficacy was found to be significantly associated with behavioural intent-to-use. Intent-to-use the EHR increased by 31% (p=0.007) for each unit increase in self-efficacy score among participants.

Discussion

Acceptance was high across the three sites, with self-efficacy being a predictor of intent-to-use the technology. This suggests that users are more likely to adopt an EHR if they believe they have the capacity to successfully navigate the technology and perform their designated tasks with it.

Conclusion

Co-producing interventions with primary care providers is crucial in sustaining EHR systems. Rather than developing a technology based on the surveillance needs of policymakers, an EHR developed from the grassroots was shown to be well-received by end-users.
Machine learning-based identification of novel hub genes associated with oxidative stress in lupus nephritis: implications for diagnosis and therapeutic targets
Authors: Zeng Huiqiong , Zhuang Yu , Yan Xiaodong , He Xiaoyan , Qiu Qianwen , Liu Wei , Zhang Ye
Published: April 2024

Background

Lupus nephritis (LN) is a complication of SLE characterised by immune dysfunction and oxidative stress (OS). Limited options exist for LN. We aimed to identify LN-related OS, highlighting the need for non-invasive diagnostic and therapeutic approaches.

Methods

LN-differentially expressed genes (DEGs) were extracted from Gene Expression Omnibus datasets (GSE32591, GSE112943 and GSE104948) and Molecular Signatures Database for OS-associated DEGs (OSEGs). Functional enrichment analysis was performed for OSEGs related to LN. Weighted gene co-expression network analysis identified hub genes related to OS-LN. These hub OSEGs were refined as biomarker candidates via least absolute shrinkage and selection operator. The predictive value was validated using receiver operating characteristic (ROC) curves and nomogram for LN prognosis. We evaluated LN immune cell infiltration using single-sample gene set enrichment analysis and CIBERSORT. Additionally, gene set enrichment analysis explored the functional enrichment of hub OSEGs in LN.

Results

The study identified four hub genes, namelySTAT1,PRODH,TXN2andSETX, associated with OS related to LN. These genes were validated for their diagnostic potential, and their involvement in LN pathogenesis was elucidated through ROC and nomogram. Additionally, alterations in immune cell composition in LN correlated with hub OSEG expression were observed. Immunohistochemical analysis reveals that the hub gene is most correlated with activated B cells and CD8 T cells. Finally, we uncovered that the enriched pathways of OSEGs were mainly involved in the PI3K-Akt pathway and the Janus kinase-signal transducer and activator of transcription pathway.

Conclusion

These findings contribute to advancing our understanding of the complex interplay between OS, immune dysregulation and molecular pathways in LN, laying a foundation for the identification of potential diagnostic biomarkers and therapeutic targets.
Comprehensive Analysis and Design of Electrical Power Systems for Nanosatellite Platforms: A Focus on Robust MPPT Control Using Sliding Mode Control Method
Authors: Eddine Kerrouche Kamel Djamel , Lina Wang , Abderrahmane Seddjar , Messaoud Bensaada , de Oliveira Nogueira Pedro Henrique , Boualem Kerrouche Mustapha
Published: April 2024

This paper is aimed at performing a comprehensive review of the approaches employed in nanosatellite platforms, specifically 1 U and 3 U, for electrical power systems (EPS). Moreover, it seeks to develop a robust maximum power point tracking (MPPT) controller using the sliding mode control (SMC) method. The proposed control strategy is intended to monitor the solar panel’s maximum power point (MPP) and adapt to changes in temperatures and solar irradiance in low Earth orbit (LEO). The EPS model, designed with the proposed sizing method, is built in MATLAB‐Simulink and integrates a solar panel, battery storage, and power converters controlled by diverse MPPT methods. Then, simulation results demonstrate the effectiveness of the proposed SMC approach compared to other conventional control methods for the designed EPS under varying LEO conditions. To achieve a robust validation of the most appropriate MPPT control method under steady‐state conditions, this paper presents an experimental investigation into the proposed EPS hardware design. The proposed SMC method achieved an increase in power generation from 10% to 12% for buck and boost power converters, respectively, compared to traditional control methods.
A Unique Combination of Mn2+ and Aluminum Adjuvant Acted the Synergistic Effect
Authors: Cen Yuwei , Chen Shujie , Wei Shuyu , Wu Shuangshuang , Tao Mingyang , Fu Youxi , Wang Yuncheng , Chen Jing , Ma Yixuan , Liu Hongyan , Song Baifen , Ma Jinzhu , Wang Beiyan , Cui Yudong
Published: April 2024

Introduction. The development of combinatorial adjuvants is a promising strategy to boost vaccination efficiency. Accumulating evidence indicates that manganese exerts strong immunocompetence and will become an enormous potential adjuvant. Here, we described a novel combination of Mn2+ plus aluminum hydroxide (AH) adjuvant that significantly exhibited the synergistic immune effect. Methodology. Initially, IsdB3 proteins as the immune-dominant fragment of IsdB proteins derived from Staphylococcus aureus (S. aureus) were prepared. IsdB3 proteins were identified by western blotting. Furthermore, we immunized C57/B6 mice with IsdB3 proteins plus Mn2+ and AH adjuvant. After the second immunization, the proliferation of lymphocytes was measured by the cell counting kit-8 (CCK-8) and the level of IFN-γ, IL-4, IL-10, and IL-17 cytokine from spleen lymphocytes in mice and generation of the antibodies against IsdB3 in serum was detected with ELISA, and the protective immune response was assessed through S. aureus challenge. Results. IsdB3 proteins plus Mn2+ and AH obviously stimulated the proliferation of spleen lymphocytes and increased the secretion of IFN-γ, IL-4, IL-10, and IL-17 cytokine in mice, markedly enhanced the generation of the antibodies against IsdB3 in serum, observably decreased bacterial load in organs, and greatly improved the survival rate of mice. Conclusion. These data showed that the combination of Mn2+ and AH significantly acted a synergistic effect, reinforced the immunogenicity of IsdB3, and offered a new strategy to increase vaccine efficiency.
Supplementary Figure S5 from First-in-human Phase I Trial of TPST-1120, an Inhibitor of PPARα, as Monotherapy or in Combination with Nivolumab, in Patients with Advanced Solid Tumors
Authors: Yarchoan Mark , Powderly John D. , Bastos Bruno R. , Karasic Thomas B. , Crysler Oxana V. , Munster Pamela N. , McKean Meredith A. , Emens Leisha A. , Saenger Yvonne M. , Ged Yasser , Stagg Robert , Smith Steven , Whiting Chan C. , Moon Anne , Prasit Peppi , Jenkins Yonchu , Standifer Nathan , Dubensky Thomas W. , Whiting Sam H. , Ulahannan Susanna V.
Published: April 2024

Elevated circulating free fatty acids (FFA) at days 57 and 85 in PR patients. Log2-fold changes in baseline normalized FFA in patients enrolled in Part 2. Samples were collected prior to TPST-1120 dose administration on day 1 of each 28-day cycle. Blue symbols: PD/SD patients; Red symbols: PR patients.
Supplementary Figure S4 from First-in-human Phase I Trial of TPST-1120, an Inhibitor of PPARα, as Monotherapy or in Combination with Nivolumab, in Patients with Advanced Solid Tumors
Authors: Yarchoan Mark , Powderly John D. , Bastos Bruno R. , Karasic Thomas B. , Crysler Oxana V. , Munster Pamela N. , McKean Meredith A. , Emens Leisha A. , Saenger Yvonne M. , Ged Yasser , Stagg Robert , Smith Steven , Whiting Chan C. , Moon Anne , Prasit Peppi , Jenkins Yonchu , Standifer Nathan , Dubensky Thomas W. , Whiting Sam H. , Ulahannan Susanna V.
Published: April 2024

Genes differentially expressed as a function of BOR on day 8. (A) Linear discriminant analysis of Log2 fold change in expression levels of 780 genes in patients stratified based on BOR. PR: partial response; SD: stable disease; PD: progressive disease. (B) Genes that maximally discriminate between PR and PD patients enrolled in combination therapy arm. * p<0.05 by Mann-Whitney U-test.
Supplementary Figure S3 from First-in-human Phase I Trial of TPST-1120, an Inhibitor of PPARα, as Monotherapy or in Combination with Nivolumab, in Patients with Advanced Solid Tumors
Authors: Yarchoan Mark , Powderly John D. , Bastos Bruno R. , Karasic Thomas B. , Crysler Oxana V. , Munster Pamela N. , McKean Meredith A. , Emens Leisha A. , Saenger Yvonne M. , Ged Yasser , Stagg Robert , Smith Steven , Whiting Chan C. , Moon Anne , Prasit Peppi , Jenkins Yonchu , Standifer Nathan , Dubensky Thomas W. , Whiting Sam H. , Ulahannan Susanna V.
Published: April 2024

Genes differentially expressed as a function of BOR on cycle 3 day 1. Genes differentially expressed on C3D1 versus treatment baseline, as a function of TPST-1120 exposure. Linear associations of C3D1 Log2 fold change in expression levels of indicated genes and TPST-1120 AUC0-24. Data are shown for both TPST-1120 monotherapy (part 1) and TPST-1120 + nivolumab combination therapy (part 2).
Supplementary Figure S1 from First-in-human Phase I Trial of TPST-1120, an Inhibitor of PPARα, as Monotherapy or in Combination with Nivolumab, in Patients with Advanced Solid Tumors
Authors: Yarchoan Mark , Powderly John D. , Bastos Bruno R. , Karasic Thomas B. , Crysler Oxana V. , Munster Pamela N. , McKean Meredith A. , Emens Leisha A. , Saenger Yvonne M. , Ged Yasser , Stagg Robert , Smith Steven , Whiting Chan C. , Moon Anne , Prasit Peppi , Jenkins Yonchu , Standifer Nathan , Dubensky Thomas W. , Whiting Sam H. , Ulahannan Susanna V.
Published: April 2024

Relationship between dose (mg BID) and AUC0-24 of TPST-1120 at steady state on Cycle 1 Day 8. Monotherapy and nivolumab combination data points offset slightly for clarity.