bluuebunny/crossref_metadata_2025 huggingface dataset:
Inequalities in geographic barriers and patient representation in lymphoma clinical trials across England
Authors: Jones David A. , Spencer Katie , Ramroth Johanna , Probert Jake , Roope Laurence S. J. , Shakir Rebecca , Broggio John , Burroughs Frank , Collins Graham P. , Clarke Philip M. , Wolstenholme Jane L. , Cutter David J.
Published: November 2024

The distribution of trial site locations may lead to disparities in geographic access and affect patient representativeness in clinical trials. We utilised trial data covering 1993–2022 from the National Institute for Health and Care Research (NIHR) Open Data Platform, 2011 and 2021 English Census and geographic data and English individual‐patient cancer registry data for patients diagnosed with lymphoma between 1997 and 2017. To assess representation, we compared patient age and sex between trial participants and the incident population. We mapped the distance and travel times of English lower layer super output areas (LSOAs) to their nearest research active NHS Trusts and assessed associations between distance and travel times and the geographic and sociodemographic characteristics of the LSOAs. Trial participants were younger than the incident population and more likely to be male. The closest NHS Trust to more than half of English LSOAs was not research active. Greater LSOA mean age, male percent, White British percent, rurality and coastal/border status were positively associated with distance and travel time (at prespecified p < 0.05 level), while greater deprivation was negatively associated. Female and older lymphoma patients in England are underrepresented in trials, with the latter facing a higher burden of geographic barriers.
Efficacy and safety of bendamustine, rituximab and bortezomib treatment in relapsed/refractory Waldenstrom Macroglobulinaemia: results of phase 2 single‐arm FIL‐BRB trial
Authors: Benevolo Giulia , Drandi Daniela , Villivà Nicoletta , Castiglione Anna , Monaco Federico , Boccomini Carola , Dessi Daniela , Califano Catello , Curreli Luigi , Cavallo Federica , Conconi Annarita , Gaidano Gianluca , Rossi Francesca Gaia , Caravita di Toritto Tommaso , Ferrante Martina , Mannina Donato , Tosi Patrizia , Pietrantuono Giuseppe , Musuraca Gerardo , Merli Michele , Sartori Roberto , Tani Monica , Freilone Roberto , Varettoni Marzia , Ferrero Simone
Published: November 2024

This multicentre phase II study Fondazione Italiana Linfomi (FIL)‐bortezomib plus rituximab plus bendamustine (BRB) tested a combination of bendamustine (90 mg/m2 on days 1–2), rituximab (375 mg/m2 intravenously on day 1) and bortezomib (1.3 mg/m2 sc on days 1, 8, 15, 22) every 28 days for six cycles in 38 symptomatic patients with relapsed/refractory Waldenstrom macroglobulinaemia (RR‐WM). Moreover, MYD88L265P and CXCR4S338X mutations were tested by droplet digital polymerase chain reaction (ddPCR) both at baseline and at the end of treatment in 21 patients. Overall response rate at the end of therapy was 84.6%, including 4 (11%) complete remission, 15 (39%) very good partial response, 12 (32%) partial responses according to IWWM response criteria. At 18, 24 and 30 months, progression‐free survival was 84.2% (95% CI 68.2%–92.6%), 81.5% (95%CI 65.1–90.7) and 78.8% (95%CI 62.0–88.8) respectively. At 18 months, the Overall survival was 92.1% (95%CI 77.5%–97.4%). Overall, 19 patients (50%) experienced grade 3–4 haematological toxicity, mainly thrombocytopenia, and grade 1–3 neuropathy rate was about 10% and required bortezomib dose reduction but did not result in treatment interruption. Moreover, BRB treatment induced the high rates of undetectable molecular minimal residual disease (MRD) at the end of the therapy. BRB regimen used as second line is an effective and well‐tolerated salvage treatment for relapsed refractory Waldenstrom macroglobulinaemia patients. MRD monitoring showed promising efficacy in clearing the residual disease.
Psychological needs related to civil inattention: A qualitative and quantitative view on public encounters
Authors: Diefenbach Sarah , Riehle Anna , Jannott Hannah , Vornhagen Joëlle‐Sophie , Stoll Johannes , Markhoff Lea , von Terzi Pia
Published: November 2024

As described by early sociological research (Goffman, 1963, Behavior in public places: Notes on the social organization of gatherings), a typical behavioural pattern in public encounters between strangers is so‐called Civil Inattention (CI). CI describes a ritual of politely communicating having noticed the other while assuring non‐communication intentions. A typical example of showing CI is initially looking at the other person but then quickly averting the gaze. As argued earlier, CI fulfils a central role in the smooth functioning of a society. Also, CI gains new relevance in the digital era, in particular regarding privacy needs. Still, previous research on CI often remained on a theoretical or descriptive level, and its psychological functions have not been explored systematically. As an advancement, our study provides a deeper understanding of CI, exploring individual narratives, relevant psychological needs, and contextual factors. We conducted a qualitative interview study (N = 25) followed by an experimental online study (N = 353) with a 2 (presence of CI) × 2 (physical distance) mixed design. It shows that CI adds to well‐being and specifically addresses needs for relatedness, security, and autonomy. However, though Study 1 suggested physical distance as a relevant contextual factor, the present experimental manipulation in Study 2 did not show significant effects.
Cross‐pathway integration of cAMP signals through cGMP and calcium‐regulated phosphodiesterases in mouse striatal cholinergic interneurons
Authors: Bompierre Ségolène , Byelyayeva Yelyzaveta , Mota Elia , Lefevre Marion , Pumo Anna , Kehler Jan , Castro Liliana R. V. , Vincent Pierre
Published: November 2024

Background and Purpose

Acetylcholine plays a key role in striatal function. Firing properties of striatal cholinergic interneurons depend on intracellular cAMP through the regulation of Ih currents. Yet, the dynamics of cyclic nucleotide signalling in these neurons have remained elusive.

Experimental approach

We used highly selective FRET biosensors and pharmacological compounds to analyse the functional contribution of phosphodiesterases in striatal cholinergic interneurons in mouse brain slices.

Key Results

PDE1A, PDE3A and PDE4 appear as the main controllers of cAMP levels in striatal cholinergic interneurons. The calcium signal elicited through NMDA or metabotropic glutamate receptors activates PDE1A, which degrades both cAMP and cGMP. Interestingly, the nitric oxide/cGMP pathway amplifies cAMP signalling via PDE3A inhibition—a mechanism hitherto unexplored in a neuronal context.

Conclusions and Implications

The expression pattern of specific PDE enzymes in striatal cholinergic interneurons, by integrating diverse intracellular pathways, can adjust cAMP responses bidirectionally. These properties eventually allow striatal cholinergic interneurons to dynamically regulate their overall activity and modulate acetylcholine release. Remarkably, this effect is the opposite of the cGMP‐induced inhibition of cAMP signals involving PDE2A in striatal medium‐sized spiny neurons, which provides important insights for the understanding of signal integration in the striatum.
Skipping of Exon 20 in EP300: A Novel Variant Linked to Rubinstein–Taybi Syndrome With Atypical and Severe Clinical Manifestations
Authors: Pavinato Lisa , Carestiato Silvia , Trajkova Slavica , Sorasio Lorena , Mantovani Giovanna , De Sanctis Luisa , Kerkhof Jennifer , McConkey Haley , Rzasa Jessica , Todd Emily , Balzo Maria , Cardaropoli Simona , Bruselles Alessandro , De Rubeis Silvia , Buxbaum Joseph D. , Tartaglia Marco , Sadikovic Bekim , Ferrero Giovanni Battista , Brusco Alfredo
Published: November 2024

Rubinstein–Taybi syndrome (RSTS) is a rare autosomal dominant neurodevelopmental disorder linked to haploinsufficiency of CREBBP (RSTS1) and EP300 (RSTS2) genes. Characteristic features often include distinctive facial traits, broad thumbs and toes, short stature, and various degrees of intellectual disability. The clinical presentation of RSTS is notably variable, making it challenging to establish a clear genotype–phenotype correlation, except for specific variants which cause the allelic Menke–Hennekam syndrome. Trio exome analysis, data collection via networking and GeneMatcher platforms, transcript processing analysis, and DNA methylation profiling were performed. We identified two unrelated patients with de novo variants in EP300 (NM_001429.4: c.3671+5G>C; c.3671+5_3671+8delGTAA) predicted to cause in‐frame exon 20 skipping, confirmed in one patient. In silico 3D protein modeling suggested that exon 20 deletion (comprising 27 amino acids) likely alters the structural conformation between the RING_CBP‐p300 and HAT‐KAT11 domains. Clinically, both patients displayed severe RSTS2‐like clinical features, including autism spectrum disorder, speech delay, hearing loss, microcephaly, developmental delay, and intellectual disability, alongside ocular, respiratory, and cardiovascular abnormalities. Additionally, one patient developed early‐onset colorectal cancer. DNA methylation profiling in Subject #1 confirmed RSTS but did not align with the specific episignatures for RSTS1 or RSTS2. We propose that skipping of exon 20 in EP300 is associated with a distinct form of Rubinstein–Taybi syndrome featuring clinical characteristics not fully aligning with RSTS1 or RSTS2. Our findings increase the understanding of RSTS genetic and molecular basis and stress the need for further research to establish definitive genotype–phenotype correlations.
High‐protein vegan and omnivorous diets improve peripheral insulin sensitivity to a similar extent in people with type 2 diabetes
Authors: Whelehan Gráinne , Dirks Marlou L. , West Sam , Abdelrahman Doaa R. , Murton Andrew J. , Finnigan Tim J. A. , Wall Benjamin T. , Stephens Francis B.
Published: November 2024

Background

High‐protein diets have been recognized as a potential strategy in the nutritional management of type 2 diabetes (T2D). Mycoprotein is a high‐fibre, high‐protein food ingredient previously shown to improve acute glycaemic control. We determined whether incorporating mycoprotein into a high‐protein vegan diet would improve glycaemic control to a greater extent than an isonitrogenous omnivorous diet in people with T2D.

Methods

Seventeen adults (f = 5, age = 58.3 ± 8.3 years, BMI = 32.9 ± 4.7 kg∙m−2, HbA1c = 60 ± 15 mmol∙mol−1) with T2D were randomly allocated to a 5‐week eucaloric high‐protein (30% energy from protein) diet, either an omnivorous diet (OMNI; 70% protein from omnivorous sources) or an isonitrogenous, mycoprotein‐rich, vegan diet (VEG; 50% protein from mycoprotein). Glycaemic control was assessed using a two‐step hyperinsulinaemic‐euglycaemic clamp (HEC) with D‐[6,6‐2H2] glucose infusion, a mixed‐meal tolerance test (MMTT) and continuous glucose monitoring.

Results

The rate of glucose disappearance (RdT), glucose disposal rate and endogenous glucose production, as well as postprandial time‐course of blood glucose, serum insulin and C‐peptide were assessed during the HEC and MMTT, respectively. Both groups had improved peripheral insulin sensitivity (intervention effect, p = 0.006; increased RdT/Insulin of 1.0 ± 0.6 and 1.0 ± 0.3 mg kg−1 min−1 in OMNI and VEG, respectively), HbA1c (intervention; p = 0.001) and glycaemic variability (intervention; p = 0.040; increased time in‐range of 11.8 ± 9.3% and 23.3 ± 12.9% in OMNI and VEG). There were no improvements in hepatic insulin sensitivity or in postprandial blood glucose and serum C‐peptide (p > 0.05) during the MMTT.

Conclusions

High‐protein diets, whether predicated on vegan or omnivorous proteins, can improve glycaemic control by increasing peripheral insulin sensitivity in people with T2D.
A Pilot Study Assessing the Accuracy of AI ChatGPT Responses for AL Amyloidosis
Authors: Saba Ludovic , Comenzo Raymond , Khouri Jack , Anwer Faiz , Landau Heather , Chaulagain Chakra
Published: November 2024

AL amyloidosis is a rare, complex and often challenging disease for both patients and healthcare providers. The availability of accurate medical information is crucial for effective diagnosis and management. In recent years, artificial intelligence (AI) has emerged as a potential tool for providing medical information. This study aims to assess the accuracy of AI ChatGPT responses for AL amyloidosis related common questions and compare them to expert opinions. A scoring system was developed to evaluate responses provided by five participating expert physicians. AI ChatGPT demonstrated an overall accuracy rate of 82% in answering AL amyloidosis‐related questions. Responses on prognosis and patient support received the highest scores (100%), while questions related to treatment options showed lower accuracy (30%–60%). The results indicate that while the AI ChatGPT demonstrates overall accuracy, there are areas for improvement and potential discrepancies compared to expert opinions. These findings highlight the importance of ongoing refinement and validation of AI‐powered medical tools and cannot yet replace the advice of experts in the disease.
Switching from ligand to receptor anti‐calcitonin gene‐related peptide (CGRP) antibodies or vice versa in non‐responders: A controlled cohort study
Authors: van Veelen Nancy , van der Arend Britt W. H. , Hiele E. , van Zwet E. W. , Terwindt Gisela M.
Published: November 2024

Background and purpose

Limited options exist for migraine prevention after stopping anti‐calcitonin gene‐related peptide monoclonal antibodies. A systematic review examining the benefits of switching between different classes (ligand vs. receptor monoclonal antibody) is essential, alongside well‐designed real‐world studies.

Methods

In this cohort study 67 patients were included, who discontinued their first treatment with erenumab or fremanezumab. Patients (n = 31) switched to another monoclonal antibody class within 3 months, whilst those in the control group (n = 36) received standard care. Allocation to either group relied largely on the availability of alternative monoclonal antibody treatments, introducing pseudo‐random allocation. Changes in monthly migraine days were compared between groups 3 months post‐discontinuation of the first monoclonal antibody or initiation of a different monoclonal antibody class. A multivariate regression model was conducted that accounted for potential confounding factors.

Results

The groups were comparable at baseline and poor treatment response was the main reason for treatment discontinuation of the first monoclonal antibody. The switching cohort experienced a reduction of 3.9 monthly migraine days (95% confidence interval −6.4, −1.3, p = 0.004) compared with the control group.

Conclusion

Transitioning to a different anti‐calcitonin gene‐related peptide monoclonal class yields reduction in monthly migraine days compared to returning to standard care for patients with inadequate initial treatment response.
Enhancing multisensory rehabilitation of visual field defects with transcranial direct current stimulation: A randomized clinical trial
Authors: Diana Lorenzo , Casati Carlotta , Melzi Lisa , Marzoli Stefania Bianchi , Bolognini Nadia
Published: November 2024

Background and Purpose

Visual rehabilitation is necessary for improving the quality of life of patients with acquired homonymous visual field defects (HVFDs). By modulating brain excitability and plasticity, transcranial direct current stimulation (tDCS) may accelerate and increase the effects of compensatory trainings, which are usually long and intensive. In the present proof‐of‐principle, double‐blind, randomized, sham‐controlled study, we assess whether anodal tDCS applied over ipsilesional occipital or parietal cortices can increase the effects of a compensatory audiovisual training for HVFDs.

Methods

Eighteen participants with chronic HVFDs were randomized to receive anodal or sham tDCS over the ipsilesional parietal or occipital cortex during a 2‐week (10 days, 2 h/day) audiovisual treatment aimed at improving oculomotor visual field exploration. Improvements were assessed by administering visual detection with eye movements and visual search tests, and a questionnaire for activities of daily living (ADLs) before the treatment, at its end, and at 1‐month and 4‐month follow‐ups; lesion analyses were performed to look for predictors of treatment effects.

Results

Anodal ipsilesional tDCS, regardless of the target area (occipital vs. parietal), speeds up and increases daily improvements during the training. Whereas long‐lasting (up to 4 months) post‐treatment improvements in visual search and ADLs were observed in all groups, a greater and stable increase of visual detections in the blind hemifield was brought about only by the adjuvant use of occipital tDCS.

Conclusions

Compensatory audiovisual rehabilitation of HFVDs is effective and benefits from the adjuvant application of occipital and parietal tDCS, which speeds up and increases training‐induced improvement.

Registry number: NCT06116760.
Challenges for the veterinary profession: A grounded theory study of veterinarians' experiences of caring for older horses
Authors: Smith Rebecca , Pinchbeck Gina , McGowan Catherine , Ireland Joanne , Perkins Elizabeth
Published: November 2024

Background

In Great Britain, owners are keeping their horses into increasingly older age, reflecting societal changes in human–animal relationships. The uptake of routine veterinary services is reported to reduce as horses age. Horse owners seek information regarding their animal's health from alternative sources before and/or following veterinary involvement. Information regarding the experiences and behaviours of veterinarians toward older horse health care provision is limited.

Objective

This study sought to explore how veterinary care for the ageing horse is conceptualised and approached by veterinarians treating horses in Great Britain.

Study design

Exploratory qualitative.

Methods

A subset of qualitative data, collected as part of a larger study investigating how owners and veterinarians make decisions regarding the care of the older horses, was analysed using a constructivist grounded theory approach. Data included semi‐structured in‐depth interviews with nine veterinarians and veterinary clinical records pertaining to the horses of 13 participating owners.

Results

Veterinarians valued regular interactions with owners to optimise a horse's management, however, the timing and nature of veterinary involvement varied. The context of older age shaped decision‐making and ‘age‐appropriate’ interventions were negotiated within the context of each horse and owner. Where participants had concerns about a horse, they sought to achieve an owner's adherence to their advice while navigating the veterinarian–owner relationship. Interpersonal dimensions of veterinarian–owner interactions appeared to shape, and could challenge, veterinarians' delivery of health care services and their own sense of being a professional who cares for animals, and about people.

Main limitations

A sample of veterinarians were recruited for this study based on horse owners' involvement.

Conclusions

The provision of veterinary care for the older horse rests upon networks of relationships. Collaboration between the profession and owners in both the design and delivery of, veterinary health care services may better enable different types of knowledge and values to be brought together more effectively.
Assessing the factors affecting the accessibility of primary dental care for people with haemophilia
Authors: Sipos Kitti , Márton Ildikó , Móré Marianna , Nagy Attila Csaba , Kiss Csongor
Published: November 2024

Introduction

Patients with haemophilia (PWH) often have difficulty accessing dental services.

Aim

To determine the accessibility of dental care for PWH and to examine their perceptions of how coronavirus type‐2 (CoV‐2) disease (COVID‐19) has affected their ability to access dental treatments following the pandemic.

Methods

The questionnaire survey was conducted between July 2022 and December 2022 at haemophilia treatment centres in Hungary. Variables with statistical significance (Pearson's Chi‐squared test; p < .05) were included in logistic regression analyses. Least absolute shrinkage and selection operator (LASSO) regression was used as a machine learning technique to identify the most predictive variables.

Results

Twenty‐one percent of the sixty‐eight participants reported that they had been refused dental treatment, mainly in primary care (86%). Dental refusal was influenced by infectious disease (OR: 4.48, CI: 1.14–17.69) and previous dental bleeding complications (OR: 4.23, CI: 1.10–16.27). There was correlation between dental visits and having a permanent dentist or receiving oral hygiene advice (OR: 9.95, CI: 2.86–34.62 and OR: 3.84, CI: 1.09–13.58). Participation in an oral hygiene consultation increased patients’ satisfaction with their dental care (OR: 6.28, 95% CI: .71–55.88). Twenty‐eight percent of patients had experienced difficulties since the start of the COVID‐19, but 84% had visited their dentist at least once between 2021 and 2022 (p = .002). Nevertheless, 16% of respondents went for only the most necessary treatments due to pandemic.

Conclusion

Refusal of dental care was high among participants, especially in primary care. The COVID‐19 pandemic has exaggerated the difficulties of PWH in accessing dental treatment.

Highlights

Patients with haemophilia (PWH) have difficulty accessing dental care, and the coronavirus type 2 (CoV‐2) disease pandemic (COVID‐19) has created a new barrier.

The study revealed a high prevalence of dental care refusal (21%), particularly in primary care (86%).

This 2022 survey found that 28% of patients experienced difficulties since the pandemic started and 16% only sought necessary treatments.
Evaluating the Impact of Contextual Offers in a Highly Selective Institution: Results From a Mixed‐Methods Contribution Analysis
Authors: Schulte Jonathan T. , Benson‐Egglenton Jessica
Published: November 2024

English university admissions increasingly make use of contextual offers, where applicants with certain socio‐demographic characteristics can be offered marginally lower entry conditions. This paper presents novel insights on the impact of contextual offer policy on one institutions' patterns of enrolment in 2022/23 via a mixed methods contribution analysis. We present evidence that the policy contributed to widening access for targeted students despite the institutions' small and highly selective intake. This effect appears to be driven by increasing applicants' likelihood of accepting an offer and allowing a small number of students to enrol despite narrowly missing standard offer criteria. While contextual offer policies thus appear to be an effective tool for improving targeted students' enrolment at an institution, further research is needed to understand the impact of contextual offers on student outcomes and experiences.
Information literacy instruction by librarians is integrated into the doctor of pharmacy curriculum in the USA but requires evidence of impact
Authors: Lapidus Mariana , Bond Irena
Published: November 2024

Background

Medical librarians play an essential role in providing information literacy instruction for pharmacy students in order to educate them on health information searching, retrieval, and evaluation. Nevertheless, there have been no peer‐reviewed publications providing comprehensive data on librarians' involvement in pharmacy education across the United States.

Objectives

The goal of this study was to investigate the instructional delivery methods, technology used, and topics taught by librarians across the Doctor of Pharmacy curriculum in the United States.

Methods

A 17‐question electronic survey was designed using Qualtrics and distributed via professional library discussion lists in 2023.

Results

Thirty‐eight librarians indicated their involvement in teaching information literacy to pharmacy students during orientation sessions, elective and credit‐bearing courses using in‐class, online synchronous, and hybrid instructional delivery formats. Topics included medical and drug databases, citation management tools, evidence‐based medicine, and free drug information resources.

Discussion

This is the first study that provides a broad insight into the teaching roles and instructional trends of medical librarians in pharmacy education.

Conclusions

Though the results of this survey demonstrate a high level of integration of library instruction into the pharmacy curriculum, more research needs to be done to collect data on medical librarians' contribution to educating student pharmacists.
Copying in medical documentation: developing an evidence‐based approach
Authors: Tsimiklis James , Howson Sarah , Kovoor Joshua , Tan Sheryn , Stretton Brandon , Gupta Aashray , Evans Shaun , Booth Andrew , Satheakeerthy Shrirajh , Lim Lauren , Stranks Jessica , Gluck Samuel , Maddison John , Gilbert Toby , Bacchi Stephen
Published: November 2024

Background

Electronic medical records (EMRs) provide multiple efficiencies in communication to clinicians. The ability to copy and paste text in an EMR can be useful; however, it also conveys a risk of inaccurate documentation. Studies in international settings have described such overuse of copying to result in ‘note bloat’, with the dilution of relevant clinical information and potential clinical detriment.

Aim

To determine the frequency of erroneous copying, characterise the component of notes in which this occurs and determine the performance of similarity metrics in the prediction of notes likely to have erroneous copying.

Methods

A cross‐sectional evaluation of all ward round notes over a 48‐h period for all long‐stay (>48 h) medical services, except the Acute Medical Unit, at the Lyell McEwin Hospital, a 257‐bed tertiary hospital in South Australia. Four similarity metrics were evaluated: longest‐sequential series of unchanged characters, similarity score (Difflib SequenceMatcher), Levenshtein distance and the Jaccard index.

Results

One hundred twenty‐eight patients were included. The number of patients who had a ward round note on two consecutive days was 97 out of 128 (75.8%). Erroneous copying was found in 8.3% of ward round notes. All (eight out of eight, 100%) of these instances of erroneous copying were in the ‘issues list’. A threshold of >850 unchanged sequential characters, when compared with the ward round note the preceding day, demonstrated reasonable performance in the prediction of erroneous copying.

Conclusions

Erroneous copying may occur in up to 8.3% of ward round notes in a variety of medical services. Automated strategies to help address this issue should be explored.
Above room temperature multiferroic and magnetoelectric properties of (1‐Φ) PZTFT‐Φ CZFMO particulate composites
Authors: Bhoi Krishnamayee , Pradhan Dhiren K , Mohanty Hari Sankar , Liyanage W. L. N. C. , Barik Alok , Rahaman M. M. , Babu S. Narendra , Gilbert Dustin A. , Rack Philip D. , Pradhan Dillip K.
Published: November 2024

Magnetoelectric (ME) composites of suitable ferroelectric and magnetic materials can display elevated magnetic and ferroelectric operational temperatures, along with substantial ME coupling, compared to conventional single‐phase multiferroics. Herein, we describe the synthesis of (1‐Φ) PZTFT‐Φ CZFMO, Φ = 0.1, 0.2, 0.3 (PZTFT: [0.6(PbZr0.53Ti0.47O3)–0.4(PbFe0.5Ta0.5)O3] CZFMO: Co0.6Zn0.4Fe1.7Mn0.3O4)] particulate (0–3) composites and report on the magnetic as well as ferroelectric phase transitions and magnetoelectric coupling. The phase formation and the induced strain in these composites are investigated via Raman spectroscopy. A large bifurcation of the zero‐field cooled‐field cooled magnetization curves confirms the highly anisotropic behavior of the composites. These curves also identify spin glass behavior in the CZFMO phase at ≈230 K. The magnetic phase transition of the composite (Φ = 0.2) is reported to be ≈532 (± 10) K. The temperature dependent dielectric data displays the ferroelectric phase transitions from the PZTFT phase and the broad relaxation peak from the CZFMO phase. The quadratic relationship between the magneto‐capacitance and the magnetization confirms the existence of biquadratic magnetoelectric coupling in the systems. The collective results are consistent with the presence of a direct magneto‐electric effect in the composites, i.e., by the application of magnetic field, the magnetic phase is strained, and this induced strain is responsible for changes of ferroelectric order parameter in the piezoelectric phase. This attribute makes the current composite structure a promising candidate for multiferroic data storage and processing technologies.
Green synthesized Fe‐doped ZnO NPs using aloe vera gel: Antimicrobial, structural, optical and magnetic properties
Authors: Chauhan Shreya , Thakur Prashant , Kishore Kamal , Lal Madan , Sharma Pankaj
Published: November 2024

Pristine (pure) ZnO and Zn1−xFexO (with Fe = 0.05, 0.10, and 0.15) nanoparticles (NPs) were successfully prepared by green synthesis using aloe vera gel. The x‐ray diffraction (XRD), Field emission scanning electron microscope, ultraviolet‐visible, photoluminescence (PL), and vibrating sample magnetometer (VSM) were employed to investigate the structural, optical, and magnetic properties of Zn1−xFexO NPs. Rietveld refined XRD data revealed that Zn1−xFexO NPs have hexagonal wurtzite structures with space group P63mc. Fe‐doping resulted in a decrease in the average grain size. The value of the Eg decreased from 2.49 to 2.17 eV with an increase in Fe3+ content. A blue shift in band edge emission shift toward lower wavelength (x = 0.00 to 0.05) and red‐shift for (x > 0.05) PL spectra. A ferromagnetic behavior with enhancement in saturation magnetization was observed with Fe3+ doping. By breaking down the bacterial cell wall and altering the genetic makeup of the cells, Zn1−xFexO NPs effectively eradicate Klebsiella pneumonia and Staphylococcus aureus in antimicrobial assessment.
Defining key deprescribing measures from electronic health data: A multisite data harmonization project
Authors: Dublin Sascha , Albertson‐Junkans Ladia , Pham Nguyen Thanh Phuong , Pavon Juliessa M. , Hastings S. Nicole , Maciejewski Matthew L. , Willis Allison , Zepel Lindsay , Hennessy Sean , Albers Kathleen B. , Mowery Danielle , Clark Amy G. , Thomas Sunil , Steinman Michael A. , Boyd Cynthia M. , Bayliss Elizabeth A.
Published: November 2024

Background

Stopping or reducing risky or unneeded medications (“deprescribing”) could improve older adults' health. Electronic health data can support observational and intervention studies of deprescribing, but there are no standardized measures for key variables, and healthcare systems have differing data types and availability. We developed definitions for chronic medication use and discontinuation based on electronic health data and applied them in a case study of benzodiazepines and Z‐drugs in five diverse US healthcare systems.

Methods

We conducted a retrospective cohort study of adults age 65+ from 2017 to 2019 with chronic benzodiazepine or Z‐drug use. We determined whether sites had access to medication orders and/or dispensings. We developed definitions for chronic use and discontinuation using both data types. Discontinuation definitions were based on (1) gaps in medication availability during follow‐up or (2) not having medication available at a fixed time point. We examined the impact of varying the gap length and requiring a 30‐day period without orders/dispensings (“halo”) around the fixed time point. We compared results derived from orders versus dispensings at one site.

Results

Approximately 1.6%–2.6% of older adults had chronic benzodiazepine/Z‐drug use (total N = 6775, ranging from 431 to 2122 across sites). Depending on the definition and site, the proportion discontinuing use during 12 months ranged from 6% to 49%. Requiring a longer gap or a 30‐day “halo” resulted in lower estimates. At one site, only 56% of those with chronic use defined from orders also qualified based on dispensings, and the discontinuation rate at 180 days was 20% from orders versus 32% from dispensings.

Conclusions

Requiring a gap of ≥90 days or a “halo” around a time point may more accurately capture discontinuation than using a shorter gap or no halo. Orders data underestimate discontinuation compared to dispensings. Work is needed to adapt these definitions for other drug classes and settings.
Validation of a model for continued employment for general workers with mental illness: A covariance analysis based on evidence from Japan
Authors: Fukuura Yoshitomo , Shigematsu Yukako , Mizuochi Yumi
Published: November 2024

Aim

To clarify the relationship and structure of the factors that influence the outcomes of continuous employment for people with mental illness and examine the necessary support for this.

Methods

The hypothesis was developed based on previous concept analysis results. To test it, a questionnaire was used comprising 21 items on the ability to continue working, 24 items on basic competencies for independent living, 21 items on workplace environment, and 27 items on outcomes of continuous employment. The study randomly selected 200 organizations in Japan serving as consultation centers for people with mental illness to recruit participants aged 20–59 years old registered at these entities as of April 1, 2022. Goodness of fit was evaluated between the models and the data.

Results

Responses were received from 296 individuals. The direct effect on the outcome of continuous employment from the basic competencies for independent living was 0.48 and that from the ability to continue working was 0.29, indicating that basic competencies for independent living had a stronger influence on the outcome of continuous employment. Combining the ability to continue working and basic competencies for independent living showed a high path coefficient of 0.56 with workplace environment, indicating a strong influence on the workplace.

Conclusions

People with mental illnesses, workplace staff, and professionals should work together to foster a supportive workplace environment. Professionals should also keep in mind the potential positive impact that people with mental illnesses can have on workplace dynamics.
The Relationship Between Preoperative Vitamin D Levels and Keloid Recurrence
Authors: Lee Da Woon , Kang Daihun , Ha Boram , Kim Da Hye , Chang Choong Hyun , Park Tae Hwan
Published: November 2024

Background

Keloids, characterized by excessive collagen deposition, often recur despite various treatments. This study explores the association between preoperative serum vitamin D levels and keloid recurrence in a Korean population.

Methods

A retrospective cohort of 160 patients who underwent keloid excision was analyzed. Preoperative serum 25(OH) vitamin D and 1,25(OH)2 vitamin D levels were measured. Recurrence rates were compared using hierarchical logistic regression, adjusting for potential confounders.

Results

Age was significantly associated with keloid recurrence (OR: 0.934, p = 0.009), indicating older age was linked to lower recurrence risk. No significant association was found between preoperative 25(OH) vitamin D (p = 0.395) and 1,25(OH)2 vitamin D levels (p = 0.925) and keloid recurrence.

Conclusions

Preoperative vitamin D levels do not predict keloid recurrence in this Korean cohort, while age is a significant predictor. Understanding the multifactorial nature of keloid pathogenesis requires further investigation into other potential risk factors.
Influences on Skin and Intrinsic Aging: Biological, Environmental, and Therapeutic Insights
Authors: Hussein Ramadan S. , Bin Dayel Salman , Abahussein Othman , El‐Sherbiny Abeer Ali
Published: November 2024

Background/Aim

Aging involves a progressive deterioration in physiological functions and increased disease susceptibility, impacting all organs and tissues, especially the skin. Skin aging is driven by intrinsic factors (genetics, cellular metabolism) and extrinsic factors (environment, lifestyle). Understanding these mechanisms is vital for promoting healthy aging and mitigating skin aging effects. This review aims to summarize the key factors influencing skin and intrinsic aging, providing a comprehensive understanding of the underlying mechanisms and contributing elements.

Methods

A comprehensive literature review was conducted, focusing on peer‐reviewed journals, clinical studies, and scientific reviews published within the last two decades. The inclusion criteria prioritized studies that addressed intrinsic and extrinsic mechanisms of skin aging. To ensure the relevance and quality of the selected sources, a systematic approach was used to assess study design, sample size, methodology, and the significance of the findings in the context of skin aging.

Findings

The review identifies major internal factors, such as cellular senescence, genetic predisposition, telomere shortening, oxidative stress, hormonal changes, metabolic processes, and immune system decline, as pivotal contributors to intrinsic aging. External factors, including UV radiation, pollution, lifestyle choices (diet, smoking, alcohol consumption, and sleep patterns), and skincare practices, significantly influence extrinsic skin aging. The interplay between these factors accelerates aging processes, leading to various clinical manifestations like wrinkles, loss of skin elasticity, pigmentation changes, and texture alterations.

Conclusion

A comprehensive understanding of both extrinsic and intrinsic factors contributing to skin aging is essential for developing effective prevention and intervention strategies. The insights gained from this review highlight the importance of a multifaceted approach, incorporating lifestyle modifications, advanced skincare routines, and emerging therapeutic technologies, to mitigate the effects of aging and promote healthier, more resilient skin.
A Scoping Review of Observational Research on Cannabis Use for Symptom Management in HIV and Cancer: Implications for Cannabis Nursing
Authors: Cho Hwayoung , Kalina Elena , Wu Jianli , Cook Robert , Salloum Ramzi , Liu Yiyang , Bian Jiang , Guo Jingchuan , Starkweather Angela
Published: November 2024

Background

People with HIV have a higher risk of developing non‐AIDS‐defining cancers in older age, leading to a significant population living with two conditions, HIV and cancer. There is an increasing interest in cannabis use for symptom management in people with chronic conditions; in 2023, the American Nurses Association officially recognised cannabis nursing as a specialty nursing practice focusing on the care of individuals seeking education/guidance in the therapeutic use of cannabis, supporting the urgency of its research. However, the scientific literature lacks a synthesised review in the focused populations.

Aim

To explore observational research on cannabis use for symptom management among people with HIV and/or cancer and identify gaps in current knowledge to inform future research and policy development.

Methods

Following the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses Extension for Scoping Reviews (PRISMA‐ScR) checklist, a literature search of relevant articles was conducted in the databases PubMed (n = 552), PsycInfo (n = 204), CINAHL (n = 164) and Embase (n = 976). Upon screening 1738 articles, 142 were identified for full‐text review and 51 were retained for data extraction.

Results

There were more studies evaluating cannabis use among people with cancer than with HIV and no studies among people living with comorbid HIV and cancer. Most studies were cross‐sectional with limited metrics on the perceived effectiveness and safety of cannabis use for symptom management and its dosing/mode of delivery for reducing symptoms. While studies focused on cannabis therapy under the provision of healthcare providers, individuals reported obtaining information about cannabis from friends/family/the Internet.

Implications for Cannabis Nursing

This body of research could be strengthened by rigorous longitudinal study designs to build causal relationships on the therapeutic effects of cannabis use and the inclusion of reliable and valid symptom assessment measures over time, which facilitates developing clinical practice guidance and policymaking in cannabis nursing.

Patient or Public Contribution

No patient or public contribution.
Longitudinal changes in regional fat and muscle composition and cardiometabolic biomarkers over 5 years of hormone therapy in transgender individuals
Authors: Lundberg Tommy R. , Tryfonos Andrea , Eriksson Lisa M.J. , Rundqvist Helene , Rullman Eric , Holmberg Mats , Maqdasy Salwan , Linge Jennifer , Leinhard Olof Dahlqvist , Arver Stefan , Andersson Daniel P. , Wiik Anna , Gustafsson Thomas
Published: November 2024

Background

Longitudinal studies investigating hormone therapy in transgender individuals are rare and often limited to 1‐ to 2‐year follow‐up periods.

Objectives and Methods

We examined changes in body composition, muscle volumes, and fat distribution as well as muscle strength, arterial stiffness, and cardiometabolic biomarkers in both transgender men (TM; n = 17, age 25 ± 5 years) and transgender women (TW; n = 16, age 28 ± 5 years) at baseline and after 1 and 5–6 years of hormone therapy in a longitudinal prospective cohort design. Whole‐body and regional fat and muscle volumes were analyzed using magnetic resonance imaging, and blood samples were taken.

Results

Skeletal muscle size increased in TM (21% after 6 years) and decreased in TW (7% after 5 years). Muscle strength increased 18% after 6 years in TM (p = 0.003) but was statistically unchanged in TW. Muscle fat infiltration changed (p < 0.05) almost completely toward the affirmed sex phenotype after 1 year of therapy in both TM and TW. The most notable changes in fat volume distribution were that TW increased total adiposity but decreased visceral fat volume, whereas TM showed increased visceral fat (70%) and liver fat but relatively stable total adipose tissue levels. Although arterial stiffness and blood pressure did not change, there was a significant increase in triglyceride and LDL cholesterol levels and a decrease in HDL levels in TM after 6 years.

Conclusion

These unique longitudinal data underscore the importance of continued clinical monitoring of the long‐term health effects of gender‐affirming hormone therapy in both TW and, perhaps especially, TM.
The uneven effect of Airbnb on the housing market: Evidence across and within Italian cities
Authors: Congiu Raffaele , Pino Flavio , Rondi Laura
Published: November 2024

We investigate if Airbnb diffusion affects residential property values differently across and within cities leveraging the heterogeneity of five Italian cities in terms of tourist attractiveness, local housing markets, and socioeconomic conditions. We find that Airbnb density growth leads to increases in house prices in all cities. Within‐city, the impact is positive both in centers and in the suburbs in more touristic towns, but only in the center in the others. Moreover, Airbnb may increase or decrease the center–periphery price gap. Our results suggest that the different impact of Airbnb on housing submarkets is driven by local disparity conditions.
The Core‐Periphery Model Under Additively Separable Preferences
Authors: Wang Congcong , Zeng Dao‐Zhi , Zhu Xiwei
Published: November 2024

This paper reexamines Krugman's core‐periphery model by substituting his constant elasticity of substitution (CES) utility with a general additively separable utility that comprehensively captures the pro‐competitive effect while preserving the income effect. The heterogeneous consumption patterns of skilled workers and unskilled workers introduce a demand adjustment effect. The resulting interaction between the dispersion force, driven by the pro‐competitive effect and the demand adjustment effect, and the agglomeration force stemming from the “second nature,” leads to various possible location patterns. These comprehensive demand and supply linkages generate novel evolutionary paths and bifurcation diagrams. Notably, high trade costs do not always lead to complete dispersion, and free trade does not necessarily result in agglomeration. Furthermore, multiple phases of redispersion are also possible.
Impact of Periodontal Lipopolysaccharides on Systemic Health: Mechanisms, Clinical Implications, and Future Directions
Authors: Santos Wanderson S. , Solon Isabelly G. , Branco Luiz G. S.
Published: November 2024

Periodontal diseases, particularly periodontitis, are complex inflammatory conditions caused by interactions between oral microbiota and the host immune response. Lipopolysaccharides (LPSs) from Gram‐negative bacteria like Tannerella forsythia, Treponema denticola, and Porphyromonas gingivalis are key in pathogenesis. This review examines how LPS impacts systemic health through direct invasion, compromised oral barriers, increased vascular permeability, and immune cell transport. LPS triggers inflammation in periodontal tissues, leading to tissue destruction and disease progression. In the bloodstream, LPS contributes to conditions, such as cardiovascular diseases, diabetes, respiratory diseases, and rheumatoid arthritis. Current treatments include mechanical debridement, antibiotics, antimicrobial mouthwashes, and anti‐inflammatory therapies. Despite progress, gaps remain in understanding the molecular mechanisms of LPS in systemic diseases. Future research should focus on longitudinal studies, the gut–oral axis, biomarkers for early detection, and the lymphatic system's role in LPS dissemination. Maintaining periodontal health is crucial for overall systemic well‐being.
Distinguishing Wolff–Parkinson–White Syndrome From Fasciculoventricular Pathway Using QRS‐T Angle Analysis
Authors: Nakagawa Ryo , Sato Kazuhisa , Yoshida Yoko , Suzuki Tsugutoshi , Nakamura Yoshihide
Published: November 2024

Background

Wolff‐Parkinson‐White (WPW) syndrome and fasciculoventricular pathway (FVP) present electrocardiographic manifestations characterized by delta waves, differentiating these two is challenging. Specifically, WPW type B with QRS width ≤120 ms, resembles typical FVP features. Because of the presence of repolarization abnormalities in WPW syndrome, our hypothesis centered on the potential utility of the QRS‐T angle for distinguishing WPW syndrome from FVP. To determine the discriminative value of the QRS‐T angle for delineating WPW syndrome from FVP.

Methods

We included cases of WPW syndrome treated with catheter ablation and FVP diagnosed via adenosine triphosphate administration between 2007 and 2023. We excluded cases with WPW type A, QRS width >120 ms, intermittent WPW, congenital heart disease or myocardial damage, ablation history, tachycardia, palpitations within 3 months, and WPW syndrome featuring an accessory pathway on the left lateral wall. Eventually, we identified 40 and 54 patients from the WPW and FVP groups, respectively. The QRS‐T angle was compared between the WPW and FVP cohorts.

Results

The QRS‐T angle in the WPW group was significantly larger than in the FVP group (45.7 ± 46.3° vs. 17.8 ± 13.9°, p < 0.001). Receiver operating characteristic curve analysis with a sensitivity and specificity of 65.0% and 72.6%, respectively, demonstrated that the optimal cut‐off value for the QRS‐T angle was 22° for distinguishing WPW from FVP. Remarkably, all cases with a QRS‐T angle >65° were within the WPW group.

Conclusions

The QRS‐T angle can offer promising utility in differentiating WPW syndrome from FVP.