bluuebunny/crossref_metadata_2025 huggingface dataset:
Can body mass and skull morphology predict seed and fruit ingestion potential for mammal species? A test using extant species and its application to extinct species
Authors: Sivault Elise , McConkey Kim R. , Bretagnolle François , Sengupta Asmita , Lambert Joanna E. , Heymann Eckhard W. , Herrel Anthony , Forget Pierre‐Michel
Published: February 2023

Larger animals are assumed to ingest larger seeds and consume larger fruits, but empirical studies reveal inconsistent trends between body mass and the average size of fruits and seeds ingested. Furthermore, no studies have explored seed size relationships with morphological traits, such as skull dimensions. Such characteristics might provide more reliable estimates of ingestion ability and allow for accurate predictions of seed dispersal capacity in species for which we lack empirical data, especially extinct species. To determine whether (i) mammalian skull dimensions are better predictors of the maximum size of ingested seeds and fruits, compared to body mass and (ii) body mass are the better predictors of mean fruit and seed sizes, we studied these relationships across three mammalian orders: Chiroptera, Primates and Carnivora.

We collected novel data on skull dimensions and collated available data on body mass and maximum and mean sizes of ingested fruits and seeds for mammals (N = 100) across the Neotropics, Asia, Africa and Madagascar. We explored the relationships between anatomical traits and fruit and seed sizes of extant species and made predictions for five extinct species.

Our results revealed that body mass and skull dimensions are essential determinants of ingested fruit and seed size in mammals. The latter traits can generate predictions for extinct species, especially coronoid height and maximum jaw gape. Nevertheless, body mass predicted larger ingested fruits and seeds than skull dimensions and explained a greater part of the variance for both maximum and mean sizes in our dataset.

Our results show how body mass and cranial anatomy constrain seed size and reinforce the importance of maintaining functional diversity in seed dispersers to maintain tropical forest structure. We also show that scientists can use morphological characteristics to predict the seed dispersal potential of extinct mammals allowing better inferences on past and future consequences of frugivore extinctions within tropical forests.

Read the free Plain Language Summary for this article on the Journal blog.
COVID‐19 and Long‐Term Economic Growth
Authors: Hao Jinji , Gregg Harry , Yao Yao
Published: February 2023

This article investigates the impact of the COVID‐19 pandemic on the long‐term economic growth of South Africa. We embed an epidemiological model in a modified Solow–Swan model and explore various channels such as morbidity, mortality, unemployment, loss of school days and capital accumulation. We demonstrate that COVID‐19 will lower the average annual growth rate of GDP per capita of South Africa by 0.07 percentage points in the next four decades, a 25 per cent decline relative to the no‐COVID benchmark. We show that human capital losses due to school closures account for more than half of the economic slowdown.
Digital community assets: Investigating the impact of online engagement with arts and peer support groups on mental health during COVID‐19
Authors: Tucker Ian , Easton Katherine , Prestwood Rebecca
Published: February 2023

The digitisation of mental health support has accelerated since the outbreak of the COVID‐19 pandemic. This study investigated the impact of digital engagement with community assets on mental health during COVID‐19. Digital engagement is typically not location‐bound, but the restricted movement enforced during ‘lockdowns’ meant that people were primarily accessing digital community assets from their home environments. We report findings from a study utilising two creative workshops and semi‐structured interviews to investigate how support operates in and through three digital community assets; an online peer support forum, a social enterprise running regular creative challenges nationally via social media and a local in‐person creative arts support group. The concept of ‘more or less digital’ captures the ways that people’s experiences of digital community assets extend beyond the platforms to incorporate settings of use. The analysis identifies how support is diluted through digital engagement, the value of minimal and muted forms of engagement and user‐led designs for future hybrid forms of support. The article concludes by emphasising the importance of analysing digital community asset engagement in the settings of use and how such knowledge is vital for planning support in a future under continual pressure to be increasingly digital.
Contributions of processes using semantic information and character‐to‐sound correspondences to kanji word‐reading performance in Japanese primary school children
Authors: Sambai Ami , Tsukada Mayu , Miki Ayaka , Uno Akira
Published: February 2023

Background

In opaque orthographies, such as English, children with low reading skills tend to rely more on semantic information due to their inadequate acquisition of sub‐lexical knowledge. This tendency has also been reported for kanji, a non‐alphabetic and opaque Japanese orthography. However, previous studies on this phenomenon have had methodological limitations, such as a small number of stimuli in reading tests and insufficient investigation of a consistency effect. This study addressed these limitations and aimed to clarify whether Japanese children with low reading accuracy are characterised by a stronger reliance on semantic information and a smaller contribution to the reading process based on character‐to‐sound correspondences to the kanji word‐reading performance than children with high reading accuracy in reading kanji words.

Methods

A total of 129 Japanese students in the fifth and sixth grades participated in this study, and 11 of them had been previously diagnosed with developmental dyslexia. They read an experimenter‐created list of kanji words. We tested how frequency, imageability and consistency of character‐to‐sound correspondences affected children's reading accuracy and error types and how the effects of these variables were modulated by reading accuracy level.

Results

For children with lower reading accuracy, the frequency and consistency effects on reading accuracy decreased, whereas the imageability effect was stronger. Children with low reading accuracy frequently did not respond, whereas children with high reading accuracy made word substitution and legitimate alternative reading of component (LARC) errors frequently.

Conclusions

The reading processing of children with low reading accuracy is characterised by a stronger reliance on semantic information and a smaller contribution of a reading process based on character‐to‐sound correspondences to reading performance than that of children with high reading accuracy. Reading characteristics of children with low reading accuracy might be due to their inadequate lexical and sub‐word knowledge.
Rapid and nondestructive analysis of lipstick on different substrates using ATR‐FTIR spectroscopy and chemometrics
Authors: Ka Khei Lim , Verma Rajesh , Tan Eva Lee Yin , Low Kah Hin , Ismail Dzulkiflee , Mohamad Asri Muhammad Naeim
Published: February 2023

Lipstick can be an important piece of evidence in crimes like murders, rapes, and suicides. Due to its prevalence, it can be an important corroborative evidence in crime reconstruction. The analysis of such evidence can provide an evidentiary link between the suspect, the victim, object, or the crime scene. We report the use of nondestructive ATR‐FTIR spectroscopy combined with chemometrics for the classification of 10 brands of lipsticks with nine samples each. Chemometric method of partial least square‐discriminant analysis (PLS‐DA) has been employed to interpret the data and classify the samples into their respective classes. The PLS‐DA model provides an AUC figure above 0.99 in all brands except one; for which it is slightly less at 0.94. We have also tested the traces of these lipstick samples on different substrates treating them as unknowns in the already trained PLS‐DA model. 100% of the samples on nine substrates viz. a cotton, nylon, plastic, dry tissue, denim (blue jeans), wet tissue, nitrile gloves, white paper, and polyester were correctly attributed to their source brand. In conclusion, the results suggest that ATR‐FTIR combined with the chemometrics is a rapid, nondestructive, and accurate method for the discrimination and source attribution of lipstick. This study has potential for use in actual forensic casework conditions.
Effect of high intensity ultrasonic treatment on structural, rheological, and gelling properties of potato protein isolate and its co‐gelation properties with egg white protein
Authors: Zhao Hongxi , Zhao Ruixuan , Liu Xinshuo , Zhang Liang , Liu Qiannan , Liu Wei , Wu Tao , Hu Honghai
Published: February 2023

The study aimed to investigate the effect of high intensity ultrasonic (HIU) treatment at different times (0, 10, 20, and 30 min) on the structure and gel properties of water‐soluble potato protein isolate (WPPI) and to further investigate the improvement of gel properties of ultrasonicated WPPI (UWPPI) by the addition of egg white protein (EWP). HIU reduced the particle size of WPPI, whose structure became loose and disordered, which improved gelling properties of UWPPI. Fourier transform infrared results indicated that α‐helix content decreased, whereas the proportion of irregular curl increased with the increase in ultrasonication time (0–20 min), indicating that the initially ordered structure of UWPPI became disordered. After HIU treatment, the free sulfhydryl groups of UWPPI and surface hydrophobicity decreased and fluorescence intensity increased. These results demonstrated that the HIU loosened the structure of UWPPI, exposing more chromogenic groups while embedding more hydrophilic groups. After thermal induction, UWPPI gel hardness increased and exhibited excellent water holding capacity. After the addition of EWP, rheological properties stabilized, and the hardness of UWPPI‐EWP gels increased significantly, forming internally structured protein gels with a tightly ordered structure and increased brightness. Thus, HIU changed the structure and gelling properties of WPPI, and the addition of EWP further enhanced the performance of hybrid protein gels.

Practical Application

High intensity ultrasonic changed the structure of water‐soluble potato protein isolate (WPPI) and improved the properties of WPPI gels. The addition of egg white protein significantly improved the quality of mixed protein gels which showed great potential industrial value.
Purification and characterization of a fungal laccase expressed in Kluyveromyces lactis suitable for baking
Authors: Molina Melisa A. , Cazzaniga Amanda , Milde Laura B. , Sgroppo Sonia C. , Zapata Pedro D. , Fonseca Maria I.
Published: February 2023

Laccase enzyme can replace chemical additives to improve texture properties and the volume of bread. Laccase encoding gene from Phlebia brevispora, a native fungus from Misiones, Argentina, was expressed in the generally recognized as safe yeast Kluyveromyces lactis. To improve laccase activity, medium conditions were optimized. The use of iron sulfate at a concentration of 1 mM led to optimum laccase activity (1289 U·L−1) on the fourth day of incubation. SDS‐PAGE analysis revealed that the molecular mass of purified laccase was about 180 kDa. Optimum pH for the enzyme was 4 and optimum temperature was 40°C. Laccase exhibited high stability at low pH and high temperature. The application of recombinant laccase to bread decreased hardness, gumminess, and chewiness and increased bread volume. Based on these results, recombinant laccase from P. brevispora with improved yield is a good option for application as an improver of the physicochemical quality of bread at the industrial level. Besides, it will allow us to advance toward our goal of developing healthy alternatives for the bakery industry. No previous work has been reported concerning the heterologous expression of the laccase gene native to the province of Misiones, Argentina, with an aim for application in baking.

Practical Application

Healthy bakeries became a trend in recent years. The use of the laccase enzyme increases the specific volume and decreases the hardness of bread, being thus an alternative for the replacement of chemical additives in the bakery industry.
NMπ 2.0: Software update to minimize the risk of false positives among determinants of reproductive success
Authors: Chybicki Igor J.
Published: February 2023

In plant populations, parentage analysis helps understand factors shaping individual reproductive success. However, estimating reproductive success determinants based on parentage counts requires decoupling the effects of individual fecundity and propagule dispersal. The neighbourhood model implemented in the NMπ software provides a standard solution for this problem based on the fixed‐effects regression‐like approach. Nonetheless, it has been recently shown that the method is prone to false discoveries when important fecundity determinants are omitted. To account for the unexplained variance in fecundity, the Bayesian approach was developed based on the new model (the hierarchical neighbourhood model; HNM). Here, I present the NMπ software update that allows the HNM approach to be used in the framework of a friendly interface. More importantly, the HNM approach is now made available for both dispersed (seedlings) and nondispersed (seeds with known mothers) progeny data. The Bayesian approach, among others, selects significant fecundity determinants, estimates the proportion of variance in reproductive potential explained by selected determinants (R2), and provides individual female and male fecundity values. Although the software was designed to handle microsatellite marker data, a solution is proposed for large sets of single nucleotide polymorphisms. The program can be run on Windows (using either a terminal or a graphical interface) as well as (using a terminal) on Linux, or macOS platforms. In any case, NMπ can utilize multicore processors to speed up the analysis. The updated package containing the code, the executable file, the user manual, and example data is available at https://www.ukw.edu.pl/pracownicy/plik/igor_chybicki/3694/.
Impact of multidisciplinary team meetings on the management of patients with breast cancer in a large private healthcare facility
Authors: Orlowski Christian , Lai John , Vereker Melissa , Antill Yoland , Richardson Gary , White Michelle , Gregory Peter , Kemp Sarah , Morgan Joanna , Ooi Corinne , Senior Jennifer , David Steven
Published: February 2023

Aims

Multidisciplinary meetings (MDMs) play a crucial role in decision‐making in breast cancer patient care. This study aimed to firstly assess the impact of breast cancer MDMs in decision‐making for breast cancer patients and secondly to determine the concordance between MDM recommendations and implementation of clinical practice.

Methods

Patient cases to be presented at the weekly breast cancer MDMs were identified and prospectively enrolled. Management plans were predicted by the treating surgeon with the pre‐MDM management plans then compared to MDM recommendations. Changes in decision‐making were assessed in the following domains: further surgery, systemic therapy (endocrine, chemotherapy or targeted), radiotherapy, enrolment in a clinical trial, further investigations, and referral to other specialists or services. Patient records were subsequently reviewed at 3 months post‐MDM to assess the rate of implementation of MDM recommendations and any reasons for discordance.

Results

Out of 50 cases, 66% (CI 53–79%; p < .005) experienced a change in management plan as a result of MDM discussion, with a total of 66 episodes of recorded change per decision‐making domain affecting the following: further surgery (7.6%), endocrine therapy (4.5%), chemotherapy (19.7%), targeted therapy (4.5%), radiotherapy (18.2%), enrolment for a clinical trial (12.1%), additional investigations (22.7%), and further referrals (10.6%). MDM recommendations were implemented in 83.7% of cases.

Conclusion

The breast cancer MDMs were found to substantially impact on the management plans for breast cancer patients, with 83.7% of MDM recommendations being implemented into clinical practice. This study reinforces the importance of MDMs in the management of these patients, as well as highlighting the need for further investigating and addressing the potential barriers to the implementation of MDM recommendations.
Standing fuel with back‐fires are effective in reducing fire hazardous in prescribed burning in the deciduous miombo woodland
Authors: Mbanze Aires Afonso , Cumbe Alberto José , Serrote Caetano , Shuangao Wang , Ribeiro Natasha Sofia
Published: February 2023

Savannah fires are of utmost importance to the livelihoods of rural households living in the miombo woodlands of southeast and southern Africa in carrying out their daily activities. In order to add to the existing knowledge on safe prescribed burning procedures, we developed an experimental physics‐based approach modelled on the implementation of a winter surface fire in northern Mozambique. Twelve experimental fire plots were established and burned to identify local conditions that allow a safe prescribed burn to be conducted in the Miombo woodland, northern Mozambique. Two non‐destructive methods were used to measure the amount of forest fuel, namely: the disk meter method and the triangular line‐intercept sample. The plots were burned alternately and parallel to the prevailing wind direction using a head and backing fire. Relationships between fire behaviour, fuel properties, site characteristics and weather conditions were determined using Analysis of Variance (ANOVA) and Covariance (ANCOVA). The ANOVA models predicted 51% and 55% of fire behaviour variance for the flame height and rate of spread, respectively, while the ANCOVA accounted for 67% and 65% of fire behaviour for the flame height and rate of spread, respectively. Findings from this research suggest that standing fuel with back‐fire produces lower‐intense fire with higher controllability.
Sperm DNA damage: The possible link between obesity and male infertility, an update of the current literature
Authors: Peel Andrew , Saini Anmol , Deluao Joshua C. , McPherson Nicole O.
Published: February 2023

Obesity prevalence worldwide is increasing significantly. Whilst maternal obesity has clear detrimental impacts on fertility, pregnancy and foetal outcomes, more recently there has been an increasing focus on the role of paternal obesity in human fertility. Recent meta‐analyses have indicated that obesity in men negatively affects basic sperm parameters such as sperm count, concentration and motility, increases the incidence of infertility and reduces the chances of conception. Sperm DNA damage, typically characterised by DNA strand breaks and oxidation of DNA nucleotides, is a specialised marker of sperm quality that has been independently associated with recurrent miscarriage, reduced assisted reproduction success and increased mutational loads in subsequent offspring. Whilst, there are still conflicting data in humans as to the association of obesity in men with sperm DNA damage, evidence from rodent models is clear, indicating that male obesity increases sperm DNA damage. Human data are often conflicting because of the large heterogeneity amongst studies, the use of body mass index as the indicator of obesity and the methods used for detection of sperm DNA damage. Furthermore, comorbidities of obesity (i.e., heat stress, adipokines, insulin resistance, changes in lipids, hypogonadism and obstructive sleep apnoea) are also independently associated with increased sperm DNA damage that is not always modified in men with obesity, and as such may provide a causative link to the discrepancies amongst human studies. In this review, we provide an update on the literature regarding the associations between obesity in men and fertility, basic sperm parameters and sperm DNA damage. We further discuss potential reasons for the discrepancies in the literature and outline possible direct and indirect mechanisms of increased sperm DNA damage resulting from obesity. Finally, we summarise intergenerational obesity through the paternal linage and how sperm DNA damage may contribute to the transmission.
Borderzone Departure Cities: Jumping‐Off Urbanism of Irregular Migration on the Edges of Europe
Authors: Katz Irit
Published: February 2023

The increasing fortification of borders produces new urban forms of irregular migration. This paper invokes the concept of “borderzone departure cities” as urban constellations created where global migration routes meet blocked borders in cities which become jumping‐off points from which migrants try to depart. The paper examines Athens and Calais as borderzone departure cities located at both sides of the EU Schengen area. By focussing on the Athenian City Plaza squat and the makeshift Calais Jungle camp as emblematic yet relational spaces of departure, the paper moves beyond the squat/camp divide to better understand how irregular migrants struggle against hostile bordering apparatuses through urban practices of meanwhile inhabitation and mobile commoning. The paper illustrates how these spaces were variously assembled, run, and experienced to form the conditions for movement and stay, each holding different potentials for creating solidarity infrastructures and negotiating forms of migrant citizenship to support the uncertain urban realities of those stuck on the move.
Unravelling the “Thin Blue Line”: Policing as an Engine of Inequality
Authors: Boyce Geoff , Massaro Vanessa , Spess Laura
Published: February 2023

This paper argues that policing be understood as a creative social force that reproduces important dimensions of earlier iterations of the colour line. The paper advances this argument by integrating findings from two distinct research projects: the first on the household financial losses that follow arrest by immigration officials in Tucson, AZ; and the second focusing on the everyday costs of policing and carceral supervision absorbed by residents of Philadelphia, PA. Together, data from these sites illuminate how exposure to policing exhausts emotional and material resources from expansive family and community networks of care and support. To theorise the connection between financial dispossession and the dispossession of future opportunity, we draw on a heuristic reading of the “thin blue line” symbol. We conclude by suggesting a need for closer attention to how contemporary state interventions drive patterns of dispossession and vulnerability that accumulate across various scales, sites, rhythms, and collectivities.
Development of machine learning models to predict posterior capsule rupture based on the EUREQUO registry
Authors: Triepels Ron J. M. A. , Segers Maartje H. M. , Rosen Paul , Nuijts Rudy M. M. A. , van den Biggelaar Frank J. H. M. , Henry Ype P. , Stenevi Ulf , Tassignon Marie‐José , Young David , Behndig Anders , Lundström Mats , Dickman Mor M.
Published: February 2023

Purpose

To evaluate the performance of different probabilistic classifiers to predict posterior capsule rupture (PCR) prior to cataract surgery.

Methods

Three probabilistic classifiers were constructed to estimate the probability of PCR: a Bayesian network (BN), logistic regression (LR) model, and multi‐layer perceptron (MLP) network. The classifiers were trained on a sample of 2 853 376 surgeries reported to the European Registry of Quality Outcomes for Cataract and Refractive Surgery (EUREQUO) between 2008 and 2018. The performance of the classifiers was evaluated based on the area under the precision‐recall curve (AUPRC) and compared to existing scoring models in the literature. Furthermore, direct risk factors for PCR were identified by analysing the independence structure of the BN.

Results

The MLP network predicted PCR overall the best (AUPRC 13.1 ± 0.41%), followed by the BN (AUPRC 8.05 ± 0.39%) and the LR model (AUPRC 7.31 ± 0.15%). Direct risk factors for PCR include preoperative best‐corrected visual acuity (BCVA), year of surgery, operation type, anaesthesia, target refraction, other ocular comorbidities, white cataract, and corneal opacities.

Conclusions

Our results suggest that the MLP network performs better than existing scoring models in the literature, despite a relatively low precision at high recall. Consequently, implementing the MLP network in clinical practice can potentially decrease the PCR rate.
Ectotherm mitochondrial economy and responses to global warming
Authors: Sokolova Inna M.
Published: February 2023

Temperature is a key abiotic factor affecting ecology, biogeography, and evolution of species. Alterations of energy metabolism play an important role in adaptations and plastic responses to temperature shifts on different time scales. Mitochondrial metabolism affects cellular bioenergetics and redox balance making these organelles an important determinant of organismal performances such as growth, locomotion, or development. Here I analyze the impacts of environmental temperature on the mitochondrial functions (including oxidative phosphorylation, proton leak, production of reactive oxygen species(ROS), and ATP synthesis) of ectotherms and discuss the mechanisms underlying negative shifts in the mitochondrial energy economy caused by supraoptimal temperatures. Owing to the differences in the thermal sensitivity of different mitochondrial processes, elevated temperatures (beyond the species‐ and population‐specific optimal range) cause reallocation of the electron flux and the protonmotive force (Δp) in a way that decreases ATP synthesis efficiency, elevates the relative cost of the mitochondrial maintenance, causes excessive production of ROS and raises energy cost for antioxidant defense. These shifts in the mitochondrial energy economy might have negative consequences for the organismal fitness traits such as the thermal tolerance or growth. Correlation between the thermal sensitivity indices of the mitochondria and the whole organism indicate that these traits experience similar selective pressures but further investigations are needed to establish whether there is a cause‐effect relationship between the mitochondrial failure and loss of organismal performance during temperature change.
STAT3 regulates 5‐Fu resistance in human colorectal cancer cells by promoting Mcl‐1–dependent cytoprotective autophagy
Authors: Yue Yuanyi , Zhang Qiang , Wang Xueqing , Sun Zhengrong
Published: February 2023

Chemoresistance to 5‐fluorouracil (5‐Fu)‐based chemotherapy is one of the primary reasons for the failure of colorectal cancer (CRC) management. STAT3 can mediate tumor drug resistance through a variety of diverse mechanisms. Nonetheless, the underlying mechanisms of STAT3‐induced 5‐Fu resistance in CRC are still poorly understood. Here, we aimed to investigate the potential mechanism(s) of STAT3‐induced 5‐Fu resistance in CRC. Quantitative RT‐PCR and Western blot were used to test the expression of STAT3 and Mcl‐1 in chemosensitive and chemoresistant CRC tissues and cell lines. After overexpression or knockdown of STAT3 or Mcl‐1, and/or treatment with or without 5‐Fu or chloroquine (CQ), we tested cell viability, inhibitory concentration 50% (IC50) value of 5‐FU, cell apoptosis, proliferation, migration, and autophagy. STAT3 and Mcl‐1 were significantly upregulated in the chemoresistant CRC tissues and cell lines, and STAT3 positively regulated Mcl‐1. Functional studies demonstrated that STAT3 promoted 5‐Fu resistance in CRC. Mechanistically, STAT3 triggered autophagy via Mcl‐1 to induce cancer chemoresistance. Our results show that STAT3 regulates 5‐Fu resistance in CRC by promoting Mcl‐1–dependent cytoprotective autophagy. Our results provide a novel role of STAT3 and may offer a new approach for managing CRC 5‐Fu resistance.
The ‘heROIC’ trial: Does the use of a robotic rehabilitation trainer change quality of life, range of movement and function in children with cerebral palsy?
Authors: Grodon Clare , Bassett Paul , Shannon Harriet
Published: February 2023

Background

Children with severe cerebral palsy (CP) (GMFCS IV/V) can find it difficult to access equipment that allows them to exercise effectively, potentially impacting their quality of life. Physiotherapists working within special schools are well placed to facilitate increased physical activity as part of the school day. This study explored whether the Innowalk Pro, a robotic rehabilitation trainer, could influence quality of life (measured by the CPCHILD questionnaire), in children with CP, alongside, joint range of movement, spasticity and functional goals of the lower limbs, measured by goniometry, modified Tardieu scale and goal attainment scoring, GAS, respectively.

Methods

A prospective single‐arm, pre–post trial was undertaken. The Innowalk Pro was used four times a week for 30 min alongside usual physiotherapy care in a school setting over a 6‐week period. Outcomes were evaluated immediately pre/post intervention and at 6 weeks and 3 months post intervention. Analysis also explored differences between primary and secondary age participants.

Results

Twenty‐seven participants aged 5–18 years with a diagnosis of CP GMFCS IV/V (10 female, 17 male, mean age 12 years) were included from a convenience sample in a special school. Quality of life improved in 36% of participants, the majority of these being secondary aged. Knee extension reduced significantly 3 months post intervention. There were no meaningful changes in spasticity. GAS goals improved in 88% of participants after using the Innowalk Pro. GAS goals tended to decline after a break from using the equipment, with 21% declining by two or more units at 3 months post intervention.

Conclusion

A 6‐week course of the Innowalk Pro can improve quality of life and functional goals for children with CP aged 5–18 years. After a break of 6–12 weeks, functional goals tend to return to baseline. Further research is needed to explore different prescriptions of the Innowalk Pro, to see if increasing the time used/increasing the frequency or number of weeks it is used for can provide longer lasting benefits.
Parents' experience of the communication process of positivity at newborn screening for metabolic diseases: A qualitative study
Authors: Bani Marco , Russo Selena , Raggi Erika , Gasperini Serena , Motta Serena , Menni Francesca , Furlan Francesca , Cefalo Graziella , Paci Sabrina , Banderali Giuseppe , Marchisio Paola , Biondi Andrea , Strepparava Maria Grazia
Published: February 2023

Background

The process of receiving a communication of positivity for metabolic diseases at expanded newborn screening (ENBS) is extremely articulated, involves a variety of actors (parents, maternal and child departments, clinical centres and laboratories) and is open to a variety of outcomes from false positive to true positive cases. Receiving communication of positivity can be highly stressful for parents and requires an adequate communication process to give clear and reliable information without causing excessive worry. This qualitative study describes the parents' experience of receiving a communication of positivity to metabolic diseases at ENBS, and their assessment of the quality of the communication process and steps, with the main aim to identify the process' strengths and weaknesses and to advance tailored recommendations to improve the communication process.

Method

Fourteen in‐depth, semi‐structured phone interviews were conducted with parents whose children resulted positive to the ENBS. As part of the ENBS communication process, parents received a first phone call communication of positivity and a second in‐person communication at metabolic clinical centres (MCC). The framework analysis method was used to organize the data and identify emerging themes.

Results

Parents were largely dissatisfied with the quality and depth of the information received and with the way the healthcare staff delivered the first communication phone call, which failed to create a caring, empathic and safe setting. Many parents tried to reduce the uncertainty by searching online information or consulting with other providers. Nevertheless, the majority of parents described the in‐person visit at MCC as clear, welcoming and reassuring.

Conclusion

More efforts are needed to improve the quality of the communication process of the ENBS. Guidelines, recommendations and standard scripts to communicate positivity are needed along with programmes and educational resources to train tailored communication skills.
Nonalcoholic fatty liver disease from a primary care perspective
Authors: Clark Jeanne M. , Cryer Donna R. H. , Morton Michelle , Shubrook Jay H.
Published: February 2023

Nonalcoholic fatty liver disease (NAFLD) affects up to one‐third of the US population. Approximately one‐fifth of patients with NAFLD have nonalcoholic steatohepatitis (NASH), characterized by hepatocyte damage and inflammation with or without fibrosis. NASH leads to greater risk of liver‐related complications and liver‐related mortality, with the poorest outcomes seen in patients with advanced fibrosis. NASH is also associated with other metabolic comorbidities and conveys an increased risk of adverse cardiovascular outcomes and extrahepatic cancers. Despite its high prevalence, NAFLD is frequently underdiagnosed. This is a significant concern, given that early diagnosis of NAFLD is a key step in preventing progression to NASH. In this review, we describe the clinical impact of NASH from the perspective of both the clinician and the patient. In addition, we provide practical guidance on the diagnosis and management of NASH for primary care providers, who play a pivotal role in the frontline care of patients with NASH, and we use case studies to illustrate real‐world scenarios encountered in the primary care setting.
Role of cathepsin D induced by Porphyromonas gingivalis lipopolysaccharide in periodontitis
Authors: Jeong Hyun Woong , Chang Dong Sik , Kim June Soo , Hwang Young Sun
Published: February 2023

Periodontitis is an inflammatory disease of tooth‐supporting tissues caused by oral bacteria. Periodontal ligament loss and alveolar bone destruction occur in progressive periodontitis. Since gingival crevicular fluids (GCF) reflects the inflammatory environment of the periodontal pocket, it is a very important specimen for developing targets for periodontitis diagnosis. An antibody array was performed using GCF collected from healthy participants and patients with periodontitis to identify the proteolytic enzymes involved in periodontitis. Of 21 targets on the antibody array membrane, kallikrein 6 (KLK6), kallikrein 10 (KLK10), cathepsin A (CathA), and cathepsin D (CathD) showed higher levels in periodontitis GCF than in GCF from healthy participants. Lipopolysaccharide stimulation of Porphyromonas gingivalis (PG‐LPS) in immortalized gingival fibroblasts only increased CathD protein levels among the four targets. The substrate cleavage activity of CathD was increased in PG‐LPS‐treated immortalized gingival fibroblast extract. The PG‐LPS‐induced substrate cleavage effect was abolished by the CathD inhibitor pepstatin A. Osteoclast formation was promoted by treatment with conditioned media from PG‐LPS‐ treated immortalized gingival fibroblasts but inhibited by the CathD inhibitor pepstatin A. These results suggest that PG‐LPS affected the osteoclast formation process by increasing CathD expression in cells around the alveolar bone, thereby participating in periodontitis progression.
Trade‐offs and synergies between ecosystem productivity and stability in temperate grasslands
Authors: Mahaut Lucie , Choler Philippe , Denelle Pierre , Garnier Eric , Thuiller Wilfried , Kattge Jens , Lemauviel‐Lavenant Servane , Lavorel Sandra , Munoz François , Renard Delphine , Serra‐Diaz Josep M. , Viovy Nicolas , Violle Cyrille
Published: February 2023

Aim

It is crucial to monitor how the productivity of grasslands varies with its temporal stability for management of these ecosystems. However, identifying the direction of the productivity–stability relationship remains challenging because ecological stability has multiple components that can display neutral, positive or negative covariations. Furthermore, evidence suggests that the direction of the productivity–stability relationship depends on the biotic interactions and abiotic conditions that underlie ecosystem productivity and stability. We decipher the relationships between grassland productivity and two components of its stability in four habitat types with contrasting environments and flora.

Location

France.

Time period

2000–2020.

Major taxa

Grassland plant species.

Methods

We used c. 20,000 vegetation plots spread across French permanent grasslands and remotely sensed vegetation indices to quantify grassland productivity and temporal stability. We decomposed stability into constancy (i.e., temporal invariability) and resistance (i.e., maximum deviation from average) and deciphered the direct and indirect effects of abiotic (namely growing season length and nitrogen input) and biotic (namely plant taxonomic diversity, trait diversity and community‐weighted mean traits) factors on productivity–stability relationships using structural equation models.

Results

We found a positive relationship between productivity and constancy and a negative relationship between productivity and resistance in all habitats. Abiotic factors had stronger effects on productivity and stability compared with biotic factors. A longer growing season enhanced grassland productivity and constancy. Nitrogen input had positive and negative effects on grassland productivity and resistance, respectively. Trait values affected the constancy and resistance of grassland more than taxonomic and trait diversity, with effects varying from one habitat to another. Productivity was not related to any biotic factor.

Main conclusions

Our findings reveal how vital it is to consider both the multiple components of stability and the interaction between environment and biodiversity to gain an understanding of the relationships between productivity and stability in real‐world ecosystems, which is a crucial step for sustainable grassland management.
Effects of pre‐analytical sample care and analysis methodology on measures of metabolic acidosis in hemodialysis patients
Authors: Correa Camilla C. , Figueiredo Mariana M. B. , Xavier Analucia R. , Kanaan Salim , Lugon Jocemir R.
Published: February 2023

Introduction

We evaluated the effects of pre‐analytical care on total carbon dioxide (tCO2) in hemodialysis patients, as calculated by blood gas analysis (ctCO2) or measured by an enzymatic assay (mtCO2).

Methods

Blood samples were collected via vascular access before dialysis sessions. For blood gas analysis, eight aliquots were collected, refrigerated or non‐refrigerated, and analyzed at 0, 4, 8, and 24 h after collection. A blood sample was then collected for the enzymatic method and distributed into 14 aliquots. Half of the aliquots were refrigerated. The samples analyzed at time point 0 were centrifuged immediately. The remaining aliquots of both the refrigerated and non‐refrigerated clusters were centrifuged before storage. Samples were analyzed at 4, 8, and 24 h post‐collection.

Findings

By blood gas analysis, no significant change was found in bicarbonate values over time, either in the non‐refrigerated or refrigerated samples. ctCO2 values during the experiment showed a minor but statistically significant increase of questionable clinical relevance in both non‐refrigerated and refrigerated aliquots. In the enzymatic assay, the reduction in mtCO2 levels during the experiment was negligible. The median absolute reductions at the end of the experiment were 1.77, 1.21, 1.04, and 1.12 mmol/L for the non‐centrifuged/non‐refrigerated, centrifuged/non‐refrigerated, non‐centrifuged/refrigerated, and centrifuged/refrigerated aliquots, respectively.

Discussion

Our results suggest that measured or calculated tCO2 levels of capped and cooled samples are adequate for analyzing the acid–base status of hemodialysis patients, even when such determination is not performed immediately after collection.
Effects of warm or cold compresses applied to the legs during hemodialysis on cramps, fatigue, and patient comfort: A placebo‐controlled randomized trial
Authors: Kesik Gülşah , Ozdemir Leyla , Yıldırım Tolga , Jabrayilov Jabrayil , Çeliksöz Gülseren
Published: February 2023

Introduction

Muscle cramps and fatigue are common complications in hemodialysis patients and have been associated with reduced patient comfort. Among the complementary therapies advocated for the management of these complications have been the application of warm or cold compresses to the extremities during a hemodialysis treatment. In this study, we compared the effects of warm or cold compresses application on cramping, fatigue, and patient comfort.

Methods

This placebo‐controlled randomized trial was done in 69 patients, who were stratified and randomly allocated to three treatment arms. Two of the three groups included an intervention; application of either warm (n = 23) or cold (n = 23) compresses to the extremities during dialysis. The third group served as a placebo control (n = 23). The study period comprised 12 hemodialysis sessions. One week after the completion of the intervention, a follow‐up dialysis session was also evaluated. Data were collected at baseline (t0), during each of 12 intervention sessions (t1—t12), and at the follow‐up session t13. Cramps, fatigue, and patient comfort were evaluated using the Cramp Episode Follow‐up Chart, Piper's Fatigue Scale, and the Hemodialysis Comfort Scale, respectively.

Results

In both the intervention and follow‐up sessions, cramping and fatigue were lower, and comfort was higher in each of the intervention groups compared to placebo controls Application of warm compresses was superior to use of cold compresses.

Discussion

Both warm and cold compress administration reduced muscle cramps, fatigue, and hemodialysis comfort in hemodialysis patients.
Biallelic mutations in FLG, TGM1, and STS genes segregated with different types of ichthyoses in eight families of Pakistani origin
Authors: Khan Niamatullah , Shah Khadim , Fozia Fozia , Khan Sher A. , Muhammad Nazif , Nasir Abdul , Ahmad Ijaz , Rehman Zia U. , Jan Abid , Muhammad Noor , Khan Saadullah
Published: February 2023

Background

Congenital ichthyosis is a diverse group of keratinization disorders associated with generalized scaling of skin of varying severity. The non‐syndromic forms of congenital ichthyosis are further grouped into common ichthyosis (ichthyosis vulgaris and X‐linked ichthyosis), autosomal recessive congenital ichthyosis, and keratopathic ichthyosis.

Objective

To identify sequence variants involved in different forms of hereditary ichthyoses.

Methods

We studied eight families with different types of ichthyosis including four families with autosomal recessive congenital ichthyosis and four families with common ichthyosis. Whole exome sequencing and PCR based genotyping was carried out to find out the molecular basis of disease.

Results

In one family, a novel duplication sequence variant NM_002016.2:c.2767dupT; NP_002007.1:p.Ser923PhefsTer2 was identified in FLG gene; in four families a previously reported nonsense sequence variant NM_000359.3:c.232C>T; NP_002007.1:p.Arg78Ter was identified in TGM1 gene, while, in three families of X‐linked recessive ichthyosis, the whole STS gene (NM_001320752.2; NP_001307681.2) regions were deleted.

Study limitation

Gene expression studies have not been performed that would have strengthened the findings of computational analysis.

Conclusion

This study highlights the significance of the c.232C>T variant in the TGM1 gene as a possible founder mutation, complete STS gene deletion as reported previously in Pakistani population, while novel sequence variant in the FLG gene expands the spectrum of variations in this gene. These findings may be used for genetic counseling of the studied families.
Disease‐free survival as a predictor of overall survival in localized renal cell carcinoma following initial nephrectomy: A retrospective analysis of Surveillance, Epidemiology and End Results‐Medicare datac
Authors: Haas Naomi B. , Song Yan , Willemann Rogerio Jaqueline , Zhang Su , Carley Christopher , Zhu JingJing , Bhattacharya Rituparna , Signorovitch James , Sundaram Murali
Published: February 2023

Objectives

This study aimed to assess whether disease‐free survival (DFS) may serve as a predictor for long‐term survival among patients with intermediate‐high risk or high risk renal cell carcinoma (RCC) post‐nephrectomy when overall survival (OS) is unavailable.

Methods

The Surveillance, Epidemiology and End Results‐Medicare database (2007–2016) was used to identify patients with non‐metastatic intermediate‐high risk and high risk RCC post‐nephrectomy. Landmark analysis and Kendall's τ were used to evaluate the correlation between DFS and OS. Multivariable regression models were used to quantify the incremental OS post‐nephrectomy associated with increased time to recurrence among patients with recurrence, adjusting for baseline covariates.

Results

A total of 643 patients were analyzed; mean age of 75 years; >95% of patients had intermediate‐high risk RCC at diagnosis; 269 patients had recurrence post‐nephrectomy. For patients with versus without recurrence at the landmark points of 1, 3, and 5 years post‐nephrectomy, the 5‐year OS were 37.0% versus 70.1%, 42.3% versus 72.8%, and 53.2% versus 78.6%, respectively. The Kendall's τ between DFS and OS post‐nephrectomy was 0.70 (95% CI: 0.65, 0.74; p < 0.001). After adjusting for baseline covariates, patients with one additional year of time to recurrence were associated with 0.73 years longer OS post‐nephrectomy (95% CI: 0.40, 1.05; p < 0.001).

Conclusion

The significant positive association of DFS and OS among patients with intermediate‐high risk and high risk RCC post‐nephrectomy from this study supports the use of DFS as a potential predictor of OS for these patients when OS data are immature.
Two‐stage distributionally robust optimization model for a pharmaceutical cold supply chain network design problem
Authors: Li Jinfeng , Liu Yankui , Yang Guoqing
Published: February 2023

Pharmaceutical safety has received increasing attention from governments and corporations, and building a safe and effective pharmaceutical cold supply chain network has become an important issue. This paper proposes a two‐stage pharmaceutical cold supply chain network design problem considering drug safety, in which the drug demand, transportation costs, and drug safety risk costs are assumed to be random variables. Due to the presence of uncertainty and the fact that information about the distribution of uncertain parameters is often only partially known, a distributionally robust optimization method is used to handle the uncertainty. A two‐stage distributionally robust optimization model is constructed, in which the reliability of the estimation of the demand necessary to satisfy the entire cold chain network is ensured to be greater than a certain predetermined level by introducing an ambiguous joint chance constraint. The decision process for the problem can be divided into strategic and operational decisions with the goal of minimizing the total costs related to facility construction, the purchase of raw materials, drug production, transportation, and safety risks. By introducing an ambiguity set with mean and covariance information to describe the uncertain parameters, the two‐stage model is eventually reformulated as a standard second‐order cone program, thus making it computationally tractable. Finally, numerical experiments are presented to demonstrate the effectiveness of the proposed models and optimization methods.