bluuebunny/crossref_metadata_2025 huggingface dataset:
Associations between personality, creative thinking and learning, self-efficacy and academic achievement: a cross-sectional survey of coaches in Chinese art schools
Authors: Fan Lijia , Sun Lei
Published: June 2024

Purpose

Prioritization of technological skills in China has led to scarce resources for art education. In this study, we tested whether personality traits were associated with creative learning and creative thinking skills, and whether these aspects of creativity were linked with academic achievement. We considered self-efficacy and 21st-century skills as mediating and moderating factors.

Design/methodology/approach

498 art school coaches were recruited from 12 Chinese universities. Coaches reported on their students’ Big Five personality traits, creative thinking skills, creative learning and self-efficacy, 21st-century skills and academic achievement. Data were analyzed with partial least squares structural equation modeling.

Findings

High openness, low conscientiousness, high extraversion and high agreeableness were associated with creative thinking skills, while high openness, low conscientiousness, high agreeableness and low neuroticism were associated with creative learning. Creative thinking and learning skills were both positively associated with academic achievement. Self-efficacy partially mediated the association between creative thinking skills and academic achievement. No moderation effects were identified.

Originality/value

Findings imply that art education would benefit from deeper consideration of individual differences and the promotion of learning environments conducive to creativity.
‘Ripple effects’ of urban environmental characteristics on cognitive performances in Eurasian red squirrels
Authors: Chow Pizza Ka Yee , Uchida Kenta , Koizumi Itsuro
Published: June 2024

Urban areas are expanding exponentially, leading more species of wildlife living in urban environments. Urban environmental characteristics, such as human disturbance, induce stress for many wildlife and have been shown to affect some cognitive traits, such as innovative problem‐solving performance. However, because different cognitive traits have common cognitive processes, it is possible that urban environmental characteristics may directly and indirectly affect related cognitive traits (the ripple effect hypothesis).

We tested the ripple effect hypothesis in urban Eurasian red squirrels residing in 11 urban areas that had different urban environmental characteristics (direct human disturbance, indirect human disturbance, areas of green coverage and squirrel population size). These squirrels were innovators who had previously repeatedly solved a food extraction task (the original task). Here, we examined whether and how urban environmental characteristics would directly and indirectly influence performance in two related cognitive traits, generalisation and (long‐term) memory. The generalisation task required the innovators to apply the learned successful solutions when solving a similar but novel problem. The memory task required them to recall the learned solution of the original task after an extended period of time.

Some of the selected urban environmental characteristics directly influenced the task performance, both at the population level (site) and at individual levels. Urban environmental characteristics, such as increased direct and indirect human disturbance, decreased the proportion of success in solving the generalisation task or the memory task at the population (site) level. Increased direct human disturbance and less green coverage increased the solving efficiency at individual levels.

We also found an indirect effect in one of the urban environmental characteristics, indirect human disturbance, in the generalisation task, but not the memory task. Such an effect was only seen at the individual level but not at the population level; indirect human disturbance decreased the first original latency, which then decreased the generalisation latency across successes.

Our results partially support the ripple effect hypothesis, suggesting that urban environmental characteristics are stressors for squirrels and have a greater impact on shaping cognitive performance than previously shown. Together, these results provide a better understanding of cognitive traits that support wildlife in adapting to urban environments.
Severity of topsoil compaction controls the impact of skid trails on soil ecological processes
Authors: Klein‐Raufhake Theresa , Hölzel Norbert , Schaper Jens Jakob , Hortmann Anja , Elmer Michael , Fornfeist Max , Linnemann Britta , Meyer Michael , Rentemeister Katharina , Santora Lea , Wöllecke Jens , Hamer Ute
Published: June 2024

Skid trails are a major management‐induced disturbance in temperate forest ecosystems with considerable impact on soil ecological processes that are so far poorly understood. In German forests, skid trails comprise 10%–20% of the forest area that is potentially affected by soil compaction through heavy machinery. We systematically investigated the influence of skid trails on physical, chemical and microbiological soil parameters at 84 paired plots across four Central European forest types.

In low mountain forests with steeper topography, skid trails had more drastic effects than in lowland forests. Skid trails in low mountain areas showed a decrease in the C to N ratio of microbial biomass (MBC/MBN), as well as increased microbial (MBC/SOC) and enzyme activities leading to faster carbon turnover (lower C/N, EOC/EN) and increased CO2 losses (CO2/SOC) from the soil.

The overall effects of the skid trails in lowland forests were small. On base‐poor soils, we found an increase in the MBC/MBN ratio, while skid trails in base‐rich lowland soils showed a reduction in CO2/SOC, suggesting a proportional increase in soil carbon storage.

Regardless of region‐specific effects, the relative increase in the bulk density of the fine soil was identified as a ‘golden trait’ that determined the effects of skid trails on many soil parameters, as shown by negative correlations with SOC, N, MBC, MBN, MBP, MBC/SOC and CO2/SOC and positive ones with the activities of certain hydrolytic enzymes.

Synthesis and applications: Our data clearly showed that carbon conversion processes and soil respiration leading to significant carbon and nutrient losses increased significantly on skid trails in low mountain regions with relatively steep slopes, which was in sharp contrast to lowland sites. The strong context dependence of our findings suggests that the mapping of soil conditions in terms of slope, substrate and moisture with high spatial resolution is mandatory to assess the vulnerability of sites to soil compaction by heavy machinery. Based on such vulnerability analysis, negative impacts can be minimised through the designation of permanently fixed skid trails, technical adaptation of vehicles (e.g. wide base tyres) as well as careful planning and timing of management operations that should be restricted to dry weather and soil moisture conditions or periods of frost.
Sustainable nature‐based solutions require establishment and maintenance of keystone plant‐pollinator interactions
Authors: Rafferty Nicole E. , Cosma Christopher T.
Published: June 2024

Many nature‐based solutions (NBS), including urban greenspaces, urban agriculture and agroforestry, depend upon animal‐pollinated plants to sequester carbon or to provide other ecosystem services. Thus, long‐term success of these solutions also depends upon resilient pollinator communities.

Despite their importance to functioning communities, a literature search revealed that 0%–3% of papers on NBS and related topics considered pollinators or pollination. Pollinators were more likely to be considered in the subgroup of papers on NBS related to agricultural production, where 12.5% considered pollination.

Conservation of species interactions is essential to conservation of biodiversity and the sustained benefits of NBS. By applying our understanding of the ecology of plant‐pollinator mutualisms to the implementation of NBS, we can promote their functioning under future climatic conditions. In particular, we point to the need to identify keystone plants and pollinators, those species that contribute most to biodiversity maintenance, community stability and ecosystem function, and to leverage these species and their interactions in NBS and conservation efforts. We further advocate for the use of phylogenetic trait‐based analyses to understand the characteristics associated with keystoneness.

Synthesis: Resilience of pollination services rests upon the responses of keystone species and their partners, and the likelihood that they continue to express traits that confer mutual benefit under future climates. By understanding the traits of species of outsized importance to their communities, we gain insight into the mechanisms underlying the resilience of pollination services and the NBS that rely on those services in a changing world.
Impact of recurrent intermittent flooding on the yield and growth of Elaeis guineensis
Authors: Fadila Ahmad Malike , Liew Kian‐Wah , Yaakub Zulkifli , Ooi Siew‐Eng
Published: June 2024

Increased frequency and severity of flooding are linked to global warming. Flooding stress can severely affect crop yields and plant survival, and therefore the livelihoods of farmers. An oil palm breeding trial plot consisting of six progenies in Terengganu, Malaysia, happened to be inundated with flooding within a year after planting and annually for 2 years thereafter. Flooding recurred at the 8th year of planting and several times after that within the 14‐year period of monitoring. Due to the uneven terrain in this trial, palms were exposed to various flood levels and were categorized into two flooding groups. Yields and survivability of the palms were not affected by low‐flood levels, in contrast to the palms in lower areas that experienced higher flood levels. Compared to neighbouring non‐flooded trials, palms exposed to high floodwaters generally experienced lower fruit yields, and reduced vertical growth with poorer canopy cover. However, one of the progenies that exhibited a moderate survival rate in high‐flooded areas outperformed the other progenies in terms of yield in these areas. Generally, young oil palms exposed to low floods were able to survive and produce yields that were comparable to palms in non‐flooded areas, though 10%–20% of the low‐flooded palms produced poor yields in the first 3–5 years. In high‐flooded areas however, oil palm survivability ranged from 45% to 73% during the early 3 years and 46%–89% thereafter. Hence, young palms exposed to recurrent flooding of approximately more than 1 m during their early years are likely to become poor yielders with poor survival rates. Observations from this study may assist oil palm farmers in the management of this crop in the event of unexpected flooding.
The key role of specific DSM‐5 diagnostic criteria in the early development of alcohol use disorder: Findings from the RADAR prospective cohort study
Authors: Slade Tim , O'Dean Siobhan M. , Chung Tammy , Mewton Louise , McCambridge Jim , Clare Philip , Bruno Raimondo , Yuen Wing See , Tibbetts Joel , Clay Peter , Henderson Alexandra , McBride Nyanda , Mattick Richard , Boland Veronica , Hutchinson Delyse , Upton Emily , Isik Ashling , Johnson Phoebe , Kypri Kypros
Published: June 2024

Background

Prevention and early intervention of alcohol use disorder (AUD) is a public health priority, yet there are gaps in our understanding of how AUD emerges, which symptoms of AUD come first, and whether there are modifiable risk factors that forecast the development of the disorder. This study investigated potential early‐warning‐sign symptoms for the development of AUD.

Methods

Data were from the RADAR study, a prospective cohort study of contemporary emerging adults across Australia (n = 565, mean age = 18.9, range = 18–21 at baseline, 48% female). Participants were interviewed five times across a 2.5‐year period. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM‐5) AUD criteria and diagnoses were assessed by clinical psychologists using the Structured Clinical Interview for DSM‐IV (SCID‐IV), modified to cover DSM‐5 criteria. Hazard analyses modeled the time from first alcoholic drink to the emergence of any AUD criteria and determined which first‐emergent AUD criteria were associated with a faster transition to disorder.

Results

By the final time point, 54.8% of the sample had experienced at least one DSM‐5 AUD criterion and 26.1% met criteria for DSM‐5 AUD. The median time from first AUD criterion to a diagnosis of AUD was 4 years. Social problems from drinking (hazard ratio [HR] = 3.24, CI95 = 2.14, 4.92, p < 0.001), major role (HR = 2.53, CI95 = 1.58, 4.06, p < 0.001), and drinking larger amounts/for longer than intended (HR = 2.04, CI95 = 1.20, 3.46, p = 0.008) were first‐onset criteria associated with a faster transition to AUD.

Conclusion

In the context of a prospective general population cohort study of the temporal development of AUD, alcohol‐related social problems, major role problems, and using more or for longer than intended are key risk factors that may be targeted for early intervention.
Nicotine pouch use by sex, school type and tobacco product use among Finnish adolescents during the 2023 change in regulatory scheme with deregulated sales
Authors: Ruokolainen Otto , Ollila Hanna , Härkänen Tommi
Published: June 2024

Background and aims

In Finland, nicotine pouches entered the national market abruptly in 2023, following a change in April 2023 from medicinal product classification into less regulated tobacco surrogate status. This study aimed to measure adolescent nicotine pouch use and associated characteristics.

Design and setting

A cross‐sectional, nationwide school‐based survey among students in comprehensive schools (COMP), general upper secondary schools (GEN) and vocational institutes (VOC) in 2023 in Finland.

Participants

A total of 151 224 respondents aged 14–20 years (mean age 16.18 years, standard deviation 1.20 years).

Measurements

Nicotine pouch use was used as the outcome variable. Demographics included age, sex, school type and tobacco product use (smoking, snus use and e‐cigarette use). Covariates included parental education and parental smoking. All measures were self‐reported.

Findings

Unadjusted results showed that current nicotine pouch use was more common among boys (11.3%) than among girls (3.3%), adolescents in VOC (15.4%) compared with COMP (6.8%) and GEN (4.3%), whereas daily use of other tobacco and nicotine products was associated with current nicotine pouch use compared with never using such products and the association was especially strong for snus use. The fully adjusted estimates of current nicotine pouch use remained strong for daily use of other tobacco and nicotine products (snus use: adjusted prevalence ratio [aPR] = 74.95, 95% confidence interval [CI] = 65.65–84.25; smoking: aPR = 1.43, 95% CI = 1.36–1.50; e‐cigarette use: aPR = 2.15, 95% CI = 2.04–2.27) and for sex (boys aPR = 1.53, 95% CI = 1.48–1.57). There was no clear evidence of differences in current nicotine pouch use by school type, age or parental factors in the fully adjusted model.

Conclusions

In Finland in 2023, during which the availability of nicotine pouches became less regulated, nicotine pouch use appeared to be more common among boys and adolescents who used other nicotine products.
Evaluation of the contribution of different groups of teeth to occlusion of patients with symptoms of temporomandibular disorders
Authors: Orczykowska M , Kojat P , Pihut M , Gronkiewicz K , Gala A
Published: June 2024

Purpose

The purpose of this study was to analyse the distribution of occlusal forces in the dental arches released during tooth clenching in patients with symptoms of temporomandibular disorders, and to analyse the age and gender structure of the patients in the study group and the control group.

Materials and method

The study was carried out on a group of 58 patients, of both genders, aged 18–40 years, with full dental arches, who presented for treatment at the Prosthodontics Clinic of the University Dental Clinic in Kraków due to symptoms of temporomandibular disorders. The patients were divided into two groups. The first group (study group) comprised 26 patients with painful temporomandibular disorders, while the second group (control group) comprised 32 patients without pain. The study only included patients over 18 years of age, with full dental arches with symptoms of temporomandibular disorders. All patients underwent a basic dental examination and a specialized functional examination of the masticatory organ. A T‐Scan III‐Novus instrument with electronic occlusal articulation paper was used to assess the distribution of occlusal contacts.

Results

In the study, women (43) were a larger group than men (15). Statistically significant values for the percentage distribution of occlusal contacts were obtained in group of women in the study group on the right and left side, in the area of molars and premolars. In the analysis of the percentage distribution of occlusal contacts in both the study and control groups, it can be seen that the first molars (teeth 16 and 26) showed a larger percentage range of values than the other teeth. The smallest values can be observed on the second incisal teeth and on the canines.

Conclusions

The first molars are, in the majority of patients, the teeth on which the strongest occlusal contacts are generated. Excessive participation of incisal teeth in occlusion might influence the development of the pain form of TMD. In order to determine whether there is a correlation between an uneven distribution of occlusal contacts and TMD pain, studies on larger numbers of patients are needed. © 2024 Australian Dental Association.
Technostress: The impact of technology on Italian dermatologists' burnout
Authors: Picone Vincenzo , Patruno Cataldo , Greco Vincenzo , Spignese Alessia , Coronella Luigi , Napolitano Maddalena
Published: June 2024

Dermatologists' burnout is a growing phenomenon. During the last years, an important role on medical stress is played by the ever‐increasing use of common technological devices (smartphones, smartwatches, PCs and tablets). The aim of the study was to investigate whether digital technology use causes burnout among Italian dermatologists, using a survey conducted among a group of Italian dermatologists. The final sample contained 194 responses valid for analysis. A positive and significant relationship between technostress, assessed through Technostress Inventory and burnout, assessed through Maslach Burnout Inventory, among Italian dermatologists was found. Our data seems suggesting a close relationship between technostress and dermatologist burnout.
Causal Relationship Between Circulating Immune Cells and Recurrent Spontaneous Abortion: A Bidirectional Mendelian Randomization Study
Authors: Yu Hailin , Hu Xianyang , Huang Xixi , Yin Tingxuan , Liu Lu , Yue Chaoyan , Du Meirong
Published: June 2024

Background

Recurrent spontaneous abortion (RSA) is a serious and common complication of pregnancy caused by multiple factors. The etiology remains incompletely understood, but immunologic factors play important roles. Here, we aimed to evaluate whether circulating immune cells causally impacted RSA.

Methods

In this study, we conducted a comprehensive two‐sample Mendelian randomization (MR) study to determine the causal association between the 731 immunophenotypes of human peripheral blood lymphocytes and the number of spontaneous abortions as well as recurrent miscarriage. Sensitivity analyses were performed to assess and minimize heterogeneity and horizontal pleiotropy. Reverse MR analysis was used to assess reverse causality.

Results

After Bonferroni‐correction, eight immunophenotypes were significantly associated with the number of spontaneous abortions: FSC‐A on CD4+ T cell (beta = −0.051, 95% CI = [−0.085, −0.017], P‐value = 0.004), CD8 on HLA DR+ CD8+ T cell (beta = −0.040, 95% CI = [−0.067, −0.014], P‐value = 0.003), HLA DR on CD33dim HLA DR+ CD11b− (beta = −0.021, 95% CI = [−0.036, −0.005], P‐value = 0.010), HLA DR+ T cell Absolute Count (beta = 0.022, 95% CI = [0.006, 0.037], P‐value = 0.008), HLA DR+ T cell % lymphocyte (beta = 0.026, 95% CI = [0.010, 0.041], P‐value = 0.001), HLA DR+ T cell % T cell (beta = 0.023, 95% CI = [0.007, 0.039], P‐value = 0.004), HLA DR+ CD4+ T cell % lymphocyte (beta = 0.034, 95% CI = [0.007, 0.060], P‐value = 0.012), and HLA DR on B cell (beta = 0.012, 95% CI = [0.003, 0.021], P‐value = 0.010). In addition, we identified two immunophenotypes associated with recurrent miscarriage: HLA DR on B cell (OR = 0.854, 95% CI = [0.757, 0.964], P‐value = 0.011), and CD19 on naive‐mature B cell (OR = 4.595, 95% CI = [1.674, 12.617], P‐value = 0.003). There was no evidence of heterogeneity, horizontal pleiotropy and reverse causality.

Conclusions

Our study demonstrated a tight link between adaptive immune cells and RSA through genetic means, thus providing potential therapeutic targets or novel diagnostic biomarkers.
SOMANZ position statement for the investigation and management of sepsis in pregnancy 2023
Authors: Bowyer Lucy , Cutts Briony A. , Barrett Helen L. , Bein Kendall , Crozier Timothy M. , Gehlert Jessica , Giles Michelle L. , Hocking Jennifer , Lowe Sandra , Lust Karin , Makris Angela , Morton Mark R. , Pidgeon Tara , Said Joanne , Tanner Helen L. , Wilkinson Lucille , Wong Maggie
Published: June 2024

Background

The Society of Australia and New Zealand (SOMANZ) published its first sepsis in pregnancy and the postpartum period guideline in 2017 (Aust N Z J Obstet Gynaecol, 57, 2017, 540). In the intervening 6 years, maternal mortality from sepsis has remained static.

Aims

To update clinical practice with a review of the subsequent literature. In particular, to review the definition and screening tools for the diagnosis of sepsis.

Materials and Methods

A multi‐disciplinary group of clinicians with experience in all aspects of the care of pregnant women analysed the clinical evidence according to the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system following searches of Cochrane, Medline and EMBASE. Where there were conflicting views, the authors reviewed the topic and came to a consensus. All authors reviewed the final position statement.

Results

This position statement has abandoned the use of the quick Sequential Organ Failure Assessment score (qSOFA) score to diagnose sepsis due to its poor performance in clinical practice. Whilst New Zealand has a national maternity observation chart, in Australia maternity early warning system charts and vital sign cut‐offs differ between states. Rapid recognition, early antimicrobials and involvement of senior staff remain essential factors to improving outcomes.

Conclusion

Ongoing research is required to discover and validate tools to recognize and diagnose sepsis in pregnancy. Australia should follow New Zealand and have a single national maternity early warning system observation chart.
Seachange Migration, Outer Metropolitan Suburbanisation, and Marginality: The Electoral Politics of the Central Coast of New South Wales, 1949–2001
Authors: Beer Chris
Published: June 2024

Seachanging and the expansion of suburbia led to important changes in Australia's human geography during the second half of the twentieth century. However, the implications of domestic migration on electoral politics have received only limited study. The Central Coast of New South Wales was one place where these two patterns of movement converged and which came to be routinely identified in public debate as electorally marginal. In reviewing this discursive positioning across both federal and state politics over several decades, the article examines how the region's marginality was often linked to the social mix created by migration primarily from Sydney, among which retirees and long distance commuters received particular attention as cohorts of voters. The analysis then turns to electoral competition in what was thus seen as a contestable space. This spanned national, state, and local issues and the major parties sometimes pre‐selected candidates offering very distinct value propositions. Overall, the Central Coast's regional political discourse reflected wider understandings of voting realignment seen around Australia, including changing perspectives on class, but also highlights how migration created new, formative communities where marginality was viewed as an important part of local political identity and practice.
Physical activity and circulating inflammatory markers and cytokines during pregnancy: A population‐based cohort study
Authors: Dhar Poshmaal , Sominsky Luba , O'Hely Martin , Dawson Samantha , Collier Fiona , Tang Mimi L. K. , Mansell Toby , Burgner David , Smith Craig , Hyde Natalie , Downing Katherine , Hesketh Kylie D. , Ponsonby Anne‐Louise , Vuillermin Peter ,   the Barwon Infant Study Investigator Group
Published: June 2024

Introduction

Physical activity (PA) during pregnancy has numerous benefits, which may be mediated via effects on the immune system. However, supportive evidence is inconsistent and is mainly from studies in high‐risk groups. We estimated the effect of PA during pregnancy on systemic inflammatory markers and cytokines in mothers recruited in the Barwon infant study.

Material and Methods

The Barwon infant study is a prebirth cohort of 1064 mothers recruited in the Barwon Region of Victoria, Australia. Participants reported their previous week's PA at their 28‐week antenatal appointment using the International PA Questionnaire. Women were grouped into low, moderate, and high PA categories based on daily duration and weekly frequency of walking, moderate‐ or vigorous‐intensity PA. Women reporting moderate levels of PA, consistent with current recommendations, served as the comparison group. Markers of systemic inflammation, high‐sensitivity C‐reactive protein (hsCRP), glycoprotein acetyls (GlycA), and 17 cytokines were measured at 28 weeks gestation and log transformed as appropriate. Regression analyses adjusted for maternal smoking, gestational diabetes mellitus, prepregnancy BMI, and household size were performed.

Results

Compared to women in the moderate group (n = 371, 42%), women reporting low PA (n = 436, 50%) had 10.1% higher hsCRP (95% CI (3.7% to 16.6%), p < 0.01) while women in high PA (n = 76, 9%) had a 14% higher hsCRP (95% CI (3.1% to 24.8%), p = 0.01). Women in the high PA category had higher interleukin (IL)‐4 (q = 0.03) and IL‐9 (q = 0.03) levels compared to those in moderate category. Each vigorous MET minute/week was associated with lower GlycA (β = −0.004, 95% CI (−0.044 to 0.035); p = 0.03).

Conclusions

Low and high PA are each associated with higher hsCRP than moderate PA, suggesting that undertaking the recommended moderate PA during pregnancy decreases systemic inflammation. High PA affects T cell‐associated cytokines during pregnancy. Evidence from our study suggests that PA can modulate the immune responses during pregnancy. Studies are now required to assess whether PA during pregnancy impacts maternal and infant clinical outcomes by modifying inflammatory responses.
Cost effectiveness of commercial portable ex vivo lung perfusion at a low‐volume US lung transplant center
Authors: Kent Johnathan , Nordgren Rachel , Ahn Daniel , Lysandrou Maria , Diaz Ashley , Fenton David , Wignakumar Thirushan , McMeekin Nicola , Salerno Christopher , Donington Jessica , Madariaga Maria Lucia L.
Published: June 2024

Background

Portable ex vivo lung perfusion during lung transplantation is a resource‐intensive technology. In light of its increasing use, we evaluated the cost‐effectiveness of ex vivo lung perfusion at a low‐volume lung transplant center in the USA.

Methods

Patients listed for lung transplantation (2015–2021) in the United Network for Organ Sharing database were included. Quality‐of‐life was approximated by Karnofsky Performance Status scores 1‐year post‐transplant. Total transplantation encounter and 1‐year follow‐up costs accrued by our academic center for patients listed from 2018 to 2021 were obtained. Cost‐effectiveness was calculated by evaluating the number of patients attaining various Karnofsky scores relative to cost.

Results

Of the 13 930 adult patients who underwent lung transplant in the United Network for Organ Sharing database, 13 477 (96.7%) used static cold storage and 453 (3.3%) used ex vivo lung perfusion, compared to 30/58 (51.7%) and 28/58 (48.3%), respectively, at our center. Compared to static cold storage, median total costs at 1 year were higher for ex vivo lung perfusion ($918 000 vs. $516 000; p = 0.007) along with the cost of living 1 year with a Karnofsky functional status of 100 after transplant ($1 290 000 vs. $841 000). In simulated scenarios, each Karnofsky‐adjusted life year gained by ex vivo lung perfusion was 1.00–1.72 times more expensive.

Conclusions

Portable ex vivo lung perfusion is not currently cost‐effective at a low‐volume transplant centers in the USA, being 1.53 times more expensive per Karnofsky‐adjusted life year. Improving donor lung and/or recipient biology during ex vivo lung perfusion may improve its utility for routine transplantation.
Are alternative variables in a set differently associated with a target variable? Statistical tests and practical advice for dealing with dependent correlations
Authors: García‐Pérez Miguel A.
Published: June 2024

The analysis of multiple bivariate correlations is often carried out by conducting simple tests to check whether each of them is significantly different from zero. In addition, pairwise differences are often judged by eye or by comparing the p‐values of the individual tests of significance despite the existence of statistical tests for differences between correlations. This paper uses simulation methods to assess the accuracy (empirical Type I error rate), power, and robustness of 10 tests designed to check the significance of the difference between two dependent correlations with overlapping variables (i.e., the correlation between X1 and Y and the correlation between X2 and Y). Five of the tests turned out to be inadvisable because their empirical Type I error rates under normality differ greatly from the nominal alpha level of .05 either across the board or within certain sub‐ranges of the parameter space. The remaining five tests were acceptable and their merits were similar in terms of all comparison criteria, although none of them was robust across all forms of non‐normality explored in the study. Practical recommendations are given for the choice of a statistical test to compare dependent correlations with overlapping variables.
Prognostic Value of APACHE IV Score in Patients Bridged to Heart Transplantation on ECMO
Authors: Lechiancole Andrea , Russo Claudio F. , Olivieri Guido M. , Maccherini Massimo , Valente Serafina , Pacini Davide , Suarez Sofia Martin , Boffini Massimo , Marro Matteo , Pelenghi Stefano , Totaro Pasquale , Isola Miriam , Martino Maria De , Bortolotti Uberto , Livi Ugolino , Vendramin Igor
Published: June 2024

Background

Methods for risk stratification of candidates for heart transplantation (HTx) supported by extracorporeal membrane oxygenation (ECMO) are limited. We evaluated the reliability of the APACHE IV score to identify the risk of mortality in this patient subset in a multicenter study.

Methods

Between January 2010 and December 2022, 167 consecutive ECMO patients were bridged to HTx; they were divided into two groups, according to a cutoff value of APACHE IV score, obtained by receiver operating characteristic curve analysis for 90‐day mortality. Kaplan–Meier survival curves were plotted, and compared through the log‐Rank test. Cox regression model was used to estimate which factors were associated with survival.

Results

The 90‐day mortality prediction of the APACHE IV score showed an area under the curve of 0.87 (95% CI: 0.80–0.94), with a cutoff value of 49 (specificity 91.7%–sensibility 69.6%). 125 patients (74.8%) showed an APACHE IV score value < 49 (Group A), and 42 (25.2%) ≥ 49 (Group B). 90‐day mortality was 11.2% in Group A and 76.2% in Group B (p < 0.01). Survival at 1 and 5 years was 85.5%, 77% versus 23.4%, 23.4% (p < 0.01) in Groups A and B. Mortality correlated at univariable analysis with recipient age, body mass index, mechanical ventilation, APACHE IV score, and platelets number. At multivariable analysis only APACHE IV score (HR: 1.07 [1.05–1.09, 95% CI]) independently affected survival.

Conclusions

The APACHE IV score represents a powerful predictor of survival in patients bridged to HTx on ECMO support, and could guide candidacy of patients on ECMO.
Quantitative evaluation of right ventricular myocardial function changes in patients with atrial septal defect before and after occlusion by noninvasive right ventricular pressure‐strain loop
Authors: Jiang Huanhuan , Ran Hongling , Xu Pan , Hu Jia , Xiahou Yu , Zhou Xiling , Liu Ming , Yuan Xinchun
Published: June 2024

Objective

The noninvasive right ventricular pressure‐strain loop (PSL) represents a novel method for the quantitative assessment of right ventricular myocardial function. Given that atrial septal defect (ASD) is a prevalent congenital heart anomaly associated with right ventricular volume overload, this study aimed to quantitatively assess the myocardial function of the right ventricle in ASD patients pre‐ and post‐occlusion by noninvasive right ventricular PSL.

Methods

This study included 36 patients diagnosed with secundum ASD group and 30 healthy adults (control group). We compared conventional right ventricular echocardiographic parameters, right ventricular strain, and myocardial work in the ASD group before occlusion, two days post‐occlusion, and three months post‐occlusion, with those in the control group.

Results

Prior to and two days following occlusion, the ASD group exhibited higher right ventricular global work index (RVGWI), right ventricular global wasted work (RVGWW), and right ventricular global constructive work (RVGCW) compared to the control group (P < .05). Within the ASD group, post‐occlusion, RVGWI, RVGCW, and RVGWW values were significantly reduced compared to pre‐occlusion values (P < .001). Furthermore, RVGWI and RVGCW showed a significant decrease three months after occlusion compared to two days post‐occlusion (P < .05). Multivariate regression analysis identified ASD diameter and pulmonary artery systolic pressure (PASP) as independent predictors of RVGWI (β = .405, P < .001; β = 2.307, P = .037) and RVGCW(β = .350, P<.001; β = 1.967, P = .023).

Conclusions

The noninvasive right ventricular PSL effectively demonstrates the alterations in right ventricular myocardial function in ASD patients, pre‐ and post‐occlusion. The metrics of right ventricular myocardial work (RVMW) offer a novel indicator for evaluating right ventricular myocardial function in these patients. Moreover, ASD diameter and PASP emerge as independent determinants of RVGWI and RVGCW.
“Saying ‘I'm not okay’ is extremely risky”: Postpartum mental health, delayed help‐seeking, and fears of the child welfare system among queer parents
Authors: Goldberg Abbie E. , Frost Reihonna L.
Published: June 2024

Parent mental health challenges in the postpartum and early parenthood have profound implications for parent, child, and family well‐being. Little research has focused on postpartum mental health challenges and barriers to help‐seeking among queer birthing people, including members of this community who may be particularly vulnerable to mental health difficulties, such as queer cis women partnered with men, trans/nonbinary parents, and queer parents who are young, low‐income, and/or of color. This mixed‐methods study of queer parents (n = 99), all of whom were assigned female at birth (AFAB) and gave birth to a child within the past several years, explores parents' postpartum mental health difficulties and perceived barriers to seeking help. Using a structural stigma framework, this study found that participants reported high rates of postpartum mental health difficulties (89%) and reported various barriers to seeking support including fears of discrimination and being deemed “unfit” by providers, which might lead to child welfare system involvement. Young parents and low‐income parents were particularly fearful of child welfare system contact and potential child removal. Factors that encouraged help‐seeking (e.g., desire to be a good parent; partner pressure to seek help) and implications for family practitioners are discussed.
A framework for understanding climate change impacts through non‐compensatory intra‐ and interspecific climate change responses
Authors: Coblentz Kyle E. , Treidel Lisa A. , Biagioli Francis P. , Fragel Christina G. , Johnson Allison E. , Thilakarathne Dinelka D. , Yang Liuqingqing , DeLong John P.
Published: June 2024

Understanding and predicting population responses to climate change is a crucial challenge. A key component of population responses to climate change are cases in which focal biological rates (e.g., population growth rates) change in response to climate change due to non‐compensatory effects of changes in the underlying components (e.g., birth and death rates) determining the focal rates. We refer to these responses as non‐compensatory climate change effects. As differential responses of biological rates to climate change have been documented in a variety of systems and arise at multiple levels of organization within and across species, non‐compensatory effects may be nearly ubiquitous. Yet, how non‐compensatory climate change responses combine and scale to influence the demographics of populations is often unclear and requires mapping them to the birth and death rates underlying population change. We provide a flexible framework for incorporating non‐compensatory changes in upstream rates within and among species and mapping their consequences for additional downstream rates across scales to their eventual effects on population growth rates. Throughout, we provide specific examples and potential applications of the framework. We hope this framework helps to enhance our understanding of and unify research on population responses to climate change.
Differences of morphological and physiological responses of sainfoin varieties/lines under simulated drought stresses
Authors: Yao Yuheng , Wang Kun , Nan Lili
Published: June 2024

Sainfoin (Onobrychis viciaefolia) is an important legume forage. This study aims to explore the response mechanisms of sainfoin germplasm resource accessions to drought stress, which provides the theoretical basis for tolerant breeding of sainfoin. In this study, 20 sainfoin germplasm resource accessions were used as the test materials, and the effects of drought stress on morphological and physiological characteristics were determined under simulated levels of drought (−0.5, −1.0, −1.5 and −2.0 MPa) × exposure times (7 days) in pots. The results showed that leaf area, leaf relative water content, root‐shoot ratio, root length, root surface area, root volume, root diameter, root tip number, chlorophyll a content, chlorophyll b content and catalase activity decreased with increasing drought stress. In contrast, proline, soluble sugar, soluble protein and malondialdehyde contents increased in response to drought. Root activity, superoxide dismutase and peroxidase activities increased first and then decreased and reached the maximum at −1.0 MPa. Cluster analysis showed that 20 sainfoin germplasm resources could be divided into three categories, of which four accessions were high tolerance types, and three accessions were low tolerance type. These findings will help provide some theoretical basis for cultivating new varieties.
Arachnoid granulations in idiopathic intracranial hypertension: Do they have an influence?
Authors: Schievelkamp Arndt‐Hendrik , Wägele Pia , Hattingen Elke
Published: June 2024

Objective

The aim of this study was to investigate whether the relative narrowing of the dural venous sinuses by arachnoid granulations (AGs) is more pronounced in patients with idiopathic intracranial hypertension (IIH) compared to healthy controls.

Background

IIH is characterized by increased intracranial pressure, which is associated with symptoms such as headache and visual disturbances. The role of cerebral venous drainage obstruction in IIH is the subject of ongoing research.

Materials and Methods

In this retrospective case–control study, 3D contrast‐enhanced magnetic resonance images of a cohort of 43 patients with IIH were evaluated for (1) the number of AGs per venous sinus and (2) the diameters of the dural venous sinuses at the site of an AG and at standardized measurement points. In addition, the minimum width of the transverse/sigmoid sinus was measured. All data were compared to the same data from a cohort of 43 control participants.

Results

Patients with IIH showed less relative sinus narrowing by AG compared to controls (median: 7%, interquartile range [IQR] 10% vs. 11%, IQR 9% in controls; p = 0.009). In patients with IIH, sinus diameter was larger at the site of an AG (70 ± 25 mm2) compared to its diameter at the standardized measurement point (48 ± 23 mm2; p = 0.010). In the superior sagittal sinus (SSS), patients with IIH had smaller AGs (median: 3 mm2, IQR 2 mm2 vs. 5 mm2, IQR 3 mm2 in controls; p = 0.023) while the respective sinus segment was larger (median: 69 mm2; IQR 21 mm2 vs. 52 mm2, IQR 26 mm2 in controls; p = 0.002). The right transverse sinus was narrower in patients with IIH (41 ± 21 mm vs. 57 ± 20 mm in controls; p < 0.001).

Conclusions

In contrast to our hypothesis, patients with IIH showed less pronounced relative sinus narrowing by AG compared to controls, especially within the SSS, where AGs were smaller and the corresponding sinus segment wider. Smaller AGs could result in lower cerebrospinal fluid resorption, favoring the development of IIH. Conversely, the smaller AGs could also be a consequence of IIH due to backpressure in the SSS because of the narrower transverse/sigmoid sinus, which widens the SSS and compresses the AG.
The evolving molecular characterisation, histological criteria and nomenclature of adenoid ameloblastoma as a World Health Organisation tumour type
Authors: Odell Edward W , Gomes Carolina Cavalieri , Thavaraj Selvam
Published: June 2024

Adenoid ameloblastoma (AA) was recently recognised as a separate tumour type in the most recent World Health Organisation (WHO) classification of head and neck tumours. This decision has been considered controversial by several groups, who have described AA as a subtype of ameloblastoma, a hybrid odontogenic tumour or to fall within the spectrum of other recognised odontogenic tumours, including dentinogenic ghost cell tumour and adenomatoid odontogenic tumour. Here we review the reasons for the WHO decision to classify AA as a separate tumour type. We also critique molecular and histological findings from recent reports published since the WHO classification. While acknowledging that the classification of tumours is constantly evolving, the balance of current evidence suggests that AA should remain a distinct tumour type, and not a subtype of ameloblastoma, pending further molecular characterisation.
The HepHIV 2023 Madrid conference: A call to action for political leadership in reaching the sustainable development goals on earlier testing and linkage to care for HIV, viral hepatitis, and sexually transmitted infections
Authors: Simões Daniel , Raben Dorthe , Moran Alejandro Bertó , Imaz Arkaitz , Stengaard Annemarie Rinder , Raahauge Anne , Sullivan Ann K. , Vaughan Elena , Brännström Johanna , De Baetselier Irith , Platteau Tom , Casabona Jordi , Del Amo Julia ,   the 2023 HepHIV Conference Organising Committee and the EuroTEST Steering Committee
Published: June 2024

Introduction and Objectives

The HepHIV 2023 Conference, held in Madrid in November 2023, highlighted how Europe is not on track to meet the United Nations (UN) sustainable development goals and Joint UN Programme on HIV/AIDS (UNAIDS) targets. This article presents the outcomes of the conference, which focus on ways to improve testing and linkage to care for HIV, viral hepatitis, and other sexually transmitted infections. HIV‐related stigma and discrimination, a major barrier to progress, was a key concept of the conference and on the agenda of the Spanish Presidency of the European Union.

Methods

The HepHIV 2023 organizing committee, alongside the Spanish Ministry of Health, oversaw the conference organization and prepared the scientific programme based on abstract rankings. Key outcomes are derived from conference presentations and discussions.

Results

Conference presentations covered the obstacles that HIV‐related stigma and discrimination continue to pose to access to services, models for data collection to better monitor progress in the future, and examples of legislative action that can be taken at national levels. Diversification of testing approaches was also highlighted, to reach key populations, (e.g. migrant populations), to increase testing offered in healthcare settings (e.g. emergency departments), and to account for different stages of epidemics across the region.

Conclusion

With a strong call for intensified action to address the impact of HIV‐related stigma and discrimination on testing uptake, the conference concluded that strengthened collaboration is required between governments and implementers around testing and linkage to care. There is also an ongoing need to ensure sustainable political commitment and appropriate resource allocation to address gaps and inequalities in access for key populations and to focus on the implementation of integrated responses to HIV, viral hepatitis, and sexually transmitted infections.
Clinical practice guidelines for the diagnosis and treatment of scabies
Authors: Uzun Soner , Durdu Murat , Yürekli Aslan , Mülayim Mehmet K. , Akyol Melih , Velipaşaoğlu Sevtap , Harman Mehmet , Taylan‐Özkan Ayşegül , Şavk Ekin , Demir‐Dora Devrim , Dönmez Levent , Gazi Umut , Aktaş Habibullah , Aktürk Aysun Ş. , Demir Gülay , Göktay Fatih , Gürel Mehmet S. , Gürok Neşe G. , Karadağ Ayşe S. , Küçük Özlem S. , Turan Çağrı , Ozden Müge G. , Ural Zeynep K. , Zorbozan Orçun , Mumcuoğlu Kosta Y.
Published: June 2024

Scabies, caused by the Sarcoptes scabiei var hominis mite burrowing into the skin, is a highly contagious disease characterized by intense nocturnal itching. Its global impact is considerable, affecting more than 200 million individuals annually and posing significant challenges to healthcare systems worldwide. Transmission occurs primarily through direct skin‐to‐skin contact, contributing to its widespread prevalence and emergence as a substantial public health concern affecting large populations. This review presents consensus‐based clinical practice guidelines for diagnosing and managing scabies, developed through the fuzzy Delphi method by dermatology, parasitology, pediatrics, pharmacology, and public health experts. The presence of burrows containing adult female mites, their eggs, and excreta is the diagnostic hallmark of scabies. Definitive diagnosis typically involves direct microscopic examination of skin scrapings obtained from these burrows, although dermoscopy has become a diagnostic tool in clinical practice. Treatment modalities encompass topical agents, such as permethrin, balsam of Peru, precipitated sulfur, and benzyl benzoate. In cases where topical therapy proves inadequate or in instances of crusted scabies, oral ivermectin is recommended as a systemic treatment option. This comprehensive approach addresses the diagnostic and therapeutic challenges associated with scabies, optimizing patient care, and management outcomes.