bluuebunny/crossref_metadata_2025 huggingface dataset:
Guidelines on the prevention of foot ulcers in persons with diabetes (IWGDF 2023 update)
Authors: Bus Sicco A. , Sacco Isabel C. N. , Monteiro‐Soares Matilde , Raspovic Anita , Paton Joanne , Rasmussen Anne , Lavery Lawrence A. , van Netten Jaap J.
Published: June 2023

Aims

This is the 2023 International Working Group on the Diabetic Foot guideline on the prevention of foot ulcers in persons with diabetes, which updates the 2019 guideline. This guideline is targeted at clinicians and other healthcare professionals.

Materials and Methods

We followed the Grading of Recommendations, Assessment, Development and Evaluations methodology to devise clinical questions and critically important outcomes in the PICO format, to conduct a systematic review of the medical‐scientific literature including, where appropriate, meta‐analyses, and to write recommendations and their rationale. The recommendations are based on the quality of evidence found in the systematic review, expert opinion where (sufficient) evidence was not available, and a weighing of the desirable and undesirable effects of an intervention, as well as patient preferences, costs, equity, feasibility and applicability.

Results

We recommend screening a person with diabetes at very low risk of foot ulceration annually for the loss of protective sensation and peripheral artery disease, and screening persons at higher risk at higher frequencies for additional risk factors. For preventing a foot ulcer, educate persons at‐risk about appropriate foot self‐care, educate not to walk without suitable foot protection, and treat any pre‐ulcerative lesion on the foot. Educate moderate‐to‐high risk people with diabetes to wear properly fitting, accommodative, therapeutic footwear, and consider coaching them to monitor foot skin temperature. Prescribe therapeutic footwear that has a demonstrated plantar pressure relieving effect during walking, to help prevent plantar foot ulcer recurrence. Consider advising people at low‐to‐moderate risk to undertake a, preferably supervised, foot‐ankle exercise programme to reduce ulcer risk factors, and consider communicating that a total increase in weight‐bearing activity of 1000 steps/day is likely safe with regards to risk of ulceration. In people with non‐rigid hammertoe with pre‐ulcerative lesion, consider flexor tendon tenotomy. We suggest not to use a nerve decompression procedure to help prevent foot ulcers. Provide integrated foot care for moderate‐to‐high‐risk people with diabetes to help prevent (recurrence of) ulceration.

Conclusions

These recommendations should help healthcare professionals to provide better care for persons with diabetes at risk of foot ulceration, to increase the number of ulcer‐free days and reduce the patient and healthcare burden of diabetes‐related foot disease.
Recent progress in food‐grade double emulsions: Fabrication, stability, applications, and future trends
Authors: Luo Tian , Wei Zihao
Published: June 2023

Compared with ordinary emulsions, the unique structures endow double emulsions with special functions, which makes them have broad prospects in delivering biologically active substances and replacing fats. In recent years, due to the instability of double emulsions, numerous experiments have been carried out on their preparation technology as well as stabilization methods. This review emphatically summarizes the research progress of double emulsions, including preparation techniques, factors affecting stability, stabilization mechanisms, and related applications. At present, in addition to the traditional mechanical agitation and ultrasonic emulsification, membrane emulsification, phase inversion, and microfluidic emulsification are the main research directions, all of which can improve the stability. Moreover, the stabilizer is also a crucial factor affecting the stability of the double emulsion. Hence, in this article emphasis is placed on surfactants, biopolymers, and solid particles. The applications of double emulsions in food industry can be divided into the following categories: encapsulating substances, controlling the release, and being served as fat substitutes. Furthermore, in the future, the main challenges are to commercialize the double emulsions and enhance their safety in food applications. Additionally, developing high internal phase Pickering double emulsions and O/W/O double emulsions may become the major research trends.
Increased neopterin in cerebrospinal fluid in active adult neurohistiocytosis
Authors: Razanamahery Jerome , Samson Maxime , Idbaih Ahmed , Greigert Helene , Comby Pierre Olivier , Cohen Aubart Fleur , Haroche Julien , Audia Sylvain , Bonnotte Bernard
Published: June 2023

Diagnosis of neuro‐histiocytosis is challenging and relies on clinical presentation, imaging, and cerebrospinal fluid (CSF) analysis to exclude differential diagnoses. Brain biopsy remains the gold standard for accurate diagnosis, but it is rarely performed because of the risk of the procedure and the low rentability in neurodegenerative presentation. Therefore, there is an unmet need to identify a specific biomarker for diagnosing neurohistiocytosis in adults. Because microglia (brain macrophages) is involved in the pathogenesis of neurohistiocytosis and produces neopterin secondary to aggression, the purpose of our study was to evaluate the value of the CSF neopterin levels for the diagnosis of active neurohistiocytosis. Of the 21 adult patients with histiocytosis, four patients had clinical symptoms compatible with neurohistiocytosis. In the two patients with a confirmed diagnosis of neurohistiocytosis, CSF neopterin levels were elevated as well as IL‐6 and IL‐10 levels. In contrast, the two other patients in whom the diagnosis of neurohistiocytosis was infirmed and all other patients with histiocytosis without active neurological disease involvement had normal CSF neopterin levels. In summary, increased CSF neopterin concentration represented a valuable tool for diagnosing active neuro‐histiocytosis in adults with histiocytic neoplasms in this preliminary study.
Inequalities in associations between young adult caregiving and social relationships: Evidence from the UK Household Longitudinal Study
Authors: Lacey Rebecca E. , Di Gessa Giorgio , Xue Baowen , McMunn Anne
Published: June 2023

Introduction

Young adult caregivers (aged 16–29 years) are an important but underrecognized group of informal caregivers. There is some evidence suggesting that young adult caregivers have fewer social relationships. However, this research has been largely cross‐sectional in design or restricted to caregivers, providing no comparison with noncaregivers. Further, there is little evidence on whether and to what extent there are inequalities in associations between young adult caregiving and social relationships by gender, age, caregiving intensity, or household income.

Methods

Using five waves of data on 3‐4000 young adults aged 16–29 from the UK Household Longitudinal Study, we investigated associations between becoming a young adult caregiver and subsequent social relationships (number of close friends and participation in organized social activities) in the short‐term (1–2 years after caregiving initiation) and longer‐term (4–5 years later). We also assessed differences by gender, age, household income, and caregiving intensity.

Results

Overall, those who became young adult caregivers, and particularly those providing 5+ h/week, reported fewer friends in the short‐ but not longer‐term. No associations were observed between young adult caregiving and participation in organized social activities. Also, there was no evidence of differences by gender, age, income, or caregiving hours.

Conclusions

Becoming a young adult caregiver is associated with a reduction in number of close friends, particularly in the short‐term. Given the importance of practical and emotional support provided by friends, the early identification of young adult caregivers and greater population awareness of caring in young adulthood may help to mitigate the effects on social relationships.
In critically ill adult patients with COVID‐19, lower energy and higher protein intake are associated with fewer mechanical ventilation and antibiotic days but not with ICU length of stay
Authors: Floro Geraldine C. , Schwenger Katherine J. P. , Ghorbani Yasaman , Zidar Deanna J. , Allard Johane P.
Published: June 2023

Background

Coronavirus disease 2019 (COVID‐19) nutrition management guidelines recommend hypocaloric, high‐protein feeding in the acute phase of critical illness. This study aimed to determine, among critically ill adults with COVID‐19, whether nutrition support affects outcomes in nonobese patients when providing a mean energy intake of ≥20 kcal/kg/day vs <20 kcal/kg/day and protein intake of ≥1.2 g/kg/day vs <1.2 g/kg/day, using actual body weight, and in patients with obesity when providing ≥20 kcal/kg/day vs <20 kcal/kg/day and a protein intake of ≥2 g/kg/day vs <2 g/kg/day using ideal body weight.

Methods

This retrospective study included adults with COVID‐19 on mechanical ventilation (MV) admitted to the intensive care unit (ICU) from 2020 to 2021. Clinical and nutrition parameters were recorded the first 14 days of ICU stay.

Results

One hundred four patients were included: 79 (75.96%) were male and had a median age of 51 years and body mass index of 29.65 kg/m2. ICU length of stay (LOS) was not affected by nutrition intake, but patients receiving <20 kcal/kg/day had fewer MV days (P = 0.029). In a subgroup analysis, MV days were lower in the nonobese group receiving <20 kcal/kg/day (P = 0.012). In the obese group, those receiving higher protein intake had fewer antibiotic days (P = 0.013).

Conclusion

In critically ill patients with COVID‐19, lower energy and higher protein intake were respectively associated with fewer MV days and, in patients with obesity, fewer antibiotic days, but they had no effect on ICU LOS.
Perioperative nutrition in the setting of pediatric inflammatory bowel disease
Authors: Wong Jonathan , Densmore John , Hilbrands Julia , Elkadri Abdul , Cabrera Jose , Noe Josh , Eickhoff Jens , Goday Praveen S.
Published: June 2023

Background

Optimization of nutrition prior to inflammatory bowel disease (IBD)–related surgery could improve outcomes. The aim of this study was to assess the perioperative nutrition status and management of children undergoing intestinal resection for treatment of their IBD.

Methods

We identified all patients with IBD who underwent primary intestinal resection. We identified malnutrition using established criteria and methods of nutrition provision at various time points (preoperative outpatient evaluation, admission, and postoperative outpatient follow‐up) for elective cases (who underwent their procedure at a scheduled admission) and urgent cases (who underwent an unplanned surgical intervention). We also recorded data on postsurgical complications.

Results

A total of 84 patients were identified in this single‐center study (male sex: 40%, mean age: 14.5 years, Crohn's disease: 65%). Thirty‐four patients (40%) had some degree of malnutrition. Prevalence of malnutrition in the urgent and elective cohorts was similar (48% vs 36%; P = 0.37). Of these patients, 29 (34%) were noted to be on some type of nutrition supplementation prior to surgery. Postoperatively, BMI z scores increased (−0.61 vs −0.42; P = 0.0008), but the percentage of patients who were malnourished did not change from preoperative status (40% vs 40%; P = 0.10). Despite this, use of nutrition supplementation was only noted in 15 (17%) patients at postoperative follow‐up. Complications were not associated with nutrition status.

Conclusion

Utilization of supplemental nutrition decreased postprocedure despite no change in malnutrition prevalence. These findings support the development of a pediatric‐specific perioperative nutrition protocol in the setting of IBD‐related surgery.
Long‐term nutrition alterations after surgery for gastrointestinal cancers
Authors: Jacobson Richard , Gurd Erin N. , Pimiento Jose M.
Published: June 2023

As surgical and adjuvant therapies for gastrointestinal (GI) cancers improve in safety and efficacy, extended survival in these diseases is becoming commonplace. Surgically induced nutrition alterations are common side effects of treatment and often debilitating. This review is intended for multidisciplinary teams to better understand the postoperative anatomy, physiology, and nutrition morbidity of GI cancer operations. We have arranged this paper by the anatomic and functional changes to the GI tract intrinsic to common cancer operations. Operation‐specific long‐term nutrition morbidity is detailed, along with the underlying pathophysiology. We have included the most common and effective interventions for the management of individual nutrition morbidities. Finally, we highlight the importance of a multidisciplinary approach to the evaluation and treatment of these patients over the oncologic surveillance period and beyond.
Effect of feed trace elements on eggs of five strains of laying hens and their health risk assessment
Authors: Hashemi Mohammad , Azadi Amin , Saghi Masumeh , Aminzare Majid , Noori Seyyed Mohammad Ali
Published: June 2023

Background

Trace elements are essential for human nutrition, and their deficiencies or excesses are strongly associated with several diseases, such as cardiovascular ones.

Objectives

The current cross‐sectional study investigated the concentration of essential trace elements (copper, non‐metal selenium, iron, zinc, cobalt and manganese) in eggs and diets of five strains of laying hens.

Methods

The yolk and albumen were analysed separately, and wet preparation was carried out following inductively coupled plasma–optical emission spectrometry detection. The target hazard quotients (THQs) for the non‐carcinogenic disease were calculated by the United States environmental protection agency (USEPA) method.

Results

The highest concentrations of selenium, zinc and manganese were found in egg yolks of native hens (0.76, 44.22 and 6.52 mg/kg, respectively). The highest amounts of copper and cobalt were recorded in the egg yolk of Lohman (2.07 and 0.023 mg/kg, respectively). On the other hand, the egg yolk of Bovans contained the highest amount of iron (57.46 mg/kg).

Conclusion

Overall, the potential health risks were minimal, and the consumption of eggs was generally safe.
Lebensmittelbedingte Krankheitsausbrüche in der Schweiz von 2007 bis 2021
Authors: Lüthi Thomas , Fridez Françoise
Published: June 2023

Lebensmittelbedingte Krankheitsausbrüche in der Schweiz werden durch die kantonalen Behörden identifiziert und dem Bundesamt für Lebensmittelsicherheit und Veterinärwesen (BLV) übermittelt. Zwischen 2007 – 2021 wurden 200 Ausbrüche gemeldet. Mindestens 4668 Personen erkrankten, 303 wurden hospitalisiert und 18 verstarben. Es wurden hauptsächlich nachgewiesen: Salmonella spp. (25), Campylobacter spp. (17), Noroviren (16) und koagulase-positive Staphylokokken (16). Die Ausbrüche fanden in Gastronomiebetrieben (85), privaten Haushalten (19), Kindergärten und Schulen (13), und bei Take-away-Verpflegungen (9) statt. Um solche Krankheitsausbrüche abklären zu können, stellt das BLV einen neuen Werkzeugkasten zur Verfügung. Dieser umfasst eine Webseite, einen Praxisleitfaden sowie ein Set von 4 Handbüchern und weiterführende Hilfsmittel.
Birthweight is associated with clinical characteristics in people with recently diagnosed type 2 diabetes
Authors: Hansen Aleksander L. , Thomsen Reimar W. , Brøns Charlotte , Svane Helene M. L. , Jensen Rasmus T. , Andersen Mette K. , Hansen Torben , Nielsen Jens S. , Vestergaard Peter , Højlund Kurt , Jessen Niels , Olsen Michael H. , Sørensen Henrik T. , Vaag Allan A.
Published: June 2023

Aims/hypothesis

Low birthweight is a risk factor for type 2 diabetes but it is unknown whether low birthweight is associated with distinct clinical characteristics at disease onset. We examined whether a lower or higher birthweight in type 2 diabetes is associated with clinically relevant characteristics at disease onset.

Methods

Midwife records were traced for 6866 individuals with type 2 diabetes in the Danish Centre for Strategic Research in Type 2 Diabetes (DD2) cohort. Using a cross-sectional design, we assessed age at diagnosis, anthropomorphic measures, comorbidities, medications, metabolic variables and family history of type 2 diabetes in individuals with the lowest 25% of birthweight (<3000 g) and highest 25% of birthweight (>3700 g), compared with a birthweight of 3000–3700 g as reference, using log-binomial and Poisson regression. Continuous relationships across the entire birthweight spectrum were assessed with linear and restricted cubic spline regression. Weighted polygenic scores (PS) for type 2 diabetes and birthweight were calculated to assess the impact of genetic predispositions.

Results

Each 1000 g decrease in birthweight was associated with a 3.3 year (95% CI 2.9, 3.8) younger age of diabetes onset, 1.5 kg/m2 (95% CI 1.2, 1.7) lower BMI and 3.9 cm (95% CI 3.3, 4.5) smaller waist circumference. Compared with the reference birthweight, a birthweight of <3000 g was associated with more overall comorbidity (prevalence ratio [PR] for Charlson Comorbidity Index Score ≥3 was 1.36 [95% CI 1.07, 1.73]), having a systolic BP ≥155 mmHg (PR 1.26 [95% CI 0.99, 1.59]), lower prevalence of diabetes-associated neurological disease, less likelihood of family history of type 2 diabetes, use of three or more glucose-lowering drugs (PR 1.33 [95% CI 1.06, 1.65]) and use of three or more antihypertensive drugs (PR 1.09 [95% CI 0.99, 1.20]). Clinically defined low birthweight (<2500 g) yielded stronger associations. Most associations between birthweight and clinical characteristics appeared linear, and a higher birthweight was associated with characteristics mirroring lower birthweight in opposite directions. Results were robust to adjustments for PS representing weighted genetic predisposition for type 2 diabetes and birthweight.

Conclusion/interpretation

Despite younger age at diagnosis, and fewer individuals with obesity and family history of type 2 diabetes, a birthweight <3000 g was associated with more comorbidities, including a higher systolic BP, as well as with greater use of glucose-lowering and antihypertensive medications, in individuals with recently diagnosed type 2 diabetes.

Graphical Abstract
Low birthweight is associated with a higher incidence of type 2 diabetes over two decades independent of adult BMI and genetic predisposition
Authors: Wibaek Rasmus , Andersen Gregers S. , Linneberg Allan , Hansen Torben , Grarup Niels , Thuesen Anne Cathrine B. , Jensen Rasmus T. , Wells Jonathan C. K. , Pilgaard Kasper A. , Brøns Charlotte , Vistisen Dorte , Vaag Allan A.
Published: June 2023

Aims/hypothesis

Low birthweight is a risk factor for type 2 diabetes. Most previous studies are based on cross-sectional prevalence data, not designed to study the timing of onset of type 2 diabetes in relation to birthweight. We aimed to examine associations of birthweight with age-specific incidence rate of type 2 diabetes in middle-aged to older adults over two decades.

Methods

Adults aged 30–60 years enrolled in the Danish Inter99 cohort in 1999–2001 (baseline examination), with information on birthweight from original birth records from 1939–1971 and without diabetes at baseline, were eligible. Birth records were linked with individual-level data on age at diabetes diagnosis and key covariates. Incidence rates of type 2 diabetes as a function of age, sex and birthweight were modelled using Poisson regression, adjusting for prematurity status at birth, parity, polygenic scores for birthweight and type 2 diabetes, maternal and paternal diabetes history, socioeconomic status and adult BMI.

Results

In 4590 participants there were 492 incident type 2 diabetes cases during a mean follow-up of 19 years. Type 2 diabetes incidence rate increased with age, was higher in male participants, and decreased with increasing birthweight (incidence rate ratio [95% CI per 1 kg increase in birthweight] 0.60 [0.48, 0.75]). The inverse association of birthweight with type 2 diabetes incidence was statistically significant across all models and in sensitivity analysis.

Conclusions/interpretation

A lower birthweight was associated with increased risk of developing type 2 diabetes independent of adult BMI and genetic risk of type 2 diabetes and birthweight.

Graphical Abstract
Physiological responses and performance factors for double-poling and diagonal-stride treadmill roller-skiing time-trial exercise
Authors: Andersson Erik P. , Lögdal Nestor , Byrne Darragh , Jones Thomas W.
Published: June 2023

Purpose

To compare physiological responses between a self-paced 4-min double-poling (DP) time-trial (TTDP) versus a 4-min diagonal-stride (DS) time-trial (TTDS). The relative importance of peak oxygen uptake ($${\dot{\text{V}}}$$

V
˙

O2peak), anaerobic capacity, and gross efficiency (GE) for projection of 4-min TTDP and TTDS roller-skiing performances were also examined.

Methods

Sixteen highly trained male cross-country skiers performed, in each sub-technique on separate occasions, an 8 × 4-min incremental submaximal protocol, to assess individual metabolic rate (MR) versus power output (PO) relationships, followed by a 10-min passive break and then the TTDP or TTDS, with a randomized order between sub-techniques.

Results

In comparison to TTDS, the TTDP resulted in 10 ± 7% lower total MR, 5 ± 4% lower aerobic MR, 30 ± 37% lower anaerobic MR, and 4.7 ± 1.2 percentage points lower GE, which resulted in a 32 ± 4% lower PO (all P < 0.01). The $${\dot{\text{V}}}$$

V
˙

O2peak and anaerobic capacity were 4 ± 4% and 30 ± 37% lower, respectively, in DP than DS (both P < 0.01). The PO for the two time-trial (TT) performances were not significantly correlated (R2 = 0.044). Similar parabolic pacing strategies were used during both TTs. Multivariate data analysis projected TT performance using $${\dot{\text{V}}}$$

V
˙

O2peak, anaerobic capacity, and GE (TTDP, R2 = 0.974; TTDS, R2 = 0.848). The variable influence on projection values for $${\dot{\text{V}}}$$

V
˙

O2peak, anaerobic capacity, and GE were for TTDP, 1.12 ± 0.60, 1.01 ± 0.72, and 0.83 ± 0.38, respectively, and TTDS, 1.22 ± 0.35, 0.93 ± 0.44, and 0.75 ± 0.19, respectively.

Conclusions

The results show that a cross-country skier’s “metabolic profile” and performance capability are highly sub-technique specific and that 4-min TT performance is differentiated by physiological factors, such as $${\dot{\text{V}}}$$

V
˙

O2peak, anaerobic capacity, and GE.
Group Actions on Twisted Sums of Banach Spaces
Authors: Castillo Jesús M. F. , Ferenczi Valentin
Published: June 2023

We study bounded actions of groups and semigroupsGon exact sequences of Banach spaces from the point of view of (generalized) quasilinear maps, characterize the actions on the twisted sum space by commutator estimates and introduce the associated notions ofG-centralizer andG-equivariant map. We will show that when (A)Gis an amenable group and (U) the target space is complemented in its bidual by aG-equivariant projection, then uniformly bounded compatible families of operators generate bounded actions on the twisted sum space; that compatible quasilinear maps are linear perturbations ofG-centralizers; and that, under (A) and (U),G-centralizers are bounded perturbations ofG-equivariant maps. The previous results are optimal. Several examples and counterexamples are presented involving the action of the isometry group of$$L_p(0,1), p\ne 2$$Lp(0,1),p≠2on the Kalton–Peck space$$Z_p$$Zp, certain non-unitarizable triangular representations of the free group$${\mathbb {F}}_\infty $$F∞on the Hilbert space, the compatibility of complex structures on twisted sums, or bounded actions on the interpolation scale of$$L_p$$Lp-spaces. In the penultimate section we consider the category ofG-Banach spaces and study its exact sequences, showing that, under (A) and (U),G-splitting and usual splitting coincide. The purpose of the final section is to present some applications, showing that several previous result are optimal and to suggest further open lines of research.
Performance and Micro-Pacing Strategies in Biathlon Skiing
Authors: Staunton Craig A. , Jonsson Kårström Malin , Björklund Glenn , Laaksonen Marko S.
Published: June 2023

Purpose

To examine the micro-pacing (within-lap) strategies during biathlon skiing with and without the biathlon rifle.

Methods

Twenty biathletes (7 women, 13 men) performed two cross-country skiing time-trials on a ≈2300 m course, once with and once without the biathlon rifle. During time-trials, biathletes wore a sensor that recorded position, distance and skiing-speed. A trajectory correction and statistical parametric mapping procedure determined the course positions (clusters) where instantaneous skiing-speed was significantly related to time-trial performance. The time differences between the fastest and slowest skier in these clusters were calculated.

Results

The fastest biathletes skied with greater instantaneous speeds in specific clusters, which included both uphill and downhill sections. The clusters represented time gains for the fastest skier over the slowest skier of between 16.1 and 25.8 s for the women and between 18.9 and 21.9 s for the men. The largest time gains between the fastest and slowest biathletes were observed in a downhill section that was preceded by a 180° turn, where time gains were between 2.9 and 4.1 s in clusters of between just 12 to 62 m. In biathlon skiing with-rifle, there were more clusters that were not present during without-rifle. When skiing with-rifle, there were additional clusters in the uphill sections that represented time gains of 5.2 s and 2.3 s for the women and men, respectively.

Conclusions

Statistical parametric mapping can be used in biathlon to provide pacing and performance feedback to athletes and coaches.
Gender Disparities in Blood Pressure and the Role of Body Mass Index: A Birth Cohort Analysis in China
Authors: Wu Jinjing , Jiao Boshen , Zhao Jiaying
Published: June 2023

Background

The slow decline in cardiovascular disease (CVD) mortality and the stagnant or increasing hypertension prevalence in low- and middle-income countries necessitate investigation. Evolving gender disparities suggested that male cardiovascular health disadvantage may be preventable, offering potential for enhancing population cardiovascular health. Despite global body mass index (BMI) increases, its role in shaping the gender disparities remains underexplored.

Objective

This study investigated the birth cohort dynamics of gender disparities in systolic/diastolic blood pressure (SBP/DBP) in China, one of the world's largest low- and middle-income countries, and explored the potential role of BMI in explaining the changing gender disparities.

Methods

Data from the China Health and Nutrition Survey (1991–2015) were analyzed using multilevel growth-curve models to estimate gender- and cohort-specific SBP/DBP trajectories among individuals born between 1950 and 1975.

Results

Men had higher SBP and DBP than women at the sample’s mean age of 41.7 years. The gender disparities in SBP and DBP increased with each successive one-year cohort from 1950 to 1975 by 0.14 mm Hg and 0.09 mm Hg, respectively. Adjusting for BMI reduced the increasing gender disparities in SBP and DBP by 31.9% and 34.4%, respectively.

Conclusion

Chinese men experienced a greater increase in SBP/DBP across successive cohorts compared to women. The increasing gender disparities in SBP/DBP were partially attributable to a greater BMI increase across cohorts among men. Given these findings, prioritizing interventions that aim to reduce BMI, particularly among men, could potentially alleviate the burden of CVD in China through lowering SBP/DBP.
Identification of novel p-cresol inhibitors that reduce Clostridioides difficile’s ability to compete with species of the gut microbiome
Authors: Harrison Mark A. , Farthing Rebecca J. , Allen Nyasha , Ahern Lucy M. , Birchall Kristian , Bond Michael , Kaur Harparkash , Wren Brendan W. , Bergeron Julien R. C. , Dawson Lisa F.
Published: June 2023

Treatment of Clostridioides difficile infection (CDI) is expensive and complex, with a high proportion of patients suffering infection relapse (20–35%), and some having multiple relapses. A healthy, unperturbed gut microbiome provides colonisation resistance against CDI through competition for nutrients and space. However, antibiotic consumption can disturb the gut microbiota (dysbiosis) resulting in the loss of colonisation resistance allowing C. difficile to colonise and establish infection. A unique feature of C. difficile is the production of high concentrations of the antimicrobial compound para-cresol, which provides the bacterium with a competitive advantage over other bacteria found in the gut. p-cresol is produced by the conversion of para-Hydroxyphenylacetic acid (p-HPA) by the HpdBCA enzyme complex. In this study, we have identified several promising inhibitors of HpdBCA decarboxylase, which reduce p-cresol production and render C. difficile less able to compete with a gut dwelling Escherichia coli strain. We demonstrate that the lead compound, 4-Hydroxyphenylacetonitrile, reduced p-cresol production by 99.0 ± 0.4%, whereas 4-Hydroxyphenylacetamide, a previously identified inhibitor of HpdBCA decarboxylase, only reduced p-cresol production by 54.9 ± 13.5%. To interpret efficacy of these first-generation inhibitors, we undertook molecular docking studies that predict the binding mode for these compounds. Notably, the predicted binding energy correlated well with the experimentally determined level of inhibition, providing a molecular basis for the differences in efficacy between the compounds. This study has identified promising p-cresol production inhibitors whose development could lead to beneficial therapeutics that help to restore colonisation resistance and therefore reduce the likelihood of CDI relapse.
Effects of spaceflight on the EEG alpha power and functional connectivity
Authors: Pusil Sandra , Zegarra-Valdivia Jonathan , Cuesta Pablo , Laohathai Christopher , Cebolla Ana Maria , Haueisen Jens , Fiedler Patrique , Funke Michael , Maestú Fernando , Cheron Guy
Published: June 2023

Electroencephalography (EEG) can detect changes in cerebral activity during spaceflight. This study evaluates the effect of spaceflight on brain networks through analysis of the Default Mode Network (DMN)'s alpha frequency band power and functional connectivity (FC), and the persistence of these changes. Five astronauts' resting state EEGs under three conditions were analyzed (pre-flight, in-flight, and post-flight). DMN’s alpha band power and FC were computed using eLORETA and phase-locking value. Eyes-opened (EO) and eyes-closed (EC) conditions were differentiated. We found a DMN alpha band power reduction during in-flight (EC: p < 0.001; EO: p < 0.05) and post-flight (EC: p < 0.001; EO: p < 0.01) when compared to pre-flight condition. FC strength decreased during in-flight (EC: p < 0.01; EO: p < 0.01) and post-flight (EC: ns; EO: p < 0.01) compared to pre-flight condition. The DMN alpha band power and FC strength reduction persisted until 20 days after landing. Spaceflight caused electrocerebral alterations that persisted after return to earth. Periodic assessment by EEG-derived DMN analysis has the potential to become a neurophysiologic marker of cerebral functional integrity during exploration missions to space.
Multi-objective optimization for multimodal transportation routing problem with stochastic transportation time based on data-driven approaches
Authors: Peng Yong , Gao Shu Han , Yu Dennis , Xiao Yun Peng , Luo Yi Juan
Published: June 2023

We study a multi-objective optimization model of a stochastic multimodal transportation network considering key impact factors such as transit cost, time, and transport mode schedule while minimizing total transportation cost and transportation time. In this study, we apply the Monte Carlo simulation to deal with the stochastic transportation time in the network and propose a data-driven approach that combines historical data and the dataset generated by the data mining algorithm to accelerate the search for the nondominated solution in the simulation. To validate the effectiveness of the proposed Data-Driven Multi-Objective Simulation Ant Colony (DD-MSAC) algorithm, we compare the optimum-seeking performance and the running time consumption of the Nondominated Sorting Genetic Algorithm-II (NSGA-II) and the Multi-Objective Simulation Ant Colony (MSAC) algorithm. Then, the MSAC algorithm is adopted as the benchmark for the comparison study on the solving performance of the proposed DD-MSAC algorithm. We conducted 30 times simulation run under different network scales in our numerical examples to show that the DD-MSAC algorithm can be equally effective as the non-data-driven MSAC algorithm in finding a nondominated solution as the average error does not exceed 5%. Meanwhile, we analyze the impact of different data-driven approaches, including data pool and support vector machine, on the solution quality and the running time. Finally, we use an example of China’s Belt Road Initiative to verify the effectiveness of the proposed algorithm.
Systematic design and data-driven evaluation of social determinants of health ontology (SDoHO)
Authors: Dang Yifang , Li Fang , Hu Xinyue , Keloth Vipina K , Zhang Meng , Fu Sunyang , Amith Muhammad F , Fan J Wilfred , Du Jingcheng , Yu Evan , Liu Hongfang , Jiang Xiaoqian , Xu Hua , Tao Cui
Published: June 2023

Objective

Social determinants of health (SDoH) play critical roles in health outcomes and well-being. Understanding the interplay of SDoH and health outcomes is critical to reducing healthcare inequalities and transforming a “sick care” system into a “health-promoting” system. To address the SDOH terminology gap and better embed relevant elements in advanced biomedical informatics, we propose an SDoH ontology (SDoHO), which represents fundamental SDoH factors and their relationships in a standardized and measurable way.

Material and Methods

Drawing on the content of existing ontologies relevant to certain aspects of SDoH, we used a top-down approach to formally model classes, relationships, and constraints based on multiple SDoH-related resources. Expert review and coverage evaluation, using a bottom-up approach employing clinical notes data and a national survey, were performed.

Results

We constructed the SDoHO with 708 classes, 106 object properties, and 20 data properties, with 1,561 logical axioms and 976 declaration axioms in the current version. Three experts achieved 0.967 agreement in the semantic evaluation of the ontology. A comparison between the coverage of the ontology and SDOH concepts in 2 sets of clinical notes and a national survey instrument also showed satisfactory results.

Discussion

SDoHO could potentially play an essential role in providing a foundation for a comprehensive understanding of the associations between SDoH and health outcomes and paving the way for health equity across populations.

Conclusion

SDoHO has well-designed hierarchies, practical objective properties, and versatile functionalities, and the comprehensive semantic and coverage evaluation achieved promising performance compared to the existing ontologies relevant to SDoH.
(Non-)deport to Discipline: The Daily Life of Afghans in Turkey
Authors: Karadağ Sibel , Sert Deniz Ş
Published: June 2023

This study contributes to discussions on the politics of (non-)deportability by focusing on the case of Afghans, the largest migrant community without a right to protection in Turkey, itself the country hosting the most refugees. This article examines how the politics of (non-)deportation is shaped and practiced for Afghans and the types of everyday strategies they employ to deal with deportability. We first argue that the politics of deportation in Turkey is predominantly shaped by the needs of the informal labour market, which accounts for one-third of the total labour force. Our findings suggest that forced labour and the hypermobility of Afghans is both tolerated and hidden by the state, while Afghans’ fear of deportability operates as a disciplining apparatus. Second, we argue that, when spectacles of deportation are performed, three crucial factors help Afghans avoid deportation, namely their qawm-based (ethnic or kinship) background, the involvement of Afghan associations, and street-level negotiations with the authorities.
Curriculum Choices for Refugees: What UNRWA’s History Can Tell Us about the Potential of UN Education Programs to Address Refugees’ ‘Unknowable Futures’
Authors: Kelcey Jo
Published: June 2023

Quality education can help refugees navigate their ‘unknowable futures’. Yet, the potential of many education programs to fulfil this promise is shaped by the varied and at times, conflicting interests inherent in aid policy and practice. This article explores these tensions through a historical examination of UNRWA’s education program in the wake of the 1967 Arab-Israeli war. I show how an embedded state-centric approach to policy limited the UN’s influence over the education it provided to Palestine refugees. This manifested through a narrow focus on access to education, and refugees’ ability to get jobs, at the expense of education’s social and political roles. I argue that this case has wider resonance for understanding the institutional dynamics of global refugee education policies and points to the need for a more nuanced understanding of claims by aid agencies that education necessarily helps refugees navigate their unknowable futures.
Chronic Achilles tendon rupture in elderly treated with a combination of the side-locking loop suture technique and early rehabilitation protocol: two cases report
Authors: Kawai Akira , Morimoto Shota , Morio Futoshi , Tachibana Toshiya , Iseki Tomoya
Published: June 2023

A chronic Achilles tendon rupture (ATR) is generally defined as a rupture that occurs more than 4–6 weeks after the initial injury. A variety of corrective techniques have been reported, such as direct repair, V-Y plasty, turndown flap, tendon transfer and free tendon grafting. These procedures generally produce good results, but have the disadvantage of requiring prolonged immobilization and weight-bearing restrictions. This may be a risk factor for falls and decreased function in the lower limbs, especially in older patients. Side-locking loop sutures (SLLS) were first introduced in 2010 as a direct repair technique for acute ATR. This technique provides higher tensile strength, which may allow for early rehabilitation protocols such as early range of motion and early weight-bearing of the ankle without postoperative immobilization. In this report, we describe two cases of chronic ATR in elderly patients treated with SLLS and an early rehabilitation protocol.
Robotic-assisted sigmoidectomy with intracorporeal anastomosis and endoscopic management of deep infiltrating intestinal endometriosis
Authors: Lomeli-Reyes David , Montoya-Ramírez Jesús , Reyes-Rodríguez Enrique , López-Almanza Perla X , Ochoa-Ruiz Paola L
Published: June 2023

Deep endometriosis, defined as external adenomyosis, is a late stage of endometriosis. Associated with very severe pain, in addition to probably being a cofactor of infertility, with a low prevalence, the diagnosis is integrated by high clinical suspicion and confirmed with imaging studies. Deep infiltration can reach sigmoid colon, which would have surgical indication as resolving treatment. We report the case of deep infiltrating endometriosis affecting sigmoid colon of a 42-year-old woman, who was diagnosed with colicky pain in the left lower quadrant and chronic constipation. Colonoscopy revealed a 90% stenosis in the proximal portion of sigmoid colon, as well as mural thickening proximal to the site of stenosis, reported by computed tomography with oral contrast, for which it was decided to perform robot-assisted sigmoidectomy, with a 6-month follow-up and with imaging control, patient continues asymptomatic and without the presence of lesions suggestive of recurrence, and there is no functional impairment.
Leveraging Predictive Modelling from Multiple Sources of Big Data to Improve Sample Efficiency and Reduce Survey Nonresponse Error
Authors: Dutwin David , Coyle Patrick , Lerner Joshua , Bilgen Ipek , English Ned
Published: June 2023

Big data has been fruitfully leveraged as a supplement for survey data—and sometimes as its replacement—and in the best of worlds, as a “force multiplier” to improve survey analytics and insight. We detail a use case, the big data classifier (BDC), as a replacement to the more traditional methods of targeting households in survey sampling for given specific household and personal attributes. Much like geographic targeting and the use of commercial vendor flags, we detail the ability of BDCs to predict the likelihood that any given household is, for example, one that contains a child or someone who is Hispanic. We specifically build 15 BDCs with the combined data from a large nationally representative probability-based panel and a range of big data from public and private sources, and then assess the effectiveness of these BDCs to successfully predict their range of predicted attributes across three large survey datasets. For each BDC and each data application, we compare the relative effectiveness of the BDCs against historical sample targeting techniques of geographic clustering and vendor flags. Overall, BDCs offer a modest improvement in their ability to target subpopulations. We find classes of predictions that are consistently more effective, and others where the BDCs are on par with vendor flagging, though always superior to geographic clustering. We present some of the relative strengths and weaknesses of BDCs as a new method to identify and subsequently sample low incidence and other populations.
RING finger E3 ubiquitin ligase gene TaAIRP2-1B controls spike length in wheat
Authors: Zhang Jialing , Li Chaonan , Li Long , Xi Yajun , Wang Jingyi , Mao Xinguo , Jing Ruilian
Published: June 2023

E3 ubiquitin ligase genes play important roles in the regulation of plant development. They have been well studied in plants, but have not been sufficiently investigated in wheat. Here, we identified a highly expressed RING finger E3 ubiquitin ligase gene TaAIRP2-1B (ABA-insensitive RING protein 2) in wheat spike. Sequence polymorphism and association analysis showed that TaAIRP2-1B is significantly associated with spike length under various conditions. The genotype with haplotype Hap-1B-1 of TaAIRP2-1B has a longer spike than that of Hap-1B-2, and was positively selected in the process of wheat breeding in China. Moreover, the TaAIRP2-1B-overexpressing rice lines have longer panicles compared with wild-type plants. The expression levels of TaAIRP2-1B in Hap-1B-1 accessions were higher than in Hap-1B-2 accessions. Further study revealed that the expression of TaAIRP2-1B was negatively regulated by TaERF3 (ethylene-responsive factor 3) via binding to the Hap-1B-2 promoter, but not via binding of Hap-1B-1. Additionally, several candidate genes interacting with TaAIRP2-1B were obtained by screening the cDNA library of wheat in yeast cells. It was found that TaAIRP2-1B interacted with TaHIPP3 (heavy metal-associated isoprenylated protein 3) and promoted TaHIPP3 degradation. Our study demonstrates that TaAIRP2-1B controls spike length, and the haplotype Hap-1B-1 of TaAIRP2-1B is a favorable natural variation for spike length enhancement in wheat. This work also provides genetic resources and functional markers for wheat molecular breeding.
Conflict and natural disaster: the impacts on medical education in Ukraine and Türkiye
Authors: Armitage Richard C
Published: June 2023

In addition to causing enormous and enduring harms to the health of populations, the Russian invasion of Ukraine and the recent earthquakes in southeast Türkiye have greatly damaged the institutions of medical education at work in these countries. This paper explores these harms and encourages medical educationalists in unaffected countries to reflect on the virtues of their own educational institutions.
Focused Ultrasound Stimulates the Prefrontal Cortex and Prevents MK-801-Induced Psychiatric Symptoms of Schizophrenia in Rats
Authors: Pan Tsung-Yu , Pan Yi-Ju , Tsai Shih-Jen , Tsai Che-Wen , Yang Feng-Yi
Published: June 2023

Background and Hypothesis

Treatment of schizophrenia remains a major challenge. Recent studies have focused on glutamatergic signaling hypoactivity through N-methyl-D-aspartate (NMDA) receptors. Low-intensity pulsed ultrasound (LIPUS) improves behavioral deficits and ameliorates neuropathology in dizocilpine (MK-801)-treated rats. The aim of this study was to investigate the efficacy of LIPUS against psychiatric symptoms and anxiety-like behaviors.

Study Design

Rats assigned to 4 groups were pretreated with or without LIPUS for 5 days. The open field and prepulse inhibition tests were performed after saline or MK-801 (0.3 mg/kg) administration. Then, the neuroprotective effects of LIPUS on the MK-801-treated rats were evaluated using western blotting and immunohistochemical staining.

Study Results

LIPUS stimulation of the prefrontal cortex (PFC) prevented deficits in locomotor activity and sensorimotor gating and improved anxiety-like behavior. MK-801 downregulated the expression of NR1, the NMDA receptor, in rat medial PFC (mPFC). NR1 expression was significantly higher in animals receiving LIPUS pretreatment compared to those receiving only MK-801. In contrast, a significant increase in c-Fos-positive cells in the mPFC and ventral tegmental area was observed in the MK-801-treated rats compared to those receiving only saline; this change was suppressed by pretreatment with LIPUS.

Conclusions

This study provides new evidence for the role of LIPUS stimulation in regulating the NMDA receptor and modulating c-Fos activity, which makes it a potentially valuable antipsychotic treatment for schizophrenia.
Substantial variation in species ages among vertebrate clades
Authors: Pie Marcio R. , Caron Fernanda S.
Published: June 2023

Ecological and evolutionary studies traditionally assume that species are comparable units of biodiversity. However, not only this assumption is rarely tested, but also there have been few attempts even to assess variation in most emergent, species-level traits and their corresponding underlying mechanisms. One such trait is species age, here defined as the time since the most recent common ancestor between a given species and its sister lineage. In this study, we demonstrate that different terrestrial vertebrate clades vary considerably in the age of their constituent species. In particular, species ages were youngest in mammals and birds as opposed to squamates and amphibians, although considerable variation was found within those clades as well. Sensitivity analyses showed that these results are unaffected by phylogenetic uncertainty or incomplete taxonomic sampling. Interestingly, there was little geographical correspondence in mean species age across taxa, as well as with temperature and precipitation stability over the past 21,000 years. We discuss candidate mechanisms that might explain differences in species ages among clades, and explore the implications of these findings in relation to recent advances in age-dependent speciation and extinction models of diversification.