bluuebunny/crossref_metadata_2025 huggingface dataset:
Coping with a global crisis—Changes in worries about the Russo–Ukrainian War
Authors: Saalwirth Christina , Leipold Bernhard
Published: September 2023

Global crises, such as the Russo–Ukrainian War, can lead to worrying, which in turn can result in health problems when not positively coped with. This study investigates how the worries of Germans are related to general coping strategies. Three consecutive online surveys were distributed from the beginning of March until the beginning of May 2022. The surveys assessed participants' worries about the Russo–Ukrainian War and their use of four coping domains for the two preceding weeks. A total of 175 (54.3% female; Mage = 33.3, SD = 13.6, 18–66 years) participants completed all three questionnaires. Worries and coping (meaning‐focused, problem‐focused, social, and avoidance coping) declined over time. Cross‐sectionally all coping domains, except meaning‐focused coping, correlated positively with initial worries, indicating a higher use of coping strategies when worries were present. In line with this, the use of both social and avoidance coping declined over the course of the study when worries were reduced. Furthermore, a higher initial use of avoidance coping was associated with a stronger decline in worries. Worries and coping strategies both declined following the Russian invasion of Ukraine which suggests that worries and coping strategies adapt to one another over time.
MAFLD fibrosis score: Using routine measures to identify advanced fibrosis in metabolic‐associated fatty liver disease
Authors: Cheung Johnny T. K. , Zhang Xinrong , Wong Grace Lai‐Hung , Yip Terry Cheuk‐Fung , Lin Huapeng , Li Guanlin , Leung Howard Ho‐Wai , Lai Jimmy Che‐To , Mahadeva Sanjiv , Nik Mustapha Nik Raihan , Wang Xiao‐Dong , Liu Wen‐Yue , Wong Vincent Wai‐Sun , Chan Wah‐Kheong , Zheng Ming‐Hua
Published: September 2023

Background

Early screening may prevent fibrosis progression in metabolic‐associated fatty liver disease (MAFLD).

Aims

We developed and validated MAFLD fibrosis score (MFS) for identifying advanced fibrosis (≥F3) among MAFLD patients.

Methods

This cross‐sectional, multicentre study consecutively recruited MAFLD patients receiving tertiary care (Malaysia as training cohort [n = 276] and Hong Kong and Wenzhou as validation cohort [n = 431]). Patients completed liver biopsy, vibration‐controlled transient elastography (VCTE), and clinical and laboratory assessment within 1 week. We used machine learning to select ‘highly important’ predictors of advanced fibrosis, followed by backward stepwise regression to construct MFS formula.

Results

MFS was composed of seven variables: age, body mass index, international normalised ratio, aspartate aminotransferase, gamma‐glutamyl transpeptidase, platelet count, and history of type 2 diabetes. MFS demonstrated an area under the receiver‐operating characteristic curve of 0.848 [95% CI 0.800–898] and 0.823 [0.760–0.886] in training and validation cohorts, significantly higher than aminotransferase‐to‐platelet ratio index (0.684 [0.603–0.765], 0.663 [0.588–0.738]), Fibrosis‐4 index (0.793 [0.735–0.854], 0.737 [0.660–0.814]), and non‐alcoholic fatty liver disease fibrosis score (0.785 [0.731–0.844], 0.750 [0.674–0.827]) (DeLong's test p < 0.05). MFS could include 92.3% of patients using dual cut‐offs of 14 and 15, with a correct prediction rate of 90.4%, resulting in a larger number of patients with correct diagnosis compared to other scores. A two‐step MFS‐VCTE screening algorithm demonstrated positive and negative predictive values and overall diagnostic accuracy of 93.4%, 89.5%, and 93.2%, respectively, with only 4.0% of patients classified into grey zone.

Conclusion

MFS outperforms conventional non‐invasive scores in predicting advanced fibrosis, contributing to screening in MAFLD patients.
Immune thrombotic thrombocytopenic purpura in older patients: Results from the Spanish TTP Registry (REPTT)
Authors: Gómez‐Seguí I. , Francés Aracil E. , Mingot‐Castellano M. E. , Vara Pampliega M. , Goterris Viciedo R. , García Candel F. , Pascual Izquierdo C. , del Río Garma J. , Guerra Domínguez L. , Vicuña Andrés I. , Garcia‐Arroba Peinado J. , Zalba Marcos S. , Vidan Estévez J. M. , González Arias E. , Campuzano Saavedra V. , García Gala J. M. , Ortega Sanchez S. , Martínez Nieto J. , Pardo Gambarte L. , Solé Rodríguez M. , Fernández‐Docampo M. , Avila Idrovo L. F. , Hernández L. , Cid J. , de la Rubia Comos J. ,   from the Spanish TTP Registry (REPTT, Registro Español de la Purpura Trombocitopénica Trombótica)
Published: September 2023

Immune thrombotic thrombocytopenic purpura (iTTP) is an ultra‐rare disease that seldom occurs in the elderly. Few reports have studied the clinical course of iTTP in older patients. In this study, we have analysed the clinical characteristics at presentation and response to therapy in a series of 44 patients with iTTP ≥60 years at diagnosis from the Spanish TTP Registry and compared them with 209 patients with <60 years at diagnosis from the same Registry. Similar symptoms and laboratory results were described in both groups, except for a higher incidence of renal dysfunction among older patients (23% vs. 43.1%; p = 0.008). Front‐line treatment in patients ≥60 years was like that administered in younger patients. Also, no evidence of a difference in clinical response and overall survival was seen in both groups. Of note, 14 and 25 patients ≥60 years received treatment with caplacizumab and rituximab, respectively, showing a favourable safety and efficacy profile, like that observed in patients <60 years.
Do both anticipated relief and anticipated regret predict decisions about influenza vaccination?
Authors: Lorimer Sara , McCormack Teresa , Hoerl Christoph , Johnston Matthew , Beck Sarah R. , Feeney Aidan
Published: September 2023

Objective

Anticipated regret has been found to predict vaccination intentions and behaviours. We examined whether anticipated relief also predicts seasonal influenza vaccination intentions and behaviour. Given claims about differences in their antecedents and function, we distinguished between counterfactual relief (relief that a worse outcome did not obtain) and temporal relief (relief that an unpleasant experience is over).

Design

Cross‐sectional.

Methods

Unvaccinated participants (N = 295) were recruited online in November 2020. Participants completed measures of anticipated regret, anticipated counterfactual relief, and anticipated temporal relief and measures of theory of planned behaviour constructs (attitudes, norms, perceived control, and intentions). One month later, the same participants were re‐surveyed and asked to report their vaccination status.

Results

Although all anticipated emotion measures were associated with intentions and behaviour, only anticipated counterfactual relief and regret independently predicted vaccination intentions in regression analyses. Mediation analysis showed both anticipated counterfactual relief and regret were indirectly, via intentions, associated with behaviour.

Conclusions

Results suggest that, regardless of valence, counterfactual emotions predict vaccination intention and, indirectly, behaviour. Furthermore, participants may differ in their sensitivity to the anticipation of positive versus negative counterfactual emotions. These findings may permit more precise targeting of interventions to increase vaccine uptake.
Trilobatin attenuates cerebral ischaemia/reperfusion‐induced blood–brain barrier dysfunction by targeting matrix metalloproteinase 9: The legend of a food additive
Authors: Feng Linying , Li Yeli , Lin Mu , Xie Dianyou , Luo Yunmei , Zhang Yuandong , He Zhixu , Gong Qihai , Zhun Zhu Yi , Gao Jianmei
Published: September 2023

Background and Purpose

Blood–brain barrier (BBB) breakdown is one of the crucial pathological changes of cerebral ischaemia–reperfusion (I/R) injury. Trilobatin (TLB), a naturally occurring food additive, exerts neuroprotective effects against cerebral I/R injury as demonstrated in our previous study. This study was designed to investigate the effect of TLB on BBB disruption after cerebral I/R injury.

Experimental Approach

Rats with focal cerebral ischaemia caused by transient middle cerebral artery occlusion were studied along with brain microvascular endothelial cells and human astrocytes to mimic BBB injury caused by oxygen and glucose deprivation/reoxygenation (OGD/R).

Key Results

The results showed that TLB effectively maintained BBB integrity and inhibited neuronal loss following cerebral I/R challenge. Furthermore, TLB increased tight junction proteins including ZO‐1, Occludin and Claudin 5, and decreased the levels of apolipoprotein E (APOE) 4, cyclophilin A (CypA) and phosphorylated nuclear factor kappa B (NF‐κB), thereby reducing proinflammatory cytokines. TLB also decreased the Bax/Bcl‐2 ratio and cleaved‐caspase 3 levels along with a reduced number of apoptotic neurons. Molecular docking and transcriptomics predicted MMP9 as a prominent gene evoked by TLB treatment. The protective effects of TLB on cerebral I/R‐induced BBB breakdown was largely abolished by overexpression of MMP9, and the beneficial effects of TLB on OGD/R‐induced loss of BBB integrity in human brain microvascular endothelial cells and astrocyte co‐cultures was markedly reinforced by knockdown of MMP9.

Conclusions and Implications

Our findings reveal a novel property of TLB: preventing BBB disruption following cerebral I/R via targeting MMP9 and inhibiting APOE4/CypA/NF‐κB axis.
Decoupling external forcings during the development of Miocene fluvial stratigraphy of the North Patagonian Foreland
Authors: López Manuel , Milanese Florencia , D'Elia Leandro , Bilmes Andrés , Bucher Joaquín , Feo Rodrigo N. , García Micaela , Calvo‐Rathert Manuel , Rapalini Augusto , Franzese Juan R.
Published: September 2023

The Patagonian Andean foreland system includes several intermountain basins filled with a Miocene non‐marine record deposited under syn‐tectonic conditions related to the Andean uplift and a regional climate change triggered by a rain shadow effect. Many of those basins, such as the Collón Cura basin in Neuquén Province, Argentina, present a well‐preserved fluvial record (i.e. the Limay Chico Member of the Caleufú Formation). Sedimentological and palaeomagnetic studies have allowed the interpretation of coeval transverse distributary fan and axial mixed‐load fluvial systems deposited between 10.6 ± 0.2 and 12.8 Ma. The basin infill arrangement shows that, while the axial mixed‐load fluvial system exhibits an aggradational stacking pattern, the transverse distributary fluvial fan system denotes three different orders of stratigraphic patterns: (i) large‐scale progradation of the transverse fluvial fan system over a time scale of 106 year; (ii) intermediate‐scale progradational–retrogradational transverse intra‐basinal fluvial fan episodes over a time scale of 105 year; and (iii) small‐scale transverse lobe progradation over a time scale of 105–104 year. These patterns were interpreted as transverse sediment flux variations triggered by variable external forcings. To decouple those forcings, we estimated the Collón Cura basin equilibrium time at 3–5 × 105 year and compared it with the time scale over which different external forcings varied in the Patagonian Andean and foreland regions during Miocene times. Large‐scale progradation is linked to an increase in sediment flux triggered by a long‐term tectonically driven exhumation forcing associated with the Miocene Patagonian Andean contractional phase. Intermediate‐scale progradational–retrogradational episodes are linked to variations in sediment flux due to a mid‐term tectonic forcing associated with the western fault system activity. The small‐scale fan lobe progradation is related to increases in sediment flux triggered by indistinguishable short‐term autogenic processes and/or high‐frequency tectonic and climatic forcings. This contribution shows the applicability and limitations of the basin equilibrium time concept to decouple external forcings from the geological record, considering their magnitude, nature and time scale, as well as the basin characteristics.
Collaboration: How does it work according to therapists and parents of young children? A systematic review
Authors: Klatte Inge S. , Ketelaar Marjolijn , de Groot Annemieke , Bloemen Manon , Gerrits Ellen
Published: September 2023

Background

Collaboration between therapists and parents of children with developmental disabilities is a key element of family‐centred care. In practice, collaboration appears to be challenging for both parents and therapists. This systematic review aims to make explicit how therapists can optimise their collaboration with parents of young children with developmental disabilities, according to the perspectives of parents and therapists.

Methods

A systematic review was conducted using the following databases: Medline (PubMed), CINAHL (OVID) and PsychINFO (OVID). Those papers were selected, which focused on collaboration using a two‐way interaction between therapists and parents, exploring the perspectives of therapists and/or parents of children between 2 and 6 years. Papers needed to be published in English or Dutch between 1998 and July 2021. Included papers were synthesised using a qualitative analysis approach by two researchers independently. Results sections were analysed line‐by‐line, and codes were formulated and discussed by all authors. Codes were aggregated, resulting in a synthesis of specific collaboration strategies in combined strategy clusters.

Results

The search generated 3439 records. In total, 24 papers were selected. Data synthesis resulted in an overview of specific strategies organised into five clusters: (1) continuously invest time in your collaboration with parents, (2) be aware of your important role in the collaboration with parents, (3) tailor your approach, (4) get to know the family and (5) empower parents to become a collaborative partner.

Conclusions

This systematic review resulted in an overview of concrete strategies for therapists to use in their collaboration with parents of children with developmental disabilities. The strategies formulated enable therapists to consciously decide how to optimise their collaboration with each individual parent. Making these strategies explicit facilitates change of practice from therapist‐led and child‐centred towards family‐centred care.
Girls are good at STEM: Opening minds and providing evidence reduces boys' stereotyping of girls' STEM ability
Authors: Cyr Emily N. , Kroeper Kathryn M. , Bergsieker Hilary B. , Dennehy Tara C. , Logel Christine , Steele Jennifer R. , Knasel Rita A. , Hartwig W. Tyler , Shum Priscilla , Reeves Stephanie L. , Dys‐Steenbergen Odilia , Litt Amrit , Lok Christopher B. , Ballinger Taylor , Nam Haemi , Tse Crystal , Forest Amanda L. , Zanna Mark , Staub‐French Sheryl , Wells Mary , Schmader Toni , Wright Stephen C. , Spencer Steven J.
Published: September 2023

Girls and women face persistent negative stereotyping within STEM (science, technology, engineering, mathematics). This field intervention was designed to improve boys' perceptions of girls' STEM ability. Boys (N = 667; mostly White and East Asian) aged 9–15 years in Canadian STEM summer camps (2017–2019) had an intervention or control conversation with trained camp staff. The intervention was a multi‐stage persuasive appeal: a values affirmation, an illustration of girls' ability in STEM, a personalized anecdote, and reflection. Control participants discussed general camp experiences. Boys who received the intervention (vs. control) had more positive perceptions of girls' STEM ability, d = 0.23, an effect stronger among younger boys. These findings highlight the importance of engaging elementary‐school‐aged boys to make STEM climates more inclusive.
Correspondence on “Sex steroid priming for growth hormone stimulation testing in children and adolescents with short stature: A systematic review”
Authors: Yau Mabel , Rapaport Robert
Published: September 2023

Duncan et al. reviewed the response to growth hormone stimulation testing after priming in peripubertal children. The concern is that there is little research documenting the response to growth hormone treatment in patients with sex hormone primed growth hormone stimulation testing and those unprimed. The controversy about priming or not can be summarized as follows: if one wants to know if the production of growth hormone during puberty will be adequate in terms of peak growth hormone responses then stimulation with priming should be done.
Comparative analysis of methodologies for predicting overall survival in patients with non‐small cell lung cancer based on the number and rate of resected positive lymph nodes: A study based on the SEER database for 2010 through 2019
Authors: Guo Qiang , Hu Sheng , Wang Silin , Su Lang , Zhang Wenxiong , Xu Jianjun , Wei Yiping
Published: September 2023

Background

Lymph node (LN) metastasis is crucial in non‐small cell lung cancer (NSCLC) prognosis and treatment, but the TNM system lacks LN quantity consideration. Our goal is to investigate the role of positive LNs (nPLN) and positive LN rate (LNR) in overall survival (OS) and assess whether they offer higher value in prognostic assessment of NSCLC than N‐stage.

Methods

Patients were stratified into four subgroups using X‐Tile software. Statistical analysis was conducted using the Kaplan–Meier method, univariate analysis, and multivariate Cox regression analysis. Model performance was evaluated using the Harrell consistency index (C‐index), Akaike information criterion (AIC), and Bayesian information criterion (BIC). The prognostic performance of the nodal classification was validated using overall survival as the endpoint.

Results

The survival curves demonstrate distinct disparities between each nPLN and LNR category. A pronounced trend toward deteriorating overall survival from N‐PLN 1 to N‐PLN 2+ was observed across all tumor size categories. However, the differences between each LNR category were only significant for tumors ≤3 cm and 5–7 cm. Notably, both nPLN and LNR classifications displayed a higher C‐index, lower AIC, and lower BIC compared with the N staging. Furthermore, the LNR classification provided superior prognostic stratification when compared with the nPLN classification.

Conclusions

Our results demonstrate that nPLN and LNR classifications may offer improved prognostic performance compared with the current N classification for LN‐positive NSCLC patients. Nonetheless, more studies are needed to assess the feasibility of incorporating these classifications into the next TNM staging system.
Development and validation of the CAIL prognostic score in non‐small cell lung cancer patients with malignant pleural effusion
Authors: Li Tianyuan , Tian Panwen , Huang Qin , Zeng Hao , Wei Qi , Li Yalun
Published: September 2023

Background

Patients with malignant pleural effusion (MPE) typically have poor prognoses, and predicting survival is challenging. The present study aimed to identify prognostic factors of overall survival (OS) in non‐small cell lung cancer (NSCLC) patients with MPE in the time of immunotherapy and targeted therapy.

Methods

Data of 344 consecutive NSCLC patients with MPE on clinical, radiological, and molecular characteristics and treatment options were collected. The risk factors in the training cohort were assessed using univariate and multivariate proportional hazards analyses. A clinical prognostic score was established and validated.

Results

According to the results of the multivariable survival analysis, the Eastern Cooperative Oncology Group (ECOG) performance score (PS), antiangiogenic therapy, immunotherapy, and lactic dehydrogenase (LDH) in pleural fluid (CAIL) prognostic score was developed (n = 275) and subsequently validated (n = 69). Patients who underwent risk stratification into low‐, moderate‐, and high‐risk groups had median OS of 46.1, 23.1, and 9.6 months, respectively (P < 0.0001). The area under the curve (AUC) analysis showed the CAIL score to be superior at predicting survival compared with the LENT score at 6 (0.84 vs. 0.77, P < 0.01), 12 (0.87 vs. 0.82, P < 0.01), and 36 months (0.80 vs. 0.77, P < 0.01).

Conclusions

For NSCLC patients with MPE, the validated CAIL prognostic score integrates clinical characteristics and therapeutic modalities to predict survival.
Assembling genetic structure of Gardenia remyi, a critically endangered tree endemic to the Hawaiian Islands
Authors: Hansen Kristina Egholm , Opgenorth Mike , Flynn Tim , Kennedy Barbara , Rønsted Nina , Olofsson Jill K. , Barnes Christopher J.
Published: September 2023

Conservation and restoration planning of extremely rare species relies on an understanding of the genetic diversity and population dynamics within a species to overcome potential inbreeding depression. Nānū or Nāʻū (Gardenia remyi H. Mann.) is an endemic tree native to the Hawaiian Islands and is one of more than 200 endangered plant species in Hawaiʻi with less than 50 individuals remaining in the wild. Efforts to understand the genetic diversity and connectivity between wild populations are foundational to conservation management plans, however little is known of the population structure of the species. In this study we utilize double digest restriction‐site associated sequencing (ddRADSeq) on both historical herbarium specimens and samples from living ex situ collections to: (1) Test the hypothesis that we can capture genetic diversity in herbarium material of G. remyi using ddRADSeq, and (2) test the hypothesis that there are genetically distinct populations or subpopulation units among different Hawaiian islands. Usable sequencing data from thirty‐seven samples of herbarium specimens collected between 1952 and 2017 and twenty wild sourced living collection samples were obtained representing all four islands where G. remyi is known to occur. Phylogenetic and population structure analysis revealed a monophyletic ingroup and a clear division between G. remyi samples of the northern island of Kauaʻi and those from the more southeastern younger islands of Molokaʻi, Maui and Hawaiʻi islands. The Kauaʻi samples were further split into a subpopulation from Southern Kauaʻi and the subpopulations from Northern Kauaʻi. Some admixed samples were detected. Our results are consistent with subpopulations of G. remyi, which needs to be considered in future conservation planning and breeding efforts to minimize inbreeding depression.
A randomized trial of continuous glucose monitoring to improve post‐transplant glycemic control
Authors: Jandovitz Nicholas , George Sam J. , Abate Mersema , Kressel Adam M. , Bolognese Alexandra C. , Lau Lawrence , Nair Vinay , Grodstein Elliot
Published: September 2023

Introduction

This study examines whether the use of inpatient Continuous Glucose Monitors provides improved glycemic control over finger‐stick glucose monitoring post‐transplant.

Methods

This is a single‐site, prospective randomized controlled trial of 40 patients receiving conventional finger‐stick glucose monitoring or continuous monitoring using the Medtronic Guardian Sensor 3 during the first 5 days post‐transplant. Included patients were adult renal transplant recipients with a diagnosis of diabetes. Assessed endpoints included post‐transplant daily median glucose level, hyperglycemic (≥180 mg/dL) and hypoglycemic (≤80 mg/dL) episodes, number of post‐transplant bacterial infections and length of stay.

Results

Groups were well matched in demographic variables. Median daily glucose was significantly lower in the intervention group. There were also significantly less episodes of hyperglycemia on postoperative days 2, 3, 4, and 5. There were no differences in the incidences of hypoglycemia, postoperative bacterial infections, or length of stay.

Conclusion

In this randomized study, the use of a continuous glucose monitor to guide post‐transplant glucose management significantly lowered the incidence of hyperglycemic episodes and median glucose levels through the first 5 days post‐transplant without increasing the number of hypoglycemic episodes. The use of these devices can be considered in the immediate post‐renal transplant setting.
Environmentally sustainable gastroenterology practice: Review of current state and future goals
Authors: Sonaiya Sneh , Marino Richard , Agollari Klea , Sharma Paranjay , Desai Madhav
Published: September 2023

Objectives

The health‐care sector contributes 4.6% of global greenhouse gas emissions, with gastroenterology playing a significant role due to the widespread use of gastrointestinal (GI) endoscopy. In this review, we aim to understand the carbon footprint in gastroenterology practice associated with GI endoscopy, conferences and recruitment, identify barriers to change, and recommend mitigating strategies.

Methods

A comprehensive search of PubMed, Embase, and the Cochrane Library was conducted to explore the carbon footprint in gastroenterology practice, focusing on endoscopy, inpatient and outpatient settings, and recruitment practices. Recommendations for mitigating the carbon footprint were derived.

Results

This narrative review analyzed 34 articles on the carbon footprint in gastroenterology practice. Carbon footprint of endoscopy in the United States is approximately 85,768 metric tons of CO2 emission annually, equivalent to 9 million gallons of gasoline consumed, or 94 million pounds of coal burned. Each endoscopy generates 2.1 kg of disposable waste (46 L volume), of which 64% of waste goes to the landfill, 28% represents biohazard waste, and 9% is recycled. The per‐case manufacturing carbon footprint for single‐use devices and reusable devices is 1.37 kg CO2 and 0.0017 kg CO2, respectively. Inpatient and outpatient services contributed through unnecessary procedures, prolonged hospital stays, and excessive use of single‐use items. Fellowship recruitment and gastrointestinal conferences added to the footprint, mainly due to air travel and hotel stays.

Conclusion

Gastrointestinal endoscopy and practice contribute to the carbon footprint through the use of disposables such as single‐use endoscopes and waste generation. To achieve environmental sustainability, measures such as promoting reusable endoscopy equipment over single‐use endoscopes, calculating institutional carbon footprints, establishing benchmarking standards, and embracing virtual platforms such as telemedicine and research meetings should be implemented.
Diabetes foot complications and standardized mortality rate in type 2 diabetes
Authors: Stedman Mike , Robinson Adam , Dunn George , Meza‐Torres Bernado , Gibson J. Martin , Reeves Neil D. , Jude Edward B. , Feher Michael , Rayman Gerry , Whyte Martin B. , Edmonds Michael , Heald Adrian H.
Published: September 2023

Aim

To quantify the impact of foot complications on mortality outcomes in people with type 2 diabetes (T2D), and how routinely measured factors might modulate that risk.

Materials and Methods

Data for individuals with T2D for 2010‐2020, from the Salford Integrated Care Record (Salford, UK), were extracted for laboratory and clinical data, and deaths. Annual expected deaths were taken from Office of National Statistics mortality data. An index of multiple deprivation (IMD) adjusted the standardized mortality ratio (SMR_IMD). Life years lost per death (LYLD) was estimated from the difference between expected and actual deaths.

Results

A total of 11 806 T2D patients were included, with 5583 new diagnoses and 3921 deaths during 2010‐2020. The number of expected deaths was 2135; after IMD adjustment, there were 2595 expected deaths. Therefore, excess deaths numbered 1326 (SMR_IMD 1.51). No foot complications were evident in n = 9857. This group had an SMR_IMD of 1.13 and 2.74 LYLD. In total, 2979 patients had any foot complication recorded. In this group, the SMD_IMR was 2.29; of these, 2555 (75%) had only one foot complication. Patients with a foot complication showed little difference in percentage HbA1c more than 58 mmol/mol. In multivariate analysis, for those with a foot complication and an albumin‐to‐creatinine ratio of more than 3 mg/mmol, the odds ratio (OR) for death was 1.93, and for an estimated glomerular filtration rate of less than 60 mL/min/1.73m2, the OR for death was 1.92.

Conclusions

Patients with T2D but without a foot complication have an SMR_IMD that is only slightly higher than that of the general population. Those diagnosed with a foot complication have a mortality risk that is double that of those without T2D.
Cytoplasmic incompatibility and female fecundity associated with Wolbachia infection in a cricket species
Authors: Zhu Dao‐Hong , Liu Long‐Tao
Published: September 2023

Wolbachia is a maternally inherited endosymbiont of the phylum α‐Proteobacteria that is found widely in arthropods and nematodes. Cytoplasmic incompatibility (CI) is the commonest endosymbiotic manipulation among arthropods, namely reduced embryo viability when Wolbachia‐infected males fertilize Wolbachia‐uninfected females.

In this study, endosymbiont infection was investigated and crossing experiments were performed in the wing‐dimorphic cricket Velarifictorus aspersus (Walker) (Orthoptera: Gryllidae) to clarify the effects of Wolbachia on host reproduction.

All the tested individuals were infected with two Wolbachia strains, wAsp‐a and wAsp‐f, which belong to supergroup A and supergroup F, respectively.

There were no obvious differences in the duration of nymph development or the proportions of females between the Wolbachia‐infected and Wolbachia‐free lines. However, crossing Wolbachia‐infected males with uninfected females reduced the hatching rate by 28% compared with that when infected males were crossed with infected females. The number of eggs laid by Wolbachia‐free females was significantly lower than laid by infected females, either mating with infected males or uninfected males.

These results suggest that Wolbachia induced incomplete CI and enhanced female fertility in V. aspersus. Because no homologous cifA and cifB genes, which are involved in CI, were found in supergroups C, D and F, it might be considered that the CI of V. aspersus was induced by strain wAsp‐a of supergroup A. Moreover, the significant increase in the density of wAsp‐a Wolbachia with nymph development might be related to the regulation of CI.
Adults living with Duchenne muscular dystrophy: old and new challenges in a cohort of 19 patients in their third to fifth decade
Authors: Gadaleta Giulio , Urbano Guido , Brusa Chiara , D'Alessandro Rossella , Rolle Enrica , Cavallina Ilaria , Mattei Alessio , Ribolla Fulvia , Raineri Claudia , Pidello Stefano , Vercelli Liliana , Ricci Federica S. , Mongini Tiziana E.
Published: September 2023

Background and purpose

Advances in multidisciplinary care are extending overall survival in Duchenne muscular dystrophy (DMD) patients. Our research objective was to delineate the clinical characteristics of this particular cohort and identify novel challenges associated with the disease.

Methods

Nineteen individuals aged 25–48 years (median 34 years) with a confirmed diagnosis of out‐of‐frame DMD gene mutation were selected.

Results

All patients were mechanically ventilated (5/19 via tracheostomy), with different patterns of cardiomyopathy. Swallowing and nutritional issues were frequent (median body mass index 18.95), with six cases requiring artificial enteral feeding (median age at start 29 years), as well as bone density alterations (11/19, 58%). Only 2/19 had been on long‐term prednisone therapy. Issues requiring at‐home/hospital assistance were respiratory infections (15/19, 79%), gastroenterological symptoms (9/19, 47%, including toxic megacolon and rectal perforation after repeated enemas), metabolic acidosis (2/19, 11%) and recurrent ischaemic strokes (1/19, 5%). From a social perspective, augmented‐alternative communication devices were necessary for 7/19 (37%), with most of the patients being assisted at home and 2/19 institutionalized. Eight/19 (42%) patients experienced psychiatric symptoms (median age at presentation 16 years) and 9/19 (47%) chronic pain (median age at onset 23 years), in both cases treated with psychoactive/analgesic drugs without major adverse events. The patients' subjective perception of physical health resulted in unfavourable scores, whilst the subjective assessment of mental health unexpectedly showed more positive values compared to other chronic neurological conditions.

Conclusions

The analysis of adults living with DMD reveals several new health‐related issues, such as the management of emergencies and safety of pharmacological treatments for psychiatric symptoms, chronic pain management, as well as an increasing caregivers burden.
Levodopa‐induced orthostatic hypotension in parkinsonism: A red flag of autonomic failure
Authors: Cani Ilaria , Guaraldi Pietro , Giannini Giulia , Sambati Luisa , Barletta Giorgio , Cortelli Pietro , Calandra‐Buonaura Giovanna
Published: September 2023

Background and purpose

Levodopa (LD) is the main treatment for parkinsonism, but its use may be limited by a potential hypotensive effect.

Methods

We evaluated the cardiovascular effect of LD performing head‐up tilt test (HUTT) before and 60 min after 100/25 mg LD/dopa‐decarboxylase inhibitor (pre‐LD vs. post‐LD HUTT) in 164 patients with parkinsonism on chronic LD treatment. Features predictive of LD‐induced orthostatic hypotension (OH) were assessed by logistic regression analysis.

Results

Basal supine blood pressure (BP) and heart rate (HR) decreased after LD. During post‐LD HUTT, BP drop and HR increase were significantly greater than at pre‐LD HUTT. Thirty‐eight percent of patients had OH at post‐LD HUTT compared to 22% of patients presenting OH at pre‐LD HUTT (p < 0.001). Risk factors for LD‐induced/worsened OH were pre‐LD OH (odds ratio [OR] = 36, 95% confidence interval [CI] = 10–131), absence of overshoot at Valsalva maneuver (OR = 9, 95% CI = 4–20), and pathological Valsalva ratio (OR = 6, 95% CI = 2–15).

Conclusions

LD administration caused/worsened hypotension in both supine and orthostatic conditions. Patients with cardiovascular autonomic failure had a higher risk of developing LD‐induced OH. In clinical practice, LD‐induced OH could represent a red flag for cardiovascular autonomic failure.
Health equity integrated epilepsy care and research: A narrative review
Authors: Gotlieb Evelyn G. , Blank Leah , Willis Allison W. , Agarwal Parul , Jette Nathalie
Published: September 2023

Background

With the unanimous approval of the Intersectoral Global Action Plan on epilepsy and other neurological disorders by the World Health Organization in May 2022, there are strong imperatives to work towards equitable neurological care.

Aims

Using epilepsy as an entry point to other neurologic conditions, we discuss disparities faced by marginalized groups including racial/ethnic minorities, Americans living in rural communities, and Americans with low socioeconomic status.

Materials and Methods

The National Institute on Minority Health Disparities Research Framework (NIMHD) was used to conduct a narrative review through a health equity lens to create an adapted framework for epilepsy and propose approaches to working towards equitable epilepsy and neurological care.

Results

In this narrative review, we identified priority populations (racial and ethnic minority, rural‐residing, and low socioeconomic status persons with epilepsy) and outcomes (likelihood to see a neurologist, be prescribed antiseizure medications, undergo epilepsy surgery, and be hospitalized) to explore disparities in epilepsy and guide our focused literature search using PubMed. In an adapted NIMHD framework, we examined individual, interpersonal, community, and societal level contributors to health disparities across five domains: (1) behavioral, (2) physical/built environment, (3) sociocultural, (4) environment, and (5) healthcare system. We take a health equity approach to propose initiatives that target modifiable factors that impact disparities and advocate for sustainable change for priority populations.

Discussion

To improve equity, healthcare providers and relevant societal stakeholders can advocate for improved care coordination, referrals for epilepsy surgery, access to care, health informatics interventions, and education (i.e., to providers, patients, and communities). More broadly, stakeholders can advocate for reforms in medical education, and in the American health insurance landscape.

Conclusions

Equitable healthcare should be a priority in neurological care.
Postmemory dreaming: Nightmares of war in third‐generation descendants of Polish and Russian survivors of World War II
Authors: Owczarski Wojciech
Published: September 2023

Various manifestations of intergenerational memory transmission have been discussed in many scientific fields. Surprisingly, little attention has been paid to these phenomena in the context of dreams. Yet, the sphere of dreaming seems the most informative illustration of how the tragic past influenced the second and third‐generation descendants of trauma survivors. Based on my talks with two descendants of WWII survivors—a Russian woman and a Polish man—I define “postmemory dreams” as night visions affected by cultural representations of historical events. The theoretical background of my study is Hirsch's concept of postmemory, Hall's continuity hypothesis of dreaming, and anthropological dream research. Postmemory dreams reflect and are shaped by the ethos of remembering and commemorating the war—the ethos often imposed by political forces and propaganda—in which the dreamers live. In the cases of my interviewees, these are the Polish ethos of victimhood and the Russian ethos of heroism.
Characterisation of IL‐1 family members in Sweet syndrome highlights the overexpression of IL‐1β and IL‐1R3 as possible therapeutic targets
Authors: Calabrese Laura , Ney Francesca , Aoki Rui , Moltrasio Chiara , Marzano Angelo V. , Kerl Katrin , Stadler Pia‐Charlotte , Satoh Takashi K. , French Lars E.
Published: September 2023

Sweet syndrome (SS) as a prototypic neutrophilic dermatosis (NDs) shares certain clinical and histologic features with monogenic auto‐inflammatory disorders in which interleukin (IL)‐1 cytokine family members play an important role. This has led to the proposal that NDs are polygenic auto‐inflammatory diseases and has fuelled research to further understand the role of IL‐1 family members in the pathogenesis of NDs. The aim of this study was to characterise the expression of the IL‐1 family members IL‐1β, IL‐36γ, IL‐33 and IL‐1R3 (IL‐1RaP) in SS. The expression profile of IL‐1β, IL‐33, IL‐36γ and their common co‐receptor IL‐1R3 was analysed by immunohistochemistry, in situ hybridisation and double immunofluorescence (IF) in healthy control skin (HC) and lesional skin samples of SS. Marked overexpression of IL‐1β in the dermis of SS (p < 0.001), and a non‐significant increase in dermal (p = 0.087) and epidermal (p = 0.345) IL‐36γ expression compared to HC was observed. Significantly increased IL‐1R3 expression within the dermal infiltrate of SS skin samples (p = 0.02) was also observed, whereas no difference in IL‐33 expression was found between SS and HC (p = 0.7139). In situ hybridisation revealed a good correlation between gene expression levels and the above protein expression levels. Double IF identifies neutrophils and macrophages as the predominant sources of IL‐1β. This study shows that IL‐1β produced by macrophages and neutrophils and IL‐1R3 are significantly overexpressed in SS, thereby indicating a potential pathogenic role for this cytokine and receptor in SS.
Yeast mitochondria can process de novo designed β‐barrel proteins
Authors: Moitra Anasuya , Tiku Vitasta , Rapaport Doron
Published: September 2023

Mitochondrial outer membrane β‐barrel proteins are encoded in the nucleus, translated in the cytosol and then targeted to and imported into the respective organelles. Detailed studies have uncovered the mechanisms involved in the import of these proteins and identified the targeting signals and the cytosolic factors that govern their proper biogenesis. Recently, de novo designed eight‐stranded β‐barrel proteins (Tmb2.3 and Tmb2.17) were shown to fold and assemble into lipid membranes. To better understand the general aspects of the biogenesis of β‐barrel proteins, we investigated the fate of these artificial proteins upon their expression in yeast cells. We demonstrate that although these proteins are de novo designed and are not related to bona fide mitochondrial β‐barrel proteins, they were targeted to mitochondria and integrated into the organelle outer membrane. We further studied whether this integration requires components of the yeast mitochondrial import machinery like Tom20, Tom70, Tob55/Sam50 and Mas37/Sam37. Whereas it seems that none of the import receptors was required for the biogenesis of the artificial β‐barrel proteins, we observed a strong dependency on the TOB/SAM complex. Collectively, our findings demonstrate that the mitochondrial outer membrane is the preferential location in yeast cells for any membrane‐embedded β‐barrel protein.
Greenhouse gas dynamics in river networks fragmented by drying and damming
Authors: Silverthorn Teresa , López‐Rojo Naiara , Foulquier Arnaud , Chanudet Vincent , Datry Thibault
Published: September 2023

River fragmentation by drying and damming is occurring more frequently in the Anthropocene era, yet there is limited knowledge of how this fragmentation influences greenhouse gas (GHG) fluxes in river networks. River networks have the potential to be important sources of GHGs to the atmosphere through both similar and dissimilar mechanisms associated with temporary (drying) and permanent (damming) fragmentation.

We conducted a review of the literature and found 49, 43 and six studies about GHGs (CO2, CH4and N2O) in rivers impacted by damming, drying and their interaction, respectively.

We found research lacking in non‐arid climates and in small water‐retention structures for studies regarding drying and damming, respectively. The major factors directly influencing GHG fluxes in river networks impacted by drying were sediment moisture, temperature, organic matter content and texture. In networks impacted by damming, the most influential factors were water temperature, dissolved oxygen, and phytoplankton Chlorophyll‐a.

Based on our literature review and meta‐ecosystem theory, we propose that the spatial distribution of fragmentation strongly influences GHG fluxes at the river‐network scale.

The actionable future research directions identified here will help to improve our understanding of the effects of fragmentation by drying and damming on GHG fluxes, with the potential to inform river management and climate change mitigation strategies.
Isolation of planarian viable cells using fluorescence‐activated cell sorting for advancing single‐cell transcriptome analysis
Authors: Kuroki Yoshihito , Agata Kiyokazu
Published: September 2023

Preparing viable single cells is critical for conducting single‐cell RNA sequencing (scRNA‐seq) because the presence of ambient RNA from dead or damaged cells can interfere with data analysis. Here, we developed a method for isolating viable single cells from adult planarian bodies using fluorescence‐activated cell sorting (FACS). This method was then applied to both adult pluripotent stem cells (aPSCs) and differentiating/differentiated cells. Initially, we employed a violet instead of ultraviolet (UV) laser to excite Hoechst 33342 to reduce cellular damage. After optimization of cell staining conditions and FACS compensation, we generated FACS profiles similar to those created using a previous method that employed a UV laser. Despite successfully obtaining high‐quality RNA sequencing data for aPSCs, non‐aPSCs produced low‐quality RNA reads (i.e., <60% of cells possessing barcoding mRNAs). Subsequently, we identified an effective FACS gating condition that excluded low‐quality cells and tissue debris without staining. This non‐staining isolation strategy not only reduced post‐dissociation time but also enabled high‐quality scRNA‐seq results for all cell types (i.e., >80%). Taken together, these findings imply that the non‐staining FACS strategy may be beneficial for isolating viable cells not only from planarians but also from other organisms and tissues for scRNA‐seq studies.
The effectiveness of vocational secondary education on entry‐level job outcomes in Japan: Safety net for low‐educated youth in a vocationally weak educational system
Authors: Ogawa Katsunori
Published: September 2023

The aim of this paper is to analyze the sociodemographic compositions and labor market entry of low‐educated youth in Japan. The paper specifically focuses on whether vocational education provides a safety net for labor market insecurities during an era of educational expansion. While past literature has shown that vocational education contributes to occupationally specific skills and a smooth transition from school to work, less is known about its effectiveness when low‐educated youth become a minority group. The case of Japan provides a unique perspective, given its historically low youth unemployment rate and strong connections between schools and employers, despite its academically oriented high school education system. The 2015 Social Stratification and Social Mobility Survey in Japan is used to evaluate trends in vocational education and their impact on employment. The key variables under examination are entry‐level job outcomes. The results show that, over the past decades, high school graduates in Japan have become a more disadvantaged group than university graduates. Among high school graduates, those from general schools tend to have more advantageous sociodemographic backgrounds than their counterparts from vocational schools. Despite the limitations, vocational high school graduates have been better rewarded in the transition to work throughout recent decades. Furthermore, the labor market premium for vocational school graduates remains stable even after accounting for the influence of school networks. Sensitivity analysis confirms the robustness of these effects. The implications of the findings are discussed within the context of the skill formation regime in Japan.