bluuebunny/crossref_metadata_2025 huggingface dataset:
Formulation and Characterization of RBCS Coated Carboplatin Loaded Nano‐Liposomal Formulation for Managing Breast Cancer
Authors: Dubey Akhilesh , Raju Faby , Lobo Cynthia Lizzie , Gs Ravi , Hebbar Srinivas , Shetty Amitha , Kumar Pankaj , El‐Zahaby Sally A.
Published: November 2024

Cell membrane‐coated Nano‐Liposomes (CM‐NLPs) offer a promising approach that combines the advantages of both host cells and synthetic nano‐liposomes (NLPs). This technique involves coating liposomes with red blood cell (RBC) membranes to enhance their functionality. In this study, novel carboplatin‐loaded NLPs (CP‐NLPs) were formulated using phospholipids (Soya Phosphatidyl Choline) and cholesterol through the thin‐film hydration method, and optimized using a 32 full factorial design. The optimized CP‐NLPs were coated with RBC membranes, resulting in the formulation “CP‐RBCs‐NLPs.” These were characterized for particle size, zeta potential, entrapment efficiency, transmission electron microscopy (TEM), differential scanning calorimetry (DSC), protein content, in vitro drug release, cell viability, and stability. The optimized CP‐RBCs‐NLPs exhibited a particle size of 103.6 nm, with zeta potential values of −27.3 mV indicating good stability. The entrapment efficiency was approximately 56%, and the drug release profile showed sustained release for up to 8 h. Cytotoxicity studies in human triple‐negative breast cancer (MDA‐MB468) cell lines demonstrated that CP‐RBCs‐NLPs effectively delivered the drug into target cells, facilitating cell death due to their bilayer structure similar to cell membranes. Overall, CP‐RBCs‐NLPs outperformed both carboplatin‐loaded conventional NLPs (CP‐CNLPs) and carboplatin‐conventional solution (CP‐CNS), making it a superior formulation for drug delivery.
Factors Affecting Mammalian Occupancy and Species Richness in Annapurna Conservation Area, Nepal
Authors: Ghimirey Yadav , Acharya Raju , Mintz Jeffrey
Published: November 2024

Species richness is an important metric used for undertaking conservation management decisions. However, species richness estimates are influenced by species detection probabilities, with potential to entirely overlook species during surveys. Occupancy models which account for imperfect detection provide unbiased estimates, ensuring accurate estimates of richness. We carried out a camera trap survey in the mountains of north‐central Nepal during 2017 and documented a total of 21 mammal species. Here, we used multi‐species occupancy models within a Bayesian hierarchical framework to reassess our initial species richness estimate and to understand the influence of environmental covariates on occupancy and species richness of mammals in the area. Our model estimated the mean species richness was ~26 species (95% CRI: 21–36 species), suggesting we might have missed ~5 species during the survey. The mean probability of occupancy and detection of mammal species were estimated to be and 0.02 (95% CRI:0.01–0.03) respectively. Mammalian species richness of the area had an anticipated positive relationship with tree canopy cover though its positive relationship with anthropogenic disturbance was surprising . Mammalian species richness had a quadratic relationship with elevation as is expected. This research contributes to baseline information of the mammal community ecology in north‐central Nepal and supports the need for future multi‐season surveys to understand the influence of temporal factors on mammalian community and species richness in the area.
Precipitation Drives Frugivory in a Subtropical Generalist Herbivore, the Gopher Tortoise, and Alters Its Functional Role as a Seed Disperser
Authors: Figueroa Adrian , Chernyavskiy Pavel , Greenacre Michael , Herrera Alyssa , Cuni Lydia , Villate Jennifer , Galetti Mauro , Liu Hong , Whitfield Steven
Published: November 2024

Consumers employ a variety of foraging strategies, and oftentimes the foraging strategy employed is related to resource availability. As consumers acquire resources, they may interact with their resource base in mutualistic or antagonistic ways—falling along a mutualism‐antagonism continuum—with implications for ecological processes such as seed dispersal. However, patterns of resource use vary temporally, and textbook herbivores may switch foraging tactics to become more frugivorous in periods of greater fleshy fruit availability. In this study, we investigated how fleshy fruit consumption of a generalist herbivore—the gopher tortoise (Gopherus polyphemus)—shifts intra‐annually following seasonal precipitation and subsequently examined how this shift toward increased frugivory influences the suite of plant syndromes dispersed. We noted a clear intra‐annual shift toward a more frugivorous diet which coincided with seasonal precipitation and subsequently observed a marked shift in the plant syndromes dispersed with increasing frugivory. We found that as this generalist herbivore became more frugivorous, it dispersed a greater variety of plant syndromes at low levels of frugivory. However, when the gopher tortoise exhibited high levels of frugivory, the seed load was dominated by those exhibiting the endozoochory syndrome. This study illustrates a functional shift in a seed‐dispersing herbivore toward that of a classical frugivore, suggesting that temporal variation in foraging strategy and the temporal scale in which foraging habits and seed dispersal interactions are quantified have implications for the suite of plant syndromes species disperse. Furthermore, trade‐offs may exist that provide plants with the endozoochory syndrome with a competitive advantage over seeds with contrasting traits, such as the foliage is the fruit syndrome which is expected to experience greater dispersal by classical herbivores.
Diet of Andean Leaf‐Eared Mice (Phyllotis) Living at Extreme Elevations on Atacama Volcanoes: Insights From Metagenomics, DNA Metabarcoding, and Stable Isotopes
Authors: Quezada‐Romegialli Claudio , Quiroga‐Carmona Marcial , D'Elía Guillermo , Harrod Chris , Storz Jay F.
Published: November 2024

On the flanks of > 6000 m Andean volcanoes that tower over the Atacama Desert, leaf‐eared mice (Phyllotis vaccarum) live at extreme elevations that surpass known vegetation limits. The diet of these mice in these barren, hyperarid environments has been the subject of much speculation. According to the arthropod fallout hypothesis, sustenance is provided by windblown insects that accumulate in snowdrifts (“aolian deposits”). Mice may also feed on saxicolous lichen or forms of cryptic vegetation that have yet to be discovered at such high elevations. We tested hypotheses about the diet of mice living at extreme elevations on Atacama volcanoes by combining metagenomic and DNA metabarcoding analyses of gut contents with stable isotope analyses of mouse tissues. Genomic analyses of contents of the gastrointestinal tract of a live‐captured mouse from the summit of Volcán Llullaillaco (6739 m) revealed an opportunistic but purely herbivorous diet, including lichens. Although we found no evidence of animal DNA in gut contents of the summit mouse, stable isotope data indicate that mice from elevations at or near vegetation limits (~5100 m) include a larger fraction of animal prey in their diet than mice from lower elevations. Some plant species detected in the gut contents of the summit mouse are known to exist at lower elevations at the base of the volcano and in the surrounding Altiplano, suggesting that they may occur at higher elevations beneath the snowpack or in other cryptic microhabitats.
Soil Physical Properties Affect Herbivory of Lampronadata cristata in a Cork Oak Forest
Authors: Shao Xinliang , Zhou Xinjuan , Wang Lin , Tan Ruxue , Lu Can , Zhang Qin , Xu Kedong
Published: November 2024

Studies have reported the important role of soil properties in regulating insect herbivory under controlled conditions or at relatively large scales. However, whether fine‐scale variation of soil properties affects insect herbivory under natural conditions in forests is still unclear. We selected a ca. 300 ha Quercus variabilis forest area where the leaf damage was mainly caused by Lampronadata cristata (Lepidoptera: Notodontidae) and set 200 10 × 10 m plots within the area. We examined insect herbivory (percent leaf area damaged) on Q. variabilis and correlated it to soil properties and tree characteristics. Insect herbivory decreased with soil sand percentage and bulk density and increased with DBH and tree height. Effects of soil sand percentage and bulk density on insect herbivory were partly mediated by DBH and tree height. Our results indicated that soil physical properties may have significant effects on insect herbivory by directly influencing insect herbivores that need to complete their life cycle in the soil, or by indirectly affecting insect herbivores through influencing DBH and tree height which reflects the total leaf biomass available to the insect herbivore. This study may help to understand the complex relationship between soil and plant–insect interactions in forest ecosystems.
Daily and seasonal variations of soil respiration from maize field under different water treatments in North China
Authors: Zhang Mengfei , Han Wenting , Li Chaoqun , Zhang Liyuan , Peng Manman , Wang Tonghua , Chen Xiangwei
Published: November 2024

To further evaluate the effect of water stress on soil respiration (RS), reveal the influencing factors of daily and seasonal RS, and systematically evaluate and compare the sensibility of different machine learning algorithms (multiple nonlinear regression [MNR], support vector machine regression [SVR], backpropagation artificial neural network [BPNN]) to estimate RS from a maize field under water stress condition, the field experiments were conducted within a maize field in Inner Mongolia, China, during the entire 2019 growing season. Various levels of deficit irrigation were conducted in the vegetative, reproductive, and mature stages. Our research indicated that soil CO2 fluxes from 100% evapotranspiration treatment (Tr1) were significantly greater than various deficit irrigation treatments (Tr2, Tr3, Tr4) during each growth stage of summer maize. The cumulative soil CO2 fluxes of Tr2, Tr3, and Tr4 decreased 24.8%, 30.3%, and 43.7% compared with Tr1, respectively. We determined that the drivers affecting the daily RS were soil temperature at 5 cm depth (TS,5) and soil surface temperature (TSF), followed by water‐filled porosity (WFPS) at 5 cm depth, but no significant correlations were observed at 25 cm depths. TS,5 and TSF also performed similar correlation with seasonal RS with R greater than 0.753 among all water treatments, followed by chlorophyll content with R greater than 0.726. During the whole growing season, the BPNN model exhibited the best predicting result, and could explain the 60%–80% and 87.8% of the variations of RS at the daily and seasonal scales, with root mean square error of 48.7–100.9 mg m−2 h−1 and 91.5 mg m−2 h−1, respectively. The SVR and MNR models could estimate the 47.9%–57% and 39.9%–52.1% of the daily RS and 81.4% and 78.6% of the seasonal RS, respectively. Overall, our study indicated the machine learning algorithms could be successfully applied to estimate RS at daily and seasonal scales from a maize field under water stress condition.
Diet of schistosome vectors influences infection outcomes
Authors: Trapp Joshua , Yu Wesley , Spaan Johannie M. , Pennance Tom , Rawago Fredrick , Ogara George , Odiere Maurice R. , Steinauer Michelle L.
Published: November 2024

Resource availability can alter infection outcomes through its impact on host immunity and on parasite reproduction. On one hand, enhanced nutrition could favor immunity, limiting the parasite, and on the other hand, it could favor establishment and reproduction of the parasite. Our study aimed to determine the effect of diet on (1) host susceptibility to infection and (2) parasite production in a snail‐trematode system. We fed Biomphalaria sudanica, a snail vector of Schistosoma mansoni, either a strict lettuce (low nutrient) or pellet (high nutrient) diet for two generations before exposing them to S. mansoni. We used two parasite strains, one that is incompatible with the snails and one that is compatible with the snails. We found that when exposed to incompatible parasites, diet did not affect snail susceptibility significantly as few snails were infected overall. However, when challenged with the compatible parasites, snails fed the high‐nutrient diet were more susceptible to infection than their low‐nutrient‐fed counterparts. The high‐nutrient‐fed snails also produced more cercariae than low‐nutrient‐fed snails, but this advantage was lost after the initial assessment at 8 weeks. Snails that obtained infections were either kept on their initial diet or switched to the other diet. This experiment showed that snails switched from a low‐to‐high‐nutrient diet produced more cercariae than those remaining on the low‐nutrient diet and similar numbers to those remaining on the high‐nutrient diet. Unexpectedly, the reciprocal diet switch (high to low nutrient) initially resulted in more cercariae relative to controls, but the pattern reversed after initial assessment. This study showed that available resources can impact the susceptibility of the vector host and the reproductive capacity of the parasites, with higher nutrients favoring parasite establishment and reproduction, highlighting the plasticity of susceptibility phenotypes, which also have a strong genetic basis. These data can aid predictions of how future environmental changes and resource availability may impact parasite transmission.
Near‐Infrared Broadband Emission for High Electroluminescence Efficiency by Cr3+/In3+‐Doped Germanate Phosphors
Authors: Su Peng , Zhao Qunyang , Lang Tianchun , Peng Lingling , Polisadova Elena , Qiang Qinping , Liu Bitao , Han Tao
Published: November 2024

In this paper, a series of KGaGeO4:0.01Cr3+, xIn3+ (KGGO:0.01Cr3+, xIn3+, x=0~0.08) phosphors were synthesized by high temperature method. KGGO:0.01Cr3+ has a far red emission in the range of 600~900 nm ascribing to the 4T2→4 A2 spin‐allowed transition of Cr3+. With the incorporation of In3+, KGGO:Cr3+, In3+ shows a near‐infrared (NIR) broadband emission in the range of 700~1200 nm, with red shift of the emission peak by 136 nm, and FWHM of 185 nm. The electroluminescence efficiency of NIR pc‐LED prepared by KGGO:0.01Cr3+, 0.02In3+ is as high as 19 % under the output power of 25 mW, which can be applied in the night vision technology and microbial growth.
Fabrication of Nanoporous Gold Film: A Novel Electrochemical Sensor for Germanium (II)
Authors: Rojas Luis A. , Vizcarra Arnoldo , Hernández‐Saravia Lucas Patricio
Published: November 2024

In this work, the fabrication of a high surface area nanoporous gold (NPG) structures on the surface of a gold electrode using a facile and green electrochemical approach via anodization–reduction method for germanium (Ge) determination is presented. The characterization of the NPG was analyzed by cyclic voltammetry, field emission scanning electron microscopy, and X‐ray diffraction techniques. Voltammetry showed an improved sensitivity for Ge (II) oxidation at this electrode when compared to a bare electrode, with a peak near to –1.3 V (vs. Ag/AgCl) at a scan rate of 100 mV s−1. The square wave anodic stripping voltammetry shows a response that is linear in the 10–40 μg L−1 Ge (II) concentration range, with a 1.53 μg L−1 limit of detection and 4.65 μg L−1 limit of quantification. The reproducibility and repeatability were assessed, and acceptable performance was achieved.
Development of Biomass‐Derived Hard Carbon for Sodium‐Ion Batteries: Optimizing Microstructure and Electrochemical Performance
Authors: Li Zesheng , Lu Qiuyu , Xu Zian , Wang Yu , Wang Hsing‐Lin
Published: November 2024

The development of sodium‐ion batteries (SIBs) as a sustainable alternative to lithium‐ion batteries has garnered considerable attention, mainly due to the abundant supply and economic viability of sodium sources. In this study, we present the synthesis and characterization of hard carbon (HC) derived from biomass coconut shells, with the objective of optimizing its performance as an anode material for SIBs. A series of HC samples (denoted as YHC‐T) were prepared via carbonization at 1000°C, 1100°C, 1200°C, 1300°C, and 1400°C. The YHC‐1200 sample, exhibiting an expanded interlayer spacing of approximately 0.384 nm, demonstrated superior sodium storage properties, achieving a high reversible specific capacity of 350 mA h g−1 and an initial Coulombic efficiency of 92.9% at a current density of 0.1 A g−1. Moreover, YHC‐1200 exhibited excellent cycling stability, retaining a capacity of 198 mAh g−1 after 1000 cycles at 1 A g−1.
High Strength Anhydrite Cement Based on Lime Mud From Water Treatment Process: One Step Synthesis in Water Environment, Characterization and Technological Parameters
Authors: Kamarou Maksim , Tan Hongbin , Moskovskikh Dmitry , Kulinich Natallia , Ma Xiaoling , Yang Feihua , Beletskii Evgenii , Alekseeva Elena , Yudin Sergey , Romanovski Valentin
Published: November 2024

In the process of water treatment from surface water sources, lime mud as waste is formed. This waste contains CaO, Ca(OH)2, and CaCO3. The article proposes a comprehensive method for processing lime mud into high‐strength anhydrite cement. The method involves the interaction of lime mud with waste sulfuric acid from the production of polymer fibers using a structure‐controlled method in the (CaO·Ca(OH)2·CaCO3)—H2SO4—H2O system at a temperature of 40°C. X‐ray diffraction analysis showed the presence of CaSO4 and CaSO4·0.62H2O phases with a purity of 99.8%. The structure‐controlled method makes it possible to control the formation and growth of calcium sulfate crystals of the required shape and size, due to which it is possible to obtain anhydrite cement with desired properties. Combined grinding of synthetic anhydrite with activator additives makes it possible to obtain anhydrite cement with a strength of up to 28.5 MPa.
Applicability of the longitudinal profile–based cirque classification—A test with large cirque datasets in the southeastern Tibetan Plateau
Authors: Jia Tian , Fu Ping , Qin Cheng‐Zhi
Published: November 2024

Accurate cirque classification is essential for understanding their formation and palaeoclimatic implications. Longitudinal‐profile‐based cirque classification offers advantages over expert classification and parameter‐based methods. This classification fits exponential or power functions to cirque profiles, employing linear classifiers based on the exponential coefficient (c‐value) and cirque height, or a threshold approach based on the power coefficient (b‐value) to classify cirques and non‐cirques. However, previous studies were limited to small sample sets. Our study extends this methodology to more extensive datasets on the southeastern Tibetan Plateau, evaluating its effectiveness across two larger sample sets. Both c‐value and b‐value based methods are tested with two classifiers: the original classifier from previous studies and the parameter‐refitted classifier trained by datasets of this study. The results show that the c‐value‐based method effectively classifies typical cirques and non‐cirques, with notable enhancements in performance based on the refitted classifier compared to the original one. The b‐value‐based method with the refitted classifier performs well in typical cirque identification but is less effective for non‐cirques compared to the original classifier. For all‐type cirques and non‐cirques, both methods demonstrated improved performance in non‐cirque classification although there was a slight trade‐off of cirque classification. Additionally, c‐value based non‐linear classifiers and b‐value optimal threshold for classifying cirque and non‐cirque have been developed, and their improved performance in this classification is discussed. Overall, the longitudinal‐profile‐based classification is more effective for typical cirques and non‐cirques, with potentials for further improvement by considering additional spatial structure information of cirques.
The role of contaminant risk landscapes in the Anthropocene
Authors: Gerson Jacqueline R
Published: November 2024

Across the planet, human mobilization of chemical pollution and widespread land‐cover changes are key markers of the Anthropocene. However, because they occur at different spatial scales, contaminant mobilization and land‐cover changes are generally studied as separate issues. Landscapes differ in how contaminants are processed and risk manifests. The way that landscapes are altered plays a critical role in the likelihood that any particular place will capture, sequester, and transform contaminants, ultimately impacting bioavailability to people and wildlife. This article introduces a conceptual framework—the “contaminant risk landscape”, which merges perspectives from geochemistry, landscape ecology, and ecotoxicology—to improve understanding of the transport, fate, and impact of toxic contaminants in the natural world. Successful management and mitigation of contaminant toxicity requires a merging of these diverse perspectives and traditions to achieve environmentally just solutions.
Forecasting range shifts using abundance distributions along environmental gradients
Authors: Billman Peter D , Carroll Kathleen A , Schleicher Derek J , Freeman Benjamin G
Published: November 2024

Globally, many species’ distributions are shifting in response to contemporary climate change. However, the direction and rate of shifts remain difficult to predict, impeding managers’ abilities to optimize resource allocation. Here, we developed a new approach for forecasting species range‐limit shifts that requires only abundance data along environmental (for example, elevational) gradients. We posited that the distribution of species’ abundances could offer insights into the potential for future range‐limit shifts. We then tested this prediction using data from several transect studies that compared historical and contemporary distributions. Consistent with our prediction, we found that strong asymmetry in abundance distributions (that is, “leaning” distributions) indeed preceded species’ lower‐limit range shifts. Accordingly, surveying abundances along environmental gradients may represent a promising, cost‐effective method for forecasting local shifts. Ideally, this approach will be incorporated by practitioners into species‐specific management planning and will inform on‐the‐ground conservation efforts.
Prevalence and Determinants of Scabies Among Schoolchildren in Ethiopia: A Systematic Review and Meta‐Analysis
Authors: Girma Abayeneh , Abdu Indiris
Published: November 2024

Background and Aims

In deprived and poor communities worldwide, scabies remains an overlooked tropical disease. Numerous individual studies have been conducted in Ethiopia on this issue, demonstrating notable disparities and inconclusive findings. This systematic review and meta‐analysis aimed to establish Ethiopia's pooled scabies prevalence and determinants among schoolchildren.

Methods

Studies were retrieved from PubMed, Scopus, Science Direct, Google Scholar, and African Journals Online through a systematic search. The Joanna Briggs Institute's critical appraisal tool was employed to assess the quality of observational studies (cross‐sectional and case‐control). The meta‐analysis was performed using Stata software version 14 and its metan command. A forest plot was used with a random effects model to calculate the pooled prevalence and its 95% confidence interval (CI). Subgroup and sensitivity analyses were employed to evaluate potential sources of heterogeneity. The funnel plot and Egger's test were used to evaluate publication bias, while heterogeneity was assessed using inverse variance (I2).

Results

In this systematic review and meta‐analysis, 14.71% (733/5104) of schoolchildren had scabies, with a 95% CI of 8.90%−20.52%. The highest prevalence is recorded in the Amhara region (17.09%; 95% CI: 2.15–32.04), and the lower prevalence is seen in the Oromia region (12.52%; 95% CI: 10.08–14.95). Children sharing clothes with scabies cases, using common sleeping beds/fomites, having a family history of scabies, and having illiterate parents are significantly associated with scabies among Ethiopian schoolchildren (based on adjusted odds ratios: 7.07; 95% CI: 1.55–12.59, 2.13; 95% CI: 0.04–4.22, 1.45; 95% CI: 0.35–3.94, 1.42; 95% CI: 0.94–0.89).

Conclusion

The current prevalence of scabies ranges from 12.52% to 17.09% and is higher in the Amhara region. The national policymakers and health planners should prioritize implementing prevention and control measures of scabies among schoolchildren through ivermectin‐based mass drug administration for three to five rounds annually until the prevalence is less than 2%.
A Comprehensive Evaluation of Agricultural Drought Vulnerability Using Fuzzy‐AHP‐Based Composite Index Integrating Sensitivity and Adaptive Capacity
Authors: Bera Debarati , Dutta Dipanwita
Published: November 2024

With increasing extreme weather events, ground water crisis and population expansion, crop stress and production failure have emerged as critical challenges. Agricultural drought vulnerability (ADV) at local and regional scales has become a global concern as it is directly related to food security, hunger issues and poverty. The Kangsabati river basin is one of the major drought‐prone river basin in the eastern India and frequently affected by the reduction of crop production or crop failure because of fluctuation of monsoonal rainfalls, poor irrigation system and harsh edaphic factors. In this context, this study focuses on assessing agricultural vulnerability in the Kangsabati basin using multi‐sensor datasets and geospatial techniques. The ADV has been assessed through multi‐source data sets covering meteorological, agricultural, soil and socio‐economic aspects using a powerful, systematic, and flexible decision‐making fuzzy‐based analytic hierarchy process (fuzzy‐AHP) technique. The ADV index is a functional product of two composite indices: the sensitivity index (SI) and the adaptivity index. The SI is derived from components like the intensity of agricultural drought index, groundwater stress, soil erosion, percentage of cultivators, marginal workers and agricultural land. Adaptive capacity depends upon human, financial, physical, infrastructural and natural capital. Each index was derived considering various factors using fuzzy‐AHP methods for weightage calculation. The composite indices revealed the variation of resource distribution precisely in each geographically distinct zone. The study shows that almost 60% of the highly sensitive zone is situated in the upper basin region characterised by undulating lands. A large part of the entire basin (48%) is moderately drought‐sensitive. The result also shows that a significant part (35%) of the upper and middle basin is highly vulnerable to agricultural drought. In contrast, the lower basin exhibits low to very low levels of vulnerability to drought. The results indicate that even though some areas are moderate to less sensitive, the vulnerability of agricultural drought has become high due to their limited adaptive capacity. The comprehensive framework developed for assessing ADV has the potential for region‐specific policy implementation and sustainable growth.
Gout in pregnancy: Obstetric and neonatal outcomes
Authors: Amar Sam , Badeghiesh Ahmad , Baghlaf Haitham , Dahan Michael H.
Published: November 2024

Objective

The pregnancy, delivery, and neonatal outcomes of pregnancies complicated by gout have yet to be evaluated in a population‐based study. We sought to evaluate the obstetric and neonatal outcomes in pregnant patients with gout using a national population database.

Methods

This is a retrospective population‐based cohort study utilizing the Healthcare Cost and Utilization Project, Nationwide Inpatient Sample (HCUP‐NIS). All women who delivered or had a maternal death in the USA (2004–2014) were included in the study. Pregnancy, delivery, and neonatal outcomes were compared between women with an ICD‐9 diagnosis of gout to those without.

Results

Overall, 9 096 788 women met the inclusion criteria. Of these, 168 women (1.8/100000) had gout. Patients with gout, compared to those without, were more likely to be older and obese and to have chronic hypertension, pregestational diabetes mellitus, and thyroid disease. Pregnant women with gout were more likely to develop gestational diabetes mellitus (aOR 1.78 [95% CI 1.17–2.72], P = 0.008), to require operative vaginal delivery (aOR 3.26 [95% CI 2.03–5.22], P = 0.0001), and to experience venous thromboembolism (aOR 8.47 [95% CI 2.06–34.82], P = 0.003) compared to pregnant patients without gout. Patients with gout were more likely to deliver a neonate with congenital anomalies compared to those without gout (aOR 3.38 [95% CI 1.24–9.20], P = 0.02).

Conclusion

Gout in pregnancy, or pregnancies complicated by a history of gout, are associated with increased risk of gestational diabetes mellitus, pulmonary embolism, and neonatal anomalies.
Self‐criticism, maternal emotional distress, and maternal hostility among Bedouin mothers with preterm infants
Authors: Assal‐Zrike Shuaa , Atzaba‐Poria Naama
Published: November 2024

This study examined the links between maternal self‐criticism, maternal postpartum emotional distress (PPED), and maternal non‐hostility among Arab‐Bedouin mothers living in southern Israel. We proposed a moderated mediation model in which self‐criticism would be related to PPED, which, in turn would be related to maternal non‐hostility. One hundred five Arab‐Bedouin mothers and their preterm (n = 48) and full‐term (n = 57) infants were recruited shortly after birth and were followed up when infants were 6 months old (corrected for prematurity). The self‐report measures were done shortly after birth, and, the measurement of observation was done at the 6‐month visit. Findings demonstrated evidence for a moderated mediation model in which higher levels of maternal self‐criticism correlated over time with higher levels of maternal PPED, and this, in turn, predicted lower levels of maternal non‐hostility. This model was found only among the preterm group.
Anabolic Sensitivity in Healthy, Lean, Older Men Is Associated With Higher Expression of Amino Acid Sensors and mTORC1 Activators Compared to Young
Authors: Horwath Oscar , Moberg Marcus , Hodson Nathan , Edman Sebastian , Johansson Mats , Andersson Eva , van Hall Gerrit , Rooyackers Olav , Philp Andrew , Apró William
Published: November 2024

Background

Sarcopenia is thought to be underlined by age‐associated anabolic resistance and dysregulation of intracellular signalling pathways. However, it is unclear whether these phenomena are driven by ageing per se or other confounding factors.

Methods

Lean and healthy young (n = 10, 22 ± 3 years, BMI; 23.4 ± 0.8 kg/m2) and old men (n = 10, 70 ± 3 years, BMI; 22.7 ± 1.3 kg/m2) performed unilateral resistance exercise followed by intake of essential amino acids (EAA). Muscle biopsies were collected from the rested and the exercised leg before, immediately after and 60 and 180 min after EAA intake. Muscle samples were analysed for amino acid concentrations, muscle protein synthesis (MPS) and associated anabolic signalling.

Results

Following exercise, peak plasma levels of EAA and leucine were similar between groups, but the area under the curve was ~11% and ~28% lower in Young (p < 0.01). Absolute levels of muscle EAA and leucine peaked 60 min after exercise, with ~15 and ~21% higher concentrations in the exercising leg (p < 0.01) but with no difference between groups. MPS increased in both the resting (~0.035%·h−1 to 0.056%·h−1, p < 0.05) and exercising leg (~0.035%·h−1 to 0.083%·h−1, p < 0.05) with no difference between groups. Phosphorylation of S6K1Thr389 increased to a similar extent in the exercising leg in both groups but was 2.8‐fold higher in the resting leg of Old at the 60 min timepoint (p < 0.001). Phosphorylation of 4E‐BP1Ser65 increased following EAA intake and exercise, but differences between legs were statistically different only at 180 min (p < 0.001). However, phosphorylation of this site was on average 78% greater across all timepoints in Old (p < 0.01). Phosphorylation of eEF2Thr56 was reduced (~66% and 39%) in the exercising leg at both timepoints after EAA intake and exercise, with no group differences (p < 0.05). However, phosphorylation at this site was reduced by ~27% also in the resting leg at 60 min, an effect that was only seen in Old (p < 0.01). Total levels of Rheb (~45%), LAT1 (~31%) and Rag B (~31%) were higher in Old (p < 0.001).

Conclusion

Lean and healthy old men do not manifest AR as evidenced by potent increases in MPS and mTORC1 signalling following EAA intake and exercise. Maintained anabolic sensitivity with age appears to be a function of a compensatory increase in basal levels of proteins involved in anabolic signalling. Therefore, our results suggest that age per se does not appear to cause AR in human skeletal muscle.
Intermittent Hypoxic–Hyperoxic Training During Inpatient Rehabilitation Improves Exercise Capacity and Functional Outcome in Patients With Long Covid: Results of a Controlled Clinical Pilot Trial
Authors: Doehner Wolfram , Fischer Azadeh , Alimi Banafsheh , Muhar Jasmin , Springer Jochen , Altmann Christoph , Schueller Per Otto
Published: November 2024

Introduction

Long COVID‐19 illness is a severely disabling disease with shortness of breath, weakness and fatigue as leading symptoms, resulting in poor quality of life and substantial delay in return to work.

No specific respiratory therapy has been validated for patients with long COVID. The intermittent hypoxia–hyperoxia training (IHHT) is a respiratory therapeutic modality to improve exercise performance via controlled respiratory conditioning. The purpose of the present study is to investigate the therapeutic effect of IHHT on functional and symptomatic recovery of patients with long COVID syndrome.

Methods

A prospective, controlled, open‐treatment interventional study was conducted in patients with long COVID who were admitted to an inpatient rehabilitation programme. Patients were assigned nonrandomized to receive IHHT in addition to the standardized rehabilitation programme (IHHT group) or standard rehabilitation alone (control group). The IHHT group received supervised sessions of intermittent hypoxic (10–12% O2) and hyperoxic (30–35% O2) breathing three times per week throughout the rehabilitation period. Primary endpoint was improved walking distance in a 6‐min walk test (6MWT) between study groups. Secondary endpoints were change in stair climbing power, dyspnoea (Borg dyspnoea Scale), fatigue assessment scale (FAS) and change in health‐related quality of life (HRQoL) assessed by patient global assessment (PGA), EQ‐5D analogue scale and the MEDIAN Corona Recovery Score (MCRS). Further assessments included maximum handgrip strength, nine hole peg test, timed up‐and‐go, respiratory function and functional ambulation category (FAC), serum analyses and safety of the intervention.

Results

A total of 145 patients were included in the study (74% female, mean age 53 ± 12 years) and assigned to IHHT (n = 70) or standard care (n = 75). The 6MWT distance improved 2.8‐fold in the IHHT group compared to the control group (91.7 ± 50.1 m vs. 32.6 ± 54.2 m, ANCOVA p < 0.001). Stair climbing power improved 3.7‐fold in the IHHT group compared to controls (−1.91 ± 2.23 s vs. −0.51 ± 1.93 s, p < 0.001). Secondary endpoints on dyspnoea, fatigue and HRQoL (PGA, EQ‐5D and MCRS) improved significantly in the IHHT group compared to controls. The IHHT group exhibited a significant decrease in blood pressure, heart rate and increase in haemoglobin levels that was not observed in the control group. No adverse events were observed.

Conclusion

Respiratory treatment with IHHT in addition to a multidisciplinary rehabilitation programme improves functional capacity, symptomatic status and quality of life in patients with disabling long COVID. IHHT has been demonstrated to be safe, well tolerated and feasible to be integrated in an inpatient rehabilitation programme to improve outcome in long COVID.
Enhancing quality of care for older adults: The age‐friendly health system (4Ms framework) and the role of general medicine physicians as system‐based complexologists
Authors: Higuchi Masaya , Watari Takashi , Ie Kenya
Published: November 2024

The aging population presents critical challenges to global healthcare systems, with Japan expected to have 35% of its population aged 65 or older by 2040. Older adults often experience multimorbidity, cognitive impairments, and physical frailties, increasing healthcare utilization and costs. Traditional medical approaches that focus on organ‐specific diagnoses are insufficient for addressing these multifaceted needs. The Age‐Friendly Health Systems (AFHS) framework, introduced in the U.S., offers a patient‐centered, value‐based approach to geriatric care, encompassing the "4Ms": Mentation, Mobility, Medication, and What Matters. These pillars prioritize cognitive health, physical function, appropriate medication use, and patient values. However, Japan has yet to implement this system widely. The integration of AFHS, with an additional focus on "Multicomplexity" (5Ms), aligns well with the core competencies of General and Family Medicine. This specialty is crucial in leading interdisciplinary efforts to enhance geriatric care, addressing fragmentation and variability in healthcare delivery. To successfully implement AFHS in Japan, general medicine physicians must be trained in managing complex conditions and coordinating care across specialties. This shift toward holistic, patientcentered care is essential for improving outcomes for older adults and reducing healthcare costs. Future research should focus on developing effective strategies for AFHS implementation and training healthcare teams for comprehensive care delivery.
Characterization of the Pathogenic Features of Multiple SARS‐CoV‐2 Pandemic Strains in Different Mouse Models
Authors: Sun Huize , Liu Kunpeng , Yu Baocheng , Zhu Miao , Jia Lijia , Yao Weitong , Chen Zhen , Hao Haojie , Zhang Xueyan , Liu Yi , Liu Haibin , Shan Chao , Huang Fang , Guan Wuxiang
Published: November 2024

Elucidating the detailed features of emerging SARS‐CoV‐2 strains both in vitro and in vivo is indispensable for the development of effective vaccines or drugs against viral infection. We thoroughly characterized the virological and pathogenic features of eight different pandemic SARS‐CoV‐2 strains, from the WT strain to current circulating sublineage EG.5.1, both in vitro and in vivo. Besides detailed virological features observed in Vero E6 cells, the Omicron variants, from BA.1 to EG.5.1, exhibited enhanced infectious effects to upper respiratory tract in K18 human angiotensin‐converting enzyme (ACE2) (K18 hACE2) transgenic mice. Both XBB.1.9.1 and EG.5.1 presented stronger tropism to brain, which could be the main reason for the increased lethal effects on mice. In addition, the pathogenesis comparisons among all these viruses in C57BL/6JGpt mice indicated that Omicron variant BA.1 and two new sublineages XBB.1.9.1 and EG.5.1 possessed dual tropisms to both human and mice, which were further confirmed by subsequent bioinformatic analyses and actual affinity comparison between viral RBDs and mouse or human receptor ACE2. Furthermore, the immunocompromised BKS‐db mice were found to be more susceptible to Omicron strains compared to C57BL/6JGpt mice, which revealed that viral infectivity was determined by both its affinity to the host receptor and host immunocompetence. Thus, this study not only contributes to a systematic understanding of the pathogenic features of SARS‐CoV‐2 in mice, but also provides new insights to combat potential future surges of new SARS‐CoV‐2 variants.
Staging Approaches to Lymphatic Surgery: Techniques and Considerations
Authors: Salibian Ara A. , Yu Nina , Patel Ketan M.
Published: November 2024

Lymphatic surgery has demonstrated promising outcomes for the treatment of lymphedema alongside nonsurgical techniques. Physiologic lymphatic surgeries including lymphovenous bypass and vascularized lymph node transplants address the fluid burden in lymphedema whereas reductive surgeries including suction lipectomy and excisional techniques address the fibroadipose component of the disease. Lymphedema patients often present with both fluid and fat components that may require different procedures for optimal results. In addition, the chronic, progressive nature of lymphedema can warrant the need for multiple procedures to address different anatomic areas as well as further improve outcomes. This paper reviews the current literature on staging different or repeated lymphatic procedures and proposes an algorithm to navigate physiologic and reductive lymphatic surgery when multiple procedures are needed to optimize surgical outcomes.
From Virtual Trainers to Companions? Examining How Digital Agency Types, Anthropomorphism, and Support Shape Para‐Social Relationships in Online Fitness
Authors: Feng Ying , Meng Jie , Cheah Jun‐Hwa
Published: November 2024

The role of virtual trainers in online fitness has increasingly captured the attention of consumers and brands as digital technology becomes more interwoven with daily life. This study extends the para‐social relationship theory by developing and testing a research model through five studies that simulate online fitness interactions. In Study 1, we examine the model and find that three characteristics (interactivity, authenticity, and companionship) positively influence consumers' social perceptions (perceived warmth and competence), para‐social relationship building, and intentions to continue using the service. Our findings also reveal that the moderating roles of coach types (human vs. avatar vs. agent) in Study 2, anthropomorphic appearance levels (high vs. low) in Study 3, and the nature of support provided (emotional vs. technical) in Study 4 significantly affect users' social perceptions and their intentions to continue using the service. Interestingly, compared to humans and avatars, using agent coaches requires greater authenticity to strengthen the para‐social relationship. When using low‐anthropomorphic digital agents and avatars, building para‐social relationships more effectively promotes consumers' continued usage intentions. Additionally, the relationship between para‐social relationship building and continued usage intentions was stronger in the emotional support group than in the technical support group. In Study 5, we found that continued usage intention positively affects online fitness subscription behaviors. These findings have implications for integrating digital agencies to enhance consumer experience and engagement in health‐focused digital environments, especially for physical fitness service providers and platform course designers.
Considering Developmental Phenotypes of Suicidality for Young Black Children
Authors: Keenan Kate , Stepp Stephanie , Anderson Leslie A. , Humphries Marisha , Hipwell Alison E. , Mbayiwa Kimberley
Published: November 2024

Suicide is currently the 5th leading cause of death among children aged 5–11, a rate that has more than tripled in the last decade, and one that has increased significantly more among Black compared to White children. Specifying early childhood phenotypes of suicidality is critical for prevention of suicidal behavior. Such phenotypes need to be culturally relevant and rigorously tested in Black youth to yield data that will inform prevention science. We used the Interpersonal Theory of Suicide, to guide both the development of a theoretical model and a research protocol to conduct a study on suicidality in young Black children. The model was informed by an ecological adaptation which considers the context of structural, systemic, and interpersonal racism as critical for conceptualizing suicidal risk and identifying factors that reduce the likelihood of suicidal ideation and behaviors among Black youth. Developmental adaptations of IPTS components were based on existing research supporting associations between theoretically similar constructs and early childhood depression and/or later suicidality. Model components include loneliness and lack of family connectedness, low self‐worth and hopelessness, and impulsivity. The components are measured via questionnaires and reactivity to behavioral probes as measured by facial emotion, heart rate variability, and self‐reported mood. Risk and protective factors include exposure to racism and discrimination and racial identity and socialization, respectively. An accelerated, longitudinal design, enrolling 5–9‐year‐old children for 6 repeated assessments over 45 months will allow us to test stability from early childhood to early adolescence. Conducting robust tests of early risk and stability of suicidality in the context of culturally relevant risk factors (e.g., racism) and protective factors (e.g., racial socialization and identity) will contribute to efforts to reverse recent trends in Black youth suicide.
What Is Needed to Determine and Potentially Improve the Clinical Effectiveness and Cost‐Effectiveness of Robot‐Assisted Reconstructive Urinary Tract and Pelvic Floor Surgery?—ICI‐RS 2024
Authors: Wyndaele Michel , Sahai Arun , Kheir George Bou , Hervé François , Ochoa D. Carolina , Rademakers Kevin , van Steenbergen Thomas , Song Qi‐Xiang , Wein Alan , Abrams Paul
Published: November 2024

Introduction

Robot‐assisted (RA) surgery has many advantages for urinary tract and pelvic floor reconstruction (UTPFR) but its application is only slowly increasing. Studies are limited in number, patients and follow‐up duration. The low‐volume high‐complexity nature of UTPFR warrants specific research to evaluate the potential role of the RA approach.

Methods

During its 2024 meeting in Bristol, the International Consultation on Incontinence‐Research Society (ICI‐RS) reviewed the current literature on RA UTPFR. Priority research questions and strategies were explored in a proposal.

Results

Four different topics were discussed. (1) Large multicentre prospective studies on RA UTPFR are needed to evaluate clinical effectiveness and safety. The RA approach needs to be prioritized in specific procedures and patients, to first improve patient care where gains are highest. (2) Models for cost‐utility analysis for RA UTPFR are needed to (re)direct limited resources as efficiently as possible in a quickly changing technological field. (3) A modular curriculum for training UTPFR surgeons to become RA certified needs to be developed, to allow valid interpretation and comparison of outcomes. (4) Technological improvements to address tissue handling, accessibility, efficiency and sustainability are needed. Digitalization can be a gamechanger for RA UTPFR through telesurgery (training and expertize coverage), augmented reality and artificial intelligence providing intra‐operative assistance, assessment and feedback.

Conclusions

The proposal discussed the need for studies on clinical and cost effectiveness, safety, and training curriculum development for RA UTPFR. Recent technological developments hold great promise for RA UTPFR. High‐priority research questions were identified.
Potential Cost‐Saving Model Utilizing Mark Cuban Cost Plus Drug Company for Purchasing Common Otolaryngology Medications
Authors: Buxo Zachary , D. Cramer John
Published: November 2024

The persistent challenge of high pharmaceutical prices has led to the emergence of vertically integrated direct‐to‐consumer distributors like Mark Cuban Cost Plus Drug Company (MCCPDC). This study aims to evaluate a cost‐saving alternative method for medication sourcing. The most frequently prescribed medications by otolaryngologists were identified through analysis of Medicare Part D data, utilizing prescriber type as a filter. Medications were assessed for availability on the MCCPDC website and drug form consistency. Cost analysis was conducted comparing current pharmaceutical spending against MCCPDC pricing. Potential otolaryngology‐driven savings were estimated at $55.6 million and $1 billion if in effect across all specialties. Our findings suggest considerable potential savings for Medicare by purchasing generic medications at MCCPDC prices.