bluuebunny/crossref_metadata_2025 huggingface dataset:
An audit of the maternal medicine clinic: Cancer and pregnancy
Authors: Harrison Mia , Umstad Mark P. , Cui Wanda , Thevathasan Iniyaval , Price Sarah A.L.
Published: January 2024

Aims

To explore the incidence and complexity of women presenting for maternity care who require concurrent cancer care, and to report the birth outcomes of these women.

Materials and Methods

A retrospective audit of women attending a ‘high risk’ maternal medicine clinic at an Australian tertiary maternity hospital between 1 October 2021 and 30 April 2023 was conducted. The inclusion criteria were a diagnosis of cancer and a concurrent pregnancy, or a diagnosis of cancer prior to the current pregnancy. Clinic lists and coding data were screened via the electronic medical record to identify potential subjects. Data were collected from the individual maternity and neonatal records.

Results

Forty of 705 (5.7%) women attending the maternal medicine clinic met the inclusion criteria, of which ten had a new diagnosis of cancer in pregnancy and 30 presented for maternity care after a previous diagnosis of cancer. Cancer therapy during pregnancy included surgery and chemotherapy. Most pregnancies (92.5%) resulted in term deliveries (≥37 weeks gestation). Four neonates were preterm, and one was small‐for‐gestational‐age. Caesarean section delivery and post‐partum haemorrhage were more common than expected, but the rate of other adverse pregnancy outcomes was consistent with the background population. Over half of neonates required neonatal intensive care unit / special care nursery admission but the indications for admission were common, self‐limiting conditions, and the length of stay was short (mean <5.0 days).

Conclusions

Approximately 6% of women attending the maternal medicine clinic had a current or previous diagnosis of cancer. Most pregnancies resulted in term deliveries and neonatal outcomes were excellent.
Regulation of immune response genes in the skin of allergic and clinically tolerant individuals exposed to p‐phenylenediamine
Authors: Meisser Sanne S. , Mitamura Yasutaka , Altunbulakli Can , Bandier Josefine , Opstrup Morten S. , Gadsbøll Anne‐Sofie Ø. , Li Manru , Tan Ge , Akdis Mubeccel , Akdis Cezmi A. , Geisler Carsten , Johansen Jeanne D. , Bonefeld Charlotte M.
Published: January 2024

Background

p‐Phenylenediamine (PPD) is a potent contact allergen found in many hair colour products. However, not all individuals develop allergic contact dermatitis (ACD) although they are regularly exposed to PPD. It is unclear whether these asymptomatic individuals are true non‐responders to PPD or whether they mount a response to PPD without showing any symptoms.

Methods

Skin biopsies were collected from 11 asymptomatic hairdressers regularly exposed to PPD and from 10 individuals with known ACD on day 4 after patch testing with 1% PPD in petrolatum and petrolatum exclusively as control. RNA sequencing and confocal microscopy were performed.

Results

T cell activation, inflammation and apoptosis pathways were up‐regulated by PPD in both asymptomatic and allergic individuals. Compared to asymptomatic individuals with a negative patch test, individuals with a strong reaction to PPD strongly up‐regulated both pro‐ and anti‐inflammatory cytokines genes. Interestingly, PPD treatment induced significant up‐regulation of several genes for chemokines, classical type 2 dendritic cell markers and regulatory T cell markers in both asymptomatic and allergic individuals. In addition, apoptosis signalling pathway was activated in both non‐responders and allergic individuals.

Conclusion

This study demonstrates that there are no true non‐responders to PPD but that the immune response elicited by PPD differs between individuals and can lead to either tolerance, subclinical inflammation or allergy.
The effect of music on the operating surgeon: a pilot randomized crossover trial (the MOSART study)
Authors: Narayanan Anantha , Cavadino Alana , Fisher James P. , Khashram Manar
Published: January 2024

Objective

The experience of stress is common among surgeons while working in the operating theatre (OT). Understanding and finding ways to mitigate this stress is important for optimizing surgical quality and maintaining clinician wellbeing. In this pilot study, we tested the feasibility and reported the outcomes of measuring the effect of background music on intra‐operative surgeon stress in the clinical environment.

Methods

The effect of Music on the Operating Surgeon: A pilot Randomized crossover Trial (the MOSART study) was conducted over a 9‐month period in a single‐centre. Vascular and general surgeons acting as primary operators (POs) performing elective, general anaesthetic operations were included. The intervention was surgeon‐selected music, and the control was the absence of music. Outcome measures were feasibility (recruitment rate, practicability, and completeness of data), heart rate variability (HRV) indices, the Six‐Item State–Trait Anxiety Inventory (STAI‐6), and the Surgical Task‐load Index (SURG‐TLX).

Results

Five POs performed 74 eligible randomized cases. The protocol was well tolerated, and no cases were abandoned. Data was incomplete in 8% of cases. The overall mean (SD) operative SURG‐TLX score was 48 (±22). Mean HR increased and RMSSD decreased significantly from baseline, suggesting reduced parasympathetic activity while operating. The presence of intra‐operative music was not found to affect the psychological or physiological outcomes.

Conclusions

A music interventional study of this nature is feasible in the operating theatre environment, though no difference was found between in the music and non‐music conditions. Follow‐up research in a simulated environment with intensive physiological monitoring could be considered.
Lack of stereopsis does not reduce surgical performance but prolongs the learning curve of vitreoretinal surgery
Authors: Vergmann Anna Stage , Olsen Frederik Emil , Nielsen Anders Bo , Vestergaard Anders Højslet , Thomsen Ann Sofia Skou , Konge Lars , Grauslund Jakob
Published: January 2024

Purpose

To investigate whether individuals with long‐term reduced stereopsis were able to obtain the same level of surgical skills in simulated vitreoretinal surgery on the Eyesi Surgical Simulator as individuals with normal stereopsis.

Methods

Twenty‐four medical students were recruited and divided into two groups according to their degree of stereopsis: Group 1 (n = 12) included subjects with normal stereopsis (60 arcsec or lower) and Group 2 (n = 12) included subjects with reduced stereopsis (120 arcsec or higher). Stereopsis was tested using the TNO test (Lameris Ootech BV, Nieuwegein, the Netherlands). The participants were trained in virtual reality‐simulated vitreoretinal surgery and continuously measured using a test with solid validity evidence and a pre‐defined pass–fail score. All data were analysed using the Wilcoxon rank sum test.

Results

We observed no differences in overall performance scores for any of the four modules. The participants with reduced stereopsis used 5.8 more attempts in bimanual training (p = 0.04), 8.8 more attempts in removal of posterior hyaloid (p = 0.04), 9.1 more attempts in navigation training (p = 0.20) and 0.3 fewer attempts in removal of internal limiting membrane (p = 0.69).

Conclusion

The final performance scores on the Eyesi Surgical Simulator were independent of the degree of stereopsis. However, the number of attempts to achieve the pre‐defined pass–fail score increased significantly with reduced stereopsis in two of four modules. These results indicate that a high degree of stereopsis is not necessary to become proficient in microsurgery but may prolong the learning curve.
“We will be the ones bearing the consequences”: A qualitative study of barriers and facilitators to shared decision‐making in hospital‐based maternity care
Authors: Waddell Alex , Goodwin Denise , Spassova Gerri , Sampson Louise , Candy Alix , Bragge Peter
Published: January 2024

Background

Pregnant women involved in decisions about their care report better health outcomes for themselves and their children. Shared decision‐making (SDM) is a priority for health services; however, there is limited research on factors that help and hinder SDM in hospital‐based maternity settings. The purpose of this study was to explore barriers and facilitators to SDM in a large tertiary maternity care service from the perspectives of multiple stakeholders.

Methods

Qualitative semi‐structured interviews were undertaken with 39 participants including women, clinicians, health service administrators and decision‐makers, and government policymakers. The interview guide and thematic analysis were based on the Theoretical Domains Framework to identify barriers and facilitators to SDM.

Results

Women expect to be included in decisions about their care. Health service administrators and decision‐makers, government policymakers, and most clinicians want to include them in decisions. Key barriers to SDM included lack of care continuity, knowledge, and clinician skills, as well as professional role and decision‐making factors. Key facilitators pertained to policy and guideline changes, increased knowledge, professional role factors, and social influences.

Conclusion

This study revealed common barriers and facilitators to SDM and highlighted the need to consider perspectives outside the patient–clinician dyad. It adds to the limited literature on barriers and facilitators to SDM in hospital care settings. Organizational‐ and system‐wide changes to service delivery are necessary to facilitate SDM. These changes may be enabled by education and training, changes to policies and guidelines to include and support SDM, and adequately timed information provision to enable SDM conversations.
Assessing the Impact of the MAS Regime in Bolivia
Authors: Bojanic Antonio N.
Published: January 2024

This study aims to analyse the impact of the Movement towards Socialism (MAS) regime on GDP, income inequality and corruption levels. The empirical findings show that GDP has increased and corruption decreased with the MAS party in power. Income inequality, however, has tended to increase, even though average values for the Gini index during the MAS years have been lower. The difference between counterfactual and actual observations (i.e. treatment effects) was regressed against three key shocks experienced by the Bolivian economy and the findings demonstrate that all these shocks are correlated with the three outcome variables.
Betulinic acid reduces inflammation in rats with sepsis‐induced myocardial dysfunction by inhibiting TLR4/MyD88/NF‐κB signaling pathway
Authors: Wang Lei , Fei Wei‐yu , Song Qian‐ying
Published: January 2024

In this study, we aimed to investigate the effect and underlying mechanism of betulinic acid (BA) on myocardial dysfunction in septic rats. Twenty‐four male Sprague–Dawley rats were randomly allocated into four groups (n = 6 rats/group): the sham operation (Control) group, the cecal ligation and puncture (CLP) group, the BA 10 mg/kg group, and the BA 50 mg/kg group. The septic rat model was induced through cecal ligation and puncture in the CLP and BA groups, except for the Control group. Then, cardiac function parameters were assessed using echocardiography, myocardial injury markers were quantified via biochemical assays, and myocardial histopathological injuries were observed through H&E staining. Inflammatory factors in the serum were measured using ELISA assays, immunohistochemistry and qRT‐PCR were performed to determine macrophage numbers and the expression of iNOS, CD86, Arg‐1, and Mrc1 in myocardial tissue. The protein expression levels of TLR4, Myd88, and NF‐κB in myocardial tissue were assessed through western blot analysis. The results showed that BA significantly improved cardiac function, reduced myocardial injury, and attenuated inflammation in CLP rats. Specifically, BA decreased LVEDD and LVESD while increasing LVEF and LVFS. Furthermore, BA upregulated the levels of BNP, cTnT, CK‐MB, LDH, IL‐6, IL‐1β, and TNF‐α in CLP rat serum. Additionally, BA reduced macrophage infiltration, inhibited M1/M2 gene expression, and downregulated TLR4, Myd88 and NF‐κB protein expression in CLP rats myocardial tissues. In conclusion, BA can inhibit myocardial inflammation and prevent sepsis‐induced myocardial dysfunction by inhibiting TLR4/MyD88/NF‐κB signaling, thereby promoting M2 macrophage polarization in myocardial tissues.
Discovery of novel chromone and acrylate‐based pancreatic lipase inhibitors: Molecular modelling, synthesis, and in vitro evaluation for the treatment of obesity
Authors: Auti Prashant S. , Paul Atish T.
Published: January 2024

By the optimization of previously established pancreatic lipase (PL) inhibitory lead, we have developed novel chromone‐containing analogues with embedded acrylate fragment as potential PL inhibitors. The analogues were designed by considering the structural features required for binding at the active site of PL enzyme with the utilization of molecular docking study. An optimized synthetic scheme was utilized for the synthesis of designed analogues of prototypes 1&2. Through in vitro PL inhibitory screening, three analogues namely, 5fj, 5gj and 9a were identified as potent PL inhibitory leads with IC50 values of 4.92, 4.23 and 3.32 μM, respectively. The protein binding of analogue 9a was analysed by fluorescence quenching study and it was found to bind at one binding site with a binding constant of 1.93 × 105 L mol−1. Analogue 9a also exhibited a competitive inhibitory mechanism with Ki value of 1.601 μM. In future, the potent lead 9a can be optimized to get a comparable or more potential PL inhibitory activity than marketed drugs.
End‐to‐End Compressed Meshlet Rendering
Authors: Mlakar D. , Steinberger M. , Schmalstieg D.
Published: January 2024

In this paper, we study rendering of end‐to‐end compressed triangle meshes using modern GPU techniques, in particular, mesh shaders. Our approach allows us to keep unstructured triangle meshes in GPU memory in compressed form and decompress them in shader code just in time for rasterization. Typical previous approaches use a compressed mesh format only for persistent storage and streaming, but must decompress it into GPU memory before submitting it to rendering. In contrast, our approach uses an identical compressed format in both storage and GPU memory. Hence, our compression method effectively reduces the in‐memory requirements of huge triangular meshes and avoids any waiting times on streaming geometry induced by the need for a decompression stage on the CPU. End‐to‐end compression also means that scenes with more geometric detail than previously possible can be made fully resident in GPU memory. Our approach is based on a novel decomposition of meshes into meshlets,i.e. disjoint primitive groups that are compressed individually. Decompression using a mesh shader allows de facto random access on the primitive level, which is important for applications such as selective streaming and fine‐grained visibility computation. We compare our approach to multiple commonly used compressed meshlet formats in terms of required memory and rendering times. The results imply that our approach reduces the required CPU–GPU memory bandwidth, a frequent bottleneck in out‐of‐core rendering.
Student engagement in synchronous online learning: Effectiveness of camera and chat/vote engagement methods
Authors: Byers Reynold E. , Carter Craig R. , Wang Yimin
Published: January 2024

The advent of the COVID‐19 pandemic accelerated the need to conduct synchronous online instruction in which students and faculty were distributed geographically but aggregated digitally onto a single screen on a computer. This approach will likely persist into the future. Thus, a better understanding of how engagement approaches can be adapted to the synchronous online teaching environment is critical for future success. This research presents an experiment‐based investigation into the effectiveness of two often‐debated engagement approaches, namely, the camera‐on and the vote/chat approaches in a synchronous online learning environment. We found that using individual engagement methods, such as requiring cameras to be on or using the vote and chat functions to elicit student responses, improves learning outcomes. Surprisingly, the combined use of these methods hinders student learning, and they perform no better than the control group where no specific engagement methods were required. We posit that the reason for this result is that too much engagement increases total cognitive load to a point where it is detrimental to learning.
Ultrasound‐guided fetal thorax compression to reduce post‐fixation twins in the mare
Authors: Arnold Leonie C. , Stout Tom A. E. , Claes Anthony N. J.
Published: January 2024

Background

Management of twin pregnancy after conceptus vesicle fixation in the horse is challenging because the reduction techniques described are either invasive, difficult to perform or associated with disappointing success rates.

Objectives

To evaluate the success of transrectal ultrasound‐guided fetal thorax compression for reducing post‐fixation twin pregnancy in mares.

Study design

Retrospective clinical study.

Methods

Sixteen mares were presented for twin reduction between 51 and 79 days of gestation. History obtained from the owner and/or referring veterinarian detailed information regarding the mare (age, breed), pregnancy (day of gestation, dizygotic versus monozygotic twins, unilateral versus bilateral fixation), treatment and outcome (one live fetus at discharge; live singleton at foaling) after twin reduction. Transrectal fetal thorax compression was performed under ultrasound guidance by two experienced operators.

Results

Overall 9 of 16 twin pregnancies were successfully reduced and the likelihood of success was significantly higher in dizygotic than monozygotic twins. The procedure was successful in 9 of 10 dizygotic twins but unsuccessful in all six cases of monozygotic twins. Among the dizygotic twins, two mares lost the pregnancy after discharge from the clinic, seven mares delivered a healthy foal of normal size.

Main limitations

Small case number.

Conclusions

Transrectal ultrasound‐guided fetal thorax compression is a minimally‐invasive and successful technique for reducing dizygotic twin pregnancies at approximately 2 months of gestation, but does not lead to any live births in cases of monozygotic twins.
Hydraulic fracturing behavior of shale–sandstone interbedded structure under true triaxial stress conditions: A comprehensive experimental analysis
Authors: Sheng Xiangchao , Yang Lei , Wang Tingyi , Zhou Xiaosheng , Yu Honghao , Zhang Yaolei , Fu Xin , Mei Jie , Pei Yan
Published: January 2024

Reservoirs characterized by shale–sandstone interbedded structures are extensively dispersed throughout China, and understanding the propagation mode of hydraulic fractures is a prerequisite for shale gas exploitation engineering. In this study, hydraulic fracturing tests were conducted using horizontal wells subjected to true triaxial compression conditions to elucidate the mechanism by which the initiated layer lithology and stress state influence the fracture morphology. Furthermore, the propagation mode of the fractures and the consequential effects on fracture network formation were investigated. The findings demonstrate four distinct interaction modes between the shale–sandstone interfaces and hydraulic fractures. The lithology of the initiated layer influences the fracture propagation trajectory, thereby affecting the propagation modes at the shale–sandstone interface and resulting in varying effects on layer penetration. The stress difference exerts a significant controlling influence on the fracturing behavior, enhancing the possibility of interconnecting multiple rock layers characterized by substantial stress differences.
The questions being asked: Academic research, the media, and regulators
Authors: Lowry Michelle
Published: January 2024

Academic research should strive to increase our understanding of the world we live in, and as such open the door for improvements in this world. With this goal in mind, this piece represents a call for academics to jointly consider their research agenda and the audience for this research. This audience might include people working in industry or policy makers. Closer connections between academia and broader audiences contribute to research that informs debates on the salient issues of today, higher quality studies on these issues, and greater impact. To provide insight on the relation between academic research and the most salient current issues, I compare topics of focus within academic journals with topics of focus in industry articles and regulatory publications. I identify gaps and suggest areas for future research.
Helicobacter pylori infection and inflammasomes
Authors: Zheng Huiling , Xia Pengyan , Fu Weiwei , Ding Shigang
Published: January 2024

Helicobacter pylori (H. pylori) causes the most prevalent bacterial infection worldwide, and more than half of the world's population is infected with H. pylori. Classified as a group 1 carcinogen of gastric cancer, H. pylori infection causes the most common chronic gastritis, which is able to progress to chronic atrophic gastritis, dysplasia, and even gastric cancer. The inflammasomes are important cytosolic multiprotein complexes to coordinate the host defense against foreign microorganisms and control the inflammatory response. It is also well‐known that inflammasome plays an important role in the occurrence of H. pylori‐induced gastric inflammation. During infection and inflammation, the activation process of inflammasome is tightly regulated by host immune system. However, excessive activation of inflammasome is closely related to the production of excessive cytokines that cause the body injury and resulting in various inflammatory diseases. In this review, we elaborate the activation and assembly mechanisms of inflammasome, the structure of different inflammasome complexes, host factors in vivo and drugs in vitro that regulate inflammasome signaling during H. pylori infection, aiming to provide novel insights and strategies for identifying new therapeutic targets for the treatment of H. pylori‐associated gastric mucosal diseases.
Paving the way for a non‐antibiotic and microbiota friendly therapy for Helicobacter pylori: In vitro and in vivo performance of lipid nanoparticles
Authors: Seabra Catarina Leal , Pinho A. Sofia , Nunes Cláudia , Amorim Irina , Pedro Nicole , Henriques Patrícia , Monteiro Cláudia , Gomes Joana , Machado Cláudia , Gartner Fátima , Pereira Luísa , Reis Salette , Reis Celso A. , Touati Eliette , Gonçalves Inês C. , Parreira Paula , Martins M. Cristina L.
Published: January 2024

Background

The World Health Organization has identified Helicobacter pylori, a Gram‐negative bacterium responsible for several gastric disorders, as one of the pathogenic bacteria that requires newer non‐antibiotic approaches for its management. We previously demonstrated that nanostructured lipid carriers (NLC) loaded with docosahexaenoic acid (DHA‐NLC) have excellent in vitro performance against H. pylori.

Materials and Methods

NLC were tested against different H. pylori strains and bacteria representative from human gut microbiota. For H. pylori, resistance development and membrane permeability assays were also performed. In vivo efficacy studies were done using an H. pylori‐infected mouse model. Microbiome analysis (16S rRNA sequencing analysis) was performed on mice feces before and after DHA‐NLC treatment.

Results

NLC specifically killed different H. pylori strains by membrane disruption without inducing bacterial resistance. In vivo studies demonstrated that DHA‐NLC (2 mg/mL containing 50 μM of DHA) reduced 90%–95% of the H. pylori burden and eradicated infection in 50% of the animals when treatment was administrated ad libitum for 14 days. No significant differences were found between the administration procedure (ad libitum vs oral gavage). Also, increasing the DHA‐NLC concentration to 4 and 8 mg/mL did not translate into an improvement in antibacterial performance. Notably, gut microbiome analysis showed no alterations, highlighting the safety to the gut microbiota. Finally, no histopathological changes were reported (stomach/liver sections).

Conclusions

Overall, our results emphasize DHA‐NLC as a promising approach for H. pylori infection management, since they can effectively reduce the H. pylori burden without affecting gut microbiota and, in opposition to antibiotics, without anticipating the development of resistance to this treatment.
Conceptualising the role of practice level in language teacher identity construction: An identities‐in‐practice study
Authors: Derakhshan Ali , Moradi Farhang , Nazari Mostafa
Published: January 2024

Language teachers deal with different groups of learners as a natural aspect of their professional careers. However, little is known about how teachers construct their identities in response to various learner groups. This study relies on the concept of identities‐in‐practice and explores how six English‐L2 teachers construct their identities across beginner and advanced levels of teaching. Data were collected from semi‐structured interviews, stimulated recalls, and classroom observations to examine teacher identities across the two practice levels. Data analyses revealed similarities and differences in teacher identities across the two levels, which involved three components: agentic variations, discursive realisations, and extended identities. These findings provide novel implications for understanding language teacher identity construction across different learner groups. The study also provides implications for teachers and teacher educators to pay focal attention to the role identity plays in teachers’ work across different practice levels.
Charting the path of sustainability discourse research: A systematic review of applied linguistic studies
Authors: Nervino Esterina , Cheung Joyce Oiwun , Chen Jiayi
Published: January 2024

This paper aims to understand the state‐of‐the‐art of research on sustainability discourse in applied linguistics. The paper adopts a systematic two‐stage review approach. In the first stage, 114 articles were classified into environment, social, and governance (ESG) according to the Global Reporting Initiative (GRI) categories. The second stage involves annotating the dataset using an open‐coding system based on data types explored in the studies, methodologies used, findings, and implications. The findings lead to a comprehensive review of diachronic changes in the investigation of sustainability topics, data types, sampling, frameworks, analytical tools, findings, and implications to ultimately set the grounds for future research on sustainability discourse in applied linguistics and related disciplines—for example, communication studies.
Control beliefs about stress and post‐traumatic growth in nurses during the COVID‐19 pandemic: The mediating roles of basic psychological needs satisfaction and optimism
Authors: Bai Chengzhi , Bai Baoyu
Published: January 2024

The purpose of this study was to examine the relationship between control beliefs about stress and post‐traumatic growth among Chinese nurses during the COVID‐19 pandemic and to examine the mediating role of basic psychological needs satisfaction and optimism in this relationship. A total of 692 Chinese nurses participated in this online study, who completed the Beliefs about Stress Scale, Post‐Traumatic Growth Inventory, Positive Psychological Capital Questionnaire, Basic Psychological Needs Satisfaction Scale and demographic variables between September and October 2020. Results indicate that 48.8% (N = 388) of nurses reported significant post‐traumatic growth related to the COVID‐19 pandemic. Moreover, control beliefs about stress were positively related to post‐traumatic growth (r = 0.38, p < 0.001), basic psychological needs satisfaction (r = 0.44, p < 0.001) and optimism (r = 0.47, p < 0.001). In addition, basic psychological needs satisfaction and optimism were both independent and serial mediators of the relationship between control beliefs about stress and post‐traumatic growth. Nurses and hospital administrators should focus on increasing nurses' control beliefs about stress and thereby enhancing their post‐traumatic growth after experiencing events such as the COVID‐19 pandemic. To support this process, programs should be designed to meet nurses' basic psychological needs and increase their optimism.
Influence of defect chemistry on the electromechanical strain properties of BNT–ST‐based ternary systems
Authors: Duong Trang An , Nguyen Hoang Thien Khoi , Frömling Till , Ahn Chang Won , Kim Byeong Woo , Han Hyoung‐Su , Lee Jae‐Shin
Published: January 2024

In this study, the stabilization of ergodicity and electromechanical strain properties of lead‐free ternary 0.75Na1/2Bi1/2TiO3–0.24SrTiO3–0.01ABO3 piezoceramics (BNT–24ST, ABO3 = BaZrO3 (BZ), CaTiO3 (CT), and BiFeO3 (BF)) were investigated. The relaxor state could be stabilized in BZ‐and BF‐modified BNT–24ST ceramics even at room temperature, whereas pure BNT–24ST and CT‐modified ceramics exhibited ferroelectric (FE) behavior. These phenomena were rationalized by analyzing the temperature‐dependent permittivity; detecting the FE‐relaxor phase transition temperature (TF‐R); and investigating features in strain, polarization, and switching current curves. Furthermore, high‐temperature conductivity data showed that relaxor behavior and realization of large strain properties strongly correlated with the concentration of oxygen vacancies in ABO3‐modified BNT–ST ternary systems.
Long‐term exposure to ambient fine particulate matter and periodontitis: An observational study using nationally representative survey data
Authors: Li Wenjing , Li Na , Liang Zhisheng , Hou Xingduo , Si Yan , Wang Xing , Feng Xiping , Tai Baojun , Hu Deyu , Lin Huancai , Wang Bo , Wang Chunxiao , Zheng Shuguo , Liu Xuenan , Rong Wensheng , Wang Weijian , Sun Shengzhi , Meng Huanxing , Zhang Zhenyu
Published: January 2024

Aim

The rising prevalence of periodontitis imposes substantial burdens on individuals and society. Identifying environmental risk factors for periodontitis may contribute to tackling the global public health burden of it. This study aimed to assess the association between long‐term exposure to PM2.5 and periodontitis in a nationally representative population from China.

Materials and Methods

In this multi‐centre cross‐sectional study of 372 communities in 31 provinces of Mainland China, we used data from the Fourth National Oral Health Survey of China in 2015–2016, in combination with high‐resolution gridded concentrations of fine particulate matter (PM2.5). Logistic regression was applied to assess the relationship between long‐term PM2.5 exposure and the risk of periodontitis. In addition, we examined whether the association varied by individual characteristics, and estimated the exposure–response relationship and the risk of damaged tooth in each tooth quadrant.

Results

A total of 8391 participants from 96 cities were diagnosed with periodontitis, accounting for 60.04% (8391/13,459) of the participants. For each 10 μg/m3 increment in 1‐, 3‐ and 5‐year average concentrations of PM2.5, the risk of total periodontitis increased by 9.0% (95% confidence interval: 6.0%, 12.0%), 8.0% (6.0, 11·0) and 7.0% (5.0, 10.0), respectively. Mild periodontitis was more strongly associated with PM2.5 exposure than moderate and severe periodontitis. The teeth in the lower anterior, lower posterior or upper anterior are more susceptible to the effect of PM2.5 on the periodontal pocket, calculus and bleeding gums.

Conclusions

Long‐term exposure to PM2.5 is significantly associated with an increased risk of periodontitis in the nationally representative Chinese population. Considering the rising prevalence of periodontitis, considerable costs of treatment, and substantially adverse effects on individuals and society, these findings suggest that stricter air quality regulations may help ease the burden of periodontal disease.
Consensus for a primary care clinical decision‐making tool for assessing, diagnosing, and managing low back pain in Alberta, Canada
Authors: Eubank Breda H. F. , Martyn Jason , Schneider Geoff M. , McMorland Gord , Lackey Sebastian W. , Zhao Xu Rong , Slomp Mel , Werle Jason R. , Robert Jill , Thomas Kenneth C.
Published: January 2024

Background

Low back pain (LBP) is a common condition causing disability and high healthcare costs. Alberta faces challenges with unnecessary referrals to specialists and long wait times. A province‐wide standardized clinical care pathway based on evidence‐based best practices can improve efficiency, reduce wait times, and enhance patient outcomes. Implementing such pathways has shown success in other areas of healthcare in Alberta. This study developed a clinical decision‐making pathway to standardize care and minimize uncertainty in assessment, diagnosis, and management.

Methods

A systematic rapid review identified existing tools and evidence that could support a comprehensive LBP clinical decision‐making tool. Forty‐seven healthcare professionals participated in four rounds of a modified Delphi approach to reach consensus on the assessment, diagnosis, and management of patients presenting to primary care with LBP in Alberta, Canada. This project was a collaborative effort between Alberta Health Services’ Bone and Joint Health Strategic Clinical Network (BJHSCN) and the Alberta Bone and Joint Health Institute (ABJHI).

Results

A province‐wide expert panel consisting of professionals from different health disciplines and regions collaborated to develop an LBP clinical decision‐making tool. This tool presents clinical care pathways for acute, subacute, and chronic LBP. It also provides guidance for history‐taking, physical examination, patient education, and management.

Conclusions

This clinical decision‐making tool will help to standardize care, provide guidance on the diagnosis and management of LBP, and assist in clinical decision‐making for primary care providers in both public and private sectors.
Healthcare contact days among older adults living with dementia
Authors: Chant Emma D. , Ritchie Christine S. , Orav E. John , Ganguli Ishani
Published: January 2024

Background

For older adults with dementia and their care partners, accessing health care outside the home involves substantial time, direct and indirect costs, and other burdens. While prior studies have estimated days spent by these individuals in or out of hospitals and nursing homes, ambulatory care burdens are likely substantial yet poorly understand. Therefore, we characterized “health care contact days”—days spent receiving ambulatory or institutional care—in this population.

Methods

We used 2019 Medicare Current Beneficiary Survey data linked to claims for community‐dwelling, ≥65‐year‐old adults with dementia in Traditional Medicare. We measured contact days including ambulatory days (with an office visit, test, imaging, procedure, or treatment) and institutional days (spent in an emergency department, hospital, skilled nursing facility, or hospice facility). We described variation and patterns in contact days. Using multivariable Poisson regression, we identified sociodemographic and clinical factors associated with contact days.

Results

In weighted analyses, 887 older adults with dementia (weighted: 2.9 million) had mean (SD) 31.1 (33.7) total contact days/year, of which 21.7 (20.6) were ambulatory. Ten percent had ≥68 contact days in the year. One‐third (34%) of ambulatory contact days involved multiple services. In multivariable models, receipt of more ambulatory contact days was associated with younger age (65–74 reference vs. −32.3% [95% CI: −42.2%, −20.7%] for 85+), higher income (>200% Federal Poverty Level [FPL] reference versus −16.6% [95% CI: −26.7%, −5.0%] for ≤200% FPL), and lack of functional impairment (reference versus −14.6% [95% CI: −23.7%, −4.4%]). Each additional chronic condition was associated with 8.2% (95% CI: 6.7%, 9.8%) more ambulatory contact days.

Conclusions

Older adults with dementia spent 31 days a year accessing care which was mostly ambulatory. These days varied widely by both clinical and sociodemographic factors. These results highlight the need to reduce patient burden through strategies such as reducing unneeded care, coordinating care, and shifting care to home settings through telemedicine and home care.
Paleoarchean metamorphism in the Acasta Gneiss Complex: Constraints from phase equilibrium modelling and in situ garnet Lu–Hf geochronology
Authors: Kaempf Jonas , Johnson Tim E. , Clark Chris , Alfing Julian , Brown Michael , Lanari Pierre , Rankenburg Kai
Published: January 2024

The oldest known evolved (felsic) rocks on Earth (c. 4.03 Ga) are found in the Acasta Gneiss Complex (AGC) in north‐western Canada and represent a fundamental keystone in unravelling the geological processes governing crustal growth and differentiation during the Hadean and early Archean. Although the timing of multiple episodes of magmatism, metamorphism and deformation in these tonalitic gneisses has been investigated extensively, the metamorphic pressure–temperature (P–T) conditions recorded by the rocks are poorly constrained. Here, we use phase equilibrium modelling coupled with in situ garnet Lu–Hf geochronology and trace element analysis for two garnet‐bearing tonalitic gneisses to decipher the metamorphic history of the AGC. The observed mineral assemblages are consistent with peak metamorphic conditions of T = 725–780°C and P = 4.5–6.2 kbar and the generation of a small amount of melt (<7 vol.%). Garnet geochronology constrains the age of metamorphism to 3.3–3.2 Ga, consistent with previous evidence for a late Paleoarchean tectono‐metamorphic event in the AGC. Subsequent isotopic disturbance of garnet at c. 1.9 Ga is interpreted to correspond to a modification of the primary Lu–Hf systematics in response to garnet resorption/recrystallization during the Paleoproterozoic Wopmay orogeny, resulting in significant scatter between these two age components. Our study adds to the small number of published P–T data for metamorphic rocks older than 2.8 Ga and shows that tonalitic gneisses in the AGC record a high apparent thermal gradient of ~140°C/kbar in the late Paleoarchean. This thermal gradient is the highest among the limited dataset, but is broadly similar to data from other Paleoarchean‐Mesoarchean crustal rocks in recording high T/P ratios (>77.5°C/kbar).
Sirenomelia: An anatomical assessment and genetic sex determination of two cases
Authors: Vander Pol Stephanie L. , MacKenzie Jennifer J. , Harrison Karen J. , Reifel Conrad W. , Smith Roger M. L. , Bale Logan , Pang Stephen C. , Taylor Sherry A. M.
Published: January 2024

The etiology of sirenomelia is currently unknown. Data are limited in comparing external and internal abnormalities using modern imaging technologies and molecular genetic analysis. The purpose of the current study was designed to compare external and internal anatomical defects in two cases of sirenomelia and Potter's sequence. Considered rare, Potter's sequence is a fetal disorder with characteristic features of bilateral renal agenesis, obstructive uropathy, atypical facial appearance, and limb malformations. The internal and external malformations of two term fetuses with sirenomelia and Potter's sequence were compared using assessment of external features, radiography and MRI on internal structures, and molecular genetic studies on sex determination. Data reveal that both fetuses were male and manifested with an overlapping but distinct spectrum of abnormalities. Principal differences were noted in the development of the ears, brain, urogenital system, lower limbs, pelvis, and vertebral column. Defects of the axial mesoderm are likely to underlie the abnormalities seen in both fetuses. The first one, which had only caudal defects, was found to have a spectrum of abnormalities most similar to those associated with more severe forms of the small pelvic outlet syndrome, although the structure and orientation of the sacrum and iliae were different from previously reported cases. The other had both caudal and cranial defects, and was most similar to those described in the axial mesodermal dysplasia syndrome. Defects associated with sirenomelia can be evaluated with standard gross anatomy examination, radiology, MRI, and modified PCR techniques to determine anatomical abnormalities and the sex of preserved specimens, respectively. Evidence indicated that sirenomelia could be developed via various etiologies.
Integrative bioinformatics and experimental validation of hub genetic markers in acne vulgaris: Toward personalized diagnostic and therapeutic strategies
Authors: Lin Qian , Cai Beichen , Ke Ruonan , Chen Lu , Ni Xuejun , Liu Hekun , Lin Xinjian , Wang Biao , Shan Xiuying
Published: January 2024

Background

Acne vulgaris is a widespread chronic inflammatory dermatological condition. The precise molecular and genetic mechanisms of its pathogenesis remain incompletely understood. This research synthesizes existing databases, targeting a comprehensive exploration of core genetic markers.

Methods

Gene expression datasets (GSE6475, GSE108110, and GSE53795) were retrieved from the GEO. Differentially expressed genes (DEGs) were identified using the limma package. Enrichment analyses were conducted using GSVA for pathway assessment and clusterProfiler for GO and KEGG analyses. PPI networks and immune cell infiltration were analyzed using the STRING database and ssGSEA, respectively. We investigated the correlation between hub gene biomarkers and immune cell infiltration using Spearman's rank analysis. ROC curve analysis validated the hub genes' diagnostic accuracy. miRNet, TarBase v8.0, and ChEA3 identified miRNA/transcription factor–gene interactions, while DrugBank delineated drug–gene interactions. Experiments utilized HaCaT cells stimulated with Propionibacterium acnes, treated with retinoic acid and methotrexate, and evaluated using RT‐qPCR, ELISA, western blot, lentiviral transduction, CCK‐8, wound‐healing, and transwell assays.

Results

There were 104 genes with consistent differences across the three datasets of paired acne and normal skin. Functional analyses emphasized the significant enrichment of these DEGs in immune‐related pathways. PPI network analysis pinpointed hub genes PTPRC, CXCL8, ITGB2, and MMP9 as central players in acne pathogenesis. Elevated levels of specific immune cell infiltration in acne lesions corroborated the inflammatory nature of the disease. ROC curve analysis identified the acne diagnostic potential of four hub genes. Key miRNAs, particularly hsa‐mir‐124‐3p, and central transcription factors like TFEC were noted as significant regulators. In vitro validation using HaCaT cells confirmed the upregulation of hub genes following Propionibacterium acnes exposure, while CXCL8 knockdown reduced pro‐inflammatory cytokines, cell proliferation, and migration. DrugBank insights led to the exploration of retinoic acid and methotrexate, both of which mitigated gene expression upsurge and inflammatory mediator secretion.

Conclusion

This comprehensive study elucidated pivotal genes associated with acne pathogenesis, notably PTPRC, CXCL8, ITGB2, and MMP9. The findings underscore potential biomarkers, therapeutic targets, and the therapeutic potential of agents like retinoic acid and methotrexate. The congruence between bioinformatics and experimental validations suggests promising avenues for personalized acne treatments.
Independent genetic differentiation between upland and lowland rice ecotypes within japonica and indica subspecies during their adaptations to different soil‐nitrogen conditions
Authors: Zhou Heng‐Ling , Wang Lei , Yue Yun‐Xia , Luo Zhi , Wang Shun‐Jie , Zhou Li‐Guo , Luo Li‐Jun , Xia Hui , Yan Ming
Published: January 2024

The soil‐nitrogen condition, which differs greatly between paddy fields (mainly in the form of ammonium, NH4+) and dry fields (mainly in the form of nitrate, NO3−), is a main environmental factor that drives the adaptive differentiation between upland and lowland rice ecotypes. However, the adaptive differentiation in terms of the nitrogen use efficiency (NUE) between upland and lowland rice has not been well addressed. In this study, we evaluated NUE‐related traits among rice landraces as well as the genetic differentiation between NUE‐associated genes and quantitative trait loci (QTLs). The japonica upland and lowland rice ecotypes showed large differences in their NUE‐related traits such as the absorption ability for NH4+ and NO3−. The indica upland and lowland rice exhibited similar performances when cultivated in solutions containing NH4+ or NO3− or when planted in paddy or dry fields. However, the indica upland rice possessed a greater ability to absorb NO3−. We identified 76 QTLs for 25 measured traits using genome‐wide association analysis. The highly differentiated NUE‐associated genes or QTLs between ecotypes were rarely shared by japonica and indica subspecies, indicating an independent genetic basis for their soil‐nitrogen adaptations. We suggested four genes in three QTLs as the candidates contributing to rice NUE during the ecotypic differentiation. In summary, the soil‐nitrogen condition drives the adaptive differentiation of NUE between upland and lowland rice independently within the japonica and indica subspecies. These findings can strengthen our understanding of rice adaptation to divergent soil‐nitrogen conditions and have implications for the improvement of NUE.
Human to machine innovation: Does legal personhood and inventorship threshold offer any leeway?
Authors: Igbokwe Ezinne Mirian
Published: January 2024

Artificial Intelligence (AI) continues to be a powerful tool in the research and development ecosystem. AI computers are invented to assist human invention and also created to invent. Where an AI is created to invent, through self‐learning, they can interact with set of data presumably created by humans and as a result, a new patentable invention(s) can emerge. However, where the AI inventors and the resulting inventions sit within the inventorship legal framework, and the theory of legal personhood continues to raise legal and policy questions that challenge some underlying or presumed settled intellectual property law assumptions. One of the contentions has been the implications of the AI machine's autonomous inventions on the legislative and judicially established threshold for patent inventorship and the jurisprudential theory of legal personhood. The judicial decisions in the United States of America (USA), United Kingdom (UK), and Australia in the Device for the Autonomous Bootstrapping of Unified Sentience (DABUS) patent applications have given judicial certainty on whether AI machine inventors qualify as inventors. However, they also reawakened the debate about the need to sustain patent incentives for AI innovations. This article draws from the inventorship threshold in the UK and US following the court decisions in the DABUS cases. The judicial decisions of courts and the administrative judgements of national Intellectual Property Offices (IPOs) relating to inventorship as well as the theory of legal personhood, reveal that an AI machine invention can be patent eligible. However, the machine does not satisfy the inventorship criteria and consequently is incapable of being named an inventor. On the other hand, the inventorship requirement of contemporaneous conception and reduction to practice meant that an AI owner/programmer may not satisfy the requirement of inventorship, even though he/she programmed the inventing machine. These decisions and judgements favour an implied situation where autonomous AI inventions could be without named inventors and owners. Consequently, those inventions will automatically form part of prior arts thereby rendering myriads of future human and AI inventions obvious or already existing in the public domain. In contributing to the discourse, this article advances the argument that to optimise the patent system, national IPOs and the courts can rely on ‘simultaneous conception and reduction to practice’ to recognise the programmer/owner or other relevant stakeholders in AI innovation as the inventor of AI autonomous inventions.