bluuebunny/crossref_metadata_2025 huggingface dataset:
Lifestyle, caries, and apical periodontitis: Results from a university‐based cross‐sectional study
Authors: Gaeta Carlo , Malvicini Giulia , Di Lascio Dominga , Martignoni Marco , Ragucci Gabriele , Grandini Simone , Marruganti Crystal
Published: November 2024

Aim

Lifestyle factors significantly influence the development of inflammatory diseases, and emerging evidence suggests they may also impact oral health. However, no studies have explored their role in apical periodontitis (AP) amongst adults. This study aimed to assess the association between adherence to the Mediterranean diet (MD), physical activity, perceived stress, and sleep quality with the periapical and caries status in a university‐based cohort.

Methodology

A total of 149 periodontally healthy patients were included in the study. Clinical assessments and radiographic examinations [Orthopantomography (opt) and periapical radiographs] were conducted to evaluate the periapical status. Data on their periapical index (PAI) score and the decayed, missing and filled teeth (DMFT) index were recorded. Validated questionnaires were used to investigate patient's lifestyles. A final logistic regression model was performed for the multivariable analysis to evaluate the predictive ability of adherence to Mediterranean lifestyle on the presence of AP; other local, systemic and environmental factors were included as independent factors in the model.

Results

Significant associations were observed between AP and high/low adherence to the MD (p = .00), high/low‐moderate physical activity (p = .00), high/low sleep quality (p = .00) and high/low perceived stress (p = .00). The final multivariable regression model showed that low adherence to MD (OR = 3.68; 95% confidence interval [CI]: 1.24–10.83; p = . 01) and reduced sleep quality (OR = 3.04; 95% CI: 1.42–6.50; p = .00) were identified as potential risk factors for AP development. On the other hand, the DMFT index showed no significant association with lifestyle factors (OR = 1.0; CI: 1.01–1.14; p = .02) but was correlated with the development of AP (OR = 1.07; CI: 1.01–1.14; p = .02).

Conclusion

Results from the present study suggest a potential association between low adherence to MD and reduced sleep quality with the development of AP. Individuals with low adherence to MD and inadequate sleep quality faced respectively 4‐fold and 3‐fold increased odds of developing periapical lesions. Further research is essential to elucidate the causal mechanisms underlying these associations and to determine whether lifestyle adjustments could improve endodontic success rate.
A single‐cell transcriptomic atlas of human stem cells from apical papilla during the committed differentiation
Authors: Weng Yingying , Xiao Ya , Shi Yijia , Li Na , Wang Jing , Yan Ming , Yu Jinhua , Li Zehan
Published: November 2024

Aim

Human stem cells derived from the apical papilla (SCAPs) are recognized for their multilineage differentiation potential and their capacity for functional tooth root regeneration. However, the molecular mechanisms underlying odonto/osteogenic differentiation remain largely unexplored. In this study, we utilized single‐cell RNA sequencing (scRNA‐seq) to conduct an in‐depth analysis of the transcriptional changes associated with chemically induced osteogenesis in SCAPs.

Methodology

scRNA‐seq identified SCAPs as distinct subpopulations. Differentially expressed genes (DEGs) and Gene Ontology (GO) analyses were conducted to evaluate the potential function of each cluster. Pseudotime trajectory analysis was employed to elucidate the potential differentiation processes of the identified SCAP populations. To investigate the osteo/odontogenic potential of Deiodinase Iodothyronine Type 2 (DIO2) on SCAPs, we performed alkaline phosphatase staining, western blot analysis, Alizarin Red S staining and immunofluorescence staining. Additionally, SCAP components were transplanted into mouse calvarial defects to evaluate osteogenesis in vivo.

Results

The analysis of cell clusters derived from our scRNA‐seq data revealed a significant shift in cellular composition when cells were cultured in a mineralization induction medium compared to those cultured in a complete medium. Both groups exhibited heterogeneity, with some cells intrinsically predisposed to osteogenesis and others appearing to be primed for proliferative functions. Notably, we identified a subpopulation characterized by high expression of DIO2, which exhibited pronounced osteogenic activity during differentiation.

Conclusions

Our study is the first to reveal a shift in the cellular composition of SCAPs when cultured in a mineralization induction medium compared to a complete medium. Following both in vitro and in vivo validation, the DIO2+ subpopulation exhibited the highest transcriptional similarity to osteogenic function, suggesting its potential utility in tissue regeneration applications.
Infants show negative changes in affect and physiology when re‐experiencing a stressor, its context, and a positive event 24‐h later
Authors: Mueller Isabelle , Snidman Nancy , DiCorcia Jennifer A. , Tronick Ed
Published: November 2024

Exposure to early life stress shapes further development, affects later stress reactivity, and mental health outcomes. Despite the central role of early experiences, there is little understanding of how these rapidly forgotten events gain their influence. An infant's ability to cope with everyday stressors is founded on successful co‐regulation through mother‐infant interaction. A significant disruption of this interaction through the Face‐to‐Face Still‐Face paradigm elicits a well‐documented behavioral and physiological stress response in infants. What has yet to be explored is whether infants show regulatory adaptions when encountering the situation over again. To fill this gap, 80 mother‐infant dyads were observed in the lab on two consecutive days. Infants in the experimental condition (n = 40) were exposed to a double Still‐Face paradigm on day one. Infants in the control group (n = 40) completed time‐matched episodes of typical play during their first visit. Mother‐infant dyads from both groups returned to the lab 24 h later and participated in the double Still‐Face paradigm. Changes in behavior (positive and negative affect), physiology (heart rate), and salivary cortisol, compared to day one and between groups, were evaluated and used to infer adaption to the previous experienced laboratory visit. Infants in the experimental condition showed a significant decrease in positive affect (p = 0.016) and an increase in heart rate (p < 0.001) on day two, compared to controls, even during baseline measures and a neutral first play episode. Infants in the control condition showed a significant decrease in affect (p = 0.05) and non‐significant increase in heart rate on day two when first encountering the Still‐Face paradigm. Infants in the experimental condition showed significant higher heart rate on day two compared to the control group (p = 0.046). Infants in the experimental condition also exhibited a marginally significant increase in salivary cortisol on day two, compared to day one (p = 0.054). The change in infant heart rate was independent of maternal heart rate which did not differ between day one and day two, or between groups. Findings suggest that a previous stressful experience may elicit a behavioral and physiological adaption in infants 24 h later. Our results suggest that even a short, acute stressful event can elicit a lasting stress response in infants 24 h later. The effect we observed was specific to the context of the stressful event, not just the stressor. More precisely, the effect “spilled over” from the stressful experience on day one into the baseline measure of day two, usually a neutral experience. The results could have implications for further research on how stressful experiences may shape the stress response.
Monocarboluminate: Sorption dependence of thermal, elastic, and transport properties
Authors: Honorio Tulio
Published: November 2024

Monocarboaluminate is the major phase in calcium aluminate cements and is the main AFm phase in modern cement that incorporates limestone additions, including limestone calcined clay cement. This study reports thermal, elastic, and transport properties of monocarboaluminate obtained from molecular simulations. Properties and structural features are computed as a function of the relative humidity (RH) and water content. Full elastic, thermal expansion and thermal conductivity tensors are provided. Quantum‐corrected estimates are provided for the heat capacity and thermal conductivity. Self‐diffusion of interlayer species is also quantified, accounting for the subdiffusive regime. This work contributes to completing property data for critical phases in cement systems.
Liquidus of SiO2 in the Li2O‐SiO2, Na2O‐SiO2, and K2O‐SiO2 systems
Authors: Lee Jaesung , Lauriano Paloma , Jung In‐Ho
Published: November 2024

The phase equilibria in the SiO2‐rich region of the Li2O‐, Na2O‐, and K2O‐SiO2 systems at 1550°C to 1650°C were experimentally studied to determine accurate liquidus of SiO2 in the systems. A classical equilibration/quenching method was used, and the equilibrated samples were analyzed by X‐ray diffraction (XRD) and electron probe microanalysis (EPMA). Samples were contained in sealed Pt crucibles and held at the target temperatures for 7–21 days to reach equilibrium condition. Sealed Pt crucibles were employed to avoid the volatile loss of alkali oxides during high temperature phase equilibration and hydration upon quenching. Accurate liquidus of SiO2 in alkali‐silicate systems was determined for the first time, and the results were analyzed using the limiting slope rule in order to understand the dissolution behavior of alkali oxides in SiO2 melt. It was confirmed that alkali oxide dissolves in SiO2 melt by producing Li+, Na+, and K+ cationic species rather than Li22+, Na22+ and K22+ species.
Using metabolic data to investigate the role of brood size in the development of endothermy
Authors: Engert Elana Rae , Andreasson Fredrik , Nord Andreas , Nilsson Jan‐Åke
Published: November 2024

Altricial songbirds transform themselves from naked poikilotherms to fully feathered endothermic homeotherms over a matter of days from hatching to fledging. The ontogeny of endothermy is a developmental milestone for birds that not only face warmer average temperatures, but also increasingly frequent cold snaps and extreme weather. The timing of development of endothermy has been studied in altricial birds for over half a century. However, the determinants and constraints of the onset of endothermy are not yet fully understood. We experimentally investigated whether brood size influences the ontogeny of endothermic heat production in 4–8 day‐old nestling blue tits Cyanistes caeruleus in southern Sweden. The thermogenic response to a cooling challenge (15°C) increased with age overall. We found that 8‐day‐old nestlings from reduced broods had a slightly increased capacity for endothermic heat production compared to enlarged broods. This difference cannot be explained by body mass because this trait did not differ between brood size categories. Although a metabolic response was present in most nestlings by day 6, it was brief, not lasting more than a few minutes, and not sufficient to maintain a stable body temperature in any age group. Our study shows that incipient endothermy is present at an early age in nestling blue tits and may advance faster in reduced broods, but that individual nestlings lack sufficient insulation and thermogenic performance to maintain homeothermy independently during the first week of life.
An Ecoinformatic Model Using Rényi's Entropy Predicts Soil Chemistry Effect on Tree Species Abundance Distributions
Authors: Xu Meng , Brush Micah
Published: November 2024

Aim

An ecological community consists of species of various abundances that reflect their responses to the environmental conditions. A classic macroecological pattern, the species abundance distribution (SAD), has been studied for diverse taxa and communities and integrated into numerous modelling tools. Despite its widespread use, a mathematical model that can capture variations in the empirical SAD and describe its response to environmental changes is still lacking. By integrating the Maximum Entropy Theory of Ecology (METE) with a generalised entropy called Rényi's entropy, we aim to develop a new ecoinformatic model that can predict the variation of empirical SAD along multiple environmental gradients.

Location

Panama.

Taxon

Angiosperms.

Methods

We extend the METE using the Rényi's entropy as an uncertainty measure. We apply this extended METE, called Rényi model, to the tree abundance data from 49 plots in Panama and predict the SAD within each plot. We estimate Rényi's parameter q by fitting the predicted SAD to the empirical SAD in each plot. We further compile climate and soil data from the Panama plots and analyse their relationships with the estimated q using multiple regressions.

Results

Rényi model provides adequate description of the empirical SADs and outperforms lognormal or log‐series models in 40 of the 49 tree plots, according to the Akaike information criterion. Variations in Renyi's q estimates (from 1/2 to 1) reflect shifts in the empirical SADs. Multiple regressions reveal that P, Al and NH4, three soil chemicals that are important for tree growth and species distribution, significantly affect Renyi's q across plots.

Main Conclusions

These findings suggest that the Rényi model and Rényi's q can characterise the SAD of communities under environmental changes. They also indicate the potential of using generalised entropies to predict macroecological patterns in stressed ecosystems.
Practice guideline: Statement regarding treatment for suspected slowly progressive type 1 diabetes (SPIDDM; probable) cases (English version)
Authors: Shimada Akira , Kawasaki Eiji , Abiru Norio , Awata Takuya , Oikawa Yoichi , Osawa Haruhiko , Kajio Hiroshi , Kozawa Junji , Takahashi Kazuma , Chujo Daisuke , Noso Shinsuke , Fukui Tomoyasu , Miura Junnosuke , Yasuda Kazuki , Yasuda Hisafumi , Imagawa Akihisa , Ikegami Hiroshi
Published: November 2024

Insulin treatment should be introduced in patients with slowly progressive type 1 diabetes (SPIDDM; definite), according to the revised diagnostic criteria of SPIDDM (2023). In contrast, SPIDDM (probable) patients are in a non‐insulin‐dependent state; therefore, a more flexible treatment can be considered, although sulfonylurea agents should be avoided. Insulin treatment has been shown to maintain endogenous insulin secretion capacity in SPIDDM (probable); however, this does not mean that all SPIDDM (probable) patients should use insulin from the early phase. Dipeptidyl peptidase‐4 inhibitors and biguanides might be the treatment of choice for SPIDDM (probable), but no evidence exists for other hypoglycemic agents. In any case, careful monitoring of the endogenous insulin secretion capacity should be carried out, and if a decrease in insulin secretion capacity is suspected, a change in treatment should be considered to prevent progression to an insulin‐dependent state.
Ray‐Resorption Syndrome in European Seabass, Dicentrarchus labrax (Linnaeus, 1758)
Authors: Kourkouta Chara , Tsipourlianos Andreas , Papandroulakis Nikos , Moutou Katerina A. , Koumoundouros George
Published: November 2024

Fin abnormalities are common in reared fish. They mainly consist of partial to complete lack of rays and severe abnormalities of fin‐supporting skeletal elements, which develop during the larval stage, up to the completion of fin skeleton ontogeny. This study reports a new abnormal condition, ray‐resorption syndrome (RSS), which developed after the completion of fin ontogeny in initially normal European seabass larvae, leading to extensive loss of fin rays. At 49 days post‐fertilisation (dpf) (15 mm standard length, SL) all fish presented normal fins. However, nineteen days later (21 mm SL), significant fin damage, characterised by ray loss or fractures, was observed in all studied populations. The dorsal fin was most affected (55%–84%), followed by the pelvic (27%–53%) and anal fins (7%–17%). Microscopically, multiple non‐mineralised areas resembling resorption lacunae were evident along all fin lepidotrichia. By 98 dpf (40 mm SL), the fin‐ray loss had advanced, reaching its higher frequency in the dorsal (74%–83%) and caudal fins (71%–94%). Gene expression analysis revealed a significant upregulation of bglap (osteoblast maturation marker), acp5a (osteoclast maturation marker) and mmp13a (extracellular‐matrix remodelling marker) in RSS specimens. The results are discussed in respect of the possible causative factors of RSS.
Just Hitching a Ride: Stable Isotopes Reveal Non‐Feeding Behaviour of Anisakis simplex Within Its Host Fish
Authors: Sabadel Amandine , Gay Melanie , Lane Henry S. , Bourgau Odile , Bury Sarah J. , Delgado Josette , Duflot Maureen
Published: November 2024

Anisakis simplex larvae, commonly found in marine fish, cause anisakiasis in humans, resulting in gastric to gastro‐allergic symptoms. Despite known health risks, the impact of Anisakidae larvae on fish hosts is less understood. This study aimed to investigate this interaction by assessing the feeding strategy of A. simplex. Anisakis larvae were isolated from North Sea Merluccius merluccius tissues (stomach, body cavity, liver and muscle) and were analysed for carbon (δ13C) and nitrogen (δ15N) isotope values. Significant differences in δ13C values were found among host tissues, with the liver differing from muscle and stomach tissues. In contrast, no differences were noted for the associated parasites. Additionally, δ15N values indicated that the host occupied a significantly higher relative trophic position than its parasite. This suggests a lack of direct nutrient transfer from host to parasite, as the parasite would typically exhibit higher stable isotope values than the tissue they feed on. Therefore, A. simplex's stable isotope values might reflect those of its previous host (crustacean and/or small fish), providing insights into diet and movement of the paratenic M. merluccius host. Further research is needed to confirm these findings across different fish species and to explore A. simplex as a proxy for trophic ecology.
Inter‐Laboratory Comparison of qPCR Assays for Piscirickettsia salmonis in Atlantic Salmon (Salmo salar L.) in 11 Chilean Laboratories
Authors: Peña Andrea , Rozas‐Serri Marco , Gardner Ian A. , Diethelm‐Varela Benjamin , Anguita Carla , Jerez Carlos Navarro , Mardones Fernando O.
Published: November 2024

Real‐time PCR (qPCR) testing is an essential component of early detection surveillance systems for Piscirickettsia salmonis infection in Atlantic salmon farms in Chile. Currently, all 11 laboratories in the authorised diagnostic laboratory network use assays based on published protocols. Compared with other P. salmonis qPCR assays, these assays have the advantage of targeting two different genes, that is, the 16S ribosomal gene and the internal transcribed spacer (ITS), potentially allowing for higher diagnostic accuracy. However, variation and lack of harmonisation of qPCR testing systems (e.g., primers/probe, RNA/DNA as target, extraction methods, etc.) may contribute to among‐laboratory variation in qPCR results and an increased frequency of false‐negative and false‐positive results. The purpose of the ring trial reported herein was to compare qPCR results from 11 laboratories in Chile routinely testing Atlantic salmon for P. salmonis as part of a national control program. The panel of 14 samples included duplicates of three concentrations of P. salmonis in a homogenised head kidney, LF89 and EM90 bacteria and two negative controls (blank and a suspension of Flavobacterium psychrophilum). The sample order was randomised across labs, samples were tested blinded and analysed without knowledge of the source lab. Of the laboratories, 8 (72.7%) had at least one incorrect result out of 14 tested samples. Low‐concentration samples (Ct of about 30) were more often incorrectly classified by reverse transcription‐qPCR (RT‐qPCR) (3/6 labs) than by qPCR (0/5). Six (54.5%) labs had at least one false‐positive result indicating that cross‐contamination was likely during sample processing. Affected laboratories are advised to conduct internal investigations to confirm the causes of false‐positive results and recommendations for design and implementation of future ring trials are discussed.
Insulin potential in preventing brain damage after traumatic brain injury: What we know
Authors: Hajikarimloo Bardia , Jabbaripour Sama , Tohidinia Amir Mohammad , Valinejad Qanati Aysan , Fahim Farzan , Javadpour Pegah , Ghasemi Rasoul
Published: November 2024

Traumatic brain injury (TBI) is a major global cause of disability and mortality. TBI results in a spectrum of primary and secondary injuries that impact neural function and overall survival. Insulin, beyond its well‐known role in regulating blood glucose levels, plays critical roles in the central nervous system (CNS). These roles include the modulation of synaptic plasticity, neurotransmitter levels, neurogenesis, and neuroprotection. Central insulin resistance, a reduced sensitivity to insulin in the brain, has been observed in TBI patients. This insulin resistance impairs insulin function in the brain and increases the risk of neurodegenerative processes. This review will delve into the central role of insulin resistance in the pathological changes observed after TBI and explore the potential benefits of insulin therapy as a treatment approach for TBI.
Using ‘Situation‐Background‐Assessment‐Recommendation’ Method in Palliative Care to Enhance Handover Quality and Nursing Practice: A Mix Method Study
Authors: Pinto Floriana , Roberto Pasquale , Ferrario Lucrezia , Marotta Laura , Montani Doriana , Auletta Gaetano , Zoppini Laura , Foglia Emanuela
Published: November 2024

Aim

To evaluate the impact of using ‘Situation‐Background‐Assessment‐Recommendation’ method (‘SBAR’) in a palliative care setting.

Background

Effective handover communication is crucial for patient safety. Standardised communication tools, such as the SBAR method, are recommended to reduce errors and improve care coordination, but their use in palliative care is not investigated.

Design

Mixed method study design, adhering to the GRAMMS guideline.

Methods

From January to October 2021, a SBAR guide tailored for palliative care was developed using the Delphi method and implemented in a Hospice setting. Data on 150 nurse handovers were collected before and after implementation to assess changes in nursing outcomes, including medication errors, adverse events and the identification of psychological and spiritual needs. Nurses' perceptions on the handover process were gathered through a qualitative survey.

Results

The SBAR guide significantly improved the handovers quality, reducing medication errors and eliminating adverse events postimplementation. The identification of psychological and spiritual needs increased during postimplementation period. Nurses also reported improved clarity, accuracy and completeness of information during handover.

Conclusion

This is the first study to evaluate the impact of SBAR for handover in palliative nursing care. Findings show the added value of using communication tools.
Incidence, and maternal and neonatal outcomes following pregnancy‐associated colorectal cancer: A population‐based linked data study
Authors: Farhana Sultana , Frawley Jane , Safi Nadom , Anazodo Antoinette , Zalcberg John R. , Sullivan Elizabeth A.
Published: November 2024

Aim

The study aimed to describe the incidence of pregnancy‐associated colorectal cancer (PACRC) in New South Wales (NSW), Australia, and to examine the perinatal outcomes of women with PACRC and their babies.

Methods

A population‐based cohort study was conducted using linked data from NSW. The study group comprised all women diagnosed with colorectal cancer during pregnancy (gestational CRC) or postpartum (postpartum CRC). Women who gave birth without cancer during pregnancy or postpartum formed the comparison group (no‐cancer group).

Results

A total of 123 women were diagnosed with PACRC (22 gestational, 101 postpartum), and 1 786 078 women were in the no‐cancer group. The incidence of PACRC was 6.9/100 000 women giving birth. From 1994 to 2013, the incidence significantly increased even when adjusting for maternal age (adjusted increase of 5.8% per year). Women with gestational CRC had significantly higher odds of severe maternal complications (AOR 29.27, 95% CI: 11.18–76.63) and were more likely to give birth by labor induction or no‐labor caesarean section (AOR 4.39, 95% CI: 1.50–12.84) than women in the no‐cancer group. Although babies born to women with gestational CRC did not experience congenital anomalies, they had higher odds of planned preterm birth (AOR 9.91, 95% CI: 1.99–49.21) and severe neonatal adverse outcomes (AOR 8.65, CI: 3.65–20.5) than babies of women without cancer.

Conclusions

The study found a significant increase in PACRC incidence in NSW over the study period, independent of maternal age. Increased interventions during gestational CRC births reflect management challenges with higher maternal and neonatal morbidities.
Parodying incompetence in (I)europa: Hearing glide insertion and communism in a Romanian politician's speech
Authors: Sprenger Anna‐Marie
Published: November 2024

My paper asks which linguistic features become enregistered to a politician's image, and how this process occurs. I examine glide insertion in the speech of former Romanian Prime Minister Viorica Dăncilă and parodies of her. As parody requires exaggeration of salient features in order to be legible, I use it to investigate what is heard as salient in Dăncilă's speech. Although glide insertion is uncharacteristic of Dăncilă's speech, parodies overrepresent Dăncilă's use of the feature. To explain this, I investigate social meanings of glide insertion through metalinguistic commentary and historical memory, finding that glide insertion links Dăncilă to Romania's Communist era. Though Dăncilă rarely uses glide insertion, the feature emblematizes her political persona. Treating parodic performance as reflecting a wider listening subject, I show the listening subject's ideologies influence the enregisterment of a feature to an individual; the process by which a politician's linguistic image arises is dialogic and heavily involves listeners.
Balancing the voices of the Global South and North in shaping health professions education
Authors: Nyoni Champion N.
Published: November 2024

Using cross‐cultural dialogue pieces from this issue, Nyoni outlines factors to consider when trying to balance voices between south and north.
Pressure‐Induced Microvascular Reactivity With Whole Foot Loading Is Unique Across the Human Foot Sole
Authors: Howe Erika E. , Bent Leah R.
Published: November 2024

Background

Foot sole plantar pressure generates transient but habitual cutaneous ischemia, which is even more exacerbated in atypical gait patterns. Thus, adequate post‐occlusive reactive hyperaemia (PORH) is necessary to maintain skin health. Plantar pressure regional variance during daily tasks potentially generates region‐specific PORH, crucial for ischemic defence.

Aims

The current work investigated regional PORH across the human foot sole resulting from stance‐like loading.

Materials & Methods

A loading device equipped with an in‐line laser speckle contrast imager measured blood flux before, during, and after whole‐foot loading for 2 and 10 min durations at 15% and 50% body weight. Flux was compared between six regions: the heel, lateral arch, medial arch, and fifth, third, and first metatarsals (MT).

Results

Baseline flux was significantly greater in the 1MT and 3MT than all other regions. Loading occluded the heel, 5MT and 3MT more than all other regions. Regional PORH peak, time to peak, area under the curve, and recovery rate were ranked between regions.

Discussion

The 3MT, followed by 5MT, overall had the strongest PORH response, suggesting a heightened protection against ischemia compared to other regions.

Conclusion

This work highlights regional variations within a healthy foot, providing a framework for future ulcer risk assessments and interventions to preserve foot health.
The pathogenicity‐associated regulators participating in the regulatory cascade for RaxSTAB and RaxX in Xanthomonas oryzae pv. oryzae
Authors: Shao Yanan , Tang Guiyu , Zhang Jinye , Zhao Jinjia , Ruan Lifang
Published: November 2024

The RaxX sulfopeptide, secreted via a type Ι secretion system, is crucial for activating XA21‐mediated innate immunity in resistant rice lines bearing the XA21 receptor kinase. Certain pathogenicity‐associated regulators that control the expression of the raxSTAB‐raxX gene cluster have been functionally characterized, but the comprehensive regulatory cascade of RaxSTAB and RaxX in Xanthomonas oryzae pv. oryzae (Xoo) remains incompletely understood. Our investigation revealed that pathogenicity‐associated regulators, including HrpG, HrpX, VemR, PhoR, and Clp, form a regulatory cascade governing the expression of the raxSTAB‐raxX gene cluster. HrpG regulates the raxSTAB‐raxX gene cluster transcription through the key regulator HrpX. VemR also participates in the transcription of the raxSTAB‐raxX. The histidine kinase PhoR positively modulates raxSTAB‐raxX expression, while the global regulator Clp directly binds the raxX promoter region to promote its transcription. These findings shed light on the intricate regulatory cascade of rax‐related genes in Xoo, emphasizing the complex roles of pathogenicity‐associated regulators within the pathogenic regulatory system.
The Effectiveness of the Moyamoya Healthy Youth Application for the Salutogenesis of Adolescents With Moyamoya Disease: A Randomized Controlled Trial
Authors: Oh Won‐Oak , Yeom Insun , Lee Anna , Han Jihee , Lee Eunji , Heo Yoo‐Jin
Published: November 2024

Adolescents with moyamoya disease can experience unexpected transient ischemic attacks, significantly impacting their daily lives. This study aimed to examine the effectiveness of the Moyamoya Healthy Youth application for adolescents with moyamoya disease. The research employed a parallel, two‐group randomized controlled trial with a repeated measures design. A total of 64 adolescents with moyamoya disease were participated. The intervention group applied the application, whereas the wait‐list group received their usual care from an outpatient clinic. The outcome variables were assessed three times during the study, from July 2021 to March 2022. Repeated measures ANOVA and Friedman test were used to analyze results. The intervention group exhibited significant improvements in stress and health behavior. No statistically significant improvement was observed in moyamoya disease knowledge, social support, sense of coherence, depression, cortisol, and symptoms. This mobile‐based strategy empowered adolescents to monitor their health behaviors and cope with stress. This intervention is a promising strategy for health care providers to enhance self‐management skills and achieve better quality of life in such adolescents.

Trial Registration: Korea Clinical Trial Registry KCT0006451. https://cris.nih.go.kr/cris/search/detailSearch.do/21925
Thinking Theoretically in Nursing Research—Positionality and Reflexivity in an Interpretative Phenomenological Analysis (IPA) Study
Authors: Ugiagbe Iyore. M. , Allan Helen. T. , Traynor Michael , Collins Linda
Published: November 2024

This paper explores the application of positionality and reflexivity drawing on the experience of a British Minority Ethnic (BME) group senior nurse researching nurses with the same ethnic heritage in an IPA study. It explores how using IPA informed reflexivity and positionality as a researcher who shared the same ethnicity with the research participants. The IPA study allowed for the exploration of Internationally Educated Nurses' (IENs) perspectives on their integration into British healthcare and their navigation of career progression. The central aims of an IPA study are to understand the participant's world, its description, the development of a clear, and open interpretative analysis with a descriptive focus on the social, cultural and theoretical context, and the participant's sense‐making of their lived experience. In this paper, we discuss how the lead researcher employed reflexivity, stated his intentionality and positionality in the conduct of the IPA study. This paper discusses some examples of the effects of positionality and reflexivity in the conduct of research by researchers of different racial background, and explicate the influence of personal and professional experiences of a researcher in using reflexivity and positionality to ensure cross‐cultural validity and reliability of an IPA research. This paper concludes that appropriate use of reflexivity and positionality in an IPA study may recognise the personal and professional influence of a researcher's experiences on the research process, including their ethnicity.
Dumping syndrome: Update on pathophysiology, diagnosis, and management
Authors: Tack Jan , Raymenants Karlien , Van de Bruaene Cedric , Scarpellini Emidio
Published: November 2024

Background

Dumping syndrome is a complex of gastrointestinal symptoms originally studied in peptic ulcer surgery patients. At present, it is most prevalent in patients who underwent bariatric, upper gastrointestinal cancer or anti‐reflux surgery. The symptom pattern comprises early and late dumping symptoms. Several management options have been reported including nutritional, pharmacological and surgical approaches.

Aims and Methods

In this study, we aimed to review the current evidence on dumping syndrome definition, diagnosis and treatment, including preliminary data from newer pharmacological studies.

Results

Current pathophysiological concepts and analyses of provocative tests has led to a clear definition of dumping syndrome, including both early and late dumping symptoms. The term postbariatric hypoglycemia represents a limited focus on late dumping only. The diagnosis relies on recognition of symptoms and signs in a patient with appropriate surgical history; and can be confirmed by provocative testing or registration of spontaneous hypoglycemia. The initial treatment focuses on dietary intervention, to which meal viscosity enhancers and/or the glycosidase inhibitor acarbose can be added. The most effective therapy is the use of short‐ or long‐acting somatostatin analogues, which is however expensive and entails side effect issues. In case of refractory hypoglycemia, diazoxide or SGLT2 inhibitors can be considered, based on limited evidence. In refractory patients, continuous enteral feeding or (rarely) surgical reinterventions have been advocated, although not supported by solid evidence. Therapies under current evaluation include the broad‐spectrum somatostatin analogue pasireotide, GLP‐1 receptor antagonists, GLP‐1 receptor agonists and administration of stable forms of glucagon are currently under study.

Conclusions

Dumping syndrome is a well‐defined but probably under‐diagnosed complication of upper gastrointestinal, especially bariatric, and surgeries. Diagnosis is confirmed by a provocative test and incremental therapies starting with diet, adding meal viscosity enhancers or glycosidase inhibitors and adding somatostatin analogues in refractory cases. A number of emerging therapies targeting intestinal propulsion, peptide hormone effects and hypoglycemic events are under evaluation.
Applying the Concept of Epistemic Injustice as a Philosophical Window to Examine Discrimination Experiences of LGBTQIA+ Migrants With Nurses
Authors: Haghiri‐Vijeh Roya
Published: November 2024

Both stigma and discrimination, defined as a lack of knowledge of and a sense of discomfort in providing care to lesbian, gay, bisexual, transgender, queer, intersex, and + (LGBTQIA+) migrants, was found to manifest in a sample of LGBTQIA+ migrants who received nursing care in a recent study. The study concluded that nurses continue to have a limited understanding of the experiences of LGBTQIA+ migrants in the Canadian context, and that LGBTQIA+ migrants continue to have troubling 'care' experiences with nurses. Miranda Fricker has developed the concept of epistemic injustice drawing on feminist philosophy and social epistemology. Epistemic injustice refers to unfair treatment of a person by judging them as 'not a knower' in a communicative situation. For example, in a few circumstances when LGBTQIA+ migrants were admitted to psychiatric units due to suicide ideations as a direct result of identifying as a LGBTQIA+ migrants, the medical and nursing team responded with 'They are in Canada now. It is safe here!' and 'So, you are [LGBTQIA + ]! What's the big deal?' These unjust statements reflect an epistemic situation in which the hearer is negating what was heard, that is, that the speaker's intersecting identities of LGBTQIA+ and new immigrant has directly led to suicide ideation. The concept of epistemic injustice helps to frame this situation as one where the care provider is not doing justice to the needs of LGBTQIA+ migrants. This article draws on the narrative of an LGBTQIA+ migrant who is not recognised as a credible source of knowledge about their own lives and needs in the context of Canadian nursing care. Epistemic injustice helps to understand how stigma and discrimination is produced in this community by the very nursing profession who ostensibly want to help them.
HSP90 Complex From OLP Lesion Induces T‐Cell Polarization via Activation of Dendritic Cells
Authors: Pan Lei , Chen Junjun , Lai Yirao , Du Guanhuan , Wang Haiyan , Sun Lei , Tang Guoyao , Wang Yufeng
Published: November 2024

Objectives

To investigate the effects of the heat shock protein 90 (HSP90) complex from oral lichen planus (OLP) lesion tissues on dendritic cell (DC) activation and the polarization of naïve T cells.

Methods

Expression of HSP90 in OLP lesions and healthy control (HC) mucosa was evaluated by single‐cell RNA sequence, IHC, qRT‐PCR, and immunoblotting. HSP90 complex was extracted by immunoprecipitation from oral mucosa as the agonist of DCs. Expression of IFN‐α and MHC was detected by flow cytometry. After cocultured with pre‐stimulated DCs, polarization of naïve T cells was investigated by cytokine analysis.

Results

HSP90 was significantly higher in the lamina propria of OLP lesion and closely related to lymphocyte infiltration. HSP90 complex of OLP lesion activated DCs via TLR9 and increased their IFN‐α secretion and MHC II expression. Pre‐stimulated DCs increased the proportion of Th17 cells.

Conclusions

HSP90 complex isolated from OLP lesion activated TLR9/IFN‐α of DCs and further promoted the polarization of naïve T cells toward Th17 immunity.
Clinical Outcome and Quality of Life after Modular Reverse Total Shoulder Arthroplasty in Comparison with Joint‐Preserving Locking Plate Osteosynthesis in Aged Patients: A Retrospective Comparison Study
Authors: Jaekel Carina , Oezel Lisa , Leibnitz Franziska , Wilms Lena Marie , Windolf Joachim , Gehrmann Sebastian Viktor , Scholz Armin Olaf
Published: November 2024

Objectives

Proximal humeral fractures (PHFs) show a high incidence in aged patients. While nondisplaced fractures achieve good results by conservative treatment, surgical procedures are discussed controversially. Next to open reduction and internal fixation (ORIF), the primary use of reverse shoulder arthroplasty (RSA) has become increasingly important. The aim of this study was to investigate the clinical function, activities of daily living (ADL), as well as pain assessment in patients with PHFs, treated by ORIF or RSA.

Methods

A retrospective comparison study was assessed. From November 2011 to March 2016, 34 patients (17 matched pairs) that had undergone either ORIF or RSA of the proximal humerus, were included in this study. Pain was measured by numeric rating scale (NRS). ADL were obtained by Katz‐Index and SF‐12. Moreover, shoulder function was assessed using the Oxford Shoulder Score (OSS). The maximum range of motion (ROM) was also recorded. From November 2011 to March 2016, 34 patients (17 matched pairs) that had undergone either ORIF (Figure or RSA of the proximal humerus) were included in this study. For statistical analyses, Student's t‐test, Wilcoxon test, and Chi‐Quadrat test were used. Statistical significance was indicated with p < 0.05.

Results

Totally 34 patients with an average age of 76.6 years were included. Surgical treatment was performed on average 5.2 days after diagnosis, differing significantly between the two groups (RSA/ORIF: 6.9/3.5 days) The operation time of RSA (97 min) was significantly longer than for ORIF (78 min). Pain assessment, as well as the Katz‐Index and the SF‐12, showed no significant differences. Moreover, clinical shoulder function showed no significant discrepancies between the two surgical techniques.

Conclusions

Aged patients with PHFs treated with RSA display similar results regarding clinical function, ADL as well as pain perception compared with ORIF. However, revision surgery rate was lower in patients who underwent RSA. Thus, the surgical treatment of PHFs by RSA represents an excellent alternative, especially with regard to an aging patient population.
Reducing the Brace Correction Stress on the Secondary Lumbar Curve Results in Excellent Muscle, Bone, and Disc Mechanical Performance: A Musculoskeletal Finite Element Simulation of AIS Patient With Rigo A3
Authors: Zhang Xiaohui , Wang Di , Lv Danyu , Lv Jinmiao , Tang Huiyi , Qian Jinlin , Liao Bagen
Published: November 2024

Objectives

The biomechanical mechanism of brace intervention on bone, muscle, and disc should be comprehensively considered for AIS patients. We aimed to developmentally construct a musculoskeletal finite element model of adolescent idiopathic scoliosis to simulate the coupling of corrective forces and analyze the mechanical properties of bone, muscle, and disc. Investigateing, more effective clinical interventions to break the vicious cycle of patients during growth.

Methods

A finite element model, including muscle, bone, and disc, was established using computed tomography data of a patient with RigoA3 adolescent idiopathic scoliosis. The three‐point force coupling, antigravity, and bending effects of the Chêneau brace were simulated, and the correction force of the secondary lumbar bend was gradually reduced while observing the mechanical characteristics of bone, muscle, and disc. The correction force in line with symmetrical spine growth was comprehensively evaluated.

Results

The correction rate of the main thoracic (MT) curve, the intervertebral space height on the concave side of the vertebrae at the apex, and the stress ratio of the intervertebral discs were optimal when the maximum corrective pressure threshold was reached. However, the proximal thoracic (PT) curve was aggravated and the axial forces on the concave side were unbalanced. At this time, the biomechanical performance of the model is also not optimal. The correction rate of the Cobb Angle of the MT curve decreased with the decrease of the correction pressure in the lumbar region. When reduced to 25% of the maximum threshold, the convex side of disc stress, intervertebral space, and muscle axial force is more in line with the biomechanical mechanism of correction and can avoid sacrificing the PT curve.

Conclusions

Downward adjustment of the corrective force to the secondary lumbar curve, using the Chêneau brace, results in better primary thoracic curvature mechanics in the musculoskeletal finite element model, suggesting that breaking the vicious cycle of scoliosis progression to guide benign spinal growth is beneficial.
How Many Checks Are Needed per Cycle in a Plant Breeding or Variety Testing Programme?
Authors: Piepho Hans‐Peter , Laidig Friedrich
Published: November 2024

Check varieties are used in plant breeding and variety testing for a number of reasons. One important use of checks is to provide connectivity between years, which facilitates comparison among genotypes of interest that are tested in different years. When long‐term data are available, such comparisons allow an assessment of realized genetic gain (RGG). Here, we consider the question of how many check varieties are needed per cycle for a reliable assessment of RGG. We propose an approach that makes use of variance component estimates for relevant random effects in a linear mixed model and plugs them into an analysis of dummy datasets set up to represent the design options being considered. Our results show that it is useful to employ a larger number of checks and to keep the replacement rate low. Furthermore, there is intercycle information to be recovered, especially when there are few checks and replacement rates are high, so modelling the cycle main effect as random pays off.
Low Infection Rates With Long‐Term Dupilumab Treatment in Patients Aged 6 Months to 5 Years: An Open‐Label Extension Study
Authors: Paller Amy S. , Ramien Michele , Cork Michael J. , Simpson Eric L. , Wine Lee Lara , Eichenfield Lawrence F. , Khokhar Faisal A. , Coleman Anna , Gherardi Guy , Chen Zhen , Zhang Annie , Cyr Sonya L.
Published: November 2024

Objective

To evaluate long‐term infection rates in children aged 6 months to 5 years with moderate‐to‐severe atopic dermatitis (AD) treated with dupilumab.

Methods

This was a post hoc analysis of an ongoing open‐label extension (OLE) study of dupilumab. Pediatric patients aged 6 months to 5 years with moderate‐to‐severe AD who had previously taken part in the LIBERTY AD PRESCHOOL phase 2 and 3 clinical trials received weight‐based subcutaneous dupilumab every 2 or 4 weeks. Exposure‐adjusted infection rates after a median dupilumab exposure of 52 weeks are compared with data from the earlier randomized, placebo‐controlled, 16‐week LIBERTY AD PRESCHOOL phase 3 trial.

Results

Infection rates were overall lower in the OLE study compared with the dupilumab and placebo groups in the earlier 16‐week trial, including total infections (101.0 patients/100 patient‐years [PY]), nonherpetic skin infections (22.7 patients/100PY), herpetic infections (7.3 patients/100PY), and nonskin infections (92.9 patients/100PY). The frequency of severe and serious infections was low (3.1 patients/100PY), compared with 17.1 placebo‐treated patients/100PY and 0 dupilumab‐treated patients in the earlier 16‐week trial, and no infections leading to treatment discontinuation were observed. Systemic anti‐infective medication use (58.9 patients/100PY) was lower in the OLE study compared with both the dupilumab and placebo groups in the 16‐week trial.

Conclusion

Overall, reduced infection rates are observed in infants and young children with moderate‐to‐severe AD treated with dupilumab long‐term, supporting the known safety profile of dupilumab.
Disaggregating citizenship: Tibetan refugees navigating identity, belonging, and exclusionary state policies in India
Authors: Dasgupta Ishani
Published: November 2024

This essay explores the struggles of second‐generation Tibetan refugees under an exclusionary Indian citizenship regime. Confronted with a national orthodoxy that entwines legal status, entitlements, and national identity, Tibetans respond by “disaggregating” citizenship. First, stateless Tibetans, born in India to refugee parents, won legal appeals by demonstrating that Tibetan nationality was no bar to Indian citizenship. In response, Indian authorities demanded that Tibetans give up refugee entitlements and remove themselves from their national space and political community in exile as the price of Indian citizenship. This article explores the diverse responses of Tibetans to the citizenship‐on‐offer: some aspiring for it, some accepting it, and others actively rejecting it. These responses illustrate strategies refugees employ to navigate citizenship regimes that often render them liminal. Refugees act both to mitigate the precarity of statelessness and to preserve their identity, community, and political aspirations against erasure. In doing so, they not only disrupt the national orthodoxy of states that negates refugee experiences but also reveal the incompleteness and contradictions of citizenship regimes.