bluuebunny/crossref_metadata_2025 huggingface dataset:
Multicomponent perinatal breastfeeding support in women with BMI >25: The Latch On multi‐centre randomised trial
Authors: O'Reilly Sharleen L. , McNestry Catherine , McGuinness Denise , Killeen Sarah Louise , Mehegan John , Coughlan Barbara , O'Brien Eileen C. , O'Brien Denise , Szafranska Marcelina , Brosnan Mary , Sheehy Lucille , Murtagh Rosie , O'Hagan Lorraine , Corbett Marie , Walsh Michelle , Keogh Regina , Power Paula , Woodcock Marie , Phelan Mary , Carroll Amy , Murray Stephanie , Scallan Charmaine , Dunn Elizabeth , McAuliffe Fionnuala M.
Published: February 2024

Objective

To investigate the effectiveness of a multicomponent breastfeeding support intervention on breastfeeding prevalence at 3 months among women with a body mass index (BMI) >25 kg/m2.

Design

Multicentre multicomponent randomised controlled trial.

Setting

Four maternity centres in Ireland.

Population

A total of 225 primiparous women and their nominated support partners. Participants were aged 18 years and over, with BMI ≥25 kg/m2, carrying a singleton pregnancy and without contraindication for breastfeeding.

Methods

The intervention included an antenatal group breastfeeding education session for participants and their support partners, followed by a planned postnatal breastfeeding assessment and telephone support for up to 6 weeks by a lactation consultant.

Main outcome measures

Any breastfeeding at 3 months postpartum.

Results

Any breastfeeding prevalence was 68.7% (n = 68) in the intervention group and 62.1% (n = 59) in the control group at 3 months postpartum (odds ratio 1.33, 95% confidence interval 0.72–2.46, p = 0.36). Any and exclusive breastfeeding rates did not significantly differ at any other time point. More women in the control group accessed support from private lactation consultants (intervention 23.5% [n = 12], control 45.3% [n = 24], p = 0.02).

Conclusions

The control group had higher than expected breastfeeding rates, and the study found no evidence of effect on the primary outcome. Providing comprehensive education and support for women intending to breastfeed remains of paramount importance.
Does trade openness mitigate environmental degradation in Organisation for Economic Co‐operation and Development (OECD) countries? Implications for achieving sustainable development
Authors: Barkat Karim , Alsamara Mouyad , Al Kwifi Osama Sam , Jarallah Shaif
Published: February 2024

The link between trade openness and CO2 emissions is a key research focus in times of pressing global sustainability needs and ongoing climate change discussions. In this study, we address the critical issue of the impact of trade openness on CO2 emissions in 20 OECD countries over a 150‐year period using historical datasets. We investigate how trade openness affects environmental sustainability within this group of nations. To overcome the challenges related to heterogeneity and cross‐sectional dependence, we applied robust cointegration techniques. Our analysis reveals direct and indirect impacts of trade openness on CO2 emissions. The direct effect demonstrated a positive correlation between trade openness and CO2 emissions, whereas the indirect effect, mediated by income growth, exerted a counteractive negative influence on this relationship. These divergent effects support the environmental Kuznets curve hypothesis. Our findings suggest that as income levels rise, the indirect effect gradually outweighs the direct effect, leading to a significant reduction in long‐term CO2 emissions in OECD countries.
From lab‐based to in‐line: Analytical tools for the characterization of whey protein denaturation and aggregation–A review
Authors: Finnegan Eoin W. , Goulding David A. , O'Callaghan T. F. , O'Mahony James A.
Published: February 2024

Whey protein denaturation and aggregation have long been areas of research interest to the dairy industry, having significant implications for process performance and final product functionality and quality. As such, a significant number of analytical techniques have been developed or adapted to assess and characterize levels of whey protein denaturation and aggregation, to either maximize processing efficiency or create products with enhanced functionality (both technological and biological). This review aims to collate and critique these approaches based on their analytical principles and outline their application for the assessment of denaturation and aggregation. This review also provides insights into recent developments in process analytical technologies relating to whey protein denaturation and aggregation, whereby some of the analytical methods have been adapted to enable measurements in‐line. Developments in this area will enable more live, in‐process data to be generated, which will subsequently allow more adaptive processing, enabling improved product quality and processing efficiency. Along with the applicability of these techniques for the assessment of whey protein denaturation and aggregation, limitations are also presented to help assess the suitability of each analytical technique for specific areas of interest.
Purification, characterization, and in vitro digestion of novel antioxidant peptides from chicken blood hemoglobin
Authors: Wang Suye , Mao Xiaoyi , Zhang Rui , Gao Yurong , Liu Dunhua
Published: February 2024

The study aimed to purify and characterize antioxidant peptides from chicken blood hemoglobin hydrolysate. The fraction M2 (< 3 KDa) with the strongest antioxidant activity was isolated by ultrafiltration, and its DPPH (1,1‐diphenyl‐2‐picryl‐hydrazyl radical) free radical scavenging rate, ABTS [2,2′‐Azinobis‐(3‐ethylbenzthiazoline‐6‐sulphonate)] free radical scavenging rate, and iron ion chelation activity were 82.91%, 77.49%, and 80.99%, respectively. After in vitro digestion, the antioxidant capacity of chicken blood hydrolysate was significantly higher than that before digestion (p < 0.05). M2 exhibited the strongest antioxidant activity after stomach digestion, with a DPPH radical scavenging rate and iron ion chelating power of 82.91% and 79.61%, respectively. Component A was purified from M2 by Sephadex G‐25 gel chromatography. The peptide sequences were identified by LC‐MS/MS from fraction A, and four peptides, AEDKKLIQ (944.54 Da), APAPAAK (625.36 Da), LSDLHAHKL (1033.57 Da), and LSNLHAYNL (1044.54 Da) were synthesized using the solid‐phase peptide method, among which APAPAAK was a novel antioxidant peptide. Molecular docking was used to simulate the binding of these four peptides to the key active site of Keap1 via hydrogen bonding. This study suggests that chicken blood may provide a new natural source of antioxidant peptides.
Recovery of phenolic compounds from peach pomace using conventional solvent extraction and different emerging techniques
Authors: Baltacıoğlu Cem , Baltacıoğlu Hande , Okur İlhami , Yetişen Mehmet , Alpas Hami
Published: February 2024

The study compared high‐pressure, microwave, ultrasonic, and traditional extraction techniques. The following extraction conditions were implemented: microwave‐assisted extraction (MAE) at 900 W power for durations of 30, 60, and 90 s; ultrasonic‐assisted extraction (UAE) at 100% amplitude for periods of 5, 10, and 15 min; and high‐pressure processing (HPP) at pressures of 400 and 500 MPa for durations of 1, 5, and 10 min. The highest yield in terms of total phenolic content (PC) was obtained in UAE with a value of 45.13 ± 1.09 mg gallic acid equivalent (GAE)/100 g fresh weight (FW). The highest PC content was determined using HPP‐500 MPa for 10 min, resulting in 40 mg GAE/100 g, and MAE for 90 s, yielding 34.40 mg GAE/100 g FW. The highest value of antioxidant activity (AA) was obtained by UAE in 51.9% ± 0.71%. The PCs were identified through the utilization of Fourier transform infrared (FTIR) spectroscopy and high‐performance liquid chromatography (HPLC). Utilizing multivariate analysis, the construction of chemometric models were executed to predict AA or total PC of the extracts, leveraging the information from IR spectra. The FTIR spectrum revealed bands associated with apigenin, and the application of HPP resulted in concentrations of 5.41 ± 0.25 mg/100 g FW for apigenin and 1.30 ± 0.15 mg/100 g FW for protocatechuic acid. Furthermore, HPLC analysis detected the presence of protocatechuic acid, caffeic acid, p‐coumaric acid, and apigenin in both green extraction methods and the classical method. Apigenin emerged as the predominant phenolic compound in peach extracts. The highest concentrations of apigenin, p‐coumaric acid, and protocatechuic acid were observed under HPP treatment, measuring 5.41 ± 0.25, 0.21 ± 0.04, and 1.30 ± 0.15 mg/kg FW, respectively.
Hearts of stone: Rapidly progressive left ventricular myocardial calcifications in severe sepsis: Case series
Authors: Tiffany Lea , Lim Lincoln J
Published: February 2024

Rapidly progressive left ventricular myocardial calcification (RPLVMC) is a rare phenomenon of severe sepsis which is associated with long‐term complications like irreversible cardiomyopathy and arrhythmias. To date, only 19 cases have been reported in literature. We present a case series of two patients with RPLVMC which manifested within a period of days in the setting of severe sepsis. Unique to previous case reports, the patients in the current case series had no pre‐existing systemic risk factors such as end‐stage kidney disease or endocrinological dysfunction. This case series aims to increase awareness of RPLVMC in severe sepsis, improve its opportunistic detection on routine medical imaging (namely chest x‐ray and computed tomography), and spur future research to develop potential prevention strategies.
Enhancing amphibian biomonitoring through eDNA metabarcoding
Authors: Mu Yawen , Zhang Jingwen , Yang Jianghua , Wu Jun , Zhang Yong , Yu Hongxia , Zhang Xiaowei
Published: February 2024

Surveying biodiversity has taken a quantum leap with environmental DNA (eDNA) metabarcoding, an immensely powerful approach lauded for its efficiency, sensitivity, and non‐invasiveness. This approach emerges as a game‐changer for the elusive realm of endangered and rare species—think nocturnal, environmentally elusive amphibians. Here, we have established a framework for constructing a reliable metabarcoding pipeline for amphibians, covering primer design, performance evaluation, laboratory validation, and field validation processes. The Am250 primer, located on the mitochondrial 16S gene, was optimal for the eDNA monitoring of amphibians, which demonstrated higher taxonomic resolution, smaller species amplification bias, and more extraordinary detection ability compared to the other primers tested. Am250 primer exhibit an 83.8% species amplification rate and 75.4% accurate species identification rate for Chinese amphibians in the in silico PCR and successfully amplified all tested species of the standard samples in the in vitro assay. Furthermore, the field‐based mesocosm experiment showed that DNA can still be detected by metabarcoding even days to weeks after organisms have been removed from the mesocosm. Moreover, field mesocosm findings indicate that eDNA metabarcoding primers exhibit different read abundances, which can affect the relative biomass of species. Thus, appropriate primers should be screened and evaluated by three experimental approaches: in silico PCR simulation, target DNA amplification, and mesocosm eDNA validation. The selection of a single primer set or multiple primers' combination should be based on the monitoring groups to improve the species detection rate and the credibility of results.
Promoting a reputation for quality
Authors: Hauser Daniel N
Published: February 2024

I model a firm that invests in the quality of its product and influences how that quality is disclosed. The firm can promote its product; at random intervals it can disclose quality for a cost. At low reputations, promotion allows a firm to reestablish itself and the firm invests to take advantage of this. However, the ability to promote crowds out incentives for investment at high reputations generated by other information sources, in particular information that is generated whenever the firm is selling a low quality product, leading to reputation cycles in settings where high reputations would have otherwise persisted.
Designing observational studies for credible causal inference in addiction research—Directed acyclic graphs, modified disjunctive cause criterion and target trial emulation
Authors: Chan Gary C. K. , Sun Tianze , Stjepanović Daniel , Vu Giang , Hall Wayne D. , Connor Jason P. , Leung Janni
Published: February 2024

Randomized controlled trials (RCTs) are considered the gold standard for causal inference. With a sufficient sample size, randomization removes confounding up to the time of randomization and allows the treatment effect to be isolated. However, RCTs may have limited generalizability and transportability and are often not feasible in addiction research due to ethical or logistical constraints. The importance of observational studies from real‐world settings has been increasingly recognized in research on health. This paper provides an overview of modern approaches to designing observational studies that enable causal inference. It illustrates three key techniques, Directed Acyclic Graphs (DAGs), modified Disjunctive Cause Criterion and Target Trial Emulation, and discusses the strengths and limitations of their applications.
Is a Māori contact‐era population of 100,000 too low? Evidence from population density analogues
Authors: Chapple Simon
Published: February 2024

This research considers the current New Zealand conventional wisdom of a Māori contact‐era population of 100,000 circa‐1770 using a variety of population density analogues. The first set of analogues examines estimated population densities of six districts in early‐contact period New Zealand for which reasonable population estimates can be constructed using methods of historical demography. The second set examines estimated population densities of pre‐industrial societies on large, relatively isolated temperate islands outside of New Zealand. The density research indicates that a contact‐era Māori population in excess of 200,000 is a distinct possibility. Based on this density analysis the current conventional wisdom's figure of 100,000 appears to be—considerably—on the low side, and suggesting considerable catastrophic early post‐contact population decline.
A comparison of the McGrath videolaryngoscope with direct laryngoscopy for rapid sequence intubation in the operating theatre: a multicentre randomised controlled trial
Authors: Kriege M. , Lang P. , Lang C. , Schmidtmann I. , Kunitz O. , Roth M. , Strate M. , Schmutz A. , Vits E. , Balogh O. , Jänig C.
Published: February 2024

Aspiration of gastric contents is a recognised complication during all phases of anaesthesia. The risk of this event becomes more likely with repeated attempts at tracheal intubation. There is a lack of clinical data on the effectiveness of videolaryngoscopy relative to direct laryngoscopy rapid sequence intubation in the operating theatre. We hypothesised that the use of a videolaryngoscope during rapid sequence intubation would be associated with a higher first pass tracheal intubation success rate than conventional direct laryngoscopy. In this multicentre randomised controlled trial, 1000 adult patients requiring tracheal intubation for elective, urgent or emergency surgery were allocated randomly to airway management using a McGrath™ MAC videolaryngoscope (Medtronic, Minneapolis, MN, USA) or direct laryngoscopy. Both techniques used a Macintosh blade. First‐pass tracheal intubation success was higher in patients allocated to the McGrath group (470/500, 94%) compared with those allocated to the direct laryngoscopy group (358/500, 71.6%), odds ratio (95%CI) 1.31 (1.23–1.39); p < 0.001. This advantage was observed in both trainees and consultants. Cormack and Lehane grade ≥ 3 view occurred less frequently in patients allocated to the McGrath group compared with those allocated to the direct laryngoscopy group (5/500, 1% vs. 94/500, 19%, respectively; p < 0.001). Tracheal intubation with a McGrath videolaryngoscope was associated with a lower rate of adverse events compared with direct laryngoscopy (13/500, 2.6% vs. 61/500, 12.2%, respectively; p < 0.001). These findings suggest that the McGrath videolaryngoscope is superior to a conventional direct laryngoscope for rapid sequence intubation in the operating theatre.
Management & surveillance of rectal neuroendocrine tumours: a single‐centre retrospective analysis
Authors: Barnard Paige , Stephensen Bree , Taylor Georgia , Huang Johnson , de Jager Elzerie , McMahon Matthew
Published: February 2024

Background

Rectal neuroendocrine tumours (rNETs) are rare but are increasing in incidence. Current management and surveillance recommendations are based on low‐grade evidence. Follow‐up practices are often inconsistent and costly. This retrospective study analyses a single‐centre's experience with rNETs to assess incidence, management practices, outcomes, and guideline adherence.

Methods

This is a single‐centre retrospective study from Queensland Australia, spanning from 2012 to 2023. Twenty‐eight rNET cases met inclusion criteria. Examined parameters included incidence, management, outcomes and adherence to European Neuroendocrine Tumour Society (ENETS) guidelines. R1 resection rate was analysed for associations with resection technique and lesion recognition and recurrence rate was assessed in all patients.

Results

This study shows an increasing incidence of rNETs during the study period, reflecting a global trend. R1 resection rate at initial endoscopy was 75%. There was a general lack of advanced endoscopic techniques utilized and poor lesion recognition, however a statistically significant correlation was not established between these factors and an R1 result (P < 0.05). Most patients with an R1 result had subsequent re‐resection to render the result R0, however five patients (33%) underwent surveillance with no reports of recurrence on follow‐up. Overall, follow‐up practices in our cohort were inconsistent and did not adhere to guidelines.

Conclusion

rNETs are increasing in incidence, emphasizing the need for standardized management and surveillance. Further training is required for rNET recognition and advanced endoscopic resection techniques. Further research is required to assess long‐term outcomes in surveilled R1 cases, understand optimal endoscopic resection techniques and further develop local surveillance guidelines.
Diabetic retinopathy as an independent marker of cardiovascular disease in type 1 diabetes: Results from a nationwide longitudinal matched case–cohort study
Authors: Mabala Ditte Simmelkær , Stokholm Lonny , Andersen Nis , Andresen Jens , Bek Toke , Heegaard Steffen , Hajari Javad , Højlund Kurt , Kawasaki Ryo , Laugesen Caroline Schmidt , Möller Sören , Pedersen Frederik Nørregaard , Schielke Katja Christina , Thykjær Anne Suhr , Grauslund Jakob
Published: February 2024

Purpose

To investigate diabetic retinopathy (DR) as a potential marker of cardiovascular disease (CVD) in adults with type 1 diabetes attending the Danish DR‐screening programme and non‐diabetes adults.

Methods

In this registry‐based matched case–cohort study, we identified 16 547 adults with type 1 diabetes, who were registered in the Danish Registry of Diabetic Retinopathy (DiaBase). Each case was age‐ and sex‐matched by five non‐diabetes individuals (n = 82 399), and odds ratios (ORs) and hazard ratios (HRs) were estimated for incident and upcoming CVD in multivariable models.

Results

Adults with type 1 diabetes (median age 44.5 years, 57.6% male) were more likely to have prevalent CVD (OR 1.29; 95% CI, 1.20–1.38) and to develop CVD within 5 years (HR 1.19; 95% CI, 1.08–1.30) as compared to non‐diabetes control. However, adults without DR were less likely to develop CVD (HR 0.84; 95% CI, 0.72–0.97) compared to the reference population. For adults with type 1 diabetes, there was an increasing risk for incident CVD for increasing levels of DR (HR 1.33, 1.95, 1.71 and 2.39 for DR‐levels 1–4, respectively). Patients with CVD at the time of the first screening had a higher risk to develop DR during follow‐up (HR 1.23; 95% CI, 1.02–1.49).

Conclusion

In a nationwide matched case–cohort study adjusted for potential confounders, DR was identified as an independent marker of prevalent and incident CVD in type 1 diabetes with increasing risk demonstrated for higher levels of DR. Likewise, CVD also independently predicted the risk of incident DR.
Humoral immune response of Galleria mellonella after mono‐ and co‐injection with Hypericum perforatum extract and Candida albicans
Authors: Genç Tülay Turgut , Kaya Serhat , Günay Melih , Çakaloğlu Çağla
Published: February 2024

Galleria mellonella is used as a model organism to study the innate immune response of insects. In this study, the humoral immune response was assessed by examining phenoloxidase activity, fungal burden, and the expression of phenoloxidase and antimicrobial peptide genes at different time point following separate and combined injections of Hypericum perforatum extract and a nonlethal dose of Candida albicans. The administration of a plant extract at low doses increased phenoloxidase activity, while higher doses had no effect. Similarly, co‐injection of a low dose of the extract with the pathogen allowed half of the yeast cells to survive after 24 h. Co‐injection of plant extract with the pathogen decreased the phenoloxidase activity at the end of 4 h compared to C. albicans mono‐injection. The phenoloxidase gene expressions was reduced in all experimental conditions with respect to the control. When plant extracts and the pathogen were administered together, gallerimycin and hemolin gene expressions were considerably higher compared to mono‐injections of plant extracts and the pathogen. The results of this study reveal that gene activation and regulatory mechanisms may change for each immune gene, and that recognition and signaling pathways may differ depending on the involved immunoregulator.
Understanding barriers to reducing antimicrobials on Australian dairy farms: A qualitative analysis
Authors: Langhorne C , Wood BJ , Wood C , Henning J , McGowan M , Schull D , Ranjbar S , Gibson JS
Published: February 2024

Introduction

Reducing antibiotic use in production animal systems is one strategy which may help to limit the development of antimicrobial resistance. To reduce antimicrobial use in food‐producing animals, it is important to first understand how antibiotics are used on farm and what barriers exist to decreasing their use. In dairy production systems, mastitis is one of the most common reasons for administering antimicrobials. Therefore, it is important to understand the motivations and behaviours of dairy farmers in relation to the diagnosis, treatment and prevention of mastitis.

Materials and methods

In this study, we interviewed a sample of dairy farmers and dairy industry professionals from the major dairying regions of eastern Australia regarding their current practices used to diagnose, treat, and control subclinical and clinical mastitis. Inductive thematic analysis was used to code interview transcripts and identify the recurrent themes.

Results

Four overarching themes were identified: (1) the challenges associated with the detection and diagnosis of clinical mastitis, including with laboratory culture, (2) the motivations behind treatment decisions for different cases, (3) decisions around dry cow therapy and the role of herd recording, and (4) concerns regarding the development of antimicrobial resistance.

Discussion

This study identifies several challenges which may limit the ability of Australian dairy farmers to reduce antimicrobial use on farm, such as the need for rapid and reliable diagnostic tests capable of identifying the pathogenic causes of mastitis and the difficulties associated with conducting herd recording for the implementation of selective dry cow therapy. Industry professionals were concerned that farmers were not using individual cow records to aid in treatment decisions, which could result in unnecessary antimicrobial use. The results of this study can act as the basis for future research aimed at assessing these issues across the broader Australian dairy industry.
Economic evaluation of personalized vs. standard dosing of 5‐fluorouracil in first‐line chemotherapy for metastatic colorectal cancer in Australia
Authors: Erku Daniel , Martin Jennifer H. , Michael Michael , Galettis Peter , Scuffham Paul
Published: February 2024

Aims

Using pharmacokinetics (PK)‐guided 5‐fluorouracil (5‐FU) for metastatic colorectal cancer (mCRC) improves overall survival (OS) and decreases toxicity, yet its value for money in the Australian setting is unknown. Our study assesses the cost‐effectiveness of PK vs. body surface area (BSA) dosing of 5‐FU for patients with mCRC.

Methods

We developed a semi‐Markov model with four health states to compare PK‐guided dosing within a FOLFOX regimen vs. BSA‐guided dosing for mCRC patients from an Australian healthcare system perspective. Transition probabilities were derived from fitted survival models, with utility values obtained directly from published studies. We calculated direct healthcare costs, quality‐adjusted life years (QALYs) and incremental cost‐effectiveness ratios (ICERs), and included both one‐way and probabilistic sensitivity analyses.

Results

BSA‐guided FOLFOX provided 1.291 QALYs at a cost of $36 379, compared with PK‐guided FOLFOX which delivered 1.751 QALYs at a cost of $32 564. Therefore, PK‐guided dosing emerges as the dominant strategy offering both better health outcomes and lower costs. The variables that had the greatest impact on the overall ICER were the adverse event rates in the BSA and PK groups, model time horizon, utility of progression‐free survival and PREDICT assay cost. Our univariate and multivariate sensitivity analysis confirmed that the ICER for PK FOLFOX consistently remained below $50 000 per QALY across all tested variables.

Conclusions

PK dose management of 5‐FU‐based chemotherapy in mCRC patients appears to be a cost‐saving strategy in Australia. However, our model estimates are drawn from limited, low‐quality evidence. Further evidence from randomized controlled trials (RCTs), directly comparing PK‐based to BSA‐based dosing across a variety of current regimens, is needed to address our model's uncertainties.
Cardiac effects of deferasirox in transfusion‐dependent patients with myelodysplastic syndromes: TELESTO study
Authors: Sarocchi Matteo , Li Junmin , Li Xiao , Wu Depei , Montaño Figueroa Efreen , Rodriguez Maria Guadalupe , Hou Ming , Finelli Carlo , Shi Hong‐Xia , Xiao Zhijian , Oliva Esther Natalie , Gercheva Kyuchukova Liana , Drummond Mark , Symeonidis Argiris , Velazquez Eric J. , Rivoli Giulia , Izquierdo Miguel , Kolekar Yogita , Spallarossa Paolo , Angelucci Emanuele
Published: February 2024

Iron overload from repeated transfusions has a negative impact on cardiac function, and iron chelation therapy may help prevent cardiac dysfunction in transfusion‐dependent patients with myelodysplastic syndromes (MDS). TELESTO (NCT00940602) was a prospective, placebo‐controlled, randomised study to evaluate the iron chelator deferasirox in patients with low‐ or intermediate‐1–risk MDS and iron overload. Echocardiographic parameters were collected at screening and during treatment. Patients receiving deferasirox experienced a significant decrease in the composite risk of hospitalisation for congestive heart failure (CHF) or worsening of cardiac function (HR = 0.23; 95% CI: 0.05, 0.99; nominal p = 0.0322) versus placebo. No significant differences between the arms were found in left ventricular ejection fraction, ventricular diameter and mass or pulmonary artery pressure. The absolute number of events was low, but the enrolled patients were younger than average for patients with MDS, with no serious cardiac comorbidities and a modest cardiovascular risk profile. These results support the effectiveness of deferasirox in preventing cardiac damage caused by iron overload in this patient population. Identification of patients developing CHF is challenging due to the lack of distinctive echocardiographic features. The treatment of iron overload may be important to prevent cardiac dysfunction in these patients, even those with moderate CHF risk.
Fully Automated Versions of Clinically Validated Nephrometry Scores Demonstrate Superior Predictive Utility versus Human Scores
Authors: Wood Andrew M. , Abdallah Nour , Heller Nicholas , Benidir Tarik , Isensee Fabian , Tejpaul Resha , Suk‐ouichai Chalairat , Curry Caleb , You Alex , Remer Erick , Haywood Samuel , Campbell Steven , Papanikolopoulos Nikolaos , Weight Christopher
Published: February 2024

Objective

To automate the generation of three validated nephrometry scoring systems on preoperative computerised tomography (CT) scans by developing artificial intelligence (AI)‐based image processing methods. Subsequently, we aimed to evaluate the ability of these scores to predict meaningful pathological and perioperative outcomes.

Patients and Methods

A total of 300 patients with preoperative CT with early arterial contrast phase were identified from a cohort of 544 consecutive patients undergoing surgical extirpation for suspected renal cancer. A deep neural network approach was used to automatically segment kidneys and tumours, and then geometric algorithms were used to measure the components of the concordance index (C‐Index), Preoperative Aspects and Dimensions Used for an Anatomical classification of renal tumours (PADUA), and tumour contact surface area (CSA) nephrometry scores. Human scores were independently calculated by medical personnel blinded to the AI scores. AI and human score agreement was assessed using linear regression and predictive abilities for meaningful outcomes were assessed using logistic regression and receiver operating characteristic curve analyses.

Results

The median (interquartile range) age was 60 (51–68) years, and 40% were female. The median tumour size was 4.2 cm and 91.3% had malignant tumours. In all, 27% of the tumours were high stage, 37% high grade, and 63% of the patients underwent partial nephrectomy. There was significant agreement between human and AI scores on linear regression analyses (R ranged from 0.574 to 0.828, all P < 0.001). The AI‐generated scores were equivalent or superior to human‐generated scores for all examined outcomes including high‐grade histology, high‐stage tumour, indolent tumour, pathological tumour necrosis, and radical nephrectomy (vs partial nephrectomy) surgical approach.

Conclusions

Fully automated AI‐generated C‐Index, PADUA, and tumour CSA nephrometry scores are similar to human‐generated scores and predict a wide variety of meaningful outcomes. Once validated, our results suggest that AI‐generated nephrometry scores could be delivered automatically from a preoperative CT scan to a clinician and patient at the point of care to aid in decision making.
Re‐investigation of the Bispingen palaeolake sediment succession (northern Germany) reveals that the Last Interglacial (Eemian) in northern‐central Europe lasted at least ~15 000 years
Authors: Lauterbach Stefan , Neumann Frank H. , Tjallingii Rik , Brauer Achim
Published: February 2024

Investigating past interglacial climatic and environmental changes can enhance our understanding of the natural rates and ranges of climate variability under interglacial boundary conditions. However, comparing past interglacial palaeoclimate records from different regions and archives is often complicated by differing and uncertain chronologies. For instance, the duration of the Last Interglacial in Europe is still controversial as southern European palaeoclimate records suggest a duration of ~16 500–18 000 years, while a length of only ~11 000 years in northern‐central Europe was previously inferred from the analysis of partly annually laminated (varved) palaeolake sediments recovered at Bispingen, northern Germany. To resolve this discrepancy, we here present sediment microfacies, geochemistry and pollen data from a new sediment core from the Bispingen palaeolake sediment succession, covering the entire Last Interglacial (Eemian) and the earliest part of the Last Glacial (Weichselian). In particular, we provide evidence that the duration of the Last Interglacial at Bispingen must have been hitherto underestimated due to the investigation of an incomplete sediment core. Using microscopic varve counting and sedimentation rate estimates for non‐varved sections on the new sediment core, we show that the Eemian in northern‐central Europe probably lasted at least ~15 000 years, about 4000 years longer than previously thought. This new duration estimate is in much better agreement with results from southern European palaeoclimate records, clarifying the enigma of a steep trans‐European vegetation gradient for several millennia at the end of the Last Interglacial.
Community science enhances modelled bee distributions in a tropical Asian city
Authors: Lim Daniel Shan En , Pang Sean Eng Howe , Koay Tze Min , Soh Zestin Wen Wen , Ascher John S. , Tan Eunice Jingmei
Published: February 2024

Bees and the ecosystem services they provide are vital to urban ecosystems, but little is understood about their distributions, particularly in the Asian tropics. This is largely due to taxonomic impediments and limited inventorying, monitoring, and digitization of occurrence records. While expert collections (EC) are demonstrably insufficient by themselves as a data source to model and understand bee distributions, the boom of community science (CS) in urban areas provides an untapped opportunity to learn about bee distributions within our cities. We used CS observations in combination with EC observations to model the distribution of bees in Singapore, a small tropical city‐state in Southeast Asia. To address the restricted spatial context, we performed multiple bias corrections and show that species distribution models performed well when estimating the distribution of habitat specialists with distinct range limits detectable within Singapore. We successfully modelled 37 bee species, where model statistics improved for 23 species upon the incorporation of CS observations. Nine species had insufficient EC observations to obtain acceptable models, but could be modelled with the incorporation of CS observations. This is the first study to combine both EC and CS observations to map and model the occurrences of tropical Asian bee species for a highly urbanized region at such fine resolution. Our results suggest that urban landscapes with impervious surfaces and higher temperatures are less suitable for bee species, and such findings can be used to advise the management of urban landscapes to optimize the diversity of bee pollinators and other organisms.
Biomarkers predicting the controller dose of omalizumab in patients with chronic spontaneous urticaria
Authors: Zubiaga‐Fernandez L. , Testera‐Montes A. , Rondon C. , Perez‐Sanchez N. , Gomez‐Perez F. , Vega‐Chicote J. M. , Bartra J. , Ferrer M. , Eguiluz‐Gracia I. , Torres M. J.
Published: February 2024

Background

Clinical trials showed the efficacy of 300 mg/4 weeks of omalizumab (OMA) during 6 months in patients with severe chronic spontaneous urticaria (CSU). Nevertheless, in real life, many patients require higher doses and/or longer treatment. This study assesses the real‐life performance of OMA in severe CSU and identifies factors associated with the response.

Methods

CSU patients eligible for OMA were recruited prospectively. Clinical data and a blood test were collected before OMA initiation. Urticaria Activity Score 7 (UAS7) was calculated at baseline and every 3 months during OMA treatment. CSU control was defined as UAS7 <7 points. This work was partially sponsored by OMA manufacturer.

Results

Eighty‐nine adults (19.1% males) with severe CSU were recruited. Median duration of CSU prior to OMA initiation was 2 years, and median severity by UAS7 at baseline was 24 points (range 10–42 points). OMA controlled 94.4% of patients, but 17.9% of responders required doses >300 mg/4 weeks. A blood basophil count >20 cells/μL (OR 13.33; 95% CI 3.32–52.63; p < .001) and the absence of hypothyroidism (OR 3.65; 95% CI 0.78–16.95; p = .099) were identified as predictive factors to achieve control with 300 mg/4 weeks. Twelve patients were able to stop OMA during the study (responders in remission, RR). RR had received OMA for a median of 29 months (12–53 months). Conversely, 32 patients had been on OMA for >29 months at the end of the study (active responders, AR). AR had received OMA for a median of 45 months (30–100 months). There were no significant differences in clinical or analytical factors between RR and AR patients.

Conclusions

Low blood basophil count and the presence of hypothyroidism might serve as biomarkers for the controller dose of OMA in severe CSU patients.
The biofilm removal effect and osteogenic potential on the titanium surface by electrolytic cleaning: An in vitro comparison of electrolytic parameters and five techniques
Authors: Zhu Yun , Xu Yangbo , Ling Zhaoting , Zhao Congrui , Xu Antian , He Fuming
Published: February 2024

Objectives

To determine the optimal current and time of electrolytic cleaning (EC), compare its biofilm removal effect with generic treatments and evaluate the influence of EC to surface characteristics and osteogenic potential of SLA titanium (Ti) discs.

Materials and Methods

The six‐species biofilm‐covered Ti discs were placed as cathodes in physiologic saline and subjected to various current and time treatments. The residual biofilms were evaluated to determine the optimal parameters. The contaminated Ti discs were randomized and treated by rotating Ti brush; ultrasonic‐scaling with metal tips; ultrasonic‐scaling with PEEK tips; air‐polishing and EC. The residual biofilms were compared using a lipopolysaccharide kit (LPS), scanning electron microscope (SEM), confocal laser scanning microscopy and colony‐forming unit counting. Non‐contaminated Ti discs were treated and characterized. The bone marrow mesenchymal stem cells (BMSCs) were cultured on treated non‐contaminated Ti discs. The adhesion, proliferation, alkaline phosphatase (ALP) activity and osteocalcin level of BMSCs were assessed.

Results

The parameters at 0.6A5min were considered optimal. For LPS and SEM, EC promoted a significantly greater biofilm removal than the other groups. There were no changes in the Ti discs' colour, topography, roughness and chemical elements after EC, and the electrolysis‐treated Ti discs obtained a super‐hydrophilic surface. EC positively impacted the proliferation and ALP activity of BMSCs, surpassing the efficacy of alternative treatments.

Conclusions

EC achieves a near‐complete eradication of contaminants on the SLA surface, causes no surface damage with improved hydrophilicity, and promotes the early osteogenic response of BMSCs, which makes it a promising treatment for peri‐implantitis.
Distinct age‐adjusted D‐dimer threshold to rule out acute pulmonary embolism in outpatients and inpatients
Authors: Liu Peng , Yu Haixu , Liu Wei , Lin Lin , Ji Ying Qun
Published: February 2024

Introduction

The diagnosis of acute pulmonary embolism (PE) is combinations of clinical probability assessments, plasma D‐dimer (DD) test results, and/or computed tomographic pulmonary angiography (CTPA).

Objective

The aim of this study is to explore the appropriate DD cutoff using the immunoturbidimetric method in outpatients and inpatients.

Methods

We retrospectively enrolled 2689 patients with suspected PE between January 2014 and December 2019. All patients underwent clinical probability assessments, DD tests, and CTPA. We investigated the appropriate cutoff level for plasma DD tests in the correlation analysis and receiver operating characteristic (ROC) curves.

Results

Among all patients, 1263 were confirmed acute PE. The age‐adjusted DD level was determined to be age × 10 μg/L (for patients aged >50 years) in outpatients. This cutoff value resulted in a sensitivity of 96.75% and a specificity of 87.02%, with the area under the curve (AUC) of 0.908 and the number needed to treat (NNT) of 1.18. For inpatients, the age‐adjusted cutoff values for the biomarker DD demonstrated poor specificity (13.34%) and NNT (9.88). However, when the DD cutoff was adjusted to 2 × the upper limit of normal (ULN), the sensitivity increased to 93.19%, while the specificity remained at 29.55%, with the AUC of 0.610 and the NNT of 4.76. The optimal DD cut‐off value was 3010 μg/L (about 5 × ULN), resulting in a sensitivity of 75.22% and specificity of 61.72%, with the AUC of 0.727 and the NNT of 2.7.

Conclusion

Using the immunoturbidimetric method to measure DD, an age‐adjusted DD cutoff (age × 10 μg/L, if aged >50 years) should be considered for outpatients with suspected PE. For inpatients, increasing the DD cutoff value to at least 2 × ULN yields the best test performance.
Epilepsy surgery during infancy: The earlier the better
Authors: Roth Jonathan , Uliel‐Sibony Shimrit , Constantini Shlomi
Published: February 2024

This commentary is on the original article by Wu et al. on pages 1215–1225 of this issue.
Impact of epilepsy surgery on developmental trajectories of children under 3 years of age
Authors: Wu Yuan , Zhang Qian , Deng Yutong , Ding Xiang , Xie Han , Wang Shuang , Liu Chang , Li Ming , Cai Lixin , Jiang Yuwu
Published: February 2024

Aim

To investigate the developmental effects of epilepsy surgery in young children.

Method

This study retrospectively reviewed 315 consecutive children under 3 years of age, and ultimately included 89 children (48 males, 41 females) with pre‐ and postsurgery developmental evaluations.

Results

The mean general quotient before surgery was 46.7 (SD 24.7). Before surgery, the general quotient decreased in 77.6% of patients, while after surgery it increased in 55.1%. Furthermore, 70% of those 20 patients whose presurgical general quotient decreased by more than 10 points experienced positive changes. General quotient scores decreased in 15 out of the 22 patients classified in the normal/marginal presurgical category. Children who underwent surgery before the age of 12 months had a median gain in general quotient score by 7.6. Short‐term general quotient scores were highly correlated with long‐term scores (r = 0.909, p < 0.001).

Interpretation

Surgical intervention was more inclined to positively impact developmental trajectories within a short postsurgical period, particularly among those affected by severe epileptic activity. However, in children with relatively typical development, certain developmental setbacks may arise. Postsurgical short‐term developmental outcomes could predict longer‐term outcomes.
The wage curve after the Great Recession
Authors: Blanchflower David , Bryson Alex , Spurling Jackson
Published: February 2024

Most economists maintain that the labour market in the USA (and elsewhere) is ‘tight’ because unemployment rates are low, and the Beveridge curve (the vacancies‐to‐unemployment ratio) is high. They infer from this that there is potential for wage‐push inflation. However, real wages fell rapidly in 2022, and prior to that, real wages had been stagnant for some time. We show that unemployment is not key to understanding wage formation in the USA, and has not been since the Great Recession. Instead, we show that rates of underemployment (the percentage of workers with part‐time hours who would prefer more hours) and the rate of inactivity (the percentage of the civilian adult population who are out of the labour force) reduce wage pressure in the USA. This finding holds in panel data with state and year fixed effects in both annual and quarterly data for the period 1980–2022, and is supportive of a wage curve that fits the data much better than a Phillips curve. The unemployment rate no longer enters significantly negative in wage equations, however specified, in the years since 2008.
Integrating data from different taxonomic resolutions to better estimate community alpha diversity
Authors: Adjei Kwaku Peprah , Carvell Claire , Isaac Nick J. B. , Mancini Francesca , O'Hara Robert B.
Published: February 2024

Integrated distribution models (IDMs), in which datasets with different properties are analysed together, are becoming widely used to model species distributions and abundance in space and time. To date, the IDM literature has focused on technical and statistical issues, such as the precision of parameter estimates and mitigation of biases arising from unstructured data sources. However, IDMs have an unrealised potential to estimate ecological properties that could not be properly derived from the source datasets if analysed separately. We present a model that estimates community alpha diversity metrics by integrating one species‐level dataset of presence–absence records with a co‐located dataset of group‐level counts (i.e. lacking information about species identity). We illustrate the ability of community IDMs to capture the true alpha diversity through simulation studies and apply the model to data from the UK Pollinator Monitoring Scheme, to describe spatial variation in the diversity of solitary bees, bumblebees and hoverflies. The simulation and case studies showed that the proposed IDM produced more precise estimates of the community diversity than the single models, and the analysis of the real dataset further showed that the alpha diversity estimates from the IDM were averages of the single models. Our findings also revealed that IDMs had a higher prediction accuracy for all the insect groups in most cases, with this performance linked to the information provided by a data source into the IDM.
Low‐head dam fragmentation, habitat alteration, and invasive predators degrade a Western United States stream fish assemblage
Authors: Haworth Matthew R. , Bestgen Kevin R.
Published: February 2024

Dams fragment streams, alter hydrology and habitat, and facilitate establishment of nonnative species worldwide to the detriment of native biota. Understanding and mitigating these effects to conserve and restore stream fish assemblages has relied on short‐ and long‐term datasets to assess acute and chronic change through time, craft management strategies, and measure remediation success. We used sampling records collected over a 29‐year period (1993–2021) to examine likely causes of fish assemblage change in the Cache la Poudre River, Colorado, USA. Numerous low‐head dams have reduced connectivity and altered flow, temperature, and habitat in the transition zone, a reach that historically supported rare and sensitive taxa valuable to regional biodiversity. We found diversity, distribution, and abundance of native species declined since the early 1990s, with formerly rare taxa extirpated and some common species becoming rare. Native taxa remained numerically dominant in warmer downstream reaches most affected by streamflow diversion but were incrementally reduced in richness and abundance upstream of low‐head dams without fishways. Concurrently, nonnative Brown Trout Salmo trutta increased in distribution and abundance, dominating upstream reaches that receive cooler and more stable flows, and expanding into downstream reaches where they were formerly absent, with likely negative consequences for native fishes. In the absence of mitigation, these collective effects, plus recent wildfire disturbance and future water development, will continue to degrade stream fish assemblages in our study area, and worldwide, where resource managers face the often‐competing interests of conserving native species, providing recreational fisheries, and meeting increasing water demands.