bluuebunny/crossref_metadata_2025 huggingface dataset:
Transitions in smoking status in nursing students: A prospective longitudinal study
Authors: Laroussy Kenza , Castellano Yolanda , Fu Marcela , Baena Antoni , Feliu Ariadna , Peruga Armando , Margalef Mercè , Aldazabal Jon , Tigova Olena , Galimany Jordi , Puig Montserrat , Moreno Carmen , Bueno Albert , López Antonio , Roca Judith , Saura Judith , Fernández Esteve , Martínez Cristina
Published: March 2023

Aim

To describe transitions in smoking status and their determining factors among nursing students between baseline (2015–2016) and follow‐up (2018–2019).

Design

Observational prospective longitudinal study of 4381 nursing students in Catalonia (Spain).

Methods

We examined transitions in smoking status from: (i) current smokers to recent quitters, (ii) never smokers to new smokers and (iii) former smokers to quitters who relapsed. We fitted logistic regression models to assess the predictors of quitting smoking.

Results

The proportion of current smokers decreased from 29.7% at baseline to 23.6% at follow‐up, with a cumulative incidence rate of quitting of 28.3% during follow‐up. Nondaily smokers were more likely to quit than daily smokers. Of those who were never smokers at baseline, 4.6% were smokers at follow‐up, and 23.2% of former smokers at baseline had relapsed at follow‐up.

Conclusions

Nondaily smokers were more likely to have quit smoking at follow‐up among this cohort of nursing students. The early implementation of a comprehensive tobacco control program that includes tobacco‐free campus policies, tobacco prevention interventions and cessation support during college years may decrease tobacco use among nursing students.

Impact

Nursing students' tobacco use is concerning, as they are the future workforce of nurses who have a key role in tobacco product use prevention and cessation. During college years, nursing students have a greater likelihood of experimenting with several smoking status changes as well as to consolidate smoking behaviors. This is the first longitudinal study to highlight the factors associated with quitting smoking among a cohort of Spanish nursing students. Being a nondaily smoker at baseline predicted quitting at follow‐up. Our findings support the early implementation of a comprehensive tobacco control program that includes tobacco‐free campus policies, tobacco prevention interventions and tobacco cessation support during college years to decrease tobacco product use prevalence among nursing students.

Reporting Method

We have adhered to STROBE guidelines. No Patient or Public Contribution. This observational study has not been registered.
The Balanced View of the Value of Conscience
Authors: McConnell Doug , Savulescu Julian
Published: March 2023

On the mainstream view, consciences are valuable because they promote moral unity. However, conscience, so defined, will systematically prevent moral growth that threatens unity, even when unity has formed around oppressive moral values. This motivates Carolyn McLeod's alternative ‘Dynamic View’ whereby consciences are valuable to the extent that they are dynamic. Consciences are dynamic when they interact with our best moral judgements to shape or ‘retool’ the moral values underpinning conscience, sometimes at an initial cost to unity. We modify and extend McLeod's account in two ways: (1) We object to her claim that conscience encourages its own retooling. We argue that the opposite is true – conscience creates a motivational barrier to change that moral judgement must overcome to successfully retool conscience. The task of ensuring dynamism, therefore, falls to moral judgement. (2) However, this motivational barrier enables conscience to play a valuable role that McLeod overlooks – compensating for the limitations of moral judgement. On our Balanced View, the value of conscience depends on it being sufficiently open to being shaped by our best moral judgements but inert enough to compensate for distorted moral judgements and to guide action when under cognitive load.
Effects of mode of heat transfer on puffing quality of rice grain: A modeling and simulation analysis
Authors: Lata Sneh , Swarnakar Ajay Kumar , Kumar Ashok , Das Susanta Kumar
Published: March 2023

Cereal grains can be puffed by heating in hot sand bed or domestic microwave oven. The purpose of this study was to explore and compare the reasons of transformational changes in preconditioned rice during its sand bed heating and microwave heating in domestic microwave oven. Mathematical modeling and simulation techniques were used to estimate the changes in microwave power absorption density and temperature of rice with the heating methods. Sand puffing, initiated from the tips of rice, progressed toward the central region of the rice following the change in temperature profile of rice and outcomes were completely puffed rice. The rice grains, placed in the different radial zones on the turntable of oven cavity, experienced nonuniform and inconsistent rate of microwave power absorption within the rice due to its placement and rotation, the oven factors, grain's shape, size, and dielectric properties. Microwave puffing, initiated from the central region of rice, progressed toward the tips of the rice. The slow rate of heating resulted in evaporative cooling of rice and most of the rice were unable to puff completely. However, the rate of microwave heating of rice was comparable with that of sand heating and about 92.0 ± 2.3% puffed was observed when rice was place in radial zone of 5.0 cm. Hence, the exact placement of rice in the oven cavity was required for achieving good puffing quality of rice.

Practical applications

The present study helps to understand the reasons for uneven puffing of rice in domestic microwave oven. This understanding of puffing process in domestic microwave oven provides an opportunity to develop strategy for microwave puffing of rice or design a specific microwave puffing equipment suitable for achieving quantitative and qualitative puffing of rice.
Catching the aging curve early
Authors: Voropai Daria , Kroeskop Annebeth
Published: March 2023

In the field of Cosmetic Medicine, more and more younger individuals seek treatments and are looking further than only beautification and catching the aging curve early by improving the internal metabolism and strengthening the tissues. There is a promising niche evolving to meet these goals. The current article discussed one of the possibilities and techniques to catch this curve.
Typing Performance and Technique of Higher Education Students with Specific Learning Disorders
Authors: Abecassis Sharon , Magen Hagit , Weintraub Naomi
Published: March 2023

Higher education students with specific learning disorders (SLD) often experience difficulties in basic learning skills, including typing on computers, which has become the most common writing mode for academic purposes. This may affect their academic performance. We compared the typing performance, product, and technique (screen gaze, finger use) of 35 SLD and 30 typically developing (TD) students using keylogging software. Compared to TD peers, students with SLD typed more slowly and less accurately, and gazed less at the screen, suggesting a less effective typing technique. They typed slower even after controlling for screen gaze, implying that additional factors may account for their lower typing speed such as language processing. Hence, students with SLD may benefit from typing instruction alongside test accommodations during computer‐based exams.
Challenges facing standardised patients representing equity‐deserving groups: Insights from health care educators
Authors: Sibbald Matt , Last Nicole , Keuhl Amy , Azim Arden , Sheth Urmi , Khalid Faran , Banji Farhan , Geekie‐Sousa Aaron , Yilmaz Derya Uzelli , Monteiro Sandra
Published: March 2023

Introduction

Health professions training programmes increasingly rely on standardised patient (SP) programmes to integrate equity‐deserving groups into learning and assessment opportunities. However, little is known about the optimal approach, and many SP programmes struggle to meet these growing needs. This study explored insights from health care educators working with SP programmes to deliver curricular content around equity‐deserving groups.

Methods

We interviewed 14 key informants in 2021 who were involved in creating or managing SP‐based education. Verbatim transcripts were analysed in an iterative coding process, anchored by qualitative content analysis methodology and informed by two theoretical frameworks: sociologic translation and simulation design. Repeated cycles of data collection and analyses continued until themes could be constructed, aligned with existing theories and grounded in empirical data, with sufficient relevance and robustness to inform educators and curricular leads.

Results

Three themes were constructed: (i) creating safety for SPs paid to be vulnerable, (ii) fidelity as an issue broader than who plays the role and (iii) engaging equity‐deserving groups. SP work involving traditionally marginalised groups risk re‐traumatization, highlighting the importance of (i) informed consent in recruiting SPs, (ii) separating role portrayal from lived experiences, (iii) adequately preparing learners and facilitators, (iv) creating time‐outs and escapes for SPs and (v) building opportunity for de‐roling with community support.

Conclusions

SP programmes are well positioned to be allies and advocates to equity‐deserving groups and to collaborate and share governance of the educational development process from its outset. SP programmes can support the delivery of curricular content around equity‐deserving groups by advocating with curricular leadership, building relationships with community partners, facilitating co‐creation and co‐delivery of educational content and building safety into simulation.
The Rome Foundation Global Epidemiology study: Conception, implementation, results, and future potential
Authors: Sperber Ami D.
Published: March 2023

Background

Methodological problems have impeded successful epidemiological research into disorders of gut‐brain interactions (DGBI), as previous studies were limited in terms of study population, diagnostic criteria, number of disorders assessed, data collection methods, and geographic area. Most prevalence estimates were based on pooling data from heterogeneous studies using inappropriate pooling methods, seriously limiting the relevance of the results. The Rome Foundatiion Global Epidemiology Study (RFGES) aimed to rectify these limitations using rigorous methodology to survey the prevalence of 22 DGBI in large population samples in 33 countries. Its aims were to conduct a comprehensive, multinational epidemiological study using rigorous research methodology, gain a better understanding of the burden of the DGBI, gain reliable regional estimates of DGBI prevalence, and advance our understanding of the pathophysiology of IBS. The study questionnaire consisted of the 89‐item Rome IV Adult Diagnostic Questionnaire enabling the diagnosis of 22 DGBI, and an 80‐item supplemental questionnaire that enabled analyses of the association of multiple factors with DGBI diagnoses.

Purpose for review article

This review paper introduces a special issue on the Rome Foundation Global Epidemiology study (RFGES) with a narrative description of its conception, development, and implementation, its outcomes to date, and its potential contribution to neurogastroenterology. It includes 15 papers that reflect the range of RFGES studies from single country papers to intra‐regional studies, to inter‐regional studies, and one global study.
Low prevalence of positive hydrogen breath tests in patients with functional gastrointestinal conditions and hypermobile Ehlers–Danlos syndrome
Authors: Dervin Humayra , Zarate‐Lopez Natalia , Sweis Rami , Mensah Alexia , Fragkos Konstantinos , Brugaletta Concetta , Raeburn Amanda , Emmanuel Anton
Published: March 2023

Background

Using hydrogen breath testing (HBT) to diagnose small intestinal bacterial overgrowth (SIBO) remains controversial in patients with functional gastrointestinal (GI) disorders, and unknown in those with hypermobility Ehlers–Danlos syndrome (hEDS). We assessed prevalence of positive HBTs in these groups, evaluated the predictive value of GI symptoms and the potential role of proton pump inhibitors (PPIs) on test results.

Methods

Sequential patients referred for HBT to a tertiary unit were classified into the following groups: GI maldigestion/malabsorption, GI sensorimotor disorders, hEDS, and functional GI disorders. All underwent standardized HBT, and the yield was assessed against symptoms and PPI use.

Key Results

A total of 1062 HBTs were performed over 3 years (70% female, mean age 48 ± 16 years). Overall, 7.5% (80/1062) patients had a positive HBT. Prevalence of positive HBT was highest in patients with GI maldigestion/malabsorption (17.9%; DOR 16.16, p < 0.001), GI sensorimotor disorders (15.9%; DOR 8.84, p < 0.001), compared to functional GI disorders (1.6%; DOR 1.0) (p < 0.0001). None of the hEDS patients tested positive for HBT. A positive HBT was independently associated with increased age (DOR 1.03; p < 0.001) and symptoms of diarrhea (DOR 3.95; p < 0.0001). Patients on PPIs tended towards a positive HBT than patients off PPIs (16.1% vs 6.9%; DOR 2.47; p < 0.0001).

Conclusions & Inferences

Less than 2% of patients with functional GI disorders, and none of the patients with hEDS had a positive HBT. Pre‐test probability was higher in patients with: GI structural or neurological disorders; use of long‐term PPIs and symptoms of diarrhea. These criteria may be helpful in making appropriate therapeutic decisions and avoiding unnecessary hydrogen breath testing.
Using a footstool does not aid simulated defecation in undifferentiated constipation: A randomized trial
Authors: Trieu Rose Qizhengyan , Prott Gillian , Sequeira Carol , Jones Michael , Mazor Yoav , Schnitzler Margaret , Malcolm Allison
Published: March 2023

Introduction

The use of a footstool has been advocated to optimize posture when sitting on the toilet and thus facilitate bowel evacuation. We aimed to assess the alterations in defecatory posture, and the changes in simulated defecation with use of a footstool in patients with constipation.

Methods

Forty‐one patients (female 93%, mean 52 year, SD 14 year) with constipation referred to a tertiary neurogastroenterology unit were enrolled. A bowel questionnaire, Hospital Anxiety and Depression Scale, and Rome questionnaire were administered prior to anorectal manometry. Each patient underwent three rectal balloon expulsion tests in randomized order with no footstool, a 7‐inch, and a 9‐inch footstool. Additional assessments included angle between spine and femur, and visual analogue scales assessing ease of evacuation, urge to defecate, and discomfort with expulsion.

Key Results

Defecatory posture was significantly altered by footstool use, with progressive narrowing of the angle between the spine and femur as footstool height increased (p < 0.001 for all comparisons). Compared with no footstool, the use of a footstool was not associated with a change in balloon expulsion time and there was no difference between the two footstool heights. Subjectively, no significant change was identified in any of the three perceptions of balloon expulsion between no footstool and footstool use.

Conclusions and Inferences

Although the use of a footstool led to changes in defecatory posture, it did not improve subjective or objective measures of simulated defecation in patients with undifferentiated constipation. Therefore, the recommendation for its use during evacuation cannot be applied to all patients with constipation.
Disordered eating and eating competence in members of online irritable bowel syndrome support groups
Authors: Evans Kate M. , Averill Michelle M. , Harris Cristen L.
Published: March 2023

Background

This study seeks to evaluate eating competence and disordered eating likelihood among members of online support groups for irritable bowel syndrome (IBS) and determine whether eating competence and disordered eating likelihood varies according to IBS symptom severity and subtype.

Methods

This cross‐sectional study is based on an anonymous survey conducted from August to September 2021. Adults with IBS (N = 225) were recruited from online and social media IBS support forums. IBS symptom severity was assessed using the validated IBS Severity Scoring System (IBS‐SSS), likelihood of disordered eating was assessed using the validated Eating Attitudes Test (EAT‐26), and eating competence was assessed using the validated Satter Eating Competence Inventory (ecSI 2.0™). Multiple linear regression was used to predict EAT‐26 total score from IBS‐SSS score, age, and IBS subtype. ANOVAs were used to examine the relationships between IBS severity level, IBS subtype, and ecSI 2.0™ total score.

Key Results

Eating competence among the sample was low at 17% while 27% was classified as likely or very likely disordered eating. IBS severity was positively associated with EAT‐26 score (p = 0.011) and ecSI 2.0™ score was significantly lower in the severe IBS group compared to the moderate IBS group (p = 0.016). No relationship was detected between IBS subtype and EAT‐26 or ecSI 2.0™ scores.

Conclusions & Inferences

IBS severity was positively associated with disordered eating likelihood and negatively associated with eating competence. This sheds light on the importance of assessing eating competence and screening for disordered eating prior to selecting therapies for patients with IBS, particularly in females with severe symptoms.
Preoperative Leg Length Discrepancy >2 cm in the Supine Decubitus Position May Induce Compensatory Pelvic Obliquity in Patients during Total Hip Arthroplasty
Authors: Sun Xiaoliang , Qiu Jiandi , Jiang Songli , Lin Lan , Yang Guojing , Yang Shengwu , Zhang Lei
Published: March 2023

Objectives

The leg length discrepancy (LLD) in the supine decubitus position may influence the inclination angle of the acetabular component during total hip arthroplasty (THA). The relationship among LLD, pelvic obliquity, and inclination angle of the acetabular component has not been well studied. This study aimed to evaluate the relationship between LLD in supine position and changes in the inclination angle of the acetabular components during THA, and the compensatory ability of the pelvis based on LLD and inclination.

Methods

A total of 135 patients were prospectively classified into three groups according to the preoperative LLD in the supine decubitus position: the cranial type group had a positive LLD value; the fixed type group had LLD = 0; and the caudal type group had a negative LLD value. Patients in the cranial type group and caudal type group were divided into four subgroups based on the LLD value (either positive or negative): LLD >3 cm subgroup; 2 ≤ LLD ≤ 3 cm subgroup; 1 ≤ LLD < 2 cm subgroup; and LLD <1 cm subgroup. The targeted and final inclination of the acetabular component was measured intra‐ and postoperatively.

Results

The results showed a significant difference in the targeted and final inclination angles among the patients in the cranial type and the caudal type groups. In the caudal type group, increased inclination was observed in the patients of LLD >3 cm subgroup (mean 3.13°) and 2 ≤ LLD ≤ 3 cm subgroup (mean 5.17°) after THA, respectively. Decreased inclination (mean, 6.16°) was observed in 2 ≤ LLD ≤ 3 cm subgroup in the cranial type group after THA.

Conclusions

Our findings revealed that in patients with discrepancy greater than 2 cm, postural pelvic obliquity imposed a remarkable influence on the inclination.
Fiscal multipliers and structural economic characteristics: Evidence from countries in sub‐Saharan Africa
Authors: Woldu Gabriel Temesgen , Szakálné Kanó Izabella
Published: March 2023

Output response to discretionary fiscal policy is a key aspect of examining various theories, findings of empirical studies and delivering guidance to policymakers. This study analyses the output response to unanticipated fiscal spending shocks under several structural economic characteristic factors, including business cycle states, debt burden, openness of the economy, exchange rate regimes and political governance regime, using annual data from 40 countries in SSA spanning from 2000 to 2019 in a panel threshold vector auto‐regression model. The findings indicate that fiscal spending multipliers have much larger effects on output in times of recession, in economies operating under lower trade openness, a fixed exchange rate, low‐debt burden, restricted capital mobility, less financial development and a democratic governance regime. Based on the results, the discretionary countercyclical fiscal policy and optimal fiscal policy action are recommended. Moreover, in order to have effective fiscal policy must target hand‐to‐mouth consumers (non‐Ricardian consumers) and firms with limited liquidity, concentrating on social services and social protection to increase short‐term demand. Likewise, A proper fiscal monetary policy mix should be considered with other structural measures to maximising the positive effects of the fiscal expansion.
Reflect–Express–Transform: Investigating Speech-Based Iterative Digital Design for Young Designers
Authors: Vyas Shantanu , Chen Ting-Ju , Woodward Jay , Krishnamurthy Vinayak R.
Published: March 2023

We investigate speech-based input as a means to enable reflective thinking for younger individuals (middle- and high-school students) during design iterations. Verbalization offers a unique way to externalize ideas in early design and could therefore lead to new pathways for exploration and iteration, especially for K-12 students who possess the creative potential but are not technically trained in the design process. Interactive design systems, however, by-and-large utilize sketching, multitouch, and gestural inputs. As a result, (1) there is little know-how regarding how to operationalize verbal inputs as a meaningful way to facilitate idea exploration and (2) there is little fundamental understanding of the underlying cognitive mechanisms for iteration through verbal communication. We take the initial steps toward these gaps by first designing and implementing the ShapOrator interface that takes verbal descriptions of geometric parameters (shape, size, instances) in a semi-natural language form and determines the appropriate transformations to a given design artifact modeled as a shape assembly. By using ShapOrator as our experimental setup, we conducted an in-depth observational study on ten middle- and high-school students tasked with designing spaceships. Our study revealed that participants were able to create a variety of designs while associating functional and topical contexts to their spaceships throughout the design iteration process.
They Didn’t Do Anything Wrong but They Did Everything White: Examination of the 1968 Harvard Crew’s Support of the Olympic Project for Human Rights
Authors: Schweinbenz Amanda Nicole , Harrison C. Keith
Published: March 2023

The iconic image of Tommie Smith and John Carlos standing on the podium, with bowed heads, black-gloved fists in the air during the playing of the American national anthem at the 1968 Summer Olympic Games in Mexico City, is a symbol of resistance and the civil rights movement. This symbolic activism was part of a larger movement, the Olympic Project for Human Rights (OPHR) that was led by Dr. Harry Edwards. The movement was designed to be a nonviolent protest against the inhumane treatment of Black men in the United States. While Edwards and several of the track-and-field athletes worked to create awareness of their fight, a small group of rowers out of Harvard University also took notice. The Harvard men’s eight was the crew selected to represent the United States at the 1968 Games in Mexico, and shortly after their selection, a number of the men decided that they too wanted to support the initiative that Edwards had started. In their attempt to prove that they were indeed allies to the Black athletes on the American team, the men met with Edwards and decided to send letters to each person selected to represent the United States at the 1968 Games in Mexico that outlined the plight of the Black American athletes. However, while their intentions may have been honorable, many within the OPHR movement did not agree with the involvement of the Harvard rowers. Several members argued that these privileged White men had no right to be involved and their initiative was unwanted. This raises important discussions surrounding allyship; more specifically what constitutes an ally compared to the “great white hope?” This paper uses Edward’s concept of allyship and the oblivious possessive investment of whiteness and critically examines the Harvard men’s support of the OPHR movement in 1968.
High level of novelty under the hood of convergent evolution
Authors: Van Belleghem Steven M. , Ruggieri Angelo A. , Concha Carolina , Livraghi Luca , Hebberecht Laura , Rivera Edgardo Santiago , Ogilvie James G. , Hanly Joseph J. , Warren Ian A. , Planas Silvia , Ortiz-Ruiz Yadira , Reed Robert , Lewis James J. , Jiggins Chris D. , Counterman Brian A. , McMillan W. Owen , Papa Riccardo
Published: March 2023

Little is known about the extent to which species use homologous regulatory architectures to achieve phenotypic convergence. By characterizing chromatin accessibility and gene expression in developing wing tissues, we compared the regulatory architecture of convergence between a pair of mimetic butterfly species. Although a handful of color pattern genes are known to be involved in their convergence, our data suggest that different mutational paths underlie the integration of these genes into wing pattern development. This is supported by a large fraction of accessible chromatin being exclusive to each species, including the de novo lineage-specific evolution of a modular
optix
enhancer. These findings may be explained by a high level of developmental drift and evolutionary contingency that occurs during the independent evolution of mimicry.
Social signal learning of the waggle dance in honey bees
Authors: Dong Shihao , Lin Tao , Nieh James C. , Tan Ken
Published: March 2023

Honey bees use a complex form of spatial referential communication. Their “waggle dance” communicates the direction, distance, and quality of a resource to nestmates by encoding celestial cues, retinal optic flow, and relative food value into motion and sound within the nest. We show that correct waggle dancing requires social learning. Bees without the opportunity to follow any dances before they first danced produced significantly more disordered dances with larger waggle angle divergence errors and encoded distance incorrectly. The former deficit improved with experience, but distance encoding was set for life. The first dances of bees that could follow other dancers showed neither impairment. Social learning, therefore, shapes honey bee signaling, as it does communication in human infants, birds, and multiple other vertebrate species.
Bees learn to dance
Authors: Chittka Lars , Rossi Natacha
Published: March 2023

Experience yields precision in the waggle dance of honey bees
Superconducting crystal may be ‘revolutionary’
Authors: Service Robert F.
Published: March 2023

After retraction, researchers make fresh claim of room temperature superconductivity
China battles alien weed at unprecedented scale
Authors: Stokstad Erik
Published: March 2023

“Mammoth” plan to control a coastal invader would benefit migratory birds
MarR-Dependent Transcriptional Regulation of
mmpSL5
Induces Ethionamide Resistance in Mycobacterium abscessus
Authors: Rodriguez Ronald , Campbell-Kruger Nick , Gonzalez Camba Jesus , Berude John , Fetterman Rachel , Stanley Sarah
Published: March 2023

Mycobacterium abscessus
(
Mabs
) is an emerging nontuberculosis mycobacterial (NTM) pathogen responsible for a wide variety of respiratory and cutaneous infections that are difficult to treat with standard antibacterial therapy.
Mabs
has a high degree of both innate and acquired antibiotic resistance to most clinically relevant drugs, including standard anti-mycobacterial agents. Ethionamide (ETH), an inhibitor of mycolic acid biosynthesis, is currently utilized as a second-line agent for treating multidrug-resistant tuberculosis infections.
Identification of Genes Required for Long-Term Survival of
Legionella pneumophila
in Water
Authors: Aurass Philipp , Kim Seongok , Pinedo Victor , Cava Felipe , Isberg Ralph R.
Published: March 2023

Water is the primary vector for transmission of
L. pneumophila
to humans, and the pathogen is adapted to persist in this environment for extended periods of time. Preventing survival of
L. pneumophila
in water is therefore critical for prevention of Legionnaires’ disease.
Permian to Triassic protolith ages of type locality eclogites in the Eastern Alps: Implications for the opening of the Meliata back-arc basin
Authors: Chang Ruihong , Neubauer Franz , Liu Yongjiang , Genser Johann , Guan Qingbin , Huang Qianwen , Yuan Sihua
Published: March 2023

The Austroalpine domain contains the type locality of eclogites, but their protolith age is unknown except for a Permian metagabbro. Therefore, we studied the non-gabbroic eclogites from the Saualpe-Koralpe Complex (SKC) representing meta-basalts within a coherent continental rift fragment subducted during the Cretaceous. Zircon laser ablation–inductively coupled plasma–mass spectrometry (LA-ICP-MS) U-Pb dating revealed protolith ages of 283 ± 5 Ma, 255 ± 3 Ma, 251 ± 3 Ma, and 241 ± 3 Ma. Magmatic zircons exhibit 176Hf/177Hf ratios of 0.282935–0.283090 and juvenile εHf(t) values of +10 to +17.4. Typical normal mid-oceanic ridge basalt (N-MORB) geochemistry is established. The SKC host metasedimentary rocks are interpreted as Variscan continental crust close to the margin of the oceanic Meliata basin and were affected by Permian metamorphism. Metamorphic zircon of one SKC eclogite yields an age of 87–93 Ma. These results combined with previous data are used to present a new model for the tectonic evolution of the distal Austroalpine unit associated with the Meliata Ocean in a Wilson cycle: The SKC represents a distal continental margin during Permian to Middle Triassic rifting, which was intruded by few gabbro bodies and numerous basaltic sills and mostly Permian pegmatites. In contrast, structurally separated thick Triassic sedimentary cover successions of the Austroalpine domain lack any magmatism, excluding SKC as Triassic basement of the sedimentary cover successions. The present eclogite-bearing piece of continental crust adjacent to the Meliata oceanic lithosphere was subducted to mantle depth during Late Cretaceous and then exhumed.
Rapid active thrust faulting at the northern Alaska Range front
Authors: Bender Adrian M. , Lease Richard O. , Rittenour Tammy , Jones James V.
Published: March 2023

Plate convergence rates strongly influence seismicity and mountain building inboard of convergent margins, but the distribution and kinematics of structures accommodating farfield convergence can be elusive. In interior Alaska, Yakutat microplate convergence drives late Pleistocene–recent right slip on the Denali fault, but westward-decreasing slip rates leave substantial residual Yakutat motion unaccounted for. Here, we show that Northern Foothills thrust slip beneath the northern Alaska Range absorbs a modern 4.4 mm/yr geodetic velocity gradient equivalent to ~78% of the 5.6 mm/yr residual Yakutat convergence along the central Denali fault. Infrared-stimulated luminescence ages of strath terrace deposits (67–4 ka; six sites) quantify Totatlanika River bedrock incision across the 1947 Mw 7.1 thrust earthquake epicentral region. Incision rates increase abruptly from <1 mm/yr to 4.8–5.6 mm/yr above the blind thrust tip near the range front. Rapid slip at 6.7 mm/yr on a steep thrust ramp beneath the northern Alaska Range front accommodates the geodetic gradient, drives rock uplift at rates matching measured incision rates, and implies that large earthquakes like the 1947 event may recur with 500–1400 yr frequency. Results illuminate focused seismogenic strain inboard of a complex convergent margin and prompt reevaluation of Alaska’s neotectonic framework.
Supplemental Material: The Paleoproterozoic granite factory: Voluminous post-collisional, ferroan, A-type granites and implications for crust formation and metallogenic tenor
Authors: Hinchey A.M. , al. et
Published: March 2023

Supplemental Text S1: Methodology. Supplemental Data S1: Lithogeochemical data.
Haemoptysis: is it really from the lungs? The well child who spits out blood
Authors: Balfour-Lynn Ian M
Published: March 2023

Blood appearing in a previously well child’s mouth may have many sources, and it should not be assumed to be haemoptysis, that is, coming from the respiratory tract below the larynx. In addition to the lungs and lower airways, consider also the upper airways, the mouth, gastrointestinal tract and cardiovascular conditions. This article discusses the differential diagnosis and appropriate investigations.
Extraskeletal Ewing sarcoma presenting as an axillary mass with pulmonary metastases
Authors: Marak James R , Singh Neha , Pathak Swasti , Awasthi Namrata P
Published: March 2023

Extraskeletal Ewing sarcoma (EES) is a tumour of rare variant of the Ewing sarcoma family of tumours. This family of tumours can have different features; however, these tumours are categorised on the basis of genetic translocation, specific molecular and immunohistochemical features. EES is seen commonly affecting young adults with poor prognosis and high mortality rates. It can be detected in various locations making its diagnosis more difficult. It can present with varied imaging features, often non-specific. However, imaging plays a vital role in the primary tumour assessment, local staging, preoperative management and surveillance. Management involves surgery with chemotherapy. Long-term prognosis in cases of metastatic disease is very poor. In literature, only three cases of axillary EES have been reported so far. Here, we report the fourth case of large EES originating in the left axillary region in a woman in her 20s. The patient was given neoadjuvant chemotherapy; however, the size of the tumour increased, which was later surgically treated with complete excision of the tumour. Unfortunately, the tumour metastasised to the lung for which the patient was irradiated. Afterwards, the patient presented to the emergency room with respiratory distress for which she was on ventilator support; sadly, the patient died after 1 week.
Association of retinal optical coherence tomography metrics and polygenic risk scores with cognitive function and future cognitive decline
Authors: Sekimitsu Sayuri , Shweikh Yusrah , Shareef Sarah , Zhao Yan , Elze Tobias , Segrè Ayellet , Wiggs Janey , Zebardast Nazlee
Published: March 2023

Purpose

To evaluate the potential of retinal optical coherence tomography (OCT) measurements and polygenic risk scores (PRS) to identify people at risk of cognitive impairment.

Methods

Using OCT images from 50 342 UK Biobank participants, we examined associations between retinal layer thickness and genetic risk for neurodegenerative disease and combined these metrics with PRS to predict baseline cognitive function and future cognitive deterioration. Multivariate Cox proportional hazard models were used to predict cognitive performance. P values for retinal thickness analyses are false-discovery-rate-adjusted.

Results

Higher Alzheimer’s disease PRS was associated with a thicker inner nuclear layer (INL), chorio-scleral interface (CSI) and inner plexiform layer (IPL) (all p<0.05). Higher Parkinson’s disease PRS was associated with thinner outer plexiform layer (p<0.001). Worse baseline cognitive performance was associated with thinner retinal nerve fibre layer (RNFL) (aOR=1.038, 95% CI (1.029 to 1.047), p<0.001) and photoreceptor (PR) segment (aOR=1.035, 95% CI (1.019 to 1.051), p<0.001), ganglion cell complex (aOR=1.007, 95% CI (1.002 to 1.013), p=0.004) and thicker ganglion cell layer (aOR=0.981, 95% CI (0.967 to 0.995), p=0.009), IPL (aOR=0.976, 95% CI (0.961 to 0.992), p=0.003), INL (aOR=0.923, 95% CI (0.905 to 0.941), p<0.001) and CSI (aOR=0.998, 95% CI (0.997 to 0.999), p<0.001). Worse future cognitive performance was associated with thicker IPL (aOR=0.945, 95% CI (0.915 to 0.999), p=0.045) and CSI (aOR=0.996, 95% CI (0.993 to 0.999) 95% CI, p=0.014). Prediction of cognitive decline was significantly improved with the addition of PRS and retinal measurements.

Conclusions and relevance

Retinal OCT measurements are significantly associated with genetic risk of neurodegenerative disease and may serve as biomarkers predictive of future cognitive impairment.
Comparing pharmaceutical company payments in the four UK countries: a cross-sectional and social network analysis
Authors: Rickard Emily , Carmel Emma , Ozieranski Piotr
Published: March 2023

Objectives

To examine the characteristics of pharmaceutical payments to healthcare and patient organisations in the four UK countries. Compare companies spending the most; types of organisations receiving payments and types of payments in the four countries. Measure the extent to which companies target payments at the same recipients in each country and whether it differs depending on the type of recipient.

Design

Cross-sectional comparative and social network analysis.

Setting

England, Scotland, Wales, Northern Ireland.

Participants

100 donors (pharmaceutical companies) reporting payments to 4229 recipients (healthcare organisations and patient organisations) in 2015.

Main outcome measures

For each country: payment totals and distribution; average number of common recipients between companies; share of payments to organisations fulfilling different roles in the health ecosystem and payments for different activities.

Results

Companies prioritised different types of recipient and different types of activity in each country. There were significant differences in the distribution of payments across the four countries, even for similar types of recipients. Recipients in England and Wales received smaller individual payments than in Scotland and Northern Ireland. Overall, targeting shared recipients occurred most frequently in England, but was also common in certain pockets of each country’s health ecosystem. We found evidence of reporting errors in Disclosure UK.

Conclusions

Our findings suggest a strategic approach to payments tailored to countries’ policy and decision-making context, indicating there may be specific vulnerabilities to financial conflicts of interest at subnational level. Payment differences between countries may be occurring in other countries, particularly those with decentralised health systems and/or high levels of independence across its decision-making authorities. We call for a single database containing all recipient types, full location details and published with associated descriptive and network statistics.
SPIRIT and CONSORT extensions for early phase dose-finding clinical trials: the DEFINE (DosE-FIndiNg Extensions) study protocol
Authors: Espinasse Aude , Solovyeva Olga , Dimairo Munyaradzi , Weir Christopher , Jaki Thomas , Mander Adrian , Kightley Andrew , Evans Jeffry , Lee Shing , Bedding Alun , Hopewell Sally , Rantell Khadija , Liu Rong , Chan An-Wen , De Bono Johann , Yap Christina
Published: March 2023

Introduction

Early phase dose-finding (EPDF) studies are critical for the development of new treatments, directly influencing whether compounds or interventions can be investigated in further trials to confirm their safety and efficacy. There exists guidance for clinical trial protocols and reporting of completed trials in the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) 2013 and CONsolidated Standards Of Reporting Randomised Trials (CONSORT) 2010 statements. However, neither the original statements nor their extensions adequately cover the specific features of EPDF trials. The DEFINE (DosE-FIndiNg Extensions) study aims to enhance transparency, completeness, reproducibility and interpretation of EPDF trial protocols (SPIRIT-DEFINE) and their reports once completed (CONSORT-DEFINE), across all disease areas, building on the original SPIRIT 2013 and CONSORT 2010 statements.

Methods and analysis

A methodological review of published EPDF trials will be conducted to identify features and deficiencies in reporting and inform the initial generation of the candidate items. The early draft checklists will be enriched through a review of published and grey literature, real-world examples analysis, citation and reference searches and consultation with international experts, including regulators and journal editors. Development of CONSORT-DEFINE commenced in March 2021, followed by SPIRIT-DEFINE from January 2022. A modified Delphi process, involving worldwide, multidisciplinary and cross-sector key stakeholders, will be run to refine the checklists. An international consensus meeting in autumn 2022 will finalise the list of items to be included in both guidance extensions.

Ethics and dissemination

This project was approved by ICR’s Committee for Clinical Research. The Health Research Authority confirmed Research Ethics Approval is not required. The dissemination strategy aims to maximise guideline awareness and uptake, including but not limited to dissemination in stakeholder meetings, conferences, peer-reviewed publications and on the EQUATOR Network and DEFINE study websites.

Registration details

SPIRIT-DEFINE and CONSORT-DEFINE are registered with the EQUATOR Network.
Epidemiology of hospitalisations due to chickenpox and quality of life lost in community and hospital settings: protocol for a prospective cohort study across two countries
Authors: Marlow Robin , Roderick Marion , Oliver Jennifer , Jordan Zoe , Amirthalingam Gayatri , Lopez-Bernal Jamie , Finn Adam , Rodrigues Fernanda
Published: March 2023

Introduction

While still a ubiquitous disease of childhood, chickenpox has been effectively controlled in many countries through the use of vaccination. Previous health economic assessment of the use of these vaccines in the UK were based on limited quality of life data and only routinely collected epidemiological outcomes.

Methods and analysis

This two armed study will carry prospective surveillance of hospital admissions and recruit from community settings to measure the acute quality of life loss caused by paediatric chickenpox both in the UK and in Portugal. The quality of life effects on children and their primary and secondary caregivers will be assessed using the EuroQol EQ-5D with the Child Health Utility instrument (CHU-9) in addition for children. Results will be used to derive quality-adjusted life year loss estimates for cases of simple varicella and the secondary complications.

Ethics and dissemination

We have received National Health Service ethical approval (REC ref: 18/ES/0040) for the inpatient arm, university ethical approval (University of Bristol ref: 60721) for the community arm and 10 sites currently are recruiting in the UK and 14 in Portugal. Informed consent is obtained from the parent(s). Results will be disseminated in peer-reviewed publications.

Trial registration number

ISRCTN15017985.
Virtual reality-assisted cognitive behavioural therapy for outpatients with alcohol use disorder (CRAVR): a protocol for a randomised controlled trial
Authors: Thaysen-Petersen Daniel , Hammerum Sigurd Krogh , Vissing Anne-Cathrine , Arnfred Benjamin Thorup , Nordahl Rolf , Adjorlu Ali , Nordentoft Merete , Oestrich Irene Henriette , Düring Signe Wegmann , Fink-Jensen Anders
Published: March 2023

Introduction

Alcohol use disorder (AUD) is a brain disorder linked to over 200 health conditions. Cognitive behavioural therapy (CBT) is considered the best practice in the treatment of AUD, but more than 60% of patients relapse within the first year after treatment. Psychotherapy combined with virtual reality (VR) has received increasing interest in the treatment of AUD. However, existing studies have primarily investigated the use of VR for cue reactivity. We therefore aimed to investigate the effect of VR-assisted CBT (VR-CBT).

Methods and analysis

This study is an assessor-blinded, randomised clinical trial being conducted at three outpatient clinics in Denmark. We will randomise 102 patients to 14 individual sessions of either manualised VR-CBT or CBT. The VR-CBT group will receive exposure to immersive high-risk VR situations from a pub, bar/party, restaurant, supermarket and at-home (30 videos) to activate high-risk-related beliefs and cravings for subsequent modification using CBT techniques. The treatment period is 6 months, and follow-up visits will be performed 3, 6, 9 and 12 months after inclusion. The primary outcome measure is the change in total alcohol consumption from baseline to 6 months after inclusion, measured with the Timeline Followback Method. Key secondary outcome measures include changes in the number of heavy drinking days, alcohol cravings, cognition, and symptoms of depression and anxiety.

Ethics and dissemination

Approval has been obtained by the research ethics committee in the Capital Region of Denmark (H-20082136) and the Danish Data Protection Agency (P-2021-217). All patients will receive both oral and written information about the trial and written informed consent will be obtained from each patient before inclusion. The study results will be disseminated in peer-reviewed publications and conference presentations.

Trial registration number

ClinicalTrial.gov,NCT05042180.
Telomere biology and ribosome biogenesis: structural and functional interconnections
Authors: Valeeva Liia R. , Abdulkina Liliia R. , Agabekian Inna A. , Shakirov Eugene V.
Published: March 2023

Telomeres are nucleoprotein structures that play a pivotal role in the protection and maintenance of eukaryotic chromosomes. Telomeres and the enzyme telomerase, which replenishes telomeric DNA lost during replication, are important factors necessary to ensure continued cell proliferation. Cell proliferation is also dependent on proper and efficient protein synthesis, which is carried out by ribosomes. Mutations in genes involved in either ribosome biogenesis or telomere biology result in cellular abnormalities and can cause human genetic diseases, defined as ribosomopathies and telomeropathies, respectively. Interestingly, recent discoveries indicate that many of the ribosome assembly and rRNA maturation factors have additional noncanonical functions in telomere biology. Similarly, several key proteins and enzymes involved in telomere biology, including telomerase, have unexpected roles in rRNA transcription and maturation. These observations point to an intriguing cross-talk mechanism potentially explaining the multiple pleiotropic symptoms of mutations in many causal genes identified in various telomeropathy and ribosomopathy diseases. In this review, we provide a brief summary of eukaryotic telomere and rDNA loci structures, highlight several universal features of rRNA and telomerase biogenesis, evaluate intriguing interconnections between telomere biology and ribosome assembly, and conclude with an assessment of overlapping features of human diseases of telomeropathies and ribosomopathies.