bluuebunny/crossref_metadata_2025 huggingface dataset:
Beta‐lactam antibiotic concentrations in critically ill patients with standard and adjusted dosages: A prospective observational study
Authors: Areskog Lejbman Ilja , Torisson Gustav , Resman Fredrik , Sjövall Fredrik
Published: February 2024

Introduction

Antibiotic concentration target attainment is known to be poor in critically ill patients. Dose adjustment is recommended in patients with altered clearance, obesity and those with bacterial species with intermediate susceptibility. The aim of this study was to investigate the variation of antibiotic concentration in critically ill patients with standard or adjusted dosing regimens.

Methods

The concentration of three beta‐lactam antibiotics used in the intensive care unit (ICU) setting, cefotaxime, piperacillin/tazobactam, and meropenem, was measured in patients with confirmed or suspected infection. Mid‐dose and trough values were collected during a single dosing interval. The pharmacokinetic endpoints were a free antibiotic concentration that, during the whole dosing interval, was above MIC (100% ƒT > MIC, primary endpoint) or above four times MIC (100% ƒT > 4MIC, secondary endpoint). Non‐species related MIC breakpoints were used (1 mg/L for cefotaxime, 8 mg/L for piperacillin/tazobactam, and 2 mg/L for meropenem).

Results

We included 102 patients (38 cefotaxime, 30 piperacillin/tazobactam, and 34 meropenem) at a single ICU, with a median age of 66 years. In total, 73% were males, 40% were obese (BMI ≥30) and the median SAPS 3 score was 63 points. Of all patients, 78 patients (76%) reached the primary endpoint (100%ƒT > MIC), with 74% for cefotaxime, 67% for piperacillin/tazobactam and 88% for meropenem. Target attainment for 100% ƒT > 4MIC was achieved in 40 (39%) patients, overall, with 34% for cefotaxime, 30% for piperacillin/tazobactam and 53% for meropenem. In patients with standard dose 71% attained 100%ƒT > MIC and 37% for 100%ƒT > 4MIC. All patients with reduced dose attained 100%ƒT > MIC and 27% attained 100% ƒT > 4MIC. In patients with increased dose 79% attained 100%ƒT > MIC and 48% 100%ƒT > 4MIC respectively.

Conclusions

Beta‐lactam antibiotics concentration vary widely in critically ill patients. The current standard dosing regimens employed during the study were not sufficient to reach 100% ƒT > MIC in approximately a quarter of the patients. In patients where dose adjustment was performed, the group with increased dose also had low target attainment, as opposed to patients with dose reduction, who all reached target. This suggests the need for further individualization of dosing where therapeutic drug monitoring can be an alternative to further increase target attainment.
Does Social Capital Enhance Stock Liquidity? An Investigation of the Resilience of the Trading Environment During a Crisis of Trust
Authors: Faff Robert , Huang Jianning , Shao Pei , Xiao Yuchao , Zhou Fuzhao
Published: February 2024

We investigate whether social capital and trust provide a form of liquidity/trading resilience, more specifically, whether social capital and trust played a role in the speed of stock recovery following activation of the market‐wide circuit breaker (MWCB) that occurred at the beginning of the COVID‐19 pandemic in March 2020. Our finding that high‐social capital firms rebounded more swiftly in terms of stock liquidity and quality of the stock trading environment provides new evidence that social capital and trust can safeguard firms’ stocks against a potential liquidity drain and rapid deterioration in the stock trading environment under extreme market conditions.
In premature rupture of membranes, maternal serum delta neutrophil index may be a predictive factor for histological chorioamnionitis and affect fetal inflammatory markers: A retrospective cross‐sectional study
Authors: Dal Yusuf , Karagün Şebnem , Akkuş Fatih , Çolak Hatun , Aytan Hakan , Coşkun Ayhan
Published: February 2024

Problem

We aimed to investigate the predictive value of delta neutrophil index (DNI) for histological choriomanionitis (HCAM) and the effect of maternal inflammatory markers on neonatal outcomes and fetal inflammatory parameters.

Method of Study

In this retrospective cross‐sectional study, 68 pregnant women without HCAM (group 1) and 46 pregnant women diagnosed with HCAM (group 2) were divided into two groups. Demographic stories of the groups; maternal hematological parameters; maternal DNI and systemic inflammatory index (SII) values; outcomes of newborns; fetal inflammatory markers were recorded and compared between groups.

Results

Maternal DNI, and SII levels were significantly higher in group 2 (p value < .05 for all). Admission to the neonatal unit (NICU) was higher in group 2 than in group 1 (p = .0001). We found that fetal inflammatory markers were significantly higher in group 2 (p values .001 for CRP, .0001 for DNI, and .002 for leukocyte). Maternal DNI was determined to be significantly diagnostic at a value of ≥1.3 in HCAM (p = .001). We observed that SII had a significant predictive value of 953036.6 (p = .019) for NICU admission. There is also a positive correlation between fetal inflammatory markers and maternal inflammatory markers.

Conclusions

We found that maternal inflammatory markers are high in HCAM, maternal DNI can predict patients who will develop HCAM, maternal SII value can predict NICU admission, fetal inflammatory markers are high in HCAM, and these markers are affected by maternal inflammatory markers.
Safety and feasibility of a functional electrical stimulation cycling‐based muscular dysfunction diagnostic method in mechanically ventilated patients
Authors: Figueiredo Thainá , Frazão Murillo , Werlang Luís A. , Kunz Adelar , Peltz Maikel , Furtado Veridiana C. , Júnior Edgar B. , Júnior Júlio M. , Silva Rosane M. , Sobral Filho Dário C.
Published: February 2024

Background

A nonvolitional diagnostic method based on FES‐Cycling technology has recently been demonstrated for mechanically ventilated patients. This method presents good sensitivity and specificity for detecting muscle dysfunction and survival prognosis, even in unconscious patients. As the clinical relevance of this method has already been reported, we aimed to evaluate its safety and feasibility.

Methods

An observational prospective study was carried out with 20 critically ill, mechanically ventilated patients. The FES‐cycling equipment was set in a specific diagnostic mode. For safety determination, hemodynamic parameters and peripheral oxygen saturation were measured before and immediately after the diagnostic protocol, as well as venous oxygen saturation and blood lactate. The creatine phosphokinase level (CPK) was measured before and 24, 48, and 72 h after the test. The time taken to carry out the entire diagnostic protocol and the number of patients with visible muscle contraction (capacity of perceptive muscular recruitment) were recorded to assess feasibility.

Results

Heart rate [91 ± 23 vs. 94 ± 23 bpm (p = 0.0837)], systolic [122 ± 19 vs. 124 ± 19 mm Hg (p = 0.4261)] and diastolic blood pressure [68 ± 13 vs. 70 ± 15 mm Hg (p = 0.3462)], and peripheral [98 (96–99) vs. 98 (95–99) % (p = 0.6353)] and venous oxygen saturation [71 ± 14 vs. 69 ± 14% (p = 0.1317)] did not change after the diagnostic protocol. Moreover, blood lactate [1.48 ± 0.65 vs. 1.53 ± 0.71 mmol/L (p = 0.2320)] did not change. CPK did not change up to 72 h after the test [99 (59–422) vs. 125 (66–674) (p = 0.2799) vs. 161 (66–352) (p > 0.999) vs. 100 (33–409) (p = 0.5901)]. The time taken to perform the diagnostic assessment was 11.3 ± 1.1 min. In addition, 75% of the patients presented very visible muscle contractions, and 25% of them presented barely visible muscle contractions.

Conclusions

The FES cycling‐based muscular dysfunction diagnostic method is safe and feasible. Hemodynamic parameters, peripheral oxygen saturation, venous oxygen saturation, and blood lactate did not change after the diagnostic protocol. The muscle damage marker (CPK) did not increase up to 72 h after the diagnostic protocol.
Outcomes of Impella 5.0 and 5.5 for cardiogenic shock: A single‐center 137 patient experience
Authors: Hong Yeahwa , Agrawal Nishant , Hess Nicholas R. , Ziegler Luke A. , Sicke McKenzie M. , Hickey Gavin W. , Ramanan Raj , Fowler Jeffrey A. , Chu Danny , Yoon Pyongsoo D. , Bonatti Johannes O. , Kaczorowski David J.
Published: February 2024

Background

This study evaluated the outcomes of patients with cardiogenic shock (CS) supported with Impella 5.0 or 5.5 and identified risk factors for in‐hospital mortality.

Methods

Adults with CS who were supported with Impella 5.0 or 5.5 at a single institution were included. Patients were stratified into three groups according to their CS etiology: (1) acute myocardial infarction (AMI), (2) acute decompensated heart failure (ADHF), and (3) postcardiotomy (PC). The primary outcome was survival, and secondary outcomes included adverse events during Impella support and length of stay. Multivariable logistic regression was performed to identify risk factors for in‐hospital mortality.

Results

One hundred and thirty‐seven patients with CS secondary to AMI (n = 47), ADHF (n = 86), and PC (n = 4) were included. The ADHF group had the highest survival rates at all time points. Acute kidney injury (AKI) was the most common complication during Impella support in all 3 groups. Increased rates of AKI and de novo renal replacement therapy were observed in the PC group, and the AMI group experienced a higher incidence of bleeding requiring transfusion. Multivariable analysis demonstrated diabetes mellitus, elevated pre‐insertion serum lactate, and elevated pre‐insertion serum creatinine were independent predictors of in‐hospital mortality, but the etiology of CS did not impact mortality.

Conclusions

This study demonstrates that Impella 5.0 and 5.5 provide effective mechanical support for patients with CS with favorable outcomes, with nearly two‐thirds of patients alive at 180 days. Diabetes, elevated pre‐insertion serum lactate, and elevated pre‐insertion serum creatinine are strong risk factors for in‐hospital mortality.
The impact of reduced muscular fitness on cardiometabolic risk factors in children aged 9–11 years
Authors: Rodríguez‐Gutiérrez Eva , Torres‐Costoso Ana , Lucas‐de la Cruz Lidia , Mesas Arthur E. , Martínez‐Vizcaíno Vicente , Díez‐Fernández Ana
Published: February 2024

Aim

To analyse the relationships between muscular fitness (MF), fat mass (FM), fat‐free mass (FFM) and its combined ratio with cardiometabolic risk (CMR) and whether the relationship between MF and CMR is mediated by body composition in schoolchildren.

Methods

A cross‐sectional study was conducted on schoolchildren from Cuenca, Spain, between September and November 2017. FM and FFM were estimated using bioimpedance analysis. The CMR index was calculated from triglycerides‐HDL‐c ratio, arterial pressure and fasting insulin. The MF index was assessed using handgrip and standing long jump tests. Analysis of covariance models assessed CMR index differences across the MF index and the FM/FFM ratio categories. Mediation analysis examined whether the MF index and the CMR index association were mediated by FM, FFM or FM/FFM ratio.

Results

The analyses involved 485 schoolchildren aged 9–11 years (55.4% girls). Children with a higher MF index had a lower CMR index (p < 0.05). This association did not persist after controlling for FM/FFM. FM, FFM and FM/FFM ratio mediated the relationship between the MF index and the CMR index.

Conclusion

Better levels of MF are associated with better cardiometabolic profile, but a healthy body composition is determinant to improve future health.
Letter: Severe underweight and sarcopenia in decompensated cirrhosis are associated with high FGF21 levels
Authors: Geladari Eleni , Alexopoulos Theodoros , Vasilieva Larisa , Tenta Roxane , Kontogianni Meropi , Alexopoulou Alexandra
Published: February 2024

LINKED CONTENT

This article is linked to Alkhouri et al papers. To view these articles, visit https://doi.org/10.1111/apt.17709 and https://doi.org/10.1111/apt.17907
Editorial: Updated epidemiology of steatotic liver disease in people withHIVin the United States—Authors' reply
Authors: Gawrieh Samer , Sulkowski Mark , Chalasani Naga , Loomba Rohit
Published: February 2024

LINKED CONTENT

This article is linked to Gawrieh et al papers. To view these articles, visithttps://doi.org/10.1111/apt.17849andhttps://doi.org/10.1111/apt.17871
Radicalizing safety: A critical narrative analysis to abolish the police
Authors: Drustrup David , Hamad Raneem , Kim Jae Young , Ali Saba Rasheed
Published: February 2024

The dominant narrative in much of the world is that public safety is provided by policing, evidenced by supportive rhetoric from institutional forces including politicians, media, and large budget allocations in all levels of government. Alongside a long history of police violence, especially against Black, Brown, poor, and other marginalized people, many social movements reject the idea that policing provides safety and seek other methods for community wellness. The present study utilizes critical narrative analysis (CNA) to describe how marginalized residents of a small city in Iowa construct their understanding of personal and community safety. Their stories and the dialectic exchange during interviews illustrated several counternarratives and moments of conscientization for participants and researchers where safety was deconstructed and understood outside the power of recycled institutional narratives. Participants rejected popular notions of safety such as police, and instead embraced safety through robust relationships, community resources, and forms of self‐knowledge such as mental health. We analyzed their interviews as efforts to be humanly recognized within violent white supremacist structures, and their stories help to radicalize popular messages about safety. We highlight their world‐making abilities as they craft their own networks of community and safety outside of the state and police.
Self‐management support with the Respiratory Adherence Care Enhancer instrument in asthma and chronic obstructive pulmonary disease: An implementation trial
Authors: Visser Claire D. , Antonisse Lisanne L. M. , Alleda Floor M. , Bos Colin , Saini Privender , Kuipers Esther , Guchelaar Henk‐Jan , Teichert Martina
Published: February 2024

Aim

Suboptimal self‐management with controller inhalation therapy in asthma and COPD is frequently observed with poor treatment outcomes. The developed ‘Respiratory Adherence Care Enhancer’ (RACE) instrument identifies and addresses individual barriers to self‐management with a theoretical underpinning. This study investigates the feasibility of pharmaceutical support with this instrument.

Methods

An implementation trial was conducted with asthma and COPD patients in 5 community pharmacies in the Netherlands. Patients were allocated to standard care or add‐on support with the RACE instrument. Patients were invited to complete the RACE questionnaire at baseline, 5‐week and 10‐week follow‐up. Barrier profiles were accessible for the intervention group with subsequent consultations at baseline and 5‐weeks. Experiences were collected from patients and consultants with a questionnaire and reported findings. Primary endpoints focused on the acceptability, practicality and implementation process. Secondary endpoints included between‐group differences in barrier and disease control outcomes from baseline at 10‐weeks follow‐up.

Results

In total, 84 patients were included; 48 were assigned to intervention and 36 to standard care. Patient satisfaction of support with the RACE instrument was high (71%). Patients felt motivated, reassured and more confident about their disease management. Consultants reported an increase in awareness of patient barriers. Patient recognition of barrier profiles was 83.9% (±12.9%). The barrier inhaler techniques decreased significantly for the intervention group at follow‐up with odds ratio 0.30 (95% confidence interval, 0.10–0.91). No significant differences were observed for changes in number of barriers and disease control.

Conclusion

Self‐management support with the RACE instrument is feasible and appreciated, facilitating behaviour change with patient‐centred pharmaceutical care in asthma and COPD.
Teacher support, academic engagement and learning anxiety in online foreign language learning
Authors: Li Xiaomeng , Zhang Falian , Duan Peng , Yu Zhonggen
Published: February 2024

Previous studies have substantiated the pivotal role of emotions and teachers in student learning, but the underlying mechanism of teachers and emotions on academic engagement remains underexplored. The present study examined the mediating role of teacher support in the relationship between foreign language learning anxiety (FLLA) and academic engagement in online classrooms. Participants were 415 Chinese university students who completed an online questionnaire. The findings of structural equation modelling indicated that teacher support had a partial mediation effect between FLLA and academic engagement. FLLA exhibited a significant negative impact on academic engagement, both directly and indirectly via perceived teacher support. Through both direct and indirect effects, FLLA could explain 44.8% of the variation in academic engagement and the mediation effect accounted for 47.3% of the total effect. The practical implication is that foreign language teachers should extend more support for learners during online learning, and provide learners with feedback adapted to their emotions.

Practitioner notes

What is already known about this topic

Emotions have a significant impact on learners' engagement, and positive academic emotions facilitate students' engagement in the class.

Students will be more engaged in learning when they perceive support from their teachers.

Teacher support was an influential external predictor of students' mood swings.

What this paper adds

The structural equation modelling shows that teacher support served as a partial mediator between foreign language learning anxiety and academic engagement.

Students' social engagement and perceived emotional support were found to have a greater impact on online foreign language learning.

This paper further corroborates the relationship among the presences in the CoI framework.

Implications for practice and/or policy

Mitigating foreign language learning anxiety and improving teacher support are necessary for effective foreign language learning in future online classes.

Teachers need to ensure continued intellectual support and provide more emotional support for learners.

Teachers are recommended to deliver feedback that aligns with students' emotional state.
Methyltransferase METTL3‐mediated maturation of miR‐4654 facilitates high glucose‐induced apoptosis and oxidative stress in lens epithelial cells via decreasing SOD2
Authors: Guo Ming , Su Fanfan , Chen Yao , Su Bo
Published: February 2024

N6‐methyladenosine (m6A) modification has been reported to have roles in modulating the development of diabetic cataract (DC). Methyltransferase‐like 3 (METTL3) is a critical m6A methyltransferase involving in m6A modification activation. Here, we aimed to explore the action and mechanism of METTL3‐mediated maturation of miR‐4654 in DC progression. Human lens epithelial cells (HLECs) were exposed to high glucose (HG) to imitate DC condition in vitro. Levels of genes and proteins were tested via qRT‐PCR and western blotting assays. The proliferation and apoptosis of HLECs were evaluated by cell counting kit‐8, 5‐ethynyl‐2′‐deoxyuridine (EdU), and flow cytometry assays, respectively. Oxidative stress was analyzed by detecting the contents of reactive oxygen species (ROS), superoxide dismutase (SOD) and malondialdehyde (MDA). The binding of miR‐4654 and SOD2 was confirmed by dual‐luciferase reporter assay. The m6A‐RNA immunoprecipitation (MeRIP) assay detected the m6A modification profile. Thereafter, we found that miR‐4654 expression was elevated in DC samples and HG‐induced HLECs. MiR‐4654 knockdown reversed HG‐mediated apoptosis and oxidative stress in HLECs. Mechanistically, miR‐4654 directly targeted SOD2, silencing of SOD2 abolished the protective effects of miR‐4654 knockdown on HLECs under HG condition. In addition, METTL3 induced miR‐4654 maturation through promoting pri‐miR‐4654 m6A modification, thereby increasing miR‐4654 content in HLECs. METTL3 was highly expressed in DC samples and HG‐induced HLECs, METTL3 deficiency protected HLECs against HG‐mediated apoptotic and oxidative injury via down‐regulating miR‐4654. In all, METTL3 induced miR‐4654 maturation in a m6A‐dependent manner, which was then reduced SOD2 expression, thus promoting apoptosis and oxidative stress in HLECs, suggesting a novel path for DC therapy.
Letter–speech sound integration in typical reading development during the first years of formal education
Authors: Beck Joanna , Chyl Katarzyna , Dębska Agnieszka , Łuniewska Magdalena , van Atteveldt Nienke , Jednoróg Katarzyna
Published: February 2024

This study investigated the neural basis of letter and speech sound (LS) integration in 53 typical readers (35 girls, all White) during the first 2 years of reading education (ages 7–9). Changes in both sensory (multisensory vs unisensory) and linguistic (congruent vs incongruent) aspects of LS integration were examined. The left superior temporal cortex and bilateral inferior frontal cortex showed increasing activation for multisensory over unisensory LS over time, driven by reduced activation to speech sounds. No changes were noted in the congruency effect. However, at age nine, heightened activation to incongruent over congruent LS pairs were observed, correlating with individual differences in reading development. This suggests that the incongruency effect evolves at varying rates depending on reading skills.
Clinical and genetic characteristics in a Chinese cohort of complex spastic paraplegia type 4
Authors: Yao Li , Cao Yuwen , Zhang Chao , Huang Xiaojun , Tian Wotu , Cao Li
Published: February 2024

Spastic paraplegia type 4 (SPG4), caused by SPAST mutations, is the most predominant subtype of hereditary spastic paraplegia. Most documented SPG4 patients present as pure form, with the complex form rarely reported. We described the clinical and genetic features of 20 patients with complex phenotypes of SPG4 and further explored the genotype–phenotype correlations. We collected detailed clinical data of all SPG4 patients and assessed their phenotypes. SPAST gene mutations were identified by Multiplex ligation‐dependent probe amplification in combination with whole exome sequencing. We further performed statistical analysis in genotype and phenotype among patients with various manifestations and different variants. Out of 90 SPG4 patients, 20 patients (male:female = 16:4) with additional neurologic deficits, namely complex form, were included in our study. The bimodal distribution of age of onset at 0–10 and 21–40 years old is concluded. On cranial MRI, obvious white matter lesions can be observed in five patients. We identified 9 novel and 8 reported SPAST mutations, of which 11 mutations were located in AAA (ATPase associated with various cellular activities) domain. The AAA cassette of spastin is the hottest mutated region among complex SPG4. All patients with cognitive impairment (CI) are males (n = 9/9). Additionally, 80% patients with ataxia are due to frameshift mutations (n = 4/5). Overall, our study summarized and analyzed the genetic and phenotypic characteristics of complex SPG4, making up over 1/5 of in‐house SPG4 cohort, among which CI and ataxia are the most common features. Further studies are expected to explore the underlying mechanisms.
Global Guidelines in Dermatology Mapping Project (GUIDEMAP)—A systematic review of the methodological quality of contact dermatitis clinical practice guidelines
Authors: van Zuuren Esther J. , Arents Bernd W. M. , Vermeulen Sofieke , Schoones Jan W. , Fedorowicz Zbys
Published: February 2024

The Global Guidelines in Dermatology Mapping Project (GUIDEMAP) assesses the methodological quality of clinical practice guidelines (CPGs) for high‐burden skin diseases. This review focuses on contact dermatitis. We searched MEDLINE, Embase, PubMed, Web of Science, Cochrane Library, Emcare, Epistemonikos, PsycINFO and Academic Search Premier for CPGs published between 1 November 2018 and 1 November 2023. Prespecified guideline resources were hand searched. Two authors independently undertook screening, data extraction and quality assessments. Instruments used were the Appraisal of Guidelines for Research and Evaluation (AGREE) II Reporting Checklist, the U.S. Institute of Medicine's (IOM) criteria of trustworthiness, The Agency for Healthcare Research and Quality's National Guideline Clearinghouse Extent Adherence to Trustworthy Standards (NEATS) Instrument and Lenzer's Red Flags. Twenty five CPGs were included, exhibiting heterogeneity in both the topics they addressed and their methodological quality. Whereas the CPGs on management of hand eczema from Denmark, Europe and the Netherlands scored best, most CPGs fell short of being clear, unbiased, trustworthy and evidence‐based. Disclosure of conflicts of interest scored well, and areas needing improvement include ‘strength and wording of recommendations’, ‘applicability’, ‘updating’ and ‘external review’. Adhering to AGREE II and Grading of Recommendations, Assessment, Development and Evaluations (GRADE) enhances methodological quality.
Movements and habitat selection of a marsupial carnivore in a modified landscape
Authors: Jones Evie M. , Koch Amelia J. , Pay James M. , Mann Dydee F. , Jones Menna E. , Hamede Rodrigo K.
Published: February 2024

Landscape modification is a major threat to carnivores worldwide, but modified landscapes can also provide important habitat for these species, as protected areas alone are insufficient. Understanding how carnivores use modified landscapes, such as production forests, can inform management strategies to improve the value of these landscapes to carnivores. Little is known about habitat selection by marsupial carnivores in production forests, where they occupy a similar ecological niche to their more well‐studied eutherian counterparts. We used GPS tracking, Hidden Markov Models, and Manly's selection ratios to identify the habitat selected in three behavioral states by the largest marsupial carnivore, the Tasmanian devil (Sarcophilus harrisii), in a timber plantation‐dominated landscape. Behavioral states were approximated as: state 1, resting or feeding at a carcass; state 2, foraging; and state 3, travel. Devils did not show preferences for any of native forest, native grassland, and plantation in any behavioral state. Within plantations, devils preferred a plantation age of 4–7 years (selection ratio [wi] = 1.52). Devils preferred roads (state 1: wi = 2.71, state 2: wi = 2.48, state 3: wi = 2.97) and plantation edges (state 1: wi = 2.38, state 2: wi = 2.24, state 3: wi = 2.78) in all behavioral states, and moved faster on roads and edges than away from them. Together, our results indicate devils use road and edges for foraging (scavenging and hunting) and travel. No measured habitat variables influenced devil home range size. To support devils in plantation landscapes, we recommend maintaining a heterogeneous landscape of different plantation ages and native remnants and reducing the risk of vehicle collisions by minimizing forestry traffic at night. Tasmanian devils share similar adaptable traits to generalist eutherian carnivore species in their use of modified landscapes. Plantations can provide valuable habitat for this and other threatened predator species.
Do pre‐transplant cultural factors predict health‐related quality of life after kidney transplantation?
Authors: Loor Jamie M. , Ford C. Graham , Leyva Yuridia , Swift Samuel , Ng Yue Harn , Zhu Yiliang , Dew Mary Amanda , Peipert J. Devin , Unruh Mark L. , Croswell Emilee , Kendall Kellee , Puttarajappa Chethan , Shapiro Ron , Myaskovsky Larissa
Published: February 2024

Background

Post‐transplant health‐related quality of life (HRQOL) is associated with health outcomes for kidney transplant (KT) recipients. However, pretransplant predictors of improvements in post‐transplant HRQOL remain incompletely understood. Namely, important pretransplant cultural factors, such as experience of discrimination, perceived racism in healthcare, or mistrust of the healthcare system, have not been examined as potential HRQOL predictors. Also, few have examined predictors of decline in HRQOL post‐transplant.

Methods

Using data from a prospective cohort study, we examined HRQOL change pre‐ to post‐transplant, and novel cultural predictors of the change. We measured physical, mental, and kidney‐specific HRQOL as outcomes, and used cultural factors as predictors, controlling for demographic, clinical, psychosocial, and transplant knowledge covariates.

Results

Among 166 KT recipients (57% male; mean age 50.6 years; 61.4% > high school graduates; 80% non‐Hispanic White), we found mental and physical, but not kidney‐specific, HRQOL significantly improved post‐transplant. No culturally related factors outside of medical mistrust significantly predicted change in any HRQOL outcome. Instead, demographic, knowledge, and clinical factors significantly predicteddeclinein each HRQOL domain: physical HRQOL—older age, more post‐KT complications, higher pre‐KT physical HRQOL; mental HRQOL—having less information pre‐KT, greater pre‐KT mental HRQOL; and, kidney‐specific HRQOL—poorer kidney functioning post‐KT, lower expectations for physical condition to improve, and higher pre‐KT kidney‐specific HRQOL.

Conclusions

Instead of cultural factors, predictors of HRQOL decline included demographic, knowledge, and clinical factors. These findings are useful for identifying patient groups that may be at greater risk of poorer post‐transplant outcomes, in order to target individualized support to patients.
Is attention necessary for the representational advantage of good exemplars over bad exemplars?
Authors: Shao Zhenan , Beck Diane M.
Published: February 2024

Real‐world (rw‐) statistical regularities, or expectations about the visual world learned over a lifetime, have been found to be associated with scene perception efficiency. For example, good (i.e., highly representative) exemplars of basic scene categories, one example of an rw‐statistical regularity, are detected more readily than bad exemplars of the category. Similarly, good exemplars achieve higher multivariate pattern analysis (MVPA) classification accuracy than bad exemplars in scene‐responsive regions of interest, particularly in the parahippocampal place area (PPA). However, it is unclear whether the good exemplar advantages observed depend on or are even confounded by selective attention. Here, we ask whether the observed neural advantage of the good scene exemplars requires full attention. We used a dual‐task paradigm to manipulate attention and exemplar representativeness while recording neural responses with functional magnetic resonance imaging (fMRI). Both univariate analysis and MVPA were adopted to examine the effect of representativeness. In the attend‐to‐scenes condition, our results replicated an earlier study showing that good exemplars evoke less activity but a clearer category representation than bad exemplars. Importantly, similar advantages of the good exemplars were also observed when participants were distracted by a serial visual search task demanding a high attention load. In addition, cross‐decoding between attended and distracted representations revealed that attention resulted in a quantitative (increased activation) rather than qualitative (altered activity patterns) improvement of the category representation, particularly for good exemplars. We, therefore, conclude that the effect of category representativeness on neural representations does not require full attention.
Clinical observations in acute neurology: A historical explanation of the present
Authors: Wijdicks Eelco F. M.
Published: February 2024

Background

The history of the development of acute neurologic disease as a biologic mechanism is of interest. Equally important is how it translated to the bedside and how the clinical examination differentiated itself.

Methods

This paper reviews primary sources pertaining to acute neurologic conditions described mostly in the 19th and 20th century. A review of monographs, treatises, textbooks, and peer‐reviewed articles was conducted.

Results

The evolution of clinical signs and syndromes associated with dynamic intracranial pathologies was predicated on the idea that animal studies informed clinicians, who then linked clinical signs to these observations. A dominant theme is that innovative technologies could trace acute processes through all their various stages, affording a complete picture of the disease process. Just as clinical descriptors of central nervous system processes evolved, the presentation of acute neuromuscular respiratory failure became better defined. Once practices incorporated these acute clinical signs, textbooks cemented their “gold standard” status with relative impunity.

Conclusions

The practise of acute neurology and neurocritical care must find out what, historically, others were seeking but could not find. Patterns of clinical presentation in acute neurology are sufficiently recognizable to guide practise decisions. Although, the currently well‐documented clinical syndromes of acute neurologic conditions (at presentation and during deterioration) have been taught for generations, practitioners have noted that they lack consistency and predictability. History also taught us that part of this improved knowledge came with designated units―a clear example of how protean systems (not always innovative neurologists or neuroscientists or technologies) shaped the history of neurology.
The effect of resolvin D1n‐3 DPA on primary oral epithelial cell migration in vitro
Authors: Balta Maria G. , Schreurs Olav , Blix Inger Johanne Schytte , Schenck Karl
Published: February 2024

Specialized pro‐resolving lipid mediators (SPMs) are known for their anti‐inflammatory and pro‐resolving actions. The aim of the present study was to find new functions of the SPM resolvin D1n‐3 DPA (RvD1n‐3 DPA) on oral epithelial cells. As a starting point, we used a dataset obtained by RNA high‐throughput sequencing of oral epithelial cells exposed to TNF‐α and RvD1n‐3 DPA versus TNF‐α alone. GOrilla enrichment analysis showed that the actin cytoskeleton was significantly overrepresented after adjustment for multiple hypothesis testing. As actin, amongst others, is closely related to cell migration, we then explored whether RvD1n‐3 DPA can modulate oral epithelial cell migration. To this end, we used an in vitro cell migration model, including TNF‐α treatment, to mimic an inflammatory cell state. The analysis revealed that RvD1n‐3 DPA increased oral epithelial cell migration in the presence but not in the absence of TNF‐α. Addition of RvD1n‐3 DPA also induced F actin accumulation around the cell nucleus, indicating that RvD1n‐3 DPA potentially can mediate processes of intracellular transport. This indicates that this lipid mediator may be a promising therapeutic candidate in oral mucosal wound healing.
Hospital variation of outcomes in status epilepticus
Authors: Terman Samuel W. , Guterman Elan L. , Lin Chun C. , Thompson Michael P. , Burke James F.
Published: February 2024

Objective

Understanding factors driving variation in status epilepticus outcomes would be critical to improve care. We evaluated the degree to which patient and hospital characteristics explained hospital‐to‐hospital variability in intubation and postacute outcomes.

Methods

This was a retrospective cohort study of Medicare beneficiaries admitted with status epilepticus between 2009 and 2019. Outcomes included intubation, discharge to a facility, and 30‐ and 90‐day readmissions and mortality. Multilevel models calculated percent variation in each outcome due to hospital‐to‐hospital differences.

Results

We included 29 150 beneficiaries. The median age was 68 years (interquartile range [IQR] = 57–78), and 18 084 (62%) were eligible for Medicare due to disability. The median (IQR) percentages of each outcome across hospitals were: 30‐day mortality 25% (0%–38%), any 30‐day readmission 14% (0%–25%), 30‐day status epilepticus readmission 0% (0%–3%), 30‐day facility stay 40% (25%–53%), and intubation 46% (20%–61%). However, after accounting for many hospitals with small sample size, hospital‐to‐hospital differences accounted for 2%–6% of variation in all unadjusted outcomes, and approximately 1%–5% (maximally 8% for 30‐day readmission for status epilepticus) after adjusting for patient, hospitalization, and/or hospital characteristics. Although many characteristics significantly predicted outcomes, the largest effect size was cardiac arrest predicting death (odds ratio = 10.1, 95% confidence interval = 8.8–11.7), whereas hospital characteristics (e.g., staffing, accreditation, volume, setting, services) all had lesser effects.

Significance

Hospital‐to‐hospital variation explained little variation in studied outcomes. Rather, certain patient characteristics (e.g., cardiac arrest) had greater effects. Interventions to improve outcomes after status epilepticus may be better focused on individual or prehospital factors, rather than at the inpatient systems level.
Gender and conceptual breadth of barriers to higher education in Asian countries
Authors: Takamatsu Reina , Min May Cho , Aktar Rumana , Wang Lina , Gao Xingjian , Akamatsu Daisuke
Published: February 2024

Psychological studies of the denial of prejudice and discrimination have suggested that although members of target groups are sensitive to episodes of discrimination, they may deny episodes of discrimination to maintain a positive self‐image. Here, through two studies, we investigated the role of the perceiver and target gender in shaping perceived barriers to education from a transnational feminist perspective. The participants were 132 Japanese university students (Study 1) and 1143 students from four Asian countries (Bangladesh, China, Myanmar, and Japan) (Study 2). They read three vignettes depicting different types of obstacles to higher education and rated the extent to which each example constituted a barrier to education. Our results support the sensitivity hypothesis. Regardless of their cultural background, the female participants tended to perceive more barriers to education than their male counterparts. However, the denial hypothesis was not consistently supported. The authors discuss the meaning of denial of educational barriers among female students and future directions.
The challenges of voluntary care provision for hospitalized patients with COVID‐19: A qualitative study of the public volunteers' experiences
Authors: Karami Fatemeh , Nikbakht Nasrabadi Alireza , Torabizadeh Camellia , Mazaheri Monir , Sayadi Leila
Published: February 2024

Introduction

During the COVID‐19 pandemic, there was a remarkable increase in public volunteering for the care of hospitalized patients. They faced challenges during their voluntary care provision. This study aimed at exploring public volunteers' experiences of the challenges of the voluntary care provision to hospitalized patients with COVID‐19.

Methods

A descriptive qualitative study with an inductive content analysis method was conducted, 2022–2023. Eighteen public volunteers providing care to hospitalized patients with COVID‐19 were purposefully selected among 10 hospitals, specialized in COVID‐19 care in Tehran and Shiraz, Iran. Data were collected over 7 months through in‐depth semistructured interviews and concurrently analyzed using conventional content analysis methods.

Findings

The challenges of voluntary care provision to hospitalized patients with COVID‐19 were illustrated in five main categories, each with two subcategories. The categories included structural challenges, interpersonal conflicts, financial constraints, covert participation and the deteriorating condition of care provision. The subcategories comprised lack of volunteer recruitment bases, ineffective organization of voluntary activities, pervasive distrust, heightened risk of clinical errors, conflicts between volunteer commitments and primary occupation, lack of financial support, lack of family support, isolation by friends, mental trauma and physical exhaustion.

Conclusion

Public volunteers encounter diverse challenges while providing care to hospitalized patients with COVID‐19, which negatively impacts their motivation to serve. By addressing these challenges, we can create a more supportive environment for volunteers and enhance the quality of care provided to patients during public health emergencies. Identifying such challenges can assist healthcare managers and policymakers develop effective strategies to mitigate mounting difficulties and enhance volunteer services, thereby improving the overall quality of care provided to patients during public health crises.

Patient Contributions

Participants were identified and recruited after the study objectives were explained in person to the managers. The participants were approached and interviewed by one author. Participation was voluntary and the participants did not receive any financial compensation for their time.
Enhancing bending performance of ultrathin flexible glass through chemical strengthening
Authors: Mao Jingyi , Yuan Jian , Guo Zhenqiang , Tian Peijing , Zhang Jiachang , Zhang Qi
Published: February 2024

Flexible glass with high bending strength is a remarkable component of flexible electronic displays. However, as a brittle material, its bending properties often do not meet requirements of application. To address this challenge, the application of chemical strengthening stands out as a viable approach to significantly bolster scratch resistance and bending strength in flexible glass. This study focuses on a conventional one‐step chemical strengthening method, employing molten potassium nitrate, to reinforce ultrathin aluminosilicate glass produced through the secondary down‐drawing thermoforming process. Effects of ion‐exchange temperature and time on mechanical properties of strengthened 110 µm flexible glass were investigated, and moreover, properties of strengthened ultrathin flexible glass with various thicknesses were compared. The results indicate that, after chemical strengthening at 380°C for 1 h, the compressive stress (CS) of 110 µm glass reaches 864.60 MPa, and the depth of layer is 15.86 µm, at which time the glass has the best bending performance and scratch resistance, and half of the faceplate spacing during glass breakage can be enhanced from 38.02 ± 2.7 to 8.40 ± 0.62 mm. For ultrathin flexible glass from 40 to 110 µm, after treatment at 380°C for 1 h, the CS of thick glass is higher than that of thin glass, and the enhancement of bending performance is better.
Early gesture use predicts children’s language development in South Korea: New evidence supporting the cross‐cultural importance of pointing
Authors: Shin So Yeon , Rowe Meredith L. , Lee Hyun Suk
Published: February 2024

Research in the U.S. and other Western countries shows that children’s early gesture use, which starts prior to verbal communication, is an important predictor of children’s later language development. Despite increasing efforts to study gesture use in diverse contexts, most of our knowledge on the role of gesture is largely based on populations of Western countries. In this study, we add to the growing body of international research by examining gesture use by 31 mothers and their 14‐month‐old infants (12 girls) in South Korea and investigate the gestures used during interaction, and whether early gesture use at 14 months predicts Korean children’s later language skills at 36 months. The results showed that in addition to using gestures observed in other cultural contexts, Korean mother‐child dyads used culturally specific gesture (i.e., bowing), showing an early sign of socialization that starts with preverbal children. In addition, Korean infants’ index‐finger pointing, but not showing and giving, predicted their later receptive and expressive vocabulary skills at 36 months, providing additional support for the importance of pointing in early language development.
IL‐8 from CD248‐expressing cancer‐associated fibroblasts generates cisplatin resistance in non‐small cell lung cancer
Authors: Wu Jieheng , Zhang Qiaoling , Wu Jiangwei , Yang Zeyang , Liu Xinlei , Lou Chunju , Wang Xuanyin , Peng Jiangying , Zhang Jinyuan , Shang Zhenling , Xiao Jing , Wang Nianxue , Zhang Ruya , Zhou Jinyao , Wang Yun , Hu Zuquan , Zhang Rui , Zhang Jian , Zeng Zhu
Published: February 2024

Chemotherapy‐resistant non‐small cell lung cancer (NSCLC) presents a substantial barrier to effective care. It is still unclear how cancer‐associated fibroblasts (CAFs) contribute to NSCLC resistance to chemotherapy. Here, we found that CD248+CAFs released IL‐8 in NSCLC, which, in turn, enhanced the cisplatin (CDDP) IC50 in A549 and NCI‐H460 while decreasing the apoptotic percentage of A549 and NCI‐H460 in vitro. The CD248+CAFs‐based IL‐8 secretion induced NSCLC chemoresistance by stimulating nuclear factor kappa B (NF‐κB) and elevating ATP‐binding cassette transporter B1 (ABCB1). We also revealed that the CD248+CAFs‐based IL‐8 release enhanced cisplatin chemoresistance in NSCLC mouse models in vivo. Relative to wild‐type control mice, the CD248 conditional knockout mice exhibited significant reduction of IL‐8 secretion, which, in turn, enhanced the therapeutic efficacy of cisplatin in vivo. In summary, our study identified CD248 activates the NF‐κB axis, which, consecutively induces the CAFs‐based secretion of IL‐8, which promotes NSCLC chemoresistance. This report highlights a potential new approach to enhancing the chemotherapeutic potential of NSCLC‐treating cisplatin.
Generalized pustular psoriasis: A nationwide population‐based study using the National Health Data System in France
Authors: Viguier Manuelle , Bentayeb Malek , Azzi Jessica , de Pouvourville Gérard , Gloede Tristan , Langellier Bérengère , Massol Jacques , Medina Patricia , Thoma Christian , Bachelez Hervé
Published: February 2024

Background

GPP is a rare, chronic, neutrophilic skin disease, with limited real‐world data characterizing patients with flares and the impact of flares on disease progression and morbidity.

Objective

Describe the clinical characteristics of patients with GPP, comorbidities, disease epidemiology and frequency and severity of flares, and compare patients with GPP with a matched severe psoriasis population.

Methods

In this population‐based real‐world cohort study an algorithm was developed to identify patients with GPP flares. Three cohorts were identified using the Système National des Données de Santé (SNDS) database covering almost the entire French population; a prevalent cohort (2010–2018), an incident cohort (2012–2015). A severe psoriasis cohort was compared with the GPP incident cohort using propensity score matching.

Results

The prevalent and incident cohorts comprised 4195 and 1842 patients, respectively. In both cohorts, mean age was 58 years; 53% were male. Comorbidities were significantly more common in the incident cohort versus matched psoriasis cohort, respectively, including hypertension (44% vs. 26%), ischaemic heart disease (26% vs. 18%) and hyperlipidaemia (25% vs. 15%). In the incident cohort, the flare rate was 0.1 flares/person‐year and 0.4 flares/person‐year among the 569 out of 1842 patients hospitalized with flares. These patients had a mean (±SD) stay of 11.6 ± 10.4 days; 25% were admitted to the intensive care unit. In 2017, the cumulative incidence and cumulative GPP age–sex standardized prevalence were 7.1 and 45.2 per million, respectively.

Conclusions

Patients with GPP had a distinct comorbidity profile compared to patients with severe psoriasis, and GPP flares were associated with long hospitalizations.