bluuebunny/crossref_metadata_2025 huggingface dataset:
The Swedish Perioperative Register: Description, validation of data mapping and utility
Authors: Holmström Björn , Enlund Gunnar , Spetz Peter , Frostell Claes
Published: November 2022

Background

Since 2013 surgical units in Sweden have reported procedures to the national Swedish Perioperative Register (SPOR). More than four million cases have been documented. Data consist of patient ID, type of surgery, diagnoses, time stamps during the perioperative process (from the decision to operate to the time of discharge from the postoperative recovery area) and quality measures. This article aims to describe SPOR and validate data mapping. Also, we wished to illustrate the utility of the SPOR in assessing variations in national surgical capacity during the COVID‐19 pandemia years 2020–2021.

Methods

After a detailed description of SPOR, we report on the validation of data performed by comparing data from local databases with data stored in the central SPOR database, assessing missing values and accuracy. Effects of the pandemic on surgical capacity were described by developing an index, based on the number of performed surgical procedures per week during four production weeks in January 2020. Subsequent weeks were then compared with this baseline.

Results

The validation effort demonstrated nearly 100% data accuracy for the number and type of surgical procedures between local and central data. Missing data was a problem for some parameters. The number of performed surgical procedures decreased dramatically from week 11 in 2020 compared with normal production on a national basis, mainly impairing elective surgery.

Discussion

Data validation revealed good agreement between local and central databases. The changes in national surgical capacity during the pandemic were illustrated by an index based on the reported surgical production.
Understanding successful policy innovation: The case of Portuguese drug policy
Authors: Moury Catherine , Escada Mafalda
Published: November 2022

Introduction

In 2000, the Portuguese minority socialist government decriminalized the possession and consumption of drugs. This law made Portugal unique in having a formal system that directs the person using drugs to a panel under the purview of the Ministry of Health, as opposed to the Ministry of Justice, and hence constitutes an ‘original innovation’. In this article, we ask under which conditions such kinds of reforms are introduced and successfully implemented.

Aims and design

After discussing the limitations of the existing literature, we present a new theoretical framework: the ‘six‐stars’ framework. We argue that successful policy innovation in democracies will only occur and persist when six institutional and individual ‘stars’ are aligned: attention, motivation to innovate, a new solution, political strategies, quality and legitimacy of the decision‐making process and guarantees for full implementation. We then apply this framework to the Portuguese Drug Policy Case through theory‐testing/process‐tracing. Relying upon a qualitative analysis of three different types of data—primary and secondary sources, official documents emitted by key actors and interviews—we identify the presence of the six aligned ‘stars’.

Conclusions

The proposed ‘six‐stars’ framework of successful drug policy innovation shows the importance of electoral mandates, communication, inclusion, transparency, deliberation and evaluation when designing innovative drug policies. It also illustrates the importance of ensuring the support of implementing agents and quickly creating visible, positive policy feedback.
Multiple pathways of integration: Acculturative change and associations with school adjustment in immigrant‐origin adolescents
Authors: Hillekens Jessie , Baysu Gülseli , Phalet Karen
Published: November 2022

Tracing developmental pathways of immigrant‐origin adolescents, this 3‐year longitudinal study (2012–2015) examined within‐person changes in cultural orientations and their consequences for school adjustment. Multivariate latent growth mixture modeling confirmed multiple pathways of integration, revealing variable acculturative changes along dual trajectories of heritage and mainstream orientations among European‐origin (N = 592, Mage = 14.45, 55.1% boys) and Turkish‐ and Moroccan‐origin adolescents (N = 1269, Mage = 14.70, 53.1% boys). Two trajectories for European‐origin adolescents differed in heritage orientations (high decreasing and low increasing); for Turkish‐ and Moroccan‐origin adolescents, three trajectories differed in mainstream orientations (high stable, low increasing, and high decreasing). Acculturative change affected aspects of later school adjustment: European‐origin adolescents in high heritage orientation trajectories reported more belonging and emotional engagement; Turkish‐ and Moroccan‐origin adolescents in high mainstream orientation trajectories reported more behavioral engagement.
Trends in social inequalities in early childhood caries using population‐based clinical data
Authors: Lopez Diego J. , Hegde Shalika , Whelan Martin , Dashper Stuart , Tsakos Georgios , Singh Ankur
Published: November 2022

Objective

To assess the longitudinal trends in social inequalities in early childhood caries (ECC) using collected population‐based data.

Methods

Clinical data on children were routinely collected from 2008 to 2019 in Victoria, Australia. ECC prevalence and severity (dmft) were quantified according to Indigenous status, culturally and linguistically diverse (CALD) status, concession cardholder status, geographic remoteness and area deprivation. The inverse probability weighting was used to quantify social inequalities in ECC. The weighted prevalence differences, and the ratio between the weighted prevalence of ECC and mean dmft and their 95% confidence interval, were then plotted.

Results

Absolute inequalities in ECC prevalence increased for children by 7% for CALD status and cardholder status between 2008 and 2019. Likewise, absolute inequalities in ECC severity in this time period increased by 0.6 for CALD status and by 0.4 for cardholder status. Relative inequalities in ECC increased by CALD (ratio: 1.3 to 2.0), cardholder status (1.3 to 2.0) and area deprivation (1.1 to 1.3). Relative inequalities in severity increased by CALD (1.5 to 2.8), cardholder (1.4 to 2.5) or area deprivation (1.3 to 1.5). Although children with Indigenous status experienced inequalities in ECC prevalence and severity, these did not increase on the absolute (ECC: 0.1–0.1 Severity: 1.0–0.1) or relative scale (ECC ratio: 1.3–1.3 Severity ratio: 1.6–1.1).

Conclusions

Trends in inequalities in ECC were different according to sociodemographic measures. Oral health policies and interventions must be evaluated on the basis of reducing the prevalence of oral diseases and oral health inequalities between population sub‐groups.
Boosting freshwater fish conservation with high‐resolution distribution mapping across a large territory
Authors: Tao Juan , Ding Chengzhi , Chen Jinnan , Ding Liuyong , Brosse Sébastien , Heino Jani , Hermoso Virgilio , Wu Ruidong , Wang Ziwang , Hu Jiaxin , Che Rongxiao , Jin Xiaowei , Ji Songhao , He Dekui
Published: November 2022

The lack of high‐resolution distribution maps for freshwater species across large extents fundamentally challenges biodiversity conservation worldwide. We devised a simple framework to delineate the distributions of freshwater fishes in a high‐resolution drainage map based on stacked species distribution models and expert information. We applied this framework to the entire Chinese freshwater fish fauna (>1600 species) to examine high‐resolution biodiversity patterns and reveal potential conflicts between freshwater biodiversity and anthropogenic disturbances. The correlations between spatial patterns of biodiversity facets (species richness, endemicity, and phylogenetic diversity) were all significant (r = 0.43–0.98,p < 0.001). Areas with high values of different biodiversity facets overlapped with anthropogenic disturbances. Existing protected areas (PAs), covering 22% of China's territory, protected 25–29% of fish habitats, 16–23% of species, and 30–31% of priority conservation areas. Moreover, 6–21% of the species were completely unprotected. These results suggest the need for extending the network of PAs to ensure the conservation of China's freshwater fishes and the goods and services they provide. Specifically, middle to low reaches of large rivers and their associated lakes from northeast to southwest China hosted the most diverse species assemblages and thus should be the target of future expansions of the network of PAs. More generally, our framework, which can be used to draw high‐resolution freshwater biodiversity maps combining species occurrence data and expert knowledge on species distribution, provides an efficient way to design PAs regardless of the ecosystem, taxonomic group, or region considered.
Retaining natural vegetation to safeguard biodiversity and humanity
Authors: Simmonds Jeremy S. , Suarez‐Castro Andres Felipe , Reside April E. , Watson James E. M. , Allan James R. , Atkinson Scott C. , Borrelli Pasquale , Dudley Nigel , Edwards Stephen , Fuller Richard A. , Game Edward T. , Linke Simon , Maxwell Sean L. , Panagos Panos , Puydarrieux Philippe , Quétier Fabien , Runting Rebecca K. , Santini Talitha , Sonter Laura J. , Maron Martine
Published: November 2022

Global efforts to deliver internationally agreed goals to reduce carbon emissions, halt biodiversity loss, and retain essential ecosystem services have been poorly integrated. These goals rely in part on preserving natural (e.g., native, largely unmodified) and seminatural (e.g., low intensity or sustainable human use) forests, woodlands, and grasslands. To show how to unify these goals, we empirically derived spatially explicit, quantitative, area‐based targets for the retention of natural and seminatural (e.g., native) terrestrial vegetation worldwide. We used a 250‐m‐resolution map of natural and seminatural vegetation cover and, from this, selected areas identified under different international agreements as being important for achieving global biodiversity, carbon, soil, and water targets. At least 67 million km2 of Earth's terrestrial vegetation (∼79% of the area of vegetation remaining) required retention to contribute to biodiversity, climate, soil, and freshwater conservation objectives under 4 United Nations’ resolutions. This equates to retaining natural and seminatural vegetation across at least 50% of the total terrestrial (excluding Antarctica) surface of Earth. Retention efforts could contribute to multiple goals simultaneously, especially where natural and seminatural vegetation can be managed to achieve cobenefits for biodiversity, carbon storage, and ecosystem service provision. Such management can and should co‐occur and be driven by people who live in and rely on places where natural and sustainably managed vegetation remains in situ and must be complemented by restoration and appropriate management of more human‐modified environments if global goals are to be realized.
Exploring Responsible Research and Innovation in Museums Through Hands‐on Activities
Authors: Ostman Rae , Nagy Peter , Mawasi Areej , Finn Ed , Wylie Ruth
Published: November 2022

Responsible research and innovation (RRI) is a framework for thinking about the implications of science, technology, engineering, and math (STEM) discoveries and innovations and shaping them in a way that is responsible to people, future generations, and the natural environment. In this paper, we present a project that engages museum visitors in learning about RRI through hands‐on activities inspired by Mary Shelley's Frankenstein story, characters, and themes. We developed a learning framework describing strategies and outcomes for RRI in informal educational settings, then created a set of seven activities that embodied the framework and studied their implementation at 13 museums. Evidence from observations and interviews are consistent with the RRI learning framework and suggest a number of practical implications for its use in museums.
Improving the quality of life for adults with Dravet syndrome
Authors: Meskis Mary Anne
Published: November 2022

This commentary is on the original article by Lo Barco et al. on pages 838–845 of this issue.
How to fight corruption: Carrots and sticks
Authors: Knyazev Dmitriy
Published: November 2022

I present a model of corruption with incomplete information where the bureaucrat may request a bribe from the citizen for providing a service. I show that corruption is detrimental to social welfare and consider a new policy to prevent it. I propose punishing bureaucrats who take bribes and rewarding citizens who report such cases. Neither punishment nor rewards can prevent corruption alone. However, the proper combination of punishment and rewards completely prevents corruption. I also show that higher bureaucracy increases corruption in equilibrium and makes it harder to combat it.
Temperature as a likely driver shaping global patterns in mineralogical composition in bryozoans: implications for marine calcifiers under global change
Authors: Figuerola Blanca , Griffiths Huw J. , Krzeminska Malgorzata , Piwoni‐Piorewicz Anna , Iglikowska Anna , Kuklinski Piotr
Published: November 2022

The Southern Ocean is showing one of the most rapid responses to human‐induced global change, thus acting as a sentinel of the effects on marine species and ecosystems. Ocean warming and acidification are already impacting benthic species with carbonate skeletons, but the magnitude of these changes to species and ecosystems remains largely unknown. Here we provide the largest carbonate mineralogical dataset to date for Southern Ocean bryozoans, which are diverse, abundant and important as carbonate producers, thus making them excellent for monitoring the effects of ocean warming and acidification. To improve our understanding of how bryozoans might respond to ocean warming and acidification, we assess latitudinal and seafloor temperature patterns of skeletal mineralogy using bryozoan species occurrences together with temperature data for the first time. Our findings, combining new mineralogical data with published data from warmer regions, show that the proportions of high‐Mg calcite and bimineralic species increase significantly towards lower latitudes and with increasing seawater temperature. These patterns are consistent with the hypothesis that seawater temperature is likely a significant driver of variations in bryozoan mineralogy at a global scale.
Gerhard Krüger's Platonic critique of Martin Heidegger
Authors: Pageau‐St‐Hilaire Antoine
Published: November 2022

This paper examines Gerhard Krüger's interpretation of Plato in light of Martin Heidegger's Destruktion of the Greeks and critique of Platonism. I argue that Krüger's new reading of Plato should be understood as a critique of Heidegger's understanding of Platonism, and thereby as a broader critique of Heidegger's thoughts on Western metaphysics and the history of Being (Seinsgeschichte). The force and originality of Krüger's response to Heidegger consist in the fact that Krüger's Plato anticipates Heidegger's critique of Platonism. Krüger thus contends that Plato (1) does not allow the understanding of truth as correctness (Übereinstimmung) to supplant the understanding of truth as disclosedness (Unverborgenheit), (2) understands and displays philosophy's dependence upon prereflexive attunements (Stimmungen); (3) appreciates the intricate relation between Being and temporality. In sum, Krüger's Plato is not guilty of Seinsvergessenheit, and rather opens up new ways for an authentic meditation on Being and on the human way toward an understanding of Being.
Pharmacological potential of zonisamide and Nigella sativa per se and combination in high‐impact trauma device‐induced traumatic brain injury in Drosophila melanogaster
Authors: Kumar Sandeep , Singh Govind
Published: November 2022

Traumatic brain injury (TBI) is a public health menace responsible for millions of fatalities and disabilities. Numerous drugs available provide symptomatic relief but cannot stop the progress of secondary injury; thus, it is required to discover newer therapeutic agents that protect neuronal damage after trauma, predominantly in secondary injury. Thus the present study was designed to study the pharmacological potential of zonisamide and Nigella sativa (NS) per se and in combination, using high‐impact trauma device (HIT)‐induced TBI model in Drosophila melanogaster (fruit flies). Oregon R+ strains of fruit flies were pre‐treated, 24 h before TBI, with different concentrations of zonisamide, NS, and their combination. The mortality rate was observed at 0 h, 6 h, and 24 h, followed by measurement of locomotor activity using climbing assay after 6 h and 24 h of TBI. Furthermore, the level of AChE and various neurotransmitters were measured along with different oxidative stress parameters at 24 h after the injury. Administration of zonisamide and NS significantly reduced mortality rate and improved locomotor activity. Both zonisamide and NS elevate levels of AChE, GABA, serotonin, and dopamine level in fruit flies, along with a significant reduction in glutamate levels. Moreover, a concentration‐dependent elevation in SOD, GSH, and catalase level and a decrease in MDA and nitrite levels were observed. Co‐administration of zonisamide and NS showed tremendous neuroprotective potential by lowering behavior impairments, oxidative damages, and restoring altered neurotransmitter levels in fruit flies compared with individual administration and thus can employ as a better therapeutic medicine for the treatment of TBI.
Racial and ethnic disparities in sentencing: What do we know, and where should we go?
Authors: Veiga Ana , Pina‐Sánchez Jose , Lewis Sam
Published: November 2022

Strong evidence of racial and ethnic disparities has been documented in recent government‐led reports, suggesting the presence of discrimination in sentencing, with Black and ethnic minority defendants being systematically sentenced more harshly than their white counterparts. However, we still do not know how these disparities come about as most of the sentencing research has relied on quantitative designs focused on documenting the problem, rather than exploring its causes. In this exploratory study we use qualitative interviews with criminal law barristers to explore the different mechanisms that may give rise to these disparities. From our interviews we identified two predominant causal mechanisms: the differential consideration of mitigating and aggravating factors and indirect discrimination arising from defendants’ socio‐economic backgrounds and over‐policing. Based on these findings, we suggest effective strategies such as explicitly listing social deprivation as a mitigating factor in the sentencing guidelines and increasing judicial diversity for redressing these disparities.
Understanding inhibitory receptor function in neutrophils through the lens of CLEC12A
Authors: McLeish Kenneth R. , Fernandes Maria J.
Published: November 2022

Neutrophils are the first leukocytes recruited from the circulation in response to invading pathogens or injured cells. To eradicate pathogens and contribute to tissue repair, recruited neutrophils generate and release a host of toxic chemicals that can also damage normal cells. To avoid collateral damage leading to tissue injury and organ dysfunction, molecular mechanisms evolved that tightly control neutrophil response threshold to activating signals, the strength and location of the response, and the timing of response termination. One mechanism of response control is interruption of activating intracellular signaling pathways by the 20 inhibitory receptors expressed by neutrophils. The two inhibitory C‐type lectin receptors expressed by neutrophils, CLEC12A and DCIR, exhibit both common and distinct molecular and functional mechanisms, and they are associated with different diseases. In this review, we use studies on CLEC12A as a model of inhibitory receptor regulation of neutrophil function and participation in disease. Understanding the molecular mechanisms leading to inhibitory receptor specificity offers the possibility of using physiologic control of neutrophil functions as a pharmacologic tool to control inflammatory diseases.
Using Stars for Moral Navigation: An Ethical Exploration into Celebrity
Authors: Archer Alfred , Sie Maureen
Published: November 2022

What role do celebrities play in our moral lives? Philosophers have explored the potential for celebrities to function as moral exemplars and role models. We argue that there are more ways in which celebrities play a role in helping us navigate our moral lives. First, gossiping about celebrities helps us negotiate our moral norms and identify competing styles of life. Second, fandom for celebrities serves as the basis for the development of distinct moral communities and identities. Third, celebrities possess high levels of epistemic power which can be used to help change and adapt our moral norms. We will then investigate two kinds of problems that arise from using celebrities in this way. Firstly, harm is done to celebrities because they are used in the ways explained in the first part of the article; secondly, celebrity life has a distinctive nature that can affect the moral agency of celebrities. Fame, we suggest, might lead to a morally unhealthy asymmetry in human relationships. We end by discussing the ethical implications of our analysis and conclude that when using stars for moral navigation, we should take into account the harm this does to them and the distinctive nature of their lives.
Contrasting genetic diversity and structure between endemic and widespread damselfishes are related to differing adaptive strategies
Authors: Robitzch Vanessa , Saenz‐Agudelo Pablo , Alpermann Tilman J. , Frédérich Bruno , Berumen Michael L.
Published: November 2022

Aim

Several marine biogeographical provinces meet at the Arabian Peninsula. Where and how these junctions affect species is poorly understood. We herein aimed to identify the barriers to dispersal and how these shape fish populations, leading to differing biogeographies despite shared habitat and co‐ancestry.

Taxon

Dascyllus marginatus (endemic) and Dascyllus abudafur (widespread).

Location

Coral reefs from the Red Sea (RS), Djibouti, Yemen, Oman, and Madagascar.

Methods

We tested potential barriers to gene flow using RADseq‐derived SNPs and identified whether population genetic differences on each side of these barriers were neutral or selective to relate this to the biogeography of the species. Seven locations (ranging over 5100 km) were sampled for the endemic and six (ranging over 7400 km) for the widespread species, taking 20 individuals per location, with two exceptions.

Results

Dascyllus marginatus populations (comprising 5648 SNPs) had an order of magnitude higher genetic differentiation compared to D. abudafur (comprising 10,667 SNPs), as well as several outlier loci that were absent in D. abudafur despite equal sampling locations. In both species, the RS and Djibouti specimens formed one genetic cluster separated from all other locations. Although ranging from the RS to Madagascar, D. abudafur was absent in Yemen and Oman.

Main Conclusions

Stronger genetic structure at smaller geographical scales and outlier loci in the endemic species seem associated with faster adaptation to environmental differences and selective pressure. Genetic differentiation in the widespread species is neutral and only occurs at large geographical distances. Restrictive transitions (between the Gulf of Aqaba and the RS or the RS and the Gulf of Aden) do not hinder gene flow in either species, and the environmental shift within the RS (at 22°N/20°N) only affected the endemic species. The genetic break in the Gulf of Aden likely reflects historical colonization processes and not contemporary environmental regimes.
Preferential looking to eyes versus mouth in early infancy: heritability and link to concurrent and later development
Authors: Viktorsson Charlotte , Portugal Ana Maria , Li Danyang , Rudling Maja , Siqueiros Sanchez Monica , Tammimies Kristiina , Taylor Mark J. , Ronald Angelica , Falck‐Ytter Terje
Published: November 2022

Background

From birth, infants orient preferentially to faces, and when looking at the face, they attend primarily to eyes and mouth. These areas convey different types of information, and earlier research suggests that genetic factors influence the preference for one or the other in young children.

Methods

In a sample of 535 5‐month‐old infant twins, we assessed eye (relative to mouth) preference in early infancy, i.e., before neural systems for social communication and language are fully developed. We investigated the contribution of genetic and environmental factors to the preference for looking at eyes, and the association with concurrent traits and follow‐up measures.

Results

Eye preference was independent from all other concurrent traits measured, and had a moderate‐to‐high contribution from genetic influences (A = 0.57; 95% CI: 0.45, 0.66). Preference for eyes at 5 months was associated with higher parent ratings of receptive vocabulary at 14 months. No statistically significant association with later autistic traits was found. Preference for eyes was strikingly stable across different stimulus types (e.g., dynamic vs. still), suggesting that infants' preference at this age does not reflect sensitivity to low‐level visual cues.

Conclusions

These results suggest that individual differences in infants' preferential looking to eyes versus mouth to a substantial degree reflect genetic variation. The findings provide new leads on both the perceptual basis and the developmental consequences of these attentional biases.
Impact of diagnosed (vs undiagnosed) dementia on family caregiving experiences
Authors: Burgdorf Julia G. , Amjad Halima
Published: November 2022

Background

Most older adults with Alzheimer's disease and related dementias (ADRD) do not receive a timely formal diagnosis, although formal diagnosis is linked to improved outcomes. Little is known about how a recognized formal diagnosis impacts family caregivers, who provide crucial support for older adults experiencing ADRD.

Methods

We analyzed 2017 National Health and Aging Trends Study and linked National Study of Caregiving data for a nationally representative sample of 724 (weighted n = 5,431,551) caregivers who assisted an older adult with probable dementia. Probable dementia was determined via previously validated composite measure. We modeled caregiver experiences as a function of recognized formal ADRD diagnosis using weighted, logistic regression and adjusting for the relevant older adult and caregiver characteristics.

Results

Among caregivers who assisted an older adult with probable dementia, those assisting an individual with recognized formal ADRD diagnosis were significantly more likely to report emotional difficulty (aOR: 1.77; p = 0.03) and family disagreement over the older adult's care (aOR: 5.53; p = 0.03). They were also more likely to assist with communication during doctors' visits (aOR: 9.71; p < 0.001) and to receive caregiving‐related training (aOR: 2.59; p = 0.01).

Conclusions

While a timely ADRD diagnosis may help ensure access to needed supports for older adult and caregiver alike, diagnosis must be linked to support as they navigate resultant complex emotions. Formal diagnosis is linked to caregiver integration with, and support from, the older adult's team of health care providers; therefore, reducing existing disparities in timely diagnosis is necessary to ensure all caregivers have equal access to support.
Heterosis in root microbiota inhibits growth of soil‐borne fungal pathogens in hybrid rice
Authors: Zhang Mengting , Wang Yinyue , Hu Yuanyi , Wang Huacai , Liu Yawen , Zhao Bingran , Zhang Jie , Fang Rongxiang , Yan Yongsheng
Published: November 2022

In nature, plants are colonized by various microbes that play essential roles in their growth and health. Heterosis is a natural genetic phenomenon whereby first‐generation hybrids exhibit superior phenotypic performance relative to their parents. It remains unclear whether this concept can be extended to the “hybridization” of microbiota from two parents in their descendants and what benefits the hybrid microbiota might convey. Here, we investigated the structure and function of the root microbiota from three hybrid rice varieties and their parents through amplicon sequencing analysis of bacterial 16S ribosomal DNA (rDNA) and fungal internal transcribed spacer (ITS) regions. We show that the bacterial and fungal root microbiota of the varieties are distinct from those of their parental lines and exhibit potential heterosis features in diversity and composition. Moreover, the root bacterial microbiota of hybrid variety LYP9 protects rice against soil‐borne fungal pathogens. Systematic analysis of the protective capabilities of individual strains from a 30‐member bacterial synthetic community derived from LYP9 roots indicated that community members have additive protective roles. Global transcription profiling analyses suggested that LYP9 root bacterial microbiota activate rice reactive oxygen species production and cell wall biogenesis, contributing to heterosis for protection. In addition, we demonstrate that the protection conferred by the LYP9 root microbiota is transferable to neighboring plants, potentially explaining the observed hybrid‐mediated superior effects of mixed planting. Our findings suggest that some hybrids exhibit heterosis in their microbiota composition that promotes plant health, highlighting the potential for microbiota heterosis in breeding hybrid crops.
Copy number variation in pituitary stalk interruption syndrome: A large case series of sporadic non‐syndromic patients and literature review
Authors: Correa‐Silva Silvia R. , Kunii Ilda , Mitne‐Neto Miguel , Moreira Caroline M. , Dias‐da‐Silva Magnus R. , Abucham Julio
Published: November 2022

Abnormal hypothalamic/posterior pituitary development appears to be a major determinant of pituitary stalk interruption syndrome (PSIS). The observation of familial cases and associated congenital abnormalities suggests a genetic basis. Single‐gene mutations explain less than 5% of the cases, and whole exome sequencing has shown heterogeneous results. The present study aimed to assess copy number variation (CNV) using array‐based comparative genomic hybridization (aCGH) in patients with non‐syndromic PSIS and comprehensively review data from the literature on CNV analysis in congenital hypopituitarism (CH) patients. Twenty‐one patients with sporadic CH from our outpatient clinics presented with ectopic posterior pituitary (EPP) and no central nervous system abnormalities on magnetic resonance image (MRI) or any other malformations on physical examination at presentation were enrolled in the study. aCGH using a whole‐genome customized 400K oligonucleotide platform was performed in our patients. For the literature review, we searched for case reports of patients with CH and CNV detected by either karyotype or aCGH reported in PubMed up to November 2021. Thirty‐five distinct rare CNVs were observed in 18 patients (86%) and two of them (6%) were classified as pathogenic: one deletion of 1.8 Mb in chromosome 17 (17q12) and one deletion of 15 Mb in chromosome 18 (18p11.32p11.21), each one in a distinct patient. In the literature review, 67 pathogenic CNVs were published in 83 patients with CH, including the present study. Most of these patients had EPP (78% out of the 45 evaluated by sellar MRI) and were syndromic (70%). The most frequently affected chromosomes were X, 18, 20 and 1. Our study has found that CNV can be a mechanism of genetic abnormality in non‐syndromic patients with CH and EPP. In future studies, one or more genes in those CNVs, both pathogenic and variant of uncertain significance, may be considered as good candidate genes.
Effectiveness of nurse‐led interventions on medication adherence in adults taking medication for metabolic syndrome: A systematic review and meta‐analysis
Authors: Kim Chun‐Ja , Kim Moonsun , Lee Ga‐Young , Park Eunyoung , Schlenk Elizabeth A.
Published: November 2022

Aims and Objectives

To determine the effectiveness of nurse‐led interventions on medication adherence, medication knowledge and clinical outcomes in adults taking medication for metabolic syndrome.

Background

Despite the significance of interventions designed to improve medication adherence, a systematic review of nurse‐led intervention studies for metabolic syndrome is lacking.

Design

A systematic review and meta‐analysis of randomised controlled trials.

Methods

The study was conducted following the PRISMA guidelines checklist. PubMed, EMBASE, PsychINFO, CINAHL, Cochrane CENTRAL and other manual sources were searched in May 2021.The quality assessment was conducted using the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies. Comprehensive Meta‐Analysis 3.0 was used to calculate the pooled effect sizes with 95% confidence intervals.

Results

This review included 20 studies of nurse‐led medication adherence interventions in 6017 adults at risk for metabolic syndrome. The pooled effect size using the random effects model indicated that nurse‐led interventions had a significantly moderate impact on enhancing medication adherence and medication knowledge and improving selected clinical outcomes of available studies in nurse‐led intervention groups compared with control groups. Duration of intervention (median 12 weeks), mode of delivery (group vs. individual) and using multiple strategies influenced outcomes of nurse‐led medication adherence interventions. The results revealed that interventions of moderate‐ to high‐quality studies were more likely to show significant improvements in medication adherence than those of low‐quality studies.

Conclusion

The meta‐analyses showed that nurse‐led interventions may enhance medication adherence and knowledge and improve clinical outcomes of this population.

Relevance to Clinical Practice

The findings may contribute to evidence‐based information about nurse‐led intervention and its selection of appropriate interventions for improving medication adherence in this population.

Patient or public contribution

Patients or the public were not directly involved in this review.
Prevalence of type 2 diabetes risk factors, including overweight and obesity, among youth attending hospital‐based paediatric care in Western Melbourne
Authors: Angley Eleanor , Matejin Emily , Gul Saba , Rodda Christine , Longmore Danielle K
Published: November 2022

Aim

To determine the prevalence of risk factors for type 2 diabetes in overweight and obese adolescents attending hospital‐based paediatric care in Western Melbourne.

Methods

One hundred overweight and obese adolescents (aged 10–17 years) who attended an outpatient clinic at Sunshine Hospital between May 2019 and May 2020 were randomly selected following a retrospective chart review of 10–17 years old for whom a height and weight had been documented. Additional risk factors for type 2 diabetes were ascertained via structured telephone interview. Data were analysed to determine the overall prevalence of risk factors for type 2 diabetes, and to evaluate for associations between each parameter with body mass index and the number of risk factors.

Results

Of the 487 adolescents who had height and weight data recorded, 45% were overweight or obese. 77% of those who were interviewed had an additional risk factor for type 2 diabetes. No association between the number of risk factors and body mass index standard deviation score was found. Additionally, there was no association between the number of risk factors for type 2 diabetes and either family history of type 2 diabetes or ethnicity.

Conclusions

This paediatric subpopulation had a high rate of risk factors for type 2 diabetes in addition to overweight and obesity, and are at risk of premature mortality and chronic morbidity should they develop type 2 diabetes.
Relationship between serum magnesium, calcium, and parathyroid concentrations in dogs with abnormally low serum 25‐hydroxyvitamin D concentration and chronic or protein‐losing enteropathy
Authors: Jones Charles , Jablonski Sara A. , Petroff Brian K. , Langlois Daniel K.
Published: November 2022

Background

The relationship between the development of SHPT and ionized magnesium (iMg) concentrations in blood of dogs with chronic gastrointestinal (GI) disease and abnormally low 25(OH)D is undefined.

Objectives

Evaluate relationships between ionized magnesium (iMg), PTH, ionized calcium (iCa), and 25(OH)D in dogs with chronic enteropathy (CE) with or without protein‐losing enteropathy (PLE) and abnormal 25(OH)D. Determine whether dogs with CE or PLE, decreased 25(OH)D and SHPT have differences in iMg, iCa, or 25(OH)D when compared to dogs that do not have SHPT.

Animals

Fifty dogs with CE +/− PLE and abnormally low serum 25(OH)D.

Methods

Retrospective search of submissions database at a veterinary diagnostic laboratory for vitamin D profiles submitted in years 2017 to 2020. Cases were excluded if supplemented with Ca, Mg, or vitamin D. Spearman correlation was performed to evaluate relationships between iMg, PTH, 25(OH)D, and iCa. Ionized Mg, iCa, and 25(OH)D concentrations were compared between dogs with SHPT and those with normal PTH concentrations.

Results

Concentrations of iMg were weakly negatively correlated with PTH (rho, −.31; P = .03), and weakly positively correlated with serum 25(OH)D (rho, .34, P = .02) and iCa (rho, .42, P = .003). Ionized magnesium concentrations were lower in dogs with abnormally low 25(OH)D and SHPT compared to dogs with abnormally low 25(OH)D and normal parathyroid hormone concentrations (P = .01).

Conclusions and Clinical Importance

Hypomagnesemia might contribute to alterations in iCa and parathyroid hormone in dogs with CE +/− PLE and abnormally low 25(OH)D.
Print media coverage of breastfeeding in Great Britain: Positive or negative?
Authors: Merritt Rowena , Eida Tamsyn , Safon Cara , Kendall Sally
Published: November 2022

Media can be a powerful communication tool to promote breastfeeding, influence mothers' breastfeeding behaviour, create positive social norms and generate support among stakeholders and policymakers for breastfeeding. However, negative stories could deter women from starting or continuing to breastfeed. This study aimed to describe the breadth and focus of the media coverage of breastfeeding and the message frames that are found in three of the most widely read national newspapers and three popular women's magazines in Great Britain over a 12‐month period, as part of the Becoming Breastfeeding Friendly in Great Britain (BBF‐GB) study. For this retrospective media analysis, 77 articles were identified and 42 were included in the study for coding and analysis. We conducted two content analyses to examine the articles' (1) message framing and (2) alignment with the eight components of an ‘enabling breastfeeding environment’ using the BBF Gear framework. Articles featuring breastfeeding appear in British newspapers and women's magazines all year round. Twenty‐four per cent had a neutral tone, while 59% predominantly focused on the positive aspects or positive social support for breastfeeding, and 17% were predominantly focused on the negative aspects or negative social attitudes towards breastfeeding. The articles mainly focused on personal stories reflecting societal barriers and positive shifts (68%), with 12% presenting an analysis of breastfeeding evidence or barriers. There were fewer references to the legislation (5%) and availability of funding (2%) and support (9%). There was no coverage of national coordination and strategy, evaluation systems, or the political will to raise breastfeeding rates.
Getting the balance just right: Desirable difficulty in health professions education
Authors: Kinsey Hannah
Published: November 2022

Drawing on Nelson and Eliasz' exploration of 'Desirable Difficulties', Kinsey describes its application to workplace training models in Health Professions Education.
An invasive seagrass drives its own success in two invaded seas by both negatively affecting native seagrasses and benefiting from those costs
Authors: Chiquillo Kelcie L. , Barber Paul H. , Vasquez Marlen I. , Cruz‐Rivera Edwin , Willette Demian A. , Winters Gidon , Fong Peggy
Published: November 2022

The nature and strength of interactions between native and invasive species can determine invasion success. Species interactions can drive, prevent or facilitate invasion, making understanding the nature and outcome of these interactions critical. We conducted mesocosm experiments to test the outcome of interactions between Halophila stipulacea, a seagrass that invaded the Mediterranean and Caribbean Seas, and native seagrasses (Cymodocea nodosa and Syringodium filiforme, respectively) to elucidate mechanisms explaining the successful invasions. Mesocosms contained intact cores with species grown either mixed or alone. Overall, in both locations, there was a pattern of the invasive growing faster with the native than when alone, while also negatively affecting the native, with similar patterns for shoot density, aboveground and belowground biomass. In the Caribbean, H. stipulacea increased by 5.6 ± 1.0 SE shoots in 6 weeks when grown with the native while, when alone, there was a net loss of −0.8 ± 1.6 SE shoots. The opposite pattern occurred for S. filiforme, although these differences were not significant. While the pattern in the Mediterranean was the same as the Caribbean, with the invasive grown with the native increasing shoots more than when it grew alone, these differences for shoots were not significant. However, when measured as aboveground biomass, H. stipulacea had negative effects on the native C. nodosa. Our results suggest that a seagrass that invaded two seas may drive its own success by both negatively affecting native seagrasses and benefiting from that negative interaction. This is a novel example of a native seagrass species facilitating the success of an invasive at its own cost, providing one possible mechanism for the widespread success of this invasive species.
Successful cardiac resynchronization therapy by left bundle branch area pacing through a chronically occluded left subclavian system with limited vascular access preventing coronary sinus lead implant
Authors: Liu Xiaoke
Published: November 2022

Background

Conventional cardiac resynchronization therapy (CRT) involves implantation of a coronary sinus pacing lead through a delivery sheath, which typically requires a large venous access through a safe sheath of 9 French or greater in size. In patients who have very limited access due to scar tissue from previous implants or critical venous stenosis/closure, such large caliber access may not be available.

Methods and Results

We report a case of CRT procedure in an 84‐year‐old male with a previous history of ischemic dilated cardiomyopathy (ejection fraction 40%) who was dependent on right ventricular pacing with worsening heart failure symptoms. The patient was incidentally discovered to have chronic total closure (CTO) of the left subclavian vein during the procedure. Although the CTO was crossed by a wire and dilated, the venous access was limited to a 7 French sheath which rendered conventional CRT through coronary sinus lead implant impossible. However, using the left bundle branch area pacing (LBBAP) technique which requires a smaller venous access, we were able to successfully achieve CRT. Postprocedure, the patient's paced QRS duration narrowed from 198 to 130 ms. His heart failure symptoms improved, and ejection fraction increased to 45% one‐month after the procedure.

Conclusions

In patients with vascular access limited to a small caliber sheath not suitable for conventional CRT, LBBAP may help achieve procedural success and improve clinical outcome.
Perioperative intravenous lidocaine use in children
Authors: Heath Chloe , Hii Justin , Thalayasingam Priya , von Ungern‐Sternberg Britta S. , Sommerfield David
Published: November 2022

Perioperative pain management impacts patient morbidity, quality of life, and hospitalization cost. In children, it impacts not only the child, but the whole family. Adjuncts for improved perioperative analgesia continue to be sought to minimize adverse side effects associated with opioids and for those in whom regional or neuraxial anesthesia is not suitable. The use of ketamine and alpha agonists may be useful in these settings but have noted adverse effects including hallucinations, hemodynamic instability, and excessive sedation. One alternative is intravenous lidocaine. Despite its off‐label use, intravenous lidocaine has demonstrated anti‐neuropathic, anti‐hyperalgesic, and anti‐inflammatory actions and is an emerging technique. Multiple studies in adults have demonstrated beneficial effects of perioperative intravenous lidocaine including improved perioperative analgesia with reduced postoperative opioid use, improved gastrointestinal function, earlier mobilization, and reduction in hospital length of stay. Despite the limited pediatric literature, some of these findings have been replicated. Large‐scale trials providing evidence for the pediatric pharmacokinetics and high‐quality safety data with respect to intravenous lidocaine are still however lacking. To date, dose ranges studied in the pediatric population have not been associated with serious side effects and current data suggests perioperative intravenous lidocaine in a subgroup of pediatric surgical patients seems well‐tolerated and beneficial.
Narratives, Ontological Security, and Unconscious Phantasy: Germany and the European Myth During the so‐called Migration Crisis
Authors: Gellwitzki C. Nicolai L. , Houde Anne‐Marie
Published: November 2022

This article synthesizes scholarship on narratives and Kleinian defense mechanisms against anxiety to develop a framework that enables a nuanced understanding of ontological security‐seeking dynamics in times of crisis. Using the case study of the German narrative of the European Union during the so‐called migration crisis of 2015, this article engages with the broader question of how unconscious phantasy influences and guides decision‐making processes on a collective level as well as the question of how exactly narratives help subjects to manage anxiety to maintain a sense of ontological security. We show that, in the case of Germany, the EU offers a highly affective political myth that has guided both the decision‐making of the government during the crisis and the construction of German self‐identity narratives by attempting to introject the good part‐object of “Europeanness.” Crucially, German self‐identity narratives and narratives on the EU were not only inextricably linked but the EU also became an idealized (Kleinian) part‐object. During the so‐called migration crisis, this fostered processes of projective identification whereby decisions subverting European values and humanitarian narratives as well as general “badness” were externalized and projected onto other member states, most notably the Visegrád states.