bluuebunny/crossref_metadata_2025 huggingface dataset:
Staging behaviours identify spatial and temporal risk of human‐wildlife conflict
Authors: Hahn Nathan R. , Wall Jake , Denninger‐Snyder Kristen , Sairowua Wilson , Goss Marc , Ndambuki Stephen , Eblate Ernest , Mbise Noel , Kiambi Sospeter , Wittemyer George
Published: May 2023

Habitat conversion to farmland has increased human‐wildlife interactions, which often lead to conflict, injury or death for people and animals. Understanding the behavioural and landscape drivers of human‐wildlife conflict is critical for managing wildlife populations. Staging behaviour prior to crop incursions has been described across multiple taxa and offers potential utility in managing conflict, but few quantitative assessments of staging have been undertaken. Animal movement data can provide valuable, fine‐scale information on such behaviour with opportunities for application to real‐time management for conflict prediction.

We developed an approach to assess the efficacy of six widely used metrics of animal movement to identify staging behaviour prior to agricultural incursions. We applied this approach to GPS data from 55 African elephants in the Serengeti‐Mara ecosystem and found tortuosity and HMM‐derived behavioural states to be the most effective for identifying staging events. We then assessed temporal patterns of defined staging at daily and seasonal scales and explored environmental and anthropogenic drivers of staging from spatial generalized logistic mixed models. Finally, we tested the viability of combining movement and simple spatial metrics to predict crop incursions based on GPS data.

Our approach identified staging behaviour that appeared to be driven largely by human activity and diurnal availability of protective cover from forest, riverine vegetation, and topography. Staging also varied substantially by season. Tortuosity and behavioural state metrics identified different staging strategies with distinct spatial distributions and anthropogenic drivers, and appeared to be linked to the juxtaposition between protected and cultivated lands. Tortuosity‐based staging combined with distance‐to‐agriculture produced promising results for pre‐event prediction of crop incursion.

Synthesis and applications. Our study found staging by elephants prior to crop use could be identified from GPS tracking data, indicating that a better understanding of movement behaviour can inform targeted and proactive human‐wildlife conflict management and inform spatial planning efforts. Our approach is extendable to other conflict‐prone species to assess pre‐conflict behaviours and space use and demonstrates some of the challenges and advantages of using animal behaviour to assess temporal and spatial heterogeneity in human‐wildlife conflict.
Vulnerable newborn types: Analysis of population‐based registries for 165 million births in 23 countries, 2000–2021
Authors: Suárez‐Idueta Lorena , Yargawa Judith , Blencowe Hannah , Bradley Ellen , Okwaraji Yemisrach B. , Pingray Veronica , Gibbons Luz , Gordon Adrienne , Warrilow Kara , Paixao Enny S. , Falcão Ila Rocha , Lisonkova Sarka , Wen Qi , Mardones Francisco , Caulier‐Cisterna Raúl , Velebil Petr , Jírová Jitka , Horváth‐Puhó Erzsebet , Sørensen Henrik Toft , Sakkeus Luule , Abuladze Lili , Gissler Mika , Heidarzadeh Mohammad , Moradi‐Lakeh Maziar , Yunis Khalid A. , Al Bizri Ayah , Karalasingam Shamala D. , Jeganathan Ravichandran , Barranco Arturo , Broeders Lisa , van Dijk Aimée E. , Huicho Luis , Quezada‐Pinedo Hugo Guillermo , Cajachagua‐Torres Kim Nail , Alyafei Fawziya , AlQubaisi Mai , Cho Geum Joon , Kim Ho Yeon , Razaz Neda , Söderling Jonas , Smith Lucy K. , Kurinczuk Jennifer , Lowry Estelle , Rowland Neil , Wood Rachael , Monteath Kirsten , Pereyra Isabel , Pravia Gabriella , Ohuma Eric O. , Lawn Joy E. ,   the National Vulnerable Newborn Prevalence Collaborative Group and Vulnerable Newborn Measurement Core Group
Published: May 2023

Objective

To examine the prevalence of novel newborn types among 165 million live births in 23 countries from 2000 to 2021.

Design

Population‐based, multi‐country analysis.

Setting

National data systems in 23 middle‐ and high‐income countries.

Population

Liveborn infants.

Methods

Country teams with high‐quality data were invited to be part of the Vulnerable Newborn Measurement Collaboration. We classified live births by six newborn types based on gestational age information (preterm <37 weeks versus term ≥37 weeks) and size for gestational age defined as small (SGA, <10th centile), appropriate (10th–90th centiles), or large (LGA, >90th centile) for gestational age, according to INTERGROWTH‐21st standards. We considered small newborn types of any combination of preterm or SGA, and term + LGA was considered large. Time trends were analysed using 3‐year moving averages for small and large types.

Main outcome measures

Prevalence of six newborn types.

Results

We analysed 165 017 419 live births and the median prevalence of small types was 11.7% – highest in Malaysia (26%) and Qatar (15.7%). Overall, 18.1% of newborns were large (term + LGA) and was highest in Estonia 28.8% and Denmark 25.9%. Time trends of small and large infants were relatively stable in most countries.

Conclusions

The distribution of newborn types varies across the 23 middle‐ and high‐income countries. Small newborn types were highest in west Asian countries and large types were highest in Europe. To better understand the global patterns of these novel newborn types, more information is needed, especially from low‐ and middle‐income countries.
Long‐term outcome in twins: on the importance of follow‐up but also of chorionicity
Authors: Lopriore Enrico
Published: May 2023

Linked article: This is a mini commentary on Choi et al., pp.1370–1378 in this issue. To view this article visit https://doi.org/10.1111/1471‐0528.17494.
Pleural effusion and thoracentesis in ICU patients: A longitudinal observational cross‐sectional study
Authors: Fjæreide Karen W. , Petersen Per L. , Mahdi Angela , Crescioli Elena , Nielsen Frederik M. , Rasmussen Bodil S. , Schjørring Olav L.
Published: May 2023

Background

Pleural effusion is common among patients in the intensive care unit (ICU) but reported prevalence varies. Thoracentesis may improve respiratory status, however, indications for this are unclear. We aimed to explore prevalence, development, and progression of pleural effusion, and the incidence and effects of thoracentesis in adult ICU patients.

Methods

This is a prospective observational study utilizing repeated daily ultrasonographic assessments of pleurae bilaterally, conducted in all adult patients admitted to the four ICUs of a Danish university hospital throughout a 14‐day period. The primary outcome was the proportion of patients with ultrasonographically significant pleural effusion (separation between parietal and visceral pleurae >20 mm) in either pleural cavity on any ICU day. Secondary outcomes included the proportion of patients with ultrasonographically significant pleural effusion receiving thoracentesis in ICU, and the progression of pleural effusion without drainage, among others. The protocol was published before study initiation.

Results

In total, 81 patients were included of which 25 (31%) had or developed ultrasonographically significant pleural effusion. Thoracentesis was performed in 10 of these 25 patients (40%). Patients with ultrasonographically significant pleural effusion, which was not drained, had an overall decrease in estimated pleural effusion volume on subsequent days.

Conclusion

Pleural effusion was common in the ICU, but less than half of all patients with ultrasonographically significant pleural effusion underwent thoracentesis. Progression of pleural effusion without thoracentesis showed reduced volumes on subsequent days.
AP‐1 is a regulatory transcription factor of inflammaging in the murine kidney and liver
Authors: Yu Xiaojie , Wang Yuting , Song Yifan , Gao Xianda , Deng Hongkui
Published: May 2023

Aging is characterized by chronic low‐grade inflammation in multiple tissues, also termed “inflammaging”, which represents a significant risk factor for many aging‐related chronic diseases. However, the mechanisms and regulatory networks underlying inflammaging across different tissues have not yet been fully elucidated. Here, we profiled the transcriptomes and epigenomes of the kidney and liver from young and aged mice and found that activation of the inflammatory response is a conserved signature in both tissues. Moreover, we revealed links between transcriptome changes and chromatin dynamics through integrative analysis and identified AP‐1 and ETS family transcription factors (TFs) as potential regulators of inflammaging. Further in situ validation showed that c‐JUN (a member of the AP‐1 family) was mainly activated in aged renal and hepatic cells, while increased SPI1 (a member of the ETS family) was mostly induced by elevated infiltration of macrophages, indicating that these TFs have different mechanisms in inflammaging. Functional data demonstrated that genetic knockdown of Fos, a major member of the AP‐1 family, significantly attenuated the inflammatory response in aged kidneys and livers. Taken together, our results revealed conserved signatures and regulatory TFs of inflammaging in the kidney and liver, providing novel targets for the development of anti‐aging interventions.
Psychometric properties of the Caring Efficacy Scale among personal care attendants working in residential aged care settings
Authors: Shrestha Sumina , Wells Yvonne , While Christine , Rahman Muhammad Aziz
Published: May 2023

Objective

This study assessed the psychometric properties of the Caring Efficacy Scale (CES) among personal care attendants providing care to older residents in residential aged care settings.

Methods

This cross‐sectional study was completed in Australia in 2020–2021. Confirmatory factor analysis (CFA) of the 30‐item original CES (Model 1) and 28‐item CES validated in registered nurses (Model 2) was conducted to assess the goodness of fit of these models in our study population. Due to unsatisfactory fit indices for both models, exploratory factor analysis (EFA) was conducted to examine the dimensionality and underlying structure of the original CES among personal care attendants. Internal consistency of the final scale and subscales identified was examined using item‐total correlations and Cronbach's alpha coefficients.

Results

Two hundred and eighty personal care attendants participated in the study. The model fit indices such as Comparative Fit Index and Tucker Lewis Index of both models were less than 0.90, while the Standardised Root Mean Square Residual and Root Mean Square of Approximation values were greater than or equal to 0.08 and 0.06, respectively. The EFA identified a two‐factor structure, and 22 items of the 30 in the original scale were retained. Item‐total correlations amongst items retained in the scale and subscales were greater than 0.3. Cronbach's alpha for the abbreviated scale was 0.85, with 0.83 and 0.79, respectively, for the two subscales.

Conclusions

The modified CES can be used as a robust tool to assess the self‐efficacy of personal care attendants in providing care to older residents in residential aged care settings.
Acute generalized exanthematous pustulosis complicated by cutaneous small vessel vasculitis: A case report and literature review
Authors: Zhang Xingwei , Zhuang Kaiwen , Lyu Xiaoyan
Published: May 2023

Acute generalized exanthematous pustulosis (AGEP) is a rare skin eruption characterized by widespread erythematous lesions covered with numerous pustules. Leukocytoclastic vasculitis is now considered an uncommon but possible histopathological feature within the clinical and pathological spectrum of AGEP. Our report describes a rare case of AGEP overlapping with cutaneous small vessel vasculitis, a condition that has only been reported once in the literature.
Combined or sequential DMEK in cases of cataract and Fuchs endothelial corneal dystrophy—A systematic review and meta‐analysis
Authors: Romano Vito , Passaro Maria Laura , Bachmann Bjoern , Baydoun Lamis , Ni Dhubhghaill Sorcha , Dickman Mor , Levis Hannah J. , Parekh Mohit , Rodriguez‐Calvo‐De‐Mora Marina , Costagliola Ciro , Virgili Gianni , Semeraro Francesco
Published: May 2023

To compare the outcomes of Descemet membrane endothelial keratoplasty (DMEK) performed after phacoemulsification and intraocular lens (IOL) implantation (sequential DMEK) and DMEK combined with phacoemulsification and IOL implantation (combined DMEK) in patients with Fuchs endothelial corneal dystrophy (FECD) and cataract. Systematic literature review and meta‐analysis performed according to the PRISMA guidelines and registered in PROSPERO. Literature searches were conducted in Medline and Scopus. Comparative studies reporting sequential DMEK and combined DMEK in FECD patients were included. The main outcome measure of the study was the corrected distance visual acuity (CDVA) improvement. Secondary outcomes were postoperative endothelial cell density (ECD), rebubbling rate and primary graft failure rate. Bias risk was assessed and a quality appraisal of the body of evidence was completed using the Cochrane Robin‐I tool. A total of 667 eyes (5 studies) were included in this review, 292 eyes (43.77%) underwent a combined DMEK, while 375 (56.22%) eyes underwent a sequential DMEK surgery. We found no evidence of a difference between the two groups (mean difference, 95% CI) regarding: (1) CDVA improvement (−0.06; −0.14, 0.03 LogMAR; 3 studies, I2: 0%; p = 0.86); (2) postoperative ECD (−62; −190, 67 cells/mm2; 4 studies, I2: 67%; p = 0.35); (3) rebubbling (risks ratio: 1.04; 0.59, 1.85; 4 studies, I2: 48%; p = 0.89); and primary graft failure rate (risks ratio: 0.91; 0.32, 2.57; 3 studies, I2: 0%; p = 0.86). Of all the 5 non‐randomized studies, all (100%) were graded as low quality. The overall quality of the analysed studies was low. Randomized controlled trials are needed to confirm no difference or superiority of one approach in terms of CDVA, endothelial cell count and postoperative complication rate between the two arms.
Small‐for‐gestational‐age and predictors of HOMA indices, leptin and adiponectin in infancy
Authors: Huang Rong , He Hua , Nuyt Anne Monique , Julien Pierre , Marc Isabelle , Levy Emile , Fraser William D. , Luo Zhong‐Cheng
Published: May 2023

Aim

To assess whether small‐for‐gestational‐age (SGA) – an indicator of poor fetal growth, may affect metabolic health biomarkers in infancy and explore the predictors.

Methods

This was a nested matched (1:2) prospective observational study of 65 SGA (birth weight < 10th percentile) and 130 optimal‐for‐gestational‐age (OGA, birth weight 25th‐75th percentiles, control) infants in the 3D birth cohort with subjects recruited in Canada from 1 May 2010 to 31 August 2012. The outcomes included homeostasis model assessment of insulin resistance (HOMA‐IR) and beta‐cell function (HOMA‐β), circulating leptin and adiponectin concentrations at age 2 years.

Results

HOMA‐IR, HOMA‐β, leptin and adiponectin concentrations were similar in SGA versus OGA infants. Female sex and accelerated growth in length during mid‐infancy (3–12 months) were associated with higher HOMA‐IR. Caucasian ethnicity and decelerated growth in weight during late infancy (12–24 months) were associated with lower HOMA‐IR. Current BMI was positively associated with circulating adiponectin in SGA infants only (+13.4% [4.0%–23.7%] per BMI z score increment).

Conclusion

Insulin resistance and secretion, circulating leptin and adiponectin levels were normal in SGA subjects in infancy at age 2 years. The novel observation in SGA‐specific positive association between current BMI and circulating adiponectin suggests dysfunctional adiposity‐adiponectin negative feedback loop development during infancy in SGA subjects.
Robotic instruments outside the surgical field can cause problems: A case of critical bleeding during robotic distal pancreatectomy
Authors: Uchida Yuichiro , Takahara Takeshi , Mii Satoshi , Mizumoto Takuya , Iwama Hideaki , Kojima Masayuki , Kato Yutaro , Uyama Ichiro , Suda Koichi
Published: May 2023

Robotic surgery has technical advantages including high optical magnification and articulation of forceps. However, the surgical field tends to be narrow due to the high magnification, and the forceps have no tactile sensation. A case of severe intraoperative bleeding from the splenic artery during robotic distal pancreatectomy is presented, with a video. A man in his 80s with a cystic tumor located at the pancreatic tail underwent robotic distal pancreatectomy. During mobilization of the pancreatic tail by an inferior approach, the root of the splenic artery was injured by the joints of the robotic instruments located outside the surgical field and the bleeding became uncontrollable under the robotic operation. It is important to always be aware of what the forceps are in contact with outside the surgical field. While dissecting the left subdiaphragmatic area in robotic distal pancreatectomy, the root area of splenic artery tends to be outside the surgical field. More attention should be paid to the positional relationship between the forceps trajectory and the major blood vessels by checking the surgical field from a distant view on a regular basis.
Mediation of self‐concept and moderation of teacher support between SES and reading achievement: Evidence from China and the United States
Authors: Ma Lihong , Xiao Leifeng , Li Qi
Published: May 2023

Background

Socioeconomic status (SES) is important in students' reading development. The mechanism of how they are linked, however, is underexplored.

Aims

This research aimed to explore whether reading self‐concept mediates the link between SES and reading achievement and whether teacher support moderates the direct and indirect link between SES and reading achievement.

Samples

Using PISA 2018 database, we selected 17,346 15‐year‐olds from 537 schools in B‐S‐J‐Z (China) and the United States (U.S.).

Methods

Multilevel linear models were calculated to explore the potential mediation of self‐concept and the potential moderation of teacher support between SES and reading achievement.

Results

Results reveal that reading self‐concept mediated the link between SES and reading achievement at student level both in China and the United States, and teacher support moderated the link between SES and reading self‐concept both at student level and school level only in China, but not in the United States.

Conclusion

Our research highlights the importance of self‐concept and teacher support in improving students' reading achievement, especially for students of low SES, which has important theoretical significance and practical enlightenment for reading instruction.
Health and well‐being of sibling carers of adults with an intellectual disability in Ireland: Four waves of data
Authors: Brennan Damien , D'Eath Maureen , McCallion Philip , McCarron Mary
Published: May 2023

Background

As the life expectancy of people with intellectual disability increases, they may now outlive their parents or their parents' ability to continue to care. Siblings of adults with intellectual disability often succeed their parents as primary carers. Little is known about the health and well‐being of this important cohort of carers who will be both caring for and ageing alongside their brother or sister with intellectual disability. The Carer's Study within The Intellectual Disability Supplement to the Irish Longitudinal Study on Ageing (IDS‐TILDA) provides a unique insight into the health and well‐being of family carers of older adults with intellectual disability including sibling carers in Ireland. This article reports on the findings from waves 1, 2, 3 and 4 of the IDS‐TILDA Carer's Study.

Methods

The IDS‐TILDA Carer's Study surveys family carers of older people (aged 40 years and older) with intellectual disability on a 3‐yearly cycle. The family carers complete a self‐administered, mixed‐methods questionnaire. The qualitative data are analysed thematically, and a descriptive analysis of the quantitative data is conducted using SPSS.

Findings

In each wave, sibling carers comprised a significant proportion of the Carer's Study participants: W1 58%; W2: 61.4%; W3: 76.7%; and W4: 45.8%. The siblings were predominantly female, not in paid employment and were caring without the support of a spouse or partner. Across the four waves, siblings reported good general health. However, a high prevalence of particular conditions including back pain, aching joints and stress was also reported, and in each wave, siblings reported feeling completely overwhelmed by their care responsibilities. Although sibling carers reported that they have considered the future, only a minority have progressed to action in this regard.

Conclusions

There is evidence of the strong relational and emotional commitment by the siblings to their brother or sister with intellectual disability. However, through the four waves of data, there was also evidence of physical, mental and financial toll. An urgent need exists to identify and engage with siblings to protect their well‐being as they provide care for an increasingly ageing sibling.
Association of Gestational Diabetes Mellitus and Perinatal Maternal Depression with Early Childhood Behavioral Problems: An Environmental Influences on Child Health Outcomes (ECHO) Study
Authors: Shuffrey Lauren C. , Morales Santiago , Jacobson Melanie H. , Bosquet Enlow Michelle , Ghassabian Akhgar , Margolis Amy E. , Lucchini Maristella , Carroll Kecia N. , Crum Rosa M. , Dabelea Dana , Deutsch Arielle , Fifer William P. , Goldson Brandon , Hockett Christine W. , Mason W. Alex , Jacobson Lisette T. , O'Connor Thomas G. , Pini Nicolò , Rayport Yael , Sania Ayesha , Trasande Leonardo , Wright Rosalind J. , Lee Seonjoo , Monk Catherine ,   program collaborators for Environmental influences on Child Health Outcomes
Published: May 2023

This study examined the association of gestational diabetes mellitus (GDM), prenatal, and postnatal maternal depressive symptoms with externalizing, internalizing, and autism spectrum problems on the Preschool Child Behavior Checklist in 2379 children aged 4.12 ± 0.60 (48% female; 47% White, 32% Black, 15% Mixed Race, 4% Asian, <2% American Indian/Alaskan Native, <2% Native Hawaiian; 23% Hispanic). Data were collected from the NIH Environmental influences on Child Health Outcomes (ECHO) Program from 2009‐2021. GDM, prenatal, and postnatal maternal depressive symptoms were each associated with increased child externalizing and internalizing problems. GDM was associated with increased autism behaviors only among children exposed to perinatal maternal depressive symptoms above the median level. Stratified analyses revealed a relation between GDM and child outcomes in males only.
CB‐HRNet: A Class‐Balanced High‐Resolution Network for the evaluation of endoscopic activity in patients with ulcerative colitis
Authors: Wang Ge , Zhang Shujiao , Li Jie , Zhao Kai , Ding Qiang , Tian Dean , Li Ruixuan , Zou Fuhao , Yu Qin
Published: May 2023

Endoscopic evaluation is the key to the management of ulcerative colitis (UC). However, there is interobserver variability in interpreting endoscopic images among gastroenterologists. Furthermore, it is time‐consuming. Convolutional neural networks (CNNs) can help overcome these obstacles and has yielded preliminary positive results. We aimed to develop a new CNN‐based algorithm to improve the performance for evaluation tasks of endoscopic images in patients with UC. A total of 12,163 endoscopic images from 308 patients with UC were collected from January 2014 to December 2021. The training set and test set images were randomly divided into 37,515 and 3191 after excluding possible interference and data augmentation. Mayo Endoscopic Subscores (MES) were predicted by different CNN‐based models with different loss functions. Their performances were evaluated by several metrics. After comparing the results of different CNN‐based models with different loss functions, High‐Resolution Network with Class‐Balanced Loss achieved the best performances in all MES classification subtasks. It was especially great at determining endoscopic remission in UC, which achieved a high accuracy of 95.07% and good performances in other evaluation metrics with sensitivity 92.87%, specificity 95.41%, kappa coefficient 0.8836, positive predictive value 93.44%, negative predictive value 95.00% and area value under the receiver operating characteristic curve 0.9834, respectively. In conclusion, we proposed a new CNN‐based algorithm, Class‐Balanced High‐Resolution Network (CB‐HRNet), to evaluate endoscopic activity of UC with excellent performance. Besides, we made an open‐source dataset and it can be a new benchmark in the task of MES classification.
Gene expression profiling and multiplex immunofluorescence analysis of bullous pemphigoid immune‐related adverse event reveal upregulation of toll‐like receptor 4/complement‐induced innate immune response and increased density of TH1 T‐cells
Authors: Marques‐Piubelli Mario L. , Seervai Riyad N. H. , Mudaliar Kumaran M. , Ma Wencai , Milton Denái R. , Wang Jing , Muhlbauer Aaron , Parra Edwin R. , Solis Luisa M. , Nagarajan Priyadharsini , Speiser Jodi , Hudgens Courtney , Cho Woo Cheal , Aung Phyu P. , Patel Anisha , Pacha Omar , Nelson Kelly C. , Tetzlaff Michael T. , Amaria Rodabe N. , Torres‐Cabala Carlos A. , Prieto Victor G. , Wistuba Ignacio I. , Curry Jonathan L.
Published: May 2023

Background

Immune checkpoint inhibitor (ICI)‐based cancer therapies cause a variety of cutaneous immune‐related adverse events (irAEs) including immunobullous skin eruptions like bullous pemphigoid (BP). However, little is known about the underlying immunopathogenic drivers of these reactions, and understanding the unique gene expression profile and immune composition of BP‐irAE remains a critical knowledge gap in the field of oncodermatology/oncodermatopathology.

Methods

BP‐irAE (n = 8) and de novo BP control (n = 8) biopsy samples were subjected to gene expression profiling using the NanoString® Technologies nCounter PanCancer Immune Profiling Panel. Multiplex immunofluorescence (mIF) studies using markers for T‐cells (CD3 and CD8), T helper 1 (TH1) cells (Tbet), TH2 cells (Gata3), TH17 cells (RORγT), and regulatory T‐cells (Tregs; FoxP3) were further evaluated using InForm® image analysis.

Results

Compared with de novo BP controls, BP‐irAE samples exhibited upregulation of 30 mRNA transcripts (p < 0.025), including toll‐like receptor 4 (TLR4) and genes associated with complement activation, and downregulation of 89 mRNA transcripts (p < 0.025), including genes associated with TH2, TH17, and B‐cell immune response. BP‐irAE demonstrated a greater density of Tbet+ (TH1) cells in the dermis (p = 0.004) and fewer Tregs in the blister floor (p = 0.028) when compared with that of de novo control BP samples.

Conclusions

BP‐irAE exhibited activation of the TLR4/complement‐driven classical innate immune response pathway, with dermal TH1 immune cell polarization and decreased Tregs in the blister floor. TLR/complement signaling may underlie the immunopathogenesis of BP‐irAE.
Changes in continuous glucose monitoring metrics and predictors of improvement 12 months after conversion from Freestyle Libre to Freestyle Libre 2
Authors: Stimson Roland H. , Dover Anna R. , Strachan Mark W. J. , Wright Rohana J. , Forbes Shareen , Gibb Fraser W.
Published: May 2023

Aims

We sought to assess whether conversion from Freestyle Libre to Freestyle Libre 2 (with low and high glucose alert functions) was associated with improved glucose metrics.

Research Design and Methods

A prospective observational study to assess changes in CGM metrics in 672 adults with type 1 diabetes when converting to Freestyle Libre 2. Secondary outcomes included predictors of reduction in time below range (TBR) and increase in time in range (TIR).

Results

TBR fell by a median of 1.0% (IQR −2.7 to 0.3, p < 0.001) after 12 months and TIR decreased by 1.0% (−8.7 to 6.0, p = 0.004). TIR did not fall in people using high glucose alerts (p = 0.353). Average duration of low glucose events (<3.9 mmoL/L) fell by 10 min (−46 to 18, p < 0.001). Significant improvements in TIR (p = 0.029) and time above 13.9 mM (p = 0.002) were observed in those using high glucose alerts. Alert threshold settings were not associated with glycaemic response; however, low alert use was independently associated with a fall in TBR of ≥0.5% (HR 1.9 [95% CI 1.2–3.1], p = 0.009) and high alert use was independently associated with a rise in TIR of ≥5% (HR 1.6 [95% CI 1.0–2.5], p = 0.043) at 12 months.

Conclusions

Conversion to Freestyle Libre 2 was associated with significant improvements in low glucose metrics. Alert function users were more likely to see improvements across all CGM metrics. Challenges remain in encouraging alert use, helping users set optimal alert thresholds and optimizing response to alerts.
Antioxidant defense enzymes in multiple sclerosis: A 5‐year follow‐up study
Authors: Essenburg Carson , Browne Richard W. , Ghazal Diala , Tamaño‐Blanco Miriam , Jakimovski Dejan , Weinstock‐Guttman Bianca , Zivadinov Robert , Ramanathan Murali
Published: May 2023

Background and purpose

Oxidative stress biomarkers are increased in multiple sclerosis (MS) lesions. Antioxidant defense enzymes regulate reactive oxygen species that can cause tissue injury in MS.

Methods

The study of 91 subjects included 64 relapsing–remitting MS (RR‐MS; 72% female, baseline age ± SD = 44.6 ± 11 years, disease duration = 13.3 ± 8.8 years, median Expanded Disability Status Scale [EDSS] = 2.0, interquartile range = 1.8) and 27 healthy controls (HC) at baseline and 5‐year follow‐up (5YFU). Serum glutathione peroxidase (GPX), glutathione‐S‐transferase (GST), glutathione reductase (GSHR), superoxide dismutase, and paraoxonase‐1 (PON1) arylesterase and paraoxonase activities were measured using kinetic enzyme assays. Total cholesterol (TC), high‐density lipoprotein cholesterol, low‐density lipoprotein cholesterol (LDL‐C), and an apolipoprotein (Apo) panel with ApoA‐I, ApoA‐II, ApoB, ApoC‐II, and ApoE were obtained. Serum neurofilament (sNfL) was used to assess axonal injury. Disability was measured on the EDSS.

Results

GSHR activity was lower in HC compared to RR‐MS at baseline and 5YFU. GPX (p = 0.008) and PON1 arylesterase and paraoxonase activities (both p = 0.05) increased between baseline and 5YFU in HC but did not increase in RR‐MS. At baseline and 5YFU, GPX and GST were associated with TC, LDL‐C, and ApoA‐II; GSHR was associated with ApoA‐II and ApoC‐II. Antioxidant enzymes were not associated with sNfL or EDSS in RR‐MS.

Conclusions

RR‐MS patients did not exhibit the changes in antioxidant enzyme activities over 5YFU found in HC; however, the differences were modest. Antioxidant enzyme activities are not associated with disability.
Immune checkpoint inhibitor‐associated central nervous system autoimmunity
Authors: Valencia‐Sanchez Cristina , Sechi Elia , Dubey Divyanshu , Flanagan Eoin P. , McKeon Andrew , Pittock Sean J. , Zekeridou Anastasia
Published: May 2023

Background and purpose

Outcome and rechallenge data on central nervous system (CNS) autoimmunity triggered by immune checkpoint inhibitors (ICIs) are limited. We aim to describe a large series of patients with ICI‐triggered CNS autoimmunity, and to compare these patients with spontaneous paraneoplastic syndromes (PNS).

Methods

We retrospectively reviewed Mayo Clinic patients with ICI‐triggered CNS autoimmunity (February 2015–June 2021). Clinical characteristics were compared to spontaneous PNS patients (with antineuronal nuclear antibody [ANNA]‐1 or anti‐Hu neurological autoimmunity, and/or neuroendocrine tumors [NET]) evaluated within the same period.

Results

Thirty‐one patients were included (55% female, median age = 63 years, range = 39–76). Median time from ICI initiation was 3.65 months (range = 0.8–44.5). The most common associated malignancies were melanoma and small cell lung cancer. CNS manifestations included encephalitis (n = 16), meningoencephalitis (n = 8), cerebellar ataxia (n = 4), demyelinating syndrome (n = 2), and myelopathy (n = 1). Magnetic resonance imaging was abnormal in 62%. Cerebrospinal fluid was inflammatory in 70%. Neural autoantibodies were identified in 47%, more frequently in patients with NET (p = 0.046). ICI was discontinued in 97%; 90% received immunosuppressive treatment. After median 6.8 months follow‐up (range = 0.7–46), 39% had unfavorable outcomes (grade ≥ 3). This was associated with higher severity degree at onset, shorter period from ICI to neurological symptom onset, and encephalitis. Four patients were rechallenged with ICI, and one relapsed. Patients with NET and with ANNA‐1 ICI‐triggered CNS autoimmunity had associated peripheral nervous system manifestations more frequently than their spontaneous counterparts (p = 0.007 and p = 0.028, respectively).

Conclusions

One third of ICI‐related CNS autoimmunity patients have unfavorable outcomes. Relapses may occur after ICI rechallenge. Neural autoantibodies are often present, more commonly in patients with NET.
A systematic review on efficacy, safety and treatment durability of intravenous immunoglobulin in autoimmune bullous dermatoses: Special focus on indication and combination therapy
Authors: Kianfar Nika , Dasdar Shayan , Daneshpazhooh Maryam , Aryanian Zeinab , Goodarzi Azadeh
Published: May 2023

Autoimmune bullous diseases (AIBDs) are a group of rare blistering dermatoses of the mucous membrane and/or skin. The efficacy, safety and treatment durability of intravenous immunoglobulin (IVIg) as an alternative treatment should be explored to systematically review the available literature regarding treatment outcomes with IVIg in AIBD patients. The predefined search strategy was incorporated into the following database, MEDLINE/PubMed, Embase, Scopus and Web of Science on 18 July 2022. Sixty studies were enrolled using Preferred Reporting Items for Systematic Reviews and Meta‐analyses guidelines. The use of IVIg alone or combined with rituximab was reported in 500 patients with pemphigus, 82 patients with bullous pemphigoid, 146 patients with mucous membranes pemphigoid and 19 patients with epidermolysis bullosa acquisita. Disease remission with IVIg therapy and RTX + IVIg combination therapy were recorded as 82.8% and 86.7% in pemphigus, 88.0% and 100% in bullous pemphigoid and 91.3% and 75.0% in mucous membrane pemphigoid, respectively. In epidermolysis bullosa acquisita, treatment with IVIg led to 78.6% disease remission; no data were available regarding the treatment with RTX + IVIg in this group of patients. Among all the included patients, 37.5% experienced at least one IVIg‐related side effect; the most common ones were headaches, fever/chills and nausea/vomiting. The use of IVIg with or without rituximab had a favourable clinical response in patients with AIBDs. IVIg has no major influence on the normal immune system, which makes its utilization for patients with AIBDs reasonable.
Marketing strategies in the age of COVID‐19: An Attitude, Belief, Context Approach
Authors: Suttikun Chompoonut , Mahasuweerachai Patcharaporn , Bicksler William Hamilton
Published: May 2023

As the COVID‐19 pandemic has severely affected the restaurant industry, the authors sought to test the effects of restaurant image on advocacy and willingness to pay premium prices. Data were collected using a questionnaire survey from a sample of 517 restaurant consumers and analyzed using a covariance‐based structural equation model to test the hypotheses. Results identified the significant influence of social media marketing and promotion of COVID 19 protocols on restaurant image. Status consumption moderated the effects of willingness to pay arising from a positive restaurant image. The Attitude, Behavior, Context (ABC) theory provided theoretical support.
Organisational justice and strain‐based conflict among Nigerian prison officers
Authors: Jenkins Morris , Lambert Eric G. , Elechi O. Oko , Hall Daniel , Otu Smart , Lanterman Jennifer L. , Barrington Claire
Published: May 2023

Most employees, including prison employees, want their employers to treat them fairly. Distributive justice (perceived fairness of outcomes) and procedural justice (perceived fairness of processes and procedures) are important dimensions of organisational justice. Limited research among correctional staff in the US suggests that views of distributive and procedural justice spill over and result in a strain‐based form of work‐family conflict. Strain‐based conflict occurs when work problems follow a person home and create conflict at home. Based on multivariate regression analysis of survey data from 120 Nigerian prison staff, distributive justice had significant negative effects on the strain‐based form of work‐family conflict. Contrary to findings among US staff, procedural justice did not have a similar significant association. The connection between views of organisational justice and strain‐based work‐family conflict appears to vary by nation.
Primary care management post gestational diabetes in Australia
Authors: Marschner Simone , Cheung N. Wah , Wing‐Lun Edwina , Kazi Samia , Trivedi Ritu , Chow Clara K.
Published: May 2023

Background

Women with a history of gestational diabetes (GD) have a high risk of developing diabetes and subsequent cardiovascular disease (CVD).

Aim

To assess whether diabetes screening and CVD risk screening occurred in general practice (GP) among postpartum women with GD.

Methods

This is a retrospective study of clinical record data of women with GD, under active GP management, from the MedicineInsight programme, run by Australia's National Prescribing Service MedicineWise, with GP sites located in Australia from January 2015 to March 2021. Documentation of screening for diabetes, assessment of lipids and measurement of blood pressure (BP) was assessed using proportions and mixed‐effects logistic regression with a log follow‐up time offset.

Results

There were 10 413 women, with a mean age of 37.9 years (standard deviation, 7.6), from 406 clinics with a mean follow‐up of 4.6 years (interquartile range, 1.8–6.2 years) A total of 29.41% (3062/10 413; 95% confidence interval [CI], 28.53–30.28) had not been assessed for diabetes, 37.40% (3894/10 413; 95% CI, 36.47–38.32) were not assessed for lipids and 2.19% (228/10 413; 95% CI, 1.91–2.47) had no BP documented. In total, 51.82% (5396/10 413; 95% CI, 50.86–52.78) were screened for all three (diabetes + lipids + BP) at least once. Obesity, comorbidities and dyslipidaemia were associated with increased likelihood of screening. New diabetes diagnosis was documented in 5.73% (597/10 413; 95% CI, 5.29–6.18) of the cohort.

Conclusion

Screening for diabetes and hyperlipidaemia was suboptimal in this high‐risk cohort of women with prior GD. Improved messaging that women with a GD diagnosis are at high cardiovascular risk may improve subsequent screening.
Combined inhibition of XIAP and autophagy induces apoptosis and differentiation in acute myeloid leukaemia
Authors: Huang Ziyang , Zhou Jifan , Jiang Yinyan , Han Yixiang , Wang Xiaofang , Li Fanfan , Jiang Songfu , Yu Kang , Zhang Shenghui
Published: May 2023

Perturbations in autophagy, apoptosis and differentiation have greatly affected the progression and therapy of acute myeloid leukaemia (AML). The role of X‐linked inhibitor of apoptosis (XIAP)‐related autophagy remains unclear in AML therapeutics. Here, we found that XIAP was highly expressed and associated with poor overall survival in patients with AML. Furthermore, pharmacologic inhibition of XIAP using birinapant or XIAP knockdown via siRNA impaired the proliferation and clonogenic capacity by inducing autophagy and apoptosis in AML cells. Intriguingly, birinapant‐induced cell death was aggravated in combination with ATG5 siRNA or an autophagy inhibitor spautin‐1, suggesting that autophagy may be a pro‐survival signalling. Spautin‐1 further enhanced the ROS level and myeloid differentiation in THP‐1 cells treated with birinapant. The mechanism analysis showed that XIAP interacted with MDM2 and p53, and XIAP inhibition notably downregulated p53, substantially increased the AMPKα1 phosphorylation and downregulated the mTOR phosphorylation. Combined treatment using birinapant and chloroquine significantly retarded AML progression in both a subcutaneous xenograft model injected with HEL cells and an orthotopic xenograft model injected intravenously with C1498 cells. Collectively, our data suggested that XIAP inhibition can induce autophagy, apoptosis and differentiation, and combined inhibition of XIAP and autophagy may be a promising therapeutic strategy for AML.
How consumer networks contribute to sustainable mindful consumption and well‐being
Authors: Teufer Birgit , Grabner‐Kräuter Sonja
Published: May 2023

Sustainable mindful consumption has positive impacts on the environment and on people's health and well‐being. However, consumption circumstances and social contexts make it difficult for consumers to engage in sustainable mindful behavior. To explore the role of consumer networks in fostering mindful consumption, sustainable behavior, and health and well‐being, interviews and focus groups with consumers, producers, and experts were conducted and analyzed using reflexive thematic analysis. Specifically, this paper contributes in three ways. First, it broadens the focus from individual mindfulness to collective mindfulness in consumption behavior. Second, it explores consumer networks as a way to overcome existing barriers to sustainable consumption and promote mindful consumption. Third, it explores the long‐term benefits of consumer‐producer collaboration to bring about top‐down and bottom‐up approaches to sustainable consumption change, beyond short‐term mindfulness interventions at the individual level.
Retrospective analysis of high‐intensity focused electromagnetic procedure synchronized with radiofrequency energy for visceral fat reduction
Authors: Kent David E. , Jacob Carolyn , Kinney Brian M.
Published: May 2023

Background

Visceral adipose tissue (VAT), present in the abdominal cavity, oftentimes contributes to an unpleasant aesthetic appearance and can be correlated with serious health issues. High‐intensity focused electromagnetic field (HIFEM) technology with synchronized radiofrequency (RF) was recently used for abdominal body shaping through subcutaneous fat reduction and muscle growth.

Aim

This study aimed to assess the effect of HIFEM + RF technology on VAT tissue.

Methods

Data of 16 men and 24 women (22–62 years, 21.2–34.3 kg/cm2) from the original study were retrospectively reviewed. All subjects received three 30‐min HIFEM + RF abdominal treatments once weekly for three consecutive weeks. The VAT area was measured in the axial plane of MRI scans at two levels: L4–L5 vertebrae and 5 cm above this level. The VAT was identified, segmented, and calculated, yielding total area in square centimeters per scan at both specified levels.

Results

By thoughtful review of the subject's post‐treatment MRI scans, no other changes in the abdominal cavity were found except for VAT. The evaluation showed a VAT reduction of 17.8% (p < 0.001) on average at 3‐month follow‐up, maintaining the results up to 6 months (−17.3%). Averaging the values obtained from both measured levels, the VAT, occupied an area of 100.2 ± 73.3 cm2 at the baseline. At the 3‐month follow‐up, the subjects achieved an average reduction of 17.9 cm2, preserving the results at 6 months (−17.6 ± 17.3 cm).

Conclusion

This retrospective analysis of MRI images objectively documented the effect of HIFEM + RF abdominal therapy on VAT. The data indicates considerable VAT reduction without serious adverse events following the HIFEM + RF procedure.
Rural higher education in Colombia: An analysis of public policy evolution
Authors: Guzmán Rincón Alfredo , Barragán Sandra , Cala‐Vitery Favio
Published: May 2023

Education can be seen as a driver for social development because people with a higher level of education can access a better income and a better quality of life. The Colombian state has proclaimed various public policies that guarantee this right, especially for rural populations that face more disparities resulting from the internal armed conflict and drug trafficking, among other issues. The purpose of this article is to describe the evolution of public policies for access to rural higher education in Colombia, as well as the starting point of the policies implemented. An interpretative method was adopted to consider the purpose of public policies from various perspectives. The results show that education can be perceived as one of the ways in which states can overcome social disparities in rural areas, which would mean different public policies for access, permanence, and timely graduation to higher education.
Participatory design of a smart forest in the Brazilian Amazon using smartphones, algorithms, and ethnographic methods
Authors: Zhang Shaozeng , da Silva Leonardo Ribeiro
Published: May 2023

This article reports on the participatory design of a smart forest project in a state forest reserve in the Brazilian Amazon in collaboration primarily with local community residents and secondarily with forest reserve managers and environmental scientists. The Smart Forest project was collectively proposed to use low‐cost digital technologies for forest‐carbon monitoring and sustainable development. Our research includes a feasibility test and impact assessment of the proposed components of the Smart Forest. It combines ethnographic fieldwork methods, such as interviews and focus groups on using recycled smartphones and sound‐recognition algorithms to remotely detect illegal logging, with innovative methods, such as field experiments using an open‐source smartphone app for participatory mapping of local traditional ecological knowledge (TEK). Our research findings, including unexpected ones, are helpful for community development, continuous participatory design, and academic research. This research was developed based on the first author Zhang's multiyear ethnographic field research in Amazonia and on the second author de Silva's local life experiences and action‐research interests.
Practical considerations for the use of SGLT‐2 inhibitors in the Asia–Pacific countries—An expert consensus statement
Authors: Liew Adrian , Lydia Aida , Matawaran Bien J. , Susantitaphong Paweena , Tran Huong Thi Bich , Lim Lee Ling
Published: May 2023

Recent clinical studies have demonstrated the effectiveness of SGLT‐2 inhibitors in reducing the risks of cardiovascular and renal events in both patients with and without type 2 diabetes mellitus. Consequently, many international guidelines have begun advocating for the use of SGLT‐2 inhibitors for the purpose of organ protection rather than as simply a glucose‐lowering agent. However, despite the consistent clinical benefits and available strong guideline recommendations, the utilization of SGLT‐2 inhibitors have been unexpectedly low in many countries, a trend which is much more noticeable in low resource settings. Unfamiliarity with the recent focus in their organ protective role and clinical indications; concerns with potential adverse effects of SGLT‐2 inhibitors, including acute kidney injury, genitourinary infections, euglycemic ketoacidosis; and their safety profile in elderly populations have been identified as deterring factors to their more widespread use. This review serves as a practical guide to clinicians managing patients who could benefit from SGLT‐2 inhibitors treatment and instill greater confidence in the initiation of these drugs, with the aim of optimizing their utilization rates in high‐risk populations.