bluuebunny/crossref_metadata_2025 huggingface dataset:
A tale of 2 digital hospitals: A qualitative study of antimicrobial stewardship teams
Authors: Van Dort Bethany A. , Ritchie Angus , Penm Jonathan , Gray Timothy J. , Ronnachit Amrita , Baysari Melissa T.
Published: January 2024

Aims

We aim to examine and understand the work processes of antimicrobial stewardship (AMS) teams across 2 hospitals that use the same digital intervention, and to identify the barriers and enablers to effective AMS in each setting.

Methods

Employing a contextual inquiry approach informed by the Systems Engineering Initiative for Patient Safety (SEIPS) model, observations and semistructured interviews were conducted with AMS team members (n = 15) in 2 Australian hospitals. Qualitative data analysis was conducted, mapping themes to the SEIPS framework.

Results

Both hospitals utilized similar systems, however, they displayed variations in AMS processes, particularly in postprescription review, interdepartmental AMS meetings and the utilization of digital tools. An antimicrobial dashboard was available at both hospitals but was utilized more at the hospital where the AMS team members were involved in the dashboard's development, and there were user champions. At the hospital where the dashboard was utilized less, participants were unaware of key features, and interoperability issues were observed. Establishing strong relationships between the AMS team and prescribers emerged as key to effective AMS at both hospitals. However, organizational and cultural differences were found, with 1 hospital reporting insufficient support from executive leadership, increased prescriber autonomy and resource constraints.

Conclusion

Organizational and cultural elements, such as executive support, resource allocation and interdepartmental relationships, played a crucial role in achieving AMS goals. System interoperability and user champions further promoted the adoption of digital tools, potentially improving AMS outcomes through increased user engagement and acceptance.
Subsequent therapy and outcomes in patients with newly diagnosed multiple myeloma experiencing disease progression after quadruplet combinations
Authors: Ravi Gayathri , Bal Susan , Joiner Laura , Giri Smit , Sentell Melissa , Hill Tiffany , Godby Kelly N. , Costa Luciano J.
Published: January 2024

The combination of anti‐CD38 monoclonal antibodies to a proteasome inhibitor, an immunomodulatory agent and dexamethasone (quadruplet—QUAD) in sequence with autologous stem cell transplantation (ASCT) leads to deep and durable responses in newly diagnosed multiple myeloma (NDMM). Disease progression in the first year post‐QUADs is uncommon. We analysed 274 consecutive NDMM patients treated with QUADs + ASCT. After a median follow‐up of 21.3 months, 20 patients had disease progression <18 months and 21 had progression ≥18 months after the onset of a QUAD regimen. All patients received subsequent anti‐MM therapy, and 38 were evaluated for response. Nine (22.0%) received T‐cell redirecting therapy as the next treatment, and 21 (51.2%) at some point in the treatment course. Response to next therapy was 26.3% for patients with progression <18 months and 52.6% for those with progression ≥18 months after the onset of a QUAD regimen. Median PFS on the next therapy was 2.5 months (95% CI 1.5–3.4) for those with progression <18 months and 7.0 months (95% CI 3.6–10.5) for those with progression ≥18 months. Efforts should focus on the early deployment of therapies with new mechanism of action for patients experiencing treatment failure after QUADs.
Quantitative computed tomography analysis of body composition changes in paediatric patients with acute lymphoblastic leukaemia
Authors: Suwannaying Kunanya , Ong Adrian A. , Dhaduk Rikeenkumar , Pei Deqing , Iijima Mayuko , Merkle Eric , Zhuang Tony Z. , Goodenough Chelsea G. , Brown Joren , Browne Emily K. , Wolcott Bruce , Cheng Cheng , Wilson Carmen L. , Pui Ching‐Hon , Ness Kirsten K. , Kaste Sue C. , Inaba Hiroto
Published: January 2024

Children with acute lymphoblastic leukaemia (ALL) are at risk for obesity and cardiometabolic diseases. To gain insight into body composition changes among children with ALL, we assessed quantitative computed tomography (QCT) data for specific body compartments (subcutaneous adipose tissue [SAT], visceral adipose tissue [VAT], total adipose tissue [TAT], lean tissue [LT], LT/TAT and VAT/SAT at lumbar vertebrae L1 and L2) at diagnosis and at off‐therapy for 189 children with ALL and evaluated associations between body mass index (BMI) Z‐score and clinical characteristics. BMI Z‐score correlated positively with SAT, VAT and TAT and negatively with LT/TAT and VAT/SAT. At off‐therapy, BMI Z‐score, SAT, VAT and TAT values were higher than at diagnosis, but LT, LT/TAT and VAT/SAT were lower. Patients aged ≥10 years at diagnosis had higher SAT, VAT and TAT and lower LT and LT/TAT than patients aged 2.0–9.9 years. Female patients had lower LT and LT/TAT than male patients. Black patients had less VAT than White patients. QCT analysis showed increases in adipose tissue and decreases in LT during ALL therapy when BMI Z‐scores increased. Early dietary and physical therapy interventions should be considered, particularly for patients at risk for obesity.
Children's information‐search strategies: Operationalizing efficiency and effectiveness
Authors: Török Georgina , Stanciu Oana , Ruggeri Azzurra
Published: January 2024

Research on the development of active learning and information search behaviors has been growing rapidly, drawing interest from multiple disciplines, from developmental psychology to cognitive science and artificial intelligence. These different perspectives can open pathways to understanding how preschool‐age children grow into adaptive and efficient active learners. However, the lack of a shared vocabulary, operationalizations, and research paradigms has led to limited cross‐talk and some conflicting findings. In this article, we advocate for using a shared operationalization of a “good” information‐search strategy, as a function of its efficiency and effectiveness within a given ecology, based on the information‐theoretic measure of expected information gain and observed behavioral outcomes, respectively. We also discuss factors that should be considered when designing experiments that examine children's information‐search competence, specifically, using formal models as performance benchmarks and accounting for children's prior knowledge, assumptions, and self‐generated goals.
Effects of WuZhi preparations on tacrolimus in pediatric and adult patients carrying the CYP3A5*1 allele of heart transplant during the early period after transplantation
Authors: Liu Li , Zhou Ying , Huang Xiao , Chen Hefen , Gong Zhujun , Zhang Jing , Zeng Fang , Zhou Hong , Zhang Yu
Published: January 2024

Aim

Wuzhi preparations (WZP) are commonly administrated with tacrolimus (TAC) in China to improve the liver function and increase the exposure of TAC. This study aims to investigate the effects of WZP on TAC in pediatric heart transplantation (HTx) patients carrying the CYP3A5*1 allele during the early period after transplantation and also make a comparison with these effects in adult recipients.

Methods

A total of 81 recipients with CYP3A5*1 allele were included and divided into the pediatric group (n = 29) and adult group (n = 52). The changes in TAC dose‐corrected trough blood concentrations (C0/D), dose requirement as well as intra‐patient variability(IPV) of C0/D after co‐therapy with WZP were evaluated.

Results

The TAC C0/D was significantly increased 1.7 and 1.8 times after co‐administration of WZP in the pediatric and adult groups, respectively. We further analyzed the pediatric patients, found that no statistical difference was observed in TAC C0/D before and after co‐therapy with WZP in children <6 years old. The changes of C0/D increased with the dose of the active ingredient (Schisantherin A) in adult patients, but not in pediatric patients. TAC IPV was reduced by 10.5% in pediatric patients and 4.8% in adult patients when co‐administrated with WZP. Furthermore, after taking WZP, the AST and TB were dramatically lowered in pediatric recipients.

Conclusion

Our study is the first attempt to demonstrate the effects of WZP on TAC in pediatric HTx recipients. By comparing these effects to those observed in adult recipients, valuable insights can be gained regarding the efficacy and potential benefits of WZP in the pediatric population.
Intensified parenthood: A qualitative study exploring parents' gendered positions in the care of child‐onset diabetes
Authors: Madsen Mie , Campbell Maria Athena , Grabowski Dan , Johannesen Jesper , Jespersen Louise Norman
Published: January 2024

Objective

This study explores how parents experience and manage the care and challenges in the period shortly after their child is diagnosed with type 1 diabetes, while placing an analytical focus on gendered dynamics between parents.

Background

Studies have shown that parents' involvement in managing their child's diabetes manifests in diverse ways. However, how parents construct and negotiate their caregiving roles and responsibilities has received little attention.

Methods

We conducted interviews with parents of 20 children (aged 0–18) recently diagnosed with type 1 diabetes, totaling 34 interviews over two time points: 20 within 4 weeks of diagnosis and 14 follow‐up interviews 4 months later. The data were analyzed using theoretical thematic analysis and interpreted within the framework of positioning theory.

Results

The analysis generated four themes: childhood diabetes intensifies the experience of parental responsibility, fluid parenting roles with 100% commitment, negotiating parental positions, and drawback of polarized positions.

Conclusion

Parents engage in complex dynamics of negotiating their caregiving roles, often leading to gender‐influenced polarized positions that shape their experiences and approaches to care and challenges.

Implications

This study highlights crucial dynamics important to address for tailoring support to meet the needs of both parents.
Intimate partner violence in the LGBTQ+ community: Implications for family court professionals
Authors: Davis Lindsey Sank , Crain Emily E.
Published: January 2024

Lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority (LGBTQ+) individuals likely experience more intimate partner violence (IPV) than their cisgender, heterosexual counterparts. Though the research on IPV among LGBTQ+ individuals is lacking in quantity, available evidence suggests LGBTQ+ individuals have unique risk factors for IPV victimization and perpetration, express identity‐specific reasons for underreporting IPV, and experience types of IPV specific to their sexual orientation and/or gender identities. Bisexual and transgender individuals appear to be at significantly higher risk of IPV victimization compared to their peers. A search of the Family Court Review archives suggests that IPV affecting bisexual parents has never been directly addressed in the publication, nor has IPV affecting transgender or gender‐nonconforming parents, and the last article on the topic of IPV in gay and lesbian relationships (Bunker Rohrbaugh, 2006) was published more than 15 years ago when marriage and adoption rights were unavailable to most LGBTQ+ individuals. The current article provides an updated and comprehensive discussion of IPV within the broader LGBTQ+ community, reviews the limitations of the extant literature and the need for more research, and demonstrates that LGBTQ+ IPV is a complex issue with which all family court practitioners should be familiar.
Effect of infiltration temperature on graphitization and properties of diamond/SiC composites with SiC matrix
Authors: Hong Tianxiang , Chen Yuhong , Liu Ruibin , Hai Wanxiu , Zhang Xiuling , Liu Meiling , Yan Suo
Published: January 2024

In this study, diamond/silicon carbide (SiC) composites were prepared by liquid Si infiltration. The effects of the infiltration temperature on the densification, diamond graphitization, and thermal conductivity of the composites were investigated. The effects of the diamond content on the thermal conductivity and bending strength were also explored. X‐ray diffraction and Raman spectroscopy detected diamond graphitization at an infiltration temperature of 1480°C. Almost no graphitized diamond was observed due to reactions between silicon and carbon to form SiC at infiltration temperatures higher than 1480°C. As the infiltration temperature increased, graphitized diamond was consumed, and the thermal conductivity of the composite rose. The thermal conductivity and bending strength of the composites depended on the diamond content, reaching values of 257 W/m K and 237 MPa, respectively, for the sample with a diamond content of 17.9 vol.%. The higher bending strength was mainly ascribed to the high diamond content and well‐bonded interface.
Corrosion behaviors of Ti3SiC2/Cu composites in molten salts
Authors: Liu Fuyan , Du Chengzhi , Wu Chenlong , Zhang Rui
Published: January 2024

The corrosion behaviors of Ti3SiC2/Cu composites synthesized by spark plasma sintering technique were investigated at 900°C in three molten salts including NaCl, Na2SO4, and Na2CO3, and the related corrosion mechanism was discussed. The morphology and composition of the composites after corrosion were characterized by scanning electron microscopy and X‐ray photoelectron spectroscopy. The results indicated that the weight gain per unit surface area of the composites was negative in molten Na2CO3, while it was positive and relatively small in molten NaCl and Na2SO4. The high weight loss of the composites in molten Na2CO3 was owing to that in molten Na2CO3, an oxidation layer of the composites was dissolved, and oxygen diffused through the layer to corrode the substrate inside. Thus, in the molten Na2CO3, the composites exhibited a worse corrosion resistance. However, in molten NaCl and Na2SO4, an oxidation layer containing SiO2 and TiO2 was formed on the surface of the composites, inhibiting its further corrosion. Conclusively, the composites showed better corrosion resistance in molten NaCl and Na2SO4.
Permeability prediction of porous aerostatic bearings through 3D morphology and fractal calculation method
Authors: Cui Jianwei , You Xiaoyu , Zhang Hongjun , Liu Jian
Published: January 2024

Porous ceramics for aerostatic bearing restrictors were fabricated using carboxymethyl cellulose and polystyrene microspheres as pore formers. The three‐dimensional morphology of the porous ceramics was nondestructively obtained using laser scanning confocal microscopy, and the processing information was eliminated by fitting the pore area fractal dimensions at different heights. A mathematical model was developed based on the assumption of elliptical tortuous capillaries to relate microstructural pore parameters to permeability by combining fractal theory, Darcy's law, and the gas conservation equation. The calculated permeability closely matched the experimental results, with an error of less than 3.5%. This method has promising potential as an alternative to pressure drop experiments. Moreover, the capacity of the fractal calculation model to establish a correlation between microstructural parameters and permeability paves a new way to design future porous aerostatic bearings.
Application of continuing nursing intervention on wound infection and ulcers in patients with diabetic foot: A meta‐analysis
Authors: Li Xu‐Xiang , Xu Jing , Chen Juan , Gao Feng , Wang Qing‐Ju , Yang Shi‐Hu
Published: January 2024

This meta‐analysis systematically evaluates the impact of continuous nursing care interventions on wound infections and ulcerations in patients with diabetic foot. A comprehensive computerized search was conducted, from database inception to November 2023, in PubMed, Embase, Google Scholar, Cochrane Library, China National Knowledge Infrastructure, and Wanfang databases for randomized controlled trials (RCTs) examining the application of continuous nursing care in diabetic foot. Two researchers independently screened the literature, extracted data, and conducted quality assessments based on inclusion and exclusion criteria. Data analysis was performed using Stata 17.0 software. A total of 23 RCTs involving 1813 diabetic foot patients were included. The analysis revealed that, compared to standard care, the implementation of continuous nursing care significantly reduced the incidence of wound infections (OR = 0.22, 95% CI: 0.15–0.32, p < 0.001) and complications (OR = 0.19, 95% CI: 0.14–0.25, p < 0.001), as well as the occurrence of foot ulcers (OR = 0.21, 95% CI: 0.12–0.35, p < 0.001). This study demonstrates that the application of continuous nursing care in diabetic foot patients can effectively reduce the occurrence of wound infections, foot ulcers, and complications, thereby facilitating patient recovery.
Defect assisted self‐reduction and post annealing of Mn ions activated garnet transparent ceramics
Authors: Yu Bin , Sun Bingheng , Fan Jintai , Hao Haoying , Shen Fangliang , Wang Jingang , Jiang Benxue , Zhang Long , Sun Jun
Published: January 2024

Transition‐metal Mn2+ ion‐doped transparent ceramics (TCs) are promising color‐convertors to improve color rendition for solid‐state lighting. However, the stabilization of Mn2+ remains a challenge owing to the changeable atmosphere in the specific preparation of TC. In this work, the variations of valence states of Mn ions in typical garnet lattice host (YAG and LuAG) throughout the TC fabrication were demonstrated. By combined first principles calculation and experimental investigation, an enhanced self‐reduction of Mn ions was clarified in LuAG host, which was originated from the higher concentration of oxygen vacancy defects. Moreover, the air annealing treatment could significantly weaken and enhance the absorption of Mn2+ and Mn3+ respectively, degrading the orange–red emission peaking at 594 nm. On account of the oxidation of Mn2+ ions, a photoluminescence spectra redshift of 9 nm was observed with increasing air annealing temperature and oxygen content, owing to strengthened crystal field strength surrounding Mn2+ ions. Finally, a high color rendering index of 74.5 of resultant white laser diodes device structured by single‐phase LuAG:Ce,Mn TCs was obtained based on an efficient energy transfer process from Ce3+ to Mn2+. This study will deepen the understanding of the crystal defects inside TCs on luminescence properties, as well as inspiring more exploration on defect control to develop high performance ceramic color‐convertor.
The effect of chemical vapor infiltration process parameters on flexural strength of porous α$\alpha$‐SiC: a numerical model
Authors: Marziale Joseph J. , Sun Jason , Walker Eric A. , Chen Yu , Salac David , Chen James
Published: January 2024

The flexural strength variability of ‐ based ceramics at elevated temperatures creates the need for an Integrated Computational Materials Engineering (ICME) framework that relates the strength of a specimen directly to its manufacturing process. To create this ICME framework, a model must first be developed which establishes a relationship between the chemical vapor infiltration (CVI) process and parameters, the resulting mesoscale pores, and the overall macroscale flexural strength. Here, a nonlinear single‐pore model of CVI is developed used in conjunction with a four‐way coupled thermo‐mechanical damage model. The individual components of the model are tested and a sample system under a four‐point bending test is explored. Results indicate that specimens with an initial porosity greater than 30% require temperatures below 1273 K to maintain structural integrity, while those with initial porosities less than 30% are temperature‐independent, allowing for optimization of the CVI processing time without compromising strength.
Randomized controlled multi‐centre study comparing shorter dental implants (6 mm) to longer dental implants (11–15 mm) in combination with sinus floor elevation procedures: 10‐year data
Authors: Thoma Daniel S. , Haas Robert , Sporniak‐Tutak Katarzyna , Garcia Abel , Taylor Thomas D. , Tutak Marcin , Pohl Veronika , Hämmerle Christoph H. F.
Published: January 2024

Aim

To compare implant survival and complication rates between shorter and standard‐length implants with sinus augmentation and restored with single crowns, at 10 years of loading.

Materials and Methods

One‐hundred and one patients (137 implants) with a ridge height of 5–7 mm in the posterior maxilla were randomly assigned to two treatment modalities: shorter implants (6 mm) (group short [GS]) or standard‐length implants (11–15 mm) with sinus grafting (group graft [GG]). Following the insertion of final restorations, patients were regularly recalled for up to 10 years. Assessed outcomes encompassed implant survival, marginal bone levels (MBLs), biological and technical parameters and patient‐reported outcome measures (OHIP‐49 = Oral Health Impact Profile). Non‐parametric statistical analysis was used to analyse the data.

Results

For the 5‐ to 10‐year follow‐up period, 77 patients with 105 implants (GS: 36 patients/48 implants; GG: 41/57) were available for re‐examination (drop‐out rate 21%). Implant survival rates at the patient level were 96.0% (GS; 2 failures) and 100% (GG) (inter‐group p = .24). Median MBLs amounted to 0.00 mm (min 0.00; max 3.25; GS) and 0.00 mm (min 0.00; max 4.55; GG) (inter‐group p = .73). Technical complications predominantly occurred within the first 5 years (inter‐group p > .05). Peri‐implantitis rates were 4.2% (GS) and 13.3% (GG) (intergroup p = .37). Median OHIP‐49 scores were 7.00 (0.00; 39.00; GS) and 9.00 (0.00; 196; GG) (inter‐group p = .61) at 10 years.

Conclusions

Based on similar 10‐year implant survival rates, reduced patient morbidity and lower costs, the use of shorter dental implants might well serve as an alternative treatment concept to longer implants placed in conjunction with sinus grafting for patients with a limited ridge height in the posterior maxilla. Study register: https://clinicaltrials.gov/ct2/show/NCT01030523.
The Equal Pay Act: Using EEOC v. Verona Area School District in the Classroom
Authors: Chain Raygan Pierce , Conklin Michael
Published: January 2024

This article provides instructions for an engaging classroom activity when discussing the Equal Pay Act of 1963. Students are asked to consider how to approach pay decisions when hiring a new employee for their business. Issues arise when the new hire asks for a higher wage than a current employee of a different sex. Legal Environment of Business/Business Law, Business Communication, and Business Ethics are all tied together in a discussion of what it means to pay someone more or less money based on their sex.
Efficacy and safety of vaginal formulations with tyndallized ferments in subjects with nonspecific vulvovaginitis: A randomized study in Italy
Authors: Forleo Francesco , Pelosi Fanny Mara , Bianco Luigina , Petrella Vincenzo
Published: January 2024

Aim

In this study, we tested the efficacy, safety, and tolerability of vaginal ovules and a vaginal douche containing tyndallized ferments in women affected by nonspecific vulvovaginitis, with or without the human papillomavirus (HPV).

Methods

The study included 91 female patients and had a randomized, controlled sequential design, with parallel groups. Ovules and douche were tested and compared to a control group treated with sterile physiological solution. Total symptom score (TSS), individual signs and symptoms, therapeutic success were evaluated, as well as safety and tolerability.

Results

The tyndallized ferments formulations (ovules and douche) had a safe and tolerable profile, and resulted in a significant decrease in TSS in patients affected by nonspecific vulvovaginitis, both at 5 and 10 days of treatment, when compared to a control group. The treatment was more effective than the control in reducing symptoms such as vulvar erythema, vulvar edema, itching, and burning. Patients affected by vulvovaginitis and HPV‐positive received a 30 days treatment either with ovules or ovules + douche, and we observed an improvement at Day 30 compared to Day 0, for both regimens.

Conclusions

Our study suggests that topical treatment with tyndallized ferments is a safe and effective strategy to reduce symptoms of nonspecific vulvovaginitis.
A decade of monitoring surveys for Xylella fastidiosa subsp. pauca in olive groves in Apulia (Italy) reveals a low incidence of the bacterium in the demarcated areas
Authors: Ciervo Margherita , Scortichini Marco
Published: January 2024

In October 2013, Xylella fastidiosa subsp. pauca (Xfp) was reported as being associated with a decline of olive groves in Salento (Apulia, Italy) and named as “olive quick decline syndrome” (OQDS). Due to its quarantine status, a series of mandatory actions were established in the Apulia region to impede its further spread in the territory. Upon the demarcation of “containment” and “buffer” zones, monitoring surveys were carried out in these areas for sampling olive trees and other host plants that showed symptoms putatively attributable to OQDS. The eradication of plants that tested positive for Xfp, including also all the asymptomatic ones in a radius of 100 or 50 m, was performed over 10 years. An analysis, based on the official data of such surveillance activities over the period of a decade, was performed. The data show that the Xfp incidence in the “containment” and “buffer” zones is very low, especially during the last three campaigns from 2020–2021 to 2022–2023, when the bacterium was detected in a range of 0.06%–0.70% of the sampled plants. In most of the sampled trees that showed symptoms of OQDS, the bacterium was not detected. Based on these data and according to epidemiological models that verified the negligible role of asymptomatic olive trees in the spreading of OQDS, we propose to eliminate the rule requiring the uprooting of all host plants that surround one Xfp‐positive tree in a radius of 50 m. Such an implementation could save many healthy centennial and monumental olive trees and the remarkable landscape that they contribute to.
Lenvatinib, sintilimab plus transarterial chemoembolization for advanced stage hepatocellular carcinoma: A phase II study
Authors: Cai Mingyue , Huang Wensou , Liang Wei , Guo Yongjian , Liang Licong , Lin Liteng , Xie Lulu , Zhou Jingwen , Chen Ye , Cao Bihui , Wu Jingqiang , Zhu Kangshun
Published: January 2024

Background & Aims

Our retrospective study has suggested encouraging outcomes of lenvatinib combined with PD‐1 inhibitor and transarterial chemoembolization (TACE) on advanced hepatocellular carcinoma (HCC). This phase II trial was conducted to prospectively investigate the efficacy and safety of lenvatinib, sintilimab (a PD‐1 inhibitor) plus TACE (Len‐Sin‐TACE) in patients with advanced stage HCC.

Methods

This was a single‐arm phase II trial. Patients with BCLC stage C HCC were recruited. They received lenvatinib (bodyweight ≥60 kg, 12 mg; bodyweight <60 kg, 8 mg) orally once daily, sintilimab (200 mg) intravenously once every 3 weeks, and on demand TACE. The primary endpoint was progression‐free survival (PFS) per mRECIST.

Results

Thirty patients were enrolled. The primary endpoint was met with a median PFS of 8.0 (95% confidence interval [CI]: 6.1–9.8) months per mRECIST, which was the same as that per RECIST 1.1. The objective response rate was 60.0% per mRECIST and 30.0% per RECIST 1.1. The disease control rate was 86.7% per mRECIST/RECIST 1.1. The median duration of response was 7.4 (95% CI: 6.6–8.2) months per mRECIST (n = 18) and 4.3 (95% CI: 4.0–4.6) months per RECIST 1.1 (n = 9). The median overall survival was 18.4 (95% CI: 14.5–22.3) months. Treatment‐related adverse events (TRAEs) occurred in 28 patients (93.3%) and grade 3 TRAEs were observed in 12 patients (40.0%). There were no grade 4/5 TRAEs.

Conclusions

Len‐Sin‐TACE showed promising antitumour activities with a manageable safety profile in patients with advanced stage HCC. The preliminary results need to be further evaluated with phase III randomized trials.
Impact of ACSL4 on the prognosis of hepatocellular carcinoma: Association with cancer‐associated fibroblasts and the tumour immune microenvironment
Authors: Toshida Katsuya , Itoh Shinji , Iseda Norifumi , Tomiyama Takahiro , Yoshiya Shohei , Toshima Takeo , Liu Yu‐Chen , Iwasaki Takeshi , Okuzaki Daisuke , Taniguchi Koji , Oda Yoshinao , Mori Masaki , Yoshizumi Tomoharu
Published: January 2024

Background & Aims

Recently, the association between hepatocellular carcinoma (HCC) and ferroptosis has been the focus of much attention. The expression of long chain fatty acyl‐CoA ligase 4 (ACSL4), a marker of ferroptosis, in tumour tissue is related to better prognosis in various cancers. In HCC, ACSL4 expression indicates poor prognosis and is related to high malignancy. However, the mechanism remains to be fully understood.

Methods

We retrospectively enrolled 358 patients with HCC who had undergone hepatic resection. Immunohistochemistry (IHC) for ACSL4 was performed. Factors associated with ASCL4 expression were investigated by spatial transcriptome analysis, and the relationships were investigated by IHC. The association between ACSL4 and the tumour immune microenvironment was examined in a public dataset and investigated by IHC.

Results

Patients were divided into ACSL4‐positive (n = 72, 20.1%) and ACSL4‐negative (n = 286, 79.9%) groups. ACSL4 positivity was significantly correlated with higher α‐fetoprotein (p = .0180) and more histological liver fibrosis (p = .0014). In multivariate analysis, ACSL4 positivity was an independent prognostic factor (p < .0001). Spatial transcriptome analysis showed a positive correlation between ACSL4 and cancer‐associated fibroblasts; this relationship was confirmed by IHC. Evaluation of a public dataset showed the correlation between ACSL4 and exhausted tumour immune microenvironment; this relationship was also confirmed by IHC.

Conclusion

ACSL4 is a prognostic factor in HCC patients and its expression was associated with cancer‐associated fibroblasts and anti‐tumour immunity.
Evidence for the elimination of viral hepatitis B and C in Egypt: Results of a nationwide survey in 2022
Authors: Kandeel Amr , Fahim Manal , Abukamar Shimaa , BahaaEldin Hala , Abuelsood Hanaa , Samy Sahar , Deghedy Ola , Sheta Amany , Naguib Amel , El Guindy Nancy , Youssef Amr , Kamel Reham , Afifi Salma , El‐Kassas Moahmed , Abdelghaffar Khaled
Published: January 2024

Introduction

Viral hepatitis C (HCV) and B (HBV) were at the top of Egypt's most significant public health challenges, with an estimated 14.7% of its population having antibodies to HCV in 2008. Egypt issued an ambitious action plan in 2014 to eliminate viral hepatitis through strengthening infection control and improving patient care. In 2018, an extensive HCV mass screening campaign was conducted for the entire country's population with treating more than 4 million patients with antivirals. This study aimed to evaluate the current prevalence of viral hepatitis in Egypt after all these efforts.

Methods

A cross‐sectional household cluster survey was conducted in all 27 Egyptian governorates to obtain a representative sample of Egypt's population. Subjects aged 1–70 years were interviewed using a standardised questionnaire that included demographics, viral hepatitis knowledge, previous infection and risk factors data. Laboratory testing was performed for all subjects for anti‐HCV and HBsAg using chemiluminescence. Subjects positive for anti‐HCV were further tested for HCV‐RNA by RT‐PCR. Prevalence rates were calculated by demographic groups and compared to the demographic health survey 2015 results.

Results

Of 20 881 subjects interviewed, 48.8% were males, 20.2% were children <15 years of age, and 53.7% were residents of rural areas. Of all subjects, 92 (0.4%) were HCV‐infected, 1577 (7.6%) were anti‐HCV positive and 177 (0.8%) were HBV‐chronically infected, including one patient who had mixed HBV and HCV current infection. The prevalence of HCV‐current and HBV chronic infections decreased by 93% and 20%, respectively, compared to 2015.

Conclusions

Egypt achieved the elimination of the viral hepatitis goal. To maintain low rates of viral hepatitis, community health education, in addition to maintaining infection control and blood safety programs, is essential.
Correlates of early child development among children with stunting: A cross‐sectional study in Uganda
Authors: Mbabazi Joseph , Pesu Hannah , Mutumba Rolland , Bromley Kieran , Ritz Christian , Filteau Suzanne , Briend André , Mupere Ezekiel , Grenov Benedikte , Friis Henrik , Olsen Mette F.
Published: January 2024

Many children in low‐ and middle‐income countries are not attaining their developmental potential. Stunting is associated with poor child development, but it is not known which correlates of stunting are impairing child development. We explored potential socioeconomic, nutritional, clinical, and household correlates of early child development among 12–59‐month‐old children with stunting in a cross‐sectional study in Uganda. Development was assessed using the Malawi Development Assessment Tool (MDAT) across four domains of gross and fine motor, language, and social skills. Linear regression analysis was used to assess correlates of development in the four domains and total MDAT score. Of 750 children included, the median [interquartile range] age was 30 [23−41] months, 55% of the children resided in rural settings with 21% from female‐headed households and 47% of mothers had no schooling. The mean ± standard deviation height‐for‐age z‐score (HAZ) was −3.02 ± 0.74, 40% of the children had a positive malaria test and 65% were anaemic (haemoglobin < 110 g/L). One‐third had children's books at home, majority (96%) used household objects to play with and most of them (70%) used toys as pretence items like those to mimic cooking. After age, sex, and site adjustments, HAZ (0.24, 95% confidence interval [CI]: 0.14−0.33) and head circumference (0.07, 95% CI: 0.02−0.12) were positive correlates of total MDAT score, whereas weight‐for‐height z‐score (WHZ) was not. Current breastfeeding was associated with 0.41 (95% CI: 0.17−0.65) lower total MDAT score. Children from households with a single income earner had 0.22 (95% CI: 0.06−0.37) lower total MDAT score. Furthermore, severe food insecurity, inflammation and positive malaria test were associated with lower scores for motor development. All family care indicator subscales (FCIs) positively correlated with the total MDAT score and this association was independent of household's socioeconomic status. In conclusion, stunting degree, head circumference, number of household income earners and stimulation by improved FCIs correlate with early child development among stunted children. The negative association with prolonged breastfeeding is likely due to reverse causality. Identified correlates may inform initiatives to support children with stunting attain their development potential.
Offspring sex ratio increases with paternal reproductive success in a colony of southern elephant seals
Authors: Allegue Hassen , Guinet Christophe , Patrick Samantha C. , Ribout Cécile , Bichet Coraline , Lepais Olivier , Réale Denis
Published: January 2024

In polygynous species, male reproductive success is often determined by their ability to dominate female harems. Harem‐holders sire a disproportionate number of offspring. Male dominance tends to correlate with age, but intense competition and early male mortality limit most males from achieving high social status. To maximize reproductive success despite low rank, offspring sex ratio adjustment may have evolved, favoring the sex with higher fitness. If traits influencing dominance are heritable and confer reproductive advantages, we expect fathers with higher reproductive success to produce more sons, as they are more likely to become dominant. In contrast, subordinate males with lower success may benefit from siring more daughters. We tested this hypothesis on a colony of southern elephant seals breeding on the Kerguelen Archipelago. We used genetic markers to link the paternity of 540 pups to 58 breeding males. We found that the probability of siring a son increases from 43% to 54% with paternal relative reproductive success, supporting the offspring sex ratio adjustment hypothesis. Given that various factors influence sex ratio in a population, future studies should tease apart these ecological processes (e.g., paternal dominance, maternal condition, local density, or adult sex ratio) and investigate how they interact with each other.
Corticobasal degeneration with visual hallucination as an initial symptom: A case report
Authors: Yoshida Kentaro , Adachi Tadashi , Suzuki Yuki , Sakuwa Mayuko , Fukuda Hiroki , Hasegawa Masato , Adachi Yoshiki , Miura Hiroshi , Hanajima Ritsuko
Published: January 2024

Although the initial symptoms of corticobasal degeneration (CBD) are varied, psychiatric symptoms are uncommon. Here, we report the autopsy findings of a patient with early CBD who presented with hallucinations. A 68‐year‐old man developed memory loss and visions of bears and insects. Because of slow vertical eye movement, postural instability, and levodopa‐unresponsive parkinsonism, the patient initially was clinically diagnosed with progressive supranuclear palsy. He died of a urinary tract infection 11 months after the onset of the disease. Histopathological examination revealed neuronal loss and gliosis, which were severe in the substantia nigra and moderate in the globus pallidus and subthalamic nucleus. Astrocytic plaques were scattered throughout the amygdala and premotor cortex. The superficial cortical layers lacked ballooned neurons and spongiosis, and tau deposition was greater in glia than in neurons. The amygdala contained a moderate number of argyrophilic grains and pretangles. Western blot analysis showed a 37‐kDa band among the low‐molecular‐weight tau fragments. Because the CBD pathology was mild, we attributed the patient's visual hallucinations to the marked argyrophilic grain pathology. CBD can occur with psychiatric symptoms, including visual hallucinations, and argyrophilic grain pathology may be associated with psychiatric symptoms.
Tracking arbuscular mycorrhizal fungi to their source: active inoculation and passive dispersal differentially affect community assembly in urban soils
Authors: Metzler Paul , Ksiazek‐Mikenas Kelly , Chaudhary V. Bala
Published: January 2024

Communities of arbuscular mycorrhizal (AM) fungi assemble passively over time via biotic and abiotic mechanisms. In degraded soils, AM fungal communities can assemble actively when humans manage mycorrhizas for ecosystem restoration.

We investigated mechanisms of urban AM fungal community assembly in a 2‐yr green roof experiment. We compared AM fungal communities in inoculated and uninoculated trays to samples from two potential sources: the inoculum and air.

Active inoculation stimulated more distinct and diverse AM fungal communities, an effect that intensified over time. In the treatment trays, 45% of AM fungal taxa were detected in the inoculum, 2% were detected in aerial samples, 23% were detected in both inoculum and air, and 30% were not detected in either source.

Passive dispersal of AM fungi likely resulted in the successful establishment of a small number of species, but active inoculation with native AM fungal species resulted in an immediate shift to a diverse and unique fungal community. When urban soils are constructed or modified by human activity, this is an opportunity for intervention with AM fungi that will persist and add diversity to that system.
Adipokines and stroke: A systematic review and meta‐analysis of disease risk and patient outcomes
Authors: Agbaedeng Thomas A. , Iroga Peter E. , Rathnasekara Vishmi Mayasha , Zacharia Anastasia L.
Published: January 2024

Obesity is reported to increase stroke risk, with adipocyte‐derived cytokines or adipokines implicated as mediators. However, the relationship between adipokines and stroke is not well clarified. Thus, we aimed to evaluate the association of adipokines with stroke using fully adjusted risk estimates that incorporated body mass index in a meta‐analysis. Data from 52 studies (62,428 patients) were pooled in a random‐effects meta‐analysis. Adiponectin was independently associated with a lower risk of pre‐existing stroke (adjusted odds ratio: 0.64 [95% confidence interval: 0.46–0.88], p < 0.01), whereas leptin (1.08 [1.00–1.17], p = 0.04), resistin (1.06 [1.04–1.08], p < 0.01) and visfatin (1.04 [1.01–1.07], p = 0.01) are associated with a higher risk of stroke, but none with incident stroke. Adipokines independently associated with an ischaemic stroke subtype were adiponectin (0.48 [0.30–0.77], p < 0.01), leptin (1.10 [1.01–1.20], p = 0.04), and resistin (1.06 [1.04–1.08], p < 0.01). Fatty acid‐binding protein‐4 (FABP‐4) independently predicted 6‐month poor functional outcomes in stroke patients (adjusted hazard ratio: 1.09 [1.06–1.12], p < 0.01); whereas both FABP‐4 (1.17 [1.03–1.34], p = 0.01) and visfatin (1.24 [1.00–1.55], p = 0.05) were predictive of 6‐month mortality. Adipokines are associated with a greater risk of pre‐existing stroke, but not with the relationship with incident stroke. Adipokines, such as FABP‐4 and visfatin, may serve as biomarkers of stroke severity and worsening of stroke outcomes.
Intracardiac echocardiography guided electrified J‐wire trans‐septal puncture: A prospective randomized controlled trial
Authors: Cheng Hui , Bangash Abdul Basit , Tao Yuhang , Jiang Ruhong , Liu Qiang , Cheng Cheng , Fu Guosheng , Jiang Chenyang
Published: January 2024

Background

Application of electrocautery to a J‐wire is used to perform transseptal puncture (TSP), but with limited evidence supporting safety and efficacy. We conducted a prospective randomized controlled trial to evaluate the safety and efficacy of this technique.

Methods

Two hundred consecutive patients were randomized in a 1:1 fashion to either the ICE‐guided electrified J‐wire TSP group or a conventional Brockenbrough (BRK) needle TSP group. The TSP was performed with a 0.032″ guidewire under 20 W, “coag” mode and was compared to TSP using the BRK needle. The primary safety endpoints were complications related to TSP. The primary efficacy endpoints included the TSP success rate, the total TSP time, and the total procedure time.

Results

All patients complete the procedure safely. The electrified J‐wire TSP group had a significantly shorter TSP time than BRK needle TSP group. The total procedure time, number of TSP attempts required to achieve successful LA access, width of the intra‐atrial shunt at the end of ablation were similar between the two groups. The incidence of new cerebral infarction detected by MRI were similar between the two groups (3/32 patients in the J‐wire TSP group and 2/26 patients in conventional BRK TSP group, p = .82). And no difference in the incidence of residual intra‐atrial shunt (4.3% vs. 6%, p = .654) during the 3‐month's follow up.

Conclusion

Using an electrified J‐wire for TSP under the guidance of ICE appears to be as safe as and more efficient than conventional BRK needle TSP, which may be especially useful in the era of non‐fluoroscopy AF ablation.
A child with Winchester syndrome responding to oral betamethasone and methotrexate
Authors: Dash Gaurav , Pradhan Swetalina , Sinha Upasna , Sinha Ruchi
Published: January 2024

Winchester syndrome (WS) is a rare genetic disorder with a handful of cases reported to date. We report a 14‐year‐old male who presented with growth retardation, contracture of left lower limb due to thick indurated skin, hypertrichosis, and bilateral corneal opacity. There was complete improvement in joint contracture with oral betamethasone pulse and weekly oral methotrexate.
How are mental state references represented in English and Japanese picture books? An analysis of the frequency of emotional and cognitive words and their relation to the self or others
Authors: Okumura Yuko , Taguchi Shunya , Kanakogi Yasuhiro
Published: January 2024

The text of picture books is a fertile source through which young children learn about mental states. By focusing on English and Japanese books (N = 100; for children aged 3–5 years) as respective representatives of independent and interdependent cultures, the present study examined the cultural differences in the use of two types of mental state language: emotion and cognition. While our findings revealed no cultural differences in emotional word tokens or types, cognitive word tokens and types were higher in English picture books than in Japanese ones. Importantly, English picture books exhibited more self‐oriented mental state references, while Japanese picture books had more other‐oriented mental state references. Our study suggests that mental state references in picture books reflect culture‐specific characteristics.
Hordeum vulgare CYP76M57 catalyzes C2 shortening of tryptophan side chain by C–N bond rearrangement in gramine biosynthesis
Authors: Ishikawa Erika , Kanai Shion , Shinozawa Akihisa , Hyakutake Mami , Sue Masayuki
Published: January 2024

The indole alkaloid gramine, 3‐(dimethylaminomethyl)indole, is a defensive specialized metabolite found in some barley cultivars. In its biosynthetic process, the tryptophan (Trp) side chain is shortened by two carbon atoms to produce 3‐(aminomethyl)indole (AMI), which is then methylated by N‐methyltransferase (HvNMT) to produce gramine. Although side chain shortening is one of the crucial scaffold formation steps of alkaloids originating from aromatic amino acids, the gene and enzyme involved in the Trp–AMI conversion reactions are unknown. In this study, through RNA‐seq analysis, 35 transcripts were shown to correlate with gramine production; among them, an uncharacterized cytochrome P450 (CYP) gene, CYP76M57, and HvNMT were identified as candidate genes for gramine production. Transgenic Arabidopsis thaliana and rice overexpressing CYP and HvNMT accumulate AMI, N‐methyl‐AMI, and gramine. CYP76M57, heterologously expressed in Pichia pastoris, was able to act on Trp to produce AMI. Furthermore, the amino group nitrogen of Trp was retained during the CYP76M57‐catalyzed reaction, indicating that the C2 shortening of Trp proceeds with an unprecedented biosynthetic process, the removal of the carboxyl group and Cα and the rearrangement of the nitrogen atom to Cβ. In some gramine‐non‐accumulating barley cultivars, arginine 104 in CYP76M57 is replaced by threonine, which abolished the catalytic activity of CYP76M57 to convert Trp into AMI. These results uncovered the missing committed enzyme of gramine biosynthesis in barley and contribute to the elucidation of the potential functions of CYPs in plants and undiscovered specialized pathways.
Universally defining Z$\mathbb {Z}$ in Q$\mathbb {Q}$ with 10 quantifiers
Authors: Daans Nicolas
Published: January 2024

We show that for a global field , every ring of ‐integers has a universal first‐order definition in with 10 quantifiers. We also give a proof that every finite intersection of valuation rings of has an existential first‐order definition in with 3 quantifiers.