bluuebunny/crossref_metadata_2025 huggingface dataset:
Oral and rectal colonization of methicillin‐resistant Staphylococcus aureus in long‐term care facility residents and their association with clinical status
Authors: Kusaka Satoru , Haruta Azusa , Kawada‐Matsuo Miki , Nguyen‐Tra Le Mi , Yoshikawa Mineka , Kajihara Toshiki , Yahara Koji , Hisatsune Junzo , Nomura Ryota , Tsuga Kazuhiro , Ohge Hiroki , Sugai Motoyuki , Komatsuzawa Hitoshi
Published: January 2024

Staphylococcus aureus is a commensal bacterium in humans, but it sometimes causes opportunistic infectious diseases such as suppurative skin disease, pneumonia, and enteritis. Therefore, it is important to determine the prevalence of S. aureus and methicillin‐resistant S. aureus (MRSA) in individuals, especially older adults. In this study, we investigated the prevalence of S. aureus and MRSA in the oral cavity and feces of residents in long‐term care facilities (LTCFs). S. aureus was isolated from the oral cavity of 61/178 (34.3%) participants, including 28 MRSA‐positive participants (15.7%), and from the feces of 35/127 (27.6%) participants, including 16 MRSA‐positive participants (12.6%). S. aureus and MRSA were isolated from both sites in 19/127 individuals (15.0%) and 10/127 individuals (7.9%), respectively. Among 19 participants with S. aureus isolation from both sites, 17 participants showed the same sequence type (ST) type. Then, we analyzed the correlation of S. aureus and MRSA in the oral cavity and rectum with the participant's condition. S. aureus and MRSA positivity in the oral cavity was significantly related to tube feeding, while there was no correlation of rectal S. aureus/MRSA with any factors. Our findings regarding the oral inhabitation of MRSA and its risk factors indicate the importance of considering countermeasures against MRSA infection in LTCFs.
Racial and ethnic disparities in emergency department transfers to public hospitals
Authors: Hsuan Charleen , Vanness David J. , Zebrowski Alexis , Carr Brendan G. , Norton Edward C. , Buckler David G. , Wang Yinan , Leslie Douglas L. , Dunham Eleanor F. , Rogowski Jeannette A.
Published: January 2024

Objective

To examine racial/ethnic differences in emergency department (ED) transfers to public hospitals and factors explaining these differences.

Data Sources and Study Setting

ED and inpatient data from the Healthcare Cost and Utilization Project for Florida (2010–2019); American Hospital Association Annual Survey (2009–2018).

Study Design

Logistic regression examined race/ethnicity and payer on the likelihood of transfer to a public hospital among transferred ED patients. The base model was controlled for patient and hospital characteristics and year fixed effects. Models II and III added urbanicity and hospital referral region (HRR), respectively. Model IV used hospital fixed effects, which compares patients within the same hospital. Models V and VI stratified Model IV by payer and condition, respectively. Conditions were classified as emergency care sensitive conditions (ECSCs), where transfer is protocolized, and non‐ECSCs. We reported marginal effects at the means.

Data Collection/Extraction Methods

We examined 1,265,588 adult ED patients transferred from 187 hospitals.

Principal Findings

Black patients were more likely to be transferred to public hospitals compared with White patients in all models except ECSC patients within the same initial hospital (except trauma). Black patients were 0.5–1.3 percentage points (pp) more likely to be transferred to public hospitals than White patients in the same hospital with the same payer. In the base model, Hispanic patients were more likely to be transferred to public hospitals compared with White patients, but this difference reversed after controlling for HRR. Hispanic patients were − 0.6 pp to −1.2 pp less likely to be transferred to public hospitals than White patients in the same hospital with the same payer.

Conclusions

Large population‐level differences in whether ED patients of different races/ethnicities were transferred to public hospitals were largely explained by hospital market and the initial hospital, suggesting that they may play a larger role in explaining differences in transfer to public hospitals, compared with other external factors.
Novel electrochemical strategies for the microbial conversion of CO2 into biomass and volatile fatty acids using a fluid‐like bed electrode in a three‐phase reactor
Authors: Llorente María , Tejedor‐Sanz Sara , Berná Antonio , Manchón Carlos , Esteve‐Núñez Abraham
Published: January 2024

Microbial electrosynthesis (MES) constitutes a bioelectrochemical process where bacteria uptake electrons extracellularly from a polarized electrode to incorporate them into their anabolic metabolism. However, the efficiency of current MES reactor designs can be lower than expected due to limitations regarding electron transfer and mass transport. One of the most promising bioreactor configurations to overcome these bottlenecks is the Microbial Electrochemical Fluidized Bed Reactor (ME‐FBR). In this study, microbial CO2 fixation is investigated for the first time in a ME‐FBR operated as a 3‐phase reactor (solid–liquid–gas). An electroconductive carbon bed, acting as a working electrode, was fluidized with gas and polarized at different potentials (−0.6, −0.8 and −1 V vs. Ag/AgCl) so it could act as an electron donor (biocathode). Under these potentials, CO2 fixation and electron transfer were evaluated. Autotrophic electroactive microorganisms from anaerobic wastewater were enriched in a ME‐FBR in the presence of 2‐bromoethanosulfonic acid (BES) to inhibit the growth of methanogens. Cyclic voltammetry analysis revealed interaction between the microorganisms and the cathode. Furthermore, volatile fatty acids like propionate, formate and acetate were detected in the culture supernatant. Acetate production had a maximum rate of ca. 1 g L−1 day−1. Planktonic cell biomass was produced under continuous culture at values as high as ca. 0.7 g L−1 dry weight. Overall, this study demonstrates the feasibility of employing a fluidized electrode with gaseous substrates and electricity as the energy source for generating biomass and carboxylic acids.
Safety of e‐cigarettes and nicotine patches as stop‐smoking aids in pregnancy: Secondary analysis of the Pregnancy Trial of E‐cigarettes and Patches (PREP) randomized controlled trial
Authors: Pesola Francesca , Smith Katie Myers , Phillips‐Waller Anna , Przulj Dunja , Griffiths Christopher , Walton Robert , McRobbie Hayden , Coleman Tim , Lewis Sarah , Whitemore Rachel , Clark Miranda , Ussher Michael , Sinclair Lesley , Seager Emily , Cooper Sue , Bauld Linda , Naughton Felix , Sasieni Peter , Manyonda Isaac , Hajek Peter
Published: January 2024

Aims

The aim of this study was to examine the safety of e‐cigarettes (EC) and nicotine patches (NRT) when used to help pregnant smokers quit.

Design

A recent trial of EC versus NRT reported safety outcomes in the randomized arms. We conducted a further analysis based on product use.

Setting

Twenty‐three hospitals in England and a stop‐smoking service in Scotland took part.

Participants

The participants comprised 1140 pregnant smokers.

Interventions

We compared women using and not using EC and NRT regularly during pregnancy.

Measurements

Measurements included nicotine intake compared with baseline, birth weight, other pregnancy outcomes, adverse events, maternal respiratory symptoms and relapse in early abstainers.

Findings

Use of EC was more common than use of NRT (47.3% vs 21.6%, P < 0.001). Women who stopped smoking (abstainers) and used EC at the end‐of‐pregnancy (EOP) reduced their salivary cotinine by 45% [49.3 ng/ml, 95% confidence interval (CI) = −79.8 to −10]. Only one abstainer used NRT at EOP. In dual users, cotinine increased by 19% (24 ng/ml, 95% CI = 3.5–68). In women reporting a reduction of at least 50% in cigarette consumption, cotinine levels increased by 10% in those using nicotine products and by 9% in those who did not. Birth weights in dual users and exclusive smokers were the same (3.1 kg). Birth weight in abstainers using either nicotine product was higher than in smokers [3.3 kg, standard deviation (SD) = 0.7] versus 3.1 kg, SD = 0.6; difference = 0.15 kg, 95% CI = 0.05–0.25) and not different from abstainers not using nicotine products (3.1 kg, SD = 0.8). Abstainers and smokers using nicotine products had no worse pregnancy outcomes or more adverse events than abstainers and smokers not using them. EC users reported more improvements than non‐users in cough [adjusted relative risk (aRR) = 0.59, 95% CI = 0.37–0.93] and phlegm (aRR = 0.53, 95% CI = 0.31–0.92), controlling for smoking status. EC or NRT use had no association with relapse.

Conclusions

Regular use of e‐cigarettes or nicotine patches by pregnant smokers does not appear to be associated with any adverse outcomes.
Leptin promotes proliferation of human undifferentiated spermatogonia by activating the PI3K/AKT/mTOR pathway
Authors: Xin Song , Xiaoxuan Li , Yixuan Zhang , Zhikang Cai
Published: January 2024

Background

Male infertility is a common disease affecting male reproductive health. Leptin is an important hormone that regulates various physiological processes, including reproductive function. However, few experimental studies have been carried out to elucidate the mechanism of leptin's effects on male reproductive function.

Objective

The purpose of this study was to investigate the effects of leptin on testicular spermatogenesis and its mechanism, so as to provide potential targets for the treatment of patients with spermatogenic dysfunction.

Methods

Testicular tissues were collected from eight prostate cancer patients undergoing surgical castration. GPR125‐positive spermatogonia were isolated by two consecutive magnetic activated cell sorting (MACS), followed by incubation with conditioned medium. To identify the signaling pathway(s) involved in the effects of leptin, undifferentiated spermatogonia were treated with different concentrations of leptin and antagonists of leptin‐related pathways. The proliferative effect of leptin was evaluated by cell counting using a hemocytometer. Expressions of p‐AKT, p‐ERK, p‐STAT, and p‐S6K were determined by western blotting analysis.

Results

Leptin promoted the growth of human GPR125‐positive spermatogonia in a concentration‐dependent manner. The most significant proliferative effect was observed using 100 ng/mL leptin after 6 days of culture. Leptin significantly increased the phosphorylation of STAT3, AKT, and ERK in undifferentiated spermatogonia. Phosphatidylinositol 3‐kinase (PI3K) inhibitor LY294002 inhibited the leptin‐induced activation of AKT, ERK, and downstream S6K. Treatment with the mammalian target of rapamycin (mTOR) inhibitor rapamycin also inhibited S6K phosphorylation. Moreover, both LY294002 and rapamycin were found to inhibit the leptin‐induced proliferation of undifferentiated spermatogonia. These results suggested that the leptin‐induced proliferation of GPR125‐positive spermatogonia was dependent on the PI3K/AKT/mTOR pathway. Further exploration of proliferation and apoptotic markers suggested that leptin may alleviate cell apoptosis by regulating the expression of Bax and FasL.

Conclusions

A certain concentration of leptin (25∼100 ng/mL) could promote proliferation of undifferentiated spermatogonia, which was mediated by PI3K/AKT/mTOR pathway.
Novel variations in TENT5D lead to teratozoospermia in infertile patients
Authors: Zhang Ying‐Teng , Shen Gan , Zhuo Liang‐Chai , Yang Xue , Wang Su‐Yan , Ruan Tie‐Chao , Jiang Chuan , Wang Xiang , Wang Yan , Yang Yi‐Hong , Shen Ying
Published: January 2024

Purpose

Teratozoospermia is the main pathogenic factor of male infertility. However, the genetic etiology of teratozoospermia is largely unknown. This study aims to clarify the relationship between novel variations in TENT5D and teratozoospermia in infertile patients.

Materials and methods

Two infertile patients were enrolled. Routine semen analysis of patients and normal controls was conducted with the WHO guidelines. Whole‐exome sequencing (WES) was conducted to identify pathogenic variants in the two patients. Morphology and ultrastructure analysis of spermatozoa in the two patients was determined by Papanicolaou staining, scanning electron microscopy (SEM), and transmission electron microscopy (TEM). The functional effect of the identified variants was analyzed by immunofluorescence staining and western blotting. The expression of TENT5D in different germ cells was detected by immunofluorescence staining.

Results

Two new hemizygous variations, c.101C > T (p.P34L) and c.125A > T (p.D42V), in TENT5D were detected in two patients with male infertility. Morphology analysis showed abnormalities in spermatozoa morphology in the two patients, including multiple heads, headless, multiple tails, coiled, and/or bent flagella. Ultrastructure analysis showed that most of the spermatozoa exhibited missing or irregularly arranged ‘9+2’ structures. Further functional experiments confirmed the abrogated TENT5D protein expression in patients. In addition, both p.P34L and p.D42V substitutions resulted in a conformational change of the TENT5D protein. We precisely analyzed the subcellular localization of TENT5D in germ cells in humans and mice. And we found that TENT5D was predominantly detected in the head and flagellum of elongating spermatids and epididymal spermatozoa.

Conclusions

Our results showed further evidence of a relationship between TENT5D mutation and human male infertility, providing new genetic insight for use in the diagnosis and treatment of male infertility.
Parents' experiences of palliative care decision‐making in neonatal intensive care units: An interpretative phenomenological analysis
Authors: Saint Denny Kelly , Lamore Kristopher , Nandrino Jean‐Louis , Rethore Sabine , Prieur Charlotte , Mur Sebastien , Storme Laurent
Published: January 2024

Aim

This work explores the experiences and meaning attributed by parents who underwent the decision‐making process of withholding and/or withdrawing life‐sustaining treatment for their newborn.

Methods

Audio‐recorded face‐to‐face interviews were led and analysed using interpretative phenomenological analysis. Eight families (seven mothers and five fathers) whose baby underwent withholding and/or withdrawing of life‐sustaining treatment in three neonatal intensive care units from two regions in France were included.

Results

The findings reveal two paradoxes within the meaning‐making process of parents: role ambivalence and choice ambiguity. We contend that these paradoxes, along with the need to mitigate uncertainty, form protective psychological mechanisms that enable parents to cope with the decision, maintain their parental identity and prevent decisional regret.

Conclusion

Role ambivalence and choice ambiguity should be considered when shared decision‐making in the neonatal intensive care unit. Recognising and addressing these paradoxical beliefs is essential for informing parent support practices and professional recommendations, as well as add to ethical discussions pertaining to parental autonomy and physicians' rapport to uncertainty.
Muscular stress is equal when resistance exercise with blood flow restriction is matched in total work volume: A cross‐sectional, cross‐over study
Authors: Okita Koichi , Omokawa Masashi , Takada Shingo , Kadoguchi Tomoyasu , Morita Noriteru , Yokota Takashi
Published: January 2024

Aim

We compared muscular metabolic stress during exercise performed at multiple intensities, from very low to moderate, with blood flow restriction (BFR) adjusted by the same work volume.

Methods

Twenty‐five healthy young adults performed unilateral plantar flexion at 1 repetition/2 s in a magnetic resonance system. The BFR exercise protocols were as follows: (A) exercise with 10% of one repetition maximum (1‐RM) for 360 s, (B) 15% 1‐RM for 240 s, (C) 20% 1‐RM for 180 s, (D) 30% 1‐RM for 120 s, and (E) 40% 1‐RM for 90 s. All protocols had the same total work volume (load × repetitions = 1800). A high‐intensity protocol at 65% 1‐RM without BFR (60 s) was also performed for comparison. We used 31P‐magnetic resonance spectroscopy to evaluate the muscular metabolic stress in the subjects' calf muscle, defined as decreases in phosphocreatine and intramuscular pH.

Results

The phosphocreatine depletion (A: 15.6 ± 0.7, B: 14.8 ± 0.8, C: 15.2 ± 0.6, D: 14.3 ± 0.6, E: 10.9 ± 0.5 mM; no significant difference [ns]) and the intramuscular pH decrease (A: 6.82 ± 0.02, B: 6.84 ± 0.01, C: 6.83 ± 0.02, D: 6.83 ± 0.02, E: 6.77 ± 0.02; ns) at the end of each exercise were similar and greater than those produced by the 65% 1‐RM without BFR.

Conclusion

If the total work volumes are equal, the metabolic stress in exercising muscle may reach similar levels at the end of exercise with BFR and could provide similar successful training effects.
Preload dependence in an animal model of mild heart failure with preserved ejection fraction (HFpEF)
Authors: Jacobsen Jens C. B. , Schubert Irene H. , Larsen Karin , Terzic Dijana , Thisted Louise , Thomsen Morten B.
Published: January 2024

Aim

Heart Failure with preserved Ejection Fraction (HFpEF) is characterized by diastolic dysfunction and reduced cardiac output, but its pathophysiology remains poorly understood. Animal models of HFpEF are challenging due to difficulties in assessing the degree of heart failure in small animals. This study aimed at inducing HFpEF in a mouse model to probe preload‐dependency.

Methods

Increased body mass and arterial hypertension were induced in mice using a Western diet and NO synthase inhibition. Preload dependence was tested ex vivo.

Results

Mice with obesity and hypertension exhibited reduced cardiac output, indicating a failing heart. Increased left ventricular filling pressure during diastole suggested reduced compliance. Notably, the ejection fraction was preserved, suggesting the development of HFpEF. Spontaneous physical activity at night was reduced in HFpEF mice, indicating exercise intolerance; however, the cardiac connective tissue content was comparable between HFpEF and control mice. The HFpEF mice showed increased vulnerability to reduced preload ex vivo, indicating that elevated left ventricular filling pressure compensated for the rigid left ventricle, preventing a critical decrease in cardiac output.

Conclusion

This animal model successfully developed mild HFpEF with a reduced pump function that was dependent on a high preload. A model of mild HFpEF may serve as a valuable tool for studying disease progression and interventions aimed at delaying or reversing symptom advancement, considering the slow development of HFpEF in patients.
Equity ownership and identification with the founding team
Authors: Weissenböck Eva , Breugst Nicola , Patzelt Holger , Dibbern Rieke
Published: January 2024

Founders benefit from identifying with their founding teams because identification facilitates cooperation in the team, aligns founders' actions with the norms and interests of the team, and, ultimately, enhances team performance. High identification with the team is likely to be shaped by structural characteristics of the founding team and, more specifically, founders' equity stakes—that is, founders' legal ownership of the venture. In the present study, we explore the consequences of equity ownership on a founder's subsequent identification with the team. We build on psychological ownership theory to theorize that, on the one hand, equity can trigger feelings of responsibility and care for the venture, but, on the other, it can also drive possessiveness and territoriality. These two opposing sides of psychological ownership suggest a curvilinear relationship between equity ownership and a founder's subsequent identification with the team. As equity is a team reward, we suggest that founders' perceptions of team performance accentuate the relationship. Longitudinal data including 156 data points from 82 founders support our theorizing. We discuss implications for the literatures on team identification, equity ownership, and psychological ownership.
What is cancer? A focus on Grade Group 1 prostate cancer
Authors: Talwar Ruchika , Akinsola Olutiwa , Penson David F.
Published: January 2024

Since the widespread adoption of prostate‐specific antigen‐based screening for prostate cancer, the prevalence of Grade Group 1 (GG1) prostate cancer has risen. Historically, these patients were subjected to overtreatment of this otherwise indolent disease process, leading to significant quality‐of‐life detriments. Active surveillance as a primary management strategy has allowed for a focus on early detection while minimising morbidity from unnecessary intervention. Here we provide a comprehensive overview of the characteristics of GG1 prostatic adenocarcinoma, including its histological features, genomic differentiators, clinical progression, and implications for treatment guidelines, all supporting the movement to reclassify GG1 disease as a non‐cancerous entity.
Engineering a pH‐responsive polymeric micelle co‐loaded with paclitaxel and triptolide for breast cancer therapy
Authors: Zhang Mengmeng , Ying Na , Chen Jie , Wu Liwen , Liu Huajie , Luo Shihua , Zeng Dongdong
Published: January 2024

Breast cancer has overtaken lung cancer as the number one cancer worldwide. Paclitaxel (PTX) is a widely used first‐line anti‐cancer drug, but it is not very effective in clinical breast cancer therapy. It has been reported that triptolide (TPL) can enhance the anticancer effect of paclitaxel, and better synergistic therapeutic effects are seen with concomitant administration of PTX and TPL. In this study, we developed pH‐responsive polymeric micelles for co‐delivery of PTX and TPL, which disassembling in acidic tumour microenvironments to target drug release and effectively kill breast cancer cells. Firstly, we synthesized amphiphilic copolymer mPEG2000‐PBAE through Michael addition reaction, confirmed by various characterizations. Polymer micelles loaded with TPL and PTX (TPL/PTX‐PMs) were prepared by the thin film dispersion method. The average particle size of TPL/PTX‐PMs was 97.29 ± 1.63 nm, with PDI of 0.237 ± 0.003 and Zeta potential of 9.57 ± 0.80 mV, LC% was 6.19 ± 0.21%, EE% was 88.67 ± 3.06%. Carrier material biocompatibility and loaded micelle cytotoxicity were assessed using the CCK‐8 method, demonstrating excellent biocompatibility. Under the same drug concentration, TPL/PTX‐PMs were the most toxic to tumour cells and had the strongest proliferation inhibitory effect. Cellular uptake assays revealed that TPL/PTX‐PMs significantly increased intracellular drug concentration and enhanced antitumor activity. Overall, pH‐responsive micellar co‐delivery of TPL and PTX is a promising approach for breast cancer therapy.
Adenosquamous carcinoma of the vulva: Rare tumor with unusual clinical presentation
Authors: El Hanbuli Hala M. , Sarie Mostafa A. Abou , Ibrahium Gehan Azoz , Al‐Amaragy Amr , Elsonbaty Mostafa
Published: January 2024

A 52‐year‐old female presented with labial ulcer of 4‐month duration. Examination showed 1 cm × 1 cm single superficial ulcer in the right labium majus. Excision was done, and histopathologic examination revealed surface ulceration and dermal invasion by epithelial neoplasm formed of biphasic proliferation of squamoid and gland‐forming cells. Immunohistochemical staining with p63 showed nuclear staining of the squamoid nests and was negative in areas with glandular differentiation, while epithelial membrane antigen and carcinoembryonic antigen highlighted the glandular elements. The case was diagnosed as primary cutaneous adenosquamous carcinoma (ASC). ASC is an uncommon malignant cutaneous neoplasm that is more aggressive than conventional squamous cell carcinoma. There are a few reports of ASC that presented as an erythematous papule or plaque with a preference for the head, neck, or upper extremities. We report a novel case of vulval ASC presented as a superficial ulcer, which is considered a unique site, and its clinical presentation.
Real‐world use of glucagon‐like peptide‐1 receptor agonists in youth with type 2 diabetes is associated with short‐term improvements in HbA1c
Authors: Samuels Stephanie L. , Chajecki Anastasia , Hu Pamela , Kayser Michelle , Weyman Kate , Pan Bernard , Brown Elizabeth A. , Van Name Michelle , Wolf Risa M.
Published: January 2024

Aim

To assess the short‐term, real‐world use and effectiveness of glucagon‐like peptide‐1 receptor agonist (GLP‐1RA) medications in the management of type 2 diabetes (T2D) in a diverse cohort of youth.

Methods

This multicentre retrospective study analysed youth prescribed a GLP‐1RA for the management of T2D at two academic paediatric diabetes centres prior to June 2022. Change in HbA1c and insulin use from baseline to first (median 91 days) and second (median 190 days) follow‐up were evaluated for those taking a GLP‐1RA. Multivariable linear mixed effects models adjusting for baseline sex, age, race/ethnicity, insurance, insulin regimen, metformin regimen, GLP‐1RA dosing frequency and the body mass index Z‐score (BMI‐Z) examined the change in HbA1c for participants for up to 6 months after baseline.

Results

A total of 136 patients with T2D (median age 16.1 [interquartile range 13.9‐18.0] years, 54% female, 56% non‐Hispanic Black, 24% Hispanic, 77% with public insurance) were prescribed GLP‐1RAs and taking them at first or second follow‐up. Median HbA1c decreased from 7.9% to 7.6% (P < .001) at a median follow‐up of 91 days (n = 109) and, among those with HbA1c available at baseline and second follow‐up (n = 83), from 8.4% to 7.4%. The proportion of patients prescribed insulin decreased from baseline to the first follow‐up visit (basal 69% to 60% [P = .008], prandial 46% to 38% [P = .03]). In multivariable analysis, there was a mean decrease in HbA1c by 0.09 percentage points per month (P = .005, 95% confidence interval −0.15, −0.03).

Conclusions

Real‐world use of GLP‐1RAs in youth with T2D is associated with decreased HbA1c levels, despite challenges with access and adherence. GLP‐1RA treatment may reduce insulin doses for youth with T2D.
Effect of intermittently scanned continuous glucose monitoring in people with diabetes with a psychosocial indication for initiation
Authors: Ssemmondo Emmanuel , Deshmukh Harshal , Wilmot Emma G. , Adeleke Kazeem A. , Shah Najeeb , Walton Chris , Barnes Dennis , Ryder Robert E. J. , Sathyapalan Thozhukat
Published: January 2024

Aim

To understand the effect of intermittently scanned continuous glucose monitoring (isCGM) in people with diabetes with a ‘psychosocial’ indication for access.

Methods

The study utilized baseline and follow‐up data from the Association of British Clinical Diabetologists nationwide audit of people with diabetes in the UK. Diabetes‐related distress (DRD) was assessed using the two‐item diabetes‐related distress scale (DDS). Participants were categorized into two groups: high DRD (DDS score ≥ 3) and lower DRD (DDS score < 3). The t‐test was used to assess the difference in the pre‐ and post‐isCGM continuous variables.

Results

The study consisted of 17 036 people with diabetes, with 1314 (7%) using isCGM for ‘psychosocial’ reasons. Follow‐up data were available for 327 participants, 322 (99%) of whom had type 1 diabetes with a median diabetes duration of 15 years; 75% (n = 241) had high levels of DRD. With the initiation of isCGM, after a mean follow‐up period of 6.9 months, there was a significant reduction in DDS score; 4 at baseline versus 2.5 at follow‐up (P < .001). The prevalence of high DRD reduced from 76% to 38% at follow‐up (50% reduction in DRD, P < .001). There was also a significant reduction in HbA1c (78.5 mmol/mol [9.3%] at baseline vs. 66.5 mmol/mol [8.2%] at follow‐up; P < .001). This group also experienced an 87% reduction in hospital admissions because of hyperglycaemia/diabetic ketoacidosis (P < .001).

Conclusion

People with diabetes who had isCGM initiated for a psychosocial indication had high levels of DRD and HbA1c, which improved with the use of isCGM.
Socio‐economic disparities in hospital care among Dutch patients with diabetes mellitus
Authors: de Vries Silvia A. G. , Sas Theo C. J. , Bak Jessica C. G. , Mul Dick , Nieuwdorp Max , Wouters Michel W. J. M. , Verheugt Carianne L.
Published: January 2024

Aim

Socio‐economic status (SES) influences diabetes onset, progression and treatment. In this study, the associations between SES and use of hospital care were assessed, focusing on hospitalizations, technology and cardiovascular complications.

Materials and Methods

This was an observational cohort study comprising 196 695 patients with diabetes (all types and ages) treated in 65 hospitals across the Netherlands from 2019 to 2020 using reimbursement data. Patients were stratified in low, middle, or high SES based on residential areas derived from four‐digit zip codes.

Results

Children and adults with low SES were hospitalized more often than patients with middle or high SES (children: 22%, 19% and 15%, respectively; p < .001, adults: 28%, 25% and 23%; p < .001). Patients with low SES used the least technology: no technology in 48% of children with low SES versus 40% with middle SES and 38% with high SES. In children, continuous subcutaneous insulin infusion (CSII) and real‐time continuous glucose monitoring (rtCGM) use was higher in high SES {CSII: odds ratio (OR) 1.54 [95% confidence interval (CI) 1.35‐1.76]; p < .001; rtCGM OR 1.39 [95% CI 1.20‐1.61]; p < .001} and middle SES [CSII: OR 1.41 (95% CI 1.24‐1.62); p < .001; rtCGM: OR 1.27 (95% CI 1.09‐1.47); p = .002] compared with low SES. Macrovascular (OR 0.78 (95% CI 0.75‐0.80); p < .001) and microvascular complications [OR 0.95 (95% CI 0.93‐0.98); p < .001] occurred less in high than in low SES.

Conclusions

Socio‐economic disparities were observed in patients with diabetes treated in Dutch hospitals, where basic health care is covered. Patients with low SES were hospitalized more often, used less technology, and adults with high SES showed fewer cardiovascular complications. These inequities warrant attention to guarantee equal outcomes for all.
REduced‐Carbohydrate intervention for managing Obesity and Reduction of gestational Diabetes (RECORD): A randomized controlled feasibility trial
Authors: Michalopoulou Moscho , Jebb Susan A. , MacKillop Lucy H. , Dyson Pamela , Hirst Jane E. , Zhu Sufen , Wire Amy , Astbury Nerys M.
Published: January 2024

Aim

To test the feasibility and acceptability of a reduced‐carbohydrate dietary program, intended to reduce the risk of gestational diabetes.

Materials and Methods

Fifty‐one pregnant women at <20 weeks' gestation, with body mass index ≥30 kg/m2, and a normal baseline oral glucose tolerance test (OGTT), were randomized 2:1 to an intervention or control group and followed‐up until delivery. The dietary intervention aimed at providing 130–150 g carbohydrate/day. Feasibility outcomes assessed at 24–28 weeks' gestation, included adoption of the reduced‐carbohydrate diet by the intervention group, and retention of all participants, assessed by completion of a second OGTT. Changes in glycemia, weight gain and dietary intake, and the maternal and neonatal outcomes were also assessed. Participants were interviewed about their experience of the intervention and the study.

Results

Forty‐nine of 51 participants attended the follow‐up OGTT, a retention rate of 96% (95% confidence interval [CI] 86.8%–98.9%). In the intervention group, carbohydrate intake at follow‐up was 190.4 (95% CI 162.5–215.6) g/day, a reduction of −24.6 (95% CI −51.5–2.4) g/day from baseline. Potentially favourable effects of the intervention on glucose control, weight gain and blood pressure were observed, but the study was not powered to detect significant differences in these. Participants found the intervention acceptable, and were content with the study processes, but some reported barriers to sustained adherence, mainly pertaining to competing priorities.

Conclusions

Retention was high, suggesting the study processes are feasible, but the carbohydrate reduction in the intervention group was small, and did not meet progression criteria, limiting the likelihood of achieving the desired goal to prevent gestational diabetes. Trial registration number: ISRCTN16235884.
Risk factor control and incident cardiovascular disease in patients with diabetes: Sex‐specific relations
Authors: Wang Xuan , Ma Hao , Li Xiang , Liang Zhaoxia , Fonseca Vivian , Qi Lu
Published: January 2024

Aim

Women with diabetes are at higher risk of cardiovascular diseases (CVD) than men with diabetes; however, the sex difference in the association between the degree of risk factor control and the risk of CVD in patients with diabetes is unclear.

Methods

In total, 17 260 participants diagnosed with diabetes from the UK Biobank were included and matched with 86 300 non‐diabetes controls based on age, sex and assessment centre. The main exposure was the number of risk factors within the target range, including glycated haemoglobin level <53 mol/mol (7%), blood pressure <140/90 mm/Hg, low‐density lipoprotein cholesterol <100 mg/dl, non‐current smoking and absence of microalbuminuria.

Results

During a median follow‐up of 13.3 years, a total of 3338 incident CVD cases, including 2807 ischaemic heart disease and 793 strokes, were documented. A more stringent control of risk factors was significantly associated with a lower risk of incident CVD, and such an association was significantly stronger in women than men. Compared with non‐diabetes participants, the diabetes‐related risk of CVD appeared to be eliminated if more than three risk factors were well controlled among women and men with diabetes. Moreover, clinical biomarkers (e.g. glycated haemoglobin and blood pressure) showed greater relative importance than other factors in women, whereas socio‐economic and psychological factors (e.g. education and depression) exhibited similar relative importance to clinical biomarkers in men with diabetes.

Conclusion

Our findings highlighted the importance of raising awareness of sex differences in the management of CVD risk factors among patients with diabetes.
Study of stress‐strain loops on cardiotoxicity related to immune checkpoint inhibitors
Authors: Chunlan Shi , Bing Yue , Xi Wei
Published: January 2024

Objective

To evaluate the effect of immune checkpoint inhibitors (ICIs) on left ventricular myocardial work by pressure‐strain loop (PSL).

Methods

Forty‐three immunotherapy patients were enrolled in the case group, and another 43 healthy volunteers were enrolled in the control group. They were examined by echocardiography before immunotherapy (T0 phase), after three cycles of treatment (T3 phase) and after six cycles of treatment (T6 phase). Conventional echocardiographic parameters, left ventricular global longitudinal strain (GLS), and myocardial work indices, including global work index (GWI), global constructive work (GCW), global work waste (GWW), and global work efficiency (GWE), were collected for analysis to compare the results of the different immunotherapy cycles.

Results

There were no statistically significant differences of baseline characteristics, conventional echocardiographic parameters, left ventricular strain, and myocardial work indices between T0 phase and control group (all p > .05). There were no statistically significant differences in LVEF between T0, T3, and T6 phase (all p > .05). GLS, GWI, GCW, and GWE were decreased and GWW was increased in T3 and T6 phase. There were no statistically significant difference between GLS in T3 and T0 phase (q = .9057, p > .05). The difference was statistically significant between GLS in T6 and T0 phase (q = 5.5651, p < .01). The difference was statistically significant between GLS in T3 and T6phase(q = 4.6594, p < .01). There were statistically significant difference in GWI, GCW, GWE, and GWW in the T3 and T6 phase compared with the T0 phase (p < .01).

Conclusion

PSL can effectively evaluate the effect of ICIs on left ventricular myocardial work, to provide a new method for the early clinical detection of ICIs‐related cardiotoxicity.
Usefulness of tissue Doppler‐derived left ventricular isovolumic contraction velocity in patients with heart failure with preserved ejection fraction
Authors: Kawata Takayuki , Omori Yuki , Suzuki Minako , Ikeda Atsushi
Published: January 2024

Background

Heart failure with preserved ejection fraction (HFpEF) is a group of diseases classified by left ventricular (LV) EF, a measure of pump function. However, LVEF does not reflect LV contractility. Previous studies have shown that tissue Doppler‐derived LV isovolumic contraction velocity (IVCv) correlates well with the LV peak dP/dt, an index of LV contractility. We explored whether LV IVCv is associated with 1‐year post‐discharge outcomes in HFpEF.

Methods

We enrolled 113 patients (median age, 86 years, 45 male) with HFpEF (EF on admission ≥ 50%) who were admitted to our hospital for the treatment of acute HF. Clinical characteristics including echocardiographic data were obtained before discharge. IVCv was obtained from the tissue Doppler waveforms of both the septal and lateral mitral annulus of the apical 4‐chamber view and averaged data were used. Primary outcomes were all‐cause death or unplanned hospitalization due to HF within the first year.

Results

Among all patients, median LVEF was 61%, left atrial diameter was 47 mm, E/e’ was 17.5, and IVCv was 4.5 cm/sec; mean tricuspid regurgitation velocity was 2.6 m/sec. Regarding laboratory data, the median plasma B‐type natriuretic peptide level was 185 pg/mL. Thirty‐four events occurred (15 deaths, 19 unplanned hospitalizations due to HF) within the first year. In multivariate Cox proportional hazards analyses, IVCv was significantly associated with outcomes (hazard ratio .68, 95% confidence interval .50–.89, p = .0095), independent of general characteristics, echocardiographic measures and pertinent laboratory parameters.

Conclusion

LV IVCv was independently associated with 1‐year outcomes in patients with HFpEF.
The impacts of biologic treatment on metabolic profiling in psoriasis
Authors: Deng Sichun , Zhou Guowei , Li Xingyu , Zhang Guanxiong , Hu Kun , Lu Yan , Li Jiashuai , Liu Yijie , Zhou Guo , Zhang Mi , Chen Junchen , Liu Hong , Kuang Yehong
Published: January 2024

Psoriasis is an immune‐mediated inflammatory disease commonly accompanied by various metabolic disorders. It is widely known that biologics could affect the metabolic status and comorbidities in psoriasis patients, however, the effects of biologics on metabolism in psoriasis patients remain poorly understood. The aim of this study was to elucidate the characteristic changes of metabolic profiling in psoriasis vulgaris (PsV) patients before and after applying biologics. Plasma samples were collected from a retrospective cohort of 43 PsV patients. Non‐targeted metabolomics analyses were performed using liquid chromatography‐mass spectrometry (LC–MS) to compare the metabolic profiles before and after applying adalimumab (ADA) or ixekizumab (IXE) for 4 weeks. Additionally, correlation analyses were conducted to investigate the associations between metabolite expression levels and clinical characteristics. The biologics significantly affected the metabolic profiles of PsV patients especially in glycerophospholipids (GPs). First, phosphatidylcholine (PC), unsaturated lysophosphatidylcholine (LPC), unsaturated lysophosphatidic acid (LPA) and unsaturated lysophosphatidylethanolamine (LPE) were significantly up‐regulated, whereas phosphatidylethanolamine (PE), saturated LPC, saturated LPA and saturated LPE were predominantly down‐regulated after biologic treatment. What is more, the changes in PE and LPA were mainly observed after applying IXE instead of ADA. Second, we also found GPs including PC, unsaturated LPC, unsaturated LPA and unsaturated LPE were primarily negatively correlated with disease severity, whereas, PE, saturated LPC, saturated LPA and saturated LPE displayed inverse correlations. Biologics could affect GP metabolism and facilitate the transition of metabolic status from a pro‐inflammatory to an anti‐inflammatory phenotype in PsV patients.
Cell–cell communication in stem cells and cancer: Alone but in touch
Authors: Radak Mehran , Fallahi Hossein
Published: January 2024

Background

Cellular communication and signaling pathways are fundamental regulators of stem cell and cancer cell behaviors. This review explores the intricate interplay of these pathways in governing cellular behaviors, focusing on their implications for diseases, particularly cancer.

Objectives

This comprehensive review aims to elucidate the significance of cellular signaling pathways in regulating the behavior of stem cells and cancer cells. It delves into the alterations in these pathways, their impact on cell fate, and their implications for developing diseases, notably cancer. The objective is to underscore the importance of understanding these signaling pathways for developing targeted therapeutic strategies.

Methods

The review critically analyzes existing literature and research findings concerning the roles of signaling pathways in stem cell behavior regulation, emphasizing their parallels and disparities in cancer cells. It synthesizes information on both direct and indirect modes of cell communication to delineate the complexity of signaling networks.

Results

Direct and indirect modes of cell communication intricately regulate the complex signaling pathways governing stem cell behaviors, influencing differentiation potential and tissue regeneration. Alterations in these pathways significantly impact stem cell fate, contributing to disease pathogenesis, including cancer. Understanding these signaling cascades offers insights into developing targeted therapies, particularly cancer treatment.

Conclusion

Understanding the regulation of signaling pathways in stem cells and the specialized subset of cancer stem cells holds promise for innovative therapeutic approaches. By targeting aberrant signaling pathways, tailored interventions may improve treatment outcomes. This review underscores the critical role of signaling pathways in cellular behaviors, offering a pathway toward developing novel, more effective therapies for diverse diseases and disorders.
Short selling and readability in financial disclosures: A controlled experiment
Authors: Sun Minxing , Xu Weike
Published: January 2024

We examine the causal effect of short‐selling on a firm's annual report readability using regulation SHO, which relaxes short‐sale constraints for a random sample of pilot stocks. Pilot firms produce significantly less readable annual reports than nonpilot firms during the experiment period. Our results are more pronounced for firms that receive less investor attention and those with poorer growth prospects. Furthermore, pilot firms increase the use of uncertainty words in annual reports during the experiment period. Our results suggest that firms produce less transparent financial disclosures that are more costly for investors to comprehend when short‐sale constraints are less rigorous.
Effects of fear of COVID‐19 on older volunteers' willingness to continue their activities: REPRINTScohort study
Authors: Takahashi Tomoya , Matsunaga Hiroko , Sagara Tomoya , Fujita Koji , Fujihira Kyoko , Ogawa Susumu , Suzuki Hiroyuki , Murayama Hiroshi , Fujiwara Yoshinori
Published: January 2024

Aim

This study examined the effects of fear of COVID‐19 on older volunteers' willingness to continue activities that required face‐to‐face interactions.

Methods

From September to November 2020, a self‐administered questionnaire survey was conducted with 481 older adult volunteers. A total of 423 responses were collected; 343 had no missing items and were included in the analysis. Analysis items included willingness to continue volunteer activities, fear of COVID‐19, mental and physical health, and a group of items related to factors influencing the continuation of volunteer activities.

Results

The structural analysis of covariance indicated that volunteer orientation, which included items considered to be factors for continuing volunteer activities, had a significant positive influence on the willingness to continue activities. Fear of COVID‐19 had a significant negative effect on the latent variable mental and physical health, which consisted of a subjective sense of health, but fear of COVID‐19 and physical and mental health had no significant effect on the willingness to continue volunteering.

Conclusions

Our results suggest that the willingness of older adults to continue volunteer activities during the COVID‐19 pandemic is influenced by their volunteer orientation and is not affected by their fear of COVID‐19. Geriatr Gerontol Int 2024; 24: 370–376.
Synthesis of highly disperse NbSi2–Si3N4 and Si3N4–NbN composite powders
Authors: Lytvyn Roman , Kud Iryna , Myslyvchenko Oleksandr , Medyukh Roman , Krushynska Larysa , Zgalat‐Lozynskyy Ostap
Published: January 2024

The behavior of reaction powder mixtures of stoichiometric compositions calculated for the synthesis of higher niobium nitride and silicide in the temperature range 800–1400°С in vacuum according to the reactions 4Nb + Si3N4 and 3Nb + 2Si3N4, respectively, has been investigated. The decomposition of Si3N4 is accompanied by the formation of lower nitride and lower silicide phases of niobium. The content of the silicide phase increases with heat treatment temperature, and, at 1400°С, NbSi2 forms. The nitride phase remains practically unchanged up to 1300°С and disappears at 1400°С. On the basis of the established regularities, we have developed synthesis methods for Si3N4–NbN and Si3N4–NbSi2 powders, which include the introduction of excess Si3N4 with respect to the stoichiometric composition. The combined two‐stage technological cycle of synthesis of Si3N4–NbN involves vacuum annealing at 1000°С and subsequent nitriding at 1300°С. The synthesis method for NbSi2–Si3N4 assumes the in situ successive formation of niobium silicide phases up to 1400°С. The synthesized Si3N4–15NbN and NbSi2–14Si3N4 powders consist of multiphase agglomerates with a mean size of 5.5 and 8.8 µm, respectively, and a nanodisperse fraction with a mean particle size of 200 nm.
Urologic perspective of genitourinary syndrome of menopause
Authors: González‐Arboleda Andrés Augusto , Arias‐Castillo Liliana , García‐Perdomo Herney Andrés
Published: January 2024

Background

Experts define the Genitourinary Syndrome of Menopause (GSM) as a collection of signs and symptoms associated with decreased oestrogen levels. Its prevalence ranges between 13% and 87% in postmenopausal women.

Objective

We aimed to describe the main pathophysiology mechanisms of GSM affecting the lower urinary tract and the manifestations and treatment options for lower urinary tract dysfunction in GSM.

Results

Several treatments and recommendations have been proposed to enhance patients' ability to manage their symptoms, such as regular sexual activity or masturbation, to increase this physiological response and reduce the severity of GSM.

Conclusion

GSM is a multifactorial and complex syndrome that affects postmenopausal women. Impairment of urogenital structures implies diverse manifestations of genital atrophy and lower urinary tract symptoms.