bluuebunny/crossref_metadata_2025 huggingface dataset:
Prognostic performance of FIGO 2023 endometrial carcinoma staging: a comparison to FIGO 2009 staging in the setting of known and unknown molecular classification
Authors: Libert Diane , Hammer Phoebe M , Hui Caressa , Kidd Elizabeth A , Folkins Ann K , Longacre Teri , Yang Eric J , Charu Vivek , Howitt Brooke E
Published: August 2024

Aims

The 2023 FIGO staging criteria for endometrial cancer (EC) introduced marked changes from the 2009 version. The full implication of these changes for patient diagnosis and treatment is unknown. We evaluate the differences in staging and prognostication between the two systems, with and without inclusion of molecular classification.

Methods and results

We assigned (1) FIGO 2009, (2) 2023 molecular‐agnostic and (3) 2023 molecular‐informed stages to 404 fully staged and molecularly classified patients with EC. Disease‐specific and progression/relapse‐free survival were analysed via the Kaplan–Meier method and compared with log‐rank testing; 118 of 252 (47%) FIGO 2009 stage I patients were upstaged based on histopathological findings alone. Stage I/II subgroup survival distribution analysis showed a worse prognosis in FIGO 2023 IIB and IIC patients. In the molecular‐informed FIGO 2023 system, three of 15 (20%) POLE‐mutated stage I/II cases were downstaged from FIGO 2009 and eight (53%) were downstaged from molecular‐agnostic FIGO 2023. Fifty‐one of 60 (85%) p53‐abnormal tumours were upstaged from the FIGO 2009, whereas 13 of 60 (22%) were upstaged from the 2023 molecular‐agnostic stage. Molecular classification improved prognostic stratification for both 2009 and 2023 FIGO systems.

Conclusions

Downstaging based on POLE mutation more accurately represents patient outcomes. However, in the absence of known POLE status, applying molecular‐agnostic FIGO 2023 criteria for stage I/II disease should be conducted with caution. For aggressive histotypes, additionally reporting FIGO 2009 stage should be considered. Upstaging based on substantial lymphovascular space invasion, aggressive histotype with any myometrial invasion and abnormal p53 improves prognostic discernment. Further subdivisions within stage I/II provide minimal additional prognostic information.
Cardiovascular disease risk in people of African ancestry with HIV in the United Kingdom
Authors: Ko Stephanie , Dominguez‐Dominguez Lourdes , Ottaway Zoe , Campbell Lucy , Fox Julie , Burns Fiona , Hamzah Lisa , Ustianowski Andrew , Clarke Amanda , Kegg Stephen , Schoeman Sarah , Jones Rachael , Pett Sarah L. , Hudson Jonathan , Post Frank A.
Published: August 2024

Objectives

Our objective was to describe the prevalence of cardiovascular disease (CVD) risk factors in people of African ancestry with HIV in the UK.

Methods

We conducted a cross‐sectional analysis of CVD risk factors in Black people with HIV aged ≥40 years and estimated the 10‐year CVD risk using QRISK®3‐2018. Correlations between body mass index (BMI) and CVD risk factors were described using Pearson correlation coefficients, and factors associated with 10‐year CVD risk ≥5% were described using logistic regression.

Results

We included 833 Black people with HIV and a median age of 54 years; 54% were female, 50% were living with obesity (BMI ≥30 kg/m2), 61% had hypertension, and 19% had diabetes mellitus. CVD risk >5% ranged from 2% in female participants aged 40–49 years to 99% in men aged ≥60 years, and use of statins ranged from 7% in those with CVD risk <2.5% to 64% in those with CVD risk ≥20%. BMI was correlated (R2 0.1–0.2) with triglycerides and diastolic blood pressure in women and with glycated haemoglobin, systolic and diastolic blood pressure, and total:high‐density lipoprotein (HDL) cholesterol ratio in men. In both female and male participants, older age, blood pressure, diabetes mellitus, and kidney disease were strongly associated with CVD risk ≥5%, whereas obesity, total:HDL cholesterol, triglycerides, and smoking status were variably associated with CVD risk ≥5%.

Conclusions

We report a high burden of CVD risk factors, including obesity, hypertension, and diabetes mellitus, in people of African ancestry with HIV in the UK. BMI‐focused interventions in these populations may improve CVD risk while also addressing other important health issues.
Evolutionary genomics analysis reveals a unique lineage of Megachile pruina found in an isolated population in Bermuda
Authors: Rose Jennifer , Gilbert M. Thomas P. , Outerbridge Mark , Morales Hernán E.
Published: August 2024

The decline in bee diversity, largely driven by habitat loss, climate change and invasive species, is well‐documented. Within this context, the genus Megachile Latreille, 1802 (Hymenoptera: Megachilidae), a diverse group of solitary leafcutter bees, lacks comprehensive species‐level conservation and taxonomic assessments, potentially concealing population declines and extinctions.

Megachile pruina is one of Bermuda's three bee species and possibly the last native bee on the island. Formerly distributed widely across the island, it is now restricted to a small 11.5 ha area within the Castle Harbour Islands Nature Reserve.

Classified as ‘Vulnerable’ under the Bermuda Protected Species Act, its taxonomic and conservation status remains uncertain, particularly its evolutionary relationships with populations in the United States.

Here, we analyse nuclear genomes and mitochondrial genomes to reveal that Bermuda's M. pruina population is genetically distinct from mainland US populations and show no close association with any sampled US population, suggesting that Bermuda's represent a unique evolutionary lineage.

Our genetic diversity assessment shows lower genetic diversity in Bermuda's population compared with the United States, highlighting a higher level of vulnerability than originally thought.

We recommend maintaining its current protection status and advocate for the pressing need of expanding ecological and biological studies to facilitate appropriate conservation and monitoring measures.
How Does Nature Exposure Affect Adults With Symptoms of Mental Illness? A Meta‐Analysis
Authors: Bettmann Joanna E. , Speelman Elizabeth , Blumenthal Ellison , Couch Scott , McArthur Tara
Published: August 2024

Existing research on the effects of nature exposure on the mental health of adults indicates that spending time in nature reduces depressive symptoms and stress, increases quality of life and mood and improves mental health. This meta‐analysis aimed to answer the question: what are the effects of nature exposure on the social, mental and physical health of adults with symptoms of mental illness? The meta‐analysis included all studies relevant to the study research questions which collected quantitative data on nature exposure using validated instruments for at least two time points on each participant and which were published between 1990 and 2020. Regarding the impact of nature exposure on adults with symptoms of mental illness, analyses showed significant, moderate effect sizes for all studies and smaller, but significant, effect sizes for studies with control groups Analyses also yielded critical information regarding the effect size of the type of nature dosage, nature setting, nature‐based activity, key mental health outcomes and other factors. These findings from the present study results have important implications regarding the potential benefits of nature exposure for adults and its role in healthcare.
Mental Health Crisis: An Evolutionary Concept Analysis
Authors: Hudson Emilie , Pariseau‐Legault Pierre , Cassivi Christine , Chouinard Chad , Goulet Marie‐Hélène
Published: August 2024

The term ‘mental health crisis’ is a widely used concept in clinical practice and research, appearing prominently in mental health literature across healthcare and social science disciplines. Within these contexts, the term is frequently either left undefined or defined rather narrowly, confined to clinical observations or guidelines targeted at healthcare providers and negating the multifaceted nature of crisis as described by those with lived experience. Therefore, the aim of this paper is to explore the characteristics of and provide a conceptual definition for the concept of ‘mental health crisis’. Rodgers' method of evolutionary concept analysis was employed and 34 articles, ranging from 1994 to 2021 and a variety of disciplines, were analysed. The results highlighted the contrast between clinically oriented surrogate terms and related concepts and those used by individuals with lived crisis experience. Antecedents of crisis included underlying vulnerabilities, relational dysfunction, collapse of life structure and struggles with activities of daily living. The concept's attributes encompassed the temporality of crisis, signs and symptoms of crisis, functional decline and crisis in family and caregivers. Finally, the consequences comprised looking inward for help, looking outward for help, and opportunities and dangers. This concept analysis serves as a foundational step in understanding ‘mental health crisis’ and its various dimensions, facilitating more nuanced discussions and interventions in the realm of mental healthcare.
Outcomes of a honey and olive oil‐based dressing material on wounds of women that have had a caesarean section in south‐western Uganda
Authors: Ngonzi Joseph , Ssenkumba Brian , Nambogo Nuriat , Ssedyabane Frank , Kamugisha Arnold , Nkwangu David , Okoth Thomas , Tibaijuka Leevan , Mulogo Edgar
Published: August 2024

Postpartum sepsis following caesarean sections among women in Uganda remains a risk. However, erratic supplies of standard dressing material make the risk a reality. Alternative wound dressing materials, therefore, remain a viable option. This study examined the outcome of a honey and olive oil‐based dressing material on caesarean section wound healing. Using the Uganda Industrial Research Institute (UIRI), the study team created I‐Dress, a wound dressing made of honey and olive oil. A case‐series study was conducted on 25 women who received I‐Dress following caesarean births at three health facilities in south‐west Uganda. Vital signs (temperature, blood pressure, and heart rate) were measured, along with wound induration, dehiscence, and discharge. The primary outcome was the length of time it took for the wound to heal. The average age of the women who received I‐Dress was 27.5 (±4.8) years. Following the application of I‐Dress, all of the women (100%) had no wound induration or dehiscence, with only two (13%) experiencing wound discharge. The vast majority of the women (88%) had never had a Caesarean section before. The mean time required for wound healing was 2.2 (±0.7) days. The findings indicate that honey and olive oil‐based dressings improve Caesarean section wound healing in terms of wound induration, dehiscence, and time to healing. These dressing materials can therefore supplement the standard dressing materials, especially in resource‐constrained settings.
‘A potentially ticking time bomb’ – barriers for prevention, diagnosis, and treatment of cardiovascular disease in people with intellectual disabilities
Authors: Plasil Tanja , Ersfjord Ellen Margrete Iveland , Berge Kim , Oldervoll Line M.
Published: August 2024

Background

Research suggests that people with intellectual disabilities have a higher risk for cardiovascular disease than the general population. The aim of this study was to identify barriers for the prevention, diagnosis, and treatment of cardiovascular disease for people with intellectual disabilities.

Method

We conducted individual interviews with relatives and general practitioners and focus group interviews with staff working at an assisted home facility, a cardiac ward, an obesity clinic and two rehabilitation centres (n = 33) in Norway. Inductive approach and thematic analysis were used to analyse the data.

Results

We identified barriers on an individual and a structural level. The underlying reason for these barriers is that health problems, such as cardiovascular disease, are regularly overlooked as the condition of intellectual disability overshadows other possible diagnoses.

Conclusion

This focus on intellectual disability rather than other explanations leads to shortcomings in the prevention, diagnoses, and treatment of cardiovascular disease in this group.
The Bio‐Restorative Concept for Implant‐Supported Restorations
Authors: Pedrinaci Ignacio , Hamilton Adam , Lanis Alejandro , Sanz Mariano , Gallucci German O.
Published: August 2024

Objective

This study aims to present the bio‐restorative approach in implant dentistry, which combines biological and restorative concepts through digital planning. This concept combines periodontal, surgical, and prosthetic variables, aiming to reduce patient morbidity while achieving satisfactory esthetic and functional outcomes in implant‐supported restorations in the long term.

Overview

Implant dentistry evolved from a primarily surgical to a recent prosthetically driven approach. This evolution was partly due to advancements in bone reconstructive techniques and an increased demand for esthetic outcomes. Recently, digital planning has introduced a new paradigm that allows for the full integration of both approaches. The bio‐restorative concept considers functional, esthetic, and biological variables in a virtual planning environment. This is achieved through the simultaneous digital assessment of (A) anatomical site characteristics and (B) implant restorative variables. These variables include digital tooth arrangement, soft–hard tissue conditions, implant variables, supra‐platform components, and a surgical plan that respects or modifies peri‐implant phenotype.

Conclusions

The bio‐restorative concept is intended to improve contemporary implant dentistry by integrating updated biological and prosthetic notions through digital planning. Adopting this paradigm has the potential to redefine the standards in implant dentistry, fostering a holistic and patient‐centered approach.

Clinical Considerations

It enhances patient and clinician satisfaction through more efficient and less invasive procedures. Significantly, it improves predictability, leading to successful implant‐supported restorations in the long term.
Many studies, but little certainty about the effects of statin discontinuation on outcomes
Authors: Odden Michelle C. , Dave Chintan V.
Published: August 2024

This editorial comments on the article byPeixoto et al.
The mutual influence of microtubules and the cortical ER on their coordinated organisation
Authors: Pal Lalita , Belausov Eduard , Dwivedi Vikas , Yechezkel Sela , Sadot Einat
Published: August 2024

The endoplasmic reticulum (ER) is the largest organelle in terms of membrane content, occupying the entire cytoplasmic volume. It is tethered to the cell cortex through ER‐plasma membrane contact sites (EPCS). Previous studies have shown that EPCSs labelled by VAP27 align with cortical microtubules, and that ER tubules elongate along microtubules. Here, we addressed the question whether this relationship is bidirectional, with EPCSs influencing microtubule organisation. Using TIRF microscopy to track EPCSs and microtubule dynamics simultaneously, we demonstrate that while EPCSs remain stable, microtubules are highly dynamic and can adjust their positioning based on nearby EPCS in Arabidopsis cotyledon epidermis. In lobes of epidermal cells enclosed by two indentations, where microtubules bundle together, EPCSs flank the bundles and exhibit a distinctive arrangement, forming symmetric arcs in relation to the lobe axis. In guard cells, transversely oriented ER tubules co‐align with microtubules. Disrupting microtubules with the drug oryzalin leads to transient guard cells‐ER remodelling, followed by its reorganisation into transverse tubules before microtubule recovery. Taken together our observations suggest, that the positioning of EPCSs and cortical microtubules, can affect each other and the organisation of cortical ER.
Efficacy of a Combination Treatment of Ablative Fractional Carbon Dioxide Laser Therapy and Recombinant Human Epidermal Growth Factor for Atrophic Acne Scars
Authors: Peng Hao , Ran Xuehui , Yang Xia , Zhou Guoyu , Lin Xiaoxi , Shen Lingyue , Wu Xianglei
Published: August 2024

Background

Atrophic acne scars (AAS) are disfiguring and permanent changes caused by inflammatory acne. Fractional carbon dioxide is a common ablative device used to treat this condition. However, issues such as unclear effectiveness, frequent treatments, and potential side effects exist. In recent years, recombinant human epidermal growth factor (rhEGF) has also been frequently reported for its application in the treatment of acne scars.

Objective

To explore the potential synergistic effect of fractional carbon dioxide laser combined with rhEGF in AAS treatment.

Methods

We enrolled 15 patients with AAS. They received fractional carbon dioxide laser treatment and were then randomly assigned to receive either rhEGF or a placebo on one side of the face. The procedure was repeated three times, and the results were evaluated using the échelle d'évaluation clinique des cicatrices d'acné (ECCA) score and analyzed using the CBS camera system, 3D analysis (3DMD). Reflectance confocal microscopy (RCM) examination was also conducted.

Results

Both sides exhibited significant improvement in the appearance of the acne scars after treatment, as confirmed by the ECCA score, 3DMD data, and CBS texture score. On the rhEGF‐treated side, the pore number and epidermal pigment area significantly improved as compared to the control side, whereas no significant differences were observed in the other data. Under RCM, a significant increase in epidermal thickness and appearance of reticular collagen fibers in the dermal layer after treatment was observed.

Conclusion

Compared to the sole use of laser, the combination of fractional carbon dioxide laser and rhEGF does not significantly enhance scar therapeutic effects. However, it does shorten the recovery period after laser treatment and improves the pore appearance.
Intravenous administration of quinidine and metoprolol for treatment of atrial fibrillation in 2 neonatal foals
Authors: Leduc Laurence , Abraham Michelle , Slack JoAnn
Published: August 2024

Atrial fibrillation (AF) is a rarely reported arrhythmia in otherwise healthy newborn foals, with a single case of cardioversion using procainamide administration described in the literature. Two neonatal Thoroughbred colts were presented to an equine hospital because of an irregularly irregular tachyarrhythmia and poor latching when trying to nurse. History, physical examination, and initial diagnostic testing including ECG and echocardiography confirmed AF without structural heart disease. The 1st foal converted into normal sinus rhythm after treatment with IV metoprolol and quinidine. The 2nd foal converted to normal sinus rhythm after a single IV dose of metoprolol, intended for rate control. Demeanor and nursing behavior improved markedly after conversion. The 2 foals had normal heart rates and sinus rhythm that persisted for 6 weeks until euthanasia in the 1st foal and for 2 years in the 2nd foal. Rate control and cardioversion should be considered as a treatment for persistent lone AF in neonatal foals.
Need for Cognition, Neuromyths, and Knowledge about the Brain in Aspiring Teachers
Authors: Boyle Eimear , Lyddy Fiona
Published: August 2024

Neuromyths are pervasive misconceptions about the brain and its functioning. They are widely held by the general population, as well as by teachers and by preservice teachers. Need for cognition (NfC) may offer a protective effect against misconceptions. The current study examined endorsement of neuromyths in a sample of aspiring teachers and other students as a function of NfC. In an online survey, participants rated agreement with a range of misconceptions and factual statements about the brain and completed a scale measuring NfC. Results showed that participants correctly rejected two thirds of the misconception statements, but there was a high level of agreement for some neuromyth items. Aspiring teachers performed better on factual statements but not neuromyths compared to those not aspiring to teach. NfC was positively associated with ratings of the factual statements, but not with the misconceptions. The findings suggest that some neuromyths remain pervasive and NfC does not confer protection.
Imaging Hypoxia to Predict Primary Neuronal Cell Damage in Branch Retinal Artery Occlusion
Authors: Jamal Sara Z. , Dieckmann Blake W. , McCollum Gary W. , Penn John S. , Jayagopal Ashwath , Imam Uddin MD
Published: August 2024

Purpose

To develop a reliable method to generate a mouse model of branch retinal artery occlusion (BRAO) using laser‐induced thrombosis of a major artery in the mouse retina. Also, to develop a reliable method to detect retinal hypoxia as predictive biomarker for the risk of neuronal cell damage in BRAO.

Methods

A reliable and reproducible model of laser‐induced BRAO was developed in mouse retina using Rose Bengal. To characterize retinal hypoxia in BRAO, pimonidazole immunostaining and HYPOX‐4 molecular imaging methods were used. Terminal deoxynucleotidyl transferase dUTP nick end labelling (TUNEL) was used to characterize neuronal cell damage in the BRAO retina. Expression of mRNA in retinal tissues from BRAO and age‐matched control retinas were analyzed using qRT‐PCR.

Results

Occlusion of a branch retinal artery near the optic nerve head (ONH) caused a pattern of retinal tissue hypoxia covering about 12.5% of the entire retina. TUNEL‐positive cells were localized in all layers in BRAO retinal tissue cross sections. In addition, qRT‐PCR data analysis suggests that BRAO is associated with both inflammation and hypoxia.

Conclusions

This study provides a reliable method for BRAO in mouse retina and demonstrates the utility of molecular imaging method to detect retinal hypoxia as predictive biomarker for the risk of neuronal cell damage in BRAO. In addition, our data suggest that BRAO retinas are associated with inflammation and also associated with hypoxia‐related neuronal cell damage.

Perspectives

Imaging areas of retinal hypoxia may provide accurate diagnosis, evaluating retinal tissue injury from BRAO.
Triangulating learner corpus and online experimental data: Evidence from gender agreement and relative clauses in L2 Greek
Authors: Papadopoulou Despina , Amvrazis Nikolaos , Douka Gerakini , Tantos Alexandros
Published: August 2024

The article introduces triangulation to converge evidence from corpus and experimental data, by means of two case studies in second language (L2) learners of Greek. The first case study investigates the acquisition of gender agreement, while the second probes the development of relative clauses. In both studies, findings from the corpus are tested against online experimentation using eye‐tracking and self‐paced reading tasks, a combination that is scarce in research implementing triangulation. The findings suggest that methodological convergence yields both congruous and incongruous evidence. However, both types of evidence contribute to a nuanced understanding of the linguistic phenomena under study, as well as the different perspectives from which they are approached. The article concludes that such an approach to triangulation can significantly contribute to enhancing the reliability and validity of the findings, provided that methodological convergence has been achieved at the design level of the study.
Maize mutant screens: from classical methods to new CRISPR‐based approaches
Authors: Lorenzo Christian Damian , Blasco‐Escámez David , Beauchet Arthur , Wytynck Pieter , Sanches Matilde , Garcia del Campo Jose Rodrigo , Inzé Dirk , Nelissen Hilde
Published: August 2024

Mutations play a pivotal role in shaping the trajectory and outcomes of a species evolution and domestication. Maize (Zea mays) has been a major staple crop and model for genetic research for more than 100 yr. With the arrival of site‐directed mutagenesis and genome editing (GE) driven by the Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR), maize mutational research is once again in the spotlight. If we combine the powerful physiological and genetic characteristics of maize with the already available and ever increasing toolbox of CRISPR‐Cas, prospects for its future trait engineering are very promising. This review aimed to give an overview of the progression and learnings of maize screening studies analyzing forward genetics, natural variation and reverse genetics to focus on recent GE approaches. We will highlight how each strategy and resource has contributed to our understanding of maize natural and induced trait variability and how this information could be used to design the next generation of mutational screenings.
Host and parasite intervality in differentially human‐modified habitats
Authors: Llopis‐Belenguer Cristina , Feijen Frida , Morand Serge , Chaisiri Kittipong , Ribas Alexis , Jokela Jukka
Published: August 2024

Host–parasite interactions are influenced by present and past eco‐evolutionary interactions and the local environment. An ecological community defines the potential host range of each parasite and the potential parasite diversity of each host species. Past and present processes translate potential to realised interaction niches of parasite and host species. Host–parasite interactions are antagonistic, which may slow the saturation of their interaction niches. Intervality, a property of bipartite networks, measures saturation of interaction niches. Intervality of a community increases as the interaction niches of species of one guild (e.g. hosts) become saturated for their interactions with another guild (e.g. parasites). Characteristics driving intervality in host and parasite communities are largely unknown, as well as the effect of environmental change on intervality of these communities. In our study, we assess if the characteristics ‘phylogenetic relatedness' and ‘overlap in ecological interactions' explain intervality of rodent host–helminth parasite communities. In addition, we contrast intervality of these communities from habitats that differ in their history of human‐driven modification. We performed the analyses for the interaction niches of both parasites and hosts, independently. Our results indicated that host and parasite communities were non‐interval or significantly less interval than expected by chance. Phylogenetic relatedness and overlap in ecological interactions did not explain the maximum values of intervality. We speculate that antagonistic coevolution in host–parasite communities may hinder communities to reach saturation, which would explain why it is difficult to find the characteristics that explain intervality of a community. Interestingly, intervality of the interaction niche of parasites (host range) increased with habitat modification (i.e. saturation increased), whereas intervality of the interaction niche of hosts (parasite diversity) decreased as habitat modification increased. These opposite trends suggest that interaction niches of parasites and hosts respond differently to habitat modification.
How Family Dynamics Shape Income Inequality Between Families With Young Children: The Case of Sweden, 1995–2018
Authors: Billingsley Sunnee , Gonalons‐Pons Pilar , Duvander Ann‐Zofie
Published: August 2024

Increased gender equality in the labor market and the home are both cited as stabilizers to income inequality between households, but shifts in the economic organization of families over the life course instead appear to amplify household income inequality. Using the case of Sweden, where men have taken longer parental leave in recent years and the age at parenthood continues to advance, we analyze between‐family income inequality for couples with a young child. Based on income data from population registers, we decompose how changes in family dynamics, pre‐ and postparenthood, contributed to income inequality in families with children between the years 1995 and 2018. Analyses show no evidence that assortative mating has increased and that a minor decline in inequality between couples over this 24‐year period resulted from two opposing trends: Dis‐equalizing changes related to women's postbirth income advancements were eclipsed by equalizing changes related to the postponement of parenthood. Postbirth income trends reveal how between‐family inequality increased through women's income development and decreased through men's. Our findings confirm the importance of family processes to household inequality and show the complex effects of both changes in the timing of parenthood and improved gender equality.
Associations between self‐reported parasomnias and psychiatric illness in 370,000 patients with sleep disorders
Authors: Hanif Umaer , Cairns Alyssa , Mysliwiec Vincent , Bettinardi Ruggero G. , Elbaz Maxime , Gimenez Ulysse , Mignot Emmanuel J. M.
Published: August 2024

Aim

To assess self‐reported parasomnias in patients with sleep disorders and explore relationships with psychiatric illness, comorbidities, subjective sleep assessments, and polysomnographic study results.

Methods

Results from intake questionnaires and polysomnographic assessments, collected from 240 sleep centers across 30 US states between 2004 and 2019, were analyzed retrospectively. Of 540,000 total patients, 371,889 who answered parasomnia‐specific questions were included. Patients responding “often” or “always” to parasomnia‐specific questions were considered “symptom‐positive,” whereas a “few times” or “never” were considered “symptom‐negative” (controls).

Results

The study sample was 54.5% male with mean age 54 years (range, 2–107 years). Frequencies for the different parasomnias were 16.0% for any parasomnia, 8.8% for somniloquy, 6.0% for hypnagogic hallucinations, 4.8% for sleep‐related eating disorder, 2.1% for sleep paralysis, and 1.7% for somnambulism. Frequent parasomnias were highly associated with diagnosed depression (odds ratio = 2.72). All parasomnias were associated with being younger and female and with symptoms of depression, anxiety, insomnia, restless legs, pain, medical conditions, fatigue, and sleepiness. Associations with objective sleep metrics showed characteristics of consolidated sleep and differentiated weakly between nonrapid eye movement sleep and rapid eye movement sleep parasomnias. Machine learning accurately classified patients with parasomnia versus controls (balanced accuracies between 71% and 79%). Benzodiazepines, antipsychotics, and opioids increased the odds of experiencing parasomnias, while antihistamines and melatonin reduced the odds. Z‐drugs were found to increase the likelihood of a sleep‐related eating disorder.

Conclusion

Our findings suggest that parasomnias may be clinically relevant, yet understudied, symptoms of depression and anxiety. Further investigation is needed to quantify the nature of multimorbidity, including causality and implications for diagnosis and treatment.
Outcomes of Pediatric Liver Transplantation in Glycogen Storage Disease Type 1b—A Single‐Center Experience
Authors: Rajasekaran Vivek , Santra Saikat , Kelgeri Chayarani , Johansen Lauren , Vijay Suresh , Sreekantam Sreevidya , Raiman Julian , Daly Anne , Sharif Khalid , Kitchen Steve , Gupte Girish
Published: August 2024

Background

Liver transplantation (LT) normalizes fasting tolerance in glycogen storage disease type (GSD) 1b. However, reported outcomes post‐LT with respect to correction of neutropenia, infection risk and growth are varied. Sodium‐glucose cotransporter‐2 (SGLT2) inhibitors have been recently shown to improve neutropenia in GSD1b patients.

Methods

In this single‐center retrospective study, we reviewed all children who underwent LT for GSD1b. Neutropenia, dose of granulocyte colony‐stimulating factor (G‐CSF), unplanned hospital attendance, anthropometrics, graft rejection, survival, and the effects of dapagliflozin were analyzed. Data from protocol biopsies obtained at 1, 5, and 10 years post‐LT and immunosuppression levels were collected.

Results

Eight children (6 female), all on G‐CSF pre‐transplant, underwent cadaveric LT for GSD1b at median age 3.6 years (IQR 3.3–5.1) with mean follow‐up time of 10.3 years (95% CI 7.5–13.1). Neutrophil count and G‐CSF requirement did not improve post‐LT. Although a reduction in unplanned hospital attendance due to infection (0.98 [95% CI 0.76–1.26] vs. 0.49 [95% CI 0.41 to 0.57] per person‐year, p < 0.01) was observed, gastrointestinal complaints and graft dysfunction accounted for a similar hospitalization burden pre‐ versus post‐LT. Body mass index (BMI) reduced post‐LT (Z‐score 1.47 [95%CI 0.39–2.23] vs. 0.56 [95% CI −0.74 to 1.45], p = 0.02), with no significant change in height.

Although all children and grafts have survived, 75% of recipients developed rejection, despite adequate immunosuppression levels, with two children having been found to have developed significant fibrosis on their 5‐year protocol biopsy. Although dapagliflozin allowed cessation of G‐CSF, no improvement in neutrophil count was observed. Despite this, a reduction in gastrointestinal and infection‐related morbidity was noted following dapagliflozin.

Conclusion

Although LT normalizes fasting tolerance in GSD1b and reduces hospital attendance due to infection, morbidity from infection and gastrointestinal manifestations persist. Children in our cohort experienced high rates of rejection necessitating titration of immunosuppression to balance risk of infection against organ rejection. Future studies should investigate whether early introduction of SGLT2 inhibitors post‐LT impact morbidity in this group.
Spectroscopic analysis of bacterial photoreactivation
Authors: Abady Keyvan Khosh , Karpourazar Negar , Krishnamoorthi Arjun , Li Runze , Rentzepis Peter M.
Published: August 2024

With the rise of bacterial infections and antibiotic resistance, spectroscopic devices originally developed for bacterial detection have shown promise to rapidly identify bacterial strains and determine the ratio of live to dead bacteria. However, the detection of the photoreactivated pathogens remains a critical concern. This study utilizes fluorescence and Raman spectroscopy to analyze bacterial responses to UV irradiation and subsequent photoreactivation. Our experimental results reveal limitations in fluorescence spectroscopy for detecting photoreactivated bacteria, as the intense fluorescence of tryptophan and tyrosine amino acids masks the fluorescence emitted by thymine molecules. Conversely, Raman spectroscopy proves more effective, showing a detectable decrease in band intensities ofE. colibacteria at 1248 and 1665 cm−1after exposure to UVC radiation. Subsequent UVA irradiation results in the partial restoration of these band intensities, indicating DNA repair and bacterial photoreactivation. This enhanced understanding aims to improve the accuracy and effectiveness of these spectroscopic tools in clinical and environmental settings.
Predicting pharmaceutical supply chain disruptions before and during the COVID‐19 pandemic
Authors: Hupman Andrea C. , Zhang Juan , Li Haitao
Published: August 2024

Disruptions
to the pharmaceutical supply chain (PSC) have negative implications for patients, motivating their prediction to improve risk mitigation. Although data analytics and machine learning methods have been proposed to support the characterization of probabilities to inform decisions and risk mitigation strategies, their application in the PSC has not been previously described. Further, it is unclear how well these models perform in the presence of emergent events representing deep uncertainty such as the COVID‐19 pandemic. This article examines the use of data‐driven models to predict PSC disruptions before and during the COVID‐19 pandemic. Using data on generic drugs from the pharmacy supply chain division of a Fortune 500 pharmacy benefit management firm, we have developed predictive models based on the naïve Bayes algorithm, where the models predict whether a specific supplier or whether a specific product will experience a supply disruption in the next time period. We find statistically significant changes in the relationships of nearly all variables associated with product supply disruptions during the pandemic, despite pre‐pandemic stability. We present results showing how the sensitivity, specificity, and false positive rate of predictive models changed with the onset of the COVID‐19 pandemic and show the beneficial effects of regular model updating. The results show that maintaining model sensitivity is more challenging than maintaining specificity and false positive rates. The results provide unique insight into the pandemic's effect on risk prediction within the PSC and provide insight for risk analysts to better understand how surprise events and deep uncertainty affect predictive models.
Individual and cultural differences in compassion, noticing suffering, and well‐being: Consequences of wanting to avoid feeling negative
Authors: Koopmann‐Holm Birgit , Beccari Alexandra , Oosthuizen Monet
Published: August 2024

Although people across the globe experience suffering, some individuals find it difficult to respond to others' distress because they might not know what would be most helpful to that person in that particular situation. For instance, would a response that focuses on the silver lining or one that acknowledges the suffering of the other person be more compassionate and helpful? In this paper, we demonstrate that the construct of avoided negative affect (ANA), the degree to which people want to avoid feeling negative, can predict individual differences and explain cultural variations in several aspects of compassion. Because ANA is a relatively new construct, we review research that focuses on concepts that are related to, but differ from ANA. Then, we summarize individual and cultural differences in ANA and their consequences for expressions of sympathy and compassion, conceptualizations of compassion, noticing suffering (including acknowledging suffering such as systemic racism), and well‐being. Across many studies conducted in various cultural contexts including Ecuador, Mexico, China, Japan, Germany, and the United States, ANA can partly explain cultural differences in different aspects of compassion. This work has important implications for cross‐cultural counseling, anti‐racism trainings, and conflict resolution. Noticing others' suffering and understanding what compassion entails for different people in different settings can result in treating others the way they want to be treated.
Reading graphic novels: A multiliteracies approach
Authors: Lynn Claudia Baska , Sayılı‐Hurley Sibel
Published: August 2024

This paper explores graphic novels that address issues of diversity and migration and enhance multiliteracies learning in the German classroom. By adopting a multiliteracies approach, the paper proposes a transformative learning approach that explores these issues within graphic novels. Examples of learning activities from an intermediate course illustrate how graphic novels amplify marginalized voices and facilitate candid inquiries into topics like racism and colonialism. The study highlights the relevance of graphic novels in addressing evolving teaching challenges and meeting the diverse demands of education in the context of global events and calls for social justice.
Life‐threatening hemorrhage as defined by the critical administration threshold in nontraumatic critical bleeding: A descriptive observational study
Authors: Matzek Luke J. , Hanson Andrew C. , Schulte Phillip J. , Cureton Kimberly D. , Kor Daryl J. , Warner Matthew A.
Published: August 2024

Background

Evaluations of critical bleeding and massive transfusion have focused on traumatic hemorrhage. However, most critical bleeding in hospitalized patients occurs outside trauma. The purpose of this study was to provide an in‐depth description examining the critical administration threshold (CAT; ≥3 units red blood cells (RBCs) in a 1‐h period) occurrences in nontraumatic hemorrhage. This will assist in establishing the framework for future investigations in nontraumatic hemorrhage.

Methods

This is an observational cohort study of adults experiencing critical bleeding defined as being CAT+ during hospitalization from 2016 to 2021 at a single academic institution. A CAT episode started with administration of the first qualifying RBC unit and ended at the time of completion of the last allogeneic unit prior to a ≥4‐h gap without subsequent transfusion. The primary goal was to describe demographic, clinical and transfusion characteristics of participants with nontraumatic critical bleeding.

Results

2433 patients suffered critical bleeding, most often occurring in the operating room (71.1%) followed by the intensive care unit (20.8%). 57% occurred on the initial day of hospitalization, with a median duration of 138 (36, 303) minutes. The median number of RBCs transfused during the episode was 5 (4, 8), with median total allogeneic units of 9 (4, 9). Hospital mortality was 19.2%. The most common cause of death was multi‐organ failure (50.3%), however death within 24 h was due to exsanguination (72.7%).

Discussion

The critical administration threshold may be employed to identify critical bleeding in non‐trauma settings of life‐threatening hemorrhage, with a mortality rate of approximately 20%.
Modeling and Control of Strip Transport in Metal Peeling
Authors: Yalamanchili Aditya V. , Sagapuram Dinakar , Pagilla Prabhakar R.
Published: August 2024

Metal peeling refers to the process of forming a thin metal strip from the surface of a rotating feedstock using controlled material removal—machining under an applied strip tension. In this paper, the mechanics of strip formation process is described, while emphasizing the role of strip tension in ensuring uniformity and quality of the peeled strip. This includes an analysis of the deformation history in the peeling zone and the transport dynamics of the strip as it moves from the cutting edge to the coiler. Using conservation laws, governing equations for strip tension and velocity that incorporate dynamic spatiotemporal interactions between peeling and transport processes are developed. Experimental demonstration includes the setup of a lab-scale prototype metal peeling system designed to validate the proposed dynamic model describing the strip transport behavior and control approach. Peeling experiments are performed with steel to evaluate the proposed control approach. Comparisons between two control strategies, with and without tension feedback, are presented and discussed. The importance of real-time tension control for mitigating strip thickness variations and improving other dimensional features of the strip such as flatness and edge waviness is also briefly discussed.
Evolution Design of Multiple Metamorphic Mechanisms Inspired by the Concept of Assur Group
Authors: Gao Yuan , Kang Xi , Li Bing
Published: August 2024

Metamorphic mechanisms that can adapt to a variety of working conditions with distinct configurations, have gained widespread attention in recent years. However, it's always difficult to design metamorphic mechanisms with various motion branches. In this paper, the evolution design of a family of novel multiple metamorphic mechanisms is conducted by the inspiration from the concept of Assur group. Adopting some class II groups which are derived from the combination of three basic links, a novel 7R multiple metamorphic mechanism is first presented and analyzed. Kinematic analysis illustrates that the mechanism contains totally 11 motion branches including three types of effective joints, i.e., non-overconstrained 7R motion branches, overconstrained 6R motion branches, and planar 4R motion branches. Reconfiguration analysis of the mechanism is presented by the kinematic curves, and it shows that there are totally ten bifurcation points. Moreover, the transformations among all the motion branches are analyzed. Then, adopting different combinations of the elements, the evolution design of more 7R multiple metamorphic mechanisms is presented. This paper proposes a family of multiple metamorphic mechanisms which can achieve a large number of motion branches, and the construction process of the mechanisms in this paper provides a new reference for designing multiple metamorphic mechanisms.
A Novel One-Degree-of-Freedom Deployable Structure and Its Plate Form
Authors: Gao Yuan , Qi Jian , Li Lin , Zhang Jun , Yang Fufu
Published: August 2024

Deployable structures are widely utilized in various fields due to their ability to switch between a deployed working state and a folded storage state. This paper presents a new method for achieving plate forms in deployable structures, allowing the formation of closed surfaces suitable for covering purposes. Initially, a novel one-degree-of-freedom (one-DOF) deployable network is proposed, employing Bennett linkages and Bennett-based 6R linkages. Subsequently, the shape of the links in the network is modified to obtain a plate form consisting of equilateral triangular panels. The paper also conducts kinematic analysis, motion property examination, and bifurcation condition discussion to demonstrate the folding properties of the proposed mechanism. Additionally, a modified scheme is proposed to enable the structure to form a closed surface, and physical prototypes are used to validate all the results. Overall, the proposed method presents new possibilities for developing practical and versatile deployable structures with broader applications.
Gaidai Risk Evaluation Method for Lifetime Assessment for Offshore Floating Wind Turbine Gearbox
Authors: Gaidai Oleg
Published: August 2024

Renewable clean energy in some cases may be viewed as an alternative to limited fossil resources. Offshore floating wind turbines (FWTs) are among the most attractive green alternatives. However, FWTs, in particular their essential components, may sustain structural damages from cyclic loads brought on by torque, bending, longitudinal loadings, as well as twisting moments. Multibody simulation tool SIMPACK was utilized to assess structural bending moments and internal forces occurring within the FWT drivetrain during its field operation. The novel risk and damage evaluation method advocated in the current study is intended to serve contemporary FWT design, enabling accurate assessments of structural lifespan distribution, given in situ environmental/field conditions. The approach described in the current study may be utilized to analyze complex multidimensional sustainable energy systems, subjected to excessive stressors during their intended service life. Contemporary risk evaluation approaches, dealing with complex energy systems are not always well-suited for handling dynamic system's high dimensionality, aggravated by nonlinear cross-correlations between structural components, subjected to dynamic nonlinear nonstationary loadings. The current study advocates a novel general-purpose lifetime assessment methodology, having a wide area of potential engineering and design applications, not limited to offshore wind/wave renewable energy systems. Key advantages of the advocated methodology lie within its robust ability to assess damage risks of complex energy and environmental systems, with a virtually unlimited number of system components (dimensions), along with the further potential to incorporate nonlinear cross-correlations between system components in real time. Note that to the author's knowledge, there are no comparable risk evaluation methods that can deal with the system's high dimensionality, utilizing raw/unfiltered simulated/measured datasets, beyond one or two-dimensional dynamic systems—except for computationally expensive direct Monte Carlo (MC) simulations.