bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparing quality of life in women with vulvovaginal lichen planus treated with topical and systemic treatments using the vulvar quality of life index
Authors: Kherlopian Ashod , Fischer Gayle
Published: April 2023

Background/Objectives

For patients with vulvovaginal lichen planus (VLP), there exists limited data on the comparison between patient quality of life treated with topical and/or systemic treatments. We characterised the treatment outcomes of VLP using the vulvar quality of life index (VQLI) comparing women treated with systemic immunosuppression, including humanised interleukin‐23 monoclonal antibody tildrakizumab, to those treated with topical corticosteroids alone.

Methods

A retrospective cohort study is reported from a dermatology practice in Sydney, Australia. Electronic medical records for adult women with a diagnosis of VLP were reviewed identifying 112 subjects. VQLI scores in four domains (symptoms, activities of daily living, anxiety and sexual function) were compared between women able to maintain remission of disease with topical monotherapy to those with recalcitrant disease requiring treatment with conventional systemic immunosuppressants and for those not responding to this treatment, tildrakizumab.

Results

At baseline women requiring tildrakizumab treatment had the highest total VQLI score (24.6), whilst women whose disease was maintained on topical treatment had the lowest (19.2). Women treated whilst on tildrakizumab had significant reduced total mean VQLI scores (13.32, 95% CI 8.61–18.01) than when treated with other Systemic (22.00, 95% CI 16.52–27.53; p < 0.001) or topical (21.71, 95% CI 16.13–26.32; p < 0.01). Women treated with tildrakizumab demonstrated statistically significant decreases in mean VQLI scores in all four domains of the VQLI compared to previous scores when on other systemic treatments.

Conclusion

We report the largest cohort study to date of adult women with VLP evaluating treatment responses to topical and systemic agents using the VQLI. In women whose VLP did not improve with conventional systemic immunosuppressants, tildrakizumab resulted in statistically significant decrease in mean VQLI scores in all 4 domains, highlighting tildrakizumab as an alternative treatment for VLP.
Effects of land‐use changes on the conservation of re‐introduced toads, Nectophrynoides asperginis
Authors: Sigala Atuhombye , Ngongolo Kelvin , Mmbaga Naza
Published: April 2023

Land‐use and land‐cover changes (LULCC) are a global threat to biodiversity conservation including endemic species such as Kihansi spray toads (KST). This study assessed the LULCC of the Kihansi catchment (KC), a potential habitat for the KST and its adjacent areas. Remote sensing (RS) and geographical information systems (GIS) through Landsat imagery and ground truthing were used to classify and monitor LULCC for 25 years, from 1995 to 2020. In addition, the questionnaire survey assesses the opinion of local communities on LULCC forms in the study area. Settlements and agricultural land increased by 26.23% and 3.7%, respectively, while forested land decreased by a rate of 10%–20% per year due to the human population increase. According to this study, land use has changed substantially because of agriculture and habitation. Proper land‐use planning is required in this scenario to ensure the long‐term protection of the reintroduced KST while also enhancing the livelihoods of nearby residents.
Dupilumab but not cyclosporine treatment shifts the microbiome toward a healthy skin flora in patients with moderate‐to‐severe atopic dermatitis
Authors: Hartmann Jan , Moitinho‐Silva Lucas , Sander Nicole , Harder Inken , Häsler Robert , Rodriguez Elke , Haufe Eva , Kleinheinz Andreas , Abraham Susanne , Heratizadeh Annice , Weisshaar Elke , Schäkel Knut , Handrick Christiane , Augustin Matthias , Wollenberg Andreas , Staubach‐Renz Petra , Ertner Konstantin , Sticherling Michael , Schwarz Beate , Quist Sven , Wiemers Franca , Schenck Florian , Wildberger Julia , Tittmann Lukas , Lieb Wolfgang , Schmitt Jochen , Werfel Thomas , Weidinger Stephan ,   the TREATgermany Study Group
Published: April 2023

Background

Atopic dermatitis (AD) patients display an altered skin microbiome which may not only be an indicator but also a driver of inflammation. We aimed to investigate associations among AD patients' skin microbiome, clinical data, and response to systemic therapy in patients of the TREATgermany registry.

Methods

Skin swabs of 157 patients were profiled with 16S rRNA gene amplicon sequencing before and after 3 months of treatment with dupilumab or cyclosporine. For comparison, 16s microbiome data from 258 population‐based healthy controls were used. Disease severity was assessed using established instruments such as the Eczema Area and Severity Index (EASI).

Results

We confirmed the previously shown correlation ofStaphylococcus aureusabundance and bacterial alpha diversity with AD severity as measured by EASI. Therapy with Dupilumab shifted the bacterial community toward the pattern seen in healthy controls. The relative abundance of Staphylococci and in particularS. aureussignificantly decreased on both lesional and non‐lesional skin, whereas the abundance ofStaphylococcus hominisincreased. These changes were largely independent from the degree of clinical improvement and were not observed for cyclosporine.

Conclusions

Systemic treatment with dupilumab but not cyclosporine tends to restore a healthy skin microbiome largely independent of the clinical response indicating potential effects of IL‐4RA blockade on the microbiome.
Ciliary neurotrophic factor stimulates stem/progenitor Leydig cell proliferation but inhibits differentiation into its lineage in rats
Authors: Quan Hehua , Wang Yiyan , Li Huitao , Zhu Qiqi , Chen Xiaofang , Ge Ren‐Shan , Li Xiaoheng
Published: April 2023

Background

Ciliary neurotrophic factor is a member of the interleukin‐6 family of cytokines. Ciliary neurotrophic factor drives many cells for their development. However, its effects on Leydig cell development remain unclear.

Methods

In the current study, we used three‐dimensional seminiferous tubule culture system to induce the proliferation and differentiation of tubule‐associated stem Leydig cells and primary progenitor Leydig cells culture to address the effects of ciliary neurotrophic factor.

Results

We found that ciliary neurotrophic factor stimulated the proliferation of stem Leydig cells but inhibited their development into the Leydig cell lineage. The ciliary neurotrophic factor‐mediated effects can be reversed by signal transducer and activator 3 inhibitor S3I‐201 and phosphatidylinositol 3‐kinase inhibitor wortmannin, indicating that ciliary neurotrophic factor acts via signal transducer and activator 3–phosphatidylinositol 3‐kinase signaling pathways to increase stem/progenitor Leydig cell proliferation. Ciliary neurotrophic factor at 1 and 10 ng/mL significantly decreased androgen production by progenitor Leydig cells. Microarray analysis of ciliary neurotrophic factor‐treated progenitor Leydig cells showed that ciliary neurotrophic factor blocked steroidogenic pathways by downregulating Scarb1, Star, and Hsd3b1, possibly by downregulating the transcription factor Nr5a1 expression.

Conclusion

Ciliary neurotrophic factor stimulates proliferation but blocks the differentiation of stem/progenitor Leydig cells.
In vitro hemolytic performance of the Realheart®V11C TAHprototype with porcine blood
Authors: Perkins Ina Laura , Mansisidor Eva Maria , Zaman Shaikh Faisal , Mudge Kyle , Bodger Owen , Najar Azad
Published: April 2023

Background

Hemolysis testing of new devices to treat heart failure is a regulatory requirement. The ASTM F1841–97 standard for hemolysis testing was developed for continuous flow pumps and does not specify test rig design. When research groups use different methodologies, results are difficult to compare. Pulsatile flow pump rigs require compliance chambers, and thus, the Aachen rig (Gräf et al) was developed for the pulsatile Reinheart TAH. The study objective was to use this rig to test the early Realheart TAH prototype V11C hemolysis performance compared to literature.

Methods

The experimental control was the continuous flow pump BPX‐80 (Medtronic) and pooled heparinized porcine blood was used.

Results

The mgNIH of BPX‐80 and V11C was 5.42 ± 1.47 and 25.20 ± 5.46 mg/100 L, respectively. The NIH ratio of V11C over BPX‐80 was 5.5.

Conclusion

The absolute and the relative hemolysis of the V11C are lower compared to both the large and small Reinheart TAH devices published values. Pulsatile pumps create more hemolysis in the Aachen rig, and it is not known if this is because how the rig handles pulsatile flow or due to the devices. Future studies will, therefore, use a pulsatile pump such as the SynCardia as clinical comparator and human blood to test the performance of future Realheart TAH prototypes.
Metacognitive prompts and numerical ordinality in solving word problems: An eye‐tracking study
Authors: Kang Tinghu , Tang Tinghao , Zhang Peizhi , Luo Shu , Qi Huanhuan
Published: April 2023

Background

The ability to translate concrete manipulatives into abstract mathematical formulas can aid in the solving of mathematical word problems among students, and metacognitive prompts play a significant role in enhancing this process.

Aims

Based on the concept of semantic congruence, we explored the effects of metacognitive prompts and numerical ordinality on information searching and cognitive processing, throughout the process of solving mathematical word problems among primary school students in China.

Sample

Participants included 73 primary school students (38 boys and 35 girls) with normal or corrected visual acuity.

Methods

This study was based on a 2 (prompt information: no‐prompt, metacognitive‐prompt) × 2 (number attribute: cardinal number, ordinal number) mixed experimental design. We analysed multiple eye‐movement indices, such as fixation duration, saccadic amplitude, and pupil size, since they pertained to the areas of interest.

Results

When solving both types of problems, pupil sizes were significantly smaller under the metacognitive‐prompt condition compared with the no‐prompt condition, and shorter dwell time for specific sentences, conditional on metacognitive prompts, indicated the optimization of the presented algorithm. Additionally, the levels of fixation durations and saccadic amplitudes were significantly higher when solving ordinal number word problems compared with solving ordinal number problems, indicating that primary school students were less efficient in reading and faced increased levels of difficulty when solving ordinal number problems.

Conclusions

The results indicate that for Chinese upper‐grade primary school students, cognitive load was lower in the metacognitive prompting condition and when solving cardinal problems, and higher when solving ordinal problems.
Imported carbon emissions: Evidence from French manufacturing companies
Authors: Dussaux Damien , Vona Francesco , Dechezleprêtre Antoine
Published: April 2023

This paper analyzes imported carbon emission at the firm level. To do so, we combine information on emissions, imports, imported emissions and energy prices for French manufacturing firms between 1997 and 2014. We document a significant increase of the carbon emissions embedded in imports of French manufacturing companies over the period 1997 to 2014 that is attributable mainly to a shift towards more carbon‐intensive products and countries. We then estimate the impact of imported emissions on domestic emissions and emission intensity using a shift‐share instrumental variable strategy based on third countries supply shocks. We do not find compelling evidence of an impact of carbon imports on total emissions, but emission efficiency improves significantly in companies offshoring emissions abroad. A 10% increase in carbon offshoring causes a 4% decline in emission intensity. In addition, we find that the elasticity of domestic emission intensity to imported emissions is stronger in energy‐intensive sectors, on high‐productivity companies and among exporters. Reassuringly, the relationship between imported emissions and emission intensity does not seem to be driven by a pollution haven motive.
Elevated insulin‐like growth factor‐1 in patients without clinical evidence of acromegaly
Authors: Careless Laura , Inder Warrick J. , Pretorius Carel , Hayes Lisa
Published: April 2023

Objectives

To (1) identify the frequency of IGF‐1 elevation in a cohort of patients without clinically suspected GH excess, in a state‐based reference laboratory over a 24‐month period, and (2) to examine potential differences in comorbidities and relevant medications between people with an elevated IGF‐1 compared to a matched control group.

Design

All IGF‐1 measurements at Pathology Queensland between 1/12/2018–1/12/2020 were identified. The medical records of those with IGF‐1 ≥1.1x the upper limit of the reference range were appraised to determine: (1) documentation of acromegalic features, (2) relevant comorbidities and medication use, and (3) further investigations to exclude pathological GH excess.

Patients and Measurements

There were 2759 IGF‐1 samples measured in 1963 people ≥18 years, over the specified period. Of these, 204 had IGF‐1 ≥1.1x the upper limit of the age‐matched reference range; 102 cases (61M, 41F) met inclusion criteria, and were matched to 102 controls with a normal IGF‐1 based on age, sex, gonadal status and pituitary anatomy on MRI.

Results

There were significant differences in the frequency of dopamine agonist use (19/102 cases vs. 6/102 controls, OR = 3.66, 95% confidence interval [CI]: 1.45–9.29, p = .009) and chronic kidney disease (CKD) (14/102 cases vs. 4/102 controls, OR = 3.90, 95% CI: 1.28–11.14, p = .024).

Conclusions

Out of 1963 patients having IGF‐1 measured, 102 (5.2%) had an elevated IGF‐1 where there was no known acromegaly, GH replacement or endogenous glucocorticoid excess. Intraindividual biological variability, assay imprecision and physiological factors are known contributors to falsely elevated IGF‐1, dopamine agonist therapy and CKD should also be considered.
Enforcing Trust: Race, gender, and the policing of citizenship in Rio de Janeiro
Authors: Haynes Marta‐Laura
Published: April 2023

Policing in Rio de Janeiro is notorious for its brutality. For Unidades da Policía Pacificadora (UPP), a proximity policing program marked by less overt violence, the forging of trust became a strategy for reshaping the image of police and favelas. Yet, this policing model reproduced racial and gender bias that was persistent in broader Brazilian society where trust is coded as white and female while danger is coded as Black and male. In UPP, these ideologies manifested in using lighter‐skinned and female officers to produce trust through whiteness and gender. For residents, pacification underscored a longstanding racial encoding of citizenship and trust as performances of whiteness and belonging. Based on fieldwork conducted between 2010 and 2015 among the military police and in favelas, I examine in this article how Brazilian ideologies of race and gender intersect with local notions about trustworthiness and class. For the UPPs, enforcing trust was attached to the expectation of submission and uniformity—ultimately strengthening white supremacy. Through intimate ethnographic accounts of commanders' and residents' experiences, I show the nuanced ways trust intersects with local ideas about race and gender and how it served both as a vehicle for pacification and as a mode of citizenship.
Efficacy and safety of Propionibacterium extract gel versus glyceryl trinitrate ointment in the treatment of chronic anal fissure: a randomized controlled trial
Authors: Gallo Gaetano , Trompetto Mario , Fulginiti Serena , La Torre Marco , Tierno Simone , Cantarella Francesco , Vanini Paolo , Tomasicchio Giovanni , Altomare Donato Francesco , Rinaldi Marcella , Santoro Giulio Aniello , Currò Giuseppe , Grossi Ugo
Published: April 2023

Aim

Chronic anal fissure (CAF) is an extremely frequent finding in clinical practice. Several topical agents have been proposed for its treatment with the common goal of increasing anodermal blood flow to promote healing. The aim of this study was to compare the efficacy and safety of a Propionibacterium extract gel (PeG) and 0.4% glyceryl trinitrate ointment (GTN) in patients with CAF.

Method

Patients were randomly allocated to a PeG or GTN group and medication was administered every 12 h for 40 days. The primary outcome was the success rate, as measured by a decrease in the REALISE scoring system for anal fissure at 10, 20 and 40 days after initiating either treatment. The secondary outcomes recorded at the same time points were healing rate, visual analogue scales for itching and burning, rate of complications and adverse events, patient quality of life and satisfaction, and cost analysis.

Results

A total of 120 patients were enrolled, and 96 patients (PeG, n = 53; GTN, n = 43) completed the primary outcomes. A significant decrease over time in the REALISE score was observed in both groups. Adverse events occurred more frequently in the GTN group than in the PeG group, peaking at visit 1 [37 (63.8%) vs. 2 (3.4%), respectively], with headache being the most prevalent. The between‐treatment cumulative average costs per patient were significantly higher for GTN than that for PeG at each follow‐up visit. There were no other significant differences between the two groups for any of the other outcomes.

Conclusion

While there was no difference in healing rates between the two treatments, PeG was more cost‐effective and associated with fewer adverse events.
Comparison of two donor‐derived cell‐free DNA tests and a blood gene‐expression profile test in heart transplantation
Authors: Rodgers Nicholas , Gerding Bryn , Cusi Vincenzo , Vaida Florin , Tada Yuko , Morris Gerald P. , Adler Eric D. , Stehlik Josef , Kim Paul J.
Published: April 2023

Background

Donor‐derived cell‐free DNA (dd‐cfDNA) testing is an emerging screening modality for noninvasive detection of acute rejection (AR). This study compared the testing accuracy for AR of two commercially available dd‐cfDNA and gene‐expression profiling (GEP) testing in heart transplant (HTx) recipients.

Methods

This is a retrospective, observational study of HTx only patients who underwent standard and expanded single nucleotide polymorphism (SNP) dd‐cfDNA between October 2020 to January 2022. Comparison with GEP was also performed. Assays were compared for correlation, accurate classification, and prediction for AR.

Results

A total of 428 samples from 112 unique HTx patients were used for the study. A positive standard SNP correlated with the expanded SNP assay (p < .001). Both standard and expanded SNP tests showed low sensitivity (39%, p = 1.0) but high specificity (82% and 84%, p = 1.0) for AR. GEP did not improve sensitivity and showed worse specificity (p < .001) compared to standard dd‐cfDNA.

Conclusion

We found no significant difference between standard and expanded SNP assays in detecting AR. We show improved specificity without change in sensitivity using dd‐cfDNA in place of GEP testing. Prospective controlled studies to address how to best implement dd‐cfDNA testing into clinical practice are needed.
Disasters and the diminishing of women's economic empowerment
Authors: Kreutzer Willow , Millerd Carly , Timbs Nathan
Published: April 2023

This paper examines, both theoretically and empirically, the relationship between rapid‐onset disasters and women's economic freedom. Rapid‐onset disasters create difficulties for all involved, but without proper discussion of and changes to women's economic status in society, they will continue to suffer disproportionately. The study answers the following question: ‘how do disasters impact women's economic empowerment?‘. It argues that there are underlying factors contributing to unequal economic opportunities that are exacerbated by disasters. Current literature discusses how disasters affect women's economic and political rights, but often it does not account for variables that may not have been captured in contemporary indices. The paper assesses women's burden of care, restrictions on mobility, formal economic employment, and access to recovery resources with respect to their economic empowerment. And it analyses 180 countries and territories that experienced disasters between 1981 and 2019 to uncover their effects on women's economic freedom. This research could facilitate and help to alter the overall narrative on women's empowerment.
Observations on the utilisation of a restored wildlife corridor by echo‐locating microbats in North Queensland's Wet Tropics
Authors: Tucker Nigel , Ford Greg
Published: April 2023

Microbat studies are uncommon in the Wet Tropics of north‐east Queensland, despite the group comprising 20% of the bioregion's mammal fauna. The significance of fragmentation and habitat connectivity to the echolocating insectivore group is unknown. Over a 12‐month period in 2021–2022, microbat presence was recorded in a 25‐year‐old restored wildlife corridor 1.2 km in length. We deployed Anabat detectors in the restored corridor, in adjacent open paddocks and in mature rainforest at either end of the corridor. Species in reference forest and corridor vegetation were consistently ‘clutter‐adapted’ bats, with low aspect ratio wings; there was little overlap with high aspect ratio species of the open pasture. Low aspect ratio microbats appear to respond to the similarity in structure between restored and adjacent natural vegetation. Re‐establishing structural and functional connectivity may improve the local persistence of ‘clutter‐adapted’ microbats.
Coarse pine bark mulch as open surface cover fails to improve establishment of sown native grasslands
Authors: Gibson‐Roy Paul , Delpratt John , Moore Greg
Published: April 2023

This study was conducted across twelve agricultural locations in south‐western Victoria, Australia, encompassing a range of soil types and climatic conditions. It investigated the addition of an open layer of coarse organic pine wood chip mulch (~70% surface cover) directly following direct seeding of native grassland species. The intent was to mimic positive effects of naturally occurring organic surface litter (which are typically depleted in such settings) on seedling emergence and establishment. Findings revealed negative results in that the use of an open layer of coarse pine chip mulch failed to improve native establishment at 12‐months or to moderate soil temperature and moisture extremes in comparison to non‐mulched plots. This outcome suggests the effectiveness of open surface mulches under the scenario of direct seeding may be highly site context, mulch‐type, and application approach dependent. In situations where such mulch applications are not likely to be beneficial, significant costs relating to their purchase and application could be avoided.
Changes in local and network brain activity after stereotactic thermocoagulation in patients with drug‐resistant epilepsy
Authors: Simula Sara , Garnier Elodie , Contento Margherita , Pizzo Francesca , Makhalova Julia , Lagarde Stanislas , Bénar Christian‐George , Bartolomei Fabrice
Published: April 2023

Objective

Stereoelectroencephalography‐guided radiofrequency thermocoagulation (SEEG‐guided RF‐TC) aims to reduce seizure frequency by modifying epileptogenic networks through local thermocoagulative lesions. Although RF‐TC is hypothesized to functionally modify brain networks, reports of changes in functional connectivity (FC) following the procedure are missing. We evaluated, by means of SEEG recordings, whether variation in brain activity after RF‐TC is related to clinical outcome.

Methods

Interictal SEEG recordings from 33 patients with drug‐resistant epilepsy (DRE) were analyzed. Therapeutic response was defined as a >50% reduction in seizure frequency for at least 1 month following RF‐TC. Local (power spectral density [PSD]) and FC changes were evaluated in 3‐min segments recorded shortly before (baseline), shortly after, and 15 min after RF‐TC. The PSD and FC strength values after thermocoagulation were compared with baseline as well as between the responder and nonresponder groups.

Results

In responders, we found a significant reduction in PSD after RF‐TC in channels that were thermocoagulated for all frequency bands (p = .007 for broad, delta and theta, p <.001 for alpha and beta bands). However, we did not observe such PSD decrease in nonresponders. At the network level, nonresponders displayed a significant FC increase in all frequency bands except theta (broad, delta, beta band: p <.001; alpha band: p <.01), although responders showed a significant FC decrease in delta (p <.001) and alpha bands (p <.05). Nonresponders showed stronger FC changes with respect to responders exclusively in TC channels (broad, alpha, theta, beta: p >.05; delta: p = .001).

Significance

Thermocoagulation induces both local and network‐related (FC) changes in electrical brain activity of patients with DRE lasting for at least 15 min. This study demonstrates that the observed short‐term modifications in brain network and local activity significantly differ between responders and nonresponders and opens new perspectives for studying the longer‐lasting FC changes after RF‐TC.
Topical emollient prevents the development of atopic dermatitis and atopic march in mice
Authors: Zhang Jiayi , Xu Xintian , Wang Xiaopan , Zhang Li , Hu Mengyan , Le Yunchen , Chen Lihong , Zheng Jie
Published: April 2023

To investigate the effect of emollient on atopic march in a murine model of atopic dermatitis (AD). Following induction of AD with topical calcipotriol (MC903) and ovalbumin (OVA), one group of mice was treated topically with a linoleic acid‐ceramide‐containing emollient, while mice without emollient treatment served as disease controls. After 28 days, clinical, histological and transcriptomic analyses were performed in the skin lesions and the lung as well as serum cytokine levels. Treatments of mice with MC903 and OVA induced a typical phenotype of AD, accompanied by increased expression levels of Th2 and basophil‐related genes in the lung. Topical emollients markedly decreased the severity of skin lesions and inflammatory cell infiltration. Moreover, emollient treatments significantly downregulated expression levels of AD‐related genes (286 of 1450 differentially expressed genes), including those related to innate inflammation (S100a8/a9, Il1b, Defb3/6, Mmp12), chemokines (Cxcl1/3, Ccl3/4) and epidermal permeability barrier (Krt2/6b/80, Serpinb12, Lce3e, Sprr2), etc. Downregulated genes were enriched in mitochondrial OXPHOS‐related pathways, while upregulated genes were mainly enriched in axon guidance and tight junctions. Moreover, topical emollient treatments decreased total serum levels of IL‐4, along with substantial reductions in IgE and thymic stromal lymphopoietin (TSLP) levels. Furthermore, 187 of 275 upregulated genes in lung tissue were also significantly downregulated, including those involved in leucocyte chemotaxis (Ccl9, Ccr2, Retnlg, Ccl3, Cxcl10, Il1r2, etc.) and basophil activation (Mcpt8, Cd200r3, Fcer1a, Ms4a2). In conclusion, topical emollient not only reduces skin inflammation, but also mitigates systemic inflammation by decreasing TSLP and IgE levels. Moreover, topical emollient reduces chemokine production and basophil infiltration and activation in the lung.
The unexpected long period of elevated CH4 emissions from an inundated fen meadow ended only with the occurrence of cattail (Typha latifolia)
Authors: Antonijević Danica , Hoffmann Mathias , Prochnow Annette , Krabbe Karoline , Weituschat Mirjam , Couwenberg John , Ehlert Sigrid , Zak Dominik , Augustin Jürgen
Published: April 2023

Drainage and agricultural use transform natural peatlands from a net carbon (C) sink to a net C source. Rewetting of peatlands, despite of high methane (CH4) emissions, holds the potential to mitigate climate change by greatly reducing CO2 emissions. However, the time span for this transition is unknown because most studies are limited to a few years. Especially, nonpermanent open water areas often created after rewetting, are highly productive. Here, we present 14 consecutive years of CH4 flux measurements following rewetting of a formerly long‐term drained peatland in the Peene valley. Measurements were made at two rewetted sites (non‐inundated vs. inundated) using manual chambers. During the study period, significant differences in measured CH4 emissions occurred. In general, these differences overlapped with stages of ecosystem transition from a cultivated grassland to a polytrophic lake dominated by emergent helophytes, but could also be additionally explained by other variables. This transition started with a rapid vegetation shift from dying cultivated grasses to open water floating and submerged hydrophytes and significantly increased CH4 emissions. Since 2008, helophytes have gradually spread from the shoreline into the open water area, especially in drier years. This process was periodically delayed by exceptional inundation and eventually resulted in the inundated site being covered by emergent helophytes. While the period between 2009 and 2015 showed exceptionally high CH4 emissions, these decreased significantly after cattail and other emergent helophytes became dominant at the inundated site. Therefore, CH4 emissions declined only after 10 years of transition following rewetting, potentially reaching a new steady state. Overall, this study highlights the importance of an integrative approach to understand the shallow lakes CH4 biogeochemistry, encompassing the entire area with its mosaic of different vegetation forms. This should be ideally done through a study design including proper measurement site allocation as well as long‐term measurements.
Exploring the attitudes of general dental practitioners to providing dietary advice alongside oral rehabilitation for older adults
Authors: O’Kane Ruairí , Watson Sinead , Woodside Jayne , McKenna Gerald J.
Published: April 2023

Objective

We aimed to capture General Dental Practitioners' (GDPs) views on delivering dietary advice to older adults in combination with treatment to replace missing teeth and identify solutions to help inform the development and implementation of future dietary interventions within primary dental care.

Background

As natural teeth are lost, older adults may need to choose softer, more manageable foods which might be of lower nutrient density. Previous research has indicated that prosthodontic rehabilitation can improve masticatory function but not the intake of nutrients, highlighting a potential need for a combined approach of oral rehabilitation and dietary counselling.

Materials and Methods

Semi‐structured telephone interviews were conducted with a purposive sampling strategy of 12 GDPs. Interviews were digitally recorded and transcribed verbatim. An iterative coding process using theme‐analytic methods was used.

Results

Twelve interviews were conducted with GDPs in the United Kingdom. The themes that emerged from the interviews included: the awareness of the importance of dietary advice among GDPs; the concerns GDPs had on patients' adherence to dietary advice; uncertainty over roles and responsibilities in the provision of dietary advice; and the limited time and remuneration for dietary advice in dental practice. A minor theme identified was the motivation of GDPs to implement dietary advice alongside oral rehabilitation. All reported that they were already providing dietary advice to their patients but that this was limited to caries prevention.

Conclusion

The GDPs interviewed expressed positive attitudes towards providing dietary advice alongside oral rehabilitation for older adults. However, a lack of confidence, awareness, time and remuneration are barriers to its provision in primary dental care. To facilitate the implementation of dietary advice alongside oral rehabilitation, clear guidance on and training in delivering dietary advice and multidisciplinary cooperation are required.
A review of the utility of prognostic tools in predicting 6‐month mortality in cancer patients, conducted in the context of voluntary assisted dying
Authors: Treleaven Lydia , Komesaroff Paul , La Brooy Camille , Olver Ian , Kerridge Ian , Philip Jennifer
Published: April 2023

Background

Eligibility to access the Victorian voluntary assisted dying (VAD) legislation requires that people have a prognosis of 6 months or less (or 12 months or less in the setting of a neurodegenerative diagnosis). Yet prognostic determination is frequently inaccurate and prompts clinician discomfort. Based on functional capacity and clinical and biochemical markers, prognostic tools have been developed to increase the accuracy of life expectancy predictions.

Aims

This review of prognostic tools explores their accuracy to determine 6‐month mortality in adults when treated under palliative care with a primary diagnosis of cancer (the diagnosis of a large proportion of people who are requesting VAD).

Methods

A systematic search of the literature was performed on electronic databases Medline, Embase and Cinahl.

Results

Limitations of prognostication identified include the following: (i) prognostic tools still provide uncertain prognoses; (ii) prognostic tools have greater accuracy predicting shorter prognoses, such as weeks to months, rather than 6 months; and (iii) functionality was often weighted significantly when calculating prognoses. Challenges of prognostication identified include the following: (i) the area under the curve (a value that represents how well a model can distinguish between two outcomes) cannot be directly interpreted clinically and (ii) difficulties exist related to determining appropriate thresholds of accuracy in this context.

Conclusions

Prognostication is a significant aspect of VAD, and the utility of the currently available prognostic tools appears limited but may prompt discussions about prognosis and alternative means (other than prognostic estimates) to identify those eligible for VAD.
An agronomic study of legacy effects from annual legume pastures in acid soils
Authors: Kidd Daniel , Premaratne Manjula , Wisdom Joanne , Nicol Dion , Ryan Megan H.
Published: April 2023

The use of acid soil‐tolerant annual legume pasture species and liming to raise soil pH can have legacy effects that improve subsequent wheat crop growth in acid soils. We established a two‐year experiment in a semi‐arid environment with and without historical lime application to investigate how acid soils (±lime) influence the legacy effects of annual legume pastures. We measured legume and cereal growth and yield, soil‐borne disease incidence, rhizosheath organic acid type and amount, legume biological nitrogen fixation (BNF) and soil moisture in Year 1, and soil microbial biomass carbon (MBC) and wheat yield and quality in Year 2. Minor differences in soil moisture and soil‐borne diseases occurred between cereals and legumes, and the poor BNF contribution of all pasture legumes improved in lime treatments. Pasture legumes produced more organic acids than cereals, which increased in limed treatments. Soil MBC in Year 2 was greater following legumes than cereals. Year 2 wheat grain yield increased following pasture legumes, more so in limed treatments. The contribution of organic acid exudation by annual legume pastures to microbial community legacy effects warrants further scrutiny in semi‐arid environments, particularly when acid soils limit typical rotational benefits.
Irritability and rejection‐elicited aggression in adolescents and young adults
Authors: Quarmley Megan , Vafiadis Athena , Jarcho Johanna M.
Published: April 2023

Background

Violence exacts staggering personal and financial costs – a burden disproportionally born by adolescents and young adults. This may be partially due to an increased sensitivity to social rejection during this critical phase of development. Irritability, a transdiagnostic symptom, is often elicited by social interactions. Yet, little is known about age differences in social rejection‐elicited aggression and irritability. Progress toward testing such relations has been hindered by a lack of ecologically‐valid tasks that enable the measurement of in‐the‐moment social rejection‐elicited aggression.

Methods

In this paper, we describe an initial study of young adults (n = 55) that demonstrates the efficacy of a novel Virtual School and Aggression Paradigm (VS‐AP). Next, we replicate these results in a second study of adolescents and young adults (ages 11–25 years; n = 173) and examine relations between social rejection‐elicited aggression, irritability, and age.

Results

We found that aggressive behavior in the VS‐AP differed for accepting, rejecting, and unpredictable peer types (Study 1: F(2, 108) = 20.57, p < .001, ε2 = .28; Study 2: F(2, 344) = 152.13, p < .001, ε2 = .47), demonstrating that the VS‐AP successfully models social rejection‐elicited aggression. In Study 2, age was negatively correlated with aggressive behavior (r = −.29, p < .001) and irritability (r = −.28, p < .001), while irritability was positively correlated with aggressive behavior (r = .28, p < .001). Age moderated the relation between social rejection‐elicited aggression and irritability. Specifically, irritability was more predictive of aggression in young adults than in adolescents (F(3, 167) = 7.07, p < .001).

Conclusions

Data suggest mechanisms promoting rejection‐elicited aggression may differ across development and vary for those with and without high levels of irritability. The VS‐AP is a promising tool for probing neurocognitive, developmental, and clinically relevant mechanisms underlying social rejection‐elicited aggression.
Considering pharmacoequity when deprescribing potentially inappropriate medications
Authors: Sloan Caroline E. , Hung Anna
Published: April 2023

This editorial comments on the article by Niznik et al. in this issue.
Psychopharmacology attitudes, beliefs, and practices among systemic family therapists and supervisors
Authors: Jones Adam C. , Robinson W. David , Delbridge Emilee J. , Brown Braden J. , McPhee Douglas P.
Published: April 2023

Many aspects of systemic family therapist (SFT) training and competence play a vital role in effective treatment and professional satisfaction. One area that has been significantly overlooked by many SFTs is the role of psychotropic medication (PM) in conjunction with talk therapy for optimal mental health outcomes. This study explores the current status of PM in SFT training and clinical practice. Our findings highlight the continued struggle of SFTs in their comfort level with addressing the PM needs of their clients. We identified a perceived inadequacy of SFT training and supervision regarding PM use. SFTs around the world need to find educational opportunities to improve their competence in working with their clients and their prescribed medications. Additional studies need to be conducted on strategies and mechanisms to improve client care. If SFTs are ignorant of PM, their treatment of clients—who often use PM—will be compromised.
The scrotum: A comparison of men's and women's aesthetic assessments
Authors: Albrecht Paula , Eimer Carolin , Kasten Erich
Published: April 2023

Background

Cosmetic surgery is a growing trend. Opportunities for an individual to attain their personal aesthetic ideal via plastic surgery have now extended as far as the genital area. Adaptive surgery on intimate areas of the body may take place for physical complaints, but may instead be due to a desire to conform to a particular ideal. Breast operations, labia reductions, and penis lengthening are long‐established interventions, the motives for which a number of previous studies have examined. Tightening of the scrotum, by contrast, is a new trend in the aesthetic surgery market. Notwithstanding its rapid increase, studies have yet to investigate aesthetic preferences as regards the scrotum.

Aims

Accordingly, the aim of the present study is to compare men's and women's evaluation of various sizes of scrotum, to the end of assisting people opting to undergo this procedure in taking decisions on their visual preferences.

Material and Methods

The participants in this study rated a number of photographs of scrotums, in nine different lengths and widths, and completed a questionnaire whose aim was to determine whether assessments differed by gender. Further, we considered whether the variables of age, extraversion, openness to experience, and consumption of pornography influenced participants' evaluations.

Results

We found no significant differences in evaluation of the aesthetic of scrotums in relation to any of these personality traits. The results show what sizes (lengths and widths) of scrotum the participants judged to be the most and least attractive.

Discussion

The esthetics of the scrotum is little explored. In this study, only normal deviations were considered, i.e. within one standard adjustment. Further studies should consider extremes.

Conclusion

Ultimately, it was barely possible to identify a “beautiful” scrotum; we must instead speak of the least ugly.
Additional diagnostic value of CNV‐seq over conventional karyotyping in prenatal diagnosis: A systematic review and meta‐analysis
Authors: Luo Heng , Wang Qian , Fu Dan , Gao Jun , Lu Dan
Published: April 2023

Objective

To identify the additional diagnostic value of CNV‐seq over conventional karyotyping on the part of chromosomal abnormalities in prenatal diagnosis.

Method

This was a systematic review conducted in accordance with PRISMA criteria. In order to clarify related research, PubMed, Web of Science databases (including Core Collection, BIOSIS Previews, MEDLINE, and so on), The Cochrane Library and Wiley Online Library were searched with the terms: “prenatal diagnosis,” “CNV‐seq,” “karyotyping,” published from January 2010 to May 2022. No language restrictions. RenMan 5.4 was used for the meta‐analysis.

Results

Eight studies were included in this systemic review and meta‐analysis, including 11 091 pregnant women with high‐risk pregnancy factors or with structurally abnormal fetus under ultrasound. CNV‐seq detected a 2% (95% CI, −0% to 4%) additional chromosomal anomalies over conventional karyotyping in the six series. A 4% (95% CI, 3%–6%) pooled mean incremental yield of pathogenic CNVs by CNV‐seq over karyotyping was observed, with a 1%–16% range.

Conclusion

CNV‐seq, applied in prenatal diagnosis, may detect more chromosomal abnormalities when compared with karyotyping. With the advantages of wide coverage, high throughput, high resolution, no culture, good compatibility, and adjustable sequencing depth, CNV‐seq has high application value in prenatal diagnosis.
The role of aviation networks for urban development
Authors: Cristea Anca D.
Published: April 2023

City officials are continuously working to attract airlines willing to fly to new destinations. The inherent expectation is that a more extensive aviation network stimulates economic growth. This paper investigates empirically the causal implication of this hypothesis. Using data on nonstop flights by origin and destination over the period 1984–2013, we propose a new measure for a metropolitan area's connectivity to the national aviation network. We then use this measure to investigate its contribution to local economic development, as captured by the growth in population, in total employment, in per‐capita income, and new firm entry. To ensure causality, we use instrumental variable methods that exploit geography and destination airports growth as a way to capture the exogenous variation in the likelihood to add new travel routes. Our results suggest that a metropolitan area's air connectivity, resulting from an expansive local aviation network, has a positive effect on population, on employment and on the number of businesses established in that location.
Effectiveness of 2‐dimensional shear wave elastography for noninvasive and reliable estimation of right atrial pressure in dogs with induced volume overload
Authors: Tamura Masahiro , Ohta Hiroshi , Osuga Tatsuyuki , Takiguchi Mitsuyoshi
Published: April 2023

Background

Two‐dimensional shear wave elastography (2D‐SWE) provides information on hepatic elastic modulus as shear wave velocity (SWV).

Hypothesis/Objectives

To assess SWV using 2D‐SWE in dogs with induced volume overload, investigate the relationship between this information and right atrial pressure (RAP) measured by invasive right heart catheterization, and also evaluate the difference in SWV before and after diuretic administration.

Animals

Six healthy beagles.

Methods

Prospective experimental study. Right heart catheterization and 2D‐SWE were performed in 6 anesthetized beagles at baseline and after the induction of volume overload. Volume overload was induced by IV hydroxyethyl starch 70/0.5 infusion (100 mL/kg/h). Furosemide (4‐6 mg/kg, IV) was administered, and the SWVs were measured.

Results

Shear wave velocity showed a significant gradual increase during acute volume overload compared to baseline. SWV was significantly positively correlated with RAP (P < .0001, ρ = 0.9729). The area under the curve of SWV to predict RAP at >10, >15, and >20 mm Hg was 0.9896 (95% confidence interval [95% CI], 0.9690‐1.000), 0.9907 (95% CI, 0.9701‐1.000), and 0.9722 (95% CI, 0.9280‐1.000), respectively. The SWV after diuretic use decreased significantly.

Conclusions and Clinical Importance

Two‐dimensional shear wave elastography might be useful for noninvasive and reliable estimation of RAP in dogs with acute volume overload and has potential as a quantitative biomarker for evaluating therapeutic response in dogs with right sided congestive heart failure.
Toll‐like receptor 7 agonist, GS‐986, is an immune‐stimulant inducing follicular helper T cells and expanding HBs antigen‐specific B cells in vitro
Authors: Mori Taizo , Yoshio Sachiyo , Yoshikawa Shiori , Tsustui Yuriko , Sakata Toshihiro , Yoshida Yuichi , Sakamoto Yuzuru , Kawai Hironari , Osawa Yosuke , Yamazoe Taiji , Aoki Yoshihiko , Fletcher Simon P. , Kanto Tatsuya
Published: April 2023

Backgrounds and Aims

Toll‐like receptor (TLR) agonists have been developed as adjuvants to efficiently induce antiviral immune responses. Specificity and potency of these compounds are essential requirements for clinical trial applications. In patients with hepatitis B virus (HBV) infections, sustained loss of hepatitis B surface antigen (HBsAg) is a therapeutic goal, which may be achievable by the sequential activation of follicular helper T cells (Tfh) and antibody‐secreting B cells. We aimed to elucidate whether novel TLR7 agonist, GS‐986, could activate immune responses involved in HBV elimination.

Methods

To clarify the impact of GS‐986 on pDCs, we quantified the expression levels of surface markers and evaluated for Tfh induction in a culture model consisting of human pDCs with allogeneic naïve CD4+ T cells. In addition, we examined whether GS‐986 could enhance HBs antibody production capacity using PBMC from CHB patients.

Results

pDCs from CHB patients had lower OX40L expression and as well as impaired capacity for Tfh induction compared with those from healthy donors. However, GS‐986–stimulated pDCs from CHB patients expressed OX40L and produced IL‐6 and IL‐12, resulting in the induction of IL‐21–producing Tfh cells (CXCR5+PD‐1+CD4+) from naïve CD4+ T cells. The Tfh‐inducing capacity of GS‐986 was reduced in the presence of an anti‐OX40L blocking antibody. Furthermore, GS‐986 promoted HBsAg‐specific antibody production in PBMCs from CHB patients.

Conclusions

GS‐986 is an adjuvant that stimulates pDCs to induce Tfh differentiation and antigen‐specific B‐cell production. This immune profile may be beneficial for therapeutic application as an immune modulator in CHB patients.