bluuebunny/crossref_metadata_2025 huggingface dataset:
Perspectives from persons living with dementia and their caregivers on emergency department visits, care transitions, and outpatient follow‐up: A qualitative study
Authors: McHugh Megan C. , Muschong Kayla M. , Bradley Sara M. , Lo Alexander X.
Published: April 2024

Background

Persons living with dementia (PLWD) experience frequent and costly emergency department (ED) visits, with poor outcomes attributed to suboptimal care and postdischarge care transitions. Yet, patient‐centered data on ED care experiences and postdischarge needs are lacking. The objective of this study was to examine the facilitators and barriers to successful ED care and care transitions after discharge, according to PLWD and their caregivers.

Methods

We conducted a qualitative study involving ED patients ages 65 and older with confirmed or suspected dementia and their caregivers. The semistructured interview protocol followed the National Quality Forum's ED Transitions of Care Framework and addressed ED care, care transitions, and outpatient follow‐up care. Interviews were conducted during an ED visit at an urban, academic ED. Traditional thematic analysis was used to identify themes.

Results

We interviewed 11 patients and 19 caregivers. Caregivers were more forthcoming than patients about facilitators and challenges experienced. Characteristics of the patients’ condition (e.g., resistance to care, forgetfulness), the availability of family resources (e.g., caregiver availability, primary care access), and system‐level factors (e.g., availability of timely appointments, hospital policies tailored to persons with dementia) served as facilitators and barriers to successful care. Some resources that would ameliorate care transition barriers could be easily provided in the ED, for example, offering clear discharge instructions and care coordination services and improving patient communication regarding disposition timeline. Other interventions would require investment from other parts of the health care system (e.g., respite for caregivers, broader insurance coverage).

Conclusions

ED care and care transitions for PLWD are suboptimal, and patient‐level factors may exacerbate existing system‐level deficiencies. Insight from patients and their caregivers may inform the development of ED interventions to design specialized care for this patient population. This qualitative study also demonstrated the feasibility of conducting ED‐based studies on PLWD during their ED visit.
Comparison of polypharmacy and potentially inappropriate medication use in older adults with and without dementia receiving residential medication management reviews
Authors: Sawan Mouna J. , Clough Alexander , Hillen Jodie , Soulsby Natalie , Gnjidic Danijela
Published: April 2024

Objectives

Among residents who had a residential medication management review (RMMR), there is a lack of studies assessing exposure to polypharmacy and potentially inappropriate medications (PIMs) in people with dementia. This study compared the exposure to polypharmacy and PIMs in residents with dementia and without dementia receiving RMMR.

Methods

A retrospective analysis was performed using data of 16,261 residents living in 343 Australian residential aged care facilities who had an RMMR in 2019. Medication use was assessed as polypharmacy (defined as ≥9 medications) and use of ≥1 PIMs using the 2019 updated Beers criteria. Dementia diagnosis was determined with ICD‐10 coding from medical records. Descriptive analyses reported resident demographics and patterns of medication use. Pearson's χ2 tests and logistic regression analysis were conducted to compare medication exposure between residents with and without dementia.

Results

Among 16,261 residents, 6781 (42%) had dementia. Residents with dementia were significantly more likely to be exposed to polypharmacy and PIMs, compared to those without dementia (74% vs. 70% and 83% vs. 73%, p < .001 respectively). Residents with dementia had 1.31 times the odds of exposure to polypharmacy (adjusted OR: 1.31, 95% CI: 1.22–1.41, p < .001) and 1.88 times the odds of being prescribed ≥1 PIMs than people without dementia (adjusted OR: 1.88, 95% CI: 1.73–2.04, p < .001).

Conclusions

In a study of residents receiving RMMR, polypharmacy and PIMs were highly common, and those with dementia were more likely to be exposed to inappropriate polypharmacy. There is a need for targeted deprescribing strategies to immediately address inappropriate prescribing in residents, particularly those living with dementia.
Fabrication and characterization of TiO2‐hydroxyapatite composite‐loaded Polysulfone membranes with integrated biocompatibility for dialysis application
Authors: Zaman Shafiq Uz , Mehdi Muhammad Shozab , Khan Khurram Imran , Arshad Amber , Rafiq Sikander , Sharif Faiza , Umar Muhammad , Hezb Ullah  , ur Rehman Saif , Wajeeh Salman , Muzamal Sheeza , Arshad Abdullah
Published: April 2024

Background

The use of Polysulfone (PSf) as membrane material for dialysis therapy is becoming more common. However, the PSf membrane can cause the adsorption of blood proteins followed by the adhesion of platelets, destruction of red blood cells, and thrombus formation. One of the biggest challenges in creating membranes for hemodialysis (HD) applications is ensuring biocompatibility. Therefore, to maintain the biocompatibility of PSf membranes, further modifications are necessary.

Methods

In this study, the performance and biocompatibility of PSf membranes were improved by the impregnation of TiO2‐hydroxyapatite composite as an additive. The TiO2‐hydroxyapatite composite was first synthesized via sintering at 1200°C, and then a dope solution composed of pristine PSf polymer solution in N‐Methyl‐2‐pyrrolidone solvent (NMP) and different wt% ratios of the synthesized composite were prepared, and resultant membranes were fabricated using a film applicator via a phase inversion scheme using water as a non‐solvent exchange medium. The synthesized composite was characterized using SEM, EDX, and XRD techniques.

Results

The FTIR analysis confirmed the weak interaction of PSf polymer with the hydroxyapatite moiety of the composite. The interaction of the synthesized composite within the membrane matrix was evaluated via leaching ratio results. The hydrophilicity, pore profile, and pure water permeation flux rates were also determined. The results of the biocompatibility study showed that membranes based on TiO2‐hydroxyapatite composite had reduced adsorption of BSA protein by 34.41% as well as less than 5% hemolysis ratio. Additionally, the study displayed thrombus formation ranging from 2.08% to 8.69%, respectively. The dialysis results indicated that compared with the original PSf membrane, the TiO2‐hydroxyapatite composite showed high clearance rates for urea (73.81%) and creatinine (72.13%) solutes, respectively.

Conclusion

Therefore, blending TiO2‐hydroxyapatite composite in the PSf membrane significantly improved the biocompatibility and removal ability of uremic solutes.
Time spent outdoors in childhood related to myopia among young adults in the Swedish ABIS cohort
Authors: Bro Tomas , Ludvigsson Johnny
Published: April 2024

Purpose

Elucidate the prevalence of myopia among young adults from a birth cohort of Swedish children and its relationship to possible risk factors during their childhood.

Methods

Five thousand two hundred young adults, mean 23.4 years and 58% females, participating in the prospective birth cohort All Babies in Southeast Sweden (ABIS) answered a questionnaire including questions regarding health and physical activity, spectacle use, myopia and age at first optical correction. Questionnaires at previous follow‐ups at ages 2–3, 5–6 and 8 years included information on type of housing, time outdoors, screen time and hours of reading. Myopia prevalence and associations with potential risk factors were analysed in univariate and multivariate regression models with Bonferroni's correction of p‐values.

Results

In the ABIS Swedish birth cohort of young adults, the prevalence of myopia was 29%. A univariate logistic regression showed a higher odds ratio for myopia with female gender (OR 1.59; p < 0.05) and a completed and started university education (OR 1.52; p < 0.05). Significantly lower odds ratios were found for hours spent outdoors at 8 years of age (OR 0.82; p < 0.05). Multivariate logistic regression showed a higher odds ratio for myopia in females (OR 1.52–1.57; p < 0.05) and completed and started university education (OR 1.34–1.49; p < 0.05) in all models. In a model including accommodative effort, measured in diopter hours at 8 years of age, hours spent outdoors were associated with a lower odds ratio for myopia (OR 0.86; p < 0.05). No association could be detected between myopia and the type of housing or near work.

Conclusion

The prevalence of myopia among young adults in a Swedish birth cohort was lower or unchanged compared to previous data. Female gender, higher education and less time spent outdoors in childhood were associated with an increased risk of developing myopia. Recommendations from child health services and schools should be given to stimulate children to spend enough time outdoors.
Letermovir prophylaxis reduced cytomegalovirus reactivation and resistance post umbilical cord blood transplantation
Authors: Yan Bingbing , Sun Guangyu , Wu Yue , Wu Weiwei , Song Kaidi , Cheng Yaxin , Huang Aijie , Pan Tianzhong , Tang Baolin , Zhu Xiaoyu
Published: April 2024

To explore the impact of letermovir (LET) prophylaxis on cytomegalovirus (CMV) reactivation and resistance in both adult and paediatric umbilical cord blood transplantation (UCBT) patients, we retrospectively compared 43 UCBT patients who received LET as CMV prophylaxis with a historical cohort of 207 UCBT patients without LET usage. LET was administered from Day +1 to Day +100. The 180‐day cumulative incidence of CMV reactivation (47.3% vs. 74.4%, p < 0.001) and the proportion of refractory CMV reactivation (15.0% vs. 42.9%, p = 0.016) were significantly lower than those in the control group. However, more frequent late CMV infection (31.0% vs. 4.3%, p = 0.002) and the 180‐day cumulative incidence of Epstein–Barr virus (EBV) reactivation (9.3% vs. 3.4%, p = 0.087) were observed in UCBT patients with LET prophylaxis. Meanwhile, older age (>15 years old) and the occurrence of pre‐engraftment syndrome were identified as the significant risk factors for CMV reactivation, and in patients at high risk, the incidence of CMV reactivation in the LET group was lower than that in the control group (46.7% vs. 86.5%, p < 0.001), while this decline was less pronounced among patients at low risk (47.8% vs. 62.1%, p = 0.120).
The CAR T‐cell race: The rules of the game
Authors: Balduzzi Adriana
Published: April 2024

The management of paediatric patients with refractory acute lymphoblastic leukaemia eligible for the CAR T cell product tisagenlecleucel involves multiple decision points between the process of patient referral to product infusion. How to address the individual patient's circumstances, optimize apheresis yields and, above all, plan the best bridging chemotherapy is clearly detailed in these comprehensive and practical recommendations by Kumar Mishra and colleagues.

Commentary on: Mishra et al. Practice guideline: Preparation for CAR T‐cell therapy in children and young adults with B‐acute lymphoblastic leukaemia. Br J Haematol 2024;204:1687‐1696
Learnings from phosphatidylinositol 3‐kinase inhibitors in lymphoma—Moving to a model where less can be more
Authors: Martynchyk Arina , Hawkes Eliza A.
Published: April 2024

The role of Pi3K inhibitors in lymphoma is diminishing due to the adverse results from trials in indolent lymphoma, but is a one‐size‐fits‐all approach to drug development penalising some lymphoma subtypes and the newer generation of Pi3K inhibitors? The report by Soumerai et al. of zandelisib with zanubrutinib in follicular and mantle cell lymphoma is an important addition to the data.

Commentary on: Soumerai et al. Safety and efficacy of zandelisib plus zanubrutinib in previously treated follicular and mantle cell lymphomas. Br J Haematol 2024;204:1762‐1770.
The power threat meaning framework 5 years on − A scoping review of the emergent empirical literature
Authors: Gallagher Orla , Regan Emma E. , O'Reilly Gary
Published: April 2024

Since its release the Power Threat Meaning Framework (PTMF) has received considerable interest and uptake. However, there have not yet been any attempts to review the scope of this emergent literature. This scoping review aimed to identify and synthesize: (1) all empirical research which utilized the PTMF in their methodologies, (2) the characteristics of these studies, (3) the different ways in which these studies utilized the PTMF, and (4) the key findings of these studies. This review was conducted in line with the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) scoping review extension (PRISMA‐ScR). Following systematic searches of academic databases and grey literature, 17 studies meeting eligibility criteria were included. These papers were subject to critical appraisal, data charting, and narrative synthesis. This review identified four uses of the PTMF: (1) PTMF‐informed data collection, (2) PTMF‐informed data analysis, (3) Experiences of/views on the PTMF, and (4) PTMF‐informed psychological practices. This evidence‐base demonstrated the merits of utilizing the PTMF across a range of disciplines, settings, and populations. This heterogeneity also presents challenges for evidence synthesis. Implications for research (e.g. importance of the coherent and consistent approach to research) and practice/policy (e.g. professional training, collaboration, service‐level barriers) are considered.
Tree post‐drought recovery: scenarios, regulatory mechanisms and ways to improve
Authors: Zlobin Ilya E.
Published: April 2024

Efficient post‐drought recovery of growth and assimilation enables a plant to return to its undisturbed state and functioning. Unlike annual plants, trees suffer not only from the current drought, but also from cumulative impacts of consecutive water stresses which cause adverse legacy effects on survival and performance. This review provides an integrated assessment of ecological, physiological and molecular evidence on the recovery of growth and photosynthesis in trees, with a view to informing the breeding of trees with a better ability to recover from water stress. Suppression of recovery processes can result not only from stress damage but also from a controlled downshift of recovery as part of tree acclimation to water‐limited conditions. In the latter case, recovery processes could potentially be activated by turning off the controlling mechanisms, but several obstacles make this unlikely. Tree phenology, and specifically photoperiodic constraints, can limit post‐drought recovery of growth and photosynthesis, and targeting these constraints may represent a promising way to breed trees with an enhanced ability to recover post‐drought. The mechanisms of photoperiod‐dependent regulation of shoot, secondary and root growth and of assimilation processes are reviewed. Finally, the limitations and trade‐offs of altering the photoperiodic regulation of growth and assimilation processes are discussed.
IGSF3 is a homophilic cell adhesion molecule that drives lung metastasis of melanoma by promoting adhesion to vascular endothelium
Authors: Guo Yue , Kasai Yutaka , Tanaka Yuto , Ohashi‐Kumagai Yuki , Sakamoto Takeharu , Ito Takeshi , Murakami Yoshinori
Published: April 2024

The immunoglobulin superfamily (IgSF) is one of the largest families of cell‐surface molecules involved in various cell–cell interactions, including cancer–stromal interactions. In this study, we undertook a comprehensive RT‐PCR‐based screening for IgSF molecules that promote experimental lung metastasis in mice. By comparing the expression of 325 genes encoding cell‐surface IgSF molecules between mouse melanoma B16 cells and its highly metastatic subline, B16F10 cells, we found that expression of the immunoglobulin superfamily member 3 gene (Igsf3) was significantly enhanced in B16F10 cells than in B16 cells. Knockdown of Igsf3 in B16F10 cells significantly reduced lung metastasis following intravenous injection into C57BL/6 mice. IGSF3 promoted adhesion of B16F10 cells to vascular endothelial cells and functioned as a homophilic cell adhesion molecule between B16F10 cells and vascular endothelial cells. Notably, the knockdown of IGSF3 in either B16F10 cells or vascular endothelial cells suppressed the transendothelial migration of B16F10 cells. Moreover, IGSF3 knockdown suppressed the extravasation of B16F10 cells into the lungs after intravenous injection. These results suggest that IGSF3 promotes the metastatic potential of B16F10 cells in the lungs by facilitating their adhesion to vascular endothelial cells.
Baicalin inhibits monosodium urate crystal‐induced pyroptosis in renal tubular epithelial cell line through Panx‐1/P2X7 pathways: Molecular docking, molecular dynamics, and in vitro experiments
Authors: Fu Wanting , Liu Ziyuan , Wang Yingzhou , Li Xindi , Yu Xiang , Li Yang , Yu Zejun , Qiu Yinsheng , Mei Zhinan , Xu Lingyun
Published: April 2024

Pyroptosis is a programmed cell death process that frequently occurs in many diseases, including hyperuricemic nephropathy (HN). In HN, a range of stimuli mediates inflammation, leading to the activation of inflammasomes and the production of gasdermin D (GSDMD). Baicalin (BA), a natural flavonoid renowned for its antioxidant and anti‐inflammatory properties, was investigated for its role in HN in this study. Initially, HN‐like inflammation and pyroptosis were induced in HK‐2 cells with treatment of monosodium urate (MSU), followed by the BA treatment. The expression of pyroptosis‐associated genes, Panx‐1 and P2X7, at both mRNA and protein levels was assessed through real‐time polymerase chain reaction (RT‐qPCR) and Western blotting (WB) without or with BA treatment. The results showed that expression of Panx‐1 and P2X7 at mRNA and protein levels was increased in MSU‐treated HK‐2 cells, which subsequently decreased upon the BA treatment. Further experiments showed that BA could combine NLRP3 inflammasome and GSDMD, destabilizing GSDMD protein. Moreover, BA protected the cell membrane from MSU‐induced damage, as evidenced by Hoechst 33342 and PI double staining, lactate dehydrogenase (LDH) assays, and electron microscopy observations. These results suggest that BA is involved in the regulating Panx‐1/P2X7 pathways and thus inhibits pyroptosis, highlighting its potential therapeutic effect for HN.
The association of CYP2C19LoF alleles with adverse clinical outcomes in stroke patients taking clopidogrel: An updated meta‐analysis
Authors: Biswas Mohitosh , Hossain Md. Shahadat , Ahmed Rupok Tahsin , Hossain Md. Sabbir , Sukasem Chonlaphat
Published: April 2024

The aggregated risk of recurrent stroke in stroke/transient ischemic attack (TIA) patients carrying CYP2C19 LoF alleles who take clopidogrel has not been investigated recently, and the available research is limited. This study aimed to perform an updated meta‐analysis to assess the association between CYP2C19 LoF alleles and the risk of recurrent stroke in patients taking clopidogrel. Databases were searched for the literature on eligible studies. The end points were recurrent stroke, composite vascular events, and bleeding events. Odds ratios (ORs) were calculated using RevMan software, where p < 0.05 was considered statistically significant. Patients carrying CYP2C19 LoF alleles who were treated with clopidogrel had a significantly increased risk of recurrent ischemic stroke compared with non‐carriers (OR 2.18, 96% CI 1.80–2.63; p < 0.00001). The risk of recurrent stroke was only significantly different in Asian patients (OR 2.29, 96% CI 1.88–2.80; p < 0.00001) but not in patients of other ethnicities; however, there were a limited number of studies in other ethnic groups. Both observational studies (OR 2.83, 96% CI 2.20–3.65; p < 0.00001) and RCTs (OR 1.48, 96% CI 1.10–1.98; p = 0.009) found associations with a significantly increased risk of recurrent ischemic stroke. Asian stroke patients or TIA patients carrying CYP2C19 LoF alleles and taking clopidogrel were at a significantly higher risk of recurrent ischemic stroke than non‐carriers. Significantly increased risk of recurrent ischemic stroke was found in both observational studies and RCTs.
The effects of patient cost‐sharing on adolescents' healthcare utilization and financial risk protection: Evidence from South Korea
Authors: Kim Seonghoon , Koh Kanghyock , Lyou Wonjun
Published: April 2024

We examine the effects of patient cost‐sharing on adolescents' healthcare utilization and out‐of‐pocket medical expenditures by exploiting the healthcare reform in South Korea that lowered the coinsurance rate for inpatient care from 20% to 5% for children under 16. We apply a difference‐in‐regression‐discontinuities design using administrative claims data. We find that the reform increased adolescents' inpatient care utilization. It also reduced out‐of‐pocket healthcare expenditures. This effect was larger among low‐income households, facilitating income redistribution. However, the lack of evidence on health improvements and household consumption spending responses suggests that generous patient cost‐sharing for adolescent healthcare may cause efficiency losses.
Enhancing the action of serotonin by three different mechanisms prevents spontaneous seizure‐induced mortality in Dravet mice
Authors: Guo Jialing , Min Daniel , Farrell Emory K. , Zhou Yupeng , Faingold Carl L. , Cotten Joseph F. , Feng Hua‐Jun
Published: April 2024

Objective

Sudden unexpected death in epilepsy (SUDEP) is an underestimated complication of epilepsy. Previous studies have demonstrated that enhancement of serotonergic neurotransmission suppresses seizure‐induced sudden death in evoked seizure models. However, it is unclear whether elevated serotonin (5‐HT) function will prevent spontaneous seizure‐induced mortality (SSIM), which is characteristic of human SUDEP. We examined the effects of 5‐HT‐enhancing agents that act by three different pharmacological mechanisms on SSIM in Dravet mice, which exhibit a high incidence of SUDEP, modeling human Dravet syndrome.

Methods

Dravet mice of both sexes were evaluated for spontaneous seizure characterization and changes in SSIM incidence induced by agents that enhance 5‐HT‐mediated neurotransmission. Fluoxetine (a selective 5‐HT reuptake inhibitor), fenfluramine (a 5‐HT releaser and agonist), SR 57227 (a specific 5‐HT3 receptor agonist), or saline (vehicle) was intraperitoneally administered over an 8‐day period in Dravet mice, and the effect of these treatments on SSIM was examined.

Results

Spontaneous seizures in Dravet mice generally progressed from wild running to tonic seizures with or without SSIM. Fluoxetine at 30 mg/kg, but not at 20 or 5 mg/kg, significantly reduced SSIM compared with the vehicle control. Fenfluramine at 1–10 mg/kg, but not .2 mg/kg, fully protected Dravet mice from SSIM, with all mice surviving. Compared with the vehicle control, SR 57227 at 20 mg/kg, but not at 10 or 5 mg/kg, significantly lowered SSIM. The effect of these drugs on SSIM was independent of sex.

Significance

Our data demonstrate that elevating serotonergic function by fluoxetine, fenfluramine, or SR 57227 significantly reduces or eliminates SSIM in Dravet mice in a sex‐independent manner. These findings suggest that deficits in serotonergic neurotransmission likely play an important role in the pathogenesis of SSIM, and fluoxetine and fenfluramine, which are US Food and Drug Administration‐approved medications, may potentially prevent SUDEP in at‐risk patients.
Changes to the acoustic properties of Gromphadorhina portentosa defensive sounds when exposed to the molting hormone, 20‐hydroxyecdysone
Authors: Parker David J. , Basak Hrithik , Foltynski Patricia , Swierk Lindsey
Published: April 2024

Steroid hormones play a pivotal role in shaping arthropod phenotypes, with 20‐hydroxyecdysone (20E) serving as a key regulator of molting, a vulnerable period in an insect's lifecycle. Despite its critical role in arthropod growth and development, the influence of 20E on arthropod behavior, particularly defensive strategies, remains poorly understood. We investigated the impact of 20E on the bioacoustic characteristics of hisses in the Madagascar hissing cockroach (Gromphadorhina portentosa), a social species with multiple complex acoustic signals. With increased 20E, we predicted that hiss production would be more likely and more defensive (i.e., longer hisses with greater intensity (dB) and reduced frequency (Hz)). We injected male G. portentosa with either a low‐ (35 μg) or high‐dose (70 μg) of 20E or a control (0 μg 20E), and we measured the presence/absence of hissing responses and their bioacoustic characteristics following a standardized tactile stimulus. Contrary to our prediction, there was no difference in the likelihood of hissing or hiss duration with 20E administration. However, administering 20E resulted in reduced hiss intensity and increased hiss frequency (as measured by peak and center frequencies), suggesting potential shifts from defensive to aggressive signaling. Our study contributes to the limited knowledge of the behavioral effects of 20E, suggesting that some arthropods may experience increased aggression or energetic limitations to defense during molting. Behavioral changes elicited by hormones have important implications for both fundamental ecology and applied pest management.
A success dressed as a failure? Evidence from post‐IPO withdrawal outcomes in Europe
Authors: Helbing Pia , Lucey Brian M.
Published: April 2024

What happens to companies that file for an initial public offering (IPO), but withdraw and do not list? How long does the post‐IPO outcome take? These questions are investigated by analysing market, firm and offer characteristics of 334 withdrawn IPOs in Europe between 2001 and 2015. The majority of withdrawn IPOs is engaged in M&A, only few file for a second time IPO. These post‐IPO withdrawal outcomes happen shortly after the IPO filing. Private equity and venture capital‐backed firms are more frequently engaging in M&A or trading. The evidence suggests that the IPO may be used as a marketing mechanism, being one of several alternatives of exit.
Primase and polymerase α tango to make an RNA–DNA hybrid primer
Authors: Yuan Zuanning , Li Huilin
Published: April 2024

Several recent cryo‐electron microscopy (cryo‐EM) studies about the eukaryotic primosome, including the human primosome described by Yin et al. in this issue, have uncovered the structural intricacies between the RNA primase and the DNA polymerase. These studies show that these two partners tango on DNA to synthesize a hybrid primer composed of ~ 10 nucleotide (nt) RNA and ~ 10‐nt DNA. They reveal key intermediate steps involved in this process; from the self‐inhibited apo state to the initiation of RNA primer synthesis, RNA primer handover to the polymerase, primer elongation by polymerase, and finally, primer termination and release. Remarkably, the polymerase domain orchestrates all major steps during primer synthesis.
How Good Is Open Bicycle Network Data? A Countrywide Case Study of Denmark
Authors: Vierø Ane Rahbek , Vybornova Anastassia , Szell Michael
Published: April 2024

Cycling is a key ingredient for a sustainability shift of Denmark's transportation system. To increase cycling rates, better bicycle infrastructure networks are required. Planning such networks requires high‐quality infrastructure data, yet the quality of bicycle infrastructure data is understudied. Here, we compare the two largest open data sets on dedicated bicycle infrastructure in Denmark, OpenStreetMap (OSM) and GeoDanmark, in a countrywide data quality assessment, asking whether the data are good enough for network‐based analysis of cycling conditions. We find that neither of the data sets is of sufficient quality, and that data conflation is necessary to obtain a more complete data set. Our analysis of the spatial variation of data quality suggests that rural areas are more prone to incomplete data. We demonstrate that the prevalent method of using infrastructure density as a proxy for data completeness is not suitable for bicycle infrastructure data, and that matching of corresponding features is thus necessary to assess data completeness. Based on our data quality assessment, we recommend strategic mapping efforts toward data completeness, consistent standards to support comparability between different data sources, and increased focus on data topology to ensure high‐quality bicycle network data.
From harmful ‘cures’ to acceptance: Reclaiming care through queer‐feminist refusal in Yael Inokai's Ein simpler Eingriff (2022)
Authors: Yanacek Holly
Published: April 2024

Swiss author Yael Inokai's novel Ein simpler Eingriff (2022) explores the various meanings and associations of care and caregiving. The novel demonstrates a particular sensitivity to the challenges of care work in nursing contexts and to the relationship between care and harm. This article draws on approaches from feminist care ethics, queer studies, and the politics of refusal to show how Inokai's text can be read as a novel of lesbian development that depicts its protagonist's journey from naïve hope for a cure to awareness of the complexity of care and, simultaneously, from shame to acceptance of her queer identity. Through acts of refusal, Inokai's novel decouples care from notions of a “cure” linked to heteronormative patriarchal power. It thereby creates space for a queer‐feminist ethics of care that is attuned to the needs of others, minimizes harm, and emphasizes relationality and acceptance.
Time Series Analysis of Nonlinear Head Dynamics Using Synthetic Data Generated with a Variably Saturated Model
Authors: Vonk Martin A. , Collenteur Raoul A. , Panday Sorab , Schaars Frans , Bakker Mark
Published: April 2024

The performance of time series models is assessed using synthetic head series simulated with a numerical model that solves Richards' equation for variably saturated flow. Heads were simulated in a homogeneous unconfined aquifer between two parallel canals; measured daily precipitation and potential evaporation are specified at the land surface and root water uptake is simulated. The head response to a precipitation event is nonlinear and depends on the saturation degree and rainfall before and after the precipitation event while evaporation reduction occurs during summers. Synthetic series were generated for 27 years and three different soil types; the unsaturated zone thickness varies between 0 and >5 m. The synthetic head series were simulated with a linear and nonlinear time series model. Performance of a linear time series model with four parameters, using a scaled Gamma response, gave R2 values ranging from 0.67 to 0.96. The nonlinear time series model with five parameters simulates recharge using a root zone reservoir after which the head response to recharge is simulated with a scaled Gamma response function. The nonlinear time series model was able to simulate all synthetic head series very well with R2 values above 0.9 for almost all models. The head response of the nonlinear model to a single precipitation event compares well to the response of the variably saturated groundwater model. The provided scripts may be used to simulate synthetic head series for other climates or for systems with additional complexity to assess the performance of other data‐driven models.
Effects of apical periodontitis treatment on hyperglycaemia in diabetes: A prospective cohort study
Authors: Davidović Brankica , Krunić Jelena , Mladenović Irena , Stojanović Nikola , Hannig Matthias , Vitkov Ljubomir
Published: April 2024

Aim

This prospective cohort study was undertaken to evaluate the success rate of root canal treatment (RCT) in type 2 diabetes mellitus (T2DM) patients with targeted level and unachieved targeted level of glycaemic control as well as the impact of RCT on the glucose blood level in T2DM patients.

Methodology

Patients needing RCT were divided into three groups: these without T2DM, that is, the control group (CG), those with targeted level of glycated haemoglobin HbA1c < 7% (TL A1c) and the third ones with unachieved targeted level (UTL A1c), that is, with HbA1c ≥ 7%. Before RCT, HbA1c and the periapical index (PAI) score were assessed, as well as 1 year later.

Results

Our results showed less favourable treatment results of RCT such as a reduction of radiographic lesions in T2DM patients, particularly in subjects with UTL A1c. The intergroup analysis of PAI score at the 12‐month follow‐up revealed a significant difference in TL A1C (p = .022) and CG (p = .001) with respect to UTL A1c. Total number of healed teeth (PAI≤2) at the 12‐month after RCT in UTL A1c was significantly lower in comparison to CG (p = .008). Contrariwise, RCT may improve the glycaemic control in diabetic patients with UTL A1c after 12 months of posttreatment. Regression analysis showed that UTL A1c patients were more likely to have AP persistence after endodontic treatment (OR = 4.788; CI: 1.157–19.816; p = .031).

Conclusions

T2DM retards the AP healing and conversely AP contributes to increasing the inflammatory burden in T2DM. RCT reduces the cumulative inflammatory burden in T2DM and thus may contribute to improvement of glycaemic control particularly in patients with UTL A1c.
Electrical discharge machining process investigation and optimization of parameters for machining of aluminum silicon dioxide (Al7075–SiO2) composite
Authors: Saravanan Kaliappan , Muthukumaran Velayutham
Published: April 2024

This research paper explores the impact of electrical discharge machining process parameters, including current, pulse‐on time (Ton), and pulse‐off time (Toff), on the material removal rate (MRR) and surface roughness (SR) during the fabrication of aluminum silicon dioxide (Al7075–SiO2) composites. The Al7075–SiO2 composites were produced through stir casting, incorporating 10% by weight of SiO2 reinforcements with an average particle size of 54 µm. To systematically investigate the process parameters' effects, Taguchi's L9 orthogonal array was implemented in the design of experiments. Subsequently, the experimental data underwent analysis of variance (ANOVA) for thorough analysis. The response table for MRR and SR demonstrated that the current significantly influenced both responses (MRR and SR). The ANOVA results provided valuable insights into the percentage contribution of each parameter to the responses. Through the analysis, the optimal control variable settings for achieving the highest MRR were identified as a current of 3 A, a pulse‐on time of 1500 µs, and a pulse‐off time of 1 µs. Conversely, to attain the lowest SR, the ideal control variable settings were determined to be a current of 1 A, a pulse‐on time of 500 µs, and a pulse‐off time of 1 µs. Results also suggest that the error was within admissible range of 5% and the percentage contribution of the current (70.19%) had the largest effect on MRR.
Deciphering the enigma of itch sensation: insights and impact from a readability study
Authors: Skrzypczak Tomasz , Skrzypczak Anna , Szepietowski Jacek C.
Published: April 2024

Background

Itch terminology is ambiguous. How itch was described in online materials and how terminology influenced the readability of these materials was previously unknown.

Materials and methods

Two groups of search terms, itch and prurigo, were translated into five of the most prevalent European Union (EU) languages. The itch group consisted of “itch” and “pruritus.” The prurigo group consisted of “prurigo,” “prurigo nodularis,” and “chronic prurigo”. Then, a search of the terms in each language was queried in the Google search engine in the private mode of the Internet browser. The first 50 results generated were assessed for suitability. Patient education was the primary objective of the materials provided, with no barriers or advertisements included. In cases where the terms yielded identical outcomes, any duplicated materials were omitted from the analysis. When translating search terms within a group led to just one shared transcription, the results were attributed to the search term with the most similar syntax. The Lix score was utilized to assess readability.

Results

314 articles in English, German, Italian, French, and Spanish were evaluated. The term “pruritus” was the most commonly used description for the sensation of itching, with 142 (45%) articles included. Overall, the mean Lix score was 54 ± 9, classifying all articles as hard to comprehend. Articles in the itch group had significantly (P < 0.001) lower mean Lix score (52 ± 9) than materials in the prurigo group (56 ± 10).

Conclusions

Despite being more accessible to conceptualize, skin conditions such as prurigo had lower readability compared to information about the itch itself. The distinction between “itch” and “pruritus” was unclear.
Evaluating the efficacy of standardized pressure ulcer management protocols in the prevention of pressure injuries among patients undergoing neurosurgical procedures
Authors: Zhang Jing , Li Wenxia , Li Yanyan , Ma Man , Shang Kun
Published: April 2024

Pressure injuries are a significant concern for patients undergoing neurosurgical procedures due to prolonged immobility and the complexity of care. This study evaluates the efficacy of standardized pressure ulcer management protocols in preventing pressure injuries and enhancing patient care in a neurosurgical context. A comprehensive retrospective analysis was conducted at a single institution from December 2020 to December 2023, comparing 50 patients who received standardized pressure ulcer management (intervention group) with 50 patients who received conventional care (control group). The study assessed the incidence of pressure ulcers, patient comfort levels using the Kolcaba Comfort Scale and sleep quality using the Richards‐Campbell Sleep Questionnaire (RCSQ). Statistical analysis was performed using SPSS software, version 27.0, applying t‐tests and chi‐square tests as appropriate. The intervention group exhibited a significantly lower incidence of pressure ulcers at all measured time points post‐surgery compared to the control group. Patient comfort levels in the intervention group were consistently higher across psychological, environmental, physiological and socio‐cultural domains. Sleep quality metrics, including sleep depth, latency to sleep onset and overall sleep quality, were significantly improved in the intervention group. The implementation of standardized pressure ulcer management protocols in neurosurgical care significantly reduces the incidence of pressure injuries, enhances patient comfort and improves sleep quality. These findings highlight the importance of adopting structured care protocols to improve postoperative outcomes and patient well‐being in neurosurgical settings.
Pilot study to evaluate left‐to‐right ventricular offset in biventricular pacing—comparison of electrocardiographic imaging and ECG
Authors: Noheria Amit , Shahab Ahmed , Andrews Christopher , Cuculich Phillip S. , Rudy Yoram
Published: April 2024

Introduction

Biventricular pacing (BiVp) improves outcomes in systolic heart failure patients with electrical dyssynchrony. BiVp is delivered from epicardial left ventricular (LV) and endocardial right ventricular (RV) electrodes. Acute electrical activation changes with different LV‐RV stimulation offsets can help guide individually optimized BiVp programming. We sought to study the BiVp ventricular activation with different LV‐RV offsets and compare with 12‐lead ECG.

Methods

In five patients with BiVp (63 ± 17‐year‐old, 80% male, LV ejection fraction 27 ± 6%), we evaluated acute ventricular epicardial activation, varying LV‐RV offsets in 20 ms increments from −40 to 80 ms, using electrocardiographic imaging (ECGI) to obtain absolute ventricular electrical uncoupling (VEUabs, absolute difference in average LV and average RV activation time) and total activation time (TAT). For each patient, we calculated the correlation between ECGI and corresponding ECG (3D‐QRS‐area and QRS duration) with different LV‐RV offsets.

Results

The LV‐RV offset to attain minimum VEUabs in individual patients ranged 20–60 ms. In all patients, a larger LV‐RV offset was required to achieve minimum VEUabs (36 ± 17 ms) or 3D‐QRS‐area (40 ± 14 ms) than that for minimum TAT (−4 ± 9 ms) or QRS duration (−8 ± 11 ms). In individual patients, 3D‐QRS‐area correlated with VEUabs (r 0.65 ± 0.24) and QRS duration correlated with TAT (r 0.95 ± 0.02). Minimum VEUabs and minimum 3D‐QRS‐area were obtained by LV‐RV offset within 20 ms of each other in all five patients.

Conclusions

LV‐RV electrical uncoupling, as assessed by ECGI, can be minimized by optimizing LV‐RV stimulation offset. 3D‐QRS‐area is a surrogate to identify LV‐RV offset that minimizes LV‐RV uncoupling.
The role of vascular adhesion protein‐1 in diabetes and diabetic complications
Authors: Yen I‐Weng , Li Hung‐Yuan
Published: April 2024

Vascular adhesion protein‐1 (VAP‐1) plays a dual role with its adhesive and enzymatic properties, facilitating leukocyte migration to sites of inflammation and catalyzing the breakdown of primary amines into harmful by‐products, which are linked to diabetic complications. Present in various tissues, VAP‐1 also circulates in a soluble form in the bloodstream. Diabetes is associated with several complications such as cardiovascular disease, retinopathy, nephropathy, and neuropathy, significantly contributing to disability and mortality. These complications arise from hyperglycemia‐induced oxidative stress, inflammation, and the formation of advanced glycation end‐products (AGEs). Earlier research, including our own from the 1990s and early 2000s, has underscored the critical role of VAP‐1 in these pathological processes, prompting extensive investigation into its contribution to diabetic complications. In this review, we examine the involvement of VAP‐1 in diabetes and its complications, alongside its link to other conditions related to diabetes, such as cancer and metabolic dysfunction‐associated fatty liver disease. We also explore the utility of soluble VAP‐1 as a biomarker for diabetes, its complications, and other related conditions. Since the inhibition of VAP‐1 to treat diabetic complications is a novel and promising treatment option, further studies are needed to translate the beneficial effect of VAP‐1 inhibitors observed in animal studies to clinical trials recruiting human subjects. Besides, future studies should focus on using serum sVAP‐1 levels for risk assessment in diabetic patients, identifying those who need intensive glycemic control, and determining the patient population that would benefit most from VAP‐1 inhibitor therapies.
Real‐world experience of Fuzheng Yiqing granule as chemoprophylaxis against COVID‐19 infection among close contacts: A prospective cohort study
Authors: Che Qianzi , Huo Ruili , Zhao Chen , Yang Wei , Xiang Xinghua , Tang Shihuan , Shi Jiaheng , Lu Cheng , Li Hongmei , Huang Luqi
Published: April 2024

Background

The objective of the current study was to evaluate whether the use of traditional Chinese medicine, Fuzheng Yiqing granule (FZYQG), was associated with a reduced infection risk of COVID‐19 in close contacts.

Research design and methods

This was a prospective cohort study across 203 quarantine centres for close contacts and secondary contacts of COVID‐19 patients in Yangzhou city. FZYQG group was defined as quarantined individuals who voluntarily took FZYQG; control group did not take FZYQG. The primary outcome was the coronavirus test positive rate during quarantine period. Logistic regression with propensity score inverse probability weighting was used for adjusted analysis to evaluate independent association between FZYQG and test positive rate.

Results

From July 13, 2021 to September 30, 2021, 3438 quarantined individuals took FZYQG and 2248 refused to take the granule. Test positive rate was significantly lower among quarantined individuals who took FZYQG (0.29% vs. 1.73%, risk ratio 0.17, 95% confidence interval (CI): 0.08–0.34, p < 0.001). On logistic regression, odds for test positive were decreased in FZYQG group (odds ratio: 0.16, 95% CI: 0.08–0.32, p < 0.001).

Conclusions

Close and secondary contacts of COVID‐19 patients who received FZYQG had a lower test positive rate than control individuals in real‐world experience.

Trial registration

This study has been registered on Chinese Clinical Trial Registry (ChiCTR2100049590) on August 5, 2021.
Differences in healthcare utilization between enrollees of fully integrated dual eligible special needs plans versus non‐fully integrated plans
Authors: Kim Hyunjee , Senders Angela , Sergi Clint , Simeon Erika , Huang Sean Shenghsiu , Dodge Hiroko H. , McConnell K. John , Roberts Eric T.
Published: April 2024

Background

Policymakers advocate care integration models to enhance Medicare and Medicaid service coordination for dually eligible individuals. One rapidly expanding model is the fully integrated dual eligible (FIDE) plan, a sub‐type of the dual eligible special needs plan (D‐SNP) in which a parent insurer manages Medicare and Medicaid spending for dually eligible individuals. We examined healthcare utilization differences among dually eligible individuals aged 65 years or older enrolled in D‐SNPs by plan type (FIDE vs non‐FIDE).

Methods

Using 2018 Medicare Advantage encounters and Medicaid claims of FIDE and non‐FIDE enrollees in six states (AZ, CA, FL, NY, TN, WI), we compared healthcare utilization between plan types, adjusting for enrollee characteristics and county indicators. We applied propensity score weighting to address differences between FIDE and non‐FIDE plan enrollees.

Results

In our main analysis, which included all dually eligible individuals in our sample, we observed no significant difference in healthcare utilization between FIDE and non‐FIDE plan enrollees. However, we identified some differences in healthcare utilization between FIDE and non‐FIDE plan enrollees in subgroup analyses. For example, among home and community‐based service (HCBS) users, FIDE plan enrollees had 6.0 fewer hospitalizations per 1000 person‐months (95% CI: −7.9, −4.0) and were 7.0 percentage points more likely to be discharged to home (95% CI: 2.6, 11.5) after hospitalization, compared to non‐FIDE plan enrollees.

Conclusion

While we found no differences in healthcare utilization between FIDE and non‐FIDE plan enrollees when considering all dually eligible individuals in our sample, some differences emerged when focusing on subgroups. For example, HCBS users with FIDE plans had fewer hospitalizations and were more likely to be discharged to their home following hospitalization, compared to HCBS users with non‐FIDE plans. These findings suggest that FIDE plans may improve care coordination for specific subsets of dually eligible individuals.