bluuebunny/crossref_metadata_2025 huggingface dataset:
Risk factors in children with optic nerve hypoplasia and septo‐optic dysplasia
Authors: Salman Michael S. , Ruth Chelsea A. , Yogendran Marina S. , Rozovsky Katya , Lix Lisa M.
Published: July 2023

Aim

To identify the risk factors for optic nerve hypoplasia (ONH) and septo‐optic dysplasia (SOD).

Method

A retrospective, population‐based study with case–control design was undertaken using the Population Research Data Repository at the Manitoba Center for Health Policy in Manitoba, Canada. Cases were 111 patients (63 males, 48 females; age range 1–35 years [mean 11 years 6 months, SD 7 years 2 months]) with ONH and SOD diagnosed from 1990 to 2019, matched to 555 unrelated population‐based controls (315 males, 240 females; age range 1–35 years [mean 11 years 6 months, SD 7 years 2 months]) on year of birth, sex, and area of residence. Additionally, 75 cases (46 males, 29 females; age range 2–35 years [mean 12 years 6 months, SD 7 years 2 months]) with ONH and SOD were matched one‐on‐one with sibling controls (40 males, 35 females; age range 0–33 years [mean 11 years 7 months, SD 7 years 10 months], the rest did not have siblings). Several antenatal maternal risk factors associated with ONH and SOD were tested for their association with case and control group membership using adjusted odds ratios (ORs) and 95% confidence intervals (CIs) from a multivariate conditional logistic regression model. The outcome was the risk of developing ONH and SOD.

Results

Maternal age at conception (OR = 0.91, 95% CI = 0.86–0.96), primigravida (OR = 3.39, 95% CI = 1.92–6.01), and smoking (OR = 2.86, 95% CI = 1.61–5.05) were independently associated with ONH and SOD in the cohort matched to unrelated controls (p < 0.001). In the sibling cohort, smoking was an important risk factor (OR = 3.65, 95% CI = 1.2–11.1, p = 0.02).

Interpretation

Unmodifiable and modifiable antenatal maternal risk factors are associated with ONH and SOD. Our investigation suggests that several risk factors reported in previous studies may have been due to confounding bias and that maternal smoking during pregnancy is the main modifiable risk factor associated with ONH and SOD.

What this paper adds

Historically, many antenatal risk factors have been associated with optic nerve hypoplasia (ONH) and septo‐optic dysplasia (SOD).

Population‐based data with matched controls for potential confounding bias are lacking.

Young maternal age at conception, primigravida, and smoking during pregnancy are the main risk factors for ONH and SOD using a population‐based, case–control design.
Prescription of guideline‐directed medical therapies in patients with diabetes and chronic kidney disease from the CURE‐CKD Registry, 2019‐2020
Authors: Nicholas Susanne B. , Daratha Kenn B. , Alicic Radica Z. , Jones Cami R. , Kornowske Lindsey M. , Neumiller Joshua J. , Fatoba Samuel T. , Kong Sheldon X. , Singh Rakesh , Norris Keith C. , Tuttle Katherine R.
Published: July 2023

Aim

Guideline‐directed medical therapy (GDMT) is designed to improve clinical outcomes. The study aim was to assess GDMT prescribing rates and prescribing‐persistence predictors in patients with diabetes and chronic kidney disease (CKD) from the Center for Kidney Disease Research, Education, and Hope Registry.

Materials and Methods

Data were obtained from adults ≥18 years old with diabetes and CKD between 1 January 2019 and 31 December 2020 (N = 39 158). Baseline and persistent (≥90 days) prescriptions for GDMT, including angiotensin converting enzyme (ACE) inhibitor/angiotensin receptor blocker (ARB), sodium‐glucose cotransporter‐2 (SGLT2) inhibitor and glucagon‐like peptide 1 (GLP‐1) receptor agonist were assessed.

Results

The population age (mean ± SD) was 70 ± 14 years, and 49.6% (n = 19 415) were women. Baseline estimated glomerular filtration rate (2021 CKD‐Epidemiology Collaboration creatinine equation) was 57.5 ± 23.0 ml/min/1.73 m2 and urine albumin/creatinine 57.5 mg/g (31.7‐158.2; median, interquartile range). Baseline and ≥90‐day persistent prescribing rates, respectively, were 70.7% and 40.4% for ACE inhibitor/ARB, 6.0% and 5.0% for SGLT2 inhibitors, and 6.8% and 6.3% for GLP‐1 receptor agonist (all p < .001). Patients lacking primary commercial health insurance coverage were less likely to be prescribed an ACE inhibitor/ARB [odds ratio (OR) = 0.89; 95% confidence interval (CI) 0.84‐0.95; p < .001], SGLT2 inhibitor (OR 0.72; 95% CI 0.64‐0.81; p < .001) or GLP‐1 receptor agonist (OR 0.89; 95% CI 0.80‐0.98; p = .02). GDMT prescribing rates were lower at Providence than UCLA Health.

Conclusions

Prescribing for GDMT was suboptimal and waned quickly in patients with diabetes and CKD. Type of primary health insurance coverage and health system were associated with GDMT prescribing.
Left ventricular apical hypertrophy emerged from the fourth‐year post heart transplantation: Case report and literature review
Authors: Zhou Binyu , Wang Haiyan , Song Lin , Shi Peixuan , Liu Tianqi
Published: July 2023

Apical hypertrophic cardiomyopathy (AHCM) is a relatively rare phenotype of hypertrophic cardiomyopathy, which is characterized by focal thickening of the left ventricular (LV) apical myocardium, showing a spade‐shaped shadow on the left ventricle. We present the case of a 59‐year‐old man who was found to have AHCM, is an asymptomatic orthotopic heart transplantation (HTx) patient. This rare and progressive case of LV apical hypertrophy emerged from the fourth year post surgery. We analyzed the etiology of this case and summarized the clinical manifestations and prognosis of AHCM following HTx by reviewing our case and the literature.
Plasma homeostatic chemokines CCL19 and CCL21 and the prognosis of ischemic stroke in two Chinese prospective cohorts
Authors: Che Bizhong , Zhong Chongke , Du Jigang , Miao Mengyuan , Shi Mengyao , Peng Yanbo , Yang Pinni , Guo Daoxia , Chen Jing , Wang Aili , Xu Tan , Zhang Yonghong , He Jiang
Published: July 2023

Background

The homeostatic chemokines CCL19 and CCL21 are involved in carotid plaque vulnerability and post‐ischemic neuroinflammatory responses. This study aimed to examine the prognostic values of CCL19 and CCL21 in ischemic stroke.

Methods

Plasma CCL19 and CCL21 were measured in 4483 ischemic stroke patients from two independent cohorts of CATIS (China Antihypertensive Trial in Acute Ischemic Stroke) and IIPAIS (Infectious Factors, Inflammatory Markers, and Prognosis of Acute Ischemic Stroke), and participants were followed up at 3 months after stroke. The primary outcome was the composite outcome of death or major disability. The associations of CCL19 and CCL21 levels with the primary outcome were examined.

Results

In CATIS, multivariable‐adjusted odds ratios of the primary outcome in the highest quartiles of CCL19 and CCL21 compared with the lowest quartiles were 2.06 and 2.62, respectively. In IIPAIS, odds ratios of the primary outcome in the highest quartiles of CCL19 and CCL21 were 2.81 and 2.78 compared with the lowest quartiles, respectively. In the pooled analysis of the two cohorts, odds ratios of the primary outcome associated with the highest quartiles of CCL19 and CCL21 were 2.24 and 2.66, respectively. Similar findings were observed in the analysis with major disability, death, and the composite outcome of death or cardiovascular events as the secondary study outcomes. Adding CCL19 and CCL21 to conventional risk factors significantly improved risk reclassification and discrimination for adverse outcomes.

Conclusions

Both CCL19 and CCL21 levels were independently associated with adverse outcomes within 3 months after ischemic stroke and should be further investigated for risk stratification and potential therapeutic targets of ischemic stroke.
Review of retracted papers in the field of neurology
Authors: Wang Xingbo , Gao Ning , Chen Huan , Wang Weiming
Published: July 2023

Background and purpose

Despite the growing awareness of academic fraud, its prevalence in the field of neurology has not been fully assessed. This review aims to analyze the characteristics of the retracted papers in the field of neurology and the reasons for the retraction to better understand the trends in this area and to assist to avoid retraction incidents.

Methods

A total of 79 papers were included, which pertained to 22 countries and 64 journals. The marking methods for retracting original papers included watermarks (89.04%), retracted signs in the text (5.48%) and no prompt (5.48%). The median M (interquartile range [IQR]) of citations in retractions in neurology was 7 (41). Studies continued to be cited after retraction with an M (IQR) of 3 (16). The journal impact factor was between 0 and 157.335, with an M (IQR) of 5.127 (3.668). 45.21% and 31.51% papers were mainly published in the first and second quartile journals, respectively. The M (IQR) time elapsed between publication and retraction was 32 (44) months. The reasons for retraction included two major categories, academic misconduct (79.75%) and academic unintentional mistakes (20.25%).

Results and conclusions

The number of retractions in neurology has been on the rise over the past decade, with fabricated academic misconduct being the main cause of the retractions. Due to the long time lag between publication and retraction, a number of unreliable findings continue to be cited following retraction. In addition to the requisite standards of academic ethics, augmenting research training and fostering interdisciplinary collaboration are crucial in enhancing research integrity.
New human in vitro co‐culture model of keratinocytes and sensory neurons like cells releasing substance P with an evaluation of the expression ofZIKVentry receptors: A potent opportunity to test Zika virus entry and to study Zika virus' infection in neurons?
Authors: Bocciarelli Claire , Cordel Nadège , Leschiera Raphael , Talagas Matthieu , Le Gall‐Ianotto Christelle , Hu Weiguo , Marcorelles Pascale , Bellemere Gaëlle , Bredif Stéphanie , Fluhr Joachim , Misery Laurent , Lebonvallet Nicolas
Published: July 2023

During the course of acute ZIKV infection, pruritus is a cardinal symptom widely documented in the literature. Its frequent association with dysesthesia and several dysautonomic manifestations, suggests a pathophysiological mechanism involving the peripheral nervous system. The aim of this study was to develop a functional human model to potentially able to be infected by ZIKV: by demonstrating the functionality on a new human model of co‐culture of keratinocyte and sensory neuron derived from induced pluripotent stem cells using a classical method of capsaicin induction and SP release, and verify the presence of ZIKV entry receptor in these cells. Depending of cellular type, receptors of the TAMs family, TIMs (TIM1, TIM3 and TIM4) and DC‐SIGN and RIG1 were present/detected. The cells incubations with capsaicin resulted in an increase of the substance P. Hence, this study demonstrated the possibility to obtain co‐cultures of human keratinocytes and human sensory neurons that release substance P in the same way than previously published in animal models which can be used as a model of neurogenic skin inflammation. The demonstration of the expression of ZIKV entry receptors in these cells allows to considerate the potent possibility that ZIKV is able to infect cells.
Heterogeneity in protocols and outcomes to study the effect of renin‐angiotensin system blockers in inflammatory bowel disease: A systematic review
Authors: Ferreira‐Duarte Mariana , Tonin Fernanda S. , Duarte‐Araújo Margarida , Fernandez‐Llimos Fernando , Morato Manuela
Published: July 2023

Background

The renin‐angiotensin system (RAS) has been associated with inflammatory bowel disease (IBD), supporting translational relevance of RAS blockers. Comparability of study design/outcomes is fundamental for data analysis/discussion.

Objectives

We aimed at evaluating the heterogeneity among protocols and outcomes to study the effect of angiotensin‐converting enzyme inhibitors or angiotensin receptor blockers in IBD.

Methods

This study was performed and reported in accordance with the Cochrane recommendations and PRISMA (PROSPERO‐CRD42022323853). Systematic searches were performed in PubMed, Scopus and Web of Science. Studies that met the inclusion criteria were selected. Quality assessment of the studies was done with the SYRCLES's risk of bias tools for animal studies.

Results

Thirty‐five pre‐clinical studies and six clinical studies were included. Chemical induction of colitis was the most used model, but variable doses of the induction agent were reported. All studies reported at least a disease activity index, a macroscopic score, or a histologic assessment, but these scores were methodologically heterogeneous and reported for different characteristics. Great heterogeneity was also found in drug interventions. Inflammatory markers assessed as outcomes were different across studies.

Conclusion

Lack of standardization of protocols and outcomes among studies threatens the evidence on how RAS blockers influence IBD outcomes.
Information theory and headache triggers
Authors: Turner Dana P. , Caplis Emily , Bertsch Julia , Houle Timothy T.
Published: July 2023

Objectives

This secondary analysis evaluated the information content exhibited by various measurement strategies of commonly perceived causes, or “triggers,” of headache attacks.

Background

When evaluating triggers of primary headache attacks, the variation observed in trigger candidates must be measured to compare against the covariation in headache activity. Given the numerous strategies that could be used to measure and record headache trigger variables, it is useful to consider the information contained in these measurements.

Methods

Using previously collected data from cohort and cross‐sectional studies, online data sources, and simulations, the Shannon information entropy exhibited by many common triggers was evaluated by analyzing available time‐series or theoretical distributions of headache triggers. The degree of information, reported in bits, was compared across trigger variables, measurement strategies, and settings.

Results

A wide range of information content was observed across headache triggers. Due to lack of variation, there was little information, near 0.00 bits, in triggers like red wine and air conditioning. Most headache triggers exhibited more information when measured using an ordinal scale of presence/degree (e.g., absent, mild, moderate, severe) versus a present/absent binary coding. For example, the trigger “joy” exhibited 0.03 bits when assessed using binary coding but 1.81 bits when coded using an ordinal scale. More information was observed with the use of count data (0.86 to 1.75 bits), Likert rating scales (1.50 to 2.76 bits), validated questionnaires (3.57 to 6.04 bits), weather variables (0.10 to 8.00 bits), and ambulatory monitoring devices (9.19 to 12.61 bits).

Conclusions

Although commonly used, all binary‐coded measurements contain ≤1.00 bit of information. Low levels of information in trigger variables make associations with headache activity more difficult to detect. Assessments that balance information‐rich measurements with reasonable participant burden using efficient formats (e.g., Likert scales) are recommended to enhance the evaluation of the association with headache activity.
University students' academic grit and academic achievements predicted by subjective well‐being, coping resources, and self‐cultivation characteristics
Authors: Harpaz Gal , Vaizman Tal , Yaffe Yosi
Published: July 2023

The connection between grit and achievement in a variety of areas is well documented. Nevertheless, the factors that affect domain‐specific academic grit and the relationship of these factors to academic achievement still require clarification. The present study aimed to explore the contribution of three main categories of variables: subjective well‐being (SWB), coping resources (e.g., self‐efficacy and help‐seeking orientation (HSO)), and self‐cultivation characteristics (e.g., savouring art and personal growth) to academic grit and academic achievement as well as the significance of academic grit as a predictor and mediator for academic achievement. The sample comprised a total of 351 university students between the ages of 18 and 58 from Anglophonic countries (US, Canada, and UK), and Israel. Using structural equation modelling (SEM), academic grit was found to be directly associated with academic achievement among university students while SWB, coping resources, and self‐cultivation characteristics were only indirectly associated with academic achievement with the mediation of academic grit. These results have important educational implications since they reveal existing effects which should serve as a basis for the implementation of university programmes. The results indicate the importance of student well‐being, coping resources, and self‐cultivating characteristics, especially regarding personal growth to perform optimally at university studies.
Trajectory and predictors of family function in caregivers of stroke survivors: A longitudinal study of the first 6 months after stroke
Authors: Zhang Wei , Ye Mingming , Zhou Wanqiong , Gao Yitian , Zhou Lanshu
Published: July 2023

Aims

This study aimed to investigate the trajectory and predictors of family function in caregivers of stroke survivors during the first 6 months after the first episode of stroke.

Design

Longitudinal study.

Methods

A total of 288 primary caregivers of patients with first‐time stroke were recruited from seven tertiary hospitals in China between July 2020 and March 2021. The following characteristics were assessed by caregivers at hospitalization (T0) and at 1 month (T1), 3 months (T2) and 6 months (T3) after the stroke: family function, general self‐efficacy, social support, coping style, caregiver burden, and sociodemographic and clinical data.

Results

Family function scores among caregivers of stroke survivors were highest in the resolve dimension and lowest in the growth and adaptation dimensions within the first 6 months. The percentages of families with low functioning were 34.7%, 33.3%, 24.8% and 17.7% at T0, T1, T2 and T3, respectively. The generalized estimating equation model revealed that family function in caregivers increased over the first 6 months (Exp(B) = 1.415–2.689,p < .05). The following factors were identified as predictors of family functioning: caregiver's age, education, residential district, self‐efficacy, social support utilization and caregiver burden.

Conclusions

Family function of caregivers of stroke survivors gradually increased during the first 6 months after stroke. However, some families demonstrated poor functioning. Caregivers' age, education, caregiver burden, self‐efficacy and social support utilization could predict family function over time.

Impact

Empirical data on family function in families of stroke survivors are important for developing psychosocial interventions that can help families adapt to stroke. This study found that families of stroke survivors were likely to be dysfunctional in the first 6 months after stroke, particularly in family growth and adaptation. Therefore, reducing caregiver burden and promoting self‐efficacy and social support utilization can help restore family functioning early after stroke.

Patient or Public Contribution

Stroke caregivers from seven hospitals in China were involved in this study and had the right to be informed of the main findings. A few patients were informed of the research results, who contributed to the dissemination.
20 years of interactive tasks in large‐scale assessments: Process data as a way towards sustainable change?
Authors: Stadler Matthias , Brandl Laura , Greiff Samuel
Published: July 2023

Background

Over the last 20 years, educational large‐scale assessments have undergone dramatic changes moving away from simple paper‐pencil assessments to innovative, technology‐based assessments. This comprehensive switch has led to some rather technical improvements such as identifying early guessing or improving standardization.

Objectives

At the same time, process data on student interaction with items has been shown to carry value for obtaining, reporting, and interpreting additional results on student skills in international comparisons. In fact, on the basis of innovative simulated assessment environments, news about student rankings, under‐ and overperforming countries, and novel ideas on how to improve educational systems are prominently featured in the media. At the same time, few of these efforts have been used in a sustainable way to create new knowledge (i.e., on a scientific level), to improve learning and instruction (i.e., on a practical level), and to provide actionable advice to political stakeholders (i.e., on a policy level).

Methods

This paper will adopt a meta‐perspective and discuss recent and current developments with a focus on these three perspectives. There will be a particular emphasis on new assessment environments that have been recently employed in large‐scale assessments.

Results and Conclusions

Most findings remain very task specific. We propose a necessary steps that need to be taken in order to yield sustainable change from analysing process data on all three levels.

Implications

New technologies might be capable of contributing to the research‐policy‐practitioner gap when it comes to utilizing the results from large‐scale assessments to increase the quality of education around the globe but this will require a more systematic approach towards researching them.
Environmentally independent selection for hybrids between divergent freshwater stickleback lineages in semi-natural ponds
Authors: Hudson Cameron Marshall , Cuenca Cambronero Maria , Moosmann Marvin , Narwani Anita , Spaak Piet , Seehausen Ole , Matthews Blake
Published: July 2023

Hybridization following secondary contact of genetically divergent populations can influence the range expansion of invasive species, though specific outcomes depend on the environmental dependence of hybrid fitness. Here, using two genetically and ecologically divergent threespine stickleback lineages that differ in their history of freshwater colonization, we estimate fitness variation of parental lineages and hybrids in semi-natural freshwater ponds with contrasting histories of nutrient loading. In our experiment, we found that fish from the older freshwater lineage (Lake Geneva) and hybrids outperformed fish from the younger freshwater lineage (Lake Constance) in terms of both growth and survival, regardless of the environmental context of our ponds. Across all ponds, hybrids exhibited the highest survival. Although wild-caught adult populations differed in their functional and defence morphology, it is unclear which of these traits underlie the fitness differences observed among juveniles in our experiment. Overall, our work suggests that when hybrid fitness is insensitive to environmental conditions, as observed here, introgression may promote population expansion into unoccupied habitats and accelerate invasion success.

Abstract

We experimentally tested the performance of two divergent stickleback lineages and their hybrids under contrasting environmental conditions in a common garden setting. Hybrid fitness appeared insensitive to environmental conditions, and this could indicate that naturally occurring introgression between the populations may promote population expansion.
Surgical site infection following open lobectomy in patients with lung cancer: A prospective study
Authors: Li Shiyu , Lin Ji , Ye Lijuan , Qiao Fu , Huang Wenzhi , Peng Yalan , Huang Jin
Published: July 2023

Objective

To assess the incidence and risk factors of surgical site infection after open pulmonary lobectomy and to quantify their clinical and economic burden.

Methods

A prospective nested case‐control study was performed on patients with lung cancer who underwent open lobectomy in the lung cancer center of West China Hospital from January 2017 to December 2019. Demographic, clinical data and medical costs were recorded. Logistic regression was used to evaluate risk factors associated with surgical site infection. A Mann‐Whitney U test was carried out to evaluate the differences in medical costs.

Results

A total of 1395 patients were eligible, and the surgical site infection incidence was 13.47% (188/1395). Of the 188 instances of surgical site infection, 171 (90.96%) were classified as organ/space infection, 8 (4.25%) as superficial incisional infection and 9 (4.79%) as deep incisional infection. The patients with surgical site infection had significantly higher mortality (3.19% vs. 0.41%, p < 0.001), higher median medical cost (90774.95 yuan vs. 63079.38 yuan, p < 0.001), and longer postoperative length of stay (15 days vs. 9 days, p < 0.001). Multivariate logistic regression analysis indicated that age (odds ratio (OR) = 1.560, p = 0.007), respiratory failure (OR = 5.984, p = 0.0012), American Society of Anesthesiologists score (OR = 1.584, p = 0.005), operating time (OR = 1.950, p < 0.001), and operation team (OR = 1.864, p < 0.001) were independent risk factors for surgical site infection.

Conclusions

The high incidence of surgical site infection indicates that postoperative infections remain a significant clinical burden in patients who underwent open lobectomy. Identifying risk factors timely through prospective surveillance may assist clinical decisions against surgical site infection.
The role of predation risk in structuring life‐history traits of crucian carp (Carassius carassius) in a series of small boreal lakes
Authors: de Meo Ilaria , Østbye Kjartan , Kahilainen Kimmo K. , Poléo Antonio B. S.
Published: July 2023

Predation is a major evolutionary force determining life‐history traits in prey by direct and indirect mechanisms. This study focuses on life‐history trait variation in crucian carp (Carassius carassius), a species well known for developing a deep body as an inducible morphological defence against predation risk. Here, the authors tested variation in growth and reproductive traits in 15 crucian carp populations in lakes along a predation risk gradient represented by increasingly efficient predator communities. Lakes were located in south‐eastern Norway and were sampled in summer 2018 and 2019. The authors expected crucian carp to attain higher growth rate, larger size, and later age at maturity with increasing predation risk. In the absence of predators, they expected high adult mortality, early maturity and increased reproductive effort caused by strong intraspecific competition. They found that the life‐history traits of crucian carp were clearly related to the presence of piscivores: with increasing predation risk, fish grew in body length and depth and attained larger asymptotic length and size at maturity. This growth was evident at young age, especially in productive lakes with pike, and it suggests that fish quickly outgrew the predation window by reaching a size refuge. Contrary to the authors’ predictions, populations had similar age at maturity. High‐predation lakes also presented low density of crucian carp. This suggests that fish from predator lakes may experience high levels of resource availability due to reduced intraspecific competition. Predation regulated life‐history traits in crucian carp populations, where larger size, higher longevity and size at maturity were observed in lakes with large gaped predators.
Traumatic chylothorax in urbanized free‐ranging black‐tufted marmosets (Callithrix penicillata)
Authors: Barros Rafaela Magalhães , de Macêdo Isabel Luana , de Sousa Davi Emanuel Ribeiro , Hirano Líria Queiroz Luz , Paludo Giane Regina , de Castro Márcio Botelho
Published: July 2023

After fatal traumatic injuries, three urbanized free‐ranging marmosets developed a milky white or pink‐white thoracic alkaline effusion with high specific gravity, triglyceride levels, and predominance of small lymphocytes. Chylothorax is an uncommon thoracic fluid accumulation in animals and humans and has not been reported in free‐ranging non‐human primates.
Understanding the Postpartum Cesarean Pain Experience Among Individuals With Publicly Funded Insurance: A Qualitative Investigation
Authors: Badreldin Nevert , DiTosto Julia D. , Leziak Karolina , Niznik Charlotte M. , Yee Lynn M.
Published: July 2023

Introduction

Pain is the most common postpartum concern and has been associated with adverse outcomes, such as difficulty with neonatal bonding, postpartum depression, and persistent pain. Furthermore, racial and ethnic disparities in the management of postpartum pain are well described. Despite this, less is known regarding patients’ lived experiences regrading postpartum pain. The purpose of this study was to assess patient experiences related to postpartum pain management after cesarean birth.

Methods

This is a prospective qualitative study of patients’ experiences with postpartum pain management after cesarean birth at a single large tertiary care center. Individuals were eligible if they had publicly funded prenatal care, were English or Spanish speaking, and underwent a cesarean birth. Purposive sampling was used to ensure a racially and ethnically diverse cohort. Participants underwent in‐depth interviews using a semistructured interview guide at 2 time points: postpartum day 2 to 3 and 2 to 4 weeks after discharge. Interviews addressed perceptions and experiences of postpartum pain management and recovery. Data were analyzed using the constant comparative method.

Results

Of 49 participants, 40.8% identified as non‐Hispanic Black and 40.8% as Hispanic. The majority (59.2%) had experienced a cesarean birth with a prior pregnancy. Thematic analysis yielded 2 overarching domains: (1) experience of pain after cesarean birth and (2) pain management and opioid use after cesarean birth. Themes related to the experience of pain included pain as a meaningful experience, pain not aligned with expectations, and limitations caused by pain. All participants discussed limitations caused by their pain, voicing frustration with pursuing activities of daily living, caring for home and family, caring for neonate, and impact on mood. Themes related to pain management and opioid use addressed a desire for nonpharmacologic pain management, positive and negative experiences using opioids, and hesitancy and perceived judgement regarding opioid use. Several participants described experiences of judgement regarding the request for opioids and needing stronger pain medications, such as oxycodone.

Discussion

Understanding experiences regarding postpartum cesarean pain management and recovery is essential to improving patient‐centered care. The experiences identified by this analysis highlight the need for individualized postpartum pain management, improved expectation counseling, and the expansion of multimodal pain management options.
Effectiveness of interprofessional tracheostomy teams: A systematic review
Authors: Ninan Ashly , Grubb Lisa M. , Brenner Michael J. , Pandian Vinciya
Published: July 2023

Aim(s)

To systematically locate, evaluate and synthesize evidence regarding effectiveness of interprofessional tracheostomy teams in increasing speaking valve use and decreasing time to speech and decannulation, adverse events, lengths of stay (intensive care unit (ICU) and hospital) and mortality. In addition, to evaluate facilitators and barriers to implementing an interprofessional tracheostomy team in hospital settings.

Design

Systematic review using Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) and Johns Hopkins Nursing Evidence‐Based Practice Model's guidance.

Methods

Our clinical question: Do interprofessional tracheostomy teams increase speaking valve use and decrease time to speech and decannulation, adverse events, lengths of stay and mortality? Primary studies involving adult patients with a tracheostomy were included. Eligible studies were systematically reviewed by two reviewers and verified by another two reviewers.

Data Sources

MEDLINE, CINAHL and EMBASE.

Results

Fourteen studies met eligibility criteria; primarily pre‐post intervention cohort studies. Percent increase in speaking valve use ranged 14%–275%; percent reduction in median days to speech ranged 33%–73% and median days to decannulation ranged 26%–32%; percent reduction in rate of adverse events ranged 32%–88%; percent reduction in median hospital length of stay days ranged 18–40 days; no significant change in overall ICU length of stay and mortality rates. Facilitators include team education, coverage, rounds, standardization, communication, lead personnel and automation, patient tracking; barrier is financial.

Conclusion

Patients with tracheostomy who received care from a dedicated interprofessional team showed improvements in several clinical outcomes.

Implications for Patient Care

Additional high‐quality evidence from rigorous, well‐controlled and adequately powered studies are necessary, as are implementation strategies to promote broader adoption of interprofessional tracheostomy team strategies. Interprofessional tracheostomy teams are associated with improved safety and quality of care.

Impact

Evidence from review provides rationale for broader implementation of interprofessional tracheostomy teams.

Reporting Method

PRISMA and Synthesis Without Meta‐analysis (SWiM).

Patient/Public Contribution

None.
Dental prosthesis use is associated with higher protein intake among older adults with tooth loss
Authors: Kusama Taro , Takeuchi Kenji , Kiuchi Sakura , Aida Jun , Hikichi Hiroyuki , Sasaki Satoshi , Kondo Katsunori , Osaka Ken
Published: July 2023

Background

Tooth loss is associated with reduced protein intake, which leads to sarcopenia and frailty in older adults.

Objective

To evaluate the protective effect of dental prostheses on decreased protein intake in older adults with tooth loss.

Methods

This cross‐sectional study was based on a self‐reported questionnaire targeting older adults. Data were obtained from the Iwanuma Survey of the Japan Gerontological Evaluation Study. We used % energy intake (%E) of total protein as the outcome and the use of dental prostheses and number of remaining teeth as explanatory variables. We estimated the controlled direct effects of tooth loss by fixing the use/non‐use of dental prostheses based on a causal mediation analysis, including possible confounders.

Results

Among 2095 participants, the mean age was 81.1 years (1SD = 5.1), and 43.9% were men. The average protein intake was 17.4%E (1SD = 3.4) of the total energy intake. Among participants with ≥20, 10–19 and 0–9 remaining teeth, the average protein intake was 17.7%E, 17.2%E/17.4%E and 17.0%E/15.4%E (with/without a dental prosthesis), respectively. Compared to participants with ≥20 remaining teeth, those with 10–19 remaining teeth without a dental prosthesis did not have a significantly different total protein intake (p > .05). Among those with 0–9 remaining teeth without a dental prosthesis, total protein intake was significantly low (−2.31%, p < .001); however, the use of dental prostheses mitigated the association by 79.4% (p < .001).

Conclusion

Our results suggest that prosthodontic treatment could contribute to maintaining protein intake in older adults with severe tooth loss.
Good people are not like good knives
Authors: Mankowitz Poppy
Published: July 2023

Is anything good simpliciter? And can things count as ‘good’ independent of the context in which ‘good’ is used? Traditionally, a number of meta‐ethicists have given positive answers. But more recently, some philosophers have used observations based on natural language to argue that things can only count as ‘good’ relative to ends and contextual thresholds. I will use work from contemporary linguistics to argue that ‘good’ is ambiguous, and that it has a moral disambiguation that attributes a fixed degree of goodness. This implies that things can count as ‘good’ simpliciter, independent of context. Not only does this result provide support for the traditional view, but it also vindicates some aspects of the more recent view.
A single MYB transcription factor with multiple functions during flower development
Authors: Chopy Mathilde , Binaghi Marta , Cannarozzi Gina , Halitschke Rayko , Boachon Benoît , Heutink Roel , Bomzan Dikki Pedenla , Jäggi Lea , van Geest Geert , Verdonk Julian C. , Kuhlemeier Cris
Published: July 2023

Members of the R2R3‐MYB transcription factor subgroup 19 (SG19) have been extensively studied in multiple plant species using different silenced or mutated lines. Some studies have proposed a function in flower opening, others in floral organ development/maturation, or specialized metabolism production. While SG19 members are clearly key players during flower development and maturation, the resulting picture is complex, confusing our understanding in how SG19 genes function.

To clarify the function of the SG19 transcription factors, we used a single system, Petunia axillaris, and targeted its two SG19 members (EOB1 and EOB2) by CRISPR‐Cas9.

Although EOB1 and EOB2 are highly similar, they display radically different mutant phenotypes. EOB1 has a specific role in scent emission while EOB2 has pleiotropic functions during flower development. The eob2 knockout mutants reveal that EOB2 is a repressor of flower bud senescence by inhibiting ethylene production. Moreover, partial loss‐of‐function mutants (transcriptional activation domain missing) show that EOB2 is also involved in both petal and pistil maturation through regulation of primary and secondary metabolism.

Here, we provide new insights into the genetic regulation of flower maturation and senescence. It also emphasizes the function of EOB2 in the adaptation of plants to specific guilds of pollinators.
Defining the danger zone: critical snow properties for predator–prey interactions
Authors: Sullender Benjamin K. , Cunningham Calum X. , Lundquist Jessica D. , Prugh Laura R.
Published: July 2023

Snowpack dynamics have a major influence on wildlife movement ecology and predator–prey interactions. Specific snow properties such as density, hardness, and depth determine how much an animal sinks into the snowpack, which in turn drives both the energetic cost of locomotion and predation risk. Here, we quantified the relationships between five field‐measured snow variables and snow track sink depths for widely distributed predators (bobcats Lynx rufus, cougars Puma concolor, coyotes Canis latrans, wolves C. lupus) and sympatric ungulate prey (caribou Rangifer tarandus, white‐tailed deer Odocoileus virginianus, mule deer O. hemionus, and moose Alces alces) in interior Alaska and northern Washington, USA. We first used generalized additive models to identify which snow metrics best predicted sink depths for each species and across all species. Next, we used breakpoint regression to identify thresholds of support for the best‐performing predictor of sink depth for each species (i.e. values wherein tracks do not sink appreciably deeper into the snow). Finally, we identified ‘danger zones,' wherein snow impedes the mobility of ungulates more than carnivores, by comparing sink depths relative to hind leg lengths among predator–prey pairs. Near‐surface (0–20 cm) snow density was the strongest predictor of sink depth across species. Thresholds of support occurred at near‐surface snow densities between 220–310 kg m–3 for predators and 300–410 kg m–3 for prey, and danger zones peaked at intermediate snow densities (200–300 kg m–3) for eight of the ten predator–prey pairs. These results can be used to link predator–prey relationships with spatially explicit snow modeling outputs and projected future changes in snow density. As climate change rapidly reshapes snowpack dynamics, these danger zones provide a useful framework to anticipate likely winners and losers of future winter conditions.
The effect of oil price shocks on stock market performance in selected African countries
Authors: Okpezune Chukwuemelie C. , Seraj Mehdi , Ozdeser Huseyin
Published: July 2023

The study's objective was to investigate how changes in oil prices affect stock market performance. The study's population consisted of selected African countries chosen based on factors like the size of their stock markets and whether or not they import or export oil. The world development indicator (WDI) and the OPEC bulletin or website served as sources for the data. The vector error correction model was used to analyse the collected data. Regarding the impact of oil price fluctuations on the performance of the stock market, the findings of the study were mixed. Oil price fluctuations have a positive impact on stock market performance for countries that import oil. For oil‐trading countries, the impacts were found to differ across examined countries. Oil price fluctuations had a mixed effect on both large and small stock markets. This demonstrates how crucial it is to investigate changes in the price of oil and how they might impact stock market performance, particularly in African countries.
Ligelizumab in adolescents with chronic spontaneous urticaria: Results of a dedicated phase 2b randomized clinical trial supported with pharmacometric analysis
Authors: Staubach Petra , Alvaro‐Lozano Montserrat , Sekerel Bulent Enis , Maurer Marcus , Ben‐Shoshan Moshe , Porter Miriam , Hua Eva , Ji Yan , Burciu Alis , Savelieva Marina , Severin Thomas , Drollmann Anton , Bienczak Andrzej
Published: July 2023

Background

Chronic spontaneous urticaria (CSU), a long‐lasting disease in children, impacts their quality of life. We report the results of a phase 2b dose‐finding trial of ligelizumab (NCT03437278) and a high‐affinity humanized monoclonal anti‐IgE antibody, in adolescents with CSU, supported by modeling and simulation analyses, mitigating challenges in pediatric drug development.

Methods

This multicenter, double‐blind, placebo‐controlled trial, randomized H1‐antihistamine‐refractory adolescent CSU patients (12–18 years) 2:1:1 to ligelizumab 24 mg, 120 mg, or placebo every 4 weeks for 24 weeks. Patients on placebo transitioned to ligelizumab 120 mg at week 12. Integrating data from the previous adult and present adolescent trial of ligelizumab, a nonlinear mixed‐effects modeling described the longitudinal changes in ligelizumab pharmacokinetics, and its effect on weekly Urticaria Activity Score (UAS7).

Results

Baseline UAS7 (mean ± SD) was 30.5 ± 7.3 (n = 24), 29.3 ± 7.7 (n = 13), and 32.5 ± 9.0 (n = 12) for patients (median age, 15 years) on ligelizumab 24 mg, 120 mg, and placebo, respectively. Change from baseline in UAS7 at week 12 with ligelizumab 24 mg, 120 mg, and placebo was −15.7 ± 10.9, −18.4 ± 12.3, and −13.0 ± 13.0, respectively. Ligelizumab was well‐tolerated. The modeling analysis showed that body weight, but not age, affected ligelizumab's apparent clearance. No significant differences between adolescents and adults were detected on the model‐estimated maximum effect and potency.

Conclusions

Ligelizumab exhibited efficacy and safety in adolescent CSU patients, consistent with that in adults. The PK and potency of ligelizumab were not impacted by age, and the same dose of ligelizumab can be used for treating adolescents and adults with CSU. Our study shows how modeling and simulation can complement pediatric drug development.
Siblings and risk of allergic rhinitis: A systematic review and meta‐analysis
Authors: Lisik Daniil , Ermis Saliha Selin Özuygur , Ioannidou Athina , Milani Gregorio Paolo , Nyassi Sungkutu , Spolidoro Giulia Carla Immacolata , Kankaanranta Hannu , Goksör Emma , Wennergren Göran , Nwaru Bright Ibeabughichi
Published: July 2023

Following the “hygiene hypothesis” and the increase in the prevalence of atopic diseases such as allergic rhinitis, a plethora of studies have investigated the role of sibship composition as a protective factor, but findings are conflicting. The aim of this study was to synthesize the global literature linking birth order and sibship size (number of siblings) to the risk of allergic rhinitis. Fifteen databases were systematically searched, with no restrictions on publication date or language. Observational studies with defined sibship composition (birth order or sibship size) as exposure and allergic rhinitis or allergic rhinoconjunctivitis (self‐reported or clinically diagnosed) as outcome were eligible. Study selection, data extraction, and quality assessment were performed independently in pairs. Relevant data were summarized in tables. Comparable numerical data were analyzed using meta‐analysis with robust variance estimation (RVE). Seventy‐six reports with >2 million subjects were identified. Being second‐ or later‐born child was associated with protection against both current (pooled risk ratio [RR] 0.79, 95% CI 0.73–0.86) and ever (RR 0.77, 95% CI 0.68–0.88) allergic rhinitis. Having siblings, regardless of birth order, was associated with a decreased risk of current allergic rhinitis (RR 0.89, 95% CI 0.83–0.95) and allergic rhinoconjunctivitis (RR 0.92, 95% CI 0.86–0.98). These effects were unchanged across age, time period, and geographical regions. Our findings thus indicate that primarily, a higher birth order, and to a lesser extent the number of siblings, is associated with a lower risk of developing allergic rhinitis.
An ancient route towards salicylic acid and its implications for the perpetual Trichormus–Azolla symbiosis
Authors: de Vries Sophie , Herrfurth Cornelia , Li Fay‐Wei , Feussner Ivo , de Vries Jan
Published: July 2023

Despite its small size, the water fern Azolla is a giant among plant symbioses. Within each of its leaflets, a specialized leaf cavity is home to a population of nitrogen‐fixing cyanobacteria (cyanobionts). Although a number of plant–cyanobiont symbioses exist, Azolla is unique in that its symbiosis is perpetual: the cyanobionts are inherited during sexual and vegetative propagation. What underpins the communication between the two partners? In angiosperms, the phytohormone salicylic acid (SA) is a well‐known regulator of plant–microbe interactions. Using high‐performance liquid chromatography–tandem mass spectrometry, we pinpoint the presence of SA in the fern. Comparative genomics and phylogenetics on SA biosynthesis genes across Chloroplastida reveal that the entire Phenylalanine ammonia‐lyase‐dependent pathway likely existed in the last common ancestor of land plants. Indeed, Azolla filiculoides secondarily lost its isochorismate synthase but has the genetic competence to derive SA from benzoic acid; the presence of SA in artificially cyanobiont‐free Azolla supports the existence of this route. Global gene expression data and SA levels from cyanobiont‐containing and ‐free A. filiculoides link SA synthesis with the symbioses: SA appears to induce cyanobacterial proliferation, whereas removal of the symbiont results in reduced SA levels in a nitrogen‐dependent manner.