bluuebunny/crossref_metadata_2025 huggingface dataset:
In sickness and in health: Loneliness, depression, and the role of marital quality among spouses of persons with dementia
Authors: Hsu Kristie Y. , Cenzer Irena , Harrison Krista L. , Ritchie Christine S. , Waite Linda , Kotwal Ashwin
Published: August 2023

Background

Older adults married to persons living with dementia (PLwD) may be at risk for loneliness and depression. We assessed the prevalence of loneliness and depressive symptoms among spouses of PLwD or cognitive impairment not dementia (CIND), and the role of marital quality in mediating these outcomes.

Methods

We used a US population‐based sample of 4071 couples enrolled in the Health and Retirement Study (2014 and 2016). We included older adults married to PLwD (N = 227), married to persons with CIND (N = 885), or married to persons with no cognitive impairment (NCI) (N = 2959). We determined the prevalence of loneliness (UCLA 3‐item scale), depressive symptoms (CESD‐8 scale), and both, using multivariable logistic regression adjusting for sociodemographic and health‐related characteristics. We then tested for interaction terms between marital quality (4‐item scale) and degree of spousal cognitive impairment for each outcome of loneliness and depressive symptoms.

Results

The sample was 55% women and on average 67‐years‐old (range: 50–97). After adjustment, spouses of persons with cognitive impairment were more likely to be lonely (NCI: 20%, CIND: 23%, PLwD: 29%; p = 0.04), depressed (NCI: 8%, CIND: 15%, PLwD: 14%; p < 0.01), and both (NCI: 4%, CIND: 9%, PLwD: 7%; p < 0.01). The association between cognition and loneliness, but not depression, differed by marital quality (interaction p‐value = 0.03). Among couples with high marital quality, spousal cognitive impairment was associated with higher likelihood of loneliness (p < 0.05). In contrast, no association existed between spousal cognition and loneliness among couples with lower marital quality (p = 0.37).

Conclusions

One in six spouses of persons with CIND or more advanced disease (PLwD) experienced depressive symptoms, and loneliness among spouses of PLwD was experienced at a twofold rate. By identifying and managing both, and facilitating interventions that promote high‐quality social connection, clinical teams might improve the lives of older couples facing dementia.
Positive and ecobiological contribution in skin photoprotection of ectoine and mannitol combined in vivo with UV filters
Authors: Fontbonne Arnaud , Teme Baba , Abric Elise , Lecerf Guillaume , Callejon Sylvie , Moga Alain , Cadars Benoît , Giraud Félix , Chavagnac‐Bonneville Marlène , Ardiet Nathalie , Guyoux Aurélie , Trompezinski Sandra
Published: August 2023

Background

Chronic exposure to ultraviolet (UV) irradiation causes immunosuppression, photoaging, and carcinogenesis by induction of a cascade of skin damages. Sunscreens currently on the market are not absorbing UV rays uniformly throughout the full UV range, high sun protection factor (SPF) sunscreens absorb most of UVB rays but are less effective in absorbing the UVA part of the spectrum. In the context, one approach could consist of preserving the skin natural resources and mechanisms, which is the foundation of the ecobiological approach, by combing UV filters and antioxidants to enhance their photoprotective effect.

Methods

First, the photoprotection properties of ectoine and mannitol association were characterized by the quantification of glutathione, reactive oxygen species, and double‐stranded DNA breaks and by the epidermal Langerhans cells functionality. Second, the protection of squalene oxidation, catalase activity, and trans‐urocanic acid (UCA) by the ectoine and mannitol association combined or not with SPF30 UV filters was assessed in vivo via non‐invasive skin samplings in 10 subjects on irradiated areas.

Results

Using in vitro irradiated skin cell models, we demonstrated that this association significantly preserved intracellular glutathione levels, reduced DNA strand breaks induced by oxidative stress, and maintained Langerhans cell functionality. In vivo this association combined with UV filters presented significantly higher protection of three natural defense systems altered by UV compared to UV filters alone: squalene oxidation, catalase activity, and preservation of trans‐UCA.

Conclusion

This study demonstrates the ecobiological potential of combining UV filters with biological protection to increase skin photoprotection provided by specific active ingredients with antioxidative and immunosuppressive properties.
Non‐surgical rhinoplasty using polydioxanone threads
Authors: Sulyman Omotara , Cristel Robert , Gandhi Nimit , Kola Eljona , Borst Selika Gutierrez , Caughlin Benjamin , Dayan Steven
Published: August 2023

Objective

To demonstrate the effects of PDO threads non‐surgical rhinoplasty on patients' quality of life (using FACE‐Q Scale) and first impression assessments.

Methods

This is a prospective cohort study of 10 adult patients who sought non surgical rhinoplasty to improve tip rotation or reduce the appearance of a dorsal hump. All patients fulfilled the study's enrollment criteria. Prior to treatment, patients completed pre‐treatment FACE‐Q surveys and pre‐treatment photos were obtained. Each patient was treated with the appropriate size and number of PDO threads necessary to achieve optimal correction result (OCR). Two weeks after treatment, the patient completed posttreatment FACE‐Q surveys and posttreatment photos were obtained and analyzed. First impression surveys were created using pre‐ and posttreatment photos, and the survey was completed by 146 blinded evaluators.

Results

There was statistically significant improvement in the FACE‐Q scores for social function (p = 0.02), psychological function (p = 0.0009) and satisfaction with nose (p = 0.0001). There was significant reduction in scores for appearance related psychosocial distress (p = 0.03). For the first impression surveys, there was a statistically significant improvement (p = 0.029) in the attractiveness scale posttreatment. Although not statistically significant, there was reduction of the dorsal hump (p = 0.15) and increase in the nasolabial angle (p = 0.48) and Goode's ratio (p = 0.16). There were no major adverse events or complications.

Conclusion

This study shows that the PDO threads alone can be used safely to achieve minor nasal changes especially in tip rotation and appearance of dorsal hump, to improve patients' quality of life, and perceived attractiveness of treated patients.
Influence of landfill use on nest‐site selection and breeding success in white storks
Authors: López‐García A. , Martínez‐Miranzo B. , Aguirre J. I.
Published: August 2023

Landscape transformation by humans through habitat degradation, agriculture intensification and urbanization results in the loss of natural feeding areas. However, populations of certain species have adapted to these changes and benefit from some anthropogenic food sources as well as an absence of predators and milder environmental conditions in urban landscapes. Although breeding near landfills secures food availability and saves energy and time spent on foraging activities, the poor food quality and risks associated with these facilities imply some fitness costs. Our study shows the effects of landfills on nest‐site selection and breeding success in white storks (Ciconia ciconia). Birds breeding near landfills occupy more urban areas where many structures are available to nest, while breeding pairs 20–30 km from landfills select nest sites with high‐quality food sources in the vicinity such as pastures, meadows and agro‐forestry areas. Furthermore, we demonstrate that habitat quality in the surrounding area is more relevant than landfills for breeding outcomes, but both of these are crucial for brood size. The number of fledglings was higher at a medium distance to the landfill than at 20–30 km from the landfill, but not near the landfill (0–10 km). This suggests that the best strategy includes food from landfills as a complementary or alternative food source. Future studies should further investigate if these shifts in habitat preference are permanent, and the potential impact of habitat degradation and landfill closures at a population level, for this species.
Phylogenomics insights into gene evolution, rapid species diversification, and morphological innovation of the apple tribe (Maleae, Rosaceae)
Authors: Zhang Lin , Morales‐Briones Diego F. , Li Yujie , Zhang Guojin , Zhang Taikui , Huang Chien‐Hsun , Guo Peng , Zhang Kaiming , Wang Yihan , Wang Hongwei , Shang Fu‐De , Ma Hong
Published: August 2023

Maleae is one of the most widespread tribes of Rosaceae and includes several important fruit crops and ornamental plants.

We used nuclear genes from 62 transcriptomes/genomes, including 26 newly generated transcriptomes, to reconstruct a well‐supported phylogeny and study the evolution of fruit and leaf morphology and the possible effect of whole genome duplication (WGD).

Our phylogeny recovered 11 well‐supported clades and supported the monophyly of most genera (except Malus, Sorbus, and Pourthiaea) with at least two sampled species. A WGD was located to the most recent common ancestor (MRCA) of Maleae and dated to c. 54 million years ago (Ma) near the Early Eocene Climatic Optimum, supporting Gillenieae (x = 9) being a parental lineage of Maleae (x = 17) and including duplicate regulatory genes related to the origin of the fleshy pome fruit. Whole genome duplication‐derived paralogs that are retained in specific lineages but lost in others are predicted to function in development, metabolism, and other processes. An upshift of diversification and innovations of fruit and leaf morphologies occurred at the MRCA of the Malinae subtribe, coinciding with the Eocene–Oligocene transition (c. 34 Ma), following a lag from the time of the WGD event.

Our results provide new insights into the Maleae phylogeny, its rapid diversification, and morphological and molecular evolution.
Risk Factors of Nonfusion after Anterior Cervical Decompression and Fusion in the Early Postoperative Period: A Retrospective Study
Authors: Peng Zihan , Liu Li , Sheng Xiaqing , Liu Hao , Ding Chen , Wang Beiyu , Hong Ying , Pan Xiaoli , Meng Yang
Published: August 2023

Objective

Although high fusion rates have been reported for anterior cervical decompression and fusion (ACDF) in the medium and long term, the risk of nonfusion in the early period after ACDF remains substantial. This study investigates early risk factors for cage nonfusion in patients undergoing single‐ or multi‐level ACDF.

Methods

This was a retrospective study. From August 2020 to December 2021, 107 patients with ACDF, including 197 segments, were enrolled, with a follow‐up of 3 months. Among the 197 segments, 155 were diagnosed with nonfusion (Nonfusion group), and 42 were diagnosed with fusion (Fusion group) in the early period after ACDF. We assessed the significance of the patient‐specific factors, radiographic indicators, serum factors, and clinical outcomes. The Wilcoxon rank sum test, t‐tests, analysis of variance, and stepwise multivariate logistic regression were used for statistical analysis.

Results

Univariate analysis showed that smoking, insufficient improvement in the C2‐7 Cobb angle (p = 0.024) and the functional spinal unit Cobb angle (p = 0.022) between preoperative and postoperative stages and lower serum calcium (fusion: 2.34 ± 0.12 mmol/L; nonfusion: 2.28 ± 0.17 mmol/L, p = 0.003) β‐carboxyterminal telopeptide end of type 1 collagen (β‐CTX) (fusion: 0.51 [0.38, 0.71]; nonfusion: 0.43 [0.31, 0.57], p = 0.008), and N‐terminal fragment of osteocalcin (N‐MID‐BGP) (fusion: 18.30 [12.15, 22.60]; nonfusion: 14.45 [11.65, 18.60], p = 0.023) are risk factors for nonfusion in the early period after ACDF. Stepwise logistic regression analysis revealed that poor C2‐7 Cobb angle improvement (odds ratio [OR], 1.107 [1.019–1.204], p = 0.017) and lower serum calcium (OR, 3.700 [1.138–12.032], p = 0.030) are risk factors.

Conclusions

Patients with successful fusion after ACDF had higher preoperative serum calcium and improved C2‐7 Cobb angle than nonfusion patients at 3 months. These findings suggest that serum calcium could be used to identify patients at risk of nonfusion following ACDF and that correcting the C2‐7 Cobb angle during surgery could potentially increase fusion in the early period after ACDF.
Surgical Strategy and Outcomes of Full Endoscopic Lumbar Discectomy for Recurrent Lumbar Disk Herniation Following a Previous Full Endoscopic Lumbar Discectomy
Authors: Wang Yan , Liu Houchen , Lin Antao , Zhang Hao , Ma Xuexiao
Published: August 2023

Objective

Recurrent lumbar disc herniation (RLDH) cannot be prevented after full endoscopic lumbar discectomy (FELD), and the optimal surgical treatment for RLDH after FELD remains controversial. The aim of the study was to suggest a surgical strategy for FELD to treat RLDH following a previous FELD and to present surgical outcomes.

Methods

Between February 2015 and March 2022, 68 patients with RLDH were surgically treated with FELD retrospectively. An original approach was suggested for the treatment of early recurrence (24 h‐2 weeks). The full endoscopic transforaminal technique (FETD) was considered for patients requiring local anesthesia, and in RLDH with FETD indications or FEID technological difficulties. The full endoscopic interlaminar technique (FEID) was chosen in RLDH with FEID indications. Both FEID and FETD were suitable if no FEID or FETD technological difficulties existed. Clinical efficacy was evaluated using the visual analog scale (VAS) score, Oswestry disability index (ODI), and modified MacNab criteria. Postoperative follow‐up data at 24 h, 3 months, and final‐follow‐up were recorded. Operation time and clinical outcomes were assessed with t test. p‐value < 0.05 was considered statistically significant.

Results

All 68 patients had an average follow‐up time of 23.8 months (range, 6–76 months). In the 13 cases of early recurrence, the operation time (32.30 ± 9.67 vs. 58.00 ± 6.16 min) in the original surgical approach group was shorter than that in the changing surgical approach group (p < 0.05). In the 28 cases of L4/5 FETD recurrence (>2 weeks), the operation time (66.17 ± 12.18 vs. 53.60 ± 5.45 min) in the FETD group was more than that in the FEID group (p < 0.05). In the 22 cases of L5S1 recurrence (>2 weeks), the operation time (55.75 ± 8.79 vs. 79.33 ± 6.65 min) in the FEID group was shorter than in the FETD group (p < 0.05). The postoperative VAS and ODI scores at 24 h, 3 months, and final‐follow up were all significantly improved, compared with their preoperative counterparts (p < 0.05). Based on the modified MacNab criteria, 88.23% of patients showed excellent or good results. Re‐recurrence occurred in three patients at 3 months. No surgical complications were observed in any of the 68 cases.

Conclusion

FELD is a safe and effective treatment option for RLDH with previous FELD. For early recurrence, the original approach was suggested. Both FEID and FETD were effective and safe for recurrence (>2 weeks), but FEID seemed more efficient for L4/5 RLDH after previous FETD and for L5S1 RLDH.
Domains Rearranged Methylase 2 maintains DNA methylation at large DNA hypomethylated shores and long‐range chromatin interactions in rice
Authors: Zhang Wei , Wang Huanhuan , Ma Yuning , Gao Baibai , Guan Pengpeng , Huang Xingyu , Ouyang Weizhi , Guo Minrong , Chen Guoting , Li Guoliang , Li Xingwang
Published: August 2023

DNA methylation plays an important role in gene regulation and genomic stability. However, large DNA hypomethylated regions known as DNA methylation valleys (DMVs) or canyons have also been suggested to serve unique regulatory functions, largely unknown in rice (Oryza sativa). Here, we describe the DMVs in rice seedlings, which were highly enriched with developmental and transcription regulatory genes. Further detailed analysis indicated that grand DMVs (gDMVs) might be derived from nuclear integrants of organelle DNA (NORGs). Furthermore, Domains Rearranged Methylase 2 (OsDRM2) maintained DNA methylation at short DMV (sDMV) shores. Epigenetic maps indicated that sDMVs were marked with H3K4me3 and/or H3K27me3, although the loss of DNA methylation had a negligible effect on histone modification within these regions. In addition, we constructed H3K27me3‐associated interaction maps for homozygous T‐DNA insertion mutant of the gene (osdrm2) and wild type (WT). From a global perspective, most (90%) compartments were stable between osdrm2 and WT plants. At a high resolution, we observed a dramatic loss of long‐range chromatin loops in osdrm2, which suffered an extensive loss of non‐CG (CHG and CHH, H = A, T, or C) methylation. From another viewpoint, the loss of non‐CG methylation at sDMV shores in osdrm2 could disrupt H3K27me3‐mediated chromatin interaction networks. Overall, our results demonstrated that DMVs are a key genomic feature in rice and are precisely regulated by epigenetic modifications, including DNA methylation and histone modifications. OsDRM2 maintained DNA methylation at sDMV shores, while OsDRM2 deficiency strongly affected three‐dimensional (3D) genome architectures.
Political animals in the Modern World: An Investigation of the National Animal Symbol
Authors: Zhu Jintao , Ilsinger Gregor
Published: August 2023

National symbols play a significant role in contemporary politics by shaping national identities. However, national animals receive little attention in the scholarship. This paper analysed the national animal’s history, strengths, formation and implications as a political symbol. It argues that using the animal as a national symbol has distinctive strengths because animal symbols have concrete traits and an interactive dimension. However, the national animals are not granted the same political significance in the formal institutional setting as other symbols because of the concern about exacerbating disunity between nations and potential undesirable international responses. Nonetheless, when the separatist movements of Catalonia and Flanders utilise the national animal, it does not face the same challenges and therefore has received more popularity from the nationals.
The novel HLA‐DQB1*06:475 allele, identified by Sanger dideoxy nucleotide sequencing in a Chinese individual
Authors: Wang Xin , Xiao Qing , Du Ke‐Ming , Zheng Zhong‐Zheng , Wang Li
Published: August 2023

HLA‐DQB1*06:475 differs from HLA‐DQB1*06:35 by one nucleotide in exon 2.
Description of two new HLA alleles: HLA‐DRB1*09:01:12 and HLA‐DRB1*09:49
Authors: Wang Fang , Li Ying , Chen Nanying , Zhang Wei , Zhu Faming
Published: August 2023

Compared to HLA‐DRB1*09:01:02:01, the alleles HLA‐DRB1*09:01:12 and HLA‐DRB1*09:49 each show one nucleotide substitution, respectively.
Ancient hybridization inCurcuma(Zingiberaceae)—Accelerator or brake in lineage diversifications?
Authors: Skopalíková Jana , Leong‐Škorničková Jana , Šída Otakar , Newman Mark , Chumová Zuzana , Zeisek Vojtěch , Jarolímová Vlasta , Poulsen Axel Dalberg , Dantas‐Queiroz Marcos V. , Fér Tomáš , Záveská Eliška
Published: August 2023

Hybridization is a widespread phenomenon in the evolution of plants and exploring its role is crucial to understanding diversification processes of many taxonomic groups. Recently, more attention is focused on the role of ancient hybridization that has repeatedly been shown as triggers of evolutionary radiation, although in some cases, it can prevent further diversification. The causes, frequency, and consequences of ancient hybridization remain to be explored. Here, we present an account of several events of ancient hybridization in turmeric, the economically important plant genusCurcuma(Zingiberaceae), which harbors about 130 known species. We analyzed 1094 targeted low‐copy genes and plastomes obtained by next‐generation sequencing of 37 species ofCurcuma, representing the known genetic diversity and spanning the geographical distribution of the genus. Using phylogenetic network analysis, we show that the entire genusCurcumaas well as its most speciose lineage arose via introgression from the genusPyrgophyllumand one of the extinct lineages, respectively. We also document a single event of ancient hybridization, withC. vamanaas a product, that represents an evolutionary dead end. We further discuss distinct circumstances of those hybridization events that deal mainly with (in)congruence in chromosome counts of the parental lineages.
Structure Optimization and Cooling Performance of a Heat Sink With Discontinuous Triangular Ribs Impacted by Hybrid Nanofluid Confined Slot Jet Impingement
Authors: Tang Zhiguo , Yin Chao , Xiang Yi , Wang Qinsheng , Cheng Jianping
Published: August 2023

Due to the increased use of high heat flux electronic equipment, improving the heat transfer capacity and surface temperature uniformity of heat sinks have become a major concern. In this study, a novel confined slot jet impingement heat sink with discontinuous triangular ribs (CSJIHS-TR) in the wall impingement zone is proposed. The upper cover plate is angled to improve the ability of the heat sink to dissipate heat. A Cu-Al2O3/water hybrid nanofluid is chosen as coolant. The main structural parameters of CSJIHS-TR are optimized using multi-objective. The optimized CSJIHS-TR is investigated using the Re and φ of the hybrid nanofluid. The results show that the optimized CSJIHS-TR exhibits an improved heat transfer capacity. The optimized CSJIHS-TR achieves a 27.8% improvement in performance evaluation criterion (PEC) and a 91.0% reduction in temperature standard deviation (Tstd) compared to the confined slot jet impingement flat-plate heat sink (CSJIFPHS). As Re of the jet impingement and φ of the hybrid nanofluid increase, the heat transfer capacity and temperature uniformity of the optimized CSJIHS-TR increase; however, the flow resistance of CSJIHS-TR also increases. In addition, compared with the mononanofluid, the temperature uniformity and the heat transfer capacity of the CSJIHS-TR with hybrid nanofluid are significantly improved.
Monomerization of TDP-43 is a key determinant for inducing TDP-43 pathology in amyotrophic lateral sclerosis
Authors: Oiwa Kotaro , Watanabe Seiji , Onodera Kazunari , Iguchi Yohei , Kinoshita Yukako , Komine Okiru , Sobue Akira , Okada Yohei , Katsuno Masahisa , Yamanaka Koji
Published: August 2023

The cytoplasmic aggregation of TAR DNA binding protein-43 (TDP-43), also known as TDP-43 pathology, is the pathological hallmark of amyotrophic lateral sclerosis (ALS). However, the mechanism underlying TDP-43 cytoplasmic mislocalization and subsequent aggregation remains unclear. Here, we show that TDP-43 dimerization/multimerization is impaired in the postmortem brains and spinal cords of patients with sporadic ALS and that N-terminal dimerization–deficient TDP-43 consists of pathological inclusion bodies in ALS motor neurons. Expression of N-terminal dimerization–deficient mutant TDP-43 in Neuro2a cells and induced pluripotent stem cell–derived motor neurons recapitulates TDP-43 pathology, such as Nxf1-dependent cytoplasmic mislocalization and aggregate formation, which induces seeding effects. Furthermore, TDP-DiLuc, a bimolecular luminescence complementation reporter assay, could detect decreased N-terminal dimerization of TDP-43 before TDP-43 pathological changes caused by the transcription inhibition linked to aberrant RNA metabolism in ALS. These findings identified TDP-43 monomerization as a critical determinant inducing TDP-43 pathology in ALS.
Constitutive Turbodomains enhance expansion and antitumor activity of allogeneic BCMA CAR T cells in preclinical models
Authors: Lin Regina J. , Sutton Janette , Bentley Trevor , Vargas-Inchaustegui Diego A. , Nguyen Duy , Cheng Hsin-Yuan , Yoon Hayung , Van Blarcom Thomas J. , Sasu Barbra J. , Panowski Siler H. , Sommer Cesar
Published: August 2023

The magnitude of CAR T cell expansion has been associated with clinical efficacy. Although cytokines can augment CAR T cell proliferation, systemically administered cytokines can result in toxicities. To gain the benefits of cytokine signaling while mitigating toxicities, we designed constitutively active synthetic cytokine receptor chimeras (constitutive Turbodomains) that signal in a CAR T cell–specific manner. The modular design of Turbodomains enables diverse cytokine signaling outputs from a single homodimeric receptor chimera and allows multiplexing of different cytokine signals. Turbodomains containing an IL-2/15Rβ–derived signaling domain closely mimicked IL-15 signaling and enhanced CAR T cell potency. Allogeneic TurboCAR T cells targeting BCMA showed no evidence of aberrant proliferation yet displayed enhanced expansion and antitumor activity, prolonging survival and preventing extramedullary relapses in mouse models. These results illustrate the potential of constitutive Turbodomains to achieve selective potentiation of CAR T cells and demonstrate the safety and efficacy of allogeneic BCMA TurboCAR T cells, supporting clinical evaluation in multiple myeloma.
Escape from the pore
Authors: Yin Xiangyun , Eisenbarth Stephanie C.
Published: August 2023

Perforin-2 mediates endocytic escape in cross-presenting dendritic cells.
Intravitreal bevacizumab improves trabeculectomy survival at 12 months: the bevacizumab in trabeculectomy study—a randomised clinical trial
Authors: Landers John A , Mullany Sean , Craig Jamie E
Published: August 2023

Aims

To evaluate the effect of an intraoperative dose of intravitreal bevacizumab (Avastin) on surgical success following trabeculectomy with mitomycin-C (MMC) over 12 months.

Methods

A single centre, parallel, double-blinded randomised, placebo-controlled trial recruiting patients requiring trabeculectomy for progressing glaucoma. Patients were randomised to intravitreal bevacizumab or placebo.

Main outcome measure

The primary outcome of treatment success was defined by ‘complete success’ when intraocular pressure (IOP) remained less than a predefined target IOP without the requirement of topical medication, or ‘qualified success’ where topical medication was required to meet the predefined target IOP threshold. Secondary outcomes included the need for subsequent IOP-lowering interventions, and structural parameters associated with bleb function.

Results

From 131 patients randomised to bevacizumab (n=65) or placebo (n=66), 128 patients completed 12 months of follow-up (98%). At 12 months, success rates were higher in the bevacizumab group (complete success: 94% vs 83%; p=0.015; qualified success: 98% vs 90%; p=0.033). Within the placebo group, the requirement for topical therapy was higher at 6 months (p=0.045) and 12 months (p=0.045), and the requirement for bleb needling was higher at 1 month (p=0.035). Blebs within the bevacizumab group were larger at 1 month (p<0.001) and demonstrated less vessel inflammation (p<0.0001).

Conclusion

Bevacizumab given as a single intravitreal dose during trabeculectomy with MMC resulted in improved surgical success as 12 months. Furthermore, bevacizumab was associated with a significant reduction in the need for additional medication or further surgery to achieve target IOP. Bevacizumab was also associated with larger blebs that were less inflamed and required fewer subsequent interventions.

Trial registration number

ACTRN12614000375651.
Oxford brain health clinic: protocol and research database
Authors: O'Donoghue Melissa Clare , Blane Jasmine , Gillis Grace , Mitchell Robert , Lindsay Karen , Semple Juliet , Pretorius Pieter M , Griffanti Ludovica , Fossey Jane , Raymont Vanessa , Martos Lola , Mackay Clare E
Published: August 2023

Introduction

Despite major advances in the field of neuroscience over the last three decades, the quality of assessments available to patients with memory problems in later life has barely changed. At the same time, a large proportion of dementia biomarker research is conducted in selected research samples that often poorly reflect the demographics of the population of patients who present to memory clinics. The Oxford Brain Health Clinic (BHC) is a newly developed clinical assessment service with embedded research in which all patients are offered high-quality clinical and research assessments, including MRI, as standard.

Methods and analysis

Here we describe the BHC protocol, including aligning our MRI scans with those collected in the UK Biobank. We evaluate rates of research consent for the first 108 patients (data collection ongoing) and the ability of typical psychiatry-led NHS memory-clinic patients to tolerate both clinical and research assessments.

Ethics and dissemination

Our ethics and consenting process enables patients to choose the level of research participation that suits them. This generates high rates of consent, enabling us to populate a research database with high-quality data that will be disseminated through a national platform (the Dementias Platform UK data portal).
Routine use of a 3D mapping system in the ablation of supraventricular arrhythmias with as low as reasonably achievable X-ray exposure (AALARA): protocol for a prospective, observational, multicentre, multinational, open-label registry study
Authors: Szegedi Nandor , Kropotkin Evgeniy , Traykov Vassil , Abdrakhmanov Ayan , Lorgat Faizel , Sapelnikov Oleg , Simons Stefanie , Amin Mohammad I
Published: August 2023

Introduction

The reduction of fluoroscopic exposure during catheter ablation of supraventricular arrhythmias is widely adopted by experienced electrophysiology physicians with a relatively short learning curve and is becoming standard of care in many parts of the world. While observational studies in the USA and some parts of Western Europe have evaluated the minimal fluoroscopic approach, there are scarce real-world data for this technique and generalisability of outcome in other economic regions.

Methods and analysis

The arrhythmias with as low as reasonably achievable X-ray exposure study is a prospective, observational, multicentre and multinational open-label registry study. Up to 700 patients undergoing catheter ablation for right-sided supraventricular arrhythmias (according to national guidelines) will be enrolled for the routine use of the EnSite Precision 3D mapping system. Participating sites are distributed in 13 countries from Central Eastern Europe, North and South Africa, the Middle East and the CIS (Commonwealth of Independent States), with different levels of expertise using minimal fluoroscopic exposure techniques. After electrophysiological procedure, patients will be followed up for 6 months either in-clinic or via telephone interview. Patients will be asked to complete a study questionnaire at enrolment and 6 months after the invasive procedure to assess quality of life changes secondary to the procedure. The study’s primary objective is to describe ionising radiation exposure during catheter ablation when the EnSite Precision 3D mapping system is used in supraventricular tachycardia ablation. The study’s secondary objective is to assess the safety and efficacy of this method. Furthermore, fluoroscopy timing, total procedure time, success rate and complications will be reported.

Ethics and dissemination

The study was approved by the ethics committee at Mohammed Bin Khalifa Specialist Cardiac Centre (BDF/R&REC/2020-504) and the medical ethics committees of all participating sites. Participants will be required to provide informed consent before enrolment in the study. The study results will be published and presented at conferences.

Trial registration number

NCT04716270
Identifying physical and psychological risk factors for musculoskeletal pain in student musicians to tailor the curriculum: a cross-sectional study protocol
Authors: James Clara E , Schmid Audrey , Nguyen-Danse Dung Anh , Bruyneel Anne-Violette
Published: August 2023

Introduction

Insufficient identification and understanding of risk factors make musicians engaging in professional practice particularly vulnerable to musculoskeletal pain. To support positive music learning and good mental, physical, and social health, student musicians need health support tailored to their needs and their instrumental practice. However, these preventive actions must be based on sound scientific approaches that reliably identify the most relevant risk factors. MuSa is a cross-sectional study examining contextual and internal risk variables associated with playing-related musculoskeletal disorders in student musicians.

Method and analysis

The design is a monocentric cross-sectional study involving student musicians in Bachelor’s 1, 2, 3 and Master’s 1, 2. Free-form questions will identify students’ lifestyle characteristics and work habits, and validated questionnaires will evaluate the interaction between pain due to music practice and psychological and physical risk factors. All data will first be analysed descriptively. Psychological network analysis will be used to explore the overall correlational structure of the dataset. A subgroup comparative analysis will be then applied according to the instrumental subcategories and work postures, including singers.

Ethics and dissemination

The full protocol was approved by the Swiss Ethics Committee ‘Commission Cantonale d’Ethique de la Recherche sur l’être humain de Genève’ (CCER, no. 2022-02206) on 13 February 2023. Outcomes will be disseminated through publication in peer-reviewed journals and presentations at conferences.
Host-microbiota relationship in the pathophysiology of aseptic abscess syndrome: protocol for a multicentre case-control study (ABSCESSBIOT)
Authors: Trefond Ludovic , Billard Elisabeth , Pereira Bruno , Richard Damien , Vazeille Emilie , Bonnet Richard , Barnich Nicolas , Andre Marc
Published: August 2023

Introduction

Aseptic abscess (AA) syndrome is a rare disease whose pathophysiology is unknown. It is often associated with inflammatory bowel disease and characterised by sterile inflammation with collections of neutrophils affecting several organs, especially the spleen. Microbiota are known to influence local and systemic immune responses, and both gut and oral microbiota perturbations have been reported in diseases associated with AA syndrome. However, interactions between these factors have never been studied in AA syndrome. The purpose of this translational case-control study (ABSCESSBIOT) is to investigate gut and/or oral microbiota in patients with AA syndrome compared with healthy controls. Moreover, microbiota associated metabolites quantification and Treg/Th17 balance characterisation will give a mechanistic insight on how microbiota may be involved in the pathophysiology of AA syndrome.

Methods and analysis

This French multicentre case-control study including 30 French centres (University hospital or regional hospital) aims to prospectively enrol 30 patients with AA syndrome with 30 matched controls and to analyse microbiota profiling (in stools and saliva), microbial metabolites quantification in stools and circulating CD4+T cell populations.

Ethics and dissemination

This study protocol was reviewed and approved by an independent French regional review board (n° 2017-A03499-44, Comité de Protection des Personnes Ile de France 1) on 10 October 2022, and declared to the competent French authority (Agence Nationale de Sécurité du Médicament et des produits de santé, France). Oral and written informed consent will be obtained from each included patient and the control participant. Study results will be reported to the scientific community at conferences and in peer-reviewed scientific journals.

Trial registration number

Clinical Trials web-based platform (NCT05537909).
How do emergency department staff respond to behaviour that challenges displayed by people living with dementia? A mixed-methods study
Authors: Goodwin Laura , Liddiard Cathy , Manning Sera , Benger Jonathan Richard , Carlton Edward , Cheston Richard , Hoskins Rebecca , Taylor Hazel , Voss Sarah
Published: August 2023

Objectives

To investigate staff experiences of, and approaches to behaviour that challenges displayed by patients with dementia in the emergency department (ED). Behaviour that challenges is defined as ‘actions that detract from the well-being of individuals due to the physical or psychological distress they cause within the settings they are performed’, and can take many forms including aggressive physical actions, shouting and verbal aggression and non-aggressive behaviour including repetitive questioning, inappropriate exposure and resistance to care.

Design

Mixed-methods study consisting of an online survey and semistructured telephone interviews. Quantitative data were analysed and presented using descriptive statistics. Qualitative data were analysed thematically.

Setting

The EDs of three National Health Service (NHS) Hospital Trusts in Southwest England.

Participants

Multidisciplinary NHS staff working in the ED.

Results

Fifty-two online survey responses and 13 telephone interviews were analysed. Most (24/36, 67%) survey respondents reported that they had received general training in relation to dementia in the last 2–5 years, however, less than a fifth (4/23, 17%) had received any ED-specific dementia training. All (48/48) felt that behaviour that challenges could potentially be prevented, though resource constraints and practice variation were identified. Four main themes emerged from the qualitative data: (1) the ‘perfect storm’ of the ED; (2) behaviour that challenges is preventable with the right resources; (3) improvisation and (4) requirement for approaches that are specific to the ED.

Conclusions

The findings of this study suggest that ED staff do not feel that they are prepared to respond effectively to behaviour that challenges displayed by people living with dementia. Future work could adapt or develop an intervention to support ED staff in responding to behaviour that challenges.
CompreHensive geriAtRician-led MEdication Review (CHARMER): protocol for a feasibility study of a hospital deprescribing behaviour change intervention
Authors: Scott Sion , Atkins Bethany , Martin-Kerry Jacqueline M , Pritchard Megan , Alldred David Phillip , Clark Allan B , Colles Antony , Hammond Amber , Murphy Katherine , Keevil Victoria L , Kellar Ian , Patel Martyn , Sims Erika , Taylor Johanna , Turner David , Witham Miles , Wright David , Bhattacharya Debi
Published: August 2023

Introduction

Over 50% of older adults are prescribed a medicine where the risk of harm outweighs the chances of benefit. During a hospital admission, older adults and carers expect medicines to be reviewed for appropriateness and any inappropriate medicines proactively deprescribed. While the principle of proactive deprescribing is an expectation of good prescribing practice, it is yet to become routine. The CompreHensive geriAtRician-led MEdication Review (CHARMER) study aims to develop and test a five-component behaviour change intervention to equip geriatricians and pharmacists to proactively deprescribe inappropriate medicines with older adults in hospital. This study aims to test the feasibility and acceptability of study processes and CHARMER implementation.

Methods and analysis

A two-arm purposive allocation feasibility study is being undertaken at four acute hospitals in England, UK (three intervention and one control). The target sample is 400 patients across all hospitals. Primary outcome measures are: (1) participant recruitment rate and (2) participant attrition rate. Secondary outcome measures are: (1) hospital readmission rate; (2) mortality rate and (3) quality of life. Quantitative data will be checked for completeness and quality, and practitioner and patient demographics descriptively analysed. We will undertake a rapid qualitative analysis on observations, interviews and study meeting minutes data. A subsequent thematic analysis will be undertaken with codes mapped to the Theoretical Domains Framework and Normalisation Process Theory. Triangulation of qualitative and quantitative data will be undertaken.

Ethics and dissemination

Ethics approval was obtained from Wales Research Ethics Committee 1 (IRAS ID 312494) and study approval from the Health Research Authority (22/WA/0087). Informed consent will be sought from all hospital staff involved in data collection activities and for patients involved in enhanced data collection activities. The findings of this study will be disseminated in peer-reviewed journals and conference presentations.

Trial registration

ISRCTN11899506.
Medical assistance in dying law: a qualitative study of French cancer physicians
Authors: Chastenet Mathilde , Renard Olivier , Laurain Pierre-Antoine , Bonnot Myriam , Chvetzoff Gisèle
Published: August 2023

Objectives

The legal landscape surrounding end-of-life care in France is subject to frequent changes. A proposed law to legalise euthanasia in April 2021 has raised questions about the role of physicians. If enacted, oncologists would likely be among the first professionals impacted, as data from countries with legalised euthanasia reveal that patients with cancer constitute the majority of those seeking this option. Currently, little is known about the attitudes of French oncologists towards euthanasia. Therefore, the aim of this study was to explore the position of cancer physicians on euthanasia and their experiences in dealing with patients who request it.

Methods

We conducted individual interviews with 24 cancer specialists (oncologists, radiotherapists and haematologists) at the Centre Léon Bérard in Lyon between August and October 2021. After full transcription, data were analysed thematically and for content. Data triangulation was used to establish the truthworthiness of the findings by two external researchers.

Results

Most cancer specialists in our study were opposed to legalising euthanasia, citing concerns about the societal, medical and ethical implications of the practice. They refused physician-assisted suicide based on their ethical duty to preserve life, avoid harm and uphold the Hippocratic Oath. Patient requests for euthanasia were rare. Surprisingly, over a quarter of the physicians interviewed did not rule out receiving active assistance in dying themselves in cases of unbearable or hopeless situations.

Conclusions

This study highlights the complex and diverse attitudes of cancer physicians towards euthanasia and physician-assisted suicide, reflecting the challenges of integrating individual and collective perspectives on end-of-life issues.
Warming adversely affects density but not growth of balsam fir regeneration across a climatic gradient in the Acadian Forest Region of eastern Canada
Authors: Collier Joe H. , MacLean David A. , Taylor Anthony R. , D'Orangeville Loïc
Published: August 2023

Balsam fir ( Abies balsamea (L.) Mill.) is projected to decline in the Acadian Forest Region under climate change. We hypothesized that along a 700 km latitudinal gradient with increasing mean annual temperature from New Brunswick to Nova Scotia, Canada, balsam fir regeneration density and growth rates would (1) decline with warming and (2) decline more in immature than in mature stands due to greater exposure to adverse climate conditions. Regeneration density, height growth, and lateral branch growth were measured in 30 mature and 28 immature plots and related to climate and stand variables using generalized additive models. Balsam fir regeneration density was negatively affected by increased mean annual temperature and increased with summer precipitation, supporting our first hypothesis, but varied by height class. Canopy cover significantly affected seedling density, but its effect varied by substrate type (coniferous litter and dry moss litter), with seedling density being greatest under low canopy cover for large seedlings and greatest at intermediate canopy cover for small seedlings. Seedling growth rates were determined by height class, canopy cover, precipitation, and coniferous litter cover. Stand maturity did not significantly affect fir regeneration density or growth rates. Our results indicate that over time, increasing mean annual temperature may reduce balsam fir regeneration density within the Acadian Forest Region, while the marginal summer precipitation increases may lead to small gains in growth.
Global fits of simplified models for dark matter with GAMBIT
Authors: Chang Christopher , Scott Pat , Gonzalo Tomás E. , Kahlhoefer Felix , White Martin
Published: August 2023

Global fits explore different parameter regions of a given model and apply constraints obtained at many energy scales. This makes it challenging to perform global fits of simplified models, which may not be valid at high energies. In this study, we derive a unitarity bound for a simplified vector dark matter model with an s-channel vector mediator and apply it to global fits of this model with in order to correctly interpret missing energy searches at the LHC. Two parameter space regions emerge as consistent with all experimental constraints, corresponding to different annihilation modes of the dark matter. We show that although these models are subject to strong validity constraints, they are currently most strongly constrained by measurements less sensitive to the high-energy behaviour of the theory. Understanding when these models cannot be consistently studied will become increasingly relevant as they are applied to LHC Run 3 data.
Product Image Recommendation with Transformer Model Using Deep Reinforcement Learning
Authors: Liu Yuan
Published: August 2023

A product image recommendation algorithm with transformer model using deep reinforcement learning is proposed. First, the product image recommendation architecture is designed to collect users’ historical product image clicking behaviors through the log information layer. The recommendation strategy layer uses collaborative filtering algorithm to calculate users’ long-term shopping interest and gated recurrent unit to calculate users’ short-term shopping interest, and predicts users’ long-term and short-term interest output based on users’ positive and negative feedback sequences. Second, the prediction results are fed into the transformer model for content planning to make the data format more suitable for subsequent content recommendation. Finally, the planning results of the transformer model are input to Deep Q-Leaning Network to obtain product image recommendation sequences under the learning of this network, and the results are transmitted to the data result layer, and finally presented to users through the presentation layer. The results show that the recommendation results of the proposed algorithm are consistent with the user’s browsing records. The average accuracy of product image recommendation is 97.1%, the maximum recommended time is 1.0[Formula: see text]s, the coverage and satisfaction are high, and the practical application effect is good. It can recommend more suitable products for users and promote the further development of e-commerce.
A Rational Account of Cognitive Control Development in Childhood
Authors: Steinbeis Nikolaus
Published: August 2023

Cognitive control is defined as a set of processes required for the organization of goal-directed thoughts and actions. It is linked to success throughout life including health, wealth, and social capital. How to support the development of cognitive control is therefore an intensively discussed topic. Progress in understanding how this critical life skill can be optimally scaffolded in long-lasting ways has been disappointing. I argue that this effort has been hampered by the predominant perspective that cognitive control is a competence or ability, the development of which is driven by predetermined maturational sequences. I propose that this traditional view needs to be overhauled in light of a growing body of evidence suggesting that cognitive control allocation is a both highly dynamic and rational process subject to cost–benefit analyses from early in development. I discuss the ramifications of shifting our perspective on cognitive control mechanisms in relation to how we design interventions. I close by spelling out new avenues for scientific inquiry.