bluuebunny/crossref_metadata_2025 huggingface dataset:
A narrative review of the literature: The role of biologics and JAK inhibitors in vitiligo
Authors: Russell Rhiannon , Daniel Benjamin S.
Published: August 2024

Vitiligo is a chronic depigmenting disorder that significantly impacts the quality of life of patients. Though there have been significant advancements in targeted therapies in skin diseases such as psoriasis or eczema, the progress in the treatment of vitiligo has been slow, with minimal studies assessing the effect of biologics, though there has been recent evidence of the effectiveness of JAK inhibition. This paper reviews the published case reports and studies for the use of systemic targeted therapies including biologics and JAK inhibitors in vitiligo.
The cardiovascular risk in bullous pemphigoid: Insights from a population‐based study
Authors: Kridin Khalaf , Goychberg Rina , Kridin Mouhammad , Kafri Niv , Barhoum Masad , Cohen Arnon D.
Published: August 2024

Background

The risk of life‐threatening major cardiovascular outcomes among patients with bullous pemphigoid (BP) is inconsistent in the current literature.

Objective

To evaluate the risk and prognostic outcomes of myocardial infarction (MI), cerebrovascular accident (CVA), peripheral vascular disease (PVD) and pulmonary embolism (PE) in patients with BP. We additionally aimed to explore the influence of different therapeutic approaches on the risk of these outcomes.

Methods

A population‐based retrospective cohort study was conducted to compare BP patients (n = 3924) with age‐, gender‐ and ethnicity‐matched control subjects (n = 19,280) with regard to incident cases of MI, CVA, PVD and PE. Adjusted hazard ratio (HR) and 95% confidence intervals (CI) were estimated by multivariate Cox regression analysis. Data were retrieved from Clalit Health Services' computerized database.

Results

Relative to their matched controls, patients with BP were at an elevated risk of MI (fully‐adjusted HR: 1.44; 95% CI: 1.14–1.81; p = 0.002), CVA (fully‐adjusted HR: 1.24; 95% CI: 1.06–1.45; p = 0.007), PVD (fully‐adjusted HR: 1.60; 95% CI: 1.27–2.03; p = 0.003) and PE (fully‐adjusted HR: 1.72; 95% CI: 1.28–2.32; p < 0.008). Patients with BP experienced heightened risk of all‐cause mortality in the presence of comorbid MI (fully‐adjusted HR: 1.61; 95% CI: 1.44–1.81; p < 0.001), CVA (fully‐adjusted HR: 1.70; 95% CI: 1.52–1.89; p < 0.001), PVD (fully‐adjusted HR: 1.38; 95% CI: 1.20–1.58; p < 0.001) and PE (fully‐adjusted HR: 1.44; 95% CI: 1.10–1.88; p = 0.007). The therapeutic approach utilized to manage BP did not significantly influence the risk of cardiovascular outcomes.

Conclusions

BP is associated with an elevated risk of MI, CVA, PVD, PE and cardiovascular mortality. Primary, secondary and tertiary cardiovascular prevention measures should be implemented among patients with BP.
Transhumance Urbanism as an Urban Otherwise: Inhabiting Agrarian Incompletion at the Intersections of Extended Urbanisation‐Extended Ruralisation
Authors: Bathla Nitin
Published: August 2024

Amid the ongoing transformation of agrarian territories in peripheral geographies across the world through extended urbanisation, this paper delves into the persistence of peasant and pastoral strategies amidst the closing down effects of land enclosure and fragmentation. Based on ethnographic research conducted with transhumant pastoralists in Delhi National Capital Region, this paper finds that instead of diminishing under agrarian‐urban transformation, pastoralists reassign use value to the fallows, wastelands, and surpluses of real estate speculation, thereby crafting a transhumance urbanism beyond the sedentary ontology of land and property. Understood as an urban otherwise, this urbanism remakes the fragments of material incompletion inherent within the agrarian‐urban transformation, offering socio‐ecological alternatives beyond the current impasse. The paper discusses the tentative, unsettled, and transient nature of this urbanism, which is always inter‐mixed with its non‐urban other. Contributing further to the scholarship emerging at the interstices of urban and agrarian studies, this paper calls for further comparative research on the territorial adaptation of peasant and pastoral populations routinely excluded from capitalist urbanisation processes unfolding in peripheral regions where sizeable itinerant populations coexist with extreme pressures of land enclosure.
Diuresis‐led volume replacement strategy in extremely low birth weight infants
Authors: Salloum Jonas Abbas , Garten Lars , Bührer Christoph
Published: August 2024

Aim

In extremely low birth weight infants, fluid overload has been associated with bronchopulmonary dysplasia and death. Excessive weight loss may increase the risk of meconium obstruction and intestinal perforation. As these infants display oliguria followed by polyuria, we embarked on a diuresis‐led volume replacement strategy as of January 2020.

Methods

This single‐centre analysis presents data of infants <1000 g birth weight surviving for more than 3 days admitted 2017–2019 (n = 217, daily volume increase) versus 2020–2022 (n = 2022, diuresis‐led volume replacement).

Results

The second cohort had lower gestational age (median [interquartile range]: 253/7 [243/7–264/7] vs. 263/7 [251/7–282/7] weeks), less antenatal steroids (58% vs. 69%), more indomethacin (66% vs. 47%) and higher initial diuresis (5.6 [4.9–6.8] vs. 4.8 [4.2–5.5] mL/kg/h) but did not differ by relative weight loss at Day 7 of life. Employing binary logistic regression with gestational age, antenatal steroids and indomethacin as covariates, the cohorts did not differ by rates of patent ductus arteriosus, abdominal surgery or severe retinopathy of prematurity, while there were significant declines in sepsis (from 32% to 19%), bronchopulmonary dysplasia (from 26% to 23%) and mortality (from 13% to 7%).

Conclusion

Diuresis‐led volume replacement appears to be safe and maybe beneficial.
Glucose disturbances in very low‐birthweight infants—Results from the prospective LIGHT study
Authors: Zamir Itay , Stoltz Sjöström Elisabeth , van den Berg Johannes , Berhan Yonas , Naumburg Estelle , Domellöf Magnus
Published: August 2024

Aim

To describe glucose homeostasis disturbances (dysglycaemia) in very low‐birthweight infants (<1500 g) during the admission period and explore associated risk factors.

Methods

The LIGHT (very low‐birthweight infants ‐ glucose and hormonal profile over time) study was a prospective observational cohort study that included 49 very low‐birthweight infants admitted to the tertiary neonatal intensive care unit in Umeå, Sweden, during 2016–2019. All glucose concentrations (n = 3515) sampled during the admission period were registered.

Results

Hyperglycaemia >10 mmol/L and hypoglycaemia <2.6 mmol/L were registered in 63% and 55% of the infants, respectively. Onset of dysglycaemia occurred almost exclusively in the first postnatal week. Hyperglycaemia followed 15% of corticosteroid doses given; all were preceded by pre‐existing hyperglycaemia. Pre‐existing hyperglycaemia was found in 66.7% of hyperglycaemic infants who received inotrope treatment. Upon commencement, 72.5% of antimicrobial treatments given were neither preceded nor followed by hyperglycaemia.

Conclusion

Dysglycaemia was common in very low‐birthweight infants. Daily means of glucose concentrations seemed to follow a postmenstrual age‐dependent pattern, decreasing towards term age suggesting a postmenstrual age‐dependent developmental mechanism. The primary mechanism causing hyperglycaemia was independent of sepsis, and corticosteroid and inotrope treatments. No hypoglycaemia was registered during ongoing insulin treatment.
An empirical investigation of the mitigating effect of debt on overinvestment as shareholder rights vary
Authors: Chung Chune Young , Kim Daejin , Lee Junyoup
Published: August 2024

In this study, we investigate the relationship between debt governance and overinvestment. We use net cash flows to debtholders as a proxy for debt governance and find that an increase in these cash flows mitigates firms' overinvestment. We also show that free cash flows lead cash‐rich and cash‐poor firms to overinvest but that debt governance attenuates this problem. Finally, we find that the mitigating effect of net cash flows to debtholders on overinvestment is highly pronounced in firms with poor governance. These findings suggest that net cash flows to debtholders are particularly effective when shareholder governance is weak. We conclude that cash flows to debtholders can effectively prevent overinvestment and reduce the agency costs of free cash flows.
Transmembrane and coiled‐coil 2 associates with Alzheimer's disease pathology in the human brain
Authors: Hopkins Paul C. R. , Troakes Claire , King Andrew , Tear Guy
Published: August 2024

Transmembrane and coiled‐coil 2 (TMCC2) is a human orthologue of the Drosophila gene dementin, mutant alleles of which cause neurodegeneration with features of Alzheimer's disease (AD). TMCC2 and Dementin further have an evolutionarily conserved interaction with the amyloid protein precursor (APP), a protein central to AD pathogenesis. To investigate if human TMCC2 might also participate in mechanisms of neurodegeneration, we examined TMCC2 expression in late onset AD human brain and age‐matched controls, familial AD cases bearing a mutation in APP Val717, and Down syndrome AD. Consistent with previous observations of complex formation between TMCC2 and APP in the rat brain, the dual immunocytochemistry of control human temporal cortex showed highly similar distributions of TMCC2 and APP. In late onset AD cases stratified by APOE genotype, TMCC2 immunoreactivity was associated with dense core senile plaques and adjacent neuronal dystrophies, but not with Aβ surrounding the core, diffuse Aβ plaques or tauopathy. In Down syndrome AD, we observed in addition TMCC2‐immunoreactive and methoxy‐X04‐positive pathological features that were morphologically distinct from those seen in the late onset and familial AD cases, suggesting enhanced pathological alteration of TMCC2 in Down syndrome AD. At the protein level, western blots of human brain extracts revealed that human brain‐derived TMCC2 exists as at least three isoforms, the relative abundance of which varied between the temporal gyrus and cerebellum and was influenced by APOE and/or dementia status. Our findings thus implicate human TMCC2 in AD via its interactions with APP, its association with dense core plaques, as well as its alteration in Down syndrome AD.
Structural modification of 2‐phenylquinoline‐4‐carboxylic acid containing SIRT3 inhibitors for the cancer differentiation therapy
Authors: Du Yanmei , Wang Xiaojing , Zhang Lihui , Qin Hongyu , Xu Guangzhao , Li Fahui , Fang Chunyan , Li Honggang , Zhang Lei
Published: August 2024

Inhibition of SIRT3 exhibited potency in triggering leukemic cell differentiation. In discovery of potent SIRT3 inhibitors for cancer differentiation therapy, structural modification was performed on the previously developed lead compound P6. A total of 33 compounds were designed and synthesized. In the enzyme inhibitory assay, several molecules S18, S26, S27 and T5 showed potent SIRT3 inhibitory activity with IC50 value of 0.53, 1.86, 5.06, and 2.88 μM, respectively. Moreover, the tested compounds exhibited SIRT3 inhibitory selectivity over SIRT1 and SIRT2. Compounds S27 and T5 were potent in inhibition the growth of MM1.S and RPMI‐8226 cells in the in vitro antiproliferative test. Significantly, representative compounds, especially S27 and T5, promoted differentiation of tested MM cells in the cellular morphological evaluation, accompanied by increasing the expression of differentiation antigen CD49e and human immunoglobulin light chain lambda and kappa. Additionally, molecule S18 without antiproliferative potency itself, showed significant inhibitory activity against growth factor IL‐6 induced RPMI‐8226 cell proliferation. Collectively, potent SIRT3 selective inhibitors with MM cell differentiation potency were developed for further discovery of anticancer drugs.
Synthesis and evaluation of di‐heterocyclic benzazole compounds as potential antibacterial and anti‐biofilm agents against Staphylococcus aureus
Authors: Aktekin Mine Buga , Oksuz Zehra , Turkmenoglu Burcin , Istifli Erman Salih , Kuzucu Mehmet , Algul Oztekin
Published: August 2024

Cumulative escalation in antibiotic‐resistant pathogens necessitates the quest for novel antimicrobial agents, as current options continue to diminish bacterial resistance. Herein, we report the synthesis of di‐heterocyclic benzazole structures (12–19) and their in vitro evaluation for some biological activities. Compounds 16 and 17 demonstrated potent antibacterial activity (MIC = 7.81 μg/mL) against Staphylococcus aureus, along with significant anti‐biofilm activity. Noteworthy is the capability of Compound 17 to inhibit biofilm formation by at least 50% at sub‐MIC (3.90 μg/mL) concentration. Furthermore, both compounds exhibited the potential to inhibit preformed biofilm by at least 50% at the MIC concentration (7.81 μg/mL). Additionally, Compounds 16 and 17 were examined for cytotoxic effects in HFF‐1 cells, using the MTT method, and screened for binding interactions within the active site of S. aureus DNA gyrase using in silico molecular docking technique, employing AutoDock 4.2.6 and Schrödinger Glidse programs. Overall, our findings highlight Compounds 16 and 17 as promising scaffolds warranting further optimization for the development of effective antibacterial and anti‐biofilm agents.
Scope‐of‐practice laws and the practice patterns of nurse practitioners and physician assistants
Authors: McMichael Benjamin J.
Published: August 2024

I evaluate whether nurse practitioners (NPs) and physician assistants (PAs) change how they practice when states relax the scope‐of‐practice laws governing these professions. I find little evidence that NPs or PAs begin providing specialty services following relaxation. Some evidence suggests that NPs specialize more in rural areas following the relaxation of scope‐of‐practice laws, but no indication that they do so generally. Overall, the evidence developed here suggests that NPs and PAs do not change how they care for patients following the relaxation of scope‐of‐practice laws, undermining patient safety arguments along these lines.
Estimated glomerular filtration rate slope and risk of primary and secondary major adverse cardiovascular events and heart failure hospitalization in people with type 2 diabetes: An analysis of the EXSCEL trial
Authors: Oulhaj Abderrahim , Aziz Faisal , Suliman Abubaker , Eller Kathrin , Bentoumi Rachid , Buse John B. , Al Mahmeed Wael , von Lewinski Dirk , Coleman Ruth L. , Holman Rury R. , Sourij Harald
Published: August 2024

Aim

The decline in estimated glomerular filtration rate (eGFR), a significant predictor of cardiovascular disease (CVD), occurs heterogeneously in people with diabetes because of various risk factors. We investigated the role of eGFR decline in predicting CVD events in people with type 2 diabetes in both primary and secondary CVD prevention settings.

Materials and Methods

Bayesian joint modelling of repeated measures of eGFR and time to CVD event was applied to the Exenatide Study of Cardiovascular Event Lowering (EXSCEL) trial to examine the association between the eGFR slope and the incidence of major adverse CV event/hospitalization for heart failure (MACE/hHF) (non‐fatal myocardial infarction, non‐fatal stroke, CV death, or hospitalization for heart failure). The analysis was adjusted for age, sex, smoking, systolic blood pressure, baseline eGFR, antihypertensive and lipid‐lowering medication, diabetes duration, atrial fibrillation, high‐density cholesterol, total cholesterol, HbA1c and treatment allocation (once‐weekly exenatide or placebo).

Results

Data from 11 101 trial participants with (n = 7942) and without (n = 3159) previous history of CVD were analysed. The mean ± SD eGFR slope per year in participants without and with previous CVD was −0.68 ± 1.67 and −1.03 ± 2.13 mL/min/1.73 m2, respectively. The 5‐year MACE/hHF incidences were 7.5% (95% CI 6.2, 8.8) and 20% (95% CI 19, 22), respectively. The 1‐SD decrease in the eGFR slope was associated with increased MACE/hHF risks of 48% (HR 1.48, 95% CI 1.12, 1.98, p = 0.007) and 33% (HR 1.33, 95% CI 1.18,1.51, p < 0.001) in participants without and with previous CVD, respectively.

Conclusions

eGFR trajectories over time significantly predict incident MACE/hHF events in people with type 2 diabetes with and without existing CVD, with a higher hazard ratio for MACE/hHF in the latter group.
Associations of childhood and adulthood body size, and child‐to‐adult body size change with adult telomere length
Authors: Liu Qing , Fan Gaojie , Bi Jianing , Fang Qing , Luo Fei , Huang Xiaofeng , Li Heng , Liu Binghai , Yan Lianyan , Guo Wenwen , Wang Youjie , Song Lulu
Published: August 2024

Aim

To comprehensively examine the associations of childhood and adulthood body size, and child‐to‐adult body size change with adult leucocyte telomere length (LTL).

Methods

We included 453 602 participants from the UK Biobank. Childhood body size at the age of 10 years was collected through a questionnaire. Adulthood body size was assessed using body mass index (BMI), waist circumference (WC), waist‐to‐hip ratio (WHR), fat mass index (FMI), and fat‐free mass index (FFMI).

Results

Individuals with plumper body size in childhood exhibited shorter LTL in adulthood (−0.0086 [−0.0017, −0.0004]). Adulthood BMI (−0.0286 [−0.0315, −0.0258]), WC (−0.0271 [−0.0303, −0.0238]), WHR (−0.0269 [−0.0308, −0.0230]) and FMI (−0.0396 [−0.0438, −0.0351]) were negatively associated with LTL, whereas FFMI (0.0095 [0.0039, 0.0152]) was positively associated with LTL. Compared to individuals consistently having an average/normal weight in both childhood and adulthood, those who maintained or developed overweight/obesity from childhood to adulthood had a shorter adult LTL, regardless of childhood body size. Notably, the LTL shortening effect was not observed in individuals with plumper body size in childhood but normal weight in adulthood.

Conclusions

Childhood and adulthood obesity are both associated with LTL shortening in adulthood. Transitioning to or maintaining overweight/obese status from childhood to adulthood is associated with shorter adult LTL, whereas this effect can be reversed if plumper children become normal weight.
Tanycyte radial morphology and proliferation are influenced by fibroblast growth factor receptor 1 and high‐fat diet
Authors: Esteve N. Alex , Rogers Deborah J. , Stagray Jacob A. , Mayeux Holly , Nora Glenae , Huval Luke , Smith Karen Müller
Published: August 2024

Fibroblast growth factor receptor 1 (FGFR1) is a widely expressed, membrane‐bound receptor that transduces extracellular signals from FGF ligands and cadherins, resulting in intracellular signals influencing cellular growth, proliferation, calcium, and transcription. FGF21 and FGF2 stimulate the proliferation of tanycytes, specialized radial astrocytes along the ventricle of the hypothalamus, and influence metabolism. Tanycytes are in a privileged position between the cerebrospinal fluid, the blood supply in the median eminence, and neurons within nuclei in the hypothalamus. The effect of FGFR1 signaling upon tanycyte morphology and metabolism was examined in adult mice with conditional deletion of the Fgfr1 gene using the Fgfr1flox/flox; Nestin‐Cre+ line. Loss of Fgfr1 resulted in shorter β tanycytes along the medial eminence. Control Fgfr1flox/flox littermates and Fgfr1flox/flox, Nestin‐Cre+ (Fgfr1 cKO) knockout mice were placed on a 1‐month long high‐fat diet (HFD) or a normal‐fat diet (NFD), to investigate differences in body homeostasis and tanycyte morphology under an obesity inducing diet. We found that FGFR1 is a vital contributor to tanycyte morphology and quantity and that it promotes stem cell maintenance in the hypothalamus and hippocampal dentate gyrus. The Fgfr1 cKO mice developed impaired tolerance to a glucose challenge test on a HFD without gaining more weight than control mice. The combination of HFD and loss of Fgfr1 gene resulted in altered β and α tanycyte morphology, and reduced stem cell numbers along the third ventricle of the hypothalamus and hippocampus.
Adsorption kinetics of organic phosphates on goethite and aluminium oxide: The equation used to describe the reaction
Authors: Asif S. K. M. D. , Debnath Abhijit
Published: August 2024

Adsorption kinetics of three organic phosphate compounds (OPs) with varying molecular sizes and structures and inorganic phosphate (Pi) were investigated on α‐Al2O3 and poorly crystalline goethite. The organic phosphates were inositol hexaphosphate (IHP), glycerol phosphate (GlyP) and glucose‐6‐phosphate (G6P), and the inorganic phosphate was KH2PO4. Batch adsorption experiments were performed at 25°C. We tested the sorption kinetic data using various non‐linear models/equations and on their transformed linear forms by applying appropriate statistics. Besides, we also used a modified non‐linear equation having four parameters to this effect. Data were found to fit best with the modified equation and described the whole sorption process satisfactorily. For sorption of compounds on to the surface of these minerals, the equation with four parameters may be used in contrast with many standard equations applied for kinetic studies in soils. Sorption was described to take place in two processes: a fast one that takes place in less than 45 min and a slow one that takes place in several hours or more. The rate of the slow process did not depend directly on the concentration of phosphate compounds in solution, but depended linearly on the amount of phosphate that was adsorbed during the fast process. These initially adsorbed ions carrying some amount of negative charge likely hindered the movement of subsequent adsorbate ions to the solid surface due to decreased surface potential. This caused the variation in fast and slow sorption rate constants. Sorption densities increased in the order, Pi >Gly P >G6P >IHP, which revealed that the sorption density and initial sorption rate of OPs decreased with increasing molecular weights of OPs.
Management of patients with neurological diseases considering post‐pandemic coronavirus disease 2019 (COVID‐19) related risks and dangers — An updated European Academy of Neurology consensus statement
Authors: Filipović Saša R. , Özturk Serefnur , Bereczki Daniel , Bodini Benedetta , Cavallieri Francesco , Fanciulli Alessandra , Guekht Alla , Helbok Raimund , Hochmeister Sonja , Martinelli Boneschi Filippo , Priori Alberto , Rakusa Martin , Romoli Michele , Willekens Barbara , Zedde Marialuisa , Sellner Johann , Moro Elena ,   the Neuro COVID‐19 Task Force of the European Academy of Neurology
Published: August 2024

Background and purpose

In October 2020, the European Academy of Neurology (EAN) consensus statement for management of patients with neurological diseases during the coronavirus disease 2019 (COVID‐19) pandemic was published. Due to important changes and developments that have happened since then, the need has arisen to critically reassess the original recommendations and address new challenges.

Methods

In step 1, the original items were critically reviewed by the EAN COVID‐19 Task Force. In addition, new recommendations were defined. In step 2, an online survey with the recommendations forged in step 1 was sent to the Managing Groups of all Scientific and Coordinating Panels of EAN. In step 3, the final set of recommendations was made.

Results

In step 1, out of the original 36 recommendations, 18 were judged still relevant. They were edited to reflect the advances in knowledge and practice. In addition, 21 new recommendations were formulated to address the new knowledge and challenges. In step 2, out of the 39 recommendations sent for the survey, nine were approved as they were, whilst suggestions for improvement were given for the rest. In step 3, the recommendations were further edited, and some new items were formed to accommodate the participants' suggestions, resulting in a final set of 41 recommendations.

Conclusion

This revision of the 2020 EAN Statement provides updated comprehensive and structured guidance on good clinical practice in people with neurological disease faced with SARS‐CoV‐2 infection. It now covers the issues from the more recent domains of COVID‐19‐related care, vaccine complications and post‐COVID‐19 conditions.
The European Border and Coast Guard Agency (Frontex) and the limits to effective judicial protection in European Union law
Authors: Nicolosi Salvatore Fabio
Published: August 2024

The principle of effective judicial protection is a cornerstone of EU law which is predicated on the existence of a complete system of judicial remedies. However, with the expansion of the operational powers of the European Border and Coast Guard Agency (Frontex) and the consequent fundamental rights concerns, this article challenges the assumption that the EU is based on such a complete system of remedies. By critically reviewing the judicial actions against Frontex before the Court of Justice, this article illustrates the limits to effective judicial protection for migrants attempting to enter the EU. It will be argued that the lack of an effective remedy suggests a violation of the right to good administration. Therefore, this article explores the potential of the bond between judicial protection and good administration to fix the loopholes within the emerging system of shared administration, in which EU agencies progressively interact with national competent authorities.
Retrospective study: Laser excision versus combined laser, cryosurgery and intralesional 5‐fluorouracil in the treatment of equine sarcoids
Authors: Offer Katie S. , Sutton David G. M.
Published: August 2024

Background

Laser excision is used routinely in the treatment of sarcoids but may be ineffective in cases where complete excision cannot be achieved. A multimodal approach is warranted in these cases. 5‐FU may improve the lethal effect of cryosurgery as an adjunct to laser excision.

Objectives

To compare two treatment protocols for equine sarcoids, laser excision alone versus a combination protocol of laser excision, cryosurgery and 5‐FU chemotherapy. Factors associated with sarcoid recurrence are also investigated.

Study design

Retrospective case controlled study.

Results

Eighty‐four horses with 168 histologically confirmed sarcoids were included, with a median follow‐up time of 39 months (IQR 21–62 months). Sarcoid recurrence at the treated site was reported in 38% of cases and in 23% of any individual sarcoid. No significant difference was demonstrated between treatment categories in either rate of sarcoid recurrence (p = 0.45 for any treated horse, p = 0.63 for individual sarcoid) or time to sarcoid recurrence (p = 0.73). Sarcoid recurrence was higher in horses with a greater number of sarcoids (OR 1.2 (1.0–1.5), p = 0.03); when treatment had been received prior to admission (OR 7.6 (2.0–33), p = 0.004). Horses with urogenital sarcoids or >1 mixed sarcoid experienced more rapid recurrence (HR 3.6 (1.3–10), p = 0.02 and HR 9.9 (3.3–30), p < 0.001) and recurrence was less rapid following the treatment of a horse's first sarcoid (HR 0.3 (0.1–0.7), p = 0.009).

Main limitations

Significant differences in case populations in each treatment category. Treatment selection was neither blinded nor randomised and missing data and recall bias limit the study's power. Sarcoid recurrence was owner reported.

Conclusions

When assessing the likelihood of sarcoid recurrence, characteristics of both the individual patient and sarcoid phenotype must be considered carefully when selecting a specific treatment protocol.
Advancements in deep learning for Alzheimer's disease diagnosis: A comprehensive exploration and critical analysis of neuroimaging approaches
Authors: Khan Fakhri Alam , Khan Abdullah , Imran Muhammad , Ahmad Awais , Jeon Gwanggil
Published: August 2024

Alzheimer's disease (AD) is a major global health concern that affects millions of people globally. This study investigates the technical challenges in AD analysis and provides a thorough analysis of AD, emphasizing the disease's worldwide effects as well as the predicted increase. It explores the technological difficulties associated with AD analysis, concentrating on the shift in automated clinical diagnosis using MRI data from conventional machine learning to deep learning techniques. This study advances our knowledge of the effects of AD and provides new developments in deep learning for precise diagnosis, providing insightful information for both clinical and future research. The research introduces an innovative deep learning model, leveraging YOLOv5 and variants of YOLOv8, to classify AD images into four (NC, EMCI, LMCI, AD) categories. This study evaluates the performance of YOLOv5 which achieved high accuracy (97%) in multi‐class classification (classes 0 to 3) with precision, recall, and F1‐score reported for each class. YOLOv8 (Small) and YOLOv8 (Medium) models are also assessed for Alzheimer's disease diagnosis, demonstrating accuracy of 97% and 98%, respectively. Precision, recall, and F1‐score metrics provide detailed insights into the models' effectiveness across different classes. Comparative analysis against a transfer learning model reveals YOLOv5, YOLOv8 (Small), and YOLOv8 (Medium) consistently outperforming across six binary classifications related to cognitive impairment. These models show improved sensitivity and accuracy compared to baseline architectures from [32]. In AD/NC classification, YOLOv8 (Medium) achieves 98.43% accuracy and 97.45% sensitivity, for EMCI/LMCI classification, YOLOv8 (Medium) also excels with 92.12% accuracy and 90.12% sensitivity. The results highlight the effectiveness of YOLOv5 and YOLOv8 variants in neuroimaging tasks, showcasing their potential in clinical applications for cognitive impairment classification. The proposed models showcase superior performance, achieving high accuracy, sensitivity, and F1‐scores, surpassing baseline architectures and previous methods. Comparative analyses highlight the robustness and effectiveness of the proposed models in AD classification tasks, providing valuable insights for future research and clinical applications.
Securing internet of things device data: An ABE approach using fog computing and generative AI
Authors: Shruti  , Rani Shalli , Boulila Wadii
Published: August 2024

With the emergence of fog computing, new paradigms for data processing and management for IoT devices have been established in the quickly changing world of teaching/learning. This study addresses the complex issues brought about by the infiltration of diverse data sources by investigating novel approaches to strengthen data security and enhance access control mechanisms in fog computing environments. The commonly used cryptographic technique known as CP‐ABE is renowned for providing accurate access control. Unfortunately, current multi‐authority CP‐ABE methods have difficulties when implemented on low‐resource IoT devices. These techniques are not appropriate for resource‐constrained IoT devices since the sizes of the secret key and ciphertext grow in proportion to the number of attributes. In this paper, a novel multi‐authority CP‐ABE approach, called MA‐based CP‐ABE, efficiently tackles these issues by optimizing the length of secret keys and ciphertext. Users' secret keys are always the same size, no matter how many attributes they own. Moreover, MA‐based CP‐ABE ensures that the size of the ciphertext scales linearly with the number of authorities rather than characteristics, which makes it a sensible option for devices with restricted resources. A Generative AI approach has also been integrated along with CP‐ABE to make sure that the IoT data is secure and privacy is maintained. As per the security and experimental analysis, the proposed approach is considered secure and suitable for IoT‐based applications.
Vonoprazan–Amoxicillin Dual Therapy With Different Amoxicillin Administration Regimens for Helicobacter pylori Treatment: A Randomized Controlled Trial
Authors: Qiu Shuhan , Huang Yu , Chen Jinnan , Guo Yixian , Li Meixuan , Ding Zhaohui , Liang Xiao , Lu Hong
Published: August 2024

Background

The effect of preprandial or postprandial administration of amoxicillin on the efficacy of vonoprazan–amoxicillin dual therapy (VA‐dual therapy) for Helicobacter pylori treatment has not been studied. It is also unclear whether amoxicillin dosing four times daily is more effective than three times daily. We aimed to investigate the effect of different amoxicillin administration regimens on the efficacy of VA‐dual therapy.

Materials and Methods

H. pylori‐infected subjects were randomly assigned to three groups in a 1:1:1 ratio to receive a 14‐day dual therapy consisting of vonoprazan 20 mg twice daily + amoxicillin 1000 mg three times daily before meals (BM‐TID) or 1000 mg three times daily after meals (AM‐TID) or 750 mg four times daily after meals (AM‐QID). H. pylori eradication rates, adverse events rates, compliance, and antibiotic resistance were compared.

Results

Between May 2021 to April 2023, 327 subjects were enrolled. The eradication rates of BM‐TID, AM‐TID, and AM‐QID dual therapy were 88.1%, 89.9%, and 93.6% in intention‐to‐treat (ITT) analysis, 90.6%, 94.2%, and 99.0% in modified ITT (MITT) analysis, and 90.4%, 94.1%, and 99.0% in per‐protocol (PP) analysis. Although there was non‐inferiority between BM‐TID and AM‐TID, as well as between AM‐TID and AM‐QID, AM‐QID was significantly more effective than BM‐TID. There were no significant differences in adverse event rates, compliance, and antibiotic resistance among the three groups.

Conclusions

Postprandial administration and the increased frequency of administration of amoxicillin may contribute to a better efficacy of VA‐dual therapy, especially for rescue therapy. All VA‐dual therapy in our study could achieve good efficacy for first‐line treatment.

Trial Registration: clinicaltrials.gov: NCT05901051.
All Good Without Anything Good. Beyond Survival: Understanding the Psychosocial Experiences of Individuals With Chronic Kidney Disease and Their Caregivers in Sri Lanka
Authors: Bulathwatta Darshika Thejani , Rudnik Agata , Bidzan Mariola
Published: August 2024

Aim

This study aims to explore the experiences of individuals with chronic kidney disease (CKD) undergoing haemodialysis and their caregivers, focusing on the disease's impact and the treatment process.

Background

In Sri Lanka, CKD is a growing health concern, particularly affecting farming communities and contributing to the strain on the biomedical healthcare system. Despite increasing awareness of CKD's physical implications, its psychosocial impact remains underexplored. This study seeks to fill this gap, aiming to inform culturally sensitive interventions and improve the healthcare system's responsiveness to the unique needs of Sinhala Buddhist individuals with CKD and their caregivers.

Design

An exploratory qualitative study.

Method

Semistructured interviews were conducted with 10 individuals undergoing haemodialysis and 5 caregivers at a dialysis unit. The interviews were audio‐recorded, transcribed and analysed using conventional qualitative content analysis.

Findings

The analysis revealed three interrelated main themes: (1) impact on standard of living (quality of life), (2) coping strategies and (3) medical experience, with a notable influence of traditional beliefs and practices.

Conclusion

The findings highlight the need for a holistic approach to CKD management that integrates physical, emotional, psychological and social aspects, considering the significant role of traditional influences. Further research is essential to develop effective interventions that can enhance the quality of life for CKD.

Patient or Public Contribution

The lived experiences of Sinhala Buddhist individuals with CKD and their caregivers served as a cornerstone, providing profound insights into the impact of the condition on their lives. Throughout the study, these participants played an instrumental role in refining the research's cultural sensitivity and relevance. Their engagement extended beyond the data collection phase to encompass feedback sessions, where they actively shared their perspectives. This ongoing collaboration ensured the study's depth and applicability to real‐world experiences. By actively involving those directly affected by CKD, this collaborative approach safeguards that the study remains rooted in their voices and addresses their unique needs.

Reporting Method

This study adhered to relevant EQUATOR guidelines (the COREQ checklist).

Trial Registration

This study is not a clinical trial, and thus, registration is not applicable.
Management of pyoderma gangrenosum during pregnancy and breastfeeding: a systematic review
Authors: Wanberg Lindsey J. , Gorman Benjamin G. , Theis‐Mahon Nicole , Goldfarb Noah , Alavi Afsaneh
Published: August 2024

Pregnancy is a conjectured risk factor for pyoderma gangrenosum (PG), an autoinflammatory neutrophilic dermatosis characterized by painful ulcers. Even so, there are no available treatment guidelines for those with PG who are pregnant or breastfeeding. To describe existing treatment options, we systematically reviewed the literature on PG treatment in pregnant or breastfeeding patients. A search over four databases was completed in October 2022. Independent reviewers accomplished screening and data extraction. 18 articles met the inclusion criteria. 15 cases involved the treatment of PG during pregnancy, and three cases involved the treatment of PG while breastfeeding. Most patients did not have a history of PG prior to pregnancy (77.7%), and most did not have PG‐associated comorbidity (61.1%). Of the cases involving treatment of PG during pregnancy, the majority (73%) found treatment success with a systemic corticosteroid (SCS). Only three cases reported an adverse outcome, including premature rupture of membranes and premature birth (16.7%); all these cases involved treatment with a SCS at >0.5 mg/kg/day during pregnancy. We present a treatment algorithm for pregnant or breastfeeding patients with PG. Our findings suggest prioritizing topicals and TNF inhibitors due to more favorable side effect profiles. However, there is a paucity of data on the safety of PG therapies in pregnancy and breastfeeding, and thus, controlled studies and pregnancy registries must be pursued.
Direct immunofluorescence on plucked hair outer root sheath can predict relapse in pemphigus vulgaris
Authors: Malhi Kittu , Chatterjee Debajyoti , Mahajan Rahul , Handa Sanjeev , De Dipankar
Published: August 2024

Background

Prospective research is lacking on the utility of plucked hair outer root sheath direct immunofluorescence (ORS DIF) in the prediction of relapse in pemphigus vulgaris (PV) and the correlation of ORS DIF positivity with serum desmoglein antibody titers.

Methods

We performed a prospective cohort study enrolling 80 PV patients in complete clinical remission at a tertiary care center in North India. Study participants underwent ORS DIF at baseline, which was repeated every 3 months. Skin biopsy DIF was done at study inclusion, repeated at 3 months, and upon clinical relapse. An antidesmoglein antibody titer was assessed concurrently with ORS DIF in a subset of patients. Patients on adjuvant therapy had their adjuvant therapy withdrawn either at the initial visit, at 3 months, or at a 6‐month follow‐up. Our objectives were to determine the association between positive ORS DIF and clinical relapse, the correlation between positive ORS DIF and skin biopsy DIF, and between positive ORS DIF and positive antidesmoglein antibody titers (when concurrently done).

Results

Twenty‐two patients (27.5%) had a clinical relapse. Baseline immunological markers significantly associated with relapse are ORS DIF positivity with IgG (16/36 [45.44%] P = 0.005) and C3 (12/29 [41.37%] P = 0.047) and greater intensity of baseline IgG and C3 positivity in ORS DIF (IgG, P = 0.002; C3, P = 0.033). Notably, a significant correlation was observed between baseline positive ORS DIF and skin biopsy DIF (IgG, ρ = 0.695; C3, ρ = 0.498). Positive ORS DIF strongly correlated with positive anti‐Dsg3 antibody titers (φs = 0.815; P < 0.01). Early withdrawal of adjuvant immunosuppressant (within 3 months) (P = 0.007) and positive ORS DIF were also associated with relapse (P = 0.017).

Conclusion and relevance

ORS DIF is a reliable predictor of PV clinical relapse and demonstrated robust correlations with skin biopsy DIF and antidesmoglein antibody titers. Periodic assessment of ORS DIF aids in determining new‐onset positivity that heralds clinical relapse.
Structural characterisation and adsorption properties of cross‐linked esterified broken rice porous starch
Authors: Che Chunbo , Su Xinying , Liang Zhao , Zhao Dan , Fu Yu , Xu Zhong , Zhang Na
Published: August 2024

In order to improve the adsorption properties and stability of porous starch, the porous starch made from ground rice starch was doubly modified by cross‐linking and esterification using sodium trimetaphosphate (STMP) as a cross‐linking agent and octenyl succinic anhydride (OSA) as an esterifying agent. Structural analysis of the samples showed that the phosphate group in STMP formed a new P‐O‐C covalent bond with the hydroxyl group in starch by substitution, OSA combined with the hydroxyl group of starch formed an ester carbonyl group, and all cross‐linking and esterification occurred in the amorphous region of starch. DSC and TG/DTG analysis showed that STMP modification performed better than OSA modification in thermal stability. However, by analysis of the oil absorption properties and freeze–thaw stability, the OSA‐modified porous starch exhibited better oil‐holding rate and freeze–thaw stability.
A brief history of ramping
Authors: Cook Benjamin , Evenden James , Genborg Ruby , Stretton Brandon , Kovoor Joshua , Gibson Kieran , Tan Sheryn , Gupta Aashray , Chan Weng O. , Bacchi Carol , Ittimani Mana , Cusack Michael , Maddison John , Gluck Samuel , Gilbert Tony , McNeill Keith , Bacchi Stephen
Published: August 2024

‘Ramping’ is a commonly used term in contemporary Australian healthcare. It is also a part of the public and political zeitgeist. However, its precise definition varies among sources. In the published literature, there are distinctions between related terms, such as ‘entry overload’ and ‘Patient Off Stretcher Time Delay’. How ramping is defined and how it came to be defined have significance for policies and procedures relating to the described phenomenon. Through examination of the history of the term, insights are obtained into the underlying issues contributing to ramping and, accordingly, associated possible solutions.
Making the invisible count: Factors influencing small e‐waste recycling intentions in the age of rapid electronics consumption
Authors: Gawande Abhishek , Jain Nikunj Kumar , Bhattacharyya Som Sekhar
Published: August 2024

The extent of e‐waste is exponentially rising as the lifetime usage of electrical and electronic device items is getting shorter. In particular, household waste comprising small electrical and electronic items (small e‐waste) is becoming an emerging yet substantive category of e‐waste globally. Small e‐waste is becoming a growing concern because of its presence across households, smaller size, stockpiling behaviour, improper disposal and inefficient management. Thus, it becomes interesting and worth examining to study the behavioural intention towards management of the small e‐waste. This is more so in India given the contextual reality that India is the most populous and one of the fastest growing economies. In order to explore the phenomenon, the current study extends the theory of planned behaviour (TPB) to empirically investigate the residents’ attitudes, intentions and behaviours, along with the extrinsic factors such as producers and government's intervention towards recycling of small e‐waste. The main findings point out that attitude, subjective norms, producers intervention and perceived data security have significant positive influence on residents’ intention to recycle small e‐waste. The study would make theoretical contribution to the literature on TPB. Furthermore, contribution would be made regarding the practical aspects of extended producer responsibility. This occurs because of identifying the significant factors influencing Indian residents’ small e‐waste recycling behavioural intention.
Advancing evidence‐based practice through the Knowledge Translation Challenge: Nurses’ important roles in research, implementation science and practice change
Authors: Chisholm Amanda , Russolillo Angela , Carter Michelle , Steinberg Marla , Lambert Leah , Knox Andrea , Black Agnes
Published: August 2024

Aim

To describe a knowledge translation capacity‐building initiative and illustrate the roles of nurses in practice change using an exemplar case study.

Design

The report uses observational methods and reflection.

Methods

The Knowledge Translation Challenge program involves a multi‐component intervention across several sites. The advisory committee invited eligible teams to attend capacity‐building workshops. Implementation plans were developed, and successful teams receive funding for a 2 year period. Evaluation involved collecting data on program uptake and impact on practice change. Data has been collected from five cohorts. The exemplar case study employed an action‐research framework.

Results

Four nurse‐led teams have demonstrated successful implementation of their practice change. The case study on implementing a clinical toolkit for clozapine management further illustrates a thoughtful planning process, and implementation journey and learnings by a team of nurses.

Conclusion

The Knowledge Translation Challenge program empowers nurses to use implementation science practices to enhance the quality and effectiveness of healthcare services. Success of this initiative serves as a model for addressing the persistent gap between knowledge and practice in clinical settings and the value of activating nurses to help close this gap.

Implications

As the most trusted and numerous profession, it is vital that nurses contribute to efforts to translate research evidence into clinical practice. The Knowledge Translation Challenge program supports nurses to lead practice change.

Impact

The Knowledge Translation Challenge program successfully equips nurses and other health care providers with the knowledge, skills and resources to implement practice improvements which enhance the quality and effectiveness of healthcare services and nursing practice.

Patient or Public Contribution

The Knowledge Translation Challenge advisory committee has three patient‐public partners that support teams to develop a patient‐oriented approach for their projects by providing feedback on the implementation plans. Each team was also supported to include patient‐public partners on their project.