bluuebunny/crossref_metadata_2025 huggingface dataset:
Infrared flashing light through the cricothyroid membrane as guidance to awake intubation with a flexible bronchoscope: A randomised cross‐over study
Authors: Kristensen Michael S. , Hesselfeldt Rasmus , Brinkenfeldt Henning K. , Biro Peter
Published: January 2023

Background

In case of distorted airway anatomy, awake intubation with a flexible bronchoscope can be extremely difficult or even impossible. To facilitate this demanding procedure, an infrared flashing light source can be placed on the patient's neck superficial to the cricothyroid membrane. The light travels through the skin and tissue to the trachea, from where it can be registered by the advancing bronchoscope in the pharynx and seen as flashing white light on the monitor. We hypothesised that the application of this technique would allow more proximal and easier identification of the correct pathway to the trachea in patients with severe airway pathology.

Methods

As part of awake intubation, patients underwent insertion of a flexible video bronchoscope via the mouth into the trachea. The procedure was performed twice, in random order in each patient, with and without the aid of the transcutaneous flashing infrared light. All insertions were video recorded to determine at which anatomical landmark within the airway the correct pathway was identified. The videos are accessible via this link: https://airwaymanagement.dk/infrared_comparative. The predefined landmarks were in successive order: oral cavity, oro‐pharynx, tip of epiglottis, arytenoid cartilages, false cords, vocal cords and trachea, as well as the spaces between them.

Results

Twenty‐two patients had a total of 44 awake insertions with the flexible bronchoscope. The median anatomical level, at which correct identification of the trachea was obtained on the monitor, was, past the epiglottis, with the conventional technique, and at the level of the oropharynx, when using the infrared flashing light (p = .005). The time until the flashing light or the vocal cords were seen was 21 (22) S, mean (SD), and 48 (62) S, during the insertion with and without infrared flashing light activated, respectively (p = .005). Endoscopists rated it easier (p = .001) to recognise the entrance to the trachea in the infrared‐group.

Conclusion

During awake intubation of patients with airway pathology, the application of trans‐cricothyroid infrared flashing light to guide the insertion of a flexible bronchoscope significantly facilitated the recognition of the pathway into the trachea and the correct advancement of the flexible endoscope.

Registration of Clinical Trial

NCT03930550.
Continuing the transformation: charting the path for the future delivery of Veteran emergency care
Authors: Ward Michael J. , Kessler Chad , Abel Erica A. , Ahern Justin , Bravata Dawn M.
Published: January 2023

Important changes in the delivery of Veteran emergency care in the early 2000s in the Department of Veteran Affairs (VA) emergency departments and urgent care clinics substantially elevated the role of emergency medicine (EM) in Veteran health care. Focused on enhancing the quality of care, emergency care visits in both VA and non‐VA (community) care locations have nearly doubled from the 1980s to more than 3 million visits in Fiscal Year 2022. Recognizing the need to plan for continued growth and the opportunity to address key research priorities, the VA Office of Emergency Medicine, together with the VA Health Services Research and Development Service, collaborated to convene a State of the Art Conference on Veteran Emergency Medicine (SAVE) in the winter of 2022. The goal of this conference was to identify research gaps and priorities for implementation of policies for three priority groups: geriatric Veterans, Veterans with mental health and substance use complaints, and Veterans presenting to non‐VA (community) emergency care sites. In this article we discuss the rationale for the SAVE conference including a brief history of VA EM and the planning process and conclude with next steps for findings from the conference.
Diffusion‐weighted magnetic resonance imaging and magnetic resonance spectroscopy for non‐invasive characterization of azoospermia: A prospective comparative single‐center study
Authors: Hesham Said Ahmed , Ragab Ahmed , Zohdy Wael , Ibrahim Ahmed Sayed , Abd El Basset Ahmed Sayed
Published: January 2023

Background

Azoospermia affects about 15% of childless males. The differential diagnosis between subtypes of azoospermia is the initial step in its management.

Objectives

To investigate the role of diffusion‐weighted magnetic resonance imaging and proton magnetic resonance spectroscopy in distinguishing obstructive azoospermia from non‐obstructive azoospermia and predicting sperm retrieval together with histological alterations in men with non‐obstructive azoospermia.

Materials and methods

This prospective comparative study involved 60 men with obstructive azoospermia (group A) and 60 men with non‐obstructive azoospermia (group B). Scrotal proton magnetic resonance spectroscopy and diffusion‐weighted magnetic resonance imaging were conducted for all participants to respectively evaluate testicular metabolites and normalized apparent diffusion coefficient 1 week before sperm retrieval.

Results

Apparent diffusion coefficient was significantly higher in group B as compared to group A (0.47 ± 0.11 vs. 0.29 ± 0.05; and 0.46 ± 0.14 vs. 0.28 ± 0.02) for the right and left testis, respectively. Conversely, testicular choline and lipids were significantly higher in group A as compared to group B. Normalized apparent diffusion coefficient, choline, and lipids at cut‐off levels of 0.353, 0.31, and 0.725 could differentiate between obstructive azoospermia and non‐obstructive azoospermia (area under the curve = 0.963; confidence interval = 0.939–0.986, area under the curve = 0.985; confidence interval = 0.974–0.997, and area under the curve = 0.970; confidence interval = 0.940–0.999, respectively). Regarding the prediction of sperm retrieval in the non‐obstructive azoospermia group, choline levels had the highest area under the curve (0.923), and its cut‐off level was 0.195. The normalized apparent diffusion coefficient was significantly lower in men with positive sperm retrieval as compared to men with unsuccessful retrieval. Finally, it was revealed that all magnetic resonance imaging parameters except creatine could independently predict testicular histology in men with non‐obstructive azoospermia. The highest prediction was 95% in normal spermatogenesis, and the least prediction was 40% in spermatid arrest. Regression analysis was used to detect final predictors and extrapolate an equation that could be used to predict testicular pathology

Conclusions

Normalized apparent diffusion coefficient and proton magnetic resonance spectroscopy are helpful in differentiating obstructive azoospermia from non‐obstructive azoospermia and predicting sperm retrieval and related histological alterations in men with non‐obstructive azoospermia.
The spatial ventricular gradient is associated with adverse outcomes in acute pulmonary embolism
Authors: Stabenau Hans Friedrich , Marcus Mason , Matos Jason D. , McCormick Ian , Litmanovich Diana , Manning Warren J. , Carroll Brett J. , Waks Jonathan W.
Published: January 2023

Background

The spatial ventricular gradient (SVG) is a vectorcardiographic measurement that reflects cardiac loading conditions via electromechanical coupling.

Objectives

We hypothesized that the SVG is correlated with right ventricular (RV) strain and is prognostic of adverse events in patients with acute pulmonary embolism (PE).

Methods

Retrospective, single‐center study of patients with acute PE. Electrocardiogram (ECG), imaging, and outcome data were obtained. SVG components were regressed on tricuspid annular plane systolic excursion (TAPSE), qualitative RV dysfunction, and RV/left ventricular (LV) ratio. Odds of adverse outcomes (30‐day mortality, vasopressor requirement, or advanced therapy) after PE were regressed on demographics, RV/LV ratios, traditional ECG signs of RV dysfunction, and SVG components using a logit model.

Results

ECGs from 317 patients (48% male, age 63.1 ± 16.6 years) with acute PE were analyzed; 36 patients (11.4%) experienced an adverse event. Worse RV hypokinesis, larger RV/LV ratio, and smaller TAPSE were associated with smaller SVG X and Y components, larger SVG Z components, and smaller SVG vector magnitude (p < .001 for all). In multivariable logistic regression, odds of adverse events after PE decreased with increasing SVG magnitude and TAPSE (OR 0.32 and 0.54 per standard deviation increase; p = .03 and p = .004, respectively). Receiver operating characteristic (ROC) analysis showed that, when combined with imaging, replacing traditional ECG criteria with the SVG significantly improved the area under the ROC from 0.70 to 0.77 (p = .01).

Conclusion

The SVG is correlated with RV dysfunction and adverse outcomes in acute PE and has a better prognostic value than traditional ECG markers.
Fifty years on: How we uncovered the unique bioenergetics of brown adipose tissue
Authors: Nicholls David G.
Published: January 2023

Exactly 50 years ago, I was a post‐doc in the laboratory of Olov Lindberg in Stockholm measuring fatty acid oxidation by mitochondria isolated from thermogenic brown adipose tissue, when we noticed a curious nonlinearity in the respiration rate. This initiated a convoluted chain of experiments revealing that the mitochondria were textbook demonstrations of the then novel and highly controversial “chemiosmotic hypothesis” of Peter Mitchell and that thermogenesis was regulated by a proton short‐circuit, mediated by a 32 kDa “uncoupling protein,” UCP1, activated by fatty acid. This review is a personal account of the research into the bioenergetics of isolated brown adipocytes and isolated mitochondria, which led, after fifteen years of investigation, to what is still accepted as the “canonical” UCP1‐mediated mechanism of nonshivering thermogenesis, uniting whole animal physiology with mitochondrial bioenergetics.
Bayesian analysis of genetic and environmental effects on litter traits in a red fox (Vulpes vulpes) herd under long‐term selection
Authors: Przysiecki Piotr , Filistowicz Andrzej , Skotarczak Ewa , Dobrzynska Patrycja , Szwaczkowski Tomasz
Published: January 2023

The economic efficiency of fur animal farms is considerably influenced by reproductive performance. The objectives of this study are to determine the effects of individual and maternal inbreeding, birth year, and dam and sire age on litter size at birth (LSB) and at weaning (LSW) and on preweaning mortality (PWM) in a red fox herd under long‐term selection, and to determine the heritability of these traits. In total, 37,973 pedigreed individuals were used to calculate the inbreeding coefficients, based on records of 14,527 litters of 3856 dams born from the year 1958 to 2015. Two data sets (all data and data for the Polish variety) were analyzed. The highest heritability was estimated for PWM (0.292, 0.306) and the lowest for LSW (0.114, 0.115). In contrast to paternal and maternal inbreeding, litter inbreeding was found to exert a significant influence. The absence of significant effects of most varieties may suggest relatively large genetic similarity in the world red fox population. This corresponds with the similarity of the results obtained for the total herd and for the Polish variety. Favorable genetic trends were observed for the studied traits, indicating that the selection applied had been a relatively effective approach to improving these traits.
Preconception health status and associated disparities among rural, Midwestern women in the United States
Authors: DiPietro Mager Natalie A. , Zollinger Terrell W. , Turman Jack E. , Zhang Jianjun , Dixon Brian E.
Published: January 2023

Background

Little is known about the preconception/interconception health and behaviors of reproductive‐age women in the rural Midwest of the United States. The purpose of this study was to quantify preconception/interconception health status and to identify disparities compared with statewide estimates.

Methods

In this cross‐sectional study, we collected data on 12 health conditions and behaviors that are risk factors for adverse maternal and infant health outcomes from nonpregnant women ages 18‐45 years in rural northwestern Ohio. Statistical tests were used to identify associations between selected demographic characteristics and a subset of eight high‐priority health measures (smoking, diabetes, heavy alcohol use, folic acid intake, normal weight, sufficient physical activity, and effective contraception use); all but physical activity could be compared with Ohio estimates derived from the Behavioral Risk Factor Surveillance System and Ohio Pregnancy Assessment Survey.

Results

Three hundred‐fifteen women participated, with 98.4% reporting at least one high‐priority risk factor. Statistically significant differences were identified among subpopulations related to smoking, folic acid, normal weight, sufficient physical activity, and effective contraception use. In addition, the proportion of participants reporting hypertension (P < 0.001), smoking (P < 0.001), abnormal weight (P = 0.002), and lack of daily folic acid intake (P = 0.006) were statistically significantly higher than expected based on statewide estimates.

Conclusions

Women in the rural Midwest of the United States are at risk for poor health and pregnancy outcomes. Statewide estimates tracking preconception/interconception health status may obscure variation for at‐risk groups, particularly in rural or underserved areas. These findings illustrate the need for interventions to advance preconception/interconception health and improve methods to capture and analyze data for rural women.
The potential of biophysiology for understanding motivation, engagement and learning experiences
Authors: Martin Andrew J. , Malmberg Lars‐Erik , Pakarinen Eija , Mason Lucia , Mainhard Tim
Published: January 2023

Background and Aims

Integrative models applied to human learning and performance emphasize the joint operation of biological, psychological, social, and educational processes to fully understand human functioning. Educational psychology researchers have typically emphasized psycho‐educational and psycho‐social factors in motivation, engagement and learning, but do not often consider the biophysiological factors.

Results

This Editorial and Special Issue advances current understanding on the role of biophysiological factors and processes in students' and teachers' motivation, engagement, and learning experiences, by showcasing recent educational research that included biophysiological measures and methods.

Conclusions

As we discuss, conducting integrative biophysiological and psycho‐educational research has potential to derive vital substantive, methodological, and applied insights that provide a rigorous basis for more effective educational theory, research, and practice.
The Cognitive and Behavioural Responses to Symptoms Questionnaire (CBRQ): Development, reliability and validity across several long‐term conditions
Authors: Picariello Federica , Chilcot Joseph , Chalder Trudie , Herdman David , Moss‐Morris Rona
Published: January 2023

Objectives

Cognitive and behavioural responses to symptoms can worsen or maintain the severity of symptoms across long‐term conditions (LTCs). Although the Cognitive and Behavioural Responses Questionnaire (CBRQ) has been used in research, its original development and psychometric properties as a transdiagnostic measure have not been reported. Our aim was to evaluate the psychometric properties of the CBRQ and a recently proposed short version, across different LTCs.

Design

Psychometric validation study.

Methods

Confirmatory factor analysis (CFA) tested the factor structure of the CBRQ in two datasets from the CBRQ's original development; (chronic fatigue syndrome,N = 230; and multiple sclerosis,N = 221) and in additional groups: haemodialysis (N = 174), inflammatory bowel disease (N = 182) and chronic dizziness (N = 185). Scale reliability and construct validity were assessed. The factor structure of the shortened CBRQ (CBRQ‐SF) was also assessed.

Results

CFA revealed that a 7‐or 8‐factor structure had generally appropriate fit supporting the originally proposed 7 factors (Fear avoidance, Damage beliefs, Catastrophising, Embarrassment avoidance, Symptom focusing, All‐or‐nothing behaviour and Avoidance/Resting behaviour). Omega coefficients indicated satisfactory internal reliability. Correlations with related constructs suggested construct validity. The scale appeared sensitive to change. The CBRQ‐SF also displayed good psychometric quality, with a better model fit than the CBRQ.

Conclusions

The CBRQ and the shortened version were shown to be reliable and valid at assessing a range of cognitive and behavioural responses to symptoms, highlighting the multi‐symptom, transdiagnostic properties of this questionnaire. Further research is necessary to determine the test–retest reliability and sensitivity to change of the CBRQ and CBRQ‐SF and a thorough evaluation of the content validity of the items.
The effects of the presence of a face and direct eye gaze on voice identity learning
Authors: Lavan Nadine , Ramanik Bamaniya Nisha , Muse Moha‐Maryam , Price Raffaella Lucy Monica , Mareschal Isabelle
Published: January 2023

We rarely become familiar with the voice of another person in isolation but usually also have access to visual identity information, thus learning to recognize their voice and face in parallel. There are conflicting findings as to whether learning to recognize voices in audiovisual vs audio‐only settings is advantageous or detrimental to learning. One prominent finding shows that the presence of a face overshadows the voice, hindering voice identity learning by capturing listeners' attention (Face Overshadowing Effect; FOE). In the current study, we tested the proposal that the effect of audiovisual training on voice identity learning is driven by attentional processes. Participants learned to recognize voices through either audio‐only training (Audio‐Only) or through three versions of audiovisual training, where a face was presented alongside the voices. During audiovisual training, the faces were either looking at the camera (Direct Gaze), were looking to the side (Averted Gaze) or had closed eyes (No Gaze). We found a graded effect of gaze on voice identity learning: Voice identity recognition was most accurate after audio‐only training and least accurate after audiovisual training including direct gaze, constituting a FOE. While effect sizes were overall small, the magnitude of FOE was halved for the Averted and No Gaze conditions. With direct gaze being associated with increased attention capture compared to averted or no gaze, the current findings suggest that incidental attention capture at least partially underpins the FOE. We discuss these findings in light of visual dominance effects and the relative informativeness of faces vs voices for identity perception.
Longevity, Fertility, and the Real Exchange Rate
Authors: Liu Xiaohui , Zhou Zhihao , Zhang Jing
Published: January 2023

We build a simple overlapping generation model to investigate the effect of life expectancy on the real exchange rate where fertility is chosen endogenously. The model reveals that, although the overall effect of life expectancy on the real exchange rate is not certain, longer life expectancy tends to cause the real exchange rate to depreciate by reducing fertility. Fertility thus serves as a mediator in the effect of life expectancy on the real exchange rate. Evidence from 148 economies (1980–2018) shows a statistically significant and robust negative relationship between life expectancy and the real exchange rate. It is estimated that a 1 year increase in life expectancy is associated with a 1.5 percent depreciation in the real exchange rate. The evidence also confirms the mediated effect of fertility. The mediated effect that fertility exerts accounts for 30 percent to 50 percent of the total effect, depending on the real exchange rate index used.
The value of pulmonary artery acceleration time in evaluating pulmonary vascular disease in preterm infants with bronchopulmonary dysplasia
Authors: Wang Liling , Liu Zhijie , Zhang Fengjuan , Xu Haiyan , Wang Haiyan , Zhao Xueqiang
Published: January 2023

Objectives

Early screening and dynamic monitoring of pulmonary vascular disease (PVD) in bronchopulmonary dysplasia (BPD) high‐risk infants is of great clinical significance. Pulmonary artery acceleration time (PAAT) is a reliable and non‐invasive method for assessing PVD in children over 1 year, but to date, few studies have used PAAT to assess pulmonary hemodynamics of preterm infants, especially those with BPD. Through dynamic monitoring the main hemodynamic indicators reflected PVD after birth, this study aimed to assess the value of PAAT in evaluating early PVD in BPD infants.

Methods

All 81 preterm infants at risk of BPD were divided into BPD and non‐BPD groups according to whether BPD occurred. Clinical characteristics, PAAT, right ventricular ejection time (RVET) and other main hemodynamic indicators at four different time points after birth were studied and compared.

Results

PAAT and PAAT/RVET increased gradually within 72 h after birth in the BPD group (p < .05), but the curve tended to be flat over time after 72 h (p > .05). At PMA32 and 36 weeks, the PAAT (49.7 ± 4.8 vs. 54.8 ± 5.7, p = .001; 50.0 ± 5.3 vs. 57.0 ± 5.3, p = .001) and PAAT/RVET (.33 ± .04 vs. .35 ± .03, p = .001; .34 ± .03 vs. .37 ± .04, p = .001) in BPD group were significantly lower than those in the non‐BPD group.

Conclusions

PAAT and PAAT/RVET in the BPD group infants showed different change patterns compared to non‐BPD group infants. PAAT can be used as a noninvasive and reliable screening method for screening and dynamic monitoring of PVD in BPD high‐risk infants.
Contrasting effects of nitrogen fertiliser application on the performance of closely related grasshoppers through changes in plant nutrient concentrations
Authors: Zhu Yu , Ma Quanhui , Zhong Zhiwei , Jiang Ming , Bakker Elisabeth S. , Harvey Jeffrey A. , (Ciska) Veen G. F. , Chen Cong , Wang Deli
Published: January 2023

Global environmental changes mediated by anthropogenic processes can affect the nutrient status of plants, with important consequences for the performance and dynamics of insect herbivores that feed on them.

While it is well documented that insects from different feeding guilds (e.g., sap‐feeders and leaf‐chewers) can respond differently to altered food resources due to their distinct physiological and ecological characteristics, little is known about how ecologically similar insect species from the same feeding guild respond to changes in food nutrient status.

Using nitrogen (N) fertiliser, the authors examined the effects of N inputs on two sympatric grasshopper species, Euchorthippus cheui and E. unicolor, that share the same host food plant, Leymus chinensis grass. The authors examined the effects of fertilisation on the individual feeding behaviour, performance and abundance of the two grasshopper species.

The nutrient (protein) content of L. chinensis leaves was enhanced by fertilisation during the entire season. However, E. cheui and E. unicolor exhibited differing growth rates, development and body size responses to fertilisation.

E. cheui preferred L. chinensis leaves from high‐N fertilised treatments, while E. unicolor preferred leaves from low‐N fertilised treatments. Moreover, fertilisation increased the abundance of E. cheui but had no significant effect on the abundance of E. unicolor in the field.

The findings imply that effective management and conservation strategies for insects should target the needs of individual species rather than species groups or communities as a whole because nutritional and environmental requirements are often species‐specific.
TP53 signal pathway confers potential therapy target in acute myeloid leukemia
Authors: Zhu Gelan , Cai Jiayi , Zhong Hua
Published: January 2023

TP53 mutation is a frequent tumor suppressor mutation and a critical prognostic indicator across studies in many malignant tumors including hematologic malignancies. However, the role of TP53 and its correlative pathway in acute myeloid leukemia (AML) is enigmatic, which may provide possible emerging strategies with the potential to improve outcomes in AML. Accordingly, we focus not only on the TP53 mutation but also on the underlying mechanisms of the mutated TP53 signal pathway. While it is now generally accepted that TP53 mutations are widely associated with a dismal prognosis, resistance to chemotherapy, and high incidence of relapse and refractory AML. Hereby, the current therapeutics targeting TP53 mutant AML are summarized in this review. This will address emerging TP53‐based therapeutic approaches, facilizing the TP53‐targeted treatment options.
Independent effect of cardiometabolic syndromes and depression on dementia in Parkinson's disease: A 12‐year longitudinal follow‐up study of a nationwide cohort
Authors: Kang Sung Hoon , Choi Yunjin , Chung Su Jin , Kim Chi Kyung , Kim Ji Hyun , Oh Kyungmi , Yoon Joon Shik , Cho Geum Joon , Koh Seong‐Beom
Published: January 2023

Background

We aimed to investigate the incidence rate of Parkinson's disease dementia (PDD) according to age and disease duration by sex. Furthermore, we explored the effect of each cardiometabolic syndrome and depression on the incidence of PDD.

Methods

Using data from the Korean National Health Insurance Service, 79,622 patients with de novo Parkinson's disease (PD) aged ≥40 years between January 2002 and December 2010 were followed to December 2019. We analyzed the incidence of PDD according to age at PD diagnosis and disease duration. To determine cardiometabolic syndromes and depression that affected PDD, we used Fine and Gray competing regression after controlling for age and sex.

Results

During the 12.5‐year follow‐up period, the incidence of PDD increased with age at PD diagnosis (0.81–45.31 per 1000 person‐years among those aged 40–44 and over 80 years, respectively) and longer disease duration (22.68 per 1000 person‐years in 1–2 years to 34.16 per 1000 person‐years in 15–16 years). Hypertension (subdistribution hazard ratio [SHR] = 1.11; 95% confidence interval [CI] 1.07–1.16), diabetes (SHR = 1.09; 95% CI 1.05–1.14), dyslipidemia (SHR = 1.15; 95% CI 1.11–1.20), and depression (SHR = 1.36; 95% CI 1.30–1.41) independently increased the risk for PDD.

Conclusions

Our findings provide insights into cardiometabolic syndromes as modifiable risk factors for incident PDD. Furthermore, our results will help in designing public health policies with respect to controlling cardiometabolic syndromes and depression to prevent incident PDD in patients with PD.
Cognitive phenotypes and factors associated with cognitive decline in a cohort of older patients with atrial fibrillation: The Strat‐AF study
Authors: Salvadori Emilia , Barucci Eleonora , Barbato Carmen , Formelli Benedetta , Cesari Francesca , Chiti Stefano , Diciotti Stefano , Giusti Betti , Gori Anna Maria , Marzi Chiara , Pescini Francesca , Pracucci Giovanni , Fainardi Enrico , Marcucci Rossella , Poggesi Anna
Published: January 2023

Background and purpose

The multifactorial relationship between atrial fibrillation (AF) and cognitive impairment needs to be elucidated. The aim of this study was to assess, in AF patients on oral anticoagulants (OACs), the prevalence of cognitive impairment, defined according to clinical criteria or data‐driven phenotypes, the prevalence of cognitive worsening, and factors associated with cognitive outcomes.

Methods

The observational prospective Strat‐AF study enrolled AF patients aged ≥ 65 years who were receiving OACs. The baseline and 18‐month protocol included clinical, functional, and cognitive assessment, and brain magnetic resonance imaging. Cognitive outcomes were: empirically derived cognitive phenotypes; clinical diagnosis of cognitive impairment; and longitudinal cognitive worsening.

Results

Out of 182 patients (mean age 77.7 ± 6.7 years, 63% males), 82 (45%) received a cognitive impairment diagnosis, which was associated with lower education level and functional status, and higher level of atrophy. Cluster analysis identified three cognitive profiles: dysexecutive (17%); amnestic (25%); and normal (58%). Compared to the normal group, the dysexecutive group was older, and had higher CHA2DS2‐VASc scores, while the amnestic group had worse cognitive and functional abilities, and medial temporal lobe atrophy (MTA). Out of 128 followed‐up patients, 35 (27%) had cognitive worsening that was associated with lower education level, worse cognitive efficiency, CHA2DS2‐VASc score, timing of OAC intake, history of stroke, diabetes, non‐lacunar infarcts, white matter hyperintensities and MTA. In multivariate models, belonging to the dysexecutive or amnestic group was a main predictor of cognitive worsening.

Conclusions

In our cohort of older AF patients, CHA2DS2‐VASc score, timing of OAC intake, and history of stroke influenced presence, type and progression of cognitive impairment. Empirically derived cognitive classification identified three groups with different clinical profiles and better predictive ability for cognitive worsening compared to conventional clinical diagnosis.
Causal effect of gut‐microbiota‐derived metabolite trimethylamine N‐oxide on Parkinson's disease: A Mendelian randomization study
Authors: Zhou Hang , Luo Yuqi , Zhang Wenjie , Xie Fen , Deng Chao , Zheng Wenhua , Zhu Shuzhen , Wang Qing
Published: January 2023

Background and purpose

It has been suggested that trimethylamine N‐oxide (TMAO) is related to Parkinson's disease (PD) in observational studies. However, the direction of this association is inconsistent. An exploratory Mendelian randomization study was conducted to investigate whether TMAO and its precursors have a causal relationship with PD.

Methods

Summary statistics were obtained for single nucleotide polymorphisms related to circulating levels of TMAO, betaine, carnitine and choline, and the corresponding data for the risk, age at onset and progression of PD from genome‐wide association studies. Inverse‐variance weighting was used as the primary method for effect estimation. The false discovery rate was applied to the correction of multiple testing. Apvalue of association <0.05 but above the false discovery rate corrected threshold was deemed suggestive evidence of a possible association. A range of robust Mendelian randomization methods were used for sensitivity analysis.

Results

Suggestive evidence was observed of an inverse causal effect of TMAO on motor fluctuations (odds ratio [OR] 0.851, 95% confidence interval [CI] 0.731, 0.990,p = 0.037) and carnitine on insomnia (OR 0.817, 95% CI 0.700, 0.954,p = 0.010) and a positive causal effect of betaine on Hoehn–Yahr stage (OR 1.397, 95% CI 1.112, 1.756,p = 0.004), Unified Parkinson's Disease Rating Scale (UPDRS) III score (β = 0.138, 95% CI 0.051, 0.225,p = 0.002), motor fluctuations (OR 1.236, 95% CI 1.011, 1.511,p = 0.039), and choline on UPDRS IV (β = 0.106, 95% CI 0.026, 0.185,p = 0.009) and modified Schwab and England Activities of Daily Living Scale score (β = 0.806, 95% CI 0.127, 1.484,p = 0.020).

Conclusions

Our findings provide suggestive evidence that TMAO and its precursors have a causal effect on the progression of PD. Further investigation of the underlying mechanisms is required.
Ischaemic cerebral small vessel disease caused by adenosine deaminase 2 deficiency syndrome
Authors: Giossi Alessia , Giliani Silvia Clara , Gamba Massimo , Toniati Paola , Magoni Mauro , Pezzini Alessandro
Published: January 2023

Background and purpose

Only a small proportion of cerebral small vessel disease (cSVD), a frequent cause of stroke and cognitive or motor disability in adults, is attributable to monogenic conditions. The hereditary nature of a patient's cSVD may be masked by a mild or non‐informative phenotype, as single‐gene disorders have a variable mode of presentation, penetrance and disease severity.

Case description

An adult patient is here described with recurrent acute ischaemic strokes due to cSVD with no other phenotypic manifestation, in whom the pathogenic c.139G>A (p.G47R) missense variant in ADA2 (NM_001282225.2), consistent with the diagnosis of adenosine deaminase 2 deficiency syndrome, was detected by targeted next‐generation sequencing.

Conclusions

Clinical suspicion of adenosine deaminase 2 deficiency syndrome may be overlooked in stroke patients in whom other specific disease features are lacking. This case enlarges the mode of presentation of the syndrome and highlights the diagnostic potential of next‐generation sequencing of known cSVD genes in young adults with recurrent small subcortical infarcts presenting with a lacunar syndrome.
Generating the structural graph‐based model from a program source‐code using chaotic forrest optimization algorithm
Authors: Arasteh Bahman , Ghanbarzadeh Reza , Gharehchopogh Farhad Soleimanian , Hosseinalipour Ali
Published: January 2023

One of the most important and costly stages in software development is maintenance. Understanding the structure of software will make it easier to maintain it more efficiently. Clustering software modules is thought to be an effective reverse engineering technique for deriving structural models of software from source code. In software module clustering, the most essential objectives are to minimize connections between produced clusters, maximize internal connections within created clusters, and maximize clustering quality. Finding the appropriate software system clustering model is considered an NP‐complete task. The previously proposed approaches' key limitations are their low success rate, low stability, and poor modularization quality. In this paper, for optimal clustering of software modules, Chaotic based heuristic method using a forest optimization algorithm is proposed. The impact of chaos theory on the performance of the other SFLA‐GA and PSO‐GA has also been investigated. The results show that using the logistic chaos approach improves the performance of these methods in the software‐module clustering problem. The performance of chaotic based FOA, SFLA‐GA and PSO‐GA is superior to the other heuristic methods in terms of modularization quality and stability of the results.
Novel indole retinoid derivative induces apoptosis and cell cycle arrest and modulates AKT and ERK signaling in HL‐60 cells
Authors: Gurkan‐Alp A. Selen , Karabay Arzu Z. , Koc Asli , Buyukbingol Erdem
Published: January 2023

Chemotherapy with targeted drugs is the first line therapy option for acute and chronic myeloid leukemia. However, hematopoietic stem cell transplantation may be used in high‐risk patients or patients with failed responses to chemo drugs. Discovery and development of more effective new agents with lower side effects is the main aim of leukemia treatment. In this study, a novel retinoid compound with tetrahydronaphthalene ring was synthesized and evaluated for anticancer activity in human chronic and acute myeloid leukemia cell lines K562 and HL‐60. Novel N‐(1H‐indol‐1‐yl)‐5,5,8,8‐tetramethyl‐5,6,7,8‐tetrahydronaphthalene‐2‐carboxamide was synthesized based on molecular hybridization of the two different bioactive structures retinoid head and indole. The effects of the synthesized carboxamide compound, which was referred to as compound 5, were determined in K562 chronic myeloid leukemia and HL‐60 acute myeloid leukemia cell lines and L929 fibroblast cell line, which served as a control. Colorimetric MTT and caspase3 activity tests, flow cytometry, western blot, and microscopic examinations were used to evaluate biological activity. Compound 5 more effectively induced cell death in HL60 cells in comparison to K562 cells and L929 fibroblast cells. Therefore, further mechanism of cell death was investigated in HL60 cell line. It was found that compound 5 induced remarkable cytotoxicity, caspase3 activation, and PARP fragmentation in HL60 cells. Flow cytometric staining showed that the percentage of cells arrested in G0/G1 was also increased with compound 5 treatment. Important modulator proteins of cell proliferation p‐ERK, p‐AKT, and p‐m‐TOR were also found to be inhibited with compound 5 treatment. Collectively, our results reveal compound 5, which is a novel indole retinoid compound as a potential active agent for the treatment of acute promyelocytic leukemia.
Discordance between joint pain and imagery severity in the ankle joint and contributors of lower limb activity limitations in adults with haemophilia: A cross‐sectional study
Authors: Chantrain Valérie‐Anne , Guillaume Sylvain , Foubert Anthe , Meeus Mira , Lobet Sébastien , Lambert Catherine , Lecouvet Frédéric , Hermans Cedric , Roussel Nathalie Anne
Published: January 2023

Introduction

People with haemophilia (PwH) suffer from knee and ankle joint pain, but the association with structural damage remains underexplored. They report activity limitations but it is unclear which factors contribute to lower limb activity limitations (LL‐AL).

Aims

This study aimed (i) to analyse the association between ankle joint pain and structure and (ii) explore the contribution of haemophilia‐related, individual and psychological factors to LL‐AL in PwH.

Methods

This study included 104 moderate/severe PwH. Ankle pain intensity was assessed with a numeric rating scale and pain sensitivity with algometry (pressure pain threshold (PPTA)). Ankle structure was assessed with MRI (IPSG‐MRI) and ultrasound (HEAD‐US), joint health with the Haemophilia Joint Health Score (HJHS). The HAL‐LOWCOM subscore evaluated LL‐AL. A Spearman correlation analysed the correlation between ankle pain and structure. The contribution of haemophilia‐related factors (joint health, overall pain (Brief Pain Inventory‐Pain Severity (BPI‐PS)), functional status (2‐Minute‐Walking‐Distance, Timed Up and Go); individual factors (age, BMI) and psychological factors (fear and avoidance beliefs over physical activity (FABQ‐PA) and work (FABQ‐Work), anxiety and depression) to LL‐AL was explored using a regression analysis.

Results

Only low correlations were found between ankle pain intensity and structure (IPSG‐MRI, HEAD‐US). PPTA was unrelated to structure. Altogether, HJHS, overall pain (BPI‐PS), FABQ‐Work and age explained 69% of HAL‐LOWCOM variance, with 65% explained by the combination of HJHS and BPI‐PS.

Conclusion

No meaningful associations were found between ankle pain and structural damage, suggesting that other factors may contribute to PwH's ankle pain. In contrast, mainly haemophilia‐related factors explained LL‐AL variance.
Quantification of bioactive components and evaluation of microbial community and antibacterial activity from Heterotrigona itama and Tetrigona binghami honeys
Authors: Wu Jiao , Han Bingjun , Chen Xiaoyu , Gao Jinglin , Zhao Shan , Sun Liping , Wang Shijie
Published: January 2023

Stingless bee honey is a precious food product with therapeutic benefits. In this study, we determined the quality of Malaysian stingless bee honeys (Heterotrigona itama and Tetrigona binghami) by the physicochemical characteristics, phenolic compounds, and organic acids. Our results revealed that the major phenolic compounds in all honey samples were chlorogenic acid and myricetin, and the major organic acids contained gluconic acid and trans‐cinnamic acid. The microbial community in honeys characterised using 16S rRNA and ITS amplicon sequencing techniques showed that Lactobacillus was assumed to be the predominant bacterium in stingless bee honeys. Furthermore, the antibacterial activity of honeys was examined in order to further demonstrate their health benefits. Our results are intended to pave the road for stingless bee honeys' probiotic capacity to be extended into our daily life.
DOAC‐stop can remove direct oral anticoagulants and allow analysis by global coagulation assays
Authors: Wang Julie , Lim Hui Yin , Nandurkar Harshal , Ho Prahlad
Published: January 2023

Introduction

Activated charcoal based compounds such as DOAC‐stop™ (DS) have been developed to remove direct oral anticoagulant (DOAC) interference in‐vitro. However, few studies have used this approach with global coagulation assays (GCAs), such as thrombin generation assays, which are sensitive to the effect of DOACs.

Methods

Thrombin generation with and without thrombomodulin (TM) via the automated ST‐Genesia system, and the overall haemostatic potential (OHP) assay, a spectrophotometric fibrin generation assay in which fibrin formation (triggered by small amounts of thrombin (overall coagulation potential, OCP)) and fibrinolysis (by the addition of thrombin and tissue plasminogen activator) were measured on (i) pooled normal plasma (PNP) spiked with varying amounts of rivaroxaban, apixaban, and dabigatran, and (ii) platelet poor plasma (PPP) from 21 non‐anticoagulated adults, before and after DS addition.

Results

Following the addition of DS to spiked PNP without thrombomodulin, thrombin and velocity index increased by 21.9% and 42.6%, respectively, while ETP increased by 6.93%. A decrease in OCP (−10.6%) and OHP (−12.7%) was observed following DS. Similar changes were seen post‐DS to plasma from non‐anticoagulated patients. Also in this group, pre‐ and post‐DS thrombin generation parameters showed high correlation, with the strongest observed for ETP (R2 = 0.94). There was a strong correlation for OHP parameters, with the closest seen with OCP (R2 = 0.96) and OHP (R2 = 0.95).

Conclusion

DS causes some changes to the ETP and OHP assay, however, strong correlations were seen pre‐ and post‐DS in all GCA parameters. These findings support the use of DS to facilitate GCA testing in anticoagulated individuals for evaluation of the underlying thrombotic state.
Getting out or switching to part‐time: Gender disparities in the impacts of corporate restructuring
Authors: LAMBERT Anne , REMILLON Delphine , SEGÚ Mariona
Published: January 2023

Whereas the literature on gender disparities in cases of large‐scale corporate restructuring focuses on discrimination in top‐down processes, this article analyses why employee self‐selection continues to yield gender inequalities. Based on the case study of an airline company and using mixed methods, the results indicate that men are more likely to accept voluntary redundancy and less likely to switch to subsidized part‐time work. While women work part‐time mostly to improve their work–life balance, men appear to be more sensitive to financial incentives and more prepared to retrain in a secondary activity. These findings suggest that restructuring amplifies women's existing labour market vulnerabilities, even under voluntary redundancy plans.
Major technological advances will enhance Australian donor‐recipient matching and improve transplant outcomes
Authors: Hiho Steven , Levvey Bronwyn , Holdsworth Rhonda , Sullivan Lucy , Westall Glen , Snell Greg
Published: January 2023

In recent times, numerous and significant technological and supportive changes have taken place in Australian transplantation. These changes are often deployed without the wider clinical community having a full understanding of what has brought about these changes and the impacts they have. Here, we aim to clarify the reasoning behind these changes and shed light on potential future endeavours to improve patient outcomes.
Progressive taxation and optimal monetary policy in a two‐country new Keynesian model
Authors: Ida Daisuke , Kaminoyama Kenichi
Published: January 2023

This paper examines the effect of tax progressivity on optimal monetary policy in a two‐country new Keynesian model. We first address the issue that coefficients in both structural equations and the central bank's loss function are crucially affected by a change in tax progressivity in both countries. Second, we show that a change in tax progressivity significantly affects the properties of international monetary policy transmission. Third, we demonstrate that the impact of tax progressivity on international monetary policy transmission depends on the value of the constant relative risk‐aversion coefficients.
Comparative impacts of the COVID‐19 pandemic on work and employment—Why industrial relations institutions matter
Authors: Dobbins Tony , Johnstone Stewart , Kahancová Marta , Lamare J. Ryan , Wilkinson Adrian
Published: January 2023

This introduction assesses the international impacts of the COVID‐19 pandemic on work and employment. It outlines conceptually why industrial relations institutions matter for shaping policy choices across different countries. This includes countries in the Global South that are not covered by conventional varieties of capitalism theories. An important focus is what IR institutions and policies played a protective role in the decommodification of labor during the pandemic, notably short‐time working (furlough) schemes, tripartite cooperative pacts, works councils, collective bargaining, and active labor market policies. IR institutions continue to matter, and the contributions in this Special Issue can inform future research.
THE SCARBROUGH REPORT AND THE UNIVERSITIES
Authors: Bowra C. M.
Published: January 2023

Note. The Report of the Interdepartmental Commission of Inquiry on Oriental, Slavonic, East European and African Studies“ (H.M.S.O. 2s. 0d.) of which Lord Scarbrough was chairman, appeared in April and could only be briefly referred to in the May number of the Universities Quarterly. The following article discusses the very important implications of this Report on the universities at greater length.

The main recommendations of the Commission were accepted by the Government during a debate initiated by Lord Hailey in the House of Lords on June 25th. A revenue grant of £125,000 will be given to the universities for the year 1947‐8 and £10,000 for post‐graduate studentships; the question of the oriental centre in London is to be considered by a working‐party, and in addition to the two sub‐committees of the UGC mentioned on page 326 an interdepartmental committee will co‐ordinate the interests of the various government departments concerned.
Blended diet for enteral tube feeding in young people: A systematic review of the benefits and complications
Authors: McCormack Siobhan , Patel Kamal , Smith Chris
Published: January 2023

Background

Interest and use of blended diets (BD) for young people who are tube fed has significantly increased in the last decade, driven primarily by the desires of motivated caregivers. This review identified, appraised and synthesised the available evidence on the benefits and complications of BD versus commercial feeds.

Methods

A systematic review following PRISMA guidance and registered with PROSPERO was conducted across PubMed, Embase, CINAHL, Scopus and Cochrane up to August 2022. Inclusion criteria: English language studies including (1) children, (2) original research (interventional and observational) and (3) examination of BD outcomes. Exclusion criteria were (1) unoriginal research or case reports, (2) focus on feeding management, preparations or attitudes and (3) comparing commercial blends only. Data were synthesised using an established narrative synthesis approach using the Mixed Methods Appraisal Tool.

Results

Eight hundred and six database results were identified and 61 were sought for retrieval. A full‐text article review revealed seven eligible studies, involving 267 participants (age range 9 months to 26 years). Studies reported differences in gastrointestinal symptoms (n = 222), medication use (n = 119), growth (n = 189) and complications or adverse events (n = 91). The results indicate positive outcomes, particularly in gastrointestinal symptom control, with few reports of mild adverse events in the included studies.

Conclusions

There is a paucity of data in this area and much heterogeneity in the included studies, but the available literature points towards positive outcomes. This is an important and highly relevant topic, and more primary research, ideally using standardised reporting, is required to answer the key questions.