bluuebunny/crossref_metadata_2025 huggingface dataset:
The reality of rurality: Understanding the impact of remoteness on out‐of‐hospital cardiac arrest in Western Australia – A retrospective cohort study
Authors: Smith Ashlea , Ball Stephen , Stewart Karen , Finn Judith
Published: September 2024

Introduction

Western Australia (WA) spans a large, sparsely‐populated area of Australia, presenting a challenge for the provision of Emergency Medical Service (EMS), particularly for time‐critical emergencies such as out‐of‐hospital cardiac arrest (OHCA).

Objective

To assess the impact of rurality on the epidemiology, incidence and survival of OHCA in WA.

Methods

We conducted a retrospective cohort study of EMS‐attended OHCA in WA from 2015 to 2022. Incidence was calculated on all OHCAs, but the study cohort for the multivariable regression analysis of rurality on survival outcomes consisted of OHCAs of medical aetiology with EMS resuscitation attempted. Rurality was categorised into four categories, derived from the Australian Standard Geographic Classification – Remoteness Areas.

Results

The age‐standardised incidence of EMS‐attended OHCA per 100 000 population increased with increasing remoteness: Major Cities = 104.9, Inner Regional = 123.3, Outer Regional = 138.0 and Remote = 103.9. Compared to Major Cities, the adjusted odds for return of spontaneous circulation (ROSC) at hospital were lower in Inner Regional (aOR = 0.71, 95%CI 0.53–0.95), Outer Regional (aOR = 0.62, 95%CI 0.45–0.86) and Remote areas (aOR = 0.52, 95%CI 0.35–0.77) but there was no statistically significant difference for 30‐day survival. Relative to Major Cities, Regional and Remote areas had longer response times, shorter transport‐to‐hospital times, and higher rates of bystander CPR and automated external defibrillator use.

Conclusions

Out‐of‐hospital cardiac arrest in rural areas had lower odds of ROSC at hospital compared to metropolitan areas, despite adjustment for known prognostic covariates. Despite WA's highly sparse regional population, these differences in ROSC are consistent with those reported in other international studies.
Oncoplastic breast surgery – a pictorial classification system for surgeons and radiation oncologists (OPSURGE)
Authors: Binks Matthew , Boyages John , Suami Hiroo , Ngui Nicholas , Meybodi Farid , Hughes T. Michael , Edirimanne Senarath
Published: September 2024

Introduction

Changes to the tumour bed following oncoplastic breast surgery complicate the administration of adjuvant radiotherapy. Consensus guidelines have called for improved interdisciplinary communication to aid adjuvant boost radiotherapy. We propose a framework of tumour bed classification following oncoplastic surgery to enhance understanding and communication between the multidisciplinary breast cancer team and facilitate effective and more precise delivery of adjuvant boost radiotherapy.

Methods

A classification system was devised by grouping oncoplastic procedures based on skin incision, tissue mobilization, tumour bed distortion, seroma formation and flap reconstruction. The system is supplemented by a colour‐coded pictorial guide to tumour bed rearrangement with common oncoplastic procedures.

Results

A 5‐tier framework was developed. Representative images were produced to describe tumour bed alterations.

Conclusion

The proposed framework (OPSURGE) improves the identification of the primary tumour bed after initial breast‐conserving surgery, which is imperative to both the surgeon in planning re‐excision and the radiation oncologist in planning boost radiotherapy.
Is a patient self‐recorded 6 minute walk test equivalent to a formally recorded 6 minute walk test
Authors: van Bavel Dirk , de Steiger Richard , McKenzie Dean
Published: September 2024

Background

Functional tests such as the 6‐minute walk test (6MWT) are used in many areas of medicine to monitor disease progression and outcomes of treatment. They are particularly helpful in Orthopaedic surgery as the outcomes have been shown to be responsive to recovery over time. The 6MWT is typically performed in a controlled supervised environment which may limit its widespread use (Terwee et al., Rheumatology (Oxford), 2006, 45, 890–902). The primary aim is to investigate if a patient measured 6MWT is comparable to a 6MWT performed under formal testing conditions (Täger et al., Int. J. Cardiol. 2014, 176, 94–98).

Methods

A total of 55 patients undergoing elective primary hip or knee replacement were instructed to use a smart watch to record a 6MWT in their home community environment (C‐6MWT). These measurements were compared to a formally tested 6MWT (F‐6MWT) at 2 separate time periods—6 and 12 weeks post‐surgery.

Results

At 6 weeks post operation the Intraclass Correlation Coefficient between a formally tested and a patient self‐administered 6MWT was 0.928 (95% CI 0.832–0.970) and at 12 weeks it was 0.831 (0594–0.935).

Conclusion

A patient recorded 6 minute walk test shows high agreement with a formally recorded one under research conditions. This makes this test a suitable way to monitor rehabilitation progression and research outcomes at multiple time periods and in remote situations.
Antepartum vs postpartum amoxicillin oral challenge in pregnant patients with a reported penicillin allergy: A two‐center prospective cohort study
Authors: Wong Jeffrey Man Hay , Liu Xiaoqing , Mak Raymond , Erdle Stephanie C. , Barber Colin , van Schalkwyk Julianne , Watt Melissa , Ande Sudharsana Rao , Ochulor Dozie , Elwood Chelsea , Poliquin Vanessa
Published: September 2024

Introduction

While 10% of pregnant individuals report a penicillin allergy, there is no established best practice for penicillin allergy delabeling in pregnancy. To better understand options for penicillin delabeling, we aimed to evaluate two penicillin allergy delabeling protocols in pregnancy regarding efficacy, adverse events, and patient satisfaction.

Material and Methods

From July 2019 to December 2022, we completed a two‐center prospective cohort study, where each site recruited pregnant patients over 24 weeks gestational age with a reported penicillin allergy. One center offered antepartum amoxicillin oral challenges, either directly or after negative skin testing (i.e., antepartum oral challenge site). Our other centers completed a two‐step approach with antepartum penicillin skin testing only and deferred oral challenges to the postpartum period (i.e., postpartum oral challenge site). Our primary outcome was the rate of penicillin allergy delabeling, defined as tolerating an antibiotic challenge with penicillin or amoxicillin. Univariate analyses were completed using chi‐squared, Fisher's exact, and Wilcoxon rank tests.

Results

During the study period, 276 pregnant patients were assessed, with 207 in the antepartum oral challenge site and 69 in the postpartum oral challenge site. Among the 204 patients who completed antepartum oral challenges, 201 (98%) passed without reactions. Deferring oral challenges to the postpartum period led to a loss of follow‐up for 37/53 (70%) of eligible individuals. Overall, 97% (201/207) of patients at the antepartum oral challenge site were delabeled from their penicillin allergy—compared to 38% (26/69) of patients referred to the postpartum oral challenge site (p < 0.0001). Three antepartum oral challenge reactions were noted, including two mild cutaneous reactions and a case of transient abdominal discomfort.

Conclusions

Antepartum amoxicillin oral challenge is a more effective method to delabel pregnant patients from their penicillin allergy. Deferral of oral challenges to the postpartum period introduces a significant barrier for penicillin allergy delabeling.
Letter: Bisphosphonate effectiveness in patients with cirrhosis—An emulated clinical trial
Authors: Zhang Mingsi , Nie Yunmeng
Published: September 2024

LINKED CONTENT

This article is linked to Tapper et al papers. To view these articles, visit https://doi.org/10.1111/apt.18127 and https://doi.org/10.1111/apt.18259
Letter: Bisphosphonate effectiveness in patients with cirrhosis—an emulated clinical trial. Authors' reply
Authors: Tapper Elliot B. , Parikh Neehar D.
Published: September 2024

LINKED CONTENT

This article is linked to Tapper et al papers. To view these articles, visit https://doi.org/10.1111/apt.18127 and https://doi.org/10.1111/apt.18257
Changes in the plasma protein‐binding rate of remifentanil during cardiopulmonary bypass
Authors: Ueda Hiroshi , Kurita Tadayoshi , Kawashima Shingo , Kitamoto Takuya , Suzuki Masako , Nakajima Yoshiki
Published: September 2024

Aims

Cardiopulmonary bypass (CPB) reduces the plasma protein‐binding rate of some anaesthetics and can enhance their pharmacological effects by increasing the unbound drug fraction. However, whether these changes occur with remifentanil remains to be explored. We investigated the changes in the protein‐binding rate of remifentanil during CPB compared with propofol.

Methods

Thirteen patients (≥18 years old) who were scheduled to undergo cardiovascular surgery with CPB were included. Arterial blood samples were collected to measure the plasma concentrations of remifentanil and propofol before CPB (T1), 30 (T2) and 60 (T3) minutes after the start of CPB, and 30 min after CPB discontinuation (T4). The samples were immediately centrifuged to separate the plasma after blood collection. Equilibrium dialysis was used to separate the unbound fraction. The remifentanil and propofol concentrations were measured by liquid chromatography‐mass spectrometry. The protein‐binding rate was calculated based on the total and unbound fraction of each drug.

Results

The remifentanil protein‐binding rates at each time point were 27.9% ± 11.2% (T1), 13.5% ± 4.4% (T2), 14.0% ± 3.3% (T3) and 24.5% ± 6.9% (T4). The propofol protein‐binding rates were 97.5% ± 0.7% (n = 4; T1), 95.8% ± 1.4% (T2), 95.3% ± 1.3% (T3) and 95.8% ± 1.1% (T4). The protein binding rates of both drugs decreased during CPB and reversed after CPB. The change in the unbound fraction was 1.2‐fold for remifentanil and 1.7‐1.9‐fold for propofol.

Conclusions

Unlike propofol, remifentanil might not demonstrate significantly enhanced pharmacological effects during CPB.
Religious contestation and Islamophobia among Iranian communities residing in the Greater Toronto area and York region
Authors: Khayambashi Shirin
Published: September 2024

Religion is an omnipresent concern for the Iranian community residing in the Greater Toronto Area and York Region (GTA and YR). While the experience of Islamophobia appears to be a unidirectional attitude from the host onto the diasporic community, this research indicates the complexities of Canada's Muslim experience. According to this research, the Iranian Diasporas present an ingroup Islamophobia by expressing anger and hostility toward Iranian Muslim community members. In an attempt to set communal boundaries by restructuring one's ethnic identity, the historical and environmental factors simultaneously influence social interaction between the Iranian Muslim community and other Iranian‐Canadians. This paper examines the Iranian religious identity and its relationship with Iranian history, Western Islamophobia, and non‐Islamiosity to examine the Iranian Muslims’ experience in Canada.
The Accuracy of Dental Implant Placement With Different Methods of Computer‐Assisted Implant Surgery: A Network Meta‐Analysis of Clinical Studies
Authors: Mahardawi Basel , Jiaranuchart Sirimanas , Arunjaroensuk Sirida , Dhanesuan Kanit , Mattheos Nikos , Pimkhaokham Atiphan
Published: September 2024

Objective

Computer‐assisted implant surgery (CAIS) has been introduced as a tool to aid in reaching a more accurate implant position. The aim of this network meta‐analysis was to compare all the available CAIS techniques and obtain collective evidence on the method that offers the highest accuracy compared to freehand implant placement.

Materials and Methods

Database search was done in PubMed, Scopus, and Cochrane library in addition to extensive search in the gray literature and related systematic reviews, aiming to find clinical studies that compared any CAIS technique with another, or with freehand implant placement. The outcomes evaluated were angle, platform, and apex deviation. The search process ended on March 18, 2024.

Results

Thirty‐three studies were included. All CAIS techniques (static with partial or full guidance, dynamic with partial or full guidance, the combination of static and dynamic CAIS) showed significantly less deviation than freehand implant placement, except for the static CAIS with guidance for the pilot drill only. The combination of static and dynamic CAIS ranked best among all other methods. Based on the GRADE system, the certainty of evidence in the outcomes of the meta‐analysis was judged as low or moderate.

Conclusions

The current study demonstrates that computer‐assisted implant surgery provides significantly higher accuracy in implant placement, with the combination of static and dynamic CAIS being the most precise. Nevertheless, future studies are needed, considering the different types, locations, and extents of edentulism in the analyzed investigations, as well as the necessity of obtaining stronger evidence.

Trial Registration

PROSPERIO number: CRD42023482030
Incidence of allergic contact dermatitis in Finland 1998–2021: A nationwide registry‐based study
Authors: Wikström Ville , Sinikumpu Suvi‐Päivikki , Jokelainen Jari , Huilaja Laura
Published: September 2024

Background

Allergic contact dermatitis (ACD) may be chronic and can cause distress, disability, and absence from work. Nationwide epidemiological studies of ACD are sparse.

Objectives

To use national registry data to study the incidence and aetiology of ACD in the working age population of Finland.

Methods

Patient records from the years 1998–2021 were obtained from the Finnish Care Register for Health Care. Study subjects aged 18–65 years were selected on the basis of a diagnosis of ACD.

Results

Total number of study subjects was 26 701. The incidence of ACD increased until 2016 after which it started to decrease. The increase was more marked in females and ACD was particularly common in women reporting reactions to cosmetics and other chemical products and in people of both sexes reacting to adhesives. The incidence ‘ACD of unspecific cause’ has decreased since 2016. The most commonly reported allergens were metals, followed by cosmetics. One fourth of subjects had ≥2 ACD diagnoses.

Conclusions

The incidence of ACD in working age subjects rose from 1998 to 2016, especially in females. However, the incidence has been decreasing since 2016. Our findings highlight the ongoing and even increasing burden of ACD among the working age population.
1117. Crepidiastrum grandicollum (Koidz.) Nakai: Compositae
Authors: Hind Nicholas , Yamanaka Masumi , Yasue Naoko
Published: September 2024

Crepidiastrum grandicollum (Koidz.) Nakai (Compositae: Lactuceae: Crepidinae) is described and illustrated. The current synonymy is provided, together with type citations for each of the names and statements of the type material. A selection of verified illustrations of the species in the literature is provided. Statements of the species' distribution, habitat and ecological preferences (with observations on the phytosociological classification), phenology, conservation status, and the etymology of both generic and specific epithets are given along with vernacular names, some of which are apparently literal translations of the Latin binomial. Cultivation, propagation, and availability notes are provided, although the species is Critically Endangered and currently only cultivated Koishikawa Botanical Garden, University of Tokyo, Japan, as part of the Ministry of the Environment's Rare Wild Fauna and Flora Species Protection and Breeding Project. Discussions include pollination syndromes in Crepidiastrum in the Bonin Islands, the intricacies of the involvement of the Honey Bee in their pollination (compared with conservation measures) and the displacement of native insect pollinators, mention of seed/achene dispersal and evolution within the genus, conservation proposals, including the use of exclosures to prevent destruction by feral goats (Capra hircus), and electric fences, adhesive traps and Teflon™ sheets to help control the lizard known as the Green Anole (Anolis carolinensis); typhoon damage and the potential for issues with ants ‐ Pheidole (Westwood) spp. (including the African Big‐headed Ant, P. megacephala) are also mentioned. Some consideration for the rôle of Arbuscular Mycorrhizal (AM) associations with the endemics in conservation programmes should not be overlooked. Attention is drawn to observations on some bizarre web sites with somewhat bogus information on the species, and why they should be disregarded.
Does maternal education moderate the relationship between adolescent cannabis use and mental health in early adulthood?
Authors: Sawyer Gemma , Howe Laura D. , Hickman Matthew , Zammit Stanley , Hines Lindsey A.
Published: September 2024

Introduction

Socioeconomic disadvantage has been associated with cannabis use and poor mental health. It is therefore hypothesised that lower maternal education, a proxy for socioeconomic disadvantage, may increase the risk of cannabis‐related mental health and substance use consequences.

Methods

A total of 5099 participants from the Avon Longitudinal Study of Parents and Children reported cannabis use via questionnaires at 16 or 18. Logistic regression was used to examine the relationship between any and regular (weekly or more) adolescent cannabis use with depression, anxiety, psychotic experiences, and problematic cannabis use at age 24. Maternal education was included as an effect modifier. Missing data were addressed through multiple imputation using chained equations.

Results

In total, 36.5% of participants reported adolescent cannabis use and, of these, 14% reported regular use. Adolescent cannabis use was associated with an increased likelihood of anxiety and problematic cannabis use; however, there was little evidence of moderation by maternal education. Regular cannabis use was associated with an increased likelihood of problematic cannabis use, with little evidence of moderation by maternal education. There was weak evidence that the association between regular cannabis use and depression (interaction p‐value = 0.024) and anxiety (interaction p‐value = 0.056) was stronger in people with high maternal education.

Discussion and Conclusions

Adolescent cannabis use is associated with increased risk of anxiety and cannabis use disorder, but there was insufficient evidence that childhood socioeconomic position (proxied by maternal education) modifies this relationship. Improved public health messages for all adolescents about these risks may be warranted.
Acquired motor speech disorders in childhood epilepsy
Authors: Eyre Michael , Rose Steve , Gwynn Rachel , Pressler Ronit M. , Clark Maria
Published: September 2024

Aim

To evaluate a group of children with epilepsy and motor speech regression, with the aim of characterizing their speech disorders, electrographic features, and outcomes.

Method

Children referred to a tertiary developmental epilepsy clinic with epilepsy and motor speech regression were identified retrospectively. A clinical history was taken, and longitudinal speech and cognitive data were recorded. Speech samples were scored for severity and speech features. Seizure frequency and epileptiform discharges in the interictal electroencephalogram were analysed.

Results

Eighteen children (10 female) were evaluated, including seven with Landau–Kleffner syndrome and six with Rasmussen syndrome. Speech regression occurred at a mean age of 5 years (SD = 2 years 6 months), which was concurrent with seizure onset or peak seizure burden in eight children. Speech features included dysarthria (n = 13), phonological errors (n = 7), and dyspraxia (n = 6). Electrographic abnormalities occurred most frequently in the left centrotemporal and right frontal regions. Among children who were followed up, intelligibility of speech was affected in 13 at baseline and seven at follow‐up (p = 0.03). Expressive language standardized scores increased from a mean (SD) of 50.0 (11.3) to 91.4 (27.8) in children with Landau–Kleffner syndrome (mean change = 41.4, 95% confidence interval [CI] 0.04–82.8, p = 0.0498) and decreased from 75.2 (15.3) to 59.0 (9.8) in children with Rasmussen syndrome (mean change −16.2, 95% CI −9.0 to −23.4, p = 0.002) over the follow‐up.

Interpretation

Motor speech disorders in epilepsy were severe, multifarious, and often fluctuated with seizure burden. Symptoms typically improved, especially in children with Landau–Kleffner syndrome, but rarely fully resolved.
Cafeteria diet compromises natural adaptations of islet cell transdifferentiation and turnover in pregnancy
Authors: Dubey Vaibhav , Tanday Neil , Irwin Nigel , Tarasov Andrei I. , Flatt Peter R. , Moffett R. Charlotte
Published: September 2024

Background

Pancreatic islet β‐cell mass expands during pregnancy, but underlying mechanisms are not fully understood. This study examines the impact of pregnancy and cafeteria diet on islet morphology, associated cellular proliferation/apoptosis rates as well as β‐cell lineage.

Methods

Non‐pregnant and pregnant Ins1Cre/+;Rosa26‐eYFP transgenic mice were maintained on either normal or high‐fat cafeteria diet, with pancreatic tissue obtained at 18 days gestation. Immunohistochemical changes in islet morphology, β‐/α‐cell proliferation and apoptosis, as well as islet cell identity, neogenesis and ductal cell transdifferentiation were assessed.

Results

Pregnant normal diet mice displayed an increase in body weight and glycaemia. Cafeteria feeding attenuated this weight gain while causing overt hyperglycaemia. Pregnant mice maintained on a normal diet exhibited typical expansion in islet and β‐cell area, owing to increased β‐cell proliferation and survival as well as ductal to β‐cell transdifferentiation and β‐cell neogenesis, alongside decreased β‐cell dedifferentiation. Such pregnancy‐induced islet adaptations were severely restricted by cafeteria diet. Accordingly, islets from these mice displayed high levels of β‐cell apoptosis and dedifferentiation, together with diminished β‐cell proliferation and lack of pregnancy‐induced β‐cell neogenesis and transdifferentiation, entirely opposing islet cell modifications observed in pregnant mice maintained on a normal diet.

Conclusion

Augmentation of β‐cell mass during gestation arises through various mechanisms that include proliferation and survival of existing β‐cells, transdifferentiation of ductal cells as well as β‐cell neogenesis. Remarkably, cafeteria feeding almost entirely annuls pregnancy‐induced islet adaptations, which may contribute to the development of gestational diabetes in the setting of dietary provoked metabolic stress.
The Exteriority of Thinking: Hegel and Heidegger
Authors: Khurana Thomas
Published: September 2024

In The Culmination, Robert Pippin offers a stunning reassessment of the achievements of absolute idealism. Having developed some of the most persuasive defenses of Hegel's absolute idealism to date, Pippin now argues that Heidegger's trenchant critique of Hegel has revealed a dogmatism at the very heart of absolute idealism: an unwarranted identification of what is with what is discursively knowable. This dogmatic identification leads to a distorted understanding of the meaning of Being, a reifying account of beings, and a neglect of our own finitude. In this article, I defend Hegel against these charges. The upshot of this discussion is twofold. Rather than evading the question of the exteriority of being, I argue, Hegel in fact aims to reveal that this exteriority is internal to thinking itself. And rather than identifying the meaning of being with discursive knowability, Hegel shows that the meaning of being resides in a form of freedom that goes beyond the self‐transparency of knowing.
Poststroke seizures and epilepsy increase the risk of dementia among stroke survivors: A population‐based study
Authors: Sung Kuan‐Lin , Kuo Miao‐Jen , Yang Hsin‐Yi , Tsai Ching‐Fang , Sung Sheng‐Feng
Published: September 2024

Objective

With global aging, the occurrence of stroke and associated outcomes like dementia are on the rise. Seizures and epilepsy are common poststroke complications and have a strong connection to subsequent dementia. This study examines the relationship between poststroke seizures (PSS) or poststroke epilepsy (PSE) and dementia using a national health care database.

Methods

We conducted a retrospective study using data from the Taiwan National Health Insurance Research Database from 2009 to 2020. We identified acute stroke patients from 2010 to 2015, excluding those with pre‐existing neurological conditions. Based on age, sex, stroke severity level, and the year of index stroke, patients with PSS or PSE were matched to those without. The main outcome was incident dementia.

Results

This study included 62 968 patients with an average age of 63 years, with males accounting for 62.9%. Of them, 60.3% had ischemic strokes, and 39.7% had hemorrhagic strokes. After an average follow‐up period of 5.2 years, dementia developed in 15.9% of patients who had PSS or PSE, as opposed to 8.4% of those without these conditions. A time‐dependent Fine and Gray competing risk analysis showed that PSS and PSE were significantly associated with dementia across all stroke types. Subgroup analyses revealed significantly increased risk of dementia across all age groups (<50, 50–64, and ≥65 years), sexes, and various stroke severity levels. The link between PSS or PSE and dementia was particularly pronounced in men, with a less distinct correlation in women.

Significance

The risk of incident dementia was higher in patients with PSS or PSE. The potential for therapeutic interventions for seizures and epilepsy to reduce poststroke dementia underscores the importance of seizure screening and treatment in stroke survivors.
Explaining the penetrating role of technology in online foreign language learning achievement
Authors: Huang Fangwei , Zhang Haijing
Published: September 2024

This study aims to integrate the technology acceptance model, classroom environment theory, and positive psychology theory to explore the relationships among learners' technology acceptance (TA), perceived online classroom environment (POCE), emotional states (enjoyment, anxiety, boredom, and burnout), and academic achievement in online classes. Six hundred and sixty‐two university students learning Chinese as a foreign language participated in the survey and completed the reading test. The results of partial least square‐structural equation modeling reveal that TA influences reading achievement directly and indirectly through anxiety (with the reversed mediating effect) and enjoyment, and the online classroom environment mediated the relationship between TA and learning emotions (except anxiety). These findings suggest that technology factors may shape the affordance of online classrooms and penetrate environmental and emotional variables to impact FL learning outcomes. Multigroup analysis with different self‐online learning time underscores that enjoyment and anxiety differ in two different effect paths (POCE‐enjoyment) and (TA‐anxiety), implying enjoyment may be more environment‐related while anxiety may be more technology‐related in the online foreign language classroom. This study provides both theoretical and pedagogical implications.
Males miss and females forgo: Auditory masking from vessel noise impairs foraging efficiency and success in killer whales
Authors: Tennessen Jennifer B. , Holt Marla M. , Wright Brianna M. , Hanson M. Bradley , Emmons Candice K. , Giles Deborah A. , Hogan Jeffrey T. , Thornton Sheila J. , Deecke Volker B.
Published: September 2024

Understanding how the environment mediates an organism's ability to meet basic survival requirements is a fundamental goal of ecology. Vessel noise is a global threat to marine ecosystems and is increasing in intensity and spatiotemporal extent due to growth in shipping coupled with physical changes to ocean soundscapes from ocean warming and acidification. Odontocetes rely on biosonar to forage, yet determining the consequences of vessel noise on foraging has been limited by the challenges of observing underwater foraging outcomes and measuring noise levels received by individuals. To address these challenges, we leveraged a unique acoustic and movement dataset from 25 animal‐borne biologging tags temporarily attached to individuals from two populations of fish‐eating killer whales (Orcinus orca) in highly transited coastal waters to (1) test for the effects of vessel noise on foraging behaviors—searching (slow‐click echolocation), pursuit (buzzes), and capture and (2) investigate the mechanism of interference. For every 1 dB increase in maximum noise level, there was a 4% increase in the odds of searching for prey by both sexes, a 58% decrease in the odds of pursuit by females and a 12.5% decrease in the odds of prey capture by both sexes. Moreover, all but one deep (≥75 m) foraging attempt with noise ≥110 dB re 1 μPa (15–45 kHz band; n = 6 dives by n = 4 whales) resulted in failed prey capture. These responses are consistent with an auditory masking mechanism. Our findings demonstrate the effects of vessel noise across multiple phases of odontocete foraging, underscoring the importance of managing anthropogenic inputs into soundscapes to achieve conservation objectives for acoustically sensitive species. While the timescales for recovering depleted prey species may span decades, these findings suggest that complementary actions to reduce ocean noise in the short term offer a critical pathway for recovering odontocete foraging opportunities.
YouTubing Remittances, Revealing (Dis)connectedness: Copresence as Fiction, Ideal and Heuristic on the YouTube Channel of Western Union
Authors: Boccagni Paolo , Marconi Valentina , Brodesco Alberto
Published: September 2024

Sending and receiving remittances is central to the negotiation of transnational family life, and to nourishing a sense of copresence among physically distant parties. Although the lived experience of this transaction has a very intimate and personal basis, it is also subject to increasing visual and public representation, as a part of the working of dedicated migration industries. Based on an in‐depth exploration of the advertising materials on the YouTube channel of Western Union (WU), we analyse how money circulation is made visible, emplaced in migrant life circumstances and co‐produced through visual narratives that illuminate the micro‐foundations of copresence and its structural limitations. While following the rationale of a commercial product, and despite their idealized contents, WU's stories are revealing about the relational affordances for virtual copresence, its shortcomings and the social embeddedness of remittances in family life.
Factors Associated With Decision to Treat or Not to Treat Helicobacter pylori Infection in Children: Data From the EuroPedHp Registry
Authors: Le Thi Thu Giang , Werkstetter Katharina , Kotilea Kallirroi , Bontems Patrick , Cabral José , Cilleruelo Maria Luz , Kori Michal , Barrio Josefa , Homan Matjaž , Kalach Nicolas , Lima Rosa , Tavares Marta , Urruzuno Pedro , Misak Zrinjka , Urbonas Vaidotas , Koletzko Sibylle ,   for the Helicobacter pylori Special Interest Group of ESPGHAN
Published: September 2024

Background

European and North‐American guidelines on management of H. pylori infection in children provide the option not to treat even if the infection is endoscopically confirmed. We used data from the EuroPedHp Registry to identify factors associated with therapy decisions.

Methods

We included treatment‐naïve patients reported between 2017 and 2020 from 30 centers in 17 European countries. Multivariable logistic regression identified factors including comorbidities within and outside the gastrointestinal (GI) tract influencing the decision for or against therapy.

Results

Of 1165 patients (52% females, median age 12.8), 28% (321/1165) reported any alarm symptom, 26% (307/1165) comorbidities, and 16% (192/1165) did not receive eradication treatment. Therapy was initiated less often in children having any GI comorbidity (57%, n = 181), particularly in those with eosinophilic esophagitis (60%, n = 35), inflammatory bowel disease (54%, n = 28), and celiac disease (43%, n = 58), compared to those with non‐GI (86%, n = 126) or no comorbidity (89%, n = 858), despite similar frequencies of alarm and non‐alarm symptoms, ulcers, erosions, and nodular gastritis. Patients with GI and without comorbidities remained more likely untreated in high versus low H. pylori prevalence countries (p < 0.0001). In children without comorbidities, factors favoring therapy included older age, being overweight, having symptoms, erosions, antral nodularity, and available antibiotic susceptibility results.

Conclusion

In this cohort, H. pylori‐infected children with GI comorbidities compared to no comorbidity showed 75% reduced chance of receiving eradication therapy. We found no evidence supporting different management strategies in infected patients with GI comorbidities compared to all pediatric patients with endoscopically proven H. pylori infection.
Recovery of bioactive compounds from oil palm waste using green extraction techniques and its applications
Authors: Chew Sook Chin , How Yu Hsuan , Hasan Zafarizal Aldrin Bin Azizul , Chu Chee Chin
Published: September 2024

Oil palm (Elaeis guineensis) is a major oil crop that significantly contributes to the Indonesia's and Malaysia's economic growth. However, oil palm processing for oil extraction generates substantial waste, such as palm kernel cake, palm‐pressed fibre, oil palm empty fruit bunches and palm oil mill effluent, which pose noticeable environmental challenges. This review explores green extraction techniques for palm waste processing, which include microwave‐assisted extraction, deep eutectic solvents, ultrasound‐assisted extraction, supercritical fluid extraction, enzyme‐assisted extraction and subcritical water extraction. The potential for industry scaling, mechanisms, applications and challenges of each technique used for oil palm waste are discussed. Microwave‐assisted extraction, ultrasound‐assisted extraction and supercritical fluid extraction are particularly promising for large‐scale production, while deep eutectic solvents paired with ultrasound‐assisted extraction show the potential to improve extraction efficiency. This review also reveals that green extraction techniques are sustainable alternative to conventional techniques by effectively recovering valuable compounds from waste with reduced environmental impact. Additionally, the diverse applications of bioactive compounds (vitamin E, phytosterols, phenolics, polyphenols and flavonoids) extracted from oil palm waste in food, pharmaceutical, cosmetic and other industries are also presented. Valuable components such as cellulose, dietary fibres and bioactive peptides derived from the waste can be applied in food coatings, high‐protein products and drug delivery systems. Biosorbents, biofuels and biodegradable products derived from the waste would also provide environmental benefits. Future research should focus on optimising the green extraction techniques for industrial use to promote responsible production and circular waste management to foster health and environmental safety.
Chemical composition and sensory profile of Spirogyra neglecta (Hassall) Kützing
Authors: Sriwattana Sujinda , Chokumnoyporn Napapan , Brennan Charles , Prinyawiwatkul Witoon
Published: September 2024

The proximate composition, selected amino acid composition, and chemical constituents of Spirogyra neglecta (Hassall) Kützing, a freshwater algae collected from Phrae province, Thailand was investigated. It was found to be a good source of protein (29.42% dry wt. basis) and fibre (6.70% dry wt. basis). The total amino acid content was 2611.85 mg/100 g edible. The chemical constituents were characterised by GC–MS, which demonstrated that it contained phytol (62.10%), ethyl 5,8,11,14,17‐icosapentaenoate (8.55%) among others. Based on its chemical composition results, it could serve as a potential ingredient with high nutritional values in the food and nutraceutical industry. Furthermore, the descriptive sensory profile consisting of 17 descriptors, namely, green colour, glossy, filamentous, aroma (algae, grassy, fishy, and earthy), flavour (algae, grassy, fishy, and earthy), sweet, bitter, and texture (fibrousness and softness), mouthfeel (entire mouth‐coating), and aftertaste (astringent), were successfully developed to allow characterisation of the sensory quality of this algae.
Experiences of Mental Health Nurses in Providing Care to Patients Receiving Electroconvulsive Therapy in South Korea
Authors: Ahn Suyoun , Shin Soyoung , Joung Jaewon
Published: September 2024

In recent years, the demand for electroconvulsive therapy has been increasing in South Korea. However, there are problems due to mental health nurses' lack of understanding about electroconvulsive therapy and the absence of systematic education. This study aimed to explore mental health nurses' experiences of providing care to patients receiving electroconvulsive therapy in South Korea. We used content analysis to analyse the data collected from focus group interviews with 22 mental health nurses working in mental health hospitals. The results revealed four themes and 10 subthemes. More specifically, the results showed that mental health nurses consider themselves helpers in recovery. They pursue the physical and emotional well‐being of patients receiving electroconvulsive therapy and strive to ensure that patients receive electroconvulsive therapy comfortably and safely. However, contentious issues such as concerns about patient dignity and autonomy lead to differing perceptions and attitudes towards electroconvulsive therapy and cause internal conflict during therapeutic interactions. Furthermore, insufficient education on electroconvulsive therapy leads to a lack of knowledge and difficulties in fulfilling the role of an information provider. The shortage of coping measures and support systems for issues such as extensive adverse effects and restricted medication increases the work burden immensely. These findings can serve as foundational data for the development of standardised nursing practices and systematic education for electroconvulsive therapy.
Handling Out‐of‐Sample Areas to Estimate the Unemployment Rate at Local Labour Market Areas in Italy
Authors: Benedetti Roberto , Piersimoni Federica , Pratesi Monica , Salvati Nicola , Suesse Thomas
Published: September 2024

Unemployment rate estimates for small areas are used to efficiently support the distribution of services and the allocation of resources, grants and funding. A Fay–Herriot type model is the most used tool to obtain these estimates. Under this approach out‐of‐sample areas require some synthetic estimates. As the geographical context is extremely important for analysing local economies, in this paper, we allow for area random effects to be spatially correlated. The spatial model parameters are estimated by a marginal likelihood method and are used to predict in‐sample as well as out‐of‐sample areas. Extensive simulation experiments are used to assess the impact of the auto‐regression parameter and of the rate of out‐of‐sample areas on the performance of this approach. The paper concludes with an illustrative application on real data from the Italian Labour Force Survey in which the estimation of the unemployment rate in each Local Labour Market Area is addressed.
Strength Amidst Struggles: A Descriptive Qualitative Study of Maternal Experiences of Low Socioeconomic Status Mothers in the Third Month Postpartum
Authors: Chee Cornelia Yin Ing , Ng Jamie Qiao Xin , Liu Verity Chandelle , Shorey Shefaly
Published: September 2024

Aim

To explore the experiences, expectations and needs of mothers from low socioeconomic status at 3 months postpartum.

Design

Descriptive qualitative.

Methods

Mothers aged 21 years old and above, from low socioeconomic status (monthly household income is less than Singapore Dollar [SGD] $4300), and irrespective of their parity were invited to participate in one‐to‐one in‐depth interviews at 3 months postpartum from September 2022 to June 2023. A semistructured guide was used in the interviews, which were conducted until data saturation. A trained researcher conducted the interviews that were audio recorded, transcribed verbatim and analysed thematically. Written informed consent was obtained and voluntary participation was reinforced.

Results

Twenty mothers participated in this study and four themes were identified: (1) difficult trade‐offs; (2) help‐seeking behaviours and (3) ‘But if?’ Concerns about Emergencies.

Conclusion

This study explored the difficult circumstances that mothers from low socioeconomic status face in their third month postpartum, and how wider societal inequalities exacerbated these circumstances. Current policies and practices need to be relooked, reframed, and reformed to address the unique needs of this community.

Implications for Patient Care

Nurses should keep mothers' struggles in balancing employment and childcare in consideration and explore other ways of supporting the low socioeconomic status mothers such as online modes in providing patient education and peer support.

Impact

Mothers from low socioeconomic status are less likely to seek formal help from healthcare professionals, external organizations and the government. These mothers need flexible, affordable and accessible childcare options to return to work. More targeted family‐oriented policies that create empowering and understanding workplaces in Singapore could help ease the stress on mothers returning to employment postpartum. Online peer support groups consisting of mothers of similar socioeconomic backgrounds could help engage and retain this hard‐to‐reach yet vulnerable population.

Reporting Method

COREQ checklist.

Patient or Public Contribution

No patient or public contribution.
Sodium–glucose cotransporter 2 inhibition through henagliflozin ameliorates cognitive impairment in patients with type 2 diabetes
Authors: Zhang Shujun , Wang Fen , Xie Lei , Xu Jialu , Song Xiaoqing , Tao Jing , Chen Juan , Ma Delin , Yu Xuefeng , Shi Xiaoli , Yang Yan
Published: September 2024

Aims/Introduction

To assess whether the sodium–glucose cotransporter 2 inhibitor, henagliflozin, improves cognitive impairment in patients with type 2 diabetes.

Materials and Methods

We carried out a prospective study on 290 patients with type 2 diabetes and cognitive impairment. Montreal Cognitive Assessment scores and plasma phosphorylated tau181 levels were used to assess cognition. The association between henagliflozin use and changes in cognition was examined using multivariable logistic regression analysis.

Results

Montreal Cognitive Assessment scores at enrollment and after 6 months were 21 (interquartile range [IQR]19–23) versus 22 (IQR 20–25; P < 0.0001) in all patients, 21 (IQR 19–23) versus 24 (IQR 22–26; P < 0.0001) in the henagliflozin group and 21 (IQR 19–22) versus 21 (IQR 19–23; P > 0.05) in the non‐sodium–glucose cotransporter 2 inhibitor group. Logistic regression analysis showed that henagliflozin treatment was associated with Montreal Cognitive Assessment score improvement independent of potential confounders (odds ratio [OR] 3.670, 95% confidence interval [CI] 2.224–6.056, P < 0.0001). Additionally, plasma phosphorylated tau181 levels significantly decreased at 6‐month follow up in all patients (OR 11.5, 95% CI 9.9–13.7 vs OR 10.1, 95% CI 7.8–12.9, P < 0.0001) and in the henagliflozin group (OR 11.5, 95% CI 10.3–13.0 vs OR 9.2, 95% CI 7.1–10.7, P < 0.0001), but not in the non‐sodium–glucose cotransporter 2 inhibitor group. Henagliflozin treatment was independently associated with decreased phosphorylated tau181 levels (OR 3.670, 95% CI 1.598–4.213, P < 0.0001).

Conclusions

Henagliflozin treatment was independently associated with improvements in Montreal Cognitive Assessment scores and plasma phosphorylated tau181 levels, indicating significant beneficial effects on cognitive impairment in patients with type 2 diabetes.
Insights on the virulence and genomic features of Lactococcus garvieae isolated from giant freshwater prawn Macrobrachium rosenbergii (de Man 1879)
Authors: Balan Rubicely , Pandey Sudarshan , Wang Pei‐Chi , Byadgi Omkar Vijay , Chen Shih‐Chu
Published: September 2024

Giant freshwater prawn (Macrobrachium rosenbergii (MR)) is a significant aquafarm species commercially cultured in Taiwan. Intensive farming practices have led to the outbreak of Lactococcus garvieae (LG), which causes Lactococcosis in MR. Recently, LG has re‐emerged and the number of mortalities in prawn farms has increased in Taiwan. However, there is no preventative strategy described and a lack of knowledge on virulence factors and pathogenesis from LG in MR. The most virulent strain of L. garvieae from M. rosenbergii was screened in vivo among seven isolates selected for infectivity testing injecting 0.1 mL of 108 CFU/mL bacterial concentration. Among the seven isolates screened, L. garvieae 109‐6 resulted in 100% mortality within 3 days post‐infection. Furthermore, 109‐6 L. garvieae LD50 dosage from in MR was found to be 106 CFU/mL. Subsequently, the most virulent strain 109‐6 was sequenced using MinIon Nanopore sequencing. Results indicated that the LG genome yielded a protein‐coding of 3857 with 59 tRNA and 16 rRNA and no plasmid. Interestingly, the distribution of subsystems in the annotated genome revealed genes related to virulence, defence, and disease among LG 50 genes. Altogether, the virulent strain and its genome data revealed distinctive features of LG, which hinted toward its pathogenicity and could facilitate for better preventive strategies.
PTPRJ is a negative regulator of insulin signaling in neuronal cells, impacting protein biosynthesis, and neurite outgrowth
Authors: Ulke Jannis , Chopra Simran , Kadiri Otsuware Linda‐Josephine , Geserick Peter , Stein Vanessa , Cheshmeh Sahar , Kleinridders André , Kappert Kai
Published: September 2024

Central insulin resistance has been linked to the development of neurodegenerative diseases and mood disorders. Various proteins belonging to the enzyme family of protein tyrosine phosphatases (PTPs) act as inhibitors of insulin signaling. Protein tyrosine phosphatase receptor type J (PTPRJ) has been identified as a negative regulator in insulin signaling in the periphery. However, the impact of PTPRJ on insulin signaling and its functional role in neuronal cells is largely unknown. Therefore, we generated a Ptprj knockout (KO) cell model in the murine neuroblast cell line Neuro2a by CRISPR‐Cas9 gene editing. Ptprj KO cells displayed enhanced insulin signaling, as shown by increased phosphorylation of the insulin receptor (INSR), IRS‐1, AKT, and ERK1/2. Further, proximity ligation assays (PLA) revealed both direct interaction of PTPRJ with the INSR and recruitment of this phosphatase to the receptor upon insulin stimulation. By RNA sequencing gene expression analysis, we identified multiple gene clusters responsible for glucose uptake and metabolism, and genes involved in the synthesis of various lipids being mainly upregulated under PTPRJ deficiency. Furthermore, multiple Ca2+ transporters were differentially expressed along with decreased protein biosynthesis. This was accompanied by an increase in endoplasmic reticulum (ER) stress markers. On a functional level, PTPRJ deficiency compromised cell differentiation and neurite outgrowth, suggesting a role in nervous system development. Taken together, PTPRJ emerges as a negative regulator of central insulin signaling, impacting neuronal metabolism and neurite outgrowth.