bluuebunny/crossref_metadata_2025 huggingface dataset:
Drug‐associated glaucoma: A real‐world study based on the Food and Drug Administration adverse event reporting system database
Authors: Wu Shi‐Nan , Chen Xiao‐Dong , Yan Dan , Wang Yu‐Qian , Wang Shao‐Pan , Guan Wen‐Ying , Huang Caihong , Hu Jiaoyue , Liu Zuguo
Published: October 2024

Background

This study aims to assess the risk of drug‐associated glaucoma and track its epidemiological characteristics using real‐world data.

Methods

Adverse event reports from the Food and Drug Administration Adverse Event Reporting System (FAERS) from January 2004 to December 2023 were analysed. Disproportionality analysis and the Bayesian Confidence Propagation Neural Network algorithm were used. The study classified drugs associated with glaucoma, assessed risk levels, and compared drug‐induced times across different categories.

Results

Eight hundred and five drugs were linked to glaucoma in the FAERS database. Disproportionality analysis identified 46 drugs with significant risk, mainly adrenergic medications (clobetasol propionate, fluocinolone acetonide), antihypertensives (hydrochlorothiazide), insulin (insulin human), anticholinergics (umeclidinium, darifenacin), VEGF inhibitors (brolucizumab, faricimab), and psychotropics (topiramate, ziprasidone). The top three high‐risk drugs were clobetasol propionate, umeclidinium, and fluocinolone acetonide. The shortest drug‐induced times were observed with indacaterol, salmeterol, and umeclidinium. Anticholinergic medications had the shortest drug‐induced time among all categories. Females (62.5%) and the elderly (average age 63.5 ± 16.8 years) were predominantly affected. Reports of drug‐associated glaucoma increased over the years.

Conclusion

Preventing drug‐associated glaucoma is more effective than treatment. Identifying the risk and drug‐induced times of systemic and ophthalmic drugs can reduce occurrence risk. Clinical practitioners should be vigilant and inform patients of these risks.
Comparison of surgical performance using articulated (ArtiSential®) and conventional instruments for colorectal laparoscopic surgery: A single‐centre, open, before‐and‐after, prospective study
Authors: Shin Hye Rim , Oh Heung‐Kwon , Ahn Hong‐min , Lee Tae‐Gyun , Choi Mi Jeoung , Jo Min Hyeong , Singhi Anuj Naresh , Kim Duck‐Woo , Kang Sung‐Bum
Published: October 2024

Aim

Rigid surgical instruments limit movement whereas articulated instruments offer better control in small spaces and allow for intuitive and ergonomic movements. However, the effectiveness of the use of articulated instruments in improving colorectal laparoscopic outcomes remains unclear. The aim of this work was to determine whether colorectal laparoscopic surgical proficiency improved when multijoint instruments were used instead of conventional ones.

Method

We enrolled 70 consecutive patients (n = 20 for conventional instruments) aged 19–80 years who underwent elective laparoscopic surgery for colorectal diseases. Unedited surgery videos were validated using the modified Global Operative Assessment of Laparoscopic Skills (mGOALS) scale. Learning curves were analysed using a cumulative sum control chart for mGOALS grades.

Results

The surgery type, length of hospital stay and 30‐day postoperative complication rates were comparable between the groups, and the surgeon's mGOALS grades were similar (p = 0.190). However, in the articulated group, the scores were significantly higher for depth perception (p = 0.012) and tissue‐handling domains (p = 0.046), while surgical duration was significantly shorter and intraoperative blood loss was significantly lower (p = 0.022), compared with those in the conventional (p = 0.002) group. Learning curve findings indicated that the first 10 and subsequent 40 surgeries in the articulated group were within the inexperienced and experienced phases, respectively. The mGOALS score in the experienced phase improved in the articulated group compared with that in the conventional group (p = 0.036).

Conclusions

The use of articulated instruments in laparoscopic colorectal surgery showed potential benefits. Further studies are needed to confirm these findings.
Changing Landscape of Open Offers in Liver Transplantation in the Machine Perfusion Era: Exposure, Equity, and Economics
Authors: Wehrle Chase J. , Gross Abby , Fares Sami , Kusakabe Jiro , Calderon Esteban , Shanmugarajah Kumaran , Uysal Melis , Fleischer Christina M. , Allkushi Erlind , Schold Jesse D. , Khalil Mazhar , Pita Alejandro , Fujiki Masato , Schlegel Andrea , Miller Charles , Hashimoto Koji , Wakam Glenn K.
Published: October 2024

Background

Open offers (OOs) in liver transplantation (LT) result from bypassing the traditional allocation system. Little is known about the trends of OOs or the differences in donor/recipient characteristics compared to traditionally placed organs. We aim to quantify modern practices regarding OOs and understand NMP's impact, focusing on social determinants of health (SDH), cost, and graft‐associated risk.

Methods

LTs from 1/1/2018 to 12/31/2023 at a single center were included. NMP was implemented on 10/1/2022. The CDC (centers for disease control)‐validated social vulnerability index (SVI) and donor risk index (DRI) were calculated. Comprehensive complications index (CCI), Clavien‐Dindo grades, patient and graft survival, and costs of transplantation were included.

Results

1162 LTs were performed; 193 (16.8%) from OOs. OOs were more common in the post‐NMP era (26.5% vs. 13.3%, p < 0.001). Pre‐NMP, patients receiving OOs had longer waitlist times (118 vs. 69 days, p < 0.001), lower MELDs (17 vs. 25 points, p < 0.001), and riskier grafts (DRI = 1.8 vs. 1.6, p = 0.004) compared to standard offers. Post‐NMP, recipients receiving OOs demonstrated no difference in waitlist time (27 vs. 20 days, p = 0.21) or graft risk (DRI = 2.03 vs. 2.23, p = 0.17). OO recipient MELD remained lower (16 vs. 22, p < 0.001). OO recipients were more socially vulnerable (SVI), pre‐NMP (0.41 vs. 0.36, p = 0.004), but less vulnerable after NMP (0.23 vs. 0.36, p = 0.019). Despite increased graft risk, pre‐NMP OO‐LTs were less expensive in the 90‐day global period ($154 939 vs. $178 970, p = 0.002) and the 180‐days pre‐/post‐LT ($208 807 vs. $228 091, p = 0.021). Cost trends remained similar with NMP.

Conclusion

OOs are increasingly utilized and may be appealing due to demonstrated cost reductions even with NMP. Although most OO‐related metrics in our center remain similar before and after machine perfusion, programs should take caution that increasing use does not worsen organ access for socially vulnerable populations.
Public Acceptance of Living Donor Liver Transplant for Colorectal Liver Metastases: A Web‐Based Survey
Authors: Chávez‐Villa Mariana , Pope‐Collins Elizabeth , Dokus Katherine , Martens John , Keller Elizabeth , Nickels Mark , Byrne Matthew , Hernandez‐Alejandro Roberto , Al‐Judaibi Bandar
Published: October 2024

Background

Recent advancements in cancer treatment and post‐transplant management have expanded the population of living donor liver transplant (LDLT) candidates. We aimed to examine variations in public acceptance of LDLT based on patient diagnosis, including unresectable colorectal liver metastases (uCRLM).

Methods

A web‐based survey collected demographic information and general perceptions about organ donation in different settings. Respondents indicated their likelihood of being a living liver donor for a family member with genetic liver disease, alcohol‐related liver disease (ALD), and uCRLM. Differences in the likelihood of donation between scenarios were compared.

Results

There were 491 survey respondents (female [76.5%], Caucasians [87.4%], and had at least a college degree [98.2%]). Most (82.4%) were aware of the option of living liver donation before the study and 95% supported living organ donation in general. Over 80% were registered as organ donors. Ninety percent indicated that they would be likely to donate to a family member with a genetic liver disease if they qualified as a living donor; significantly more than ALD (59%) and uCRLM (71%) (p < 0.001). Willingness to donate to patients with uCRLM was significantly higher (p < 0.001) than the hypothetical patient with ALD with a clinically accepted recovery period of 6 months.

Conclusions

This study is the first of its kind to assess the public acceptance of living liver donation for uCRLM. Respondents were as or more supportive of donating to uCRLM as they were of generally accepted indications for LT. Further surveys with a broader respondent pool are warranted.
What do we mean by “agency”? A framework and tools for supporting visitors' agency in museums and science centers
Authors: Letourneau Susan M. , Schloss Dana , Perez Sylvia , Aucapina Franklin , Baburyan Michael , Curto Kate , Gomez Edwin , McDonald Truck , Multani Satbir , Taylor Trevor , Tumolo Sam , Umer Laycca
Published: October 2024

Agency is a central value within museums and science centers, but it has not been defined and operationalized in ways that can guide museum practice or support inclusion for new audiences. In this project, an interdepartmental group of science center staff co‐created a conceptual framework for noticing and supporting visitors' agency. The framework includes four interconnected aspects of agency: physical environment, social engagement, choice and autonomy, and relevance and empowerment. Conceptualizing agency as multifaceted led to more expansive approaches for supporting it, allowing staff to move beyond open‐endedness to consider a wider range of supports and structures that can make museum experiences more inviting and inclusive. The framework informed the development of practical tools for use by exhibit/program developers and facilitators. Tools are freely available and guide museum staff in questioning current practices and integrating the four facets of agency into planning, prototyping, and observation of interactive experiences.
Integrated multiomic analyses: An approach to improve understanding of diabetic kidney disease
Authors: Hill Claire , McKnight Amy Jayne , Smyth Laura J.
Published: October 2024

Aim

Diabetes is increasing in prevalence worldwide, with a 20% rise in prevalence predicted between 2021 and 2030, bringing an increased burden of complications, such as diabetic kidney disease (DKD). DKD is a leading cause of end‐stage kidney disease, with significant impacts on patients, families and healthcare providers. DKD often goes undetected until later stages, due to asymptomatic disease, non‐standard presentation or progression, and sub‐optimal screening tools and/or provision. Deeper insights are needed to improve DKD diagnosis, facilitating the identification of higher‐risk patients. Improved tools to stratify patients based on disease prognosis would facilitate the optimisation of resources and the individualisation of care. This review aimed to identify how multiomic approaches provide an opportunity to understand the complex underlying biology of DKD.

Methods

This review explores how multiomic analyses of DKD are improving our understanding of DKD pathology, and aiding in the identification of novel biomarkers to detect disease earlier or predict trajectories.

Results

Effective multiomic data integration allows novel interactions to be uncovered and empathises the need for harmonised studies and the incorporation of additional data types, such as co‐morbidity, environmental and demographic data to understand DKD complexity. This will facilitate a better understanding of kidney health inequalities, such as social‐, ethnicity‐ and sex‐related differences in DKD risk, onset and progression.

Conclusion

Multiomics provides opportunities to uncover how lifetime exposures become molecularly embodied to impact kidney health. Such insights would advance DKD diagnosis and treatment, inform preventative strategies and reduce the global impact of this disease.
Impact Absorption Power of Polyolefin Fused Filament Fabrication 3D‐Printed Sports Mouthguards: In Vitro Study
Authors: Nassani Leonardo Mohamad , Storts Samuel , Novopoltseva Irina , Place Lauren Ann , Fogarty Matthew , Schupska Pete
Published: October 2024

Background/Aim

This study aims to evaluate and compare the impact absorption capacities of thermoformed ethylene vinyl acetate (EVA) mouthguards and 3D‐printed polyolefin mouthguards used in sports dentistry applications. The objective is to determine whether 3D‐printed polyolefin mouthguards offer superior impact toughness compared to traditional EVA mouthguards commonly used in sports settings.

Materials and Methods

Six material samples were assessed: five pressure‐formed EVA mouthguards (PolyShok, Buffalo Dental, Erkoflex, Proform, and Drufosoft) and one 3D‐printed synthetic polymer (polyolefin). The materials were evaluated using a modified American Society for Testing and Materials (ASTM) D256 Test Method A for Izod pendulum impact resistance of plastics. Polyolefin samples were 3D‐printed using fused filament fabrication (FFF) technology. Notably, the FFF process included samples printed with notches placed either parallel or perpendicular to the build direction. This orientation served as a study factor, allowing for comparison of material behavior under different printing conditions. Impact testing was conducted using an Izod impact tester to assess the materials' performance under controlled impact conditions.

Results

The study achieved a high power (1.0) in power analysis, indicating strong sensitivity to detect significant differences. Among molded materials, PolyShok showed significantly lower impact toughness compared to others (p = 0.06). The mean impact absorption of EVA materials was 5.4 ± 0.3 kJ/m2, significantly lower than polyolefin materials, which demonstrated 12.9 ± 0.7 kJ/m2 and superior performance (p = 0.0). Horizontal‐notched polyolefin samples exhibited higher impact strength compared to vertical‐notched samples (p = 0.009).

Conclusions

3D‐printed polyolefin mouthguards exhibited significantly higher impact toughness than thermoformed EVA mouthguards. While EVA materials demonstrated structural robustness, their lower impact resistance and observed tearing in other test specimens suggest the need for alternative testing standards to better reflect real‐world conditions. 3D‐printed mouthguards fabricated with build orientations perpendicular to the direction of impact demonstrate significantly enhanced impact absorption. Further research into manufacturing methods and testing protocols is recommended to optimize mouthguard performance under impact scenarios.
Accuracy and Consistency of Gemini Responses Regarding the Management of Traumatized Permanent Teeth
Authors: Portilla Nicolas Dufey , Garcia‐Font Marc , Nagendrababu Venkateshbabu , Abbott Paul V. , Sanchez Jose Antonio Gonzalez , Abella Francesc
Published: October 2024

Background

The aim of this cross‐sectional observational analytical study was to assess the accuracy and consistency of responses provided by Google Gemini (GG), a free‐access high‐performance multimodal large language model, to questions related to the European Society of Endodontology position statement on the management of traumatized permanent teeth (MTPT).

Materials and Methods

Three academic endodontists developed a set of 99 yes/no questions covering all areas of the MTPT. Nine general dentists and 22 endodontic specialists evaluated these questions for clarity and comprehension through an iterative process. Two academic dental trauma experts categorized the knowledge required to answer each question into three levels. The three academic endodontists submitted the 99 questions to the GG, resulting in 297 responses, which were then assessed for accuracy and consistency. Accuracy was evaluated using the Wald binomial method, while the consistency of GG responses was assessed using the kappa‐Fleiss coefficient with a confidence interval of 95%. A 5% significance level chi‐squared test was used to evaluate the influence of question level of knowledge on accuracy and consistency.

Results

The responses generated by Gemini showed an overall moderate accuracy of 80.81%, with no significant differences found between the responses of the academic endodontists. Overall, high consistency (95.96%) was demonstrated, with no significant differences between GG responses across the three accounts. The analysis also revealed no correlation between question level of knowledge and accuracy or consistency, with no significant differences.

Conclusions

The results of this study could significantly impact the potential use of Gemini as a free‐access source of information for clinicians in the MTPT.
Influence of Using a Puncturing Method and Cooldown Period Before Pressing the Second‐Layered Sheet on the Final Thickness of Double‐Layered Sports Mouthguards: An Experimental Study
Authors: Uma Uthai , Tretanyuth Peerathat , Panitchumroen Puripat , Chomin Sirawish
Published: October 2024

Aim

The thickness of the mouthguard is a crucial factor in its protective ability for athletes. This study aimed to investigate the final thickness of double‐layered sports mouthguards, which were fabricated using different methods before pressing the second layer.

Materials and Methods

Seven upper working models (n = 7 per group) were prepared for mouthguard fabrication. The first 3‐mm mouthguard sheet underwent heating, pressing, and vacuuming onto the model, followed by various protocols before the second 3‐mm sheet was pressed. Group 1: The second sheet was pressed immediately. Group 2: The first sheet underwent a 1‐h cooldown period before pressing the second sheet. Group 3: The interproximal areas of the first sheet were punctured followed by immediate pressing of the second sheet. Group 4: The first sheet was punctured followed by a 1‐h cooldown before pressing the second sheet. After 24 h, the mouthguard thickness was measured at various points on the left and right central incisors and first molars using a digital caliper. The thickness analysis was performed using SPSS 29.0 with one‐way ANOVA and Tukey post hoc analysis.

Results

At the labial surface of the central incisors, Group 4 exhibited the highest thickness, while Group 3 had the lowest (p < 0.001). Groups 1 and 2 did not show significant differences in thickness. At the incisal edges, Group 3 again had the lowest thickness (p < 0.05), with no significant differences observed among the other groups. There were no significant differences in thickness across all areas at the first molars, including cusp tips, pits, and buccal surfaces (p > 0.05). Group 4 demonstrated greater uniformity at the central incisors in thickness compared with the other groups.

Conclusions

Using the puncturing method at interproximal areas combined with a cooldown period could enhance mouthguard thickness at the labial surfaces of the central incisors and improve its thickness uniformity.
Somatic variant analysis of resected brain tissue in epilepsy surgery patients
Authors: Sanders Maurits W. C. B. , Koeleman Bobby P. C. , Brilstra Eva H. , Jansen Floor E. , Baldassari Sara , Chipaux Mathilde , Sim Nam Suk , Ko Ara , Kang Hoon‐Chul , Blümcke Ingmar , Lal Dennis , Baulac Stéphanie , Lee Jeong Ho , Aronica Eleonora , Braun Kees P. J.
Published: October 2024

We studied the distribution of germline and somatic variants in epilepsy surgery patients with (suspected) malformations of cortical development (MCD) who underwent surgery between 2015 and 2020 at University Medical Center Utrecht (the Netherlands) and pooled our data with four previously published cohort studies. Tissue analysis yielded a pathogenic variant in 203 of 663 (31%) combined cases. In 126 of 379 (33%) focal cortical dysplasia (FCD) type II cases and 23 of 37 (62%) hemimegalencephaly cases, a pathogenic variant was identified, mostly involving the mTOR signaling pathway. Pathogenic variants in 10 focal epilepsy genes were found in 48 of 178 (27%) FCDI/mild MCD/mMCD with oligodendroglial hyperplasia and epilepsy cases; 36 of these (75%) were SLC35A2 variants. Six of 69 (9%) patients without a histopathological lesion had a pathogenic variant in SLC35A2 (n = 5) or DEPDC5 (n = 1). A germline variant in blood DNA was confirmed in all cases with a pathogenic variant in tissue, with a variant allele frequency (VAF) of ~50%. In seven of 114 patients (6%) with a somatic variant in tissue, mosaicism in blood was detected. More than half of pathogenic somatic variants had a VAF < 5%. Further analysis of the correlation between genetic variants and surgical outcomes will improve patient counseling and may guide postoperative treatment decisions.
Fatigue Crack Segmentation and Characterization of Additively Manufactured Ti‐6Al‐4V Using X‐Ray Computed Tomography
Authors: Hejazi Bardia , Compart Amaya , Fritsch Tobias , Wagner Ruben , Weidner Anja , Biermann Horst , Benz Christopher , Sander Manuela , Bruno Giovanni
Published: October 2024

X‐ray computed tomography (XCT) is extremely useful for the non‐destructive analysis of additively manufactured (AM) components. AM components often show manufacturing defects such as lack‐of‐fusion (LoF), which are detrimental to the fatigue life of components. To better understand how cracks initiate and propagate from internal defects, we fabricated Ti‐6Al‐4V samples with an internal cavity using electron beam powder bed fusion. The samples were tested in high‐cycle and very high‐cycle fatigue regimes. XCT was used to locate crack initiation sites and to determine characteristic properties of cracks and defects with the aid of deep learning segmentation. LoF defects exposed to the outer surface of the samples after machining were found to be as detrimental to fatigue life as the internal artificial defects. This work can benefit industries that utilize the AM of high‐strength, lightweight alloys, in the design and manufacturing of components to improve part reliability and fatigue life.
Ecological but Not Biological Traits of European Riverine Invertebrates Respond Consistently to Anthropogenic Impacts
Authors: Sinclair James S. , Stubbington Rachel , Schäfer Ralf B. , Barešová Libuše , Bonada Núria , Csabai Zoltán , Jones J. Iwan , Larrañaga Aitor , Murphy John F. , Pařil Petr , Polášek Marek , Rasmussen Jes J. , Straka Michal , Várbíró Gábor , Verdonschot Ralf C. M. , Welti Ellen A. R. , Haase Peter
Published: October 2024

Aim

To determine which riverine invertebrate traits respond consistently to anthropogenic impacts across multiple biogeographic regions.

Location

Europe.

Time Period

1981–2021.

Major Taxa Studied

Riverine invertebrates.

Methods

We compiled a database of riverine invertebrate community time series for 673 sites across six European countries spanning six freshwater ecoregions. We compared trait responses to anthropogenic impacts (quantified as changes in ‘ecological quality’) among regions for seven ‘ecological’ traits, which reflect habitat preferences, and nine ‘biological’ traits (e.g., morphology or life history), which represent taxon‐specific attributes that can influence ecosystem processes.

Results

Four ecological traits (current, microhabitat, salinity and trophic preferences) and one biological trait (dispersal mode) responded consistently across regions. These responses were primarily driven by spatial differences among poorer to better quality sites. Responses to temporal changes in quality were comparable but less pronounced.

Main Conclusions

Consistent responses to anthropogenic impacts across multiple ecological traits indicate these traits may improve broader scale measurements, comparisons and predictions of community responses. However, we could not use ecological traits to identify the actions of specific stressors because multiple traits always responded as a group. Inconsistent responses across almost all biological traits indicated that these traits may be less predictive of impacts across regions. Predictions of how biological traits, and associated ecosystem processes, respond to anthropogenic impacts may be most effective at regional scales where responses are more consistent.
New nomenclature and subclassification of steatotic liver disease and loss of skeletal muscle mass: A longitudinal cohort study
Authors: Kim Aryoung , Kang Danbee , Choi Sung Chul , Sinn Dong Hyun , Gwak Geum‐Youn
Published: October 2024

Aims

Identifying risk factors for sarcopenia is important due to its significant effect on health. The association between sarcopenia and the newly proposed steatotic liver disease (SLD) and its subclassification has largely been unexplored.

Methods

This longitudinal cohort study included 67 905 adults who underwent at least two health checkup examinations. SLD participants were categorized as cryptogenic SLD, metabolic dysfunction‐associated SLD, metabolic dysfunction‐associated alcoholic liver disease, or alcoholic liver disease. Appendicular skeletal muscle mass (ASM) was evaluated by bioelectrical impedance analysis.

Results

The average duration of follow‐up was 5.9 years. The annual ASM change was −31.0 g (95% CI −32.3, −29.6) and −38.3 g (−40.3, −36.3) in participants without and with SLD, respectively. When assessed based on SLD severity, annual ASM loss was fastest in SLD participants with Fibrosis‐4 score ≥1.3, followed by those with Fibrosis‐4 score <1.3 and those without SLD. In multivariable adjusted analysis, annual ASM loss was fastest in participants with metabolic dysfunction‐associated alcoholic liver disease (−49.8 g; −93.1, −6.5), followed by those with metabolic dysfunction‐associated SLD (−24.7 g; −60.4, 11.1), and alcoholic liver disease (−24.4 g; −91.1, 42.3), and slowest in those with cryptogenic SLD (reference). This pattern was more pronounced in participants with Fibrosis‐4 score ≥1.3.

Conclusion

The loss of skeletal muscle mass was fastest in the participants with metabolic dysfunction‐associated alcoholic liver disease, followed by participants with metabolic dysfunction‐associated SLD, alcoholic liver disease, and cryptogenic SLD. Particular attention to prevent sarcopenia should be given to SLD patients with cardiometabolic risk factors or alcohol consumption, especially in patients with advanced fibrosis.
Seeing Otherwise: ‘The Least of These’ and Revelation in Jean‐Luc Marion
Authors: Breedlove Thomas
Published: October 2024

In his familiar essay in Phenomenology and the ‘Theological Turn’, Jean‐François Courtine writes that the ‘cardinal experience’ of revelatory phenomena would undoubtedly be the incarnation. But in its singularity, this experience, he admits, seems to elude phenomenological thought. Against such a judgement, many Christian traditions affirm Christ's ongoing presence in diverse privileged sites, in the eucharist, saints, the Church itself, and, via Christ's own identification with ‘the least of these’ in Matthew's parable, in those who suffer. This essay considers this last possibility of divine manifestation, taking up ‘the least of these’ to reconsider the relationship between finitude and the infinite in Jean‐Luc Marion's phenomenogical account of revelation and saturation. While the heart of Marion's account, both in his words and according to his critics, has primarily concerned revelation's contradiction of finite experience, this essay argues that the development of Marion's own hermeneutics and his attentiveness to paradox and kenosis also reveal the confirmation of finitude at the heart of revelation. Revelation, that is, though it comes from elsewhere, is not other than finitude, but finitude otherwise, finitude's transfiguration.
Adherence and uncertainty during rehabilitation for urinary incontinence: Validation of a scale
Authors: Terzoni Stefano , Parozzi Mauro , Mora Cristina , Marconi Pietro , Wallace Eva , Gaia Giorgia , Maruccia Serena , Sighinolfi Chiara , Lusignani Maura , Pinna Barbara , Ricci Cristian , Ferrara Paolo
Published: October 2024

We sought to create an Italian version of Mishel's Uncertainty in Illness Scale, dedicated to people undergoing conservative rehabilitation for urinary incontinence, for studying uncertainty as a determinant of therapeutic adherence. Urinary incontinence has a high prevalence worldwide, ranging from 25% to 45%. Incontinence is often treatable with conservative interventions but demands a long and intensive commitment from the patient. Results are not immediate, and relapses are possible. These patients can experience uncertainty and difficulty complying with rehabilitation programs, hence the importance of the therapeutic relationship with a healthcare professional. Mishel's theory of uncertainty can be used to measure uncertainty and the effects of such a relationship, but no instrument currently exists for this purpose. Prospective observational study enrolling all male and female adult patients admitted to a nurse‐led outpatient pelvic clinic for non‐neurogenic urinary incontinence, excluding puerpera. A scale named MUIS‐PF (pelvic floor) was created, based on previous versions of Mishel's scale, and administered during the first consultation and at the end of the rehabilitation program. Internal consistency was assessed, and exploratory factor analysis was conducted. A total of 109 patients enrolled (54 M, 55 F) aged 64 ± 5 years, medial initial leakage 245 grams/day, IQR [90; 370]. Seventy‐nine percent obtained continence; there were no dropouts during the study. Internal consistency of the MUIS‐PF was high (93%), and structure analysis yielded a clear separation of the factors. Patient uncertainty decreased significantly at the end of the program compared to the first consultation (p < 0.001). The MUIS‐PF is valid and reliable. Utilizing the correct approach, the nurse could significantly reduce the uncertainty of persons with incontinence by listening, giving clear information and searching for the best solution for their continence issues.
Perception, attitude, and opinion of parents of cleft lip and palate patients treated with nasoalveolar molding (NAM): A cross‐sectional questionnaire study
Authors: Martínez‐Orellana Ana , Camañes‐Gonzalvo Sara , Tejero‐Martínez Ana , Salom‐Alonso Lucas , Bellot‐Arcís Carlos , García‐Sanz Verónica , Paredes‐Gallardo Vanessa
Published: October 2024

Background

The main goal of the nasoalveolar molding (NAM) is to mitigate the initial severity of the cleft, facilitating the subsequent surgical procedures. Nevertheless, the use of the appliance entails high stress levels for families.

Aim

The aim of this study was to assess the perceptions, attitudes, and opinions of parents whose cleft‐affected children underwent treatment using the NAM technique.

Design

A cross‐sectional questionnaire study was conducted on a cohort of relatives of infants born with cleft lip and palate who were treated with the NAM appliance. The parents completed a 59‐item questionnaire that had been previously validated.

Results

The initial cohort consisted of 104 families. The level of satisfaction was high, and there was a direct correlation with early diagnosis. Satisfaction levels varied depending on the cleft type, with a decrease in cases of bilateral presentation. Satisfaction was influenced by the newborns' adaptation and the absence of complications. Parents who exhibited lower levels of satisfaction contemplated terminating the treatment.

Conclusions

Parents expressed high satisfaction with NAM treatment, due to effective management and understanding. Bilateral clefts and delayed diagnosis can significantly impact satisfaction. These results emphasize the importance of personalized approaches to address challenges in NAM treatment, particularly in instances of bilateral clefts and delayed diagnoses.
Microstructure and ablation behavior of C/C–HfC–SiC composites fabricated by reactive melt infiltration with Hf–Si alloy
Authors: Xu Chongqing , Jia Chenglan , Liu Qian , Peng Zheng , Chen Sian
Published: October 2024

C/C–HfC–SiC composites were prepared by reactive melt infiltration using Hf–Si alloy (Hf, more than 95 wt%) with a density of 3.86 g/cm3 and an open porosity of 8.34%. The microstructure, mechanical properties, and ablation behavior at high temperatures were studied in detail. SiC played a crucial role in alleviating the thermal mismatch between HfC and PyC, which formed at the interface between the carbon matrix and the HfC matrix. The flexural strength and modulus of C/C–HfC–SiC composites were 237 MPa and 37.6 GPa, respectively. The C/C–HfC–SiC composites exhibited excellent ablation resistance with a linear ablation rate of 8.9 × 10−3 mm/s and maintained a surface temperature above 2925°C during ablation. During this process, HfO₂ remained in a molten state with high viscosity and served as a thermal barrier, while the volatilization of SiO₂ effectively removed heat, protecting the composites from further ablation.
Management of human epidermal growth factor receptor inhibitors‐related acneiform rash: A position paper based on the first Europe/USA Delphi consensus process
Authors: Apalla Z. , Freites‐Martinez A. , Grafanaki K. , Ortiz‐Brugues A. , Nikolaou V. , Fattore D. , Sollena P. , Deverapalli S. , Babakoohi S. , Galimont A. , Kluger N. , Beylot‐Barry M. , Larocca C. , Iriarte C. , Smith J. , Tattersall I. , Dodiuk‐Gad R. , Sauder M. , Carrera C. , Kwong B. , Whitley M. , Leboeuf N. , Romano P. , Starace M. , Mateeva V. , Riganti J. , Hirner J. , Patel A. B. , Reyes‐Habito C. M. , Kraehenbuehl L. , Kheterpal M. , Fida M. , Hassel J. , Lacouture M. , Sibaud V.
Published: October 2024

Background

There is a need for unified guidance in the management of acneiform rash induced by epidermal growth factor receptor inhibitors (EGFRi) among dermatologists.

Objective

To establish unified international guidelines for the management of acneiform rash caused by EGFR inhibitors, based on an experts' Delphi consensus.

Methods

The initiative was led by five members of the European Academy of Dermatology and Venereology Task Force ‘Dermatology for Cancer Patients’ who developed a questionnaire that was circulated to a group of 32 supportive oncodermatology experts in Europe, Canada, Argentina, the US States and Asia. The questionnaire consisted of 84 statements in total, regarding diagnosis and treatment of EGFRi‐induced acneiform rash. Experts responded to an anonymous 5‐point Likert scale survey. The coordinators collected the first‐round responses that were checked for consensus (≥75% agreement in positive [agree or strongly agree] or in negative [disagree or strongly disagree] vote). The statements that did not reach strong consensus in the first round were revised, according to experts' feedback, for a second‐round survey.

Results

Strong consensus was reached in 75/84 (89.3%) of the statements, whilst moderate consensus was achieved in 6/84 elements. Key points include consideration of low‐dose isotretinoin for refractory grade II/III acneiform rash, use of topical steroid‐sparing agents like topical pimecrolimus in the maintenance phase and use of doxycycline in either 100 or 200 mg per day as prophylactic treatment. Interestingly, experts did not recommend topical antibiotics, neither for prevention, nor for treatment. Consensus failure in 3/84 objects is mostly related to the lack of robust data on these topics.

Conclusion

This consensus offers crucial insights often overlooked by radiotherapists, general practitioners, dermatologists and oncologists, and it is expected to improve the management of oncologic patients treated with EGFRi in different settings and continents.
Monolithic Hybrid Abutment Crowns (Screw‐Retained) Versus Monolithic Hybrid Abutments With Monolithic Crowns (Adhesively Cemented): Three‐Year Data of a Prospective Clinical Split‐Mouth Study
Authors: Naumann Michael , Happe Arndt , Holtkamp Agnes , Blender Sarah M.
Published: October 2024

Objectives

This study compares the restoration of single‐tooth implants with screw‐retained lithium‐disilicate hybrid‐abutment crowns and single‐tooth lithium‐disilicate crowns adhesively bonded to hybrid abutments with regard to objective clinical and subjective patient‐specific evaluation criteria over a time of observation of 3 years.

Materials and Methods

Two bone‐level implants were placed in contralateral sides of the same jaw in 10 patients, each with two single‐tooth gaps. After osseointegration, implants were uncovered and an impression was taken. In accordance with the split‐mouth design, one implant in each patient was restored with a screw‐retained hybrid abutment crown and the other implant with a hybrid abutment and an adhesively bonded single‐tooth crown. The restorations were randomly allocated to the implants. Prefabricated titanium bases were used. The ceramic abutments and restorations were fabricated monolithically with pressed lithium‐disilicate ceramic. An objective evaluation (survival, technical, or biological complications, FIPS) by the practitioner and a subjective evaluation (satisfaction, OHIP) by the patient were carried out after 3, 6, 12, 24, and 36 months after restoration placement.

Results

Both restoration types showed a survival rate of 100% after 3 years of observation. No technical or biological complications occurred. No significant difference was observed between the two types of restoration neither for objective (survival, technical or biological complications, FIPS) nor subjective (satisfaction, OHIP) evaluation criteria (p > 0.05).

Conclusion

No statistically significant differences were observed between screw‐retained and cemented pressed lithium‐disilicate restorations on bone‐level implants for both objective and subjective evaluation criteria, respectively.

Clinical Significance

Monolithic hybrid‐abutment crowns (screw‐retained) and monolithic hybrid abutments with single‐tooth crowns (cemented) made of pressed lithium disilicate can be used to successfully restore single implants.
Strategies to promote safety for sexual and gender minority youth in secondary schools: A longitudinal analysis
Authors: Real André Gonzales , Sherwood S. Henry , Ioverno Salvatore , Russell Stephen T.
Published: October 2024

In order to promote school safety for sexual and gender minority youth (SGMY), many schools implement strategies such as SGM‐focused policies and gender‐sexuality alliances (GSAs). Little is known about the effects such strategies have over time on feelings of safety at school for SGMY. Hierarchical Linear Models were conducted using longitudinal data from 417 SGMY attending secondary schools to examine trajectories of feelings of safety and the effects of SGM‐focused policies, GSA presence, or GSA membership on feelings of safety. Findings indicate that SGM‐focused policies and GSAs had direct benefits for safety at school SGMY, both independently and in combination; however, GSA membership was not. Schools should implement a combination of school strategies to promote safer environments for SGMY.
Social needs and health outcomes in two rural Veteran populations
Authors: Friedman Hannah R. , Griesemer Ida , Hausmann Leslie R. M. , Fix Gemmae M. , Hyde Justeen , Gurewich Deborah
Published: October 2024

Background

Addressing social needs is a priority for many health systems, including the Veterans Health Administration (VA). Nearly a quarter of Veterans reside in rural areas and experience a high social need burden. The purpose of this study was to assess the prevalence and association with health outcomes of social needs in two distinct rural Veteran populations.

Methods

We conducted a survey (n = 1150) of Veterans at 2 rural VA sites, 1 in the Northeast and 1 in the Southeast (SE), assessing 11 social needs (social disconnection, employment, finance, food, transportation, housing, utilities, internet access, legal needs, activities of daily living [ADL], and discrimination). We ran weighted‐logistic regression models to predict the probability of experiencing four outcomes (poor access to care, no‐show visits, and self‐rated physical and mental health) by individual social need.

Findings

More than 80% of Veterans at both sites reported ≥1 social need, with social disconnection the most common; Veterans at the SE site reported much higher rates. A total of 9 out of 11 needs were associated with higher probability of poor physical and mental health, particularly financial needs (average marginal effect [AME]: 0.21–0.32, p < 0.001) and ADL (AME: 0.27–0.34, p < 0.001). We found smaller associations between social needs and poor access to care and no‐show visits.

Conclusion

High prevalence of social needs in rural Veteran population and significant associations with four health outcomes support the prioritization of addressing social determinants of health for health systems. Differences in the findings between sites support tailoring interventions to specific patient populations.
The Pharmacokinetics of Subcutaneous Eprinomectin in Plasma and Milk in Dry Dairy Cattle
Authors: Miller Ranee A. , McCluney Tyana S. , Halleran Jennifer L. , Baynes Ronald E. , Foster Derek M.
Published: October 2024

Parasitic infections in dairy cattle reduce herd immunity, milk production, and conception rates. This leads to higher production costs, compromised animal welfare, and increased interest in extralabel drug use. The extralabel use of anthelmintics poses food safety risks for consumers since appropriate withdrawal intervals in milk have yet to be established. Although topical eprinomectin has no milk withdrawal time, more research is needed to determine the residues present in milk after subcutaneous administration. This study aimed to characterize the pharmacokinetics of injectable eprinomectin in dry dairy cows. We hypothesized that, when given at the labeled dose, eprinomectin residues in dry dairy cattle would be below the FDA milk tolerance at the onset of lactation. Plasma was collected daily from 13 mature dairy cattle for 7 days postadministration, followed by periodic samples for 90 days. After calving, milk was collected daily until 90 days. Eprinomectin concentrations were measured using HPLC‐fluorescence detection. The maximum eprinomectin concentration in plasma and milk was approximately 36 ng/mL 43 h after administration and 3 ng/mL at the onset of lactation, respectively. The low eprinomectin levels in milk collected from these lactating dairy cattle suggest that administering eprinomectin at dry‐off is unlikely to result in violative residues. However, subcutaneous eprinomectin in lactating dairy cattle would be hard to justify unless there is evidence that the approved topical formulation is clinically ineffective.
Coordination of distributed adaptive signal control and advisory speed optimization based on shockwave theory
Authors: Xie Ning , Dong Changyin , Wang Hao
Published: October 2024

This paper presents a distributed adaptive signal control and advisory speed coordination method based on shockwave theory, which accommodates diverse traffic conditions. In order to assess signal control efficiency under various scenarios, an innovative evaluation index termed synthetic delay is introduced based on the analysis of traffic dynamics at intersections. Considering the formation and dissipation of queue, and flow fluctuation of incoming traffic, it automatically evaluates control delay and throughput with distinctive significances. The distributed adaptive control method calculates the optimal green time in real time to minimize total synthetic delay at intersections. Furthermore, the coordination of advisory speed with the signal control schemes is addressed to ensure smooth progressions for vehicles. The proposed method considers the saturation of traffic and upstream traffic flow changes, leading to adaptability to changing traffic scenarios and effective coordination of traffic control. Several simulations were conducted and compared with the proposed method with other control methods. The results demonstrate that the proposed methods reduce the control delay and increase intersection throughput remarkably under different traffic saturations, confirming their effectiveness.
Ontogenetic correlates, not direct adaptation, explain the evolution of stelar morphology
Authors: Suissa Jacob S. , Niklas Karl J. , Tomescu Alexandru M. F. , Friedman William E.
Published: October 2024

The primary vascular system of plants (the stele) has attracted interest from paleobotanists, developmental biologists, systematists, and physiologists for nearly two centuries. Ferns, with their diverse stelar morphology, deep evolutionary history, and prominent fossil record, have been a major focus in studies of the stele. To explain the diversity of stelar morphology, past adaptive hypotheses have invoked biomechanics, hydraulics, and drought tolerance as key selection pressures in the evolution of stelar complexity; but, these hypotheses often isolate the stele from a whole‐plant developmental context, ignoring potential covariation between vascular patterning and shoot morphology. Furthermore, incongruence between expected patterns and observed data challenge adaptive hypotheses, precluding a comprehensive explanation of stelar evolution. While ontogeny has been previously recognized as a factor in stelar diversification, it has not been fully integrated into a comprehensive framework. Here we synthesize 150‐years of research on stelar morphology, incorporating developmental, physiological, and phylogenetic data to present the ontogenetic hypothesis of stelar evolution. This hypothesis posits that stelar morphology is an integrated feature of whole‐plant ontogeny, not a trait shaped by direct selection for adaptive patterns. This shift in perspective provides an updated framework for understanding the determinants of stelar morphology and focusses future efforts to ask more incisive questions about the evolution and function of primary vascular architecture.
State‐Dependent Exchange Rate Pass‐Through
Authors: Carrière‐Swallow Yan , Firat Melih , Furceri Davide , Jiménez Daniel
Published: October 2024

We estimate how the rate of pass‐through from the exchange rate to domestic prices varies across states of the economy and depending on the shocks that drive fluctuations in the exchange rate. We confirm several results from the literature and uncover new facts. Drawing on the experience of a large sample of advanced and emerging market economies over the past 30 years, we document that exchange rate pass‐through is significantly larger during periods of elevated uncertainty and when inflation is high. Using a novel identification strategy, we also show that pass‐through is higher when exchange rate fluctuations are driven by U.S. monetary policy.
Regulating AI in the ‘twin transitions’: Significance and shortcomings of the AI Act in the digitalised electricity sector
Authors: Espinosa Apráez Brenda , Noorman Merel
Published: October 2024

The use of artificial intelligence (AI) in the electricity sector is increasing as part of the twin digital and green transitions in the European Union (EU). AI technologies can be used for optimisation, prediction and scheduling purposes, offering possible solutions to the challenges presented by the ongoing energy transition. At the same time, AI technologies in general, not only in the electricity sector, also raise concerns about (unintended) harms and risks for people. To respond to these concerns, the EU has taken steps to regulate the responsible development and use of AI. A significant milestone in this endeavour is the recent adoption of the AI Act, the first horizontal EU legislation introducing harmonised rules for AI systems. In this paper, we examine different uses of AI in the electricity domain and investigate the extent to which the upcoming AI Act applies to them. In addition, we identify the shortcomings of the AI Act in the context of the electricity sector, as well as aspects that are not covered by this legislation. We show that the AI Act will only cover a narrow subset of AI systems in the electricity sector and that addressing some of the challenges that these systems pose may require further regulation.