bluuebunny/crossref_metadata_2025 huggingface dataset:
Indonesian dentists' views on providing oral health care for older adults
Authors: Werdiningsih Monika , Ramadhani Atik , Samnieng Patcharaphol , John Jacob , Adiatman Melissa
Published: September 2024

Background

With demographic changes in aging populations, dentists require special care protocols to treat older adults with diverse and complex oral health needs and problems. Knowledge, positive attitudes, and sufficient practice experience are essential components for promptly treating older adults. However, many dentists encounter multiple barriers influencing their willingness to provide care for older adults. This study assessed Indonesian dentists' knowledge, attitudes, and practices (KAP) in providing oral health care (OHC) for older adults, including their willingness and barriers.

Methods

A cross‐sectional survey was conducted with 392 dentists employing an online questionnaire between April and June 2022. The respondents' KAP was categorised utilising a modified Blooms' cut‐off point of ≥60%. Data were analysed using descriptive statistics, the x2 test, and logistic regression.

Results

Most dentists demonstrated adequate knowledge (62.2%), a positive attitude (95.4%), sufficient practice experience (91.6%), and a high willingness (98%) to provide OHC services for older adults. However, 91.4% encountered barriers primarily related to interpersonal communication, disease complexity and polypharmacy, and patient functional status. Significant associations were found between dentists' attitudes toward practices and willingness to attend geriatric dentistry training with knowledge.

Conclusion

Implementation of continuing professional development (CPD) in geriatric dentistry, the inclusion of geriatric dentistry into the undergraduate curriculum, and enhancing clinic accessibility for older adults may improve dentists' preparedness and benefit the future provision of OHC for older adults in Indonesia.
Occipital condyle syndrome due to small‐cell lung carcinoma: A case report
Authors: Yamashita Satoshi , Kinouchi Toru , Otsu Tomoyuki , Tsumura Makoto , Taira Akihiko , Tomura Masaki , Mizuno Yuri , Akamatsu Naoki , Murai Hiroyuki
Published: September 2024

Skull base metastases, including those from small‐cell lung carcinoma (SCLC), can present with various syndromes depending on the site of involvement, such as orbital syndrome, parasellar syndrome, middle fossa syndrome, jugular foramen syndrome, and occipital condyle syndrome (OCS). One such example is OCS, which consists of unilateral occipital headache accompanied with ipsilateral hypoglossal palsy. This case report describes a 51‐year‐old man initially diagnosed with OCS, which led to the discovery of systemic bone metastases from SCLC. Magnetic resonance imaging showed lesions in the occipital condyle and hypoglossal canal, while positron emission tomography‐computed tomography identified a lung mass and widespread metastases. SCLC is highly aggressive and metastatic, with the bone being a common site of spread. In this case, the OCS preceded the diagnosis of the underlying malignancy. Prompt diagnosis and treatment are crucial, as patients with OCS often have advanced disease. This case highlights the importance of considering SCLC as a potential etiology for OCS, given the propensity for bone metastases. Early recognition and evaluation of OCS is essential to initiate appropriate management.
Impact of Interventions on Medication Adherence in Patients With Coexisting Diabetes and Hypertension
Authors: Maniki Pauline Tendai , Chaar Betty Bouad , Aslani Parisa
Published: September 2024

Background

The coexistence of diabetes and hypertension is prevalent due to shared risk factors. Pharmacological treatment has been reported to be effective in managing both conditions. However, treatment effectiveness depends on the extent to which a patient adheres to their treatment. Poor adherence to long‐term treatment for chronic diseases is a growing global problem of significant magnitude. Several interventions have been developed to help improve medication adherence in patients with coexisting diabetes and hypertension. This review aimed to determine the characteristics of these interventions and their impact on medication adherence.

Methods

A systematic review of the literature was conducted using the PRISMA guidelines and registered in the PROSPERO International Registry of Systematic Reviews. Studies were searched in the databases CINAHL, Embase and Medline to identify relevant articles published during 2012–2023. The search concepts included ‘medication adherence’, ‘hypertension’, ‘diabetes’ and ‘intervention’. Studies were included if they were in English and evaluated the impact of an intervention aimed at promoting adherence to medications for both diabetes and hypertension.

Results

Seven studies met the inclusion criteria, with five demonstrating a statistically significant improvement in medication adherence. Of the five studies that improved medication adherence, four were multifaceted and one was a single‐component intervention. All successful interventions addressed at least two factors influencing non‐adherence. Patient education was the foundation of most of the successful interventions, supported by other strategies, such as follow‐ups and reminders.

Conclusion

Multifaceted interventions that also included patient education had a positive impact on medication adherence in patients with coexisting diabetes and hypertension. Improving adherence in patients with coexisting diabetes and hypertension requires a multipronged approach that considers the range of factors impacting medication‐taking.

Patient or Public Contribution

This systematic review provides comprehensive insights into the benefits of patient‐centred approaches in intervention development and strengthening. Such patient involvement ensures that medication adherence interventions are more relevant, acceptable and effective, ultimately leading to better health outcomes and more meaningful patient engagement in healthcare research.
Global meta‐analysis of physicians' experiences of workplace sexual harassment by patients
Authors: Kamau‐Mitchell Caroline , Bin Waleed Khalid , Gallagher Mark M.
Published: September 2024

The World Health Organization recognises that sexual harassment is an occupational hazard in medicine, but the prevalence of sexual harassment by patients is unknown. This global meta‐analysis found that a pooled prevalence of 45.13% of 18 803 physicians from several specialities (e.g. internal medicine and surgery) have ever experienced it. Hospitals should implement protective measures such as panic alarms for night shifts and isolated wards.
Immune checkpoint inhibitors in infectious disease
Authors: King Hannah A. D. , Lewin Sharon R.
Published: September 2024

Following success in cancer immunotherapy, immune checkpoint blockade is emerging as an exciting potential treatment for some infectious diseases, specifically two chronic viral infections, HIV and hepatitis B. Here, we will discuss the function of immune checkpoints, their role in infectious disease pathology, and the ability of immune checkpoint blockade to reinvigorate the immune response. We focus on blockade of programmed cell death 1 (PD‐1) to induce durable immune‐mediated control of HIV, given that anti‐PD‐1 can restore function to exhausted HIV‐specific T cells and also reverse HIV latency, a long‐lived form of viral infection. We highlight several key studies and future directions of research in relation to anti‐PD‐1 and HIV persistence from our group, including the impact of immune checkpoint blockade on the establishment (AIDS, 2018, 32, 1491), maintenance (PLoS Pathog, 2016, 12, e1005761; J Infect Dis, 2017, 215, 911; Cell Rep Med, 2022, 3, 100766) and reversal of HIV latency (Nat Commun, 2019, 10, 814; J Immunol, 2020, 204, 1242), enhancement of HIV‐specific T cell function (J Immunol, 2022, 208, 54; iScience, 2023, 26, 108165), and investigating the effects of anti‐PD‐1 and anti‐CTLA‐4 in vivo in people with HIV on ART with cancer (Sci Transl Med, 2022, 14, eabl3836; AIDS, 2021, 35, 1631; Clin Infect Dis, 2021, 73, e1973). Our future work will focus on the impact of anti‐PD‐1 in vivo in people with HIV on ART without cancer and potential combinations of anti‐PD‐1 with other interventions, including therapeutic vaccines or antibodies and less toxic immune checkpoint blockers.
Effectiveness of virtual reality glasses versus white noise on dental anxiety in children with attention‐deficit hyperactivity disorder: A randomised controlled clinical trial
Authors: Aly Nahla A. , Abdelrahman Amina M. , Omar Tarek E. I. , Dowidar Karin ML
Published: September 2024

Background

Management of children with attention‐deficit hyperactivity disorder (ADHD) can be challenging due to their disruptive behaviour. Basic behaviour management techniques (BMTs) may not be sufficient, and adjunctive strategies such as virtual reality (VR) glasses or white noise can be employed.

Aim

To assess and compare the effectiveness of VR, white noise and basic BMTs on dental anxiety and behaviour of children with ADHD.

Design

Forty‐eight children with ADHD were recruited for this parallel, three‐armed randomised controlled clinical trial, which involved three visits at one‐week intervals, including examination, preventive measures and restorations. Children were randomly divided into three groups: VR, white noise and basic BMTs. Outcome measures were Faces Image Scale (FIS), Heart Rate (HR) and Venham's Behaviour Rating Scale (VBRS).

Results

No significant difference was found between the groups in FIS scores. White noise group had a significantly lower mean HR than control group in all visits. Scores of VBRS in VR and white noise groups were significantly lower than those in the control group during the restorative visit.

Conclusions

VR and white noise could be beneficial in managing dental anxiety and improving behaviour in children with ADHD and could be used as adjunctive strategies to basic BMTs.
Digital therapeutics in hypertension: How to make sustainable lifestyle changes
Authors: Chen Chaoyi , Liu Aiting , Zhang Zhengzhipeng , Chen Jie , Huang Hui
Published: September 2024

Various digital therapeutic products have been validated and approved since 2017. They have demonstrated efficacy and safety as a new therapeutic modality in various disorders or conditions. Hypertension is a common but serious condition that can be prevented or controlled with lifestyle changes and medicines. Although a digital therapeutic in hypertension is validated and approved in Japan, whether digital therapeutics (DTx) can significantly improve sustainable lifestyle changes is still a controversial topic. Most studies did not discuss the long‐term gain challenges. In this review, the authors discuss the definition of DTx, and analyze the motivation, engagement and adherence challenges of DTx in hypertension. Some ongoing artificial intelligence (AI)‐enabled or cognitive behavioral therapy (CBT)‐based digital interventions and behavioral strategies for implementing sustainable lifestyle changes are identified and analyzed. With AI‐enabled interventions and behavioral strategies, DTx might be one of the effective approaches to make sustainable lifestyle changes.
Multifaceted bioinformatic analysis of m6A‐related ferroptosis and its link with gene signatures and tumour‐infiltrating immune cells in gliomas
Authors: Yang Yang , Hao Liu , Guiyang Liu , Haozhe Piao
Published: September 2024

Whether N6‐Methyladenosine (m6A)‐ and ferroptosis‐related genes act on immune responses to regulate glioma progression remains unanswered. Data of glioma and corresponding normal brain tissues were fetched from the TCGA database and GTEx. Differentially expressed genes (DEGs) were identified for GO and KEGG enrichment analyses. The FerrDb database was based to yield ferroptosis‐related DEGs. Hub genes were then screened out using the cytoHubba database and validated in clinical samples. Immune cells infiltrating into the glioma tissues were analysed using the CIBERSORT R script. The association of gene signature underlying the m6A‐related ferroptosis with tumour‐infiltrating immune cells and immune checkpoints in low‐grade gliomas was analysed. Of 6298 DEGs enriched in mRNA modifications, 144 were ferroptosis‐related; NFE2L2 and METTL16 showed the strongest positive correlation. METTL16 knockdown inhibited the migrative and invasive abilities of glioma cells and induced ferroptosis in vitro. NFE2L2 was enriched in the anti‐m6A antibody. Moreover, METTL16 knockdown reduced the mRNA stability and level of NFE2L2 (both p < 0.05). Proportions of CD8+ T lymphocytes, activated mast cells and M2 macrophages differed between low‐grade gliomas and normal tissues. METTL16 expression was negatively correlated with CD8+ T lymphocytes, while that of NFE2L2 was positively correlated with M2 macrophages and immune checkpoints in low‐grade gliomas. Gene signatures involved in the m6A‐related ferroptosis in gliomas were identified via bioinformatic analyses. NFE2L2 interacted with METTL16 to regulate the immune response in low‐grade gliomas, and both molecules may be novel therapeutic targets for gliomas.
Effect of vacuum combined with ultrasound on color protection of pomegranate juice
Authors: Jiang Chunlu , Zhang Min , Wang Yuchuan , Shen Dongbei , Law Chung Lim , Luo Zhenjiang
Published: September 2024

Pomegranate juice is prone to color fission during processing and storage due to the instability of anthocyanins, resulting in significant economic losses. This study aims to inhibit the browning of pomegranate juice during processing using the combined technology of vacuum and ultrasound for maintaining its color as much as possible. Pomegranate juice was treated with vacuum (0.5 MPa) and ultrasound (300, 600, 900, 1200, and 1500 W; 15, 20, 25, 30, and 35 min), respectively, to investigate the effects on the color, antioxidant capacity, anthocyanin/polyphenol content, and polyphenol oxidase activity of pomegranate juice. The results showed that the combined treatment of vacuum and ultrasound had a better effect on improving the total anthocyanin content of pomegranate juice than vacuum or ultrasound treatment alone. Vacuum combined with ultrasound can reduce the browning during pomegranate juice processing, increasing browning inhibition rates by 46.01% and 46.19%; reduce the activity of PPO enzyme and increase the inhibition rate of PPO enzyme activity by 35.58%; maintain a high total phenolic content, increasing the total phenolic content of pomegranate juice by 29.27% and 33.79%, respectively; and improve the ABTS scavenging rates by 2.89% and 1.92%, and increase DPPH scavenging rates by 1.35% and 3.01%. Moreover, vacuum ultrasound treatment had no significant effect on the odor of pomegranate juice. Vacuum combined with ultrasonic treatment is beneficial for protecting the color of pomegranate juice and improving its antioxidant performance during the processing. Therefore, combined technology of vacuum and ultrasound would be a promising method for future food processing.

Practical applications

This study provides a simple and novel method for protecting the color of pomegranate juice during processing. The combination of vacuum and ultrasound has a certain protective effect on the color of pomegranate juice during processing, and also provides new ideas for color protection research.
Insights from user experience and evaluation of a mobile health nutrition intervention for children with autism: A qualitative study
Authors: Slater Courtney N. , Schroeder Krista , Fultz Amanda , Kuschner Emily S. , O'Malley Lauren , Johnson Kelsey , Benvenuti Teresa , Chittams Jesse , Quinn Ryan J. , Graham Thomas J. , Pinto‐Martin Jennifer , Levy Susan E. , Kral Tanja V. E.
Published: September 2024

Background

Children with autism spectrum disorder (ASD) experience high rates of atypical eating behaviours, such as food neophobia. Mobile health (mHealth) interventions have been found to improve communication, behaviour and social skills for children with ASD. However, there is limited evidence examining mHealth nutrition interventions among children with ASD.

Methods

The present study comprised a qualitative descriptive study that used qualitative content analysis to explore parent and child experiences with a novel mHealth nutrition intervention. Ten parent–child dyads provided user feedback and evaluation of the intervention. Data collection tools included a semistructured interview guide and a quantitative questionnaire with open‐ended questions. Data analysis of the interview transcripts and open‐ended questionnaire responses was an iterative process that continued until saturation was achieved. Descriptive statistics were used to analyse quantitative questionnaire data.

Results

Analysis of the qualitative semistructured interviews led to emergence of three themes: (1) positive intervention outcomes; (2) parent suggestions for improvement; and (3) barriers to engagement. Each theme included subthemes. Questionnaire data revealed the ability to pick rewards and the virtual character that reinforced dietary goals (“Nutrition Ninja”) were the most liked components of the application. Sending messages within the application and the Nutrition Ninja game were the least liked components of the application.

Conclusions

Collectively, findings indicated that the app served as an interactive tool prompting dietary change and conversations within families. Yet, for some families, the intervention design, resistance to change or child disinterest hindered use and implementation of the intervention.
Diffuse Large B‐Cell Lymphoma in a Cynomolgus Monkey
Authors: Li Heling , Zhang Long , Chen Zhigang , Zong Faliang , Tian Baohong , Chen Xinglong , Liu Deli , Ning Qing , Wang Hong
Published: September 2024

A captive 17‐year‐old male cynomolgus monkey (Macaca fascicularis) developed diffuse large B‐cell lymphoma (DLBCL). This was the first report of DLBCL presenting with a mandible mass and violation of the paranasal sinus in a cynomolgus monkey. The neoplasm showed marked microscopical malignant aspects. Immunohistochemical staining showed strong positive expression of CD20. These features may contribute to the diagnosis and therapeutics of DLBCL in NHPs.
Luteinizing hormone supplementation with human menopausal gonadotropin versus low dose human chorionic gonadotropin during ovarian stimulation does not affect live birth rates after fresh and frozen embryo transfer
Authors: Fischer Linnea , Chung Rebecca K. , Kim Sung Tae , Flyckt Rebecca , Weinerman Rachel
Published: September 2024

Aim

Luteinizing hormone (LH) plays an important role in ovarian follicle maturation. Human menopausal gonadotropin (hMG) or low dose human chorionic gonadotropin (hCG) can provide LH supplementation during in vitro fertilization (IVF) ovarian stimulation, though studies directly comparing their impact on IVF outcomes are limited. The aim of the study was to determine whether LH supplementation with hMG versus low dose hCG during IVF stimulation affects live birth rate.

Methods

Fresh and frozen embryo transfers (ET) from 2017 to 2021 after standard long or antagonist protocols supplemented with hMG (75–250 IU) or low dose hCG (50–100 IU) during stimulation cycles in our academic center were included. Statistical analysis was performed with T‐tests, Mann–Whitney U tests, Chi‐square, and multiple linear and logistic regression.

Results

Four hundred and sixty eight unique stimulation cycles resulting in 213 fresh and 412 frozen embryo transfers were analyzed. There was a lower mature oocyte yield (10.9 vs. 11.8, p = 0.044) but similar high‐quality blastocyst yield (3.6 vs. 3.9, p = 0.11) for hMG vs low dose hCG. Live birth rates per transfer were comparable for fresh (42% vs. 49%, p = 0.24) and frozen (46% vs. 53%, p = 0.45) embryo transfers. Multiple logistic regressions showed no association between supplemental gonadotropin and live birth for both fresh and frozen embryo transfers.

Conclusion

Fresh and frozen IVF‐ET pregnancy outcomes were comparable after hMG versus low dose hCG supplementation, suggesting flexibility in supplemental LH dosing regimens that may address patient or physician preference or cost concerns.
Insurtech, sensor data, and changes in customers' coverage choices: Evidence from usage‐based automobile insurance
Authors: Soleymanian Miremad , Weinberg Charles B. , Zhu Ting
Published: September 2024

In this paper, we examine the role of usage‐based auto insurance on customers' decisions to change their insurance coverage at the renewal. Using a sample of 135,540 customers, we study whether usage‐based insurance (UBI) can facilitate the upselling and cross‐selling efforts of the firm, possibly leading to higher coverage choices and additional insurance product purchases. Our results suggest that UBI customers are more likely to change their coverage choice than non‐UBI customers at first (but not second) renewal. Both price discounts and the information provided by UBI affect the customers' coverage changes. Among UBI customers, those who get higher UBI discounts are more likely to both increase their insurance coverage (upselling) and add the comprehensive coverage option (cross‐selling), which is not directly related to driving behavior at the time of first (annual) renewal. Moreover, customers who have received more negative feedback (daily hard brakes) are more likely to increase their insurance coverage.
Long‐term clinical outcomes of healthy dogs with increased alanine aminotransferase
Authors: Adams J.
Published: September 2024

Objectives

To define a reference interval for alanine aminotransferase for the practice laboratory and then identify and longitudinally follow the clinical health and alanine aminotransferase levels in a cohort of clinically healthy dogs with increased alanine aminotransferase levels documented during wellness screening.

Materials and Methods

Alanine aminotransferase levels of 125 clinically healthy dogs were used to define a reference interval for the practice laboratory. The electronic records of 315 clinically healthy dogs which had undergone wellness screening including assessment of alanine aminotransferase levels at a first‐opinion veterinary hospital in the UK were reviewed between January 2012 and January 2023. Clinically healthy dogs with increased alanine aminotransferase levels relative to the top of the reference interval determined for the practice on at least one test during the study period were identified. These were longitudinally followed through electronic medical records to determine their long‐term clinical outcomes over a period of up to 11 years.

Results

The reference interval for alanine aminotransferase in the practice laboratory was calculated as 10.6 to 181.8 U/L. Nineteen clinically healthy dogs were identified as having increased alanine aminotransferase levels. One dog from the group with increased alanine aminotransferase levels was diagnosed with chronic hepatitis and died of liver failure, while the other 18 dogs died of other causes, or were still alive at the end of the study, with no clinical signs associated with liver disease. One dog in the group with consistently normal alanine aminotransferase levels also died from clinical signs attributed to liver disease.

Clinical Significance

Only a small proportion of clinically healthy dogs with increased alanine aminotransferase levels documented on wellness screening developed clinically relevant liver dysfunction over long‐term follow‐up.
Population genomics of seal lice provides insights into the postglacial history of northern European seals
Authors: Sromek Ludmila , Johnson Kevin P. , Kunnasranta Mervi , Ylinen Eeva , Virrueta Herrera Stephany , Andrievskaya Elena , Alexeev Vyacheslav , Rusinek Olga , Rosing‐Asvid Aqqalu , Nyman Tommi
Published: September 2024

Genetic analyses of host‐specific parasites can elucidate the evolutionary histories and biological features of their hosts. Here, we used population‐genomic analyses of ectoparasitic seal lice (Echinophthirius horridus) to shed light on the postglacial history of seals in the Arctic Ocean and the Baltic Sea region. One key question was the enigmatic origin of relict landlocked ringed seal populations in lakes Saimaa and Ladoga in northern Europe. We found that that lice of four postglacially diverged subspecies of the ringed seal (Pusa hispida) and Baltic gray seal (Halichoerus grypus), like their hosts, form genetically differentiated entities. Using coalescent‐based demographic inference, we show that the sequence of divergences of the louse populations is consistent with the geological history of lake formation. In addition, local effective population sizes of the lice are generally proportional to the census sizes of their respective seal host populations. Genome‐based reconstructions of long‐term effective population sizes revealed clear differences among louse populations associated with gray versus ringed seals, with apparent links to Pleistocene and Holocene climatic variation as well as to the isolation histories of ringed seal subspecies. Interestingly, our analyses also revealed ancient gene flow between the lice of Baltic gray and ringed seals, suggesting that the distributions of Baltic seals overlapped to a greater extent in the past than is the case today. Taken together, our results demonstrate how genomic information from specialized parasites with higher mutation and substitution rates than their hosts can potentially illuminate finer scale population genetic patterns than similar data from their hosts.
Virtuous leadership: Ambiguities, challenges, and precedents
Authors: Haldane John
Published: September 2024

Virtuous leadership is the focus of a growing body of academic literature but is little discussed by contemporary philosophers. Current treatments tend to over‐generalisation: assimilating diverse features to a few broad categories and applying simplified ethical theories. This essay argues that virtue and character education need to be keyed to specific activities, that “virtuous leadership” is in danger of being confused with extrinsic activism, and that the history of ethics in health care provides an instructive example of thinking ethically about practice. Questions commonly posed in the literature—What specific virtues are required for leadership? How may these be formed?—are unduly simple and often rest on faulty assumptions about the nature of leadership and of the structure of virtuous action. Philosophers engaged in advising professionals about the virtues of leadership would do well to consider how the relevant points apply to their own practice.
Does the subjective response during the measurement of fusional reserves affect the clinical diagnosis?
Authors: Rovira‐Gay Cristina , Argilés Marc , Mestre Clara , Vinuela‐Navarro Valldeflors , Pujol Jaume
Published: September 2024

Introduction

Fusional reserves differ with the method of measurement. The goal of this study was to compare the subjective and objective responses during the measurement of positive and negative fusional reserves using both step and ramp methods.

Methods

A haploscopic system was used to measure fusional reserves. Eye movements were recorded using an EyeLink 1000 Plus eye tracker (SR Research). The stimulus disparity was changed to either mimic a prism bar (steps) or a Risley prism (ramp). Subjective responses were obtained by pressing a key on the keyboard, whereas objective break and recovery points were determined offline using a custom algorithm coded in Matlab.

Results

Thirty‐three adults participated in this study. For the ramp method, the subjective and objective responses were similar for the negative (break and recovery points (t(32) = −0.82, p = 0.42) and (t(32) = 0.42, p = 0.67), respectively) and positive fusional reserves (break and recovery points (U = −1.34, p = 0.18) and t(19) = −0.25, p = 0.81), respectively). For the step method, no significant differences in positive fusional reserves were observed when measured subjectively and objectively for the break (t(32) = 1.27, p = 0.21) or the recovery point (U = −2.02, Bonferroni‐adjusted p = 0.04). For the negative fusional reserve, differences were not significant for either the break or recovery points (U = −0.10, p = 0.92 and t(19) = 1.17, p = 0.26, respectively).

Conclusion

Subjective and objective responses exhibited good agreement when measured with the ramp and step methods.
Etiologies of atrioventricular block in young patients: A single‐center study in China
Authors: Zheng Jianhong , Chen Xin , Luo Guanhao , Zhang Qianhuan , Liao Hongtao , Deng Hai , Fang Xianhong , Xue Yumei , Liu Yang , Wu Shulin
Published: September 2024

Background

Atrioventricular block (AVB) is common in the elderly and therefore considered to be a degenerative disease of the cardiac conduction system. However, there exist other etiologies contributing to AVB in young patients. This study aimed to determine the etiologies in patients aged before 60 years receiving their first pacemaker implantation for AVB in China.

Methods and Results

Medical records and diagnostic tests of AVB patients were reviewed to identify the etiologies between 2010 and 2021 at Guangdong Provincial People's Hospital. Eight hundred and twenty‐six patients (median age 47 years; 47.9% males) were included. The etiologies were identified in 336 (40.7%) cases, including complications to cardiac surgery (n = 190 [23.0%]), myocarditis (n = 57 [6.9%]), myocardial infarction (n = 25 [3.0%]), complications to catheter‐based interventional procedures (n = 21 [2.5%]) and others (n = 43 [5.2%]). AVB caused by myocardial infarction was more common in men (5.8% vs. 0.5%, p < .001), while women received pacing treatment earlier (48 vs. 46 years, p = .019). Men were more likely to suffer from dilated cardiomyopathy (6.6% vs. 2.1%, p = .001) and atrial fibrillation/flutter (23.0% vs. 12.8%, p < .001). The number of first pacemaker implantation increased with age especially among patients with unclear etiologies.

Conclusion

The etiology of AVB was only determined in approximately 40% of patients receiving their first pacemaker implantation aged before 60 years. The predominance of AVB with unknown etiology and potential gender differences warrants further studies.
Coronary sinus signal amplitude: A predictor of the atrial substrate and low voltage areas
Authors: Mohsen Yazan , Großmann Nora , Draheim Jennifer , Horlitz Marc , Stöckigt Florian
Published: September 2024

Background

Low voltage areas (LVA) are pivotal in atrial fibrillation (AF) pathogenesis, influencing local left atrial LA excitation and perpetuating AF occurrences. While pulmonary vein isolation (PVI) with cryo‐balloon (CB) ablation is effective for AF, it doesn't provide insights into the LA substrate or detect LVA, which affects ablation success rates. This study examines whether LA voltage and LVAs can be anticipated by analyzing the voltage signal amplitude at the coronary sinus (CS) catheter, which is standard in CB and radiofrequency ablation procedures.

Methods

A retrospective analysis of 284 patients with recurrent AF undergoing RF catheter ablation was conducted at a high‐volume EP center in Germany. The correlation between LA voltage and LVA with the CS signal was explored.

Results

The signal amplitude in the CS significantly correlated with voltage in LA walls, particularly in the proximal CS (correlation coefficient ρ = 0.81, p < 0.001). A CS signal cut‐off of 1.155 mV effectively predicted severe atrial LVAs (>40%) with a sensitivity of 90.7% and a specificity of 100%. While a threshold of 1.945 mV identified patients with no significant atrial LVAs (<5%) with a sensitivity of 88% and a specificity of 50% (AUC: 0.81, 95% CI: 0.71–0.89, p < 0.001).

Conclusion

The CS signal amplitude is associated with the LA voltage. Due to its potential as a diagnostic tool for atrial LVAs, the signal amplitude in the CS could provide valuable information about the LA substrate, especially when 3D mapping is not feasible.
Uptake and translocation of nanoplastics in mono and dicot vegetables
Authors: Zytowski Eric , Mollavali Mohanna , Baldermann Susanne
Published: September 2024

The excessive production and use of plastics increase the release of micro‐ and nanoplastics (MNPs) into the environment. In recent years, research has focused on the occurrence of MNPs in air, soil and water. Nevertheless, there is still a lack of knowledge regarding MNPs in plants. To determine the load, translocation of MNPs and their effects on metabolism, pak choi, tomato, radish and asparagus have been exposed with fluorescent‐labelled poly(methyl methacrylate) or polystyrene (PS) MNPs. The entry of nanoparticles (NPs) of various sizes (100–500 nm) and surface modifications (unmodified, COOH or NH2) into plants has been demonstrated using confocal laser scanning microscopy (CLSM). The translocalization from root to shoot and the accumulation of NP in the intercellular spaces were regardless of the surface modification. In addition, metabolomics was used to evaluate metabolic changes induced by MNPs in pak choi. Changes in phenolic compounds, phytohormone derivatives and other classes of compounds known to be triggered by various environmental stresses have been identified. The present study demonstrates the uptake and translocalization of MNPs in edible parts of vegetables and may pose a hazard for humans.
Concurrent Measurement of O2 Production and Isoprene Emission During Photosynthesis: Pros, Cons and Metabolic Implications of Responses to Light, CO2 and Temperature
Authors: Jardine Kolby Jeremiah , Som Suman , Gallo Luiza Beraldi , Demus Jilian , Domingues Tomas Ferreira , Wistrom Christina Marie , Gu Lianhong , Tcherkez Guillaume , Niinemets Ülo
Published: September 2024

Traditional leaf gas exchange experiments have focused on net CO2 exchange (Anet). Here, using California poplar (Populus trichocarpa), we coupled measurements of net oxygen production (NOP), isoprene emissions and δ18O in O2 to traditional CO2/H2O gas exchange with chlorophyll fluorescence, and measured light, CO2 and temperature response curves. This allowed us to obtain a comprehensive picture of the photosynthetic redox budget including electron transport rate (ETR) and estimates of the mean assimilatory quotient (AQ = Anet/NOP). We found that Anet and NOP were linearly correlated across environmental gradients with similar observed AQ values during light (1.25 ± 0.05) and CO2 responses (1.23 ± 0.07). In contrast, AQ was suppressed during leaf temperature responses in the light (0.87 ± 0.28), potentially due to the acceleration of alternative ETR sinks like lipid synthesis. Anet and NOP had an optimum temperature (Topt) of 31°C, while ETR and δ18O in O2 (35°C) and isoprene emissions (39°C) had distinctly higher Topt. The results confirm a tight connection between water oxidation and ETR and support a view of light‐dependent lipid synthesis primarily driven by photosynthetic ATP/NADPH not consumed by the Calvin–Benson cycle, as an important thermotolerance mechanism linked with high rates of (photo)respiration and CO2/O2 recycling.
Temporal Gene Expression Profiles From Pollination to Seed Maturity in Sorghum Provide Core Candidates for Engineering Seed Traits
Authors: Jain Rubi , Dhaka Namrata , Krishnan Kushagra , Yadav Garima , Priyam Prachi , Sharma Manoj Kumar , Sharma Rita A.
Published: September 2024

Sorghum (Sorghum bicolor (L.) Moench) is a highly nutritional multipurpose millet crop. However, the genetic and molecular regulatory mechanisms governing sorghum grain development and the associated agronomic traits remain unexplored. In this study, we performed a comprehensive transcriptomic analysis of pistils collected 1–2 days before pollination, and developing seeds collected –2, 10, 20 and 30 days after pollination of S. bicolor variety M35‐1. Out of 31 337 genes expressed in these stages, 12 804 were differentially expressed in the consecutive stages of seed development. These exhibited 10 dominant expression patterns correlated with the distinct pathways and gene functions. Functional analysis, based on the pathway mapping, transcription factor enrichment and orthology, delineated the key patterns associated with pollination, fertilization, early seed development, grain filling and seed maturation. Furthermore, colocalization with previously reported quantitative trait loci (QTLs) for grain weight/size revealed 48 differentially expressed genes mapping to these QTL regions. Comprehensive literature mining integrated with QTL mapping and expression data shortlisted 25, 17 and 8 core candidates for engineering grain size, starch and protein content, respectively.
Balancing barriers and strategies – Nurses’ experiences of conducting lifestyle counseling
Authors: Behm Lina , Brånhage Maja , Jönsson Sofie , Rask Marie
Published: September 2024

Objectives

Over 70% of the disease burden in Europe is the result of chronic diseases caused by lifestyle. Lifestyle counseling can improve lifestyle habits and thereby health. However, according to research, there are several barriers to healthcare personnel carrying out counseling. The aim of this study was to explore nurses’ experiences of conducting lifestyle counseling.

Design

A qualitative descriptive study was conducted in southern Sweden between August 2021 and December 2021.

Sample

Eleven nurses were recruited from both inpatient and outpatient care in northeastern Sweden through a combination of purposive and snowball sampling.

Measurements

Individual semistructured interviews were performed digitally using an interview guide. The interviews were analyzed via qualitative content analysis.

Results

The nurses experienced several challenges in performing lifestyle counseling. However, knowledge gaps, sensitive topics, organizational dynamics, and time constraints were balanced using strategies. The theme of their responses can be explained by the following categories: “Collaboration with patients is key,” “From self‐interest to teamwork,” and “The organization can assist or hinder.”

Conclusions

Lifestyle counseling needs to be prioritized within healthcare. Nurses need tools and knowledge to be able to feel comfortable with the task. All healthcare organizations need to work with lifestyle counseling in a structured way according to national guidelines.
Unravelling soybean responses to early and late Tetranychus urticae (Acari: Tetranychidae) infestation
Authors: Ruffatto K. , da Silva L. C. O. , Neves C. d. O. , Kuntzler S. G. , de Lima J. C. , Almeida F. A. , Silveira V. , Corrêa F. M. , Minello L. V. P. , Johann L. , Sperotto R. A.
Published: September 2024

Soybean is a crucial source of food, protein, and oil worldwide that is facing challenges from biotic stresses. Infestation of Tetranychus urticae Koch (Acari: Tetranychidae) stands out as detrimentally affecting plant growth and grain production. Understanding soybean responses to T. urticae infestation is pivotal for unravelling the dynamics of mite–plant interactions. We evaluated the physiological and molecular responses of soybean plants to mite infestation after 5 and 21 days.

We employed visual/microscopy observations of leaf damage, H2O2 accumulation, and lipid peroxidation. Additionally, the impact of mite infestation on shoot length/dry weight, chlorophyll concentration, and development stages was analysed. Proteomic analysis identified differentially abundant proteins (DAPs) after early (5 days) and late (21 days) infestation. Furthermore, GO, KEGG, and protein–protein interaction analyses were performed to understand effects on metabolic pathways.

Throughout the analysed period, symptoms of leaf damage, H2O2 accumulation, and lipid peroxidation consistently increased. Mite infestation reduced shoot length/dry weight, chlorophyll concentration, and development stage duration. Proteomics revealed 185 and 266 DAPs after early and late mite infestation, respectively, indicating a complex remodelling of metabolic pathways. Photorespiration, chlorophyll synthesis, amino acid metabolism, and Krebs cycle/energy production were impacted after both early and late infestation. Additionally, specific metabolic pathways were modified only after early or late infestation.

This study underscores the detrimental effects of mite infestation on soybean physiology and metabolism. DAPs offer potential in breeding programs for enhanced resistance. Overall, this research highlights the complex nature of soybean response to mite infestation, providing insights for intervention and breeding strategies.
The contributions of the Iranian health‐care system in the crisismanship of COVID‐19: A qualitative study
Authors: Farazmand Ali , Danaeefard Hassan , Ghanbary Vanani Raziyeh
Published: September 2024

This study aims to comprehend the contributions of Iran's health‐care system (HCS) in the “crisismanship” of the coronavirus (COVID‐19) pandemic from the perspectives of citizens, policy makers, managers, and public sector employees. The primary question is what have been the contributions of Iran's HCS in the crisismanship of COVID‐19? The study was designed and conducted using a qualitative strategy. It is reported that three core contributions were made: (1) the leadership of “a whole of crisis governance,” (2) the leading “a whole of crisis management,” and (3) conducting “a whole of operational activities during the COVID‐19.” Through this empirical study, we hope to fill a gap by examining the leadership contributions of the Iranian HCS in fighting COVID‐19. The findings of this study can provide researchers and thinkers with insights into policy and strategy making in times of crises such as those surrounding COVID‐19.

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Gray Matter Volumes Mediate the Relationship Between Disease Duration and Balance Control Performance in Chronic Ankle Instability
Authors: Xu Zhen , Xiao Songlin , Shen Bin , Zhang Chuyi , Zhan Jianglong , Li Jun , Li Jingjing , Zhou Junhong , Fu Weijie
Published: September 2024

The relationship between structural changes in the cerebral gray matter and diminished balance control performance in patients with chronic ankle instability (CAI) has remained unclear. This paper aimed to assess the difference in gray matter volume (GMV) between participants with CAI and healthy controls (HC) and to characterize the role of GMV in the relationship between disease duration and balance performance in CAI. 42 participants with CAI and 33 HC completed the structural brain MRI scans, one‐legged standing test, and Y‐balance test. Regional GMV was measured by applying voxel‐based morphometry methods. The result showed that, compared with HC, participants with CAI exhibited lower GMV in multiple brain regions (familywise error [FWE] corrected p < 0.021). Within CAI only, but not in HC, lower GMV in the thalamus (β = −0.53, p = 0.003) and hippocampus (β = −0.57, p = 0.001) was associated with faster sway velocity of the center of pressure (CoP) in eyes closed condition (i.e., worse balance control performance). The GMV in the thalamus (percentage mediated [PM] = 32.02%; indirect effect β = 0.119, 95% CI = 0.003 to 0.282) and hippocampus (PM = 33.71%; indirect effect β = 0.122, 95% CI = 0.005 to 0.278) significantly mediated the association between the disease duration and balance performance. These findings suggest that the structural characteristics of the supraspinal elements is critical to the maintenance of balance control performance in individuals suffering from CAI, which deserve careful consideration in the management and rehabilitation programs in this population.
Refining cPRA calculation to improve HLA compatibility assessment in organ transplantation: A detailed picture of the Paris waiting list
Authors: Usureau Cédric , Lhotte Romain , Clichet Valentin , Foroutan Alexandre , Devriese Magali , Taupin Jean‐Luc
Published: September 2024

The determination of panel reactive antibodies (cPRA) scores plays a critical role in assessing the immunological compatibility between organ transplant recipients and potential donors. Traditional cPRA methods focus on a limited number of HLA loci using physical cytotoxicity tests. However, advancements such as the Luminex single antigen (LSA) assay, which uses mean fluorescence intensity (MFI) of individualised HLA antigens for antibody evaluation, provide a foundation for a more precise assessment. We developed cPRAdictor, a novel cPRA calculation tool using a large series of HLA‐type individuals in France with NGS. cPRAdictor was applied to a cohort of 5962 kidney transplant candidates in Paris. We analysed how extending the range of HLA specificities could affect cPRA values. Implementing cPRAdictor revealed and allowed quantification of the significant discrepancies in cPRA values that appeared when HLA loci C and DP, and antigen‐specific antibodies were taken into account. Notably, over 43% of the immunised transplant candidates showed an increase in calculated cPRA values when considering C/DP loci and antigen‐specific antibodies, negatively impacting their eligibility and prioritisation in the transplantation programme. These findings highlight the necessity of revisiting cPRA calculation methodologies to include a broader spectrum of immunological data, as more exhaustive and precise information regarding anti‐HLA antibodies in patients' sera and donor and recipient HLA typing are available prospectively. This will strongly improve both accuracy and equity at the organ allocation step, especially for highly sensitised candidates for whom organ offers are very limited in number.
Esp in Action: Application of LEM in Gaziantep Industry Through Online Language Teaching
Authors: Tilfarlioğlu Filiz Yalçin , Yavuz Emine
Published: September 2024

The study was conducted in Gaziantep, an industrial city in the Southeastern Anatolia region of Turkiye. This study was a joint effort of Gaziantep University and a company that participated in many international activities. Through fieldwork and literature reviews, it was determined that there are no foreign language studies towards business people and business English in Gaziantep. The objectives of this study, was aimed at business people and the business world, were determined based on this preliminary research and existing foreign language teaching studies; the goal was to determine how to close the language gap in the business world. Distance education was used to make the study easy to access; for participants to be able to access the training program at any time and place. After necessary procedures were established, the employees who could participate in the project were determined. The employees' primary needs and foreign language levels were determined with a pre-test and a need analysis. A training model was developed accordingly, and the eight-week training was started. The training content was organized according to the lean educational method, considering the needs of all participants, and the efficiency of the method in question was examined. Training content, incorporating technological tools and interactive materials, was planned to ensure that participants enjoyed learning throughout the course. The success of the training was evaluated based on findings obtained by comparing pre-test and post-test results. In light of these findings, it has been proven that language success can be increased quickly by using the lean educational method effectively. It has been determined that great success can be achieved quickly with the lean educational method, a training model used to achieve rapid success in areas for adult groups and the business world. In addition, this study determined that people with time constraints could easily participate in the program with distance education and save time while doing so.