bluuebunny/crossref_metadata_2025 huggingface dataset:
OpenSAFELY: The impact of COVID‐19 on azathioprine, leflunomide and methotrexate monitoring, and factors associated with change in monitoring rate
Authors: Brown Andrew D. , Fisher Louis , Curtis Helen J. , Wiedemann Milan , Hulme William J. , Speed Victoria , Hopcroft Lisa E. M. , Cunningham Christine , Costello Ruth E. , Galloway James B. , Russell Mark D. , Bechman Katie , Kurt Zeyneb , Croker Richard , Wood Chris , Walker Alex J. , Schaffer Andrea L. , Bacon Seb C. J. , Mehrkar Amir , Hickman George , Bates Chris , Cockburn Jonathan , Parry John , Hester Frank , Harper Sam , Goldacre Ben ,   The OpenSAFELY Collaborative, MacKenna Brian
Published: April 2024

Aims

The COVID‐19 pandemic created unprecedented pressure on healthcare services. This study investigates whether disease‐modifying antirheumatic drug (DMARD) safety monitoring was affected during the COVID‐19 pandemic.

Methods

A population‐based cohort study was conducted using the OpenSAFELY platform to access electronic health record data from 24.2 million patients registered at general practices using TPP's SystmOne software. Patients were included for further analysis if prescribed azathioprine, leflunomide or methotrexate between November 2019 and July 2022. Outcomes were assessed as monthly trends and variation between various sociodemographic and clinical groups for adherence with standard safety monitoring recommendations.

Results

An acute increase in the rate of missed monitoring occurred across the study population (+12.4 percentage points) when lockdown measures were implemented in March 2020. This increase was more pronounced for some patient groups (70–79 year‐olds: +13.7 percentage points; females: +12.8 percentage points), regions (North West: +17.0 percentage points), medications (leflunomide: +20.7 percentage points) and monitoring tests (blood pressure: +24.5 percentage points). Missed monitoring rates decreased substantially for all groups by July 2022. Consistent differences were observed in overall missed monitoring rates between several groups throughout the study.

Conclusion

DMARD monitoring rates temporarily deteriorated during the COVID‐19 pandemic. Deterioration coincided with the onset of lockdown measures, with monitoring rates recovering rapidly as lockdown measures were eased. Differences observed in monitoring rates between medications, tests, regions and patient groups highlight opportunities to tackle potential inequalities in the provision or uptake of monitoring services. Further research should evaluate the causes of the differences identified between groups.
Self‐regulation and shared regulation in collaborative learning in adaptive digital learning environments: A systematic review of empirical studies
Authors: Sharma Kshitij , Nguyen Andy , Hong Yvonne
Published: April 2024

Adaptive learning technologies are closely related to learners' self‐regulatory processes in individual and collaborative learning. This study presents the outcomes of a systematic literature review of empirical evidence on adaptive learning environments to foster self‐regulation and shared regulation of learning in collaborative settings. We provide an overview of what and how adaptive technologies have been used to understand and promote self‐regulated learning in collaborative contexts. A search resulted in 38 papers being analysed. Specifically, we identified the seven main objectives (feedback and scaffolding, self‐regulatory skills and strategies, learning trajectories, collaborative learning processes, adaptation and regulation, self‐assessment, and help‐seeking behaviour) that the adaptive technology research has been focusing on. We also summarize the implications derived from the reviewed papers and frame them within seven thematic areas. Finally, this review stresses that future research should consider developing a converging theoretical framework that would enable concrete monitoring and support for self‐regulation and socially shared regulation of learning. Our findings set a baseline to support the adoption and proliferation of adaptive learning technology within self‐regulated learning research and development.

Practitioner notes

What is already known about this topic

By providing personalized and learner‐centric adaptive learning environments (ADLEs), adaptive learning technology can support and foster self‐regulated learning (SRL) practices.

It is possible to create a more student‐centred and effective learning environment by combining adaptive learning and collaborative learning.

Socially shared regulatory activities can involve planning, monitoring, controlling and reflecting on a group's learning processes.

What this paper adds

Provides a systematic literature review of empirical evidence on ADLEs, SRL and socially shared regulation of learning (SSRL) in collaborative contexts.

Summarizes the insights on (S)SRL through ADLEs in collaborative learning.

Identifies challenges and opportunities for ADLEs to support (S)SRL in collaborative learning.

Implications for practice and/or policy

Learning analytics and educational technology researchers will be able to use the systematic review as a guide for future research.

Learning analytics and educational technology practitioners will be able to use the systematic review as a summary of the field's current state.
Ageing, osteoporosis and intellectual disability; risks differ, and diagnosis can be missed
Authors: Burke Eilish A. , Carroll Rachael , O'Dwyer Maire , Walsh J Bernard , McCallion Philip , McCarron Mary
Published: April 2024

Background

People with intellectual disability often present atypically for various health conditions, making it challenging to identify concerns, particularly when communication challenges are also considered. Additionally, they may face barriers to healthcare access, resulting in many conditions going unnoticed. Health screening inequities are also evident in this population, and osteoporosis, a silent condition often only diagnosed postfracture, requires screening; however, if this does not happen, it may result in unnecessary fracture. Therefore the aim of this study is to identify predictors of osteoporosis in older adults with intellectual disability and examine potential inequity in the diagnosis of the condition.

Methods

The study used data from the Intellectual Disability Supplement to The Irish Longitudinal Study on Ageing (IDS‐TILDA). Bone quality was measured using quantitative ultrasound (QUS). Logistic regression was performed to identify significant predictors of poor bone quality, including chronic health conditions, dietary intake, medication use and activity levels.

Results

Out of 575 participants who completed QUS, osteoporosis prevalence was objectively measured at 41%, with a further 33.2% measured within the osteopenic range, but less than 2 in 10 had a doctor's diagnosis of osteoporosis. Reported Dual‐Energy X‐ray Absorptiometry screening uptake was low at 18.2%. Three major predictor variables of osteoporosis and osteopenia were found significant: difficulty walking 100 yards, taking antiepileptic drugs medicines and taking proton pump inhibitors. The model achieved an overall classification accuracy of 70.8% for osteopenia and 72.5% for identifying osteoporosis.

Conclusion

The study highlights the different risk factors in people with intellectual disability, the potential for missed diagnoses and the likelihood there is inadequate screening. There is an urgent need for robust risk assessment and reasonable adjustments to ensure equitable screening and targeted preventive strategies. Clinicians must consider specific concerns for this population to avoid missed diagnoses and reduce the adverse effects of osteoporosis/osteopenia, such as an increased risk of fragility fractures.
Molecular detection of Lotmaria passim in intestine of Japanese honeybees (Apis cerana japonica)
Authors: Suzuki Akihiko , Sakamoto Yoshiko
Published: April 2024

Crithidia mellificae and Lotmaria passim are trypanosomatids that infect honeybees, and many studies suggest that both parasites contribute to the decline in the honeybee population. The Japanese honeybee (Apis cerana japonica) is a native honeybee that inhabits various areas of Japan and is one of the most important pollinators. Both parasites have been well studied in the western honeybee (Apis mellifera) but have been poorly investigated in A. c. japonica. The present study investigated the presence of C. mellificae and L. passim in one feral and six managed A. c. japonica colonies at three different institutes. Five out of seven colonies were polymerase chain reaction‐positive for L. passim (71.4%); however, C. mellificae was not detected. Four of the five colonies were positive in both the midgut and hindgut, but one was positive only in the hindgut. A homology search and phylogenetic tree of the glycosomal glyceraldehyde‐3‐phosphate dehydrogenase (gGAPDH) and cytochrome b (Cytb) genes obtained in this study indicated that the sequences belonged to L. passim. The results of this study emphasize concerns regarding the health of this ecologically important pollinator and the importance of further investigation of the prevalence of L. passim in A. c. japonica in a wider area of Japan.
Presence of immunoglobulin E‐expressing antibody‐secreting cells in the dermis close to bullous pemphigoid lesions
Authors: Budair Fatimah , Kambe Naotomo , Kogame Toshiaki , Hirata Masahiro , Takimoto‐Ito Riko , Mostafa Alshimaa , Nomura Takashi , Kabashima Kenji
Published: April 2024

Antibody‐secreting cells (ASCs) produce immunoglobulin (Ig) G and IgE autoantibodies in secondary lymphoid organs. Evidence also suggests their existence in the skin in various chronic inflammatory conditions, and in association with CXCL12 and CXCL13, they regulate the recruitment/survival of ASCs and germinal center formation to generate ASCs, respectively. However, the presence of IgG and IgE in bullous pemphigoid (BP) lesions needs to be addressed. Here, we aimed to analyse BP skin for the presence of IgG and IgE and the factors contributing to their generation, recruitment, and persistence. Skin samples from 30 patients with BP were stained to identify ASCs and the immunoglobulin type they expressed. The presence of tertiary lymphoid organ (TLO) elements, which generate ASCs in non‐lymphoid tissues, and the chemokines CXCL12 and CXCL13, which regulate the migration/persistence of ASCs in lymphoid tissues and formation of TLOs, respectively, were evaluated in BP skin. BP skin harboured ASCs expressing the two types of antibodies IgG and IgE. ASCs were found in high‐grade cellular aggregates containing TLO elements: T cells, B cells, CXCL12+ cells, CXCL13+ cells and high endothelial venules. IgG+ ASCs were detected among these aggregates, whereas IgE+ ASCs were dispersed throughout the dermis. CXCL12+ fibroblast‐like cells were located close to ASCs. The inflammatory microenvironment of BP lesions may contribute to the antibody load characteristic of the skin of patients with BP by providing a site for the presence of ASCs. CXCL13 and CXCL12 expression may contribute to the generation and recruitment/survival of ASCs, respectively.
Maximum sustainable employment: Adding to the beacons of wild fisheries governance
Authors: Bavinck Maarten , Scholtens Joeri , Fabinyi Michael
Published: April 2024

This paper proposes to establish Maximum Sustainable Employment (MSE) as a new guiding light, or beacon, for wild fisheries governance. This new social beacon complements the directives provided by the prevailing beacons: Maximum Sustainable Yield (MSY) and Maximum Economic Yield (MEY). The argument is that context matters: in countries where poverty levels are high and alternative employment is scarce, fisheries governors cannot limit themselves to a sectoral perspective. Instead, they must include the remunerative employment and ‘decent work’ that wild fisheries offer society in their strategic deliberations. This perspective is especially relevant for countries in the Global South, but it also has a bearing on the Global North. After discussing the history of scientific fisheries management and the relevance of employment in fisheries, the paper considers the arguments made against MSE. It concludes with a reflection on the balancing of the three beacons in line with prevailing circumstances.
Characterisation of resistant starch from Vigna unguiculata for the development of an oral‐colon delivery agent
Authors: Sewnarain Priyanta , Dwarka Depika , Mellem John J.
Published: April 2024

There is a significant concern associated with the delivery of chemotherapeutics to the colon due to limited drug absorption in the gastrointestinal tract. Starch has received great interest as a delivery agent owing to its cost efficacy and high availability. In this study, native resistant starch and acid‐modified resistant starch from Vigna unguiculata were used to produce microcapsules containing camptothecin as an oral‐colon‐specific drug delivery agent. Functional characteristics such as solubility, swelling power, amylose content, emulsifying, foaming together with water and oil absorption capacity of native resistant starch and acid‐modified resistant starch were established. The prepared microcapsules were characterised and subjected to simulated digestion with the obtained residue evaluated for cytotoxicity using the MTT assay. It was observed that acid‐modified resistant starch had the best functional properties (water absorption capacity: 2.76 g g−1, oil absorption capacity: 3.13 g g−1, amylose: 35%, foaming capacity: 17.73%, and emulsifying activity: 33.33%) as compared to its native resistant starch (water absorption capacity: 2.03 g g−1, oil absorption capacity: 2.81 g g−1, amylose: 32%, foaming capacity: 4% and emulsifying activity: 23.56%). The microcapsules had a particle size of 0.25–0.35 μm, moisture content between 1.12% and 3.41% and a high encapsulation efficiency of 96.40 and 98.96% for native resistant starch and acid‐modified resistant starch capsules respectively. Results for MTT assay showed cancerous cells to be inhibited by microcapsules with noncancerous cells less affected.
Apigenin encapsulated in spray‐dried liposomes coated with chitosan: heat, pH, light, oxygen, salt and storage stability
Authors: Ang San‐San , Thoo Yin Yin , Siow Lee Fong
Published: April 2024

Apigenin (AP) is a natural flavonoid with multiple health benefits that can be used in functional foods. However, the hydrophobicity and poor aqueous solubility of AP have hindered its food application. With ethanol injection and spray drying, encapsulated AP in dried chitosan‐coated liposomes could be promising in delivering AP via foods. By comparing with the unencapsulated AP, this study examined the potential of spray‐dried chitosan‐coated apigenin liposomes (SCAL) in preserving the AP content and antioxidant capacity against food‐related heat, pH, light, oxygen and salt conditions. The moisture sorption isotherms and storage stability of SCAL were also investigated. The results show that the encapsulated AP in SCAL had better stability against pH (pH 2, pH 4, pH 6 and pH 7), light, oxygen and salt stress (0.1, 0.3 and 0.5 M NaCl) than the unencapsulated AP. The limits of relative humidity (RH) for SCAL storage were found to be <50% at 25 °C, <60% at 35 °C and <70% at 45 °C. SCAL could preserve AP over 90 days in room (86.55–95.42%) and chilled (91.54–95.79%) conditions. These findings suggest the potential of spray‐dried chitosan‐coated liposomes in improving the stability of AP, hence SCAL is promising for delivering AP in functional foods.
Nurses' perspectives on shared decision‐making in the daily care of hospitalized patients with dementia: An exploratory qualitative study
Authors: Plantinga Annette , Roodbol Petrie F. , van Munster Barbara C. , Finnema Evelyn J.
Published: April 2024

Aim

Gain insight into the process of shared decision‐making (SDM) in daily hospital care for patients with dementia from nurses' perspectives.

Design

Explorative qualitative design.

Methods

In‐depth digital interviews were conducted with 14 registered nurses between June and November 2022. A phenomenological approach was applied using Colaizzi's seven‐step method.

Results

Five themes were identified in the data: (1) SDM in daily care: How shared decision‐making is applied; (2) Nurses' perceptions and competence: How nurses perceive and manage SDM; (3) Nurses' roles and advocacy: The evolving roles of nurses and their advocacy efforts, (4) Recognition of dementia and its impact: How nurses recognize and manage dementia; and (5) Interventions to support SDM: Strategies and interventions to facilitate SDM.

Conclusion

This study highlights the complexity of SDM in patients with dementia. It demonstrates the importance of the involvement of relatives, omission of patient goals in discussions and perceived deficiencies of nurses. The early identification of dementia, evaluation of nuanced capacity and targeted communication are essential. Further research and enhanced training are required to improve care in this context.

Impact

Potential areas for further research on SDM in nurses involving patients with dementia include investigating the effects of integrating goal discussions into SDM training for nurses, overcoming barriers to SDM competence, and challenging the idea that SDM is solely the responsibility of physicians. These findings highlight the need for policies that encourage interdisciplinary collaboration, address misconceptions and recommend training programmes that focus on applying SDM to the daily care of patients with dementia, thereby improving the overall quality of patient care.

Reporting Method

The Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist was used for reporting.

Patient or Public Contribution

No patient or public contribution.
The impact of a climate of perceived organizational support on nurses' well‐being and healthcare‐unit performance: A longitudinal questionnaire study
Authors: Larsman Pernilla , Pousette Anders , Törner Marianne
Published: April 2024

Aim

To investigate the relationship between nurses' climate of perceived organizational support, and their well‐being and healthcare‐unit performance.

Design

A two‐wave cohort questionnaire study among nurses within six hospitals in Sweden.

Methods

Hypotheses were tested using cross‐lagged path models on the individual (organizational support, job satisfaction, burnout, intention to stay) and aggregate levels (care‐unit organizational support, team effectiveness, patient safety climate and patient safety). Analyses were based on 1.817 nurses in 228 care‐units (T1), 1.362 nurses in 213 care‐units (T2) and longitudinal samples of 711 nurses and 140 care‐units.

Results

Organizational support (T1) positively influenced job satisfaction (T2) and tended to decrease burnout (T2) but did not affect turnover intent. Reversed relationships were also found. No statistically significant prospective effects were found on the aggregate level.

Conclusion

The results indicated a prospective reciprocally reinforcing relationship between organizational support and job satisfaction. Burnout and intention to stay were predictors rather than outcomes of the organizational support climate.

Implications for the Profession and/or Patient Care

A climate where nurses perceive that their organization values their contributions and cares about their well‐being is beneficial for their job satisfaction and health, which, according to previous research, may influence nurse retention.

Impact

The study addressed perceived organizational support as a potential predictor of nurses' well‐being and healthcare‐unit performance. A mutually reinforcing relation was indicated between organizational support and nurses' job satisfaction and health. Job dissatisfaction, burnout symptoms and turnover intentions were prospectively negatively related to the organizational support. Identifying and implementing a variety of practical measures to support perceptions of organizational support may be an effective way for healthcare management to start and sustain the development of a healthier work environment for healthcare professionals.

Reporting Method

STROBE statement for cohort studies.

Patient or Public Contribution

No patient or public contribution.
Electrical storm after left ventricular assist device (LVAD) implantation
Authors: Karikalan Suganya , Tan Min Choon , Zhang Nan , El‐Masry Hicham , Killu Ammar M. , DeSimone Christopher V. , Deshmukh Abhishek J. , McLeod Christopher J. , Sorajja Dan , Srivathsan Komandoor , Scott Luis , Cha Yong‐Mei , Lee Justin Z.
Published: April 2024

Introduction

Ventricular tachycardia storm or electrical storm (ES) is a common complication following left ventricular assist device (LVAD) implantation. The factors contributing to ES and outcomes are less studied. The study aimed to determine the factors associated with ES and the probability of survival in patients undergoing LVAD in three tertiary centers over a span of 15 years.

Methods

We performed a retrospective cohort study on all patients who underwent LVAD implantation at the Mayo Clinic (Rochester, Phoenix, and Jacksonville) from January 1, 2006 to December 31, 2020. ES was defined as ≥3 episodes of sustained ventricular tachycardia over a period of 24 h with no identifiable reversible cause. Detailed chart reviews of the electronic health records within the Mayo Clinic and outside medical records were performed.

Results

A total of 883 patients who underwent LVAD implantation were included in our study. ES occurred in 7% (n = 61) of patients with a median of 13 days (interquartile range [IQR]: 5–297 days) following surgery. We found 57% of patients (n = 35) developed ES within 30 days, while 43% (n = 26) patients developed ES at a median of 545  (IQR 152–1032) days after surgery. Following ES, 26% of patients died within 1 year. Patients with ES had a significant association with a history of ventricular arrhythmias and implantable cardioverter defibrillator (ICD) shocks before the procedure. ES was significantly associated with reduced survival compared to patients without ES (hazards ratio [HR]: 1.92, 95% CI: 1.39–2.64, p < .001).

Conclusion

Following LVAD implantation, the rate of ES was 7% with majority of ES occurring within 30 days of LVAD. Risk factors for ES included pre‐implant history of ventricular arrhythmias and ICD shock. ES was significantly associated with reduced survival compared to patients without ES.
Capsiate ameliorates secondary hyperparathyroidism by improving insulin sensitivity and inhibiting angiogenesis
Authors: Li Peiting , Zhou Jianda , Wang Tianyin , Li Jun , Wu Wei
Published: April 2024

Secondary hyperparathyroidism has a significant impact on the overall well‐being of the body. Capsiates, known for their antioxidant and metabolic properties, have emerged as a promising alternative treatment for secondary hyperparathyroidism. This study aims to evaluate the effects and mechanisms of capsiates in the treatment of secondary hyperparathyroidism. To achieve our research objectives, we conducted a study on patients' serum and examined changes in metabolic markers using serum metabolomics. We induced secondary hyperparathyroidism in rat through dietary intervention and divided them into four groups. The first group, referred to as the Parathyroid Hormone (PTH) group, received a low‐calcium and high‐phosphate diet (0.2% calcium, 1.2% phosphorus). The second group served as the control group, receiving a standard phosphate and calcium diet (0.6% calcium, 0.6% phosphorus). The third group, called the capsiates group, consisted of rat from the control group treated with capsiates (intraperitoneal injection of 2 mg/kg capsiates for 2 weeks after 2 weeks of dietary intervention). The fourth group was the capsiates‐treated PTH group. Subsequently, we conducted ribose nucleic acid (RNA) sequencing on parathyroid gland cells and evaluated serum thyroxine levels, oxidative stress, expression of proteins associated with vascular neogenesis, measurement of SOD, GSH and 3‐nitrotyrosine, micro‐CT and histological staining. The serum metabolomic data revealed a significant decrease in capsiate levels in the secondary hyperparathyroidism group. Administration of capsiates to PTH rat resulted in increased calcium levels compared to the PTH group. Additionally, the PTH + Capsiates group showed significantly lower levels of PTH and phosphate compared to the PTH group. The PTH group exhibited a notable increase in the quantity and size of mitochondria compared to the control group. Following capsiates administration to the PTH group, there was a significant reduction in the number of mitochondria and length of microvilli, but an increase in the size of mitochondria compared to the PTH group. Sequencing analysis revealed that vascular endothelial growth factor (VEGF) and Vascular Endothelial Growth Factor Receptor 1 (VEGFR1) play crucial roles in this process. Vascular‐related variables and downstream signalling were significantly elevated in hyperthyroidism and were alleviated with capsaicin treatment. Finally, combining capsiates with the PTH group improved bone mineral density, Tb.N, BV.TV, Cs.Th, Tt.Ar, OPG, Ob.TV and Oc.TV, as well as the mineral apposition rate, but significantly decreased Tb.Sp and Receptor Activator for Nuclear Factor‐κ B Ligand (RANKL) compared to the PTH group. The findings suggest that capsiates can improve secondary hyperparathyroidism and ameliorated osteoporosis outcomes by inhibiting angiogenesis and reducing oxidative stress.
Prevalence of metastases outside the liver and abdominal lymph nodes on 68Ga‐DOTATOC‐PET/CT in patients with small intestinal and pancreatic neuroendocrine tumours
Authors: Wedin Maria , Janson Eva Tiensuu , Wallin Göran , Sundin Anders , Daskalakis Kosmas
Published: April 2024

Metastases outside the liver and abdominal/retroperitoneal lymph nodes are nowadays detected frequently in patients with neuroendocrine tumours (NETs), owing to the high sensitivity of positron emission tomography (PET) with Gallium‐68‐DOTA‐somatostatin analogues (68Ga‐SSA) and concomitant diagnostic computed tomography (CT). Our aim was to determine the prevalence of extra‐abdominal metastases on 68Ga‐DOTATOC‐PET/CT in a cohort of patients with small intestinal (Si‐NET) and pancreatic NET (Pan‐NET), as well as that of pancreatic metastasis in patients with Si‐NET. Among 2090 patients examined by 68Ga‐DOTATOC‐PET/CT at two tertiary referral centres, a total of 1177 patients with a history of Si‐ or Pan‐NET, were identified. The most recent 68Ga‐DOTATOC‐PET/CT report for each patient was reviewed, and the location and number of metastases of interest were recorded. Lesions outside the liver and abdominal nodes were found in 26% of patients (n = 310/1177), of whom 21.5% (255/1177) were diagnosed with Si‐NET and 4.5% (55/1177) Pan‐NET. Bone metastases were found in 18.4% (215/1177), metastases to Virchow's lymph node in 7.1% (83/1177), and lung/pleura in 4.8% (56/1177). In the subset of 255 Si‐NET patients, 5.4% (41/255) manifested lesions in the pancreas, 1.5% in the breast (18/255), 1.3% in the heart (15/255) and 1% in the orbita (12/255). In Si‐NET patients, the Ki‐67 proliferation index was higher in those with ≥2 metastatic sites of interest, than with 1 metastatic site, (p <0.001). Overall, extra‐abdominal or pancreatic metastases were more often found in patients with Si‐NET (34%) than in those with Pan‐NET (13%) (p <0.001). Bone metastases were 2.6 times more frequent in patients with Si‐NET compared to Pan‐NET patients (p <0.001). Lesions to the breast and orbita were encountered in almost only Si‐NET patients. In conclusion, lesions outside the liver and abdominal nodes were detected in as many as 26% of the patients, with different prevalence and metastatic patterns in patients with Si‐NET compared to Pan‐NET. The impact of such metastases on overall survival and clinical decision‐making needs further evaluation.
2% supramolecular salicylic acid hydrogel vs. adapaline gel in mild to moderate acne vulgaris treatment: A multicenter, randomized, evaluator‐blind, parallel‐controlled trial
Authors: Ye Cong Xiu , Yi JinLing , Su Zhen , Gao Xinghua , Jiang Xian , Yu Nan , Xiang Leihong , Zeng Weihui , Li Ji , Jin Hongzhong , Liu Wei , Zheng Yue , Lai Wei
Published: April 2024

Objective

Salicylic acid (SA) has been used for treatment of acne of different severity levels. However, there are few researches about the safety and efficacy for treatment of mild to moderate acne, and the improvement of the skin condition by using 2% supramolecular salicylic acid (SSA) compared to Davuwen Adapaline gel.

Methods

A multicenter, randomized, assessor‐blind and parallel‐controlled study was conducted. A total of 500 patients (trial group: 249, control group: 251) with mild to moderate (grade I–II) facial acne vulgaris were recruited in this study over a 16‐week trial period. Patients in the trial group were treated with Broda 2% SSA hydrogel, while control group treated with Davuwen Adapaline gel once a day. The number of inflammatory papules, comedones, and pustules were counted and the rate of lesion reduction was calculated pre‐ and post‐treatment. Then, the skin physiological indicators, including L*a*b*, TEWL, skin sebum and hydration were measured. Statistical analysis was conducted using SAS 9.4. Significance was set at p = 0.05.

Results

At the end of 12 weeks' therapy, the regression and markedly improvement rate of the trail group and the control group were 51.01% and 43.10% respectively, and there was no significant difference in the improvement rate between two groups (p = 0.0831). Although, there was no difference in adverse events rate between two groups, the adverse events rate of the trail group was 0.40%, a little lower than the control group (0.80%). Moreover, there was a significant difference in the numbers of pores at T1 between two groups.

Conclusion

Both 2% SSA and Adapaline gel were equally effective in the treatment of mild to moderate acne vulgaris. 2% SSA is worth the clinical promotion and application in mild to moderate acne vulgaris.
Morphometric analysis of the effects of high molecular weight sodium hyaluronate and amino acids mixture on face rejuvenation
Authors: Kabakci Ayse Gül , Cengizler Çağlar , Eren Dilek , Bozkir Memduha Gülhal
Published: April 2024

Background

Skin aging can be observed at various levels in the epidermis, dermis, and dermo‐epidermal junction. Reducing the cosmetic effects of skin aging in the facial region is a widespread demand due to common aesthetic concerns. Consequently, many injectable products on the market promise antiaging effects and cosmetic improvements. We aimed to evaluate the cosmetic efficacy of a high molecular weight sodium hyaluronate and amino acids mixture for the facial region using morphometric analysis.

Methods

This study evaluates the morphometric effectiveness of an injectable mixture (high molecular weight sodium hyaluronate, glycine, L‐Proline, L‐leucine, L‐lysine HCL, L‐valine, and L‐alanine collagen active ingredient) on the mid‐face and jawline in women aged 30–55. We used morphological measurements and digital image data to assess changes and determine effectiveness. Various computational methods were applied simultaneously with statistical tests for validation.

Results

The hydration assessment showed a significant increase on both sides of the face. A noticeable decrease was observed in gonion angle, bitragion breadth, bigonion breadth, and marionette wrinkle scale. These results suggest combining mechanical and chemical stimulation from the injection and its components (hyaluronic and amino acids) effectively enhances skin quality.

Conclusions

The study indicates that the mechanical stimulation of the injection improves skin quality. Combining hyaluronic and amino acids (collagen, elastin, and pro‐synthetic) is a safe and effective alternative for antiaging treatments.
Combined exposure to UV and PM affect skin oxinflammatory responses and it is prevented by antioxidant mix topical application: Evidences from clinical study
Authors: Ferrara Francesca , Yan Xi , Pecorelli Alessandra , Guiotto Anna , Colella Sante , Pasqui Arianna , Lynch Stephen , Ivarsson John , Anderias Sara , Choudhary Hina , White Stacy , Valacchi Giuseppe
Published: April 2024

Background

Exposure to environmental stressors like particulate matter (PM) and ultraviolet radiation (UV) induces cutaneous oxidative stress and inflammation and leads to skin barrier dysfunction and premature aging. Metals like iron or copper are abundant in PM and are known to contribute to reactive oxygen species (ROS) production.

Aims

Although it has been suggested that topical antioxidants may be able to help in preventing and/or reducing outdoor skin damage, limited clinical evidence under real‐life exposure conditions have been reported. The aim of the present study was to evaluate the ability of a topical serum containing 15% ascorbic acid, 0.5% ferulic acid, and 1% tocopherol (CF Mix) to prevent oxinflammatory skin damage and premature aging induced by PM + UV in a human clinical trial.

Methods

A 4‐day single‐blinded, clinical study was conducted on the back of 15 females (18–40 years old). During the 4 consecutive days, the back test zones were treated daily with or without the CF Mix, followed by with/without 2 h of PM and 5 min of UV daily exposure.

Results

Application of the CF Mix prevented PM + UV‐induced skin barrier perturbation (Involucrin and Loricrin), lipid peroxidation (4HNE), inflammatory markers (COX2, NLRP1, and AhR), and MMP9 activation. In addition, CF Mix was able to prevent Type I Collagen loss.

Conclusion

This is the first human study confirming multipollutant cutaneous damage and suggesting the utility of a daily antioxidant topical application to prevent pollution induced skin damage.
Tracing the International Transmission of a Crisis through Multinational Firms
Authors: BIERMANN MARCUS , HUBER KILIAN
Published: April 2024

We show that multinational firms transmit shocks across countries through their internal capital markets. We study a credit supply shock to parent firms in Germany. International affiliates outside Germany supported their parents through internal lending, became financially constrained themselves, and experienced lower real growth. We find that managers were “Darwinist” with respect to international affiliates but “Socialist” in the home country, that internal capital markets transmitted the credit shock more strongly than a nonfinancial shock, and that access to developed credit markets attenuated the real effects. The total real impact of shock transmission through multinationals on foreign economies was large.
The association between leptin and diabetes: A meta‐analysis
Authors: Wu Xin‐Yu , Song Han‐Bing , Wang Jian‐Wei
Published: April 2024

Purpose

The study object was to determine the relationship between leptin and diabetes.

Methods

We searched for the literature on the relationship between leptin and diabetes from PubMed, EMBASE, Cochrane Library, and CNKI databases. We carried out the meta‐analysis by calculating the Std. Mean Difference (SMD) and 95% confidence intervals (CIs) to study the relationship between leptin and diabetes. We performed the Chi‐square‐based Q test and I2 statistics to evaluate the potential heterogeneity, and the sensitivity analysis was performed to evaluate the stability of our results. Moreover, Begg's test was performed to evaluate the publication bias.

Results

There are 10 studies in this study for meta‐analysis, which include 1879 patients (diabetic (n = 1024); and nondiabetic patients (n = 855)). The results indicated that the levels of serum leptin were significantly increased in patients with diabetes (SMD = 1.78, 95% CI [0.81, 2.76]), especially those with gestational diabetes mellitus compared with controls (SMD = 3.03, 95% CI [1.21, 4.86]). However, the results showed that there was no difference in serum leptin levels between type 2 diabetes and controls (SMD = 0.34, 95% CI [−1.06, 1.74]).

Conclusions

Our analysis indicated that the levels of serum leptin were significantly elevated in patients with diabetes especially those with gestational diabetes mellitus compared with controls.
Epidemiology of cervical cancer and HPV infection in Asia and Oceania
Authors: Ueda Yutaka
Published: April 2024

Cancer will continue to be a major source of morbidity and mortality globally during the foreseeable future. Human papillomavirus (HPV)‐related cancer is now a serious problem in both women and men. The most common HPV‐related cancer is cervical cancer in females and oropharyngeal cancer in males. Eastern Africa has a high age‐standardized incidence of HPV‐related cancers, followed in order by Southern Africa, Central Africa, and then the rest of Africa. Among Asian and Oceania countries, Fiji, Papua New Guinea, Solomon Islands, Indonesia, Maldives, and Myanmar have extremely high age‐standardized incidences and mortality. Oropharyngeal cancer is less common than cervical cancer, but the age‐standardized incidence, for both females and males, is higher in Western Europe, Northern Europe, North America, and Australia/New Zealand. Oropharyngeal cancer incidence rates differ significantly from the rates of cervical cancer within the same countries. In Asia and Oceania, the incidence of oropharyngeal cancer is particularly high among females in Bhutan, Bangladesh, and Australia, and it is highest among males in Bangladesh, New Caledonia, Australia, and French Polynesia. To a certain extent, cervical cancer can be reduced through the development of cervical screening programs and improvements in screening uptake. On the other hand, for oropharyngeal cancer, as of yet, no effective means of cancer screening has been established. Widespread uptake of HPV vaccine will contribute to the reduction of HPV‐related cancers in Asia and Oceania, but also in the rest of the world.
Statin treatment intensity and cerebral vasomotor reactivity response in patients with ischemic stroke
Authors: Sabayan Behnam , Akhavan Sigari Amirhossein , Modir Royya , Meyer Brett C. , Hemmen Thomas , Meyer Dawn , Bavarsad Shahripour Reza
Published: April 2024

Background and Purpose

Cerebral vasomotor reactivity (VMR) is vital for regulating brain blood flow and maintaining neurological function. Impaired cerebral VMR is linked to a higher risk of stroke and poor post‐stroke outcomes. This study explores the relationship between statin treatment intensity and VMR in patients with ischemic stroke.

Methods

Seventy‐four consecutive patients (mean age 69.3 years, 59.4% male) with recent ischemic stroke were included. VMR levels were assessed 4 weeks after the index stroke using transcranial Doppler, measuring the breath‐holding index (BHI) as an indicator of the percentage increase in middle cerebral artery blood flow (higher BHI signifies higher VMR). Multistep multivariable regression models, adjusted for demographic and cerebrovascular risk factors, were employed to examine the association between statin intensity treatment and BHI levels.

Results

Forty‐one patients (55%) received high‐intensity statins. Patients receiving high‐intensity statins exhibited a mean BHI of 0.85, whereas those on low‐intensity statins had a mean BHI of 0.67 (mean difference 0.18, 95% confidence interval: 0.13‐0.22, p‐value<.001). This significant difference persisted in the fully adjusted model (adjusted mean values: 0.84 vs. 0.68, p‐value: .008). No significant differences were observed in BHI values within patient groups on high‐intensity or low‐intensity statin therapy (all p‐values>.05). Furthermore, no significant association was found between baseline low‐density lipoprotein (LDL) levels and BHI.

Conclusions

High‐intensity statin treatment post‐ischemic stroke is linked to elevated VMR independent of demographic and clinical characteristics, including baseline LDL level. Further research is needed to explore statin therapy's impact on preserving brain vascular function beyond lipid‐lowering effects.
Case–control study of heart rate variability and sleep apnea in childhood sickle cell disease
Authors: Bokov Plamen , Koehl Bérengère , Dudoignon Benjamin , Benkerrou Malika , Delclaux Christophe
Published: April 2024

Obstructive sleep apnea (OSA) is common in sickle cell disease (SCD) despite the absence of overweight, suggesting a specific pathophysiology. We previously showed that otherwise healthy children with increased pharyngeal compliance, a main endotype of OSA, exhibited decreased sympathetic modulation. Our objective was to assess whether modifications of heart rate variability (HRV) and compliance are associated in SCD. Cases (children with SCD, African or Caribbean ethnicity) and controls (otherwise healthy children, same ethnicity), aged 4–18 years, were selected from our database of children referred for OSA and matched for sex, age, and obstructive apnea–hypopnoea index (OAHI) score. The children underwent polysomnography and acoustic pharyngometry (to compute compliance). HRV analyses were performed from 5 min ECG recordings in wakeful, NREM, and REM sleep states and from the whole night. Twenty‐one pairs were analysed (median age 10.5 years, 24 girls). Children with SCD had lower BMI z‐scores and more tonsil hypertrophy than control children. Children with SCD and OSA (OAHI ≥2/hour) were characterised by lower compliance than children with SCD without OSA. An inverse relationship between compliance and SD2 (HRV from whole night, inversely related to sympathetic modulation) was evidenced (negative relationship in SCD: R = −0.63, p = 0.002 vs. positive relationship in controls R = 0.59, p = 0.006). In conclusion, while the decrease in sympathetic modulation in control children may contribute to increasing pharyngeal compliance, its decrease seems protective in children with sickle cell disease, which underlines the specificity of OSAS pathophysiology in SCD that could be due to sickle cell disease related smooth muscle dystonia.
Antiviral therapy response in patients with chronic hepatitis B and fatty liver: A systematic review and meta‐analysis
Authors: Rui Fajuan , Garcia Elizabeth , Hu Xinyu , Ni Wenjing , Xue Qi , Xu Yayun , Xu Xiaoming , Shi Junping , Nguyen Mindie H. , Cheung Ramsey C. , Li Jie
Published: April 2024

The impact of concurrent fatty liver (FL) on response to antiviral therapy in chronic hepatitis B (CHB) patients has not been well characterized. We aimed to systematically review and analyse antiviral treatment response in CHB patients with and without FL. We searched PubMed, Embase, Web of Science and the Cochrane Library databases from inception to 31 May 2023 for relevant studies. Biochemical response (BR), complete viral suppression (CVS) and hepatitis B e antigen (HBeAg) seroconversion in CHB patients with FL (CHB‐FL) and without FL (non‐FL CHB) were compared. In an initial pool of 2101 citations, a total of 10 studies involving 2108 patients were included. After 12 weeks of treatment, CHB‐FL patients as compared with non‐FL CHB patients had lower BR rate (48.37% [108/227] vs. 72.98% [126/174], p = .04) but similar trend for CVS (36.86% [80/227] vs. 68.81% [114/174], p = .05) and similar rates of HBeAg seroconversion (6.59% [7/103] vs. 7.40% [7/110], p = .89). However, at week 48, there were no statistically significant differences between CHB‐FL and non‐FL CHB patients in any of the outcomes, including BR (60.03% [213/471] vs. 69.37% [314/717], p = .67), CVS (65.63% [459/746] vs. 73.81% [743/1132], p = .27) and HBeAg seroconversion (10.01% [30/275] vs. 14.06% [65/453], p = .58) with similar findings for week 96. BR rate was lower in CHB‐FL patients after 12 weeks of antiviral treatment. However, after a longer follow‐up of either 48 or 96 weeks, no statistically significant differences were observed in BR, CVS or HBeAg seroconversion rates between CHB patients with and without FL.
Respiratory symptoms due to a twisted nasogastric tube: A case report
Authors: Edalatifard Maryam , Roostaei Ghazal , Rahimi Besharat , Abtahi Hamidreza , Kazemizadeh Hossein , Asadi Sanaz , Khoshnam Rad Niloofar
Published: April 2024

Insertion of a nasogastric tube (NGT) is generally considered safe; however, it is not without risk, and in cases of misplacement, complications and even death may occur. In this article, we reported a case of NGT misplacement in a 75‐year‐old male, which resulted in aspiration pneumonia. We also reviewed published cases of NGT misplacement. Clinicians should pay enough attention to the confirmation of the proper placement of an NGT. A systematic approach for NGT insertion and confirmation is required to prevent misplacement.
Association between serum cytokines and timeframe for conversion from clinical high‐risk to psychosis
Authors: Zhang TianHong , Wei YanYan , Xu LiHua , Tang XiaoChen , Hu YeGang , Liu HaiChun , Wang ZiXuan , Chen Tao , Li ChunBo , Wang JiJun
Published: April 2024

Aim

Although many studies have explored the link between inflammatory markers and psychosis, there is a paucity of research investigating the temporal progression in individuals at clinical high‐risk (CHR) who eventually develop full psychosis. To address this gap, we investigated the correlation between serum cytokine levels and Timeframe for Conversion to Psychosis (TCP) in individuals with CHR.

Methods

We enrolled 53 individuals with CHR who completed a 5‐year follow‐up with a confirmed conversion to psychosis. Granulocyte macrophage‐colony stimulating factor (GM‐CSF), interleukin (IL)‐1β, 2, 6, 8, 10, tumor necrosis factor‐α (TNF‐α), and vascular endothelial growth factor (VEGF) levels were measured at baseline and 1‐year. Correlation and quantile regression analyses were performed.

Results

The median TCP duration was 14 months. A significantly shorter TCP was associated with higher levels of TNF‐α (P = 0.022) and VEGF (P = 0.016). A negative correlation was observed between TCP and TNF‐α level (P = 0.006) and VEGF level (P = 0.04). Quantile regression indicated negative associations between TCP and GM‐CSF levels below the 0.5 quantile, IL‐10 levels below the 0.3 quantile, IL‐2 levels below the 0.25 quantile, IL‐6 levels between the 0.65 and 0.75 quantiles, TNF‐α levels below the 0.8 quantile, and VEGF levels below the 0.7 quantile. A mixed linear effects model identified significant time effects for IL‐10 and IL‐2, and significant group effects for changes in IL‐2 and TNF‐α.

Conclusions

Our findings underscore that a more pronounced baseline inflammatory state is associated with faster progression of psychosis in individuals with CHR. This highlights the importance of considering individual inflammatory profiles during early intervention and of tailoring preventive measures for risk profiles.