bluuebunny/crossref_metadata_2025 huggingface dataset:
An intervention to improve antibiotic prescription behavior in veterinary students: A protocol based on the multi‐theory model to tackle antimicrobial resistance
Authors: Hassani Laleh , Toghroli Razie , Aghamolaei Teamur , Sharifi Hamid , Jajarmi Maziar , Sharma Manoj
Published: February 2024

Background and Aims

Antimicrobial resistance (AMR) is a global health threat. Moreover, incorrect and inappropriate drug prescription behavior is considered a fundamental risk factor. Thus, the present study aims to develop, implement, and evaluate the effectiveness of an educational program based on the multi‐theoretical model (MTM) in improving antibiotic prescription behavior in veterinary students of Iran.

Methods

The present study will include four phases including a qualitative phase, an instrument design and psychometric test phase, and a cross‐sectional, and an interventional phase. In the first phase, the sampling will be purposive with a maximum variety. The interviews will be conducted with a sample of veterinarians.

Results

The data will be analyzed in MAXQDA 10. In the second phase, the face and content validity will be tested by a panel of experts as field specialists. A confirmatory factor analysis will be used to test construct validity, and Cronbach's alpha coefficient and intracluster correlation coefficient will be used to determine the internal consistency of the instrument. Then, at this stage, a number of veterinary students will be selected through a multi‐stage sampling method. In the cross‐sectional phase, another sample of veterinary students will complete a researcher‐made questionnaire. Then, Spearman's correlation coefficient test will be used to test the relationship between the two stages of behavior initiation and behavior continuation. The data will be analyzed in SPSS 22. In the third phase, some veterinary students will be selected through a census and will be randomly divided into a control and an intervention group. To collect data in the final phase, the researcher‐made questionnaire that was designed in the second phase of the study based on a multi‐theory model will be used to extract data. To compare demographic characteristics, compare the correlation between the constructs of the multi‐theory model with antibiotic prescribing behavior in the cross‐sectional phase and compare the scores of the constructs of the MTM in two intervention and control groups paired‐samplesTtest and independent‐samplesTtest will be used.

Conclusion

The present study will aim to improve antibiotic prescription behavior in veterinary students based on a MTM. The findings can be used as a model for training students in clinical fields such as veterinary medicine and general medicine at university at a national level. After verification and approval by experts and university professors, we can expect a change in the educational curriculum to include instructions on how to write out prescriptions for students. There are hopes that the present study if conducted accurately and widely to help prevent AMR in livestock, humans, and society.
Online versus in‐person surgical near‐peer teaching in undergraduate medical education during the COVID‐19 pandemic: A mixed‐methods study
Authors: Iyer Priyanka , Mok Valerie , Sehmbi Arjan Singh , Kessaris Nicos , Zakri Rhana , Dasgupta Prokar , Chandak Pankaj
Published: February 2024

Background and Aims

The coronavirus disease 2019 (COVID‐19) pandemic stimulated a paradigm shift in medical and surgical education from in‐person teaching to online teaching. It is unclear whether an in‐person or online approach to surgical teaching for medical students is superior. We aim to compare the outcomes of in‐person versus online surgical teaching in generating interest in and improving knowledge of surgery in medical students. We also aim the quantify the impact of a peer‐run surgical teaching course.

Methods

A six‐session course was developed by medical students and covered various introductory surgical topics. The first iteration was offered online to 70 UK medical students in March 2021, and the second iteration was in‐person for 20 students in November 2021. Objective and subjective knowledge was assessed through questionnaires before and after each session, and also for the entire course. Data were analyzed from this mixed‐methods study to compare the impact of online versus in‐person teaching on surgical knowledge and engagement.

Results

Students in both iterations showed significant improvement of 33%–282% across the six sessions in knowledge and confidence after completing the course (p < 0.001). There was no significant difference in the level of objective knowledge, enjoyment, or organization of the course between online and in‐person groups, although the in‐person course was rated as more engaging (mean Likert score 9.1 vs. 9.7, p = 0.033).

Discussion

Similar objective and subjective surgical teaching outcomes were achieved in both iterations, including in “hands‐on” topics such as suturing, gowning, and gloving. Students who completed the online course did not have any lower knowledge or confidence in their surgical skills; however, the in‐person course was reported to be more engaging. Surgical teaching online and in‐person may be similarly effective and can be delivered according to what is most convenient for the circumstances, such as in COVID‐19.
Dexamphetamine increased speech and visual unimodal illusions in healthy participants without affecting temporal binding window
Authors: Voon Fui‐Ling , Loffman Sean J. , Lim Mark J. H. , Lee Joseph W. Y. , Iyyalol Rajan , Martin‐Iverson Mathew T.
Published: February 2024

Objective

Stimuli received beyond a very short timeframe, known as temporal binding windows (TBWs), are perceived as separate events. In previous audio‐visual multisensory integration (McGurk effect) studies, widening of TBWs has been observed in people with schizophrenia. The present study aimed to determine if dexamphetamine could increase TBWs in unimodal auditory and unimodal visual illusions that may have some validity as experimental models for auditory and visual hallucinations in psychotic disorders.

Methods

A double‐blind, placebo‐controlled, counter‐balanced crossover design with permuted block randomisation for drug order was followed. Dexamphetamine (0.45 mg/kg, PO, q.d.) was administered to healthy participants. Phantom word illusion (speech illusion) and visual‐induced flash illusion/VIFI (visual illusion) tests were measured to determine if TBWs were altered as a function of delay between stimuli presentations. Word emotional content for phantom word illusions was also analysed.

Results

Dexamphetamine significantly increased the total number of phantom words/speech illusions (p < 0.01) for pooled 220–1100 ms ISIs in kernel density estimation and the number of positive valence words heard (beta = 2.20, 95% CI [1.86, 2.55], t = 12.46, p < 0.001) with a large effect size (std. beta = 1.05, 95% CI [0.89, 1.22]) relative to placebo without affecting the TBWs. For the VIFI test, kernel density estimation for pooled 0–801 ms ISIs showed a significant difference (p < 0.01) in the data distributions of number of target flash (es) perceived by participants after receiving dexamphetamine as compared with placebo.

Conclusions

Overall, healthy participants who were administered dexamphetamine (0.45 mg/kg, PO, q.d.) experienced increases in auditory and visual illusions in both phantom word illusion and VIFI tests without affecting their TBWs.
Parents' views and experiences of the home mathematics environment: A cross‐country study
Authors: Cahoon Abbie , Campver Yanet , Estévez Nancy , Jiménez Lira Carolina , Paz García Daniela Susana , Benavides Pando Elia Veronica , Simms Victoria
Published: February 2024

The purpose of the current study was to qualitatively explore the home mathematical environment across two regions in two different countries (i.e., Cuba and Mexico), replicating a qualitative study previously conducted in Northern Ireland (NI), United Kingdom (Cahoon et al., 2017). Semi‐structured interviews with parents/caregivers of children (3‐ to 5‐year‐olds) in both Mexico (n = 13) and Cuba (n = 40) were completed to investigate their views, experiences and attitudes towards the home mathematical environment. Thematic analysis was used to explore themes relevant to the home mathematical environment. Three consistent themes were found in the Mexican and Cuban data: Numeracy Environment Structure, Expectations and Attitudes and Views of Technology. Two unique themes were found in the Mexico data: Interactions Related to Reading or Mathematics, and Child's Attitudes in Relation to Mathematics. One unique theme was found in the Cuban interviews: Interactions for Learning. Although diverse themes were identified, consistencies were also observed. This suggests that some home numeracy practices may be universal in nature. This research increases the understanding of human development in context.
Neoadjuvant chemo‐ or chemo‐radiation‐therapy of pancreatic ductal adenocarcinoma differentially shift ECM composition, complement activation, energy metabolism and ribosomal proteins of the residual tumor mass
Authors: Stillger Maren N. , Kurowski Konrad , Bronsert Peter , Brombacher Eva , Kreutz Clemens , Werner Martin , Tang Laura , Timme‐Bronsert Sylvia , Schilling Oliver
Published: February 2024

Pancreatic ductal adenocarcinoma (PDAC) is a highly lethal cancer, often diagnosed at stages that dis‐qualify for surgical resection. Neoadjuvant therapies offer potential tumor regression and improved resectability. Although features of the tumor biology (e.g., molecular markers) may guide adjuvant therapy, biological alterations after neoadjuvant therapy remain largely unexplored. We performed mass spectrometry to characterize the proteomes of 67 PDAC resection specimens of patients who received either neoadjuvant chemo (NCT) or chemo‐radiation (NCRT) therapy. We employed data‐independent acquisition (DIA), yielding a proteome coverage in excess of 3500 proteins. Moreover, we successfully integrated two publicly available proteome datasets of treatment‐naïve PDAC to unravel proteome alterations in response to neoadjuvant therapy, highlighting the feasibility of this approach. We found highly distinguishable proteome profiles. Treatment‐naïve PDAC was characterized by enrichment of immunoglobulins, complement and extracellular matrix (ECM) proteins. Post‐NCT and post‐NCRT PDAC presented high abundance of ribosomal and metabolic proteins as compared to treatment‐naïve PDAC. Further analyses on patient survival and protein expression identified treatment‐specific prognostic candidates. We present the first proteomic characterization of the residual PDAC mass after NCT and NCRT, and potential protein candidate markers associated with overall survival. We conclude that residual PDAC exhibits fundamentally different proteome profiles as compared to treatment‐naïve PDAC, influenced by the type of neoadjuvant treatment. These findings may impact adjuvant or targeted therapy options.
A diagnostically challenging case of inflammatory myofibroblastic tumor primary to the peritoneum
Authors: Karibe Jurii , Teranishi Jun‐ichi , Kawahara Takashi , Noguchi Takeaki , Takeshima Teppei , Osaka Kimito , Kumagai Eita , Sawazumi Tomoe , Fujii Satoshi , Uemura Hiroji
Published: February 2024

Introduction

Inflammatory myofibroblastic tumors are difficult to diagnose because of the lack of specific indicators. We describe a diagnostically challenging case of an inflammatory myofibroblastic tumor primary to the peritoneum.

Case presentation

The patient was a 25‐year‐old male who presented at our hospital with lower abdominal pain. Computed tomography revealed a mass lesion 80 mm in diameter just above the bladder. This was suspected to be a bleeding tumor of the urachus. Since malignancy could not be ruled out, surgery was planned. This revealed a fragile tumor arising from the peritoneum. Following its removal, the tumor was diagnosed by histopathological analysis as an inflammatory myofibroblastic tumor.

Conclusion

We describe a case of inflammatory myofibroblastic tumor primary to the peritoneum diagnosed by histopathology. Inflammatory myofibroblastic tumor should be considered in the differential diagnosis of abdominal wall and anterior bladder tumors.
Adolescents' relationships with parents and romantic partners in eight countries
Authors: Gorla Laura , Rothenberg W. Andrew , Lansford Jennifer E. , Bacchini Dario , Bornstein Marc H. , Chang Lei , Deater‐Deckard Kirby , Di Giunta Laura , Dodge Kenneth A. , Gurdal Sevtap , Junla Daranee , Liu Qin , Long Qian , Oburu Paul , Pastorelli Concetta , Skinner Ann T. , Sorbring Emma , Steinberg Laurence , Tirado Liliana Maria Uribe , Yotanyamaneewong Saengduean , Alampay Liane P. , Al‐Hassan Suha M.
Published: February 2024

Introduction

Creating romantic relationships characterized by high‐quality, satisfaction, few conflicts, and reasoning strategies to handle conflicts is an important developmental task for adolescents connected to the relational models they receive from their parents. This study examines how parent–adolescent conflicts, attachment, positive parenting, and communication are related to adolescents' romantic relationship quality, satisfaction, conflicts, and management.

Method

We interviewed 311 adolescents at two time points (females = 52%, ages 15 and 17) in eight countries (China, Colombia, Italy, Kenya, the Philippines, Sweden, Thailand, and the United States). Generalized and linear mixed models were run considering the participants' nesting within countries.

Results

Adolescents with negative conflicts with their parents reported low romantic relationship quality and satisfaction and high conflicts with their romantic partners. Adolescents experiencing an anxious attachment to their parents reported low romantic relationship quality, while adolescents with positive parenting showed high romantic relationship satisfaction. However, no association between parent–adolescent relationships and conflict management skills involving reasoning with the partner was found. No associations of parent–adolescent communication with romantic relationship dimensions emerged, nor was there any effect of the country on romantic relationship quality or satisfaction.

Conclusion

These results stress the relevance of parent–adolescent conflicts and attachment as factors connected to how adolescents experience romantic relationships.
The role of second trimester uterine artery Doppler in predicting obstetric and neonatal outcomes in abnormal first trimester maternal serum pregnancy‐associated plasma protein‐A and free β‐human chorionic gonadotropin values
Authors: Dal Yusuf , Akkuş Fatih , Karagün Şebnem , Nessar Ahmet Zeki , Karaca Sefanur Gamze , Coşkun Ayhan
Published: February 2024

Aim

This study aims to determine whether second‐trimester uterine artery (UtA) Doppler combined with first‐trimester abnormal pregnancy‐associated plasma protein‐A (PAPP‐A) and β‐human chorionic gonadotropin (β‐Hcg) levels predicts adverse obstetric and neonatal outcomes.

Materials and Methods

This study of 289 pregnant women included 196 with normal PAPP‐A and free β‐HCG values (control group) and 93 with abnormal values (study group) in the first‐trimester screening test. Second‐trimester UtA Doppler sonography was done in these pregnancies. The perinatal prediction and screening potential of UtA Doppler pulsatility index (PI) parameters were examined in the study group.

Results

UtA PI >95 percentile increased birth before the 37th week by 4.46 times, birth before the 34th week by 7.44 times, preeclampsia risk by 3.25 times, fetal growth restriction (FGR) risk by 4.89 times, and neonatal intensive care unit (NICU) admission rates by 3.66 times in the study group (p < 0.05 for all). UtA PI >95 percentile had 49.2% sensitivity and 82.1% specificity for birth before 37 weeks. For birth before 34 weeks, sensitivity was 80.0% and specificity 65.0%. FGR has 70.5% sensitivity and 67.1% specificity. Screening for preeclampsia has 66.6% sensitivity and 61.9% specificity.

Conclusion

Adding UtA Doppler in the second trimester to pregnancies with abnormal PAPP‐A and/or free β‐Hcg values in the first trimester may be a useful screening method for adverse outcomes.
Evaluating the biological (antidiabetic) potential of TEM, FTIR, XRD, and UV‐spectra observed berberis lyceum conjugated silver nanoparticles
Authors: Mughal Tafail Akbar , Ali Shaukat , Mumtaz Shumaila , Summer Muhammad , Saleem Muhammad Zubair , Hassan Ali , Hameed Muhammad Usman
Published: February 2024

Diabetes is a life‐threatening disease that affects different parts of the body including the liver, kidney, and pancreas. The core root of diabetes is mainly linked to oxidative stress produced by reactive oxygen species (ROS). Berberis lyceum Royle (BLR) is the source of natural products. It comprises numerous bioactive compounds having antioxidant activities. In the current investigation, silver nanoparticles from BLR root extract were synthesized, characterized, and assessed for antidiabetic potential. UV spectrophotometry, Transmission electron microscopy (TEM), Fourier transform infra‐red spectroscopy (FTIR), and x‐ray diffraction (XRD) were applied for the characterization of NPs. It was evident from the morphological studies that the synthesized NPs were spherical and the average size was 11.02 nm. Results revealed that BLR‐AgNPs showed higher radical scavenging activity as compared to BLR extract. Moreover, BLR‐AgNPs displayed superior in vivo and in vitro antidiabetic activity in comparison to BLR extract. Glucose level (116.5 ± 5.1 mg/dL), liver function test (ALAT: 54.038 ± 6.2 IU/L; ASAT: 104.42 ± 13.9 IU/L; ALP: 192.6 ± 2.4 IU/L; bilirubin: 1.434 ± 0.14 mg/dL; total protein: 5.14 ± 0.24 mg/dL), renal function test (urea: 39.6 ± 0.63 mg/dL; uric acid: 21.4 ± 0.94 mg/dL; creatinine: 0.798 ± 0.03 mg/dL; albumin: 4.14 ± 0.2 mg/dL), lipid profile level (cholesterol: 101.62 ± 3 mg/dL; triglyceride: 110.42 ± 7 mg/dL; HDL‐C: 29.7 ± 3 mg/dL; LDL‐C: 47.056 ± 1 mg/dL; VLDL‐C: 22.0 ± 1.3 mg/dL) and hematology (WBCs: 3.82 ± 0.24 103 /μL; RBCs: 4.78 ± 0.42 106 /μL; Hb: 12.6 ± 1.0 g/dL; Hematocrit: 39.4 ± 3.7%; MCV: 65.8 ± 3 fL; platelets: 312 ± 22.4; neutrophils: 34.8 ± 1.87; eosinophils: 3.08 ± 0.43; monocytes: 3.08 ± 0.28; lymphocytes: 75.6 ± 3.77) confirmed the significant antidiabetic potential of BLR‐AgNPs. Histopathological examination authenticated that BLR‐AgNPs caused a significant revival in the morphology of the liver, kidney, and pancreas. Hence, findings of the study suggested the BLR‐AgNPs as a potent antidiabetic agent and could be an appropriate nanomedicine to prevent diabetes in future.

Research Highlights

Berberis lyceum extract as a reducing, capping, and stabilization agent for the BLR‐AgNPs synthesis

Evaluation of α‐amylase inhibition, antioxidant, and α‐glucosidase inhibition potential

Thorough characterization using Fourier transform infrared spectroscopy, Transmission electron microscopy, x‐ray diffraction, and UV–VIS spectrophotometer, which is 1st of its kind

In‐vivo antidiabetic activity evaluation through multiple biomarkers
Differentiation of large extracellular vesicles in oral fluid: Combined protocol of small force centrifugation and sedimentation pattern analysis
Authors: Kawano Takamasa , Okamura Kohji , Shinchi Hiroki , Ueda Koji , Nomura Takeshi , Shiba Kiyotaka
Published: February 2024

Extracellular vesicles (EVs) in biofluids are highly heterogeneous entities in terms of their origins and physicochemical properties. Considering the application of EVs in diagnostic and therapeutic fields, it is of extreme importance to establish differentiating methods by which focused EV subclasses are operationally defined. Several differentiation protocols have been proposed; however, they have mainly focused on smaller types of EVs, and the heterogeneous nature of large EVs has not yet been fully explored. In this report, to classify large EVs into subgroups based on their physicochemical properties, we have developed a protocol, named EV differentiation by sedimentation patterns (ESP), in which entities in the crude large EV fraction are first moved through a density gradient of iodixanol with small centrifugation forces, and then the migration patterns of molecules through the gradients are analysed using a non‐hierarchical data clustering algorithm. Based on this method, proteins in the large EV fractions of oral fluids clustered into three groups: proteins shared with small EV cargos and enriched in immuno‐related proteins (Group 1), proteins involved in energy metabolism and protein synthesis (Group 2), and proteins required for vesicle trafficking (Group 3). These observations indicate that the physiochemical properties of EVs, which are defined through low‐speed gradient centrifugation, are well associated with their functions within cells. This protocol enables the detailed subclassification of EV populations that are difficult to differentiate using conventional separation methods.
Beta‐Catenin‐Mutated Hepatocellular Adenomas at Hepatobiliary Phase MRI: A Systematic Review and Meta‐Analysis
Authors: Shen Luyao , Altmayer Stephan , Tse Justin R.
Published: February 2024

Background

Beta‐catenin‐mutated hepatocellular adenomas (β‐HCAs) can appear iso‐ to hyperintense at the hepatobiliary phase (HBP) at magnetic resonance imaging (MRI). Given the relatively lower prevalence of β‐HCAs, prior studies had limited power to show statistically significant differences in the HBP signal intensity between different subtypes.

Purpose

To assess the diagnostic performance of HBP MRI to discriminate β‐HCA from other subtypes.

Study Type

Systemic review and meta‐analysis.

Population

Ten original studies were included, yielding 266 patients with 397 HCAs (9%, 36/397 β‐HCAs and 91%, 361/397 non‐β‐HCAs).

Field Strength/Sequence

1.5 T and 3.0 T, HBP.

Assessment

PubMed, Web of Science, and Embase databases were searched from January 1, 2000, to August 31, 2023, for all articles reporting HBP signal intensity in patients with histopathologically proven HCA subtypes. QUADAS‐2 was used to assess risk of bias and concerns regarding applicability.

Statistical Tests

Univariate random‐effects model was used to calculate pooled estimates. Heterogeneity estimates were assessed with I2 heterogeneity index. Meta‐regression (mixed‐effect model) was used to test for differences in the prevalence of HBP signal between HCA groups. The threshold for statistical significance was set at P < 0.05.

Results

HBP iso‐ to hyperintensity was associated with β‐HCAs (pooled prevalence was 72.3% in β‐HCAs and 6.3% in non‐β‐HCAs). Pooled sensitivity and specificity were 72.3% (95% confidence interval 54.1–85.3) and 93.7% (93.8–97.7), respectively. Specificity had substantial heterogeneity with I2 of 83% due to one study, but not for sensitivity (I2 = 0). After excluding this study, pooled sensitivity and specificity were 77.4% (59.6–88.8) and 94.1% (88.9–96.9), with no substantial heterogeneity. One study had high risk of bias for patient selection and two studies were rated unclear for two domains.

Data Conclusion

Iso‐ to hyperintensity at HBP MRI may help to distinguish β‐HCA subtype from other HCAs with high specificity. However, there was heterogeneity in the pooled estimates.

Level of Evidence

3

Technical Efficacy

Stage 2
The impact of ABO blood types on humoral immunity responses and antibody persistency after different COVID‐19 vaccine regimens
Authors: Sadat Larijani Mona , Javadi Amir , Eskandari Seyed Ebrahim , Doroud Delaram , Ashrafian Fatemeh , Banifazl Mohammad , Khamesipour Ali , Bavand Anahita , Ramezani Amitis
Published: February 2024

This study evaluated the possible effects of blood types on coronavirus disease (COVID‐19) vaccine immunogenicity and antibody (Ab) persistency. Five different vaccinated groups against COVID‐19 were investigated at Pasteur Institute of Iran from April 2021 to December 2022. Anti‐Spike IgG and neutralizing Ab rise were tracked on Day 21 as well as the humoral immune persistency assessment 180 after booster shots. Late adverse events up to 6 months after the booster dose were collected. The results showed that blood type A, led to a significantly higher anti‐Spike Ab rise in AstraZeneca primed recipients in comparison with Sinopharm primed ones in heterologous regimens (p: 0.019). Furthermore, blood type O was a great co‐effector in homologous AstraZeneca recipients regarding neutralizing Ab rise (0.013). In addition, blood type O led to a better anti‐Spike Ab persistency in the Sinopharm homologous group whereas type A had the best effect on neutralizing Ab durability in the same vaccine group. What is more, Rh‐positive individuals in AstraZeneca + PastoCovac Plus group had a higher rate of anti‐Spike Ab rise (p = 0.001). Neutralizing Ab rise was also induced in AstraZeneca homologous and heterologous regimens of Rh‐positive individuals significantly higher than Sinopharm primed cases. The present study showed the potential impact of blood types A/O and Rh‐positive on a better humoral immune responses and Ab persistency. It is proposed that blood type A and Rh‐positive could increase the Ab rise in AstraZeneca vaccinated individuals. Moreover, blood type O might be a better co‐effector of anti‐Spike Ab persistency in Sinopharm recipients.
A Wandering Mind is Not Always a Creative Mind: How Thought Dynamics Explain the Relationship between Mind Wandering and Creativity
Authors: de Rooij Alwin , Atef Ali , Faber Myrthe
Published: February 2024

A wandering mind is not always a creative mind. Anecdotes about ideas spontaneously entering awareness during walks, showers, and other off‐task activities are plenty. The science behind it, however, is still inconclusive. Creativity might result from how thought context—whether thoughts are on‐task or off‐task—relates to thought dynamics—how thoughts unfold. To explore this, study 1 (n = 85) surveyed creative professionals about a single idea they had earlier in the day. The spontaneity of thoughts positively correlated with self‐reported creativity, whereas off‐task thoughts or doing something else did not. Study 2 (n = 180) replicated these findings in a student sample during an idea generation task and added that free movement of thoughts also correlates with self‐reported originality during idea generation. As indicated by expert ratings, no relationship of thought dynamics and thought context was found with population‐level creativity. Herewith, this study suggests that thought dynamics, rather than thought context, explain the often suggested relationship between mind wandering and creativity.
Supercritical extraction of betalains from the peel of different pitaya species
Authors: Lacerda Vander Rocha , Bastante Cristina Cejudo , Machado Noelia D. , Vieites Rogério Lopes , Casas Cardoso Lourdes , Mantell‐Serrano Casimiro
Published: February 2024

BACKGROUND

Pitaya is a fruit with high consumer acceptance and health benefits. Pitaya peel is a waste product with potential in the food industry, as an antioxidant enrichment and natural colouring. Therefore, there is an interest in recovering its constituents and searching for pitaya species with greater potential. This work aimed to obtain bioactive extracts from the dried peel of pitaya fruits of the species Selenicereus monacanthus (Lem.), S. costaricensis W. and S. undatus H. using supercritical fluids at different pressures (100, 250 and 400 bar) and ethanol–water 15% v/v or ethanol 100% as co‐solvents. The extraction yield, antioxidant activity, colour and total betalain content were evaluated.

RESULTS

The extract obtained from S. monacanthus showed the highest extraction yield (49.6 g kg−1), followed by S. costaricensis (27.5 g kg−1) and S. undatus (17.7 g kg−1) at 400 bar and 35 °C using ethanol 15%, v/v. The antioxidant capacity was strongly influenced by pressure, favouring the obtaining of betalain‐rich extracts at higher pressures, especially in the species S. costaricensis (0.6 g kg−1) and S. monacanthus (0.3 g kg−1). To improve the extraction of S. undatus (the most cultivated species), the procedure of subsequential extractions was applied. This procedure considerably increased the extraction yield, antioxidant activity and total content of betalains. The use of ethanol 100% provided more bioactive fractions and achieved a good separation of betalains.

CONCLUSION

The supercritical extraction method can overcome the challenge of efficiently extracting compounds from pitaya peel, due to the presence of bioactive compounds of great polarity. © 2024 Society of Chemical Industry.
Early mobilisation after hip fracture surgery is associated with improved patient outcomes: A systematic review and meta‐analysis
Authors: Agarwal Nikhil , Feng Tony , Maclullich Alasdair , Duckworth Andrew , Clement Nicholas
Published: February 2024

Introduction

The aims of this systematic review and meta‐analysis were to determine if after hip fracture surgery (1) early mobilisation is associated with improved clinical outcomes, and if so (2) are benefits directly proportional to how soon after surgery the patient mobilises.

Methods

A Preferred Reporting Items for Systematic Reviews and Meta‐Analyses systematic review was conducted using four databases to identify all studies that compared postoperative early mobilisation with delayed mobilisation, in patients after hip fracture surgery. The Critical Appraisal Skills Programme checklist was employed for critical appraisal and evaluation of all studies that met the inclusion criteria.

Results

A total of 13 studies, including 297,435 patients were identified, of which 235,275 patients were mobilised early and 62,160 were mobilised late. Six studies assessed 30‐day mortality, of which two also investigated 30‐day complication rates. Pooled meta‐analysis demonstrated that there were significantly lower 30‐day mortality rates (odds ratio [OR] 0.35, 95% confidence interval [CI] 0.31–0.41, p < 0.001) and complication rates (OR 0.43, 95% CI 0.36–0.51, p < 0.001) in patients mobilising early after hip fracture surgery. Five studies investigated length of stay (LOS) and meta‐analysis revealed no difference between groups (mean difference −0.57 days, 95% CI −1.89–0.74, p = 0.39).

Conclusion

Early mobilisation in hip fracture patients is associated with a reduction in 30‐day mortality and complication rates compared to delayed mobilisation, but no difference in LOS. These findings illustrate that early mobilisation is associated with superior post operative outcomes. However, a direct casual effect remains to be demonstrated, and further work on the factors underlying delayed mobilisation is required.
Exploring caregivers' attitudes and beliefs about nutrition and weight management for young people with Duchenne muscular dystrophy
Authors: Billich Natassja , Bray Paula , Truby Helen , Evans Maureen , Ryan Monique M. , Carroll Kate , de Valle Katy , Villano Daniella , Kornberg Andrew , Sowerby Bianca , Farrar Michelle A. , Menezes Manoj P. , Holland Sandra , Lindeback Rachel , Cairns Anita , Davidson Zoe E.
Published: February 2024

Introduction/Aims

Obesity disproportionately affects children and adolescents with Duchenne muscular dystrophy (DMD) and with adverse consequences for disease progression. This study aims to: explore barriers, enablers, attitudes, and beliefs about nutrition and weight management; and to obtain caregiver preferences for the design of a weight management program for DMD.

Methods

We surveyed caregivers of young people with DMD from four Australian pediatric neuromuscular clinics. Survey questions were informed by the Theoretical Domains Framework and purposefully designed to explore barriers and enablers to food and weight management. Caregivers were asked to identify their preferred features in a weight management program for families living with DMD.

Results

Fifty‐three caregivers completed the survey. Almost half (48%) perceived their son as above healthy weight. Consequences for those children were perceived to be self‐consciousness (71%), a negative impact on self‐esteem (64%) and movement (57%). Preventing weight gain was a common reason for providing healthy food and healthy eating was a high priority for families. Barriers to that intention included: time constraints, selective food preferences, and insufficient nutrition information. Caregivers preferred an intensive six‐week weight management program addressing appetite management and screen time.

Discussion

Managing weight is an important issue for caregivers of sons with DMD; yet several barriers exist. Individualized 6 week programs are preferred by caregivers to improve weight management for DMD.
Offspring cardiometabolic outcomes and postnatal growth trajectories after exposure to maternal SARS‐CoV‐2 infection
Authors: Shook Lydia L. , Castro Victor M. , Herzberg Emily M. , Fourman Lindsay T. , Kaimal Anjali J. , Perlis Roy H. , Edlow Andrea G.
Published: February 2024

Objective

The objective of this study is to determine whether in utero exposure to SARS‐CoV‐2 is associated with increased risk for a cardiometabolic diagnosis by 18 months of age.

Methods

This retrospective electronic health record (EHR)‐based cohort study included the live‐born offspring of all individuals who delivered during the COVID‐19 pandemic (April 1, 2020–December 31, 2021) at eight hospitals in Massachusetts. Offspring exposure was defined as a positive maternal SARS‐CoV‐2 polymerase chain reaction test during pregnancy. The primary outcome was presence of an ICD‐10 code for a cardiometabolic disorder in offspring EHR by 18 months. Weight‐, length‐, and BMI‐for‐age z scores were calculated and compared at 6‐month intervals from birth to 18 months.

Results

A total of 29,510 offspring (1599 exposed and 27,911 unexposed) were included. By 18 months, 6.7% of exposed and 4.4% of unexposed offspring had received a cardiometabolic diagnosis (crude odds ratio [OR] 1.47 [95% CI: 1.10 to 1.94], p = 0.007; adjusted OR 1.38 [1.06 to 1.77], p = 0.01). Exposed offspring had a significantly greater mean BMI‐for‐age z score versus unexposed offspring at 6 months (z score difference 0.19 [95% CI: 0.10 to 0.29], p < 0.001; adjusted difference 0.04 [−0.06 to 0.13], p = 0.4).

Conclusions

Exposure to maternal SARS‐CoV‐2 infection was associated with an increased risk of receiving a cardiometabolic diagnosis by 18 months preceded by greater BMI‐for‐age at 6 months.
The Toxicological Effects of e‐Cigarette Use in the Upper Airway: A Scoping Review
Authors: Worden Cameron P. , Hicks Kayla B. , Hackman Trevor G. , Yarbrough Wendell G. , Kimple Adam J. , Farzal Zainab
Published: February 2024

Objective

While evidence continues to emerge on the negative health effects of electronic cigarettes (e‐cigarettes) on the lungs, little is known regarding their deleterious effects on the upper airway. The purpose of this review is to summarize the toxicological effects of e‐cigarettes, and their components, on the upper airway.

Data Sources

PubMed, SCOPUS, EMBASE databases.

Review Methods

Systematic searches were performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta‐analyses guidelines from 2003 to 2023. Studies were included if they investigated the toxicological effects of e‐cigarette exposure on human or animal upper airway tissue. Two authors independently screened, reviewed, and appraised all included articles.

Results

A total of 822 unique articles were identified, of which 53 met inclusion criteria and spanned subsites including the oral cavity (22/53 studies), nasal cavity/nasopharynx (13/53), multiple sites (10/53), larynx (5/53), trachea (2/53), and oropharynx (1/53). The most commonly observed consequences of e‐cigarette use on the upper airway included: proinflammatory (15/53 studies), histological (13/53), cytotoxicity (11/53), genotoxicity (11/53), and procarcinogenic (6/53). E‐cigarette humectants independently induced toxicity at multiple upper airway subsites, however, effects were generally amplified when flavoring(s) and/or nicotine were added. Across almost all studies, exposure to cigarette smoke exhibited increased toxicity in the upper airway compared with exposure to e‐cigarette vapor.

Conclusion

Current data suggest that while e‐cigarettes are generally less harmful than traditional cigarettes, they possess a distinct toxicological profile that is enhanced upon the addition of flavoring(s) and/or nicotine. Future investigations into underexamined subsites, such as the oropharynx and hypopharynx, are needed to comprehensively understand the effects of e‐cigarettes on the upper airway.
Peopled landscapes: Questions of coexistence in invasive plant management and rewilding
Authors: Atchison Jennifer , Pickerill Jenny , Arnold Crystal , Gibbs Leah M. , Gill Nicholas , Hubbard Ella , Lorimer Jamie , Watson Matt
Published: February 2024

The concept of ‘peopled landscapes’ is based on the notion that it is not possible, nor socially or politically desirable, to remove people from the environment in the era of the Anthropocene. As such, it is necessary to document and develop ways to coexist and flourish.

This review examines emergent scholarship about peopled landscapes and biodiversity conservation by considering invasive plant management and rewilding as social processes. While invasive plant management and rewilding are often understood as separate, thinking through social scientific research and examples from Australia and the UK, we demonstrate how both forms of human action in landscapes can be more usefully understood as social relations with nature involving social change and social action.

Drawing attention to agency, practices and capacity, we show how diverse forms of human and nonhuman actions are recognised, attributed or acknowledged in biodiversity conservation in peopled landscapes.

In practice, centring the idea of peopled landscapes (rather than conceiving of the environment as where the impact of people is minimised) shows how invasive plant management and rewilding can be understood as related responses to environmental problems.

Flourishing and coexistence in peopled landscapes require recognition of the diverse human and nonhuman agencies that shape the politics of acceptable action, and illustrate the inseparability of environmental and social justice.

Read the free Plain Language Summary for this article on the Journal blog.
Acrylonitrile‐butadiene‐styrene‐based composites for the manufacture of anthropomorphic simulators
Authors: Thomazi Eduardo , Roman Celso , Vanni Jessica Silvestre , Gamba Thiago O. , Zorzi Janete E. , Perottoni Cláudio A.
Published: February 2024

The development of functional compounds for extrusion applied in the additive manufacturing of anthropomorphic simulators is interesting, as it guarantees the manufacture of a 3D model similar to the patient. These simulators find applications in therapies or laboratory tests involving x‐rays. In order to replicate human conditions in these tests, it is essential to create materials that closely match the properties of human tissue, including the smoothness of soft tissues and the hardness of the bone tissue. This study developed ceramic‐polymeric composites, where the tomography intensity of each mixture was measured experimentally. Combinations of acrylonitrile butadiene styrene (ABS) with zirconium oxide and basic bismuth carbonate allowed imitation of bone tissue. The samples containing zirconium oxide and basic bismuth carbonate presented results that exceeded the minimum limit and reached a value close to 2000 Hounsfield units (HU) with 12% basic bismuth carbonate content. Combinations of ABS with hydroxyapatite and aluminum oxide can imitate soft tissues. The use of a surfactant facilitated the mixing of ceramic filler with polymer. Finally, 3D printing of a physical model was performed using a dual extruder printer, allowing simultaneous printing of bone and soft tissue components.

Highlights

Material mimicking x‐ray attenuation similar to bone tissue.

Relation between 3D printing porosity and intensity in Hounsfield unit.

Computed tomography tests on a 3D printed anthropomorphic phantom.

Creating a 3D model from a Computed Tomography scan.

Double extruder for 3D printing of two tissue simultaneously.
Thermal and mechanical properties of aminolyzed‐poly(lactic acid) with amine‐terminated dendritic polymer: Surface and bulk functionalization
Authors: Shakoorjavan Sima , Dobrzyńska‐Mizera Monika , Akbari Somaye , Sterzyński Tomasz
Published: February 2024

This study details the effect of surface and bulk functionalization of poly(lactic acid) (PLA) with an amine‐terminated dendritic polymer, poly(amidoamine) (PAMAM), on the thermal and mechanical properties of PLA‐based formulations. Fourier‐transform infrared spectroscopy (FTIR) confirmed the presence of –NH2 groups derived from PAMAM, through emerging new peaks at around 1650 cm−1 associated with –NH bending vibration and separate double peak between 3705 and 3110 cm−1 associated with stretching vibration of –NH amide groups, in both surface and bulk functionalized PLA samples. Differential scanning calorimetry (DSC) measurements revealed a lowering of cold‐crystallization temperature (Tcc) for both surface and bulk functionalized PLA, suggesting that PAMAM served as a nucleating agent. According to thermogravimetric results (TGA), bulk treatment deteriorated the thermal stability of the polymer; while surface modification did not influence the decomposition pathway. Mechanical test results revealed that PAMAM greatly influenced the stiffens and ductility of the composites, with more pronounced changes for higher aminolysis rates. Therefore, the 3‐h PAMAM surface functionalization of PLA limits its affinity to solvents' content and enhances crystallization upon permissible deterioration in mechanical properties.

Highlights

Development of aminolyzed‐PLA by surface and bulk modification with PAMAM dendritic polymer.

PAMAM as a nucleating agent for PLA.

Surface modification as the favorable condition to introduce NH2 groups to PLA.
Transforming care planning: linking risk assessment and risk management
Authors: Shaddel Farshad , Weaver Clare
Published: February 2024

It is well established that a good risk assessment is essential for safe care planning in psychiatric inpatient units. However, the current practice, at best, is inconsistent and can fluctuate between being unsafe and being over‐restrictive. Here the authors describe a fresh approach to the process of risk‐informed care planning and how this improved the safety of their patients’ care while making it less restrictive.
Royal College of Psychiatrists International Congress 2023
Authors: Ogden Joy
Published: February 2024

The Royal College of Psychiatrists’ conference was held over four days in Liverpool, in July 2023, with world‐renowned keynote speakers and key opinion leaders in mental health covering a wide range of topics. Joy Ogden reports here on some of the highlights of the conference.
Machine learning models to evaluate mortality in pediatric patients with pneumonia in the intensive care unit
Authors: Lin Siang‐Rong , Wu Jeng‐Hung , Liu Yun‐Chung , Chiu Pei‐Hsin , Chang Tu‐Hsuan , Wu En‐Ting , Chou Chia‐Ching , Chang Luan‐Yin , Lai Fei‐Pei
Published: February 2024

Objectives

This study aimed to predict mortality in children with pneumonia who were admitted to the intensive care unit (ICU) to aid decision‐making.

Study Design

Retrospective cohort study conducted at a single tertiary hospital.

Patients

This study included children who were admitted to the pediatric ICU at the National Taiwan University Hospital between 2010 and 2019 due to pneumonia.

Methodology

Two prediction models were developed using tree‐structured machine learning algorithms. The primary outcomes were ICU mortality and 24‐h ICU mortality. A total of 33 features, including demographics, underlying diseases, vital signs, and laboratory data, were collected from the electronic health records. The machine learning models were constructed using the development data set, and performance matrices were computed using the holdout test data set.

Results

A total of 1231 ICU admissions of children with pneumonia were included in the final cohort. The area under the receiver operating characteristic curves (AUROCs) of the ICU mortality model and 24‐h ICU mortality models was 0.80 (95% confidence interval [CI], 0.69–0.91) and 0.92 (95% CI, 0.86–0.92), respectively. Based on feature importance, the model developed in this study tended to predict increased mortality for the subsequent 24 h if a reduction in the blood pressure, peripheral capillary oxygen saturation (SpO2), or higher partial pressure of carbon dioxide (PCO2) were observed.

Conclusions

This study demonstrated that the machine learning models for predicting ICU mortality and 24‐h ICU mortality in children with pneumonia have the potential to support decision‐making, especially in resource‐limited settings.
Fibrotic lung diseases in children
Authors: Sunman Birce , Kiper Nural
Published: February 2024

In children, pulmonary fibrosis (PF) is an extremely unusual entity that can be observed in some types of interstitial lung disease (ILD). Defining whether ILD is accompanied by PF is important for targeted therapy. Algorithm for the diagnosis of PF in children is not clearly established. Besides, the clinical, radiological, and histological definitions commonly used to diagnose particularly the cases of idiopathic PF in adult patients, is not applicable to pediatric cases. However, a few studies conducted in children offer good exemplary diagnostic approach to fibrosing ILD. Thorax high resonance computed tomography and/or lung biopsy scanning can provide valuable information about PF. Another issue that has not been clearly established is when to start antifibrotic treatment in pediatric patients with PF. The objective of this current review is to provide a comprehensive overview of pediatric PF by drawing upon adult research, particularly focusing on the areas of uncertainty.
Impulse oscillometry bronchodilator response in preschool children
Authors: Meoli Aniello , Trischler Jordis , Hutter Martin , Dressler Melanie , Esposito Susanna , Blümchen Katharina , Zielen Stefan , Schulze Johannes
Published: February 2024

Background

In preschoolers, performing an acceptable spirometry and measuring bronchodilator response (BDR) is challenging; in this context, impulse oscillometry (IOS) represents a valid alternative. However, more studies on the standardization of BDR for IOS in young children are required.

Objective

The objective of the study was to identify optimal thresholds to define a positive BDR test with IOS in preschoolers with suspected asthma.

Methods

Children aged 3–6 years with suspected asthma and their lung function investigated with both IOS and spirometry pre‐ and post‐BDR were retrospectively analyzed. The spirometric BDR was defined as positive when the change of FEV1 was ≥12% or ≥200 mL. The oscillometric BDR was defined as positive in case of change of at least −40% in R5, +50% in X5, and −80% in AX.

Results

Among 72 patients, 36 (age 5.2 ± 1 years; 64% boys) were selected for the subsequent analysis according to ATS/ERS quality criteria of measurements; specifically, 19 patients did not meet IOS and 36 did not meet spirometry criteria. The spirometric BDR was found positive in seven subjects (19.4%); conversely, a positive oscillometric BDR was identified in four patients (11.1%). No patient presented a positive BDR response with both methods. In IOS, the mean decrease in R5 and AX was 19.9% ± 10% and 44% ± 22.1%, and the mean increase in X5 was 23.3% ± 17.8%, respectively. A decrease in R5 of 25.7% (AUC 0.77, p = .03) and an increase in X5 of 25.7% (AUC 0.75, p = .04) showed the best combination of sensitivity and specificity to detect an increase of FEV1 ≥ 12% and/or ≥200 mL.

Conclusion

The IOS represents a valid alternative to spirometry to measure BDR in preschool children and should be the gold standard in this age group. We are considering a decrease of 26% in R5 and an increase of 26% in X5 as diagnostic threshold for BDR.