bluuebunny/crossref_metadata_2025 huggingface dataset:
Romiplostim for treatment of thrombocytopenia in dogs: A retrospective assessment and clinical outcomes
Authors: Ryu Min‐Ok , Kim Jin‐Kyung , An Ju‐Hyun , Seo Kyoung‐Won , Oh Ye‐In , Youn Hwa‐Young
Published: June 2024

Background

Romiplostim, a thrombopoietin analog, is commonly used to treat immune‐mediated thrombocytopenia (ITP) in humans, but its use in dogs remains limited.

Objectives

Evaluate the effects and adverse events of romiplostim administration in dogs with thrombocytopenia caused by various underlying diseases.

Animals

Forty‐two client‐owned dogs with naturally occurring thrombocytopenia at 2 referral animal hospitals.

Methods

Retrospective, multi‐institutional analysis to evaluate the outcomes of romiplostim treatment in dogs.

Results

Among the dogs treated with romiplostim, 27 experienced an increase in platelet count and 26 maintained a platelet count within the reference range. Platelet count improvement was observed in various conditions: primary ITP (90%, n = 18/20), pancytopenia of unknown etiology (42.9%, n = 3/7), chemotherapy‐induced thrombocytopenia (50%, n = 3/6), babesiosis (100%, n = 1/1), radiotherapy‐induced thrombocytopenia (0%, n = 0/1), and disseminated intravascular coagulopathy (33.3%, n = 2/6). The median time for platelet recovery (>50 000/μL) after romiplostim administration was 4 days, and the median time for platelet count normalization was 7 days. Median hospitalization time for the improvement group (I) was 5 days. The survival‐to‐discharge rates were 85%, 40%, and 28.6% for dogs with primary ITP, secondary thrombocytopenia, and thrombocytopenia of unknown etiology, respectively.

Conclusions and Clinical Importance

Romiplostim is a well‐tolerated and promising treatment for primary ITP in dogs, suggesting its potential as a valuable therapeutic option for dogs with thrombocytopenia caused by various underlying conditions. These findings emphasize the need for further research to optimize romiplostim dosing and understand its role in treating secondary thrombocytopenia and pancytopenia of unknown etiology.
Effect of recombinant human thyroid stimulating hormone on radioactive iodine uptake by thyroid carcinoma in dogs
Authors: Scheemaeker Stephanie , Peremans Kathelijne , Vandermeulen Eva , Duchateau Luc , Roggeman Tom , Daminet Sylvie
Published: June 2024

Background

The high doses of radioiodine‐131 (131I) and, subsequently, the high radioactive burden for dog and environment warrants optimization of 131I therapy in dogs with thyroid carcinoma (TC).

Hypothesis/Objectives

To evaluate the effect of a revised protocol with recombinant human thyroid stimulating hormone (rhTSH) on tumor radioactive iodine uptake (RAIU) in dogs with TC.

Animals

Nine client‐owned dogs diagnosed with TC.

Methods

A prospective cross‐over study in which tumor RAIU was calculated and compared at 8 hours (8h‐RAIU) and 24 hours (24h‐RAIU) after injection of radioactive iodine‐123 (123I), once with and once without rhTSH (ie, 250 μg, IM, 24 and 12 hours before 123I) in each dog. Simultaneously, serum total thyroxine (TT4) and TSH were measured at baseline (T0), and 6 (T6), 12 (T12), 24 (T24), and 48 hours (T48) after the first rhTSH administration.

Results

Tumor RAIU was significantly higher at 24 hours with rhTSH compared to no rhTSH (mean difference = 8.85%, 95% CI of [1.56; 16.14]; P = .03), while this was non‐significant at 8 hours (mean difference = 4.54%, 95% CI of [0.35; 8.73]; P = .05). A significant change of serum TT4 (median difference T24 − T0 = 35.86 nmol/L, interquartile range [IQR] = 15.74 nmol/L) and TSH (median difference T24 − T0 = 1.20 ng/mL, IQR = 1.55 ng/mL) concentrations occurred after administration of rhTSH (P < .001).

Conclusions and Clinical Importance

Recombinant human TSH could optimize 131I treatment in dogs with TC by increasing tumor RAIU and thus 131I treatment efficacy.
Potential for extending the chloramphenicol dosing interval for canine urinary tract infections
Authors: KuKanich Kate S. , Anderson Elayna E. , Carcamo Tzic Astrid D. , KuKanich Butch
Published: June 2024

Canine urinary excretion of chloramphenicol was evaluated to optimize a dosing protocol for treating urinary tract infections. Seven healthy male intact purpose‐bred Beagles and six healthy client‐owned dogs of various breeds each received a single oral 50 mg/kg dose of chloramphenicol. Urine was collected at baseline, and 6, 8, 12, and 24 h after chloramphenicol. Chloramphenicol urine concentrations were measured and compared to the epidemiological cutoff value for E. coli (16 mcg/mL). At 8 h, mean chloramphenicol concentration from all dogs was 266.9 mcg/mL (90% CI 136.2–397.7 mcg/mL) but was lower in Beagles than client‐owned dogs. At 12 h, mean chloramphenicol concentration from all dogs was 111.0 mcg/mL (90% CI 36.9–185.0 mcg/mL) and was lower in Beagles (10.6 mcg/mL, 90% CI 1.4–19.8 mcg/mL) than client‐owned dogs (228.0 mcg/mL, 90% CI 103.0–353.1 mcg/mL). Urine half‐life was similar for all dogs (1.8–3.8 h). This justifies dosing chloramphenicol 50 mg/kg PO q 8 h. All client‐owned dogs additionally maintained concentrations well above 16 mcg/mL, for 12 h, suggesting that q 12‐h dosing might be appropriate for non‐Beagle dogs with susceptible lower urinary tract infections. A clinical trial in dogs with urinary tract infections is needed as well as further investigation into potential breed differences.
Transjugular intrahepatic portosystemic shunt in patients with splanchnic vein thrombosis: Prevalence and management of patent foramen ovale
Authors: Becchetti Chiara , De Nicola Stella , Gallo Camilla , Perricone Giovanni , Annoni Giuseppe , Solcia Marco , Musca Francesco , Alfonsi Angela , Morelli Francesco , Barbosa Fabiane , Brambillasca Pietro M. , Rampoldi Antonio , Airoldi Aldo , Belli Luca S.
Published: June 2024

Background and Aims

Transjugular intrahepatic portosystemic shunt (TIPS) is an established procedure for the treatment of several complications of portal hypertension (PH), including non‐neoplastic portal vein thrombosis (PVT). Selection criteria for TIPS in PVT are not yet well established. Despite anecdotal, cases of thromboembolic events from paradoxical embolism due to the presence of patent foramen ovale (PFO) after TIPS placement have been reported in the literature. Therefore, we aimed at describing our experience in patients with non‐neoplastic splanchnic vein thrombosis (SVT) who underwent TIPS following PFO screening.

Methods

We conducted a single‐centre retrospective study, including consecutive patients who underwent TIPS for the complications of cirrhotic and non‐cirrhotic portal hypertension (NCPH) and having SVT.

Results

Of 100 TIPS placed in patients with SVT, 85 patients were screened for PFO by bubble‐contrast transthoracic echocardiography (TTE) with PFO being detected in 22 (26%) cases. PFO was more frequently detected in patients with non‐cirrhotic portal hypertension (NCPH) (23% in the PFO group vs. 6% in those without PFO, p = .04) and cavernomatosis (46% in the PFO group vs. 19% in those without PFO, p = .008). Percutaneous closure was effectively performed in 11 (50%) after multidisciplinary evaluation of anatomical and clinical features. No major complications were observed following closure.

Conclusions

PFO screening and treatment may be considered feasible for patients with SVT who undergo TIPS placement.
Prophylactic antibiotics in patients with alcohol‐associated hepatitis receiving steroids: A systematic review and meta‐analysis
Authors: Quek Joo Wei E. , Loo Jing Hong , Jaroenlapnopparat Aunchalee , Jimenez Cesar , Al‐Karaghouli Mustafa , Vargas Victor , Arab Juan Pablo , Abraldes Juan G. , Wong Yu Jun
Published: June 2024

Background & Aims

The benefits of prophylactic antibiotics in patients with alcohol‐associated hepatitis (AH) receiving steroids remain unclear. We aimed to assess the clinical impact of prophylactic antibiotics in AH patients receiving steroids.

Methods

We systematically reviewed four electronic databases from inception to 30 November 2023. Pooled estimates were analysed using random‐effects models. The primary outcome was 90‐day survival. Secondary outcomes included infection at days 30 and 90 days, hepatorenal syndrome (HRS), acute kidney injury (AKI), hepatic encephalopathy (HE) and drug‐related adverse events (AE). Trial sequential analyses were performed for the primary outcome of 90‐day mortality.

Results

We screened 419 articles and included six eligible studies (four RCTs and two matched cohort studies) with a total of 510 patients. Compared to standard medical treatment (SMT), prophylactic antibiotics were associated with a lower risk of infection at 30 days (OR: 0.35, 95%CI: 0.20–0.59, I
2 = 0%), infection at 90 days (OR: 0.26, 95%CI: 0.10–0.67, I
2 = 0%) and a lower rate of HE (OR: 0.32, 95%CI: 0.12–0.87, I
2 = 0%). However, prophylactic antibiotics did not improve 90‐day survival, sepsis‐related mortality, HRS, or AKI. The risks of drug‐related AE and fungal infections were similar in patients with AH who received prophylactic antibiotics or SMT. Using trial sequential analysis, the minimum sample size required to detect a 15% relative risk reduction in 90 days mortality with prophylactic antibiotics was 1171.

Conclusions

In hospitalized AH patients receiving steroid therapy, prophylactic antibiotics reduced the risk of infection and HE, but did not improve survival or prevent AKI compared to SMT.
Economic growth and Indian wealth‐income ratios in the long run: 1860–2018
Authors: Kumar Rishabh
Published: June 2024

This paper presents new series on the evolution of wealth‐income ratios in India. I construct a new macro‐history dataset, covering the period 1860–2018 and containing historical series on the composition and level of national wealth, national income, savings, investment and prices. These data show a gradual rise in India's national wealth‐to‐national income ratio (β = W/Y) since the mid‐twentieth century, with the main takeoff occurring around the end of the twentieth century. I ascribe this pattern to the steady increase in saving rates since independence which were themselves the consequence of income shifts in favor of higher saving sectors under India's mixed economy era. Prior to 1950, wealth‐income ratios fluctuated a lot on account of land prices and low economic growth. These series offer an alternative timeline of wealth concentration in the absence of long‐run distributional data. In colonial India, land was dominant in national wealth, and its ownership was concentrated. In recent decades the importance of capital and urban land—both also concentrated in ownership—has increased.
ICU nurses' practice and intention to implement early mobilization: A multi‐centre cross‐sectional survey
Authors: Wang Jiani , Shi Chenxi , Xiao Qian , Jia Yanrui
Published: June 2024

Background

Early mobilization (EM) is acknowledged for its safety and benefits in the recovery of critically ill patients, yet its implementation in intensive care units (ICU) remains inconsistently aligned with established guidelines. This discrepancy highlights a gap between theoretical endorsement and practical application. While barriers to EM have been extensively studied, the intentions and perceived practices of ICU nurses towards EM, especially in certain geographical regions, have not been adequately understood.

Aim

The objective of this study is to assess the perceptions, actual practices and intentions of ICU nurses regarding the implementation of EM for patients in the ICU setting.

Study Design

A cross‐sectional, multi‐centre, survey‐based study.

Results

The study collected data through an electronic questionnaire from 227 ICU nurses across eight hospitals in Beijing, China, concerning their experiences, practices and intentions related to EM. The survey response rate was 50% (114 of 227), indicating a moderate level of engagement by the target population. Among the surveyed participants, 68.7% (n = 156) reported having experience with EM for critically ill patients. Of these experienced nurses, 49.3% (n = 77) indicated they carried out EM less frequently than once per week, while only 29.5% (n = 46) reported dedicating more than 20 min to EM activities per patient. Only 24.2% (n = 55) of participants confirmed the presence of specific EM guidelines in their workplace. Notably, guideline adherence could be influenced by the patient's condition severity, which may affect how these protocols are applied. Notably, the approach and frequency of EM practices showed significant variation across different ICUs. A substantial majority (75%, n = 170) of participants expressed a strong intention towards implementing EM, correlating significantly with factors such as having a higher education level (bachelor's degree or higher), receiving departmental support, encountering fewer perceived barriers, and belonging to specific departments like respiratory (SICU) and surgery (RICU). The EM guidelines mentioned by participants were primarily focused on specific protocols and guidance, highlighting the emphasis on structured approaches to EM in their clinical settings.

Conclusions

Despite the recognized experience with EM among ICU nurses, there is a notable divergence between their practices and the recommendations outlined in EM guidelines. This study underscores the need for the establishment of clear, actionable guidelines, alongside the provision of targeted educational programmes and robust support systems, to foster the consistent and effective implementation of EM in ICU settings.

Relevance to Clinical Practice

This study underscores the clinical relevance of EM in ICU settings, advocating for the development of precise EM guidelines to improve patient outcomes.
Putting soil microbes on first: identifying the engines of home‐field advantage in litter decomposition
Authors: Keiser Ashley D.
Published: June 2024

This article is a Commentary on Shigyo et al. (2024); 243: 2146–2156.
NAcM‐OPT protects keratinocytes from H2O2‐induced cell damage by promoting autophagy
Authors: Xiong Renxue , Shen Qingmei , Li Yujie , Jin Shiyu , Dong Tingru , Song Xiuzu , Guan Cuiping
Published: June 2024

This study aimed to investigate the protective effect of NAcM‐OPT, a small molecule inhibitor of defective in cullin neddylation 1 (DCN1), on H2O2‐induced oxidative damage in keratinocytes. Immortalized human keratinocytes (HaCaT cells) were treated with NAcM‐OPT and exposed to oxidative stress. CCK‐8 assays were used to measure cell viability. The mGFP‐RFP‐LC3 dual fluorescent autophagy indicator system was utilized to evaluate changes in autophagic flux. Western blotting was used to measure the expression of the autophagy‐related proteins LC3 and Beclin 1. Keratinocytes were treated with the autophagy activator rapamycin, and HaCaT cell supernatant was added to PIG1 cells (immortalized human melanocytes), followed by evaluation of tyrosinase (TYR) expression via qRT‐PCR. NAcM‐OPT increased cell viability and cell proliferation. Furthermore, this molecule promoted autophagic flux through increased expression of autophagy‐related proteins under H2O2‐induced oxidative stress. Additionally, rapamycin increased the mRNA levels of TYR in PIG1 cells. Moreover, NAcM‐OPT alleviated mitochondrial damage, restored mitochondrial function, and upregulated the expression of NFE2L2, HO1, NQO1, and GCLM. Importantly, NAcM‐OPT also increased epidermal thickness, follicle length, and melanin synthesis under oxidative stress in vivo. These findings suggest that NAcM‐OPT may be a promising small molecule antioxidant drug for the treatment of vitiligo.
Regulation of a single inositol 1‐phosphate synthase homeologue by HSFA6B contributes to fibre yield maintenance under drought conditions in upland cotton
Authors: Yu Li'ang , Dittrich Anna C. Nelson , Zhang Xiaodan , Brock Jordan R. , Thirumalaikumar Venkatesh P. , Melandri Giovanni , Skirycz Aleksandra , Edger Patrick P. , Thorp Kelly R. , Hinze Lori , Pauli Duke , Nelson Andrew D.L.
Published: June 2024

Drought stress substantially impacts crop physiology resulting in alteration of growth and productivity. Understanding the genetic and molecular crosstalk between stress responses and agronomically important traits such as fibre yield is particularly complicated in the allopolyploid species, upland cotton (Gossypium hirsutum), due to reduced sequence variability between A and D subgenomes. To better understand how drought stress impacts yield, the transcriptomes of 22 genetically and phenotypically diverse upland cotton accessions grown under well‐watered and water‐limited conditions in the Arizona low desert were sequenced. Gene co‐expression analyses were performed, uncovering a group of stress response genes, in particular transcription factors GhDREB2A‐A and GhHSFA6B‐D, associated with improved yield under water‐limited conditions in an ABA‐independent manner. DNA affinity purification sequencing (DAP‐seq), as well as public cistrome data from Arabidopsis, were used to identify targets of these two TFs. Among these targets were two lint yield‐associated genes previously identified through genome‐wide association studies (GWAS)‐based approaches, GhABP‐D and GhIPS1‐A. Biochemical and phylogenetic approaches were used to determine that GhIPS1‐A is positively regulated by GhHSFA6B‐D, and that this regulatory mechanism is specific to Gossypium spp. containing the A (old world) genome. Finally, an SNP was identified within the GhHSFA6B‐D binding site in GhIPS1‐A that is positively associated with yield under water‐limiting conditions. These data lay out a regulatory connection between abiotic stress and fibre yield in cotton that appears conserved in other systems such as Arabidopsis.
Transcriptomic analysis of a cold‐resistant Nordic microalga: unraveling the mechanisms underlying adaptation to low temperatures
Authors: Spain Olivia , Bajhaiya Amit K. , Tanner Hugh , Cook Sam , Funk Christiane
Published: June 2024

Cold stress imposes a great physiological impact on most photosynthetic organisms. The acclimation to cold is very poorly studied in microalgae, even though understanding the molecular mechanisms underlying their cold tolerance has implications for biotechnological applications, such as the development of cold‐tolerant strains for industrial purposes. Scenedesmus sp. B2‐2 is a Nordic strain of green freshwater microalgae that thrives in cold conditions. Here, we analyzed transcriptomic changes of B2‐2 when exposed to the cold (5°C) and compared it to a control grown at 25°C. The aim was to understand more about the mechanisms underlying B2‐2's adaptation to low temperatures. We studied differentially expressed genes (DEGs) related to lipid synthesis, carbon metabolism and photosynthesis. Scenedesmus sp. B2‐2 produced more lipids when exposed to cold conditions and did not reduce its carbon metabolism or photosynthetic processes. 24 putative cold‐responsive genes were found to be non‐responsive in Scenedesmus sp. B2‐2 when grown at 5°C. These genes could serve as targets for genetic engineering to enhance cold tolerance in algal strains used in biotechnology. We also studied B2‐2´s cell wall changes in response to cold by measuring cell wall thickness at 1, 4, 12, 24, 48, 72, 120 and 240 hours of cold exposure and correlating the results to the transcriptomic data. The results show that the cell wall thickens with increased duration of cold exposure. Several glycosyltransferases were found to be significantly up‐regulated throughout cold exposure and may play a role in cell wall thickening.
Decoding load or selection in visuospatial working memory?
Authors: Tortajada Miriam , Fahrenfort Johannes J. , Sandoval‐Lentisco Alejandro , Martínez‐Pérez Víctor , Palmero Lucía B. , Castillo Alejandro , Fuentes Luis J. , Campoy Guillermo , Olivers Christian N. L.
Published: June 2024

Flexible updating of information in Visual Working Memory (VWM) is crucial to deal with its limited capacity. Previous research has shown that the removal of no longer relevant information takes some time to complete. Here, we sought to study the time course of such removal by tracking the accompanying drop in load through behavioral and neurophysiological measures. In the first experimental session, participants completed a visuospatial retro‐cue task in which the Cue‐Target Interval (CTI) was manipulated. The performance revealed that it takes about half a second to make full use of the retro‐cue. In a second session, we sought to study the dynamics of load‐related electroencephalographic (EEG) signals to track the removal of information. We applied Multivariate Pattern Analysis (MVPA) to EEG data from the same task. Right after encoding, results replicated previous research using MVPA to decode load. However, especially after the retro‐cue, results suggested that classifiers were mainly sensitive to a selection component, and not so much to load per se. Additionally, visual cue variations, as well as eye movements that accompany load manipulations can also contribute to decoding. These findings advise caution when using MVPA to decode VWM load, as classifiers may be sensitive to confounding operations.
The problems with pin bones: Intermuscular bone development and function in salmonids and their implications for aquaculture
Authors: Lyall Brianne A. , Witten P. Eckhard , Carter Chris G. , Perrott Matthew R. , Symonds Jane E. , Walker Seumas P. , Waddington Zac , Amoroso Gianluca
Published: June 2024

A healthy skeletal system is fundamental to fish welfare and performance and a key physiological feature of a robust fish. The presence of skeletal deformities in farmed salmonids is a persistent welfare problem in aquaculture, and one which threatens to impede industry growth. Deformities of the fine bones of fish, such as ribs and intermuscular bones (IBs), have received less attention than vertebral body deformities, despite their potential to compromise fish welfare and product quality. IBs, commercially known as pin bones, are small spicule‐like bones embedded in the muscle fillets of salmonids, cyprinids and other basal teleost species. In farmed basal teleosts, they impact fish processing, have negative effects on the economic value of fish and present a potential consumer health concern if ingested. Current understanding of IB development and function in teleosts has mostly relied on morphological research. More recently, advances in our understanding of molecular mechanisms of IB development in cyprinids have been made, largely due to the exploration of breeding IB‐free fish for use in aquaculture. In this review, we explore the existing literature on IBs in teleosts, highlight the points of contention within this field of research and identify the significant knowledge gaps about the development and function of salmonid IBs. To our knowledge, there is no available research on the function of IBs and scarce research concerning IB development in salmonids. Future research on teleost IBs would benefit from the use of consistent terminology to facilitate interdisciplinary collaboration and identify research outputs in this field.
Mixedness in conflict: The impact of Yugoslav wars on intermarriages in the Western Balkans
Authors: Lendák‐Kabók Karolina
Published: June 2024

This paper examines the phenomenon of intermarriages in the Western Balkans, shedding light on their intricate relationship with the region's tumultuous history, ethnic diversity, and socio‐political dynamics. Through a comprehensive exploration of interethnic unions across different areas, the study delves into how these marriages have historically served as symbols of coexistence and integration, particularly during the mid‐20th century, when they were encouraged by the newly‐formed states to unite the different nations living in them. However, the rise of ethno‐nationalism and the Yugoslav Wars significantly impacted these marital patterns, underscoring the complex interplay between politics, culture, and traditional norms. The paper highlights the decline in mixed marriages post‐war, persistent ethnic tensions, and varying dynamics in different locales, suggesting that comprehensive approaches are needed for sustainable peace and unity in the Western Balkans. Through this lens, intermarriages emerge not just as personal unions but as potent symbols and potential catalysts for broader societal transformations, albeit within a context of considerable challenges and the need for nuanced, multifaceted approaches to fostering lasting interethnic harmony.
Skin & SMAS layer remodeling technique (SSRT): Achieving both volume and lifting effects with filler treatments
Authors: Hong Gi‐Woong , Yi Kyu‐Ho
Published: June 2024

Background

The skin & SMAS layer remodeling technique (SSRT) represents a significant advancement in facial aesthetic treatments. Traditional methods primarily address wrinkles and volume loss, whereas SSRT focuses on achieving both volume and natural lifting effects through strategic filler injections. This technique emphasizes the anatomical and dynamic properties of facial tissues, particularly the SMAS, to enhance facial symmetry and contours while maintaining natural movement.

Materials and Methods

SSRT employs a combination of firm and soft hyaluronic acid fillers to sculpt a youthful, dynamic appearance, simulating the natural lift of a smiling expression. This study explores the effects of gravity on facial tissues and uses advanced imaging techniques to corroborate the shifting of tissues. The technique is compared with other recognized methods, such as true lift and myomodulation, to evaluate its effectiveness in balancing volume enhancement and dynamic facial expressions.

Results

The results indicate that SSRT uniquely balances volume enhancement and dynamic facial expressions, achieving a visibly lifted but natural appearance. The use of advanced imaging techniques substantiates SSRT's effectiveness by showing the shifting of tissues. SSRT reduces the risks associated with excessive filler use and aligns with contemporary aesthetic preferences.

Conclusion

SSRT offers a novel approach by mimicking the facial lift observed when lying down, providing insights into potential transformative “lifts” when upright. By strategically combining firm and soft hyaluronic acid fillers, SSRT achieves a balance of volume and lift, enhancing facial symmetry and maintaining natural movement. This technique represents a significant advancement in facial aesthetic treatments, offering a natural and dynamic alternative to traditional methods.
Ambient noise tomography reveals complex crustal structure beneath eastern and northeastern Tibet: Insight into regional crustal flow
Authors: Wu Tengfei , Zou Chenyang , Hua Yujin , Chen Meng
Published: June 2024

We present a 3‐D crustal S‐wave velocity (Vs) model for eastern and northeastern Tibet utilizing ambient noise tomography. Our model reveals that crustal flow channels are absent in northeastern Tibet. In this region, the Kunlun Fault (KLF) significantly impacts mid‐lower crust low‐Vs anomalies. In addition, isolated low‐Vs anomalies beneath the Qilian orogeny are unrelated to the low‐Vs materials of the Tibetan Plateau. In the mid‐lower crust of the Songpan‐Ganzi terrane, its northeastern corner exhibits continuous low‐Vs anomalies, limited to areas south of the West Qinglin and west of 104° E. This suggests that a small‐scale northward viscous flow of crustal materials exists in the eastern KLF. However, two significant crustal flow channels (Vs ≤ 3.3 km/s) are observed in eastern Tibet. The east–west tectonic movements and the obstruction of the Sichuan Basin together facilitate the dispersion of crustal materials southward from eastern Tibet.
Removal of an anterior chamber foreign body using hydropulsion and ophthalmic viscoelastic device capture in a dog
Authors: Wiggans K. Tomo
Published: June 2024

Objective

To describe the removal of an adherent, presumed plant‐based, anterior chamber foreign body (ACFB) from the inferior iridocorneal angle in a dog using hydropulsion and ophthalmic viscoelastic device (OVD) capture.

Animal Studied

A 6‐year‐old female spayed pit bull terrier who was referred for further evaluation of a corneal opacity after being observed running into a thorned succulent plant 1 month earlier. On ophthalmic examination, no corneal foreign body was noted, though mild uveitis was present. Gonioscopy revealed a suspected plant foreign body (thorn tip) in the inferior iridocorneal angle.

Procedure

Under general anesthesia, the ACFB was dislodged from the inferior iridocorneal angle using hydropulsion with balanced salt solution. The superior half of the anterior chamber had been filled with 2% hydroxypropyl methylcellulose OVD to trap the foreign object. One month later, the uveitis had resolved and repeat gonioscopy confirmed the absence of any ACFB in the iridocorneal angle.

Conclusion

In the absence of an intraoperative goniolens or endoscopy, hydropulsion and OVD capture of adherent ACFBs may be a feasible option for removal.
Algebraicity of hypergeometric functions with arbitrary parameters
Authors: Fürnsinn Florian , Yurkevich Sergey
Published: June 2024

We provide a complete classification of the algebraicity of (generalized) hypergeometric functions with no restriction on the set of their parameters. Our characterization relies on the interlacing criteria of Christol and Beukers–Heckman for globally bounded and algebraic hypergeometric functions, however, in a more general setting that allows arbitrary complex parameters with possibly integral differences. We also showcase the adapted criterion on a variety of different examples.
Anti-melanoma differentiation-associated gene 5 (anti-MDA5) positive dermatomyositis: early detection is crucial
Authors: Goradia Shruti , Holper Sarah , Lim Yuan Z , Brady Sharmayne R E
Published: June 2024

Anti-melanoma differentiation-associated gene 5-positive (Anti-MDA5) dermatomyositis (DM) is an aggressive phenotype of DM associated with rapidly progressive interstitial lung disease (RP-ILD). It is a rare condition that carries high mortality. Diagnosis and management of patients with anti-MDA5 DM RP-ILD presents several challenges, including uncertainty around treatment algorithms and a lack of evidence to inform practice. This case report of a patient with anti-MDA5 DM RP-ILD highlights these challenges, emphasising the fulminant course of this disease despite aggressive immunosuppression. Further research is required to guide management and to minimise morbidity and mortality, and greater awareness of the condition is required to minimise delays in diagnosis.
Reducing intersectional stigma among transgender women in Brazil to promote uptake of HIV testing and PrEP: study protocol for a randomised controlled trial of Manas por Manas
Authors: Sevelius Jae , Veras Maria Amelia Sousa Mascena , Gomez Jose Luis , Saggese Gustavo , Mocello Adrienne Rain , Bassichetto Katia Cristina , Neilands Torsten B , Lippman Sheri A
Published: June 2024

Introduction

Globally, transgender (‘trans’) women experience extreme social and economic marginalisation due to intersectional stigma, defined as the confluence of stigma that results from the intersection of social identities and positions among those who are oppressed multiple times. Among trans women, gender-based stigma intersects with social positions such as engagement in sex work and substance use, as well as race-based stigma to generate a social context of vulnerability and increased risk of HIV acquisition. In Brazil, trans women are the ‘most at-risk’ group for HIV, with 55 times higher estimated odds of HIV infection than the general population; further, uptake of HIV testing and pre-exposure prophylaxis (PrEP) among trans women is significantly lower than other at-risk groups. Through extensive formative work, we developed Manas por Manas, a multilevel intervention using HIV prevention strategies with demonstrated feasibility and acceptability by trans women in Brazil, to address intersectional stigma and increase engagement in the HIV prevention continuum.

Methods and analysis

We are conducting a two-arm randomised wait-list controlled trial of the intervention’s efficacy in São Paulo, Brazil, to improve uptake of HIV testing and PrEP among transgender women (N=400). The primary outcomes are changes in HIV testing (self-testing and clinic based), changes in PrEP uptake and changes in PrEP persistence at baseline and follow-up assessment for 12 months at 3-month intervals.

Ethics and dissemination

This study was approved by University of California, San Francisco Institutional Review Board (15-17910) and Comissão Nacional de Ética em Pesquisa (Research Ethics National Commission, CAAE: 25215219.8.0000.5479) in Brazil. Participants provided informed consent before enrolment. We are committed to collaboration with National Institutes of Health officials, other researchers, and health and social services communities for rapid dissemination of data and sharing of materials. The results will be published in peer-reviewed academic journals and scientific presentations.

Trial registration number

NCT03081559.
Statins for neuroprotection in spontaneous intracerebral haemorrhage (STATIC): protocol for a multicentre, prospective and randomised controlled trial
Authors: Gao Daiquan , Chu Xuehong , Zhang Yunzhou , Yan Heli , Niu Lijian , Jiang Xuebin , Bao Shiying , Ji Xunming , Wu Chuanjie
Published: June 2024

Introduction

Intracerebral haemorrhage (ICH) is a neurological emergency with high morbidity and mortality, and current treatment is limited. Emerging evidence has reported that statins can exert neuroprotective effects in cerebrovascular diseases. However, most of the published clinical studies are retrospective. Therefore, it is important to conduct a prospective randomised controlled trial to further validate the efficacy and safety of statins in patients with ICH.

Methods and analysis

The present study is performed at Xuan Wu Hospital Capital Medical University, Beijing Fengtai You'anmen Hospital and Shunping County Hospital, Hebei Province. The target number of patients is 98. Eligible patients are randomly assigned in a 1:1 ratio to the statins group or the control group. The primary outcome is the perihaemorrhagic oedema to haematoma ratio at 7 days. Secondary outcomes include mortality at 30 days, haematoma resolution rate at 7 days, National Institute of Health stroke scale (NIHSS) score at 7 days or discharge, ordinal distribution of modified Rankin scale (mRS) score at 90 days, the proportion of patients with an mRS score of 0–2 on day 90, the proportion of patients with an mRS score of 0–3 on day 90, absolute haematoma volume changes between initial and 7-day follow-up CT scan, absolute perihaematomal oedema changes between initial and 7-day follow-up CT scan.

Ethics and dissemination

The trial has been approved by the ethics committees of Xuan Wu Hospital Capital Medical University, Beijing Fengtai You'anmen Hospital and Shunping County Hospital, Hebei Province. The results will be disseminated in a peer-reviewed journal and in conference reports.

Trial registration number

NCT04857632.
Unravelling clinicians’ shared decision-making adoption: a qualitative exploration through the lens of diffusion of innovations theory
Authors: Spinnewijn Laura , Aarts Johanna WM , Braat Didi , Scheele Fedde
Published: June 2024

Objectives

This study uses the diffusion of innovations (DOI) theory to comprehensively understand the adoption of shared decision-making (SDM) in clinical practice, specifically focusing on the ‘knowledge’ and ‘persuasion’ stages within DOI. We aim to understand the challenges and dynamics associated with SDM adoption, offering insights for more patient-centred decision-making in healthcare.

Design

This qualitative study employs a modified framework analysis approach, integrating ethnographic and interview data from prior research, along with additional interviews. The framework used is based on the DOI theory.

Study setting and participants

This study was conducted in the obstetrics and gynaecology department of a tertiary teaching hospital in the Eastern region of the Netherlands. It included interviews with 20 participants, including gynaecologists, obstetrics registrars and junior doctors currently practising in the department. Additionally, data from prior research conducted within the same department were incorporated, ensuring the maintenance of contextual consistency.

Results

Findings reveal a complex interplay between SDM’s benefits and challenges. Clinicians value SDM for upholding patient autonomy and enhancing medical practice, viewing it as valuable for medical decision-making. Decision aids are seen as advantageous in supporting treatment decisions. Challenges include compatibility issues between patient and clinician preferences, perceptions of SDM as time-consuming and difficult and limitations imposed by the rapid pace of healthcare and its swift decisions. Additionally, perceived complexity varies by situation, influenced by colleagues’ attitudes, with limited trialability and sparsely observed instances of SDM.

Conclusions

Clinicians’ decision to adopt or reject SDM is multifaceted, shaped by beliefs, cognitive processes and contextual challenges. Cognitive dissonance is critical as clinicians reconcile their existing practices with the adoption of SDM. Practical strategies such as practice assessments, open discussions about SDM’s utility and reflective practice through professional development initiatives empower clinicians to make the best informed decision to adopt or reject SDM.
Is screening for motor skill deficits in Tyrolean preschool children warranted and feasible? A protocol for a two-stage cross-sectional study
Authors: Scheiber Barbara , Spiegl Claudia , Plattner Jasmin , Monsberger Sabine , Federolf Peter
Published: June 2024

Introduction

Children with developmental coordination disorder (DCD) show deviations in motor development and motor skills in early childhood where the learning and execution of coordinated motor skills are below the level expected for their age. Early detection of DCD is critical to provide an opportunity for intervention and support, yet many cases remain undetected until school age. The study described aims to determine the warranty, feasibility and validity of a mobility screening in Tyrolean kindergartens and evaluate its potential benefit to enhance the motor development prospects of affected children.

Methods and analysis

This research employs a two-stage cross-sectional approach with 6 months of follow-up assessments. The initial stage involves a playful mobility screening for all participating kindergarten children, followed by individual assessments for those displaying conspicuous motor skills. Motor skills will be evaluated using MobiScreen 4–6 and the Movement Assessment Battery for Children-2. Prior to the screening, informed consent is obtained from kindergarten bodies and authorities, parents and the children themselves. Parents are provided with information sheets and questionnaires to assess their attitudes and their child’s eligibility. The study described aims to form a representative sample of kindergarten children, aged 4–6, in Tyrol. To target approximately 20–40 children with DCD for follow-up, the goal is to include 650 children, assuming an incidence of 3%–6%. For the follow-up, matching control groups will be formed and information about how identified motor deficits were addressed, including therapies or sports, will be gathered. Quantitative data will mainly be analysed descriptively, while feedback from kindergarten teachers regarding the practical implementation will be analysed using qualitative content analyses, according to Mayring.

Ethics and dissemination

The study has been approved by the Research Committee for Scientific Ethical Questions (RCSEQ 3369/24). Findings will be disseminated through contributions, peer-reviewed journals, and conferences.
Description of subgroup reporting in clinical trials of chronic diseases: a meta-epidemiological study
Authors: Wei Lili , Butterly Elaine , Rodríguez Pérez Jesús , Chowdhury Avirup , Shemilt Richard , Hanlon Peter , McAllister David
Published: June 2024

Introduction

In trials, subgroup analyses are used to examine whether treatment effects differ by important patient characteristics. However, which subgroups are most commonly reported has not been comprehensively described.

Design and settings

Using a set of trials identified from the US clinical trials register (ClinicalTrials.gov), we describe every reported subgroup for a range of conditions and drug classes.

Methods

We obtained trial characteristics from ClinicalTrials.gov via the Aggregate Analysis of ClinicalTrials.gov database. We subsequently obtained all corresponding PubMed-indexed papers and screened these for subgroup reporting. Tables and text for reported subgroups were extracted and standardised using Medical Subject Headings and WHO Anatomical Therapeutic Chemical codes. Via logistic and Poisson regression models we identified independent predictors of result reporting (any vs none) and subgroup reporting (any vs none and counts). We then summarised subgroup reporting by index condition and presented all subgroups for all trials via a web-based interactive heatmap (https://ihwph-hehta.shinyapps.io/subgroup_reporting_app/).

Results

Among 2235 eligible trials, 23% (524 trials) reported subgroups. Follow-up time (OR, 95%CI: 1.13, 1.04–1.24), enrolment (per 10-fold increment, 3.48, 2.25–5.47), trial starting year (1.07, 1.03–1.11) and specific index conditions (eg, hypercholesterolaemia, hypertension, taking asthma as the reference, OR ranged from 0.15 to 10.44), predicted reporting, sponsoring source and number of arms did not. Results were similar on modelling any result reporting (except number of arms, 1.42, 1.15–1.74) and the total number of subgroups. Age (51%), gender (45%), racial group (28%) were the most frequently reported subgroups. Characteristics related to the index condition (severity/duration/types etc) were frequently reported (eg, 69% of myocardial infarction trials reported on its severity/duration/types). However, reporting on comorbidity/frailty (five trials) and mental health (four trials) was rare.

Conclusion

Other than age, sex, race ethnicity or geographic location and characteristics related to the index condition, information on variation in treatment effects is sparse.

PROSPERO registration number

CRD42018048202.
Protocol for a double-blind placebo-controlled randomised controlled trial assessing the impact of oral semaglutide in amyloid positivity (ISAP) in community dwelling UK adults
Authors: Koychev Ivan , Adler Amanda I , Edison Paul , Tom Brian , Milton Joanne E , Butchart Joe , Hampshire Adam , Marshall Charles , Coulthard Elizabeth , Zetterberg Henrik , Hellyer Peter , Cormack Francesca , Underwood Benjamin R , Mummery Catherine J , Holman Rury R
Published: June 2024

Introduction

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), currently marketed for type 2 diabetes and obesity, may offer novel mechanisms to delay or prevent neurotoxicity associated with Alzheimer’s disease (AD). The impact of semaglutide in amyloid positivity (ISAP) trial is investigating whether the GLP-1 RA semaglutide reduces accumulation in the brain of cortical tau protein and neuroinflammation in individuals with preclinical/prodromal AD.

Methods and analysis

ISAP is an investigator-led, randomised, double-blind, superiority trial of oral semaglutide compared with placebo. Up to 88 individuals aged ≥55 years with brain amyloid positivity as assessed by positron emission tomography (PET) or cerebrospinal fluid, and no or mild cognitive impairment, will be randomised. People with the low-affinity binding variant of the rs6971 allele of the Translocator Protein 18 kDa (TSPO) gene, which can interfere with interpreting TSPO PET scans (a measure of neuroinflammation), will be excluded.

At baseline, participants undergo tau, TSPO PET and MRI scanning, and provide data on physical activity and cognition. Eligible individuals are randomised in a 1:1 ratio to once-daily oral semaglutide or placebo, starting at 3 mg and up-titrating to 14 mg over 8 weeks. They will attend safety visits and provide blood samples to measure AD biomarkers at weeks 4, 8, 26 and 39. All cognitive assessments are repeated at week 26. The last study visit will be at week 52, when all baseline measurements will be repeated. The primary end point is the 1-year change in tau PET signal.

Ethics and dissemination

The study was approved by the West Midlands—Edgbaston Research Ethics Committee (22/WM/0013). The results of the study will be disseminated through scientific presentations and peer-reviewed publications.

Trial registration number

ISRCTN71283871.
Public preferences and willingness to pay for a net zero NHS: a protocol for a discrete choice experiment in England and Scotland
Authors: Loría-Rebolledo Luis Enrique , Abbott Michael , Antunes Mélanie , Norwood Patricia , Ryan Mandy , Watson Verity , Wu Hangjian
Published: June 2024

Introduction

Climate change poses a major threat to our health, livelihoods and the planet. In 2020, the UK National Health Service (NHS) committed to reducing its Scope 1, 2 and 3 emissions to reach net zero by 2045. Although a net zero NHS would help to limit the consequences of climate change, little is known about the UK general public’s values and preferences for the proposed service changes needed to reach net zero.

Methods

This study will elicit the public’s preferences for actions to help achieve net zero NHS in England and Scotland using a discrete choice experiment (DCE). The DCE attributes and levels describe actions that can be taken by the NHS across key areas: buildings and estates, outdoor space, travel and transport, provision of care, goods and services and food and catering. The survey was designed using online think-aloud interviews with 17 members of the public. Two versions of the survey will be administered to a sample of up to 2200 respondents. One will include a payment vehicle as income tax increases. We will estimate the relative importance of each attribute and, for the former survey, the monetary trade-offs which individuals are willing to make between attributes. Where possible, we will match both samples to gauge preference robustness with the inclusion of the monetary payment. We will test whether respondents’ preferences differ based on their socioeconomic circumstances and attitudes toward the NHS and climate change.

Ethics and dissemination

The University of Aberdeen’s School of Medicine, Medical Sciences and Nutrition Ethics Research Board has approved the study (reference: SERB/690090). All participants will provide informed consent. Results will be submitted to peer-reviewed publications and presented at relevant conferences and seminars. A lay summary of the research will be published on the Health Economics Research Unit website.