bluuebunny/crossref_metadata_2025 huggingface dataset:
Aid, Attitudes, and Insurgency: Evidence from Development Projects in Northern Afghanistan
Authors: Sexton Renard , Zürcher Christoph
Published: April 2023

Prevalent counterinsurgency theories posit that small development aid projects can help stabilize regions in conflict. A widely assumed mechanism runs through citizen attitudes, often called “winning hearts and minds,” where aid brings economic benefits and sways public perceptions, leading to more cooperation and, eventually, less violence. Following a preregistered research design, we test this claim using difference‐in‐differences, leveraging original survey data, and new geocoded information about infrastructure projects in northern Afghanistan. We find that aid improves perceived economic conditions but erodes attitudes toward government and improves perceptions of insurgents. These attitudinal effects do not translate into changes in violence or territorial control. Testing mechanisms, we find projects with robust local consultation have fewer negative attitudinal effects, as do health and education projects. These findings challenge the “hearts and minds” theory but complement the wider literature on legitimacy, suggesting that foreign aid can improve human development but rarely meaningfully brings political stabilization.
No Entry in a Pandemic: Public Support for Border Closures
Authors: Kobayashi Yoshiharu , Cilizoglu Menevis , Heinrich Tobias , Christiansen William
Published: April 2023

Effective response to and rapid and reliable detection of infectious disease outbreaks require successful coordination of countries’ border policies early on. As threats from diseases are highly salient to the public, researchers agree that a better understanding of domestic politics is crucial. This article investigates a key piece of this question: public demands for border closures. Our experiments in the United Kingdom and the United States show that a greater pandemic threat mildly increases support for border closures, but the World Health Organization's (WHO) guidance against border closures and reminders about international legal obligations to follow the guidance substantially weaken support for border closures. However, during the COVID‐19 pandemic, many countries flouted WHO's recommendations and restricted their borders. Examining media attention suggests people's lack of knowledge of the WHO guidance as a crucial reason for those border closures. Our study produces insights into the design of effective global health governance.
Border Anxiety in International Discourse
Authors: Simmons Beth A. , Shaffer Robert
Published: April 2023

International borders have become a growing security concern in many parts of the world. Porous borders have raised concerns about a host of external threats—real and imagined—that in turn potentially inform policy decisions about border security. We examine global official discourse and show that border discourse has become more frequent, localized, non‐state‐centric, and negative over time. However, negative rhetoric is not convincingly linked with objective measures of globalization is only partially explained by political violence between and within states, and influences border‐hardening policies. This raises the possibility that the border fortification trend noted in the international relations literature has not only a material basis but is also fueled by negative emotive rhetoric that may be deployed strategically for domestic purposes. We call for a research agenda that incorporates border discourse more centrally into international and comparative politics.
FiNuTyper: Design and validation of an automated deep learning‐based platform for simultaneous fiber and nucleus type analysis in human skeletal muscle
Authors: Lundquist August , Lázár Enikő , Han Nan S. , Emanuelsson Eric B. , Reitzner Stefan M. , Chapman Mark A. , Shirokova Vera , Alkass Kanar , Druid Henrik , Petri Susanne , Sundberg Carl J. , Bergmann Olaf
Published: April 2023

Aim

While manual quantification is still considered the gold standard for skeletal muscle histological analysis, it is time‐consuming and prone to investigator bias. To address this challenge, we assembled an automated image analysis pipeline, FiNuTyper (Fiber and Nucleus Typer).

Methods

We integrated recently developed deep learning‐based image segmentation methods, optimized for unbiased evaluation of fresh and postmortem human skeletal muscle, and utilized SERCA1 and SERCA2 as type‐specific myonucleus and myofiber markers after validating them against the traditional use of MyHC isoforms.

Results

Parameters including cross‐sectional area, myonuclei per fiber, myonuclear domain, central myonuclei per fiber, and grouped myofiber ratio were determined in a fiber‐type‐specific manner, revealing that a large degree of sex‐ and muscle‐related heterogeneity could be detected using the pipeline. Our platform was also tested on pathological muscle tissue (ALS and IBM) and adapted for the detection of other resident cell types (leucocytes, satellite cells, capillary endothelium).

Conclusion

In summary, we present an automated image analysis tool for the simultaneous quantification of myofiber and myonuclear types, to characterize the composition and structure of healthy and diseased human skeletal muscle.
Using morphometrics to identify sex in the eastern blue‐tongued skink (Tiliqua scincoides)
Authors: Bird A , Monks D , Hughes IP
Published: April 2023

Introduction

Tiliqua scincoides coexists with human activity and is frequently presented for rehabilitation due to injury. The correct identification of sex is important as animals identified as female should be subject to a different decision‐making matrix for rehabilitation. However, identification of sex is notoriously difficult in Tiliqua scincoides. We describe a reliable, safe and cost‐effective morphometry‐based method.

Materials and methods

Adult and sub‐adult, wild Tiliqua scincoides dead on presentation or euthanased due to their presenting injuries were collected in South‐East Queensland (SE Qld). Head‐width to snout‐vent length ratio (H:SV) and head‐width to trunk length ratio (H:T) were measured and sex was defined at necropsy. Similar data were obtained from a previous study in Sydney, New South Wales (NSW). H:SV and H:T were assessed for accuracy of sex prediction by the area under the receiver operating characteristic curve (AUC‐ROC). Optimal cut‐points were identified.

Results

The AUC‐ROC for the H:T test was for NSW adults, 0.99 (n = 29), NSW sub‐adults, 0.95 (n = 10), Qld adults, 0.90 (n = 35) and Qld sub‐adults, 0.79 (n = 25). In all cases, H:T was as good or superior to H:SV. H:T cut‐points optimized for female sexing or both sexes ranged from 0.20 to 0.23 depending on State and adult status. Sensitivities and specificities of the test at suggested optimal cut‐points ranged from 0.54 to 1.0.

Conclusion

We describe how H:T can be used as an accurate method to determine sex in Tiliqua scincoides. However, it is more accurate in adults than sub‐adults and more accurate in NSW skinks than in SE Qld skinks.
The collective voice of unions and workplace training in Italy: New insights from mixed methods
Authors: Berton Fabio , Carreri Anna , Devicienti Francesco , Ricci Andrea
Published: April 2023

Using a three‐phase approach that combines quantitative (pooled OLS, fixed effects and IV) with qualitative (semi‐structured interviews) analyses, we find that in Italy, workplace unions are more likely to enhance training when they sign a firm‐level agreement and when they can get access to external funds for financing. We also identify three channels: what we call a ‘maturation effect’, double‐track communication and watch‐dog function. We argue that these results are consistent with the idea that the impact of workplace unions on training depends on the empowerment of its collective voice within an institutional framework that does not fit either of the standard models provided by collective and liberal market economies.
Influence of physical fitness of coronary disease patients on vagal reentry and heart rate recovery after exercise with and without fluid replacement
Authors: Soares Júlio César d. Á. , Laurino Maria Júlia L. , Silva Anne K. F. d. , Santos Lorena A. , Vanderlei Luiz Carlos M.
Published: April 2023

Background

Fluid replacement during exercise has been studied as an important strategy to enhance recovery, however, studies are needed to investigate the effect of this strategy in different physical profiles. The aim of the study was to investigate the influence of physical fitness of coronary artery disease (CAD) patients on vagal reentry and heart rate recovery after exercise performed with and without fluid replacement.

Methods

Nonrandomized crossover clinical trial. Thirty‐three CAD patients were submitted to (I) cardiopulmonary exercise test: to divide the sample into lower and higher VO2 peak groups; (II) control protocol (CP): composed of rest, aerobic exercise and passive recovery; (III) hydration protocol (HP): composed of the same activities as the CP, but with water intake during exercise. The recovery was evaluated by vagal reentry and heart rate recovery immediately after exercise.

Results

The results did not show significant differences between the higher and lower VO2 peak groups. In addition, the hydration strategy adopted was not able to cause significant changes between control and HPs, regardless of group. However, a time effect was observed, suggesting anticipation of vagal reactivation and heart rate reduction in HP.

Conclusions

Physical fitness did not influence vagal reentry and heart rate recovery in CAD patients after exercise. However, the hydration strategy seems to have anticipated vagal reentry and produced a more efficient reduction in heart rate regardless of the individuals’ physical fitness, but these results should be analyzed with caution due to the absence of significant differences between groups and protocols.
Safety, tolerability, pharmacokinetic/pharmacodynamic characteristics of bersiporocin, a novel prolyl‐tRNA synthetase inhibitor, in healthy subjects
Authors: Park Min Young , Bae Sungyeun , Heo Jung A , Park Mihee , Kim YuKyung , Han Jumi , Jang In‐Jin , Yu Kyung‐Sang , Oh Jaeseong
Published: April 2023

Bersiporocin, a novel first‐in‐class prolyl‐tRNA synthetase (PRS) inhibitor currently under clinical development, was shown to exert an antifibrotic effect through the downregulation of collagen synthesis in various pulmonary fibrosis models. The aim of this first‐in‐human, randomized, double‐blind, placebo‐controlled, single‐ and multiple‐dose, dose‐escalation study was to evaluate the safety, tolerability, pharmacokinetic (PK) and pharmacodynamic (PD) characteristics of bersiporocin in healthy adults. A total of 40 and 32 subjects were included in a single‐ (SAD) and multiple‐ascending dose (MAD) study, respectively. No severe or serious adverse events were observed after a single oral dose up to 600 mg and multiple oral doses up to 200 mg twice daily for 14 days. The most common treatment‐emergent adverse events were gastrointestinal adverse events. To improve the tolerability, initial bersiporocin solution was changed to the enteric‐coated formulation. Afterward, the enteric‐coated tablet was used in the last cohort of SAD and in the MAD study. Bersiporocin showed dose‐proportional PK characteristics after a single dose up to 600 mg and multiple doses up to 200 mg. Upon reviewing the safety and PK data, the final SAD cohort (800 mg enteric‐coated tablet) was canceled by the Safety Review Committee. The levels of pro‐peptide of type 3 procollagen were lower after treatment with bersiporocin than after the placebo in the MAD study, whereas no significant change was observed in other idiopathic pulmonary fibrosis (IPF) biomarkers. In conclusion, the safety, PK, and PD profile of bersiporocin supported its further investigation in patients with IPF.
Changes in co‐use of alcohol and cannabis among Nordic adolescents in the 21st century: Results from the European School Survey Project on Alcohol and Other Drugs study
Authors: Raitasalo Kirsimarja , Rossow Ingeborg , Moan Inger Synnøve , Bye Elin K. , Svensson Johan , Thor Siri , Ekholm Ola , Pisinger Veronica , Arnarsson Ársæll , Bloomfield Kim
Published: April 2023

Introduction

In the 21st century, there has been a decline in alcohol use among adolescents in most Nordic countries, while trends of cannabis use have diverged. We explore how alcohol and cannabis use, respectively, and co‐use of the two substances, have changed among Nordic adolescents. Three hypotheses are used to frame the study: (i) cannabis use has substituted alcohol use; (ii) there has been a parallel decline in both substances; and/or (iii) there has been a ‘hardening’ of users, implying that alcohol users increasingly use cannabis.

Methods

Data from the European School Survey Project on Alcohol and Other Drugs, conducted among 15‐ to 16‐year‐olds in Denmark, Finland, Iceland, Norway and Sweden (N = 74,700, 49% boys), were used to explore trends of past‐year alcohol and cannabis use in the period 2003–2019.

Results

The proportion of adolescents reporting alcohol use decreased significantly in all Nordic countries except Denmark. The proportion of those using cannabis only was low (0.0%–0.7%) and stable in all countries. The total number of substance use occasions declined among all adolescents in all countries but Denmark. Among alcohol users, cannabis use became increasingly prevalent in all countries but Denmark.

Discussion and Conclusions

We found no support for the ‘parallel decline hypothesis' in alcohol and cannabis use among Nordic adolescents. Partially in line with the ‘substitution hypothesis’, cannabis use accounted for an increasing proportion of all substance use occasions. Our results suggests that the co‐use of alcohol and cannabis has become more common, thus also providing support to the ‘hardening’ hypothesis.
Disasters and corruption: public expectations and tolerance—evidence from Mexico
Authors: Gawronski Vincent T. , Levitt Barry S. , Olson Richard S.
Published: April 2023

Disaster corruption is a vexing problem, damaging state legitimacy and exacerbating human suffering. Mexico has a history of both major disasters and persistently high levels of corruption. A magnitude 7.1 earthquake in 2017 provided an opportunity to study change over time in expectations and tolerance of corruption in disaster relief. Twenty years earlier, Mexico City residents expected, on average, essentially three out of 10 hypothetical trucks loaded with humanitarian assistance to be lost to corruption but expressed near zero tolerance of such conduct. By 2018–19, Mexico City residents expected more than one‐half of all relief, six out of 10 trucks, to be stolen, and could tolerate three out of 10 trucks being pilfered. Similar results were found at the national level. Hence, Mexicans appear to be giving up on the state. Addressing corruption in disaster risk reduction and humanitarian relief specifically might provide a template for improving public trust across other state institutions.
Health‐related quality of life in patients with β‐thalassemia: Data from the phase 3 BELIEVE trial of luspatercept
Authors: Cappellini Maria Domenica , Taher Ali T. , Piga Antonio , Shah Farrukh , Voskaridou Ersi , Viprakasit Vip , Porter John B. , Hermine Olivier , Neufeld Ellis J. , Thompson Alexis A. , Tang Derek , Yucel Aylin , Lord‐Bessen Jennifer , Yu Peiwen , Guo Shien , Shetty Jeevan K. , Miteva Dimana , Zinger Tatiana , Backstrom Jay T. , Oliva Esther Natalie
Published: April 2023

Background

Patients with transfusion‐dependent (TD) β‐thalassemia require long‐term red blood cell transfusions (RBCTs) that lead to iron overload, impacting health‐related quality of life (HRQoL).

Methods

The impact of luspatercept, a first‐in‐class erythroid maturation agent, versus placebo on HRQoL of patients with TD β‐thalassemia was evaluated in the phase 3 BELIEVE trial. HRQoL was assessed at baseline and every 12 weeks using the 36‐item Short Form Health Survey (SF‐36) and Transfusion‐dependent Quality of Life questionnaire (TranQol). Mean change in HRQoL was evaluated from baseline to week 48 for patients receiving luspatercept + best supportive care (BSC) and placebo + BSC and between luspatercept responders and non‐responders.

Results

Through week 48, for both groups, mean scores on SF‐36 and TranQol domains were stable over time and did not have a clinically meaningful change. At week 48, more patients who achieved clinical response (≥50% reduction in RBCT burden over 24 weeks) in the luspatercept + BSC group had improvement in SF‐36 Physical Function compared with placebo + BSC (27.1% vs. 11.5%; p = .019).

Conclusions

Luspatercept + BSC reduced transfusion burden while maintaining patients' HRQoL. HRQoL domain improvements from baseline through 48 weeks were also enhanced for luspatercept responders.
Are whole‐organism performance and thermal preference linked to endo‐ and ectoparasites in a short‐lived lizard?
Authors: Lee Ko‐Huan , Whiting Martin J. , Leu Stephan T.
Published: April 2023

Wild animals are often concurrently infected by multiple parasites, which are assumed to negatively affect their host by exploiting the host's resources. The cumulative effect of parasite infections is often not studied. Despite this assumption, many hosts do not suffer significant costs from parasitism in the wild. Hosts can adapt to parasitic infections by mounting physiological and behavioural defences. A commonly used behavioural defence by ectotherms is to frequently visit warm environments to increase body temperature (i.e., behavioural fever) and thereby mount an immune response to parasites. Using the Australian common garden skink (Lampropholis guichenoti), we investigated the cumulative effect of endo‐ and ectoparasites on host performance. First, we investigated whether endo‐ and ectoparasites were associated with whole‐organism performance in the lizards. Second, we explored whether host individuals responded to their parasite infection through thermoregulatory behaviour. We found no significant relationship between parasitism and body condition. However, the infection with ectoparasitic mites was significantly related to reduced sprint speed, while the nematode infection had no significant relationship with any of our three performance measures (sprint speed, endurance and foraging efficiency). We showed no evidence of behavioural fever and infected lizards did not differ in their body temperature from uninfected lizards. Our findings suggest that short‐lived lizards may simply endure parasitic infections. The study provides an important example of how multiple infections with endo‐ and ectoparasites affect their host. It adds to the growing evidence for a negligible effect of parasites on host whole‐organism performance.
Application of a Ridden Horse Pain Ethogram in Icelandic horses: A pilot study
Authors: Garcia Helene Dragelund , Lindegaard Casper , Dyson Sue
Published: April 2023

Background

A disturbing number of ridden horses are lame, although assumed by riders to be pain free. A Ridden Horse Pain Ethogram (RHpE) was developed; an RHpE score of ≥8/24 is likely to indicate the presence of musculoskeletal pain. Pain assessment in Icelandic horses is challenging; the RHpE may facilitate lameness recognition.

Objectives

To determine the repeatability of application of an adapted RHpE to Icelandic horses by a single observer. To evaluate the relationship between RHpE scores and lameness or abnormalities of canter.

Study design

Prospective, cross‐sectional study.

Methods

Video‐recordings of 30 Icelandic horses performing a standardised test (walk, trot, tölt, canter) were acquired. The adapted RHpE, to include tölt, was applied to all recordings twice in random order by a single observer. Agreement was assessed using Cohen's kappa. The presence of lameness, abnormalities of canter and lameness grade was determined by an independent expert. The association between maximum lameness grade and RHpE score was tested using Spearman's rank correlation.

Results

All horses exhibited both lameness, the majority in >1 limb, and abnormalities of canter. The RHpE score was ≥8/24 in 96% (median 10/24 and 10.5/24, respectively, for the two assessments). There was substantial to near‐perfect agreement for the majority of behaviours (63.6%) and moderate or fair agreement for 32%. There was no correlation between maximum lameness grades and RHpE scores.

Main limitations

The absence of non‐lame horses with correct saddle fit for horse and rider.

Conclusions

There was good repeatability of application of the RHpE. Musculoskeletal pain was associated with RHpE scores of ≥8/24 in the majority of horses. Data acquired from non‐lame horses, ridden in well‐fitting tack by riders of appropriate size, are needed to determine if the threshold of step frequency in trot needs to be adjusted for more accurate application of the RHpE in Icelandic horses.
Is attention all you need for intraday Forex trading?
Authors: Grądzki Przemysław , Wójcik Piotr
Published: April 2023

The main objective of this paper is to analyse whether the Transformer neural network, which has become one of the most influential algorithms in Artificial Intelligence over the last few years, exhibits predictive capabilities for high‐frequency Forex data. The prediction task is to classify short‐term Forex movements for six currency pairs and five different time intervals from 60 to 720 min. We find that the Transformer exhibits high predictive power in the context of intraday Forex trading. This performance is slightly better than for the carefully selected benchmark – ResNet‐LSTM, which currently is a state‐of‐the‐art algorithm. Since intraday Forex trading based on deep learning models is largely unexplored, we offer insight on which currency pair and time interval are amenable to devising a profitable trading strategy. We also show that high predictive accuracy can be misleading in real world trading for short time intervals, as models trained on OHLC data tend to report the highest accuracy when the spread cost is the highest. This renders assessment based on typical machine learning metrics overly optimistic. Therefore, it is critical to backtest frequent intraday Forex trading strategies with realistic cost assumptions, which is rarely the case in empirical literature. Lastly, sensitivity analysis shows that the length of the time interval used for training does not play a critical role in the Transformer's predictive capabilities, whereas features derived from technical analysis are essential.
Comparison of IGLV2‐14 light chain sequences of patients with AL amyloidosis or multiple myeloma
Authors: Berghaus Natalie , Schreiner Sarah , Poos Alexandra M. , Raab Marc S. , Goldschmidt Hartmut , Mai Elias K. , Salwender Hans‐Jürgen , Bernhard Helga , Thurner Lorenz , Müller‐Tidow Carsten , Weinhold Niels , Hegenbart Ute , Schönland Stefan O. , Huhn Stefanie
Published: April 2023

Light chain amyloidosis (AL) is one of the most common forms of systemic amyloidosis and is caused by the deposition of insoluble fibrils derived from misfolded and aggregated immunoglobulin light chains (LC). To uncover the causes leading to this aggregation, we compared AL LC sequences with those of patients with the related disease multiple myeloma (MM), which do not aggregate in insoluble fibrils in vivo. IGLV2‐14 is one of the most common AL‐associated IGLV subfamilies. Here, we analysed IGLV2‐14 LC sequences of 13 AL and eight MM patients in detail. We found that AL‐associated LCs presented a lower median mutation count (7.0 vs. 11.5 in MM; P = 0.045), as well as an overall composition of less charged amino acids than MM LCs. However, we did not find a mutation that was present in ≥ 50% of the AL and not in the MM sequences. Furthermore, we did not find a significant difference in the isoelectric point (pI) in general, suggesting similar stability of the LCs in AL and MM. However, the subgroup of patients without a detectable heavy chain stood out. Surprisingly, they are characterized by an increase in mutation count (median 7.0 vs. 5.5) and pI (median 7.82 vs. 6.44, P = 0.043). In conclusion, our data suggest that the amount of mutations and the introduction of charges play a crucial role in AL fibril formation, as well as the absence or presence of a potential heavy chain binding partner.
On the consideration of loading interaction in combined high and low cycle fatigue life prediction
Authors: Liu Pengshuai , Wang Xiaowei , Shen Qin , Li Fangjie , Liu Min , Sun Yujuan
Published: April 2023

Based on the analysis of the test data and Miner's rule, a combined high and low cycle fatigue (CCF) life prediction model considering the loading interaction is established by introducing coupled damage. The coupled damage is determined by multiplying the high cycle fatigue damage and the low cycle fatigue damage by a coupled damage coefficient
. According to the analysis of the test data, the coupled damage coefficient
is positively correlated with the high cycle stress ratio
. In addition, an interaction factor, which reflects the loading interaction effect, is introduced to correct the coefficient
. The CCF experimental data of four materials are employed for model verification and comparison among the proposed model, Miner's rule, and Trufyakov–Kovalchuk model (T–K model). The proposed model exhibits a relatively higher prediction accuracy and is more suitable for predicting the fatigue life of CCF.
As above, not so below: Long‐term dynamics of net primary production across a dryland transition zone
Authors: Brown Renée F. , Collins Scott L.
Published: April 2023

Drylands are key contributors to interannual variation in the terrestrial carbon sink, which has been attributed primarily to broad‐scale climatic anomalies that disproportionately affect net primary production (NPP) in these ecosystems. Current knowledge around the patterns and controls of NPP is based largely on measurements of aboveground net primary production (ANPP), particularly in the context of altered precipitation regimes. Limited evidence suggests belowground net primary production (BNPP), a major input to the terrestrial carbon pool, may respond differently than ANPP to precipitation, as well as other drivers of environmental change, such as nitrogen deposition and fire. Yet long‐term measurements of BNPP are rare, contributing to uncertainty in carbon cycle assessments. Here, we used 16 years of annual NPP measurements to investigate responses of ANPP and BNPP to several environmental change drivers across a grassland–shrubland transition zone in the northern Chihuahuan Desert. ANPP was positively correlated with annual precipitation across this landscape; however, this relationship was weaker within sites. BNPP, on the other hand, was weakly correlated with precipitation only in Chihuahuan Desert shrubland. Although NPP generally exhibited similar trends among sites, temporal correlations between ANPP and BNPP within sites were weak. We found chronic nitrogen enrichment stimulated ANPP, whereas a one‐time prescribed burn reduced ANPP for nearly a decade. Surprisingly, BNPP was largely unaffected by these factors. Together, our results suggest that BNPP is driven by a different set of controls than ANPP. Furthermore, our findings imply belowground production cannot be inferred from aboveground measurements in dryland ecosystems. Improving understanding around the patterns and controls of dryland NPP at interannual to decadal scales is fundamentally important because of their measurable impact on the global carbon cycle. This study underscores the need for more long‐term measurements of BNPP to improve assessments of the terrestrial carbon sink, particularly in the context of ongoing environmental change.
Switching from continuous veno‐venous hemodiafiltration to intermittent sustained low‐efficiency daily hemodiafiltration (SLED‐f) in pediatric acute kidney injury: A prospective cohort study
Authors: Sethi Sidharth Kumar , Raina Rupesh , Bansal Shyam Bihari , Soundararajan Anvitha , Dhaliwal Maninder , Raghunathan Veena , Kalra Meenal , Soni Kritika , Mahato Samit Kumar , Vadhera Ananya , Yadav Dinesh Kumar , Bunchman Timothy
Published: April 2023

Introduction

Continuous kidney replacement therapy (CKRT) is the preferred modality in critically ill children with acute kidney injury. Upon improvement, intermittent hemodialysis is usually initiated as a step‐down therapy, which can be associated with several adverse events. Hybrid therapies such as Sustained low‐efficiency daily dialysis with pre‐filter replacement (SLED‐f) combines the slow sustained features of a continuous treatment, ensuring hemodynamic stability, with similar solute clearance along with the cost effectiveness of conventional intermittent hemodialysis. We examined the feasibility of using SLED‐f as a transition step‐down therapy after CKRT in critically ill pediatric patients with acute kidney injury.

Methods

A prospective cohort study was conducted in children admitted to our tertiary care pediatric intensive care units with multi‐organ dysfunction syndrome including acute kidney injury who received CKRT for management. Those patients receiving fewer than two inotropes to maintain perfusion and failed a diuretic challenge were switched to SLED‐f.

Results

Eleven patients underwent 105 SLED‐f sessions (mean of 9.55 +/− 4.90 sessions per patient), as a part of step‐down therapy from continuous hemodiafiltration. All (100%) our patients had sepsis associated acute kidney injury with multiorgan dysfunction and required ventilation. During SLED‐f, urea reduction ratio was 64.1 +/− 5.3%, Kt/V was 1.13 +/− 0.1, and beta‐2 microglobulin reduction was 42.5 +/−4%. Incidence of hypotension and requirement of escalation of inotropes during SLED‐f was 18.18%. Filter clotting occurred twice in one patient.

Conclusion

SLED‐f is a safe and effective modality for use as a transition therapy between CKRT and intermittent hemodialysis in children in the PICU.
Arabic‐speaking male immigrants' perceptions of preventive initiatives: An interview study
Authors: Dahl Marie , Søndergaard Susanne F. , Al‐Allaq Rafel Salman , Diederichsen Axel , Lindholt Jes S.
Published: April 2023

Background

Arabic‐speaking men are a sparsely investigated population in health promotion and disease prevention. This may hamper their ability to achieve the highest obtainable health due to less accessibility and acceptability of preventive measures.

Aim

We explored Arabic‐speaking (Palestinian, Iraqi and Somali) male immigrants' perceptions of preventive initiatives in general and such initiatives for cardiovascular diseases (CVD) in particular to understand how to address inequalities in engagement in prevention.

Methods

This qualitative study employed content analysis of semistructured interviews with 60–66‐year‐old Arabic‐speaking men living in Denmark. Supplementary, structured data, for example, health data, were collected. From June to August 2020, 10 men were interviewed.

Findings

Preventive initiatives were found ethically and culturally acceptable alongside personally and socially relevant; they were perceived as humanitarian and caring for the participants' health, respecting of their self‐determination and enabling their empowerment. Thus, the participants entreated that their fellow countrymen be assisted in achieving the prerequisite coping capabilities to address inequality in access, perceived acceptance and relevance. This led us to define one main category ‘Preventive initiatives ‐ Caring and humanitarian aid empower us’ with the underlying subcategories: ‘We are both hampered and strengthened by our basic assumptions’ and ‘We need help to achieve coping capabilities enabling us to engage in preventive initiatives’.

Conclusion

Prevention was perceived as acceptable and relevant. Even so, Arabic‐speaking men may be a hard‐to‐reach group due to their basic assumptions and impaired capabilities for engaging in prevention. Addressing inequality in accessibility, acceptability and relevance in regard to prevention may be promoted through a person‐centred approach embracing invitees' preferences, needs and values; and by strengthening invitees' health literacy through efforts at the structural, health professional and individual levels.

Public Contribution

This study was based on interviews. The interviewees were recruited as public representatives to assist us in building an understanding of Arabic‐speaking male immigrants' perceptions of preventive initiatives in general and preventive initiatives for CVD in particular.
Success rate of orthograde endodontic retreatment after failed apicectomy – A retrospective study
Authors: Appel David , Schäfer Edgar , Appel Carsten
Published: April 2023

Aim

Orthograde retreatment after failed apicectomy maybe a treatment alternative to endodontic resurgery. The purpose of this study was to examine the clinical outcome of orthograde endodontic retreatment after failed apicectomy.

Methodology

Success was rated radiographically in 191 cases of orthograde retreatment after failed apicectomy that were treated in a private practice with a documented recall of at least 12 months. The radiographs were rated individually by two observers, in cases of disagreement a consensus was reached by joint discussion with a third observer. Success or failure were evaluated according to previously described criteria. The success rate and the median survival were calculated using the Kaplan–Meier survival analysis. The log rank test was used to evaluate the effect of prognostic factors/predictors. Hazard ratios of predictors were analysed using Univariate Cox Proportional Hazard regression analysis.

Results

The mean follow‐up of the included 191 patients (124 females, 67 males) was 32.13 (±23.68) months and the median was 25 months. The overall recall rate was 54%. Cohen Kappa analysis revealed nearly perfect agreement between both observers (k = 0.81; p = 1.0). The overall percentage of success was 84.82% (complete healing 79.06%, incomplete healing 5.76%). The median survival was 86 months (95% CI: 56–86). None of the selected predictors had an influence on the treatment outcome (p > .05).

Conclusions

Orthograde retreatment should be considered a valuable treatment option after failed apicectomy. A surgical endodontic retreatment can still be a treatment option after orthograde retreatment to obtain outcome for the patient.
Deficiency of angiopoietin‐like 4 enhances CD8+ T cell bioactivity via metabolic reprogramming for impairing tumour progression
Authors: Ding Shizhen , Lin Zhijie , Zhang Xiaoyuan , Jia Xiaoqing , Li Hualing , Fu Yi , Wang Xuefeng , Zhu Guoqiang , Lu Guotao , Xiao Weiming , Gong Weijuan
Published: April 2023

Angiopoietin‐like 4 (ANGPTL4) is a secreted metabolism‐modulating glycoprotein involved in the progression of tumours, cardiovascular diseases, metabolic syndrome and infectious diseases. In this study, more CD8+ T cells were activated to be effector T cells in ANGPTL4−/− mice. Impaired growth of tumours implanted in 3LL, B16BL6 or MC38 cells and reduced metastasis by B16F10 cells were observed in ANGPTL4−/− mice. Bone marrow (BM) transplantation experiments displayed that deficiency of ANGPTL4 in either host or BM cells promoted CD8+ T cell activation. However, ANGPTL4 deficiency in CD8+ T cells themselves showed more efficient anti‐tumour activities. Recombinant ANGPTL4 protein promoted tumour growth in vivo with the less CD8+ T cell infiltration and it directly downregulated CD8+ T cell activation ex vivo. Transcriptome sequencing and metabolism analysis identified that ANGPTL4−/− CD8+ T cells increased glycolysis and decreased oxidative phosphorylation, which was dependent on the PKCζ‐LKB1‐AMPK‐mTOR signalling axis. Reverse correlation of elevated ANGPTL4 levels in sera and tumour tissues with activated CD8+ T cells in the peripheral blood was displayed in patients with colorectal cancer. These results demonstrated that ANGPTL4 decreased immune surveillance in tumour progression by playing an immune‐modulatory role on CD8+ T cells via metabolic reprogramming. Efficient blockade of ANGPTL4 expression in tumour patients would generate an effective anti‐tumour effect mediated by CD8+ T cells.
Senescent T cells: Beneficial and detrimental roles
Authors: Laphanuwat Phatthamon , Gomes Daniel Claudio Oliveira , Akbar Arne N.
Published: April 2023

As the thymus involutes during aging, the T‐cell pool has to be maintained by the periodic expansion of preexisting T cells during adulthood. A conundrum is that repeated episodes of activation and proliferation drive the differentiation of T cells toward replicative senescence, due to telomere erosion. This review discusses mechanisms that regulate the end‐stage differentiation (senescence) of T cells. Although these cells, within both CD4 and CD8 compartments, lose proliferative activity after antigen‐specific challenge, they acquire innate‐like immune function. While this may confer broad immune protection during aging, these senescent T cells may also cause immunopathology, especially in the context of excessive inflammation in tissue microenvironments.
RETRACTED: Effect of diabetic foot ulcers and other risk factors on the prevalence of lower extremity amputation: A meta‐analysis
Authors: Zhang Huiling , Huang Chuanwang , Bai Jie , Wang Jing
Published: April 2023

A meta‐analysis study was conducted to measure the consequence of diabetic foot ulcers (DFUs) and other risk factors (RFs) on the prevalence of lower extremity amputation (LEA). A comprehensive literature inspection till February 2023 was applied and 2765 interrelated studies were reviewed. Of the 32 chosen studies enclosed, 9934 subjects were in the chosen studies' starting point, and 2906 of them were with LEA. Odds ratio (OR) in addition to 95% confidence intervals (CIs) were used to compute the value of the effect of DFUs and other RFs on the prevalence of LEA by the continuous and dichotomous approaches and a fixed or random effect model. Male gender (OR, 1.30; 95% CI, 1.17–1.44, P < .001), smoking (OR, 1.24; 95% CI, 1.01–1.53, P = .04), previous foot ulcer (OR, 2.69; 95% CI, 1.93–3.74, P < .001), osteomyelitis (OR, 3.87; 95% CI, 2.28–6.57, P < .001), gangrene (OR, 14.45; 95% CI, 7.03–29.72, P < .001), hypertension (OR, 1.17; 95% CI, 1.03–1.33, P = .01), and white blood cells count (WBCC) (MD, 2.05; 95% CI, 1.37–2.74, P < .001) were significantly shown to be an RF in LEA in subjects with DFUs. Age (MD, 0.81; 95% CI, −0.75 to 2.37, P = .31), body mass index (MD, −0.55; 95% CI, −1.15 to 0.05, P = .07), diabetes mellitus type (OR, 0.99; 95% CI, 0.63–1.56, P = .96), and glycated haemoglobin (MD, 0.33; 95% CI, −0.15 to 0.81, P = .17) were not shown to be an RF in LEA in subjects with DFUs. Male gender, smoking, previous foot ulcer, osteomyelitis, gangrene, hypertension, and WBCC were significantly shown to be an RF in LEA in subjects with DFUs. However, age and diabetes mellitus type were not shown to be RF in LEA in subjects with DFUs. However, caused of the small sample sizes of several chosen studies for this meta‐analysis, care must be exercised when dealing with its values.
Membrane receptors mediate the rapid facilitation of short‐term memory by estradiol in the dorsal hippocampus of female mice
Authors: Kuun‐Hadden Talya , Brar Ramneek , Klemens Melissa N. , MacLusky Neil J. , Choleris Elena
Published: April 2023

Estrogens play a key role in learning and memory via delayed genomic and early‐onset rapid mechanisms. Systemic treatment with 17β‐estradiol (E2) rapidly facilitates object recognition, social recognition and object placement short‐term memory in ovariectomized female mice within a timescale of only 40 min following administration. The dorsal hippocampus is one critical site of rapid estrogenic effects. Estrogen receptors (ER) are located in the cell nucleus, cytoplasm and membrane. Membrane ERs alone can mediate the rapid facilitation of long‐term memory consolidation by estrogens. This study determined the role of membrane ERs in the rapid effects of 17‐β estradiol (E2) on short‐term memory within the dorsal hippocampus of ovariectomized mice. We infused E2 conjugated to bovine serum albumin (BSA‐E2) that prevents it from crossing the cell membrane and found that the rapid facilitation by E2 of short‐term memory in the social recognition, object recognition and object placement tasks is mediated by membrane ERs, independently of intracellular receptors.
Safeguarding survival: Older persons with multiple chronic conditions' unplanned readmission experiences: A mixed methods systematic review
Authors: Coatsworth‐Puspoky Robin , Dahlke Sherry , Duggleby Wendy , Hunter Kathleen F.
Published: April 2023

Aims and objectives

The aim of this study was to create a holistic understanding of the psychosocial processes of older persons with multiple chronic conditions' experience with unplanned readmission experiences within 30 days of discharge home and identify factors influencing these psychosocial processes.

Design

Mixed methods systematic review.

Data Sources

Six electronic databases (Ovid MEDLINE (R) All 1946‐present, Scopus, CINAHL, Embase, PsychINFO and Web of Science).

Review Methods

Peer‐reviewed articles published between 2010 and 2021 and addressed study aims (n = 6116) were screened. Studies were categorised by method: qualitative and quantitative. Qualitative data synthesis used a meta‐synthesis approach and applied thematic analysis. Quantitative data synthesis used vote counting. Data (qualitative and quantitative) were integrated through aggregation and configuration.

Results

Ten articles (n = 5 qualitative; n = 5 quantitative) were included. ‘Safeguarding survival’ described older persons' unplanned readmission experience. Older persons experienced three psychosocial processes: identifying missing pieces of care, reaching for lifelines and feeling unsafe. Factors influencing these psychosocial processes included chronic conditions and discharge diagnosis, increased assistance with functional needs, lack of discharge planning, lack of support, increased intensity of symptoms and previous hospital readmission experiences.

Conclusions

Older persons felt more unsafe as their symptoms increased in intensity and unmanageability. Unplanned readmission was an action older persons required to safeguard their recovery and survival.

Relevance to Clinical Practice

Nurses play a critical role in assessing and addressing factors that influence older persons' unplanned readmission. Identifying older persons' knowledge about chronic conditions, discharge planning, support (caregivers and community services), changes in functional needs, intensity of symptoms and past readmission experiences may prepare older persons to cope with their return home. Focusing on their health‐care needs across the continuum of care (community, home and hospital) will mitigate the risks for unplanned readmission within 30 days of discharge.

Reporting Method

PRISMA guidelines.

Patient or Public Contribution

No patient or public contribution due to design.
Clinical practice guideline appraisal and algorithm development to identify recommendations related to nursing practice for post‐stroke dysphagia
Authors: Jiang Li , Zhang Wei , Qian Lan , Wang Cong
Published: April 2023

Aims and Objectives

To assess the methodological quality of current clinical practice guidelines related to post‐stroke dysphagia and develop an algorithm using nursing process as a framework for clinical nursing.

Background

Dysphagia is a serious complication of stroke. Yet the recommendations related to nursing in guidelines have not been systematically sorted out, so they are difficult for nurses to use to guide clinical nursing practice.

Design

Systematic review.

Methods

A systematic review of literature was performed using the PRISMA Checklist. A systematic search for relevant guidelines published between 2017 and 2022 was conducted. Appraisal of Guidelines for Research and Evaluation II instrument was used to assess methodological quality. Recommendations related to nursing practice from high‐quality guidelines were summarised and developed into an algorithm to provide reference for the standardised construction of nursing practice scheme.

Results

991 records were initially identified from database searches and other sources. Finally, 10 guidelines were included, of which 5 were rated as high quality. A total of 27 recommendations from the 5 highest‐scoring guidelines were summarised and used to develop an algorithm.

Conclusions

This study indicated deficiencies and variability in current available guidelines. Based on five high‐quality guidelines, we developed an algorithm to facilitate nurses' adherence to guidelines and contribute to evidence‐based nursing. In the future, high‐quality guidelines, together with large‐sample and multi‐centre clinical researches are suggested to give more scientific and convincing evidence to nursing of post‐stroke dysphagia.

Relevance to Clinical Practice

The findings indicate that nursing process may provide a unified framework for standardised nursing of different diseases. Nursing leaders are recommended to adopt this algorithm in their units. In addition, nursing administrators and educators should promote the application of nursing diagnosis to help nurses foster nursing thinking mode.

Patient or Public Contribution

No patient or public involvement in this review.
HIV‐related mortality in the United States during the COVID‐19 pandemic: A population‐based study
Authors: He Xinyuan , Lv Fan , Fox Marissa , Yeo Yee Hui , Zou Biyao , Liu Jinli , Zhao Yunyu , Zu Jian , Li Yan , Tang Weiming , Zhang Lei , Ji Fanpu
Published: April 2023

Background

US progress toward ending the HIV epidemic was disrupted during the COVID‐19 pandemic.

Objectives

To determine the impact of the pandemic on HIV‐related mortality and potential disparities.

Methods

Using data from the Centers for Disease Control and Prevention and the United States (US) Census Bureau, HIV‐related mortality data of decedents aged ≥25 years between 2012 and 2021 were analyzed. Excess HIV‐related mortality rates were estimated by determining the difference between observed and projected mortality rates during the pandemic. The trends of mortality were quantified with joinpoint regression analysis.

Results

Of the 79,725 deaths documented in adults aged 25 years and older between 2012 and 2021, a significant downward trend was noted in HIV‐related mortality rates before the pandemic, followed by a surge during the pandemic. The observed mortality rates were 18.8% (95% confidence interval [CI]: 13.1%–25.5%) and 25.4% (95%CI: 19.9%–30.4%) higher than the projected values in 2020 and 2021, respectively. Both of these percentages were higher than that in the general population in 2020 (16.4%, 95%CI: 14.9%–17.9%) and 2021 (19.8%, 95%CI: 18.0%–21.6%), respectively. Increased HIV‐related mortality was observed across all age subgroups, but those aged 25–44 years demonstrated the greatest relative increase and the lowest COVID‐19‐related deaths when compared to middle‐ and old‐aged decedents. Disparities were observed across racial/ethnic subgroups and geographic regions.

Conclusions

The pandemic led to a reversal in the attainments made to reduce the prevalence of HIV. Individuals living with HIV were disproportionately affected during the pandemic. Thoughtful policies are needed to address the disparity in excess HIV‐related mortality.