bluuebunny/crossref_metadata_2025 huggingface dataset:
Therapeutic potential of hesperidin in diabetes mellitus‐induced erectile dysfunction through Nrf2‐mediated ferroptosis and oxidative stress
Authors: Xin Sheng , Song Wen , Mao Jiaquan , Hu Peng , Chen Zhong , Liu Jihong , Song Xiaodong , Fang Qian , Cui Kai
Published: November 2024

Background

Among erectile dysfunction (ED) caused by metabolic abnormalities, diabetes mellitus‐induced ED (DMED) progresses rapidly, manifests with severe symptoms, and shows reduced responsiveness to conventional medications. Hyperglycemia in the corpus cavernosum has been linked to the induction of both ferroptosis and oxidative stress, which are mediated by nuclear factor E2 related factor 2 (Nrf2). Hesperidin (Hes), a flavonoid compound, has been revealed to activate Nrf2 in certain diabetic complications, yet the efficacy of Hes on DMED and the specific mechanism remain unclear.

Objectives

To elucidate the potential mechanism and efficacy of Hes in regulating Nrf2‐mediated ferroptosis and oxidative stress in DMED.

Materials and methods

DMED rats were constructed through the intraperitoneal injection of streptozotocin (STZ), partially supplemented with Hes. In parallel, in vitro research utilized human umbilical vein endothelial cells (HUVECs), with glucose addition to simulating a high glucose (HG) environment, and induced with Hes or ML385 (an Nrf2 inhibitor). Penile tissues and HUVECs were harvested for subsequent analyses.

Results

The results of this study indicate that Hes partially reversed the impaired erectile function. The expression of Nrf2, glutathione peroxidase 4 (GPX4), and heme oxygenase‐1 (HO‐1) in the corpus cavernosum elevated after supplementing with Hes, resulted in an inhibition in ferroptosis and oxidative stress. Moreover, the quantity and function of erectile effector cells were restored, and cavernous fibrosis was ameliorated. In HG‐induced HUVECs, Hes ameliorated Nrf2‐mediated ferroptosis and oxidative stress, effects which ML385 partially reversed.

Conclusions

Hes exerts a therapeutic effect on DMED rats and a regulatory mechanism on the Nrf2–HO‐1/GPX4 axis, concurrently revitalizing endothelial and smooth muscle cells, and diminishing fibrosis. Our study provides robust preclinical evidence for employing Hes in treating DMED.
How Much Does the Business Development of Circular Eco‐Efficient Practices Improve by Shaking Stakeholders up?
Authors: Garces‐Ayerbe Concepción , Rivera‐Torres Pilar , Darmandieu Aurore
Published: November 2024

European firms are currently in a process of transition toward a circular economy, which is expected to guarantee sustainable growth over time. Developing eco‐efficient practices is a necessary step in this transition. This study analyzes the impact of stakeholder engagement in a circular business ecosystem on the development of these circular eco‐efficient practices. Past literature has evidenced the impact of stakeholder environmental pressure on firm strategic decisions and outcomes. We adopt the stakeholder theory from a more recent vision, arguing that “shaking stakeholders up” within a circular ecosystem is a more advanced strategy than the traditional approach of reacting to stakeholder pressure. Using structural equation modeling, we examine the data of 14,726 European firms and their relationships with five primary stakeholder groups. The results offer theoretical and empirical support for the idea that firms can go further in adopting eco‐efficient circular practices by shaking stakeholders up, selecting them, and managing relationships with them.
Novel BRAT1 Deep Intronic Variant Affects Splicing Regulatory Elements Causing Cerebellar Hypoplasia Syndrome: Genotypic and Phenotypic Expansion
Authors: Poleg Tomer , Proskorovski‐Ohayon Regina , Dolgin Vadim , Hadar Noam , Safran Amit , Agam Nadav , Jean Matan M. , Freund Ofek , Gradstein Libe , Shelef Ilan , Sadaka Yair , Birk Ohad S.
Published: November 2024

Biallelic mutations in BRAT1 result in lethal neonatal rigidity and multifocal seizure syndrome and a milder neurodevelopmental disorder of cerebellar atrophy with or without seizures (NEDCAS, MIM 618056). Combining linkage analysis and whole‐genome sequencing (WGS), we identified a novel deep intronic BRAT1 variant, NC_000007.14 (NM_152743.4):c.128‐1585 T > G, in 3 siblings of a consanguineous Bedouin family exhibiting NEDCAS. In silico analyses followed by molecular studies demonstrated this variant's impact on splice regulatory elements, forming a cryptic exon, resulting in a deleterious frameshift and aberrant transcript. Previously reported pathogenic BRAT1 splice‐site mutations were adjacent to exons, affecting canonical consensus splice sites, and identifiable by whole‐exome sequencing. The deep intronic BRAT1 disease‐causing variant is thus unique and underscores the potential of intronic splice regulatory elements in BRAT1 disease pathogenesis, demonstrating the utility of WGS in identifying noncoding variants in unresolved cases. The affected individuals (deep into their twenties) are among the longest‐surviving patients described to date—delineating the NEDCAS phenotype at these ages. Although sharing homozygosity of the same variant, they show varying penetrance of nystagmus and extreme variability in the extent of ataxia and age of onset of developmental delay. Notably, we summarize all documented BRAT1 splice variants reported to date and their phenotypic associations.
Prevalence, pattern, contact sensitisers and impact on quality‐of‐life of occupational dermatitis among beekeepers in North India
Authors: Qayoom Misbah , Hassan Iffat , Jeelani Shazia
Published: November 2024

Background

Beekeepers face specific occupational health risks due to exposure to bee products and chemicals. Propolis is a notable cause of contact hypersensitivity in beekeepers. Its chemical composition varies by region, complicating allergy investigations. While propolis allergies are documented in Western populations, no studies exist in India.

Aim

To assess the prevalence and patterns of dermatitis among beekeepers, identify contact sensitisers and evaluate its impact on quality‐of‐life (QoL).

Methods

An 18‐month community‐based cross‐sectional study was conducted involving 340 beekeepers from the Kashmir Valley in North India. Data collection included personal interviews, dermatological examinations and patch testing using self‐made antigens of propolis, beeswax, royal jelly and standardised Baseline Indian Standard Series. The Dermatology Life Quality Index (DLQI) was used to measure the impact of dermatitis on QoL.

Results

Dermatitis prevalence among beekeepers was 17.1%, with the majority presenting with hand eczema. Onset or worsening of dermatitis was reported by 77.6% after working in apiaries. Significant associations were found with duration of beekeeping (p < 0.05) and a history of atopy (p < 0.001). Patch testing revealed 27.5% of beekeepers with positive reactions, primarily to propolis (10% in pet). The mean DLQI score was 3.5, indicating a generally small impact on QoL.

Conclusion

Dermatitis was a common occupational condition among beekeepers, strongly associated with the duration of beekeeping and a history of atopy, though its overall impact on QoL was limited. Propolis emerged as a primary sensitiser in the study population.
Evaluation of Heterogeneity in the Coding Region of BRAF, MAP2K1, and MAP2K2 Genes in Primary and Metastatic Melanomas
Authors: Fernandes Mariana , Barcelos Denise , Carapeto Fernando Cintra Lopes , Cardili Leonardo , Comodo Andreia Neves , Mazloum Susana Fares , Marins Maryana Mara , Mendes Agatha Ribeiro , Pesquero João Bosco , Landman Gilles
Published: November 2024

Introduction

The incidence of melanoma has been increasing in recent decades. BRAF mutations appear in 50%–70% of melanomas. The BRAF‐targeted therapy increased the disease‐free survival of patients with metastatic melanoma, but this response may be short, due to several resistance mechanisms, such as the presence of other subclones with mutations. Evaluation of mutations and heterogeneity in the coding region of the BRAF, MAP2K1, and MAP2K2 genes in primary and metastatic melanomas.

Patients and Methods

Twenty‐seven samples of primary and metastatic superficial spreading melanoma (SSM) and acral lentiginous melanoma (ALM) were analyzed for BRAF, MAP2K1, and MAP2K2 mutations using the next‐generation sequencing technique.

Results

In ALM, the mutation rate found was 50% in the BRAF and MAP2K1 genes and 28.6% in MAP2K2. In the SSM, BRAF was mutated in 76.9%, MAP2K1 in 30.8%, and MAP2K2 in 23.2% of the cases. All samples were formed by distinct tumor subclones in the same lesion. Intertumoral heterogeneity was present between primary and metastatic lesions of ALM in BRAF, MAP2K1, and MAP2K2; the cases of SSM were heterogeneous for BRAF and MAP2K1.

Conclusion

We sought to evaluate the mutations in the BRAF, MAP2K1, and MAP2K2 genes, revealing a heterogeneous mutation profile in samples of ALM and SSM.
Parental perspectives following the implementation of advanced hybrid closed‐loop therapy in children and adolescents with type 1 diabetes and elevated glycaemia
Authors: Lai Sin‐ting Tiffany , Styles Sara E. , Boucsein Alisa , Zhou Yongwen , Michaels Venus , Jefferies Craig , Wilshire Esko , De Bock Martin I. , Wheeler Benjamin J.
Published: November 2024

Aims

To identify from a parental perspective facilitators and barriers of effective implementation of advanced hybrid closed‐loop (AHCL) therapy in children and adolescents with type 1 diabetes (T1D) with elevated glycaemia.

Methods

Semi‐structured interviews were conducted with parents of participants while in a post‐trial extension phase of the CO‐PILOT randomized controlled trial. The Capability, Opportunity, Motivation, Behaviour Model and Theoretical Domain Framework informed the interviews and framework analysis.

Results

Eleven parents of 9 children and adolescents were interviewed. The median age of their children and adolescents was 14.2 years (IQR 13.3–14.7) with median HbA1c 78 mmol/mol (IQR 75–86) (9.3% IQR 9–10) before starting AHCL. Facilitators of implementing AHCL therapy included the following: (1) knowledge acquired from training, (2) establishing routines and action plans, (3) remote glucose monitoring, (4) achievement of glycaemic goals through automation, (5) children/adolescents' capability to use AHCL independently, (6) improved outcomes incentivized continued AHCL, (7) optimism about sustained improvements and (8) social support from healthcare providers, school staff, peers and parents. Barriers to AHCL implementation included the following: (1) challenges with device usability, (2) need for technical support, (3) forgotten knowledge and skills, (4) non‐adherence to best practices, (5) negative social influences, (6) physical and psychosocial burden and (7) negative emotions.

Conclusions

This study provides comprehensive insights into parental perspectives of influences on implementing AHCL therapy in children and adolescents with elevated glycaemia. As parents remain key partners in diabetes care, these findings inform successful implementation of AHCL and development of future diabetes technology.
Natriuretic peptide levels and predicting risk of developing new diabetes mellitus and metabolic syndrome
Authors: Singh Jasraj , Adel Fadi W. , Scott Christopher G. , Chen Horng H.
Published: November 2024

Aims

Define the relationship between N‐terminal atrial natriuretic peptide (NT‐ANP) levels and incident metabolic syndrome and type 2 diabetes mellitus (‘metabolic disease’) in healthy adults and develop a risk prediction score.

Materials and Methods

Retrospective cohort study of Olmsted County Heart Function Study participants, a random sampling of county residents aged 45 years and older (n = 2042). Clinical data were collected during enrolment between 1997 and 2000 and upon follow‐up 4 years later. Outcomes were followed for 8 years. We studied 715 subjects without metabolic disease at enrolment who completed follow‐up, assessing incident metabolic disease as the primary outcome. Youden's index was used to identify optimal cut‐points and develop the risk score.

Results

Upon multivariate analysis adjusting for age gender, HDL and triglycerides, higher baseline serum NT‐ANP levels were associated with a lower risk of metabolic disease (OR: 0.65, CI 0.49–0.85, p = 0.002). Higher baseline serum insulin and aldosterone levels were associated with higher risk of incident metabolic disease (OR: 2.04, CI 1.57–2.65, p < 0.001; OR: 1.43, CI 1.14–1.81, p = 0.002, respectively). Baseline serum NT‐ANP < 3337 pg/mL was 96.6% sensitive for future development of metabolic disease. A weighted score including all three biomarkers was 78.6% sensitive and 77.3% specific.

Conclusions

In healthy adults aged 45 years or older, higher baseline NT‐ANP levels are associated with a lower four‐year risk of developing metabolic disease. Serum NT‐ANP levels are a sensitive biomarker of future risk of metabolic disease and have screening utility when combined with insulin and aldosterone levels into a composite score.
Multimodality Imaging in Chronic Constrictive Pericarditis
Authors: Karamarkou Christina , Maltsinioti Charalampia , Bruder Oliver , Babady Mehran
Published: November 2024

This case highlights the use of multimodality imaging in the diagnosis and management of chronic constrictive pericarditis (CP) in a 37‐year‐old male with a history of T‐wave inversions on electrocardiogram (ECG). The patient underwent adenosine stress cardiac magnetic resonance (CMR) due to suspicion of coronary artery disease (CAD). CMR revealed findings suggestive of chronic CP, including pericardial thickening and septal shudder, with computed tomography (CT) confirming the presence of pericardial calcification. The diagnosis was established through the combination of CMR and CT imaging. The patient underwent a successful pericardiectomy. This case emphasizes the crucial role of CMR and CT in diagnosing and guiding the management of CP.
Attenuated processing of task‐irrelevant speech and other auditory stimuli: fMRI evidence from arithmetic tasks
Authors: Ylinen Artturi , Hannula‐Sormunen Minna , McMullen Jake , Lehtinen Erno , Wikman Patrik , Alho Kimmo
Published: November 2024

When performing cognitive tasks in noisy conditions, the brain needs to maintain task performance while additionally controlling the processing of task‐irrelevant and potentially distracting auditory stimuli. Previous research indicates that a fundamental mechanism by which this control is achieved is the attenuation of task‐irrelevant processing, especially in conditions with high task demands. However, it remains unclear whether the processing of complex naturalistic sounds can be modulated as easily as that of simpler ones. To address this issue, the present fMRI study examined whether activity related to task‐irrelevant meaningful speech is attenuated similarly as that related to meaningless control sounds (nonsense speech and noise‐vocoded, unintelligible sounds). The sounds were presented concurrently with three numerical tasks varying in difficulty: an easy control task requiring no calculation, a ‘routine’ arithmetic calculation task and a more demanding ‘creative’ arithmetic task, where solutions are generated to reach a given answer. Consistent with their differing difficulty, the tasks activated fronto‐parieto‐temporal regions parametrically (creative > routine > control). In bilateral auditory regions, activity related to the speech stimuli decreased as task demands increased. Importantly, however, the attenuation was more pronounced for meaningful than nonsense speech, demonstrating that distractor type can strongly modulate the extent of the attenuation. This also suggests that semantic processing may be especially susceptible to attenuation under conditions with increased task demands. Finally, as this is the first study to utilize the ‘creative’ arithmetic task, we conducted exploratory analyses to examine its potential in assessing neural processes involved in mathematical problem‐solving beyond routine arithmetic.
Patterns of Gene Flow in Anopheles coluzzii Populations From Two African Oceanic Islands
Authors: Campos Melina , Rašić Gordana , Viegas João , Cornel Anthony J. , Pinto João , Lanzaro Gregory C.
Published: November 2024

The malaria vector Anopheles coluzzii is widespread across West Africa and is the sole vector species on the islands of São Tomé and Príncipe. Our interest in the population genetics of this species on these islands is part of an assessment of their suitability for a field trial involving the release of genetically engineered A. coluzzii. The engineered construct includes two genes that encode anti‐Plasmodium peptides, along with a Cas9‐based gene drive. We investigated gene flow among A. coluzzii subpopulations on each island to estimate dispersal rates between sites. Sampling covered the known range of A. coluzzii on both islands. Spatial autocorrelation suggests 7 km to be the likely extent of dispersal of this species, whereas estimates based on a convolutional neural network were roughly 3 km. This difference highlights the complexity of dispersal dynamics and the value of using multiple approaches. Our analysis also revealed weak heterogeneity among populations within each island but did identify areas weakly resistant or permissive of gene flow. Overall, A. coluzzii on each of the two islands exist as single Mendelian populations. We expect that a gene construct that includes a low‐threshold gene drive and has minimal fitness impact should, once introduced, spread relatively unimpeded across each island.
Integrating Anthropogenic–Pesticide Interactions Into a Soil Health‐Microbial Index for Sustainable Agriculture at Global Scale
Authors: Xu Nuohan , Chen Bingfeng , Wang Yan , Lei Chaotang , Zhang Zhenyan , Ye Yangqing , Jin Mingkang , Zhang Qi , Lu Tao , Dong Huaping , Shou Jianxin , Penuelas Josep , Zhu Yong‐Guan , Qian Haifeng
Published: November 2024

Soil microbiota in intensive agriculture are threatened by pesticides, economic activities, and land‐use changes. However, the interactions among these anthropogenic factors remain underexplored. By analyzing 2356 soil metagenomes from around the world, we developed a comprehensive soil health‐microbial index that integrates microbial diversity, nutrient cycling potential, metabolic potential, primary productivity, and health risks to assess how the soil microbiota respond to anthropogenic factors. Our results indicated that the health‐microbial index was the lowest with severe pesticide contamination. Pesticides, in combination with other anthropogenic and climatic factors, exacerbate the decline in this index. Machine learning predictions suggest that the health‐microbial index in approximately 26% of global farmland could decline between 2015 and 2040, even under sustainable development scenarios. Even with strategies to reduce pesticide usage, we cannot completely halt the decline in the health‐microbial index. Our findings highlight that sustaining soil microbial health on a global scale requires addressing not only pesticide management but also broader anthropogenic impacts.
Image Analysis Characterizes Phenotypic Variation in the Growth of Mushroom‐Forming Fungus Schizophyllum commune
Authors: Matsumae Hiromi , Sudo Megumi , Imanishi Tadashi , Hosoya Tsuyoshi
Published: November 2024

Schizophyllum commune, a common wood‐decay mushroom known for its extremely high genetic variation and as a rare cause of human respiratory diseases, could be a promising model fungus contributing to both biology and medicine. To better understand its phenotypic variation, we developed an image analysis system that quantifies morphological and physiological traits of mycelial colonies in Petri dishes. This study evaluated growth of six wild and one clinical isolates of Japanese S. commune, subjected to different temperatures and glucose concentrations, including a condition mimicking the human respiratory environment. Our analysis revealed that combinations of two growth indices, area and whiteness, and profiling by clustering algorithms highlighted strain‐specific responses. For example, the clinical isolate was the whitest under the respiratory‐like condition. We also found that the growth rate was strongly determined by glucose concentration, while the effects of temperature on growth varied among the strains, suggesting that while glucose preference is common in this species, responses to temperature differ between strains. This system showed sufficient sensitivity to detect variation in mycelial growth. Our study provides a key to unraveling morphological and physiological traits behind the high polymorphisms in S. commune, including the ability to colonize the human respiratory tract.
Messages from the past: the petroglyphs of El Hierro Island, Canary Islands
Authors: Guglielmi Mario , Troll Valentin R. , Foest Joerg , Carracedo Juan Carlos
Published: November 2024

Ancient cultures have frequently made use of stone surfaces to carve and engrave symbols, letters and messages for others. These petroglyphs usually have a lasting character and are frequently preserved well beyond the survival of the culture that produced the petroglyphs. In this article, we focus on the written and pictorial testimony of the pre‐Hispanic era of the island of El Hierro (Canary Islands, Spain), which exploited a series of volcanic rock features to create a written testimony of their presence and their way of life. This specific cultural heritage has been adapted to the specific geological features on the island and the emerging stone masonry skill of the aboriginal culture of the original islanders, creating a unique and lasting record of their ability to use geological elements for cultural development.
Pedagogical Translanguaging for Epistemic Inclusion: Scaffolding Strategies in Bilingual Subject Instruction in Norway
Authors: Moraczewska Agnieszka
Published: November 2024

Bilingual subject instruction (BSI) is one form of language support classes in Norwegian schools, preparing students from language minorities for mainstream instruction by combining subject and language tutoring through the students’ home language. This article examines interactions within a Polish–Norwegian classroom setting, focusing on the concept of pedagogical translanguaging and scaffolding for epistemic inclusion of student resources. Grounded in the framework of translanguaging pedagogy and scaffolding techniques for student comprehension and production, the study involves a micro‐analysis of recorded dyadic interactions between a bilingual teacher and three students in individual BSI classes. The findings highlight language shifts as integral to teacher–student interactions, demonstrating the diligent use of scaffolding techniques for co‐constructing knowledge. The study underscores the mediating role of translanguaging practices in supporting both content and language knowledge, emphasizing the active integration of students’ previous knowledge and experiences for fostering epistemic inclusion.
Push and pull factors in return migration intentions among first‐generation Croatian migrants in Germany and Ireland
Authors: Liu Yang Vincent , Kutnjak Ivković Sanja , Pavlović Vinogradac Valentina
Published: November 2024

Why are some migrants more willing to move back to their homeland than others? Using a mixed methods approach, this article sheds light on the factors contributing to the desire for return migration among first‐generation Croatian migrants (N = 499). In particular, the current study focuses on the role that migrants' trust in state institutions in both their homeland and current countries of residence plays in their desire to return to the homeland. Quantitative analyses reveal that factors of institutional trust strongly correlate with migrants' willingness to return to Croatia, as do short‐term visits and (dis)satisfaction with their current lives, particularly for those who left Croatia for personal reasons instead of institutional ones. The qualitative results suggest that the pull factors of return migration tend to be personal, while the push factors are largely institutional. In addition, the idea of a “future” for both the returnees (e.g. financial stability) and the country (e.g. political conditions) is the key to migrants' decision‐making about returning.
Surface morphology modulation in multilayer scaffolds via ion doping for bone tissue engineering
Authors: Riosalido Paula M. , Velásquez Pablo , Murciano Ángel , De Aza Piedad N.
Published: November 2024

This work proposes the use of multilayer scaffolds as a strategy for developing biomimetic structures for bone tissue regeneration. The scaffolds consist of a glass–ceramic core composed of CaSiO3/Ca2P6O17, which provides mechanical properties of 2.3 MPa and a total porosity of ∼74%. To modify the surface morphology a double bioactive coating consisting of Ca3(PO4)2/CaSiO3 doped with Na+ and K+, along with varying amounts of Mg2+ (0–0.75 g MgCO3) was carried out giving a total porosity of 89.8%. The resulting scaffolds were assessed for in vitro bioactivity according to ISO 23317. After immersion in SBF, the W‐05 scaffolds displayed diverse surface morphologies: square HA structure (W‐05‐3D), hollow HA spheres (W‐05‐7D) and smooth HA layer (W‐05‐21D). Cell viability of 3T3 fibroblasts exposed to W‐05 scaffolds in direct and indirect assays at concentrations of 15 and 30 mg/mL was assessed according to ISO 10993–5. Initially, cell proliferation decreased compared to controls, but differences became non‐statistically significant after 72 h. Hollow spheres (W‐05‐7D) enhanced cell viability compared to other morphologies and plastic controls. Additionally, degradation products of W‐05 stimulated cell division, underscoring scaffold biocompatibility.
Temperament and executive functioning correlates of ADHD symptom severity during early versus middle childhood
Authors: Peisch Virginia , Ferrara Erica , Gourdet Gaelle , Zimon Matthew , Mastrangelo Carissa , Arnett Anne
Published: November 2024

Background

This study investigated associations among temperament, executive functioning (EF), and attention‐deficit/hyperactivity disorder (ADHD) symptom severity at two developmental stages.

Methods

Participants were 61 4‐year‐old children and 165 8–11‐year‐old children (126 ADHD, 39 typically developing [TD]). Caregivers reported on temperament (effortful control [EC], negative affect, and surgency), and ADHD symptoms. Three aspects of EF (working memory, inhibitory control, and processing speed) were measured with neuropsychological tests.

Results

Among 4‐year‐olds, variance in ADHD symptom severity was only explained by the temperament variables. EC was not significantly correlated with any of the EFs in this cohort. Among school‐aged children, low EC, high surgency, high negative affect, and reduced working memory were associated with greater ADHD symptom severity. EC was significantly and positively correlated with processing speed in the school‐aged children.

Conclusions

Results are consistent with a neurodevelopmental model of ADHD, wherein dysregulated temperament is associated with ADHD in young children, while both dysregulated temperament and cognitive skills are associated with ADHD in middle childhood. Results could inform the selection of clinical tools for diagnostic evaluation of pediatric ADHD symptoms and clinical follow‐up.
Longitudinal analysis of Annual Wellness Visit use among Medicare enrollees: Provider, enrollee, and clinic factors
Authors: Gabbard Jennifer L. , Beurle Ellis , Zhang Zhang , Frechman Erica L. , Lenoir Kristin , Duchesneau Emilie , Mielke Michelle M. , Hanchate Amresh D.
Published: November 2024

Background

The utilization of Annual Wellness Visits (AWVs), preventive healthcare visits covered by Medicare Part B, has grown steadily since their inception in 2011. However, longitudinal patterns and variations in use across enrollees, providers, and clinics remain poorly understood.

Objective

This study aimed to analyze AWV usage trends from 2018 to 2022 among a sizable cohort of Medicare beneficiaries, employing electronic health record (EHR) data. The goal was to assess AWV frequency and explore variations across enrollees, providers, and clinics.

Design

This retrospective observational study utilized EHR data from Medicare beneficiaries aged 66 and above, receiving continuous primary care from 2018 to 2022 (N = 24,549). Enrollees were classified into three categories based on their AWV utilization over a 5‐year period: low users (0–1 AWVs), moderate users (2–3 AWVs), and regular users (4–5 AWVs). AWV usage patterns were examined across individual demographics and provider/clinic characteristics using multilevel regression models.

Key Results

Over the 2018–2022 period, 58.6% were regular AWV users, 27.7% were moderate users, and 13.7% were low users. Differences in primary care providers and clinics accounted for 56.4% (95% CI, 45.3%–66.9%) of the variation between low and regular users. Among enrollees who visited the same providers and clinics, individuals were less likely to be regular users of AWVs if they were 85 and older, Hispanic, from socioeconomically disadvantaged areas, or had multiple comorbidities.

Conclusions

The majority of Medicare beneficiaries in the study engaged with AWVs, with 86% having two or more over the 5‐year period. These findings underscore the broad acceptance of AWVs among beneficiaries but also show that clinic and provider factors influence usage, especially among older, minoritized, and socioeconomically disadvantaged populations. Interventions at the provider and clinic levels are necessary to further improve AWV uptake, particularly for vulnerable groups.
Incremental healthcare costs of the simple SOF measure of phenotypic frailty in community‐dwelling older adults
Authors: Ensrud Kristine E. , Schousboe John T. , Kats Allyson M. , Fink Howard A. , Taylor Brent C. , Sheets Kerry M. , Boyd Cynthia M. , Langsetmo Lisa
Published: November 2024

Background

Frailty defined by the Cardiovascular Health Study (CHS) phenotype is associated with higher healthcare expenditures in community‐dwelling Medicare beneficiaries after accounting for claims‐based cost indicators. However, frailty assessment using the CHS phenotype is often not feasible in routine clinical practice. We evaluated whether frailty identified by the simple Study of Osteoporotic Fractures (SOF) phenotype is associated with subsequent incremental costs after accounting for claims‐derived cost indicators.

Methods

Prospective study utilizing data from four cohort studies of older adults linked with Medicare claims composed of 8264 community‐dwelling fee‐for‐service beneficiaries (4389 women, 3875 men). SOF Frailty Phenotype (three components: weight loss, poor energy, and inability to rise from chair five times without using arms) and CHS Frailty Phenotype (operationalized using five components) derived from cohort data. Participants were classified as robust, prefrail, or frail using each phenotype. Multimorbidity index (CMS Hierarchical Conditions Categories score) and Kim frailty indicator (approximating the deficit accumulation index) derived from claims. Annualized total and sector‐specific healthcare costs ascertained for 36 months after frailty assessment.

Results

Average annualized total healthcare costs (2023 US dollars) were $15,021 in women and $15,711 in men. After accounting for claims‐based multimorbidity and frailty indicators, average incremental costs of SOF phenotypic frailty (two or three components) versus robust (none) were $7142 in women and $5961 in men, only modestly lower than incremental costs of CHS phenotypic frailty ($9422 in women, $6479 in men). SOF phenotypic frailty in both sexes was associated with higher subsequent expenditures in the inpatient, skilled nursing facility, and home healthcare sectors.

Conclusions

As observed with CHS phenotypic frailty, SOF phenotypic frailty is associated with higher subsequent total and sector‐specific expenditures after accounting for claims‐derived indicators. The parsimonious SOF phenotype can be readily assessed in space‐constrained and time‐limited practice settings to improve identification of older adults at high risk of costly care.
Use of digital food records in clinical settings: lessons in translation from a randomised controlled trial
Authors: Barnett Amandine , Mayr Hannah L. , Keating Shelley E. , Conley Marguerite M. , Webb Lindsey , Jegatheesan Dev K. , Staudacher Heidi M. , Macdonald Graeme A. , Kelly Jaimon T. , Campbell Katrina L. , Hickman Ingrid J.
Published: November 2024

Background

Digital food records offer efficiencies in collecting and assessing dietary information remotely; however, research into factors impacting their translation into clinical settings is limited.

Methods

The study examined factors that may impact the integration of digital food records into clinical dietetic practice by assessing (1) the source and rate of data errors received, (2) the impact of dietitian‐adjusted data on dietary variables and (3) the acceptance of use in a complex chronic condition cohort. Adults from specialist clinics enroled in a randomised controlled feasibility trial participated. Participants recorded their dietary intake using a mobile food diary application (Research Food diary, Xyris Software Pty Ltd.); it was analysed via electronic nutrition analysis software (FoodWorks, Xyris Software Pty Ltd.). Records were verified and corrected by a dietitian. Dietary variables assessed before (participant‐unadjusted data) and after (dietitian‐adjusted data) were compared by the Wilcoxon signed‐rank test, Bland–Altman and Passing–Bablok analysis. Surveys and Interviews assessed participants'; acceptance of the mobile application's usability.

Results

Errors appeared in 93% of records. Dietitian‐adjusted median data were higher for most variables compared to participant‐unadjusted median data (p < 0.05, median changes between 0.0% and 64.7%) of 59 participant records (median age 51 years, interquartile range 38–58). There was poor agreement between participant‐unadjusted and dietitian‐adjusted data for some dietary variables. Sixty‐four percent surveyed (n = 32/50) found the app easy to use, whereas 29 interviews provided insights into facilitators and challenges of use.

Conclusions

Significant barriers to integrating digital food records into clinical settings exist requiring dietitian adjustment to correct errors which has major implications for estimates of diet quality and intake.
The evolution of nutritional care in children with food allergies – With a focus on cow's milk allergy
Authors: Meyer Rosan , Groetch Marion , Santos Alexandra , Venter Carina
Published: November 2024

Cow's milk allergy (CMA) remains one of the most common and complex paediatric food allergies. In the last decade, our understanding has advanced in terms of immunoglobulin E (IgE)‐mediated CMA and focus is now also paid to non‐IgE‐mediated CMA, particularly in some Western countries where incidence rates are high. We have had significant progress in the last 10 years in relation to our understanding of existing supportive tests for IgE‐mediated CMA, with the advancement of newer tests, such as the basophil activation test (BAT), which have shown great promise. However, little advancement has been made in terms of tests for non‐IgE‐mediated CMA, and controversy still exists around symptoms. Our understanding of the natural history of CMA has also advanced with more awareness of different phenotypes. While the mainstay of management remains cow's milk elimination, the importance of supporting breastfeeding and avoidance of unwarranted cow's milk elimination diets in breastfeeding mothers has been highlighted. For non‐breastfed children, there has been some advancement in the formulas offered for the management of CMA, including the recognition of hydrolysed rice‐based formulas and increased demand for nutritionally complete plant‐based options, some of which are currently being assessed. The addition of pro, pre and synbiotics is considered safe to use, although research and guidance on routine use remain absent. Knowledge of tolerance induction from studies on the early introduction of peanuts has also highlighted the importance of a more active approach to managing CMA with the use of milk ladders, primarily in non‐IgE‐mediated CMA and baked milk (BM) introduction in IgE‐mediated CMA. In addition, modulation of the microbiome and diet diversity during complementary feeding has been a major advancement in the last 10 years. While data on poor growth and feeding difficulties in children with CMA has not changed much, increased rates of obesity are now also reported. Finally, novel approaches, including oral immunotherapy, the use of milk ladders and earlier consideration of BM, have advanced somewhat in the last decade, although the risks and benefits of these novel approaches require further research. While CMA remains a complicated allergy to diagnose and manage, the evolution of science has advanced our knowledge and brought some novel innovations, which combined have enhanced our practice.
Workforce development in private practice dietetics: experiences and perceptions of experienced practitioners
Authors: Donnelly Jennifer , Walsh Louisa , Lane Rebecca , Hughes Roger
Published: November 2024

Background

Changes in Australian health policies and public funding models have increased the demand for private dietetics services over the past two decades. Limited available workforce data indicate that over half of the Australian dietetics workforce works in private practice at some level, with approximately 30%–50% of dietitians now entering private practice as new graduates. These changes in the sector have implications for dietetics workforce development. The present study aimed to explore private practice dietitians' perceptions and experiences about workforce development needed to successfully work as a private practice dietitian.

Methods

Australian private practice dietitians were purposively sampled for participation in semistructured interviews on their experiences of, and perceptions about, workforce development needs for successful private practice. Data were analysed using qualitative thematic analysis methods.

Results

Sixteen dietitians participated. Twenty‐seven themes emerged across seven constructs spanning pathways to practice, the work of private practitioners, workforce preparation, competency development, placements, competency requirements and challenges.

Conclusions

Experienced private practice dietitians offer critical insights into the workforce development needs and challenges of the sector. Study participants indicated that their preparation for private practice was suboptimal and they have endured many challenges during their careers. This study highlights the need for a strategic approach to workforce development for private practice, including further research into the preparation and needs of this evolving area.
Screening and surveillance practices for Multiple Endocrine Neoplasia type 1‐related Neuroendocrine Tumours in European Neuroendocrine Tumor Society Centers of Excellence (ENETS CoE)—An ENETS MEN1 task force questionnaire study
Authors: Pieterman Carolina R. C. , Grozinsky‐Glasberg Simona , O'Toole Dermot , Howe James R. , Ambrosini Valentina , Belli Susana H. , Andreassen Mikkel , Begum Nehara , Denecke Timm , Faggiano Antongiulio , Falconi Massimo , Grey Jo , Knigge Ulrich P. , Kolarova Teodora , Niederle Bruno , Nieveen van Dijkum Els , Partelli Stefano , Pascher Andreas , Rindi Guido , Ruszniewski Philippe , Stättner Stefan , Vandamme Timon , Valle Juan W. , Vullierme Marie‐Pierre , Welin Staffan , Perren Aurel , Bartsch Detlef K. , Kaltsas Gregory K. , Valk Gerlof D.
Published: November 2024

Multiple Endocrine Neoplasia type 1 (MEN1) Clinical Practice Guidelines (2012) are predominantly based on expert opinion due to limited available evidence at the time, leaving room for interpretation and variation in practices. Evidence on the natural course of MEN1‐related neuroendocrine tumours (NET) and the value of screening programs has increased and new imaging techniques have emerged. The aim of this study is to provide insight in the current practices of screening and surveillance for MEN1‐related NETs in ENETS Centers of Excellence (CoEs). A clinical practice questionnaire was distributed among all 65 ENETS CoEs. Response rate was 91% (59/65). In 14% of CoEs <10 patients, in 50% 10–49, in 31% 50–100 and in 3 centres (5%) >100 patients with MEN1 are seen. Practices with regard to screening and surveillance of NETs were markedly heterogeneous. Differences between countries were noted in the use of gut hormones for biochemical screening and the choice for imaging modality for screening/surveillance of pancreatic NETs (PanNETs). Magnetic resonance imaging (MRI) is the preferred modality for screening and surveillance of PanNETs, whereas this is computed tomography (CT) for thoracic NETs. Practices regarding screening for thoracic NETs were more homogeneous among larger volume CoEs, with longer screening intervals. The majority of CoEs tailored the surveillance of small pancreatic and lung NETs to observed growth rate. 68% of CoEs advise patients with clinical MEN1 with negative genetic testing to undergo periodic screening like mutation‐positive patients. In conclusion, there is still marked heterogeneity in practice, although there are also common trends. Differences were sometimes associated with volume or country, but often no association was found. This underscores the need for clear and evidence‐based practice recommendations.
Clinical and Dermoscopic Comparison of the Efficacy and Safety of 5% Fluorouracil Topical Cream and 1% Niacinamide Topical Gel in the Treatment of Actinic Keratosis: A Randomized Controlled Trial
Authors: Poostiyan Nazila , Barati Mahbube , Shahmoradi Zabiholah , Saber Mina
Published: November 2024

Background

Actinic keratosis (AK) is a common skin condition treated by dermatologists; however, the effectiveness, superiority, and potential side effects of current treatment protocols are still debated.

Aim

This study aimed to compare the effectiveness and safety of 5% fluorouracil topical cream and 1% niacinamide topical gel in patients with AK.

Methods

In a randomized clinical trial, 26 patients with 95 AK lesions were assigned to receive either 5% fluorouracil topical cream twice daily for 4 weeks or 1% niacinamide topical gel twice daily for 3 months. Photography and dermoscopy before and after treatment were used to evaluate the outcomes.

Results

The study included 26 patients who underwent randomization and treatment. Analysis of the improvement response after treatment through photography and dermoscopy scores, as well as patients' perspectives, showed that the fluorouracil group had significantly better outcomes than the niacinamide group. However, treatment complications including burning, itching, and erythema were significantly more frequent in the fluorouracil group than in the niacinamide group.

Conclusions

Although 5% fluorouracil cream is more effective than 1% niacinamide gel in treating AK lesions, it is also associated with more frequent side effects.
Effect of daily immersion of different beverages on the surface roughness and color stability of 3D‐printed denture base resins
Authors: Gad Mohammed M. , Alramadan Hassan , Alkoudemi Mohammed , Aljubran Hussain , Altayyar Raand , Alghamdi Deena , Baba Nadim Z. , Khan Soban Q. , Abualsaud Reem , Elhagali Ahmed Fathey , Al‐Harbi Fahad A.
Published: November 2024

Purpose

To measure the effect of daily immersion in varying beverages (distilled water, tea, carbonated beverage, and orange juice) on surface roughness and color stability of 3D‐printed denture base resins.

Materials and Methods

160 acrylic resin discs (15 × 2.5 mm) were made from heat‐polymerized (HP), and 3D‐printed resins (FormLabs, ASIGA, and NextDent). Resin discs (N = 40) were immersed in different solutions (distilled water, tea, carbonated beverage, or orange juice; (n = 10/group)). Surface roughness (Ra, µm) was measured initially (T0), 6 months post immersion (T1), and 12 months post immersion (T2) using a non‐contact profilometer. Color change (∆E00) was calculated using CIEL2000 at T1 and T2 using a spectrophotometer. The data were analyzed using Mann‐Whitney U test and Kruskal‐Wallis test in addition to general linear modeling (α = 0.05).

Results

Significant differences in surface roughness (Ra) were found between the baseline and immersion in distilled water, carbonated beverage, and orange juice (p < 0.05). HP resin showed increased roughness with all immersion solutions compared to T0 with the highest value seen at T1 with tea. ASIGA resin had the highest mean Ra of 1.78 (0.43) after carbonated beverage immersion, while FormLabs resin had the lowest mean Ra of 0.88 (0.06) after distilled water immersion. Tea immersion did not significantly affect Ra among the resins (p > 0.05). Noticeable color changes were observed after immersion in tea, carbonated beverage, and orange juice. All resins exceeded perceptibility and acceptability thresholds at T1 and T2. The combined effect of time and resin on color change was statistically significant (p < 0.001), while the combined effects of time/immersion solution, immersion solution/resin, and immersion solution/resin/time were not.

Conclusion

Carbonated beverage, tea, and orange juice increase the surface roughness of 3D‐printed resins. Tea, carbonated beverage, and orange juice resulted in noticeable color changes of HP and 3D‐printed denture base resins and this change was time‐dependent.
Mental Health in China: Social Change in Life Course Trajectories
Authors: Ge Tingshuai , Van Leeuwen Frans Johannes , Jiang Quanbao , Leopold Liliya
Published: November 2024

Knowledge about life course trajectories and intercohort changes in mental health is limited mainly to Western populations. To address this gap, our study analyzes mental health trajectories in China, drawing on data on depressive symptoms from the China Family Panel Studies over the period 2012–2020 (N = 31,700 individuals aged 16–70; N = 87,787 person‐years). Employing hierarchical linear regression models, our findings reveal moderate increases in depressive symptoms over the life course and across cohorts. Subgroup analyses indicate that women, people with lower educational attainment, and people with rural hukou experienced more depressive symptoms and a more pronounced increase in depressive symptoms with age. These disparities narrowed across cohorts. We discuss these patterns in the context of Chinese cultural dynamics, including son preference, the impact of education and hukou on the accumulation of stress over the life course, family policy and equity policy transitions, and the changing stigma of mental health.