bluuebunny/crossref_metadata_2025 huggingface dataset:
The Laurentian University Financial Scandal: Accounting and Audit Deficiencies*
Authors: Pilon Marc , Ryan Jo‐Anne
Published: December 2024

This case study investigates the shocking 2021 insolvency and resulting financial scandal at Laurentian University, a publicly funded post‐secondary institution in the province of Ontario, Canada. The case exposes significant weaknesses in internal control, highlights the institution's inability to become financially sustainable, and serves as a warning about the importance of responsible governance. Using publicly available information, the case study focuses on the financial, governance, and auditing elements resulting from the scandal. The Laurentian scandal is a significant Canadian accounting event that merits attention from the accounting community in Canada and beyond because important lessons can be learned about financial management and corporate governance. The case study is best suited for analysis in an upper‐year professional integration undergraduate course or at the graduate level in an assurance course. The case study is also valuable for those in academic governance.
The cost of maternity and neonatal care in Aotearoa New Zealand: A cost analysis by plurality and gestation using a population‐based cohort
Authors: Anderson Karyn , Sadler Lynn , Edlin Richard
Published: December 2024

Background

Maternity services in New Zealand are largely delivered by autonomously practising community midwives. This model of care is unique and may result in differences in the distribution of maternity healthcare utilisation and costs compared to other countries. New Zealand‐specific cost data are needed to inform economic analyses, local policy and healthcare resource planning.

Aims

To provide estimates of the average total cost of maternity and neonatal healthcare for New Zealand women and infants, including cost impacts of multiple and preterm births.

Materials and Methods

A whole‐of‐population linked dataset, including 262 687 pregnancies resulting in a live birth (from 1 January 2016 to 30 June 2020), was created by combining several sources of healthcare data to calculate an average per‐pregnancy cost of healthcare, taking a public health system perspective, during antenatal, intrapartum, and postnatal periods to one year after birth.

Results

The mean cost of public healthcare was NZ$19 795 for both maternal and infant care to one year post‐birth. The bulk of this cost was incurred during pregnancy and birth. Mean total cost to one year was NZ$69 895 for twin and NZ$201 448 for higher order multiple compared to singleton pregnancies at NZ$19 098. Mean total healthcare cost decreased as gestation increased.

Conclusions

Most of the costs associated with pregnancy and childbirth were incurred during the birth and in the early neonatal period. Costs were disproportionately higher for multiple and preterm births.

These cost data can usefully inform policy and assist healthcare decision‐making around reproductive and neonatal technologies.
Race, shaming, and international human rights
Authors: Búzás Zoltán I. , Bassan‐Nygate Lotem
Published: December 2024

Can human rights organizations (HROs) shame governments without fueling racism against diasporas or appearing racist? To what extent can shamed governments recover public support lost to shaming by accusing their critics of racism? Employing two U.S.‐based survey experiments involving 6,739 respondents and 11 prominent HRO interviews, we offer three novel findings. First, shaming decreased support for shamed countries (Israel and China) but did not fuel racism (antisemitism and anti‐Asianism). If shamers face a racial dilemma, it is less about how to shame without fueling racism and more about how to shame without appearing racist. Our second finding points toward a solution: when shaming included an anti‐racist cue denouncing racism, respondents perceived it as less racist. Finally, shamed governments can employ racial countershaming to recover some, but not all, of the public support lost to shaming. We contribute to the international relations shaming literature and offer recommendations about racially responsible shaming.
Amplitude‐integrated electroencephalography showed alterations in cerebral activity in monochorionic twins with twin‐to‐twin transfusion syndrome
Authors: Schreiner Christina , Staudt Anna , Neubauer Vera , Kiechl‐Kohlendorfer Ursula , Griesmaier Elke
Published: December 2024

Aim

Monochorionic twins are at higher risk of perinatal mortality and morbidity, primarily due to pregnancy‐related complications, such as twin‐to‐twin transfusion syndrome (TTTS). We aimed to investigate whether amplitude‐integrated electroencephalography (aEEG) signals are different between monochorionic twins with and without TTTS.

Methods

This was a retrospective single‐centre study conducted at Innsbruck Medical University Hospital, Austria. Preterm infants born before 32 weeks of gestation between 6 November 2010 and 6 December 2022 were eligible. The aEEG was analysed for the total maturation score, its component scores and the number of sleep–wake cycles per hour.

Results

We enrolled 79 monochorionic twin infants (48% male) and 157 dichorionic (62% male) twin infants. We found no differences between these two groups of preterm infants regarding the total maturation and component scores, or the number of sleep wake cycles. Monochorionic twins with TTTS showed significantly lower total maturation scores and individual component scores compared to monochorionic twins without TTTS.

Conclusion

Preterm infants with TTTS showed differences in neonatal aEEG signals. Whether these differences are caused by prematurity‐related or TTTS‐related factors, such as hemodynamic and metabolic changes due to placental anastomoses, should be investigated in future prospective studies, to gain more insight into this important topic.
Sleep profiles and their associations with adiposity and cardiorespiratory fitness among adolescents
Authors: Bakalár Peter , Janda David , Kostičová Michaela , Kopčáková Jaroslava , Kolarčik Peter , Badura Petr , Gába Aleš
Published: December 2024

Aim

This study aimed to identify sleep profiles in a representative sample of Slovak adolescents and investigate their associations with adiposity indicators and cardiorespiratory fitness.

Methods

Data from the 2022 Health Behaviour in School‐aged Children (HBSC) study conducted in Slovakia were analysed. Survey questions on sleep duration and problems from the entire HBSC sample (n = 8906) were used to identify sleep profiles. Associations with adiposity indicators and cardiorespiratory fitness were investigated in a subsample of 924 adolescents (average age 13.3 ± 1.48; 56.2% boys) who completed the HBSC survey, bioimpedance analysis, and 20‐metre shuttle run test.

Results

Three sleep profiles were identified—optimal sleepers, optimal sleepers with sporadic sleep problems and poor sleepers. Crude models showed that poor sleepers had significantly higher body fat percentage and fat mass index, along with lower cardiorespiratory fitness, compared to optimal sleepers. After adjustment, only the association between sleep profiles and cardiorespiratory fitness remained significant.

Conclusion

The observed associations between sleep profiles and cardiorespiratory fitness may help better target future intervention resources towards adolescents with low cardiorespiratory fitness levels.
Effect of dietary supplementation with rumen‐protected amino acids, lysine and methionine, on the performance of Comisana ewes and on the growth of their lambs
Authors: Grassi Giulia , Di Gregorio Paola , Capasso Giambattista , Rando Andrea , Perna Anna Maria
Published: December 2024

The purpose of the study was to evaluate the effect of supplementing the diets of Comisana ewes with rumen protected methionine and lysine (RP‐ML) for a duration of 60 days on quantitative–qualitative production of milk, antioxidant parameters of milk and blood, biochemical parameters of blood, and lambs' growth performance. Two groups of 15 ewes with equal average body weight were considered for the trial. The control group was administered a standard diet (Control, C) and the experimental group the standard diet supplemented with 1.5% lysine and 1.0% methionine (Treated, T). Results showed that RP‐ML supplementation positively influenced milk yield, fat and protein content, and casein (p < 0.01). Furthermore, lambs of the T group, compared with those of the C group, showed a 15% higher growth rate during the suckling period of 42 days. Finally, the total antioxidant capacity of milk, measured by ferric reducing antioxidant power and 2,2′‐azino‐bis(3‐ethylbenzotiazolin‐6‐sulfonic acid assay, was significantly lower in T groups (p < 0.05). In conclusion, the results showed that the integration of RP‐ML in ewes could be a valid strategy in order to improve their performances but further investigations are necessary to define the right concentration to be administered to the animals.
Systematic review and meta‐analysis of vancomycin therapeutic level for treatment of vancomycin‐sensitive enterococcal infections
Authors: Katip Wasan , Lee Shaun Wen Huey , Kasatpibal Nongyao , Rayanakorn Ajaree
Published: December 2024

Aims

Evidence on the optimal targets of vancomycin for treating other Gram‐positive infections apart from methicillin‐resistant Staphylococcus aureus (MRSA) is lacking. This review aims to identify the recommended vancomycin therapeutic level for favourable clinical outcomes among patients infected with vancomycin‐sensitive enterococcal infections.

Methods

Analytical studies describing the vancomycin levels of vancomycin‐sensitive enterococcal infections among adult population were searched. The primary outcome was 30‐day all‐cause mortality, and the secondary outcomes were clinical failure and nephrotoxicity. Study characteristics were extracted and pooled using random‐effects meta‐analysis. The study quality was assessed using the Joanna Briggs Institute critical appraisal tool.

Results

A total of nine retrospective cohorts studies involving 1013 patients with vancomycin‐sensitive enterococci were included. The meta‐analysis found that high area under the curve to minimum inhibitory concentration ratio (AUC/MIC) of vancomycin ≥ 389 mg*h/L significantly lowered the 30‐day mortality (odds ratio [OR], 0.44, 95% confidence interval [CI], 0.26–0.75). Analysis of the target AUC/MIC showed that high vancomycin AUC/MIC (≥ 389–400 mg*h/L) significantly reduced clinical failure rate (OR 0.59, 95% CI 0.37–0.94). The mortality and treatment failure rates did not differ significantly between those with high or low trough levels. Higher vancomycin AUC/MIC and trough levels were significantly associated with increased nephrotoxicity (OR 3.11, 95% CI 1.65–5.89; OR 2.95, 95% CI 1.60–5.44, respectively).

Conclusions

The use of a higher vancomycin AUC/MIC concentration can be effective to reduce 30‐day mortality and clinical failure but this needs to take into consideration the risk of nephrotoxicity. Well‐conducted prospective studies are warranted due to the scarcity of evidence.
Frequency‐adjusted borders ordinal forest: A novel tree ensemble method for ordinal prediction
Authors: Buczak Philip
Published: December 2024

Ordinal responses commonly occur in psychology, e.g., through school grades or rating scales. Where traditionally parametric statistical models like the proportional odds model have been used, machine learning (ML) methods such as random forest (RF) are increasingly employed for ordinal prediction. With new developments in assessment and new data sources yielding increasing quantities of data in the psychological sciences, such ML approaches promise high predictive performance. As RF does not inherently account for ordinality, several extensions have been proposed. A promising approach lies in assigning optimized numeric scores to the ordinal response categories and using regression RF. However, these optimization procedures are computationally expensive and have been shown to yield only situational benefit. In this work, I propose Frequency‐Adjusted Borders Ordinal Forest (fabOF), a novel tree ensemble method for ordinal prediction forgoing extensive optimization while offering improved predictive performance in simulation and an illustrative example of student performance. To aid interpretation, I additionally introduce a permutation variable importance measure for fabOF tailored towards ordinal prediction. When applied to the illustrative example, an interest in higher education, mother's education, and study time are identified as important predictors of student performance. The presented methodology is made available through an accompanying R package.
BCR::ABL1‐induced mitochondrial morphological alterations as a potential clinical biomarker in chronic myeloid leukemia
Authors: Suzuki Kohjin , Watanabe Naoki , Torii Satoru , Arakawa Satoko , Ochi Kiyosumi , Tsuchiya Shun , Yamada Kazuhiro , Kawamura Yoko , Ota Sadao , Komatsu Norio , Shimizu Shigeomi , Ando Miki , Takaku Tomoiku
Published: December 2024

The BCR::ABL1 oncogene plays a crucial role in the development of chronic myeloid leukemia (CML). Previous studies have investigated the involvement of mitochondrial dynamics in various cancers, revealing potential therapeutic strategies. However, the impact of BCR::ABL1 on mitochondrial dynamics remains unclear. In this study, we demonstrated that BCR::ABL1 is sufficient to induce excessive mitochondrial fragmentation by activating dynamin‐related protein (DRP)1 through the mitogen‐activated protein kinase (MAPK) pathway. Leukocytes obtained from patients with CML and the BCR::ABL1‐positive cell lines exhibited increased mitochondrial fragmentation compared to leukocytes obtained from healthy donors and BCR::ABL1‐negative cells. Furthermore, the analysis of BCR::ABL1‐transduced cells showed increased phosphorylation of DRP1 at serine 616 and extracellular signal‐regulated kinase (ERK) 1/2. Moreover, the inhibition of DRP1 and upstream mitogen‐activated extracellular signal‐regulated kinase (MEK) 1/2 suppressed mitochondrial fragmentation. Strikingly, DRP1 inhibition effectively reduced the viability of BCR::ABL1‐positive cells and induced necrotic cell death. Additionally, a label‐free artificial intelligence‐driven flow cytometry successfully identified not only the BCR::ABL1‐transduced cells but also peripheral leukocytes from CML patients by assessing mitochondrial morphological alterations. These findings suggested the crucial role of BCR::ABL1‐induced mitochondrial fragmentation in driving BCR::ABL1‐positive cell proliferation, and the potential use of mitochondrial morphological alterations as a clinical biomarker for the label‐free detection of CML cells.
Photodynamische Therapie in der Dermatologie: Bewährte und neue Indikationen
Authors: Balakirski Galina , Lehmann Percy , Szeimies Rolf‐Markus , Hofmann Silke C.
Published: December 2024

Die photodynamische Therapie (PDT) ist international zur Behandlung von In‐situ‐Formen des keratinozytären Hautkrebses (aktinische Keratosen, Morbus Bowen, Basalzellkarzinome) zugelassen. Für diese Indikationen bestehen standardisierte Behandlungsprotokolle mit Schmalspektrum‐Lichtquellen oder (künstlichem) Tageslicht, die zu Heilung, geringer Rezidivrate der Läsionen und sehr gutem kosmetischen Ergebnis führen. Die Tageslicht‐PDT ist dabei im Hinblick auf die deutlich geringere Schmerzhaftigkeit und damit verbundene höhere Akzeptanz durch die Patienten der konventionellen PDT überlegen.

Neuere Indikationen, für die noch keine Zulassung vorliegt, für die die Studienlage aber ausreichende Wirksamkeit belegt, sind entzündliche (Lichen sclerosus, Akne) und infektiöse Dermatosen (Viruswarzen, kutane Leishmaniose, atypische Mykobakteriose). Darüber hinaus wird die PDT zunehmend in der ästhetischen Dermatologie zur Hautverjüngung eingesetzt.
Probleme bei der Diagnose der kutanen Leishmaniose: Eine retrospektive Studie zur Analyse klinischer, histopathologischer und immunhistochemischer Merkmale
Authors: Guillet Carole , Stillhard Andrea , Welti Michèle , Hauser Xenia , Kempf Werner , Riera Cristina , Grimm Felix , Schmid‐Grendelmeier Peter , Kolm Isabel
Published: December 2024

Hintergrund

Die Inzidenz der kutanen Leishmaniose (CL) in der Schweiz nimmt aufgrund von Migration und Globalisierung zu. Ziel dieser Arbeit war es, die Inzidenz der CL in der Schweiz zu untersuchen und die klinischen und histopathologischen Schwierigkeiten bei der Diagnose der CL zu identifizieren.

Patienten und Methodik

In dieser retrospektiven Studie wurden klinische und histopathologische Charakteristika aller CL‐Fälle aus zwei dermatopathologischen Labors zwischen 2000 und 2022 analysiert. Hautbiopsien wurden mit HE, Giemsa und immunhistochemischen Färbungen (CD1a, spezifischer Leishmania‐Antikörper)untersucht. Eine Leishmania‐PCR erfolgte sofern ausreichend Gewebe vorhanden stand.

Ergebnisse

42 Fälle (27 m, 15 w) wurden eingeschlossen. Die korrekte klinische Diagnose einer CL wurde nur in 15 (35.7%) Fällen gestellt. In sieben (16.6%) Fällen wurde die CL bei der ersten histopathologischen Untersuchung übersehen. Zwei histopathologische Hauptmuster wurden beobachtet: granulomatös und pseudolymphomatös. Die immunhistochemische Färbung mit CD1a und Leishmania‐spezifischem Antikörper war in 91% bzw. 80% der Fälle positiv. Die Leishmania‐PCR war in 25 von 26 Fällen positiv, wobei überwiegend Altwelt‐Spezies nachgewiesen wurden.

Schlussfolgerung

CL ist in der Schweiz selten und wird klinisch und histopathologisch oft fehldiagnostiziert. CD1a und spezifische Leishmania‐Antikörperfärbungen sind hilfreich. Auch bei negativer Reiseanamnese in Endemiegebiete sollte bei nicht heilenden Ulzera differentialdiagnostisch an eine CL gedacht werden.
A tale of long tails: Evolution of host specialization in non‐pollinating fig wasps
Authors: Farache Fernando H. A. , Cruaud Astrid , Genson Guénaëlle , Kjellberg Finn , Rasplus Jean‐Yves , Pereira Rodrigo A. S.
Published: December 2024

The evolution of host specialization and feeding habits in non‐pollinating fig wasps remains poorly understood.

This study investigates these dynamics within the wasp genus Idarnes, which exhibits diverse life strategies and degrees of host specificity.

We reconstructed the phylogeny of 57 Idarnes species using four genetic markers—two mitochondrial, one nuclear and one ribosomal—and performed ancestral state reconstructions to elucidate the evolution of host specialization.

Our analyses reveal that host monophagy is ancestral in Idarnes, with oligophagy evolving independently in several lineages. Oligophagous species are more prevalent in kleptoparasitic compared to gall‐inducing lineages. Early gallers—which are wasps that colonize figs during the pre‐receptive stage of development—are predominantly monophagous, while some oligophagous species occur in the galler lineage that uses flower ovaries at the fig receptive phase.

The relative ovipositor length correlates with the number of host species visited by kleptoparasite species, suggesting morphological adaptations play a role in host specialization. In the gall‐inducing lineages, the use of multiple host species seems not primarily constrained by the ovipositor size but possibly by the capacity of the wasp to induce galls in a non‐typical host species.

This study provides valuable insights into the mechanisms driving host specialization in fig wasps, enhancing our understanding of this intricate insect‐plant system.
The effect of fly exclusion on scavenger community and carrion decomposition varies with carrion type in a Tibetan alpine meadow
Authors: He Shuaibing , Hu Xinna , Zhu Weize , Sun Wenxiao , Wei Chunrong , Sun Shucun , Wu Xinwei
Published: December 2024

Animal carrion, an ephemeral but nutritional resource, supports diverse invertebrate species involved in the decomposition process. Necrophagous flies, as the primary colonisers on carrion, can largely affect the invertebrate community and associated carrion decomposition rates; however, field data integrating different carrion types to examine the effect of fly exclusion are evidently lacking.

We conducted a field experiment to investigate the responses of arthropod scavengers and the carrion decomposition rate to fly exclusion using yak carrion and chicken carrion in a Tibetan alpine meadow.

Results show that flies (maggots) and necrophagous beetles (Coleoptera: Silphidae) were the predominant scavengers on both yak carrion and chicken carrion in the Tibetan alpine meadow. The responses of maggots, necrophagous beetles and predatory beetles varied with carrion types. Specifically, during the early stage of decomposition, maggots were more abundant on chicken carrion compared to yak carrion, while necrophagous beetles and predatory beetles dominated yak carrion during the late stage. The exclusion of flies significantly decreased the richness and the abundance of arthropods on yak carrion, as well as the decomposition rate of yak carrion. Fly exclusion significantly decreased the abundance of arthropods on chicken carrion but not affected the decomposition rate of chicken carrion.

Our findings clearly demonstrate that excluding flies can modify temporal successional traits and structure of scavenger community, as well as decomposition rates of both chicken carrion and yak carrion, albeit with varying effect degrees. This study represents a comprehensive investigation into the influences of necrophagous flies and carrion type on carrion decomposition on the Tibetan Plateau, which holds important implications for understanding necrophilous assemblages.
How Do We Get the Public Into Public Health Research? Learnings and Key Recommendations From Initiating a Community Involvement Project Scheme
Authors: McGrath Carmel , Lasseter Gemma , Hopewell‐ Kelly Noreen , Anderson Emma , Brooks‐Pollock Ellen , Christensen Hannah , Denford Sarah , Essery Rosie , Dawson Shoba , Schiller Evelyn , Silvonen Taru , Stokes Christina , Thomas Amy , Thomas Clare , Gibson Andy
Published: December 2024

Introduction

There are many recognised benefits of public involvement, including more relevant research. The COVID‐19 pandemic highlighted the existing health inequalities and disparities in access to care and treatment for under‐served groups, necessitating meaningful and sustainable approaches to engaging them in health research. However, there is limited guidance to suggest what groundwork and processes are necessary for initiating such projects. This paper outlines the practical approaches taken to initiate a community involvement project scheme and offers key recommendations from this work.

Methods

The National Institute for Health and Care Research (NIHR) Health Protection Research Unit established a community involvement scheme in 2021, funding four community involvement projects enabling researchers to engage with under‐served communities. Reflections were captured through regular quarterly meeting group discussions, meeting notes and email correspondence.

Results

The paper presents the steps taken to initiate a scheme that provided funding for a diverse range of projects working with under‐served communities. The projects demonstrated the value of allocating time to build relationships and trust, maintaining flexibility, and providing short‐term benefits such as remuneration and training to the community.

Discussion

This paper has highlighted the need for research organisations to allocate funding and resources within their infrastructures for building trusting relationships with community leaders and communities.

Conclusion

This paper has outlined the steps undertaken to engage with under‐served communities to bridge the gap between public health research and those communities. We present key recommendations to guide future initiatives aspiring to engage under‐served communities in health research.

Patient or Public Contribution

Public contributors have been involved in all of the four community involvement projects mentioned in this paper. Two public contributors are also co‐authors and have provided input to the writing and review of this manuscript.
Germline mutations predisposing to melanoma and associated malignancies and syndromes: a narrative review
Authors: López Riquelme Irene , Martínez García Silvestre , Serrano Ordónez Ana , Martínez Pilar Leandro
Published: December 2024

The pathogenesis of melanoma is influenced by a complex combination of environmental factors and individual genetic susceptibility. Familial melanoma refers to cases where there are two first‐degree relatives with a melanoma diagnosis. Less strict definitions include second‐degree relatives or even three or more of any degree from the same family, although this is not clearly defined in the literature. The term hereditary melanoma is reserved for sporadic or familial melanomas linked to high‐risk genes with high penetrance. The first genes related to melanoma were CDKN2A and CDK4, but recently, other genes, mostly tumor suppressor genes, have been described. Internal malignancies, particularly pancreatic cancer, have also been associated with melanoma. Recent studies suggest that there could be a link between melanoma and other neoplasms and tumor predisposition syndromes. This review presents an updated overview of familial melanoma criteria and genes involved in melanoma pathogenesis, emphasizing their clinicopathological aspects and other associated malignancies.
The Incomplete Leap: On the Transition From Union Registration to the First Collective Agreement
Authors: Ramos Vincent Jerald , Suguitan Edgar Antonio
Published: December 2024

In decentralized systems where unionization and bargaining occur at the establishment level, what explains the (speedy) transition from union registration to the first collective agreement? While prior evidence in some developed countries (i.e., the United States) estimates this transition to be approximately a year, on average, little to no evidence exists in other contexts where unions play a less central role, as is the case in many developing countries. Addressing this gap, we analyze the Philippines where national unionization and collective bargaining coverage rates are relatively low. Using methods from survival analysis on novel register data of all new union registrations from 2016 to 2021, we descriptively demonstrate that: (i) median union membership density is low at 40%; (ii) only 20% of all new union registrations successfully register a contract within the first 5 years; and (iii) unions with higher densities, that are independent, and in the manufacturing sector are associated with elevated transition rates to a collective agreement.
Exploring Therapeutic Relational Connection in Virtual Healthcare: Insights From Nurse Practitioner Practice With Young Adults Living With Chronic Illness
Authors: Duffy Lisa V. , Evans Rebecka , Bennett Veronica , Jones Rachel
Published: December 2024

Aim

To identify the essential characteristics of therapeutic relational connection (TRC) as viewed by nurse practitioners (NPs) in the practice of their virtual visits caring for young adults living with chronic illness.

Design

This is a qualitative descriptive study of data obtained from open‐ended items on an online questionnaire.

Methods

The sample was recruited through an electronic listserv sent by the National Association of Pediatric Nurse Practitioners (NAPNAP) to access a national sample. Study data were collected and managed using REDCap electronic data capture tools. Data analysis was conducted through open and axial coding towards grounded theory. The ‘towards grounded theory’ approach adapts and evolves grounded theory principles to incorporate broader perspectives, enhancing flexibility and contextual sensitivity in the co‐construction of knowledge between researcher and participants. TRC was the central phenomenon.

Results

Four themes emerged from the data including Characteristics of TRC, Behavioural Manifestations, Potential Outcomes and Environment.

Conclusion

The transfer of skills from in‐person clinic visits to the virtual setting is not synonymous. As virtual visits continue to be implemented as a mode to provide quality healthcare, identification of best practises for establishing an intentional use of TRC during virtual visits may be an essential component in the patient‐provider relationship. Educational interventions can be designed to train providers to identify their current practices and ways in which they might adapt their in‐person approach to the virtual visit.

Impact

Identifying essential elements of TRC in virtual visits may achieve improved outcomes as an emergent healthcare delivery model for young adults with chronic illness.

Patient Contribution

No patient or public contribution. Patient or public contribution was not indicated in this study as the aim was to identify the characteristics of TRC from NPs.
Enhancing the Resilience of Bereaved Parents: Practical Experiences and Needs Perceived by Healthcare Professionals
Authors: Cheng Lei , Cai Siyu , Zhou Xuan , Zhai Xiaowen
Published: December 2024

Aims

To explore the practical experiences and perceived needs of healthcare professionals in fostering resilience among bereaved parents.

Design

A qualitative descriptive study was conducted.

Methods

Twenty‐seven healthcare professionals were recruited from the Paediatric Palliative Care Special Group of the Paediatrics Society of the Chinese Medical Association. The participants included 9 physicians, 7 nurses and 11 social workers from 22 hospitals and 5 community‐based services. In‐depth interviews were conducted between July and December 2022. Data were analysed using content analysis.

Results

Guided by the Society‐to‐Cells Resilience Theory, this study identified 10 categories of practical experiences and seven of perceived needs, encompassing multiple levels: society (integrating multidisciplinary resource; preserving relevant cultural tradition; advocating for system enhancements; raising public awareness), community (establishing an accessible support network; fostering an inclusive community; offering proactive community support), family (providing anticipatory guidance; enhancing family cohesion; navigating bereavement resources; providing ongoing follow‐up and support), individual (evaluating grief‐related experiences; offering tailored personal support; sustaining connections; addressing spiritual needs) and physiological (managing body reactions; maintaining physical well‐being).

Conclusion

This study provides insights from healthcare professionals, highlighting practices and identifying significant gaps in current approaches to building resilience in bereaved parents. The findings suggest that resilience is a socially constructed, multidimensional process that can be nurtured through a holistic approach to better support this vulnerable group.

Impact

The study's findings lay the foundation for developing targeted interventions to foster resilience among bereaved parents. A holistic, empowering approach is essential to strengthen their coping mechanisms and facilitate healing at multiple levels, ultimately contributing to the creation of a robust, effective support system for this resilient yet vulnerable population.

No Patient or Public Contribution

This study was about the experiences and perceptions of healthcare providers. It was designed and conducted by researchers who were both researchers and healthcare providers.
Using Virtual Care to Assess the Health Needs of People With Intellectual Disabilities: A Scoping Review
Authors: Devitt Alison , Nott Melissa , Nelson Stephanie , Sgarlata Julia , Gray Michelle , Balachandran Srilaxmi , Taskin Asma
Published: December 2024

Background

The COVID‐19 pandemic precipitated a rapid roll‐out of virtual health care services to people with intellectual disabilities. Limited evidence is available for clinicians to guide virtual care delivery.

Method

Twenty‐three studies were identified through systematic searching of 16 databases. Extracted data were mapped to the NSW Virtual Health Strategy.

Results

Evidence exists to support the use of virtual care for screening, diagnosis, assessment, and review of people with intellectual disabilities, with benefits for clients, carers, and clinicians. Evidence mapped well to the priority areas of the NSW Virtual Health Strategy, highlighting the need for clinician training and specific supports and adaptations to ensure accessibility for people with intellectual disabilities.

Conclusions

The use of virtual care to assess the health needs of people with intellectual disabilities across the lifespan is nascent. An opportunity exists for co‐design with people with intellectual disabilities to reduce barriers to accessing and engaging in virtual care.
The Accuracy of 3D‐Printed Fixed Dental Restorations
Authors: Alammar Amirah , Att Wael , Beuer Florian
Published: December 2024

Objective

The aim of this in vitro study was to evaluate the accuracy of resin‐based fixed dental restorations, namely veneers, single crowns, and four‐unit fixed partial dental prosthesis (FPDs), using two different 3D printing technologies and polymer‐based materials.

Materials and Methods

A standard maxillary polyurethane jaw model containing prepared teeth was scanned using an intraoral scanner. The generated STL data were used to design the restorations virtually using CAD software. Two 3D printers were utilized for the provisional digital light processing and stereolithography for the castable resin patterns. Each printer produced 10 specimens of each type of restoration, for a total of 80 restorations. The 3D‐printed restorations were then 3D scanned using the same intraoral scanner and evaluated for external and internal dimensional accuracy in terms of trueness and precision. A one‐way ANOVA and two‐sample T‐test were implemented to compute the precision (variability between groups) and trueness (with the designed CAD model). A level of statistical significance of p‐value < 0.05 was set.

Results

Statistical differences in the external dimensional analysis of the incisors, molars, and four‐unit FPD with p‐values < 0.001, 0.002, and 0.004, respectively. For the internal dimensional analysis, the overall mean values of trueness ranged between 17 and 52 μm, and the variability was significant.

Conclusion

The external and internal dimensional accuracy values of the 3D‐printed fixed dental restorations in this in vitro study in terms of trueness can be clinically accepted after chairside modifications. However, significant variability between the 3D‐printed restorations was observed. Further investigations are needed to improve the accuracy of the 3D‐printed fixed dental restorations.

Clinical Significance

In terms of clinical applications, 3D‐printed fixed dental restorations produced by both 3D‐printing technologies and polymer‐based materials achieved acceptable levels of trueness, although some variability was observed. Significant deviations from the CAD model may require further chairside adjustments. Future integration of AI with 3D‐printing may further improve the accuracy and efficiency of fixed dental restoration production.
From silence to song: Testosterone triggers extensive transcriptional changes in the female canary HVC
Authors: Ko Meng‐Ching , Frankl‐Vilches Carolina , Bakker Antje , Sohnius‐Wilhelmi Nina , Alcami Pepe , Gahr Manfred
Published: December 2024

Seasonal song production in canaries is influenced by gonadal hormones, but the molecular mechanisms underlying testosterone‐induced song development in adult female canaries, which rarely sing naturally, remain poorly understood. We explored testosterone‐induced song development in adult female canaries by comparing gene regulatory networks in the song‐controlling brain area HVC at multiple time points (1 h to 14 days) post‐treatment with those of placebo‐treated controls. Females began vocalizing within 4 days of testosterone treatment, with song complexity and HVC volume increasing progressively over 2 weeks. Rapid transcriptional changes involving 2739 genes preceded song initiation. Over 2 weeks, 9913 genes—approximately 64% of the canary's protein‐coding genome—were differentially expressed, with 98% being transiently regulated. These genes are linked to various biological functions, with early changes at the cellular level and later changes affecting the nervous system level after prolonged hormone exposure. Our findings suggest that testosterone‐induced song development is accompanied by extensive and dynamic transcriptional changes in the HVC, implicating widespread neuronal involvement. These changes underpin the gradual emergence of singing behavior, providing insights into the neural basis of seasonal behavioral patterns.
Predicting glioblastoma progression using MR diffusion tensor imaging: A systematic review
Authors: Cozzi Francesca M. , Mayrand Roxanne C. , Wan Yizhou , Price Stephen J.
Published: December 2024

Background and purpose

Despite multimodal treatment of glioblastoma (GBM), recurrence beyond the initial tumor volume is inevitable. Moreover, conventional MRI has shortcomings that hinder the early detection of occult white matter tract infiltration by tumor, but diffusion tensor imaging (DTI) is a sensitive probe for assessing microstructural changes, facilitating the identification of progression before standard imaging. This sensitivity makes DTI a valuable tool for predicting recurrence. A systematic review was therefore conducted to investigate how DTI, in comparison to conventional MRI, can be used for predicting GBM progression.

Methods

We queried three databases (PubMed, Web of Science, and Scopus) using the search terms: (diffusion tensor imaging OR DTI) AND (glioblastoma OR GBM) AND (recurrence OR progression). For included studies, data pertaining to the study type, number of GBM recurrence patients, treatment type(s), and DTI‐related metrics of recurrence were extracted.

Results

In all, 16 studies were included, from which there were 394 patients in total. Six studies reported decreased fractional anisotropy in recurrence regions, and 2 studies described the utility of connectomics/tractography for predicting tumor migratory pathways to a site of recurrence. Three studies reported evidence of tumor progression using DTI before recurrence was visible on conventional imaging.

Conclusions

These findings suggest that DTI metrics may be useful for guiding surgical and radiotherapy planning for GBM patients, and for informing long‐term surveillance. Understanding the current state of the literature pertaining to these metrics’ trends is crucial, particularly as DTI is increasingly used as a treatment‐guiding imaging modality.
Physiological and Biochemical Responses of Tobacco at Different Growth Stages to Alternaria alternata
Authors: Ping He , Wenjing Rao , Zhikai Dong , Xingxian He , Jiawei Zhao , Zhongxu Chen , Liu Lin
Published: December 2024

Tobacco brown spot, caused by Alternaria alternata (Fries) Keissler, is one of the main leaf diseases of tobacco. It is common in the mature stage of tobacco but rarely occurs in the early growth stage. Therefore, it is also called ‘mature spot’ by tobacco farmers. However, the physiological and biochemical mechanisms underlying the responses of tobacco plants at different growth stages to A. alternata remain unclear. In this experiment, A. alternata was inoculated into two tobacco varieties, Yun87 and HongHuaDaJinYuan (HD), at the immature and mature stages respectively. The disease index, stomata, reactive oxygen species (OFR and H2O2) and main defence enzymes (SOD, POD, PPO, CAT and PAL) of tobacco at the two growth stages were analysed. Results showed that the disease index of tobacco plants in the immature stage was lower than that of tobacco plants at the mature stage at 5 days after inoculation. Stomatal opening was not significantly different between the immature and mature stages, but the stomatal apertures of HD and Yun87 decreased by 1%–2.33% at 12 h after inoculation. Moreover, the OFR and H2O2 contents in the mature stage were significantly higher than those in the immature stage. SOD activity was higher in the immature stage than in the mature stage, whereas POD activity was higher in the mature stage than in the immature stage. PPO, CAT and PAL activities were not significantly different between the immature and mature stages. Reactive oxygen species and defence enzymes began to respond at 12 h after inoculation. Specifically, SOD and PAL activities peaked at 12 h, whereas CAT activity peaked at 24 h. The response levels and rates of H2O2 content, SOD activity and PAL activity were higher in the immature stage than in the mature stage. Correlation analysis revealed that the strength of the effect of these factors was different. In general, tobacco resistance to brown spot disease was higher in the immature stage than in the mature stage, and this resistance was mediated by the response rates and levels of stomata, reactive oxygen species and defence enzymes.
Sex‐Specific Metabolic Effects of Gestational Chronodisruption and Maternal Melatonin Supplementation in Rat Offspring
Authors: Méndez Natalia , Corvalan Fernando , Halabi Diego , Vasquez Abigail , Vergara Karina , Noriega Hector , Ehrenfeld Pamela , Sanhueza Katiushka , Seron‐Ferre Maria , Valenzuela Guillermo J. , Torres‐Farfan Claudia
Published: December 2024

Gestational chronodisruption, increasingly common due to irregular light exposure, disrupts maternal‐fetal circadian signaling, leading to long‐term health issues in offspring. We utilized a chronic photoperiod shifting model (CPS) in pregnant rats to induce chronodisruption and investigated the potential mitigating effects of maternal melatonin supplementation (CPS + Mel). Male and female offspring were evaluated at 3 ages (90, 200, and 400 days of age) for metabolic profiles, hormonal responses, cytokine levels, and adipose tissue activity. Our findings indicate that gestational chronodisruption leads to increased birth weight by approximately 15% in male and female offspring and increased obesity prevalence in male offspring, accompanied by a 30% reduction in nocturnal melatonin levels and a significant disruption in corticosterone rhythms. Male CPS offspring also exhibited decreased lipolytic activity in white adipose tissue, with a 25% reduction in glycerol release compared to controls, indicating impaired metabolic flexibility. In contrast, female offspring, while less affected metabolically, showed a 25% increase in adipose tissue lipolytic activity and higher levels of pro‐inflammatory cytokines such as IL‐6 (increased by 40%). Scheduled melatonin supplementation in chronodisrupted mothers, administered throughout gestation, effectively normalized birth weights in both sexes, reduced obesity prevalence in males by 18%, and improved lipolytic activity in male offspring, bringing it closer to control levels. In females, melatonin supplementation moderated cytokine levels, reducing IL‐6 by 35% and restoring IL‐10 levels to near‐control values. These results highlight the importance of sex‐specific prenatal interventions, particularly the role of melatonin in preventing disruptions to fetal metabolic and inflammatory pathways caused by gestational chronodisruption. Melatonin treatment would prevent maternal circadian rhythm misalignment, thereby supporting healthy fetal development. This study opens new avenues for developing targeted prenatal care strategies that align maternal and fetal circadian rhythms, mitigating the long‐term health risks associated with chronodisruption during pregnancy.
Bulevirtide Monotherapy Is Safe and Well Tolerated in Chronic Hepatitis Delta: An Integrated Safety Analysis of Bulevirtide Clinical Trials at Week 48
Authors: Asselah Tarik , Lampertico Pietro , Aleman Soo , Bourlière Marc , Streinu‐Cercel Adrian , Bogomolov Pavel , Morozov Viacheslav , Stepanova Tatiana , Lazar Stefan , Manuilov Dmitry , Mercier Renee‐Claude , Tseng Steve , Ye Lei , Flaherty John F. , Osinusi Anu , Da Ben L. , Chee Grace M. , Lau Audrey H. , Brunetto Maurizia R. , Wedemeyer Heiner
Published: December 2024

Background and Aims

The safety and tolerability of bulevirtide (BLV), a novel entry inhibitor of hepatitis delta virus, were evaluated in an integrated analysis of clinical trial results from patients with chronic hepatitis delta (CHD).

Methods

Week 48 on‐treatment clinical and laboratory results from two Phase 2 trials (MYR203 [NCT02888106] and MYR204 [NCT03852433]) and one Phase 3 trial (MYR301 [NCT03852719]) were pooled (N = 269). Patients were grouped as follows: BLV 2 mg (n = 64), BLV 10 mg (n = 115), pegylated interferon‐alfa (n = 39) and control (n = 51). The control group consisted of patients assigned to the delayed treatment group in Study MYR301.

Results

Adverse events (AEs) that occurred more frequently with BLV 2 mg and BLV 10 mg versus control included increased total bile acid levels (20% and 17% vs. 0%), injection‐site reactions (16% and 20% vs. 0%), headache (16% and 17% vs. 0%), pruritus (11% and 10% vs. 0%) and eosinophilia (9% and 4% vs. 0%). Increases in total bile acid levels were observed with BLV without clear correlation with AEs, such as pruritus, eosinophilia or vitamin D deficiency. Grade 3 or 4 study drug–related AEs occurred in a higher proportion of patients receiving pegylated interferon‐alfa (51%) than with BLV 2 or 10 mg (3% and 4%, respectively). There were no serious AEs related to BLV, and no patients discontinued BLV due to an AE. Neither hepatic decompensation nor death occurred.

Conclusions

BLV monotherapy was safe and well tolerated through 48 weeks of treatment in patients with CHD.

Trial Registration: NCT02888106, NCT03852433 and NCT03852719
Daily Complementary Feeding With Eggs Improves Fibroblast Growth Factor 21 in Infants
Authors: Nakiranda Regina , Malan Linda , Ricci Hannah , Kruger Herculina S. , Nienaber Arista , Visser Marina , Ricci Cristian , Faber Mieke , Smuts Cornelius M.
Published: December 2024

This secondary analysis of the Eggcel‐growth study investigated the effect of daily egg intake for 6 months in infants aged 6–9 months on environmental enteric dysfunction (EED) biomarkers and the association of EED markers with growth faltering. A randomised controlled trial was conducted in Jouberton, South Africa, among 500 infants randomly assigned equally to either an intervention group receiving a daily chicken egg or a control group. Both groups were followed up for 6 months. Data on infant and maternal sociodemographic information and anthropometric status of infants were collected. EED and inflammatory markers were analysed using Q‐Plex Human EED (11‐Plex) assay. There was a significant reduction in fibroblast growth factor 21 (FGF21) concentration in the intervention group (B = −0.132; 95% CI −0.255, −0.010; p = 0.035). Baseline, insulin‐like growth factor 1 (IGF‐1) was positively associated with endpoint length‐for‐age z‐score (LAZ), weight‐for‐age z‐score (WAZ) and weight‐for‐length z‐score (WLZ) and there was an inverse relationship between baseline FGF21 and intestinal fatty acid‐binding protein (I‐FABP) with endpoint growth indicators. Baseline IGF‐1 was positively associated with reduced odds of wasting, stunting and being underweight (p < 0.001) and baseline FGF21 was associated with increased odds of stunting (p = 0.002), wasting (p = 0.031) and being underweight (p = 0.035). There was a 20% increased odds of stunting with baseline I‐FABP (p = 0.045) and a 30% increased odds of being underweight with baseline soluble CD14 (p = 0.039). Complementary feeding with eggs decreased growth hormone resistance (reduced FGF21 levels); however, FGF21 and I‐FABP levels were linked to increased growth faltering.

Trial Registration: ClinicalTrials.gov: NCT05168085