bluuebunny/crossref_metadata_2025 huggingface dataset:
Early use of long‐acting injectable antipsychotics in bipolar disorder type I: An expert consensus
Authors: Vieta Eduard , Tohen Mauricio , McIntosh Diane , Kessing Lars Vedel , Sajatovic Martha , McIntyre Roger S.
Published: October 2024

Introduction

Long‐acting injectable antipsychotics (LAIs) are not routinely offered to patients living with bipolar disorder type I (BP‐I), despite widespread evidence that supports their benefits over oral antipsychotics, particularly in early disease.

Methods

A round‐table meeting of psychiatrists convened to discuss barriers and opportunities and provide consensus recommendations around the early use of LAIs for BP‐I.

Results

LAIs are rarely prescribed to treat BP‐I unless a patient has severe symptoms, sub‐optimal adherence to oral antipsychotics, or has experienced multiple relapses. Beyond country‐specific accessibility issues (e.g., healthcare infrastructure and availability/approval status), primary barriers to the effective use of LAIs were identified as attitudinal and knowledge/experience‐based. Direct discussions between healthcare providers and patients about treatment preferences may not occur due to a preconceived notion that patients prefer oral antipsychotics. Moreover, as LAIs have historically been limited to the treatment of schizophrenia and the most severe cases of BP‐I, healthcare providers might be unaware of the benefits LAIs provide in the overall management of BP‐I. Improved treatment adherence associated with LAIs compared to oral antipsychotics may support improved outcomes for patients (e.g., reduced relapse and hospitalization). Involvement of all stakeholders (healthcare providers, patients, and their supporters) participating in the patient journey is critical in early and shared decision‐making processes. Clinical and database studies could potentially bridge knowledge gaps to facilitate acceptance of LAIs.

Conclusion

This review discusses the benefits of LAIs in the management of BP‐I and identifies barriers to use, while providing expert consensus recommendations for potential solutions to support informed treatment decision‐making.
Risk factors and disease trajectories of recurrent immune thrombocytopenia in children
Authors: Yang Yuan‐Ning , Chen Li‐Wen , Chen Jiann‐Shiuh , Lin Yung‐Chieh , Yeh Yun‐Hsuan , Cheng Chao‐Neng
Published: October 2024

This retrospective study aimed to analyse the course and outcome of recurrent immune thrombocytopenia (ITP) in children and to identify factors associated with recurrence. A total of 497 newly diagnosed ITP children with platelet <30 × 109/L between January 1988 and December 2019 were included. Recurrent ITP was defined as a new event of thrombocytopenia after at least 3 months of remission without treatment. Twenty‐nine (5.8%) children experienced 48 recurrent episodes. The median time from diagnosis to recurrence was 22 months. Most recurrences occurred in children aged 1.5–10 years with a recent infection history. Compared to non‐recurrent ITP, children with recurrent ITP had delayed remission with lower platelets at 1 month and 3 months postdiagnosis. Multivariate analysis identified aged 1.5–10 years (hazard ratio [HR] 3.65, 95% confidence interval [CI]: 1.35–9.82) and delayed remission at 7–12 months (HR 4.04, 95% CI: 1.37–11.95) as predictors for recurrence. Most recurrent ITP patients had minor or mild symptoms, higher platelet counts, did not require treatment, and achieved remission within 12 months. The similar remission trajectories among the first and recurrent ITP, but different from the courses in the non‐recurrent ITP, suggest that recurrent ITP might have a unique biological basis.
Identification of BAY61‐3606 Derivatives With Improved Activity in Splicing Modulation That Induces Inclusion of Cassette Exons Similar to the Splicing Factor 3B Subunit 1 Mutation
Authors: Matsumaru Takanori , Iwamatsu Toshiki , Ishigami Kana , Inai Makoto , Kanto Wataru , Ishigaki Ayumi , Toyoda Atsushi , Shuto Satoshi , Maenaka Katsumi , Nakagawa Shinichi , Maita Hiroshi
Published: October 2024

Splicing modulation by a small compound offers therapeutic potential for diseases caused by splicing abnormality. However, only a few classes of compounds that can modulate splicing have been identified. We previously identified BAY61‐3606, a multiple kinase inhibitor, as a compound that relaxes the splicing fidelity at the 3′ splice site recognition. We have also reported the synthesis of derivatives of BAY61‐3606. In this study, we tested those compounds for their splicing modulation capabilities and identified two contrasting compounds. These compounds were further investigated for their effects on the whole transcriptome, and analysis of changes in transcription and splicing revealed that the highly active derivative in the splicing reporter assay also showed significantly higher activity in modulating the splicing of endogenously expressed genes. Particularly, cassette exon inclusion was highly upregulated by this compound, and clustering analysis revealed that these effects resembled those in splicing factor 3b subunit 1 (SF3B1) K700E mutant cells but contrasted with those of the splicing inhibitor H3B‐8800. Additionally, a group of serine/arginine‐rich (SR) protein genes was identified as representatively affected, likely via modulation of poison exon inclusion. This finding could guide further analysis of the mode of action of these compounds on splicing, which could be valuable for developing drugs for diseases associated with splicing abnormalities.
Accuracy of Zygomatic Implant Placement Using Task‐Autonomous Robotic System or Dynamic Navigation: An In Vitro Study
Authors: Chen Jinyan , Tao Baoxin , Yu Xinbo , Wu Yiqun , Wang Feng
Published: October 2024

Objectives

To evaluate and compare the accuracy of task‐autonomous robot‐assisted implant surgery (RAIS) and dynamic computer‐assisted implant surgery (dCAIS) for zygomatic implant placement.

Materials and Methods

Ten atrophic edentulous maxilla models requiring zygomatic implant (ZI) placement were randomly divided into the RAIS and dCAIS groups. Osteotomies and implant placement were performed under the guidance of a task‐autonomous robotic system or dynamic navigation system. A total of 20 ZIs were analyzed. The angular, coronal, lateral coronal, coronal depth, apical, lateral apical, and apical depth deviations were measured and analyzed between the two groups. The primary outcome parameters were the angular deviations between the planned and the placed ZIs. Data was subjected to descriptive and comparative statistical analysis. The significance of inter‐group differences for continuous variables was assessed with Student's two‐sample t‐tests, Welch two‐sample t‐tests, and Mann–Whitney U tests according to the distribution normality and variance homogeneity.

Results

ZI placement deviations were compared between the RAIS and dCAIS groups, showing a mean angular deviation of 0.92 ± 0.40° versus 2.03 ± 0.53° (p < 0.001), a mean (±SD) coronal deviation of 0.48 ± 0.25 mm versus 1.29 ± 0.46 mm (p < 0.001), and a mean apical deviation of 0.88 ± 0.28 mm versus 1.96 ± 0.46 mm (p < 0.001).

Conclusions

For computer‐guided ZI placement, task‐autonomous RAIS was superior to dCAIS in terms of accuracy.
Rapid population response to a hunting ban in a previously overharvested, threatened landbird
Authors: Carboneras Carles , Šilarová Eva , Škorpilová Jana , Arroyo Beatriz
Published: October 2024

Empirical data are essential to assess the outcomes of management decisions in the context of adaptive management. We used flyway‐level population indices of a declining game bird to assess population changes after introducing hunting management measures as part of the European Union (EU)‐wide Adaptive Harvest Management mechanism (AHMM). In one flyway, a full hunting ban led to the start of population recovery; numbers increased by 25% in 2 years and the 10‐year population trend improved from “moderate decline” to “stable.” In the other flyway, harvest was only reduced (allegedly by 60% although statistics from key countries were incomplete), and numbers continued to fall (−15% decline). Our study shows positive results of the leading AHMM for a landbird in Europe and provides empirical evidence of the speed of population response and the timeframe needed for change to occur and to be detected. It showcases the successful application of policy mechanisms underpinned by science.
Lead‐based ammunition is a threat to the endangered New Zealand Kea (Nestor notabilis)
Authors: Buenz Eric J. , Finkelstein Myra , Cieraad Ellen , Howard Pauline , Parry Gareth J. , Hunter Simon , Hampton Jordan O. , Bakker Victoria J. , Sloan Fiona , Hodgson Ben , Weston Kerry A.
Published: October 2024

Lead (Pb) poisoning is a significant threat to Aotearoa New Zealand's endangered kea (Nestor notabilis), an avian species important to Māori. Historically, exposure was thought to be from lead‐containing building materials; however, recent field observations suggest lead‐based ammunition as an additional source. We used stable lead isotopes to investigate the sources of lead to kea. Comparing 207 Pb/206 Pb ratios in kea blood (n = 91) to both ammunition and building materials, we found approximately one‐third of exposed kea (blood lead > 10 µg/dL) had lead isotope ratios consistent with exposure to lead‐based ammunition. As lead ammunition is still used, including in government‐sponsored culling programs, our data indicate an urgent need to shift toward non‐lead ammunition use to prevent further poisoning and aid conservation efforts. Collaborating with tangata whenua/Māori guardians, we advocate for immediate policy changes to eliminate lead‐based ammunition in kea habitat to safeguard this endangered culturally treasured species from extinction.
From causes of conflict to solutions: Shifting the lens on human–carnivore coexistence research
Authors: Artelle Kyle A. , Johnson Heather E. , McCaffery Rebecca , Schell Christopher J. , Williams Tyus D. , Wilson Seth M.
Published: October 2024

Human‐carnivore conflicts pose significant challenges in the management and conservation of carnivores across the globe. Abundant research has led to generalizable insights into the causes of such conflicts. For example, conflicts predictably occur when carnivores have access to human food resources, particularly when their natural foods are scarce. However, similar insights into the effectiveness of interventions aimed at coexistence remains comparatively scarce. We hypothesized that this disparity might be reflected in a bias toward research focused on causes of conflict rather than interventions to address it. To test our hypothesis, we evaluated the content of studies on human–carnivore conflicts and coexistence in Canada and the United States from 2010 to 2021. We found that studies disproportionately focused on causes of conflict, with that discrepancy increasing through our study period. We also found a disproportionate focus on black bears and wolves and western jurisdictions, and a disproportionate use of observational (vs. experimental) approaches. Studies on conflict interventions were primarily directed at the carnivores themselves (e.g., lethal approaches) versus human elements (e.g., attractant management, policies), despite evidence that the latter are more effective. We expect that a shift in focus toward solutions‐oriented research, integrating insights across geographies, taxa, social contexts, and disciplines, would facilitate effective interventions and foster coexistence, improving outcomes for people and carnivores alike.
Renaissance humanism and Martin Luther: The birth of nation‐states
Authors: Şencan Selin
Published: October 2024

This article explores the interaction between Renaissance humanism and Martin Luther's Reformation in fostering the emergence of nation‐states in Europe. It argues that the emphasis on individualism, critical thinking, and a return to classical ideals during the Renaissance provided a fertile ground for Luther's challenge to the Catholic Church's authority. Luther's Reformation, with its focus on Scripture and a direct relationship between believer and God, further eroded the Church's control and transnational influence. This convergence of intellectual and religious transformations created a space for the development of distinct national identities and the consolidation of power by European monarchs. The article will examine how these movements challenged the existing political and religious order, ultimately contributing to the rise of nation‐states as the dominant political entity in Europe.
Music and the politics of famine: everyday discourses and shame for suffering
Authors: Pendle Naomi , Akoi Abraham Diing
Published: October 2024

Understanding the politics of famine is crucial to understanding why famines still occur. A key part of this is how famine is remembered, understood, and discussed. This paper focuses on songs popular among communities that have recently experienced deadly famine. Contemporary famines almost always manifest in armed conflict contexts, where there is limited political freedom. Here, songs and music can be an important way to debate sensitive political issues. This paper focuses on the way that songs and music shape ‘regimes of truth’ around famine, and who is shamed and held accountable for associated suffering. It is based on long‐term ethnographic research, the recordings of famine‐related songs, and collaborative analysis in Jonglei and Warrap States (South Sudan) in 2021–24. The paper shows how songs can mock soldiers for their seizing of assets during times of hunger and how they can create familial shame for famine suffering, shifting responsibility away from the real causes to family members.
China–Latin America relations in the context of the Belt and Road Initiative
Authors: Lei Yu
Published: October 2024

Motivation

As a leading programme aimed at promoting “connectivity” and “exchanges of people,” BRI is providing a new avenue to expand China's presence and influence in Latin America and contribute to its rise at the systemic (global) level. Research shows that China's BRI in Latin America is not merely an economic initiative, but offers a combination of economic, political, and strategic objectives and consequences.

Purpose

The purpose of the research is to examine China's BRI in Latin America from geopolitical perspectives, as well as its motivations, focuses, and consequences. It contributes to the scholarly discussion by analysing China's BRI in the greater picture of China's rise at the systemic (global) level and examining it through a political economy lens.

Approach and methods

The research examines China's BRI in Latin America with a special focus on large‐scale infrastructure projects that may have geopolitical implications and transform the built landscape in the region. The research is based on a critical review of the literature, and especially the Chinese academic literature, government documents, and corporate documents provided by some Chinese companies involved in large‐scale BRI projects.

Findings

The research finds that BRI helps China increase its economic and political co‐operation with the states of Latin America. China is increasingly capable of reaping not only economic but also geopolitical benefits from BRI by intensifying economic and, by extension, political relations with Latin America.

Policy implications

China's BRI in Latin America looks to obtain not merely economic, but also political and strategic benefits from China's “soft” power. Chinese policy‐makers should be aware that China's “soft power” and interest could be strengthened if BRI could be implemented in accordance with the principles of advancing democratization, “good governance,” and environmental protection.
Time‐Dependent Morphological Changes in Traumatic Immature Teeth With Necrotic Pulps Following Regenerative Endodontic Treatment: A Retrospective Study
Authors: Maree Manal , Nabriski Omri , Yoshpe Margarita , Lin Shaul , Kaufman Arieh Y.
Published: October 2024

Background/Aim

Regenerative endodontic treatment is a promising approach for healing periapical lesions and continuous root maturation. Although previous studies have reported its outcomes, the dynamics of morphological changes over time remain unclear. Therefore, this study aimed to evaluate changes in the periapical status and root dimensions over a 60‐month follow‐up period.

Materials and Methods

The follow‐up duration, periapical status changes, calcific barrier formation, degree of apical closure and radiographic root area changes were compared with those of the last follow‐up in this retrospective study. Radiographic root area changes were calculated as the difference between the total root and total canal areas.

Results

Fifty‐eight patients (81 teeth) underwent regenerative endodontic treatment during the study period, of whom 32 patients (36 teeth, 62%) were included. The survival and success rates of the treated teeth were 100% and 94.4%, respectively. All teeth developed a calcific bridge in the cervical third of the root canal, indicating the presence of vital tissue. Apical narrowing (partial or total) was observed in 75% of the cases. The root maturation stage affected the percentage increase in the radiographic root area. Teeth in Cvek stages II–III showed a higher radiographic root area increase than more mature teeth. All tooth radiographic root areas increased significantly in the initial 20 months of the treatment and moderately thereafter.

Conclusions

Regenerative endodontic treatment is a safe approach for traumatised immature teeth. The presence of a radiographic calcified bridge may be an early indication of treatment success. The main complete tooth morphological changes occur after approximately 20 months posttreatment. These findings may help clinicians better understand the time‐dependent changes in the root morphology after treatment, improve the follow‐up schedule and predict the progress of healing during follow‐up visits.
Can ChatGPT Revolutionize Language Learning? Unveiling the Power of AI in Multilingual Education Through User Insights and Pedagogical Impact
Authors: Yu Hao , Guo Yunyun , Yang Hailiang , Zhang Weiyu , Dong Yan
Published: October 2024

In the era of accelerating globalization, the necessity for multilingual education is increasingly prominent. This study investigates the effectiveness of the AI‐based chatbot ChatGPT in multilingual teaching applications. This study employs a quasi‐experimental research methodology to examine the experiences of 100 international students at a university in Western China. The investigation delves into multiple dimensions of ChatGPT's effectiveness, including user interface design, operational experience, educational interaction, student engagement, personalized learning recommendations, and the enhancement of cultural understanding. The findings indicate that ChatGPT demonstrates significant potential in multilingual teaching, particularly in providing personalized learning support and facilitating cultural comprehension. However, improvements are needed in aspects of user interface friendliness, interaction naturalness, and depth. This research not only provides empirical support for the use of ChatGPT in multilingual education but also introduces a fresh perspective on integrating AI technology into educational practices, thereby advancing its role in multilingual teaching.
Differences in Mathematical and Verbal Achievement Between Girls and Boys: The Heuristic Potential of the Structural Typing Approach in Large‐Scale Studies
Authors: Merkys Gediminas , Vaitkevičius Sigitas , Bubeliene Daiva , Sakalauskas Leonidas
Published: October 2024

The results of total testing from the years 2015–2022 on the mathematical and verbal achievement of Lithuanian pupils (N ≈ 250,000) are presented. These are the standardised tests from grades 4 to 12. The K‐Means method has discovered six types of achievement. The highest achievement type is dominated by girls (61.1%) who perform well on both mathematical and verbal tasks. The lowest achievement type is dominated by boys (57.4%) who solve both mathematical and verbal tasks extremely poorly. Each of these types makes up 1/5 of the population, and the gap between the means of their groups is about 2.5 standard deviations. The remaining four types of achievement are in the 20th to 80th percentile and make up about 60% of the population. Differences in means within the same type between mathematic and verbal achievement average 0.85 standard deviations or span one quartile. Gender differences are clearly visible in this subgroup: boys solve mathematical tasks better and verbal tasks worse; girls solve verbal tasks better and mathematical tasks worse. Big data may form a mixed distribution. It is appropriate to first discover the basic types of achievement and only then look for gender‐specific differences. Such a type‐building approach is heuristically superior to the conventional approach of working only with the mixed dataset.
Crack Growth and Fatigue Strength of Deck‐Rib Welded Joints in Orthotropic Steel Decks Integrating Mean Stress Effect
Authors: Li Xincheng , Fu Zhongqiu , Ji Bohai , Sun Guyu
Published: October 2024

Fatigue tests were conducted to investigate the effects of mean stress, stress range, and deck thickness on crack growth and fatigue failure of the deck‐rib welded joint. According to the experimental results, a fatigue failure criterion and a fatigue evaluation method for deck‐rib welded joints, which consider mean stress effect, was proposed. The results indicated that the stress range remains the dominating factor, but the influence of mean stress cannot be ignored. It was proposed that the crack length reaching approximately 150 mm and the depth reaching around 70% deck thickness can be taken as the fatigue failure criterion, while increase in mean stress would reduce the critical crack length but increase the critical crack depth. Besides, multiple cracks will weaken the fatigue strength. It is recommended to use Walker method and the FAT 71 curve with enhancement factor
to evaluate the fatigue strength under symmetrical stress cycle.
Effect of Wet‐Dry Cycles on the Loading–Unloading Damage of Granite
Authors: Zhu Ling , He Zhihao , Liu Rong , Li Tiantao , Du Ruifeng , Sun Mengyu
Published: October 2024

Investigating the effect of wet‐dry (W‐D) cycling on loading–unloading damage is crucial for ensuring the stability of granite slopes in mountainous areas prone to strong earthquakes. This study conducted a series of W‐D cycling and loading–unloading tests on granite samples, complemented by weight measurements, wave velocity assessments, and nuclear magnetic resonance (NMR) tests on samples subjected to W‐D cycling. The results indicated that W‐D cycling reduced the mechanical properties of granite and increased the irreversible strain, dissipated energy, and number of acoustic emission (AE) counts during loading–unloading. The increase in the number of W‐D cycles led to a significant rise in the number of small‐scale, intergranular, and transgranular microcracks and the gradual formation of middle‐scale and large‐scale microcracks. W‐D cycling weakened the granite because of crystal expansion and contraction as well as mineral dissolution, whereas loading–unloading damaged the granite through inconsistent deformation resulting from the varying hardness of different minerals. This study provides a foundation for understanding the formation mechanism of seismically cracked slopes under the combined effects of rainfall and earthquakes.
Vertical Distribution of Rocky Intertidal Organisms Shifts With Sea‐Level Variability on the Northeast Pacific Coast
Authors: Kaplanis Nikolas J. , Denny Mark W. , Raimondi Peter T.
Published: October 2024

Disentangling the effects of cyclical variability in environmental forcing and long‐term climate change on natural communities is a major challenge for ecologists, managers, and policy makers across ecosystems. Here we examined whether the vertical distribution of rocky intertidal taxa has shifted with sea‐level variability occurring at multiple temporal scales and/or long‐term anthropogenic sea‐level rise (SLR). Because of the distinct zonation characteristic of intertidal communities, any shift in tidal dynamics or average sea level is expected to have large impacts on community structure and function. We found that across the Northeast Pacific Coast (NPC), sea level exhibits cyclical seasonal variability, tidal amplitude exhibits ecologically significant variability coherent with the 18.6‐year periodicity of lunar declination, and long‐term sea‐level rise is occurring. Intertidal taxa largely do not exhibit significant vertical distribution shifts coherent with short‐term (monthly to annual) sea‐level variability but do exhibit taxa‐specific vertical distribution shifts coherent with cyclical changes in lunar declination and long‐term SLR at decadal timescales. Finally, our results show that responses to cyclical celestial mechanics and SLR vary among taxa, primarily according to their vertical distribution. Long‐term SLR is occurring on ecologically relevant scales, but the confounding effects of cyclical celestial mechanics make interpreting shifts in zonation or community structure challenging. Such cyclical dynamics alternatingly amplify and dampen long‐term SLR impacts and may modify the impacts of other global change related stressors, such as extreme heat waves and swell events, on intertidal organisms living at the edge of their physiological tolerances. As a result, intertidal communities will likely experience cyclical periods of environmental stress and concomitant nonlinear shifts in structure and function as long‐term climate change continues. Our results demonstrate that consistent, large‐scale monitoring of marine ecosystems is critical for understanding natural variability in communities and documenting long‐term change.
Influence of oipA Phase Variation on Virulence Phenotypes Related to Type IV Secretion System in Helicobacter pylori
Authors: Lai Jing , Angulmaduwa Sacheera , Kim Myeong‐A , Kim Aeryun , Tissera Kavinda , Cho Yong‐Joon , Cha Jeong‐Heon
Published: October 2024

Background

oipA, an outer membrane protein of Helicobacter pylori, is linked to IL‐8 induction and gastric inflammation, but its role is debated due to inconsistent findings. This study aims to explore the role of oipA phase variation in modulating the virulence traits of H. pylori, a bacterium strongly associated with the development of gastric cancer.

Material and Methods

American clinical isolate AH868 strain for naturally occurring phase variations of the oipA gene, and G27 strain for in vitro–induced phase variations were used to elucidate oipA's impact on key virulence phenotypes, including cell elongation, CagA phosphorylation, and IL‐8 induction.

Results

Using AH868 strain, natural oipA phase variation does not affect cell elongation and IL‐8 induction. Interestingly, however, in vitro–induced oipA phase variations in G27 strain uncovered that 9.4% of oipA “Off” transformants exhibit reduced cell elongation while all maintaining consistent IL‐8 induction levels. Additionally, complementation of oipA “Off to On” status restores the cell elongation phenotype in 12.5% of transformants, highlighting the importance of oipA in maintaining normal cell morphology. Crucially, these variations in cell elongation are not linked to changes in bacterial adherence capabilities. Furthermore, the study shows a correlation among oipA phase variation, cell elongation, and CagA phosphorylation, suggesting that oipA influences the functionality of the Type IV secretion system. Whole‐genome sequencing of selected transformants reveals genetic variations in bab paralogue, cagY gene, and other genomic regions, underscoring the complex genetic interactions that shape H. pylori's virulence.

Conclusions

Our research provides new insights into the subtle yet significant role of oipA phase variation in H. pylori pathogenicity, emphasizing the need for further studies to explore the intricate molecular mechanisms involved. This understanding could pave the way for targeted therapeutic strategies to mitigate the impact of H. pylori on human health.
The Safe Environment for Every Kid Model in the Swedish Child Health Services: Adoption and Introduction in a Healthcare Region
Authors: Golsäter Marie , Andersson Ann‐Christine
Published: October 2024

Background

Early support for children and families in need can improve children's health and development. In a Swedish region, a new working model called Safe Environment for Every Kid (SEEK) was introduced in the Child Health Services to facilitate the early identification of psychosocial risk factors.

Objective

The aim of this study was to describe the adoption and introduction of the SEEK model in the Child Health Services of Region Jönköping County.

Methods

Quantitative data were analysed using descriptive statistics, whereas qualitative data were analysed separately by a thematic approach. The results were then interpreted together with documents (including CHS management meeting notes and documents describing planning and training sessions) using an exploratory mixed‐methods approach to give a comprehensive description of the adoption and introduction of the SEEK model.

Results

The results show that the SEEK model improved coordination and collaboration, which led to better integrated care for children and families. The structure was regarded as supportive when introducing the SEEK model in Child Health Services. The questionnaire, as part of the SEEK model, was used in 88% of possible health visits. The most reported reason for not using it was a lack of time.

Conclusions

The desire to make a difference and thereby promote better health and development for children was a crucial factor for the nurses in adopting the SEEK model in their clinical practice. The design using coaches was also appreciated and supported the adoption and introduction of the SEEK model.

Patient or Public Contribution

Parents and healthcare professionals did not contribute to the research process. The results are based on dialogues between CHS nurses and parents after the parents filled in the SEEK questionnaire, providing an understanding of professional relationships when dealing with challenging issues.
Pulmonary arterial hypertension: updates and perspective with newer therapies
Authors: Prasad Jyotika D. , Williams Trevor J. , Whitford Helen M.
Published: October 2024

Pulmonary arterial hypertension (PAH) is a rare condition for which a remarkable change has been witnessed in the epidemiology, assessment and treatment landscape over the last three decades. Well‐established registries from the Western world have not only highlighted the shift in the epidemiology to an older, more comorbid cohort but have also identified markers of prognosis that have been validated as part of risk stratification scores in multiple cohorts. The emphasis on early identification through a systematic assessment pathway and the option of upfront combination therapy with serial risk stratification assessment has laid the foundation for the standard of care and improved prognosis. This review provides an update on the assessment and newer therapies for PAH.
Development and validation of a predictive scoring system for hypoglycaemic agents for optimal control of blood glucose during glucocorticoid therapy
Authors: Kato Ayaka , Fuwa Masayuki , Asano Motochika , Mori Ichiro , Iida Saori , Okada Hideyuki , Uno Yoshihiro , Fujioka Kei , Morita Hiroyuki
Published: October 2024

Background

Glucocorticoid (GC) treatments are often used. There is limited information on the prediction of hyperglycaemia after GC administration.

Aims

This study aimed to identify the risk factors for hyperglycaemia after glucocorticoid (GC) administration and the need for hypoglycaemic agents to correct it and to develop and validate a novel scoring system for predicting GC‐induced hyperglycaemia.

Methods

In a development set, 508 adults receiving prednisolone (PSL) for the first time were divided into two groups based on treatment with or without hypoglycaemic agents. Clinical and laboratory parameters were compared, and risk factors were identified using logistic regression analysis after performing univariate analyses between the two groups. A point‐addition scoring system with several categories and coefficients for each risk factor was constructed to predict the need for hypoglycaemic agents. The scoring system was then applied and validated on two validation sets: A and B.

Results

Older age, higher glycated haemoglobin percentage, body mass index and initial PSL dosage were identified as risk factors. The sensitivity, specificity and accuracy of the scoring system were 70.6%, 81.9% and 77.1% in the development set; 75.8%, 78.4% and 77.4% in validation set A; and 79.4%, 73.9% and 75.3% in validation set B respectively. By fitting the total score in the development set and the probability of hyperglycaemia to a logistic curve, a figure was created to show the probability of GC‐induced hyperglycaemia in patients scheduled to receive GC.

Conclusion

This scoring system is a novel, valid and reliable tool for predicting GC‐induced hyperglycaemia and the need for hypoglycaemic agents to correct it.
Ant‐Pollination: Conditional Outcomes Depending on Environmental Features and Species Interactions
Authors: Torezan‐Silingardi Helena Maura , Del‐Claro Kleber
Published: October 2024

The intricate web of interactions in nature has led to unexpected partnerships between plants and animals, greatly influencing ecosystem dynamics. In this discussion, we'll explore the Pollination Syndrome Hypothesis and consider a scenario where a partnership with unexpected pollinators emerges. We suggest that ant pollination has been largely overlooked, but ants can surprisingly play a crucial role and have a history of success in pollinating dry system plants. We will present both negative and positive aspects that must be observed in ant‐pollination syndrome. Additionally, we aim to explore the often‐underestimated phenomenon of ant pollination and the overlooked tiny, discreet, unnoticed flowers found in our fields and forests, especially in dry ecosystems, savannas and mountain fields, which may hold numerous undiscovered secrets about these interactions. We encourage young biologists to engage in natural history observations and to perform manipulative experiments directly in the field to understand the true nature of these successful ant‐pollinations.
Findings from the ‘Ask Me About PrEP’ HIV Pre‐Exposure Prophylaxis Awareness Programme in England
Authors: Edwards Jonny , Paparini Sara , Nutland Will , Thompson Marc , Samba Phil
Published: October 2024

Rationale

HIV incidence has decreased in England by over a third since 2019. Despite the early success of HIV Pre‐Exposure Prophylaxis (PrEP) in reducing HIV transmission in the United Kingdom, many people who could benefit from HIV PrEP do not yet know about it, or know how to access it.

Aims and Objectives

This paper presents the findings of the first England‐wide national peer‐to‐peer based diffusion model to disseminate information about PrEP. Ask Me About PrEP (AMAP) was a 5‐month pilot programme which commenced in November 2021. Volunteer mobilisers were encouraged to use their existing knowledge of their communities and geographical areas to assist them in discussing PrEP with their peers.

Method

12 enrolled mobilisers took part in three project evaluation focus groups between November 2021 and March 2022, and five AMAP project staff took part in one focus group in March 2022. Additionally, descriptive statistical analysis explored volunteer mobiliser recruitment to the AMAP project, demographical data of project staff and volunteer mobilisers, volunteer mobiliser attrition rates, and the project's impact.

Results

96 volunteers enrolled, completed training and volunteered as mobilisers. Thoroughout the project, mobilisers engaged their peers in 11,889 conversations about PrEP through individual conversations, online group conversations, online workplace educational events, and social media. The focus groups enabled key stakeholders to reflect on their experiences of the pilot programme. Four key themes were identified during the focus groups: motivations to mobilise and recruitment experiences; training, learning, and materials; mobilisation activity; and support and social networking.

Conclusion

Our evaluation demonstrates that peer‐to‐peer diffusion models used to increase awareness of HIV PrEP in key unreached groups, offer an acceptable public health intervention model for volunteers and project staff.
Examination of the relationship between nurses’ adherence to medication administration principles and their attitudes toward patient safety
Authors: Yilmaz Coşkun Ela , Özsaban Aysel , Üzen Cura Şengül
Published: October 2024

Background

Preventing errors associated with medication administration is achievable through nurses’ adherence to correct principles.

Objective

This study aims to investigate the relationship between nurses’ adherence to medication administration principles and their attitudes toward patient safety.

Method

This study adopts a descriptive and relationship‐seeking research design. A total of 310 nurses who met the inclusion criteria participated in the study. Data collection tools included the “Nurse Information Form,” “Medication Administration Principles Adherence Form,” and “Patient Safety Attitude Scale”.

Results

Among the participating nurses, 32.9% (n = 102) reported experiencing a medication administration error, and 77.7% (n = 241) witnessed such an error. The study revealed a statistically significant positive relationship between nurses’ adherence to medication administration principles and their attitudes toward patient safety (p < 0.001).

Conclusions

This study underscores the importance of nurses’ adherence to medication administration principles in ensuring patient safety.
Immune Response of Silver Pomfret (Pampus argenteus) CC Chemokine Ligand Gene Family to Photobacterium damselae Subsp. Damselae and Nocardia seriolae Infections
Authors: Yan Kaiheng , Zhang Youyi , Li Yuanbo , Tang Mengke , Xu Yifan , Yan Xiaojun , Hu Jiabao , Wang Yajun
Published: October 2024

Chemokines play a crucial role in immune responses by facilitating the migration of cells expressing corresponding chemokine receptors along concentration gradients. Photobacterium damselae subsp. Damselae (PDD) and Nocardia seriolae (NS) are known to induce substantial mortality in silver pomfret populations, yet there exists a dearth of research regarding the immune response of CCLs in PDD‐ or NS‐infected silver pomfret. In our investigation, we identified 10 PaCCLs, which include one fish‐specific CCL (PaCCL44). Phylogenetic analysis revealed considerable diversity in CCL types and copy numbers among various teleost fishes. Notably, silver pomfret lacks specific CCL genes, with most PaCCLs exhibiting heightened expression levels in immune‐related organs such as the spleen and kidney, and some being expressed in mucosal immune‐related organs like the skin and gills. Transcriptome analysis conducted on silver pomfret infected with NS and PDD elucidated that the expression changes of PaCCLs primarily manifested in the spleen during the initial stages of NS infection, shifting to the kidney in later stages. Conversely, the expression changes of PaCCLs following PDD infection predominantly occurred in the kidney. In vitro studies using silver pomfret spleen cell lines demonstrated an early peak in PaCCLs expression during infection, followed by gradual decline with NS treatment and rapid diminishment with PDD treatment. These findings suggest that PaCCLs primarily support the innate immunity of silver pomfret, potentially exhibiting chemotactic effects in the early infection stages, such as the synergistic action of PaCCL4 and PaCCL25, and later serving as direct antibacterial agents. NS invasion is characterised by a chronic infection affecting multiple organs, whereas PDD primarily inflicts severe damage to the kidney. PaCCL19a and PaCCL19b are specific to PDD, and their expression levels may decrease in the later stages of infection due to PDD immune escape. These data offer initial insights into understanding the mechanism underlying the innate immune response of the CCL gene family in silver pomfret and provide theoretical underpinnings for fish culture practices.
Factors Influencing the Prevalence of Hyperpigmented Melanistic Lesions in Smallmouth Bass Micropterus dolomieu in the Susquehanna River Basin, Pennsylvania
Authors: Schall Megan K. , Smith Geoffrey D. , Blazer Vicki S. , Walsh Heather L. , Wagner Tyler
Published: October 2024

Hyperpigmented melanistic lesions (HPMLs) are a visual anomaly documented on the skin of smallmouth bass Micropterus dolomieu in the Susquehanna River Basin, Pennsylvania and in numerous other geographical locations. Currently, there is a lack of information on environmental and fish characteristics that may influence the prevalence of HPMLs associated with a recently described Adomavirus. The goal of this study was to understand potential drivers associated with HPMLs in socioeconomically and ecologically important riverine smallmouth bass populations. A total of 16,220 smallmouth bass were collected and examined for HPMLs between 2012 and 2022 in the Susquehanna River Basin. Overall, HPMLs were documented on 2.9% of fish collected. The interaction between temperature and fish size suggested differing relationships between shorter and longer fish with respect to temperature. Predicted probability of HPML prevalence ranged from 1.1% (95% CI = 0.3, 3.2) at 4°C to 0.01% (CI = 0.00, 0.04) at 26°C for an age‐0 (125 mm) fish. In contrast, predicted probability of HPML prevalence ranged from 10.5% (95% CI = 5.8, 18.9) at 4°C to 0.8% (CI = 0.4, 1.5) at 26°C for an adult (322 mm) fish. Overall, HPMLs were more common in longer fish during cooler temperature periods which also corresponds to key life history periods for smallmouth bass (e.g., pre‐spawn and overwintering) and could represent different exposure histories for juvenile and adult fish.
Detection of walnut internal quality via improved YOLOv5 and x‐ray imaging
Authors: Lei Jiale , Zheng Weiqiang , Zhang Liping , Lv Wentao , Li Yihao
Published: October 2024

This study proposes a walnut target detection algorithm based on improved YOLOv5 and x‐ray imaging to meet the demand for internal quality detection and removal in the Xinjiang walnut industry. By replacing the C3 module in the backbone layer with the C2f module and the couple‐head in the head layer with the decouple‐head, the algorithm reduces computational complexity, enhances robustness and generalizability, and retains more spatial information, thereby improving the performance of multicategory small target detection. In addition, this paper replaces the original CIOU loss function with the EIOU loss function to improve the convergence speed of the algorithm's accuracy and boundary aspect ratio. Compared with the original model, the improved model, improved YOLOv5, maintains the same average precision for normal walnuts while increasing the average precision for shriveled walnuts and empty‐shell walnuts by 8.2% and 0.4%, respectively. Compared with other mainstream models, such as VGG16, ResNet50, YOLOv5s, YOLOv7, YOLOv8s, YOLOv9s, and YOLOv10s, this model achieves the highest detection accuracy and good detection performance, with a single‐image detection time of 11.9 ms, meeting the requirements for real‐time detection. This work lays a foundation for automatic robot detection of the internal quality and removal of walnuts, showing practical application potential.

Practical applications

Xinjiang stands as a prominent producer of walnuts; however, due to the decentralized nature of its cultivation and management processes, a notable prevalence of internal empty shells and shrinkage is observed, which substantially diminishes their commercial value. The integration of YOLOv5 with x‐ray imaging technology promises to enhance the precision of internal quality assessments of walnuts. The improved YOLOv5 model, as delineated in this study, exhibits the highest detection accuracy when benchmarked against a multitude of other models. It achieves a detection latency of merely 11.9 ms per image, thereby satisfying the stringent demands for real‐time detection applications. This model is designed for integration into x‐ray systems with an adjunctive sorting mechanism, which facilitates the inspection and exclusion of defective walnuts on conveyor belts.
Glucose‐lowering medication associated with weight loss may limit the progression of diabetic neuropathy in type 2 diabetes
Authors: Ponirakis Georgios , Al‐Janahi Ibrahim , Elgassim Einas , Hussein Rawan , Petropoulos Ioannis N. , Gad Hoda , Khan Adnan , Zaghloul Hadeel B. , Siddique Mashhood A. , Ali Hamda , Mohamed Fatima F. S. , Ahmed Lina H. M. , Dakroury Youssra , El Shewehy Abeer M. M. , Saeid Ruba , Mahjoub Fadwa , Al‐Thani Shaikha N. , Ahmed Farheen , Homssi Moayad , Mahmoud Salah , Hadid Nebras H. , Obaidan Aisha Al , Salivon Iuliia , Mahfoud Ziyad R. , Zirie Mahmoud A. , Al‐Ansari Yousuf , Atkin Stephen L. , Malik Rayaz A.
Published: October 2024

Aim

Obesity is a major risk factor for diabetic peripheral neuropathy (DPN) in type 2 diabetes (T2D). This study investigated the effect of glucose lowering medication associated with weight change on DPN.

Methods

Participants with T2D were grouped based on whether their glucose lowering medications were associated with weight gain (WG) or weight loss (WL). They underwent clinical, metabolic testing and assessment of neuropathic symptoms, vibration perception threshold (VPT), sudomotor function and corneal confocal microscopy (CCM) at baseline and follow‐up between 4 and 7 years.

Results

Of 76 participants, 69.7% were on glucose lowering medication associated with WG, and 30.3% were on glucose lowering medication associated with WL. At baseline, participants in the WG group had a significantly longer duration of diabetes (p < .01), higher douleur neuropathique en 4 (DN4) score (p < .0001) and VPT (p = .01) compared with those in the WL group. Over a 56‐month period, participants in the WG group showed no significant change in body weight (p = .11), HbA1c (p = .18), triglycerides (p = .42), DN4 (p = .11), VPT (p = .15) or Sudoscan (p = .43), but showed a decline in corneal nerve fiber density (CNFD), corneal nerve branch density (CNBD) and corneal nerve fiber length (CNFL) (p < .0001). Participants in the WL group showed a reduction in weight (p = .01) and triglycerides (p < .05), no change in DN4 (p = .30), VPT (p = .31) or Sudoscan (p = .17) and a decline in the corneal nerve branch density (p < .01).

Conclusions

Participants treated with glucose lowering medication associated with weight gain had worse neuropathy and greater loss of corneal nerves during follow‐up, compared to patients treated with medication associated with weight loss.
Making green cocoa: Deforestation, the legacy of war, and agrarian capitalism in Côte d'Ivoire
Authors: Grajales Jacobo , Toukpo Oscar
Published: October 2024

This article examines the legacy of war on environmental policy, contributing to recent literature on the linkages between armed violence, conservation, rural livelihoods and global value chains. It argues that environmental norms reshape agricultural practices, but also the means by which people claim control over land and labour. Using the case of cocoa in Côte d'Ivoire, this paper examines the impact of ‘zero‐deforestation’ policies on the country's last agricultural frontier: its western forestlands, where migration and deforestation have driven the development of the cocoa economy for years. The region is now feeling the effects of global trade policies such as the European Deforestation‐Free Regulation (EUDR), competition for the last remaining forests and social fault lines inherited from the war. This article traces the origins of the zero‐deforestation policy, its national and local impact and its implications for social struggles over the control of land and labour.