bluuebunny/crossref_metadata_2025 huggingface dataset:
Adaptation and Implementation of a Volunteer-Delivered, Telephone-Based, Social Support Program HOW-R-U? During the COVID-19 Pandemic: A Pragmatic Study
Authors: Robinson Elizabeth , Dickins Marissa , Lad Lina , Beard Sharryn , McGill Deidre , Hayes Johanna , Fabri Anne Marie , Wade Henni , Meyer Claudia , Lowthian Judy A
Published: April 2024

Background and Objectives

Public health concerns surrounding social isolation and loneliness heightened during the coronavirus disease 2019 (COVID-19) pandemic, as infection prevention measures led to increased feelings of loneliness and depression. Our objective was to evaluate the implementation of the HOW-R-U? program, during the pandemic (March 2020–December 2021). HOW-R-U? is a weekly volunteer-delivered telephone program designed to facilitate social connection and ease feelings of social isolation, loneliness, and depression in older people.

Research Design and Methods

This pragmatic study used the Implementation Framework for Aged Care to adapt and implement HOW-R-U? in an Australian aged and community care organization and a tertiary health service in Melbourne. The evaluation involved analysis of program data, semistructured interviews, and surveys with program recipients, volunteers, and referrers. A process evaluation was conducted alongside an assessment of outcomes including pre- and post-symptoms of isolation, depression, and loneliness.

Results

The implementation evaluation indicated that codesigned systems and processes effectively supported the ongoing implementation of HOW-R-U? with transition into business as usual across both organizations. Recipients reported that telephone calls had a positive impact on their lives, whereas volunteers reported enjoyment of supporting others. Several challenges were identified, namely in program reach and fidelity.

Discussion and Implications

HOW-R-U? was well regarded by all involved, and evaluation learnings have informed implementation into business as usual by both organizations.
Fleeing a Well-Founded Fear of Persecution to Be Persecuted Again? The Case of LGBTIQ+ Refugees and Asylum Seekers in Uganda
Authors: D’Orsi Cristiano
Published: April 2024

This work focuses on the legal promotion and protection of the rights of LGBTIQ+ asylum seekers and refugees in Uganda. Uganda’s treatment of LGBTIQ+ communities is one of the harshest in Africa, with the adoption of legal instruments criminalizing LGBTIQ+ people, as well as same-sex relations. These instruments apply to all LGBTIQ+ people present in Uganda, including asylum seekers and refugees. Refugees have never been granted refugee status on the basis of their sexual orientation and/or gender identity. Asylum claims based solely on sexual orientation and/or gender identity are systematically rejected by the Ugandan Commissioner for Refugees. This article shows that, despite efforts by the United Nations High Commissioner for Refugees (UNHCR) and non-governmental organizations, Uganda remains a country hostile to LGBTIQ+ asylum seekers and refugees specifically, and to LGBTIQ+ communities generally. LGBTIQ+ refugees must conduct a discreet life to avoid being penalized because of their sexual orientation and/or gender identity. The ambiguous positions of African institutions, such as the African Union, do not help in securing such people’s rights and protection. Serious changes are needed if Uganda is to adhere to human rights principles that safeguard the rights of LGBTIQ+ communities.
Dialectical Order-Making through Ambiguity: Contestation Is the Norm in International Peace and Security Maintenance
Authors: Hofmann Stephanie C
Published: April 2024

What kind of order and contestation dynamics emerge if the initial institutional bargain includes liberal, partially liberal, and nonliberal visions of order? This contribution to the special issue locates the liberal ideational and institutional properties within the crisis management domain and analyzes contestation dynamics and their impact. My argument is twofold. First, liberal visions of order (e.g., based on human rights and self-determination) have coexisted alongside other aspirations focusing on the right of nonintervention and privileged political communities because post–World War II conflict management is rooted in the legal ambiguity of the Charter of the United Nations (UN). This ambiguity (low legalized institutionalization) gives space to different interpretations of what counts as peace, enforcement, threat, and the relationship between the UN and regional organizations (low liberal embeddedness). Second, ambiguity and competing visions of order sustain persistent contestation, which produces dialectical ordering within and outside the UN. Within dialectical ordering, order-challenging contestation occurs when actors disengage from the global level or when their vision of order becomes globally hegemonic. While order-challenging attempts in the realm of crisis management exist, they have remained unsuccessful so far. Seen from this perspective, there has never been a liberal international order in conflict management—only liberal attempts to impose a liberal order on an ongoing dialectical order-making process. So far, other order-challenging attempts, such as Russia’s sphere of influence or China’s developmental peace approaches, have also remained unsuccessful. Contestation remains the norm.
Hierarchy and Endogenous Contestation in the Liberal International Order
Authors: Mukherjee Rohan
Published: April 2024

A previous generation of influential scholarship treated international institutions as instruments of cooperation built by self-interested states to achieve mutually beneficial outcomes. Recent scholarship, including this special forum, suggests that the rational design of institutions does not guarantee their durability and that liberal institutions are intrinsically prone to contestation. This essay takes a step back and posits that the hierarchical nature of international order itself creates conditions for contestation, but not for the reasons typically identified in the literature. Institutionalized disagreement over distributional outcomes, values, and hypocrisy is ultimately about the politics of status between differently ranked states. While these differences are due to the hierarchical nature of order, it is the same hierarchy that can contribute to their resolution when leading states engage in institutional reforms—for example, by making institutional membership and leadership more inclusive. The essay closes with some reflections on a prominent source of hierarchy in the liberal international order (LIO): the legacy of Eurocentrism and colonialism in world politics. While countries in the Global South have typically engaged in order-consistent contestation, it is the LIO’s leading states that have engaged in order-challenging contestation. The present sense of crisis in the LIO might therefore have more to do with Western anxieties about security competition with China, Russian aggression, and domestic crises of liberalism than the “rise of the rest.”
Analysis of laboratory data transmission between two healthcare institutions using a widely used point-to-point health information exchange platform: a case report
Authors: Luu Hung S , Campbell Walter S , Cholan Raja A , Edgerton Mary E , Englund Andrea , Keller Alana , Korte Elizabeth D , Mitchell Sandra H , Watkins Greg T , Westervelt Lindsay , Wyman Daniel , Powell Stephen
Published: April 2024

Objective

The objective was to identify information loss that could affect clinical care in laboratory data transmission between 2 health care institutions via a Health Information Exchange platform.

Materials and Methods

Data transmission results of 9 laboratory tests, including LOINC codes, were compared in the following: between sending and receiving electronic health record (EHR) systems, the individual Health Level Seven International (HL7) Version 2 messages across the instrument, laboratory information system, and sending EHR.

Results

Loss of information for similar tests indicated the following potential patient safety issues: (1) consistently missing specimen source; (2) lack of reporting of analytical technique or instrument platform; (3) inconsistent units and reference ranges; (4) discordant LOINC code use; and (5) increased complexity with multiple HL7 versions.

Discussion and Conclusions

Using an HIE with standard messaging, SHIELD (Systemic Harmonization and Interoperability Enhancement for Laboratory Data) recommendations, and enhanced EHR functionality to support necessary data elements would yield consistent test identification and result value transmission.
Life history correlations and trade-offs resulting from selection for dispersal in Tribolium castaneum
Authors: Pointer Michael D , Spurgin Lewis G , McMullan Mark , Butler Simon , Richardson David S
Published: April 2024

Dispersal is an important facet of the life history of many organisms and is, therefore, subject to selective pressure but does not evolve in isolation. Across nature, there are examples of dispersal syndromes and life history strategies in which suites of traits coevolve and covary with dispersal in combinations that serve to maximize fitness in a given ecological context. The red rust flour beetle, Tribolium castaneum, is a model organism and globally significant post-harvest pest that relies on dispersal to reach new patches of ephemeral habitat. Dispersal behaviour in Tribolium has a strong genetic basis. However, a robust understanding of the relationship between dispersal and other life-history components, which could elucidate evolutionary processes and allow pest managers to control their spread and reduce the impact of infestation, is currently lacking. Here, we use highly replicated lines of T. castaneum previously artificially selected for divergent small-scale dispersal propensity to robustly test several important life history components: reproductive strategy, development time, and longevity. As predicted, we find that a suite of important changes as a result of our selection on dispersal: high dispersal propensity is associated with a lower number of longer mating attempts by males, lower investment in early life reproduction by females, slower development of later-laid offspring, and longer female life span. These findings indicate that correlated intraspecific variation in dispersal and related traits may represent alternative life history strategies in T. castaneum. We therefore suggest that pest management efforts to mitigate the species’ agro-economic impact should consider the eco-evolutionary dynamics within multiple life histories. The benefits of doing so could be felt both through improved targeting of efforts to reduce spread and also in forecasting how the selection pressures applied through pest management are likely to affect pest evolution.
Impact of COVID-19 on asthma and COPD patients’ hospital care: a lesson for future pandemics
Authors: Awwad Oriana , AlMuhaissen Suha , Abdel Jalil Mariam , Battah Zaina , Abu Hammour Khawla , Almonayer Saja
Published: April 2024

Objectives

Preventive measure for COVID-19 spread have dramatically affected patients with chronic diseases worldwide, including asthma/chronic obstructive pulmonary disease (COPD) patients. This study aimed to examine the impact of the COVID-19 outbreak and the associated lockdown on the medical care provision of asthma/COPD patients in Jordan. The healthcare behaviours and perceptions of these patients regarding the outbreak were also investigated.

Methods

A population-based cohort study was conducted on asthma/COPD patients seeking medical care during 2019–2021 at a tertiary hospital in Jordan. Patients were interviewed by phone call, their medical files were also accessed. Demographics, clinical information, and those related to healthcare access (clinic visits, hospital admissions, and emergency room [ER] visits), exacerbation management and medication adherence were all collected.

Key findings

A total of 371 cases were identified, the majority (65.2%) were asthmatics. The most (76.3%) were not vaccinated (influenza or pneumococcal), none had a written action plan. The study findings showed reduced healthcare utilization (hospital admission and ER visits) during the study period (P < 0.05). Clinic visits also decreased over 2019–2020 (P < 0.05). Accordingly, the pattern of acute exacerbation treatment also changed with fewer antibiotics and inhaled corticosteroids administered during the pandemic (P < 0.05). Medication adherence was relatively low (14.6%–17.25%). Telemedicine was not provided during the study period.

Conclusions

The study demonstrated disruption in healthcare utilization. There is need for better preparedness for future pandemics to maintain the routine medical care services. Telemedicine should be introduced as part of healthcare systems. Efforts are still needed to optimize medication adherence in Jordan. Future research is needed to better address COVID-19 impact on chronic patients.
Portosystemic shunt surgery for severe portal hypertension due to portal thrombosis after bariatric surgery
Authors: Reyes Natalia , Jarufe Alessandra , Briceño Eduardo , Viñuela Eduardo , Martínez Jorge , Dib Martin , Jarufe Nicolás
Published: April 2024

Portal vein thrombosis is a rare complication after laparoscopic sleeve gastrectomy, a widely performed bariatric surgery procedure. Occasionally, the development of portal vein thrombosis can progress to more severe conditions, including portal hypertension and cavernomatosis, thereby presenting a complex and challenging clinical scenario. The management of such complications often requires careful consideration; however, surgical intervention in the form of a splenorenal shunt is an exceptional indication. We present the case of a 33-year-old female patient who had previously undergone laparoscopic sleeve gastrectomy in 2014 and subsequently developed portal thrombosis, followed by cavernomatosis and associated complications of portal hypertension. A proximal splenorenal shunt procedure and splenectomy were successfully performed to manage portal hypertension. The presentation of this clinical case aims to contribute to the available evidence and knowledge surrounding this rare and challenging pathology.
A case of acute appendicitis caused by obstruction due to caecal cancer
Authors: Nakayama Yoko , Yamaguchi Minekazu , Tamaki Kaho , Hidaka Masaaki
Published: April 2024

Acute appendicitis supposedly results from appendix obstruction caused by various conditions, including caecal cancer. Here, we report an adenocarcinoma found in the specimen of a 65-year-old man diagnosed with acute appendicitis. The adenocarcinoma was detected in the appendix stump after emergency laparoscopic appendectomy. The patient was diagnosed with caecal cancer based on post-operative lower endoscopy findings, and an additional laparoscopic right hemicolectomy was performed. Acute appendicitis can occur at any age and may require emergency surgery. It is a benign disease that can be cured entirely by appendectomy in most cases but may result from an underlying malignant disease in some cases, especially in patients >40 years of age. Thus, clinicians should consider the possibility of a malignancy while diagnosing and treating acute appendicitis.
Estimating event probabilities via signal temporal logic and first occurrence distributions
Authors: Zhang Siqi , Qin Xiaolin , Zhang Ju , Liu Jiang
Published: April 2024

Estimating the probability of events is a significant challenge in many fields, often requiring a probabilistic model or additional labels and tasks for accurate prediction. However, those methods have limited scalability or unnecessary computational resource consumption due to predicting unrelated values. To address these issues, we propose a novel approach that estimates event probabilities based on the distributions of their first occurrence in the time domain. By using Signal Temporal Logic formulas to describe events and applying an algorithm that estimates complex events’ probabilities through simple event occurrence distributions, this study presents an efficient approach that does not depend on high-precision prediction. We evaluate the performance of our method on simulated scenarios of unmanned aerial vehicle motion and autonomous driving.
KAOSS: turbulent, but disc-like kinematics in dust-obscured star-forming galaxies at z ∼ 1.3–2.6
Authors: Birkin Jack E , Puglisi A , Swinbank A M , Smail Ian , An Fang Xia , Chapman S C , Chen Chian-Chou , Conselice C J , Dudzevičiūtė U , Farrah D , Gullberg B , Matsuda Y , Schinnerer E , Scott D , Wardlow J L , van der Werf P
Published: April 2024

We present spatially resolved kinematics of 27 ALMA-identified dust-obscured star-forming galaxies (DSFGs) at z ∼ 1.3–2.6, as traced by Hα emission using VLT/KMOS near-infrared integral field spectroscopy from the ‘KMOS-ALMA Observations of Submillimetre Sources’ (KAOSS) Large Programme. We derive Hα rotation curves and velocity dispersion profiles for the DSFGs, and find that among the 27 sources with bright, spatially extended Hα emission, 24 display evidence for disc-like kinematics. We measure a median inclination-corrected velocity at 2.2 Rd of vrot = 190 ± 40 km s−1 and intrinsic velocity dispersion of σ0 = 87 ± 6 km s−1 for these disc-like sources. The kinematics yield median circular velocities of vcirc = 230 ± 20 km s−1 and dynamical masses within 2Re (∼ 7 kpc radius) of Mdyn = (1.1 ± 0.2) × 1011 M⊙. Compared to less actively star-forming galaxies, KAOSS DSFGs are both faster rotating with higher intrinsic velocity dispersions, but have similar vrot/σ0 ratios, median v/σ0 = 2.5 ± 0.5. We suggest that the kinematics of the DSFGs are primarily rotation supported but with a non-negligible contribution from pressure support, which may be driven by star formation or mergers/interactions. We estimate the normalization of the stellar mass Tully–Fisher relation (sTFR) for the disc-like DSFGs and compare it with local studies, finding no evolution at fixed slope between z ∼ 2 and z ∼ 0. Finally, we show that the kinematic properties of the DSFG population are consistent with them evolving into massive early-type galaxies, the dominant z ∼ 0 population at these masses.
Impact of neoadjuvant pembrolizumab adherence on pathologic complete response in triple-negative breast cancer: a real-world analysis
Authors: LeVee Alexis , Wong Megan , Flores Sarah , Ruel Nora , McArthur Heather , Waisman James , Mortimer Joanne
Published: April 2024

Background

The addition of pembrolizumab (pembro) to neoadjuvant chemotherapy (NAC) is standard of care for the treatment of early triple-negative breast cancer (TNBC) after KEYNOTE-522 trial demonstrated improved pathologic complete response (pCR) rates with the combination. However, the optimal treatment strategy for TNBC remains uncertain as questions persist about which patients benefit from pembro and the best treatment schedule and regimen. We identified real-world clinical characteristics and treatment variables associated with response to NAC plus pembro.

Methods

Patients with early TNBC treated with NAC plus pembro between February 2020 and September 2023 were identified. Univariate and multivariate analysis was performed using logistic regression to identify factors associated with pCR. Cox proportional hazard prediction models were used to identify predictors of invasive disease-free survival and overall survival in this cohort.

Results

A pCR was achieved in 75 (63.6%) of 118 patients. Age at diagnosis (P = .04), Ki-67 (P = .004), duration from start of pembro to surgery (P = .006) and NAC to surgery (P = .01), number of cycles of pembro (P = .04) and NAC (P = .02), and completion of at least 8 cycles of pembro (P = .015) and NAC (P = .015) were each significantly associated with pCR in univariate analysis. In multivariate analysis, patients younger than 55 years at time of diagnosis (vs age > 55 years) and those completing at least 8 cycles of pembro remained predictive of pCR (OR’s 2.50, 2.49, P = .035 and .037, respectively).

Conclusions

In this real-world analysis of patients with TNBC treated with NAC plus pembro, younger age and the completion of at least 8 cycles of pembrolizumab were associated with pCR.
String-Based Methods for Tonal Harmony
Authors: Sears David R. W.
Published: April 2024

Corpus studies employing string-based methods in music research often suffer from the contiguity  fallacy - the assumption that note or chord events on the musical surface depend only on their immediate neighbors. In symbolic music corpora, for example, researchers often divide the corpus into contiguous sequences of n events (called n-grams) for the purposes of pattern discovery, classification, similarity estimation, and prediction. And yet since much of the world's music is hierarchically organized such that certain events are more stable (or prominent) than others, non-contiguous events often serve as focal points in the sequence. Thus, this chapter considers how we might adapt skip-grams, which include sub-sequences in an n-gram distribution if their constituent members occur within a certain number of skips, to address questions related to the analysis of tonal harmony in a corpus of Haydn string quartets.
Cytochrome b5 diversity in green lineages preceded the evolution of syringyl lignin biosynthesis
Authors: Zhao Xianhai , Zhao Yunjun , Zeng Qing-yin , Liu Chang-Jun
Published: April 2024

Lignin production marked a milestone in vascular plant evolution, and the emergence of syringyl (S) lignin is lineage specific. S-lignin biosynthesis in angiosperms, mediated by ferulate 5-hydroxylase (F5H, CYP84A1), has been considered a recent evolutionary event. F5H uniquely requires the cytochrome b5 protein CB5D as an obligatory redox partner for catalysis. However, it remains unclear how CB5D functionality originated and whether it coevolved with F5H. We reveal here the ancient evolution of CB5D-type function supporting F5H-catalyzed S-lignin biosynthesis. CB5D emerged in charophyte algae, the closest relatives of land plants, and is conserved and proliferated in embryophytes, especially in angiosperms, suggesting functional diversification of the CB5 family before terrestrialization. A sequence motif containing acidic amino residues in Helix 5 of the CB5 heme-binding domain contributes to the retention of CB5D function in land plants but not in algae. Notably, CB5s in the S-lignin–producing lycophyte Selaginella lack these residues, resulting in no CB5D-type function. An independently evolved S-lignin biosynthetic F5H (CYP788A1) in Selaginella relies on NADPH-dependent cytochrome P450 reductase as sole redox partner, distinct from angiosperms. These results suggest that angiosperm F5Hs coopted the ancient CB5D, forming a modern cytochrome P450 monooxygenase system for aromatic ring meta-hydroxylation, enabling the reemergence of S-lignin biosynthesis in angiosperms.
Vacuolar degradation of plant organelles
Authors: Otegui Marisa S , Steelheart Charlotte , Ma Wenlong , Ma Juncai , Kang Byung-Ho , De Medina Hernandez Victor Sanchez , Dagdas Yasin , Gao Caiji , Goto-Yamada Shino , Oikawa Kazusato , Nishimura Mikio
Published: April 2024

Plants continuously remodel and degrade their organelles due to damage from their metabolic activities and environmental stressors, as well as an integral part of their cell differentiation programs. Whereas certain organelles use local hydrolytic enzymes for limited remodeling, most of the pathways that control the partial or complete dismantling of organelles rely on vacuolar degradation. Specifically, selective autophagic pathways play a crucial role in recognizing and sorting plant organelle cargo for vacuolar clearance, especially under cellular stress conditions induced by factors like heat, drought, and damaging light. In these short reviews, we discuss the mechanisms that control the vacuolar degradation of chloroplasts, mitochondria, endoplasmic reticulum, Golgi, and peroxisomes, with an emphasis on autophagy, recently discovered selective autophagy receptors for plant organelles, and crosstalk with other catabolic pathways.
Development of a cloud-based flow rate tool for eNAMPT biomarker detection
Authors: Buchanan Bailey C , Tang Yisha , Lopez Hannah , Casanova Nancy G , Garcia Joe G N , Yoon Jeong-Yeol
Published: April 2024

Increased levels of extracellular nicotinamide phosphoribosyltransferase (eNAMPT) are increasingly recognized as a highly useful biomarker of inflammatory disease and disease severity. In preclinical animal studies, a monoclonal antibody that neutralizes eNAMPT has been generated to successfully reduce the extent of inflammatory cascade activation. Thus, the rapid detection of eNAMPT concentration in plasma samples at the point of care (POC) would be of great utility in assessing the benefit of administering an anti-eNAMPT therapeutic. To determine the feasibility of this POC test, we conducted a particle immunoagglutination assay on a paper microfluidic platform and quantified its extent with a flow rate measurement in less than 1 min. A smartphone and cloud-based Google Colab were used to analyze the flow rates automatically. A horizontal flow model and an immunoagglutination binding model were evaluated to optimize the detection time, sample dilution, and particle concentration. This assay successfully detected eNAMPT in both human whole blood and plasma samples (diluted to 10 and 1%), with the limit of detection of 1–20 pg/mL (equivalent to 0.1–0.2 ng/mL in undiluted blood and plasma) and a linear range of 5–40 pg/mL. Furthermore, the smartphone POC assay distinguished clinical samples with low, mid, and high eNAMPT concentrations. Together, these results indicate this POC assay, which utilizes low-cost materials, time-effective methods, and a straightforward immunoassay (without surface immobilization), may reliably allow rapid determination of eNAMPT blood/plasma levels to advantage patient stratification in clinical trials and guide ALT-100 mAb therapeutic decision-making.
Efficient Solver of Relativistic Hydrodynamics with an Implicit Runge–Kutta Method
Authors: Touroux Nathan , Kitazawa Masakiyo , Murase Koichi , Nahrgang Marlene
Published: April 2024

We propose a new method to solve the relativistic hydrodynamic equations based on implicit Runge–Kutta methods with a locally optimized fixed-point iterative solver. For numerical demonstration, we implement our idea for ideal hydrodynamics using the one-stage Gauss–Legendre method as an implicit method. The accuracy and computational cost of our new method are compared with those of explicit ones for the (1+1)D Riemann problem, as well as the (2+1)D Gubser flow and event-by-event initial conditions for heavy-ion collisions generated by TRENTo. We demonstrate that the solver converges with only one iteration in most cases, and as a result, the implicit method requires a smaller computational cost than the explicit one at the same accuracy in these cases, while it may not converge with an unrealistically large Δt. By showing a relationship between the one-stage Gauss–Legendre method with the iterative solver and the two-step Adams–Bashforth method, we argue that our method benefits from both the stability of the former and the efficiency of the latter.
OA35 Amplifying young voices: the crucial role of young people living with rheumatic conditions in shaping information, advice and guidance
Authors: Woolley Lynne , Bovey-Pilkington Dawn
Published: April 2024

Background/Aims

In 2021, Versus Arthritis launched Young Experts - a project to improve the quality and availability of information for young people aged 11-16 living with rheumatic conditions. The adolescent years are a distinct and formative period in life and a lack of youth accessible information had been identified.

Methods

Firstly, we completed an audit of current resources, research, and standards. This helped us identify best practice as well as gaps, including a lack of accessible developmentally appropriate resources and resources for families/professionals supporting young people. Secondly, we gathered insight through UK-wide surveys, focus groups and interviews with young people and parents. This helped us prioritise topics (school was selected as the initial priority topic) and identify key messages. Thirdly, we ran an online co-production project with over 30 young people. Creative activities were facilitated by youth workers and content creators over the course of several weeks on school based topics. Each week built on the last - building on themes, checking understanding, and prioritising. As themes emerged the team also engaged with healthcare professionals, health-based youth workers and education staff to explore key areas and professional perspectives.

Results

A wealth of insight has been gathered on supporting young people living with a rheumatic condition to thrive at school. The initial focus was on support development, but the insight has also had the added benefit of influencing campaigning and awareness raising work. Young people flagged a greater focus on creating films featuring young people and retaining hard copy resources, which fundamentally shaped the new resource development plan. Resources must be in accessible, engaging formats for all young people. Youth feedback led to a greater focus on resources that change their community and society (e.g. actions of school leaders and staff), alongside resources for young people. Prioritisation of messaging to include more content on ‘quality communication’, ‘school engagement’, ‘mental health and wellbeing’ and ‘relationships of trust between school and young people’. Impact on young participants included new friendships, self-management support, and a focus on youth social action to improve things for the next generation of young people. New resources included a series of films co-designed with young people, and school staff resources.

Conclusion

Engaging young people in shaping information should challenge assumptions on content, key messaging and approaches. To design without the involvement young people could lead to new resources that fail to lever their full potential - in both challenging communities to be more inclusive and/or meeting the needs of young people and their families. With thanks to the young people involved in the project and continuing to support this vital work.

Disclosure

L. Woolley: None. D. Bovey-Pilkington: None.
P034 Lessons and feedback from a patient event: Salford Scleroderma Open Day 2023
Authors: Corotana Monisha , Samaranayaka Muditha , Dinsdale Graham , Hughes Michael , Johnson Lily , Wragg Elizabeth
Published: April 2024

Background/Aims

The 2023 Scleroderma Open Day at Salford Royal Hospital coincided with World Scleroderma Day on June 29, and was organised by the hospital's dedicated Scleroderma team. The Open Day featured a rich program; informative expert talks, a first-hand account from a scleroderma patient, and an array of stalls offering invaluable tips, information, and important contacts. Attendees, comprising patients and their friends and family, actively engaged in the event and provided feedback through forms distributed during the event.

Methods

The feedback forms employed in this study encompassed a wide spectrum of vital information, including demographic details of attendees, their holistic evaluations of the event, preferences for event duration, assessments of lecture quality, convenience, and reflections on the efficacy of face-to-face event delivery. Moreover, attendees were encouraged to share their perspectives on potential themes for future Open Days and express their willingness to participate in forthcoming research initiatives.

Results

The assessment of different facets of the Open Day on a scale from 1 (poor) to 5 (very good) revealed remarkable attendee satisfaction (Table 1). Lectures received an admirable mean rating of 4.3 (SD = 0.57). The venue itself was highly appreciated, with an impressive mean rating of 4.7 (SD = 0.57), indicating the success of the hospital as a welcoming host. The choice of face-to-face delivery over online alternatives was favourably endorsed, earning a mean rating of 4.4 (SD = 0.55). It is noteworthy that more than half (60%) of attendees rated the Open Day as ‘good’ (4/5), while a remarkable 40% rated the Open Day as ‘exceptional’ (5/5).

Conclusion

The Scleroderma Open Day at Salford Royal Hospital proved highly successful in providing valuable information on scleroderma, management, and access to additional resources for patients and their loved ones. A significant proportion of attendees expressed interest in participating in future research endeavours, promising a brighter outlook for scleroderma research and care. Potential topics for upcoming events, including the effects of scleroderma on organs, oral and dental health, and medication side effects, were also identified, offering a roadmap for addressing the evolving needs of the scleroderma community.

Disclosure

M. Corotana: None. M. Samaranayaka: None. G. Dinsdale: None. M. Hughes: None. L. Johnson: None. E. Wragg: None.
P113 Rheumatoid arthritis modifies the relationship between depression and overall mortality among African Americans
Authors: Banerjee Sri , Khubchandani Jagdish , Mesidor Maica , Lane Pilar , Gonzales-Lagos Rafael
Published: April 2024

Background/Aims

Rheumatoid arthritis (RA) has been known to be connected with many comorbidities and vascular diseases. Depression is two times more common in the RA population versus the general population. In this research, we will demonstrate the effect of depression on overall mortality and how the connection is influenced by rheumatoid arthritis among African Americans.

Methods

The National Health and Nutrition Examination Survey (NHANES) is a survey completed by non-institutionalized population of the United States. All respondents from the NHANES survey, who were 20 years or older and African American between the years 2005-2010 were included in the analysis with follow-up through December 31, 2019. Healthcare diagnosed self-reported information was used for the determination of RA. We determined depression by Patient Health Questionnaire (PHQ-9) with score ≥ 10. Analysis was performed using complex samples Cox regression to determine the relationship of depression on all-cause mortality and how rheumatoid arthritis influences this.

Results

Percent mortality among African American individuals with rheumatoid arthritis was 23.34% (CI 17.18%-29.34%) among males and 20.83% (CI 15.8-25.8) among females with mean follow-up of 10.1 years. For overall mortality, the age and sex-adjusted hazard ratio (HR) for depression was 2.52 (95% confidence interval [CI], 1.34-4.74 p = 0.01). The adjusted HR was elevated, 3.82 (CI 1.07-13.58, p = 0.04), among people with depression who also had rheumatoid arthritis but close to 1.0 (1.79 CI 0.47-6.88, p = 0.37) among individuals with depression who had no rheumatoid arthritis, after adjusting for medical (tobacco use, hypertension, and obesity) and demographic risk factors (poverty-income-ratio, age, and gender).

Conclusion

Among African Americans, we found that not only does depression lead to 2.5 times higher overall mortality but also rheumatoid arthritis occurrence affects this relationship even after controlling for potential confounders. As for treatment, African Americans are treated less with Disease-Modifying Anti-Rheumatic Drugs (DMARDS) than Caucasians according to previous research. Prevention and treatment programs for rheumatoid arthritis and screening for depression are especially important to treat comorbidities and to implement social change.

Disclosure

S. Banerjee: None. J. Khubchandani: None. M. Mesidor: None. P. Lane: None. R. Gonzales-Lagos: None.
P132 Longitudinal changes in the Scleroderma Health Assessment Questionnaire visual analogue scales in patients with systemic sclerosis: a retrospective cohort study
Authors: Hughes Michael , Sylvestre Yvonne , Manning Joanne , Mandzuk Melissa , Samaranayaka Muditha , Dinsdale Graham , Herrick Ariane
Published: April 2024

Background/Aims

The aim was to examine the course, impact of baseline predictors, and relationship with functional ability, of the six Scleroderma Health Assessment Questionnaire (SHAQ) visual analogue scales (VAS) over time in patients with SSc.

Methods

A retrospective analysis of patients attending annual review visits at a tertiary SSc center between 2005 and February 2020. Linear Mixed-effect models were used to assess longitudinal trajectories and effect of potential prognostic factors on the six different SHAQ VAS, except finger ulcers where the VAS scale was dichotomised (presence/absence) and analysed using a random intercept logistic regression model. To assess whether longitudinal changes in SHAQ VAS correlated with the HAQ-DI/11-point scleroderma functional index, we obtained the gradients of individual linear regression models, overall and by disease type.

Results

537 patients (75% lcSSc) with at ≥ 2 available time-points were included. Mean follow-up time and number of review visits were 6.8 (SD = ±4.2) years 6.4 (SD = ±3.7) visits, respectively. The mean (SD) RP and disease duration (defined as the first non-RP symptom) were 7.6 (11.9) and 8.0 (8.2) years, respectively. Time-in-study (Table 1) was associated with increase in VAS intestinal (p = 0.004), overall disease (p = 0.001) and presence of ulcers (p = 0.013). There was a trend observed concerning RP VAS (p = 0.068) and VAS breathing (p = 0.074), and no difference with VAS pain (p = 0.183). Time since RP onset showed a significant negative association with VAS pain (b=-0.01, [95%CI= -0.01 to 0.00], p = 0.032). Age had a significant negative effect on intestinal VAS (b=-0.01 [95%CI= -0.01 to -0.00], p = 0.040). Presence of ulcers increased with disease duration (OR = 0.97 [95%Cl= 0.94 to 1.00], p = 0.026), and in those with diffuse disease (OR = 0.54 [95%CI= 0.31 to 0.95], p = 0.033). For patients who were anti-RNP positive (compared to negative), the overall disease score VAS was higher (b = 0.23, 95%Cl= 0.00 to 0.45, p = 0.048) higher. All correlations between SHAQ VAS scales and function (HAQ-DI and 11-point scleroderma functional index) were positive (Table 2), and were almost exclusively stronger in patients with diffuse disease.

Conclusion

Longitudinal assessment of the SHAQ VAS scales provides important insights into disease trajectory. We have identified baseline factors associated with VAS outcomes, and associations with function over time.

Disclosure

M. Hughes: None. Y. Sylvestre: None. J. Manning: None. M. Mandzuk: None. M. Samaranayaka: None. G. Dinsdale: None. A. Herrick: None.
E039 Multiple myeloma and neurological complications: prevalence and risk factors
Authors: Dhifallah Malek , Fenniche Insaf , Feki Afef , Djemaa Samar Ben , Kallel Med Hedi , Fourat Hela , Akrout Rim , Baklouti Sofien
Published: April 2024

Background/Aims

Multiple myeloma (MM) is a malignant haematological disorder with a highly variable clinical presentation. Few studies have explored the neurological complications (CN) associated with MM. The objectives of this study were to describe the neurological manifestations observed in MM and to determine predictive factors for neurological complications.

Methods

We collected data from 126 cases of symptomatic multiple myeloma patients followed in our department over a 30-year period (1993 - 2023). We gathered sociodemographic, clinical, and laboratory data. Neurological complications were diagnosed based on clinical findings and magnetic resonance imaging data.

Results

Our study included 126 patients with an average age of 65.23 ± 11.63 years [36-92], and a male-to-female sex ratio of 3.8. Bone pain was present in 92.1% (116 cases) with an average duration of 4 months. The mean erythrocyte sedimentation rate and C-reactive protein levels were 99.08 mm at H1 [3-190] and 27.74 [0-196], respectively. Hemoglobin levels were less than 10g/dl in 51.2% of cases, with an average of 9.902 ± 2.22 g/dl [5-13.9]. Calcium levels exceeded 2.75 mmol/l in 20% of cases, with an average of 2.49 ± 0.33 mmol/l. The mean creatinine level was 88.28 ± 77.9 μmol/l [36-587], with levels above 177 μmol/l observed in 15 cases (10.4%). The Durie and Salmon prognostic classification categorized our patients as follows: Stage IA (3.2%), Stage IIA (4%), Stage IIB (0.8%), Stage IIIA (72.2%), and Stage IIIB (18.3%). Neurological complications were present in 22.2% of patients (n = 28). Sixteen patients (12.7%) had spinal cord compression, with nine having dorsal involvement, six having conus medullaris involvement, and one having cervical involvement. Radicular pain affected 14 patients, with eight experiencing sciatalgia and four having cruralgia. Two patients (1.8%) had carpal tunnel syndrome. No cerebral involvement was observed in our series. In our study, only creatinine levels were significantly lower in patients who developed neurological complications (64.35 vs. 95.19, p = 0.004). However, the occurrence of neurological complications was independent of age (p = 0.696), duration of evolution (p = 0.669), erythrocyte sedimentation rate (p = 0.541), C-reactive protein (p = 0.963), hemoglobin (p = 0.076), or calcium levels (p = 0.274). No association was found between neurological complications and gender (p = 0.849) or prognostic stage (p = 0.119)

Conclusion

Neurological manifestations in MM are diverse and often underestimated. The diagnosis of MM should be considered in the presence of spinal or radicular compression, especially when the laboratory findings suggest it.

Disclosure

M. Dhifallah: None. I. Fenniche: None. A. Feki: None. S. Ben Djemaa: None. M. Kallel: None. H. Fourat: None. R. Akrout: None. S. Baklouti: None.
Marginal and Obsolete? Rural Hospitals in Early Modern Europe: A Case Study of Catalonia
Authors: Marfany Julie
Published: April 2024

Small local hospitals have been neglected by historians, and frequently assumed to have been marginal to their communities and largely obsolete by the eighteenth century. This paper questions such assumptions via a case study of Catalonia. It provides the first comprehensive estimates for the number of hospitals over the course of the eighteenth century, and then examines a sample of surviving accounts and other documentation to analyse the extent and nature of care provided. While the quality of care varied and most hospitals were restricted by their income, particularly against a background of war and rising prices, many nevertheless provided considerable care both to transient populations of foundlings and migrants and to their local communities. The paper calls for a re-evaluation of these forms of care in line with the re-evaluation of women’s caring work.
Cortactin controls bone homeostasis through regulating the differentiation of osteoblasts and osteoclasts
Authors: Yang Xiaoli , Chen Meng , Wang Shuang , Hu Xingli , Zhou Jie , Yuan Hairui , Zhu Endong , Wang Baoli
Published: April 2024

Cortactin (CTTN), a cytoskeletal protein and substrate of Src kinase, is implicated in tumor aggressiveness. However, its role in bone cell differentiation remains unknown. The current study revealed that CTTN was upregulated during osteoblast and adipocyte differentiation. Functional experiments demonstrated that CTTN promoted the in vitro differentiation of mesenchymal stem/progenitor cells into osteogenic and adipogenic lineages. Mechanistically, CTTN was able to stabilize the protein level of mechanistic target of rapamycin kinase (mTOR), leading to the activation of mTOR signaling. In-depth investigation revealed that CTTN could bind with casitas B lineage lymphoma-c (c-CBL) and counteract the function of c-CBL, a known E3 ubiquitin ligase responsible for the proteasomal degradation of mTOR. Silencing c-Cbl alleviated the impaired differentiation of osteoblasts and adipocytes caused by CTTN siRNA, while silencing mTOR mitigated the stimulation of osteoblast and adipocyte differentiation induced by CTTN overexpression. Notably, transplantation of CTTN-silenced bone marrow stromal cells (BMSCs) into the marrow of mice led to a reduction in trabecular bone mass, accompanied by a decrease in osteoblasts and an increase in osteoclasts. Furthermore, CTTN-silenced BMSCs expressed higher levels of receptor activator of nuclear factor κB ligand (RANKL) than control BMSCs did and promoted osteoclast differentiation when cocultured with bone marrow-derived osteoclast precursor cells. This study provides evidence that CTTN favors osteoblast differentiation by counteracting the c-CBL-induced degradation of mTOR and inhibits osteoclast differentiation by downregulating the expression of RANKL. It also suggests that maintaining an appropriate level of CTTN expression may be advantageous for maintaining bone homeostasis.
Parasitic Nematodes of Sugarcane: A Major Productivity Impediment and Grand Challenges in Management
Authors: Bhuiyan Shamsul A. , Sherring Kylie , Eglinton Jason
Published: April 2024

Sugarcane is an important cash crop grown in 137 countries, accounting for 80% of global sugar production. It supports the livelihood of more than 100 million people and up to 25% of the rural population in some countries. Plant-parasitic nematodes are one significant constraint in sugarcane production and can lead to a loss of up to 30% in productivity. More than 300 species of parasitic nematodes have been discovered in sugarcane soil. Owing to limited data, the potential damage to sugarcane crops caused by parasitic nematodes is often underestimated. The main nematodes present in sugarcane fields are root-lesion (Pratylenchus spp.), spiral (Helicotylenchus spp.), root-knot (Meloidogyne spp.), dagger (Xiphinema spp.), stunt (Tylenchorhynchus spp.), ring (Criconemella spp.), and stubby (Paratrichodorus spp.). Among these, Meloidogyne javanica and Pratylenchus zeae are the most damaging nematode species. Management of nematodes is a challenging task as there are no clear symptoms of their presence, and they often come in multiple species with varying levels of pathogenicity. Moreover, the management options available are not always effective. Integrated nematode management is a sustainable strategy for controlling nematode infestations. It involves using all possible methods to suppress the parasitic nematode population in a compatible manner and reduce it below economic threshold levels. This article focuses on the challenges of managing nematodes in sugarcane and highlights the opportunity for implementing a sustainable nematode management strategy.
Automated Insulin Delivery in Women With Pregnancy Complicated by Type 1 Diabetes
Authors: Lee Tara T.M. , Collett Corinne , Bergford Simon , Hartnell Sara , Scott Eleanor M. , Lindsay Robert S. , Hunt Katharine F. , McCance David R. , Barnard-Kelly Katharine , Rankin David , Lawton Julia , Reynolds Rebecca M. , Flanagan Emma , Hammond Matthew , Shepstone Lee , Wilinska Malgorzata E. , Sibayan Judy , Kollman Craig , Beck Roy , Hovorka Roman , Murphy Helen R. ,   for the AiDAPT Collaborative Group
Published: April 2024

(Abstracted from N Engl J Med 2023;389:1566–1578

Hyperglycemia during pregnancy is an important risk factor for complications, such as preterm birth, large birth weight, and admission to the intensive care unit. Those at highest risk already have glycated hemoglobin above target levels at the start of pregnancy.
Early Metformin in Gestational Diabetes
Authors: Dunne Fidelma , Newman Christine , Alvarez-Iglesias Alberto , Ferguson John , Smyth Andrew , Browne Marie , O’Shea Paula , Devane Declan , Gillespie Paddy , Bogdanet Delia , Kgosidialwa Oratile , Egan Aoife , Finn Yvonne , Gaffney Geraldine , Khattak Aftab , O’Keeffe Derek , Liew Aaron , O’Donnell Martin
Published: April 2024

(Abstracted from JAMA 2023;330(16):1547–1556

Worldwide, about 2.93 million pregnancies are complicated by gestational diabetes mellitus (GDM) annually. GDM is associated with an increased risk of maternal adverse outcomes, such as weight gain, cesarean delivery (CD), and preeclampsia, as well as fetal adverse outcomes, such as admission to the neonatal intensive care unit (NICU) due to birth injuries and respiratory disease.