bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical guidance of pyoderma gangrenosum 2022
Authors: Yamamoto Toshiyuki , Yamasaki Kenshi , Yamanaka Keiichi , Komine Mayumi , Kawakami Tamihiro , Yamamoto Osamu , Kanekura Takuro , Higuchi Tetsuya , Takahashi Toshiya , Matsushima Yoshiaki , Kikuchi Nobuyuki ,   Japanese Dermatological Association Pyoderma Gangrenosum Treatment Guidelines Drafting Committee
Published: June 2023

Pyoderma gangrenosum (PG) is a rare, neutrophilic skin disease. For the purpose of accurate diagnosis and proper treatment of PG, the Japanese clinical practice guidance for PG developed by the Japanese Dermatological Association was published in 2022. In this guidance, clinical aspects, pathogenesis, current therapies, and clinical questions on PG are described from the viewpoints of current knowledge and evidence‐based medicine. Here, the English version of the Japanese clinical practice guidelines for PG is presented and is intended to be widely referred to in the clinical examination and treatment of PG.
Post‐cardiac arrest intensive care in Sweden: A survey of current clinical practice
Authors: Järpestam Sara , Martinell Louise , Rylander Christian , Lilja Linus
Published: June 2023

Background

European guidelines recommend targeted temperature management (TTM) in post‐cardiac arrest care. A large multicentre clinical trial, however, showed no difference in mortality and neurological outcome when comparing hypothermia to normothermia with early treatment of fever. The study results were valid given a strict protocol for the assessment of prognosis using defined neurological examinations. With the current range of recommended TTM temperatures, and applicable neurological examinations, procedures may differ between hospitals and the variation of clinical practice in Sweden is not known.

Aim

The aim of this study was to investigate current practice in post‐resuscitation care after cardiac arrest as to temperature targets and assessment of neurological prognosis in Swedish intensive care units (ICUs).

Methods

A structured survey was conducted by telephone or e‐mail in all Levels 2 and 3 (= 53) Swedish ICUs during the spring of 2022 with a secondary survey in April 2023.

Results

Five units were not providing post‐cardiac arrest care and were excluded. The response rate was 43/48 (90%) of the eligible units. Among the responding ICUs, normothermia (36–37.7°C) was applied in all centres (2023). There was a detailed routine for the assessment of neurological prognosis in 38/43 (88%) ICUs. Neurological assessment was applied 72–96 h after return of spontaneous circulation in 32/38 (84%) units. Electroencephalogram and computed tomography and/or magnetic resonance imaging were the most common technical methods available.

Conclusion

Swedish ICUs use normothermia including early treatment of fever in post‐resuscitation care after cardiac arrest and almost all apply a detailed routine for the assessment of neurological prognosis. However, available methods for prognostic evaluation varies between hospitals.
Emergency medicine physician workforce attrition differences by age and gender
Authors: Gettel Cameron J. , Courtney D. Mark , Agrawal Pooja , Madsen Tracy E. , Rothenberg Craig , Mills Angela M. , Lall Michelle D. , Keim Samuel M. , Kraus Chadd K. , Ranney Megan L. , Venkatesh Arjun K.
Published: June 2023

Background

Emergency care workforce concerns have gained national prominence given recent data suggesting higher than previously estimated attrition. With little known regarding characteristics of physicians leaving the workforce, we sought to investigate the age and number of years since residency graduation at which male and female emergency physicians (EPs) exhibited workforce attrition.

Methods

We performed a repeated cross‐sectional analysis of EPs reimbursed by Medicare linked to date of birth and residency graduation date data from the American Board of Emergency Medicine for the years 2013–2020. Stratified by gender, our primary outcomes were the median age and number of years since residency graduation at the time of attrition, defined as the last year during the study time frame that an EP provided clinical services. We constructed a multivariate logistic regression model to examine the association between gender and EP workforce attrition.

Results

A total of 25,839 (70.2%) male and 10,954 (29.8%) female EPs were included. During the study years, 5905 male EPs exhibited attrition at a median (interquartile range [IQR]) age of 56.4 (44.5–65.4) years, and 2463 female EPs exhibited attrition at a median (IQR) age of 44.0 (38.0–53.9) years. Female gender (adjusted odds ratio 2.30, 95% confidence interval 1.82–2.91) was significantly associated with attrition from the workforce. Male and female EPs had respective median (IQR) post–residency graduation times in the workforce of 17.5 (9.5–25.5) years and 10.5 (5.5–18.5) years among those who exhibited attrition and one in 13 males and one in 10 females exited clinical practice within 5 years of residency graduation.

Conclusions

Female physicians exhibited attrition from the EM workforce at an age approximately 12 years younger than male physicians. These data identify widespread disparities regarding EM workforce attrition that are critical to address to ensure stability, longevity, and diversity in the EP workforce.
Silencing the call of the wild – howling behaviour and responses of the wolf to Anthropocene in India
Authors: Sadhukhan S. , Khan S. , Habib B.
Published: June 2023

Wolves use howls to maintain large territories, intra‐pack communication and social bonding. Besides their physical presence, howls are also instrumental in creating fear and impacting foraging behaviour among the lower cascade. Anthropocene‐led behavioural alteration in vocalization has been observed in a wide range of species, but the effect on wolf howl is unknown. In this context, we have studied the howling behaviour of the Indian wolf through playback surveys (n = 264) across the anthropogenic gradient. We found a disparity in their howl response – based on the distance to villages. In the low disturbed East‐Maharashtra (EM), wolves mostly avoided responding to howling surveys (HS) if done within 1200 m of villages [response rate (RR) = 0.03 ± 0.021], but they did respond once it was done far from villages (>1200 m) (RR = 0.226 ± 0.075). In high human‐density West‐Maharashtra (WM), wolves showed high RR within 1200 m from the villages (RR = 0.148 ± 0.031). But the RR within 500 m from villages was less as howling near villages might lead to easy detection. The collared wolf data showed significantly high RR (0.635 ± 0.067) in their home‐range core, but low RR if the core area was close to a village. Therefore, howling too close to a village is disadvantageous, although their tolerance for responding to HS has increased in the human‐dominated landscape. The extent of the village may increase further with development, which will leave fewer areas for the wolf to defend territory with a long‐range howl. The wolves might behaviourally adapt to a human‐modified landscape by reducing their howling intensity. Adaptation to a fragmented habitat may save the wolves from extinction, but the repercussions of the fundamental behavioural alteration might adversely impact wolf behaviour and the ecological cascade. Whereas ecologists are mainly concerned with the extinction of species, this study highlights the vulnerability of fundamental behaviour of a keystone species attributed to human‐induced contemporary evolution.
A structural variant at ASIP associated with the darkness of hair coat is found in multiple zebu cattle populations
Authors: Trigo Beatriz Batista , Alves Natália Fonseca , Milanesi Marco , Garcia José Fernando , Terefe Endashaw , Hanotte Olivier , Tijjani Abdulfatai , Utsunomiya Yuri Tani
Published: June 2023

A structural variant (SV) in the agouti signaling protein gene (ASIP), namely ASIP‐SV1, has been found to strongly correlate with the darkness of hair coat in specific regions of the body of bulls from the zebu (Bos indicus) Nellore breed. Here we visually analyzed the whole‐genome sequence of zebu and taurine (Bos taurus) cattle to elucidate the extent of spread of ASIP‐SV1 in different cattle populations. Of 216 sequences analyzed, 63 zebu (45.9%) and five taurine (6.3%) animals had at least one copy of ASIP‐SV1. Four of the taurine animals presenting the SV were Romagnola cattle, a breed with history of zebu introgression. The remaining taurine animal was a Simmental, a breed frequently used in crossbreeding. These data provide evidence that ASIP‐SV1 is commonly found in zebu populations, in addition to taurine animals with zebu admixture.
The Expressive Forms of Amazonian Indigenous Peoples and Ayahuasca: the Huni Kuin and other Pano groups
Authors: Goulart Sandra Lucia
Published: June 2023

I approach a set of processes that involve transformations, transpositions, and intermediations between different expressive forms of Amazonian Indigenous Peoples associated with the use of ayahuasca. I focus on groups of the Pano linguistic stock, particularly the Huni Kuin (Kaxinawa) and the example of the MAHKU (Movimento dos Artistas Huni Kuin), a new artistic collective created by some of these Indigenous People. I point to the complex meanings of the various expressive forms of these peoples, from traditional (oral narratives, graphics, visionary images linked to shamanic practices) to more recently adopted (figurative drawing and graphic recording in book format). I emphasize the importance of ayahuasca for the elaboration of these different expressive forms. By highlighting the meanings that imply the use of ayahuasca in certain Indigenous contexts, I also intend to contribute to the expansion of understanding of and broader debate about psychedelic experiences.
Further investigation of lead exposure as a potential threatening process for a scavenging marsupial species
Authors: Hutchinson DJ , Jones EM , Pay JM , Clarke JR , Lohr MT , Hampton JO
Published: June 2023

There is a growing recognition of the harmful effects of lead exposure on avian and mammalian scavengers. This can lead to both lethal and non‐lethal effects which may negatively impact wildlife populations. Our objective was to assess medium‐term lead exposure in wild Tasmanian devils (Sarcophilus harrisii). Frozen liver samples (n = 41), opportunistically collected in 2017–2022, were analysed using inductively coupled plasma mass spectrometry (ICP‐MS) to determine liver lead concentrations. These results were then used to calculate the proportion of animals with elevated lead levels (>5 mg/kg dry weight) and examine the role of explanatory variables that may have influenced the results. The majority of samples analysed were from the south‐east corner of Tasmania, within 50 km of Hobart. No Tasmanian devil samples were found to have elevated lead levels. The median liver lead concentration was 0.17 mg/kg (range 0.05–1.32 mg/kg). Female devils were found to have significantly higher liver lead concentrations than males (P = 0.013), which was likely related to lactation, but other variables (age, location, body mass) were not significant. These results suggest that wild Tasmanian devil populations currently show minimal medium‐term evidence of exposure to lead pollution, although samples were concentrated in peri‐urban areas. The results provide a baseline level which can be used to assess the impact of any future changes in lead use in Tasmania. Furthermore, these data can be used as a comparison for lead exposure studies in other mammalian scavengers, including other carnivorous marsupial species.
An unusual occurrence of autoimmune pancreatitis after gam‐Covid‐Vac (Sputnik V): A case report and literature review
Authors: Chahed Ferdaous , Ben Fadhel Najah , Maamri Kais , Abdelali Mabrouk , Ben Romdhane Haifa , Chadli Zohra , Ben Fredj Nadia , Zrig Ahmed , Aouam Karim , Chaabane Amel
Published: June 2023

The safety profile of the Sputnik V vaccine is generally reassuring. Nevertheless, an enhanced risk of new‐onset of immune‐mediated diseases has been increasingly reported following the adenoviral‐based Covid‐19 vaccine, including inflammatory arthritis, Guillain‐Barré syndrome, optical neuromyelitis, acute disseminated encephalomyelitis, subacute thyroiditis and acute liver injury as well as glomerulopathy. However, no case of autoimmune pancreatitis has been reported yet. Herein, we describe a case of type I autoimmune pancreatitis that may be due to the Sputnik V Covid‐19 vaccine.
Green side of informal institutions: Social trust and environmental sustainability
Authors: Sun Daxin , Zhang Yaxin , Meng Xiaohua
Published: June 2023

Informal institutions are found to shape the behaviors of economic organizations within the business world by creating localized social norms and moral commitments. However, the existing literature pays greater attention to the financial consequences of such institutions, and little is known about their environmental impacts, especially in the context of transition economies. By linking institutional theory with environmental strategy literature, in this study, we develop a theoretical framework and empirically test how social trust, one of the dimensions of informal institutions, influences corporate environmental responsibility. Using a longitudinal data set of Chinese listed firms from 2006 to 2015, we find support that firms located in regions with a higher level of social trust engage in more environmental responsibility activities. We also show that this effect is more pronounced when local environmental protests are fewer and information transparency is worse. Our findings highlight the importance of social trust in environmental governance and provide evidence of how it serves as a substitute for formal environmental institutions in transition economies.
A Double-Robust Test for High-Dimensional Gene Coexpression Networks Conditioning on Clinical Information
Authors: Ding Maomao , Li Ruosha , Qin Jin , Ning Jing
Published: June 2023

It has been increasingly appealing to evaluate whether expression levels of two genes in a gene coexpression network are still dependent given samples' clinical information, in which the conditional independence test plays an essential role. For enhanced robustness regarding model assumptions, we propose a class of double-robust tests for evaluating the dependence of bivariate outcomes after controlling for known clinical information. Although the proposed test relies on the marginal density functions of bivariate outcomes given clinical information, the test remains valid as long as one of the density functions is correctly specified. Because of the closed-form variance formula, the proposed test procedure enjoys computational efficiency without requiring a resampling procedure or tuning parameters. We acknowledge the need to infer the conditional independence network with high-dimensional gene expressions, and further develop a procedure for multiple testing by controlling the false discovery rate. Numerical results show that our method accurately controls both the type-I error and false discovery rate, and it provides certain levels of robustness regarding model misspecification. We apply the method to a gastric cancer study with gene expression data to understand the associations between genes belonging to the transforming growth factor β signaling pathway given cancer-stage information.
Enhancing intraoral scanner accuracy using scan aid for multiple implants in the edentulous arch: An in vivo study
Authors: Kernen Florian , Brändle Dominik , Wagendorf Oliver , Recca Mario , Mehrhof Jürgen , Vach Kirstin , Nahles Susanne , Nelson Katja , Flügge Tabea
Published: June 2023

Objectives

Intraoral scans of multiple implants in the edentulous arch are challenged by the absence of a distinct surface morphology between scan bodies. A scan aid was applied in such situation and evaluated for intraoral scanning accuracy in vivo.

Materials and Methods

87 implants in 22 patients were scanned with scan aid (SA) and without scan aid (NO) using two different intraoral scanners (CS3600 [CS] and TRIOS3 [TR]). Master casts were digitized by a laboratory scanner. Virtual models were superimposed using an inspection software and Linear deviation and precision were measured. Statistical analysis was performed using linear mixed models (α = .05).

Results

Total mean linear deviation within the CS group was 189 μm without scan aid and 135 μm when using the scan aid. The TR group's total mean deviation was 165 μm with and without a scan aid. Significant improvement with scan aid was observed for the CS group (p = .001), and no difference was found in the TR group. 96% of scan bodies were successfully scanned in the TR‐SA group compared to 86% for the TR‐NO group, 83% for the CS‐SA, and 70% for the CS‐NO group, respectively.

Conclusions

The evaluated scan aid improved linear deviation compared to unsplinted scans for the CS group but not for the TR group. These differences could originate from different scanning technologies used, active triangulation (CS) and confocal microscopy (TR). The scan aid improved the ability to recognize scan bodies successfully with both systems, which could have a favorable clinical impact overall.
The Underside of Microfinance: Performance Indicators and Informal Debt in Cambodia
Authors: Green W. Nathan , Chhom Theavy , Mony Reach , Estes Jennifer
Published: June 2023

Microfinance is a dominant strategy used to promote rural development around the world. Rather than directly track its impact on borrowers, however, microfinance institutions rely on indicators of financial performance adopted from commercial banking as proxies for positive social impact. Yet, as critical research has shown, the industry depends on coercive peer pressure, social shaming and various forms of gendered exploitation to achieve its high rates of loan repayment. This article maintains that there is a need to investigate how the microfinance industry's own indicators of impact contribute to the ways microfinance can harm borrowers. Based on qualitative research in Cambodia during 2021 and 2022, the article demonstrates how financial performance indicators, most notably portfolio quality, both hide and exacerbate the ways that borrowers juggle debt between formal and informal lenders. In making this argument, the article advances critical scholarship on microfinance by showing how microfinance repayment structures debt‐juggling practices in ways that put borrowers at greater risk of over‐indebtedness. As a result, the microfinance industry is able to claim that it successfully helps to alleviate poverty, even as it accumulates profits by appropriating wealth from poor and low‐income households across the global South.
Comparative efficacy and safety of Gla‐300 versus IDegAsp in insulin‐naïve people with type 2 diabetes mellitus uncontrolled on oral anti‐diabetics
Authors: Ritzel Robert , Ghosh Sujoy , Emral Rifat , Malek Rachid , Zeng Longyi , Mabunay Maria Aileen , Landgraf Wolfgang , Guyot Patricia , Serafini Paul , Pushkarna Divya , Malik Rayaz A.
Published: June 2023

Aim

To compare the efficacy and safety of insulin glargine‐300 once daily (Gla‐300) with insulin degludec/aspart (IDegAsp) once daily in patients with type 2 diabetes (T2D) inadequately controlled on oral anti‐diabetic drugs (OADs).

Materials and methods

A systematic literature review of randomized controlled trials was followed by an indirect treatment comparison of studies involving insulin naïve adults, inadequately controlled [glycated haemoglobin (HbA1c) ≥7.0%] on OADs, who received Gla‐300 or IDegAsp once daily. Outcomes of interest were change in HbA1c, blood glucose, weight and insulin dose, as well as incidence and event rate of hypoglycaemia and other adverse events.

Results

Four trials with broadly similar baseline patient characteristics were included in the meta‐analyses and indirect treatment comparison. At 24‐28 weeks, the indirect comparison of Gla‐300 to IDegAsp once daily estimated no statistically significant difference for change in HbA1c (%) from baseline [mean difference of 0.10% (95% CI: −0.20, 0.39; p = .52)]; a statistically significant mean difference of −1.31 kg (95% CI: −1.97, −0.65; p < .05) for change in body weight from baseline; statistically significant odds ratios of 0.62 (95% CI: 0.41, 0.93; p < .05) for incidence of any hypoglycaemia; and 0.47 (95% CI: 0.25, 0.87; p < .05) for incidence of anytime confirmed hypoglycaemia (plasma glucose <3.0‐3.1 mmol/L). No significant differences were observed for insulin dose and adverse events.

Conclusion

In insulin‐naïve patients with T2D inadequately controlled on OADs, commencing Gla‐300 shows a comparable HbA1c reduction, but with significantly less weight gain and a lower incidence of any and confirmed hypoglycaemia compared with commencing IDegAsp.
Liver fibrosis markers and all cause mortality in people with type 2 diabetes: A population based study (The Ayrshire Diabetes Outcomes Cohort (ADOC) Study)
Authors: Collier Andrew , Curran Christopher , Cameron Lyall , Wild Sarah H. , Byrne Christopher D.
Published: June 2023

Aims

To describe the distribution of the biomarker scores Fibrosis‐4 (FIB4), nonalcoholic fatty liver disease (NAFLD) fibrosis score (NFS), and aspartate aminotransferase to platelet ratio index (APRI), and the associations between risk categories and all‐cause mortality.

Materials and Methods

This was a retrospective cohort study of 12 589 patients, with follow‐up from January 2012 until November 2021. The cut‐off points used to identify low risk were: FIB4 <1.3 if aged <65 years or <2.0 if aged ≥65 years; NFS < −1.455 if aged <65 years or <0.12 if aged ≥ 65 years; APRI <1 (independent of age). High‐risk cut‐off points were FIB4 >2.67, NFS >0.676 and APRI ≥1 (all independent of age). Multivariable Cox regression analysis was performed to assess the association between liver fibrosis scores and all‐cause mortality.

Results

The mean ± standard deviation age was 65.2 ± 12.1 years, 54.5% were men and the median (interquartile range) diabetes duration was 5.8 (2.8–9.3) years. The prevalence of high‐risk categories was 6.1% for FIB4, 23.5% for NFS and 1.6% for APRI. During a median follow‐up of 9.8 years, 3925 patients (31.1%) died, resulting in a crude mortality rate of 40.4 per 1000 person‐years. The overall adjusted all‐cause mortality hazard ratios (95% confidence intervals [CIs]) in the high‐ compared with low‐fibrosis‐risk groups were 3.69 (1.95–2.75) for FIB4, 2.32 (2.88–4.70) for NFS, and 3.92 (2.88–5.34) for APRI. Stratified adjusted all‐cause mortality hazard ratios for individuals under 65 years and people over 65 years of age at cohort entry were 3.89 (95% CI 2.99–5.05) and 1.44 (95% CI 1.28–1.61) for FIB4, 2.50 (95% CI 1.89–3.18) and 1.35 (95% CI 1.24–1.48) for NFS and 3.74 (95% CI 2.73–5.14) and 1.64 (95% CI 1.24–2.17) for APRI.

Conclusions

All three fibrosis risk scores were positively associated with all‐cause mortality in people with type 2 diabetes, with higher relative risks in younger than older people. Effective interventions are required to minimize excess mortality in people at high risk of liver fibrosis.
Safety, tolerability, pharmacokinetics and pharmacodynamics of multiple ascending doses of the novel long‐acting glucagon analogue HM15136 in overweight and obese patients with co‐morbidities
Authors: Shin Wonjung , Hompesch Marcus , Byeon JinHee , Kang Seohyun , Choi Jaehyuk , Baek Seungjae
Published: June 2023

Aim

To evaluate the safety, tolerability, pharmacokinetics and pharmacodynamics of multiple ascending doses of the novel long‐acting glucagon analogue HM15136 in overweight/obese patients with co‐morbidities, with and without type 2 diabetes (T2D).

Materials and Methods

This was a phase 1, double‐blind, randomized, placebo‐controlled, two‐part trial with a 12‐week treatment period of once‐weekly subcutaneous HM15136 (0.02/0.04/0.06 mg/kg). Part 1 included patients with dyslipidaemia and/or hypertension and no T2D. Part 2 included patients with dyslipidaemia and/or hypertension plus T2D.

Results

In part 1, 23/27 (85.2%) patients receiving HM15136 and all patients receiving placebo (9/9 [100%]) experienced a treatment‐emergent adverse event (TEAE). Five of 27 (18.5%) patients receiving HM15136 developed anti‐HM15136 antibodies. Dose‐dependent increases in mean HM15136 serum concentration and fasting plasma glucose (FPG) were observed, as were dose‐dependent weight reductions of 0.5%/2.3%/2.6% at doses of 0.02/0.04/0.06 mg/kg, respectively. In part 2, 8/12 (66.7%) patients receiving HM15136 and all patients receiving placebo (4/4 [100.0%]) reported a TEAE. Two (16.7%) patients developed anti‐HM15136 antibodies. Dose‐dependent increases in mean HM15136 serum concentration were observed. FPG of more than 200 mg/dL was reported in 4/9 (44.4%) and 2/3 (66.7%) patients receiving 0.02 and 0.06 mg/kg, respectively. The 0.06 mg/kg dose was not tolerated in part 2 because of hyperglycaemia. Patients receiving 0.02 mg/kg showed a 0.9% weight reduction. No serious TEAEs leading to discontinuation were reported in either study part.

Conclusions

This study of HM15136 provides a preliminary safety and tolerability profile with initial insights into its efficacy profile.
Sumatriptan, a serotonin 5HT1B receptor agonist, acutely reduces insulin secretion and sensitivity and glucose effectiveness in overweight humans: A double‐blinded placebo‐controlled cross‐over trial
Authors: Golubic Rajna , Hussein Ismail Mouhamad , Josipovic Masa , Kennet Jane , Galderisi Alfonso , Evans Mark L.
Published: June 2023

Aim

Evidence from mouse models suggests that brain serotonergic pathways control blood glucose. We hypothesized that sumatriptan (5HT1B‐receptor agonist) would alter glucose homeostasis in humans.

Materials and Methods

We conducted a two‐visit random‐order double‐blinded placebo‐controlled cross‐over trial in 10 overweight adults that were otherwise healthy. Participants received sumatriptan (single dose, 100 mg) or placebo before undergoing a 60‐min intravenous glucose tolerance test, followed by a 120‐min hyperinsulinaemic euglycaemic clamp.

Results

Glucose excursion was greater during intravenous glucose tolerance test with sumatriptan compared with placebo [iAUC0‐60 min 316 (268‐333) vs. 251 (197‐319) min/mmol/L p = .047]. This was probably explained by a combination of reduced circulating insulin levels [iAUC0‐10 min 1626 (1103‐2733) vs. 2336 (1702‐3269) min/pmol/L, p = .005], reduced insulin sensitivity [M/I‐value 2.11 (1.15, 4.05) vs. 3.03 (1.14, 4.90) mg/kg/min per pmol/L, p = .010] and glucose effectiveness [SG 0.17 (0.12, 0.21) vs. 0.22 (0.18, 0.65)/min, p = .027].

Conclusions

5HT1B receptors have a glucoregulatory role in humans, probably acting on insulin secretion, insulin sensitivity and glucose effectiveness.
Larval diet impacts flight performance in monarch butterflies
Authors: Ebada Ali , de Roode Jacobus C. , Majewska Ania A.
Published: June 2023

Few studies have described the effects of larval diet quality on adult insect flight performance. Flight muscle development and high‐powered flight in insects are associated with costly energetic demands. Because larval diet is the energy source that powers these mechanisms, we asked whether larval diet has an impact on flight performance and metabolism in the monarch butterfly (Danaus plexippus Linnaeus).

Monarch caterpillars from the eastern North American and Puerto Rican populations were fed a diet of either Asclepias incarnata L. (native to the eastern North American population) or Asclepias curassavica L. (native to the Puerto Rican population and uncommon in eastern North America). We flew the monarchs on a tethered flight mill to acquire flight performance metrics including velocity, distance, duration, power, and oxygen consumption rate.

Monarchs reared on the A. incarnata L. milkweed showed slower, shorter, and less powerful flights than those fed on A. curassavica L. However, eastern North American and Puerto Rican monarchs, which were reared under summer conditions, did not differ in flight metrics or post‐flight metabolic rates.

The results suggest that flight in eastern North American and Puerto Rican monarchs is similar during the breeding season, yet the milkweed the caterpillars consume has important implications for flight performance.
Host plant selection by Cerambycidae in two different strata in association with seasonality and physical wood characteristics in a tropical dry forest
Authors: Vargas‐Cardoso Orthon Ricardo , Toledo‐Hernández Víctor Hugo , Corona‐López Angélica M. , Flores‐Palacios Alejandro , Figueroa‐Brito Rodolfo , Sosa‐Armenta Jessica Maria , López‐Martínez Víctor
Published: June 2023

1. There is little information on tropical dry forests regarding cerambycids and their relationship with seasonality, vertical stratification, and physical characteristics of the wood they require to develop.

2. In this work, we determined whether cerambycids in a tropical dry forest of central Mexico differed in the selection of oviposition sites in two different strata throughout two seasons; the relationship between the time of exposure of branches and the emergence of cerambycids; the emergence of these insects in relation to the physical characteristics of the wood and its relationship with stratification and seasonality; and if there was a seasonal shift between strata by cerambycids. Branch segments from 81 woody plant species were cut and exposed to allow the cerambycids to oviposit; the branches were harvested in four 2‐month periods and placed in emergence chambers. For each plant species, we measured the density, decomposition rate, and offered volume of wood.

3. There was a greater quantity of generalist species of stratum (15) and season (12), and we found six important habitat indicator species: three species were significantly associated with the canopy and the dry season, two species preferred the dry season but not strata, and one species preferred both strata in the dry season and the ground during the rainy season. Cerambycid species generally selected soft and ephemeral wood resources.

4. Branch selection by cerambycids in Central Mexico is not random choice; it is determined by season, stratum, density, and especially by host type, decomposition, and volume. Finally, there is a greater abundance of cerambycids in the ground and a greater richness of species in the canopy.
Deep learning‐based image processing for financial audit risk quantification in healthcare
Authors: Ma Yanzhe
Published: June 2023

Recently, deep learning technology has gradually penetrated various fields. Today, the field of healthcare is also closely linked to deep learning technology. Image processing technology based on deep learning can accurately segment medical images, which is convenient for medical research and pathological analysis. Accurate distribution of images can effectively save medical resources. Therefore, image processing techniques can contribute to the quantification and assessment of economic audit risks. In recent years, medical image segmentation has achieved many research results. However, with the improvement of accuracy, the segmentation standards of medical images are also becoming more and more stringent. For medical images, they tend to have rough and fuzzy boundaries and noise disturbances of different shapes. The above problems pose challenges for accurate localization and segmentation of lesion regions. On the other hand, in the field of medical images, there are also problems such as unbalanced number of samples and scarcity of large medical image datasets. In response to these problems, this paper conducts research work and proposes an Attention Mechanism and Multi‐Scale spatial Pooling‐based conditional Adversarial Network (AM‐MSP‐cGAN) model to achieve automatic segmentation of medical images. AM‐MSP‐cGAN can learn more detailed features from fuzzy boundaries, and effectively solve the problem of data lack, thereby promoting economic audit risk quantification and assessment in the healthcare field.
Secondary orientation effects on the low cycle fatigue behaviors of rectangular‐sectional Ni‐based single crystal superalloys at medium and high temperatures
Authors: Rui Shao‐Shi , He Zhiwu , Guo Yiyun , Su Yue , Han Qi‐Nan , Ma Xianfeng , Shi Hui‐Ji
Published: June 2023

Turbine blades made of Ni‐based single crystal superalloys (NBSXs) have long‐strip shaped cross sections and rectangular‐sectional structures, where the secondary orientation produces potential effects even the primary orientation is fixed at [001]. Low cycle fatigue behaviors between [010] and [110] transversely oriented rectangular‐sectional NBSX specimens were compared. Obvious differences existed under 600°C but disappeared under 850°C, with the deformation mechanism and fracture mode transitions. Secondary orientation effects on stress asymmetry and fatigue life cannot be described by the conventional LCP model and critical plane method but were well explained by dislocation path length‐dependent back‐stress model and A.N. May's random slip model.
Ecological restoration in the age of apocalypse
Authors: Svejcar Lauren N. , Davies Kirk W. , Ritchie Alison L.
Published: June 2023

Billions of dollars are spent annually on ecological restoration efforts around the world and yet successful attainment of restoration targets still falls short in many regions. Globally, ecosystem restoration is becoming increasingly challenged with changes in climate. Years with extreme climatic events that limit plant establishment, such as severe drought, heatwaves, and floods are projected to increase in frequency. A critical evaluation of current ecological restoration practices and changes to those practices are needed to attain global restoration targets. For plant restoration, many efforts globally focus on planting in a single year following disturbance. The odds of restoration efforts being conducted in a year that is inconducive to plant establishment may be calculated using climatic risk data. We propose a risk‐mitigation approach to restoration wherein plantings are conducted across multiple years for projects in a bet‐hedging strategy and evaluated through an adaptive management approach.
Bringing migrants' perspectives in ‘migration as an adaptation strategy’ discourses
Authors: Van Praag Lore
Published: June 2023

Over the last few years, migration is increasingly being framed as an adaptation strategy to deal with climate change, to move away from apocalyptic representations of migration in debates on climate change. While acknowledging the merit of this discourse, this commentary calls for more attention to include migrants' perspectives in debates on environmental migration and reflecting on how such discourses work out in practice. As most studies have focused on regions of origin being impacted adversely by climate change, and the ability/willingness to migrate, the perspectives of migrants themselves and how they feel about their migration and integration, whether internally or internationally, facing slow‐onset or sudden climate impacts, have not been discussed thoroughly. This point of view is needed to grasp the preconditions of success for such discourses, as migrants occupy vulnerable positions in immigrant societies, but are pressured to have a ‘double engagement’ towards both the region of origin and destination.
The relationship between the incision line and position of the latissimus dorsi muscle for subcutaneous implantable cardioverter‐defibrillator intermuscular implantations
Authors: Sonoda Yusuke , Fukuzawa Koji , Kiuchi Kunihiko , Takami Mitsuru , Izawa Yu , Nakamura Toshihiro , Takahara Hiroyuki , Yamamoto Kyoko , Nakasone Kazutaka , Suzuki Yuya , Tani Kenichi , Iwai Hidehiro , Nakanishi Yusuke , Shoda Mitsuhiko , Murakami Atsushi , Yonehara Shogo , Hirata Ken‐ichi
Published: June 2023

Introduction

Intermuscular implantations of subcutaneous implantable cardioverter‐defibrillators (S‐ICD) have been recommended, but the position of the anterior border of the latissimus dorsi muscle (LDM) has not previously been evaluated in establishing an incision line to facilitate the intermuscular approach. The objective of this study is to evalua the position and trend of the anterior border of the LDM in patients who are candidates for implantable cardioverter‐defibrillators.

Methods

The distance from the back to the anterior border of the LDM (A) and the anterior–posterior width of the chest wall (B) were measured on computed tomography retrospectively, and the ratio (=A/B) was used as the position of the anterior border of the LDM. In addition, the variability and factors affecting the values were evaluated.

Results

An analysis was performed on 78 patients, and the position of the anterior border of the LDM (=A/B) exhibited a normal distribution, with a mean value of 0.53 ± 0.062 (0.41–0.69). The position of the anterior border of the LDM tended to be more anterior in younger, taller, male, primary prevention, nonheart failure, low brain natriuretic peptide level, and nondiabetic patients.

Conclusion

The position of the anterior border of the LDM varied from case to case with variable results. Conventional incisions on the midaxillary line may be inappropriate for intermuscular implantations, and the position of the anterior border of the LDM should be evaluated in each individual case to establish the incision line.
The effect of apigenin, an aryl hydrocarbon receptor antagonist, in Phthalate‐Exacerbated eosinophilic asthma model
Authors: Kim Seo‐Hee , Quoc Quang Luu , Park Hae‐Sim , Shin Yoo Seob
Published: June 2023

Endocrine disrupting chemicals have been known to contribute to the aggravation of inflammatory diseases including asthma. We aimed to investigate the effects of mono‐n‐butyl phthalate (MnBP) which is one of the representing phthalates, and its antagonist in an eosinophilic asthma mouse model. BALB/c mice were sensitized by intraperitoneal injection of ovalbumin (OVA) with alum and followed by three nebulized OVA challenges. MnBP was administered through drinking water administration throughout the study period, and its antagonist, apigenin, was orally treated for 14 days before OVA challenges. Mice were assessed for airway hyperresponsiveness (AHR), differential cell count and type 2 cytokines in bronchoalveolar lavage fluid were measured in vivo. The expression of the aryl hydrocarbon receptor was markedly increased when MnBP was administered. MnBP treatment increased AHR, airway inflammatory cells (including eosinophils), and type 2 cytokines following OVA challenge compared to vehicle‐treated mice. However, apigenin treatment reduced all asthma features, such as AHR, airway inflammation, type 2 cytokines, and the expression of the aryl hydrocarbon receptor in MnBP‐augmented eosinophilic asthma. Our study suggests that MnBP exposure may increase the risk of eosinophilic inflammation, and apigenin treatment may be a potential therapy for asthma exacerbated by endocrine‐disrupting chemicals.
The pro‐inflammatory signature of lipopolysaccharide in spontaneous contracting embryoid bodies differentiated from mouse embryonic stem cells
Authors: Scharmacher Jennifer , Wartenberg Maria , Sauer Heinrich
Published: June 2023

Embryonic stem (ES) cells differentiate towards all three germ layers, including cardiac cells and leukocytes, and may be therefore suitable to model inflammatory reactions in vitro. In the present study, embryoid bodies differentiated from mouse ES cells were treated with increasing doses of lipopolysaccharide (LPS) to mimic infection with gram‐negative bacteria. LPS treatment dose‐dependent increased contraction frequency of cardiac cell areas and calcium spikes and increased protein expression of α‐actinin. LPS treatment increased the expression of the macrophage marker CD68 and CD69, which is upregulated after activation on T cells, B cells and NK cells. LPS dose‐dependent increased protein expression of toll‐like receptor 4 (TLR4). Moreover, upregulation of NLR family pyrin domain containing 3 (NLRP3), IL‐1ß and cleaved caspase 1 was observed, indicating activation of inflammasome. In parallel, generation of reactive oxygen species (ROS), nitric oxide (NO), and expression of NOX1, NOX2, NOX4 and eNOS occurred. ROS generation, NOX2 expression and NO generation were downregulated by the TLR4 receptor antagonist TAK‐242 which abolished the LPS‐induced positive chronotropic effect of LPS. In conclusion, our data demonstrate that LPS induced a pro‐inflammatory cellular immune response in tissues derived from ES cells, recommending the in vitro model of embryoid bodies for inflammation research.
Predicting three categories of Dementia Assessment Sheet for Community‐based Integrated Care System 8‐items score‐based glycemic targets using the number of animal names recalled
Authors: Hiiragi Hiroko , Minami Taichi , Terauchi Yasuo
Published: June 2023

Aims/Introduction

The Dementia Assessment Sheet for Community‐based Integrated Care System 8‐items (DASC‐8) assesses memory, orientation, instrumental activities of daily living and basic activities of daily living. Category I (DASC‐8 score ≤10), category II (11 ≤ DASC‐8 score ≤16) and category III (DASC‐8 score ≥17) have been defined. Based on these categories, the glycemic targets in diabetes patients aged ≥65 years have been proposed by the Japan Diabetes Society and the Japan Geriatrics Society Joint Committee. DASC‐8 is difficult to apply to patients without family members or supportive persons. We propose a verbal fluency test as the screening tool.

Materials and Methods

We enrolled 69 inpatients aged ≥65 years with type 2 diabetes, who were administered the DASC‐8 and VF tests, which included recalling animal names and common nouns starting with a specified letter in 1 min. The relationship between DASC‐8 and verbal fluency test scores was investigated.

Results

Animal fluency correlated with DASC‐8 scores after adjustment for patient characteristics. Animal scores correlated with orientation, instrumental activities of daily living and basic activities of daily living scores of DASC‐8, and tended to show a relationship with DASC‐8 memory scores. An animal score ≥8 predicted category I with a sensitivity of 89% and a specificity of 57%. An animal score ≤6 predicted category III with a sensitivity of 85% and a specificity of 67%.

Conclusions

Animal scores would be useful in predicting the categories of DASC‐8. Animal fluency could be a screening tool of DASC‐8 when a patient's family member or supportive person is absent.
Sequential mergers under incomplete information
Authors: Cong Jiajia , Zhou Wen
Published: June 2023

We study sequential mergers under incomplete information where the follower is ignorant about the leader's merger synergy. When the follower's own synergy is sufficiently large, incomplete information induces both firms to merge more. These additional mergers benefit both firms and total welfare but hurt consumers. If the follower's synergy is very small, the leader is unable to take any strategic action, and most results are reversed. The analysis suggests that incomplete information strengthens the strategic complementarity between the two mergers and thereby increases the likelihood of a merger wave.
Diphenylcyclopropenone and platelet‐rich plasma in the management of severe or recalcitrant alopecia areata
Authors: Abd El‐Magid Wafaa Mohamed , Mohamed Raghda Alaa‐Eldeen , Elsharkawy Reham Ezz‐Eldawla
Published: June 2023

Background

Alopecia areata (AA) is a common disease characterized by hair loss with an autoimmune background. There are many lines of therapy, but no standard line for all cases. Consequently, treating severe forms of AA is challenging.

Objective

This study aimed to compare the efficacy and safety of the combination of diphenylcyclopropenone (DPCP) and platelet‐rich plasma (PRP) with DPCP alone in treating patients with severe or refractory AA.

Patients and methods

Our randomized clinical trial was conducted on patients with severe and recalcitrant AA. Group A included 13 patients who received only DPCP, while Group B included 11 patients who received both DPCP and PRP. After sensitization in both groups of patients, DPCP was applied to half the scalp weekly. In addition, PRP injection in all scalp was performed once a month in group B. The patients in both groups completed the study for six months.

Results

The regrowth scale results were 53.85% and 54.5% for groups A and B, respectively. Although the response rate of group B was higher than that of group A, there is no statistically significant difference between the two groups.

Conclusion

From our clinical trial, it can be concluded that DPCP alone or combined with PRP is an effective and safe method for treating severe or recalcitrant AA.
Explore highly relevant questions in the Baumann skin type questionnaire through the digital skin analyzer: A retrospective single‐center study in South Korea
Authors: Cho Soo Ick , Kim Donghyeon , Lee Hoonjae , Um Terry TaeWoong , Kim Hongseok
Published: June 2023

Background

Baumann skin type questionnaire (BSTQ) has been widely used for evaluating skin types in dermatology. However, it requires excessive assessment time and lacks sufficient clinical validation for the Asian population.

Aims

We aimed to establish optimized BSTQ based on dermatological assessment of the Asian population.

Methods

This was a single‐center retrospective study, where the patient completed a modified BSTQ and a digital photography examination. The answers to four question groups for evaluating skin properties, including oily versus dry (O‐D), sensitive versus resistant (S‐R), pigmented versus non‐pigmented (P‐N), and wrinkled versus tight (W‐T) were compared with the measurements. Highly relevant questions are selected using two different strategies and used to determine the threshold level, which was compared with skin‐type measurement.

Results

In O‐D, S‐R, P‐N, and W‐T, 3–5 out of 6, 2–6 out of 9, 3–6 out of 7, and 4–9 out of 11 questions were selected, respectively. As a result, skin type scores from two strategies and measurements showed similar Pearson correlation coefficient values compared to modified BSTQ (for O‐D and sebum, 0.236/0.266 vs. 0.232; for O‐D and porphyrin, 0.230/0.267 vs. 0.230; for S‐R and redness, 0.157/0.175 vs. 0.095; for S‐R and porphyrin, 0.061 vs. 0.051; for P‐N and melanin pigmentation, 0.156/0.208 vs. 0.150; for W‐T and wrinkle, 0.265/0.269 vs. 0.217).

Conclusion

Two strategies for optimizing BSTQ are proposed and validated for Asian patients. Compared to the BSTQ, our methods show comparable performance with a significantly reduced number of questions.
Clinical features of cutaneous infantile hemangioma combined with asymptomatic infantile hepatic hemangioma and efficacy of propranolol treatment
Authors: Li Li , Yu Lu , Xu Zigang , Wei Li , Zhang Bin , Han Xiaofeng , Sun Yujuan , Ma Lin
Published: June 2023

Introduction

Infantile hepatic hemangioma (IHH) is a common liver tumor in infants and shares the same characteristics as cutaneous infantile hemangioma (IH). Propranolol is effective for symptomatic IHH. The clinical features between cutaneous IH and IHH, and treatment efficacy of IHH (smaller than 4 cm) is unclear. To evaluate the correlation of clinical features between cutaneous IH and IHH, as well as efficacy of systemic propranolol in the treatment of cutaneous IH combined with IHH.

Materials and Methods

The clinical data of infants with complicated cutaneous IH combined with IHH treated with systemic propranolol (1.5 ~ 2 mg/(kg d)) from January 2011 to October 2020 were retrospectively analyzed.

Results

Forty‐five cases with IHH combined with complicated cutaneous IH were reviewed. Single cutaneous IH is more likely to be combined with focal IHH, cutaneous IH greater than 5, more likely to be combined with multiple IHH (Pearson = 0.546, p < 0.01). The mean age of focal and multiple IHH regression was 11.93 ± 14.42 months and 10.20 ± 9.15 months, respectively.

Conclusions

The number of cutaneous IH were correlated with the number of IHH. There was no difference in the age of complete remission for focal and multiple IHH.