bluuebunny/crossref_metadata_2025 huggingface dataset:
Have there been changes in daily smoking and cigarette consumption among adolescents? Investigation between 1999 and 2019 among Finnish adolescents
Authors: Ruokolainen Otto , Ollila Hanna , Raitasalo Kirsimarja
Published: November 2023

Background and aims

It is postulated that due to decreased smoking rates and increased denormalisation of smoking, those who start and maintain smoking have more socially disadvantaged characteristics and are more dependent on nicotine than those who do not (the so‐called ‘hardening’ hypothesis). The aim of this study was to measure changes in daily smoking and cigarette consumption among Finnish adolescents according to background factors.

Design and setting

A repeated cross‐sectional study using data from European School Survey Project on Alcohol and other Drugs (ESPAD) on six representative cross‐sections of 15‐ to 16‐year‐old students between 1999 and 2019 in Finland.

Participants

A total of 11 377 males and 12 247 females.

Measurements

The outcome measures included the proportion of daily smokers among current smokers, daily smoking and the estimated mean number of smoked cigarettes per day (CPD). Substance use, parental monitoring and school performance were used as independent variables. All measures were self‐reported.

Findings

Daily smoking decreased over time and daily smokers constituted a smaller part of current smokers in 2019 compared with 1999 (the ratio among boys 0.68 and 0.43, respectively; among girls 0.59 and 0.43). Boys using cannabis (interaction between cannabis*survey year: P = 0.020; in 2019 odds ratio [OR]: 3.68, 95% confidence interval [CI] 2.23–6.08) and girls with heavy episodic drinking (interaction between heavy episodic drinking*survey year: P = 0.006, in 2019 OR: 9.00, 95% CI 5.61–14.42) had elevated adjusted odds for daily smoking over time. The estimated mean number of CPD decreased among daily smokers from 9.0 in 1999 to 7.2 in 2019 (P = 0.0002) and the differences diminished between groups based on gender, snus/alcohol use and parental monitoring. The between‐group differences remained with regard to cannabis use (P = 0.0233 in 2019) and school performance (P = 0.0111 in 2019).

Conclusions

Among currently smoking Finnish adolescents, the proportion of daily smokers decreased between 1999 and 2019, as did the number of cigarettes smoked per day (CPD) among daily smokers, suggesting an absence of ‘hardening’ in this group. However, differences were observed related to the odds of daily smoking and the mean number of CPD, indicating the change has been less favorable among some adolescent groups than others.
‘There's something they can do’: Educating aged care staff about the trajectory of dementia, palliative care and the Namaste Care™ program: A mixed methods study
Authors: Karacsony Sara , Abela Melissa R. , Eccleston Claire
Published: November 2023

Objective

To evaluate outcomes of education about the dementia illness trajectory and Namaste Care™ program on aged care staff's knowledge, attitudes, self‐perceived skills and competence.

Methods

A convergent mixed methods research design was adopted to compare the results of quantitative and qualitative data following an education intervention. Nurses and aged care staff (n = 35) undertook 2 × 2 h training sessions over 3 days. Data were collected pre‐ and post‐intervention using three validated surveys. Qualitative data were collected through interviews and a focus group. Thematic analysis was used to generate themes. Quantitative and qualitative data were integrated and compared during interpretation and discussion of the findings.

Results

Significant improvements in knowledge, attitudes and skills survey scores from already published data were confirmed by the qualitative findings in this study. Three key themes were derived from the data, comprising dementia‐related education and knowledge changes, recognising the benefits of the Namaste Care™ program, and the importance of changing practice.

Conclusions

Dementia education using the Namaste Care™ program enabled staff to identify gaps in knowledge and skills within their own practice. Staff perceived that the Namaste Care™ program can be a driver for practice change including palliative care to improve quality of life for people living in the advanced stages of dementia.
Naringenin alleviates the excessive lipid deposition of polycystic ovary syndrome rats and insulin‐resistant adipocytes by promoting PKGIα
Authors: Xiang Yungai , Wang Meng , Yu Guo , Wan Lijing , Song Yuxia , Li Yan , Geng Xujing , Tan Li
Published: November 2023

Background

Naringenin (NGEN) has anti‐inflammatory and anti‐diabetic effects. On this basis, this study aims to determine whether NGEN affects insulin resistance (IR) in polycystic ovary syndrome (PCOS).

Methods

CCK‐8 assay and oil red O staining were used to detect the cytotoxicity of NGEN and lipid production in cells or tissues, respectively. The differentiated mature SW872 cells were treated with palmitic acid (PA) to mimic IR cell model. Through detecting glucose consumption, the changes of inflammation and glycolipid metabolism can be observed with the assessment on expression levels of the inflammatory factors as well as lipid synthesis‐ (ACC, SREBP1c, PPARγ), glucose metabolism‐ and thermogenesis (ATGL, GLUT4, UCP1)‐related genes. Insulin sensitivity was determined by changes in glucose consumption and PKGIα pathway. PKGIα was silenced to verify the protective mechanism of NGEN. PCOS rat model was constructed to confirm the results of cell experiments in vivo.

Results

NGEN generated no effect on SW872 cell viability. SW872 cells were differentiated and mature, as evidenced by lipid droplet formation, lipid synthesis gene activation, sugar metabolism and inhibition of thermogenesis‐related genes. PA induction promoted lipid synthesis in mature adipocytes, and inhibited glucose metabolism and cell insulin sensitivity. NGEN pretreatment effectively alleviated the above‐mentioned abnormalities. The protective mechanism of NGEN was achieved through promoting PKGIα activation. NGEN also mitigated the abnormal glucose and lipid metabolism in PCOS rats.

Conclusion

NGEN inhibits the expression of PKGIα to alleviate IR that occurs in PCOS.
‘There is no other option’: Exploring health care providers' experiences implementing regional multisite midwifery model of care in South Australia
Authors: McKellar Lois , Fleet Julie‐Anne , Adelson Pamela
Published: November 2023

Introduction

In the past 30 years, 60% of South Australia’s rural maternity units have closed. Evidence demonstrates midwifery models of care offer regional Australia sustainable birthing services. Five birthing sites within the York and Northern Region of South Australia, designed in collaboration with key stakeholders, offered a new all‐risk midwifery continuity of care model (MMoC). All pregnant women in the region were allocated to a known midwife once pregnancy was confirmed. In July 2019, the pilot program was implemented and an evaluation undertaken.

Objective

The study aimed to evaluate the effectiveness, acceptability, and sustainability of the new midwifery model of care from the perspective of health care providers.

Design

The evaluation utilised a mixed methods design using focus groups and surveys to explore experiences of health care providers impacted by the implementation of the MMoC. This paper reports on midwives, doctors and nurses experiences at different time points, to gain insight into the model of care from the care providers impacted by the change to services.

Findings

The first round of focus groups included 14 midwives, 6 hospital nurses/midwives and 5 doctors with the overarching theme that the ‘MMoC was working well.’ The second round of focus groups were undertaken across the five sites with 10 midwives, 9 hospital nurses/midwives and 5 doctors. The overarching theme captured all participants commitment to the MMoC, with agreement that ‘there is no other option ‐ it has to work’.

Discussion

All participants reported positive outcomes and a strong commitment to navigate the changes required to implement the new model of care. Collaboration and communication was expressed as key elements for success. Specific challenges and complexities were evident including a need to clarify expectations and the workload for midwives, and for nurses who were accustomed to having midwives 24 hours a day in hospitals.

Conclusion

This innovative model responds to challenges in providing rural maternity care and offers a sustainable model for maternity services and workforce. There is an overwhelming commitment and consensus that there is ‘no other option–it has to work’.
Reconsidering the role of prophylactic pancreaticojejunostomy in pancreatic enucleation: balancing the benefits and risks
Authors: Shi Yihua , Li Zheng , Li Borui , Chen Haidi , Chen Chen , Ji Shunrong , Yu Xianjun , Xu Xiaowu
Published: November 2023

Background

The incidence of postoperative pancreatic fistula (POPF) following enucleation is high, and prophylactic pancreaticojejunostomy (PPJ) is frequently performed. Minimally invasive enucleation (MEN) has been demonstrated to be safe and feasible, leaving most enucleation wounds exposed.

Methods

The clinical data of 40 patients who underwent open enucleation with PPJ at our center between 2012 and 2021 were compared with those of 80 patients who underwent MEN.

Results

The MEN group had better outcomes than the PPJ group in terms of intraoperative bleeding (50.0 versus 100.0 mL), postoperative semi‐liquid diet recovery (2.0 versus 5.0 days), and postoperative length of stay (7.7 versus 12.5 days). While the MEN group had higher rates of complex enucleation (60.0% versus 40.0%), main pancreatic duct repair (32.5% versus 10.0%), discharge with drains (48.8% versus 25.0%), and grade B POPFs (47.5% versus 17.5%). Both surgical methods effectively preserved pancreatic function; however, two patients in the PPJ group experienced severe haemorrhaging and died. Additionally, during the follow‐up period, gastrointestinal bleeding was found and discomfort in the surgical area was reported.

Conclusion

Pancreatic enucleation combined with PPJ should be avoided, and although a biochemical or grade B POPF may develop after MEN, it can be compensated for by preserving pancreatic function and ensuring a good long‐term quality of life in the patients.
How to do a single‐stage perforator based nasolabial flap for reconstruction of early‐stage tongue cancer
Authors: Arahill‐Whitham Jacob Brian , Thomson Benjamin James , Malayil Vineetha , Surendra Vishak
Published: November 2023

Tongue cancers are one of the most common subsites of malignancy in the head and neck, of which the majority are squamous cell carcinoma (SCC). Reconstruction following ablative surgery is challenging because of the role of the tongue in articulation, deglutition and protection of the airway. Microvascular free flaps are the current gold standard of reconstruction but are not feasible in all patients. Local and regional flaps provide a less challenging, faster alternative and may be more appropriate in comorbid patients with high anaesthetic risk as well as those with previously irradiated neck and poor vasculature. Nasolabial flaps are not commonly used for tongue reconstruction, requiring a two‐staged procedure to allow division of the pedicle. We submit a modification of nasolabial flap as an inferiorly based, islanded perforator flap. This allows for single‐stage reconstruction of tongue and floor of the mouth defects following resection of early‐stage tongue cancers.
Novel single‐centre experience – evaluation of outcomes post‐implementation of a coordinated combined breast reconstruction service
Authors: Armanios Alexander S. , Nyandoro Munyaradzi G. , Jayachitra Nisha , Hamza Saud
Published: November 2023

Background

Autologous breast reconstruction services are logistically complex and challenging to implement but have better outcomes than implants. This study aimed to evaluate the effect of implementing a coordinated, low‐cost combined breast reconstruction service (0.8 FTE nurse liaison, 0.25 FTE plastic surgeon, two dedicated breast surgeons 0.05 FTE each and protected weekly all‐day oncoplastic theatre) on unit productivity and efficiency in reducing wait times for immediate autologous breast reconstruction.

Methods

A retrospective cohort study was conducted on all patients who underwent immediate autologous breast reconstruction at Fiona Stanley Hospital between two study periods, pre‐intervention – February 2016 to June 2019 and post‐intervention – November 2022. Data were analysed using SPSS v.27.

Results

One hundred twenty‐seven participants were included, with 49% (n = 62) in the post‐intervention group. Most procedures performed were therapeutic (n = 108, 85%). DIEP was the most common flap (84%), and the mean BMI was 26.9 (SD ± 4.2).

There was a statistically significant increase in the number of high‐risk gene carriers' prophylactic cases and bilateral cases performed post‐intervention (5% to 26%, P = 0.001) and (29% to 55%, P = 0.003), respectively.

Time to surgery on the waitlist did not significantly change after the intervention (therapeutic group: 3.1 to 3.5 weeks, P = 0.821; prophylactic group: 55.0 to 61.1 weeks, P = 1.000). Overall, there was a marked increase in the overall productivity of the breast service unit in terms of mastectomies, total reconstructions, and autologous reconstructions performed.

Conclusions

This single‐centre experience showed that implementing a coordinated service significantly increased the unit's productivity. This low‐cost intervention can be applied to other healthcare settings.
Effect of COVID‐19 home confinement on the efficacy of orthokeratology, 0.01% atropine and combined treatment
Authors: Xu Shengsong , Jiang Jinyun , Yu Mengting , Gao Jiajia , Wang Mengyi , Kuang Longhao , Hu Yin , Kee Chea‐su , Yang Xiao , He Mingguang
Published: November 2023

Purpose

To investigate the effect of COVID‐19 home confinement on the efficacy of the interventions for controlling myopia, and to select effective therapies to control myopia during COVID‐19 confinement.

Method

Children (n = 164) aged 8–12 years with spherical equivalent refraction of −1.00 to −6.00 diopters were stratified into two age subgroups and randomly allocated into the control, 0.01% atropine, orthokeratology (ortho‐k) and atropine combined ortho‐k (ACO) groups. Axial length (AL) was measured at baseline, 6‐, 12‐, 18‐ and 24‐month visits. The follow‐up spanned the period before the COVID‐19 outbreak, the period of the home confinement, and the period of the school reopening. Hence, the AL change in different periods was collected and compared. Data analysis was performed following the criteria of intention to treat (ITT).

Results

All 164 children were involved in the ITT analysis. Compared to control, all interventions can still reduce the AL elongation during the COVID‐19 home confinement period (all p < 0.05). However, the efficacy was compromised: individuals experienced more AL elongation during the COVID‐19 home confinement period in the control, 0.01% atropine and ACO groups (all p < 0.05). Interestingly, in the ortho‐k group, the difference was insignificant (p = 0.178), and the interaction between the intervention type (control vs. ortho‐k) and the confinement severity was significant (p for interaction = 0.041), which is different from the atropine (p for interaction = 0.248) or ACO group (p for interaction = 0.988). These results were stable after being adjusted by other variables based on the multivariable regression model.

Conclusion

Ortho‐k was less affected by the COVID‐19 home confinement, which is potentially a better therapy for children in this high‐risk environment. Further investigations are warranted to validate this issue.
Genome‐wide search reveals the uniqueness of DNA regions associated with coat color and innate immunity in Hokkaido Native Horse
Authors: Amano Tomoko , Yokawa Haruhi , Masuda Yutaka , Tozaki Teruaki , Kawai Masahito , Shirai Kouichi
Published: November 2023

Hokkaido Native Horse (HKD) is a horse breed native to Hokkaido in Japan known for the traits such as coat color with no white spots and adaptability to the local cold climate. To examine whether those traits of HKD are conferred at the DNA level, we attempted to identify fixed DNA regions in HKD individuals, that is, the selection signatures of HKD. A comparison of genome‐wide single nucleotide polymorphism genotypes in 58 HKD individuals by principal component analysis, and cluster analysis between breeds, including HKD, and within the HKD individuals indicated the genetic independence of HKD as a breed. Tajima's D analysis and runs of homozygosity analysis identified 23 selection signatures unique to HKD (P < 0.05), and following database search found 20 traits that were associated with those selection signatures; among these traits, coat color traits, face and body markings, showed the highest important value (0.50 and 0.46). Enrichment analysis of genes in the selection signatures identified six gene ontology terms (P < 0.05), and a term related to innate immunity (regulation of defense response; GO:0031347) showed the highest positive fold enrichment value (7.13). These results provide the first scientific evidence of a genetic basis for the traits of HKD.
A phase II trial of nivolumab followed by ipilimumab and nivolumab in advanced non‐clear‐cell renal cell carcinoma
Authors: Conduit Ciara , Davis Ian D. , Goh Jeffrey C. , Kichenadasse Ganessan , Gurney Howard , Harris Carole A. , Pook David , Krieger Laurence , Parnis Francis , Underhill Craig , Adams Diana , Roncolato Felicia , Joshua Anthony , Ferguson Tom , Prithviraj Prashanth , Morris Michelle , Harrison Michelle , Begbie Stephen , Hovey Elizabeth , George Mathew , Liow Elizabeth C. , Link Emma K. , McJannett Margaret , Gedye Craig ,   the Australian and New Zealand Urogenital and Prostate Cancer Trials Group (ANZUP),   the UNISoN Investigators
Published: November 2023

Objective

To evaluate the efficacy of sequential treatment with ipilimumab and nivolumab following progression on nivolumab monotherapy in individuals with advanced, non‐clear‐cell renal cell carcinoma (nccRCC).

Materials and Methods

UNISoN (ANZUP1602; NCT03177239) was an open‐label, single‐arm, phase 2 clinical trial that recruited adults with immunotherapy‐naïve, advanced nccRCC. Participants received nivolumab 240 mg i.v. two‐weekly for up to 12 months (Part 1), followed by sequential addition of ipilimumab 1 mg/kg three‐weekly for four doses to nivolumab if disease progression occurred during treatment (Part 2). The primary endpoint was objective tumour response rate (OTRR) and secondary endpoints included duration of response (DOR), progression‐free (PFS) and overall survival (OS), and toxicity (treatment‐related adverse events).

Results

A total of 83 participants were eligible for Part 1, including people with papillary (37/83, 45%), chromophobe (15/83, 18%) and other nccRCC subtypes (31/83, 37%); 41 participants enrolled in Part 2. The median (range) follow‐up was 22 (16–30) months. In Part 1, the OTRR was 16.9% (95% confidence interval [CI] 9.5–26.7), the median DOR was 20.7 months (95% CI 3.7‐not reached) and the median PFS was 4.0 months (95% CI 3.6–7.4). Treatment‐related adverse events were reported in 71% of participants; 19% were grade 3 or 4. For participants who enrolled in Part 2, the OTRR was 10%; the median DOR was 13.5 months (95% CI 4.8–19.7) and the median PFS 2.6 months (95% CI 2.2–3.8). Treatment‐related adverse events occurred in 80% of these participants; 49% had grade 3, 4 or 5. The median OS was 24 months (95% CI 16–28) from time of enrolment in Part 1.

Conclusions

Nivolumab monotherapy had a modest effect overall, with a few participants experiencing a long DOR. Sequential combination immunotherapy by addition of ipilimumab in the context of disease progression to nivolumab in nccRCC is not supported by this study, with only a minority of participants benefiting from this strategy.
Efficacy of indocyanine green fluorescence‐guided inguinal lymph node dissection for penile cancer: a randomised trial
Authors: Yuan Peng , Xie Yu , Xu Ran , Li Yuanwei , Yao Kun , Liu Jianye , Yan Bin , Jiang Shusuan , Lu Qiang , Chen Qian , Zang Hongjing , Xiong Wei , Tang Yongxiang , Hu Shuo , Wang Long
Published: November 2023

Objectives

To investigate the safety and efficacy of indocyanine green (ICG) fluorescence‐guided inguinal lymph node dissection (ILND) in patients with penile cancer.

Patients and Methods

A prospective, single‐blind, randomised controlled clinical trial (ChiCTR2100044584) was performed among patients with penile caner who underwent bilateral modified ILND at four centres in China between 1 April 2021 and 30 June 2022. Patients aged 18–80 years and diagnosed with squamous cell carcinomas were included. Each enrolled patient was randomly assigned to either ICG fluorescence‐guided ILND by a laparoscopic or robot‐assisted approach in one groin, with non‐ICG fluorescence‐guided ILND in the other groin acting as a control. The primary outcome was the number of retrieved ILNs. Secondary outcomes included complications according to the Clavien–Dindo classification and the ILN non‐compliance (inadequate removal of ILNs) rate.

Results

A total of 45 patients were included in the intention‐to‐treat (ITT) analysis, and the 42 who completed the entire study were included in the per protocol (PP) analysis. There were no ICG‐related complications in any of the patients. The results of the ITT and PP analyses indicated that the total number of unilateral ILNs retrieved was higher on the ICG side than on the non‐ICG side (mean 13 vs 9 ILNs, difference 4 ILNs [95% CI 2.7–4.4], P = 0.007), and the number of unilateral deep and superficial ILNs was higher on the ICG side. Furthermore, the LN non‐compliance rate was lower on the ICG side than on the non‐ICG side. Additionally, there was no significant difference in local complications in the groins between the two sides (P > 0.05).

Conclusion

An ICG fluorescence‐guided ILND was safe for patients with penile cancer. This procedure can improve the number of ILNs retrieved and reduce the LN non‐compliance rate without increased complications. ICG fluorescence‐guided ILND is beneficial and recommended for selected patients with penile cancer.
Modern pollen assemblages from the hinterland of the Tibetan Plateau and their significance for reconstructions of past vegetation
Authors: Ma Linyuan , Li Zhiguang , Xu Qinghai , Li Hongmei , Zhang Kailong , Li Yuecong , Zhang Ruchun , Cao Xianyong , Zhang Shengrui
Published: November 2023

We conducted a detailed field vegetation investigation combined with the collection of surface soil samples for pollen analysis in the alpine meadow and steppe vegetation zones (30 sites in each zone) in the hinterland of the Tibetan Plateau. Our objectives were to determine the source area of exotic pollen, the relationship between pollen percentages and the cover of the major plant taxa, and the characteristics of the pollen assemblages from surface soils and lake sediments and their vegetation significance. Our principal findings are: (i) the two vegetation zones are herbaceous although arboreal pollen types are present in the related pollen assemblages (2 and 16.8% in the alpine meadow and steppe zones, respectively); (ii) arboreal pollen is assumed to be transported mainly by the Indian monsoon from the forests of the southern Himalayan foothills or river valleys – the spatial distribution of the percentages and concentrations of arboreal pollen in the study sites shows that pollen concentrations have the strongest correlation with the Indian monsoon's variations; (iii) there are regional differences in (a) the relationship between pollen percentages and the cover of the main plant taxa and (b) the indicator plant taxa representative of pollen assemblages and vegetation types zones – the regional vegetation of the study region and pollen productivity variations between plant taxa are likely to be the main causes behind these differences; and (iv) the pollen assemblages from surface soils and lake sediments have similar characteristics and correspond well to the regional vegetation of the alpine meadow zone. In the alpine steppe zone, the pollen assemblages from surface soils and lake sediments are quite different, caused mainly by the over‐representation of Artemisia. Our study supplies a detailed description of pollen–vegetation relationships on the hinterland of the Tibetan Plateau and provides scientific references for interpreting stratigraphic pollen assemblages and reconstructing regional vegetation.
Assessment of crestal bone loss and periodontal parameters of polymer infiltrated ceramic network versus lithium disilicate implant hybrid abutment crowns in the esthetic zone (A randomized clinical trial)
Authors: Mahmoud Inas Adel , ElTannir Adel Mohamed , Eissa Sherihan Mohamed , ElBasty Reham Said
Published: November 2023

Background

Lithium disilicate can be reliable when restoring implants in the esthetic zone. However, it has a high elastic modulus. This might increase the amount of forces transmitted to the crestal bone.

Aim of the Study

To evaluate the crestal bone loss and peri‐implant periodontal parameters of polymer infiltrated ceramic network compared to lithium disilicate implant‐supported hybrid abutment crowns after 12 months of follow‐up.

Methodology

44 patients were enrolled. They were randomly assigned into two groups (n = 22). The first group received 22 implants restored with polymer‐infiltrated ceramic network (Vitaenamic) hybrid abutment crowns. The second group received 22 implants restored with lithium disilicate (e.max) hybrid abutment crowns over immediately placed implants in the esthetic zone. Periapical radiographs were taken immediately after prosthetic placement and 1 year later utilizing a parallel technique, to assess crestal bone loss. Periodontal parameters were assessed after 1 year.

Results

Regarding crestal bone loss, a comparison between group I (Vitaenamic) and group II (e.max) was made by using an Independent t‐test, which showed an insignificant difference between them (p > 0.05). A comparison between groups I and II revealed insignificant differences regarding periodontal parameters (probing depth, bleeding on probing, visible plaque, and suppuration).

Conclusions

Regarding bone stability and periodontal parameters, polymer infiltrated ceramic network and lithium disilicate hybrid abutment crowns showed comparable results. Both materials showed clinically acceptable hard and soft tissue responses.
Metabolic re‐programming of keratinocytes in response to contact allergens
Authors: Menzel Mandy , Mraz Veronika , Vaher Helen , Geisler Carsten , Menné Bonefeld Charlotte
Published: November 2023

Background

Allergic contact dermatitis (ACD) is a common skin disease caused by the recognition of haptens by the immune system. Keratinocytes play an important role in the initiation and facilitation of inflammatory responses in ACD. Immune responses are associated with major changes in metabolism. However, metabolic re‐programming is not well studied in ACD; specifically, knowledge of metabolic alterations in structural cells is lacking.

Methods

Metabolic re‐programming in ACD was studied using publicly available transcriptome datasets. Primary pooled keratinocytes and a keratinocyte cell line (HaCaT) were stimulated with contact allergens, and inflammatory responses and expression of metabolic markers were measured by qPCR and flow cytometry, respectively.

Results

ACD is characterized by metabolic re‐programming with a metabolic profile similar to atopic dermatitis. Exposure to contact allergens causes a wide array of metabolic alterations. Stimulation of keratinocytes with contact allergens induced inflammatory responses typical for ACD and was associated with an up‐regulation of proteins representative for glucose uptake, fatty acid metabolism, oxidative phosphorylation and to some extent arginine biosynthesis. Changes in these metabolic pathways were also observed when comparing lesional with non‐lesional contact dermatitis skin.

Conclusions

ACD is, similarly to other inflammatory skin diseases, characterized by metabolic re‐programming. Contact allergen exposure induces expression of a wide array of metabolic pathways, which is at least in part mediated through metabolic re‐programming of keratinocytes.
The role of warmed‐humidified carbon dioxide insufflation in colorectal surgery: A systematic review and meta‐analysis
Authors: Sharma Sahil , McKechnie Tyler , Khamar Jigish , Wu Kathy , Hong Dennis , Eskicioglu Cagla
Published: November 2023

Background

Maintenance of normothermia is a crucial part of enhanced recovery after colorectal surgery. Dry‐cold carbon dioxide (CO2) traditionally used for insufflation in laparoscopic surgery and negative pressure operating theatres has been associated with intraoperative hypothermia. Studies suggest that use of warmed‐humidified CO2 may promote normothermia. However, due to a scarcity of high‐quality studies demonstrating a proven benefit on intraoperative core body temperature, its use in colorectal surgery remains limited. Therefore, the aim of this review was to evaluate the effects of warmed‐humidified CO2 compared to traditional dry‐cold CO2, or ambient air in operating theatres, during colorectal surgery.

Methods

A search of Medline, EMBASE, and CENTRAL was performed. Randomised controlled trials (RCTs) that compared patients receiving warmed‐humidified CO2 with either dry‐cold CO2 insufflation in laparoscopic procedures or no insufflation during open surgery were included. The primary outcome was change in intraoperative core body temperature. Secondary outcomes included length of stay, operating time, return of gastrointestinal function, wound infection, and postoperative pain. A pairwise meta‐analysis was performed using inverse variance random effects.

Results

Among the six RCTs included, 208 patients received warmed‐humidified CO2 (42.3% female, mean age: 65.8 years) and 210 patients received either dry‐cold CO2 in laparoscopic procedures or no gas insufflation during open procedures (46.2% female, mean age: 66.1 years). No significant difference was found for change in intraoperative core body temperature (MD = 0.01, 95% CI: −0.1, 0.11, p = 0.90, very low certainty). Patients in the warmed‐humidified CO2 group had significantly higher pain scores on postoperative day 1 (MD = 1.61, 95% CI: 0.91, 2.31, p < 0.05, very low certainty). No significant differences were found in any of the other secondary outcomes studied.

Conclusion

Patients undergoing colorectal surgery receiving warmed‐humidified CO2 do not experience any clinically meaningful difference in core body temperature change compared to their counterparts receiving dry‐cold CO2 insufflation or no insufflation. However, patients may report greater pain scores on postoperative day 1 with warmed‐humidified CO2. There is likely no clinically important difference between warmed‐humidified CO2 and dry‐cold CO2 for patients undergoing colorectal surgery. Patient, clinician, and institution factors should be considered when deciding between these two insufflation modalities.
Contextualizing sociodemographic differences in Tibetan attitudes toward large carnivores
Authors: Gao Yufang , Wang Yiqing , Lee Andy T. L. , Liu Yuntian , Luo Yu , Orrick Kaggie , Alexander Justine Shanti , Sangpo Ju Tashi , Clark Susan G.
Published: November 2023

Fostering human–wildlife coexistence necessitates a thorough and nuanced grasp of local attitudes toward wildlife. Attitudes can vary substantially based on the sociodemographic backgrounds of individuals within a society. This study examines Tibetan attitudes toward large carnivores, emphasizing the importance of contextualization in discerning the effects of sociodemographic factors on attitudes. We began by analyzing existing research on Tibetan attitudes toward wildlife in China, identifying previously studied sociodemographic variables. We then executed an online survey to evaluate the affective, behavioral, cognitive, and overall attitudes of ethnic Tibetans in China toward snow leopards (Panthera uncia), gray wolves (Canis lupus), and brown bears (Ursus arctos). Our findings show that while factors such as gender, age, religious identity, and level of education shape these attitudes, their influence differs depending on the specific attitude component and the target animal under examination. Therefore, making broad generalizations about sociodemographic differences in attitudes can be misleading. It is imperative for attitude research to clearly define the attitude component (what type of attitude), object (attitude toward what), and circumstance (attitude in which situation) being studied. Conducting ethnographic fieldwork in collaboration with local cultural experts can deepen our understanding of local perspectives and the ways sociodemographic factors influence attitudes. Such insights are pivotal for developing conservation strategies attuned to local sociocultural contexts.
Daily diary study of associations between alcohol, cannabis, co‐use and sleep quality in individuals with intentions to use cannabis to cope with anxiety
Authors: Sznitman Sharon R. , Martin‐Willett Renée , Ma WenHao , Karoly Hollis C. , Bidwell L. Cinnamon
Published: November 2023

Introduction

Sleep problems and anxiety conditions are common comorbidities and may be influenced by cannabis and alcohol use. This study examined daily within‐person variation in subjective sleep quality among individuals with anxiety symptoms after cannabis or alcohol were used alone, and after co‐use.

Methods

A total of 347 individuals with intentions to use cannabis to cope with anxiety reported their cannabis and alcohol use in the previous 24 h and their previous nights' sleep quality for 30 consecutive days. Mixed‐effects models examined whether the within‐person daily variation in use of cannabis and alcohol (alone and co‐use) was associated with subjective sleep quality. Models also examined whether daily cannabis and alcohol use associations with sleep were moderated by frequency of cannabis, alcohol and co‐use during the study period.

Results

Compared to non‐use, participants reported better sleep after cannabis‐use‐only and after co‐use, but not after alcohol‐use‐only. People who more frequently use alcohol and cannabis reported sleeping better after cannabis‐use‐only days compared to those who use cannabis and alcohol less frequently.

Discussion and Conclusions

The study's utilisation of naturalistic data among individuals with anxiety symptoms replicated previously reported experimental findings among individuals without sleep and anxiety problems that overall, cannabis is associated with higher subjective sleep quality. The results expand upon other research to suggest that more frequent use of alcohol and cannabis may moderate daily associations of cannabis use and sleep, potentially through pharmacokinetics and cross‐sensitisation.
Geographic tongue: What is this disease?
Authors: Horiuchi Yasuhiro
Published: November 2023

Geographic tongue or benign migratory glossitis, is a unique and peculiar tongue condition, producing a map‐like appearance with filiform papillae atrophy, on different parts of the tongue. The lesions change in shape with time. The exact etiology remains unknown, although it has been suggested relating the lingual microbiota of a patient. The association between geographic tongue and psoriasis has long been pointed out, and histological similarities existed between both as well. Increasingly, recent findings suggest the involvement of certain oral bacteria. Here, we discuss these findings with an overview of the recent literature.
Explaining and predicting animal migration under global change
Authors: Howard Christine , Mason Tom H. E. , Baillie Stephen R. , Border Jennifer , Hewson Chris M. , Houston Alasdair I. , Pearce‐Higgins James W. , Bauer Silke , Willis Stephen G. , Stephens Philip A.
Published: November 2023

Many migratory species are declining due to global environmental change. Yet, their complex annual cycles make unravelling the impacts of potential drivers such as climate and land‐use change on migrations a major challenge. Identifying where, when and how threatening processes impact species' migratory journeys and population dynamics is crucial for identifying effective conservation actions. Here, we describe how a new migration modelling framework – Spatially explicit Adaptive Migration Models (SAMMs) – can simulate the optimal behavioural decisions required to migrate across open land‐ or seascapes varying in character over space and time, without requiring predefined behavioural rules. Models of adaptive behaviour have been used widely in theoretical ecology but have great untapped potential in real‐world contexts. Applying adaptive behaviour models across open environments will allow users to explore how migratory species may adapt their routes and usage of intermediate sites in response to environmental change. We outline how SAMMs can be used to model migratory journeys through aerial, terrestrial and aquatic environments, demonstrating their potential using a case study on the common cuckoo (Cuculus canorus) and comparing modelled to observed behaviours. SAMMs offer a tool to identify the key threats faced by migratory species, how they could adapt to future migratory journeys in response to changing environmental conditions and the consequences of not being able to adapt to change.
Children with dyslexia show no deficit in exogenous spatial attention but show differences in visual encoding
Authors: Ramamurthy Mahalakshmi , White Alex L. , Yeatman Jason D.
Published: November 2023

In the search for mechanisms that contribute to dyslexia, the term “attention” has been invoked to explain performance in a variety of tasks, creating confusion since all tasks do, indeed, demand “attention.” Many studies lack an experimental manipulation of attention that would be necessary to determine its influence on task performance. Nonetheless, an emerging view is that children with dyslexia have an impairment in the exogenous (automatic/reflexive) orienting of spatial attention. Here we investigated the link between exogenous attention and reading ability by presenting exogenous spatial cues in the multi‐letter processing task—a task relevant for reading. The task was gamified and administered online to a large sample of children (N = 187) between 6 and 17 years. Children with dyslexia performed worse overall at rapidly recognizing and reporting strings of letters. However, we found no evidence for a difference in the utilization of exogenous spatial cues, resolving two decades of ambiguity in the field. Previous studies that claimed otherwise may have failed to distinguish attention effects from overall task performance or found spurious group differences in small samples.

Research Highlights

We manipulated exogenous visual spatial attention using pre‐cues in a task that is relevant for reading and we see robust task effects of exogenous attention.

We found no evidence for a deficit in utilizing exogenous spatial pre‐cues in children with dyslexia.

However, children with dyslexia showed reduced recognition ability for all letter positions.

Children with dyslexia were just as likely to make letter transposition errors as typical readers.
The role of cerebral palsy registries in improving patient care and collaboration: A global perspective
Authors: Bakkeheim Egil
Published: November 2023

This commentary is on the original article by Goldsmith et al. on pages 765–777 of this issue.
The evidence for shaken baby syndrome (abusive head trauma) is still flawed
Authors: Brook Chris B.
Published: November 2023

Chris Brook: none.
Impact of a 4‐week intensive track and field training intervention on glycaemia in adolescents with type 1 diabetes: The ChilDFiT1 study
Authors: Zimmer Rebecca T. , Birnbaumer Philipp , Sternad Christoph , Zunner Beate E. M. , Schierbauer Janis , Fritsch Maria , Fröhlich‐Reiterer Elke , Hofmann Peter , Sourij Harald , Aberer Felix , Moser Othmar
Published: November 2023

Aim

To investigate the safety and efficacy of track and field training compared with intensification of insulin treatment only in adolescents with type 1 diabetes (T1D).

Materials and Methods

Eighteen adolescents (seven females) with T1D were included (age 15.1 ± 1.1 years, HbA1c 7.3% ± 1.0% [56.3 ± 10.9 mmol/mol]). After a 4‐week observational control phase, participants were randomized to either stand‐alone intensive glycaemic management (IT; telemedicine or on‐site visits, three times/week) or additionally performed track and field exercise (EX; three 60‐minute sessions/week) for 4 weeks. Glycaemia was assessed via continuous glucose monitoring during observational control and intervention phases.

Results

Time in range (70‐180 mg/dL; 3.9‐10.0 mmol/L) significantly improved from the observational control phase to the exercise intervention phase in EX (69% ± 13% vs. 72% ± 11%, P = .049), but not in IT (59% ± 22% vs. 62% ± 16%, P = .399). Time below range 1 (54‐69 mg/dL; < 3.9 mmol/L) improved in IT (3.1% ± 1.9% vs. 2.0% ± 0.8%, P = .017) and remained stable in EX (2.0% ± 1.7 vs. 1.9% ± 1.1%, P = .999). The EX group's HbA1c ameliorated preintervention to postintervention (mean difference: ΔHbA1c −0.19% ± 0.17%, P = .042), which was not seen within the IT group (ΔHbA1c −0.16% ± 0.37%, P = .40). Glucose standard deviation was reduced significantly in EX (55 ± 11 vs. 51 ± 10 mg/dL [3.1 ± 0.6 vs. 2.8 ± 0.6 mmol/L], P = .011), but not in IT (70 ± 24 vs. 63 ± 18 mg/dL [3.9 ± 1.3 vs. 3.5 ± 1.0 mmol/L], P = .186).

Conclusion

Track and field training combined with intensive glycaemic management improved glycaemia in adolescents with T1D, which was not observed in the non‐exercise group.
Evaluation of relational factor in patient satisfaction with the treatment received by dental students
Authors: Macpherson Ignacio , Sanagustín Elisa , Roqué María Victoria , Giner‐Tarrida Lluís
Published: November 2023

Introduction

The study focused on the importance of the relational factor and empathy in the general satisfaction of patients for the treatment received by university dental students. To achieve this objective, a tool capable of evaluating the most humanistic dimensions (empathy, kindness, trust) in the development of dental treatment has been designed.

Materials and Methods

A review of the literature was carried out and, based on its findings, a questionnaire was designed to assess patient satisfaction with the dental student's empathy. It consisted of 20 questions and was completed by 80 patients. The questionnaire was subjected to a validation process using the Delphi method (content validity) and psychometric analysis (construct validity), through a principal components analysis (PCA).

Results

The results of the PCA showed the existence of four components that suggest grouping the 20 questions into three blocks with a sequential structure, in which the questions would describe the patient's satisfaction throughout their treatment: reception and explanation of the treatment; development and progress of treatment; and expectations and completion of treatment. In each of these blocks, satisfaction was determined by a specific humanistic dimension: communication, trust and benevolence.

Conclusion

The validated questionnaire is an effective tool to analyse the relational factors that determine patient satisfaction in a treatment. Furthermore, the analysis of the questionnaire suggests that communication, trust and benevolence are elements that acquire singular importance throughout the care process. This analysis is essential for the acquisition of humanistic skills by future professionals and to optimize the dentist‐patient relationship.
Protein therapeutics as an emerging strategy to deal with skin cancer: A short review
Authors: Kulshrestha Sunanda , Goel Anjana
Published: November 2023

Cancer has turned into a global menace with an exponential increase in the rate of death every year. Amongst all forms of cancers, skin cancer is the one becoming more common day by day because of the increased exposure to ultraviolet rays, chemicals, pollutants, etc. Skin cancer is of three types namely basal cell, squamous cell and melanoma which is one of the most aggressive forms of cancer with a low survival rate and easy relapse. Melanoma is also notorious for being multi‐drug resistant which accounts for its low survival rates in it. Many kinds of therapeutics are been practiced in the contemporary world, but among them, protein therapeutics is been emerging as a promising field with multiple molecular pathway targets that have revolutionized the science of oncology. Proteins acts as small‐molecule targets for cancer cells by binding to the cell surface receptors. Proteins including bromodomain and extra‐terminal domain (BET) and some toxin proteins are been tried on for dealing with melanoma targeting the major pathways including MAPK, NF‐κB and PI3K/AKT. The protein therapeutics also targets the tumour microenvironment including myofibrils, lymphatic vessels etc., thus inducing tumour cell death. In the review, several kinds of proteins and their function toward cell death will be highlighted in the context of skin cancer. In addition to this, the review will look into the inhibition of the function of other inflammatory pathways by inflammasomes and cytokines, both of which have a role in preventing cancer.
One‐dimensional atrous conv‐net based architecture for automatic diagnosis of epilepsy using electroencephalography signals and its brain–computer interface applications
Authors: Handa Palak , Gupta Muskan , Gupta Esha , Goel Nidhi
Published: November 2023

Precise monitoring and diagnosis of epilepsy by manual analysis of EEG signals are challenging due to the low doctor‐to‐patient ratio, and shortage of medical resources. To automate this diagnosis in real‐time, EEG based Brain–Computer Interface (BCI) system with integration of artificial intelligence techniques will prove to be propitious. This work proposes an end‐to‐end, one‐dimensional atrous conv‐net‐based architecture for automatic epilepsy diagnosis using EEG signals with a conceptual framework of the EEG‐BCI system for routine monitoring and clinical use. The proposed architecture has a robust backbone of six blocks of atrous convolutional layers activated with exponential linear unit functions. The six blocks are followed by the addition of a long short‐term memory layer for automatic feature extraction and sequential EEG data analysis. The efficacy of the proposed architecture has been verified on three publicly available EEG datasets using various evaluation metrics, feature maps, test set evaluation, and ablation studies. An average training and validation accuracy of 96.16% and 90.80% has been achieved upon multiple runs for the three datasets. Ablation experiments indicate that the addition of each block contributed to increasing 17%–25% accuracy scores during the classification of epileptic and non‐epileptic EEG signals. The real‐time EEG‐BCI has been analyzed using weight optimization of the proposed architecture through the NVIDIA Tensor RT framework on a 40 GB DGX A100 NVIDIA workstation. The proposed architecture has generalized well in comparison with the existing techniques for the three EEG datasets and achieved a low training and validation loss with optimum evaluation metrics. This makes the proposed architecture suitable for future EEG‐BCI system deployment in the automatic diagnosis of epilepsy.