bluuebunny/crossref_metadata_2025 huggingface dataset:
Data from Microenvironmental Regulation of BRCA1 Gene Expression by c-Jun and Fra2 in Premalignant Human Ovarian Surface Epithelial Cells
Authors: Zhou Lixin , Graves Marcia , MacDonald Gwen , Cipollone Jane , Mueller Christopher R. , Roskelley Calvin D.
Published: January 2024

Abstract
Reduced BRCA1 gene expression is common in the sporadic form of ovarian carcinoma. The spread of this highly lethal cancer often begins when tumor cell clusters are shed into the fluid of the abdominopelvic cavity such that they can float freely before seeding distant sites on the peritoneal walls and organs. Thus, the microenvironment that tumor cells find themselves in changes dramatically during these early shedding and floating stages of transperitoneal metastasis. To mimic this microenvironmental change in vitro, we released premalignant human ovarian surface epithelial cells from the substratum and forced them to cluster in suspension. Under these conditions, steady state levels of BRCA1 mRNA and protein fell significantly and the transcriptional activation state of the BRCA1 promoter was suppressed. Analysis of the promoter indicated that the previously identified “CRE” element located within the “positive regulatory region” (PRR) contributed to this suppression. More specifically, we show that the suppression was mediated, at least in part, by a suspension culture–driven decrease in the levels of two members of the AP1 transcription factor complex, c-Jun and Fra2, that bind to the CRE element. Therefore, a microenvironmental change that is manifested during the initial stages of ovarian carcinoma dissemination may, potentially, help suppress BRCA1 expression in sporadic tumors and thus promote their progression. Mol Cancer Res; 11(3); 272–81. ©2013 AACR.
Klimawandel für Lungenfachärzte: ein fokussierter Überblick
Authors: Balakrishnan Bathmapriya , Callahan Sean J. , Cherian Sujith V. , Subramanian Abirami , Sarkar Sauradeep , Bhatt Nitin , Scholand Mary-Beth
Published: January 2024

Der Klimawandel hat negative Auswirkungen auf die globale Gesundheit. Temperaturschwankungen, Unwetter, eine sich verschlechternde Luftqualität und eine zunehmend unsichere Versorgung mit Nahrungsmitteln und sauberem Wasser bedrohen in wachsendem Maße die menschliche Gesundheit. Bis zum Ende des 21. Jahrhunderts wird mit einem globalen Temperaturanstieg von bis zu 6,4 °C gerechnet, was die Bedrohung weiter verschärft. Die Öffentlichkeit und die Angehörigen der Gesundheitsberufe, einschließlich der Lungenfachärzte, sind sich der negativen Auswirkungen des Klimawandels und der Luftverschmutzung bewusst und unterstützen die Bemühungen zur Minderung ihrer Folgen. In der Tat gibt es deutliche Hinweise darauf, dass ein vorzeitiger Herztod mit der Exposition gegenüber Luftverschmutzung über die Atemwege, die als Eintrittspforte fungieren, zusammenhängt. Es gibt jedoch nur wenige Leitlinien, die Lungenfachärzten helfen, die Auswirkungen des Klimawandels und der Luftverschmutzung auf das breite Spektrum von Lungenerkrankungen zu erkennen. Lungenfachärzte benötigen evidenzbasiertes Wissen über die Auswirkungen des Klimawandels und der Luftverschmutzung auf bestimmte Lungenerkrankungen, um Patienten kompetent informieren und Risiken minimieren zu können. Unser Ziel ist es, Lungenfachärzte mit dem Wissen und den Werkzeugen auszustatten, die sie benötigen, um die Gesundheit ihrer Patienten zu verbessern und negative Auswirkungen trotz der Bedrohungen durch den Klimawandel zu verhindern. In dieser Übersichtsarbeit stellen wir den aktuellen Wissensstand zu den Auswirkungen des Klimawandels und der Luftverschmutzung auf eine Vielzahl von Lungenerkrankungen dar. Dieses Wissen soll es ermöglichen, anstelle einer reaktiven Behandlung von Krankheiten einen proaktiven und individualisierten Ansatz für Präventionsstrategien für Patienten zu entwickeln.
Rare Onset of Erdheim-Chester Disease in Children and Young Adults: A Case Series and Review of the Literature
Authors: Romano Carmine , Pegoraro Francesco , Vaglio Augusto , Spezzani Chiara , Sieni Elena , Fotzi Ilaria , Lenge Matteo , Di Rita Andrea , Peraio Simone , Noris Alice , Gaggiano Carla , Grosso Salvatore , Giordano Flavio
Published: January 2024

Introduction: Erdheim-Chester disease (ECD) is a rare histiocytic neoplasm that affects patients, predominantly males aged 40–70 years, with very heterogeneous clinical presentation and prognosis. In 2020, Goyal et al. proposed consensus recommendations for the management of patients with ECD, remarking on the exceptional presentation of the disease in the pediatric population. Case Presentation: The first patient, a 20-year-old male, underwent cervical laminectomy and partial removal of a cervical spine lesion, initially apparently consistent with cervical schwannomas. The second patient, a 9-year-old female, received surgery for an extra-axial lesion of the greater sphenoid wing, radiologically consistent with a meningioma. Conclusion: At present, 15 pediatric cases have been reported in the literature with involvement of the central nervous system, with no consensus on the diagnostic and therapeutic management, as Pegoraro et al. evidenced in their pediatric multicenter case series. The present article adds two new cases of ECD with onset in childhood and young adulthood, who received the diagnosis after neurosurgical procedures.
Effects of Liquid and Bar Soaps on the Skin of Brazilian Newborns: A Randomized Controlled Trial
Authors: Ramos Mily Constanza Moreno , Velasco Maria Valeria Robles , Bueno Mariana , Veríssimo Maria de La Ó Ramallo
Published: January 2024

Introduction: Compared to adults, newborns’ skin has a thinner epidermis and stratum corneum with decreased hydration levels, higher transepidermal water loss, and a pH variation between 5.5 and 7.5. These characteristics can predispose to the occurrence of dryness, infections, and dermatological conditions. Water and liquid soap with adequate formulation have shown to be beneficial and safe for newborns’ skin. However, studies evaluating the effect of bar soap, products widely used in Brazil and Latin America, are unknown. Therefore, the objective of this study was to compare the effects of liquid and bar soaps on the term newborns’ skin. Methods: This randomized controlled, parallel, single-blind clinical trial was conducted at a public university hospital in São Paulo, Brazil. 100 healthy term newborns with no congenital anomalies, acute diseases, or dermatological conditions were randomized to use liquid soap (experimental group) or bar soap (control group). Skin pH, transepidermal water loss, stratum corneum hydration, sebum content, and skin condition were assessed before and after the first bath, at 48 h, 14 days, and 28 days after birth. These evaluations were performed on the forearm, abdomen, buttocks, and thigh. In addition, the mother’s perception of soap use was also evaluated. Results: Data of 100 newborns were analyzed by intention to treat. The rate of retention was 53%. Newborns exposed to the liquid soap presented significantly better skin acidification (p < 0.001) and significantly better stratum corneum hydration (p < 0.001) than the skin of newborns exposed to the bar soap, regardless of the area evaluated. There were no significant differences in transepidermal water loss, sebum content, dryness, erythema, or skin breakdown and the mother’s perceptions of the use of the soaps. Conclusion: Newborns in the experimental group presented better skin acidification and stratum corneum hydration when compared to newborns in the control group.
Seasonality of Reproduction in a Subtropical Free-Living Finch Amandava amandava: Plasticity of Adenohypophyseal Gonadotropes, Lactotropes, and Thyrotropes
Authors: Mohanty Banalata
Published: January 2024

Introduction: This study sought to decipher the mechanism of transitions between life-history stages in a seasonally reproducing subtropical finch, Amandava amandava delineating the plasticity of the gonadotropes (LH cells), lactotropes (PRL cells), and thyrotropes (TSH cells) in the pituitary gland including the pars tuberalis, with regard to the in situ expression, morphological characteristics, and alteration in the plasma levels of hormones. Methods: Immunohistochemistry of LH, PRL, TSH cells, morphometry and densitometry of expressed hormones (Image J software analysis), and ELISA for plasma hormonal levels were performed. Results: LH, PRL, and TSH cells showed remarkable plasticity during the annual seasonal reproductive cycle. In the PT, all the 3 cell types were detected during the breeding phase, with additional detection of the TSH immunoreactivity during the pre-breeding and the PRL immunoreactivity during post-breeding phases. Pars distalis (PD) expressions and the plasma levels of the LH and TSH were at the peak during the breeding phase, but the PRL peak was during the post-breeding phase. In addition to PRL in the neurohypophysis and in the median eminence, hypothalamic PRL, and TSH were also elucidated. Conclusions: This study suggests activation of the gonadal axis by the PT TSH which might transduce seasonal cues, but not specifically photoperiod, in the birds of the tropics/subtropics. Post-breeding phase sustained high plasma TSH and peak plasma PRL might coordinate the transition to the non-breeding phase including the trigger of parental care as the later hormone assigned with. Hypothalamic TSH and PRL might influence events of seasonality through central modulation.
Predictive Value of the Hb/RDW Ratio for the Risk of All-Cause Death in Patients with Heart Failure with Different Ejection Fractions
Authors: Zhou Jing , Ma Wenfang , Wan Yu , Zhou Yanji , Wan Wen , Gu Wenyi , Li Hongxia , Xu Chenggong , Chen Lixing
Published: January 2024

Introduction: The prognostic value of the ratio of haemoglobin to red cell distribution width (HRR) in different types of heart failure (HF) is not well known. Method and Results: We analysed the long-term prognostic value of HRR in patients with HF using the Cox proportional risk model and Kaplan-Meier method. We reviewed consecutive 972 HF patients. The overall mortality rate was 45.68%. Mortality was 52.22% in the HFrEF group and 40.99% in the HFpEF + HFmrEF group. Cox regression showed that when HRR increased by 1 unit, the risk of all-cause death in all HF patients decreased by 22.8% (HR: 0.772, 95% CI: 0.724, 0.823, p < 0.001), in the HFpEF + HFmrEF group it decreased by 15.5% (HR: 0.845, 95% CI: 0.774, 0.923, p < 0.001), and in the HFrEF group it decreased by 36.1% (HR: 0.639, 95% CI: 0.576, 0.709, p < 0.0001). Subgroup analysis showed that there were interactions between the EF and HRR groups. The group in which HRR best predicted all-cause death from HF was group 1 (EF <40%, HRR <9.45), followed by group 2 (EF <40%, HRR ≥9.45), and group 3 (EF ≥40%, HRR <9.45). HRR had no predictive value in group 4 (EF ≥40%, HRR ≥9.45). Conclusion: HRR is an important predictor of all-cause mortality in patients with HF, especially HFrEF. There is an interaction between HRR group and LVEF group.
Lesson plan analysis protocol in assessing mathematics and science lessons
Authors: Telesphore Habiyaremye Hashituky , Ntivuguruzwa Celestin , Ntawiha Philothere , Agnes Mbonyiryivuze , Josiane Mkagihana , Edwin Byusa , Celine Byukusenge , Jeannette Musengimana , Aline Dorimana , Fidele Ukobizaba , Kizito Ndihokubwayo
Published: January 2024

Lesson planning is important in an educational setting. This study assessed how Rwandan tutors and teachers prepare lesson plans (LPs) before implementing them in a classroom. We employed a current and standard lesson plan analysis protocol (LPAP) developed by researchers from Rwanda to code data. We collected a representative sample of 119 mathematics and science subject lesson plans from teacher training college tutors and secondary school teachers for analysis to serve its usability. The study results revealed that only 11% of collected LPs were teachable as they were rated in both a good (70-79% scores) and very good (80-89% scores) range of LPAP interpretation. It was also found that the special education needs, lesson approaches, and lesson evaluation components got low mean scores (below 50%). These components were not given appropriate attention in developed LPs. Therefore, this study suggests that tutors and teachers build a quality lesson plan based on the standard LPAP.
Challenges to professional teacher development through workplace culture management
Authors: Khairiah Khairiah , Amin Alfauzan , Muassomah Muassomah , Mareta Mira , Sulistyorini Sulistyorini , Yusuf Mirna
Published: January 2024

The implementation of professional teacher development in Indonesia has been lacking. Many teachers continue to underperform, as evidenced by their workplace behaviors that violate the ethics of their profession. Workplace culture has contributed significantly to, and been detrimentally affected by, this lack of professionalism. Using a qualitative approach, this study seeks to explore the forms, factors, and implications of these challenges for the management of workplace culture. Teachers are simultaneously the objects and key informants of this research, which was conducted through observation of secondary-level madrasas spread throughout Bengkulu Province, Indonesia, as well as interviews with 15 teachers. This study identifies three main challenges: i) teachers have difficulty accessing professional training; ii) teachers cannot readily continue their educations; and iii) teachers have trouble writing and publishing academic works. These challenges are caused by a multitude of factors, primarily the lack of the funding, facilities, and infrastructure for professional development, as well as teachers limited digital literacy, and result in a workplace culture where initiative goes unrewarded, discipline is lacking, and teachers are unmotivated. As such, this study recommends significant improvements to the structure, culture, and infrastructure of educational institutions, thereby allowing teachers to overcome the challenges that hinder their professional development.
Scientific digital poster assignments: strengthen concepts, train creativity, and communication skills
Authors: Wisanti Wisanti , Indah Novita Kartika , Putri Eva Kristinawati
Published: January 2024

Student-centered learning promotes the development of students’ knowledge and skills with poster assignments used to ensure their active participation in academics. Therefore, this research aims to explore student competencies in concept strengthening, creativity, and communication skills from working on digital poster project assignments. Research using observation method with a quantitative approach. Data were collected from 86 participants learning plant systematics in their first semester based on the criteria for strengthening the concept, creativity, communication, and student responses. The instruments used for data collection were a poster scoring rubric and a closed questionnaire. Data were analyzed descriptively with simple statistics in the form of average, standard deviation, and percentage. The hypothesis about the correlation of concept strengthening, creativity, and communication was tested with Spearman’s coefficient. The result showed that students made 29 posters with concept strengthening, creativity and communication skills in the very good (3.42±0.49), very good (3.57±0.26), and very good (3.41±0.25) categories, respectively. Student competency shows a positive correlation between communication skills and concept reinforcement and between communication skills and creativity. Students give a positive response to the application of posters in learning in terms of learning experiences, concept strengthening, creativity and communication. Hence, using posters as project assignments in learning helps develop students’ knowledge and skills by acquiring varied experiences.
Analysis of the Indonesian Version of the Statistical Anxiety Scale (SAS) Instrument with a Psychometric Approach
Authors: Iriyadi Deni , Asdar Ahsanul Khair , Afriadi Bambang , Samad Mohammad Ardani , Syaputra Yogi Damai
Published: January 2024

This study aims to validate the psychometric approach (using the RASCH Model and Confirmatory Factor Analysis) on the Indonesian version of the Statistical Anxiety Scale (SAS) instrument. Sampling in this study used cluster random sampling with a total sample of 1651 which was divided into 3 regions of Indonesia (Western Indonesia, Central Indonesia and Eastern Indonesia) with details of 457 males (27.46%) and 1194 females (72.54%). The number of samples from the West Indonesia region was 922 people (55.71%), the Central Indonesia region was 605 people (36.76%), and the Eastern Indonesia region was 124 people (7.53%). The results of the factor analysis (CFA) show that the dimensions/elements of the SAS instrument meet the criteria which are then continued using the Rating Scale Model (RSM) approach. From the results of the tests performed, it shows that all items on the Statistical Anxiety Scale (SAS) instrument meet the specified criteria. Thus, the SAS instrument adopted in the Indonesian context can be used to measure students' statistical anxiety. The results of the research conducted became the initial capital to increase students' statistical anxiety considering that statistics courses are needed in completing studies, especially quantitative research.
Memorization and discussion methods effect on achievement and communication skills
Authors: Sukino Sukino , Sumin Sumin , Mahrus Erwin , Salim Ahmad , Muttaqin Imron , Supriyatno Triyo
Published: January 2024

This study aimed to determine learning outcomes and discuss the effect of the combination of memorization and small group discussion methods on students’ achievement and communication skills. A quantitative method was applied in this study with a quasi-experimental design. The subject of this study is 60 students in Islamic Education, Faculty of Education and Teacher Training (FTIK) at the Pontianak State Institute for Islamic Studies, divided into a control and an experimental group. Data were collected through pre-test and post-test from the control and experimental groups and then analyzed using the independent samples t-test using statistical software JASP version 0.16.4. The findings revealed that there are differences between outcome learning and communication skills between the control group which only uses the small group discussion method and the experimental group which employs a combination of memorization and small group discussion methods in the course of developing Islamic Education material. The findings of this study confirm that combining the two methods, memorization, and small group discussion, is highly effective in improving learning achievement and communication skills at the student level. Further research is suggested to explore and determine other factors affecting learning outcomes and methods.
Fostering students’ mathematical reasoning through a cooperative learning model
Authors: Mukuka Angel , Alex Jogymol Kalariparampil
Published: January 2024

This study sought to ascertain whether the student teams-achievement division (STAD) model of cooperative learning is effective in fostering students’ mathematical reasoning. Using the cluster random sampling technique, 301 eleventh-grade students between the ages of 14 and 20 were chosen from six public secondary schools within one district in Zambia. Students were given tasks on quadratic equations and functions both before and after the intervention. A robust analysis of the covariance test revealed that students’ mathematical reasoning abilities were significantly higher for the group that received instruction using the STAD approach than for the group that was taught using conventional methods of instruction at each of the five design points where regression slopes were comparable. A Chi-square test of independence further revealed that the STAD learning approach was associated with a greater proportion of students who demonstrated an appropriate degree of mathematical reasoning ability for each of the three indicators (conjecturing, justifying, and mathematizing). These results demonstrate that enhancing students’ mathematical reasoning abilities through the integration of classroom activities that engage students intellectually, physically, and socially is beneficial.
O sistema portuário brasileiro e o novo modelo de portos chinês: um estudo de direito comparado
Authors:   Universidade de São Paulo. Faculdade de Direito, Messias Caio Leal
Published: January 2024

O presente trabalho tem como objetivo compreender as propostas brasileiras e chinesas para o setor portuário. Essa investigação se justifica pela necessidade urgente de modernização do setor portuário no Brasil e de definição de um modelo que responda efetivamente às necessidades do país. Esse trabalho parte do pressuposto de que a China tem hoje um modelo portuário único, trabalha-se com a hipótese de que elementos desse modelo poderiam ser assimilados pelo Brasil, o que impõe um novo tratamento normativo. Este trabalho tem como base a revisão da literatura especializada do Direito Portuário que compara os diversos modelos existentes, sobretudo, as definições propostas pelo Banco Mundial. Para melhor entender a singularidade do modelo chinês, faz-se recurso à metodologia do Direito Comparado, assim como ao método analítico. Espera-se, com este estudo, que tem enorme potencial de aplicação concreta, compreender de que modo o sistema brasileiro, que já recebe investimentos chineses, pode ser impactado pela influência do modelo chinês e quais as consequências dessa interação, assim como refletir sobre a conveniência e adequação da possível adoção de elementos desse modelo em nossa realidade.
Abstract 19052: Interferon B1A-Induced Dilated Cardiomyopathy
Authors: DiCaro Michael , Turnbull Scott , Abdallah Ala , Lei KaChon , Ahsan Chowdhury H
Published: January 2024

Introduction:
Congestive heart failure is a leading causes of morbidity and mortality. Interferon therapy is a rare cause of dilated cardiomyopathy (DCM) and Heart Failure with Reduced Ejection Fraction (HFrEF). Specifically, interferon Alpha has been associated with cardiotoxicity. Here we describe a case of interferon B1A - induced HFrEF and DCM in a patient who took subcutaneous Interferon B1A for 11 years before developing clinical signs of heart failure. To our knowledge, only four other cases have been reported.

Case Description:
A 70-year-old man with a history of multiple sclerosis managed with Interferon B1A presented with shortness of breath, orthopnea, and lower extremity edema for 10 days. Physical examination revealed jugular venous distension and pitting edema. Brain natriuretic peptide (BNP) was 1580 pg/mL, troponin was 49 ng/L. Lipid panel, complete blood count, complete metabolic panel, Hemoglobin A1c, and thyroid stimulating hormone were within normal limits. Urine drug screen was negative. Chest X-ray revealed pulmonary vascular congestion and small pleural effusions bilaterally. A Transthoracic echocardiogram revealed mild aortic root dilatation (4.1cm), significant four-chamber dilatation, severely reduced left ventricular (LV) systolic function with an estimated ejection fraction of 20%, diastolic LV dysfunction, and moderately reduced systolic RV function, consistent with HFrEF and DCM (LVIDD 6.1cm). Coronary angiography showed normal coronary anatomy. The patient was started on guideline-directed medical therapy for HFrEF. Close follow-up was arranged to track improvement in systolic function after cessation of interferon b1a and consideration for Cardiac MRI and possible RV biopsy to evaluate for other causes of cardiomyopathy.

Discussion/Conclusions:
Due to the patient’s negative ischemic workup and absence of risk factors for cardiovascular disease, we strongly suspect that the patient’s cardiomyopathy was due to interferon B1A. With only 4 other cases of interferon B1A-induced DCM reported, it is a rare cause of medication-induced DCM. Interferon B1A should be considered a potential risk factor for developing heart failure, especially in high-risk patients.
Single Bolus r-SAK Before Primary PCI for ST-Segment–Elevation Myocardial Infarction
Authors: Chen Pengsheng , Eikelboom John W. , Tan Chunyue , Zhang Wenhao , Xu Yi , Bai Jianling , Wang Jun , Wang Tong , Gong Xiaoxuan , Liu Kun , Chen Xin , Wang Xiaoyan , Zhu Li , Zhao Xin , Yang Naiquan , Jiang Jun , Pu Jun , Zhao Bo , Chen Zengguang , Li Baihong , Wang Guoyu , Lu Chuan , Ying Lianghong , Jiang Meng , Zhu Xiaomei , Ma Jiazheng , Dong Zhou , Li Chen , Zong Jiaxin , Zhang Fumin , Zhu Jun , Huang Jun , Kong Xiangqing , Yu Hao , Li Chunjian ,   for the OPTIMA-5 Investigators
Published: January 2024

BACKGROUND:

It is uncertain whether adjunctive thrombolysis is beneficial for patients with ST-segment–elevation myocardial infarction undergoing percutaneous coronary intervention (PCI) within 120 minutes of presentation. This study was to determine whether in patients presenting with ST-segment–elevation myocardial infarction a single bolus recombinant staphylokinase (r-SAK) before timely PCI leads to improved patency of the infarct-related artery and reduces the infarct size.

METHODS:

This is an open-label, prospective, multicenter, randomized study. We enrolled patients aged 18 to 75 years who were within 12 hours of symptom onset of ST-segment–elevation myocardial infarction and expected to undergo PCI within 120 minutes. Patients were administered loading doses of aspirin and ticagrelor and intravenous heparin and were randomized to receive 5 mg bolus of r-SAK or normal saline intravenously before PCI. The primary end point was Thrombolysis in Myocardial Infarction flow grade 2 to 3 or grade 3 in the infarct-related artery 60 minutes after thrombolysis. The infarct size was detected by cardiac magnetic resonance 5 days after randomization. The safety end point was major bleeding (Bleeding Academic Research Consortium ≥3) during 30-day follow-up.

RESULTS:

A total of 283 patients were screened from 8 centers and 200 were randomized (median age, 58.5 years; 14% female). The median symptom to thrombolysis time was 252.5 (interquartile range, 142.8–423.8) minutes and thrombolysis to coronary arteriography was 50.0 (interquartile range, 37.0–66.0) minutes. Patients randomized to r-SAK compared with normal saline more often had Thrombolysis in Myocardial Infarction flow grade 2 to 3 (69.0% versus 29.0%;
P
<0.001) and Thrombolysis in Myocardial Infarction flow grade 3 (51.0% versus 18.0%;
P
<0.001) and had smaller infarct size (21.91±10.84% versus 26.85±12.37%;
P
=0.016). There was no increase in major bleeding (r-SAK, 1.0% versus control, 3.0%;
P
=0.616).

CONCLUSIONS:

A single bolus r-SAK before primary PCI for ST-segment–elevation myocardial infarction improves infarct-related artery patency and reduces infarct size without increasing major bleeding.

REGISTRATION:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT05023681.
Detection and Control of Pregnancy Hypertension Using Self-Monitoring of Blood Pressure With Automated Telemonitoring: Cost Analyses of the BUMP Randomized Trials
Authors: Campbell Helen E. , Chappell Lucy C. , McManus Richard J. , Tucker Katherine L. , Crawford Carole , Green Marcus , Rivero-Arias Oliver
Published: January 2024

BACKGROUND:

Pregnancy hypertension continues to cause maternal and perinatal morbidity. Two linked UK randomized trials showed adding self-monitoring of blood pressure (SMBP) with automated telemonitoring to usual antenatal care did not result in earlier detection or better control of pregnancy hypertension. This article reports the trials’ integrated cost analyses.

METHODS:

Two cost analyses. SMBP with usual care was compared with usual care alone in pregnant individuals at risk of hypertension (BUMP 1 trial [Blood Pressure Monitoring in High Risk Pregnancy to Improve the Detection and Monitoring of Hypertension], n=2441) and with hypertension (BUMP 2 trial, n=850). Clinical notes review identified participant-level antenatal, intrapartum, and postnatal care and these were costed. Comparisons between trial arms used means and 95% CIs. Within BUMP 2, chronic and gestational hypertension cohorts were analyzed separately. Telemonitoring system costs were reported separately.

RESULTS:

In BUMP 1, mean (SE) total costs with SMBP and with usual care were £7200 (£323) and £7063 (£245), respectively, mean difference (95% CI), £151 (−£633 to £936). For the BUMP 2 chronic hypertension cohort, corresponding figures were £13 384 (£1230), £12 614 (£1081), mean difference £323 (−£2904 to £3549) and for the gestational hypertension cohort were £11 456 (£901), £11 145 (£959), mean difference £41 (−£2486 to £2567). The per-person cost of telemonitoring was £6 in BUMP 1 and £29 in BUMP 2.

CONCLUSIONS:

SMBP was not associated with changes in the cost of health care contacts for individuals at risk of, or with, pregnancy hypertension. This is reassuring as SMBP in pregnancy is widely prevalent, particularly because of the COVID-19 pandemic.

REGISTRATION:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT03334149.
Association Between Age at Diagnosis of Type 2 Diabetes and Hospitalization for Heart Failure: A Population‐Based Study
Authors: Ke Calvin , Shah Baiju R. , Thiruchelvam Deva , Echouffo‐Tcheugui Justin B.
Published: January 2024

Background

The relation between age at diagnosis of type 2 diabetes (T2D) and hospitalization for heart failure (HHF) is unclear. We assessed the association between age at diagnosis of T2D and HHF.

Methods and Results

We conducted a population‐based cohort study using administrative health databases from the Canadian province of Ontario, including participants without prior heart failure. We identified people with new‐onset T2D between April 1, 2005 and March 31, 2015, and matched each person with 3 diabetes‐free adults, according to birth year and sex. We estimated adjusted hazard ratios (HRs) and rate ratios (RRs) for the association between age at T2D diagnosis and incident HHF, which was assessed until March 31, 2020. Among 743 053 individuals with T2D and 2 199 539 matched individuals without T2D, 126 241 incident HHF events occurred over 8.9 years. T2D was associated with a greater adjusted hazard of HHF at younger ages (eg, HR at age 30 years: 6.94 [95% CI, 6.54–7.36]) than at older ages (eg, HR at age 60 years: 2.50 [95% CI, 2.45–2.56]) relative to matched individuals. Additional adjustment for mediators (hypertension, coronary artery disease, and chronic kidney disease) marginally attenuated this relationship. Age at T2D diagnosis was associated with a greater number of HHF events relative to matched individuals at younger ages (eg, RR at age 30 years: 6.39 [95% CI, 5.76–7.08]) than at older ages (eg, RR at age 60 years: 2.65 [95% CI, 2.54–2.76]).

Conclusions

Younger age at T2D diagnosis is associated with a disproportionately elevated HHF risk relative to age‐matched individuals without T2D.
Screening of Moyamoya Disease From Retinal Photographs: Development and Validation of Deep Learning Algorithms
Authors: Hong JaeSeong , Yoon Sangchul , Shim Kyu Won , Park Yu Rang
Published: January 2024

BACKGROUND:

Moyamoya disease (MMD) is a rare and complex pathological condition characterized by an abnormal collateral circulation network in the basal brain. The diagnosis of MMD and its progression is unpredictable and influenced by many factors. MMD can affect the blood vessels supplying the eyes, resulting in a range of ocular symptoms. In this study, we developed a deep learning model using real-world data to assist a diagnosis and determine the stage of the disease using retinal photographs.

METHODS:

This retrospective observational study conducted from August 2006 to March 2022 included 498 retinal photographs from 78 patients with MMD and 3835 photographs from 1649 healthy participants. Photographs were preprocessed, and an ResNeXt50 model was developed. Model performance was measured using receiver operating curves and their area under the receiver operating characteristic curve, accuracy, sensitivity, and F1-score. Heatmaps and progressive erasing plus progressive restoration were performed to validate the faithfulness.

RESULTS:

Overall, 322 retinal photographs from 67 patients with MMD and 3752 retinal photographs from 1616 healthy participants were used to develop a screening and stage prediction model for MMD. The average age of the patients with MMD was 44.1 years, and the average follow-up time was 115 months. Stage 3 photographs were the most prevalent, followed by stages 4, 5, 2, 1, and 6 and healthy. The MMD screening model had an average area under the receiver operating characteristic curve of 94.6%, with 89.8% sensitivity and 90.4% specificity at the best cutoff point. MMD stage prediction models had an area under the receiver operating characteristic curve of 78% or higher, with stage 3 performing the best at 93.6%. Heatmap identified the vascular region of the fundus as important for prediction, and progressive erasing plus progressive restoration result shows an area under the receiver operating characteristic curve of 70% only with 50% of the important regions.

CONCLUSIONS:

This study demonstrated that retinal photographs could be used as potential biomarkers for screening and staging of MMD and the disease stage could be classified by a deep learning algorithm.
Real Face Value: The Processing of Naturalistic Facial Expressions in the Macaque Inferior Temporal Cortex
Authors: Taubert Jessica , Japee Shruti
Published: January 2024

For primates, expressions of fear are thought to be powerful social signals. In laboratory settings, faces with fearful expressions have reliably evoked valence effects in inferior temporal cortex. However, because macaques use so called “fear grins” in a variety of different contexts, the deeper question is whether the macaque inferior temporal cortex is tuned to the prototypical fear grin, or to conspecifics signaling fear? In this study, we combined neuroimaging with the results of a behavioral task to investigate how macaques encode a wide variety of fearful facial expressions. In Experiment 1, we identified two sets of macaque face stimuli using different approaches; we selected faces based on the emotional context (i.e., calm vs. fearful), and we selected faces based on the engagement of action units (i.e., neutral vs. fear grins). We also included human faces in Experiment 1. Then, using fMRI, we found that the faces selected based on context elicited a larger valence effect in the inferior temporal cortex than faces selected based on visual appearance. Furthermore, human facial expressions only elicited weak valence effects. These observations were further supported by the results of a two-alternative, forced-choice task (Experiment 2), suggesting that fear grins vary in their perceived pleasantness. Collectively, these findings indicate that the macaque inferior temporal cortex is more involved in social intelligence than commonly assumed, encoding emergent properties in naturalistic face stimuli that transcend basic visual features. These results demand a rethinking of theories surrounding the function and operationalization of primate inferior temporal cortex.
Amygdalar Excitation of Hippocampal Interneurons Can Lead to Emotion-driven Overgeneralization of Context
Authors: John Yohan J. , Wang Jingyi , Bullock Daniel , Barbas Helen
Published: January 2024

Context is central to cognition: Detailed contextual representations enable flexible adjustment of behavior via comparison of the current situation with prior experience. Emotional experiences can greatly enhance contextual memory. However, sufficiently intense emotional signals can have the opposite effect, leading to weaker or less specific memories. How can emotional signals have such intensity-dependent effects? A plausible mechanistic account has emerged from recent anatomical data on the impact of the amygdala on the hippocampus in primates. In hippocampal CA3, the amygdala formed potent synapses on pyramidal neurons, calretinin (CR) interneurons, as well as parvalbumin (PV) interneurons. CR interneurons are known to disinhibit pyramidal neuron dendrites, whereas PV neurons provide strong perisomatic inhibition. This potentially counterintuitive connectivity, enabling amygdala to both enhance and inhibit CA3 activity, may provide a mechanism that can boost or suppress memory in an intensity-dependent way. To investigate this possibility, we simulated this connectivity pattern in a spiking network model. Our simulations revealed that moderate amygdala input can enrich CA3 representations of context through disinhibition via CR interneurons, but strong amygdalar input can impoverish CA3 activity through simultaneous excitation and feedforward inhibition via PV interneurons. Our model revealed an elegant circuit mechanism that mediates an affective “inverted U” phenomenon: There is an optimal level of amygdalar input that enriches hippocampal context representations, but on either side of this zone, representations are impoverished. This circuit mechanism helps explain why excessive emotional arousal can disrupt contextual memory and lead to overgeneralization, as seen in severe anxiety and posttraumatic stress disorder.
Clarifying the placement of Trifolium capense in Leobordea (Fabaceae)
Authors: LE ROUX M. MARIANNE , KLOPPER RONELL R. , BOATWRIGHT JAMES S.
Published: January 2024

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Monsoon Planet: Bimodal Rainfall Distribution due to Barrier Structure in Pressure Fields
Authors: Katzenberger Anja , Petri Stefan , Feulner Georg , Levermann Anders
Published: January 2024

Monsoon systems transport water and energy across the globe, making them a central component of the global circulation system. Changes in different forcing parameters have the potential to fundamentally change the monsoon characteristics as indicated in various paleoclimatic records. Here, we use the Atmosphere Model developed at the Geophysical Fluid Dynamics Laboratory (GFDL-AM2) and couple it with a slab ocean in order to analyze the monsoon’s sensitivity to changes in different parameters on a planet with idealized topography (varying land position, slab depth, atmospheric CO2 concentration, solar radiation, sulfate aerosol concentration, and surface albedo). This Monsoon Planet concept of an aquaplanet with a broad zonal land stripe allows us to reduce the influence of topography and to access the relevant meridional monsoon dynamics. In simulations with monsoon dynamics, a bimodal rainfall distribution develops during the monsoon months with one maximum over the tropical ocean and the other one over land. The intensity and extent of the monsoon depend on the relative height of a local maximum in the surface pressure field that is acting as a barrier and is determining the coastward moisture transport. Changes in the barrier height occur during the course of one year but can also be induced when varying different parameters in the sensitivity analysis (e.g., the increase of atmospheric CO2 reduces the barrier height, resulting in an increase of rainfall, while aerosols have the opposing effect). This bimodal rainfall structure separated by a pressure barrier is also present in reanalysis data of the West African monsoon.

Significance Statement

Monsoon rainfall directly impacts the livelihood of millions of individuals in the tropics. Because monsoons transport energy and water around the globe, their influence reaches far beyond the tropics, and changes in their dynamics affect the climate both locally and globally. The individual monsoon systems are subject to various forcing factors that determine the monsoon characteristics in partly opposing ways. Here, we implement a model setup of the Monsoon Planet to study the monsoon’s sensitivity to various forcings in a simplified design, allowing us to gain new insights into monsoon dynamics. We find that a local maximum in the pressure field is acting as a barrier for moisture transport and thus determines the monsoon characteristics over land.
Factors Associated With HIV Testing in Adolescent and Young Adult Females With a History of STI
Authors: Addison Jessica , Caves Kyzwana , Melvin Patrice , Fitzgerald Susan , Woods Elizabeth R. , Walsh Kathleen E.
Published: January 2024

To determine the percentage of female adolescent patients (13-26 years old) who had HIV testing ordered within 90 days of incident sexually transmitted infection (STI) diagnosis during an outpatient clinic visit. This was a retrospective chart review study evaluating 830 visits among 589 female patients 13 to 26 years who had an incident STI diagnosed in outpatient Adolescent Medicine or Pediatric Practices in an urban, nonprofit, academic, free-standing children’s hospital at the main campus and a community site in the Northeast United States. Odds of HIV screening was greater at the community-based adolescent medicine practice (odds ratio [OR] = 3.17; 95% confidence interval [CI]: [1.92, 5.24]) and when seen by an adolescent medicine provider (OR = 1.44; 95% CI: [1.02, 2.03]). Only 33.5% (n = 283) of 844 clinical encounters had HIV screening obtained within 90 days of incident STI diagnosis. Overall, HIV screening rates within 90 days of STI diagnosis was low, and there is much room for improvement.
In unsteady waters: How mayors and chief administrative officers make sense of a public service bargain in disequilibrium
Authors: Grøn Caroline Howard , Opstrup Niels , Salomonsen Heidi Houlberg , Villadsen Anders Ryom
Published: January 2024

Public service bargains (PSBs) have become a central heuristic to understand the relationship between politicians and senior bureaucrats. In this article, we add to the existing literature by exploring how both politicians and senior bureaucrats make sense of a PSB in disequilibrium. Based on individual and focus group interviews and six case studies of breakdown in the bargain, we find that bargains may be unstable due to both changing circumstances and differences in interpretations. We add to previous research by demonstrating how the differences in interpretations may manifest themselves along two dimensions, that is, in the balance between the types of competences and rewards that should be included in the bargain as perceived by politicians and senior civil servants, as well as how the competences and rewards agreed upon are interpreted.

Points for practitioners

The way mayors and chief administrative officers (CAOs) understand their relationship (the public service bargain) can sometimes reach a state of disequilibrium. This study explores how such a disequilibrium is interpreted by the relevant actors in terms of competences and rewards. Proactive renegotiation and alignment between mayors and CAOs is essential in responding to individual and relational dynamics to ensure efficient and legitimate cooperation between political and administrative actors.
Simulating Local Biases in Visual Attention in Neurocognitive Performance
Authors: Berry Benjamin A. , Meyer Gregory J. , O’Gorman Emily T. , Roy Manali , Sholander Larson E. , Mihura Joni L.
Published: January 2024

Typical visual perception includes an attention bias toward right hemisphere mediated global, holistic cortical processing. An atypically local, detail-oriented focus of attention is characteristic of left hemisphere processing and is often observed in patients whose field of attention is restricted by certain types of neurocognitive impairment. We designed the present pair of studies to induce a local attentional focus to observe its consequences on neurocognitive measures of visuospatial processing. In Experiment I, participants wore glasses mimicking simultanagnosia, a disorder of visual attention, to induce a narrowed, atypical attentional style while they completed visual neuropsychological tasks. This simulation impaired participants’ capacities to visually synthesize and efficiently reproduce Complex Figure stimuli as measured with the Boston Qualitative Scoring System (BQSS), and it induced an atypical attentional style on Rorschach Performance Assessment System (R-PAS) responses. In Experiment II, participants wore glasses designed to provoke differential hemispheric activation, also hypothesized to influence style of visual attention; but this manipulation did not influence neurocognitive task performance. We discuss implications for the interpretation of BQSS and R-PAS scores and offer directions for future research.
Understanding how online solution–focused hypnotherapy can support the wellbeing of police personnel and treat symptoms of anxiety and depression
Authors: Barney Emily , Treby Emma , Johannes Gary , Seymour Kerry
Published: January 2024

Background: The mental health and wellbeing of police personnel has received increased attention over the last 5 years and rates of mental illness amongst employees are high. Anxiety and depression are the most common mental illnesses within the police force, yet little is known about how effective psychotherapeutic interventions are in treating the symptoms of these mental illnesses in police personnel, that is, how many police personnel recover from anxiety and depression after completing a course of psychotherapy. In the psychotherapy outcome literature, recovery rates for anxiety and depression in clinical samples following treatment are low, between 37% and 47%, suggesting similar outcomes can be expected within the police force using current therapy models. Further research into new or unused interventions is therefore needed to improve recovery rates within the police force. Method: This pilot study explored how a new type of psychotherapy, online Solution Focused Hypnotherapy (SFH), can support the wellbeing of police personnel and effectively treat symptoms of anxiety and depression. A quantitative design was used to measure changes in anxiety (GAD-7) and depression (PHQ-9) symptom severity at pre- and post-intervention and measure changes in wellness using a rating scale (Life Wellness Indicator Tool) at the end of each session. Results: A total of 42 police personnel, both officers and staff, participated in the study and 20 qualified SFH therapists delivered the online intervention. The main finding was that 78% of police personnel who completed a course of SFH and started with clinically significant symptoms of anxiety and/or depression had recovered from their illness following the intervention (i.e. scored below 5 on at least one outcome measure). A total of 97.2% of participants achieved ‘wellness’ after the intervention, compared to 19% at pre-intervention and no participants experienced an increase in symptom scores after completing the intervention. Conclusion: Online Solution Focused Hypnotherapy (SFH) can support the wellbeing of both police officers and staff and effectively treat the symptoms of anxiety and depression. Our findings suggest that SFH is an effective, well liked and safe intervention to use within the police force and provides support for more resources into a larger randomised controlled trial.
Relationships of Transformational and Paternalistic Leadership Styles With Follower Needs, Multidimensional Work Motivations and Organizational Commitment: A Mediated Model
Authors: Çivit Selinay , Göncü-Köse Aslı
Published: January 2024

Paternalistic Leadership (PL) style is suggested to be an emic manifestation of Transformational Leadership (TL) in cultural contexts characterized by high power distance and collectivism. The present study investigated the effects of TL and PL behaviors on employees’ multidimensional work motivation and organizational commitment and the mediating effects of satisfaction of psychological needs (needs for autonomy, competence, and relatedness) in these relationships. Data were collected from 423 white-collar employees and analyzed by Structural Equation Modeling. The findings revealed that TL was significantly related to employees’ autonomous and controlled work motivations as well as amotivation via its association with the satisfaction of employees’ needs for autonomy, competence, and relatedness. PL was associated with employees’ autonomous work motivations and amotivation via satisfaction of employees’ need for relatedness. Autonomous motivations were positively associated with affective commitment; whereas controlled motivations were positively related to normative commitment. Amotivation was negatively associated with all types of commitment. The findings are discussed in terms of theoretical and practical implications as well as suggestions for future research.