bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness and safety of insulin glargine 300 U/mL in insulin‐naïve individuals according to diabetes duration: Results from the REALI European pooled data analysis
Authors: Gourdy Pierre , Bonadonna Riccardo C. , Mauricio Didac , Müller‐Wieland Dirk , Mauquoi Celine , Vera Carine , Bonnemaire Mireille , Freemantle Nick 
Published: October 2024

AbstractAimTo evaluate the effectiveness and safety of insulin glargine 300 U/mL (Gla‐300) initiation according to diabetes duration (DD).Materials and MethodsWe analysed patient‐level data from 2381 insulin‐naïve individuals with type 2 diabetes (T2D), of whom 2349 (98.7%) were treated with Gla‐300 for 24 weeks. Of the 2381 participants, 1048 (44.0%) had a DD of less than 8 years and 1333 (56.0%) had a DD of 8 years or longer. We further analysed the subgroups of participants having a DD of less than 4 years (N = 450), 4‐8 years (N = 598), 8‐12 years (N = 627) and 12 years or longer (N = 706).ResultsMean ± standard deviation age was 60.2 ± 9.0 years in participants with a DD less than 8 years and 64.2 ± 8.8 years in those with a DD of 8 years or longer. At 24 weeks of Gla‐300 therapy, HbA1c improved with a least‐squares (LS) mean change from baseline of −1.88% (95% confidence interval [CI], −1.95 to −1.80) and −1.71% (95% CI, −1.77 to −1.65), respectively, resulting in a LS mean difference between groups of 0.17% (95% CI, 0.07 to 0.26; P = .0005). In the subgroup analysis, LS mean HbA1c reduction from baseline to week 24 was highest in participants with a DD of less than 4 years and lowest in participants with a DD of 12 years or longer. Overall, incidences of symptomatic and severe hypoglycaemia were low, irrespective of DD, without body weight changes.ConclusionsGla‐300 was effective and safe in insulin‐naïve individuals with T2D, regardless of DD. Improvement in HbA1c was greater when Gla‐300 was initiated in participants with a DD of less than 4 years, although the difference between the groups was modest.
Genetic Independence of Naturally Correlated Variation in Resistance to Endemic and Novel Pathogens
Authors: Hood Michael E. , Bruns Emily L. , Antonovics Janis , Davis Isabel , Launi Michelle , Bulzoni Sophia , Rothberg Samantha E. 
Published: October 2024

ABSTRACTThe emergence of new diseases is an urgent concern, but hosts can also vary in resistance to pathogens that are novel to them, facilitating evolutionary rescue. However, little is known about the genetic source for polymorphic resistance to novel pathogens or its relationship to defences against endemic diseases. With anther‐smut disease from wild plant populations, we used selection experiments and genetic analyses to show that resistances to novel and endemic pathogens are genetically independent, despite being positively correlated in nature. Moreover, novel‐pathogen resistance presented a much simpler genetic basis and more rapid response to selection. We demonstrate that polymorphic resistance to a newly introduced disease is genetically determined and not an extension of defences against the related endemic pathogen, challenging the conventional view of nonhost resistance.
Pharmacological Impacts of Mucopolysacccharide Polysulfates in the Epidermis Involves Inhibition of Amphiregulin‐Mediated Signals in Keratinocytes
Authors: Hirase Ryo , Fujita Tomoyuki , Miyai Tomohiro , Kawasaki Hiroshi , Koseki Haruhiko 
Published: October 2024

ABSTRACTThe epidermis, the most superficial layer of the human skin, serves a critical barrier function, protecting the body from external pathogens and allergens. Dysregulation of epidermal differentiation contributes to barrier dysfunction and has been implicated in the pathology of various dermatological diseases, including atopic dermatitis (AD). Mucopolysaccharide polysulphate (MPS) is a moisturising agent used to treat xerosis in patients with AD. However, its mechanism of action on keratinocytes, the main constituents of the epidermis, remains unclear. In this study, we investigated the effect of MPS on keratinocytes by subjecting adult human epidermal and three‐dimensional cultured keratinocytes to MPS treatment, followed by transcriptome analysis. The analysis revealed that MPS treatment enhances keratinocyte differentiation and suppresses proliferation. We focused on amphiregulin (AREG), a membrane protein that belongs to the epidermal growth factor (EGF) family and possesses a heparin‐binding domain, as a significant target among the genes altered by MPS. MPS exerted an inhibitory effect directly on AREG, rather than on EGF receptors or other members of the EGF family. Furthermore, AREG leads to a reduction in epidermal barrier function, whereas MPS contributes to barrier enhancement via AREG inhibition. Collectively, these findings suggest that MPS modulates barrier function through AREG inhibition, offering insights into potential therapeutic strategies for skin barrier restoration.
Stress enhances aggression in male rats with genetic stress hyper‐reactivity
Authors: Harter Aspen M. , Kim Chris , Yamazaki Anna , Lee Luca , Ji Michelle T. , Nemesh Mariya , Redei Eva E. 
Published: October 2024

AbstractThe current study investigated stress‐induced aggressive behavior in the resident‐intruder test in males of the genetically stress hyper‐reactive Wistar Kyoto More Immobile (WMI), and the nearly isogenic, control Wistar Kyoto Less Immobile (WLI) strains. Tests were carried out against same‐age intruders during adolescence, and same‐age and juvenile intruders in adulthood. In adolescence and adulthood, prior acute restraint stress decreased social interactions and decreased aggressive behaviors of adolescents and adult WLIs. However, prior stress precipitated aggression in the adult WMI males toward both same‐age, and juvenile intruders compared with control WMIs and WLIs. Trunk blood levels of testosterone and androstenedione increased in stressed WLIs, but not in WMIs, suggesting no direct role of androgens in the increased aggression of WMIs. Expressions of aggression‐relevant genes showed patterns commensurate with being causative in aggressive behavior. The methyl‐CpG binding protein 2 was lower in the frontal cortex of control WMIs, and in the amygdala of stressed WMIs compared with their respective WLIs. Frontal cortex expression of vasopressin receptor 1a and serotonin transporter increased, solely in WMI males after stress. As behaviors were the same toward same‐age and non‐threatening juvenile intruders, the stress‐induced increase in confrontational behavior of the adult WMI male was not because of enhanced fear or anxiety. These results suggest that genetic stress hyper‐reactivity is a risk factor for stress‐induced increases in aggression in males. Additionally, as known aggression‐related genes showed expression patterns paralleling aggressive behavior, this model system could identify novel molecular pathways leading to stress‐enhanced aggression.
A Biofilm Channel Origin for Vermiform Microstructure in Carbonate Microbialites
Authors: Ibarra Yadira , Marenco Pedro J. , Centlivre Jakob P. , Hedlund Brian P. , Rademacher Laura K. , Greene Sarah E. , Bottjer David J. , Corsetti Frank A. 
Published: October 2024

ABSTRACTA three‐dimensional tubular fabric known as “vermiform microstructure” in Phanerozoic and Neoproterozoic carbonate microbialites has been hypothesized to represent the body fossil of nonspicular keratose demosponges. If correct, this interpretation extends the sponge body fossil record and origin of animals to ~890 Ma. However, the veracity of the keratose sponge interpretation for vermiform microstructure remains in question, and the origin of the tubular fabric is enigmatic. Here we compare exceptionally well‐preserved microbialite textures from the Upper Triassic to channel networks created by modern microbial biofilms. We demonstrate that anastomosing channel networks of similar size and geometries are produced by microbial biofilms in the absence of sponges, suggesting the origin for vermiform microstructure in ancient carbonates is not unique to sponges and perhaps best interpreted conservatively as likely microbial in origin. We present a taphonomic model of early biofilm lithification in seawater with anomalously high carbonate saturation necessary to preserve delicate microbial textures. This work has implications for the understanding of three‐dimensional biofilm architecture that goes beyond the current micro‐scale observations available from living biofilm experiments and suggests that biofilm channel networks have an extensive fossil record.
Gendered industry and feminization of the labor force: A social reproduction analysis from China
Authors: Nyangchak Niangjijia 
Published: October 2024

AbstractThis study examines the effect of industrialization on the feminization of the labor focusing on a Tibetan embroidery industry in China. The industry is pivotal in addressing poverty, employing women, safeguarding ethnic culture, and stimulating local economic growth. Through the lens of social reproduction in feminist political economy, an analytical framework was developed to discuss the findings. The results reveal that while the embroidery industry is gendered and serves as a vital source of income for women, it inadvertently overlooks the inherent paradoxes in unpaid labor of social reproduction. State subsidies push forward the industry, but the unpaid and hidden labor rooted within household and community spheres, coupled with the industry's nascent stage, pulls back growth. These push‐pull dynamics underlie a homebound trap where most embroidery artisans are confined to low‐paid, home‐based piecework in an informal labor market. The study outlines implications to navigate a way out of this trap.
Discordance of human epidermal growth factor receptor 2‐low status between breast primary and distant metastases with clinical–pathological correlation
Authors: Yang Ellen , D'Alfonso Timothy M , Morrow Monica , Brogi Edi , Wen Hannah Y 
Published: October 2024

AimsBreast cancer with human epidermal growth factor receptor 2 (HER2) immunohistochemistry (IHC) 1+ or 2+ with negative in‐situ hybridisation (ISH) (HER2‐low) can now be targeted by HER2 antibody drug conjugates. We set out to compare HER2 status between matched primary invasive breast carcinoma (IBC) and distant metastases (DM) with clinical–pathological correlation, with specific interest in HER2‐low.MethodsBiomarker studies and clinical–pathological features of primary IBC with matched DM diagnosed between 2021 and 2022 were retrospectively analysed. HER2 status was assessed per 2023 American Society of Clinical Oncology/College of American Pathologists (ASCO/CAP) guidelines for IHC (4B5) and ISH (IQFISH pharmDX). Bilateral breast primaries were excluded. HER2 IHC 0 to 1+ were reassessed.ResultsOne hundred and forty‐seven cases of primary IBC with matched DM were identified. Biomarkers were performed on core biopsy (n = 74) and resection (n = 73). One hundred and twenty‐six (86%) were initially classified as ‘HER2‐negative’; of these, 67 (46%) were reclassified as HER2‐low. Patients with HER2‐positive primaries were younger (P = 0.01) and had an increased incidence of micropapillary carcinoma (P = 0.02). HER2‐low primaries also had an increased incidence of micropapillary carcinoma (P = 0.02) and oestrogen receptor (ER) positivity (P = 0.02) compared to HER2 0. One hundred and sixty‐nine matched DM cases excluding bone metastasis were identified (range = one to seven metastases per IBC). The most common sites of metastases were liver (50 of 169, 30%), lung (36 of 169; 21%), distant lymph node (26 of 169, 15%); 138 DM cases (82%) were previously classified as ‘HER2‐negative’, and 62 (37%) were reclassified as HER2‐low. Like HER2‐low primaries, HER2‐low metastases were frequently ER‐positive (52 of 62; 84%) (P = 0.02). Brain metastases were more frequently HER2‐positive (five of 32; 16%) (P = 0.04). Comparing HER2 status in matched primaries and DM, HER2 status was discordant in 62 cases (37%). Most changes occurred from HER2‐low to HER2 0 (33 of 169, 20%), HER2 0 to HER2‐low (17 of 169, 10%) and HER2‐low to positive (10 of 169, 6%). All HER2‐low to HER2 0 changes were HER2 1+ to 0. In 30 patients with multiple DM sites (47 cases), HER2 status among different DM samples was discordant in 16 patients (53%), mainly from HER2‐low to HER2 0 (16 of 47, 34%).ConclusionA significant proportion of previous ‘HER2‐negative’ primaries and DM cases were reclassified as HER2‐low. Discordant HER2 status between IBC primary and metastasis and between different DM sites demonstrated tumour heterogeneity and highlights the need for HER2 retesting in distant metastasis.
Self‐Deception in Human–Sex Robot Intimacy
Authors: Lee Jin Hee , Chuang Christina 
Published: October 2024

ABSTRACTA common sentiment among anti‐sex‐robot scholars is the apprehension that sex robots will normalize and perpetuate sexual violence towards humans. In this new chapter within the feminist sex war, the authors of this article tend to agree with anti‐sex‐robot concerns and seek to further identify potential harms of sex robots. However, instead of characterizing the harm in terms of what the robots represent and symbolize, we are primarily interested in the internal state of the user and the type of relationship that will emerge between human users and sex robots, which we argue is an unprecedented sexual relation. Unlike other comparable sex products and services, sex robots occupy a liminal space between being perceived as both a sexual property and agent, oscillating based on the preferences and convenience of the user. We argue that this oscillation that enables human–sex robot intimacy requires self‐deception, which in turn entails individual moral responsibility. Thus, we articulate a novel virtue‐based approach of examining human–robot intimacy that focuses on cultivating erotic flourishing. We conclude that people have a moral responsibility to exhibit self‐awareness within the dynamics of their intimate relationship with sex robots and the (contradictory) beliefs required to maintain such intimacy.
The effect of interprofessional education on the surgical team members' self‐efficacy perception of interprofessional communication in the healthcare system
Authors: Hosseinpour Azam , Keshmiri Fatemeh 
Published: October 2024

AbstractAimThe current study aimed to assess the effect of interprofessional education on participants' self‐efficacy perception of interprofessional communication at different levels of a healthcare system (relationships in the interpersonal, interprofessional, and administration levels).DesignThis is a sequential explanatory mixed‐method study.MethodLearners include surgical residents, surgical technology nurses, and anesthesia nurses (n = 130) who participated in the intervention and control groups. The quasi‐experimental study was conducted in the first step. The educational strategy was interprofessional education and the main teaching method was case‐based learning. The self‐efficacy perception of the participants was assessed by a 26‐item questionnaire before and 1 month after the intervention. The descriptive tests (mean, SD, percentage), student t‐tests, and ANOVA were analyzed. The participants' experiences were explored through semi‐structured interviews. Qualitative content was analyzed by Lundman and Graneheim's approach.ResultsThe results showed that the scores of the learners in the intervention group (4.05 ± 0.31) improved significantly compared to the control group (3.35 ± 0.37) (p = 0.0001). In the present study, the experiences of the participants were categorized into a theme “explicit and implicit confrontations with perceived distrust in the system” which includes two categories “failure to internalize professionalism among team members” and “dominance of a paternalistic culture within the health care system”.ConclusionThe results showed the positive impact of interprofessional education interventions on participants' self‐efficacy perception of interprofessional communication. The results showed that interprofessional education, with the participation of different professionals and managers at different levels of a healthcare system, improved the participants' perception of self‐efficacy regarding interprofessional communication. The results showed the improvement in the participants' communication with team members and managers required to solve the perceived explicit and implicit confrontations in the surgical departments.Implications For the ProfessionThe implementation of an interprofessional education strategy focused on interprofessional professionalism and collaboration principles in clinical activities, formal and informal education in the surgical department is recommended.
A qualitative exploratory study into medical, nursing and allied health professional experiences of elective withdrawal of non‐invasive ventilation in a motor neurone disease cohort
Authors: Cox Gemma , Davis Charlie , Woodley Julie 
Published: October 2024

AbstractRationale, Aims and ObjectivesWith absence of a cure, the mainstay of management for patients with motor neurone disease (MND) is holistic supportive care and symptom control. Non‐invasive ventilation (NIV) can provide relief from distressing dyspnoea which often accompanies progressive respiratory muscle weakness. Some patients using NIV will become dependent on it, with a small proportion of these patients going on to request withdrawal. Despite being legal in the UK, elective withdrawal of NIV can be emotionally and ethically challenging for the staff involved. To guide the process of symptom‐controlled withdrawal, in 2015 the Association for Palliative Medicine (APM) released clinical guidance. The aim of this study is to explore the experiences of the multi‐disciplinary team (MDT) involved in elective withdrawal of NIV in an MND cohort following the publication of this guidance.MethodA qualitative, semi‐structured interview study of eight NHS qualified staff members (three Doctors, four Nurses, one Allied Health Professional). Clinicians were asked questions relating to their experiences of the withdrawals. After full transcription, data was analysed thematically.ResultsFour main themes were identified, offering insight into how the withdrawals affected staff's well‐being and summarised via an ‘enablers and barriers’ model. The setting was important, as was the depth and longevity of the clinician's investment in the patient. Positive influences on staff's well‐being arose from the sense of fulfilling the patient's wishes, good teamwork, presence of an experienced clinician and awareness of the APM (2015) Guidance. Conversely, barriers to well‐being were expressed through the unpredictability of each scenario, moral and ethical uncertainties, external pressures on time, mismatched expectations, poor communication and the emotional intensity of the act.ConclusionElective withdrawal is highly emotive, simultaneously positively and negatively influencing staff well‐being. By addressing the potential mitigating factors, the overall impact on staff's mental health and well‐being maybe improved and thus, subsequently, patient care.
How can we reduce healthcare costs by using Enhanced Recovery After Surgery more effectively in different groups of gynaecological patients? A single‐centre experience
Authors: Polková Markéta , Koliba Peter , Kabele Pavel , Dubová Oľga , Hodyc Daniel , Škodová Magdalena Kolínková , Zikán Michal , Sládková Petra , Tichá Marie , Brtnický Tomáš 
Published: October 2024

AbstractIntroductionThe objective of this study was to assess the impact of the Enhanced Recovery After Surgery (ERAS) programme implementation on treatment costs at a university‐type centre, using the DRG scheme.Materials and MethodsRetrospective analysis of patients' data in a group of 604 individuals enroled in the study. We evaluated three groups of patients according to the ERAS clinical protocol (CP): (1) CP oncogynaecology, (2) CP simple hysterectomy, (3) CP laparoscopy. The study aimed to evaluate the impact on the length of stay (LOS), savings in bed‐days, and the reduction in direct treatment costs. Three parameters—antibiotic consumption, blood derivative consumption and laboratory test costs—were chosen to compare direct treatment costs. The statistical significance of the difference in the observed parameters was tested by a two‐sample unpaired t test with unequal variances at the 0.05 significance level.ResultsWe analysed data from 604 patients. In all three groups, the length of stay (LOS) was significantly reduced. The most significant reduction was observed in the CP oncogynaecology group, where the LOS was reduced from 11.1 days to 6.8 days (2022) and 7.6 days (2023) compared to 2019 (p < 0.05). Furthermore, there was a notable reduction in inpatient bed‐days, which resulted in the capacity being made available to admit additional patients. A statistically significant reduction in direct costs was observed in the group of CP hysterectomy (antibiotic use) and in the CP laparoscopy (laboratory test costs).ConclusionsThe implementation of the ERAS principles resulted in a number of significant positive economic impacts—reduction in the LOS and a corresponding increase in bed capacity for new patients. Additionally, direct treatment costs, including those related to antibiotic use or laboratory testing were reduced. The Czech Republic's acute healthcare system, like the majority of European healthcare systems, is financed by the DRG system. This flat‐rate payment per patient encourages hospital management to seek cost‐reduction strategies. The results of our study indicate that fast‐track protocols represent a potential viable approach to reducing the cost of treatment while simultaneously meeting the recommendations of evidence‐based medicine.
Testing the predictions of Chapman's five love languages theory: Does speaking a partner's primary love language predict relationship quality?
Authors: Flicker Sharon M. , Sancier‐Barbosa Flavia 
Published: October 2024

AbstractChapman's claim that the key to marital happiness is “speaking” your partner's primary “love language” has been highly influential in pop culture and incorporated into therapeutic practice. However, the theory has not yet been empirically validated. The current study tests his theory, examining the hypothesis that satisfaction with one's partner's primary love language behavior predicts relationship satisfaction better than satisfaction with one's partner's nonprimary love language behavior. We recruited a sample (n = 696, M = 43.8 years, 70% married, 97.3% cohabitating) through Amazon CloudResearch. Chapman's hypothesis was not supported. Participants' satisfaction with their partners' primary love language behavior no better‐predicted relationship satisfaction or perceived love than the lower‐ranked love languages. Words of Affirmation and Quality Time better predicted perceived love and relationship satisfaction than participants' primary love language. These results replicate previous research and suggest that these should remain targets of intervention for relationship therapists.
Time is the enemy: The speed of proximity‐based knowledge diffusion
Authors: Perri Alessandra , Rullani Francesco , Giuliani Elisa , Sabbadin Elisa , Oriani Raffaele 
Published: October 2024

AbstractDoes knowledge spread more quickly when firms are geographically closer? Focusing on knowledge diffusion from multinational enterprises (MNEs) subsidiaries in the context of the US semiconductor industry, our analysis suggests that the broader MNE patents are, in terms of the knowledge sources they draw on, the slower the speed of knowledge diffusion to more spatially proximate firms, compared to more distant ones. Moreover, our findings suggest that this outcome could be attributed to a greater reliance on knowledge sources that are internal to the MNE network or located geographically distant. We provide interpretative cues for these findings and provide policy recommendations in line with our results.