bluuebunny/crossref_metadata_2025_split huggingface dataset:
Interpreting epigenetic causes of recurrent hypokalemia and seizures: Gitelman syndrome co‐exist with pseudohypoparathyroidism type 1B
Authors: Zhang Xiuzhen , Bi Xin , Wu Yan , Xu Ping 
Published: January 2024

AbstractWe describe a unique case of 27‐year‐old male with Gitelman syndrome (GS) co‐exist with pseudohypoparathyroidism type 1B (PHP1B). The patient presented with a 5‐year history of seizures, tetany, and numbness of the extremities. Further examinations showed recurrent hypokalemia, inappropriate kaliuresis, hypocalcemia, hyperphosphatemia, and elevated PTH levels. A novel variant of autosomal recessive GS (p.Val287Met SLC12A3) and a novel 492.3Kb deletion containing the whole of STX16, were discovered by a whole‐exome sequencing. Following the diagnosis, calcitriol, calcium, and potassium supplements were started. Hematuria calcium and phosphorus levels, as well as blood potassium levels, have recovered and remained within normal ranges after 3 years of follow‐up. Our findings have important consequences for supporting the idea that heterozygosity for variants have effects on the patients' clinical performance with autosomal recessive inheritance disorders. Further study is need for the putative effects of the variant. Likewise, further investigation with regards to the gene–gene interaction relations between GS and other electrolyte imbalance disorders is warranted.
Challenges to well‐being in critical care
Authors: Shaw Rachel L. , Morrison Rachael , Webb Sarah , Balogun Omobolanle , Duncan Heather P. , Butcher Isabelle 
Published: January 2024

AbstractBackgroundPaediatric critical care (PCC) is a high‐pressure working environment. Staff experience high levels of burnout, symptoms of post‐traumatic stress, and moral distress.AimTo understand challenges to workplace well‐being in PCC to help inform the development of staff interventions to improve and maintain well‐being.Study DesignThe Enhanced Critical Incident Technique (ECIT) was used. ECIT encompasses semi‐structured interviews and thematic analysis. We identified ‘critical incidents’, challenges to well‐being, categorized them in a meaningful way, and identified factors which helped and hindered in those moments. Fifty‐three nurses and doctors from a large UK quaternary PCC unit were consented to take part.ResultsThemes generated are: Context of working in PCC, which examined staff's experiences of working in PCC generally and during COVID‐19; Patient care and moral distress explored significant challenges to well‐being faced by staff caring for increasingly complex and chronically ill patients; Teamwork and leadership demonstrated the importance of team‐belonging and clear leadership; Changing workforce explored the impact of staffing shortages and the ageing workforce on well‐being; and Satisfying basic human needs, which identified absences in basic requirements of food and rest.ConclusionsStaff's experiential accounts demonstrated a clear need for psychologically informed environments to enable the sharing of vulnerabilities, foster support, and maintain workplace well‐being. Themes resonated with the self‐determination theory and Maslow's hierarchy of needs, which outline requirements for fulfilment (self‐actualization).Relevance to Clinical PracticeWell‐being interventions must be informed by psychological theory and evidence. Recommendations are flexible rostering, advanced communication training, psychologically‐informed support, supervision/mentoring training, adequate accommodation and hot food. Investment is required to develop successful interventions to improve workplace well‐being.
Impact of pupil and defocus ring intersection area on retinal defocus
Authors: Guo Yujuan , Zhang Mingxu , Tong Yuting , Ma Xiaoqi , Wang Siyao , Li Yu , Du Yuqin , Zhou Yuehua 
Published: January 2024

AbstractPurposeWith the rising prevalence of myopia, especially among the young, orthokeratology (Ortho‐K) stands out as a promising approach, not only to reduce myopia but also to control the progression of axial length (AL). This study examined how the intersection area between the pupil and defocus ring influenced retinal defocus and axial growth after Ortho‐K.MethodsA case–control study was conducted with 100 participants (100 eyes). Both AL and the refraction difference value (RDV), that is, the peripheral refractive error measured with respect to the central value after wearing Ortho‐K lenses, were determined. Subjects were categorised into two groups based on the size of the intersection area after 3 months of lens wear: Group A (<4.58 mm2) and Group B (≥4.58 mm2).ResultsGroup B demonstrated significantly lower changes in AL and RDV at 30–40° and 40–53° compared with Group A after 3 months of lens wear (all p < 0.05). After 6 months of lens wear, Group B showed significantly lower changes in AL and RDV in the 40–53° region compared with Group A (all p < 0.05). Correlation analysis revealed that as the intersection area increased, the changes in AL and RDV at 0–53°, 30–40° and 40–53° eccentricity decreased after both 3 and 6 months of lens wear (all p < 0.01).ConclusionsA larger intersection area between the pupil and defocus ring within a certain time period can cause a greater amount of myopic defocus at 30–53° from the fovea. The results suggest that a larger intersection area might lead to more effective control of axial growth.
Rapid recovery in a child with febrile ulceronecrotic Mucha‐Habermann disease following intravenous immunoglobulin administration
Authors: Somasundaram Arun , Gupta Ankan , Sathishkumar Dharshini , Mathew Lydia , George Anju , Thomas Meera 
Published: January 2024

AbstractFebrile ulceronecrotic Mucha‐Habermann disease (FUMHD), a lymphocyte‐mediated inflammatory skin disorder, is considered a severe variant of pityriasis lichenoides et varioliformis acuta that can lead to a fatal outcome if not managed in a timely fashion. Children with FUMHD can have systemic complications involving various organs. The scarcity of reported cases and the absence of well‐designed studies or randomized clinical trials to evaluate different therapeutic modalities pose a major challenge in treating this potentially life‐threatening disorder. We report a five‐year‐old child with FUMHD and seizures treated unsuccessfully with a combination of systemic steroids, methotrexate, dapsone, and oral erythromycin, who improved rapidly and achieved disease control with just a single infusion of low‐dose intravenous immunoglobulin.
The tone of the president's immigration rhetoric
Authors: Eshbaugh‐Soha Matthew , Wise Stephanie 
Published: January 2024

AbstractWe examine the tone of the president's immigration policy speeches as a function of the political context, policy characteristics, and individual presidents in two ways. First, we describe the tone of the president's immigration rhetoric using DICTION software and its five global categories of tone. Second, we hypothesize that commonality and optimism, two categories of tone expressive of immigration policy, will co‐vary by political context, policy characteristics of immigration, and a president's approach to rhetoric. To test our expectations, we collected presidential mentions of immigration since 1953 from the Public Papers of the Presidents. Key variables, like the president's honeymoon and the post‐9/11 era, increase a president's commonality tone, and the president's approval ratings encourage greater optimism. Individual presidents also shape presidential rhetoric, indicating the importance of presidential style to immigration tone, especially for optimism. We conclude with implications of our work for the systematic study of presidential tone and the prospects for comprehensive immigration reform.
Multidomain spectral approach to rational‐order fractional derivatives
Authors: Klein Christian , Stoilov Nikola 
Published: January 2024

AbstractWe propose a method to numerically compute fractional derivatives (or the fractional Laplacian) on the whole real line via Riesz fractional integrals. The compactified real line is divided into a number of intervals, thus amounting to a multidomain approach; after transformations in accordance with the underlying curve ensuring analyticity of the respective integrands, the integrals over the different domains are computed with a Clenshaw–Curtis algorithm. As an example, we consider solitary waves for fractional Korteweg‐de Vries equations and compare these to results obtained with a discrete Fourier transform.
A visual art intervention program for older people with stroke in residential care settings: A feasibility study
Authors: Pang Chui Ping Phyllis , Cheung Daphne Sze Ki , Chiang Vico Chung Lim 
Published: January 2024

AbstractIntroductionStroke poses challenges to the physiological, psychosocial and spiritual well‐being of affected individuals. As the impacts of stroke might not be reversible, a shift in focus to providing care is desirable. Visual art interventions using visual and symbolic art can help participants to express their feelings, give them a sense of choice and the feeling that they are retaining a sense of control, promote insights, restructure their sense of cognition and instil hope. There have been few studies on visual art interventions involving older people with stroke and none in residential care homes (RCHs). Theoretical support and rigorous research designs on the subject are lacking. Thus, this study seeks to address this research gap by examining the feasibility of a visual art intervention for older people in RCHs and exploring the impacts on their holistic well‐being.MethodsThis was a single‐blinded, two‐arm, randomised controlled feasibility study grounded on Watson's Caring Theory. The Holistic Well‐Being Scale and Caring Factor Survey were used in the study, with three assessment time‐points: before the intervention (T1), at the mid‐point of the intervention (T2) and immediately after the intervention (T3).ResultsSixty‐one older people with stroke were recruited from 14 RCHs and randomised into the intervention and control groups. The recruitment rate was 44.53%, and the retention rate for the intervention group was 93.55%. Implementing the programme was affordable (at approximately US$126/head), the duration was acceptable (721 min) and the feedback from participants and staff of the RCHs was positive.ConclusionsThe visual art intervention programme proved to be clinically feasible. This study adds new insights to the development of visual art interventions and to the caring sciences. The efficacy of the programme on holistic well‐being has yet to be confirmed.
Estimation of treatment effect among treatment responders with a time‐to‐event endpoint
Authors: Nordland Andreas , Martinussen Torben 
Published: January 2024

AbstractIn a placebo‐controlled clinical study one may calculate the average treatment effect to convey the effect of the active treatment on some outcome. However, if it is speculated that the treatment only has an effect if the patient responds to the treatment defined by a certain biomarker response, then it is arguably more relevant to estimate the treatment effect among such responders. We present such a causal parameter that is based on principal stratification and is identified under the exclusion of a treatment effect among the nonresponders. We focus on time‐to‐event outcomes allowing for right censoring, and construct a doubly robust and efficient estimator based on the associated efficient influence function. The properties of the estimator are showcased in a simulation study and the methodology is applied to the Leader trial investigating the effect of liraglutide on the occurrence of cardiovascular events.
Dermoscopy and reflectance confocal microscopy finding of different anatomic sites of Langerhans cell histiocytosis
Authors: Zhang Gaolei , Wang Xingjia , Wang Yuhan , Li Qian , Zhang Sheng , Jiang Lixiao , Deng Wei , Liu Xiaoyan , Wang Jianhua 
Published: January 2024

AbstractBackgroundRecognizing Langerhans cell histiocytosis (LCH) might be a challenge due to its rarity. Reflectance confocal microscopy (RCM) and dermoscopy were emergent promising non‐invasive technique as auxiliary tools in diagnosis of different skin conditions. However, the RCM and dermoscopic features of LCH had been less investigated. To reveal the common RCM and dermoscopic features of LCH.Materials and methodsForty cases of LCH were retrospectively analyzed according to age, locations, clinical, RCM, and dermoscopic features from September 2016 to December 2022. To reveal the differences and common in clinical, RCM, and dermoscopic features that occur in different anatomic location.ResultsIn the study, sites of predilection include the trunk 31/40 (77.5%), extremity 21/40 (52.5%), face 14/40 (35%), scalp 11/40 (27.5%), vulvar 4/40 (10%), and nail 2/40 (5%). All LCHs had the common RCM features. There were significant differences in clinical and dermoscopic features for age and lesion anatomic site. The common dermoscopic features for scalp, face, trunk, and extremity were the erythematous scaly rash, purplish‐red globules or patches, scar‐like streaks with ectatic vessels. While the features for nail LCH were purpuric striae, onycholysis and purulent scaly rash, and the erosive erythematous plaque and purulent scaly rash for vulvar LCH. The common RCM features of all LCH showed a focal highly reflective dense image in the surface keratin layer, epidermis architectural disarray, obscuration of dermo‐epidermal junction, numerous polygonal, large, medium reflective, short dendrites cells in the epidermis, and dermis. All LCH involving the vulvar and nail did not manifest skin lesions.ConclusionRCM and dermoscopy showed promising value for diagnosis and differentiation of LCH.
Identify social and job disparities in the relationship between job‐housing balance and urban commuting using Baidu trajectory big data
Authors: Zhou Lei , Xiao Weiye , Li Han , Wang Chen , Wang Xueqin , Zheng Zhenlong 
Published: January 2024

AbstractThe job‐housing relationship is a well‐documented topic in urban and economic geography literature, but the disparities in job‐housing relationships across workers' sociodemographic statuses have yet to be fully explored. This study utilizes a Baidu trajectory dataset and spatial analysis tools to examine job‐housing relationships in Zhuhai, China, taking into account disparities in workers' socioeconomic status and job types. Origin–destination analysis indicates that job‐housing relationships for commercial and public service sectors are balanced in the urban core, whereas, for the secondary sector, the relationship is more balanced in the suburban area compared to the central urban area. Network analysis further reveals the presence of self‐contained communities for the secondary sector in peripheral areas. We find that high‐income workers in the secondary sector experience longer commuting distances, in contrast to their counterparts in the commercial and public service sectors. These insights underscore the significance of considering workers' skills in urban and economic planning.
Effects of In-Exercise Carbohydrate Supplementation on Prolonged High-Intensity Exercise Performance in Oral Contraceptive Users
Authors: Lee Serene J.L. , Van Rens Fleur E.C.A. , Peiffer Jeremiah J. 
Published: January 2024

Purpose: To examine the impact of oral contraceptive (OC) phases on performance, physiological, and subjective responses to prolonged, intensive exercise when carbohydrate (CHO) stores are reduced. Methods: Ten well-trained female cyclists using monophasic OC completed 4 identical trials (>150 min) under conditions of in-trial 60-g·h−1 CHO supplementation (CHO+) or placebo (CHO−) during the sugar- (SUG) and active-pill (ACT) phases of their OC cycle. Each trial comprised two 400-kcal time trials (TT) separated by 1 hour of submaximal cycling at first ventilatory threshold. Results: Change in completion time from TT1 to TT2 was minimized in CHO+ compared with CHO− (4.06 [2.55] vs 6.08 [5.33] min; P = .019, effect size = −0.36). An interaction effect of OC and CHO was observed for time to complete TT (P = .006), mean TT power (P = .002), mean TT heart rate (P = .002), and posttrial emotional balance (P = .020) and negative emotional state (P = .033). In ACT, mean TT power and heart rate were higher in CHO+ when compared with CHO−, resulting in faster TTs in CHO+ and improved posttrial emotional well-being. When CHO was not supplemented, TT power and heart rate were higher in SUG when compared with ACT, resulting in faster TTs in SUG and improved posttrial emotional balance. Conclusion: CHO depletion during ACT negatively influenced TT performance and emotional well-being when compared with SUG. Irrespective of OC pill phase, CHO supplementation should be prioritized to sustain performance and improve postexercise recovery–stress balance.
Mode of carbon and energy metabolism shifts lipid composition in the thermoacidophile
Acidianus
Authors: Rhim Jeemin H. , Zhou Alice , Amenabar Maximiliano J. , Boyer Grayson M. , Elling Felix J. , Weber Yuki , Pearson Ann , Boyd Eric S. , Leavitt William D. 
Published: January 2024

ABSTRACT

The degree of cyclization, or ring index (RI), in archaeal glycerol dibiphytanyl glycerol tetraether (GDGT) lipids was long thought to reflect homeoviscous adaptation to temperature. However, more recent experiments show that other factors (e.g., pH, growth phase, and energy flux) can also affect membrane composition. The main objective of this study was to investigate the effect of carbon and energy metabolism on membrane cyclization. To do so, we cultivated
Acidianus
sp. DS80, a metabolically flexible and thermoacidophilic archaeon, on different electron donor, acceptor, and carbon source combinations (S
0
/Fe
3+
/CO
2
, H
2
/Fe
3+
/CO
2
, H
2
/S
0
/CO
2
, or H
2
/S
0
/glucose). We show that differences in energy and carbon metabolism can result in over a full unit of change in RI in the thermoacidophile
Acidianus
sp. DS80. The patterns in RI correlated with the normalized electron transfer rate between the electron donor and acceptor and did not always align with thermodynamic predictions of energy yield. In light of this, we discuss other factors that may affect the kinetics of cellular energy metabolism: electron transfer chain (ETC) efficiency, location of ETC reaction components (cytoplasmic
vs.
extracellular), and the physical state of electron donors and acceptors (gas
vs.
solid). Furthermore, the assimilation of a more reduced form of carbon during heterotrophy appears to decrease the demand for reducing equivalents during lipid biosynthesis, resulting in lower RI. Together, these results point to the fundamental role of the cellular energy state in dictating GDGT cyclization, with those cells experiencing greater energy limitation synthesizing more cyclized GDGTs.

IMPORTANCE

Some archaea make unique membrane-spanning lipids with different numbers of five- or six-membered rings in the core structure, which modulate membrane fluidity and permeability. Changes in membrane core lipid composition reflect the fundamental adaptation strategies of archaea in response to stress, but multiple environmental and physiological factors may affect the needs for membrane fluidity and permeability. In this study, we tested how
Acidianus
sp. DS80 changed its core lipid composition when grown with different electron donor/acceptor pairs. We show that changes in energy and carbon metabolisms significantly affected the relative abundance of rings in the core lipids of DS80. These observations highlight the need to better constrain metabolic parameters, in addition to environmental factors, which may influence changes in membrane physiology in Archaea. Such consideration would be particularly important for studying archaeal lipids from habitats that experience frequent environmental fluctuations and/or where metabolically diverse archaea thrive.
Treatment of intraorbital arteriovenous fistulas with direct puncture: a case series and review of treatments since 1978
Authors: Pathuri Sarath C , Johnson William C , Russell Keannette L P , Robledo Ariadna , Albuquerque Felipe C , Kan Peter , Mascitelli Justin R 
Published: January 2024

Intraorbital arteriovenous fistulas (IOAVFs) are rare vascular pathologies that may be effectively treated with direct puncture (DP) of the venous supply and may offer a definitive and safe cure when done under ultrasound or stereotactic guidance. Here we present three new cases of DP treatment of IOAVFs, indications for safe use, and their potential complications in comparison to the existing literature on DP and other modalities.
Three patients with IOAVFs were treated with DP with ultrasound guidance, stereotactic guidance, and fluoroscopy. Final digital subtraction angiography (DSA) revealed complete cure of IOAVFs. A literature review via PubMed was performed on treatments of IOAVFs since 1978.
All three cases of DP resulted in successful cures with 2/3 cases resulting in complications from orbital hematoma formation. 49 total treatments including the cases herein have been documented. DP treatment constituted 5/49, conservative management 17/49, transarterial 8/49, transvenous 18/49, and surgical 3/49. Some cases received more than one mode of treatment. Transarterial and surgical managements were found to have higher complication rates than transvenous and DP.
DP is a safe and effective treatment of IOAVFs that can be performed via multiple image guided methods and guarantees a definitive cure. Orbital hematomas are a potential complication of which operators should be aware.
Integrating humanities in healthcare: a mixed-methods study for development and testing of a humanities curriculum for front-line health workers in Karachi, Pakistan
Authors: Siddiqi Danya Arif , Miraj Fatima , Munir Mehr , Naz Nowshaba , Shaikh Asna Fatima , Khan Areeba Wajahat , Dossa Shama , Nadeem Inamullah , Hargraves Monica J , Urban Jennifer , Shah Mubarak Taighoon , Chandir Subhash 
Published: January 2024

Lady health workers (LHWs) provide lifesaving maternal and child health services to >60% of Pakistan’s population but are poorly compensated and overburdened. Moreover, LHWs’ training does not incorporate efforts to nurture attributes necessary for equitable and holistic healthcare delivery. We developed an interdisciplinary humanities curriculum, deriving its strengths from local art and literature, to enhance character virtues such as empathy and connection, interpersonal communication skills, compassion and purpose among LHWs. We tested the curriculum’s feasibility and impact to enhance character strengths among LHWs.We conducted a multiphase mixed-methods pilot study in two towns of Karachi, Pakistan. We delivered the humanities curriculum to 48 LHWs via 12 weekly sessions, from 15 June to 2 September 2021. We developed a multiconstruct character strength survey that was administered preintervention and postintervention to assess the impact of the training. In-depth interviews were conducted with a subset of randomly selected participating LHWs.Of 48 participants, 47 (98%) completed the training, and 34 (71%) attended all 12 sessions. Scores for all outcomes increased between baseline and endline, with highest increase (10.0 points, 95% CI 2.91 to 17.02; p=0.006) observed for empathy/connection. LHWs provided positive feedback on the training and its impact in terms of improving their confidence, empathy/connection and ability to communicate with clients. Participants also rated the sessions highly in terms of the content’s usefulness (mean: 9.7/10; SD: 0.16), the success of the sessions (mean: 9.7/10; SD: 0.17) and overall satisfaction (mean: 8.2/10; SD: 3.3).A humanities-based training for front-line health workers is a feasible intervention with demonstrated impact of nurturing key character strengths, notably empathy/connection and interpersonal communication. Evidence from this study highlights the value of a humanities-based training, grounded in local literature and cultural values, that can ultimately translate to improved well-being of LHWs thus contributing to better health outcomes among the populations they serve.