bluuebunny/crossref_metadata_2025_split huggingface dataset:
‘We are somehow fixated on this being a diabetes drug’: a qualitative study exploring the views of cardiologists and nephrologists about sodium‐glucose cotransporter 2 inhibitor initiation
Authors: Milder Tamara Y. , Stocker Sophie L. , Baysari Melissa T. , Day Richard O. , Greenfield Jerry R. 
Published: August 2023

AbstractBackgroundSodium‐glucose cotransporter 2 inhibitors (SGLT2i) are now indicated for heart failure and chronic kidney disease (CKD), irrespective of the presence of diabetes. Hence, cardiologists and nephrologists have an important role in initiating these drugs.AimsTo explore cardiologists' and nephrologists' perspectives regarding initiating SGLT2i and their safety monitoring practices when initiating SGLT2i.MethodsPurposive and snowball approaches were used to recruit participants working in diverse areas in New South Wales, Australia. Semi‐structured interviews were conducted with 12 cardiologists and 12 nephrologists. Interviews were conducted until thematic saturation was reached. Emergent themes were identified from transcripts. An iterative general inductive approach was used for data analysis.ResultsThere was a reluctance amongst most non‐heart‐failure subspecialist cardiologists to initiate SGLT2i. Reasons included the perception of SGLT2i as diabetes drugs, concern about side effects, lack of experience and issues with follow‐up. In contrast, nephrologists reported feeling confident to initiate SGLT2i. Nephrologists varied in their opinions about the severity of CKD at which SGLT2i initiation was reasonable and monitoring of renal function following initiation. Government subsidisation was an important factor in the decision to prescribe SGLT2i to people without diabetes.ConclusionsOur findings highlight the complex transition from the perception of SGLT2i as diabetes drugs to cardiometabolic and reno‐protective agents. Interdisciplinary collaboration may enable greater confidence amongst specialists to initiate SGLT2i, including in patients with CKD. Additionally, there is a need for clear and detailed guidance about SGLT2i prescription in patients with renal dysfunction and renal function monitoring following SGLT2i initiation.
Impact of COVID‐19 and lockdown on COPD admissions to Christchurch Hospital, New Zealand 2020–2021: a combined quantitative and qualitative study
Authors: Zhang Xianzhi , Wilkinson Amanda , Storer Malina , Epton Michael J. 
Published: August 2023

AbstractBackgroundDuring the year following New Zealand's first COVID‐19 lockdown, a 33% reduction in chronic obstructive pulmonary disease (COPD)‐related admissions occurred and persisted beyond this period at Christchurch Hospital.AimTo identify contributing factors which may have resulted in a persistent decrease in COPD hospitalisation rates at Christchurch Hospital following the 2020 COVID‐19 lockdown.MethodsUsing an explanatory sequential mixed‐methods research design, we (i) retrospectively analysed hospital admissions and primary healthcare access by people with COPD (n = 1358) in Canterbury before, during and after COVID lockdown (24 March 2019 to 2021) and (ii) undertook individual interviews from a sample of patients (n = 14).ResultsPatients who were not re‐admitted following the COVID‐19 lockdown had fewer general practice encounters, acute primary care access, antibiotic and prednisone prescriptions. Proportionally fewer Māori and more Pacific patients were admitted with COPD following lockdown. Positive contributing factors at a primary care level included improvements in primary care interactions and medication management. At a patient and community level, there were improvements in lifestyle, self‐management practices, social support and contact precautions. However, a subgroup of patients described negative effects such as social isolation.ConclusionA combination of patient, primary care and community‐level factors led to an overall persistent decrease in COPD admissions following the COVID‐19 lockdown. Future targeted and individualised measures focusing on these modifiable factors may decrease future COPD‐related hospital admissions. The study design facilitated further explanation about factors that contributed to the persistent decrease in hospital admissions among people living with COPD and has underscored the importance of social support, patient empowerment and reduction in barriers in accessing care in admission reduction.
Autoimmunity in immune checkpoint inhibitor‐induced immune‐related adverse events: A focus on autoimmune skin toxicity and pneumonitis
Authors: Berner Fiamma , Flatz Lukas 
Published: August 2023

SummaryImmune checkpoint inhibitors (ICIs) have revolutionized cancer therapy. However, their use is frequently associated with immune‐related adverse events (irAEs) potentially affecting any organ. The mechanisms mediating such irAEs remain poorly understood and biomarkers to predict the development of irAEs are lacking. Growing evidence shows the importance of self‐antigens in mediating irAEs during ICI therapy, in particular the well‐described melanocyte differentiation antigens in melanoma patients. This review will focus on two novel classes of self‐antigens involved in mediating autoimmune skin toxicity and pneumonitis in non‐small cell lung cancer patients treated with immunotherapy. T cells specific for these self‐antigens are thought to not only mediate irAEs but are thought to simultaneously mediate anti‐tumor responses and are therefore associated with both autoimmune toxicity and response to ICI therapy. We further discuss emerging cellular and proteomic immune signatures of irAEs that may serve as biomarkers to help predict which patients are at higher risk of developing these irAEs. The determination of new tumor antigens involved in ICI therapy and the identification of related biomarkers brings us a step forward in the mechanistic understanding of ICIs and will help to monitor patients at higher risk of developing irAEs. Lastly, we discuss the current challenges in collecting research samples for the study of ICI‐related mechanisms and in distinguishing between immune signatures of response and those of irAEs.
Domestic violence against women has increased during the COVID‐19 pandemic: A perspective paper about the need for change to current and future practice
Authors: Usher Kim , Jackson Debra , Fatema Syadani Riyad , Jones Rikki 
Published: August 2023

AbstractThe COVID‐19 outbreak led to widespread disruption and stress to people's lives. Concern about the escalation of domestic violence (DV) rates and related mental health issues soon emerged following the implementation of strategies aimed at curbing the spread of the virus. This perspective paper presents an overview of the issues, argues for greater recognition of the link between DV against women and serious emotional distress, and the need for greater awareness and knowledge about DV among mental health professionals. While we acknowledge that men also experience DV, their rates are much lower than for women and in this paper our focus is on women.
Reconstructing ancient dispersal through Antarctica: A case study of stream‐inhabiting beetles
Authors: Sýkora Vít , Herrera‐Alsina Leonel , Maier Crystal , Martínez‐Román Nicolás Rafael , Archangelsky Miguel , Bilton David T. , Seidel Matthias , Leschen Richard A. B. , Fikáček Martin 
Published: August 2023

AbstractAimAlthough Antarctica hosted a diverse fauna and flora in the past, its modern climate is too extreme for many lineages: their recent extinction makes it difficult to include the continent in historical biogeographical analyses. We use southern temperate stream‐inhabiting beetles as a model to explore whether Antarctica may be included in historical biogeographic reconstructions in a group absent from Antarctica today, and to test its role in shaping the current distribution of stream‐inhabiting insects.TaxonColeoptera, Elmidae.LocationSouthern Hemisphere temperate regions and Antarctica.MethodsWe included Antarctica in historical biogeographic analyses indirectly, as a component of distance matrices specifying the relative positions of continents, or by specifying Antarctica as a stepping‐stone between remaining continents (in LEMAD). We used a newly constructed dated phylogeny of Elmidae to test the performance of these constrained analyses under different parameter settings and geographical scenarios.ResultsAntarctica can be implemented into historical biogeographic analyses via indirect constraints to produce biologically relevant reconstructions when long‐distance dispersal events are highly penalized, the maximum number of areas per species is low, and expected extinction rates are high (in LEMAD). Unconstrained models, including those without Antarctica, result in simpler scenarios with fewer biogeographic events and better fit to data. The origin of austral clades of Elmidae post‐date the separation of Gondwanan landmasses.Main ConclusionsAntarctica can be included in historical biogeographic reconstructions under a priori assumptions that (1) it was part of the ancient biogeography of the clade, (2) the taxon has limited dispersal ability, making long‐distance dispersal highly unlikely and (3) maximum range size is limited. These assumptions may be biologically justified for many animal groups. Over‐water dispersal has been crucial in shaping the modern distribution of austral stream‐inhabiting beetles, likely facilitated by ocean currents and dispersal through Antarctica until the Oligocene.
AAK1‐like: A putative pseudokinase with potential roles in cargo uptake in bloodstream form Trypanosoma brucei parasites
Authors: Black Jennifer A. , Klinger Christen M. , Lemgruber Leandro , Dacks Joel B. , Mottram Jeremy C. , McCulloch Richard 
Published: August 2023

AbstractSelection and internalization of cargo via clathrin‐mediated endocytosis requires adaptor protein complexes. One complex, AP‐2, acts during cargo selection at the plasma membrane. African trypanosomes lack all components of the AP‐2 complex, except for a recently identified orthologue of the AP‐2‐associated protein kinase 1, AAK1. In characterized eukaryotes, AAK1 phosphorylates the μ2 subunit of the AP‐2 complex to enhance cargo recognition and uptake into clathrin‐coated vesicles. Here, we show that kinetoplastids encode not one, but two AAK1 orthologues: one (AAK1L2) is absent from salivarian trypanosomes, while the other (AAK1L1) lacks important kinase‐specific residues in a range of trypanosomes. These AAK1L1 and AAK1L2 novelties reinforce suggestions of functional divergence in endocytic uptake within salivarian trypanosomes. Despite this, we show that AAK1L1 null mutant Trypanosoma brucei, while viable, display slowed proliferation, morphological abnormalities including swelling of the flagellar pocket, and altered cargo uptake. In summary, our data suggest an unconventional role for a putative pseudokinase during endocytosis and/or vesicular trafficking in T. brucei, independent of AP‐2.
Experiences of in‐hospital care among dementia caregivers in the context of high neighborhood‐level disadvantage
Authors: Golden Blair P. , Block Laura , Benson Clark , Cotton Quinton D. , Wieben Ann , Kaiksow Farah , Gilmore‐Bykovskyi Andrea 
Published: August 2023

AbstractBackgroundPersons living with dementia (PLWD) experience high rates of hospitalization and rehospitalization, exposing them to added risk for adverse outcomes including delirium, hastened cognitive decline, and death. Hospitalizations can also increase family caregiver strain. Despite disparities in care quality surrounding hospitalizations for PLWD, and evidence suggesting that exposure to neighborhood‐level disadvantage increases these inequities, experiences with hospitalization among PLWD and family caregivers exposed to greater levels of neighborhood disadvantage are poorly understood. This study examined family caregiver perspectives and experiences of hospitalizations among PLWD in the context of high neighborhood‐level disadvantage.MethodsWe analyzed data from the Stakeholders Understanding of Prevention Protection and Opportunities to Reduce HospiTalizations (SUPPORT) study, an in‐depth, multisite qualitative study examining hospitalization and rehospitalization of PLWD in the context of high neighborhood disadvantage, to identify caregiver perspectives and experiences of in‐hospital care. Data were analyzed using rapid identification of themes; duplicate transcript review was used to enhance rigor.ResultsData from N = 54 individuals (47 individual interviews, 2 focus groups with 7 individuals) were analyzed. Sixty‐three percent of participants identified as Black/African American, 35% as non‐Hispanic White, and 2% declined to report. Caregivers' experiences were largely characterized by PLWD receiving suboptimal care that caregivers viewed as influenced by system pressures and inadequate workforce competencies, leading to communication breakdowns and strain. Caregivers described poor collaboration between clinicians and caregivers with regard to in‐hospital care delivery, including transitional care. Caregivers also highlighted the lack of person‐focused care and the exclusion of the PLWD from care.ConclusionsCaregiver perspectives highlight opportunities for improving hospital care for PLWD in the context of neighborhood disadvantage and recognition of broader issues in care structure that limit their capacity to be actively involved in care. Further work should examine and develop strategies to improve caregiver integration during hospitalizations across diverse contexts.
BACE2 deficiency impairs expression and function of endothelial nitric oxide synthase in brain endothelial cells
Authors: He Tongrong , d'Uscio Livius V. , Katusic Zvonimir S. 
Published: August 2023

AbstractBeta‐site amyloid precursor protein (APP)‐cleaving enzyme 2 (BACE2) is highly expressed in cerebrovascular endothelium. Notably, BACE2 is one of the most downregulated genes in cerebrovascular endothelium derived from patients with Alzheimer's disease. The present study was designed to determine the role of BACE2 in control of expression and function of endothelial nitric oxide synthase (eNOS). Genetic downregulation of BACE2 with small interfering RNA (BACE2siRNA) in human brain microvascular endothelial cells (BMECs) significantly decreased expression of eNOS and elevated levels of eNOS phosphorylated at threonine residue Thr495, thus leading to reduced production of nitric oxide (NO). BACE2siRNA also suppressed expression of APP and decreased production and release of soluble APPα (sAPPα). In contrast, adenovirus‐mediated overexpression of APP increased expression of eNOS. Consistent with these observations, nanomolar concentrations of sAPPα and APP 17mer peptide (derived from sAPPα) augmented eNOS expression. Further analysis established that γ‐aminobutyric acid type B receptor subunit 1 and Krüppel‐like factor 2 may function as downstream molecular targets significantly contributing to BACE2/APP/sAPPα‐induced up‐regulation of eNOS. In agreement with studies on cultured human endothelium, endothelium‐dependent relaxations to acetylcholine and basal production of cyclic GMP were impaired in cerebral arteries of BACE2‐deficient mice. We propose that in the brain blood vessels, BACE2 may function as a vascular protective protein.image
Moral beacons: Understanding moral character and moral influence
Authors: Helzer Erik G. , Cohen Taya R. , Kim Yeonjeong , Iorio Alessandro , Aven Brandy 
Published: August 2023

AbstractObjectiveWe introduce the concept of moral beacons—individuals who are higher in moral character than their peers and prominent within their social environment—and examine the degree to which moral beacons increase the moral awareness of their peers.BackgroundUsing data from cohorts of students in graduate business education across two universities, we applied theory and methods from organizational behavior, personality psychology, and social networks analysis to test two research questions about moral beacons.MethodWe used latent profile analysis of data from personality questionnaires and social network surveys completed by graduate business students at two universities (N = 502) to identify individuals classified as moral beacons. We used peer nominations and an in‐class business case discussion exercise to assess moral influence.ResultsLatent profile analysis identified a latent class of moral beacons in our sample. These individuals received more nominations from their peers in end‐of‐class surveys as guides for moral thought and action and positively impacted the moral awareness of their peers in a discussion of a difficult business case about possible lead poisoning of employees, but did not significantly change their counterparts' moral awareness in a different case.ConclusionsThese results provide promising initial evidence that moral beacons can be distinguished from their peers by both moral character and social prominence and can act as guides for others, at times encouraging greater consideration of the moral aspects of situations and decisions. As these results are the first of their kind, we encourage further replication and investigations of moral beacons and moral influence in other settings.
Characterisation of parathyroid hormone concentration in extremely preterm or very low birthweight infants in routine clinical screening for metabolic bone disease: A service evaluation cohort study
Authors: Levene Ilana , Dhami Amraj , Moreno Mar , Shine Brian , Chinoy Amish , Padidela Raja , Molnar Zoltan 
Published: August 2023

AimTo characterise parathyroid hormone (PTH) concentrations in infants at high risk for metabolic bone disease, in order to assist clinical decisions around the use of PTH for screening.MethodsInfants born under 28 weeks' postmenstrual age or with birthweight under 1.5 kg in a tertiary neonatal unit in the UK were included. Clinical guidance was to assess PTH concentration in the first 3 weeks after birth. Clinical information was extracted from prospective records.ResultsSixty‐four infants had mean birth gestation of 26 weeks and birthweight of 882 g. Median PTH (sent on median day 18 of life) was 9.2 pmol/L (interquartile range 5.3–17 pmol/L). Sixty‐seven per cent of infants had a PTH greater than 7 pmol/L. For 22% of the infants, raised PTH was not accompanied by abnormal phosphate or alkaline phosphatase. Eighty‐nine per cent of infants tested were insufficient or deficient for 25‐hydroxyvitamin D.ConclusionsUniversal screening highlights the high frequency of high PTH in this high‐risk population, implying a need for calcium supplementation. A considerable number of infants would not be identified as showing potential signs of metabolic bone disease if the assessment excludes the use of PTH. The high level of 25‐hydroxyvitamin D deficiency may be a confounder.
Neonatal clinical examination and selective ultrasound screening are not reliable for the early diagnosis of hip dysplasia: A retrospective cohort study
Authors: Johnson Mitchell D , Kuschel Carl , Donnan Leo 
Published: August 2023

AimTo compare the incidence, clinical features and timing of initial treatment of early‐ and later‐presenting developmental dysplasia of the hip (DDH) in infancy in the context of a risk‐based selective ultrasound screening programme.MethodsWe conducted a retrospective observational study of infants born at a tertiary perinatal centre in Melbourne, Australia, between July 2016 and June 2020 and treated for DDH up to 18 months of age at a tertiary paediatric centre. The incidence of DDH was calculated for early‐ and later‐presenting cases. Clinical features and ultrasound indications were analysed using multivariate logistic regression.ResultsThere were 192 infants with DDH requiring treatment, 100 (52%) of which were not detected by universal neonatal hip examination and selective ultrasound screening based on risk factors (overall incidence 6.3 per 1000 livebirths). The median age at which treatment was commenced was delayed by 8 weeks for the later‐presenting group compared to those detected through screening (16.7 vs. 7.9 weeks, P < 0.001). Skin crease asymmetry was associated with later presentation (adjusted odds ratio (aOR) 44.03, 95% confidence interval (CI) 9.99–333), whilst breech presentation (aOR 0.08, 95% CI 0.02–0.26) and Barlow/Ortolani test positivity (aOR 0.06, 95% CI 0.01–0.25) were associated with early presentation. Only 39 (1.45%) infants receiving a screening ultrasound had DDH.ConclusionApproximately half of all infants with DDH were not detected by combining risk‐based selective ultrasound screening with neonatal clinical findings, highlighting the failure of this screening method to reliably detect a significant proportion of dysplastic infant hips.
‘Credible, but not really reliable’: teachers' responses to children's literature on energy production and the environment
Authors: Lammert Catherine 
Published: August 2023

AbstractIncorporating climate change into literacy curriculum is an important goal globally, but one that has gone unmet in typical elementary classrooms. One reason may be a lack of preparation of teachers to select texts on this topic. This research involved preservice elementary literacy teachers in a children's literature course evaluating children's picture books on the environmental topic of energy production. Preservice teachers rated each text's enjoyability for students, the credibility of the content, and discussed the underlying assumptions about natural resources in each narrative. A sequential explanatory mixed‐methods analysis was applied. Findings suggest that preservice teachers generally found texts about energy production to be enjoyable for children, and they did not believe that books on energy production might evoke fear or frustration amongst elementary students. However, they differed in their views of authorial credibility. Some felt that personal experiences with text content (i.e., being an indigenous author writing about the need to preserve tribal lands) strengthened authors' credibility while others believed personal closeness made the text more opinionated and therefore less credible. This research suggests the need for elementary teachers to be better prepared to interrogate corporate bias and personal bias in texts about climate change.
Another Fever Year? Making sense of pandemics with a historical graphic novel
Authors: Griffith Robin , Smith Jennifer M. 
Published: August 2023

AbstractThis qualitative study highlights how children's literature can serve as a springboard for discussing current events while making connections with a similar historical event. Undergraduate students enrolled in children's literature courses read the graphic novel Fever Year: The Killer Flu of 1918 and discussed the parallels between the book and the COVID‐19 pandemic. Findings indicate strong text‐to‐self and text‐to‐world connections between the events of the flu of 1918 highlighted in the graphic novel and those of the COVID‐19 pandemic. Connections included restrictions and closures, mask mandates, vaccine development, medical theories, and theories of spread. Information dissemination and consumption was a prominent theme.