bluuebunny/crossref_metadata_2025_split huggingface dataset:
Beyond the ‘big smoke’: Enabling supervision of ophthalmology trainees in regional, rural and remote Australia
Authors: Jessup Belinda , Allen Penny , Khanal Santosh , Baker‐Smith Victoria , Barnett Tony 
Published: March 2023

AbstractObjectiveExpansion of opportunities for ophthalmology training beyond the ‘big smoke’ is anticipated to support the future distribution of ophthalmologists in regional, rural and remote areas of Australia. However, little is known about what enables supervision outside of metropolitan tertiary hospital settings that would contribute to positive training experiences for specialist medical trainees and encourage them to leave the ‘big smoke’ once qualified. The aim of this study was therefore to explore the perceived enablers of ophthalmology trainee supervision in regional, rural and remote health settings across Australia.SettingAustralia.ParticipantsOphthalmologists working in regional, rural or remote health settings with experience and/or interest in supervising ophthalmology trainees (n = 16).DesignQualitative design involving semistructured interviews.ResultsSeven key enablers of ophthalmology trainee supervision in regional, rural and remote health settings were identified: adequate physical infrastructure, resources and funding to host a trainee; availability of online curriculum and teaching resources so as to ensure equity of training opportunities; pre‐established training posts, driven by supervision ‘champions’; a critical mass of ophthalmologists to help share the supervisory load; relationships and support between training posts, the training network and the Specialist Medical College; alignment of trainee competence and attitude with the needs of the training setting; and the recognition of reciprocal benefits for supervisors through supporting trainees, including workforce support and renewal.ConclusionWith training experiences beyond the ‘big smoke’ anticipated to influence future ophthalmology workforce distribution, implementation of enablers of trainee supervision should occur in regional, rural and remote health settings wherever possible.
The next generation virus‐like particle platform for the treatment of peanut allergy
Authors: Sobczak Jan M. , Krenger Pascal S. , Storni Federico , Mohsen Mona O. , Balke Ina , Reseviča Gunta , Heath Matthew D. , Carreno Velazquez Thalia L. , Kramer Matthias F. , Scott Callum J. W. , Skinner Murray A. , Zeltiņš Andris , Kündig Thomas M. , Vogel Monique , Bachmann Martin F. 
Published: March 2023

AbstractBackgroundAllergy to peanut is one of the leading causes of anaphylactic reactions among food allergic patients. Immunization against peanut allergy with a safe and protective vaccine holds a promise to induce durable protection against anaphylaxis caused by exposure to peanut. A novel vaccine candidate (VLP Peanut), based on virus‐like particles (VLPs), is described here for the treatment of peanut allergy.Methods and ResultsVLP Peanut consists of two proteins: a capsid subunit derived from Cucumber mosaic virus engineered with a universal T‐cell epitope (CuMVTT) and a CuMVTT subunit fused with peanut allergen Ara h 2 (CuMVTT‐Ara h 2), forming mosaic VLPs. Immunizations with VLP Peanut in both naïve and peanut‐sensitized mice resulted in a significant anti‐Ara h 2 IgG response. Local and systemic protection induced by VLP Peanut were established in mouse models for peanut allergy following prophylactic, therapeutic, and passive immunizations. Inhibition of FcγRIIb function resulted in a loss of protection, confirming the crucial role of the receptor in conferring cross protection against peanut allergens other than Ara h 2.ConclusionVLP Peanut can be delivered to peanut‐sensitized mice without triggering allergic reactions, while remaining highly immunogenic and offering protection against all peanut allergens. In addition, vaccination ablates allergic symptoms upon allergen challenge. Moreover, the prophylactic immunization setting conferred the protection against subsequent peanut‐induced anaphylaxis, showing the potential for preventive vaccination. This highlights the effectiveness of VLP Peanut as a prospective break‐through immunotherapy vaccine candidate toward peanut allergy. VLP Peanut has now entered clinical development with the study PROTECT.
Phenotype and genotype of concurrent keratoconus and Fuchs endothelial corneal dystrophy
Authors: Liu Siyin , Sadan Amanda N. , Muthusamy Kirithika , Zarouchlioti Christina , Jedlickova Jana , Pontikos Nikolas , Thaung Caroline , Hardcastle Alison J. , Netukova Magdalena , Skalicka Pavlina , Dudakova Lubica , Bunce Catey , Tuft Stephen J. , Davidson Alice E. , Liskova Petra 
Published: March 2023

AbstractPurposeTo characterise the phenotype and genotype of concurrent keratoconus and Fuchs endothelial corneal dystrophy (KC + FECD).MethodsWe recruited 20 patients with concurrent KC + FECD for a retrospective observational case series from the United Kingdom and the Czech Republic. We compared eight parameters of corneal shape (Pentacam, Oculus) with two groups of age‐matched controls who had either isolated keratoconus (KC) or isolated FECD. We genotyped probands for an intronic triplet TCF4 repeat expansion (CTG18.1) and the ZEB1 variant c.1920G >T p.(Gln640His).ResultsThe median age at diagnosis of patients with KC + FECD was 54 (interquartile range 46 to 66) years, with no evidence of KC progression (median follow‐up 84 months, range 12 to 120 months). The mean (standard deviation (SD)) of the minimum corneal thickness, 493 (62.7) μm, was greater than eyes with KC, 458 (51.1) μm, but less than eyes with FECD, 590 (55.6) μm. Seven other parameters of corneal shape were more like KC than FECD. Seven (35%) probands with KC + FECD had a TCF4 repeat expansion of ≥50 compared to five controls with isolated FECD. The average of the largest TCF4 expansion in cases with KC + FECD (46 repeats, SD 36 repeats) was similar to the age‐matched controls with isolated FECD (36 repeats, SD 28 repeats; p = 0.299). No patient with KC + FECD harboured the ZEB1 variant.ConclusionsThe KC + FECD phenotype is consistent with KC but with superimposed stromal swelling from endothelial disease. The proportion of cases with a TCF4 expansion is similar in concurrent KC + FECD and age‐matched controls with isolated FECD.
Dynamic structure of posttraumatic growth among victims of the 2021 Henan floods: A 6‐month, three‐wave longitudinal study
Authors: Gou Zepeng , Ma Zhihao 
Published: March 2023

AbstractPosttraumatic growth (PTG) following traumatic events is a dynamic and transformational process. However, its dynamic structure is currently unknown. The study aimed to estimate the dynamic structure of PTG at the nuance level based on PTG measurement items using network analysis. A three‐wave longitudinal study was conducted from July 20, 2021, to January 30, 2022, among the victims experiencing the 2021 Henan floods. The final sample (n = 297) completed reports of PTG after 0, 3, and 6 months of the disaster. We employed the graphical vector autoregressive model approach to estimate extended network models. Contemporaneous network results revealed strong positive associations between domains of PTG in the same measurement window, especially between new possibilities and personal strength. Moreover, temporal network results—the internal interplays among PTG items across measurement windows—revealed that the domain of relating to others plays a central role in the dynamics of PTG. Although other domains predicted an increase in relating to others, relating to others inhibited the development of other domains, especially new possibilities and personal strength. Our study identifies the culture‐specific process of PTG and provides empirical evidence on the explanatory models of PTG and the Janus–Face model of PTG.
Longer time to recovery from acute kidney injury is associated with major adverse kidney events in patients with cirrhosis
Authors: Patidar Kavish R. , Naved Mobasshir A. , Kabir Shaowli , Grama Ananth , Allegretti Andrew S. , Cullaro Giuseppe , Asrani Sumeet K. , Worden Astin , Desai Archita P. , Ghabril Marwan S. , Nephew Lauren D. , Orman Eric S. 
Published: March 2023

SummaryBackgroundIn patients with cirrhosis and acute kidney injury (AKI), longer time to AKI‐recovery may increase the risk of subsequent major‐adverse‐kidney‐events (MAKE).AimsTo examine the association between timing of AKI‐recovery and risk of MAKE in patients with cirrhosis.MethodsHospitalised patients with cirrhosis and AKI (n = 5937) in a nationwide database were assessed for time to AKI‐recovery and followed for 180‐days. Timing of AKI‐recovery (return of serum creatinine <0.3 mg/dL of baseline) from AKI‐onset was grouped by Acute‐Disease‐Quality‐Initiative Renal Recovery consensus: 0–2, 3–7, and >7‐days. Primary outcome was MAKE at 90‐180‐days. MAKE is an accepted clinical endpoint in AKI and defined as the composite outcome of ≥25% decline in estimated‐glomerular‐filtration‐rate (eGFR) compared with baseline with the development of de‐novo chronic‐kidney‐disease (CKD) stage ≥3 or CKD progression (≥50% reduction in eGFR compared with baseline) or new haemodialysis or death. Landmark competing‐risk multivariable analysis was performed to determine the independent association between timing of AKI‐recovery and risk of MAKE.Results4655 (75%) achieved AKI‐recovery: 0–2 (60%), 3–7 (31%), and >7‐days (9%). Cumulative‐incidence of MAKE was 15%, 20%, and 29% for 0–2, 3–7, >7‐days recovery groups, respectively. On adjusted multivariable competing‐risk analysis, compared to 0‐2‐days, recovery at 3–7 and >7‐days was independently associated with an increased risk for MAKE: sHR 1.45 (95% CI 1.01–2.09, p = 0.042), sHR 2.33 (95% CI 1.40–3.90, p = 0.001), respectively.ConclusionLonger time to recovery is associated with an increased risk of MAKE in patients with cirrhosis and AKI. Further research should examine interventions to shorten AKI‐recovery time and its impact on subsequent outcomes.
Successful all robotic‐assisted excision of highly malignant mediastinal neuroblastoma in a toddler: A case report
Authors: Ochi Takanori , Koga Hiroyuki , Ueno Hiroyasu , Fujimura Junya , Kosaka Seitaro , Miyake Yuichiro , Yoshida Shiho , Lane Geoffrey J. , Suzuki Kenji , Yamataka Atsuyuki 
Published: March 2023

AbstractAn otherwise well 28‐month‐old girl presented with fever/left thigh pain. Computed tomography identified a 7 cm right posterior mediastinal tumor extending to the paravertebral and intercostal spaces with multiple bone and bone marrow metastases on bone scintigraphy. Thoracoscopic biopsy diagnosed MYCN non‐amplified neuroblastoma. Chemotherapy shrank the tumor to 5 cm by 35 months of age. Robotic‐assisted resection was chosen because the patient was large enough and public health insurance coverage was available. At surgery, the tumor was well‐demarcated by chemotherapy and dissection posteriorly from the ribs/intercostal spaces and medially from the paravertebral space and azygos vein was facilitated by superior visualization/instrument articulation. The capsule of the resected specimen was intact on histopathology, confirming complete tumor resection. Despite minimum distance specifications between arms, trocars, and target sites with robotic assistance, excision was safe without instrument collisions. Robotic assistance should be actively considered for pediatric malignant mediastinal tumor provided the thorax is of adequate size.
Total pelvic exenteration for mucinous adenocarcinoma arising from an implantation cyst 26 years after surgery for rectal cancer
Authors: Fujita Yusuke , Itatani Yoshiro , Kawada Kenji , Sumiyoshi Takayuki , Akamatsu Shusuke , Tsuge Itaru , Okada Takuya , Fujimoto Masakazu , Okamoto Takuya , Nishiyama Kazuhiro , Kasahara Keiko , Okumura Shintaro , Okamura Ryosuke , Maekawa Hisatsugu , Nishigori Tatsuto , Hoshino Nobuaki , Hisamori Shigeo , Tsunoda Shigeru , Hida Koya , Obama Kazutaka 
Published: March 2023

AbstractA 47‐year‐old man underwent low anterior resection for rectal cancer and was surveilled for 5 years without metastasis. Twenty‐four years later, the patient developed an implantation cyst at the anastomotic site. Two years after the diagnosis, colonoscopy revealed a disintegrated area in the lesion, and pathological examination of the biopsy specimen revealed adenocarcinoma. Due to the suspicion of invasion into the surrounding organs, the patient underwent laparoscopic total pelvic exenteration after neoadjuvant chemoradiotherapy. A transabdominal and transperineal endoscopic approach was used for safe en bloc excision of the tumor. Pathological examination of the specimen confirmed mucinous adenocarcinoma arising from the implantation cyst. Although an implantation cyst is considered benign, it is important to suspect malignant transformation when its appearance changes. For the accurate diagnosis of implantation cysts, surgeons, endoscopists, and radiologists should be aware of this disease.
Ubiquitin‐specific peptidases: Players in bone metabolism
Authors: Shen Jianlin , Lin Xiaoning , Dai Feifei , Chen Guoli , Lin Haibin , Fang Bangjiang , Liu Huan 
Published: March 2023

AbstractOsteoporosis is an ageing‐related disease, that has become a major public health problem and its pathogenesis has not yet been fully elucidated. Substantial evidence suggests a strong link between overall age‐related disease progression and epigenetic modifications throughout the life cycle. As an important epigenetic modification, ubiquitination is extensively involved in various physiological processes, and its role in bone metabolism has attracted increasing attention. Ubiquitination can be reversed by deubiquitinases, which counteract protein ubiquitination degradation. As the largest and most structurally diverse cysteinase family of deubiquitinating enzymes, ubiquitin‐specific proteases (USPs), comprising the largest and most structurally diverse cysteine kinase family of deubiquitinating enzymes, have been found to be important players in maintaining the balance between bone formation and resorption. The aim of this review is to explore recent findings highlighting the regulatory functions of USPs in bone metabolism and provide insight into the molecular mechanisms governing their actions during bone loss. An in‐deep understanding of USPs‐mediated regulation of bone formation and bone resorption will provide a scientific rationale for the discovery and development of novel USP‐targeted therapeutic strategies for osteoporosis.
Developmental coordination disorder subtypes in children: An unsupervised clustering
Authors: Gras Domitille , Ploix Maes Emmanuelle , Doulazmi Mohamed , Huron Caroline , Galléa Cécile , Boespflug Tanguy Odile , Germanaud David , Roze Emmanuel 
Published: March 2023

AbstractAimTo identify subtypes of developmental coordination disorder (DCD) in children.MethodChildren with DCD diagnosed through comprehensive evaluation at Robert‐Debré Children's University Hospital (Paris, France) were consecutively enrolled from February 2017 to March 2020. We performed an unsupervised hierarchical clustering based on principal component analysis using a large set of variables encompassing cognitive, motor, and visuospatial scores (Wechsler Intelligence Scale for Children, Fifth Edition; Developmental Neuropsychological Assessment, Second Edition; Movement Assessment Battery for Children, Second Edition).ResultsOne hundred and sixty‐four children with DCD were enrolled (median age 10 years 3 months; male:female ratio 5.56:1). We identified distinct subgroups with mixed visuospatial and gestural disorders, or with pure gestural disorders that predominantly impaired either speed or precision. Associated neurodevelopmental disorders, such as attention‐deficit/hyperactivity disorder, did not influence the results of the clustering. Importantly, we identified a subgroup of children with marked visuospatial impairment with the lowest scores in almost all of the evaluated domains, and the poorest school performance.InterpretationThe classification of DCD into distinct subgroups could be indicative of prognosis and provide critical information to guide patient management, taking into account the child's neuropsychological profile. Beyond this clinical interest, our findings also provide a relevant framework with homogeneous subgroups of patients for research on the pathogenesis of DCD.What this paper adds

Unsupervised hierarchical clustering identified four subgroups of children with developmental coordination disorder.
Two subgroups had combined visuospatial/gestural difficulties, and two had pure gestural disorders.
Severe visuospatial impairment was associated with poor performance in most domains including school.
Difficulties in the gestural‐only clusters were predominantly either gestural precision or speed.
Reduction in the prevalence of methicillin‐resistant Staphylococcus aureus in tissue and wound swab samples taken from outpatients attending a specialist diabetic foot clinic 2005–2021
Authors: Moore James , Gooday Catherine , Soliman Reham , Dhatariya Ketan 
Published: March 2023

AbstractAimsTo assess annual change in prevalence of methicillin resistant Staphylococcus aureus (MRSA) from tissue and wound swab samples from foot ulcers (DFUs) in people with diabetes between 2005 and 2021.MethodsA retrospective analysis of everyone with MRSA positive wound or tissue swabs taken from our specialist multidisciplinary foot clinic between July 2005 and July 2021.ResultsA total of 406 MRSA positive isolates from DFU swabs were identified from 185 individuals attending the foot clinic. There were 22 hospital‐acquired infections (HAIs) and 159 community‐acquired infections (CAIs). Fifty‐two per cent (n = 37) of these individuals from 2010 to 2021 (n = 71) had presence of at least three risk factors for MRSA. The total number of swabs sent was 6312 from 1916 individuals living with diabetes. Annual MRSA DFU prevalence peaked in 2008 at 14.6% (n = 38), decreased in 2013 to 5.2% (n = 20) and did not exceed 4% (n = 6) from 2015 to 2021. Hospital MRSA was lowest in 2021 (n = 211), a 76% fall from 2007 (n = 880). Incidence of MRSA HAI from 2015 to 2021 ranged from 5.4% (n = 14) in 2020 to 11.5% (n = 41) in 2018.ConclusionsPrevalence of MRSA in DFU infections treated as outpatients is decreasing in line with falls in hospital acquired blood‐borne infections and with overall hospital MRSA incidence. This is likely a reflection of the combination of interventions, including stringent antibiotic prescribing and decolonisation strategies. Reduction in prevalence should have positive impact on outcomes in people living with diabetes, reducing the complication of osteomyelitis and necessity for long‐term antibiotic administration.
Fish larvae dynamics in temperate estuaries: A review on processes, patterns and factors that determine recruitment
Authors: Arevalo Elorri , Cabral Henrique N. , Villeneuve Bertrand , Possémé Carl , Lepage Mario 
Published: March 2023

AbstractEarly life stages of fish (eggs and larvae) are particularly vulnerable with mortality rates of up to 99% recorded for a large number of species. High mortality rates result from the limited swimming ability of larvae preventing them from escaping sub‐optimal environmental conditions, predators or low prey density areas. In this context, estuaries are key nursery areas for larval and juvenile fish. Estuarine habitats offer environmental conditions favourable to the survival and growth of early stages, through abundant good‐quality prey and protection from predators. A vast literature on larvae occurring in temperate estuaries exists, but an overall perspective is lacking. The occurrence of fish larvae in temperate estuaries depends on several factors. First, the choice of spawning time and location is primordial, as they have evolved to optimise the entry and the retention of larvae in the estuary as well as the conditions experienced by young stages. Secondly, larval growth and survival depend on key environmental factors (e.g. salinity, water temperature, freshwater inputs, turbidity and dissolved oxygen concentration). Knowledge of the larval dynamics in temperate estuaries is scarce for some topics and biased towards some species or geographical areas. The main goal of the present literature review is to synthesise existing knowledge regarding spawning timing and location and larval ecology for fish species occurring in coasts and estuaries, identifying the main patterns, consensus or conflicting hypotheses and highlighting major gaps. Research needs and future perspectives were outlined.
Temporal‐frequency distribution and multi‐fractal characterization of acoustic emission of rock materials containing two parallel pre‐existing flaws
Authors: Lei Ruide , Tan Yunliang , Berto Filippo , Hu Chao , Qi Xing 
Published: March 2023

AbstractTo explore the temporal‐frequency distribution and multi‐fractal characterization of acoustic emission (AE) signals, a series of uniaxial compressive tests on flawed sandstone containing different flaw geometric arrangements were conducted. The results show that there are primarily low‐frequency and low‐amplitude signals at relatively low stress levels. With the increase of stress level, the components of high‐frequency and high‐amplitude signals increase remarkably. Spectrum width (∆α) follows an approximate trend of first decreasing and then increasing with increasing stress levels. When the stress level increases to 0.8σc, spectrum morphology (∆α0) changes from a positive value to a negative value, indicating that the failure mechanism in rock transforms from microcrack damage to large‐scale shear rupture. Additionally, spectrum measure subset (∆f) and ∆α0 present an opposite trend. With regard to the flawed sandstone, the fracture mechanism is predominately dominated by the microscopic tensile cracks, whereas the microscopic shear cracks in intact sandstone account for a large proportion.