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Background Aims Materials and Methods Results Discussion Conclusion Given that students from socio‐economically disadvantaged family backgrounds are more likely to suffer from low academic performance, there is an interest in identifying features of academic resilience, which may mitigate the relationship between disadvantaged socio‐economic status and academic performance.This study sought to combine machine learning and explainable artificial intelligence (XAI) technique to identify key features of academic resilience in mathematics learning during COVID‐19.Based on PISA 2022 data in 79 countries/economies, the random forest model coupled with Shapley additive explanations (SHAP) value technique not only uncovered the key features of academic resilience but also examined the contributions of each key feature.Findings indicated that 35 features were identified in the classification of academically resilient and non‐academically resilient students, which largely validated the previous academic resilient framework. Notably, gender differences were shown in the distribution of some key features. Research findings also indicated that resilient students tended to have a stable emotional state, high levels of self‐efficacy, low levels of truancy and positive future aspirations.This study has established a research paradigm essentially methodological in nature to bridge the gap between psychological theories and big data in the field of educational psychology.To sum up, our study shed light on the issues of education equity and quality from a global perspective in the times of the COVID‐19 pandemic. [ABSTRACT FROM AUTHOR]

Waldenstrom macroglobulinaemia (WM), the predominant subtype of lymphoplasmacytic lymphoma with bone marrow involvement and serum IgM paraprotein, is a haematological condition commonly associated with renal parenchymal involvement. However, antineutrophil cytoplasmic antibody (ANCA)‐negative pauci‐immune crescentic glomerulonephritis (PICGN) in kidney infiltrated by lymphoma is very rare, with only two cases described in chronic lymphocytic leukaemia in English literature so far. We herein report the first patient with WM developing ANCA‐negative PICGN. He was a 76‐year‐old male who presented with elevated serum globulin level and bilateral groin lymph node enlargement, subsequently diagnosed to have WM after pathologic examination of the bone marrow and groin lymph node. One month later, he was found to have acute kidney injury and proteinuria. Renal biopsy confirmed the presence of parenchymal involvement by WM accompanied by PICGN; while ANCA testing was negative. He was treated with pulse methylprednisolone followed by oral prednisolone. In addition, six courses of intravenous rituximab and oral cyclophosphamide were given. There was significant improvement in both his renal and haematological conditions. The clinical course of this case suggested that ANCA‐negative PICGN may represent a paraneoplastic syndrome and a rare manifestation of WM‐associated renal lesion. Early kidney biopsy and prompt treatment may improve the outcome of patients. [ABSTRACT FROM AUTHOR]

Background and aims: Despite evidence that patients living with cancer who continue to smoke after diagnosis are at higher risk for all‐cause mortality and reduced treatment efficacy, many cancer patients continue to smoke. This protocol is for a study to test the effectiveness of a self‐determination theory‐based intervention (quit immediately or progressively) plus instant messaging (WhatsApp or WeChat) to help smokers with cancer to quit smoking. Design: This will be a multi‐centre, two‐arm (1:1), single‐blind, pragmatic, individually randomized controlled trial. Setting: Taking part will be specialist outpatient clinics in five major hospitals in different location‐based clusters in Hong Kong. Participants: The sample will include 1448 Chinese smokers living with cancer attending medical follow‐ups at outpatient clinics. Interventions: The intervention group will receive brief advice (approximately 5–8 minutes) from research nurses in the outpatient clinics and then be invited to choose their own quit schedules (immediate or progressive). During the first 6‐month follow‐up period they will receive instant messaging with smoking cessation advice once per week for the first 3 months, and thereafter approximately once per month. They will also receive four videos, and those opting to quit progressively will receive a smoking reduction leaflet. The control group will also receive brief advice but be advised to quit immediately, and instant messaging with general health advice during the first 6‐month follow‐up period using the same schedule as the intervention group. Participants in both groups will receive smoking cessation leaflets. Measurements The primary outcome is biochemically validated smoking abstinence at 6 months, as confirmed by saliva cotinine level and carbon monoxide level in expired air. Secondary outcomes include biochemically validated smoking abstinence at 12 months, self‐reported 7‐day point prevalence of smoking abstinence at 6 and 12 months, self‐reported ≥ 50% reduction of cigarette consumption at 6 and 12 months and quality of life at 6 and 12 months. All time‐points for outcomes measures are set after randomization. Comments The results could inform research, policymaking and health‐care professionals regarding smoking cessation for patients living with cancer, and therefore have important implications for clinical practice and health enhancement. [ABSTRACT FROM AUTHOR]

Background and aims: Despite evidence that patients living with cancer who continue to smoke after diagnosis are at higher risk for all-cause mortality and reduced treatment efficacy, many cancer patients continue to smoke. This protocol is for a study to test the effectiveness of a self-determination theory-based intervention (quit immediately or progressively) plus instant messaging (WhatsApp or WeChat) to help smokers with cancer to quit smoking. Design: This will be a multi-centre, two-arm (1:1), single-blind, pragmatic, individually randomized controlled trial. Setting: Taking part will be specialist outpatient clinics in five major hospitals in different location-based clusters in Hong Kong. Participants: The sample will include 1448 Chinese smokers living with cancer attending medical follow-ups at outpatient clinics. Interventions: The intervention group will receive brief advice (approximately 5-- 8 minutes) from research nurses in the outpatient clinics and then be invited to choose their own quit schedules (immediate or progressive). During the first 6-month follow-up period they will receive instant messaging with smoking cessation advice once per week for the first 3 months, and thereafter approximately once per month. They will also receive four videos, and those opting to quit progressively will receive a smoking reduction leaflet. The control group will also receive brief advice but be advised to quit immediately, and instant messaging with general health advice during the first 6-month follow-up period using the same schedule as the intervention group. Participants in both groups will receive smoking cessation leaflets. Measurements: The primary outcome is biochemically validated smoking abstinence at 6 months, as confirmed by saliva cotinine level and carbon monoxide level in expired air. Secondary outcomes include biochemically validated smoking abstinence at 12 months, self-reported 7-day point prevalence of smoking abstinence at 6 and 12 months, selfreported ≥ 50% reduction of cigarette consumption at 6 and 12 months and quality of life at 6 and 12 months. All time-points for outcomes measures are set after randomization. Comments: The results could inform research, policymaking and health-care professionals regarding smoking cessation for patients living with cancer, and therefore have important implications for clinical practice and health enhancement. [ABSTRACT FROM AUTHOR]

Objectives: To determine whether the new classification system published by Jordans et al for cesarean scar pregnancy (CSP) can guide management and treatment outcomes. Methods: A retrospective study of women diagnosed with CSP from October 2010 to December 2022 in a single tertiary center was performed. Sonographic records of these women were classified into three types according to the classification published by Jordans et al. Treatment outcomes were compared across each type of CSP. Results: The study included a total of 84 women, where 60 (71.4%), 17 (20.2%), and 7 (8.3%) of them were categorized into Type 1, 2, and 3 CSP, respectively. A total of 47 (55.9%) women were managed with methotrexate, 22 (26.2%) underwent surgical management of the CSP without removal of the Cesarean section (CS) niche, and 11 (13.1%) underwent surgery to remove the CSP and the CS niche. Overall treatment success rates for medical management and surgical management were 70 and 97%, respectively. Four women were managed expectantly and continued their pregnancies, among which three carried beyond 34 weeks and had good neonatal outcomes. Conclusions: The classification as published by Jordans et al is easily replicable and readily implemented clinically. Our findings show that a higher proportion of Type 1 and Type 2 CSP were treated successfully by a less invasive medical approach with a high success rate, whereas most Type 3 CSP required surgical resection to successfully remove the CSP and the CS niche. Prospective studies are required to confirm these findings and further validate the clinical utility of this nomenclature system. [ABSTRACT FROM AUTHOR]

This article explores the relationship between cognitive impairment and functional limitations in individuals with haemophilia in Hong Kong. The study reveals that patients who experience difficulties with memory, attention, and executive functioning tend to have poorer performance at work or school. These cognitive functions are crucial for setting and achieving goals, as well as adapting to one's surroundings, so deficiencies in these areas can impact occupational or educational performance. The findings suggest that regular monitoring of cognitive function should be integrated into the standard care for haemophilia patients, particularly those facing occupational or vocational challenges. Further research is necessary to develop a cost-effective and clinically feasible method for monitoring cognitive function in these individuals. The study investigates how cognitive impairment affects functional limitations in haemophilia patients. The researchers discover that impairments in attention, motor processing speed, and cognitive flexibility are linked to a decline in functional status. The study proposes that regular screening for cognitive deficits and cognitive rehabilitation may be necessary for this population. However, the study has limitations, such as potential selection bias and the absence of a control group. Further research is needed to validate the findings and assess the long-term consequences of functional limitations in haemophilia patients. [Extracted from the article]

Osteoporotic fracture is a prevalent noncommunicable disease globally, causing significant mortality, morbidity, and disability. As the population ages, the healthcare and economic burden of osteoporotic fracture is expected to increase further. Due to its multifactorial features, the development of osteoporotic fracture involves a complex interplay of multiple risk factors, including genetic, environmental, and lifestyle factors. Helicobacter pylori, which infects approximately 43% of the world's population, has been associated with increased fracture risk due to hypochlorhydria from atrophic gastritis and systemic inflammation from elevated pro‐inflammatory cytokines. However, the potential impact of H. pylori infection and eradication on fracture risk remains contentious among various studies due to the study design and inadequate adjustment of confounding factors including baseline gastritis phenotype. In this review, we provided a comprehensive evaluation of the current evidence focusing on the underlying mechanisms and clinical evidence of the association between H. pylori infection and osteoporotic fracture. We also discussed the potential benefits of H. pylori eradication on fracture risk. [ABSTRACT FROM AUTHOR]

Background and Purpose: Radiation therapy‐induced gastrointestinal distress is partly associated with the elimination of gut microbiota. The effectiveness of 5‐HT receptor antagonists to treat radiation therapy‐induced emesis implies a pathophysiological role of 5‐HT. Peripheral 5‐HT is derived from intestinal epithelium. We have investigated the role of gut microbiota in regulating intestinal 5‐HT availability. Experimental Approach: A radiation therapy murine model accompanied by faecal microbiota transplantation from donors fed different diets was investigated, and mouse ileal organoids were used for mechanistic studies. The clinical relevance was validated by a small‐scale human study. Key Results: Short‐term high‐fat diet (HFD) induced gut bacteria to produce butyrate. Irradiated mice receiving HFD‐induced microbiome had the lowest ileal levels of 5‐HT, compared with other recipients. Treatment with butyrate increased 5‐HT uptake in mouse ileal organoids, assayed by the real‐time tracking of a fluorescent substrate for monoamine transporters. Silencing the 5‐HT transporter (SERT) in the organoids abolished butyrate‐stimulated 5‐HT uptake. The competitive tests using different types of selective 5‐HT reuptake inhibitors suggested that butyrate acted as a positive allosteric modulator of SERT. In human gut microbiota, butyrate production was associated with the interconversion between acetate and butyrate. Faecal contents of both acetate and butyrate were negatively associated with serum 5‐HT, but only butyrate was positively correlated with body mass index in humans. Conclusion and Implications: Short‐term HFD may be beneficial for alleviating gastrointestinal reactions by increasing butyrate to suppress local 5‐HT levels and providing energy to cancer patients given radiation therapy. [ABSTRACT FROM AUTHOR]

Objective: Neuropathic pain poses a persistent challenge in clinical management. Neuromodulation has emerged as a last‐resort therapy. Conventional spinal cord stimulation (Con SCS) often causes abnormal sensations and provides short analgesia, whereas high‐frequency spinal cord stimulation (HF SCS) is a newer therapy that effectively alleviates pain without paresthesia. However, the modes of action of 10kHz HF SCS (HF10 SCS) in pain relief remain unclear. To bridge this knowledge gap, we employed preclinical models that mimic certain features of clinical SCS to explore the underlying mechanisms of HF10 SCS. Addressing these issues would provide the scientific basis for improving and evaluating the effectiveness, reliability, and practicality of different frequency SCS in clinical settings. Methods: We established a preclinical SCS model to examine its effects in a neuropathic pain rat model. We conducted bulk and single‐cell RNA sequencing in the spinal dorsal horn (SDH) to examine cellular and molecular changes under different treatments. We employed genetic manipulations through intrathecal injection of a lentiviral system to explore the SCS‐mediated signaling axis in pain. Various behavioral tests were performed to evaluate pain conditions under different treatments. Results: We found that HF10 SCS significantly reduces immune responses in the SDH by inactivating the Kaiso‐P2X7R pathological axis in microglia, promoting long‐lasting pain relief. Targeting Kaiso‐P2X7R in microglia dramatically improved efficacy of Con SCS treatment, leading to reduced neuroinflammation and long‐lasting pain relief. Interpretation: HF10 SCS could improve the immunopathologic state in the SDH, extending its benefits beyond symptom relief. Targeting the Kaiso‐P2X7R axis may enhance Con SCS therapy and offer a new strategy for pain management. ANN NEUROL 2024;95:966–983 [ABSTRACT FROM AUTHOR]

Dementia is a long‐term and progressive syndrome that not only influences the person with dementia (PWD) but also the caregiver. However, informal caregivers are not always empathic and understand the symptoms of dementia, leading to destructive caregiving relationships and poor quality of caregiving. VR‐based simulation interventions can provide a more realistic and memorable learning experience for caregivers to walk in PWDs' shoes. This review aimed to provide practitioners and researchers with insights on developing and/or adopting an effective VR‐based simulation intervention for enhancing the empathy of informal caregivers of PWD. A mixed‐methods systematic review was conducted. Quantitative, qualitative, and mixed‐methods studies were searched from MEDLINE, PsycINFO, CINAHL, Scopus, Embase, and Cochrane Library updating. Standard JBI critical appraisal instruments were used for the quality appraisal. A convergent segregated approach was used to synthesize and integrate the data. A total of seven studies were included. Inconsistent quantitative results were reported on the effects of VR‐based simulation on empathy enhancement. Significant effects were reported on knowledge of dementia and emotion‐focused coping strategies. Two themes were generated from the qualitative studies, including "Informal caregivers gained better insight into problems encountered by older people with dementia" and "Thinking from the perspective of older people with dementia, leading to changes in attitudes and behaviours towards dementia". The qualitative synthesized evidence showed that informal caregivers gained better insight into problems encountered by PWD, but the quantitative synthesized results are inconsistent. Yet, informal caregivers experienced a change in attitude by thinking from the perspective of PWD. [ABSTRACT FROM AUTHOR]

Despite the advent of various medical interventions for cancer treatment, the disease continues to pose a formidable global health challenge, necessitating the development of new therapeutic approaches for more effective treatment outcomes. Photodynamic therapy (PDT), which utilizes light to activate a photosensitizer to produce cytotoxic reactive oxygen species (ROS) for eradicating cancer cells, has emerged as a promising approach for cancer treatment due to its high spatiotemporal precision and minimal invasiveness. However, the widespread clinical use of PDT faces several challenges, including the inefficient production of ROS in the hypoxic tumor microenvironment, the limited penetration depth of light in biological tissues, and the inadequate accumulation of photosensitizers at the tumor site. Over the past decade, there has been increasing interest in the utilization of photofunctional transition metal complexes as photosensitizers for PDT applications due to their intriguing photophysical and photochemical properties. This review provides an overview of the current design strategies used in the development of transition metal complexes as innovative phototherapeutics, aiming to address the limitations associated with PDT and achieve more effective treatment outcomes. The current challenges and future perspectives on the clinical translation of transition metal complexes are also discussed. [ABSTRACT FROM AUTHOR]

It remains a challenge to produce soft robots that can mimic the responsive adaptability of living organisms. Rather than fabricating soft robots from bulk hydrogels,hydrogels are integrated into the interfacial assembly of aqueous two‐phase systems to generate ultra‐soft and elastic all‐aqueous aquabots that exhibit responsive adaptability, that can shrink on demand and have electrically conductive functions. The adaptive functions of the aquabots provide a new platform to develop minimally invasive surgical devices, targeted drug delivery systems, and flexible electronic sensors and actuators. [ABSTRACT FROM AUTHOR]

This study investigated the relationship between compassion and mindfulness in teaching among early years practitioners, with low levels of psychological distress as a mediator. A total of 81 early years practitioners were recruited from the United Kingdom via mass emails and announcements on social media platforms. Findings based on path analysis indicated that lower psychological distress mediated the positive relation between compassion and intrapersonal mindfulness in teaching, after controlling for level of education, years of practice, and role of practitioner. More specifically, compassion was related to psychological distress, intrapersonal mindfulness, and interpersonal mindfulness in teaching, whereas psychological distress was related to intrapersonal mindfulness, but not interpersonal mindfulness in teaching. The present findings inform early years practitioners and researchers of a differential chain of processes between compassion, psychological distress, and mindfulness in teaching. [ABSTRACT FROM AUTHOR]

Summary Background Aims Methods Results Conclusions Optimal glycaemic control has well‐established health benefits in patients with diabetes mellitus (DM). It is uncertain whether optimal glycaemic control can benefit liver‐related outcomes.To examine the association of optimal glycaemic control with hepatocellular carcinoma (HCC) and liver‐related mortality.In a population‐based cohort, we identified patients with newly diagnosed DM between 2001 and 2016 in Hong Kong. Optimal glycaemic control was defined as mean haemoglobin A1c (HbA1c) <7% during the 3‐year lead‐in period after DM diagnosis. By applying propensity score matching to balance covariates, we analysed glycaemic control via competing risk models with outcomes of interest being HCC and liver‐related mortality.We identified 146,430 patients (52.2% males, mean age 61.4 ± 11.8 years). During a median follow‐up duration of 7.0 years, 1099 (0.8%) and 978 (0.7%) patients developed HCC and liver‐related deaths. Optimal glycaemic control, when compared to suboptimal glycaemic control, was associated with reduced risk of HCC (subdistribution hazard ratio [SHR] 0.70, 95% CI 0.61–0.79). The risk of HCC increased with incremental HbA1c increases beyond >7% (SHR 1.29–1.71). Significant associations with HCC were also found irrespective of age (SHR 0.54–0.80), sex (SHR 0.68–0.69), BMI <25 or ≥25 kg/m2 (SHR 0.63–0.75), smoking (SHR 0.61–0.72), hepatic steatosis (SHR 0.67–0.68) and aspirin/statin/metformin use (SHR 0.67–0.75). A lower risk of liver‐related mortality in relation to optimal glycaemic control was also observed (SHR 0.70, 95% CI 0.61–0.80).Glycaemic control is an independent risk factor for HCC and liver‐related mortality, and should be incorporated into oncoprotective strategies in the general DM population. [ABSTRACT FROM AUTHOR]

Gender‐affirming hormone therapy (GAHT) is used by many transgender and gender‐diverse adults to align physical characteristics with their gender identity, reduce gender incongruence and improve psychological functioning. This narrative review provides an overview of the initiation and monitoring of GAHT in an Australian context. Trans individuals treated with testosterone typically receive standard testosterone doses and formulations recommended for cisgender men, whereas those receiving estradiol GAHT are typically treated with estradiol in combination with an anti‐androgen in those without orchidectomy. Proactive monitoring and mitigation of cardiovascular risk factors is pertinent in all transgender and gender‐diverse adults and bone health is an important consideration in those using estradiol GAHT. [ABSTRACT FROM AUTHOR]

Introduction: To evaluate use and utility of the Fetal Alcohol Spectrum Disorder (FASD) Hub Australia website. Methods: Online REDCap user survey incorporating the Website Evaluation Questionnaire, open ended questions, Google metrics data and an accessibility audit. Results: Seventy‐six participants: researchers (32%), health professionals (29%) and policymakers/advocates (16%) completed the survey. Most were from Australia (95%) and were likely or very likely to recommend the FASD Hub to colleagues (92%), friends (74%) and patients (72%). The mean Website Evaluation Questionnaire score was at least 3.45/5 for all dimensions (ease of use, hyperlinks, structure, relevance, comprehension, completeness, layout, search option); range 3.45 (search option) to 4.04 (relevance). Participants found the content trustworthy (92%) but wanted more information for, and to support, Aboriginal and Torres Strait Islander peoples, and improved search capacity. Google metrics identified 25,534 unique users over 6 months (82% new users); 83% aged 18–44 years, 72% female and 35% international. Conclusions: Users found the FASD Hub accessible, authoritative and useful and suggested improvements. [ABSTRACT FROM AUTHOR]

Background: Parents' high academic expectations are positively associated with young children's mathematical abilities. However, minimal attention has been devoted to whether, and how, different ways of conveying the performance targets would result in different outcomes. Aims: The current study investigated whether and how parents' perfectionistic strivings and concerns were associated with young children's mathematical abilities through home mathematical activities, children's approach motivation to learn mathematics, and children's avoidance motivation to learn mathematics. Sample: Participants included 211 kindergarteners in Hong Kong and their parents. Methods: Data were collected through individual child tests and parent questionnaires. Results: Structural equation modelling revealed that parents' perfectionistic strivings had a direct positive link with children's mathematical abilities, an indirect link via approach motivation to learn mathematics, and an indirect link via home mathematical activities, and then approach motivation. Parents' perfectionistic concerns had a direct negative link with children's mathematical abilities, an indirect link via approach motivation to learn mathematics, and an indirect link via avoidance motivation to learn mathematics. Conclusions: Early childhood practitioners are recommended to raise parents' awareness of how to communicate high‐performance targets to children in a constructive manner. [ABSTRACT FROM AUTHOR]

Purpose: To investigate axial elongation (AE) and changes in relative peripheral refraction (RPR) in anisomyopic children undergoing orthokeratology (ortho‐k). Methods: Bilateral anisomyopic children, 7–12 years of age, were treated with ortho‐k. Axial length (AL) and RPR, from 30° nasal (N30°) to 30° temporal (T30°), were measured at baseline and every 6 months over the study period. AE, changes in RPR and changes in the interocular AL difference were determined over time. Results: Twenty‐six of the 33 subjects completed the 2‐year study. The AE of the higher myopic (HM) eyes (at least 1.50 D more myopia than the other eye) (0.26 ± 0.29 mm) was significantly smaller than for the less myopic (LM) eyes (0.50 ± 0.27 mm; p = 0.003), leading to a reduction in the interocular difference in AL (p = 0.001). Baseline RPR measurements in the HM eyes were relatively more hyperopic at T30°, N20° and N30° (p ≤ 0.02) and greater myopic shifts were observed at T20° (p < 0.001), T30° (p < 0.001), N20° (p = 0.02) and N30° (p = 0.01) after lens wear. After 2 years of ortho‐k lens wear, temporal–nasal asymmetry increased significantly, being more myopic at the temporal locations in both eyes (p < 0.001), while AE was associated with the change in RPR at N20° (β = 0.134, p = 0.01). The interocular difference in AE was also positively associated with the interocular difference in RPR change at N30° (β = 0.111, p = 0.02). Conclusions: Ortho‐k slowed AE in bilateral anisomyopia, with slower growth in the HM eyes leading to a reduction in interocular AL differences. After ortho‐k, RPR changed from hyperopia to myopia, with greater changes induced in the HM eyes, and slower AE was associated with a more myopic shift in RPR, especially in the nasal field of both eyes. [ABSTRACT FROM AUTHOR]

Objective: Accumulating evidence indicates that oxidative stress and the disruption of antioxidant defenses play an important role in the neurobiology of bipolar disorder (BD). Studies have found that increased oxidative stress may be associated with cell apoptosis and neuronal damage in BD patients. Hence, this study explored the research field related to BD and oxidative stress from a bibliometrics perspective. Methods: Literature search and relevant data retrieval based on the Web of Sciences Core Collection (WoSCC). R software (version 4.2.2), VOSviewer software (version 1.6.18), and CiteSpace (version 6.1.6) were used in this bibliometric analysis. Results: A total of 2081 publications related to BD and oxidative stress were published between 1986 and 2024. Bipolar Disorders was the journal that had the most publications in this area (72; 3.46%; IF = 5.9), while the United States (1285; 61.7%) and the University of Toronto (377; 18.1%) were the most productive country and institution, respectively. Apart from "oxidative stress" and "bipolar disorder," the most frequently used keywords were "schizophrenia," "prefrontal cortex," and "nitric oxide." Conclusions: The growing number of publications related to BD and oxidative stress in recent years highlights the importance of this research field. Hot topics in research related to BD and oxidative stress included animal experiments and molecular mechanisms, psychiatric‐related inflammation and biomarkers, neurodegenerative diseases, and metabolism. Furthermore, the biological mechanisms of BD, particularly biomarkers and inflammation, may be the emerging research priority area in the future. [ABSTRACT FROM AUTHOR]

Objective: Although the relative survival rate of childhood cancer has increased substantially in recent years, the pursuit of successful outcomes is often accompanied by negative impacts on pediatric and adolescent cancer survivors and their parents' physical and psychological well‐being. However, little is known about their experiences during the period of cancer survivorship. This study aimed to gain an understanding of the experience of cancer survivorship among pediatric and adolescent cancer survivors and their parents. Methods: This study utilized a descriptive qualitative study employing the photovoice design. From September 2022 to March 2023, 17 pediatric and adolescent cancer survivors (9–18 years), who had completed active treatment at least 6 months before recruitment, participated in this study. A total of 217 photographs submitted by survivors and their parents and the interview data, were thematically analyzed to identify themes and subthemes. Results: The analysis revealed five prominent themes: indelible marks, struggling with late effects, striving to return to normalcy, the strength of support, and living in the moment and hope for the future. Conclusion: The findings shed light on the experiences of pediatric and adolescent cancer survivors and their parents throughout the cancer journey, elucidating the influence on both negative and positive aspects. Additionally, the study highlighted that photovoice facilitated self‐reflection, the discovery of values, and the recognition of strengths and can be a therapeutic strategy for pediatric and adolescent cancer survivors and their parents in further research. [ABSTRACT FROM AUTHOR]

Rapid changes in artificial intelligence (AI) have already impacted the medical field. While the use of AI to assist medical diagnosis has been documented, AI is continually expanding within medical applications. AI applications in sonography and their effect on ultrasound examinations and sonographers are still indeterminate. Six papers were reviewed to investigate AI applications and effects within the sonography field. These papers provided results on a range of ultrasound applications including breast, obstetric, skin lesions, carotid, blood flow and cardiac ultrasound imaging when combined with AI. In this narrative review, the application of AI demonstrated that accuracy and speed of clinical diagnosis can be improved. These six aspects of ultrasound imaging combined with AI demonstrated the potential to assist the operator and clinicians with a diagnosis in various applications and settings. Additionally, AI can be beneficial to telehealth applications for rural and remote areas where healthcare access can be limited. These changes are opportunities to assist with medical care to provide benefits to patients, sonographers and clinicians as AI transitions to a positive integration within many aspects of clinical care. [ABSTRACT FROM AUTHOR]

Aim: To develop 10‐year cardiovascular disease (CVD) risk prediction models in Chinese patients with type 2 diabetes mellitus (T2DM) managed in primary care using machine learning (ML) methods. Methods: In this 10‐year population‐based retrospective cohort study, 141 516 Chinese T2DM patients aged 18 years or above, without history of CVD or end‐stage renal disease and managed in public primary care clinics in 2008, were included and followed up until December 2017. Two‐thirds of the patients were randomly selected to develop sex‐specific CVD risk prediction models. The remaining one‐third of patients were used as the validation sample to evaluate the discrimination and calibration of the models. ML‐based methods were applied to missing data imputation, predictor selection, risk prediction modelling, model interpretation, and model evaluation. Cox regression was used to develop the statistical models in parallel for comparison. Results: During a median follow‐up of 9.75 years, 32 445 patients (22.9%) developed CVD. Age, T2DM duration, urine albumin‐to‐creatinine ratio (ACR), estimated glomerular filtration rate (eGFR), systolic blood pressure variability and glycated haemoglobin (HbA1c) variability were the most important predictors. ML models also identified nonlinear effects of several predictors, particularly the U‐shaped effects of eGFR and body mass index. The ML models showed a Harrell's C statistic of >0.80 and good calibration. The ML models performed significantly better than the Cox regression models in CVD risk prediction and achieved better risk stratification for individual patients. Conclusion: Using routinely available predictors and ML‐based algorithms, this study established 10‐year CVD risk prediction models for Chinese T2DM patients in primary care. The findings highlight the importance of renal function indicators, and variability in both blood pressure and HbA1c as CVD predictors, which deserve more clinical attention. The derived risk prediction tools have the potential to support clinical decision making and encourage patients towards self‐care, subject to further research confirming the models' feasibility, acceptability and applicability at the point of care. [ABSTRACT FROM AUTHOR]

Background: Survivors of adolescent and young adult (AYA) cancer experience significant psychological distress and encounter barriers to accessing mental health care. Few studies have investigated racial/ethnic disparities in psychological health outcomes among AYA survivors, and none have compared outcomes within a racially minoritized population. Methods: National Health Interview Survey data (2010–2018) were analyzed that identified non‐Hispanic Black (hereafter, Black) survivors of AYA cancer and age‐ and sex‐matched Black noncancer controls. Sociodemographic factors, chronic health conditions, modifiable behaviors (smoking and alcohol use), and psychological outcomes were assessed with χ2 tests. Logistic regression models, adjusted for survey weights, were used to evaluate the odds of psychological distress by cancer status after adjusting for covariates. Interactions between variables and cancer status were investigated. Results: The study included 334 Black survivors of AYA cancer and 3340 Black controls. Compared to controls, survivors were more likely to report moderate/severe distress (odds ratio [OR], 1.64; p <.001), use mental health care (OR, 1.53; p =.027), report an inability to afford mental health care (OR, 3.82; p <.001), and use medication for anxiety and/or depression (OR, 2.16; p =.001). Forty‐one percent of survivors reported moderate/severe distress, and only 15% used mental health care. Among survivors, ages 18–39 years (vs. 40–64 years) and current smoking (vs. never smoking) were associated with the presence of moderate/severe distress. Among survivors with distress, high poverty status was associated with reduced utilization of mental health care. Conclusions: A cancer diagnosis for a Black AYA is associated with greater psychological distress within an already vulnerable population. Black survivors of adolescent and young adult cancer have higher levels of psychological distress than Black individuals without a history of cancer and are more likely to report an inability to afford mental health care. There is a gap in receipt of mental health care among Black survivors, with approximately 40% of survivors reporting moderate/severe distress and only 15% reporting a mental health care visit. [ABSTRACT FROM AUTHOR]

The article investigates preservice teachers' experiences and perceptions of adopting performance-based assessment (PBA) in literary texts. Topics include the challenges of aligning formative assessment with high-stakes exams, the shift from traditional summative assessments to process-oriented pedagogies, and the benefits of integrating performance-based assessments to enhance student learning and align with educational reforms.

Liver kinase B1 (LKB1/STK11) is an important regulator of pancreatic β‐cell identity and function. Elimination of Lkb1 from the β‐cell results in improved glucose‐stimulated insulin secretion and is accompanied by profound changes in gene expression, including the upregulation of several neuronal genes. The mechanisms through which LKB1 controls gene expression are, at present, poorly understood. Here, we explore the impact of β cell‐selective deletion of Lkb1 on chromatin accessibility in mouse pancreatic islets. To characterize the role of LKB1 in the regulation of gene expression at the transcriptional level, we combine these data with a map of islet active transcription start sites and histone marks. We demonstrate that LKB1 elimination from β‐cells results in widespread changes in chromatin accessibility, correlating with changes in transcript levels. Changes occurred in hundreds of promoter and enhancer regions, many of which were close to neuronal genes. We reveal that dysregulated enhancers are enriched in binding motifs for transcription factors (TFs) important for β‐cell identity, such as FOXA, MAFA or RFX6, and we identify microRNAs (miRNAs) that are regulated by LKB1 at the transcriptional level. Overall, our study provides important new insights into the epigenetic mechanisms by which LKB1 regulates β‐cell identity and function. [ABSTRACT FROM AUTHOR]

Background Methods Results Materialism refers to values that equate materialistic possessions with happiness and success. Gathering materialistic possessions is also central to materialists' life. Extant research has widely shown that materialism is detrimental to people's well‐being, but its influences on meaning in life are less clear. In this article, we address two principal research questions within the framework of self‐determination theory: First, we explore the association between varying dimensions of materialism and the perceived meaning in life; second, we investigate the factors that mediate the relationship between materialistic values and meaning in life.Two cross‐sectional online survey studies (Study 1: 190 Chinese participants; Study 2: 767 participants [mainly Caucasians] from Prolific) were conducted to test a hypothesized serial double mediation model, in which basic psychological needs satisfaction and subjective well‐being were the two serial factors mediating the materialistic happiness to meaning in life relationship.Among the three materialism values, only materialistic happiness was negatively associated with meaning in life. Basic psychological needs satisfaction and subjective well‐being serially mediated the relationship. Theoretical and practical implications were discussed. [ABSTRACT FROM AUTHOR]

Summary: Acyl‐CoA‐Binding Proteins (ACBPs) bind acyl‐CoA esters and function in lipid metabolism. Although acbp3‐1, the ACBP3 mutant in Arabidopsis thaliana ecotype Col‐0, displays normal floral development, the acbp3‐2 mutant from ecotype Ler‐0 characterized herein exhibits defective adaxial anther lobes and improper sporocyte formation.To understand these differences and identify the role of ERECTA in ACBP3 function, the acbp3 mutants and acbp3‐erecta (er) lines were analyzed by microscopy for anther morphology and high‐performance liquid chromatography for lipid composition.Defects in Landsberg anther development were related to the ERECTA‐mediated pathway because the progenies of acbp3‐2 × La‐0 and acbp3‐1 × er‐1 in Col‐0 showed normal anthers, contrasting to that of acbp3‐2 in Ler‐0. Polymorphism in the regulatory region of ACBP3 enabled its function in anther development in Ler‐0 but not Col‐0 which harbored an AT‐repeat insertion. ACBP3 expression and anther development in acbp3‐2 were restored using ACBP3pro (Ler)::ACBP3 not ACBP3pro (Col)::ACBP3. SPOROCYTELESS (SPL), a sporocyte formation regulator activated ACBP3 transcription in Ler‐0 but not Col‐0.For anther development, the ERECTA‐related role of ACBP3 is required in Ler‐0, but not Col‐0. The disrupted promoter regulatory region for SPL binding in Col‐0 eliminates the role of ACBP3 in anther development. [ABSTRACT FROM AUTHOR]

Diseases in which cutaneous plasma cell infiltrates predominate are rare and usually of unknown etiology, including those that transition from benign to malignant, such as cutaneous plasmacytosis, multicentric Castleman disease, and extramedullary plasmacytoma. These diseases may present as purplish, reddish‐brown cutaneous plaques or nodules. Here, we report an exceptional case of lichen planus (LP) in which the patient had classic histopathological features, but the infiltrating inflammatory cells were plasma cells with restricted light chain expression. The patient presented with severe rashes, including purplish‐red plaques and nodules, erythema, and erosions in the palmoplantar area, verrucous hyperplasia of the oral mucosa, and anonychia of the toes. These findings suggest a possible role of plasma cells with restricted light chain expression in the LP. Clinicians should closely follow patients for changes in their rash, perform repeat biopsies if necessary, and regularly conduct multisystemic evaluations. [ABSTRACT FROM AUTHOR]

Biomaterials capable of continuously inactivating pathogens are essential for suppressing transmission of infectious diseases, such as epidemic cerebrospinal meningitis and pulmonary tuberculosis. Here, capillary condensation of air moisture within nano‐confined spaces between superhydrophilic rigid nanorods is shown and target microbiology spontaneously stretch and inactivate aerosolized microorganisms. Specifically, the negative Gaussian curvature‐shaped water condensate causes fluidic straining, comprising surface tension and Laplace pressure, strong enough to deform and eliminate the selected bacteria. Plate counting quantifies the sharply reduced contact‐killing period for superhydrophilic and bare nanorods (6 vs 100 min for E. coli, 20 vs 120 min for S. aureus) under relative humidity of 70%. Theoretical calculations and experimental studies indicate increased mechanical straining and mechano‐bactericidal by improving air moisture content. To further illustrate utility, long‐term antibacterial medical masks are fabricated by integrating such nanorods onto commercial fabrics. Collectively, these findings highlight the immense potential of capillary condensation‐induced fluidic straining as an eco‐friendly, broad‐spectrum, and highly efficient antibacterial strategy. [ABSTRACT FROM AUTHOR]

Aim: To develop evidence‐based clinical algorithms for management of common intrapartum urinary abnormalities. Population: Women with singleton, term pregnancies in active labour and immediate postnatal period, at low risk of complications. Setting: Healthcare facilities in low‐ and middle‐income countries. Search strategy: A systematic search and review were conducted on the current guidelines from WHO, NICE, ACOG and RCOG. Additional search was done on PubMed and The Cochrane Database of Systematic Reviews up to May 2020. Case scenarios: Four common intrapartum urinary abnormalities were selected: proteinuria, ketonuria, glycosuria and oliguria. Using reagent strip testing, glycosuria was defined as ≥2+ on one occasion or of ≥1+ on two or more occasions. Proteinuria was defined as ≥2+ and presence of ketone indicated ketonuria. Oliguria was defined as hourly urine output ≤30 ml. Thorough initial assessment using history, physical examination and basic investigations helped differentiate most of the underlying causes, which include diabetes mellitus, dehydration, sepsis, pre‐eclampsia, shock, anaemia, obstructed labour, underlying cardiac or renal problems. A clinical algorithm was developed for each urinary abnormality to facilitate intrapartum management and referral of complicated cases for specialised care. Conclusions: Four simple, user‐friendly and evidence‐based clinical algorithms were developed to enhance intrapartum care of commonly encountered maternal urine abnormalities. These algorithms may be used to support healthcare professionals in clinical decision‐making when handling normal and potentially complicated labour, especially in low resource countries. Evidence‐based clinical algorithms developed to guide intrapartum management of commonly encountered urinary abnormalities. An evidence‐based clinical algorithm was developed to enhance intrapartum management of commonly encountered urinary abnormalities. [ABSTRACT FROM AUTHOR]

Objective: To construct algorithms with a sequential decision analysis pathway for monitoring of the fetal heart rate and managing fetal heart rate bradycardia, late decelerations and tachycardia during labour. Population: Low‐risk pregnant women in labour with singleton cephalic term pregnancies. Setting: Institutional births in low‐ and middle‐income countries. Search strategy: We sought relevant published clinical algorithms, guidelines and randomised trials/reviews by searching the Cochrane Library, PubMed and Google on the terms: "fetal AND heart AND rate AND algorithm AND (labour OR intrapartum)", up to March 2020. Case scenarios: The two scenarios included were fetal heart rate bradycardia or late decelerations (potentially related to uterine rupture, placental abruption, cord prolapse, maternal hypotension, uterine hyperstimulation or unexplained) and fetal heart rate tachycardia (potentially related to maternal hyperthermia, infection, dehydration or unexplained). The algorithms provide pathways for definition, assessment, diagnosis, interventions to correct the abnormalities and ongoing monitoring leading to mode of birth, and linking to other algorithms in the series. Conclusions: The algorithms provide a framework for monitoring and managing fetal heart rate bradycardia, late decelerations and tachycardia during labour. We emphasise the inherent diagnostic inaccuracy of fetal heart rate monitoring, the tendency to over‐diagnose fetal compromise, the need to consider fetal heart rate information in the context of other clinical features and the need to engage in informed, shared, family‐centred decision‐making. We note the need for further research on methods of fetal assessment during labour including clinical fetal arousal testing and the rapid biophysical profile test. Decision analysis algorithms for fetal bradycardia, late decelerations and tachycardia highlight diagnostic limitations. Decision analysis algorithms for fetal bradycardia, late decelerations and tachycardia highlight diagnostic limitations. [ABSTRACT FROM AUTHOR]

Aim: Therapeutic inertia, hypoglycaemia and poor treatment persistence can lead to glycaemic fluctuation and poor outcomes in type 2 diabetes (T2D). We compared glycated haemoglobin (HbA1c) variability, insulin initiation, severe hypoglycaemia and clinical events in patients with T2D initiated dipeptidyl peptidase‐4 inhibitors (DPP4is) at low versus high HbA1c thresholds. Methods: Using territory‐wide electronic medical records in Hong Kong, we curated a propensity score‐matched cohort of patients initiated DPP4i at HbA1c <7.5% versus ≥7.5% in 2007‐2019. We expressed the HbA1c variability score (HVS) as a proportion of HbA1c varied by ≥0.5% compared with preceding values. We used the Cox model to compare the risks of insulin initiation and clinical outcomes, adjusted for time‐varying variables between the two groups. Mediation analysis estimated the effects of HbA1c variability on outcomes. Results: Among 6874 insulin‐naïve patients who initiated DPP4i, 88.7% were treated with metformin and 79.6% with sulphonylureas at baseline (54.9% men; mean age 65.2 ± 11.4 years). After a median follow‐up of 4.6 years, compared with the high‐threshold plus high‐HVS group (≥50%), the low‐threshold plus low‐HVS (<50%) group had reduced hazard ratios (95% confidence interval) of insulin initiation (0.35, 0.31‐0.40), severe hypoglycaemia (0.38, 0.34‐0.44), major adverse cardiovascular endpoints (0.76, 0.66‐0.88), heart failure (0.42, 0.36‐0.49), end‐stage kidney disease (0.65, 0.36‐0.49) and mortality (0.45, 0.35‐0.57). Reduced HbA1c variability explained 31.1%‐81.2% of the effect size of DPP4i initiation at HbA1c <7.5% versus ≥7.5% on outcomes. Conclusions: In Chinese patients with T2D, avoiding therapeutic inertia with intensified glycaemic control at HbA1c <7.5% using drugs with low risk of hypoglycaemia and good tolerability, such as DPP4i, delayed insulin treatment, reduced HbA1c variability and improved clinical events. [ABSTRACT FROM AUTHOR]

Objective: To identify patients presenting to an acute medical hospital with common signs and symptoms that occur in people with eating disorders (EDs), and determine by retrospective file audit if these are diagnosed cases of an ED. Method: The investigators screened electronic medical records of people 16 years and older for common signs and symptoms of an ED such as hypokalemia, in patients presenting to an acute hospital in Sydney, Australia from 2018 to 2020. Cases where the clinical finding was unexplained had their file audited. Cases with a known ED diagnosis or coded with an ED were also retrieved to audit. Results: Investigators identified 192 definite ED cases with a total of 598 episodes of care from 2018 to 2020 presenting to the hospital. Eighty‐three cases were identified as possible EDs due to unexplained clinical signs consistent with an ED, but were not confirmed cases due to lack of clinical history in the file. Only 19.1% of presentations were diagnostically coded with an ED in the electronic medical record. Discussion: Our study revealed a large number of definite ED cases presenting to an acute medical hospital via the emergency department, who were not recognized as having an ED. Greater awareness of clinical signs and symptoms of an ED, such as unexplained low body mass index and hypokalemia, is necessary among acute care clinicians. Correctly identifying EDs in those seeking somatic care should be a public health priority, to facilitate timely and equitable access to diagnostic assessment and evidence based treatment. Public significance: People with eating disorders (EDs) present to acute care settings and have a relatively high utilization of generalist health services with nonspecific problems such as abdominal pain. An enhanced understanding of healthcare utilization by people with EDs, who may not disclose their symptoms, is crucial for improving access to treatment. [ABSTRACT FROM AUTHOR]

This paper aims to understand the state‐of‐the‐art of research on sustainability discourse in applied linguistics. The paper adopts a systematic two‐stage review approach. In the first stage, 114 articles were classified into environment, social, and governance (ESG) according to the Global Reporting Initiative (GRI) categories. The second stage involves annotating the dataset using an open‐coding system based on data types explored in the studies, methodologies used, findings, and implications. The findings lead to a comprehensive review of diachronic changes in the investigation of sustainability topics, data types, sampling, frameworks, analytical tools, findings, and implications to ultimately set the grounds for future research on sustainability discourse in applied linguistics and related disciplines—for example, communication studies. [ABSTRACT FROM AUTHOR]

Despite the considerable research interest in InGaN‐based microdisk lasers, owing to their unique circular geometry distinct from vertical cavity surface‐emitting lasers (VCSEL) or edge‐emitting lasers, commercial products remain scant due to deficient performance under electrical injection. This study proposes an innovative method integrating a thin‐film configuration with a metallic undercut, significantly augmenting optical confinement, overlap factor, and thus lasing performance. This approach results in a diminished lasing threshold from 1500 to 670 Wcm−2 and a record high quality (Q) factor of 10100 under electrical injection. Strain relaxation in the metallic undercut, identified via scanning near‐field optical microscopy (SNOM), beneficially mitigates the Quantum Confined Stark Effect (QCSE), boosting the internal quantum efficiency of the laser. Furthermore, a beneficial blue‐shift in the emission spectrum aligns with the lasing peak, strengthening the Q factor. A tactfully implemented recessed top contact enables electrical injection lasing without optical performance compromise. The study provides invaluable insights for future microdisk laser technology advancements, potentially leading to specialized functionalities, including quantum optics, thereby opening new avenues for research and applications in this field. [ABSTRACT FROM AUTHOR]

Acne is a chronic inflammatory skin condition that involves Cutibacterium acnes (C. acnes), which is classified into six main phylotypes (IA1, IA2, IB, IC, II and III). Acne development is associated with loss of C. acnes phylotype diversity, characterised by overgrowth of phylotype IA1 relative to other phylotypes. It was also shown that purified extracellular vesicles (EVs) secreted by C. acnes can induce an acne‐like inflammatory response in skin models. We aimed to determine if the inflammatory profile of EVs secreted by C. acnes phylotype IA1 from an inflammatory acne lesion was different from C. acnes phylotype IA1 from normal skin, thus playing a direct role in the severity of inflammation. EVs were produced in vitro after culture of two clinical strains of C. acnes phylotype IA1, T5 from normal human skin and A47 from an inflammatory acne lesion, and then incubated with either human immortalised keratinocytes, HaCaT cells, or skin explants obtained from abdominoplasty. Subsequently, quantitative PCR (qPCR) was performed for human β‐defensin 2 (hBD2), cathelicidin (LL‐37), interleukin (IL)‐1β, IL‐6, IL‐8, IL‐17α and IL‐36γ, and ELISA for IL‐6, IL‐8 and IL‐17α. We found that EVs produced in vitro by C. acnes derived from inflammatory acne lesions significantly increased the pro‐inflammatory cytokines and anti‐microbial peptides at both transcriptional and protein levels compared with EVs derived from normal human skin. We show for the first time that C. acnes EVs from inflammatory acne play a crucial role in acne‐associated inflammation in vitro and that C. acnes phylotype IA1 collected from inflammatory acne lesion and normal skin produce different EVs and inflammatory profiles in vitro. [ABSTRACT FROM AUTHOR]

Summary: Several professional societies have provided recommendations for prescribing medications for insomnia. None has provided an integrative analysis that concurrently quantifies safety and efficacy (e.g., risk–benefit ratios). This represents an important gap for informing clinician decision‐making. Accordingly, the aim of the present review is to provide such an analysis for five classes of sleep‐promoting medications. Adverse event data values were extracted from the most recent FDA‐approved package inserts and converted to an integer before being placebo‐adjusted and standardized as a rate per 1000 (AEr). Efficacy data, pre‐to‐post self‐reported data for active and placebo conditions were acquired from pivotal trials identified in "white papers" and systematic reviews/meta‐analyses. Weighted effect sizes were calculated for subjective sleep latency, wake time after sleep onset and total sleep time, and then were averaged by medication class for each sleep continuity variable. Overall efficacy was represented by a single variable, SWT (sleep latency + wake time after sleep onset + total sleep time). Risk–benefit was represented using a simple ratio value. For safety, it was found that melatonin receptor agonists had the lowest adverse event rate (AEr = 43.1), and non‐benzodiazepine benzodiazepine receptor agonists had the highest rate (AEr = 255.0). For efficacy, it was found that the pre‐to‐post placebo adjusted effect sizes were largest for benzodiazepines (effect size = 1.94) and smallest for melatonin receptor agonists (effect size = 0.109). For risk–benefit, histamine antagonist had the most favourable profile (risk–benefit = 69.5), while melatonin receptor agonist had the least favourable profile (risk–benefit = 395.7). Overall, the combined metric for risk–benefit suggests that treatment with a histamine antagonist is optimal and potentially represents the best first‐line therapy for the medical management of insomnia. [ABSTRACT FROM AUTHOR]

Plasma proteins have been a valuable source of biomarkers for clinical uses and for monitoring of the illicit use of prohibited substances or practices in equine sports. We have previously reported the first use of label‐free proteomics in profiling equine plasma proteome. This study aimed to refine the method by systematically evaluating various plasma fractionation methods and the use of narrower precursor mass ranges in data‐independent acquisition (DIA) mass spectrometry (MS). Tandem fractionations of equine plasma with octanoic acid precipitation followed by solid‐phase extraction (SPE) with C4 cartridges provided the largest increase in the number of new proteins identified. The use of two narrow precursor mass ranges of m/z 400–600 and 600–800 in DIA not only identified most proteins detectable by using a single mass range of m/z 350–1500 but also identified ~27% more proteins. The improved method was applied to analyse the plasma proteome of 'postrace' samples which, unlike other samples, had been collected from racehorses soon after racing. Multivariate data analysis has identified upregulation of 14 proteins and downregulation of six proteins in postrace plasma compared with the non‐postrace plasma samples. Literature review of these proteins has provided evidence of exercise‐induced haemolysis and changes in antioxidant enzyme activities, kinin system, insulin signalling and energy metabolism after strenuous exercise. The improved method has enabled a deeper profiling of the equine plasma proteome and identified the proteins associated with normal physiological changes after racing which are potential confounding factors in the development of a biomarker approach for doping control. [ABSTRACT FROM AUTHOR]

Objective: Endotracheal tube (ETT) surface electrodes are used to monitor the vagus nerve (VN), recurrent laryngeal nerve (RLN), and external branch of the superior laryngeal nerve (EBSLN) during thyroid and parathyroid surgery. Alternative nerve monitoring methods are desirable when intubation under general anesthesia is not desirable or possible. In this pilot study, we compared the performance of standard ETT electrodes to four different noninvasive cutaneous recording electrode types (two adhesive electrodes and two needle electrodes) in three different orientations. Methods: The VN was stimulated directly during thyroid and parathyroid surgery using a Prass stimulator probe. Electromyographic (EMG) responses for each patient were recorded using an ETT plus one of the following four cutaneous electrode types: large‐foot adhesive, small‐foot adhesive, long‐needle and short‐needle. Each of the four electrode types was placed in three orientations: (1) bilateral, (2) ipsilateral mediolateral, and (3) ipsilateral craniocaudal. Results: Four surgical cases were utilized for data collection with the repetitive measures obtained in each subject. Bilateral electrode orientation was superior to ipsilateral craniocaudal and ipsilateral mediolateral orientations. Regardless of electrodes type, all amplitudes in the bilateral orientation were >100 μV. When placed bilaterally, the small‐foot adhesive and the long‐needle electrodes obtained the highest EMG amplitudes as a percentage of ETT amplitudes. Conclusion: Cutaneous electrodes could potentially be used to monitor the VN during thyroid and parathyroid procedures. Different electrode types vary in their ability to record amplitudes and latencies. Bilateral orientation improves EMG responses in all electrode types. Additional validation of cutaneous electrodes as an alternative noninvasive method to monitor the VN is needed. [ABSTRACT FROM AUTHOR]

Objectives: Community based dementia prevalence studies are expensive and resource intensive. Aotearoa New Zealand (NZ) has never had a community based dementia prevalence study representing all major ethnic groups. In recent years, dementia prevalence estimates have been derived from routinely collected health data but issues of underdiagnosis and undercoding limit their utility. Capture‐recapture techniques can estimate the number of dementia cases missing from health datasets by modelling the ascertained overlaps between linked data sources. Methods: Three routinely collected national health data sets—interRAI, Public hospital discharges, and Pharmaceuticals—were linked and all prevalent cases of dementia in NZ for the year 1 January 2021–31 December 2021 were identified. Capture‐recapture analysis fitted eight loglinear models to the data, with the best fitting model used to estimate the number of prevalent cases missing from all three datasets. Results: We estimated that almost half (47.8%) of dementia cases are not present in any of the three datasets. Dementia prevalence increased from 3.7% to 7.1% (95% CI 6.9%–7.4%) in the NZ 60+ population and from 4.9% to 9.2% (95% CI 8.9%–9.6%) in the NZ 65+ population when missing cases were included. Estimates of missing cases were significantly higher (p < 0.001) in Māori (49.2%), Pacific peoples (50.6%) and Asian (59.6%) compared to Europeans (46.4%). Conclusions: This study provides updated estimates of dementia prevalence in NZ and the proportion of undiagnosed dementia in NZ, highlighting the need for better access to dementia assessment and diagnosis. [ABSTRACT FROM AUTHOR]

Introduction: Impaired laryngopharyngeal sensation has been implicated in obstructive sleep apnea (OSA) and may play an important pathophysiological role. We evaluated sensory function in OSA by examining the laryngeal adductor reflex (LAR) response rate and temporal profile to tactile stimulation. Methods: Laryngeal sensation testing was performed in awake adults with and without diagnosed OSA by stimulating the medial aryepiglottic fold or arytenoid using 30‐mm 5–0 and 4–0 nylon Cheung‐Bearelly monofilaments. Video analysis by two independent reviewers evaluated for the presence of the LAR in response to satisfactory stimuli and LAR latency to vocal fold adduction. Results: Twenty‐six OSA and 12 control subjects were tested with 270 satisfactory stimuli. The mean full LAR response rate to 4–0 stimulation was 38.3% in OSA vs 86.9% in control subjects (p <0.001) and to 5–0 stimulation was 27% in OSA vs 63.9% in control subjects (p <0.001). The mean LAR latency to vocal fold closure in OSA was 123.7 ms (SD 35.8) vs 156.4 ms (SD 44.3) in control (p = 0.04) subjects. OSA LAR latency was positively correlated with the apnea‐hypopnea index (r = 0.30; p = 0.008). Conclusion: The OSA group exhibited reduced LAR response rates and shortened LAR latency, where latency was correlated with disease severity. Laryngeal hyposensitivity was affirmed and changes to LAR sensorimotor temporal dynamics were revealed. These pathophysiological alterations to the LAR may be accounted for by decreased somatosensory receptor sensitivity, increased sympathetic tone, and reorganized brain stem function in OSA. Level of Evidence: 3 Laryngoscope, 134:3856–3861, 2024 [ABSTRACT FROM AUTHOR]

During Hong Kong's 2019 political turmoil and the subsequent impact of the coronavirus disease 2019 pandemic, a rapid rise in turnover rates in certain occupations, such as teachers, medical workers and civil servants, was observed. Some attributed this trend to the increasing rate of emigration. Previous studies have suggested that younger and better‐educated individuals are more likely to emigrate, and that the emigration of a specific group of the population has various impacts on the society of origin. Therefore, we explored the demographic characteristics of potential emigrants in Hong Kong and contrasted such findings with a previous wave of migration to examine the potential impact of the current wave. Based on a territory‐wide telephone survey, we found that (1) the associations of age and level of education with the intention to emigrate internationally (i.e., to destinations other than mainland China) corresponded to the typical young, well‐educated emigrant described in the literature; (2) a higher level of income was associated with a lower intention of international migration; (3) people in occupations such as professionals and managers, clerical and service workers and students reported a greater intention to emigrate than other groups; and (4) individuals born in Hong Kong were more likely to emigrate and less likely to move to mainland China than those born in mainland China. The implications of these intended migration patterns for ageing and fertility, short‐ and long‐term workforce shortages in tertiary sectors and the city's overall competitiveness are discussed. [ABSTRACT FROM AUTHOR]

Aim: To develop evidence‐based clinical algorithms for the assessment and management of spontaneous, uncomplicated labour and vaginal birth. Population: Pregnant women at any stage of labour, with singleton, term pregnancies considered to be at low risk of developing complications. Setting: Health facilities in low‐ and middle‐income countries. Search Strategy: We searched for relevant published algorithms, guidelines, systematic reviews and primary research studies on Cochrane Library, PubMed, and Google on terms related to spontaneous, uncomplicated labour and childbirth up to 01 June 2023. Case scenarios: Three case scenarios were developed to cover assessments and management for spontaneous, uncomplicated first, second and third stage of labour. The algorithms provide pathways for definition, assessments, diagnosis, and links to other algorithms in this series for management of complications. Conclusions: We have developed three clinical algorithms to support evidence‐based decision making during spontaneous, uncomplicated labour and vaginal birth. These algorithms may help guide health care staff to institute respectful care, appropriate interventions where needed, and potentially reduce the unnecessary use of interventions during labour and childbirth. Evidence‐based clinical algorithms may help support respectful, high quality intrapartum care. [Correction added on 23 August 2024, after first online publication: The Abstract has been updated to structure layout in this version.] [ABSTRACT FROM AUTHOR]

The effects of climate change on marine ecosystems are causing cascading impacts on livelihood, food security, and culture through fisheries. Such impacts interact and exacerbate the effects of overfishing on marine social‐ecological systems, complicating the rebuilding of ecosystems to achieve desirable and sustainable ocean futures. Developing effective pathways for ecosystem rebuilding requires consideration of the co‐benefits and trade‐offs between ecological and social dimensions and between fishing sectors. However, the effects of intensifying climate change on such co‐benefits or trade‐offs are yet to be well understood, particularly in regions where ecosystem rebuilding is urgently needed. We applied a numerical optimization routine to define the scope for improvement toward the Pareto‐frontier for ecological robustness and economic benefits of the northern South China Sea (NSCS) and the East China Sea (ECS) ecosystems. These two ecosystems were used to represent over‐exploited low‐ and mid‐latitude systems, respectively, and the optimization aimed to improve their status through fisheries management. We find that the ECS ecosystem has the possibility of increasing the economic benefits generated by the fisheries it supports under climate change by 2050 while increasing the uncertainty of achieving biodiversity objectives. Nevertheless, climate change is projected to reduce the scope to restore ecosystem structures and the potential economic benefits in the NSCS ecosystem. This study highlights the contrasting impacts of climate change on the co‐benefits/trade‐offs in ecosystem rebuilding and the benefits obtainable by different fishing sectors even in neighboring ecosystems. We conclude that consideration at the nexus of climate–biodiversity‐fisheries is a key to developing effective ecosystem rebuilding plan. [ABSTRACT FROM AUTHOR]

Pseudaminic acid (Pse) is found in the polysaccharide structures of the cell surface of various Gram‐negative pathogenic bacteria including Acinetobacter baumannii and considered as an important component of cell surface glycans including oligosaccharides and glycoproteins. However, the glycosyltransferase that is responsible for the Pse glycosylation in A. baumannii remains unknown yet. In this study, through comparative genomics analysis of Pse‐positive and negative A. baumannii clinical isolates, we identified a potential glycosyltransferase, KpsS1, located right downstream of the Pse biosynthesis genetic locus. Deletion of this gene in an Pse‐positive A. baumannii strain, Ab8, impaired the glycosylation of Pse to the surface CPS and proteins, while the gene knockout strain, Ab8ΔkpsS1, could still produce Pse with 2.86 folds higher amount than that of Ab8. Furthermore, impairment of Pse glycosylation affected the morphology and virulence potential of A. baumannii, suggesting the important role of this protein. This study will provide insights into the further understanding of Pse in bacterial physiology and pathogenesis. [ABSTRACT FROM AUTHOR]

Summary: Background: Adverse outcomes of cirrhosis remain a top priority. Aims: We examined the distribution of cirrhosis causes, HCC incidence and mortality and related changes over time in a nationwide U.S. cohort. Methods: A retrospective study of a national sample of commercially insured patients with cirrhosis from Optum's de‐identified Clinformatics® Data Mart Database (CDM). Results: A total of 628,743 cirrhosis cases were identified with 45% having NAFLD, 19.5% HCV, and 16.3% ALD. African Americans had the highest rate of decompensation (60.6%), while Asians had the highest rate of HCC (2.4%), both p < 0.001. African Americans more frequently had HCV (28.4%) while Hispanic/Latinos more frequently had NAFLD (49.2%, p < 0.001). Patients in the 2014–2021 cohort were significantly older (63.0 ± 12.8 vs. 57.0 ± 14.3), less frequently decompensated (54.5% vs. 58.3%) but more frequently had HCC (1.7% vs. 0.6%) and NAFLD (46.5% vs. 44.2%), all p < 0.001. The overall annual incidence of HCC was 0.76% (95% CI: 0.75–0.77) with a 5‐year cumulative incidence of 4.03% (95% CI: 3.98–4.09), with significant variation by sex, race/ethnicity, and cirrhosis aetiology. The overall median years of survival were 11.4 (95% CI: 11.3–11.5) with a 5‐year cumulative survival of 73.4% (95% CI: 73.3%–73.6%), also with significant disparities in similar subgroups (lowest in cryptogenic cirrhosis and worse in 2014–2021 vs. 2003–2013). The 2014–2021 period was independently associated with worse survival (aHR: 1.14, 95% CI: 1.08–1.20). Conclusions: HCC incidence and survival vary by aetiology among patients with cirrhosis, with cryptogenic cirrhosis having the lowest survival and lower survival in the more recent time period. [ABSTRACT FROM AUTHOR]