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Background: The 2018 UNOS allocation policy change deprioritized geographic boundaries to organ distribution, and the effects of this change have been widespread. The aim of this investigation was to analyze changes in donor transplant center distance for organ travel and corresponding outcomes before and after the allocation policy change. Methods: The UNOS database was utilized to identify all adult patients waitlisted for heart transplants from 2016 to 2021. Transplant centers were grouped by average donor heart travel distance based on whether they received more or less than 50% of organs from >250 miles away. Descriptive statistics were provided for waitlisted and transplanted patients. Regression analyses modeled waitlist mortality, incidence of transplant, overall survival, and graft survival. Results: Centers with a longer average travel distance had a higher mean annual transplant volume with a reduction in total days on a waitlist (86.6 vs. 149.2 days), an increased cold ischemic time (3.6 vs. 3.2 h), with no significant difference in post‐transplant overall survival or graft survival. Conclusions: The benefits of reducing waitlist time while preserving post‐transplant outcomes extend broadly. The trends observed in this investigation will be useful as we revise organ transplant policy in the era of new organ procurement and preservation techniques. [ABSTRACT FROM AUTHOR]

Background and Purpose: Antipsychotics such as olanzapine are associated with significant metabolic dysfunction, attributed to gut microbiome dysbiosis. A recent notion that most psychotropics are detrimental to the gut microbiome has arisen from consistent findings of metabolic adverse effects. However, unlike olanzapine, the metabolic effects of lurasidone are conflicting. Thus, this study investigates the contrasting effects of olanzapine and lurasidone on the gut microbiome to explore the hypothesis of 'gut neutrality' for lurasidone exposure. Experimental Approach: Using Sprague–Dawley rats, the effects of olanzapine and lurasidone on the gut microbiome were explored. Faecal and blood samples were collected weekly over a 21‐day period to analyse changes to the gut microbiome and related metabolic markers. Key Results: Lurasidone triggered no significant weight gain or metabolic alterations, instead positively modulating the gut microbiome through increases in mean operational taxonomical units (OTUs) and alpha diversity. This novel finding suggests an underlying mechanism for lurasidone's metabolic inertia. In contrast, olanzapine triggered a statistically significant decrease in mean OTUs, substantial compositional variation and a depletion in short‐chain fatty acid abundance. Microbiome depletion correlated with metabolic dysfunction, producing a 30% increase in weight gain, increased pro‐inflammatory cytokine expression, and increased blood glycaemic and triglyceride levels. Conclusion and Implications: Our results challenge the notion that all antipsychotics disrupt the gut microbiome similarly and highlights the potential benefits of gut‐neutral antipsychotics, such as lurasidone, in managing metabolic side effects. Further research is warranted to validate these findings in humans to guide personalised pharmacological treatment regimens for schizophrenia. [ABSTRACT FROM AUTHOR]

Emotions play an important role in fostering positive parenting and healthy child development. This qualitative study explored the affective experiences of racially diverse US fathers with low income across the prenatal, postnatal, and early childhood periods. Semi‐structured interviews were conducted with 24 fathers. Interview questions asked about fathers' early parenting experiences that elicit parenting emotions of different valence. Results from thematic analysis demonstrated activation of multiple emotions depending on different proximal and distal experiences. Specific to proximal experiences, fathers reported feeling both excited and anxious about pregnancy and joyful and disappointed at childbirth. Related to distal experiences, fathers reported feeling encouraged by their social support networks that further aid their parenting, but feeling marginalized given systematic barriers (e.g., societal bias, high incarceration rates of Black fathers). Most importantly, fathers' parenting emotions, especially negative ones, led to them resolving to stay involved in their children's lives, gaining a sense of responsibility, and changing behaviors to do right by their children. Fathers resorted to various coping strategies to regulate their negative emotions. Overall, fathers with low income are emotionally resilient. Infant and early childhood health professionals should support fathers' mental health to promote father‐child engagement and thus, ultimately, young children's mental health and wellbeing. [ABSTRACT FROM AUTHOR]

Acute mountain sickness (AMS) is a well‐studied illness defined by clinical features (e.g., headache and nausea), as assessed by the Lake Louise score (LLS). Although obvious in its severe form, early stages of AMS are poorly defined and easily confused with common travel‐related conditions. Measurement of hypoxaemia, the cause of AMS, should be helpful, yet to date its utility for identifying AMS susceptibility remains unclear. This study quantified altitude‐induced hypoxaemia in individuals during an ascent to 4800 m to determine the utility of nocturnal pulse oximetry measurements for prediction of AMS. Eighteen individuals (36 ± 16 years of age) ascended to 4800 m over 12 days. Symptomology of AMS was assessed each morning via LLS criteria, with participants categorized as either AMS‐positive (LLS ≥ 3 with headache) or AMS‐negative. Overnight peripheral oxygen saturations (ov‐SpO2${{S}_{{\mathrm{p}}{{{\mathrm{O}}}_2}}}$) were recorded continuously (1 Hz) using portable oximeters. Derivatives of these recordings were compared between AMS‐positive and ‐negative subjects (Mann–Whitney U‐test). Exploratory analyses (Pearson's) were conducted to investigate relationships between overnight parameters and AMS severity. Overnight derivatives, including ov‐SpO2${{S}_{{\mathrm{p}}{{{\mathrm{O}}}_2}}}$, heart rate/ov‐SpO2${{S}_{{\mathrm{p}}{{{\mathrm{O}}}_2}}}$, variance, oxygen desaturation index, hypoxic burden and total sleep time at <80% SpO2${{S}_{{\mathrm{p}}{{{\mathrm{O}}}_2}}}$, all differed significantly between AMS‐positive and ‐negative subjects (all P < 0.01), with cumulative/relative frequency plots highlighting these differences visually. Exploratory analysis revealed that ov‐SpO2${{S}_{{\mathrm{p}}{{{\mathrm{O}}}_2}}}$ from 3850 m was correlated with peak LLS at 4800 m (r = 0.58–0.61). The findings highlight the potential for overnight oximetry to predict AMS susceptibility during ascent to high altitude. Further investigation is required to develop, evaluate and optimize predictive models to improve AMS management and prevention. What is the central question of this study?Early stages of acute mountain sickness are poorly defined, with existing assessment methods for the illness being highly ineffective. Can overnight pulse oximetry be used as a detection and prediction tool for deterioration in acute mountain sickness?What is the main finding and its importance?Overnight oximetry measurements from 3850 m were significantly correlated with acute mountain sickness severity at 4800 m (3 days later), whereas Lake Louise scores from the same time points were unrelated. These findings highlight the potential for pulse oximetry recorded from lower camps to be predictive of acute mountain sickness severity at higher altitude. [ABSTRACT FROM AUTHOR]

This article analyses data at the intersection of digital geographies, critical data studies, and Black studies to bring clarity to relations, differences, and frictions between Black knowledge‐making and common data practices. I highlight artist Tonika Lewis Johnson's project, Inequity for Sale, and detail a genealogy of the data she uses in this project to illustrate how she situates these data within the afterlives of slavery. Drawing from Avery Gordon's theorisation of haunting and ideas towards absences and erasures in Black archival practice, I argue that absences in data can lead to narratives that focus on violence as a singular historical event that is isolated from a larger history of violence. I suggest that bringing a curiosity to these absences, rather than dismissing them or framing them as oversights, can help re‐situate data within a broader temporal‐relational context that brings a sense of Black humanity to the fore. [ABSTRACT FROM AUTHOR]

Copyright of Plants, People, Planet is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Summary: Background: Nearly half of adult patients undergoing surgery experience moderate or severe postoperative pain. Inadequate pain management hampers postoperative recovery and function and may be associated with adverse outcomes. This multidisciplinary consensus statement provides principles that might aid postoperative recovery, and which should be applied throughout the entire peri‐operative pathway by healthcare professionals, institutions and patients. Methods: We conducted a directed literature review followed by a four‐round modified Delphi process to formulate recommendations for organisations and individuals. Results: We make recommendations for the entire peri‐operative period, covering pre‐admission; admission; intra‐operative; post‐anaesthetic care unit; ward; intensive care unit; preparation for discharge; and post‐discharge phases of care. We also provide generic principles of peri‐operative pain management that clinicians should consider throughout the peri‐operative pathway, including: assessing pain to facilitate function; use of multimodal analgesia, including regional anaesthesia; non‐pharmacological strategies; safe use of opioids; and use of protocols and training for staff in caring for patients with postoperative pain. Conclusions: We hope that with attention to these principles and their implementation, outcomes for adult patients having surgery might be improved. [ABSTRACT FROM AUTHOR]

Background and Aims Methods Results and Conclusion There is currently a dearth of tools to assess parents' use of effective interactive strategies for supporting early mathematics learning. One potential such strategy is sustained shared thinking. This study therefore constructed and validated a scale for measuring parents' use of sustained shared thinking during joint mathematics activities with young children, and examined its antecedents and outcomes.Four hundred and sixty‐six parents completed a questionnaire about their conceptions of mathematics teaching and learning, home practices, as well as their kindergarten children's approach and avoidance motivation to learn mathematics. Additionally, the children were tested on numeration skills.Results showed that our new scale has three factors: exchanging ideas with children about mathematical problem‐solving processes, creating a child‐centred atmosphere for mathematics learning, and engaging children in mathematical thinking. Parents' uses of these three strategies were predicted by their constructivist conception of mathematics teaching and learning, and were differentially associated with the children's numeration skills, approach, and avoidance motivation to learn mathematics. Potential uses of our new scale in future home mathematics environment research are discussed. [ABSTRACT FROM AUTHOR]

Objective Methods Results Interpretation The objective of this study was to investigate the association between developmental and premorbid body composition measurements and the risk of motor neuron disease (MND).We performed a cohort study in the UK Biobank to assess the association of developmental body metrics and premorbid body composition measures (using 28 measurements and 7 patterns of body composition) with the risk of MND. Among participants with longitudinal measures, we compared the changes in body composition over time between individuals who later developed MND and those who remained free of MND.Among the 412,691 individuals included in this study, 549 people received an MND diagnosis during the follow‐up visit. Higher birth weight was associated with an increased risk of MND among individuals born over 4 kg (hazard ratio [HR] per kg increase = 2.21, 95% confidence interval [CI] = 1.38–3.55), and taller adult height was associated with an increased risk of MND (HR per 5 cm increase = 1.10, 95% CI = 1.03–1.17). We observed that measures of elevated fat mass were associated with a lower risk of MND more than 5 years before diagnosis. A higher “leg‐dominant fat distribution” pattern was associated with an increased risk whereas higher “muscle strength” was associated with a reduced risk of MND 5 years before diagnosis. Longitudinal analyses indicated a faster decline in measures of fat mass and muscle strength, as well as a shift in fat distribution from arm to leg dominant, among individuals who later developed MND, compared with others.Body composition at early and middle age may be indicative of the risk of MND development. ANN NEUROL 2024 [ABSTRACT FROM AUTHOR]

The cytoskeleton is essential for spatial and temporal organisation of a wide range of cellular and tissue‐level processes, such as proliferation, signalling, cargo transport, migration, morphogenesis, and neuronal development. Cytoskeleton research aims to study these processes by imaging, or by locally manipulating, the dynamics and organisation of cytoskeletal proteins with high spatiotemporal resolution: which matches the capabilities of optical methods. To date, no photoresponsive microtubule‐stabilising tool has united all the features needed for a practical high‐precision reagent: a low potency and biochemically stable non‐illuminated state; then an efficient, rapid, and clean photoresponse that generates a high potency illuminated state; plus good solubility at suitable working concentrations; and efficient synthetic access. We now present CouEpo, a photocaged epothilone microtubule‐stabilising reagent that combines these needs. Its potency increases approximately 100‐fold upon irradiation by violet/blue light to reach low‐nanomolar values, allowing efficient photocontrol of microtubule dynamics in live cells, and even the generation of cellular asymmetries in microtubule architecture and cell dynamics. CouEpo is thus a high‐performance tool compound that can support high‐precision research into many microtubule‐associated processes, from biophysics to transport, cell motility, and neuronal physiology. [ABSTRACT FROM AUTHOR]

Insects attach to various surfaces that differ, among others, in roughness and wettability. Identifying surface characteristics that allow or prevent insects from attaching are an important research avenue of pest control. Here we take an experimental approach to analyse the attachment of common bed bugs, Cimex lectularius Linnaeus (1758), to Perspex (PMMA) substrates. We construct a reliable centrifuge device that allows the measurement of attachment forces at substrate roughnesses, Ra, between 0.02 and 1.3 μm and at two wettabilities. Our results suggest that bed bug attachment to surfaces is minimal at a substrate roughness of 0.2 and 0.4 μm on normal PMMA, where the lowest attachment force was 0.8 mN and the safety factor 15. At lower and higher roughness, attachment forces were higher and the safety factor increased to a maximum of 133. On PMMA that was made superhydrophobic by spray‐coating, attachment was lowest (0.2 mN) at the lowest roughness and continuously increased with increasing roughness, reaching 2.5 mN and a safety factor of 46. For every roughness, attachment forces were lower on superhydrophobic than on normal PMMA. This knowledge may inspire the development of repelling substrates for bed bug control. [ABSTRACT FROM AUTHOR]

Background: Adolescents and young adults (AYAs) receiving hematopoietic cell transplantation (HCT) are at high risk of poor psychosocial health. This study aimed to determine whether the Promoting Resilience in Stress Management (PRISM) intervention mitigated these risks during the first 6 months posttransplant. Methods: This multisite, parallel, randomized trial was conducted from April 2019 to March 2023. Eligible AYAs were aged 12–24 years, English speaking, and within 1 month of HCT for cancer or cancer predisposition syndrome. They were assigned 1:1 to PRISM (a brief, skills‐based intervention targeting "resilience resources" [stress management, goal setting, cognitive reframing, and meaning making]) or usual care (UC). Outcomes included total symptoms of depression and anxiety (Hospital Anxiety and Depression Scale; primary outcome), hope (Snyder Hope Scale), resilience (10‐item Connor–Davidson Resilience Scale), and health‐related quality of life (HRQOL; Pediatric Quality of Life Inventory Cancer Module). Analyses leveraged multivariable linear regressions; exploratory analyses assessed the influence of baseline depression or anxiety. Results: Of 94 enrolled and randomized AYAs, the mean age was 16.7 years (SD, 4.2); 43 (46%) were female, 56 (60%) were non‐Hispanic White, 22 (23%) were Hispanic, and nine (10%) were Black. Most (77%) had leukemia. Of n = 50 randomized to PRISM and n = 44 to UC, 37 (74%) and 33 (73%) completed all study procedures, respectively. In intention‐to‐treat analyses, PRISM did not affect 6‐month depression and anxiety (β = −1.1; 95% CI, −3.7 to 1.5), hope (β = 0.83; 95% CI, −3.3 to 4.9), resilience (β = −0.01; 95% CI, −3.0 to 3.0), or HRQOL (β = 1.5; 95% CI, −4.7 to 7.9). Among AYAs with preexisting anxiety or depression, PRISM recipients reported greater 6‐month improvements in hope (score change, +3.71; SD, 6.9) versus UC recipients (score change, −2.76; SD, 6.5) (p =.04). Conclusions: Resilience coaching did not influence outcomes in this sample. Exploratory findings suggest it may be more effective when directed toward those with concurrent distress. In a randomized trial conducted during the COVID‐19 pandemic among adolescents and young adults receiving hematopoietic cell transplantation for cancer or cancer predisposition, standardized resilience coaching did not influence patient‐reported depression. Exploratory findings suggest it may have promoted hopeful patterns of thoughts in the subset of participants who reported preexisting depression or anxiety. [ABSTRACT FROM AUTHOR]

Summary: The circuitry underlying the initiation, maintenance, and coordination of wakefulness, rapid eye movement sleep, and non‐rapid eye movement sleep is not thoroughly understood. Sleep is thought to arise due to decreased activity in the ascending reticular arousal system, which originates in the brainstem and awakens the thalamus and cortex during wakefulness. Despite the conventional association of sleep–wake states with hippocampal rhythms, the mutual influence of the hippocampal formation in regulating vigilance states has been largely neglected. Here, we focus on the subiculum, the main output region of the hippocampal formation. The subiculum, particulary the ventral part, sends extensive monosynaptic projections to crucial regions implicated in sleep–wake regulation, including the thalamus, lateral hypothalamus, tuberomammillary nucleus, basal forebrain, ventrolateral preoptic nucleus, ventrolateral tegmental area, and suprachiasmatic nucleus. Additionally, second‐order projections from the subiculum are received by the laterodorsal tegmental nucleus, locus coeruleus, and median raphe nucleus, suggesting the potential involvement of the subiculum in the regulation of the sleep–wake cycle. We also discuss alterations in the subiculum observed in individuals with sleep disorders and in sleep‐deprived mice, underscoring the significance of investigating neuronal communication between the subiculum and pathways promoting both sleep and wakefulness. [ABSTRACT FROM AUTHOR]

The article "A call for transdiagnostic attention to insomnia and its treatment in mental healthcare" published in the Journal of Sleep Research highlights the prevalence of insomnia across various psychiatric disorders, emphasizing its impact on emotional distress and the effectiveness of cognitive behavioral therapy for insomnia (CBT-I) in treating conditions like major depressive disorder and PTSD. The study, conducted with participants recruited through the Netherlands Sleep Registry, reveals high rates of co-occurring insomnia in individuals with mental health issues, underscoring the need for a transdiagnostic approach to addressing insomnia in mental healthcare. Network analysis suggests direct links between insomnia severity and symptoms of MDD, GAD, and BPD, while indirect associations are observed with SAD, PD, and PTSD. The findings stress the importance of systematically addressing insomnia in patients with affective and emotion regulation disorders, advocating for the inclusion of CBT-I as a potential dual treatment strategy for psychiatric conditions. [Extracted from the article]

Objectives Methods Results Conclusion Interpatient variability in bipolar I depression (BP‐D) symptoms challenges the ability to predict pharmacotherapeutic outcomes. A machine learning workflow was developed to predict remission after 8 weeks of pharmacotherapy (total score of ≤8 on the Montgomery Åsberg Depression Rating Scale [MADRS]).Supervised machine learning models were trained on data from BP‐D patients treated with olanzapine (N = 168) and were externally validated on patients treated with olanzapine/fluoxetine combination (OFC; N = 131) and lamotrigine (LTG; N = 126). Top predictors were used to develop a prognosis rule informing how many symptoms should change and by how much within 4 weeks to increase the odds of achieving remission.An AUC of 0.76 (NIR:0.59; p = 0.17) was established to predict remission in olanzapine‐treated subjects. These trained models achieved AUCs of 0.70 with OFC (NIR:0.52; p < 0.03) and 0.73 with LTG (NIR:0.52; p < 0.003), demonstrating external replication of prediction performance. Week‐4 changes in four MADRS symptoms (reported sadness, reduced sleep, reduced appetite, and concentration difficulties) were top predictors of remission. Across all pharmacotherapies, three or more of these symptoms needed to improve by ≥2 points at Week‐4 to have a 65% chance of achieving remission at 8 weeks (OR: 3.74, 95% CI: 2.45–5.76; p < 9.3E‐11).Machine learning strategies achieved cross‐trial and cross‐drug replication in predicting remission after 8 weeks of pharmacotherapy for BP‐D. Interpretable prognoses rules required only a limited number of depressive symptoms, providing a promising foundation for developing simple quantitative decision aids that may, in the future, serve as companions to clinical judgment at the point of care. [ABSTRACT FROM AUTHOR]

Background and purpose: Late‐onset mitochondrial disorders are diagnostically challenging with significant heterogeneity in disease presentation. A case is reported of a 67‐year‐old gentleman who presented with a 3‐month history of seizures, recurrent encephalopathy, ataxia and weight loss, preceded by recent initiation of haemodialysis for end‐stage chronic kidney disease. Methods: Extensive work‐up including serological, cerebrospinal fluid, magnetic resonance imaging and electroencephalography was performed. Whole exome sequencing and muscle biopsy confirmed the diagnosis. Results: Magnetic resonance imaging brain demonstrated a single non‐enhancing T2 fluid attenuated inversion recovery hyperintense cortical/subcortical signal change in the right temporal lobe and cerebellar atrophy. Given the subacute presentation of uncertain aetiology, he was empirically treated for autoimmune/paraneoplastic encephalitis. Despite radiological resolution of the cortical abnormality 2 weeks later, there was no clinical improvement. Further collateral history unveiled a mildly ataxic gait and longstanding hearing loss suggestive of a genetic cause. Whole exome sequencing revealed a likely pathogenic, heteroplasmic mitochondrial DNA variant in the MT‐TV gene, m.1659T>C, present at higher levels of heteroplasmy in muscle (91%) compared to other mitotic tissues. A high fat/protein diet and multivitamins including co‐enzyme Q10 were commenced. Treatment of the nutritional deficiency and avoidance of intermittent fasting due to unreliable oral intake secondary to encephalopathy probably contributed to the clinical improvement seen over the ensuing few months, with resolution of his encephalopathy and return to his baseline gait and weight. Conclusion: An adult case is reported with an acute neurological presentation mimicking encephalitis, caused by a heteroplasmic m.1659T>C MT‐TV variant, previously reported once in a child who displayed a different clinical phenotype. [ABSTRACT FROM AUTHOR]

S‐Limonene (s‐Lim) is a monocyclic monoterpene found in a variety of plants and has been shown to present antioxidant and cardioprotective activity in experimental models of myocardial infarction. The aim of this study was to evaluate the potential mechanism by which s‐Lim exerts its antiarrhythmic effect, focusing on the blockade of β‐adrenoceptor (β‐AR) and its effects on various in vivo and in vitro parameters, including electrocardiogram (ECG) measurements, left ventricular developed pressure (LVDP), the β‐adrenergic pathway, sarcomeric shortening and L‐type calcium current (ICa,L). In isolated hearts, 10 μM of s‐Lim did not alter the ECG profile or LVPD. s‐Lim increased the heart rate corrected QT interval (QTc) (10.8%) at 50 μM and reduced heart rate at the concentrations of 30 (12.4%) and 50 μM (16.6%). s‐Lim (10 μM) also inhibited the adrenergic response evoked by isoproterenol (ISO) (1 μM) reducing the increased of heart rate, LVDP and ECG changes. In ventricular cardiomyocyte, s‐Lim antagonized the effect of dobutamine by preventing the increase of sarcomeric shortening, demonstrating a similar effect to atenolol (blocker β1‐AR). In vivo, s‐Lim antagonized the effect of ISO (agonists β1‐AR), presenting a similar effect to propranolol (a non‐selective blocker β‐AR). In ventricular cardiomyocyte, s‐Lim did not alter the voltage dependence for ICa,L activation or the ICa,L density. In addition, s‐Lim did not affect changes in the ECG effect mediated by 5 μM forskolin (an activator of adenylate cyclase). In an in vivo caffeine/ISO‐induced arrhythmia model, s‐Lim (1 mg/kg) presented antiarrhythmic action verified by a reduced arrhythmia score, heart rate, and occurrence of ventricular premature beats and inappropriate sinus tachycardia. These findings indicate that the antiarrhythmic activity of s‐Lim is related to blockade of β‐AR in the heart. [ABSTRACT FROM AUTHOR]

Background: Malondialdehyde–acetaldehyde (MAA) adducts lead to generation of anti‐MAA autoantibodies and have been independently identified in inflamed periodontal and rheumatoid arthritis (RA) tissues. This study evaluates serum samples from RA cases and osteoarthritis (OA) controls to quantify associations between periodontal clinical measures, alveolar bone loss (ABL), and anti‐Porphyromonas gingivalis, anti‐Prevotella intermedia, and anti‐Fusobacterium nucleatum antibody concentrations with anti‐MAA antibody concentrations. Methods: Participants (n = 284 RA cases, n = 330 OA controls) underwent periodontal clinical assessments and ABL measurements. Serum immunoglobulin (Ig) A, IgG, and IgM anti‐MAA and serum IgG antibacterial antibody concentrations were quantified by enzyme‐linked immunosorbent assay (ELISA). Analyses utilized simple linear regression and multivariable adjusted models. Results: No significant associations of periodontal clinical measures with serum anti‐MAA were found. Moderate (p = 0.038 and p = 0.036, respectively) and high ABL (p = 0.012 and p = 0.014, respectively) in RA cases (but not in OA) were positively associated with IgG and IgM anti‐MAA. Anti‐P. gingivalis and anti‐P. intermedia antibody concentrations were positively associated with IgA (p = 0.001 for both), IgG (p = 0.007 and p = 0.034, respectively), and IgM anti‐MAA antibody concentrations (p < 0.001 and p = 0.020, respectively), while anti‐F. nucleatum was positively associated with IgG anti‐MAA (p = 0.042), findings that were similar across groups. Conclusions: A positive association was demonstrated between ABL and serum IgG and IgM anti‐MAA antibody concentrations that was unique to RA and not observed in OA. Serum anti‐P. gingivalis, anti‐P. intermedia, and anti‐F. nucleatum antibody concentrations displayed significant associations with anti‐MAA antibody in both groups. These findings suggest MAA may play a role in the interrelationship between the periodontium and RA. [ABSTRACT FROM AUTHOR]

Vaccine efficacy varies globally, often showing reduced immune responses in low‐ and middle‐income countries, possibly due to the immunomodulatory effects of parasitic infections like malaria. This systematic review evaluates the impact of malaria on immune responses to unrelated vaccines in humans and animals. We systematically searched five databases—MEDLINE, Web of Science, Global Health, Scopus and Embase—up to 5th December 2023. Eligible studies compared immune responses to WHO‐approved vaccines between malaria‐infected and uninfected groups, or between antimalarial‐treated and untreated groups. Meta‐analysis was performed using random‐effects models with standardised mean differences (SMDs) as summary statistics. The study is registered with PROSPERO (CRD42022298053). Twenty‐four articles (17 human, 7 animal) met the inclusion criteria, with 13 human articles contributing data for the meta‐analysis. Significant heterogeneity was observed. Vaccine responses were higher in malaria uninfected individuals (SMD 0.34, 95% CI 0.07 to 0.60, I2 = 87.15%) with weaker differences between antimalarial‐treated and untreated groups (SMD 0.07, 95% CI −0.01 to 0.16, I2 = 85.01%). The overall SMD for malaria uninfected/treated vs. infected/untreated was 0.15, 95% CI 0.05–0.26, I2 = 90.91. Narrative analysis suggested malaria's adverse impact on vaccine responses in animals. Malaria infection may impair vaccines responses; with preventive treatment of malaria partially reversing these effects, highlighting the need for targeted public health interventions. [ABSTRACT FROM AUTHOR]

Pharmacogenomic (PGx) biomarkers integrated using machine learning can be embedded within the electronic health record (EHR) to provide clinicians with individualized predictions of drug treatment outcomes. Currently, however, drug alerts in the EHR are largely generic (not patient‐specific) and contribute to increased clinician stress and burnout. Improving the usability of PGx alerts is an urgent need. Therefore, this work aimed to identify principles for optimal PGx alert design through a health‐system‐wide, mixed‐methods study. Clinicians representing multiple practices and care settings (N = 1062) in urban, rural, and underserved regions were invited to complete an electronic survey comparing the usability of three drug alerts for citalopram, as a case study. Alert 1 contained a generic warning of pharmacogenomic effects on citalopram metabolism. Alerts 2 and 3 provided patient‐specific predictions of citalopram efficacy with varying depth of information. Primary outcomes included the System's Usability Scale score (0–100 points) of each alert, the perceived impact of each alert on stress and decision‐making, and clinicians' suggestions for alert improvement. Secondary outcomes included the assessment of alert preference by clinician age, practice type, and geographic setting. Qualitative information was captured to provide context to quantitative information. The final cohort comprised 305 geographically and clinically diverse clinicians. A simplified, individualized alert (Alert 2) was perceived as beneficial for decision‐making and stress compared with a more detailed version (Alert 3) and the generic alert (Alert 1) regardless of age, practice type, or geographic setting. Findings emphasize the need for clinician‐guided design of PGx alerts in the era of digital medicine. [ABSTRACT FROM AUTHOR]

Policymakers have increasingly turned to 'in‐work transfers' to boost incomes among poorer workers and strengthen work incentives. One attraction of these is that labour supply elasticities are typically greatest at the extensive margin. Because in‐work transfers are normally subject to earnings‐related phase‐outs, they tend to most strongly incentivize part‐time work, weakening incentives to increase hours beyond that. But if part‐time work generates relatively little in the way of human capital and career progression, then policy design should factor in the longer‐term consequences of labour supply choices along the intensive margin. To that end, we use a dynamic model of female labour supply with endogenous human capital accumulation, and study actual and hypothetical welfare reforms in the UK. We show that for a given expansion in the government budget, those reforms that incentivize full‐time work can do considerably more to increase incomes, including among poorer households, and to raise welfare. Our results suggest that in‐work transfers could be refined by paying greater attention to the intensive margin effects through the design of their phase‐outs. [ABSTRACT FROM AUTHOR]

Purpose: The US Food and Drug Administration's Sentinel Innovation Center aimed to establish a query‐ready, quality‐checked distributed data network containing electronic health records (EHRs) linked with insurance claims data for at least 10 million individuals to expand the utility of real‐world data for regulatory decision‐making. Methods: In this report, we describe the resulting network, the Real‐World Evidence Data Enterprise (RWE‐DE), including data from two commercial EHR‐claims linked assets collectively termed the Commercial Network covering 21 million lives, and four academic partner institutions collectively termed the Development Network covering 4.5 million lives. Results: We discuss provenance and completeness of the data converted in the Sentinel Common Data Model (SCDM), describe patient populations, and report on EHR‐claims linkage characterization for all contributing data sources. Further, we introduce a standardized process to store free‐text notes in the Development Network for efficient retrieval as needed. Conclusions: Finally, we outline typical use cases for the RWE‐DE where it can broaden the reach of the types of questions that can be addressed by the Sentinel system. [ABSTRACT FROM AUTHOR]

Community pharmacies are rapidly becoming destinations for health services beyond medication dispensing. Delivery models for community‐based services have become increasingly complex, creating expanded opportunities and necessitating collaboration between pharmacists in the community setting and other health care professionals. As a result, it is essential to articulate best practices and recommendations to assist stakeholders in responding to the changing landscape and optimize care for patients. This white paper provides a summary of published examples of interprofessional practice that include community pharmacies in the United States and internationally, and then adapts established guiding principles for interprofessional practice to the community pharmacy setting to outline a framework and specific recommendations for consideration. This framework highlights a need to place patients at the center of collaborative community‐based care models, have organizational leaders show a commitment to and establish an infrastructure for interprofessional collaboration that includes community‐based pharmacists, foster respect for community pharmacy practice, address communication and technology barriers in the health care system, and finally, embrace interprofessional learning in the community pharmacy setting. Addressing challenges and embracing opportunities is vital to accelerate practice transformation and further position community‐based pharmacists as essential members of interprofessional care teams. [ABSTRACT FROM AUTHOR]

The oral delivery of most atypical antipsychotics is severely challenged by their low oral bioavailability and significant food effects that necessitate patient compliance. Lipid formulations are an attractive delivery system for overcoming the dosing challenges of antipsychotics, but their negative impact on the gut microbiota can interfere with the pharmacodynamic response through disruption of the gut‐brain axis. Here, novel gut microbiota‐targeting microcapsules are engineered to provide a multifunctional approach for improving both the pharmacokinetic and pharmacodynamic properties of the antipsychotic, lurasidone. The microcapsules are comprised of a lipid core that facilitates the solubilization and oral absorption of the lipophilic drug and an outer carbohydrate polymer (inulin) shell that positively modulates the gut microbiota by facilitating microbial fermentation. Fed‐fasted variability in lurasidone solubilization is mitigated through microencapsulation with inulin‐lipid microcapsules (ILM), while microbiota enrichment is coupled with enhanced serotonin levels in the small intestine, faeces, and plasma. The realization of multifunctional ILM confirms the pharmacokinetics and efficacy of mental health therapies, such as antipsychotics, can be optimized through strategic encapsulation within functional formulations that target the gut microbiota for effective modulation of the gut‐brain axis. [ABSTRACT FROM AUTHOR]

ABSTRACT Introduction to Computer Science is traditionally the first course that all computer science and software engineering majors take. The course introduces many problem‐solving techniques which can be challenging for many freshman students. In order to mitigate some of the issues of this course, we, at the Higher Education Institute, introduced a new prerequisite course, Introduction to Programming Logic, which is a required course for all students who have not taken any previous computer science course. In the Summer Session of 2022, we included prize‐based learning in one of the sections of the course. Prize‐based learning is similar to both problem‐based learning and project‐based learning in many aspects, including the principle of student‐centred learning. However, it differs with respect to the motivation for student success. This approach utilises the students' ambition to win, to encourage students to work harder and learn more both inside as well as outside the classroom. [ABSTRACT FROM AUTHOR]

Acute mountain sickness (AMS) causes serious illness for many individuals ascending to high altitude (HA), although preventable with appropriate acclimatisation. AMS is a clinical diagnosis, with symptom severity evaluated using the Lake Louise Score (LLS). Reliable methods of predicting which individuals will develop AMS have not been developed. This systematic review evaluates whether a predictive relationship exists between oxygen saturation and subsequent development of AMS. PubMed, PubMed Central, MEDLINE, Semantic Scholar, Cochrane Library, University of Birmingham Library and clinicaltrials.gov databases were systematically searched from inception to 15 June 2023. Human studies involving collection of peripheral blood oxygen saturation (SpO2${{S}_{{\mathrm{p}}{{{\mathrm{O}}}_{\mathrm{2}}}}}$) from healthy lowlanders during ascent to HA that evaluated any relationship between SpO2${{S}_{{\mathrm{p}}{{{\mathrm{O}}}_{\mathrm{2}}}}}$ and AMS severity were considered for eligibility. Risk of bias was assessed using a modified Newcastle–Ottawa Tool for cohort studies (PROPSPERO CRD42023423542). Seven of 980 total identified studies were ultimately included for data extraction. These studies evaluated SpO2${{S}_{{\mathrm{p}}{{{\mathrm{O}}}_{\mathrm{2}}}}}$ and AMS (via LLS) in 1406 individuals during ascent to HA (3952–6300 m). Risk of bias was ‘low’ for six and ‘moderate’ for one of the included studies. Ascent profiles and SpO2${{S}_{{\mathrm{p}}{{{\mathrm{O}}}_{\mathrm{2}}}}}$ measurement methodology varied widely, as did the statistical methods for AMS prediction. Decreasing oxygen saturation measured with pulse oximetry during ascent shows a positive predictive relationship for individuals who develop AMS. Studies have high heterogeneity in ascent profile and oximetry measurement protocols. Further studies with homogeneous methodology are required to enable statistical analysis for more definitive evaluation of AMS predictability by pulse oximetry. [ABSTRACT FROM AUTHOR]

Objective Background Method Results Conclusion Implications This scoping review systematically examined the applied family science literature involving families raising young children to understand how relevant studies have applied artificial intelligence (AI)‐facilitated technologies.Family research is exploring the application of AI. However, there is a critical need for a review study that systematically examines the varied use of AI in applied family science to inform family practitioners and policymakers.Comprehensive literature searches were conducted in nine databases. Of the 10,022 studies identified, 21 met inclusion criteria: peer‐reviewed journal article; published between 2014–2024; written in English; involved the use of AI in collecting data, analyzing data, or providing family‐centered services; included families raising young children 0–5 years; and was quantitative in analysis.Most studies focused on maternal and child health outcomes in low‐ and middle‐income countries. All studies identified were in the AI use domain of data analysis, with 76% of the studies having a focus on identifying the most important predictors. Random forest performed as the best machine learning model. Only one study directly mentioned the ethical use of AI.Overall, the applied family science evidence base that employs AI is limited in size and scope, with most studies using AI for data analysis purposes with limited ethical considerations.AI models in applied family science can inform family services and policies aimed at promoting family and child health. However, thoughtful consideration of AI ethics and fairness is needed to prevent the negative social impacts of AI on marginalized groups of families and their young children. [ABSTRACT FROM AUTHOR]

Family members and loved ones of individuals with Borderline Personality Disorder (BPD) can experience high levels of distress. Types of distress reported by family members include burden, grief, depression, guilt, and powerlessness. Hopelessness is a construct that has received little attention despite its potential relevance for this group. This study sought to examine, and assess potential change in, hopelessness among individuals attending a 12‐week Family Connections (FC) program. Participants were 75 family members, 29 men and 46 women. Most participants were parents (n = 43; 57%). Data were collected at four time‐points and outcomes included hopelessness, burden, and grief. The majority of participants (82%) reported scores within the ‘minimal’ or ‘mild’ ranges of hopelessness before the FC program. A greater proportion of participants in the 60–70 year age group reported scores in the ‘moderate/severe’ category when compared with younger age groups. The mean hopelessness score for all participants before FC was 4.61 which is considered mild. There was no significant difference in hopelessness scores after program completion. Although mean scores increased at both 3‐month and 12‐month follow‐ups, they continued to remain in the ‘mild’ category. Hopelessness scores in the current study are similar to those reported in previous studies, although no significant change was found after FC completion. Concepts of personal vs. situational hopelessness should be considered, as well as the relevance of assessing personal hopelessness for this participant group. Further research is needed to determine the relationship between family member hopelessness and index client wellbeing. [ABSTRACT FROM AUTHOR]

The catalytic relevance of Fe(IV) species in non‐heme iron catalysis has motivated synthetic advances in well‐defined five‐ and six‐coordinate Fe(IV) complexes for a better understanding of their fundamental electronic structures and reactivities. Herein, we report the syntheses of FeDipp2 and FeMes2, a pair of unusual four‐coordinate non‐heme formally Fe(IV) complexes with S=1 ground states supported by strongly donating bisamide ligands. By combining spectroscopic characterization and computational modeling, we found that small variations in ligand aryl substituents resulted in substantial changes in both structures and bonding. This work highlights the strong donor capabilities and modularity of the bisamide ligand set. More broadly, it is a critical contribution to the utilization of ligand design to modulate molecular geometries and electronic structures of low‐coordinate, high‐valent iron complexes. [ABSTRACT FROM AUTHOR]

Age‐related differences in identification performance between younger (18–35 years) and older adults (62–68 years), alongside the cross‐age effect (CAE), where people recognise own‐age faces better than other‐age faces, were investigated. Self‐reported levels of other‐age contact and attitudes, participants' memory for the unbiased lineup instructions, and the confidence‐accuracy (C‐A) relationship were also examined. Participants (N = 154) viewed two filmed events: one with a young adult target and one with an older adult target. Older adults were less likely than younger adults to identify the perpetrator. Interestingly, the CAE, contact, attitudes, and choosing behaviours did not impact identification performance. Older adults experienced more difficulty remembering the pre‐lineup instructions than younger adults, but only after the first lineup. Confidence was predictive of accuracy for both age groups, but this relationship was differently influenced by the CAE. The findings provide further insights into the factors that may impact younger and older adults' identification performance. [ABSTRACT FROM AUTHOR]

A long‐standing issue about the correct identification of an important starting reagent, iron(III) hexafluoroacetylacetonate, Fe(hfac)3 (1), has been resolved. The tris‐chelated mononuclear complex was found to crystallize in two polymorph modifications which can be assigned as the low‐temperature (1‐L) monoclinic P21/n and the high‐temperature (1‐H) trigonal P. Low‐temperature polymorph 1‐L was found to transform to 1‐H upon sublimation at 44 °C. Two modifications are clearly distinguished by powder X‐ray diffraction (PXRD), single‐crystal X‐ray diffraction, differential scanning calorimetry (DSC), and melting‐point measurements. On the other hand, the two forms share similar characteristics in direct analysis in real‐time mass spectrometry (DART‐MS), attenuated total reflection (ATR) spectroscopy, and some physical properties, such as color, volatility, sensitivity, and solubility. Analysis of the literature and some of our preliminary data strongly suggest that the appearance of two polymorph modifications for trivalent metal (both transition and main group) hexafluoroacetylacetonates is a common case for several largely used complexes not yet accounted for in the crystallographic databases. [ABSTRACT FROM AUTHOR]

Background: Traditional plaster‐cast fabrication of an ankle‐foot orthosis (AFO), although robust, is time‐consuming and cumbersome. 3D scanning is quickly gaining attention as an alternative to plaster casting the foot and ankle region for AFO fabrication. The aim of this study was to assess the accuracy and speed of two high‐performing 3D scanners compared with plaster casting in pediatric patients requiring an AFO. Methods: Ten participants (mean age 10.0 ± 3.9 years) prescribed AFOs for a movement disorder were 3D scanned with the high‐cost Artec Eva (Eva) and low‐cost Structure Sensor II (SSII) using one‐person (1p) and two‐person (2p) protocols. Accuracy and speed for both 3D scanners were compared with corresponding plaster cast measures (≤5% acceptable difference). Bland and Altman plots were generated to show mean bias and limits of agreement. Results: Overall, Eva and SSII were accurate for foot, ankle, and lower leg key clinical landmarks (Eva‐1p: 4.4 ± 7.3%; Eva‐2p: 3.2 ± 7.5%; SSII‐1p: 0.6 ± 7.4%; SSII‐2p: 0.7 ± 8.2%). Bland and Altman plots for the SSII demonstrated lower biases for 1p (bias 0.5 mm, LoA: −12.4–13.5 mm) and 2p (0.4 mm, LoA: −11.4–12.2 mm) protocols compared with Eva for 1p (bias 2.3 mm, LoA: −8.0–12.7 mm) and 2p (1.8 mm, LoA: −10.7–14.3 mm) protocols. The SSII 2p protocol was the fastest 3D scanning method (26.4 ± 11.1 s). Conclusions: The high‐cost Eva and low‐cost SSII 3D scanners using the 1p and 2p protocols produced comparable accuracy and faster capture of key clinical landmarks compared with plaster cast measures for the fabrication of AFOs in pediatric patients. [ABSTRACT FROM AUTHOR]

miRNAs are tiny noncoding ribonucleotides that function as critical regulators of gene‐expression in eukaryotes. A single miRNA may be involved in the regulation of several target mRNAs forming complex cellular networks to regulate diverse aspects of development in an organism. The deregulation of miRNAs has been associated with several human diseases. Therefore, miRNA‐based therapeutics is gaining interest in the pharmaceutical industry as the next‐generation drugs for the cure of many diseases. Medicinal plants have also been used for the treatment of several human diseases and their curative potential is attributed to their reserve in bioactive metabolites. A role for miRNAs as regulators of the phytometabolic pathways in plants has emerged in the recent past. Experimental studies have also indicated the potential of plant encoded secondary phytometabolites to act as cross‐regulators of mammalian miRNAs and transcripts to regulate human diseases (like cancer). The evidence for this cross‐kingdom gene regulation through miRNA has gathered considerable enthusiasm in the scientific field, even though there are on‐going debates regarding the reproducibility and the effectiveness of these findings. In this review, we provide information to connect the medicinal and gene regulatory properties of secondary phytometabolites, their regulation by miRNAs in plants and their effects on human miRNAs for regulating downstream metabolic or pathological processes. While further extensive research initiatives and good clinical evidence are required to prove or disapprove these findings, understanding of these regulations will have important implications in the potential use of synthetic or artificial miRNAs as effective alternatives for providing health benefits. [ABSTRACT FROM AUTHOR]

Objective: Given the diverse ethnic backgrounds of aged care clients, there is a critical requirement to translate psychosocial assessment tools into various languages to effectively evaluate social engagement and quality of life in older adults receiving aged care services. This study aimed to translate psychosocial tools into Turkish, Korean and Mandarin, the primary languages spoken by clients of an Australian community aged care provider. Methods: A co‐development approach encompassing forward and backward translations of the Australian Community Participation Questionnaire and ICEpop CAPability measure for Older people tools, along with focus group discussions involving bilingual staff (n = 7) and clients (n = 16), was employed to ensure precision and cultural relevance. Multiple iterations were undertaken until linguistic, conceptual and scaling equivalence was achieved, with recorded sessions transcribed and analysed thematically. Results: Cultural appropriateness significantly impacted the delivery of questions within the tools, emphasising translation challenges tied to specific queries. These difficulties included the lack of terms for unique places of worship, the use of outdated language (e.g., references to reading newspapers), and varying priorities in social and well‐being matters between Western and Eastern/Asian cultures. Staff feedback identified that formal translated tool versions eased administration for culturally and linguistically diverse (CALD) clients, enabling them to independently interpret questions, resulting in improved questionnaire completion rates. Conclusions: Insights indicate the need for continued efforts in tailoring assessment tools to diverse cultural contexts to ensure accurate and meaningful data collection. [ABSTRACT FROM AUTHOR]

This study seeks to explore how companies around the world create a culture of innovation by examining common themes that underpin innovation. Through a case study approach, we examined the innovation practices of nine companies and identified six key themes prevalent across all companies: (1) emphasis on research and development; (2) flexibility and adaptability; (3) diversity and inclusion; (4) continuous learning and development; (5) risk‐taking and experimentation; and (6) sustainability. Building on these themes, we propose a new framework for creating a culture of innovation, called the Innovation 360° framework—a systematic approach for companies to understand and build a culture of innovation. Innovation 360° is centered on the core tenets of diversity, inclusion, and sustainability, driven by internal "pull" and external "push" factors of innovation that emphasize flexibility and adaptability, continuous learning and development, and risk‐taking and experimentation. We also discuss the practical benefits and potential drawbacks of the framework. Ultimately, by embracing this framework, companies can improve their innovation capacity and stay ahead of the competition while demonstrating their commitment to social responsibility. However, careful consideration of the framework's potential limitations is necessary to ensure its suitability for different types of companies and industries. [ABSTRACT FROM AUTHOR]

Regular exercise positively impacts neurocognitive health, particularly in aging individuals. However, low adherence, particularly among older adults, hinders the adoption of exercise routines. While brain plasticity mechanisms largely support the cognitive benefits of exercise, the link between physiological and behavioral factors influencing exercise adherence remains unclear. This study aimed to explore this association in sedentary middle‐aged and older adults. Thirty‐one participants underwent an evaluation of cortico‐motor plasticity using transcranial magnetic stimulation (TMS) to measure changes in motor‐evoked potentials following intermittent theta‐burst stimulation (iTBS). Health history, cardiorespiratory fitness, and exercise‐related behavioral factors were also assessed. The participants engaged in a 2‐month supervised aerobic exercise program, attending sessions three times a week for 60 min each, totaling 24 sessions at a moderate‐to‐vigorous intensity. They were divided into Completers (n = 19), who attended all sessions, and Dropouts (n = 12), who withdrew early. Completers exhibited lower smoking rates, exercise barriers, and resting heart rates compared to Dropouts. For Completers, TMS/iTBS cortico‐motor plasticity was associated with better exercise adherence (r = −.53, corrected p =.019). Exploratory hypothesis‐generating regression analysis suggested that post‐iTBS changes (β = −7.78, p =.013) and self‐efficacy (β = −.51, p =.019) may predict exercise adherence (adjusted‐R2 =.44). In conclusion, this study highlights the significance of TMS/iTBS cortico‐motor plasticity, self‐efficacy, and cardiovascular health in exercise adherence. Given the well‐established cognitive benefits of exercise, addressing sedentary behavior and enhancing self‐efficacy are crucial for promoting adherence and optimizing brain health. Clinicians and researchers should prioritize assessing these variables to improve the effectiveness of exercise programs. Adherence to exercise and its cognitive brain health benefits relies on the mechanism of neuroplasticity, which may be altered by sedentariness and lack of self‐efficacy in middle‐aged and older adults. This study provides a better understanding of the link between physiological TMS/iTBS cortico‐motor plasticity and exercise‐related behavioral measures, which may advance current evidence and allow therapists and researchers to optimize and tailor exercise interventions for cognitive brain health. [ABSTRACT FROM AUTHOR]

Sporotrichosis diagnosis involves a series of analyses, including culture and antibody detection in serum samples. Serologic methods may sometimes yield false‐negative or false‐positive results, leading to inaccurate diagnoses. This study assessed specific patient groups in which antibody detection of different isotypes and subclasses may lack sensitivity. An enzyme‐linked immunosorbent assay (ELISA) with Sporothrix brasiliensis exoantigens was used to investigate IgM, IgG, IgG1, IgG2, IgG3, IgG4, IgA, IgA1 and IgA2 antibodies in human serum samples. Eighty serum samples from patients with different sporotrichosis clinical manifestations, including cutaneous forms with and without hypersensitivity manifestations, extracutaneous forms (bone, ocular, meningeal and pulmonary), disseminated cutaneous forms and disseminated forms in individuals living with HIV/AIDS, diabetics and alcoholics, were evaluated. The ELISA sensitivities in the detection of different antibodies ranged from 0.85 to 0.60 for the detection of IgG2 and IgG3, respectively. The antibodies with higher area under ROC curves were IgG2, IgG, IgA and IgA1. There were no significant differences in the immunological reactivity of the tested antibodies among different clinical forms of sporotrichosis. The data revealed a higher likelihood of a false‐negative outcome in patients with lesions in the nasal mucosa regarding the detection of IgM and a lower likelihood in patients with lymphocutaneous sporotrichosis regarding the detection of IgG3. Patients with hypersensitivity manifestations had a 3.71 odds ratio to yield negative results in total IgG detection. In conclusion, we identified specific patient groups in which antibody detection may lack sensitivity, thus contributing to a better understanding of the diagnostic challenges associated with this condition. [ABSTRACT FROM AUTHOR]