bluuebunny/crossref_metadata_2025 huggingface dataset:
Experimental investigations into abrasive flow machining (AFM) of 3D printed ABS and PLA parts
Authors: Dixit Nitin , Sharma Varun , Kumar Pradeep
Published: August 2021

Purpose

The surface roughness of additively manufactured parts is usually found to be high. This limits their use in industrial and biomedical applications. Therefore, these parts required post-processing to improve their surface quality. The purpose of this study is to finish three-dimensional (3D) printed acrylonitrile butadiene styrene (ABS) and polylactic acid (PLA) parts using abrasive flow machining (AFM).

Design/methodology/approach

A hydrogel-based abrasive media has been developed to finish 3D printed parts. The developed abrasive media has been characterized for its rheology and thermal stability using sweep tests, thermogravimetric analysis (TGA) and differential thermal analysis (DTA). The ABS and PLA cylindrical parts have been prepared using fused deposition modeling (FDM) and finished using AFM. The experiments were designed using Taguchi (L9 OA) method. The effect of process parameters such as extrusion pressure (EP), layer thickness (LT) and abrasive concentration (AC) was investigated on the amount of material removed (MR) and percentage improvement in surface roughness (%ΔRa).

Findings

The developed abrasive media was found to be effective for finishing FDM printed parts using AFM. The microscope images of unfinished and finished showed a significant improvement in surface topography of additively manufactures parts after AFM. The results reveal that AC is the most significant parameter during the finishing of ABS parts. However, EP and AC are the most significant parameters for MR and %ΔRa, respectively, during the finishing of PLA parts.

Practical implications

The FDM technology has applications in the biomedical, electronics, aeronautics and defense sectors. PLA has good biodegradable and biocompatible properties, so widely used in biomedical applications. The ventilator splitters fabricated using FDM have a profile similar to the shape used in the present study.

Research limitations/implications

The present study is focused on finishing FDM printed cylindrical parts using AFM. Future research may be done on the AFM of complex shapes and freeform surfaces printed using different additive manufacturing (AM) techniques.

Originality/value

An abrasive media consists of xanthan gum, locust bean gum and fumed silica has been developed and characterized. An experimental study has been performed by combining printing parameters of FDM and finishing parameters of AFM. A comparative analysis in MR and %ΔRa has been reported between 3D printed ABS and PLA parts.
Casting of complex structures in aluminum using gypsum molds produced via binder jetting
Authors: Giorleo Luca , Bonaventi Michele
Published: August 2021

Purpose

The purpose of present paper is to enlarge the knowledge about the performance of gypsum powder to realize complex molds or cores for aluminum casting.

Design/methodology/approach

The research was divided into two activities: simple; and complex-part production capability. In the simple-part step, the performance of gypsum powder and the minimum mold thickness that would withstand the casting process. In the complex-part step, the authors first investigated the powder removability as a function of geometry complexity and then binder jetting performance was evaluated for the case of lattice-structure fabrication.

Findings

All the geometries tested withstand the casting process demonstrating the benefits in terms of complexity part design; however, the process suffers of all the typical defect of casting as misrun, porosity and cold shut.

Originality/value

The results found in this research improve the benefits related to additive manufacturing application in industrial environment and in particular to the binder jetting technology and the rapid casting approach.
A comparative analysis of the compression characteristics of a thermoplastic polyurethane 3D printed in four infill patterns for comfort applications
Authors: Nace Susan Erica , Tiernan John , Holland Donal , Ni Annaidh Aisling
Published: August 2021

Purpose

Most support surfaces in comfort applications and sporting equipment are made from pressure-relieving foam such as viscoelastic polyurethane. However, for some users, foam is not the best material as it acts as a thermal insulator and it may not offer adequate postural support. The additive manufacturing of such surfaces and equipment may alleviate these issues, but material and design investigation is needed to optimize the printing parameters for use in pressure relief applications. This study aims to assess the ability of an additive manufactured flexible polymer to perform similarly to a viscoelastic foam for use in comfort applications.

Design/methodology/approach

Three-dimensional (3D) printed samples of thermoplastic polyurethane (TPU) are tested in uniaxial compression with four different infill patterns and varying infill percentage. The behaviours of the samples are compared to a viscoelastic polyurethane foam used in various comfort applications.

Findings

Results indicate that TPU experiences an increase in strength with an increasing infill percentage. Findings from the study suggest that infill pattern impacts the compressive response of 3D printed material, with two-dimensional patterns inducing an elasto-plastic buckling of the cell walls in TPU depending on infill percentage. Such buckling may not be a beneficial property for comfort applications. Based on the results, the authors suggest printing from TPU with a low-density 3D infill, such as 5% gyroid.

Originality/value

Several common infill patterns are characterised in compression in this work, suggesting the importance of infill choices when 3D printing end-use products and design for manufacturing.
What is unmanaged forest and how does it sustain biodiversity in landscapes with a long history of intensive forestry?
Authors: Bruun Hans Henrik , Heilmann‐Clausen Jacob
Published: August 2021

A recent paper by Schall et al. (2020) concluded that beech forests managed in even‐aged (EA) rotation systems were more efficient than unmanaged (UNM) forest and forest managed in uneven‐aged (UEA) selective cutting systems in supporting landscape‐scale biodiversity in Germany.

The authors based their conclusion on a comprehensive multitaxon survey and a promising resampling model for assessing gamma diversity at landscape scale. Here, we challenge their conclusions and evaluate the importance of UNM forests for conservation of forest biodiversity.

The average amount of dead wood reported from EA stands (27.8 m3/ha) was almost 30% higher than reported from UNM stands (21.6 m3/ha) in the study. Averages from long UNM temperate forests in Europe are typically six to seven times higher (131–157 m3/ha). We therefore conclude the UNM studied stands to reflect legacies of former management, and to be poorly representative of UNM forests. Data from our own studies, including long UNM beech stands in Denmark, demonstrate how this shortcoming seriously undermines the general validity of the presented results to conservation of forest biodiversity.

Synthesis and applications. Preservation and restoration of intact forest ecosystems remains essential to biodiversity conservation. We show that the findings of Schall et al. (2020) do not contradict this important notion. Schall and colleagues identified UEA management systems as potentially inferior to more traditional EA management systems for conserving forest biodiversity at the landscape scale. The paper also provides insight into the limited short‐term conservation value of simply abandoning forest management in intensively managed landscapes. Based on this, we call for discarding the current orthodox view of non‐intervention when new forest reserves are created in temperate Europe. Active reinforcement of natural disturbance regimes and active habitat creation may lead to faster recovery of natural stand structure and forest biodiversity.
Intimate genetic relationships and fungicide resistance in multiple strains of Aspergillus fumigatus isolated from a plant bulb
Authors: Takahashi Hiroki , Oiki Sayoko , Kusuya Yoko , Urayama Syun‐ichi , Hagiwara Daisuke
Published: August 2021

Fungal infections are increasingly dangerous because of environmentally dispersed resistance to antifungal drugs. Azoles are commonly used antifungal drugs, but they are also used as fungicides in agriculture, which may enable enrichment of azole‐resistant strains of the human pathogen Aspergillus fumigatus in the environment. Understanding of environmental dissemination and enrichment of genetic variation associated with azole resistance in A. fumigatus is required to suppress resistant strains. Here, we focused on eight strains of azole‐resistant A. fumigatus isolated from a single tulip bulb for sale in Japan. This set includes strains with TR34/L98H/T289A/I364V/G448S and TR46/Y121F/T289A/S363P/I364V/G448S mutations in the cyp51A gene, which showed higher tolerance to several azoles than strains harbouring TR46/Y121F/T289A mutation. The strains were typed by microsatellite typing, single nucleotide polymorphism profiles, and mitochondrial and nuclear genome analyses. The strains grouped differently using each typing method, suggesting historical genetic recombination among the strains. Our data also revealed that some strains isolated from the tulip bulb showed tolerance to other classes of fungicides, such as QoI and carbendazim, followed by related amino acid alterations in the target proteins. Considering spatial–temporal factors, plant bulbs are an excellent environmental niche for fungal strains to encounter partners, and to obtain and spread resistance‐associated mutations.
Does preoperative locally applied estrogen treatment facilitate prolapse‐associated symptoms in postmenopausal women with symptomatic pelvic organ prolapse? A randomised controlled double‐masked, placebo‐controlled, multicentre study
Authors: Marschalek M‐L , Bodner K , Kimberger O , Zehetmayer S , Morgenbesser R , Dietrich W , Obruca C , Husslein H , Umek W , Koelbl H , Bodner‐Adler B
Published: August 2021

Objective

To evaluate whether locally applied vaginal estrogen affects prolapse‐associated complaints compared with placebo treatment in postmenopausal women prior to surgical prolapse repair.

Design

Randomised, double‐masked, placebo‐controlled, multicentre study.

Setting

Urogynaecology unit at the Medical University of Vienna and University Hospital of Tulln.

Population

Postmenopausal women with symptomatic pelvic organ prolapse and planned surgical prolapse repair.

Methods

Women were randomly assigned local estrogen cream or placebo cream 6 weeks preoperatively.

Main outcome measures

The primary outcome was differences in subjective prolapse‐associated complaints after 6 weeks of treatment prior to surgery, assessed with the comprehensive German pelvic floor questionnaire. Secondary outcomes included differences in other pelvic floor‐associated complaints (bladder, bowel or sexual function).

Results

Out of 120 women randomised, 103 (86%) remained for the final analysis. After 6 weeks of treatment the prolapse domain score did not differ between the estrogen and the placebo groups (4.4 ± 0.19 versus 4.6 ± 0.19; mean difference, −0.21; 95% CI −0.74 to 0.33; P = 0.445). Multivariate analysis, including only women receiving the intervention, showed that none of the confounding factors modified the response to estradiol.

Conclusions

These results demonstrate that preoperative locally applied estrogen does not ameliorate prolapse‐associated symptoms in postmenopausal women with symptomatic pelvic organ prolapse.

Tweetable abstract

Preoperative local estrogen does not ameliorate prolapse‐associated symptoms in postmenopausal women with pelvic organ prolapse.
Managerial Optimism and Debt Covenants
Authors: Infuehr Jakob , Laux Volker
Published: August 2021

This paper studies the effects of managerial optimism on the optimal design of debt covenants. We find that managers who are more optimistic about the future success of their investment ideas provide lenders with greater control rights via tighter covenants. This is optimal for optimistic managers even though they understand that tighter covenants increase the probability of covenant violations and lead to excessive lender intervention. The broad reason for this result is that optimists wish to write contracts that repay lenders more frequently in bad states rather than in good states, and the only way to achieve this is by granting lenders more control rights. Our model generates new predictions and offers a novel explanation for the empirical evidence that covenants in debt contracts are set very tightly and are often violated.
Chances and limitations when uncovering essential and non‐essential genes of Bacillus subtilis phages with CRISPR‐Cas9
Authors: Kohm Katharina , Basu Syamantak , Nawaz Muhammad M. , Hertel Robert
Published: August 2021

Virulent bacterial viruses, also known as phages or bacteriophages, are considered as a potential option to fight antibiotic‐resistant bacteria. However, their biology is still poorly understood, and only a fraction of phage genes is assigned with a function. To enable the first classification, we explored new options to test phage genes for their requirement on viral replication. As a model, we used the smallest known Bacillus subtilis phage Goe1, and the Cas9‐based mutagenesis vector pRH030 as a genetic tool. All phage genes were specifically disrupted, and individual survival rates and mutant genotypes were investigated. Surviving phages relied on the genome integrity through host intrinsic non‐homologues end joining system or a natural alteration of the Cas9 target sequence. Quantification of phage survivors and verifying the underlying genetic situation enables the classification of genes in essential or non‐essential sets for viral replication. We also observed structural genes to hold more natural mutations than genes of the genome replication machinery.
Novel genetic characteristics in low‐grade fetal adenocarcinoma of the lung
Authors: Zhang Shuyang , Yin Huihui , Zhang Jing , Yang Lu , Yang Guangjian , Jia Jia , Jiao Yuchen , Ying Jianming , Wang Yan
Published: August 2021

Background

Low‐grade fetal adenocarcinoma of the lung (L‐FLAC) is a rare subtype of lung adenocarcinoma with undetermined histological features and genetic abnormalities. In this study, we attempted to investigate the pathological characteristics and genomic profiles of L‐FLAC.

Methods

Among 9839 cases of primary lung adenocarcinoma resected at Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College between January 2011 and June 2016, three cases diagnosed with L‐FLAC were selected. An immunohistochemical profile and whole exome sequencing (WES) using tumor and normal tissues was conducted. The last follow‐up date of patients was January 2021.

Results

Three cases diagnosed with L‐FLAC were finally screened, suggesting a percentage of 0.03%. All three patients were male and diagnosed as stage I following radical lobectomy. The missense variant was found to be the major gene mutation type using WES. CTNNB1 and DICER1 were the two most frequent gene mutations. All cases demonstrated positive TTF‐1 expression. In addition, two patients showed positive expression of β‐catenin (nuclear/cytoplasmic expression), CgA and Sny. Negative expression of PD‐L1 in tumor cells was observed in all three cases. One case with a relatively high tumor mutation burden (TMB) (2.18 mut/Mb) had an inferior overall survival of 11.5 months. However, the other two cases with a lower TMB (0.12 and 0.74 mut/Mb) still acquired disease‐free status up to the last follow‐up date.

Conclusions

L‐FLAC has a specific molecular background which is different from lung adenocarcinoma. Furthermore, gene heterogeneity was found and might be the reason for a dramatically different prognosis in these L‐FLAC patients.
Prevalence of overweight and obesity from 5 to 19 years of age in Gothenburg, Sweden
Authors: Bygdell Maria , Célind Jimmy , Lilja Lina , Martikainen Jari , Simonson Lena , Sjögren Lovisa , Ohlsson Claes , Kindblom Jenny M.
Published: August 2021

Aim

The aim of this study was to present prevalence data for overweight and obesity across school age in a large, recent, population‐based cohort of children in Gothenburg, Sweden.

Methods

We included 66,807 children (48.5% girls) aged 5–18.9 years who had their height and weight measured in school health care 2015–2018. The BMI values were categorised according to the age‐dependent cut‐offs for overweight and obesity from the International Obesity Task Force (IOTF).

Results

Overall, the prevalence of overweight and obesity for girls and boys was 18.1% and 18.0%, respectively. We observed increasing proportions of overweight (girls 11.5–17.1% and boys 8.4–17.4%) and obesity (girls 3.0–4.2% and boys 2.7–6.1%) with increasing age (p < 0.001 for trend in both sexes). Moreover, girls had higher prevalence of overweight during ages 5.0 to 8.9 years compared with boys (p < 0.001), while boys had higher prevalence of obesity 15.0–18.9 years compared with girls (p < 0.001).

Conclusion

In conclusion, we demonstrate increasing prevalence of overweight and obesity across the entire school age range, as well as differences in prevalences between boys and girls, in a population‐based sample of 67,000 children in Gothenburg city, Sweden. Continuous monitoring of schoolchildren, together with effective preventive measures, is crucial to curb the obesity epidemic and its consequences.
Parental dietary arachidonic acid altered serum fatty acid profile, hepatic antioxidant capacity, and lipid metabolism in domestic pigeons (Columba livia)
Authors: Xu Qianqian , Wang Xiaoming , Liu Yating , Dong Xinyang , Zou Xiaoting
Published: August 2021

The aim of this study was to explore the effects of dietary arachidonic acid on serum fatty acid profile, hepatic antioxidant capacity, and lipid metabolism in pigeon squabs by supplementing arachidonic acid in their parental diets. A completely randomized design was conducted consisting of control group, 0.05% dietary arachidonic acid supplementation group, 0.1% dietary arachidonic acid supplementation group, and 0.2% dietary arachidonic acid supplementation group. Six randomly selected squabs from each group were sampled on Day 21 post‐hatch. Results indicated that moderate level (0.05%) of arachidonic acid in parental diets for pigeon squabs improved lipid metabolism via regulation on serum lipid profile and fatty acid composition and tended to reduce hepatic lipid accumulation in the premise of negligible damage to antioxidant status. Unfortunately, excessive parental supplementation of dietary arachidonic acid might be harmful to squab health. The regulatory effects of arachidonic acid were sensitive to the arachidonic acid doses. In conclusion, parental dietary arachidonic acid at 0.05% could be beneficial for squabs to maintain health as reflective aspects in ameliorative serum lipid profile, fatty acid composition, and reduced hepatic lipid accumulation.
Staying ‘Covid‐safe’: Proposals for embedding behaviours that protect against Covid‐19 transmission in the UK
Authors: Michie Susan , West Robert , Pidgeon Nick , Reicher Stephen , Amlôt Richard , Bear Laura
Published: August 2021

Objectives

The Scientific Pandemic Insights group on Behaviours (SPI‐B) as part of England’s Scientific Advisory Group on Emergencies (SAGE), were commissioned by the UK Cabinet Office to identify strategies to embed infection control behaviours to minimize Covid‐19 transmission in the long term.

Methods

With minimal direct evidence available, three sources of information were used to develop a set of proposals: (1) a scoping review of literature on sustaining behaviour change, (2) a review of key principles used in risk and safety management, and (3) prior reports and reviews on behaviour change from SPI‐B. The information was collated and refined through discussion with SPI‐B and SAGE colleagues to finalize the proposals.

Results

Embedding infection control behaviours in the long‐term will require changes to the financial, social, and physical infrastructure so that people in all sections of society have the capability, opportunity, and motivation needed to underpin those behaviours. This will involve building Covid‐safe educational programmes, regulating to ensure minimum standards of safety in public spaces and workspaces, using communications and social marketing to develop a Covid‐safe culture and identity, and providing resources so that all sections of society can build Covid‐safe behaviours into their daily lives.

Conclusions

Embedding ‘Covid‐safe’ behaviours into people’s everyday routines will require a co‐ordinated programme to shape the financial, physical, and social infrastructure in the United Kingdom. Education, regulation, communications, and social marketing, and provision of resources will be required to ensure that all sections of society have the capability, opportunity, and motivation to enact the behaviours long term.
Quantitative dSTORM super‐resolution microscopy localizes Aurora kinase A/AURKA in the mitochondrial matrix
Authors: Durel Béatrice , Kervrann Charles , Bertolin Giulia
Published: August 2021

Background information

Mitochondria are dynamic organelles playing essential metabolic and signaling functions in cells. Their ultrastructure has largely been investigated with electron microscopy (EM) techniques. However, quantifying protein‐protein proximities using EM is extremely challenging. Super‐resolution microscopy techniques as direct stochastic optical reconstruction microscopy (dSTORM) now provide a fluorescent‐based, quantitative alternative to EM. Recently, super‐resolution microscopy approaches including dSTORM led to valuable advances in our knowledge of mitochondrial ultrastructure, and in linking it with new insights in organelle functions. Nevertheless, dSTORM is mostly used to image integral mitochondrial proteins, and there is little or no information on proteins transiently present at this compartment. The cancer‐related Aurora kinase A/AURKA is a protein localized at various subcellular locations, including mitochondria.

Results

We first demonstrate that dSTORM coupled to GcoPS can resolve protein proximities within individual submitochondrial compartments. Then, we show that dSTORM provides sufficient spatial resolution to visualize and quantify the most abundant pool of endogenous AURKA in the mitochondrial matrix, as previously shown for overexpressed AURKA. In addition, we uncover a smaller pool of AURKA localized at the OMM, which could have a potential functional readout. We conclude by demonstrating that aldehyde‐based fixatives are more specific for the OMM pool of the kinase instead.

Conclusions

Our results indicate that dSTORM coupled to GcoPS colocalization analysis is a suitable approach to explore the compartmentalization of non‐integral mitochondrial proteins as AURKA, in a qualitative and quantitative manner. This method also opens up the possibility of analyzing the proximity between AURKA and its multiple mitochondrial partners with exquisite spatial resolution, thereby allowing novel insights into the mitochondrial functions controlled by AURKA.

Significance

Probing and quantifying the presence of endogenous AURKA – a cell cycle‐related protein localized at mitochondria – in the different organelle subcompartments, using quantitative dSTORM super‐resolution microscopy.
Chronic itch: emerging treatments following new research concepts
Authors: Misery Laurent , Brenaut Emilie , Pierre Ophélie , Le Garrec Raphaele , Gouin Olivier , Lebonvallet Nicolas , Abasq‐Thomas Claire , Talagas Matthieu , Le Gall‐Ianotto Christelle , Besner‐Morin Catherine , Fluhr Joachim W. , Leven Cyril
Published: August 2021

Until recently, itch pathophysiology was poorly understood and treatments were poorly effective in relieving itch. Current progress in our knowledge of the itch processing, the numerous mediators and receptors involved has led to a large variety of possible therapeutic pathways. Currently, inhibitors of IL‐31, IL‐4/13, NK1 receptors, opioids and cannabinoids, JAK, PDE4 or TRP are the main compounds involved in clinical trials. However, many new targets, such as Mas‐related GPCRs and unexpected new pathways need to be also explored.
Relationship between Fusobacterium nucleatum and antitumor immunity in colorectal cancer liver metastasis
Authors: Sakamoto Yuki , Mima Kosuke , Ishimoto Takatsugu , Ogata Yoko , Imai Katsunori , Miyamoto Yuji , Akiyama Takahiko , Daitoku Nobuya , Hiyoshi Yukiharu , Iwatsuki Masaaki , Baba Yoshifumi , Iwagami Shiro , Yamashita Yo‐ichi , Yoshida Naoya , Komohara Yoshihiro , Ogino Shuji , Baba Hideo
Published: August 2021

Fusobacterium nucleatum has been detected in 8%‐13% of human colorectal cancer, and shown to inhibit immune responses against primary colorectal tumors in animal models. Thus, we hypothesized that the presence of F. nucleatum might be associated with reduced T cell density in colorectal cancer liver metastases (CRLM). We quantified F. nucleatum DNA in 181 CRLM specimens using quantitative PCR assay. The densities of CD8+ T cells, CD33+ cells (marker for myeloid‐derived suppressor cells [MDSCs]), and CD163+ cells (marker for tumor‐associated macrophages [TAMs]) in CRLM tissue were determined by immunohistochemical staining. Fusobacterium nucleatum was detected in eight (4.4%) of 181 CRLM specimens. Compared with F. nucleatum‐negative CRLM, F. nucleatum‐positive CRLM showed significantly lower density of CD8+ T cells (P = .033) and higher density of MDSCs (P = .001). The association of F. nucleatum with the density of TAMs was not statistically significant (P = .70). The presence of F. nucleatum is associated with a lower density of CD8+ T cells and a higher density of MDSCs in CRLM tissue. Upon validation, our findings could provide insights to develop strategies that involve targeting microbiota and immune cells for the prevention and treatment of CRLM.
Effect of weight‐loss diets prior to elective surgery on postoperative outcomes in obesity: A systematic review and meta‐analysis
Authors: Pavlovic Natalie , Boland Robert A. , Brady Bernadette , Genel Furkan , Harris Ian A. , Flood Victoria M. , Naylor Justine M.
Published: August 2021

This systematic review investigated the effects of weight‐loss diets before elective surgery on preoperative weight loss and postoperative outcomes in people with obesity. Electronic databases were searched from inception to May 2021. Inclusion criteria were prospective cohort or randomised controlled studies that compared effects of weight‐loss diets to standard care on postoperative outcomes in adults with obesity awaiting surgery. Participants with cancer or undergoing bariatric surgery were excluded. Data on preoperative weight change, length of stay, postoperative complications and patient‐reported outcome measures were extracted and synthesised in meta‐analyses. One randomised controlled trial involving total knee arthroplasty and two that investigated general surgery were eligible that included 173 participants overall. Each study compared low‐calorie diets using meal replacement formulas to usual care. There is very‐low‐quality evidence of a statistically significant difference favouring the intervention for preoperative weight loss (mean difference [MD] −6.67 kg, 95% confidence interval [CI] −12.09 to −1.26 kg; p = 0.02) and low‐quality evidence that preoperative weight‐loss diets do not reduce postoperative complications to 30 days (odds ratio [OR] 0.34, 95% CI 0.08–1.42; p = 0.14) or length of stay (MD −3.72 h, 95% CI −10.76 to 3.32; p = 0.30). From the limited data that is of low quality, weight loss diets before elective surgery do not reduce postoperative complications.
Is synoptic operative reporting necessary for Crohn's disease surgery? Variability in surgical reports across inflammatory bowel disease referral centres
Authors: Mujukian Angela , Truong Adam , Steinhagen Emily , Prashansha Vaidya , Lightner Amy L. , Morin Frédéric , Zaghiyan Karen , de Buck van Overstraeten Anthony , Fleshner Phillip
Published: August 2021

Aim

Ileocolic resection (ICR) is the most commonly performed operation in Crohn's disease (CD) patients. The surgical report is a vital tool for accessing information to gauge a patient's long‐term prognosis and guide treatment decisions. Dictated narrative reports are the traditional method for surgical documentation but often lack essential information. The objective was to assess the quality of operation note in CD patients undergoing ICR.

Method

This was a multi‐institutional retrospective cohort collaborative study involving four tertiary inflammatory bowel disease referral centres in the USA and Canada. The patients were consecutive CD patients undergoing ICR between 2014 and 2020. There were no interventions. The main outcome measures were the variability and frequency of 28 critical items in the operation note.

Results

An analysis of 400 consecutive operation reports in four institutions (n = 100/institution) revealed significant variability in almost all variables. The initial surgical approach and wound protector use were the most consistently or frequently reported across all inflammatory bowel disease centres. The limitation was that this was a retrospective cohort study with inevitable selection bias.

Conclusions

This study highlights the need for synoptic reporting in CD patients undergoing ICR.
Accounting conservatism and corporate cash levels: Empirical evidence from Latin America
Authors: Manoel Aviner Augusto Silva , Moraes Marcelo Botelho da Costa
Published: August 2021

Research Question/Issues

The aim of this research is to shed light on the role accounting conservatism plays in the determination of firms' cash levels. Previous literature suggests that conservatism is a governance mechanism that can alleviate agency problems associated with managers' investment decisions. Hence, we hypothesize that strong conservatism limits managers' ability to expend cash to benefit themselves. For that, we used an unbalanced panel data of firms from Latin America (Argentina, Brazil, Chile, Mexico, and Peru) with data available from 2000 to 2018.

Research Findings/Insights

Our results are, for the most part, consistent with our theoretical predictions. Indeed, we find strong and robust evidence that Latin American firms with more conservative accounting policies have higher cash holdings as a result of a reduction in cash misappropriation. These results are robust to alternative measures of conservatism, after controlling for other factors associated with timely loss recognition, for country fixed effects and after a battery of robustness checks.

Theoretical/Academic Implications

Our analyses suggest that increased conservatism has the potential to bring real economic benefits to organizations, serving as an efficient mechanism that reduces agency costs regarding cash management by inducing a more efficient use of cash holdings. Therefore, we contribute to the international literature on conservatism, cash holdings, and corporate governance by demonstrating the importance of conservatism in firms' decisions on how cash is employed. These findings are particularly interesting because cash expropriation can have a devastating impact on shareholder wealth.

Practitioner/Policy Implications

Given the ongoing debate about whether neutrality, as opposed to conservatism, is a desirable feature in financial reports, by documenting how conservatism reduces agency problems related to cash management, we also provide practical implications for accounting standard‐setters.
Safety, tolerability, and pharmacokinetics of single‐ and multiple‐dose administration of islatravir (MK‐8591) in adults without HIV
Authors: Matthews Randolph P. , Ankrom Wendy , Friedman Evan , Jackson Rudd Deanne , Liu Yang , Mogg Robin , Panebianco Deborah , De Lepeleire Inge , Petkova Magdalena , Grobler Jay A. , Stoch Selwyn Aubrey , Iwamoto Marian
Published: August 2021

Islatravir (MK‐8591) is a nucleoside analogue in development for the treatment and prevention of HIV‐1. Two phase 1 trials were conducted during initial evaluation of islatravir: rising single doses (Study 1) and rising multiple doses (Study 2) of oral islatravir in male and female participants without HIV (aged 18–60 years). Safety, tolerability, and pharmacokinetics of islatravir (plasma) and islatravir‐triphosphate (peripheral blood mononuclear cells) were assessed. In Study 1, 24 participants, assigned to 1 of 3 panels, received alternating single doses of islatravir in a fasted state from 5 mg to 400 mg, or placebo, over 3 dosing periods; a 30 mg dose was additionally assessed following a high‐fat meal. In Study 2, 8 participants per dose received 3 once‐weekly doses of 10, 30, or 100 mg islatravir or placebo in a fasted state. For each panel in both trials, 6 participants received active drug and 2 received placebo. Islatravir was generally well‐tolerated, with no serious adverse events or discontinuations due to adverse events. Islatravir was rapidly absorbed (median time to maximum plasma concentration 0.5 hours); plasma half‐life was 49–61 h; intracellular islatravir‐triphosphate half‐life was 118–171 h. Plasma exposure increased in an approximately dose‐proportional manner; there was no meaningful food effect. There was a modest degree of intracellular islatravir‐triphosphate accumulation after multiple weekly dosing. After single oral doses of islatravir greater than or equal to 5 mg, intracellular islatravir‐triphosphate levels were comparable to levels associated with efficacy in preclinical studies. These results warrant continued clinical investigation of islatravir.
What does modularity mean?
Authors: Zelditch Miriam L. , Goswami Anjali
Published: August 2021

Modularity is now generally recognized as a fundamental feature of organisms, one that may have profound consequences for evolution. Modularity has recently become a major focus of research in organismal biology across multiple disciplines including genetics, developmental biology, functional morphology, population and evolutionary biology. While the wealth of new data, and also new theory, has provided exciting and novel insights, the concept of modularity has become increasingly ambiguous. That ambiguity is underlain by diverse intuitions about what modularity means, and the ambiguity is not merely about the meaning of the word—the metrics of modularity are measuring different properties and the methods for delimiting modules delimit them by different, sometimes conflicting criteria. The many definitions, metrics and methods can lead to substantial confusion not just about what modularity means as a word but also about what it means for evolution. Here we review various concepts, using graphical depictions of modules. We then review some of the metrics and methods for analyzing modularity at different levels. To place these in theoretical context, we briefly review theories about the origins and evolutionary consequences of modularity. Finally, we show how mismatches between concepts, metrics and methods can produce theoretical confusion, and how potentially illogical interpretations can be made sensible by a better match between definitions, metrics, and methods.
Introducing the youth residential rehabilitation service: An operational and experiential overview of a psychosocial residential support option for young people experiencing mental health challenges
Authors: Spies Rebecca , Ennals Priscilla , Egan Rebecca , Hemus Philippa , Gonzales Regine , Droppert Kathryn , Tidhar Michael , McMullan Sarah , Lessing Kate , Wood Tom , Bride Rachael , Bendall Sarah , Simmons Magenta
Published: August 2021

Aim

A range of residential supports is available for young people experiencing mental health challenges. One Australian example is the Youth Residential Rehabilitation Service, which provides up to 12 months of intensive psychosocial support in a residential setting to young people aged 16–25 experiencing serious mental health challenges. This paper aimed to add to the scant literature on these services, describing the experiences of young people and staff members across the duration of a stay.

Methods

This study drew on collaborative autoethnography to engage and centre the direct lived experience of young people who had lived, and staff who had worked, in a Youth Residential Rehabilitation Service.

Results

We identified three phases that young people typically journey through during their stay at the service. The Arriving phase was marked by appropriate referrals, a warm welcome, a period of settling in and the development of trusting relationships. The Discovering phase saw young people identifying and enacting their strengths, hopes and values. Community connections were a focus of the Continuing phase as lives after service exit were envisioned and created.

Conclusions

Drawing on collaborative autoethnography methods represents one approach to amplify the voice of young people in service design and evaluation. This paper richly described some of the possibilities and complexities of the Youth Residential Rehabilitation Service experience, which can be used to inform the service's pacing and structure of support.
Carbon emission savings and short‐term health care impacts from telemedicine: An evaluation in epilepsy
Authors: Blenkinsop Stephen , Foley Aideen , Schneider Natascha , Willis Joseph , Fowler Hayley J. , Sisodiya Sanjay M.
Published: August 2021

Objective

Health systems make a sizeable contribution to national emissions of greenhouse gases that contribute to global climate change. The UK National Health Service is committed to being a net zero emitter by 2040, and a potential contribution to this target could come from reductions in patient travel. Achieving this will require actions at many levels. We sought to determine potential savings and risks over the short term from telemedicine through virtual clinics.

Methods

During the severe acute respiratory syndrome coronavirus 2 (SARS‐2‐CoV) pandemic, scheduled face‐to‐face epilepsy clinics at a specialist site were replaced by remote teleclinics. We used a standard methodology applying conversion factors to calculate emissions based on the total saved travel distance. A further conversion factor was used to derive emissions associated with electricity consumption to deliver remote clinics from which net savings could be calculated. Patients’ records and clinicians were interrogated to identify any adverse clinical outcomes.

Results

We found that enforced telemedicine delivery for over 1200 patients resulted in the saving of ~224 000 km of travel with likely avoided emissions in the range of 35 000–40 000 kg carbon dioxide equivalent (CO2e) over a six and half month period. Emissions arising directly from remote delivery were calculated to be <200 kg CO2e (~0.5% of those for travel), representing a significant net reduction of greenhouse gas emissions. Only one direct adverse outcome was identified, with some additional benefits identified anecdotally.

Significance

The use of telemedicine can make a contribution toward reduced emissions in the health care sector and, in the delivery of specialized epilepsy services, had minimal adverse clinical outcomes over the short term. However, these outcomes will likely vary with clinic locations, medical specialties and conditions.
Antiseizure medication adherence trajectories in Medicare beneficiaries with newly treated epilepsy
Authors: Terman Samuel W. , Kerr Wesley T. , Marcum Zachary A. , Wang Lu , Burke James F.
Published: August 2021

Objective

This study was undertaken to characterize trajectories of antiseizure medication (ASM) adherence in adults with newly treated epilepsy and to determine predictors of trajectories.

Methods

This was a retrospective cohort study using Medicare. We included beneficiaries with newly treated epilepsy (one or more ASM and none in the preceding 2 years, plus International Classification of Diseases codes) in 2010–2013. We calculated the proportion of days covered (proportion of total days with any ASM pill supply) for 8 quarters or until death. Group‐based trajectory models characterized and determined predictors of trajectories.

Results

We included 24 923 beneficiaries. Models identified four groups: early adherent (60%), early nonadherent (18%), late adherent (11%), and late nonadherent (11%). Numerous predictors were associated with being in the early nonadherent versus early adherent group: non‐White race (e.g., Black, odds ratio [OR] = 1.7, 95% confidence interval [CI] = 1.5–1.8), region (e.g., South vs. Northeast: OR = 1.2, 95% CI = 1.1–1.4), and once daily initial medication (OR = 1.1, 95% CI = 1.0–1.3). Predictors associated with decreased odds of being in the early nonadherent group included older age (OR = .9 per decade, 95% CI = .9–.9), female sex (OR = .9, 95% CI = .8–1.0), full Medicaid eligibility (OR = .6, 95% CI = .4–.8), neurologist visit (OR = .6, 95% CI = .6–.7), and initial older generation ASM (OR = .6, 95% CI = .6–.7).

Significance

We identified four ASM adherence trajectories in individuals with newly treated epilepsy. Whereas risk factors for early nonadherence such as race or geographic region are nonmodifiable, our work highlighted a modifiable risk factor for early nonadherence: lacking a neurologist. These data may guide future interventions aimed at improving ASM adherence, in terms of both timing and target populations.
Declining fungal diversity in Arctic freshwaters along a permafrost thaw gradient
Authors: Kluge Mariana , Wauthy Maxime , Clemmensen Karina Engelbrecht , Wurzbacher Christian , Hawkes Jeffrey A. , Einarsdottir Karolina , Rautio Milla , Stenlid Jan , Peura Sari
Published: August 2021

Climate change–driven permafrost thaw has a strong influence on pan‐Arctic regions, via, for example, the formation of thermokarst ponds. These ponds are hotspots of microbial carbon cycling and greenhouse gas production, and efforts have been put on disentangling the role of bacteria and archaea in recycling the increasing amounts of carbon arriving to the ponds from degrading watersheds. However, despite the well‐established role of fungi in carbon cycling in the terrestrial environments, the interactions between permafrost thaw and fungal communities in Arctic freshwaters have remained unknown. We integrated data from 60 ponds in Arctic hydro‐ecosystems, representing a gradient of permafrost integrity and spanning over five regions, namely Alaska, Greenland, Canada, Sweden, and Western Siberia. The results revealed that differences in pH and organic matter quality and availability were linked to distinct fungal community compositions and that a large fraction of the community represented unknown fungal phyla. Results display a 16%–19% decrease in fungal diversity, assessed by beta diversity, across ponds in landscapes with more degraded permafrost. At the same time, sites with similar carbon quality shared more species, aligning a shift in species composition with the quality and availability of terrestrial dissolved organic matter. We demonstrate that the degradation of permafrost has a strong negative impact on aquatic fungal diversity, likely via interactions with the carbon pool released from ancient deposits. This is expected to have implications for carbon cycling and climate feedback loops in the rapidly warming Arctic.
Phytoplankton and cyanobacteria abundances in mid‐21st century lakes depend strongly on future land use and climate projections
Authors: Kakouei Karan , Kraemer Benjamin M. , Anneville Orlane , Carvalho Laurence , Feuchtmayr Heidrun , Graham Jennifer L. , Higgins Scott , Pomati Francesco , Rudstam Lars G. , Stockwell Jason D. , Thackeray Stephen J. , Vanni Michael J. , Adrian Rita
Published: August 2021

Land use and climate change are anticipated to affect phytoplankton of lakes worldwide. The effects will depend on the magnitude of projected land use and climate changes and lake sensitivity to these factors. We used random forests fit with long‐term (1971–2016) phytoplankton and cyanobacteria abundance time series, climate observations (1971–2016), and upstream catchment land use (global Clumondo models for the year 2000) data from 14 European and 15 North American lakes basins. We projected future phytoplankton and cyanobacteria abundance in the 29 focal lake basins and 1567 lakes across focal regions based on three land use (sustainability, middle of the road, and regional rivalry) and two climate (RCP 2.6 and 8.5) scenarios to mid‐21st century. On average, lakes are expected to have higher phytoplankton and cyanobacteria due to increases in both urban land use and temperature, and decreases in forest habitat. However, the relative importance of land use and climate effects varied substantially among regions and lakes. Accounting for land use and climate changes in a combined way based on extensive data allowed us to identify urbanization as the major driver of phytoplankton development in lakes located in urban areas, and climate as major driver in lakes located in remote areas where past and future land use changes were minimal. For approximately one‐third of the studied lakes, both drivers were relatively important. The results of this large scale study suggest the best approaches for mitigating the effects of human activity on lake phytoplankton and cyanobacteria will depend strongly on lake sensitivity to long‐term change and the magnitude of projected land use and climate changes at a given location. Our quantitative analyses suggest local management measures should focus on retaining nutrients in urban landscapes to prevent nutrient pollution from exacerbating ongoing changes to lake ecosystems from climate change.
Woody plant encroachment enhanced global vegetation greening and ecosystem water‐use efficiency
Authors: Deng Yuanhong , Li Xiaoyan , Shi Fangzhong , Hu Xia
Published: August 2021

Aim

Encroachment of woody plants into grasslands and savannas (WPE) has been observed world‐wide. However, the general ecohydrological effects of this striking change in land cover are uncertain owing to divergent results in various areas and unknown global spatial distribution. Here, we reveal the patterns and dynamics of WPE and its effects on leaf area index (LAI), gross primary production (GPP), components of evapotranspiration (ET) and ecosystem water‐use efficiency (EWUE).

Location

Global.

Time period

Contemporary.

Major taxa studied

Woody plants.

Methods

We used remote sensing to identify the distribution of WPE in 2002–2018, validated at 442 WPE sites, and analysed the pattern of WPE across geographical gradients. The multi‐time‐scale impacts of WPE were revealed through pairwise comparison. Differences among biomes/climate zones were compared by the Kruskal–Wallis test. The relationship of WPE to vegetation greening and the effects of WPE on EWUE were explored.

Results

Global WPE expanded persistently from 2002 to 2018, but the rate of increase decreased after 2010; spatially, the average rate of change was .3%/year. High values of WPE in 2018 occurred in arid and semi‐arid regions, with the peak WPE in the multi‐annual mean precipitation of 350–400 mm. Pairwise comparison showed that WPE increased the LAI, GPP, ET and ratio of transpiration to ET, with the strongest effects in summer, and enhanced annual EWUE. Both global pixel‐ and site‐level WPE mainly showed vegetation greening. The above findings varied among bioclimatic conditions; particularly in semi‐arid areas, WPE was positively correlated with vegetation greening and remarkably improved EWUE.

Main conclusions

The ongoing WPE contributed to vegetation greening and elevated vegetation productivity by increasing the LAI and partitioning more water into transpiration; these findings indicate that the WPE process should be incorporated into the carbon cycle and ecohydrology models. However, attention should also be focused on controlling adverse consequences of WPE in arid areas.