bluuebunny/crossref_metadata_2025 huggingface dataset:
Mass Flux Analysis of Abiotic Tetrachloroethene Dense Nonaqueous Phase Liquid Pool Dissolution in a Heterogeneous Flow Environment
Authors: Klemm Sara M. , Seagren Eric A. , Becker Jennifer G. , Mayer Alex S.
Published: May 2021

Porous aquifer materials are often characterized by layered heterogeneities that influence groundwater flow and present complexities in contaminant transport modeling. Such flow variations also have the potential to impact the dissolution flux from dense nonaqueous phase liquid (DNAPL) pools. This study examined how these heterogeneous flow conditions affected the dissolution of a tetrachloroethene (PCE) pool in a two‐dimensional intermediate‐scale flow cell containing coarse sand. A steady‐state mass‐balance approach was used to calculate the PCE dissolution rate at three different flow rates. As expected, aqueous PCE concentrations increased along the length of the PCE pool and higher flow rates decreased the aqueous PCE concentration in the effluent. Nonreactive tracer studies at two flow rates confirmed the presence of a vertical flow gradient, with the most rapid velocity located at the bottom of the tank. These results suggest that flow focusing occurred near the DNAPL pool. Effluent PCE concentrations and pool dissolution flux rates were compared to model predictions assuming local equilibrium (LE) conditions at the DNAPL pool/aqueous phase interface and a uniform distribution of flow. The LE model did not describe the data well, even over a wide range of PCE solubility and macroscopic transverse dispersivity values. Model predictions assuming nonequilibrium mass‐transfer‐limited conditions and accounting for vertical flow gradients, however, resulted in a better fit to the data. These results have important implications for evaluating DNAPL pool dissolution in the field where subsurface heterogeneities are likely to be present.
Association of liver stiffness and steatosis with hepatocellular carcinoma development in patients with hepatitis C virus infection who received direct‐acting antiviral therapy and achieved sustained virological response
Authors: Tada Toshifumi , Nishimura Takashi , Matono Tomomitsu , Yoshida Masahiro , Yuri Minako , Fujiwara Aoi , Yuri Yukihisa , Takashima Tomoyuki , Aizawa Nobuhiro , Ikeda Naoto , Enomoto Hirayuki , Kumada Takashi , Iijima Hiroko
Published: May 2021

Aim

The pathogenic process underlying the development of hepatocellular carcinoma (HCC) is not yet clear in patients with chronic hepatitis C virus who receive direct‐acting antiviral therapy and achieve sustained virological response. This study investigated two risk factors for HCC in these patients; specifically, hepatic fibrosis and steatosis.

Methods

A total of 355 patients in whom hepatitis C virus was eradicated by direct‐acting antiviral were evaluated. Fibrosis and steatosis were assessed using transient elastography (TE) and the controlled attenuation parameter (CAP). Inverse probability weighting was applied to patient age, sex, albumin–bilirubin, α‐fetoprotein, history of HCC, TE, or CAP.

Results

The 12‐, 24‐, and 36‐month cumulative incidence rates of HCC were 0.9%, 2.4%, and 4.1%, respectively. Univariate analysis with the Cox proportional hazards model showed that whereas a high TE value (≥10 kPa) was significantly associated with HCC development (HR 7.861, 95% CI 2.126–29.070; p = 0.002), CAP was not. Additionally, univariate analysis with the Cox proportional hazards model adjusted by inverse probability weighting showed that a high TE value was significantly associated with HCC development (HR 3.980, 95% CI, 1.036–15.290; p = 0.044), whereas CAP was not. The cumulative inverse probability weighting‐adjusted incidence of HCC rates at 12, 24, and 36 months were 0.0%, 0.5%, and 1.7%, respectively, in patients with a low TE value, and 2.5%, 5.1%, and 7.6%, respectively, in those with a high TE value.

Conclusion

A high TE value was a risk factor for HCC in hepatitis C virus patients who received direct‐acting antiviral therapy and achieved sustained virological response.
The Oxygen project: a prospective study to assess the effectiveness of a targeted intervention to improve oxygen management in hospitalised patients
Authors: Nguyen Benjamin , Gunaratne Yodithya , Kemp Teresa , Chan Wei , Cochrane Belinda
Published: May 2021

Background

Oxygen is commonly used in the acute care setting. However, used inappropriately, oxygen therapy can result in adverse consequences, including progressive respiratory failure and death.

Aim

To investigate the effectiveness of a targeted intervention to improve prescribing practice and therapeutic application of supplemental oxygen.

Methods

Respiratory, Oncology and Surgery wards were targeted for the intervention. Nursing and junior medical staff from these wards undertook an education programme about safe use of oxygen. Cross‐sectional data about oxygen prescribing, administration and monitoring were collected on inpatients in these wards at baseline, and at 3 and 6 months post‐intervention, using a modified version of the British Thoracic Society Oxygen Audit Tool.

Results

At baseline, there was a written prescription for oxygen in 56% of patients (n = 43) using oxygen and this increased to 75% (n = 44) at 3 months, and remained at 65% (n = 48) at 6 months. However, the increased prescription rates were not statistically significant when compared to baseline (χ2 = 3.54, df = 1, P = 0.06 and χ2 = 0.73, df = 1, P = 0.40, respectively). The observed increase in oxygen prescriptions was driven by the medical wards: Oncology ward at 3 months (χ2 = 8.24, df = 1, P = 0.004); and Respiratory ward at 3 months (χ2 = 3.31, df = 1, P = 0.069) and 6 months (χ2 = 4.98, df = 1, P = 0.026).

Conclusion

The education programme intervention to improve oxygen prescription showed promise in the medical wards but did not impact outcomes in the surgical ward setting, where different strategies may be needed.
Unfractionated heparin reduces hepcidin levels in critically ill patients
Authors: Vagionas Dimitrios , Politou Marianna , Kompoti Maria , Papadakis Dimitrios‐Dorotheos , Kostakou Eirini , Theodoulou Danai , Kaniaris Evangelos , Rovina Nikoletta , Koutsoukou Antonia , Vasileiadis Ioannis
Published: May 2021

A strong anti‐hepcidin activity has been observed in heparins. Mean hepcidin levels were significantly reduced compared to baseline, following the first day of unfractionated heparin administration in critically patients. Heparin displayed a strong independent negative association with hepcidin. These results may lead to future treatment methods of forms of anaemia characterised by hepcidin excess, common among the critically ill.
Fantastic IgA plasma cells and where to find them
Authors: Isho Baweleta , Florescu Alexandra , Wang Angela A. , Gommerman Jennifer L.
Published: May 2021

IgA is produced in large quantities at mucosal surfaces by IgA+ plasma cells (PC), protecting the host from pathogens, and restricting commensal access to the subepithelium. It is becoming increasingly appreciated that IgA+ PC are not constrained to mucosal barrier sites. Rather, IgA+ PC may leave these sites where they provide both host defense and immunoregulatory function. In this review, we will outline how IgA+ PC are generated within the mucosae and how they subsequently migrate to their “classical” effector site, the gut lamina propria. From there we provide examples of IgA+ PC displacement from the gut to other parts of the body, referencing examples during homeostasis and inflammation. Lastly, we will speculate on mechanisms of IgA+ PC displacement to other tissues. Our aim is to provide a new perspective on how IgA+ PC are truly fantastic beasts of the immune system and identify new places to find them.
Nail disease in neonatal abstinence syndrome
Authors: Flanagan Kelly E. , Lal Karan , Blankenship Kaitlin , Gorji Nasim , Rork Jillian , Wiss Karen
Published: May 2021

Background/Objectives

Neonatal abstinence syndrome (NAS) incidence continues to rise in the United States due to increasing opioid use disorder in pregnancy. While cutaneous excoriations have been noted in NAS, there is a paucity of literature regarding abnormal nail findings in NAS.

Methods

A retrospective, observational case series was conducted of twelve patients with NAS and abnormal nail findings who were admitted to the neonatal intensive care unit between January 1, 2018, and May 1, 2020.

Results

Twelve neonates (10 male, 2 female, mean gestational age at birth 38.1 weeks) with NAS diagnosis and abnormal nail findings were identified between January 1, 2018, and May 1, 2020. NAS was diagnosed by elevated Modified Finnegan Neonatal Abstinence Syndrome Tool (M‐FNAST) scores. All patients required pharmacologic treatment for NAS with seven (58.3%) requiring phenobarbital in addition to first‐line morphine. Common nail findings included periungual erythema, yellow crusting, desquamation of the proximal and/or distal lateral nail folds and sheared distal nail edges. Two patients (16.7%) required antibiotic treatment for paronychia. Peak M‐FNAST scores were positively correlated with number of abnormal nail findings (r = .58, P = .047).

Conclusions

Twelve neonates with severe NAS demonstrated similar nail abnormalities, likely secondary to NAS agitation and motor hyperactivity. Nail exams, therefore, are important in the setting of suspected or confirmed NAS to limit continued nail trauma and infection. Our findings also introduce an association between NAS severity and abnormal nail findings, which will require larger studies for further confirmation.
Effect of Photobiomodulation on the Incidence of Alveolar Osteitis and Postoperative Pain following Mandibular Third Molar Surgery: A Double‐Blind Randomized Clinical Trial
Authors: Nejat Amir Hossein , Eshghpour Majid , Danaeifar Nasrin , Abrishami Majid , Vahdatinia Farshid , Fekrazad Reza
Published: May 2021

The current study aimed to evaluate the effectiveness of photobiomodulation therapy for the prevention of incidence of alveolar osteitis (AO) and postoperative pain following third molar surgery. In this double‐blind clinical trial, the impacted teeth of patients having bilateral impacted mandibular third molars were surgically extracted; for each participant, one socket was randomly assigned to receive photobiomodulation treatment, the other received sham treatment. 660 nm 200 mW CW was applied at a distance of ~1cm to 4 points on the occlusal area of extraction socket (beam area at the tissue ~0.64 cm2, 312.5 mW cm−2, 1J, 1.6 J cm−2). Also, 810 nm 200 mW CW was applied at tissue surface at three points on the buccal and three points on the lingual gingiva, for 15 s (400 mW cm−2, 3 J, 6 J cm−2). There was a statistically meaningful difference in AO frequency between the two groups, and the photobiomodulation group showed lower AO frequency compared with the sham PBM treatment (P‐value = 0.035). According to the findings of this study, photobiomodulation therapy reduced the incidence of AO following surgical removal of impacted mandibular third molars. The incidence of AO typically occurs 3–7 days post‐extraction, and our results suggest that PBM treatment within the 7 days could help reduce the risk of AO development.
Approaches in Energy Exclusive Security: Theories of Energy Security and the Dominance of Realism
Authors: Kilinç‐Pala Pinar Buket
Published: May 2021

Energy security is an important component of power politics, which explains the distribution of limited resources and the consequences thereof. Yet contemporary international relations theories tend to focus more on the “security” element when it comes to energy security and somewhat underplay the “power” component that lies behind it. This may limit their purchase and nuance in explaining contemporary and future energy security developments. This article offers an initial theoretical argument that reveals and emphasizes how energy changes and shapes power and security concepts and, thus, requires an improved conceptual model in international relations theory. I provide a conceptual overview of energy and security before adapting and empirically examining existing international relations theories (realism, neorealism, liberalism). I then conceptualize energy security within the scope of realism and aim to emphasize the specific importance of power that energy security theory and policy requires. To do so, I investigate the Energy Security Development Capability and identify the elements that could contribute to the advancement of energy security. I also note why realism is still seen as a dominant approach to understand energy security.

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How participation in ecological restoration can foster a connection to nature
Authors: Furness Ella
Published: May 2021

There have been strong claims made for ecological restoration's potential as a practice which is conductive to rethinking relationships with nature. The involvement of lay people in “hands‐on restoration” is thought to hold potential for enabling re‐examinations of human connection to nature. Restoration scholars suggest causal mechanisms present in restoration practice which may explain why it is so conductive to enabling connection to nature. This research used participatory observation and in‐depth interviewing to examine these largely untested ideas and gives insight into the casual mechanisms they present. Focusing on one case of ecological restoration in the Highlands of Scotland, the study found that exertion and achievement gained through restoration work created positive affect which people associated with their experience of nature, that laboring in nature created belonging and ownership, and that physical immersion enabled intimacy with nature. It found that learning about the legacies of human agency on landscape reduced reification and that the wider narrative of restoration gave people both a sense of being part of the unfolding history of the landscape and part of a redemptive future. It also found that focused attention created vivid memories and elevated the significance of the experience of being in nature and ritual created remarkable, memorable events. This study adds to previous work, finding that the emotional labor of leaders, the use of educational techniques, and the kinds of tasks in which participants engage are important in creating particular ideas of the relationship between humans and nature.
Floral resource selection by wild bees and honey bees in the Midwest United States: implications for designing pollinator habitat
Authors: Simanonok Stacy C. , Otto Clint R. V. , Buhl Deborah A.
Published: May 2021

Many seed mix recommendations for creating pollinator habitat are in part based on anecdotal evidence or field observations of bees visiting forbs (i.e. use). However, there is limited information on what forbs are preferred by bees, particularly in working landscapes where bee forage may be limited. We examined floral resource selection by wild bees and honey bees on grasslands in the Midwest using a 5‐year dataset containing over 8,000 plant‐bee interactions. We observed wild bees visiting 83 forb species, but only 14 species were significantly selected (i.e. bees visited a plant more than expected based on availability). Approximately 70% of all wild bee visitations were on native flowers, whereas only 20% of all honey bee visitations were on natives. Honey bees visited 70 forb species, but only four forbs were significantly selected. The selection ratio for each forb species was not correlated with proportion of use by wild bees or honey bees, suggesting that bee visitation data alone do not elucidate patterns of forb selection or avoidance. We then compared our resource selection results to forbs recommended by U.S. Department of Agriculture (USDA) for regional pollinator habitat plantings. Many forbs that were selected by bees in our study were also recommended by USDA; however, some USDA‐recommended forbs were selected against by bees. A greater understanding of which floral resources are selected by bees can assist land managers in assessing conservation seed mixes and ultimately provide diverse, season‐long pollinator forage in working landscapes.
Infrastructure as techno‐politics of differentiation: Socio‐political effects of mega‐infrastructures in Kenya
Authors: Lesutis Gediminas
Published: May 2021

The Standard Gauge Railway (SGR) in Kenya, inaugurated in 2017, has been promoted by the Kenyan government as a promise of “development” and “prospering people.” This paper demonstrates how, contrary to these narratives, the SGR reiterates the pre‐existing relations of difference mediated by class, geography, and ethnicity. Focusing on material and semiotic forms of the SGR infrastructures, it specifically shows how the railway project functions as the techno‐politics of differentiation that governs by including “prospering publics” of urban middle classes into Kenya's modernist development vision, providing unstable hopes for “development” to more precarious peri‐urban and rural “anticipating populations,” but simultaneously constituting “excluded populations” in rural landscapes that are denied the possibility of being a part of the national modernist development vision. Highlighting this intimate relationship between infrastructure, governance, and biopolitics, the paper demonstrates that mega‐infrastructures – differentiating between the publics included in, and the populations excluded from, the state's development visions and practices, as well as unstable subjective dispositions in‐between – engender modalities of non‐belonging that fall outside of (inherently liberal) frames of “citizenship” or a “public” frequently employed in critical infrastructure scholarship.
Minipool testing for SARS‐CoV‐2 RNA in United States blood donors
Authors: Bakkour Sonia , Saá Paula , Groves Jamel A. , Montalvo Leilani , Di Germanio Clara , Best Sonja M. , Grebe Eduard , Livezey Kristin , Linnen Jeffrey M. , Strauss Donna , Kessler Debra , Bonn Mark , Green Valerie , Williamson Phillip , Kleinman Steve , Stramer Susan L. , Stone Mars , Busch Michael P. ,   for the NHLBI Recipient Epidemiology and Donor Evaluation Study‐IV‐Pediatric (REDS‐IV‐P)
Published: May 2021

Background

SARS‐CoV‐2 RNA prevalence in blood donors from large geographic areas of high community transmission is limited. We tested residual donor plasma minipools (MPs) to determine SARS‐CoV‐2 RNAemia prevalence in six United States areas.

Study Design/Methods

Blood donations collected from 7 March 2020 to 25 September 2020 were tested for SARS‐CoV‐2 RNA (vRNA) in MP of 6 or 16 donations using the Grifols Procleix SARS‐CoV‐2 research‐use only (RUO) transcription‐mediated amplification (TMA) assay. Reactive results were confirmed using an alternate target region TMA assay. Reactive MPs were tested by TMA after serial dilution to estimate viral load. Testing for anti‐SARS‐CoV‐2 antibodies and infectivity was performed.

Results

A total of 17,995 MPs corresponding to approximately 258,000 donations were tested for vRNA. Three confirmed reactive MP16 were identified. The estimated prevalence of vRNA reactive donations was 1.16/100,000 (95% CI 0.40, 3.42). The vRNA‐reactive samples were non‐reactive for antibody, and the estimated viral loads of the (presumed single) positive donations within each MP ranged from <1000 to <4000 copies/ml. When tested, no infectivity was observed in inoculated permissive cell cultures.

Discussion

Blood donation MP‐nucleic acid testing (NAT) indicated that SARS‐CoV‐2 RNAemia is infrequent and, when detected, the vRNA was at low concentrations. Only one RNA‐reactive MP could be tested for infectivity for operational reasons and was not infectious in cell culture. These findings support current recommendations from international and national regulatory agencies to not screen donors by NAT.
Integrin α4β1 is required for IL‐1α‐ and Nrf2‐dependent, Cox‐2 induction in fibroblasts, supporting a mechanism that suppresses α‐SMA expression
Authors: Zheng Rui , Varney Scott D. , Wu Lei , DiPersio C. Michael , Van De Water Livingston
Published: May 2021

Growth and repair processes, both normal and pathological, require reciprocal interactions between cells and their microenvironment. Integrins are bidirectional, cell surface receptors that transduce mechanical and chemical signals to and from the extracellular matrix. We recently reported that keratinocyte α3β1 is required for interleukin (IL)‐1α secretion. Importantly, IL‐1α regulates fibroblast Cox‐2 expression and prostaglandin E2 (PGE2) secretion, thereby linking keratinocyte integrin function to a paracrine signal that suppresses the myofibroblast phenotype. We now report that fibroblast integrin α4β1 is required for this IL‐1α‐induced, Cox‐2 expression. Moreover, Cox‐2 induction by IL‐1α requires Nuclear factor erythroid 2‐related factor 2 (Nrf2), the master regulator of redox homeostasis; and integrin α4β1 is necessary to maintain IL‐1α‐dependent, Nrf2 levels. Treating fibroblasts with a Nrf‐2 activating compound inhibits TGF‐β‐dependent, alpha smooth muscle actin (α‐SMA) expression and stress fibre formation. Our data suggest that fibroblast integrin α4β1 regulates—depending on microenvironmental cues—the differentiated state of fibroblasts through a signalling network in which IL‐1α, Cox‐2 and Nrf2 participate.
Correlations Between Medicine Ball Throw With Wheelchair Mobility and Isokinetic Tests in Basketball Para-Athletes
Authors: Ribeiro Neto Frederico , Loturco Irineu , Henrique Lopes Guilherme , Rodrigues Dorneles Jefferson , Irineu Gorla José , Gomes Costa Rodrigo Rodrigues
Published: May 2021

Context: A detailed analysis of wheelchair basketball skills in beginner wheelchair basketball players (WBP) can provide practitioners with important indications regarding the selection and prospective development of potential sports talents. A comprehensive WBP evaluation can be very time consuming, mainly during the initial phases of the training processes, which could be a barrier in clinical and practical settings. Moreover, the large number and the turnover of beginner WBP attending rehabilitation centers make the applicability of field and strength tests unfeasible. Objective: To verify the relationships between the medicine ball throw (MBT) and wheelchair basketball mobility performance field tests and the shoulder and trunk peak torque in male and female beginner WBP. Design: Cross-sectional study. Setting: Rehabilitation Hospital Network, Paralympic Program. Participants: Thirty-seven female and male beginner WBP. Main Outcomes Measures: Participants performed wheelchair basketball field tests (speed, agility, strength, and power tests) and the maximum strength test in the isokinetic dynamometer. The outcomes were correlated with the MBT results. Results: The MBT presented significantly very high and perfect correlations with all wheelchair basketball field tests assessed (5-m sprint, 20-m sprint, and zig-zag agility test with and without a ball), and peak torque (R2 ranging from .810 to .995; P ≤ .05) for male and female athletes. Conclusions: The MBT, a simple and feasible test, can be used for estimating and determining the wheelchair mobility performance of female and male beginner WBP. It is suggested to measure the distance of a 5-kg medicine ball thrown by athletes during training and testing routines to follow the players’ progression.
The Nocebo Effect and Pediatric Concussion
Authors: Kirkwood Michael W. , Howell David R. , Brooks Brian L. , Wilson Julie C. , Meehan III William P.
Published: May 2021

While placebo effects are well recognized within clinical medicine, “nocebo effects” have received much less attention. Nocebo effects are problems caused by negative expectations derived from information or treatment provided during a clinical interaction. In this review, we examine how nocebo effects may arise following pediatric concussion and how they may worsen symptoms or prolong recovery. We offer several suggestions to prevent, lessen, or eliminate such effects. We provide recommendations for clinicians in the following areas: terminology selection, explicit and implicit messaging to patients, evidence-based recommendations, and awareness of potential biases during clinical interactions. Clinicians should consider the empirically grounded suggestions when approaching the care of pediatric patients with concussion.
Gestational low-dose BPA exposure impacts suprachiasmatic nucleus neurogenesis and circadian activity with transgenerational effects
Authors: Nesan Dinushan , Feighan Kira M. , Antle Michael C. , Kurrasch Deborah M.
Published: May 2021

Fetal BPA exposure, even below safe regulatory limits, disrupts the developing hypothalamus and affects behavior and activity.
Visualizing 3D imagery by mouth using candy-like models
Authors: Baumer Katelyn M. , Lopez Juan J. , Naidu Surabi V. , Rajendran Sanjana , Iglesias Miguel A. , Carleton Kathleen M. , Eisenmann Cheyanne J. , Carter Lillian R. , Shaw Bryan F.
Published: May 2021

Edible and nonedible models of complex 3D imagery can be identified by mouth at accuracies equivalent to eyesight.
Draft Genome Sequence of the Wild Edible Mushroom Pleurotus ostreatoroseus DPUA 1720
Authors: Dias da Silva Suelen , Carvalho dos Santos Eliane , Mendes Cordeiro da Silva Waldeyr , Alves da Silva Magalhães Alessandra , Perrone Barbosa Elliza Emily , Simas Teixeira Maria Francisca , Pereira José Odair , da Mota Adolfo José
Published: May 2021

The draft whole-genome sequence of the mushroom
Pleurotus ostreatoroseus
DPUA 1720 (38,588,587 bp) is presented here. This report contributes to the prospective research for bioactive compounds in the genus
Pleurotus
.
Supplemental Material: Slab-derived sulfate generates oxidized basaltic magmas in the southern Cascade arc (California, USA)
Authors: Muth Michelle , Wallace Paul
Published: May 2021

Tables S1–S14, Figures S1–S16, and supplemental methods.
Supplemental Material: Excess ice loads in the Indian Ocean sector of East Antarctica during the last glacial period
Authors: Ishiwa Takeshige , al. et
Published: May 2021

Sea-level dataset and glacial isostatic adjustment modeling results.
Supplemental Material: Refining the Paleoproterozoic tectonothermal history of the Penokean Orogen: New U-Pb age constraints from the Pembine-Wausau terrane, Wisconsin, USA
Authors: Zi Jian-Wei , al. et
Published: May 2021

Sample locations, photomicrographs and backscattered electon images Figures S1-S4, and data Tables S1-S11.
Scoping review of the psychosocial aspects of infertility in developing countries: protocol
Authors: Salie Mariam , Roomaney Rizwana , Andipatin Michelle , Volks Cal
Published: May 2021

Introduction

Infertility is a widespread social phenomenon. For both women and men, there are several psychosocial issues associated with infertility. Numerous systematic reviews have focused on individuals’ psychosocial issues pertaining to infertility, however, these have been conducted in developed countries. Thus, there is a gap in the current literature to analyse individuals’ psychosocial issues associated with infertility in developing countries. Given that there are various contextual factors to consider for appropriate interventions to be implemented, it is vital to explore this topic in a developing context.

Methods and analysis

A scoping review will be conducted. A total of 12 databases were identified and a search string including terms related to infertility, psychosocial aspects and developing countries was developed. The inclusion and exclusion of each article will be determined through the guidelines provided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow chart. Quantitative and qualitative data will be collated. The findings will summarise existing research on psychosocial aspects of infertility in developing countries and identify gaps in the research corpus.

Ethics and dissemination

Data will not be collected from participants. Instead, data will be extracted from published studies and therefore no ethical approval is required. The findings will be published in a peer-reviewed journal.
Erectile dysfunction and penile rehabilitation after pelvic fracture: a systematic review and meta-analysis
Authors: Schmid Florian A , Held Ulrike , Eberli Daniel , Pape Hans-Christoph , Halvachizadeh Sascha
Published: May 2021

Objective

To investigate the rate of erectile dysfunction (ED) after pelvic ring fracture (PRF).

Design

Systematic review and meta-analysis.

Methods

A systematic literature search of the Cochrane, EMBASE, MEDLINE, Scopus and Web of Science Library databases was conducted in January 2020. Included were original studies performed on humans assessing ED after PRF according to the 5-item International Index of Erectile Function (IIEF-5) questionnaire and fracture classification following Young and Burgess, Tile or Arbeitsgemeinschaft für Osteosynthesefragen/Orthopedic Trauma Association. Furthermore, interventional cohort studies assessing the effect of penile rehabilitation therapy with phosphodiesterase-5-inhibitors (PDE-5-I) on IIEF-5 scores compared before and after treatment were included. Results were presented as forest plots of proportions of patients with ED after PRF or mean changes on IIEF-5 questionnaires before and after penile rehabilitation. Studies not included in the quantitative analysis were narratively summarised. Risk of bias assessment was conducted using the revised tool for the Quality Assessment on Diagnostic Accuracy Studies.

Results

The systematic literature search retrieved 617 articles. Seven articles were included in the qualitative analysis and the meta-analysis. Pooled proportions revealed 37% of patients with ED after suffering any form of PRF (result on probability scale pr=0.37, 95% CI: 0.26 to 0.50). Patients after 3 months of penile rehabilitation therapy reported a higher IIEF-5 score than before (change score=6.5 points, 95% CI: 2.54 to 10.46, p value=0.0013).

Conclusion

Despite some heterogeneity and limited high-quality research, this study concludes that patients suffering from any type of PRF have an increased risk of developing ED. Oral intake of PDE-5-I for the purpose of penile rehabilitation therapy increases IIEF-5 scores and may relevantly influence quality-of-life in these patients.

PROSPERO registration number

CRD42020169699.
Efficacy of calcium dobesilate in treating Chinese patients with mild-to-moderate non-proliferative diabetic retinopathy (CALM-DR): protocol for a single-blind, multicentre, 24-armed cluster-randomised, controlled trial
Authors: Hu Hao , Liu Jiang , Wang Duolao , Qiu Shanhu , Yuan Yang , Wang Fenghua , Wen Liang , Song Qi , Sun Zi-lin
Published: May 2021

Introduction

Calcium dobesilate (CaD) has been used in the treatment of diabetic retinopathy (DR) due to its potential in protecting against retinal vascular damage. However, there is limited evidence exploring its efficacy in combating DR progression. This study is aimed at evaluating whether CaD could prevent DR progression into an advanced stage among Chinese patients with mild-to-moderate non-proliferative DR (NPDR).

Methods and analysis

This study is a single-blind, multicentre, cluster-randomised, controlled superiority trial. A total of 1272 patients with mild-to-moderate NPDR will be enrolled and randomly assigned at a 1:1 ratio into the control group (conventional treatment group) and the intervention group (conventional treatment plus CaD (500 mg three times per day) for 12 months). Patients will be followed at 1, 3, 6 and 12 months after randomisation and receiving treatments, with the severity of DR assessed by the Early Treatment Diabetic Retinopathy Study (ETDRS) scale. The primary endpoint is the progression of DR during follow-up, which is defined as an increase of two or more steps in the ETDRS scale. The secondary endpoints include the concomitant changes in visual acuity, presence, number, location and type of retinal lesions, and retinal blood vessel diameter as well as the arteriovenous ratio at different visits.

Ethics and dissemination

Each local ethics committee (first Vote: Ethical Review Committees of Zhongda Hospital of Southeast University (2019ZDSYLL132-P01)) has approved the study. The results will be published in high impact peer-reviewed scientific journals aimed at the general reader.

Trial registration numbers

NCT04283162.
Work stress and oral conditions: a systematic review of observational studies
Authors: Sato Yukihiro , Saijo Yasuaki , Yoshioka Eiji
Published: May 2021

Objectives

Although psychological stress is a risk factor for oral diseases, there seems to be no review on work stress. This study aimed to review the evidence on the association between work stress and oral conditions, including dental caries, periodontal status and tooth loss.

Design

A systematic review of published observational studies.

Data sources

A systematic literature search was conducted in PubMed and Scopus databases on 12 August 2020.

Study selection

Articles were screened based on the following inclusion criteria: published after 1966; in English only; epidemiological studies on humans (except case studies, reviews, letters, commentaries and editorials); and examined the association of work stress with dental caries, periodontal status and tooth loss.

Data extraction

Data were extracted from eligible studies. A quality assessment was conducted using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies.

Results

Of 402 articles identified, 11 met the inclusion criteria, and 1 study assessed the association of work stress with dental caries and periodontal status. Of 11 studies, 1 reported a non-significant association between work stress and dental caries; 8 of 9 studies reported a significant association between work stress and worse periodontal status; and 1 of 2 studies reported a significant association between work stress and tooth loss. Nine of 11 studies were cross-sectional, while the remaining 2 studies had unclear methodology. Only two studies were sufficiently adjusted for potential confounders. Eight studies assessed work stress but did not use the current major measures. Three studies were rated as fair, while eight studies had poor quality.

Conclusions

There is a lack of evidence on the association of work stress with dental caries and tooth loss. Eight studies suggested potential associations between periodontal status and work stress. Cohort studies using the major work stress measures and adjusting for the potential confounders are needed.
Intimate partner violence and social connection among married women in rural Bangladesh
Authors: Stoff Laura W , Bates Lisa M , Schuler Sidney Ruth , Renner Lynette M , Erickson Darin J , Osypuk Theresa L
Published: May 2021

Background

Intimate partner violence (IPV) is high among married women in Bangladesh. Social isolation is a well-established correlate of women’s exposure to IPV, but the role of such factors in low-income and middle-income countries is not well understood. In this study, we explore whether social connection is protective against IPV among married women in rural Bangladesh.

Methods

Data were drawn from a multistage, stratified, population-based longitudinal sample of 3355 married women in rural Bangladesh, who were surveyed on individual and contextual risk factors of IPV. Negative binomial regression models were used to estimate the association between three different domains of social connection (natal family contact, female companionship and instrumental social support), measured at baseline in 2013, and the risk of three different forms of IPV (psychological, physical and sexual), approximately 10 months later, adjusted for woman’s level of education, spouse’s level of education, level of household wealth, age and age of marriage.

Results

Adjusted models showed that instrumental social support was associated with a lower risk of past year psychological IPV (risk ratio (RR)=0.84, 95% CI 0.769 to 0.914), sexual IPV (RR=0.90, 95% CI 0.822 to 0.997) and physical IPV (RR=0.81, 95% CI 0.718 to 0.937). Natal family contact was also associated with a lower risk of each type of IPV, but not in a graded fashion. Less consistent associations were observed with female companionship.

Conclusion

Our findings suggest that social connection, particularly in the form of instrumental support, may protect married women in rural Bangladesh from experiencing IPV.
Roles of allostatic load, lifestyle and clinical risk factors in mediating the association between education and coronary heart disease risk in Europe
Authors: Hicks Blánaid , Veronesi Giovanni , Ferrario Marco M , Forrest Hannah , Whitehead Margaret , Diderichsen Finn , Tunstall-Pedoe Hugh , Kuulasmaa Kari , Sans Susana , Salomaa Veikko , Thorand Barbara , Peters Annette , Soderberg Stefan , Cesana Giancarlo , Bobak Martin , Iacoviello Licia , Palmieri Luigi , Zeller Tanja , Blankenberg Stefan , Kee Frank
Published: May 2021

Background

Previous studies have shown that differential exposure to lifestyle factors may mediate the association between education and coronary heart diseases (CHD). However, few studies have examined the potential roles of allostatic load (AL) or differential susceptibility.

Methods

25 310 men and 26 018 women aged 35–74 and CHD free at baseline were identified from 21 European cohorts and followed for a median of 10 years, to investigate the mediating role of AL, as well as of smoking, alcohol use and body mass index (BMI), on educational differences in CHD incidence, applying marginal structural models and three-way decomposition.

Results

AL is a mediator of the association between educational status and CHD incidence, with the highest proportion mediated observed among women and largely attributable to differential exposure, (28% (95% CI 19% to 44%)), with 8% (95% CI 0% to 16%) attributable to differential susceptibility. The mediating effects of smoking, alcohol and BMI, compared with AL, were relatively small for both men and women.

Conclusion

Overall, the educational inequalities in CHD incidence were partially mediated through differential exposure to AL. By contrast, the mediation of the educational gradient in CHD by investigated lifestyle risk factors was limited. As differential susceptibility in men was found to have a predominant role in the accumulation of AL in low educational classes, the investigation of AL-related risk factors is warranted.
Deaths from ‘diseases of despair’ in Britain: comparing suicide, alcohol-related and drug-related mortality for birth cohorts in Scotland, England and Wales, and selected cities
Authors: Walsh David , McCartney Gerry , Minton Jon , Parkinson Jane , Shipton Deborah , Whyte Bruce
Published: May 2021

Background

The contribution of increasing numbers of deaths from suicide, alcohol-related and drug-related causes to changes in overall mortality rates has been highlighted in various countries. In Scotland, particular vulnerable cohorts have been shown to be most at risk; however, it is unclear to what extent this applies elsewhere in Britain. The aim here was to compare mortality rates for different birth cohorts between Scotland and England and Wales (E&W), including key cities.

Methods

Mortality and population data (1981–2017) for Scotland, E&W and 10 cities were obtained from national statistical agencies. Ten-year birth cohorts and cohort-specific mortality rates (by age of death, sex, cause) were derived and compared between countries and cities.

Results

Similarities were observed between countries and cities in terms of peak ages of death, and the cohorts with the highest death rates. However, cohort-specific rates were notably higher in Scotland, particularly for alcohol-related and drug-related deaths. Across countries and cities, those born in 1965–1974 and 1975–1984 had the highest drug-related mortality rates (peak age at death: 30–34 years); the 1965–1974 birth cohort also had the highest male suicide rate (peak age: 40–44 years). For alcohol-related causes, the highest rates were among earlier cohorts (1935–1944, 1945–1954, 1955–1964)—peak age 60–64 years.

Conclusions

The overall similarities suggest common underlying influences across Britain; however, their effects have been greatest in Scotland, confirming greater vulnerability among that population. In addressing the socioeconomic drivers of deaths from these causes, the cohorts identified here as being at greatest risk require particular attention.
Waiting, strange: transplant recipient experience, medical time and queer/crip temporalities
Authors: Wasson Sara
Published: May 2021

People who receive a ‘solid’ organ transplant from a deceased person may experience imaginative challenges in making sense of how the transfer impacts their own past and future, as shown in existing scholarship. Building on such work, this article considers how the temporalities of medical encounter itself may also become temporally ambiguous, posing representational challenges both pre-transplantation and post-transplantation. The dominant narrative of transplant in transplantation journals and hospital communications, both clinical and patient-facing, presents surgery as a healing moment, yet the recipient’s experience of hospital, pharmacology and daily self-monitoring may be disorienting in multiple ways which resist conventional conceptions of medical temporalities of cure. Examining memoirs by Robert Pensack and Richard McCann, this article suggests the transplant temporalities may be fruitfully approached through scholarship of ‘queering’ time and ‘crip’ time. While the medical narrative of transplant focuses on the event of transplantation, these texts construct post-transplant time as still profoundly structured by waiting, expectation and suspense, the transformed body less healed than permanently contingent and fragile in different ways. I do not purport to uncover the ‘truth’ of bleak survival hidden within a story of the miraculous. Rather, I am reaching for a critical practice to recognise subtle entanglements of medicalised time, and identify a tension and synthesis between miracle and the chronic, an insight which may also be of service for other critical approaches to memoir of heroic medicine.
Challenges in the design, interpretation, and reporting of randomized controlled clinical studies on the health effects of whole foods
Authors: Musa-Veloso Kathy , Racey Megan , MacFarlane Amanda , Bier Dennis , Lamarche Benoît , Trumbo Paula , House James
Published: May 2021

Given the challenges with nutrition research, the Canadian Nutrition Society and Intertek Health Sciences Inc held an expert consultation in late 2019 to discuss the development and implementation of best practices for clinical trials on whole foods. Key challenges in the design, interpretation, and reporting of clinical efficacy studies on whole foods and opportunities for the future development of best practices are reported.

Novelty: Outlines existing tools, resources, and checklists for clinical nutrition trials and provides clear and tangible steps to develop best practices for studies on whole foods.
Photochemical reaction of superoxide radicals with 1-naphthol
Authors: Liu Ying , Zhu Mengyu , Hu Yadong , Zhao Yijun , Zhu Chengzhu
Published: May 2021

The photochemical reactions between 1-naphthol (1-NP) and the superoxide anion radical (O2•–) were investigated in detail by using 365 nm UV irradiation. The results showed that the conversion rate of 1-NP decreased with the increase of the initial concentration of 1-NP, whereas by increasing the pH and riboflavin concentration, the photochemical reaction was accelerated. The second-order reaction rate constant was estimated to be (3.64 ± 0.17) × 108 L mol−1s−1. The major photolysis products identified by using gas chromatography – mass spectrometry (GC–MS) were 1,4-naphquinone and 2,3-epoxyresin-2,3-dihydro-1,4-naphquinone, and their reaction pathways were also discussed. An atmospheric model showed that both the bulk water reaction and the heterogeneous surface reaction deserve attention in atmospheric aqueous chemistry.
The complex chemistry of diversity and inclusion: a 30-year synthesis
Authors: Impellizzeri Stefania , Coe Imogen R.
Published: May 2021

Dr. Margaret-Ann Armour’s career as a research chemist, educator, and advocate spanned more than 40 years. Much of her work took place within a disciplinary culture ignorant of the scholarship supporting organizational change towards inclusive excellence. Her contributions are extensively covered in other articles in this special issue, and her achievements are all the more remarkable given that her colleague, Dr. Gordon Freeman, held gender-biased attitudes that he shared in a peer reviewed article in a national science journal. Three decades later, another Canadian chemist, Dr. Tomáš Hudlický, published a peer reviewed essay in an international chemistry journal that included his views on the negative impacts of diversity initiatives on organic synthesis research. Both articles were retracted, but clearly a faulty and pervasively biased peer review system enabled the distribution of prejudiced opinions that were neither informed by demonstrated expertise, nor supported by data. These two events are reflective of challenges that Dr. Armour faced in her efforts to diversify chemical sciences. We need to build on her critical work to increasing awareness about inclusive excellence in chemistry, as well as educating scientists on what constitutes an informed opinion. Here, we use Freeman and Hudlický incidents as case studies to indicate how pervasive bias can be superficially perceived as scientific scholarship. Furthermore, we use analogies of analytical processes to illustrate how talent gets systemically excluded. Finally, we provide recommendations to chemistry community members for improving outcomes in terms of synthesis of new knowledge, ideas, and solutions, toward leveraging all the available human talent and creating an environment that is both excellent and inclusive.
Rehabilitation of concrete one-way slabs using precast prestressed concrete prisms
Authors: Gerami Saeed , Svecova Dagmar
Published: May 2021

The rehabilitation of structures is a complex process that involves many considerations. This paper presents results of a feasibility study on the use of precast prestressed concrete prisms (PCPs) as a near-surface mounted reinforcement for rehabilitation of cracked one-way slabs. The PCPs were cast with high-strength concrete and were concentrically prestressed by one 9 mm diameter stress-relieved seven-wire steel strand. Six identical one-way slabs with a length of 3000 mm, a width of 600 mm, and a depth of 200 mm were tested. They were first loaded until cracking, then were fully unloaded and subsequently rehabilitated with four PCPs before loading them to failure. Deflected profiles and crack widths of the slabs before and after rehabilitation were compared in this research. This rehabilitation method reduced the magnitude of deflection and crack width of the samples. The cracks induced in the first phase of loading before PCP rehabilitation appeared fully closed after the PCP rehabilitation until load equal to five times the original cracking loads of the slabs was reached.