bluuebunny/crossref_metadata_2025 huggingface dataset:
Chromosome‐level genome assembly of burbot (Lota lota) provides insights into the evolutionary adaptations in freshwater
Authors: Han Zhiqiang , Liu Manhong , Liu Qi , Zhai Hao , Xiao Shijun , Gao Tianxiang
Published: March 2021

The burbot (Lota lota) is the only member of the order Gadiformes adapted solely to freshwater. This species has the widest longitudinal range among freshwater fish worldwide. Burbot serves as a good model for studies on adaptive genome evolution from marine to freshwater environments. However, a high‐quality reference genome of burbot has not yet been released. Here, the first chromosome‐level genome of burbot was constructed using PacBio long sequencing and Hi‐C technology. A total of 95.24 Gb polished PacBio sequences were generated, and the preliminary genome assembly was 575.83 Mb in size with a contig N50 size of 2.15 Mb. The assembled sequences were anchored to 22 pseudochromosomes by using Hi‐C data. The final assembled genome after Hi‐C correction was 575.92 Mb, with a contig N50 of 2.01 Mb and a scaffold N50 of 22.10 Mb. A total of 22,067 protein‐coding genes were predicted, 94.82% of which were functionally annotated. Phylogenetic analyses indicated that burbot diverged with the Atlantic cod approximately 43.8 million years ago. In addition, 377 putative genes that appear to be under positive selection in burbot were identified. These positively selected genes might be involved in the adaptation to the freshwater environment. These genome data provide an invaluable resource for the ecological and evolutionary study of the order Gadiformes.
High cost of illness in fibromyalgia patients in Iran, irrespective of disease severity: A prospective cost study
Authors: Gharibpoor Faeze , Nasrollahzadeh Elaheh , Ghavidel‐Parsa Banafshesh , Ghaffari Mohammad Ebrahim , Bidari Ali
Published: March 2021

Aims

This study aimed to estimate the economic burden of fibromyalgia (FM) in 6 months, using a cost‐diary, and to evaluate its relationship with the disease severity.

Methods

This is a prospective cost‐of‐illness study on 62 participants with an FM diagnosis within a 6 month period. Patients completed the questionnaires, including FIQR (Revised Fibromyalgia Impact Questionnaire) and SF‐12 (12‐item short‐form survey). The cost‐diary method was used to track the cost of the disease. The participants received six cost‐diary booklets during the study period to report their FM‐related costs, hours, and days of productivity loss. The final costs are reported in US dollars.

Results

Most of the participants were women (90.3%) with a mean (±SD) age of 40.80 (±5.50) years and a mean (±SD) FIQR score of 54.38 (±14.13). Moreover, 45.2% of patients fulfilled all six booklets, whereas 24.2% returned only one booklet. The participants showed a mean (±SD) direct healthcare, non‐healthcare, and indirect cost of $ 2817.08 (±$ 1860.04), $ 1497.98(±$ 1358.21), and $ 1449.05(±$ 3637.41) per patient for 6 months, respectively.

Conclusion

Fibromyalgia is associated with high health‐related and non‐health‐related costs in our country, irrespective of its severity. This study warrants urgent consideration in managing the disease burden on both patients and society.
Digital Health in Response to COVID‐19 in Low‐ and Middle‐income Countries: Opportunities and Challenges
Authors: Mitgang Elizabeth A. , Blaya Joaquin A. , Chopra Mickey
Published: March 2021

COVID‐19 has pulled back the curtain on health system fragility to expose persistent and deepening inequities worldwide. The limited capacity of low‐ and lower‐middle income countries (LMICs) to respond to the pandemic and its impact on the health of populations – particularly the most vulnerable – presents a marked challenge. In this context, countries face the enormous task of rethinking the way essential services will be delivered. A critical and essential part of solving these challenges will be using information and communication technology and digital health to enhance direct communication with the public; scale proven and innovative service delivery models; and empower the frontlines. However, if the deployment, adaptation, or expansion of these innovations are not user‐centered for the most marginalized or do not learn from past lessons, it could be highly wasteful at best. At worst, such shortcomings could exacerbate pre‐existing weaknesses in the health care system such as exclusion of peripheral populations, disempowerment of health workers, and proliferation of unregulated private providers. We provide recommendations of which innovations should be prioritized and implementation principles to address the current challenges while responding to the need to fundamentally change service delivery for accelerated impact.
Characteristics and outcomes of thymomas in Latin America: Results from over 10 years of experience (CLICaP‐LATimus)
Authors: Martín Claudio , Enrico Diego , Mas Luis , Patane Ana Karina , Arrieta Oscar , Soria Tannia , Cardona Andrés F. , Ruiz‐Patiño Alejandro , Ruiz Rossana , Rioja Patricia , Lozano Sophia , Zatarain‐Barrón Zyanya Lucia , Barrón Feliciano , Puparelli Carmen , Tsou Florencia , Corassa Marcelo P. , Freitas Helano C. , Cordeiro de Lima Vladmir Cláudio , Rojas Leonardo , Ordóñez‐Reyes Camila , Corrales Luis , Sotelo Carolina , Rodríguez July , Ricaurte Luisa , Ávila Jenny , Archila Pilar , Rosell Rafael , Cuello Mauricio , Remon Jordi ,   CLICaP
Published: March 2021

Background

Thymomas are a group of rare neoplasms of the anterior mediastinum. The objective of this study was to describe the demographics, clinical characteristics and treatment approaches in Latin America.

Methods

This was a retrospective multicenter cohort study including patients with histologically proven thymomas diagnosed between 1997 and 2018. Demographics, clinicopathological characteristics and therapeutic outcomes were collected locally and analyzed in a centralized manner.

Results

A total of 135 patients were included. Median age at diagnosis was 53 years old (19–84), 53.3% (n = 72) of patients were female and 87.4% had an ECOG performance score ranging from 0–1. A total of 47 patients (34.8%) had metastatic disease at diagnosis. Concurrent myasthenia gravis occurred in 21.5% of patients. Surgery was performed in 74 patients (54.8%), comprising 27 (20%) tumorectomies and 47 (34.8%) thymectomies. According to the Masaoka‐Koga system, overall survival (OS) at five‐years was 73.4%, 63.8% and 51%, at stages I–II, III–IVA and IVB, respectively (p = 0.005). Furthermore, patients with low lactate dehydrogenase (LDH) (≤373 IU/L) at baseline and myasthenia gravis concurrence showed significantly better OS (p = 0.001 and p = 0.008, respectively). In multivariate analysis, high LDH levels (HR 2.8 [95% confidence interval [CI]: 1.1–7.8]; p = 0.036) at baseline and not performing a surgical resection (HR 4.1 [95% CI: 1.3–12.7]; p = 0.016) were significantly associated with increased risk of death.

Conclusions

Our data provides the largest insight into the clinical characteristics and outcomes of patients with thymomas in Latin America. Survival in patients with thymomas continues to be very favorable, especially when subjected to adequate local control.
Clinical‐therapeutic study on the efficacy and safety of thalidomide in the management of discoid lupus erythematosus. A single‐centre, retrospective study
Authors: Tirado‐Sánchez Andrés , Aguilar‐Mena Cristina , Rodriguez‐Mendoza Angeles , Hernández‐Salgado Yesica , Bonifaz Alexandro
Published: March 2021

Thalidomide is a second‐line treatment for discoid lupus erythematosus (DLE). The efficacy of this treatment, the minimum effective doses, and safety is poorly documented in the literature. The aim of the study was to determine the efficacy and tolerance of thalidomide as first or second line of therapy for discoid lupus erythematosus. We present a retrospective single‐centre study of 68 patients with DLE treated with thalidomide from 2003 to 2019. The inclusion criteria were the presence of clinical lesions suggestive of DLE, confirmed by histological examination and direct immunofluorescence. The mean age at diagnosis was 37.45 years (range 18–65 years). Thalidomide was started an average of 2.25 years after the diagnosis of DLE, as second‐line therapy in 85% of the cases (58 patients), and as first‐line therapy in 10 patients (15%). Fifty‐six patients improved with thalidomide (82%), 39 cases achieved complete remission and 17 partial remissions. The mean duration of follow‐up with thalidomide was 8.4 months (range 3–25 months). Five patients discontinued thalidomide due to adverse events. The most frequent side effect was headache (23.5%). Thalidomide is effective and safe in DLE patients as first or second‐line treatment with a good safety profile.
Cutaneous manifestations of patients with Human Immunodeficiency Virus (HIV) Infection: A retrospective review of a tertiary referral centre with clinicopathological correlation
Authors: Han Winn Hui , Yong Jo Yen , Yong Shin Shen , Faheem Nik Aimee Azizah , Toh Yen Fa , Chew Man Fong , Kwan Zhenli , Azwa Iskandar
Published: March 2021

Introduction

The majority of patients with Human Immunodeficiency Virus (HIV) will have cutaneous manifestation during their disease course. We report the spectrum of cutaneous manifestations and clinicopathological concordance in the diagnosis of skin diseases in patients with HIV.

Methods

A retrospective review of all cutaneous manifestations of HIV‐infected patients with skin biopsy‐proven histopathological confirmation, treated in the University of Malaya Medical Centre, from 2016 till 2018, was performed. Clinical characteristics and histopathological correlation of these patients were reviewed.

Results

A total of 38 cases were included where the median age was 40.5 (interquartile range (IQR) 13.3). The median duration of HIV diagnosis to the development of skin disease was 3 years (IQR 7.8). Majority of our patients were male (89.5%, n = 34), and the commonest mode of transmission is men who have sex with men (36.8%, n = 14). Most patients (92.1%, n = 35) had Acquired Immunodeficiency Syndrome when they presented with skin diseases, predominantly non‐infectious types (51.4%, n = 19). Commonest skin diseases include eczema (n = 7) and pruritic papular eruption of HIV (n = 6). Papules and plaques were the commonest morphology for both infectious and non‐infectious skin diseases.

Duration of HIV diagnosis (P = 0.018) and non‐compliance to Highly Active Antiretroviral Therapy (HAART) (P = 0.014) were significantly associated with the development of non‐infectious skin diseases. Overall, clinicopathological concordance was 84.2% in our centre.

Conclusion

A wide spectrum of cutaneous diseases can occur in HIV patients depending on the degree of immunosuppression. skin biopsy along with appropriate stains, and microbiological cultures are important in helping clinicians clinch the right diagnosis.
Collective rumination: When “problem talk” impairs organizational resilience
Authors: Knipfer Kristin , Kump Barbara
Published: March 2021

When adversity strikes, organization members often turn to others in order to vent their negative emotions and receive social support. While social interaction is commonly seen as a major resource for organizational resilience, dysfunctional social interactions and their negative effects on coping with and overcoming adversity are less well understood. This conceptual article develops theory on collective rumination—defined as repetitive and prolonged discussions of adverse events that center on the negative and uncontrollable aspects of the situation—and its detrimental effects on organizational resilience. We elaborate that collective rumination emerges through a vicious circle of a shared negative situational assessment and mutual contagion with highly negative emotions. Based on our theorizing, we propose that collective rumination is negatively related to three core dimensions of organizational resilience: perceptions of control, commitment to joint action, and the acceptance of adversity as a challenge. With our conceptual article, we answer earlier calls to theorize about forms of social interactions that are not valuable but destructive for organizational resilience and elucidate previously neglected social dynamics that are dysfunctional for recovering from adversity.
Individualized model for predicting COVID‐19 deterioration in patients with cancer: A multicenter retrospective study
Authors: Xu Bin , Song Ke‐Han , Yao Yi , Dong Xiao‐Rong , Li Lin‐Jun , Wang Qun , Yang Ji‐Yuan , Hu Wei‐Dong , Xie Zhi‐Bin , Luo Zhi‐Guo , Luo Xiu‐Li , Liu Jing , Rao Zhi‐Guo , Zhang Hui‐Bo , Wu Jie , Li Lan , Gong Hong‐Yun , Chu Qian , Song Qi‐Bin , Wang Jie
Published: March 2021

The 2019 novel coronavirus has spread rapidly around the world. Cancer patients seem to be more susceptible to infection and disease deterioration, but the factors affecting the deterioration remain unclear. We aimed to develop an individualized model for prediction of coronavirus disease (COVID‐19) deterioration in cancer patients. The clinical data of 276 cancer patients diagnosed with COVID‐19 in 33 designated hospitals of Hubei, China from December 21, 2019 to March 18, 2020, were collected and randomly divided into a training and a validation cohort by a ratio of 2:1. Cox stepwise regression analysis was carried out to select prognostic factors. The prediction model was developed in the training cohort. The predictive accuracy of the model was quantified by C‐index and time‐dependent area under the receiver operating characteristic curve (t‐AUC). Internal validation was assessed by the validation cohort. Risk stratification based on the model was carried out. Decision curve analysis (DCA) were used to evaluate the clinical usefulness of the model. We found age, cancer type, computed tomography baseline image features (ground glass opacity and consolidation), laboratory findings (lymphocyte count, serum levels of C‐reactive protein, aspartate aminotransferase, direct bilirubin, urea, and d‐dimer) were significantly associated with symptomatic deterioration. The C‐index of the model was 0.755 in the training cohort and 0.779 in the validation cohort. The t‐AUC values were above 0.7 within 8 weeks both in the training and validation cohorts. Patients were divided into two risk groups based on the nomogram: low‐risk (total points ≤ 9.98) and high‐risk (total points > 9.98) group. The Kaplan‐Meier deterioration‐free survival of COVID‐19 curves presented significant discrimination between the two risk groups in both training and validation cohorts. The model indicated good clinical applicability by DCA curves. This study presents an individualized nomogram model to individually predict the possibility of symptomatic deterioration of COVID‐19 in patients with cancer.
Transcriptional dysregulation by aberrant enhancer activation and rewiring in cancer
Authors: Okabe Atsushi , Kaneda Atsushi
Published: March 2021

Cell identity is controlled by regulatory elements, such as promoters, enhancers, and insulators, within the genome. These regulatory elements interact in the nucleus and form tissue‐specific chromatin structures. Dysregulation of these elements and their interactions can lead to loss of cell identity and promote the development of diseases such as cancer. Tumor cells acquire aberrantly activated enhancers at oncogenic driver genes through various mechanisms. Small genomic changes such as mutations, insertions, and amplifications can form aberrant enhancers. Genomic rearrangements at the chromosomal level, including translocations and inversions, are also often observed in cancers. These rearrangements can result in repositioning of enhancers to locations near tumor‐type‐specific oncogenes. Chromatin structural changes caused by genomic or epigenomic changes lead to mis‐interaction between enhancers and proto‐oncogenes, ultimately contributing to tumorigenesis through activation of oncogenic signals. Additional epigenomic mechanisms can also cause aberrant enhancer activation, including those associated with overexpression of oncogenic transcription factors and the mutation of transcriptional cofactors. Exogenous viral DNA can also lead to enhancer aberrations. Here, we review the mechanisms underlying aberrant oncogene activation through enhancer activation and rewiring, both of which are caused by genomic or epigenomic alterations in non‐coding regions.
Insectivorous bat occupancy is mediated by drought and agricultural land use in a highly modified ecoregion
Authors: Smith Trinity N. , Furnas Brett J. , Nelson Misty D. , Barton Daniel C. , Clucas Barbara
Published: March 2021

Aim

California's Central Valley, one of the most productive agricultural regions worldwide, is home to a high number of at‐risk species due to habitat conversion. Amplifying the issue, the Central Valley faces severe droughts, creating water scarcity in surrounding natural areas. At least 14 insectivorous bat species live in this region, and prior studies show mixed results regarding the impact of agriculture and drought on bats. The aim of this study was to investigate how bats use agricultural areas during drought.

Location

Central Valley, California, United States.

Methods

We deployed ultrasonic acoustic detectors at 274 sites from March through July of 2016, the final year of an extreme drought, and 2017, one of the wettest years on record. We identified bats to species, used single‐species occupancy models including biologically relevant covariates and created spatial projections of ecoregion‐wide occupancy for each species.

Results

We modelled occupancy for eight bat species. Long‐distance migrants in the study area contracted their geographic range during the drought, while resident species did not. Five of the eight bats in this analysis were more likely to occupy areas with orchard crop cover. Lastly, arid‐adapted bats used cultivated landscapes during the drought but retracted their range after the drought ended.

Main conclusions

Migratory bats appeared to shift occupancy more during drought than resident bats, possibly because of lower roost fidelity. Additionally, the effects of drought on some bat species in the Central Valley may be buffered by agricultural landscapes acting as drought refugia. Overall, this study demonstrates the benefits of broad‐scale acoustic studies which can serve as a tool to track changing bat distributions on the landscape and provide baseline occupancy for acoustically detectable species.
The burden of poor glycaemic control in people with newly diagnosed type 2 diabetes in Sweden: A health economic modelling analysis based on nationwide data
Authors: Hellgren Margareta , Svensson Ann‐Marie , Franzén Stefan , Ericsson Åsa , Gudbjörnsdottir Soffia , Ekström Nils , Bertilsson Rebecka , Valentine William , Malkin Samuel
Published: March 2021

Aim

To evaluate the economic and clinical burden associated with poor glycaemic control in Sweden, in people with type 2 diabetes (T2D) initiating first‐line glucose‐lowering therapy.

Materials and Methods

Population data were obtained from Swedish national registers. Immediate glycaemic control was compared with delays in achieving control of 1 and 3 years, with outcomes projected over 3, 10 and 50 years in the validated IQVIA CORE Diabetes Model. Glycaemic control was defined as glycated haemoglobin (HbA1c) targets of 52, 48 and 42 mmol/mol, as recommended in Swedish guidelines, according to age and disease duration. Costs (expressed in 2019 Swedish krona [SEK]) were accounted from a Swedish societal perspective.

Results

Immediate glycaemic control was associated with population‐level cost savings of up to SEK 279 million and SEK 673 million versus delays of 1 and 3 years, respectively, as well as small population‐level life expectancy benefits of up to 1305 and 2590 life years gained. Reduced levels of burden were a result of lower incidence and delayed time to onset of diabetes‐related complications.

Conclusions

Even in people with T2D initiating first‐line glucose‐lowering therapy, the economic burden of poor glycaemic control in Sweden is substantial, but could be reduced by early and effective treatment to achieve glycaemic targets.
Unusual complication of late presentation deceleration aortic injury
Authors: Risher William , Stevenson Samuel , Danrad Raman , Kerut Edmund K. , Batson Robert , Bhalla Ritu , Vander Heide Richard , Hollier Larry H.
Published: March 2021

A 50‐year‐old patient presented with a stroke. An ascending aortic mass noted by computed tomography was attached to the aortic wall and was found to be thrombus at surgery. Pathologic examination revealed an intraluminal thrombus attached to a focal segment of intimal fragmentation. Sectioning of the aortic wall revealed what were findings consistent with what would be noted with a previously unrecognized traumatic ascending aortic deceleration injury. To our knowledge, this is the first case of a late presentation of deceleration aortic injury, presenting with a thrombus within the ascending aorta.
The interaction processes of the fish assemblages between the Yangtze River and Poyang Lake, China
Authors: Zhang Chen , Li Mingzheng , Chang Tao , Gao Xin , Liu Huanzhang , Cao Wenxuan
Published: March 2021

Lateral hydrological connectivity (LHC) maintains the high biodiversity and ecosystem functions in the river–floodplain system. We investigated the changes in the taxonomic and functional composition of fish assemblages in the lateral connection channel between the Yangtze River and Poyang Lake, China, during the dry and wet seasons and which factors drive the changes. The results indicated more lake‐residence species and fewer river–lake species in the channel during the wet season than the dry season, leading to significant seasonal differences in taxonomic compositions and trait patterns. Water temperature, water level and fish migration influenced fish assemblage structures in the channel. Water‐level fluctuations that limited food sources and suitable habitats promoted the migration of riverine and lake‐residence fish during both seasons. Water temperature and level also significantly influenced species‐specific migration. Water temperature influenced the spawning migration of river–lake fish during the wet season. Based on these results, we found temporal species‐specific migration dynamics in fish assemblages in the lateral channel that were related to species’ life‐history traits. Therefore, we inferred that the temporal–spatial interaction of the fish community in the river–floodplain system is essentially derived from the evolutionary adaption to the monsoon climate. This process is well studied and predictable, and can be beneficial for managing the river–floodplain systems. The invasion risk of the exotic species, including fish and macroinvertebrates, should be assessed before implementing LHC restoration.
Reflections of psychomotor skill development in preclinical simulation: A qualitative analysis
Authors: Ziada Hassan M. , Ditmyer Marcia M. , Abubakr Neamat H.
Published: March 2021

Introduction

Reflection on competency helps students become more proficient in performing skills, with the ultimate goal of better retention of knowledge and skill. Competency progression involves a complex interplay of factors, and not having the insight of such multiple perspectives of the same experience, we will not be able to understand students as learners fully and consequently may rely on assumption and may not be able to provide the necessary interventions for growth and progress towards competency. This study aims to investigate students' insight of their own progression during psychomotor skill development.

Materials and Methods

Data were obtained from scanned reflective dialogue log document portfolios from the preclinical fixed dental prosthodontics section, which is part of a comprehensive dental care course during the second year. Data were coded using NVivo software version 12 plus (QSR International Pty Ltd, Vic, Australia), and subsequent thematic analyses identified emerging themes.

Results

Three themes emerged and these were (a) challenges to overcome, (b) feed‐back and self‐appraisal, and (c) progress and growth. The qualitative data generated did not reveal considerable variation in the students' reflections, and the three themes seem to interrelate.

Conclusions

The main challenge was the concept of the single path of insertion and the perception that it was a source of frustration during this course. Self‐appraisal identified time management issues and the transformation from preconceived or learned concepts. As the semester progressed, students reflected progress and growth.
Multivariate‐bounded Gaussian mixture model with minimum message length criterion for model selection
Authors: Azam Muhammad , Bouguila Nizar
Published: March 2021

Bounded support Gaussian mixture model (BGMM) has been proposed for data modelling as an alternative to unbounded support mixture models for the cases when the data lies in bounded support. In this paper, we propose applications of multivariate BGMM in data clustering for more insightful analysis of the model. We also propose minimum message length (MML) criterion for model selection in data clustering using multivariate BGMM. The presented model is applied to data clustering in several speech (TSP and Spoken Digits) and image databases (MNIST and Fashion MNIST). We also propose the application of BGMM in code‐book generation at feature extraction phase. Inspired by the success of bag of visual words approach in computer vision, it is also introduced in speech data representation and validated through experiments presented in this paper. For validation of model selection criterion, MML is applied to different medical, speech and image datasets. Experimental results obtained during the model selection through MML are further compared with seven different model selection criteria. The results presented in the paper demonstrate the effectiveness of BGMM for clustering speech and image databases, code‐book generation through clustering for feature representation and model selection.
Defect‐based multiaxial fatigue life prediction of L‐PBF additive manufactured metals
Authors: Sanaei Niloofar , Fatemi Ali
Published: March 2021

Fatigue cracks in additively manufactured (AM) components typically initiate from critical defects such as gas porosities and lack of fusion defects. In addition, such components are often subjected to multiaxial stresses at fatigue critical locations due to complex geometry and/or multiaxial loads. In this work, a fracture mechanics framework based on defects and their characteristics was used for multiaxial fatigue life prediction of laser‐based powder bed fusion (L‐PBF) fabricated Ti‐6Al‐4V and 17‐4 PH specimens as illustrative examples. Modes I and II and mixed‐mode small crack growth were considered in the predictions based on the experimentally observed damage mechanisms, depending on the metal, fabrication process, and post‐process treatment conditions. Implications of initial defects characteristics under multiaxial loading and the effect of roughness‐induced closure in mixed‐mode crack growth are also discussed.
Gender disparities operate in opposite directions for hospitalizations and mortality among individuals receiving long‐term ART in rural Uganda
Authors: Massah G , Zhang W , Birungi J , Nanfuka M , Zhu J , Okoboi S , Kaleebu P , Tibenganas B , Moore DM
Published: March 2021

Objectives

We conducted an analysis to determine if differences in health‐seeking behaviour can explain gender disparities in mortality among long‐term survivors receiving antiretroviral therapy (ART) in rural Uganda.

Methods

From June 2012 to January 2014, we enrolled patients receiving a first‐line ART regimen for at least 4 years without previous viral load (VL) testing in Jinja, Uganda. We measured HIV VL at study entry. We switched participants to second‐line therapy, if VL was ≥ 1000 copies/mL on two measurements, and followed participants for 3 years. We collected clinical and behavioural data at enrolment and every 6 months after that. We used Poisson regression to examine factors associated with hospitalizations and Cox proportional hazards modelling to assess mortality to September 2016.

Results

We enrolled 616 participants (75.3% female), with a median age of 44 years and a median duration of ART use of 6 years. Of these, 113 (18.3%) had VLs ≥ 1000 copies/mL. Hospitalizations occurred in 101 participants (7% of men vs. 20% of women; P < 0.001). A total of 22 (3.6%) deaths occurred, 9% of men vs. 2% of women (P < 0.001). Multivariate modelling revealed that mortality was associated with age [adjusted hazard ratio (AHR) = 1.07 per year increase; 95% confidence interval (CI): 1.01–1.13], male gender (AHR = 2.57; 95% CI 1.06–6.23) and time‐updated CD4 counts (AHR = 0.67 per 100 cell increment; 95% CI: 0.52–0.88). Virological failure was not associated with mortality (P = 0.762).

Conclusion

Female patients receiving ART in rural Uganda were three times more likely to be hospitalized than men, but male mortality was nearly four times higher. Facilitating care for acute medical problems may help to improve survival among male ART patients.
Light pollution is the fastest growing potential threat to firefly conservation in the Atlantic Forest hotspot
Authors: Vaz Stephanie , Manes Stella , Gama‐Maia Danielle , Silveira Luiz , Mattos Gustavo , Paiva Paulo C. , Figueiredo Marcos , Lorini Maria Lucia
Published: March 2021

In addition to being threatened by habitat loss derived from deforestation and urbanisation, fireflies are further deeply impacted by light pollution, which impairs their unique use of light signals to communicate and track females. The impact of stressors that can lead to declines in firefly populations is poorly known in the southern hemisphere, including the Atlantic Forest where they are especially diverse, associated with lack of knowledge about their distributions.

Here, we model the potential distribution of the tracker ghost fireflyAmydetes fastigiataand investigate whether light pollution, urbanisation and deforestation are increasing over time in this area.

We found that light pollution is the stressor with the most prominent increase rates over its distribution. Light pollution is significantly increasing in extent and intensity over time, outpassing urbanisation and deforestation which increased at lower rates. Protected areas successfully buffer effects of urbanisation and deforestation, but are incapable to halt the spread of light pollution.

Increasing light pollution is especially concerning due to the spotlighting behaviour ofA. fastigiatato track females through the night, which is imperilled by overshadowing lights. Light pollution trends are increasing fast and should be considered as a significant stressor even within protected areas – which calls for a reform in regional conservation policies and designation of new areas to be prioritised.

We presented a framework for the evaluation of threat rates based on species distribution models that can foster future research and assess vulnerabilities of important species facing global change.
Assessing long‐term effects of artificial light at night on insects: what is missing and how to get there
Authors: Kalinkat Gregor , Grubisic Maja , Jechow Andreas , van Grunsven Roy H. A. , Schroer Sibylle , Hölker Franz
Published: March 2021

Widespread and significant declines of insect population abundances and biomass are currently one of the most pressing issues in entomology, ecology and conservation biology. It has been suggested that artificial light at night is one major driver behind this trend.

Recent advances in the gathering and analysis of long‐term data sets of insect population and biomass trends, however, have mostly focused on the effects of climate change and agricultural intensification.

We posit here that adequate assessment of artificial night at light that would be required to evaluate its role as a driver of insect declines is far from trivial. Currently its implementation into entomological monitoring programmes and long‐running ecological experiments is hampered by several challenges that arise due to (i) its relatively late appearance as a biodiversity threat on the research agenda and (ii) the interdisciplinary nature of the research field where biologists, physicists and engineers still need to develop a set of standardised assessment methods that are both biologically meaningful and easy to implement.

As more studies that address these challenges are urgently needed, this article aims to provide a short overview of the few existing studies that have attempted to investigate longer‐term effects of artificial light at night on insect populations.

To improve the quality and relevance of studies addressing artificial light at night and its effect on insects, we present a set of best practise recommendations where this field needs to be heading in the coming years and how to achieve it.
Protein restriction during puberty alters nutritional parameters and affects ovarian and uterine histomorphometry in adulthood in rats
Authors: de Morais Oliveira Diego Augusto , Lupi Luiz Antonio , Silveira Henrique Spaulonci , de Almeida Chuffa Luiz Gustavo
Published: March 2021

In a large part of the population inefficient ingestion of proteins, whether for cultural, aesthetic or economic reasons, is a global concern. Low‐protein diets can cause severe functional complications, mainly during the development and maturation of organs and systems, including the female reproductive system. The present study investigated the effect of nutritional protein restriction during puberty on the oestrous cycle and expression of sex steroid receptors (AR, ERα e ERβ) in ovarian and uterine tissues of adult rats. Protein restriction promoted lower body weight gain, feed efficiency and higher caloric intake. There was an increase in the oestrus phase arrest without changing the total length of the oestrous cycle. The consumption of low‐protein diet also reduced the thickness of the uterine endometrium (uterine epithelium and endometrial stroma) in addition to increasing the number of primary and atretic follicles in the ovaries. Furthermore, the low‐protein diet reduced the levels of androgen receptor (AR) and increased the oestrogen receptor β (ERβ) in the ovary, while no significant changes were observed in the uterus. Our study reinforces the importance of adequate protein intake during puberty, since physiological changes in this developmental period interfere with the histomorphometry of the ovaries and uteri, possibly resulting in impaired folliculogenesis and fertility in the reproductive period.
Oral mini‐pulse therapy in vitiligo: a systematic review
Authors: Chavez‐Alvarez Sonia , Herz‐Ruelas Maira , Raygoza‐Cortez Ana Karina , Suro‐Santos Yeudiel , Ocampo‐Candiani Jorge , Alvarez‐Villalobos Neri Alejandro , Villarreal‐Martinez Alejandra
Published: March 2021

Background

There is limited evidence supporting the use of alternative treatments for patients with nonstable vitiligo.

Objective

This study aimed to review the effects of oral mini‐pulse (OMP) therapy in the management of nonsegmental vitiligo.

Methods

The following databases were searched between inception and May 2020 for relevant studies: Scopus, Web of Science, MEDLINE, and Embase. All randomized controlled trials that compared OMP therapy with any other active treatment or placebo for nonstable vitiligo were included. The Cochrane’s risk of bias tool was used to evaluate the risk of bias (ROB) in selected studies, and the overall quality of evidence of each outcome was assessed using the Grading Recommendations, Assessment, Development, and Evaluations (GRADE) system.

Results

Four studies met our selection criteria. All of them were conducted in India and included 246 patients. OMP therapy included betamethasone or dexamethasone. The duration of treatment was 6 months in all studies. Up to 32% of patients achieved a repigmentation rate of >75% when OMP therapy was administered as monotherapy. No difference was observed between OMP therapy and other treatments in arresting the disease, and weight gain was the most frequent adverse effect. The overall ROB in all included studies was relatively high because of the randomization process, outcome measurement and informed selection of outcomes.

Conclusion

Based on the findings of these studies, OMP therapy did not demonstrate additional value compared with other treatments. Hence, there is an urgent need to conduct high‐quality clinical trials to evaluate this therapy.
The red blood cell as a novel regulator of human B‐cell activation
Authors: Lennon Charlotte S. , Cao Huan , Hall Andrew M. , Vickers Mark A. , Barker Robert N.
Published: March 2021

Non‐immune cells are increasingly recognized as important in regulating immunity, but the role of red blood cells (RBC) remains relatively unexplored, despite their abundance in the circulation and a cell surface rich in potential ligands. Here, we determine whether RBC influence the activation state of human B cells. Separation of RBC from peripheral blood mononuclear cells increased B‐cell expression of HLA‐DR/DP/DQ, whilst reconstitution reduced the levels of B‐cell activation markers HLA‐DR/DP/DQ, CD86, CD69 and CD40, as well as decreasing proliferative responses and IgM secretion. Inhibition of B cells required contact with RBC and was abrogated by either removal of sialic acids from RBC or blocking the corresponding lectin receptor CD22 on B cells. Chronic lymphocytic leukaemia B cells express low levels of CD22 and were less susceptible to inhibition by RBC, which may contribute to their activated phenotype. Taken together, the results identify a novel mechanism that may suppress inappropriate responsiveness of healthy B cells whilst circulating in the bloodstream.
Dental fear among adolescents with cleft
Authors: Corcoran Mirjami , Karki Saujanya , Harila Virpi , Luoto Anni , Ylikontiola Leena , Sándor George K. , Anttonen Vuokko
Published: March 2021

Background

Dental fear is a prevalent phenomenon among children and adolescents globally.

Aim

To investigate dental fear among 18‐year‐olds with cleft lip and/or palate (CLP) at their final follow‐up cleft clinic visit, and to evaluate the association between dental fear and OHRQoL.

Design

This cross‐sectional study included the cohort of children with CLP treated at the Oulu University Hospital Cleft Lip and Palate Center, in northern Finland since 1995. A total of 62 of 64 individuals participated in this study. The validated Finnish version of the Oral Health Impact Profile (OHIP‐14) was used to assess OHRQoL. Dental fear was studied using the validated Modified Dental Anxiety Scale (MDAS) and cognitive vulnerability model (CVM).

Results

Almost two fifths of the participants reported moderate dental fear. Participants with cleft including lip and participants reporting impact on OHRQoL reported higher mean MDAS scores. In an unadjusted model, adolescents with cleft including lip had risk for higher dental MDAS scores compared with the ones with cleft including only palate.

Conclusions

Dental fear is common among adolescents with CLP, specifically among those with clefts involving the lip. OHRQoL and dental fear seem to be associated.
Stainless steel crown vs bulk fill composites for the restoration of primary molars post‐pulpectomy: 1‐year survival and acceptance results of a randomized clinical trial
Authors: Olegário Isabel Cristina , Bresolin Carmela Rampazzo , Pássaro Ana Laura , de Araujo Mariana Pinheiro , Hesse Daniela , Mendes Fausto Medeiros , Raggio Daniela Prócida
Published: March 2021

Background

A key factor for the success and longevity of the endodontic treatment is sealing of the cavity after restorative treatment.

Aim

The aim of this randomised clinical trial was to evaluate the 1‐year survival of endodontic treatment in primary molars restored with stainless steel crowns (SSCs) and bulk fill composite resin (BF). As a secondary outcome, the acceptance of both children and parents was evaluated.

Design

Ninety‐one 3‐ to 8‐year‐old children with at least one primary molar requiring endodontic treatment were selected. Participants were randomized to SSC or BF and evaluated after 1, 3, 6, and 12 months. An acceptance questionnaire was completed immediately after the treatment. The primary outcome was the endodontic treatment success, evaluated in the intention‐to‐treat (ITT) population using the Kaplan‐Meier and non‐inferiority Cox regression analyses, with a non‐inferiority limit of 15%. Sensitivity analysis between the success rates after 1 year was performed using Miettinen‐Nurminen's method. The Mann‐Whitney test was used to compare the treatment acceptance (α = 5%).

Results

The survival rate after 1 year was BF = 75% and SSC = 88% (HR = 1.41; 90% CI 0.57‐3.43). ITT analysis showed a success rate of BF = 86.7% and SSC = 82.6% (RR = 0.95; 0.78‐1.16). The non‐inferiority hypothesis between the survival of endodontic treatment could not be proved in both analyses (P > .05). The overall acceptance scores did not differ between the restorative groups (P > .05).

Conclusion

This study failed to show non‐inferiority of BF compared with the SSC. The materials were well accepted by both children and their parents.
The use of transillumination in mapping demarcated enamel opacities in anterior teeth: A cross‐sectional study
Authors: Marouane Omar , Manton David J.
Published: March 2021

Background

Despite intensive efforts for categorizing demarcated enamel opacities, often related to molar incisor hypomineralization (MIH), there is a lack of descriptive criteria aiming to describe them physically outside the scope of color and size. This is most likely due to the indices focusing on molar, not anterior, teeth.

Aim

To map and classify demarcated lesions on permanent anterior teeth using reflected and transilluminated light. The association between classification and related lesion characteristics was also examined.

Design

Permanent anterior teeth with demarcated opacities related to MIH were selected. For each tooth, standardized photographs were taken using transmitted and reflected light. Each lesion was mapped and classified according to its color, lesion size, surface integrity, and type. The data were analyzed using the chi‐square and Fisher's exact tests. A logistic regression analysis was performed to identify the risk of PEB.

Results

There were significant relationships between lesion size, color, and type with surface integrity. Lesion type and size were more important than lesion color for assessing the risk of PEB. There was also a significant relationship between lesion size and lesion color.

Conclusions

Lesion size and type are significant clinical parameters for assessing the risk of PEB on enamel opacities related to MIH.
Social networks and people with intellectual disabilities: A systematic review
Authors: Harrison Rachel Abigail , Bradshaw Jill , Forrester‐Jones Rachel , McCarthy Michelle , Smith Sharon
Published: March 2021

Background

Despite the importance of social networks for health and well‐being, relatively little is known about the ways in which adults with intellectual disabilities in the U.K. experience their social networks.

Method

A systematic review was completed to identify research focused on the social networks of adults with intellectual disabilities. Studies published from 1990 to 2019 were identified. Studies were thematically analysed.

Results

Quantitative, qualitative and mixed methods studies were analysed to identify key factors influencing social networks. Experiences of people with intellectual disabilities identified themes of identity, powerlessness, inclusion, family and support. These themes are discussed with reference to theories of stigma and normalisation.

Conclusions

Stigma and normalisation can be used to better understand the needs, desires and dreams of people with intellectual disabilities for ordinary relationships, from which they are regularly excluded. Implications for policy and practice are discussed in relation to building and repairing often spoiled identities.
Cross‐validation of best linear unbiased predictions of breeding values using an efficient leave‐one‐out strategy
Authors: Cheng Jian , Dekkers Jack C. M. , Fernando Rohan L.
Published: March 2021

Empirical estimates of the accuracy of estimates of breeding values (EBV) can be obtained by cross‐validation. Leave‐one‐out cross‐validation (LOOCV) is an extreme case of k‐fold cross‐validation. Efficient strategies for LOOCV of predictions of phenotypes have been developed for a simple model with an overall mean and random marker or animal genetic effects. The objective here was to develop and evaluate an efficient LOOCV method for prediction of breeding values and other random effects under a general mixed linear model with multiple random effects. Conventional LOOCV of EBV requires inverting an (n‐1)×(n‐1) covariance matrix for each of n (= number of observations) data sets. Our efficient LOOCV obtains the required inverses from the inverse of the covariance matrix for all n observations. The efficient method can be applied to complex models with multiple fixed and random effects, but requires fixed effects to be treated as random, with large variances. An alternative is to precorrect observations using estimates of fixed effects obtained from the complete data, but this can lead to biases. The efficient LOOCV method was compared to conventional LOOCV of predictions of breeding values in terms of computational demands and accuracy. For a data set with 3,205 observations and a model with multiple random and fixed effects, the efficient LOOCV method was 962 times faster than the conventional LOOCV with precorrection for fixed effects based on each training data set but resulted in identical EBV. A computationally efficient LOOCV for prediction of breeding values for single‐ and multiple‐trait mixed models with multiple fixed and random effects was successfully developed. The method enables cross‐validation of predictions of breeding values and of any linear combination of random and/or fixed effects, along with leave‐one‐out precorrection of validation phenotypes.
Relative age and specific learning disorder diagnoses: A Finnish population‐based cohort study
Authors: Arrhenius Bianca , Gyllenberg David , Vuori Miika , Tiiri Elina , Lempinen Lotta , Sourander Andre
Published: March 2021

Background

Being among the youngest in class has previously been associated with attention‐deficit/hyperactivity disorder (ADHD) and academic disadvantage, but the relative age effect on learning disorders is less well understood. This study examined whether relatively young children are more likely to be diagnosed with specific learning disorders than their older peers.

Methods

The setting included all 388,650 children born singleton in Finland from 1996 to 2002. Cases diagnosed with specific learning disorders in specialized health care by the age of 10 were identified from national registers. Cumulative incidences of specific learning disorders and the corresponding incidence rate ratios (IRRs) and 95% confidence intervals (CIs) were calculated for each birth month compared to January.

Results

During follow‐up, 3162 (0.8% of 388,650) children were diagnosed with a specific learning disorder. Children born in December displayed higher cumulative incidences for specific learning disorders than children born in January (IRR: 1.77, 95% CI: 1.50–2.11). The findings were similar for girls (IRR: 2.01, 1.44–2.83) and boys (IRR: 1.70, 1.39–2.08). ADHD did not explain the association, as the IRR for the youngest children with specific learning disorders and ADHD was 1.59 (1.13–2.26) compared to those without ADHD (IRR: 1.84, 1.51–2.24).

Conclusions

Relatively younger children in Finnish schools were more likely to be diagnosed with a specific learning disorder by the age of 10. Increased awareness of how relative age differences affect the likelihood for children to be diagnosed with specific learning disorders is needed among parents, clinicians, and teachers.