bluuebunny/crossref_metadata_2025 huggingface dataset:
Tropical tall forests are more sensitive and vulnerable to drought than short forests
Authors: Liu Liyang , Chen Xiuzhi , Ciais Philippe , Yuan Wenping , Maignan Fabienne , Wu Jin , Piao Shilong , Wang Ying‐Ping , Wigneron Jean‐Pierre , Fan Lei , Gentine Pierre , Yang Xueqin , Gong Fanxi , Liu Hui , Wang Chen , Tang Xuli , Yang Hui , Ye Qing , He Bin , Shang Jiali , Su Yongxian
Published: December 2021

Our limited understanding of the impacts of drought on tropical forests significantly impedes our ability in accurately predicting the impacts of climate change on this biome. Here, we investigated the impact of drought on the dynamics of forest canopies with different heights using time‐series records of remotely sensed Ku‐band vegetation optical depth (Ku‐VOD), a proxy of top‐canopy foliar mass and water content, and separated the signal of Ku‐VOD changes into drought‐induced reductions and subsequent non‐drought gains. Both drought‐induced reductions and non‐drought increases in Ku‐VOD varied significantly with canopy height. Taller tropical forests experienced greater relative Ku‐VOD reductions during drought and larger non‐drought increases than shorter forests, but the net effect of drought was more negative in the taller forests. Meta‐analysis of in situ hydraulic traits supports the hypothesis that taller tropical forests are more vulnerable to drought stress due to smaller xylem‐transport safety margins. Additionally, Ku‐VOD of taller forests showed larger reductions due to increased atmospheric dryness, as assessed by vapor pressure deficit, and showed larger gains in response to enhanced water supply than shorter forests. Including the height‐dependent variation of hydraulic transport in ecosystem models will improve the simulated response of tropical forests to drought.
Development and field testing of a decision aid to facilitate shared decision making for adults newly diagnosed with attention‐deficit hyperactivity disorder
Authors: Aoki Yumi , Tsuboi Takashi , Takaesu Yoshikazu , Watanabe Koichiro , Nakayama Kazuhiro , Kinoshita Yasuhito , Kayama Mami
Published: December 2021

Background

The number of individuals who are diagnosed with attention‐deficit hyperactivity disorder (ADHD) during adulthood has increased in recent years. However, there is still no decision aid (DA) to help adults newly diagnosed with ADHD make decisions regarding further treatments.

Objective

This study aimed to describe the development process of a DA for adults newly diagnosed with ADHD and its field testing during the shared decision‐making (SDM) process in a clinical setting.

Methods

The development process involved the creation of a DA prototype using the International Patient Decision Aid Standards criteria and revision of the prototype through the stakeholders' reviews. The field testing of the DA compared scores before and after the SDM process on the service users' knowledge scale, decisional conflict scale and the Conners Adult ADHD Rating Scales.

Results

The developed DA contained options of watchful waiting with own coping skills and pharmacological treatment, which consisted of several kinds of drug options. Fifteen adults newly diagnosed with ADHD participated in the field testing. The participant decision‐making quality outcomes such as their knowledge and decisional conflict improved after the SDM process. ADHD severity did not change.

Conclusion

A DA for adults with ADHD was systematically developed following the international criteria. Field testing indicated that the DA could serve as a tool to facilitate the SDM process. Further research on this DA is necessary before its routine implementation.

Patient or Public Contribution

During the development process of the DA, the service users who had already been diagnosed with ADHD reviewed the DA prototype and provided feedback, which improved the final version of the DA.
REALLOCATION EFFECTS OF MONETARY POLICY
Authors: Miyakawa Daisuke , Oikawa Koki , Ueda Kozo
Published: December 2021

We construct a model that introduces nominal rigidity into R&D‐driven endogenous growth with heterogeneous firms. The model shows that high nominal growth leads to an increase in the market share of innovative firms as menu‐cost burdens are relatively heavier for less innovative firms. This reallocation effect yields a positive effect of monetary expansion on both real growth and welfare. The optimal nominal growth can be strictly positive even under nominal rigidity. Moreover, menu costs can improve welfare. Japanese firm‐level data are consistent with the model implication in that under higher inflation, large firms grow faster than small firms.
In vitro biological activity of extracts from marine bacteria cultures against Toxoplasma gondii and Mycobacterium tuberculosis
Authors: Quintero Marynes , Blandón Lina M. , Vidal Oscar M. , Guzman Juan D. , Gómez-Marín Jorge E. , Patiño Albert D. , Molina Diego A. , Puerto-Castro Gloria M. , Gómez-León Javier
Published: December 2021

Aims

To evaluate the biological activity of extracts from cultures of marine bacteria against Toxoplasma gondii and Mycobacterium tuberculosis.

Methods and Results

Ethyl acetate extracts obtained from seven marine bacteria were tested against T. gondii GFP-RH and M. tuberculosis H37Rv. The cytotoxicity on HFF-1 cells was measured by a microplate resazurin fluorescent approach, and the haemolytic activity was determined photometrically. The extracts from Bacillus sp. (INV FIR35 and INV FIR48) affected the tachyzoite viability. The extracts from Bacillus, Pseudoalteromonas, Streptomyces and Micromonospora exhibited effects on infection and proliferation processes of parasite. Bacillus sp. INV FIR48 extract showed an minimum inhibitory concentration value of 50 µg ml−1 against M. tuberculosis H37Rv. All the extracts exhibited relatively low toxicity to HFF-1 cells and the primary culture of erythrocytes, except Bacillus sp. INV FIR35, which decreased cell viability under 20%. Liquid chromatography coupled to mass spectrometry analysis of the most active bacterial extract Bacillus sp. INV FIR48 showed the presence of peptide metabolites related to surfactin.

Conclusions

The extract from culture of deep-sea Bacillus sp. INV FIR48 showed anti-T. gondii and anti-tuberculosis (TB) biological activity with low cytotoxicity. In addition, peptide metabolites were detected in the extract.

Significance and Impact of the Study

Toxoplasmosis and TB are among the most prevalent diseases worldwide, and the current treatment drugs exhibit side effects. This study confirm that marine bacteria are on hand sources of anti-infective natural products.
Novel strategies for inhibition of bacterial biofilm in chronic rhinosinusitis
Authors: Shariati Aref , Vesal Soheil , Khoshbayan Amin , Goudarzi Parnian , Darban-Sarokhalil Davood , Razavi Shabnam , Didehdar Mojtaba , Chegini Zahra
Published: December 2021

An important role has been recently reported for bacterial biofilm in the pathophysiology of chronic diseases, such as chronic rhinosinusitis (CRS). CRS, affecting sinonasal mucosa, is a persistent inflammatory condition with a high prevalence around the world. Although the exact pathological mechanism of this disease has not been elicited yet, biofilm formation is known to lead to a more significant symptom burden and major objective clinical indicators. The high prevalence of multidrug-resistant bacteria has severely restricted the application of antibiotics in recent years. Furthermore, systemic antibiotic therapy, on top of its insufficient concentration to eradicate bacteria in the sinonasal biofilm, often causes toxicity, antibiotic resistance, and an effect on the natural microbiota, in patients. Thus, coming up with alternative therapeutic options instead of systemic antibiotic therapy is emphasized in the treatment of bacterial biofilm in CRS patients. The use of topical antibiotic therapy and antibiotic eluting sinus stents that induce higher antibiotic concentration, and decrease side effects could be helpful. Besides, recent research recognized that various natural products, nitric oxide, and bacteriophage therapy, in addition to the hindered biofilm formation, could degrade the established bacterial biofilm. However, despite these improvements, new antibacterial agents and CRS biofilm interactions are complicated and need extensive research. Finally, most studies were performed in vitro, and more preclinical animal models and human studies are required to confirm the collected data. The present review is specifically discussing potential therapeutic strategies for the treatment of bacterial biofilm in CRS patients.
Keratoacanthoma or cutaneous squamous cell carcinoma revealing a DNA mismatch repair default (Muir‐Torre Syndrome)
Authors: Miao Y. , Kolb F. , Tomasic G. , Lupu J. , Routier E. , Robert C.
Published: December 2021

Keratoacanthoma (KA) and well‐differentiated cutaneous squamous cell carcinoma (cSCC) are hardly distinguishable clinically and histologically. They both can be seen in patients with hereditary non‐polyposis colorectal cancer (HNPCC) or Lynch Syndrome, corresponding to DNA microsatellite instability. In our case, a young man had the excision of two rapidly growing skin tumours for which distinction between KA and cSCC was initially clinically and pathologically challenging. The diagnosis of well‐differentiated cSCCs was made and the patient was treated with surgery. Ten years after the first cSCC, he was diagnosed with Muir‐Torre syndrome, a variant of Lynch syndrome, with an heterozygote mutation of the MSH2 gene. This later diagnosis allowed to screen his family members for the same mutation and to adopt an appropriate follow‐up regarding the risk of digestive tumours for him and his family. Furthermore, it is important to know that, in case of non‐resectable cSCC occurring in this patient, immunotherapy using anti‐PD1 antibody would probably be effective due to the known increased immunogenicity of MMR deficient tumours.
Treatment approaches of advanced cutaneous squamous cell carcinoma
Authors: Peris K. , Piccerillo A. , Del Regno L. , Di Stefani A.
Published: December 2021

Common primary cutaneous squamous cell carcinoma (CSCC) accounts for 20% of keratinocyte cancers that is usually successfully treated with surgery or radiotherapy. In a minority of cases, CSCC lesions may progress to locally advanced or metastatic disease that may be difficult to be treated causing significant morbidity and mortality. Chemotherapies and targeted therapy with anti‐epidermal growth factor receptor antibodies have been used off‐label in small studies and case reports of advanced CSCC, but data are scarce and response short‐lived. Recently, two PD‐1 immune checkpoint inhibitors, cemiplimab and pembrolizumab, have been approved for the treatment of advanced CSCC; specifically the former can be administered in patients with locally advanced and metastatic tumours, while the latter in case of recurrent metastatic CSCC. The introduction of immune checkpoint inhibitors represents a breakthrough in the treatment of CSCC, since numerous clinical trials showed that these agents may provide remarkable clinical benefit with an acceptable safety profile, in a high‐need population who had no standard of care. In addition, real‐world studies are needed to validate the results observed in clinical trials and numerous clinical trials in the neoadjuvant or adjuvant setting are ongoing. Finally, further studies should investigate predictive biomarkers useful to better select patients to maximize the treatment efficacy.
Cutaneous SCC with orbital invasion: case series
Authors: Nägeli M. , Mangana J. , Chaloupka K. , Dummer R.
Published: December 2021

Cutaneous squamous cell carcinoma (cSCC) is the most common tumour entity that grows secondarily into the orbital area, while basal cell carcinoma (BCC) is the most common periocular and eyelid tumour. Diagnostic delays are common and may increase post‐treatment complications. The therapy is challenging and must be discussed at an interdisciplinary tumour board. We discuss four cases of cSCC with orbital invasion treated with immune‐checkpoint inhibitors with variable responses.
Risk of overactive bladder associated with cholinesterase inhibitors in dementia
Authors: Masurkar Prajakta P. , Chatterjee Satabdi , Sherer Jeffrey T. , Chen Hua , Johnson Michael L. , Aparasu Rajender R.
Published: December 2021

BACKGROUND

Although cholinesterase inhibitors (ChEIs) are the primary treatment for dementia, they are associated with overactive bladder (OAB), necessitating antimuscarinic use. Limited data exist regarding the risk of OAB across individual ChEIs in dementia. This study evaluated the risk of OAB associated with individual ChEIs in older adults with dementia.

METHODS

This was a new user retrospective cohort study using Medicare claims data involving Parts A, B, and D claims dataset from 2013 to 2015. The study included older adults (aged 65 and older) with a diagnosis of dementia using donepezil, galantamine, or rivastigmine. New ChEI claims were identified with a 6‐month baseline washout period. Patients with OAB diagnosis or any antimuscarinic or mirabegron use in the baseline period were excluded. The primary outcome of interest was OAB diagnosis or prescription of antimuscarinics or mirabegron within 6 months of ChEI initiation. Multivariable cox proportional hazards regression with propensity scores (PS) as covariates and inverse probability of treatment weighting generated using generalized boosted models was used to assess the risk of OAB among donepezil, galantamine, and rivastigmine users.

RESULTS

The study included 524,975 older adults with dementia who were incident users of ChEIs (donepezil 80.72%, rivastigmine 16.41%, galantamine 2.87%). Overall, OAB diagnosis/antimuscarinic/mirabegron prescription was observed in 5.07% of the cohort within 6 months of ChEIs prescription. The Cox regression model with PS as covariate approach found that donepezil use increased the risk of OAB compared to rivastigmine (aHR, 1.13; 95% CI, 1.08–1.28; p < 0.0001). However, there was no differential risk of OAB between galantamine and rivastigmine. The findings were consistent with the generalized boosted models.

CONCLUSIONS

The study found that the risk of OAB varies across individual ChEIs with an increased risk of OAB with donepezil compared to rivastigmine. The study findings suggest the need to understand and manage medication‐related morbidity in older adults with dementia.
The effectiveness of acupressure for managing postoperative pain in patients with thoracoscopic surgery: A randomized control trial.
Authors: Hsu Hsing‐Chi , Fang Hsin‐Yuan , Kuo Chi‐Chung , Su Shu‐Fen , Liang Wen‐Miin , Ma Wei‐Fen
Published: December 2021

Purpose

More than 86% patients experience moderate to severe pain after thoracoscopic surgery. A combination of diverse nonpharmacological pain relief methods is a developing trend for pain management. The purpose of this study was to explore the effect of acupressure in reducing pain after thoracoscopic surgery.

Design

A Randomized controlled study with purpose sampling was used for this study. Patients who underwent thoracoscopic surgery at a medical center in central Taiwan were enrolled. Study data was collected from September 2020 to April 2021 after the approval of the institutional review board. A total of 100 participants were randomized into two groups (49 and 51 in the experimental and control groups, respectively).

Methods

Participants in the experimental group received acupressure at the Neiguan (PC6) and Shenmen (HT7) acupoints thrice a day for 2 days, whereas those in the control group received routine treatment and did not receive acupressure. The measurement included questionnaires for the collection of general information, physiological information, and disease rating scale. The Visual Analogue Scale‐Pain (VAS‐P) was used to measure the severity of pain. SPSS statistical software was used for data analysis. Independent sample t‐test and chi‐squared test were used for descriptive statistics, and paired t‐test and linear mixed model were used to examine the effect of acupressure in alleviating pain.

Findings

After acupressure intervention, the pain score of the experimental group was lower than that of the control group, and this difference was significant β = 17.76, p < 0.001 on day 1 after intervention; β = 19.80, p < 0.001 on day 2 after intervention. The postoperative pain score in the experimental group on day 2 after intervention was significantly lower than that in the control group (t = 2.039, p = 0.044). After the subjects received acupressure, pain index significantly decreased after considering the interaction between time and group (p < 0.001). Regardless of the type of surgery, there were significant differences in pain index when the interaction between time and group was considered (p < 0.001).

Conclusions

This study provided an experimental basis that acupressure can help in pain management in patients after thoracoscopic surgery, and the pain relief results become more significant as the duration of intervention increases.

Clinical relevance

Acupressure is effective in relieving postoperative pain in any type of thoracoscopic surgery. Nurses can use acupressure to help control pain in patients after thoracoscopic surgery.
Preventive effect of swim bladder hydrolysates on cyclophosphamide‐induced ovarian injury in mice
Authors: Ge Enhui , Zha Rui , Gao Qing , Guo Lirong , Wang Binglong , Lin Qiqi , Zhang Guifeng , Xie Weiquan , Yin Hui , Liu Tao
Published: December 2021

Aims

This study aimed to prepare swim bladder hydrolysate (SBH) with Mn < 4000 Da, and investigate its effects on cyclophosphamide (CTX)‐mediated ovarian injury in mice.

Methods

Hydrolysates were prepared by heating extraction, enzymatic hydrolysis and ultrafiltration. Mn and distribution of SBH were analyzed via gel filtration chromatography and matrix‐assisted laser desorption/ionization time‐of‐flight mass spectrometry. Changes in the mouse oestrus cycle were determined by cytological examination. The number of follicles was examined using histopathology. Enzyme‐linked immunosorbent assays (ELISAs) were used to determine the serum sex hormone levels.

Results

The Mn of SBH, prepared by heating extraction, enzymatic hydrolysis, ultrafiltration, and from different batches, was below 4000 Da, and the preparation process was stable. Compared with the control group, the low‐, middle‐, and high‐dose SBH treatment groups showed different trends in oestrus duration, serum sex hormone levels, and the number of primordial and secondary follicles. The oestrus cycle duration of the high‐dose SBH group was longer than that of the model group. The serum luteinizing hormone, follicle‐stimulating hormone, and anti‐Müllerian hormone levels in the middle‐dose group were the closest to those of control group. The number of primordial and secondary follicles in the medium‐dose group was significantly higher than that in the model group and closest to those of control group.

Conclusion

After heating extraction, trypsin/Flavourzyme hydrolysis and ultrafiltration, a hydrolysate with Mn below 4000 Da could be prepared. We found that a moderate (400 mg/kg) SBH dose resulted in the greatest effect on ovarian injury remission in mice.
Is periodontitis a risk factor of benign or malignant colorectal tumor? A population‐based cohort study
Authors: Fu Martin M. , Chien Wu‐Chien , Chung Chi‐Hsiang , Lee Wei‐Cheng , Tu Hsiao‐Pei , Fu Earl
Published: December 2021

Objective

To examine the risk of developing benign or malignant colorectal tumors in patients with periodontitis within 15 years using Taiwan's National Health Insurance Database.

Background

Studies have shown that colorectal carcinoma often develops under inflammatory conditions and changes of microbiota in the gut. Recently, a link between Fusobacterium nucleatum, a periodontal pathogen, and colorectal carcinoma has been proposed. However, whether periodontitis is a risk of developing colorectal tumor remains uncertain.

Methods

In total, 35 124 participants were enrolled from 2000 to 2015 to examine the development risk of benign colorectal tumors, including 11 708 patients with periodontitis who received therapy (group 1), 11 708 patients with periodontitis not receiving periodontal treatment (group 2), and 11 708 non‐periodontitis controls after matching for gender, age, and index year. To examine the risk of developing colorectal malignancy, 11 720 participants were assigned to each of the three groups. Cox proportional hazards model and Kaplan–Meier methods were used to compare the risks. Sensitivity analysis was performed, excluding the diagnoses during the first 1 or 5 years.

Results

After the follow‐up, 177, 154, and 63 participants in group 1, group 2, and control group had benign colorectal tumors. Patients with periodontitis tended to be associated with a greater rate of having a benign colorectal tumor. The adjusted hazard ratios (aHRs) were 3.77 (95% confidence interval [CI] 2.01–4.82, p < .001) and 2.85 (95% CI 1.62–3.74, p < .001) for groups 1 and 2, respectively. Regarding the risk of malignant colorectal tumor, 20, 18, and 14 participants who developed malignant tumors were included in group 1, group 2, and control group; however, no significant increase in malignancy was observed in periodontitis groups (aHR1.92, 95% CI 0.74–2.36, p = .482; aHR 1.50, 95% CI 0.68–1.97, p = .529, for the two periodontitis groups, respectively).

Conclusions

The results of this study suggest that patients with periodontitis may have an increased risk of developing benign, but not malignant, colorectal tumors.
Measurement and analysis of technological progress bias in China's mariculture industry
Authors: Sun Yanan , Ji Jianyue
Published: December 2021

Choosing a technological progress bias that matches the factor endowment structure is significant for optimizing resource allocation and improving productivity. Therefore, in this study, a data envelopment analysis method is applied to calculate the input‐biased technological progress index of China's mariculture industry from 2006 to 2018, measure the bias of technological progress, and analyze its desirability. The results indicate the following: first, there is input‐biased technological progress in various regions and its contribution to the total factor productivity (TFP) in most regions is positive. Second, there are differences in the bias of technological progress during the sample period; that is, the technological progress between capital and labor, capital and mariculture area, and labor and mariculture area, is steadily biased toward using capital and saving labor, is mostly biased toward using capital and saving mariculture area, and is relatively biased toward using mariculture area and saving labor, respectively. Third, the results support constructing factor endowment indicators to analyze the desirability of technological progress bias and discover technological mismatch. Based on the research results, this study presents relevant policy recommendations to promote the scientific development of China's mariculture industry.
Molecular mechanism of albumin in suppressing invasion and metastasis of hepatocellular carcinoma
Authors: Fu Xiao , Yang Yixuan , Zhang Dazhi
Published: December 2021

Background & Aims

Worldwide, hepatocellular carcinoma (HCC) is one of the most common causes of death in people. Albumin (ALB) is considered as an important indicator for HCC prognosis, and evidence has shown HCC cell growth can be regulated by ALB. However, the role of ALB in hepatocarcinogenesis and the mechanism of action is still unknown.

Methods

The expression of ALB was determined by clinical profiles, immunohistochemistry, and western blot. Wound healing and Transwell assays were conducted to evaluate the effects of ALB during migration and invasion in HCC. We used mass spectrometry coupled isobaric tags for relative and absolute quantitation (iTRAQ)‐technology to identify secretory differentially expressed proteins (DEPs) in ALB knockdown HepG2 cells. Western blot, reverse transcription‐quantitative polymerase chain reaction and enzyme‐linked immunosorbent assay techniques were used for verification.

Results

We suggested that ALB was associated with aggressive metastasis and depleting ALB significantly promoted invasion and migration of HCC. A total of 210 DEPs were identified after silencing of ALB. We observed that a negative correlation between ALB and urokinase plasminogen activator surface receptor (uPAR) expression levels.

Conclusions

ALB acts as a tumour suppressor and plays a key role in HCC progression, particularly in invasion and metastasis. Suppression of ALB promoted migration and invasion of HCC cells by increasing uPAR, matrix metalloproteinase (MMP2), and MMP9.
International medical graduates' experiences before and after migration: A meta‐ethnography of qualitative studies
Authors: Al‐Haddad Mo , Jamieson Susan , Germeni Evi
Published: December 2021

Introduction

International medical graduates (IMGs) represent a large portion of practising doctors in many countries. Many experience difficulties, including higher rates of complaints against them and lower exam pass rates. The UK's General Medical Council (GMC) recently set targets to ‘eliminate disproportionate complaints’ and ‘eradicate disadvantage and discrimination in medical education’. Our timely meta‐ethnography aimed to synthesise existing qualitative literature on the wider personal and professional experiences of IMGs to identify factors affecting IMGs' professional practice (either directly or indirectly).

Methods

In September 2019, we systematically searched Medline, Embase, Cochrane, PsycINFO, ERIC and EdResearch for peer‐reviewed qualitative and mixed‐methods articles that described experiences of IMGs. We extracted participant quotes and authors' themes from included articles and used the technique of meta‐ethnography to synthesise the data and develop new overarching concepts.

Results

Of the 1613 articles identified, 57 met our inclusion criteria. In total, the articles corresponded to 46 studies that described the experiences of 1142 IMGs practising in all six continents in a range of settings, including primary and secondary care. We developed five key concepts: migration dimensions (issues considered by IMGs when migrating), a challenging start (the stressful early period), degree of dissonance (between the IMG and host country in relation to the four main barriers of language, culture, medical education and belonging), levelling the playing field (interventions to reduce the impact of the barriers) and survive then thrive (adjustments IMGs made). A conceptual model that brings these constructs together in a line of argument is presented.

Conclusions

This meta‐ethnography, based on a large amount of diverse qualitative studies, is the first to provide a comprehensive picture of the experiences and challenges that IMGs face before and after migration. Our results should be used to guide the development of interventions aiming to support IMGs and meet the GMC targets.
Nurses' practices and obstacles to oral care quality in intensive care units in Upper Egypt
Authors: Abdelhafez Amal Ismael , Tolba Asmaa Atiaa
Published: December 2021

Background

Oral care is one of the fundamental nursing care procedures used to decrease oral colonization, dental plaque, respiratory infections, and patient stay and cost.

Aims

This study aimed to identify intensive care unit (ICU) nurses' self‐assessment of oral care frequency, skill competency, documentation, oral care tools, and obstacles to oral care quality. In addition, it proposed exploring associations between nurses' attitudes about the importance of oral care and the priority of other interventions.

Study design and setting

A cross‐sectional descriptive study was conducted in two ICUs (trauma and general) in the main teaching hospital in Upper Egypt. Of 105 nurses selected using convenience sampling, 91 completed the questionnaire.

Results

About 60.4% of ICU nurses did not attend any oral care training programme, 40.7% reported performing oral care four times per shift in intubated patients, 62.6% reported that their skills needed improvement, 37.4% saw themselves as competent, and 86.8% documented oral care in patients' records. Significant positive correlations were found, indicating that nurses' attitudes towards the importance of oral care showed the same tendency as the priority given to other interventions, such as eye care, bowel care, documentation, hygiene, catheters, feeding, and wound care (correlation coefficient [r] = 0.290, 0.511, 0.333, 0.425, 0.431, 0.345, and 0.337, respectively). Furthermore, a toothbrush (84.6%) was often used, while chlorhexidine was not used (90.1%). The major obstacles to the provision of oral care as perceived by the nurses were the fear of aspiration and life‐threatening interventions (95.6%), inadequate nurse–patient ratios (94.5%), irregular competency evaluations (92.3%), unavailability of oral care guidelines (92.3%), and shortage of time (84.6%).

Conclusion

The participating nurses were mindful of the importance and priority of oral care. Many of them did not attend oral care training programmes and considered that their skills needed improvement. Moreover, ICU nurses reported many obstacles hindering oral care quality.

Relevance to clinical practice

This research identifies the importance of developing in‐service oral care training programmes to improve ICU nurses' skill competency. High‐quality oral care can be provided by focusing on and overcoming obstacles that hinder nurses' oral care practice.
Infection with SARS‐CoV‐2 among children with asthma: evidence from Global Asthma Network
Authors: Chiang Chen‐Yuan , Ellwood Philippa , Ellwood Eamon , García‐Marcos Luis , Masekela Refiloe , Asher Innes , Badellino Héctor , Sanz Alberto Bercedo , Douros Konstantinos , El Sony Asma , Diaz Carlos González , Rodríguez MS Albi , Moreno‐Salvador Ana , Pérez‐Martini Luis F. , Filho Nelson Rosário , Shpakou Andrei , Sulaimanov Shairbek , Tavakol Marzieh , Valverde‐Molina José , Yousef Abdullah A , Pearce Neil ,   The GAN COVID Study Group
Published: December 2021

Background

Clinical presentations of coronavirus disease 2019 (COVID‐19) among children with asthma have rarely been investigated. This study aimed to assess clinical manifestations and outcome of COVID‐19 among children with asthma, and whether the use of asthma medications was associated with outcomes of interest.

Methods

The Global Asthma Network (GAN) conducted a global survey among GAN centers. Data collection was between November 2020 and April 2021.

Results

Fourteen GAN centers from 10 countries provided data on 169 children with asthma infected with severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2). COVID‐19 was asymptomatic in 58 (34.3%), mild in 93 (55.0%), moderate in 14 (8.3%), and severe/critical in 4 (2.4%). Thirty‐eight (22.5%) patients had exacerbation of asthma and 21 (12.4%) were hospitalized for a median of 7 days (interquartile range 3–16). Those who had moderate or more severe COVID‐19 were significantly more likely to have exacerbation of asthma as compared to those who were asymptomatic or had mild COVID‐19 (adjusted odds ratio (adjOR) 3.97, 95% CI 1.23–12.84). Those who used inhaled bronchodilators were significantly more likely to have a change of asthma medications (adjOR 2.39, 95% CI 1.02–5.63) compared to those who did not. Children who used inhaled corticosteroids (ICS) did not differ from those who did not use ICS with regard to being symptomatic, severity of COVID‐19, asthma exacerbation, and hospitalization.

Conclusions

Over dependence on inhaled bronchodilator may be inappropriate. Use of ICS may be safe and should be continued in children with asthma during the pandemic of COVID‐19.
Natural capital approaches: shifting the UN Decade on Ecosystem Restoration from aspiration to reality
Authors: Farrell Catherine A. , Aronson James , Daily Gretchen C. , Hein Lars , Obst Carl , Woodworth Paddy , Stout Jane C.
Published: December 2021

The UN Decade on Ecosystem Restoration offers a vital opportunity to advance scaled‐up, integrated approaches that reverse ecosystem degradation, biodiversity loss, and climate disruption and deterioration. Combining tools across disciplines is essential to addressing these interwoven, global crises through inclusive, equitable strategies with demonstrable socio‐economic benefits. Tools and initiatives described here, including the EcoHealth Network, the System of Environmental Economic Accounting Ecosystem Accounting and its application through the INCASE project in Ireland, and the Natural Capital Project, present ready‐made approaches to engage with policymakers and stakeholders in a transparent way. These examples are working to yield accurate indicators revealing the true costs and benefits of restoration policies and projects in both environmental and social terms. We highlight that collaborative efforts, particularly engagement between ecologists, economists, and other stakeholders, are essential to inform the ongoing development of fit‐for‐purpose natural capital approaches, and that synergies between natural capital and restoration approaches can be further strengthened to raise awareness of, and progress, restoration projects on the scale the UN Decade on Ecosystem Restoration envisages. We also reflect on the term “natural capital,” which is often misunderstood as implying that monetary metrics should take preference over non‐monetary arguments or considerations, thereby presenting a barrier to engagement for some ecologists, environmentalists, and stakeholders. Natural capital approaches offer us opportunities to track and support the necessary changes to expand and embed the culture of restoration into decision‐making across sectors, highlighting multiple benefits for society and economy.
Transparent conductive properties of TiON thin films
Authors: Akazawa Housei
Published: December 2021

Titanium oxynitride (TiON) thin films were deposited on glass substrates by reactive sputtering of a Ti target under a flow of O2 and N2 gases. When the total number of O and N atoms bonded to Ti was small, the TiON films took on a nano-crystalline fcc structure primarily oriented toward the (200) direction. As the TiON films became more oxidized and/or nitrided, they gradually transformed into an amorphous state with their carrier concentration being between 1018 and 1019 cm−3. The efficiency of oxidization was six times higher than that of nitridation. The optical transmittance of TiON films deposited at RT under sufficient O2 and N2 flow rates reached 100% at wavelengths longer than 1000 nm. However, complete termination of Ti with N atoms failed to occur at low O2 flow rates even when the N2 flow rate was increased. The carrier concentration (n) of the TiON films could be varied in a wide range between 1018 and 3 × 1021 cm−3. The n (×10−19 cm−3) versus Hall mobility (μ) (cm2 V−1 s−1) plot scaled as log μ = 1.23 − 0.38⋅log n between 1 × 1018 and 1 × 1020 cm−3. The Hall mobility reached 20–50 cm2 V−1 s−1 at n = 1018 cm−3, which means this film is promising as an amorphous semiconductor. The log–log plot of resistivity (ρ) (mΩ cm) against n scaled as log ρ = 1.74 − 0.87⋅log n.
Effect of buffer termination on intermixing and conductivity in LaTiO3/SrTiO3 heterostructures integrated on Si(100)
Authors: Chen Tongjie , Ahmadi-Majlan Kamyar , Lim Zheng Hui , Zhang Zhan , Ngai Joseph H. , Kumah Divine P.
Published: December 2021

The control of chemical exchange across heterointerfaces formed between ultrathin functional transition-metal oxide layers provides an effective route to manipulate the electronic properties of these systems. By determining the layer-resolved structural profile across the interface between the Mott insulator, LaTiO3 (LTO) grown epitaxially on SrTiO3 (STO)-buffered silicon by molecular beam epitaxy, we find that interfacial cationic exchange depends on the surface termination of the strained STO buffer. Using a combination of temperature-dependent transport and synchrotron x-ray crystal truncation rods and reciprocal space mapping, an enhanced conductivity in STO/LTO/SrO-terminated STO buffers compared to heterostructures with TiO2-terminated STO buffers is correlated with La/Sr exchange and the formation of metallic La1−xSrxTiO3. La/Sr exchange effectively reduces the strain energy of the system due to the large lattice mismatch between the nominal oxide layers and the Si substrate.
Reconstruction of time-dependent forces acting on a vibrating structure from pressure measurements
Authors: Hu Long , Bi Chuan-Xing , Zhang Yong-Bin , Zhang Xiao-Zheng
Published: December 2021

This paper proposes an approach to reconstruct the time-dependent forces acting on a vibrating structure from pressure measurements. In the approach, the pressures measured in the near field of the structure are related to the exciting forces at the reconstruction points by the transfer functions determined in an experimental way, whereupon the time-dependent forces can be reconstructed with these pressures as inputs. In the reconstruction process, an additional regularization with a mixed lp,q-norm term is introduced to resolve the ill-posed inverse problem, which is able to take advantage of the prior knowledge of space and time characteristics of the forces. A numerical simulation of reconstructing the time-dependent forces acting on a plate and two experiments of reconstructing the impact forces acting on a semi-cylindrical shell and an elliptically shaped structure are carried out. The results demonstrate the feasibility of the proposed approach for reconstructing the forces in both temporal and spatial domains from pressure measurements. The proposed approach provides a non-contact and real-time way to identify the locations of forces and reconstruct their time histories, which can be further used to reveal the mechanical cause of the radiated noise.
Challenges in confirming drug effectiveness after early approval
Authors: Lynch Holly Fernandez , Robertson Christopher T.
Published: December 2021

Reform requires clarity about whether, when, and how meaningful postapproval trials are possible
Forest fight
Authors: Popkin Gabriel
Published: December 2021

Germany invented “scientific” forestry. But a huge dieback triggered by climate change has ignited a fierce debate over how the nation should manage its trees
Draft Genome Sequences of Cefepime-Resistant and -Susceptible Escherichia coli Strains and Imipenem-Resistant and -Susceptible Pseudomonas aeruginosa Strains
Authors: Batchelder Kendra , Ward Liz , Collins Elsa , Miles Caitlin , Palm Stefania , Mohamed Aisha , Feinstein Larry
Published: December 2021

Draft genome sequences ofEscherichia coliandPseudomonas aeruginosastrains collected from clinical infections were used to determine the prevalence of newly emerging antibiotic resistance genes in Maine. Comparisons between cefepime-resistant and -susceptibleE. colistrains and imipenem-resistant and -susceptibleP. aeruginosastrains are being conducted.
Draft Genome Sequence of
Schnuerera
sp. Strain xch1, Isolated from the Tibetan Plateau
Authors: Gu Jiahao , Xiao Chenhan , Liu Yongqin
Published: December 2021

In this study, we report the draft genome sequence of
Schnuerera
sp. strain xch1, which was isolated from a high-altitude thermal spring on the Tibetan Plateau. The enzymes and metabolic pathways of the strain may have further applications in biomass technology.
Eukaryotic Communities in Aquatic Mesocosms with and without Calcined Dolomite Investigated Using 18S rRNA Amplicon-Based Metagenomics
Authors: Itaya Yuki , Nakamura Shogo , Akiyama Tatsushi , Kuninishi Kenji
Published: December 2021

We report the 18S rRNA gene amplicon data from aquatic mesocosms with and without calcined dolomite. Intramacronucleata and Eumetazoa were present in roughly the same amounts in the water phase in both mesocosms. Chlorophyceae and several groups were detected as the major eukaryotes in the microbes attached to the calcined dolomite surface.
Genome Sequence of the Thermophilic Soil Bacterium Ureibacillus terrenus ATCC BAA-384
T
Authors: Simoes Junior Milto , MacLea Kyle S.
Published: December 2021

Ureibacillus terrenus
TH9A
T
(=ATCC BAA-384
T
) was isolated from uncultivated soil in Italy in 1995. We present a draft genome sequence for the type strain, with a predicted genome length of 2,936,851 bp, containing 2,766 protein-coding genes, 82 RNA genes, and 5 CRISPR arrays, with a G+C content of 42.5%.
Middle Jurassic to Early Cretaceous tectonic evolution of the western Klamath Mountains and outboard Franciscan assemblages, northern California–southern Oregon, USA
Authors: Chapman* Alan D. , Yule Doug , Schmidt William , LaMaskin Todd
Published: December 2021

The Klamath Mountains province and adjacent Franciscan subduction complex (northern California–southern Oregon) together contain a world-class archive of subduction-related growth and stabilization of continental lithosphere. These key elements of the North American Cordillera expanded significantly from Middle Jurassic to Early Cretaceous time, apparently by a combination of tectonic accretion and continental arc– plus rift-related magmatic additions. The purpose of this field trip is twofold: to showcase the rock record of continental growth in this region and to discuss unresolved regional geologic problems. The latter include: (1) the extent to which Mesozoic orogenesis (e.g., Siskiyou and Nevadan events plus the onset of Franciscan accretion) was driven by collision of continental or oceanic fragments versus changes in plate motion, (2) whether growth involved “accordion tectonics” whereby marginal basins (and associated fringing arcs) repeatedly opened and closed or was driven by the accretion of significant volumes of material exotic to North America, and (3) the origin of the Condrey Mountain schist, a composite low-grade unit occupying an enigmatic structural window in the central Klamaths—at odds with the east-dipping thrust sheet regional structural “rule.” Respectively, we assert that (1) if collision drove orogenesis, the requisite exotic materials are missing (we cannot rule out the possibility that such materials were removed via subduction and/or strike slip faulting); (2) opening and closure of the Josephine ophiolite-floored and Galice Formation–filled basin demonstrably occurred adjacent to North America; and (3) the inner Condrey Mountain schist domain is equivalent to the oldest clastic Franciscan subunit (the South Fork Mountain schist) and therefore represents trench assemblages underplated >100 km inboard of the subduction margin, presumably during a previously unrecognized phase of shallow-angle subduction. In aggregate, these relations suggest that the Klamath Mountains and adjacent Franciscan complex represent telescoped arc and forearc upper plate domains of a dynamic Mesozoic subduction zone, wherein the downgoing oceanic plate took a variety of trajectories into the mantle. We speculate that the downgoing plate contained alternating tracts of smooth and dense versus rough and buoyant lithosphere—the former gliding into the mantle (facilitating slab rollback and upper plate extension) and the latter enhancing basal traction (driving upper plate compression and slab-shallowing). Modern snapshots of similarly complex convergent settings are abundant in the western Pacific Ocean, with subduction of the Australian plate beneath New Guinea and adjacent island groups providing perhaps the best analog.
Ultrahigh-temperature granulite-facies metamorphism and exhumation of deep crust in a migmatite dome during late- to post-orogenic collapse and extension in the central Adirondack Highlands (New York, USA)
Authors: Metzger Ellen P. , Leech Mary L. , Davis Michael W. , Reeder Jackson V. , Swanson Brandon A. , Waring Heather V.
Published: December 2021

This study combines field observations, mineral and whole-rock geochemistry, phase equilibrium modeling, and U-Pb sensitive high-resolution ion microprobe (SHRIMP) zircon geochronology to investigate sillimanite-bearing felsic migmatites exposed on Ledge Mountain in the central Adirondack Highlands (New York, USA), part of an extensive belt of mid-crustal rocks comprising the hinterland of the Mesoproterozoic Grenville orogen. Phase equilibrium modeling suggests minimum peak metamorphic conditions of 960–1025 °C and 11–12.5 kbar during the Ottawan orogeny—significantly higher pressure-temperature conditions than previously determined—followed by a period of near-isothermal decompression, then isobaric cooling. Petrography reveals abundant melt-related microstructures, and pseudosection models show the presence of at least ~15%–30% melt during buoyancy-driven exhumation and decompression. New zircon data document late Ottawan (re)crystallization at ca. 1047 ± 5 to 1035 ± 2 Ma following ultrahigh-temperature (UHT) metamorphism and anatexis on the retrograde cooling path. Inherited zircon cores give a mean date of 1136 ± 5 Ma, which suggests derivation of these felsic granulites by partial melting of older igneous rocks. The ferroan, anhydrous character of the granulites is similar to that of the ca. 1050 Ma Lyon Mountain Granite and consistent with origin in a late- to post-Ottawan extensional environment. We present a model for development of a late Ottawan migmatitic gneiss dome in the central Adirondacks that exhumed deep crustal rocks including the Snowy Mountain and Oregon anorthosite massifs with UHT Ledge Mountain migmatites. Recognition of deep crustal meta-plutonic rocks recording UHT metamorphism in a migmatite gneiss dome has significant implications for crustal behavior in this formerly thickened orogen.
Mapping global trends in vaccine sales before and during the first wave of the COVID-19 pandemic: a cross-sectional time-series analysis
Authors: Zeitouny Seraphine , Suda Katie J , Mitsantisuk Kannop , Law Michael R , Tadrous Mina
Published: December 2021

Background

While the COVID-19 pandemic may have substantially hindered the provision of routine immunisation services worldwide, we have little data on the impact of the pandemic on vaccine supply chains.

Methods

We used time-series analysis to examine global trends in vaccine sales for a total of 34 vaccines and combination vaccines using data from the IQVIA MIDAS Database between August 2014 and August 2020 across 84 countries. We grouped countries into three income-level categories, and we modelled the changes in vaccine sales from April to August 2020 versus April to August 2019 using autoregressive integrated moving average models.

Results

In March 2020, global sales of vaccines dropped from 1211.1 per 100 000 to 806.2 per 100 000 population in April 2020, an overall decrease of 33.4%; however, the vaccine sales interruptions recovered disproportionately across economies. Between April 2020 and August 2020, we found a significant decrease of 20.6% (p<0.001) in vaccine sales across high-income countries (HICs), in contrast with a significant increase of 10.7% (p<0.001) across lower middle-income countries (LMICs), relative to the same period in 2019. From August 2014 through August 2020, monthly per capita vaccine sales across HICs remained, on average, at least four times higher than in LMICs and nearly three times higher than in upper middle-income countries.

Conclusion

Our study revealed the heterogeneous impact of COVID-19 on vaccine sales across economies while underlining the substantial consistent disparities in per capita vaccine sales before and during the first wave of the COVID-19 pandemic. Action to ensure equitable distribution of vaccines is needed.