bluuebunny/crossref_metadata_2025 huggingface dataset:
Endoscopic management of perihilar cholangiocarcinoma
Authors: Kawashima Hiroki , Ohno Eizaburo , Ishikawa Takuya , Mizutani Yasuyuki , Iida Tadashi , Yamamura Takeshi , Kakushima Naomi , Furukawa Kazuhiro , Nakamura Masanao
Published: April 2022

Endoscopic management for perihilar cholangiocarcinoma (PHCC) is evolving toward more accurate diagnosis and safer drainage. In imaging, it is important to diagnose the entire lesion using multidetector‐row computed tomography to determine resectability and optimal surgical planning, followed by local diagnosis using endoscopic retrograde cholangiopancreatography. Video peroral cholangioscopy and probe‐based confocal laser endomicroscopy have been newly introduced as diagnostic imaging methods and are being applied clinically. In transpapillary forceps biopsy for PHCC diagnosis, the location in the bile duct (for mapping biopsy) and the number of biopsy samples should be determined depending on resectability, the morphological type, and future surgical planning. Preoperative drainage has shifted from percutaneous transhepatic biliary drainage to endoscopic nasobiliary drainage given the possibility of seeding metastasis. In addition, considering potential patient discomfort from a nasal tube, the usefulness of the placement of a plastic stent above the papilla (inside stent) as a bridging therapy for surgery has been reported. For drainage of unresectable PHCC, the improved prognosis due to advances in chemotherapy has necessitated a strategy that accounts for reintervention. Thus, in addition to uncovered self‐expandable metallic stents (SEMS), exchangeable slim fully covered SEMS and inside stents have started to be used. In addition to the conventional transpapillary approach, an endoscopic ultrasonography‐guided approach has been introduced, and a combination of both methods has also been proposed. To improve the quality of life and prognosis of PHCC patients, endoscopists need to understand and be able to use the various methods of endoscopic management for PHCC.
Cost‐effectiveness of sodium‐glucose cotransporter‐2 inhibitors versus dipeptidyl peptidase‐4 inhibitors among patients with type 2 diabetes with and without established cardiovascular diseases: A model‐based simulation analysis using 10‐year real‐world data and targeted literature review
Authors: Peng Zi‐Yang , Yang Chun‐Ting , Ou Huang‐Tz , Kuo Shihchen
Published: April 2022

Aim

We conducted a model‐based economic analysis of sodium‐glucose cotransporter‐2 inhibitors (SGLT2is) versus dipeptidyl peptidase‐4 inhibitors (DPP4is) in patients with type 2 diabetes (T2D), with and without established cardiovascular diseases (CVDs), using 10‐year real‐world data.

Materials and Methods

A Markov model was utilized to estimate healthcare costs and quality‐adjusted life‐years (QALYs) over a 10‐year simulation time horizon from a healthcare sector perspective, with both costs and QALYs discounted at 3% annually. Model inputs were derived from analyses of Taiwan's National Health Insurance Research Database or published studies of Taiwanese populations. The primary outcome measure was the incremental cost‐effectiveness ratios (ICERs). Incorporated with our study findings, a targeted literature review was conducted to synthesize updated evidence on the cost‐effectiveness of SGLT2is versus DPP4is.

Results

Over 10 years, use of SGLT2is versus DPP4is yielded ICERs of $3244 and $4186 per QALY gained for patients with T2D, with and without established CVDs, respectively. Results were robust across a series of sensitivity and scenario analyses, showing ICERs between $‐1074 (cost‐saving) and $8467 per QALY gained for patients with T2D with established CVDs and between $369 and $37 122 per QALY gained for patients with T2D without established CVDs.

Conclusions

Use of SGLT2is versus DPP4is was highly cost‐effective for patients with T2D regardless of their CVD history in real‐world clinical practice. Our results extend current evidence by showing SGLT2is as an economically rational alternative over DPP4is for T2D treatment in routine care. Future research is warranted to explore the heterogeneous economic benefits of SGLT2is given diverse patient characteristics in clinical settings.
Effectiveness of low‐carbohydrate diets for long‐term weight loss in obese individuals: A meta‐analysis of randomized controlled trials
Authors: Silverii Giovanni Antonio , Cosentino Claudia , Santagiuliana Federica , Rotella Francesco , Benvenuti Federica , Mannucci Edoardo , Cresci Barbara
Published: April 2022

Aim

To assess whether low‐carbohydrate (LC) diets are associated with differences in weight loss and well‐being in people with obesity, and their cardiovascular and renal safety.

Materials and Methods

A meta‐analysis of randomized controlled trials longer than 3 months, retrieved through an extensive search on MedLine and Embase databases, comparing weight loss with LC and control diets in people with body mass index (BMI) greater than 30 kg/m2, was conducted.

Results

We retrieved 25 trials. Compared with controls, LC diets were associated with significant reduction of body weight at 3‐4 (MD −2.59 [−3.93, −1.25] kg) and 6‐8 months (MD −2.64 [−4.32, −0.95]), but no difference at 10‐14 and 18‐30 months, and significantly greater BMI reduction at 3‐4 months (−1.66 [−2.70, −0.61] kg/m2), but not at other time points. Because only four trials reported data on renal function and psychological variables, renal safety and impact on well‐being could not be assessed. Differences in fasting plasma glucose at any time point were not statistically significant. No significant differences in total or LDL cholesterol or blood pressure were found in the long term, whereas a long‐term reduction of triglycerides (23.26 [−45.53, −0.98] mg/dl at 18‐30 months), and increase of HDL cholesterol (MD 4.94 [0.30, 9.57] mg/dl at 18‐30 months), were observed.

Conclusion

LC diets are associated with greater short‐term weight loss than non‐carbohydrate–restricted diets and a longer term favourable effect on cardiovascular risk factors. Further evidence on long‐term efficacy and renal safety is needed before LC diets can be recommended as the preferred diets in obese people.
Efficacy and safety of oral semaglutide by subgroups of patient characteristics in the PIONEER phase 3 programme
Authors: Aroda Vanita R. , Bauer Robert , Christiansen Erik , Haluzík Martin , Kallenbach Klaus , Montanya Eduard , Rosenstock Julio , Meier Juris J.
Published: April 2022

Aims

To evaluate the efficacy and safety of oral semaglutide versus comparators by patient characteristic subgroups in patients with type 2 diabetes.

Materials and Methods

Change from baseline in glycated haemoglobin (HbA1c) and body weight, and achievement of HbA1c <7.0% with oral semaglutide 7 mg, oral semaglutide 14 mg, flexibly dosed oral semaglutide (flex) and comparators were assessed across baseline subgroups (age, race, ethnicity, diabetes duration, body mass index and HbA1c) from the PIONEER programme. Treatment differences were analysed using a mixed model for repeated measurements for continuous variables and a logistic regression model for the binary endpoint. Pooled safety data were analysed descriptively.

Results

Changes from baseline in HbA1c and body weight, and the odds of achieving HbA1c <7.0%, were greater with oral semaglutide 14 mg/flex (n = 1934) and higher or similar with oral semaglutide 7 mg (n = 823) versus comparators (n = 2077) across most subgroups. Changes in HbA1c with oral semaglutide 14 mg/flex were greater for patients with higher baseline HbA1c (HbA1c >9.0%: –1.7% to –2.6%; HbA1c <8.0%: –0.7% to –1.2%). In some trials, Asian patients experienced greater HbA1c reductions with oral semaglutide 14 mg/flex (–1.5% to –1.8%) than other racial groups (–0.6% to –1.6%). The overall incidence of adverse events (AEs) with oral semaglutide was similar to that with comparators and was consistent across subgroups. More gastrointestinal AEs were observed with oral semaglutide, versus comparators, across subgroups.

Conclusions

Oral semaglutide demonstrated consistently greater HbA1c and body weight reductions across a range of patient characteristics, with greater HbA1c reductions seen at higher baseline HbA1c levels.
Lack of clinically relevant differences in safety and pharmacokinetics after second‐dose administration of intranasal diazepam within 4 h for acute treatment of seizure clusters: A population analysis
Authors: Cascino Gregory D. , Tarquinio Daniel , Wheless James W. , Hogan Robert Edward , Sperling Michael R. , Desai Jay , Vazquez Blanca , Samara Emil , Misra Sunita N. , Carrazana Enrique , Rabinowicz Adrian L. ,   for the DIAZ.001.05 Study Group
Published: April 2022

Objective

Current diazepam nasal spray labeling requires waiting 4 h before administering a second dose. The objective of the current analyses was to examine safety and pharmacokinetic profiles of second doses of diazepam nasal spray given 0−4 h after the first dose.

Methods

Two datasets were analyzed. The first, a long‐term, repeat‐dose safety study of diazepam nasal spray, compared rates of treatment‐emergent adverse events (TEAEs), serious TEAEs, and treatment‐related TEAEs for patients receiving ≥1 second dose ≤4 h versus all second doses >4 h after the first. The second was a population pharmacokinetic analysis using data from three phase 1 studies to model drug exposure when a second dose of diazepam nasal spray was administered across multiple time points (1 min−4 h) following the first dose.

Results

In the repeat‐dose safety study, a second dose of diazepam nasal spray was administered ≤24 h after the first to treat 485 seizure clusters in 79 patients. Rates of TEAEs were similar between patients receiving ≥1 second dose in ≤4 h (89.5%, n = 38) compared with >4–24 h only (80.5%, n = 41). The most common treatment‐related TEAEs were associated with nasal discomfort, which was mild or moderate and transient. There were no reports of respiratory or cardiac depression. The pharmacokinetic simulations of second doses predicted comparable elevations of plasma diazepam concentrations with administrations across a range of intervals after the first dose (1 min−4 h).

Significance

These data indicate that the safety and pharmacokinetic profiles of a second dose of diazepam nasal spray administered within 4 h of the first dose are consistent with those associated with current labeling. This is potentially important for patients with seizure clusters who have a recurrent seizure within 4 h of first treatment and might benefit from immediate retreatment to reduce the risk of progression to status epilepticus.
Deep transfer learning for COVID‐19 fake news detection in Persian
Authors: Ghayoomi Masood , Mousavian Maryam
Published: April 2022

The spread of fake news on social media has increased dramatically in recent years. Hence, fake news detection systems have received researchers' attention globally. During the COVID‐19 outbreak in 2019 and the worldwide epidemic, the importance of this issue becomes more apparent. Due to the importance of the issue, a large number of researchers have begun to collect English datasets and to study COVID‐19 fake news detection. However, there are a large number of low‐resource languages, including Persian, that cannot develop accurate tools for automatic COVID‐19 fake news detection due to the lack of annotated data for the task. In this article, we aim to develop a corpus for Persian in the domain of COVID‐19 where the fake news is annotated and to provide a model for detecting Persian COVID‐19 fake news. With the impressive advancement of multilingual pre‐trained language models, the idea of cross‐lingual transfer learning can be proposed to improve the generalization of models trained with low‐resource language datasets. Accordingly, we use the state‐of‐the‐art deep cross‐lingual contextualized language model, XLM‐RoBERTa, and the parallel convolutional neural networks to detect Persian COVID‐19 fake news. Moreover, we use the idea of knowledge transferring across‐domains to improve the results by using both the English COVID‐19 dataset and the general domain Persian fake news dataset. The combination of both cross‐lingual and cross‐domain transfer learning has outperformed the models and it has beaten the baseline by 2.39% significantly.
Dietary restriction modulates mitochondrial DNA damage and oxylipin profile in aged rats
Authors: Gureev Artem P. , Andrianova Nadezda V. , Pevzner Irina B. , Zorova Ljubava D. , Chernyshova Ekaterina V. , Sadovnikova Irina S. , Chistyakov Dmitry V. , Popkov Vasily A. , Semenovich Dmitry S. , Babenko Valentina A. , Silachev Denis N. , Zorov Dmitry B. , Plotnikov Egor Y. , Popov Vasily N.
Published: April 2022

Age‐related impairment of coordination of the processes of maintaining mitochondrial homeostasis is associated with a decrease in the functionality of cells and leads to degenerative processes. mtDNA can be a marker of oxidative stress and tissue degeneration. However, the mechanism of accumulation of age‐related damage in mtDNA remains unclear. In the present study, we analyzed the accumulation of mtDNA damage in several organs of rats during aging and the possibility of reversing these alterations by dietary restriction (DR). We showed that mtDNA of brain compartments (with the exception of the cerebellum), along with kidney mtDNA, was the most susceptible to accumulation of age‐related damage, whereas liver, testis, and lung were the least susceptible organs. DR prevented age‐related accumulation of mtDNA damage in the cortex and led to its decrease in the lung and testis. Changes in mtDNA copy number and expression of genes involved in the regulation of mitochondrial biogenesis and mitophagy were also tissue‐specific. There was a tendency for an age‐related decrease in the copy number of mtDNA in the striatum and its increase in the kidney. DR promoted an increase in the amount of mtDNA in the cerebellum and hippocampus. mtDNA damage may be associated not only with the metabolic activity of organs, but also with the lipid composition and activity of processes associated with the isoprostanes pathway of lipid peroxidation. The comparison of polyunsaturated fatty acids and oxylipin profiles in old rats showed that DR decreased the synthesis of arachidonic acid and its metabolites synthesized by the cyclooxygenase, cytochrome P450 monooxygenases and lipoxygenase metabolic pathways.
Record‐setting algal bloom in polymictic Lake Balaton (Hungary): A synergistic impact of climate change and (mis)management
Authors: Istvánovics Vera , Honti Márk , Torma Péter , Kousal Josh
Published: April 2022

After 25 years of apparently successful eutrophication management, a record‐breaking mixed bloom of Ceratium furcoides and Aphanizomenon flos‐aquae developed unexpectedly in 2019 in the large, polymictic Lake Balaton. The peak concentration of chlorophyll exceeded 300 mg/m3, 1.5 times higher than the pre‐management maxima. The external load was insufficient to provide the phosphorus (P) required to support this bloom, and its taxonomic composition was radically different from blooms in the 1980s. We hypothesised: (1) that unusually long periods of intermittent stratification led to anoxic P release from the sediments, providing the required P; and (2) that the surprising bloom composition indicated a potential regime shift.

To test hypothesis 1, we analysed decade‐long high‐frequency data on drivers of lake metabolism recorded at a shallow near‐shore observatory. To explore likely dissolved oxygen (DO) conditions in deep water in 2019, we performed a sensitivity analysis of a one‐dimensional DO model driven by the General Ocean Turbulence Model, the latter being calibrated against high‐frequency hydrometeorological data measured in the open water. Hypothesis 2 was examined by a sequential t‐test analysis applied to multidecadal (1976–2020) data on phytoplankton biomass and composition, nutrient loads and summer mean air temperature.

We found that DO depletion (<1 g/m3) was the immediate precursor of the large 2019 bloom. The synergistic impact of a climatic regime shift and multiple coincident management actions provoked a shift in phytoplankton composition in 2013 and forced the ecosystem into the state of internal eutrophication.

In the present ecosystem state, similarly large blooms could develop in any summer depending on the sequence of weather events. Within the present, warmer climate regime identified here, the effectiveness of external nutrient control in eutrophication management may be limited by changes in the thermal structure. Therefore, it is vital to supplement external nutrient control with internal nutrient control strategies, such as water level regulation, to manage eutrophication and prevent future blooms.

Large, continuous polymictic lakes are susceptible to small changes in water level, because the likelihood of stratification (and thus the likeliness of a eutrophication event) increases steeply and non‐linearly with increasing depth. With a climate that continues to warm, and the associated changes expected in internal lake processes, it is possible that we will see regime shifts (such as that identified in Lake Balaton) across more lakes globally. Managing these conditions will require case‐specific modifications of lake management plans.
Plant hydraulics, stomatal control, and the response of a tropical forest to water stress over multiple temporal scales
Authors: Detto Matteo , Pacala Stephen W.
Published: April 2022

Many tropical regions are experiencing an intensification of drought, with increasing severity and frequency. The ecosystem response to these changes is still highly uncertain. On short time scales (from diurnal to seasonal), tropical forests respond to water stress by physiological controls, such as stomatal regulation and phenological adjustment, to cope with increasing atmospheric water demand and reduced water supply. However, the interactions among biological processes and co‐varying environmental factors that determine the ecosystem‐level fluxes are still unclear. Furthermore, climate variability at longer time scales, such as that generated by ENSO, produces less predictable effects because it depends on a highly stochastic combination of factors that might vary among forests and even between events in the same forest. This study will present some emerging patterns of response to water stress from 5 years of water, carbon, and energy fluxes observed on a seasonal tropical forest in central Panama, including an increase in productivity during the 2015 El Niño. These responses depend on the combination of environmental factors experienced by the forest throughout the seasonal cycle, in particular, increase in solar radiation, stimulating productivity, and increasing vapor pressure deficit (VPD) and decreasing soil moisture, limiting stomata opening. These results suggest a critical role of plant hydraulics in mediating the response to water stress over a broad range of temporal scales (diurnal, intraseasonal, seasonal, and interannual), by acclimating canopy conductance to light and VPD during different soil moisture regimes. A multilayer photosynthesis model coupled with a plant hydraulics scheme can reproduce these complex responses. However, results depend critically on parameters regulating water transport efficiency and the cost of water stress. As these costs have not been properly identified and quantified yet, more empirical research is needed to elucidate physiological mechanisms of hydraulic failure and recover, for example embolism repair and xylem regrowth.
Positron‐emitting radiotracers spatially resolve unexpected biogeochemical relationships linked with methane oxidation in Arctic soils
Authors: Schmidt Michael P. , Mamet Steven D. , Senger Curtis , Schebel Alixandra , Ota Mitsuaki , Tian Tony W. , Aziz Umair , Stein Lisa Y. , Regier Tom , Stanley Kevin , Peak Derek , Siciliano Steven D.
Published: April 2022

Arctic soils are marked by cryoturbic features, which impact soil‐atmosphere methane (CH4) dynamics vital to global climate regulation. Cryoturbic diapirism alters C/N chemistry within frost boils by introducing soluble organic carbon and nutrients, potentially influencing microbial CH4 oxidation. CH4 oxidation in soils, however, requires a spatio‐temporal convergence of ecological factors to occur. Spatial delineation of microbial activity with respect to these key microbial and biogeochemical factors at relevant scales is experimentally challenging in inherently complex and heterogeneous natural soil matrices. This work aims to overcome this barrier by spatially linking microbial CH4 oxidation with C/N chemistry and metagenomic characteristics. This is achieved by using positron‐emitting radiotracers to visualize millimeter‐scale active CH4 uptake areas in Arctic soils with and without diapirism. X‐ray absorption spectroscopic speciation of active and inactive areas shows CH4 uptake spatially associates with greater proportions of inorganic N in diapiric frost boils. Metagenomic analyses reveal Ralstonia pickettii associates with CH4 uptake across soils along with pertinent CH4 and inorganic N metabolism associated genes. This study highlights the critical relationship between CH4 and N cycles in Arctic soils, with potential implications for better understanding future climate. Furthermore, our experimental framework presents a novel, widely applicable strategy for unraveling ecological relationships underlying greenhouse gas dynamics under global change.
Using isotope pool dilution to understand how organic carbon additions affect N2O consumption in diverse soils
Authors: Stuchiner Emily R. , von Fischer Joseph C.
Published: April 2022

Nitrous oxide (N2O) is a formidable greenhouse gas with a warming potential ~300× greater than CO2. However, its emissions to the atmosphere have gone largely unchecked because the microbial and environmental controls governing N2O emissions have proven difficult to manage. The microbial process N2O consumption is the only know biotic pathway to remove N2O from soil pores and therefore reduce N2O emissions. Consequently, manipulating soils to increase N2O consumption by organic carbon (OC) additions has steadily gained interest. However, the response of N2O emissions to different OC additions are inconsistent, and it is unclear if lower N2O emissions are due to increased consumption, decreased production, or both. Simplified and systematic studies are needed to evaluate the efficacy of different OC additions on N2O consumption. We aimed to manipulate N2O consumption by amending soils with OC compounds (succinate, acetate, propionate) more directly available to denitrifiers. We hypothesized that N2O consumption is OC‐limited and predicted these denitrifier‐targeted additions would lead to enhanced N2O consumption and increased nosZ gene abundance. We incubated diverse soils in the laboratory and performed a 15N2O isotope pool dilution assay to disentangle microbial N2O emissions from consumption using laser‐based spectroscopy. We found that amending soils with OC increased gross N2O consumption in six of eight soils tested. Furthermore, three of eight soils showed Increased N2O Consumption and Decreased N2O Emissions (ICDE), a phenomenon we introduce in this study as an N2O management ideal. All three ICDE soils had low soil OC content, suggesting ICDE is a response to relaxed C‐limitation wherein C additions promote soil anoxia, consequently stimulating the reduction of N2O via denitrification. We suggest, generally, OC additions to low OC soils will reduce N2O emissions via ICDE. Future studies should prioritize methodical assessment of different, specific, OC‐additions to determine which additions show ICDE in different soils.
HIV‐associated thrombotic thrombocytopenic purpura (HIV‐TTP): A practical guide and review of the literature
Authors: Louw Susan , Jacobson Barry Frank , Wiggill Tracey Monica , Chapanduka Zivanai , Sarah Mayne Elizabeth
Published: April 2022

Background

Thrombotic thrombocytopenic purpura (TTP), a serious thrombotic microangiopathy (TMA), is prevalent in the South African HIV‐infected population. The exact pathogenesis of HIV‐associated TTP (HIV‐TTP) is however still unclear with diagnostic and therapeutic inconsistancies.

Methods

A systematic review of the published literature regarding HIV‐TTP was performed.

Results

HIV‐TTP is still associated with significant morbidity and mortality in Africa despite the availability of anti‐retroviral therpy (ART). Diagnosis of HIV‐TTP requires the presence of a micro‐angiopathic haemolytic anaemia with significant red blood cell schistocytes and thrombocytopenia in the absence of another TMA but background activation of the coagulation system and inflammation in HIV infected people can result in diagnostic anbiguity. Plasma therapy in the form of infusion or exchange is successful but expensive, associated with side‐effects and not widely available. Adjuvant immunosuppression therapy may of benefit in patients with HIV‐TTP and ART must always be optimised. Endothelial dysfunction caused by chronic inflammation and complement activation most likely contributes to the development of HIV‐TTP.

Conclusion

The role of adjuvant immunomodulating therpy, the therapeutic targets and pathogenic contribution from endothelial dysfunction in HIV‐TTP requires further investigation.
Classified processing of different rice bran fractions according to their component distributions
Authors: Yu Cheng‐wei , Luo Ting , Xie Tian , Li Jing , Deng Ze‐yuan
Published: April 2022

Rice grains were obtained from two Chinese provinces (Hubei and Guangxi) and then their rice bran was abraded into four equal fractions by weight from outside to inside. The component distributions in these four fractions were then investigated. The contents of total lipid‐soluble antioxidant showed no significant difference between rice bran from the Hubei province and the Guangxi province. But the content of total water‐soluble antioxidant was 1690.20 ± 86.40 mg kg−1 for rice bran from the Hubei province, significantly higher than those from the Guangxi province (1014.67 ± 71.09 mg kg−1). Obvious differences between four rice bran fractions or two provinces were proved by principal component analysis (PCA). Lipase activities decreased significantly from outer fractions to inner fractions, and lipids mainly distributed in three outer fractions. The essential element contents decreased significantly, but a main heavy metal element (Pb) in cereal increased significantly to 0.36 mg kg−1 from outer fractions to inner fractions, which was just slightly below the upper limit of Chinese Standard (0.40 mg kg−1). Although protein contents had no significant difference in four fractions, the amino acid compositions were quite different. In summary, different fractions of rice bran had different compositions, which could provide guidance for the classified processing of rice bran.
Role of hormones in the pregnancy and sex‐specific outcomes to infections with respiratory viruses*
Authors: Cervantes Orlando , Cruz Talavera Irene , Every Emma , Coler Brahm , Li Miranda , Li Amanda , Li Hanning , Adams Waldorf Kristina
Published: April 2022

Pregnant women infected with pathogenic respiratory viruses, such as influenza A viruses (IAV) and coronaviruses, are at higher risk for mortality, hospitalization, preterm birth, and stillbirth. Several factors are likely to contribute to the susceptibility of pregnant individuals to severe lung disease including changes in pulmonary physiology, immune defenses, and effector functions of some immune cells. Pregnancy is also a physiologic state characterized by higher levels of multiple hormones that may impact the effector functions of immune cells, such as progesterone, estrogen, human chorionic gonadotropin, prolactin, and relaxin. Each of these hormones acts to support a tolerogenic immune state of pregnancy, which helps prevent fetal rejection, but may also contribute to an impaired antiviral response. In this review, we address the unique role of adaptive and innate immune cells in the control of pathogenic respiratory viruses and how pregnancy and specific hormones can impact their effector actions. We highlight viruses with sex‐specific differences in infection outcomes and why pregnancy hormones may contribute to fetal protection but aid the virus at the expense of the mother's health.
Wound repair, safety, and functional outcomes in reconstructive lower extremity foot and ankle surgery using a dehydrated amnion/chorion allograft membrane
Authors: Tacktill Jordan Z. , Rasor Zachary , Adams Josh , Driver Gary , Shannon Logan , Hudzinski Scott , Carter Marissa J. , Isaac Adam L. , Zelen Charles M.
Published: April 2022

Amniotic membranes are known to be rich in growth factors, cytokines, and matrix proteins, which can help support wound closure and may improve patient outcomes in foot and ankle surgical interventions. In this Institutional Review Board (IRB) approved clinical study, 21 consecutive patients undergoing lower extremity soft tissue and bone reconstruction surgery received dehydrated human amnion and chorion allograft (dHACA) placed as a covering over the deep layers of the surgical wound during closure. Wound healing complications were assessed and American Orthopaedic Foot and Ankle Society (AOFAS) scores were compiled from over a 1‐year follow‐up period. Summary statistics were calculated for average pain, function, and alignment. The average overall AOFAS pre‐treatment score was 35.8 ± 23.0 and the post‐treatment score significantly improved to 87.5 ± 6.4 (P = 3.7 × 10−10). The pain‐score improved from pre‐treatment at 10.0 ± 11.0 to post‐treatment at 36.7 ± 4.8 (P = 5.0 × 10−5). The pre‐treatment function score was 18.7 ± 12.9 and at post‐treatment increased to 38.5 ± 5.7 (P = 5.8 × 10−5). Lastly, the alignment score at pre‐treatment was 7.1 ± 4.4 and at post‐treatment was 12.4 ± 2.6 (P = .001). These improvements in functional scores were accompanied with clinical observations of reduced surgical complications including a lack of wound dehisance in the cohort. These clinical findings suggest that the application of aseptically processed dHACA may reduce wound complications and as such may aide in clinical improvements in foot and ankle surgical interventions however a larger comparative trial should be considered to validate these initial findings.
Impact of the Anthropocene on the status of the world's small carnivores: A global macroecological perspective
Authors: Torres‐Romero Erik Joaquín , Giordano Anthony J.
Published: April 2022

Aim

The continued erosion of global biodiversity resulting from Earth's sixth mass extinction event has been particularly pronounced on mammalian carnivores. Here, we evaluated the status of the world's small carnivore species (SCS) (<15 kg), examined their trending status and assessed the threats they face globally and regionally.

Location

Worldwide.

Taxon

Small carnivore species.

Methods

Using a global 100 km2grid, we analysed the impact of 12 variables (anthropogenic and landscape) on general small carnivore richness (SCR), threatened species richness and the number of declining SCS. We applied simple, multiple and simultaneous regression models to explore the associations between landscape conditions and human impacts on SCR.

Results

Approximately 22% (n = 49) of SCS are classified as threatened (vulnerable, endangered and critically endangered), with the largest number occurring in the Indo‐Malayan, followed by the Afrotropical regions. The family Mustelidae had the greatest number of threatened species, followed by the Felidae, Viverridae and Eupleridae. Euplerids, however, had the highest proportion of threatened species (90%). Human accessibility had the strongest negative impact on global species richness, whereas landscape modification gradient, indigenous lands and intact forest structure, all predicted higher levels of overall and threatened SCR. Approximately 84% of SCS are threatened by illegal wildlife trafficking, with greatest proportion hailing from the Indo‐Malayan region, followed by the Afrotropical region.

Conclusions

Landscape conditions play a leading role in the conservation of SCS. However, the impact of humans has dramatically modified the spatial patterns of small carnivores across the globe. We believe new incentives promoting more sustainable landscapes could facilitate coexistence between carnivores and human communities. We advocate for new policies promoting sustainable practices, which are needed to help mitigate extinction risk and facilitate coexistence with small carnivores across the planet's human‐dominated landscapes.
Metabolic syndrome and periodontitis among adults: The 2018 Indonesia National Health Survey
Authors: Santoso Cornelia Melinda Adi , Bramantoro Taufan , Kardos László , Szakács Dóra Fanni , Nagy Attila
Published: April 2022

Aim

This study aimed to examine the association between metabolic syndrome (MetS), its components, and periodontitis among Indonesian adults.

Materials and Methods

Cross‐sectional data from the 2018 Indonesia National Health Survey (Riskesdas) was analysed. The sample included dentate individuals aged 35 years or older for whom complete information was available on components of MetS and periodontitis, including bleeding on probing (BOP) (N = 13,356), pocket depth (PD) (N = 13,273), and clinical attachment loss (CAL) (N = 13,000). Rate ratios (RRs) and 95% confidence intervals (CIs) were estimated with negative binomial regression models.

Results

The prevalence of MetS was 41.0%. The prevalence of individuals having at least one tooth with BOP, one tooth with PD ≥4 mm, or one sextant with CAL ≥4 mm was 74.9%, 40.7%, and 40.6%, respectively. No associations were observed between MetS and BOP, PD, or CAL, but hyperglycaemia was constantly positively associated with BOP (RR = 1.06; 95% CI 1.01–1.11), PD (RR = 1.13; 95% CI 1.03–1.23), and CAL (RR = 1.15; 95% CI 1.08–1.23).

Conclusions

Our findings support the potential influence of hyperglycaemia on periodontitis. Incorporating oral disease prevention strategies into the management of systemic diseases could be beneficial for reducing the burden of these diseases in Indonesia.
Investigating shrinkage corrected drying characteristics, rehydration, color profile and microstructural evolution during solar drying of pineapple slices
Authors: Rani Poonam , Tripathy Punyadarshini Punam
Published: April 2022

The study describes the solar drying characteristics of pineapple slices with incorporation of shrinkage and influence of drying and rehydration on structural alterations, color profile and microstructure. Samples were dried in mixed mode solar dryer at an air velocity of 0.5 m/s, with recorded average solar radiation, ambient and drying chamber temperature of 665 W/m2, 33°C and 65°C, respectively, from initial moisture content of 89.9% to a final moisture content of 23% in 6.5 h. Samples showed 43.7% higher drying rate and 82.25% lesser moisture diffusivity on consideration of shrinkage. Moisture diffusivity was increased with a reduction in moisture content during drying on ignoring the shrinkage, while it was initially increased and then gradually reduced at later hours when shrinkage effect was considered. The slices showed overall shrinkage of 86.95% during drying but could recover only 35–45.57% of its volume during rehydration. The water absorption and volume recovery were consistently higher at rehydration temperature of 60°C followed by 45°C and 30°C. Solar dried and rehydrated samples demonstrated overall color change of 16.80 ± 1.15 and 5.87 ± 2.5–7.56 ± 1.43, respectively. Scanning electron micrographs of solar dried samples presented collapsed cellular matrix but rehydrated samples showed porous microstructure indicating regaining of honeycomb network.

Practical Applications

Solar drying is an essential sustainable approach to reduce the tremendous post‐harvest losses of fruits and it also offers the advantages of energy cost saving, higher affordability level and greater payback power to farmers. Present study explored the drying characteristics, followed by rehydration characteristics and effect of drying and rehydration on quality attributes of pineapple slices. Therefore, results are helpful for food processors and engineers in optimization of drying and rehydration processes to obtain best quality products, shelf‐life extension of perishable fruits. Solar dried pineapple slices will give better returns to farmers. Moreover, dried pineapple can be utilized as dried chips/snacks, powder, etc. and also can be further rehydrated to reconstitute for utilization in different value added food products like ice‐cream, cakes, flakes, granules etc.
Antimicrobial effect of zinc oxide nanoparticles on Campylobacter jejuni and Salmonella enterica serovar Enteritidis
Authors: He Yiping , Capobianco Joseph , Irwin Peter , Reed Sue , Lee Joe
Published: April 2022

Engineered nanoparticles have been explored for their potential to serve as additives to foods, their packages, and contact surfaces because they are stable in a wide range of harsh environments and display inherent antimicrobial properties. However, while nanometer sized particles have demonstrated unique properties that can potentially benefit food technologies, size and shape of the particles may have significant impact on their antimicrobial activities and toxicity as well. This manuscript characterized the size and morphology of five commercially available ZnO nanoparticles and determined the antimicrobial performance for two common foodborne pathogens, Campylobacter and Salmonella. The results indicate that all grades of ZnO powders displayed antimicrobial properties on Campylobacter within 30 min, and that statistical methods could not differentiate between the grades when treated as categorical variables. Similarly, ZnO powders were found to be effective antimicrobial agents for Salmonella, though longer exposure times were needed and the grades did not perform equally. From comparison of the particle size distribution data and microscopic images of the grades of ZnO powders used in the study, it can be deduced that not only size, but also morphology have an impact on the antimicrobial activity.
A new early hominin calcaneus from Kromdraai (South Africa)
Authors: Harper Christine M. , Zipfel Bernhard , DeSilva Jeremy M. , McNutt Ellison J. , Thackeray Francis , Braga José
Published: April 2022

The Kromdraai site in South Africa has yielded numerous early hominin fossils since 1938. As a part of recent excavations within Unit P, a largely complete early hominin calcaneus (KW 6302) was discovered. Due to its role in locomotion, the calcaneus has the potential to reveal important form/function relationships. Here, we describe KW 6302 and analyze its preserved morphology relative to human and nonhuman ape calcanei, as well as calcanei attributed to Australopithecus afarensis, Australopithecus africanus, Australopithecus sediba, Homo naledi, and the Omo calcaneus (either Paranthropus or early Homo). KW 6302 calcaneal morphology is assessed using numerous quantitative metrics including linear measures, calcaneal robusticity index, relative lateral plantar process position, Achilles tendon length reconstruction, and a three‐dimensional geometric morphometric sliding semilandmark analysis. KW 6302 exhibits an overall calcaneal morphology that is intermediate between humans and nonhuman apes, although closer to modern humans. KW 6302 possesses many traits that indicate it was likely well‐adapted for terrestrial bipedal locomotion, including a relatively flat posterior talar facet and a large lateral plantar process that is similarly positioned to modern humans. It also retains traits that indicate that climbing may have remained a part of its locomotor repertoire, such as a relatively gracile tuber and a large peroneal trochlea. Specimens from Kromdraai have been attributed to either Paranthropus robustus or early Homo; however, there are no definitively attributed calcanei for either genus, making it difficult to taxonomically assign this specimen. KW 6302 and the Omo calcaneus, however, fall outside the range of expected variation for an extant genus, indicating that if the Omo calcaneus was Paranthropus, then KW 6302 would likely be attributed to early Homo (or vice versa).
National registry‐based data of adverse events in Finnish long‐term professional homecare in 2009–2019
Authors: Kivimäki Taina , Stolt Minna , Katajisto Jouko , Charalambous Andreas , Suhonen Riitta
Published: April 2022

Aims and objectives

The aim of this study was to discover the nature of the adverse events in Finnish long‐term professional homecare reported by professionals, and to identify the circumstances in which adverse events occur and their consequences.

Background

Adverse events are incidents causing unintended and unnecessary harm to older people at home. Safety is a basic human right and a fundamental prerequisite for independent living among older people at home. Few studies have focused on both long‐term professional homecare environment and the safety of older people.

Design

The research was a descriptive registry‐based study.

Methods

This study consisted of adverse events (N = 61248) in Finnish public long‐term professional homecare (2009–2019). Data were described using frequencies and percentages. STROBE statement checklist was chosen for reporting the study process.

Results

By profession, practical nurses and registered nurses reported the most of adverse events (89.8%). These were either critical incidents (78.3%) or near misses (20.0%) and concerned medicine, injuries and accidents, information flow or management. Consequences for older people were usually rated from no‐harm to moderate harm. For long‐term professional homecare, image harm, extra financial costs, no‐harm and prolonged care for older people were among the consequences. Personnel frequently observed the older people afterwards and informed older people of adverse events, yet some of actions were unknown.

Conclusions

Many harmful adverse events are considered harmless for older people. Sometimes this can lead to unmet care needs or missed care. The degree of harm needs to be assessed in terms of physical, mental and social health with the HaiPro reporting system for homecare.

Relevance to clinical practice

An understanding and a comprehensive view of the situation and holistic assessment of care needs includes safety and safety risks to increase safety and feeling of safety for older people at home.
Recurrent cervical cancer with PD‐L1 amplification treated with nivolumab: A case enrolled in the BELIEVE trial
Authors: Yoshimoto Daisuke , Taguchi Ayumi , Tanikawa Michihiro , Sone Kenbun , Shimoi Tatsunori , Tsuruga Tetsushi , Oda Katsutoshi , Osuga Yutaka
Published: April 2022

Patients with cervical cancer benefiting from immune checkpoint inhibitors (ICIs) are limited. Recently, PD‐L1 amplification has been attracted attention as a reliable marker of ICIs. A 47‐year‐old woman with stage IIB cervical cancer experienced disease progression during postoperative adjuvant chemotherapy. Cancer genomic profiling revealed that the tumor was microsatellite stable with PD‐L1 amplification, therefore, nivolumab was administered by enrolling in the BELIEVE trial. Despite nivolumab treatment, remarkable disease progression was observed. At the beginning of nivolumab treatment, the patient already had multiple liver metastases with severe systemic inflammation as indicated by a high neutrophil‐to‐lymphocyte ratio (NLR), both of which are negative predictive markers for ICI. Despite the presence of PD‐L1 amplification, nivolumab was ineffective in cancer progression, which may be attributable to the presence of liver metastasis and high NLR. ICI is recommended to be administered at an early stage of cancer treatment to enhance its effectiveness.
Risk of fractures and subsequent mortality in non‐alcoholic fatty liver disease: A nationwide population‐based cohort study
Authors: Wester Axel , Hagström Hannes
Published: April 2022

Background

Studies suggest an association between osteoporosis and non‐alcoholic fatty liver disease (NAFLD), but whether patients with NAFLD are at increased risk of fractures is unknown.

Objectives

The aim was to determine the rate and risk of fractures and the mortality rate after fracture in patients with NAFLD compared to the general population.

Methods

This was a nationwide population‐based cohort study using data from the Swedish National Patient Registry on 10,678 patients with NAFLD from 1987 to 2016. Patients were matched for sex, age, and municipality with 99,176 controls from the Swedish Total Population Registry. Cox regression was used to estimate fracture rates. The risk of fractures was assessed while accounting for competing risks (death and liver transplantation).

Results

A total of 12,312 fractures occurred during 761,176 person‐years of follow‐up. Patients with NAFLD (17.5 per 1000 person‐years) had a slightly higher fracture rate than controls (16.1 per 1000 person‐years; adjusted hazard ratio 1.11, 95% confidence interval [CI] 1.05–1.19), although the 5‐year risk of fractures was similar (8.0%, 95% CI 7.4–8.6 versus 7.3%, 95% CI 7.2–7.5). Additionally, 1‐year mortality after fracture was similar in NAFLD and controls.

Conclusions

Patients with NAFLD have a slightly higher rate of fractures but long‐term risk of fractures comparable to the general population. This suggests that broad surveillance of risk factors for fractures in patients with NAFLD is not motivated.
Do Adolescents Intervene in Intergroup Bias‐based Bullying? Bystander Judgments and Responses to Intergroup Bias‐based Bullying of Refugees
Authors: Gönültaş Seçil , Mulvey Kelly Lynn
Published: April 2022

This study examined 587 Turkish adolescents’ (Mage = 13.14, SD = 1.61) judgments and bystander responses towards hypothetical intragroup interpersonal (Turkish victim) and intergroup bias‐based (Syrian refugee victim) bullying. Intergroup factors and social‐cognitive skills were assessed as predictors. Findings revealed that adolescents were less likely to see bullying as acceptable and less likely to explicitly support the bully in intragroup interpersonal bullying compared to intergroup bias‐based bullying. Further, adolescents with higher theory of mind and empathy were more likely to evaluate intergroup bias‐based bullying as less acceptable and more likely to challenge the bully. Adolescents’ prejudice and discrimination towards refugees were predictors of bystander judgments and responses to intergroup bias‐based bullying. This study provides implications for anti‐bullying intervention programs.
Facing the heat: Political instability and firm new product innovation in sub‐Saharan Africa
Authors: Krammer Sorin M. S. , Kafouros Mario I.
Published: April 2022

We examine how political instability (PI) affects firms' product innovation and the strategies that firms can employ in response to PI. We argue that while higher levels of PI influence firms' innovation negatively, greater international exposure (through foreign ownership and exporting) can help firms partly overcome this external challenge and innovate. We test these predictions using a dataset of 3000 manufacturing firms across 15 countries from Sub‐Saharan Africa. The empirical results confirm a robust and negative effect of PI on firms' product innovation through several mechanisms. They also suggest that all firms in a country, regardless of ownership structure, are equally affected by PI. Finally, higher levels of exporting weaken the deleterious effects of PI on innovation for both domestic and foreign firms. Our study offers insights into the barriers of innovation in emerging economies and explicates why some firms are more innovative than others in politically unstable contexts.